Sample records for hand previous studies
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Hand assessment in older adults with musculoskeletal hand problems: a reliability study.
Myers, Helen L; Thomas, Elaine; Hay, Elaine M; Dziedzic, Krysia S
2011-01-07
Musculoskeletal hand pain is common in the general population. This study aims to investigate the inter- and intra-observer reliability of two trained observers conducting a simple clinical interview and physical examination for hand problems in older adults. The reliability of applying the American College of Rheumatology (ACR) criteria for hand osteoarthritis to community-dwelling older adults will also be investigated. Fifty-five participants aged 50 years and over with a current self-reported hand problem and registered with one general practice were recruited from a previous health questionnaire study. Participants underwent a standardised, structured clinical interview and physical examination by two independent trained observers and again by one of these observers a month later. Agreement beyond chance was summarised using Kappa statistics and intra-class correlation coefficients. Median values for inter- and intra-observer reliability for clinical interview questions were found to be "substantial" and "moderate" respectively [median agreement beyond chance (Kappa) was 0.75 (range: -0.03, 0.93) for inter-observer ratings and 0.57 (range: -0.02, 1.00) for intra-observer ratings]. Inter- and intra-observer reliability for physical examination items was variable, with good reliability observed for some items, such as grip and pinch strength, and poor reliability observed for others, notably assessment of altered sensation, pain on resisted movement and judgements based on observation and palpation of individual features at single joints, such as bony enlargement, nodes and swelling. Moderate agreement was observed both between and within observers when applying the ACR criteria for hand osteoarthritis. Standardised, structured clinical interview is reliable for taking a history in community-dwelling older adults with self reported hand problems. Agreement between and within observers for physical examination items is variable. Low Kappa values may have resulted
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Heydorn, S; Menné, T; Andersen, K E; Bruze, M; Svedman, C; Basketter, D; Johansen, J D
2003-06-01
Recently, we showed that 10 x 2% of consecutively patch-tested hand eczema patients had a positive patch test to a selection of fragrances containing fragrances relevant to hand exposure. In this study, we used repeated skin exposure to a patch test-positive fragrance allergen in patients previously diagnosed with hand eczema to explore whether immersion of fingers in a solution with or without the patch-test-positive fragrance allergen would cause or exacerbate hand eczema on the exposed finger. The study was double blinded and randomized. All participants had a positive patch test to either hydroxycitronellal or Lyral (hydroxyisohexyl 3-cyclohexene carboxaldehyde). Each participant immersed a finger from each hand, once a day, in a solution containing the fragrance allergen or placebo. During the first 2 weeks, the concentration of fragrance allergen in the solution was low (approximately 10 p.p.m.), whilst during the following 2 weeks, the concentration was relatively high (approximately 250 p.p.m.), imitating real-life exposure to a household product like dishwashing liquid diluted in water and the undiluted product, respectively. Evaluation was made using a clinical scale and laser Doppler flow meter. 3 of 15 hand eczema patients developed eczema on the finger immersed in the fragrance-containing solution, 3 of 15 on the placebo finger and 3 of 15 on both fingers. Using this experimental exposure model simulating real-life exposure, we found no association between immersion of a finger in a solution containing fragrance and development of clinically visible eczema on the finger in 15 participants previously diagnosed with hand eczema and with a positive patch test to the fragrance in question.
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Functional Assessment of the Vanderbilt Multigrasp Myoelectric Hand: A Continuing Case Study
Dalley, Skyler A.; Bennett, Daniel A.; Goldfarb, Michael
2015-01-01
This paper presents a case study involving the functional assessment of the Vanderbilt Multigrasp (VMG) hand prosthesis on a single transradial amputee subject. In particular, a transradial amputee subject performed the Southampton Hand Assessment Procedure (SHAP) using the hand prosthesis and multigrasp myoelectric controller in a series of experimental sessions occurring over a multi-week time span. The subject’s index of function (IoF) improved with each session, although essentially plateaued after the fourth session, resulting in a IoF score of 87, which compares favorably to SHAP scores published in previous studies. PMID:25571412
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HandTutor™ enhanced hand rehabilitation after stroke--a pilot study.
Carmeli, Eli; Peleg, Sara; Bartur, Gadi; Elbo, Enbal; Vatine, Jean-Jacques
2011-12-01
This study assessed the potential therapeutic benefi t of using HandTutor™ 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. 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. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p < 0.0003. 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.
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Programming of left hand exploits task set but that of right hand depends on recent history.
Tang, Rixin; Zhu, Hong
2017-07-01
There are many differences between the left hand and the right hand. But it is not clear if there is a difference in programming between left hand and right hand when the hands perform the same movement. In current study, we carried out two experiments to investigate whether the programming of two hands was equivalent or they exploited different strategies. In the first experiment, participants were required to use one hand to grasp an object with visual feedback or to point to the center of one object without visual feedback on alternate trials, or to grasp an object without visual feedback and to point the center of one object with visual feedback on alternating trials. They then performed the tasks with the other hand. The result was that previous pointing task affected current grasping when it was performed by the left hand, but not the right hand. In experiment 2, we studied if the programming of the left (or right) hand would be affected by the pointing task performed on the previous trial not only by the same hand, but also by the right (or left) hand. Participants pointed and grasped the objects alternately with two hands. The result was similar with Experiment 1, i.e., left-hand grasping was affected by right-hand pointing, whereas right-hand grasping was immune from the interference from left hand. Taken together, the results suggest that when open- and closed-loop trials are interleaved, motor programming of grasping with the right hand was affected by the nature of the online feedback on the previous trial only if it was a grasping trial, suggesting that the trial-to-trial transfer depends on sensorimotor memory and not on task set. In contrast, motor programming of grasping with the left hand can use information about the nature of the online feedback on the previous trial to specify the parameters of the movement, even when the type of movement that occurred was quite different (i.e., pointing) and was performed with the right hand. This suggests that
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Mellet, Emmanuel; Mazoyer, Bernard; Leroux, Gaelle; Joliot, Marc; Tzourio-Mazoyer, Nathalie
2016-01-01
The aim of this study was to characterize, using fMRI, the functional asymmetries of hand laterality task (HLT) in a sample of 295 participants balanced for handedness. During HLT, participants have to decide whether the displayed picture of a hand represent a right or a left hand. Pictures of hands’ back view were presented for 150 ms in the right or left hemifield. At the whole hemisphere level, we evidenced that the laterality of the hand and of the hemifield in which the picture was displayed combined their effects on the hemispheric asymmetry in an additive way. We then identified a set of 17 functional homotopic regions of interest (hROIs) including premotor, motor, somatosensory and parietal regions, whose activity and asymmetry varied with the laterality of the presented hands. When the laterality of a right hand had to be evaluated, these areas showed stronger leftward asymmetry, the hROI located in the primary motor area showing a significant larger effect than all other hROIs. In addition a subset of six parietal regions involved in visuo-motor integration together with two postcentral areas showed a variation in asymmetry with hemifield of presentation. Finally, while handedness had no effect at the hemispheric level, two regions located in the parietal operculum and intraparietal sulcus exhibited larger leftward asymmetry with right handedness independently of the hand of presentation. The present results extend those of previous works in showing a shift of asymmetries during HLT according to the hand presented in sensorimotor areas including primary motor cortex. This shift was not affected by manual preference. They also demonstrate that the coordination of visual information and handedness identification of hands relied on the coexistence of contralateral motor and visual representations in the superior parietal lobe and the postcentral gyrus. PMID:27999536
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Gasoline on hands: preliminary study on collection and persistence.
Darrer, Melinda; Jacquemet-Papilloud, Joëlle; Delémont, Olivier
2008-03-05
The identification of an arsonist remains one of the most difficult challenges a fire investigation has to face. Seeking and detection of traces of gasoline could provide a valuable information to link a suspect with an arson scene where gasoline was used to set-up the fire. In this perspective, a first study was undertaken to evaluate a simple, fast and efficient method for collecting gasoline from hands, and to assess its persistence over time. Four collection means were tested: PVC, PE and Latex gloves, as well as humidified filter paper. A statistical assessment of the results indicates that Latex and PVC gloves worn for about 20 min, as well as paper filter rubbed on hands, allow an efficient collection of gasoline applied to hands. Due to ease of manipulation and to a reduced amount of volatile compounds detected from the matrix, PVC gloves were selected for the second set of experiments. The evaluation of the persistence of gasoline on hands was then carried out using two initial quantities (500 and 1000 microl). Collection was made with PVC gloves after 0, 30 min, 1, 2 and 4h, on different volunteers. The results show a common tendency of massive evaporation of gasoline during the first 30 min: a continued but non-linear decrease was observed along different time intervals. The results of this preliminary study are in agreement with other previous researches conducted on the detection of flammable liquid residues on clothes, shoes and skin.
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Hand controller commonality evaluation process
NASA Technical Reports Server (NTRS)
Stuart, Mark A.; Bierschwale, John M.; Wilmington, Robert P.; Adam, Susan C.; Diaz, Manuel F.; Jensen, Dean G.
1993-01-01
Hand controller selection for NASA's Orbiter and Space Station Freedom is an important area of human-telerobot interface design and evaluation. These input devices will control remotely operated systems that include large crane-like manipulators (e.g., Remote Manipulator System or RMS), smaller, more dexterous manipulators (e.g., Flight Telerobotic Servicer or FTS), and free flyers (e.g., Orbital Maneuvering Vehicle or OMV). Candidate hand controller configurations for these systems vary in many ways: shape, size, number of degrees-of-freedom (DOF), operating modes, provision of force reflection, range of movement, and 'naturalness' of use. Unresolved design implementation issues remain, including such topics as how the current Orbiter RMS rotational and translational rate hand controllers compare with the proposed Space Station Freedom hand controllers, the advantages that position hand controllers offer for these applications, and whether separate hand controller configurations are required for each application. Since previous studies contain little empirical hand controller task performance data, a controlled study is needed that tests Space Station Freedom candidate hand controllers during representative tasks. This study also needs to include anthropometric and biomechanical considerations.
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Grasp with hand and mouth: a kinematic study on healthy subjects.
Gentilucci, M; Benuzzi, F; Gangitano, M; Grimaldi, S
2001-10-01
Neurons involved in grasp preparation with hand and mouth were previously recorded in the premotor cortex of monkey. The aim of the present kinematic study was to determine whether a unique planning underlies the act of grasping with hand and mouth in humans as well. In a set of four experiments, healthy subjects reached and grasped with the hand an object of different size while opening the mouth (experiments 1 and 3), or extending the other forearm (experiment 4), or the fingers of the other hand (experiment 5). In a subsequent set of three experiments, subjects grasped an object of different size with the mouth, while opening the fingers of the right hand (experiments 6-8). The initial kinematics of mouth and finger opening, but not of forearm extension, was affected by the size of the grasped object congruently with the size effect on initial grasp kinematics. This effect was due neither to visual presentation of the object, without the successive grasp motor act (experiment 2) nor to synchronism between finger and mouth opening (experiments 3, 7, and 8). In experiment 9 subjects grasped with the right hand an object of different size while pronouncing a syllable printed on the target. Mouth opening and sound production were affected by the grasped object size. The results of the present study are discussed according to the notion that in an action each motor act is prepared before the beginning of the motor sequence. Double grasp preparation can be used for successive motor acts on the same object as, for example, grasping food with the hand and ingesting it after bringing it to the mouth. We speculate that the circuits involved in double grasp preparation might have been the neural substrate where hand motor patterns used as primitive communication signs were transferred to mouth articulation system. This is in accordance with the hypothesis that Broca's area derives phylogenetically from the monkey premotor area where hand movements are controlled.
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Results of telerobotic hand controller study using force information and rate control
NASA Technical Reports Server (NTRS)
Willshire, Kelli F.; Harrison, F. W.; Hogge, Edward F.; Williams, Robert L.; Soloway, Donald
1992-01-01
To increase quantified information about the effectiveness and subjective workload of force information relayed through manipulator input control devices, a space related task was performed by eight subjects with kinesthetic force feedback and/or local force accommodation through three different input control devices (i.e., hand controllers) operating in rate control mode. Task completion time, manipulator work, and subjective responses were measured. Results indicated a difference among the hand controllers. For the Honeywell six degree-of-freedom hand controller, the overall task completion times were shortest, the amount of work exerted was the least, and was the most preferred by test subjects. Neither force accommodation with or without reflection resulted in shorter task completion times or reduced work although those conditions were better than no force information for some aspects. Comparisons of results from previous studies are discussed.
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RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.
Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon
2017-06-01
The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.
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Hand function evaluation: a factor analysis study.
Jarus, T; Poremba, R
1993-05-01
The purpose of this study was to investigate hand function evaluations. Factor analysis with varimax rotation was used to assess the fundamental characteristics of the items included in the Jebsen Hand Function Test and the Smith Hand Function Evaluation. The study sample consisted of 144 subjects without disabilities and 22 subjects with Colles fracture. Results suggest a four factor solution: Factor I--pinch movement; Factor II--grasp; Factor III--target accuracy; and Factor IV--activities of daily living. These categories differentiated the subjects without Colles fracture from the subjects with Colles fracture. A hand function evaluation consisting of these four factors would be useful. Such an evaluation that can be used for current clinical purposes is provided.
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Neufuss, Johanna; Humle, Tatyana; Cremaschi, Andrea; Kivell, Tracy L
2017-02-01
There has been an enduring interest in primate tool-use and manipulative abilities, most often with the goal of providing insight into the evolution of human manual dexterity, right-hand preference, and what behaviours make humans unique. Chimpanzees (Pan troglodytes) are arguably the most well-studied tool-users amongst non-human primates, and are particularly well-known for their complex nut-cracking behaviour, which has been documented in several West African populations. However, their sister-taxon, the bonobos (Pan paniscus), rarely engage in even simple tool-use and are not known to nut-crack in the wild. Only a few studies have reported tool-use in captive bonobos, including their ability to crack nuts, but details of this complex tool-use behaviour have not been documented before. Here, we fill this gap with the first comprehensive analysis of bonobo nut-cracking in a natural environment at the Lola ya Bonobo sanctuary, Democratic Republic of the Congo. Eighteen bonobos were studied as they cracked oil palm nuts using stone hammers. Individual bonobos showed exclusive laterality for using the hammerstone and there was a significant group-level right-hand bias. The study revealed 15 hand grips for holding differently sized and weighted hammerstones, 10 of which had not been previously described in the literature. Our findings also demonstrated that bonobos select the most effective hammerstones when nut-cracking. Bonobos are efficient nut-crackers and not that different from the renowned nut-cracking chimpanzees of Bossou, Guinea, which also crack oil palm nuts using stones. © 2016 Wiley Periodicals, Inc.
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Hand skin reconstruction from skeletal landmarks.
Lefèvre, P; Van Sint Jan, S; Beauthier, J P; Rooze, M
2007-11-01
Many studies related to three-dimensional facial reconstruction have been previously reported. On the other hand, no extensive work has been found in the literature about hand reconstruction as an identification method. In this paper, the feasibility of virtual reconstruction of hand skin based on (1) its skeleton and (2) another hand skin and skeleton used as template was assessed. One cadaver hand and one volunteer's hand have been used. For the two hands, computer models of the bones and skin were obtained from computerized tomography. A customized software allowed locating spatial coordinates of bony anatomical landmarks on the models. From these landmarks, the spatial relationships between the models were determined and used to interpolate the missing hand skin. The volume of the interpolated skin was compared to the real skin obtained from medical imaging for validation. Results seem to indicate that such a method is of interest to give forensic investigators morphological clues related to an individual hand skin based on its skeleton. Further work is in progress to finalize the method.
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Is Hand Selection Modulated by Cognitive-perceptual Load?
Liang, Jiali; Wilkinson, Krista; Sainburg, Robert L
2018-01-15
Previous studies proposed that selecting which hand to use for a reaching task appears to be modulated by a factor described as "task difficulty". However, what features of a task might contribute to greater or lesser "difficulty" in the context of hand selection decisions has yet to be determined. There has been evidence that biomechanical and kinematic factors such as movement smoothness and work can predict patterns of selection across the workspace, suggesting a role of predictive cost analysis in hand-selection. We hypothesize that this type of prediction for hand-selection should recruit substantial cognitive resources and thus should be influenced by cognitive-perceptual loading. We test this hypothesis by assessing the role of cognitive-perceptual loading on hand selection decisions, using a visual search task that presents different levels of difficulty (cognitive-perceptual load), as established in previous studies on overall response time and efficiency of visual search. Although the data are necessarily preliminary due to small sample size, our data suggested an influence of cognitive-perceptual load on hand selection, such that the dominant hand was selected more frequently as cognitive load increased. Interestingly, cognitive-perceptual loading also increased cross-midline reaches with both hands. Because crossing midline is more costly in terms of kinematic and kinetic factors, our findings suggest that cognitive processes are normally engaged to avoid costly actions, and that the choice not-to-cross midline requires cognitive resources. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
Saharan, Lokesh; Tadesse, Yonas
2016-04-01
This paper presents a biomimetic, lightweight, 3D printed and customizable robotic hand with locking mechanism consisting of Twisted and Coiled Polymer (TCP) muscles based on nylon precursor fibers as artificial muscles. Previously, we have presented a small-sized biomimetic hand using nylon based artificial muscles and fishing line muscles as actuators. The current study focuses on an adult-sized prosthetic hand with improved design and a position/force locking system. Energy efficiency is always a matter of concern to make compact, lightweight, durable and cost effective devices. In natural human hand, if we keep holding objects for long time, we get tired because of continuous use of energy for keeping the fingers in certain positions. Similarly, in prosthetic hands we also need to provide energy continuously to artificial muscles to hold the object for a certain period of time, which is certainly not energy efficient. In this work we, describe the design of the robotic hand and locking mechanism along with the experimental results on the performance of the locking mechanism.
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You, Je Sung; Kim, Hoon; Park, Jung Soo; Baek, Kyung Min; Jang, Mun Sun; Lee, Hye Sun; Chung, Sung Phil; Kim, SeungWhan
2015-03-01
The major components affecting high quality cardiopulmonary resuscitation (CPR) have been defined as the ability of the rescuer, hand position, position of the rescuer and victim, depth and rate of chest compressions, and fatigue. Until now, there have been no studies on dominant versus non-dominant hand position and the rescuer's side of approach. This study was designed to evaluate the effectiveness of hand position and approach side on the quality of CPR between right-handed (RH) and left-handed (LH) novice rescuers. 44 health science university students with no previous experience of basic life support (BLS) volunteered for the study. We divided volunteers into two groups by handedness. Adult BLS was performed on a manikin for 2 min in each session. The sequences were randomly performed on the manikin's left side of approach (Lap) with the rescuer's left hand in contact with the sternum (Lst), Lap/Rst, Rap/Lst and Rap/Rst. We compared the quality of chest compressions between the RH and LH groups according to predetermined positions. A significant decrease in mean compression depth between the two groups was only observed when rescuers performed in the Rap/Lst scenario, regardless of hand dominance. The frequency of correct hand placement also significantly decreased in the Lap/Rst position for the LH group. The performance of novice rescuers during chest compressions is influenced by the position of the dominant hand and the rescuer's side of approach. In CPR training and real world situations, a novice rescuer, regardless of handedness, should consider hand positions for contacting the sternum identical to the side of approach after approaching from the nearest and most accessible side, for optimal CPR performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Hand1 overexpression inhibits medulloblastoma metastasis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Asuthkar, Swapna; Guda, Maheedhara R.; Martin, Sarah E.
2016-08-19
Medulloblastoma (MB) is the most frequent malignant pediatric brain tumor. Current treatment includes surgery, radiation and chemotherapy. However, ongoing treatment in patients is further classified according to the presence or absence of metastasis. Since metastatic medulloblastoma are refractory to current treatments, there is need to identify novel biomarkers that could be used to reduce metastatic potential, and more importantly be targeted therapeutically. Previously, we showed that ionizing radiation-induced uPAR overexpression is associated with increased accumulation of β-catenin in the nucleus. We further demonstrated that uPAR protein act as cytoplasmic sequestration factor for a novel basic helix-loop-helix transcription factor, Hand1. Amongmore » the histological subtypes classical and desmoplastic subtypes account for the majority while large cell/anaplastic variant is most commonly associated with metastatic disease. In this present study using immunohistochemical approach and patient data mining for the first time, we demonstrated that Hand1 expression is observed to be downregulated in all the subtypes of medulloblastoma. Previously we showed that Hand1 overexpression regulated medulloblastoma angiogenesis and here we investigated the role of Hand1 in the context of Epithelial-Mesenchymal Transition (EMT). Moreover, UW228 and D283 cells overexpressing Hand1 demonstrated decreased-expression of mesenchymal markers (N-cadherin, β-catenin and SOX2); metastatic marker (SMA); and increased expression of epithelial marker (E-cadherin). Strikingly, human pluripotent stem cell antibody array showed that Hand1 overexpression resulted in substantial decrease in pluripotency markers (Nanog, Oct3/4, Otx2, Flk1) suggesting that Hand1 expression may be essential to attenuate the EMT and our findings underscore a novel role for Hand1 in medulloblastoma metastasis. - Highlights: • Hand1 expression is downregulated in Medulloblastoma. • Hand1 over
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Evidence of common and separate eye and hand accumulators underlying flexible eye-hand coordination
Jana, Sumitash; Gopal, Atul
2016-01-01
Eye and hand movements are initiated by anatomically separate regions in the brain, and yet these movements can be flexibly coupled and decoupled, depending on the need. The computational architecture that enables this flexible coupling of independent effectors is not understood. Here, we studied the computational architecture that enables flexible eye-hand coordination using a drift diffusion framework, which predicts that the variability of the reaction time (RT) distribution scales with its mean. We show that a common stochastic accumulator to threshold, followed by a noisy effector-dependent delay, explains eye-hand RT distributions and their correlation in a visual search task that required decision-making, while an interactive eye and hand accumulator model did not. In contrast, in an eye-hand dual task, an interactive model better predicted the observed correlations and RT distributions than a common accumulator model. Notably, these two models could only be distinguished on the basis of the variability and not the means of the predicted RT distributions. Additionally, signatures of separate initiation signals were also observed in a small fraction of trials in the visual search task, implying that these distinct computational architectures were not a manifestation of the task design per se. Taken together, our results suggest two unique computational architectures for eye-hand coordination, with task context biasing the brain toward instantiating one of the two architectures. NEW & NOTEWORTHY Previous studies on eye-hand coordination have considered mainly the means of eye and hand reaction time (RT) distributions. Here, we leverage the approximately linear relationship between the mean and standard deviation of RT distributions, as predicted by the drift-diffusion model, to propose the existence of two distinct computational architectures underlying coordinated eye-hand movements. These architectures, for the first time, provide a computational basis for
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Yancosek, Kathleen E; Mullineaux, David R
2011-01-01
The aim of this study was to quantify stability of nondominant handwriting kinematics and legibility in participants with functional loss of the previously dominant hand. Twelve adult volunteers provided two handwriting samples 6 weeks apart. Handwriting tasks (Compose a Sentence, Copy Alphabet, Copy Date, Copy Sentence, and Draw Circles) were performed in cursive writing on standard white, lined paper taped to a digitizer to record kinematic and kinetic variables of velocity, displacement, force, and on-paper time. Results showed minimal performance variability within subjects and marked variability between subjects, as well as variability between tasks for all participants. Stylistic stability of the handwriting samples was assessed by two independent evaluators. These evaluators matched all handwriting samples at test to retest times with 89%-100% accuracy, suggesting value in the "whole" handwriting sample and emphasizing the idiosyncratic nature of handwriting. Results suggest that handwriting skill stability in the previously nondominant hand varies across subjects and task demands.
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Hand grip strength and dexterity function in children aged 6-12 years: A cross-sectional study.
Omar, Mohammed T A; Alghadir, Ahmad H; Zafar, Hamayun; Al Baker, Shaheerah
Cross-sectional and clinical measurement. Assessment of hand function considers an essential part in clinical practice. To develop normative values of hand grip strength and dexterity function for 6-12-year-old children in Saudi Arabia. Grip strength and dexterity function was measured in 525 children using Grip Track hand dynamometer (JTECH Medical, Midvale, UT, USA) and 9-hole pegboard test respectively. The grip strength and dexterity function was improved as age progressed regardless of gender. Across all age groups, the hand grip strength of boys was significantly higher than girls for dominant hand (31.75 ± 10.33 vs 28.24 ± 9.35; P < .001) and nondominant hand (31.01 ± 10.27 vs 27.27 ± 9.30; P < .001). The girls performed slightly faster than boys for dominant hand (19.70 vs 20.68; P < .05) and nondominant hand (21.79 vs 23.46; P < .05). In general, girls completed a 9-HPT faster than boys in the 2 of 7 age groups: 11 years (9-HPT scores = 2.10 seconds; P < .01) and 12 years (9-HPT scores = 1.93 seconds; P < .01). The overall patterns of hand grip strength and dexterity function observed in the present study are similar to the previous studies that established acceleration of grip strength with advanced age, and faster performance scores in older children than younger children in both genders. Norms of hand grip strength and dexterity enable therapists to identify some developmental characteristics of hand function among Saudi children, determine the presence of impairment, and compare scores from children in different clinical settings. Not applicable. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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Hand1 overexpression inhibits medulloblastoma metastasis.
Asuthkar, Swapna; Guda, Maheedhara R; Martin, Sarah E; Antony, Reuben; Fernandez, Karen; Lin, Julian; Tsung, Andrew J; Velpula, Kiran K
2016-08-19
Medulloblastoma (MB) is the most frequent malignant pediatric brain tumor. Current treatment includes surgery, radiation and chemotherapy. However, ongoing treatment in patients is further classified according to the presence or absence of metastasis. Since metastatic medulloblastoma are refractory to current treatments, there is need to identify novel biomarkers that could be used to reduce metastatic potential, and more importantly be targeted therapeutically. Previously, we showed that ionizing radiation-induced uPAR overexpression is associated with increased accumulation of β-catenin in the nucleus. We further demonstrated that uPAR protein act as cytoplasmic sequestration factor for a novel basic helix-loop-helix transcription factor, Hand1. Among the histological subtypes classical and desmoplastic subtypes account for the majority while large cell/anaplastic variant is most commonly associated with metastatic disease. In this present study using immunohistochemical approach and patient data mining for the first time, we demonstrated that Hand1 expression is observed to be downregulated in all the subtypes of medulloblastoma. Previously we showed that Hand1 overexpression regulated medulloblastoma angiogenesis and here we investigated the role of Hand1 in the context of Epithelial-Mesenchymal Transition (EMT). Moreover, UW228 and D283 cells overexpressing Hand1 demonstrated decreased-expression of mesenchymal markers (N-cadherin, β-catenin and SOX2); metastatic marker (SMA); and increased expression of epithelial marker (E-cadherin). Strikingly, human pluripotent stem cell antibody array showed that Hand1 overexpression resulted in substantial decrease in pluripotency markers (Nanog, Oct3/4, Otx2, Flk1) suggesting that Hand1 expression may be essential to attenuate the EMT and our findings underscore a novel role for Hand1 in medulloblastoma metastasis. Copyright © 2016 Elsevier Inc. All rights reserved.
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Chrapusta, Anna; Kropotov, Juri D; Pąchalska, Maria
2017-06-08
Introduction. There is a lack in the worldwide literature of reports on the Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in patients after bilateral hand amputation The aim of this study was to test a hypothesis regarding developing Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation with the use of Event Related Potentials (ERPs). On the basis of previous research, the amplitudes of P3 ERP components elicited in the cued GO/NOGO tasks have been chosen as candidates for neuromarkers of PTSD. Case study. A 24-year-old patient had undergone bilateral hand amputation 12 months previously. The patient was repeatedly operated on (he had undergone successful bilateral hand replantation) and despite the severity of the injuries, he recovered. However, the patient complained of flashbacks, anxiety and sleep difficulties. Specialist tests showed the presence of PTSD. The patient participated in the cued GO/NOGO task (Kropotov, 2009) with recording 19-channel EEG. P3 GO and NOGO waves in this task were found to be significantly smaller, in comparison to a group of healthy control subjects of the same age (N=23) taken from the HBI normative database (https://www.hbimed.com/). This observed pattern of ERP waves in the patient corresponds to the pattern found in PTSD patients. Conclusions. ERPs in a GO/NOGO task can be used in the assessment of the functional brain changes induced by chronic PTSD.
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Diller, Thomas; Kelly, J William; Blackhurst, Dawn; Steed, Connie; Boeker, Sue; McElveen, Danielle C
2014-06-01
We previously published a formula to estimate the number of hand hygiene opportunities (HHOs) per patient-day using the World Health Organization's "Five Moments for Hand Hygiene" methodology (HOW2 Benchmark Study). HHOs can be used as a denominator for calculating hand hygiene compliance rates when product utilization data are available. This study validates the previously derived HHO estimate using 24-hour video surveillance of health care worker hand hygiene activity. The validation study utilized 24-hour video surveillance recordings of 26 patients' hospital stays to measure the actual number of HHOs per patient-day on a medicine ward in a large teaching hospital. Statistical methods were used to compare these results to those obtained by episodic observation of patient activity in the original derivation study. Total hours of data collection were 81.3 and 1,510.8, resulting in 1,740 and 4,522 HHOs in the derivation and validation studies, respectively. Comparisons of the mean and median HHOs per 24-hour period did not differ significantly. HHOs were 71.6 (95% confidence interval: 64.9-78.3) and 73.9 (95% confidence interval: 69.1-84.1), respectively. This study validates the HOW2 Benchmark Study and confirms that expected numbers of HHOs can be estimated from the unit's patient census and patient-to-nurse ratio. These data can be used as denominators in calculations of hand hygiene compliance rates from electronic monitoring using the "Five Moments for Hand Hygiene" methodology. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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Hand preferences in captive orangutans (Pongo pygmaeus).
O'malley, Robert C; McGrew, W C
2006-07-01
The strength of the evidence for population-level handedness in the great apes is a topic of considerable debate, yet there have been few studies of handedness in orangutans. We conducted a study of manual lateralization in a captive group of eight orangutans (Pongo pygmaeus) ranking the degrees of manual preference according to a defined framework. We analyzed five behavioral patterns: eat (one- and two-handed), make/modify tool, oral tool-use, and manual tool-use. Although some individuals showed significant manual preferences for one or more tasks, at the group-level both one-handed and two-handed eating, oral tool-use, and make/modify tool were ranked at level 1 (unlateralized). Manual tool-use was ranked at level 2, with four subjects demonstrating significant hand preferences, but no group-level bias to the right or left. Four subjects also showed hand specialization to the right or left across several tasks. These results are consistent with most previous studies of manual preference in orangutans. The emergence of manual lateralization in orangutans may relate to more complex manipulative tasks. We hypothesize that more challenging manual tasks elicit stronger hand preferences.
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The study on hand-arm vibration syndrome in China.
Lin, Wang; Chunzhi, Zhang; Qiang, Zhang; Kai, Zhang; Xiaoli, Zeng
2005-07-01
To review the main achievement and problems of study on hand-arm vibration syndrome in China. The epidemiological and clinical study indicate that HAVS was reported from almost provinces in China, the prevalence of VWF ranges from 2.5% to 82.8% in the workers with vibrating tool use. The exposure-response relationship between prevalence of VWF and intensity and duration of exposed to hand-transmitted vibration has confirmed. Diagnostic criteria of HAVS has been established and performed by Chinese government in 1985, and it was revised by government as a national standard for occupational health in 2002. The "hygienic standard for hand-transmitted vibration in workplace" as a national standard and the "methods of measurement and assessment for hand-transmitted vibration" as a recommend standard were published by government also. The limited value of exposed to hand-arm vibration was 5.0 m/s2 that is energy equivalent frequency-weighted acceleration for a period of 4 h (ahw(4)). There are some problems in this field of China need to further study in the future.
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Hand surface area estimation formula using 3D anthropometry.
Hsu, Yao-Wen; Yu, Chi-Yuang
2010-11-01
Hand surface area is an important reference in occupational hygiene and many other applications. This study derives a formula for the palm surface area (PSA) and hand surface area (HSA) based on three-dimensional (3D) scan data. Two-hundred and seventy subjects, 135 males and 135 females, were recruited for this study. The hand was measured using a high-resolution 3D hand scanner. Precision and accuracy of the scanner is within 0.67%. Both the PSA and HSA were computed using the triangular mesh summation method. A comparison between this study and previous textbook values (such as in the U.K. teaching text and Lund and Browder chart discussed in the article) was performed first to show that previous textbooks overestimated the PSA by 12.0% and HSA by 8.7% (for the male, PSA 8.5% and HSA 4.7%, and for the female, PSA 16.2% and HSA 13.4%). Six 1D measurements were then extracted semiautomatically for use as candidate estimators for the PSA and HSA estimation formula. Stepwise regressions on these six 1D measurements and variable dependency test were performed. Results show that a pair of measurements (hand length and hand breadth) were able to account for 96% of the HSA variance and up to 98% of the PSA variance. A test of the gender-specific formula indicated that gender is not a significant factor in either the PSA or HSA estimation.
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Tamaru, Yoshiki; Naito, Yasuo; Nishikawa, Takashi
2017-11-01
Elderly people are less able to manipulate objects skilfully than young adults. Although previous studies have examined age-related deterioration of hand movements with a focus on the phase after grasping objects, the changes in the reaching phase have not been studied thus far. We aimed to examine whether changes in hand shape patterns during the reaching phase of grasping movements differ between young adults and the elderly. Ten healthy elderly adults and 10 healthy young adults were examined using the Simple Test for Evaluating Hand Functions and kinetic analysis of hand pre-shaping reach-to-grasp tasks. The results were then compared between the two groups. For kinetic analysis, we measured the time of peak tangential velocity of the wrist and the inter-fingertip distance (the distance between the tips of the thumb and index finger) at different time points. The results showed that the elderly group's performance on the Simple Test for Evaluating Hand Functions was significantly lower than that of the young adult group, irrespective of whether the dominant or non-dominant hand was used, indicating deterioration of hand movement in the elderly. The peak tangential velocity of the wrist in either hand appeared significantly earlier in the elderly group than in the young adult group. The elderly group also showed larger inter-fingertip distances with arch-like fingertip trajectories compared to the young adult group for all object sizes. To perform accurate prehension, elderly people have an earlier peak tangential velocity point than young adults. This allows for a longer adjustment time for reaching and grasping movements and for reducing errors in object prehension by opening the hand and fingers wider. Elderly individuals gradually modify their strategy based on previous successes and failures during daily living to compensate for their decline in dexterity and operational capabilities. © 2017 Japanese Psychogeriatric Society.
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Gracco, Antonio; Bruno, Giovanni; De Stefani, Alberto; Siviero, Laura; Perri, Alessandro; Stellini, Edoardo
Recently a classification of patient's skeletal age based on the phalanx maturation, The Middle Phalanx Maturation of the third finger (MPM) method, was suggested. The aim of this study is to evaluate if there is a difference in MPM between the right and left hand. Two hundred fifty-four patients were obtained from the Complex Operating Unit of Orthodontics of Padua University Hospital. The total sample size has been selected by appropriate statistical calculations resulting in 130 patients. It was decided to further double the sample size of a previous study to ensure a robust statistical analysis. Radiographs of the right and left were obtained using the MPM method. Stages were compared using the right hand as a reference. The statistical analysis (Fisher exact test) was performed for the entire sample and related to gender in order to compare the right and the left hand stages. In MPS2, 6 out 49 (12.2%) males and 7 out 27 females (25.9%) showed MPS3 in the left hand (p-value < 0.05). In all other stages, a total agreement (100%) was found. The authors confirm the use of the right hand as reference. In patients with MPS2 an additional radiograph on the left hand can be taken in order to increase the diagnostic accuracy. In all other stages other radiographs are not needed as a total agreement between the right and left hand was found.
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Negative stimulus-response compatibility observed with a briefly displayed image of a hand.
Vainio, Lari
2011-12-01
Manual responses can be primed by viewing an image of a hand. The left-right identity of the viewed hand reflexively facilitates responses of the hand that corresponds to the identity. Previous research also suggests that when the response activation is triggered by an arrow, which is backward-masked and presented briefly, the activation manifests itself in the negative priming effect. The present study showed that response activation, which is produced by an identity of a briefly presented image of a hand, can be similarly associated with a negative priming effect. However, in contrast to the previously reported negative priming effects, the hand stimuli produced negative priming even when the hand was not backward-masked and did not contain task-relevant information. The study supports the view that the automatic inhibition of motor activation triggered by briefly viewed objects is a general and basic functional principle in exogenous motor control processes. Copyright © 2011 Elsevier Inc. All rights reserved.
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López Martín, M Beatriz; Erice Calvo-Sotelo, Alejo
To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
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Kinematic and kinetic differences between left-and right-handed professional baseball pitchers.
Diffendaffer, Alek Z; Fleisig, Glenn S; Ivey, Brett; Aune, Kyle T
2018-03-21
While 10% of the general population is left-handed, 27% of professional baseball pitchers are left-handed. Biomechanical differences between left- and right-handed college pitchers have been previously reported, but these differences have yet to be examined at the professional level. Therefore, the purpose of this study was to compare pitching biomechanics between left- and right-handed professional pitchers. It was hypothesised that there would be significant kinematic and kinetic differences between these two groups. Pitching biomechanics were collected on 96 left-handed pitchers and a group of 96 right-handed pitchers matched for age, height, mass and ball velocity. Student t-tests were used to identify kinematic and kinetic differences (p < 0.05). Of the 31 variables tested, only four were found to be significantly different between the groups. Landing position of the stride foot, trunk separation at foot contact, maximum shoulder external rotation and trunk forward tilt at ball release were all significantly greater in right-handed pitchers. The magnitude of the statistical differences found were small and not consistent with differences in the two previous, smaller studies. Thus, the differences found may be of minimal practical significance and mechanics can be taught the same to all pitchers, regardless of throwing hand.
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Takenaga, Tetsuya; Goto, Hideyuki; Sugimoto, Katsumasa; Tsuchiya, Atsushi; Fukuyoshi, Masaki; Nakagawa, Hiroki; Nozaki, Masahiro; Takeuchi, Satoshi; Otsuka, Takanobu
2017-12-01
It is known that the humeral retroversion of baseball players is greater in the throwing arm than in the nonthrowing arm. An investigation measuring dry bone specimens also showed that the right humerus had greater retroversion than the left. Considering these facts, it was hypothesized that humeral retroversion would differ between right- and left-handed players. This study aimed to compare the bilateral humeral retroversion between right- and left-handed skeletally mature baseball players. We investigated 260 (196 right-handed and 64 left-handed) male baseball players who belonged to a college or amateur team. Bilateral humeral retroversion was assessed using an ultrasound-assisted technique (humeral torsion angle [HTA]) as described by previous studies. Analysis of covariance, adjusted for handedness and baseball position, assessed the effect of throwing arm dominance on HTA. In comparison of the throwing arm, HTA was significantly smaller in left-handed (left humerus) than in right-handed (right humerus) players (77° vs. 81°; P < .001). In comparison of the nonthrowing arm, HTA was significantly greater in left-handed (right humerus) than in right-handed (left humerus) players (73° vs. 69°; P < .001). The mean side-to-side difference of HTA was significantly smaller in left-handed than in right-handed players (3° vs. 12°; P < .001). Humeral retroversion of left-handed skeletally mature baseball players was significantly smaller in the throwing arm, greater in the nonthrowing arm, and smaller in side-to-side differences than that of right-handed players. These findings may be key to understanding some of the biomechanical differences between right- and left-handed baseball players. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
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Systematic review of cost-of-illness studies in hand eczema.
Politiek, Klaziena; Oosterhaven, Jart A F; Vermeulen, Karin M; Schuttelaar, Marie-Louise A
2016-08-01
The individual burden of disease in hand eczema patients is considerable. However, little is known about the socio-economic impact of this disease. The aims of this review were to evaluate the literature on cost-of-illness in hand eczema, and to compose a checklist for future use. The literature was retrieved from the MEDLINE and EMBASE databases up to October 2015. Quality evaluation was based on seven relevant items in cost-of-illness studies. Cost data (direct and indirect) were extracted and converted into euros (2014 price level) by use of the Dutch Consumer Price Index. Six articles were included. The mean annual total cost per patient ranged from €1311 [corrected] to €9792 (direct cost per patient, €521 to €3722; [corrected] and indirect cost per patient, €100 to €6846). Occupational hand eczema patients showed indirect costs up to 70% of total costs, mainly because of absenteeism. A large diversity in hand eczema severity was found between studies. The socio-economic burden of hand eczema is considerable, especially for more severe and/or occupational hand eczema. Absenteeism from paid work leads to a high total cost-of-illness, although disregard of presenteeism often leads to underestimation of indirect costs. Differences in included cost components, the occupational status of patients and hand eczema severity make international comparison difficult. A checklist was added to standardize the approach to cost-of-illness studies in hand eczema. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Case-Cohort Studies: Design and Applicability to Hand Surgery.
Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J
2018-04-24
Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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Hand specific representations in language comprehension.
Moody-Triantis, Claire; Humphreys, Gina F; Gennari, Silvia P
2014-01-01
Theories of embodied cognition argue that language comprehension involves sensory-motor re-enactments of the actions described. However, the degree of specificity of these re-enactments as well as the relationship between action and language remains a matter of debate. Here we investigate these issues by examining how hand-specific information (left or right hand) is recruited in language comprehension and action execution. An fMRI study tested self-reported right-handed participants in two separate tasks that were designed to be as similar as possible to increase sensitivity of the comparison across task: an action execution go/no-go task where participants performed right or left hand actions, and a language task where participants read sentences describing the same left or right handed actions as in the execution task. We found that language-induced activity did not match the hand-specific patterns of activity found for action execution in primary somatosensory and motor cortex, but it overlapped with pre-motor and parietal regions associated with action planning. Within these pre-motor regions, both right hand actions and sentences elicited stronger activity than left hand actions and sentences-a dominant hand effect. Importantly, both dorsal and ventral sections of the left pre-central gyrus were recruited by both tasks, suggesting different action features being recruited. These results suggest that (a) language comprehension elicits motor representations that are hand-specific and akin to multimodal action plans, rather than full action re-enactments; and (b) language comprehension and action execution share schematic hand-specific representations that are richer for the dominant hand, and thus linked to previous motor experience.
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Mentor's hand hygiene practices influence student's hand hygiene rates.
Snow, Michelle; White, George L; Alder, Stephen C; Stanford, Joseph B
2006-02-01
There were 3 objectives for this prospective quasiexperimental study. The first was to determine the effect of mentor's hand hygiene practices on student's hand hygiene rates during clinical rotations. The second was to assess the difference in hand hygiene rates for students with and without prior medical experience. The third was to assess the student's opinion and beliefs regarding hand hygiene. Sixty students enrolled in a certified nursing program were selected to participate in the study. Each study group was observed twice during the 30-day span. The first observational period was conducted on day 1 of clinical rotation. The second observational period was conducted on day 30 of clinical rotation. Students were observed for hand hygiene. Also assessed were medical experience, sex, gloving, age, and mentor's hand hygiene practices. After observational period 2, a brief questionnaire was given to students to determine their opinion and beliefs regarding hand hygiene. The questionnaire was divided into 5 sections: student's commitment to hand hygiene, their perception of hand hygiene inconvenience, the necessity of hand hygiene, the student's ability to perform hand hygiene, and their opinion on the frequency of medical staff's hand hygiene. The mentor's practice of hand hygiene was the strongest predictor of the student's rate of hand hygiene for both observational periods (P < .01). Furthermore, students without prior medical experience had a significant increase in hand hygiene rates when comparing observational period 1 to observational period 2 (P < .01). Glove usage was associated with increased hand hygiene rates by 50% during observational period 1 (P = .01) and 44% during observational period 2 (P < .01). Male students during observational period 1 practiced hand hygiene 30% less often than female students (P < .01); however, during observational period 2, there was no significant difference between hand hygiene rates for males and females (P = .82
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Jongsma, Marijtje L A; Meulenbroek, Ruud G J; Okely, Judith; Baas, C Marjolein; van der Lubbe, Rob H J; Steenbergen, Bert
2013-01-01
Motor imagery (MI) refers to the process of imagining the execution of a specific motor action without actually producing an overt movement. Two forms of MI have been distinguished: visual MI and kinesthetic MI. To distinguish between these forms of MI we employed an event related potential (ERP) study to measure interference effects induced by hand orientation manipulations in a hand laterality judgement task. We hypothesized that this manipulation should only affect kinesthetic MI but not visual MI. The ERPs elicited by rotated hand stimuli contained the classic rotation related negativity (RRN) with respect to palm view stimuli. We observed that laterally rotated stimuli led to a more marked RRN than medially rotated stimuli. This RRN effect was observed when participants had their hands positioned in either a straight (control) or an inward rotated posture, but not when their hands were positioned in an outward rotated posture. Posture effects on the ERP-RRN have not previously been studied. Apparently, a congruent hand posture (hands positioned in an outward rotated fashion) facilitates the judgement of the otherwise more demanding laterally rotated hand stimuli. These ERP findings support a kinesthetic interpretation of MI involved in solving the hand laterality judgement task. The RRN may be used as a non-invasive marker for kinesthetic MI and seems useful in revealing the covert behavior of MI in e.g. rehabilitation programs.
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Pardini, Matteo; Samson, Rebecca S.; D'Angelo, Egidio; Friston, Karl J.; Toosy, Ahmed T.; Gandini Wheeler‐Kingshott, Claudia A.M.
2015-01-01
Abstract Motor fMRI studies, comparing dominant (DH) and nondominant (NDH) hand activations have reported mixed findings, especially for the extent of ipsilateral (IL) activations and their relationship with task complexity. To date, no study has directly compared DH and NDH activations using an event‐related visually guided dynamic power‐grip paradigm with parametric (three) forces (GF) in healthy right‐handed subjects. We implemented a hierarchical statistical approach aimed to: (i) identify the main effect networks engaged when using either hand; (ii) characterise DH/NDH responses at different GFs; (iii) assess contralateral (CL)/IL‐specific and hemisphere‐specific activations. Beyond confirming previously reported results, this study demonstrated that increasing GF has an effect on motor response that is contextualised also by the use of DH or NDH. Linear analysis revealed increased activations in sensorimotor areas, with additional increased recruitments of subcortical and cerebellar areas when using the NDH. When looking at CL/IL‐specific activations, CL sensorimotor areas and IL cerebellum were activated with both hands. When performing the task with the NDH, several areas were also recruited including the CL cerebellum. Finally, there were hand‐side‐independent activations of nonmotor‐specific areas in the right and left hemispheres, with the right hemisphere being involved more extensively in sensori‐motor integration through associative areas while the left hemisphere showing greater activation at higher GF. This study shows that the functional networks subtending DH/NDH power‐grip visuomotor functions are qualitatively and quantitatively distinct and this should be taken into consideration when performing fMRI studies, particularly when planning interventions in patients with specific impairments. Hum Brain Mapp 36:5079–5100, 2015. © 2015 Wiley Periodicals, Inc. PMID:26415818
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Xu, Bing; Wang, Huang-Lei; Xiong, Dan; Sheng, Li-Pin; Yang, Qi-Sheng; Jiang, Shan; Xu, Peng; Chen, Zhi-Qiao; Zhao, Yan
2015-01-01
Previous studies have shown improved external chest compression (ECC) quality and delayed rescuer fatigue when the dominant hand (DH) was in contact with the sternum. However, many rescuers prefer placing the non-dominant hand (NH) in contact with the sternum during ECC. We aimed to investigate the effects of up-down hand position switch on the quality of ECC and the fatigue of rescuers during cardiopulmonary resuscitation (CPR). After completion of a review of the standard adult basic life support (BLS) course, every candidate performed 10 cycles of single adult CPR twice on an adult manikin with either a constant hand position (CH) or a switched hand position (SH) in random order at 7-day intervals. The rescuers’ general characteristics, hand positions, physiological signs, fatigue appearance and ECC qualities were recorded. Our results showed no significant differences in chest compression quality for the DH position rescuers between the CH and SH sessions (p>0.05, resp.). And also no significant differences were found for Borg score (p = 0.437) or cycle number (p = 0.127) of fatigue appearance after chest compressions between the two sessions. However, for NH position rescuers, the appearance of fatigue was delayed (p = 0.046), with a lower Borg score in the SH session (12.67 ± 2.03) compared to the CH session (13.33 ± 1.95) (p = 0.011). Moreover, the compression depth was significantly greater in the SH session (39.3 ± 7.2 mm) compared to the CH session (36.3 ± 8.1 mm) (p = 0.015). Our data suggest that the up-down hand position switch during CPR may delay the fatigue of non-dominant hand position rescuers and improve the quality of chest compressions. PMID:26267353
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Life-style factors and hand eczema.
Anveden Berglind, I; Alderling, M; Meding, B
2011-09-01
Previous knowledge of the impact of certain life-style factors on hand eczema is scanty. To investigate a possible association between hand eczema and life-style factors such as obesity, physical exercise, stress, smoking and alcohol consumption. In a cross-sectional public health survey in Stockholm, Sweden, 27,994 (58%) randomly chosen individuals aged 18-64 years completed a postal questionnaire regarding physical and mental health, social relations, economic status and work. Of these, 27,793 individuals responded to the question regarding hand eczema and were included in the present study. The association between life-style factors and hand eczema was analysed by prevalence proportion ratios (PPR), using a generalized linear model. Hand eczema was more common among individuals who reported high stress levels, PPR 1·326 (95% CI 1·303-1·350). There was also a positive dose-response relationship between hand eczema and stress. Hand eczema was less common among individuals reporting high physical exercise, and most apparent in women, PPR 0·781 (95% CI 0·770-0·792). Men who reported high alcohol intake reported hand eczema less often, PPR 0·958 (95% CI 0·930-0·987). Obese individuals reported hand eczema more commonly, PPR 1·204 (95% CI 1·174-1·234). There was a slight increase of hand eczema among smokers, PPR 1·025 (95% CI 1·006-1·044). Hand eczema was more common in individuals who reported stress, obesity and smoking. In individuals who reported high physical exercise levels hand eczema was less common. As there appears to be an association between life-style factors and hand eczema it is important to consider life-style factors in clinical practice. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.
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NASA Astrophysics Data System (ADS)
Ohn-Bar, Eshed; Martin, Sujitha; Trivedi, Mohan Manubhai
2013-10-01
We focus on vision-based hand activity analysis in the vehicular domain. The study is motivated by the overarching goal of understanding driver behavior, in particular as it relates to attentiveness and risk. First, the unique advantages and challenges for a nonintrusive, vision-based solution are reviewed. Next, two approaches for hand activity analysis, one relying on static (appearance only) cues and another on dynamic (motion) cues, are compared. The motion-cue-based hand detection uses temporally accumulated edges in order to maintain the most reliable and relevant motion information. The accumulated image is fitted with ellipses in order to produce the location of the hands. The method is used to identify three hand activity classes: (1) two hands on the wheel, (2) hand on the instrument panel, (3) hand on the gear shift. The static-cue-based method extracts features in each frame in order to learn a hand presence model for each of the three regions. A second-stage classifier (linear support vector machine) produces the final activity classification. Experimental evaluation with different users and environmental variations under real-world driving shows the promise of applying the proposed systems for both postanalysis of captured driving data as well as for real-time driver assistance.
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Impaired hand size estimation in CRPS.
Peltz, Elena; Seifert, Frank; Lanz, Stefan; Müller, Rüdiger; Maihöfner, Christian
2011-10-01
A triad of clinical symptoms, ie, autonomic, motor and sensory dysfunctions, characterizes complex regional pain syndromes (CRPS). Sensory dysfunction comprises sensory loss or spontaneous and stimulus-evoked pain. Furthermore, a disturbance in the body schema may occur. In the present study, patients with CRPS of the upper extremity and healthy controls estimated their hand sizes on the basis of expanded or compressed schematic drawings of hands. In patients with CRPS we found an impairment in accurate hand size estimation; patients estimated their own CRPS-affected hand to be larger than it actually was when measured objectively. Moreover, overestimation correlated significantly with disease duration, neglect score, and increase of two-point-discrimination-thresholds (TPDT) compared to the unaffected hand and to control subjects' estimations. In line with previous functional imaging studies in CRPS patients demonstrating changes in central somatotopic maps, we suggest an involvement of the central nervous system in this disruption of the body schema. Potential cortical areas may be the primary somatosensory and posterior parietal cortices, which have been proposed to play a critical role in integrating visuospatial information. CRPS patients perceive their affected hand to be bigger than it is. The magnitude of this overestimation correlates with disease duration, decreased tactile thresholds, and neglect-score. Suggesting a disrupted body schema as the source of this impairment, our findings corroborate the current assumption of a CNS involvement in CRPS. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
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Acoustothermometric study of the human hand under hyperthrmia and hypothermia
NASA Astrophysics Data System (ADS)
Anosov, A. A.; Belyaev, R. V.; Vilkov, V. A.; Dvornikova, M. V.; Dvornikova, V. V.; Kazanskii, A. S.; Kuryatnikova, N. A.; Mansfel'd, A. D.
2013-01-01
The results of an acoustothermometric study of the human hand under local hyperthermia and hypothermia are presented. Individuals under testing plunged their hands in hot or cold water for several minutes. Thermal acoustic radiation was detected by two sensors placed near the palm and near the backside of the tested hand. The internal temperature profiles of the hand were reconstructed. The indirect estimate of the reconstruction error was 0.6°C, which is acceptable for medical applications. Hyperthermia was achieved by placing the hand in water with a maximal temperature of 44°C for 2 min. In this case, the internal temperature was 35.4 ± 0.6°C. Hypothermia was achieved by placing the hand in water with a temperature of 17.8°C for 15 min. In this case, the internal temperature decreased from 26 to 24°C. The use of a four-sensor planar receiving array allowed dynamic mapping of the acoustic brightness temperature of the hand.
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Gløersen, Marthe; Mulrooney, Elisabeth; Hammer, Hilde Berner; Slatkowsky-Christensen, Barbara; Faraj, Karwan; Isaksen, Thore; Neogi, Tuhina; Kvien, Tore K; Magnusson, Karin; Haugen, Ida Kristin
2017-01-01
Introduction We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms. Methods and analysis The Nor-Hand study is a hospital-based observational study including 300 patients with evidence of hand OA by ultrasound and/or clinical examination. The baseline examination consists of functional tests and joint assessment of the hands, medical assessment, pain sensitisation tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet), CT and MRI of the dominant hand, conventional radiographs of the hands and feet, fluorescence optical imaging of the hands, collection of blood and urine samples as well as self-reported demographic factors and OA-related questionnaires. Two follow-up examinations are planned. Cross-sectional analyses will be used to investigate agreements and associations between different relevant measures at the baseline examination, whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes. Ethics and dissemination The protocol is approved by the Norwegian Regional Committee for Medical and Health Research Ethics (Ref. no: 2014/2057). The participants receive oral and written information about the project and sign a consent form before participation. They can, whenever they want, withdraw from the study, and all de-identified data will be safely stored on the research server at Diakonhjemmet Hospital. Results will be presented at international and national congresses and in peer-reviewed rheumatology journals. Trial registration number NCT03083548; Pre
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Proprioceptive recalibration in the right and left hands following abrupt visuomotor adaptation.
Salomonczyk, Danielle; Henriques, Denise Y P; Cressman, Erin K
2012-03-01
Previous studies have demonstrated that after reaching with misaligned visual feedback of the hand, one adapts his or her reaches and partially recalibrates proprioception, such that sense of felt hand position is shifted to match the seen hand position. However, to date, this has only been demonstrated in the right (dominant) hand following reach training with a visuomotor distortion in which the rotated cursor distortion was introduced gradually. As reach adaptation has been shown to differ depending on how the distortion is introduced (gradual vs. abrupt), we sought to examine proprioceptive recalibration following reach training with a cursor that was abruptly rotated 30° clockwise relative to hand motion. Furthermore, because the left and right arms have demonstrated selective advantages when matching visual and proprioceptive targets, respectively, we assessed proprioceptive recalibration in right-handed subjects following training with either the right or the left hand. On average, we observed shifts in felt hand position of approximately 7.6° following training with misaligned visual feedback of the hand, which is consistent with our previous findings in which the distortion was introduced gradually. Moreover, no difference was observed in proprioceptive recalibration across the left and right hands. These findings suggest that proprioceptive recalibration is a robust process that arises symmetrically in the two hands following visuomotor adaptation regardless of the initial magnitude of the error signal.
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The Performance of Left-Handed Participants on a Preferential Reaching Test
ERIC Educational Resources Information Center
Mamolo, Carla M.; Roy, Eric A.; Bryden, Pamela J.; Rohr, Linda E.
2005-01-01
Previous research in our laboratory has examined the distribution of preferred hand (PH) reaches in working space with right-handed participants. In one study, we examined the effects of tool position and task demands on the frequency of PH reaches with right-handers (Mamolo, Roy, Bryden, & Rohr, 2004). We found that PH reaches were at a maximum…
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An elicitation study of critical care nurses' salient hand hygiene beliefs.
Piras, Susan E; Lauderdale, Jana; Minnick, Ann
2017-10-01
To describe critical care nurses' hand hygiene attitudinal, normative referent, and control beliefs. Hand hygiene is the primary strategy to prevent healthcare-associated infections. Social influence is an underdeveloped hand hygiene strategy. This qualitative descriptive study was conducted with 25 ICU nurses in the southeastern United States. Data were collected using the Nurses' Salient Belief Instrument. Thematic analysis generated four themes: Hand Hygiene is Protective; Nurses look to Nurses; Time-related Concerns; and Convenience is Essential. Nurses look to nurses as hand hygiene referents and believe hand hygiene is a protective behaviour that requires time and functional equipment. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Nakano, Mitsuko; Tanaka, Shigeki; Izuno, Kenji; Ichihara, Shigeru
2012-01-01
An experimental study was conducted with a young woman who had suddenly developed mirror writing in the right hand, which she used for writing. She was not cured for eight years. The patient was ambidextrous and had no medical complaints except for migraine with perceptual and sensory abnormalities, and an enlarged cavity of the septum pellucidum. A previous study using functional magnetic resonance imaging (fMRI), conducted when she imagined letters and wrote letters in the air with either hand, indicated that both her cerebral hemispheres were active. In the present study three experiments were conducted using a tachistoscope to explore the stage in the cognitive process when directional errors emerged. In the experiments, after independently being presented with Attneave's meaningless figures or letters to each hemisphere, participants were requested to do the following: (a) verbally respond whether the orientation of two consecutively shown figures were the same or different and the letters were standard or reversed; (b) distinguish the orientations with right and left hand movements other than by writing (by pushing a button); and (c) reproduce the stimuli (drawing) immediately after the presentation. Results showed a higher rate of incorrect directions only when drawings were reproduced by the right hand. Results also indicated that the woman's inaccurate judgment in direction emerged only when in writing and not at the perceptual level, or when responding with hand movements other than writing. Her migraine was cured after five years following the experiment. The mirror writing was cured 2-3 months later.
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Lysdal, Susan Hovmand; Søsted, Heidi; Andersen, Klaus Ejner; Johansen, Jeanne Duus
2011-09-01
Occupational hand eczema is common in hairdressers, owing to wet work and hairdressing chemicals. To estimate the prevalence of hand eczema and its career consequences among hairdressers in Denmark. A register-based study was conducted, comprising all graduates from hairdressing vocational schools from 1985 to 2007 (n = 7840). The participants received a self-administered postal questionnaire including questions on hand eczema, atopic dermatitis, and career change. A response rate of 67.9% (n = 5324) was obtained. Of the respondents, 44.3% no longer worked as hairdressers and had worked for an average of 8.4 years in the profession before leaving it. Hand eczema was more common among ex-hairdressers (48.4%) than among current hairdressers (37.6%) (p < 0.0001), and significantly more ex-hairdressers (26.8%) than current hairdressers (15.7%) had chronic hand eczema (p < 0.0001). Of the respondents with hand eczema, 75% were aged 15-24 years at onset, and 45.5% gave hand eczema as a reason for career change. In this group, logistic regression analysis showed that chronic hand eczema contributed the most to the decision to change career (odds ratio 50.12; 95% confidence interval 18.3-137). Hairdressers work an average of 8.4 years in the profession before leaving it, and hand eczema contributes significantly to this career change. © 2011 John Wiley & Sons A/S.
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[Epidemiological study of traumatic hand injuries in Toluca, State of Mexico].
Osnaya-Moreno, Humberto; Romero-Espinosa, Jesús Fernando; Mondragón-Chimal, Marco Antonio; Ochoa-González, Gabriel; Escoto-Gómez, Jorge Armando
2014-01-01
Traumatic hand injuries are among the principal types of injuries. These injuries refer to any acute damage caused to the hand by an external agent. The aim of this study was to determine the characteristics of these injuries in our unit. To determine the characteristics of hand injuries at the Plastic and Reconstructive Surgery of the Centro Médico "Licenciado Adolfo López Mateos" (CMLALM) and compare the results with those reported in other countriesMethods: Retrospective study of patients diagnosed with traumatic hand injury treated at the Plastic and Reconstructive Surgery service at CMLALM during the period from September 6, 2010 to September 5, 2011. One hundred five cases were treated. There was a predominance of males (82.9%). The most affected group was 20-29 years old (44.8%). The right hand was the most injured (46.7%). The most common mechanism of injury was due to abrasion (41%) followed by sharp objects (32.4%). The dominant hand was the most damaged (50.47%). The most common injuries were open type (88.6%) and single type (84.8%). Hand injuries were more common in men and were occupationally related; therefore, occupational safety programs must be improved. The characteristics of traumatic hand injuries in our unit were very similar to those seen worldwide.
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Referral of sensation to an advanced humanoid robotic hand prosthesis.
Rosén, Birgitta; Ehrsson, H Henrik; Antfolk, Christian; Cipriani, Christian; Sebelius, Fredrik; Lundborg, Göran
2009-01-01
Hand prostheses that are currently available on the market are used by amputees to only a limited extent, partly because of lack of sensory feedback from the artificial hand. We report a pilot study that showed how amputees can experience a robot-like advanced hand prosthesis as part of their own body. We induced a perceptual illusion by which touch applied to the stump of the arm was experienced from the artificial hand. This illusion was elicited by applying synchronous tactile stimulation to the hidden amputation stump and the robotic hand prosthesis in full view. In five people who had had upper limb amputations this stimulation caused referral touch sensation from the stump to the artificial hand, and the prosthesis was experienced more like a real hand. We also showed that this illusion can work when the amputee controls the movements of the artificial hand by recordings of the arm muscle activity with electromyograms. These observations indicate that the previously described "rubber hand illusion" is also valid for an advanced hand prosthesis, even when it has a robotic-like appearance.
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Gløersen, Marthe; Mulrooney, Elisabeth; Mathiessen, Alexander; Hammer, Hilde Berner; Slatkowsky-Christensen, Barbara; Faraj, Karwan; Isaksen, Thore; Neogi, Tuhina; Kvien, Tore K; Magnusson, Karin; Haugen, Ida Kristin
2017-09-24
We have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms. The Nor-Hand study is a hospital-based observational study including 300 patients with evidence of hand OA by ultrasound and/or clinical examination. The baseline examination consists of functional tests and joint assessment of the hands, medical assessment, pain sensitisation tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet), CT and MRI of the dominant hand, conventional radiographs of the hands and feet, fluorescence optical imaging of the hands, collection of blood and urine samples as well as self-reported demographic factors and OA-related questionnaires. Two follow-up examinations are planned. Cross-sectional analyses will be used to investigate agreements and associations between different relevant measures at the baseline examination, whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes. The protocol is approved by the Norwegian Regional Committee for Medical and Health Research Ethics (Ref. no: 2014/2057). The participants receive oral and written information about the project and sign a consent form before participation. They can, whenever they want, withdraw from the study, and all de-identified data will be safely stored on the research server at Diakonhjemmet Hospital. Results will be presented at international and national congresses and in peer-reviewed rheumatology journals. NCT03083548; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the
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Custom-made silicone hand prosthesis: A case study.
Nayak, S; Lenka, P K; Equebal, A; Biswas, A
2016-09-01
Up to now, a cosmetic glove was the most common method for managing transmetacarpal (TMC) and carpometacarpal (CMC) amputations, but it is devoid of markings and body color. At this amputation level, it is very difficult to fit a functional prosthesis because of the short available length, unsightly shape, grafted skin, contracture and lack of functional prosthetic options. A 30-year-old male came to our clinic with amputation at the 1st to 4th carpometacarpal level and a 5th metacarpal that was projected laterally and fused with the carpal bone. The stump had grafted skin, redness, and an unhealed suture line. He complained of pain projected over the metacarpal and suture area. The clinical team members decided to fabricate a custom-made silicone hand prosthesis to accommodate the stump, protect the grafted skin, improve the hand's appearance and provide some passive function. The custom silicone hand prosthesis was fabricated with modified flexible wires to provide passive interphalangeal movement. Basic training, care and maintenance instructions for the prosthesis were given to the patient. The silicone hand prosthesis was able to restore the appearance of the lost digits and provide some passive function. His pain (VAS score) was reduced. Improvement in activities of daily living was found in the DASH questionnaire and Jebsen-Taylor Hand Function test. A silicone glove is a good option for more distal amputations, as it can accommodate any deformity, protect the skin, enhance the appearance and provide functional assistance. This case study provides a simple method to get passively movable fingers after proximal hand amputation. Copyright © 2016. Published by Elsevier Masson SAS.
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... study, only 58% of female and 48% of male middle- and high-school students washed their hands after using the bathroom. Yuck! How to Wash Your Hands Correctly There's a right way to wash your hands. Follow these simple ...
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Adiposity and hand osteoarthritis: the Netherlands Epidemiology of Obesity study
2014-01-01
Introduction Obesity, usually characterized by the body mass index (BMI), is a risk factor for hand osteoarthritis (OA). We investigated whether adipose tissue and abdominal fat distribution are associated with hand OA. Methods The Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort aged 45 to 65 years, including 5315 participants (53% women, median BMI 29.9 kg/m2). Fat percentage and fat mass (FM) (kg) were estimated using bioelectrical impedance analysis. The waist-to-hip ratio (WHR) was calculated. In 1721 participants, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (cm2) were assessed using abdominal MR imaging. Hand OA was defined according to the ACR criteria. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association of fat percentage, FM, WHR, VAT and SAT with hand OA using logistic regression analyses per standard deviation, stratified by sex and adjusted for age. Results Hand OA was present in 8% of men and 20% of women. Fat percentage was associated with hand OA in men (OR 1.34 (95% CI 1.11 to 1.61)) and women (OR 1.26 (1.05 to 1.51)), as was FM. WHR was associated with hand OA in men (OR 1.45 (1.13 to 1.85)), and to a lesser extent in women (OR 1.17 (1.00 to 1.36)). Subgroup analysis revealed that VAT was associated with hand OA in men (OR1.33 (1.01 to 1.75)). This association increased after additional adjustment for FM (OR 1.51 (1.13 to 2.03)). Conclusions Fat percentage, FM and WHR were associated with hand OA. VAT was associated with hand OA in men, suggesting involvement of visceral fat in hand OA. PMID:24447395
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Erichsen Andersson, Annette; Frödin, Maria; Dellenborg, Lisen; Wallin, Lars; Hök, Jesper; Gillespie, Brigid M; Wikström, Ewa
2018-01-04
Hand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room. The study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach. Doubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in "safe spaces" worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene. Enabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136 ). Date of registration 2016/11/28, retrospectively registered.
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Miranda, B H; Spilsbury, Z P; Rosala-Hallas, A; Cerovac, S
2016-10-01
Hand injuries are common, contributing up to 30% of accident and emergency (A&E) attendances. The aim of this study was to prospectively analyse the pathological demographics of hand injuries in a level 1 trauma centre with a Hand Trauma Unit and direct A&E links, and compare clinical and intra-operative findings. The null hypothesis was that there would be no differences between clinical and intra-operative findings (100% diagnostic concordance). Data were prospectively collected for referrals during 2012. Referral diagnosis, additional pathologies found on clinical assessment and intra-operative findings were documented on a live database accessible from both the Hand Unit and associated operating theatres. Odds ratios were calculated using SAS. Injuries (1526) were identified in 1308 patients included in the study. Diagnostic concordance between Hand Unit clinical examination and intra-operative findings was 92.5% ± 2.85% (mean ± SEM); this was lower for flexor tendon injuries (56.3%) because a greater number of additional pathologies were found intra-operatively (2.25 ± 0.10). This 'trend' was noted across multiple referral pathologies including phalangeal fractures (1.28 ± 0.02; 82.9%), lacerations (1.33 ± 0.04; 79.1%), extensor tendon injuries (1.30 ± 0.05; 87.8%) and dislocations (1.18 ± 0.05; 87.8%). Odds ratio analysis indicated a relationship between primary referral diagnoses that were more or less likely to be associated with additional injuries (p < 0.05); referral diagnoses of flexor tendon injuries and lacerations were most likely to be associated with additional injuries. As hand injuries are a common presentation to A&E departments, greater emphasis should be placed on training clinicians in the management of hand trauma. Our findings, coupled with the presented relevant literature reports, lead us to advocate that A&E departments should move towards a system wherein links to specialist hand trauma services are in place; we
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[Study on an Exoskeleton Hand Function Training Device].
Hu, Xin; Zhang, Ying; Li, Jicai; Yi, Jinhua; Yu, Hongliu; He, Rongrong
2016-02-01
Based on the structure and motion bionic principle of the normal adult fingers, biological characteristics of human hands were analyzed, and a wearable exoskeleton hand function training device for the rehabilitation of stroke patients or patients with hand trauma was designed. This device includes the exoskeleton mechanical structure and the electromyography (EMG) control system. With adjustable mechanism, the device was capable to fit different finger lengths, and by capturing the EMG of the users' contralateral limb, the motion state of the exoskeleton hand was controlled. Then driven by the device, the user's fingers conducting adduction/abduction rehabilitation training was carried out. Finally, the mechanical properties and training effect of the exoskeleton hand were verified through mechanism simulation and the experiments on the experimental prototype of the wearable exoskeleton hand function training device.
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Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.
Bishop, Lauri; Gordon, Andrew M; Kim, Heakyung
2017-01-01
The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly. Assessments were repeated on completion of training. Results showed significant improvements after training on the Assisting Hand Assessment (mean difference, 2.0 Assisting Hand Assessment units; P = 0.011) and on the upper-extremity component of the Fugl-Meyer scale (raw score mean difference, 4.334; P = 0.001). No significant improvements between pretest and posttest were noted on the Jebsen-Taylor Test of Hand Function, the Quality of Upper Extremity Skills Test, or the Pediatric Evaluation of Disability Inventory after intervention. Total active mobility of digits and grip strength also failed to demonstrate significant changes after training. Participants tolerated training with the hand robotic device, and significant improvements in bimanual hand use, as well as impairment-based scales, were noted. Improvements were carried over into bimanual skills during play. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand key components of neuroplasticity; (2) Discuss the benefits of robotic therapy in the recovery of hand function in pediatric patients with hemiplegia; and (3) Appropriately incorporate robotic therapy into the treatment plan of pediatric patients with hemiplegia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the
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Lucas, Nathanael Cc; Hume, Carl G; Al-Chanati, Abdal; Diprose, William; Roberts, Sally; Freeman, Josh; Mogol, Vernon; Hoskins, David; Hamblin, Richard; Frampton, Chris; Bagg, Warwick; Merry, Alan F
2017-01-13
Hand hygiene is important in reducing healthcare-associated infections. The World Health Organization has defined 'five moments' when hand hygiene compliance is required. During 2013, New Zealand national data showed poor compliance with these moments by medical students. To improve medical students' compliance with the five moments. In this prospective student-led quality improvement initiative, student investigators developed, implemented and evaluated a multi-modal intervention comprising a three-month social media campaign, a competition and an entertaining educational video. Data on individual patient-medical student interactions were collected covertly by observers at baseline and at one week, six weeks and three months after initiation of the intervention. During the campaign, compliance improved in moment 2, but not significantly in moments 1, 3, 4 or 5. Statistical analysis of amalgamated data was limited by non-independent data points-a consideration apparently not always addressed in previous studies. The initiative produced improvements in compliance by medical students with one hand hygiene moment. Statistical analysis of amalgamated data for all five moments should allow for the non-independence of each occasion in which clinicians interact with a patient. More work is needed to ensure excellent hand hygiene practices of future doctors.
