Padrões de dominância manual, podálica e performance motora em gêmeos

O método de gêmeos envolve a análise diferencial de gêmeos monozigóticos (MZs) e dizigóticos (DZs) a fim de determinar a proporção de variância em um determinado traço atribuível a fatores genéticos e ambientais. Sendo geneticamente idênticos, os gêmeos MZs tendem a apresentar alto índice de concordância em vários atributos comportamentais, enquanto que, os DZs, compartilham 50 % da carga genética, manifestando um reduzido grau de concordância. Todavia, pesquisadores têm investigado possíveis mecanismos genéticos subjacentes do desenvolvimento cerebral para dominância manual e, não têm encontrado utilidade no método de gêmeos, pois, desde 1924, em todos os estudos de dominância manual em gêmeos, a taxa de discordância para o canhotismo e destrimanismo têm sido similares em MZs e DZs. Além disso, frequentemente gêmeos mostram taxa mais alta de prevalência para o canhotismo que os não gêmeos. O objetivo deste estudo foi investigar as possíveis diferenças entre gêmeos destros e canhotos (MZs e DZs combinados) e não gêmeos em variáveis fenótipicas específicas relacionadas à dominância manual, incluindo dominância podálica (chute de penalty), consistência de dominância manual, canhotismo familiar (CF+), postura manual e medidas de habilidades motoras em três testes : Batidas digitais, Tabuleiro de Annett e Pontilhar Pontinhos. Foram avaliados 286 gêmeos ( 255 destros, 34 canhotos) e, 251 não gêmeos (141 destros e 110 canhotos). A análise dos dados revelou o aumento de canhotismo no sexo masculino em três vezes mais do que no feminino. Além disto, destros e canhotos gêmeos foram mais mistos em suas dominâncias manuais e apontaram alta incidência de CF+ entre parentes de primeiro grau que não gêmeos canhotos e destros. Em concordância com estudos anteriores, a frequência de chute contralateral foi mais alta nos mistos do que nos que apresentaram consistência na dominância manual, especialmente entre os canhotos. No que diz respeito à habilidade manual, não foram encontradas diferenças significativas nos três testes de habilidade manual. Conforme as expectativas, destros e canhotos foram mais proficientes na manipulação do estímulo com suas mãos dominantes. Em todas as três medidas, em contraste com os destros, os canhotos (gêmeos e não gêmeos) apresentaram redução entre as assimetrias manuais. Por extensão, o aumento da prevalência de canhotismo entre gêmeos não poderia ser atribuída a influências patológicas, inversão de assimetria ou ordem de nascimento. É possível, levar em consideração, observando a diferença robusta em dominância manual mista que, o padrão de lateralização neuromotora, pode ser mais difusamente organizado nos hemisférios dos gêmeos que em não gêmeos, mas, esta sugestão requer evidência direta, pelo menos a partir de testes de neuro-imagem.

Relationship between happiness, stress and musculoskeletal disorders in portuguese dentists

Tese de doutoramento, Medicina Dentária (Dentisteria Conservadora), Universidade de Lisboa, Faculdade de Medicina Dentária, 2016

Gulliver, medium, technique

In the four Parts of Gulliver’s Travels the narrator attends closely to the manual skills, crafts and techniques of the different countries visited and to the materials and instruments by which they are mediated. The patterned, motif-like presentation of these observations and their rich contextual background, historical and literary, indicate their special significance. These references to technique play an important, previously underappreciated roll in Gulliver. They form a thematic connection between its embodied, sensual, compulsive descriptions of the world and its socio-political satire, the latter focusing on technocratic, professionalized statecraft. They are crucial to the peculiar fullness with which Swift’s writing imagines different communities of practice, different ecologies of mind.

