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At least 19 recordsLinked to original sources
PubMed2000

Manual therapy for asthma.

BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms of action are commonly used to treat patients with asthma. Manual therapy practitioners are also varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic physicians. A systematic review across disciplines is warranted. OBJECTIVES: To evaluate the evidence for the effects of manual therapies for treatment of patients with bronchial asthma. SEARCH STRATEGY: Trials were searched in computerized general (EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane Rehabilitation Field, ICL, and MANTIS). In addition, bibliographies from included studies were assessed, and authors of known studies were contacted for additional information about published and unpublished trials. Date of most recent search: December 1998. SELECTION CRITERIA: Trials were included if they: (1) were randomised; (2) included asthmatic children or adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes. DATA COLLECTION AND ANALYSIS: All three reviewers independently extracted data and assessed trial quality using a standard form. MAIN RESULTS: From an initial 316 unique citations, 48 full text articles were retrieved and evaluated, which resulted in nine citations to five RCTs (290 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed. One small trial compared chest physiotherapy to placebo and one small trial compared footzone therapy to a no treatment control. Neither trial found differences in lung function between groups. REVIEWER'S CONCLUSIONS: There is insufficient evidence to support the use of manual therapies for patients with asthma. There is a need to conduct adequately-sized RCTs that examine the effects of manual therapies on clinically relevant outcomes. Future trials should maintain observer blinding for outcome assessments, and report on the costs of care and adverse events. Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma.

Adult↗
PubMed1999

The health impact of smoking in manual and non-manual social class men and women: a test of the Blaxter hypothesis.

Blaxter has hypothesized that harmful behavioral habits like smoking have a greater impact on health in the non-manual than in the manual social classes, possibly because other adverse exposures have a more important role in the manual social classes. However, the outcome measure used was a composite measure of physiological indices of morbidity and the relevance of this to other health problems is uncertain. We have therefore investigated the effect of smoking on mortality, to test whether the risk of death associated with smoking differs between manual and non-manual social classes. Data on 6831 men and 7993 women, aged 45-64 when screened in the Renfrew and Paisley study, a large prospective observational study in the West of Scotland, have been analyzed. All cause mortality rate ratios for smokers compared with never smokers have been calculated within manual and non-manual social classes. Although the age adjusted rate ratios are slightly higher among the non-manual men and women (2.19 [1.83-2.61] versus 1.92 [1.71-2.17] for non-manual and manual men respectively, and 1.75 [1.54-1.99] versus 1.65 [1.50-1.82] for non-manual and manual women), this difference between social classes is not statistically significant (p-values for test of difference 0.26 and 0.47 for men and women respectively). When additionally adjusted for other risk factors, cardiorespiratory symptoms and deprivation, this picture remained the same (p-values for test of difference are 0.41 and 0.50 for men and women respectively). Similar results were found when the cohort was divided by deprivation categories rather than social classes or when smoking related mortality rather than mortality from all causes was used as the outcome measure. We therefore conclude that the health impact of smoking is similar in each socio-economic group. The relative health improvement consequent on smoking cessation is thus similar in different socio-economic groups.

Aged↗
PubMed2003

Elimination of instrument-driven reflex manual differential leukocyte counts. Optimization of manual blood smear review criteria in a high-volume automated hematology laboratory.

Automated peripheral blood leukocyte differential counts (LDCs) are widely accepted in routine practice. However, many laboratories still reflexively perform manual LDCs based solely on abnormal automated results or instrument "flags," before any manual triage step. We describe our transition to a procedure that uses manual methods to validate, rather than to replace, automated LDCs (an approach recommended early in the development of automated methods, but still not used in many clinical laboratories). Manual microscopic scans were performed in lieu of manual LDCs. Each scan that revealed cell types not quantifiable by the instrument triggered a manual LDC. However, if the manual scan simply confirmed the cell types seen on automated LDC, then the automated result was released, even if clinically significant quantitative abnormalities were present. This policy reduced manual LDCs by more than 70% and was validated by a manual retrospective audit. Patient care and laboratory operations can be optimized by using manual microscopic examination as a validation procedure rather than as a reflexive substitute for automated methods. There is no clinical rationale for reflex performance of manual LDCs based solely on instrument warnings.

Automation↗
PubMed1990

Policy and procedure manual: keeping a high quality manual.

Policy and procedure manuals are now commonly used in hospitals. The policy and procedure manual provides critical care nurses with a wealth of information. Policies are developed to guide the staff to perform nursing care adequately. Together policies and the corresponding procedures let critical care nurses know how to proceed to meet the organisation and the unit goals. As critical care expands the number of policies increases, which may make it more difficult to find a specific policy quickly. Critical care nurses need to look at other solutions for communicating some necessary pieces of information and check to make sure that policy is stated briefly, to the point and logical. It is also necessary to check to see if the information included in the manual is policy and associated procedures. If it is drug information, equipment usage, standards of care, or patient/family teaching material it could be incorporated in a different format or separate manual. As care givers nurses must monitor policies and procedures that are written and make sure they are simple to read, logically written, and easy to find.

Critical Care↗
PubMed1982

The technical manual and the diagnostic manual for the basic radiological system.

