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Biomedical subjects

R Ronen

Publications and source records attributed to R Ronen.

13 recordsLinked to original sources
PubMed2001

Quality of care for urinary incontinence in a rehabilitation setting for patients with stroke. Simultaneous monitoring of process and outcome.

OBJECTIVE: To study the quality of care provided for patients with urinary incontinence following a stroke, by monitoring both process and outcome elements of care simultaneously. DESIGN: Prospective follow-up of patients (of all ages and of both sexes) with urinary incontinence that appeared following a stroke who were admitted for rehabilitation during a six 6-month period. SETTING: A ward for stroke rehabilitation in The Loewenstein Hospital-Rehabilitation Centre in Raanana, Israel. RESULTS: Thirty-seven patients with stroke and urinary incontinence (mean age 61 years, 68% men) were included in the study; 84% of the 37 patients were discharged, although only 25% of them were continent. No lasting complications of urinary incontinence developed and there was no interference with rehabilitation activities. There was a correlation between incontinence and low score of Functional Independence Measure (FIM) on admission, being higher on discharge in those who became continent than in those who did not. CONCLUSIONS: Ward staff are aware of the potential problem of incontinence in patients with stroke. The problem is identified on admission and accorded adequate attention and care with satisfactory outcomes. The approach of monitoring process and outcome elements of care simultaneously in conditions that, during inpatient rehabilitation of patients with stroke, may endanger life, interfere with rehabilitation and delay functional recovery, could be a useful way to assess and improve the quality of care.

Activities of Daily Living↗
PubMed1997

[Quality of life in younger adults (17-49) after first stroke--a two year follow-up].

To study the effect of stroke on the quality of life in younger adults, 199 patients 17-49 years of age who had sustained a first stroke between 1.11.92 and 31.10.93 were followed up. They were interviewed by telephone at 3, 6, 12 and 24 months after the event. 2 died during the first year of follow-up, and 8 had recurrent strokes. After 2 years, 8 additional patients had died and 4 had sustained recurrent events. Gradual improvement was reported within all age groups and in all areas. During the 3-6 months period, a mean of 4% improvement occurred in functional capability, 15% in social and recreational activity and 8% in return-to-work. The 6-12 month period showed an increase of 3% in improvement in mean functional capability, 10% in social and recreational activity and 2% in return-to-work. 1 year after the stroke 27% remained with moderate to severe disability, but over 86% were functionally independent in their daily living activities. There were no significant changes during the second year of follow-up in these statistics. 67% of those employed prior to their stroke returned to work and approximately 70% reported a return to prestroke social and recreational activity. These results demonstrate that the relatively high recovery rate and functional improvement during a year of follow-up were not accompanied by similar rates of improvement in employment and in social integration. They indicate the need for increased emphasis on long-term psychosocial rehabilitation services within the community.

Adult↗
PubMed1996

[Incidence, risk factors and causes of stroke in young adults].

A 1-year, nation-wide study was conducted to determine the incidence, risk factors and causes of stroke in young adults. Permanent residents of Israel of both genders, aged 17-49 years, who were referred to 23 general hospitals with a first, acute stroke from 1 Nov. 1992 to 31 Oct. 1993, were studied. Briefed investigators administered a prospective questionnaire pertaining to demographic and socioeconomic variables; past, present and family histories; and condition on admission and discharge. 253 subjects, 17-49 years of age, of whom 62.8% were men, had a first stroke during the year. The incidence was 10.3/100,000/year, increasing with age. 80.6% of strokes were due to infarctions, 9.9% intracerebral hemorrhages, 7.9% subarachnoid hemorrhages, and 1.6% were of undetermined type. There was no seasonal variation in incidence; 45.6% occurred in the morning. The main risk factors were smoking (53.6%), hypertension (43.4%), hyperlipidemia (22%) and diabetes (21%). Atherosclerosis was the main cause of the strokes (52%). In 3.5% there was no residual damage, 10.3% were left with minimal damage, 40.3% remained with minor disability, 19% with moderate disability, 17.4% with severe disability and 9.9% died. The data on incidence concur with those published from western Europe. However, the data on risk factors differ from those of young adults and are identical with those of the older population. Although these risk factors can be modified, preventive measures were insufficiently used. More comprehensive diagnosis is needed to determine stroke etiology in each patient and establishing a national stroke registry is important for planning and improving services.

Adolescent↗
PubMed1996

Stroke in the young in Israel. Incidence and outcomes.

BACKGROUND AND PURPOSE: Data on stroke in the young in Israel are fragmentary. To obtain an overall perspective and to assess the nature and magnitude of the problem, a study was conducted on stroke occurrence in the young population during 1 year. Incidence and outcomes are reported in this communication. METHODS: We conducted a prospective ascertainment of first stroke in all permanent residents of Israel aged 17 to 49 years who were referred to all acute-care hospitals in the country or died before reaching them. RESULTS: We identified 253 first stroke victims in the studied population; 62.8% were male. The age- and sex-adjusted incidence rate for all types of stroke was 10.36/100 000 per year (males, 13.00; females, 7.71). The majority of strokes (80.6%) were cerebral infarctions, with 9.9% intracerebral hemorrhages, 7.9% subarachnoid hemorrhages, and 1.6% strokes of unspecified type. The case-fatality rate for all types of stroke was 9.9% (mortality within the first 4 weeks after the event, on average 6 days). The survival rate was 95% for cerebral infarctions, 64% for intracerebral hemorrhages, and 80% for subarachnoid hemorrhages; 86.7% of all survivors remained with an impairment resulting in a disability. CONCLUSIONS: Incidence rates were similar to those reported from developed Western countries. The case-fatality rate of 9.9% and the considerable percentage of survivors with a disability in a population at the beginning of their family, professional, and social lives indicate the magnitude of the problem.

