Diagnostic Yield and Economic Implications of Whole-Exome Sequencing for ASD Diagnosis in Israel

Whole-exome sequencing (WES) is an effective approach to identify the susceptibility of genetic variants of autism spectrum disorder (ASD). The Israel Ministry of Health supports WES as an adjunct tool for ASD diagnosis, despite its unclear diagnostic yield and cost effectiveness. To address this knowledge gap, we applied WES to a population-based sample of 182 Bedouin and Jewish children with ASD from southern Israel, and assessed its yield in a gene panel of 205 genes robustly associated with ASD. We then compared the incremental cost-effectiveness ratios (ICERs) for an ASD diagnosis by WES, chromosomal microarray analysis (CMA), and CMA + WES. Overall, 32 ASD candidate variants were detected in 28 children, corresponding to an overall WES diagnostic yield of 15.4%. Interestingly, the diagnostic yield was significantly higher for the Bedouin children than for the Jewish children, i.e., 27.6% vs. 11.1% (p = 0.036). The most cost-effective means for genetic testing was the CMA alone, followed closely by the CMA + WES strategy (ICER = USD 117 and USD 124.8 per child). Yet, WES alone could become more cost effective than the other two approaches if there was to be a 25% increase in its yield or a 50% decrease in its cost. These findings suggest that WES should be recommended to facilitate ASD diagnosis in Israel, especially for highly consanguineous populations, such as the Bedouin.

The School of Bourgeois Religion: Jewish Children, Emotions, and the Hebrew Bible

Children’s literature, conceptualized as a means of enculturation, is a vehicle for transmitting a society’s or community’s shared values, and is designed to mould children’s behaviour according to what is thought appropriate. As such, it is a powerful cultural agent and consequently a valuable source in the historical study of emotions. This article sets out to explore what can be gained from looking at literature designed for the religious education of Jewish children as sources that shed light on the role of emotions in the process of religious modernization in Judaism. Based on the assumption that feelings are to be viewed as a form of knowledge which is transmitted, acquired, and acted out in specific cultural contexts, several criteria for analysing the verbalization, representation, and use of emotions in Jewish children’s literature are outlined by focusing on the subgenre of Jewish children’s bibles. This analysis allows us to explore how emotions unfolded in educational literature, and how they became an integral and transformative part of religious knowledge, self-assertion, (re)definition, and identity formation at a time of tremendous change for Judaism.

Dental health of preschool children after two-years of a supervised tooth brushing program in Southern Israel

Background Supervised tooth brushing is an important part of leading national oral health improvement programs in different countries. With the cessation of water fluoridation in 2014, a new program was immediately required to provide community-based caries prevention, especially amongst young children. The aim of this study was to determine whether a supervised tooth brushing program (STBP) in kindergartens could reduce dental caries amongst preschool children, when compared with children from the same community who did not participate in the program. The study was performed 2 years after the start of the program. Methods Two Jewish and two Arab local authorities (one participating and one control) were randomly chosen. In each local authority, 4 kindergartens (children aged 5) were randomly chosen, giving a total of 16 kindergartens. Children in the intervention group brushed once daily at kindergartens, with fluoridated toothpaste, for two school- years. All the children were examined using the WHO Oral Health Survey Methods Ed.4. Results Two hundred eighty-three five-year-old children were examined, 157 of them Jewish (86 participants in STBP, 71 non-participants) and 126 Arab (59 vs 67 respectively). Among Jewish children, the fraction of untreated decayed teeth was 61% in the participant group and 65% for non-participants, and amongst the Arab children 69% vs. 90% respectively. The fraction of treated decayed teeth for the participant group was 37% compared to 29% for the non-participants among Jewish children, whilst for the Bedouin group it was 23% vs. 8% respectively. Conclusions After 2 years, supervised tooth brushing with fluoride toothpaste shows a favorable effect. This study suggests that dental health of children participating in STBP was better than the control group. Fewer carious teeth and more treated carious lesions were recorded in this group. This program can be applied to low SES communities nationwide. Guidelines for fluoride concentration in toothpaste for children should be re-considered based on high caries levels.

Navigating a Limited ‘World of Possibilities’: Refugee Journeys of Jewish Children and Youth in the Aftermath of the Holocaust

What can historians bring to the current discussion about refugee journeys? Building on the example of a group of 1,115 young Jewish survivors who went to Canada in the immediate aftermath of the Holocaust, this article addresses two essential questions: why did they leave and why did they go to Canada and not elsewhere? Drawing on Nicolas Mariot and Claire Zalc's notion of a ‘world of possibilities’ and taking into consideration age as a category of analysis, I argue that one can formulate hypotheses about these journeys by, first, mapping what was and was not available to the young survivors at different moments of their displacement and, second, by looking at how individuals navigated these possibilities and constraints. In so doing, this article aims to nuance approaches that uncritically emphasise agency, and therefore erase the specificity of young people's experiences of displacement.

‘From Nazi Inferno to Soviet Hell’: Polish-Jewish children and youth and their trajectories of survival during and after the Second World War

This article relates the experiences of Polish-Jewish children, born or raised in Germany, who survived the war in the Soviet hinterland, and validates that their traumatic wartime experiences had long-lasting consequences. Over the course of the years 1938 to 1945, as well as throughout the post-war decade, this group of children survived several fundamental, political transformations, which deeply affected and irrevocably changed their lives. These caesuras thrust them through a triad of transitions: as young deportees and refugees they ceased to be children; they were moved forcibly from one country to another; and the emotional pain and trauma they experienced during forced migrations. All of these children were refugees three or more times over: expelled from Germany to Poland, deported or sent to the interior of the Soviet Union, ‘repatriated’ from the USSR to Poland, they fled to Displaced Persons camps in Germany or Austria, and finally emigrated to Western countries. These extremely personal accounts of Polish-Jewish children experiences not only open a window into the past and help us to better understand the special plight of child victims and survivors, but they also allow us to reflect more deeply, thoughtfully, and comprehensively on the present-day issues of forced migration, displacement, and refugee crises.

Cecilia Razovsky, the American Activist Who Rescued German Jewish Children (1933-1945)

This article deals with the reaction of one particular American Jewish sector – the Jewish women - and their response to Nazi persecution of European Jews in the 1930s and the 1940s. As against the widespread accusations that American Jews did not do enough to help their co-religionists during those tragic years, this paper claims that Jewish women, of all social standing – from homemakers to professionals – were actively involved in organizing rescue operations and assisting refugees. Of particular note is one extraordinary woman – Cecilia Razovsky-Davidson.