An Advisory Group for the World Health Organization has devised a technique manual for use with the Basic Radiological System (BRS). This provides a step-by-step illustration for all the techniques which are likely to be required in rural or small hospitals anywhere. The manual can be modified to match the BRS units produced by different manufacturers. The cooperation of the local trained radiographers will be necessary at the time of installation. A similar manual has been produced for hand-processing using a time-temperature relationship. A diagnostic interpretation manual has been devised to match the BRS projections. This will aid the doctor who has to interpret the films without a radiologist.

Manuals as Topic↗
PubMed1991

Manual laterality in nonhuman primates: a distinction between handedness and manual specialization.

This article examines individual and group manual lateralization in nonhuman primates as a function of task's demands. It is suggested to distinguish low- from high-level manual activities with respect to the novelty variable and to the spatiotemporal scale of the movements. This review shows that low-level tasks lead to (a) symmetrical distributions of hand biases for the group and (b) manual preferences that are not indicative of the specialization of the contralateral hemisphere. In contrast, behaviors expressed in high-level tasks (a) show asymmetrical distribution of hand biases for the group and (b) seem to be related to a specialization of the contralateral hemisphere. Two types of lateralization, handedness and manual specialization, correspond to the 2 levels of tasks that are distinguished.

Animals↗
PubMed1999

Analysis of multiple activity manual materials handling tasks using A Guide to Manual Materials Handling.

Manual handling of materials continues to be a hazardous activity, leading to a very significant number of severe overexertion injuries. Designing jobs that are within the physical capabilities of workers is one approach ergonomists have adopted to redress this problem. As a result, several job design procedures have been developed over the years. However, these procedures are limited to designing or evaluating only pure lifting jobs or only the lifting aspect of a materials handling job. This paper describes a general procedure that may be used to design or analyse materials handling jobs that involve several different kinds of activities (e.g. lifting, lowering, carrying, pushing, etc). The job design/analysis procedure utilizes an elemental approach (breaking the job into elements) and relies on databases provided in A Guide to Manual Materials Handling to compute associated risk factors. The use of the procedure is demonstrated with the help of two case studies.

Accidents, Occupational↗
PubMedDate not supplied

[Reliability of manual medical examination techniques of the cervical spine. Study of quality assurance in manual diagnosis].

OBJECTIVE: Chiropractic techniques are of particular importance for the examination of the cervical spine. The aim of this study was to assess interexaminer reliability of examination techniques of the cervical spine in subjects with and without musculoskeletal distortions of the neck. The interrater method was used with five independent examiners. METHOD: Twenty patients suffering from neck diseases and 20 asymptomatic subjects of similar age and gender were randomized and assessed by five examiners blind to patient histories. Statistical analysis was carried out using multiple logistic regression and the calculation of kappa. RESULTS: Compared to asymptomatic subjects, patients experienced pain significantly often when pressure was applied to the cervical zygapophysial joints and the superficial neck muscles (p < or = 0.05 and p < or = 0.01). In addition, segmental function tests induced kinesialgia significantly more often in patients than in asymptomatic subjects (p < or = 0.05 and p < or = 0.01). A significant relationship was not found between the patient's health status and the findings from muscle palpation and functional examination of the motion segments. The assessment of agreement within examiners beyond chance had to be calculated, aside from for few exceptions, little to moderate (0.2 < kappa < or = 0.6). CONCLUSIONS: Chiropractic techniques are an essential part of every examination of the cervical spine. The clinical impact has not been scientifically established until up to now. Based on our findings and literature, we conclude that interexaminer reliability of manual diagnosis in the examination of the cervical spine should be improved by standardizing the examination process and setting guidelines for documentation and evaluation criteria. Controlled and frequently repeated training sessions also contribute to the reproducibility of findings from manual examinations.

Adult↗
PubMed2003

Inadequacy of manual cleaning for reprocessing single-use, triple-lumen sphinctertomes: simulated-use testing comparing manual with automated cleaning methods.

BACKGROUND AND AIMS: Despite widespread reuse of single-use sphinctertomes, publications regarding the adequacy of reprocessing are conflicting and the cautery wire channel is seldom evaluated. Our objective was to use thickened artificial test soil containing microorganisms to perform simulated-use tests combined with in-situ and destructive testing to evaluate cleaning efficacy and ethylene oxide sterilization of single-use triple lumen sphinctertomes. METHODS: New triple-lumen sphinctertomes were soiled with thickened artificial test soil containing 6 log(10) per milliliter of Enterococcus faecalis and Bacillus stearothermophilus by inoculation through the distal end and dried for 1 hour, 24 hours, or 7 days before cleaning. The efficacy of manual cleaning was compared with that of automated cleaning with the Medisafe SI-Auto narrow-lumen cleaner. After cleaning, Bradford's reagent was injected into the channels as a direct method of detecting residual protein. Destructive testing was done to determine the levels of residual protein, carbohydrate, hemoglobin, endotoxin, and viable bacteria in the cleaned device. Destructive sterility testing of the devices also was performed after ethylene oxide sterilization. RESULTS: Both in-situ and destructive testing demonstrated that manual cleaning and automated washers connected via the luer ports did not remove soil or organisms from the cautery wire channel. Only retro-flushing in the SI-Auto provided adequate cleaning of all 3 channels. If reprocessing was delayed for more than 24 hours, retro-flush cleaning was no longer effective. Ethylene oxide sterilization failure was detected only for devices held for 7 days before cleaning and sterilization. In-use testing showed that patient secretions gained access to the cautery wire channel. CONCLUSIONS: Only retro-flushing done within 24 hours of use provided adequate cleaning for multi-lumen, single-use sphinctertomes. Our data validate the efficacy of reprocessing sphinctertomes once with SI-Auto retro-flush cleaning followed by 2 hours of ethylene oxide sterilization.

