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PubMed2001

Stone tool function at the paleolithic sites of Starosele and Buran Kaya III, Crimea: behavioral implications.

Stone tools are often the most abundant type of cultural remains at Paleolithic sites, yet their function is often poorly understood. Investigations of stone tool function, including microscopic use-wear and residue analyses, were performed on a sample of artifacts from the Paleolithic sites of Starosele (40,000-80,000 years BP) and Buran Kaya III (32,000-37,000 years BP). The Middle Paleolithic levels at Starosele exhibit a typical variant of the local Micoquian Industry. The artifacts from Buran Kaya III most closely resemble an Early Streletskayan Industry associated with the early Upper Paleolithic. The results of the functional analyses suggest that hominids at both sites were exploiting woody and starchy plant material as well as birds and mammals. Both sites show evidence of hafting of a wide variety of tools and the possible use of projectile or thrusting spears. These analyses were performed by using two different techniques conducted by independent researchers. Combined residue and use-wear analyses suggest that both the Upper Paleolithic and Middle Paleolithic hominids at these sites were broad-based foragers capable of exploiting a wide range of resources.

Animals↗

PubMed2006

Assessment of diet in young children with an emphasis on fruit and vegetable intake: using CADET--Child and Diet Evaluation Tool.

OBJECTIVES: To develop a concise, simple tool for use by non-specialists to assess diet in children aged 3-7 years attending primary schools. DESIGN: A 24-hour food tick list covering all aspects of the diet and with a focus on fruit and vegetable consumption was developed. This was compared against a 24-hour semi-weighed food diary obtained for the same day as the tick list. SETTING: Six primary schools with a range of socio-economic and ethnic backgrounds from a large city in the north of England (Leeds). PARTICIPANTS: One hundred and eighty children returned completed packs of information; a response rate of 77% of those who were willing to take part, 48% of those approached. RESULTS: On average, 2.4 items of fruit including juice (2.1 items as 5-a-day count) were eaten and 1.6 items of vegetables (excluding potato). Twenty-seven per cent and 36% of boys and 23% and 24% of girls reported not eating any fruit or vegetables, respectively, on the recording day. Correlations comparing the diary and tick list were high for both foods (range r=0.44 to 0.89) and nutrients (range r=0.41 to 0.68). The level of misclassification was much less than would be expected by chance. Parent and teacher evaluation of the tick list was very positive. Parents felt the tick list was easy and quick to complete. CONCLUSION: The Child and Diet Evaluation Tool (CADET) tick list has been used successfully for rapid collection of food and nutrient information from children aged 3-7 years from diverse social and ethnic backgrounds. The tool has performed better than many food-frequency questionnaires in comparison to a food diary.

Child↗

PubMed2004

A suite of objective biomechanical measurement tools for personal load carriage system assessment.

For application to military and civilian needs, Defence Research and Development Canada--Toronto contracted Queen's University, Kingston to develop a suite of biomechanical assessment and analytical tools to supplement human-based load carriage system assessment methods. This suite of tools permitted efficient objective evaluation of biomechanical aspects of load-bearing webbing, vests, packs and their components, and therefore contributed to early system assessment and a rapid iterative design process. This paper is a summary of five assessment and analytical tools. A dynamic load carriage simulator was developed to simulate cadence of walking, jogging and running. The simulator comprised a computer-controlled pneumatic platform that oscillated anthropometrically weighted mannequins of varying dimensions from which measures of skin contact pressure, hip reaction forces and moments and relative pack-person displacements were taken. A stiffness tester for range of motion provided force-displacement data on pack suspension systems. A biomechanical model was used to determine forces and moments on the shoulders and hips, and validated using a static load distribution mannequin. Subjective perceptual rating systems were used gather soldier feedback during a standardized mobility circuit. Objective outcome measures were validated by means of other objective measures (e.g., Optotrak, video, Instron, etc.) and then compared to subjective ratings. This approach led to development of objective performance criteria for load carriage systems and to improvements in load carriage designs that could be used both in the military and in general.

