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PubMedDate not supplied

[The sequelae of the intraspecific isolation of adult rats (right-handed, left-handed and ambidextrous animals)].

We studied the influence of social isolation at the age of 2 months on zoosocial behaviour of mixed-bred male rats with different paw preference. Paw preference was determined in the test of reaching for food in the horizontal tube. The level of aggression but not sociability was found to increase significantly in dextral and ambidextrous late isolants. In sinistrals the increase of sociability but not aggression was observed. Analysis of probabilistic ethological structure of aggressive behaviour showed its validity and revealed the appearance of pathological aggression as a result of isolation in all groups of animals. Being connected with a disfunction of the regulating role of the right brain hemisphere this feature of aggressive behaviour is most pronounced in dextrals and ambidextrals.

Aggression↗
PubMed1995

From mouth to hand: applying dental technology to hand rehabilitation.

Low-temperature thermoplastic and plaster splints are frequently used in the treatment of tendon and ligament injuries of the fingers. Splints made from these materials are problematic in that they degrade with exposure to the chemicals and physical stresses found in the field environment. Chromium-based alloys, commonly used in dental appliances, have been found suitable for use in the fabrication of finger splints. Splints made from these materials are lightweight, durable, relatively inexpensive, and can withstand the rigors of the field environment. Durable splints can enhance clinical outcome and decrease soldier "down time" from repeated sick call visits for splint repair.

Chromium Alloys↗
PubMed1998

["All that time we were working hand in hand ..." a comparative study on the effects of professionalization on German and American intensive care nurses].

The discussion about improving and reevaluating nursing education and nursing practice in Germany is often oriented at the US-american nurses' training. Here one finds a higher degree of professionalisation and university nursing programs. A German-US-American comparative study of 13 ICU nurses each analyzes what effects a higher degree of professionalism has on every day nursing practice. Using the data of structured interviews, dimensions of job perception and aspects of coping capabilities with stress in regard to patient care and relation with physicians of both nursing groups are compared. Results show that US-American nurses often refer to cognitive aspects of being in control of a situation and emphasize their professional part. When assessing their experiences they mainly describe actions they took emphasizing cooperation and help they gave each other. German nurses accentuate the emotional side, describing fear, anger, rage and helplessness. In their relations with physicians the US-American nurses are more likely to insist on their nursing competence, while German nurses tend to be annoyed, resignated, and try to withdraw from the situation. These differences are discussed in relation to the different nursing programs. The US-American education, stressing supervision and the ability to reflect upon one's action seems to have a positive influence on coping capabilities and enhance job satisfaction.

Adaptation, Psychological↗
PubMed2003

[Hand surgery training].

Training of the hand surgeon HAND SURGEON A CONCEPT: The hand surgeon is supposed to be in charge of all the hand lesions regarding, skeleton, muscles, tendons, nerves and vessels. He has to be able to insure reparation and coverage of all of them. So he is involved in all the structures, which insure integrity and function of the hand. PURPOSE AND WAYS OF TRAINING: To obtain the asked ability, the hand surgeon training has to be global and sustained by two underlying surgical specialities: orthopedic surgery and plastic and reconstructive surgery. From 2000 after many years of dealings, a Right to the Title in Hand Surgery was born. This Right to the Title wants to be the formal recognition of the specific training of the hand surgeon. For the well-recognized ancient hand surgeons they need to be confirmed by one's peers. Now a day the hand surgeon has to satisfy to this specific training: Passed the complete training and exam of the Orthopedic or Plastic surgery board. Spent at least 6 months as resident in the other underlying specialty. Passed a microsurgery examination. Passed one of the four national Hand Surgery diplomas (DIU/Inter-Universitary Diploma). The examinations have been harmonized. A common formation is delivered regarding hand surgery, the way of examination is the same and the formation is 2 years long. The final exam is presented in front of board of examiners where a teacher of one of the other three national diplomas is present. Spent at least 2 years in a formative hand surgery unit, listed by the French College of Hand Surgeons, as senior surgeon. Those requirements are heavy to assume and need a heavy personal involvement. That seems to be necessary to have an ability level as high as possible. Emergency surgery practice is absolutely necessary in this training. All the 17 university formative hand surgery units listed by the French College of Hand Surgeons are members of the FESUM (European Federation of the Emergency Hand Units). Unfortunately it is non-sufficient to train the necessary number of hand surgeons needed in France today. So we try to obtain from the authority the formal recognition of a training period in private practice. Eleven out of the 28 hand units listed as formative by the French College of Hand Surgeons are in private practice and may be recognized as formative in the hand surgeon training. That needs to create an official agreement between university and private Units. This part of the training is yet accepted by the Right to the Title commission for a 6-month training period. But this needs a legal modification or adaptation of the private units legal status so they will be able to offer a quite equivalent conditions of training. Now a days 233 surgeons in France passed the Right to the Title. Among them, the oldest do not have emergency practice any more. So unfortunately, out of 1,400,000 hand injuries a year in France, only few are actually cared by hand surgeons. The emergency training needs at least a three to four senior surgeons team, operating and caring emergencies, 24 h a day, 365 days a year. They need to be surrounded by high-level technical facilities for this type of surgery. Only this type of unit may have a frequent severe hand traumatology practice, especially regarding microsurgery. But on the other hand a less complex hand unit operating only planed surgery and less complicated emergencies, may also be definitively formative. This only depends on the hand surgeon's qualification. It is only with a very demanding and high-level training program that our credibility as hand surgeon may be definitively established. The mainstay of this training is the combined action of the FESUM, the French College of Hand Surgeons and the DIU diploma. The Right to the Title formally confirms that training. For university or private unit, to be a member of the FESUM, must continue to guarantee a high level training regarding emergencies as in number as in complexity. We proposed as minimum level of practice (a year) to be a formative hand surgery unit: 10-15 hand and upper limb replantations; 25-30 very severe hand injuries (revascularization etc.); at least 1000-1500 hand surgery procedures.

