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Single-unit recording has revealed both hand and eye movement-related activity in the parietal cortex of the macaque monkey. These experiments, as well as neuropsychological studies, are unravelling the complex nature of how the eye and the hand work together in the control of visually guided movements.
The specialty of hand therapy was developed in response to advances in surgical techniques that enabled greater functional restoration of injured and diseased upper extremities. Such restoration requires the therapeutic intervention of a skilled, specialized practitioner who is able to integrate the principles of rehabilitation with these surgical interventions (Chai, Dimick, & Dasach, 1987). This article will provide a general overview of hand therapy as practiced by one midwestern institution.
BACKGROUND: In most surgical theatres, a 1 min or even longer hand wash is routine as part of the pre-operative hand disinfection. But its benefit has recently been seen critically. METHODS: We have therefore investigated the effect of a 1 min hand wash on skin hydration and on the efficacy of consecutive surgical hand rubbing with three standard alcohols (60% propan-1-ol, 60% propan-2-ol, 80% ethanol; all v/v) on the resident hand flora. Three types of treatment were performed: (i) a 1 min pre-wash before surgical hand disinfection, (ii) no pre-wash before surgical hand disinfection and (iii) no pre-wash but use of a brush for 1 min during disinfection procedure. The efficacy of the alcohols was determined according to prEN 12791 with the same 20 volunteers in paired groups. To assess the effect of the hand wash on skin hydration, 10 volunteers washed their hands with sapo kalinus for 1 min and dried hands with a paper towel. Skin hydration was measured with a corneometer before the hand wash and subsequently up to 10 min thereafter both on the palm and dorsum of hands. We also tested the reduction of bacterial spores by a 15 s hand wash according to EN 1499 after artificial contamination of hands of 14 volunteers with spores of B. stearothermophilus. RESULTS: Propan-1-ol (60%) was most effective with a mean log10 reduction of 2.11, followed by ethanol (80%) with a mean log10 reduction of 1.76 and propan-2-ol (60%) with a mean log10 reduction of 0.57 (all immediate effect without hand wash). The efficacy of the alcohols was neither significantly improved nor impaired by a preceding 1 min hand wash, but there is a trend towards better efficacy on dry hands. Using a brush for 1 min during disinfection resulted in a better efficacy with all alcohols. An anaylsis of variance revealed that the immediate effect of ethanol (p = 0.013) and propan-2-ol (p = 0.001) is significantly influenced by the variation of treatments which is mainly explained by the effect of brushing during disinfection. But no significant difference between treatment variations was found in the sustained effect with any of the alcohols. Skin hydration increased significantly by a 1 min hand wash for up to 10 min despite drying hands with a paper towel. A 15 s hand wash reduced the number of bacterial spores significantly from log10 3.84 to log10 1.99 (p = 0.001). CONCLUSIONS: There is no benefit of a hand wash as part of surgical hand disinfection except that a short hand wash of 15 s can effectively reduce spores. The best time for this short hand wash is at the beginning of work in hospital, but at the latest in the sluice of the operating theatre about 10 min before applying an alcohol-based hand rub to give the skin enough time to dry.
This study was planned for the purpose of investigating the effect of hand preference on hand anthropometric measurements, with the participation of 393 healthy university students. The hand preference direction of the subjects was established according to the Edinburgh Inventory, and five hand preference determination groups were constituted after calculation of the laterality score. During performance of the hand anthropometric measurements, values for both hands were calculated, and seven parameters were evaluated for each hand. Hand width and shape index were found to be high for the right hand, but the palmar length/width ratio was found to be high for the left hand, for strong and weak right handers, respectively. No significant statistical values were obtained among ambidextrous subjects, although their parameters resembled these groups' values. Additionally, in the left-handed group, reverse direction asymmetric values were established, but significant statistical values were not obtained. An increase in right and left hand asymmetry was established going from the strong right hand preferent group to the strong left hand preferent group (on a decreasing scale of right hand preference). If the laterality score is evaluated without regard to groups, left hand shape index and right hand finger index may be accepted as phenotype indicators of hand preference. Left hand shape index and right hand finger index increased in correlation with the tendency for left hand and right hand preference, respectively. The findings reveal that, environmental factors such as hand activity, hormones, and brain asymmetry may play a role in the effect of hand preference on hand anthropometric measurements. In our study, we found no difference in asymmetry in regard to the sex of the subjects, generally.