Biomechanical Phenomena↗

PubMed2005

Identifying predictors of comfort and discomfort in using hand tools.

The aim of the study was to identify predictors of comfort and discomfort in using hand tools. For this purpose, the comfort questionnaire for hand tools (CQH) was developed based on the results of a previous study. In the current study, four screwdrivers were evaluated on comfort (expected comfort at first sight and comfort after short time use) using the CQH and discomfort (local perceived discomfort). The results showed that expected comfort at first sight was predicted by aesthetics. Additionally, functionality and physical interaction, and adverse body effects were the major predictors of overall comfort after short time use. Discomfort was predicted by adverse body effects only. It is concluded that comfort and discomfort in using hand tools have partly the same underlying factors: discomfort feelings also affect the comfort experience.

Adult↗

PubMed1994

A quantitative evaluation of gloves used with non-powered hand tools in routine maintenance tasks.

Non-powered hand tools are a major means of carrying out routine maintenance and repair activities. The use of gloves in such situations is essential in order to protect the hands from potential injuries. Together, the gloves and hand tools accomplish the task by transmitting the muscle force on to the workpiece. Several studies have reported that the capability of hands to exert force/torque is severely influenced by the use of gloves. The use of gloves could also lead to a cumulative trauma disorder, rapid onset of muscular fatigue, etc. Most previous studies have focused on determining the influence of gloves on grip strength or push/pull forces one would exert while using devices such as knives. The purpose of this study was to determine the influence of a variety of commercially available gloves on the force/torque exertion capability of workers with wrenches and screwdrivers that are commonly used in performing routine maintenance and repairs. Nineteen males participated in the study and, using seven different hand tools and nine varieties of commercial gloves, exerted peak volitional torques on a simulated workpiece. The peak torque and electromyogram of flexor and extensor muscles were recorded. The results indicated that muscle activity did not differ significantly between the glove and no-glove conditions and the peak torque exertion capability of individuals generally increased with gloves. The magnitude of torque exerted on the workpiece was different for different gloves. The results also contradict some of the previously reported findings.

Adult↗

PubMed2005

Trauma-related dissociative (conversion) disorders in children and adolescents--an overview of assessment tools and treatment principles.

A high proportion of patients in child and adolescent psychiatry with significant dissociative symptomatology after early childhood traumatization may go undiagnosed, be wrongly diagnosed and/or inappropriately treated. The diagnostics and treatment of dissociative disorders have been limited by lack of comprehensive, reliable and valid instruments and the ongoing polarization and fierce controversy regarding treatment. However, recent neurobiological findings of neurochemical, functional and structural cerebral consequences of early stressful childhood experiences point out a need for active, early and effective identification and treatment interventions. We present an update on assessment tools available in the Nordic countries, and an overview of different appropriate therapeutic intervention models for children and adolescents. A systematic overview of studies of dissociation in children and adolescent published over the last decade disclosed a total of 1019 references. The 465 papers describing aspects of assessment tools and/or treatment were studied in detail. Reliable and valid screening questionnaires and diagnostic interviews for children and adolescents now allow for effective early identification of dissociative disorders. A combination of individual psychotherapy, pharmacotherapy and family therapy are often required to handle dissociative disorders in children and adolescents. Cognitive-behavioural therapy, hypnotherapy, Eye-Movement Desensitization-Reprocessing (EMDR), psychodynamic therapy and an integrated approach are the main described psychotherapeutic approaches, but treatment of dissociation in children and adolescent does not require allegiance to any one particular treatment model. However, achievement of physical safety by providing a safe environment is a primary goal that supersedes any other therapeutic work. Assessments tools are now available, and appropriate therapeutic intervention models may hopefully contribute to reduce the risk of wrong diagnoses and inappropriate treatment of dissociative symptomatology in children and adolescents. However, controlled clinical trials of the various interventions and longitudinal outcome studies are needed.

