Thesis (M.S.)--Eastern Michigan University, 2004. / Includes bibliographical references (leaves 37-40).

Hand Osteoarthritis (HOA) is the most common joint disease that affects the finger joints of older adults. Individuals with HOA have decreased handgrip strength and hand function. People with this condition have difficulties in grasping, gripping, twisting, and turning objects in daily living. As the disease advances structural changes such as loss of normal joint space, osteophyte formation, and bony nodules in people with HOA are common. Several investigators have examined the relationship between hand or body anthropometrics and handgrip strength and hand function in healthy diverse populations; however, no previous studies have investigated this association in people with HOA. The purpose of this thesis was to investigate the relationship between body and hand anthropometrics with hand strength and function in people with HOA, encompassing 2 papers. The first manuscript in this thesis was to describe the relationship between body and hand anthropometric variables with hand strength in people with HOA. In addition, it sought to establish the relative contribution among those variables for hand grip and pinch strengths in people with HOA. The second manuscript in this thesis was to describe the relationship between body and hand anthropometric variables with hand function in people with HOA. Further, it examines how anthropometric and demographic factors in combination explain hand function and health status in people with HOA. Finally, the thesis addresses the implications for the studies, limitations, and conclusions. / Thesis / Master of Science (MSc)

Hand motion analysis methods have been providing researchers with motion investigation initiatives, revealing motion features and mechanisms in both healthy subjects and patients suffering from hand dysfunctions. Technical advancements have led to the maturation of motion capturing methods such as goniometric gloves. In this project, the CyberGlove as a manufactured product was chosen as a potential tool for the development of a hand function assessment system that would ultimately distinguish between healthy subjects and patients suffering from hand dysfunctions. In this study, the evaluation of the CyberGlove as a feasible clinical tool and its technical adaptations were done in parallel. The sensor output characteristics were investigated using X-ray photography as a spatial golden standard and the sensors were shown to exhibit linear qualities with optimal nonlinearities at 0.6%. The measurement sensitivity and accuracy by the CyberGlove was improved by establishing a calibration protocol suiting the sensor characteristics. Through a calibration protocol using calibration tools made by thermoplastics, the angular measurement error was found to decrease from 7.2% to 1.2%. The technical development of the software part of the project involved the inclusion of data preprocessing, display and analysis modules. To investigate the motion exhibited by healthy subjects, 32 healthy subjects were recruited and they were asked to complete a series of motion according to a designed motion protocol involving a static trial, a timed-grip trial and a rapid-grip trial. Motion features were extracted from recorded motion data by identification and quantification of temporal or spatial characteristics in motion such as joint sequence of events, angular kinematics, finger tip path features and phase diagram features. Some features were evaluated by pattern correlation analysis by linear regression, and healthy subjects all shared similar patterns resulting in high levels of regression coefficients R2 and low levels of slope deviations m. The establishment of motion features along with a prototype motion measurement system allows the continuous development on the CyberGlove as a hand function assessment tool when supported by later clinical adaptations or studies. / published_or_final_version / Orthopaedics and Traumatology / Master / Master of Philosophy

Introduction: Hand hygiene, the most effective and economical way to prevent the transmission of many bacteria and viruses in healthcare settings, yet, its compliance rate remained unacceptably poor in many countries. Compliance with hand hygiene among healthcare workers increased substantially during outbreak of serious acute respiratory symptoms (SARS) in 2003 but decreased to the baseline after SARS, to improve compliance rate sustainable, many hand hygiene intervention programs have been established since 2003. However, the effectiveness of these programs were in big variations. The objectives of this review were to identify the effectiveness of these hand hygiene intervention programs. Methods: This review was conducted using the search engines – PubMed. The key words “hand hygiene”, “hand-washing”, “compliance”, “healthcare personnel”, and “program*” were used for searching literature published from 2003 to July 2012.. Forty-Seven articles were initially obtained. After screening and reviewing of these articles,9 articles met the requirements for inclusion and exclusion criteria were included in this review. The outcome measure was set as the differences and relative ratios in the observed hand hygiene compliance rate before and after intervention. Results: Results showed that 8 hand hygiene programs were effective while 1 programme was ineffective in improving hand hygiene compliance rates. Of the eight studies that reported improvement in compliance with hand hygiene, improvement in compliance rate after the interventions was ranged from (24% to 50%) while the relative ratio of compliance (after vs. before intervention) was ranged from 1.78 to 4. The study that reported no improvement in compliance with hand hygiene had a relative high naseline hand hygiene compliance rate of 61% Conclusion: Hand hygiene programs that improve compliance rate among healthcare workers were effective overall. The effectiveness of hand hygiene programs seemed to be positively associated with the numbers of intervention types involved. Research on non-compliance and intrapersonal behavior on hand hygiene was suggested for future investigation. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M.Med.Sc.)--University of Hong Kong, 2004. / Also available in print.

