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Lazary A.,Reuth Medical Center | Weinberg I.,Reuth Medical Center | Vatine J.-J.,Outpatient and Research Division | Vatine J.-J.,Tel Aviv University | And 4 more authors.
International Journal of Infectious Diseases | Year: 2014

Background: Contaminated textiles in hospitals contribute to endogenous, indirect-contact, and aerosol transmission of nosocomial related pathogens. Copper oxide impregnated linens have wide-spectrum antimicrobial, antifungal, and antiviral properties. Our aim was to determine if replacing non-biocidal linens with biocidal copper oxide impregnated linens would reduce the rates of healthcare-associated infections (HAI) in a long-term care ward. Methods: We compared the rates of HAI in two analogous patient cohorts in a head injury care ward over two 6-month parallel periods before (period A) and after (period B) replacing all the regular non-biocidal linens and personnel uniforms with copper oxide impregnated biocidal products. Results: During period B, in comparison to period A, there was a 24% reduction in the HAI per 1000 hospitalization-days (p< 0.05), a 47% reduction in the number of fever days (>38.5. °C) per 1000 hospitalization-days (p< 0.01), and a 32.8% reduction in total number of days of antibiotic administration per 1000 hospitalization-days (p< 0.0001). Accordingly there was saving of approximately 27% in costs of antibiotics, HAI-related treatments, X-rays, disposables, labor, and laundry, expenses during period B. Conclusions: The use of biocidal copper oxide impregnated textiles in a long-term care ward may significantly reduce HAI, fever, antibiotic consumption, and related treatment costs. © 2014 The Authors.


Dickstein R.,Haifa University | Levy S.,Reuth Medical Center | Shefi S.,Haifa University | Holtzman S.,Haifa University | And 2 more authors.
NeuroRehabilitation | Year: 2014

BACKGROUND: Stroke is the leading cause of adult disability, with walking impairment being a devastating indicator of chronic post-stroke hemiparesis. Limited resources exist for individual treatments; therefore, the delivery of safe group exercise therapy is highly desired. OBJECTIVE: To examine whether the application of group-based motor imagery practice to community-dwelling individuals with chronic hemiparesis improves gait. METHODS: Sixteen individuals with chronic hemiparesis from two community centers participated in the study, with eight from each center. Four participants in each center received five weeks of the experimental intervention, consisting of group-based motor imagery exercises of gait tasks, followed by five weeks of control treatment of motor imagery exercises for the affected upper extremity. Four other subjects in each center received the same treatments in reverse order. Pre- and post intervention measurements included clinical and biomechanical gait parameters. RESULTS: Comparisons within (pre- vs. post) and between treatments (experimental vs. control) indicated no significant change in any gait variable. Nevertheless, the verbal reports of most participants alluded to satisfaction with the experimental intervention and to an increase in self-confidence. CONCLUSIONS: Despite the lack of evidence for the effectiveness of group-based motor imagery practice in improving gait among individuals with chronic hemiparesis, the contrast between the measured outcomes and the positive verbal reports merits further inquiry. © 2014 ? IOS Press and the authors.


Gvion A.,Ono Academic College | Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Cortex | Year: 2010

The article describes AE, a Hebrew-speaking individual with acquired dysgraphia, who makes mainly letter position errors in writing. His dysgraphia resulted from impairment in the graphemic buffer, but unlike previously studied patients, most of his errors related to the position of letters rather than to letter identity: 80% of his errors were letter position errors in writing, and only 7% of his errors were letter omissions, substitutions, and additions. Letter position errors were the main error type across tasks (writing to dictation and written naming), across output modalities (writing and typing), and across stimuli, e.g., migratable words (words in which letter migration forms another word), irregular words, and nonwords. Letter position errors occurred mainly in the middle letters of a word. AE's writing showed a significant length effect, and no lexicality, migratability, or frequency effects. His letter position deficit was manifested selectively in writing; he made no letter position errors in reading, demonstrating the dissociability of letter position encoding in reading and writing. These data support the existence of a letter order function in the graphemic buffer that is separate from the function responsible for activating letter identities. © 2009 Elsevier Srl.