The associations between right and left hand skills to cerebral motor lateralization were studied in right-handed subjects with (FS+) and without (FS-) familial sinistrality. Hand preference was assessed by Oldfield questionnaire and hand skill by the peg moving task. The mean peg moving times (PMTs) and their standard deviations (SDs) were calculated for each hand. There was a significant positive linear correlation between the mean right and left hand PMTs. In males, the mean difference between the left and right PMTs (L-R) showed a significant negative linear correlation with the mean right hand PMTs. There was no significant correlation between these parameters in females. The mean L-R PMTs were found to be positively linearly correlated with the mean left hand PMT in FS- males, FS- and FS+ females (no correlation in FS+ males). The results indicated the contribution of the mean left hand PMTs to L-R hand skill is much higher than that of the mean right hand PMTs. In males, there was no significant correlation between SDs of the mean right and left hand PMTs. In females, SD of the mean right hand PMT was found to be positively linearly related to SD of the left hand PMT. In males, L-R SDs were found to be negatively linearly related to SDs of the mean right hand PMTs and positively linearly related to the SDs of the mean left hand PMTs. In females, only the mean left hand PMT positively linearly correlated with L-R SDs. Here again, the left hand prominently influenced the L-R SDs. In males, SD for the mean right hand PMT showed no relation to right hand PMT. There was, however, a negative linear correlation between SD of the mean right hand PMT and the left hand PMT (no correlations in female). It was concluded that the left hand (right brain) would be of higher significance than the right hand (left brain) in determining the degree of the right-bias in hand skill and its stability in right-handers.
BACKGROUND: There were 3 objectives for this prospective quasiexperimental study. The first was to determine the effect of mentor's hand hygiene practices on student's hand hygiene rates during clinical rotations. The second was to assess the difference in hand hygiene rates for students with and without prior medical experience. The third was to assess the student's opinion and beliefs regarding hand hygiene. METHODS: Sixty students enrolled in a certified nursing program were selected to participate in the study. Each study group was observed twice during the 30-day span. The first observational period was conducted on day 1 of clinical rotation. The second observational period was conducted on day 30 of clinical rotation. Students were observed for hand hygiene. Also assessed were medical experience, sex, gloving, age, and mentor's hand hygiene practices. After observational period 2, a brief questionnaire was given to students to determine their opinion and beliefs regarding hand hygiene. The questionnaire was divided into 5 sections: student's commitment to hand hygiene, their perception of hand hygiene inconvenience, the necessity of hand hygiene, the student's ability to perform hand hygiene, and their opinion on the frequency of medical staff's hand hygiene. RESULTS: The mentor's practice of hand hygiene was the strongest predictor of the student's rate of hand hygiene for both observational periods (P < .01). Furthermore, students without prior medical experience had a significant increase in hand hygiene rates when comparing observational period 1 to observational period 2 (P < .01). Glove usage was associated with increased hand hygiene rates by 50% during observational period 1 (P = .01) and 44% during observational period 2 (P < .01). Male students during observational period 1 practiced hand hygiene 30% less often than female students (P < .01); however, during observational period 2, there was no significant difference between hand hygiene rates for males and females (P = .82). Questionnaires were completed by 47 students, who reported a strong commitment to hand hygiene, belief in its necessity, and ability to perform hand hygiene (with scores in the high 90s on a 10 to 100 rating scale). CONCLUSION: Mentor's use of hand hygiene and glove usage was associated with increased hand hygiene among students. Even though students reported strongly positive attitudes toward hand hygiene, students had a low overall rate of hand hygiene.
