The Jerusalem TeleRehabilitation System, a new low-cost, haptic rehabilitation approach.

Survivors of brain injury or stroke can improve movement ability with intensive, supervised practice. Since the hours of supervised therapy with a physical or occupational therapist are limited, telerehabilitation will enable patients to greatly expand the hours that they practice therapeutic exercises. The Jerusalem TeleRehabilitation System (JTRS) consists of patient and therapist systems plus a central server and database connected via the internet. The system can work in two modes: (1) a cooperative mode in which the therapist and patient are online at the same time, and (2) a stand-alone mode in which the patient uses the system on his own. In both cases, the system will monitor the status and progress of the patient and various parameters of his movement abilities, and prepare reports for the patient and for the therapist. From the clinic, the therapist will be able to change the screen seen by the patient and change the level and types of tasks, as needed. Compared to existing systems, our system will have the following advantages: (1) inexpensive and easy to use; (2) remote monitoring and control of the patient's computer by the therapist in the clinic; (3) more detailed analysis of patient status and progress; (4) a "smart" system which self-adapts to the patient's capabilities in real time, increasing or decreasing the difficulty of the exercise as needed; and (5) a central, international database which, by gathering data on many patients over time, will provide the basis for "smart" therapy and will also facilitate coordinated multicenter research studies.     

Movement in the ipsilesional hand is segmented following unilateral brain damage

Unilateral stroke results in hemiplegia or hemiparesis of the contralateral side of the body. The ipsilateral side of the body, the so-called "good" side, is often assumed to have no deficit. However, there is increasing evidence that the function of the unaffected limbs, especially the upper extremities, is different from that of normal age-matched controls. In the present study, we examined the motor control of both hands of chronic stroke subjects, 6 with left hemisphere brain damage (LHBD) and 5 with right hemisphere brain damage (RHBD). The control group consisted of 5 normal age-matched subjects. The task of the subject was to move a handle by flexing his/her fingers until the target position was reached. The target position was set as 33% of the range of each subject. No time constraints were imposed. The movements of the normal subjects were basically smooth, with few hesitations. In contrast to this, the movements of both hands in the two stroke groups were segmented and characterized by multiple starts and stops. As compared to normals, the time to reach the target, the number of pauses during the movement, and the percent of time spent in pauses, were significantly greater for both hands of the LHBD group. In the RHBD group, the percent of time spent in pauses was significantly greater than the control group for the ipsilesional hand. The increased segmentation seen in the movements of the ipsilesional, as well as the contralesional. hands of the hemiplegic subjects suggests that the motor deficits in stroke patients may be due to a global inability to correctly plan and carry out movements.     

Postural Balance Following Aerobic Fatigue Tests: A Longitudinal Study Among Young Athletes

General fatigue can cause aggravation of postural balance, with increased risk for injuries. The present longitudinal study aimed to evaluate the postural balance of young athletes following field aerobic tests throughout 1 year of training. Thirty children from a sports center in Nazareth, participating in a 3 times/week training program (specific to basketball, soccer, or athletic training), were assessed. Postural balance parameters were taken before, immediately after, and 10 min after a 20 m shuttle-run aerobic test, at 3 time points during 1 training year (Start/Y, Mid/Y, and End/Y). Fitness improved at the Mid/Y and End/Y compared to Start/Y. Postural balance significantly deteriorated immediately after the aerobic test and improved significantly in the 10-min testing in all 3 time points, with significant deterioration in the End/Y compared with the Start/Y. In conclusions, postural balance deteriorates immediately after aerobic exercises, and at the end of the year. To better practice drills related to postural balance and possibly to prevent injuries, it is best for young athletes to properly rest immediately following aerobic exercises and to practice postural balance mainly at the beginning and at the middle of the training year.     

ZIONIST IMMIGRATION POLICY PUT TO THE TEST

This article tackles the multifaceted question of why Israel adopted an open immigration policy in 1948 and adhered to that policy in spite of the proven difficulties it inflicted on the state. The main supposition made is that the immigration policy of the young State of Israel did not constitute a drastic change from earlier Zionist approaches and practices. It was, rather, the implementation of Zionist policy that emerged in the 1930s and heightened in the 1940s, but could not be carried out as long as the Zionist Organization lacked sovereignty and the British controlled the gates of Palestine. The article elaborates on the motivation for the futile attempt made at the end of 1951 to employ some measures of regulation in immigration. It suggests that they stemmed not only from the lessons of the mass immigration of 1948–1951, but also from the fact that in late 1951 the Jewish people and Zionism were not suffering a period of national emergency as the very existence of Israel was no longer in jeopardy and no Jewish community around the world was under acute threat. Finally the article interprets the criticism of the attempts at regulation as utilizing a Zionist rationalization, expecting Israel to act differently from other immigrant states.     