Carmeli E.,Tel Aviv University | Peleg S.,Reuth Medical Center | Bartur G.,Reuth Medical Center | Bartur G.,Outpatient and Research Division | And 4 more authors.
Physiotherapy Research International | Year: 2011

Background and Purpose. This study assessed the potential therapeutic benefit of using HandTutorTM in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. Method. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Results. Following 15 consecutive treatment sessions, a significant improvement was observed within the experimental group (95% confidence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutorTM performance accuracy on x axis and performance accuracy on y axis p < 0.0003. Conclusion. The results from this pilot study support further investigation of the use of the HandTutorTM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation. © 2010 John Wiley & Sons, Ltd.


Gvion A.,Ono Academic College | Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Frontiers in Human Neuroscience | Year: 2013

Nissim, a 64 years old Hebrew-speaking man who sustained an ischemic infarct in the left occipital lobe, exhibited an intriguing pattern. He could hold a deep and fluent conversation about abstract and complex issues, such as the social risks in unemployment, but failed to retrieve imageable words such as ball, spoon, carrot, or giraffe. A detailed study of the words he could and could not retrieve, in tasks of picture naming, tactile naming, and naming to definition, indicated that whereas he was able to retrieve abstract words, he had severe difficulties when trying to retrieve imageable words. The same dissociation also applied for proper names-he could retrieve names of people who have no visual image attached to their representation (such as the son of the biblical Abraham), but could not name people who had a visual image (such as his own son, or Barack Obama). When he tried to produce imageable words, he mainly produced perseverations and empty speech, and some semantic paraphasias. He did not produce perseverations when he tried to retrieve abstract words. This suggests that perseverations may occur when the phonological production system produces a word without proper activation in the semantic lexicon. Nissim evinced a similar dissociation in comprehension-he could understand abstract words and sentences but failed to understand sentences with imageable words, and to match spoken imageable words to pictures or to semantically related imageable words. He was able to understand proverbs with imageable literal meaning but abstract figurative meaning. His comprehension was impaired also in tasks of semantic associations of pictures, pointing to a conceptual, rather than lexical source of the deficit. His visual perception as well as his phonological input and output lexicons and buffers (assessed by auditory lexical decision, word and sentence repetition, and writing to dictation) were intact, supporting a selective conceptual system impairment. He was able to retrieve gestures for objects and pictures he saw, indicating that his access to concepts often sufficed for the activation of the motoric information but did not suffice for access to the entry in the semantic lexicon. These results show that imageable concepts can be selectively impaired, and shed light on the organization of conceptual-semantic system. © 2013Gvionand Friedmann.


Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Aphasiology | Year: 2012

Background: Within cognitive neuropsychological models conduction aphasia has been conceptualised as a phonological buffer deficit. It may affect the output buffer, the input buffer, or both. The phonological output buffer is a short-term storage, responsible for the short-term maintenance of phonological units until their articulation, as well as for phonological and morphological composition. The phonological input buffer holds input strings until they are identified in the input lexicon. Thus the phonological buffers are closely related to phonological short-term memory (pSTM), and hence it is important to assess pSTM in conduction aphasia. Because the input and output buffers play different roles, impairment in each of them predicts different impairments in the patient's ability to understand certain sentences, to learn new words and names, and to remember and recall lists of words and numbers for short time periods.This research was supported by a research grant from the National Institute for Psychobiology in Israel (Friedmann 2004-5-2b), by the Israel Science Foundation (grant no. 1296/06, Friedmann), and by the ARC Centre of Excellence in Cognition and its Disorders (CCD), Macquarie University.Aims: This study explored in detail pSTM in individuals with conduction aphasia, comparing individuals with input and output deficits, recall and recognition tasks, and stimuli of various types. It also tested pSTM in six age groups of healthy individuals, assessing the effect of age on various types of stimuli. This paper presents a new battery of 10 recall and recognition span tests, designed to assess pSTM in aphasia and to measure spans and effects on spans.Methods & Procedures: The participants were 14 Hebrew-speaking individuals with conduction aphasia, 12 with input or input-output phonological buffer deficit, and 2 with only output deficit, and 296 healthy individuals.Outcomes & Results: The analyses of the spans and effects on pSTM in the 10 tests indicated that all the participants with conduction aphasia had limited pSTM, significantly poorer than that of the control participants, and no semantic STM impairment. They had shorter spans, smaller length and similarity effects, and larger sentential effect than the controls. The individuals with conduction aphasia who had an impairment in the phonological input buffer showed deficit in both the recall and recognition span tasks. The individuals with the output conduction aphasia showed impairment only in the recall tasks. The healthy individuals showed age effect on span tasks involving words, but no effect of age on span tasks of nonwords.Conclusions: pSTM is impaired in conduction aphasia, and different pSTM impairments characterise different types of conduction aphasia. Output conduction aphasia causes difficulties only when verbal output is required, whereas input conduction aphasia also causes a deficit when only recognition is required. This suggests that rehearsal can take place without the phonological output buffer. Age differentially affects pSTM for words and nonwords in healthy adults: whereas the encoding of words changes, the ability to remember nonwords is unchanged. © 2012 Copyright 2012 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business.


Gvion A.,Tel Aviv University | Gvion A.,Reuth Medical Center | Friedmann N.,Tel Aviv University
Aphasiology | Year: 2012

Background: The nature of the relation between phonological working memory and sentence comprehension is still an open question. This question has theoretical implications with respect to the existence of various working memory resources and their involvement in sentence processing. It also bears clinical implications for the language impairment of patients with phonological working memory limitation, such as individuals with conduction aphasia.Aims: This study explored whether limited phonological working memory impairs sentence comprehension in conduction aphasia.Methods & Procedures: The participants were 12 Hebrew-speaking individuals with conduction aphasia who, according to 10 recall and recognition span tasks, had limited phonological short-term memory in comparison to 296 control participants. Experiments 1 and 2 tested their comprehension of relative clauses, which require semantic-syntactic reactivation, using sentence-picture matching and plausibility judgement tasks. Experiments 3 and 4 tested phonological reactivation, using two tasks: a paraphrasing task for sentences containing an ambiguous word in which disambiguation requires re-accessing the word form of the ambiguous word, and rhyme judgement within sentences. In each task the distance between a word and its reactivation was manipulated by adding words/syllables, intervening arguments, or intervening embeddings.Outcomes & Results: Although their phonological short-term memory, and hence their phonological working memory, was very impaired, the individuals with conduction aphasia comprehended relative clauses well, even in sentences with a long distance between the antecedent and the gap. They failed to understand sentences that required phonological reactivation when the phonological distance was long.Conclusions: The theoretical implication of this study is that phonological working memory is not involved when only semantic-syntactic reactivation is required. Phonological working memory does support comprehension in very specific conditions: when phonological reactivation is required after a long phonological distance. The clinical implication of these results is that because most of the sentences in daily language input can be understood without phonological reactivation, individuals with phonological working memory impairment, such as individuals with conduction aphasia, are expected to understand sentences well, as long as they understand the meaning of the sentences and do not attempt to repeat them or encode them phonologically. © 2012 Copyright 2012 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business.


Ginsburg P.,Tel Aviv University | Bartur G.,Reuth Medical Center | Peleg S.,Reuth Medical Center | Vatine J.J.,Reuth Medical Center | And 2 more authors.
European Neurology | Year: 2011

