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At least 235 records · Page 13Linked to original sources

Splenectomy revised: manually assisted splenectomy with the dexterity device--a feasibility study in 22 patients.

Laparoscopic splenectomy claims a number of advantages over open surgery: less trauma, quicker recovery, and faster return to normal activity. On the other hand, laparoscopic splenectomy is complex and time consuming, and so far, many surgeons are reluctant to perform such an operation. A new device was designed to give manual access to the abdomen through a utility laparotomy. By using one hand in the abdomen during laparoscopy, the surgeon regains direct tactile sense and hand-eye coordination. A pilot study to assess the feasibility of this method has been performed in 22 patients. The operation could be completed easily in 21 patients (95%). The average blood loss was 230 mL, and the average postoperative stay was 3.9 days. With this simple, inexpensive method, it is possible to combine the established convenience, safety, efficacy of open surgery with the advantages of minimally invasive surgery.

Adolescent↗

The Timed Test of Money Counting: a short physical performance test for manual dexterity and cognitive capacity.

The competent handling of money is an essential basis for living independently. Seventy-eight consecutively admitted patients to a geriatric hospital underwent the Timed Test of Money Counting (TTMC) which measures patients' ability to open a purse, take out all the money and count it. Further assessment included Mini-Mental State Examination (MMSE), Barthel Index of ADL, Self-maintaining and Instrumental Activities of Daily Living (IADL), grip strength and Williams' Board Test. The TTMC was reliable (inter-rater and intra-rater) and showed construct and concurrent validity with other measures of physical function. Unlike many other physical performance tests the TTMC is quickly performed and requires no special equipment or training.

Activities of Daily Living↗

Effect of augmented visual feedback from a virtual reality simulation system on manual dexterity training.

Little research has been published about the impact of simulation technology on the learning process of novel motor skills. Especially the role of augmented feedback (FB) on the quality of performance and the transfer of the acquired behaviour to a no-augmented FB condition require further investigation. Therefore, novice dental students were randomly assigned to one of three groups and given the task of drilling a geometrical class 1 cavity. The FB group trained under augmented visual FB conditions, provided by the virtual reality (VR) system (DentSim). The no-FB group practised under normal vision conditions, in the absence of augmented FB. A control group performed the test sessions without participating in any training programme. All preparations were evaluated by the VR grading system according to four traditional (outline shape, floor depth, floor smoothness and wall inclination), and two critical, criteria (pulp exposure and damage to adjacent teeth). Performance analyses revealed an overall trend towards significant improvement with training for the experimental groups. The FB group obtained the highest scores. It scored better for floor depth (P < 0.001), whilst the no-FB group was best for floor smoothness (P < 0.005). However, at the retention tests, the FB group demonstrated inferior performance in comparison with the no-FB group. The transfer test on a traditional unit revealed no significant differences between the training groups. Consequently, drilling experience on a VR system under the condition of frequently provided FB and lack of any tutorial input was considered to be not beneficial to learning. The present data are discussed in view of the guidance hypothesis of FB, which refers to the apprentice's dependence on FB.

Adolescent↗

The oral hygiene performance test: development and validation of dental dexterity scale for the elderly.

This paper describes a test which was developed for use in assessing the functional oral hygiene status of an elderly population. The instrument was tested among 80 community-dwelling elderly subjects 65 or more years old. The instrument, the Oral Hygiene Performance Test [OHPT], is a direct-observation measure which objectively quantifies the individual's ability to perform oral hygiene and thus reduces subjective evaluation. The test utilized several items from other already-validated instruments currently in use in geriatric medicine to assess functional abilities in a geriatric population. Additional items were developed by the research team and were included in this 17-item test. The OHPT was validated with common measures of physical function and direct-observation measures. Construct validity was assessed by comparison of the OHPT scores with other commonly used measures of other dimensions. The instrument proved to be reliable and demonstrated construct as well as concurrent validity. It appears that the OHPT can prove useful to clinicians in assessing the oral physical function of elderly patients with regard to their maintenance of oral hygiene. Because the OHPT is a direct-observation instrument, it can even elicit higher functions in elderly patients. While effective among the studied population, the instrument may still need to be validated among more diverse populations, such as various ethnic groups and demented or severely impaired populations.

Black or African American↗

Circadian rhythm in pain, stiffness, and manual dexterity in rheumatoid arthritis: relation between discomfort and disability.

Fourteen patients with rheumatoid arthritis (RA) self rated their pain and stiffness on separate 10 cm visual analogue scales and performed bead intubation coordinometry (BIC) on six occasions each day for seven consecutive days. In addition, 14 healthy controls matched for age and sex also performed BIC measurements according to the same schedule. Data were analysed using least squares and cosine vector techniques. Significant circadian rhythms in patients with RA were detected in pain, stiffness, and BIC, and in controls in BIC. Pain was least in patients with RA at 1700 and stiffness at 1724. Peak BIC performance occurred almost simultaneously in RA (1544) and control (1528) subjects and for subjects with RA occurred within the 95% confidence interval of least pain and stiffness. These data suggest that the inferior performance of subjects with RA may be an accentuation of the normal physiological variation seen in healthy controls, but may be modulated by the patient's level of pain or stiffness, or both.

Adult↗