Speed and accuracy in hand speed in relation to sex-related differences were studied in left-handed normal subjects. Hand skill was assessed by a peg moving task. Hand speed increased linearly with successive trials (motor learning). Left-hand speed exhibited a higher learning capacity than right-hand speed. Right-hand speed and right-hand learning were equivalent in males and females. Left-hand speed was higher in females than males; left-hand learning was equivalent in males and females. Left minus right (L-R) hand speed decreased linearly with right-hand speed; left-hand speed did not influence L-R hand speed. Learning curves were constructed for each subject. Standard error of a learning curve was considered as accuracy of hand skill. In females, accuracy of hand movement decreased as hand speed increased. In males, only accuracy of right-hand speed decreased as right-hand speed increased; left-hand accuracy did not depend on left-hand speed. It was concluded that right brain controlling left hand in left-handers has a higher capacity than left brain for motor learning; L-R hand speed was largely determined by left brain; accuracy in hand skill depends on both brains in females, and on only left brain in males; the female brain is more bilaterally organized than male brain in fine motor control.
PURPOSE: The etiology of hand discomfort during hand assisted laparoscopic nephrectomy may be ischemic in nature. We determined if pneumoperitoneal pressure sustained to the hand during hand assisted laparoscopic nephrectomy poses an occupational risk, contributing to local hand hypoxia and resultant extremity pain. MATERIALS AND METHODS: A total of 442 measurements of hand oxygen saturation were made during hand assisted laparoscopic nephrectomy. A Nellcor OxiMax Max-1 oxygen sensor was attached to the left index finger of each surgeon and hand assisted laparoscopic nephrectomy was performed using a LapDisc at 15 mm Hg pneumoperitoneal pressures. Local hand oximetry readings and a numerical pain distress scale (range 0 to 10) were recorded every 2 minutes. To control for motion artifact oximetry readings were taken during hand motion and at rest. The Student t test was used to compare differences in local hand oxygen saturation and hand pain in and between study groups. RESULTS: A history of hand pain during hand assisted laparoscopic nephrectomy was significantly associated with local hypoxia during operative motion and at rest (p = 0.023 and 0.012, respectively), even with an adequate fascial incision and standard pneumoperitoneal pressures. During hand assisted laparoscopic nephrectomy hand pain was most significantly associated with local hypoxia after 24 minutes (p = 0.0002), when local oxygen saturation was 56% to 88%. CONCLUSIONS: A cohort of urologists is predisposed to ischemic hand pain during hand assisted laparoscopic nephrectomy. The etiology of this pain may be hypoxic in nature, attributable to pneumoperitoneal pressure decreasing perfusion and causing venous congestion or regional local ischemia. Circumferential antebrachial constriction from the LapDisc does not seem to be a significant contributing factor in the presence of an adequate fascial incision. Hand pain secondary to ischemia is most significant after 24 minutes at 15 mm Hg. Future studies in more subjects are called for to validate these findings to elucidate which surgeons are predisposed to this potential occupational hazard and what perioperative measures can be taken to avoid hand pain during hand assisted laparoscopic nephrectomy.