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Hand preferences for bimanual coordination in 29 bonobos (Pan paniscus).
Chapelain, Amandine S; Hogervorst, Eef
2009-01-03
Brain lateralization has long been thought to be unique to humans. To investigate the origins and functions of this feature, researchers study behavioural laterality in other animals. Despite a substantial database, manual laterality in non-human primates remains a controversial topic. We give here a review of the main findings on manual preference in great apes. This article presents data on hand preferences for a bimanual coordination in 29 bonobos (Pan paniscus). The study aims to provide data on manual laterality for a complex bimanual task in this very interesting and rarely studied species. Hand preferences were assessed using the 'tube task'. This task has been used with other species, which allows reliable data comparisons. The task requires a bimanual coordinated precise action: the subject holds the tube with one hand while reaching for food inside with the other hand. As a complex task, this measure has been shown to be efficient in revealing hand preferences. It has revealed group-level right bias in chimpanzees. Bonobos had never been tested. We recorded both independent bouts (counting only the first pattern of a sequence of identical actions) and frequency (counting every action). The bonobos exhibited strong hand preferences. With frequency, 11 bonobos were classified as right-handed, 15 were left-handed and 3 had no preference. With bouts, 8 bonobos were right-handed, 9 were left-handed and 12 had no preference. No group-level bias appeared. The results are discussed in relation with previous findings and theories on brain lateralization.
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Porac, Clare
2009-03-01
Searleman and Porac (2001) studied lateral preference patterns among successfully switched left-hand writers, left-hand writers with no switch pressure history, and left-hand writers who did not switch when pressured. They concluded that left-handers who successfully shift to right-hand writing are following an inherent right-sided lateralisation pattern that they already possess. Searleman and Porac suggested that the neural mechanisms that control lateralisation in the successfully switched individuals are systematically different from those of other groups of left-handers. I examined patterns of skilled and less-skilled hand preference and skilled hand performance in a sample of 394 adults (ages 18-94 years). The sample contained successfully switched left-hand writers, left-handers pressured to shift who remained left-hand writers, left-handers who did not experience shift pressures, and right-handers. Both skilled hand preference and skilled hand performance were shifted towards the right side in successfully switched left-hand writers. This group also displayed mixed patterns of hand preference and skilled hand performance in that they were not as right-sided as "natural" right-handers nor were they as left-sided as the two left-hand writing groups, which did not differ from each other. The experience of being pressured to switch to right-hand writing was not sufficient to shift lateralisation patterns; the pressures must be experienced in the context of an underlying neural control mechanism that is amenable to change as a result of these external influences.
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Normalisation of brain connectivity through compensatory behaviour, despite congenital hand absence.
Hahamy, Avital; Sotiropoulos, Stamatios N; Henderson Slater, David; Malach, Rafael; Johansen-Berg, Heidi; Makin, Tamar R
2015-01-06
Previously we showed, using task-evoked fMRI, that compensatory intact hand usage after amputation facilitates remapping of limb representations in the cortical territory of the missing hand (Makin et al., 2013a). Here we show that compensatory arm usage in individuals born without a hand (one-handers) reflects functional connectivity of spontaneous brain activity in the cortical hand region. Compared with two-handed controls, one-handers showed reduced symmetry of hand region inter-hemispheric resting-state functional connectivity and corticospinal white matter microstructure. Nevertheless, those one-handers who more frequently use their residual (handless) arm for typically bimanual daily tasks also showed more symmetrical functional connectivity of the hand region, demonstrating that adaptive behaviour drives long-range brain organisation. We therefore suggest that compensatory arm usage maintains symmetrical sensorimotor functional connectivity in one-handers. Since variability in spontaneous functional connectivity in our study reflects ecological behaviour, we propose that inter-hemispheric symmetry, typically observed in resting sensorimotor networks, depends on coordinated motor behaviour in daily life.
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Hand-pumps as reservoirs for microbial contamination of well water
Ferguson, Andrew S.; Mailloux, Brian J.; Ahmed, Kazi M.; van Geen, Alexander; McKay, Larry D.; Culligan, Patricia J.
2018-01-01
The retention and release of total coliforms and Escherichia coli was investigated in hand-pumps removed from tubewells tapping a faecally contaminated aquifer in Matlab, Bangladesh, and from a new hand-pump deliberately spiked with E. coli. All hand-pumps were connected to reservoirs of sterile water and flushed. Faecal coliforms were observed in the discharge from all three of the previously used hand-pumps, at concentrations comparable to levels measured in discharge when they were attached to the tubewells. During daily flushing of one of the previously used hand-pumps, the concentration of total coliforms in the discharge remained relatively constant (≈103 MPN/100 mL). Concentrations of E. coli in the pump discharge declined over time, but E. coli was still detectable up to 29 days after the start of flushing. In the deliberately spiked hand-pump, E. coli was observed in the discharge over 125 days (t50 = 8 days) and found to attach preferentially to elastomeric materials within the hand-pump. Attempts to disinfect both the village and new hand-pumps using shock chlorination were shown to be unsuccessful. These results demonstrate that hand-pumps can act as persistent reservoirs for microbial indicator bacteria. This could potentially influence drinking water quality and bias testing of water quality. PMID:22048430
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Bimanual proprioceptive performance differs for right- and left-handed individuals.
Han, Jia; Waddington, Gordon; Adams, Roger; Anson, Judith
2013-05-10
It has been proposed that asymmetry between the upper limbs in the utilization of proprioceptive feedback arises from functional differences in the roles of the preferred and non-preferred hands during bimanual tasks. The present study investigated unimanual and bimanual proprioceptive performance in right- and left-handed young adults with an active finger pinch movement discrimination task. With visual information removed, participants were required to make absolute judgments about the extent of pinch movements made to physical stops, either by one hand, or by both hands concurrently, with the sequence of presented movement extents varied randomly. Discrimination accuracy scores were derived from participants' responses using non-parametric signal detection analysis. Consistent with previous findings, a non-dominant hand/hemisphere superiority effect was observed, where the non-dominant hands of right- and left-handed individuals performed overall significantly better than their dominant hands. For all participants, bimanual movement discrimination scores were significantly lower than scores obtained in the unimanual task. However, the magnitude of the performance reduction, from the unimanual to the bimanual task, was significantly greater for left-handed individuals. The effect whereby bimanual proprioception was disproportionately affected in left-handed individuals could be due to enhanced neural communication between hemispheres in left-handed individuals leading to less distinctive separation of information obtained from the two hands in the cerebral cortex. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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Kodama, Rie; Muraki, Shigeyuki; Oka, Hiroyuki; Iidaka, Toshiko; Teraguchi, Masatoshi; Kagotani, Ryohei; Asai, Yoshiki; Yoshida, Munehito; Morizaki, Yutaka; Tanaka, Sakae; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru; Yoshimura, Noriko
2016-09-01
To examine the prevalence and pattern of hand osteoarthritis (HOA), and determine its relationship with grip strength and hand pain. Among the participants of the third survey of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study, 507 Japanese men and 1028 Japanese women were included. Radiographs of both hands were graded for osteoarthritis (OA) using the modified Kellgren-Lawrence (KL) scale. HOA was defined as the presence of at least one affected joint. The absence or presence of subchondral erosion was also scored. The prevalence of HOA (KL grade ≥2) was 89.9% in men and 92.3% in women (p = 0.11), and it was significantly associated with age. OA in the distal interphalangeal (DIP) joint was the highest overall. After adjusting for age, sex, body mass index, and the residing area, both severity (KL grade ≥3) and erosion were significantly related to low grip strength and hand pain. With regard to the joint groups, severe OA in the DIP and first carpometacarpal joints were related to hand pain. This study showed a high prevalence of radiographic HOA and a significant relationship between hand pain and the severity of HOA, in addition to erosion.
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Hand washing practices in two communities of two states of Eastern India: an intervention study.
Ray, Sandip Kumar; Zaman, Forhad Akhtar; Laskar, Nasrin Banu
2010-01-01
Public health importance of hand washing as well as its importance in reduction of communicable diseases such as diarrhea and acute respiratory infections have been highlighted in many studies worldwide. This study was designed to study the hand washing practices followed in two urban slums as well as to assess and compare the status of different components of hand washing at the pre- and post-intervention phases. A community-based cross-sectional intervention study on hand washing practices was carried out at two urban slums situated in two states of Eastern India with similar sociocultural and linguistic background. The study was carried out by using an interview technique as well as observation of hand washing practices. Interpersonal communication for behavioural change was chosen as a method of intervention. The majority (>90%) practiced hand washing after defecation in both the study areas. However, hand washing following all six steps and for stipulated time period was seen to be poor before intervention. Significant improvement was observed in all the aspects of hand washing after intervention in both the areas. The poor practice of hand washing was observed in some situations and needed attention. Use of soap and clean material for drying hands after hand washing was poor initially followed by improvement after intervention. Based on the findings of the study, it could be suggested that Behaviour Change Communication program should be further planned with emphasis on different components of hand washing with a final objective to bring down the incidence of target diseases.
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Health promotion, wellness, and prevention in hand therapy: A survey study.
Lucado, Ann M; Taylor, David W; Wendland, Deborah M; Connors, Brian
Descriptive study. Noncommunicable diseases including diabetes and cardiovascular disease are associated with increased complications and cost of health care. To describe beliefs and extent to which hand therapists include health promotion, wellness, and prevention (HPWP) in practice and to elucidate barriers to the incorporation of HPWP. A 38-question survey evaluating hand therapists' beliefs, practice of HPWP, and barriers was sent to American Society of Hand Therapists members. About 270 American Society of Hand Therapists members participated. Respondents believed they had a role in HPWP, including occupational (95%), physical (92%), emotional (87%), and psychological (84%) factors and instrumental activities of daily living management (98%). Physical activity is most frequently addressed (42%), whereas other health behaviors are rarely addressed. Time, patient interest, and resources were among identified barriers. The importance of health promotion and disease prevention practice is being recognized as critical to successful health outcomes. The study results suggest the need to develop HPWP educational programming for hand therapists and the need to consider expansion of understanding of HPWP initiatives and subsequent benefits to patients. 5. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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Moisturizing alcohol hand gels for surgical hand preparation.
Jones, R D; Jampani, H; Mulberry, G; Rizer, R L
2000-03-01
With the use of novel formulary technology, unique moisturizing hand gels have been developed that offer significant advantages in perioperative and other health care settings. These advantages include the time-saving capabilities of a waterless formulation, the persistence and effectiveness of a surgical scrub, and the moisturization and protective properties of a lotion. Extensive laboratory and clinical studies, involving in vivo antimicrobial activity against resident and transient flora, skin moisturization on normal and dry skin, and compatibility with latex gloves, have supported these advantages. Nondrying alcohol hand gels can be used for antiseptic hand washing, hand scrubs between procedures (i.e., reentry scrubs), brushless surgical scrubs, moisturizers, and glove-donning aids.
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[Does the hand solely belong in the hands of a qualified hand surgeon?
Güven, Asim; Kols, Kerstin; Fischer, Klaus; Schönberger, Michael; Allert, Sixtus
2017-09-01
Background In Germany, Hand Surgery is an additional qualification that can only be obtained by a three-year training after a completed residency in General Surgery, Plastic Surgery or Trauma and Orthopaedic Surgery. Nevertheless, injuries and diseases of the hand are also treated by physicians without this particular qualification. It is questionable whether these treatments more often lead to medical malpractice. Material and Methods 376 charges of medical malpractice in surgical treatments of the hand and forearm that were closed in 2014 and 2015 were collected by the Arbitration Board for Medical Liability Issues of the Medical Association of North Germany.Cases with proven medical malpractice were classified by the qualification of the physician in charge and analysed. A statistical analysis was performed with the use of the program SPSS (IBM). Results Medical malpractice was proven in 42 of 113 cases with an attending physician who held the additional qualification for Hand Surgery (37.2 %). For physicians without this qualification, the figures were 79 out of 155 (51.0 %) in the group of trauma and orthopaedic surgeons and 54 out of 108 (50.0 %) in the group of general surgeons. The differences between the hand surgeons and the trauma and orthopaedic surgeons (p = 0.017) and between hand surgeons and general surgeons were significant (p = 0.037). Conclusions It was shown that physicians with an additional qualification in hand surgery had signifcantly fewer proven medical malpratice cases than physicians without this qualification. The following trends were observed in the cases of the physicians without the additional qualification in hand surgery: underestimation of the severity of trauma to soft tissues and infections of the hand, errors in the surgical examination of the hand, including functional tests of tendons and nerves, as well as in diagnostic findings after X-ray studies of the hand. Georg Thieme Verlag KG Stuttgart · New York.
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Consistency of hand preference: predictions to intelligence and school achievement.
Kee, D W; Gottfried, A; Bathurst, K
1991-05-01
Gottfried and Bathurst (1983) reported that hand preference consistency measured over time during infancy and early childhood predicts intellectual precocity for females, but not for males. In the present study longitudinal assessments of children previously classified by Gottfried and Bathurst as consistent or nonconsistent in cross-time hand preference were conducted during middle childhood (ages 5 to 9). Findings show that (a) early measurement of hand preference consistency for females predicts school-age intellectual precocity, (b) the locus of the difference between consistent vs. nonconsistent females is in verbal intelligence, and (c) the precocity of the consistent females was also revealed on tests of school achievement, particularly tests of reading and mathematics.
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Mouton, J; Houdre, H; Beccari, R; Tarissi, N; Autran, M; Auquit-Auckbur, I
2016-12-01
The SHAM Insurance Company in Lyon, France, estimated that inadequate hand wound exploration in the emergency room (ER) accounted for 10% of all ER-related personal injury claims in 2013. The objective of this study was to conduct a critical analysis of 80 claims that were related to hand wound management in the ER and led to compensation by SHAM. Eighty claims filed between 2007 and 2010 were anonymised then included into the study. To be eligible, claims had to be filed with SHAM, related to the ER management of a hand wound in an adult, and closed at the time of the study. Claims related to surgery were excluded. For each claim, we recorded 104 items (e.g., epidemiology, treatments offered, and impact on social and occupational activities) and analysed. Of the 70 patients, 60% were manual workers. The advice of a surgeon was sought in 16% of cases. The most common wound sites were the thumb (33%) and index finger (17%). Among the missed lesions, most involved tendons (74%) or nerves (29%). Many patients had more than one reason for filing a claim. The main reasons were inadequate wound exploration (97%), stiffness (49%), and dysaesthesia (41%). One third of patients were unable to return to their previous job. Mean sick-leave duration was 148 days and mean time from discharge to best outcome was 4.19%. Most claims (79%) were settled directly with the insurance company, 16% after involvement of a public mediator, and 12% in court. The mean compensatory damages award was 4595Euros. Inadequate surgical exploration of hand wounds is common in the ER, carries a risk of lasting and sometimes severe residual impairment, and generates considerable societal costs. IV. Copyright © 2016. Published by Elsevier Masson SAS.
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Inspections of Hand Washing Supplies and Hand Sanitizer in Public Schools
ERIC Educational Resources Information Center
Ramos, Mary M.; Blea, Mary; Trujillo, Rebecca; Greenberg, Cynthia
2010-01-01
Hand washing and hand antisepsis are proven infection control measures in the school setting, yet barriers such as lack of soap, paper towels, and hand sanitizer can hinder compliance. This pilot study measured the prevalence of hand cleaning supplies in public schools. Ten school districts (93 schools) participated in school nurse inspections. In…
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One hand or the other? Effector selection biases in right and left handers.
Main, Julie C; Carey, David P
2014-11-01
Much debate in the handedness literature has centred on the relative merits of questionnaire-based measures assessing hand preference versus simple movement tasks such as peg moving or finger tapping, assessing hand performance. A third paradigm has grown in popularity, which assesses choices by participants when either hand could be used to execute movements. These newer measures may be useful in predicting possible "reversed" asymmetries in proportions of non-right handed ("adextral") people. In the current studies we examine hand choice in large samples of dextral (right handed) and adextral participants. Unlike in some previous experiments on choice, we found that left handers were as biased towards their dominant hand as were right handers, for grasping during a puzzle-making task (study 1). In a second study, participants had to point to either of two suddenly appearing targets with one hand or the other. In study 2, left handers were not significantly less one handed than their right-handed counterparts as in study 1. In a final study, we used random effects meta analysis to summarise the possible differences in hand choice between left handers and right handers across all hand choice studies published to date. The meta analysis suggests that right handers use their dominant hand 12.5% more than left handers favour their dominant hand (with 95% confidence that the real difference lies between 7% and 18%). These last results suggest that our two experiments reported here may represent statistical Type 2 errors. This mean difference may be related to greater left hemispheric language and praxic laterality in right handers. Nevertheless, more data are needed regarding the precise proportions of left and right handers who favour their preferred hands for different tasks. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Hand hygiene compliance in transplant and other special patient groups: an observational study.
Graf, Karolin; Ott, Ella; Wolny, Michael; Tramp, Nadine; Vonberg, Ralf-Peter; Haverich, Axel; Chaberny, Iris Freya
2013-06-01
This study evaluates hand hygiene behavior of health care workers in a German university hospital stratified for treatment of special patient groups (eg, transplant patients). From 2008 to 2010, comprehensive education and training of all health care workers was implemented to improve hand hygiene compliance. Consumption rates of alcohol-based hand rub and gloves were collected and evaluated. Of the 5,647 opportunities of hand disinfection evaluated, 1,607 occurred during care for transplant patients. To our knowledge, this is the largest survey of hand hygiene compliance in special patient groups on intensive care units in a university hospital in Germany. Health care workers on surgical intensive care units showed lower hand hygiene compliance compared with health care workers on other types of intensive care units. Compliance toward hand hygiene was significantly higher on hemato-oncologic and pediatric wards. In general, hand disinfection was performed significantly more frequently after an intervention than before (P < .05, 95% confidence interval: 1.24-1.84). Overall, there was no significant difference in hand hygiene compliance when caring for transplant patients or other patients (odds ratio, 1.16; 95% confidence interval: 0.95-1.42). Nurse's and physician's hand hygiene compliance improved because of education. Hand hygiene compliance is not increased in the care for transplant patients (despite their predisposition for nosocomial infections) compared with other patients. Additional studies will be necessary to further investigate these findings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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McAteer, J; Stone, S; Fuller, C; Charlett, A; Cookson, B; Slade, R; Michie, S
2008-03-01
Previous observational measures of healthcare worker (HCW) hand-hygiene behaviour (HHB) fail to provide adequate standard operating procedures (SOPs), accounts of inter-rater agreement testing or evidence of sensitivity to change. This study reports the development of an observational tool in a way that addresses these deficiencies. Observational categories were developed systematically, guided by a clinical guideline, previous measures and pilot hand-hygiene behaviour observations (HHOs). The measure, a simpler version of the Geneva tool, consists of HHOs (before and after low-risk, high-risk or unobserved contact), HHBs (soap, alcohol hand rub, no action, unknown), and type of HCW. Inter-observer agreement for each category was assessed by observation of 298 HHOs and HHBs by two independent observers on acute elderly and intensive care units. Raw agreement (%) and Kappa were 77% and 0.68 for HHB; 83% and 0.77 for HHO; and 90% and 0.77 for HCW. Inter-observer agreement for overall compliance of a group of HCWs was assessed by observation of 1191 HHOs and HHBs by two pairs of independent observers. Overall agreement was good (intraclass correlation coefficient = 0.79). Sensitivity to change was examined by autoregressive time-series modelling of longitudinal observations for 8 months on the intensive therapy unit during an Acinetobacter baumannii outbreak and subsequent strengthening of infection control measures. Sensitivity to change was demonstrated by a rise in compliance from 80 to 98% with an odds ratio of increased compliance of 7.00 (95% confidence interval: 4.02-12.2) P < 0.001.
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Ground Robotic Hand Applications for the Space Program study (GRASP)
NASA Astrophysics Data System (ADS)
Grissom, William A.; Rafla, Nader I.
1992-04-01
This document reports on a NASA-STDP effort to address research interests of the NASA Kennedy Space Center (KSC) through a study entitled, Ground Robotic-Hand Applications for the Space Program (GRASP). The primary objective of the GRASP study was to identify beneficial applications of specialized end-effectors and robotic hand devices for automating any ground operations which are performed at the Kennedy Space Center. Thus, operations for expendable vehicles, the Space Shuttle and its components, and all payloads were included in the study. Typical benefits of automating operations, or augmenting human operators performing physical tasks, include: reduced costs; enhanced safety and reliability; and reduced processing turnaround time.
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Ground Robotic Hand Applications for the Space Program study (GRASP)
NASA Technical Reports Server (NTRS)
Grissom, William A.; Rafla, Nader I. (Editor)
1992-01-01
This document reports on a NASA-STDP effort to address research interests of the NASA Kennedy Space Center (KSC) through a study entitled, Ground Robotic-Hand Applications for the Space Program (GRASP). The primary objective of the GRASP study was to identify beneficial applications of specialized end-effectors and robotic hand devices for automating any ground operations which are performed at the Kennedy Space Center. Thus, operations for expendable vehicles, the Space Shuttle and its components, and all payloads were included in the study. Typical benefits of automating operations, or augmenting human operators performing physical tasks, include: reduced costs; enhanced safety and reliability; and reduced processing turnaround time.
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Inspections of hand washing supplies and hand sanitizer in public schools.
Ramos, Mary M; Blea, Mary; Trujillo, Rebecca; Greenberg, Cynthia
2010-10-01
Hand washing and hand antisepsis are proven infection control measures in the school setting, yet barriers such as lack of soap, paper towels, and hand sanitizer can hinder compliance. This pilot study measured the prevalence of hand cleaning supplies in public schools. Ten school districts (93 schools) participated in school nurse inspections. In November 2008, 90 schools (97%) reported their inspection results. Among 697 total bathrooms, 88.8% had soap and 91.7% had paper towels or hand dryers. Hand sanitizer was reported in 1.2% of bathrooms and 15.2% of cafeterias. No difference was observed between boys' and girls' bathrooms, or primary and secondary schools, in the prevalence of soap or paper towels/hand dryers. Hand washing supplies were generally available in public school bathrooms. Alcohol-based hand sanitizer in school bathrooms was reported occasionally and should be discouraged. Hand sanitizer in a supervised setting, the school cafeteria, was not often reported and should be promoted.
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The utility of hand transplantation in hand amputee patients.
Alolabi, Noor; Chuback, Jennifer; Grad, Sharon; Thoma, Achilles
2015-01-01
To measure the desirable health outcome, termed utility, and the expected quality-adjusted life years (QALYs) gained with hand composite tissue allotransplantation (CTA) using hand amputee patients and the general public. Using the standard gamble (SG) and time trade-off (TTO) techniques, utilities were obtained from 30 general public participants and 12 amputee patients. The health utility and net QALYs gained or lost with transplantation were computed. A sensitivity analysis was conducted to account for the effects of lifelong immunosuppression on the life expectancy of transplant recipients. Higher scores represent greater utility. Hand amputation mean health utility as measured by the SG and TTO methods, respectively, was 0.72 and 0.80 for the general public and 0.69 and 0.70 for hand amputees. In comparison, hand CTA mean health utility was 0.74 and 0.82 for the general public and 0.83 and 0.86 for amputees. Hand CTA imparted an expected gain of 0.9 QALYs (SG and TTO) in the general public and 7.0 (TTO) and 7.8 (SG) QALYs in hand amputees. A loss of at least 1.7 QALYs was demonstrated when decreasing the life expectancy in the sensitivity analysis in the hand amputee group. Hand amputee patients did not show a preference toward hand CTA with its inherent risks. With this procedure being increasingly adopted worldwide, the benefits must be carefully weighed against the risks of lifelong immunosuppressive therapy. This study does not show clear benefit to advocate hand CTA. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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Magnusson, Karin; Bech Holte, Kristine; Juel, Niels Gunnar; Brox, Jens Ivar; Hagen, Kåre Birger; Haugen, Ida Kristin; Berg, Tore Julsrud
2017-01-01
Objective To explore whether having long-term type 1 diabetes (>45 years) is associated with a higher prevalence of radiographic hand OA, erosive hand OA and increased hand pain, disability and stiffness. Methods In total N = 96 persons with type 1 diabetes diagnosed before 1970 were included (mean [SD] age: 62.2 [7.4], mean [SD] HbA1c: 7.43 [0.80] and N = 49 [51%] men). Regular measurements of their HbA1c were obtained till 2015. We included N = 69 healthy controls without any diabetes (mean [SD] age: 63.0 [7.0], mean [SD] HbA1c: 5.41 [0.32], N = 29 [42%] men). The groups were compared for radiographic hand OA (Kellgren-Lawrence grade ≥2 in ≥1 joint) and erosive hand OA (central erosions in ≥1 joint), Australian/Canadian index (AUSCAN) for hand pain, disability and stiffness using regression analyses adjusted for age, sex, educational level and waist circumference. Results We found no associations between having long term type 1 diabetes and more prevalent radiographic hand OA (OR = 0.83, 95% CI = 0.38–1.81). We found a trend towards higher prevalence of erosive hand OA in diabetes patients (OR = 2.96, 95% CI = 0.82–10.64). Strong and consistent associations were observed between long term type 1 diabetes and increased hand pain (B = 2.78, 95% CI = 1.65–3.91), disability (B = 5.30, 95% CI = 3.48–7.12) and stiffness (B = 2.00, 95% CI = 1.33–2.67). These associations were particularly strong for women and participants below the median age of 61 years. Conclusion Long-term type 1 diabetes was not associated with radiographic hand OA, but was strongly associated with hand pain, disability and stiffness. The association between diabetes and erosive hand OA warrants further investigation. PMID:28510594
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Hand synergies during reach-to-grasp.
Mason, C R; Gomez, J E; Ebner, T J
2001-12-01
An emerging viewpoint is that the CNS uses synergies to simplify the control of the hand. Previous work has shown that static hand postures for mimed grasps can be described by a few principal components in which the higher order components explained only a small fraction of the variance yet provided meaningful information. Extending that earlier work, this study addressed whether the entire act of grasp can be described by a small number of postural synergies and whether these synergies are similar for different grasps. Five right-handed adults performed five types of reach-to-grasps including power grasp, power grasp with a lift, precision grasp, and mimed power grasp and mimed precision grasp of 16 different objects. The object shapes were cones, cylinders, and spindles, systematically varied in size to produce a large range of finger joint angle combinations. Three-dimensional reconstructions of 21 positions on the hand and wrist throughout the reach-to-grasp were obtained using a four-camera video system. Singular value decomposition on the temporal sequence of the marker positions was used to identify the common patterns ("eigenpostures") across the 16 objects for each task and their weightings as a function of time. The first eigenposture explained an average of 97.3 +/- 0.89% (mean +/- SD) of the variance of the hand shape, and the second another 1.9 +/- 0.85%. The first eigenposture was characterized by an open hand configuration that opens and closes during reach. The second eigenposture contributed to the control of the thumb and long fingers, particularly in the opening of the hand during the reach and the closing in preparation for object grasp. The eigenpostures and their temporal evolutions were similar across subjects and grasps. The higher order eigenpostures, although explaining only small amounts of the variance, contributed to the movements of the fingers and thumb. These findings suggest that much of reach-to-grasp is effected using a base
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Effect of hand sanitizer location on hand hygiene compliance.
Cure, Laila; Van Enk, Richard
2015-09-01
Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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Nikandish, Reza; Shahbazi, Sharbanoo; Golabi, Sedigheh; Beygi, Najimeh
2008-02-01
Previous research has suggested improved quality of chest compressions when the dominant hand was in contact with the sternum. However, the study was in health care professionals and during conventional chest compression-ventilation CPR. The aim of this study was to test the hypothesis, in null form, that the quality of external chest compressions (ECC) in novice rescuers during 5min of uninterrupted chest compression CPR (UCC-CPR) is independent of the hand in contact with the sternum. Confirmation of the hypothesis would allow the use of either hand by the novice rescuers during UCC-CPR. Fifty-nine first year public heath students participated in this randomised double-blind crossover study. After completion of a standard adult BLS course, they performed single rescuer adult UCC-CPR for 5 min on a recording Resusci Anne. One week later they changed the hand of contact with the sternum while performing ECC. The quality of ECC was recorded by the skill meter for the dominant and non-dominant hand during 5 min ECC. The total number of correct chest compressions in the dominant hand group (DH), mean 183+/-152, was not statistically different from the non-dominant hand group (NH), mean 152+/-135 (P=0.09). The number of ECC with inadequate depth in the DH group, mean 197+/-174 and NH group, mean 196+/-173 were comparable (P=0.1). The incidence of ECC exceeding the recommended depth in the DH group, mean 51+/-110 and NH group, mean 32+/-75 were comparable (P=0.1). Although there is a trend to increased incidence of correct chest compressions with positioning the dominant hand in contact with the sternum, it does not reach statistical significance during UCC-CPR by the novice rescuers for 5 min.
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Postural Hand Synergies during Environmental Constraint Exploitation
Della Santina, Cosimo; Bianchi, Matteo; Averta, Giuseppe; Ciotti, Simone; Arapi, Visar; Fani, Simone; Battaglia, Edoardo; Catalano, Manuel Giuseppe; Santello, Marco; Bicchi, Antonio
2017-01-01
Humans are able to intuitively exploit the shape of an object and environmental constraints to achieve stable grasps and perform dexterous manipulations. In doing that, a vast range of kinematic strategies can be observed. However, in this work we formulate the hypothesis that such ability can be described in terms of a synergistic behavior in the generation of hand postures, i.e., using a reduced set of commonly used kinematic patterns. This is in analogy with previous studies showing the presence of such behavior in different tasks, such as grasping. We investigated this hypothesis in experiments performed by six subjects, who were asked to grasp objects from a flat surface. We quantitatively characterized hand posture behavior from a kinematic perspective, i.e., the hand joint angles, in both pre-shaping and during the interaction with the environment. To determine the role of tactile feedback, we repeated the same experiments but with subjects wearing a rigid shell on the fingertips to reduce cutaneous afferent inputs. Results show the persistence of at least two postural synergies in all the considered experimental conditions and phases. Tactile impairment does not alter significantly the first two synergies, and contact with the environment generates a change only for higher order Principal Components. A good match also arises between the first synergy found in our analysis and the first synergy of grasping as quantified by previous work. The present study is motivated by the interest of learning from the human example, extracting lessons that can be applied in robot design and control. Thus, we conclude with a discussion on implications for robotics of our findings. PMID:28900393
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Lambert, Anthony; Hallett, Charlene
2009-07-01
Hand preference for sending mobile-phone text messages ("texting") and its relationship with hand preference for other activities were investigated in a questionnaire study with 886 participants. Overall rates of both sinistrality and dextrality were reduced for texting, in comparison with other activities, due to the substantial number of individuals who use both hands simultaneously when performing this activity. Because they both involve verbal expression, it was hypothesised that the association between hand preferences for texting and writing might be stronger than the association between either of these tasks and more spatial activities, such as throwing. This prediction was not confirmed, either in the sample as a whole or in a sub-group of individuals who reported writing and throwing with opposite hands. Females were less likely than males to use their left hand when sending text messages. Implications of these findings are discussed, in relation to theoretical views of handedness and in relation to practical aspects of mobile-phone design.
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The Influence of Speed and Grade on Wheelchair Propulsion Hand Pattern
Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.
2015-01-01
Background The hand pattern used during manual wheelchair propulsion (i.e., full-cycle hand path) can provide insight into an individual's propulsion technique. However, previous analyses of hand patterns have been limited by their focus on a single propulsion condition and reliance on subjective qualitative characterization methods. The purpose of this study was to develop a set of objective quantitative parameters to characterize hand patterns and determine the influence of propulsion speed and grade of incline on the patterns preferred by manual wheelchair users. Methods Kinematic and kinetic data were collected from 170 experienced manual wheelchair users on an ergometer during three conditions: level propulsion at their self-selected speed, level propulsion at their fastest comfortable speed, and graded propulsion (8%) at their level self-selected speed. Hand patterns were quantified using a set of objective parameters and differences across conditions were identified. Findings Increased propulsion speed resulted in a shift away from under-rim hand patterns. Increased grade of incline resulted in the hand remaining near the handrim throughout the cycle. Interpretation Manual wheelchair users change their hand pattern based on task-specific constraints and goals. Further work is needed to investigate how differences between hand patterns influence upper extremity demand and potentially lead to the development of overuse injuries and pain. PMID:26228706
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Hand biometric recognition based on fused hand geometry and vascular patterns.
Park, GiTae; Kim, Soowon
2013-02-28
A hand biometric authentication method based on measurements of the user's hand geometry and vascular pattern is proposed. To acquire the hand geometry, the thickness of the side view of the hand, the K-curvature with a hand-shaped chain code, the lengths and angles of the finger valleys, and the lengths and profiles of the fingers were used, and for the vascular pattern, the direction-based vascular-pattern extraction method was used, and thus, a new multimodal biometric approach is proposed. The proposed multimodal biometric system uses only one image to extract the feature points. This system can be configured for low-cost devices. Our multimodal biometric-approach hand-geometry (the side view of the hand and the back of hand) and vascular-pattern recognition method performs at the score level. The results of our study showed that the equal error rate of the proposed system was 0.06%.
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Chubby hands or little fingers: sex differences in hand representation.
Coelho, Lara A; Gonzalez, Claudia L R
2018-04-03
Disturbed body representation is a condition defined by the perception that one's body size is different from their anatomical size. While equal amounts of males and females suffer from disturbed body representation, there appear to be differences in the direction of this distortion. Females will typically overestimate, whereas males will typically underestimate body size. One part of the body that has been consistently misperceived is the hands. This misrepresentation consists of two distinct characteristics: an overestimation of hand width, and an underestimation of finger length. Many of these studies, however, have used predominately female participants, allowing for the possibility that women are driving this distortion. The aim of the present study was to examine possible sex differences in hand perception. To this end, participants estimated the location of ten landmarks on their hands when their hands were hidden from view. Our results indicate that females follow the characteristic distortion, whereas males only underestimate finger length (albeit more than females). These findings are surprising, because the hands are not an area of concern for weight gain/loss. We discuss these findings in relation to body dysmorphia literature.
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Workplace screening for hand dermatitis: a pilot study.
Nichol, K; Copes, R; Spielmann, S; Kersey, K; Eriksson, J; Holness, D L
2016-01-01
Health care workers (HCWs) are at increased risk for developing occupational skin disease (OSD) such as dermatitis primarily due to exposure to wet work. Identification of risk factors and workplace screening can help early detection of OSD to avoid the condition becoming chronic. To determine risk factors and clinical findings for hand dermatitis using a workplace screening tool. Employees at a large teaching hospital in Toronto, Canada, were invited to complete a two-part hand dermatitis screening tool. Part 1 inquired about hand hygiene practices and Part 2 comprised a visual assessment of participants' hands by a health professional and classification as (i) normal, (ii) mild dermatitis or (iii) moderate/severe dermatitis. Risk factors were determined using chi-square and Cochran-Armitage analysis on a dichotomous variable, where Yes represented either a mild or moderate/severe disease classification. There were 183 participants out of 643 eligible employees; response rate 28%. Mild or moderate/severe dermatitis was present in 72% of participants. These employees were more likely to work directly with patients, have worked longer in a health care setting, wash hands and change gloves more frequently, wear gloves for more hours per day, have a history of eczema or dermatitis and report a current rash on the hands or rash in the past 12 months. There was a high percentage of HCWs with dermatitis and risk factors for dermatitis. These findings argue for increased attention to prevention and early identification of hand dermatitis and support further testing of the workplace screening tool. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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The psychosocial burden of hand eczema: Data from a European dermatological multicentre study.
Marron, Servando E; Tomas-Aragones, Lucia; Navarro-Lopez, Jorge; Gieler, Uwe; Kupfer, Jörg; Dalgard, Florence J; Lien, Lars; Finlay, Andrew Y; Poot, Françoise; Linder, Dennis; Szepietowski, Jacek C; Misery, Laurent; Jemec, Gregor B E; Romanov, Dmitry; Sampogna, Francesca; Szabo, Csanad; Altunay, Ilknur K; Spillekom-van Koulil, Saskia; Balieva, Flora; Ali, Faraz M; Halvorsen, Jon A; Marijuan, Pedro C
2018-06-01
The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema. The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities. Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema. Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P = .02), and for depression (median = 4.0) than controls (3.0, P < .001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P = .038, P < .001, and P < .001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68). This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Walsh, E; Guilmette, D N; Longo, M R; Moore, J W; Oakley, D A; Halligan, P W; Mehta, M A; Deeley, Q
2015-01-01
Hypnotic suggestibility (HS) is the ability to respond automatically to suggestions and to experience alterations in perception and behavior. Hypnotically suggestible participants are also better able to focus and sustain their attention on an experimental stimulus. The present study explores the relation between HS and susceptibility to the rubber hand illusion (RHI). Based on previous research with visual illusions, it was predicted that higher HS would lead to a stronger RHI. Two behavioral output measures of the RHI, an implicit (proprioceptive drift) and an explicit (RHI questionnaire) measure, were correlated against HS scores. Hypnotic suggestibility correlated positively with the implicit RHI measure contributing to 30% of the variation. However, there was no relation between HS and the explicit RHI questionnaire measure, or with compliance control items. High hypnotic suggestibility may facilitate, via attentional mechanisms, the multisensory integration of visuoproprioceptive inputs that leads to greater perceptual mislocalization of a participant's hand. These results may provide insight into the multisensory brain mechanisms involved in our sense of embodiment.
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Do 'chlorine covers' exert a sustained bactericidal effect on the bacterial hand flora?
Koller, W; Rotter, M L; Gottardi, W
1995-11-01
Treatment of skin with chlorine generates 'chlorine covers' which, in a previous study, exerted significant sustained bactericidal effects against transient skin flora on the upper arm and forearm. In this investigation, this effect was studied on both the transient and resident flora of the hands using test models for the evaluation of hand disinfectants as agreed upon in Austria and Germany. Chlorine covers were generated by bathing hands in a solution of 2% sodium tosylchloramide for 1 min. Subsequently, this cover was destroyed on one, randomly selected, hand by bathing it in a solution of 0.5% sodium thiosulphate for 15 s. The amount of chlorine on the fingertips of chlorinated hands was 2.2 +/- 0.4 micrograms/cm2; that on subsequently dechlorinated hands was 0.2 +/- 0.1 microgram/cm2. In experiments with artificially contaminated hands (Escherichia coli), the kinetics of bacterial die-off were the same on both hands. Also, in experiments with resident flora, the kinetics of bacterial die-off did not suggest bacterial reductions that increase with the duration of contact with the chlorine cover. It was concluded that with the test models used, a significant sustained antimicrobial effect of the chlorine cover could not be demonstrated on hands.
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Left-hand dominance in children: Prevalence and maternal stereotypes in a South-east Nigerian city.
Uwaezuoke, Samuel N; Eke, Christopher B; Nwobi, Emmanuel A
2015-01-01
The objectives of the study are to estimate the prevalence of left-hand dominance among children of selected mothers in an urban city and to determine the mothers' stereotypes about left-handedness. A cross-sectional study of mothers (N = 222) selected by systematic random sampling was done. The mothers were interviewed with structured questionnaires. Data were analyzed with appropriate descriptive statistics on SPSS. The estimated prevalence of left-hand dominance in their children was 7.52%. A left-handed mother was more likely to have a left-handed child. A substantial number of the mothers held negative stereotypes about left-hand dominance and showed a good knowledge about other types of handedness with a significant difference in the responses between right-handers and left-handers. The prevalence of left-hand dominance in their children supports previous reports which show that left-handedness usually occurs in less than 10% of the population. The mothers' negative stereotypes signify the likelihood of stigmatizing the children with this hand dominance.
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Hand Biometric Recognition Based on Fused Hand Geometry and Vascular Patterns
Park, GiTae; Kim, Soowon
2013-01-01
A hand biometric authentication method based on measurements of the user's hand geometry and vascular pattern is proposed. To acquire the hand geometry, the thickness of the side view of the hand, the K-curvature with a hand-shaped chain code, the lengths and angles of the finger valleys, and the lengths and profiles of the fingers were used, and for the vascular pattern, the direction-based vascular-pattern extraction method was used, and thus, a new multimodal biometric approach is proposed. The proposed multimodal biometric system uses only one image to extract the feature points. This system can be configured for low-cost devices. Our multimodal biometric-approach hand-geometry (the side view of the hand and the back of hand) and vascular-pattern recognition method performs at the score level. The results of our study showed that the equal error rate of the proposed system was 0.06%. PMID:23449119
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Hand hygiene knowledge and perceptions among anesthesia providers.
Fernandez, Patrick G; Loftus, Randy W; Dodds, Thomas M; Koff, Matthew D; Reddy, Sundara; Heard, Stephen O; Beach, Michael L; Yeager, Mark P; Brown, Jeremiah R
2015-04-01
Health care worker compliance with hand hygiene guidelines is an important measure for health care-associated infection prevention, yet overall compliance across all health care arenas remains low. A correct answer to 4 of 4 structured questions pertaining to indications for hand decontamination (according to types of contact) has been associated with improved health care provider hand hygiene compliance when compared to those health care providers answering incorrectly for 1 or more questions. A better understanding of knowledge deficits among anesthesia providers may lead to hand hygiene improvement strategies. In this study, our primary aims were to characterize and identify predictors for hand hygiene knowledge deficits among anesthesia providers. We modified this previously tested survey instrument to measure anesthesia provider hand hygiene knowledge regarding the 5 moments of hand hygiene across national and multicenter groups. Complete knowledge was defined by correct answers to 5 questions addressing the 5 moments for hand hygiene and received a score of 1. Incomplete knowledge was defined by an incorrect answer to 1 or more of the 5 questions and received a score of 0. We used a multilevel random-effects XTMELOGIT logistic model clustering at the respondent and geographic location for insufficient knowledge and forward/backward stepwise logistic regression analysis to identify predictors for incomplete knowledge. The survey response rates were 55.8% and 18.2% for the multicenter and national survey study groups, respectively. One or more knowledge deficits occurred with 81.6% of survey respondents, with the mean number of correct answers 2.89 (95% confidence interval, 2.78- 2.99). Failure of providers to recognize prior contact with the environment and prior contact with the patient as hand hygiene opportunities contributed to the low mean. Several cognitive factors were associated with a reduced risk of incomplete knowledge including providers responding
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Eye-hand coupling during closed-loop drawing: evidence of shared motor planning?
Reina, G Anthony; Schwartz, Andrew B
2003-04-01
Previous paradigms have used reaching movements to study coupling of eye-hand kinematics. In the present study, we investigated eye-hand kinematics as curved trajectories were drawn at normal speeds. Eye and hand movements were tracked as a monkey traced ellipses and circles with the hand in free space while viewing the hand's position on a computer monitor. The results demonstrate that the movement of the hand was smooth and obeyed the 2/3 power law. Eye position, however, was restricted to 2-3 clusters along the hand's trajectory and fixed approximately 80% of the time in one of these clusters. The eye remained stationary as the hand moved away from the fixation for up to 200 ms and saccaded ahead of the hand position to the next fixation along the trajectory. The movement from one fixation cluster to another consistently occurred just after the tangential hand velocity had reached a local minimum, but before the next segment of the hand's trajectory began. The next fixation point was close to an area of high curvature along the hand's trajectory even though the hand had not reached that point along the path. A visuo-motor illusion of hand movement demonstrated that the eye movement was influenced by hand movement and not simply by visual input. During the task, neural activity of pre-motor cortex (area F4) was recorded using extracellular electrodes and used to construct a population vector of the hand's trajectory. The results suggest that the saccade onset is correlated in time with maximum curvature in the population vector trajectory for the hand movement. We hypothesize that eye and arm movements may have common, or shared, information in forming their motor plans.
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Adaptive flexibility of the within-hand attentional gradient in touch: An MEG study.
Kida, Tetsuo; Tanaka, Emi; Kakigi, Ryusuke
2018-06-21
Previous studies have demonstrated the cortical mechanisms for the gradient of spatial attention in vision and audition, whereas those for touch have yet to be elucidated in detail. In order to examine the within-hand gradient of tactile spatial attention in the cerebral cortex, we used magnetoencephalography (MEG) to record cortical responses to an electrocutaneous stimulation presented randomly to any of the five fingers of the right hand at a random interstimulus interval (750-1250 ms). Participants attended to the index finger, ring finger, or both to detect a rare target stimulus in a sequence of frequent standard stimuli presented to the attended finger(s) by silent counting. Neuromagnetic responses around the contralateral primary and secondary somatosensory cortices (SIc and SIIc) at 50-70 ms and 80-100 ms, respectively, for the stimulation of the index or ring finger were stronger when that finger was attended than when the distant finger was attended or at rest. The amplitude of the SIIc response was also intermediate when the index and ring fingers were simultaneously attended. The SIIc response to the task-irrelevant stimulation of the thumb or little finger increased when the index or ring finger was attended, respectively, suggesting an across-finger gradient of tactile attention. Simultaneous attention to the index and ring fingers decreased the SIIc response to the task-irrelevant stimulation of the intervening middle finger more than that with attention to either one of the two fingers. The earliest attentional sign was observed for the SI M40c response, with the amplitude increasing with the stimulation of the unattended finger. Furthermore, late responses in the temporo-parietal junction (TPJ) and prefrontal cortex (PFC) were stronger with the stimulation of the unattended finger than with that of the attended finger. Thus, the present study provides cortical evidence for the adaptive control of the within-hand, across-finger gradient of
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NASA Technical Reports Server (NTRS)
Venkataraman, Subramanian T. (Editor); Iberall, Thea (Editor)
1990-01-01
Recent studies of human hand function and their implications for the design of robot hands are discussed in reviews and reports. Topics addressed include human grasp choice and robotic grasp analysis, opposition space and human prehension, coordination in normal and prosthetic reaching, and intelligent exploration by the human hand. Consideration is given to a task-oriented dextrous manipulation architecture, the control architecture for the Belgrade/USC hand, the analysis of multifingered grasping and manipulation, and tactile sensing for shape interpretation. Diagrams, graphs, and photographs are provided.
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The cortical activation pattern by a rehabilitation robotic hand: a functional NIRS study
Chang, Pyung-Hun; Lee, Seung-Hee; Gu, Gwang Min; Lee, Seung-Hyun; Jin, Sang-Hyun; Yeo, Sang Seok; Seo, Jeong Pyo; Jang, Sung Ho
2014-01-01
Introduction: Clarification of the relationship between external stimuli and brain response has been an important topic in neuroscience and brain rehabilitation. In the current study, using functional near infrared spectroscopy (fNIRS), we attempted to investigate cortical activation patterns generated during execution of a rehabilitation robotic hand. Methods: Ten normal subjects were recruited for this study. Passive movements of the right fingers were performed using a rehabilitation robotic hand at a frequency of 0.5 Hz. We measured values of oxy-hemoglobin (HbO), deoxy-hemoglobin (HbR) and total-hemoglobin (HbT) in five regions of interest: the primary sensory-motor cortex (SM1), hand somatotopy of the contralateral SM1, supplementary motor area (SMA), premotor cortex (PMC), and prefrontal cortex (PFC). Results: HbO and HbT values indicated significant activation in the left SM1, left SMA, left PMC, and left PFC during execution of the rehabilitation robotic hand (uncorrected, p < 0.01). By contrast, HbR value indicated significant activation only in the hand somatotopic area of the left SM1 (uncorrected, p < 0.01). Conclusions: Our results appear to indicate that execution of the rehabilitation robotic hand could induce cortical activation. PMID:24570660
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Study on Surgical Management of Post Burn Hand Deformities
Ahmed, Firdos; Jash, Prabir Kumar; Gupta, Madhumita; Suba, Santanu
2015-01-01
Context Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer. Aim The aim of this study is to evaluate the different surgical procedures for resurfacing after release of post-burn hand contractures in terms of functional recovery and aesthetic outcome. Settings and Design It’s a prospective, non-randomised study of 50 patients admitted and undergoing surgical reconstructive procedures for post burn hand contractures in our plastic surgery department. Materials and Methods Resurfacing procedures were done according to type of contracture with individualisation for each case. All cases were followed up with physiotherapy and splinting advices. Functional and aesthetic outcome and recurrence of contracture for each procedure was noted at 6 months. Results Forty seven percent of the cases were reconstructed with skin grafting, 30% cases with Z plasties and 23% with flap coverage. Split thickness skin grafts (STSG) and full thickness graft (FTSG) reconstructed cases had good recovery of joint mobility in 43% and 75% of cases respectively. Reconstructive procedures were aesthetically acceptable to the patients in 63%, 75% and 94% of STSG, FTSG and Z plasty cases respectively. Recurrence was seen in 17% of STSG done cases. Conclusion Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z plasties with proper planning gives maximum length gain with no donor morbidity as other procedures. Postoperative physiotherapy and splinting is must for better outcome in all cases. PMID:26435994
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Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study.
Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K; Mali, Gaurao Vasant
2016-09-01
To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus , Staphylococcus epidermidis , Pseudomonas aeruginosa , Escherichia coli , and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical isolates of the aforementioned test organisms. The well variant of agar disk diffusion test using Mueller-Hinton agar was used for evaluating the antimicrobial efficacy of hand sanitizers. McFarland 0.5 turbidity standard was taken as reference to adjust the turbidity of bacterial suspensions. Fifty microliters of the hand sanitizer was introduced into each of the 4 wells while the 5 th well incorporated with sterile water served as a control. This was done for all the test organisms and plates were incubated in an incubator for 24 h at 37C. After incubation, antimicrobial effectiveness was determined using digital caliper (mm) by measuring the zone of inhibition. The mean diameters of zones of inhibition (in mm) observed in Group A (Sterillium), Group B (PureHands), Group C (Lifebuoy), and Group D (Dettol) were 22 ± 6, 7.5 ± 0.5, 9.5 ± 1.5, and 8 ± 1, respectively. Maximum inhibition was found with Group A against all the tested organisms. Data were statistically analyzed using analysis of variance, followed by post hoc test for group-wise comparisons. The difference in the values of different sanitizers was statistically significant at P < 0.001. Sterillium was the most effective hand sanitizer to maintain the hand hygiene.
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Comparative assessment of antimicrobial efficacy of different hand sanitizers: An in vitro study
Jain, Vardhaman Mulchand; Karibasappa, Gundabaktha Nagappa; Dodamani, Arun Suresh; Prashanth, Vishwakarma K.; Mali, Gaurao Vasant
2016-01-01
Background: To evaluate the antimicrobial efficacy of four different hand sanitizers against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis as well as to assess and compare the antimicrobial effectiveness among four different hand sanitizers. Materials and Methods: The present study is an in vitro study to evaluate antimicrobial efficacy of Dettol, Lifebuoy, PureHands, and Sterillium hand sanitizers against clinical isolates of the aforementioned test organisms. The well variant of agar disk diffusion test using Mueller-Hinton agar was used for evaluating the antimicrobial efficacy of hand sanitizers. McFarland 0.5 turbidity standard was taken as reference to adjust the turbidity of bacterial suspensions. Fifty microliters of the hand sanitizer was introduced into each of the 4 wells while the 5th well incorporated with sterile water served as a control. This was done for all the test organisms and plates were incubated in an incubator for 24 h at 37C. After incubation, antimicrobial effectiveness was determined using digital caliper (mm) by measuring the zone of inhibition. Results: The mean diameters of zones of inhibition (in mm) observed in Group A (Sterillium), Group B (PureHands), Group C (Lifebuoy), and Group D (Dettol) were 22 ± 6, 7.5 ± 0.5, 9.5 ± 1.5, and 8 ± 1, respectively. Maximum inhibition was found with Group A against all the tested organisms. Data were statistically analyzed using analysis of variance, followed by post hoc test for group-wise comparisons. The difference in the values of different sanitizers was statistically significant at P < 0.001. Conclusion: Sterillium was the most effective hand sanitizer to maintain the hand hygiene. PMID:27857768
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Yeh, Su-Ling; Lane, Timothy Joseph; Chang, An-Yi; Chien, Sung-En
2017-01-01
Inducing the rubber hand illusion (RHI) requires that participants look at an imitation hand while it is stroked in synchrony with their occluded biological hand. Previous explanations of the RHI have emphasized multisensory integration, and excluded higher cognitive functions. We investigated the relationship between the RHI and higher cognitive functions by experimentally testing task switch (as measured by switch cost) and mind wandering (as measured by SART score); we also included a questionnaire for attentional control that comprises two subscales, attention-shift and attention-focus. To assess experience of RHI, the Botvinick and Cohen (1998) questionnaire was used and illusion onset time was recorded. Our results indicate that rapidity of onset reliably indicates illusion strength. Regression analysis revealed that participants evincing less switch cost and higher attention-shift scores had faster RHI onset times, and that those with higher attention-shift scores experienced the RHI more vividly. These results suggest that the multi-sensory hypothesis is not sufficient to explain the illusion: higher cognitive functions should be taken into account when explaining variation in the experience of ownership for the rubber hand. PMID:29312048
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Clinical Assessment and Diagnostics of Patients With Hand Disorders: A Case Study Approach.
Leow, Mabel Qi He; Lim, Rebecca Qian Ru; Tay, Shian Chao
Clinical assessment of the hand is important for diagnosing underlying hand disorders. Using a case study approach, the clinical assessment for three disorders of the hands is presented: trigger finger (stenosing tenosynovitis), carpal tunnel syndrome, and ulnar-sided wrist injury (styloid impingement). We assess the annular one pulley and finger range of motion for patients with trigger finger. To diagnose for carpal tunnel syndrome, assessment for Tinel's sign, Phalen's sign, abductor pollicis brevis muscle bulk, two-point discrimination, and obtaining a nerve conduction study are performed. Assessment for ulnar-sided wrist injury includes wrist range of motion, assessment of distal radial ulnar joint stability, provocation tests, grip strength, x-ray, and magnetic resonance imaging. This article begins with a description of the hand and wrist anatomy. For each case study, the clinical history is described, followed by a discussion of the pathophysiology, clinical assessments, and diagnostic tests.
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Huisstede, Bionka M A; Hoogvliet, Peter; Coert, J Henk; Fridén, Jan
2013-12-01
Multidisciplinary treatment guidelines for Dupuytren disease can aid in optimizing the quality of care for patients with this disorder. Therefore, this study aimed to achieve consensus on a multidisciplinary treatment guideline for Dupuytren disease. A European Delphi consensus strategy was initiated. A systematic review reporting on the effectiveness of interventions was conducted and used as an evidence-based starting point for this study. In total, 39 experts (hand surgeons, hand therapists, and physical medicine and rehabilitation physicians) participated in the Delphi consensus strategy. Each Delphi round consisted of a questionnaire, an analysis, and a feedback report. After four Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of Dupuytren disease. No nonsurgical interventions were included in the guideline. Needle and open fasciotomy, and a limited fasciectomy and dermofasciectomy, were seen as suitable surgical techniques for Dupuytren disease. Factors relevant for choosing one of these surgical techniques were identified and divided into patient-related (age, comorbidity), disease-related (palpable cord, previous surgery in the same area, skin involvement, time of recovery, recurrences), and surgeon-related (years of experience) factors. Associations of these factors with the choice of a specific surgical technique were reported in the guideline. Postsurgical rehabilitation should always include instructions and exercise therapy; postsurgical splinting should be performed on indication. Relevant details for the use of surgical and postsurgical interventions were described. This treatment guideline is likely to promote further discussion on related clinical and scientific issues and may therefore contribute to better treatment of patients with Dupuytren disease.
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Nudging to improve hand hygiene.
Caris, M G; Labuschagne, H A; Dekker, M; Kramer, M H H; van Agtmael, M A; Vandenbroucke-Grauls, C M J E
2018-04-01
Hand hygiene is paramount to prevent healthcare-associated infections, but improving compliance is challenging. When healthcare workers seldom encounter healthcare-associated infections, they will consider the odds of causing infections through poor hand hygiene negligible. Cognitive biases such as these may induce non-compliance. Nudging, 'a friendly push to encourage desired behaviour', could provide an easily implemented, inexpensive measure to address cognitive biases and thus support hand hygiene interventions. To investigate whether behavioural nudges, displayed as posters, can increase the use of alcohol-based hand rub. We developed nudges based on a systematic review of previously described cognitive biases, and tested these through a cross-sectional survey among the target audience. We then conducted a controlled before-after trial on two hospital wards, to assess the effect of these nudges on the use of alcohol-based hand rub, measured with electronic dispensers. Poisson regression analyses adjusted for workload showed that nudges displayed next to dispensers increased their overall use on one ward [poster 1: relative risk: 1.6 (95% confidence interval: 1.2-2.2); poster 2: 1.7 (1.2-2.5)] and during doctor's rounds on both wards [poster 1: ward A: 1.7 (1.1-2.6); ward B: 2.2 (1.3-3.8)]. Use of dispensers without adjacent nudges did not increase. Nudges based on cognitive biases that play a role in hand hygiene, and displayed as posters, could provide an easy, inexpensive measure to increase use of alcohol-based hand rub. When applying nudges to change behaviour, it is important to identify the right nudge for the right audience. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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Study of left-handed materials
NASA Astrophysics Data System (ADS)
Zhou, Jiangfeng
Left handed materials (LHMs) are artificial materials that have negative electrical permittivity, negative magnetic permeability, and negative index of refraction across a common frequency band. They possess electromagnetic (EM) properties not found in nature. LHMs have attracted tremendous attention because of their potential applications to build the perfect lens and cloaking devices. In the past few years there has been ample proof for the existence of LHMs in the microwave frequency range. Recently, researchers are trying hard to push the operating frequency of LHMs into terahertz and the optical regime. In this thesis, we start with the theoretical prediction of left handed materials made by Veselago 40 years ago, introducing the unique electromagnetic properties of the left handed materials. After discussing the realization of LHMs by the split ring resonators (SRRs) and wire designs, we briefly review the development of LHMs from microwave frequency to the optical regime. We discuss the chiral metamaterial, which provides an alternative approach to realize negative refractive index. In Chapter 2, we discuss the electromagnetic properties of the SRRs and the breakdown of linear scaling properties of SRRs at infrared and optical frequencies. By discussing the current modes, and the electric and magnetic moments, we study three resonance modes of SRR with respect to different polarizations of EM waves. Through numerical simulations, we find the breakdown of linear scaling, due to the free electron kinetic energy for frequencies above 100 THz. This result is important. It proves that researchers cannot push metamaterials into the optical regime by just scaling down the geometrical size of metamaterial designs used at low frequency. Due to the breakdown of the linear scaling property, a much smaller structure size of LHMs design is required in the optical regime, so new designs with simpler topology are needed. In Chapter 3, we discuss a short wire pair design
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The art and science of photography in hand surgery.
Wang, Keming; Kowalski, Evan J; Chung, Kevin C
2014-03-01
High-quality medical photography plays an important role in teaching and demonstrating the functional capacity of the hands as well as in medicolegal documentation. Obtaining standardized, high-quality photographs is now an essential component of many surgery practices. The importance of standardized photography in facial and cosmetic surgery has been well documented in previous studies, but no studies have thoroughly addressed the details of photography for hand surgery. In this paper, we provide a set of guidelines and basic camera concepts for different scenarios to help hand surgeons obtain appropriate and informative high-quality photographs. A camera used for medical photography should come equipped with a large sensor size and an optical zoom lens with a focal length ranging anywhere from 14 to 75 mm. In a clinic or office setting, we recommend 6 standardized views of the hand and 4 views for the wrist; additional views should be taken for tendon ruptures, nerve injuries, or other deformities of the hand. For intraoperative pictures, the camera operator should understand the procedure and pertinent anatomy in order to properly obtain high-quality photographs. When digital radiographs are not available and radiographic film must be photographed, it is recommended to reduce the exposure and change the color mode to black and white to obtain the best possible pictures. The goal of medical photography is to present the subject in an accurate and precise fashion. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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van der Kamp, John; de Wit, Matthieu M; Masters, Rich S W
2012-04-01
We investigated whether the control of movement of the left hand is more likely to involve the use of allocentric information than movements performed with the right hand. Previous studies (Gonzalez et al. in J Neurophys 95:3496-3501, 2006; De Grave et al. in Exp Br Res 193:421-427, 2009) have reported contradictory findings in this respect. In the present study, right-handed participants (N = 12) and left-handed participants (N = 12) made right- and left-handed grasps to foveated objects and peripheral, non-foveated objects that were located in the right or left visual hemifield and embedded within a Müller-Lyer illusion. They were also asked to judge the size of the object by matching their hand aperture to its length. Hand apertures did not show significant differences in illusory bias as a function of hand used, handedness or visual hemifield. However, the illusory effect was significantly larger for perception than for action, and for the non-foveated compared to foveated objects. No significant illusory biases were found for reach movement times. These findings are consistent with the two-visual system model that holds that the use of allocentric information is more prominent in perception than in movement control. We propose that the increased involvement of allocentric information in movements toward peripheral, non-foveated objects may be a consequence of more awkward, less automatized grasps of nonfoveated than foveated objects. The current study does not support the conjecture that the control of left-handed and right-handed grasps is predicated on different sources of information.
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The influence of speed and grade on wheelchair propulsion hand pattern.
Slowik, Jonathan S; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R
2015-11-01
The hand pattern used during manual wheelchair propulsion (i.e., full-cycle hand path) can provide insight into an individual's propulsion technique. However, previous analyses of hand patterns have been limited by their focus on a single propulsion condition and reliance on subjective qualitative characterization methods. The purpose of this study was to develop a set of objective quantitative parameters to characterize hand patterns and determine the influence of propulsion speed and grade of incline on the patterns preferred by manual wheelchair users. Kinematic and kinetic data were collected from 170 experienced manual wheelchair users on an ergometer during three conditions: level propulsion at their self-selected speed, level propulsion at their fastest comfortable speed and graded propulsion (8%) at their level self-selected speed. Hand patterns were quantified using a set of objective parameters, and differences across conditions were identified. Increased propulsion speed resulted in a shift away from under-rim hand patterns. Increased grade of incline resulted in the hand remaining near the handrim throughout the cycle. Manual wheelchair users change their hand pattern based on task-specific constraints and goals. Further work is needed to investigate how differences between hand patterns influence upper extremity demand and potentially lead to the development of overuse injuries and pain. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Knowledge Retention for Computer Simulations: A study comparing virtual and hands-on laboratories
NASA Astrophysics Data System (ADS)
Croom, John R., III
The use of virtual laboratories has the potential to change physics education. These low-cost, interactive computer activities interest students, allow for easy setup, and give educators a way to teach laboratory based online classes. This study investigated whether virtual laboratories could replace traditional hands-on laboratories and whether students could retain the same long-term knowledge in virtual laboratories as compared to hands-on laboratories. This study is a quantitative quasi-experiment that used a multiple posttest design to determine if students using virtual laboratories would retain the same knowledge as students who performed hands-on laboratories after 9 weeks. The study was composed of 336 students from 14 school districts. Students had their performances on the laboratories and their retention of the laboratories compared to a series of factors that might have affected their retention using a pretest and two posttests, which were compared using a t test. The results showed no significant difference in short-term learning between the hands-on laboratory groups and virtual laboratory groups. There was, however, a significant difference (p = .005) between the groups in long-term retention; students in the hands-on laboratory groups retained more information than those in the virtual laboratory groups. These results suggest that long-term learning is enhanced when a laboratory contains a hands-on component. Finally, the results showed that both groups of students felt their particular laboratory style was superior to the alternative method. The findings of this study can be used to improve the integration of virtual laboratories into science curriculum.
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Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study.
Luchetti, Martina; Cutti, Andrea G; Verni, Gennaro; Sacchetti, Rinaldo; Rossi, Nicolino
2015-01-01
This work explores the functional and psychosocial impact of the multigrip Michelangelo (M) prosthetic hand. Transradial myoelectric prosthesis users (6 men, median age: 47 y) participated in a crossover longitudinal study. A multifactorial assessment protocol was applied before the application of M and after 3 mo (functional assessment) and 6 mo (psychosocial assessment) of home use. Functional assessment included both practical tests (i.e., Southampton Hand Assessment Procedure [SHAP], Box and Blocks Test [BBT], and Minnesota Manual Dexterity Test [MMDT]) and self-report functional scales. Psychosocial assessment consisted of a clinical interview and a battery of self-report questionnaires concerning current anxious-depressive symptoms and health-related quality of life, body image concerns, adjustment and satisfaction with prosthesis, social support, coping style, and personality. Increased manual dexterity was observed after 3 mo based on improvements in the SHAP, BBT, and MMDT. Two important themes emerged from the clinical interviews at the 6 mo follow-up: (1) the enhanced functionality and (2) the "like a real hand" aspect of the M, which further increased prosthesis integration to the Self. A few patients expressed concerns about M dimension, noise, and weight. The M appeared to restore hand function and natural appearance. The present findings provide preliminary evidence, and additional studies are needed.
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Sandora, Thomas J; Taveras, Elsie M; Shih, Mei-Chiung; Resnick, Elissa A; Lee, Grace M; Ross-Degnan, Dennis; Goldmann, Donald A
2005-09-01
Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). A
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Interventions to improve hand hygiene compliance in patient care.
Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H; Taljaard, Monica
2017-09-01
Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This is an update of a previously published review. To assess the short- and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of the Cochrane Register of Controlled Trials, PubMed, Embase, and CINAHL. We conducted the searches from November 2009 to October 2016. We included randomised trials, non-randomised trials, controlled before-after studies, and interrupted time series analyses (ITS) that evaluated any intervention to improve compliance with hand hygiene using soap and water or alcohol-based hand rub (ABHR), or both. Two review authors independently screened citations for inclusion, extracted data, and assessed risks of bias for each included study. Meta-analysis was not possible, as there was substantial heterogeneity across studies. We assessed the certainty of evidence using the GRADE approach and present the results narratively in a 'Summary of findings' table. This review includes 26 studies: 14 randomised trials, two non-randomised trials and 10 ITS studies. Most studies were conducted in hospitals or long-term care facilities in different countries, and collected data from a variety of healthcare workers. Fourteen studies assessed the success of different combinations of strategies recommended by the World Health Organization (WHO) to improve hand hygiene compliance. Strategies consisted of the following: increasing the availability of ABHR, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support, and staff involvement. Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such
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Does framing the hot hand belief change decision-making behavior in volleyball?
Raab, Markus; MacMahon, Clare
2015-06-01
Previous discussions of the hot hand belief, wherein athletes believe that they have a greater chance of scoring after 2 or 3 hits (successes) compared with 2 or 3 misses, have focused on whether this is the case within game statistics. Researchers have argued that the perception of the hot hand in random sequences is a bias of the cognitive system. Yet most have failed to explore the impact of framing on the stability of the belief and the behavior based on it. The authors conducted 2 studies that manipulated the frame of a judgment task. In Study 1, framing was manipulated via instructions in a playmaker allocation paradigm in volleyball. In Study 2, the frame was manipulated by presenting videos for allocation decisions from either the actor or observer perspective. Both manipulations changed the hot hand belief and sequential choices. We found in both studies that the belief in continuation of positive or negative streaks is nonlinear and allocations to the same player after 3 successive hits are reduced. The authors argue that neither the hot hand belief nor hot hand behavior is stable, but rather, both are sensitive to decision frames. The results can inform coaches on the importance of how to provide information to athletes.
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Faculty Workshops for Teaching Information Assurance through Hands-On Exercises and Case Studies
ERIC Educational Resources Information Center
Yuan, Xiaohong; Williams, Kenneth; Yu, Huiming; Rorrer, Audrey; Chu, Bei-Tseng; Yang, Li; Winters, Kathy; Kizza, Joseph
2017-01-01
Though many Information Assurance (IA) educators agree that hands-on exercises and case studies improve student learning, hands-on exercises and case studies are not widely adopted due to the time needed to develop them and integrate them into curricula. Under the support of the National Science Foundation (NSF) Scholarship for Service program, we…
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Implementing AORN recommended practices for hand hygiene.
Patrick, Marcia; Van Wicklin, Sharon A
2012-04-01
This article focuses on implementing the revised AORN "Recommended practices for hand hygiene in the perioperative setting." The content of the document has been expanded and reorganized from the previous iteration and now includes specific activity statements about water temperature, water and soap dispensing controls, the type of dispensers to use, paper towel dispenser requirements, placement of soap and rub dispensers, and regulatory requirements for products and recommendations for hand hygiene practices. A successful hand hygiene program allows end users to have input into the selection and evaluation of products and should include educating personnel about proper hand hygiene, product composition and safety, and how and when to use specific products. Measures for competency evaluation and compliance monitoring include observations, quizzes, skills labs, electronic monitoring systems, handheld device applications, and data collection forms. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.
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Design of a force reflecting hand controller for space telemanipulation studies
NASA Technical Reports Server (NTRS)
Paines, J. D. B.
1987-01-01
The potential importance of space telemanipulator systems is reviewed, along with past studies of master-slave manipulation using a generalized force reflecting master arm. Problems concerning their dynamic interaction with the human operator have been revealed in the use of these systems, with marked differences between 1-g and simulated weightless conditions. A study is outlined to investigate the optimization of the man machine dynamics of master-slave manipulation, and a set of specifications is determined for the apparatus necessary to perform this investigation. This apparatus is a one degree of freedom force reflecting hand controller with closed loop servo control which enables it to simulate arbitrary dynamic properties to high bandwidth. Design of the complete system and its performance is discussed. Finally, the experimental adjustment of the hand controller dynamics for smooth manual control performance with good operator force perception is described, resulting in low inertia, viscously damped hand controller dynamics.
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Pate, M L; Nummer, B
2013-10-01
The purpose of this study was to quantify the presence of minor open-wound hand injuries in addition to Salmonella, Staphylococcus aureus, coliforms, and Escherichia coli on the hands of farm workers who hand-harvest fruit crops in Utah. Data collection was conducted on four farms without USDA Good Agricultural Practices (GAP) certification and on two farms with GAP certification. This study identified essential safety issues that need to be addressed for improving the effectiveness of safety training for migrant farm workers. Farms that have a food safety audit program in place are less likely to have farm workers exposed to pathogenic bacteria and open-wound injuries to their hands. High frequency of S. aureus may indicate a potentially higher risk for wound infection within this worker population. This could lead to infections that are resistant to the antibiotics commonly used to treat ordinary staph infections, resulting in greater work loss time and medical expenses for these workers. Higher frequencies of bacterial presence on workers' hands on non-certified farms indicate a need to identify essential practices to improve worker hygiene habits and on-farm management practices to promote healthy hygiene. Open-wound injuries to migrant farm workers during hand-harvesting could create additional health problems with the possibility of infection and the spread of diseases. Continued research is needed to understand workers' acceptance of these injuries and barriers to personal protection.
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The Art and Science of Photography in Hand Surgery
Wang, Keming; Kowalski, Evan J.; Chung, Kevin C.
