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Background: Evidence is lacking on the phenomenon of peer-to-peer human milk-sharing in the Middle East, specifically, in Israel. Research Aims: This study aimed to uncover peer-to-peer human milk-sharing in Israel, learn about how and whether donors engage in safe milk handling and storage practices, and assess knowledge about human milk and breastfeeding among this milk-sharing population. We also aimed to investigate donors' selectiveness in their decisions about to whom they donate their milk and their perceptions about the sale and purchase of human milk. Methods: We conducted a semi-structured online survey, including both closed- and open-ended questions and used mixed methods to analyze responses descriptively. We used non-probability sampling to obtain a broad sample of human milk donors. Results: Out of 250 completed surveys, most participants (87.2%, n = 218) reported engaging in safe milk-sharing practices and were generally knowledgeable about the health risks associated with milk-sharing. Participant religiosity was associated with somewhat lower hygiene practices (r = −0.15, p ≤.05). Most of the participants (81.7%, n = 190) were against the sale of human milk. Participants generally expressed no preference about the recipient of their milk, with some exceptions. Conclusion: The milk-handling and storage practices of the participants in this study suggest a need to improve knowledge and awareness of safe milk storage temperature and the importance of washing hands before pumping milk, particularly within the religious sector. We propose that guidelines about safe milk-sharing practices be written and adopted by the Israeli Ministry of Health, and communicated through pediatricians, family doctors, nurses in Mother and Child Clinics (In Hebrew: Tipat Halav), and social media. [ABSTRACT FROM AUTHOR]

The detrimental impact of visitor-induced litter pollution on ecosystems, wildlife, and overall quality of life emphasizes the urgency of mitigating it. This study uniquely focuses on diverse visitors' perceptions of littering behavior in open spaces, facilitating comprehensive assessment and targeted mitigation strategies. This study aimed to analyze attitudes, willingness to act, and responsibility perceptions, considering diverse demographics in Israel's multicultural context. It sought insights into littering rationales, potential remedies, and the identification of relatively acceptable littering behaviors for focused attention. This profound comprehension is crucial for conserving ecologically sensitive open areas, necessitating optimized management for interface preservation. Leveraging insights from an online survey involving 401 recent open-space visitors, this research reveals a disparity between self-professed and actual littering practices. Intriguingly, 32% of participants who claimed never to litter described instances of doing so. Furthermore, disparities emerged between anti-litter attitudes, willingness to act, and individual accountability, which were influenced by demographic variables. While individuals from various demographic cohorts attested to littering behavior, young ultra-Orthodox Jews possessing solely a high school level of education exhibited a proclivity for increased littering. Perceptions predominantly attribute purposeful and recreational motives to littering, rather than substantial reasons. Participants conceive a diverse range of effective strategies to address the issue, highlighting its intricate and multifaceted nature. Consequently, this study advocates for a multifaceted approach combining enhanced enforcement, educational campaigns, informative initiatives, and infrastructural enhancements. By acknowledging the complexities of littering behavior and embracing multifarious interventions, policymakers can enhance the likelihood of successfully curbing this pervasive challenge. [ABSTRACT FROM AUTHOR]

Urban climate policy offers a significant opportunity to promote improved public health. The evidence around climate and health cobenefits is growing but has yet to translate into widespread integrated policies. This article presents two systematic reviews: first, looking at quantified cobenefits of urban climate policies, where transportation, land use, and buildings emerge as the most studied sectors; and second, looking at review papers exploring the barriers and enablers for integrating these health cobenefits into urban policies. The latter reveals wide agreement concerning the need to improve the evidence base for cobenefits and consensus about the need for greater political will and leadership on this issue. Systems thinking may offer a way forward to help embrace complexity and integrate health cobenefits into decision making. Knowledge coproduction to bring stakeholders together and advance policy-relevant research for urban health will also be required. Action is needed to bring these two important policy agendas together. [ABSTRACT FROM AUTHOR]

Background: Although telemedicine care has grown in recent years, telepsychiatry is growing at a slower pace than expected, because service providers often hamper the assimilation and expansion of telepsychiatry due their attitudes and perceptions. The unified theory of acceptance and use of technology (UTAUT) is a model that was developed to assess the factors influencing the assimilation of a new technology. We used the UTAUT model to examine the associations between the attitudes and perceptions of psychiatrists in Israel toward telepsychiatry and their intention to use it. Methods: An online, close-ended questionnaire based on a modified UTAUT model was distributed among psychiatrists in Israel. Seventy-six questionnaires were completed and statistically analyzed. Results: The behavioral intention of Israeli psychiatrists to use telepsychiatry was relatively low, despite their perceptions of themselves as capable of high performance with low effort. Nonetheless, they were interested in using telepsychiatry voluntarily. Experience in telepsychiatry, and to a lesser extent, facilitating conditions, were found to be positively correlated with the intention to use telepsychiatry. Psychiatrists have a positive attitude toward treating patients by telepsychiatry and perceive its risk as moderate. Discussion: Despite high performance expectancy, low effort expectancy, low perceived risk, largely positive attitudes, high voluntariness, and the expectancy for facilitating conditions, the intention to use telepsychiatry was rather low. This result is explained by the low level of experience, which plays a pivotal role. We recommend promoting the facilitating conditions that affect the continued use of telepsychiatry when initiating its implementation, and conclude that it is critical to create a sense of success during the initial stages of experience. [ABSTRACT FROM AUTHOR]

A growing body of literature reports associations between exposure to particulate matter with diameter ≤2.5 μm (PM 2.5) during pregnancy and birth outcomes. However, findings are inconsistent across studies. To assess the association between PM 2.5 and birth outcomes of fetal growth in a cohort with high prevalence of siblings by multilevel models accounting for geographical- and mother-level correlations. In Israel, we used Maccabi Healthcare Services data to establish a population-based cohort of 381,265 singleton births reaching 24–42 weeks' gestation and birth weight of 500–5000 g (2004–2015). Daily PM 2.5 predictions from a satellite-based spatiotemporal model were linked to the date of birth and maternal residence. We generated mean PM 2.5 values for the entire pregnancy and for exposure periods during pregnancy. Associations between exposure and birth outcomes were modeled by using multilevel logistic regression with random effects for maternal locality of residence, administrative census area (ACA) and mother. In fully adjusted models with a mother-level random intercept only, a 10-μg/m3 increase in PM 2.5 over the entire pregnancy was positively associated with term low birth weight (TLBW) (Odds ratio, OR = 1.25, 95% confidence interval, CI: 1.09,1.43) and small for gestational age (SGA) (OR = 1.15, 95% CI: 1.06,1.26). Locality- and ACA-level effects accounted for <0.4% of the variance while mother-level effects explained ∼50% of the variability. Associations varied by exposure period, infants' sex, birth order, and maternal pre-pregnancy BMI. Consideration of mother-level variability in a region with high fertility rates provides new insights on the strength of associations between PM 2.5 and birth outcomes. • New evidence from the Middle East – a region with scarce data. • Maternal exposure to PM2.5 was associated with fetal growth outcomes. • Associations were clearer when mother-level clustering in the data was accounted for. • Associations were modified by infant's sex, birth order and maternal pre-pregnancy BMI. • Associations were highest for low socio-economic status and for third trimester of pregnancy. [ABSTRACT FROM AUTHOR]