OBJECTIVE: The major aim of this study was to determine whether a combination of hand preference inventories and hand performance measures identifies distinct handedness groups. If distinct groups are identified, then these subgroupings can be used in future studies to learn more about the neurobiology of these distinct handedness groups. BACKGROUND: Although most individuals classify themselves as right- or left-handed, it is not entirely clear whether handedness should be determined based on preference inventories, hand performance tasks, or a combination of these measures. Given that hand preference is linked in part to hemispheric specialization of language, it is important to clearly define hand preference groups if lateralized differences between right- and left-handers are to be explored. Healthy adult right- and left-handers were examined from a multivariate perspective in an attempt to determine whether handedness subgroups exist within performance data. METHOD: Hand preference of 62 right- and left-handed male and female adults was assessed using items from Briggs and Nebes' and Oldfield's handedness inventories. Individuals were assigned to right- and left-hand preference groups, both by visually inspecting the distribution of preference scores and via cluster analysis. Asymmetries in performance of unimanual motor tasks (grooved pegboard, finger-tapping, and grip strength) were then examined using a multivariate approach. RESULTS: Sixteen items from the two-handedness inventories were used to determine preference-based handedness groups. Two non-overlapping groups, right- and left-hand preference, were identified. Writing hand was highly correlated with hand-preference group, as only three individuals in the entire sample wrote with the non-preferred hand. The expected unimodal distributions of performance asymmetry scores, known as laterality quotients (LQs), were seen. However, when those LQs were viewed from a multivariate perspective, distinct performance-based groups emerged. In more than 90% of the observed cases, the performance-based groups corresponded to preference-based groups. No sex differences were found; the relationship between preference and performance measures was not significantly different for men and women. CONCLUSIONS: Writing hand was highly correlated with scores from a hand preference inventory. In contrast, the use of a single hand performance measure, finger tapping or pegboard, did not always correctly classify an individual as right- or left-handed. However, when both of these hand performance measures were used together. individuals were correctly classified as right- or left-handed. Using this approach, two approximately non-overlapping groups, right- and left-handers, emerged. Thus, handedness is probably not a one-dimensional trait or behavior, and must be defined using multiple measures that assess different aspects of hand preference and performance. The implications for hemispheric specialization of language and neural asymmetry research are discussed.
The associations among hand preference, hand skill (peg moving time, PMT) and hand performance (dot filling/20 s) were analyzed in left-handed subjects. In the total sample, the degree of left-hand preference linearly decreased from -100 to zero (Geschwind scores, GSs) as the number of dots placed by the right hand increased (direct correlation); the left hand did not show any significant relation to GSs. The right-hand PMT linearly decreased as the GSs decreased (negative linear correlation); the left hand skill did not exhibit any significant correlation with GSs. There was a negative linear correlation between right-hand PMT and dot-filling with right hand; the left-hand PMT was not related to dot-filling with left hand. In males, the right-hand PMT showed a negative linear correlation with GSs; no significant correlation between PMT and GSs was found for the left hand. There was a negative linear correlation between right minus left (R - L) PMT and GSs. Dot-filling with right hand was found to be positively linearly correlated with GSs (no correlation for the left hand). The L - R dot-filling showed a negative linear correlation with GSs. PMT for the right hand exhibited a significant negative linear relation to dot-filling only with right hand. Sex and familial sinistrality caused minor changes in these relationships. It was concluded that the left brain would constitute the main factor determining the degree of left-handedness.
CONTEXT: Surgical site infections prolong hospital stays, are among the leading nosocomial causes of morbidity, and a source of excess medical costs. Clinical studies comparing the risk of nosocomial infection after different hand antisepsis protocols are scarce. OBJECTIVE: To compare the effectiveness of hand-cleansing protocols in preventing surgical site infections during routine surgical practice. DESIGN: Randomized equivalence trial. SETTING: Six surgical services from teaching and nonteaching hospitals in France. PATIENTS: A total of 4387 consecutive patients who underwent clean and clean-contaminated surgery between January 1, 2000, and May 1, 2001. INTERVENTIONS: Surgical services used 2 hand-cleansing methods alternately every other month: a hand-rubbing protocol with 75% aqueous alcoholic solution containing propanol-1, propanol-2, and mecetronium etilsulfate; and a hand-scrubbing protocol with antiseptic preparation containing 4% povidone iodine or 4% chlorhexidine gluconate. MAIN OUTCOME MEASURES: Thirty-day surgical site infection rates were the primary end point; operating department teams' tolerance of and compliance with hand antisepsis were secondary end points. RESULTS: The 2 protocols were comparable in regard to surgical site infection risk factors. Surgical site infection rates were 55 of 2252 (2.44%) in the hand-rubbing protocol and 53 of 2135 (2.48%) in the hand-scrubbing protocol, for a difference of 0.04% (95% confidence interval, -0.88% to 0.96%). Based on subsets of personnel, compliance with the recommended duration of hand antisepsis was better in the hand-rubbing protocol of the study compared with the hand-scrubbing protocol (44% vs 28%, respectively; P =.008), as was tolerance, with less skin dryness and less skin irritation after aqueous solution use. CONCLUSIONS: Hand-rubbing with aqueous alcoholic solution, preceded by a 1-minute nonantiseptic hand wash before each surgeon's first procedure of the day and before any other procedure if the hands were soiled, was as effective as traditional hand-scrubbing with antiseptic soap in preventing surgical site infections. The hand-rubbing protocol was better tolerated by the surgical teams and improved compliance with hygiene guidelines. Hand-rubbing with liquid aqueous alcoholic solution can thus be safely used as an alternative to traditional surgical hand-scrubbing.
