replace hands-on training: Topics by Science.gov

Sample records for replace hands-on training

Design of rehabilitation robot hand for fingers CPM training

NASA Astrophysics Data System (ADS)

Zhou, Hongfu; Chan, T. W.; Tong, K. Y.; Kwong, K. K.; Yao, Xifan

2008-10-01

This paper presents a low-cost prototype for rehabilitation robot aide patient do hands CPM (continuous passive motion) training. The design of the prototype is based on the principle of Rutgers Master II glove, but it is better in performance for more improvement made. In the design, it uses linear motors to replace pneumatic actuators to make the product more portable and mobile. It increases finger training range to 180 degree for the full range training of hand finger holding and extension. Also the prototype can not only be wearing on palm and fore arm do training for face to face with finger move together, but also be put in the opposite hand glove wear direction for hand rehabilitation training. During the research, Solidworks is used as the tool for mechanical design and movement simulation. It proved through experiment that the prototype made in the research is appropriate for hand do CPM training.
Haptically facilitated bimanual training combined with augmented visual feedback in moderate to severe hemiplegia.

PubMed

Boos, Amy; Qiu, Qinyin; Fluet, Gerard G; Adamovich, Sergei V

2011-01-01

This study describes the design and feasibility testing of a hand rehabilitation system that provides haptic assistance for hand opening in moderate to severe hemiplegia while subjects attempt to perform bilateral hand movements. A cable-actuated exoskeleton robot assists the subjects in performing impaired finger movements but is controlled by movement of the unimpaired hand. In an attempt to combine the neurophysiological stimuli of bilateral movement and action observation during training, visual feedback of the impaired hand is replaced by feedback of the unimpaired hand, either by using a sagittaly oriented mirror or a virtual reality setup with a pair of virtual hands presented on a flat screen controlled with movement of the unimpaired hand, providing a visual image of their paretic hand moving normally. Joint angles for both hands are measured using data gloves. The system is programmed to maintain a symmetrical relationship between the two hands as they respond to commands to open and close simultaneously. Three persons with moderate to severe hemiplegia secondary to stroke trained with the system for eight, 30 to 60 minute sessions without adverse events. Each demonstrated positive motor adaptations to training. The system was well tolerated by persons with moderate to severe upper extremity hemiplegia. Further testing of its effects on motor ability with a broader range of clinical presentations is indicated.
Component Repair Experiment-1: An Experiment Evaluating Electronic Component-Level Repair During Spaceflight

NASA Technical Reports Server (NTRS)

Easton, John W.; Struk, Peter M.

2012-01-01

The Component Repair Experiment-1 (CRE-1) examines the capability for astronauts to perform electronics repair tasks in space. The goal is to determine the current capabilities and limits for the crew, and to make recommendations to improve and expand the range of work that astronauts may perform. CRE-1 provided two-layer, functional circuit boards and replacement components, a small tool kit, written and video training materials, and 1 hr of hands on training for the crew slated to perform the experiment approximately 7 months prior to the mission. Astronauts Michael Fincke and Sandra Magnus performed the work aboard the International Space Station (ISS) in February and March 2009. The astronauts were able to remove and replace components successfully, demonstrating the feasibility of performing component-level electronics repairs within a spacecraft. Several unsuccessful tasks demonstrated areas in need of improvement. These include improved and longer training prior to a mission, an improved soldering iron with a higher operating temperature and steady power source, video training and practice boards for refresher work or practice before a repair, and improved and varied hand tools and containment system.
Education in Basic Skills and Training for Productive Work

NASA Astrophysics Data System (ADS)

Labarca, Guillermo

1998-09-01

The success of global policies and strategies aimed at training for productive work depends to a large extent on the level of development of basic skills among the work force and, likewise, training costs will vary according to the level of general preparation of those entering on the process. In view of the close relationship between the structure of the school system, the development of basic skills and actual training, different options are available to resolve imbalances between training for productive employment and previous basic education. Our conclusions are that training cannot replace basic education, that the process of technological change goes hand in hand with an increased demand for workers with a high level of education, that substituting training in specific skills for good basic education is not the most efficient option, and that one of the favorable effects of primary education is that it facilitates after- school training. This article seeks to identify certain dimensions of human resource training which are often overlooked in relation to both basic skills and specific training proper: namely, the imbalances existing between vocational training and previous education, and the options available for correcting them.
Handwriting or Typewriting? The Influence of Pen- or Keyboard-Based Writing Training on Reading and Writing Performance in Preschool Children.

PubMed

Kiefer, Markus; Schuler, Stefanie; Mayer, Carmen; Trumpp, Natalie M; Hille, Katrin; Sachse, Steffi

2015-01-01

Digital writing devices associated with the use of computers, tablet PCs, or mobile phones are increasingly replacing writing by hand. It is, however, controversially discussed how writing modes influence reading and writing performance in children at the start of literacy. On the one hand, the easiness of typing on digital devices may accelerate reading and writing in young children, who have less developed sensory-motor skills. On the other hand, the meaningful coupling between action and perception during handwriting, which establishes sensory-motor memory traces, could facilitate written language acquisition. In order to decide between these theoretical alternatives, for the present study, we developed an intense training program for preschool children attending the German kindergarten with 16 training sessions. Using closely matched letter learning games, eight letters of the German alphabet were trained either by handwriting with a pen on a sheet of paper or by typing on a computer keyboard. Letter recognition, naming, and writing performance as well as word reading and writing performance were assessed. Results did not indicate a superiority of typing training over handwriting training in any of these tasks. In contrast, handwriting training was superior to typing training in word writing, and, as a tendency, in word reading. The results of our study, therefore, support theories of action-perception coupling assuming a facilitatory influence of sensory-motor representations established during handwriting on reading and writing.
Handwriting or Typewriting? The Influence of Pen- or Keyboard-Based Writing Training on Reading and Writing Performance in Preschool Children

PubMed Central

Kiefer, Markus; Schuler, Stefanie; Mayer, Carmen; Trumpp, Natalie M.; Hille, Katrin; Sachse, Steffi

2015-01-01

Digital writing devices associated with the use of computers, tablet PCs, or mobile phones are increasingly replacing writing by hand. It is, however, controversially discussed how writing modes influence reading and writing performance in children at the start of literacy. On the one hand, the easiness of typing on digital devices may accelerate reading and writing in young children, who have less developed sensory-motor skills. On the other hand, the meaningful coupling between action and perception during handwriting, which establishes sensory-motor memory traces, could facilitate written language acquisition. In order to decide between these theoretical alternatives, for the present study, we developed an intense training program for preschool children attending the German kindergarten with 16 training sessions. Using closely matched letter learning games, eight letters of the German alphabet were trained either by handwriting with a pen on a sheet of paper or by typing on a computer keyboard. Letter recognition, naming, and writing performance as well as word reading and writing performance were assessed. Results did not indicate a superiority of typing training over handwriting training in any of these tasks. In contrast, handwriting training was superior to typing training in word writing, and, as a tendency, in word reading. The results of our study, therefore, support theories of action-perception coupling assuming a facilitatory influence of sensory-motor representations established during handwriting on reading and writing. PMID:26770286
Broadcasting Engineering Laboratories--Audio/Video and Data--in Real-Time over the Internet

ERIC Educational Resources Information Center

Jain, Prashant K.; Gu, Yuxiang; Rizwan-uddin

2008-01-01

Internet extends the reach of existing laboratory and training infrastructure to beyond the walls of such facilities. Though nothing can replace the hands-on experience in a laboratory; a carefully developed web-based digital lab may be the next best thing. In some cases, there may be benefits associated with a "distance laboratory" that…
Technical tips for collagenase injection treatment for Dupuytren contracture.

PubMed

Meals, Roy A; Hentz, Vincent R

2014-06-01

We describe technical tips for injecting collagenase into Dupuytren cords based on experience acquired during the prerelease Food and Drug Administration clinical trials and with subsequent clinical practice. These tips include techniques for extracting the reconstituted enzyme efficiently from the vial, injecting the cord(s) with increased safety to the tendons, and anesthetizing the hand before manipulation. The tips are intended to supplement but by no means replace the manufacturer's prescribing information and training video. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Beyond Fine Tuning: Adding capacity to leverage few labels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hodas, Nathan O.; Shaffer, Kyle J.; Yankov, Artem

2017-12-09

In this paper we present a technique to train neural network models on small amounts of data. Current methods for training neural networks on small amounts of rich data typically rely on strategies such as fine-tuning a pre-trained neural networks or the use of domain-specific hand-engineered features. Here we take the approach of treating network layers, or entire networks, as modules and combine pre-trained modules with untrained modules, to learn the shift in distributions between data sets. The central impact of using a modular approach comes from adding new representations to a network, as opposed to replacing representations via fine-tuning.more » Using this technique, we are able surpass results using standard fine-tuning transfer learning approaches, and we are also able to significantly increase performance over such approaches when using smaller amounts of data.« less
Nurse extenders offer a way to trim staff expenses.

PubMed

Eastaugh, S R; Regan-Donovan, M

1990-04-01

Troubles confronting hospital nursing--from a national shortage of nurses to low morale, high turnover, and rising costs of replacing and retaining staff members--require creative approaches and a rethinking of traditional primary care nursing. Nurse extender programs place non-nursing tasks in the hands of technicians trained to deliver meals, transport patients, take vital signs, and perform other patient care tasks.
Lessons learned from implementing a wet laboratory molecular training workshop for beach water quality monitoring.

PubMed

Verhougstraete, Marc Paul; Brothers, Sydney; Litaker, Wayne; Blackwood, A Denene; Noble, Rachel

2015-01-01

Rapid molecular testing methods are poised to replace many of the conventional, culture-based tests currently used in fields such as water quality and food science. Rapid qPCR methods have the benefit of being faster than conventional methods and provide a means to more accurately protect public health. However, many scientists and technicians in water and food quality microbiology laboratories have limited experience using these molecular tests. To ensure that practitioners can use and implement qPCR techniques successfully, we developed a week long workshop to provide hands-on training and exposure to rapid molecular methods for water quality management. This workshop trained academic professors, government employees, private industry representatives, and graduate students in rapid qPCR methods for monitoring recreational water quality. Attendees were immersed in these new methods with hands-on laboratory sessions, lectures, and one-on-one training. Upon completion, the attendees gained sufficient knowledge and practice to teach and share these new molecular techniques with colleagues at their respective laboratories. Key findings from this workshop demonstrated: 1) participants with no prior experience could be effectively trained to conduct highly repeatable qPCR analysis in one week; 2) participants with different desirable outcomes required exposure to a range of different platforms and sample processing approaches; and 3) the collaborative interaction amongst newly trained practitioners, workshop leaders, and members of the water quality community helped foster a cohesive cohort of individuals which can advocate powerful cohort for proper implementation of molecular methods.
Lessons Learned from Implementing a Wet Laboratory Molecular Training Workshop for Beach Water Quality Monitoring

PubMed Central

Verhougstraete, Marc Paul; Brothers, Sydney; Litaker, Wayne; Blackwood, A. Denene; Noble, Rachel

2015-01-01

Rapid molecular testing methods are poised to replace many of the conventional, culture-based tests currently used in fields such as water quality and food science. Rapid qPCR methods have the benefit of being faster than conventional methods and provide a means to more accurately protect public health. However, many scientists and technicians in water and food quality microbiology laboratories have limited experience using these molecular tests. To ensure that practitioners can use and implement qPCR techniques successfully, we developed a week long workshop to provide hands-on training and exposure to rapid molecular methods for water quality management. This workshop trained academic professors, government employees, private industry representatives, and graduate students in rapid qPCR methods for monitoring recreational water quality. Attendees were immersed in these new methods with hands-on laboratory sessions, lectures, and one-on-one training. Upon completion, the attendees gained sufficient knowledge and practice to teach and share these new molecular techniques with colleagues at their respective laboratories. Key findings from this workshop demonstrated: 1) participants with no prior experience could be effectively trained to conduct highly repeatable qPCR analysis in one week; 2) participants with different desirable outcomes required exposure to a range of different platforms and sample processing approaches; and 3) the collaborative interaction amongst newly trained practitioners, workshop leaders, and members of the water quality community helped foster a cohesive cohort of individuals which can advocate powerful cohort for proper implementation of molecular methods. PMID:25822486
A prospective study on the risk of glove fingertip contamination during draping in joint replacement surgery.

PubMed

Makki, D; Deierl, K; Pandit, A; Trakru, S

2014-09-01

The aim of this prospective study was to investigate the risk of contamination of surgical gloves during preparation and draping in joint replacement surgery. During 46 hip and knee replacement procedures, the gloves of orthopaedic consultants (n=5) and registrars (n=3) were assessed for contamination immediately after draping by impression of gloved fingers on blood agar. Contamination was evaluated by the surgeon's grade, the type of procedure, the role of the assistant and the dominance of the hand. A total of 125 pairs of top gloves were examined (79 pairs from registrars and 46 pairs from consultants). Bacterial contamination was isolated on 19 pairs (15.2%) (16 pairs from registrars and 3 pairs from consultants, p=0.04). Coagulase negative staphylococci were the main isolates and contamination was considered low in all cases (1-5 colonies). Contamination was seen more on the dominant hand (16 gloves from dominant hands and 6 from non-dominant hands, p=0.04), on the index finger and thumb. More contaminated gloves were seen in hip arthroplasty procedures (16 pairs from total hip replacements vs 3 pairs from total knee replacements, p=0.02). Contamination of glove fingertips during draping in joint replacement procedures is more likely to occur among junior surgeons, in hip rather than knee arthroplasty procedures and on the dominant hand. It is therefore essential that surgeons of different grades replace gloves used in draping to avoid exposing patients to the risk of infection.
A prospective study on the risk of glove fingertip contamination during draping in joint replacement surgery

PubMed Central

Deierl, K; Pandit, A; Trakru, S

2014-01-01

Introduction The aim of this prospective study was to investigate the risk of contamination of surgical gloves during preparation and draping in joint replacement surgery. Methods During 46 hip and knee replacement procedures, the gloves of orthopaedic consultants (n=5) and registrars (n=3) were assessed for contamination immediately after draping by impression of gloved fingers on blood agar. Contamination was evaluated by the surgeon’s grade, the type of procedure, the role of the assistant and the dominance of the hand. Results A total of 125 pairs of top gloves were examined (79 pairs from registrars and 46 pairs from consultants). Bacterial contamination was isolated on 19 pairs (15.2%) (16 pairs from registrars and 3 pairs from consultants, p=0.04). Coagulase negative staphylococci were the main isolates and contamination was considered low in all cases (1–5 colonies). Contamination was seen more on the dominant hand (16 gloves from dominant hands and 6 from non-dominant hands, p=0.04), on the index finger and thumb. More contaminated gloves were seen in hip arthroplasty procedures (16 pairs from total hip replacements vs 3 pairs from total knee replacements, p=0.02). Conclusions Contamination of glove fingertips during draping in joint replacement procedures is more likely to occur among junior surgeons, in hip rather than knee arthroplasty procedures and on the dominant hand. It is therefore essential that surgeons of different grades replace gloves used in draping to avoid exposing patients to the risk of infection. PMID:25198974
A hand-ergonomics training kit: development and evaluation of a package to support improved awareness and critical thinking.

PubMed

Garmer, Karin; Sperling, Lena; Forsberg, Anette

2002-01-01

A need for a hand-ergonomics training kit has been identified to increase critical thinking concerning choice of hand tools. This study deals with the design, use and evaluation of a hand-ergonomics training kit for use in ergonomics training programmes. The effects on awareness of hand ergonomics among training course participants have been evaluated by means of a questionnaire and interviews at a car production plant in Sweden. The evaluation was carried out about one and a half years after training with the hand-ergonomics training kit. The training kit consists of a guide to practical exercises, equipment for measuring hand size and strength, examples of hand tools for use in practical exercises, equipment for testing and evaluating the hand tools and checklists and judgement forms for qualitative evaluation. In addition, the kit contains relevant scientifically based reference reports on hand ergonomics. The evaluation showed that the practical exercises with the hand-ergonomic training kit had, to a remarkable extent, increased individuals' awareness of anthropometric differences and of the importance of ergonomically well-designed hand tools. After the practical exercises with the training kit, communication within the plant when choosing hand tools seems to be based on objective criteria to a higher degree, however, the results indicate that this communication could be further improved.
Alternative Fuels Data Center: Missouri High School Students Get Hands-On

Science.gov Websites

Training With Biodiesel Missouri High School Students Get Hands-On Training With Biodiesel to someone by E-mail Share Alternative Fuels Data Center: Missouri High School Students Get Hands-On Training Hands-On Training With Biodiesel on Twitter Bookmark Alternative Fuels Data Center: Missouri High School
Meta-analysis of food safety training on hand hygiene knowledge and attitudes among food handlers.

PubMed

Soon, Jan Mei; Baines, Richard; Seaman, Phillip

2012-04-01

Research has shown that traditional food safety training programs and strategies to promote hand hygiene increases knowledge of the subject. However, very few studies have been conducted to evaluate the impact of food safety training on food handlers' attitudes about good hand hygiene practices. The objective of this meta-analytical study was to assess the extent to which food safety training or intervention strategies increased knowledge of and attitudes about hand hygiene. A systematic review of food safety training articles was conducted. Additional studies were identified from abstracts from food safety conferences and food science education conferences. Search terms included combinations of "food safety," "food hygiene," "training," "education," "hand washing," "hand hygiene," "knowledge," "attitudes," "practices," "behavior," and "food handlers." Only before- and after-training approaches and cohort studies with training (intervention group) and without training (control group) in hand hygiene knowledge and including attitudes in food handlers were evaluated. All pooled analyses were based on a random effects model. Meta-analysis values for nine food safety training and intervention studies on hand hygiene knowledge among food handlers were significantly higher than those of the control (without training), with an effect size (Hedges' g) of 1.284 (95% confidence interval [CI] ∼ 0.830 to 1.738). Meta-analysis of five food safety training and intervention studies in which hand hygiene attitudes and self-reported practices were monitored produced a summary effect size of 0.683 (95% CI ∼ 0.523 to 0.843). Food safety training increased knowledge and improved attitudes about hand hygiene practices. Refresher training and long-term reinforcement of good food handling behaviors may also be beneficial for sustaining good hand washing practices.
Inulin and erythritol as sucrose replacers in short-dough cookies: sensory, fracture, and acoustic properties.

PubMed

Laguna, Laura; Primo-Martín, Cristina; Salvador, Ana; Sanz, Teresa

2013-05-01

The effect of sucrose replacement by erythritol and inulin was studied in short-dough cookies using instrumental and sensory analysis. Two levels of replacement were used (25% and 50% of total sucrose content). Descriptive sensory analysis showed that the sucrose replacement affects visual and texture cookies characteristics, being the differences perceived by mouth greater than by hand. In general, sucrose substitutes produced a less crispy cookie and lower consumer acceptability, with the exception of 25% sucrose replacement by inulin. Matrix aeration attributes such as open and crumbly obtained by trained panel were important properties, and correlated positively with consumer acceptance and negatively with maximum force at break (hardness). Inulin cookies sensory properties were more similar to the control than the erythritol cookies. Also, consumer overall acceptance decreased significantly with sucrose replacement by erythritol. The analysis of texture and sound revealed that inulin cookies were softer whereas erythritol cookies were harder in comparison with control cookies; despite this difference, inulin cookies had similar sound characteristics to erythritol cookies. © 2013 Institute of Food Technologists®
Attitudes of general dental practitioners towards implant dentistry in an environment with widespread provision of implant therapy.

PubMed

Lang-Hua, Bich Hue; Lang, Niklaus P; Lo, Edward C M; McGrath, Colman P J

2013-03-01

To determine attitudes of general dental practitioners in a community where provision dental implants is a well-known treatment modality; and to identify variations in the attitudes with respect to dentists' factors, training factors and implant provision factors. A questionnaire survey to a random sample of registered dentists In Hong Kong was performed. Attitudes towards implant dentistry with respect to (i) perceived superiority of implant therapy, (ii) perceived outcomes of dental implant therapy, (iii) perceived complications & maintenance issues and (iv) placement issues were ascertained. In addition, information was collected on dentists' factors, training factors and implant provision factors. Variations in attitudes towards implant dentistry were explored in bivariate and regression analyses. Among eligible practitioners (n = 246), the response rate was 46.3%. Dentists perceived implants to be superior to conventional prostheses for the replacement of a single missing posterior tooth (80%, 67) and likewise, for the replacement of a single missing anterior tooth (67%, 67), P < 0.05. Variations in attitudes with respect to attitudes exists with respect to dentists' factors (years in practice [P < 0.05]), place of graduation (P < 0.05); implant trainings factors ("hand-on" training [P < 0.05]); number of days of training (P < 0.05) and implant experience factors (Number of patients treated [P < 0.05]) and number of implants placed (P < 0.05). In a community where provision of dental implants is widespread among its General Dental Practitioners (GDPs), their attitudes are not wholly in line with evidence-based knowledge. Variations in their attitudes existed with respect to dentist factors, training and experience issues. © 2012 John Wiley & Sons A/S.
Video-Assisted Thoracoscopic Surgery Lobectomy Performed Satisfaction and Complications of Patients During Hands-on Training Courses.

PubMed

Ma, Dongjie; Song, Xiaonan; Li, Shanqing; Liu, Hongsheng; Cui, Yushang; Huang, Cheng; Zhou, Xiaoyun; Qin, Yingzhi; Li, Li; Chen, Yeye

2018-04-16

It was aimed to concern about the satisfaction and procedural complications of patients during the thoracoscopy exist of hands-on training in this present study. The patients with non-small-cell carcinoma underwent video-assisted thoracoscopic surgery (VATS) lobectomy during hands-on training courses at thoracoscopic center in our hospital and collected from January 2009 and December 2014. The rates of satisfaction and complications of patients were compared from hands-on training group and control group. Potential risk factors associated with post-VATS complications of patients and thoracoscopist-related variables were analyzed. There were 54 patients join in six meetings with hands-on thoracoscopy training in our center. There was no significant difference between patients for hands-on training group (n = 54) and control group (n = 54), including sex, age, BMI, smoking, PpoFEV1 and comorbidities. The satisfaction rate and the incidence of complication were similar between the two groups. Univariate analyses showed that elder age, heart disease, chronic obstructive pulmonary disease, long operative time, and first-time mentorship were significantly associated with post-VATS complications of patients in hands-on training group. We should pay more attention to the characteristics of patent and the experience of mentor before VATS hands-on training courses.

[Study on an Exoskeleton Hand Function Training Device].

PubMed

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.
Unique Assessment of Hand Surgery Knowledge by Specialty.

PubMed

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.
Medical student hand preference, perceived dexterity, and impact of handedness on training.

PubMed

Callahan, Devon; de Virgilio, Christian; Tillou, Areti; DeUgarte, Daniel A

2016-07-01

The ubiquity of right-handed instruments and a predominance of right-handed surgical faculty present a challenge to left-handed trainees. Little is known about hand preference and its impact on specialty selection. We sought to evaluate hand preference, perceived dexterity, and impact of handedness on training among medical students. A survey was distributed to third and fourth year medical students. Hand preference was queried for various activities. A Likert scale was used to assess perceived dexterity and impact of handedness on training. Fisher's exact test was used to compare groups. Of those queried, 131 (37%) responded. Handedness was defined by writing preference: right (80%), left (18%), other (2%). Left-handed students were more likely to perceive themselves to be ambidextrous (50% versus 15%; P < 0.001) and prefer their contralateral hand for at least one other activity (50% versus 4%; P < 0.001). Left-handed students were significantly more likely to report that handedness affected their specialty selection (33% versus 10%; P < 0.01) and training (58% versus 6%; P < 0.001). In addition, they reported that they would benefit from additional training with right-handed instruments (61% versus 31%; P < 0.01), availability of left-handed instruments (63% versus 8%; P < 0.001), and trainers who adapted to their handedness (70% versus 14%; P < 0.001). Left-handed medical students reported greater ambidexterity and adverse impact of handedness on training. These results provide a contemporary snapshot of hand preference in medical students and an argument for improving and adapting surgical training for left-handed individuals. Copyright © 2016 Elsevier Inc. All rights reserved.
Hand luggage in the train toilet.

PubMed

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.
The interdisciplinary effect of hands-on science as measured by the Tennessee Comprehensive Assessment Program (TCAP)

NASA Astrophysics Data System (ADS)

Cherry, Elvis H.

This study examined the difference in scale scores from Tennessee's standardized test the Tennessee Comprehensive Assessment Program (TCAP). Archival data from the years 2002 and 2005 were compared using ANOVA tests at < .01 and < .05 levels. TCAP/NCE Scale Scores for academic subjects of Science, Math, Social Studies and Reading were used. 3922 student test results were divided into groups based on the number of years the student had a trained hands-on science teacher. Trained hands-on science teachers were identified from Metropolitan Nashville Public Schools (MNPS) Science Department inservice records, which gave information on the teacher's participation in The Hands-on Science Initiative, Biology Gateway and Physical Science training. This information included not only that the teacher had be trained but also the dates of training. The study revealed 1600 students who attended MNPS between the years 2002 and 2005; in grades five through seven that never had a hands-on science trained teacher. About 1600 students in those same years had a hands-on science teacher for only one year, and 588 students had a hands-on science teacher for two of the three years. Lastly of the 3922 students in the study there were 44 students who had a hands-on science teacher for all three years. The results of the ANOVA test showed statistically significant gains in science, math and social studies but not in reading for students who had trained hands-on science teachers for at least one year.
Effects of hand grip exercise on shoulder joint internal rotation and external rotation peak torque.

PubMed

Lee, Dong-Rour; Jong-Soon Kim, Laurentius

2016-08-10

The goal of this study is to analyze the effects of hand grip training on shoulder joint internal rotation (IR)/external rotation (ER) peak torque for healthy people. The research was conducted on 23 healthy adults in their 20 s-30 s who volunteered to participate in the experiment. Hand grip power test was performed on both hands of the research subjects before/after the test to study changes in hand grip power. Isokinetic machine was used to measure the concentric IRPT (internal rotation peak torque) and concentric ERPT (external rotation peak torque) at the velocity of 60°/sec, 90°/sec, and 180°/sec before/after the test. Hand grip training was performed daily on the subject's right hand only for four weeks according to exercise program. Finally, hand grip power of both hands and the maximum torque values of shoulder joint IR/ER were measured before/after the test and analyzed. There was a statistically significant difference in the hand grip power of the right hand, which was subject to hand grip training, after the experiment. Also, statistically significant difference for shoulder ERPT was found at 60°/sec. Hand grip training has a positive effect on shoulder joint IRPT/ERPT and therefore can help strengthen muscles around the shoulder without using weight on the shoulder. Consequently, hand grip training would help maintain strengthen the muscles around the shoulder in the early phase of rehabilitation process after shoulder surgery.
The relationship between human security, demand for arms and disarmament in the horn of Africa.

PubMed

Gebrewold, Kiflemariam

2002-01-01

The drive to find security through possession of weapons is linked to the history and culture of a social group. Amongst pastoralists in the Horn of Africa there is a failure of security through state systems such as police and the recent replacement of less-lethal traditional weapons by small arms and other light weapons. A warrior or vendetta culture with these arms leads to violent inter-clan clashes with many casualties, although traditional methods of weapons control still seem operational within clans. Understanding the drive to seek weapons is essential in finding ways to control their use. Improving the capacities of the police must come hand in hand with human rights training and an end to corruption. Further work is required on how traditional methods of arms control can be co-operatively linked with state controls.
Accelerometry Measuring the Outcome of Robot-Supported Upper Limb Training in Chronic Stroke: A Randomized Controlled Trial

PubMed Central

Lemmens, Ryanne J. M.; Timmermans, Annick A. A.; Janssen-Potten, Yvonne J. M.; Pulles, Sanne A. N. T. D.; Geers, Richard P. J.; Bakx, Wilbert G. M.; Smeets, Rob J. E. M.; Seelen, Henk A. M.

2014-01-01

Purpose This study aims to assess the extent to which accelerometers can be used to determine the effect of robot-supported task-oriented arm-hand training, relative to task-oriented arm-hand training alone, on the actual amount of arm-hand use of chronic stroke patients in their home situation. Methods This single-blind randomized controlled trial included 16 chronic stroke patients, randomly allocated using blocked randomization (n = 2) to receive task-oriented robot-supported arm-hand training or task-oriented (unsupported) arm-hand training. Training lasted 8 weeks, 4 times/week, 2×30 min/day using the (T-)TOAT ((Technology-supported)-Task-Oriented-Arm-Training) method. The actual amount of arm-hand use, was assessed at baseline, after 8 weeks training and 6 months after training cessation. Duration of use and intensity of use of the affected arm-hand during unimanual and bimanual activities were calculated. Results Duration and intensity of use of the affected arm-hand did not change significantly during and after training, with or without robot-support (i.e. duration of use of unimanual use of the affected arm-hand: median difference of −0.17% in the robot-group and −0.08% in the control group between baseline and after training cessation; intensity of the affected arm-hand: median difference of 3.95% in the robot-group and 3.32% in the control group between baseline and after training cessation). No significant between-group differences were found. Conclusions Accelerometer data did not show significant changes in actual amount of arm-hand use after task-oriented training, with or without robot-support. Next to the amount of use, discrimination between activities performed and information about quality of use of the affected arm-hand are essential to determine actual arm-hand performance. Trial Registration Controlled-trials.com ISRCTN82787126 PMID:24823925
Hand luggage in the train toilet

PubMed Central

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
Research on the Value Evaluation of Used Pure Electric Car Based on the Replacement Cost Method

NASA Astrophysics Data System (ADS)

Tan, zhengping; Cai, yun; Wang, yidong; Mao, pan

2018-03-01

In this paper, the value evaluation of the used pure electric car is carried out by the replacement cost method, which fills the blank of the value evaluation of the electric vehicle. The basic principle of using the replacement cost method, combined with the actual cost of pure electric cars, puts forward the calculation method of second-hand electric car into a new rate based on the use of AHP method to construct the weight matrix comprehensive adjustment coefficient of related factors, the improved method of value evaluation system for second-hand car
Implementation of an innovative hands-on training to improve adherence to hygiene rules: A feasibility Study.

PubMed

Stock, Stephanie; Tebest, Ralf; Westermann, Kristina; Samel, Christina; Strohbücker, Barbara; Stosch, Christoph; Wenchel, Hans-Martin; Redaèlli, Marcus

2016-01-01

Hospital-acquired infections (HAI) still pose a major problem in inpatient care. The single most important measure for preventing HAIs is to improve adherence to hand hygiene among health care professionals. To assess the feasibility of an innovative hands-on training to improve adherence to hygiene rules under standardized and under real life conditions. Before-after controlled cohort trial to assess the feasibility of implementing an innovative hands-on training to improve hand hygiene adherence. Large university hospital in Germany. Fifty trained nurses from three wards with an average age of 32years (±10.22years) and an average vocational experience of 6.85years (±7.54years). The intervention consisted of a hands-on training in the skills lab of the University of Cologne complemented by a 12-week observation period before and after the training on participating wards. The training comprised important skills with respect to hand hygiene, venipuncture, dressing changes of central venous catheters, preparation of IV infusions, and donning of gloves using sterile technique. A communication training was included to enable nurses to enforce hygiene rules in their collaboration with peers and physicians. The intervention was taught in small groups with a wide array of interactive teaching methods. It was evaluated using the objective structured clinical examination (OSCE) format. Observations were conducted by a trained infection control nurse. Before (after) the intervention 622 (612) occasions of hand hygiene were documented. A highly significant improvement in hygiene compliance was observed pre- and post-intervention (64.3% vs. 79.2%; p≤0.0001). The OSCE evaluation showed significant improvements in all subscales. The developed and conducted hands-on training seems feasible and is successful in significantly improving adherence to hygiene rules under standardized and real life conditions. Whether the effect is stable over time is subject to further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.
Influence of Inter-Training Intervals on Intermanual Transfer Effects in Upper-Limb Prosthesis Training: A Randomized Pre-Posttest Study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2015-01-01

Improvement in prosthetic training using intermanual transfer (the transfer of motor skills from the trained, “unaffected” hand to the untrained, “affected” hand) has been shown in previous studies. The aim of this study is to determine the influence of the inter-training interval on the magnitude of the intermanual transfer effects. This was done using a mechanistic, randomized, single-blinded pretest-posttest design. Sixty-four able-bodied, right-handed participants were randomly assigned to the Short and Long Interval Training Groups and the Short and Long Interval Control Groups. The Short and Long Interval Training Groups used a prosthesis simulator in their training program. The Short and Long Interval Control Groups executed a sham training program, that is, a dummy training program in which the same muscles were trained as with the prosthesis simulator. The Short Interval Training Group and the Short Interval Control Groups trained on consecutive days, while the Long Interval Training Group and Long Interval Control Group trained twice a week. To determine the improvement in skills, a test was administered before, immediately after, and at two points in time after the training. Training was performed with the “unaffected” arm; tests were performed with the “affected” arm. The outcome measurements were: the movement time (the time from the beginning of the movement until completion of the task); the duration of maximum hand opening, (the opening of the prosthetic hand while grasping an object); and the grip-force control (the error from the required grip-force during a tracking task). Intermanual transfer was found in movement times, but not in hand opening or grip-force control. The length of the inter-training interval did not affect the magnitude of intermanual transfer effects. No difference in the intermanual transfer effect in upper-limb prosthesis training was found for training on a daily basis as compared to training twice a week. Nederlands Trial Register NTR3888.
Influence of Inter-Training Intervals on Intermanual Transfer Effects in Upper-Limb Prosthesis Training: A Randomized Pre-Posttest Study

PubMed Central

Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

2015-01-01

Improvement in prosthetic training using intermanual transfer (the transfer of motor skills from the trained, “unaffected” hand to the untrained, “affected” hand) has been shown in previous studies. The aim of this study is to determine the influence of the inter-training interval on the magnitude of the intermanual transfer effects. This was done using a mechanistic, randomized, single-blinded pretest-posttest design. Sixty-four able-bodied, right-handed participants were randomly assigned to the Short and Long Interval Training Groups and the Short and Long Interval Control Groups. The Short and Long Interval Training Groups used a prosthesis simulator in their training program. The Short and Long Interval Control Groups executed a sham training program, that is, a dummy training program in which the same muscles were trained as with the prosthesis simulator. The Short Interval Training Group and the Short Interval Control Groups trained on consecutive days, while the Long Interval Training Group and Long Interval Control Group trained twice a week. To determine the improvement in skills, a test was administered before, immediately after, and at two points in time after the training. Training was performed with the “unaffected” arm; tests were performed with the “affected” arm. The outcome measurements were: the movement time (the time from the beginning of the movement until completion of the task); the duration of maximum hand opening, (the opening of the prosthetic hand while grasping an object); and the grip-force control (the error from the required grip-force during a tracking task). Intermanual transfer was found in movement times, but not in hand opening or grip-force control. The length of the inter-training interval did not affect the magnitude of intermanual transfer effects. No difference in the intermanual transfer effect in upper-limb prosthesis training was found for training on a daily basis as compared to training twice a week. Trial Registration Nederlands Trial Register NTR3888 PMID:26075396
Tablet based simulation provides a new solution to accessing laparoscopic skills training.

PubMed

Bahsoun, Ali Nehme; Malik, Mohsan Munir; Ahmed, Kamran; El-Hage, Oussama; Jaye, Peter; Dasgupta, Prokar

2013-01-01

Access to facilities that allow trainees to develop their laparoscopic skills is very limited in the hospital environment and courses can be very expensive. We set out to build an inexpensive yet effective trainer to allow laparoscopic skill acquisition in the home or classroom environment based on using a tablet as a replacement for the laparoscopic stack and camera. The cavity in which to train was made from a cardboard box; we left the sides and back open to allow for natural light to fill the cavity. An iPad 2 (Apple Inc.) was placed over the box to act as our camera and monitor. We provided 10 experienced laparoscopic surgeons with the task of passing a suture needle through 3 hoops; then they filled in a questionnaire to assess Face (training capacity) and Content (performance) validity. On a 5-point Likert scale, the tablet-based laparoscopic trainer scored a mean 4.2 for training capacity (hand eye coordination, development, and maintenance of lap skills) and for performance (graphics, video, and lighting quality) it scored a mean 4.1. The iPad 2-based laparoscopic trainer was successfully validated for training. It allows students and trainees to practice at their own pace and for inexpensive training on the go. Future "app-"based skills are planned. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
STS-102 MS Helms, Usachev and Voss pose on the FSS at Launch Pad 39B during TCDT

NASA Technical Reports Server (NTRS)

2001-01-01

KENNEDY SPACE CENTER, Fla. -- STS-102 Mission Specialists Susan Helms, Yury Usachev and James Voss clasp hands showing their unity as the Expedition Two crew who will be replacing Expedition One on the International Space Station. Behind them can be seen the tops of the solid rocket booster and external tank on Space Shuttle Discovery. The STS-102 crew is at KSC for Terminal Countdown Demonstration Test activities, which include the emergency training and a simulated launch countdown. STS-102 is the eighth construction flight to the Space Station, with Discovery carrying the Multi-Purpose Logistics Module Leonardo. Expedition One will return to Earth with Discovery. Launch on mission STS-102 is scheduled for March 8.
Feasibility study into self-administered training at home using an arm and hand device with motivational gaming environment in chronic stroke.

PubMed

Nijenhuis, Sharon M; Prange, Gerdienke B; Amirabdollahian, Farshid; Sale, Patrizio; Infarinato, Francesco; Nasr, Nasrin; Mountain, Gail; Hermens, Hermie J; Stienen, Arno H A; Buurke, Jaap H; Rietman, Johan S

2015-10-09

Assistive and robotic training devices are increasingly used for rehabilitation of the hemiparetic arm after stroke, although applications for the wrist and hand are trailing behind. Furthermore, applying a training device in domestic settings may enable an increased training dose of functional arm and hand training. The objective of this study was to assess the feasibility and potential clinical changes associated with a technology-supported arm and hand training system at home for patients with chronic stroke. A dynamic wrist and hand orthosis was combined with a remotely monitored user interface with motivational gaming environment for self-administered training at home. Twenty-four chronic stroke patients with impaired arm/hand function were recruited to use the training system at home for six weeks. Evaluation of feasibility involved training duration, usability and motivation. Clinical outcomes on arm/hand function, activity and participation were assessed before and after six weeks of training and at two-month follow-up. Mean System Usability Scale score was 69 % (SD 17 %), mean Intrinsic Motivation Inventory score was 5.2 (SD 0.9) points, and mean training duration per week was 105 (SD 66) minutes. Median Fugl-Meyer score improved from 37 (IQR 30) pre-training to 41 (IQR 32) post-training and was sustained at two-month follow-up (40 (IQR 32)). The Stroke Impact Scale improved from 56.3 (SD 13.2) pre-training to 60.0 (SD 13.9) post-training, with a trend at follow-up (59.8 (SD 15.2)). No significant improvements were found on the Action Research Arm Test and Motor Activity Log. Remotely monitored post-stroke training at home applying gaming exercises while physically supporting the wrist and hand showed to be feasible: participants were able and motivated to use the training system independently at home. Usability shows potential, although several usability issues need further attention. Upper extremity function and quality of life improved after training, although dexterity did not. These findings indicate that home-based arm and hand training with physical support from a dynamic orthosis is a feasible tool to enable self-administered practice at home. Such an approach enables practice without dependence on therapist availability, allowing an increase in training dose with respect to treatment in supervised settings. This study has been registered at the Netherlands Trial Registry (NTR): NTR3669 .
Handedness influences intermanual transfer in chimpanzees (Pan troglodytes) but not rhesus monkeys (Macaca mulatta).

PubMed

Boeving, Emily R; Lacreuse, Agnès; Hopkins, William D; Phillips, Kimberley A; Novak, Melinda A; Nelson, Eliza L

2015-03-01

Intermanual transfer refers to an effect, whereby training one hand to perform a motor task improves performance in the opposite untrained hand. We tested the hypothesis that handedness facilitates intermanual transfer in two nonhuman primate species: rhesus monkeys (N = 13) and chimpanzees (N = 52). Subjects were grouped into one of four conditions: (1) left-handers trained with the left (dominant) hand; (2) left-handers trained with the right (nondominant) hand; (3) right-handers trained with the left (nondominant) hand; and (4) right-handers trained with the right (dominant) hand. Intermanual transfer was measured using a task where subjects removed a Life Savers(®) candy (monkeys) or a washer (chimpanzees) from metal shapes. Transfer was measured with latency by comparing the average time taken to solve the task in the first session with the trained hand compared to the first session with the untrained hand. Hypotheses and predictions were derived from three models of transfer: access: benefit training with nondominant hand; proficiency: benefit training with dominant hand; and cross-activation: benefit irrespective of trained hand. Intermanual transfer (i.e., shorter latency in untrained hand) occurred regardless of whether monkeys trained with the dominant hand or nondominant hand, supporting the cross-activation model. However, transfer was only observed in chimpanzees that trained with the dominant hand. When handedness groups were examined separately, the transfer effect was only significant for right-handed chimpanzees, partially supporting the proficiency model. Findings may be related to neurophysiological differences in motor control as well as differences in handedness patterning between rhesus monkeys and chimpanzees.
Handedness influences intermanual transfer in chimpanzees (Pan troglodytes) but not rhesus monkeys (Macaca mulatta)

PubMed Central

Boeving, Emily R.; Lacreuse, Agnès; Hopkins, William D.; Phillips, Kimberley A.; Novak, Melinda A.; Nelson, Eliza L.

2015-01-01

Intermanual transfer refers to an effect whereby training one hand to perform a motor task improves performance in the opposite untrained hand. We tested the hypothesis that handedness facilitates intermanual transfer in two nonhuman primate species: rhesus monkeys (N = 13) and chimpanzees (N = 52). Subjects were grouped into one of four conditions: (1) left-handers trained with the left (dominant) hand; (2) left-handers trained with the right (non-dominant) hand; (3) right-handers trained with the left (non-dominant) hand; and (4) right-handers trained with the right (dominant) hand. Intermanual transfer was measured using a task where subjects removed a Life Savers® candy (monkeys) or a washer (chimpanzees) from metal shapes. Transfer was measured with latency by comparing the average time taken to solve the task in the first session with the trained hand compared to the first session with the untrained hand. Hypotheses and predictions were derived from three models of transfer: access: benefit training with non-dominant hand; proficiency: benefit training with dominant hand; and cross-activation: benefit irrespective of trained hand. Intermanual transfer (i.e., shorter latency in untrained hand) occurred regardless of whether monkeys trained with the dominant hand or non-dominant hand, supporting the cross-activation model. However, transfer was only observed in chimpanzees that trained with the dominant hand. When handedness groups were examined separately, the transfer effect was only significant for right-handed chimpanzees, partially supporting the proficiency model. Findings may be related to neurophysiological differences in motor control as well as differences in handedness patterning between rhesus monkeys and chimpanzees. PMID:25466868
Increased functional connectivity between cortical hand areas and praxis network associated with training-related improvements in non-dominant hand precision drawing.

PubMed

Philip, Benjamin A; Frey, Scott H

2016-07-01

Chronic forced use of the non-dominant left hand yields substantial improvements in the precision and quality of writing and drawing. These changes may arise from increased access by the non-dominant (right) hemisphere to dominant (left) hemisphere mechanisms specialized for end-point precision control. To evaluate this prediction, 22 healthy right-handed adults underwent resting state functional connectivity (FC) MRI scans before and after 10 days of training on a left hand precision drawing task. 89% of participants significantly improved left hand speed, accuracy, and smoothness. Smoothness gains were specific to the trained left hand and persistent: 6 months after training, 71% of participants exhibited above-baseline movement smoothness. Contrary to expectations, we found no evidence of increased FC between right and left hemisphere hand areas. Instead, training-related improvements in left hand movement smoothness were associated with increased FC between both sensorimotor hand areas and a left-lateralized parieto-prefrontal network implicated in manual praxis. By contrast, skill retention at 6 months was predicted by changes including decreased FC between the representation of the trained left hand and bilateral sensorimotor, parietal, and premotor cortices, possibly reflecting consolidation and a disengagement of early learning processes. These data indicate that modest amounts of training (<200min total) can induce substantial, persistent improvements the precision and quality of non-dominant hand control in healthy adults, supported by strengthened connectivity between bilateral sensorimotor hand areas and a left-lateralized parieto-prefrontal praxis network. Copyright © 2016 Elsevier Ltd. All rights reserved.
The effect of basic life support education on laypersons' willingness in performing bystander hands only cardiopulmonary resuscitation.

PubMed

Cho, Gyu Chong; Sohn, You Dong; Kang, Ku Hyun; Lee, Won Woong; Lim, Kyung Soo; Kim, Won; Oh, Bum Jin; Choi, Dai Hai; Yeom, Seok Ran; Lim, Hoon

2010-06-01

Recently, hands only CPR (cardiopulmonary resuscitation) has been proposed as an alternative to standard CPR for bystanders. The present study was performed to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR. The participants for this study were non-medical personnel who applied for BLS training program that took place in 7 university hospitals in and around Korea for 6 months. Before and after BLS training, all the participants were given questionnaires for bystander CPR, and 890 respondents were included in the final analyses. Self-assessed confidence score for bystander CPR, using a visual analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to 87.0+/-13.7 after the training with statistical significance (p 0.001). Before the training, 19% of respondents reported willingness to perform standard CPR on a stranger, and 30.1% to perform hands only CPR. After the training, this increased to 56.7% of respondents reporting willingness to perform standard CPR, and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95% CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the respondents, who reported they would decline to perform standard CPR, stated that fear of liability and fear of disease transmission were deciding factors after the BLS training. The BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Priming Hand Motor Training with Repetitive Stimulation of the Fingertips; Performance Gain and Functional Imaging of Training Effects.

PubMed

Lotze, Martin; Ladda, Aija Marie; Roschka, Sybille; Platz, Thomas; Dinse, Hubert R

Application of repetitive electrical stimulation (rES) of the fingers has been shown to improve tactile perception and sensorimotor performance in healthy individuals. To increase motor performance by priming the effects of active motor training (arm ability training; AAT) using rES. We compared the performance gain for the training increase of the averaged AAT tasks of both hands in two groups of strongly right-handed healthy volunteers. Functional Magnetic Resonance Imaging (fMRI) before and after AAT was assessed using three tasks for each hand separately: finger sequence tapping, visually guided grip force modulation, and writing. Performance during fMRI was controlled for preciseness and frequency. A total of 30 participants underwent a two-week unilateral left hand AAT, 15 participants with 20 minutes of rES priming of all fingertips of the trained hand, and 15 participants without rES priming. rES-primed AAT improved the trained left-hand performance across all training tasks on average by 32.9%, non-primed AAT improved by 29.5%. This gain in AAT performance with rES priming was predominantly driven by an increased finger tapping velocity. Functional imaging showed comparable changes for both training groups over time. Across all participants, improved AAT performance was associated with a higher contralateral primary somatosensory cortex (S1) fMRI activation magnitude during the grip force modulation task. This study highlights the importance of S1 for hand motor training gain. In addition, it suggests the usage of rES of the fingertips for priming active hand motor training. Copyright © 2016 Elsevier Inc. All rights reserved.
Factors Affecting Hand Hygiene Adherence at a Private Hospital in Turkey.

PubMed

Teker, Bahri; Ogutlu, Aziz; Gozdas, Hasan Tahsin; Ruayercan, Saliha; Hacialioglu, Gulizar; Karabay, Oguz

2015-10-01

Nosocomial infections are the main problems rising morbidity and mortality in health care settings. Hand hygiene is the most effective method for preventing these infections. In this study, we aimed to investigate the factors related with hand hygiene adherence at a private hospital in Turkey. This study was conducted between March and June 2010 at a private hospital in Turkey. During the observation period, employees were informed about training, then posters and images were hanged in specific places of the hospital. After the initial observation, training on nosocomial infections and hand hygiene was provided to the hospital staff in March 2010. Contacts were classified according to occupational groups and whether invasive or not. These observations were evaluated in terms of compatibility with hand hygiene guidelines. Hand hygiene adherence rate of trained doctors was higher than untrained ones before patient contact and after environment contact [48% (35/73) versus 82% (92/113) p<0.05 and 23% (5/22) versus 76% (37/49) p<0.05 respectively]. Hand hygiene adherence rate of trained nurses was higher than untrained ones before patient contact [63% (50/79) versus 76% (37/49) p<0.05]. Hand hygiene adherence rate of trained assistant health personnel was higher than untrained ones before asepsis [20% (2/10) versus 73% (16/22) p<0.05]. In addition, it was seen that hand antiseptics were used when hand washing was not possible. The increase at the rate of hand washing after training reveals the importance of feedback of the observations, as well as the training. One of the most important ways of preventing nosocomial infections is hand hygiene training that should be continued with feedbacks.
Public cardiopulmonary resuscitation training rates and awareness of hands-only cardiopulmonary resuscitation: a cross-sectional survey of Victorians.

PubMed

Bray, Janet E; Smith, Karen; Case, Rosalind; Cartledge, Susie; Straney, Lahn; Finn, Judith

2017-04-01

To provide contemporary Australian data on the public's training in cardiopulmonary resuscitation (CPR) and awareness of hands-only CPR. A cross-sectional telephone survey in April 2016 of adult residents of the Australian state of Victoria was conducted. Primary outcomes were rates of CPR training and awareness of hands-only CPR. Of the 404 adults surveyed (mean age 55 ± 17 years, 59% female, 73% metropolitan residents), 274 (68%) had undergone CPR training. Only 50% (n = 201) had heard of hands-only CPR, with most citing first-aid courses (41%) and media (36%) as sources of information. Of those who had undergone training, the majority had received training more than 5 years previously (52%) and only 28% had received training or refreshed training in the past 12 months. Most received training in a formal first-aid class (43%), and received training as a requirement for work (67%). The most common reasons for not having training were: they had never thought about it (59%), did not have time (25%) and did not know where to learn (15%). Compared to standard CPR, a greater proportion of respondents were willing to provide hands-only CPR for strangers (67% vs 86%, P < 0.001). From an Australian perspective, there is still room for improvement in CPR training rates and awareness of hands-only CPR. Further promotion of hands-only CPR and self-instruction (e.g. DVD kits or online) may see further improvements in CPR training and bystander CPR rates. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Occupational Safety. Hand Tools. Pre-Apprenticeship Phase 1 Training.

ERIC Educational Resources Information Center

Lane Community Coll., Eugene, OR.

This self-paced student training module on safety when using hand tools is one of a number of modules developed for Pre-apprenticeship Phase 1 Training. Purpose of the module is to teach students the correct safety techniques for operating common hand- and arm-powered tools, including selection, maintenance, technique, and uses. The module may…
Hydrocortisone, Neomycin, and Polymyxin

MedlinePlus

... your pharmacist or doctor. Replace and tighten the cap or dropper right away. Wash your hands to ... instilling the next drop. Replace and tighten the cap on the dropper bottle. Do not wipe or ...
Multidisciplinary Graduate Training in Social Research Methodology and Computer-Assisted Qualitative Data Analysis: A Hands-On/Hands-Off Course Design

ERIC Educational Resources Information Center

Bourque, Claude Julie; Bourdon, Sylvain

2017-01-01

Drawing on the experience of training graduate students and researchers in qualitative and mixed-methods analysis since the mid-1990s, the authors reflect on the evolution of a multidisciplinary graduate course developed in a Canadian university since 2007. The hands-on/hands-off course design based on the use of NVivo was developed in parallel…
Changes in cortical, cerebellar and basal ganglia representation after comprehensive long term unilateral hand motor training.

PubMed

Walz, A D; Doppl, K; Kaza, E; Roschka, S; Platz, T; Lotze, M

2015-02-01

We were interested in motor performance gain after unilateral hand motor training and associated changes of cerebral and cerebellar movement representation tested with functional magnetic resonance imaging (fMRI) before and after training. Therefore, we trained the left hand of strongly right-handed healthy participants with a comprehensive training (arm ability training, AAT) over two weeks. Motor performance was tested for the trained and non-trained hand before and after the training period. Functional imaging was performed for the trained and the non-trained hand separately and comprised force modulation with the fist, sequential finger movements and a fast writing task. After the training period the performance gain of tapping movements was comparable for both hand sides, whereas the motor performance for writing showed a higher training effect for the trained hand. fMRI showed a reduction of activation in supplementary motor, dorsolateral prefrontal cortex, parietal cortical areas and lateral cerebellar areas during sequential finger movements over time. During left hand writing lateral cerebellar hemisphere also showed reduced activation, while activation of the anterior cerebellar hemisphere was increased. An initially high anterior cerebellar activation magnitude was a predictive value for high training outcome of finger tapping and visual guided movements. During the force modulation task we found increased activation in the striate. Overall, a comprehensive long-term training of the less skillful hand in healthy participants resulted in relevant motor performance improvements, as well as an intermanual learning transfer differently pronounced for the type of movement tested. Whereas cortical motor area activation decreased over time, cerebellar anterior hemisphere and striatum activity seem to represent increasing resources after long-term motor training. Copyright © 2014 Elsevier B.V. All rights reserved.
Fine finger motor skill training with exoskeleton robotic hand in chronic stroke: stroke rehabilitation.

PubMed

Ockenfeld, Corinna; Tong, Raymond K Y; Susanto, Evan A; Ho, Sze-Kit; Hu, Xiao-ling

2013-06-01

Background and Purpose. Stroke survivors often show a limited recovery in the hand function to perform delicate motions, such as full hand grasping, finger pinching and individual finger movement. The purpose of this study is to describe the implementation of an exoskeleton robotic hand together with fine finger motor skill training on 2 chronic stroke patients. Case Descriptions. Two post-stroke patients participated in a 20-session training program by integrating 10 minutes physical therapy, 20 minutes robotic hand training and 15 minutes functional training tasks with delicate objects(card, pen and coin). These two patients (A and B) had cerebrovascular accident at 6 months and 11 months respectively when enrolled in this study. Outcomes. The results showed that both patients had improvements in Fugl-Meyer assessment (FM), Action Research Arm Test (ARAT). Patients had better isolation of the individual finger flexion and extension based on the reduced muscle co-contraction from the electromyographic(EMG) signals and finger extension force after 20 sessions of training. Discussion. This preliminary study showed that by focusing on the fine finger motor skills together with the exoskeleton robotic hand, it could improve the motor recovery of the upper extremity in the fingers and hand function, which were showed in the ARAT. Future randomized controlled trials are needed to evaluate the clinical effectiveness.
The Effectiveness of Hands-on Health Informatics Skills Exercises in the Multidisciplinary Smart Home Healthcare and Health Informatics Training Laboratories.

PubMed

Sapci, A H; Sapci, H A

2017-10-01

This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring devices before and after the hands-on laboratory course. Two web-based pretraining and posttraining questionnaires were sent to 64 students who received hands-on training with wireless remote patient monitoring devices in smart home healthcare and health informatics laboratories. All 64 students completed the pretraining survey (100% response rate), and 49 students completed the posttraining survey (76% response rate). The quantitative data analysis showed that 95% of students had an interest in taking more hands-on laboratory courses. Sixty-seven percent of students had no prior experience with medical image, physiological data acquisition, storage, and transmission protocols. After the hands-on training session, 75.51% of students expressed improved confidence about training patients to measure blood pressure monitor using wireless devices. Ninety percent of students preferred to use a similar experiential approach in their future learning experience. Additionally, the qualitative data analysis demonstrated that students were expecting to have more courses with hands-on exercises and integration of technology-enabled delivery and patient monitoring concepts into the curriculum. This study demonstrated that the multidisciplinary smart home healthcare and health informatics training laboratories and the hands-on exercises improved students' technology adoption rates and their self-confidence in using wireless patient monitoring devices. Schattauer GmbH Stuttgart.
Influence of the type of training task on intermanual transfer effects in upper-limb prosthesis training: A randomized pre-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2017-01-01

Intermanual transfer, the transfer of motor skills from the trained hand to the untrained hand, can be used to train upper limb prosthesis skills. The aim of this study was to determine the relation between the magnitude of the intermanual transfer effect and the type of training task. The used tasks were based on different aspects of prosthetic handling: reaching, grasping, grip-force production and functional tasks. A single-blinded clinical trial, with a pre-posttest design was executed. Seventy-one able-bodied, right-handed participants were randomly assigned to four training and two control groups. The training groups performed a training program with an upper-limb prosthesis simulator. One control group performed a sham training (a dummy training without the prosthesis simulator) and another control group received no training at all. The training groups and sham group trained on five consecutive days. To determine the improvement in skills, a test was administered before, immediately after, and one week after the training. Training was performed with the 'unaffected' arm; tests were performed with the 'affected' arm, with the latter resembling the amputated limb. In this study half of the participants trained with the dominant hand, while the other half trained with the non-dominant hand. Participants executed four tests that corresponded to the different training tasks. The tests measured the reaching (movement time and symmetry ratio), grasping (opening time, duration of maximum hand opening, and closing time), grip-force production (deviation of asked grip-force) and functional (movement time) performance. Half of the participants were tested with their dominant arm and half of the participants with their non-dominant arm. Intermanual transfer effects were not found for reaching, grasping or functional tasks. However, we did find intermanual transfer effects for grip-force production tasks. Possibly, the study design contributed to the negative results due to the duration of the training sessions and test sessions. The positive results of the grip-force production might be an effect of the specificity of the training, that was totally focused on training grip-force production. When using intermanual transfer training in novice amputees, specific training should be devoted to grip-force.
Influence of the type of training task on intermanual transfer effects in upper-limb prosthesis training: A randomized pre-posttest study

PubMed Central

Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

2017-01-01

Intermanual transfer, the transfer of motor skills from the trained hand to the untrained hand, can be used to train upper limb prosthesis skills. The aim of this study was to determine the relation between the magnitude of the intermanual transfer effect and the type of training task. The used tasks were based on different aspects of prosthetic handling: reaching, grasping, grip-force production and functional tasks. A single-blinded clinical trial, with a pre-posttest design was executed. Seventy-one able-bodied, right-handed participants were randomly assigned to four training and two control groups. The training groups performed a training program with an upper-limb prosthesis simulator. One control group performed a sham training (a dummy training without the prosthesis simulator) and another control group received no training at all. The training groups and sham group trained on five consecutive days. To determine the improvement in skills, a test was administered before, immediately after, and one week after the training. Training was performed with the ‘unaffected’ arm; tests were performed with the ‘affected’ arm, with the latter resembling the amputated limb. In this study half of the participants trained with the dominant hand, while the other half trained with the non-dominant hand. Participants executed four tests that corresponded to the different training tasks. The tests measured the reaching (movement time and symmetry ratio), grasping (opening time, duration of maximum hand opening, and closing time), grip-force production (deviation of asked grip-force) and functional (movement time) performance. Half of the participants were tested with their dominant arm and half of the participants with their non-dominant arm. Intermanual transfer effects were not found for reaching, grasping or functional tasks. However, we did find intermanual transfer effects for grip-force production tasks. Possibly, the study design contributed to the negative results due to the duration of the training sessions and test sessions. The positive results of the grip-force production might be an effect of the specificity of the training, that was totally focused on training grip-force production. When using intermanual transfer training in novice amputees, specific training should be devoted to grip-force. PMID:29190727
Occupational exposure to polybrominated diphenyl ethers (PBDEs) and other flame retardant foam additives at gymnastics studios: Before, during and after the replacement of pit foam with PBDE-free foams.

PubMed

Ceballos, Diana M; Broadwater, Kendra; Page, Elena; Croteau, Gerry; La Guardia, Mark J

2018-07-01

Coaches spend long hours training gymnasts of all ages aided by polyurethane foam used in loose blocks, mats, and other padded equipment. Polyurethane foam can contain flame retardant additives such as polybrominated diphenyl ethers (PBDEs), to delay the spread of fires. However, flame retardants have been associated with endocrine disruption and carcinogenicity. The National Institute for Occupational Safety and Health (NIOSH) evaluated employee exposure to flame retardants in four gymnastics studios utilized by recreational and competitive gymnasts. We evaluated flame retardant exposure at the gymnastics studios before, during, and after the replacement of foam blocks used in safety pits with foam blocks certified not to contain several flame retardants, including PBDEs. We collected hand wipes on coaches to measure levels of flame retardants on skin before and after their work shift. We measured flame retardant levels in the dust on window glass in the gymnastics areas and office areas, and in the old and new foam blocks used throughout the gymnastics studios. We found statistically higher levels of 9 out of 13 flame retardants on employees' hands after work than before, and this difference was reduced after the foam replacement. Windows in the gymnastics areas had higher levels of 3 of the 13 flame retardants than windows outside the gymnastics areas, suggesting that dust and vapor containing flame retardants became airborne. Mats and other padded equipment contained levels of bromine consistent with the amount of brominated flame retardants in foam samples analyzed in the laboratory. New blocks did not contain PBDEs, but did contain the flame retardants 2-ethylhexyl 2,3,4,5-tetrabromobenzoate and 2-ethylhexyl 2,3,4,5-tetrabromophthalate. We conclude that replacing the pit foam blocks eliminated a source of PBDEs, but not 2-ethylhexyl 2,3,4,5-tetrabromobenzoate and 2-ethylhexyl 2,3,4,5-tetrabromophthalate. We recommend ways to further minimize employee exposure to flame retardants at work and acknowledge the challenges consumers have identifying chemical contents of new products. Published by Elsevier Ltd.
Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: a randomized controlled trial.

PubMed

Timmermans, Annick A A; Lemmens, Ryanne J M; Monfrance, Maurice; Geers, Richard P J; Bakx, Wilbert; Smeets, Rob J E M; Seelen, Henk A M

2014-03-31

Over fifty percent of stroke patients experience chronic arm hand performance problems, compromising independence in daily life activities and quality of life. Task-oriented training may improve arm hand performance after stroke, whereby augmented therapy may lead to a better treatment outcome. Technology-supported training holds opportunities for increasing training intensity. However, the effects of robot-supported task-oriented training with real life objects in stroke patients are not known to date. The aim of the present study was to investigate the effectiveness and added value of the Haptic Master robot combined with task-oriented arm hand training in chronic stroke patients. In a single-blind randomized controlled trial, 22 chronic stroke patients were randomly allocated to receive either task-oriented robot-assisted arm-hand training (experimental group) or task-oriented non-robotic arm-hand training (control group). For training, the T-TOAT (Technology-supported Task-Oriented Arm Training) method was applied. Training was provided during 8 weeks, 4 times/week, 2 × 30 min/day. A significant improvement after training on the Action Research Arm Test (ARAT) was demonstrated in the experimental group (p = 0.008). Results were maintained until 6 months after cessation of the training. On the perceived performance measure (Motor Activity Log (MAL)), both, the experimental and control group improved significantly after training (control group p = 0.008; experimental group p = 0.013). The improvements on MAL in both groups were maintained until 6 months after cessation of the training. With regard to quality of life, only in the control group a significant improvement after training was found (EuroQol-5D p = 0.015, SF-36 physical p = 0.01). However, the improvement on SF-36 in the control group was not maintained (p = 0.012). No between-group differences could be demonstrated on any of the outcome measures. Arm hand performance improved in chronic stroke patients, after eight weeks of task oriented training. The use of a Haptic Master robot in support of task-oriented arm training did not show additional value over the video-instructed task-oriented exercises in highly functional stroke patients. Current Controlled Trials ISRCTN82787126.
The Effect of Intensive Bimanual Training on Coordination of the Hands in Children with Congenital Hemiplegia

ERIC Educational Resources Information Center

Hung, Ya-Ching; Casertano, Lorenzo; Hillman, Andrew; Gordon, Andrew M.

2011-01-01

Recent studies have suggested efficacy of intensive bimanual training in improving the quality and quantity of affected hand use in children with hemiplegia. However, it is not known whether such training affects the coordination of the two hands. In the present study, 20 children with congenital hemiplegia (age 4-10 years; MACS levels I-II) were…
Proprioceptive recalibration in the right and left hands following abrupt visuomotor adaptation.

PubMed

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.
A review of virtual reality based training simulators for orthopaedic surgery.

PubMed

Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

2016-02-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.
A Competency-Based "Hands-On" Training Package for Direct-Care Staff.

ERIC Educational Resources Information Center

Burch, Mary R.; And Others

1987-01-01

Evaluation of a combined "hands-on" and videotape training package used to teach direct care staff in an Intermediate Care Facility to conduct daily activities for profoundly mentally retarded persons indicated staff performance improved after the training and was maintained at three-week follow-up. (Author/DB)
Interacting hands: the role of attention for the joint Simon effect

PubMed Central

Liepelt, Roman

2014-01-01

Recent research in monkeys and humans has shown that the presence of the hands near an object enhances spatial processing for objects presented near the hand. This study aimed to test the effect of hand position on the joint Simon effect. In Experiment 1, two human co-actors shared a Simon task while placing their response hands either near the objects appearing on the monitor or away from the monitor. Experiment 2 varied each co-actor’s hand position independently. Experiment 3 tested whether enhanced spatial processing for objects presented near the hand is obtained when replacing one of the two co-actors by a non-human event-producing rubber hand. Experiment 1 provided evidence for a Simon effect. Hand position significantly modulated the size of the Simon effect in the joint Simon task showing an increased Simon effect when the hands of both actors were located near the objects on the monitor, than when they were located away from the monitor. Experiment 2 replicated this finding showing an increased Simon effect when the actor’s hand was located near the objects on the monitor, but only when the co-actor also produced action events in spatial reference. A similar hand position effect was observed in Experiment 3 when a non-human rubber hand replaced the human co-actor. These findings suggest that external action events that are produced in spatial reference bias the distribution of attention to the area near the hand. This strengthens the weight of the spatial response codes (referential coding) and hence increases the joint Simon effect. PMID:25566140
Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial.

