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PubMed1989

Agitation and touch in the nursing home.

The relationship between manifestations of agitated behaviors and interpersonal distance was examined in 24 nursing home residents with high agitation and severe cognitive impairment. Analysis indicated that agitated residents displayed divergent responses to touch: touch was related to an increase in aggressive behaviors and to a decrease in physically nonaggressive behaviors (e.g., strange movements). The positive relationship between aggressiveness and touching suggests that residents may interpret touching as a violation of their personal space. The finding that residents exhibited fewer strange movements when touched suggests that touching can act as a quieting and comforting form of communication. The implications of these findings for caregivers are discussed.

Aged↗
PubMed1990

[Experimental studies on the transitional characteristics from touch sensation to pressure sensation in the mechanoreceptive sensation of periodontium].

Many studies have made on the physiological significance of the periodontium in relation to oral functions. But, although its importance to oral functions has been pointed out, few investigations have been carried out on the periodontal pressoreceptive information system. To help rectify this situation, as a link in investigations of soft-food textures, the author attempted to determine how a sense of pressure was perceived when loads gradually increasing from very small were applied to the tooth surface. In addition, the author attempted to clarify the way the periodontium discerns differences between initial and secondary loadings in a range of small loads between the touch sensation and the pressure sensation. Subjects were 10 males with sound, natural dentition and no disorders in mandibular functions. In order to eliminate intervention from pressoreceptors in the masticatory muscles and the mandibular joints, the upper first premolar was chosen as the test tooth. Small loads were applied in 2 directions: parallel to the first premolar vertical axis (vertical) and from the lingual to the buccal sides parallel to the occlusal plane (horizontal). For vertical loading, the mesial pit on the occlusal surface was chosen as the loading point. The middle point on the lingual surface was chosen as loading point for horizontal loading. First, loading on the tooth surface was gradually increased to obtain (1) threshold value for touch sensation; that is, minimal load required to incite a touch sensation, and (2) critical value for pressure sensation; that is, minimal load required to incite the pressure sensation subsequent to the touch sensation. Each subject was requested to press a hand switch in the moment he experienced the sensation of being touched and then again when, during increases of load, the touch sensation changed to the pressure sensation. The loading device was built into an electric strain gauge. Loads were increased gradually from 0 g to 60 g, with an increase ratio of about 10 g/sec. Loading wave and switching signal were simultaneously recorded on an oscillograph. Second, in order to determine the ability to discriminate small loads, with the same loading device, initial load was applied to the tooth. This load served as control. As soon as the load was sensed, it was removed. Then the secondary (testing) load was applied. Subjects were requested to say whether the secondary load was larger, smaller than or same as the initial one.(ABSTRACT TRUNCATED AT 400 WORDS)

Bite Force↗
PubMedDate not supplied

The language of touch.

A conceptual framework is discussed from which to consider the meaning of touch in nursing research and practice. The impact of interpersonal touch is examined through a review of literature that demonstrates the relationship of touching to human development. The importance of acknowledging the physiologic foundations of touch is reinforced, with considerations as to dangers in accepting all forms of touch as therapeutic. Existing research into the physiologic and psychosocial bases of tactile interaction is explored, and qualitative symbols for a language of touch are presented. These qualitative symbols create the foundations for discussing a construct of tactile arousal.

Humans↗
PubMed1985

Differential spread of blockade of touch, cold, and pinprick during spinal anesthesia.