With the new Centers for Disease Control and Prevention (CDC) guideline on hand hygiene, hospitals often introduce alcohol-based hand rubs for hand disinfection. Healthcare workers, however, may reject the new products because of skin irritation or other skin-related problems, which they experience after years of handwashing. In order to facilitate a successful introduction and continued use of alcohol-based hand rubs in hospitals, we have reviewed and summarized the major studies on the topic. Occupational hand dermatitis may occur in up to 30% of healthcare workers. It is mainly described as an irritant contact dermatitis caused by detergents. The diagnosis is usually clinical. Allergic reactions are very rare. After using an alcohol-based hand rub for the first time, healthcare workers may have a burning skin sensation that can be explained by pre-irritated skin. In this case the skin barrier has usually been impaired by frequent handwashing or occlusive gloves. This may result in a vicious circle whereby the healthcare worker increases the frequency of handwashing and reduces the frequency of hand disinfection. Prevention of irritant contact dermatitis is possible by selection of a low-irritating hand rub, which contains emollients, the correct use of the hand rub and a clear guideline when to disinfect and wash hands in the clinical setting. Common mistakes in the use of alcohol-based hand rubs are application to pre-irritated skin and washing hands before hand disinfection, which is, in general, not necessary, or after hand disinfection, which results in washing off the emollients. Clear preparation and guidance of healthcare workers before the introduction of alcohol-based hand rubs can help to enhance compliance in hand hygiene. The switch from handwash to alcohol-based hand rub will improve healthcare workers skin if mistakes are avoided and hand rinses are used correctly.
The use of a patient's own hand as a tool to estimate the area of burn injury is well documented. The area of the palmar surface of one hand has been estimated to be 1 percent of the body surface area. The area of the palmar surface of the hand was measured to test the accuracy of this estimate and then compared with the body surface area as calculated by formulas in common use. This study also sought to determine the natural history of the growth of the hand to permit development of a readily available, bedside means of estimating hand area and body surface area. Bilateral hand tracings were obtained from 800 volunteers ranging in age from 2 to 89 years. The area of each tracing was determined using an integrating planimeter. The height and weight of each individual were measured, and his/her body surface area was calculated. The palmar hand's percentage of body surface area was determined by calculating the quotient for hand area divided by body surface area. Additionally, the width of the hand was measured from the ulnar aspect at the palmar digital crease of the small finger to the point where the thumb rested against the base of the index finger. The length of the hand was measured from the middle of the interstylon to the tip of the middle finger. These two figures were multiplied together to obtain a product which approximated the area of the hand. Based on the most commonly used DuBois formula for calculating body surface area, the area of palmar surface of the hand corresponds to 0.78 +/- 0.08 percent of the body surface area in adults. The percentage varies somewhat with age and reaches a maximum of 0.87 +/- 0.06 percent in young children. Multiplying the length of the hand by its width overestimates the area of the hand as determined by planimetry by only 2 percent. A patient's own hand may be used as a complementary, readily available template for estimation of burn area or other areas of disease or injury. In adults, the area of tracing of the outline of the hand is 0.78 percent of the body surface area, whereas in children, this number tends to be slightly higher. In the emergency room or on the wards, a simple product of length multiplied by width of the hand will closely approximate the area as determined by planimetry. This method allows a more accurate determination of the area of the palmar surface of the hand than the 1 percent estimate, which may lead to an overestimation of the size of a burn wound in adults.