Augmented optometry training simulator with multi-point haptics

Training of optometrists is traditionally achieved under close supervision of peers and superiors. With the rapid advancement in technology, medical procedures are performed more efficiently and effectively, resulting in faster recovery times and less trauma to the patient. However, application of this technology has made it difficult to effectively demonstrate and teach these manual skills as the education is now a combination of not only the medical procedure but also the use of the technology. In this paper we propose to increase the training capabilities of optometry students through haptically-enabled single-point and multi-point training tools as well as augmented reality techniques. Haptics technology allows a human to touch and feel virtual computer models as though they are real. Through physical connection to the operator, haptic devices are considered to be personal robots that are capable of improving the human-computer interaction with a virtual environment. These devices have played an increasing role in developing expertise, reducing instances of medical error and reducing training costs. A haptically-enabled virtual training environment, integrated with an optometry slit lamp instrument can be used to teach cognitive and manual skills while the system tracks the performance of each individual. These interactions would ideally replicate every aspect of the real procedure, consequently preparing the trainee for every possible scenario, without risking the health of a real patient.

Efeito da prática no controle de torque isométrico em crianças com transtorno de desenvolvimento de coordenação

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Multidisciplinary approach in the teaching of dental sculpture and anatomy

The purpose of the Dental Sculpture and Anatomy discipline is to introduce undergraduate students to the study of the anatomic and morphological characteristics of permanent and primary human dentition, through classes, books and cognitive and psychomotor activities. This discipline supports the teaching of specific knowledge necessary for a more extensive education, involving interdisciplinarity as a means of knowledge exchange among several areas of dentistry, to achieve comprehensive professional education. Students must recognize the dental morphology from samples of preserved teeth, and reproduce the morphology through three-dimensional models made of stone or wax blocks. In this article, the authors describe the process for producing teeth collars and macro dental models made of stone, their importance and benefits of utilization. The purpose of the study was to encourage the teaching of Dental Sculpture and Anatomy toundergraduate students of the Bauru School of Dentistry, University of Sao Paulo, through activities that would associate theory, practice and the development of manual skills.