The differential levels of sensory blockade of pinprick, cold, and touch were monitored throughout the course of spinal anesthesia administered to 50 patients to determine variations in the degree of spread during onset, plateau, and regression, and to establish the effects of epinephrine and the effect of posture during injection. A significant difference was observed between the dermatomal level of sensory loss of touch and the dermatomal level of loss of either pinprick or cold during onset, at 5 min in patients given tetracaine with epinephrine, at time of maximum spread in patients given tetracaine with epinephrine or in the sitting position, and in all groups during regression. Loss of touch began later, never extended as far cephalad, and regressed sooner. The extent of this difference was greatest during regression, when the anesthetic was given to patients in the sitting position, after epinephrine. The level at which the sense of touch was lost seemed to mark the limits of the zone of solid spinal anesthesia; these limits could not be assessed effectively using pinprick. We propose that loss of touch sensation be used to assess whether anesthesia is adequate to avoid tourniquet pain. If there is loss of touch sensation above the L1 dermatome, it is unlikely that tourniquet pain will occur.

Adult↗
PubMed2003

Integration of advanced technologies to enhance problem-based learning over distance: Project TOUCH.

Distance education delivery has increased dramatically in recent years as a result of the rapid advancement of communication technology. The National Computational Science Alliance's Access Grid represents a significant advancement in communication technology with potential for distance medical education. The purpose of this study is to provide an overview of the TOUCH project (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) with special emphasis on the process of problem-based learning case development for distribution over the Access Grid. The objective of the TOUCH project is to use emerging Internet-based technology to overcome geographic barriers for delivery of tutorial sessions to medical students pursuing rotations at remote sites. The TOUCH project also is aimed at developing a patient simulation engine and an immersive virtual reality environment to achieve a realistic health care scenario enhancing the learning experience. A traumatic head injury case is developed and distributed over the Access Grid as a demonstration of the TOUCH system. Project TOUCH serves as an example of a computer-based learning system for developing and implementing problem-based learning cases within the medical curriculum, but this system should be easily applied to other educational environments and disciplines involving functional and clinical anatomy. Future phases will explore PC versions of the TOUCH cases for increased distribution.

Craniocerebral Trauma↗
PubMed1995

Noxious stimuli induce an N-methyl-D-aspartate receptor-dependent hypersensitivity of the flexion withdrawal reflex to touch: implications for the treatment of mechanical allodynia.

Primary C-fiber afferents can induce a state of increased excitability in spinal cord neurons amplifying their responsiveness to noxious and innocuous stimuli--the phenomenon of central sensitization. We have examined whether the hypersensitivity to low-intensity stimuli (mechanical allodynia) evoked by C-afferent conditioning inputs is NMDA receptor dependent. The enhancement by C-afferent conditioning stimuli of the normally low or absent cutaneous touch-evoked responses of posterior biceps femoris/semitendinosus flexor motoneurons in the decerebrate-spinal rat has been used as a model of touch-evoked allodynia. Three different noxious conditioning stimuli (electrical stimulation of the sural nerve at C-fiber strength, cutaneous application of mustard oil and the intramuscular (i.m.) injection of bradykinin) enhanced touch-evoked responses and decreased the threshold of the flexor reflex to mechanical stimulation. Intrathecal (i.t.) injections of NMDA (20 pmol) produced a similar effect. A non-competitive NMDA antagonist MK 801, administered prior to the conditioning input at doses that did not modify the baseline reflex, significantly attenuated both the enhancement of touch-evoked responses and the threshold decrease following the noxious conditioning stimuli. Treatment with MK 801 some time after the conditioning input when the mechanical hypersensitivity is fully established, also reduced the increased touch-evoked responses. The reduction in threshold and the increase in touch responsiveness induced by cutaneous and muscle noxious C-fiber conditioning stimuli in the rat spinal cord are, therefore, both prevented and reversed by NMDA receptor antagonism. NMDA antagonists may be potentially useful, therefore, in treating postinjury pain hypersensitivity.

Animals↗
PubMed2005

Hypopituitary patients prefer a touch-screen to paper quality of life questionnaire.