Emergency Treatment↗
PubMed1994

Measurement of hand bone mineral content by dual energy x-ray absorptiometry: development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis.

OBJECTIVES--To develop a method of measuring hand bone mineral content (BMC) by dual energy x ray absorptiometry (DXA); to apply this method of measuring hand BMC to normal volunteers to ascertain causes of variability; and to measure hand BMC in patients with rheumatoid arthritis (RA) of varying duration and severity. METHODS--The x ray beam of the Hologic QDR 1000 dual energy x ray absorptiometer was hardened by introducing a perspex-aluminium plate and the analysis software altered to allow for the small tissue bulk of the hand compared with the torso. Ninety five volunteers (46 men age 24-81 and 49 women age 20-83) had scans of both hands. Eight volunteers were assessed repeatedly to establish reproducibility and effect of hand position. Fifty six patients (22 men, 34 women, age range 25-86 years) with RA of differing duration and severity, had hand BMC measurement by DXA. RESULTS--The precision of BMC measurement was 2.3% with no additional variation due to hand position. Hand dominance had no significant effect on BMC. In men, hand BMC correlated with height (r = 0.57, p < 0.0001), weight (r = 0.58, p < 0.0001), forearm span (r = 0.5, p = 0.0006) and hand volume (r = 0.66, p < 0.0001). In women hand BMC correlated with height (r = 0.66, p < 0.0001), weight (r = 0.4, p = 0.003), forearm span (r = 0.3, p = 0.03) and hand volume (r = 0.49, p = 0.0008). After correcting for all these variables, male volunteers had significantly higher hand BMC than female volunteers (p = 0.01) and patients with RA had lower hand BMC than normal volunteers (total hand BMC in male volunteers 90.9 gms, 95% CI 86.9-95, in male patients 81.7 gms, 95% CI 73.7-89.6, p < 0.004, total hand BMC in female volunteers 62.2 gms 95% CI 59.8-64.5, female patients 52.3 gms, 95% CI 48.1-56.5, p < 0.005). In patients with RA, the hand BMC showed an inverse correlation with age (r = -0.44, p = 0.01), disease duration (r = -0.62, p = 0.0003), Larsen's grades (r = -0.62, p = 0.0002) and modified Sharp's method score (r = -0.69, p < 0.0001) in female patients only. CONCLUSIONS--A new, sensitive and reproducible technique of measurement of hand bone mineral content by DXA, has been developed and this method has been applied to normal volunteers and patients with RA. Hand dominance had no significant effect on hand BMC. After correcting for physical size, men have higher hand BMC than women. Hand BMC inversely correlates in women patients with disease duration and other validated methods of assessing radiological outcome in RA. Longitudinal studies are needed to establish its role in monitoring disease progression.

Absorptiometry, Photon↗
PubMedDate not supplied

Compliance and efficacy of hand rubbing during in-hospital practice.

OBJECTIVE: To compare alcohol-based hand rubbing with hand washing using antimicrobial soap regarding antimicrobial efficacy and compliance with routine practice in hospital and intensive care units. SUBJECTS AND METHODS: From February to June 2003, 35 nurses were randomly selected from a nursing staff of 141 and divided into two groups: hand rubbing and hand washing groups. Hand cultures were obtained before and after health care procedures. The nurses were observed on days 1, 7 and 14 of the study, in order to determine compliance and efficacy of the hand hygiene methods. RESULTS: A total of 368 routine patient care activities were observed during the study period. Hand rubbing with alcohol-based solutions significantly reduced the bacterial contamination of the hands of the nurses more than hand washing with an antimicrobial soap (54 and 27%, respectively; p < 0.01). Compliance was also better in the hand rubbing group than in the hand washing group (72.5 and 15.4%, respectively; p < 0.001). Compliance with hand rubbing was markedly lower among the nurses who had experience of more than 3 years in hospital practice. Both hand rubbing and hand washing compliance were poorer among nurses working in intensive care units than among nurses working in the other hospital wards. Generally, after taking off gloves, nurses preferred hand washing to hand rubbing. CONCLUSION: These data indicate that alcohol-based hand rubbing reduces mean bacterial counts on the hands of nurses more effectively than hand washing with antimicrobial soaps, and compliance rates with hand rubbing were also higher than with hand washing. Nevertheless, the compliance with hand rubbing was markedly lower in more experienced nurses.

Adult↗