Medicine and the Politics of Neutrality: The Professional and Political Lives of Palestinian Physicians in Israel

The Israeli public health system is one of the few arenas in which Arab and Jewish citizens collaborate in their day to day work, with Palestinian citizens comprising 11% of practicing physicians. This dissertation examines how medicine’s ethical framework of universality and political neutrality affects social dynamics in healthcare settings in a context of national conflict. The study is based on 22-months of ethnographic research, including fieldwork in two hospitals and an analysis of in-depth interviews and media content. It demonstrates how Palestinian physicians navigate a delicate balance between ideals of medical neutrality and expressions of suspicion and hostility on the part of Jewish patients and colleagues. In Israel, the ethos of a politically neutral health sphere is a ‘shared fiction’ that is propagated by government officials, hospital administrations, ethics committees, physicians, and patients. An ideal that is loosely based on humanitarian ideas of medical neutrality and professional ethics’ principles of impartiality. But it is hyperbolized to encapsulate entire institutional spaces where “politics” is considered out of bounds. This work looks into the practice of maintaining the Israeli health system hygienically clean from ‘politics.’ The making of an exceptional space within which all non-medical considerations are perceived to be suspended. Yet, this classification of ‘neutral’ and ‘political’ is inconsistent. The rules of purity and pollution are applied selectively to Jewish-Israeli and Palestinian physicians and neutrality emerges as an antipolitics that suppresses Palestinian nationality. For Palestinian physicians, upholding ideas of neutrality is critical for their personal survival in the Israeli medical sphere, to maintain a professional identity, and advance a medical career. But they are also painfully cognizant of the limitations of this selectively applied ideal. In making visible Palestinian citizens’ efforts to shape their individual and collective conditions of existence through medical practice, this dissertation illuminates how ideologies of the medical sphere shape their struggle in distinctive ways. It analyzes medicine and healthcare as spaces of micro-level struggles for equality and recognition, and demonstrates how ideas of neutrality serve as fungible political tools in the hands of both hegemonic elites and counter-hegemonic forces in a national conflict.Doctor of Philosoph

Portion coherence: enhancing the relevance of introductory courses in teacher education

Studies investigating coherence in teacher preparation often attempt to achieve comprehensive coherence across all components of training to optimize the educational process. Nevertheless, the pursuit of intense coherence presents notable challenges. To address these challenges, we propose the concept of portion coherence, exemplified by the Trio model, which guides pre-service teachers in integrating theories into their practices. Through a mixed-method study, we compared pre-service teachers’ perceptions of the importance and relevance of introductory courses at the semester’s outset and conclusion. While both groups reported a reduction in perceived importance, the intervention group noted a significantly smaller decline in perceived relevance compared to the control group. This suggests that models of portion coherence may enhance the perceived relevance of educational courses, while the perceived relevance of introductory education courses may serve as an indicator of cross-course coherence

Supportive and palliative care for people with respiratory problems and pre-existing serious mental illness

PURPOSE OF REVIEW: People living with serious mental illness are at a higher risk of developing respiratory problems that can lead to increased morbidity and early mortality. This review aimed to identify recent advances in care provision for people with respiratory problems and preexisting serious mental illness to ease symptom burden and reduce the risk of premature mortality. RECENT FINDINGS: Intervention-based studies in this area are scarce. The evidence reviewed originated from observational studies. Concluding comments from the synthesis suggest there are specific needs for proactive screening of respiratory function as part of routine physical health checks across care settings for people living with serious mental illness, more stringent monitoring of comorbid chronic lung conditions and increased attention in reducing the frequency respiratory infections. Integrated services across care settings are needed to support people with serious mental illness to limit the impact of modifiable lifestyle factors known to be detrimental to respiratory health, such as smoking. SUMMARY: Key priorities are identified to improve accessibility and inclusivity of respiratory care pathways for people living with serious mental illness to support early detection and proactive monitoring of respiratory problems to help reduce the risk of early mortality

Single cell dissection of plasma cell heterogeneity in symptomatic and asymptomatic myeloma

Multiple myeloma, a plasma cell malignancy, is the second most common blood cancer. Despite extensive research, disease heterogeneity is poorly characterized, hampering efforts for early diagnosis and improved treatments. Here, we apply single cell RNA sequencing to study the heterogeneity of 40 individuals along the multiple myeloma progression spectrum, including 11 healthy controls, demonstrating high interindividual variability that can be explained by expression of known multiple myeloma drivers and additional putative factors. We identify extensive subclonal structures for 10 of 29 individuals with multiple myeloma. In asymptomatic individuals with early disease and in those with minimal residual disease post-treatment, we detect rare tumor plasma cells with molecular characteristics similar to those of active myeloma, with possible implications for personalized therapies. Single cell analysis of rare circulating tumor cells allows for accurate liquid biopsy and detection of malignant plasma cells, which reflect bone marrow disease. Our work establishes single cell RNA sequencing for dissecting blood malignancies and devising detailed molecular characterization of tumor cells in symptomatic and asymptomatic patients