UNLABELLED: Health Related Quality of Life questionnaires are frequently used for research, however only recently has their use been recommended in the routine clinical management of pituitary patients. Questionnaires frequently have complex scoring systems, and may be cumbersome, limiting widespread application. Touch-screen technology can overcome these limitations. We have developed a touch-screen 'Questions on Life Satisfaction-Hypopituitarism' QLS-H (Flash 5 Action script, program design by IG) questionnaire and compared its use and accuracy with a paper version questionnaire in 50 pituitary patients who were attending routine clinics. The HRQoL Z-score for the patient group was lower than the average for the normal UK population, as might be predicted for this patient group. There was no statistically significant difference between scores obtained by the touch-screen and paper questionnaires; mean (SD) Z score was -1.33 (1.4) for touch-screen and -1.26 (1.5) for paper. The touch-screen was preferred by 80% of patients, and quicker to complete (<5min). Additionally, there were significant errors in 14 (28%) of manually scored paper questionnaires. IN CONCLUSION: Touch-screen QLS-H questionnaires have advantages over the paper version for the routine clinical assessment of patients with hypopituitarism.

Adult↗
PubMed1995

The differentiation and function of the touch receptor neurons of Caenorhabditis elegans.

We have identified several genes required for four aspects of the differentiation and function of a set of six touch receptor neurons in the nematode Caenorhabditis elegans: (1) the generation of appropriate cells; (2) the specification of those cells to differentiate as touch receptors; (3) the maintenance of the differentiated state; and (4) the expression of products need for the cell function. Three major conclusions about the development of the touch cells arise from the analysis of these genes. First, specification of cell fate is a combinatorial process. At least seven genes, none of which are expressed solely in these cells, are needed to restrict the expression of touch-cell features in the appropriate cells. Second, the differentiated state must also be maintained. Three genes appear necessary for this maintenance function. Third, regulation of development is not strictly linear; at least one gene is needed at more than one stage of differentiation. In addition to being interested in the factor that determine cell fate, we are also interested in understanding the molecular basis of mechanosensory transduction. The function class genes are particularly important in this regard, especially those that when mutant result in the loss of the touch response without producing any obvious morphological defects in the touch cells.

Animals↗
PubMed1999

Ergonomic automated anesthesia recordkeeper using a mobile touch screen with voice navigtion.

OBJECTIVE: To develop an ergonomically designed computerized recordkeeping tool for anesthesiologists that allows the clinician to maintain visual contact with the patient while performing recordkeeping. METHODS: To simplify the human interface software, we developed two general use software components. All purpose menu type 1 (APM1) was used for entering events using a tree structured menu. APM1 was designed to adapt to the limits of human memory, by using Miller's rule of 7 to guide the input process. APM1 can be considered to be a three-dimensional table list consisting of 7 vertical and 7 horizontal choices, which has further 5 tree-structured divergences. APM1 is also completely configurable by the user. All purpose menu 2 (APM2) was used to implement the system-initiated human interface where the system will prompt the user by voice for each entry. When users touch a key on APM1 and APM2, the system was designed to respond with a voice prompt. A touch-screen was also utilized and designed to fit the anesthesia machine. The screen is equipped with a small speaker for voice response and a microphone for voice recognition. The positions of the screen are adjustable supported by a long flexible limb (85 cm). RESULTS: After improving the design, systems were assembled for 10 operating rooms. Of the multiple features of the VOCAAR user interface, the following were well accepted by users and employed daily: touch-screen input, and voice response. The noncompulsory use rate was 87% during the initial 2 weeks, increased to 94% after 2 weeks and 100% after two months. The mean sound emission by voice response (n = 10, mean +/- SD) was 8.2 +/- 2.3 dB at the main anesthetist site (35 cm from the speaker mounted on the touch-screen), 2.2 +/- 1.3 dB at the staff site (1.5 m from the touch-screen), which was only audible for anesthesiologist but for surgeon. DISCUSSION: An EARK system was designed to allow the user to maintain visual contact with the patient while performing recordkeeping tasks. The combination of a mobile touch screen and voice response/recognition facilitated the design goals of the system. Although the system has enjoyed universal clinical acceptance, the voice functions remain too limited to satisfy the needs of a completely handsfree user interface. Enhancements to voice recognition technology will offer the potential for improved functionality. Additional research is also needed to better define the relationship between vigilance and visual contact with the patient.

