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At least 163 records · Page 9Linked to original sources
PubMed2002

Effects of manual work on recovery from lateral epicondylitis.

OBJECTIVES: This study investigates the influence of manual work on the persistence of lateral epicondylitis during a 12-month follow-up period after consultation in general practice. METHODS: A cohort study was made of 164 adult consulters with tennis elbow, who had initially been recruited to a randomized controlled trial from 23 general practices in North Staffordshire and South Cheshire. As part of the recruitment process prior to treatment randomization, self-reported questionnaires on symptoms and sociodemographic characteristics were completed. Four weeks, six months, and twelve months later, the schedules were repeated. The main outcomes were measures of elbow symptoms (pain and function) based on a ten-point Likert scale. Total pain and function for the whole 12-month period were assessed using an area-under-the-curve (AUC) analysis. The pain and function scores were analyzed according to employment status (manual versus nonmanual work) and severe versus mild upper-limb stress in manual occupations. RESULTS: The AUC scores for elbow pain and function were significantly higher for the manual workers, and manual work was associated with increased elbow pain and decreased function in the 4-week and 6-month follow-ups. The greater the severity of upper-limb stresses, the worse the outcome. CONCLUSIONS: Previous epidemiologic studies have shown that manual occupations are a risk factor for developing lateral epicondylitis. It is feasible that resuming manual work after treatment may hinder recovery or increase the risk of relapse. The study lends support to this hypothesis.

Activities of Daily Living↗
PubMed2002

Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial.

BACKGROUND: Neck pain is a common problem, but the effectiveness of frequently applied conservative therapies has never been directly compared. OBJECTIVE: To determine the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner. DESIGN: Randomized, controlled trial. SETTING: Outpatient care setting in the Netherlands. PATIENTS: 183 patients, 18 to 70 years of age, who had had nonspecific neck pain for at least 2 weeks. INTERVENTION: 6 weeks of manual therapy (specific mobilization techniques) once per week, physical therapy (exercise therapy) twice per week, or continued care by a general practitioner (analgesics, counseling, and education). MEASUREMENTS: Treatment was considered successful if the patient reported being "completely recovered" or "much improved" on an ordinal six-point scale. Physical dysfunction, pain intensity, and disability were also measured. RESULTS: At 7 weeks, the success rates were 68.3% for manual therapy, 50.8% for physical therapy, and 35.9% for continued care. Statistically significant differences in pain intensity with manual therapy compared with continued care or physical therapy ranged from 0.9 to 1.5 on a scale of 0 to 10. Disability scores also favored manual therapy, but the differences among groups were small. Manual therapy scored consistently better than the other two interventions on most outcome measures. Physical therapy scored better than continued care on some outcome measures, but the differences were not statistically significant. CONCLUSION: In daily practice, manual therapy is a favorable treatment option for patients with neck pain compared with physical therapy or continued care by a general practitioner.

Adolescent↗
PubMed2000

[Comparison of the efficacy of cleaning and disinfection of videoscopes: mechanized versus manual].

AIM: a) To analyze the effectiveness of the automated cleaning and disinfection of endoscopies (Olympus miniETD, not previously tested) versus the manual method; b) To evaluate the drying and storage procedures used in our unit. MATERIAL AND METHODS: Prospective 10-day study. The endoscopies were randomized for automated or manual cleaning and disinfection. Endoscopic samples were collected for microbiology studies at three points during the process: a) after endoscopy (after manual cleaning with water), b) after cleaning with enzymatic detergent and disinfection (automated or manual) and c) at the first hour in the morning. RESULTS: Sixty-five samples were collected after endoscopy: 26 from gastroscopy, 26 from colonoscopy and 13 from duodenoscopy (positive cultures were found in 22, 25 and 10, respectively). The 35 samples collected after automated disinfection were negative, as were 29 of the 30 collected after manual disinfection (p = 0.46). Sixty-four of the 65 samples were negative for hepatitis B and hepatitis C. The only sample positive for hepatitis C became negative after manual disinfection. Positive culture was found in 15% of the samples collected before beginning the session. CONCLUSIONS: a) Automated cleaning and disinfection (Olympus miniETD) are as effective as manual cleaning. b) Drying and storage procedures should be improved and/or disinfection should be carried out again before the first endoscopy of each session.

Colonoscopes↗
PubMed2001

Manual medicine diversity: research pitfalls and the emerging medical paradigm.

