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Tener D, Lusky-Weisrose E, Roe D, Mor R, Sigad LI, Shaharabani M, Yahia-Zetawy Y, Qwekiss-Halabi S, Rozenfeld-Tzafar N. School principals coping with child sexual abuse in their schools. Child Abuse Negl 2022; 129:105656. [PMID: 35561442 DOI: 10.1016/j.chiabu.2022.105656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/13/2022] [Accepted: 04/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Schools serve a central role in prevention, disclosure and intervention in cases of child sexual abuse (CSA). As school principals often face CSA cases in their daily work, they may hold the key to making social change on this front. However, research on principals' experiences of contending with CSA remains limited. OBJECTIVE The current study is part of a larger qualitative research project examining various Israeli educators' coping with CSA among their students in diverse cultural contexts. In this study, we specifically focused on principals. The research questions were: (1) What are the unique ways in which school principals cope with cases of CSA during their course of daily work? (2) Do their cultural contexts and cultural affiliations shape their coping, and if so, how? METHODS In-depth interviews were conducted with 25 principals from multiple cultural groups (secular, religious and ultra-Orthodox Jews, and Arab-Muslims), which were analyzed using a thematic approach. RESULTS The findings indicated that principals demonstrate three types of coping strategies in response to encounters with CSA in the course of their work: they may act as "navigators" (exclusively responsible); "sharers" (rely on teamwork); or "balancers" (negotiating between cultural and legal demands). Furthermore, two contextual factors affected their construction of coping: ongoing professional experience in cases of CSA and personal experiences, including being a CSA survivor. CONCLUSIONS This study highlights the importance of principals in identifying and leading interventions for CSA cases. It also raises the need for training to combine reflective, experience-based practice alongside evidence-informed practice.
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Affiliation(s)
- Dafna Tener
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Efrat Lusky-Weisrose
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel; Oranim College of Education, Department of Education for Children at Risk, Faculty of Graduate Studies, Israel.
| | - Daniel Roe
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Roni Mor
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Laura I Sigad
- Oranim College of Education, Department of Education for Children at Risk, Faculty of Graduate Studies, Israel
| | - Maggi Shaharabani
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Yasmin Yahia-Zetawy
- Oranim College of Education, Department of Education for Children at Risk, Faculty of Graduate Studies, Israel
| | - Salwa Qwekiss-Halabi
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Nili Rozenfeld-Tzafar
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
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Grosskopf I, Ringel Y, Charach G, Maharshak N, Mor R, Iaina A, Weintraub M. Metformin enhances clearance of chylomicrons and chylomicron remnants in nondiabetic mildly overweight glucose-intolerant subjects. Diabetes Care 1997; 20:1598-602. [PMID: 9314642 DOI: 10.2337/diacare.20.10.1598] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the effect of metformin on the metabolism of intestinally derived lipoproteins in nondiabetic individuals who were mildly overweight and glucose intolerant. RESEARCH DESIGN AND METHODS A total of nine subjects with a BMI > or = 25 kg/m(2) and fasting serum glucose < or = 6.1 mmol/l and who were glucose intolerant were studied. The subjects underwent a vitamin A fat-loading test before and after a 3-month treatment with 850 mg metformin twice a day. The metabolic behavior of the postprandial lipoproteins was compared with that found in a group of 19 healthy normolipidemic individuals who participated in a previous study. RESULTS Mean total plasma, chylomicron fraction, and nonchylomicron fraction retinyl palmitate (RP) pretreatment levels were 3.4-fold, 3.59-fold, and 3-fold higher, respectively, in the study group than in the normolipidemic group and were reduced by 50, 56, and 32%, respectively, after 3 months of metformin treatment. The decrease of chylomicron levels after treatment was positively correlated to the fasting triglyceride values before treatment (r = 0.73, P = 0.039) and to the serum insulin level at 120 min of standard glucose loading before treatment (r = 0.91, P = 0.002). CONCLUSIONS Metformin was shown to be beneficial in the clearance of postprandial lipoproteins in nondiabetic individuals who were mildly overweight and glucose intolerant.
