Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals.

The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates.

Functional range of movement of the hand : declination angles to reachable space

 The measurement of the range of hand joint movement is an essential part of clinical practice and rehabilitation. Current methods use three finger joint declination angles of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints. In this paper we propose an alternate form of measurement for the finger movement. Using the notion of reachable space instead of declination angles has significant advantages. Firstly, it provides a visual and quantifiable method that therapists, insurance companies and patients can easily use to understand the functional capabilities of the hand. Secondly, it eliminates the redundant declination angle constraints. Finally, reachable space, defined by a set of reachable fingertip positions, can be measured and constructed by using a modern camera such as Creative Senz3D or built-in hand gesture sensors such as the Leap Motion Controller. Use of cameras or optical-type sensors for this purpose have considerable benefits such as eliminating and minimal involvement of therapist errors, non-contact measurement in addition to valuable time saving for the clinician. A comparison between using declination angles and reachable space were made based on Hume's experiment on functional range of movement to prove the efficiency of this new approach.

Changes in corticomotor excitability and inhibition after exercise are influenced by hand dominance and motor demand

Previous studies on handedness have often reported functional asymmetries in corticomotor excitability (CME) associated with voluntary movement. Recently, we have shown that the degree of post-exercise corticomotor depression (PED) and increase in short-interval cortical inhibition (SICI) after a repetitive finger movement task was less when the task was performed at a maximal voluntary rate (MVR) than when it was performed at a submaximal sustainable rate (SR). In the current study, we have compared the time course of PED and SICI in the dominant (DOM) and nondominant (NDOM) hands after an MVR and SR finger movement task to determine the influence of hand dominance and task demand. We tracked motor-evoked potential (MEP) amplitude from the first dorsal interosseous muscle of the DOM and NDOM hand for 20 min after a 10-s index finger flexion-extension task at MVR and SR. For all hand-task combinations, we report a period of PED and increased SICI lasting for up to 8 min. We find that the least demanding task, one that involved index finger movement of the DOM hand at SR, was associated with the greatest change in PED and SICI from baseline (63.6±5.7% and 79±2%, P<0.001, PED and SICI, respectively), whereas the most demanding task (MVR of the NDOM hand) was associated with the least change from baseline (PED: 88.1±3.6%, SICI: 103±2%; P<0.001). Our findings indicate that the changes in CME and inhibition associated with repetitive finger movement are influenced both by handedness and the degree of demand of the motor task and are inversely related to task demand, being smallest for an MVR task of the NDOM hand and greatest for an SR task of the DOM hand. The findings provide additional evidence for differences in neuronal processing between the dominant and nondominant hemispheres in motor control.

A non-contact measurement system for the range of motion of the hand

An accurate and standardised tool to measure the active range of motion (ROM) of the hand is essential to any progressive assessment scenario in hand therapy practice. Goniometers are widely used in clinical settings for measuring the ROM of the hand. However, such measurements have limitations with regard to inter-rater and intra-rater reliability and involve direct physical contact with the hand, possibly increasing the risk of transmitting infections. The system proposed in this paper is the first non-contact measurement system utilising Intel Perceptual Technology and a Senz3D Camera for measuring phalangeal joint angles. To enhance the accuracy of the system, we developed a new approach to achieve the total active movement without measuring three joint angles individually. An equation between the actual spacial position and measurement value of the proximal inter-phalangeal joint was established through the measurement values of the total active movement, so that its actual position can be inferred. Verified by computer simulations, experimental results demonstrated a significant improvement in the calculation of the total active movement and successfully recovered the actual position of the proximal inter-phalangeal joint angles. A trial that was conducted to examine the clinical applicability of the system involving 40 healthy subjects confirmed the practicability and consistency in the proposed system. The time efficiency conveyed a stronger argument for this system to replace the current practice of using goniometers.