PubMed

Nijenhuis, Sharon M; Prange-Lasonder, Gerdienke B; Stienen, Arno Ha; Rietman, Johan S; Buurke, Jaap H

2017-02-01

To compare user acceptance and arm and hand function changes after technology-supported training at home with conventional exercises in chronic stroke. Secondly, to investigate the relation between training duration and clinical changes. A randomised controlled trial. Training at home, evaluation at research institute. Twenty chronic stroke patients with severely to mildly impaired arm and hand function. Participants were randomly assigned to six weeks (30 minutes per day, six days a week) of self-administered home-based arm and hand training using either a passive dynamic wrist and hand orthosis combined with computerised gaming exercises (experimental group) or prescribed conventional exercises from an exercise book (control group). Main outcome measures are the training duration for user acceptance and the Action Research Arm Test for arm and hand function. Secondary outcomes are the Intrinsic Motivation Inventory, Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength. The control group reported a higher training duration (189 versus 118 minutes per week, P = 0.025). Perceived motivation was positive and equal between groups ( P = 0.935). No differences in clinical outcomes over training between groups were found (P ⩾ 0.165). Changes in Box and Block Test correlated positively with training duration ( P = 0.001). Both interventions were accepted. An additional benefit of technology-supported arm and hand training over conventional arm and hand exercises at home was not demonstrated. Training duration in itself is a major contributor to arm and hand function improvements.
Eye movement training is most effective when it involves a task-relevant sensorimotor decision.

PubMed

Fooken, Jolande; Lalonde, Kathryn M; Mann, Gurkiran K; Spering, Miriam

2018-04-01

Eye and hand movements are closely linked when performing everyday actions. We conducted a perceptual-motor training study to investigate mutually beneficial effects of eye and hand movements, asking whether training in one modality benefits performance in the other. Observers had to predict the future trajectory of a briefly presented moving object, and intercept it at its assumed location as accurately as possible with their finger. Eye and hand movements were recorded simultaneously. Different training protocols either included eye movements or a combination of eye and hand movements with or without external performance feedback. Eye movement training did not transfer across modalities: Irrespective of feedback, finger interception accuracy and precision improved after training that involved the hand, but not after isolated eye movement training. Conversely, eye movements benefited from hand movement training or when external performance feedback was given, thus improving only when an active interceptive task component was involved. These findings indicate only limited transfer across modalities. However, they reveal the importance of creating a training task with an active sensorimotor decision to improve the accuracy and precision of eye and hand movements.

An automated hand hygiene training system improves hand hygiene technique but not compliance.

PubMed

Kwok, Yen Lee Angela; Callard, Michelle; McLaws, Mary-Louise

2015-08-01

The hand hygiene technique that the World Health Organization recommends for cleansing hands with soap and water or alcohol-based handrub consists of 7 poses. We used an automated training system to improve clinicians' hand hygiene technique and test whether this affected hospitalwide hand hygiene compliance. Seven hundred eighty-nine medical and nursing staff volunteered to participate in a self-directed training session using the automated training system. The proportion of successful first attempts was reported for each of the 7 poses. Hand hygiene compliance was collected according to the national requirement and rates for 2011-2014 were used to determine the effect of the training system on compliance. The highest pass rate was for pose 1 (palm to palm) at 77% (606 out of 789), whereas pose 6 (clean thumbs) had the lowest pass rate at 27% (216 out of 789). One hundred volunteers provided feedback to 8 items related to satisfaction with the automated training system and most (86%) expressed a high degree of satisfaction and all reported that this method was time-efficient. There was no significant change in compliance rates after the introduction of the automated training system. Observed compliance during the posttraining period declined but increased to 82% in response to other strategies. Technology for training clinicians in the 7 poses played an important education role but did not affect compliance rates. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
Does Curriculum Practical Training Affect Engineers' Workplace Outcomes? Evidence from an Engineer Survey in China

ERIC Educational Resources Information Center

Li, Jing; Zhang, Yu; Tsang, Mun; Li, Manli

2015-01-01

With the increasing attention to STEM (Science, Technology, Engineering, and Math), hands-on Curriculum Practical Training (CPT) has been expanding rapidly worldwide as a requirement of the undergraduate engineering education. In China, a typical CPT for undergraduate engineering students requires several weeks of hands-on training in the…
40 CFR 745.225 - Accreditation of training programs: target housing and child-occupied facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... equipment to be used for lecture and hands-on training. (B) A copy of the course test blueprint for each..., the delivery of the lecture, course test, hands-on training, and assessment activities. This includes... containment and cleanup methods, and post-renovation cleaning verification. (vii) The dust sampling technician...
40 CFR 745.225 - Accreditation of training programs: target housing and child-occupied facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... equipment to be used for lecture and hands-on training. (B) A copy of the course test blueprint for each..., the delivery of the lecture, course test, hands-on training, and assessment activities. This includes... containment and cleanup methods, and post-renovation cleaning verification. (vii) The dust sampling technician...
Effects of Theory Training, Hands-on Supervision and a Self-Instructional Treatment Manual on Staff Competency

ERIC Educational Resources Information Center

Hatlenes, Linda Teikari; Eikeseth, Svein

2016-01-01

Employing a randomized control group design, this study compared the efficacy of staff training using theory training, hands-on supervision and a self-instructional teaching manual. Participants were 12 undergraduate, health or social-work students. Initially, participants were given a three-hour lecture, and as a result, staff-participants…
Effects of hand-training in persons with myotonic dystrophy type 1--a randomised controlled cross-over pilot study.

PubMed

Aldehag, Anna; Jonsson, Hans; Lindblad, Jan; Kottorp, Anders; Ansved, Tor; Kierkegaard, Marie

2013-10-01

To investigate the effects of a hand-training programme on grip, pinch and wrist force, manual dexterity and activities of daily living, in adults with myotonic dystrophy type 1 (DM1). In this randomised controlled trial with a crossover design, 35 adults with DM1 were, after stratification for grip force, assigned by lot to two groups. Group A started with 12 weeks of hand training, while group B had no intervention. After a wash-out period of 12 weeks, where none received training, the order was reversed. The Grippit® was used as primary outcome measure and the hand-held Microfet2™ myometer, the Purdue Pegboard, the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS) were secondary outcome measures. Assessments were performed before and after training and control periods, i.e. four times altogether. Ten persons dropped out and 13 had acceptable adherence. Intention-to-treat analyses revealed significant intervention effects for isometric wrist flexor force (p = 0.048), and for COPM performance (p = 0.047) and satisfaction (p = 0.027). On an individual level, improvements were in general showed after a training period. The hand-training programme had positive effects on wrist flexor force and self-perception of occupational performance, and of satisfaction with performance. No evident detrimental effects were shown. Myotonic dystrophy type 1 (DM1) is a slowly progressive neuromuscular disease characterised by myotonia and muscle weakness and wasting. People with DM1 are often concerned about their ability to carry out ADL and to participate in, e.g. work, sports and hobbies when they gradually become weaker. This pilot study showed that a hand-training programme improved wrist flexor force and self-perception and satisfaction of occupational performance. Resistance training of hand muscles with a silicon-based putty can be a therapy option for people with DM1 in clinical practise.
Enhancement of anatomical learning and developing clinical competence of first-year medical and allied health profession students.

PubMed

Keim Janssen, Sarah A; VanderMeulen, Stephane P; Shostrom, Valerie K; Lomneth, Carol S

2014-01-01

Hands-on educational experiences can stimulate student interest, increase knowledge retention, and enhance development of clinical skills. The Lachman test, used to assess the integrity of the anterior cruciate ligament (ACL), is commonly performed by health care professionals and is relatively easy to teach to first-year health profession students. This study integrated teaching the Lachman test into a first-year anatomy laboratory and examined if students receiving the training would be more confident, competent, and if the training would enhance anatomical learning. First-year medical, physician assistant and physical therapy students were randomly assigned into either the intervention (Group A) or control group (Group B). Both groups received the course lecture on knee anatomy and training on how to perform the Lachman test during a surface anatomy class. Group A received an additional 15 minutes hands-on training for the Lachman test utilizing a lightly embalmed cadaver as a simulated patient. One week later, both groups performed the Lachman test on a lightly embalmed cadaver and later completed a post-test and survey. Students with hands-on training performed significantly better than students with lecture-only training in completing the checklist, a post-test, and correctly diagnosing an ACL tear. Students in Group A also reported being more confident after hands-on training compared to students receiving lecture-only training. Both groups reported that incorporating clinical skill activities facilitated learning and created excitement for learning. Hands-on training using lightly embalmed cadavers as patient simulators increased confidence and competence in performing the Lachman test and aided in learning anatomy. © 2013 American Association of Anatomists.
Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial.

PubMed

Kim, Young Joon; Cho, Youngsuk; Cho, Gyu Chong; Ji, Hyun Kyung; Han, Song Yi; Lee, Jin Hyuck

2017-06-01

Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant's CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor.
Short Term Motor-Skill Acquisition Improves with Size of Self-Controlled Virtual Hands

PubMed Central

Ossmy, Ori; Mukamel, Roy

2017-01-01

Visual feedback in general, and from the body in particular, is known to influence the performance of motor skills in humans. However, it is unclear how the acquisition of motor skills depends on specific visual feedback parameters such as the size of performing effector. Here, 21 healthy subjects physically trained to perform sequences of finger movements with their right hand. Through the use of 3D Virtual Reality devices, visual feedback during training consisted of virtual hands presented on the screen, tracking subject’s hand movements in real time. Importantly, the setup allowed us to manipulate the size of the displayed virtual hands across experimental conditions. We found that performance gains increase with the size of virtual hands. In contrast, when subjects trained by mere observation (i.e., in the absence of physical movement), manipulating the size of the virtual hand did not significantly affect subsequent performance gains. These results demonstrate that when it comes to short-term motor skill learning, the size of visual feedback matters. Furthermore, these results suggest that highest performance gains in individual subjects are achieved when the size of the virtual hand matches their real hand size. These results may have implications for optimizing motor training schemes. PMID:28056023
Evaluation of Hands-Free Devices for the Display of Maintenance Procedures

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Hoffman, Ronald B.; Litaker, Harry, Jr.; Solem, Jody; Holden, Kritina; Twyford, Evan; Conlee, Carl

2007-01-01

Over the past year, NASA's focus has turned to crewed long duration and exploration missions. On these journeys, crewmembers will be required to execute thousands of procedures to maintain life support systems, check out space suits, conduct science experiments, and perform medical exams. To support the many complex tasks crewmembers undertake in microgravity, NASA is interested in providing crewmembers a hands-free work environment to promote more efficient operations. The overarching objective is to allow crewmembers to use both of their hands for tasks related to their mission, versus holding a paper manual or interacting with a display. The use of advanced, hands-free tools will undoubtedly make the crewmembers task easier, but they can also add to overall task complexity if not properly designed. A leading candidate technology for supporting a hands-free environment is the Head-Mounted Display (HMD). A more recent technology (e-book reader) that could be easily temp-stowed near the work area is also a potential hands-free solution. Previous work at NASA involved the evaluation of several commercially available HMDs for visual quality, comfort, and fit, as well as suitability for use in microgravity. Based on results from this work, three HMDs were selected for further evaluation (along with an e-book reader), using International Space Station (ISS)-like maintenance procedures. Two evaluations were conducted in the Space Station Mockup and Trainer Facility (SSMTF) located at the NASA Johnson Space Center (building 9). The SSMTF is a full scale, medium fidelity replica of the pressurized portions of the ISS. It supports crew training such as ingress and egress, habitability, and emergency procedures. In each of the two evaluations, the participants performed two maintenance procedures. One maintenance procedure involved inspecting air filters in a life support system and replacing them with a clean filter if one were found to be contaminated. The second maintenance procedure focused on working in a confined space; specifically, pulling down a rack to inspect wiring configurations, and rewiring in a different pattern. The maintenance procedures were selected to assess mobility, tool use, and access to multiple document sources during task performance. That is, the participant had to move from rack to rack, use a wrench, a camera, etc., replace components, and refer to diagrams to complete tasks. A constraint was imposed that the ISS-like format of the procedures was to be retained, and not modified or optimized for the electronic device ("plug and play" approach). This was based on future plans to test with real procedures on ISS.
Impact of a multi-faceted training intervention on the improvement of hand hygiene and gloving practices in four healthcare settings including nursing homes, acute-care geriatric wards and physical rehabilitation units.

PubMed

Eveillard, Matthieu; Raymond, Françoise; Guilloteau, Véronique; Pradelle, Marie-Thérèse; Kempf, Marie; Zilli-Dewaele, Marina; Joly-Guillou, Marie-Laure; Brunel, Patrick

2011-10-01

To assess the impact of a multi-faceted training program on the compliance with hand hygiene and gloving practices. Hand hygiene is considered as the cornerstone of the prevention of hospital-acquired infections. Several studies have enhanced the poor effectiveness of training programs in improving hand hygiene compliance. A before-after evaluation study. The study was conducted in four healthcare settings before and after an intervention program which included the performance feedback of the first evaluation phase, three six-h training sessions, the assessment of hand hygiene performance with teaching boxes and the organisation of one full-day session devoted to institutional communication around hand hygiene in each setting. Hand hygiene compliance and quality of hand rubbing were evaluated. Hand hygiene opportunities were differentiated into extra-series opportunities (before or after a single contact and before the first contact or after the last contact of a series of consecutive contacts) and intra-series opportunities (from the opportunity following the first contact to the opportunity preceding the last in the same series). Overall, 969 contacts corresponding to 1,470 hand hygiene opportunities (760 during the first phase and 710 during the second) were observed. A significant improvement of observed practices was recorded for the hand hygiene compliance in intra-series opportunities (39·0% vs. 19·0%; p < 10(-5) ), the proportion of gloves worn if indicated (71·4% vs. 52·0%; p < 0·001) and the quality of hand rubbing (85·0% vs. 71·9%; p < 10(-5) ). Some of the performances measured for both hand hygiene and gloving practices were improved. We plan to extend this investigation by performing a qualitative study with experts in behavioural sciences to try improving practices for which adherence was still weak after the training program such as hand hygiene in intra-series opportunities. This study underscored the usefulness of implementing contextualised training programs, while more traditional courses have shown little impact. © 2011 Blackwell Publishing Ltd.
The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot.

PubMed

Hu, X L; Tong, K Y; Wei, X J; Rong, W; Susanto, E A; Ho, S K

2013-10-01

Loss of hand function and finger dexterity are main disabilities in the upper limb after stroke. An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training was investigated on persons with chronic stroke (n=10) in this work. All subjects attended a 20-session training (3-5times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Significant motor improvements were observed in the Fugl-Meyer hand/wrist and shoulder/elbow scores (p<0.05), and also in the Action Research Arm Test and Wolf Motor Function Test (p<0.05). Significant reduction in spasticity of the fingers as was measured by the Modified Ashworth Score (p<0.05). The training improved the muscle co-ordination between the antagonist muscle pair (flexor digitorum (FD) and extensor digitorum (ED)), associated with a significant reduction in the ED EMG level (p<0.05) and a significant decrease of ED and FD co-contraction during the training (p<0.05); the excessive muscle activities in the biceps brachii were also reduced significantly after the training (p<0.05). Copyright © 2013 Elsevier Ltd. All rights reserved.
Common Conditions of the Hand for the Nurse Practitioner: How to Diagnose, How to Manage, and When to Refer to a Hand Surgeon.

PubMed

Young, Amanda L

In many parts of the United States, a plastics-trained hand surgeon can be in limited supply. Depending on individual state law, nurse practitioners can manage common and moderately complex hand conditions, the undertaking of which requires extensive training, high command of the anatomy, and knowing when referral is necessary.
Effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy.

PubMed

Shin, Ji-Won; Song, Gui-Bin; Hwangbo, Gak

2015-07-01

[Purpose] The purpose of the study was to evaluate the effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy. [Subjects] Sixteen children (9 males, 7 females) with spastic diplegic cerebral palsy were recruited and randomly assigned to the conventional neurological physical therapy group (CG) and virtual reality training group (VRG). [Methods] Eight children in the control group performed 45 minutes of therapeutic exercise twice a week for eight weeks. In the experimental group, the other eight children performed 30 minutes of therapeutic exercise and 15 minutes of a training program using virtual reality twice a week during the experimental period. [Results] After eight weeks of the training program, there were significant differences in eye-hand coordination and visual motor speed in the comparison of the virtual reality training group with the conventional neurological physical therapy group. [Conclusion] We conclude that a well-designed training program using virtual reality can improve eye-hand coordination in children with cerebral palsy.
Evaluation of the effectiveness of a transfer (interhemispheric) training programme in the early stages of fencing training.

PubMed

Witkowski, Mateusz; Bronikowski, Michał; Nowik, Agnieszka; Tomczak, Maciej; Strugarek, Jan

2017-07-24

A high level of motor coordination (with an emphasis on the accuracy of hand movements) is an important part of fencers' training. Research on motor coordination shows that both hemispheres of the brain are involved in controlling the action of each of the upper limbs. As the physical training of one hand is believed to significantly increase the performance of the other (untrained) hand [14], the authors attempt to verify the hypothesis that specialized training of the nondominant limb can improve the performance of the dominant hand in fencing. The study was carried out in Poznań, Poland, in 2015 and involved the experimental (N=8) and control (N=8) groups of cadets (12.7±0.5 years old); body mass 38.69±4.08; body height 153.47±6.17), who were randomly selected from fencers belonging to the Fencing Club "Warta" in Poznań, Poland. Participants in the study belonged to one training group with a similar training experience of about six years. All participants in the study (N = 16) declared righthandedness during trainings and duels. Their right lateralization was also confirmed in a survey, which was conducted using the Edinburgh Questionnaire [21]. The experimental training programme included six weeks of specialized training of the coordination skills of the nondominant side. It was carried out five times a week. Each session took 30 minutes. The aim of the study was to determine the effect of transfer (interhemispheric) training with the use of the nondominant hand in particular, on the performance of the dominant hand in fencing. The results indicate that the transfer (interhemispheric) training reduced test accomplishment time in tasks performed with the right upper limb during accuracy tests. The procedures applied in the study also reduced test accomplishment time in tasks performed with the left upper limb. The study demonstrates that an interhemispheric training programme can effectively improve the accuracy of fencing actions, at least in the early stages of training.
[Phonological characteristics and rehabilitation training of abnormal velar in children with functional articulation disorders].

PubMed

Lina, Xu; Feng, Li; Yanyun, Zhang; Nan, Gao; Mingfang, Hu

2016-12-01

To explore the phonological characteristics and rehabilitation training of abnormal velar in patients with functional articulation disorders (FAD). Eighty-seven patients with FAD were observed of the phonological characteristics of velar. Seventy-two patients with abnormal velar accepted speech training. The correlation and simple linear regression analysis were carried out on abnormal velar articulation and age. The articulation disorder of /g/ mainly showed replacement by /d/, /b/ or omission. /k/ mainly showed replacement by /d/, /t/, /g/, /p/, /b/. /h/ mainly showed replacement by /g/, /f/, /p/, /b/ or omission. The common erroneous articulation forms of /g/, /k/, /h/ were fronting of tongue and replacement by bilabial consonants. When velar combined with vowels contained /a/ and /e/, the main error was fronting of tongue. When velar combined with vowels contained /u/, the errors trended to be replacement by bilabial consonants. After 3 to 10 times of speech training, the number of erroneous words decreased to (6.24±2.61) from (40.28±6.08) before the speech training was established, the difference was statistically significant (Z=-7.379, P=0.000). The number of erroneous words was negatively correlated with age (r=-0.691, P=0.000). The result of simple linear regression analysis showed that the determination coefficient was 0.472. The articulation disorder of velar mainly shows replacement, varies with the vowels. The targeted rehabilitation training hereby established is significantly effective. Age plays an important role in the outcome of velar.
Effects of two-handed task training on upper limb function of chronic hemiplegic patients after stroke

PubMed Central

Yang, Byung Il; Song, Bo Kyoung; Joung, Sang Mi

2017-01-01

[Purpose] The purpose of this study was to determine whether two-handed task training is effective on motor learning of injured cerebral cortex activation and upper extremity function recovery after stroke. [Subjects and Methods] Two hemiplegic subjects participated in this study: one patient was affected on the dominant side of the body and the other was affected on the non-dominant side of the body, and both scored in the range of 58–66 in the Fugl-Meyer assessment. The excitability of the corticospinal tract and Manual Function Test were examined. [Results] The excitability of the corticospinal tract and the Manual Function Test showed significant differences in the activation of both sides of the cerebral cortex and in the variation in learning effect of upper extremity motor function recovery in patients with hemiplegic non-dominant hand (left). [Conclusion] The results suggested that two-handed task training had a different influence on dominant hand (right) and non-dominant hand (left) motor recovery. PMID:28210051
Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.

PubMed

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 Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Hand-assisted laparoscopic sigmoid colectomy skills acquisition: augmented reality simulator versus human cadaver training models.

PubMed

Leblanc, Fabien; Senagore, Anthony J; Ellis, Clyde N; Champagne, Bradley J; Augestad, Knut M; Neary, Paul C; Delaney, Conor P

2010-01-01

The aim of this study was to compare a simulator with the human cadaver model for hand-assisted laparoscopic colorectal skills acquisition training. An observational prospective comparative study was conducted to compare the laparoscopic surgery training models. The study took place during the laparoscopic colectomy training course performed at the annual scientific meeting of the American Society of Colon and Rectal Surgeons. Thirty four practicing surgeons performed hand-assisted laparoscopic sigmoid colectomy on human cadavers (n = 7) and on an augmented reality simulator (n = 27). Prior laparoscopic colorectal experience was assessed. Trainers and trainees completed independently objective structured assessment forms. Training models were compared by trainees' technical skills scores, events scores, and satisfaction. Prior laparoscopic experience was similar in both surgeon groups. Generic and specific skills scores were similar on both training models. Generic events scores were significantly better on the cadaver model. The 2 most frequent generic events occurring on the simulator were poor hand-eye coordination and inefficient use of retraction. Specific events were scored better on the simulator and reached the significance limit (p = 0.051) for trainers. The specific events occurring on the cadaver were intestinal perforation and left ureter identification difficulties. Overall satisfaction was better for the cadaver than for the simulator model (p = 0.009). With regard to skills scores, the augmented reality simulator had adequate qualities for the hand-assisted laparoscopic colectomy training. Nevertheless, events scores highlighted weaknesses of the anatomical replication on the simulator. Although improvements likely will be required to incorporate the simulator more routinely into the colorectal training, it may be useful in its current form for more junior trainees or those early on their learning curve. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial

PubMed Central

Kim, Young Joon; Cho, Youngsuk; Cho, Gyu Chong; Ji, Hyun Kyung; Han, Song Yi; Lee, Jin Hyuck

2017-01-01

Objective Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. Methods Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant’s CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. Results In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. Conclusion Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor. PMID:28717778

Effect of ultrasound training of physicians working in the prehospital setting.

PubMed

Krogh, Charlotte Loumann; Steinmetz, Jacob; Rudolph, Søren Steemann; Hesselfeldt, Rasmus; Lippert, Freddy K; Berlac, Peter A; Rasmussen, Lars S

2016-08-04

Advances in technology have made ultrasound (US) devices smaller and portable, hence accessible for prehospital care providers. This study aims to evaluate the effect of a four-hour, hands-on US training course for physicians working in the prehospital setting. The primary outcome measure was US performance assessed by the total score in a modified version of the Objective Structured Assessment of Ultrasound Skills scale (mOSAUS). Prehospital physicians participated in a four-hour US course consisting of both hands-on training and e-learning including a pre- and a post-learning test. Prior to the hands-on training a pre-training test was applied comprising of five videos in which the participants should identify pathology and a five-minute US examination of a healthy volunteer portraying to be a shocked patient after a blunt torso trauma. Following the pre-training test, the participants received a four-hour, hands-on US training course which was concluded with a post-training test. The US examinations and screen output from the US equipment were recorded for subsequent assessment. Two blinded raters assessed the videos using the mOSAUS. Forty participants completed the study. A significant improvement was identified in e-learning performance and US performance, (37.5 (SD: 10.0)) vs. (51.3 (SD: 5.9) p = < 0.0001), total US performance score (15.3 (IQR: 12.0-17.5) vs. 17.5 (IQR: 14.5-21.0), p = < 0.0001) and in each of the five assessment elements of the mOSAUS. In the prehospital physicians assessed, we found significant improvements in the ability to perform US examinations after completing a four-hour, hands-on US training course.
Hip Replacement Surgery

MedlinePlus

... Download Download EPUB Download PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement ... This leaves your hands and arms free for balance or to use crutches. Use a long-handled " ...
A new therapeutic application of brain-machine interface (BMI) training followed by hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for patients with severe hemiparetic stroke: A proof of concept study.

PubMed

Kawakami, Michiyuki; Fujiwara, Toshiyuki; Ushiba, Junichi; Nishimoto, Atsuko; Abe, Kaoru; Honaga, Kaoru; Nishimura, Atsuko; Mizuno, Katsuhiro; Kodama, Mitsuhiko; Masakado, Yoshihisa; Liu, Meigen

2016-09-21

Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy improved paretic upper extremity motor function in patients with severe to moderate hemiparesis. We hypothesized that brain machine interface (BMI) training would be able to increase paretic finger muscle activity enough to apply HANDS therapy in patients with severe hemiparesis, whose finger extensor was absent. The aim of this study was to assess the efficacy of BMI training followed by HANDS therapy in patients with severe hemiparesis. Twenty-nine patients with chronic stroke who could not extend their paretic fingers were participated this study. We applied BMI training for 10 days at 40 min per day. The BMI detected the patients' motor imagery of paretic finger extension with event-related desynchronization (ERD) over the affected primary sensorimotor cortex, recorded with electroencephalography. Patients wore a motor-driven orthosis, which extended their paretic fingers and was triggered with ERD. When muscle activity in their paretic fingers was detected with surface electrodes after 10 days of BMI training, we applied HANDS therapy for the following 3 weeks. In HANDS therapy, participants received closed-loop, electromyogram-controlled, neuromuscular electrical stimulation (NMES) combined with a wrist-hand splint for 3 weeks at 8 hours a day. Before BMI training, after BMI training, after HANDS therapy and 3month after HANDS therapy, we assessed Fugl-Meyer Assessment upper extremity motor score (FMA) and the Motor Activity Log14-Amount of Use (MAL-AOU) score. After 10 days of BMI training, finger extensor activity had appeared in 21 patients. Eighteen of 21 patients then participated in 3 weeks of HANDS therapy. We found a statistically significant improvement in the FMA and the MAL-AOU scores after the BMI training, and further improvement was seen after the HANDS therapy. Combining BMI training with HANDS therapy could be an effective therapeutic strategy for severe UE paralysis after stroke.
The effects of resistance training on muscle strength, joint pain, and hand function in individuals with hand osteoarthritis: a systematic review and meta-analysis.

PubMed

Magni, Nicoló Edoardo; McNair, Peter John; Rice, David Andrew

2017-06-13

Hand osteoarthritis is a common condition characterised by joint pain and muscle weakness. These factors are thought to contribute to ongoing disability. Some evidence exists that resistance training decreases pain, improves muscle strength, and enhances function in people with knee and hip osteoarthritis. However, there is currently a lack of consensus regarding its effectiveness in people with hand osteoarthritis. Therefore, the aim of this systematic review and meta-analysis was to establish whether resistance training in people with hand osteoarthritis increases grip strength, decreases joint pain, and improves hand function. Seven databases were searched from 1975 until July 1, 2016. Randomised controlled trials were included. The Cochrane Risk of Bias Tool was used to assess studies' methodological quality. The Grade of Recommendations Assessment, Development, and Evaluation system was adopted to rate overall quality of evidence. Suitable studies were pooled using a random-effects meta-analysis. Five studies were included with a total of 350 participants. The majority of the training programs did not meet recommended intensity, frequency, or progression criteria for muscle strengthening. There was moderate-quality evidence that resistance training does not improve grip strength (mean difference = 1.35; 95% confidence interval (CI) = -0.84, 3.54; I 2 = 50%; p = 0.23 ). Low-quality evidence showed significant improvements in joint pain (standardised mean difference (SMD) = -0.23; 95% CI = -0.42, -0.04; I 2 = 0%; p = 0.02) which were not clinically relevant. Low-quality evidence demonstrated no improvements in hand function following resistance training (SMD = -0.1; 95% CI = -0.33, 0.13; I 2 = 28%; p = 0.39). There is no evidence that resistance training has a significant effect on grip strength or hand function in people with hand osteoarthritis. Low-quality evidence suggests it has a small, clinically unimportant pain-relieving effect. Future studies should investigate resistance training regimes with adequate intensity, frequency, and progressions to achieve gains in muscle strength.
Fastener starter tool

NASA Technical Reports Server (NTRS)

Chandler, Faith T. (Inventor); Arnett, Michael C. (Inventor); Garton, Harry L. (Inventor); Valentino, William D. (Inventor)

2003-01-01

A fastener starter tool includes a number of spring retention fingers for retaining a small part, or combination of parts. The tool has an inner housing, which holds the spring retention fingers, a hand grip, and an outer housing configured to slide over the inner housing and the spring retention fingers toward and away from the hand grip, exposing and opening, or respectively, covering and closing, the spring retention fingers. By sliding the outer housing toward (away from) the hand grip, a part can be released from (retained by) the tool. The tool may include replaceable inserts, for retaining parts, such as screws, and configured to limit the torque applied to the part, to prevent cross threading. The inner housing has means to transfer torque from the hand grip to the insert. The tool may include replaceable bits, the inner housing having means for transferring torque to the replaceable bit.
A data mining technique for discovering distinct patterns of hand signs: implications in user training and computer interface design.

PubMed

Ye, Nong; Li, Xiangyang; Farley, Toni

2003-01-15

Hand signs are considered as one of the important ways to enter information into computers for certain tasks. Computers receive sensor data of hand signs for recognition. When using hand signs as computer inputs, we need to (1) train computer users in the sign language so that their hand signs can be easily recognized by computers, and (2) design the computer interface to avoid the use of confusing signs for improving user input performance and user satisfaction. For user training and computer interface design, it is important to have a knowledge of which signs can be easily recognized by computers and which signs are not distinguishable by computers. This paper presents a data mining technique to discover distinct patterns of hand signs from sensor data. Based on these patterns, we derive a group of indistinguishable signs by computers. Such information can in turn assist in user training and computer interface design.
The evolution of functional hand replacement: From iron prostheses to hand transplantation

PubMed Central

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
Hands-On Sports Medicine Training for Residents.

ERIC Educational Resources Information Center

Tanji, Jeffrey L.

1989-01-01

Describes the development of a hands-on sports medicine training program for residents at the University of California, Davis, Medical Center. Education strategies include clinical teaching, on-the-field education, experiential learning, and didactic instruction. Programs focusing exclusively on sports medicine are needed because the number of…
Effectiveness of functional hand splinting and the cognitive orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols

PubMed Central

2014-01-01

Background Cerebral palsy (CP) and brain injury (BI) are common conditions that have devastating effects on a child’s ability to use their hands. Hand splinting and task-specific training are two interventions that are often used to address deficits in upper limb skills, both in isolation or concurrently. The aim of this paper is to describe the method to be used to conduct two randomised controlled trials (RCT) investigating (a) the immediate effect of functional hand splints, and (b) the effect of functional hand splints used concurrently with task-specific training compared to functional hand splints alone, and to task-specific training alone in children with CP and BI. The Cognitive Orientation to Occupational Performance (CO-OP) approach will be the task-specific training approach used. Methods/Design Two concurrent trials; a two group, parallel design, RCT with a sample size of 30 participants (15 per group); and a three group, parallel design, assessor blinded, RCT with a sample size of 45 participants (15 per group). Inclusion criteria: age 4-15 years; diagnosis of CP or BI; Manual Abilities Classification System (MACS) level I – IV; hand function goals; impaired hand function; the cognitive, language and behavioural ability to participate in CO-OP. Participants will be randomly allocated to one of 3 groups; (1) functional hand splint only (n=15); (2) functional hand splint combined with task-specific training (n=15); (3) task-specific training only (n=15). Allocation concealment will be achieved using sequentially numbered, sealed opaque envelopes opened by an off-site officer after baseline measures. Treatment will be provided for a period of 2 weeks, with outcome measures taken at baseline, 1 hour after randomisation, 2 weeks and 10 weeks. The functional hand splint will be a wrist cock-up splint (+/- thumb support or supination strap). Task-specific training will involve 10 sessions of CO-OP provided in a group of 2-4 children. Primary outcome measures will be the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scale (GAS). Analysis will be conducted on an intention-to-treat basis. Discussion This paper outlines the protocol for two randomised controlled trials investigating functional hand splints and CO-OP for children with CP and BI. PMID:25023385
Using virtual data for training deep model for hand gesture recognition

NASA Astrophysics Data System (ADS)

Nikolaev, E. I.; Dvoryaninov, P. V.; Lensky, Y. Y.; Drozdovsky, N. S.

2018-05-01

Deep learning has shown real promise for the classification efficiency for hand gesture recognition problems. In this paper, the authors present experimental results for a deeply-trained model for hand gesture recognition through the use of hand images. The authors have trained two deep convolutional neural networks. The first architecture produces the hand position as a 2D-vector by input hand image. The second one predicts the hand gesture class for the input image. The first proposed architecture produces state of the art results with an accuracy rate of 89% and the second architecture with split input produces accuracy rate of 85.2%. In this paper, the authors also propose using virtual data for training a supervised deep model. Such technique is aimed to avoid using original labelled images in the training process. The interest of this method in data preparation is motivated by the need to overcome one of the main challenges of deep supervised learning: using a copious amount of labelled data during training.
[Hand hygiene technique assessment using electronic equipment in 26 Hungarian healthcare institutions].

PubMed

Lehotsky, Ákos; Morvai, Júlia; Szilágyi, László; Bánsághi, Száva; Benkó, Alíz; Haidegger, Tamás

2017-07-01

Hand hygiene is probably the most effective tool of nosocomial infection prevention, however, proper feedback and control is needed to develop the individual hand hygiene practice. Assessing the efficiency of modern education tools, and digital demonstration and verification equipment during their wide-range deployment. 1269 healthcare workers took part in a training organized by our team. The training included the assessment of the participants' hand hygiene technique to identify the most often missed areas. The hand hygiene technique was examined by a digital device. 33% of the participants disinfected their hands incorrectly. The most often missed sites are the fingertips (33% on the left hand, 37% on the right hand) and the thumbs (42% on the left hand, 32% on the right hand). The feedback has a fundamental role in the development of the hand hygiene technique. With the usage of electronic devices feedback can be provided efficiently and simply. Orv Hetil. 2017; 158(29): 1143-1148.
Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis.

PubMed

Domínguez-Navarro, Fernando; Igual-Camacho, Celedonia; Silvestre-Muñoz, Antonio; Roig-Casasús, Sergio; Blasco, José María

2018-05-01

Balance and proprioceptive deficits are frequently persistent after total joint replacement, limiting functionality and involving altered movement patterns and difficulties in walking and maintaining postural control among patients. The goal of this systematic review was to evaluate the short- and mid-term effects of proprioceptive and balance training for patients undergoing total knee and hip replacement. This is a systematic review of literature. MEDLINE, Embase, Cochrane Library, PEDro, and Scopus were the databases searched. The review included randomized clinical trials in which the experimental groups underwent a training aimed at improving balance and proprioception, in addition to conventional care. The studies had to assess at least one of the following outcomes: self-reported functionality or balance (primary outcomes), knee function, pain, falls, or quality of life. Eight trials were included, involving 567 participants. The quantitative synthesis found a moderate to high significant effect of balance and proprioceptive trainings on self-reported functionality and balance after total knee replacement. The effects were maintained at mid-term in terms of balance alone. Conversely, preoperative training did not enhance outcomes after total hip arthroplasty. The synthesis showed that, in clinical terms, balance trainings are a convenient complement to conventional physiotherapy care to produce an impact on balance and functionality after knee replacement. If outcomes such as improvement in pain, knee range of movement, or patient quality of life are to be promoted, it would be advisable to explore alternative proposals specifically targeting these goals. Further research is needed to confirm or discard the current evidence ultimately, predominantly in terms of the effects on the hips and those yielded by preoperative interventions. Copyright © 2018 Elsevier B.V. All rights reserved.
Effects of Computer-Aided Interlimb Force Coupling Training on Paretic Hand and Arm Motor Control following Chronic Stroke: A Randomized Controlled Trial

PubMed Central

Lin, Chueh-Ho; Chou, Li-Wei; Luo, Hong-Ji; Tsai, Po-Yi; Lieu, Fu-Kong; Chiang, Shang-Lin; Sung, Wen-Hsu

2015-01-01

Objective We investigated the training effects of interlimb force coupling training on paretic upper extremity outcomes in patients with chronic stroke and analyzed the relationship between motor recovery of the paretic hand, arm and functional performances on paretic upper limb. Design A randomized controlled trial with outcome assessment at baseline and after 4 weeks of intervention. Setting Taipei Veterans General Hospital, National Yang-Ming University. Participants Thirty-three subjects with chronic stroke were recruited and randomly assigned to training (n = 16) and control groups (n = 17). Interventions The computer-aided interlimb force coupling training task with visual feedback included different grip force generation methods on both hands. Main Outcome Measures The Barthel Index (BI), the upper extremity motor control Fugl-Meyer Assessment (FMA-UE), the Motor Assessment Score (MAS), and the Wolf Motor Function Test (WMFT). All assessments were executed by a blinded evaluator, and data management and statistical analysis were also conducted by a blinded researcher. Results The training group demonstrated greater improvement on the FMA-UE (p<.001), WMFT (p<.001), MAS (p = .004) and BI (p = .037) than the control group after 4 weeks of intervention. In addition, a moderate correlation was found between the improvement of scores for hand scales of the FMA and other portions of the FMA UE (r = .528, p = .018) or MAS (r = .596, p = .015) in the training group. Conclusion Computer-aided interlimb force coupling training improves the motor recovery of a paretic hand, and facilitates motor control and enhances functional performance in the paretic upper extremity of people with chronic stroke. Trial Registration ClinicalTrials.gov NCT02247674. PMID:26193492
Hazardous Materials Management and Emergency Response Training Center at Hanford

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ollero, J.; Muth, G.; Bergland, R.

1994-12-31

The Hanford Site will provide high-fidelity training using simulated job-site situations to prepare workers for known and unknown hazards. Hanford is developing the Hazardous Materials Management and Emergency Response (HAMMER) Training Center to operate as a user facility for the site, region and international labor unions. The center will focus on providing hands-on, realistic training situations. The Training Center is a partnership among U.S. Department of Energy (DOE); its contractors; labor; local, state, and tribal governments; Xavier and Tulane Universities of Louisiana and other Federal agencies. The hands-on training aids at HAMMER is justified based on regulatory training requirements, themore » desire for enhanced safety, and the commitment to continuous improvement of training quality.« less
A Compliant Four-bar Linkage Mechanism that Makes the Fingers of a Prosthetic Hand More Impact Resistant

PubMed Central

Choi, Kyung Yun; Akhtar, Aadeel; Bretl, Timothy

2017-01-01

Repeated mechanical failure due to accidental impact is one of the main reasons why people with upper-limb amputations abandon commercially-available prosthetic hands. To address this problem, we present the design and evaluation of a compliant four-bar linkage mechanism that makes the fingers of a prosthetic hand more impact resistant. Our design replaces both the rigid input and coupler links with a monolithic compliant bone, and replaces the follower link with three layers of pre-stressed spring steel. This design behaves like a conventional four-bar linkage but adds lateral compliance and eliminates a pin joint, which is a main site of failure on impact. Results from free-end and fixed-end impact tests show that, compared to those made with a conventional four-bar linkage, fingers made with our design absorb up to 11% more energy on impact with no mechanical failure. We also show the integration of these fingers in a prosthetic hand that is low-cost, light-weight, and easy to assemble, and that has grasping performance comparable to commercially-available hands. PMID:29527386
Effects of lips and hands on auditory learning of second-language speech sounds.

PubMed

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.
Aggression Replacement Training[R] Stands the Test of Time

ERIC Educational Resources Information Center

Amendola, Mark; Oliver, Robert

2010-01-01

There have been longstanding debates in the scientific community regarding what qualifies as evidence for programs that work with challenging youth. There are also a variety of levels of evidence on a continuum from promising to proven. Aggression Replacement Training[R] has stood the test of time in terms of its scientific underpinning and…
Brief compression-only cardiopulmonary resuscitation training video and simulation with homemade mannequin improves CPR skills.

PubMed

Wanner, Gregory K; Osborne, Arayel; Greene, Charlotte H

2016-11-29

Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt). Participants viewed the training video and practiced with the homemade mannequin. This was a parallel-design study with pre and post training evaluations of CPR skills (compression rate, depth, hand position, release), and hands-off time (time without compressions). CPR skills were evaluated using a sensor-equipped mannequin and two blinded CPR experts observed testing of participants. Twenty-four participants were included: 12 never-trained and 12 currently certified in CPR. Comparing pre and post training, the never-trained group had improvements in average compression rate per minute (64.3 to 103.9, p = 0.006), compressions with correct hand position in 1 min (8.3 to 54.3, p = 0.002), and correct compression release in 1 min (21.2 to 76.3, p < 0.001). The CPR-certified group had adequate pre and post-test compression rates (>100/min), but an improved number of compressions with correct release (53.5 to 94.7, p < 0.001). Both groups had significantly reduced hands-off time after training. Achieving adequate compression depths (>50 mm) remained problematic in both groups. Comparisons made between groups indicated significant improvements in compression depth, hand position, and hands-off time in never-trained compared to CPR-certified participants. Inter-rater agreement values were also calculated between the CPR experts and sensor-equipped mannequin. A brief internet-based video coupled with skill practice on a homemade mannequin improved compression-only CPR skills, especially in the previously untrained participants. This training method allows for widespread compression-only CPR training with a tactile learning component, without fees or advance preparation.
Learning and Motivation to Transfer after an E-Learning Programme: Impact of Trainees' Motivation to Train, Personal Interaction and Satisfaction

ERIC Educational Resources Information Center

Peters, Stephanie; Barbier, Marie; Faulx, Daniel; Hansez, Isabelle

2012-01-01

While e-learning appears to be increasingly present in training and education, the systematic evaluation of its effectiveness remains understudied. In this paper, we determine the mediating role of satisfaction between motivation to train and personal interaction, on the one hand, and learning and motivation to transfer, on the other hand. A…
Systemic mistakes in hand hygiene practice in Ukraine: detection, consequences and ways of elimination

PubMed Central

Klymenko, Iryna; Kampf, Günter

2015-01-01

Aim: Every year, millions of people around the world suffer from different infectious diseases, considerable part of which are hospital-acquired infections. WHO considers hand hygiene as a priority measure aimed to reduce the level of infection. We evaluated various aspects related to the situational behavior and prioritization regarding hand hygiene measures among the healthcare workers of Ukraine. Method: Identification of system mistakes in hand hygiene was carried out first of all by direct and indirect observation of the activities of medical and pharmaceutical personnel in their everyday practice as well as during their participation in trainings on routine hand hygiene. Questionnaires also were used to estimate the level of hand hygiene compliance of participants of the study. During this period 112 training courses, 315 master-classes and presentations on proper hand hygiene were realized. The target audience included health care workers of medical centers, clinics, maternity hospitals, health care organizations and staff of pharmacies and pharmaceutical manufacturing enterprises in all regions of Ukraine. 638 respondents took part in anonymous survey on hand hygiene practice. Results: The most common mistakes were to regard hand washing and hand disinfection equally, to wash hands before doing a hand disinfection, to neglect the five moments for hand hygiene and to ignore hand hygiene before and after wearing protective gloves. Practitioners, medical attendants, pharmacy and pharmaceutical industry workers highlighted the need for practical and understandable instructions of various hand hygiene procedures, including the clarification of the possible technical mistakes. This became a ground for us to create individual master classes on hand hygiene for each cluster of healthcare workers. Conclusions: Changing hand hygiene behavior and attitude is possible by beginning to observe clinical practice and by involving healthcare workers in teaching and training. PMID:25699224

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hopper, Calvin Mitchell

In May 1973 the University of New Mexico conducted the first nationwide criticality safety training and education week-long short course for nuclear criticality safety engineers. Subsequent to that course, the Los Alamos Critical Experiments Facility (LACEF) developed very successful 'hands-on' subcritical and critical training programs for operators, supervisors, and engineering staff. Since the inception of the US Department of Energy (DOE) Nuclear Criticality Technology and Safety Project (NCT&SP) in 1983, the DOE has stimulated contractor facilities and laboratories to collaborate in the furthering of nuclear criticality as a discipline. That effort included the education and training of nuclear criticality safetymore » engineers (NCSEs). In 1985 a textbook was written that established a path toward formalizing education and training for NCSEs. Though the NCT&SP went through a brief hiatus from 1990 to 1992, other DOE-supported programs were evolving to the benefit of NCSE training and education. In 1993 the DOE established a Nuclear Criticality Safety Program (NCSP) and undertook a comprehensive development effort to expand the extant LACEF 'hands-on' course specifically for the education and training of NCSEs. That successful education and training was interrupted in 2006 for the closing of the LACEF and the accompanying movement of materials and critical experiment machines to the Nevada Test Site. Prior to that closing, the Lawrence Livermore National Laboratory (LLNL) was commissioned by the US DOE NCSP to establish an independent hands-on NCSE subcritical education and training course. The course provided an interim transition for the establishment of a reinvigorated and expanded two-week NCSE education and training program in 2011. The 2011 piloted two-week course was coordinated by the Oak Ridge National Laboratory (ORNL) and jointly conducted by the Los Alamos National Laboratory (LANL) classroom education and facility training, the Sandia National Laboratory (SNL) hands-on criticality experiments training, and the US DOE National Criticality Experiment Research Center (NCERC) hands-on criticality experiments training that is jointly supported by LLNL and LANL and located at the Nevada National Security Site (NNSS) This paper provides the description of the bases, content, and conduct of the piloted, and future US DOE NCSP Criticality Safety Engineer Training and Education Project.« less
Early intensive hand rehabilitation after spinal cord injury ("Hands On"): a protocol for a randomised controlled trial.

PubMed

Harvey, Lisa A; Dunlop, Sarah A; Churilov, Leonid; Hsueh, Ya-Seng Arthur; Galea, Mary P

2011-01-17

Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete) undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. NCT01086930 (12th March 2010)ACTRN12609000695202 (12th August 2009).
[The effect of floating-needle therapy combined with rehabilitation training for the hand function recovery of post-stroke patients].

PubMed

Yang, Jiangxia; Xiao, Hong

2015-08-01

To explore the improvement of hand motion function,spasm and self-care ability of daily life for stroke patients treated with floating-needle combined with rehabilitation training. Eighty hand spasm patients of post-stroke within one year after stroke were randomly divided into an observation group and a control group, 40 cases in each one. In the two groups, rehabilitation was adopted for eight weeks,once a day,40 min one time. In the observation group, based on the above treatment and according to muscle fascia trigger point, 2~3 points in both the internal and external sides of forearm were treated with floating-needle. The positive or passive flexion and extension of wrist and knuckle till the relief of spasm hand was combined. The floating-needle therapy was given for eight weeks, on the first three days once a day and later once every other day. Modified Ashworth Scale(MAS), activity of daily life(ADL, Barthel index) scores and Fugl-Meyer(FMA) scores were used to assess the spasm hand degree,activity of daily life and hand motion function before and after 7-day, 14-day and 8-week treatment. After 7-day, 14-day and 8-week treatment, MAS scores were apparently lower than those before treatment in the two groups(all P<0. 05), and Barthel scores and FMA scores were obviously higher than those before-treatment(all P<0. 05). After 14-day and 8-week treatment, FMA scores in the observation group were markedly higher than those in the control group(both P<0. 05). Floating-needle therapy combined with rehabilitation training and simple rehabilitation training could both improve hand spasm degree, hand function and activity of daily life of post-stroke patients, but floating-needle therapy combined with rehabilitation training is superior to simple rehabilitation training for the improvement of hand function.
Impact of mild versus moderate intensity aerobic walking exercise training on markers of bone metabolism and hand grip strength in moderate hemophilic A patients.

PubMed

Al-Sharif, Fadwa Al-Ghalib; Al-Jiffri, Osama Hussien; El-Kader, Shehab Mahmoud Abd; Ashmawy, Eman Mohamed

2014-03-01

Patients with hemophilia A have low bone density than healthy controls. It is now widely recognized that physical activity and sports are beneficial for patients with hemophilia. To compare the effects of mild and moderate intensity treadmill walking exercises on markers of bone metabolism and hand grip strength in male patients with moderate hemophilia A. Fifty male patients with moderate hemophilia, and age range from 25 to 45 years. The subjects were randomly assigned into 2 equal groups; the first group (A) received moderate intensity aerobic exercise training. The second group (B) received mild intensity aerobic exercise training. There was a 32.1% and 24.8% increase in mean values of serum calcium and hand grip strength respectively and 22.7 % reduction in mean values of parathyroid hormone in moderate exercise training group (A). While there was a 15.1 % and 15 % increase in mean values of Serum Calcium and Hand grip strength respectively and 10.3 % reduction in mean values of parathyroid hormone in mild exercise training group(B). The mean values of serum calcium and hand grip strength were significantly increased, while the mean values of parathyroid hormone were significantly decreased in both groups . There were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. Moderate intensity aerobic exercise training on treadmill is appropriate to improve markers of bone metabolism and hand grip strength in male patients with hemophilia A.
Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study.

PubMed

Causer, Joe; Harvey, Adrian; Snelgrove, Ryan; Arsenault, Gina; Vickers, Joan N

2014-08-01

We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback. Copyright © 2014 Elsevier Inc. All rights reserved.
Effects of hand cycle training on physical capacity in individuals with tetraplegia: a clinical trial.

PubMed

Valent, Linda J M; Dallmeijer, Annet J; Houdijk, Han; Slootman, Hans J; Janssen, Thomas W; Post, Marcel W M; van der Woude, Lucas H

2009-10-01

Regular physical activity is important for people with tetraplegia to maintain fitness but may not always be easily integrated into daily life. In many countries, hand cycling has become a serious option for daily mobility in people with tetraplegia. However, little information exists regarding the suitability of this exercise mode for this population. The purpose of this study was to evaluate the effects of a structured hand cycle training program in individuals with chronic tetraplegia. Pretraining and posttraining outcome measurements of physical capacity were compared. Structured hand cycle interval training was conducted at home or in a rehabilitation center in the Netherlands. Twenty-two patients with tetraplegia (American Spinal Injury Association Impairment Scale classification A-D) at least 2 years since injury participated. The intervention was an 8- to 12-week hand cycle interval training program. Primary outcomes of physical capacity were: peak power output (POpeak) and peak oxygen uptake (Vo(2)peak), as determined in hand cycle peak exercise tests on a motor-driven treadmill. Secondary outcome measures were: peak muscle strength (force-generating capacity) of the upper extremities (as assessed by handheld dynamometry), respiratory function (forced vital capacity and peak expiratory flow) and participant-reported shoulder pain. Significant improvements following a mean of 19 (SD=3) sessions of hand cycle training were found in POpeak (from 42.5 W [SD=21.9] to 50.8 W [SD=25.4]), Vo(2)peak (from 1.32 L.min(-1) [SD=0.40] to 1.43 L.min(-1) [SD=0.43]), and mechanical efficiency, as reflected by a decrease in submaximal oxygen uptake. Except for shoulder abduction strength, no significant effects were found on the secondary outcomes. Common health complications, such as urinary tract infections, bowel problems, and pressure sores, led to dropout and nonadherence. Patients with tetraplegia were able to improve their physical capacity through regular hand cycle interval training, without participant-reported shoulder-arm pain or discomfort.
Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial.

PubMed

Srikesavan, Cynthia Swarnalatha; Shay, Barbara; Robinson, David B; Szturm, Tony

2013-03-09

Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann-Whitney U test. The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand. ClinicalTrials.gov: NCT01635582.
Piano training in youths with hand motor impairments after damage to the developing brain

PubMed Central

Lampe, Renée; Thienel, Anna; Mitternacht, Jürgen; Blumenstein, Tobias; Turova, Varvara; Alves-Pinto, Ana

2015-01-01

Damage to the developing brain may lead to impairment of the hand motor function and negatively impact on patients’ quality of life. Development of manual dexterity and finger and hand motor function may be promoted by learning to play the piano. The latter brings together music with the intensive training of hand coordination and fine finger mobility. We investigated if learning to play the piano helped to improve hand motor skills in 18 youths with hand motor disorders resulting from damage during early brain development. Participants trained 35–40 minutes twice a week for 18 months with a professional piano teacher. With the use of a Musical Instrument Digital Interface piano, the uniformity of finger strokes could be objectively assessed from the timing of keystrokes. The analysis showed a significant improvement in the uniformity of keystrokes during the training. Furthermore, the youths showed strong motivation and engagement during the study. This is nevertheless an open study, and further studies remain needed to exclude effects of growth and concomitant therapies on the improvements observed and clarify which patients will more likely benefit from learning to play the piano. PMID:26345312
Piano training in youths with hand motor impairments after damage to the developing brain.

PubMed

Lampe, Renée; Thienel, Anna; Mitternacht, Jürgen; Blumenstein, Tobias; Turova, Varvara; Alves-Pinto, Ana

2015-01-01

Damage to the developing brain may lead to impairment of the hand motor function and negatively impact on patients' quality of life. Development of manual dexterity and finger and hand motor function may be promoted by learning to play the piano. The latter brings together music with the intensive training of hand coordination and fine finger mobility. We investigated if learning to play the piano helped to improve hand motor skills in 18 youths with hand motor disorders resulting from damage during early brain development. Participants trained 35-40 minutes twice a week for 18 months with a professional piano teacher. With the use of a Musical Instrument Digital Interface piano, the uniformity of finger strokes could be objectively assessed from the timing of keystrokes. The analysis showed a significant improvement in the uniformity of keystrokes during the training. Furthermore, the youths showed strong motivation and engagement during the study. This is nevertheless an open study, and further studies remain needed to exclude effects of growth and concomitant therapies on the improvements observed and clarify which patients will more likely benefit from learning to play the piano.
Effects of electromyography-driven robot-aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke.

PubMed

Rong, Wei; Tong, Kai Yu; Hu, Xiao Ling; Ho, Sze Kit

2015-03-01

An electromyography-driven robot system integrated with neuromuscular electrical stimulation (NMES) was developed to investigate its effectiveness on post-stroke rehabilitation. The performance of this system in assisting finger flexion/extension with different assistance combinations was evaluated in five stroke subjects. Then, a pilot study with 20-sessions training was conducted to evaluate the training's effectiveness. The results showed that combined assistance from the NMES-robot could improve finger movement accuracy, encourage muscle activation of the finger muscles and suppress excessive muscular activities in the elbow joint. When assistances from both NMES and the robot were 50% of their maximum assistances, finger-tracking performance had the best results, with the lowest root mean square error, greater range of motion, higher voluntary muscle activations of the finger joints and lower muscle co-contraction in the finger and elbow joints. Upper limb function improved after the 20-session training, indicated by the increased clinical scores of Fugl-Meyer Assessment, Action Research Arm Test and Wolf Motor Function Test. Muscle co-contraction was reduced in the finger and elbow joints reflected by the Modified Ashworth Scale. The findings demonstrated that an electromyography-driven NMES-robot used for chronic stroke improved hand function and tracking performance. Further research is warranted to validate the method on a larger scale. Implications for Rehabilitation The hand robotics and neuromuscular electrical stimulation (NMES) techniques are still separate systems in current post-stroke hand rehabilitation. This is the first study to investigate the combined effects of the NMES and robot on hand rehabilitation. The finger tracking performance was improved with the combined assistance from the EMG-driven NMES-robot hand system. The assistance from the robot could improve the finger movement accuracy and the assistance from the NMES could reduce the muscle co-contraction on finger and elbow joints. The upper limb functions were improved on chronic stroke patients after the pilot study of 20-session hand training with the combined assistance from the EMG-driven NMES-robot. The muscle spasticity on finger and elbow joints was reduced after the training.
Training Analysis of P-3 Replacement Pilot Training.

ERIC Educational Resources Information Center

Browning, Robert F.; And Others

The report covers an evaluation of current P-3 pilot training programs at the replacement squadron level. It contains detailed discussions concerning training hardware and software that have been supplied. A detailed examination is made of the curriculum and the simulation capabilities and utilization of P-3 operational flight trainers. Concurrent…
An augmented reality home-training system based on the mirror training and imagery approach.

PubMed

Trojan, Jörg; Diers, Martin; Fuchs, Xaver; Bach, Felix; Bekrater-Bodmann, Robin; Foell, Jens; Kamping, Sandra; Rance, Mariela; Maaß, Heiko; Flor, Herta

2014-09-01

Mirror training and movement imagery have been demonstrated to be effective in treating several clinical conditions, such as phantom limb pain, stroke-induced hemiparesis, and complex regional pain syndrome. This article presents an augmented reality home-training system based on the mirror and imagery treatment approaches for hand training. A head-mounted display equipped with cameras captures one hand held in front of the body, mirrors this hand, and displays it in real time in a set of four different training tasks: (1) flexing fingers in a predefined sequence, (2) moving the hand into a posture fitting into a silhouette template, (3) driving a "Snake" video game with the index finger, and (4) grasping and moving a virtual ball. The system records task performance and transfers these data to a central server via the Internet, allowing monitoring of training progress. We evaluated the system by having 7 healthy participants train with it over the course of ten sessions of 15-min duration. No technical problems emerged during this time. Performance indicators showed that the system achieves a good balance between relatively easy and more challenging tasks and that participants improved significantly over the training sessions. This suggests that the system is well suited to maintain motivation in patients, especially when it is used for a prolonged period of time.
Effect of Structured Touch and Guided Imagery for Pain and Anxiety in Elective Joint Replacement Patients--A Randomized Controlled Trial: M-TIJRP.

PubMed

Forward, John Brent; Greuter, Nancy Elizabeth; Crisall, Santa J; Lester, Houston F

2015-01-01

Postoperative management of pain after total joint arthroplasty remains a challenge despite advancements in analgesics. Evidence shows that complementary modalities with mind-body and tactile-based approaches are valid and effective adjuncts to reduce pain and anxiety postoperatively. To investigate the effectiveness of the "M" Technique (M), a registered method of structured touch using a set sequence and number of strokes, and a consistent level of pressure on hands and feet, compared with guided imagery and usual care, for the reduction of pain and anxiety in patients undergoing elective total knee or hip replacement surgery. Randomized controlled trial: M-TIJRP (MiTechnique and guided Imagery in Joint Replacement Patients [Mighty Junior P]). At a community hospital, 225 male and female patients, aged 38 to 90 years, undergoing elective total hip or knee replacement were randomly assigned to 1 of 3 groups (75 patients in each): M, guided imagery, or usual care. They were blinded to their assignment until the intervention. Reduction of pain and anxiety postoperatively. Secondary outcomes measured use of pain medication and patient satisfaction. This study yielded positive findings for the management of pain and anxiety in patients undergoing elective joint replacement using M and guided imagery for 18 to 20 minutes compared with usual care. M showed the largest predicted decreases in both pain and anxiety between groups. There was no significant difference in narcotic pain medication use between groups. Patient satisfaction survey ratings were highest for M, followed by guided imagery. The benefit of M may be because of the specifically structured sequence of touch by competent caring, trained providers.
Effect of Structured Touch and Guided Imagery for Pain and Anxiety in Elective Joint Replacement Patients—A Randomized Controlled Trial: M-TIJRP

PubMed Central

Forward, John Brent; Greuter, Nancy Elizabeth; Crisall, Santa J; Lester, Houston F

2015-01-01

Context: Postoperative management of pain after total joint arthroplasty remains a challenge despite advancements in analgesics. Evidence shows that complementary modalities with mind-body and tactile-based approaches are valid and effective adjuncts to reduce pain and anxiety postoperatively. Objective: To investigate the effectiveness of the “M” Technique (M), a registered method of structured touch using a set sequence and number of strokes, and a consistent level of pressure on hands and feet, compared with guided imagery and usual care, for the reduction of pain and anxiety in patients undergoing elective total knee or hip replacement surgery. Methods: Randomized controlled trial: M-TIJRP (MiTechnique and guided Imagery in Joint Replacement Patients [Mighty Junior P]). At a community hospital, 225 male and female patients, aged 38 to 90 years, undergoing elective total hip or knee replacement were randomly assigned to 1 of 3 groups (75 patients in each): M, guided imagery, or usual care. They were blinded to their assignment until the intervention. Main Outcome Measures: Reduction of pain and anxiety postoperatively. Secondary outcomes measured use of pain medication and patient satisfaction. Results: This study yielded positive findings for the management of pain and anxiety in patients undergoing elective joint replacement using M and guided imagery for 18 to 20 minutes compared with usual care. M showed the largest predicted decreases in both pain and anxiety between groups. There was no significant difference in narcotic pain medication use between groups. Patient satisfaction survey ratings were highest for M, followed by guided imagery. Conclusion: The benefit of M may be because of the specifically structured sequence of touch by competent caring, trained providers. PMID:26222093
77 FR 37773 - Airworthiness Directives; BAE Systems (Operations) Limited Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... (FAA), Department of Transportation (DOT). ACTION: Final rule. SUMMARY: We are adopting a new... airplanes. This AD was prompted by a report of a crack found on the left-hand sidewall well on the nose... stiffeners on the left-hand sidewall on the NLG bay for cracks, and repair or replace the sidewall if...
Replacing maladaptive speech with verbal labeling responses: an analysis of generalized responding.

PubMed Central

Foxx, R M; Faw, G D; McMorrow, M J; Kyle, M S; Bittle, R G

1988-01-01

We taught three mentally handicapped students to answer questions with verbal labels and evaluated the generalized effects of this training on their maladaptive speech (e.g., echolalia) and correct responding to untrained questions. The students received cues-pause-point training on an initial question set followed by generalization assessments on a different set in another setting. Probes were conducted on novel questions in three other settings to determine the strength and spread of the generalization effect. A multiple baseline across subjects design revealed that maladaptive speech was replaced with correct labels (answers) to questions in the training and all generalization settings. These results replicate and extend previous research that suggested that cues-pause-point procedures may be useful in replacing maladaptive speech patterns by teaching students to use their verbal labeling repertoires. PMID:3225258
The principles, procedures and pitfalls in identifying archaeological and historical wood samples

PubMed Central

Cartwright, Caroline R.

2015-01-01

Background The science of wood anatomy has evolved in recent decades to add archaeological and historical wood to its repertoire of documenting and characterizing modern and fossil woods. The increasing use of online wood anatomy databases and atlases has fostered the adoption of an international consensus regarding terminology, largely through the work of the International Association of Wood Anatomists (IAWA). Scope and Conclusions This review presents an overview for the general reader of the current state of principles and procedures involved in the study of the wood anatomy of archaeological and historical specimens, some of which may be preserved through charring, waterlogging, desiccation or mineral replacement. By means of selected case studies, the review evaluates to what extent varying preservation of wood anatomical characteristics limits the level of identification to taxon. It assesses the role played by increasingly accessible scanning electron microscopes and complex optical microscopes, and whether these, on the one hand, provide exceptional opportunities for high-quality imaging and analysis of difficult samples, but, on the other hand, might be misleading the novice into thinking that advanced technology can be a substitute for specialized botanical training in wood anatomy. PMID:25953039
49 CFR 172.338 - Replacement of identification numbers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 2 2013-10-01 2013-10-01 false Replacement of identification numbers. 172.338..., TRAINING REQUIREMENTS, AND SECURITY PLANS Marking § 172.338 Replacement of identification numbers. If more than one of the identification number markings on placards, orange panels, or white square-on-point...
49 CFR 172.338 - Replacement of identification numbers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Replacement of identification numbers. 172.338..., TRAINING REQUIREMENTS, AND SECURITY PLANS Marking § 172.338 Replacement of identification numbers. If more than one of the identification number markings on placards, orange panels, or white square-on-point...
49 CFR 172.338 - Replacement of identification numbers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Replacement of identification numbers. 172.338..., TRAINING REQUIREMENTS, AND SECURITY PLANS Marking § 172.338 Replacement of identification numbers. If more than one of the identification number markings on placards, orange panels, or white square-on-point...

Effect of specialized task training of each hemisphere on interlimb transfer in individuals with hemiparesis.

PubMed

Yoo, In-gyu; Jung, Min-ye; Yoo, Eun-young; Park, Soo-hyun; Park, Ji-hyuk; Lee, Jin; Kim, Han-sol

2013-01-01

Therapeutic concept of interlimb transfer provides very important information relevant to patients with stroke because it can be applied to help these patients recover movement skills disrupted following unilateral damage to the brain. The purpose of this study was to determine the transfer effects for both specialized training in each hemisphere and reversed training of a specialized task. Twenty patients (ten women and ten men) with stroke and hemiparesis participated. All participants were in Brunnstrom recovery stage five or higher for arm and hand function and had Mini-Mental State Examination scores ≥25. We used a training task involving a modified static cone, modified box and block, and modified pegboard tasks. The specified-training group performed the reaching movements (based on grip, reach, and release movements) in a modified training setting in which left-handed participants began from a single starting location and proceeded to one of three target locations (1S3T condition), and the right-handed participants started form one of three starting locations and proceeded to a single target location (3S1T condition). The unspecified training group performed these movements starting under reverse-start and target conditions. As a result of the left-to-right limb transfer in the specified-training group differed significantly in duration from that in the pre-training group. Also, the biceps brachii and triceps (lateral head) muscles were significantly more active after performing the specified training than before. On the other hand, the activity of the upper trapezius muscle did not significantly differ after specified training compared with before training. Consequently, a symmetric transfer advantage was observed that depended on the characteristic resources of each hemisphere. The transfer of specified training from one arm to the other had a more positive influence on functional recovery than did unspecified training for patients with stroke and hemiparesis.
The Black Cloud Phenomenon in Hand Surgery.

PubMed

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.
Motor learning and cross-limb transfer rely upon distinct neural adaptation processes.