Adolescent↗

PubMed1999

Development of a screening tool for detecting undernutrition and dietary inadequacy among rural elderly in Malaysia: simple indices to identify individuals at high risk.

Undernutrition and the consumption of poor diets are prevalent among elderly people in developing countries. Recognising the importance of the early identification of individuals at high nutritional risk, this study aimed to develop a simple tool for screening. A cross-sectional study was conducted on 11 randomly selected villages among the 62 in Mersing District, Malaysia. Undernutrition was assessed using body mass index, plasma albumin and haemoglobin on 285 subjects. Dietary inadequacy (a count of nutrients falling below two-thirds of the Recommended Dietary Allowances) was examined for 337 subjects. Logistic regression analysis was performed to identify significant predictors of undernutrition and dietary inadequacy from social and health factors, and to derive appropriate indices based on these predictions. The multivariate predictors of undernutrition were 'no joint disease', 'smoker', 'no hypertension', 'depended on others for economic resource', 'respiratory disease', 'perceived weight loss' and 'chewing difficulty', with a joint sensitivity of 56% and specificity of 84%. The equivalent predictors of dietary inadequacy were 'unable to take public transport', 'loss of appetite', 'chewing difficulty', 'no regular fruit intake' and 'regularly taking less than three meals per day', with a joint sensitivity of 77% and specificity of 47%. These predictions, with minor modification to simplify operational use, led to the production of a simple screening tool. The tool can be used by public health professionals or community workers or leaders as a simple and rapid instrument to screen individual at high risk of undernutrition and/or dietary inadequacy.

Aged↗

PubMed2001

Population-based survey of childhood disability in eastern Jeddah using the ten questions tool.

PURPOSE: To identify the prevalence of handicapping disabilities among children up to 15 years of age and their epidemiological pattern in the eastern part of Jeddah. METHODS: In a population-based cross-sectional household survey in the eastern Jeddah area, Saudi Arabia, a multistage sampling method was applied to screen children in 875 houses using the ten questions survey tool for identification of disabilities. Further information collected for detected disabilities included possible risk factors, cause of the disability as perceived by the family and services previously provided to the child. RESULTS: A total of 137 cases of disability were detected giving a point prevalence rate of 36.7 per 1,000 children. Twenty-nine children (21.2%) were discovered for the first time during the survey. The majority of cases were male (57.7%) and the mean age for all cases was 10 years (SD = 5.5) with no case detected under one year of age. Disabled children were in the fourth or fifth birth order among their brothers and sisters and 47 (34%) of them were recorded as a second or third disability in the same family. Number of disabilities in the same child varied widely: 59% of cases had a single disability. 22% had two conditions and 19% had three or more conditions. Speech. motor and mental disabilities ranked top of the disabilities detected by the ten-question tool. The commonest cause of these disabilities as perceived by the family was hereditary diseases followed by childhood illnesses. Significant risk factors associated to these conditions included larger number of children in the family, older age of either parent. histories of handicapping conditions in the original families of either of the parents and presence of handicapping condition in the mothers. Families reported lack of services provided to their disabled children in the community. CONCLUSIONS: The survey tool managed to document. successfully, a prevalence rate of childhood disabilities in the community with a general picture of their types and suspected causes which is quite comparable to that found in Saudi Arabia. It also reported a low service delivery for these disabilities and identified some risk factors related to their occurrence. It is recommended to apply this survey method with certain modifications to suit the local culture in Saudi Arabia. Improvement of the services rendered to handicapped children in Jeddah is also recommended.

Adolescent↗

PubMed2004

The development of the Stroke Physiotherapy Intervention Recording Tool (SPIRIT).