2013-01-01
High-quality medical photography plays an important role in teaching and demonstrating the functional capacity of the hands, as well as in medicolegal documentation. Obtaining standardized, high-quality photographs is now an essential component of many surgery practices. The importance of standardized photography in facial and cosmetic surgery has been well documented in previous studies, but no studies have thoroughly addressed the details of photography for hand surgery. In this paper, we will provide a set of guidelines and basic camera concepts for different scenarios to help hand surgeons obtain appropriate and informative high quality photographs. A camera used for medical photography should come equipped with a large sensor size and an optical zoom lens with a focal length ranging anywhere from 14-75mm. In a clinic or office setting, we recommend six standardized views of the hand and four views for the wrist, and additional views should be taken for tendon ruptures, nerve injuries, or other deformities of the hand. For intra-operative pictures, the camera operator should understand the procedure and pertinent anatomy in order to properly obtain high-quality photographs. When digital radiographs are not available, and radiographic film must be photographed, it is recommended to reduce the exposure and change the color mode to black and white to obtain the best possible pictures. The goal of medical photography is to present the subject in an accurate and precise fashion. PMID:23755927
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A threat to a virtual hand elicits motor cortex activation.
González-Franco, Mar; Peck, Tabitha C; Rodríguez-Fornells, Antoni; Slater, Mel
2014-03-01
We report an experiment where participants observed an attack on their virtual body as experienced in an immersive virtual reality (IVR) system. Participants sat by a table with their right hand resting upon it. In IVR, they saw a virtual table that was registered with the real one, and they had a virtual body that substituted their real body seen from a first person perspective. The virtual right hand was collocated with their real right hand. Event-related brain potentials were recorded in two conditions, one where the participant's virtual hand was attacked with a knife and a control condition where the knife only struck the virtual table. Significantly greater P450 potentials were obtained in the attack condition confirming our expectations that participants had a strong illusion of the virtual hand being their own, which was also strongly supported by questionnaire responses. Higher levels of subjective virtual hand ownership correlated with larger P450 amplitudes. Mu-rhythm event-related desynchronization in the motor cortex and readiness potential (C3-C4) negativity were clearly observed when the virtual hand was threatened-as would be expected, if the real hand was threatened and the participant tried to avoid harm. Our results support the idea that event-related potentials may provide a promising non-subjective measure of virtual embodiment. They also support previous experiments on pain observation and are placed into context of similar experiments and studies of body perception and body ownership within cognitive neuroscience.
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Human motion retrieval from hand-drawn sketch.
Chao, Min-Wen; Lin, Chao-Hung; Assa, Jackie; Lee, Tong-Yee
2012-05-01
The rapid growth of motion capture data increases the importance of motion retrieval. The majority of the existing motion retrieval approaches are based on a labor-intensive step in which the user browses and selects a desired query motion clip from the large motion clip database. In this work, a novel sketching interface for defining the query is presented. This simple approach allows users to define the required motion by sketching several motion strokes over a drawn character, which requires less effort and extends the users’ expressiveness. To support the real-time interface, a specialized encoding of the motions and the hand-drawn query is required. Here, we introduce a novel hierarchical encoding scheme based on a set of orthonormal spherical harmonic (SH) basis functions, which provides a compact representation, and avoids the CPU/processing intensive stage of temporal alignment used by previous solutions. Experimental results show that the proposed approach can well retrieve the motions, and is capable of retrieve logically and numerically similar motions, which is superior to previous approaches. The user study shows that the proposed system can be a useful tool to input motion query if the users are familiar with it. Finally, an application of generating a 3D animation from a hand-drawn comics strip is demonstrated.
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Modeling the finger joint moments in a hand at the maximal isometric grip: the effects of friction.
Wu, John Z; Dong, Ren G; McDowell, Thomas W; Welcome, Daniel E
2009-12-01
The interaction between the handle and operator's hand affects the comfort and safety of tool and machine operations. In most of the previous studies, the investigators considered only the normal contact forces. The effect of friction on the joint moments in fingers has not been analyzed. Furthermore, the observed contact forces have not been linked to the internal musculoskeletal loading in the previous experimental studies. In the current study, we proposed a universal model of a hand to evaluate the joint moments in the fingers during grasping tasks. The hand model was developed on the platform of the commercial software package AnyBody. Only four fingers (index, long, ring, and little finger) were included in the model. The anatomical structure of each finger is comprised of four phalanges (distal, middle, proximal, and metacarpal phalange). The simulations were performed using an inverse dynamics technique. The joint angles and the normal contact forces on each finger section reported by previous researchers were used as inputs, while the joint moments of each finger were predicted. The predicted trends of the dependence of the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joint moments on the cylinder diameter agree with those of the contact forces on the fingers observed in the previous experimental study. Our results show that the DIP and PIP joint moments reach their maximums at a cylinder diameter of about 31mm, which is consistent with the trend of the finger contact forces measured in the experiments. The proposed approach will be useful for simulating musculoskeletal loading in the hand for occupational activities, thereby optimizing tool-handle design.
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Young People's Cognitive Achievement as Fostered by Hands-on-Centred Environmental Education
ERIC Educational Resources Information Center
Dieser, Olivia; Bogner, Franz X.
2016-01-01
In line with previous studies, where outdoor nature experience was shown to support adolescents' environmental knowledge, our study monitored the influence of a hands-on environmental programme within a National Park on cognitive knowledge achievement. A sample of 4th and 5th graders (n = 289) completed a week-long outreach conservation programme…
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Is the hand to speech what speech is to the hand?
Mildner, V
2000-01-01
Interference between the manual and the verbal performance on two types of concurrent verbal-manual tasks was studied on a sample of 48 female right-handers. The more complex verbal task (storytelling) affected both hands significantly, the less complex (essentially phonemic) task affected only the right hand, with insignificant negative influence on the left-hand performance. No significant reciprocal effects of the motor task on verbalization were found.
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Case study on the orientation of phaco hand pieces during steam sterilization processes.
van Doornmalen Gomez Hoyos, J P C M; van Wezel, R A C; van Doornmalen, H W J M
2015-05-01
Steam sterilization is an essential part of infection prevention. The literature shows that sterilization of medical instruments containing channels is not trivial. Phaco hand pieces have a simple configuration: a device contains a channel with a constant radius. No literature was found indicating whether the sterilization conditions on the inner surface of a phaco hand piece are influenced by the orientation of the hand piece. To determine whether the orientation of a phaco hand piece influences the results of a sterilization process of this device. A qualitative case study, including experiments, is performed with a protocolled combination of steam sterilizer, process, phaco hand piece, orientation of the phaco hand piece, and wrapping. In this specific case, the orientation of the hand piece influenced the result of the steam sterilization process; in vertically (upright) oriented phaco hand pieces with free water drainage, sterilization conditions are reproducibly established. In the same process, in horizontally oriented or vertically oriented hand pieces without free drainage, these conditions are not established in a reproducible way. In the investigated combination of sterilizer, process, load, loading pattern and wrapping, phaco hand pieces have to be oriented vertically (upright) with free water drainage to obtain steam sterilization conditions on the inner surface. It is likely that instruments with comparable configuration and dimensions will yield comparable results. It is therefore recommended that this issue is considered during the development of medical instruments and during performance qualifications of such instruments. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Snow, Michelle; White, George L.; Kim, Han S.
2008-01-01
Routine hand hygiene has been cited by the World Health Organization and the Centers for Disease Control and Prevention as a cost-effective and important hygiene measure in preventing the spread of infectious diseases. Several studies have explored children's hand hygiene habits, effects of scheduled hand hygiene, hand hygiene environmental…
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Hand-transmitted vibration and biodynamic response of the human hand-arm: a critical review.
Dong, R G; Rakheja, S; Schopper, A W; Han, B; Smutz, W P
2001-01-01
Hand-arm vibration syndrome (HAVS) has been associated with prolonged exposure to vibration transmitted to the human hand-arm system from hand-held power tools, vibrating machines, or hand-held vibrating workpieces. The biodynamic response of the human hand and arm to hand transmitted vibration (HTV) forms an essential basis for effective evaluations of exposures, vibration-attenuation mechanisms, and potential injury mechanisms. The biodynamic response to HTV and its relationship to HAVS are critically reviewed and discussed to highlight the advances and the need for further research. In view of its strong dependence on the nature of HTV and the lack of general agreement on the characteristics of HTV, the reported studies are first reviewed to enhance an understanding of HTV and related issues. The characteristics of HTV and relevant unresolved issues are discussed on the basis of measured data, proposed standards, and measurement methods, while the need for further developments in measurement systems is emphasized. The studies on biodynamic response and their findings are grouped into four categories based on the methodology used and the objective. These include studies on (1) through-the-hand-arm response, expressed in terms of vibration transmissibility; (2) to-the-hand response, expressed in terms of the force-motion relationship of the hand-arm system; (3) to-the-hand biodynamic response function, expressed in terms of vibration energy absorption; and (4) computer modeling of the biodynamic response characteristics.
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Hand Hygiene – Evaluation of Three Disinfectant Hand Sanitizers in a Community Setting
Babeluk, Rita; Jutz, Sabrina; Mertlitz, Sarah; Matiasek, Johannes; Klaus, Christoph
2014-01-01
Hand hygiene is acknowledged as the single most important measure to prevent nosocomial infections in the healthcare setting. Similarly, in non-clinical settings, hand hygiene is recognised as a key element in helping prevent the spread of infectious diseases. The aim of this study was to evaluate the efficacy of three different disinfectant hand sanitizers in reducing the burden of bacterial hand contamination in 60 healthy volunteers in a community setting, both before and after education about the correct use of hand sanitizers. The study is the first to evaluate the efficacy and ease of use of different formulations of hand rubs used by the general population. The products tested were: Sterillium (perfumed, liquid), desderman pure gel (odorless, gel) and Lavit (perfumed, spray). Sterillium and desderman are EN1500 (hygienic hand rub) certified products (available in pharmacy) and Lavit is non EN1500 certified and available in supermarkets. The two EN1500 certified products were found to be significantly superior in terms of reducing bacterial load. desderman pure gel, Sterillium and Lavit reduced the bacterial count to 6.4%, 8.2% and 28.0% respectively. After education in the correct use of each hand rub, the bacterial load was reduced even further, demonstrating the value of education in improving hand hygiene. Information about the testers' perceptions of the three sanitizers, together with their expectations of a hand sanitizer was obtained through a questionnaire. Efficacy, followed by skin compatibility were found to be the two most important attributes of a hand disinfectant in our target group. PMID:25379773
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Extended documentation for hand dermatitis patients: Pilot study on irritant exposures.
Uter, Wolfgang; Bauer, Andrea; Bensefa-Colas, Lynda; Brans, Richard; Crépy, Marie-Noëlle; Giménez-Arnau, Ana; Larese Filon, Francesca; Ljubojević Hadžavdić, Suzana; Pesonen, Maria; Schuttelaar, Marie L; Wilkinson, Mark; Lidén, Carola
2018-05-30
Irritant exposure may be a contributory cause or the sole cause of (occupational) hand dermatitis. However, the documentation of irritant exposures in clinical practice is not standardized. To examine the feasibility and usefulness of a form with different items addressing both occupational and non-occupational irritant exposures in a semiquantitative way. Between May 2016 and May 2017, successive patients with work-related hand dermatitis, irrespective of aetiology, were examined in 9 specialized European departments. Department-specific investigation was supplemented with the above proforma. The results were recorded by use of an anonymized secured online documentation system in a pilot study. Altogether, 193 patients were included; 114 females and 79 males, with a mean age of 40 years (range 18-68 years). The most common occupational group comprised healthcare workers (n = 35); occupational exposure of the hands to gloves, dusts and water without detergents of >2 hours/day was seen in 54.5%, 24.4% and 24.3% of patients, respectively. Non-occupational exposures rarely exceeded 2 hours/day. It is hoped that the set of descriptors will offer a basis for (clinical) epidemiological studies assessing the role of irritant exposures in occupational hand dermatitis, and to support a high level of quality and consistency in daily patient care. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Furukawa, Kiminobu; Suzuki, Harue; Fukuda, Jun
2012-11-01
To observe the real-time muscle activity of bilateral hands while subjects draw circles under 2 conditions: with and without using Ramachandran's mirror-box. A total of 24 healthy volunteers. Subjects drew 4 circles sequentially using their dominant hand with the other hand at rest, both with and without looking at a mirror image. Circles were marked by 8 dots on the paper, which subjects connected up to draw the shape. The activity of the bilateral first dorsal interosseus muscles was recorded using surface electromyography. Muscle activity of the dominant hand remained constant during each task. In contrast, muscle activity of the non-dominant hand increased under the condition of watching the image in the mirror, but was low under the non-watching condition. Furthermore, muscle activity of the non-dominant hand increased over the duration of the task. However, wide variation between subjects was observed under the mirror-image condition. Increased muscle action potential of the non-dominant hand may be induced by the circle drawing task of the dominant hand during Ramachandran's mirror-box therapy, which supports previous observations of increased brain activity caused by watching a mirror image.
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Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Shimizu, Taro; Kamiya, Toru; Sato, Yumiko; Arakawa, Soichi; Lee, Jong Ja; Iwata, Kentaro; Mihashi, Mutsuko; Tokuda, Yasuharu
2016-03-01
Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.
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40 CFR 152.93 - Citation of a previously submitted valid study.
Code of Federal Regulations, 2010 CFR
2010-07-01
... Data Submitters' Rights § 152.93 Citation of a previously submitted valid study. An applicant may demonstrate compliance for a data requirement by citing a valid study previously submitted to the Agency. The... the original data submitter, the applicant may cite the study only in accordance with paragraphs (b...
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Superior Temporal Gyrus Volume Abnormalities and Thought Disorder in Left-Handed Schizophrenic Men
Holinger, Dorothy P.; Shenton, Martha E.; Wible, Cynthia G.; Donnino, Robert; Kikinis, Ron; Jolesz, Ferenc A.; McCarley, Robert W.
2010-01-01
Objective Studies of schizophrenia have not clearly defined handedness as a differentiating variable. Moreover, the relationship between thought disorder and anatomical anomalies has not been studied extensively in left-handed schizophrenic men. The twofold purpose of this study was to investigate gray matter volumes in the superior temporal gyrus of the temporal lobe (left and right hemispheres) in left-handed schizophrenic men and left-handed comparison men, in order to determine whether thought disorder in the left-handed schizophrenic men correlated with tissue volume abnormalities. Method Left-handed male patients (N=8) with DSM-III-R diagnoses of schizophrenia were compared with left-handed comparison men (N=10) matched for age, socioeconomic status, and IQ. Magnetic resonance imaging (MRI) with a 1.5-T magnet was used to obtain scans, which consisted of contiguous 1.5-mm slices of the whole brain. MRI analyses (as previously defined by the authors) included the anterior, posterior, and total superior temporal gyrus in both the left and right hemispheres. Results There were three significant findings regarding the left-handed schizophrenic men: 1) bilaterally smaller gray matter volumes in the posterior superior temporal gyrus (16% smaller on the right, 15% smaller on the left); 2) a smaller volume on the right side of the total superior temporal gyrus; and 3) a positive correlation between thought disorder and tissue volume in the right anterior superior temporal gyrus. Conclusions These results suggest that expression of brain pathology differs between left-handed and right-handed schizophrenic men and that the pathology is related to cognitive disturbance. PMID:10553736
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In a demanding task, three-handed manipulation is preferred to two-handed manipulation
NASA Astrophysics Data System (ADS)
Abdi, Elahe; Burdet, Etienne; Bouri, Mohamed; Himidan, Sharifa; Bleuler, Hannes
2016-02-01
Equipped with a third hand under their direct control, surgeons may be able to perform certain surgical interventions alone; this would reduce the need for a human assistant and related coordination difficulties. However, does human performance improve with three hands compared to two hands? To evaluate this possibility, we carried out a behavioural study on the performance of naive adults catching objects with three virtual hands controlled by their two hands and right foot. The subjects could successfully control the virtual hands in a few trials. With this control strategy, the workspace of the hands was inversely correlated with the task velocity. The comparison of performance between the three and two hands control revealed no significant difference of success in catching falling objects and in average effort during the tasks. Subjects preferred the three handed control strategy, found it easier, with less physical and mental burden. Although the coordination of the foot with the natural hands increased trial after trial, about two minutes of practice was not sufficient to develop a sense of ownership towards the third arm.
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In a demanding task, three-handed manipulation is preferred to two-handed manipulation.
Abdi, Elahe; Burdet, Etienne; Bouri, Mohamed; Himidan, Sharifa; Bleuler, Hannes
2016-02-25
Equipped with a third hand under their direct control, surgeons may be able to perform certain surgical interventions alone; this would reduce the need for a human assistant and related coordination difficulties. However, does human performance improve with three hands compared to two hands? To evaluate this possibility, we carried out a behavioural study on the performance of naive adults catching objects with three virtual hands controlled by their two hands and right foot. The subjects could successfully control the virtual hands in a few trials. With this control strategy, the workspace of the hands was inversely correlated with the task velocity. The comparison of performance between the three and two hands control revealed no significant difference of success in catching falling objects and in average effort during the tasks. Subjects preferred the three handed control strategy, found it easier, with less physical and mental burden. Although the coordination of the foot with the natural hands increased trial after trial, about two minutes of practice was not sufficient to develop a sense of ownership towards the third arm.
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Kingston, Gail A; Judd, Dr Jenni; Gray, Marion A
2014-01-01
The aim of this research study was to gain an understanding of how rural and remote residents in North Queensland, Australia, engaged in work, activities of daily living tasks and social activities following a traumatic hand injury. Findings from a previous retrospective survey with these participants revealed that patients experienced difficulties such as pain for many years after their injury; however, because of the survey methodology, the voices of participants were not heard. This study contributes to a larger project that seeks to propose a model of service delivery to rural and remote residents who have sustained a traumatic injury. Utilising an interpretive phenomenological research design, data were gathered through in-depth, semistructured interviews. Fifteen participants were recruited into this study and questions were designed to explore the experience of having a traumatic hand injury in rural and remote areas of North Queensland. The thematic analysis indicated five major themes: injury and impairment, pain, occupation and activity, and resilience. Participants reported that having a hand injury often caused further injury due to the impairment. The pain experienced could be 'all consuming' yet participants reported 'pushing through' this pain to complete daily tasks. Participants reported that they would 'go mad' if they did not work and highlighted the importance of activity in their recovery. Participants felt grateful at having their hand and thought towards the future. Being self-reliant was important but they were willing to accept support from others when needed. Incorporating activity and occupation in rehabilitation programs as opposed to focusing on strict protocols is an important consideration in the recovery process of rural and remote residents. In particular, engaging in activity and occupation was an important part of managing the pain associated with the hand trauma. This research also found that participants demonstrated resilient
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TMS stimulus-response asymmetry in left- and right-handed individuals.
Daligadu, Julian; Murphy, Bernadette; Brown, Jeff; Rae, Brendan; Yielder, Paul
2013-02-01
There have been inconsistencies in the literature regarding asymmetrical neural control and results of experiments using TMS techniques. Therefore, the aim of this study was to further our understanding of the neural relationships that may underlie performance asymmetry with respect to the distal muscles of the hand using a TMS stimulus-response curve technique. Twenty-four male subjects (12 right handed, 12 left handed) participated in a TMS stimulus-response (S-R) curve trial. Focal TMS was applied over the motor cortex to find the optimal position for the first dorsal interossei muscle and to determine rest threshold (RTh). Seven TMS intensities ranging from 90 to 150 % of RTh were delivered in 10 % increments. One single TMS block consisted of 16 stimuli at each intensity. Peak-to-peak amplitudes were measured and the S-R curve generated. In right-handed subjects, the mean difference in slopes between the right and left hand was -0.011 ± 0.03, while the mean difference between hands in left-handed subjects was -0.049 ± 0.08. Left-handed normalized data in right handers displayed a mean of 1.616 ± 1.019 (two-tailed t test p < 0.05). The left-handed group showed a significant change in the normalized slope as indicated by a mean of 1.693 ± 0.149 (two-tailed t test p < 0.00006). The results found in this study reinforce previous work which suggests that there is an asymmetry in neural drive that exists in both left- and right-handed individuals. However, the results show that the non-dominant motor hemisphere displays a greater amount of excitability than the dominant, which goes against the conventional dogma. This asymmetry indicates that the non-dominant hemisphere may have a higher level of excitation or a lower level of inhibition for both groups of participants.
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MRSA Incidence and Antibiotic Trends in Urban Hand Infections: A 10-Year Longitudinal Study.
Kistler, Justin M; Thoder, Joseph J; Ilyas, Asif M
2018-01-01
Methicillin-resistant Staphylococcus aureus (MRSA) is the most reported pathogen in hand infections at urban medical centers throughout the country. Antibiotic sensitivity trends are not well known. The purposes of this study were to examine and determine the drug resistance trends for MRSA infections of the hand and to provide recommendations for empiric antibiotic treatment based on sensitivity profiles. A 10-year longitudinal, retrospective chart review was performed on all culture-positive hand infections encountered at a single urban medical center from 2005 to 2014. The proportions of all organisms were calculated for each year and collectively. MRSA infections were additionally subanalyzed for antibiotic sensitivity. A total of 815 culture-positive hand infections were identified. Overall, MRSA grew on culture in 46% of cases. A trend toward decreasing annual MRSA incidence was noted over the 10-year study period. There was a steady increase in polymicrobial infections during the same time. Resistance to clindamycin increased steadily during the 10-year study, starting at 4% in 2008 but growing to 31% by 2014. Similarly, levofloxacin resistance consistently increased throughout the study, reaching its peak at 56% in 2014. The annual incidence of MRSA in hand infections has declined overall but remains the most common pathogen. There has been an alternative increase in the number of polymicrobial infections. MRSA resistance to clindamycin and levofloxacin consistently increased during the study period. Empiric antibiotic therapy for hand infections should not only avoid penicillin and other beta-lactams but should also consider avoiding clindamycin and levofloxacin for empiric treatment.
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The efficacy of peloid therapy in management of hand osteoarthritis: a pilot study
NASA Astrophysics Data System (ADS)
Kasapoğlu Aksoy, Meliha; Altan, Lale; Eröksüz, Rıza; Metin Ökmen, Burcu
2017-12-01
Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion (ROM), and joint stiffness, leading to impaired hand function and difficulty in performance of daily living activities. Mud bath therapy has been reported to play a primary role in the prevention and management of OA. Thus, we planned to conduct a study aimed at investigating the effects of peloid therapy on pain, functional state, grip strength, and the quality of life and performing a comparative analysis of the outcomes of peloid therapy. In this randomized, controlled, single-blind, pilot study, patients ( n = 33) underwent peloid therapy over 2 weeks, 5 sessions a week, for a total of 10 sessions and home exercise program in group 1. Patients in group 2 (control, n = 30) received only the same home exercise program as in group 1. Patients were evaluated just before, and 2 and 6 weeks after the start of the study with Visual Analogue Scale (VAS), Australian/Canadian Hand Osteoarthritis Index (AUSCAN), Health Assessment Questionnaire (HAQ), hand grip strength (HGS), and pinch strength (PS). Statistically significant improvements were observed in all parameters assessed at week 2 and week 6 in the group 1 ( p < 0.05). Statistically significant differences were observed in HGS scores in the group 2 at week 2 and in AUSCAN scores at week 6 ( p < 0.05). Intergroup comparisons of the scores revealed significant differences between the peloid therapy group and control group in VAS, HAQ, AUSCAN, HGS, and PS scores at week 2 and week 6 ( p < 0.05). This study demonstrates that peloid therapy might be an effective and confident treatment modality in the management of symptomatic osteoarthritis of the hand and may provide effective pain control and improvements in the hand functions, quality of life, and grip strength.
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Back to basics: hand hygiene and surgical hand antisepsis.
Spruce, Lisa
2013-11-01
Health care-associated infections (HAIs) are a significant issue in the United States and throughout the world, but following proper hand hygiene practices is the most effective and least expensive way to prevent HAIs. Hand hygiene is inexpensive and protects patients and health care personnel alike. The four general types of hand hygiene that should be performed in the perioperative environment are washing hands that are visibly soiled, hand hygiene using alcohol-based products, surgical hand scrubs, and surgical hand scrubs using an alcohol-based surgical hand rub product. Barriers to proper hand hygiene may include not thinking about it, forgetting, skin irritation, a lack of role models, or a lack of a safety culture. One strategy for improving hand hygiene practices is monitoring hand hygiene as part of a quality improvement project, but the most important aspect for perioperative team members is to set an example for other team members by following proper hand hygiene practices and reminding each other to perform hand hygiene. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.
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Agarwal, Uma Shankar; Besarwal, Raj Kumar; Gupta, Rahul; Agarwal, Puneet; Napalia, Sheetal
2014-01-01
Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients. PMID:24891648
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de la Vega, Irmgard; Dudschig, Carolin; De Filippis, Mónica; Lachmair, Martin; Kaup, Barbara
2013-02-01
The body-specificity hypothesis (Casasanto, 2009) associates positive emotional valence and the space surrounding the dominant hand, and negative valence and the space surrounding the non-dominant hand. This effect has not only been found for manual responses, but also for the left and right side. In the present study, we investigated whether this compatibility effect still shows when hand and side carry incongruent information, and whether it is then related to hand or to side. We conducted two experiments which used an incongruent hand-response key assignment, that is, participants had their hands crossed. Participants were instructed to respond with their right vs. left hand (Experiment 1) or with the right vs. left key (Experiment 2). In both experiments, a compatibility effect related to hand emerged, indicating that the association between hand and valence overrides the one between side and valence when hand and side carry contradicting information. Copyright © 2013 Elsevier B.V. All rights reserved.
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2012-01-01
Background Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak. Methods A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14). Classrooms were systematically assigned to an intervention or control group by grade (cluster design). Hand hygiene facilities (sanitizer and soap) were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs. Results Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days). Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P = 0.002, P < 0
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Hand function in workers with hand-arm vibration syndrome.
Cederlund, R; Isacsson, A; Lundborg, G
1999-01-01
Hand-arm vibration syndrome has been specially addressed in the Scandinavian countries in recent years, but the syndrome is still not sufficiently recognized in many countries. The object of this preliminary study was to describe the nature and character of vibration-induced impairment in the hands of exposed workers. Twenty symptomatic male workers (aged 28 to 65 years) subjected to vibration by hand-held tools were interviewed about subjective symptoms and activities of daily living and were assessed with a battery of objective tests for sensibility, dexterity, grip function, and grip strength. The test results were compared with normative data. The majority of patients complained of cold intolerance, numbness, pain, sensory impairment, and difficulties in handling manual tools and in handwriting. The various objective tests showed considerable variation in indications of pathologic outcome, revealing differences in sensitivity to detect impaired hand function. Semmes-Weinstein monofilament testing for perception of light touch-deep pressure sensation, the small-object shape identification test, and moving two-point discrimination testing for functional sensibility provided the most indications of pathologic outcomes. The authors conclude that vibration-exposed patients present considerable impairment in hand function.
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Negative Stimulus-Response Compatibility Observed with a Briefly Displayed Image of a Hand
ERIC Educational Resources Information Center
Vainio, Lari
2011-01-01
Manual responses can be primed by viewing an image of a hand. The left-right identity of the viewed hand reflexively facilitates responses of the hand that corresponds to the identity. Previous research also suggests that when the response activation is triggered by an arrow, which is backward-masked and presented briefly, the activation manifests…
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Packham, Tara; MacDermid, Joy C
2013-01-01
The Patient-Rated Wrist and Hand Evaluation (PRWHE) is a self-reported assessment of pain and disability to evaluate outcome after hand injuries. Rasch analysis is an alternative strategy for examining the psychometric properties of a measurement scale based in item response theory, rather than classical test theory. This study used Rasch analysis to examine the content, scoring and measurement properties of the PRWHE. PRWHE scores (n = 264) from persons with a traumatic injury or reconstructive surgery to one hand were collected from an outpatient hand rehabilitation facility. Rasch analysis was conducted to assess how the PRWHE fit the Rasch model, confirms the scaling structure of the pain and disability subscales, and identifies any areas of bias from differential item functioning. Rasch analysis of the PRWHE supports internal consistency of the scale (α = 0.96) and reliability (as measured by the person separation index) of 0.95. While gender, age, diagnosis, and duration since injury all systematically influenced how people scored the PRWHE, hand dominance and affected side did not. Rasch analysis supported a 3 subscale structure (pain, specific activities and usual activities) rather than the current divisions of pain and disability. Initial examination of the PRWHE indicates the psychometric properties of consistency, reliability and responsiveness previously tested by classical methods are further supported by Rasch analysis. It also suggests the scale structure may be best considered as 3 subscales rather than simply pain and disability. Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Biederman, G. B.; Fairhall, J. L.; Raven, K. A.; Davey, V. A.
1998-01-01
A study involving six children (ages 5-13) with mental retardation found that overall passive modeling was significantly more effective than hand-over-hand modeling in teaching skills, and that passive modeling was significantly more effective than hand-over-hand modeling with response-contingent verbal prompting. (Author/CR)
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ERIC Educational Resources Information Center
Wright, Tessa; Wormsley, Diane P.; Kamei-Hannan, Cheryl
2009-01-01
Using a subset of data from the Alphabetic Braille and Contracted Braille Study, researchers analyzed the patterns and characteristics of hand movements as predictors of reading performance. Statistically significant differences were found between one- and two-handed readers and between patterns of hand movements and reading rates. (Contains 6…
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Evidence for right-hand feeding biases in a left-handed population.
Flindall, Jason W; Stone, Kayla D; Gonzalez, Claudia L R
2015-05-01
We have recently shown that actions with similar kinematic requirements, but different end-state goals may be supported by distinct neural networks. Specifically, we demonstrated that when right-handed individuals reach-to-grasp food items with intent to eat, they produce smaller maximum grip apertures (MGAs) than when they grasp the same item with intent to place it in a location near the mouth. This effect was restricted to right-handed movements; left-handed movements showed no difference between tasks. The current study investigates whether (and to which side) the effect may be lateralized in left-handed individuals. Twenty-one self-identified left-handed participants grasped food items of three different sizes while grasp kinematics were captured via an Optotrak Certus motion capture array. A main effect of task was identified wherein the grasp-to-eat action generated significantly smaller MGAs than did the grasp-to-place action. Further analysis revealed that similar to the findings in right-handed individuals, this effect was significant only during right-handed movements. Upon further inspection however, we found individual differences in the magnitude and direction of the observed lateralization. These results underscore the evolutionary significance of the grasp-to-eat movement in producing population-level right-handedness in humans as well as highlighting the heterogeneity of the left-handed population.
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Hand Washing Among School Children in Bogotá, Colombia
Lopez-Quintero, Catalina; Freeman, Paul
2009-01-01
Objectives. We assessed hand-washing behaviors and intentions among school children in Bogotá, Colombia, to help identify and overcome barriers to proper hygiene practices. Methods. Data on hand-washing behavior and intentions and individual and contextual factors were collected from 2042 sixth- through eighth-grade students in 25 schools in Bogotá via anonymous questionnaires. A member of the school administration or teaching staff completed a questionnaire about the school environment. Site inspections of bathroom facilities were conducted. Results. Only 33.6% of the sample reported always or very often washing hands with soap and clean water before eating and after using the toilet. About 7% of students reported regular access to soap and clean water at school. A high level of perceived control was the strongest predictor of positive hand-washing intentions (adjusted odds ratio [AOR] = 6.0; 95% confidence interval [CI] = 4.8, 7.5). Students with proper hand-washing behavior were less likely to report previous-month gastrointestinal symptoms (OR = 0.8; 95% CI = 0.6, 0.9) or previous-year school absenteeism (OR = 0.7; 95% CI = 0.6, 0.9). Conclusions. Scarcity of adequate facilities in most schools in Bogotá prevents children from adopting proper hygienic behavior and thwarts health promotion efforts. The current renovation program of public schools in Bogotá provides a unique opportunity to meet the challenges of providing a supportive environment for adoption of healthy behaviors. PMID:19008513
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Meng, Shuang; Oi, Misato; Saito, Godai; Saito, Hirofumi
2017-01-01
Previous studies, mainly using a first-person perspective (1PP), have shown that the judgments of the hand laterality judgment (HLJ) task are dependent on biomechanical constraints (BC). Specifically, differing reaction times (RT) for hand pictures rotated medially or laterally around the mid sagittal plane are attributed to the BC effect on motor imagery. In contrast, we investigated whether the HLJ task is also subject to BC when performed from a third-person perspective (3PP) as well as 1PP using near-infrared spectroscopy (NIRS) to measure the brain activity of prefrontal cortex (PFC) in right-handed participants assigned to 1PP or 3PP groups. The 1PP group judged whether a presented hand was their own left or right hand, and the 3PP group whether it was the other's left or right hand. Using their HLJ task error rates, the 1PP and 3PP groups were subdivided into an Error Group (EG) and No Error Group (NEG). For the 1PP group, both EG and NEG showed a significant Hand Laterality × Orientation interaction for RT, indicating the BC effect on motor imagery. For the 3PP group, however, neither EG nor NEG showed the interaction, even though EG showed a significantly longer RT than NEG. These results suggest that the 3PP EG appropriately followed the 3PP task instruction, while the NEG might have taken 1PP. However, the 3PP EG NIRS profile of left PFC showed a significant Hand Laterality × Orientation interaction, while the 1PP EG did not. More noteworthy is that the left PFC activation of EG showed an interaction between the 1PP and 3PP groups when the left hand was presented. Furthermore, in the NEG, the PFC activation was not influenced by the BC in either the 1PP or 3PP condition. These results indicate that BC interferes with the HLJ task performed from the 1PP and 3PP.
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Hand anthropometry of Indian women.
Nag, Anjali; Nag, P K; Desai, Hina
2003-06-01
Data on the physical dimension of the hand of Indian women are scanty. This information is necessary to ascertain human-machine compatibility in the design of manual systems for the bare and gloved hand, such as design and sizing of hand tools, controls, knobs and other applications in different kinds of precision and power grips. The present study was undertaken to generate hand anthropometric data of 95 women, working in informal industries (beedi, agarbatti and garment making). Fifty one hand measurements of the right hand (lengths, breadths, circumferences, depths, spreads and clearances of hand and fingers) were taken, using anthropometric sliding and spreading calipers, measuring tape and handgrip strength dynamometer. The data were statistically analyzed to determine the normality of data and the percentile values of different hand dimensions, and simple and multiple regression analysis were done to determine better predictors of hand length and grip strength. The hand breadths, circumferences and depths were approximately normally distributed, with some deviation in case of the finger lengths. Hand length was significantly correlated with the fist, wrist and finger circumferences. The fist and wrist circumferences, in combination, were better predictors of hand length. The hand lengths, breadths and depths, including finger joints of the Indian women studied were smaller than those of American, British and West Indian women. The hand circumferences of the Indian women were also smaller than the American women. Grip strengths of Indian women (20.36 +/- 3.24 kg) were less than those of American, British and West Indian women. Grip strength was found to be statistically significant with hand dimensions, such as hand height perpendicular to wrist crease (digit 5), proximal interphalangeal joint breadth (digit 3) and hand spread across wedge 1. The women who are forced to frequently use cutters, strippers and other tools, which are not optimally designed to
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The Geriatric Hand: Correlation of Hand-Muscle Function and Activity Restriction in Elderly
ERIC Educational Resources Information Center
Incel, Nurgul Arinci; Sezgin, Melek; As, Ismet; Cimen, Ozlem Bolgen; Sahin, Gunsah
2009-01-01
On the basis of the importance of hand manipulation in activities of daily living (ADL), deterioration of hand function because of various factors reduces quality and independence of life of the geriatric population. The aim of this study was to identify age-induced changes in manual function and to quantify the correlations between hand-muscle…
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Pesyna, Colin; Pundi, Krishna; Flanders, Martha
2011-03-09
The neural control of hand movement involves coordination of the sensory, motor, and memory systems. Recent studies have documented the motor coordinates for hand shape, but less is known about the corresponding patterns of somatosensory activity. To initiate this line of investigation, the present study characterized the sense of hand shape by evaluating the influence of differences in the amount of grasping or twisting force, and differences in forearm orientation. Human subjects were asked to use the left hand to report the perceived shape of the right hand. In the first experiment, six commonly grasped items were arranged on the table in front of the subject: bottle, doorknob, egg, notebook, carton, and pan. With eyes closed, subjects used the right hand to lightly touch, forcefully support, or imagine holding each object, while 15 joint angles were measured in each hand with a pair of wired gloves. The forces introduced by supporting or twisting did not influence the perceptual report of hand shape, but for most objects, the report was distorted in a consistent manner by differences in forearm orientation. Subjects appeared to adjust the intrinsic joint angles of the left hand, as well as the left wrist posture, so as to maintain the imagined object in its proper spatial orientation. In a second experiment, this result was largely replicated with unfamiliar objects. Thus, somatosensory and motor information appear to be coordinated in an object-based, spatial-coordinate system, sensitive to orientation relative to gravitational forces, but invariant to grasp forcefulness.
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Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil.
Pickering, Amy J; Davis, Jennifer; Boehm, Alexandria B
2011-09-01
Handwashing education and promotion are well established as effective strategies to reduce diarrhea and respiratory illness in countries around the world. However, access to reliable water supplies has been identified as an important barrier to regular handwashing in low-income countries. Alcohol-based hand sanitizer (ABHS) is an effective hand hygiene method that does not require water, but its use is not currently recommended when hands are visibly soiled. This study evaluated the efficacy of ABHS on volunteers' hands artificially contaminated with Escherichia coli in the presence of dirt (soil from Tanzania) and cooking oil. ABHS reduced levels of E. coli by a mean of 2.33 log colony forming units (CFU) per clean hand, 2.32 log CFU per dirt-covered hand, and 2.13 log CFU per oil-coated hand. No significant difference in efficacy was detected between hands that were clean versus dirty or oily. ABHS may be an appropriate hand hygiene method for hands that are moderately soiled, and an attractive option for field settings in which access to water and soap is limited.
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The role of vision on hand preshaping during reach to grasp.
Winges, Sara A; Weber, Douglas J; Santello, Marco
2003-10-01
During reaching to grasp objects with different shapes hand posture is molded gradually to the object's contours. The present study examined the extent to which the temporal evolution of hand posture depends on continuous visual feedback. We asked subjects to reach and grasp objects with different shapes under five vision conditions (VCs). Subjects wore liquid crystal spectacles that occluded vision at four different latencies from onset of the reach. As a control, full-vision trials (VC5) were interspersed among the blocked vision trials. Object shapes and all VCs were presented to the subjects in random order. Hand posture was measured by 15 sensors embedded in a glove. Linear regression analysis, discriminant analysis, and information theory were used to assess the effect of removing vision on the temporal evolution of hand shape. We found that reach duration increased when vision was occluded early in the reach. This was caused primarily by a slower approach of the hand toward the object near the end of the reach. However, vision condition did not have a significant effect on the covariation patterns of joint rotations, indicating that the gradual evolution of hand posture occurs in a similar fashion regardless of vision. Discriminant analysis further supported this interpretation, as the extent to which hand posture resembled object shape and the rate at which hand posture discrimination occurred throughout the movement were similar across vision conditions. These results extend previous observations on memory-guided reaches by showing that continuous visual feedback of the hand and/or object is not necessary to allow the hand to gradually conform to object contours.
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Laible, Mona; Grieshammer, Steven; Seidel, Gundula; Rijntjes, Michel; Weiller, Cornelius; Hamzei, Farsin
2012-09-01
Previous studies demonstrated a posterior shift of activation toward the primary sensory cortex (S1) following stroke; however, any relationship between this posterior shift and clinical outcome measures for the affected hand function were unclear. The authors investigated the possible role of S1 in motor recovery. Assuming that previous studies examined inhomogeneous groups of patients, the authors selected participants with chronic stroke who had moderate hand paresis, normal sensory examination and somatosensory-evoked potentials, and no lesion within the S1, thalamus, or brain stem. Constraint-induced movement therapy (CIMT) was used to train the impaired hand. To relate fMRI (functional MRI) activation changes from baseline to post-CIMT, a correlation analysis was performed with changes of the Wolf Motor Function Test (WMFT) as a test for the hand function. A close relationship was found between increases in hand function and peak changes in activation within the ipsilesional S1. With a better outcome, greater increases in activation within the S1 were evident (P < .03; r = 0.73). In selected patients, the sensory network influences training-induced motor gains. This predictive knowledge of plasticity when applying CIMT may suggest strategies to enhance the effect of therapy, such as the addition of electrical stimulation to enhance S1 excitability.
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Antimicrobial efficacy of soap and water hand washing versus an alcohol-based hand cleanser.
Holton, Ronald H; Huber, Michaell A; Terezhalmy, Geza T
2009-12-01
The emergence of alcohol-based hand cleansers may represent an alternative to soap and water in the clinical dental setting. In this study, the antimicrobial efficacy of traditional hand washing vs. a unique alcohol-based hand cleanser with persistence was evaluated. Two experienced dentists participated over a 10-day period. On days 1-5, each clinician used an antibacterial liquid soap (Dial, Dial Corporation, Scottsdale, AZ). Days 6-10, an alcohol-based hand cleanser (Triseptin Water Optional, Healthpoint Surgical, Fort Worth, TX) was used. Sampling was by modified glove juice technique. The results indicate that the alcohol-based hand cleanser dramatically outperforms the traditional hand washing agent in the general dental setting.
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Bilinauskaite, Milda; Mantha, Vishveshwar Rajendra; Rouboa, Abel Ilah; Ziliukas, Pranas; Silva, Antonio Jose
2013-01-01
The aim of this paper is to determine the hydrodynamic characteristics of swimmer's scanned hand models for various combinations of both the angle of attack and the sweepback angle and shape and velocity of swimmer's hand, simulating separate underwater arm stroke phases of freestyle (front crawl) swimming. Four realistic 3D models of swimmer's hand corresponding to different combinations of separated/closed fingers positions were used to simulate different underwater front crawl phases. The fluid flow was simulated using FLUENT (ANSYS, PA, USA). Drag force and drag coefficient were calculated using (computational fluid dynamics) CFD in steady state. Results showed that the drag force and coefficient varied at the different flow velocities on all shapes of the hand and variation was observed for different hand positions corresponding to different stroke phases. The models of the hand with thumb adducted and abducted generated the highest drag forces and drag coefficients. The current study suggests that the realistic variation of both the orientation angles influenced higher values of drag, lift, and resultant coefficients and forces. To augment resultant force, which affects swimmer's propulsion, the swimmer should concentrate in effectively optimising achievable hand areas during crucial propulsive phases. PMID:23691493
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Feasibility study of a hand guided robotic drill for cochleostomy.
Brett, Peter; Du, Xinli; Zoka-Assadi, Masoud; Coulson, Chris; Reid, Andrew; Proops, David
2014-01-01
The concept of a hand guided robotic drill has been inspired by an automated, arm supported robotic drill recently applied in clinical practice to produce cochleostomies without penetrating the endosteum ready for inserting cochlear electrodes. The smart tactile sensing scheme within the drill enables precise control of the state of interaction between tissues and tools in real-time. This paper reports development studies of the hand guided robotic drill where the same consistent outcomes, augmentation of surgeon control and skill, and similar reduction of induced disturbances on the hearing organ are achieved. The device operates with differing presentation of tissues resulting from variation in anatomy and demonstrates the ability to control or avoid penetration of tissue layers as required and to respond to intended rather than involuntary motion of the surgeon operator. The advantage of hand guided over an arm supported system is that it offers flexibility in adjusting the drilling trajectory. This can be important to initiate cutting on a hard convex tissue surface without slipping and then to proceed on the desired trajectory after cutting has commenced. The results for trials on phantoms show that drill unit compliance is an important factor in the design.
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Fragrance allergy in patients with hand eczema - a clinical study.
Heydorn, Siri; Johansen, Jeanne Duus; Andersen, Klaus E; Bruze, Magnus; Svedman, Cecilia; White, Ian R; Basketter, David A; Menné, Torkil
2003-06-01
Fragrance allergy and hand eczema are both common among dermatological patients. Fragrance mix (FM) and its constituents have a recognized relevance to exposure to fine fragrances and cosmetic products. Based on extensive chemical analysis and database search, a new selection of fragrances was established, including 14 known fragrance allergens present in products to which hand exposure would occur. A non-irritating patch-test concentration for some fragrances was established in 212 consecutive patients. 658 consecutive patients presenting with hand eczema were patch tested with the European standard series and the developed selection of fragrances. 67 (10.2%) of the 658 patients had a positive reaction to 1 or more of our selection of fragrance chemicals present in the new selection. The most common reactions to fragrances not included in the FM were to citral, Lyral (hydroxyisohexyl-3-cyclohexene carboxaldehyde) and oxidized l-limonene. A concomitant reaction to the FM identified potential fragrance allergy in less than (1/2) of these patients. Exposure assessment and a statistically significant association between a positive patch test to our selected fragrances and patients' history support the relevance of this selection of fragrances. Those with a positive reaction to our selected fragrances were significantly more likely to have 1 or more positive patch tests in the standard series. This observation is the basis for the hypothesis concerning cross-reactivity and the effect of simultaneous exposure. The study found that fragrance allergy could be a common problem in patients with eczema on the hands.
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Wallace, Patricia S; Whishaw, Ian Q
2003-01-01
Previous work has described human reflexive grasp patterns in early infancy and visually guided reaching and grasping in late infancy. There has been no examination of hand movements in the intervening period. This was the purpose of the present study. We video recorded the spontaneous hand and digit movements made by alert infants over their first 5 months of age. Over this period, spontaneous hand and digit movements developed from fists to almost continuous, vacuous movements and then to self-directed grasping movements. Amongst the many hand and digit movements observed, four grasping patterns emerged during this period: fists, pre-precision grips associated with numerous digit postures, precision grips including the pincer grasp, and self-directed grasps. The finding that a wide range of independent digit movements and grasp patterns are displayed spontaneously by infants within their first 5 months of age is discussed in relation to the development of the motor system, including the suggestion that direct connections of the pyramidal tract are functional relatively early in infancy. It is also suggested that hand babbling, consisting of first vacuous and then self-directed movements, is preparatory to targeted reaching.
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A mechatronics platform to study prosthetic hand control using EMG signals.
Geethanjali, P
2016-09-01
. This prototype facilitated the study of various issues of pattern recognition and identified an efficient classifier, along with a feature ensemble, in the implementation of EMG controlled prosthetic hands in a laboratory setting at low-cost. This platform may help to motivate and facilitate prosthetic hand research in developing countries.
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Iwakiri, Kentaro; Kobayashi, Akio; Seki, Masahiko; Ando, Yoshiyuki; Tsujio, Tadao; Hoshino, Masatoshi; Nakamura, Hiroaki
2017-11-15
MINI: Fourteen hundred consecutive patients were investigated for evaluating the utility of waterless hand rub before orthopaedic surgery. The risk in the surgical site infection incidence was the same, but costs of liquids used for hand hygiene were cheaper and the hand hygiene time was shorter for waterless protocol, compared with traditional hand scrub. A retrospective cohort study with prospectively collected data. The aim of this study was to compare SSI incidences, the cost of hand hygiene agents, and hand hygiene time between the traditional hand scrub and the waterless hand rub protocols before orthopedic surgery. Surgical site infections (SSI) prolong hospitalization and are a leading nosocomial cause of morbidity and a source of excess cost. Recently, a waterless hand rub protocol comprising alcohol based chlorhexidine gluconate for use before surgery was developed, but no studies have yet examined its utility in orthopedic surgery. Fourteen hundred consecutive patients who underwent orthopedic surgery (spine, joint replacement, hand, and trauma surgeries) in our hospital since April 1, 2012 were included. A total of 712 cases underwent following traditional hand scrub between April 1, 2012 and April 30, 2013 and 688 cases underwent following waterless hand rub between June 1, 2013 and April 30, 2014. We compared SSI incidences within all and each subcategory between two hand hygiene protocols. All patients were screened for SSI within 1 year after surgery. We compared the cost of hand hygiene agents and hand hygiene time between two groups. The SSI incidences were 1.3% (9 of 712) following the traditional protocol (2 deep and 7 superficial infections) and 1.1% (8 of 688) following the waterless protocol (all superficial infections). There were no significant differences between the two groups. The costs of liquids used for one hand hygiene were about $2 for traditional hand scrub and less than $1 for waterless hand rub. The mean hand hygiene time was 264
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Kaneko, Fuminari; Blanchard, Caroline; Lebar, Nicolas; Nazarian, Bruno; Kavounoudias, Anne; Romaiguère, Patricia
2015-01-01
It is well known that kinesthetic illusions can be induced by stimulation of several sensory systems (proprioception, touch, vision…). In this study we investigated the cerebral network underlying a kinesthetic illusion induced by visual stimulation by using functional magnetic resonance imaging (fMRI) in humans. Participants were instructed to keep their hand still while watching the video of their own moving hand (Self Hand) or that of someone else's moving hand (Other Hand). In the Self Hand condition they experienced an illusory sensation that their hand was moving whereas the Other Hand condition did not induce any kinesthetic illusion. The contrast between the Self Hand and Other Hand conditions showed significant activation in the left dorsal and ventral premotor cortices, in the left Superior and Inferior Parietal lobules, at the right Occipito-Temporal junction as well as in bilateral Insula and Putamen. Most strikingly, there was no activation in the primary motor and somatosensory cortices, whilst previous studies have reported significant activation in these regions for vibration-induced kinesthetic illusions. To our knowledge, this is the first study that indicates that humans can experience kinesthetic perception without activation in the primary motor and somatosensory areas. We conclude that under some conditions watching a video of one's own moving hand could lead to activation of a network that is usually involved in processing copies of efference, thus leading to the illusory perception that the real hand is indeed moving. PMID:26287488
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Kaneko, Fuminari; Blanchard, Caroline; Lebar, Nicolas; Nazarian, Bruno; Kavounoudias, Anne; Romaiguère, Patricia
2015-01-01
It is well known that kinesthetic illusions can be induced by stimulation of several sensory systems (proprioception, touch, vision…). In this study we investigated the cerebral network underlying a kinesthetic illusion induced by visual stimulation by using functional magnetic resonance imaging (fMRI) in humans. Participants were instructed to keep their hand still while watching the video of their own moving hand (Self Hand) or that of someone else's moving hand (Other Hand). In the Self Hand condition they experienced an illusory sensation that their hand was moving whereas the Other Hand condition did not induce any kinesthetic illusion. The contrast between the Self Hand and Other Hand conditions showed significant activation in the left dorsal and ventral premotor cortices, in the left Superior and Inferior Parietal lobules, at the right Occipito-Temporal junction as well as in bilateral Insula and Putamen. Most strikingly, there was no activation in the primary motor and somatosensory cortices, whilst previous studies have reported significant activation in these regions for vibration-induced kinesthetic illusions. To our knowledge, this is the first study that indicates that humans can experience kinesthetic perception without activation in the primary motor and somatosensory areas. We conclude that under some conditions watching a video of one's own moving hand could lead to activation of a network that is usually involved in processing copies of efference, thus leading to the illusory perception that the real hand is indeed moving.
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Rabbi, Sifat E; Dey, Nepal C
2013-01-30
Hand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. This study compared hand washing knowledge and practices in BRAC's water; sanitation and hygiene (WASH) programme areas over time. This study is a cross-sectional comparative study between baseline (2006), midline (2009) and end-line (2011) surveys in 50 sub-districts from the first phase of the programme. Thirty thousand households from 50 sub-districts were selected in two steps: i) 30 villages were selected from each sub-district by cluster sampling, and ii) 20 households were chosen systematically from each village. The matched households were considered (26,404 in each survey) for analysis. Data were collected from households through face-to-face interview using a pre-tested questionnaire. Respondents were the adult female members of the same households, who had knowledge of day-to-day household activities related to water, sanitation and hygiene. A gap between perception and practice of proper hand washing practices with soap was identified in the study areas. Hand washing practice with soap before eating was much lower than after defecation. In baseline data, 8% reported to wash their hands with soap which significantly increased to 22% in end line. Hand washing knowledge and practices before cooking food, before serving food and while handling babies is considerably limited than other critical times. A multivariate analysis shows that socio-economic factors including education of household head and respondent, water availability and access to media have strong positive association with hand washing with soap. Gap between knowledge and practice still persists in hand washing practices. Long term and extensive initiatives can aware people about the effectiveness of hand washing.
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In pursuit of our ancestors' hand laterality.
Bargalló, Amèlia; Mosquera, Marina; Lozano, Sergi
2017-10-01
The aim of this paper is to apply a previously published method (Bargalló and Mosquera, 2014) to the archaeological record, allowing us to identify the hand laterality of our ancestors and determine when and how this feature, which is exhibited most strongly in humans, appeared in our evolutionary history. The method focuses on identifying handedness by looking at the technical features of the flakes produced by a single knapper, and discovering how many flakes are required to ascertain their hand preference. This method can potentially be applied to the majority of archaeological sites, since flakes are the most abundant stone tools, and stone tools are the most widespread and widely-preserved remains from prehistory. For our study, we selected two Spanish sites: Gran Dolina-TD10.1 (Atapuerca) and Abric Romaní (Barcelona), which were occupied by pre-Neanderthal and Neanderthal populations, respectively. Our analyses indicate that a minimum number of eight flakes produced by the same knapper is required to ascertain their hand preference. Even though this figure is relatively low, it is quite difficult to obtain from many archaeological sites. In addition, there is no single technical feature that provides information about handedness, instead there is a combination of eight technical features, localised on the striking platforms and ventral surfaces. The raw material is not relevant where good quality rocks are used, in this case quartzite and flint, since most of them retain the technical features required for the analysis. Expertise is not an issue either, since the technical features analysed here only correlate with handedness (Bargalló and Mosquera, 2014). Our results allow us to tentatively identify one right-handed knapper among the pre-Neanderthals of level TD10.1 at Gran Dolina (Atapuerca), while four of the five Neanderthals analysed from Abric Romaní were right-handed. The hand preference of the fifth knapper from that location (AR5) remains unclear
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Terada, Yasuhiko; Kono, Saki; Uchiumi, Tomomi; Kose, Katsumi; Miyagi, Ryo; Yamabe, Eiko; Fujinaga, Yasunari; Yoshioka, Hiroshi
2014-01-01
The purpose of this study was to improve the reliability and validity of skeletal age assessment using an open and compact pediatric hand magnetic resonance (MR) imaging scanner. We used such a scanner with 0.3-tesla permanent magnet to image the left hands of 88 healthy children (aged 3.4 to 15.7 years, mean 8.8 years), and 3 raters (2 orthopedic specialists and a radiologist) assessed skeletal age using those images. We measured the strength of agreement in ratings by values of weighted Cohen's κ and the proportion of cases excluded from rating because of motion artifact and inappropriate positioning. We compared the current results with those of a previous study in which 93 healthy children (aged 4.1 to 16.4 years, mean 9.7 years) were examined with an adult hand scanner. The κ values between raters exceeded 0.80, which indicates almost perfect agreement, and most were higher than those of the previous study. The proportion of cases excluded from rating because of motion artifact or inappropriate positioning was also reduced. The results indicate that use of the compact pediatric hand scanner improved the reliability and validity of skeletal age assessments.
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Lausberg, Hedda; Cruz, Robyn Flaum
2004-01-01
Several studies of patients with unilateral brain damage and a patient with spontaneous callosal disconnection [Journal of Neurology, Neurosurgery, and Psychiatry 61 (1996) 176; Neuropsychologia 37 (1999) 559; Neuropsychologia 39 (2001) 1432] suggest that the imitation of positions of the hand relative to the head is a strongly lateralised left hemispheric function. In contrast, the imitation of finger configurations draws on resources of both hemispheres with a predominance of the right hemisphere. While these findings suggest a specific pattern of imitation impairment in split-brain patients, thus far, no imitation deficits have been reported in split-brain patients. Three patients with complete callosotomy and two control groups, four patients with partial callosotomy and 10 healthy subjects, imitated hand-head positions and finger configurations with non-lateralised and tachistoscopic stimulus presentation. In addition, the influence of visual control on the imitation performance was examined. One split-brain patient showed the predicted dissociation as she had severe right hemispheric deficit in imitating hand-head positions, while finger configuration imitation was preserved. The other two split-brain patients had no impairment in hand-head position imitation. Withdrawal of visual control significantly deteriorated imitation of finger configurations in the split-brain group, but not in the controls, demonstrating that the split-brain patients relied heavily on visual control as a compensatory strategy indicating an imitation deficit in the separate hemispheres. The findings question the previously held belief that in split-brain patients both hemispheres are perfectly capable of imitating gestures and that imitation is not dependent on hemispherically specialised functions.
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Effect of gender and hand laterality on pain processing in human neonates.
Ozawa, Mio; Kanda, Katsuya; Hirata, Michio; Kusakawa, Isao; Suzuki, Chieko
2011-01-01
Previous studies in adults have reported that handedness and gender can affect pain perception. However, it is currently unclear when these differences emerge in human development. Therefore, we examined prefrontal responses to pain stimulation among newborns during their first acute pain experience after birth. Forty newborns at 4-6 days postnatal age were observed during clinically required blood sampling while prefrontal activation was measured with near infrared spectroscopy. Blood sampling in this study was the first experience of a procedure involving skin breaking for these infants. We divided subjects into a right-hand stimulation group (n=21) and a left-hand stimulation group (n=19), depending on whether blood was sampled from the right or the left hand. A three-way analysis of variance (ANOVA) was conducted to examine the effects of several variables on the magnitude of the oxy-Hb value in response to pain stimulus, including stimulus side (right hand or left hand), gender (male or female), recording side (right prefrontal area or left prefrontal area) and interactions between these variables. The data revealed a significant effect of stimulus side (F (1, 72)=9.892, P=0.002), showing that the right-hand stimulation induced a greater prefrontal activation than the left-hand stimulation. No significant gender difference or interactions were found. Our findings suggest that hand laterality affects pain perception even in neonates. However, gender differences in pain perception did not appear to occur during the neonatal period. Further investigations using brain-imaging techniques are required to identify laterality- or gender-related differences in pain processing in humans. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Sheridan, R L; Baryza, M J; Pessina, M A; O'Neill, K M; Cipullo, H M; Donelan, M B; Ryan, C M; Schulz, J T; Schnitzer, J J; Tompkins, R G
1999-01-01
OBJECTIVE: To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA: Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-term outcomes associated with such a plan of care have not been previously reported. METHODS: Over a 10-year period, 495 children with 698 acutely burned hands were managed at a regional pediatric burn facility; 219 children with 395 injured hands were followed in the authors' outpatient clinic for at least 1 year and an average of >5 years. The authors' approach to the acutely burned hand emphasizes ranging and splinting throughout the hospital stay, prompt sheet autograft wound closure as soon as practical, and the selective use of axial pin fixation and flaps. Long-term follow-up, hand therapy, and reconstructive surgery are emphasized. RESULTS: Normal functional results were seen in 97% of second-degree and 85% of third-degree injuries; in children with burns involving underlying tendon and bone, 70% could perform activities of daily living and 20% had normal function. Reconstructive hand surgery was required in 4.4% of second-degree burns, 32% of third-degree burns, and 65% of those with injuries involving underlying bone and tendon. CONCLUSIONS: When managed in a coordinated long-term program, the large majority of children with serious hand burns can be expected to have excellent functional results. Images Figure 1. Figure 2. PMID:10203090
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Hand surgery volume and the US economy: is there a statistical correlation?
Gordon, Chad R; Pryor, Landon; Afifi, Ahmed M; Gatherwright, James R; Evans, Peter J; Hendrickson, Mark; Bernard, Steven; Zins, James E
2010-11-01
To the best of our knowledge, there have been no previous studies evaluating the correlation of the US economy and hand surgery volume. Therefore, in light of the current recession, our objective was to study our institution's hand surgery volume over the last 17 years in relation to the nation's economy. A retrospective analysis of our institution's hand surgery volume, as represented by our most common procedure (ie, carpal tunnel release), was performed between January 1992 and October 2008. Liposuction and breast augmentation volumes were chosen to serve as cosmetic plastic surgery comparison groups. Pearson correlation statistics were used to estimate the relationship between the surgical volume and the US economy, as represented by the 3 market indices (Dow Jones, NASDAQ, and S&P500). A combined total of 7884 hand surgery carpal tunnel release (open or endoscopic) patients were identified. There were 1927 (24%) and 5957 (76%) patients within the departments of plastic and orthopedic surgery, respectively. In the plastic surgery department, there was a strong negative (ie, inverse relationship) correlation between hand surgery volume and the economy (P < 0.001). In converse, the orthopedic department's hand surgery volume demonstrated a positive (ie, parallel) correlation (P < 0.001). The volumes of liposuction and breast augmentation also showed a positive correlation (P < 0.001). To our knowledge, we have demonstrated for the first time an inverse (ie, negative) correlation between hand surgery volumes performed by plastic surgeons in relation to the US economy, as represented by the 3 major market indices. In contrast, orthopedic hand surgery volume and cosmetic surgery show a parallel (ie, positive) correlation. This data suggests that plastic surgeons are increasing their cosmetic surgery-to-reconstructive/hand surgery ratio during strong economic times and vice versa during times of economic slowdown.
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Lee, Nigel; Firmin, Meaghan; Gao, Yu; Kildea, Sue
2018-07-01
Clinicians hand position and advised pushing techniques may impact on rates of perineal injury. To assess the association of four techniques used in management of second stage with risk of moderate and severe perineal injury. Retrospective cross-sectional study. A metropolitan maternity hospital and a private maternity hospital in Brisbane, Australia. Term women with singleton, cephalic presentation experiencing a non-operative vaginal birth from January 2011 to December 2016. The research sites perinatal database recorded data on clinicians approach to instructing women during second stage and hand position at birth. Women were identified from matching the inclusion criteria (n = 26,393) then grouped based on combinations of hands-on, hand- poised, directed and undirected pushing. The associations with perineal injury were estimated using odds ratios obtained by multivariate analysis. Primary outcomes were the risk of moderate and severe perineal injury. The significance was set at 0.001. In Nulliparous women there was no difference in the risk of moderate or severe perineal injury between the different techniques. In multiparous women the use of a hands-on/directed approach was associated with a significant increase in the risk of moderate (AOR 1.18, 95% CI 1.10-1.27, p < 0.001) and severe perineal injury (AOR 1.50, 95% CI 1.20-1.88, p < 0.001) compared to hands-poised/undirected. A hands poised/undirected approach could be utilised in strategies for the prevention of moderate and severe perineal injury. Copyright © 2018 Elsevier Ltd. All rights reserved.
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NASA Technical Reports Server (NTRS)
Kretsinger, R. H.; Nakayama, S.
1993-01-01
In the previous three reports in this series we demonstrated that the EF-hand family of proteins evolved by a complex pattern of gene duplication, transposition, and splicing. The dendrograms based on exon sequences are nearly identical to those based on protein sequences for troponin C, the essential light chain myosin, the regulatory light chain, and calpain. This validates both the computational methods and the dendrograms for these subfamilies. The proposal of congruence for calmodulin, troponin C, essential light chain, and regulatory light chain was confirmed. There are, however, significant differences in the calmodulin dendrograms computed from DNA and from protein sequences. In this study we find that introns are distributed throughout the EF-hand domain and the interdomain regions. Further, dendrograms based on intron type and distribution bear little resemblance to those based on protein or on DNA sequences. We conclude that introns are inserted, and probably deleted, with relatively high frequency. Further, in the EF-hand family exons do not correspond to structural domains and exon shuffling played little if any role in the evolution of this widely distributed homolog family. Calmodulin has had a turbulent evolution. Its dendrograms based on protein sequence, exon sequence, 3'-tail sequence, intron sequences, and intron positions all show significant differences.
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Kimberley, Teresa J; Pickett, Kristen A
2012-01-01
The pathophysiology of focal hand dystonia (FHD) is not clearly understood. Previous studies have reported increased and decreased cortical activity associated with motor tasks. The aim of this study was to investigate blood oxygen level dependent (BOLD) signal changes in functional magnetic resonance imaging within the hand area of primary motor cortex during cued movement of individual digits. Eight healthy individuals and five individuals with right hand FHD participated. Beta weight contrasts were examined within the hand area of the motor cortex. In both groups, BOLD signal changes in the hemisphere contralateral to the moving hand were greater in the left hemisphere than the right. Between groups, no difference was found during control of the left hand, but a significant difference was seen during right hand movement; specifically, individuals with dystonia showed increased contralateral and decreased ipsilateral cortical response associated with the affected hand as compared to healthy individuals. This suggests a similar, albeit exaggerated pattern of activation in individuals with FHD on the affected side. These results suggest different levels of ipsilateral and contralateral activation between healthy and dystonic individuals but also show a relative difference between symptomatic and asymptomatic control within the patient population.
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Hand aperture patterns in prehension.
Bongers, Raoul M; Zaal, Frank T J M; Jeannerod, Marc
2012-06-01
Although variations in the standard prehensile pattern can be found in the literature, these alternative patterns have never been studied systematically. This was the goal of the current paper. Ten participants picked up objects with a pincer grip. Objects (3, 5, or 7cm in diameter) were placed at 30, 60, 90, or 120cm from the hands' starting location. Usually the hand was opened gradually to a maximum immediately followed by hand closing, called the standard hand opening pattern. In the alternative opening patterns the hand opening was bumpy, or the hand aperture stayed at a plateau before closing started. Two participants in particular delayed the start of grasping with respect to start of reaching, with the delay time increasing with object distance. For larger object distances and smaller object sizes, the bumpy and plateau hand opening patterns were used more often. We tentatively concluded that the alternative hand opening patterns extended the hand opening phase, to arrive at the appropriate hand aperture at the appropriate time to close the hand for grasping the object. Variations in hand opening patterns deserve attention because this might lead to new insights into the coordination of reaching and grasping. Copyright © 2011 Elsevier B.V. All rights reserved.
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Satisfaction with medical treatment in patients with hand dermatitis - a cross-sectional study.
Herschel, Solveig; Schmitt, Jochen; Bauer, Andrea
2013-10-01
Despite the significant clinical and economic burden of hand dermatitis, data on patients' satisfaction with treatment and related determining factors are lacking. We performed a cross-sectional study using a standardized survey, including all patients with hand dermatitis treated between 12/2001 and 11/2008 at the Department of Dermatology, TU Dresden. Patients were asked about socio-demographic data, disease characteristics, occupational data, quality of life, treatment satisfaction and their treatment goals. Based on an a priori model, possible impact factors on treatment satisfaction were analyzed using regression modeling. Of 382 contacted patients, 215 agreed to participate in the study (133 [61.3%] female). The mean age was 42 years. 155 patients (72.1%) had had severe or very severe hand dermatitis in the past. The majority of the patients were satisfied with the medical treatment. Treatment satisfaction was determined by the impression of professional competence (p < 0.001), physicians' empathy (p < 0.001), sufficient information on course, prognosis, and treatment options (p < 0.001), the patients' self-treatment competency (p < 0.001), quality of life (p = 0.007), as well as on the severity of hand dermatitis (p < 0.001). The data point out that in the therapy of chronic hand dermatitis, along with professional competence, the physicians' empathy, provision of sufficient information about the disease, and teaching self-treatment competency play a prominent role in improving the treatment satisfaction of the patients. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.
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Bashford, Luke; Mehring, Carsten
2016-01-01
To study body ownership and control, illusions that elicit these feelings in non-body objects are widely used. Classically introduced with the Rubber Hand Illusion, these illusions have been replicated more recently in virtual reality and by using brain-computer interfaces. Traditionally these illusions investigate the replacement of a body part by an artificial counterpart, however as brain-computer interface research develops it offers us the possibility to explore the case where non-body objects are controlled in addition to movements of our own limbs. Therefore we propose a new illusion designed to test the feeling of ownership and control of an independent supernumerary hand. Subjects are under the impression they control a virtual reality hand via a brain-computer interface, but in reality there is no causal connection between brain activity and virtual hand movement but correct movements are observed with 80% probability. These imitation brain-computer interface trials are interspersed with movements in both the subjects' real hands, which are in view throughout the experiment. We show that subjects develop strong feelings of ownership and control over the third hand, despite only receiving visual feedback with no causal link to the actual brain signals. Our illusion is crucially different from previously reported studies as we demonstrate independent ownership and control of the third hand without loss of ownership in the real hands.
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Using environmental engineering to increase hand hygiene compliance: a cross-over study protocol
Schmidtke, Kelly Ann; Aujla, Navneet; Marshall, Tom; Hussain, Abid; Hodgkinson, Gerard P; Arheart, Kristopher; Marti, Joachim; Birnbach, David J; Vlaev, Ivo
2017-01-01
Introduction Compliance with hand hygiene recommendations in hospital is typically less than 50%. Such low compliance inevitably contributes to hospital-acquired infections that negatively affect patients’ well-being and hospitals’ finances. The design of the present study is predicated on the assumption that most people who fail to clean their hands are not doing so intentionally, they just forget. The present study will test whether psychological priming can be used to increase the number of people who clean their hands on entering a ward. Here, we present the protocol for this study. Methods and analysis The study will use a randomised cross-over design. During the study, each of four wards will be observed during four conditions: olfactory prime, visual prime, both primes and neither prime. Each condition will be experienced for 42 days followed by a 7-day washout period (total duration of trial=189 days). We will record the number of people who enter each ward and whether they clean their hands during observation sessions, the amount of cleaning material used from the dispensers each week and the number of hospital-acquired infections that occur in each period. The outcomes will be compared using a regression analysis. Following the initial trail, the most effective priming condition will be rolled out for 3 months in all the wards. Ethics and dissemination Research ethics approval was obtained from the South Central—Oxford C Research Ethics Committee (16/SC/0554), the Health Regulatory Authority and the sponsor. Trial registration number ISRCTN (15397624); Edge ID 86357. PMID:28893752
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Brunetti, L; Santoro, E; De Caro, F; Cavallo, P; Boccia, G; Capunzo, M; Motta, O
2006-06-01
The observance of hand hygiene compliance is important to reduce cross-infection by micro-organisms. The aim of this preliminary study was to evaluate the level of hand hygiene in healthcare workers from different departments, with particular emphasis on transient flora. The study was conducted in three departments (Surgery, Intensive Care Unit, Obstetrics and Gynecology) of a hospital in Campania, southern Italy. Over a six-month period, 50 healthcare workers were randomly tested. Imprints of palms and fingertips were taken monthly during the morning shift. The number of colonies per plate was counted and transient pathogens were identified. Risk factors for hand contamination were determined. Total flora was found in the following CFU means per palm and per five fingertips (95% CI): Obstetrics and Gynecology [palms 130 CFUs (95% CI 85-180); fingertips 125 CFUs (95% CI 92-160)]; ICU [palms 80 CFUs (95% CI 58-99); fingertips 62 CFUs (95% CI 45-82)]; Surgery [palms 75 CFUs (95% CI 41-120); fingertips 70 CFUs (95% CI 52-90)] Transient flora was found on 39% of healthcare workers' hands. The only factor associated with hand contamination by transient flora was the absence of gloving during healthcare procedure (P = 0.02).
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Reduction in finger blood flow induced by hand-transmitted vibration: effect of hand elevation.
Ye, Ying; Mauro, Marcella; Bovenzi, Massimo; Griffin, Michael J
2015-10-01
This study investigated the effect of hand elevation on reductions in finger blood flow (FBF) induced by hand-transmitted vibration. Fourteen males attended six sessions on six separate days, with a control sessions and a vibration session (125-Hz vibration at 44 ms(-2) rms) with the right hand supported at each of three elevations: 20 cm below heart level (HL), at HL, and 20 cm above HL. Finger blood flow on the left and right hand was measured every 30 s during each 25-min session comprised of five periods: (1) no force and no vibration (5 min), (2) 2-N force and no vibration (5 min), (3) 2-N force and vibration (5 min), (4) 2-N force and no vibration (5 min), and (5) no force and no vibration (5 min). Without vibration, FBF decreased with increasing elevation of the hand. During vibration of the right hand, FBF reduced on both hands. With elevation of the right hand, the percentage reduction in FBF due to vibration (relative to FBF on the same finger at the same elevation before exposure to vibration) was similar on the middle and little fingers of both hands. After cessation of vibration, there was delayed return of FBF with all three hand heights. Vibration of one hand reduces FBF on both exposed and unexposed hands, with the reduction dependent on the elevation of the hand. The mechanisms responsible for vibration-induced reductions in FBF seem to reduce blood flow as a percentage of the blood flow without vibration. Tasks requiring the elevation of the hands will be associated with lower FBF, and the FBF will be reduced further if there is exposure to hand-transmitted vibration.