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Affiliation(s)
- I Grosskopf
- Department of Internal Medicine C Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel
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Weintraub MS, Grosskopf I, Charach G, Mor R, Rubinstein A, Wollman Y, Judevices R, Iaina A. Bezafibrate therapy in patients with isolated low high-density lipoprotein cholesterol levels may have a beneficial effect in prevention of atherosclerosis. Metabolism 1995; 44:1401-9. [PMID: 7476325 DOI: 10.1016/0026-0495(95)90137-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Although a low plasma high-density lipoprotein cholesterol (HDL-C) level is a well-accepted risk factor for coronary artery disease (CAD), it is unclear whether pharmacologic agents can effectively increase HDL-C levels and/or reduce the incidence of CAD in patients with isolated low HDL-C levels. An important determinant of HDL levels is the efficiency of postprandial lipoprotein catabolism. The purpose of the present study was to evaluate the efficacy of bezafibrate therapy in increasing HDL-C levels in these patients and to examine its effect on postprandial lipoprotein levels. Fasting and postprandial lipid and lipoprotein levels were studied in 23 patients with isolated low HDL-C levels before and during 3 and 6 months of bezafibrate treatment. Postprandial lipoprotein levels were evaluated using the vitamin A-fat loading test, in which these intestinally derived lipoproteins are specifically labeled with retinyl palmitate (RP). Patients with isolated low HDL had significantly higher levels of chylomicron RP than a control group of 19 normolipidemic subjects. The area below the chylomicron RP curve was 17,773 +/- 6,821 versus 13,936 +/- 6,217 micrograms/L.h, respectively (P < .005). No differences were found in chylomicron remnant levels between the groups. Bezafibrate therapy reduced the chylomicron RP area by 27%, from 17,773 +/- 6,821 to 12,895 +/- 2,576, and the nonchylomicron RP area by 25%, from 6,059 +/- 3,310 to 4,430 +/- 1,963 (P < .0001). It increased fasting HDL-C levels from 35 +/- 3 to 38 +/- 1.4 mg/dL after 3 months (P < .001) and to 40 +/- 2.2 mg/dL after 6 months (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M S Weintraub
- Department of Medicine C, Tel Aviv Medical Center, Tel Aviv University, Israel
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Moshkovitz Y, Lusky A, Mor R. [Coronary artery bypass without extra corporeal circulation]. Harefuah 1995; 129:81-7, 160. [PMID: 8543246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
240 patients underwent coronary artery bypass grafting (CABG) without extracorporeal circulation (ECC). Mean grafts per patient was 1.9 (range 1-5). The internal mammary artery (IMA) was used in 210 cases (87%), but in only 53 (22%) were there grafts to the circumflex marginals. Unfavorable results included an operative mortality of 7 cases (2.9%), nonfatal perioperative myocardial infarction (MI) (2.5%), stroke (0.4%), and sternal infection (1.7%). There were 2 deaths among 17 patients (12%) with calcified aorta, and 4 among 40 (10%) who underwent emergency operation. Multivariate analysis showed these 2 risk factors to be the only predictors of early mortality: emergency operation odds ratio 9.8, and calcified aorta odds ratio 8.0. Perioperative risk factors that were not major predictors of early mortality or unfavorable outcome included left ventricular dysfunction (EF < 35%: 52 patients, 22%), congestive heart failure (53, 22%), cardiogenic shock (8, 3%), acute MI (67, 28%), age > 70 years (64, 27%), renal failure (22, 9%), and stroke or carotid disease (12, 5%). Followup ranged from 1-31 months (mean 12). There were 9 late deaths (4 cardiac), and 18 cases (7.5%) of early return of angina. 1-year actuarial survival was 92%; 192 patients (80%) had uneventful outcomes and are doing well. Calcified aorta, nonuse of the IMA, reoperation, and diabetes mellitus were independent predictors of unfavorable events. We conclude that CABG without ECC can be performed with relatively low operative mortality, but there seems to be increased risk of early return of angina. It should therefore be considered for those patients with appropriate coronary anatomy in whom ECC poses a very high risk. However, it is still a hazardous procedure when used as as an emergency operation, and for cases with calcified aorta.
