Health Scan: A step forward in accessibility

Only in November 2018 will health facilities be bound by law and regulations to make all such places accessible.

By JUDY SIEGEL-ITZKOVICH
A man in a wheelchair [Illustrative]. (photo credit: Carlos Jasso/Reuters)
A man in a wheelchair [Illustrative].
(photo credit: Carlos Jasso/Reuters)
The need for wheelchair-bound patients to be examined by a doctor on the ground floor of their health fund clinics because there is no way for them to reach an upper floor is gradually disappearing. But although major improvements in accessibility have already been carried out, only in November 2018 will health facilities be bound by law and regulations to make all such places accessible – not only to those who cannot walk but also the blind, deaf and others. Finance Minister Yair Lapid and Health Minister Yael German recently approved guidelines to make health services accessible; the initial law that required specific guidelines to carry out the law was passed five years ago.
According to Orli Boni, the Health Ministry’s chief occupational therapist, even before the law was passed, health facilities were encouraged to start making changes in health fund clinics, hospitals and other facilities so that the disabled could receive the health services they deserved.
But each guideline is debated in the Knesset by committees because making changes cost a great deal of money and are opposed by institutions that have to retrofit their buildings and those that have to build new ones.
Even though the regulations were approved by the two ministers, there remain additional regulations that have yet to be approved, Boni said. The guidelines that have now been approved involve disabled parking areas, signs, steps and ramps, auditory warnings, acoustics, braille and so on.
Making health services accessible to the disabled reduces the gap in health care, she said.
Boni, who is ready for the disabled to send her complaints about specific places that are inaccessible (by writing to her at orly.boni@moh.health.gov.il), said that voluntary organizations representing people with various disabilities have been partners from the start in pointing out problems and making suggestions.
So far, 100 “accessibility officers” have been appointed (an additional task to their regular jobs) in health funds, hospitals, district health offices and other facilities. Their assignment is to facilitate changes to make the premises accessible to people with various disabilities, Boni said. “We have so far held training sessions of eight whole-day meetings of these officers.”
“There are still problems in implementing the 2008 law; money is being allocated by the institutions only gradually, and we are doing surveys of facilities’ accessibility,” she continued. The cost of making all facilities accessible was once estimated at NIS 200 million, said Boni, but in the end it will probably turn out to be much more.
CRANBERRIES AND INFECTIONS Many people – especially women – have long claimed that eating cranberries or drinking their juice can prevent urinary tract infections (UTIs). But is this popular belief a myth, or scientific fact? In recent years, some studies have suggested that cranberries prevent UTIs by hindering bacteria from sticking to the walls of the urinary tract, thanks to phytochemicals known as proanthocyanidins (PACs). Yet the mechanisms by which cranberry materials may alter bacterial behavior have not been fully understood.
Canadian researchers at McGill University’s chemical engineering department are shedding light on the biological mechanisms by which cranberries may impart protective properties against urinary tract and other infections.
Two new studies, spearheaded by Prof. Nathalie Tufenkji, add to evidence of cranberries’ beneficial effects against UTI-causing bacteria. The findings also point to the potential for cranberry derivatives to be used to prevent bacterial colonization in medical devices such as catheters.
In a study published recently in the Canadian Journal of Microbiology, Tufenkji and members of her laboratory report that cranberry powder can inhibit the ability of Proteus mirabilis, a bacterium frequently implicated in complicated UTIs, to swarm on agar plates and swim within the agar. The experiments also show that increasing concentrations of cranberry powder reduce the bacteria’s production of urease, an enzyme that contributes to the virulence of infections.
These results build on previous work by the McGill lab, showing that cranberry materials hinder movement of other bacteria involved in UTIs. A genome-wide analysis of an uropathogenic E. coli revealed that expression of the gene that encodes for the bacteria’s flagellar filament was decreased in the presence of cranberry PACs.
The team’s findings are significant because bacterial movement is a key mechanism for the spread of infection, as infectious bacteria literally swim to disseminate in the urinary tract and to escape the host immune response.
“While the effects of cranberry in living organisms remain subject to further study, our findings highlight the role that cranberry consumption might play in the prevention of chronic infections,” Tufenkji says. More than 150 million cases of UTI are reported globally each year, and antibiotic treatment remains the standard approach for managing these infections. But unsuitable or overuse of antibiotics is responsible for the current rise of bacterial resistance, which underscores the importance of developing another approach, he concluded. “Based on the demonstrated bioactivity of cranberry, its use in catheters and other medical devices could someday yield considerable benefits to patient health.”
TV DANGERS The dangers posed to children by overviewing of TVs are well known. But there is another risk that most people don’t think about – the sets, thin or thick, can fall on then.
The Los Angeles Times reported recently on a new US study that in 2011 alone, TVs falling on children caused over 17,000 injuries that warranted a trip to a hospital. As more than half of American homes have three or more sets, the rate of such injuries is increasing: Emergency room visits involving toppled TVs have increased 95 percent since 1990, the newspaper reported.
On average, a “TV plummeting from an armoire, bureau or rickety shelf sends a child to a hospital emergency department once every 30 minutes,” the paper reported, quoting the study in Pediatrics. Almost two-thirds occurred in children below the age of five , and boys accounted for a little more than 60% of cases. Almost two-thirds of injuries were to a child’s neck or head, while 22% more suffered injuries to their legs.
While many of the LCD, LED and plasma sets are replacing the old-fashioned large cathode-ray TVs, these heavy sets are often kept on dressers and armoires in less-frequented rooms and a source of danger. In addition, in earthquake-prone areas. the large sets could fall on children in a catastrophe. Thus TV sets of all kinds should be anchored to prevent injury. In addition, don’t place remote controls on top of screens, as young children can be induced to climb to reach them.