OBJECTIVE: To study the prevalence of hand pain and hand disability in an open population, and the contribution of their potential determinants. METHODS: Baseline data were used from 7983 participants in the Rotterdam study (a population based study in people aged > or =55 years). A home interview was used to determine the presence of hand pain during the previous month, rheumatoid arthritis, osteoarthritis in any joint, diabetes, stroke, thyroid disease, neck/shoulder pain, gout, history of fracture in the past five years, and Parkinson's disease, as well as age, sex, and occupation. Hand disability was defined as the mean score of eight questions related to hand function. Body mass index was measured and hand x rays were taken. RESULTS: The one month period prevalence of hand pain was 16.9%. The prevalence of hand disability was 13.6%. In univariate analysis for hand pain, rheumatoid arthritis had the highest explained variance (R(2)) and odds ratio. For hand disability, aging showed the highest explained variance and Parkinson's disease had the highest odds ratio. All determinants together showed an explained variance of 19.8% for hand pain and 25.2% for hand disability. In multivariate analysis, positive radiographic hand osteoarthritis was a poor explanation for hand pain (R(2) = 0.5%) or hand disability (R(2) = 0). CONCLUSIONS: The contribution of available potential determinants in this study was about 20% for hand pain and 25% for hand disability in an unselected population of elderly people. Thus a greater part of hand pain/hand disability remains unexplained.
The role of kinaesthetic afferences in controlling coupling of voluntary oscillation of the hand and foot, both in-phase and anti-phase, was investigated by modifying the mechanical properties of one of the two segments (the hand) with applied inertial or elastic loads. Loads consisted of a lead disk, rotating coaxially with the wrist (total inertial momentum 15 g m2), or in two symmetrical rubber bands (elasticity, 4 g deg(-1)) connected 5 cm away from the wrist pivot. Experiments were performed on five male and five female subjects. Both the frequency responses of the hand and foot (i.e. the phase relations between the onset of muscular activation in limb extensors and the onset of the related movement) and the inter-limb phase relations (the phase differences between the hand and foot movement cycles and between the onsets of the electromyographic (EMG) activity in hand and foot extensors) were analysed. The hand frequency-response was fitted with a 2nd-order model, allowing us to describe the loaded and unloaded conditions through the changes in the model response. Inertial loading induced an immediate and steep decay in the frequency response, with a clear-cut reduction of the model resonance frequency, while elastic loading shifted the response to the right and upwards. Inter-limb phase relations were only partially affected by inertial loading of the hand. Despite the fact that the load strongly increased the difference between the frequency-responses of the hand and foot, when hand and foot were oscillated in-phase only about half of this difference remained as an increased phase-lag between hand and foot oscillations. The other half was offset by an advance of the contraction of the hand movers with respect to the foot movers. This compensation mechanism was more effective during anti-phase than during in-phase movements. Elastic loading improved inter-limb synchronisation, since it superimposed the hand frequency-response on that of the foot. In this condition, the requested synchronisation (in-phase or anti-phase) could be achieved by an almost simultaneous (or in strict phase opposition) contraction of the hand and foot movers. In conclusion, the main feedback reaction to the de-coupling effect of hand loading consisted in modifying the timing of activation of the muscles moving the extremities. An advance of hand movers on foot movers is already present in unloaded conditions to compensate for the difference in the natural mechanical properties of the two segments. This advance is enhanced when increasing the inertia of the hand system and attenuated when increasing its elasticity.