Recent studies published in leading medical journals have concluded that chiropractic treatment is not particularly helpful for relieving asthma and migraine symptoms because even though study participants showed notable improvement in symptoms, those subjects who received sham manual medicine treatments also showed improvement. Yet the sham treatment received by control groups in these studies is reminiscent in many ways of traditional osteopathic manipulation. This seems to represent not only a failure to recognize the value of many manual medicine techniques but also an ignorance of the broad spectrum of manual medicine techniques used by various practitioners, from osteopathic physicians to chiropractors to physical therapists. Such blind spots compromise research methodology with regard to manual medicine studies, which could, in turn, diminish the role of manual medicine in clinical practice. Osteopathic manipulative treatment provides an excellent model for recognizing and integrating the full range of manual medicine techniques into research and clinical applications because of the wide range of techniques employed. The potential exists for these techniques to contribute much to medical research and clinical practice--provided that osteopathic physicians and other manual medicine practitioners work to alleviate ignorance about the efficacy of various forms of manipulation.

Asthma↗
PubMed2004

Interproximal plaque mass and fluoride retention after brushing and flossing--a comparative study of powered toothbrushing, manual toothbrushing and flossing.

PURPOSE: To determine differences in interproximal plaque mass and fluoride retention with different modes of toothbrushing and flossing. MATERIALS AND METHODS: Forty-seven subjects in good health used four treatments in a four-period, randomized, crossover design: 1) manual brushing only; 2) manual brushing and daily flossing; 3) electric brushing using a rotational oscillation toothbrush; and 4) electric brushing using a sonic toothbrush. Subjects used a standard sodium fluoride dentifrice during the eight-day experimental periods and a fluoride-free dentifrice during the seven-day washout periods between treatments. Interproximal plaque samples were taken on Day 1 and on Day 8, weighed, and analyzed for fluoride content. RESULTS: The amount of interproximal plaque was lowest with sonic brushing, which left 43-65% less plaque than all other treatments. Manual brushing and flossing yielded less plaque than manual brushing alone and rotational oscillation brushing. Differences were statistically significant (p < 0.05) for treatment; there was no time effect on plaque mass. For fluoride retention, at Day 1 sonic brushing gave at least 54% more fluoride in the interproximal plaque than all other treatments, which was significant. All treatments demonstrated a significant increase in fluoride concentration with time except manual brushing and flossing, which showed a significant decrease. At Day 8, the fluoride concentration was significantly higher for sonic brushing than for manual brushing or rotational oscillation brushing by over 40%, and all treatments exhibited significantly greater fluoride than the manual brushing and flossing combination. CONCLUSION: The mode of toothbrushing may impact the amount of plaque retained interproximally and its fluoride concentration.

Adult↗
PubMed1986

[Creative arts activity in manually handicapped patients].

Congenital or acquired conditions directly or indirectly causal in total or partial impairment of manual function are set out. The possibilities for creative-expressive activity, using various techniques, nothwithstanding manual disabilities are pointed out. In Cefischer, who until his war-related loss of both upper limbs had been a renowned cartoonist, a comparison of his works, drawn initially by hand and later with the mouth, reveals his characteristic style of expression having remained the same. Further examples are given of creative expression in the presence of manual disability even under extreme circumstances (such as 11 years of confinement to the Iron Lung). Arts and crafts work of persons with leprosy-related manual handicaps are mentioned; typewriter graphics as a method inaugurated by Basset is presented as used in young people with total manual disability. Partial disability of manual function due to arthritis was present in Renoir, Jawlensky, and Grandma Moses, the course of their conditions is described over time. Contents and form of their pictures, after long years of being manually disabled, do not reveal any essential changes in comparison to their earlier ones.

Art↗
PubMed1985

Comparison of fully automated and manual ejection fraction calculations: validation and pitfalls.

