Efrat Merrick

A review of suicide behavior among Arab adolescents.

Islam prohibits the taking of ones life, because this way you will interfere with the work of G-d (Allah), which is clear from several places in the Quran. Concerning individual suicide or suicide attempts in various Arab countries the literature is sparse and the incidence low. In this paper we present a review of research from Israel showing that suicide epidemiology among the Arab population of children and adolescents display a low incidence, but an increase has been observed over the past decade, but still much lower than the Jewish population. We believe that there is a need for the development of prevention and intervention strategies in order to keep this incidence low.

Suicide Behavior in Persons with Intellectual Disability

Suicide is today in the Western world one of the leading causes of death and most people have had suicidal ideation at some time during their life. In the population of persons with intellectual disability some researchers have thought that impaired intellectual capacity could act as a buffer to suicidal behavior, but the fact is that the few studies conducted in that population contest this assumption and showed that the characteristics of suicidality in this population are very similar to persons without intellectual disability. This paper reviews the studies conducted and describe the symptomatology in this population. Professionals working with this population should therefore be aware of and assess for this behavior. Sadness or depression are symptoms that could indicate later suicidal behavior.

Clinical holistic medicine: the Dean Ornish program ("opening the heart") in cardiovascular disease.

Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based), exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with holistic medical theories, like the Antonovsky concept of rehabilitating the sense of coherence and the life mission theory for holistic medicine. We believe there is a need for the allocation of resources for further research into the aspects of holistic health and its methods, where positive and significant results have been proven and reproduced at several sites.

Adolescents with Intellectual Disability and Suicidal Behavior

It has been assumed that impaired intellectual capacity could act as a buffer to suicidality in the population of children and adolescents with intellectual disability. The few studies that have been conducted contest this assumption, and in fact, the findings showed that the characteristics of suicidality in the population of children and adolescents with intellectual disability are very similar to other adolescents without intellectual disability. This paper reviews the few studies conducted and describe the symptomatology in this population.

Childhood Injury Prevention: Intervention in the Bedouin City of Rahat

For several years, the National Center for Childrens Health and Safety (Beterem) has worked on many levels to promote safety and prevent injury of the children in Israel. As part of intervention programs in 20 communities around Israel, this paper describes a 1-year, multidisciplinary, multistrategic childhood safety promotion and injury prevention project. The project took place in the Bedouin city of Rahat in the Southern part of Israel, the Negev, conducted by a local safety coordinator. This specific intervention study took place from March 2003 to March 2004. The main goal was to identify hazards and dangerous obstacles in public places in Rahat, then remove or repair the obstacles found, in order to secure a safe public environment for children. “Obstacle” was defined as any barrier that could endanger the safety of a child. Ten examples are used to illustrate this applied research project, and 80% of the problems were solved within the project period (time to solve between 1 week to 3 months, depending on various factors). We recommend the involvement of a safety coordinator from the community to focus on safety hazards for children, the use of a documentation diary to log the time frame, and also the use of pictures to illustrate the hazards and the changes, or to use as arguments in the lobbying process.

Recent trends in adolescent asthma.

Asthma is a disability that can affect the quality of life of the adolescent going through a period with difficulty and often rebellion, but gentle care from the primary physician will guide the adolescent through this period. A worldwide increase in childhood asthma has been observed and recent data from the National Health Interview Survey-2003 in the United States showed an overall 12.5% of children under age 18 years, who ever had asthma diagnosed. This short communication reviews the recent U.S. findings with research on adolescent asthma in Israel, where a study from year 2000 found a higher percentage of ever had diagnosed asthma (13.7%).

Children with intellectual disability in residential care centers. Trends in Israel 1999-2004.

Children and adolescents with intellectual disability (ID) have historically gone through various stages from being left or activity killed, to being placed in care, to being rehabilitated or educated and today with efforts to keep as normal a life as possible inspite of their disability. This study was conducted in order to look at the trends of children with ID in residential care centers in Israel. Since 1998 an annual survey of all medical clinics in residentail care centers has been conducted by the Office of the Medical Director of the Ministry of Social Affairs and data was extracted from the national surveys during 1999-2004. Out of a total residential care population of about 6,000 persons with ID about 1,000 were children, but a downward trend was observed over the study period with children 18.1% of the total residential care population in 1999 to 14.4% in 2004 (a total of 954 persons aged 0-19 years in 2004). Further detailed studies should be conducted in order to get a clearer picture of this present pediatric population in residential care.

Trends in aging. Persons with intellectual disability in residential care centers in Israel

Increased lifespan in persons with intellectual disability (ID) has been observed worldwide due to progress in medical technology and improved social awareness and pressure for better treatment. The present study was conducted to monitor the trends in aging in persons with ID in residential care centers in Israel. This population is about 25% of the total population of persons known with ID in Israel. Since 1998-1999, an annual survey of medical-clinic activity for all residential care centers for people with ID has been conducted, and data from these surveys were used to investigate the trend in aging. The residential care center population today comprises about 6,500 persons of all ages. From 1999 to 2004, the population of 40-49 year olds remained stable, but the 50-59 year olds increased by 4.5 %, while the 60 yeare and older group increased by 2.1%. Older people with ID have the same needs as other older people do and are subject to the same agerelated impairments and illnesses, albeit at an earlier pace than the general population. Recommendations for service for this population are discussed.