Thirty four per cent of 2110 patients with eczema attending a contact dermatitis clinic presented with hand eczema. An epidemiological comparison was made of patients with hand eczema and non-hand eczema (defined as eczema on parts of the body other than the hands). Occupational eczema was significantly more common in the hand eczema than the non-hand eczema group (P = 0.0011). The prevalence of atopy was the same in both groups (13%). The prevalence of irritant contact dermatitis was higher in the hand eczema group (32%) than the non-hand eczema group (13%) (P less than 0.0001). The rate of allergic contact dermatitis was lower in the hand eczema group (23%) than the non-hand eczema group (39%) (P less than 0.0001). The rate of positive patch test reactions was lower in the hand eczema group (41%) than the non-hand eczema group (56%) (P less than 0.0001). Nickel sulphate (8%), cobalt chloride (3%), potassium dichromate (3%), and fragrance mix (4%) were common allergens encountered in hand eczema group. None of these allergens was specifically more prevalent in the hand eczema than the non-hand eczema group. However, the prevalence of allergy to nickel, colophony, epoxy resin and medicaments was significantly higher in the non-hand eczema group.
This study aimed to reveal the influence of gender, athletic events and athletic experience on the subjective dominant hand and the dominant hand based on the laterality quotient (LQ). It also aimed to examine the validity of the Edinburgh Inventory (Oldfield, 1971). Males and females (n=3,726) living in 7 prefectures in Japan (age: 16-45 yrs) participated in this survey. Analysis was performed on 3,557 separate datasets with high reliability. The reliability of the survey was examined using a test-retest method consisting of 100 people selected randomly from all participants. All participants provided the same answers for each question. The influence of gender, event and experience was examined for the subjective and LQ-based dominant hands. In addition, concordance rates of the subjective dominant hand and the LQ-based dominant hand and both dominant hands were examined. Differences of concordance rates between hands used in the 10 movement questions of the Inventory and the subjective dominant hand were tested using the chi(2) test. The frequency differences among items were tested using Ryan's method (multiple comparisons). Significant gender differences were found between rates of the LQ-based dominant hand (males: 94.4%; females: 96.6%) and the subjective dominant hand (males: 91.6%; females: 94.0%), but the degree was only 2.0-4.0%. Insignificant differences were found among athletic events, two groups of different athletic experience, and gender according to each athletic event. The subjective dominant hand almost always agreed with the LQ-based dominant hand (complete concordance rate=0.96, kappa=0.67). Of the 10 question items, inexperienced answers were found only in the item "Knife (without fork)". The "Toothbrush", "Broom (upper hand)", and "Opening box (lid)" items had significantly lower correspondence with the subjective dominant hand (79.7-87.0%) than the other items (92.1-95.7%). In conclusion, athletic experience appears to have little influence on handedness, although there is a slight gender difference. The subjective dominant hand almost always agrees with the dominant hand based on the Inventory. A more efficient handedness inventory may be constructed by excluding the above 4 items.
Hand washing and hand disinfection put considerable stress on the skin thus requiring specific hand care. It is important however that the care products do not impair the effect of hand disinfectants. We therefore investigated the interaction of two hand care products (oil-in-water and water-in-oil emulsions) on the microbicidal efficacy of different alcoholic hand-rubs, using the contamination model described in EN 1500. The mean log10-reduction factors for three hand-rubs varied between 4.03 and 4.22 compared with 3.76 and 4.43 for six possible combinations of hand-rubs and hand care products applied immediately prior to disinfection. Differences between reduction factors achieved with hand-rubs alone and in combination with hand care were not significant. Repeated application of care products with subsequent hand disinfection also did not result in significantly lower reduction factors than achieved with hand disinfection alone. Our data suggest that administration of selected products for hand care does not necessarily impair hand disinfection and is therefore recommended for occupational health as well as for infection control reasons.