Design and control of multi-finger haptic devices for dexterous manipulation

En la interacción con el entorno que nos rodea durante nuestra vida diaria (utilizar un cepillo de dientes, abrir puertas, utilizar el teléfono móvil, etc.) y en situaciones profesionales (intervenciones médicas, procesos de producción, etc.), típicamente realizamos manipulaciones avanzadas que incluyen la utilización de los dedos de ambas manos. De esta forma el desarrollo de métodos de interacción háptica multi-dedo dan lugar a interfaces hombre-máquina más naturales y realistas. No obstante, la mayoría de interfaces hápticas disponibles en el mercado están basadas en interacciones con un solo punto de contacto; esto puede ser suficiente para la exploración o palpación del entorno pero no permite la realización de tareas más avanzadas como agarres. En esta tesis, se investiga el diseño mecánico, control y aplicaciones de dispositivos hápticos modulares con capacidad de reflexión de fuerzas en los dedos índice, corazón y pulgar del usuario. El diseño mecánico de la interfaz diseñada, ha sido optimizado con funciones multi-objetivo para conseguir una baja inercia, un amplio espacio de trabajo, alta manipulabilidad y reflexión de fuerzas superiores a 3 N en el espacio de trabajo. El ancho de banda y la rigidez del dispositivo se han evaluado mediante simulación y experimentación real. Una de las áreas más importantes en el diseño de estos dispositivos es el efector final, ya que es la parte que está en contacto con el usuario. Durante este trabajo se ha diseñado un dedal de bajo peso, adaptable a diferentes usuarios que, mediante la incorporación de sensores de contacto, permite estimar fuerzas normales y tangenciales durante la interacción con entornos reales y virtuales. Para el diseño de la arquitectura de control, se estudiaron los principales requisitos para estos dispositivos. Entre estos, cabe destacar la adquisición, procesado e intercambio a través de internet de numerosas señales de control e instrumentación; la computación de equaciones matemáticas incluyendo la cinemática directa e inversa, jacobiana, algoritmos de detección de agarres, etc. Todos estos componentes deben calcularse en tiempo real garantizando una frecuencia mínima de 1 KHz. Además, se describen sistemas para manipulación de precisión virtual y remota; así como el diseño de un método denominado "desacoplo cinemático iterativo" para computar la cinemática inversa de robots y la comparación con otros métodos actuales. Para entender la importancia de la interacción multimodal, se ha llevado a cabo un estudio para comprobar qué estímulos sensoriales se correlacionan con tiempos de respuesta más rápidos y de mayor precisión. Estos experimentos se desarrollaron en colaboración con neurocientíficos del instituto Technion Israel Institute of Technology. Comparando los tiempos de respuesta en la interacción unimodal (auditiva, visual y háptica) con combinaciones bimodales y trimodales de los mismos, se demuestra que el movimiento sincronizado de los dedos para generar respuestas de agarre se basa principalmente en la percepción háptica. La ventaja en el tiempo de procesamiento de los estímulos hápticos, sugiere que los entornos virtuales que incluyen esta componente sensorial generan mejores contingencias motoras y mejoran la credibilidad de los eventos. Se concluye que, los sistemas que incluyen percepción háptica dotan a los usuarios de más tiempo en las etapas cognitivas para rellenar información de forma creativa y formar una experiencia más rica. Una aplicación interesante de los dispositivos hápticos es el diseño de nuevos simuladores que permitan entrenar habilidades manuales en el sector médico. En colaboración con fisioterapeutas de Griffith University en Australia, se desarrolló un simulador que permite realizar ejercicios de rehabilitación de la mano. Las propiedades de rigidez no lineales de la articulación metacarpofalange del dedo índice se estimaron mediante la utilización del efector final diseñado. Estos parámetros, se han implementado en un escenario que simula el comportamiento de la mano humana y que permite la interacción háptica a través de esta interfaz. Las aplicaciones potenciales de este simulador están relacionadas con entrenamiento y educación de estudiantes de fisioterapia. En esta tesis, se han desarrollado nuevos métodos que permiten el control simultáneo de robots y manos robóticas en la interacción con entornos reales. El espacio de trabajo alcanzable por el dispositivo háptico, se extiende mediante el cambio de modo de control automático entre posición y velocidad. Además, estos métodos permiten reconocer el gesto del usuario durante las primeras etapas de aproximación al objeto para su agarre. Mediante experimentos de manipulación avanzada de objetos con un manipulador y diferentes manos robóticas, se muestra que el tiempo en realizar una tarea se reduce y que el sistema permite la realización de la tarea con precisión. Este trabajo, es el resultado de una colaboración con investigadores de Harvard BioRobotics Laboratory. ABSTRACT When we interact with the environment in our daily life (using a