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Replicating Human Hand Synergies Onto Robotic Hands: A Review on Software and Hardware Strategies.
Salvietti, Gionata
2018-01-01
This review reports the principal solutions proposed in the literature to reduce the complexity of the control and of the design of robotic hands taking inspiration from the organization of the human brain. Several studies in neuroscience concerning the sensorimotor organization of the human hand proved that, despite the complexity of the hand, a few parameters can describe most of the variance in the patterns of configurations and movements. In other words, humans exploit a reduced set of parameters, known in the literature as synergies, to control their hands. In robotics, this dimensionality reduction can be achieved by coupling some of the degrees of freedom (DoFs) of the robotic hand, that results in a reduction of the needed inputs. Such coupling can be obtained at the software level, exploiting mapping algorithm to reproduce human hand organization, and at the hardware level, through either rigid or compliant physical couplings between the joints of the robotic hand. This paper reviews the main solutions proposed for both the approaches.
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de Aceituno, Anna Fabiszewski; Bartz, Faith E; Hodge, Domonique Watson; Shumaker, David J; Grubb, James E; Arbogast, James W; Dávila-Aviña, Jorgé; Venegas, Fabiola; Heredia, Norma; García, Santos; Leon, Juan S
2015-11-01
Effective hand hygiene is essential to prevent the spread of pathogens on produce farms and reduce foodborne illness. The U.S. Food and Drug Administration Food Safety Modernization Act Proposed Rule for Produce Safety recommends the use of soap and running water for hand hygiene of produce handlers. The use of alcohol-based hand sanitizer (ABHS) may be an effective alternative hygiene intervention where access to water is limited. There are no published data on the efficacy of either soap or ABHS-based interventions to reduce microbial contamination in agricultural settings. The goal of this study was to assess the ability of two soap-based (traditional or pumice) and two ABHS-based (label-use or two-step) hygiene interventions to reduce microbes (coliforms, Escherichia coli, and Enterococcus spp.) and soil (absorbance of hand rinsate at 600 nm [A600]) on farmworker hands after harvesting produce, compared with the results for a no-hand-hygiene control. With no hand hygiene, farmworker hands were soiled (median A600, 0.48) and had high concentrations of coliforms (geometric mean, 3.4 log CFU per hand) and Enterococcus spp. (geometric mean, 5.3 log CFU per hand) after 1 to 2 h of harvesting tomatoes. Differences in microbial loads in comparison to the loads in the control group varied by indicator organism and hygiene intervention (0 to 2.3 log CFU per hand). All interventions yielded lower concentrations of Enterococcus spp. and E. coli (P < 0.05), but not of coliforms, than were found in the control group. The two-step ABHS intervention led to significantly lower concentrations of coliforms and Enterococcus spp. than the pumice soap and label-use ABHS interventions (P < 0.05) and was the only intervention to yield significantly fewer samples with E. coli than were found in the control group (P < 0.05). All interventions removed soil from hands (P < 0.05), soap-based interventions more so than ABHS-based interventions (P < 0.05). ABHS-based interventions were
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Thyssen, Jacob Pontoppidan; Linneberg, Allan; Menné, Torkil; Nielsen, Niels Henrik; Johansen, Jeanne Duus
2009-12-01
An association between nickel contact allergy and hand eczema has previously been demonstrated. In 1990, Denmark regulated the extent of nickel release in the ear-piercing process as well as nickel release from consumer products. This study aimed to evaluate the effect of the Danish nickel regulation by comparing the prevalence of concomitant nickel allergy and hand eczema observed in two repeated cross-sectional studies performed in the same general population in Copenhagen. In 1990 and 2006, 3881 18-69 year olds completed a postal questionnaire and were patch tested with nickel. Data were analysed by logistic regression analyses and associations were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). The prevalence of concomitant nickel contact allergy and a history of hand eczema decreased among 18-35-year-old women from 9.0% in 1990 to 2.1% in 2006 (P < 0.01). The association between nickel contact allergy and a history of hand eczema decreased in this age group between 1990 (OR = 3.63; CI = 1.33-9.96) and 2006 (OR = 0.65; CI = 0.29-1.46). Among older women, no significant changes were observed in the association between nickel contact allergy and hand eczema. Regulatory control of nickel exposure may have reduced the effect of nickel on hand eczema in the young female population.
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Hand Matters: Left-Hand Gestures Enhance Metaphor Explanation
ERIC Educational Resources Information Center
Argyriou, Paraskevi; Mohr, Christine; Kita, Sotaro
2017-01-01
Research suggests that speech-accompanying gestures influence cognitive processes, but it is not clear whether the gestural benefit is specific to the gesturing hand. Two experiments tested the "(right/left) hand-specificity" hypothesis for self-oriented functions of gestures: gestures with a particular hand enhance cognitive processes…
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Šenolt, Ladislav
Hand osteoarthritis (OA) is a common chronic disorder causing pain and limitation of mobility of affected joints. The prevalence of hand OA increases with age and more often affects females. Clinical signs obviously do not correlate with radiographic findings - symptomatic hand OA affects approximately 26 % of adult subjects, but radiographic changes can be found in up to two thirds of females and half of males older than 55 years.Disease course differ among individual patients. Hand OA is a heterogeneous disease. Nodal hand OA is the most common subtype affecting interphalangeal joints, thumb base OA affects first carpometacarpal joint. Erosive OA represents a specific subtype of hand OA, which is associated with joint inflammation, more pain, functional limitation and erosive findings on radiographs.Treatment of OA is limited. Analgesics and nonsteroidal anti-inflammatory drugs are the only agents reducing symptoms. New insights into the pathogenesis of disease should contribute to the development of novel effective treatment of hand OA.
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Eye-hand coordination during a double-step task: evidence for a common stochastic accumulator
Gopal, Atul
2015-01-01
Many studies of reaching and pointing have shown significant spatial and temporal correlations between eye and hand movements. Nevertheless, it remains unclear whether these correlations are incidental, arising from common inputs (independent model); whether these correlations represent an interaction between otherwise independent eye and hand systems (interactive model); or whether these correlations arise from a single dedicated eye-hand system (common command model). Subjects were instructed to redirect gaze and pointing movements in a double-step task in an attempt to decouple eye-hand movements and causally distinguish between the three architectures. We used a drift-diffusion framework in the context of a race model, which has been previously used to explain redirect behavior for eye and hand movements separately, to predict the pattern of eye-hand decoupling. We found that the common command architecture could best explain the observed frequency of different eye and hand response patterns to the target step. A common stochastic accumulator for eye-hand coordination also predicts comparable variances, despite significant difference in the means of the eye and hand reaction time (RT) distributions, which we tested. Consistent with this prediction, we observed that the variances of the eye and hand RTs were similar, despite much larger hand RTs (∼90 ms). Moreover, changes in mean eye RTs, which also increased eye RT variance, produced a similar increase in mean and variance of the associated hand RT. Taken together, these data suggest that a dedicated circuit underlies coordinated eye-hand planning. PMID:26084906
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Chong, Hyun Ju; Han, Soo Jeong; Kim, Yong Jae; Park, Hye Young; Kim, Soo Ji
2014-01-01
While a number of studies have tested the therapeutic effectiveness of playing musical instruments, such as the electronic keyboard using Musical Instrument Digital Interface (MIDI), it is still unclear whether outcomes of electronic keyboard playing are related to hand function tests. The purpose of this study was to investigate the correlation between MIDI-keyboard playing and hand function tests, including grip strength, Box and Block test (BBT), and Jensen-Taylor Hand Function Test (JTHF). A total of 66 stroke patients were recruited from medical centers and were classified into acute (n = 21), subacute (n = 28), and chronic (n = 17) recovery stages. The participants' mean age was 60.5 years. The MIDI-keyboard playing protocol based on sequential key pressing was implemented. All hand function tests were performed by certified occupational therapists. MIDI scores from participants at all three recovery stages were significantly correlated with BBT and grip strength. Overall, MIDI-keyboard playing scores demonstrated moderate to high correlations with hand function tests except for participants at the chronic stage and the JTHF, which showed no correlation. These findings suggest that MIDI-keyboard playing has great potential as an assessment tool of hand function, especially hand dexterity in acute and subacute stroke patients. Further studies are needed to refine the specific keyboard playing tasks that increase responsiveness to traditional hand function tests.
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Improvement of Hand Movement on Visual Target Tracking by Assistant Force of Model-Based Compensator
NASA Astrophysics Data System (ADS)
Ide, Junko; Sugi, Takenao; Nakamura, Masatoshi; Shibasaki, Hiroshi
Human motor control is achieved by the appropriate motor commands generating from the central nerve system. A test of visual target tracking is one of the effective methods for analyzing the human motor functions. We have previously examined a possibility for improving the hand movement on visual target tracking by additional assistant force through a simulation study. In this study, a method for compensating the human hand movement on visual target tracking by adding an assistant force was proposed. Effectiveness of the compensation method was investigated through the experiment for four healthy adults. The proposed compensator precisely improved the reaction time, the position error and the variability of the velocity of the human hand. The model-based compensator proposed in this study is constructed by using the measurement data on visual target tracking for each subject. The properties of the hand movement for different subjects can be reflected in the structure of the compensator. Therefore, the proposed method has possibility to adjust the individual properties of patients with various movement disorders caused from brain dysfunctions.
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Bobrova, E V; Bogacheva, I N; Lyakhovetskii, V A; Fabinskaja, A A; Fomina, E V
2017-01-01
In order to test the hypothesis of hemisphere specialization for different types of information coding (the right hemisphere, for positional coding; the left one, for vector coding), we analyzed the errors of right and left-handers during a task involving the memorization of sequences of movements by the left or the right hand, which activates vector coding by changing the order of movements in memorized sequences. The task was first performed by the right or the left hand, then by the opposite hand. It was found that both'right- and left-handers use the information about the previous movements of the dominant hand, but not of the non-dom" inant one. After changing the hand, right-handers use the information about previous movements of the second hand, while left-handers do not. We compared our results with the data of previous experiments, in which positional coding was activated, and concluded that both right- and left-handers use vector coding for memorizing the sequences of their dominant hands and positional coding for memorizing the sequences of non-dominant hand. No similar patterns of errors were found between right- and left-handers after changing the hand, which suggests that in right- and left-handersthe skills are transferred in different ways depending on the type of coding.
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Foot forces induced through Tai Chi push-hand exercises.
Wong, Shiu Hong; Ji, Tianjian; Hong, Youlian; Fok, Siu Lun; Wang, Lin
2013-08-01
The low impact forces of Tai Chi push-hand exercises may be particularly suited for older people and for those with arthritis; however, the biomechanics of push-hand exercises have not previously been reported. This paper examines the ground reaction forces (GRFs) and plantar force distributions during Tai Chi push-hand exercises in a stationary stance with and without an opponent. Ten male Tai Chi practitioners participated in the study. The GRFs of each foot were measured in three perpendicular directions using two force plates (Kistler). The plantar force distribution of each foot was measured concurrently using an insole sensor system (Novel). The results showed that the average maximum vertical GRF of each foot was not more than 88% ± 6.1% of the body weight and the sum of the vertical forces (103% ± 1.4%) generated by the two feet approximately equals the body weight at any one time. The horizontal GRFs generated by the two feet were in the opposite directions and the measured mean peak values were not more than 12% ± 2.8% and 17% ± 4.3% of the body weight in the medio-lateral and antero-posterior directions respectively. Among the nine plantar areas, the toes sustained the greatest plantar force. This study indicates that push-hand exercises generate lower vertical forces than those induced by walking, bouncing, jumping and Tai Chi gait, and that the greatest plantar force is located in the toe area, which may have an important application in balance training particularly for older adults.
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... Stiff Hands Find a hand surgeon near you. Videos Figures Figure 1: Hand splint to help straighten ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...
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... Hand Fractures Find a hand surgeon near you. Videos Hand Fractures Close Popup Figures Figure 1 - Examples ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...
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Foroughipour, Azam; Firuzeh, Farah; Ghahiri, Ataolah; Norbakhsh, Vajihe; Heidari, Tayebeh
2011-01-01
BACKGROUND: The objective of the present study was to evaluate the effect of the two methods of delivery, “hands-on” vs. “hands poised”, on perineal trauma and delivery outcome in primiparous women referred to Shariati Hospital of Isfahan during 2007-2008. METHODS: In a clinical trial study, 100 low risk primiparous pregnant women were randomly assigned to two hands-on and hand-poised (hands-off) groups. In the hands-on group, this method was used to control fetal head in the second stage of labor. It means that the fingers of one hand supported fetal occiput and the other hand applied slight pressure on the head to control the delivery of the head during the crowning process. In the hands-poised group, midwife observed the parturient woman and do not touch perineum during the second labor stage while fetal head was delivering. Then, the two groups were compared in terms of perineal trauma, as well as neonatal and delivery outcome. RESULTS: Demographic characteristics of all studied women were similar in two groups. The rate of episiotomy was higher in hands-on group (84% vs. 40%, p = 0.001). The rate of postpartum hemorrhage (4th stage) was higher in hands-on group (12% vs. 4%, p = 0.04). The rate of mild and moderate postpartum pain in hands-on group was higher than hands-off group (70% vs. 58% and 29% vs. 10%, p < 0.001) but sever pain was not different in two groups. CONCLUSIONS: It seems that hands-poised method is associated with less perineal trauma, particularly regarding the lower need for episiotomy and postpartum hemorrhage. PMID:22279480
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Li, Zhi; Durgin, Frank H
2011-06-01
Palm boards are often used as a nonverbal measure in human slant perception studies. It was recently found that palm boards are biased and relatively insensitive measures, and that an unrestricted hand gesture provides a more sensitive response (Durgin, Hajnal, Li, Tonge, & Stigliani, Acta Psychologica, 134, 182-197, 2010a). In this article, we describe an original design for a portable lightweight digital device for measuring hand orientation. This device is microcontroller-based and uses a micro inclinometer chip as its inclination sensor. The parts are fairly inexpensive. This device, used to measure hand orientation, provides a sensitive nonverbal method for studying slant perception, which can be used in both indoor and outdoor environments. We present data comparing the use of a free hand to palm-board and verbal measures for surfaces within reach and explain how to interpret free-hand measures for outdoor hills.
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High-impact articles in hand surgery.
Eberlin, Kyle R; Labow, Brian I; Upton, Joseph; Taghinia, Amir H
2012-06-01
There have been few attempts to identify classic papers within the hand surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited hand surgery articles published in six peer-reviewed journals. The 50 most highly cited hand surgery articles were identified in the Journal of Bone and Joint Surgery (JBJS) American, JBJS British, Plastic and Reconstructive Surgery, Journal of Hand Surgery (JHS) American, JHS British/European, and Hand. Articles were evaluated for citations per year, surgical/anatomical topic, and type of study. Clinical studies were further sub-categorized by level of evidence. The distribution of topics was compared with all indexed hand surgery articles. The educational relevance was assessed via comparison with lists of "classic" papers. The most common subjects were distal radius fracture, carpal tunnel syndrome, and flexor tendon repair. There was moderate correlation between the distribution of these topics and all indexed hand surgery articles (rho = 0.71). There were 31 clinical studies, of which 16 were therapeutic, ten were prognostic, and five were diagnostic. These articles assessed the outcomes of an intervention, described an anatomical/functional observation, introduced an innovation, presented a discovery/classification, or validated a questionnaire. There were only three randomized trials. Using citations per year to control for the influence of time since publication, 36 articles were consistently highly cited. Twenty-three articles were on Stern's Selected Readings in Hand Surgery, considered important in education. The top 50 highly cited articles in hand surgery reflect the most common clinical, scientific, and educational efforts of the field.
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Hand therapist use of patient report outcome (PRO) in practice: a survey study.
Valdes, Kristin; MacDermid, Joy; Algar, Lori; Connors, Brian; Cyr, Lisa M; Dickmann, Sharon; Lucado, Ann M; Naughton, Nancy
2014-01-01
The purpose of this survey was to gain greater insight into hand therapists' use of Patient Report Outcome (PRO) measures. An 11-question survey that evaluated therapists' perceptions, preferences, and patterns of use of patient report outcome measures was sent to members of ASHT. A total of 633 ASHT members participated in the survey study. A large majority of participants (92%) responded affirmatively to using a PRO measure in practice. The DASH was reported as the most frequently used measure (90%). The majority of therapists (84%) discuss the results of the outcome measurement score with their patients. Of the participants who use more than one outcome measure, 44% report that this allows them to better establish their patient's functional and physical limitations. The findings in this study suggest that a large percentage of hand therapists are currently including a PRO measure in their hand therapy practice. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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The Kinematics of Trunk and Upper Extremities in One-Handed and Two-Handed Backhand Stroke
Stępień, Adam; Bober, Tadeusz; Zawadzki, Jerzy
2011-01-01
The aim of this study was to present kinematics of trunk and upper extremities in tennis players who perform one-handed and two-handed backhand strokes. The study aimed to address the question of whether one of those techniques has some important advantage over the other. If so, what makes it superior? The study included 10 tennis coaches with average coaching experience of 9 years. The coaches were asked to hit 15 one-handed and two-handed backhands. The tests were carried out in a laboratory. A sponge ball was used in order to protect the measurement equipment. Video motion analysis was carried out using BTS SMART system; images were recorded with 6 cameras with a rate of 120 frames per second. The analysis of both backhand strokes focused on the second phase of the stroke (acceleration). The use of an eight-element model of human body for description of upper body motion in both techniques revealed kinematic differences in how both backhands are performed. The two-handed backhand was performed in closed kinetic chain with 8 degrees of freedom, whereas the one-handed backhand involved an open kinetic chain with 7 degrees of freedom. Higher rigidity of upper extremities which are connected with trunk in the two-handed backhand, contributes to an elevated trunk effect in this stroke. This is confirmed by higher component velocities for racket handle, which result from trunk rotation in the two-handed backhand and a negative separation angle in the two-handed backhand at the moment of contact of the racket with the ball. The study does not provide a clear-cut answer to the question of advantages of one technique over the other; however, it reveals dissimilar patterns of driving the racket in both techniques, which suggests the need for extending the analysis of techniques of both backhands with additional kinematics of tennis racket in consideration of measurements of ball velocities. PMID:23486650
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Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project.
Grönhagen, C; Lidén, C; Wahlgren, C-F; Ballardini, N; Bergström, A; Kull, I; Meding, B
2015-11-01
There is a well-known association between atopic dermatitis (AD) and hand eczema but less is known about how age at onset, persistence and severity of AD influence the risk of developing hand eczema. To examine the role of AD in the occurrence of hand eczema in adolescence. In addition, associations between asthma and rhinoconjunctivitis, sensitization to common airborne and food allergens, and hand eczema were studied. From the population-based birth cohort BAMSE, 2927 adolescents who had been followed up repeatedly concerning allergy-related disease were included. Questionnaires identified adolescents with hand eczema at 16 years, and their blood was analysed for specific IgE. A total of 152 (5·2%) adolescents had hand eczema at the age of 16 years. Many of these adolescents had a history of AD (n = 111; 73·0%) and asthma and/or rhinitis (n = 83; 54·6%), respectively. Children with AD (aged 0-16 years) had more than threefold increased odds ratios (OR) for having hand eczema; those with persistent or severe AD had a crude OR of 6·1 [95% confidence interval (CI) 4·0-9·1] and 5·3 (95% CI 2·9-9·6), respectively. We confirm a strong association between AD during childhood and hand eczema in adolescence. Children with persistent or more severe AD are at greater risk of developing hand eczema. Asthma and/or rhinoconjunctivitis, positive specific IgE or age at onset of AD are not associated with hand eczema in adolescence. © 2015 British Association of Dermatologists.
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Using environmental engineering to increase hand hygiene compliance: a cross-over study protocol.
Schmidtke, Kelly Ann; Aujla, Navneet; Marshall, Tom; Hussain, Abid; Hodgkinson, Gerard P; Arheart, Kristopher; Marti, Joachim; Birnbach, David J; Vlaev, Ivo
2017-09-11
Compliance with hand hygiene recommendations in hospital is typically less than 50%. Such low compliance inevitably contributes to hospital-acquired infections that negatively affect patients' well-being and hospitals' finances. The design of the present study is predicated on the assumption that most people who fail to clean their hands are not doing so intentionally, they just forget. The present study will test whether psychological priming can be used to increase the number of people who clean their hands on entering a ward. Here, we present the protocol for this study. The study will use a randomised cross-over design. During the study, each of four wards will be observed during four conditions: olfactory prime, visual prime, both primes and neither prime. Each condition will be experienced for 42 days followed by a 7-day washout period (total duration of trial=189 days). We will record the number of people who enter each ward and whether they clean their hands during observation sessions, the amount of cleaning material used from the dispensers each week and the number of hospital-acquired infections that occur in each period. The outcomes will be compared using a regression analysis. Following the initial trail, the most effective priming condition will be rolled out for 3 months in all the wards. Research ethics approval was obtained from the South Central-Oxford C Research Ethics Committee (16/SC/0554), the Health Regulatory Authority and the sponsor. ISRCTN (15397624); Edge ID 86357. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Hand osteoarthritis: an epidemiological perspective.
Kalichman, Leonid; Hernández-Molina, Gabriela
2010-06-01
Hand osteoarthritis (OA) is a highly prevalent condition with a wide spectrum of clinical presentations. We review herein the prevalence, impact on hand function, and various risk factors related to hand OA. PubMed and MEDLINE databases (1950-2009) were searched for the keywords: "hand," "hand osteoarthritis," "distal interphalangeal," "proximal interphalangeal," "metacarpophalangeal," and "carpometacarpal." Published material emphasizing cohort, cross-sectional, and case-control studies regarding epidemiology, clinical features, functional impairment, and associated risk factors of hand OA were included. Hand OA is a heterogeneous, age- and gender-dependent disorder, occurring more frequently in women over 50 years of age. In the elderly population, the prevalence of radiographic hand OA can reach 80%. OA has a strong genetic predisposition, apparently gender- and phenotype-specific. A history of heavy manual labor or a repetitive use of the hand also has been linked to OA. Other variables such as weight, smoking, joint hyperlaxity, age of menarche, bone and cartilage mineralization factors, grip strength, and handedness may play a role. Symptomatic hand OA may cause functional impairment due to loss of strength, thus limiting the individual's ability to perform daily tasks. Several risk factors for hand OA have been identified; however, their interrelationship is not clearly understood. The development of preventive strategies and future research goals is needed. Copyright 2010 Elsevier Inc. All rights reserved.
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Effects of lips and hands on auditory learning of second-language speech sounds.
Hirata, Yukari; Kelly, Spencer D
2010-04-01
Previous research has found that auditory training helps native English speakers to perceive phonemic vowel length contrasts in Japanese, but their performance did not reach native levels after training. Given that multimodal information, such as lip movement and hand gesture, influences many aspects of native language processing, the authors examined whether multimodal input helps to improve native English speakers' ability to perceive Japanese vowel length contrasts. Sixty native English speakers participated in 1 of 4 types of training: (a) audio-only; (b) audio-mouth; (c) audio-hands; and (d) audio-mouth-hands. Before and after training, participants were given phoneme perception tests that measured their ability to identify short and long vowels in Japanese (e.g., /kato/ vs. /kato/). Although all 4 groups improved from pre- to posttest (replicating previous research), the participants in the audio-mouth condition improved more than those in the audio-only condition, whereas the 2 conditions involving hand gestures did not. Seeing lip movements during training significantly helps learners to perceive difficult second-language phonemic contrasts, but seeing hand gestures does not. The authors discuss possible benefits and limitations of using multimodal information in second-language phoneme learning.
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Systematic review of non-surgical therapies for osteoarthritis of the hand: an update.
Lue, S; Koppikar, S; Shaikh, K; Mahendira, D; Towheed, T E
2017-09-01
To update our earlier systematic reviews which evaluated all published randomized controlled trials (RCTs) evaluating pharmacological and non-pharmacological therapies in patients with hand osteoarthritis (OA). Surgical therapies were not evaluated. RCTs published between March 2008 and December 2015 were added to the previous systematic reviews. A total of 95 RCTs evaluating various pharmacological and non-pharmacological therapies in hand OA were analyzed in this update. Generally, the methodological quality of these RCTs has improved since the last update, with more studies describing their methods for randomization, blinding, and allocation concealment. However, RCTs continue to be weakened by a lack of consistent case definition and a lack of standardized outcome assessments specific to hand OA. The number and location of evaluated hand joints continues to be underreported, and only 25% of RCTs adequately described the method used to ensure allocation concealment. These remain major weaknesses of published RCTs. A meta-analysis could not be performed because of marked study heterogeneity, insufficient statistical data available in the published RCTs, and a small number of identical comparators. Hand OA is a complex area in which to study the efficacy of therapies. There has been an improvement in the overall design and conduct of RCTs, however, additional large RCTs with a more robust methodological approach specific to hand OA are needed in order to make clinically relevant conclusions about the efficacy of the diverse treatment options available. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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Bone loss from the hand in women following distal forearm fracture.
Ingle, B M; Eastell, R
2001-01-01
Bone loss occurs after distal forearm fracture, but it is unclear if this bone loss is fully recovered. We designed a cross-sectional study to evaluate the time course of the bone loss from the hand after distal forearm fracture. We identified 40 women who had a fracture of the distal forearm within the previous 4.5 years. Their ages ranged from 42 to 81 (mean 64 years) and time since fracture 6 to 54 (mean 28 months). These were compared with 95 women (mean age 67, range 57 to 80 years) from a population-based cohort. Lumbar spine (LS) and hand bone mineral density (BMD) were measured in all subjects using a Hologic QDR 1000/W densitometer. Ultrasound of the fingers of both hands was measured in the forearm fracture group using a DBM Sonic 1200 R model. Compared to controls, LS BMD was decreased by 6.4% (p<0.001), non-fractured hand by 3.2% (p<0.001) and the fractured hand by 6.1% (p<0.001) in the forearm fracture group. The mean difference in bone density between the fractured and non-fractured hand was 0.0207 g/cm2, the average value for the non-fractured hand being 0.304 g/cm2. The decement in hand BMD was equivalent to 6.2% (p<0.0001). The difference in hand BMD between the fractured and non-fractured side was greatest when the time since fracture was short; there was no further difference in hand BMD after 2 years. Ultrasound showed a mean difference of 18.7 m/s in amplitude-dependent speed of sound (AD-SoS) with the average value being 1893 m/s. A 1.0% decrease was observed in the fractured hand AD-SoS (p<0.05). A strong relationship was observed between AD-SoS and BMD in both hands (r = 0.70, p<0.001). We conclude that distal forearm fracture results in a significant decrease in hand BMD that is partially reversible. The decrease in hand BMD is reflected in the ultrasound properties of the finger phalanx.
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Do WiFi-based hand hygiene dispenser systems increase hand hygiene compliance?
Scheithauer, Simone; Bickenbach, Johannes; Heisel, Hans; Fehling, Patrick; Marx, Gernot; Lemmen, Sebastian
2018-05-17
Innovative methods to ensure better compliance in hand hygiene are urgently needed. The aim of this study was to determine if WiFi-based hand hygiene dispenser-driven self-assessment systems (Wireless Fidelity, WiFi-dispenser) can support the work of infection control teams. Our results suggest that the continuous monitoring of dispenser usage can be a valuable addition to infection prevention and control programs, when used in a bundle in combination with conventional hand hygiene training. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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Previous Employment and Job Satisfaction Conditions: The Case of Regional Administration
NASA Astrophysics Data System (ADS)
Amalia, Myronaki; Nikolaos, Antonakas
2009-08-01
In the present work we study the different dimensions of satisfaction and the way of constitution of satisfaction of an important sample of the employees in the Regional administration of Crete and in their connection with the variable of the previous employment. We found statistically important differences for the components of satisfaction from the life, collaboration in and outside from the department, in the social satisfaction and the variable of the years in the service (labour group with <5 years in the service, group with 5-9 years in the service and labour group with 10-15 years in the service). The group with total few years in the work <5, presented smaller social and labour satisfaction than the other previous employment groups. In the other hand the group with many years in the service presents bigger satisfaction than the other groups. Finally, is important to note that the sample present some interesting characteristics.
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Rothwell, Lucas; Britton, John; Bogdanovica, Ilze
2015-06-15
Cigarette price increases reduce smoking prevalence but as a tobacco control policy are undermined by the availability of lower cost alternatives such as hand-rolling tobacco. The aim of this descriptive study is to explore time trends in the price of manufactured cigarettes and hand-rolling tobacco, and in the numbers of people who smoke these products, over recent years in the UK. UK. Trends in the most popular price category (MPPC) data for cigarettes and hand-rolling tobacco from 1983 to 2012 adjusted for inflation using the Retail Price Index, and trends in smoking prevalence and the proportion of smokers using hand-rolling tobacco from 1974 to 2010. After adjustment for inflation, there was an increase in prices of manufactured cigarettes and hand-rolling tobacco between 1983 and 2012. Between 1974 and 2010, the prevalence of smoking fell from 45% to 20%, and the estimated total number of smokers from 25.3 to 12.4 million. However the number of people smoking hand-rolling tobacco increased from 1.4 to 3.2 million, and MPPC cigarette price was strongly correlated with number of people smoking hand-rolling tobacco. Although the ecological study design precludes conclusions on causality, the association between increases in manufactured cigarette price and the number of people smoking hand-rolling tobacco suggests that the lower cost of smoking hand-rolling tobacco encourages downtrading when cigarette prices rise. The magnitude of this association indicates that the lower cost of hand-rolling tobacco seriously undermines the use of price as a tobacco control measure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Politiek, Klaziena; Christoffers, Wietske Andrea; Coenraads, Pieter-Jan; Schuttelaar, Marie-Louise Anna
2016-09-01
Acitretin has been used off-label for years to treat chronic hand eczema, but acitretin is less often prescribed as alitretinoïne was approved. This study evaluates both retinoids in a daily practice cohort of patients with severe chronic hand eczema in terms of drug survival and reasons for discontinuation. Patients using alitretinoin or acitretin between 01-01-1994 and 01-08-2015 were included in this retrospective daily practice study and analyzed by Kaplan-Meier drug survival curves. Potential determinants were analyzed by Cox regression analyses. Ninety-five patients were treated with alitretinoin and 109 patients with acitretin. The main reasons for discontinuation were adverse events and cleared hand eczema, 29.5 and 27.4% in alitretinoin versus 43.1 and 23.9% in acitretin. Patients with hyperkeratotic hand eczema had most often a good effect of treatment: 68.3% in alitretinoin and 50.7% in acitretin treatment. The drug survival rates of alitretinoin and acitretin after 12, 24, 36, and 52 weeks were 69.3, 45.1, 19.6, 7.0% and 74.3, 45.5, 33.8, 23.2%, respectively. Alitretinoin and acitretin are effective treatment options for patients with hand eczema. However, both treatments were more effective in patients with hyperkeratotic hand eczema. Fewer patients discontinued alitretinoin compared with acitretin due to adverse events. © 2016 Wiley Periodicals, Inc.
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Hadden, Kristie; Prince, Latrina Y; Schnaekel, Asa; Couch, Cory G; Stephenson, John M; Wyrick, Theresa O
2016-08-01
This study aimed to update a portion of a 2008 study of patient education materials from the American Society for Surgery of the Hand Web site with new readability results, to compare the results to health literacy best practices, and to make recommendations to the field for improvement. A sample of 77 patient education documents were downloaded from the American Society for Surgery of the Hand Web site, handcare.org, and assessed for readability using 4 readability tools. Mean readability grade-level scores were derived. Best practices for plain language for written health materials were compiled from 3 government agency sources. The mean readability of the 77 patient education documents in the study was 9.3 grade level. This reading level is reduced from the previous study in 2008 in which the overall mean was 10.6; however, the current sample grade level still exceeds recommended readability according to best practices. Despite a small body of literature on the readability of patient education materials related to hand surgery and other orthopedic issues over the last 7 years, readability was not dramatically improved in our current sample. Using health literacy as a framework, improvements in hand surgery patient education may result in better understanding and better outcomes for patients seeing hand surgeons. Improved understanding of patient education materials related to hand surgery may improve preventable negative outcomes that are clinically significant as well as contribute to improved quality of life for patients. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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Cued Dichotic Listening with Right-Handed, Left-Handed, Bilingual and Learning-Disabled Children.
ERIC Educational Resources Information Center
Obrzut, John E.; And Others
This study used cued dichotic listening to investigate differences in language lateralization among right-handed (control), left handed, bilingual, and learning disabled children. Subjects (N=60) ranging in age from 7-13 years were administered a consonant-vowel-consonant dichotic paradigm with three experimental conditions (free recall, directed…
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Health care workers' hand decontamination practices: an Irish study.
Creedon, Sile A
2006-02-01
The primary purpose of this quasi-experimental research is to observe health care workers' compliance with hand-hygiene guidelines during patient care in an intensive care unit in Ireland before (pretest) and after (posttest) implementation of a multifaceted hand-hygiene program. Health care workers' attitudes, beliefs, and knowledge in relation to compliance with handwashing guidelines were also investigated. A convenience sample of nurses, doctors, physiotherapists, and care assistants (n = 73 observational participants, n = 62 questionnaire respondents) was used. Data (N = 314 observations, 62 questionnaires) were analyzed descriptively and cross-tabulated using chi-square (Pearson's) and Mann-Whitney statistical tests. Results revealed that a significant shift (32%) occurred in health care workers' compliance with handwashing guidelines (pretest 51%, posttest 83%, p < .001) following the interventional hand-hygiene program. Significant changes were also found in relation to health care workers' attitudes, beliefs, and knowledge (p < .05).
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Does Framing the Hot Hand Belief Change Decision-Making Behavior in Volleyball?
ERIC Educational Resources Information Center
Raab, Markus; MacMahon, Clare
2015-01-01
Purpose: Previous discussions of the hot hand belief, wherein athletes believe that they have a greater chance of scoring after 2 or 3 hits (successes) compared with 2 or 3 misses, have focused on whether this is the case within game statistics. Researchers have argued that the perception of the hot hand in random sequences is a bias of the…
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Hand injuries from snow blowers: a report of an epidemic.
Tetz, D J; Aghababian, R
1995-01-01
During a record snowfall in Worcester, Massachusetts, 11-13 December 1992, 37 male patients with hand injuries suffered during snow blower operation were seen at three area hospitals. Two previous reports describe 13 patients seen over a 3-year period and 28 patients over a 12-year period. This report describes the largest number of hand injuries from snow blowers that have occurred over a 48-hour period. The snow was unusual because of the high water density in the initial 9 inches (23 cm) that fell at an average temperature of 33 degrees F (0.6 degree C) with the final depth of 30 inches (76 cm), causing the machines to become clogged. Patients admitted to reaching into a running machine in 35/37 (95%) cases, 11/37 (30%) claimed the auger and impeller blades were disengaged, and 2/37 (5%) patients claimed their injuries occurred with the engines turned off. All injuries occurred when the patients placed their hands down the chute, contacting the impeller blades. Injuries involved 32 long, 15 ring, 13 index, and five small fingers and ranged from simple lacerations to partial phalangeal amputations. The majority, 27/37 (73%), were managed in emergency departments without interventions in the operating suites. Infection occurred in one patient who had the lesion repaired in the operating suite. As in previous studies, no differences were found for the variables of snow-blower age, type, or horsepower, or on experience level or age of the operators.(ABSTRACT TRUNCATED AT 250 WORDS)
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Marzoli, Daniele; Menditto, Silvia; Lucafò, Chiara; Tommasi, Luca
2013-08-01
In a previous study, we found that when required to imagine another person performing an action, participants reported a higher correspondence between their own dominant hand and the hand used by the imagined person when the agent was visualized from the back compared to when the agent was visualized from the front. This suggests a greater involvement of motor representations in the back-view perspective, possibly indicating a greater proneness to put oneself in the agent's shoes in such a condition. In order to assess whether bringing to the foreground the right or left hand of an imagined agent can foster the activation of the corresponding motor representations, we required 384 participants to imagine a person-as seen from the right or left side-performing a single manual action and to indicate the hand used by the imagined person during movement execution. The proportion of right- versus left-handed reported actions was higher in the right-view condition than in the left-view condition, suggesting that a lateral vantage point may activate the corresponding hand motor representations, which is in line with previous research indicating a link between the hemispheric specialization of one's own body and the visual representation of others' bodies. Moreover, in agreement with research on hand laterality judgments, the effect of vantage point was stronger for left-handers (who reported a higher proportion of right- than left-handed actions in the right-view condition and a slightly higher proportion of left- than right-handed actions in the left-view condition) than for right-handers (who reported a higher proportion of right- than left-handed actions in both view conditions), indicating that during the mental simulation of others' actions, right-handers rely on sensorimotor processes more than left-handers, while left-handers rely on visual processes more than right-handers.
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NASA Astrophysics Data System (ADS)
Umami, M. K.
2018-01-01
This study is a preliminary survey on thumb reach of Indonesian population when interacting with single-handed device. This study was aimed to know the thumb reach envelope on the screen of mobile phone. The correlation between the thumb reach vs. the hand length and thumb length was also identified. Thirty young adults participated in the study. All participants had normal body stature and were right-handed person. In the observational phase, the participant was asked to colour the canvas area on the screen of the mobile phone by using his/her thumb. The participant had to complete the task by applying the single hand interaction. The participant should grab the mobile phone as he/she use it normally in his/her daily activities. The thumb reach envelope of participants was identified from the coloured area of the canvas. The results of this study found that participants with a large hand length and thumb length tend to have a large thumb reach. The results of this study also show the thumb reach area of the participants is forming an elliptical shape that runs from the northeast to southwest on the device screen.
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Jeong, Sun Young; Kim, Kyung Mi
2016-01-01
Hand hygiene is the single most important measure to prevent transmission of infection, but the compliance rate of healthcare workers is relatively low. This study was conducted to identify the knowledge, beliefs, behavior, and affecting factors about hand hygiene among nursing students. A descriptive survey study. The study was carried out in two South Korean nursing schools. A total 208 nursing students participated in this study. Questionnaires were used to collect data. The percentage of correct answers in the survey section concerning hand hygiene knowledge was 68.1%. No significant difference in the knowledge, behavioral beliefs, normative beliefs, or control beliefs data was found related to general characteristics. Behavioral beliefs correlated with normative beliefs (r=.25, p<.001) and hand hygiene behavior (r=.17, p=.017), and control beliefs correlated with hand hygiene behavior (r=.18, p=.010). The results suggest that knowledge is not enough to change the beliefs related to hand hygiene; positive behavioral beliefs and strong control beliefs are also needed to increase hand hygiene compliance. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Turner, Ronald B.; Fuls, Janice L.; Rodgers, Nancy D.
2010-01-01
These studies evaluated the effectiveness of ethanol hand sanitizers with or without organic acids to remove detectable rhinovirus from the hands and prevent experimental rhinovirus infection. Ethanol hand sanitizers were significantly more effective than hand washing with soap and water. The addition of organic acids to the ethanol provided residual virucidal activity that persisted for at least 4 h. Whether these treatments will reduce rhinovirus infection in the natural setting remains to be determined. PMID:20047916
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Moseley, G Lorimer; Gallace, Alberto; Iannetti, Gian Domenico
2012-12-01
either hand was positively related to its distance from the body midline (pooled data: r = 0.76, P < 0.001). Crossing the affected hand over the body midline had small but significant effects on both spontaneous pain (which was reduced) and the sense of ownership over the hand (which was increased) (P < 0.04 for both). We conclude that impaired spatial perception modulated temperature of the limbs, tactile processing, spontaneous pain and the sense of ownership over the hands. These results show that complex regional pain syndrome involves more complex neurological dysfunction than has previously been considered.
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Conceptual distortions of hand structure are robust to changes in stimulus information.
Ambroziak, Klaudia B; Tamè, Luigi; Longo, Matthew R
2018-05-01
Previous studies showed stereotyped distortions in hand representations. People judge their knuckles as farther forward in the hand than they actually are. The cause of this bias remains unclear. We tested whether both visual and tactile information contribute to the bias. In Experiment 1, participants judged the location of their knuckles by pointing to the location on their palm with: (1) a metal baton (using vision and touch), (2) a metal baton while blindfolded (using touch), or (3) a laser pointer (using vision). Distal mislocalisations were found in all conditions. In Experiment 2, we investigated whether judgments are influenced by visual landmarks such as creases. Participants localized their knuckles on either a photograph of their palm or a silhouette. Distal mislocalisations were apparent in both conditions. These results show that distal biases are resistant to changes in stimulus information, suggesting that such mislocalisations reflect a conceptual mis-representation of hand structure. Copyright © 2018 Elsevier Inc. All rights reserved.
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Aristotle's illusion reveals interdigit functional somatosensory alterations in focal hand dystonia.
Tinazzi, Michele; Marotta, Angela; Fasano, Alfonso; Bove, Francesco; Bentivoglio, Anna Rita; Squintani, Giovanna; Pozzer, Lara; Fiorio, Mirta
2013-03-01
In focal hand dystonia, the cortical somatosensory representation of the fingers is abnormal, with overlapping receptive fields and reduced interdigit separation. These abnormalities are associated with deficits in sensory perception, as previously demonstrated by applying tactile stimuli to one finger at a time. What is still unknown is whether the sensory deficits can be observed when tactile perception involves more than one finger. To address this issue, we applied 'Aristotle's illusion' to 15 patients with focal hand dystonia, 15 patients with dystonia not affecting the hand (blepharospasm and cervical dystonia) and 15 healthy control subjects. In this illusion, one object touching the contact point of two crossed fingertips is perceived as two objects by a blindfolded subject. The same object placed between two parallel fingertips is correctly perceived as one. The illusory doubling sensation is because of the fact that the contact point between the crossed fingers consists of non-adjacent and functionally unrelated skin regions, which usually send sensory signals to separate spots in the somatosensory cortex. In our study, participants were touched by one sphere between the second-third digits, the second-fourth digits and the fourth-fifth digits of both hands, either in crossed or in parallel position, and had to refer whether they felt one or two stimuli. The percentage of 'two stimuli' responses was an index of the illusory doubling. Both healthy control subjects and dystonic patients presented Aristotle's illusion when the fingers were crossed. However, patients with focal hand dystonia presented a significant reduction of the illusion when the sphere was placed between the crossed fourth and fifth digits of the affected hand. This reduction correlated with the severity of motor disease at the fingers. Similar findings were not observed in non-hand dystonia and control groups. The reduction of Aristotle's illusion in non-affected fingers and its
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The effect of concurrent hand movement on estimated time to contact in a prediction motion task.
Zheng, Ran; Maraj, Brian K V
2018-04-27
In many activities, we need to predict the arrival of an occluded object. This action is called prediction motion or motion extrapolation. Previous researchers have found that both eye tracking and the internal clocking model are involved in the prediction motion task. Additionally, it is reported that concurrent hand movement facilitates the eye tracking of an externally generated target in a tracking task, even if the target is occluded. The present study examined the effect of concurrent hand movement on the estimated time to contact in a prediction motion task. We found different (accurate/inaccurate) concurrent hand movements had the opposite effect on the eye tracking accuracy and estimated TTC in the prediction motion task. That is, the accurate concurrent hand tracking enhanced eye tracking accuracy and had the trend to increase the precision of estimated TTC, but the inaccurate concurrent hand tracking decreased eye tracking accuracy and disrupted estimated TTC. However, eye tracking accuracy does not determine the precision of estimated TTC.
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A qualitative analysis of the experience and impact of killing in hand-to-hand combat.
Jensen, Peter R; Simpson, Duncan
2014-08-01
A growing body of research suggests that killing during military combat is closely associated with posttraumatic stress disorder (PTSD), as well as a number of other adverse mental health related conditions (e.g., dissociative experiences, violent behavior, functional impairment). This article provides first-person perspectives on the experiences and impact of killing by service members with the goal of expanding our understanding of the impact of taking a life during war. In audio-recorded phenomenological interviews, 9 service members described their experiences and the subsequent impact of killing during hand-to-hand combat. A description, supported by participant quotations, was constructed to represent the participants' experiences. Results suggest the experience and aftermath of taking a life in hand-to-hand combat was disturbing, psychologically stressful, and necessitated some form of coping after the event. Service members who killed in hand-to-hand combat viewed their actions as necessary to preserve their life and that killing in hand-to-hand combat was more emotionally taxing than killing by shooting. Our findings may help to improve providers' understanding of service members' first-person experiences of killing in hand-to-hand combat and thus provide the basis for the development of a connected and genuine relationship with such military clients. Copyright © 2014 International Society for Traumatic Stress Studies.
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Pan, Daniel; Xu, Xueyan S; Welcome, Daniel E; McDowell, Thomas W; Warren, Christopher; Wu, John; Dong, Ren G
2018-06-01
This study conducted two series of experiments to investigate the relationships between hand coupling force and biodynamic responses of the hand-arm system. In the first experiment, the vibration transmissibility on the system was measured as a continuous function of grip force while the hand was subjected to discrete sinusoidal excitations. In the second experiment, the biodynamic responses of the system subjected to a broadband random vibration were measured under five levels of grip forces and a combination of grip and push forces. This study found that the transmissibility at each given frequency increased with the increase in the grip force before reaching a maximum level. The transmissibility then tended to plateau or decrease when the grip force was further increased. This threshold force increased with an increase in the vibration frequency. These relationships remained the same for both types of vibrations. The implications of the experimental results are discussed. Practitioner Summary: Shocks and vibrations transmitted to the hand-arm system may cause injuries and disorders of the system. How to take hand coupling force into account in the risk assessment of vibration exposure remains an important issue for further studies. This study is designed and conducted to help resolve this issue.
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Spacesuit Glove-Induced Hand Trauma and Analysis of Potentially Related Risk Variables
NASA Technical Reports Server (NTRS)
Charvat, Chacqueline M.; Norcross, Jason; Reid, Christopher R.; McFarland, Shane M.
2015-01-01
Injuries to the hands are common among astronauts who train for extravehicular activity (EVA). When the gloves are pressurized, they restrict movement and create pressure points during tasks, sometimes resulting in pain, muscle fatigue, abrasions, and occasionally more severe injuries such as onycholysis. Glove injuries, both anecdotal and recorded, have been reported during EVA training and flight persistently through NASA's history regardless of mission or glove model. Theories as to causation such as glove-hand fit are common but often lacking in supporting evidence. Previous statistical analysis has evaluated onycholysis in the context of crew anthropometry only. The purpose of this study was to analyze all injuries (as documented in the medical records) and available risk factor variables with the goal to determine engineering and operational controls that may reduce hand injuries due to the EVA glove in the future. A literature review and data mining study were conducted between 2012 and 2014. This study included 179 US NASA crew who trained or completed an EVA between 1981 and 2010 (crossing both Shuttle and ISS eras) and wore either the 4000 Series or Phase VI glove during Extravehicular Mobility Unit (EMU) spacesuit EVA training and flight. All injuries recorded in medical records were analyzed in their association to candidate risk factor variables. Those risk factor variables included demographic characteristics, hand anthropometry, glove fit characteristics, and training/EVA characteristics. Utilizing literature, medical records and anecdotal causation comments recorded in crewmember injury data, investigators were able to identify several risk factors associated with increased risk of glove related injuries. Prime among them were smaller hand anthropometry, duration of individual suited exposures, and improper glove-hand fit as calculated by the difference in the anthropometry middle finger length compared to the baseline EVA glove middle finger length.
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Spacesuit Glove-Induced Hand Trauma and Analysis of Potentially Related Risk Variables
NASA Technical Reports Server (NTRS)
McFarland, Shane M.; Reid, Christopher R.; Norcross, Jason; Charvat, Jacqueline M.
2015-01-01
Injuries to the hands are common among astronauts who train for extravehicular activity (EVA). When the gloves are pressurized, they restrict movement and create pressure points during tasks, sometimes resulting in pain, muscle fatigue, abrasions, and occasionally more severe injuries such as onycholysis. Glove injuries, both anecdotal and recorded, have been reported during EVA training and flight persistently through NASA's history regardless of mission or glove model. Theories as to causation such as glove-hand fit are common but often lacking in supporting evidence. Previous statistical analysis has evaluated onycholysis in the context of crew anthropometry only (Opperman et al 2010). The purpose of this study was to analyze all injuries (as documented in the medical records) and available risk factor variables with the goal to determine engineering and operational controls that may reduce hand injuries due to the EVA glove in the future. A literature review and data mining study were conducted between 2012 and 2014. This study included 179 US NASA crew who trained or completed an EVA between 1981 and 2010 (crossing both Shuttle and ISS eras) and wore either the 4000 Series or Phase VI glove during Extravehicular Mobility Unit (EMU) spacesuit EVA training and flight. All injuries recorded in medical records were analyzed in their association to candidate risk factor variables. Those risk factor variables included demographic characteristics, hand anthropometry, glove fit characteristics, and training/EVA characteristics. Utilizing literature, medical records and anecdotal causation comments recorded in crewmember injury data, investigators were able to identify several risk factors associated with increased risk of glove related injuries. Prime among them were smaller hand anthropometry, duration of individual suited exposures, and improper glove-hand fit as calculated by the difference in the anthropometry middle finger length compared to the baseline EVA
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Prevalence, incidence and predictive factors for hand eczema in young adults – a follow-up study
2013-01-01
Background Hand eczema is common in the general population and affects women twice as often as men. It is also the most frequent occupational skin disease. The economic consequences are considerable for society and for the affected individuals. Methods To investigate the prevalence and incidence of hand eczema and to evaluate risk factors for development of hand eczema in young adults. Subjects and methods; This is a prospective follow-up study of 2,403 young adults, 16 – 19 years old in 1995 and aged 29 – 32 years, 13 years later, in 2008. They completed a postal questionnaire that included questions regarding one-year prevalence of hand eczema, childhood eczema, asthma, rhino-conjunctivitis and factors considered to affect hand eczema such as hand-washing, washing and cleaning, cooking, taking care of small children and usage of moisturisers. These factors were evaluated with the multinominal logistic regression analysis. Results The one-year prevalence of hand eczema was 15.8% (females 20.3% and males 10.0%, p < 0.001). The incidence was 11.6 cases per 1000 person-years (females 14.3 and males 5.2, p < 0.001). Childhood eczema was the most important risk factor for hand eczema. The odds ratios were 13.17 when having hand eczema 1995 and 2008 compared to 5.17 in 2008 (p < 0.001). A high frequency of hand washing was important in predicting hand eczema only when having 1-year prevalence 2008, OR 1.02 (p = 0.038). Conclusions After 13 years an increased 1-year prevalence of hand eczema was found. The significant risk factors for hand eczema changed over time from endogenous to exogenous factors. PMID:24164871
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Eye tracking a self-moved target with complex hand-target dynamics
Landelle, Caroline; Montagnini, Anna; Madelain, Laurent
2016-01-01
Previous work has shown that the ability to track with the eye a moving target is substantially improved when the target is self-moved by the subject's hand compared with when being externally moved. Here, we explored a situation in which the mapping between hand movement and target motion was perturbed by simulating an elastic relationship between the hand and target. Our objective was to determine whether the predictive mechanisms driving eye-hand coordination could be updated to accommodate this complex hand-target dynamics. To fully appreciate the behavioral effects of this perturbation, we compared eye tracking performance when self-moving a target with a rigid mapping (simple) and a spring mapping as well as when the subject tracked target trajectories that he/she had previously generated when using the rigid or spring mapping. Concerning the rigid mapping, our results confirmed that smooth pursuit was more accurate when the target was self-moved than externally moved. In contrast, with the spring mapping, eye tracking had initially similar low spatial accuracy (though shorter temporal lag) in the self versus externally moved conditions. However, within ∼5 min of practice, smooth pursuit improved in the self-moved spring condition, up to a level similar to the self-moved rigid condition. Subsequently, when the mapping unexpectedly switched from spring to rigid, the eye initially followed the expected target trajectory and not the real one, thereby suggesting that subjects used an internal representation of the new hand-target dynamics. Overall, these results emphasize the stunning adaptability of smooth pursuit when self-maneuvering objects with complex dynamics. PMID:27466129
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Schweisfurth, Meike A; Frahm, Jens; Schweizer, Renate
2015-09-01
Individual intra-digit somatotopy of all phalanges of the middle and little finger of the right and left hand was studied by functional magnetic resonance imaging in 12 healthy subjects. Phalanges were tactilely stimulated and activation in BA 3b of the human primary somatosensory cortex could be observed for each individual phalanx. Activation peaks were further analysed using the Direction/Order (DiOr) method, which identifies somatotopy, if a significantly high number of subjects exhibit ordered distal-to-proximal phalanx representions along a similar direction. Based on DiOr, ordered and similar-direction-aligned intra-digit maps across subjects were found at the left hand for the little and middle finger and at the right hand for the little finger. In these digits the proximal phalanges were represented more medially along the course of the central sulcus than the distal phalanges. This is contrasted by the intra-digit maps for the middle finger of the right hand, which showed larger inter-subject variations of phalanx alignments without a similar within-digit representation across subjects. As all subjects were right-handed and as the middle finger of the dominant hand probably plays a more individual role in everyday tactile performance than the little finger of the right hand and all left-hand digits, the observed variation might reflect a functional somatotopy based on individual use of that particular digit at the dominant hand. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
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Unimanual SNARC Effect: Hand Matters.
Riello, Marianna; Rusconi, Elena
2011-01-01
A structural representation of the hand embedding information about the identity and relative position of fingers is necessary to counting routines. It may also support associations between numbers and allocentric spatial codes that predictably interact with other known numerical spatial representations, such as the mental number line (MNL). In this study, 48 Western participants whose typical counting routine proceeded from thumb-to-little on both hands performed magnitude and parity binary judgments. Response keys were pressed either with the right index and middle fingers or with the left index and middle fingers in separate blocks. 24 participants responded with either hands in prone posture (i.e., palm down) and 24 participants responded with either hands in supine (i.e., palm up) posture. When hands were in prone posture, the counting direction of the left hand conflicted with the direction of the left-right MNL, whereas the counting direction of the right hand was consistent with it. When hands were in supine posture, the opposite was true. If systematic associations existed between relative number magnitude and an allocentric spatial representation of the finger series within each hand, as predicted on the basis of counting habits, interactions would be expected between hand posture and a unimanual version of the spatial-numerical association of response codes (SNARC) effect. Data revealed that with hands in prone posture a unimanual SNARC effect was present for the right hand, and with hands in supine posture a unimanual SNARC effect was present for the left hand. We propose that a posture-invariant body structural representation of the finger series provides a relevant frame of reference, a within-hand directional vector, that is associated to simple number processing. Such frame of reference can significantly interact with stimulus-response correspondence effects, like the SNARC, that have been typically attributed to the mapping of numbers on a left
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Hand sanitizer-dispensing door handles increase hand hygiene compliance: a pilot study.
Babiarz, Lukasz S; Savoie, Brent; McGuire, Mark; McConnell, Lauren; Nagy, Paul
2014-04-01
Improving rates of hand hygiene compliance (HHC) has been shown to reduce nosocomial disease. We compared the HHC for a traditional wall-mounted unit and a novel sanitizer-dispensing door handle device in a hospital inpatient ultrasound area. HHC increased 24.5%-77.1% (P < .001) for the exam room with the sanitizer-dispensing door handle, whereas it remained unchanged for the other rooms. Technical improvements like a sanitizer-dispensing door handle can improve hospital HHC. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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Chong, Hyun Ju; Cho, Sung-Rae; Kim, Soo Ji
2014-01-01
As a sequential, programmed movement of fingers, keyboard playing is a promising technique for inducing execution and a high level of coordination during finger movements. Also, keyboard playing can be physically and emotionally rewarding for adolescents in rehabilitation settings and thereby motivate continued involvement in treatment. The purpose of this study is to evaluate the effects of keyboard playing using Musical Instrument Digital Interface (MIDI) on finger movement for adolescents with brain damage. Eight adolescents with brain damage, ages 9 to 18 years (M = 13 years, SD = 2.78), in physical rehabilitation settings participated in this study. Measurements included MIDI keyboard playing for pressing force of the fingers and hand function tests (Grip and Pinch Power Test, Box and Block Test of Manual Dexterity [BBT], and the Jebsen Taylor Hand Function Test). Results showed increased velocity of all fingers on the MIDI-based test, and statistical significance was found in the velocity of F2 (index finger), F3 (middle finger), and F5 (little finger) between pre- and post-training tests. Correlation analysis between the pressing force of the finger and hand function tests showed a strong positive correlation between the measure of grip power and the pressing force of F2 and F5 on the Grip and Pinch Strength Test. All fingers showed strong correlation between MIDI results and BBT. For the Jebsen Taylor Hand Function Test, only the moving light objects task at post-training yielded strong correlation with MIDI results of all fingers. The results support using keyboard playing for hand rehabilitation, especially in the pressing force of individual finger sequential movements. Further investigation is needed to define the feasibility of the MIDI program for valid hand rehabilitation for people with brain damage.
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Factors associated with combined hand and foot eczema.
Agner, T; Aalto-Korte, K; Andersen, K E; Foti, C; Gimenéz-Arnau, A; Goncalo, M; Goossens, A; Le Coz, C; Diepgen, T L
2017-05-01
As for hand eczema, the aetiology of foot eczema is multifactorial and not very well understood. The aim of the present study was to identify factors associated with foot eczema in a cohort of hand eczema patients being classified into different subgroups. Associations between foot and hand eczema were studied in a cross-sectional design in a cohort of hand eczema patients. Consecutive patients were recruited from nine different European Centres during the period October 2011-September 2012. Data on demographic factors, presence of foot eczema, hand eczema duration and severity, and whether the hand eczema was work-related or not were available, as well as patch-test results. Of a total of 427 hand eczema patients identified, information on foot eczema was available in 419 patients who were included in the present study. A total of 125 patients (29.8%) had concomitant foot and hand eczema. It was found more often in association with hyperkeratotic hand eczema (P = 0.007) and was less often associated with irritant hand eczema (P < 0.001). However, foot eczema was nevertheless found in 18% of patient with irritant hand eczema and in 25% of patients with occupational hand eczema. Combined foot and hand eczema was associated with more severe and long-standing hand eczema (P < 0.001 and P = 0.004, respectively). Contact allergy was found in 51.8% with no difference between patients with combined foot and hand eczema and patients with hand eczema only. Occurrence of combined foot and hand eczema is a common finding and not restricted to endogenous hand eczema. © 2016 European Academy of Dermatology and Venereology.
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Czarnuch, Stephen; Mihailidis, Alex
2015-03-27
We present the development and evaluation of a robust hand tracker based on single overhead depth images for use in the COACH, an assistive technology for people with dementia. The new hand tracker was designed to overcome limitations experienced by the COACH in previous clinical trials. We train a random decision forest classifier using ∼5000 manually labeled, unbalanced, training images. Hand positions from the classifier are translated into task actions based on proximity to environmental objects. Tracker performance is evaluated using a large set of ∼24 000 manually labeled images captured from 41 participants in a fully-functional washroom, and compared to the system's previous colour-based hand tracker. Precision and recall were 0.994 and 0.938 for the depth tracker compared to 0.981 and 0.822 for the colour tracker with the current data, and 0.989 and 0.466 in the previous study. The improved tracking performance supports integration of the depth-based tracker into the COACH toward unsupervised, real-world trials. Implications for Rehabilitation The COACH is an intelligent assistive technology that can enable people with cognitive disabilities to stay at home longer, supporting the concept of aging-in-place. Automated prompting systems, a type of intelligent assistive technology, can help to support the independent completion of activities of daily living, increasing the independence of people with cognitive disabilities while reducing the burden of care experienced by caregivers. Robust motion tracking using depth imaging supports the development of intelligent assistive technologies like the COACH. Robust motion tracking also has application to other forms of assistive technologies including gaming, human-computer interaction and automated assessments.
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"In Situ Vascular Nerve Graft" for Restoration of Intrinsic Hand Function: An Anatomical Study.
Mozaffarian, Kamran; Zemoodeh, Hamid Reza; Zarenezhad, Mohammad; Owji, Mohammad
2018-06-01
In combined high median and ulnar nerve injury, transfer of the posterior interosseous nerve branches to the motor branch of the ulnar nerve (MUN) is previously described in order to restore intrinsic hand function. In this operation a segment of sural nerve graft is required to close the gap between the donor and recipient nerves. However the thenar muscles are not innervated by this nerve transfer. The aim of the present study was to evaluate whether the superficial radial nerve (SRN) can be used as an "in situ vascular nerve graft" to connect the donor nerves to the MUN and the motor branch of median nerve (MMN) at the same time in order to address all denervated intrinsic and thenar muscles. Twenty fresh male cadavers were dissected in order to evaluate the feasibility of this modification of technique. The size of nerve branches, the number of axons and the tension at repair site were evaluated. This nerve transfer was technically feasible in all specimens. There was no significant size mismatch between the donor and recipient nerves Conclusions: The possible advantages of this modification include innervation of both median and ulnar nerve innervated intrinsic muscles, preservation of vascularity of the nerve graft which might accelerate the nerve regeneration, avoidance of leg incision and therefore the possibility of performing surgery under regional instead of general anesthesia. Briefly, this novel technique is a viable option which can be used instead of conventional nerve graft in some brachial plexus or combined high median and ulnar nerve injuries when restoration of intrinsic hand function by transfer of posterior interosseous nerve branches is attempted.
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Hand-arm vibration syndrome among a group of construction workers in Malaysia.
Su, Ting Anselm; Hoe, Victor Chee Wai; Masilamani, Retneswari; Awang Mahmud, Awang Bulgiba
2011-01-01
To determine the extent of hand transmitted vibration exposure problems, particularly hand-arm vibration syndrome (HAVS), among construction workers in Malaysia. A cross-sectional study was conducted on a construction site in Kuala Lumpur, Malaysia. 243 workers were recruited. Questionnaire interviews and hand examinations were administered to 194 respondents. Vibration magnitudes for concrete breakers, drills and grinders were measured using a 3-axis accelerometer. Clinical outcomes were compared and analysed according to vibration exposure status. Vibration total values for concrete breakers, impact drills and grinders were 10.02 ms(-2), 7.72 ms(-2) and 5.29ms(-2), respectively. The mean 8 h time-weighted hand transmitted vibration exposure, A(8), among subjects on current and previous construction sites was 7.52 (SD 2.68) ms(-2) and 9.21 (SD 2.48) ms(-2), respectively. Finger tingling, finger numbness, musculoskeletal problems of the neck, finger coldness, abnormal Phalen's test and abnormal light touch sensation were significantly more common in the high vibration exposure group (n=139) than the low-moderate vibration exposure group (n=54). Mean total lifetime vibration dose among exposed subjects was 15.2 (SD 3.2) m(2) h(3) s(-4) (ln scale). HAVS prevalence was 18% and the prevalence ratio of stage 1 and higher disease in the high vibration exposure group versus the low-moderate vibration exposure group was 4.86 (95% CI 1.19 to 19.80). Hand transmitted vibration is a recognisable problem in tropical countries including Malaysia. The current study has identified clinical symptoms and signs suggesting HAVS among construction workers exposed to hand transmitted vibration in a warm environment.
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Hughes, Charmayne M L; Reissig, Paola; Seegelke, Christian
2011-09-01
The issue of handedness has been the topic of great interest for researchers in a number of scientific domains. It is typically observed that the dominant hand yields numerous behavioral advantages over the non-dominant hand during unimanual tasks, which provides evidence of hemispheric specialization. In contrast to advantages for the dominant hand during motor execution, recent research has demonstrated that the right hand has advantages during motor planning (regardless of handedness), indicating that motor planning is a specialized function of the left hemisphere. In the present study we explored hemispheric advantages in motor planning and execution in left- and right-handed individuals during a bimanual grasping and placing task. Replicating previous findings, both motor planning and execution was influenced by object end-orientation congruency. In addition, although motor planning (i.e., end-state comfort) was not influenced by hand or handedness, motor execution differed between left and right hand, with shorter object transport times observed for the left hand, regardless of handedness. These results demonstrate that the hemispheric advantages often observed in unimanual tasks do not extend to discrete bimanual tasks. We propose that the differences in object transport time between the two hands arise from overt shifting visual fixation between the two hands/objects. Copyright © 2011 Elsevier B.V. All rights reserved.
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Genetic Influences on Hand Osteoarthritis in Finnish Women – A Replication Study of Candidate Genes
Hämäläinen, Satu; Solovieva, Svetlana; Vehmas, Tapio; Luoma, Katariina; Leino-Arjas, Päivi; Hirvonen, Ari
2014-01-01
Objectives Our aims were to replicate some previously reported associations of single nucleotide polymorphisms (SNPs) in five genes (A2BP1, COG5, GDF5, HFE, ESR1) with hand osteoarthritis (OA), and to examine whether genes (BCAP29, DIO2, DUS4L, DVWA, HLA, PTGS2, PARD3B, TGFB1 and TRIB1) associated with OA at other joint sites were associated with hand OA among Finnish women. Design We examined the bilateral hand radiographs of 542 occupationally active Finnish female dentists and teachers aged 45 to 63 and classified them according to the presence of OA by using reference images. Data regarding finger joint pain and other risk factors were collected using a questionnaire. We defined two hand OA phenotypes: radiographic OA in at least three joints (ROA) and symptomatic DIP OA. The genotypes were determined by PCR-based methods. In statistical analysis, we used SNPStats software, the chi-square test and logistic regression. Results Of the SNPs, rs716508 in A2BP1 was associated with ROA (OR = 0.7, 95% CI 0.5–0.9) and rs1800470 in TGFB1 with symptomatic DIP OA (1.8, 1.2–2.9). We found an interaction between ESR1 (rs9340799) and occupation: teachers with the minor allele were at an increased risk of symptomatic DIP OA (2.8, 1.3–6.5). We saw no association among the dentists. We also found that the carriage of the COG5 rs3757713 C allele increased the risk of ROA only among women with the BCAP29 rs10953541 CC genotype (2.6; 1.1–6.1). There was also a suggestive interaction between the HFE rs179945 and the ESR1 rs9340799, and the carriage of the minor allele of either of these SNPs was associated with an increased risk of symptomatic DIP OA (2.1, 1.3–2.5). Conclusions Our results support the earlier findings of A2BP1 and TBGF1 being OA susceptibility genes and provide evidence of a possible gene-gene interaction in the genetic influence on hand OA predisposition. PMID:24825461
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Bryant, Mon S; Workman, Craig D; Jamal, Fariha; Meng, Hao; Jackson, George R
A single group, repeated measures design was used. Tremor can lead to impaired hand function in patients with Parkinson's disease (PD) and essential tremor (ET). Difficulty with handwriting is a common complaint in these patients suffering from hand tremors. The effect of hand resistance exercise on handwriting is unknown. To explore the influence of 6 weeks of home-based hand resistance exercise on handwriting in individuals with PD and ET. Nine individuals with PD and 9 with ET participated in the study. The average age was 65.3 (6.0) years with an average disease duration of 7.8 years. Participants were instructed to perform a home-based, hand and arm resistance exercise program 3 times a week for 6 weeks. Samples of the area of handwriting and maximal grip strength were measured at baseline and after 6 weeks of exercise. The area of the handwriting sample and maximal grip strength measured before and after 6 weeks were compared. Mean grip strength of the participants with PD improved after 6 weeks of hand resistance exercise (P = .031), but grip strength did not change in ET (P = .091). The size of the handwriting samples (words and sentences) did not change after exercise in either participants with PD or ET. Micrographia in patients with PD and macrographia in patients with ET represent complex fine motor skills. More research is needed to understand what therapies could be effective in modifying the size and quality of handwriting. The purpose of this feasibility study was to explore the influence of home-based wrist resistance exercise on handwriting in individuals with PD and ET. Despite small gains in grip strength, the size of the handwriting samples (words and sentences) did not change for patients with PD or ET following a 6-week home-based hand resistance exercise program. Published by Elsevier Inc.
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Rinaldi, Luca; Vecchi, Tomaso; Fantino, Micaela; Merabet, Lotfi B; Cattaneo, Zaira
2015-10-01
Recent evidence suggests that in representing numbers blind individuals might be affected differently by proprioceptive cues (e.g., hand positions, head turns) than are sighted individuals. In this study, we asked a group of early blind and sighted individuals to perform a numerical bisection task while executing hand movements in left or right peripersonal space and with either hand. We found that in bisecting ascending numerical intervals, the hemi-space in which the hand was moved (but not the moved hand itself) influenced the bisection bias similarly in both early blind and sighted participants. However, when numerical intervals were presented in descending order, the moved hand (and not the hemi-space in which it was moved) affected the bisection bias in all participants. Overall, our data show that the operation to be performed on the mental number line affects the activated spatial reference frame, regardless of participants' previous visual experience. In particular, both sighted and early blind individuals' representation of numerical magnitude is mainly rooted in world-centered coordinates when numerical information is given in canonical orientation (i.e., from small to large), whereas hand-centered coordinates become more relevant when the scanning of the mental number line proceeds in non-canonical direction. Copyright © 2015 Elsevier Ltd. All rights reserved.
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The effect of hand movements on numerical bisection judgments in early blind and sighted individuals
Rinaldi, Luca; Vecchi, Tomaso; Fantino, Micaela; Merabet, Lotfi B.; Cattaneo, Zaira
2017-01-01
Recent evidence suggests that in representing numbers blind individuals might be affected differently by proprioceptive cues (e.g., hand positions, head turns) than are sighted individuals. In this study, we asked a group of early blind and sighted individuals to perform a numerical bisection task while executing hand movements in left or right peripersonal space and with either hand. We found that in bisecting ascending numerical intervals, the hemi-space in which the hand was moved (but not the moved hand itself) influenced the bisection bias similarly in both early blind and sighted participants. However, when numerical intervals were presented in descending order, the moved hand (and not the hemi-space in which it was moved) affected the bisection bias in all participants. Overall, our data show that the operation to be performed on the mental number line affects the activated spatial reference frame, regardless of participants’ previous visual experience. In particular, both sighted and early blind individuals’ representation of numerical magnitude is mainly rooted in world-centered coordinates when numerical information is given in canonical orientation (i.e. from small to large), whereas hand-centered coordinates become more relevant when the scanning of the mental number line proceeds in non-canonical direction. PMID:26184675
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Predictive models to determine imagery strategies employed by children to judge hand laterality.
Spruijt, Steffie; Jongsma, Marijtje L A; van der Kamp, John; Steenbergen, Bert
2015-01-01
A commonly used paradigm to study motor imagery is the hand laterality judgment task. The present study aimed to determine which strategies young children employ to successfully perform this task. Children of 5 to 8 years old (N = 92) judged laterality of back and palm view hand pictures in different rotation angles. Response accuracy and response duration were registered. Response durations of the trials with a correct judgment were fitted to a-priori defined predictive sinusoid models, representing different strategies to successfully perform the hand laterality judgment task. The first model predicted systematic changes in response duration as a function of rotation angle of the displayed hand. The second model predicted that response durations are affected by biomechanical constraints of hand rotation. If observed data could be best described by the first model, this would argue for a mental imagery strategy that does not involve motor processes to solve the task. The second model reflects a motor imagery strategy to solve the task. In line with previous research, we showed an age-related increase in response accuracy and decrease in response duration in children. Observed data for both back and palm view showed that motor imagery strategies were used to perform hand laterality judgments, but that not all the children use these strategies (appropriately) at all times. A direct comparison of response duration patterns across age sheds new light on age-related differences in the strategies employed to solve the task. Importantly, the employment of the motor imagery strategy for successful task performance did not change with age.