PubMed

Stöckel, Tino; Carroll, Timothy J; Summers, Jeffery J; Hinder, Mark R

2016-08-01

Performance benefits conferred in the untrained limb after unilateral motor practice are termed cross-limb transfer. Although the effect is robust, the neural mechanisms remain incompletely understood. In this study we used noninvasive brain stimulation to reveal that the neural adaptations that mediate motor learning in the trained limb are distinct from those that underlie cross-limb transfer to the opposite limb. Thirty-six participants practiced a ballistic motor task with their right index finger (150 trials), followed by intermittent theta-burst stimulation (iTBS) applied to the trained (contralateral) primary motor cortex (cM1 group), the untrained (ipsilateral) M1 (iM1 group), or the vertex (sham group). After stimulation, another 150 training trials were undertaken. Motor performance and corticospinal excitability were assessed before motor training, pre- and post-iTBS, and after the second training bout. For all groups, training significantly increased performance and excitability of the trained hand, and performance, but not excitability, of the untrained hand, indicating transfer at the level of task performance. The typical facilitatory effect of iTBS on MEPs was reversed for cM1, suggesting homeostatic metaplasticity, and prior performance gains in the trained hand were degraded, suggesting that iTBS interfered with learning. In stark contrast, iM1 iTBS facilitated both performance and excitability for the untrained hand. Importantly, the effects of cM1 and iM1 iTBS on behavior were exclusive to the hand contralateral to stimulation, suggesting that adaptations within the untrained M1 contribute to cross-limb transfer. However, the neural processes that mediate learning in the trained hemisphere vs. transfer in the untrained hemisphere appear distinct. Copyright © 2016 the American Physiological Society.
Motor learning and cross-limb transfer rely upon distinct neural adaptation processes

PubMed Central

Carroll, Timothy J.; Summers, Jeffery J.; Hinder, Mark R.

2016-01-01

Performance benefits conferred in the untrained limb after unilateral motor practice are termed cross-limb transfer. Although the effect is robust, the neural mechanisms remain incompletely understood. In this study we used noninvasive brain stimulation to reveal that the neural adaptations that mediate motor learning in the trained limb are distinct from those that underlie cross-limb transfer to the opposite limb. Thirty-six participants practiced a ballistic motor task with their right index finger (150 trials), followed by intermittent theta-burst stimulation (iTBS) applied to the trained (contralateral) primary motor cortex (cM1 group), the untrained (ipsilateral) M1 (iM1 group), or the vertex (sham group). After stimulation, another 150 training trials were undertaken. Motor performance and corticospinal excitability were assessed before motor training, pre- and post-iTBS, and after the second training bout. For all groups, training significantly increased performance and excitability of the trained hand, and performance, but not excitability, of the untrained hand, indicating transfer at the level of task performance. The typical facilitatory effect of iTBS on MEPs was reversed for cM1, suggesting homeostatic metaplasticity, and prior performance gains in the trained hand were degraded, suggesting that iTBS interfered with learning. In stark contrast, iM1 iTBS facilitated both performance and excitability for the untrained hand. Importantly, the effects of cM1 and iM1 iTBS on behavior were exclusive to the hand contralateral to stimulation, suggesting that adaptations within the untrained M1 contribute to cross-limb transfer. However, the neural processes that mediate learning in the trained hemisphere vs. transfer in the untrained hemisphere appear distinct. PMID:27169508
The Efficacy of an 8-Week Concurrent Strength and Endurance Training Programme on Hand Cycling Performance.

PubMed

Nevin, Jonpaul; Waldron, Mark; Patterson, Stephen; Smith, Paul; Price, Mike; Hunt, Alex

2018-03-20

The aim of the present study was to investigate the effects of an 8-week concurrent strength and endurance training programme in comparison to endurance training only on several key determinants of hand cycling performance. Five H4 and five H3 classified hand cyclists with at least one year's hand cycling training history consented to participate in the study. Subjects underwent a battery of tests to establish body mass, body composition, VO2peak, maximum aerobic power, gross mechanical efficiency, maximal upper body strength, and 30 km time trial performance. Subjects were matched into pairs based upon 30 km time trial performance and randomly allocated to either a concurrent strength and endurance or endurance training only, intervention group. Following an 8-week training programme based upon a conjugated block periodisation model, subjects completed a second battery of tests. A mixed model, 2-way analysis of variance (ANOVA) revealed no significant changes between groups. However, the calculation of effect sizes (ES) revealed that both groups demonstrated a positive improvement in most physiological and performance measures with subjects in the concurrent group demonstrating a greater magnitude of improvement in body composition (ES -0.80 vs. -0.22) maximal aerobic power (ES 0.97 vs. 0.28), gross mechanical efficiency (ES 0.87 vs. 0.63), bench press 1 repetition maximum (ES 0.53 vs. 0.33), seated row 1 repetition maximum (ES 1.42 vs. 0.43), and 30 km time trial performance (ES -0.66 vs. -0.30). In comparison to endurance training only, an 8-week concurrent training intervention based upon a conjugated block periodisation model appears to be a more effective training regime for improving the performance capabilities of hand cyclists.
Neonatal Seizure Detection Using Deep Convolutional Neural Networks.

PubMed

Ansari, Amir H; Cherian, Perumpillichira J; Caicedo, Alexander; Naulaers, Gunnar; De Vos, Maarten; Van Huffel, Sabine

2018-04-02

Identifying a core set of features is one of the most important steps in the development of an automated seizure detector. In most of the published studies describing features and seizure classifiers, the features were hand-engineered, which may not be optimal. The main goal of the present paper is using deep convolutional neural networks (CNNs) and random forest to automatically optimize feature selection and classification. The input of the proposed classifier is raw multi-channel EEG and the output is the class label: seizure/nonseizure. By training this network, the required features are optimized, while fitting a nonlinear classifier on the features. After training the network with EEG recordings of 26 neonates, five end layers performing the classification were replaced with a random forest classifier in order to improve the performance. This resulted in a false alarm rate of 0.9 per hour and seizure detection rate of 77% using a test set of EEG recordings of 22 neonates that also included dubious seizures. The newly proposed CNN classifier outperformed three data-driven feature-based approaches and performed similar to a previously developed heuristic method.
Analyzing qualitative data with computer software.

PubMed Central

Weitzman, E A

1999-01-01

OBJECTIVE: To provide health services researchers with an overview of the qualitative data analysis process and the role of software within it; to provide a principled approach to choosing among software packages to support qualitative data analysis; to alert researchers to the potential benefits and limitations of such software; and to provide an overview of the developments to be expected in the field in the near future. DATA SOURCES, STUDY DESIGN, METHODS: This article does not include reports of empirical research. CONCLUSIONS: Software for qualitative data analysis can benefit the researcher in terms of speed, consistency, rigor, and access to analytic methods not available by hand. Software, however, is not a replacement for methodological training. PMID:10591282
Cross-education of wrist extensor strength is not influenced by non-dominant training in right-handers.

PubMed

Coombs, Timothy A; Frazer, Ashlyn K; Horvath, Deanna M; Pearce, Alan J; Howatson, Glyn; Kidgell, Dawson J

2016-09-01

Cross-education of strength has been proposed to be greater when completed by the dominant limb in right handed humans. We investigated whether the direction of cross-education of strength and corticospinal plasticity are different following right or left limb strength training in right-handed participants. Changes in strength, muscle thickness and indices of corticospinal plasticity were analyzed in 23 adults who were exposed to 3-weeks of either right-hand strength training (RHT) or left-hand strength training (LHT). Maximum voluntary wrist extensor strength in both the trained and untrained limb increased, irrespective of which limb was trained, with TMS revealing reduced corticospinal inhibition. Cross-education of strength was not limited by which limb was trained and reduced corticospinal inhibition was not just confined to the trained limb. Critically, from a behavioral perspective, the magnitude of cross-education was not limited by which limb was trained.
Sequencing bilateral and unilateral task-oriented training versus task oriented training alone to improve arm function in individuals with chronic stroke.

PubMed

McCombe Waller, Sandy; Whitall, Jill; Jenkins, Toye; Magder, Laurence S; Hanley, Daniel F; Goldberg, Andrew; Luft, Andreas R

2014-12-14

Recovering useful hand function after stroke is a major scientific challenge for patients with limited motor recovery. We hypothesized that sequential training beginning with proximal bilateral followed by unilateral task oriented training is superior to time-matched unilateral training alone. Proximal bilateral training could optimally prepare the motor system to respond to the more challenging task-oriented training. Twenty-six participants with moderate severity hemiparesis Intervention: PARTICIPANTS received either 6-weeks of bilateral proximal training followed sequentially by 6-weeks unilateral task-oriented training (COMBO) or 12-weeks of unilateral task-oriented training alone (SAEBO). A subset of 8 COMB0 and 9 SAEBO participants underwent three functional magnetic resonance imaging (fMRI) scans of hand and elbow movement every 6 weeks. Fugl-Meyer Upper extremity scale, Modified Wolf Motor Function Test, University of Maryland Arm Questionnaire for Stroke, Motor cortex activation (fMRI). The COMBO group demonstrated significantly greater gains between baseline and 12-weeks over all outcome measures (p = .018 based on a MANOVA test) and specifically in the Modified Wolf Motor Function test (time). Both groups demonstrated within-group gains on the Fugl-Meyer Upper Extremity test (impairment) and University of Maryland Arm Questionnaire for Stroke (functional use). fMRI subset analyses showed motor cortex (primary and premotor) activation during hand movement was significantly increased by sequential combination training but not by task-oriented training alone. Sequentially combining a proximal bilateral before a unilateral task-oriented training may be an effective way to facilitate gains in arm and hand function in those with moderate to severe paresis post-stroke compared to unilateral task oriented training alone.
Task-Oriented Training with Computer Games for People with Rheumatoid Arthritis or Hand Osteoarthritis: A Feasibility Randomized Controlled Trial.

PubMed

Srikesavan, Cynthia Swarnalatha; Shay, Barbara; Szturm, Tony

2016-09-13

To examine the feasibility of a clinical trial on a novel, home-based task-oriented training with conventional hand exercises in people with rheumatoid arthritis or hand osteoarthritis. To explore the experiences of participants who completed their respective home exercise programmes. Thirty volunteer participants aged between 30 and 60 years and diagnosed with rheumatoid arthritis or hand osteoarthritis were proposed for a single-center, assessor-blinded, randomized controlled trial ( ClinicalTrials.gov : NCT01635582). Participants received task-oriented training with interactive computer games and objects of daily life or finger mobility and strengthening exercises. Both programmes were home based and were done four sessions per week with 20 minutes each session for 6 weeks. Major feasibility outcomes were number of volunteers screened, randomized, and retained; completion of blinded assessments, exercise training, and home exercise sessions; equipment and data management; and clinical outcomes of hand function. Reaching the recruitment target in 18 months and achieving exercise compliance >80% were set as success criteria. Concurrent with the trial, focus group interviews explored experiences of those participants who completed their respective programmes. After trial initiation, revisions in inclusion criteria were required to promote recruitment. A total of 17 participants were randomized and 15 were retained. Completion of assessments, exercise training, and home exercise sessions; equipment and data collection and management demonstrated excellent feasibility. Both groups improved in hand function outcomes and exercise compliance was above 85%. Participants perceived both programmes as appropriate and acceptable. Participants who completed task-oriented training also agreed that playing different computer games was enjoyable, engaging, and motivating. Findings demonstrate initial evidence on recruitment, feasibility of trial procedures, and acceptability of task-oriented training in people with rheumatoid arthritis or hand osteoarthritis. Since the pilot trial was unsuccessful in participant recruitment, a large trial will not follow.
Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

PubMed

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.
High Performance EVA Glove Collaboration: Glove Injury Data Mining Effort

NASA Technical Reports Server (NTRS)

Reid, C. R.; Benosn, E.; England, S.; Norcross, J. R.; McFarland, S. M.; Rajulu, S.

2014-01-01

Human hands play a significant role during extravehicular activity (EVA) missions and Neutral Buoyancy Lab (NBL) training events, as they are needed for translating and performing tasks in the weightless environment. It is because of this high frequency usage that hand- and arm-related injuries and discomfort are known to occur during training in the NBL and while conducting EVAs. Hand-related injuries and discomforts have been occurring to crewmembers since the days of Apollo. While there have been numerous engineering changes to the glove design, hand-related issues still persist. The primary objectives of this study are therefore to: 1) document all known EVA glove-related injuries and the circumstances of these incidents, 2) determine likely risk factors, and 3) recommend ergonomic mitigations or design strategies that can be implemented in the current and future glove designs. METHODS: The investigator team conducted an initial set of literature reviews, data mining of Lifetime Surveillance of Astronaut Health (LSAH) databases, and data distribution analyses to understand the ergonomic issues related to glove-related injuries and discomforts. The investigation focused on the injuries and discomforts of U.S. crewmembers who had worn pressurized suits and experienced glove-related incidents during the 1980 to 2010 time frame, either during training or on-orbit EVA. In addition to data mining of the LSAH database, the other objective of the study was to find complimentary sources of information such as training experience, EVA experience, suit-related sizing data, and hand-arm anthropometric data to be tied to the injury data from LSAH. RESULTS: Past studies indicated that the hand was the most frequently injured part of the body during both EVA and NBL training. This study effort thus focused primarily on crew training data in the NBL between 2002 and 2010. Of the 87 recorded training incidents, 19 occurred to women and 68 to men. While crew ages ranged from thirties to fifties, the age category most affected was in the forties range. Incident rate calculations (incidents per 100 training runs) revealed that the 2002, 2003, and 2004 time periods registered the highest reported incident rate levels (3.4, 6.1, and 4.1 respectively) when compared to the following years (all = 1.0). In addition to general hand-arm discomfort being the highest reported result from training, specific types of hand injuries or symptoms included erythema, fingernail delamination, abrasions, muscle soreness/fatigue, paresthesia, bruising, blanching, and edema. Specific body locations most affected by hand injuries included the metacarpophalangeal joints, fingernails, finger crotches, fingers in general, interphalangeal joints, and fingertips. Causes of injuries reported in the LSAH data were primarily attributed to the forces that the gloved hands were exposed to due to hand intensive tasks and/or poor glove sizing. DISCUSSION: Although the age data indicate that most injuries are reported by male crewmembers in their forties, that is also the dominant gender and age range of most EVA crew therefore it is not an unexpected finding. Age and gender analysis will continue as more details on the uninjured population is accrued. While there is a reasonable mechanism to link training quantity to injury, the results were inconsistent and point to the need for a consistent method of suit-related injury screening and documentation. For instance, the high-incident rate levels for the years 2002 to 2004 could be attributed to a comprehensive medical review of crewmembers post-NBL EVA training that occurred from July 19, 2002 to January 16, 2004. Furthermore, there could have been increased awareness from an investigation at the NBL. These investigations may have temporarily increased the fidelity of reported injuries and discomforts during these dates as compared to surrounding years, when injury signs and symptom were no longer actively being investigated but rather voluntarily reported. Data mining for possible mechanistic factors continues and includes more detailed training timelines, hand anthropometry, and suit sizing information. The limited published data looking at hand-arm anthropometry correlated hand-anthropometry metrics with injuries stemming from glove design and operation. Future work will include further evaluation of body sizing and fit in relation to hand injury incidents.
Hand Rehabilitation Robotics on Poststroke Motor Recovery

PubMed Central

2017-01-01

The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics. PMID:29230081
77 FR 15636 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... proposed rulemaking (NPRM). SUMMARY: We propose to adopt a new airworthiness directive (AD) for all Airbus... cables on the left- and right- hand sides to determine whether a certain part number is installed, and replacement if necessary. We are proposing this AD to prevent non- availability of left- or right-hand off...
Towards an open, collaborative, reusable framework for sharing hands-on bioinformatics training workshops

PubMed Central

Revote, Jerico; Suchecki, Radosław; Tyagi, Sonika; Corley, Susan M.; Shang, Catherine A.; McGrath, Annette

2017-01-01

Abstract There is a clear demand for hands-on bioinformatics training. The development of bioinformatics workshop content is both time-consuming and expensive. Therefore, enabling trainers to develop bioinformatics workshops in a way that facilitates reuse is becoming increasingly important. The most widespread practice for sharing workshop content is through making PDF, PowerPoint and Word documents available online. While this effort is to be commended, such content is usually not so easy to reuse or repurpose and does not capture all the information required for a third party to rerun a workshop. We present an open, collaborative framework for developing and maintaining, reusable and shareable hands-on training workshop content. PMID:26984618
Improving motor performance without training: the effect of combining mirror visual feedback with transcranial direct current stimulation.

PubMed

von Rein, Erik; Hoff, Maike; Kaminski, Elisabeth; Sehm, Bernhard; Steele, Christopher J; Villringer, Arno; Ragert, Patrick

2015-04-01

Mirror visual feedback (MVF) during motor training has been shown to improve motor performance of the untrained hand. Here we thought to determine if MVF-induced performance improvements of the left hand can be augmented by upregulating plasticity in right primary motor cortex (M1) by means of anodal transcranial direct current stimulation (a-tDCS) while subjects trained with the right hand. Participants performed a ball-rotation task with either their left (untrained) or right (trained) hand on two consecutive days (days 1 and 2). During training with the right hand, MVF was provided concurrent with two tDCS conditions: group 1 received a-tDCS over right M1 (n = 10), whereas group 2 received sham tDCS (s-tDCS, n = 10). On day 2, performance was reevaluated under the same experimental conditions compared with day 1 but without tDCS. While baseline performance of the left hand (day 1) was not different between groups, a-tDCS exhibited stronger MVF-induced performance improvements compared with s-tDCS. Similar results were observed for day 2 (without tDCS application). A control experiment (n = 8) with a-tDCS over right M1 as outlined above but without MVF revealed that left hand improvement was significantly less pronounced than that induced by combined a-tDCS and MVF. Based on these results, we provide novel evidence that upregulating activity in the untrained M1 by means of a-tDCS is capable of augmenting MVF-induced performance improvements in young normal volunteers. Our findings suggest that concurrent MVF and tDCS might have synergistic and additive effects on motor performance of the untrained hand, a result of relevance for clinical approaches in neurorehabilitation and/or exercise science. Copyright © 2015 the American Physiological Society.
Effectiveness of a training programme to improve hand hygiene compliance in primary healthcare

PubMed Central

2009-01-01

Background Hand hygiene is the most effective measure for preventing infections related to healthcare, and its impact on the reduction of these infections is estimated at 50%. Non-compliance has been highlighted in several studies in hospitals, although none have been carried out in primary healthcare. Main objective To evaluated the effect of a "Hand Hygiene for the reduction of healthcare-associated infections" training program for primary healthcare workers, measured by variation from correct hand hygiene compliance, according to regulatory and specific criteria, 6 months after the baseline, in the intervention group (group receiving a training program) and in the control group (a usual clinical practice). Secondary objectives -To describe knowledges, attitudes and behaviors as regards hand hygiene among the professionals, and their possible association with "professional burnout", stratifying the results by type of group (intervention and usual clinical practice). -To estimate the logistic regression model that best explains hand hygiene compliance. Methods/Design Experimental study of parallel groups, with a control group, and random assignment by Health Center. Area of study.- Health centers in north-eastern Madrid (Spain). Sample studied.- Healthcare workers (physicians, odontostomatologists, pediatricians, nurses, dental hygienists, midwife and nursing auxiliaries). Intervention.- A hand hygiene training program, including a theoretical-practical workshop, provision of alcohol-based solutions and a reminder strategy in the workplace. Other variables: sociodemographic and professional knowledges, attitudes, and behaviors with regard to hand hygiene. Statistical Analysis: descriptive and inferential, using multivariate methods (covariance analysis and logistic regression). Discussion This study will provide valuable information on the prevalence of hand hygiene non-compliance, and improve healthcare. PMID:20015368
Wrist-worn accelerometers in assessment of energy expenditure during intensive training.

PubMed

Kinnunen, H; Tanskanen, M; Kyröläinen, H; Westerterp, K R

2012-11-01

We assessed the ability of the Polar activity recorder (AR) to measure energy expenditure (EE) during military training. Twenty-four voluntary male conscripts participated in the study and wore an AR on the non-dominant wrist 24 h a day for 7 d. The AR analyzed and stored the frequency of hand movements (f_hand) into memory at 1 min intervals. The relationship between f_hand and EE was studied over a 7 d period of military training using the doubly labeled water (DLW) technique. In addition, the relationship between f_hand and EE was analyzed during walking and running on a treadmill with an indirect calorimeter (IC), and f_hand was measured during a supervised 45 min field march test where the conscripts carried combat gear. EE was expressed as physical activity level (PAL), total energy expenditure (TEE), and activity-induced energy expenditure adjusted for body mass (AEE/BM). Over the 7 d period, f_hand alone explained 46% of inter-individual variation in PAL(DLW). After inclusion of body height and mass in the model used to predict PAL(DLW) from f_hand, a very high positive correlation and a low standard error of estimate (SEE) were observed between the AR and DLW techniques: for TEE r = 0.86 (p < 0.001), the SEE was 6.3%, and for AEE/BM r = 0.84 (p < 0.001), the SEE was 12.8%. In the treadmill exercise, f_hand correlated highly with PAL(IC) (r = 0.97 ± 0.02). In the 45 min field march test, the AR measured similar f_hand as on the treadmill at the same speed. In conclusion, the wrist-worn AR can be regarded as a reliable and valid method for assessing EE during intensive training.
Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design

PubMed Central

Timmermans, Annick AA; Seelen, Henk AM; Willmann, Richard D; Kingma, Herman

2009-01-01

Background It is the purpose of this article to identify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning. Methods A literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE (1997–2007). Results One hundred and eighty seven scientific papers/book references were identified as being relevant. Rehabilitation approaches for upper limb training after stroke show to have shifted in the last decade from being analytical towards being focussed on environmentally contextual skill training (task-oriented training). Training programmes for enhancing motor skills use patient and goal-tailored exercise schedules and individual feedback on exercise performance. Therapist criteria for upper limb rehabilitation technology are suggested which are used to evaluate the strengths and weaknesses of a number of current technological systems. Conclusion This review shows that technology for supporting upper limb training after stroke needs to align with the evolution in rehabilitation training approaches of the last decade. A major challenge for related technological developments is to provide engaging patient-tailored task oriented arm-hand training in natural environments with patient-tailored feedback to support (re) learning of motor skills. PMID:19154570
Physical Therapy--Hands-on Education, Hands-on Healing

ERIC Educational Resources Information Center

Reese, Susan

2004-01-01

Physical therapists and physical therapist assistants are working to improve the quality of life for those with health problems--and career and technical education is working to improve the quality of their training. Training to become a physical therapist requires both an academic and a clinical education with courses in psychology, biology,…

78 FR 71615 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

...TM Program (Hands-on, Online, Blended models). Trainee Reaction Survey-- 180 1 15/60 Hands-On Model. Trainee Reaction Survey-- 180 1 15/60 Online Model. Trainee Reaction Survey-- 180 1 15/60 Blended Model... Program (Train-the- Participant Survey. Trainer model). Trainee Reaction Survey-- 30 1 15/60 Train-the...
A Qualitative Investigation of the Attitudes and Self-Perceptions of Music Theory Faculty Not Trained in Teaching Pedagogy on Their Classroom Effectiveness

ERIC Educational Resources Information Center

Shanefield, Andrew

2011-01-01

Historically, college teachers have received little to no training in teaching and course design (Weimer, 1990), as content mastery was, and still is, a primary credential for employment consideration. Moreover, traditional teacher training programs have been the focus of the K-12 domain, where pedagogy and content go hand in hand (National…
Teaching Skills to Use a Computer Mouse in Preschoolers with Developmental Disabilities: Shaping Moving a Mouse and Eye-Hand Coordination

ERIC Educational Resources Information Center

Shimizu, Hirofumi; Yoon, Soyoung; McDonough, Christopher S.

2010-01-01

We taught seven preschoolers with developmental disabilities to point-and-click with a computer mouse. The computer-based training program consisted of three parts, based on a task analysis of the behavioral prerequisites to point-and-click. Training 1 was designed to shape moving the mouse. Training 2 was designed to build eye-hand coordination…
Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Task-Oriented Mirror Therapy Training on Hand Rehabilitation of Acute Stroke Patients.

PubMed

Kim, Jinhong; Yim, Jongeun

2018-02-06

BACKGROUND Impairments of hand function make it difficult to perform daily life activities and to return to work. The aim of this study was to investigate the effect of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) combined with task-oriented mirror therapy (TOMT) on hand rehabilitation in acute stroke patients. MATERIAL AND METHODS Twenty subacute stroke patients in the initial stages (<3 months) participated in the study. Subjects were allocated to 2 groups: the experimental group received HF-rTMS + TOMT and the control group received HF-rTMS. TOMT training was conducted in 10 sessions over 2 weeks for 30 min. rTMS was applied at a 20 Hz frequency over the hand motor area in the cortex of the affected hemisphere for 15 min. Outcomes, including motor-evoked potential (MEP), pinch grip, hand grip, and box and block test, were measured before and after training. RESULTS Significant improvements in the MEP and hand function variables were observed in both groups (p<0.05). In particular, hand functions (pinch grip and box and block test) were significantly different between the 2 groups (p<0.05). CONCLUSIONS HF-rTMS combined with TOMT had a positive effect on hand function and can be used for the rehabilitation of precise hand movements in acute stroke patients.
Retrospective Perceptions and Views of Engineering Students about Physics and Engineering Practicals

ERIC Educational Resources Information Center

Bhathal, R.

2011-01-01

Hands-on practical work in physics and engineering has a long and well-established tradition in Australian universities. Recently, however, the question of whether hands-on physics and engineering practicals are useful for engineering students and whether they could be deleted or whether these could be replaced with computer simulations has been…
Development of a minimum performance standard for hand-held fire extinguishers as a replacement for Halon 1211 on civilian transport category aircraft

DOT National Transportation Integrated Search

2002-08-01

One or more Halon 1211 hand-held fire extinguishers are specified in Federal Aviation Regulation (FAR) Part 25.851 as a requirement on transport category aircraft with 31 or more seats. Halon 1211 has been linked to the destruction of the ozone layer...
Integrated versus isolated training of the hemiparetic upper extremity in haptically rendered virtual environments.

PubMed

Qiu, Qinyin; Fluet, Gerard G; Saleh, Soha; Lafond, Ian; Merians, Alma S; Adamovich, Sergei V

2010-01-01

This paper describes the preliminary results of an ongoing study of the effects of two training approaches on motor function and learning in persons with hemi paresis due to cerebrovascular accidents. Eighteen subjects with chronic stroke performed eight, three-hour sessions of sensorimotor training in haptically renedered environments. Eleven subjects performed training activities that integrated hand and arm movement while another seven subjects performed activities that trained the hand and arm with separately. As a whole, the eighteen subjects made statistically significant improvements in motor function as evidenced by robust improvements in Wolf Motor Function Test times and corresponding improvements in Jebsen Test of Hand Function times. There were no significant between group effects for these tests. However, the two training approaches elicited different patterns and magnitudes of performance improvement that suggest that they may elicit different types of change in motor learning and or control.
A national survey of program director opinions of core competencies and structure of hand surgery fellowship training.

PubMed

Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

2012-10-01

We assessed hand surgery program directors' opinions of essential components of hand surgery training and potential changes in the structure of hand surgery programs. We recruited all 74 program directors of Accreditation Council of Graduate Medical Education-accredited hand surgery fellowship programs to participate. We designed a web-based survey to assess program directors' support for changes in the structure of training programs and to assess opinions of components that are essential for graduates to be proficient. Respondents were asked to rate 9 general areas of practice, 97 knowledge topics, and 172 procedures. Each component was considered essential if 50% or more of respondents thought that graduates must be fully knowledgeable of the topic and be able to perform the procedure at the end of training. The response rate was 84% (n = 62). A minority of program directors (n = 15; 24%) supported creation of additional pathways for hand surgery training, and nearly three-quarters (n = 46; 74%) preferred a fellowship model to an integrated residency model. Most program directors (n = 40; 65%) thought that a 1-year fellowship was sufficient to train a competent hand surgeon. Wrist, distal radius/ulna, forearm, and peripheral nerve conditions were rated as essential areas of practice. Of the detailed components, 76 of 97 knowledge topics and 98 of 172 procedures were rated as essential. Only 48% respondents (n = 30) rated microsurgery as it relates to free tissue transfer as essential. However, small and large vessel laceration repairs were rated as essential by 92% (n = 57) and 77% (n = 48) of respondents, respectively. This study found resistance to prolonging the length of fellowship training and introduction of an integrated residency pathway. To train all hand surgeons in essential components of hand surgery, programs must individually evaluate exposure provided and find innovative ways to augment training when necessary. Studies of curriculum content in hand surgery affect the future scope of hand surgery practice and highlight areas in need of reform and enhancement. Copyright © 2012. Published by Elsevier Inc.
Workers with hand dermatitis and workplace training experiences: A qualitative perspective.

PubMed

Zack, Bethany; Arrandale, Victoria H; Holness, Dorothy Linn

2017-01-01

Workplace training may help to prevent contact dermatitis, a common work-related disease. Information on the characteristics of existing workplace training programs and worker perceptions of this training is limited. Fourteen workers with suspected occupational contact dermatitis participated in one-on-one, semi-structured interviews. An inductive thematic analysis approach was used to identify interview themes. Workers expressed a desire for hands-on training with content relevant to their job tasks, favored training from supervisors who had practical experience, and were conflicted about employer motivations for providing training. Few workers had received training on skin protection. In many cases, the training workers had received differed greatly from their desired training. Although, workers with contact dermatitis describe having received workplace training, some question its value and effectiveness. This perspective may be attributed not only to the content and methods of training but also the health and safety culture of the workplace. Am. J. Ind. Med. 60:69-76, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Preparation and Design for a Training Effectiveness Evaluation of Device 2F64C for Replacement Pilot Training.

ERIC Educational Resources Information Center

Browning, Robert F.; And Others

This report details the setting up of a program to assess the training potential of a new simulator (Device 2F64C) for training SH-3 replacement helicopter pilots. Section 2 describes the training situation at the fleet readiness squadron prior to and during the transition to a new curriculum that resulted from an instructional system development…
Transfer of motor skill learning from the healthy hand to the paretic hand in stroke patients: a randomized controlled trial.

PubMed

Ausenda, C; Carnovali, M

2011-09-01

Bilateral transfer of a motor skill is a phenomenon based on the observation that the performance of a skill with one hand can "teach" the same skill to the other hand. In this study the ability of bilateral transfer to facilitate the motor skill of the paretic hand in patients that suffered a stroke was tested. In a randomized controlled trial subjects were randomly assigned to either the test group or the control group. The experiment was performed in a general hospital rehabilitation facility for inpatients and outpatients. We studied 20 outpatients, who had their first stroke episode characterized by a brain lesion to a single hemisphere, at the end of their rehabilitation treatment. The criteria used for the selection were based on a physical examination, the time elapsed from the stroke and cognitive requirements. The experiment consisted in training the healthy hand of each patient from the test group to execute the nine hole peg test 10 times a day, for three consecutive days, and then test the paretic hand with the same test and with bimanual tasks. The control group was not trained but went through the same analysis. The homogeneity of the two groups has been proven. In the test group we found that the execution speed of the nine hole peg test with the paretic hand, after training the healthy hand, was on average 22.6% faster than the value recorded at baseline. The training had a positive effect on the execution of bimanual tasks. Meanwhile, no significant difference was found in the control group. This is the first evidence that bilateral transfer of motor skills is present in patients that suffered a stroke, and that it improves the ability of the affected hand. This observation could open the way to the development of a new approach for the rehabilitation of stroke patients.
Optimizing pattern recognition-based control for partial-hand prosthesis application.

PubMed

Earley, Eric J; Adewuyi, Adenike A; Hargrove, Levi J

2014-01-01

Partial-hand amputees often retain good residual wrist motion, which is essential for functional activities involving use of the hand. Thus, a crucial design criterion for a myoelectric, partial-hand prosthesis control scheme is that it allows the user to retain residual wrist motion. Pattern recognition (PR) of electromyographic (EMG) signals is a well-studied method of controlling myoelectric prostheses. However, wrist motion degrades a PR system's ability to correctly predict hand-grasp patterns. We studied the effects of (1) window length and number of hand-grasps, (2) static and dynamic wrist motion, and (3) EMG muscle source on the ability of a PR-based control scheme to classify functional hand-grasp patterns. Our results show that training PR classifiers with both extrinsic and intrinsic muscle EMG yields a lower error rate than training with either group by itself (p<0.001); and that training in only variable wrist positions, with only dynamic wrist movements, or with both variable wrist positions and movements results in lower error rates than training in only the neutral wrist position (p<0.001). Finally, our results show that both an increase in window length and a decrease in the number of grasps available to the classifier significantly decrease classification error (p<0.001). These results remained consistent whether the classifier selected or maintained a hand-grasp.
Hand washing compliance among retail food establishment workers in Minnesota.

PubMed

Allwood, Paul B; Jenkins, Timothy; Paulus, Colleen; Johnson, Lars; Hedberg, Craig W

2004-12-01

Inadequate hand washing by food workers is an important contributing factor to foodborne disease outbreaks in retail food establishments (RFEs). We conducted a survey of RFEs to investigate the effect of hand washing training, availability of hand washing facilities, and the ability of the person in charge (PIC) to describe hand washing according to the Minnesota Food Code (food code) on workers' ability to demonstrate food code-compliant hand washing. Only 52% of the PICs could describe the hand washing procedure outlined in the food code, and only 48% of workers could demonstrate code-compliant hand washing. The most common problems observed were failure to wash for 20 s and failure to use a fingernail brush. There was a strong positive association between the PIC being a certified food manager and being able to describe the food code hand washing procedure (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.2 to 13.7), and there was an even stronger association between the PIC being able to describe hand washing and workers being able to demonstrate code-compliant hand washing (OR, 15; 95% CI, 6 to 37). Significant associations were detected among correct hand washing demonstration, physical infrastructure for hand washing, and the hand washing training methods used by the establishment. However, the principal determinant of successful hand washing demonstration was the PIC's ability to describe proper hand washing procedure. These results suggest that improving hand washing practices among food workers will require interventions that address PIC knowledge of hand washing requirement and procedure and the development and implementation of effective hand washing training methods.
Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial

PubMed Central

2013-01-01

Background Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. Methods/Design The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann–Whitney U test. Discussion The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand. Trial registration ClinicalTrials.gov: NCT01635582 PMID:23497529
Intermanual transfer and bilateral cortical plasticity is maintained in older adults after skilled motor training with simple and complex tasks

PubMed Central

Dickins, Daina S. E.; Sale, Martin V.; Kamke, Marc R.

2015-01-01

Intermanual transfer refers to the phenomenon whereby unilateral motor training induces performance gains in both the trained limb and in the opposite, untrained limb. Evidence indicates that intermanual transfer is attenuated in older adults following training on a simple ballistic movement task, but not after training on a complex task. This study investigated whether differences in plasticity in bilateral motor cortices underlie these differential intermanual transfer effects in older adults. Twenty young (<35 years-old) and older adults (>65 years) trained on a simple (repeated ballistic thumb abduction) and complex (sequential finger-thumb opposition) task in separate sessions. Behavioral performance was used to quantify intermanual transfer between the dominant (trained) and non-dominant (untrained) hands. The amplitude of motor-evoked potentials induced by single pulse transcranial magnetic stimulation was used to investigate excitability changes in bilateral motor cortices. Contrary to predictions, both age groups exhibited performance improvements in both hands after unilateral skilled motor training with simple and complex tasks. These performance gains were accompanied by bilateral increases in cortical excitability in both groups for the simple but not the complex task. The findings suggest that advancing age does not necessarily influence the capacity for intermanual transfer after training with the dominant hand. PMID:25999856
Computer-aided training sensorimotor cortex functions in humans before the upper limb transplantation using virtual reality and sensory feedback.

PubMed

Kurzynski, Marek; Jaskolska, Anna; Marusiak, Jaroslaw; Wolczowski, Andrzej; Bierut, Przemyslaw; Szumowski, Lukasz; Witkowski, Jerzy; Kisiel-Sajewicz, Katarzyna

2017-08-01

One of the biggest problems of upper limb transplantation is lack of certainty as to whether a patient will be able to control voluntary movements of transplanted hands. Based on findings of the recent research on brain cortex plasticity, a premise can be drawn that mental training supported with visual and sensory feedback can cause structural and functional reorganization of the sensorimotor cortex, which leads to recovery of function associated with the control of movements performed by the upper limbs. In this study, authors - based on the above observations - propose the computer-aided training (CAT) system, which generating visual and sensory stimuli, should enhance the effectiveness of mental training applied to humans before upper limb transplantation. The basis for the concept of computer-aided training system is a virtual hand whose reaching and grasping movements the trained patient can observe on the VR headset screen (visual feedback) and whose contact with virtual objects the patient can feel as a touch (sensory feedback). The computer training system is composed of three main components: (1) the system generating 3D virtual world in which the patient sees the virtual limb from the perspective as if it were his/her own hand; (2) sensory feedback transforming information about the interaction of the virtual hand with the grasped object into mechanical vibration; (3) the therapist's panel for controlling the training course. Results of the case study demonstrate that mental training supported with visual and sensory stimuli generated by the computer system leads to a beneficial change of the brain activity related to motor control of the reaching in the patient with bilateral upper limb congenital transverse deficiency. Copyright © 2017 Elsevier Ltd. All rights reserved.
The Effect of the Duration of Basic Life Support Training on the Learners' Cardiopulmonary and Automated External Defibrillator Skills

PubMed Central

Kang, Ku Hyun; Song, Keun Jeong; Lee, Chang Hee

2016-01-01

Background. Basic life support (BLS) training with hands-on practice can improve performance during simulated cardiac arrest, although the optimal duration for BLS training is unknown. This study aimed to assess the effectiveness of various BLS training durations for acquiring cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skills. Methods. We randomised 485 South Korean nonmedical college students into four levels of BLS training: level 1 (40 min), level 2 (80 min), level 3 (120 min), and level 4 (180 min). Before and after each level, the participants completed questionnaires regarding their willingness to perform CPR and use AEDs, and their psychomotor skills for CPR and AED use were assessed using a manikin with Skill-Reporter™ software. Results. There were no significant differences between levels 1 and 2, although levels 3 and 4 exhibited significant differences in the proportion of overall adequate chest compressions (p < 0.001) and average chest compression depth (p = 0.003). All levels exhibited a greater posttest willingness to perform CPR and use AEDs (all, p < 0.001). Conclusions. Brief BLS training provided a moderate level of skill for performing CPR and using AEDs. However, high-quality skills for CPR required longer and hands-on training, particularly hands-on training with AEDs. PMID:27529066
Monitoring Technology: The Qualimetric Foundations of the Educational Process of the University

ERIC Educational Resources Information Center

Krokhina, Julia A.; Aleksandrova, Natalia S.; Buldakova, Natalya V.; Ashrafullina, Gulnaz S.; Shinkaruk, Vladimir M.

2016-01-01

The relevance of the research problem is determined by the current discrepancy between the requirements of society to quality of students' training--future specialists with higher education, on the one hand, and level of training received by graduates on the other hand. The tendency of the discrepancies noted is a consequence of the properties of…
Maternal Knowledge and Behaviors regarding Discipline: The Effectiveness of a Hands-On Education Program in Positive Guidance

ERIC Educational Resources Information Center

Saunders, Rachel; McFarland-Piazza, Laura; Jacobvitz, Deborah; Hazen-Swann, Nancy; Burton, Rosalinda

2013-01-01

This study examined which method is most effective in supporting parents to use positive guidance techniques, a lecture-based only parent training series or a lecture-based plus hands-on parent training series. Maternal characteristics of depression, stress level, and attitudes towards positive guidance were explored as possible moderators. In…
Views on the Oberg-Manske-Tonkin Classification System for Congenital Anomalies of the Hand and Upper Limb.

PubMed

Lowry, R Brian; Bedard, Tanya; Kiefer, Gerhard N; Sass, Kimberly R

2017-05-01

A new classification system was proposed by Tonkin et al as a replacement for the Swanson/International Federation of Societies for Surgery of the Hand system. We have reviewed their aims and have pointed out a number of problems that will make it difficult to be universally accepted. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Sustained effect of resistance training on blood pressure and hand grip strength following a detraining period in elderly hypertensive women: a pilot study

PubMed Central

Nascimento, Dahan da Cunha; Tibana, Ramires Alsamir; Benik, Franklin M; Fontana, Keila Elizabeth; Neto, Frederico Ribeiro; de Santana, Frederico Santos; Santos-Neto, Leopoldo; Silva, Renato André Sousa; Silva, Alessandro Oliveira; Farias, Darlan Lopes; Balsamo, Sandor; Prestes, Jonato

2014-01-01

Introduction Hypertension is the most prevalent modifiable risk factor with a high prevalence among older adults. Exercise is a nonpharmacological treatment shown to benefit all patients with hypertension. Objective This study examined the effects of a 14-week moderate intensity resistance training program (RT) on the maintenance of blood pressure and hand grip strength during an extended detraining period in elderly hypertensive women. Methods Twelve hypertensive sedentary elderly women completed 14 weeks of whole body RT at a moderate perceived exertion following a detraining period of 14 weeks. Results Following the training period, participants demonstrated an increase in absolute hand grip strength (P=0.001), relative hand grip strength (P=0.032) and a decrease of systolic (P=0.001), diastolic (P=0.008), and mean blood pressure (P=0.002) when compared to pre-exercise values. In addition, these effects were sustained after 14 weeks of detraining. Conclusion Resistance training may be a valuable method to improve muscular strength and blood pressure in elderly people with benefits being maintained up to 14 weeks following training cessation. PMID:24477221
Analysis of Potential Glove-Induced Hand Injury Metrics During Typical Neutral Buoyancy Training Operations

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.
Training, Retention, and Transfer of Data Entry Perceptual and Motoric Processes Over Long Retention Intervals

NASA Technical Reports Server (NTRS)

Kole, James A.; Schneider, Vivian I.; Healy, Alice F.; Barshi, Immanuel

2017-01-01

Subjects trained in a standard data entry task, which involved typing numbers (e.g., 5421) using their right hands. At test (6 months post-training), subjects completed the standard task, followed by a left-hand variant (typing with their left hands) that involved the same perceptual, but different motoric, processes as the standard task. At a second test (8 months post-training), subjects completed the standard task, followed by a code variant (translating letters into digits, then typing the digits with their right hands) that involved different perceptual, but the same motoric, processes as the standard task. For each of the three tasks, half the trials were trained numbers (old) and half were new. Repetition priming (faster response times to old than new numbers) was found for each task. Repetition priming for the standard task reflects retention of trained numbers; for the left-hand variant reflects transfer of perceptual processes; and for the code variant reflects transfer of motoric processes. There was thus evidence for both specificity and generalizability of training data entry perceptual and motoric processes over very long retention intervals.
Fire Extinguisher Training for Fire Watch and Designated Workers, Course 9893

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harris, Jimmy D.

At Los Alamos National Laboratory (LANL), all workers must be aware of LANL fire protection policies and be trained on what to do in the event of a fire. This course, Fire Extinguisher Training for Fire Watch and Designated Workers (#9893), provides awareness-level and hands-on training for fire watch personnel and designated workers. Fire watch personnel and designated workers are appointed by line management and must receive both awareness-level training and hands-on training in the use of portable fire extinguishers to extinguish an incipient-stage fire. This training meets the requirements of the Occupational Safety and Health Administration (OSHA) Code ofmore » Federal Regulations (CFR) 29 CFR 1910.157, Portable Fire Extinguishers, and Procedure (P) 101-26, Welding, Cutting, and Other Spark-/Flame-Producing Operations.« less
Risk Reduction and Measures of Injury for EVA Associated Upper Extremity Medical Issues: Extended Vent Tube Study

NASA Technical Reports Server (NTRS)

Jones, Jeffrey A.; Hoffman, Ronald B.; Harvey, C. M.; Bowen, C. K.; Hudy, C. E.; Gernhardt, M. L.

2007-01-01

During Neutral Buoyancy Lab (NBL) training sessions, a large amount of moisture accumulates in the EVA gloves. The glove design restricts the extension of the EVA suit s ventilation/cooling system to the hand. Subungual redness and fingernail pain develops for many astronauts following their NBL training sessions with subsequent oncholysis occurring over succeeding weeks. Various attempts have been made to reduce or avoid this problem. The causal role of moisture has yet to be defined. Methods: To determine the contribution that moisture plays in the injury to the fingers and fingernails during EVA training operations in NBL, the current Extravehicular Mobility Unit (EMU), with a Portable Life Support System (PLSS) was configured with a ventilation tube that extended down a single arm of the crewmember during the test and compared with the unventilated contralateral arm; with the ventilated hand serving as the experimental condition (E) and the opposite arm as the control (C). A cross-over design was used with opposite handedness for the vent tube on a subsequent NBL training run. Moisture content measures were conducted at six points on each hand with three types of moisture meters. A questionnaire was administered to determine subjective thermal hand discomfort, skin moisture perception, and hand and nail discomfort. Photographs and video were recorded. Measures were applied to six astronauts pre- and post-run in the NBL. Results: The consistent trends in relative hydration ratios at the dorsum, from 3.34 for C to 2.11 for E, and first ring finger joint locations, from 2.46 for C to 1.96 for E, indicated the extended vent tube promoted skin drying. The experimental treatment appeared to be more effective on the left hand versus the right hand, implying an interaction with hand anthropometry and glove fit. Video analyses differentiated fine and gross motor training tasks during runs and will be discussed. Conclusions: This potential countermeasure was effective in reducing the risks of hand and nail discomfort symptoms from moderate to low in two of six subjects. Improved design in the ventilation pattern of such a countermeasure is expected to improve the countermeasure s efficiency.
SKILLED BIMANUAL TRAINING DRIVES MOTOR CORTEX PLASTICITY IN CHILDREN WITH UNILATERAL CEREBRAL PALSY

PubMed Central

Friel, Kathleen M.; Kuo, Hsing-Ching; Fuller, Jason; Ferre, Claudio L.; Brandão, Marina; Carmel, Jason B.; Bleyenheuft, Yannick; Gowatsky, Jaimie L.; Stanford, Arielle D.; Rowny, Stefan B.; Luber, Bruce; Bassi, Bruce; Murphy, David LK; Lisanby, Sarah H.; Gordon, Andrew M.

2015-01-01

Background Intensive bimanual therapy can improve hand function in children with unilateral spastic cerebral palsy (USCP). We compared the effects of structured bimanual skill training vs. unstructured bimanual practice on motor outcomes and motor map plasticity in children with USCP. Objective We hypothesized that structured skill training would produce greater motor map plasticity than unstructured practice. Methods Twenty children with USCP (average age 9,5; 12 males) received therapy in a day-camp-setting, 6 h/day, 5 days/week, for 3 weeks. In structured skill training (n=10), children performed progressively more difficult movements and practiced functional goals. In unstructured practice (n=10), children engaged in bimanual activities but did not practice skillful movements or functional goals. We used the Assisting Hand Assessment (AHA), Jebsen-Taylor test of Hand Function (JTTHF) and Canadian Occupational Performance Measure (COPM) to measure hand function. We used single-pulse transcranial magnetic stimulation (TMS) to map the representation of first dorsal interosseous (FDI) and flexor carpi radialis (FCR) muscles bilaterally. Results Both groups showed significant improvements in bimanual hand use (AHA; p<0.05) and hand dexterity (JTTHF; p<0.001). However, only the structured skill group showed increases in the size of the affected hand motor map and amplitudes of motor evoked potentials (p<0.01). Most children who showed the most functional improvements (COPM) had the largest changes in map size. Conclusions These findings uncover a dichotomy of plasticity: the unstructured practice group improved hand function but did not show changes in motor maps. Skill training is important for driving motor cortex plasticity in children with USCP. PMID:26867559
Effector-independent motor sequence representations exist in extrinsic and intrinsic reference frames.

PubMed

Wiestler, Tobias; Waters-Metenier, Sheena; Diedrichsen, Jörn

2014-04-02

Many daily activities rely on the ability to produce meaningful sequences of movements. Motor sequences can be learned in an effector-specific fashion (such that benefits of training are restricted to the trained hand) or an effector-independent manner (meaning that learning also facilitates performance with the untrained hand). Effector-independent knowledge can be represented in extrinsic/world-centered or in intrinsic/body-centered coordinates. Here, we used functional magnetic resonance imaging (fMRI) and multivoxel pattern analysis to determine the distribution of intrinsic and extrinsic finger sequence representations across the human neocortex. Participants practiced four sequences with one hand for 4 d, and then performed these sequences during fMRI with both left and right hand. Between hands, these sequences were equivalent in extrinsic or intrinsic space, or were unrelated. In dorsal premotor cortex (PMd), we found that sequence-specific activity patterns correlated higher for extrinsic than for unrelated pairs, providing evidence for an extrinsic sequence representation. In contrast, primary sensory and motor cortices showed effector-independent representations in intrinsic space, with considerable overlap of the two reference frames in caudal PMd. These results suggest that effector-independent representations exist not only in world-centered, but also in body-centered coordinates, and that PMd may be involved in transforming sequential knowledge between the two. Moreover, although effector-independent sequence representations were found bilaterally, they were stronger in the hemisphere contralateral to the trained hand. This indicates that intermanual transfer relies on motor memories that are laid down during training in both hemispheres, but preferentially draws upon sequential knowledge represented in the trained hemisphere.
Effector-Independent Motor Sequence Representations Exist in Extrinsic and Intrinsic Reference Frames

PubMed Central

Wiestler, Tobias; Waters-Metenier, Sheena

2014-01-01

Many daily activities rely on the ability to produce meaningful sequences of movements. Motor sequences can be learned in an effector-specific fashion (such that benefits of training are restricted to the trained hand) or an effector-independent manner (meaning that learning also facilitates performance with the untrained hand). Effector-independent knowledge can be represented in extrinsic/world-centered or in intrinsic/body-centered coordinates. Here, we used functional magnetic resonance imaging (fMRI) and multivoxel pattern analysis to determine the distribution of intrinsic and extrinsic finger sequence representations across the human neocortex. Participants practiced four sequences with one hand for 4 d, and then performed these sequences during fMRI with both left and right hand. Between hands, these sequences were equivalent in extrinsic or intrinsic space, or were unrelated. In dorsal premotor cortex (PMd), we found that sequence-specific activity patterns correlated higher for extrinsic than for unrelated pairs, providing evidence for an extrinsic sequence representation. In contrast, primary sensory and motor cortices showed effector-independent representations in intrinsic space, with considerable overlap of the two reference frames in caudal PMd. These results suggest that effector-independent representations exist not only in world-centered, but also in body-centered coordinates, and that PMd may be involved in transforming sequential knowledge between the two. Moreover, although effector-independent sequence representations were found bilaterally, they were stronger in the hemisphere contralateral to the trained hand. This indicates that intermanual transfer relies on motor memories that are laid down during training in both hemispheres, but preferentially draws upon sequential knowledge represented in the trained hemisphere. PMID:24695723
Alternatives across Latin America: catalysing change in the curriculum.

PubMed

Jukes, Nick

2009-01-01

A 6-week series of seminars addressing replacement of harmful animal use in education and training was held across Latin America in March-April 2008. Organised by InterNICHE and partner organisations in Bolivia, Peru, Brazil, Argentina and Mexico, the events built on the experience of previous major outreach in Russia and India. Up to 6 full-day seminars were held at universities and independent venues in each country. Smaller meetings with campaigners, teachers and professional bodies complemented the large presentations. All events included spoken presentations, demonstrations and free trials of a wide range of alternatives. Speakers included InterNICHE experts and those from the host countries who are involved in replacement work. Partner organisations were empowered through the process of planning and execution of the seminars, and the tour helped to identify and provide support to others who are progressing humane education initiatives. Further collaboration is now planned. Information on the current situation concerning animal use and alternatives, including laws and regulations, was also gathered from each country. The tour succeeded in raising awareness and generating interest in replacement alternatives, also by national-level interviews and media coverage. Information and freeware alternatives were widely distributed, and further translations of material into Spanish and Portuguese are in progress. To continue the hands-on access to alternatives provided at the seminars, a Mexican / Central American Alternatives Loan System has been established, and others are being built in Peru and Brasil. The donation of computers and alternatives to selected universities is also being planned in order to establish multimedia laboratories that will promote alternatives through example.
Replacing Maladaptive Speech with Verbal Labeling Responses: An Analysis of Generalized Responding.

ERIC Educational Resources Information Center

Foxx, R. M.; And Others

1988-01-01

Three mentally handicapped students (aged 13, 36, and 40) with maladaptive speech received training to answer questions with verbal labels. The results of their cues-pause-point training showed that the students replaced their maladaptive speech with correct labels (answers) to questions in the training setting and three generalization settings.…
All Hands Online : Official Magazine of the U.S. Navy

Science.gov Websites

Hands logo Search Departments Advancements and Promotions Around The Fleet Diversity Focus on Service Health and Fitness History and Heritage Pay and Benefits Talking with Sailors Training and Education , mid-spring afternoon in Port Hueneme, California, at the Navy Safe Harbor Wounded Warrior Training
Effects of Lips and Hands on Auditory Learning of Second-Language Speech Sounds

ERIC Educational Resources Information Center

Hirata, Yukari; Kelly, Spencer D.

2010-01-01

Purpose: 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…
Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis.

PubMed

Merians, Alma S; Fluet, Gerard G; Qiu, Qinyin; Saleh, Soha; Lafond, Ian; Davidow, Amy; Adamovich, Sergei V

2011-05-16

Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training.
Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis

PubMed Central

2011-01-01

Background Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Methods Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. Results The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Conclusions Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training. PMID:21575185
The Combined Effects of Adaptive Control and Virtual Reality on Robot-Assisted Fine Hand Motion Rehabilitation in Chronic Stroke Patients: A Case Study.

PubMed

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping; Todd, Catherine

2018-01-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills. The effectiveness of the proposed system is tested by conducting clinical trials on a chronic stroke patient and verified through clinical evaluation methods by measuring the key kinematic features such as active range of motion (ROM), finger strength, and velocity. By comparing the pretraining and post-training results, the study demonstrates that the proposed method can further enhance the effectiveness of fine hand motion rehabilitation training by improving finger ROM, strength, and coordination. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
[Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand].

PubMed

Zhu, C; Yi, N; Shi, M N; Liang, Y Y; Zhou, Y B; Dang, R; Qi, Z S; Zhao, H Y

2017-07-20

Objective: To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand. Methods: Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n =18) and comprehensive training group (CT, n =28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test. Results: (1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups ( t =0.834, P >0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in group CT, with no statistical differences between them ( χ (2)=2.140, P >0.05). After treatment, the ratio of excellent and good results according to TAM in patients of group CT (6/7) was higher than that in group RT (5/9, χ (2)=0.023, P =0.038). The ratios of excellent and good results according to TAM in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.023 and -4.780, P values below 0.05). (3) The improved score of hand function in patients of group CT was (26±12) points, which was higher than (15±7) points in group RT ( t =3.278, P =0.002). The score of hand function in patients of groups RT and CT after treatment was significantly higher than that before treatment (with t values respectively 2.628 and 6.125, P values below 0.05). There were no significant differences in grades of hand function of patients between the two groups before treatment ( Z =-0.286, P >0.05). After treatment, the grade of hand function in patients of group CT was higher than that in group RT( Z =-1.993, P =0.046). The grades of hand function in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.717 and -4.998, P values below 0.01). Conclusions: For patients with scar contracture after burn injury of dorsal hand, early functional training combined with hand flexing training band can improve the range of motion of hand joints and functional recovery of hand, and the result was better than functional training alone.
Program director opinions of core competencies in hand surgery training: analysis of differences between plastic and orthopedic surgery accredited programs.

PubMed

Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

2013-03-01

The authors' aim was to conduct a national survey of hand surgery fellowship program directors to determine differences of opinions of essential components of hand surgery training between program directors from plastic and orthopedic surgery programs. The authors performed a Web-based survey of 74 program directors from all Accreditation Council for Graduate Medical Education-accredited hand surgery fellowship programs to determine components that are essential for hand surgery training. The survey included assessment of nine general areas of practice, 97 knowledge topics, and 172 procedures. Twenty-seven scales of related survey items were created to determine differences between specialty groups based on clinical themes. An 84 percent response rate was achieved, including 49 orthopedic and 12 plastic surgery program directors. There were significant differences in mean responses between the specialty groups in 11 of 27 scales. Only one scale, forearm fractures, contained items with a significantly stronger preference for essential rating among orthopedic surgeons. The other 10 scales contained items with a significantly higher preference for essential rating among plastic surgeons, most of which related to soft-tissue injury and reconstruction. The burn scale had the greatest discrepancy in opinion of essential ratings between the groups, followed by pedicled and free tissue transfer, and amputation and fingertip injuries. Despite being united under the subspecialty of hand surgery, program directors tend to emphasize clinical areas that are stressed in their respective primary disciplines. These differences promote the advantage of programs that provide exposure to both plastic surgery-trained and orthopedic surgery-trained hand surgeons.
Comparative effectiveness of instructional methods: oral and pharyngeal cancer examination.

PubMed

Clark, Nereyda P; Marks, John G; Sandow, Pamela R; Seleski, Christine E; Logan, Henrietta L

2014-04-01

This study compared the effectiveness of different methods of instruction for the oral and pharyngeal cancer examination. A group of thirty sophomore students at the University of Florida College of Dentistry were randomly assigned to three training groups: video instruction, a faculty-led hands-on instruction, or both video and hands-on instruction. The training intervention involved attending two sessions spaced two weeks apart. The first session used a pretest to assess students' baseline didactic knowledge and clinical examination technique. The second session utilized two posttests to assess the comparative effectiveness of the training methods on didactic knowledge and clinical technique. The key findings were that students performed the clinical examination significantly better with the combination of video and faculty-led hands-on instruction (p<0.01). All students improved their clinical exam skills, knowledge, and confidence in performing the oral and pharyngeal cancer examination independent of which training group they were assigned. Utilizing both video and interactive practice promoted greater performance of the clinical technique on the oral and pharyngeal cancer examination.
The Application of Leap Motion in Astronaut Virtual Training

NASA Astrophysics Data System (ADS)

Qingchao, Xie; Jiangang, Chao

2017-03-01

With the development of computer vision, virtual reality has been applied in astronaut virtual training. As an advanced optic equipment to track hand, Leap Motion can provide precise and fluid tracking of hands. Leap Motion is suitable to be used as gesture input device in astronaut virtual training. This paper built an astronaut virtual training based Leap Motion, and established the mathematics model of hands occlusion. At last the ability of Leap Motion to handle occlusion was analysed. A virtual assembly simulation platform was developed for astronaut training, and occlusion gesture would influence the recognition process. The experimental result can guide astronaut virtual training.
Cosmetic dermatologic surgical training in US dermatology residency programs: identifying and overcoming barriers.

PubMed

Bauer, Bruce; Williams, Erin; Stratman, Erik J

2014-02-01

The public and other medical specialties expect dermatologists who offer cosmetic dermatology services to provide competent care. There are numerous barriers to achieving cosmetic dermatology competency during residency. Many dermatology residents enter the workforce planning to provide cosmetic services. If a training gap exists, this may adversely affect patient safety. To identify resources available for hands-on cosmetic dermatology training in US dermatology residency training programs and to assess program director (PD) attitudes toward cosmetic dermatology training during residency and strategies, including discounted pricing, used by training programs to overcome barriers related to resident-performed cosmetic dermatology procedures. An online survey in academic dermatology practices among PDs of US dermatology residency programs. Frequency of cosmetic dermatology devices and injectables used for dermatology resident hands-on cosmetic dermatology training, categorizing PD attitudes toward cosmetic dermatology training during residency and describing residency-related discounted pricing models. Responses from PDs were received from 53 of 114 (46%) US dermatology residency programs. All but 3 programs (94%) offered hands-on cosmetic dermatology training using botulinum toxin, and 47 of 53 (89%) provided training with hyaluronic acid fillers. Pulsed dye lasers represented the most common laser use experienced by residents (41 of 52 [79%]), followed by Q-switched Nd:YAG (30 of 52 [58%]). Discounted procedures were offered by 32 of 53 (60%) programs, with botulinum toxin (30 of 32 [94%]) and fillers (27 of 32 [84%]) most prevalent and with vascular lasers (17 of 32 [53%]) and hair removal lasers (12 of 32 [38%]) less common. Various discounting methods were used. Only 20 of 53 (38%) PDs believed that cosmetic dermatology should be a necessary aspect of residency training; 14 of 52 (27%) PDs thought that residents should not be required to perform any cosmetic dermatology procedures. Although almost every program provides hands-on cosmetic dermatology training, there are barriers to training, including patient preferences, costs of procedures and products, and PD attitudes toward cosmetic dermatology training. To promote patient safety, procedural competency is imperative.

Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients.

PubMed

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping

2017-07-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive rehabilitation training in restoring motor skills after a stroke. This study focuses on the rehabilitation of fine hand motion skills due to their vital role in performing delicate activities of daily living (ADL) tasks. The proposed rehabilitation system combines an adaptive assist-as-needed (AAN) control algorithm and a Virtual Reality (VR) based rehabilitation gaming system (RGS). The developed system is described and its effectiveness is validated through clinical trials on a group of eight subacute stroke patients for a period of six weeks. The impact of the training is verified through standard clinical evaluation methods and measuring key kinematic parameters. A comparison of the pre- and post-training results indicates that the method proposed in this study can improve fine hand motion rehabilitation training effectiveness.
A head-to-head hands-on comparison of ERCP mechanical simulator (EMS) and Ex-vivo Porcine Stomach Model (PSM)

PubMed Central

Leung, Joseph W; Wang, Dong; Hu, Bing; Lim, Brian

2011-01-01

Background ERCP mechanical simulator (EMS) and ex-vivo porcine stomach model (PSM) have been described. No direct comparison was reported on endoscopists' perception regarding their efficacy for ERCP training Objective Comparative assessment of EMS and PSM. Design Questionnaire survey before and after practice. Setting Hands-on practice workshops. Subjects 22 endoscopists with prior experience in 111±225 (mean±SD) ERCP. Interventions Participants performed scope insertion, selective bile duct cannulation with guide wire and insertion of a single biliary stent. Simulated fluoroscopy with external pin-hole camera (EMS), or with additional transillumination (PSM) was used to monitor exchange of accessories. Main outcome measure Participants rated their understanding and confidence before and after hands-on practice, and credibility of each simulator for ERCP training. Comparative efficacy of EMS and PSM for ERCP education was scored (1=not, 10=very) based on pre and post practice surveys: realism (tissue pliability, papilla anatomy, visual/cannulation realism, wire manipulation, simulated fluoroscopy, overall experience); usefulness (assessment of results, supplementing clinical experience, easy for trainees to learn new skills) and application (overall ease of use, prepare trainees to use real instrument and ease of incorporation into training). Results Before hands-on practice, both EMS and PSM received high scores. After practice, there was a significantly greater increase in confidence score for EMS than PSM (p<0.003). Participants found EMS more useful for training (p=0.017). Limitations: Subjective scores. Conclusions Based on head-to-head hands-on comparison, endoscopists considered both EMS and PSM credible options for improving understanding and supplementing clinical ERCP training. EMS is more useful for basic learning. PMID:22163080
Hebbian learning of hand-centred representations in a hierarchical neural network model of the primate visual system.

PubMed

Born, Jannis; Galeazzi, Juan M; Stringer, Simon M

2017-01-01

A subset of neurons in the posterior parietal and premotor areas of the primate brain respond to the locations of visual targets in a hand-centred frame of reference. Such hand-centred visual representations are thought to play an important role in visually-guided reaching to target locations in space. In this paper we show how a biologically plausible, Hebbian learning mechanism may account for the development of localized hand-centred representations in a hierarchical neural network model of the primate visual system, VisNet. The hand-centered neurons developed in the model use an invariance learning mechanism known as continuous transformation (CT) learning. In contrast to previous theoretical proposals for the development of hand-centered visual representations, CT learning does not need a memory trace of recent neuronal activity to be incorporated in the synaptic learning rule. Instead, CT learning relies solely on a Hebbian learning rule, which is able to exploit the spatial overlap that naturally occurs between successive images of a hand-object configuration as it is shifted across different retinal locations due to saccades. Our simulations show how individual neurons in the network model can learn to respond selectively to target objects in particular locations with respect to the hand, irrespective of where the hand-object configuration occurs on the retina. The response properties of these hand-centred neurons further generalise to localised receptive fields in the hand-centred space when tested on novel hand-object configurations that have not been explored during training. Indeed, even when the network is trained with target objects presented across a near continuum of locations around the hand during training, the model continues to develop hand-centred neurons with localised receptive fields in hand-centred space. With the help of principal component analysis, we provide the first theoretical framework that explains the behavior of Hebbian learning in VisNet.
Hebbian learning of hand-centred representations in a hierarchical neural network model of the primate visual system

PubMed Central

Born, Jannis; Stringer, Simon M.

2017-01-01

A subset of neurons in the posterior parietal and premotor areas of the primate brain respond to the locations of visual targets in a hand-centred frame of reference. Such hand-centred visual representations are thought to play an important role in visually-guided reaching to target locations in space. In this paper we show how a biologically plausible, Hebbian learning mechanism may account for the development of localized hand-centred representations in a hierarchical neural network model of the primate visual system, VisNet. The hand-centered neurons developed in the model use an invariance learning mechanism known as continuous transformation (CT) learning. In contrast to previous theoretical proposals for the development of hand-centered visual representations, CT learning does not need a memory trace of recent neuronal activity to be incorporated in the synaptic learning rule. Instead, CT learning relies solely on a Hebbian learning rule, which is able to exploit the spatial overlap that naturally occurs between successive images of a hand-object configuration as it is shifted across different retinal locations due to saccades. Our simulations show how individual neurons in the network model can learn to respond selectively to target objects in particular locations with respect to the hand, irrespective of where the hand-object configuration occurs on the retina. The response properties of these hand-centred neurons further generalise to localised receptive fields in the hand-centred space when tested on novel hand-object configurations that have not been explored during training. Indeed, even when the network is trained with target objects presented across a near continuum of locations around the hand during training, the model continues to develop hand-centred neurons with localised receptive fields in hand-centred space. With the help of principal component analysis, we provide the first theoretical framework that explains the behavior of Hebbian learning in VisNet. PMID:28562618
The 10 Hz Frequency: A Fulcrum For Transitional Brain States.