PURPOSE: To develop a recording system that describes physiotherapy interventions for the rehabilitation of postural control post-stroke. METHODS DESIGN: A draft recording tool was developed using the method described by Edwards et al, involving literature searches and collaboration with senior clinicians. It was piloted with stroke physiotherapists using a cross-sectional survey design to assess validity, utility and completeness. Participants used the recording tool to record five treatment sessions. Feedback regarding the utility and completeness of the system was obtained via short semi-structured interviews. SETTING: 11 NHS Trusts. PARTICIPANTS: 35 stroke physiotherapists working in acute and rehabilitation settings recorded the treatment of 120 patients in 590 treatment sessions. RESULTS: A double-sided A4 form with a checklist of 79 physiotherapy interventions in 9 categories was produced: the Stroke Physiotherapy Intervention Recording Tool (SPIRIT). The participants found it quick and easy to use and reflective of clinical practice. There were a few missing interventions and some confusion regarding definition of terms. Revisions were to include the omitted interventions and to produce a user's booklet defining the categories and interventions. CONCLUSIONS: SPIRIT provides a system for recording physiotherapy treatment for stroke patients which reflects current clinical practice in acute and rehabilitation settings.

Adult↗

PubMed2000

Impact resistance of materials for guards on cutting machine tools--requirements in future European safety standards.

Guards on machine tools are meant to protect operators from injuries caused by tools, workpieces, and fragments hurled out of the machine's working zone. This article presents the impact resistance requirements, which guards according to European safety standards for machine tools must satisfy. Based upon these standards the impact resistance of different guard materials was determined using cylindrical steel projectiles. Polycarbonate proves to be a suitable material for vision panels because of its high energy absorption capacity. The impact resistance of 8-mm thick polycarbonate is roughly equal to that of a 3-mm thick steel sheet Fe P01. The limited ageing stability, however, makes it necessary to protect polycarbonate against cooling lubricants by means of additional panes on both sides.

Accidents, Occupational↗

PubMed2002

Proposal for an indexical method of evaluating risk of hand tool operators' exposure to mechanical vibrations.

The article presents proposals for an indexical evaluation of exposure of hand tool operators to vibrations. The presented indices have been developed on the basis of the results of laboratory tests. The examinations studied the effect of pressure force and grip force exerted by an operator on a hand tool as well as the amplitudes and frequencies of an exciting signal on vibrations transmitted in the hand-tool handle system.

Biomechanical Phenomena↗

PubMed2005

Gas chromatography-mass spectroscopy analysis of emissions from cement when using ultrasonically driven tools.

BACKGROUND: Ultrasonically driven tools have been used to reduce the incidence of complications during cement removal at revision hip replacement operations. These have been shown to be safe and effective in various ways, but produce fumes. METHODS: Using gas chromatography-mass spectroscopy, we analyzed the fumes produced during the use of these ultrasonic tools for the removal of bone cement, both in the laboratory and during actual surgery. RESULTS: Benzene, styrene, methylmethacrylate, xylene, toluene, isopropyl alcohol and dichlorobenzene were some of the substances isolated from the fumes in the laboratory. Styrene and methylmethacrylate were the main components. Concentrations of all the above components taken from the breathing zone of the operating staff during actual surgery were well below the safety limits. INTERPRETATION: The use of ultrasonic tools for cement removal appears to be safe.

Air Pollutants, Occupational↗

PubMedDate not supplied

The NUCOG: validity and reliability of a brief cognitive screening tool in neuropsychiatric patients.