toothbrush, opening doors, using cell-phones, etc.), or in professional situations (medical interventions, manufacturing processes, etc.) we typically perform dexterous manipulations that involve multiple fingers and palm for both hands. Therefore, multi-Finger haptic methods can provide a realistic and natural human-machine interface to enhance immersion when interacting with simulated or remote environments. Most commercial devices allow haptic interaction with only one contact point, which may be sufficient for some exploration or palpation tasks but are not enough to perform advanced object manipulations such as grasping. In this thesis, I investigate the mechanical design, control and applications of a modular haptic device that can provide force feedback to the index, thumb and middle fingers of the user. The designed mechanical device is optimized with a multi-objective design function to achieve a low inertia, a large workspace, manipulability, and force-feedback of up to 3 N within the workspace; the bandwidth and rigidity for the device is assessed through simulation and real experimentation. One of the most important areas when designing haptic devices is the end-effector, since it is in contact with the user. In this thesis the design and evaluation of a thimble-like, lightweight, user-adaptable, and cost-effective device that incorporates four contact force sensors is described. This design allows estimation of the forces applied by a user during manipulation of virtual and real objects. The design of a real-time, modular control architecture for multi-finger haptic interaction is described. Requirements for control of multi-finger haptic devices are explored. Moreover, a large number of signals have to be acquired, processed, sent over the network and mathematical computations such as device direct and inverse kinematics, jacobian, grasp detection algorithms, etc. have to be calculated in Real Time to assure the required high fidelity for the haptic interaction. The Hardware control architecture has different modules and consists of an FPGA for the low-level controller and a RT controller for managing all the complex calculations (jacobian, kinematics, etc.); this provides a compact and scalable solution for the required high computation capabilities assuring a correct frequency rate for the control loop of 1 kHz. A set-up for dexterous virtual and real manipulation is described. Moreover, a new algorithm named the iterative kinematic decoupling method was implemented to solve the inverse kinematics of a robotic manipulator. In order to understand the importance of multi-modal interaction including haptics, a subject study was carried out to look for sensory stimuli that correlate with fast response time and enhanced accuracy. This experiment was carried out in collaboration with neuro-scientists from Technion Israel Institute of Technology. By comparing the grasping response times in unimodal (auditory, visual, and haptic) events with the response times in events with bimodal and trimodal combinations. It is concluded that in grasping tasks the synchronized motion of the fingers to generate the grasping response relies on haptic cues. This processing-speed advantage of haptic cues suggests that multimodalhaptic virtual environments are superior in generating motor contingencies, enhancing the plausibility of events. Applications that include haptics provide users with more time at the cognitive stages to fill in missing information creatively and form a richer experience. A major application of haptic devices is the design of new simulators to train manual skills for the medical sector. In collaboration with physical therapists from Griffith University in Australia, we developed a simulator to allow hand rehabilitation manipulations. First, the non-linear stiffness properties of the metacarpophalangeal joint of the index finger were estimated by using the designed end-effector; these parameters are implemented in a scenario that simulates the behavior of the human hand and that allows haptic interaction through the designed haptic device. The potential application of this work is related to educational and medical training purposes. In this thesis, new methods to simultaneously control the position and orientation of a robotic manipulator and the grasp of a robotic hand when interacting with large real environments are studied. The reachable workspace is extended by automatically switching between rate and position control modes. Moreover, the human hand gesture is recognized by reading the relative movements of the index, thumb and middle fingers of the user during the early stages of the approximation-to-the-object phase and then mapped to the robotic hand actuators. These methods are validated to perform dexterous manipulation of objects with a robotic manipulator, and different robotic hands. This work is the result of a research collaboration with researchers from the Harvard BioRobotics Laboratory. The developed experiments show that the overall task time is reduced and that the developed methods allow for full dexterity and correct completion of dexterous manipulations.