PubMed

Garcia-Rill, E; D'Onofrio, S; Luster, B; Mahaffey, S; Urbano, F J; Phillips, C

A 10 Hz rhythm is present in the occipital cortex when the eyes are closed (alpha waves), in the precentral cortex at rest ( mu rhythm), in the superior and middle temporal lobe ( tau rhythm), in the inferior olive (projection to cerebellar cortex), and in physiological tremor (underlying all voluntary movement). These are all considered resting rhythms in the waking brain which are "replaced" by higher frequency activity with sensorimotor stimulation. That is, the 10 Hz frequency fulcrum is replaced on the one hand by lower frequencies during sleep, or on the other hand by higher frequencies during volition and cognition. The 10 Hz frequency fulcrum is proposed as the natural frequency of the brain during quiet waking, but is replaced by higher frequencies capable of permitting more complex functions, or by lower frequencies during sleep and inactivity. At the center of the transition shifts to and from the resting rhythm is the reticular activating system, a phylogenetically preserved area of the brain essential for preconscious awareness.
Boosting the Motor Outcome of the Untrained Hand by Action Observation: Mirror Visual Feedback, Video Therapy, or Both Combined-What Is More Effective?

PubMed

Bähr, Florian; Ritter, Alexander; Seidel, Gundula; Puta, Christian; Gabriel, Holger H W; Hamzei, Farsin

2018-01-01

Action observation (AO) allows access to a network that processes visuomotor and sensorimotor inputs and is believed to be involved in observational learning of motor skills. We conducted three consecutive experiments to examine the boosting effect of AO on the motor outcome of the untrained hand by either mirror visual feedback (MVF), video therapy (VT), or a combination of both. In the first experiment, healthy participants trained either with MVF or without mirror feedback while in the second experiment, participants either trained with VT or observed animal videos. In the third experiment, participants first observed video clips that were followed by either training with MVF or training without mirror feedback. The outcomes for the untrained hand were quantified by scores from five motor tasks. The results demonstrated that MVF and VT significantly increase the motor performance of the untrained hand by the use of AO. We found that MVF was the most effective approach to increase the performance of the target effector. On the contrary, the combination of MVF and VT turns out to be less effective looking from clinical perspective. The gathered results suggest that action-related motor competence with the untrained hand is acquired by both mirror-based and video-based AO.
Boosting the Motor Outcome of the Untrained Hand by Action Observation: Mirror Visual Feedback, Video Therapy, or Both Combined—What Is More Effective?

PubMed Central

Ritter, Alexander; Seidel, Gundula; Puta, Christian; Gabriel, Holger H. W.; Hamzei, Farsin

2018-01-01

Action observation (AO) allows access to a network that processes visuomotor and sensorimotor inputs and is believed to be involved in observational learning of motor skills. We conducted three consecutive experiments to examine the boosting effect of AO on the motor outcome of the untrained hand by either mirror visual feedback (MVF), video therapy (VT), or a combination of both. In the first experiment, healthy participants trained either with MVF or without mirror feedback while in the second experiment, participants either trained with VT or observed animal videos. In the third experiment, participants first observed video clips that were followed by either training with MVF or training without mirror feedback. The outcomes for the untrained hand were quantified by scores from five motor tasks. The results demonstrated that MVF and VT significantly increase the motor performance of the untrained hand by the use of AO. We found that MVF was the most effective approach to increase the performance of the target effector. On the contrary, the combination of MVF and VT turns out to be less effective looking from clinical perspective. The gathered results suggest that action-related motor competence with the untrained hand is acquired by both mirror-based and video-based AO. PMID:29849570
Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: a case study.

PubMed

Fluet, Gerard G; Patel, Jigna; Qiu, Qinyin; Yarossi, Matthew; Massood, Supriya; Adamovich, Sergei V; Tunik, Eugene; Merians, Alma S

2017-07-01

The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated. This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl-Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation. Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing. This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. Implications for rehabilitation Intensive hand and finger rehabilitation activities can be added to an in-patient rehabilitation program for persons with subacute stroke. Targeted training of the thumb may have an impact on activity level function in persons with upper extremity hemiparesis. Untrained transfer tasks can be utilized to confirm that training tasks have elicited motor learning. Changes in cortical motor maps can be used to document changes in brain function which can be used to evaluate changes in motor behavior persons with subacute stroke.
Training and good science are the foundation stones for animal replacement.

PubMed

Davidge, Kelly S; Wilkinson, J Malcolm

2017-11-01

Good science, the training of energetic and enthusiastic young researchers, and the experience of industry veterans, will all be needed to drive the implementation and regulatory approval of animal replacement methods in industry.
Flight Hour Reductions in Fleet Replacement Pilot Training through Simulation.

ERIC Educational Resources Information Center

Smode, Alfred F.

A project was undertaken to integrate the 2F87F operational flight trainer into the program for training replacement patrol plane pilots. The objectives were to determine the potential of the simulator as a substitute environment for learning aircraft tasks and to effectively utilize the simulator in pilot training. The students involved in the…
Virtual Reality Simulator Systems in Robotic Surgical Training.

PubMed

Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

2018-06-01

The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.
A comparison of traditional handwashing training with active handwashing training in the food handler industry.

PubMed

Lillquist, Dean R; McCabe, Mary L; Church, Kurt Haden

2005-01-01

The Centers for Disease Control and Prevention (CDC) have stated that poor personal hygiene is the third most commonly reported food preparation practice contributing to foodborne disease and h further claimed that contaminated hands may be the most important means by which enteric viruses are transmitted. The study reported here compared the effectiveness of traditional (lecture/video) training with that of traditional training that provided an added active (hands-on) component for the retention of handwashing procedures two weeks after the initial training. Sixty-six food handlers attending training courses were included in the study. All participants received the same lecture/video presentation. Twenty-two (33 percent) of the participants received an additional interactive training component. All participants were tested by a 20-item written test on the day of training. Two weeks after the training, 25 to 30 percent of participants from each group were retested. Results revealed that the participants involved in the interactive training had statistically significant better test performances both on the day of training and on the two-week retest.
Entrepreneurship Education at Indian Industrial Training Institutes--A Case Study of the Prescribed, Adopted and Enacted Curriculum in and around Bangalore

ERIC Educational Resources Information Center

Zenner, Lea; Kumar, Kothandaraman; Pilz, Matthias

2017-01-01

On the one hand, India is a growing economy that needs skilled labour, self-employed entrepreneurs and employees to tackle its economic and social challenges. On the other hand, India faces high unemployment rates, especially among young people. Graduates from industrial training institutes (ITIs) in particular are often facing difficulties in…
Fire Extinguisher Designated Worker and Fire Watch: Self-Study Course 15672

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harris, Jimmy D.

At Los Alamos National Laboratory (LANL), all workers must be aware of LANL fire protection policies and be trained on what to do in the event of a fire. This course, Fire Extinguisher Training for Fire Watch and Designated Workers (#9893), provides awareness-level and hands-on training for fire watch personnel and designated workers. Fire watch personnel and designated workers are appointed by line management and must receive both awareness-level training and hands-on training in the use of portable fire extinguishers to extinguish an incipient-stage fire. This training meets the requirements of the Occupational Safety and Health Administration (OSHA) Code ofmore » Federal Regulations (CFR) 29 CFR 1910.157, Portable Fire Extinguishers, and Procedure (P) 101-26, Welding, Cutting, and Other Spark-/Flame-Producing Operations.« less
Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Wong, Janet Y H; Yu, Esther Y T; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Zhang, Joni; Macfarlane, Duncan; Chung, Louisa M Y

2016-01-01

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.
Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study

PubMed Central

Ng, Shamay S. M.; Cheng, Yoyo T. Y.; Yu, Esther Y. T.; Chow, Gary C. C.; Chak, Yvonne T. C.; Chan, Ivy K. Y.; Zhang, Joni; Macfarlane, Duncan

2016-01-01

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults. PMID:27525020
Optical illusion alters M1 excitability after mirror therapy: a TMS study.

PubMed

Läppchen, C H; Ringer, T; Blessin, J; Seidel, G; Grieshammer, S; Lange, R; Hamzei, F

2012-11-01

The contralesional primary motor cortex (M1) has been suggested to be involved in the motor recovery after mirror therapy, but whether the ipsilesional M1 is influenced by the contralesional M1 via transcallosal interhemispheric inhibition (IHI) is still unclear. The present study investigated the change of IHI as well as the intracortical inhibition and intracortical facilitation of both M1 induced by training in a mirror with the use of transcranial magnetic stimulation (TMS). In this 2 × 2 factorial design (time × group), healthy subjects exercised standardized motor skills with their right hand on four consecutive days. Either a mirror (mirror group) or a board (control group) was positioned between their hands. Before and after training TMS was applied along with training tests of both hands. Tests were the same motor skills exercised daily by both groups. Tests of the untrained left hand improved significantly more in the mirror group than in the control group after training (P = 0.02) and showed a close correlation with an increase of intracortical inhibition of M1(left). IHI did not show any difference between investigation time points and groups. The present study confirms the previous suggestion of the involvement of the "contralesional" left-side (ipsilateral to the hand behind the mirror) M1 after mirror therapy, which is not mediated by IHI. Even with the same motor skill training (both groups performed same motor skills) but with different visual information, different networks are involved in training-induced plasticity.
Hand Hygiene Practices Among Indian Medical Undergraduates: A Questionnaire-Based Survey

PubMed Central

Modi, Pranav D; Solanki, Rajavi; Modi, Janhavi; Chandramani, Srinath; Gill, Niharika

2017-01-01

Background and objectives To prevent the spread of infections in all healthcare settings, hand hygiene must be routinely practiced. Appropriate hand hygiene techniques can go a long way in reducing nosocomial infections, cross-transmission of microorganisms and the risk of occupational exposure to infectious diseases. World Health Organisation (WHO) has taken an incredible approach called “My Five Moments for Hand Hygiene" which defines the key moments when health-care workers should perform hand hygiene. We thus carried out a survey to assess knowledge of hand hygiene practices among undergraduate medical students. Materials and methods A cross-sectional survey was conducted among 523 Indian medical undergraduates. The questionnaire used was adapted from the WHO hand hygiene knowledge questionnaire for health-care workers and was distributed both, in print and online formats. The response to each question was examined using percentages. Results Nearly 57% (n=298) of medical students who participated in this study did not receive any formal training in hand hygiene. Only 27% (n=141) students knew that the most frequent source of germs responsible for health-care associated infections were the germs already present on or within the patient. Nearly 68.6% (n= 359) students were unaware of the sequence of hand washing and hand rubbing. Although 71.9% (n=376 ) students claimed that they use an alcohol-based hand rub routinely, only 36.1% (n=189 ) students knew the time required for a hand rub to kill the germs on the hands. Overall hand hygiene knowledge was low in 6.9% (n=36), moderate in 80.9% (n=423) and good in 12.2% (n=23) of respondents. Conclusions The awareness about hand hygiene practices among medical students is low. Nearly 57% (n=298) of the respondents never received any formal training in hand hygiene throughout their course of medical undergraduate study. To prevent the spread of infections in healthcare settings, medical students should be given proper training in hand hygiene practices right from the first year of the medical curriculum. This should be done by running workshops and annual seminars on hand hygiene practices and making it a requisite for clinical skills assessment. PMID:28936375
49 CFR 236.207 - Electric lock on hand-operated switch; control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Block Signal Systems Standards § 236.207 Electric lock on hand-operated... 49 Transportation 4 2011-10-01 2011-10-01 false Electric lock on hand-operated switch; control...
Training and Transfer of Training in Rapid Visual Search for Camouflaged Targets

PubMed Central

Neider, Mark B.; Ang, Cher Wee; Voss, Michelle W.; Carbonari, Ronald; Kramer, Arthur F.

2013-01-01

Previous examinations of search under camouflage conditions have reported that performance improves with training and that training can engender near perfect transfer to similar, but novel camouflage-type displays [1]. What remains unclear, however, are the cognitive mechanisms underlying these training improvements and transfer benefits. On the one hand, improvements and transfer benefits might be associated with higher-level overt strategy shifts, such as through the restriction of eye movements to target-likely (background) display regions. On the other hand, improvements and benefits might be related to the tuning of lower-level perceptual processes, such as figure-ground segregation. To decouple these competing possibilities we had one group of participants train on camouflage search displays and a control group train on non-camouflage displays. Critically, search displays were rapidly presented, precluding eye movements. Before and following training, all participants completed transfer sessions in which they searched novel displays. We found that search performance on camouflage displays improved with training. Furthermore, participants who trained on camouflage displays suffered no performance costs when searching novel displays following training. Our findings suggest that training to break camouflage is related to the tuning of perceptual mechanisms and not strategic shifts in overt attention. PMID:24386301

E-Training: Meeting the Users on Their Terms.

ERIC Educational Resources Information Center

Daghita, Joan; Dudley, Kathryn; Heekin, Janet; Terry, Nancy

The National Institutes of Health (NIH) Library has developed a Web-based training program in response to feedback obtained from a customer survey on learning preferences. A majority of the participants surveyed preferred Web-based training over hands-on training, seminars, printed guides, and personal tutorials. Participants reported that they…
Sight-Singing Scores of High School Choristers with Extensive Training in Movable Solfege Syllables and Curwen Hand Signs

ERIC Educational Resources Information Center

McClung, Alan C.

2008-01-01

Randomly chosen high school choristers with extensive training in solfege syllables and Curwen hand signs (N = 38) are asked to sight-sing two melodies, one while using Curwen hand signs and the other without. Out of a perfect score of 16, the mean score with hand signs was 10.37 (SD = 4.23), and without hand signs, 10.84 (SD = 3.96). A…
A Challenge-Based Approach to Body Weight-Supported Treadmill Training Poststroke: Protocol for a Randomized Controlled Trial.

PubMed

Naidu, Avantika; Brown, David; Roth, Elliot

2018-05-03

Body weight support treadmill training protocols in conjunction with other modalities are commonly used to improve poststroke balance and walking function. However, typical body weight support paradigms tend to use consistently stable balance conditions, often with handrail support and or manual assistance. In this paper, we describe our study protocol, which involved 2 unique body weight support treadmill training paradigms of similar training intensity that integrated dynamic balance challenges to help improve ambulatory function post stroke. The first paradigm emphasized walking without any handrails or manual assistance, that is, hands-free walking, and served as the control group, whereas the second paradigm incorporated practicing 9 essential challenging mobility skills, akin to environmental barriers encountered during community ambulation along with hands-free walking (ie hands-free + challenge walking). We recruited individuals with chronic poststroke hemiparesis and randomized them to either group. Participants trained for 6 weeks on a self-driven, robotic treadmill interface that provided body weight support and a safe gait-training environment. We assessed participants at pre-, mid- and post 6 weeks of intervention-training, with a 6-month follow-up. We hypothesized greater walking improvements in the hands-free + challenge walking group following training because of increased practice opportunity of essential mobility skills along with hands-free walking. We assessed 77 individuals with chronic hemiparesis, and enrolled and randomized 30 individuals poststroke for our study (hands-free group=19 and hands-free + challenge walking group=20) from June 2012 to January 2015. Data collection along with 6-month follow-up continued until January 2016. Our primary outcome measure is change in comfortable walking speed from pre to post intervention for each group. We will also assess feasibility, adherence, postintervention efficacy, and changes in various exploratory secondary outcome measures. Additionally, we will also assess participant responses to a study survey, conducted at the end of training week, to gauge each group's training experiences. Our treadmill training paradigms, and study protocol represent advances in standardized approaches to selecting body weight support levels without the necessity for using handrails or manual assistance, while progressively providing dynamic challenges for improving poststroke ambulatory function during rehabilitation. ClinicalTrials.gov NCT02787759; https://clinicaltrials.gov/ct2/show/NCT02787759 (Archived by Webcite at http://www.webcitation.org/6yJZCrIea). ©Avantika Naidu, David Brown, Elliot Roth. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 03.05.2018.
Higher-order Brain Areas Associated with Real-time Functional MRI Neurofeedback Training of the Somato-motor Cortex.

PubMed

Auer, Tibor; Dewiputri, Wan Ilma; Frahm, Jens; Schweizer, Renate

2018-05-15

Neurofeedback (NFB) allows subjects to learn self-regulation of neuronal brain activation based on information about the ongoing activation. The implementation of real-time functional magnetic resonance imaging (rt-fMRI) for NFB training now facilitates the investigation into underlying processes. Our study involved 16 control and 16 training right-handed subjects, the latter performing an extensive rt-fMRI NFB training using motor imagery. A previous analysis focused on the targeted primary somato-motor cortex (SMC). The present study extends the analysis to the supplementary motor area (SMA), the next higher brain area within the hierarchy of the motor system. We also examined transfer-related functional connectivity using a whole-volume psycho-physiological interaction (PPI) analysis to reveal brain areas associated with learning. The ROI analysis of the pre- and post-training fMRI data for motor imagery without NFB (transfer) resulted in a significant training-specific increase in the SMA. It could also be shown that the contralateral SMA exhibited a larger increase than the ipsilateral SMA in the training and the transfer runs, and that the right-hand training elicited a larger increase in the transfer runs than the left-hand training. The PPI analysis revealed a training-specific increase in transfer-related functional connectivity between the left SMA and frontal areas as well as the anterior midcingulate cortex (aMCC) for right- and left-hand trainings. Moreover, the transfer success was related with training-specific increase in functional connectivity between the left SMA and the target area SMC. Our study demonstrates that NFB training increases functional connectivity with non-targeted brain areas. These are associated with the training strategy (i.e., SMA) as well as with learning the NFB skill (i.e., aMCC and frontal areas). This detailed description of both the system to be trained and the areas involved in learning can provide valuable information for further optimization of NFB trainings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Supervisors with Micros: Trends and Training Needs.

ERIC Educational Resources Information Center

Bryan, Leslie A., Jr.

1986-01-01

Results of a study conducted by Purdue University concerning the use of computers by supervisors in manufacturing firms are presented and discussed. Examines access to computers, minicomputers versus mainframes, training time on computers, replacement of staff, creation of personnel problems, and training methods. (CT)
Martial arts striking hand peak acceleration, accuracy and consistency.

PubMed

Neto, Osmar Pinto; Marzullo, Ana Carolina De Miranda; Bolander, Richard P; Bir, Cynthia A

2013-01-01

The goal of this paper was to investigate the possible trade-off between peak hand acceleration and accuracy and consistency of hand strikes performed by martial artists of different training experiences. Ten male martial artists with training experience ranging from one to nine years volunteered to participate in the experiment. Each participant performed 12 maximum effort goal-directed strikes. Hand acceleration during the strikes was obtained using a tri-axial accelerometer block. A pressure sensor matrix was used to determine the accuracy and consistency of the strikes. Accuracy was estimated by the radial distance between the centroid of each subject's 12 strikes and the target, whereas consistency was estimated by the square root of the 12 strikes mean squared distance from their centroid. We found that training experience was significantly correlated to hand peak acceleration prior to impact (r(2)=0.456, p =0.032) and accuracy (r(2)=0. 621, p=0.012). These correlations suggest that more experienced participants exhibited higher hand peak accelerations and at the same time were more accurate. Training experience, however, was not correlated to consistency (r(2)=0.085, p=0.413). Overall, our results suggest that martial arts training may lead practitioners to achieve higher striking hand accelerations with better accuracy and no change in striking consistency.
Evaluation of a functional hand orthosis combined with electrical stimulation adjunct to arm-hand rehabilitation in subacute stroke patients with a severely to moderately affected hand function.

PubMed

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2018-01-09

To investigate the usability and effectiveness of a functional hand orthosis, combined with electrical stimulation adjunct to therapy-as-usual, on functional use of the moderately/severely impaired hand in sub-acute stroke patients. Single case experiment (A-B-A'-design) involving eight sub-acute stroke patients. The functional hand orthosis and electrical stimulation were used for six weeks, four days/week, 45'/day. Action_Research_Arm_Test, Intrinsic_Motivation_Inventory. At group level, patients improved 19.2 points (median value) (interquartile range: [8.8, 29.5] points) on the Action_Research_Arm_Test (p = 0.001). After correcting for spontaneous recovery and/or therapy-as-usual effects Action_Research_Arm_Test scores still improved significantly (median: 17.2 points; interquartile range: [5.1, 29.2] points) (p = 0.002). At individual level, six patients had improved as to arm-hand skill performance at follow-up (p < = 0.010). In one patient, arm-hand skill performance improvement did not attain statistical significance. In another patient, no arm-hand skill performance improvement was observed. Average Intrinsic_Motivation_Inventory sub-scores were between 4.6 and 6.3 (maximum: 7), except for 'perceived pressure/tension' (3.3). Sub-acute stroke patients who display only little/modest improvement on their capacity to perform daily activities, seem to benefit from training with a dynamic arm orthosis in combination with electrical stimulation. Patients' perceived intrinsic motivation and sense of self-regulation was high. Implications for rehabilitation Arm-hand training featuring the dynamic hand orthosis in combination with electrical stimulation shows a shift from no dexterity to dexterity. As to the users' experience regarding the dynamic hand orthosis, patients perceive a high-intrinsic motivation and sense of self-regulation. Combining the orthosis with electrical stimulation creates opportunities for a nonfunctional hand towards task-oriented training.
Bystander cardiopulmonary resuscitation training experience and self-efficacy of age and gender group: a nationwide community survey.

PubMed

Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Sung Ok; Kim, Young Taek; Cho, Sung-Il

2016-08-01

We hypothesized that recent hands-on practice for cardiopulmonary resuscitation (CPR) would be strongly associated with a higher likelihood of self-efficacy in bystander CPR among laypersons according to age and gender group. We used the National Korean Community Health Survey database of 228921 representatively sampled responders from 253 counties in 2012. Laypersons who had previous CPR training were eligible. Exposure variables were having had CPR training with hands-on practice session with a manikin (Practical-CPR-Training) and CPR training within the last 2 years (Recent-CPR-Training). Primary outcome was self-efficacy in bystander CPR. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects of CPR training across different age and gender groups. Of 62425 eligible respondents who have had CPR training, 20213 (32.4%) had Practical-CPR-Training. Adjusted odds ratios (AORs) for self-efficacy were 4.08 (3.78-4.41) in Practical-CPR-Training, 2.61 (2.50-2.73) in male, 1.26 (1.16-1.36) in good self-rated health, 1.19 (1.10-1.29) in high school graduate, 1.19 (1.01-1.39) in persons living with stroke patients in household, and 1.17 (1.10-1.24) in Recent-CPR-Training. In interaction models, Practical-CPR-Training showed higher self-efficacy in all age and gender groups, whereas Recent-CPR-Training was not associated with better self-efficacy in elderly group, male (AOR, 0.90 [0.69-1.18]) and female (AOR, 0.94 [0.72-1.23]). Self-efficacy in bystander CPR was higher in person with recent CPR training with hands-on practice with a manikin. Copyright © 2015 Elsevier Inc. All rights reserved.
Retraining and assessing hand movement after stroke using the MusicGlove: comparison with conventional hand therapy and isometric grip training

PubMed Central

2014-01-01

Background It is thought that therapy should be functional, be highly repetitive, and promote afferent input to best stimulate hand motor recovery after stroke, yet patients struggle to access such therapy. We developed the MusicGlove, an instrumented glove that requires the user to practice gripping-like movements and thumb-finger opposition to play a highly engaging, music-based, video game. The purpose of this study was to 1) compare the effect of training with MusicGlove to conventional hand therapy 2) determine if MusicGlove training was more effective than a matched form of isometric hand movement training; and 3) determine if MusicGlove game scores predict clinical outcomes. Methods 12 chronic stroke survivors with moderate hemiparesis were randomly assigned to receive MusicGlove, isometric, and conventional hand therapy in a within-subjects design. Each subject participated in six one-hour treatment sessions three times per week for two weeks, for each training type, for a total of 18 treatment sessions. A blinded rater assessed hand impairment before and after each training type and at one-month follow-up including the Box and Blocks (B & B) test as the primary outcome measure. Subjects also completed the Intrinsic Motivation Inventory (IMI). Results Subjects improved hand function related to grasping small objects more after MusicGlove compared to conventional training, as measured by the B & B score (improvement of 3.21±3.82 vs. -0.29±2.27 blocks; P=0.010) and the 9 Hole Peg test (improvement of 2.14±2.98 vs. -0.85±1.29 pegs/minute; P=0.005). There was no significant difference between training types in the broader assessment batteries of hand function. Subjects benefited less from isometric therapy than MusicGlove training, but the difference was not significant (P>0.09). Subjects sustained improvements in hand function at a one month follow-up, and found the MusicGlove more motivating than the other two therapies, as measured by the IMI. MusicGlove games scores correlated strongly with the B & B score. Conclusions These results support the hypothesis that hand therapy that is engaging, incorporates high numbers of repetitions of gripping and thumb-finger opposition movements, and promotes afferent input is a promising approach to improving an individual’s ability to manipulate small objects. The MusicGlove provides a simple way to access such therapy. PMID:24885076
Retraining and assessing hand movement after stroke using the MusicGlove: comparison with conventional hand therapy and isometric grip training.

PubMed

Friedman, Nizan; Chan, Vicky; Reinkensmeyer, Andrea N; Beroukhim, Ariel; Zambrano, Gregory J; Bachman, Mark; Reinkensmeyer, David J

2014-04-30

It is thought that therapy should be functional, be highly repetitive, and promote afferent input to best stimulate hand motor recovery after stroke, yet patients struggle to access such therapy. We developed the MusicGlove, an instrumented glove that requires the user to practice gripping-like movements and thumb-finger opposition to play a highly engaging, music-based, video game. The purpose of this study was to 1) compare the effect of training with MusicGlove to conventional hand therapy 2) determine if MusicGlove training was more effective than a matched form of isometric hand movement training; and 3) determine if MusicGlove game scores predict clinical outcomes. 12 chronic stroke survivors with moderate hemiparesis were randomly assigned to receive MusicGlove, isometric, and conventional hand therapy in a within-subjects design. Each subject participated in six one-hour treatment sessions three times per week for two weeks, for each training type, for a total of 18 treatment sessions. A blinded rater assessed hand impairment before and after each training type and at one-month follow-up including the Box and Blocks (B & B) test as the primary outcome measure. Subjects also completed the Intrinsic Motivation Inventory (IMI). Subjects improved hand function related to grasping small objects more after MusicGlove compared to conventional training, as measured by the B & B score (improvement of 3.21±3.82 vs. -0.29±2.27 blocks; P=0.010) and the 9 Hole Peg test (improvement of 2.14±2.98 vs. -0.85±1.29 pegs/minute; P=0.005). There was no significant difference between training types in the broader assessment batteries of hand function. Subjects benefited less from isometric therapy than MusicGlove training, but the difference was not significant (P>0.09). Subjects sustained improvements in hand function at a one month follow-up, and found the MusicGlove more motivating than the other two therapies, as measured by the IMI. MusicGlove games scores correlated strongly with the B & B score. These results support the hypothesis that hand therapy that is engaging, incorporates high numbers of repetitions of gripping and thumb-finger opposition movements, and promotes afferent input is a promising approach to improving an individual's ability to manipulate small objects. The MusicGlove provides a simple way to access such therapy.
Glove Use and Glove Education in Workers with Hand Dermatitis.

PubMed

Rowley, Kyle; Ajami, Daana; Gervais, Denise; Mooney, Lindsay; Belote, Amy; Kudla, Irena; Switzer-McIntyre, Sharon; Holness, D Linn

2016-01-01

Occupational skin diseases are common. The occurrence of occupational skin diseases represents a failure of primary prevention strategies that may include the use of personal protective equipment, most commonly gloves. The objective of this study was to describe current glove use and education practices related to gloves in workers being assessed for possible work-related hand dermatitis. Participants included consecutive patients being assessed for possible work-related hand dermatitis. A self-administered questionnaire obtained information on demographics, workplace characteristics and exposures, glove use, and education regarding gloves. Ninety percent of the 105 participants reported using gloves. Only 44% had received training related to glove use in the workplace. Major gaps in training content included skin care when using gloves, warning signs of skin problems, and glove size. If the worker indicated no glove training received, the majority reported they would have used gloves if such training was provided. Although the majority of workers being assessed wore gloves, the minority had received training related to glove use. Particular gaps in training content were identified. Those who had not received training noted they would likely have used gloves if training had been provided.
Event-driven contrastive divergence for spiking neuromorphic systems.

PubMed

Neftci, Emre; Das, Srinjoy; Pedroni, Bruno; Kreutz-Delgado, Kenneth; Cauwenberghs, Gert

2013-01-01

Restricted Boltzmann Machines (RBMs) and Deep Belief Networks have been demonstrated to perform efficiently in a variety of applications, such as dimensionality reduction, feature learning, and classification. Their implementation on neuromorphic hardware platforms emulating large-scale networks of spiking neurons can have significant advantages from the perspectives of scalability, power dissipation and real-time interfacing with the environment. However, the traditional RBM architecture and the commonly used training algorithm known as Contrastive Divergence (CD) are based on discrete updates and exact arithmetics which do not directly map onto a dynamical neural substrate. Here, we present an event-driven variation of CD to train a RBM constructed with Integrate & Fire (I&F) neurons, that is constrained by the limitations of existing and near future neuromorphic hardware platforms. Our strategy is based on neural sampling, which allows us to synthesize a spiking neural network that samples from a target Boltzmann distribution. The recurrent activity of the network replaces the discrete steps of the CD algorithm, while Spike Time Dependent Plasticity (STDP) carries out the weight updates in an online, asynchronous fashion. We demonstrate our approach by training an RBM composed of leaky I&F neurons with STDP synapses to learn a generative model of the MNIST hand-written digit dataset, and by testing it in recognition, generation and cue integration tasks. Our results contribute to a machine learning-driven approach for synthesizing networks of spiking neurons capable of carrying out practical, high-level functionality.
Event-driven contrastive divergence for spiking neuromorphic systems

PubMed Central

Neftci, Emre; Das, Srinjoy; Pedroni, Bruno; Kreutz-Delgado, Kenneth; Cauwenberghs, Gert

2014-01-01

Restricted Boltzmann Machines (RBMs) and Deep Belief Networks have been demonstrated to perform efficiently in a variety of applications, such as dimensionality reduction, feature learning, and classification. Their implementation on neuromorphic hardware platforms emulating large-scale networks of spiking neurons can have significant advantages from the perspectives of scalability, power dissipation and real-time interfacing with the environment. However, the traditional RBM architecture and the commonly used training algorithm known as Contrastive Divergence (CD) are based on discrete updates and exact arithmetics which do not directly map onto a dynamical neural substrate. Here, we present an event-driven variation of CD to train a RBM constructed with Integrate & Fire (I&F) neurons, that is constrained by the limitations of existing and near future neuromorphic hardware platforms. Our strategy is based on neural sampling, which allows us to synthesize a spiking neural network that samples from a target Boltzmann distribution. The recurrent activity of the network replaces the discrete steps of the CD algorithm, while Spike Time Dependent Plasticity (STDP) carries out the weight updates in an online, asynchronous fashion. We demonstrate our approach by training an RBM composed of leaky I&F neurons with STDP synapses to learn a generative model of the MNIST hand-written digit dataset, and by testing it in recognition, generation and cue integration tasks. Our results contribute to a machine learning-driven approach for synthesizing networks of spiking neurons capable of carrying out practical, high-level functionality. PMID:24574952
Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players.

PubMed

Chieffo, Raffaella; Straffi, Laura; Inuggi, Alberto; Gonzalez-Rosa, Javier J; Spagnolo, Francesca; Coppi, Elisabetta; Nuara, Arturo; Houdayer, Elise; Comi, Giancarlo; Leocani, Letizia

2016-01-01

Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS) offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP) and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls), together with electromyographic recording of mirror movements (MMs) to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH) than on the non-dominant hemisphere (NDH). On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB) indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14) and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere.
Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players

PubMed Central

Inuggi, Alberto; Gonzalez-Rosa, Javier J.; Spagnolo, Francesca; Coppi, Elisabetta; Nuara, Arturo; Houdayer, Elise; Comi, Giancarlo; Leocani, Letizia

2016-01-01

Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS) offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP) and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls), together with electromyographic recording of mirror movements (MMs) to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH) than on the non-dominant hemisphere (NDH). On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB) indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14) and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere. PMID:27336584
Aggression Replacement Training for Violent Young Men in a Forensic Psychiatric Outpatient Clinic.

PubMed

Hornsveld, Ruud H J; Kraaimaat, Floris W; Muris, Peter; Zwets, Almar J; Kanters, Thijs

2015-11-01

The effects of Aggression Replacement Training (ART) were explored in a group of Dutch violent young men aged 16 to 21 years, who were obliged by the court to follow a treatment program in a forensic psychiatric outpatient clinic. To evaluate the training, patients completed a set of self-report questionnaires at three moments in time: at intake/before a waiting period, after the waiting period/before the training, and after the training. During the waiting period, the patients did not change on most measures, although they displayed a significant increase in anger. The patients who completed the therapy scored significantly lower on psychopathy than the patients who dropped out. The training produced significant decreases in physical aggression and social anxiety and showed trends toward a decline in self-reported hostility, general aggression, and anger. After the training, the patients scored comparably with a reference group on measures of hostility and aggressive behavior. Altogether, these results provide tentative support for the efficacy of the ART for violent young men referred to forensic psychiatric outpatient settings. © The Author(s) 2014.
Positioning the endoscope in laparoscopic surgery by foot: Influential factors on surgeons' performance in virtual trainer.

PubMed

Abdi, Elahe; Bouri, Mohamed; Burdet, Etienne; Himidan, Sharifa; Bleuler, Hannes

2017-07-01

We have investigated how surgeons can use the foot to position a laparoscopic endoscope, a task that normally requires an extra assistant. Surgeons need to train in order to exploit the possibilities offered by this new technique and safely manipulate the endoscope together with the hands movements. A realistic abdominal cavity has been developed as training simulator to investigate this multi-arm manipulation. In this virtual environment, the surgeon's biological hands are modelled as laparoscopic graspers while the viewpoint is controlled by the dominant foot. 23 surgeons and medical students performed single-handed and bimanual manipulation in this environment. The results show that residents had superior performance compared to both medical students and more experienced surgeons, suggesting that residency is an ideal period for this training. Performing the single-handed task improves the performance in the bimanual task, whereas the converse was not true.
Induced sensorimotor brain plasticity controls pain in phantom limb patients

PubMed Central

Yanagisawa, Takufumi; Fukuma, Ryohei; Seymour, Ben; Hosomi, Koichi; Kishima, Haruhiko; Shimizu, Takeshi; Yokoi, Hiroshi; Hirata, Masayuki; Yoshimine, Toshiki; Kamitani, Yukiyasu; Saitoh, Youichi

2016-01-01

The cause of pain in a phantom limb after partial or complete deafferentation is an important problem. A popular but increasingly controversial theory is that it results from maladaptive reorganization of the sensorimotor cortex, suggesting that experimental induction of further reorganization should affect the pain, especially if it results in functional restoration. Here we use a brain–machine interface (BMI) based on real-time magnetoencephalography signals to reconstruct affected hand movements with a robotic hand. BMI training induces significant plasticity in the sensorimotor cortex, manifested as improved discriminability of movement information and enhanced prosthetic control. Contrary to our expectation that functional restoration would reduce pain, the BMI training with the phantom hand intensifies the pain. In contrast, BMI training designed to dissociate the prosthetic and phantom hands actually reduces pain. These results reveal a functional relevance between sensorimotor cortical plasticity and pain, and may provide a novel treatment with BMI neurofeedback. PMID:27807349
Brief history of intermolecular and intersurface forces in complex fluid systems.

PubMed

Israelachvili, Jacob; Ruths, Marina

2013-08-06

We review the developments of ideas, concepts, and theories of intermolecular and intersurface forces and how these were influenced (or ignored) by observations of nature and, later, systematic experimentation. The emphasis of this review is on the way things gradually changed: experimentation replaced rhetoric, measurement and quantification replaced hand waving, energy replaced force in calculations, discrete atoms replaced the (continuum) aether, thermodynamics replaced mechanistic models, randomness and probability replaced certainty, and delicate experiments on the subnanoscale revealed fascinating self-assembling structures and complex behavior of even the simplest systems. We conclude by discussing today's unresolved challenges: how complex "dynamic" multicomponent--especially living biological--systems that receive a continuous supply of energy can be far from equilibrium and not even in any steady state. Such systems, never static but evolving in both space and time, are still far from being understood both experimentally and theoretically.
Improvements in hand function in adults with chronic tetraplegia following a multi-day 10Hz rTMS intervention combined with repetitive task practice

PubMed Central

Gomes-Osman, Joyce; Field-Fote, Edelle C.

2014-01-01

Background and Purpose Evidence suggests the use of stimulation to increase corticomotor excitability improves hand function in persons with cervical spinal cord injury (SCI). We assessed effects of multi-day application of 10Hz repetitive transcranial magnetic stimulation (rTMS) applied to the corticomotor hand area combined with repetitive task practice (RTP) in participants with tetraplegia and neurologically healthy participants. Methods Using a double-blind randomized crossover design, 11 participants with chronic tetraplegia and 10 neurologically healthy participants received 3 sessions of 10Hz rTMS+RTP and 3 sessions of sham-rTMS+RTP to the corticomotor hand region controlling the weaker hand. RTMS was interleaved with RTP of a skilled motor task between pulse trains. Hand function (Jebsen-Taylor Hand Function Test [JTT], pinch, and grasp strength) and corticomotor excitability (amplitude of motor-evoked potential) were assessed prior to and following the rTMS+RTP and sham-rTMS+RTP phases. We assessed significance using paired t-tests on pre-post differences and effect sizes using standardized response mean (SRM). Results RTMS+RTP was associated with larger effect sizes compared to sham-rTMS+RTP for improvement in JTT for both the trained hand (SRM=0.85 and 0.42, respectively), non-trained hand (0.55, 0.31, respectively), and for grasp strength of the trained hand in the SCI group (0.67, 0.39, respectively) alone. Effect sizes for all other measures were small and there were no statistical between-condition differences in the outcomes assessed. Discussion and Conclusions RTMS may be a valuable adjunct to RTP for improving hand function in persons with tetraplegia. Higher stimulation dose (frequency, intensity, number of sessions) may be associated with larger effects. Video Abstract available (See Supplemental Digital Conent 1) for more insights from the authors. PMID:25415549

49 CFR 231.13 - Passenger-train cars with open-end platforms.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Passenger-train cars with open-end platforms. 231... Passenger-train cars with open-end platforms. (a) Hand brakes—(1) Number. Each passenger-train car shall be...) Location. Each hand brake shall be so located that it can be safely operated while car is in motion. (b...
49 CFR 231.13 - Passenger-train cars with open-end platforms.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Passenger-train cars with open-end platforms. 231... Passenger-train cars with open-end platforms. (a) Hand brakes—(1) Number. Each passenger-train car shall be...) Location. Each hand brake shall be so located that it can be safely operated while car is in motion. (b...
49 CFR 231.13 - Passenger-train cars with open-end platforms.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Passenger-train cars with open-end platforms. 231... Passenger-train cars with open-end platforms. (a) Hand brakes—(1) Number. Each passenger-train car shall be...) Location. Each hand brake shall be so located that it can be safely operated while car is in motion. (b...
49 CFR 231.13 - Passenger-train cars with open-end platforms.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Passenger-train cars with open-end platforms. 231... Passenger-train cars with open-end platforms. (a) Hand brakes—(1) Number. Each passenger-train car shall be...) Location. Each hand brake shall be so located that it can be safely operated while car is in motion. (b...
49 CFR 231.13 - Passenger-train cars with open-end platforms.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Passenger-train cars with open-end platforms. 231... Passenger-train cars with open-end platforms. (a) Hand brakes—(1) Number. Each passenger-train car shall be...) Location. Each hand brake shall be so located that it can be safely operated while car is in motion. (b...
An IoT-Enabled Stroke Rehabilitation System Based on Smart Wearable Armband and Machine Learning.

PubMed

Yang, Geng; Deng, Jia; Pang, Gaoyang; Zhang, Hao; Li, Jiayi; Deng, Bin; Pang, Zhibo; Xu, Juan; Jiang, Mingzhe; Liljeberg, Pasi; Xie, Haibo; Yang, Huayong

2018-01-01

Surface electromyography signal plays an important role in hand function recovery training. In this paper, an IoT-enabled stroke rehabilitation system was introduced which was based on a smart wearable armband (SWA), machine learning (ML) algorithms, and a 3-D printed dexterous robot hand. User comfort is one of the key issues which should be addressed for wearable devices. The SWA was developed by integrating a low-power and tiny-sized IoT sensing device with textile electrodes, which can measure, pre-process, and wirelessly transmit bio-potential signals. By evenly distributing surface electrodes over user's forearm, drawbacks of classification accuracy poor performance can be mitigated. A new method was put forward to find the optimal feature set. ML algorithms were leveraged to analyze and discriminate features of different hand movements, and their performances were appraised by classification complexity estimating algorithms and principal components analysis. According to the verification results, all nine gestures can be successfully identified with an average accuracy up to 96.20%. In addition, a 3-D printed five-finger robot hand was implemented for hand rehabilitation training purpose. Correspondingly, user's hand movement intentions were extracted and converted into a series of commands which were used to drive motors assembled inside the dexterous robot hand. As a result, the dexterous robot hand can mimic the user's gesture in a real-time manner, which shows the proposed system can be used as a training tool to facilitate rehabilitation process for the patients after stroke.
Aggression Replacement Training and Childhood Trauma

ERIC Educational Resources Information Center

Amendola, A. Mark; Oliver, Robert W.

2013-01-01

Aggression Replacement Training (ART) was developed by the late Arnold Goldstein of Syracuse University to teach positive alternatives to children and youth with emotional and behavioral problems (Glick & Gibbs, 2011; Goldstein, Glick, & Gibbs, 1998). ART provides cognitive, affective, and behavioral interventions to build competence in…
Effect of two contrasting interventions on upper limb chronic pain and disability: a randomized controlled trial.

PubMed

Sundstrup, Emil; Jakobsen, Markus D; Andersen, Christoffer H; Jay, Kenneth; Persson, Roger; Aagaard, Per; Andersen, Lars L

2014-01-01

Chronic pain and disability of the arm, shoulder, and hand severely affect labor market participation. Ergonomic training and education is the default strategy to reduce physical exposure and thereby prevent aggravation of pain. An alternative strategy could be to increase physical capacity of the worker by physical conditioning. To investigate the effect of 2 contrasting interventions, conventional ergonomic training (usual care) versus resistance training, on pain and disability in individuals with upper limb chronic pain exposed to highly repetitive and forceful manual work. Examiner-blinded, parallel-group randomized controlled trial with allocation concealment. Slaughterhouses located in Denmark, Europe. Sixty-six adults with chronic pain in the shoulder, elbow/forearm, or hand/wrist and work disability were randomly allocated to 10 weeks of specific resistance training for the shoulder, arm, and hand muscles for 3 x 10 minutes per week, or ergonomic training and education (usual care control group). Pain intensity (average of shoulder, arm, and hand, scale 0 - 10) was the primary outcome, and disability (Work module of DASH questionnaire) as well as isometric shoulder and wrist muscle strength were secondary outcomes. Pain intensity, disability, and muscle strength improved more following resistance training than usual care (P < 0.001, P = 0.05, P <0.0001, respectively [corrected]). Pain intensity decreased by 1.5 points (95% confidence interval -2.0 to -0.9) following resistance training compared with usual care, corresponding to an effect size of 0.91 (Cohen's d). Blinding of participants is not possible in behavioral interventions. However, at baseline outcome expectations of the 2 interventions were similar. Resistance training at the workplace results in clinical relevant improvements in pain, disability, and muscle strength in adults with upper limb chronic pain exposed to highly repetitive and forceful manual work. NCT01671267.
Implicit Learning of a Finger Motor Sequence by Patients with Cerebral Palsy After Neurofeedback.

PubMed

Alves-Pinto, Ana; Turova, Varvara; Blumenstein, Tobias; Hantuschke, Conny; Lampe, Renée

2017-03-01

Facilitation of implicit learning of a hand motor sequence after a single session of neurofeedback training of alpha power recorded from the motor cortex has been shown in healthy individuals (Ros et al., Biological Psychology 95:54-58, 2014). This facilitation effect could be potentially applied to improve the outcome of rehabilitation in patients with impaired hand motor function. In the current study a group of ten patients diagnosed with cerebral palsy trained reduction of alpha power derived from brain activity recorded from right and left motor areas. Training was distributed in three periods of 8 min each. In between, participants performed a serial reaction time task with their non-dominant hand, to a total of five runs. A similar procedure was repeated a week or more later but this time training was based on simulated brain activity. Reaction times pooled across participants decreased on each successive run faster after neurofeedback training than after the simulation training. Also recorded were two 3-min baseline conditions, once with the eyes open, another with the eyes closed, at the beginning and end of the experimental session. No significant changes in alpha power with neurofeedback or with simulation training were obtained and no correlation with the reductions in reaction time could be established. Contributions for this are discussed.
Design of a complex virtual reality simulation to train finger motion for persons with hemiparesis: a proof of concept study.

PubMed

Adamovich, Sergei V; Fluet, Gerard G; Mathai, Abraham; Qiu, Qinyin; Lewis, Jeffrey; Merians, Alma S

2009-07-17

Current neuroscience has identified rehabilitation approaches with the potential to stimulate adaptive changes in the brains of persons with hemiparesis. These approaches include, intensive task-oriented training, bimanual activities and balancing proximal and distal upper extremity interventions to reduce competition between these segments for neural territory. This paper describes the design and feasibility testing of a robotic/virtual environment system designed to train the hand and arm of persons with hemiparesis. The system employs a simulated piano that presents visual, auditory and tactile feedback comparable to an actual piano. Arm tracking allows patients to train both the arm and hand as a coordinated unit, emphasizing the integration of both transport and manipulation phases. The piano trainer includes songs and scales that can be performed with one or both hands. Adaptable haptic assistance is available for more involved subjects. An algorithm adjusts task difficulty in proportion to subject performance. A proof of concept study was performed on four subjects with upper extremity hemiparesis secondary to chronic stroke to establish: a) the safety and feasibility of this system and b) the concurrent validity of robotically measured kinematic and performance measures to behavioral measures of upper extremity function. None of the subjects experienced adverse events or responses during or after training. As a group, the subjects improved in both performance time and key press accuracy. Three of the four subjects demonstrated improvements in fractionation, the ability to move each finger individually. Two subjects improved their aggregate time on the Jebsen Test of Hand Function and three of the four subjects improved in Wolf Motor Function Test aggregate time. The system designed in this paper has proven to be safe and feasible for the training of hand function for persons with hemiparesis. It features a flexible design that allows for the use and further study of adjustments in point of view, bilateral and unimanual treatment modes, adaptive training algorithms and haptically rendered collisions in the context of rehabilitation of the hemiparetic hand.
Design of a complex virtual reality simulation to train finger motion for persons with hemiparesis: a proof of concept study

PubMed Central

Adamovich, Sergei V; Fluet, Gerard G; Mathai, Abraham; Qiu, Qinyin; Lewis, Jeffrey; Merians, Alma S

2009-01-01

Background Current neuroscience has identified rehabilitation approaches with the potential to stimulate adaptive changes in the brains of persons with hemiparesis. These approaches include, intensive task-oriented training, bimanual activities and balancing proximal and distal upper extremity interventions to reduce competition between these segments for neural territory. Methods This paper describes the design and feasibility testing of a robotic/virtual environment system designed to train the hand and arm of persons with hemiparesis. The system employs a simulated piano that presents visual, auditory and tactile feedback comparable to an actual piano. Arm tracking allows patients to train both the arm and hand as a coordinated unit, emphasizing the integration of both transport and manipulation phases. The piano trainer includes songs and scales that can be performed with one or both hands. Adaptable haptic assistance is available for more involved subjects. An algorithm adjusts task difficulty in proportion to subject performance. A proof of concept study was performed on four subjects with upper extremity hemiparesis secondary to chronic stroke to establish: a) the safety and feasibility of this system and b) the concurrent validity of robotically measured kinematic and performance measures to behavioral measures of upper extremity function. Results None of the subjects experienced adverse events or responses during or after training. As a group, the subjects improved in both performance time and key press accuracy. Three of the four subjects demonstrated improvements in fractionation, the ability to move each finger individually. Two subjects improved their aggregate time on the Jebsen Test of Hand Function and three of the four subjects improved in Wolf Motor Function Test aggregate time. Conclusion The system designed in this paper has proven to be safe and feasible for the training of hand function for persons with hemiparesis. It features a flexible design that allows for the use and further study of adjustments in point of view, bilateral and unimanual treatment modes, adaptive training algorithms and haptically rendered collisions in the context of rehabilitation of the hemiparetic hand. PMID:19615045
Restricted transfer of learning between unimanual and bimanual finger sequences

PubMed Central

Bai, Wenjun

2016-01-01

When training bimanual skills, such as playing piano, people sometimes practice each hand separately and at a later stage combine the movements of the two hands. This poses the critical question of whether motor skills can be acquired by separately practicing each subcomponent or should be trained as a whole. In the present study, we addressed this question by training human subjects for 4 days in a unimanual or bimanual version of the discrete sequence production task. Both groups were then tested on trained and untrained sequences on both unimanual and bimanual versions of the task. Surprisingly, we found no evidence of transfer from trained unimanual to bimanual or from trained bimanual to unimanual sequences. In half the participants, we also investigated whether cuing the sequences on the left and right hand with unique letters would change transfer. With these cues, untrained sequences that shared some components with the trained sequences were performed more quickly than sequences that did not. However, the amount of this transfer was limited to ∼10% of the overall sequence-specific learning gains. These results suggest that unimanual and bimanual sequences are learned in separate representations. Making participants aware of the interrelationship between sequences can induce some transferrable component, although the main component of the skill remains unique to unimanual or bimanual execution. NEW & NOTEWORTHY Studies in reaching movement demonstrated that approximately half of motor learning can transfer across unimanual and bimanual contexts, suggesting that neural representations for unimanual and bimanual movements are fairly overlapping at the level of elementary movement. In this study, we show that little or no transfer occurred across unimanual and bimanual sequential finger movements. This result suggests that bimanual sequences are represented at a level of the motor hierarchy that integrates movements of both hands. PMID:27974447
Virtual Reality Glasses and "Eye-Hands Blind Technique" for Microsurgical Training in Neurosurgery.

PubMed

Choque-Velasquez, Joham; Colasanti, Roberto; Collan, Juhani; Kinnunen, Riina; Rezai Jahromi, Behnam; Hernesniemi, Juha

2018-04-01

Microsurgical skills and eye-hand coordination need continuous training to be developed and refined. However, well-equipped microsurgical laboratories are not so widespread as their setup is expensive. Herein, we present a novel microsurgical training system that requires a high-resolution personal computer screen, smartphones, and virtual reality glasses. A smartphone placed on a holder at a height of about 15-20 cm from the surgical target field is used as the webcam of the computer. A specific software is used to duplicate the video camera image. The video may be transferred from the computer to another smartphone, which may be connected to virtual reality glasses. Using the previously described training model, we progressively performed more and more complex microsurgical exercises. It did not take long to set up our system, thus saving time for the training sessions. Our proposed training model may represent an affordable and efficient system to improve eye-hand coordination and dexterity in using not only the operating microscope but also endoscopes and exoscopes. Copyright © 2018 Elsevier Inc. All rights reserved.
A retrospective outcomes study examining the effect of interactive metronome on hand function.

PubMed

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.
An Assessment of Basic Patient Safety Skills in Residents Entering the First Year of Clinical Training.

PubMed

Comunale, Mark E; Sandoval, Mathew; Broussard, La Toya

2018-06-01

During safety rounds, we observed few residents demonstrating hand hygiene and patient identification as they began their postgraduate clinical training. We assessed baseline performance of these 2 basic safety skills in residents entering the first year of postgraduate clinical training (PGY1). PGY1 residents beginning training on July 1, 2013, and July 1, 2014, at our institution were examined using a simulated scenario testing for hand hygiene and patient identification. Nurse volunteers posed as patients and evaluated each resident using a standardized scoring tool. Residents were observed for the following behaviors when interacting: (1) hand hygiene before or upon entry into the patient's room (HHE); (2) resident introducing himself or herself (INTRO); (3) resident identifying patient (IDNB); (4) resident comparing patient's stated name and date of birth to patient's ID band (IDC); (5) resident explaining procedure to patient (EXP); and (6) resident performing hand hygiene upon exiting patient's room (HHL). A total of 114 residents were examined. Compliance results were as follows: HHE at 66% (75); INTRO at 96% (110); IDNB at 52% (59); IDC at 42% (48); EXP at 90% (103); and HHL at 58% (66). Developing and hardwiring basic patient safety skills is essential for creating an institutional culture of safety. We used a simulated patient scenario to provide a baseline assessment of 2 important safety skills.The results obtained demonstrate poor compliance with hand hygiene and patient identification. Our results suggest that there is a need for additional training and perhaps new methods of training and reinforcement in medical school and beyond, to hardwire these basic patient safety skills.
Perceived Barriers to the Use of High-Fidelity Hands-On Simulation Training for Contrast Reaction Management: Why Programs are Not Using It.

PubMed

Chinnugounder, Sankar; Hippe, Daniel S; Maximin, Suresh; O'Malley, Ryan B; Wang, Carolyn L

2015-01-01

Although subjective and objective benefits of high-fidelity simulation have been reported in medicine, there has been slow adoption in radiology. The purpose of our study was to identify the perceived barriers in the use of high-fidelity hands-on simulation for contrast reaction management training. An IRB exempt 32 questions online web survey was sent to 179 non-military radiology residency program directors listed in the Fellowship and Residency Electronic Interactive Database Access system (FREIDA). Survey questions included the type of contrast reaction management training, cost, time commitment of residents and faculty, and the reasons for not using simulation training. Responses from the survey were summarized as count (percentage), mean ± standard deviation (SD), or median (range). 84 (47%) of 179 programs responded, of which 88% offered CRM training. Most (72%) conducted the CRM training annually while only 4% conducted it more frequently. Didactic lecture was the most frequently used training modality (97%), followed by HFS (30%) and computer-based simulation (CBS) (19%); 5.5% used both HFS and CBS. Of the 51 programs that offer CRM training but do not use HFS, the most common reason reported was insufficient availability (41%). Other reported reasons included cost (33%), no access to simulation centers (33%), lack of trained faculty (27%) and time constraints (27%). Although high-fidelity hands-on simulation training is the best way to reproduce real-life contrast reaction scenarios, many institutions do not provide this training due to constraints such as cost, lack of access or insufficient availability of simulation labs, and lack of trained faculty. As a specialty, radiology needs to better address these barriers at both an institutional and national level. Copyright © 2015 Mosby, Inc. All rights reserved.
Development of the TARGET Training Effectiveness Tool and Underlying Algorithms Specifying Training Method - Performance Outcome Relationships

DTIC Science & Technology

2014-05-01

hand and right hand on the piano, or strumming and chording on the guitar . Perceptual This skill category involves detecting and interpreting sensory...measured as the percent correct, # correct, accumulated points, task/test scoring correct action/timing/performance. This also includes quality rating by...competition and scoring , as well as constraints, privileges and penalties. Simulation-Based The primary delivery environment is an interactive synthetic
The control of sequential aiming movements: the influence of practice and manual asymmetries on the one-target advantage.

PubMed

Lavrysen, Ann; Helsen, Werner F; Tremblay, Luc; Elliott, Digby; Adam, Jos J; Feys, Peter; Buekers, Martinus J

2003-04-01

The present experiment was conducted to explore the effect of practice on the one-target advantage in manual aiming, as well as asymmetries in intermanual transfer of training. Reaction and movement times for the first movement were longer in the 2-target than in the 1-target task, regardless of the amount of practice, hand preference and practice hand. When two movements were required, peak velocity was lower and, proportionally, more time was spent after peak velocity. Our kinematic results suggest that the one-target advantage is related to both predefined strategies as well as movement implementation processes during execution. Therefore, an integration of advance planning and on-line explanations for the one-target advantage is suggested. Regarding manual asymmetries, right-handers showed more transfer of training from the left to the right hand than vice versa. Left-handers exhibited a reversed pattern of asymmetric transfer of training to right-handers, but they were more disadvantaged using their non-dominant hand. These latter two findings have implications for models of manual asymmetry and upper limb control.
Effects of 8-week sensory electrical stimulation combined with motor training on EEG-EMG coherence and motor function in individuals with stroke.

PubMed

Pan, Li-Ling Hope; Yang, Wen-Wen; Kao, Chung-Lan; Tsai, Mei-Wun; Wei, Shun-Hwa; Fregni, Felipe; Chen, Vincent Chiun-Fan; Chou, Li-Wei

2018-06-15

The peripheral sensory system is critical to regulating motor plasticity and motor recovery. Peripheral electrical stimulation (ES) can generate constant and adequate sensory input to influence the excitability of the motor cortex. The aim of this proof of concept study was to assess whether ES prior to each hand function training session for eight weeks can better improve neuromuscular control and hand function in chronic stroke individuals and change electroencephalography-electromyography (EEG-EMG) coherence, as compared to the control (sham ES). We recruited twelve subjects and randomly assigned them into ES and control groups. Both groups received 20-minute hand function training twice a week, and the ES group received 40-minute ES on the median nerve of the affected side before each training session. The control group received sham ES. EEG, EMG and Fugl-Meyer Assessment (FMA) were collected at four different time points. The corticomuscular coherence (CMC) in the ES group at fourth weeks was significantly higher (p = 0.004) as compared to the control group. The notable increment of FMA at eight weeks and follow-up was found only in the ES group. The eight-week rehabilitation program that implemented peripheral ES sessions prior to function training has a potential to improve neuromuscular control and hand function in chronic stroke individuals.
Active and Passive Haptic Training Approaches in VR Laparoscopic Surgery Training.

PubMed

Marutani, Takafumi; Kato, Toma; Tagawa, Kazuyoshi; Tanaka, Hiromi T; Komori, Masaru; Kurumi, Yoshimasa; Morikawa, Shigehiro

2016-01-01

Laparoscopic surgery has become a widely performed surgery as it is one of the most common minimally invasive surgeries. Doctors perform the surgery by manipulating thin and long surgical instruments precisely with the assistance of laparoscopic video with limited field of view. The power control of the instruments' tip is especially very important, because excessive power may damage internal organs. The training of this surgical technique is mainly supervised by an expert in hands-on coaching program. However, it is difficult for the experts to spend sufficient time for coaching. Therefore, we aim to teach the expert's hand movements in laparoscopic surgery to trainees using VR-based simulator, which is equipped with a guidance force display device. To realize the system, we propose two haptic training approaches for transferring the expert's hand movements to the trainee. One is active training, and the other is passive training. The former approach shows the expert's movements only when the trainee makes large errors while the latter shows the expert's movements continuously. In this study, we validate the applicability of these approaches through tasks in VR laparoscopic surgery training simulator, and identify the differences between these approaches.

Intracortical inhibition and facilitation with unilateral dominant, unilateral nondominant and bilateral movement tasks in left- and right-handed adults.

PubMed

McCombe Waller, Sandy; Forrester, Larry; Villagra, Federico; Whitall, Jill

2008-06-15

To investigate intracortical inhibition and facilitation in response to unilateral dominant, nondominant and bilateral biceps activation and short-term upper extremity training in right- and left-handed adults. Paired-pulse transcranial magnetic stimulation was used to measure intracortical excitability in motor dominant and nondominant cortices of 26 nondisabled adults. Neural facilitation and inhibition were measured in each hemisphere during unilateral dominant, nondominant and bilateral arm activation and after training in each condition. No differences were seen between right- and left-handed subjects. Intracortical facilitation and decreased inhibition were seen in each hemisphere with unilateral activation/training of contralateral muscles and bilateral muscle activation/training. Persistent intracortical inhibition was seen in each hemisphere with ipsilateral muscle activation/training. Inhibition was greater in the nondominant hemisphere during dominant hemisphere activation (dominant arm contraction). Strongly dominant individuals show no difference in intracortical responses given handedness. Intracortical activity with unilateral and bilateral arm activation and short-term training differs based on hemispheric dominance, with the motor dominant hemisphere exerting a larger inhibitory influence over the nondominant hemisphere. Bilateral activation and training have a disinhibitory effect in both dominant and nondominant hemispheres.
Peripheral Intravenous Catheterisation in Obstetric Patients in the Hand or Forearm Vein: A Randomised Trial

PubMed Central

Tan, Peng Chiong; Mackeen, Anjana; Khong, Su Yen; Omar, Siti Zawiah; Azmi, M. A. Noor

2016-01-01

A peripheral intravenous catheter is often inserted as part of care during labour. The catheter is inserted into the back of the hand or lower forearm vein in usual practice. There is no trial data to guide the care provider on which is the better insertion site in any clinical setting. 307 women admitted to the labour ward who required insertion of intravenous catheter were randomised to back of hand or lower forearm vein catheter insertion. Catheter insertion is by junior to mid-grade providers. We evaluated insertion success at the first attempt, pain during insertion and catheter replacement due to malfunction as main outcomes. After catheter removal, we recorded patient satisfaction with site, future site preference and insertion site swelling, bruising, tenderness, vein thrombosis and pain. Insertion of a catheter into back of hand vein is more likely to be successful at the first attempt. Insertion pain score, catheter replacement rate, patient satisfaction, patient fidelity to site in a future insertion and insertion site complications rate are not different between trial arms. In conclusion, both insertion sites are suitable; the back of the hand vein maybe easier to cannulate and seems to be preferred by our frontline providers. PMID:26987593
Learning to Comprehend Foreign-Accented Speech by Means of Production and Listening Training

ERIC Educational Resources Information Center

Grohe, Ann-Kathrin; Weber, Andrea

2016-01-01

The effects of production and listening training on the subsequent comprehension of foreign-accented speech were investigated in a training-test paradigm. During training, German nonnative (L2) and English native (L1) participants listened to a story spoken by a German speaker who replaced all English /?/s with /t/ (e.g., *"teft" for…
Video Games: Utilization of a Novel Strategy to Improve Perceptual-Motor Skills in the Non-Institutionalized Elderly.

ERIC Educational Resources Information Center

Drew, Benjamin; Waters, Judith

One of the most serious problems associated with aging concerns the decline in perceptual-motor skills, due to illness and/or lack of use based on poor motivation. Investigations of training programs to improve hand-eye coordination have yielded mixed results. A study was conducted to examine the effects of a training program to improve hand-eye…
Very brief training for laypeople in hands-only cardiopulmonary resuscitation. Effect of real-time feedback.

PubMed

González-Salvado, Violeta; Fernández-Méndez, Felipe; Barcala-Furelos, Roberto; Peña-Gil, Carlos; González-Juanatey, José Ramón; Rodríguez-Núñez, Antonio

2016-06-01

Bystander cardiopulmonary resuscitation (CPR) improves survival from out-of-hospital cardiac arrest, but rates and performance quality remain low. Although training laypeople is a primary educational goal, the optimal strategy is not well defined. This study aimed to determine whether a short training with real-time feedback was able to improve hands-only CPR among untrained citizens. On the occasion of the 2015 World Heart Day and the European Restart a Heart Day, a pilot study involving 155 participants (81 laypeople, 74 health care professionals) was conducted. Participants were invited to briefly practice hands-only CPR on a manikin and were after evaluated during a 2-minute chest compression (CC) test. During training brief instructions regarding hand position, compression rate and depth according to the current guidelines were given and real-time feedback was provided by a Laerdal SkillReporting System. Mean CC rate was significantly higher among health care professionals than among laypeople (119.07 ± 12.85 vs 113.02 ± 13.90 min(-1); P = .006), although both met the 100-120 CC min(-1) criterion. Laypeople achieved noninferior results regarding % of CC at adequate rate (51.46% ± 35.32% vs health care staff (55.97% ± 36.36%; P = .43) and depth (49.88% ± 38.58% vs 50.46% ± 37.17%; P = .92), % of CC with full-chest recoil (92.77% ± 17.17% vs 0.91% ± 18.84; P = .52), and adequate hand position (96.94% ± 14.78% vs 99.74 ± 1.98%; P = .11). The overall quality performance was greater than 70%, noninferior for citizens (81.23% ± 20.10%) vs health care staff (85.95% ± 14.78%; P = .10). With a very brief training supported by hands-on instructor-led advice and visual feedback, naïve laypeople are able to perform good-quality CC-CPR. Simple instructions, feedback, and motivation were the key elements of this strategy, which could make feasible to train big numbers of citizens. Copyright © 2016 Elsevier Inc. All rights reserved.
Neural Substrates for the Effects of Rehabilitative Training on Motor Recovery After Ischemic Infarct

NASA Astrophysics Data System (ADS)

Nudo, Randolph J.; Wise, Birute M.; Sifuentes, Frank; Milliken, Garrett W.

1996-06-01

Substantial functional reorganization takes place in the motor cortex of adult primates after a focal ischemic infarct, as might occur in stroke. A subtotal lesion confined to a small portion of the representation of one hand was previously shown to result in a further loss of hand territory in the adjacent, undamaged cortex of adult squirrel monkeys. In the present study, retraining of skilled hand use after similar infarcts resulted in prevention of the loss of hand territory adjacent to the infarct. In some instances, the hand representations expanded into regions formerly occupied by representations of the elbow and shoulder. Functional reorganization in the undamaged motor cortex was accompanied by behavioral recovery of skilled hand function. These results suggest that, after local damage to the motor cortex, rehabilitative training can shape subsequent reorganization in the adjacent intact cortex, and that the undamaged motor cortex may play an important role in motor recovery.
Hands-on workshops as an effective means of learning advanced technologies including genomics, proteomics and bioinformatics.