Anesthesiology↗
PubMed2001

Non-touch fittings in hospitals: a possible source of Pseudomonas aeruginosa and Legionella spp.

Non-touch fittings are gradually becoming very common in the bathrooms and toilets of public facilities and restaurants. Hospitals and other healthcare facilities have recently started to install these types of water taps to lower water consumption, thus saving costs, and to prevent healthcare workers from touching the tap, thus promoting hygiene. This study analysed the bacteriological water quality of 38 non-touch water taps in different settings in a 450-bed secondary-care hospital in Upper Austria. Two different tap types were installed: 23 taps were without temperature selection and 15 were with temperature selection (cold and warm). A membrane filtration method was used, and the authors screened for both indicator organisms and Pseudomonas aeruginosa in 100 ml water samples. In 10 non-touch taps without temperature selection, the authors also screened for Legionella spp. in 500 ml water samples. Seventy four percent of the taps without temperature selection and 7% of the taps with temperature selection showed contamination with P. aeruginosa (P<0.001). None of the taps showed contamination with indicator organisms. Detailed analysis of the source of contamination revealed that the magnetic valve and the outlet itself were heavily contaminated, whereas the junction from the central pipe system was free of contamination. All 10 analysed taps showed contamination with Legionella spp. It was concluded that the local contamination of non-touch fittings is a result of the low amount of water that flows through the outlet, the low water pressure and the column of water, which is 'still-standing' and has a temperature of about 35 degrees C, thus providing nearly ideal growth conditions for P. aeruginosa. Additionally, the presence of materials such as rubber, PVC, etc. in the fittings enhances the adhesion of P. aeruginosa and thus the production of biofilms. In conclusion, the authors wish to encourage infection control teams to evaluate the use of non-touch fittings in hospitals, especially when they are installed in risk areas.

Austria↗
PubMed2000

In fencing, does intensive practice equally improve the speed performance of the touche when it is performed alone and in combination with the lunge?

Global movements are generally composed of several simple movements. In this study we tested the hypothesis that the effects of practice on the performance of a simple movement cannot be highlighted when it is performed alone but only when it is part of a global movement. For this purpose we examined the performance of the touche movement in fencing, in terms of maximal speed of the foil, when it is performed alone and in combination with the lunge. The touche can be assimilated to a pointing task towards a target while the lunge can be assimilated to a forward stepping movement. Four international class fencers and five novices were tested. The results show that 1) the performance in the isolated touche condition was comparable between the two test populations, 2) the performance was higher in the expert population compared to the novice population in the sequential touche + lunge condition, and 3) the velocity of the centre of mass at the time of the peak velocity of the touche was higher in the expert population than in the novice population in the sequential touche + lunge condition. In line with Bernstein's concepts on the effects of practice on motor control it is suggested that the experts exploit to advantage the forces developed during the lunge whereas the novices do not.

Adult↗
PubMed1994

A ward comparison between the One Touch II and Glucometer II blood glucose meters.

A 6-week clinical evaluation of the One Touch II blood glucose meter was performed in a medical ward specializing in diabetic patients and compared to the existing Glucometer II system. Nursing staff trained in both methods performed 267 capillary blood glucose measurements using the two meters. A reference capillary blood glucose was performed simultaneously on 129 of these occasions using a Yellow Springs Instrument analyser. The One Touch II correlated better with the reference (r = 0.97) than the Glucometer II (r = 0.86) and was equally close or closer to the Yellow Springs Instrument on 82% of occasions. A greater proportion of samples measured by the One Touch II were within 15% of the reference value (83% vs 66%). There were also 17 cases where the One Touch II was able to give a measurement which was outwith the analytical range of the Glucometer II. A questionnaire revealed the nursing staff unanimously preferred using the One Touch II to their present meter. It is concluded that in a ward setting the One Touch II meter showed improved accuracy, usefulness in its wider analytical range, and a greater user preference in comparison to the Glucometer II.