Resting multigated blood-pool studies were performed on 61 patients without arrhythmias and data were simultaneously acquired to two computer systems. Using one computer, manual ejection fraction (EF) was calculated by two trained observers. EF was also calculated from the other computer using a commercially available fully automated program; quality control (QC) images were routinely obtained to evaluate correct left-ventricular center location, background region assignment, or gross edge mispositioning. When errors were noted, the automated analysis was reprocessed with operator intervention. Forty-eight of the 61 studies (78%) produced adequate QC images. Operator redefinition of the left ventricular center and background of the 13 QC failures raised the automated success level to 92%. Correlation of the manual EF by two observers was excellent (r = 0.969). The automated EF measurements correlated well with the average observer's (r = 0.898). An improved version of software reduced the QC failures from 13 to 10. Operator assisted automated processing gave the success rate of 94%. The remaining 6% of patients required manual processing to obtain a correct ejection fraction. Our normal range for manual EF is greater than or equal to 0.50 and our corresponding normal range for this group of patients using the automated program was greater than or equal to 0.44. Based on greater than or equal to 0.44, four patients with a low manual EF had a normal automated EF. All four patients had cardiac disease but there was no evidence of abnormal cardiac function. The fully automated program provided good correlation with manual EF and can remove some of the subjectivity in manual edge determination. However, QC images must be carefully examined and the normal EF range for the automated program must be determined.

Adult↗
PubMed1985

Comparison of performance for leukocyte differential counting of the Technicon H6000 system with a manual reference method using the NCCLS standard.

The National Committee for Clinical Laboratory Standards (NCCLS) has published a tentative standard for leukocyte differential counting, by means of which a manual or automated method for leukocyte differential counting can be compared with a manual reference method. The performance of the Technicon H6000 system was evaluated using the standard at Stamford and Overlook Hospitals. A total of 502 patient samples were analyzed: 315 from Overlook and 187 from Stamford. The H6000 system was found to be approximately four times more precise than the 200-cell manual reference method for each cell type. Correlation of the H6000 system with the manual method was good, with correlation coefficients of 0.98 for neutrophils and lymphocytes, 0.96 for eosinophils, 0.72 for monocytes, and 0.5 for basophils. The clinical sensitivity of the H6000 system, measured in terms of false normals and false abnormals, was similar to that of the manual reference method when measured against itself. There were no clinically significant discrepancies in results from the H6000 system, except for possibly one case where a patient was already on antibiotic therapy. The NCCLS standard was found to be a useful but rather complex and involved method for evaluating the performance of the H6000 system, the major problem being the amount of work needed to count manually the number of cells required for the manual reference method.

Diagnostic Errors↗
PubMed2005

The manualization of a treatment programme for personality disorder.

BACKGROUND: The advantages of manualized psychological treatments include: the promotion of evidence-based practice, the enhancement of treatment integrity, the facilitation of staff training, and the potential replicability of treatment. ARGUMENT: The manualization of a multi-component, multidisciplinary treatment programme for male personality-disordered offenders is described. The background to this development is explained and the treatment setting is described briefly, followed by a description of the eight treatment manuals: (1) the treatment overview, (2) Psychoeducation focusing on personality disorder diagnosis and core beliefs, (3) Trust and Self-awareness group exercises, (4) Stop and Think! -- a social problem-solving intervention, (5) Controlling Angry Aggression, (6) Controlling Substance Use, (7) Criminal Thinking/Belief Therapy, and (8) Skills for Living -- a social skills manual. CONCLUSIONS: In addition to the original aims of manualization, this exercise has clarified the treatment programme, included less highly trained staff in the delivery of therapy and permitted the evaluation of treatment modules, thus contributing to the incremental evaluation of the overall programme. These manuals may usefully be shared with other practitioners in the field.

Adult↗
PubMed1996

Manual-based treatments: the clinical application of research findings.

In addition to their now required use in controlled outcome studies, treatment manuals offer important advantages for clinical practice. Manual-based treatments are often empirically-validated, more focused, and more disseminable. They are useful in the training and supervision of therapists. Criticisms of manual-based treatments center on five main themes: they are conceptually at odds with fundamental principles of cognitive-behavioral therapy; they preclude idiographic case formulation; they undermine therapists' clinical artistry; they apply primarily to research samples which differ from the patients practitioners treat; and they promote particular 'schools' of psychological therapy. This paper emphasizes the inherent limitations of idiographic case formulation. It is argued that treatment manuals are consistent with an actuarial approach to assessment and therapy, which, on average, is superior to individual clinical judgment. Available data suggest that standardized treatment is no less effective than individualized therapy. Manual-based treatment demands therapist skill in its implementation. In suitably chosen therapists these skills are more a function of training than amount of clinical experience. Treatment manuals are likely to encourage a pragmatic approach to therapy and should not discourage clinical innovations.

Humans↗
PubMed1999

Improved cognitive knowledge of midwives practising in the eastern Cape Province of the Republic of South Africa through the study of a self-education manual.