PubMed

Reisdorph, Nichole; Stearman, Robert; Kechris, Katerina; Phang, Tzu Lip; Reisdorph, Richard; Prenni, Jessica; Erle, David J; Coldren, Christopher; Schey, Kevin; Nesvizhskii, Alexey; Geraci, Mark

2013-12-01

Genomics and proteomics have emerged as key technologies in biomedical research, resulting in a surge of interest in training by investigators keen to incorporate these technologies into their research. At least two types of training can be envisioned in order to produce meaningful results, quality publications and successful grant applications: (1) immediate short-term training workshops and (2) long-term graduate education or visiting scientist programs. We aimed to fill the former need by providing a comprehensive hands-on training course in genomics, proteomics and informatics in a coherent, experimentally-based framework. This was accomplished through a National Heart, Lung, and Blood Institute (NHLBI)-sponsored 10-day Genomics and Proteomics Hands-on Workshop held at National Jewish Health (NJH) and the University of Colorado School of Medicine (UCD). The course content included comprehensive lectures and laboratories in mass spectrometry and genomics technologies, extensive hands-on experience with instrumentation and software, video demonstrations, optional workshops, online sessions, invited keynote speakers, and local and national guest faculty. Here we describe the detailed curriculum and present the results of short- and long-term evaluations from course attendees. Our educational program consistently received positive reviews from participants and had a substantial impact on grant writing and review, manuscript submissions and publications. Copyright © 2013. Production and hosting by Elsevier Ltd.
Assessment of Self-Contamination During Removal of Personal Protective Equipment for Ebola Patient Care.

PubMed

Casanova, Lisa M; Teal, Lisa J; Sickbert-Bennett, Emily E; Anderson, Deverick J; Sexton, Daniel J; Rutala, William A; Weber, David J

2016-10-01

OBJECTIVE Ebola virus disease (EVD) places healthcare personnel (HCP) at high risk for infection during patient care, and personal protective equipment (PPE) is critical. Protocols for EVD PPE doffing have not been validated for prevention of viral self-contamination. Using surrogate viruses (non-enveloped MS2 and enveloped Φ6), we assessed self-contamination of skin and clothes when trained HCP doffed EVD PPE using a standardized protocol. METHODS A total of 15 HCP donned EVD PPE for this study. Virus was applied to PPE, and a trained monitor guided them through the doffing protocol. Of the 15 participants, 10 used alcohol-based hand rub (ABHR) for glove and hand hygiene and 5 used hypochlorite for glove hygiene and ABHR for hand hygiene. Inner gloves, hands, face, and scrubs were sampled after doffing. RESULTS After doffing, MS2 virus was detected on the inner glove worn on the dominant hand for 8 of 15 participants, on the non-dominant inner glove for 6 of 15 participants, and on scrubs for 2 of 15 participants. All MS2 on inner gloves was observed when ABHR was used for glove hygiene; none was observed when hypochlorite was used. When using hypochlorite for glove hygiene, 1 participant had MS2 on hands, and 1 had MS2 on scrubs. CONCLUSIONS A structured doffing protocol using a trained monitor and ABHR protects against enveloped virus self-contamination. Non-enveloped virus (MS2) contamination was detected on inner gloves, possibly due to higher resistance to ABHR. Doffing protocols protective against all viruses need to incorporate highly effective glove and hand hygiene agents. Infect Control Hosp Epidemiol 2016;1-6.
Resiliency and Aggression Replacement Training[R] with Families

ERIC Educational Resources Information Center

Calame, Robert; Parker, Kimberlee; Amendola, Mark; Oliver, Robert

2011-01-01

Aggression Replacement Training[R] (ART) is a psychoeducational approach to working with young people who experience difficulties with interpersonal relationships and prosocial behavior. ART[R] originated with Skillstreaming and developed into a three-component model. Arnold P. Goldstein recognized that the complex problems of youth would not…
Development of a Tissue Engineered Scaffold for Meniscus Replacement

DTIC Science & Technology

2008-12-01

include loss of manpower, rehabilitation costs, waste of training time/ money , cost to retrain members as replacements, hospitalization costs, disability...injuries in the United States Armed Forces. Mil Med, 1999. 164(8 Suppl): p. 633 pages. Lauder , T.D., et al., Sports and physical training injury
How many training modalities are needed to obtain procedural confidence in intraosseous access? A questionnaire study.

PubMed

Hallas, Peter; Folkestad, Lars; Brabrand, Mikkel

2011-12-01

Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiology societies in Scandinavia. The responders without real-life experience with IO (n=322) were classified as 'not confident' or 'confident' in IO. Of total responders 22.8% without training felt confident. Confidence increased to 74.8% after one training modality, 87.9% after two modalities, 98.7% after three modalities and 100% after four modalities (P<0.0001). Of total responders 89.5% who had 'workshop or similar training with hands-on experience' as sole teaching method was confident. Confidence in IO increases with the number of learning modalities. 'Workshop or similar training with hands-on experience' as single training modality seemed as effective as the combination of two modalities.
Sensory stimulation augments the effects of massed practice training in persons with tetraplegia.

PubMed

Beekhuizen, Kristina S; Field-Fote, Edelle C

2008-04-01

To compare functional changes and cortical neuroplasticity associated with hand and upper extremity use after massed (repetitive task-oriented practice) training, somatosensory stimulation, massed practice training combined with somatosensory stimulation, or no intervention, in persons with chronic incomplete tetraplegia. Participants were randomly assigned to 1 of 4 groups: massed practice training combined with somatosensory peripheral nerve stimulation (MP+SS), somatosensory peripheral nerve stimulation only (SS), massed practice training only (MP), and no intervention (control). University medical school setting. Twenty-four subjects with chronic incomplete tetraplegia. Intervention sessions were 2 hours per session, 5 days a week for 3 weeks. Massed practice training consisted of repetitive practice of functional tasks requiring skilled hand and upper-extremity use. Somatosensory stimulation consisted of median nerve stimulation with intensity set below motor threshold. Pre- and post-testing assessed changes in functional hand use (Jebsen-Taylor Hand Function Test), functional upper-extremity use (Wolf Motor Function Test), pinch grip strength (key pinch force), sensory function (monofilament testing), and changes in cortical excitation (motor evoked potential threshold). The 3 groups showed significant improvements in hand function after training. The MP+SS and SS groups had significant improvements in upper-extremity function and pinch strength compared with the control group, but only the MP+SS group had a significant change in sensory scores compared with the control group. The MP+SS and MP groups had greater change in threshold measures of cortical excitability. People with chronic incomplete tetraplegia obtain functional benefits from massed practice of task-oriented skills. Somatosensory stimulation appears to be a valuable adjunct to training programs designed to improve hand and upper-extremity function in these subjects.
Replacement Attack: A New Zero Text Watermarking Attack

NASA Astrophysics Data System (ADS)

Bashardoost, Morteza; Mohd Rahim, Mohd Shafry; Saba, Tanzila; Rehman, Amjad

2017-03-01

The main objective of zero watermarking methods that are suggested for the authentication of textual properties is to increase the fragility of produced watermarks against tampering attacks. On the other hand, zero watermarking attacks intend to alter the contents of document without changing the watermark. In this paper, the Replacement attack is proposed, which focuses on maintaining the location of the words in the document. The proposed text watermarking attack is specifically effective on watermarking approaches that exploit words' transition in the document. The evaluation outcomes prove that tested word-based method are unable to detect the existence of replacement attack in the document. Moreover, the comparison results show that the size of Replacement attack is estimated less accurate than other common types of zero text watermarking attacks.
A Distance Learning Case Study.

ERIC Educational Resources Information Center

Boord, Patricia M.

1998-01-01

To address diminishing resources and increased training demands, the Operational Training Unit (OTU) of the Federal Bureau of Investigation has saved almost $2 million by developing a distance education course to replace one full week of training at the FBI Academy. Discussion focuses on major issues faced by OTU in designing/delivering this…
Prehensile control of a hand prosthesis by a microcontroller.

PubMed

Chappell, P H; Kyberd, P J

1991-09-01

The functional replacement of a natural hand and wrist is usually achieved by a split hook or an electrically powered and myoelectrically controlled artificial hand with one degree of freedom. In contrast to the commercial devices, this paper describes an experimental hand with four electric motors, nineteen sensors, and control algorithms which are written for a microcontroller. The hand significantly improves the prehension capabilities of an artificial device and leads to a design which is easily controlled by a user as it mimics the control system of the natural hand.
T-4G Methodology: Undergraduate Pilot Training T-37 Phase.

ERIC Educational Resources Information Center

Woodruff, Robert R.; And Others

The report's brief introduction describes the application of T-4G methodology to the T-37 instrument phase of undergraduate pilot training. The methodology is characterized by instruction in trainers, proficiency advancement, a highly structured syllabus, the training manager concept, early exposure to instrument training, and hands-on training.…
Development of a Minimum Performance Standard for Hand-Held Fire Extinguishers as a Replacement for Halon 1211 on Civilian Transport Category Aircraft

NASA Astrophysics Data System (ADS)

Webster, Harry

2002-08-01

One or more Halon 1211 hand-held fire extinguishers are specified in Federal Aviation Regulation (FAR) Part 25.851 as a requirement on transport category aircraft with 31 or more seats. Halon 1211 has been linked to the destruction of the ozone layer and production of new Halon 1211 has been halted per the Montreal Protocol in 1993. The phase out of Halon 1211, as the hand-held firefighting agent of choice, for civilian transport category aircraft has necessitated the development of a Minimum Performance Standard (MPS) to evaluate replacement agents. The purpose of the MPS is to insure that there is no reduction in safety, both in terms of effectiveness in fighting onboard fires and toxicity to the passengers and crew. The MPS specifies two new tests that replacement agents must pass in addition to requiring national certifications such as provided by Underwriters Laboratories. The first test evaluates the "flooding" characteristics of the agent against a hidden in-flight fire. This test determines the ability of a streaming agent to function as a flooding agent. The second test evaluates the performance of the agent in fighting a terrorist fire scenario and the associated toxicity hazard. This test measures the agent's ability to extinguish a triple-seat fire in an aircraft cabin under in-flight conditions and the toxicity characteristics of both the neat agent and the products of decomposition. This MPS will insure that the replacement agents will meet or exceed the performance of Halon 1211 both in fighting fires and maintaining a safe breathing environment in aircraft cabins.
Georgia Turns to the West for Ideas

ERIC Educational Resources Information Center

Nemtsova, Anna

2008-01-01

Georgia, along with a number of other former Soviet countries, is rapidly reforming its higher-education system. Russian is being replaced by English in classrooms and textbooks. Western-trained professors are flooding campuses with new methods of teaching and liberal-arts courses are replacing vocational training. This change is part of broader…
School-Based Aggression Replacement Training

ERIC Educational Resources Information Center

Roth, Becky Sue; Striepling-Goldstein, Susan

2003-01-01

Aggression Replacement Training (ART) is a potent K-12 intervention that responds to many of the developmental and natural needs of aggressive and antisocial students. Woven into the curriculum preventatively or as a stand-alone course in response to an antisocial school climate, ART facilitates the learning necessary to reach and provide lasting…
Learning by viewing versus learning by doing: A comparative study of observer and participant experiences during an interprofessional simulation training.

PubMed

Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Engeberg, Janecke Merethe; Breivik, Marit; Brattebø, Guttorm

2017-01-01

Larger student groups and pressure on limited faculty time have raised the question of the learning value of merely observing simulation training in emergency medicine, instead of active team participation. The purpose of this study was to examine observers and hands-on participants' self-reported learning outcomes during simulation-based interprofessional team training regarding non-technical skills. In addition, we compared the learning outcomes for different professions and investigated team performance relative to the number of simulations in which they participated. A concurrent mixed-method design was chosen to evaluate the study, using questionnaires, observations, and focus group interviews. Participants included a total of 262 postgraduate and bachelor nursing students and medical students, organised into 44 interprofessional teams. The quantitative data showed that observers and participants had similar results in three of six predefined learning outcomes. The qualitative data emphasised the importance of participating in different roles, training several times, and training interprofessionally to enhance realism. Observing simulation training can be a valuable learning experience, but the students' preferred hands-on participation and learning by doing. For this reason, one can legitimise the observer role, given the large student groups and limited faculty time, as long as the students are also given some opportunity for hands-on participation in order to become more confident in their professional roles.

An IoT-Enabled Stroke Rehabilitation System Based on Smart Wearable Armband and Machine Learning

PubMed Central

Yang, Geng; Pang, Gaoyang; Zhang, Hao; Li, Jiayi; Deng, Bin; Pang, Zhibo; Xu, Juan; Jiang, Mingzhe; Liljeberg, Pasi; Xie, Haibo; Yang, Huayong

2018-01-01

Surface electromyography signal plays an important role in hand function recovery training. In this paper, an IoT-enabled stroke rehabilitation system was introduced which was based on a smart wearable armband (SWA), machine learning (ML) algorithms, and a 3-D printed dexterous robot hand. User comfort is one of the key issues which should be addressed for wearable devices. The SWA was developed by integrating a low-power and tiny-sized IoT sensing device with textile electrodes, which can measure, pre-process, and wirelessly transmit bio-potential signals. By evenly distributing surface electrodes over user’s forearm, drawbacks of classification accuracy poor performance can be mitigated. A new method was put forward to find the optimal feature set. ML algorithms were leveraged to analyze and discriminate features of different hand movements, and their performances were appraised by classification complexity estimating algorithms and principal components analysis. According to the verification results, all nine gestures can be successfully identified with an average accuracy up to 96.20%. In addition, a 3-D printed five-finger robot hand was implemented for hand rehabilitation training purpose. Correspondingly, user’s hand movement intentions were extracted and converted into a series of commands which were used to drive motors assembled inside the dexterous robot hand. As a result, the dexterous robot hand can mimic the user’s gesture in a real-time manner, which shows the proposed system can be used as a training tool to facilitate rehabilitation process for the patients after stroke. PMID:29805919
Alcohol-based instant hand sanitizer use in military settings: a prospective cohort study of Army basic trainees.

PubMed

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.
Objective Structured Assessment of Technical Skills (OSATS) evaluation of theoretical versus hands-on training of vaginal breech delivery management: a randomized trial.

PubMed

Buerkle, Bernd; Rueter, Katharina; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2013-12-01

To compare the skills of performing a vaginal breech (VB) delivery after hands-on training versus demonstration. We randomized medical students to a 30-min demonstration (group 1) or a 30-min hands-on (group 2) training session using a standardized VB management algorithm on a pelvic training model. Subjects were tested with a 25 item Objective Structured Assessment of Technical Skills (OSATS) scoring system immediately after training and 72 h thereafter. OSATS scores were the primary outcome. Performance time (PT), self assessment (SA), confidence (CON), and global rating scale (GRS) were the secondary outcomes. Statistics were performed using the Mann-Whitney U-test, chi-square test, and multiple linear regression analysis. 172 subjects were randomized. OSATS scores (primary outcome) were significantly higher in group 2 (n=88) compared to group 1 (n=84) (21.18±2.29 vs. 20.19±2.37, respectively; p=0.006). The secondary outcomes GRS (10.31±2.28 vs. 9.17±2.21; p=0.001), PT (214.60±57.97 s vs. 246.98±59.34 s; p<0.0001), and CON (3.14±0.89 vs. 2.85±0.90; p=0.04) were also significantly different between groups, favoring group 2. After 72 h, primary and secondary outcomes were not significantly different between groups. In a multiple linear regression analysis, group assignment (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.14-2.05; p<0.0001) and gender (OR 2.91; 95% CI 2.45-3.38; p<0.0001) independently influenced OSATS scores. Hands-on training leads to a significant improvement of VB management in a pelvic training model, but this effect was only seen in the short term. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Approach-Avoidance Training Effects Are Moderated by Awareness of Stimulus-Action Contingencies.

PubMed

Van Dessel, Pieter; De Houwer, Jan; Gast, Anne

2016-01-01

Prior research suggests that repeatedly approaching or avoiding a stimulus changes the liking of that stimulus. In two experiments, we investigated the relationship between, on one hand, effects of approach-avoidance (AA) training on implicit and explicit evaluations of novel faces and, on the other hand, contingency awareness as indexed by participants' memory for the relation between stimulus and action. We observed stronger effects for faces that were classified as contingency aware and found no evidence that AA training caused changes in stimulus evaluations in the absence of contingency awareness. These findings challenge the standard view that AA training effects are (exclusively) the product of implicit learning processes, such as the automatic formation of associations in memory. © 2015 by the Society for Personality and Social Psychology, Inc.
Transmission of helminth eggs through hands in a high-risk community.

PubMed

Gulliver, Francesca; Jeandron, Aurelie; Nguyen, Viet Anh; Do, Hong Anh; Ensink, Jeroen H J

2014-10-01

The role that hands play in the transmission of Ascaris is not well understood. A newly developed method to quantify the presence helminth eggs on hands was tested among a group of farmers in Vietnam. High turbidity in hand rinse samples meant that the adopted sugar solution had to be replaced by zinc sulphate as a flotation solution. The survey found 34% (31/90) of study participant hands' were positive for helminth eggs, though concentrations were low and ranged from 0-10 eggs/2 hands. The use of fresh excreta in agriculture was the only variable that showed an association with the concentrations of eggs found on hands. The results highlight the need to promote handwashing with soap to prevent the transmission of soil-transmitted helminth infections. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Innovative approaches to the rehabilitation of upper extremity hemiparesis using virtual environments

PubMed Central

MERIANS, A. S.; TUNIK, E.; FLUET, G. G.; QIU, Q.; ADAMOVICH, S. V.

2017-01-01

Aim Upper-extremity interventions for hemiparesis are a challenging aspect of stroke rehabilitation. Purpose of this paper is to report the feasibility of using virtual environments (VEs) in combination with robotics to assist recovery of hand-arm function and to present preliminary data demonstrating the potential of using sensory manipulations in VE to drive activation in targeted neural regions. Methods We trained 8 subjects for 8 three hour sessions using a library of complex VE’s integrated with robots, comparing training arm and hand separately to training arm and hand together. Instrumented gloves and hand exoskeleton were used for hand tracking and haptic effects. Haptic Master robotic arm was used for arm tracking and generating three-dimensional haptic VEs. To investigate the use of manipulations in VE to drive neural activations, we created a “virtual mirror” that subjects used while performing a unimanual task. Cortical activation was measured with functional MRI (fMRI) and transcranial magnetic stimulation. Results Both groups showed improvement in kinematics and measures of real-world function. The group trained using their arm and hand together showed greater improvement. In a stroke subject, fMRI data suggested virtual mirror feedback could activate the sensorimotor cortex contralateral to the reflected hand (ipsilateral to the moving hand) thus recruiting the lesioned hemisphere. Conclusion Gaming simulations interfaced with robotic devices provide a training medium that can modify movement patterns. In addition to showing that our VE therapies can optimize behavioral performance, we show preliminary evidence to support the potential of using specific sensory manipulations to selectively recruit targeted neural circuits. PMID:19158659
Gaps in exposure to essential competencies in hand surgery fellowship training: a national survey of program directors.

PubMed

Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

2013-03-01

Graduate medical education has moved towards competency-based training. The aim of this study was to assess hand surgery program directors' opinions of exposure gaps in core competencies rated as essential for hand surgery training. We surveyed the 74 ACGME hand surgery fellowship program directors. Respondents rated their opinion of 9 general areas of practice, 97 knowledge topics, and 172 procedures into one of three categories: essential, exposure needed, or unnecessary. Program directors also rated trainee exposure of each component at their respective program. Moderate and large exposure gaps were respectively defined as presence of at least 25 and 50 % of programs rating trainees as not having proficiency in the component at the end of training. Sixty-two of 74 program directors (84 %) responded to the survey. For the 76 knowledge topics and 98 procedures rated as essential, a majority of the knowledge topics (61 %; n = 46) and procedures (72 %; n = 71) had at least a moderate exposure gap. In addition, 22 % (n = 17) of the essential knowledge topics and 26 % (n = 25) of the essential procedures had a large exposure gap. This study illuminates the discrepancies between what is believed to be important for practicing hand surgeons and graduates' proficiency as perceived by program directors. The field of hand surgery must work to determine if program directors have unrealistic expectations for what is essential for practicing hand surgeons or if reforms are needed to improve exposure to essential skills in hand surgery training.
Relationship between the Short-Term Visual Memory and IQ in the Right-and Left-Handed Subjects Trained in Different Educational Programs: I-General Assessment

ERIC Educational Resources Information Center

Yilmaz, Yavuz; Yetkin, Yalçin

2014-01-01

The relationship between mean intelligence quotient (IQ), hand preferences and visual memory (VM) were investigated on (N = 612) males and females students trained in different educational programs in viewpoint of laterality. IQ was assessed by cattle's culture Fair intelligence test-A (CCFIT-A). The laterality of the one side of the body was…
Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement.

PubMed

Valtonen, Anu; Pöyhönen, Tapani; Sipilä, Sarianna; Heinonen, Ari

2010-06-01

To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area. Randomized controlled trial. Research laboratory and hospital rehabilitation pool. Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial. Twelve-week progressive aquatic resistance training (n=26) or no intervention (n=24). Mobility limitation assessed by walking speed and stair ascending time, and self-reported physical functional difficulty, pain, and stiffness assessed by Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire. Knee extensor power and knee flexor power assessed isokinetically, and thigh muscle cross-sectional area (CSA) by computed tomography. Compared with the change in the control group, habitual walking speed increased by 9% (P=.005) and stair ascending time decreased by 15% (P=.006) in the aquatic training group. There was no significant difference between the groups in the WOMAC scores. The training increased knee extensor power by 32% (P<.001) in the operated and 10% (P=.001) in the nonoperated leg, and knee flexor power by 48% (P=.003) in the operated and 8% (P=.002) in the nonoperated leg compared with controls. The mean increase in thigh muscle CSA of the operated leg was 3% (P=.018) and that of the nonoperated leg 2% (P=.019) after training compared with controls. Progressive aquatic resistance training had favorable effects on mobility limitation by increasing walking speed and decreasing stair ascending time. In addition, training increased lower limb muscle power and muscle CSA. Resistance training in water is a feasible mode of rehabilitation that has wide-ranging positive effects on patients after knee replacement surgery. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Hand and Wrist Injuries in Elite Boxing: A Longitudinal Prospective Study (2005-2012) of the Great Britain Olympic Boxing Squad.

PubMed

Loosemore, Michael; Lightfoot, Joseph; Gatt, Ian; Hayton, Mike; Beardsley, Chris

2017-03-01

Background: The purpose of this investigation was to explore prospectively the nature and duration of hand and wrist injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2012. Methods: Longitudinal prospective injury surveillance of the GB boxing squad was performed from 2005 to 2012. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 hours. Results: Finger carpometacarpal instability and finger metacarpophalangeal joint extensor hood and capsule sprain also known as "boxer's knuckle" injuries were significantly more common than other injury diagnoses. The number of injuries during training or competition was similar, which is remarkable given the far greater number of training hours than competition hours performed. Injury rate for hand and wrist injuries in competition was 347 injuries per 1000 hours, while the estimated injury rate in training was <0.5 injuries per 1000 hours. Conclusion: Carpometacarpal instability and boxer's knuckle were more common than any other kind of hand and wrist injury in this cohort of elite amateur boxers. The rate of hand and wrist injuries was higher in competition than in training. Our study highlights the importance of hand and wrist injury prevention in the competition environment.
Talking Typewriter Training Program in a Rehabilitation Setting.

ERIC Educational Resources Information Center

Kupshunas, Sue

1984-01-01

As part of a state residential center's 16-week training program to assist blind adults, aged 16-65, in acquiring employability skills, clients receive hands-on training in mastering the IBM Memory 100 Audio Unit typewriter. Training includes assessing prerequisite secretarial skills, using self-instructional materials, and evaluating performance.…
Robotics Technician Training at Macomb Community College.

ERIC Educational Resources Information Center

Lynch, Edward J.

Approved in 1979, the robotics technician training program at Macomb County Community College (MCC) in Warren (Michigan) provides students with training in hydraulics and electronics as well as with hands-on training in the area of robotics. Furthermore, the program faculty includes individuals with work experience in electronics, fluid power, and…
Training at altitude in practice.

PubMed

Dick, F W

1992-10-01

There can be little doubt that training at altitude is fundamental to preparing an athlete for competition at altitude. However the value of training at altitude for competition at sea level appears on the one hand to lack total acceptance amongst sports scientists; and on the other to hold some cloak of mystery for coaches who have yet to enjoy first hand experience. The fact is that very few endurance athletes will ignore the critical edge which altitude training affords. Each fraction of a percentage of performance advantage gained through methods which are within the rules of fair play in sport, may shift the balance between failure and achievement. Moreover, there is growing support for application of training at altitude for speed-related disciplines. This paper aims to demystify the subject by dealing with practical aspects of training at altitude. Such aspects include a checklist of what should and should not be done at altitude, when to use altitude relative to target competitions, and specific training examples.
U.S. Army Medical Department Journal, October-December 2007

DTIC Science & Technology

2007-12-01

Warrior Task Training requirements (such as weapons assembly/disassembly and functions check; individual chemical, biological , radiological, nuclear...training program focused on hands-on training in the 40 Army Warrior Tasks and 11 Battle Drills, to include advanced land navigation training; weapons ...familiarization and qualification; convoy operations; chemical, biological , radiological, nuclear and high- explosive defense; and squad and platoon
Method for neural network control of motion using real-time environmental feedback

NASA Technical Reports Server (NTRS)

Buckley, Theresa M. (Inventor)

1997-01-01

A method of motion control for robotics and other automatically controlled machinery using a neural network controller with real-time environmental feedback. The method is illustrated with a two-finger robotic hand having proximity sensors and force sensors that provide environmental feedback signals. The neural network controller is taught to control the robotic hand through training sets using back- propagation methods. The training sets are created by recording the control signals and the feedback signal as the robotic hand or a simulation of the robotic hand is moved through a representative grasping motion. The data recorded is divided into discrete increments of time and the feedback data is shifted out of phase with the control signal data so that the feedback signal data lag one time increment behind the control signal data. The modified data is presented to the neural network controller as a training set. The time lag introduced into the data allows the neural network controller to account for the temporal component of the robotic motion. Thus trained, the neural network controlled robotic hand is able to grasp a wide variety of different objects by generalizing from the training sets.
Heavy-metal contamination on training ranges at the Grafenwoehr Training Area, Germany

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zellmer, S.D.; Schneider, J.F.

1993-05-01

Large quantities of lead and other heavy metals are deposited in the environment of weapons ranges during training exercises. This study was conducted to determine the type, degree, and extent of heavy-metal contamination on selected handgun, rifle, and hand-grenade ranges at Grafenwoehr Training Area, Germany. Soil, vegetation, and surface-water samples were collected and analyzed using the inductively-coupled plasma atomic-emission spectroscopy (ICP-AES) method and the toxic characterization leaching procedure (TCLP). The ICP-AES results show that above-normal levels of lead and copper are in the surface soil at the handgun range, high concentrations of lead and copper are in the berm andmore » soil surface at the rifle range, and elevated levels of cadmium and above-normal concentrations of arsenic, copper, and zinc are present in the surface soil at the hand-grenade range. The TCLP results show that surface soils can be considered hazardous waste because of lead content at the rifle range and because of cadmium concentration at the hand-grenade range. Vegetation at the handgun and rifle ranges has above-normal concentrations of lead. At the hand-grenade range, both vegetation and surface water have high levels of cadmium. A hand-held X-ray fluorescence (XRF) spectrum analyzer was used to measure lead concentrations in soils in a field test of the method. Comparison of XRF readings with ICP-AES results for lead indicate that the accuracy and precision of the hand-held XRF unit must improve before the unit can be used as more than a screening tool. Results of this study show that heavy-metal contamination at all three ranges is limited to the surface soil; heavy metals are not being leached into the soil profile or transported into adjacent areas.« less
Effects of repetitive transcranial magnetic stimulation in performing eye-hand integration tasks: four preliminary studies with children showing low-functioning autism.

PubMed

Panerai, Simonetta; Tasca, Domenica; Lanuzza, Bartolo; Trubia, Grazia; Ferri, Raffaele; Musso, Sabrina; Alagona, Giovanna; Di Guardo, Giuseppe; Barone, Concetta; Gaglione, Maria P; Elia, Maurizio

2014-08-01

This report, based on four studies with children with low-functioning autism, aimed at evaluating the effects of repetitive transcranial magnetic stimulation delivered on the left and right premotor cortices on eye-hand integration tasks; defining the long-lasting effects of high-frequency repetitive transcranial magnetic stimulation; and investigating the real efficacy of high-frequency repetitive transcranial magnetic stimulation by comparing three kinds of treatments (high-frequency repetitive transcranial magnetic stimulation, a traditional eye-hand integration training, and both treatments combined). Results showed a significant increase in eye-hand performances only when high-frequency repetitive transcranial magnetic stimulation was delivered on the left premotor cortex; a persistent improvement up to 1 h after the end of the stimulation; better outcomes in the treatment combining high-frequency repetitive transcranial magnetic stimulation and eye-hand integration training. Based on these preliminary findings, further evaluations on the usefulness of high-frequency repetitive transcranial magnetic stimulation in rehabilitation of children with autism are strongly recommended. © The Author(s) 2013.
Enhanced Aggression Replacement Training with Children and Youth with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Moynahan, Luke

2003-01-01

An enhanced form of Aggression Replacement Training is being used with children and youth with autism spectrum disorder and particularly those with Asperger's Syndrome who present behavioural challenges. Initial results in a Norwegian centre indicate that, with some modifications and enhancements, the programme is an appropriate strategy for…
Cues-Pause-Point Language Training: Teaching Echolalics Functional Use of Their Verbal Labeling Repertoires.

ERIC Educational Resources Information Center

McMorrow, Martin J.; And Others

1987-01-01

A cues-pause-point procedure was used to train two severely retarded females to remain quiet before, during, and briefly after the presentation of questions and then to verbalize on the basis of environmental cues whose labels represented the correct responses. Echolalia was rapidly replaced by correct responding on the trained stimuli. (Author/JW)
Electromyography Biofeedback Exergames to Enhance Grip Strength and Motivation.

PubMed

Garcia-Hernandez, Nadia; Garza-Martinez, Karen; Parra-Vega, Vicente

2018-02-01

Hand strength weakness affects the performance of most activities of daily living. This study aims to design, develop, and test an electromyography (EMG) biofeedback training system based on serious games to promote motivation and synchronization and proper work intensity in grip exercises for improving hand strength. An EMG surface sensor, soft balls with different stiffness and three exergames, conforms the system to drive videogame clues in response to EMG-inferred grip strength, while overseeing motivation. An experiment was designed to study the effect of performing handgrip (HG) exercises with the proposed system versus traditional exercises. Participants, organized into two groups, followed a training program for each hand. One group followed a HG exergame training (ET) with the dominant hand and traditional HG training with the nondominant hand and inverse sequence by the second group. Initial and final grip forces were measured using a digital dynamometer. Questionnaires evaluated motivation and user experience, and exercise performance was evaluated in terms of work and rest time percentage and maximal voluntary contraction percentage over contraction periods. Data were analyzed for statistically significant differences and increase of means. Participants showed significantly better exercise performance and higher grip forces, with sustained intrinsic motivation and user experience, with the ET. Improvement in force level arises evidently from the synchronized work-rest time pattern and appropriated intensity of the muscle activity. This leads to support that EMG biofeedback exergames improve motor neurons firing and resting.

Is the cervical vertebral maturation (CVM) method effective enough to replace the hand-wrist maturation (HWM) method in determining skeletal maturation?-A systematic review.

PubMed

Szemraj, Agnieszka; Wojtaszek-Słomińska, Anna; Racka-Pilszak, Bogna

2018-05-01

Chronological age provides only general information on the development of a child/adolescent. However, the biological age of the patient is more significant. One of the methods is the determination of the bone age based on the development of the hand and wrist bones. In 1972 a method for assessing cervical vertebral maturation on the cephalometric radiographs was introduced (CVM method). As a result, additional patient radiation was eliminated. Currently, this type of radiograph is routinely applied in orthodontic treatment. The aim of the study was to assess the usefulness of the CVM method and to verify the assumption, according to which the CVM method modified by Baccetti et al. may replace the method for the assessment of skeletal maturation based on a hand-wrist X-ray, which is known as the hand-wrist maturation (HWM) method. The present study reviewed the literature between 2006 and 2016. In the first stage of selection 905 articles were obtained. Finally, 10 articles were enrolled for the review. All of the studies presented a high level of correlation between the examined methods. In eight articles the researchers admitted that the CVM classification could replace the HWM method, known as the "gold standard". In two studies , the researchers suggested considering the CVM method an additional method despite its compatibility and usefulness. The lowest correlation coefficient was 0.616 and the highest 0.937. The assessment of the skeletal age with the CVM is done on a cephalometric radiograph, routinely used in orthodontic practice, which makes it easy to apply. The determination of features of only C2, C3 and C4 vertebrae is possible even if the patient wears an X-ray protective thyroid collar. Therefore, the radiation dose is minimized. The CVM method shows a high level of correlation with the HWM method. Copyright © 2018 Elsevier B.V. All rights reserved.
Society of Neurological Surgeons boot camp courses: knowledge retention and relevance of hands-on learning after 6 months of postgraduate year 1 training.

PubMed

Selden, Nathan R; Anderson, Valerie C; McCartney, Shirley; Origitano, Thomas C; Burchiel, Kim J; Barbaro, Nicholas M

2013-09-01

In July 2010, the Society of Neurological Surgeons (SNS) introduced regional courses to promote patient safety and teach fundamental skills and knowledge to all postgraduate Year 1 (PGY1) trainees entering Accreditation Council for Graduate Medical Education (ACGME)-accredited US neurosurgery residency programs. Data from these courses demonstrated significant didactic learning and high faculty and resident satisfaction with hands-on training. Here, the authors evaluated the durability of learning from and the relevance of participation in SNS PGY1 courses as measured midway through PGY1 training. Resident participants were resurveyed 6 months after boot camp course attendance to assess knowledge retention and course effectiveness. Exposure to relevant hands-on experiences during PGY1 training and the subjective value of pre-residency simulated training in the courses were assessed. Ninety-four percent of all residents entering US PGY1 neurosurgical training participated in the 2010 SNS boot camp courses. One hundred sixty-four (88%) of these resident participants responded to the survey. Six months after course completion, 99% of respondents believed the boot camp courses benefited beginning neurosurgery residents and imparted skills and knowledge that would improve patient care. The PGY1 residents' knowledge of information taught in the courses was retained 6 months after initial testing (p < 0.0001). The learning and other benefits of participation in a national curriculum for residents entering PGY1 neurosurgical training were maintained 6 months after the courses, halfway through the initial training year.
Use of a machine learning algorithm to classify expertise: analysis of hand motion patterns during a simulated surgical task.

PubMed

Watson, Robert A

2014-08-01

To test the hypothesis that machine learning algorithms increase the predictive power to classify surgical expertise using surgeons' hand motion patterns. In 2012 at the University of North Carolina at Chapel Hill, 14 surgical attendings and 10 first- and second-year surgical residents each performed two bench model venous anastomoses. During the simulated tasks, the participants wore an inertial measurement unit on the dorsum of their dominant (right) hand to capture their hand motion patterns. The pattern from each bench model task performed was preprocessed into a symbolic time series and labeled as expert (attending) or novice (resident). The labeled hand motion patterns were processed and used to train a Support Vector Machine (SVM) classification algorithm. The trained algorithm was then tested for discriminative/predictive power against unlabeled (blinded) hand motion patterns from tasks not used in the training. The Lempel-Ziv (LZ) complexity metric was also measured from each hand motion pattern, with an optimal threshold calculated to separately classify the patterns. The LZ metric classified unlabeled (blinded) hand motion patterns into expert and novice groups with an accuracy of 70% (sensitivity 64%, specificity 80%). The SVM algorithm had an accuracy of 83% (sensitivity 86%, specificity 80%). The results confirmed the hypothesis. The SVM algorithm increased the predictive power to classify blinded surgical hand motion patterns into expert versus novice groups. With further development, the system used in this study could become a viable tool for low-cost, objective assessment of procedural proficiency in a competency-based curriculum.
Private Astronaut Training Prepares Commercial Crews of Tomorrow

NASA Technical Reports Server (NTRS)

2015-01-01

A new company that includes a handful of former NASA personnel is already taking applications for the first comprehensive commercial astronaut training approved by the Federal Aviation Administration. Waypoint 2 Space, located at Johnson Space Center, hopes to draw space tourists and enthusiasts and future commercial crewmembers with first-hand NASA know-how, as well as agency training technology.
MIST VR. A laparoscopic surgery procedures trainer and evaluator.

PubMed

Sutton, C; McCloy, R; Middlebrook, A; Chater, P; Wilson, M; Stone, R

1997-01-01

The key bimanual instrument tasks involved in laparoscopic surgery have been abstracted for use in a virtual reality surgical skills evaluator and trainer. The trainer uses two laparoscopic instruments mounted on a frame with position sensors which provide instrument movement data that is translated into interactive real time graphics on a PC (P133, 16 Mb RAM, graphics acceleration card). An accurately scaled operating volume of 10 cm3 is represented by a 3D cube on the computer screen. "Camera" position and size of target objects can be varied for different skill levels. Targets appear randomly within the operating volume according to the skill task and can be grasped and manipulated with the instruments. Accuracy and errors during the tasks and time to completion are logged. Mist VR has tutorial, training, examination, analysis and configuration modes. Six tasks have been selected and include combinations of instrument approach, target acquisition, target manipulation and placement, transfer between instruments, target contact with optional diathermy, and controlled instrument withdrawal/replacement. Tasks can be configured for varying degrees of difficulty and the configurations saved to a library for reuse. Specific task configurations can be assigned to individual students. In the examination mode the supervisor can select the tasks, repetitions and order and save to a specific file for that trainee. Progress can be assessed and there is the option for playback of the training session or examination. Data analyses permit overall, including task, and right or left hand performances to be quantified. Mist VR represents a significant advance over the subjective assessment of training performances with existing "plastic box" basic trainers.
Participatory ergonomic intervention versus strength training on chronic pain and work disability in slaughterhouse workers: study protocol for a single-blind, randomized controlled trial.

PubMed

Sundstrup, Emil; Jakobsen, Markus D; Andersen, Christoffer H; Jay, Kenneth; Persson, Roger; Aagaard, Per; Andersen, Lars L

2013-02-21

The prevalence of musculoskeletal pain in the shoulder, arm and hand is high among slaughterhouse workers, allegedly due to the highly repetitive and forceful exposure of these body regions during work. Work disability is a common consequence of these pains. Lowering the physical exposure through ergonomics intervention is the traditional strategy to reduce the workload. An alternative strategy could be to increase physical capacity of the worker through strength training. This study investigates the effect of two contrasting interventions, participatory ergonomics versus strength training on pain and work disability in slaughterhouse workers with chronic pain. 66 slaughterhouse workers were allocated to 10 weeks of (1) strength training of the shoulder, arm and hand muscles for 3 x 10 minutes per week, or (2) participatory ergonomics involving counseling on workstation adjustment and optimal use of work tools (~usual care control group). Inclusion criteria were (1) working at a slaughterhouse for at least 30 hours per week, (2) pain intensity in the shoulder, elbow/forearm, or hand/wrist of at least 3 on a 0-10 VAS scale during the last three months, (3) pain lasting for more than 3 months, (4) frequent pain (at least 3 days per week) (5) at least moderate work disability, (6) no strength training during the last year, (7) no ergonomics instruction during the last year.Perceived pain intensity (VAS scale 0-10) of the shoulder, elbow/forearm and hand/wrist (primary outcome) and Disability of the Arm, Shoulder and Hand (Work module, DASH questionnaire) were measured at baseline and 10-week follow-up. Further, total muscle tenderness score and muscle function were assessed during clinical examination at baseline and follow-up. This RCT study will provide experimental evidence of the effectiveness of contrasting work-site interventions aiming at reducing chronic pain and work disability among employees engaged in repetitive and forceful work. ClinicalTrials.gov:NCT01671267.
Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial.

PubMed

Moutzouri, Maria; Gleeson, Nigel; Coutts, Fiona; Tsepis, Elias; John, Gliatis

2018-02-01

To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function. A single-blind controlled clinical trial. University Hospital of Rion, Greece. A total of 52 participants following total knee replacement. The primary outcome was the Timed Up and Go Test and the secondary outcomes were balance, joint position error, the Knee Outcome Survey Activities of Daily Living Scale, and pain. Patients were assessed on three separate occasions (presurgery, 8 weeks post surgery, and 14 weeks post surgery). Participants were randomized to either focal sensorimotor exercise training (experimental group) or functional exercise training (control group). Both groups received a 12-week home-based programme prescribed for 3-5 sessions/week (35-45 minutes). Consistently greater improvements ( F 2,98 = 4.3 to 24.8; P < 0.05) in group mean scores favour the experimental group compared to the control group: Timed Up and Go (7.8 ± 2.9 seconds vs. 4.6 ± 2.6 seconds); balance (2.1 ± 0.9° vs. 0.7 ± 1.2°); joint position error (13.8 ± 7.3° vs. 6.2 ± 9.1°); Knee Outcome Survey Activities of Daily Living Scale (44.2 ± 11.3 vs. 26.1 ± 11.4); and pain (5.9 ± 1.3 cm vs. 4.6 ± 1.1 cm). Patterns of improvement for the experimental group over time were represented by a relative effect size range of 1.3-6.5. Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.
Sequence specific motor performance gains after memory consolidation in children and adolescents.

PubMed

Dorfberger, Shoshi; Adi-Japha, Esther; Karni, Avi

2012-01-01

Memory consolidation for a trained sequence of finger opposition movements, in 9- and 12-year-old children, was recently found to be significantly less susceptible to interference by a subsequent training experience, compared to that of 17-year-olds. It was suggested that, in children, the experience of training on any sequence of finger movements may affect the performance of the sequence elements, component movements, rather than the sequence as a unit; the latter has been implicated in the learning of the task by adults. This hypothesis implied a possible childhood advantage in the ability to transfer the gains from a trained to the reversed, untrained, sequence of movements. Here we report the results of transfer tests undertaken to test this proposal in 9-, 12-, and 17-year-olds after training in the finger-to-thumb opposition sequence (FOS) learning task. Our results show that the performance gains in the trained sequence partially transferred from the left, trained hand, to the untrained hand at 48-hours after a single training session in the three age-groups tested. However, there was very little transfer of the gains from the trained to the untrained, reversed, sequence performed by either hand. The results indicate sequence specific post-training gains in FOS performance, as opposed to a general improvement in performance of the individual, component, movements that comprised both the trained and untrained sequences. These results do not support the proposal that the reduced susceptibility to interference, in children before adolescence, reflects a difference in movement syntax representation after training.
Classification of EMG signals using artificial neural networks for virtual hand prosthesis control.

PubMed

Mattioli, Fernando E R; Lamounier, Edgard A; Cardoso, Alexandre; Soares, Alcimar B; Andrade, Adriano O

2011-01-01

Computer-based training systems have been widely studied in the field of human rehabilitation. In health applications, Virtual Reality presents itself as an appropriate tool to simulate training environments without exposing the patients to risks. In particular, virtual prosthetic devices have been used to reduce the great mental effort needed by patients fitted with myoelectric prosthesis, during the training stage. In this paper, the application of Virtual Reality in a hand prosthesis training system is presented. To achieve this, the possibility of exploring Neural Networks in a real-time classification system is discussed. The classification technique used in this work resulted in a 95% success rate when discriminating 4 different hand movements.
Variability in Resident Operative Hand Experience by Specialty.

PubMed

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.
NASA/ARC proposed training in intelligent control

NASA Technical Reports Server (NTRS)

Berenji, Hamid R.

1990-01-01

Viewgraphs on NASA Ames Research Center proposed training in intelligent control was presented. Topics covered include: fuzzy logic control; neural networks in control; artificial intelligence in control; hybrid approaches; hands on experience; and fuzzy controllers.
The Impact of Musical Training on Hand Biomechanics in String Musicians.

PubMed

Gorniak, Stacey L; Collins, Evan D; Goldie Staines, Kimberly; Brooks, Forrest A; Young, Ricardo V

2018-04-01

The effects of musical training on the body in professional musicians remain an understudied area, particularly in reference to understanding and managing orthopedic/neuromuscular deviations and injuries in this population. The purpose of this study was to evaluate hand/finger fine motor function in musicians via physical examination as well as laboratory-based evaluations. Thirteen healthy noninjured young elite string musicians participated in this study. Performance of musicians was compared with healthy age-matched, sex-matched, and handedness-matched nonmusician controls. Musicians exhibited decreased intrinsic muscle strength compared with controls; however, no change in extrinsic muscle strength was found between groups. No between-group differences in overall force control were found; however, Group × Hand (right vs left) interactions were found in force control. These data suggest that musicians are a unique population with respect to: (1) fine motor control of the hand; and (2) exhibit changes in differential hand use. This suggests cortical reorganization of string musicians, such that this population should be studied separately from typical healthy controls with respect to hand function.
Intermanual transfer effect in young children after training in a complex skill: mechanistic, pseudorandomized, pretest-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2015-05-01

Intermanual transfer implies that motor skills learned on one side of the body transfer to the untrained side. This effect was previously noted in adults practicing with a prosthesis simulator. The study objective was to determine whether intermanual transfer is present in children practicing prosthetic handling. A mechanistic, pseudorandomized, pretest-posttest design was used. The study was conducted in a primary school in the Netherlands. The participants were children who were able-bodied (N=48; 25 boys, 23 girls; mean age=5.1 years) and randomly assigned to an experimental group or a control group. The experimental group performed 5 training sessions using a prosthesis simulator on the training arm. Before (pretest), immediately after (posttest), and 6 days after (retention test) the training program, their ability to handle the prosthesis with the contralateral (test) arm was measured. The control group only performed the tests. Half of the children performed the tests with the dominant hand, and the other half performed the tests with the nondominant hand. During the tests, movement time and control of force were measured. An interaction effect of group by test was found for movement time. Post hoc tests revealed significant improvement in the experimental group between the posttest and the retention test. No force control effect was found. Only children who were able-bodied were included. Measurements should have been masked and obtained without tester interference. The fact that 4 children whose results were slower than the mean result discontinued training may have biased the findings. The intermanual transfer effect was present in 5-year-old children undergoing training in prosthetic handling. After training of one hand, children's movement times for the other, untrained hand improved. This finding may be helpful for training children who are novice users of a prosthesis. © 2015 American Physical Therapy Association.
Criticality Safety Evaluation for the TACS at DAF

DOE Office of Scientific and Technical Information (OSTI.GOV)

Percher, C. M.; Heinrichs, D. P.

2011-06-10

Hands-on experimental training in the physical behavior of multiplying systems is one of ten key areas of training required for practitioners to become qualified in the discipline of criticality safety as identified in DOE-STD-1135-99, Guidance for Nuclear Criticality Safety Engineer Training and Qualification. This document is a criticality safety evaluation of the training activities and operations associated with HS-3201-P, Nuclear Criticality 4-Day Training Course (Practical). This course was designed to also address the training needs of nuclear criticality safety professionals under the auspices of the NNSA Nuclear Criticality Safety Program1. The hands-on, or laboratory, portion of the course will utilizemore » the Training Assembly for Criticality Safety (TACS) and will be conducted in the Device Assembly Facility (DAF) at the Nevada Nuclear Security Site (NNSS). The training activities will be conducted by Lawrence Livermore National Laboratory following the requirements of an Integrated Work Sheet (IWS) and associated Safety Plan. Students will be allowed to handle the fissile material under the supervision of an LLNL Certified Fissile Material Handler.« less
Evaluation of Highly Realistic Training for Navy Corpsmen: Results for Field Medical Training Battalion-West

DTIC Science & Technology

2015-05-14

suggestions do you have for improving the training?” Demographics. The pretest and posttest asked for information on participants’ gender, age, race...confidence about performing specific hands- on medical procedures. Considered together, the training satisfaction and pretest / posttest results suggest that...highest by participants was the use of live actors. Comparisons of pretest and posttest survey responses revealed that the training produced significant
Comparing "pick and place" task in spatial Augmented Reality versus non-immersive Virtual Reality for rehabilitation setting.

PubMed

Khademi, Maryam; Hondori, Hossein Mousavi; Dodakian, Lucy; Cramer, Steve; Lopes, Cristina V

2013-01-01

Introducing computer games to the rehabilitation market led to development of numerous Virtual Reality (VR) training applications. Although VR has provided tremendous benefit to the patients and caregivers, it has inherent limitations, some of which might be solved by replacing it with Augmented Reality (AR). The task of pick-and-place, which is part of many activities of daily living (ADL's), is one of the major affected functions stroke patients mainly expect to recover. We developed an exercise consisting of moving an object between various points, following a flash light that indicates the next target. The results show superior performance of subjects in spatial AR versus non-immersive VR setting. This could be due to the extraneous hand-eye coordination which exists in VR whereas it is eliminated in spatial AR.
Restricted transfer of learning between unimanual and bimanual finger sequences.

PubMed

Yokoi, Atsushi; Bai, Wenjun; Diedrichsen, Jörn

2017-03-01

When training bimanual skills, such as playing piano, people sometimes practice each hand separately and at a later stage combine the movements of the two hands. This poses the critical question of whether motor skills can be acquired by separately practicing each subcomponent or should be trained as a whole. In the present study, we addressed this question by training human subjects for 4 days in a unimanual or bimanual version of the discrete sequence production task. Both groups were then tested on trained and untrained sequences on both unimanual and bimanual versions of the task. Surprisingly, we found no evidence of transfer from trained unimanual to bimanual or from trained bimanual to unimanual sequences. In half the participants, we also investigated whether cuing the sequences on the left and right hand with unique letters would change transfer. With these cues, untrained sequences that shared some components with the trained sequences were performed more quickly than sequences that did not. However, the amount of this transfer was limited to ∼10% of the overall sequence-specific learning gains. These results suggest that unimanual and bimanual sequences are learned in separate representations. Making participants aware of the interrelationship between sequences can induce some transferrable component, although the main component of the skill remains unique to unimanual or bimanual execution. NEW & NOTEWORTHY Studies in reaching movement demonstrated that approximately half of motor learning can transfer across unimanual and bimanual contexts, suggesting that neural representations for unimanual and bimanual movements are fairly overlapping at the level of elementary movement. In this study, we show that little or no transfer occurred across unimanual and bimanual sequential finger movements. This result suggests that bimanual sequences are represented at a level of the motor hierarchy that integrates movements of both hands. Copyright © 2017 the American Physiological Society.
Priming for Improved Hand Strength in Persons with Chronic Tetraplegia: A Comparison of Priming-Augmented Functional Task Practice, Priming Alone, and Conventional Exercise Training

PubMed Central

Gomes-Osman, Joyce; Tibbett, Jacqueline A.; Poe, Brandon P.; Field-Fote, Edelle C.

2017-01-01

Many everyday tasks cannot be accomplished without adequate grip strength, and corticomotor drive to the spinal motoneurons is a key determinant of grip strength. In persons with tetraplegia, damage to spinal pathways limits transmission of signals from motor cortex to spinal motoneurons. Corticomotor priming, which increases descending drive, should increase corticospinal transmission through the remaining spinal pathways resulting in increased grip strength. Since the motor and somatosensory cortices share reciprocal connections, corticomotor priming may also have potential to influence somatosensory function. The purpose of this study was to assess changes in grip (precision, power) force and tactile sensation associated with two different corticomotor priming approaches and a conventional training approach and to determine whether baseline values can predict responsiveness to training. Participants with chronic (≥1 year) tetraplegia (n = 49) were randomized to one of two corticomotor priming approaches: functional task practice plus peripheral nerve somatosensory stimulation (FTP + PNSS) or PNSS alone, or to conventional exercise training (CET). To assess whether baseline corticospinal excitability (CSE) is predictive of responsiveness to training, in a subset of participants, we assessed pre-intervention CSE of the thenar muscles. Participants were trained 2 h daily, 5 days/week for 4 weeks. Thirty-seven participants completed the study. Following intervention, significant improvements in precision grip force were observed in both the stronger and weaker hand in the FTP + PNSS group (effect size: 0.51, p = 0.04 and 0.54, p = 0.03, respectively), and significant improvements in weak hand precision grip force were associated with both PNSS and CET (effect size: 0.54, p = 0.03 and 0.75, p = 0.02, respectively). No significant changes were observed in power grip force or somatosensory scores in any group. Across all groups, responsiveness to training as measured by change in weak hand power grip force was correlated with baseline force. Change in precision grip strength was correlated with measures of baseline CSE. These findings indicate that corticomotor priming with FTP + PNSS had the greatest influence on precision grip strength in both the stronger and weaker hand; however, both PNSS and CET were associated with improved precision grip strength in the weaker hand. Responsiveness to training may be associated with baseline CSE. PMID:28144229
Aggression Replacement Training: Putting Theory and Research to Work

ERIC Educational Resources Information Center

Hollin, Clive R.

2003-01-01

There are many problems posed by aggressive youth, the harm to victims and the loss of young people into the criminal justice system and penal confinement. Aggression Replacement Training (ART) was developed by Arnold Goldstein and his colleagues as a means of working with aggressive young people to help them learn new, prosocial ways of behaving.…
Today's Apprentices, Tomorrow's Leaders.

ERIC Educational Resources Information Center

Tuholski, Robert J.

1982-01-01

Describes an innovative three-year apprenticeship training program in metal cutting tool operation which combines a certification program from the company with an associate in arts degree in applied technology (industrial engineering) from a community college. The combination of hands-on training with theoretical training is explained. (CT)

Physical fitness and job performance of firefighters.

PubMed

Rhea, Matthew R; Alvar, Brent A; Gray, Rayne

2004-05-01

Accurate correlations between a wide range of physical fitness measures and occupational demands are needed in order to identify specific fitness tests and training needs for firefighters. Twenty professional firefighters performed numerous fitness and job-related performance tests. Pearson product moment correlations were performed to identify the relationship between fitness components and job performance. Significant correlations (p <0.05) with job performance were identified for total fitness (r = -0.62), bench press strength (r = -0.66), hand grip strength (r = -0.71), bent-over row endurance (r = -0.61), bench press endurance (r = -0.73), shoulder press endurance (r = -0.71), bicep endurance (r = -0.69), squat endurance (r = -0.47), and 400-m sprint time (r = 0.79). It is apparent that firefighting taxes virtually all aspects of physical fitness. These data can help the exercise specialist choose appropriate tests and prescribe specific fitness programs for firefighters. Traditional firefighter exercise programs focusing mainly on cardiovascular fitness should be replaced with physical conditioning programs that address all components of fitness.
Sensorimotor Learning during a Marksmanship Task in Immersive Virtual Reality

PubMed Central

Rao, Hrishikesh M.; Khanna, Rajan; Zielinski, David J.; Lu, Yvonne; Clements, Jillian M.; Potter, Nicholas D.; Sommer, Marc A.; Kopper, Regis; Appelbaum, Lawrence G.

2018-01-01

Sensorimotor learning refers to improvements that occur through practice in the performance of sensory-guided motor behaviors. Leveraging novel technical capabilities of an immersive virtual environment, we probed the component kinematic processes that mediate sensorimotor learning. Twenty naïve subjects performed a simulated marksmanship task modeled after Olympic Trap Shooting standards. We measured movement kinematics and shooting performance as participants practiced 350 trials while receiving trial-by-trial feedback about shooting success. Spatiotemporal analysis of motion tracking elucidated the ballistic and refinement phases of hand movements. We found systematic changes in movement kinematics that accompanied improvements in shot accuracy during training, though reaction and response times did not change over blocks. In particular, we observed longer, slower, and more precise ballistic movements that replaced effort spent on corrections and refinement. Collectively, these results leverage developments in immersive virtual reality technology to quantify and compare the kinematics of movement during early learning of full-body sensorimotor orienting. PMID:29467693
Optical Science: Deploying Technical Concepts and Engaging Participation through Digital Storytelling

NASA Astrophysics Data System (ADS)

Thomas, R. G.; Berry, K.; Arrigo, J.; Hooper, R. P.

2013-12-01

Technical 'hands-on' training workshops are designed to bring together scientists, technicians, and program managers from universities, government agencies, and the private sector to discuss methods used and advances made in instrumentation and data analysis. Through classroom lectures and discussions combined with a field-day component, hands-on workshop participants get a 'full life cycle' perspective from instrumentation concepts and deployment to data analysis. Using film to document this process is becoming increasingly more popular, allowing scientists to add a story-telling component to their research. With the availability of high-quality and low priced professional video equipment and editing software, scientists are becoming digital storytellers. The science video developed from the 'hands-on' workshop, Optical Water Quality Sensors for Nutrients: Concepts, Deployment, and Analysis, encapsulates the objectives of technical training workshops for participants. Through the use of still photography, video, interviews, and sound, the short video, An Introduction to CUAHSI's Hands-on Workshops, produced by a co-instructor of the workshop acts as a multi-purpose tool. The 10-minute piece provides an overview of workshop field day activities and works to bridge the gap between classroom learning, instrumentation application and data analysis. CUAHSI 'hands-on' technical workshops have been collaboratively executed with faculty from several universities and with the U.S. Geological Survey. The video developed was designed to attract new participants to these professional development workshops, to stimulate a connection with the environment, to act as a workshop legacy resource, and also serve as a guide for prospective hands-on workshop organizers. The effective use of film and short videos in marketing scientific programs, such as technical trainings, allows scientists to visually demonstrate the technologies currently being employed and to provide a more intriguing perspective on scientific research.
[An Introduction to A Newly-developed "Acupuncture Needle Manipulation Training-evaluation System" Based on Optical Motion Capture Technique].

PubMed

Zhang, Ao; Yan, Xing-Ke; Liu, An-Guo

2016-12-25

In the present paper, the authors introduce a newly-developed "Acupuncture Needle Manipulation Training-evaluation System" based on optical motion capture technique. It is composed of two parts, sensor and software, and overcomes some shortages of mechanical motion capture technique. This device is able to analyze the data of operations of the pressing-hand and needle-insertion hand during acupuncture performance and its software contains personal computer (PC) version, Android version, and Internetwork Operating System (IOS) Apple version. It is competent in recording and analyzing information of any ope-rator's needling manipulations, and is quite helpful for teachers in teaching, training and examining students in clinical practice.
SENSory re-learning of the UPPer limb after stroke (SENSUPP): study protocol for a pilot randomized controlled trial.

PubMed

Carlsson, Håkan; Rosén, Birgitta; Pessah-Rasmussen, Hélène; Björkman, Anders; Brogårdh, Christina

2018-04-17

Many stroke survivors suffer from sensory impairments of their affected upper limb (UL). Although such impairments can affect the ability to use the UL in everyday activities, very little attention is paid to sensory impairments in stroke rehabilitation. The purpose of this trial is to investigate if sensory re-learning in combination with task-specific training may prove to be more effective than task-specific training alone to improve sensory function of the hand, dexterity, the ability to use the hand in daily activities, perceived participation, and life satisfaction. This study is a single-blinded pilot randomized controlled trial (RCT) with two treatment arms. The participants will be randomly assigned either to sensory re-learning in combination with task-specific training (sensory group) or to task-specific training only (control group). The training will consist of 2.5 h of group training per session, 2 times per week for 5 weeks. The primary outcome measures to assess sensory function are as follows: Semmes-Weinstein monofilament, Shape/Texture Identification (STI™) test, Fugl-Meyer Assessment-upper extremity (FMA-UE; sensory section), and tactile object identification test. The secondary outcome measures to assess motor function are as follows: Box and Block Test (BBT), mini Sollerman Hand Function Test (mSHFT), Modified Motor Assessment Scale (M-MAS), and Grippit. To assess the ability to use the hand in daily activities, perceived participation, and life satisfaction, the Motor Activity Log (MAL), Canadian Occupational Performance Measure (COPM), Stroke Impact Scale (SIS) participation domain, and Life Satisfaction checklist will be used. Assessments will be performed pre- and post-training and at 3-month follow-up by independent assessors, who are blinded to the participants' group allocation. At the 3-month follow-up, the participants in the sensory group will also be interviewed about their general experience of the training and how effective they perceived the training. The results from this study can add new knowledge about the effectiveness of sensory re-learning in combination with task-specific training on UL functioning after stroke. If the new training approach proves efficient, the results can provide information on how to design a larger RCT in the future in persons with sensory impairments of the UL after stroke. ClinicalTrials.gov, NCT03336749 . Registered on 8 November 2017.
Transportation research methods : a guide to searching for funding opportunities.

DOT National Transportation Integrated Search

2017-03-01

This project developed a training methodology focused on external funding. This hands-on training presented the basics of external funding identification, teambuilding and collaborative partners, and proposal element design. Real-time searches and tu...
Effects of hand gestures on auditory learning of second-language vowel length contrasts.

PubMed

Hirata, Yukari; Kelly, Spencer D; Huang, Jessica; Manansala, Michael

2014-12-01

Research has shown that hand gestures affect comprehension and production of speech at semantic, syntactic, and pragmatic levels for both native language and second language (L2). This study investigated a relatively less explored question: Do hand gestures influence auditory learning of an L2 at the segmental phonology level? To examine auditory learning of phonemic vowel length contrasts in Japanese, 88 native English-speaking participants took an auditory test before and after one of the following 4 types of training in which they (a) observed an instructor in a video speaking Japanese words while she made syllabic-rhythm hand gesture, (b) produced this gesture with the instructor, (c) observed the instructor speaking those words and her moraic-rhythm hand gesture, or (d) produced the moraic-rhythm gesture with the instructor. All of the training types yielded similar auditory improvement in identifying vowel length contrast. However, observing the syllabic-rhythm hand gesture yielded the most balanced improvement between word-initial and word-final vowels and between slow and fast speaking rates. The overall effect of hand gesture on learning of segmental phonology is limited. Implications for theories of hand gesture are discussed in terms of the role it plays at different linguistic levels.
Replacement Condition Detection of Railway Point Machines Using an Electric Current Sensor.

PubMed

Sa, Jaewon; Choi, Younchang; Chung, Yongwha; Kim, Hee-Young; Park, Daihee; Yoon, Sukhan

2017-01-29

Detecting replacement conditions of railway point machines is important to simultaneously satisfy the budget-limit and train-safety requirements. In this study, we consider classification of the subtle differences in the aging effect-using electric current shape analysis-for the purpose of replacement condition detection of railway point machines. After analyzing the shapes of after-replacement data and then labeling the shapes of each before-replacement data, we can derive the criteria that can handle the subtle differences between "does-not-need-to-be-replaced" and "needs-to-be-replaced" shapes. On the basis of the experimental results with in-field replacement data, we confirmed that the proposed method could detect the replacement conditions with acceptable accuracy, as well as provide visual interpretability of the criteria used for the time-series classification.
Microsurgeons do better--tactile training might prevent the age-dependent decline of the sensibility of the hand.

PubMed

Schmauss, Daniel; Megerle, Kai; Weinzierl, Andrea; Agua, Kariem; Cerny, Michael; Schmauss, Verena; Lohmeyer, Joern A; Machens, Hans-Guenther; Erne, Holger

2015-12-01

Recent data demonstrate that the normal sensibility of the hand seems to be age-dependent with the best values in the third decade and a consecutive deterioration afterwards. However, it is not clear if long-term tactile training might prevent this age-dependent decline. We evaluated sensibility of the hand in 125 surgeons aged between 26 and 75 years who perform microsurgical operations, thereby undergoing regular tactile training. We examined sensibility of the radial digital nerve of the index finger (N3) and the ulnar digital nerve of the small finger (N10) using static and moving two-point discrimination (2PD) tests and compared the results to 154 age-matched individuals without specific long-term tactile training. We found significantly lower static and moving 2PD values for the sixth, seventh, and eighth decade of life in the microsurgery group compared to the control group (p < 0.05). This study demonstrates that long-term tactile training might prevent the known age-dependent decline of the sensibility of the hand. © 2015 Peripheral Nerve Society.
Snorkel: Rapid Training Data Creation with Weak Supervision.

PubMed

Ratner, Alexander; Bach, Stephen H; Ehrenberg, Henry; Fries, Jason; Wu, Sen; Ré, Christopher

2017-11-01

Labeling training data is increasingly the largest bottleneck in deploying machine learning systems. We present Snorkel, a first-of-its-kind system that enables users to train state-of- the-art models without hand labeling any training data. Instead, users write labeling functions that express arbitrary heuristics, which can have unknown accuracies and correlations. Snorkel denoises their outputs without access to ground truth by incorporating the first end-to-end implementation of our recently proposed machine learning paradigm, data programming. We present a flexible interface layer for writing labeling functions based on our experience over the past year collaborating with companies, agencies, and research labs. In a user study, subject matter experts build models 2.8× faster and increase predictive performance an average 45.5% versus seven hours of hand labeling. We study the modeling tradeoffs in this new setting and propose an optimizer for automating tradeoff decisions that gives up to 1.8× speedup per pipeline execution. In two collaborations, with the U.S. Department of Veterans Affairs and the U.S. Food and Drug Administration, and on four open-source text and image data sets representative of other deployments, Snorkel provides 132% average improvements to predictive performance over prior heuristic approaches and comes within an average 3.60% of the predictive performance of large hand-curated training sets.
Daily iTBS worsens hand motor training--a combined TMS, fMRI and mirror training study.

PubMed

Läppchen, C H; Ringer, T; Blessin, J; Schulz, K; Seidel, G; Lange, R; Hamzei, F

2015-02-15

Repetitive transcranial magnetic stimulation (rTMS) is used to increase regional excitability to improve motor function in combination with training after neurological diseases or events such as stroke. We investigated whether a daily application of intermittent theta burst stimulation (iTBS; a short-duration rTMS that increases regional excitability) improves the training effect compared with sham stimulation in association with a four-day hand training program using a mirror (mirror training, MT). The right dorsal premotor cortex (dPMC right) was chosen as the target region for iTBS because this region has recently been emphasized as a node within a network related to MT. Healthy subjects were randomized into the iTBS group or sham group (control group CG). In the iTBS group, iTBS was applied daily over dPMC right, which was functionally determined in an initial fMRI session prior to starting MT. MT involved 20 min of hand training daily in a mirror over four days. The hand tests, the intracortical excitability and fMRI were evaluated prior to and at the end of MT. The results of the hand training tests of the iTBS group were surprisingly significantly poorer compared with those from the CG group. Both groups showed a different course of excitability in both M1 and a different course of fMRI activation within the supplementary motor area and M1 left. We suggest the inter-regional functional balance was affected by daily iTBS over dPMC right. Maybe an inter-regional connectivity within a network is differentially balanced. An excitability increase within an inhibitory-balanced network would therefore disturb the underlying network. Copyright © 2014 Elsevier Inc. All rights reserved.
West German Biotech Institute Trains Third World Scientists.