Blood Glucose↗
PubMed2005

Genome-wide identification of touch- and darkness-regulated Arabidopsis genes: a focus on calmodulin-like and XTH genes.

We sought to gain insight into functions potentially altered by mechanostimulation and investigate the relationship between touch and darkness responses. Microarrays and quantitative RT-PCR were conducted to identify genes and analyze behaviors of calmodulin-like (CML) and xyloglucan endotransglucosylase/hydrolase (XTH) genes. Strikingly, 589 genes had touch-inducible expression; 171 had reduced expression. Darkness increased expression of 461 genes and decreased expression of 72 genes. Over half of the touch-inducible genes resembled the TCH genes in that they were also up-regulated by darkness; 67% of those darkness-inducible were also touch inducible. Expression of 12 CMLs and four XTHs was elevated by touch; three XTHs had reduced expression. In darkness-treated plants, 10 CMLs and nine XTHs had increased expression and one XTH was repressed. Over 2.5% of total genes were touch-inducible. Many were also darkness up-regulated, consistent with the hypothesis that these stimuli have partially overlapping signal transduction pathways. Regulated gene identities suggest that calcium and kinase signaling, wall modification, disease resistance and downstream transcriptional responses may be altered in response to mechanostimulation or darkness.

Arabidopsis↗
PubMed2005

In touch: plant responses to mechanical stimuli.

Perception and response to mechanical stimuli are likely essential at the cellular and organismal levels. Elaborate and impressive touch responses of plants capture the imagination as such behaviors are unexpected in otherwise often quiescent creatures. Touch responses can turn plants into aggressors against animals, trapping and devouring them, and enable flowers to be active in ensuring crosspollination and shoots to climb to sunlit heights. Morphogenesis is also influenced by mechanical perturbations, including both dynamic environmental stimuli, such as wind, and constant forces, such as gravity. Even individual cells must sense turgor and wall integrity, and subcellular organelles can translocate in response to mechanical perturbations. Signaling molecules and hormones, including intracellular calcium, reactive oxygen species, octadecanoids and ethylene, have been implicated in touch responses. Remarkably, touch-induced gene expression is widespread; more than 2.5% of Arabidopsis genes are rapidly up-regulated in touch-stimulated plants. Many of these genes encode calcium-binding, cell wall modifying, defense, transcription factor and kinase proteins. With these genes as tools, molecular genetic methods may enable elucidation of mechanisms of touch perception, signal transduction and response regulation.

Flowers↗
PubMed2001

[Evaluation of usefulness of touch smear cytology for the diagnosis of Helicobacter pylori infection].

The aim of this study was to assess the utility of the touch smear cytology for the detection of Helicobacter pylori (H. pylori) infection compared with biological culture, immunohistochemistry and rapid urease test. 1) The diagnostic concordance rate of touch smear cytology compared with both immunohistochemistry and biological culture of the same specimen were 94.2% and 93.8%, respectively. Diagnosis using the touch smear cytology had no statistically significant relation with numbers of H. pylori in the samples determined by immunohistochemistry. 2) Compared with biologic culture, the sensitivity and specificity of rapid urease test were 85.0% and 96.3%, and that of touch smear cytology were 91.2%, 96.3%, respectively. 3) Two biopsies were taken from each lesion (all the patients had two lesions; at the body and antrum) and examined using touch smear cytology. In all the positive lesions, the two biopsies were positive and p value concerning the numbers of H. pylori was significant. In conclusion, touch smear cytology is considered to be one of the reliable methods for the detection of H. pylori infection because of its high accuracy rate, convenience, rapidity, low cost and stability.