OBJECTIVES: To examine the validity and reliability of a brief cognitive screen instrument, the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), in patients with dementia, major psychiatric disorders and neurological disorders, and to compare its performance with the Mini-Mental State Examination (MMSE). METHOD: The NUCOG was undertaken with the MMSE on a total of 347 individuals, with 82 subjects in the control group and 265 in the patient group. The patient group consisted of patients with dementia (n=65), non-dementing neurological disorders (n=44) and psychiatric illness (n=156). The patient group was further broken into subgroups of dementing and psychiatric disorders for further analysis. A subgroup of patients (n=22) underwent detailed neuropsychological testing. RESULTS: The NUCOG and MMSE scores, which correlated strongly, were highest in the control group, and lowest in the dementia group, with psychiatric and neurological patients scoring similarly. Internal consistency and reliability were high. Scores were significantly affected by age and years of education. The NUCOG differentiated the four broad groups and the dementia subgroups more strongly than the MMSE. The NUCOG subscale scores correlated strongly with most neuropsychological subtests undertaken. At a cut-off score of 80/100, sensitivity of the NUCOG for detection of dementia was 0.84 and specificity 0.86. CONCLUSIONS: The NUCOG is a valid and reliable cognitive tool that is sensitive and specific for the detection of dementia. The NUCOG was able to differentiate dementia and psychiatric subgroups which were not able to be discriminated on MMSE scores. The NUCOG appears to be a well-tolerated, reliable and highly useful clinical tool that offers benefits over and above the MMSE.

Adult↗

PubMed1991

Monitoring universal precautions: a new assessment tool.

OBJECTIVES: Two pilot studies were conducted to produce efficacy data on an observational tool designed to assess the use of Universal Precautions (UP) in patient care settings. The instrument addresses barrier precautions, hand-washing, handling of sharps, and avoidance of unprotected mouth to mouth resuscitation. DESIGN: The Universal Precautions Assessment Tool was submitted to a panel of 3 experts to establish consensual validity. It was pilot tested by 2 simultaneous observers to establish interrater reliability. SETTING: Pilot Study I was conducted in 3 different units within a 100-bed U.S. Army hospital. Pilot Study II was conducted in the emergency department of a large university-based hospital. PARTICIPANTS: Subjects observed were registered nurses providing acute patient care. RESULTS: Two simultaneous raters calculated UP compliance rates of 76.4% and 78.6%, respectively, for 9 nurses in Pilot Study I, and 62% and 65%, respectively, for 5 nurses in Pilot Study II. The intraclass correlation coefficient for the raters' scores in Pilot Study I was 0.992 with a 95% confidence interval (0.979, 0.997). Consensual validity was established. CONCLUSIONS: The instrument has acceptable interrater reliability under the conditions used. Limitations to use include the possibility of a Hawthorne effect and the fact that assessing proper implementation of UP occasionally relies on a "judgment call" by the observer. With test conditions adjusted to minimize these limitations and with proper consideration of sample size, the tool can be used by researchers and by monitors of hospital quality control to measure UP compliance of caregivers individually or collectively.

Cooperative Behavior↗

PubMed2006

RADCONTAB 1.0: a look-up tables tool for radiological assessment of contaminated land on Nuclear Licensed sites.

This note describes a simple electronic spreadsheet 'look-up tables' tool (RADCONTAB version 1.0), developed by British Nuclear Fuels plc (BNFL) to facilitate the radiological assessment of land affected by existing 'historic' radioactive contamination on UK Nuclear Licensed sites. The specification and design of the tool have been subject to open consultation and peer review. The tool with accompanying guide is now freely available on the internet.

Environmental Exposure↗

PubMed2004

Management of patients with diabetes through information technology: tools for monitoring and control of the patients' metabolic behavior.