ERIC Educational Resources Information Center

O'Sullivan, Dermot A.

1987-01-01

Describes a six-week program designed to give scientists from developing countries advanced training in biotechnology methods. Stresses the need to provide the participants with "hands-on" experiences to enhance their ability to contribute to biotechnology programs in their home countries and to train others locally. (TW)
Hand Surgery Questions on the Orthopaedic In-Training Examination: Analysis of Content and Reference.

PubMed

Martin, Adam S; McMains, M Craig; Shacklett, Andrew G; Awan, Hisham M

2018-06-01

To provide an updated analysis of the hand surgery section of the Orthopaedic In-Training Examination (OITE) from 2009 to 2015. The goal was to contribute to the existing literature on the analysis of OITE questions, to aid both residents and residency programs in preparation for the OITE and board examination. The authors analyzed all OITE questions pertaining to hand surgery between 2009 and 2015. Hand questions were analyzed for category and subcategory of content, cited reference, treatment intervention, and imaging modality used. Hand-related questions comprised 157 of the 1,872 OITE questions (8.4%). Nine general topic areas were identified, the most common of which were fracture-dislocation, tendon/ligament, nerve, congenital, and amputation. Trends existed in the recommended references; the 5 journals and 2 textbooks that were consistently cited included the Journal of Hand Surgery (American Volume), the Journal of the American Academy of Orthopaedic Surgeons, the Journal of Bone and Joint Surgery (American Volume), the Journal of Hand Surgery (European Volume), Hand Clinics, Orthopaedic Knowledge Update, and Green's Operative Hand Surgery, respectively. Knowledge regarding topics and resources used for OITE hand questions could be mutually beneficial to both residents and residency programs. This information would consolidate resident OITE and board examination study time. Furthermore, this analysis could help residency programs develop or improve educational conferences and journal clubs. An understanding of question content and sources should enable efficient learning and improved scores on this section of the examination. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Intensive training of motor function and functional skills among young children with cerebral palsy: a systematic review and meta-analysis.

PubMed

Tinderholt Myrhaug, Hilde; Østensjø, Sigrid; Larun, Lillebeth; Odgaard-Jensen, Jan; Jahnsen, Reidun

2014-12-05

Young children with cerebral palsy (CP) receive a variety of interventions to prevent and/or reduce activity limitations and participation restrictions. Some of these interventions are intensive, and it is a challenge to identify the optimal intensity. Therefore, the objective of this systematic review was to describe and categorise intensive motor function and functional skills training among young children with CP, to summarise the effects of these interventions, and to examine characteristics that may contribute to explain the variations in these effects. Ten databases were searched for controlled studies that included young children (mean age less than seven years old) with CP and assessments of the effects of intensive motor function and functional skills training. The studies were critically assessed by the Risk of bias tool (RoB) and categorised for intensity and contexts of interventions. Standardised mean difference were computed for outcomes, and summarised descriptively or in meta-analyses. Thirty-eight studies were included. Studies that targeted gross motor function were fewer, older and with lower frequency of training sessions over longer training periods than studies that targeted hand function. Home training was most common in studies on hand function and functional skills, and often increased the amount of training. The effects of constraint induced movement therapy (CIMT) on hand function and functional skills were summarised in six meta-analyses, which supported the existing evidence of CIMT. In a majority of the included studies, equal improvements were identified between intensive intervention and conventional therapy or between two different intensive interventions. Different types of training, different intensities and different contexts between studies that targeted gross and fine motor function might explain some of the observed effect variations. Home training may increase the amount of training, but are less controllable. These factors may have contributed to the observed variations in the effectiveness of CIMT. Rigorous research on intensive gross motor training is needed. CRD42013004023.
CONICAL, RADIOGRAPHIC, AND PATIENT-REPORTED RESULTS OF SURFACE REPLACING PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY OF THE HAND

PubMed Central

Amirtharajah, Mohana; Fufa, Duretti; Lightdale, Nina; Weiland, Andew

2011-01-01

The purpose of this study was to evaluate the one-year clinical, radiologic and patient-reported results of surface-replacing proximal interphalangeal joint arthroplasty (SR-PIP) of the hand. Fifteen patients with 18 joints underwent the procedure, and nine patients with 11 joints had follow-up of at least one year's duration. Of these joints, six had a diagnosis of osteoarthritis with no history of trauma, three had post-traumatic arthritis, one had psoriatic arthritis, and one had erosive arthritis. The mean clinical follow-up was at 3.3 years, and the mean radiographic follow-up was at 3.1 years. The average post-operative gain in range of motion at the PIP joint was 28 degrees and was statistically significant. Six patients completed self-reported questionnaires at a mean of 4.8 years post-operatively. The mean Disabilities of the Arm, Shoulder and Hand (DASH) score post-operatively was 17, and the Michigan Hand Questionnaire (MHQ) score for overall satisfaction was 70. There were three complications but only one reoperation. Seven of 11 joints showed some evidence of subsidence on follow-up radiographic examination. However, no joints were revised sec-ondary to loosening. Longer follow-up is needed to determine if this observable radiologic subsidence leads to symptomatic loosening of the implant PMID:22096433
Behavioral and neural effects of congruency of visual feedback during short-term motor learning.

PubMed

Ossmy, Ori; Mukamel, Roy

2018-05-15

Visual feedback can facilitate or interfere with movement execution. Here, we describe behavioral and neural mechanisms by which the congruency of visual feedback during physical practice of a motor skill modulates subsequent performance gains. 18 healthy subjects learned to execute rapid sequences of right hand finger movements during fMRI scans either with or without visual feedback. Feedback consisted of a real-time, movement-based display of virtual hands that was either congruent (right virtual hand movement), or incongruent (left virtual hand movement yoked to the executing right hand). At the group level, right hand performance gains following training with congruent visual feedback were significantly higher relative to training without visual feedback. Conversely, performance gains following training with incongruent visual feedback were significantly lower. Interestingly, across individual subjects these opposite effects correlated. Activation in the Supplementary Motor Area (SMA) during training corresponded to individual differences in subsequent performance gains. Furthermore, functional coupling of SMA with visual cortices predicted individual differences in behavior. Our results demonstrate that some individuals are more sensitive than others to congruency of visual feedback during short-term motor learning and that neural activation in SMA correlates with such inter-individual differences. Copyright © 2017 Elsevier Inc. All rights reserved.
Effectiveness of revised fluid replacement guidelines for military training in hot weather.

PubMed

Kolka, Margaret A; Latzka, Willliam A; Montain, Scott J; Corr, William P; O'Brien, Karen K; Sawka, Michael N

2003-03-01

This study compared the revised U.S. Army fluid replacement guidelines (REV) with the old guidelines (OLD) on daily changes in serum sodium concentration (Na+) and body mass (BM) during Basic Combat Training at Fort Benning, GA during two successive summers. Recruits (n = 550; OLD = 277, REV = 273) were evaluated before and after 8-12 h of outdoor military combat training in hot weather. The WBGT (mean +/- SD) averaged 26.6 +/- 1.7 degrees C for OLD and 27.4 +/- 0.9 degrees C for REV (NS). Serum Na+ decreased from 137.5 +/- 1.6 mEq x L(-1) to 137.0 +/- 2.1 mEq x L(-1) after outdoor military training in OLD (p < 0.05). Twenty-two recruits (8%) had serum sodium fall to below 135 mEq x L(-1) during OLD. Serum Na+ increased from 139.0 +/- 1.7 mEq x L(-1) to 139.4 +/- 2.1 mEq x L(-1) after outdoor military training in REV (p < 0.05). Only two recruits (1%) had serum Na+ fall to below 135 mEq x L(-1) during REV. BM increased an average of 1.3 +/- 1.4 kg (p < 0.05) in OLD and an average of 0.4 +/- 1.7 kg in REV (p < 0.05). The revised guidelines effectively reversed the decrease in serum sodium, reduced the increase in body mass, maintained hydration and minimized overdrinking during hot weather military training compared with the old fluid replacement guidelines.
Trial-by-trial analysis of intermanual transfer during visuomotor adaptation

PubMed Central

Wojaczynski, Greg J.; Ivry, Richard B.

2011-01-01

Studies of intermanual transfer have been used to probe representations formed during skill acquisition. We employ a new method that provides a continuous assay of intermanual transfer, intermixing right- and left-hand trials while limiting visual feedback to right-hand movements. We manipulated the degree of awareness of the visuomotor rotation, introducing a 22.5° perturbation in either an abrupt single step or gradually in ∼1° increments every 10 trials. Intermanual transfer was observed with the direction of left-hand movements shifting in the opposite direction of the rotation over the course of training. The transfer on left-hand trials was less than that observed in the right hand. Moreover, the magnitude of transfer was larger in our mixed-limb design compared with the standard blocked design in which transfer is only probed at the end of training. Transfer was similar in the abrupt and gradual groups, suggesting that awareness of the perturbation has little effect on intermanual transfer. In a final experiment, participants were provided with a strategy to offset an abrupt rotation, a method that has been shown to increase error over the course of training due to the operation of sensorimotor adaptation. This deterioration was also observed on left-hand probe trials, providing further support that awareness has little effect on intermanual transfer. These results indicate that intermanual transfer is not dependent on the implementation of cognitively assisted strategies that participants might adopt when they become aware that the visuomotor mapping has been perturbed. Rather, the results indicate that the information available to processes involved in adaptation entails some degree of effector independence. PMID:21917998
A rehabilitation device to improve the hand grasp function of stroke patients using a patient-driven approach.

PubMed

Park, Wanjoo; Jeong, Wookjin; Kwon, Gyu-Hyun; Kim, Yun-Hee; Kim, Laehyun

2013-06-01

This paper proposes a robotic hand rehabilitation device for grasp training. The device is designed for stroke patients to train and recover their hand grasp function in order to undertake activities of daily living (ADL). The device consists of a control unit, two small actuators, an infrared (IR) sensor, and pressure sensors in the grasp handle. The advantages of this device are that it is small in size, inexpensive, and available for use at home without specialist's supervision. In addition, a novel patient-driven strategy based on the patient's movement intention detected by the pressure sensors without bio-signals is introduced. Once the system detects a patient's movement intention, it triggers the robotic device to move the patient's hand to form the normal grasping behavior. This strategy may encourage stroke patients to participate in rehabilitation training to recover their hand grasp function and it may also enhance neural plasticity. A user study was conducted in order to investigate the usability, acceptability, satisfaction, and suggestions for improvement of the proposed device. The results of this survey included positive reviews from therapists and a stroke patient. In particular, therapists expected that the proposed patient-driven mode can motivate patients for their rehabilitation training and it can be effective to prevent a compensational strategy in active movements. It is expected that the proposed device will assist stroke patients in restoring their grasp function efficiently.
A description of a non-invasive surgical training pathway using translational tools to teach intracoelomic implantation of acoustic transmitters in fish.

PubMed

Brosnan, Ian G; Williams, Wendy O; Sanders, George E; McGarry, Louise P; Greene, Charles H

2018-05-29

Researchers engaged in surgical implantation of acoustic transmitters into fish must receive adequate and appropriate training to ensure the welfare of their subjects and the quality of the data collected. Increasingly, they are being encouraged to partner with veterinarians to improve training, and to consider the principles of animal welfare in training. Here, we describe a 5-stage training pathway, including implementation of new training tools, the Translational Training Tools ™ and field certification, that was developed collaboratively by researchers and veterinarians and address the 3 R's of animal welfare in the context of surgical training. The 3 R's include animal replacement, reduction of the number of animals used, and refinement of technique to decrease or eliminate pain or distress. The Translational Training Tools ™ , described in the context of the training pathway, use tools as replacement models during training to reduce the number of animals used, and allows for refinement of surgical skills prior to working on live animals. The purpose of this paper is to document the Translational Training Tools ™ and the training pathway, which will be useful in developing de novo protocols for review by Institutional Animal Care and Use Committees (IACUCs) and similar bodies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Enhancement of motor-imagery ability via combined action observation and motor-imagery training with proprioceptive neurofeedback.

PubMed

Ono, Yumie; Wada, Kenya; Kurata, Masaya; Seki, Naoto

2018-06-01

Varied individual ability to control the sensory-motor rhythms may limit the potential use of motor-imagery (MI) in neurorehabilitation and neuroprosthetics. We employed neurofeedback training of MI under action observation (AO: AOMI) with proprioceptive feedback and examined whether it could enhance MI-induced event-related desynchronization (ERD). Twenty-eight healthy young adults participated in the neurofeedback training. They performed MI while watching a video of hand-squeezing motion from a first-person perspective. Eleven participants received correct proprioceptive feedback of the same hand motion with the video, via an exoskeleton robot attached to their hand, upon their successful generation of ERD. Another nine participants received random feedback. The training lasted for approximately 20 min per day and continued for 6 days within an interval of 2 weeks. MI-ERD power was evaluated separately, without AO, on each experimental day. The MI-ERD power of the participants receiving correct feedback, as opposed to random feedback, was significantly increased after training. An additional experiment in which the remaining eight participants were trained with auditory instead of proprioceptive feedback failed to show statistically significant increase in MI-ERD power. The significant training effect obtained in shorter training time relative to previously proposed methods suggests the superiority of AOMI training and physiologically-congruent proprioceptive feedback to enhance the MI-ERD power. The proposed neurofeedback training could help patients with motor deficits to attain better use of brain-machine interfaces for rehabilitation and/or prosthesis. Copyright © 2018 Elsevier Ltd. All rights reserved.
Structuralized box-trainer laparoscopic training significantly improves performance in complex virtual reality laparoscopic tasks.

PubMed

Laski, Dariusz; Stefaniak, Tomasz J; Makarewicz, Wojciech; Proczko, Monika; Gruca, Zbigniew; Sledziński, Zbigniew

2012-03-01

In the era of flowering minimally invasive surgical techniques there is a need for new methods of teaching surgery and supervision of progress in skills and expertise. Virtual and physical box-trainers seem especially fit for this purpose, and allow for improvement of proficiency required in laparoscopic surgery. The study included 34 students who completed the authors' laparoscopic training on physical train-boxes. Progress was monitored by accomplishment of 3 exercises: moving pellets from one place to another, excising and clipping. Analysed parameters included time needed to complete the exercise and right and left hand movement tracks. Students were asked to do assigned tasks prior to, in the middle and after the training. The duration of the course was 28 h in total. Significant shortening of the time to perform each exercise and reduction of the left hand track were achieved. The right hand track was shortened only in exercise number 1. Exercises in the laboratory setting should be regarded as an important element of the process of skills acquisition by a young surgeon. Virtual reality laparoscopic training seems to be a new, interesting educational tool, and at the same time allows for reliable control and assessment of progress.
77 FR 41886 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... Transportation (DOT). ACTION: Final rule. SUMMARY: We are adopting a new airworthiness directive (AD) for all... the left- and right-hand sides to determine whether a certain part number is installed, and replacement if necessary. We are issuing this AD to prevent non-availability of left- or right-hand off-wing...
Measuring the validation of assessing the non-dominant-hand function by ALSFRS-r in Chinese ALS patients.

PubMed

Hu, Fangfang; Jin, Jiaoting; Jia, Rui; Xiang, Li; Qi, Huaguang; Zhao, Xing; Dang, Jingxia

2017-12-01

ALSFRS-r is a widely accepted rating scale for measuring the global function of Amyotrophic Lateral Sclerosis (ALS) patients, but we found some limitations of ALSFRS-r in assessing the function of non-dominant hand in Chinese ALS patients. We reviewed 95 ALS patients who expressed upper-limb symptoms at first visit and analyzed the ALSFRS-r score and subscale. In both upper limb involved patients, the ALSFRS-r had no difference between dominant-hand and non-dominant-hand onset groups (39.15±5.55 vs 38.0±5.91, p=0.477). But in only one upper limb involved patients, the ALSFRS-r score in non-dominant-hand onset patients was higher than dominant-hand onset patients (43.94±3.44 vs 40.87±4.42, p<0.05), especially in item of handwriting, cutting food and handing utensils (3.56±0.89 vs 2.2±1.27 p=0.001, 3.44±1.03 vs 1.8±1.21 p=0.000). When the item of cutting food and handing utensils was replaced by using food bowl and chopsticks to assess the function of non-dominant-hand, the modified ALSFRS-r score was significantly lower than original ALSFRS-r (43.94±3.44 vs 42.88±3.07 p=0.001), the progression rate was slower (0.81±0.63 vs 0.64±0.63, p=0.001). So, for Chinese ALS patients, using food bowl and chopsticks should replace the item of cutting food and handling utensils to assess the non-dominant-hand function, especially in non-dominant-hand onset patients. Copyright © 2017. Published by Elsevier Ltd.
Break with tradition: donating cadavers for scientific purposes and reducing the use of sentient beings.

PubMed

Ciliberti, Rosagemma; Martini, Mariano; Bonsignore, Alessandro; Penco, Susanna

2016-01-01

In recent years, the development of research and the increased awareness of our moral duties beyond the human species have pushed the scientific community to revise widely-accepted ontological reductionist views that regard non-human animals as mere things. The new horizons offered by the development of advanced research methods therefore require an on-going commitment to new perspectives able to find the right balance between the need for scientific knowledge on one hand and the respect for animal life on the other. This is in line with increasing attention to animal welfare and expansion of the "3Rs model": replacement, reduction, refinement.With the view of promoting the adoption of alternative methods, human body donation for research can contribute not only to the acquisition of important information for human health and for doctors' training, but also can reduce significantly the number of animals sacrificed.By investigating the scientific and ethical reasons that may encourage cadaver donation, the authors aim to promote the adoption of the practice in Italy following other European experiences.
Benefits of music training are widespread and lifelong: a bibliographic review of their non-musical effects.

PubMed

Dawson, William J

2014-06-01

Recent publications indicate that musical training has effects on non-musical activities, some of which are lifelong. This study reviews recent publications collected from the Performing Arts Medicine Association bibliography. Music training, whether instrumental or vocal, produces beneficial and long-lasting changes in brain anatomy and function. Anatomic changes occur in brain areas devoted to hearing, speech, hand movements, and coordination between both sides of the brain. Functional benefits include improved sound processing and motor skills, especially in the upper extremities. Training benefits extend beyond music skills, resulting in higher IQs and school grades, greater specialized sensory and auditory memory/recall, better language memory and processing, heightened bilateral hand motor functioning, and improved integration and synchronization of sensory and motor functions. These changes last long after music training ends and can minimize or prevent age-related loss of brain cells and some mental functions. Early institution of music training and prolonged duration of training both appear to contribute to these positive changes.
Astronaut John Young replaces tools in Lunar Roving Vehicle during EVA

NASA Technical Reports Server (NTRS)

1972-01-01

Astronaut John W. Young, commander of the Apollo 16 lunar landing mission, replaces tools in the Apollo lunar hand tool carrier at the aft end of the Lunar Roving Vehicle during the second Apollo 16 extravehicular activity (EVA-2) at the Descartes landing site. This photograph was taken by Astronaut Charles M. Duke Jr., lunar module pilot. Smoky Mountain, with the large Ravine crater on its flank, is in the left background. This view is looking northeast.
Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity.

PubMed

Patel, Jigna; Qiu, Qinyin; Yarossi, Mathew; Merians, Alma; Massood, Supriya; Tunik, Eugene; Adamovich, Sergei; Fluet, Gerard

2017-07-01

Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing. Implications for Rehabilitation Rehabilitation of individuals with severely paretic upper extremities after stroke is challenging due to limited movement capacity and few options for therapeutic training. Long-term functional recovery of the arm after stroke depends on early return of active hand control, establishing a need for acute training methods focused distally. This study demonstrates the feasibility of an early hand-based intervention using virtual reality based priming and scaled motor activities which can allow for participation by persons without the motor control required for traditionally presented rehabilitation and testing.
Do we need animal hands-on courses for transplantation surgery?

PubMed

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.
Hands-on 2.0: improving transfer of training via the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program.

PubMed

Dort, Jonathan; Trickey, Amber; Paige, John; Schwarz, Erin; Dunkin, Brian

2017-08-01

Practicing surgeons commonly learn new procedures and techniques by attending a "hands-on" course, though trainings are often ineffective at promoting subsequent procedure adoption in practice. We describe implementation of a new program with the SAGES All Things Hernia Hands-On Course, Acquisition of Data for Outcomes and Procedure Transfer (ADOPT), which employs standardized, proven teaching techniques, and 1-year mentorship. Attendee confidence and procedure adoption are compared between standard and ADOPT programs. For the pilot ADOPT course implementation, a hands-on course focusing on abdominal wall hernia repair was chosen. ADOPT participants were recruited among enrollees for the standard Hands-On Hernia Course. Enrollment in ADOPT was capped at 10 participants and limited to a 2:1 student-to-faculty ratio, compared to the standard course 22 participants with a 4:1 student-to-faculty ratio. ADOPT mentors interacted with participants through webinars, phone conferences, and continuous email availability throughout the year. All participants were asked to provide pre- and post-course surveys inquiring about the number of targeted hernia procedures performed and related confidence level. Four of 10 ADOPT participants (40%) and six of 22 standard training participants (27%) returned questionnaires. Over the 3 months following the course, ADOPT participants performed more ventral hernia mesh insertion procedures than standard training participants (median 13 vs. 0.5, p = 0.010) and considerably more total combined procedures (median 26 vs. 7, p = 0.054). Compared to standard training, learners who participated in ADOPT reported greater confidence improvements in employing a components separation via an open approach (p = 0.051), and performing an open transversus abdominis release, though the difference did not achieve statistical significance (p = 0.14). These results suggest that the ADOPT program, with standardized and structured teaching, telementoring, and a longitudinal educational approach, is effective and leads to better transfer of learned skills and procedures to clinical practice.
Training Impact Analysis for Land Warrior Block II

DTIC Science & Technology

2006-01-01

maximum W... ... 384 384 instructor requirement - S~ Infantry OSUT STraining company size (25 training companies) NA NA 200•:• LW systems to equip all...Grenade, NA NA 10 M 18 Green SMK C-111 TACTICAL Low Expertise Medium Expertise High Expertise EMPLOYMENT Tasks/Skills Taught No Task Number...Practical Exercise of Tactical Employment on LW Capabilities (Leader Task) G945 Hand Grenade, NA NA 10 M18 Yellow SMK G950 Hand Grenade, NA NA 3 M18 Red SMK
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.
EEG-Based Brain-Computer Interface for Decoding Motor Imagery Tasks within the Same Hand Using Choi-Williams Time-Frequency Distribution

PubMed Central

Alwanni, Hisham; Baslan, Yara; Alnuman, Nasim; Daoud, Mohammad I.

2017-01-01

This paper presents an EEG-based brain-computer interface system for classifying eleven motor imagery (MI) tasks within the same hand. The proposed system utilizes the Choi-Williams time-frequency distribution (CWD) to construct a time-frequency representation (TFR) of the EEG signals. The constructed TFR is used to extract five categories of time-frequency features (TFFs). The TFFs are processed using a hierarchical classification model to identify the MI task encapsulated within the EEG signals. To evaluate the performance of the proposed approach, EEG data were recorded for eighteen intact subjects and four amputated subjects while imagining to perform each of the eleven hand MI tasks. Two performance evaluation analyses, namely channel- and TFF-based analyses, are conducted to identify the best subset of EEG channels and the TFFs category, respectively, that enable the highest classification accuracy between the MI tasks. In each evaluation analysis, the hierarchical classification model is trained using two training procedures, namely subject-dependent and subject-independent procedures. These two training procedures quantify the capability of the proposed approach to capture both intra- and inter-personal variations in the EEG signals for different MI tasks within the same hand. The results demonstrate the efficacy of the approach for classifying the MI tasks within the same hand. In particular, the classification accuracies obtained for the intact and amputated subjects are as high as 88.8% and 90.2%, respectively, for the subject-dependent training procedure, and 80.8% and 87.8%, respectively, for the subject-independent training procedure. These results suggest the feasibility of applying the proposed approach to control dexterous prosthetic hands, which can be of great benefit for individuals suffering from hand amputations. PMID:28832513
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 glove middle finger length.
STS-37 crewmembers test CETA hand cart during training session in JSC's WETF

NASA Technical Reports Server (NTRS)

1989-01-01

STS-37 Atlantis, Orbiter Vehicle (OV) 104, Mission Specialist (MS) Jerry L. Ross and MS Jerome Apt test crew and equipment translation aid (CETA) manual hand over hand cart during underwater session in JSC's Weightless Environment Training Facility (WETF) Bldg 29. Wearing an extravehicular mobility unit (EMU), Ross pulls the CETA manual cart along the rail while Apt holds onto the back of the cart. The test will determine how difficult it is to maneuver cargo in such a manner when it is done in space on STS-37. The goal is to find the best method for astronauts to move around the exterior of Space Station Freedom (SSF).
Variations of In-Service Training for Primary Mathematics Teachers: An Empirical Study

ERIC Educational Resources Information Center

Selter, Christoph; Gräsel, Cornelia; Reinold, Martin; Trempler, Kati

2015-01-01

Previous findings indicate that the effectiveness of in-service teacher training can be increased by a (pedagogical) content knowledge orientation on the one hand and the stimulation of cooperation among teachers on the other. In this paper, three versions of a multi-phase training program were compared in a quasi-experimental field study with a…
Setup of a novel biofeedback prototype for sensorimotor control of the hand and preliminary application in patients with peripheral nerve injuries.

PubMed

Chiu, Haw-Yen; Hsu, Hsiu-Yun; Su, Fong-Chin; Jou, I-Ming; Lin, Cheng-Feng; Kuo, Li-Chieh

2013-02-01

Biofeedback training is widely used for rehabilitative intervention in patients with central or peripheral nervous impairment to train correct movement patterns; however, no biofeedback apparatus is currently available to correct pinch force ratios for patients with sensory deficiencies. A cross-sectional and longitudinal design was used in an observational measurement study for establishing a prototype and to determine the effects of biofeedback intervention, respectively. This study aimed to develop a computerized evaluation and re-education biofeedback (CERB) prototype for application in clinical settings. A CERB prototype was developed integrating pinch apparatus hardware, a biofeedback user-controlled interface, and a data processing/analysis interface to detect momentary pinch performances in 79 people with normal hand sensation. Nine patients with hand sensory impairments were recruited to investigate the effects of training hand function with the CERB prototype. Hand dominance, pinch pattern, and age significantly affected the peak pinch force and force ratio for lifting a 480-g object with a steel surface. In the case of the 79 volunteers with normal hand sensation, hand dominance affected the time lag between peak pinch force and maximum load; however, it was unaffected by pinch pattern or age. Training with the CERB prototype produced significant improvements in force ratio and better performance in the pin insertion subtests, although the results for both 2-point discriminative and Semmes-Weinstein monofilament tests did not change significantly. The intervention findings are preliminary. This study developed a conjunct system suited for evaluating and restoring sensorimotor function for patients with impaired hand sensibility. The results from the participants with normal hand sensation could serve as a reference database for comparison with patients with nerve injuries.
Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: a case study

PubMed Central

Fluet, Gerard G.; Patel, Jigna; Qiu, Qinyin; Yarossi, Matthew; Massood, Supriya; Adamovich, Sergei V.; Tunik, Eugene; Merians, Alma S.

2016-01-01

Purpose The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated. Methods This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl–Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation. Results Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing. Conclusion This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. PMID:27669997
Multi-stage learning aids applied to hands-on software training.

PubMed

Rother, Kristian; Rother, Magdalena; Pleus, Alexandra; Upmeier zu Belzen, Annette

2010-11-01

Delivering hands-on tutorials on bioinformatics software and web applications is a challenging didactic scenario. The main reason is that trainees have heterogeneous backgrounds, different previous knowledge and vary in learning speed. In this article, we demonstrate how multi-stage learning aids can be used to allow all trainees to progress at a similar speed. In this technique, the trainees can utilize cards with hints and answers to guide themselves self-dependently through a complex task. We have successfully conducted a tutorial for the molecular viewer PyMOL using two sets of learning aid cards. The trainees responded positively, were able to complete the task, and the trainer had spare time to respond to individual questions. This encourages us to conclude that multi-stage learning aids overcome many disadvantages of established forms of hands-on software training.
Training Efficiency and Transfer Success in an Extended Real-Time Functional MRI Neurofeedback Training of the Somatomotor Cortex of Healthy Subjects

PubMed Central

Auer, Tibor; Schweizer, Renate; Frahm, Jens

2015-01-01

This study investigated the level of self-regulation of the somatomotor cortices (SMCs) attained by an extended functional magnetic resonance imaging (fMRI) neurofeedback training. Sixteen healthy subjects performed 12 real-time functional magnetic resonance imaging neurofeedback training sessions within 4 weeks, involving motor imagery of the dominant right as well as the non-dominant left hand. Target regions of interests in the SMC were individually localized prior to the training by overt finger movements. The feedback signal (FS) was defined as the difference between fMRI activation in the contra- and ipsilateral SMC and visually presented to the subjects. Training efficiency was determined by an off-line general linear model analysis determining the fMRI percent signal changes in the SMC target areas accomplished during the neurofeedback training. Transfer success was assessed by comparing the pre- and post-training transfer task, i.e., the neurofeedback paradigm without the presentation of the FS. Group results show a distinct increase in feedback performance (FP) in the transfer task for the trained group compared to a matched untrained control group, as well as an increase in the time course of the training, indicating an efficient training and a successful transfer. Individual analysis revealed that the training efficiency was not only highly correlated to the transfer success but also predictive. Trainings with at least 12 efficient training runs were associated with a successful transfer outcome. A group analysis of the hemispheric contributions to the FP showed that it is mainly driven by increased fMRI activation in the contralateral SMC, although some individuals relied on ipsilateral deactivation. Training and transfer results showed no difference between left- and right-hand imagery, with a slight indication of more ipsilateral deactivation in the early right-hand trainings. PMID:26500521

Distance learning for the RN first assistant.

PubMed

Degon, Ronald

2010-01-01

The number of online, distance-learning programs has increased to accommodate the needs of today's adult learners; these include new programs that feature perioperative courses for RN first assistants (RNFAs). Whereas the advantages of these programs include flexible schedules and the ability to participate at one's own pace, the disadvantages can include the lack of immediate access to faculty members who can answer questions or clarify information, and the added difficulty of learning a technical skill without hands-on training. The RNFA training program at Rock Valley College, Rockford, Illinois, is a hybrid training program that includes three phases: an online component, a hands-on workshop, and a clinical preceptorship. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Hand assessment in older adults with musculoskeletal hand problems: a reliability study.

PubMed

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, in part, from a low prevalence of clinical signs and symptoms in the study participants. The decision to use clinical interview and hand assessment variables in clinical practice or further research in primary care should include consideration of clinical applicability and training alongside reliability. Further investigation is required to determine the relationship between these clinical questions and assessments and the clinical course of hand pain and hand problems in community-dwelling older adults.
[Post-stroke shoulder-hand syndrome treated with floating-needle therapy combined with rehabilitation training: a randomized controlled trial].

PubMed

Zhou, Zhao-Hui; Zhuang, Li-Xing; Chen, Zhen-Hu; Lang, Jian-Ying; Li, Yan-Hui; Jiang, Gang-Hui; Xu, Zhan-Qiong; Liao, Mu-Xi

2014-07-01

To compare the clinical efficacy in the treatment of post-stroke shoulder-hand syndrome between floating-needle therapy and conventional acupuncture on the basis of rehabilitation training. One hundred cases of post-stroke shoulder-hand syndrome were randomized into a floating-needle group and an acupuncture group, 50 cases in each one. The passive and positive rehabilitation training was adopted in the two groups. Additionally, in the floating-needle group, the floating-needle therapy was used. The needle was inserted at the site 5 to 10 cm away from myofasical trigger point (MTrP), manipulated and scattered subcutaneously, for 2 min continuously. In the acupuncture group, the conventional acupuncture was applied at Jianqian (EX-UE), Jianyu (LI 15), Jianliao (TE 14), etc. The treatment was given once every two days, 3 times a week, and 14 days of treatment were required. The shoulder hand syndrome scale (SHSS), the short form McGill pain scale (SF-MPQ) and the modified Fugl-Meyer motor function scale (FMA) were used to evaluate the damage severity, pain and motor function of the upper limbs before and after treatment in the two groups. The clinical efficacy was compared between the two groups. SHSS score, SF-MPQ score and FMA score were improved significantly after treatment in the two groups (all P < 0.01), and the improvements in the floating-needle group were superior to those in the acupuncture group (all P < 0.05). The total effective rate was 94.0% (47/50) in the floating-needle group, which was better than 90.0% (45/50) in the acupuncture group (P < 0.05). The floating-needle therapy combined with rehabilitation training achieves a satisfactory efficacy on post-stroke shoulder-hand syndrome, which is better than the combined therapy of conventional acupuncture and rehabilitation training.
Evidence Report: Risk of Performance Errors Due to Training Deficiencies

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Dempsey, Donna L.

2016-01-01

Substantial evidence supports the claim that inadequate training leads to performance errors. Barshi and Loukopoulos (2012) demonstrate that even a task as carefully developed and refined over many years as operating an aircraft can be significantly improved by a systematic analysis, followed by improved procedures and improved training (see also Loukopoulos, Dismukes, & Barshi, 2009a). Unfortunately, such a systematic analysis of training needs rarely occurs during the preliminary design phase, when modifications are most feasible. Training is often seen as a way to compensate for deficiencies in task and system design, which in turn increases the training load. As a result, task performance often suffers, and with it, the operators suffer and so does the mission. On the other hand, effective training can indeed compensate for such design deficiencies, and can even go beyond to compensate for failures of our imagination to anticipate all that might be needed when we send our crew members to go where no one else has gone before. Much of the research literature on training is motivated by current training practices aimed at current training needs. Although there is some experience with operations in extreme environments on Earth, there is no experience with long-duration space missions where crews must practice semi-autonomous operations, where ground support must accommodate significant communication delays, and where so little is known about the environment. Thus, we must develop robust methodologies and tools to prepare our crews for the unknown. The research necessary to support such an endeavor does not currently exist, but existing research does reveal general challenges that are relevant to long-duration, high-autonomy missions. The evidence presented here describes issues related to the risk of performance errors due to training deficiencies. Contributing factors regarding training deficiencies may pertain to organizational process and training programs for spaceflight, such as when training programs are inadequate or unavailable. Furthermore, failure to match between tasks on the one hand, and learning and memory abilities on the other hand is a contributing factor, especially when individuals' relative efficiency with which new information is acquired, and adjustments made in behavior or thinking, are inconsistent with mission demands. Thus, if training deficiencies are present, the likelihood of errors or of the inability to successfully complete a task increases. What's more, the overall risk to the crew, the vehicle, and the mission increases.
Age-Specific Effects of Mirror-Muscle Activity on Cross-Limb Adaptations Under Mirror and Non-Mirror Visual Feedback Conditions.

PubMed

Reissig, Paola; Stöckel, Tino; Garry, Michael I; Summers, Jeffery J; Hinder, Mark R

2015-01-01

Cross-limb transfer (CLT) describes the observation of bilateral performance gains due to unilateral motor practice. Previous research has suggested that CLT may be reduced, or absent, in older adults, possibly due to age-related structural and functional brain changes. Based on research showing increases in CLT due to the provision of mirror visual feedback (MVF) during task execution in young adults, our study aimed to investigate whether MVF can facilitate CLT in older adults, who are known to be more reliant on visual feedback for accurate motor performance. Participants (N = 53) engaged in a short-term training regime (300 movements) involving a ballistic finger task using their dominant hand, while being provided with either visual feedback of their active limb, or a mirror reflection of their active limb (superimposed over the quiescent limb). Performance in both limbs was examined before, during and following the unilateral training. Furthermore, we measured corticospinal excitability (using TMS) at these time points, and assessed muscle activity bilaterally during the task via EMG; these parameters were used to investigate the mechanisms mediating and predicting CLT. Training resulted in significant bilateral performance gains that did not differ as a result of age or visual feedback (both p > 0.1). Training also elicited bilateral increases in corticospinal excitability (p < 0.05). For younger adults, CLT was significantly predicted by performance gains in the trained hand (β = 0.47), whereas for older adults it was significantly predicted by mirror activity in the untrained hand during training (β = 0.60). The present study suggests that older adults are capable of exhibiting CLT to a similar degree to younger adults. The prominent role of mirror activity in the untrained hand for CLT in older adults indicates that bilateral cortical activity during unilateral motor tasks is a compensatory mechanism. In this particular task, MVF did not facilitate the extent of CLT.
Machine learning of molecular properties: Locality and active learning

NASA Astrophysics Data System (ADS)

Gubaev, Konstantin; Podryabinkin, Evgeny V.; Shapeev, Alexander V.

2018-06-01

In recent years, the machine learning techniques have shown great potent1ial in various problems from a multitude of disciplines, including materials design and drug discovery. The high computational speed on the one hand and the accuracy comparable to that of density functional theory on another hand make machine learning algorithms efficient for high-throughput screening through chemical and configurational space. However, the machine learning algorithms available in the literature require large training datasets to reach the chemical accuracy and also show large errors for the so-called outliers—the out-of-sample molecules, not well-represented in the training set. In the present paper, we propose a new machine learning algorithm for predicting molecular properties that addresses these two issues: it is based on a local model of interatomic interactions providing high accuracy when trained on relatively small training sets and an active learning algorithm of optimally choosing the training set that significantly reduces the errors for the outliers. We compare our model to the other state-of-the-art algorithms from the literature on the widely used benchmark tests.
Reducing saturated fat with oleogel/shortening blends in a baked product.

PubMed

Mert, Behic; Demirkesen, Ilkem

2016-05-15

Short dough cookie structure, characterized by its aerated and tender texture, depends on the presence of solid fat during kneading. The objective of this study was to investigate the potential application of Candelilla wax (CDW) containing oleogels for partial replacement of the shortening in cookies. Oleogels were prepared with different amounts of CDW and blended with a commercial bakery shortening. After crystallizing the oleogel/shortening blends by using a pilot scale crystallization unit, the blends were evaluated in a cookie formulations. When the shortening was completely replaced with oleogel softer products were obtained compared to liquid oil, but they were harder than the shortening containing products. On the other hand, partial replacement of shortening with oleogels provided much more acceptable dough and cookie characteristics. Results suggest that gradual replacement of shortening with oleogels may be a suitable approach for reduction of saturated fat in short dough products. Copyright © 2015 Elsevier Ltd. All rights reserved.
Retention of sequential drug discriminations under fixed-interval schedules for long time periods without training.

PubMed

Li, Mi; McMillan, Donald E

2003-08-22

The experiments showed that sequential drug discriminations can be learned and retained under a fixed-interval (FI) schedule for more than 18 months without additional training under a complex three-choice procedure. Pigeons were trained to discriminate among 5 mg/kg pentobarbital, 2 mg/kg D-amphetamine, and saline. After responding stabilized, dose-response curves were determined for other drugs. Subsequently, pentobarbital was replaced with 5 mg/kg morphine as a training drug, and D-amphetamine was replaced with 30 mg/kg caffeine. After the pigeons learned these new discriminations, dose-response curves were redetermined. Initially, chlordiazepoxide substituted for pentobarbital, cocaine substituted for D-amphetamine, and nicotine partially substituted for D-amphetamine. Morphine, Delta9-tetrahydrocannabinol, and caffeine did not substitute for either drug. After retraining with morphine and caffeine, responding occurred on the pentobarbital/morphine key after pentobarbital, chlordiazepoxide and morphine and on the D-amphetamine/caffeine key after D-amphetamine, cocaine and caffeine. After nicotine and Delta9-tetrahyrdocannabinol, responding occurred on the saline key. These data show that drug discriminations learned under fixed-interval schedules are retained for long time periods, even when discrimination training with other drugs occurs during the retention period.
Hand and Wrist Injuries in Boxing and the Martial Arts.

PubMed

Drury, Benjamin Todd; Lehman, Thomas P; Rayan, Ghazi

2017-02-01

Hand and wrist injuries in martial arts are typically a reflection of the combat nature of this discipline. In striking sports, the axial load mechanism of injury is common and causes fractures and dislocations; in grappling sports, sprain injuries and degenerative changes predominate. There is clear evidence to support that hand protection reduces the risk of hand injury. Traditional training in martial arts on proper technique and target selection in striking sports reduces the risk of hand injury, and is an important component of hand and wrist injury prevention. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Hand hygiene in preventing nosocomial infections:a nursing research.

PubMed

Di Muzio, M; Cammilletti, V; Petrelli, E; Di Simone, E

2015-01-01

To verify whether there is some correlation between the nursing workload and the occurrence of healthcare-associated infections. An anonymous questionnaire made up of 20 items has been drafted for this specific purpose and delivered to a sample of 70 participants, including 33 nurses and 37 nursing students of a well-known University Hospital in Rome. The study is supported by extensive documental research, and a specific literature review. Hand hygiene is a mandatory daily practice, simple but critical, but not always clear enough for both nurses and students. The investigation demonstrated inconsistencies between nurses' and students' behaviour and what is recommended by the new WHO international guidelines. The documented correlation between the workload and the occurrence of healthcare-associated infections may be explained by the negative effect of nursing workload on correct hand-washing procedures. Out of the total sample, 58.6% answered affirmatively to both the presence of healthcare-associated infections within their unit and an excessive daily workload. Indeed, the remaining 41.4% of the sample do not report an excessive workload and states that "there are no healthcare-associated infections within their operational reality, at least not in the time period covered by the present investigation". Although limited to a small sample, this study may reveal that the correct practice of hand washing, prompted and considered fundamental by WHO, is still much underrated. Hand hygiene should be better understood and practiced in all healthcare facilities, through a series of interventions such as: specific training courses, the presence of a gel sanitizer next to each patient's bed or in each patient's room, as well as the adoption of the new international guidelines in all units. The analysis of other correlations found the presence of a protective factor (RR<1) regarding the replacement of gloves for each patient and the use of disinfectant gel, both related to the excessive workload and the presence of infections. In fact, we found no statistically significant values to support such considerations (p>0.05). The same considerations could be also inferred as far as the presence of gel dispensers and disposable wipes near hospital beds are concerned, for the distribution of information leaflets about proper hand hygiene and the frequency of updating courses declared by both nurses and nursing students. The quality of health care starts from the simplest things, such proper hand hygiene.
Telerobotic control of a dextrous manipulator using master and six-DOF hand-controllers for space assembly and servicing tasks

NASA Technical Reports Server (NTRS)

O'Hara, John M.

1987-01-01

Two studies were conducted evaluating methods of controlling a telerobot; bilateral force reflecting master controllers and proportional rate six degrees of freedom (DOF) hand controllers. The first study compared the controllers on performance of single manipulator arm tasks, a peg-in-the-hole task, and simulated satellite orbital replacement unit changeout. The second study, a Space Station truss assembly task, required simultaneous operation of both manipulator arms (all 12 DOFs) and complex multiaxis slave arm movements. Task times were significantly longer and fewer errors were committed with the hand controllers. The hand controllers were also rated significantly higher in cognitive and manual control workload on the two-arm task. The master controllers were rated significantly higher in physical workload. There were no significant differences in ratings of manipulator control quality.
49 CFR 236.923 - Task analysis and basic requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... classroom, simulator, computer-based, hands-on, or other formally structured training and testing, except... for Processor-Based Signal and Train Control Systems § 236.923 Task analysis and basic requirements...) Based on a formal task analysis, identify the installation, maintenance, repair, modification...
The European Urology Residents Education Programme Hands-on Training Format: 4 Years of Hands-on Training Improvements from the European School of Urology.

PubMed

Somani, Bhaskar K; Van Cleynenbreugel, Ben; Gozen, Ali; Palou, Jaun; Barmoshe, Sas; Biyani, Shekhar; Gaya, Josep M; Hellawell, Giles; Pini, Gio; Oscar, Faba R; Sanchez Salas, Rafael; Macek, Petr; Skolarikos, Andreas; Wagner, Christian; Eret, Viktor; Haensel, Stephen; Siena, Giampaolo; Schmidt, Marek; Klitsch, Max; Vesely, Stepan; Ploumidis, Achilles; Proietti, Silvia; Kamphuis, Guido; Tokas, Theodore; Geraghty, Rob; Veneziano, Dominico

2018-03-14

The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017). The resulting EUREP HOT format was verified by collecting and prospectively analysing the following data: total number of participants attending different HOT courses; participants' age; country of origin; and feedback obtained annually. A total of 796 participants from 54 countries participated in 1450 HOT sessions over the last 4 yr. This included 294 (20%) ureteroscopy (URS) sessions, 237 (16.5%) transurethral resection (TUR) sessions, 840 (58%) basic laparoscopic sessions, and 79 (5.5%) intermediate laparoscopic sessions. While 712 residents (89%) were from Europe, 84 (11%) were from non-European nations. Of the European residents, most came from Italy (16%), Germany (15%), Spain (15%), and Romania (8%). Feedback for the basic laparoscopic session showed a constant improvement in scores over the last 4 yr, with the highest scores achieved last year. This included feedback on improvements in tutor rating (p=0.017), organisation (p<0.001), and personal experience with EUREP (p<0.001). Limitations lie in the difficulties associated with the use of an advanced training curriculum with wet laboratory or cadaveric courses in this format, although these could be performed in other training centres in conjunction with EUREP. The EUREP trainee demographics show that the purpose of the course is being achieved, with excellent feedback reported. While European trainees dominate the demographics, participation from a number of non-European countries suggests continued ESU collaboration with other national societies and wider dissemination of simulation training worldwide. In this paper we look at methodological improvements and feedback for the European Urology Residents Education Programme hands-on-training over the last 4 yr. Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.
77 FR 49702 - Airworthiness Directives; Embraer S.A. Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... replacing the AMS controller processor module with one containing new software, and a new AFM revision. This... protection system. We are issuing this AD to prevent the possibility of a right-hand (RH) engine compressor... down. Also there is the possibility of right hand (RH) engine compressor to stall after the Auxiliary...
78 FR 73687 - Airworthiness Directives; DASSAULT AVIATION Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... Transportation (DOT). ACTION: Final rule; request for comments. SUMMARY: We are adopting a new airworthiness... for cracking of the right-hand (RH) and left-hand (LH) inboard flaps, and replacement if necessary...
Stimulating the cerebellum affects visuomotor adaptation but not intermanual transfer of learning.

PubMed

Block, Hannah; Celnik, Pablo

2013-12-01

When systematic movement errors occur, the brain responds with a systematic change in motor behavior. This type of adaptive motor learning can transfer intermanually; adaptation of movements of the right hand in response to training with a perturbed visual signal (visuomotor adaptation) may carry over to the left hand. While visuomotor adaptation has been studied extensively, it is unclear whether the cerebellum, a structure involved in adaptation, is important for intermanual transfer as well. We addressed this question with three experiments in which subjects reached with their right hands as a 30° visuomotor rotation was introduced. Subjects received anodal or sham transcranial direct current stimulation on the trained (experiment 1) or untrained (experiment 2) hemisphere of the cerebellum, or, for comparison, motor cortex (M1). After the training period, subjects reached with their left hand, without visual feedback, to assess intermanual transfer of learning aftereffects. Stimulation of the right cerebellum caused faster adaptation, but none of the stimulation sites affected transfer. To ascertain whether cerebellar stimulation would increase transfer if subjects learned faster as well as a larger amount, in experiment 3 anodal and sham cerebellar groups experienced a shortened training block such that the anodal group learned more than sham. Despite the difference in adaptation magnitude, transfer was similar across these groups, although smaller than in experiment 1. Our results suggest that intermanual transfer of visuomotor learning does not depend on cerebellar activity and that the number of movements performed at plateau is an important predictor of transfer.
Adjacent level effects of bi level disc replacement, bi level fusion and disc replacement plus fusion in cervical spine--a finite element based study.

PubMed

Faizan, Ahmad; Goel, Vijay K; Biyani, Ashok; Garfin, Steven R; Bono, Christopher M

2012-03-01

Studies delineating the adjacent level effect of single level disc replacement systems have been reported in literature. The aim of this study was to compare the adjacent level biomechanics of bi-level disc replacement, bi-level fusion and a construct having adjoining level disc replacement and fusion system. In total, biomechanics of four models- intact, bi level disc replacement, bi level fusion and fusion plus disc replacement at adjoining levels- was studied to gain insight into the effects of various instrumentation systems on cranial and caudal adjacent levels using finite element analysis (73.6N+varying moment). The bi-level fusion models are more than twice as stiff as compared to the intact model during flexion-extension, lateral bending and axial rotation. Bi-level disc replacement model required moments lower than intact model (1.5Nm). Fusion plus disc replacement model required moment 10-25% more than intact model, except in extension. Adjacent level motions, facet loads and endplate stresses increased substantially in the bi-level fusion model. On the other hand, adjacent level motions, facet loads and endplate stresses were similar to intact for the bi-level disc replacement model. For the fusion plus disc replacement model, adjacent level motions, facet loads and endplate stresses were closer to intact model rather than the bi-level fusion model, except in extension. Based on our finite element analysis, fusion plus disc replacement procedure has less severe biomechanical effects on adjacent levels when compared to bi-level fusion procedure. Bi-level disc replacement procedure did not have any adverse mechanical effects on adjacent levels. Copyright © 2011 Elsevier Ltd. All rights reserved.
Nicorette reborn? E-cigarettes in light of the history of nicotine replacement technology.

PubMed

Elam, Mark J

2015-06-01

E-cigarettes are currently hotly debated as threatening to re-normalize cigarette smoking and make nicotine addiction publicly acceptable once more. In this paper I contextualize the e-cigarette controversy in light of longstanding disagreements about the meaning and significance of nicotine replacement technologies. A concerted effort to develop such technologies first emerged in Sweden at the end of the 1960s, embodying a vital tension. Two competing 'scripts' vied to influence and shape innovative designs. On the one hand, Nicorette chewing gum was conceived as a therapeutic device aiding smoking cessation. On the other hand, it was cast as a cigarette substitute designed to deliver nicotine 'in the right way', thereby advancing the creative destruction of the combustible cigarette as a drug delivery platform. Drawing on historical and archival research I outline how these two alternative innovation scripts started out entangled with each other before becoming disentangled, leading to the eventual stabilization of Nicorette gum as a therapeutic product to be deployed in the treatment of smoking as a dependence disorder. While a post-therapeutic future for nicotine replacement was charted by Michael Russell at the beginning of the 1990s, it is only with the rise of e-cigarettes after 2003 that such a future has started to verge on reality. E-cigarettes can be seen as resurrecting the historically marginalized script of nicotine replacement as dedicated to righting nicotine consumption and freeing it from the wrongful drug delivery of the modern cigarette. Copyright © 2015 Elsevier B.V. All rights reserved.
A comparative study of slow and fast suryanamaskar on physiological function

PubMed Central

Bhavanani, Ananda Balayogi; Udupa, Kaviraja; Madanmohan; Ravindra, PN

2011-01-01

Background: Numerous scientific studies have reported beneficial physiological changes after short- and long-term yoga training. Suryanamaskar (SN) is an integral part of modern yoga training and may be performed either in a slow or rapid manner. As there are few studies on SN, we conducted this study to determine the differential effect of 6 months training in the fast and slow versions. Materials and Methods: 42 school children in the age group of 12–16 years were randomly divided into two groups of 21 each. Group I and Group II received 6 months training in performance of slow suryanamaskar (SSN) and fast suryanamaskar (FSN), respectively. Results: Training in SSN produced a significant decrease in diastolic pressure. In contrast, training in FSN produced a significant increase in systolic pressure. Although there was a highly significant increase in isometric hand grip (IHG) strength and hand grip endurance (HGE) in both the groups, the increase in HGE in FSN group was significantly more than in SSN group. Pulmonary function tests showed improvements in both the groups though intergroup comparison showed no significance difference. Maximum inspiratory pressure (MIP) and maximum expiratory pressure increased significantly in both the groups with increase of MIP in FSN group being more significant than in SSN. Conclusion: The present study reports that SN has positive physiological benefits as evidenced by improvement of pulmonary function, respiratory pressures, hand grip strength and endurance, and resting cardiovascular parameters. It also demonstrates the differences between SN training when performed in a slow and fast manner, concluding that the effects of FSN are similar to physical aerobic exercises, whereas the effects of SSN are similar to those of yoga training. PMID:22022125
Participatory ergonomic intervention versus strength training on chronic pain and work disability in slaughterhouse workers: study protocol for a single-blind, randomized controlled trial

PubMed Central

2013-01-01

Background The prevalence of musculoskeletal pain in the shoulder, arm and hand is high among slaughterhouse workers, allegedly due to the highly repetitive and forceful exposure of these body regions during work. Work disability is a common consequence of these pains. Lowering the physical exposure through ergonomics intervention is the traditional strategy to reduce the workload. An alternative strategy could be to increase physical capacity of the worker through strength training. This study investigates the effect of two contrasting interventions, participatory ergonomics versus strength training on pain and work disability in slaughterhouse workers with chronic pain. Methods/design 66 slaughterhouse workers were allocated to 10 weeks of (1) strength training of the shoulder, arm and hand muscles for 3 x 10 minutes per week, or (2) participatory ergonomics involving counseling on workstation adjustment and optimal use of work tools (~usual care control group). Inclusion criteria were (1) working at a slaughterhouse for at least 30 hours per week, (2) pain intensity in the shoulder, elbow/forearm, or hand/wrist of at least 3 on a 0–10 VAS scale during the last three months, (3) pain lasting for more than 3 months, (4) frequent pain (at least 3 days per week) (5) at least moderate work disability, (6) no strength training during the last year, (7) no ergonomics instruction during the last year. Perceived pain intensity (VAS scale 0–10) of the shoulder, elbow/forearm and hand/wrist (primary outcome) and Disability of the Arm, Shoulder and Hand (Work module, DASH questionnaire) were measured at baseline and 10-week follow-up. Further, total muscle tenderness score and muscle function were assessed during clinical examination at baseline and follow-up. Discussion This RCT study will provide experimental evidence of the effectiveness of contrasting work-site interventions aiming at reducing chronic pain and work disability among employees engaged in repetitive and forceful work. Trial registration ClinicalTrials.gov:NCT01671267 PMID:23433448

Training based on mirror visual feedback influences transcallosal communication.

PubMed

Avanzino, Laura; Raffo, Alessia; Pelosin, Elisa; Ogliastro, Carla; Marchese, Roberta; Ruggeri, Piero; Abbruzzese, Giovanni

2014-08-01

Mirror visual feedback (MVF) therapy has been demonstrated to be successful in neurorehabilitation, probably inducing neuroplasticity changes in the primary motor cortex (M1). However, it is not known whether MVF training influences the hemispheric balance between the M1s. This topic is of extreme relevance when MVF training is applied to stroke rehabilitation, as the competitive interaction between the two hemispheres induces abnormal interhemispheric inhibition (IHI) that weakens motor function in stroke patients. In the present study, we evaluated, in a group of healthy subjects, the effect of motor training and MVF training on the excitability of the two M1s and the IHI between M1s. The IHI from the 'active' M1 to the opposite M1 (where 'active' means the M1 contralateral to the moving hand in the motor training and the M1 of the seen hand in the MVF training) increased, after training, in both the experimental conditions. Only after motor training did we observe an increase in the excitability of the active M1. Our findings show that training based on MVF may influence the excitability of the transcallosal pathway and support its use in disorders where abnormal IHI is a potential target, such as stroke, where an imbalance between the affected and unaffected M1s has been documented. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Functional consequences of experience-dependent plasticity on tactile perception following perceptual learning.

PubMed

Trzcinski, Natalie K; Gomez-Ramirez, Manuel; Hsiao, Steven S

2016-09-01

Continuous training enhances perceptual discrimination and promotes neural changes in areas encoding the experienced stimuli. This type of experience-dependent plasticity has been demonstrated in several sensory and motor systems. Particularly, non-human primates trained to detect consecutive tactile bar indentations across multiple digits showed expanded excitatory receptive fields (RFs) in somatosensory cortex. However, the perceptual implications of these anatomical changes remain undetermined. Here, we trained human participants for 9 days on a tactile task that promoted expansion of multi-digit RFs. Participants were required to detect consecutive indentations of bar stimuli spanning multiple digits. Throughout the training regime we tracked participants' discrimination thresholds on spatial (grating orientation) and temporal tasks on the trained and untrained hands in separate sessions. We hypothesized that training on the multi-digit task would decrease perceptual thresholds on tasks that require stimulus processing across multiple digits, while also increasing thresholds on tasks requiring discrimination on single digits. We observed an increase in orientation thresholds on a single digit. Importantly, this effect was selective for the stimulus orientation and hand used during multi-digit training. We also found that temporal acuity between digits improved across trained digits, suggesting that discriminating the temporal order of multi-digit stimuli can transfer to temporal discrimination of other tactile stimuli. These results suggest that experience-dependent plasticity following perceptual learning improves and interferes with tactile abilities in manners predictive of the task and stimulus features used during training. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Functional consequences of experience-dependent plasticity on tactile perception following perceptual learning

PubMed Central

Trzcinski, Natalie K; Gomez-Ramirez, Manuel; Hsiao, Steven S.

2016-01-01

Continuous training enhances perceptual discrimination and promotes neural changes in areas encoding the experienced stimuli. This type of experience-dependent plasticity has been demonstrated in several sensory and motor systems. Particularly, non-human primates trained to detect consecutive tactile bar indentations across multiple digits showed expanded excitatory receptive fields (RFs) in somatosensory cortex. However, the perceptual implications of these anatomical changes remain undetermined. Here, we trained human participants for nine days on a tactile task that promoted expansion of multi-digit RFs. Participants were required to detect consecutive indentations of bar stimuli spanning multiple digits. Throughout the training regime we tracked participants’ discrimination thresholds on spatial (grating orientation) and temporal tasks on the trained and untrained hands in separate sessions. We hypothesized that training on the multi-digit task would decrease perceptual thresholds on tasks that require stimulus processing across multiple digits, while also increasing thresholds on tasks requiring discrimination on single digits. We observed an increase in orientation thresholds on a single-digit. Importantly, this effect was selective for the stimulus orientation and hand used during multi-digit training. We also found that temporal acuity between digits improved across trained digits, suggesting that discriminating the temporal order of multi-digit stimuli can transfer to temporal discrimination of other tactile stimuli. These results suggest that experience-dependent plasticity following perceptual learning improves and interferes with tactile abilities in manners predictive of the task and stimulus features used during training. PMID:27422224
ASTD Technical and Skills Training Handbook.

ERIC Educational Resources Information Center

Kelly, Leslie, Ed.

This handbook is intended to serve as a hands-on reference for technical trainers, many of whom are resident experts in corporations who have been recruited from within the organization rather than individuals with training background. It contains 23 chapters by experts in the field: (1) The History of Technical Training (Richard A. Swanson and…
30 CFR 75.1502 - Mine emergency evacuation and firefighting program of instruction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... through a realistic SCSR training unit or device that provides the sensation of SCSR airflow resistance... of approval, the operator shall conduct training in accordance with the revised program. (b) New or... self-rescue devices, including hands-on training in the complete donning and transferring of all types...
30 CFR 75.1502 - Mine emergency evacuation and firefighting program of instruction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... through a realistic SCSR training unit or device that provides the sensation of SCSR airflow resistance... of approval, the operator shall conduct training in accordance with the revised program. (b) New or... self-rescue devices, including hands-on training in the complete donning and transferring of all types...
30 CFR 75.1502 - Mine emergency evacuation and firefighting program of instruction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... through a realistic SCSR training unit or device that provides the sensation of SCSR airflow resistance... of approval, the operator shall conduct training in accordance with the revised program. (b) New or... self-rescue devices, including hands-on training in the complete donning and transferring of all types...
Defining the Engaging Learning Experience from the Athletic Training Student Perspective

ERIC Educational Resources Information Center

Mazerolle, Stephanie M.; Bowman, Thomas G.; Benes, Sarah S.

2014-01-01

Context: Clinical experiences are an integral part of athletic training education and are where students gain the hands-on, practical knowledge and skills necessary to provide quality patient care in the field. However, some clinical education experiences may not allow athletic training students to become clinically integrated. Objective: To…
Irrigation of steppe soils in the south of Russia: Problems and solutions (Analysis of Irrigation Practices in 1950-1990)

NASA Astrophysics Data System (ADS)

Minashina, N. G.

2009-07-01

Experience in irrigation of chernozems in the steppe zone of Russia for a period from 1950 to 1990 is analyzed. By the end of this period and in the subsequent years, the areas under irrigation reduced considerably, and the soil productivity worsened. This was caused by the improper design of irrigation systems, on the one hand, and by the low tolerance of chernozems toward increased moistening upon irrigation, on the other hand. The analysis of the factors and regimes of soil formation under irrigation conditions shows that irrigation-induced changes in the soil hydrology also lead to changes in the soil physicochemical, biochemical, and other properties. In particular, changes in the composition of exchangeable cations lead to the development of solonetzic process. In many areas, irrigation of chernozems was accompanied by the appearance of solonetzic, vertic, saline, and eroded soils. The development of soil degradation processes is described. In general, the deterioration of irrigated chernozems was related to the absence of adequate experience in irrigation of steppe soils, unskilled personnel, improper regime of irrigation, and excessively high rates of watering. In some cases, the poor quality of irrigation water resulted in the development of soil salinization and alkalization. To improve the situation, the training of personnel is necessary; the strategy of continuous irrigation should be replaced by the strategy of supplementary irrigation in the critical periods of crop development.
Tactile perceptual learning: learning curves and transfer to the contralateral finger.

PubMed

Kaas, Amanda L; van de Ven, Vincent; Reithler, Joel; Goebel, Rainer

2013-02-01

Tactile perceptual learning has been shown to improve performance on tactile tasks, but there is no agreement about the extent of transfer to untrained skin locations. The lack of such transfer is often seen as a behavioral index of the contribution of early somatosensory brain regions. Moreover, the time course of improvements has never been described explicitly. Sixteen subjects were trained on the Ludvigh task (a tactile vernier task) on four subsequent days. On the fifth day, transfer of learning to the non-trained contralateral hand was tested. In five subjects, we explored to what extent training effects were retained approximately 1.5 years after the final training session, expecting to find long-term retention of learning effects after training. Results showed that tactile perceptual learning mainly occurred offline, between sessions. Training effects did not transfer initially, but became fully available to the untrained contralateral hand after a few additional training runs. After 1.5 years, training effects were not fully washed out and could be recuperated within a single training session. Interpreted in the light of theories of visual perceptual learning, these results suggest that tactile perceptual learning is not fundamentally different from visual perceptual learning, but might proceed at a slower pace due to procedural and task differences, thus explaining the apparent divergence in the amount of transfer and long-term retention.
Building capacity to reduce disparities in diabetes: training community health workers using an integrated distance learning model.

PubMed

Colleran, Kathleen; Harding, Erika; Kipp, Billie Jo; Zurawski, Andrea; MacMillan, Barbara; Jelinkova, Lucie; Kalishman, Summers; Dion, Denise; Som, Dara; Arora, Sanjeev

2012-01-01

The purpose of this study is to determine whether an innovative interactive distance training program is an effective modality to train community health workers (CHWs) to become members of the diabetes health care team. The University of New Mexico Health Sciences Center has developed a rigorous diabetes training program for CHWs involving both distance and hands-on learning as part of Project ECHO™ (Extension for Community Healthcare Outcomes). Twenty-three diverse CHW participants from across New Mexico were enrolled in the first training session. Participants completed surveys at baseline and at the end of the program. They attended a 3-day hands-on training session, followed by weekly participation in tele/video conferences for 6 months. Wilcoxon signed-rank statistics were used to compare pre- and posttest results. Participants demonstrated significant improvements in diabetes knowledge (P = .002), diabetes attitudes (P = .04) and confidence in both clinical and nonclinical skills (P < .001 and P = .04, respectively). Additionally, during focus group discussions, participants reported numerous benefits from participation in the program. Community health worker participation in the Project ECHO diabetes training program resulted in significant increases in knowledge, confidence, and attitudes in providing care to patients with diabetes. Studies are ongoing to determine whether the training has a positive impact on patient outcomes.
Upper limb training using Wii Sports Resort for children with hemiplegic cerebral palsy: a randomized, single-blind trial.

PubMed

Chiu, Hsiu-Ching; Ada, Louise; Lee, Hsin-Min

2014-10-01

To investigate whether Wii Sports Resort training is effective and if any benefits are maintained. Randomized, single-blind trial. Sixty-two hemiplegic children with cerebral palsy (6-13 years). Experimental group undertook six weeks of home-based Wii Sports Resort training plus usual therapy, while the control group received usual therapy. Outcomes were coordination, strength, hand function, and carers' perception of hand function, measured at baseline, six, and 12 weeks by a blinded assessor. There was a trend of mean difference (MD) for the experimental group to have more grip strength by six (MD 4.0 N, 95% confidence interval (CI) -0.8 to 8.8, p = 0.10) and 12 (MD 4.1 N, 95% CI -2.1 to 10.3, p = 0.19) weeks, and to have a higher quantity of hand function according to carers' perception by six (MD 4.5 N, 95% CI -0.7 to 9.7, p = 0.09) and strengthened by 12 (MD 6.4, 95% CI 0.6 to 12.3, p = 0.03) weeks than the control group. There was no difference between groups in coordination and hand function by six or 12 weeks. Wii training did not improve coordination, strength, or hand function. Beyond the intervention, carers perceived that the children used their hands more. © The Author(s) 2014.
Just What Do We Mean by "Investment"?