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Affiliation(s)
- Y Moshkovitz
- Dept. of Cardiac Surgery, Chaim Sheba Medical Center, Tel Hashomer
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Rubin M, Bilik R, Mor R, Nobel M, Antebi E. Alteration of pulmonary function by filtration of intravenous nutrient mixture. Nutrition 1993; 9:153-5. [PMID: 8485328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In view of contradicting results concerning alteration in lung function during hyperalimentation and the administration of intravenous lipid emulsion, a study was planned to determine possible changes in pulmonary blood perfusion during administration of total nutrient admixture (TNA) and the effect of filtration. Sixteen patients (8 men, 8 women; mean age 65.6 yr) with no previous lung disease received TNA at the rate of 4-5 g lipid/h as preoperative treatment for 5-9 days (mean 6.7 days). The 5-microns filter was randomly used in eight patients. The lung blood perfusion parameters measured repeatedly during this period included blood gases, percentage of the predicted value of vital capacity (VC), and pulmonary diffusing capacity for carbon monoxide (DLCO), as well as the value of the dead space volume and the tidal volume ratio (VD/VT) and the calculated shunt (QS/QT). TNA infusion appears to cause only a slight decrease in PaO2 and DLCO and a similar increase in VC and QS/QT, whereas VD/VT decreased significantly. The latter effect was abolished by filtration of TNA. There were no significant differences between the two groups. We therefore conclude that short-term preoperative administration of TNA at the rate of 4-5 g lipid/h in patients without preexisting lung disease does not jeopardize lung functions. Filtration of the TNA is, however, recommended to avoid the potential hazardous effects of long-term treatment of TNA on lung function.
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Affiliation(s)
- M Rubin
- Department of Surgery A, Beilinson Medical Center, Tel Aviv, Israel
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Ginsburg H, Khoury C, Davidson S, Yahav H, Mor R. Secretion of two different flowing masses by lymphokine-activated killer cells. Nat Immun 1993; 12:25-34. [PMID: 8431661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
When grown on mesenchyme-fibroblastoid monolayers made of 16-day-old embryos, lymphokine-activated killer (LAK) cells in clones derived from nude mouse lymph node cells are signaled to synthesize and secrete two mucoid masses. The first is made of chondroitin sulfate, as determined by the degradation of 35S- and [3H]glucosamine-labeled macromolecules in the extracellular matrix, by hyaluronidase, and by chondroitin sulfate lyase AC. This determination correlates with the distinctive blue staining by periodic acid-Schiff/alcian blue (PAS-Ab) at pH 1.0. In the present study, two different masses were identified when methanol-fixed and dried LAK cells and their secretions were examined prior to staining. The chondroitin-sulfate-containing mass appeared as an optically bright structure. It also produced a positive fluorescence with rabbit anti-mouse perforin. The second structure, which appeared as a flowing material or as filling holes in the first, could be identified by its high optical density. However, it was not stained by PAS-Ab and was not blackened by osmium tetroxide. The biochemical nature of the second mass has yet to be determined. Both masses seemed eventually to mix, producing pools, in lacunae, or to spread into the culture space.