Cross Infection↗
PubMed1976

Computer printing and filing of microbiology reports. 2. Evaluation and comparison with a manual system, and comparison of two manual systems.

A manual system of microbiology reporting with a National Cash Register (NCR) form with printed names of bacteria and antiboitics required less time to compose reports than a previous manual system that involved rubber stamps and handwriting on plain report sheets. The NCR report cost 10-28 pence and, compared with a computer system, it had the advantages of simplicity and familarity, and reports were not delayed by machine breakdown, operator error, or data being incorrectly submitted. A computer reporting system for microbiology resulted in more accurate reports costing 17-97 pence each, faster and more accurate filing and recall of reports, and a greater range of analyses of reports that was valued particularly by the control-of-infection staff. Composition of computer-readable reports by technicians on Port-a-punch cards took longer than composing NCR reports. Enquiries for past results were more quickly answered from computer printouts of reports and a day book in alphabetical order.

Attitude↗
PubMed1989

Manual behavior, lateralization of manual skills and cognitive performance of preschool children.

Direction and degree of manual specialization (functional asymmetry between the hands) on a pegboard task, and fine motor ability (total number of pegs inserted) of both hands were correlated with verbal and visuospatial performances for 47 preschool children. No significant differences were found between right-, and left-, and mixed-handers even though the best motor skills were shown by the 6 mixed-handed subjects, who also had the highest scores on cognitive tasks. Verbal and visuospatial performances were not correlated with degree or direction of manual specialization. They were instead correlated with the level of motor ability of both hands. Motor maturation should be viewed, then, as a process that implies a richer motor performance of both hands and could be interpreted as a more specific diagnostic parameter than the traditional indices of handedness in cognitive fields.

Child Development↗
PubMed1980

[Studies on the influence of mixing ratio and manual or mechanical mixinng ratio and manual or mechanical mixing on physical properties of composites (author's transl)].

The study was carried out in order to see whether the physical properties (microhardness, cone-flow-point, compressive strength, abrasion resistance, density, dimensional change adherence to enamel) of the powder-liquid- composite are dependent upon the processing conditions (powder-liquid-ratio, manual or mechanical mixing). We found that the higher the powder-liquid-ratio the higher the microhardness, compressive strength, density and the least the volume contraction. The abrasion resistance and the adherence to enamel depended not significantly upon the mixing ratio. In a manual mixed composite the highest cone-flow-point has been found to lie between a high and a low powder-liquid-ratio. All this findings show clearly that a standardized powder-liquid-ratio is a necessary prerequisite to an optimal quality of the composite. This optimal ratio can be guaranteed by a proper predosage in capsules. Mechanical mixing increased the microhardness, cone-flow-point, compressive strength and density. This fact is due to homogenity and small porosity. Mechanical mixed and injection-capsule composites are recommendable.

Biomechanical Phenomena↗
PubMed1986

Concurrent performance of rhythmically compatible or incompatible vocal and manual tasks: evidence for two sources of interference in verbal-manual timesharing.

Forty-two normal, right-handed adults performed rhythmic finger tapping with the left or right hand while concurrently reciting sentences that were either compatible or incompatible with the rhythm being tapped. Both kinds of sentences slowed tapping equally, and the interference was lateralized so that the right hand was affected more than the left. In contrast, the regularity of finger tapping was disrupted to a much greater degree by incompatible sentences than by compatible sentences, and the effect was comparable in the left and right hands. The results implicate two mechanisms of verbal-manual interference--capacity limitation and timing constraints--and thus reconcile certain inconsistencies among findings from previous concurrent-task studies.

Adolescent↗
PubMed1997

Verbal-to-manual and manual-to-verbal dual-task interference in left-handed and right-handed adults.

Verbal-manual interference was investigated with 80 students who were divided into four groups by sex and hand preference. Unilateral finger-tapping was measured during no-load conditions and during two concurrent tasks of word reading (aloud) and sentence reading (silent). During concurrent tasks, no selective interference effects for the preferred hand were found; however, when participants were classified according to consistent handedness instead of hand preference, consistent right-handers exhibited selective right-hand tapping interference during concurrent word reading, whereas consistent left-handers showed generalized interference. During concurrent sentence reading, men showed selective right-hand interference, irrespective of handedness. The influence of tapping on word reading was also examined. Concurrent tapping lowered word-reading performance substantially, showing that finger-tapping and word reading interfered reciprocally.

Adolescent↗