ERIC Educational Resources Information Center

Carr, Clay

1989-01-01

Discusses the need to develop ways of measuring the cost effectiveness of investment in employee training. Examples of employees with various training needs and their possible impact on the organization are presented, the replacement of humans with machine intelligence is discussed, and the application of performance technology is suggested. (LRW)
Effect of Virtual Reality-based Bilateral Upper Extremity Training on Upper Extremity Function after Stroke: A Randomized Controlled Clinical Trial.

PubMed

Lee, Suhyun; Kim, Yumi; Lee, Byoung-Hee

2016-12-01

In the present study, we aimed to investigate the effect of virtual reality-based bilateral upper extremity training (VRBT) on paretic upper limb function and muscle strength in patients with stroke. Eighteen stroke survivors were assigned to either the VRBT group (n = 10) or the bilateral upper limb training group (BT, n = 8). Patients in the VRBT group performed bilateral upper extremity exercises in a virtual reality environment, whereas those in the BT group performed conventional bilateral upper extremity exercises. All training was conducted for 30 minutes day -1 , 3 days a week, for a period of 6 weeks. Patients were assessed for upper extremity function and hand strength. Compared with the BT group, the VRBT group exhibited significant improvements in upper extremity function and muscle strength (p < 0.05) after the 6-week training programme. The Box and Block test results revealed that upper extremity function and elbow flexion in hand strength were significantly improved in terms of group, time and interaction effect of group by time. Furthermore, the VRBT group demonstrated significant improvements in upper extremity function, as measured by the Jebsen Hand Function Test and Grooved Pegboard test, and in the hand strength test, as measured by elbow extension, grip, palmar pinch, lateral pinch and tip pinch, in both time and the interaction effect of group by time. These results suggest that VRBT is a feasible and beneficial means of improving upper extremity function and muscle strength in individuals following stroke. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Rehabilitation (exercise and strength training) and osteoarthritis: A critical narrative review.

PubMed

Nguyen, Christelle; Lefèvre-Colau, Marie-Martine; Poiraudeau, Serge; Rannou, François

2016-06-01

Rehabilitation is widely recommended in national and international guidelines for managing osteoarthritis (OA) in primary care settings. According to the 2014 OA Research Society International (OARSI) recommendations, rehabilitation is even considered the core treatment of OA and is recommended for all patients. Rehabilitation for OA widely includes land- and water-based exercise, strength training, weight management, self-management and education, biomechanical interventions, and physically active lifestyle. We performed a critical narrative review of the efficacy and safety of rehabilitation for managing OA and discuss evidence-based international recommendations. The process of article selection was unsystematic. Articles were selected based on authors' expertise, self-knowledge, and reflective practice. For the purpose of the review, we focused on land- and water-based exercise and strength training for knee, hip and hand OA. Other aspects of rehabilitation in OA are treated elsewhere in this special issue. Exercise therapy is widely recommended for managing knee, hip and hand OA. However, the level of evidence varies according to OA location. Overall, consistent evidence suggests that exercise therapy and specific strengthening exercise or strength training for the lower limb reduce pain and improve physical function in knee OA. Evidence for other OA sites are less consistent. Therefore, because of the lack of specific studies, recommendations for hip and hand OA are mainly derived from studies of knee OA. In addition, no recommendations have been established regarding the exercise regimen. The efficacy and safety of exercise therapy and strength training need to be further evaluated in randomized controlled trials of patients with hip and hand OA. The optimal delivery of exercise programs also has to be more clearly defined. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Assessing neuromuscular block at the larynx: the effect of change in resting cuff pressure and a comparison with video imaging in anesthetized humans.

PubMed

Girling, K J; Bedforth, N M; Spendlove, J L; Mahajan, R P

1999-02-01

Neuromuscular block (NMB) at the larynx has been assessed by measuring the cuff pressure (CP) in an endotracheal tube (ETT) placed between the vocal cords. In this study, we evaluated the decrease in resting cuff pressure (RCP) after the administration of rocuronium and the effect of this decrease on the assessment of NMB, and we compared CP measurement with an alternative technique, video imaging (VI). In 20 patients, NMB was determined at the hand by mechanomyography and at the larynx initially by CP and subsequently by VI, recording images using a fiberoptic bronchoscope via a laryngeal mask. Train-of-four stimuli were applied at both sites. After baseline measurements, the ETT was replaced, and rocuronium was infused to achieve a steady-state 50% (n = 10) or 75% (n = 10) block at the hand. CP measurements were recorded before and after restoration of RCP to prerocuronium pressure, followed by further VI measurements. The mean RCP decreased from 21 +/- 4 to 12 +/- 5 mm Hg after rocuronium. At 50% block at the hand, the CP estimate of block at the larynx with reduced RCP was 62% +/- 18%, and that after restoring RCP was 29% +/- 13%; VI estimated 27% +/- 14% block. At 75% block at the hand, CP and VI estimated 52% +/- 11% and 46% +/- 9% block, respectively (RCP maintained). We conclude that RCP decreases after the administration of rocuronium, that restoring RCP significantly alters CP estimates of NMB, and that VI is in agreement with CP measurement if RCP is maintained at prerelaxant values. In this study, we show that a muscle relaxant-induced decrease in resting tension at the larynx may confound the assessment of neuromuscular block by cuff pressure measurement. The preliminary data suggest that video imaging may provide a suitable alternative to cuff pressure measurement to assess neuromuscular block at the larynx.
Quantitative impact of direct, personal feedback on hand hygiene technique.

PubMed

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.
Snorkel: Rapid Training Data Creation with Weak Supervision

PubMed Central

Ratner, Alexander; Bach, Stephen H.; Ehrenberg, Henry; Fries, Jason; Wu, Sen; Ré, Christopher

2018-01-01

Labeling training data is increasingly the largest bottleneck in deploying machine learning systems. We present Snorkel, a first-of-its-kind system that enables users to train state-of- the-art models without hand labeling any training data. Instead, users write labeling functions that express arbitrary heuristics, which can have unknown accuracies and correlations. Snorkel denoises their outputs without access to ground truth by incorporating the first end-to-end implementation of our recently proposed machine learning paradigm, data programming. We present a flexible interface layer for writing labeling functions based on our experience over the past year collaborating with companies, agencies, and research labs. In a user study, subject matter experts build models 2.8× faster and increase predictive performance an average 45.5% versus seven hours of hand labeling. We study the modeling tradeoffs in this new setting and propose an optimizer for automating tradeoff decisions that gives up to 1.8× speedup per pipeline execution. In two collaborations, with the U.S. Department of Veterans Affairs and the U.S. Food and Drug Administration, and on four open-source text and image data sets representative of other deployments, Snorkel provides 132% average improvements to predictive performance over prior heuristic approaches and comes within an average 3.60% of the predictive performance of large hand-curated training sets. PMID:29770249
Replacement Condition Detection of Railway Point Machines Using an Electric Current Sensor

PubMed Central

Sa, Jaewon; Choi, Younchang; Chung, Yongwha; Kim, Hee-Young; Park, Daihee; Yoon, Sukhan

2017-01-01

Detecting replacement conditions of railway point machines is important to simultaneously satisfy the budget-limit and train-safety requirements. In this study, we consider classification of the subtle differences in the aging effect—using electric current shape analysis—for the purpose of replacement condition detection of railway point machines. After analyzing the shapes of after-replacement data and then labeling the shapes of each before-replacement data, we can derive the criteria that can handle the subtle differences between “does-not-need-to-be-replaced” and “needs-to-be-replaced” shapes. On the basis of the experimental results with in-field replacement data, we confirmed that the proposed method could detect the replacement conditions with acceptable accuracy, as well as provide visual interpretability of the criteria used for the time-series classification. PMID:28146057
Bihemispheric Transcranial Direct Current Stimulation Enhances Effector-Independent Representations of Motor Synergy and Sequence Learning

PubMed Central

Husain, Masud; Wiestler, Tobias; Diedrichsen, Jörn

2014-01-01

Complex manual tasks—everything from buttoning up a shirt to playing the piano—fundamentally involve two components: (1) generating specific patterns of muscle activity (here, termed “synergies”); and (2) stringing these into purposeful sequences. Although transcranial direct current stimulation (tDCS) of the primary motor cortex (M1) has been found to increase the learning of motor sequences, it is unknown whether it can similarly facilitate motor synergy learning. Here, we determined the effects of tDCS on the learning of motor synergies using a novel hand configuration task that required the production of difficult muscular activation patterns. Bihemispheric tDCS was applied to M1 of healthy, right-handed human participants during 4 d of repetitive left-hand configuration training in a double-blind design. tDCS augmented synergy learning, leading subsequently to faster and more synchronized execution. This effect persisted for at least 4 weeks after training. Qualitatively similar tDCS-associated improvements occurred during training of finger sequences in a separate subject cohort. We additionally determined whether tDCS only improved the acquisition of motor memories for specific synergies/sequences or whether it also facilitated more general parts of the motor representations, which could be transferred to novel movements. Critically, we observed that tDCS effects generalized to untrained hand configurations and untrained finger sequences (i.e., were nonspecific), as well as to the untrained hand (i.e., were effector-independent). Hence, bihemispheric tDCS may be a promising adjunct to neurorehabilitative training regimes, in which broad transfer to everyday tasks is highly desirable. PMID:24431461

Enhancing entrepreneurship and professionalism in medical informatics instruction: a collaborative training model.

PubMed

Carroll, Cathryn A; Rychlewski, Walt; Teat, Marty; Clawson, Darrin

2004-01-01

This report describes an innovative training program designed to foster entrepreneurship and professionalism in students interested in the field of medical informatics. The course was developed through a private-public interinstitutional collaboration involving four academic institutions, one private firm specializing in health care information management systems, and a philanthropic organization. The program challenged students to serve in multiple roles on multidisciplinary teams and develop an innovative hand-held solution for drug information retrieval. Although the course was technically and behaviorally rigorous and required extensive hands-on experience in a nontraditional learning environment, both students and faculty responded positively.
A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS).

PubMed

Hilal, Ziad; Kumpernatz, Anne K; Rezniczek, Günther A; Cetin, Cem; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2017-03-01

To compare medical students' skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ± 6.39 vs 27.51 ± 10.27, respectively; P < 0.0001). Global rating scale (1.49 ± 0.76 vs 2.33 ± 0.94, respectively; P < 0.0001), confidence (2.22 ± 0.75 vs 3.26 ± 0.94, respectively; P = 0.04), self-assessment (2.03 ± 0.62 vs 2.51 ± 0.77, respectively; P < 0.0001), and performance time (38.81 ± 11.58 seconds vs 47.23 ± 17.35 seconds, respectively; P = 0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00 ± 6.50 vs 25.59 ± 6.09, respectively; P = 0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores. Hands-on training is superior to video demonstration for teaching VE on a pelvic model.
A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS)

PubMed Central

Hilal, Ziad; Kumpernatz, Anne K.; Rezniczek, Günther A.; Cetin, Cem; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B.

2017-01-01

Abstract Background: To compare medical students’ skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. Methods: We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. Results: In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ± 6.39 vs 27.51 ± 10.27, respectively; P < 0.0001). Global rating scale (1.49 ± 0.76 vs 2.33 ± 0.94, respectively; P < 0.0001), confidence (2.22 ± 0.75 vs 3.26 ± 0.94, respectively; P = 0.04), self-assessment (2.03 ± 0.62 vs 2.51 ± 0.77, respectively; P < 0.0001), and performance time (38.81 ± 11.58 seconds vs 47.23 ± 17.35 seconds, respectively; P = 0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00 ± 6.50 vs 25.59 ± 6.09, respectively; P = 0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores. Conclusions: Hands-on training is superior to video demonstration for teaching VE on a pelvic model. PMID:28296771
Risk Assessment Training Experience (RATE) – University of Iowa Superfund Research Center.

EPA Science Inventory

These modules will offer hands-on training in the primary areas of risk assessment (i.e., legal background, hazard identification, dose-response assessment, exposure assessment, and risk characterization) at the University of Iowa Superfund Research Program on October 2, 2017. An...
Effects of laparoscopic instrument and finger on force perception: a first step towards laparoscopic force-skills training.

PubMed

Raghu Prasad, M S; Manivannan, M; Chandramohan, S M

2015-07-01

In laparoscopic surgery, no external feedback on the magnitude of the force exerted is available. Hence, surgeons and residents tend to exert excessive force, which leads to tissue trauma. Ability of surgeons and residents to perceive their own force output without external feedback is a critical factor in laparoscopic force-skills training. Additionally, existing methods of laparoscopic training do not effectively train residents and novices on force-skills. Hence, there is growing need for the development of force-based training curriculum. As a first step towards force-based laparoscopic skills training, this study analysed force perception difference between laparoscopic instrument and finger in contralateral bimanual passive probing task. The study compared the isometric force matching performance of novices, residents and surgeons with finger and laparoscopic instrument. Contralateral force matching paradigm was employed to analyse the force perception capability in terms of relative (accuracy), and constant errors in force matching. Force perception of experts was found to be better than novices and residents. Interestingly, laparoscopic instrument was more accurate in discriminating the forces than finger. The dominant hand attempted to match the forces accurately, whereas non-dominant hand (NH) overestimated the forces. Further, the NH of experts was found to be most accurate. Furthermore, excessive forces were applied at lower force levels and at very high force levels. Due to misperception of force, novices and residents applied excessive forces. However, experts had good control over force with both dominant and NHs. These findings suggest that force-based training curricula should not only have proprioception tasks, but should also include bimanual force-skills training exercises in order to improve force perception ability and hand skills of novices and residents. The results can be used as a performance metric in both box and virtual reality based force-skills training.
[Technology: training centers--a new method for learning surgery in visceral surgery].

PubMed

Troidl, H

1996-01-01

The importance of training centers can be best described after first answering a few questions like: 1. What kind of surgery will we deal with in the future? 2. What kind of surgeon do we need for this surgery, if it is basically different? 3. How will this surgeon have to be educated/trained for this different surgery? Although I am aware of the fact, that statements about future prospects are usually doomed to fail, I maintain that endoscopic surgery will be an essential part of general surgery. If this is so, surgery will be dominated by extremely complicated technology, new techniques and new instruments. It will be a "different" surgery. It will offer more comfort at the same safety. The surgeon of the future will still need a certain personality; he will still need intuition and creativity. To survive in our society, he will have to be an organiser and even a businessman. Additionally, something new has to be added: he will have to understand modern, complicated technology and will have to use totally different instruments for curing surgical illness. This makes it clear that we will need a different education/training and may be even a different selection of surgeons. We should learn from other professions sharing common interests with surgery, for example, sports where the common interest is achieving most complicated motions and necessarily highly differentiated coordination. Common interest with airline pilots is the target of achieving absolute security. They have a highly differentiated selection and training concept. Training centers may be-under certain prerequisites-a true alternative for this necessary form of training. They must have a concept, i.e. contents and aims have to be defined, structured and oriented on the requirements of surgery for the patient. Responsibility for the concept, performance and control can only be in the hands of Surgical Societies and Universities. These prerequisites correspond most likely to training centers being established by universities and managed by them. Training centers set up by the industry contain some trouble spots, from "sponsoring" over "normal business" to "corruption". Being aware of the fact that training centers will replace traditional "surgery schools"-teaching in their current state is technology and techniques-they are a true alternative for learning/training in general surgery.
Lay Bystanders' Perspectives on What Facilitates Cardiopulmonary Resuscitation and Use of Automated External Defibrillators in Real Cardiac Arrests.

PubMed

Malta Hansen, Carolina; Rosenkranz, Simone Mørk; Folke, Fredrik; Zinckernagel, Line; Tjørnhøj-Thomsen, Tine; Torp-Pedersen, Christian; Sondergaard, Kathrine B; Nichol, Graham; Hulvej Rod, Morten

2017-03-13

Many patients who suffer an out-of-hospital cardiac arrest will fail to receive bystander intervention (cardiopulmonary resuscitation [CPR] or defibrillation) despite widespread CPR training and the dissemination of automated external defibrillators (AEDs). We sought to investigate what factors encourage lay bystanders to initiate CPR and AED use in a cohort of bystanders previously trained in CPR techniques who were present at an out-of-hospital cardiac arrest. One-hundred and twenty-eight semistructured qualitative interviews with CPR-trained lay bystanders to consecutive out-of-hospital cardiac arrest, where an AED was present were conducted (from January 2012 to April 2015, in Denmark). Purposive maximum variation sampling was used to establish the breadth of the bystander perspective. Twenty-six of the 128 interviews were chosen for further in-depth analyses, until data saturation. We used cross-sectional indexing (using software), and inductive in-depth thematic analyses, to identify those factors that facilitated CPR and AED use. In addition to prior hands-on CPR training, the following were described as facilitators: prior knowledge that intervention is crucial in improving survival, cannot cause substantial harm, and that the AED will provide guidance through CPR; prior hands-on training in AED use; during CPR performance, teamwork (ie, support), using the AED voice prompt and a ventilation mask, as well as demonstrating leadership and feeling a moral obligation to act. Several factors other than previous hands-on CPR training facilitate lay bystander instigation of CPR and AED use. The recognition and modification of these factors may increase lay bystander CPR rates and patient survival following an out-of-hospital cardiac arrest. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
The effects of aging on the asymmetry of inter-limb transfer in a visuomotor task.

PubMed

Pan, Zhujun; Van Gemmert, Arend W A

2013-09-01

The direction of the asymmetry of inter-limb transfer has been suggested to identify the specialization of each hemisphere when performing a motor task. In an earlier study, we showed that trajectory information is only transferred from the right to the left hand, while final movement outcome-associated parameters transferred in both directions when right-hand-dominant individuals perform a motor task with visual distorted feedback. In the current study, we try to replicate this finding in young adults and test whether the asymmetry of inter-limb transfer in visuomotor task reduces in older adults, suggesting that hemispheric lateralization reduces with age. Young and older adults (all right-hand-dominant) performed a multidirectional point-to-point drawing task in which the visual feedback was rotated and the gain was increased. Half of the participants in each age group trained with the right hand and the other half trained with the left hand. Performances of both hands with non-distorted and distorted visual feedback were collected from all participants before and after the training session. The results showed that the pattern of inter-limb transfer was similar between young and older adults, i.e., inter-limb transfer is asymmetric for initial direction and symmetric for movement time and trajectory length. The results suggest that older adults retain the specialized functions of the non-dominant (right) hemisphere allowing them to program movement direction of a graphic aiming task when visual feedback is distorted.
Upper-limb sensory impairments after stroke: Self-reported experiences of daily life and rehabilitation.

PubMed

Carlsson, Håkan; Gard, Gunvor; Brogårdh, Christina

2018-01-10

To describe stroke survivors' experiences of sensory impairment in the upper limb, the influence of such impairment on daily life, coping strategies used, and sensory training for the affected hand. A qualitative study with a content analysis approach. Fifteen post-stroke patients interviewed individually. Five categories emerged from the data: "Changed and varied perception of the sensation"; "Affected movement control"; "Problems using the hand in daily life"; "Various strategies to cope with upper limb disability"; and "Lack of sensory training". Numbness and tingling, changes in temperature sensitivity, and increased sensitivity to touch and pain were reported. Many subjects had difficulty adjusting their grip force and performing movements with precision. It was problematic and mentally fatiguing managing personal care and carrying out household and leisure activities. Practical adaptations, compensation with vision, increased concentration, and use of the less affected hand were strategies used to overcome difficulties. Despite their problems very few subjects had received any specific sensory training for the hand. Stroke survivors perceive that sensory impairment of the upper limb has a highly negative impact on daily life, but specific rehabilitation for the upper limb is lacking. These findings imply that the clinical management of upper limb sensory impairment after stroke requires more attention.
Wearable Sensors for eLearning of Manual Tasks: Using Forearm EMG in Hand Hygiene Training

PubMed Central

Kutafina, Ekaterina; Laukamp, David; Bettermann, Ralf; Schroeder, Ulrik; Jonas, Stephan M.

2016-01-01

In this paper, we propose a novel approach to eLearning that makes use of smart wearable sensors. Traditional eLearning supports the remote and mobile learning of mostly theoretical knowledge. Here we discuss the possibilities of eLearning to support the training of manual skills. We employ forearm armbands with inertial measurement units and surface electromyography sensors to detect and analyse the user’s hand motions and evaluate their performance. Hand hygiene is chosen as the example activity, as it is a highly standardized manual task that is often not properly executed. The World Health Organization guidelines on hand hygiene are taken as a model of the optimal hygiene procedure, due to their algorithmic structure. Gesture recognition procedures based on artificial neural networks and hidden Markov modeling were developed, achieving recognition rates of 98.30% (±1.26%) for individual gestures. Our approach is shown to be promising for further research and application in the mobile eLearning of manual skills. PMID:27527167
Wearable Sensors for eLearning of Manual Tasks: Using Forearm EMG in Hand Hygiene Training.

PubMed

Kutafina, Ekaterina; Laukamp, David; Bettermann, Ralf; Schroeder, Ulrik; Jonas, Stephan M

2016-08-03

In this paper, we propose a novel approach to eLearning that makes use of smart wearable sensors. Traditional eLearning supports the remote and mobile learning of mostly theoretical knowledge. Here we discuss the possibilities of eLearning to support the training of manual skills. We employ forearm armbands with inertial measurement units and surface electromyography sensors to detect and analyse the user's hand motions and evaluate their performance. Hand hygiene is chosen as the example activity, as it is a highly standardized manual task that is often not properly executed. The World Health Organization guidelines on hand hygiene are taken as a model of the optimal hygiene procedure, due to their algorithmic structure. Gesture recognition procedures based on artificial neural networks and hidden Markov modeling were developed, achieving recognition rates of 98 . 30 % ( ± 1 . 26 % ) for individual gestures. Our approach is shown to be promising for further research and application in the mobile eLearning of manual skills.
Teaching and training acute renal replacement therapy in children.

PubMed

López-Herce, Jesús; Ferrero, Luis; Mencía, Santiago; Antón, Montserrat; Rodríguez-Núñez, Antonio; Rey, Corsino; Rodríguez, Luis

2012-05-01

The objective of this study is to describe and analyse the initial experience in paediatric acute renal replacement therapy (ARRT) education by means of specific courses. Three paediatric ARRT courses were run. The course programme included initial and final multiple-choice question (MCQ) exams, short lectures, practical workshops [in vitro peritoneal dialysis (PD) and continuous renal replacement therapy (CRRT) machines skill stations, real-time PD and CRRT in paediatric animal models and paediatric CRRT advanced simulation scenarios based on real cases) and an anonymous survey on the perceived value of the course (score from 0: very bad to 10: perfect). Number of students per workshop was six to eight. Continuous assessment of participants' performance was done. In the initial MCQ, only 11% of students answered correctly at least 70% of questions, while in the final test, 90.5% hit this target (P < 0.001). In the performance assessments, all of the students demonstrated sufficient acquisition of practical skills. In the perceived value survey, the course methodology was rated at 9.3, organization 9.9, teaching staff 9.6, lectures 9 and practical sessions 9.1. Specifically designed CRRT and PD courses are adequate for teaching the theoretical aspects and training these procedures. The combination of laboratory, training with animals and advanced simulation scenarios might have a synergistic effect on learning.
An unusual case of an immersion hand presentation in a military signaller operating in the jungle in Belize.

PubMed

Forbes, Kirstie E; Foster, P

2017-12-01

Belize, hosting one of the British Army's overseas training areas, provides access to challenging terrain and austere environments, which allows the delivery of training to soldiers on survival and combat within the jungle environment. A 26-year-old infanteer on exercise in Belize presented with progressive bilateral dry, painful, oedematous hands, secondary to the harsh environmental conditions of the jungle and inadequate drying of his hands resulting in his inability to perform his combat duties. The symptoms completely resolved with drying, emollient application and analgesia. While there are no reported cases of immersion hand, comparisons can be made with the well-reported warm weather immersion foot. This case highlights the importance of force preparation and soldier education for units deploying to the jungle. Simple preventive measures, including adequate 'wet-dry' drills and use of emollients can reduce the prevalence of immersion hand, a preventable condition, which can have a significant impact on the overall combat effectiveness of the unit. © 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.
Using Hand Grip Force as a Correlate of Longitudinal Acceleration Comfort for Rapid Transit Trains

PubMed Central

Guo, Beiyuan; Gan, Weide; Fang, Weining

2015-01-01

Longitudinal acceleration comfort is one of the essential metrics used to evaluate the ride comfort of train. The aim of this study was to investigate the effectiveness of using hand grip force as a correlate of longitudinal acceleration comfort of rapid transit trains. In the paper, a motion simulation system was set up and a two-stage experiment was designed to investigate the role of the grip force on the longitudinal comfort of rapid transit trains. The results of the experiment show that the incremental grip force was linearly correlated with the longitudinal acceleration value, while the incremental grip force had no correlation with the direction of the longitudinal acceleration vector. The results also show that the effects of incremental grip force and acceleration duration on the longitudinal comfort of rapid transit trains were significant. Based on multiple regression analysis, a step function model was established to predict the longitudinal comfort of rapid transit trains using the incremental grip force and the acceleration duration. The feasibility and practicably of the model was verified by a field test. Furthermore, a comparative analysis shows that the motion simulation system and the grip force based model were valid to support the laboratory studies on the longitudinal comfort of rapid transit trains. PMID:26147730
Development of an intelligent surgical training system for Thoracentesis.

PubMed

Nakawala, Hirenkumar; Ferrigno, Giancarlo; De Momi, Elena

2018-01-01

Surgical training improves patient care, helps to reduce surgical risks, increases surgeon's confidence, and thus enhances overall patient safety. Current surgical training systems are more focused on developing technical skills, e.g. dexterity, of the surgeons while lacking the aspects of context-awareness and intra-operative real-time guidance. Context-aware intelligent training systems interpret the current surgical situation and help surgeons to train on surgical tasks. As a prototypical scenario, we chose Thoracentesis procedure in this work. We designed the context-aware software framework using the surgical process model encompassing ontology and production rules, based on the procedure descriptions obtained through textbooks and interviews, and ontology-based and marker-based object recognition, where the system tracked and recognised surgical instruments and materials in surgeon's hands and recognised surgical instruments on the surgical stand. The ontology was validated using annotated surgical videos, where the system identified "Anaesthesia" and "Aspiration" phase with 100% relative frequency and "Penetration" phase with 65% relative frequency. The system tracked surgical swab and 50mL syringe with approximately 88.23% and 100% accuracy in surgeon's hands and recognised surgical instruments with approximately 90% accuracy on the surgical stand. Surgical workflow training with the proposed system showed equivalent results as the traditional mentor-based training regime, thus this work is a step forward a new tool for context awareness and decision-making during surgical training. Copyright © 2017 Elsevier B.V. All rights reserved.
75 FR 13646 - Public Meeting With Interested Persons To Discuss the Proposed AC 20-42D, Hand Fire Extinguishers...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... Systems Fire Protection Working Group (IASFPWG) to draft a revision to the current AC 20-42C, issued on... approved replacement agents for Halon 1211 and establishes an FAA approved minimum performance standard...
The 10 Hz Frequency: A Fulcrum For Transitional Brain States

PubMed Central

Garcia-Rill, E.; D’Onofrio, S.; Luster, B.; Mahaffey, S.; Urbano, F. J.; Phillips, C.

2016-01-01

A 10 Hz rhythm is present in the occipital cortex when the eyes are closed (alpha waves), in the precentral cortex at rest (mu rhythm), in the superior and middle temporal lobe (tau rhythm), in the inferior olive (projection to cerebellar cortex), and in physiological tremor (underlying all voluntary movement). These are all considered resting rhythms in the waking brain which are “replaced” by higher frequency activity with sensorimotor stimulation. That is, the 10 Hz frequency fulcrum is replaced on the one hand by lower frequencies during sleep, or on the other hand by higher frequencies during volition and cognition. The 10 Hz frequency fulcrum is proposed as the natural frequency of the brain during quiet waking, but is replaced by higher frequencies capable of permitting more complex functions, or by lower frequencies during sleep and inactivity. At the center of the transition shifts to and from the resting rhythm is the reticular activating system, a phylogenetically preserved area of the brain essential for preconscious awareness. PMID:27547831
Do Right- and Left-Handed Monkeys Differ on Cognitive Measures?

NASA Technical Reports Server (NTRS)

Hopkins, William D.; Washburn, David A.

1994-01-01

Twelve left- and 14 right-handed monkeys were compared on 6 measures of cognitive performance (2 maze-solving tasks, matching-to-sample, delayed matching-to-sample, delayed response using spatial cues, and delayed response using form cues). The dependent variable was trials-to-training criterion for each of the 6 tasks. Significant differences were found between left- and right-handed monkeys on the 2 versions of the delayed response task. Right-handed monkeys reached criterion significantly faster on the form cue version of the task, whereas left-handed monkeys reached criterion significantly faster on delayed response for spatial position (p less than .05). The results suggest that sensitive hand preference measures of laterality can reveal differences in cognitive performance, which in turn may reflect underlying laterality in functional organization of the nervous system.
A novel approach to improve hand hygiene compliance of student nurses

PubMed Central

2013-01-01

Background The National University Hospital, Singapore routinely undertakes standardized Hand Hygiene auditing with results produced by ward and by staff type. In 2010 concern was raised over consistently low compliance by nursing students averaging 45% (95% CI 42%–48%) prompting us to explore novel approaches to educating our next generation of nurses to improve their hand hygiene practice. We introduced an experiential learning assignment to final year student nurses on attachment to NUH inclusive of hand hygiene auditor training followed by a period of hand hygiene observation. The training was based on the World Health Organisation (WHO) “My 5 moments for hand hygiene” approach. Upon completion students completed an anonymous questionnaire to evaluate their learning experience. Findings By 2012, nursing students were 40% (RR: 1.4, 95% CI 1.3–1.5, p<0.001) more likely to comply with hand hygiene practices. 97.5% (359/368) of nursing students felt that the experience would enhance their own hand hygiene practice and would recommend participating in audits as a learning instrument. Conclusions With consideration of all stakeholders a sustainable, flexible, programme was implemented. Experiential learning of hand hygiene was a highly valued educational tool and in our project was directly associated with improved hand hygiene compliance. Feedback demonstrated popularity amongst participants and success in achieving its program objectives. While this does not guarantee long term behavioural change it is intuitive that instilling good habits and messages at the early stages of a career will potentially have significant long-term impact. PMID:23721611
Effectiveness of training on infant feeding practices among community influencers in a rural area of west Bengal.

PubMed

Haldar, A; Ray, S; Biswas, R; Biswas, B; Mukherjee, D

2001-01-01

Total 34 Influencers were trained in a subcentre area of South 24-parganas district of West Bengal. Knowledge was imparted to community influencers on infant feeding practices through lecture, group discussion, question-answer session and hand-on-training by trained health workers. Pre-assessment was done before initiation of training. Repeat training was conducted at frequent intervals within a period of 3 months. Mean score of knowledge of influencers during pre-training assessment was 13.3 and improved thereafter-following training to 20.8 (1st assessment), 20.6 (2nd assessment), 23.7 (3rd assessment) and 25.2 (final-assessment). Repeat training had also desired impact.

International Workshop on Educational Infrastructure: Conclusions (Summary of Proceedings, Guadalajara, Jalisco, Mexico, February 24-27, 2002).

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Programme on Educational Building.

This document summarizes themes developed and conclusions from the International Workshop on Educational Infrastructure. The opening topic was "Delivering Education and Training in the Knowledge Society." It was clear to participants that educational infrastructure must go hand-in-hand with reengineering processes to adjust to the needs…
Social Exchange in Dutch Schools for Vocational Education and Training

ERIC Educational Resources Information Center

Thomsen, Maren; Karsten, Sjoerd; Oort, Frans J.

2015-01-01

In this study we examined the role of trust as a mediator in social exchange between teachers and their school, particularly between perceived procedural justice and perceived organizational support, on the one hand, and teachers' affective organizational commitment and organizational citizenship behaviour, on the other hand. A model was developed…
Effect of concurrent resistance and sprint training on body composition and cardiometabolic health indicators in masters cyclists

PubMed Central

Delvecchio, Luke; Reaburn, Peter; Trapp, Gail; Korhonen, Marko T.

2016-01-01

In older previously sedentary individuals endurance training imposes a more effective stimulus to enhance cardiometabolic health compared with resistance or sprint training. We examined the effect of replacing a portion of endurance training with combined resistance and/or sprint training and how this influences cardiometabolic health indicators in masters endurance cyclists. Twenty-seven well-trained male road cyclists (53.7±8.2 years) were allocated to a resistance and track sprint-cycling training group (RTC, n=10), an endurance and track sprint-cycling group (ETC, n=7) or a control endurance group (CTRL, n=10). Both the RTC and ETC groups completed a 12-week intervention of specific training while the CTRL group maintained their endurance training load. Lower limb lean mass (LLM), trunk fat mass (TFM), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before and after the intervention period. TFM decreased for all groups (P<0.05) while LLM significantly increased for RTC and ETC groups (P<0.05). No significant between group or time effects were observed for FBG, TC, TG, SBP, or DBP. The results suggest that replacing a portion of endurance training with 12 weeks of ETC or RTC training favourably affects body composition by lowering TFM and increasing LLM without negatively affecting cardiometabolic health indicators in well-trained masters endurance cyclists. PMID:27807523
Effects of specific muscle imbalance improvement training on the balance ability in elite fencers.

PubMed

Kim, Taewhan; Kil, Sekee; Chung, Jinwook; Moon, Jeheon; Oh, Eunyoung

2015-05-01

[Purpose] The lunge Motion that occurs frequently in fencing training and matches results in imbalance of the upper and lower limbs muscles. This research focuses on the improvement of the imbalance that occurs in the national team fencers of the Republic of Korea through specific muscle imbalance improvement training. [Subjects] The subjects of this research were limited to right-handed male fencers. Nine male, right-handed national fencing athletes were selected for this study (4 epee, 5 sabre; age 28.2 ± 2.2 years; height 182.3 ± 4.0 cm; weight 76.5 ± 8.2 kg; experience 12.4 ± 3.0 years). [Methods] The specific muscle imbalance improvement training program was performed for 12 weeks and Pre-Post tests were to evaluate its effect on the experimental group. Measurements comprised anthropometry, test of balance, and movement analysis. [Results] After the training program, mediolateral sway of the nondominant lower limb and the balance scale showed statistically significant improvement. [Conclusion] The specific muscle imbalance improvement training program used in this research was proven to be effective for improving the muscle imbalance of elite fencers.
Quality improvement program for the B83 bomb hand truck

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loll, M.B.; Buck, S.A.

1998-04-01

This report describes the problems, issues, and history of the H1347 bomb hand truck for the B83 bomb after the bomb was put into stockpile in the mid-1980s. Major issues that were reported in Unsatisfactory Reports (URs) were cracking problems on stacking fixture welds, cracked welds on the caster bracket receptacles on the cradle, cracked caster mounting brackets, casters unlocking from the swivel lock position, and caster tires rubbing and binding on the stacking frame. Resolution of these and other problems is described. The introduction of the H695B storage-only bomb hand truck to alleviate a shortage of bomb hand trucksmore » in the mid-1990s is described. The development and qualification of the H1347A bomb hand truck as a replacement for the H695 B is covered. The results from load test evaluations on the stacking fixture, cradle, and casters for the H1347 are described along with towing results on one and two-high stack configurations of B83 bombs in bomb hand trucks. New towing and truck/trailer transport procedures are described. Development, evaluation, and production recommendations for a stronger caster mounting bracket are described.« less
KSC-08pd0039

NASA Image and Video Library

2008-01-13

KENNEDY SPACE CENTER, FLA. -- Mike Berger, with Lockheed Martin, examines the internal connector on space shuttle Atlantis' external tank to which the replacement feed-through connector in the engine cutoff, or ECO, sensor system will be attached. The replacement connector is seen below Berger's hand. The feed-through connector passes the wires from the inside of the tank to the outside. Results of a tanking test on Dec. 18 pointed to an open circuit in the feed-through connector wiring, which is located at the base of the tank. The pins in the replacement connector have been precisely soldered to create a connection that allows sensors inside the tank to send signals to the computers onboard Atlantis. The work is being done on Launch Pad 39A. Space shuttle Atlantis is now targeted for launch on Feb. 7. Photo credit: NASA/George Shelton
Apollo 13 Astronaut James Lovel during lunar surface simulation training

NASA Image and Video Library

1970-01-16

S70-28229 (16 Jan. 1970) --- Astronaut James A. Lovell Jr., commander of the Apollo 13 lunar landing mission, participates in lunar surface simulation training at the Manned Spacecraft Center. Lovell is attached to a Six Degrees of Freedom Simulator. He is carrying an Apollo Lunar Hand Tools carrier in his right hand.
The Effect of Special Operations Training on Testosterone, Lean Body Mass, and Strength and the Potential for Therapeutic Testosterone Replacement: A Review of the Literature

DTIC Science & Technology

2016-07-01

Effects of Testosterone or Anabolic Androgenic Steroid on Body Mass, Lean Body Mass, and Strength in Patients with Disease or Muscle Wasting...of Ranger training reportedly decreased body mass, fat mass, and lean body mass (LBM), with reductions in field measures of strength and power of...Table 3. Effects of Testosterone or Anabolic Androgenic Steroid with Resistance Training on Lean Body Mass and Strength Source Subjects Treatment
Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

PubMed

Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

2012-10-01

To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. www.ClinicalTrials.gov, NCT01618565. I.
Ground reaction force characteristics of Tai Chi push hand.

PubMed

Chang, Yao-Ting; Chang, Jia-Hao; Huang, Chen-Fu

2014-01-01

Push Hand is an advanced training technique for the Yang-style old frame 108 forms Tai Chi Chuan. It is performed by two practitioners. To clarify how people use forces during Push Hand training, it is important to review the ground reaction force (GRF). Here, we quantify the characteristics of the GRF during Push Hand training. Kinematic data and GRF data from 10 Tai Chi Chuan practitioners (29.9 ± 7.87 years) were synchronously recorded using a three-dimensional motion analysis system (200 frames · s(-1)) and three-dimensional force plates (1000 Hz). The resultant GRF for both feet for the 0%, 50% and 100% phases of attack and defence were compared to body weight using a paired-samples t-test. The differences in the resultant GRF between the 0%, 50% and 100% phases of attack and defence were tested by one-way repeated-measures ANOVA. The significance level was set to 0.05. The total resultant GRF was almost equal to the participant's body weight in push hand. This result was consistent throughout the entire push hand process. Our results revealed that the GRF was comparable to the body weight, implying that practitioners do not push or resist their opponents during the push hand process.
Perceptions of Emergency Medicine Residency and Hand Surgery Fellowship Program Directors in the Appropriate Disposition of Upper Extremity Emergencies.

PubMed

Drolet, Brian C; Lifchez, Scott D; Jacoby, Sidney M; Varone, Andrew; Regan, Linda A; Baren, Jill M; Akelman, Edward; Osterman, A Lee; Levin, L Scott

2015-12-01

To survey emergency medicine (EM) residency and hand surgery fellowship program directors (PDs) to identify consensus in their perceptions of appropriate emergency care of upper extremity emergencies. We created a framework to group common upper extremity emergency diagnoses and surveyed PDs to evaluate the training background--EM, general orthopedic or plastic surgery, or hand fellowship--most appropriate to provide acute, point-of-care management for each of these diagnostic groupings. Responses were pooled and consensus was established with greater than 75% agreement between groups. We received 79 responses from hand fellowship PDs (90% response rate) and 151 responses from EM PDs (49% response rate). We identified consensus for the training background that PDs in both specialties felt was appropriate to care for 17 of 21 diagnostic groupings in the framework. There was a high level of consensus between EM and hand surgery PDs regarding diagnoses that acutely require training in hand surgery versus those that can be managed by an EM physician. Our diagnostic framework may help reduce unnecessary hand surgery consultation and may help to identify patients who do not require more specialized acute care and thus decrease unnecessary transfers. Economic and Decision Analyses IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
The management of heat stress for the firefighter: a review of work conducted on behalf of the Toronto Fire Service.

PubMed

McLellan, Tom M; Selkirk, Glen A

2006-07-01

This report provides a summary of research conducted through a grant provided by the Workplace Safety Insurance Board of Ontario. The research was divided into two phases; first, to define safe work limits for firefighters wearing their protective clothing and working in warm environments; and, the second, to examine strategies to reduce the thermal burden and extend the operational effectiveness of the firefighter. For the first phase, subjects wore their protective ensemble and carried their self-contained breathing apparatus (SCBA) and performed very light, light, moderate or heavy work at 25 degrees C, 30 degrees C or 35 degrees C. Thermal and evaporative resistance coefficients were obtained from thermal manikin testing that allowed the human physiological responses to be compared with modeled data. Predicted continuous work times were then generated using a heat strain model that established limits for increases in body temperature to 38.0 degrees C, 38.5 degrees C and 39.0 degrees C. Three experiments were conducted for the second phase of the project. The first study revealed that replacing the duty uniform pants that are worn under the bunker pants with shorts reduced the thermal strain for activities that lasted longer than 60 min. The second study examined the importance of fluid replacement. The data revealed that fluid replacement equivalent to at least 65% of the sweat lost increased exposure time by 15% compared with no fluid replacement. The last experiment compared active and passive cooling. Both the use of a mister or forearm and hand submersion in cool water significantly increased exposure time compared with passive cooling that involved only removing most of the protective clothing. Forearm and hand submersion proved to be most effective and produced dramatic increases in exposure time that approximated 65% compared with the passive cooling procedure. When the condition of no fluid replacement and passive cooling was compared with fluid replacement and forearm and hand submersion, exposure times were effectively doubled with the latter condition. The heat stress wheel that was generated can be used by Commanders to determine safe work limits for their firefighters during activities that involve wearing their protective clothing and carrying their SCBA.
Fusion of Haptic and Gesture Sensors for Rehabilitation of Bimanual Coordination and Dexterous Manipulation.

PubMed

Yu, Ningbo; Xu, Chang; Li, Huanshuai; Wang, Kui; Wang, Liancheng; Liu, Jingtai

2016-03-18

Disabilities after neural injury, such as stroke, bring tremendous burden to patients, families and society. Besides the conventional constrained-induced training with a paretic arm, bilateral rehabilitation training involves both the ipsilateral and contralateral sides of the neural injury, fitting well with the fact that both arms are needed in common activities of daily living (ADLs), and can promote good functional recovery. In this work, the fusion of a gesture sensor and a haptic sensor with force feedback capabilities has enabled a bilateral rehabilitation training therapy. The Leap Motion gesture sensor detects the motion of the healthy hand, and the omega.7 device can detect and assist the paretic hand, according to the designed cooperative task paradigm, as much as needed, with active force feedback to accomplish the manipulation task. A virtual scenario has been built up, and the motion and force data facilitate instantaneous visual and audio feedback, as well as further analysis of the functional capabilities of the patient. This task-oriented bimanual training paradigm recruits the sensory, motor and cognitive aspects of the patient into one loop, encourages the active involvement of the patients into rehabilitation training, strengthens the cooperation of both the healthy and impaired hands, challenges the dexterous manipulation capability of the paretic hand, suits easy of use at home or centralized institutions and, thus, promises effective potentials for rehabilitation training.
Fusion of Haptic and Gesture Sensors for Rehabilitation of Bimanual Coordination and Dexterous Manipulation

PubMed Central

Yu, Ningbo; Xu, Chang; Li, Huanshuai; Wang, Kui; Wang, Liancheng; Liu, Jingtai

2016-01-01

Disabilities after neural injury, such as stroke, bring tremendous burden to patients, families and society. Besides the conventional constrained-induced training with a paretic arm, bilateral rehabilitation training involves both the ipsilateral and contralateral sides of the neural injury, fitting well with the fact that both arms are needed in common activities of daily living (ADLs), and can promote good functional recovery. In this work, the fusion of a gesture sensor and a haptic sensor with force feedback capabilities has enabled a bilateral rehabilitation training therapy. The Leap Motion gesture sensor detects the motion of the healthy hand, and the omega.7 device can detect and assist the paretic hand, according to the designed cooperative task paradigm, as much as needed, with active force feedback to accomplish the manipulation task. A virtual scenario has been built up, and the motion and force data facilitate instantaneous visual and audio feedback, as well as further analysis of the functional capabilities of the patient. This task-oriented bimanual training paradigm recruits the sensory, motor and cognitive aspects of the patient into one loop, encourages the active involvement of the patients into rehabilitation training, strengthens the cooperation of both the healthy and impaired hands, challenges the dexterous manipulation capability of the paretic hand, suits easy of use at home or centralized institutions and, thus, promises effective potentials for rehabilitation training. PMID:26999149
Creating Nanotechnicians for the 21st Century Workplace

NASA Astrophysics Data System (ADS)

Burke, Michael; Jean, Kristi; Brown, Cheryl; Barrett, Rick; Leopold, Carrie

The North Dakota State College of Science (NDSCS) Nanoscience Technology Training Program was designed and implemented to meet the growing demand for technicians skilled in nanofabrication, surface analysis and production of various micro and nano-scale products. The program emphasizes hands-on training and utilizes a state-of-the-art Applied Science and Advanced Manufacturing Training Laboratory to develop the KSA’s (knowledge, skills, attitudes) needed by industry. Two-year Associate in Applied Science degree, diploma and certificate tracks are offered in four industry focus areas; nanotechnology, microelectronics technology, bio-fuels technology and biotechnology. Students learn to work in multidisciplinary teams on design, prototyping, analysis and manufacturing processes of products. The program also hosts an extensive hands-on outreach program which interacted with over 8000 secondary school science students and 500 teachers in the first 12 months of operation.
Hospitalists' ability to use hand-carried ultrasound for central venous pressure estimation after a brief training intervention: a pilot study.

PubMed

Martin, L David; Ziegelstein, Roy C; Howell, Eric E; Martire, Carol; Hellmann, David B; Hirsch, Glenn A

2013-12-01

Access to hand-carried ultrasound technology for noncardiologists has increased significantly, yet development and evaluation of training programs are limited. We studied a focused program to teach hospitalists image acquisition of inferior vena cava (IVC) diameter and IVC collapsibility index with interpretation of estimated central venous pressure (CVP). Ten hospitalists completed an online educational module prior to attending a 1-day in-person training session that included directly supervised IVC imaging on volunteer subjects. In addition to making quantitative assessments, hospitalists were also asked to visually assess whether the IVC collapsed more than 50% during rapid inspiration or a sniff maneuver. Skills in image acquisition and interpretation were assessed immediately after training on volunteer patients and prerecorded images, and again on volunteer patients at least 6 weeks later. Eight of 10 hospitalists acquired adequate IVC images and interpreted them correctly on 5 of the 5 volunteer subjects and interpreted all 10 prerecorded images correctly at the end of the 1-day training session. At 7.4 ± 0.7 weeks (range, 6.9-8.6 weeks) follow-up, 9 of 10 hospitalists accurately acquired and interpreted all IVC images in 5 of 5 volunteers. Hospitalists were also able to accurately determine whether the IVC collapsibility index was more than 50% by visual assessment in 180 of 198 attempts (91% of the time). After a brief training program, hospitalists acquired adequate skills to perform and interpret hand-carried ultrasound IVC images and retained these skills in the near term. Though calculation of the IVC collapsibility index is more accurate, coupling a qualitative assessment with the IVC maximum diameter measurement may be acceptable in aiding bedside estimation of CVP. © 2013 Society of Hospital Medicine.
Tribal Air Quality Monitoring.

ERIC Educational Resources Information Center

Wall, Dennis

2001-01-01

The Institute for Tribal Environmental Professionals (ITEP) (Flagstaff, Arizona) provides training and support for tribal professionals in the technical job skills needed for air quality monitoring and other environmental management tasks. ITEP also arranges internships, job placements, and hands-on training opportunities and supports an…
User Centred Design and Nosocomials in Surgical ICUs: A Mobile Application for Peer Monitoring and Training in Hand Hygiene.

PubMed

Kariyawasam, Nadish; Wong, Ming Chao; Turner, Paul

2017-01-01

Nosocomial infections are a global public health risk. In low and middle-income countries the problem is acute with very high infection rates commonly contributing to poor patient outcomes including mortality. Organisational, cultural, and individual factors have been identified in these high rates, with poor hand hygiene compliance amongst clinicians a major risk factor. New approaches to achieving clinician behaviour change are required. User-centred approaches have proven effective to engage and support changes in clinician behaviours through the use of electronic tools. This paper reports on the experience of co-designing and implementing a mobile application with clinicians to enhance hand hygiene compliance. The peer monitoring and training supported by the application aims to directly contribute to evidence on reductions in infection rates in two surgical ICUs in Sri Lanka.
Learning to Solve a Business Problem: "Hands-On" Can Get Results

ERIC Educational Resources Information Center

Neeson, Robyn; Billington, Leo; Barrett, Rowena

2007-01-01

Small business training can facilitate business growth. The authors show that a "hands-on" approach can have a direct impact on a business owner's current situation. They consider this in relation to the problem of being unable to find the right staff, demonstrating that a program such as the one they describe enables learning and…
The Creation of Contrasting Education and Training Markets in England and New Zealand

ERIC Educational Resources Information Center

Strathdee, Rob

2006-01-01

This paper argues that the current skill strategies of New Labour (in England) and the Labour-led Coalition (in New Zealand) are part of a broader project to construct contrasting markets in education and training. On one hand, the skill strategies are helping to construct open education and training markets through creating institutional-based…

Evaluating Didactic Methods for Training Medical Students in the Use of Bedside Ultrasound for Clinical Practice at a Faculty of Medicine in Romania.

PubMed

Florescu, Cosmin C; Mullen, Jeffrey A; Nguyen, Vivian My; Sanders, Brooke E; Vu, Priscilla Quynh-Phuon

2015-10-01

Medical students' time is limited, so efficiency in medical education is valued. This research project aimed to determine the most effective means to teach bedside ultrasound to medical students in a 1-week training course. We hypothesized that the best method would include a combination of podcasts and hands-on teaching; therefore, there would be a statistically significant difference among the various methods of teaching. Medical students were randomly assigned to 3 groups. All groups attended a 50-minute hands-on bedside ultrasound training session. Students in the first group attended a 50-minute live lecture before the hands-on session, whereas students in the second group watched a podcast that covered the same material as the live lecture. Students in the third group served as the control and only attended the hands-on sessions. Five topics were covered during the course: (1) introduction to ultrasound, (2) pulmonary ultrasound, (3) cardiac ultrasound, (4) hepatobiliary ultrasound, and (5) focused assessment with sonography for trauma. Students completed a 20-question pre- and post-training quiz that covered basic ultrasound principles. Students also conducted a focused assessment with sonography for trauma examination for the practical portion of their evaluation. Students' pre- to post-training quiz scores increased from 33.6% to 72.6% correct in the lecture group (n = 21; P < .0001), from 40.7% to 75.5% correct in the podcast group (n = 20; P< .0001), and from 37.8% to 70.0% correct in the control group (n = 23; P< .0001). Data analysis of written and practical examination scores showed no significant differences among the groups [F(2,61) = 0.885; P = .418; F(2,60) = 1.739; P = .184, respectively]. These results suggest that all 3 methods are equally effective in teaching novice medical students basic ultrasound knowledge and skills. © 2015 by the American Institute of Ultrasound in Medicine.
Crossmodal representation of a functional robotic hand arises after extensive training in healthy participants.

PubMed

Marini, Francesco; Tagliabue, Chiara F; Sposito, Ambra V; Hernandez-Arieta, Alejandro; Brugger, Peter; Estévez, Natalia; Maravita, Angelo

2014-01-01

The way in which humans represent their own bodies is critical in guiding their interactions with the environment. To achieve successful body-space interactions, the body representation is strictly connected with that of the space immediately surrounding it through efficient visuo-tactile crossmodal integration. Such a body-space integrated representation is not fixed, but can be dynamically modulated by the use of external tools. Our study aims to explore the effect of using a complex tool, namely a functional prosthesis, on crossmodal visuo-tactile spatial interactions in healthy participants. By using the crossmodal visuo-tactile congruency paradigm, we found that prolonged training with a mechanical hand capable of distal hand movements and providing sensory feedback induces a pattern of interference, which is not observed after a brief training, between visual stimuli close to the prosthesis and touches on the body. These results suggest that after extensive, but not short, training the functional prosthesis acquires a visuo-tactile crossmodal representation akin to real limbs. This finding adds to previous evidence for the embodiment of functional prostheses in amputees, and shows that their use may also improve the crossmodal combination of somatosensory feedback delivered by the prosthesis with visual stimuli in the space around it, thus effectively augmenting the patients' visuomotor abilities. © 2013 Published by Elsevier Ltd.
AGGIESAT 1

DTIC Science & Technology

2007-03-31

The objectives of the program were to educate and train the future workforce through a national student satellite design and fabrication competition...program among AFOSR, AIAA, NASA GSFC, and AFRL/VS. The objectives of the program were to educate and train the future workforce through a national...The kickoff meeting with the Air Force was held on March 16, 2005, the System Concept Review was on May 6, 2005, SHOT I (Student Hands-On Training via a
Behavioral evidence for left-hemisphere specialization of motor planning

PubMed Central

Meulenbroek, Ruud G. J.; Steenbergen, Bert

2010-01-01

Recent studies suggest that the left hemisphere is dominant for the planning of motor actions. This left-hemisphere specialization hypothesis was proposed in various lines of research, including patient studies, motor imagery studies, and studies involving neurophysiological techniques. However, most of these studies are primarily based on experiments involving right-hand-dominant participants. Here, we present the results of a behavioral study with left-hand-dominant participants, which follows up previous work in right-hand-dominant participants. In our experiment, participants grasped CD casings and replaced them in a different, pre-cued orientation. Task performance was measured by the end-state comfort effect, i.e., the anticipated degree of physical comfort associated with the posture that is planned to be adopted at movement completion. Both left- and right-handed participants showed stronger end-state comfort effects for their right hand compared to their left hand. These results lend behavioral support to the left-hemisphere-dominance motion-planning hypothesis. PMID:21184219
Hands-Only CPR

MedlinePlus

... Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational Conferences Programs ... Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational Conferences Programs ...
Using a motivational paradigm to improve handwashing compliance.

PubMed

Cole, Mark

2006-05-01

The education and training of staff is frequently cited as essential to the development and maintenance of hand hygiene compliance, which is often quoted as the single most effective measure to prevent Hospital Acquired Infection. Despite much time, effort and cost, there is a growing frustration within infection control that training programmes do not appear to have a lasting effect on behaviour or produce consistently good hand hygiene compliers. This paper intends to encourage debate by suggesting that handwashing needs to be considered within a wider educational context and the motivational factors that impact upon performance acknowledged and addressed. A critique of learning theories in relation to hand hygiene will discuss why the use of traditional programmes in isolation may be unsuccessful, and how models and theories based in other disciplines could be adapted to help produce sustainable changes in practice. This paper recognises the contribution of contemporary training methods but argues that models such as [Prochaska, J., DiClemente, C., 1984. The Transtheoretical Approach; Crossing Traditional Boundaries of Therapy. Dow Jones Irwin, Homewood] stages of change transtheoretical model (TTM) and the interventionist paradigm of motivational interviewing could be borrowed and adapted from health promotion and applied to hand hygiene as their function, to increase understanding and enhance motivation in order to achieve sustainable behavioural change, are attributes which have resonance for a challenging problem like hand hygiene compliance.
Technologies for safe births.

PubMed

1984-01-01

The basic elements of a safe birth are proper prenatal care, adequate preparation of the mother, health worker, and site, awareness of the progress of labor and safe delivery, recognition of danger signs, and appropriate follow-up care. Technologies are differentiated by determining 1) the needs of rural birth attendants, 2) the nature of delivery kits, 3) proper cleanliness of the hands and equipment, and appropriate use of 5) disinfecting equipment, 6) drugs and medications, 7) the vertical position, 8) specialized instruments, and 9) records and support materials. Alternatives for measuring time are indicated. Customized kits available from UNICEF are described; some of the problems with these kits are reported. The logistics, referral procedures, and training and supervision needed for appropriate program managements are discussed. Adapting technologies to the local environment requires assessing the practices of traditional birth attendants (TBAs), the provision of kits (cost, ease of use and maintenance, replacement, durability, availability), the training required for proper use of equipment, the logistics of kit use, side effects of technologies, community attitudes, and evaluation. The advantages and disadvantages of including or not including particular supplies in the kit are discussed, i.e., the container for boiling water would either be a local pot or the aluminum carrying case. In lieu of a fingernail brush, a twig may be used for nail cleaning. Hand washing where water shortages exist might entail using a tin with a hole plugged with a stick to let water trickle as needed. Antiseptic solutions such a Dettol or Savlon can be used where a severe shortage exists. Basic equipment includes: soap and water, a container for boiling, other sterile containers, a protective cover of delivery area, towels, swabs, an optional apron, cord ties, a cutting instrument, gauze, a receiving blanket, records, and a carrying case.
Improving hand functional use in subjects with multiple sclerosis using a musical keyboard: a randomized controlled trial.

PubMed

Gatti, Roberto; Tettamanti, Andrea; Lambiase, Simone; Rossi, Paolo; Comola, Mauro

2015-06-01

Playing an instrument implies neuroplasticity in different cerebral regions. This phenomenon has been described in subjects with stroke, suggesting that it could play a role in hand rehabilitation. The aim of this study is to analyse the effectiveness of playing a musical keyboard in improving hand function in subjects with multiple sclerosis. Nineteen hospitalized subjects were randomized in two groups: nine played a turned-on musical keyboard by sequences of fingers movements (audio feedback present) and 10 performed the same exercises on a turned-off musical keyboard (audio feedback absent). Training duration was half an hour per day for 15 days. Primary outcome was the perceived hand functional use measured by ABILHAND Questionnaire. Secondary outcomes were hand dexterity, measured by Nine-Hole Peg Test, and hand strength, measured by Jamar and Pinch dynamometers. Two-way analysis of variance was used for data analysis. The interaction time × group was significant (p = 0.003) for ABILHAND Questionnaire in favour of experimental group (mean between-group difference 0.99 logit [IC95%: 0.44; 1.54]). The two groups showed a significant time effect for all outcomes except for Jamar measure. Playing a musical keyboard seems a valid method to train the functional use of hands in subjects with multiple sclerosis. Copyright © 2014 John Wiley & Sons, Ltd.
Teaching Managers to Manage

ERIC Educational Resources Information Center

Mitchell, Howard M.

1970-01-01

Haphazard training is replaced by an organized conceptual approach to managment development, with attention to managerial functions and activities, appropriate courses, general reading, and training costs. (LY)
Space Shuttle Reusable Solid Rocket Motor (RSRM) Hand Cleaning Solvent Replacement at Kennedy Space Center (KSC)

NASA Technical Reports Server (NTRS)

Keen, Jill M.; DeWeese, Darrell C.; Key, Leigh W.

1997-01-01

At Kennedy Space Center (KSC), Thiokol Corporation provides the engineering to assemble and prepare the Space Shuttle Reusable Solid Rocket Motor (RSRM) for launch. This requires hand cleaning over 86 surfaces including metals, adhesives, rubber and electrical insulations, various painted surfaces and thermal protective materials. Due to the phase-out of certain ozone depleting chemical (ODC) solvents, all RSRM hand wipe operations being performed at KSC using l,l,1-trichloroethane (TCA) were eliminated. This presentation summarizes the approach used and the data gathered in the effort to eliminate TCA from KSC hand wipe operations.
Neural correlates of working memory training in HIV patients: study protocol for a randomized controlled trial.

PubMed

Chang, L; Løhaugen, G C; Douet, V; Miller, E N; Skranes, J; Ernst, T

2016-02-02

Potent combined antiretroviral therapy decreased the incidence and severity of HIV-associated neurocognitive disorders (HAND); however, no specific effective pharmacotherapy exists for HAND. Patients with HIV commonly have deficits in working memory and attention, which may negatively impact many other cognitive domains, leading to HAND. Since HAND may lead to loss of independence in activities of daily living and negative emotional well-being, and incur a high economic burden, effective treatments for HAND are urgently needed. This study aims to determine whether adaptive working memory training might improve cognitive functions and neural network efficiency and possibly decrease neuroinflammation. This study also aims to assess whether subjects with the LMX1A-rs4657412 TT(AA) genotype show greater training effects from working memory training than TC(AG) or CC(GG)-carriers. 60 HIV-infected and 60 seronegative control participants will be randomized to a double-blind active-controlled study, using adaptive versus non-adaptive Cogmed Working Memory Training® (CWMT), 20-25 sessions over 5-8 weeks. Each subject will be assessed with near- and far-transfer cognitive tasks, self-reported mood and executive function questionnaires, and blood-oxygenation level-dependent functional MRI during working memory (n-back) and visual attention (ball tracking) tasks, at baseline, 1-month, and 6-months after CWMT. Furthermore, genotyping for LMX1A-rs4657412 will be performed to identify whether subjects with the TT(AA)-genotype show greater gain or neural efficiency after CWMT than those with other genotypes. Lastly, cerebrospinal fluid will be obtained before and after CWMT to explore changes in levels of inflammatory proteins (cytokines and chemokines) and monoamines. Improving working memory in HIV patients, using CWMT, might slow the progression or delay the onset of HAND. Observation of decreased brain activation or normalized neural networks, using fMRI, after CWMT would lead to a better understanding of how neural networks are modulated by CWMT. Moreover, validating the greater training gain in subjects with the LMX1A-TT(AA) genotype could lead to a personalized approach for future working memory training studies. Demonstrating and understanding the neural correlates of the efficacy of CWMT in HIV patients could lead to a safe adjunctive therapy for HAND, and possibly other brain disorders. ClinicalTrial.gov, NCT02602418.
Effect of neurofeedback and electromyographic-biofeedback therapy on improving hand function in stroke patients.

PubMed

Rayegani, S M; Raeissadat, S A; Sedighipour, L; Rezazadeh, I Mohammad; Bahrami, M H; Eliaspour, D; Khosrawi, S

2014-01-01

The aim of the present study was to evaluate the effect of applying electroencephalogram (EEG) biofeedback (neurobiofeedback) or electromyographic (EMG) biofeedback to conventional occupational therapy (OT) on improving hand function in stroke patients. This study was designed as a preliminary clinical trial. Thirty patients with stroke were entered the study. Hand function was evaluated by Jebsen Hand Function Test pre and post intervention. Patients were allocated to 3 intervention cohorts: (1) OT, (2) OT plus EMG-biofeedback therapy, and (3) OT plus neurofeedback therapy. All patients received 10 sessions of conventional OT. Patients in cohorts 2 and 3 also received EMG-biofeedback and neurofeedback therapy, respectively. EMG-biofeedback therapy was performed to strengthen the abductor pollicis brevis (APB) muscle. Neurofeedback training was aimed at enhancing sensorimotor rhythm after mental motor imagery. Hand function was improved significantly in the 3 groups. The spectral power density of the sensorimotor rhythm band in the neurofeedback group increased after mental motor imagery. Maximum and mean contraction values of electrical activities of the APB muscle during voluntary contraction increased significantly after EMG-biofeedback training. Patients in the neurofeedback and EMG-biofeedback groups showed hand improvement similar to conventional OT. Further studies are suggested to assign the best protocol for neurofeedback and EMG-biofeedback therapy.
Classification of right-hand grasp movement based on EMOTIV Epoc+

NASA Astrophysics Data System (ADS)

Tobing, T. A. M. L.; Prawito, Wijaya, S. K.

2017-07-01

Combinations of BCT elements for right-hand grasp movement have been obtained, providing the average value of their classification accuracy. The aim of this study is to find a suitable combination for best classification accuracy of right-hand grasp movement based on EEG headset, EMOTIV Epoc+. There are three movement classifications: grasping hand, relax, and opening hand. These classifications take advantage of Event-Related Desynchronization (ERD) phenomenon that makes it possible to differ relaxation, imagery, and movement state from each other. The combinations of elements are the usage of Independent Component Analysis (ICA), spectrum analysis by Fast Fourier Transform (FFT), maximum mu and beta power with their frequency as features, and also classifier Probabilistic Neural Network (PNN) and Radial Basis Function (RBF). The average values of classification accuracy are ± 83% for training and ± 57% for testing. To have a better understanding of the signal quality recorded by EMOTIV Epoc+, the result of classification accuracy of left or right-hand grasping movement EEG signal (provided by Physionet) also be given, i.e.± 85% for training and ± 70% for testing. The comparison of accuracy value from each combination, experiment condition, and external EEG data are provided for the purpose of value analysis of classification accuracy.
Identification of hand motion using background subtraction method and extraction of image binary with backpropagation neural network on skeleton model

NASA Astrophysics Data System (ADS)

Fauziah; Wibowo, E. P.; Madenda, S.; Hustinawati

2018-03-01

Capturing and recording motion in human is mostly done with the aim for sports, health, animation films, criminality, and robotic applications. In this study combined background subtraction and back propagation neural network. This purpose to produce, find similarity movement. The acquisition process using 8 MP resolution camera MP4 format, duration 48 seconds, 30frame/rate. video extracted produced 1444 pieces and results hand motion identification process. Phase of image processing performed is segmentation process, feature extraction, identification. Segmentation using bakground subtraction, extracted feature basically used to distinguish between one object to another object. Feature extraction performed by using motion based morfology analysis based on 7 invariant moment producing four different classes motion: no object, hand down, hand-to-side and hands-up. Identification process used to recognize of hand movement using seven inputs. Testing and training with a variety of parameters tested, it appears that architecture provides the highest accuracy in one hundred hidden neural network. The architecture is used propagate the input value of the system implementation process into the user interface. The result of the identification of the type of the human movement has been clone to produce the highest acuracy of 98.5447%. The training process is done to get the best results.
Hands-On Exercise in Environmental Structural Geology Using a Fracture Block Model.

ERIC Educational Resources Information Center

Gates, Alexander E.

2001-01-01

Describes the use of a scale analog model of an actual fractured rock reservoir to replace paper copies of fracture maps in the structural geology curriculum. Discusses the merits of the model in enabling students to gain experience performing standard structural analyses. (DDR)
Psychomotor control in a virtual laparoscopic surgery training environment: gaze control parameters differentiate novices from experts.