Adolescent↗
PubMed1996

A community-oriented programme for rehabilitation of persons with arthritis.

A community-oriented programme for rehabilitation of persons with arthritis is described. It combines an 8-week ambulatory rehabilitation course (including patient education) at a rehabilitation institution, with long-term self-rehabilitation (at patients' homes), supervised by primary-care nurses. Sixty persons (mean age 54; 80% females) with a 13-year average duration of arthritis, were suffering pain, physical limitations, difficulties in social activities, tension and a tendency to depression. They had completed the course and a 12-month self-rehabilitation at home, and were assessed with the Arthritis Impact Measurement Scales (AIMS) questionnaire on admission to the course, at its completion and 1 year thereafter. Assessment upon completion of the course showed improvement in all areas studied. Measurements at follow-up showed that the majority carried out self-rehabilitation activities and preserved the improved functional status. The programme provided a much-needed service to arthritis sufferers living in the community, and promoted both the reorientation of institution-based rehabilitation professionals towards the community and self-rehabilitation and the cooperation between the institution and primary care.

Activities of Daily Living↗
PubMed1995

The introduction of a quality assurance programme into hospitals in Israel. A concerted action programme on quality assurance (COMAC) in Israeli hospitals (1990-1993).

OBJECTIVE: To describe the introduction of the COMAC Quality Assurance Programme into hospitals in Israel. DESIGN: Outline of the programme in general, and in Israel in particular, and description of the experience of implementing and evaluating the programme. SETTING: Sixteen general hospitals on a local level and the country coordinating team on a national level, during 28 months (March 1991 to June 1993). RESULTS: Fourteen hospitals, out of the 16 (or 87%) completed all the programme's phases. In most of these 14 hospitals there occurred an improvement in the quality assurance infrastructure (in general, and in the addressed topics in particular), an increase in committees designed to exert a monitoring function related to the quality of care and the acquisition of competence for the performance of quality assurance activities. CONCLUSION: The COMAC programme had a meaningful impact on Israeli hospitals participating in it.

Hospitals, General↗
PubMed1995

Implementation and evaluation of a quality assurance programme.

Describes the three stages of implementation of a quality assurance programme (preparatory, development of quality assurance structure and process, appearance of quality assurance outcomes). Observes that it is advantageous to implement the programme by providing external support to internal quality assurance efforts. Mentions the way of conducting a formative and a summative evaluation of a programme as well as the factors that influence the effectiveness of a programme.

Data Collection↗
PubMed1994

[Concerted action program for quality assurance of European community hospitals as applied in Israel].

The concerted action program on quality assurance (QA) of the European Community (COMAC) was implemented in 14 hospitals in Israel. It was focused on prevention of pressure sores, preoperative assessment, prophylactic use of antibiotics in elective surgery and proper keeping of medical and nursing records. Mechanisms for quality assessment and interventions for improvement and monitoring were implemented. Improvement in QA infrastructure, processes of care in the project topics, and in QA awareness were found. Management involvement, previous motivation for professional improvement, behavioral strategies for change and having highly respected QA leaders were found to contribute to the development of effective QA. Professional associations and national authorities should be responsible for establishing support systems as well as promoting legislation, formulating guidelines, recommending allotment of resources, and developing educational programs.

Europe↗
PubMed1991

Xylanase and xylosidase activities in avocado fruit.

The activities of xylanase and xylosidase were demonstrated in mature avocado (Persea americana Mill.) fruits from different cultivars. When monitored on the day of harvest during the season at 1-month intervals, xylanase activity decreased and xylosidase activity increased between January and February and then remained stable until May. When monitored during the ripening process (January harvest), xylanase activity was constant, and xylosidase activity reached a peak at the climax of ethylene evolution and cellulase activity. Xylanase, which originated from Trichoderma viride and was added to the medium in which avocado discs were incubated, induced ethylene evolution.

Journal Article↗
PubMed1975

Melosis as a source of spontaneous mutations in Schizophyllum commune.

Spontaneous mutation frequencies were determined for two loci in the fungus Schizophyllum commune, at meiosis and at mitosis. For both loci the meiotic frequency is significantly higher than the mitotic frequency. No correlation was found between meiotic mutagenesis and recombination of markers bracketing the mutant site. The meiotic temperature affected the spontaneous mutation frequency but not the recombination frequency in the cross examined. A number of suppressor mutations were detected for both loci examined. Almost all the suppressors are closely linked to the site they suppress. The distribution of mutations among the suppressor sites was different at meiosis and at mitosis.

Basidiomycota↗