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[Hand motor dysfunctions in computer users].
Shavlovskaia, O A; Shvarkov, S B; Posokhov, S I
2010-01-01
It were studied 239 female typists aged from 16 to 62 years (mean age 20,1±7,8 years) using author's questionnaire for computer typists to assess hand function and develop preventive measures of disturbances revealed. Indirect signs of tunnel hand neuropathy (27,2%), focal hand dystonia (21,4%) and muscular-tonic syndromes of different localization (18%) have been found. Typists are a risk group of fine hand motor dysfunctions. As preventive measures, authors recommend to use computer auxiliary devices, to change a motor stereotype during the day, to make hand "motor holidays", to organize working place.
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Hand-independent representation of tool-use pantomimes in the left anterior intraparietal cortex.
Ogawa, Kenji; Imai, Fumihito
2016-12-01
Previous neuropsychological studies of ideomotor apraxia (IMA) indicated impairments in pantomime actions for tool use for both right and left hands following lesions of parieto-premotor cortices in the left hemisphere. Using functional magnetic resonance imaging (fMRI) with multi-voxel pattern analysis (MVPA), we tested the hypothesis that the left parieto-premotor cortices are involved in the storage or retrieval of hand-independent representation of tool-use actions. In the fMRI scanner, one of three kinds of tools was displayed in pictures or letters, and the participants made pantomimes of the use of these tools using the right hand for the picture stimuli or with the left hand for the letters. We then used MVPA to classify which kind of tool the subjects were pantomiming. Whole-brain searchlight analysis revealed successful decoding using the activities largely in the contralateral primary sensorimotor region, ipsilateral cerebellum, and bilateral early visual area, which may reflect differences in low-level sensorimotor components for three types of pantomimes. Furthermore, a successful cross-classification between the right and left hands was possible using the activities of the left inferior parietal lobule (IPL) near the junction of the anterior intraparietal sulcus. Our finding indicates that the left anterior intraparietal cortex plays an important role in the production of tool-use pantomimes in a hand-independent manner, and independent of stimuli modality.
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Shoulder pain and concomitant hand oedema among stroke patients with pronounced arm paresis
2013-01-01
Background The aim of this prospective study was to identify clinical factors associated with the development of shoulder pain in stroke patients with pronounced arm paresis. Methods At stroke onset, 485 patients were initially assessed in 2007–2009. Sixty-three patients with pronounced arm paresis completed the study, and 21 of these developed shoulder pain. Clinical findings were recorded fortnightly by the attending physiotherapist during hospital stay. Results Hand oedema on the paretic side was more common in patients developing shoulder pain compared with those who did not develop shoulder pain. The onset of shoulder pain was associated with concomitant hand oedema. High NIHSS score was associated with developing shoulder pain. Patients with a history of shoulder pain developed pain earlier than those without previous shoulder pain. Patients with haemorrhagic stroke were significantly more prone to developing shoulder pain. Conclusions One-third of the stroke patients with pronounced arm paresis developed shoulder pain. Concomitant hand oedema seems to be an additional symptom of shoulder injury. Patients with low general status are more vulnerable to develop post-stroke shoulder pain. PMID:24765589
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Environmentally compatible hand wipe cleaning solvents
NASA Technical Reports Server (NTRS)
Clayton, Catherine P.; Kovach, Michael P.
1995-01-01
Several solvents of environmental concern have previously been used for hand wipe cleaning of SRB surfaces, including 1,1,1-trichloroethane, perchloroethylene, toluene, xylene, and MEK. USBI determined the major types of surfaces involved, and qualification requirements of replacement cleaning agents. Nineteen environmentally compatible candidates were tested on 33 material substrates with 26 types of potential surface contaminants, involving over 7,000 individual evaluations. In addition to the cleaning performance evaluation, bonding, compatibility, and corrosion tests were conducted. Results showed that one cleaner was not optimum for all surfaces. In most instances, some of the candidates cleaned better than the 1,1,1-trichloroethane baseline control. Aqueous cleaners generally cleaned better, and were more compatible with nonmetallic materials, such as paints, plastics, and elastomers. Organic base cleaners were better on metal surfaces. Five cleaners have been qualified and are now being implemented in SRB hand wipe cleaning operations.
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Another cause of occupational entrapment neuropathy: la main du cuisinier (the chef's hand).
Krishnan, Arun V; Fulham, Michael J; Kiernan, Matthew C
2009-04-01
Recent studies have raised the possibility of a predisposition to mononeuropathies in a number of professions including musicians, cleaners, and industrial workers. There are, however, no previous reports of increased rates of mononeuropathies in the culinary arts. The authors report three cases of mononeuropathies occurring in professional chefs that presented over a 3-month period in the same outpatient clinic, with a case each of distal ulnar neuropathy, distal median motor neuropathy (thenar motor syndrome) and posterior interosseous neuropathy. There was no history of direct hand trauma in any of the patients. In all three patients, the injuries occurred exclusively in the dominant hand, further strengthening the argument for an occupational link.
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The Rubber Hand Illusion: Feeling of Ownership and Proprioceptive Drift Do Not Go Hand in Hand
Rohde, Marieke; Di Luca, Massimiliano; Ernst, Marc O.
2011-01-01
In the Rubber Hand Illusion, the feeling of ownership of a rubber hand displaced from a participant's real occluded hand is evoked by synchronously stroking both hands with paintbrushes. A change of perceived finger location towards the rubber hand (proprioceptive drift) has been reported to correlate with this illusion. To measure the time course of proprioceptive drift during the Rubber Hand Illusion, we regularly interrupted stroking (performed by robot arms) to measure perceived finger location. Measurements were made by projecting a probe dot into the field of view (using a semi-transparent mirror) and asking participants if the dot is to the left or to the right of their invisible hand (Experiment 1) or to adjust the position of the dot to that of their invisible hand (Experiment 2). We varied both the measurement frequency (every 10 s, 40 s, 120 s) and the mode of stroking (synchronous, asynchronous, just vision). Surprisingly, with frequent measurements, proprioceptive drift occurs not only in the synchronous stroking condition but also in the two control conditions (asynchronous stroking, just vision). Proprioceptive drift in the synchronous stroking condition is never higher than in the just vision condition. Only continuous exposure to asynchronous stroking prevents proprioceptive drift and thus replicates the differences in drift reported in the literature. By contrast, complementary subjective ratings (questionnaire) show that the feeling of ownership requires synchronous stroking and is not present in the asynchronous stroking condition. Thus, subjective ratings and drift are dissociated. We conclude that different mechanisms of multisensory integration are responsible for proprioceptive drift and the feeling of ownership. Proprioceptive drift relies on visuoproprioceptive integration alone, a process that is inhibited by asynchronous stroking, the most common control condition in Rubber Hand Illusion experiments. This dissociation implies that
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Kloppenburg, M; Maheu, E; Kraus, V B; Cicuttini, F; Doherty, M; Dreiser, R-L; Henrotin, Y; Jiang, G-L; Mandl, L; Martel-Pelletier, J; Nelson, A E; Neogi, T; Pelletier, J-P; Punzi, L; Ramonda, R; Simon, L S; Wang, S
2015-05-01
Hand osteoarthritis (OA) is a very frequent disease, but yet understudied. However, a lot of works have been published in the past 10 years, and much has been done to better understand its clinical course and structural progression. Despite this new knowledge, few therapeutic trials have been conducted in hand OA. The last OARSI recommendations for the conduct of clinical trials in hand OA dates back to 2006. The present recommendations aimed at updating previous recommendations, by incorporating new data. The purpose of this expert opinion, consensus driven exercise is to provide evidence-based guidance on the design, execution and analysis of clinical trials in hand OA, where published evidence is available, supplemented by expert opinion, where evidence is lacking, to perform clinical trials in hand OA, both for symptom and for structure-modification. They indicate core outcome measurement sets for studies in hand OA, and list the methods and instruments that should be used to measure symptoms or structure. For both symptom- and structure-modification, at least pain, physical function, patient global assessment, HR-QoL, joint activity and hand strength should be assessed. In addition, for structure-modification trials, structural progression should be measured by radiographic changes. We also provide a research agenda listing many unsolved issues that seem to most urgently need to be addressed from the perspective of performing "good" clinical trials in hand OA. These updated OARSI recommendations should allow for better standardizing the conduct of clinical trials in hand OA in the next future. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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Balkhy, Husam H; Nisivaco, Sarah M; Husain, Aliya N; Jeevanandam, Valluvan; Arif, Quidsia
Coronary artery bypass surgery is most commonly performed using a hand-sewn technique with a continuous monofilament suture. The C-Port distal anastomotic device is a miniature stapler designed to create an arteriotomy and attach the graft to the coronary artery all in one step. It is the only distal coronary anastomotic device currently approved for clinical use and can be useful in facilitating less invasive coronary surgery. This report examines the histological attributes of such an anastomosis in a patient who underwent heart transplantation approximately 1 year after robotic totally endoscopic stapled coronary bypass using the C-Port anastomotic device. There have been no previous reports of histological examination of this type of bypass graft in humans in the literature. We found that the C-Port single-shot stapled coronary anastomotic device had a similar histological appearance to a traditional hand-sewn technique using monofilament suture. The amount of inflammation around the anastomosis using the two techniques was found to be comparable in this histological case study in an explanted human heart. There was no evidence of increased neointimal hyperplasia. These findings add to the already known equivalent clinical patency rates of the C-Port device in coronary bypass procedures.
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Epidemiology of bacterial hand infections.
Houshian, Shirzad; Seyedipour, Sedigheh; Wedderkopp, Niels
2006-07-01
The aim of the study was to delineate and update the bacteriological spectrum, characterize patterns and sites of injury, evaluate laboratory tests and possible causes of complications in patients with bacterial hand infections. All hand infections operated on in the department of orthopedics at Odense University Hospital during the period 1992-2001 were reviewed retrospectively. A standard protocol was used to collect data for each patient. We also examined all laboratory reports and recorded the identity of the etiologic organism, if known, for all cases of bacterial hand infections. Four hundred and eighteen patients (296 men and 122 women) with hand infections were operated on between 1992 and 2001 in our department. The median age of the patients was 40 years (range 1-93). The average interval from primary injury to operation was 10 days (range 1-50). The etiology was laceration/puncture in 35%. The site of infection was subcutaneous in 45% followed by tendon, joint and bone in 27, 18 and 5%, respectively. The bacteria isolated from the patients showed that 184 cultures (44%) were pure Staphylococcus aureus followed by 49 cultures (11.7%) of mixed organisms. Body temperature and C-reactive protein (CRP) were normal in three quarters of all patients with hand infections in our series. However the erythrocyte sedimentation rate (ESR) was elevated in 50% of the patients and was a significantly better test for infection in this study than CRP (p = 0.002). Neither the severity of infection nor the etiology of infection was related in any way to the initial temperature, CRP or ESR in this study. Complications were noted in 14.8% of all patients, and were especially related to diabetes, and mixed infection. Despite modern antibiotics, hand infections with a variety of organisms continue to be a source of morbidity and possible long-term disability. Most hand infections are the result of minor wounds that have been neglected. A complete history and physical
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Finger impedance evaluation by means of hand exoskeleton.
Fiorilla, Angelo Emanuele; Nori, Francesco; Masia, Lorenzo; Sandini, Giulio
2011-12-01
Modulation of arm mechanical impedance is a fundamental aspect for interaction with the external environment and its regulation is essential for stability preservation during manipulation. Even though past research on human arm movements has suggested that models of human finger impedance would benefit the study of neural control mechanisms and the design of novel hand prostheses, relatively few studies have focused on finger and hand impedance. This article touches on the two main aspects of this research topic: first it introduces a mechanical refinement of a device that can be used to effectively measure finger impedance during manipulation tasks; then, it describes a pilot study aimed at identifying the inertia of the finger and the viscous and elastic properties of finger muscles. The proposed wearable exoskeleton, which has been designed to measure finger posture and impedance modulation while leaving the palm free, is capable of applying fast displacements while monitoring the interaction forces between the human finger and the robotic links. Moreover, due to the relatively small inertia of the fingers, it allows us to meet some stringent specifications, performing relatively large displacements (~45°) before the stretch reflex intervenes (~25 ms). The results of measurements on five subjects show that inertia, damping, and stiffness can be effectively identified and that the parameters obtained are comparable with values from previous studies.
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Body ownership and the four-hand illusion.
Chen, Wen-Yeo; Huang, Hsu-Chia; Lee, Yen-Tung; Liang, Caleb
2018-02-01
Recent studies of the rubber hand illusion (RHI) have shown that the sense of body ownership is constrained by several factors and yet is still very flexible. However, exactly how flexible is our sense of body ownership? In this study, we address this issue by investigating the following question: is it possible that one may have the illusory experience of owning four hands? Under visual manipulation, the participant adopted the experimenter's first-person perspective (1PP) as if it was his/her own. Sitting face to face, the participant saw four hands-the experimenter's two hands from the adopted 1PP together with the subject's own two hands from the adopted third-person perspective (3PP). We found that: (1) the four-hand illusion did not occur in the passive four-hand condition. (2) In the active four-hand condition, the participants tapped their index fingers, imitated by the experimenter. When tactile stimulations were not provided, the key illusion was not induced, either. (3) Strikingly, once all four hands began to act with the same pattern and received synchronous tactile stimulations at the same time, many participants felt as if they had two more hands. These results show that the sense of body ownership is much more flexible than most researchers have suggested.
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Fitting a hand-glove prosthesis to enhance the reconstructed mutilated hand.
Leow, M E; Kour, A K; Pereira, B P; Pho, R W
1998-03-01
Microsurgical reconstruction of the severely mutilated hand aimed at improving prehensile functions often does not address the esthetic aspects of the hand. The poor appearance of the reconstructed hand affects its active display and use. A hand-glove prosthesis may be prescribed in this instance to enhance the overall form and function of the mutilated hand. We reviewed 16 cases of mutilating hand injuries in which surgical reconstructions were performed and the patients were subsequently fitted with a hand-glove prosthesis to augment the outcome. An improved appearance was achieved in all patients fitted with the prosthesis. The patients' sense of confidence was also enhanced, which in turn promoted the active and open use of the reconstructed hands. While prescribed primarily to improve the appearance of the reconstructed hands, these prostheses were documented to enhance the physical hand functions in 11 cases by increasing the span of the hand and providing an opposable post and a palmar base for holding and for anchorage. The prosthesis enhanced assistive functions of the reconstructed hands and freed the contralateral normal hand for use in bimanual activities, such as holding a wallet and taking out money, supporting a note pad for writing, and holding a plate at buffet receptions. At the 18-month follow-up visit, 13 (87%) of the patients continued to use their prosthesis. Wear and tear were problems associated with the frequent use of the prosthesis. The expected life span of the prosthesis with daily use ranged from 2 to 3 years. All the patients acknowledged that the prosthesis played a role in their rehabilitation and that it helped them to overcome the initial psychological trauma and to come to terms with their physical loss.
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Tobacco smoking and hand eczema - is there an association?
Sørensen, Jennifer A; Clemmensen, Kim K; Nixon, Rosemary L; Diepgen, Thomas L; Agner, Tove
2015-12-01
Numerous risk factors have been suggested for hand eczema. This systematic review evaluates the association between tobacco smoking and hand eczema. To review the literature systematically on the association between smoking and hand eczema. The PubMed and EMBASE databases were searched up to 27 January 2015 for articles on the association between tobacco smoking and hand eczema, including human studies in English and German only. Experimental studies, studies on tobacco allergy, case reports, reviews and studies on second-hand smoking were excluded. Twenty articles were included. Among studies in occupational settings, three of seven found a statistically significant positive association between tobacco smoking and hand eczema prevalence rate, as did four of eight population-based studies. The association was stronger for studies in occupational settings than for population-based studies. No studies reported tobacco to be a clear protective factor for hand eczema. Two of five studies regarding severity found a positive association between smoking and hand eczema severity. Overall, the data indicate that smoking may cause an increased frequency of hand eczema, particularly in high-risk occupations. However, data from studies controlling for other risk factors are conflicting, and few prospective studies are available. Studies controlling for other risk factors are needed, and information regarding the diagnosis of subclasses of hand eczema, as well as severity, may be important. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Frames of reference in action plan recall: influence of hand and handedness.
Seegelke, Christian; Hughes, Charmayne M L; Wunsch, Kathrin; van der Wel, Robrecht; Weigelt, Matthias
2015-10-01
Evidence suggests that people are more likely to recall features of previous plans and use them for subsequent movements, rather than generating action plans from scratch for each movement. The information used for plan recall during object manipulation tasks is stored in extrinsic (object-centered) rather than intrinsic (body-centered) coordinates. The present study examined whether action plan recall processes are influenced by manual asymmetries. Right-handed (Experiment 1) and left-handed (Experiment 2) participants grasped a plunger from a home position using either the dominant or the non-dominant hand and placed it at one of the three target positions located at varying heights (home-to-target moves). Subsequently, they stepped sideways down from a podium (step-down podium), onto a podium (step-up podium), or without any podium present (no podium), before returning the plunger to the home platform using the same hand (target-back-to-home moves). The data show that, regardless of hand and handedness, participants grasped the plunger at similar heights during the home-to-target and target-back-to-home moves, even if they had to adopt quite different arm postures to do so. Thus, these findings indicate that the information used for plan recall processes in sequential object manipulation tasks is stored in extrinsic coordinates and in an effector-independent manner.
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Safety of elective hand surgery following axillary lymph node dissection for breast cancer.
Hershko, Dan D; Stahl, Shalom
2007-01-01
The development of lymphedema is the most feared complication shared by breast cancer survivors undergoing hand surgery after prior axillary lymph node dissection (ALND). Traditionally, these patients are advised to avoid any interventional procedures in the ipsilateral upper extremity. However, the appropriateness of some of these precautions was recently challenged by some surgeons claiming that elective hand operations can be safely performed in these patients. The purpose of this study was to evaluate our experience and determine the safety of elective hand operations in breast cancer survivors. The medical records of patients operated for different hand conditions after prior breast surgery and ALND at our institution between 1983 and 2002 were reviewed. The techniques and preventive measures performed, use of antibiotics, and upper extremity complications associated with the operations were analyzed. Overall, we operated on 27 patients after prior ALND performed for breast cancer. Follow-up was available for 25 patients. Four patients had pre-existing lymphedema. The surgical technique used was similar to that performed in patients without prior ALND and antibiotic prophylaxis was not given. Delayed wound healing was observed in one patient and finger joint stiffness in another. Two patients with pre-existing lymphedema developed temporary worsening of their condition. None of the patients developed new lymphedema. The results of the present study support the few previous studies, suggesting that hand surgery can be safely performed in patients with prior ALND. Based on these findings, the appropriateness of the rigorous precautions and prohibitions regarding the care and use of the ipsilateral upper extremity may need to be reconsidered.
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Less invasive new vaginoplasty using laparoscopy, atelocollagen sponge, and hand-made mould.
Miyahara, Yoshiya; Yoshida, Shigeki; Shirakawa, Tokuro; Makihara, Natsuko; Niiya, Kiyoshi; Ebina, Yasuhiko; Yamada, Hideto
2013-03-19
The purpose of this study was to validate the therapeutic efficacy of the innovative surgical approach using laparoscopy, atelocollagen sponge, and hand-made mould on the achievement of a satisfactory neovagina in patients with vaginal agenesis. The current study involved four patients diagnosed as having Mayer-Rokitansky-Küster-Hauser syndrome. After creating a vaginal tunnel, the mould wrapped with atelocollagen sponge was placed within the neovagina. The hand-made mould made of expanded polystyrene was started to insert into the neovagina at 7 days after operation. Since this mould is lighter and easier to adjust compared with the previous commercialized ones, it was less stressful for the patients to master the procedure than previous methods. Average operation time was 124 minutes with average blood loss being 45 ml. Average hospital stay was 23 days. The mean length of the neovagina one week postoperation was 8 cm with two fingers in width in all patients. No remarkable postoperative complications were noted. At two months after surgery, the neovagina was confirmed to be completely epithelialized in all patients, assessed by Schiller's test. This innovative surgical procedure using a mould wrapped with atelocollagen sponge may be a more useful approach for the treatment of vaginal agenesis.
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Effects of Hand Proximity and Movement Direction in Spatial and Temporal Gap Discrimination.
Wiemers, Michael; Fischer, Martin H
2016-01-01
Previous research on the interplay between static manual postures and visual attention revealed enhanced visual selection near the hands (near-hand effect). During active movements there is also superior visual performance when moving toward compared to away from the stimulus (direction effect). The "modulated visual pathways" hypothesis argues that differential involvement of magno- and parvocellular visual processing streams causes the near-hand effect. The key finding supporting this hypothesis is an increase in temporal and a reduction in spatial processing in near-hand space (Gozli et al., 2012). Since this hypothesis has, so far, only been tested with static hand postures, we provide a conceptual replication of Gozli et al.'s (2012) result with moving hands, thus also probing the generality of the direction effect. Participants performed temporal or spatial gap discriminations while their right hand was moving below the display. In contrast to Gozli et al. (2012), temporal gap discrimination was superior at intermediate and not near hand proximity. In spatial gap discrimination, a direction effect without hand proximity effect suggests that pragmatic attentional maps overshadowed temporal/spatial processing biases for far/near-hand space.
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Goodarzi, Naser; Dabbaghi, Parviz; Valipour, Habib; Vafadari, Behnam
2015-04-01
Based on the previous studies, we know that the hemispheric lateralization defects, increase the probability of psychological disorders. We also know that dominant limb is controlled by dominant hemisphere and limb preference is used as an indicator for hemisphere dominance. In this study we attempted to explore the hemispheric dominance by the use of three limbs (hand, foot and eye). We performed this survey on two samples, psychiatric patients compared with normal population. For this purpose, knowing that the organ dominance is stabilized in adolescence, and age has no effect on the people above 15, we used 48 high school girls and 65 boys as the final samples of normal population. The patient group included 57 male and 26 female who were chronic psychiatric patients. The result shows that left-eye dominance is more in patients than the normal group (P=0.000) but the handedness and footedness differences are not significance. In psychotic, bipolar and depressive disorders, eye dominance had significant difference (P=0.018). But this is not true about hand and foot dominance. Our findings proved that generally in psychiatric patients, left-eye dominance is more common, left-eye dominance is also more in psychotic and depressive disorders. It is less common in bipolar disorders.
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Goodarzi, Naser; Dabbaghi, Parviz; Valipour, Habib; Vafadari, Behnam
2015-01-01
Introduction: Based on the previous studies, we know that the hemispheric lateralization defects, increase the probability of psychological disorders. We also know that dominant limb is controlled by dominant hemisphere and limb preference is used as an indicator for hemisphere dominance. In this study we attempted to explore the hemispheric dominance by the use of three limbs (hand, foot and eye). Methods: We performed this survey on two samples, psychiatric patients compared with normal population. For this purpose, knowing that the organ dominance is stabilized in adolescence, and age has no effect on the people above 15, we used 48 high school girls and 65 boys as the final samples of normal population. The patient group included 57 male and 26 female who were chronic psychiatric patients. Results: The result shows that left-eye dominance is more in patients than the normal group (P=0.000) but the handedness and footedness differences are not significance. In psychotic, bipolar and depressive disorders, eye dominance had significant difference (P=0.018). But this is not true about hand and foot dominance. Discussion: Our findings proved that generally in psychiatric patients, left-eye dominance is more common, left-eye dominance is also more in psychotic and depressive disorders. It is less common in bipolar disorders. PMID:27307954
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[A case with apraxia of tool use: selective inability to form a hand posture for a tool].
Hayakawa, Yuko; Fujii, Toshikatsu; Yamadori, Atsushi; Meguro, Kenichi; Suzuki, Kyoko
2015-03-01
Impaired tool use is recognized as a symptom of ideational apraxia. While many studies have focused on difficulties in producing gestures as a whole, using tools involves several steps; these include forming hand postures appropriate for the use of certain tool, selecting objects or body parts to act on, and producing gestures. In previously reported cases, both producing and recognizing hand postures were impaired. Here we report the first case showing a selective impairment of forming hand postures appropriate for tools with preserved recognition of the required hand postures. A 24-year-old, right-handed man was admitted to hospital because of sensory impairment of the right side of the body, mild aphasia, and impaired tool use due to left parietal subcortical hemorrhage. His ability to make symbolic gestures, copy finger postures, and orient his hand to pass a slit was well preserved. Semantic knowledge for tools and hand postures was also intact. He could flawlessly select the correct hand postures in recognition tasks. He only demonstrated difficulties in forming a hand posture appropriate for a tool. Once he properly grasped a tool by trial and error, he could use it without hesitation. These observations suggest that each step of tool use should be thoroughly examined in patients with ideational apraxia.
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Reyes, Carlen; Leyland, Kirsten M; Peat, George; Cooper, Cyrus; Arden, Nigel K; Prieto-Alhambra, Daniel
2016-08-01
Studies of previous cohorts have demonstrated an association between a status of overweight/obesity and the presence of knee and hand osteoarthritis (OA). However, no data on the effect of these factors on the OA burden are available. The aim of the present study was to analyze the effect of being overweight or obese on the incidence of routinely diagnosed knee, hip, and hand OA. The study was conducted in a population-based cohort using primary care records from the Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària database (>5.5 million subjects, covering >80% of the population of Catalonia, Spain). Participants were subjects ages ≥40 years who were without a diagnosis of OA on January 1, 2006 and had available body mass index (BMI) data. All subjects were followed up from January 1, 2006 to December 31, 2010 or to the time of loss to follow-up or death. Measures included the World Health Organization categories of BMI (exposure), and incident clinical diagnoses of knee, hip, or hand OA according to International Classification of Diseases, Tenth Revision codes. In total, 1,764,061 subjects were observed for a median follow-up period of 4.45 years (interquartile range 4.19-4.98 years). Incidence rates (per 1,000 person-years at risk) of knee, hip, and hand OA were 3.7 (99% confidence interval [99% CI] 3.6-3.8), 1.7 (99% CI 1.7-1.8), and 2.6 (99% CI 2.5-2.7), respectively, among subjects in the normal weight category, and 19.5 (99% CI 19.1-19.9), 3.8 (99% CI 3.7-4.0), and 4.0 (99% CI 3.9-4.2), respectively, in those with a classification of grade II obesity. Compared to subjects with normal weight, being overweight or obese increased the risk of OA at all 3 joint sites, especially at the knee. A status of overweight, grade I obesity, and grade II obesity increased the risk of knee OA by a factor of 2-fold, 3.1-fold, and 4.7-fold, respectively. Being overweight or obese increases the risk of hand, hip, and knee OA, with the
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Stange-Rezende, L; Stamm, T A; Schiffert, T; Sahinbegovic, E; Gaiger, A; Smolen, J; Machold, K P
2006-01-01
To explore the effect of infrared radiation of a tiled stove on patients with hand osteoarthritis (OA). A randomized controlled crossover study was performed with 45 patients with hand OA. This sample was randomly assigned to two groups: group A [first 3 hours spent three times a week during 3 weeks in a heated tiled stove room ('Stove Period') and after 2 weeks without treatment this group was observed for another 3 weeks ('Control Period')]; and group B (first assigned to the control period and the stove period following the treatment-free period). Assessments included the visual analogue scale (VAS) for general pain, pain in the hands, and global hand function, grip strength, the Moberg Picking-up Test (MPUT), the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), and the Medical Outcomes Study (MOS) 36-item Short-Form Health Status Survey (SF-36). Fourteen (31%) patients improved on the VAS for general pain at the end of the tiled stove period as compared to 10 patients (22%) during the control period (p = 0.314, chi2-test). The AUSCAN pain domain showed a significant improvement after the tiled stove period (p = 0.034). Others pain parameters analysed (VAS for pain in hands and SF-36 bodily pain) showed moderate but not significant improvement (p = 0.682 and p = 0.237, respectively) compared to the control period. This study did not prove positive effects of the tiled stove exposure, although the numerical improvement in all pain measures suggests some possible positive effects on this symptom of hand OA.
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Ojajärvi, J.
1980-01-01
The effectiveness of various hand washing and disinfection methods in removing transient skin bacteria was studied in hospital after dry or moist contamination of the hands when nursing burn patients. The results were compared with those of laboratory tests with volunteers. A fairly good correlation of the bacterial reductions existed between hospital and laboratory tests. All other methods removed Staph. aureus from the hands more effectively than liquid soap. Gram-negative bacilli were more easily removed than staphylococci, even with soap wash alone. In hospital, none of the washing and disinfection methods always removed all patient-borne bacteria from the hands. After dry or moist contamination and subsequent washing with soap only, colonies of Staph. aureus were often detected in finger-print samples. Staphylococci were more often completely removed by a 4% chlorhexidine detergent scrub and alcoholic solutions (either with or without previous soap wash) than by liquid soap, hexachlorophene or iodophor preparations. Gram-negative bacilli were more easily removed by all the washing and disinfection methods. After moist contamination, Gram-negative bacilli were more often completely removed from the hands by ethanol than by other treatments. The results of the present study emphasize the importance of always using gloves when nursing a profuse spreader of bacteria or one who must be protected from infection. PMID:6778914
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Heede, N G; Thyssen, J P; Thuesen, B H; Linneberg, A; Johansen, J D
2016-08-01
Information about predictive factors of hand eczema is crucial for primary prevention. To investigate predictive factors of hand eczema in adult Danes from the general population. Participants from a cross-sectional 5-year follow-up study in the general population, aged 18-72 years (n = 2270), completed questionnaires about skin health and were grouped into four hand eczema groups: 'never', 'incident', 'nonpersistent' and 'persistent'. Multiple logistic regression models adjusted for age group and sex were used to evaluate associations with baseline variables. The participation rate for the follow-up study was 66·5% (29·7% of the participants originally invited to the baseline study). A history of atopic dermatitis (AD) was associated with both persistent and incident hand eczema [odds ratio (OR) 9·0, 95% confidence interval (95% CI) 5·6-14·4 and OR 3·0, 95% CI 1·7-5·2, respectively]. Thus, even in adulthood, a history of AD should be considered as a predictor of incident hand eczema. While filaggrin gene (FLG) null mutations were not associated with incident hand eczema, a statistically significant association was observed with persistent hand eczema (OR 3·1, 95% CI 1·8-5·2). Finally, contact sensitization (23 allergens without nickel) was also associated with persistent hand eczema (OR 2·5, 95% CI 1·2-5·0), independently of a history of AD. This study confirms a history of AD as the strongest predictor of persistent hand eczema. We additionally found that a history of AD was associated with incident hand eczema in adults, in contrast to FLG mutations, which were associated only with persistent hand eczema in individuals with a history of AD, and not with incident hand eczema. Our study adds new knowledge to the interplay between AD, FLG mutations and hand eczema in the adult general population. © 2016 British Association of Dermatologists.
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Guideline Implementation: Hand Hygiene.
Goldberg, Judith L
2017-02-01
Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.
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Toucan hand feeding and nestling growth.
St Leger, Judy; Vince, Martin; Jennings, Jerry; McKerney, Erin; Nilson, Erika
2012-05-01
A retrospective analysis of hand-feeding records and growth data from 3 facilities was performed to determine the growth pattern for 8 toucan species raised in captivity. General philosophies of breeding and rearing were similar but approaches to hand-feeding varied. General hand-feeding and chick management records from hatch to fledging were reviewed for 2 of the 3 facilities. Effective hand-feeding formulas were commercially available and minimally modified. Growth curves were developed. Curves approximated typical expected patterns of nestling growth with no loss of weight at fledging. This study provides a basis for hand-feeding protocols and growth curves to assess development.
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Turner, Casey E; Hahn, Michael E; Kellogg, Ronald T
2017-03-01
Unilateral hand contractions increase activation in the motor cortex of the contralateral hemisphere, providing a means to alter the relative degree of activation in the right hemisphere versus the left hemisphere through spreading activation. Prior research reported enhanced verbal creativity as measured by performance on remote associate problems in Hebrew from left-hand contractions (right-hemisphere activation). We sought to extend the previous findings to English problems and to homograph interpretation. In Experiment 1, unilateral hand contractions in fact altered performance on the English remote associates, but in the direction of improved performance following right-hand contractions and left-hemisphere activation. In Experiment 2, the probability of retrieving atypical interpretations of homographs with multiple meanings was least likely for left-hemisphere dominant strong right handers, but the hand contraction manipulation had no effect.
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Project CHECO Southeast Asia Report. Ranch Hand: Herbicide Operations in SEA
1971-07-13
Fortunately, the value of collecting and documenting our SEA expe-Uriences was recognized at an early date. In 1962 , Hq USAF directed CINCPACAF to...January 1962 to carry out the specific operations plan published the previous month, code named Sillm bI I "Ranch Hand." The first Ranch Hand aircraft...flew missions from 12 January 1962 I through 20 March 1962 . These missions were conducted along Route 15 north- 7/ west of Saigon and in the Ca Mau
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[Saw Injuries to the Hand - Epidemiological Aspects].
Veith, N T; Braun, B; Fritz, T; Pohlemann, T; Tschernig, T; Ziegler, R; Mörsdorf, P; Knopp, W
2017-04-01
Background: No current studies regarding saw injuries have been published in German literature for quite some time. Despite awareness measures and safety instructions, saw accidents along with crush injuries are the most common causes of severe hand injuries. Approximately 12,000 circular saw injuries occur in Germany each year. Since professional providers have increased prices due to the rising energy costs and a wide range of different home appliance saws are available, increasing use has been made of portable circular saws in the do-it-yourself market sector. Patients and methods: At our hospital, we evaluated the data of 51 male patients with saw injuries. The present study investigated factors that may contribute to accidents involving saws. Results: 80 % of the accidents occurred at home, usually on weekends or after work. 51 % of the accidents happened while patients cut firewood. In 84 % of the cases, an electric table saw was used. The majority of severe hand injuries were sustained with lower priced saws. Injuries occurred most frequently between 11 a. m. and 2 p. m., primarily with injuries to bones, tendons, blood vessels and nerves. Replantable amputations or partial amputations occured rarely. In 37 % of the patients, anatomical reconstruction using osteosynthesis and/or microsurgical techniques was performed successfully. Conclusions: Saw injuries to the hand are sustained almost exclusively by men. Serious injuries from low-priced table saws and due to the lack of protective covering are predominant. Preventive measures and mandatory training could reduce the number of saw injuries in the years to come. The results obtained by us largely confirm the data from previous publications. Georg Thieme Verlag KG Stuttgart · New York.
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ERIC Educational Resources Information Center
Rogow, Sally M.
1987-01-01
The manual development of 148 blind, visually impaired, and visually impaired multi-handicapped students, aged 3-19, was studied. Results indicated a significant relationship between object manipulation and speech, and an inverse relationship between object manipulation and stereotypic hand mannerisms. Optimal development of manual functions and…
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Operating room waste reduction in plastic and hand surgery.
Albert, Mark G; Rothkopf, Douglas M
2015-01-01
Operating rooms (ORs), combined with labour and delivery suites, account for approximately 70% of hospital waste. Previous studies have reported that recycling can have a considerable financial impact on a hospital-wide basis; however, its importance in the OR has not been demonstrated. To propose a method of decreasing cost through judicious selection of instruments and supplies, and initiation of recycling in plastic and hand surgery. The authors identified disposable supplies and instruments that are routinely opened and wasted in common plastic and hand surgery procedures, and calculated the savings that can result from eliminating extraneous items. A cost analysis was performed, which compared the expense of OR waste versus single-stream recycling and the benefit of recycling HIPAA documents and blue wrap. Fifteen total items were removed from disposable plastic packs and seven total items from hand packs. A total of US$17,381.05 could be saved per year from these changes alone. Since initiating single-stream recycling, the authors' institution has saved, on average, US$3,487 per month at the three campuses. After extrapolating at the current savings rate, one would expect to save a minimum of US$41,844 per year. OR waste reduction is an effective method of decreasing cost in the surgical setting. By revising the contents of current disposable packs and instrument sets designated for plastic and hand surgery, hospitals can reduce the amount of opened and unused material. Significant financial savings and environmental benefit can result from this judicious supply and instrument selection, as well as implementation of recycling.
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Ali, Syed S; Wilson, Michael P; Castillo, Edward M; Witucki, Peter; Simmons, Todd T; Vilke, Gary M
2013-02-01
The use of alcohol-based hand sanitizers has recently become widespread. To the authors' knowledge, no previous study has examined whether application of ethanol-based hand sanitizers by the person operating a common breathalyzer machine will affect the accuracy of the readings. This was a prospective study investigating whether the use of hand sanitizer applied according to manufacturer's recommendations (Group I), applied improperly at standard doses (Group II), or applied improperly at high doses (Group III) had an effect on breathalyzer readings of individuals who had not ingested alcohol. The participants of the prospective study were divided into three groups to assess the effect of hand sanitizer on breathalyzer readings. Group I used one pump (1.5 mL) of hand sanitizer (Purell), allowing the hands to dry per manufacturer's recommendations; Group II used one pump (1.5 mL), without allowing the hands to dry; and Group III used two pumps (3 mL), without allowing the hands to dry. Breathalyzer measures for each group are presented as medians with interquartile ranges (IQR) and ranges. Differences between each sequential group (I vs. II and II vs. III) were assessed using a Mann-Whitney U-test (p < 0.05 significant). There were 25 study participants in each group for a total of 75 participants. The initial breathalyzer readings of all study participants were 0.000 g/dL. The median breathalyzer reading was 0.004 g/dL in Group I (IQR = 0.001 to 0.008 g/dL), 0.051 g/dL in Group II (IQR = 0.043 to 0.064 g/dL), and 0.119 g/dL in Group III (IQR = 0.089 to 0.134 g/dL). Measures between each subsequent group were all statistically different (p < 0.001). The use of common alcohol-based hand sanitizer may cause false-positive readings with a standard hospital breathalyzer when the operator uses the hand sanitizer correctly. The breathalyzer readings are further elevated if more sanitizer is used or if it is not allowed to dry appropriately. © 2013 by the Society for
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van der Meer, Esther W C; van Dongen, Johanna M; Boot, Cécile R L; van der Gulden, Joost W J; Bosmans, Judith E; Anema, Johannes R
2016-05-01
The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results.
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Peters, Michael; Reimers, Stian; Manning, John T
2006-11-01
In an Internet study unrelated to handedness, 134,317 female and 120,783 male participants answered a graded question as to which hand they preferred for writing. This allowed determination of hand preference patterns across 7 ethnic groups. Sex differences in left-handedness were found in 4 ethnic groups, favoring males, while no significant sex differences were found in three of the groups. Prevalence of left-handedness in the largest of the ethnic groups (self-labelled as "White") was comparable to contemporary hand preference data for this group [Gilbert, A. N., & Wysocki, C. J. (1992). Hand preference and age in the United states. Neuropsychologia, 30, 601-608] but the prevalence of left-handedness in individuals >70 years of age was considerably higher in the present study. Individuals who indicated "either" hand for writing preference had significantly lower spatial performance (mental rotation task) and significantly higher prevalence of hyperactivity, dyslexia, asthma than individuals who had clear left or right hand preferences, in support of Crow et al. [Crow, T., Crow, L., Done, D., & Leask, S. (1998). Relative hand skill predicts academic ability: global deficits at the point of hemispheric indecision. Neuropsychologia, 36, 1275-1282]. Similarly, an association of writing hand preference and non-heterosexual orientation was clearest for individuals with "either" writing hand responses. We conclude that contradictions in the literature as to whether or not these variables are linked to handedness stem largely from different definitions of hand preference. Due to a lack of statistical power in most studies in the literature, the "either" hand writing preference group that yielded the most salient results in this study is not normally available for analysis.
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Pilot study of digital tools to support multimodal hand hygiene in a clinical setting.
Thirkell, Gary; Chambers, Joanne; Gilbart, Wayne; Thornhill, Kerrill; Arbogast, James; Lacey, Gerard
2018-03-01
Digital tools for hand hygiene do not share data, limiting their potential to support multimodal programs. The Christie NHS Foundation Trust, United Kingdom, worked with GOJO (in the United States), MEG (in Ireland), and SureWash (in Ireland) to integrate their systems and pilot their combined use in a clinical setting. A 28-bed medical oncology unit piloted the system for 5 weeks. Live data from the tools were combined to create a novel combined risk status metric that was displayed publicly and via a management Web site. The combined risk status reduced over the pilot period. However, larger and longer duration studies are required to reach statistical significance. Staff and especially patient reaction was positive in that 70% of the hand hygiene training events were by patients. The digital tools did not negatively impact clinical workflow and received positive engagement from staff and patients. The combined risk status did not change significantly over the short pilot period because there was also no specific hand hygiene improvement campaign underway at the time of the pilot study. The results indicate that integrated digital tools can provide both rich data and novel tools that both measure impact and provide feedback to support the implementation of multimodal hand hygiene campaigns, reducing the need for significant additional personnel resources. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
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Soft robotic devices for hand rehabilitation and assistance: a narrative review.
Chu, Chia-Ye; Patterson, Rita M
2018-02-17
The debilitating effects on hand function from a number of a neurologic disorders has given rise to the development of rehabilitative robotic devices aimed at restoring hand function in these patients. To combat the shortcomings of previous traditional robotics, soft robotics are rapidly emerging as an alternative due to their inherent safety, less complex designs, and increased potential for portability and efficacy. While several groups have begun designing devices, there are few devices that have progressed enough to provide clinical evidence of their design's therapeutic abilities. Therefore, a global review of devices that have been previously attempted could facilitate the development of new and improved devices in the next step towards obtaining clinical proof of the rehabilitative effects of soft robotics in hand dysfunction. A literature search was performed in SportDiscus, Pubmed, Scopus, and Web of Science for articles related to the design of soft robotic devices for hand rehabilitation. A framework of the key design elements of the devices was developed to ease the comparison of the various approaches to building them. This framework includes an analysis of the trends in portability, safety features, user intent detection methods, actuation systems, total DOF, number of independent actuators, device weight, evaluation metrics, and modes of rehabilitation. In this study, a total of 62 articles representing 44 unique devices were identified and summarized according to the framework we developed to compare different design aspects. By far, the most common type of device was that which used a pneumatic actuator to guide finger flexion/extension. However, the remainder of our framework elements yielded more heterogeneous results. Consequently, those results are summarized and the advantages and disadvantages of many design choices as well as their rationales were highlighted. The past 3 years has seen a rapid increase in the development of soft robotic
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The Role of Hand Dominance in Beginning Braille Readers
ERIC Educational Resources Information Center
Wright, Tessa
2009-01-01
In this article, the author examines the role of "hand dominance" in beginning braille readers. "Hand dominance" refers to whether an individual is "right handed" or "left handed." The data for these analyses were taken from the Alphabetic Braille and Contracted Braille Study (ABC Braille Study). The ABC Braille Study was a five-year nonrandomized…
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Landgren, Ola; Shim, Youn K; Michalek, Joel; Costello, Rene; Burton, Debra; Ketchum, Norma; Calvo, Katherine R; Caporaso, Neil; Raveche, Elizabeth; Middleton, Dan; Marti, Gerald; Vogt, Robert F
2015-11-01
Multiple myeloma has been classified as exhibiting "limited or suggestive evidence" of an association with exposure to herbicides in Vietnam War veterans. Occupational studies have shown that other pesticides (ie, insecticides, herbicides, fungicides) are associated with excess risk of multiple myeloma and its precursor state, monoclonal gammopathy of undetermined significance (MGUS); however, to our knowledge, no studies have uncovered such an association in Vietnam War veterans. To examine the relationship between MGUS and exposure to Agent Orange, including its contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), in Vietnam War veterans. This was a prospective cohort study conducted in 2013 to 2014, testing for MGUS in serum specimens collected and stored in 2002 by the Air Force Health Study (AFHS). The relevant exposure data collected by the AFHS was also used. We tested all specimens in 2013 without knowledge of the exposure status. The AFHS included former US Air Force personnel who participated in Operation Ranch Hand (Ranch Hand veterans) and other US Air Force personnel who had similar duties in Southeast Asia during the same time period (1962 to 1971) but were not involved in herbicide spray missions (comparison veterans). Agent Orange was used by the US Air Force personnel who conducted aerial spray missions of herbicides (Operation Ranch Hand) in Vietnam from 1962 to 1971. We included 479 Ranch Hand veterans and 479 comparison veterans who participated in the 2002 follow-up examination of AFHS. Agent Orange and TCDD. Serum TCDD levels were measured in 1987, 1992, 1997, and 2002. Risk of MGUS measured by prevalence, odds ratios (ORs), and 95% CIs. The 479 Ranch Hand veterans and 479 comparison veterans had similar demographic and lifestyle characteristics and medical histories. The crude prevalence of overall MGUS was 7.1% (34 of 479) in Ranch Hand veterans and 3.1% (15 of 479) in comparison veterans. This translated into a 2.4-fold increased risk
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Peng, Zhen; Braun, Daniel A.
2015-01-01
In a previous study we have shown that human motion trajectories can be characterized by translating continuous trajectories into symbol sequences with well-defined complexity measures. Here we test the hypothesis that the motion complexity individuals generate in their movements might be correlated to the degree of creativity assigned by a human observer to the visualized motion trajectories. We asked participants to generate 55 novel hand movement patterns in virtual reality, where each pattern had to be repeated 10 times in a row to ensure reproducibility. This allowed us to estimate a probability distribution over trajectories for each pattern. We assessed motion complexity not only by the previously proposed complexity measures on symbolic sequences, but we also propose two novel complexity measures that can be directly applied to the distributions over trajectories based on the frameworks of Gaussian Processes and Probabilistic Movement Primitives. In contrast to previous studies, these new methods allow computing complexities of individual motion patterns from very few sample trajectories. We compared the different complexity measures to how a group of independent jurors rank ordered the recorded motion trajectories according to their personal creativity judgment. We found three entropic complexity measures that correlate significantly with human creativity judgment and discuss differences between the measures. We also test whether these complexity measures correlate with individual creativity in divergent thinking tasks, but do not find any consistent correlation. Our results suggest that entropic complexity measures of hand motion may reveal domain-specific individual differences in kinesthetic creativity. PMID:26733896
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Boyer, Doug M; Yapuncich, Gabriel S; Chester, Stephen G B; Bloch, Jonathan I; Godinot, Marc
2013-12-01
Questions surrounding the origin and early evolution of primates continue to be the subject of debate. Though anatomy of the skull and inferred dietary shifts are often the focus, detailed studies of postcrania and inferred locomotor capabilities can also provide crucial data that advance understanding of transitions in early primate evolution. In particular, the hand skeleton includes characteristics thought to reflect foraging, locomotion, and posture. Here we review what is known about the early evolution of primate hands from a comparative perspective that incorporates data from the fossil record. Additionally, we provide new comparative data and documentation of skeletal morphology for Paleogene plesiadapiforms, notharctines, cercamoniines, adapines, and omomyiforms. Finally, we discuss implications of these data for understanding locomotor transitions during the origin and early evolutionary history of primates. Known plesiadapiform species cannot be differentiated from extant primates based on either intrinsic hand proportions or hand-to-body size proportions. Nonetheless, the presence of claws and a different metacarpophalangeal [corrected] joint form in plesiadapiforms indicate different grasping mechanics. Notharctines and cercamoniines have intrinsic hand proportions with extremely elongated proximal phalanges and digit rays relative to metacarpals, resembling tarsiers and galagos. But their hand-to-body size proportions are typical of many extant primates (unlike those of tarsiers, and possibly Teilhardina, which have extremely large hands). Non-adapine adapiforms and omomyids exhibit additional carpal features suggesting more limited dorsiflexion, greater ulnar deviation, and a more habitually divergent pollex than observed plesiadapiforms. Together, features differentiating adapiforms and omomyiforms from plesiadapiforms indicate increased reliance on vertical prehensile-clinging and grasp-leaping, possibly in combination with predatory behaviors in
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Cutaneous protothecosis in a patient with previously undiagnosed HIV infection.
Fong, Kenneth; Tee, Shang-Ian; Ho, Madeline S L; Pan, Jiun Yit
2015-08-01
Protothecosis is an uncommon condition resulting from infection by achlorophyllous algae of the Prototheca species. Immunocompromised individuals are generally most susceptible to protothecal infection and tend to develop severe and disseminated disease. However, the association between protothecosis and HIV-induced immunosuppression is not clear, with only a handful of cases having been described to date. Here we report a case of cutaneous protothecosis in a Chinese man with previously undiagnosed HIV infection that responded well to oral itraconazole. © 2014 The Australasian College of Dermatologists.
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Hand size and growth in untreated and IGF-I treated patients with Laron syndrome.
Konen, O; Silbergeld, A; Lilos, P; Kornreich, L; Laron, Z
2009-03-01
We have previously reported on the linear growth, growth of the head circumference and foot length in untreated and IGF-I treated patients with Laron syndrome (LS) (primary GH insensitivity). To assess the size and growth of the hands in patients with LS from early childhood to adult age. Ten IGF-I treated children with LS (4 M, 6 F) and 24 untreated patients (10 M, 14 F) were studied. Measurements of palm length were made on available standardized hand X-rays from infancy to adult age. The measurements were compared to normal references and SD values were calculated for each measurement. The growth of the hand was compared to the concomitant height of the body. Hand SDS in untreated patients with LS decreased with age, from a mean of -2.8 +/- 0.7 (age 1-3 years) to -7.3 +/- 0.8 (age 13-15 years) and to -9.0 +/- 3.9 (age 40-50 years). During 9 years of IGF-I treatment the hand size deficit SDS did not improve in contradistinction to the height SDS which decreased from -6.2 +/- 1.2 to -3.9 +/- 0.5. Congenital IGF-I deficiency, as in Laron syndrome, profoundly affects the size and growth of the hand as part of its growth retardation characteristics, resulting in acromicria.
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Kelly, Rachel; Mizelle, J C; Wheaton, Lewis A
2015-08-01
Prior work has demonstrated that perspective and handedness of observed actions can affect action understanding differently in right and left-handed persons, suggesting potential differences in the neural networks underlying action understanding between right and left-handed individuals. We sought to evaluate potential differences in these neural networks using electroencephalography (EEG). Right- and left-handed participants observed images of tool-use actions from egocentric and allocentric perspectives, with right- and left-handed actors performing the actions. Participants judged the outcome of the observed actions, and response accuracy and latency were recorded. Behaviorally, the highest accuracy and shortest latency was found in the egocentric perspective for right- and left-handed observers. Handedness of subject showed an effect on accuracy and latency also, where right-handed observers were faster to respond than left-handed observers, but on average were less accurate. Mu band (8-10 Hz) cortico-cortical coherence analysis indicated that right-handed observers have coherence in the motor dominant left parietal-premotor networks when looking at an egocentric right or allocentric left hands. When looking in an egocentric perspective at a left hand or allocentric right hand, coherence was lateralized to right parietal-premotor areas. In left-handed observers, bilateral parietal-premotor coherence patterns were observed regardless of actor handedness. These findings suggest that the cortical networks involved in understanding action outcomes are dependent on hand dominance, and notably right handed participants seem to utilize motor systems based on the limb seen performing the action. The decreased accuracy for right-handed participants on allocentric images could be due to asymmetrical lateralization of encoding action and motoric dominance, which may interfere with translating allocentric limb action outcomes. Further neurophysiological studies will
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A randomized control hands-on defibrillation study-Barrier use evaluation.
Wampler, David; Kharod, Chetan; Bolleter, Scotty; Burkett, Alison; Gabehart, Caitlin; Manifold, Craig
2016-06-01
Chest compressions and defibrillation are the only therapies proven to increase survival in cardiac arrest. Historically, rescuers must remove hands to shock, thereby interrupting chest compressions. This hands-off time results in a zero blood flow state. Pauses have been associated with poorer neurological recovery. This was a blinded randomized control cadaver study evaluating the detection of defibrillation during manual chest compressions. An active defibrillator was connected to the cadaver in the sternum-apex configuration. The sham defibrillator was not connected to the cadaver. Subjects performed chest compressions using 6 barrier types: barehand, single and double layer nitrile gloves, firefighter gloves, neoprene pad, and a manual chest compression/decompression device. Randomized defibrillations (10 per barrier type) were delivered at 30 joules (J) for bare hand and 360J for all other barriers. After each shock, the subject indicated degree of sensation on a VAS scale. Ten subjects participated. All subjects detected 30j shocks during barehand compressions, with only 1 undetected real shock. All barriers combined totaled 500 shocks delivered. Five (1%) active shocks were detected, 1(0.2%) single layer of Nitrile, 3(0.6%) with double layer nitrile, and 1(0.2%) with the neoprene barrier. One sham shock was reported with the single layer nitrile glove. No shocks were detected with fire gloves or compression decompression device. All shocks detected barely perceptible (0.25(±0.05)cm on 10cm VAS scale). Nitrile gloves and neoprene pad prevent (99%) responder's detection of defibrillation of a cadaver. Fire gloves and compression decompression device prevented detection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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... a scar Find a hand surgeon near you. Videos Figures Figure 1: Examples of hand splints PDF ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...
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Ekstrand, Elisabeth; Rylander, Lars; Lexell, Jan; Brogårdh, Christina
2016-11-02
Despite that disability of the upper extremity is common after stroke, there is limited knowledge how it influences self-perceived ability to perform daily hand activities. The aim of this study was to describe which daily hand activities that persons with mild to moderate impairments of the upper extremity after stroke perceive difficult to perform and to evaluate how several potential factors are associated with the self-perceived performance. Seventy-five persons (72 % male) with mild to moderate impairments of the upper extremity after stroke (4 to 116 months) participated. Self-perceived ability to perform daily hand activities was rated with the ABILHAND Questionnaire. The perceived ability to perform daily hand activities and the potentially associated factors (age, gender, social and vocational situation, affected hand, upper extremity pain, spasticity, grip strength, somatosensation of the hand, manual dexterity, perceived participation and life satisfaction) were evaluated by linear regression models. The activities that were perceived difficult or impossible for a majority of the participants were bimanual tasks that required fine manual dexterity of the more affected hand. The factor that had the strongest association with perceived ability to perform daily hand activities was dexterity (p < 0.001), which together with perceived participation (p = 0.002) explained 48 % of the variance in the final multivariate model. Persons with mild to moderate impairments of the upper extremity after stroke perceive that bimanual activities requiring fine manual dexterity are the most difficult to perform. Dexterity and perceived participation are factors specifically important to consider in the rehabilitation of the upper extremity after stroke in order to improve the ability to use the hands in daily life.
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Zapka, C; Leff, J; Henley, J; Tittl, J; De Nardo, E; Butler, M; Griggs, R; Fierer, N; Edmonds-Wilson, S
2017-03-28
Hands play a critical role in the transmission of microbiota on one's own body, between individuals, and on environmental surfaces. Effectively measuring the composition of the hand microbiome is important to hand hygiene science, which has implications for human health. Hand hygiene products are evaluated using standard culture-based methods, but standard test methods for culture-independent microbiome characterization are lacking. We sampled the hands of 50 participants using swab-based and glove-based methods prior to and following four hand hygiene treatments (using a nonantimicrobial hand wash, alcohol-based hand sanitizer [ABHS], a 70% ethanol solution, or tap water). We compared results among culture plate counts, 16S rRNA gene sequencing of DNA extracted directly from hands, and sequencing of DNA extracted from culture plates. Glove-based sampling yielded higher numbers of unique operational taxonomic units (OTUs) but had less diversity in bacterial community composition than swab-based sampling. We detected treatment-induced changes in diversity only by using swab-based samples ( P < 0.001); we were unable to detect changes with glove-based samples. Bacterial cell counts significantly decreased with use of the ABHS ( P < 0.05) and ethanol control ( P < 0.05). Skin hydration at baseline correlated with bacterial abundances, bacterial community composition, pH, and redness across subjects. The importance of the method choice was substantial. These findings are important to ensure improvement of hand hygiene industry methods and for future hand microbiome studies. On the basis of our results and previously published studies, we propose recommendations for best practices in hand microbiome research. IMPORTANCE The hand microbiome is a critical area of research for diverse fields, such as public health and forensics. The suitability of culture-independent methods for assessing effects of hygiene products on microbiota has not been demonstrated. This is the
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Grabowska, Anna; Gut, Malgorzata; Binder, Marek; Forsberg, Lars; Rymarczyk, Krystyna; Urbanik, Andrzej
2012-01-01
The purpose of this study was to investigate the differences in the brain organization of motor control in left- and right-handers and to study whether early left-to-right handwriting switch changes the cortical representation of finger movements in the left and right hemispheres. Echo-planar MR imaging was performed in 52 subjects: consistent right-handers (RH), consistent left-handers (LH), and subjects who had been forced at an early age to switch their left-hand preferences toward the right side. The scanning was performed during simple (flexion/extension of the index finger) and complex (successive finger-thumb opposition) tasks. Subjects performed the tasks using both the preferred and non-preferred hand. In right-handers, there was a general predominance of left-hemisphere activation relative to right hemisphere activation. In lefthanders this pattern was reversed. The switched subjects showed no such volumetric asymmetry. Increasing levels of complexity of motor activity resulted in an increase in the volume of consistently activated areas and the involvement of the ipsilateral in addition to contralateral activations. In both right- and left-handers, movements of the preferred hand activated mainly the contralateral hemisphere, whereas movements of the non-preferred hand resulted in a more balanced pattern of activation in the two hemispheres, indicating greater involvement of the ipsilateral activations. Overall, this study shows that in both left- and right-handed subjects, the preferred hand is controlled mainly by the hemisphere contralateral to that hand, whereas the non-preferred hand is controlled by both hemispheres. The switched individuals share features of both lefthanders and right-handers regarding their motor control architectures.
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Leff, J.; Henley, J.; Tittl, J.; De Nardo, E.; Butler, M.; Griggs, R.; Fierer, N.
2017-01-01
ABSTRACT Hands play a critical role in the transmission of microbiota on one’s own body, between individuals, and on environmental surfaces. Effectively measuring the composition of the hand microbiome is important to hand hygiene science, which has implications for human health. Hand hygiene products are evaluated using standard culture-based methods, but standard test methods for culture-independent microbiome characterization are lacking. We sampled the hands of 50 participants using swab-based and glove-based methods prior to and following four hand hygiene treatments (using a nonantimicrobial hand wash, alcohol-based hand sanitizer [ABHS], a 70% ethanol solution, or tap water). We compared results among culture plate counts, 16S rRNA gene sequencing of DNA extracted directly from hands, and sequencing of DNA extracted from culture plates. Glove-based sampling yielded higher numbers of unique operational taxonomic units (OTUs) but had less diversity in bacterial community composition than swab-based sampling. We detected treatment-induced changes in diversity only by using swab-based samples (P < 0.001); we were unable to detect changes with glove-based samples. Bacterial cell counts significantly decreased with use of the ABHS (P < 0.05) and ethanol control (P < 0.05). Skin hydration at baseline correlated with bacterial abundances, bacterial community composition, pH, and redness across subjects. The importance of the method choice was substantial. These findings are important to ensure improvement of hand hygiene industry methods and for future hand microbiome studies. On the basis of our results and previously published studies, we propose recommendations for best practices in hand microbiome research. PMID:28351915
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-01
... Authorization To Export Previously Imported Liquefied Natural Gas on a Short-Term Basis AGENCY: Office of Fossil Energy, DOE. ACTION: Notice of application. SUMMARY: The Office of Fossil Energy (FE) of the Department... Activities, Office of Fossil Energy, P.O. Box 44375, Washington, DC 20026-4375. Hand Delivery or Private...
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2017-01-01
Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength was performed with 32 healthy male workers with a mean age (standard deviation) of 30.44 (5.35) years wearing five industrial gloves at three hand skin temperatures. Their ages and anthropometric characteristics including body mass index (BMI), hand length, hand width, hand depth, hand palm, and wrist circumference were measured. The hand was exposed to different bath temperatures (5 °C, 25 °C, and 45 °C) and hand grip strength was measured using a Jamar hydraulic hand dynamometer with and without wearing the gloves (chemical protection glove, rubber insulating glove, anti-vibration impact glove, cotton yarn knitted glove, and RY-WG002 working glove). The data were analyzed using the Shapiro–Wilk test, Pearson correlation coefficient, Tukey test, and analysis of variance (ANOVA) of the within-subject design analysis. The results showed that wearing gloves significantly affected the maximum grip strength. Wearing the RY-WG002 working glove produced a greater reduction on the maximum grip when compared with the bare hand, while low temperatures (5 °C) had a significant influence on grip when compared to medium (25 °C) and high (45 °C) hand skin temperatures. In addition, participants felt more discomfort in both environmental extreme conditions. Furthermore, they reported more discomfort while wearing neoprene, rubber, and RY-WG002 working gloves. PMID:29207573
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Continuous involuntary hand movements and schizencephaly: epilepsia partialis continua or dystonia?
Marinelli, Lucio; Bonzano, Laura; Saitta, Laura; Trompetto, Carlo; Abbruzzese, Giovanni
2012-04-01
Schizencephaly is regarded as a malformation of cortical development (due to abnormal neuronal organization) and may be associated with continuous involuntary hand movements. The mechanisms underlying these movements are not clear and both dystonia and epilepsia partialis continua have been considered in previously reported cases. We describe a young patient affected by schizencephaly and continuous involuntary movements of the contralateral hand. Functional MRI showed bilateral cerebral activation, while the subject performed tapping movements with the affected hand and no significant difference in the activation pattern after diazepam infusion. Standard and back-averaged EEG showed no alterations. The results obtained from these investigations and the clinical features of the involuntary movements are not in favor of an epileptic genesis, while support the diagnosis of secondary dystonia.
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On the Other Hand: Overflow Movements of Infants’ Hands and Legs During Unimanual Object Exploration
Soska, Kasey C.; Galeon, Margaret A.; Adolph, Karen E.
2011-01-01
Motor overflow is extraneous movement in a limb not involved in a motor action. Typically, overflow is observed in people with neurological impairments and in healthy children and adults during strenuous and attention-demanding tasks. In the current study, we found that young infants produce vast amounts of motor overflow, corroborating claims of symmetry being the default state of the motor system. While manipulating an object with one hand, all 27 of the typically-developing 4.5- to 7.5-month-old infants who we observed displayed overflow movements of the free hand (on 4/5 of unimanual actions). Mirror-image movements of the hands occurred on 1/8 of unimanual actions, and the hands and legs moved in synchrony on 1/3 of unimanual acts. Motor overflow was less frequent when infants were in a sitting posture and when infants watched their acting hand, suggesting that upright posture and visual examination may help to alleviate overflow and break obligatory symmetry in healthy infants. PMID:22487940
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The challenge of diagnosing focal hand dystonia in musicians.
Rosset-Llobet, J; Candia, V; Fàbregas i Molas, S; Dolors Rosinés i Cubells, D; Pascual-Leone, A
2009-07-01
To most clinicians, medical problems in musicians, particularly those concerning focal hand dystonia, constitute an unfamiliar domain difficult to manage. The latter can importantly influence diagnostics and the course of treatment. The purpose of this study was to enlighten the issue and to identify possible problems in diagnosing musicians' cramp within the Spanish medical community. We used a brief questions' catalog and clinical histories of 665 musicians seen at our clinic for performing artists. We analyzed patients' diagnosis records in 87 cases of focal hand dystonia (13.1%). In so doing, we surveyed previous diagnoses and diverse treatments prescriptions prior to referral to our clinic. Referrals came primarily from orthopaedists and neurologists. The 52.9% arrived at our clinic without a diagnosis or a suspicion of suffering from focal dystonia. The most frequently attempted diagnoses other than musicians' dystonia included nerve compression, tendonitis and trigger fingers. Commonly prescribed treatments included rest, various surgical procedures, physiotherapy and oral anti-inflammatory medication. This data depicts the diagnostic challenges of medical professionals may encounter when confronted with musician's focal dystonia.
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Effectiveness of a nonrinse, alcohol-free antiseptic hand wash.
Moadab, A; Rupley, K F; Wadhams, P
2001-06-01
This study evaluated the efficacy of a novel surfactant, allantoin, and benzalkonium chloride hand sanitizer using the US Food and Drug Administration's method for testing antiseptic hand washes that podiatric physicians and other health-care personnel use. The alcohol-free product, HandClens, was compared with an alcohol-based product, Purell. Independent researchers from the California College of Podiatric Medicine conducted the study using 40 volunteer students from the class of 2001. The results show that HandClens outperformed Purell and met the regulatory requirements for a hand sanitizer. Purell failed as an antimicrobial hand wash and was less effective than a control soap used in the study.
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Munoz-Price, L Silvia; Patel, Zalak; Banks, Shawn; Arheart, Kristopher; Eber, Scott; Lubarsky, David A; Birnbach, David J
2014-06-01
Forty anesthesia providers were evaluated with and without hand sanitizer dispensers present on the anesthesia machine. Having a dispenser increased the frequency of hand hygiene only from 0.5 to 0.8 events per hour (P = .01). Other concomitant interventions are needed to further increase hand hygiene frequency among anesthesia providers.
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The evolution of functional hand replacement: From iron prostheses to hand transplantation
Zuo, Kevin J; Olson, Jaret L
2014-01-01
The hand is an integral component of the human body, with an incredible spectrum of functionality. In addition to possessing gross and fine motor capabilities essential for physical survival, the hand is fundamental to social conventions, enabling greeting, grooming, artistic expression and syntactical communication. The loss of one or both hands is, thus, a devastating experience, requiring significant psychological support and physical rehabilitation. The majority of hand amputations occur in working-age males, most commonly as a result of work-related trauma or as casualties sustained during combat. For millennia, humans have used state-of-the-art technology to design clever devices to facilitate the reintegration of hand amputees into society. The present article provides a historical overview of the progress in replacing a missing hand, from early iron hands intended primarily for use in battle, to today’s standard body-powered and myoelectric prostheses, to revolutionary advancements in the restoration of sensorimotor control with targeted reinnervation and hand transplantation. PMID:25152647
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Su, Bowen; Ma, Qing; Edwards, Christopher J; Williams, Mark; Adams, Jo
2017-10-01
To compare the characteristics of early hand involvement in rheumatoid arthritis (RA) using two matched populations, from the UK and China. A cohort comparison study was conducted. Sixty Chinese patients recruited from Shanghai, China were matched on gender and age with 60 patients from a prospective early RA cohort from the UK (SARAH trial). The procedures of data collection in China followed the standard operating procedures employed in the SARAH trial. Outcome measures including Michigan Hand Outcomes Questionnaire (MHQ), medication history and physical assessments were used to assess functional ability and hand impairment. UK patients reported significantly more hand pain (P = 0.015), less satisfaction with dominant hand performance (P = 0.040), more swollen and tender joints (P = 0.016 and P = 0.001) and greater dexterity of both dominant and non-dominant hands (P < 0.001 and P < 0.001), while Chinese patients had higher disease activity indicated by erythrocyte sedimentation rate and C-reactive protein, more rheumatoid factor, less satisfaction in both dominant and non-dominant hand appearances (P < 0.001 and P < 0.001, respectively) and greater dominant hand deformity (P = 0.003). No statistically significant differences were seen in range of movement and overall hand function as reported by the MHQ. The severity of RA is not milder in China than in the UK and the characteristics of hand involvement tend to be different. Clinicians should consider country-specific differences in managing pain and delivering treatment. It would be helpful for a future study to investigate the RA impact characteristics on a wider range of patients both from within China and from other populations. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
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Functional study of hands among patients dialysed for more than 10 years.
Chazot, C; Chazot, I; Charra, B; Terrat, J C; Vanel, T; Calemard, E; Ruffet, M; Laurent, G
1993-01-01
Sixty-six haemodialysed (HD) in centre patients (24 h/m2/week, acetate bath, cuprophane membrane), with a mean age of 59.2 years, treated for 16.7 +/- 4.5 years, underwent clinical examination of their hands to determine anatomical and functional alterations. For each hand a functional score was calculated from a medicolegal technique based on sensitivity and angulation amplitude (rating from 0 to 100). Dialysis-related arthropathy (DRA), including carpal-tunnel (CT) syndrome, was scored as well as hand muscle amyotrophia. Trigger fingers, abnormal synovial hypertrophy, and one or more non-functional tendons were found in 15, 26, and 33% of the patients respectively. Thirteen percent had pseudoporphyria. Amyotrophy was moderate or severe in 39%. The global functional score (mean of the two unilateral functional scores) decreased with time spent on haemodialysis and was correlated with the DRA score. The unilateral functional score was linked to tendinous lesions, amyotrophy, and presence of pulses, but not to CT surgery or presence of AV fistula. Hands with ulnar insult at the elbow shown by electromyography had significantly lower functional scores. Repercussions of hand functional alteration may have an important social and psychological impact in daily life. The responsibility of amyloidosis is evidenced by tendinous lesions and nervous entrapment. Ulnar palsy is also important because of the vital motor role of that nerve in hand function.
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Helmich, I; Lausberg, H
2014-10-01
The present study addresses the previously discussed controversy on the contribution of the right and left cerebral hemispheres to the production and conceptualization of spontaneous hand movements and gestures. Although it has been shown that each hemisphere contains the ability to produce hand movements, results of left hemispherically lateralized motor functions challenge the view of a contralateral hand movement production system. To examine hemispheric specialization in hand movement and gesture production, ten right-handed participants were tachistoscopically presented pictures of everyday life actions. The participants were asked to demonstrate with their hands, but without speaking what they had seen on the drawing. Two independent blind raters evaluated the videotaped hand movements and gestures employing the Neuropsychological Gesture Coding System. The results showed that the overall frequency of right- and left-hand movements is equal independent of stimulus lateralization. When hand movements were analyzed considering their Structure, the presentation of the action stimuli to the left hemisphere resulted in more hand movements with a phase structure than the presentation to the right hemisphere. Furthermore, the presentation to the left hemisphere resulted in more right and left-hand movements with a phase structure, whereas the presentation to the right hemisphere only increased contralateral left-hand movements with a phase structure as compared to hand movements without a phase structure. Gestures that depict action were primarily displayed in response to stimuli presented in the right visual field than in the left one. The present study shows that both hemispheres possess the faculty to produce hand movements in response to action stimuli. However, the left hemisphere dominates the production of hand movements with a phase structure and gestures that depict action. We therefore conclude that hand movements with a phase structure and gestures that
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Lacey, R J; Lewis, M; Sim, J
2005-10-01
To investigate the association of occupational factors, both physical and psychosocial, with hand paraesthesia, and whether any such associations differ according to the concurrent presence of neck and upper limb pain (NULP). A questionnaire was mailed to an age-stratified random sample of 9596 adults. All subjects were asked about hand paraesthesia in the past 4 weeks. Information was obtained on respondents' main job (the job held for the longest time), whether this job involved any of six neck or upper limb activities on most or all days of the working week, and questions on the psychosocial aspects of the work environment. The questionnaire also asked about NULP according to a preshaded manikin. A total of 5133 people replied to the survey (adjusted response 53.5%). Of these, 1592 reported abnormal feelings in the hands (prevalence of 31.9%). Prolonged gripping, prolonged bending of the neck forwards, working with arms at/above shoulder height, low job control, many changes in tasks and low job support were independently associated with hand paraesthesia. Among responders also reporting NULP, working with arms at/above shoulder height and many changes in tasks were independently associated with hand paraesthesia; prolonged gripping was linked to hand paraesthesia in the absence of NULP. Hand paraesthesia is associated with physical and psychosocial workplace factors, although different work-related factors were associated with hand paraesthesia according to the concurrent presence of NULP, suggesting that these symptoms may not always be mediated in the same way.