OBJECTIVES: To determine whether the Maternal Care manual of the Perinatal Education Programme (PEP) is effective in improving the cognitive knowledge of midwives. DESIGN: A prospective controlled trial in a region where PEP was not previously used. The midwifery knowledge of all midwives caring for pregnant women in the three towns was tested before the commencement of the study. The Maternal Care manual was then introduced to the midwives in he study town and they worked through the programme. Following the completion of the manual, all midwives were tested again with the same test. The time interval between the pre and post testing was 12 months. SETTING: Three towns on the Eastern Cape Province of South Africa. PARTICIPANTS: All Midwives caring for pregnant women in three towns. INTERVENTIONS: The Maternal Care manual of PEP was studied by the midwives in the study town. MEASUREMENTS AND FINDINGS: Changes in cognitive knowledge were tested with multiple choice questions. A significant improvement (p < 0.0001) was achieved in the study town. The mean score (maximum 70) improved by 22.4 (32%) marks, from 35.9 (51%) to 58.3 (83%). KEY CONCLUSIONS: The cognitive knowledge of midwives who completed the Maternal Care manual improved significantly. IMPLICATIONS FOR PRACTICE: These findings are to particular importance as the method by which the Maternal Care manual of PEP was applied conforms to the method suggested for the its national use.

Adult↗
PubMed1999

Using self-instructional pictorial manuals to teach child-care skills to mothers with intellectual disabilities.

Children of parents with intellectual disabilities (i.e., IQs less than 80, labeled as having mental retardation) are at risk for neglect due to inadequate parenting abilities. Previous studies have shown that these parents are responsive to parent-training packages consisting of instructions, pictorial cues, modeling, feedback, and reinforcement. This study evaluated the effectiveness of self-learning pictorial-parenting manuals in teaching basic child-care skills (diapering, treating diaper rash, bathing, safety) to parents with intellectual disabilities who are monitored by child protection agencies. The manuals alone increased child-care skills (to levels seen in parents without disabilities) in 9 out of the 10 mothers in the study and in 12 of 13 child-care skills. The remaining skill was acquired with the full training package. Follow-up indicated that the acquired skills were maintained for up to 3 years. Mean correct performance with the manual was positively correlated with the trainer's rating of the mother's reading level and acceptance of the manual when the mother was first given the manual. Consumer satisfaction ratings of the manuals were high. These results indicate that many parents with intellectual disabilities may improve their child-care skills without intensive training and that self-instruction may be an easily disseminable and cost-effective way of reducing the risk of child neglect due to parenting skill deficiencies.

Child Abuse↗
PubMed2000

Evaluation of the Agricultural Safety and Health Best Management Practices Manual.

The Agricultural Safety and Health Best Management Practices (ASHBMP) Manual was developed as an alternative intervention tool to help identify and correct farmwork hazards. A modified pretest-posttest control group experimental design was used to test the effectiveness of the manual with three intervention groups and a control. Testing consisted of conducting baseline and post-intervention audits on 150 farms in Pennsylvania. Significant differences were found among groups of farmers who were given the ASHBMP Manual and those who were not given the manual. The results of the data analysis also showed a positive significant difference among farmers who reduced their farm hazard levels through use of the ASHBMP Manual over farmers who received the Control (traditional safety fact sheets). The data supports the conclusion that the ASHBMP Manual is an effective tool for helping farmers reduce workplace hazards.

Agriculture↗
PubMed2006

One small step for manuals: Computer-assisted training in twelve-step facilitation.

OBJECTIVE: The burgeoning number of empirically validated therapies has not been met with systematic evaluation of practical, inexpensive means of teaching large numbers of clinicians to use these treatments effectively. An interactive, computer-assisted training program that sought to impart skills associated with the Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) Twelve-Step Facilitation (TSF) manual was developed to address this need. METHOD: Twenty-five community-based substance use-treatment clinicians were randomized to one of two training conditions: (1) access to the computer- assisted training program plus the TSF manual or (2) access to the manual only. The primary outcome measure was change from preto posttraining in the clinicians' ability to demonstrate key TSF skills. RESULTS: The data suggested that the clinicians' ability to implement TSF, as assessed by independent ratings of adherence and skill for the key TSF interventions, was significantly higher after training for those who had access to the computerized training condition than those who were assigned to the manual-only condition. Those assigned to the computer-assisted training condition also demonstrated greater gains in a knowledge test assessing familiarity with concepts presented in the TSF manual. CONCLUSIONS: Computer-based training may be a feasible and effective means of training larger numbers of clinicians in empirically supported, manual-guided therapies.