Oral and manual language skills of hearing children of deaf parents

This paper reviews a study of the language skills of normal hearing children whose parents are deaf and use manual communication.

Basic management skills : resource manual /

Operated pursuant to contract no. 271-75-4018.

Bicycle skills course instruction manual.

"August 2007"--Colophon.

Bicycle skills course instruction manual.

"September 1994."--P. 7.

The effect of Amblyopia on motor and psychosocial skills in children

Background/Aims: In an investigation of the functional impact of amblyopia on children, the fine motor skills, perceived self-esteem and eye movements of amblyopic children were compared with that of age-matched controls. The influence of amblyogenic condition or treatment factors that might predict any decrement in outcome measures was investigated. The relationship between indirect measures of eye movements that are used clinically and eye movement characteristics recorded during reading was examined and the relevance of proficiency in fine motor skills to performance on standardised educational tests was explored in a sub-group of the control children. Methods: Children with amblyopia (n=82; age 8.2 ± 1.3 years) from differing causes (infantile esotropia n=17, acquired strabismus n=28, anisometropia n=15, mixed n=13 and deprivation n=9), and a control group of children (n=106; age 9.5 ± 1.2 years) participated in this study. Measures of visual function included monocular logMAR visual acuity (VA) and stereopsis assessed with the Randot Preschool Stereoacuity test, while fine motor skills were measured using the Visual-Motor Control (VMC) and Upper Limb Speed and Dexterity (ULSD) subtests of the Brunicks-Oseretsky Test of Motor Proficiency. Perceived self esteem was assessed for those children from grade 3 school level with the Harter Self Perception Profile for Children and for those in younger grades (preschool to grade 2) with the Pictorial Scale of Perceived Competence and Acceptance for Young Children. A clinical measure of eye movements was made with the Developmental Eye Movement (DEM) test for those children aged eight years and above. For appropriate case-control comparison of data, the results from amblyopic children were compared with age-matched sub-samples drawn from the group of children with normal vision who completed the tests. Eye movements during reading for comprehension were recorded by the Visagraph infra-red recording system and results of standardised tests of educational performance were also obtained for a sub-set of the control group. Results Amblyopic children (n=82; age 8.2 ± 1.7 years) performed significantly poorer than age-matched control children (n=37; age 8.3 ± 1.3 years) on 9 of 16 fine motor skills sub-items and for the overall age-standardised scores for both VMC and ULSD items (p<0.05); differences were most evident on timed manual dexterity tasks. The underlying aetiology of amblyopia and level of stereoacuity significantly affected fine motor skill performance on both items. However, when examined in a multiple regression model that took into account the inter-correlation between visual characteristics, poorer fine motor skills performance was only associated with strabismus (F1,75 = 5.428; p =0. 022), and not with the level of stereoacuity, refractive error or visual acuity in either eye. Amblyopic children from grade 3 school level and above (n=47; age 9.2 ± 1.3 years), particularly those with acquired strabismus, had significantly lower social acceptance scores than age-matched control children (n=52; age 9.4 ± 0.5 years) (F(5,93) = 3.14; p = 0.012). However, the scores of the amblyopic children were not significantly different to controls for other areas related to self-esteem, including scholastic competence, physical appearance, athletic competence, behavioural conduct and global self worth. A lower social acceptance score was independently associated with a history of treatment with patching but not with a history of strabismus or wearing glasses. Amblyopic children from pre-school to grade 2 school level (n=29; age = 6.6 ± 0.6 years) had similar self-perception scores to their age-matched peers (n=20; age = 6.4 ± 0.5 years). There were no significant differences between the amblyopic (n=39; age 9.1 ± 0.9 years) and age-matched control (n = 42; age = 9.3 ± 0.38 years) groups for any of the DEM outcome measures (Vertical Time, Horizontal Time, Number of Errors and Ratio (Horizontal time/Vertical time)). Performance on the DEM did not significantly relate to measures of VA in either eye, level of binocular function, history of strabismus or refractive error. Developmental Eye Movement test outcome measures Horizontal Time and Vertical Time were significantly correlated with reading rates measured by the Visagraph for both reading for comprehension and naming numbers (r>0.5). Some moderate correlations were also seen between the DEM Ratio and word reading rates as recorded by Visagraph (r=0.37). In children with normal vision, academic scores in mathematics, spelling and reading were associated with measures of fine motor skills. Strongest effect sizes were seen with the timed manual dexterity domain, Upper Limb Speed and Dexterity. Conclusions Amblyopia may have a negative impact on a child’s fine motor skills and an older child’s sense of acceptance by their peers may be influenced by treatment that includes eye patching. Clinical measures of eye movements were not affected in amblyopic children. A number of the outcome measures of the DEM are associated with objective recordings of reading rates, supporting its clinical use for identification of children with slower reading rates. In children with normal vision, proficiency on clinical measures of fine motor skill are associated with outcomes on standardised measures of educational performance. Scores on timed manual dexterity tasks had the strongest association with educational performance. Collectively, the results of this study indicate that, in addition to the reduction in visual acuity and binocular function that define the condition, amblyopes have functional impairment in childhood development skills that underlie proficiency in everyday activities. The study provides support for strategies aimed at early identification and remediation of amblyopia and the co-morbidities that arise from abnormal visual neurodevelopment.

The DOOR manual for plant nurseries

In the nursery industry, generic research conducted by government institutions is often not specific enough to be highly valued and adopted by the individual operator. Operators need practical solutions to their particular problems. Such problems almost invariably involve sets of conditions common to few other enterprises. This uniqueness reflects the almost infinite variation of options available in terms of species grown, media used, fertiliser, amendments and chemicals applied and the way water is supplied. The DOOR (Do Our Own Research) method advocates a relatively unexplored way of generating new, statistically sound research information in the nursery industry. The manual aims to enhance nursery operators' understanding and skills development in the following areas: critially evaluating opportunities and problems in the nursery environment, gathering relevant information, deriving and prioritising potential solutions to problems and opportunities, becoming familiar with the scientific method employed in testing potential solutions, carrying out statistically sound aand rigorous research, and developing recommendations that flow from the research information generated. The DOOR approach has application in a number of other industries and may provide important support at a time of declining research, development and extension investment by the public sector.