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Transient risk factors for acute traumatic hand injuries: a case‐crossover study in Hong Kong
Chow, C Y; Lee, H; Lau, J; Yu, I T S
2007-01-01
Objectives To identify the remediable transient risk factors of occupational hand injuries in Hong Kong in order to guide the development of prevention strategies. Methods The case‐crossover study design was adopted. Study subjects were workers with acute hand injuries presenting to the government Occupational Medicine Unit for compensation claims within 90 days from the date of injury. Detailed information on exposures to specific transient factors during the 60 minutes prior to the occurrence of the injury, during the same time interval on the day prior to the injury, as well as the usual exposure during the past work‐month was obtained through telephone interviews. Both matched‐pair interval approach and usual frequency approach were adopted to assess the associations between transient exposures in the workplace and the short‐term risk of sustaining a hand injury. Results A total of 196 injured workers were interviewed. The results of the matched‐pair interval analysis matched well with the results obtained using the usual frequency analysis. Seven significant transient risk factors were identified: using malfunctioning equipment/materials, using a different work method, performing an unusual work task, working overtime, feeling ill, being distracted and rushing, with odds ratios ranging from 10.5 to 26.0 in the matched‐pair interval analysis and relative risks ranging between 8.0 and 28.3 with the usual frequency analysis. Wearing gloves was found to have an insignificant protective effect on the occurrence of hand injury in both analyses. Conclusions Using the case‐crossover study design for acute occupational hand injuries, seven transient risk factors that were mostly modifiable were identified. It is suggested that workers and their employers should increase their awareness of these risk factors, and efforts should be made to avoid exposures to these factors by means of engineering and administrative controls supplemented by safety
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Congenital hand anomalies in Upper Egypt
Abulezz, Tarek; Talaat, Mohamed; Elsani, Asem; Allam, Karam
2016-01-01
Background: Congenital hand anomalies are numerous and markedly variant. Their significance is attributed to the frequent occurrence and their serious social, psychological and functional impacts on patient's life. Patients and Methods: This is a follow-up study of 64 patients with hand anomalies of variable severity. All patients were presented to Plastic Surgery Department of Sohag University Hospital in a period of 24 months. Results: This study revealed that failure of differentiation and duplication deformities were the most frequent, with polydactyly was the most common anomaly encountered. The mean age of presentation was 6 years and female to male ratio was 1.46:1. Hand anomalies were either isolated, associated with other anomalies or part of a syndrome. Conclusion: Incidence of congenital hand anomalies in Upper Egypt is difficult to be estimated due to social and cultural concepts, lack of education, poor registration and deficient medical survey. Management of hand anomalies should be individualised, carefully planned and started as early as possible to achieve the best outcome. PMID:27833283
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The effect of smartphone addiction on hand joints in psoriatic patients: an ultrasound-based study.
Megna, M; Gisonni, P; Napolitano, M; Orabona, G Dell'Aversano; Patruno, C; Ayala, F; Balato, N
2018-01-01
Distal interphalangeal (DIP) arthritis is a frequent form of psoriatic arthritis being often linked to nail psoriasis. Modern society is characterized by overuse of smartphones. Indeed, literature has recently focalized on research into smartphone addiction and health-related problems. As smartphone addiction is able to determine overuse and repeated movements of DIP joints and nails, the aim of this study was to evaluate the impact of smartphone use on hand joints of young psoriatic patients. An observational study involving four different groups such as non-smartphone-addicted (SA) psoriatic patients, SA psoriatic patients, non-SA controls and SA controls was performed. Each subject underwent an ultrasound examination of both hands by three independent and blinded to group assignment radiologists. A specific score was used to evaluate the inflammatory state of the analysed joints. The total ultrasound score was statistically significantly higher in SA controls respect to non-SA controls (3.4 vs. 1.4; P < 0.05) as well as in SA psoriasis patients compared to non-SA psoriatic subjects (15.2 vs. 6.7; P < 0.01). Higher mean of ultrasound score was found for left hand in controls (both SA or not) and for right hand in psoriatic subjects (both SA or not), however without reaching statistical significance. Smartphone overuse was found to be linked with higher signs of inflammation of musculoskeletal structures of hands joints in both psoriasis and controls through ultrasound examination. Therefore, smartphone overuse may be a factor which facilitate or speed up the possible development of psoriatic arthritis. © 2017 European Academy of Dermatology and Venereology.
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Hand luggage in the train toilet.
Loth, M; Molenbroek, J F M; van Eijk, D J
2018-01-01
The train toilet can form a barrier for those wishing to travel by train as it is perceived as being dirty, and therefore its use as being unpleasant. In addition, Dutch train toilet users have the additional issue of storing their hand luggage in the toilet's confined spaceOBJECTIVE:In this article, we examine the issue of Dutch travelers with hand luggage in relation to their use of train toilets. We investigate the type of hand luggage train travelers have with them and lastly, we study what travelers do with their hand luggage when using the toilet. As part of an overarching study, we asked two specific questions on what travelers do with their hand luggage in a train toilet environment, followed by 22 observations from observational research. In the questionnaire, train travelers reported that bringing hand luggage into the train toilet is a problem because of the lack of storage space, and their fear of losing their seat. From the observational research, we noted that the participants mainly held their hand luggage on their bodies, and to a lesser extent, they placed it on the floor of the train toilet itself. None of the 22 participants used the hook to hang up their bag and/ or their coat. Travelers need a facility in the train toilet to store their hand luggage. Women have a stronger need for this than men, as they almost always carry an item with them. In addition, they use the toilet in hovering position or seated, with their backs to the wall, so they have limited space to store hand luggage on their backs or shoulders as men do. Most participants kept their hand luggage at a distance from the bowl, and the majority kept it off the floor (14 of the 22) because they were aware of the hygiene. The positioning of the coat/luggage hook at 1840 mm above the floor was considered to be too high, out of people's comfort area.
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Hand luggage in the train toilet
Loth, M.; Molenbroek, J.F.M.; van Eijk, D.J.
2018-01-01
BACKGROUND: The train toilet can form a barrier for those wishing to travel by train as it is perceived as being dirty, and therefore its use as being unpleasant. In addition, Dutch train toilet users have the additional issue of storing their hand luggage in the toilet’s confined space OBJECTIVE: In this article, we examine the issue of Dutch travelers with hand luggage in relation to their use of train toilets. We investigate the type of hand luggage train travelers have with them and lastly, we study what travelers do with their hand luggage when using the toilet. METHODS: As part of an overarching study, we asked two specific questions on what travelers do with their hand luggage in a train toilet environment, followed by 22 observations from observational research. RESULTS: In the questionnaire, train travelers reported that bringing hand luggage into the train toilet is a problem because of the lack of storage space, and their fear of losing their seat. From the observational research, we noted that the participants mainly held their hand luggage on their bodies, and to a lesser extent, they placed it on the floor of the train toilet itself. None of the 22 participants used the hook to hang up their bag and/ or their coat. CONCLUSIONS: Travelers need a facility in the train toilet to store their hand luggage. Women have a stronger need for this than men, as they almost always carry an item with them. In addition, they use the toilet in hovering position or seated, with their backs to the wall, so they have limited space to store hand luggage on their backs or shoulders as men do. Most participants kept their hand luggage at a distance from the bowl, and the majority kept it off the floor (14 of the 22) because they were aware of the hygiene. The positioning of the coat/luggage hook at 1840 mm above the floor was considered to be too high, out of people’s comfort area. PMID:29630580
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Hand contamination during routine care in medical wards: the role of hand hygiene compliance.
Monistrol, Olga; López, M Liboria; Riera, Montserrat; Font, Roser; Nicolás, Carme; Escobar, Miguel Angel; Freixas, Núria; Garau, Javier; Calbo, Esther
2013-04-01
The hands of healthcare workers (HCWs) are the most common vehicle for the transmission of micro-organisms from patient to patient and within the healthcare environment. The aim of this study was to evaluate the impact of a multimodal campaign on the type and amount of resident and transient flora and the presence of potential risk factors for hand contamination during routine care. A before-after (PRE and POST periods) interventional study was carried out in medical wards of a tertiary care hospital. Eighty-nine samples were analysed. Samples were cultured immediately before patient contact using a glove-juice method. Data collected included socio-demographic and risk factors for hand contamination. Flora was measured as log10 c.f.u. ml(-1) and evaluated by comparing median values in the PRE and POST periods. Transient flora was isolated from the hands of 67.4 and 46.1 % of HCWs in the PRE and POST periods, respectively (P<0.001). Enterobacteriaceae, Pseudomonas spp. and meticillin-sensitive Staphylococcus aureus were the predominant contaminants. Resident flora was isolated from 92.1 % of HCWs in the PRE period and from 70.8 % in the POST period (P<0.001). The meticillin-resistant coagulase-negative staphylococci log10 c.f.u. count ml(-1) decreased from 1.96 ± 1.2 to 0.89 ± 1.2 (mean ± s d; P<0.001), and the global flora count decreased from 2.77 ± 1.1 to 1.56 ± 1.4 (P<0.001). In the POST period, the wearing of fewer rings (P<0.001), shorter fingernail length (P = 0.008), a shorter time since recent hand hygiene (HH) (P = 0.007) and an increased use of alcohol-based hand rub instead of soap (P<0.001) were documented. The HH multimodal strategy reduced the number of risk factors and the level of HCW hand contamination.
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Hand/Wrist Disorders among Sign Language Communicators.
ERIC Educational Resources Information Center
Smith, Susan M.; Kress, Tyler A.; Hart, William M.
2000-01-01
A study assessed the frequency of self-reported hand/wrist problems among 184 sign-language communicators. Fifty-nine percent reported experiencing hand/wrist problems, 26 percent reported experiencing hand/wrist problems severe enough to limit their ability to work, and 18 percent reported a medical diagnosis of wrist tendinitis, carpal tunnel…
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Dermal exposure studies incorporating urinary biomarker measurements are complicated because dermal sampling may intercept or remove the target chemical before it is absorbed. A hand wipe subsampling method has been developed using polyurethane foam-tipped (PUF) swabs to minim...
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The hot hand belief and framing effects.
MacMahon, Clare; Köppen, Jörn; Raab, Markus
2014-09-01
Recent evidence of the hot hand in sport-where success breeds success in a positive recency of successful shots, for instance-indicates that this pattern does not actually exist. Yet the belief persists. We used 2 studies to explore the effects of framing on the hot hand belief in sport. We looked at the effect of sport experience and task on the perception of baseball pitch behavior as well as the hot hand belief and free-throw behavior in basketball. Study 1 asked participants to designate outcomes with different alternation rates as the result of baseball pitches or coin tosses. Study 2 examined basketball free-throw behavior and measured predicted success before each shot as well as general belief in the hot hand pattern. The results of Study 1 illustrate that experience and stimulus alternation rates influence the perception of chance in human performance tasks. Study 2 shows that physically performing an act and making judgments are related. Specifically, beliefs were related to overall performance, with more successful shooters showing greater belief in the hot hand and greater predicted success for upcoming shots. Both of these studies highlight that the hot hand belief is influenced by framing, which leads to instability and situational contingencies. We show the specific effects of framing using accumulated experience of the individual with the sport and knowledge of its structure and specific experience with sport actions (basketball shots) prior to judgments.
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Leib, Raz; Rubin, Inbar; Nisky, Ilana
2018-05-16
Interaction with an object often requires the estimation of its mechanical properties. We examined whether the hand that is used to interact with the object and their handedness affected people's estimation of these properties using stiffness estimation as a test case. We recorded participants' responses on a stiffness discrimination of a virtual elastic force field and the grip force applied on the robotic device during the interaction. In half of the trials, the robotic device delayed the participants' force feedback. Consistent with previous studies, delayed force feedback biased the perceived stiffness of the force field. Interestingly, in both left-handed and right-handed participants, for the delayed force field, there was even less perceived stiffness when participants used their left hand than their right hand. This result supports the idea that haptic processing is affected by laterality in the brain, not by handedness. Consistent with previous studies, participants adjusted their applied grip force according to the correct size and timing of the load force regardless of the hand that was used, the handedness, or the delay. This suggests that in all these conditions, participants were able to form an accurate internal representation of the anticipated trajectory of the load force (size and timing) and that this representation was used for accurate control of grip force independently of the perceptual bias. Thus, these results provide additional evidence for the dissociation between action and perception in the processing of delayed information.
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NASA Astrophysics Data System (ADS)
Pine, Jerome; Aschbacher, Pamela; Roth, Ellen; Jones, Melanie; McPhee, Cameron; Martin, Catherine; Phelps, Scott; Kyle, Tara; Foley, Brian
2006-05-01
A large number of American elementary school students are now studying science using the hands-on inquiry curricula developed in the 1990s: Insights; Full Option Science System (FOSS); and Science and Technology for Children (STC). A goal of these programs, echoed in the National Science Education Standards, is that children should gain abilities to do scientific inquiry and understanding about scientific inquiry. We have studied the degree to which students can do inquiries by using four hands-on performance assessments, which required one or three class periods. To be fair, the assessments avoided content that is studied in depth in the hands-on programs. For a sample of about 1000 fifth grade students, we compared the performance of students in hands-on curricula with an equal number of students with textbook curricula. The students were from 41 classrooms in nine school districts. The results show little or no curricular effect. There was a strong dependence on students' cognitive ability, as measured with a standard multiple-choice instrument. There was no significant difference between boys and girls. Also, there was no difference on a multiple-choice test, which used items released from the Trends in International Mathematics and Science Study (TIMSS). It is not completely clear whether the lack of difference on the performance assessments was a consequence of the assessments, the curricula, and/or the teaching.
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Conson, Massimiliano; Volpicella, Francesco; De Bellis, Francesco; Orefice, Agnese; Trojano, Luigi
2017-10-01
A key point in motor imagery literature is that judging hands in palm view recruits sensory-motor information to a higher extent than judging hands in back view, due to the greater biomechanical complexity implied in rotating hands depicted from palm than from back. We took advantage from this solid evidence to test the nature of a phenomenon known as self-advantage, i.e. the advantage in implicitly recognizing self vs. others' hand images. The self-advantage has been actually found when implicitly but not explicitly judging self-hands, likely due to dissociation between implicit and explicit body representations. However, such a finding might be related to the extent to which motor imagery is recruited during implicit and explicit processing of hand images. We tested this hypothesis in two behavioural experiments. In Experiment 1, right-handed participants judged laterality of either self or others' hands, whereas in Experiment 2, an explicit recognition of one's own hands was required. Crucially, in both experiments participants were randomly presented with hand images viewed from back or from palm. The main result of both experiments was the self-advantage when participants judged hands from palm view. This novel finding demonstrate that increasing the "motor imagery load" during processing of self vs. others' hands can elicit a self-advantage in explicit recognition tasks as well. Future studies testing the possible dissociation between implicit and explicit visual body representations should take into account the modulatory effect of motor imagery load on self-hand processing. Copyright © 2017. Published by Elsevier B.V.
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Automated joint space width quantification of hand and wrist joints: a proof of concept study.
Huo, Yinghe; Veldhuizen, Renske D; van der Heijde, Desiree M; Besselink, Nick J; Jacobs, Johannes W G; van Laar, Jacob M; Viergever, Max A; Vincken, Koen L; Lafeber, Floris P; de Hair, Maria J H
2016-01-01
To compare as proof of concept the sensitivity to change of automated quantification of radiographic wrist and hand joint space width (JSW) with scoring JSW according to the Sharp/van der Heijde scoring method (SHS) in two strategy groups of a treat-to-target and tight-control early rheumatoid arthritis (RA) study. Digital radiographs were assessed for JSW changes of 134 patients of the 236 patients participating in the second Computer Assisted Management in Early Rheumatoid Arthritis trial, of whom both baseline and year 2 radiographs were available (year 1 radiographs n=125). Of those 134 patients, 70 started with methotrexate and prednisone (MTX+Pred) and 64 with MTX and placebo (MTX+Plac). JSW change over 1 and 2 years of the hands and wrists was assessed, applying both the joint space narrowing (JSN) subscore of the SHS by 2 readers and the automated assessment with the JSW quantification software 'JSQ'. For both methods, progression of JSW change of the hand and wrist was analysed using linear mixed modelling (dependent variable 'JSW', factor 'strategy group', covariate 'follow-up time in years', interaction term 'strategy group*follow-up time'; radiographs of baseline, year 1 and year 2 were used). For each method the standardised mean difference (SMD) for the change in JSW from baseline to year 2 between the treatment strategies was obtained using a non-parametric method. Patient characteristics of the current subpopulation were similar to those of the whole study population. JSN of the hand and wrist according to SHS at 2 years was present in 16 vs. 23% in the MTX+Pred group vs. the MTX+Plac group. The mean yearly progression rates of JSW change of the hands and wrists using JSQ were -0.00mm (95% confidence interval (CI) -0.01; 0.01) for MTX+Pred vs. -0.02mm (95%CI -0.03; -0.01) for MTX+Plac, p=0.045, and using SHS JSN they were 0.19 units (95%CI 0.09; 0.30) vs. 0.30 units (95%CI 0.14; 0.45) for MTX+Pred vs. MTX+Plac, p=0.271. The SMD for the change from
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Mangalam, Madhur; Desai, Nisarg; Singh, Mewa
2015-01-01
A practical approach to understanding lateral asymmetries in body, brain, and cognition would be to examine the performance advantages/disadvantages associated with the corresponding functions and behavior. In the present study, we examined whether the division of labor in hand usage, marked by the preferential usage of the two hands across manual operations requiring maneuvering in three-dimensional space (e.g., reaching for food, grooming, and hitting an opponent) and those requiring physical strength (e.g., climbing), is associated with higher hand performance in free-ranging bonnet macaques, Macaca radiata. We determined the extent to which the macaques exhibit laterality in hand usage in an experimental unimanual and a bimanual food-reaching task, and the extent to which manual laterality is associated with hand performance in an experimental hand-performance-differentiation task. We observed negative relationships between (a) the latency in food extraction by the preferred hand in the hand-performance-differentiation task (wherein, lower latency implies higher performance), the preferred hand determined using the bimanual food-reaching task, and the normalized difference between the performance of the two hands, and (b) the normalized difference between the performance of the two hands and the absolute difference between the laterality in hand usage in the unimanual and the bimanual food-reaching tasks (wherein, lesser difference implies higher manual specialization). Collectively, these observations demonstrate that the division of labor between the two hands is associated with higher hand performance. PMID:25806511
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Carey, David P; Otto-de Haart, E Grace; Buckingham, Gavin; Dijkerman, H Chris; Hargreaves, Eric L; Goodale, Melvyn A
2015-01-01
Many studies have argued for distinct but complementary contributions from each hemisphere in the control of movements to visual targets. Investigators have attempted to extend observations from patients with unilateral left- and right-hemisphere damage, to those using neurologically-intact participants, by assuming that each hand has privileged access to the contralateral hemisphere. Previous attempts to illustrate right hemispheric contributions to the control of aiming have focussed on increasing the spatial demands of an aiming task, to attenuate the typical right hand advantages, to try to enhance a left hand reaction time advantage in right-handed participants. These early attempts have not been successful. The present study circumnavigates some of the theoretical and methodological difficulties of some of the earlier experiments, by using three different tasks linked directly to specialized functions of the right hemisphere: bisecting, the gap effect, and visuospatial localization. None of these tasks were effective in reducing the magnitude of left hand reaction time advantages in right handers. Results are discussed in terms of alternatives to right hemispheric functional explanations of the effect, the one-dimensional nature of our target arrays, power and precision given the size of the left hand RT effect, and the utility of examining the proportions of participants who show these effects, rather than exclusive reliance on measures of central tendency and their associated null hypothesis significance tests.
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Carey, David P.; Otto-de Haart, E. Grace; Buckingham, Gavin; Dijkerman, H. Chris; Hargreaves, Eric L.; Goodale, Melvyn A.
2015-01-01
Many studies have argued for distinct but complementary contributions from each hemisphere in the control of movements to visual targets. Investigators have attempted to extend observations from patients with unilateral left- and right-hemisphere damage, to those using neurologically-intact participants, by assuming that each hand has privileged access to the contralateral hemisphere. Previous attempts to illustrate right hemispheric contributions to the control of aiming have focussed on increasing the spatial demands of an aiming task, to attenuate the typical right hand advantages, to try to enhance a left hand reaction time advantage in right-handed participants. These early attempts have not been successful. The present study circumnavigates some of the theoretical and methodological difficulties of some of the earlier experiments, by using three different tasks linked directly to specialized functions of the right hemisphere: bisecting, the gap effect, and visuospatial localization. None of these tasks were effective in reducing the magnitude of left hand reaction time advantages in right handers. Results are discussed in terms of alternatives to right hemispheric functional explanations of the effect, the one-dimensional nature of our target arrays, power and precision given the size of the left hand RT effect, and the utility of examining the proportions of participants who show these effects, rather than exclusive reliance on measures of central tendency and their associated null hypothesis significance tests. PMID:26379572
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ERIC Educational Resources Information Center
Lee, Hung-Shan; Liu, Shiang-Yao; Yeh, Ting-Kuang
2016-01-01
This study was designed to exemplify how hands-on based teaching strategies enhanced students' knowledge and positive attitudes towards sharks. Hands-on activities for sharks' biological and morphological features were carried out. Eleven elementary school students from a remote area in Taiwan were recruited and assigned to the hands-on condition.…
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Hand in Hand: Media Literacy and Internet Safety
ERIC Educational Resources Information Center
Gallagher, Frank
2011-01-01
Internet safety cannot be effectively taught without also teaching media literacy. The two go hand in hand, and both are necessary, but neither is sufficient. To understand why, it is important to first appreciate what the real risks to children are. Many of the early Internet safety programs were based on a fear of predators. Predators turned out…
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Abzug, Joshua M; Osterman, Meredith; Rivlin, Michael; Paryavi, Ebrahim; Osterman, A Lee
2014-09-01
Research projects are presented at the Annual Meetings of the American Society for Surgery of the Hand (ASSH). It is unknown how many achieve publication in peer-reviewed journals. We sought to determine current rates of publication of podium and poster presentations. All ASSH podium and poster presentations from 2000 to 2005 were reviewed, and an Internet-based search using PubMed and Google was conducted to determine whether the presented studies had been published. Times to publication and journal names were recorded. Data were analyzed with descriptive statistics. Fisher's exact test was conducted to compare current trends with previous trends. Of 1127 podium and poster presentations reviewed, 46% were published in peer-reviewed journals. Forty-seven percent of published presentations (242 presentations) were in Journal of Hand Surgery, and 11% (59 presentations) were in Journal of Bone and Joint Surgery. Forty-five percent of presentations were published within 2 years and 66% within 3 years. The publication rate for podium presentations was significantly higher than that previously reported for Journal of Hand Surgery, at 54% compared with 44% (P=0.004). Currently, fewer than half of the studies presented at Annual Meetings of the ASSH achieve publication in peer-reviewed journals. Presentations are most likely to be published within 3 years, and almost half are published in Journal of Hand Surgery.
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Vieira, Ana Isabel; Nogueira, Dália; de Azevedo Reis, Elisabeth; da Lapa Rosado, Maria; Vânia Nunes, Maria; Castro-Caldas, Alexandre
2016-01-01
Frailty is a common syndrome among elderly and sensory decline may exacerbate functional decline. The hand function, the manual dexterity, the performance of the daily living skills and the social interactions are determined, in a large degree, by sensory integrity. However, hand tactile sensory deterioration has been little explored in frailty. We performed a cross sectional observational study with 181 of institutionalized elders. From the initial sample we selected 50 subjects (68-99 years) who met the inclusion/exclusion criteria. Our goals were (1) to analyse the relationship between tactile discrimination (TD) of the hand, avoidance behaviours and attitudes towards social touch (BATST) and phenotype frailty criteria (unintentional weight loss, self-perception of exhaustion, decrease grip strength - GS, slow walking speed, low level of physical activity), (2) to explore whether other variables can contribute to explain the differences between pre-frail and frail elders. The results showed that increasing age is related to decline of TD of the hand (p=0.021) and to decrease in GS (p=0.025); women have significantly lower level of GS (p=0.001); TD decrease is correlated with higher avoidance BATST (p=0.000) and with lower GS (p=0.000); Lower GS corresponds to more avoidance BATST (p=0.003). Hand TD also can differentiate frail and pre-frail elderly subjects in this sample (p=0.037). Decreased TD of the hand may have implications on the functionality and on interpersonal relationships. TD of the hand also explains frailty levels in this sample. Hand TD should be used in assessment and intervention protocols in pre-frail and frail elders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Rubber Hand Illusion Affects Joint Angle Perception
Butz, Martin V.; Kutter, Esther F.; Lorenz, Corinna
2014-01-01
The Rubber Hand Illusion (RHI) is a well-established experimental paradigm. It has been shown that the RHI can affect hand location estimates, arm and hand motion towards goals, the subjective visual appearance of the own hand, and the feeling of body ownership. Several studies also indicate that the peri-hand space is partially remapped around the rubber hand. Nonetheless, the question remains if and to what extent the RHI can affect the perception of other body parts. In this study we ask if the RHI can alter the perception of the elbow joint. Participants had to adjust an angular representation on a screen according to their proprioceptive perception of their own elbow joint angle. The results show that the RHI does indeed alter the elbow joint estimation, increasing the agreement with the position and orientation of the artificial hand. Thus, the results show that the brain does not only adjust the perception of the hand in body-relative space, but it also modifies the perception of other body parts. In conclusion, we propose that the brain continuously strives to maintain a consistent internal body image and that this image can be influenced by the available sensory information sources, which are mediated and mapped onto each other by means of a postural, kinematic body model. PMID:24671172
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AuYeung, Willa; Canales, Robert A; Leckie, James O
2008-11-01
Information on the fraction of total hand surface area touching a contaminated object is necessary in accurately estimating contaminant (e.g., pesticides, pathogens) loadings onto the hands during hand-to-object contacts. While several existing physical-stochastic human exposure models require such surface area data to estimate dermal and non-dietary ingestion exposure, there are very limited data sets. This paper provides statistical distributions of fractional surface areas (FSAs) for children's outdoor hand contacts. These distributions were constructed by combining information collected from two distinct studies exploring children's activity patterns and quantifying hand contact surface area. Results show that for outdoor contacts with "All Objects", a range of 0.13-0.27 captured median FSAs, while a range of 0.12-0.24 captured time-weighted FSAs. Overall, an FSA of 0.31 captured 80-100% of FSAs involved in each child's outdoor hand contacts, depending upon the object of interest. These values are much lower than the often conservative assumptions of up to 1 (i.e., the entire hand) that researchers currently make regarding FSAs involved in indoor and outdoor contacts [USEPA, 1997. Standard operating procedures (SOPs) for residential exposure assessments. Contract no. 68-W6-0030. http://www.epa.gov/pesticides/trac/science/trac6a05.pdf].
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O'Donoghue, Margaret; Ng, Suk-Hing; Suen, Lorna Kp; Boost, Maureen
2016-01-01
Whilst numerous studies have investigated nurses' compliance with hand hygiene and use of alcohol-based hand rub (ABHR), limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU). With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW), comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA), agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Before the intervention, overall hand hygiene compliance was low (28.9 %). Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. The educational intervention led to increased awareness of hand hygiene opportunities and better acceptance of ABHR use. The reduced time needed to perform hand
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Xiloyannis, Michele; Gavriel, Constantinos; Thomik, Andreas A C; Faisal, A Aldo
2017-10-01
Matching the dexterity, versatility, and robustness of the human hand is still an unachieved goal in bionics, robotics, and neural engineering. A major limitation for hand prosthetics lies in the challenges of reliably decoding user intention from muscle signals when controlling complex robotic hands. Most of the commercially available prosthetic hands use muscle-related signals to decode a finite number of predefined motions and some offer proportional control of open/close movements of the whole hand. Here, in contrast, we aim to offer users flexible control of individual joints of their artificial hand. We propose a novel framework for decoding neural information that enables a user to independently control 11 joints of the hand in a continuous manner-much like we control our natural hands. Toward this end, we instructed six able-bodied subjects to perform everyday object manipulation tasks combining both dynamic, free movements (e.g., grasping) and isometric force tasks (e.g., squeezing). We recorded the electromyographic and mechanomyographic activities of five extrinsic muscles of the hand in the forearm, while simultaneously monitoring 11 joints of hand and fingers using a sensorized data glove that tracked the joints of the hand. Instead of learning just a direct mapping from current muscle activity to intended hand movement, we formulated a novel autoregressive approach that combines the context of previous hand movements with instantaneous muscle activity to predict future hand movements. Specifically, we evaluated a linear vector autoregressive moving average model with exogenous inputs and a novel Gaussian process ( ) autoregressive framework to learn the continuous mapping from hand joint dynamics and muscle activity to decode intended hand movement. Our approach achieves high levels of performance (RMSE of 8°/s and ). Crucially, we use a small set of sensors that allows us to control a larger set of independently actuated degrees of freedom of a hand
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Gonzalez, Jean; Roman, Manuela; Hall, Michael; Godavarty, Anuradha
2012-01-01
Hand-held near-infrared (NIR) optical imagers are developed by various researchers towards non-invasive clinical breast imaging. Unlike these existing imagers that can perform only reflectance imaging, a generation-2 (Gen-2) hand-held optical imager has been recently developed to perform both reflectance and transillumination imaging. The unique forked design of the hand-held probe head(s) allows for reflectance imaging (as in ultrasound) and transillumination or compressed imaging (as in X-ray mammography). Phantom studies were performed to demonstrate two-dimensional (2D) target detection via reflectance and transillumination imaging at various target depths (1-5 cm deep) and using simultaneous multiple point illumination approach. It was observed that 0.45 cc targets were detected up to 5 cm deep during transillumination, but limited to 2.5 cm deep during reflectance imaging. Additionally, implementing appropriate data post-processing techniques along with a polynomial fitting approach, to plot 2D surface contours of the detected signal, yields distinct target detectability and localization. The ability of the gen-2 imager to perform both reflectance and transillumination imaging allows its direct comparison to ultrasound and X-ray mammography results, respectively, in future clinical breast imaging studies.
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Lu, Hsueh-Kuan; Chiang, Li-Ming; Chen, Yu-Yawn; Chuang, Chih-Lin; Chen, Kuen-Tsann; Dwyer, Gregory B.; Hsu, Ying-Lin; Chen, Chun-Hao; Hsieh, Kuen-Chang
2016-01-01
This study aimed to establish a hand-to-hand (HH) model for bioelectrical impedance analysis (BIA) fat free mass (FFM) estimation by comparing with a standing position hand-to-foot (HF) BIA model and dual energy X-ray absorptiometry (DXA); we also verified the reliability of the newly developed model. A total of 704 healthy Chinese individuals (403 men and 301 women) participated. FFM (FFMDXA) reference variables were measured using DXA and segmental BIA. Further, regression analysis, Bland–Altman plots, and cross-validation (2/3 participants as the modeling group, 1/3 as the validation group; three turns were repeated for validation grouping) were conducted to compare tests of agreement with FFMDXA reference variables. In male participants, the hand-to-hand BIA model estimation equation was calculated as follows: FFMmHH = 0.537 h2/ZHH − 0.126 year + 0.217 weight + 18.235 (r2 = 0.919, standard estimate of error (SEE) = 2.164 kg, n = 269). The mean validated correlation coefficients and limits of agreement (LOAs) of the Bland–Altman analysis of the calculated values for FFMmHH and FFMDXA were 0.958 and −4.369–4.343 kg, respectively, for hand-to-foot BIA model measurements for men; the FFM (FFMmHF) and FFMDXA were 0.958 and −4.356–4.375 kg, respectively. The hand-to-hand BIA model estimating equation for female participants was FFMFHH = 0.615 h2/ZHH − 0.144 year + 0.132 weight + 16.507 (r2 = 0.870, SEE = 1.884 kg, n = 201); the three mean validated correlation coefficient and LOA for the hand-to-foot BIA model measurements for female participants (FFMFHH and FFMDXA) were 0.929 and −3.880–3.886 kg, respectively. The FFMHF and FFMDXA were 0.942 and −3.511–3.489 kg, respectively. The results of both hand-to-hand and hand-to-foot BIA models demonstrated similar reliability, and the hand-to-hand BIA models are practical for assessing FFM. PMID:27775642
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Lu, Hsueh-Kuan; Chiang, Li-Ming; Chen, Yu-Yawn; Chuang, Chih-Lin; Chen, Kuen-Tsann; Dwyer, Gregory B; Hsu, Ying-Lin; Chen, Chun-Hao; Hsieh, Kuen-Chang
2016-10-21
This study aimed to establish a hand-to-hand (HH) model for bioelectrical impedance analysis (BIA) fat free mass (FFM) estimation by comparing with a standing position hand-to-foot (HF) BIA model and dual energy X-ray absorptiometry (DXA); we also verified the reliability of the newly developed model. A total of 704 healthy Chinese individuals (403 men and 301 women) participated. FFM (FFM DXA ) reference variables were measured using DXA and segmental BIA. Further, regression analysis, Bland-Altman plots, and cross-validation (2/3 participants as the modeling group, 1/3 as the validation group; three turns were repeated for validation grouping) were conducted to compare tests of agreement with FFM DXA reference variables. In male participants, the hand-to-hand BIA model estimation equation was calculated as follows: FFM m HH = 0.537 h²/Z HH - 0.126 year + 0.217 weight + 18.235 ( r ² = 0.919, standard estimate of error (SEE) = 2.164 kg, n = 269). The mean validated correlation coefficients and limits of agreement (LOAs) of the Bland-Altman analysis of the calculated values for FFM m HH and FFM DXA were 0.958 and -4.369-4.343 kg, respectively, for hand-to-foot BIA model measurements for men; the FFM (FFM m HF ) and FFM DXA were 0.958 and -4.356-4.375 kg, respectively. The hand-to-hand BIA model estimating equation for female participants was FFM F HH = 0.615 h²/Z HH - 0.144 year + 0.132 weight + 16.507 ( r ² = 0.870, SEE = 1.884 kg, n = 201); the three mean validated correlation coefficient and LOA for the hand-to-foot BIA model measurements for female participants (FFM F HH and FFM DXA ) were 0.929 and -3.880-3.886 kg, respectively. The FFM HF and FFM DXA were 0.942 and -3.511-3.489 kg, respectively. The results of both hand-to-hand and hand-to-foot BIA models demonstrated similar reliability, and the hand-to-hand BIA models are practical for assessing FFM.
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The Plastic Surgery Hand Curriculum.
Silvestre, Jason; Levin, L Scott; Serletti, Joseph M; Chang, Benjamin
2015-12-01
Designing an effective hand rotation for plastic surgery residents is difficult. The authors address this limitation by elucidating the critical components of the hand curriculum during plastic surgery residency. Hand questions on the Plastic Surgery In-Service Training Exam for six consecutive years (2008 to 2013) were characterized by presence of imaging, vignette setting, question taxonomy, answer domain, anatomy, and topic. Answer references were quantified by source and year of publication. Two hundred sixty-six questions were related to hand surgery (22.7 percent of all questions; 44.3 per year) and 61 were accompanied by an image (22.9 percent). Vignettes tended to be clinic- (50.0 percent) and emergency room-based (35.3 percent) (p < 0.001). Questions required decision-making (60.5 percent) over interpretation (25.9 percent) and recall skills (13.5 percent) (p < 0.001). Answers focused on interventions (57.5 percent) over anatomy/pathology (25.2 percent) and diagnoses (17.3 percent) (p < 0.001). Nearly half of the questions focused on the digits. The highest yield topics were trauma (35.3 percent), reconstruction (24.4 percent), and aesthetic and functional problems (14.2 percent). The Journal of Hand Surgery (American volume) (20.5 percent) and Plastic and Reconstructive Surgery (18.0 percent) were the most-cited journals, and the median publication lag was 7 years. Green's Operative Hand Surgery was the most-referenced textbook (41.8 percent). These results will enable trainees to study hand surgery topics with greater efficiency. Faculty can use these results to ensure that tested topics are covered during residency training. Thus, a benchmark is established to improve didactic, clinical, and operative experiences in hand surgery.
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ECHOS: Early Childhood Hands-On Science Efficacy Study
ERIC Educational Resources Information Center
Brown, Judy A.; Greenfield, Daryl B.; Bell, Elizabeth; Juárez, Cheryl Lani; Myers, Ted; Nayfeld, Irena
2013-01-01
"ECHOS: Early Childhood Hands-On Science" was developed at the Miami Science Museum as a comprehensive set of science lessons sequenced to lead children toward a deeper understanding of science content and the use of science process skills. The purpose of the research is to determine whether use of the "ECHOS" model will…
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Bear, Brian J; Peimer, Clayton A; Kaplan, F Thomas D; Kaufman, Gregory J; Tursi, James P; Smith, Ted
2017-05-01
Collagenase Clostridium histolyticum (CCH) is approved for the treatment of adults with Dupuytren contracture with a palpable cord. This open-label, phase 4 study evaluated the safety and efficacy of CCH for the retreatment of recurrent contractures in joints that were previously effectively treated with CCH. Patients participating in a long-term follow-up study who had contracture recurrence (increased ≥ 20° with a palpable cord) after successful treatment in the previous study were eligible. Recurrent joint contractures were treated with up to 3 CCH injections (∼ 1 month apart). Patients were followed for 1 year to evaluate safety. Assessments included change in joint contracture, range of motion, and the percentage of joints that achieved contracture of 5° or less at day 30 after the last injection. The efficacy analysis included 51 patients with 1 treated joint per patient (31 metacarpophalangeal, 20 proximal interphalangeal). A total of 35 joints (69%) received 1 injection, 12 (24%) received 2 injections, and 4 (8%) received 3 injections. Fifty-seven percent of joints achieved contracture of 5° or less (29 of 51). Overall, 86% (43 of 50) patients had a 20° or greater increase in range of motion. The adverse event profile was consistent with previous studies. One ligament injury was reported. At a short-term follow-up of 1 year, recurrent contracture in joints previously successfully treated with CCH may be effectively retreated with up to 3 injections of CCH. Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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A new method for recognizing hand configurations of Brazilian gesture language.
Costa Filho, C F F; Dos Santos, B L; de Souza, R S; Dos Santos, J R; Costa, M G F
2016-08-01
This paper describes a new method for recognizing hand configurations of the Brazilian Gesture Language - LIBRAS - using depth maps obtained with a Kinect® camera. The proposed method comprised three phases: hand segmentation, feature extraction, and classification. The segmentation phase is independent from the background and depends only on pixel depth information. Using geometric operations and numerical normalization, the feature extraction process was done independent from rotation and translation. The features are extracted employing two techniques: (2D)2LDA and (2D)2PCA. The classification is made with a novelty classifier. A robust database was constructed for classifier evaluation, with 12,200 images of LIBRAS and 200 gestures of each hand configuration. The best accuracy obtained was 95.41%, which was greater than previous values obtained in the literature.
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Marshall, M; van der Windt, D; Nicholls, E; Myers, H; Hay, E; Dziedzic, K
2009-11-01
Patterns of radiographic osteoarthritis (ROA) of the hand are often examined by row, with the four joints of the thumb studied inconsistently. The objectives of this study were to determine relationships of ROA at different hand joints, use the findings to define radiographic sub-groups and investigate their associations with pain and function. Sixteen joints in each hand were scored for the presence of ROA in a community-dwelling cohort of adults, 50-years-and-over, with self-reported hand pain or problems. Principal components analysis (PCA) with varimax rotation was used to study patterns of ROA in the hand joints and identify distinct sub-groups. Differences in pain and function between these sub-groups were assessed using Australian/Canadian Osteoarthritis Index (AUSCAN), Grip Ability Test (GAT) and grip and pinch strength. PCA was undertaken on data from 592 participants and identified four components: distal interphalangeal joints (DIPs), proximal interphalangeal joints (PIPs), metacarpophalangeal joints (MCPs), thumb joints. However, the left thumb interphalangeal (IP) joint cross-loaded with the PIP and thumb groups. On this basis, participants were categorised into four radiographic sub-groups: no osteoarthritis (OA), finger only OA, thumb only OA and combined thumb and finger OA. Statistically significant differences were found between the sub-groups for AUSCAN function, and in women alone for grip and pinch strength. Participants with combined thumb and finger OA had the worst scores. Individual thumb joints can be clustered together as a joint group in ROA. Four radiographic sub-groups of hand OA can be distinguished. Pain and functional difficulties were highest in participants with both thumb and finger OA.
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Motes Rodrigo, Alba; Ramirez Torres, Carlos Eduardo; Hernandez Salazar, Laura Teresa; Laska, Matthias
2018-05-01
Spider monkeys are interesting to study with regard to hand preferences, as they are one of the few primate species that lack a thumb and, thus, are unable to perform a precision grip. Further, being platyrrhine primates, they also largely lack independent motor control of the digits and, thus, have only limited manual dexterity. It was therefore the aim of the present study to assess hand preferences in black-handed spider monkeys ( Ateles geoffroyi ) in 4 tasks differing in task demand: simple unimanual reaching for food and 3 versions of the widely used tube task, including 2 bimanual versions that differ from each other in the degree of fine motor control needed and a unimanual version that does not require coordinated action of the hands. We found that black-handed spider monkeys display significant hand preferences at the individual, but not at the population, level. This was true both in the 2 bimanual coordinated tasks and in the 2 unimanual tasks. Further, our results show that the majority of animals were consistent in the hand they preferred in these 4 tasks. Our findings only partially support the notion that task demand positively correlates with strength of hand preference. Finally, we found that the index finger was the most frequently used digit in all 3 tube tasks, although the animals also used other digits and 2- and 3-finger combinations to extract food from a tube. We conclude that limited manual dexterity does not prevent spider monkeys from displaying strong and consistent hand preferences at the individual level. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Bernocchi, Palmira; Mulè, Chiara; Vanoglio, Fabio; Taveggia, Giovanni; Luisa, Alberto; Scalvini, Simonetta
2018-03-01
To evaluate the feasibility and safety of home rehabilitation of the hand using a robotic glove, and, in addition, its effectiveness, in hemiplegic patients after stroke. In this non-randomized pilot study, 21 hemiplegic stroke patients (Ashworth spasticity index ≤ 3) were prescribed, after in-hospital rehabilitation, a 2-month home-program of intensive hand training using the Gloreha Lite glove that provides computer-controlled passive mobilization of the fingers. Feasibility was measured by: number of patients who completed the home-program, minutes of exercise and number of sessions/patient performed. Safety was assessed by: hand pain with a visual analog scale (VAS), Ashworth spasticity index for finger flexors, opponents of the thumb and wrist flexors, and hand edema (circumference of forearm, wrist and fingers), measured at start (T0) and end (T1) of rehabilitation. Hand motor function (Motricity Index, MI), fine manual dexterity (Nine Hole Peg Test, NHPT) and strength (Grip test) were also measured at T0 and T1. Patients performed, over a mean period 56 (49-63) days, a total of 1699 (1353-2045) min/patient of exercise with Gloreha Lite, 5.1 (4.3-5.8) days/week. Seventeen patients (81%) completed the full program. The mean VAS score of hand pain, Ashworth spasticity index and hand edema did not change significantly at T1 compared to T0. The MI, NHPT and Grip test improved significantly (p = 0.0020, 0.0156 and 0.0024, respectively) compared to baseline. Gloreha Lite is feasible and safe for use in home rehabilitation. The efficacy data show a therapeutic effect which need to be confirmed by a randomized controlled study.
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Ozcan, Ayse; Tulum, Zeliha; Pinar, Lamia; Başkurt, Ferdi
2004-12-01
This study was done to evaluate differences in pressure pain threshold, grip strength, manual dexterity and touch pressure threshold in the dominant and non-dominant hands of right- and left-handed subjects, and to compare findings within and between these groups. Thirty-nine right-handed and twenty-one left-handed subjects participated in the study. Pressure pain threshold was assessed using a dolorimeter, grip strength was assessed with a hand-grip dynamometer, manual dexterity was evaluated using the VALPAR Component Work Sample-4 system, and touch pressure threshold was determined using Semmes Weinstein monofilaments. Results for the dominant and non-dominant hands were compared within and between the groups. In the right-handed subjects, the dominant hand was significantly faster with the VALPAR Component Work Sample-4, showed significantly greater grip strength, and had a significantly higher pressure pain threshold than the non-dominant hand. The corresponding results for the two hands were similar in the left-handed subjects. The study revealed asymmetrical manual performance in grip strength, manual dexterity and pressure pain threshold in right-handed subjects, but no such asymmetries in left-handed subjects.
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Skin reactions related to hand hygiene and selection of hand hygiene products.
Larson, Elaine; Girard, Raphaelle; Pessoa-Silva, Carmem Lucia; Boyce, John; Donaldson, Liam; Pittet, Didier
2006-12-01
In October 2004, The World Health Organization (WHO) launched the World Alliance for Patient Safety. Within the alliance, the first priority of the Global Patient Safety Challenge is to reduce health care-associated infection. A key action within the challenge is to promote hand hygiene in health care globally as well as at the country level through the campaign "Clean Care is Safer Care." As a result, the WHO is developing Guidelines on Hand Hygiene in Health Care, designed to be applicable throughout the world. This paper summarizes one component of the global WHO guidelines related to the impact of hand hygiene on the skin of health care personnel, including a discussion of types of skin reactions associated with hand hygiene, methods to reduce adverse reactions, and factors to consider when selecting hand hygiene products. Health care professionals have a higher prevalence of skin irritation than seen in the general population because of the necessity for frequent hand hygiene during patient care. Ways to minimize adverse effects of hand hygiene include selecting less irritating products, using skin moisturizers, and modifying certain hand hygiene practices such as unnecessary washing. Institutions need to consider several factors when selecting hand hygiene products: dermal tolerance and aesthetic preferences of users as well as practical considerations such as convenience, storage, and costs.
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Forer, Yaara; Block, Colin; Frenkel, Shahar
2017-09-01
The goal of this experiment was to evaluate and compare the antimicrobial efficacy of routine preoperative hand washing using commercial medicated sponge brushes versus an alcoholic hand rub, by comparing bacterial growth on ophthalmic surgeons' hands after application of each of these methods. Twenty ophthalmic surgeons were recruited at the Hadassah-Hebrew University Medical Center in Jerusalem, Israel. Samples were collected twice from the hands of each surgeon after hand decontamination using two different protocols during routine surgical practice. The routine preparation consisted of a 3-minute surgical scrub using commercial brush-sponges incorporating either 4% chlorhexidine gluconate (CHG) or 1% povidone-iodine (PVP-I) formulations with detergent, followed by drying the hands with a sterile towel, while the 70% ethanol solution was applied for 60-seconds and allowed to air dry. Half of the group was randomly assigned to provide samples first after the routine method and the alcoholic solution a week later, and the other half of the group was sampled in the reverse order. Viable counts of bacteria were evaluated using a modified glove juice method. Bacterial colonies were enumerated after incubation for 24 hours and expressed as colony forming units (CFU)/mL for each pair of hands. Geometric mean counts were 1310 and 39 CFU/mL, in the routine and alcohol rub groups, respectively, representing a mean log 10 reduction in 1.53. The difference between the paired bacterial counts for the routine versus the alcohol rub was statistically significant (p < 0.0001). There was no statistically significant difference between log 10 reductions for CHG and PVP-I (p = 0.97). This study provides evidence that an alcohol rub protocol is more effective in reducing bacterial counts on hands than routine surgical hand preparation with PVP-I and CHG in a population of practicing ophthalmic surgeons in the operative clinical setting. Thus, it provides a safe alternative as a
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Stiffness map of the grasping contact areas of the human hand.
Pérez-González, Antonio; Vergara, Margarita; Sancho-Bru, Joaquin L
2013-10-18
The elasticity and damping of the soft tissues of the hand contribute to dexterity while grasping and also help to stabilise the objects in manipulation tasks. Although some previous works have studied the force-displacement response of the fingertips, the responses in all other regions of the hand that usually participate in grasping have not been analysed to date. In this work we performed experimental measurements in 20 subjects to obtain a stiffness map of the different grasping contact areas of the human hand. A force-displacement apparatus was used to simultaneously measure force and displacement at 39 different points on the hand at six levels of force ranging from 1N to 6N. A non-linear force-displacement response was found for all points, with stiffness increasing with the amount of force applied. Mean stiffness for the different points and force levels was within the range from 0.2N/mm to 7.7N/mm. However, the stiffness range and variation with level of force were found to be different from point to point. A total of 13 regions with similar stiffness behaviours were identified. The stiffness in the fingertips increased linearly with the amount of force applied, while in the palm it remained more constant for the range of forces considered. It is hypothesised that the differences in the stiffness behaviour from one region to another allow these regions to play different roles during grasping. © 2013 Elsevier Ltd. All rights reserved.
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Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria
2017-01-01
Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.
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van den Noort, Josien C; Verhagen, Rens; van Dijk, Kees J; Veltink, Peter H; Vos, Michelle C P M; de Bie, Rob M A; Bour, Lo J; Heida, Ciska T
2017-10-01
This proof-of-principle study describes the methodology and explores and demonstrates the applicability of a system, existing of miniature inertial sensors on the hand and a separate force sensor, to objectively quantify hand motor symptoms in patients with Parkinson's disease (PD) in a clinical setting (off- and on-medication condition). Four PD patients were measured in off- and on- dopaminergic medication condition. Finger tapping, rapid hand opening/closing, hand pro/supination, tremor during rest, mental task and kinetic task, and wrist rigidity movements were measured with the system (called the PowerGlove). To demonstrate applicability, various outcome parameters of measured hand motor symptoms of the patients in off- vs. on-medication condition are presented. The methodology described and results presented show applicability of the PowerGlove in a clinical research setting, to objectively quantify hand bradykinesia, tremor and rigidity in PD patients, using a single system. The PowerGlove measured a difference in off- vs. on-medication condition in all tasks in the presented patients with most of its outcome parameters. Further study into the validity and reliability of the outcome parameters is required in a larger cohort of patients, to arrive at an optimal set of parameters that can assist in clinical evaluation and decision-making.
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Antimicrobial efficacy of alcohol-based hand gels.
Guilhermetti, M; Marques Wiirzler, L A; Castanheira Facio, B; da Silva Furlan, M; Campo Meschial, W; Bronharo Tognim, M C; Botelho Garcia, L; Luiz Cardoso, C
2010-03-01
In recent years, several commercial alcohol-based hand gels have appeared on the market to improve the hand-cleansing compliance of healthcare workers. Although the antimicrobial efficacy of these products has been reported in different countries, few studies have investigated this subject in Brazil. In this study, we assessed the antimicrobial efficacy of 12 alcohol-based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to the European Standard EN 1500 (EN 1500). The following alcohol gels were tested: Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel and Soft Care Gel. In addition, 70% w/w ethyl alcohol and three alcohol-based hand rubs (Sterillium, Sterillium Gel, and Spitaderm), commonly used in Europe and effective according to EN 1500, were also tested. All the products tested, except for two, were approved by the EN 1500 test protocol with a 60s application. The results confirmed the antimicrobial efficacy of the majority of the alcohol gels produced in Brazil for hand hygiene of healthcare workers. Copyright 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
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Natsopoulos, D; Kiosseoglou, G; Xeromeritou, A; Alevriadou, A
1998-09-01
Two hundred seventy children of school age, 135 of whom were left-handed and an equivalent number of whom were right-handed, have been examined in the present study using a test battery of nine language ability measures: Vocabulary, Similarities, Comprehension (WISC-R), Deductive Reasoning, Inductive Reasoning, Sentence Completion, Comprehension of Sentential Semantics, Comprehension of Syntax, and Text Processing. The data analysis has indicated that: (1) One-factor solution applies both to the right- and left-handed population according to Standard Error Scree Method (Zoski & Jurs, 1996) with regard to language ability measures. (2) Handedness discriminates between right-handers (superior) and left-handers (inferior) in language ability. (3) There have been subgroups of left-handed children who differ in language ability distribution compared with right-handed children according to Hierarchical Cluster Analysis. (4) Extreme versus mild bias to hand preference and hand skill do not differentiate performance subgroups neither within the left-handed nor within the right-handed main group. (5) Sex and familial sinistrality do not affect performance. The results are discussed in relation to (a) "human balanced polymorphism" theory advocated by Annett (mainly Annett, 1985, 1993a; Annett & Manning, 1989), (b) potential pathology (mainly Bishop, 1984, 1990a; Coren & Halpern, 1991; Satz, Orsini, Saslow & Henry, 1985) and "developmental instability" (Yeo, Gangestad & Daniel, 1993), and delay of left-hemisphere maturation in left-handed individuals (Geschwind & Galaburda, 1985a,b, 1987), by pointing out the strength and weaknesses of these theoretical approaches in accounting for the present data. Copyright 1998 Academic Press.
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The Effect of Antibacterial Formula Hand Cleaners on the Elimination of Microbes on Hands
NASA Astrophysics Data System (ADS)
Coleman, J. R.
2002-05-01
: The purpose of this project is to find out which one of the antibacterial hand cleanser (antibacterial bar soap, antibacterial liquid hand soap, and liquid hand sanitizer) is more effective in eliminating microbes. If antibacterial- formula liquid hand soap is used on soiled hands, then it will be more effective in eliminating microbes. Germs are microorganisms that cause disease and can spread from person-to-person. Bacteria are a kind of microbe, an example of which is Transient Flora that is often found on hands. Hand washing prevents germs from spreading to others. During the procedure, swabs were used to take samples before and after the soiled hands had been washed with one of the antibacterial hand cleansers. Nutrient Easygel was poured into petri dishes to harden for 1 day, and then samples were swabbed on the gel. The Petri dishes were placed in an incubator for 24 hours, and then data was recorded accordingly. The antibacterial liquid hand soap was sufficient in eliminating the majority of bacteria. The hands had 65% of the bacteria on them, and after the liquid hand soap was used only 37% of the bacteria remained.
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Functional Anatomy of Writing with the Dominant Hand
Najee-ullah, Muslimah ‘Ali; Hallett, Mark
2013-01-01
While writing performed by any body part is similar in style, indicating a common program, writing with the dominant hand is particularly skilled. We hypothesized that this skill utilizes a special motor network supplementing the motor equivalence areas. Using functional magnetic resonance imaging in 13 normal subjects, we studied nine conditions: writing, zigzagging and tapping, each with the right hand, left hand and right foot. We identified brain regions activated with the right (dominant) hand writing task, exceeding the activation common to right-hand use and the writing program, both identified without right-hand writing itself. Right-hand writing significantly differed from the other tasks. First, we observed stronger activations in the left dorsal prefrontal cortex, left intraparietal sulcus and right cerebellum. Second, the left anterior putamen was required to initiate all the tested tasks, but only showed sustained activation during the right-hand writing condition. Lastly, an exploratory analysis showed clusters in the left ventral premotor cortex and inferior and superior parietal cortices were only significantly active for right-hand writing. The increased activation with right-hand writing cannot be ascribed to increased effort, since this is a well-practiced task much easier to perform than some of the other tasks studied. Because parietal-premotor connections code for particular skills, it would seem that the parietal and premotor regions, together with basal ganglia-sustained activation likely underlie the special skill of handwriting with the dominant hand. PMID:23844132
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Functional anatomy of writing with the dominant hand.
Horovitz, Silvina G; Gallea, Cecile; Najee-Ullah, Muslimah 'ali; Hallett, Mark
2013-01-01
While writing performed by any body part is similar in style, indicating a common program, writing with the dominant hand is particularly skilled. We hypothesized that this skill utilizes a special motor network supplementing the motor equivalence areas. Using functional magnetic resonance imaging in 13 normal subjects, we studied nine conditions: writing, zigzagging and tapping, each with the right hand, left hand and right foot. We identified brain regions activated with the right (dominant) hand writing task, exceeding the activation common to right-hand use and the writing program, both identified without right-hand writing itself. Right-hand writing significantly differed from the other tasks. First, we observed stronger activations in the left dorsal prefrontal cortex, left intraparietal sulcus and right cerebellum. Second, the left anterior putamen was required to initiate all the tested tasks, but only showed sustained activation during the right-hand writing condition. Lastly, an exploratory analysis showed clusters in the left ventral premotor cortex and inferior and superior parietal cortices were only significantly active for right-hand writing. The increased activation with right-hand writing cannot be ascribed to increased effort, since this is a well-practiced task much easier to perform than some of the other tasks studied. Because parietal-premotor connections code for particular skills, it would seem that the parietal and premotor regions, together with basal ganglia-sustained activation likely underlie the special skill of handwriting with the dominant hand.
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Structure design for a Two-DoF myoelectric prosthetic hand to realize basic hand functions in ADLs.
Hoshigawa, Suguru; Jiang, Yinlai; Kato, Ryu; Morishita, Soichiro; Nakamura, Tatsuhiro; Yabuki, Yoshiko; Yokoi, Hiroshi
2015-01-01
Prosthetic hands are desired by those who have lost a hand or both hands not only for decoration but also for the functions to help them with their activities of daily living (ADL). Prosthetic robotic hands that are developed to fully realize the function of a human hand are usually too expensive to be economically available, difficult to operate and maintain, or over heavy for longtime wearing. The aim of this study is therefore to develop a simplified prosthetic hand (sim-PH), which is to be controlled by myoelectric signals from the user, to realize the most important grasp motions in ADL by trading off the cost and performance. This paper reports the structure design of a two-DoF sim-PH with two motors to drive the CM joint of the thumb and the interlocked MP joints of the other four fingers. In order to optimize the structure, the model of the sim-PH was proposed based on which 7 sim-PHs with different structural parameters were manufactured and tested in a pick-and-place experiment. Correspondence analysis of the experimental results clarified the relationship between the hand functions and the shapes of fingers.
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Widrig, Reto; Suter, Andy; Saller, Reinhard; Melzer, Jörg
2007-04-01
The use of topical preparations for symptom relief is common in osteoarthritis. The effects of ibuprofen (5%) and arnica (50 g tincture/100 g, DER 1:20), as gel preparations in patients with radiologically confirmed and symptomatically active osteoarthritis of interphalangeal joints of hands, were evaluated in a randomised, double-blind study in 204 patients, to ascertain differences in pain relief and hand function after 21 days' treatment. Diagnosis was according to established criteria; primary endpoints were pain intensity and hand function; statistical design was as per current regulatory guidelines for testing topical preparations. There were no differences between the two groups in pain and hand function improvements, or in any secondary end points evaluated. Adverse events were reported by six patients (6.1%) on ibuprofen and by five patients (4.8%) on arnica. Our results confirm that this preparation of arnica is not inferior to ibuprofen when treating osteoarthritis of hands.
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Promoting a Hand Hygiene Program Using Social Media: An Observational Study.
Pan, Sung-Ching; Sheng, Wang-Huei; Tien, Kuei-Lien; Chien, Kuang-Tse; Chen, Yee-Chun; Chang, Shawn-Chwen
2016-01-01
Hand hygiene is an important component in infection control to protect patient safety and reduce health care-associated infection. Our aim was to evaluate the efficacy of different social media on the promotion of a hand hygiene (HH) program. The observational study was conducted from May 5 to December 31, 2014, at a 2600-bed tertiary care hospital. A 3-minute video of an HH campaign in 8 languages was posted to YouTube. The Chinese version was promoted through three platforms: the hospital website, the hospital group email, and the Facebook site of a well-known Internet illustrator. The video traffic was analyzed via Google Analytics. HH compliance was measured in November 2013 and 2014. There were 5252 views of the video, mainly of the Chinese-language version (3509/5252, 66.81%). The NTUH website had 24,000 subscribers, and 151 of them viewed the video (connection rate was 151/24,000, 0.63%). There were 9967 users of the hospital email group and the connection rate was 0.91% (91/9967). The connection rate was 6.17% (807/13,080) from Facebook, significantly higher than the other 2 venues (both P<.001). HH compliance sustained from 83.7% (473/565) in 2013 to 86.7% (589/679) in 2014 (P=.13) among all HCWs. Facebook had the highest connection rate in the HH video campaign. The use of novel social media such as Facebook should be considered for future programs that promote hand hygiene and other healthy behaviors.
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Interventions to improve hand hygiene compliance in patient care.
Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H
2010-09-08
Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the
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Matched cohort study of external cephalic version in women with previous cesarean delivery.
Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian
2017-07-01
To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.
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The tropical diabetic hand syndrome: a surgical perspective.
Nthumba, Peter; Cavadas, Pedro C; Landin, Luis
2013-01-01
Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with
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Interventions to improve patient hand hygiene: a systematic review.
Srigley, J A; Furness, C D; Gardam, M
2016-09-01
Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HCAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Ten studies were included, most of which were uncontrolled before-after studies (N=8). The majority of interventions (N=7) were multi-modal, with components similar to healthcare worker hand hygiene programmes, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HCAI outcomes and four studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. In conclusion, interventions to improve patient hand hygiene may reduce the incidence of HCAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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Madan, Ira; Parsons, Vaughan; Cookson, Barry; English, John; Lavender, Tina; McCrone, Paul; Murphy, Caroline; Ntani, Georgia; Rushton, Lesley; Smedley, Julia; Williams, Hywel; Wright, Alison; Coggon, David
2016-03-17
Hand dermatitis can be a serious health problem in healthcare workers. While a range of skin care strategies and policy directives have been developed in recent years to minimise the risk, their effectiveness and cost-effectiveness remain unclear. Evidence now suggests that psychological theory can facilitate behaviour change with respect to improved hand care practices. Therefore, we will test the hypothesis that a behavioural change intervention to improve hand care, based on the Theory of Planned Behaviour and implementation intentions, coupled with provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of hand dermatitis, when compared to standard care, among nurses working in the UK National Health Service (NHS) who are particularly at risk. Secondary aims will be to assess impacts on participants' beliefs and behaviour regarding hand care. In addition, we will assess the cost-effectiveness of the intervention in comparison with normal care. We will conduct a cluster randomised controlled trial at 35 NHS hospital trusts/health boards/universities, focussing on student nurses with a previous history of atopic disease or hand eczema and on nurses in intensive care units. Nurses at 'intervention-light' sites will be managed according to what would currently be regarded as best practice, with provision of an advice leaflet about optimal hand care to prevent hand dermatitis and encouragement to contact their occupational health (OH) department early if hand dermatitis occurs. Nurses at 'intervention-plus' sites will additionally receive a behavioural change programme (BCP) with on-going active reinforcement of its messages, and enhanced provision of moisturising cream. The impact of the interventions will be compared using information collected by questionnaires and through standardised photographs of the hands and wrists, collected at baseline and after 12 months follow-up. In addition, we will assemble relevant economic data
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NASA Technical Reports Server (NTRS)
Rosheim, Mark; Trechsel, Hans
1993-01-01
Anthropomorphic telerobotic hand contains actuators, joints, sensors, and complex wiring harnesses. Glove protects interior components of hand from dirt and damage. Imitates motions of human fingers and wrist in lifelike and dexterous way. Incorporates pitch/yaw joints in wrist and head knuckles. Hand modular; so fingers removable, interchangeable units. Feature simplifies servicing and maintenance, which must be done frequently in such complex mechanism.
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ERIC Educational Resources Information Center
Wallace, Carolyn S.
2004-01-01
A previous study (Wallace, Yang, Hand, & Hohenshell, 2001) indicated that seventh-grade life science students using a learning tool known as the Science Writing Heuristic (SWH) performed significantly better on conceptual test questions than did a control group. In the present study, the researcher studied more deeply how students utilized a…
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Lozano, Marina; Estalrrich, Almudena; Bondioli, Luca; Fiore, Ivana; Bermúdez de Castro, José-Maria; Arsuaga, Juan Luis; Carbonell, Eudald; Rosas, Antonio; Frayer, David W
2017-11-01
Fossil hominids often processed material held between their upper and lower teeth. Pulling with one hand and cutting with the other, they occasionally left impact cut marks on the lip (labial) surface of their incisors and canines. From these actions, it possible to determine the dominant hand used. The frequency of these oblique striations in an array of fossil hominins documents the typically modern pattern of 9 right- to 1 left-hander. This ratio among living Homo sapiens differs from that among chimpanzees and bonobos and more distant primate relatives. Together, all studies of living people affirm that dominant right-handedness is a uniquely modern human trait. The same pattern extends deep into our past. Thus far, the majority of inferred right-handed fossils come from Europe, but a single maxilla from a Homo habilis, OH-65, shows a predominance of right oblique scratches, thus extending right-handedness into the early Pleistocene of Africa. Other studies show right-handedness in more recent African, Chinese, and Levantine fossils, but the sample compiled for non-European fossil specimens remains small. Fossil specimens from Sima del los Huesos and a variety of European Neandertal sites are predominately right-handed. We argue the 9:1 handedness ratio in Neandertals and the earlier inhabitants of Europe constitutes evidence for a modern pattern of handedness well before the appearance of modern Homo sapiens. © 2017 Wiley Periodicals, Inc.
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Cutaneous reflexes in small muscles of the hand
Caccia, M. R.; McComas, A. J.; Upton, A. R. M.; Blogg, T.
1973-01-01
A study has been made of the responses of motoneurones innervating small muscles of the hand to electrical and mechanical stimulation of the skin. Both excitatory and inhibitory effects could be observed in the same muscle after a single stimulus to a given area of skin. The earliest excitatory and inhibitory responses are probably mediated by group III and the smaller group II afferent nerve fibres. A later inhibition results from activity in the larger group II fibres which are connected to cutaneous mechanoreceptors, especially those in the tips of the fingers and thumb. This late inhibitory reflex may operate through the fusimotor system. The possible roles of these reflexes are discussed in relation to previous investigations in man and the cat. PMID:4272546
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Soysal Tomruk, Melda; Ozalevli, Sevgi; Dizdar, Gorkem; Narin, Selnur; Kilinc, Oguz
2015-07-01
Hand dexterity is important for daily living activities and can be related to cognitive functions in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between cognitive dysfunction and hand dexterity in patients with COPD. 35 COPD patients and 36 healthy individuals were assessed. The Minnesota Hand Dexterity Test and Mini Mental State Examination (MMSE) were used for assessment of cognitive function and hand dexterity. Hand dexterity test scores and cognitive function of COPD patients' were significantly lower than the healthy group (p < 0.01). The MMSE scores were negatively correlated with hand dexterity scores in the COPD group (p < 0.05). There was a relationship between cognitive function and hand dexterity in the patients with COPD; however, hand dexterity did not alter according to hypoxemia severity. Hand dexterity which is important in daily living activities should be evaluated in greater detail with further studies in COPD patients.
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Exposure of the surgeon's hands to radiation during hand surgery procedures.
Żyluk, Andrzej; Puchalski, Piotr; Szlosser, Zbigniew; Dec, Paweł; Chrąchol, Joanna
2014-01-01
The objective of the study was to assess the time of exposure of the surgeon's hands to radiation and calculate of the equivalent dose absorbed during surgery of hand and wrist fractures with C-arm fluoroscope guidance. The necessary data specified by the objective of the study were acquired from operations of 287 patients with fractures of fingers, metacarpals, wrist bones and distal radius. 218 operations (78%) were percutaneous procedures and 60 (22%) were performed by open method. Data on the time of exposure and dose of radiation were acquired from the display of the fluoroscope, where they were automatically generated. These data were assigned to the individual patient, type of fracture, method of surgery and the operating surgeon. Fixations of distal radial fractures required longer times of radiation exposure (mean 61 sec.) than fractures of the wrist/metacarpals and fingers (38 and 32 sec., respectively), which was associated with absorption of significantly higher equivalent doses. Fixations of distal radial fractures by open method were associated with statistically significantly higher equivalent doses (0.41 mSv) than percutaneous procedures (0.3 mSv). Fixations of wrist and metacarpal bone fractures by open method were associated with lower equivalent doses (0.34 mSv) than percutaneous procedures (0.37 mSv),but the difference was not significant. Fixations of finger fractures by open method were associated with lower equivalent doses (0.13 mSv) than percutaneous procedures (0.24 mSv), the difference being statistically non-significant. Statistically significant differences in exposure time and equivalent doses were noted between 4 surgeons participating in the study, but no definitive relationship was found between these parameters and surgeons' employment time. 1. Hand surgery procedures under fluoroscopic guidance are associated with mild exposure of the surgeons' hands to radiation. 2. The equivalent dose was related to the type of fracture
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Birdwell, J Alexander; Hargrove, Levi J; Weir, Richard F ff; Kuiken, Todd A
2015-01-01
Fine-wire intramuscular electrodes were used to obtain electromyogram (EMG) signals from six extrinsic hand muscles associated with the thumb, index, and middle fingers. Subjects' EMG activity was used to control a virtual three-degree-of-freedom (DOF) hand as they conformed the hand to a sequence of hand postures testing two controllers: direct EMG control and pattern recognition control. Subjects tested two conditions using each controller: starting the hand from a predefined neutral posture before each new posture and starting the hand from the previous posture in the sequence. Subjects demonstrated their abilities to simultaneously, yet individually, move all three DOFs during the direct EMG control trials; however, results showed subjects did not often utilize this feature. Performance metrics such as failure rate and completion time showed no significant difference between the two controllers.
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Diwan, Vishal; Gustafsson, Charlotte; Rosales Klintz, Senia; Joshi, Sudhir Chandra; Joshi, Rita; Sharma, Megha; Shah, Harshada; Pathak, Ashish; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia
2016-01-01
To describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital. A rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India. The study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used. Out of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future. Self-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.
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Hand sensibility measures used by therapists.
Mielke, K; Novak, C B; Mackinnon, S E; Feely, C A
1996-03-01
Sensory evaluations are frequently used to assess patients with functional loss resulting from nerve injury. The results of these tests are routinely utilized by hand surgeons as an indication for conservative management or surgical intervention in the evaluation of surgical outcome and in the determination of disability ratings. Reports in the literature regarding specific tests for sensibility show variation in their application. The purpose of this study was to evaluate which tests are used to evaluate hand sensibility and the techniques of application currently used by hand therapists. Two hundred members of the American Society of Hand Therapists were randomly selected and a survey was sent to these members. The results of this study identify the need to develop standardized protocols for sensory evaluations and the need for therapists to follow the standardized methods for administration of moving and static two-point discrimination, and Semmes-Weinstein monofilaments, if comparisons of results between centers are to be meaningful.
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Crossing the Hands Increases Illusory Self-Touch
Pozeg, Polona; Rognini, Giulio; Salomon, Roy; Blanke, Olaf
2014-01-01
Manipulation of hand posture, such as crossing the hands, has been frequently used to study how the body and its immediately surrounding space are represented in the brain. Abundant data show that crossed arms posture impairs remapping of tactile stimuli from somatotopic to external space reference frame and deteriorates performance on several tactile processing tasks. Here we investigated how impaired tactile remapping affects the illusory self-touch, induced by the non-visual variant of the rubber hand illusion (RHI) paradigm. In this paradigm blindfolded participants (Experiment 1) had their hands either uncrossed or crossed over the body midline. The strength of illusory self-touch was measured with questionnaire ratings and proprioceptive drift. Our results showed that, during synchronous tactile stimulation, the strength of illusory self-touch increased when hands were crossed compared to the uncrossed posture. Follow-up experiments showed that the increase in illusion strength was not related to unfamiliar hand position (Experiment 2) and that it was equally strengthened regardless of where in the peripersonal space the hands were crossed (Experiment 3). However, while the boosting effect of crossing the hands was evident from subjective ratings, the proprioceptive drift was not modulated by crossed posture. Finally, in contrast to the illusion increase in the non-visual RHI, the crossed hand postures did not alter illusory ownership or proprioceptive drift in the classical, visuo-tactile version of RHI (Experiment 4). We argue that the increase in illusory self-touch is related to misalignment of somatotopic and external reference frames and consequently inadequate tactile-proprioceptive integration, leading to re-weighting of the tactile and proprioceptive signals.The present study not only shows that illusory self-touch can be induced by crossing the hands, but importantly, that this posture is associated with a stronger illusion. PMID:24699795
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Vainio, L; Alén, H; Hiltunen, S; Lehikoinen, K; Lindbäck, H; Patrikainen, A; Paavilainen, P
2013-02-01
Previous research has shown that subliminally presented arrows produce negative priming effect in which responses are performed slower when primes and targets are calling for the same response than different response. This phenomenon has been attributed to self-inhibitory mechanisms of response processes. Similar negative priming was recently observed when participants responded to the direction of the target arrow and the prime was a briefly displayed image of a left or right hand. Responses were made slower when the left-right identity of the viewed hand was compatible with the responding hand. This was suggested to demonstrate that the proposed motor self-inhibition is a general and basic functional principle in manual control processes. However, the behavioural evidence observed in that study was not capable of showing whether the negative priming associated with a briefly displayed hand could reflect other inhibitory processes than the motor self-inhibition. The present study uses an electrophysiological indicator of automatic response priming, the lateralized readiness potential (LRP), to investigate whether the negative priming triggered by the identity of the viewed hand does indeed reflect motor self-inhibition processes. The LRP revealed a pattern of motor activation that was in line with the motor self-inhibition hypothesis. Thus, the finding supports the view that the self-inhibition mechanisms are not restricted to arrow stimuli that are presented subliminally. Rather, they are general sensorimotor mechanisms that operate in planning and control of manual actions. Copyright © 2012 Elsevier Ltd. All rights reserved.