Use of antiseptic hand rubs in the health and community services industry: an Australian population-based survey

BACKGROUND: The use of antiseptic hand rubs (AHRs), rather than washing with soap and water, is considered to be the gold standard for reducing the frequency of nosocomial infections, as well as being less damaging to the hands than washing with soap and water, but little is known at a population level about usage patterns for AHRs. OBJECTIVES: To describe AHR use patterns among workers in the health and community services industry in Australia. METHODS: Using data from a population-based survey of Australian workers, we focused on health and community services workers' exposure to chemicals at work, including the use of AHRs. Data regarding the frequency of hand-washing were also collected. RESULTS: Nine hundred and fifty-six health and community service workers participated in the Australian National Hazard Exposure Worker Surveillance survey. Of these, 11% reported using AHRs, and 31% reported hand-washing >20 times per shift. According to an adjusted logistic regression model, professional workers [adjusted odds ratio (aOR) 2.29, 95% confidence interval (CI): 1.40-3.72] and frequent hand washers (aOR 3.08, 95%CI: 1.92-4.93) were more likely to use AHRs. CONCLUSIONS: AHR use by health and community service workers was generally lower than expected. AHR use was most likely to be reported by professionals and frequent hand washers, suggesting that AHRs are used as an adjunct to conventional hand-washing.

2nd hand cinema

Image of scratched frames from 16mm film, reframed and published as stand-alone image

Measurement and assessment of hand functionality via a cloud-based implementation

This book constitutes the proceedings of the 13th International Conference on Smart Homes and Health Telematics, ICOST 2015, held in Geneva, Switzerland, in June 2015.

Embedded markets, communities, and the invisible hand of social norms

The authors'ethnographic work on social norms is intended to unravel the noninstrumental core of embedded markets. In offering a theory of “the invisible hand of social norms,” the authors show that consumer and seller behavior have expressive, moral, and emotional underpinnings that cannot be understood without a broader conceptualization of human motives and actions. This ethnography provides a rich understanding of the role of community and the behavioral dimensions of markets, which in turn helps deconstruct the current axiomatic treatment of transaction-centric markets and to reconstruct the market as a socially embedded institution in which community ties are formed and sustained.

Uso de ferramentas por macacos-prego em manguezais

The present study discusses the geographical distribution and the context on the occupation of mangrove swamp areas by capuchin monkeys. In addition, we assess how the dispersion to the mangrove allowed the exploration of different food items, permitting the development of predation by ambush and the use of cracking tools. From 2004 to 2008 we surveyed the main estuaries of Brazilian Amazon coast, from northeastern state of Pará to the eastern boundary of the state of Maranhão, and recorded the presence of two species of capuchin monkeys in the mangrove forest areas. Cebus apella has been widely distributed in the mangrove at the estuaries examined (excluding C. libidinosus areas). Its presence is often related to Amazon forest remnants in the neighbourhood of the mangrove swamps and thus it is possible that some groups live in both kinds of habitats. However, we recorded some populations restricted only to mangrove swamp surrounded by open areas. On the other hand, Cebus libidinosus had a distribution more restricted and isolated in mangroves. Its pattern of habitat use is consistent with geographic distribution in mangrove patches. It seems that the possible contact zone previously proposed in the literature for that two species has no evident barriers in the mangrove. Furthermore, we record cracking sites and systematic observations on the tool use, carnivory and predation by ambush in Cebus libidinosus from 2006 to 2008. Cebus libidinosus is the only Neotropical primate species in which the tool use has been systematically recorded in nature. However all previous studies had been obtained is open areas (Cerrado and Caatinga). Thus, the present study is first one to report that behaviour in forested habitats in which the tool use to cracking by capuchin monkeys is associated with the consumption of meat. In the Caatinga and Cerrado, food shortages and terrestriality has been proposed by different authors to explain the evolution of tool use in primates. Here, we analyzed the relative contribution of these two variables as selective pressures for the tool use by capuchin monkeys in the mangrove forests, an ecological scenario in which food resources is available around the year and terrestriality is limited by structural habitat features, as the presence of stilt roots and muddy soil

Efeitos da cafeína sobre a memória de saguis (Callithrix jacchus)