Aim: To examine test-retest reliability of time and frequency domain heart rate variability (HRV) in patients 1 month after stroke during rest, paced breathing and light-to-moderate physical activity. Methods: Fifteen patients up to 1 month after stroke underwent two measurements of HRV, with the measurements 4 days apart. Measurements took place under three conditions while sitting: (1) at rest with self-select breathing frequency, (2) paced breathing and (3) cycling while sitting. Reliability was assessed statistically by calculating intraclass correlation coefficients (ICC), standard error of measurement and coefficient of variance (CV). Results: The relative reliability was found to be good-to-excellent for SDNN (ICC: 0.86-0.91), RMSSD (ICC: 0.81-0.87) and HF (ICC: 0.91-0.94) in all three conditions and poor for LF at rest and paced breathing (ICC: 0.43-0.47). The absolute reliability for all measures was found to be poor (CV >15%). Conclusions: HRV can be reliably assessed at rest, paced breathing and light-to-moderate physical activity for identifying differences between patients, while individual changes in autonomic functioning exhibited large random variations between test-retest measurements. Copyright © 2011 S. Karger AG, Basel.


Rosenbaum T.,Inner Stability Ltd. | Aloni R.,Tel Aviv University | Heruti R.,Tel Aviv University | Heruti R.,Reuth Medical Center
Journal of Sexual Medicine | Year: 2014

Introduction: Surrogate partner therapy (SPT) is a controversial and often misunderstood practice. Aim: The aim of this study was to review the history and evidence-based literature regarding SPT, describe and provide a model for ethical SPT practice, and present two case examples illustrating ethical concerns. Methods: Literature review and report of clinical experience were the methods used. Main Outcome Measure: Results of literature review and clinical experience were assessed for this study. Results: Sex therapy pioneers Masters and Johnson introduced surrogacy in sex therapy; however, there is a lack of published evidence supporting treatment efficacy and ethico-legal questions have limited the practice from becoming a common intervention. SPT can be an effective intervention that may enhance sexual medicine practice. However, SPT must be offered according to legal, professional, and ethical standards. Conclusions: Sexual medicine practitioners should consider SPT based on the ethical paradigms offered, and sex therapy practices utilizing SPT should collect and publish outcome data. Rosenbaum T, Aloni R, and Heruti R. Surrogate partner therapy: Ethical considerations in sexual medicine. © 2013 International Society for Sexual Medicine.


Zerach G.,Ariel University | Anat B.,Haifa University | Solomon Z.,Tel Aviv University | Heruti R.,Reuth Medical Center
Journal of Sexual Medicine | Year: 2010

Introduction. The aversive impact of combat and combat-induced posttraumatic stress disorder (PTSD) on marital intimacy and sexual satisfaction has been examined in several studies. Nevertheless, the toll of war captivity on marital intimacy in relation to dyadic adjustment and sexual satisfaction remains unknown. In particular, the mediating role of marital intimacy in the relationship between PTSD symptoms and dyadic adjustment and between PTSD symptoms and sexual satisfaction has not yet been systematically explored thus far. Aims: This study aimed to examine the interrelationships of PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy among ex-prisoners of war (ex-POWs). Methods. A sample of Israeli veterans ex-POWs (ex-POWs: N = 105) from the 1973 Yom Kippur War and a matched comparison group of veterans who participated in the same war but were not held captive (control: N = 94) were compared in the study variables. Main Outcome Measures: The PTSD inventory, dyadic adjustment scale, index of sexual satisfaction, and capacity for intimacy questionnaire. Results. Findings revealed that ex-POWs reported higher levels of PTSD symptoms and lower levels of dyadic adjustment and sexual satisfaction than comparable controls. There were also differences between the groups in the pattern of relations between PTSD symptoms, dyadic adjustment, sexual satisfaction, and marital intimacy. Finally, for ex-POWs, marital intimacy partially mediated the relationships between PTSD symptoms and dyadic adjustment and sexual satisfaction outcome measures. Conclusions. PTSD symptoms are implicated in marital problems of ex-POWs. A significant relationship was found between the traumatized ex-POW's capacity for intimacy and both their sexual satisfaction and dyadic adjustment. Zerach G, Anat B-D, Solomon Z, and Heruti R. Posttraumatic symptoms, marital intimacy, dyadic adjustment, and sexual satisfaction among ex-prisoners of war. © 2010 International Society for Sexual Medicine.

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