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The fraction of total hand surface area involved in young children's outdoor hand-to-object contacts
DOE Office of Scientific and Technical Information (OSTI.GOV)
AuYeung, Willa; Canales, Robert A.; Leckie, James O.
2008-11-15
Information on the fraction of total hand surface area touching a contaminated object is necessary in accurately estimating contaminant (e.g., pesticides, pathogens) loadings onto the hands during hand-to-object contacts. While several existing physical-stochastic human exposure models require such surface area data to estimate dermal and non-dietary ingestion exposure, there are very limited data sets. This paper provides statistical distributions of fractional surface areas (FSAs) for children's outdoor hand contacts. These distributions were constructed by combining information collected from two distinct studies exploring children's activity patterns and quantifying hand contact surface area. Results show that for outdoor contacts with 'All Objects',more » a range of 0.13-0.27 captured median FSAs, while a range of 0.12-0.24 captured time-weighted FSAs. Overall, an FSA of 0.31 captured 80-100% of FSAs involved in each child's outdoor hand contacts, depending upon the object of interest. These values are much lower than the often conservative assumptions of up to 1 (i.e., the entire hand) that researchers currently make regarding FSAs involved in indoor and outdoor contacts [USEPA, 1997. Standard operating procedures (SOPs) for residential exposure assessments. Contract no. 68-W6-0030. < (http://www.epa.gov/pesticides/trac/science/trac6a05.pdf)>].« less
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The effect of hand position on perceived finger orientation in left- and right-handers.
Fraser, Lindsey E; Harris, Laurence R
2017-12-01
In the absence of visual feedback, the perceived orientation of the fingers is systematically biased. In right-handers these biases are asymmetrical between the left and right hands in the horizontal plane and may reflect common functional postures for the two hands. Here we compared finger orientation perception in right- and left-handed participants for both hands, across various hand positions in the horizontal plane. Participants rotated a white line on a screen optically superimposed over their hand to indicate the perceived position of the finger that was rotated to one of seven orientations with the hand either aligned with the body midline, aligned with the shoulder, or displaced by twice the shoulder-to-midline distance from the midline. We replicated the asymmetric pattern of biases previously reported in right-handed participants (left hand biased towards an orientation ~30° inward, right hand ~10° inward). However, no such asymmetry was found for left-handers, suggesting left-handers may use different strategies when mapping proprioception to body or space coordinates and/or have less specialization of function between the hands. Both groups' responses rotated further outward as distance of the hand from the body midline increased, consistent with other research showing spatial orientation estimates diverge outward in the periphery. Finally, for right-handers, precision of responses was best when the hand was aligned with the shoulder compared to the other two conditions. These results highlight the unique role of hand dominance and hand position in perception of finger orientation, and provide insight into the proprioceptive position sense of the upper limbs.
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ERIC Educational Resources Information Center
Wilson, Josie; McLaughlin, T. F.; Derby, K. Mark; Conley, Diane
2013-01-01
The purpose of this study was to increase the formation of the pre-handwriting skill of imitating lines and circles with two 2-year-old preschool students using a hand-over-hand prompting procedure. Both students attended a preschool special education classroom in a rural school district. During baseline, line and circle imitation for both…
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Vindenes, Hilde K; Svanes, Cecilie; Lygre, Stein H L; Hollund, Bjørg-Eli; Langhammer, Arnulf; Bertelsen, Randi J
2017-10-01
Chemical exposures at work and at home may cause hand eczema. However, this has been scarcely described for Norway. To investigate the prevalence of, and occupational risk factors for, hand eczema in Norway. Among 50 805 respondents (aged ≥20 years) to the third Nord-Trøndelag Health Study (HUNT3), 5757 persons reported ever having hand eczema, and 4206 answered a hand eczema questionnaire. The lifetime prevalences of hand eczema were 8.4% in men and 13.8% in women (p < 0.001), with onset at age ≤10 years in 24% (men) and 20% (women), and onset at age ≥30 years in 37% (men) and 25% (women) (p < 0.001). Work-related hand eczema affected 4.8% of the population, and was most frequently associated with health/social work (29%) and occupational cleaning (20%) in women, and with farming (26%) and industrial occupations (27%) in men. Cleaning detergents (75%) and other chemicals (36%) were the most common exacerbating factors. The prevalence of hand eczema was 11.3%, and that of work-related hand eczema was 4.8%. Hand eczema was more common in women than in men, but with a later onset in men. Cleaning detergents were the most common aggravating factors. A large proportion of the Nord-Trøndelag population is employed in farming, providing the possibility to identify farming as an important risk factor for hand eczema. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Kurth, Florian; Mayer, Emeran A; Toga, Arthur W; Thompson, Paul M; Luders, Eileen
2013-09-01
Numerous studies suggest that interhemispheric inhibition-relayed via the corpus callosum-plays an important role in unilateral hand motions. Interestingly, transcallosal inhibition appears to be indicative of a strong laterality effect, where generally the dominant hemisphere exerts inhibition on the nondominant one. These effects have been largely identified through functional studies in adult populations, but links between motor performance and callosal structure (especially during sensitive periods of neurodevelopment) remain largely unknown. We therefore investigated correlations between Purdue Pegboard performance (a test of motor function) and local callosal thickness in 170 right-handed children and adolescents (mean age: 11.5 ± 3.4 years; range, 6-17 years). Better task performance with the right (dominant) hand was associated with greater callosal thickness in isthmus and posterior midbody. Task performance using both hands yielded smaller and less significant correlations in the same regions, while task performance using the left (nondominant) hand showed no significant correlations with callosal thickness. There were no significant interactions with age and sex. These links between motor performance and callosal structure may constitute the neural correlate of interhemispheric inhibition, which is thought to be necessary for fast and complex unilateral motions and to be biased towards the dominant hand. Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.
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Job Burnout Reduces Hand Hygiene Compliance Among Nursing Staff.
Manomenidis, Georgios; Panagopoulou, Efharis; Montgomery, Anthony
2017-10-13
Health professional burnout has been associated with suboptimal care and reduced patient safety. However, the extent to which burnout influences hand hygiene compliance among health professionals has yet to be explored. The aim of the study was to examine whether job burnout reduces hand washing compliance among nursing staff. A diary study was conducted. Forty registered nurses working in a general city hospital in Thessaloniki, Greece, completed a questionnaire, while they were monitored for hand hygiene compliance following the World Health Organization protocol for hand hygiene assessment. Burnout was measured using validated items from the Maslach Burnout Inventory. Data were collected from September to October 2015. Multiple regression analysis showed that controlling for years in practice, burnout was negatively associated with hand hygiene compliance (R = 0.322, F(3,36) = 5.704, P < 0.01). Nurses reporting higher levels of burnout were less likely to comply with hand hygiene opportunities (b = - 3.72, 95% confidence interval = -5.94 to -1.51). This study showed that burnout contributes to suboptimal care by reducing compliance to hand hygiene among nurses. Given the crucial role of hand hygiene compliance for the prevention of in-hospital infections, this study highlights the need for interventions targeting the prevention of burnout among nursing staff.
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Shin, David H; Bohn, Deborah K; Agel, Julie; Lindstrom, Katy A; Cronquist, Sara M; Van Heest, Ann E
2015-05-01
To measure and compare hand function for children with normal hand development, congenital hand differences (CHD), and neuromuscular disease (NMD) using a function test with touch screen technology designed as an iPhone application. We measured touch screen hand function in 201 children including 113 with normal hand formation, 43 with CHD, and 45 with NMD. The touch screen test was developed on the iOS platform using an Apple iPhone 4. We measured 4 tasks: touching dots on a 3 × 4 grid, dragging shapes, use of the touch screen camera, and typing a line of text. The test takes 60 to 120 seconds and includes a pretest to familiarize the subject with the format. Each task is timed independently and the overall time is recorded. Children with normal hand development took less time to complete all 4 subtests with increasing age. When comparing children with normal hand development with those with CHD or NMD, in children aged less than 5 years we saw minimal differences; those aged 5 to 6 years with CHD took significantly longer total time; those aged 7 to 8 years with NMD took significantly longer total time; those aged 9 to 11 years with CHD took significantly longer total time; and those aged 12 years and older with NMD took significantly longer total time. Touch screen technology has becoming increasingly relevant to hand function in modern society. This study provides standardized age norms and shows that our test discriminates between normal hand development and that in children with CHD or NMD. Diagnostic III. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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Left-handed and right-handed U(1) gauge symmetry
NASA Astrophysics Data System (ADS)
Nomura, Takaaki; Okada, Hiroshi
2018-01-01
We propose a model with the left-handed and right-handed continuous Abelian gauge symmetry; U(1) L × U(1) R . Then three right-handed neutrinos are naturally required to achieve U(1) R anomaly cancellations, while several mirror fermions are also needed to do U(1) L anomaly cancellations. Then we formulate the model, and discuss its testability of the new gauge interactions at collider physics such as the large hadron collider (LHC) and the international linear collider (ILC). In particular, we can investigate chiral structure of the interactions by the analysis of forward-backward asymmetry based on polarized beam at the ILC.
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Ostolaza, M; Abudarham, J; Dilascio, S; Drault-Boedo, E; Gallo, S; Garcete, A; Kramer, M; Maiaru, M; Mendelevich, A; Modica, M; Peralta, F; Sanchez-Correa, C
2017-04-01
In clinical practice it is important to be able to assess the function of the upper limb of the patient who has suffered a stroke. There is currently no systemic review that could identify assessment tools for the 'fine use of the hand' and 'use of both hand and arm'. Primary, to identify observational tools which can assess the fine use of the hand and the use of both hand and arm in patients with stroke sequels. Secondary, to analyze the bias risk in the included articles, describing and categorizing the clinical utility, validity and reliability. A search was carried in Medline, LILACS, SciELO and Open Grey, which included articles published until October 2015. Studies that validate assessing tools of the upper limb in subjects with a stroke sequel which evaluate the fine use of the hand and the use of both hand and arm were included. Eleven tools in evaluate observational haven been selected, which assess the fine use of the hand and the use of hand and arm. In every case both validity and reliability have been reported, but clinical utility has been less considered for assessment. The studies that researched these tools showed a high risk of bias in their development. ARAT-19 showed a lower bias risk, but when it has to do with applicability and the reference trial is taken into account, the level of concern is high.
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Analysis of Hand and Wrist Postural Synergies in Tolerance Grasping of Various Objects
Liu, Yuan; Jiang, Li; Yang, Dapeng; Liu, Hong
2016-01-01
Human can successfully grasp various objects in different acceptable relative positions between human hand and objects. This grasp functionality can be described as the grasp tolerance of human hand, which is a significant functionality of human grasp. To understand the motor control of human hand completely, an analysis of hand and wrist postural synergies in tolerance grasping of various objects is needed. Ten healthy right-handed subjects were asked to perform the tolerance grasping with right hand using 6 objects of different shapes, sizes and relative positions between human hand and objects. Subjects were wearing CyberGlove attaching motion tracker on right hand, allowing a measurement of the hand and wrist postures. Correlation analysis of joints and inter-joint/inter-finger modules were carried on to explore the coordination between joints or modules. As the correlation between hand and wrist module is not obvious in tolerance grasping, individual analysis of wrist synergies would be more practical. In this case, postural synergies of hand and wrist were then presented separately through principal component analysis (PCA), expressed through the principal component (PC) information transmitted ratio, PC elements distribution and reconstructed angle error of joints. Results on correlation comparison of different module movements can be well explained by the influence factors of the joint movement correlation. Moreover, correlation analysis of joints and modules showed the wrist module had the lowest correlation among all inter-finger and inter-joint modules. Hand and wrist postures were both sufficient to be described by a few principal components. In terms of the PC elements distribution of hand postures, compared with previous investigations, there was a greater proportion of movement in the thumb joints especially the interphalangeal (IP) and opposition rotation (ROT) joint. The research could serve to a complete understanding of hand grasp, and the design
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Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria
2017-01-01
Background Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. Method This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Results Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. Conclusions A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies. PMID:28614403
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Hand hygiene monitoring technology: protocol for a systematic review.
Srigley, Jocelyn A; Lightfoot, David; Fernie, Geoff; Gardam, Michael; Muller, Matthew P
2013-11-12
Healthcare worker hand hygiene is thought to be one of the most important strategies to prevent healthcare-associated infections, but compliance is generally poor. Hand hygiene improvement interventions must include audits of compliance (almost always with feedback), which are most often done by direct observation - a method that is expensive, subjective, and prone to bias. New technologies, including electronic and video hand hygiene monitoring systems, have the potential to provide continuous and objective monitoring of hand hygiene, regular feedback, and for some systems, real-time reminders. We propose a systematic review of the evidence supporting the effectiveness of these systems. The primary objective is to determine whether hand hygiene monitoring systems yield sustainable improvements in hand hygiene compliance when compared to usual care. MEDLINE, EMBASE, CINAHL, and other relevant databases will be searched for randomized control studies and quasi-experimental studies evaluating a video or electronic hand hygiene monitoring system. A standard data collection form will be used to abstract relevant information from included studies. Bias will be assessed using the Cochrane Effective Practice and Organization of Care Group Risk of Bias Assessment Tool. Studies will be reviewed independently by two reviewers, with disputes resolved by a third reviewer. The primary outcome is directly observed hand hygiene compliance. Secondary outcomes include healthcare-associated infection incidence and improvements in hand hygiene compliance as measured by alternative metrics. Results will be qualitatively summarized with comparisons made between study quality, the measured outcome, and study-specific factors that may be expected to affect outcome (for example, study duration, frequency of feedback, use of real-time reminders). Meta-analysis will be performed if there is more than one study of similar systems with comparable outcome definitions. Electronic and video
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Shim, Jae Kun; Karol, Sohit; Hsu, Jeffrey; de Oliveira, Marcio Alves
2008-04-01
The aim of this study was to investigate the contralateral motor overflow in children during single-finger and multi-finger maximum force production tasks. Forty-five right handed children, 5-11 years of age produced maximum isometric pressing force in flexion or extension with single fingers or all four fingers of their right hand. The forces produced by individual fingers of the right and left hands were recorded and analyzed in four-dimensional finger force vector space. The results showed that increases in task (right) hand finger forces were linearly associated with non-task (left) hand finger forces. The ratio of the non-task hand finger force magnitude to the corresponding task hand finger force magnitude, termed motor overflow magnitude (MOM), was greater in extension than flexion. The index finger flexion task showed the smallest MOM values. The similarity between the directions of task hand and non-task hand finger force vectors in four-dimensional finger force vector space, termed motor overflow direction (MOD), was the greatest for index and smallest for little finger tasks. MOM of a four-finger task was greater than the sum of MOMs of single-finger tasks, and this phenomenon was termed motor overflow surplus. Contrary to previous studies, no single-finger or four-finger tasks showed significant changes of MOM or MOD with the age of children. We conclude that the contralateral motor overflow in children during finger maximum force production tasks is dependent upon the task fingers and the magnitude and direction of task finger forces.
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Che Daud, Ahmad Zamir; Yau, Matthew K; Barnett, Fiona; Judd, Jenni
2016-01-01
In a previous study consensus was sought from Malaysian occupational therapists of occupation-based intervention (OBI) that was perceived as a means and an end. Occupation as a means refers to occupational and purposeful tasks as a therapeutic agent while occupation as an end refers to occupation as an outcome of intervention. The purpose of this follow-up study was to describe the occupational therapists' experiences of providing OBI in hand injury rehabilitation in Malaysia. Sixteen occupational therapists with more than five years of experience in hand rehabilitation were individually interviewed on their experiences of using OBI in practice. Data were thematically analysed using interpretative phenomenological analysis. Definition of "Occupation as a means", and "Occupation as an end" was broadened after data analysis of interviews to include two new themes: "Rewarding yet challenging" and "Making OBI a reality". Occupational therapists had positive experiences with OBI and perceived that occupation as a means and an end can be merged into a single therapy session when the occupational therapists use an occupation that is therapeutic. Although occupation as a means and as an end have different purposes, when the ultimate goal is to enhance the clients' maximum level of functioning both can be used for successful rehabilitation of hand injuries.
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The challenge of diagnosing focal hand dystonia in musicians
Rosset-Llobet, J.; Candia, V.; Molas, S. Fàbregas i; Dolors Rosinés i Cubells, D.; Pascual-Leone, A.
2012-01-01
Background and purpose To most clinicians, medical problems in musicians, particularly those concerning focal hand dystonia, constitute an unfamiliar domain difficult to manage. The latter can importantly influence diagnostics and the course of treatment. The purpose of this study was to enlighten the issue and to identify possible problems in diagnosing musicians’ cramp within the Spanish medical community. Methods We used a brief questions’ catalog and clinical histories of 665 musicians seen at our clinic for performing artists. We analyzed patients’ diagnosis records in 87 cases of focal hand dystonia (13.1%). In so doing, we surveyed previous diagnoses and diverse treatments prescriptions prior to referral to our clinic. Results Referrals came primarily from orthopaedists and neurologists. The 52.9% arrived at our clinic without a diagnosis or a suspicion of suffering from focal dystonia. The most frequently attempted diagnoses other than musicians’ dystonia included nerve compression, tendonitis and trigger fingers. Commonly prescribed treatments included rest, various surgical procedures, physiotherapy and oral anti-inflammatory medication. Conclusions This data depicts the diagnostic challenges of medical professionals may encounter when confronted with musician’s focal dystonia. PMID:19473363
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Pulling boat hands: a unique dermatosis from coastal New England.
Toback, A C; Korson, R; Krusinski, P A
1985-04-01
We report a previously unrecognized hand dermatosis, pulling boat hands (PBH), occurring in thirteen participants at the Outward Bound School on Hurricane Island, Maine. Painful and pruritic macules, plaques, and vesicles developed exclusively while subjects lived aboard a pulling boat, the school's open rowing/sailing craft. Nine of those affected were women and eight had Raynaud's phenomenon or vasospasm. These subjects experienced thirty episodes of PBH during May through October, 1978 to 1982. Histopathology revealed a superficial and deep lymphohistiocytic perivascular infiltrate, subepidermal blister formation, red blood cell extravasation, and dermal capillary thrombosis compatible with cold injury to the skin. All patients experienced prolonged percussion to their hands while rowing as well as a continuous environmental exposure to cold air, wind, humidity, ocean spume, and precipitation. These clinical, histopathologic, and environmental findings suggest a unique syndrome that combines the vascular effects of mechanical trauma from rowing with those of nonfreezing cold injury.
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Inaida, S; Shobugawa, Y; Matsuno, S; Saito, R; Suzuki, H
2016-09-01
Norovirus (NoV) epidemics normally peak in December in Japan; however, the peak in the 2009-2010 season was delayed until the fourth week of January 2010. We suspected intensive hand hygiene that was conducted for a previous pandemic influenza in 2009 as the cause of this delay. We analysed the NoV epidemic trend, based on national surveillance data, and its associations with monthly output data for hand hygiene products, including alcohol-based skin antiseptics and hand soap. The delayed peak in the NoV incidence in the 2009-2010 season had the lowest number of recorded cases of the five seasons studied (2006-2007 to 2010-2011). GII.4 was the most commonly occurring genotype. The monthly relative risk of NoV and monthly output of both alcohol-based skin antiseptics and hand soap were significantly and negatively correlated. Our findings suggest an association between hand hygiene using these products and prevention of NoV transmission.
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Tang, Rixin; Whitwell, Robert L; Goodale, Melvyn A
2014-01-01
Previous research (Whitwell et al. in Exp Brain Res 188:603-611, 2008; Whitwell and Goodale in Exp Brain Res 194:619-629, 2009) has shown that trial history, but not anticipatory knowledge about the presence or absence of visual feedback on an upcoming trial, plays a vital role in determining how that feedback is exploited when grasping with the right hand. Nothing is known about how the non-dominant left hand behaves under the same feedback regimens. In present study, therefore, we compared peak grip aperture (PGA) for left- and right-hand grasps executed with and without visual feedback (i.e., closed- vs. open-loop conditions) in right-handed individuals under three different trial schedules: the feedback conditions were blocked separately, they were randomly interleaved, or they were alternated. When feedback conditions were blocked, the PGA was much larger for open-loop trials as compared to closed-loop trials, although this difference was more pronounced for right-hand grasps than left-hand grasps. Like Whitwell et al., we found that mixing open- and closed-loop trials together, compared to blocking them separately, homogenized the PGA for open- and closed-loop grasping in the right hand (i.e., the PGAs became smaller on open-loop trials and larger on closed-loop trials). In addition, the PGAs for right-hand grasps were entirely determined by trial history and not by knowledge of whether or not visual feedback would be available on an upcoming trial. In contrast to grasps made with the right hand, grasps made by the left hand were affected both by trial history and by anticipatory knowledge of the upcoming visual feedback condition. But these effects were observed only on closed-loop trials, i.e., the PGAs of grasps made with the left hand on closed-loop trials were smaller when participants could anticipate the availability of feedback on an upcoming trial (alternating trials) than when they could not (randomized trials). In contrast, grasps made with the
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Motor cortex hand area and speech: implications for the development of language.
Meister, Ingo Gerrit; Boroojerdi, Babak; Foltys, Henrik; Sparing, Roland; Huber, Walter; Töpper, Rudolf
2003-01-01
Recently a growing body of evidence has suggested that a functional link exists between the hand motor area of the language dominant hemisphere and the regions subserving language processing. We examined the excitability of the hand motor area and the leg motor area during reading aloud and during non-verbal oral movements using transcranial magnetic stimulation (TMS). During reading aloud, but not before or afterwards, excitability was increased in the hand motor area of the dominant hemisphere. This reading effect was found to be independent of the duration of speech. No such effect could be found in the contralateral hemisphere. The excitability of the leg area of the motor cortex remained unchanged during reading aloud. The excitability during non-verbal oral movements was slightly increased in both hemispheres. Our results are consistent with previous findings and may indicate a specific functional connection between the hand motor area and the cortical language network.
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Ginn, T Adam; Smith, Adam M; Snyder, Jon R; Koman, L Andrew; Smith, Beth P; Rushing, Julia
2005-07-01
Repetitive trauma to the hand is a concern for baseball players. The present study investigated the effects of repetitive trauma and the prevalence of microvascular pathological changes in the hands of minor league professional baseball players. In contrast to previous investigators, we documented the presence of abnormalities in younger, asymptomatic individuals. Thirty-six baseball players on active minor league rosters underwent a history and physical examination of both hands as well as additional specialized tests, including Doppler ultrasound, a timed Allen test, determination of digital brachial pressure indices, and ring sizing of fingers. Data were compared between gloved hands and throwing hands, hitters and nonhitters, and players at four different positions (catcher [nine subjects], outfielder [seven subjects], infielder [five subjects], and pitcher [fifteen subjects]). Digital brachial indices in the ring fingers of the gloved (p < 0.05) and throwing hands (p < 0.02) of catchers were significantly diminished compared with those in all other players. Doppler testing showed a significantly greater prevalence of abnormal flow in the ulnar artery at Guyon's canal when catchers were compared with other position players (p < 0.01). Doppler abnormalities were significantly more common in the gloved hand compared with the throwing hand (p < 0.05). Seven of nine catchers (and only catchers) were found to have index finger hypertrophy (average change, two ring sizes; p < 0.01); the hypertrophy occurred at the proximal phalanx and the proximal interphalangeal joint of the gloved hand. Catchers had a significantly higher prevalence of subjective hand symptoms (specifically, weakness in the gloved hand) compared with pitchers and infielders/outfielders (44% compared with 7% and 17%, respectively; p < 0.05). Microvascular changes are present in the hands of otherwise healthy professional baseball players in all positions, with a significantly higher prevalence in
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Eye Tracking of Occluded Self-Moved Targets: Role of Haptic Feedback and Hand-Target Dynamics.
Danion, Frederic; Mathew, James; Flanagan, J Randall
2017-01-01
Previous studies on smooth pursuit eye movements have shown that humans can continue to track the position of their hand, or a target controlled by the hand, after it is occluded, thereby demonstrating that arm motor commands contribute to the prediction of target motion driving pursuit eye movements. Here, we investigated this predictive mechanism by manipulating both the complexity of the hand-target mapping and the provision of haptic feedback. Two hand-target mappings were used, either a rigid (simple) one in which hand and target motion matched perfectly or a nonrigid (complex) one in which the target behaved as a mass attached to the hand by means of a spring. Target animation was obtained by asking participants to oscillate a lightweight robotic device that provided (or not) haptic feedback consistent with the target dynamics. Results showed that as long as 7 s after target occlusion, smooth pursuit continued to be the main contributor to total eye displacement (∼60%). However, the accuracy of eye-tracking varied substantially across experimental conditions. In general, eye-tracking was less accurate under the nonrigid mapping, as reflected by higher positional and velocity errors. Interestingly, haptic feedback helped to reduce the detrimental effects of target occlusion when participants used the nonrigid mapping, but not when they used the rigid one. Overall, we conclude that the ability to maintain smooth pursuit in the absence of visual information can extend to complex hand-target mappings, but the provision of haptic feedback is critical for the maintenance of accurate eye-tracking performance.
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Eye Tracking of Occluded Self-Moved Targets: Role of Haptic Feedback and Hand-Target Dynamics
Mathew, James
2017-01-01
Abstract Previous studies on smooth pursuit eye movements have shown that humans can continue to track the position of their hand, or a target controlled by the hand, after it is occluded, thereby demonstrating that arm motor commands contribute to the prediction of target motion driving pursuit eye movements. Here, we investigated this predictive mechanism by manipulating both the complexity of the hand-target mapping and the provision of haptic feedback. Two hand-target mappings were used, either a rigid (simple) one in which hand and target motion matched perfectly or a nonrigid (complex) one in which the target behaved as a mass attached to the hand by means of a spring. Target animation was obtained by asking participants to oscillate a lightweight robotic device that provided (or not) haptic feedback consistent with the target dynamics. Results showed that as long as 7 s after target occlusion, smooth pursuit continued to be the main contributor to total eye displacement (∼60%). However, the accuracy of eye-tracking varied substantially across experimental conditions. In general, eye-tracking was less accurate under the nonrigid mapping, as reflected by higher positional and velocity errors. Interestingly, haptic feedback helped to reduce the detrimental effects of target occlusion when participants used the nonrigid mapping, but not when they used the rigid one. Overall, we conclude that the ability to maintain smooth pursuit in the absence of visual information can extend to complex hand-target mappings, but the provision of haptic feedback is critical for the maintenance of accurate eye-tracking performance. PMID:28680964
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Hand pressures during arboreal locomotion in captive bonobos (Pan paniscus).
Samuel, Diana S; Nauwelaerts, Sandra; Stevens, Jeroen M G; Kivell, Tracy L
2018-04-19
Evolution of the human hand has undergone a transition from use during locomotion to use primarily for manipulation. Previous comparative morphological and biomechanical studies have focused on potential changes in manipulative abilities during human hand evolution, but few have focused on functional signals for arboreal locomotion. Here, we provide this comparative context though the first analysis of hand loading in captive bonobos during arboreal locomotion. We quantify pressure experienced by the fingers, palm and thumb in bonobos during vertical locomotion, suspension and arboreal knuckle-walking. The results show that pressure experienced by the fingers is significantly higher during knuckle-walking compared with similar pressures experienced by the fingers and palm during suspensory and vertical locomotion. Peak pressure is most often experienced at or around the third digit in all locomotor modes. Pressure quantified for the thumb is either very low or absent, despite the thumb making contact with the substrate during all suspensory and vertical locomotor trials. Unlike chimpanzees, bonobos do not show a rolling pattern of digit contact with the substrate during arboreal knuckle-walking - instead, we found that digits 3 and 4 typically touch down first and digit 5 almost always made contact with the substrate. These results have implications for interpreting extant and fossilized hand morphology; we expect bonobo (and chimpanzee) bony morphology to primarily reflect the biomechanical loading of knuckle-walking, while functional signals for arboreal locomotion in fossil hominins are most likely to appear in the fingers, particularly digit 3, and least likely to appear in the morphology of the thumb. © 2018. Published by The Company of Biologists Ltd.
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2014-01-01
Background Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance. Results Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times. Conclusions Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a
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Anderson, Maureen E C; Sargeant, Jan M; Weese, J Scott
2014-05-07
Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance. Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times. Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a component of a multimodal hand
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Digit ratio (2D:4D) and hand preference for writing in the BBC Internet Study.
Manning, J T; Peters, M
2009-09-01
The ratio of the length of the second to the fourth digit (2D:4D) may be negatively correlated with prenatal testosterone. Hand preference has been linked with prenatal testosterone and 2D:4D. Here we show that 2D:4D is associated with hand preference for writing in a large internet sample (n>170,000) in which participants self-reported their finger lengths. We replicated a significant association between right 2D:4D and writing hand preference (low right 2D:4D associated with left hand preference) as well as a significant correlation between writing hand preference and the difference between left and right 2D:4D or Dr-l (low Dr-l associated with left hand preference). A new significant correlation between left 2D:4D and writing hand preference was also shown (high left 2D:4D associated with left hand preference). There was a clear interaction between writing hand preference and 2D:4D: The left 2D:4D was significantly larger than the right 2D:4D in male and female left-handed writers, and the right hand 2D:4D was significantly larger than the left hand 2D:4D in male and female right-handed writers.
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Koch Hansen, Lars; Mohammed, Anna; Pedersen, Magnus; Folkestad, Lars; Brodersen, Jacob; Hey, Thomas; Lyhne Christensen, Nicolaj; Carter-Storch, Rasmus; Bendix, Kristoffer; Hansen, Morten R; Brabrand, Mikkel
2016-12-01
Reducing hands-off time during cardiopulmonary resuscitation (CPR) is believed to increase survival after cardiac arrests because of the sustaining of organ perfusion. The aim of our study was to investigate whether charging the defibrillator before rhythm analyses and shock delivery significantly reduced hands-off time compared with the European Resuscitation Council (ERC) 2010 CPR guideline algorithm in full-scale cardiac arrest scenarios. The study was designed as a full-scale cardiac arrest simulation study including administration of drugs. Participants were randomized into using the Stop-Only-While-Shocking (SOWS) algorithm or the ERC2010 algorithm. In SOWS, chest compressions were only interrupted for a post-charging rhythm analysis and immediate shock delivery. A Resusci Anne HLR-D manikin and a LIFEPACK 20 defibrillator were used. The manikin recorded time and chest compressions. Sample size was calculated with an α of 0.05 and 80% power showed that we should test four scenarios with each algorithm. Twenty-nine physicians participated in 11 scenarios. Hands-off time was significantly reduced 17% using the SOWS algorithm compared with ERC2010 [22.1% (SD 2.3) hands-off time vs. 26.6% (SD 4.8); P<0.05]. In full-scale cardiac arrest simulations, a minor change consisting of charging the defibrillator before rhythm check reduces hands-off time by 17% compared with ERC2010 guidelines.
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Eye-hand preference in schizophrenia: sex differences and significance for hand function.
Liu, Yi-Chia; Yang, Yen Kuang; Lee, I Hui; Lin, Keh-Chung; Jeffries, Keith J; Lee, Li-Ching
2004-06-01
Hand preference and eye dominance were investigated in 73 (30 women, 43 men) schizophrenic patients and 71 (30 women, 41 men) healthy controls. There were significantly more schizophrenic patients and normal controls who were significantly right-hand dominant. However, schizophrenic patients showed a significant excess of left-eye dominance relative to controls (65.8% vs 29.6%; Odds Ratio= 4.75, p< .001). In addition, female schizophrenic patients showed a higher rate of nonright (either left or inconsistent) eye dominance (80%) than male schizophrenic patients (55.8%) and controls (33.3%). Analysis of hand performance on the Purdue Pegboard Test indicated that schizophrenic patients who showed crossed eye-hand dominance scored higher than did patients without crossed eye-hand dominance.
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Hand Washing Induces a Clean Slate Effect in Moral Judgments: A Pupillometry and Eye-Tracking Study
Kaspar, Kai; Krapp, Vanessa; König, Peter
2015-01-01
Physical cleansing is commonly understood to protect us against physical contamination. However, recent studies showed additional effects on moral judgments. Under the heading of the “Macbeth effect” direct links between bodily cleansing and one’s own moral purity have been demonstrated. Here we investigate (1) how moral judgments develop over time and how they are altered by hand washing, (2) whether changes in moral judgments can be explained by altered information sampling from the environment, and (3) whether hand washing affects emotional arousal. Using a pre-post control group design, we found that morality ratings of morally good and bad scenes acquired more extreme values in the control group over time, an effect that was fully counteracted by intermediate hand washing. This result supports the notion of a clean slate effect by hand washing. Thereby, eye-tracking data did not uncover differences in eye movement behavior that may explain differences in moral judgments. Thus, the clean slate effect is not due to altered information sampling from the environment. Finally, compared to the control group, pupil diameter decreased after hand washing, thus demonstrating a direct physiological effect. The results shed light on the physiological mechanisms behind this type of embodiment phenomenon. PMID:25994083
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Surgical hand disinfection with a propanol-based hand rub: equivalence of shorter application times.
Kampf, G; Ostermeyer, C; Heeg, P
2005-04-01
The aim of this study was to determine the efficacy of a propanol-based hand rub at application times shorter than 3 min. The bacterial pre-value was obtained from the finger tips (prEN 12791). Subjects treated their hands with the reference procedure (n-propanol, 60%) for 3 min or the product (crossover design). Sterillium was applied for 3, 2, 1.5 and 1 min. Four other preparations were tested for 1 min. Post-values (immediate effect) were taken from one hand, and the other hand was gloved for 3h. After the gloves were removed, the second post-value was taken (sustained effect). Sterillium was more effective than the reference procedure at 3, 2 and 1.5 min (immediate and sustained effect). The immediate effect after 1 min was significantly lower [mean log(10) reduction factor (RF): 1.91+/-0.90 vs. 2.52+/-0.95; P=0.001], whereas the sustained effect was not (mean RF: 1.81+/-1.06 vs. 2.05+/-1.14; P=0.204). All other preparations failed the efficacy requirement at 1 min for both the immediate and sustained effect. Using 2 x 3 mL Sterillium for a total of 1.5 min for surgical hand disinfection was at least as effective as the 3-min reference disinfection.
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Reyes, Carlen; Leyland, Kirsten M; Peat, George; Cooper, Cyrus; Arden, Nigel K
2016-01-01
Objective Previous cohorts have reported associations between overweight/obesity and knee and hand osteoarthritis (OA). However, no data on the effect of these on the OA burden are available. We aimed to analyse the effect of overweight and obesity on the incidence of routinely diagnosed knee, hip, and hand OA. Methods Design: population-based cohort Setting: primary care records from the SIDIAP database (>5.5 million subjects) covering >80% of the population of Catalonia, Spain. Participants: ≥40 years old with no OA on 01/01/2006 and with body mass index (BMI) data available. Follow-up: from 01/01/2006 to 12/31/2010, loss to follow-up, or death. Measures: BMI World Health Organization categories (exposure), and incident clinical diagnoses of knee, hip, or hand OA (ICD-10 codes). Results 1,764,061 subjects were observed for a median (inter-quartile range) of 4.45 (4.19 to 4.98) years. Incidence rates (per 1000 PY) of knee, hip and hand OA ranged from 3.7 (3.6 to 3.8), 1.7 (1.7 to 1.8) and 2.6 (2.5 to 2.7) amongst normal-weight, to 19.5 (19.1 to 19.9), 3.8 (3.7 to 4.0) and 4.0 (3.9 to 4.2) in the grade II obese respectively. Compared to normal-weight subjects, being overweight or obese increased the risk of OA at all three sites, especially at the knee: overweight and (grade I, II) obesity increased knee OA risk by a factor of 2, 3.1 and 4.7 fold respectively. Conclusions Both overweight and obesity increase the risk of hand, hip, and knee OA, especially for the latter, with a dose-response gradient with increasing BMI. PMID:27059260
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Damman, Wendy; Liu, Rani; Kroon, Féline P B; Reijnierse, Monique; Huizinga, Tom W J; Rosendaal, Frits R; Kloppenburg, Margreet
2017-11-01
Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort. Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m 2 ). Mean differences were estimated between patients with versus without comorbidities, adjusted for age and sex: for general disease burden [health-related quality of life (HRQOL), Medical Outcomes Study Short Form-36 physical component scale (0-100)] and disease-specific burden [self-reported hand function (0-36), pain (0-20; Australian/Canadian Hand OA Index), and tender joint count (TJC, 0-30)]. Differences above a minimal clinically important improvement/difference were considered clinically relevant. The study included 538 patients (mean age 61 yrs, 86% women, 88% fulfilled American College of Rheumatology classification criteria). Mean (SD) HRQOL, function, pain, and TJC were 44.7 (8), 15.6 (9), 9.3 (4), and 4.8 (5), respectively. Any comorbidity was present in 54% (287/531) of patients and this was unfavorable [adjusted mean difference presence/absence any comorbidity (95% CI): HRQOL -4.4 (-5.8 to -3.0), function 1.9 (0.4-3.3), pain 1.4 (0.6-2.1), TJC 1.3 (0.4-2.2)]. Number of comorbidities and both musculoskeletal (e.g., connective tissue disease) and nonmusculoskeletal comorbidities (e.g., pulmonary and cardiovascular disease) were associated with disease burden. Associations with HRQOL and function were clinically relevant. Comorbidities showed clinically relevant associations with disease burden. Therefore, the role of comorbidities in hand OA should be considered when interpreting disease outcomes and in patient management.
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Improving physician's hand over among oncology staff using standardized communication tool
Alolayan, Ashwaq; Alkaiyat, Mohammad; Ali, Yosra; Alshami, Mona; Al-Surimi, Khaled; Jazieh, Abdul-Rahman
2017-01-01
Cancer patients are frequently admitted to hospital for many reasons. During their hospitalization they are handled by different physicians and other care providers. Maintaining good communication among physicians is essential to assure patient safety and the delivery of quality patient care. Several incidents of miscommunication issues have been reported due to lack of a standardized communication tool for patients' hand over among physicians at our oncology department. Hence, this improvement project aims at assessing the impact of using a standardized communication tool on improving patients' hand over and quality of patient care. A quality improvement team has been formed to address the issue of cancer patients' hand over. We adopted specific hand over tool to be used by physicians. This tool was developed based on well-known and validated communication tool called ISBAR - Identify, Situation, Background, Assessment and Recommendation, which contains pertinent information about the patient's condition. The form should be shared at a specific point in time during the handover process. We monitored the compliance of physician's with this tool over 16 weeks embedded by four ‘purposive’ and ‘sequential’ Plan-Do-Study-Act (PDSA) cycles; where each PDSA cycle was developed based on the challenges faced and lessons learned in each step and the result of the previous PDSA cycle. Physicians compliance rate of using the tool had improved significantly from 45% (baseline) to 100% after the fourth PDSA cycle. Other process measure was measuring acknowledgment of hand over receipt email at two checkpoints at 8:00 – 9:00 a.m. and 4:00 – 5:00 p.m. The project showed that using a standardized handover form as a daily communication method between physicians is a useful idea and feasible to improve cancer patients handover with positive impact on many aspects of healthcare process and outcomes. PMID:28174657
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Hopkins, William D; Gardner, Molly; Mingle, Morgan; Reamer, Lisa; Schapiro, Steven J
2013-11-01
There remain considerable questions regarding the evidence for population-level handedness in nonhuman primates when compared with humans. One challenge in comparing human and nonhuman primate handedness involves the procedures used to characterize individual handedness. Studies of human handedness use consistency in hand use within and between tasks as a basis for hand preference classification. In contrast, studies of handedness in nonhuman primates use statistical criteria for classifying handedness. In this study, we examined within- and between-task consistency in hand use as a means of characterizing individual handedness in a sample of 300 captive chimpanzees (Pan troglodytes). Chimpanzees showed population-level right-handedness for both within- and between-tasks consistency, though the proportion of right-handed chimpanzees was lower than what has typically been reported for humans. We further found that there were small, but significant, associations in hand use between measures. There were no significant sex or colony effects on the distribution of handedness. The results are discussed in the context of theories on the evolution of handedness in nonhuman primates.
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Hopkins, William D.; Gardner, Molly; Mingle, Morgan; Reamer, Lisa; Schapiro, Steven J.
2013-01-01
There remain considerable questions regarding the evidence for population-level handedness in nonhuman primates when compared with humans. One challenge in comparing human and nonhuman primate handedness involves the procedures used to characterize individual handedness. Studies of human handedness use consistency in hand use within and between tasks as a basis for hand preference classification. In contrast, studies of handedness in nonhuman primates use statistical criteria for classifying handedness. In this study, we examined within- and between-task consistency in hand use as a means of characterizing individual handedness in a sample of 300 captive chimpanzees (Pan troglodytes). Chimpanzees showed population-level right-handedness for both within- and between-tasks consistency, though the proportion of right-handed chimpanzees was lower than what has typically been reported for humans. We further found that there were small, but significant, associations in hand use between measures. There were no significant sex or colony effects on the distribution of handedness. The results are discussed in the context of theories on the evolution of handedness in nonhuman primates. PMID:23356440
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Hands-on Science: Does It Matter What Students' Hands Are On?
ERIC Educational Resources Information Center
Triona, Lara M.; Klahr, David
2007-01-01
Hands-on science typically uses physical materials to give students first-hand experience in scientific methodologies, but the recent availability of virtual laboratories raises an important question about whether what students' hands are on matters to their learning. The overall findings of two articles that employed simple comparisons of…
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Does neuromuscular taping influence hand kinesiology? A pilot study on Down's Syndrome.
Rigoldi, C; Galli, M; Celletti, C; Blow, D; Camerota, F; Albertini, G
2015-01-01
This paper is a first attempt analysis of hand and upper limb proprioception coordination induced by NeuroMuscular Taping (NMT): application in a group of 5 participants with Down syndrome. The participants underwent a drawing test with motion capture system acquisition before and after NMT application. Specific and descriptive parameters were computed and analysed in order to quantify the differences. Results showed statistical differences between pre and post treatment sessions: the 5 participants with Down syndrome evidenced more reliance on proprioceptive signals in the post treatment session during the execution of the specific writing tasks. Based on the hypothesis that modifications in proprioception should alter motor pathway mapping of the motor cortex, Neuromuscular taping may play a role in the treatment of dysgraphia and improving hand coordination following CNS impairment, even though a small treatment group was chosen for this pilot study the results lead to further discussions concerning the role of different afferent signals in a pathological context.
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Goldman, Mitchel P; Moradi, Amir; Gold, Michael H; Friedmann, Daniel P; Alizadeh, Kaveh; Adelglass, Jeffrey M; Katz, Bruce E
2018-01-01
Calcium hydroxylapatite (CaHA) microspheres suspended in a carrier gel is an opaque dermal filler that has been used to provide immediate volume correction in the dorsal hands. To assess the safety and effectiveness of CaHA for the correction of volume loss in the hands up to 12 months. This multicenter, controlled, single-blind study (NCT01832090) included 114 subjects randomized 3:1 to CaHA treatment and untreated control groups. Effectiveness was assessed by blinded investigators using the validated Merz Hand Grading Scale (MHGS). Subject-reported improvement was assessed using the Global Aesthetic Improvement Scale. Effects of treatment on hand function were also assessed. A total of 75% of subjects achieved ≥1-point improvement on the MHGS (p < .0001) at 3 months (primary end point); this response was generally maintained through 12 months. Proportions of subjects reporting improvement ranged from 98% (3 months) to 86% (12 months). There were no clinically significant differences between control and CaHA-treated subjects in any hand function measure. Adverse events were generally expected, minor, short-lived, injection-related, and similar to those observed in previous CaHA clinical studies. Treatment with CaHA results in significant improvement in the appearance of the dorsal hand and is well tolerated.
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Fox, Cherie; Wavra, Teresa; Drake, Diane Ash; Mulligan, Debbie; Bennett, Yvonne Pacheco; Nelson, Carla; Kirkwood, Peggy; Jones, Louise; Bader, Mary Kay
2015-05-01
Critically ill patients are at marked risk of hospital-acquired infections, which increase patients' morbidity and mortality. Registered nurses are the main health care providers of physical care, including hygiene to reduce and prevent hospital-acquired infections, for hospitalized critically ill patients. To investigate a new patient hand hygiene protocol designed to reduce hospital-acquired infection rates and improve nurses' hand-washing compliance in an intensive care unit. A preexperimental study design was used to compare 12-month rates of 2 common hospital-acquired infections, central catheter-associated bloodstream infection and catheter-associated urinary tract infection, and nurses' hand-washing compliance measured before and during use of the protocol. Reductions in 12-month infection rates were reported for both types of infections, but neither reduction was statistically significant. Mean 12-month nurse hand-washing compliance also improved, but not significantly. A hand hygiene protocol for patients in the intensive care unit was associated with reductions in hospital-acquired infections and improvements in nurses' hand-washing compliance. Prevention of such infections requires continuous quality improvement efforts to monitor lasting effectiveness as well as investigation of strategies to eliminate these infections. ©2015 American Association of Critical-Care Nurses.
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Hand hygiene monitoring technology: protocol for a systematic review
2013-01-01
Background Healthcare worker hand hygiene is thought to be one of the most important strategies to prevent healthcare-associated infections, but compliance is generally poor. Hand hygiene improvement interventions must include audits of compliance (almost always with feedback), which are most often done by direct observation - a method that is expensive, subjective, and prone to bias. New technologies, including electronic and video hand hygiene monitoring systems, have the potential to provide continuous and objective monitoring of hand hygiene, regular feedback, and for some systems, real-time reminders. We propose a systematic review of the evidence supporting the effectiveness of these systems. The primary objective is to determine whether hand hygiene monitoring systems yield sustainable improvements in hand hygiene compliance when compared to usual care. Methods/Design MEDLINE, EMBASE, CINAHL, and other relevant databases will be searched for randomized control studies and quasi-experimental studies evaluating a video or electronic hand hygiene monitoring system. A standard data collection form will be used to abstract relevant information from included studies. Bias will be assessed using the Cochrane Effective Practice and Organization of Care Group Risk of Bias Assessment Tool. Studies will be reviewed independently by two reviewers, with disputes resolved by a third reviewer. The primary outcome is directly observed hand hygiene compliance. Secondary outcomes include healthcare-associated infection incidence and improvements in hand hygiene compliance as measured by alternative metrics. Results will be qualitatively summarized with comparisons made between study quality, the measured outcome, and study-specific factors that may be expected to affect outcome (for example, study duration, frequency of feedback, use of real-time reminders). Meta-analysis will be performed if there is more than one study of similar systems with comparable outcome definitions
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Prism adaptation in alternately exposed hands.
Redding, Gordon M; Wallace, Benjamin
2013-08-01
We assessed intermanual transfer of the proprioceptive realignment aftereffects of prism adaptation in right-handers by examining alternate target pointing with the two hands for 40 successive trials, 20 with each hand. Adaptation for the right hand was not different as a function of exposure sequence order or postexposure test order, in contrast with adaptation for the left hand. Adaptation was greater for the left hand when the right hand started the alternate pointing than when the sequence of target-pointing movements started with the left hand. Also, the largest left-hand adaptation appeared when that hand was tested first after exposure. Terminal error during exposure varied in cycles for the two hands, converging on zero when the right hand led, but no difference appeared between the two hands when the left hand led. These results suggest that transfer of proprioceptive realignment occurs from the right to the left hand during both exposure and postexposure testing. Such transfer reflects the process of maintaining spatial alignment between the two hands. Normally, the left hand appears to be calibrated with the right-hand spatial map, and when the two hands are misaligned, the left-hand spatial map is realigned with the right-hand spatial map.
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ERIC Educational Resources Information Center
Ritter, Janice T.
2001-01-01
Discusses a computer teacher's incorporation of hand-held computer technology into her third- and fifth-grade students' study of acid rain. The project successfully brought two grade levels together for cross-grade research, provided an opportunity for classroom teachers and technology specialists to work collaboratively, and enhanced students'…
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Schaffner, Donald W; Schaffner, Kristin M
2007-01-01
This research was undertaken to determine the effectiveness of an alcohol-based hand sanitizer on hands contaminated with a nonpathogen surrogate for Escherichia coli O157:H7, where the source of the contamination was frozen hamburger patties. A nonpathogenic nalidixic acid-resistant food-grade strain of Enterobacter aerogenes was used to inoculate frozen hamburger patties composed of 76% lean beef and 24% fat. Thirty-two individuals participated to produce the data used in this study. Each participant handled nine patties at least three times, a sample for microbiological analysis was collected from the surface of one hand, the participant sanitized both hands, and a sample was collected from the other hand. Burger handling created perceptible and visible food debris on the hands of most participants. Computer simulations also were used to perform a variety of risk calculations. The average reduction in bacteria from the use of sanitizer on hands contaminated by frozen burgers containing E. aerogenes was 2.6 +/- 0.7 log CFU per hand. An experiment designed to simultaneously test the effect of sanitizer on E. aerogenes and E. coli O157:H7 also revealed no significant difference in sanitizer effectiveness against the two organisms. The results of the real-world risk estimation calculations (using the actual prevalence and concentration of E. coli O157:H7 in ground beef) predict that once in 1 million trials, a single pathogen cell will be transferred to a single lettuce piece. The effectiveness of this sanitizer intervention was similar to that for hand washing and glove use previously reported. The person-to-person microbial reduction variability from sanitizer use is similar to published data for glove use and was less variable than published data on hand washing effectiveness.
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Humphries, Ailsa; Chen, Zhe; Neumann, Ewald
2017-01-01
Previous studies have shown that stimulus repetition can lead to reliable behavioral improvements. Although this repetition priming (RP) effect has been reported in a number of paradigms using a variety of stimuli including words, objects, and faces, only a few studies have investigated mathematical cognition involving arithmetic computation, and no prior research has directly compared RP effects in a linguistic task with an arithmetic task. In two experiments, we used a within-subjects design to investigate and compare the magnitude of RP, and the effects of changing the color or the response hand for repeated, otherwise identical, stimuli in a word and an arithmetic categorization task. The results show that the magnitude of RP was comparable between the two tasks and that changing the color or the response hand had a negligible effect on priming in either task. These results extended previous findings in mathematical cognition. They also indicate that priming does not vary with stimulus domain. The implications of the results were discussed with reference to both facilitation of component processes and episodic memory retrieval of stimulus-response binding.
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Comparative study of state-of-the-art myoelectric controllers for multigrasp prosthetic hands.
Segil, Jacob L; Controzzi, Marco; Weir, Richard F ff; Cipriani, Christian
2014-01-01
A myoelectric controller should provide an intuitive and effective human-machine interface that deciphers user intent in real-time and is robust enough to operate in daily life. Many myoelectric control architectures have been developed, including pattern recognition systems, finite state machines, and more recently, postural control schemes. Here, we present a comparative study of two types of finite state machines and a postural control scheme using both virtual and physical assessment procedures with seven nondisabled subjects. The Southampton Hand Assessment Procedure (SHAP) was used in order to compare the effectiveness of the controllers during activities of daily living using a multigrasp artificial hand. Also, a virtual hand posture matching task was used to compare the controllers when reproducing six target postures. The performance when using the postural control scheme was significantly better (p < 0.05) than the finite state machines during the physical assessment when comparing within-subject averages using the SHAP percent difference metric. The virtual assessment results described significantly greater completion rates (97% and 99%) for the finite state machines, but the movement time tended to be faster (2.7 s) for the postural control scheme. Our results substantiate that postural control schemes rival other state-of-the-art myoelectric controllers.
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Girard, R; Amazian, K; Fabry, J
2001-02-01
The aim of the study was to demonstrate that the introduction of rub-in hand disinfection (RHD) in hospital units, with the implementation of suitable equipment, drafting of specific protocols, and training users, improved compliance of hand disinfection and tolerance of user's hands. In four hospital units not previously using RHD an external investigator conducted two identical studies in order to measure the rate of compliance with, and the quality of, disinfection practices, [rate of adapted (i.e., appropriate) procedures, rate of correct (i.e., properly performed) procedures, rate of adapted and correct procedures carried out] and to assess the state of hands (clinical scores of dryness and irritation, measuring hydration with a corneometer). Between the two studies, the units were equipped with dispensers for RHD products and staff were trained. Compliance improved from 62.2 to 66.5%, quality was improved (rate of adapted procedures from 66.8% to 84.3%, P > or = 10(-6), rate of correct procedures from 11.1% to 28.9%, P > or = 10(-8), rate of adapted and correct procedures from 6.0 to 17.8%, P > or = 10(-8)). The tolerance was improved significantly (P > or = 10(-2)) for clinical dryness and irritation scores, although not significantly for measurements using a corneometer. This study shows the benefit of introducing RHD with a technical and educational accompaniment. Copyright 2001 The Hospital Infection Society.
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The SmartHand transradial prosthesis
2011-01-01
Background Prosthetic components and control interfaces for upper limb amputees have barely changed in the past 40 years. Many transradial prostheses have been developed in the past, nonetheless most of them would be inappropriate if/when a large bandwidth human-machine interface for control and perception would be available, due to either their limited (or inexistent) sensorization or limited dexterity. SmartHand tackles this issue as is meant to be clinically experimented in amputees employing different neuro-interfaces, in order to investigate their effectiveness. This paper presents the design and on bench evaluation of the SmartHand. Methods SmartHand design was bio-inspired in terms of its physical appearance, kinematics, sensorization, and its multilevel control system. Underactuated fingers and differential mechanisms were designed and exploited in order to fit all mechatronic components in the size and weight of a natural human hand. Its sensory system was designed with the aim of delivering significant afferent information to the user through adequate interfaces. Results SmartHand is a five fingered self-contained robotic hand, with 16 degrees of freedom, actuated by 4 motors. It integrates a bio-inspired sensory system composed of 40 proprioceptive and exteroceptive sensors and a customized embedded controller both employed for implementing automatic grasp control and for potentially delivering sensory feedback to the amputee. It is able to perform everyday grasps, count and independently point the index. The weight (530 g) and speed (closing time: 1.5 seconds) are comparable to actual commercial prostheses. It is able to lift a 10 kg suitcase; slippage tests showed that within particular friction and geometric conditions the hand is able to stably grasp up to 3.6 kg cylindrical objects. Conclusions Due to its unique embedded features and human-size, the SmartHand holds the promise to be experimentally fitted on transradial amputees and employed as a bi
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Eleveld, C A; Schuller, A A
2016-02-01
A research project investigated the extent to which a preferential use of one hand or the other has an effect on dental hygiene on the left or right side of the mouth. The study made use of epidemiological dental-care data from the Netherlands Organisation for Applied Scientific Research and of data from a dental practice specifically collected for this project. The results revealed that among a population which is 85-90% right-handed, statistically significantly more dental plaque was found on the right side of the mouth than on the left. A separate study revealed the prevalence of statistically significantly more dental plaque on the right side than on the left among right-handed people and, among left-handed people, a non-statistically significant trend of more dental plaque on the left than the right. It is concluded that dental hygiene on the left side and the right side of the mouth is very likely to be dependent on the preferential use of one hand or the other. The differences between the left side of the mouth and right among left- and right-handed people are, however, so small that it is questionable whether these should be taken into consideration in giving instructions about dental hygiene.
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... this page: //medlineplus.gov/ency/patientinstructions/000552.htm Hand fracture - aftercare To use the sharing features on ... need to be repaired with surgery. Types of Hand Fractures Your fracture may be in one of ...
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Self-reported hand eczema among dental workers in Japan - a cross-sectional study.
Minamoto, Keiko; Watanabe, Takeshi; Diepgen, Thomas L
2016-10-01
Dental workers are considered to have a high risk of developing occupational hand eczema. To estimate the prevalence of work-related hand eczema and associated risk factors in dental workers in Japan. A self-administered questionnaire was sent by mail to all dental clinics of Kumamoto City, Japan. In addition, patch testing with 24 dentistry-related allergens was offered. In total, 46.4% of dental workers (n = 528: response 31.4%, based on 97 clinics) reported a lifetime history of chronic hand eczema. The 1-year prevalence was 36.2%. According to logistic regression analysis, the most important risk factors for the 1-year prevalence were a personal history of atopic dermatitis [odds ratio (OR) 4.7, 95% confidence interval (CI): 2.2-8.8], asthma and/or allergic rhinitis (OR 2.0, 95%CI: 1.3-3.0), dry skin (OR 1.7, 95%CI: 1.1-2.7), shorter duration of work (OR 2.0, 95%CI: 1.2-3.5 for up to 10 years versus >20 years), and washing hands >10 times per day (OR 1.6, 95%CI: 1.0-2.5). Fifty-four workers were patch tested. Rubber chemicals and acrylates were the most frequent occupationally relevant contact allergens. Dental workers in Japan have a high prevalence of hand eczema. Health education to prevent hand eczema and more frequent patch testing are needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Growth rates and energy intake of hand-reared cheetah cubs (Acinonyx jubatus) in South Africa.
Bell, K M; Rutherfurd, S M; Morton, R H
2012-04-01
Growth rate is an important factor in neonatal survival. The aim of this study was to determine growth rates in hand-reared cheetah cubs in South Africa fed a prescribed energy intake, calculated for growth in the domestic cat. Growth was then compared with previously published data from hand-reared cubs in North America and the relationship between growth and energy intake explored. Daily body weight (BW) gain, feed and energy intake data was collected from 18 hand-reared cheetah cubs up to 120 days of age. The average pre-weaning growth rate was 32 g/day, which is lower than reported in mother-reared cubs and hand-reared cubs in North American facilities. However, post-weaning growth increased to an average of 55 g/day. Growth was approximately linear prior to weaning, but over the entire age range it exhibited a sigmoidal shape with an asymptotic plateau averaging 57 kg. Energy intake associated with pre-weaning growth was 481 kJ ME/kg BW(0.75). Regression analysis described the relationship between metabolic BW, metabolisable energy (ME) intake, and hence daily weight gain. This relationship may be useful in predicting energy intake required to achieve growth rates in hand-reared cheetah cubs similar to those observed for their mother-reared counterparts. © 2011 Blackwell Verlag GmbH.
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Su, T A; Hoe, V C W
2008-12-01
Validity and reliability of the information relating to hand-transmitted vibration exposure and vibration-related health outcome are very important for case finding in hand-arm vibration syndrome (HAVS) studies. In a local HAVS study among a group of construction workers in Kuala Lumpur, Malaysia, a questionnaire translated into Malay was created based on the Hand-transmitted Vibration Health Surveillance--Initial Questionnaire and Clinical Assessment, from Vibration Injury Network. This study was conducted to determine the reliability of standardised questions in the questionnaire used in the study. 15 subjects were selected randomly from the sampling frame of the HAVS study. Test-retest reliability was conducted on all items contained in parts 1-6 of the questionnaire and clinical assessment form, with an interval of 13-14 days between the first and second administration. Kappa coefficient and percentage agreement were calculated for all standardised questions. The kappa coefficient and percentage agreement for all standardised questions varied from -0.174 to 1.000 and 66.7 to 100.0 percent, respectively. The kappa coefficient for important questions related to current vibratory tool usage, tingling, numbness and hand grip weakness were 0.714, 0.432, -0.077 and -0.120, respectively, while the percentage agreement for current vibratory tool usage, finger colour change, tingling, numbness and hand grip weakness were 85.7 percent, 92.8 percent, 79.5 percent, 85.7 percent and 71.4 percent, respectively. Intra-rater reliability on the extent of vibration exposure was good, with the intra-class correlation coefficient (95 percent confidence interval) ranging from 0.786 (0.334-0.931) to 0.975 (0.923-0.992). Critical questions on vascular, neurological and musculoskeletal symptoms of HAVS were found to be reliable. The history on the extent of vibration exposure revealed good reliability when explored by the investigator alone. This questionnaire is considered reliable
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Physical examination of the hand.
Kenney, Raymond J; Hammert, Warren C
2014-11-01
Examination of the hand is an essential piece of a hand surgeon's skill set. This current concepts review presents a systematic process of performing a comprehensive physical examination of the hand including vascular, sensory, and motor assessments. Evaluations focused on specific hand diseases and injuries are also discussed. This information can be useful for any health care provider treating patients with hand conditions. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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Hand-pressing trials and hand-to-mouth soil transfer experiments were conducted to better understand soil loadings, soil transfer ratios for three mouthing activities, and variations in particle size distributions under various conditions. Results indicated that sand caused highe...
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Hospital hand hygiene opportunities: where and when (HOW2)? The HOW2 Benchmark Study.
Steed, Connie; Kelly, J William; Blackhurst, Dawn; Boeker, Sue; Diller, Thomas; Alper, Paul; Larson, Elaine
2011-02-01
Measurement and monitoring of health care workers' hand hygiene compliance (i.e., actions/opportunities) is a key component of strategies to eliminate hospital-acquired infections. Little data exist on the expected number of hand hygiene opportunities (HHOs) in various hospital settings, however. The purpose of this study was to estimate HHOs in 2 types of hospitals--large teaching and small community--and 3 different clinical areas-medical-surgical intensive care units, general medical wards, and emergency departments. HHO data were collected through direct observations using the World Health Organization's monitoring methodology. Estimates of HHOs were developed for 12-hour AM/PM shifts and 24-hour time frames. During 436.7 hours of observation, 6,640 HHOs were identified. Estimates of HHOs ranged from 30 to 179 per patient-day on inpatient wards and from 1.84 to 5.03 per bed-hour in emergency departments. Significant differences in HHOs were found between the 2 hospital types and among the 3 clinical areas. This study is the first to use the World Health Organization's data collection methodology to estimate HHOs in general medical wards and emergency departments. These data can be used as denominator estimates to calculate hand hygiene compliance rates when product utilization data are available. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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Santello, Marco; Bianchi, Matteo; Gabiccini, Marco; Ricciardi, Emiliano; Salvietti, Gionata; Prattichizzo, Domenico; Ernst, Marc; Moscatelli, Alessandro; Jörntell, Henrik; Kappers, Astrid M.L.; Kyriakopoulos, Kostas; Albu-Schäffer, Alin; Castellini, Claudio; Bicchi, Antonio
2017-01-01
The term ‘synergy’ – from the Greek synergia – means ‘working together’. The concept of multiple elements working together towards a common goal has been extensively used in neuroscience to develop theoretical frameworks, experimental approaches, and analytical techniques to understand neural control of movement, and for applications for neuro-rehabilitation. In the past decade, roboticists have successfully applied the framework of synergies to create novel design and control concepts for artificial hands, i.e., robotic hands and prostheses. At the same time, robotic research on the sensorimotor integration underlying the control and sensing of artificial hands has inspired new research approaches in neuroscience, and has provided useful instruments for novel experiments. The ambitious goal of integrating expertise and research approaches in robotics and neuroscience to study the properties and applications of the concept of synergies is generating a number of multidisciplinary cooperative projects, among which the recently finished 4-year European project “The Hand Embodied” (THE). This paper reviews the main insights provided by this framework. Specifically, we provide an overview of neuroscientific bases of hand synergies and introduce how robotics has leveraged the insights from neuroscience for innovative design in hardware and controllers for biomedical engineering applications, including myoelectric hand prostheses, devices for haptics research, and wearable sensing of human hand kinematics. The review also emphasizes how this multidisciplinary collaboration has generated new ways to conceptualize a synergy-based approach for robotics, and provides guidelines and principles for analyzing human behavior and synthesizing artificial robotic systems based on a theory of synergies. PMID:26923030
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Santello, Marco; Bianchi, Matteo; Gabiccini, Marco; Ricciardi, Emiliano; Salvietti, Gionata; Prattichizzo, Domenico; Ernst, Marc; Moscatelli, Alessandro; Jörntell, Henrik; Kappers, Astrid M L; Kyriakopoulos, Kostas; Albu-Schäffer, Alin; Castellini, Claudio; Bicchi, Antonio
2016-07-01
The term 'synergy' - from the Greek synergia - means 'working together'. The concept of multiple elements working together towards a common goal has been extensively used in neuroscience to develop theoretical frameworks, experimental approaches, and analytical techniques to understand neural control of movement, and for applications for neuro-rehabilitation. In the past decade, roboticists have successfully applied the framework of synergies to create novel design and control concepts for artificial hands, i.e., robotic hands and prostheses. At the same time, robotic research on the sensorimotor integration underlying the control and sensing of artificial hands has inspired new research approaches in neuroscience, and has provided useful instruments for novel experiments. The ambitious goal of integrating expertise and research approaches in robotics and neuroscience to study the properties and applications of the concept of synergies is generating a number of multidisciplinary cooperative projects, among which the recently finished 4-year European project "The Hand Embodied" (THE). This paper reviews the main insights provided by this framework. Specifically, we provide an overview of neuroscientific bases of hand synergies and introduce how robotics has leveraged the insights from neuroscience for innovative design in hardware and controllers for biomedical engineering applications, including myoelectric hand prostheses, devices for haptics research, and wearable sensing of human hand kinematics. The review also emphasizes how this multidisciplinary collaboration has generated new ways to conceptualize a synergy-based approach for robotics, and provides guidelines and principles for analyzing human behavior and synthesizing artificial robotic systems based on a theory of synergies. Copyright © 2016 Elsevier B.V. All rights reserved.
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NASA Astrophysics Data System (ADS)
Santello, Marco; Bianchi, Matteo; Gabiccini, Marco; Ricciardi, Emiliano; Salvietti, Gionata; Prattichizzo, Domenico; Ernst, Marc; Moscatelli, Alessandro; Jörntell, Henrik; Kappers, Astrid M. L.; Kyriakopoulos, Kostas; Albu-Schäffer, Alin; Castellini, Claudio; Bicchi, Antonio
2016-07-01
The term 'synergy' - from the Greek synergia - means 'working together'. The concept of multiple elements working together towards a common goal has been extensively used in neuroscience to develop theoretical frameworks, experimental approaches, and analytical techniques to understand neural control of movement, and for applications for neuro-rehabilitation. In the past decade, roboticists have successfully applied the framework of synergies to create novel design and control concepts for artificial hands, i.e., robotic hands and prostheses. At the same time, robotic research on the sensorimotor integration underlying the control and sensing of artificial hands has inspired new research approaches in neuroscience, and has provided useful instruments for novel experiments. The ambitious goal of integrating expertise and research approaches in robotics and neuroscience to study the properties and applications of the concept of synergies is generating a number of multidisciplinary cooperative projects, among which the recently finished 4-year European project ;The Hand Embodied; (THE). This paper reviews the main insights provided by this framework. Specifically, we provide an overview of neuroscientific bases of hand synergies and introduce how robotics has leveraged the insights from neuroscience for innovative design in hardware and controllers for biomedical engineering applications, including myoelectric hand prostheses, devices for haptics research, and wearable sensing of human hand kinematics. The review also emphasizes how this multidisciplinary collaboration has generated new ways to conceptualize a synergy-based approach for robotics, and provides guidelines and principles for analyzing human behavior and synthesizing artificial robotic systems based on a theory of synergies.
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Robati, Reza M; Asadi, Elmira; Shafiee, Anoosh; Namazi, Nastaran; Talebi, Atefeh
2018-04-01
There are different modalities for hand rejuvenation. Fractional Er:YAG laser and long pulse Nd:YAG laser were introduced for treating hand wrinkles. We plan to compare fractional Er:YAG laser and long pulse Nd:YAG laser in a randomized controlled double-blind design with multiple sessions and larger sample size in comparison with previous studies. Thirty-three participants with hand wrinkles entered this study. They were randomly allocated to undergo three monthly laser treatments on each hand, one with a fractional Er:YAG laser and the other with a long pulse Nd:YAG laser. The evaluations included assessment of clinical improvement determined by two independent dermatologists not enrolled in the treatment along with measuring skin biomechanical property of hands using a sensitive biometrologic device with the assessment of cutaneous resonance running time (CRRT). Moreover, potential side effects and patients' satisfaction have been documented at baseline, 1 month after each treatment, and 3 months after the final treatment session. Clinical evaluation revealed both modalities significantly reduce hand wrinkles (p value < 0.05), with no significant difference between two lasers. Mean CRRT values also decreased significantly after the laser treatment compared to those of the baseline in both laser groups. There was no serious persistent side effect after both laser treatments. Both fractional Er:YAG and long pulse Nd:YAG lasers show substantial clinical improvement of hand skin wrinkles with no serious side effects. However, combination treatment by these lasers along with the other modalities such as fat transfer could lead to better outcomes in hand rejuvenation. IRCT2016032020468N4.
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Kurozawa, Youichi; Hosoda, Takenobu; Nasu, Yoshiro
2010-01-01
Current perception threshold (CPT) has been proposed as a quantitative method for assessment of peripheral sensory nerve function. The aim of this review of selected reports is to provide an overview of CPT measurement for the assessment of the neurological component of hand-arm vibration syndrome (HAVS). The CPT values at 2000 Hz significantly increased for patients with HAVS. This result supports the previous histological findings that demyelination is found predominantly in the peripheral nerves in the hands of men exposed to hand-arm vibration. Diagnostic sensitivity and specificity were high for severe cases of Stockholm sensorineural (SSN) stage 3 compared with non-exposed controls, but not high for mild cases of SSN stage 1 or 2 and for carpal tunnel syndrome associated with HAVS. However, there are only a few studies on the diagnostic validity of the CPT test for the neurological components of HAVS. Further research is needed and should include diagnostic validity and standardizing of measurement conditions such as skin temperature. PMID:24031119
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Validation of hand and foot anatomical feature measurements from smartphone images
NASA Astrophysics Data System (ADS)
Amini, Mohammad; Vasefi, Fartash; MacKinnon, Nicholas
2018-02-01
A smartphone mobile medical application, previously presented as a tool for individuals with hand arthritis to assess and monitor the progress of their disease, has been modified and expanded to include extraction of anatomical features from the hand (joint/finger width, and angulation) and foot (length, width, big toe angle, and arch height index) from smartphone camera images. Image processing algorithms and automated measurements were validated by performing tests on digital hand models, rigid plastic hand models, and real human hands and feet to determine accuracy and reproducibility compared to conventional measurement tools such as calipers, rulers, and goniometers. The mobile application was able to provide finger joint width measurements with accuracy better than 0.34 (+/-0.25) millimeters. Joint angulation measurement accuracy was better than 0.50 (+/-0.45) degrees. The automatically calculated foot length accuracy was 1.20 (+/-1.27) millimeters and the foot width accuracy was 1.93 (+/-1.92) millimeters. Hallux valgus angle (used in assessing bunions) accuracy was 1.30 (+/-1.29) degrees. Arch height index (AHI) measurements had an accuracy of 0.02 (+/-0.01). Combined with in-app documentation of symptoms, treatment, and lifestyle factors, the anatomical feature measurements can be used by both healthcare professionals and manufacturers. Applications include: diagnosing hand osteoarthritis; providing custom finger splint measurements; providing compression glove measurements for burn and lymphedema patients; determining foot dimensions for custom shoe sizing, insoles, orthotics, or foot splints; and assessing arch height index and bunion treatment effectiveness.