Current Care Guidelines for Cardiopulmonary Resuscitation : Implementation, skills and attitudes

Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and students ability to implement the guideline recommendations in clinical practices after publication of the Current Care (CC) guidelines for CPR 2002. Material and methods: CPR practices in Finnish health centres; especially concerning rapid defibrillation programmes, as well as the implementation of CC guidelines for CPR was studied in a mail survey to chief physicians of every health centre in Finland (Study I). The CPR skills using an automated external defibrillator (AED) were compared in a study including Objective stuctured clinical examination (OSCE) of resuscitation skills of nurses and nursing students in Finnish and Swedish hospital and institution (Studies II, III). Attitudes towards CPR-D and CPR guidelines among medical and nursing students and secondary hospital nurses were studied in surveys (Studies IV, V). The nurses receiving different CPR training were compared in a randomized trial including OSCE of CPR skills of nurses in Finnish Hospital (Study VI). Results: Two years after the publication, 40.7% of Finnish health centres used national resuscitation guidelines. The proportion of health centres having at least one AED (66%) and principle of nurse-performed defibrillation without the presence of a physician (42%) had increased. The CPR-D training was estimated to be insufficient regarding basic life support and advanced life support in the majority of health centres (Study I). CPR-D skills of nurses and nursing students in two specific Swedish and Finnish hospitals and institutions (Study II and III) were generally inadequate. The nurses performed better than the students and the Swedish nurses surpassed the Finnish ones. Geriatric nurses receiving traditional CPR-D training performed better than those receiving an Internet-based course but both groups failed to defibrillate within 60 s. Thus, the performance was not satisfactory even two weeks after traditional training (Study VI). Unlike the medical students, the nursing students did not feel competent to perform procedures recommended in the cardiopulmonary resuscitation guidelines including the defibrillation. However, the majority of nursing students felt confident about their ability to perform basic life support. The perceived ability to defibrillate correlated significantly with a positive attitude towards nurse-performed defibrillation and negatively with fear of damaging the patient s heart by defibrillation (Study IV). After the educational intervention, the nurses found their level of CPR-D capability more sufficient than before and felt more confident about their ability to perform defibrillation themselves. A negative attitude toward defibrillation correlated with perceived negative organisational attitudes toward cardiopulmonary resuscitation guidelines. After CPR-D education in the hospital, the majority (64%) of nurses hesitated to perform defibrillation because of anxiety and 27 % hesitated because of fear of injuring the patient. Also a negative personal attitude towards guidelines increased markedly after education (Study V). Conclusions: Although a significant change had occurred in resuscitation practices in primary health care after publication of national cardiopulmonary resuscitation guidelines the participants CPR-D skills were not adequate according to the CPR guidelines. The current way of teaching is unlikely to result in participants being able to perform adequate and rapid CPR-D. More information and more frequent training are needed to diminish anxiety concerning defibrillation. Negative beliefs and attitudes toward defibrillation affect the nursing students and nurses attitudes toward cardiopulmonary resuscitation guidelines. CPR-D education increased the participants self-confidence concerning CPR-D skills but it did not reduce their anxiety. AEDs have replaced the manual defibrillators in most institutions, but in spite of the modern devices the anxiety still exists. Basic education does not provide nursing students with adequate CPR-D skills. Thus, frequent training in the workplace has vital importance. This multi-professional program supported by the administration might provide better CPR-D skills. Distance learning alone cannot substitute for traditional small-group learning, tutored hands-on training is needed to learn practical CPR-D skills. Standardized testing would probably help controlling the quality of learning. Training of group-working skills might improve CPR performance.