Adult↗
PubMed1981

Utility of behavioral self-help manuals in a minimal-contact smoking cessation program.

The effectiveness of two commercially available smoking cessation manuals was evaluated under minimal therapist contact conditions. Forty cigarette smokers who volunteered to participate in a self-help quit smoking program were randomly assigned to one of three conditions: 18 to Pomerleau and Pomerleau's 1977 manual, 13 to Danaher and Lichtenstein's 1978 manual, and nine to a waiting-list control. Six-month follow-ups indicate that the former manual offers a useful treatment approach, while no firm conclusions can be made regarding the latter manual. Utility of self-help manuals in multilevel treatment programs is discussed.

Adolescent↗
PubMed1999

Dissemination of an evidence-based intervention manual to improve managed care mammography rates.

After collaborating with the Centers for Disease Control and Prevention to develop an evidence-based mammography intervention manual, the dissemination of the manual in a managed care setting was assessed. Using qualitative methods (in-depth interviews), factors were examined that motivated use of the manual by the quality improvement units of eight Prudential HealthCare health plans. Seven of the plans implemented more intensive interventions after having received the manual than in the previous year. Factors that facilitated use of the manual and implementation of recommendations included: internal motivation, support of senior level management, adequate resources (time, personnel, and funds) to support interventions, and the organization and content of the manual itself.

Aged↗
PubMed1983

Evaluation of a cardiopulmonary-resuscitation training manual for pharmacists.

The development and evaluation of a training manual for pharmacists participating in cardiopulmonary resuscitation (CPR) efforts at an institution encompassing ambulatory-care, acute-care, and emergency-trauma facilities are described. The manual was developed to familiarize pharmacists who had little or no experience in CPR procedures with the equipment and medications used and the pharmacist's role on the CPR team. To evaluate the effectiveness of the manual, a 29-question multiple-choice test was administered to 35 staff pharmacists who were randomly assigned to study and control groups. Training manuals were issued to members of the study group, who were asked to document time spent studying them. Three weeks after the pretest, the same test was administered to all subjects. There was no control on the number of CPR events attended during the three-week period. The study group spent less than two hours (mean +/- S.D. = 97.5 +/- 34.22 min) using the manual. For the study group, posttest scores were significantly higher than pretest scores. The difference in pretest scores for the study and control groups was not significant, but for the posttest the study group scores were significantly higher. Because use of the manual appeared to improve knowledge of drug therapy and procedures used in CPR, the pharmacy department incorporated it into its orientation procedure.

Education, Pharmacy, Continuing↗
PubMed1994

Computer-based vs manual health maintenance tracking. A controlled trial.

OBJECTIVE: To compare computer-based with manual health maintenance tracking systems to determine whether (1) a computer-based system will result in better provider compliance with the practice health maintenance protocol, (2) the incremental cost of operating a computer-based vs a manual health maintenance tracking system differs, and (3) inactive patients will respond to health maintenance reminders. DESIGN: Two-year prospective, randomized, controlled trial. SETTING: Rural, multiple-office, nonprofit, fee-for-service family practice. PATIENTS: Adult members of families in which at least one member had been seen by the practice within the past 2 years. INTERVENTION: A computer-based health maintenance tracking system that generated annual provider and patient reminders for all patients regardless of appointment status compared with a manual flowchart-based tracking system in which patient reminders were triggered by provider request. OUTCOME MEASURES: Provider compliance with the health maintenance protocol determined by preintervention and postintervention chart audits, costs of computer-based tracking, and response of inactive patients to health maintenance reminders. RESULTS: Overall provider compliance with the health maintenance protocol increased 15 percentage points in the computer-based tracking group and four percentage points in the manual group. The computer-based tracking group had significantly higher provider compliance than the manual group for eight of 11 procedures. The computer-based tracking system cost 78 cents per patient per year to operate. It was not associated with increased office visits or patient billings. CONCLUSIONS: Computer-based health maintenance tracking improved provider health maintenance compliance compared with a manual system. The finding that health maintenance compliance improved without a significant increase in patient visits or billings requires confirmation in other settings but suggests that considerable health maintenance can be incorporated into ongoing patient care.

Adult↗