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Dong, Ren G; Sinsel, Erik W; Welcome, Daniel E; Warren, Christopher; Xu, Xueyan S; McDowell, Thomas W; Wu, John Z
2015-09-01
The hand coordinate systems for measuring vibration exposures and biodynamic responses have been standardized, but they are not actually used in many studies. This contradicts the purpose of the standardization. The objectives of this study were to identify the major sources of this problem, and to help define or identify better coordinate systems for the standardization. This study systematically reviewed the principles and definition methods, and evaluated typical hand coordinate systems. This study confirms that, as accelerometers remain the major technology for vibration measurement, it is reasonable to standardize two types of coordinate systems: a tool-based basicentric (BC) system and an anatomically based biodynamic (BD) system. However, these coordinate systems are not well defined in the current standard. Definition of the standard BC system is confusing, and it can be interpreted differently; as a result, it has been inconsistently applied in various standards and studies. The standard hand BD system is defined using the orientation of the third metacarpal bone. It is neither convenient nor defined based on important biological or biodynamic features. This explains why it is rarely used in practice. To resolve these inconsistencies and deficiencies, we proposed a revised method for defining the realistic handle BC system and an alternative method for defining the hand BD system. A fingertip-based BD system for measuring the principal grip force is also proposed based on an important feature of the grip force confirmed in this study.
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NASA Technical Reports Server (NTRS)
Lee, Sukhan
1989-01-01
Robot hand includes thumblike members on left and right sides and fingerlike member at middle. Configuration of digits enables hand to adapt to variously shaped objects, grasp them robustly and reliably, and manipulate them. Reduces complexity of control mechanisms and provides kinesthetic perception of shapes of grasped objects. Mechanical hand with two thumbs and middle finger made from commercially available components. With specially designed dc motors and assemblies of gears, size of hand reduced considerably. Suited to handling objects in industrial tasks.
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Both hand position and movement direction modulate visual attention
Festman, Yariv; Adam, Jos J.; Pratt, Jay; Fischer, Martin H.
2013-01-01
The current study explored effects of continuous hand motion on the allocation of visual attention. A concurrent paradigm was used to combine visually concealed continuous hand movements with an attentionally demanding letter discrimination task. The letter probe appeared contingent upon the moving right hand passing through one of six positions. Discrimination responses were then collected via a keyboard press with the static left hand. Both the right hand's position and its movement direction systematically contributed to participants' visual sensitivity. Discrimination performance increased substantially when the right hand was distant from, but moving toward the visual probe location (replicating the far-hand effect, Festman et al., 2013). However, this effect disappeared when the probe appeared close to the static left hand, supporting the view that static and dynamic features of both hands combine in modulating pragmatic maps of attention. PMID:24098288
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2014-01-01
Background Evaluations are essential to judge the success of public health programmes. In Europe, the proportion of public health programmes that undergo evaluation remains unclear. The European Centre for Disease Prevention and Control sought to determine the frequency of evaluations amongst European national public health programmes by using national hand hygiene campaigns as an example of intervention. Methods A cohort of all national hand hygiene campaigns initiated between 2000 and 2012 was utilised for the analysis. The aim was to collect information about evaluations of hand hygiene campaigns and their frequency. The survey was sent to nominated contact points for healthcare-associated infection surveillance in European Union and European Economic Area Member States. Results Thirty-six hand hygiene campaigns in 20 countries were performed between 2000 and 2012. Of these, 50% had undergone an evaluation and 55% of those utilised the WHO hand hygiene intervention self-assessment tool. Evaluations utilised a variety of methodologies and indicators in assessing changes in hand hygiene behaviours pre and post intervention. Of the 50% of campaigns that were not evaluated, two thirds reported that both human and financial resource constraints posed significant barriers for the evaluation. Conclusion The study identified an upward trend in the number of hand hygiene campaigns implemented in Europe. It is likely that the availability of the internationally-accepted evaluation methodology developed by the WHO contributed to the evaluation of more hand hygiene campaigns in Europe. Despite this rise, hand hygiene campaigns appear to be under-evaluated. The development of simple, programme-specific, standardised guidelines, evaluation indicators and other evidence-based public health materials could help promote evaluations across all areas of public health. PMID:24507086
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Stowell, Jennifer D.; Forlin-Passoni, Daniela; Radford, Kay; Bate, Sheri L.; Dollard, Sheila C.; Bialek, Stephanie R.; Cannon, Michael J.
2014-01-01
Congenital cytomegalovirus (CMV) transmission can occur when women acquire CMV while pregnant. Infection control guidelines may reduce risk for transmission. We studied the duration of CMV survival after application of bacteria to the hands and after transfer from the hands to surfaces and the effectiveness of cleansing with water, regular and antibacterial soaps, sanitizer, and diaper wipes. Experiments used CMV AD169 in saliva at initial titers of 1 × 105 infectious particles/ml. Samples from hands or surfaces (points between 0 and 15 min) were placed in culture and observed for at least 2 weeks. Samples were also tested using CMV real-time PCR. After application of bacteria to the hands, viable CMV was recovered from 17/20 swabs at 0 min, 18/20 swabs at 1 min, 5/20 swabs at 5 min, and 4/20 swabs at 15 min. After transfer, duration of survival was at least 15 min on plastic (1/2 swabs), 5 min on crackers and glass (3/4 swabs), and 1 min or less on metal and cloth (3/4 swabs); no viable virus was collected from wood, rubber, or hands. After cleansing, no viable virus was recovered using water (0/22), plain soap (0/20), antibacterial soap (0/20), or sanitizer (0/22). Viable CMV was recovered from 4/20 hands 10 min after diaper wipe cleansing. CMV remains viable on hands for sufficient times to allow transmission. CMV may be transferred to surfaces with reduced viability. Hand-cleansing methods were effective at eliminating viable CMV from hands. PMID:24185855
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Stowell, Jennifer D; Forlin-Passoni, Daniela; Radford, Kay; Bate, Sheri L; Dollard, Sheila C; Bialek, Stephanie R; Cannon, Michael J; Schmid, D Scott
2014-01-01
Congenital cytomegalovirus (CMV) transmission can occur when women acquire CMV while pregnant. Infection control guidelines may reduce risk for transmission. We studied the duration of CMV survival after application of bacteria to the hands and after transfer from the hands to surfaces and the effectiveness of cleansing with water, regular and antibacterial soaps, sanitizer, and diaper wipes. Experiments used CMV AD169 in saliva at initial titers of 1 × 10(5) infectious particles/ml. Samples from hands or surfaces (points between 0 and 15 min) were placed in culture and observed for at least 2 weeks. Samples were also tested using CMV real-time PCR. After application of bacteria to the hands, viable CMV was recovered from 17/20 swabs at 0 min, 18/20 swabs at 1 min, 5/20 swabs at 5 min, and 4/20 swabs at 15 min. After transfer, duration of survival was at least 15 min on plastic (1/2 swabs), 5 min on crackers and glass (3/4 swabs), and 1 min or less on metal and cloth (3/4 swabs); no viable virus was collected from wood, rubber, or hands. After cleansing, no viable virus was recovered using water (0/22), plain soap (0/20), antibacterial soap (0/20), or sanitizer (0/22). Viable CMV was recovered from 4/20 hands 10 min after diaper wipe cleansing. CMV remains viable on hands for sufficient times to allow transmission. CMV may be transferred to surfaces with reduced viability. Hand-cleansing methods were effective at eliminating viable CMV from hands.
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The Visible Hand: Markets, Politics, and Regulation in Post-Katrina New Orleans
ERIC Educational Resources Information Center
Jabbar, Huriya
2016-01-01
In this article Huriya Jabbar examines how the regulatory environment in post-Hurricane Katrina New Orleans has influenced choice, incentives, and competition among schools. While previous research has highlighted the mechanisms of competition and individual choice--the "invisible hand"--and the creation of markets in education, Jabbar…
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Ethical, financial, and policy considerations in hand transplantation.
Chang, Jeff; Mathes, David W
2011-11-01
Currently, more than 65 hand transplants have been performed with studies demonstrating favorable cosmetic and functional outcomes and cortical reintegration of the transplanted hand. Due to such favorable outcomes, many view hand transplant as a potential gold standard for treatment of a double amputee. However, ethical debate continues regarding risks and benefits of this nonlifesaving procedure. Clinicians, patients, and society must agree on whether hand transplantation is ethical and affordable. If a decision is made to transplant a hand, this must be performed in a dedicated center that facilitates integration of multiple specialists, ethicists, pharmacists, and rehabilitationists. Copyright © 2011 Elsevier Inc. All rights reserved.
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Do we need animal hands-on courses for transplantation surgery?
Golriz, Mohammad; Hafezi, Mohammadreza; Garoussi, Camelia; Fard, Nassim; Arvin, Jalal; Fonouni, Hamidreza; Nickkholgh, Arash; Kulu, Yakob; Frongia, Giovani; Schemmer, Peter; Mehrabi, Arianeb
2013-01-01
Transplantation surgery requires many years of training. This study evaluates and presents the results of our recent four-yr animal hands-on courses of transplantation surgery on participants' training. Since 2008, five two-d hands-on courses of transplantation surgery were performed on swine models at our department. Sixty-one participants were asked to answer three questionnaires (pre-course, immediate post-course, subsequent post-course). The questions pertained to their past education, expectations, and evaluation of our courses, as well as our course's effectiveness in advancing their surgical abilities. The results were analyzed, compared and are presented herein. On average, 1.8 multiorgan procurements, 2.3 kidney, 1.5 liver, and 0.7 pancreas transplantations were performed by each participant. 41.7% of participants considered their previous practical training only satisfactory; 85% hoped for more opportunities to practice surgery; 73.3% evaluated our courses as very good; and 95.8% believed that our courses had fulfilled their expectations. 66% found the effectiveness of our course in advancing their surgical abilities very good; 30% good, and 4% satisfactory. Animal hands-on courses of transplantation surgery are one of the best options to learn and practice different operations and techniques in a near to clinical simulated model. Regular participation in such courses with a focus on practical issues can provide optimal opportunities for trainees with the advantage of direct mentoring and feedback. © 2013 John Wiley & Sons A/S.
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iHand: an interactive bare-hand-based augmented reality interface on commercial mobile phones
NASA Astrophysics Data System (ADS)
Choi, Junyeong; Park, Jungsik; Park, Hanhoon; Park, Jong-Il
2013-02-01
The performance of mobile phones has rapidly improved, and they are emerging as a powerful platform. In many vision-based applications, human hands play a key role in natural interaction. However, relatively little attention has been paid to the interaction between human hands and the mobile phone. Thus, we propose a vision- and hand gesture-based interface in which the user holds a mobile phone in one hand but sees the other hand's palm through a built-in camera. The virtual contents are faithfully rendered on the user's palm through palm pose estimation, and reaction with hand and finger movements is achieved that is recognized by hand shape recognition. Since the proposed interface is based on hand gestures familiar to humans and does not require any additional sensors or markers, the user can freely interact with virtual contents anytime and anywhere without any training. We demonstrate that the proposed interface works at over 15 fps on a commercial mobile phone with a 1.2-GHz dual core processor and 1 GB RAM.
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Hand grips strength effect on motor function in human brain using fMRI: a pilot study
NASA Astrophysics Data System (ADS)
Ismail, S. S.; Mohamad, M.; Syazarina, S. O.; Nafisah, W. Y.
2014-11-01
Several methods of motor tasks for fMRI scanning have been evolving from simple to more complex tasks. Motor tasks on upper extremity were applied in order to excite the increscent of motor activation on contralesional and ipsilateral hemispheres in brain. The main objective of this study is to study the different conditions for motor tasks on upper extremity that affected the brain activation. Ten healthy right handed with normal vision (3 male and 7 female, age range=20-30 years, mean=24.6 years, SD=2.21) participated in this study. Prior to the scanning, participants were trained on hand grip tasks using rubber ball and pressure gauge tool outside the scanner. During fMRI session, a block design with 30-s task blocks and alternating 30-s rest periods was employed while participants viewed a computer screen via a back projection-mirror system and instructed to follow the instruction by gripping their hand with normal and strong grips using a rubber ball. Statistical Parametric mapping (SPM8) software was used to determine the brain activation. Both tasks activated the primary motor (M1), supplementary motor area (SMA), dorsal and ventral of premotor cortex area (PMA) in left hemisphere while in right hemisphere the area of primary motor (M1) somatosensory was activated. However, the comparison between both tasks revealed that the strong hand grip showed the higher activation at M1, PMA and SMA on left hemisphere and also the area of SMA on right hemisphere. Both conditions of motor tasks could provide insights the functional organization on human brain.
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The effect of improved hand hygiene on nosocomial MRSA control.
Marimuthu, Kalisvar; Pittet, Didier; Harbarth, Stephan
2014-01-01
The purpose of this review is to examine studies that have assessed the association between hand hygiene enhancement and methicillin-resistant Staphylococcus aureus (MRSA) rates and to explore controversies surrounding this association. Many studies have been published confirming the link between improved hand hygiene compliance and reduction in MRSA acquisition and infections, including bacteremia. These studies have also shown the cost-beneficial nature of these programmes. Despite considerable research some issues remain unanswered still, including the temporal relationship between hand hygiene enhancement strategies and decrease in MRSA rates, association between hand hygiene enhancement and MRSA-related surgical site infections, diminishing effect of hand hygiene compliance on MRSA rates after reaching a threshold and the role of instituting contact precautions in the setting of low MRSA rates and sufficient hand hygiene compliance. In conclusion, enhancement of hand hygiene compliance has been shown to reduce MRSA rates; however, some open issues warrant further investigation.
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Hand controller study of force and control mode
NASA Technical Reports Server (NTRS)
Morris, A. Terry
1992-01-01
The objectives are to compare and evaluate the utility and effectiveness of various input control devices, e.g., hand controllers, with respect to the relative importance of force and operation control mode (rate or position) for Space Station Freedom (SSF) related tasks. The topics are presented in viewgraph form and include the: Intelligent Research Systems Lab (ISRL) experimental design; Telerobotic Systems Research Laboratory (TSRL) final experimental design; and factor analysis summary of results.
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Moving a Rubber Hand that Feels Like Your Own: A Dissociation of Ownership and Agency
Kalckert, Andreas; Ehrsson, H. Henrik
2012-01-01
During voluntary hand movement, we sense that we generate the movement and that the hand is a part of our body. These feelings of control over bodily actions, or the sense of agency, and the ownership of body parts are two fundamental aspects of the way we consciously experience our bodies. However, little is known about how these processes are functionally linked. Here, we introduce a version of the rubber hand illusion in which participants control the movements of the index finger of a model hand, which is in full view, by moving their own right index finger. We demonstrated that voluntary finger movements elicit a robust illusion of owning the rubber hand and that the senses of ownership and agency over the model hand can be dissociated. We systematically varied the relative timing of the finger movements (synchronous versus asynchronous), the mode of movement (active versus passive), and the position of the model hand (anatomically congruent versus incongruent positions). Importantly, asynchrony eliminated both ownership and agency, passive movements abolished the sense of agency but left ownership intact, and incongruent positioning of the model hand diminished ownership but did not eliminate agency. These findings provide evidence for a double dissociation of ownership and agency, suggesting that they represent distinct cognitive processes. Interestingly, we also noted that the sense of agency was stronger when the hand was perceived to be a part of the body, and only in this condition did we observe a significant correlation between the subjects’ ratings of agency and ownership. We discuss this in the context of possible differences between agency over owned body parts and agency over actions that involve interactions with external objects. In summary, the results obtained in this study using a simple moving rubber hand illusion paradigm extend previous findings on the experience of ownership and agency and shed new light on their relationship. PMID
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Fallahi, Ali Asghar; Jadidian, Ali Akbar
2011-09-01
It has been suggested that athletes with longer fingers and larger hand surfaces enjoy stronger grip power. Therefore, some researchers have examined a number of factors and anthropometric variables that explain this issue. To our knowledge, the data is scarce. Thus, the aim of this study was to investigate the effect of hand dimensions, hand shape and some anthropometric characteristics on handgrip strength in male grip athletes and non-athletes. 80 subjects aged between 19 and 29 participated in this study in two groups including: national and collegian grip athletes (n=40), and non-athletes (n=40). Body height and mass were measured to calculate body mass index. The shape of the dominant hand was drawn on a piece of paper with a thin marker so that finger spans, finger lengths, and perimeters of the hand could be measured. The hand shape was estimated as the ratio of the hand width to hand length. Handgrip strength was measured in the dominant and non-dominant hand using a standard dynamometer. Descriptive statistics were used for each variable and independent t test was used to analyze the differences between the two groups. The Pearson correlation coefficient test was used to evaluate the correlation between studied variables. Also, to predict important variables in handgrip strength, the linear trend was assessed using a linear regression analysis. There was a significant difference between the two groups in absolute handgrip strength (p<0.001) and handgrip/height ratio (p<0.001). The indices of body height, body mass, lean body mass and body fat content (p<0.001) were significantly greater in grip athletes. All hand variables except FS1-4 (p>0.05) were significantly different between the groups (p<0.001). After controlling body mass all hand anthropometric characteristics except thumb length (r=0.240, p= 0.135), hand shape (r=-0.029, p=0.858), middle finger length (r=0.305, p=0.056) and forearm circumference (r=0.162, p=0.319) significantly correlated with
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Fallahi, Ali Asghar; Jadidian, Ali Akbar
2011-01-01
It has been suggested that athletes with longer fingers and larger hand surfaces enjoy stronger grip power. Therefore, some researchers have examined a number of factors and anthropometric variables that explain this issue. To our knowledge, the data is scarce. Thus, the aim of this study was to investigate the effect of hand dimensions, hand shape and some anthropometric characteristics on handgrip strength in male grip athletes and non-athletes. 80 subjects aged between 19 and 29 participated in this study in two groups including: national and collegian grip athletes (n=40), and non-athletes (n=40). Body height and mass were measured to calculate body mass index. The shape of the dominant hand was drawn on a piece of paper with a thin marker so that finger spans, finger lengths, and perimeters of the hand could be measured. The hand shape was estimated as the ratio of the hand width to hand length. Handgrip strength was measured in the dominant and non-dominant hand using a standard dynamometer. Descriptive statistics were used for each variable and independent t test was used to analyze the differences between the two groups. The Pearson correlation coefficient test was used to evaluate the correlation between studied variables. Also, to predict important variables in handgrip strength, the linear trend was assessed using a linear regression analysis. There was a significant difference between the two groups in absolute handgrip strength (p<0.001) and handgrip/height ratio (p<0.001). The indices of body height, body mass, lean body mass and body fat content (p<0.001) were significantly greater in grip athletes. All hand variables except FS1-4 (p>0.05) were significantly different between the groups (p<0.001). After controlling body mass all hand anthropometric characteristics except thumb length (r=0.240, p= 0.135), hand shape (r=−0.029, p=0.858), middle finger length (r=0.305, p=0.056) and forearm circumference (r=0.162, p=0.319) significantly correlated with
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Birnbach, D J; King, D; Vlaev, I; Rosen, L F; Harvey, P D
2013-09-01
This study investigated the impact of a fresh scent on the rate of hand hygiene compliance (HHC) among novice healthcare providers. In all, 165 participants examined a standardized patient with one sample exposed to fresh scent (N = 79) and the other exposed to the standard environment (N = 86). Hand hygiene behaviours were tracked before patient contact using video surveillance. The standard environment group had an HHC rate of 51% whereas participants in the fresh scent group had a higher HHC rate of 80% (P < 0.001). These data demonstrate that hand hygiene behaviour may be subconsciously influenced by cues in the environment. © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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Mott, Peter J; Sisk, Brian W; Arbogast, James W; Ferrazzano-Yaussy, Cristina; Bondi, Cara A M; Sheehan, James J
2007-11-01
We investigated the impact of a customized alcohol-based instant hand sanitizer hand-hygiene regimen in an Army basic training setting. The entire population at the U.S. Army Field Artillery Training Center, Fort Sill, Oklahoma, participated in the 13-week prospective cohort study between January 18, 2005 and April 18, 2005. Two training battalions were randomly assigned to the control group, one to the primary intervention group (customized Purell Instant Hand Sanitizer regimen, education, reinforcement) and one to the secondary intervention group (customized Purell Instant Hand Sanitizer regimen). When compared to the control group, intervention groups experienced 40% less respiratory illness (p < 0.001), 48% less gastrointestinal illness (p < 0.02), 44% less lost training time (p < 0.001), and 31% fewer health care encounters (p < 0.001). These findings suggest that this intervention is capable of significantly reducing illness in this setting and has the potential to help reduce absenteeism in the military workforce as a whole.
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Tool making, hand morphology and fossil hominins
Marzke, Mary W.
2013-01-01
Was stone tool making a factor in the evolution of human hand morphology? Is it possible to find evidence in fossil hominin hands for this capability? These questions are being addressed with increasingly sophisticated studies that are testing two hypotheses; (i) that humans have unique patterns of grip and hand movement capabilities compatible with effective stone tool making and use of the tools and, if this is the case, (ii) that there exist unique patterns of morphology in human hands that are consistent with these capabilities. Comparative analyses of human stone tool behaviours and chimpanzee feeding behaviours have revealed a distinctive set of forceful pinch grips by humans that are effective in the control of stones by one hand during manufacture and use of the tools. Comparative dissections, kinematic analyses and biomechanical studies indicate that humans do have a unique pattern of muscle architecture and joint surface form and functions consistent with the derived capabilities. A major remaining challenge is to identify skeletal features that reflect the full morphological pattern, and therefore may serve as clues to fossil hominin manipulative capabilities. Hominin fossils are evaluated for evidence of patterns of derived human grip and stress-accommodation features. PMID:24101624
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Tool making, hand morphology and fossil hominins.
Marzke, Mary W
2013-11-19
Was stone tool making a factor in the evolution of human hand morphology? Is it possible to find evidence in fossil hominin hands for this capability? These questions are being addressed with increasingly sophisticated studies that are testing two hypotheses; (i) that humans have unique patterns of grip and hand movement capabilities compatible with effective stone tool making and use of the tools and, if this is the case, (ii) that there exist unique patterns of morphology in human hands that are consistent with these capabilities. Comparative analyses of human stone tool behaviours and chimpanzee feeding behaviours have revealed a distinctive set of forceful pinch grips by humans that are effective in the control of stones by one hand during manufacture and use of the tools. Comparative dissections, kinematic analyses and biomechanical studies indicate that humans do have a unique pattern of muscle architecture and joint surface form and functions consistent with the derived capabilities. A major remaining challenge is to identify skeletal features that reflect the full morphological pattern, and therefore may serve as clues to fossil hominin manipulative capabilities. Hominin fossils are evaluated for evidence of patterns of derived human grip and stress-accommodation features.
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Promoting Hand Hygiene With a Lighting Prompt.
Diegel-Vacek, Lauren; Ryan, Catherine
2016-10-01
The objective of this pilot study was to assess an automatic sink light design intervention as a prompt for clinician hand hygiene (as defined by World Health Organization [WHO]). Healthcare-associated infections (HAIs) are still leading causes of morbidity and mortality and contribute to burdens on our healthcare system. Hand hygiene has been related to reducing the rate of HAIs and positively impacting both patient and hospital outcomes. This pilot study was a prospective, longitudinal observational study of a convenience sample of healthcare clinicians. In one inpatient room, clinicians were exposed to a hand hygiene reminder that consisted of a light turning on over the sink as they entered. A control room (the adjacent inpatient room) did not have the intervention. A total of 88 clinician encounters were monitored during the study. On the first observation day at the initial activation of the signal light system, the percentage of clinicians performing hand hygiene upon entering a room was only 7% in the control room and 23% in the intervention room. During the second observation (Day 14), those percentages were 16% in the control room and 30% in the intervention room. During the third observation (Day 21), those percentages were 23% in the control room and 23% in the intervention room. The healthcare system frequently relies on expensive technology to improve healthcare delivery, but implementation of low-cost, low-technology methods such as this light may be effective in prompting hand hygiene. © The Author(s) 2016.
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Hand skill measurement: a gauge for treatment.
Bell, E; Jurek, K; Wilson, T
1976-02-01
Objective measurements of performance are vital with the increasing necessity to justify the need for occupational therapy services, and to conduct studies that measure the effectiveness of treatment procedures. This paper reports on a measurement of hand skill that was standardized by comparing hand skill performance among the able-bodied, or normal, population. The performance on this test o patients with various types of disabilities and the implications for treatment are discussed. For the paraplegic, the hand skill test indicates the need for occupational therapy services; for the quadriplegic, the test measures the effectiveness of functional orthotic devices; and for the hemiplegic, the hand skill test determines the potential for success in one aspect of self-care, dressing.
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The Black Cloud Phenomenon in Hand Surgery.
Zhao, Emily; Tiedeken, Nathan; Wang, William; Fowler, John
2018-04-01
The term black cloud for a surgeon is generally used to describe someone who is unusually busy compared with his or her counterparts, and it is a superstition that tends to pervade the medical world. The purpose of this study is to investigate whether black clouds exist in hand surgery. We examined one academic year's worth of hand surgery-specific call at a level I trauma center and tabulated the number of hand-related patient transfers and add-on cases per surgeon. Each surgeon was given a black cloud rating by the fellows who were in training that year. Correlations were made between the black cloud rating and the surgeons' call volume. There were 12 surgeons who shared 365 days of hand call, and 5 of them are hand surgery fellowship trained. Those 5 surgeons tended to be busier on their call days, with more cases added on overnight and the next day, and also had worse black cloud ratings than the 7 non-hand fellowship trained surgeons. In regard to hand surgery, while true emergencies occur and require emergent intervention, how busy hand surgeons may be during call may be influenced by a variety of factors not related to their patients' problems but rather their daily schedules, their hospitals' ability to facilitate add-on cases, and their rapport with their fellow surgeons to share case loads.
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Ambron, Elisabetta; White, Nicole; Faseyitan, Olufunsho; Kessler, Sudha K; Medina, Jared; Coslett, H Branch
2018-04-18
Changes in the perceived size of a body part using magnifying lenses influence tactile perception and pain. We investigated whether the visual magnification of one's hand also influences the motor system, as indexed by transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs). In Experiment 1, MEPs were measured while participants gazed at their hand with and without magnification of the hand. MEPs were significantly larger when participants gazed at a magnified image of their hand. In Experiment 2, we demonstrated that this effect is specific to the hand that is visually magnified. TMS of the left motor cortex did not induce an increase of MEPs when participants looked at their magnified left hand. Experiment 3 was performed to determine if magnification altered the topography of the cortical representation of the hand. To that end, a 3 × 5 grid centered on the cortical hot spot (cortical location at which a motor threshold is obtained with the lowest level of stimulation) was overlaid on the participant's MRI image, and all 15 sites in the grid were stimulated with and without magnification of the hand. We confirmed the increase in the MEPs at the hot spot with magnification and demonstrated that MEPs significantly increased with magnification at sites up to 16.5 mm from the cortical hot spot. In Experiment 4, we used paired-pulse TMS to measure short-interval intracortical inhibition and intracortical facilitation. Magnification was associated with an increase in short-interval intracortical inhibition. These experiments demonstrate that the visual magnification of one's hand induces changes in motor cortex excitability and generates a rapid remapping of the cortical representation of the hand that may, at least in part, be mediated by changes in short-interval intracortical inhibition.
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Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T
2016-08-01
The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.
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Changing the paradigm: messages for hand hygiene education and audit from cluster analysis.
Gould, D J; Navaie, D; Purssell, E; Drey, N S; Creedon, S
2018-04-01
Hand hygiene is considered to be the foremost infection prevention measure. How healthcare workers accept and make sense of the hand hygiene message is likely to contribute to the success and sustainability of initiatives to improve performance, which is often poor. A survey of nurses in critical care units in three National Health Service trusts in England was undertaken to explore opinions about hand hygiene, use of alcohol hand rubs, audit with performance feedback, and other key hand-hygiene-related issues. Data were analysed descriptively and subjected to cluster analysis. Three main clusters of opinion were visualized, each forming a significant group: positive attitudes, pragmatism and scepticism. A smaller cluster suggested possible guilt about ability to perform hand hygiene. Cluster analysis identified previously unsuspected constellations of beliefs about hand hygiene that offer a plausible explanation for behaviour. Healthcare workers might respond to education and audit differently according to these beliefs. Those holding predominantly positive opinions might comply with hand hygiene policy and perform well as infection prevention link nurses and champions. Those holding pragmatic attitudes are likely to respond favourably to the need for professional behaviour and need to protect themselves from infection. Greater persuasion may be needed to encourage those who are sceptical about the importance of hand hygiene to comply with guidelines. Interventions to increase compliance should be sufficiently broad in scope to tackle different beliefs. Alternatively, cluster analysis of hand hygiene beliefs could be used to identify the most effective educational and monitoring strategies for a particular clinical setting. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Renner, Jason M.
2000-01-01
Discusses how designing a hand washing-friendly environment can help to reduce the spread of germs in school restrooms. Use of electronic faucets, surface risk management, traffic flow, and user- friendly hand washing systems that are convenient and maximally hygienic are examined. (GR)
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Siritaratiwat, Wantana; Inthachom, Rumrada; Warnset, Somporn
2012-02-01
Specially designed chairs are expensive. A hand-made chair easily constructed from recycled material can be an alternative option. However data on the feasibility of hand-made chair use at home is limited. The present study aimed to explore the usage of a hand-made chair at home in children with moderate to severe motor disabilities. Seventeen children with cerebral palsy were recruited. Main caregivers were interviewed regarding the possibility of using the chair at home. Home visits and observations were also performed to explain how the chair had been used at home. Nine children (52.9%) used the chair everyday. Seven of these nine children were seated at least 30 minutes each time and two to three times per day. The total time that children spent on the hand-made chair each day ranged from 10 to 90 minutes. The severity of disability and main caregivers' workload may explain an inadequate usage of the hand-made chair. A few modifications may help to improve the applicability of the hand-made chair.
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[Hand transplantation and implantation of nerve chips. New developments within hand surgery].
Dahlin, L; Fridén, J; Hagberg, L; Lundborg, G
1999-10-06
Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open up new perspectives in the coming millennium.
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[Hand transplantation and implantation of nerve chips. New developments within hand surgery].
Dahlin, L; Fridén, J; Hagberg, L; Lundborg, G
2000-03-20
Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open iup new perspectives in the coming millennium.
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[Hand injuries from combat sports].
Hanna, W A; Laier, P
2015-06-01
Each year 3.1% of German adults suffer from accidents related to sports and 75% of the injured athletes are male between 20 and 29 years old. The upper limbs are affected in more than 20% of cases and one third of these injuries involve the hands and fingers. More than half a million athletes are organized in combat sport associations in Germany with an increasing trend. Combat sports are commonly said to have a high risk of injuries to the hand. The aim of this study was to test this hypothesis as well as to describe typical hand injuries associated with combat sports. A systematic review of literature (up to January 2015) in PubMed/Medline and The Cochrane Library as well as a secondary search in the reference lists were carried out. Conclusive comparative studies on the incidence and severity of hand injuries directly related to combat sports action could not be found in the currently available literature. The overall risk of suffering from a sports injury seems to be relatively low in combat sports compared to other sports. Boxing, however, seems to be the most dangerous sport for injuries to the upper extremities and especially the hand. The injury pattern after punching (emergency patients and professional boxers) shows that more than half of these fractures affect the 5th metacarpal and 25% of these are the classical boxer's fracture. This differs significantly from the fracture distribution generally associated with sports, where fractures of the phalanges are the most common. Two rare conditions that may occur as a result of repeated punching are referred to as carpal bossing and boxer's knuckle and excellent results are described for both injury forms after surgical therapy.
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Jain, Susan; Edgar, Denise; Bothe, Janine; Newman, Helen; Wilson, Annmaree; Bint, Beth; Brown, Megan; Alexander, Suzanne; Harris, Joanna
2015-12-01
Within the Australian public health care system, an observation model is used to assess hand hygiene practice in health care workers, culminating in a publicly available healthcare service performance indicator. The intent of this study was for the results to inform the development of a strategy to support individual auditors and local sustainability of the hand hygiene auditing program. This qualitative study used a values clarification tool to gain an understanding of the experiences of hand hygiene auditors. The methodology involved qualitative interpretation of focus group discussions to identify the enablers and barriers to successful performance of the auditors' role. Twenty-five participants identified congruous themes of the need for peer and managerial support, improved communication and feedback, and consideration for succession planning. There was consistency in the participants' most frequently identified significant barriers in undertaking the role. Hand hygiene auditors take pride in their role and work toward the goal of reducing health care-associated infections by having a part to play in improving hand hygiene practices of all staff members. Important themes, barriers, and enablers were identified in this study. This research will be of interest nationally and globally, considering the dearth of published information on the experience of hand hygiene auditors. This study provides evidence of the need to support individual hand hygiene auditors. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
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Grasping with the eyes of your hands: hapsis and vision modulate hand preference.
Stone, Kayla D; Gonzalez, Claudia L R
2014-02-01
Right-hand preference has been demonstrated for visually guided reaching and grasping. Grasping, however, requires the integration of both visual and haptic cues. To what extent does vision influence hand preference for grasping? Is there a hand preference for haptically guided grasping? Two experiments were designed to address these questions. In Experiment 1, individuals were tested in a reaching-to-grasp task with vision (sighted condition) and with hapsis (blindfolded condition). Participants were asked to put together 3D models using building blocks scattered on a tabletop. The models were simple, composed of ten blocks of three different shapes. Starting condition (Vision-First or Hapsis-First) was counterbalanced among participants. Right-hand preference was greater in visually guided grasping but only in the Vision-First group. Participants who initially built the models while blindfolded (Hapsis-First group) used their right hand significantly less for the visually guided portion of the task. To investigate whether grasping using hapsis modifies subsequent hand preference, participants received an additional haptic experience in a follow-up experiment. While blindfolded, participants manipulated the blocks in a container for 5 min prior to the task. This additional experience did not affect right-hand use on visually guided grasping but had a robust effect on haptically guided grasping. Together, the results demonstrate first that hand preference for grasping is influenced by both vision and hapsis, and second, they highlight how flexible this preference could be when modulated by hapsis.
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Kikuchi-Numagami, K; Suetake, T; Yanai, M; Takahashi, M; Tanaka, M; Tagami, H
2000-06-01
The skin of golfers' hands provides a suitable model to study the effect of chronic sun exposure, because one of their hands is exposed to the outer environment, especially sunlight, while the other one is always protected by a glove during play. Our purpose was to find out the influence of photodamage on the properties of the skin surface of middle-aged Japanese by using non-invasive methods. We measured hydration state, and water barrier function of the stratum corneum (SC) and the color of the skin of the dorsum of the hands. In a separate study, we evaluated the skin surface contour by using replicas taken from the skin in a slightly stretched or relaxed position. We found a significant decrease in hydration of the skin surface of the exposed skin as compared to that of the protected skin, whereas no such difference was found with transepidermal water loss, a parameter for water barrier function of the SC. Luminance of skin color was also reduced in the sun-exposed skin. Replica analysis revealed that large wrinkles developing in a relaxed position were more prominent on the exposed than on the protected skin, while fine furrows noted in a slightly stretched position were shallower on the former than the latter. The data obtained indicate that the chronically exposed skin of golfers' hands shows morphological and functional changes resulting from long time exposure to the outer environment especially sunlight. Furthermore, bioengineering non-invasive methods are found to be useful to detect early photodamage of the skin in a more quantitative fashion which is rather difficult to demonstrate clinically.
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2009-01-01
Background The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care. Methods The study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general) hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality of life, sick leave and
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NASA Astrophysics Data System (ADS)
Kustusch, Mary Bridget
2016-06-01
Students in introductory physics struggle with vector algebra and these challenges are often associated with contextual and representational features of the problems. Performance on problems about cross product direction is particularly poor and some research suggests that this may be primarily due to misapplied right-hand rules. However, few studies have had the resolution to explore student use of right-hand rules in detail. This study reviews literature in several disciplines, including spatial cognition, to identify ten contextual and representational problem features that are most likely to influence performance on problems requiring a right-hand rule. Two quantitative measures of performance (correctness and response time) and two qualitative measures (methods used and type of errors made) were used to explore the impact of these problem features on student performance. Quantitative results are consistent with expectations from the literature, but reveal that some features (such as the type of reasoning required and the physical awkwardness of using a right-hand rule) have a greater impact than others (such as whether the vectors are placed together or separate). Additional insight is gained by the qualitative analysis, including identifying sources of difficulty not previously discussed in the literature and revealing that the use of supplemental methods, such as physically rotating the paper, can mitigate errors associated with certain features.
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Zhan, P; Ge, Y P; Lu, X L; She, X D; Li, Z H; Liu, W D
2010-07-01
Two feet-one hand syndrome (bilateral plantar tinea pedis with coexistent unilateral tinea manuum) is commonly seen in dermatology clinics, but the cause of the unilateral hand involvement remains unresolved. To investigate the unilateral hand involvement in this syndrome. This was a case-control study. The experimental group comprised 113 patients with bilateral tinea pedis and unilateral tinea manuum and the control group comprised 44 patients with tinea pedis only, without tinea manuum. Clinical data were recorded and pathogens were identified by fungal examination. The predominant pathogen, Trichophyton rubrum, was genotyped by PCR amplification of tandem repeat elements from the ribosomal DNA nontranscribed spacer region. Scratching habits were significantly different between the groups, and there was a significant relationship between tinea manuum and the hand reportedly used to scratch the feet. In analysis of isolates from the feet and the involved hand, 94.5% of pairs were of the same species, and 80% of pairs had the same genotypes. Contact between hands and feet probably results in the transmission of dermatophytes from the feet to the scratching hand.
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Time Seeing a Hand Surgeon Is Not Associated With Patient Satisfaction.
Teunis, Teun; Thornton, Emily R; Jayakumar, Prakash; Ring, David
2015-07-01
Previous studies, predominantly in the primary care setting, identified time spent with the physician as an important predictor of satisfaction. It is unknown if the same holds true in hand surgery. Is patient satisfaction measured immediately after an office visit associated with the duration of time spent with the hand surgeon? What other factors are associated with satisfaction directly after the visits and 2 weeks after the appointment? We prospectively enrolled 81 patients visiting our hand and upper extremity surgery outpatient clinic. We recorded their demographics and measured physical function, pain behavior, symptoms of depression, time spent in the waiting room, time spent with the physician, and patient satisfaction. Office times were measured using our patient ambulatory tracking system and by a research assistant outside the clinic room. To assess satisfaction we used items from the Consumer Assessment of Healthcare Providers and Systems survey (a federally developed standardized survey instrument) relevant to our study. Two weeks later, 51 (64%) patients were available for telephone followup and the same measures were completed. Mean time spent with the hand surgeon was 8 ± 5 minutes and mean in-office wait time to see the hand surgeon was 32 ± 18 minutes. A priori power analyses indicated that 77 patients would provide 80% power to detect an effect size f(2) = 0.18 for a regression with five predictors. This means that we would detect time spent with the physician as a significant factor if it accounted for 7% or more of the variability in satisfaction. Time spent with the hand surgeon was not associated with patient satisfaction measured directly after the visit (r = -0.023; p = 0.84). Longer time waiting to see the physician correlated with decreased patient satisfaction (r = -0.30; p = 0.0057). The final multivariable model for increased satisfaction directly after the office visit included shorter waiting time (regression coefficient [β] -0
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Unique Assessment of Hand Surgery Knowledge by Specialty.
Silvestre, Jason; Lin, Ines C; Chang, Benjamin; Levin, L Scott
2016-03-01
Orthopedic and plastic surgery residents receive unique training yet often compete for similar hand surgery fellowships. This study compared didactic hand surgery training during orthopedic and plastic surgery residency. The Plastic Surgery In-Service Training Exam and Orthopaedic In-Training Examination were analyzed for hand content for the years 2009 to 2013. Topics were categorized with the content outline for the Surgery of the Hand Examination. Differences were elucidated by means of Fisher's exact test. Relative to the Orthopaedic In-Training Examination, the Plastic Surgery In-Service Training Exam had greater hand representation (20.3 percent versus 8.1 percent; p < 0.001) with more annual hand questions (40 ± 3 versus 24 ± 2; p < 0.001). The Plastic Surgery Exam questions had more words, were less often level I-recall type, and were less often image-based. The questions focused more on finger and hand/palm anatomy, whereas the Orthopaedic examination was more wrist-focused. The Plastic Surgery Exam emphasized wound management and muscle/tendon injuries, but underemphasized fractures/dislocations. References differed, but Journal of Hand Surgery (American Volume) and Green's Operative Hand Surgery were common on both examinations. The Plastic Surgery Exam had a greater publication lag for journal references (10.7 ± 0.5 years versus 9.0 ± 0.6; p = 0.035). Differences in didactic hand surgery training are elucidated for plastic surgery and orthopedic residents. Deficiencies in the Plastic Surgery In-Service Training Exam hand curriculum relative to the Orthopaedic In-Training Examination may underprepare plastic surgeons for the Surgery of the Hand Examination. These data may assist future modifications to hand surgery training in the United States.
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Quantitative impact of direct, personal feedback on hand hygiene technique.
Lehotsky, Á; Szilágyi, L; Ferenci, T; Kovács, L; Pethes, R; Wéber, G; Haidegger, T
2015-09-01
This study investigated the effectiveness of targeting hand hygiene technique using a new training device that provides objective, personal and quantitative feedback. One hundred and thirty-six healthcare workers in three Hungarian hospitals participated in a repetitive hand hygiene technique assessment study. Ultraviolet (UV)-labelled hand rub was used at each event, and digital images of the hands were subsequently taken under UV light. Immediate objective visual feedback was given to participants, showing missed areas on their hands. The rate of inadequate hand rubbing reduced from 50% to 15% (P < 0.001). However, maintenance of this reduced rate is likely to require continuous use of the electronic equipment. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
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Evaluation of hand-arm and whole-body vibrations in construction and property management.
Coggins, Marie A; Van Lente, Eric; McCallig, Margaret; Paddan, Gurmail; Moore, Ken
2010-11-01
To identify and measure the magnitude of hand-arm vibration (HAV) and whole-body vibration (WBV) sources (tools, vehicles etc.) in use within a previously unexamined sector: a construction and property management company. To evaluate the effect of factors such as age of tool, materials being worked on, number and location of tool handles, tool weight, and manufacturer brand on HAV magnitude and the effect of factors such as manufacturer machine brand, terrain, and work task on WBV magnitude. This study was carried out in a construction and property management company, employees (n = 469) working in the engineering services and maintenance departments who use vibrating equipment as part of their work were invited to participate. Two hundred and eighty-nine employees working as general operatives, excavator drivers, stone masons, carpenters, labourers, fitters, welders, and gardeners agreed to participate. A total of 20 types of hand tool (n = 264) and 11 types of vehicle (n = 158) in use within the company were selected for inclusion in the study. Five pieces of equipment had never previously been measured. Vibration measurements were carried out in accordance with ISO 5349-1 (Mechanical vibration-measurement and assessment of human exposure to hand transmitted vibration-Part 1: general guidance. 2001) (HAV) and ISO 2631-1 (Mechanical vibration and shock: evaluation of human exposure to WBV in the working environment. Part 1-general requirements. 1997) (WBV). Vibration measurements were made while workers were operating the equipment as part of their normal work activities. A wide range of vibration emission values were recorded for most tool types, e.g. orbital sanders (1.39-10.90 m s⁻²) and angle grinders (0.28-12.25 m s⁻²), and vehicle, e.g. forklifts (0.41-1.00 m s⁻²) and tractors (0.04-0.42 m s⁻²). Vibration magnitudes were largely consistent with those found in previous studies. The highest HAV magnitude was measured on a demolition hammer (13.3 m
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Reedman, Sarah Elizabeth; Beagley, Simon; Sakzewski, Leanne; Boyd, Roslyn N
2016-08-01
The aim of this pilot study was to evaluate reproducibility of the Jebsen Taylor Test of Hand Function (JTTHF) in children. Eighty-seven typically developing children 5 to 10 years old were included from five Outside School Hours Care centers in the Greater Brisbane Region, Australia. Hand function was assessed on two occasions with a modified JTTHF, then reproducibility was assessed using Intraclass Correlation Coefficient (ICC [3,1]) and the Standard Error of Measurement (SEM). Total scores for male and female children were not significantly different. Five-year-old children were significantly different to all other age groups and were excluded from further analysis. Results for 71 children, 6 to 10 years old were analyzed (mean age 8.31 years (SD 1.32); 33 males). Test-retest reliability for total scores on the dominant and nondominant hands were ICC 0.74 (95% CI 0.61, 0.83) and ICC 0.72 (95% CI 0.59, 0.82), respectively. 'Writing' and 'Simulated Feeding' subtests demonstrated poor reproducibility. The Smallest Real Difference was 5.09 seconds for total score on the dominant hand. Findings indicate good test-retest reliability for the JTTHF total score to measure hand function in typically developing children aged 6 to 10 years.
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Variability in Resident Operative Hand Experience by Specialty.
Silvestre, Jason; Lin, Ines C; Levin, L Scott; Chang, Benjamin
2018-01-01
Recent attention has sought to standardize hand surgery training in the United States. This study analyzes the variability in operative hand experience for orthopedic and general surgery residents. Case logs for orthopedic and general surgery residency graduates were obtained from the American Council of Graduate Medical Education (2006-2007 to 2014-2015). Plastic surgery case logs were not available for comparison. Hand surgery case volumes were compared between specialties with parametric tests. Intraspecialty variation in orthopedic surgery was assessed between the bottom and top 10th percentiles in procedure categories. Case logs for 9605 general surgery residents and 5911 orthopedic surgery residents were analyzed. Orthopedic surgery residents performed a greater number of hand surgery cases than general surgery residents ( P < .001). Mean total hand experience ranged from 2.5 ± 4 to 2.8 ± 5 procedures for general surgery residents with no reported cases of soft tissue repairs, vascular repairs, and replants. Significant intraspecialty variation existed in orthopedic surgery for all hand procedure categories (range, 3.3-15.0). As the model for hand surgery training evolves, general surgeons may represent an underutilized talent pool to meet the critical demand for hand surgeon specialists. Future research is needed to determine acceptable levels of training variability in hand surgery.
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Deep Invasive Fungal Infection of the Hand in a Child Mimicking a Local Gigantism.
Chatterjee, Anirban; Chatterjee, Shamita
2018-04-01
Subcutaneous and deep fungal infections in the hand are rare among children. These are usually found in immunocompromised adults or in persons engaged in soil handling activities, due to direct exposure, especially in the tropics. Delay in diagnosis is usual because pyogenic and other granulomatous infections are considered first. The authors present the case of a healthy, immunocompetent 2½-year-old child who presented with progressive swelling of the right hand mimicking a localized gigantism of the entire hand. Multiple operative drainage procedures done previously had failed to resolve the condition. A biopsy established the presence of fungal hyphae, thus confirming the diagnosis of deep fungal infection of the hand and guided proper therapeutic intervention. A strong index of suspicion needs to be maintained in cases not responding to conventional antibacterial therapy, and both microbiologic and histopathologic samples need to be obtained to establish the diagnosis.
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NASA Technical Reports Server (NTRS)
McFarland, Shane
2016-01-01
Injuries to the hands are common among astronauts who train for extravehicular activity. When the gloves are pressurized, they restrict movement and create pressure points during tasks, sometimes resulting in pain, muscle fatigue, abrasions, and occasionally more severe injuries such as onycholysis. A brief review of NASA's Lifetime Surveillance of Astronaut Health's injury database reveals that 76 percent of astronaut hand and arm injuries from training between 1993 and 2010 occurred either to the fingernail, finger crotch, metacarpophalangeal joint, or fingertip. The purpose of this study was to assess the potential of using small sensors to measure forces acting on the fingers and hand within pressurized gloves and other variables such as skin temperature, humidity, and fingernail strain of a NASA crewmember during typical NBL (Neutral Buoyancy Laboratory) training activity. During the 5-hour exercise, the crewmember seemed to exhibit very large forces on some fingers, resulting in higher strain than seen in previous glove-box testing. In addition, vital information was collected on the glove cavity environment with respect to temperature and humidity. All of this information gathered during testing will be carried forward into future testing, potentially in glove-box- or 1G- (1 gravitational force) or NBL-suited environments, to better characterize and understand the possible causes of hand injury amongst NASA crew.
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ERIC Educational Resources Information Center
Liu, Xiufeng
2006-01-01
Based on current theories of chemistry learning, this study intends to test a hypothesis that computer modeling enhanced hands-on chemistry laboratories are more effective than hands-on laboratories or computer modeling laboratories alone in facilitating high school students' understanding of chemistry concepts. Thirty-three high school chemistry…
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ERIC Educational Resources Information Center
Frohlich, Lauren; Wesley, Alison; Wallen, Margaret; Bundy, Anita
2012-01-01
Purpose: Pain associated with hypermobility of wrist and hand joints can contribute to decreased handwriting output. This study examined the effectiveness of a neoprene wrist/hand splint in reducing pain and increasing handwriting speed and endurance for students with joint hypermobility syndrome. Methods: Multiple baseline, single system design…
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Toddler hand preference trajectories predict 3-year language outcome.
Nelson, Eliza L; Gonzalez, Sandy L; Coxe, Stefany; Campbell, Julie M; Marcinowski, Emily C; Michel, George F
2017-11-01
A growing body of work suggests that early motor experience affects development in unexpected domains. In the current study, children's hand preference for role-differentiated bimanual manipulation (RDBM) was measured at monthly intervals from 18 to 24 months of age (N = 90). At 3 years of age, children's language ability was assessed using the Preschool Language Scales 5th edition (PLS™-5). Three distinct RDBM hand preference trajectories were identified using latent class growth analysis: (1) children with a left hand preference but a moderate amount of right hand use; (2) children with a right hand preference but a moderate amount of left hand use; and (3) children with a right hand preference and only a mild amount of left hand use. Stability over time within all three trajectories indicated that children did not change hand use patterns from 18 to 24 months. Children with the greatest amount of preferred (i.e., right) hand use demonstrated higher expressive language scores compared to children in both trajectories with moderate levels of non-preferred hand use. Children with the greatest amount of right hand use also had higher scores for receptive language compared to children with a right hand preference but moderate left hand use. Results support that consistency in handedness as measured by the amount of preferred hand use is related to distal language outcomes in development. © 2017 Wiley Periodicals, Inc.
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Price, A; Eccles, R
2017-10-01
Left- or right-handedness is a common human trait, and it has been previously reported that human nasal airflow dominance correlates with hand dominance. Any relationship between hand dominance and nasal airflow dominance would be unusual. This study aimed to measure nasal airflow and look for any relationship to handedness. The modified Glatzel mirror was used to record the dominant nasal passage at 15-minute intervals over a 6-hour period in 29 healthy participants consisting of 15 left-handers and 14 right-handers. In left-handers, the percentage of time that the left nasal passage was dominant ranged from 0 to 100 per cent. In right-handers, the percentage of time that the right nasal passage was dominant ranged from 4.2 to 95.8 per cent. No correlation between nasal airflow dominance and hand dominance was identified. The results do not support the hypothesis that nasal airflow and handedness are related.
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Hand posture and cognitive control: The congruency sequence effect is reduced near the hands.
Englert, Julia; Wentura, Dirk
2016-10-01
According to several recent articles, attentional processing seems to be modulated by the proximity of one's own hand to a stimulus. Weidler and Abrams (Psychonomic Bulletin & Review, 21, 462-469, 2014) found a significant reduction of the Eriksen flanker effect when the stimuli were presented close to the participants' hands. They interpreted this as evidence for stronger cognitive control near the hands. Using a near-by hands manipulation intended to vary distance while keeping posture of the hands constant, we found a modulation of the congruency sequence effect (CSE or Gratton effect), i.e., a larger flanker effect following incompatible trials than following compatible trials. The CSE was eliminated near the hands. Though we did not find a reduction in the flanker effect itself (which might be the result of using a near-by hand manipulation somewhat different from that of Weidler and Abrams), this result can be considered to be compatible with Weidler and Abrams' original hypothesis if the congruency sequence effect is interpreted in terms of cognitive control.
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Bracci, Stefania; Ietswaart, Magdalena; Peelen, Marius V; Cavina-Pratesi, Cristiana
2010-06-01
Accumulating evidence points to a map of visual regions encoding specific categories of objects. For example, a region in the human extrastriate visual cortex, the extrastriate body area (EBA), has been implicated in the visual processing of bodies and body parts. Although in the monkey, neurons selective for hands have been reported, in humans it is unclear whether areas selective for individual body parts such as the hand exist. Here, we conducted two functional MRI experiments to test for hand-preferring responses in the human extrastriate visual cortex. We found evidence for a hand-preferring region in left lateral occipitotemporal cortex in all 14 participants. This region, located in the lateral occipital sulcus, partially overlapped with left EBA, but could be functionally and anatomically dissociated from it. In experiment 2, we further investigated the functional profile of hand- and body-preferring regions by measuring responses to hands, fingers, feet, assorted body parts (arms, legs, torsos), and non-biological handlike stimuli such as robotic hands. The hand-preferring region responded most strongly to hands, followed by robotic hands, fingers, and feet, whereas its response to assorted body parts did not significantly differ from baseline. By contrast, EBA responded most strongly to body parts, followed by hands and feet, and did not significantly respond to robotic hands or fingers. Together, these results provide evidence for a representation of the hand in extrastriate visual cortex that is distinct from the representation of other body parts.
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Ietswaart, Magdalena; Peelen, Marius V.; Cavina-Pratesi, Cristiana
2010-01-01
Accumulating evidence points to a map of visual regions encoding specific categories of objects. For example, a region in the human extrastriate visual cortex, the extrastriate body area (EBA), has been implicated in the visual processing of bodies and body parts. Although in the monkey, neurons selective for hands have been reported, in humans it is unclear whether areas selective for individual body parts such as the hand exist. Here, we conducted two functional MRI experiments to test for hand-preferring responses in the human extrastriate visual cortex. We found evidence for a hand-preferring region in left lateral occipitotemporal cortex in all 14 participants. This region, located in the lateral occipital sulcus, partially overlapped with left EBA, but could be functionally and anatomically dissociated from it. In experiment 2, we further investigated the functional profile of hand- and body-preferring regions by measuring responses to hands, fingers, feet, assorted body parts (arms, legs, torsos), and non-biological handlike stimuli such as robotic hands. The hand-preferring region responded most strongly to hands, followed by robotic hands, fingers, and feet, whereas its response to assorted body parts did not significantly differ from baseline. By contrast, EBA responded most strongly to body parts, followed by hands and feet, and did not significantly respond to robotic hands or fingers. Together, these results provide evidence for a representation of the hand in extrastriate visual cortex that is distinct from the representation of other body parts. PMID:20393066
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Clinical Features and Awareness of Hand Eczema in Korea
Park, Jae Beom; Lee, Seung Ho; Kim, Kea Jeung; Lee, Ga-Young; Yang, Jun-Mo; Kim, Do Won; Lee, Seok Jong; Lee, Cheol Heon; Park, Eun Joo; Kim, Kyu Han; Eun, Hee Chul; Chang, Sung Eun; Moon, Kee Chan; Kim, Seong Hyun; Kim, Seong Jin; Kim, Byung-Soo; Lee, Jun Young; Kim, Hyung-Ok; Kang, Hoon; Lee, Min Geol; Kim, Soo-Chan; Ro, Young Suck; Ko, Joo Yeon; Park, Mi Youn; Kim, Myung Hwa; Shin, Jeong Hyun; Choi, Hae Young; Hong, Chang Kwun; Lee, Sung Yul; Bak, Hana
2016-01-01
Background Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. Objective To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. Methods To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. Results The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. Conclusion Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment. PMID:27274632
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Pechlaner, S; Hussl, H
1998-01-01
The hand is very exposed to injuries in the daily man's work. The multiple functions of the hand are based on vitality, sensibility, motor function and stability. In severe hand injuries the functional results of the repair are often very poor. In a complex injury of the hand we are faced with the damage of the soft tissue and bone and the loss of vitality and function of the hand. The cause of hand injuries are mainly a crush trauma or the rotating saw. Basically, we recommend an extended primary repair. After the radical debridement we have to reconstruct the damaged structures. We start doing the osteosynthesis and stabilization of the joints. Thereafter, suturing of extensor and flexor tendons. Then, we do the microsurgical reconstructions of vessels and nerves. In case tendons and bones are exposed we have to cover the defect with a pedicled or a free flap. In a long ischemic time we have to change our concept and do the reconstruction of the vessels first. Our results in vitality and sensibility are listed. In the result of a complex hand injury each single functional restoration is very important. Therefore, it is necessary that severe hand injuries are treated at well established centres for hand surgery.
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Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W
2016-08-01
BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.
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Embodied neurofeedback with an anthropomorphic robotic hand
Braun, Niclas; Emkes, Reiner; Thorne, Jeremy D.; Debener, Stefan
2016-01-01
Neurofeedback-guided motor imagery training (NF-MIT) has been suggested as a promising therapy for stroke-induced motor impairment. Whereas much NF-MIT research has aimed at signal processing optimization, the type of sensory feedback given to the participant has received less attention. Often the feedback signal is highly abstract and not inherently coupled to the mental act performed. In this study, we asked whether an embodied feedback signal is more efficient for neurofeedback operation than a non-embodiable feedback signal. Inspired by the rubber hand illusion, demonstrating that an artificial hand can be incorporated into one’s own body scheme, we used an anthropomorphic robotic hand to visually guide the participants’ motor imagery act and to deliver neurofeedback. Using two experimental manipulations, we investigated how a participant’s neurofeedback performance and subjective experience were influenced by the embodiability of the robotic hand, and by the neurofeedback signal’s validity. As pertains to embodiment, we found a promoting effect of robotic-hand embodiment in subjective, behavioral, electrophysiological and electrodermal measures. Regarding neurofeedback signal validity, we found some differences between real and sham neurofeedback in terms of subjective and electrodermal measures, but not in terms of behavioral and electrophysiological measures. This study motivates the further development of embodied feedback signals for NF-MIT. PMID:27869190
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Control of a Supernumerary Robotic Hand by Foot: An Experimental Study in Virtual Reality
Abdi, Elahe; Burdet, Etienne; Bouri, Mohamed; Bleuler, Hannes
2015-01-01
In the operational theater, the surgical team could highly benefit from a robotic supplementary hand under the surgeon’s full control. The surgeon may so become more autonomous; this may reduce communication errors with the assistants and take over difficult tasks such as holding tools without tremor. In this paper, we therefore examine the possibility to control a third robotic hand with one foot’s movements. Three experiments in virtual reality were designed to assess the feasibility of this control strategy, the learning curve of the subjects in different tasks and the coordination of foot movements with the two natural hands. Results show that the limbs are moved simultaneously, in parallel rather than serially. Participants’ performance improved within a few minutes of practice without any specific difficulty to complete the tasks. Subjective assessment by the subjects indicated that controlling a third hand by foot has been easy and required only negligible physical and mental efforts. The sense of ownership was reported to improve through the experiments. The mental burden was not directly related to the level of motion required by a task, but depended on the type of activity and practice. The most difficult task was moving two hands and foot in opposite directions. These results suggest that a combination of practice and appropriate tasks can enhance the learning process for controlling a robotic hand by foot. PMID:26225938
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Popević, Martin B; Janković, Srđan M; Borjanović, Srđan S; Jovičić, Slavica R; Tenjović, Lazar R; Milovanović, Aleksandar P S; Bulat, Petar
2014-03-01
A frequently encountered exposure profile for hand-arm vibration in contemporary occupational setting comprises workers with a long history of intermittent exposure but without detectable signs of hand-arm vibration syndrome (HAVS). Yet, most of the published studies deal with developed HAVS cases, rarely discussing the biological processes that may be involved in degradation of manual dexterity and grip strength when it can be most beneficial - during the asymptomatic stage. In the present paper, a group of 31 male asymptomatic vibration-exposed workers (according to the Stockholm Workshop Scale) were compared against 30 male controls. They were tested using dynamometry and dexterimetry (modelling coarse and fine manual performance respectively) and cold provocation was done to detect possible differences in manual performance drop on these tests. The results showed reduced manual dexterity but no significant degradation in hand grip strength in the exposed subjects. This suggests that intermittent exposure profile and small cumulative vibration dose could only lead to a measurable deficit in manual dexterity but not hand grip strength even at non-negligible A(8) levels and long term exposures.
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Pickering, Amy J; Davis, Jennifer; Blum, Annalise G; Scalmanini, Jenna; Oyier, Beryl; Okoth, George; Breiman, Robert F; Ram, Pavani K
2013-09-01
Handwashing is difficult in settings with limited resources and water access. In primary schools within urban Kibera, Kenya, we investigated the impact of providing waterless hand sanitizer on student hand hygiene behavior. Two schools received a waterless hand sanitizer intervention, two schools received a handwashing with soap intervention, and two schools received no intervention. Hand cleaning behavior after toilet use was monitored for 2 months using structured observation. Hand cleaning after toileting was 82% at sanitizer schools (N = 2,507 toileting events), 38% at soap schools (N = 3,429), and 37% at control schools (N = 2,797). Students at sanitizer schools were 23% less likely to have observed rhinorrhea than control students (P = 0.02); reductions in student-reported gastrointestinal and respiratory illness symptoms were not statistically significant. Providing waterless hand sanitizer markedly increased student hand cleaning after toilet use, whereas the soap intervention did not. Waterless hand sanitizer may be a promising option to improve student hand cleansing behavior, particularly in schools with limited water access.
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Marjadi, B; McLaws, M-L
2010-11-01
Few attempts to increase healthcare workers' hand hygiene compliance have included an in-depth analysis of the social and behavioural context in which hand hygiene is not undertaken. We used a mixed method approach to explore hand hygiene barriers in rural Indonesian healthcare facilities to develop a resource-appropriate adoption of international guidelines. Two hospitals and eight clinics (private and public) in a rural Indonesian district were studied for three months each. Hand hygiene compliance was covertly observed for two shifts each in three adult wards at two hospitals. Qualitative data were collected from direct observation, focus group discussions and semistructured in-depth and informal interviews within healthcare facilities and the community. Major barriers to compliance included longstanding water scarcity, tolerance of dirtiness by the community and the healthcare organisational culture. Hand hygiene compliance was poor (20%; 57/281; 95% CI: 16-25%) and was more likely to be undertaken after patient contact (34% after-patient contact vs 5% before-patient contact, P<0.001) and 'inherent' opportunities associated with contacts perceived to be dirty (49% 'inherent' vs 11% 'elective' opportunities associated with clean contacts, P<0.001). Clinicians frequently touched patients without hand hygiene, and some clinicians avoided touching patients altogether. The provision of clean soap and water and in-service training will not overcome strong social and behavioural barriers unless interventions focus on long term community education and managerial commitment to the provision of supportive working conditions. Copyright © 2010 The Hospital Infection Society. All rights reserved.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Salisbury, Curt Michael; Dullea, Kevin J.
Technologies pertaining to a robotic hand are described herein. The robotic hand includes one or more fingers releasably attached to a robotic hand frame. The fingers can abduct and adduct as well as flex and tense. The fingers are releasably attached to the frame by magnets that allow for the fingers to detach from the frame when excess force is applied to the fingers.
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Extending the Theory of Normative Social Behavior to Predict Hand-Washing among Koreans.
Chung, Minwoong; Lapinski, Maria Knight
2018-04-10
The current study tests the predictions of the theory of normative social behavior (TNSB) in a hand-washing context in a Korean sample and extends the theory to examine the role of perceived publicness, a variable believed to activate face concerns, as a moderator of the norm-behavior relationship. The findings show substantial main effects for all of the study variables on behavior. In addition, the descriptive norm-behavior relationship is moderated by perceived publicness and outcome expectations, but the nature of the interactions is not consistent with that evidenced in previous literature on US samples. Implications for normative theory and communication campaigns are discussed.
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Lluch Girbés, E; Meeus, M; Baert, I; Nijs, J
2015-04-01
Traditional understanding of osteoarthritis-related pain has recently been challenged in light of evidence supporting a key role of central sensitization in a subgroup of this population. This fact may erroneously lead musculoskeletal therapists to conclude that hands-on interventions have no place in OA management, and that hands-off interventions must be applied exclusively. The aim of this paper is to encourage clinicians in finding an equilibrium between hands-on and hands-off interventions in patients with osteoarthritis-related pain dominated by central sensitization. The theoretical rationale for simultaneous application of manual therapy and pain neuroscience education is presented. Practical problems when combining these interventions are also addressed. Future studies should explore the combined effects of these treatment strategies to examine whether they increase therapeutic outcomes against current approaches for chronic osteoarthritis-related pain. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Oppong, Raymond; Nicholls, Elaine; Whitehurst, David G. T.; Hill, Susan; Hammond, Alison; Hay, Elaine M.; Dziedzic, Krysia
2015-01-01
Objectives. Evidence regarding the cost-effectiveness of joint protection and hand exercises for the management of hand OA is not well established. The primary aim of this study is to assess the cost-effectiveness (cost-utility) of these management options. In addition, given the absence of consensus regarding the conduct of economic evaluation alongside factorial trials, we compare different analytical methodologies. Methods. A trial-based economic evaluation to assess the cost-utility of joint protection only, hand exercises only and joint protection plus hand exercises compared with leaflet and advice was undertaken over a 12 month period from a UK National Health Service perspective. Patient-level mean costs and mean quality-adjusted life years (QALYs) were calculated for each trial arm. Incremental cost-effectiveness ratios (ICERs) were estimated and cost-effectiveness acceptability curves were constructed. The base case analysis used a within-the-table analysis methodology. Two further methods were explored: the at-the-margins approach and a regression-based approach with or without an interaction term. Results. Mean costs (QALYs) were £58.46 (s.d. 0.662) for leaflet and advice, £92.12 (s.d. 0.659) for joint protection, £64.51 (s.d. 0.681) for hand exercises and £112.38 (s.d. 0.658) for joint protection plus hand exercises. In the base case, hand exercises were the cost-effective option, with an ICER of £318 per QALY gained. Hand exercises remained the most cost-effective management strategy when adopting alternative methodological approaches. Conclusion. This is the first trial evaluating the cost-effectiveness of occupational therapy-supported approaches to self-management for hand OA. Our findings showed that hand exercises were the most cost-effective option. PMID:25339642
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Rai, Herleen; Knighton, Shanina; Zabarsky, Trina F; Donskey, Curtis J
2017-09-01
To facilitate patient hand hygiene, there is a need for easy-to-use products. In a survey of 100 patients, a single-use ethanol hand sanitizer packet took less time to access than a single-use moist towelette packet (3 vs 23 seconds) and was preferred by 74% of patients for mealtime hand hygiene. Performance of patient hand hygiene increased when a reminder was provided at the time of meal tray delivery. Published by Elsevier Inc.
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Logan, Gordon D; Crump, Matthew J C
2009-10-01
Everyone knows that attention to the details disrupts skilled performance, but little empirical evidence documents this fact. We show that attention to the hands disrupts skilled typewriting. We had skilled typists type words preceded by cues that told them to type only the letters assigned to one hand or to type all of the letters. Cuing the hands disrupted performance markedly, slowing typing and increasing the error rate (Experiment 1); these deleterious effects were observed even when no keystrokes were actually inhibited (Experiment 3). However, cuing the same letters with colors was not disruptive (Experiment 2). We account for the disruption with a hierarchical control model, in which an inner loop controls the hands and an outer loop controls what is typed. Typing letters using only one hand requires the outer loop to monitor the inner loop's output; the outer loop slows inner-loop cycle time to increase the likelihood of inhibiting responses with the unwanted hand. This produces the disruption.
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IJmker, Stefan; Blatter, Birgitte M.; de Korte, Elsbeth M.
2007-01-01
Introduction The objective of the present study is to describe the extent of productivity loss among computer workers with neck/shoulder symptoms and hand/arm symptoms, and to examine associations between pain intensity, various physical and psychosocial factors and productivity loss in computer workers with neck/shoulder and hand/arm symptoms. Methods A cross-sectional design was used. The study population consisted of 654 computer workers with neck/shoulder or hand/arm symptoms from five different companies. Descriptive statistics were used to describe the occurrence of self-reported productivity loss. Logistic regression analyses were used to examine the associations. Results In 26% of all the cases reporting symptoms, productivity loss was involved, the most often in cases reporting both symptoms (36%). Productivity loss involved sickness absence in 11% of the arm/hand cases, 32% of the neck/shoulder cases and 43% of the cases reporting both symptoms. The multivariate analyses showed statistically significant odds ratios for pain intensity (OR: 1.26; CI: 1.12–1.41), for high effort/no low reward (OR: 2.26; CI: 1.24–4.12), for high effort/low reward (OR: 1.95; CI: 1.09–3.50), and for low job satisfaction (OR: 3.10; CI: 1.44–6.67). Physical activity in leisure time, full-time work and overcommitment were not associated with productivity loss. Conclusion In most computer workers with neck/shoulder symptoms or hand/arm symptoms productivity loss derives from a decreased performance at work and not from sickness absence. Favorable psychosocial work characteristics might prevent productivity loss in symptomatic workers. PMID:17636455
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A retrospective outcomes study examining the effect of interactive metronome on hand function.
Shank, Tracy M; Harron, Wendy
2015-01-01
Interactive Metronome (IM, The Interactive Metronome Company, Sunrise, Florida, USA) is a computer-based modality marketed to rehabilitation professionals who want to improve outcomes in areas of coordination, motor skills, self-regulation behaviors, and cognitive skills. This retrospective study examined the efficacy of IM training on improving timing skills, hand function, and parental report of self-regulatory behaviors. Forty eight children with mixed motor and cognitive diagnoses completed an average of 14 one-hour training sessions over an average of 8.5 weeks in an outpatient setting. Each child was assessed before and after training with the Interactive Metronome Long Form Assessment, the Jebsen Taylor Test of Hand Function, and a parent questionnaire. All three measures improved with statistical significance despite participants having no direct skill training. These results suggest an intimate relationship between cognition and motor skills that has potential therapeutic value. Level 4, Retrospective Case Series. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
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Soni, Dileep; Raisingani, Deepak; Mathur, Rachit; Madan, Nidha; Visnoi, Suchita
2016-01-01
To evaluate the incidence of apical crack initiation during canal preparation with stainless steel K-files and hand protaper files (in vitro study). Sixty extracted mandibular premo-lar teeth are randomly selected and embedded in an acrylic tube filled with autopolymerizing resin. A baseline image of the apical surface of each specimen was recorded under a digital microscope (80×). The cervical and middle thirds of all samples were flared with #2 and #1 Gates-Glidden (GG) drills, and a second image was recorded. The teeth were randomly divided into four groups of 15 teeth each according to the file type (hand K-file and hand-protaper) and working length (WL) (instrumented at WL and 1 mm less than WL). Final image after dye penetration and photomicrograph of the apical root surface were digitally recorded. Maximum numbers of cracks were observed with hand protaper files compared with hand K-file at the WL and 1 mm short of WL. Chi-square testing revealed a highly significant effect of WL on crack formation at WL and 1 mm short of WL (p = 0.000). Minimum numbers of cracks at WL and 1 mm short of WL were observed with hand K-file and maximum with hand protaper files. Soni D, Raisingani D, Mathur R, Madan N, Visnoi S. Incidence of Apical Crack Initiation during Canal Preparation using Hand Stainless Steel (K-File) and Hand NiTi (Protaper) Files. Int J Clin Pediatr Dent 2016;9(4):303-307.