BACKGROUND: The junction of telemedicine home monitoring with multifaceted disease management programs seems nowadays a promising direction to combine the need for an intensive approach to deal with diabetes and the pressure to contain the costs of the interventions. Several projects in the European Union and the United States are implementing information technology-based services for diabetes management using a comprehensive approach. Within these systems, the role of tools for data analysis and automatic reminder generation seems crucial to deal with the information overload that may result from large home monitoring programs. The objective of this study was to describe the automatic reminder generation system and the summary indicators used in a clinical center within the telemedicine project M2DM, funded by the European Commission, and to show their usage during a 7-month on-field testing period. METHODS: M2DM is a multi-access service for management of patients with diabetes. The basic functionality of the technical service includes a Web-based electronic medical record and messaging system, a computer telephony integration service, a smart-modem located at home, and a set of specialized software modules for automated data analysis. The information flow is regulated by a software scheduler, called the Organizer, that, on the basis of the knowledge on the health care organization, is able to automatically send e-mails and alerts notifications as well as to commit activities to software agents, such as data analysis. Thanks to this system, it was possible to define an automatic reminder system, which relies on a data analysis tool and on a number of technologies for communication. Within the M2DM system, we have also defined and implemented a number of indexes able to summarize the patients' day-by-day metabolic control. In particular, we have defined the global risk index (GRI) of developing microangiopathic complications. RESULTS: The system for generating automatic alarms and reminders coupled with the indexes for evaluating the patients' metabolic control has been used for 7 months at the Fondazione Salvatore Maugeri (FSM) in Pavia, Italy. Twenty-two patients (43 +/- 16 years old, 12 men and 10 women) have been involved; six dropped out from the study. The average number of monthly automatic messages was 29.44 +/- 9.83, i.e., about 1.8 messages per patient per month. The number of monthly alarm reminders generated by the system was 16.44 +/- 4.39, so that the number of alarms per patient was about 1. The number of messages sent by patients and physicians during the project was about 13 per month. The GRI analysis shows, during the last trimester, a slight improvement of the performance of the FSM clinic, with a decrease in the percentage of badly controlled values from 33% to 27%. Finally, we found the presence of a linear increasing correlation between the mean GRI values and the number of alarms generated by the system. CONCLUSIONS: A telemedicine system may incorporate features that make it a suitable technological backbone for implementing a disease management program. The availability of data analysis tools, automated messaging system, and summary indicators of the effectiveness of the health care program may help in defining efficient clinical interventions.

Diabetes Mellitus↗

PubMed1999

Secret patterns: validation of a screening tool to detect bulimia.

We prospectively validated a two-item screening tool for bulimia. Subjects recruited from a women's health practice completed the previously developed two-item screening tool ("Do you ever eat in secret?" and "Are you satisfied with your eating patterns?") at their initial office visit. This was validated against a telephone interview with a licensed psychologist. The prevalence of current bulimia was 16% in 75 subjects, determined by psychologists' assessment (sensitivity 75%, specificity 49%) and 4% by DSM-III-R criteria. The positive and negative predictive values of one screening question positive were 22% and 91%, respectively, when compared with the psychologists' assessments as the gold standard. This screening tool allows physicians to identify patients who warrant further valuation for bulimia.

Adolescent↗

PubMed1999

Virtual microscopy and the Internet as telepathology consultation tools. A study of gastrointestinal biopsy specimens.

Telepathology (TP) is the practice of pathology at a distance using videomicroscopy and telecommunication tools. We explore the use of "virtual microscopy" techniques and the Internet as tools for TP gastrointestinal biopsy consultations. Thirty-five gastrointestinal biopsy specimens were photographed in Los Angeles by using a high-resolution digital camera, a light microscope, and a Pentium 166 microcomputer. Several (2-8) digital photomicrographs were collected at 40x or 100x optical magnification, using 2,700 x 3,400 pixel resolution. The photomicrographs illustrated all the tissue fragments present in 1 of the biopsy levels. They were saved in medium compression JPEG image format. These images can be magnified digitally up to 600% without visible degradation and scrolled at different magnifications on a video monitor, simulating examination under a light microscope. The images files (281 to 3,324 KB) were attached to e-mail messages containing patient information and sent through the Internet to Michigan for interpretation using a Power Macintosh 7100 system. The e-mail process was successful in 100% of instances; 2 files were corrupted owing to user error and had to be resent. Additional photos were requested in 1 case. In 33 of 35 cases, there was diagnostic concordance between the original and the TP diagnoses. The 2 discrepancies were due to diagnostic disagreement. This technology offers pathologists relatively inexpensive and effective tools for gastrointestinal TP consultations.

Biopsy↗