PubMed

Wilson, Mark; McGrath, John; Vine, Samuel; Brewer, James; Defriend, David; Masters, Richard

2010-10-01

Surgical simulation is increasingly used to facilitate the adoption of technical skills during surgical training. This study sought to determine if gaze control parameters could differentiate between the visual control of experienced and novice operators performing an eye-hand coordination task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Typically adopted hand movement metrics reflect only one half of the eye-hand coordination relationship; therefore, little is known about how hand movements are guided and controlled by vision. A total of 14 right-handed surgeons were categorised as being either experienced (having led more than 70 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The eight experienced and six novice surgeons completed the eye-hand coordination task from the LAP Mentor basic skills package while wearing a gaze registration system. A variety of performance, movement, and gaze parameters were recorded and compared between groups. The experienced surgeons completed the task significantly more quickly than the novices, but only the economy of movement of the left tool differentiated skill level from the LAP Mentor parameters. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. The findings of the study provide support for the utility of assessing strategic gaze behaviour to better understand the way in which surgeons utilise visual information to plan and control tool movements in a virtual reality laparoscopic environment. It is hoped that by better understanding the limitations of the psychomotor system, effective gaze training programs may be developed.
Psychomotor control in a virtual laparoscopic surgery training environment: gaze control parameters differentiate novices from experts

PubMed Central

McGrath, John; Vine, Samuel; Brewer, James; Defriend, David; Masters, Richard

2010-01-01

Background Surgical simulation is increasingly used to facilitate the adoption of technical skills during surgical training. This study sought to determine if gaze control parameters could differentiate between the visual control of experienced and novice operators performing an eye-hand coordination task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Typically adopted hand movement metrics reflect only one half of the eye-hand coordination relationship; therefore, little is known about how hand movements are guided and controlled by vision. Methods A total of 14 right-handed surgeons were categorised as being either experienced (having led more than 70 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The eight experienced and six novice surgeons completed the eye-hand coordination task from the LAP Mentor basic skills package while wearing a gaze registration system. A variety of performance, movement, and gaze parameters were recorded and compared between groups. Results The experienced surgeons completed the task significantly more quickly than the novices, but only the economy of movement of the left tool differentiated skill level from the LAP Mentor parameters. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. Conclusion The findings of the study provide support for the utility of assessing strategic gaze behaviour to better understand the way in which surgeons utilise visual information to plan and control tool movements in a virtual reality laparoscopic environment. It is hoped that by better understanding the limitations of the psychomotor system, effective gaze training programs may be developed. PMID:20333405
78 FR 20227 - Airworthiness Directives; Cessna Aircraft Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

...,592 1,847 Replacement of LH and RH brackets 6 work-hours x $85 per hour = $510. 4,101 4,611 Authority.... operators Inspection of the affected inboard 1 work-hour x $85 per hour Not Applicable $85 643 airplanes x... Labor cost Parts cost product Replacement of left-hand (LH) brackets..... 3 work-hours x $85 per hour...
A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis.

PubMed

Barr, Andrew J; Campbell, T Mark; Hopkinson, Devan; Kingsbury, Sarah R; Bowes, Mike A; Conaghan, Philip G

2015-08-25

Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. PROSPERO registration number: CRD 42013005009.
Acute effect of whole body vibration on isometric strength, squat jump, and flexibility in well-trained combat athletes.

PubMed

Kurt, C; Pekünlü, E

2015-06-01

The purpose of this study was to investigate the effect of whole body vibration (WBV) training on maximal strength, squat jump, and flexibility of well-trained combat athletes. Twelve female and 8 male combat athletes (age: 22.8 ± 3.1 years, mass: 65.4 ± 10.7 kg, height: 168.8 ± 8.8 cm, training experience: 11.6 ± 4.7 years, training volume: 9.3 ± 2.8 hours/week) participated in this study. The study consisted of three sessions separated by 48 hours. The first session was conducted for familiarization. In the subsequent two sessions, participants performed WBV or sham intervention in a randomized, balanced order. During WBV intervention, four isometric exercises were performed (26 Hz, 4 mm). During the sham intervention, participants performed the same WBV intervention without vibration treatment (0 Hz, 0 mm). Hand grip, squat jump, trunk flexion, and isometric leg strength tests were performed after each intervention. The results of a two-factor (pre-post[2] × intervention[2]) repeated measures ANOVA revealed a significant interaction (p = 0.018) of pre-post × intervention only for the hand grip test, indicating a significant performance increase of moderate effect (net increase of 2.48%, d = 0.61) after WBV intervention. Squat jump, trunk flexion, and isometric leg strength performances were not affected by WBV. In conclusion, the WBV protocol used in this study potentiated hand grip performance, but did not enhance squat jump, trunk flexion, or isometric leg strength in well-trained combat athletes.

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior

ERIC Educational Resources Information Center

Schieltz, Kelly M.; Wacker, David P.; Harding, Jay W.; Berg, Wendy K.; Lee, John F.; Padilla Dalmau, Yaniz C.; Mews, Jayme; Ibrahimovic, Muska

2011-01-01

The purpose of this study was to evaluate the effects of functional communication training (FCT) on the occurrence of non-targeted disruptive behavior. The 10 participants were preschool-aged children with developmental disabilities who engaged in both destructive (property destruction, aggression, self-injury) and disruptive (hand flapping,…
Time-specific contribution of the supplementary motor area to intermanual transfer of procedural knowledge

PubMed Central

Perez, MA; Tanaka, S; Wise, SP; Willingham, DT; Cohen, LG

2008-01-01

The supplementary motor area (SMA) makes a crucial contribution to intermanual transfer: the ability to use one hand to perform a skill practiced and learned with the other hand. However, the timing of this contribution relative to movement remains unknown. Here, 33 healthy volunteers performed a 12-item sequence in the serial reaction time task (SRTT). During training, each participant responded to a sequence of visual cues presented at 1 Hz by pressing one of 4 keys with their right hand. The measure of intermanual transfer was response time (RT) during repetition of the trained sequence with the left hand, which was at rest during learning. Participants were divided into 3 groups, which did not differ in their learning rates or amounts. In 2 groups, 1 Hz repetitive transcranial magnetic stimulation (rTMS) induced transient virtual lesions of the SMA during training, either 100 ms before each cue (the premovement group) or during each key press (the movement group). The third group received sham stimulation (the sham group). After training with the right hand, RTs for performance with the left (transfer) hand were longer for the premovement group than for the movement or sham groups. Thus SMA’s most crucial contribution to intermanual transfer occurs in the interval between movements, when the memory of a prior movement plays a role in encoding specific sequences. These results provide insight into frontal-lobe contributions to procedural knowledge. PMID:18815252
The European Academy laparoscopic “Suturing Training and Testing’’ (SUTT) significantly improves surgeons’ performance

PubMed Central

Sleiman, Z.; Tanos, V.; Van Belle, Y.; Carvalho, J.L.; Campo, R.

2015-01-01

The efficiency of suturing training and testing (SUTT) model by laparoscopy was evaluated, measuring the suturingskill acquisition of trainee gynecologists at the beginning and at the end of a teaching course. During a workshop organized by the European Academy of Gynecological Surgery (EAGS), 25 participants with three different experience levels in laparoscopy (minor, intermediate and major) performed the 4 exercises of the SUTT model (Ex 1: both hands stitching and continuous suturing, Ex 2: right hand stitching and intracorporeal knotting, Ex 3: left hand stitching and intracorporeal knotting, Ex 4: dominant hand stitching, tissue approximation and intracorporeal knotting). The time needed to perform the exercises is recorded for each trainee and group and statistical analysis used to note the differences. Overall, all trainees achieved significant improvement in suturing time (p < 0.005) as measured before and after completion of the training. Similar significantly improved suturing time differences (p < 0.005) were noted among the groups of trainees with different laparoscopic experience. In conclusion a short well-guided training course, using the SUTT model, improves significantly surgeon’s laparoscopic suturing ability, independently of the level of experience in laparoscopic surgery. Key words: Endoscopy, laparoscopic suturing, psychomotor skills, surgery, teaching, training suturing model. PMID:26977264
Tobacco Use, Exposure to Secondhand Smoke and Cessation Training among Third-Year Medical Technology Students in Thailand.

PubMed

Namjuntra, Pisit; Suriyaprom, Kanjana

2015-10-01

Compare tobacco use, exposure to second-hand smoke, and smoking cessation training among third-year medical technology students in Thailand between 2006 and 2011. The medical technology student survey was carried out with Global Health Professions Student Survey (GHPSS) between October and November 2011. The population of the present study was all students in nine medical technology schools. There were 773 students enrolled in this study yielding a response rate of 95.1%. The prevalence of current cigarette smokers had decreased from 2006 to 2011 (4.8% to 1.4%, respectively). Rates of exposure to second-hand smoke at home were 36.3% in 2006 and 39.7% in 2011, while rates of exposure to second-hand smoke in other places did not change. Most students recognized that they should give patients counseling to quit smoking, but only 20.6% in 2006 and 28.4% in 2011 of them had received formal training in tobacco cessation counseling. There were low percentages of current cigarette smoking but high percentages of exposure to second-hand smoke among medical technology students. The percentage of cessation training was still low among students. Therefore, medical technology schools should provide formal training in tobacco cessation for all students to help improve their ability in providing advice to patients.
A Comparative Study on Real Lab and Simulation Lab in Communication Engineering from Students' Perspectives

ERIC Educational Resources Information Center

Balakrishnan, B.; Woods, P. C.

2013-01-01

Over the years, rapid development in computer technology has engendered simulation-based laboratory (lab) in addition to the traditional hands-on (physical) lab. Many higher education institutions adopt simulation lab, replacing some existing physical lab experiments. The creation of new systems for conducting engineering lab activities has raised…
Biomedical Big Data Training Collaborative (BBDTC): An effort to bridge the talent gap in biomedical science and research.

PubMed

Purawat, Shweta; Cowart, Charles; Amaro, Rommie E; Altintas, Ilkay

2016-06-01

The BBDTC (https://biobigdata.ucsd.edu) is a community-oriented platform to encourage high-quality knowledge dissemination with the aim of growing a well-informed biomedical big data community through collaborative efforts on training and education. The BBDTC collaborative is an e-learning platform that supports the biomedical community to access, develop and deploy open training materials. The BBDTC supports Big Data skill training for biomedical scientists at all levels, and from varied backgrounds. The natural hierarchy of courses allows them to be broken into and handled as modules . Modules can be reused in the context of multiple courses and reshuffled, producing a new and different, dynamic course called a playlist . Users may create playlists to suit their learning requirements and share it with individual users or the wider public. BBDTC leverages the maturity and design of the HUBzero content-management platform for delivering educational content. To facilitate the migration of existing content, the BBDTC supports importing and exporting course material from the edX platform. Migration tools will be extended in the future to support other platforms. Hands-on training software packages, i.e., toolboxes , are supported through Amazon EC2 and Virtualbox virtualization technologies, and they are available as: ( i ) downloadable lightweight Virtualbox Images providing a standardized software tool environment with software packages and test data on their personal machines, and ( ii ) remotely accessible Amazon EC2 Virtual Machines for accessing biomedical big data tools and scalable big data experiments. At the moment, the BBDTC site contains three open Biomedical big data training courses with lecture contents, videos and hands-on training utilizing VM toolboxes, covering diverse topics. The courses have enhanced the hands-on learning environment by providing structured content that users can use at their own pace. A four course biomedical big data series is planned for development in 2016.
Stimulating the cerebellum affects visuomotor adaptation but not intermanual transfer of learning

PubMed Central

Block, Hannah; Celnik, Pablo

2013-01-01

When systematic movement errors occur, the brain responds with a systematic change in motor behavior. This type of adaptive motor learning can transfer intermanually; adaptation of movements of the right hand in response to training with a perturbed visual signal (visuomotor adaptation) may carry over to the left hand. While visuomotor adaptation has been studied extensively, it is unclear whether the cerebellum, a structure involved in adaptation, is important for intermanual transfer as well. We addressed this question with three experiments in which subjects reached with their right hands as a 30° visuomotor rotation was introduced. Subjects received anodal or sham transcranial direct current stimulation (tDCS) on the trained (Experiment 1) or untrained (Experiment 2) hemisphere of the cerebellum, or, for comparison, motor cortex (M1). After the training period, subjects reached with their left hand, without visual feedback, to assess intermanual transfer of learning aftereffects. Stimulation of the right cerebellum caused faster adaptation, but none of the stimulation sites affected transfer. To ascertain whether cerebellar stimulation would increase transfer if subjects learned faster as well as a larger amount, in Experiment 3 anodal and sham cerebellar groups experienced a shortened training block such that the anodal group learned more than sham. Despite the difference in adaptation magnitude, transfer was similar across these groups, although smaller than in Experiment 1. Our results suggest that intermanual transfer of visuomotor learning does not depend on cerebellar activity, and that the number of movements performed at plateau is an important predictor of transfer. PMID:23625383
The University of Kansas Applied Sensing Program: An operational perspective

NASA Technical Reports Server (NTRS)

Martinko, E. A.

1981-01-01

The Kansas applied remote sensing (KARS) program conducts demonstration projects and applied research on remote sensing techniques which enable local, regional, state and federal agency personnel to better utilize available satellite and airborne remote sensing systems. As liason with Kansas agencies for the Earth Resources Laboratory (ERL), Kansas demonstration project, KARS coordinated interagency communication, field data collection, hands-on training, and follow-on technical assistance and worked with Kansas agency personnel in evaluating land cover maps provided by ERL. Short courses are being conducted to provide training in state-of-the-art remote sensing technology for university faculty, state personnel, and persons from private industry and federal government. Topics are listed which were considered in intensive five-day courses covering the acquisition, interpretation, and application of information derived through remote sensing with specific training and hands-on experience in image interpretation and the analysis of LANDSAT data are listed.
Integrating electron microscopy into nanoscience and materials engineering programs

NASA Astrophysics Data System (ADS)

Cormia, Robert D.; Oye, Michael M.; Nguyen, Anh; Skiver, David; Shi, Meng; Torres, Yessica

2014-10-01

Preparing an effective workforce in high technology is the goal of both academic and industry training, and has been the engine that drives innovation and product development in the United States for over a century. During the last 50 years, technician training has comprised a combination of two-year academic programs, internships and apprentice training, and extensive On-the-Job Training (OJT). Recently, and especially in Silicon Valley, technicians have four-year college degrees, as well as relevant hands-on training. Characterization in general, and microscopy in particular, is an essential tool in process development, manufacturing and QA/QC, and failure analysis. Training for a broad range of skills and practice is challenging, especially for community colleges. Workforce studies (SRI/Boeing) suggest that even four year colleges often do not provide the relevant training and experience in laboratory skills, especially design of experiments and analysis of data. Companies in high-tech further report difficulty in finding skilled labor, especially with industry specific experience. Foothill College, in partnership with UCSC, SJSU, and NASA-Ames, has developed a microscopy training program embedded in a research laboratory, itself a partnership between university and government, providing hands-on experience in advanced instrumentation, experimental design and problem solving, with real-world context from small business innovators, in an environment called `the collaboratory'. The program builds on AFM-SEM training at Foothill, and provides affordable training in FE-SEM and TEM through a cost recovery model. In addition to instrument and engineering training, the collaboratory also supports academic and personal growth through a multiplayer social network of students, faculty, researchers, and innovators.
Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia

PubMed Central

Chan, Catherine Qiu Hua; Low, Lian Leng; Lee, Kheng Hock

2016-01-01

Many patients with pernicious anemia are treated with lifelong intramuscular (IM) vitamin B12 replacement. As early as the 1950s, there were studies suggesting that oral vitamin B12 replacement may provide adequate absorption. Nevertheless, oral vitamin B12 replacement in patients with pernicious anemia remains uncommon in clinical practice. The objective of this review is to provide an update on the effectiveness of oral vitamin B12 for the treatment of pernicious anemia, the recommended dosage, and the required frequency of laboratory test and clinical monitoring. Relevant articles were identified by PubMed search from January 1, 1980 to March 31, 2016 and through hand search of relevant reference articles. Two randomized controlled trials, three prospective papers, one systematic review, and three clinical reviews fulfilled our inclusion criteria. We found that oral vitamin B12 replacement at 1000 μg daily was adequate to replace vitamin B12 levels in patients with pernicious anemia. We conclude that oral vitamin B12 is an effective alternative to vitamin B12 IM injections. Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options. PMID:27602354
Autogenic Training and Hand Temperature Biofeedback in the Treatment of Migraine: A Preliminary Analysis.

ERIC Educational Resources Information Center

Jessup, B.; And Others

The possibility of alleviating migraine headaches by autogenic relaxation training, with or without hand temperature biofeedback, was assessed. The study examined five independent groups in a bi-directional control group design. Volunteer migraine sufferers served as subjects, each participating for 12 weeks. The first four weeks of the study were…
The LET Procedure for Prosthetic Myocontrol: Towards Multi-DOF Control Using Single-DOF Activations.

PubMed

Nowak, Markus; Castellini, Claudio

2016-01-01

Simultaneous and proportional myocontrol of dexterous hand prostheses is to a large extent still an open problem. With the advent of commercially and clinically available multi-fingered hand prostheses there are now more independent degrees of freedom (DOFs) in prostheses than can be effectively controlled using surface electromyography (sEMG), the current standard human-machine interface for hand amputees. In particular, it is uncertain, whether several DOFs can be controlled simultaneously and proportionally by exclusively calibrating the intended activation of single DOFs. The problem is currently solved by training on all required combinations. However, as the number of available DOFs grows, this approach becomes overly long and poses a high cognitive burden on the subject. In this paper we present a novel approach to overcome this problem. Multi-DOF activations are artificially modelled from single-DOF ones using a simple linear combination of sEMG signals, which are then added to the training set. This procedure, which we named LET (Linearly Enhanced Training), provides an augmented data set to any machine-learning-based intent detection system. In two experiments involving intact subjects, one offline and one online, we trained a standard machine learning approach using the full data set containing single- and multi-DOF activations as well as using the LET-augmented data set in order to evaluate the performance of the LET procedure. The results indicate that the machine trained on the latter data set obtains worse results in the offline experiment compared to the full data set. However, the online implementation enables the user to perform multi-DOF tasks with almost the same precision as single-DOF tasks without the need of explicitly training multi-DOF activations. Moreover, the parameters involved in the system are statistically uniform across subjects.
The Effect of Personnel Stability on Organizational Performance: Do Battalions with Stable Command Groups Achieve Higher Training Proficiency at the National Training Center?

DTIC Science & Technology

2008-01-01

Graduate School and the students they work with on a routine basis. All three of my committee members have been superb mentors in helping me develop the...Deployable” and “Individual Replacement Induced Non-Deployable.” Wartime non-deployable status is provided to soldiers who are unavailable due to medical ...responder medical tasks, mastery of communication systems, and basic reporting requirements. The unit can progress to small-unit level collective training
Handheld echocardiographic screening for rheumatic heart disease by non-experts.

PubMed

Ploutz, Michelle; Lu, Jimmy C; Scheel, Janet; Webb, Catherine; Ensing, Greg J; Aliku, Twalib; Lwabi, Peter; Sable, Craig; Beaton, Andrea

2016-01-01

Handheld echocardiography (HAND) has good sensitivity and specificity for rheumatic heart disease (RHD) when performed by cardiologists. However, physician shortages in RHD-endemic areas demand less-skilled users to make RHD screening practical. We examine nurse performance and interpretation of HAND using a simplified approach for RHD screening. Two nurses received training on HAND and a simplified screening approach. Consented students at two schools in Uganda were eligible for participation. A simplified approach (HAND performed and interpreted by a non-expert) was compared with the reference standard (standard portable echocardiography, performed and interpreted by experts according to the 2012 World Heart Federation guidelines). Reasons for false-positive and false-negative HAND studies were identified. A total of 1002 children were consented, with 956 (11.1 years, 41.8% male) having complete data for review. Diagnoses included: 913 (95.5%) children were classified normal, 32 (3.3%) borderline RHD and 11 (1.2%) definite RHD. The simplified approach had a sensitivity of 74.4% (58.8% to 86.5%) and a specificity of 78.8% (76.0% to 81.4%) for any RHD (borderline and definite). Sensitivity improved to 90.9% (58.7% to 98.5%) for definite RHD. Identification and measurement of erroneous colour jets was the most common reason for false-positive studies (n=164/194), while missed mitral regurgitation and shorter regurgitant jet lengths with HAND were the most common reasons for false-negative studies (n=10/11). Non-expert-led HAND screening programmes offer a potential solution to financial and workforce barriers that limit widespread RHD screening. Nurses trained on HAND using a simplified approach had reasonable sensitivity and specificity for RHD screening. Information on reasons for false-negative and false-positive screening studies should be used to inform future training protocols, which could lead to improved screening performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Midwives' and doctors' perceptions of their preparation for and practice in managing the perineum in the second stage of labour: a cross-sectional survey.

PubMed

East, Christine E; Lau, Rosalind; Biro, Mary Anne

2015-01-01

to identify the perceptions of midwives and doctors at Monash Women's regarding their educational preparation and practices used for perineal management during the second stage of labour. anonymous cross-sectional semi-structured questionnaire ('The survey'). the three maternity hospitals that form Monash Women's Maternity Services, Monash Health, Victoria, Australia. midwives and doctors attending births at one or more of the three Monash Women's maternity hospitals. a semi-structured questionnaire was developed, drawing on key concepts from experts and peer-reviewed literature. surveys were returned by 17 doctors and 69 midwives (37% response rate, from the 230 surveys sent). Midwives and doctors described a number of techniques they would use to reduce the risk of perineal trauma, for example, hands on the fetal head/perineum (11.8% of doctors, 61% of midwives), the use of warm compresses (45% of midwives) and maternal education and guidance with pushing (49.3% of midwives). When presented with a series of specific obstetric situations, respondents indicated that they would variably practice hands on the perineum during second stage labour, hands off and episiotomy. The majority of respondents indicated that they agreed or strongly agreed that an episiotomy should sometimes be performed (midwives 97%, doctors 100%). All the doctors had training in diagnosing severe perineal trauma involving anal sphincter injury (ASI), with 77% noting that they felt very confident with this. By contrast, 71% of the midwives reported that they had received training in diagnosing ASI and only 16% of these reported that they were very confident in this diagnosis. All doctors were trained in perineal repair, compared with 65% of midwives. Doctors were more likely to indicate that they were very confident in perineal repair (88%) than the midwives (44%). Most respondents were not familiar with the rates of perineal trauma either within their workplace or across Australia. Midwives and doctors indicated that they would use the hands on or hands off approach or episiotomy depending on the specific clinical scenario and described a range of techniques that they would use in their overall approach to minimising perineal trauma during birth. Midwives were more likely than doctors to indicate their lack of training and/or confidence in conducting perineal repair and diagnosing ASI. many midwives indicated that they had not received training in diagnosing ASI, perineal repair and midwives' and doctors' knowledge of the prevalence of perineal outcomes was poor. Given the importance of these skills to women cared for by midwives and doctors, the findings may be used to inform the development of quality improvement activities, including training programs and opportunities for gaining experience and expertise with perineal management. The use of episiotomy and hands on/hands off the perineum in the survey scenarios provides reassurance that doctors and midwives take a number of factors into account in their clinical practice, rather than a preference for one or more interventions over others. Copyright © 2014 Elsevier Ltd. All rights reserved.
The Effectiveness of 1 Hz rTMS Over the Primary Motor Area of the Unaffected Hemisphere to Improve Hand Function After Stroke Depends on Hemispheric Dominance.

PubMed

Lüdemann-Podubecká, Jitka; Bösl, Kathrin; Theilig, Steven; Wiederer, Ralf; Nowak, Dennis Alexander

2015-01-01

Inhibition of motor cortex excitability of the contralesional hemisphere may improve dexterity of the affected hand after stroke. 40 patients (17 dominant hemispheric stroke, 23 non-dominant hemispheric stroke) with a mild to moderate upper limb motor impairment were enrolled in a double-blind, randomized, placebo-controlled trial with two parallel-groups. Both groups received 15 daily sessions of motor training preceded by either 1 Hz rTMS or sham rTMS. Behavioral and neurophysiological evaluations were performed at baseline, after the first week and after the third week of treatment, and after a 6 months follow-up. In both groups motor function of the affected hand improved significantly. Patients with stroke of the non-dominant hemisphere made a similar improvement, regardless of whether the motor training was preceded by sham or 1 Hz rTMS. Patients with stroke of the dominant hemisphere had a less favorable improvement than those with stroke of the non-dominant hemisphere after motor training preceded by sham rTMS. However, when 1 Hz rTMS preceded the motor training, patients with stroke of the dominant hemisphere made a similar improvement as those with stroke of the non-dominant hemisphere. Motor recovery of the affected upper limb after stroke is determined by dominance of the affected hemisphere. Stroke of the dominant hemisphere is associated with per se poorer improvement of the affected hand. 1 Hz rTMS over the contralesional M1 significantly improves dexterity of the affected hand in patients with stroke of the dominant hemisphere, but not in those with stroke of the non-dominant hemisphere. Copyright © 2015 Elsevier Inc. All rights reserved.
Combined analysis of cortical (EEG) and nerve stump signals improves robotic hand control.

PubMed

Tombini, Mario; Rigosa, Jacopo; Zappasodi, Filippo; Porcaro, Camillo; Citi, Luca; Carpaneto, Jacopo; Rossini, Paolo Maria; Micera, Silvestro

2012-01-01

Interfacing an amputee's upper-extremity stump nerves to control a robotic hand requires training of the individual and algorithms to process interactions between cortical and peripheral signals. To evaluate for the first time whether EEG-driven analysis of peripheral neural signals as an amputee practices could improve the classification of motor commands. Four thin-film longitudinal intrafascicular electrodes (tf-LIFEs-4) were implanted in the median and ulnar nerves of the stump in the distal upper arm for 4 weeks. Artificial intelligence classifiers were implemented to analyze LIFE signals recorded while the participant tried to perform 3 different hand and finger movements as pictures representing these tasks were randomly presented on a screen. In the final week, the participant was trained to perform the same movements with a robotic hand prosthesis through modulation of tf-LIFE-4 signals. To improve the classification performance, an event-related desynchronization/synchronization (ERD/ERS) procedure was applied to EEG data to identify the exact timing of each motor command. Real-time control of neural (motor) output was achieved by the participant. By focusing electroneurographic (ENG) signal analysis in an EEG-driven time window, movement classification performance improved. After training, the participant regained normal modulation of background rhythms for movement preparation (α/β band desynchronization) in the sensorimotor area contralateral to the missing limb. Moreover, coherence analysis found a restored α band synchronization of Rolandic area with frontal and parietal ipsilateral regions, similar to that observed in the opposite hemisphere for movement of the intact hand. Of note, phantom limb pain (PLP) resolved for several months. Combining information from both cortical (EEG) and stump nerve (ENG) signals improved the classification performance compared with tf-LIFE signals processing alone; training led to cortical reorganization and mitigation of PLP.
Evaluation of an Efficient Method for Training Staff to Implement Stimulus Preference Assessments

ERIC Educational Resources Information Center

Roscoe, Eileen M.; Fisher, Wayne W.

2008-01-01

We used a brief training procedure that incorporated feedback and role-play practice to train staff members to conduct stimulus preference assessments, and we used group-comparison methods to evaluate the effects of training. Staff members were trained to implement the multiple-stimulus-without-replacement assessment in a single session and the…
Haptic display for the VR arthroscopy training simulator

NASA Astrophysics Data System (ADS)

Ziegler, Rolf; Brandt, Christoph; Kunstmann, Christian; Mueller, Wolfgang; Werkhaeuser, Holger

1997-05-01

A specific desire to find new training methods arose from the new fields called 'minimal invasive surgery.' With the technical advance modern video arthroscopy became the standard procedure in the ORs. Holding the optical system with the video camera in one hand, watching the operation field on the monitor, the other hand was free to guide, e.g., a probe. As arthroscopy became a more common procedure it became obvious that some sort of special training was necessary to guarantee a certain level of qualification of the surgeons. Therefore, a hospital in Frankfurt, Germany approached the Fraunhofer Institute for Computer Graphics to develop a training system for arthroscopy based on VR techniques. At least the main drawback of the developed simulator is the missing of haptic perception, especially of force feedback. In cooperation with the Department of Electro-Mechanical Construction at the Darmstadt Technical University we have designed and built a haptic display for the VR arthroscopy training simulator. In parallel we developed a concept for the integration of the haptic display in a configurable way.
Enhancing Entrepreneurship and Professionalism in Medical Informatics Instruction: A Collaborative Training Model

PubMed Central

Carroll, Cathryn A.; Rychlewski, Walt; Teat, Marty; Clawson, Darrin

2004-01-01

This report describes an innovative training program designed to foster entrepreneurship and professionalism in students interested in the field of medical informatics. The course was developed through a private–public interinstitutional collaboration involving four academic institutions, one private firm specializing in health care information management systems, and a philanthropic organization. The program challenged students to serve in multiple roles on multidisciplinary teams and develop an innovative hand-held solution for drug information retrieval. Although the course was technically and behaviorally rigorous and required extensive hands-on experience in a nontraditional learning environment, both students and faculty responded positively. PMID:15064292

Golf hand prosthesis performance of transradial amputees.

PubMed

Carey, Stephanie L; Wernke, Matthew M; Lura, Derek J; Kahle, Jason T; Dubey, Rajiv V; Highsmith, M Jason

2015-06-01

Typical upper limb prostheses may limit sports participation; therefore, specialized terminal devices are often needed. The purpose of this study was to evaluate the ability of transradial amputees to play golf using a specialized terminal device. Club head speed, X-factor, and elbow motion of two individuals with transradial amputations using an Eagle Golf terminal device were compared to a non-amputee during a golf swing. Measurements were collected pre/post training with various stances and grips. Both prosthesis users preferred a right-handed stance initially; however, after training, one preferred a left-handed stance. The amputees had slower club head speeds and a lower X-factor compared to the non-amputee golfer, but increased their individual elbow motion on the prosthetic side after training. Amputees enjoyed using the device, and it may provide kinematic benefits indicated by the increase in elbow flexion on the prosthetic side. The transradial amputees were able to swing a golf club with sufficient repetition, form, and velocity to play golf recreationally. Increased elbow flexion on the prosthetic side suggests a potential benefit from using the Eagle Golf terminal device. Participating in recreational sports can increase amputees' health and quality of life. © The International Society for Prosthetics and Orthotics 2014.
The Plastic Surgery Hand Curriculum.

PubMed

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.
Management Challenge for the Early 1980’s.

DTIC Science & Technology

1980-01-01

AD-Al17 b86 LEADERSHIP AND MANAGEMENT DEVELOPMENT CENTER MAXWELL--ETC F/G 5/9 MANAGEMENT CHALLENGE FOR THE EARLY l980S.(U) UNCtASSIFIED 1980 J T...being replaced as fast as management might desire. This situation can be over- come through complementary training policies. First, continue to pursue...classroom instruction, on-the- job training, and further implement the Resource Management Team concept wthin the Comptroller Community. This training
Teacher-in-Space Trainees - Arriflex Motion Picture Camera

NASA Image and Video Library

1985-09-20

S85-40668 (18 Sept. 1985) --- The two teachers, Sharon Christa McAuliffe (left) and Barbara R. Morgan have hands-on experience with an Arriflex motion picture camera following a briefing on space photography. The two began training Sept. 10, 1985 with the STS-51L crew and learning basic procedures for space travelers. The second week of training included camera training, aircraft familiarization and other activities. Photo credit: NASA
Eyeless in Gaza, Part II.

ERIC Educational Resources Information Center

Gatto, John Taylor

1997-01-01

Suggests that modern schooling was founded on elitist principles and has resulted in making people dumber, weakening families, replacing religion, lowering incomes, reproducing the class structure by dividing children into classes that correlate closely with family income, and concentrating wealth and power in the hands of a small fraction of the…
Study of Fire Extinguishment of a Replacement Fluid for Use in Transformers in Lieu of Askarel

DOT National Transportation Integrated Search

1981-04-01

A series of tests were performed at the Factory Mutual Test Center 1) to obtain information on the performance of various extinguishing agents used with hand-held fire extinguishers to control fire involving a Midel,a transformer fluid for replacem...
E-Learning in Business

ERIC Educational Resources Information Center

Schweizer, Heidi

2004-01-01

e-Learning is replacing face-to-face classroom instruction in a growing number of businesses, but what is the prospect for the continued proliferation of e-learning in business? On one hand, the quality of instruction, the cost-effectiveness of new technology, a supportive e-learning educational culture, an expansion of the Internet, an increase…
Soy protein isolate inhibits hepatic tumor promotion in mice fed a high-fat liquid diet

USDA-ARS?s Scientific Manuscript database

Alcoholic and nonalcoholic fatty liver disease are risk factors for development of hepatocellular carcinoma, but the underlying mechanisms are poorly understood. On the other hand, ingestion of soy-containing diets may oppose the development of certain cancers. We previously reported that replacing ...
Safety and Quality Training Simulator

NASA Technical Reports Server (NTRS)

Scobby, Pete T.

2009-01-01

A portable system of electromechanical and electronic hardware and documentation has been developed as an automated means of instructing technicians in matters of safety and quality. The system enables elimination of most of the administrative tasks associated with traditional training. Customized, performance-based, hands-on training with integral testing is substituted for the traditional instructional approach of passive attendance in class followed by written examination.
The Dual System of Vocational Training in Germany. BASIS-INFO 11-1995. Social Policy.

ERIC Educational Resources Information Center

Kraemer, Dagmar

The dual system of vocational training is a joint government-industry program and part of the general educational system in Germany. It provides hands-on training in private businesses coupled with specialized instruction in public vocational schools at no cost to students. The objective of the dual system is to provide young people with the best…
Basic CNC Operation. Training Workbook [and] Assessment and Training Guide [and] Hands-on Assessment.

ERIC Educational Resources Information Center

Anoka-Hennepin Technical Coll., Minneapolis, MN.

This workbook is intended for students taking a course in basic computer numerical control (CNC) operation that was developed during a project to retrain defense industry workers at risk of job loss or dislocation because of conversion of the defense industry. The workbook contains daily training guides for each of the course's 13 sessions. Among…
Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy.

PubMed

Morrison, Steven; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

2014-01-01

For older adults with type 2 diabetes (T2DM), declines in balance and walking ability are risk factors for falls, and peripheral neuropathy magnifies this risk. Exercise training may improve balance, gait and reduce the risk of falling. This study investigated the effects of 12weeks of aerobic exercise training on walking, balance, reaction time and falls risk metrics in older T2DM individuals with/without peripheral neuropathy. Adults with T2DM, 21 without (DM; age 58.7±1.7years) and 16 with neuropathy (DM-PN; age 58.9±1.9years), engaged in either moderate or intense supervised exercise training thrice-weekly for 12weeks. Pre/post-training assessments included falls risk (using the physiological profile assessment), standing balance, walking ability and hand/foot simple reaction time. Pre-training, the DM-PN group had higher falls risk, slower (hand) reaction times (232 vs. 219ms), walked at a slower speed (108 vs. 113cm/s) with shorter strides compared to the DM group. Following training, improvements in hand/foot reaction times and faster walking speed were seen for both groups. While falls risk was not significantly reduced, the observed changes in gait, reaction time and balance metrics suggest that aerobic exercise of varying intensities is beneficial for improving dynamic postural control in older T2DM adults with/without neuropathy. Copyright © 2014 Elsevier Inc. All rights reserved.
Impact of training on emergency resuscitation skills: Impact on Millennium Development Goals (MDGs) 4 and 5.

PubMed

Gülmezoglu, A Metin; Lawrie, Theresa A

2015-11-01

Although significant progress has been made towards Millennium Development Goal (MDG) 4 and 5 targets, maternal and neonatal mortality rates remain unacceptably high in low- and middle-income countries (LMICs). The potential for improvements in maternal and neonatal health outcomes with increased facility utilization in these countries is undermined by a lack of appropriate and timely treatment. Skilful emergency resuscitation can be the difference between life and death; therefore, training in emergency resuscitation is essential for health-care practitioners at all levels, with regular refresher sessions to ensure skill retention. Whilst there is little robust evidence on the impact of resuscitation training interventions on practitioner skills or patient outcomes, such training interventions are likely to have the greatest impact if integrated into a broader approach to improve the quality of care. Accelerated investments in training must go hand in hand with ensuring the availability of quality equipment and upgrading infrastructure to reduce the gap between current MDG status and what is achieved by the end of 2015; and to accelerate reductions in mortality rates beyond 2015 towards new Countdown targets. Copyright © 2015 Elsevier Ltd. All rights reserved.
Virtual microscopes in podiatric medical education.

PubMed

Becker, John H

2006-01-01

In many medical schools, microscopes are being replaced as teaching tools by computers with software that emulates the use of a light microscope. This article chronicles the adoption of "virtual microscopes" by a podiatric medical school and presents the results of educational research on the effectiveness of this adoption in a histology course. If the trend toward virtual microscopy in education continues, many 21st-century physicians will not be trained to operate a light microscope. The replacement of old technologies by new is discussed. The fundamental question is whether all podiatric physicians should be trained in the use of a particular tool or only those who are likely to use it in their own practice.
Meaningful Watershed Experiences for Middle and High School Students

NASA Astrophysics Data System (ADS)

Landry, Melinda; Smith, Cynthia; Greene, Joy

2014-05-01

Prince William County Public Schools and George Mason University in Virginia, USA, partnered to provide Meaningful Watershed Educational Experiences (MWEEs) for over 25,000 middle and high school students (11-18 year olds) across 34 schools. This school district, situated in a rapidly growing region 55 km southwest of Washington DC, has over 82,000 K-12 students. As native forest cover has been replaced with farming and urbanization, water quality has significantly degraded in the 166,534 km2 Chesapeake Bay watershed. This project was designed to increase student awareness of their impact on the land and waters of the largest estuary in the United States. MWEE is a long-term comprehensive project that incorporates a classroom preparation phase, a hands-on outdoor field investigation, and a reflection and data-sharing component. Training and technical assistance enhances the capacity of teachers of 6th grade, high school Earth Science and Environmental Science to deliver MWEEs which includes schoolyard stewardship, inquiry driven field study, use of hand-held technology and computer based mapping and analysis, project sharing and outreach. George Mason University researchers worked closely with K-12 science educators to create a comprehensive watershed-focused curriculum. Graduate and undergraduate students with strong interests in environmental science and education were trained to deliver the field investigation component of the MWEE. Representative teachers from each school were provided 3 days of professional development and were responsible for the training of their school's science education team. A comprehensive curriculum provided teachers with activities and tools designed to enhance students' mastery of state science objectives. Watershed concepts were used as the unifying theme to support student understanding of curriculum and STEM objectives including: scientific investigation, data collection and communication, chemistry, energy, erosion, human interaction with the environment, land use, and decision making based on cost-benefit analysis. Through this program, students make the connection that the health of their local schoolyard will affect the health of the Chesapeake Bay watershed. Groups ranging from 65 - 150 students per day travel to either Occoquan Bay U.S. Fish and Wildlife Refuge or Manassas National Battlefield Park for their field investigation. During the investigation, learners rotate through up to four different 45-minute stations led by GMU students and/or retired science schoolteachers. Depending on the field site visited, stations include water chemistry testing, benthic macroinvertebrate collection and identification, wetland functions, watershed topography and water conservation. Thus this experience raises students' understanding of their place within the Chesapeake Bay watershed and their impact on local and regional ecosystems. Additionally, this field investigation directly increases university students' ability to successfully immerse the public in discussions of complex science topics as well as engage them in hands-on learning experiences. This university-K12 partnership was made possible through grants and partnerships with National Oceanic and Atmospheric Administration, Alice Ferguson Foundation, the National Park Service, U. S. Fish and Wildlife Refuge System, SPARK, PWCS Education Foundation, and Dominion Power.
Electrical stimulation during skill training with a therapeutic glove enhances the induction of cortical plasticity and has a positive effect on motor memory.

PubMed

Christova, Monica; Rafolt, Dietmar; Golaszewski, Stefan; Nardone, Raffaele; Gallasch, Eugen

2014-08-15

To examine whether afferent stimulation of hand muscles has a facilitating effect on motor performance, learning and cortical excitability, healthy subjects were trained on the grooved pegboard test (GTP) while wearing a mesh glove (MG) with incorporated electrical stimulation. Three study groups (n=12) were compared in a between subjects design, the bare handed (BH), gloved (MG) and gloved with electrical stimulation (MGS) groups. Motor performance was assessed by the GPT completion time across 4 training blocks, and further one block was retested 7 days later to determine the off-line effects. On-line learning was obtained by normalizing the completion time values to the first training block, and off-line learning was obtained by normalizing the retest values to the last training block. Cortical excitability was assessed via single and paired-pulse transcranial magnetic stimulation (TMS) at pre-training, post-training and 30 min post-training. Motor evoked potential recruitment curve, short-latency intracortical inhibition and intracortical facilitation were estimated from the TMS assessments. Motor performance across all 4 training blocks was poor in the MG and MGS groups, while on-line learning was not affected by wearing the glove or by afferent stimulation. However, off-line learning, tested 7 days after training, was improved in the MGS group compared to the MG group. In addition, post-training corticospinal excitability was increased in the MGS group. It can be concluded that afferent stimulation improves off-line learning and thus has a positive effect on motor memory, likely due to LTP-like cortical plasticity in the consolidation phase. Copyright © 2014 Elsevier B.V. All rights reserved.
Curriculum for Commissioning Energy Efficient Buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Webster, Lia

2012-12-27

In July 2010, the U.S. Department of Energy (DOE) awarded funding to PECI to develop training curriculum in commercial energy auditing and building commissioning. This program was created in response to the high demand for auditing and commissioning services in the U.S. commercial buildings market and to bridge gaps and barriers in existing training programs. Obstacles addressed included: lack of focus on entry level candidates; prohibitive cost and time required for training; lack of hands-on training; trainings that focus on certifications & process overviews; and lack of comprehensive training. PECI organized several other industry players to create a co-funded projectmore » sponsored by DOE, PECI, New York State Energy and Research Development Authority (NYSERDA), California Energy Commission (CEC), Northwest Energy Efficiency Alliance (NEEA) and California Commissioning Collaborative (CCC). After awarded, PECI teamed with another DOE awardee, New Jersey Institute of Technology (NJIT), to work collaboratively to create one comprehensive program featuring two training tracks. NJIT’s Center for Building Knowledge is a research and training institute affiliated with the College of Architecture and Design, and provided e-learning and video enhancements. This project designed and developed two training programs with a comprehensive, energy-focused curriculum to prepare new entrants to become energy auditors or commissioning authorities (CxAs). The following are the key elements of the developed trainings, which is depicted graphically in Figure 1: • Online classes are self-paced, and can be completed anywhere, any time • Commissioning Authority track includes 3 online modules made up of 24 courses delivered in 104 individual lessons, followed by a 40 hour hands-on lab. Total time required is between 75 and 100 hours, depending on the pace of the independent learner. • Energy Auditor track includes 3 online modules made up of 18 courses delivered in 72 individual lessons, followed by a 24 hour hands-on lab. Total time required is between 50 and 70 hours, depending on the pace of the independent learner. • Individual courses can be taken for continuing education credits. • Assessments are included for each course, and a score of at least 80% is required for completion. • Completion of Modules 1 through 3 is prerequisite for participating in the laboratory. More experienced participants have the option to test out of Modules 1 and 2 and complete Module 3 to progress to the laboratory.« less
Infection prevention and mass vaccination training for U.S. point of dispensing staff and volunteers: a national study.

PubMed

Rebmann, Terri; Loux, Travis M; Zink, Thomas K; Swick, Zachary; Wakefield, Mary

2015-03-01

Points of dispensing (PODs) are deployed for medical countermeasure mass dispensing. However, infection prevention and vaccine administration pre-event training offered and just-in-time (JIT) education planned for POD workers have not been assessed. Disaster planners were sent an online questionnaire in 2013. McNemar tests compared training offered to staff versus volunteers and pre-event training versus JIT training. In total, 301 disaster planners participated. The most frequent pre-event training included hand hygiene (59.1% and 28.0%) and personal protective equipment (PPE) selection (52.1% and 24.1%) for staff and volunteers, respectively. Few provided pre-event training on the cold chain technique (14.8% and 5.1%) or smallpox vaccine administration (4.7% and 2.3%) for staff or volunteers. For all topics except smallpox vaccine administration, more staff than volunteers received pre-event training (P < .01). The most frequent planned JIT training includes hand hygiene (79.8% and 73.5%) and PPE selection (79.4% and 70.0%) to staff and volunteers. For all topics, more JIT education is planned for staff than volunteers (P < .001). More JIT training is planned than has been given pre-event for all topics (P < .001). More pre-event training is needed on infection prevention and vaccine administration to ensure safe and successful POD deployment. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
Physiological modules for generating discrete and rhythmic movements: action identification by a dynamic recurrent neural network.

PubMed

Bengoetxea, Ana; Leurs, Françoise; Hoellinger, Thomas; Cebolla, Ana M; Dan, Bernard; McIntyre, Joseph; Cheron, Guy

2014-01-01

In this study we employed a dynamic recurrent neural network (DRNN) in a novel fashion to reveal characteristics of control modules underlying the generation of muscle activations when drawing figures with the outstretched arm. We asked healthy human subjects to perform four different figure-eight movements in each of two workspaces (frontal plane and sagittal plane). We then trained a DRNN to predict the movement of the wrist from information in the EMG signals from seven different muscles. We trained different instances of the same network on a single movement direction, on all four movement directions in a single movement plane, or on all eight possible movement patterns and looked at the ability of the DRNN to generalize and predict movements for trials that were not included in the training set. Within a single movement plane, a DRNN trained on one movement direction was not able to predict movements of the hand for trials in the other three directions, but a DRNN trained simultaneously on all four movement directions could generalize across movement directions within the same plane. Similarly, the DRNN was able to reproduce the kinematics of the hand for both movement planes, but only if it was trained on examples performed in each one. As we will discuss, these results indicate that there are important dynamical constraints on the mapping of EMG to hand movement that depend on both the time sequence of the movement and on the anatomical constraints of the musculoskeletal system. In a second step, we injected EMG signals constructed from different synergies derived by the PCA in order to identify the mechanical significance of each of these components. From these results, one can surmise that discrete-rhythmic movements may be constructed from three different fundamental modules, one regulating the co-activation of all muscles over the time span of the movement and two others elliciting patterns of reciprocal activation operating in orthogonal directions.
Neural representation of hand kinematics during prehension in posterior parietal cortex of the macaque monkey.

PubMed

Chen, Jessie; Reitzen, Shari D; Kohlenstein, Jane B; Gardner, Esther P

2009-12-01

Studies of hand manipulation neurons in posterior parietal cortex of monkeys suggest that their spike trains represent objects by the hand postures needed for grasping or by the underlying patterns of muscle activation. To analyze the role of hand kinematics and object properties in a trained prehension task, we correlated the firing rates of neurons in anterior area 5 with hand behaviors as monkeys grasped and lifted knobs of different shapes and locations in the workspace. Trials were divided into four classes depending on the approach trajectory: forward, lateral, and local approaches, and regrasps. The task factors controlled by the animal-how and when he used the hand-appeared to play the principal roles in modulating firing rates of area 5 neurons. In all, 77% of neurons studied (58/75) showed significant effects of approach style on firing rates; 80% of the population responded at higher rates and for longer durations on forward or lateral approaches that included reaching, wrist rotation, and hand preshaping prior to contact, but only 13% distinguished the direction of reach. The higher firing rates in reach trials reflected not only the arm movements needed to direct the hand to the target before contact, but persisted through the contact, grasp, and lift stages. Moreover, the approach style exerted a stronger effect on firing rates than object features, such as shape and location, which were distinguished by half of the population. Forty-three percent of the neurons signaled both the object properties and the hand actions used to acquire them. However, the spread in firing rates evoked by each knob on reach and no-reach trials was greater than distinctions between different objects grasped with the same approach style. Our data provide clear evidence for synergies between reaching and grasping that may facilitate smooth, coordinated actions of the arm and hand.

The Linguistic Core Approach to StructuredTranslation and Analysis of Low Resource Languages

DTIC Science & Technology

2017-09-02

grammars from no training data and partial training data (as given by GFL). We are now anno - tating GFL for English, Portuguese, Chinese and...translation. In Proc. EMNLP, 2014. [20] F. Drewes, H.- J . Kreowski, and A. Habel. Hyperedge replacement graph grammars. Handbook of Graph Grammars, 1:95–162...tory, Jena, 2015. [41] B. Jones, J . Andreas, D. Bauer, K-M. Hermann, and K. Knight. Semantics- based machine translation with hyperedge replacement
40 CFR 82.40 - Technician training and certification.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 18 2013-07-01 2013-07-01 false Technician training and certification. 82.40 Section 82.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., videos or a hands-on demonstration. (2) Test subject material. The certification tests must adequately...
40 CFR 82.40 - Technician training and certification.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Technician training and certification. 82.40 Section 82.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., videos or a hands-on demonstration. (2) Test subject material. The certification tests must adequately...
40 CFR 82.40 - Technician training and certification.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 18 2012-07-01 2012-07-01 false Technician training and certification. 82.40 Section 82.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., videos or a hands-on demonstration. (2) Test subject material. The certification tests must adequately...
Cross-education after high-frequency versus low-frequency volume-matched handgrip training.

PubMed

Boyes, Natasha G; Yee, Peter; Lanovaz, Joel L; Farthing, Jonathan P

2017-10-01

Cross-education training programs cause interlimb asymmetry of strength and hypertrophy. We examined the cross-education effects from a high-frequency (HF) versus a low-frequency (LF) volume-matched handgrip training program on interlimb asymmetry. Right-handed participants completed either HF (n = 10; 2 × 6 repetitions 10 times per week) or LF (n = 9; 5 × 8 repetitions 3 times per week) training. Testing occurred twice before and once after 4 weeks of right-handed isometric handgrip training totaling 120 weekly repetitions. Measures were maximal isometric handgrip and wrist flexion torque, muscle thickness, and muscle activation (electromyography; EMG). Grip strength was greater in both limbs posttraining, pooled across groups (P < 0.001). Trained limb muscle thickness increased in both groups (P < 0.05; untrained, P = 0.897). EMG and wrist flexion torque did not change (all P > 0.103). Both LF and HF induced cross-education of grip strength to the untrained limb, but HF did not reduce asymmetry. These findings have implications for injury rehabilitation. Muscle Nerve 56: 689-695, 2017. © 2017 Wiley Periodicals, Inc.
LANDSAT technology transfer to the private and public sectors through community colleges and other locally available institutions, phase 2 program

NASA Technical Reports Server (NTRS)

Rogers, R. H. (Principal Investigator)

1982-01-01

A program established by NASA with the Environmental Research Institute of Michigan (ERIM) applies a network where the major participants are NASA, universities or research institutes, community colleges, and local private and public organizations. Local users are given an opportunity to obtain "hands on" training in LANDSAT data analysis and Geographic Information System (GIS) techniques using a desk top, interactive remote analysis station (RAS). The RAS communicates with a central computing facility via telephone line, and provides for generation of land use and land suitability maps and other data products via remote command. During the period from 22 September 1980 - 6 March 1982, 15 workshops and other training activities were successfully conducted throughout Michigan providing hands on training on the RAS terminals for 250 or more people and user awareness activities such as exhibits and demonstrations for 2,000 or more participants.
Johnson Space Center: Workmanship Training

NASA Technical Reports Server (NTRS)

Patterson, Ashley; Sikes, Larry; Corbin, Cheryl; Rucka, Becky

2015-01-01

Special processes require special skills, knowledge and experienced application. For over 15 years, the NASA Johnson Space Center's Receiving, Inspection and Test Facility (RITF) has provided Agency-wide NASA Workmanship Standards compliance training, issuing more than 500 to 800 training completion certificates annually. It is critical that technicians and inspectors are trained and that they maintain their proficiency to implement the applicable standards and specifications. Training services include "hands-on" training to engineers, technicians, and inspectors in the areas of electrostatic discharge (ESD), soldering, surface mount technology (SMT), crimping, conformal coating, and fiber-optic terminations.
Workmanship Training Industry

NASA Technical Reports Server (NTRS)

Patterson, Ashley; Sikes, Larry; Corbin, Cheryl; Rucka, Rebecca

2015-01-01

Special processes require special skills, knowledge and experienced application. For over 15 years, the NASA Johnson Space Center's Receiving, Inspection and Test Facility (RITF) has provided Workmanship Standards compliance training, issuing more than 500 to 800 training completion certificates annually. It is critical that technicians and inspectors are trained and that they maintain their proficiency to implement the applicable standards and specifications. Training services include 'hands-on' training to engineers, technicians, and inspectors in the areas of electrostatic discharge (ESD), soldering, fiber optics, lithium battery handling, torque and wire safety, and wire wrapping.
NBIC-Convergence as a Paradigm Platform of Sustainable Development

NASA Astrophysics Data System (ADS)

Dotsenko, Elena

2017-11-01

Today, the fastest rates of scientific and technological development are typical for the spheres of nano-systems and materials industry, information and communication systems, as well as spheres of direct human impact on environment - power industry, urbanization, and industrial infrastructure. Accelerate replacement of a human by machines and robots, the construction of megacities; the transportation of huge volumes of environmentally hazardous goods takes place against the background of intensive generation of knowledge, the transition of the results of fundamental research into specific production technologies. In this process, on the one hand, a fundamentally new format for technological restructuring of the world economy is being developed. On the other hand, a new platform for human-environment interaction is being formed, where both positive and negative environmental impacts will be determined by unstudied factors in the near future. The reason for this is in the forthcoming replacement of the technologies that are familiar to us, although dynamically developing, by fundamentally new - convergent. Entering the front line of technological development - NBIC-convergence - requires a new paradigm of sustainable development.
New Technologies for Surgery of the Congenital Cardiac Defect

PubMed Central

Kalfa, David; Bacha, Emile

2013-01-01

The surgical repair of complex congenital heart defects frequently requires additional tissue in various forms, such as patches, conduits, and valves. These devices often require replacement over a patient’s lifetime because of degeneration, calcification, or lack of growth. The main new technologies in congenital cardiac surgery aim at, on the one hand, avoiding such reoperations and, on the other hand, improving long-term outcomes of devices used to repair or replace diseased structural malformations. These technologies are: 1) new patches: CorMatrix® patches made of decellularized porcine small intestinal submucosa extracellular matrix; 2) new devices: the Melody® valve (for percutaneous pulmonary valve implantation) and tissue-engineered valved conduits (either decellularized scaffolds or polymeric scaffolds); and 3) new emerging fields, such as antenatal corrective cardiac surgery or robotically assisted congenital cardiac surgical procedures. These new technologies for structural malformation surgery are still in their infancy but certainly present great promise for the future. But the translation of these emerging technologies to routine health care and public health policy will also largely depend on economic considerations, value judgments, and political factors. PMID:23908869
Mentorship for operational research capacity building: hands-on or hands-off?

PubMed

Harries, A D; Marais, B; Kool, B; Ram, S; Kumar, A M V; Gounder, S; Viney, K; Brostrom, R; Roseveare, C; Bissell, K; Reid, A J; Zachariah, R; Hill, P C

2014-06-21

Mentorship is a key feature of operational research training courses run by the International Union Against Tuberculosis and Lung Disease and Médecins Sans Frontières. During the recent South Pacific paper writing module, the faculty discussed 'hands-on' mentorship (direct technical assistance) vs. 'hands-off' mentorship (technical advice). This article explores the advantages and disadvantages of each approach. Our collective experience indicates that 'hands-on' mentorship is a valuable learning experience for the participant and a rewarding experience for the mentor. This approach increases the likelihood of successful course completion, including publishing a well written paper. However, mentors must allow participants to lead and take ownership of the paper, in keeping with a first author position.
The Impact of E-Learning on Medical Education in Russia

ERIC Educational Resources Information Center

Trukhacheva, N.; Tchernysheva, S.; Krjaklina, T.

2011-01-01

New educational technologies prove to be capable of solving many problems in medical training. Students do not see e-learning as replacing traditional instructor-led training but as a complement to it, forming part of a blended-learning strategy. Innovations in e-learning technologies point toward a revolution in education, allowing learning to be…
The effect of bench model fidelity on fluoroscopy-guided transforaminal epidural injection training: a randomized control study.

PubMed

Gonzalez-Cota, Alan; Chiravuri, Srinivas; Stansfield, R Brent; Brummett, Chad M; Hamstra, Stanley J

2013-01-01

The purpose of this study was to determine whether high-fidelity simulators provide greater benefit than low-fidelity models in training fluoroscopy-guided transforaminal epidural injection. This educational study was a single-center, prospective, randomized 3-arm pretest-posttest design with a control arm. Eighteen anesthesia and physical medicine and rehabilitation residents were instructed how to perform a fluoroscopy-guided transforaminal epidural injection and assessed by experts on a reusable injectable phantom cadaver. The high- and low-fidelity groups received 30 minutes of supervised hands-on practice according to group assignment, and the control group received 30 minutes of didactic instruction from an expert. We found no differences at posttest between the high- and low-fidelity groups on global ratings of performance (P = 0.17) or checklist scores (P = 0.81). Participants who received either form of hands-on training significantly outperformed the control group on both the global rating of performance (control vs low-fidelity, P = 0.0048; control vs high-fidelity, P = 0.0047) and the checklist (control vs low-fidelity, P = 0.0047; control vs high-fidelity, P = 0.0047). Training an epidural procedure using a low-fidelity model may be equally effective as training on a high-fidelity model. These results are consistent with previous research on a variety of interventional procedures and further demonstrate the potential impact of simple, low-fidelity training models.
Short-Term Effects of Whole-Body Vibration Combined with Task-Related Training on Upper Extremity Function, Spasticity, and Grip Strength in Subjects with Poststroke Hemiplegia: A Pilot Randomized Controlled Trial.

PubMed

Lee, Jung-Sun; Kim, Chang-Yong; Kim, Hyeong-Dong

2016-08-01

The aim of this study was to determine the effect of whole-body vibration training combined with task-related training on arm function, spasticity, and grip strength in subjects with poststroke hemiplegia. Forty-five subjects with poststroke were randomly allocated to 3 groups, each with 15 subjects as follows: control group, whole-body vibration group, and whole-body vibration plus task-related training group. Outcome was evaluated by clinical evaluation and measurements of the grip strength before and 4 weeks after intervention. Our results show that there was a significantly greater increase in the Fugl-Meyer scale, maximal grip strength of the affected hand, and grip strength normalized to the less affected hand in subjects undergoing the whole-body vibration training compared with the control group after the test. Furthermore, there was a significantly greater increase in the Wolf motor function test and a decrease in the modified Ashworth spasticity total scores in subjects who underwent whole-body vibration plus task-related training compared with those in the other 2 groups after the test. The findings indicate that the use of whole-body vibration training combined with task-related training has more benefits on the improvement of arm function, spasticity, and maximal grip strength than conventional upper limb training alone or with whole-body vibration in people with poststroke hemiplegia.
Comparative Effectiveness of Hands-on Versus Computer Simulation-Based Training for Contrast Media Reactions and Teamwork Skills.

PubMed

Wang, Carolyn L; Chinnugounder, Sankar; Hippe, Daniel S; Zaidi, Sadaf; O'Malley, Ryan B; Bhargava, Puneet; Bush, William H

2017-01-01

To assess the performance of interprofessional teams of radiologists, technologists, and nurses trained with high-fidelity hands-on (HO) simulation and computer-based (CB) simulation training for contrast reaction management (CR) and teamwork skills (TS). Nurses, technologists, and radiology residents were randomized into 11 teams of three (one of each). Six teams underwent HO training and five underwent CB training for CR and TS. Participants took written tests before and after training and were further tested using a high-fidelity simulation scenario. HO and CB groups scored similarly on all written tests and each showed improvement after training (P = .002 and P = .018, respectively). During the final scenario test, HO teams tended to receive higher grades than CB teams on CR (95% versus 81%, P = .17) and made fewer errors in epinephrine administration (0/6 versus 2/5, P = .18). HO and CB teams scored similarly on TS (51% versus 52%, P = .66), but overall scores were lower for TS than for CR skills in both the HO (P = .03) and CB teams (P = .06). HO training was more highly rated than CB as an effective educational tool (P = .01) and for effectiveness at teaching CR and team communication skills (P = .02). High-fidelity simulation can be used to both train and test interprofessional teams of radiologists, technologists, and nurses for both CR and TS and is more highly rated as an effective educational tool by participants than similar CB training. However, a single session of either type of training may be inadequate for mastering TS. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
A virtual reality-based system integrated with fmri to study neural mechanisms of action observation-execution: A proof of concept study

PubMed Central

Adamovich, S.V.; August, K.; Merians, A.; Tunik, E.

2017-01-01

Purpose Emerging evidence shows that interactive virtual environments (VEs) may be a promising tool for studying sensorimotor processes and for rehabilitation. However, the potential of VEs to recruit action observation-execution neural networks is largely unknown. For the first time, a functional MRI-compatible virtual reality system (VR) has been developed to provide a window into studying brain-behavior interactions. This system is capable of measuring the complex span of hand-finger movements and simultaneously streaming this kinematic data to control the motion of representations of human hands in virtual reality. Methods In a blocked fMRI design, thirteen healthy subjects observed, with the intent to imitate (OTI), finger sequences performed by the virtual hand avatar seen in 1st person perspective and animated by pre-recorded kinematic data. Following this, subjects imitated the observed sequence while viewing the virtual hand avatar animated by their own movement in real-time. These blocks were interleaved with rest periods during which subjects viewed static virtual hand avatars and control trials in which the avatars were replaced with moving non-anthropomorphic objects. Results We show three main findings. First, both observation with intent to imitate and imitation with real-time virtual avatar feedback, were associated with activation in a distributed frontoparietal network typically recruited for observation and execution of real-world actions. Second, we noted a time-variant increase in activation in the left insular cortex for observation with intent to imitate actions performed by the virtual avatar. Third, imitation with virtual avatar feedback (relative to the control condition) was associated with a localized recruitment of the angular gyrus, precuneus, and extrastriate body area, regions which are (along with insular cortex) associated with the sense of agency. Conclusions Our data suggest that the virtual hand avatars may have served as disembodied training tools in the observation condition and as embodied “extensions” of the subject’s own body (pseudo-tools) in the imitation. These data advance our understanding of the brain-behavior interactions when performing actions in VE and have implications in the development of observation- and imitation-based VR rehabilitation paradigms. PMID:19531876
Applying Deep Learning in Medical Images: The Case of Bone Age Estimation.

PubMed

Lee, Jang Hyung; Kim, Kwang Gi

2018-01-01

A diagnostic need often arises to estimate bone age from X-ray images of the hand of a subject during the growth period. Together with measured physical height, such information may be used as indicators for the height growth prognosis of the subject. We present a way to apply the deep learning technique to medical image analysis using hand bone age estimation as an example. Age estimation was formulated as a regression problem with hand X-ray images as input and estimated age as output. A set of hand X-ray images was used to form a training set with which a regression model was trained. An image preprocessing procedure is described which reduces image variations across data instances that are unrelated to age-wise variation. The use of Caffe, a deep learning tool is demonstrated. A rather simple deep learning network was adopted and trained for tutorial purpose. A test set distinct from the training set was formed to assess the validity of the approach. The measured mean absolute difference value was 18.9 months, and the concordance correlation coefficient was 0.78. It is shown that the proposed deep learning-based neural network can be used to estimate a subject's age from hand X-ray images, which eliminates the need for tedious atlas look-ups in clinical environments and should improve the time and cost efficiency of the estimation process.
Simple training tricks for mastering and taming bypass procedures in neurosurgery

PubMed Central

Hafez, Ahmad; Raj, Rahul; Lawton, Michael T.; Niemelä, Mika

2017-01-01

Background: Neurosurgeons devoted to bypass neurosurgery or revascularization neurosurgery are becoming scarcer. From a practical point of view, “bypass neurosurgeons” are anastomosis makers, vessels technicians, and time-racing repairers of vessel walls. This requires understanding the key features and hidden tricks of bypass surgery. The goal of this paper is to provide simple and inexpensive tricks for taming the art of bypass neurosurgery. Most of these tricks and materials described can be borrowed, donated, or purchased inexpensively. Methods: We performed a review of relevant training materials and recorded videos for training bypass procedures for 3 years between June 2014 and July 2017. In total, 1,300 training bypass procedures were performed, of which 200 procedures were chosen for this paper. Results: A training laboratory bypass procedures is required to enable a neurosurgeon to develop the necessary skills. The important skills for training bypass procedures gained through meticulous practice to be as reflexes are coordination, speed, agility, flexibility, and reaction time. Bypassing requires synchronization between the surgeon's gross movements, fine motoric skills, and mental strength. The suturing rhythm must be timed in a brain–body–hand fashion. Conclusion: Bypass-training is a critical part of neurosurgical training and not for a selected few. Diligent and meticulous training can enable every neurosurgeon to tame the art of bypass neurosurgery. This requires understanding the key features and hidden tricks of bypass surgery, as well as uncountable hours of training. In bypass neurosurgery, quality and time goes hand in hand. PMID:29285411
Training Law Enforcement Officials on Responding to Equine Calls

ERIC Educational Resources Information Center

Anderson, Kathleen P.; Stauffer, Gary; Stauffer, Monte; Anderson, Doug; Biodrowski, Kristie

2016-01-01

The occurrence of equine abuse/neglect cases is an ongoing issue. However, officials responding to equine cases are rarely experienced in handling horses. Therefore, workshops teaching basic horse husbandry were offered to better equip and prepare officials to respond to equine cases. Trainings consisted of both classroom and hands-on sessions.…
Pre-Service Teacher Training at the Museum School

ERIC Educational Resources Information Center

Stetson, Ranae; Stroud, Nicole Devlin

2014-01-01

This article describes the powerful and long-term partnership between a museum preschool and a local university teacher preparation program. The authors describe the unique and rich learning environment of the Museum School and its dramatic and positive impact on pre-service teacher training. The hands-on learning experiences taught at the Museum…

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