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Affiliation(s)
- H Ginsburg
- Department of Immunology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
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Ginsburg H, Coleman R, Davidson S, Khoury C, Mor R. Lymphokine-activated killer (LAK) cells are identical to the uterine granulated metrial gland (GMG) cells. Transplant Proc 1989; 21:186-9. [PMID: 2705222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- H Ginsburg
- Department of Immunology, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Mittelman M, Fink G, Mor R, Avidor I, Spitzer S. Inflammatory bronchial polyps complicated by massive hemoptysis. Eur J Respir Dis 1986; 69:63-6. [PMID: 3743692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Santo M, Levy A, Levy MJ, Weinberger A, Mor R, Avidor I, Rousso I, Pinkhas J. Pneumonectomy in pulmonary mucormycosis complicating Behçet's disease. Postgrad Med J 1986; 62:485-6. [PMID: 3774682 PMCID: PMC2418765 DOI: 10.1136/pgmj.62.728.485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A 37 year old man with Behçet's disease who was maintained on prolonged corticosteroid therapy, developed diabetic ketoacidosis and pneumonia. Secondary infection with mucor intervened with abscess formation cured by pneumonectomy. The association of Behçet's disease and mucormycosis has not been previously reported, although diabetes mellitus was almost certainly the predisposing cause. Surgical treatment offers the best chance of survival in similar cases.
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Abstract
Echocardiographic evaluation of 42 patients with sarcoidosis disclosed 13 patients (group A) with abnormalities compatible with sarcoid heart involvement such as thickening or thinning of the septum (eight patients), pericardial effusion (four patients), and increased end-diastolic dimension of the left ventricle with decreased systolic function (three patients). The remaining 29 patients (group B) were diagnosed as having normal echocardiograms. The clinical data revealed no statistically significant difference between the groups regarding age, sex, chest x-ray stage, activity, and previous heart disease. Group A patients had older clinical onset of the disease (52 vs 83 months; p less than 0.05) and higher incidence of ECG abnormalities than group B patients. There were no statistically significant differences between the groups regarding two-dimensional echocardiographic internal dimensions of both ventricular chambers. The radionuclear right ventricular ejection fraction was low in both groups and the left ventricular ejection fraction was depressed in group A patients (p less than 0.01). As observed in pathologic studies, the septum is a target structure which can be characterized echocardiographically. Screening suspected sarcoid heart disease involvement is important to characterize patients with a relatively high risk of clinical cardiac abnormalities such as complete atrioventricular block, ventricular arrhythmias, congestive heart failure, and sudden death.
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Mor R, Pitlik S, Rosenfeld JB. Indomethacin- and Moduretic--induced hyperkalemia. Isr J Med Sci 1983; 19:535-7. [PMID: 6862860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Simultaneous administration of indomethacin and Moduretic (Merck Sharp & Dohme, USA, 5 mg of amiloride HCl, 50 mg hydrochlorothiazide) to a 78-yr-old patient resulted in severe hyperkalemia twice. When administered alone, neither drug significantly changed the normal serum potassium levels. Laboratory findings suggest an alteration of the internal balance of potassium as the main mechanism of this particular drug-induced hyperkalemia.
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Mor R, Pitlik S, Dux S, Rosenfeld JB. Parotitis and pancreatitis complicating infectious mononucleosis. Isr J Med Sci 1982; 18:709-10. [PMID: 6286529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Mor R, Pitlik S, Rosenfeld JB. [The antibiotic treatment of biliary tract infections]. Harefuah 1981; 100:433-5. [PMID: 7274824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
The prevalence of ear lobe crease (ELC) was determined in 421 patients with myocardial infarction (MI) and in 421 controls. A higher prevalence (p less than 0.05) of ELC was found in MI patients (77 percent) in comparison to controls (40 percent), regardless of age. In addition, a higher prevalence was found in patients in whom MI was combined with diabetic retinopathy or hypertension, and in Ashkenazi Jews compared to non-Ashkenazi Jews. Ear lobe biopsies in 12 subjects revealed tears of the elastic fibers in all subjects with ELC, and prearteriole wall thickening in subjects with MI and/or ELC, but not in the 2 subjects with neither MI nor ELC. The early appearance of ELC may imply the existence of coronary heart disease with or without coronary risk factors.
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Mor R, Pitlik S, Rosenfeld JB. [Ascariasis--an unusual case of pyloric obstruction]. Harefuah 1980; 98:163-164. [PMID: 7399362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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