Evaluation of a preventive intervention for child anxiety in two randomized attention-control school trials

The present research examined the effectiveness of a cognitive-behavioral therapy (CBT) based intervention program, FRIENDS, for children from grades 4 to 6, using random assignment at the school-level and an attention-control design in two longitudinal studies. The first study targeted children with anxiety symptoms (N = 191, mean age = 10.1) as screened with self, parent, and teacher-reports; the second study took a universal approach with full classrooms of children participating (N = 253, mean age = 9.8). The results showed no intervention effect in both studies, with children’s anxiety symptoms decreasing over time regardless of whether they were in the story-reading (attention control) or FRIENDS condition. The findings also indicated that girls reported a higher level of anxiety than boys and children in higher grades reported lower anxiety relative to younger children in both studies. In addition, similar patterns were found using a subgroup of children with high-anxiety symptoms from both studies.     

Perceptuomotor functioning in preschool children with symptoms of attention deficit hyperactivity disorder

Given limited research on perceptual-motor functioning of preschool children with symptoms of ADHD, the purpose of this study was to compare the fine motor, gross motor, visuomotor, and oral-motor functioning of 49 4- to 6-yr.-old children with symptoms of Attention Deficit Hyperactivity Disorder and 48 typically developing children. Analysis showed scores of the ADHD group were significantly lower than those of the control group on all perceptuomotor measures. In addition, scores on all measures yielded significant correlations with scores on the Hyperactive-Inattentive scale of the Preschool Behavior Questionnaire. Regression analyses indicated that the scores of gross motor and visuomotor functioning were significant predictors of group classification (with and without ADHD). These findings extend the well documented findings of perceptuomotor deficits among school-age children with ADHD into the preschool period and emphasize the importance of early assessment and treatment of these deficits in young children with symptoms of ADHD.     

Intergenerational transmission: The individuation process and the capacity for intimacy of adult children of holocaust survivors

This article deals with the intergenerational processes of adult children of Holocaust surviors. By exploring their level of individuation from the parental family and their capacity for intimacy with spouses, the research findings reveal that: Adult children of survivors are emotionally more interconnected to their parents than are their counterparts (using the MIS). Adult children of survivors have a lower intimacy capacity with their spouses in comparison with the control group. These findings are explained from an intergenerational perspective regarding a post-traumatic population.Received PhD from University of Wisconsin-Madison. Current research in the individuation process throughout adulthood, and the post-traumatic effect of Holocaust survivors.     

Single Motherhood Via Donor-Insemination (DI): Separation, Absence, and Family Creation

The formation of single motherhood by choice via donor-insemination became one of the alternative family structures in recent years. This paper presents the construction of pre-maternal processes, decision-making and the actual preparation for motherhood via a clinical case study. The therapeutic process is developed through mutual co-construction of patient-therapist relationships that implement analytic relational concepts. The absence of the paternal figure generates a unique creation of familial emotional space. The lack of a conceptual, as well as, a clinical body of knowledge leads both therapist and patient to find new boundaries and meaningful bonds for this family structure.     

Same-Gender Couple Therapy: Creating New Objects in Intimacy and Parenehood Transition

The formation of same-gender couple and parental relationships is described and analyzed from a combined relational and couple therapy. The parenthood transition of a homosexual couple into a family structure, that includes two biological parents and a stepfather, creates tremendous turbulence and crises. The couple link is transformed throughout critical and major changes from a two-ness unit into a four- one, which develops unique relationships with the mother and the baby. This paper presents how therapists can treat and intervene in both intra-psychic gender crises as well as inter-psychic breakdowns of the couple shared reality. The therapeutic processes highlight the transformative changes that the homosexual couple has to experience in order to accept the loss of previous accomplishments in gender identity and love relationships. In addition, therapy helps to disentangle co-joint couple objects while creating new shared spaces.Aviva Mazor, PhD, is at the Bob Shapell School of Social Work, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, 69978, Israel (A-mazor@netvision.net.il). She received a PhD from University of Wisconsin-Madison. Her current research is in combined relational and family therapy with alternative families, separation processes from multigenerational perspective, and the post-traumatic effects of holocaust child-survivors.