Caffeine is considered the most consumed psychostimulant in the world, presenting several central and peripheral effects. In the Central Nervous System the major effect occur by its antagonistic activity at the A1 and A2a subtypes of the adenosine receptors. These receptors are responsible for the slow-wave sleep induction, and their binding, caused by the consumption of foods and beverages that contain caffeine, cause behaviors like increase of alertness, mood and locomotion. The effects of caffeine on memory are still discussed because of the diversity of experimental protocols. Also, it does not have the same effects on all stages of the processing of memory - acquisition, consolidation and recall. Thus, using the marmoset (Callitrhix jacchus) as subject, we aim to evaluate the effects of caffeine on the memory of this primate through the conditioned place preference paradigm, where the animal selects a context by presence of food. This cognitive task consists of five phases. The first phase was two sessions of pre-exposure, in which they were evaluated for preference for any compartment of the apparatus. Then, we proceeded the training, conditioning the animals to the food-present context for 8 days. Then, there was administration of caffeine or placebo (10mg/kg) for 8 consecutive days, during the pre-sleep phase, where the 20 animals were distributed in two groups: placebo and repeated. The forth phase was one day of retraining, a re-exposure of the apparatus to the marmosets followed by the administration of caffeine (for the repeated group and a new group called abstinence) or placebo (for placebo and abstinence groups). Finally, was the test where we evaluated if the subjects learned where the food was present. Moreover, in this work we evaluate the existence of differences between females and males on the task, and the locomotor activity for the experimental groups. The results showed that in the pre-exposure phase the animals were habituated on the apparatus and did not present differences for any contexts. In training, they were able to learn the conditioning task, independent of gender. For the retraining, the two groups exhibited more interactions in rewarded context than that in non-rewarded context. Nevertheless, in the locomotor activity, the repeated group moved similarly in contact with the apparatus and outside of it. In the other hand, the animals of the placebo group moved more when in contact with the apparatus. In the test phase, the marmosets under influence of caffeine presented an increase in the locomotor activity when compared with the placebo group, corroborating works that show this increase in locomotion. In the learning evaluation, the continuous and abstinence groups had a bad performance in the task in relation to the placebo and acute groups. This suggests that the prolonged administration of caffeine disrupts the memories because it affected sleep, which is largely responsible offline processing of memories

A influência do status social no forrageio de itens camuflados e avermelhados em sagüis (Callithrix jacchus) cativos

Seeing colors can be advantageous, because they are an important signal for providing information about the environment, such as the location of food. However, not every animals sees these chromatic signals in the same way. In primates, the group of Plathyrrhini has polymorphic sex-linked vision with males always dichromats and dichromats or trichromats females. Studies indicate that trichromats during foraging would benefit by seeing better than dichromats ripe fruits against the green foliage background. On the other hand, dichromats appear to distinguish camouflaged insects better than trichromats. The marmoset (Callihtrix jacchus) is a neotropical primate species that have color vision polymorphism. This species establishes family groups with highly reproductive bias, with breeding females often having preferential access to food. This work aims to study whether the social context influences the foraging ability of camouflaged and red items in groups of C. jacchus. Four groups of captive marmosets were presented to four food tasks, involving difficult, easy, reddish and camouflaged food targets. Foods were presented in a concentrated and dispersed manner, to check whether there was monopolization of the resources by the dominant subjects and if this would affect the ability of individuals to find the food targets. Success was measured by latency to food acquisition and number of targets consumed. Males and females differed in their foraging success for camouflaged and reddish items, although this difference has not appeared in all situations and experimental conditions. In general males were more successful for detecting camouflaged items while females succeeded more in identifying reddish items. There were no differences in foraging success between individuals of different social status, however, there were differences in the success of consumption of food items for different situations when food was concentrate compared with dispersed food. Taken as a role, there was a greater difficulty in detecting food items when they were presented in concentrated arrangement, which is supposed to be related to a higher difficulty to approach and stay near the food. Although it appears that there was no direct competition seems to have group's indirect influence on the detection of food items and foraging success of individuals, affecting mainly those items more difficult to detect

Hand injuries in a human caused by a South American porcupine (ourico-cacheiro)

Human injuries caused by South American porcupines (in Portuguese, ourico-cacheiro) are rare. This study reports severe hand injuries provoked by the body spines of the animal in a human and discusses the circumstances involved in the accident, with emphasis on environmental factors.