The lack of detailed descriptions makes positive identification of individual bones of the human hand difficult. In some instances, labelled photographs and line diagrams depicting a few anatomical features are available in the literature while in other cases, unlabelled photographs and diagrams are provided. Textbooks generally describe each hand bone as having a head, shaft and base. The morphology of metacarpals is more commonly described than that of the phalanges. Thus, identification and siding of hand bones are rare, which excludes them from use in many forensic cases. Forensic anthropological studies also include the determination of demographic characteristics such as stature and sex. Parts of the human skeleton that are accurate predictors in determining stature and sex include the skull, pelvis, femur and tibia. Hand bones are often excluded from such studies due to their relatively small size and poor preservation. The aims of this study were firstly, to provide detailed morphological descriptions of metacarpals and phalangeal bones of the human hand; secondly, to develop regression formulae for stature using the hand bones and thirdly, to develop discriminant function formulae in which the hand bones can be used to determine the sex of an unknown individual. The study comprised 200 sets of hands of South African individuals. The results indicate that there are morphological features of individual bones of the human hand that can be used to identify and side them. Regression formulae have been devised whereby the length of a hand bone can be regressed to that of a long bone, which in turn can then be used to determine stature. The sexing accuracy, using the bones of the hand, is high for males and females. Average accuracies recorded were more than 80% in most cases, and more than 75% in all cases. Analyses of human hand bones can thus add valuable information when assessing skeletons of unknown individuals. / Thesis (PhD)--University of Pretoria, 2010. / Anatomy / unrestricted

BACKGROUND Influenza is a potential threat to life, economies and security in our globalized world. However, it is still unclear how efficacious non-pharmaceutical interventions are in reducing the virus’ transmission and how the underlying mechanisms of its transmission modes work. Since 2008, numbers of randomized controlled trials (RCTs) regarding the efficacy of hand hygiene interventions in reducing influenza transmission have been published, yet no metaanalysis has ever been performed. Besides, a guinea pig model in 2009 showed that the efficiency of aerosol transmission is adjusted by the ambient temperature and humidity. Therefore, further evidence is needed to confirm the hypothesis. OBJECTIVES To evaluate the efficacy of hand hygiene interventions alone or combined with facemasks in reducing influenza transmission in the community and to investigate the possible roles of latitude, temperature and humidity in relation to the efficacy of the interventions in controlling the spread of influenza. SEARCH METHODS This meta-analysis followed the PRISMA statement. I searched the MEDLINE, PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Library databases. SELECTION CRITERIA I included all RCTs assessing the effect of hand hygiene interventions in preventing influenza spread in community settings with clear outcome definitions of laboratory confirmed influenza, clinically diagnosed influenza-like illness (ILI) and their related absenteeism. DATA COLLECTION AND ANALYSIS I ranked the methodological quality of each outcome with GRADEprofiler. I also assessed the heterogeneity across RCTs using I2 statistic and publication bias through visual inspection of Begg’s funnel plots and statistical assessment of regression and rank-correlation. I conducted the meta-analysis with random-effect models and further performed separate analyses for developed and developing countries data in case of a significant level of heterogeneity being noted across the studies. I also incorporated meta-regression to assess the association of latitude, temperature and humidity with the efficacy of hand hygiene interventions. RESULTS I identified 1,593 articles in the initial database search, excluded 1,535, included five from reference lists of review articles, retrieved full articles of 33 and included ten for analysis. The quality of evidence of both laboratory confirmed influenza and ILI were high while that of absenteeism was low. The combination of hand hygiene interventions and facemasks contributed to a significant 45% reduced risk of influenza-related absenteeism in the combined country data while it contributed a significant 23% to a reduced risk of both laboratory confirmed influenza and ILI in developed countries subgroup analysis. The metaregression revealed that the efficacy of the combination of hand hygiene interventions with facemasks increased in a less humid environment. CONCLUSIONS The combination of hand hygiene interventions with facemasks is an effective low-cost intervention to prevent influenza. Further studies to assess the association between humidity and mode of influenza transmission are critically important to support the international guideline on hand hygiene interventions and facemask use. / published_or_final_version / Public Health / Master / Master of Public Health

One of the greatest challenges in controlling robotic hands is grasping and manipulating objects in unstructured and uncertain environments. Robotic hands are typically too rigid to react against unexpected impacts and disturbances in order to prevent damage. The human hands have great versatility and robustness due, in part, to the passive compliance and damping. Designing mechanical elements that are inspired by the nonlinear joint compliance of human hands is a promising solution to achieve human-like grasping and manipulation. However, the exact role of biomechanical elements in realizing joint stiffness is unknown. We conducted a series of experiments to investigate nonlinear stiffness and damping of the metacarpophalangeal (MCP) joint at the index finger. We designed a custom-made mechanism to integrate electromyography sensors (EMGs) and a motion capture system to collect data from 19 subjects. We investigated the relative contributions of muscle-tendon units and the MCP capsule ligament complex to joint stiffness with subject-specific modeling. The results show that the muscle-tendon units provide limited contribution to the passive joint compliance. This findings indicate that the parallel compliance, in the form of the capsule-ligament complex, is significant in defining the passive properties of the hand. To identify the passive damping, we used the hysteresis loops to investigate the energy dissipation function. We used symbolic regression and principal component analysis to derive and interpret the damping models. The results show that the nonlinear viscous damping depends on the cyclic frequency, and fluid and structural types of damping also exist at the MCP joint. Inspired by the nonlinear stiffness of the MCP joint, we developed a miniaturized mechanism that uses pouring liquid plastic to design energy storing elements. The key innovations in this design are: a) a set of nonlinear elasticity of compliant materials, b) variable pulley configurations to tune the stiffness profile, and c) pretension mechanism to scale the stiffness profile. The design exhibits human-like passive compliance. By taking advantage of miniaturized joint size and additive manufacturing, we incorporated the novel joint design in a novel robotic manipulator with six series elastic actuators (SEA). The robotic manipulator has passive joint compliance with the intrinsic property of human hands. To validate the system, we investigated the Cartesian stiffness of grasping with low-level force control. The results show that that the overall system performs a great force tracking with position feedback. The parallel compliance decreases the motor efforts and can stabilize the system. / text

Thesis (Ph. D.)--UCLA, 2009. / Vita. Includes bibliographical references (leaves 302-319).

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