Bacteriological Techniques↗
PubMedDate not supplied

Postnatal touch stimulation acutely alters corticosterone levels and glucocorticoid receptor gene expression in the neonatal rat.

Environmental manipulation early in life can alter the development of the hypothalamic-pituitary-adrenal (HPA) axis by mechanisms that are still unclear. The aim of the present work was to study the acute effects of postnatal touch stimulation, in an attempt to understand the mechanism by which touch stimulation early in life alters the HPA response to stress in adult animals. Rat pups were gently brushed for 15 min daily during the 1st postnatal week. Serum corticosterone levels were determined by radioimmunoassays, while glucocorticoid receptor (GR) gene expression was assayed by semiquantitative reverse transcriptase-polymerase chain reaction. Touch stimulation induced a significant decrease (30-36%) in serum corticosteroid secretion during the 1st and 2nd postnatal day as compared to the unstimulated group. In contrast, GR gene expression in the touch stimulation group was significantly increased in several brain areas such as the hippocampus (19-21%), frontal cortex (26-34%) and midbrain (15-24%). The results thus indicate that neonatal touch stimulation causes acute hormone- secretion and gene-expression changes within the period of stimulation. These changes may be the underlying cause for the permanent changes that have been observed in adult animals touch-stimulated as neonates.

Animals↗
PubMed1999

Automated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires.

PURPOSE: To evaluate alternative automated methods of collecting data on quality of life (QOL) in cancer patients. After initial evaluation of a range of technologies, we compared computer touch-screen questionnaires with paper questionnaires scanned by optical reading systems in terms of patients' acceptance, data quality, and reliability. PATIENTS AND METHODS: In a randomized cross-over trial, 149 cancer patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, version 2.0 (EORTC QLQ-C30), and the Hospital Anxiety and Depression Scale (HADS) on paper and on a touch screen. In a further test-retest study, 81 patients completed the electronic version of the questionnaires twice, with a time interval of 3 hours between questionnaires. RESULTS: Fifty-two percent of the patients preferred the touch screen to paper; 24% had no preference. The quality of the data collected with the touch-screen system was good, with no missed responses. At the group level, the differences between scores obtained with the two modes of administration of the instruments were small, suggesting equivalence for most of the QOL scales, with the possible exception of the emotional, fatigue, and nausea/vomiting scales and the appetite item, where patients tended to give more positive responses on the touch screen. At the individual patient level, the agreement was good, with a kappa coefficient from 0.57 to 0.77 and percent global agreement from 61% to 97%. The electronic questionnaire had good test-retest reliability, with correlation coefficients between the two administrations from 0.78 to 0.95, kappa coefficients of agreement from 0.55 to 0.90, and percent global agreement from 56% to 100%. CONCLUSION: Computer touch-screen QOL questionnaires were well accepted by cancer patients, with good data quality and reliability.

Adult↗
PubMed1995

Cytopathologic touch preparations (imprints) from core needle biopsies: accuracy compared with that of fine-needle aspirates.

OBJECTIVE: The aim of this study was to evaluate the touch preparation (imprint) cytology method for obtaining rapid interpretations from core material obtained during abdominal percutaneous biopsy. SUBJECTS AND METHODS: For 28 patients undergoing biopsy of abdominal masses, paired slides were prepared for rapid staining by use of smears of standard fine-needle aspirates and by use of a touch preparation of the core material obtained with a semiautomated biopsy gun. The slides were scored in comparison with the final cytopathologic and histopathologic diagnosis. RESULTS: Touch preparation slides were equivalent in diagnostic yield to fine-needle aspirate smears, demonstrating similar cellular features. Touch preparation slides revealed features of tumor architecture not present on smears. CONCLUSION: Touch preparation cytology offers rapid diagnosis from a single core biopsy sample. Carefully performed, the touch preparation method preserves the core material for subsequent permanent fixation and sectioning.

Abdominal Neoplasms↗