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עמוד בית
Sun, 26.05.24

June 2022 - (Issue 54)

Articles & Reviews (Hebrew)
Nir Tsur, MD, Hillel Sztern, BSc, Shlomi Abouhassira, MD, Ofer Drori, PhD, Eden Bitton, MD, COL Zivan Beer, MD, MHA
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Background: Military events often result in physical and mental casualties, emphasizing the critical role of organic medical staff, including reserve personnel, in preserving lives during combat. This study aims to investigate the frequency of medals of honor awarded to medical staff, both in absolute numbers and relative to their presence within fighting units across Israel's wars.

Methods: Our research utilizes unclassified data pertaining to medals of honor conferred by the IDF between 1948 and 2021. The study primarily focuses on the recipients' professions and acts of bravery.

Results: The findings reveal a notable prevalence of medical staff among the esteemed recipients of medals of honor, both in absolute terms and in relation to their representation within fighting units. Furthermore, the analysis indicates an increasing number of women being recognized among the medical staff recipients.

Conclusions: Medical staff, including physicians, paramedics, nurses, and medics, play crucial roles that align with their unique professions. Their contributions in saving lives and rescuing personnel amidst dangerous situations are acknowledged and honored by commanders.

Keywords: commendation, medical staff ,gender medicine
David Erez, MSc, Itay Ketko, MSc, Daniel S. Moran, PhD
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Providing soldiers with adequate sleep is essential for maintaining performance and achieving mission objectives. However, military operations often disrupt sleep patterns, causing potential errors or accidents. Despite its significance in the military, the need for sleep is frequently misunderstood, and its impact on performance is underestimated. In 2020, the Israeli Defense Forces (IDF) revised the General Staff Order 33.0213 - Sleep Hours of IDF Soldiers Sleep following several years of consultation and deliberation. The revised General Staff Order increases the daily sleep entitlement from six to seven hours of continuous sleep per night. Amending the daily sleep entitlement is an essential first step to reducing sleep deprivation in the IDF. Sleep deprivation impacts performance and the ability to rapidly make decisions and endangers soldier safety. However, to fully benefit from this revised sleep order, the IDF must also modify the attitudes, understanding, and behaviors regarding sleep. Therefore, this paper calls to strengthen the amended sleep order by implementing a multipronged approach that includes an institutional paradigm shift, soldier education, and a robust research program. The authors believe that the combination of these proposed interventions is essential to optimize sleep and improve the health, safety, and performance of every soldier in the IDF.

Keywords: hours of sleep, restorative sleep, soldiers, physical performance, cognitive performance, sleep deprivation
Articles & Reviews (English)
Ziv Izhaki, MD, MHA, Shai Herzberger, MD, MHA, Tomer Talmy, MD, Einat Haikin Herzberger, MD, Racheli Magnezi PhD, MBA, MHA, Anat Hershko-Klement, MD
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Background: The COVID-19 pandemic constitutes a global health challenge in which healthcare workers (HCW) play a crucial role. We aimed to assess the perceptions of HCW on the COVID-19 pandemic and their attitudes towards the forthcoming vaccine.

Methods: A total of 647 hospital and community HCW (including 48 military physicians) from israel participated in a cross-sectional, online survey administered in September 2020.

Results: The majority (78.8%) of HCW did not agree with the perception that COVID-19 is a seasonal, flu-like illness. In addition, most participants (70.1%) did not agree that lockdowns are an essential measure to overcoming the COVID-19 pandemic. Most (60.5%) of the participants believed that the negative socio-economic impacts of restrictive measures outweigh the health-related benefits. Nurses tended to support lockdowns. Women were less supportive of this measure, compared to men. Most HCW intend to vaccinate (73.6%) and recommend (79.2%) vaccination for COVID-19, both lower than reported rates for influenza vaccination. Nurses were less likely to get vaccinated or recommend vaccination, but supported restrictions more than physicians (Influenza: OR 0.23, OR 0.24 respectively, COVID-19: OR 0.38, OR 0.4 respectively. p=0<0.01). Community HCW encourage their patients to get influenza vaccines more than hospital personnel (OR=3.18, p=0.02), but there were no differences between to the two groups in encouragement to vaccinate for COVID-19.

Conclusions: Educational interventions should be instituted to bridge gaps in perception and knowledge of public health and preventive measures among subsets of HCW.

Keywords: COVID-19, healthcare workers, disease perception, vaccination
Nir Tsur, MD, Yaakov Eyal, MD, Iris Dotan, MD, LTC Oded Ben-Ari, MD, LTC Saleh Daher, MD, COL Zivan Beer, MD
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Background: Inflammatory Bowel Disease (IBD) is commonly diagnosed between ages 21-26, which overlaps with the average age of military personnel in the Israel Defense Forces (IDF). Therefore, military personnel often receive their initial diagnosis of IBD during their service. Today, when an IDF soldier is diagnosed with IBD, they are removed from active service. This study follows four Navy Special Operation Forces (SOF) personnel diagnosed with IBD during their service. Despite guidelines, all of the Navy SOF personnel diagnosed with IBD completed their full service and their peers without any medical incidents.

Methods: A prospective observational study including all Navy SOF personnel diagnosed with IBD.

Results: Subjects were four male Navy SOF soldiers with a mean age of 21 years. Three patients had Crohn’s disease (CD), and one had ulcerative colitis (UC). The mean follow-up was 612 days (329-819). Two patients were treated with mesalamine; all were treated with dietary modifications. The average grounding period in which the soldiers were suspended from combat activity was 90 days. All continued
active service under close monitoring or as needed, and no failure of assigned missions was documented.

Conclusions: In our study, all Navy SOF personnel diagnosed with IBD could continue active high-intensity military missions. No events of sudden incapacitation or severe disabling flareups were detected. Our study recommends modified restrictions during active flare-ups, consistent follow-ups and active service for soldiers with IBD in remission.

Keywords: IDF, IBD, QOL Tailored Medicine
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