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  1. French translation and cross-cultural adaptation of the Michigan Hand Outcomes Questionnaire and the Brief Michigan Hand Outcomes Questionnaire.

    Efanov, J I; Shine, J J; Darwich, R; Besner Morin, C; Arsenault, J; Harris, P G; Danino, A M; Izadpanah, A

    2018-04-01

    Patient-Reported Outcome Measures (PROMs) are important clinical devices for evaluating injuries and surgeries of the hand. However, some of the most widely used questionnaires, such as the MHQ and bMHQ, are currently unavailable in French, which prevents them from being used in the French Canadian province of Quebec as well as in other French-speaking nations. We therefore intend to develop valid and culturally adapted French translations of the afore-mentioned questionnaires. Two independent bilingual translators converted all English questionnaires to French. Two distinct translators then translated the French versions back to English in reverse-blinded fashion. Discrepancies between the original and second English versions were examined by a committee of four bilingual healthcare professionals before final French translations of all documents were produced. Thirty patients bilingual in French and English were then asked to complete the original and French versions of the MHQ and bMHQ. Their answers were compared in order to assess the accuracy of our translation. In light of these findings, revised French versions were produced. French versions of the MHQ and bMHQ questionnaires produced metrological qualities of validity and fidelity with an inter-class correlation superior to 0.90 and a kappa coefficient of 0.81 to 1. Clinical applicability revealed the distribution of scores according to disease process was reproducible between the English and French versions. PROM translation requires a rigorous process in order to achieve strong metrological qualities in both the original and translated versions. We produced French translations of the MHQ and bMHQ by abiding to the Beaton method of cross-cultural adaptation of self-reported measures. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  2. Cross-cultural adaptation, validation, and reliability of the Michigan Hand Outcomes Questionnaire among Persian population.

    Ebrahimzadeh, Mohammad H; Birjandinejad, Ali; Kachooei, Amir Reza

    2015-01-01

    We aimed to validate a cross-culturally adapted version of the Persian Michigan Hand Outcomes Questionnaire (MHOQ). We followed the Beaton's guideline to translate the questionnaire to Persian. We administered the final version to 223 patients among which 79 patients returned 3 days later to respond to the Persian MHOQ for the second time. In the first visit, respondents also filled the Disabilities of the Arm Shoulder and Hand (DASH) and rated the pain based on the Visual Analogue Scale (VAS). Cronbach's alpha for the total MHOQ was 0.79 which showed good internal consistency. Intraclass correlation coefficient (ICC) for the total MHOQ was 0.84 which demonstrated good reliability between test and retest. The absolute correlation coefficient between total MHOQ and the DASH was as high as 0.74. Persian version of the MHOQ proved to be a reliable and valid instrument to be implemented among Persian population with the hand and wrist disorders.

  3. Cultural adaptation of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome: A Turkish version study

    Ilker Ilhanli

    2015-03-01

    Full Text Available Objective: Cultural adaptations of the questionnaires are important for easy use. We aimed to assess the reliability and validity of the Turkish Version of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome. Methods: To assess test-retest reliability, the Turkish “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaires were answered by patients and controls and were repeated a week later. For testing internal consistency, the Cronbach's alpha test was used. For testing validity, correlations between the subscales of the “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaire were measured in patient groups. One hundred patients with idiopathic Carpal Tunnel Syndrome and 50 healthy participants were included in the study. Results: In test-retest reliability, intraclass correlations of the subscales of the “Michigan Hand Outcomes Questionnaire” were high. Cronbach's alphas were found to be high in all subscales. There was no significant correlation between asthetics and pain scales. We found significant differences between patients and controls regarding all subscales of the “Michigan Hand Outcomes Questionnaire”. Correlations between subscales of the “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaire were significant. We found no difference between one-hand effected and two-hand effected patients, in terms of the “Michigan Hand Outcomes Questionnaire”, “Disabilities of Arm, Shoulder and Hand” questionnaire Function/Symptom and Work average scores. Conclusion: This study showed that the Turkish version of the “Michigan Hand Outcomes Questionnaire” is reliable and valid and can be used in Turkish patients with Carpal Tunnel Syndrome because it is comprehensible and practicable

  4. Translation and cultural adaptation of the Brief Michigan Hand Questionnaire to Brazilian Portuguese language.

    Fernandes, Carlos Henrique; Neto, Jorge Raduan; Meirelles, Lia Miyamoto; Pereira, Carina Nascimento Mastrocinque; Dos Santos, João Baptista Gomes; Faloppa, Flavio

    2014-09-01

    The use of patient-reported outcome questionnaires is recommended in orthopedic studies. However, validated tools are necessary to ensure the comparability of results across different studies, centers, and countries. The Brief Michigan Hand Questionnaire (BMHQ) can be used for outcome measures in self-evaluation after carpal tunnel release. This study aimed to translate the BMHQ to Portuguese to permit cross-cultural adaptation to Brazilians patients. We translated the Brief Michigan Hand Questionnaire from the original version (English) to Brazilian Portuguese. The translation and cultural adaptation of the content of this tool consisted of six stages, according to the methodology proposed by medical literature: (1) initial translation of the questionnaire by two independent translators; (2) synthesis of translations and reconciliation; (3) back-translation to English of the reconciled version; (4) verification of the cultural equivalence process by an expert committee; (5) pre-testing in a sample of patients to verify understanding of the items; and (6) development of a final version of the BMHQ. The pre-final version of the tool was applied to 43 patients to verify its understanding. Pre-testing showed that the questions and options were satisfactorily understood. The number of items from the original English version was maintained in the Brazilian Portuguese version of BMHQ. The Brazilian Portuguese version of the BMHQ is easily understood by patients and will be useful to clinicians and researchers.

  5. Three-question set from Michigan Neuropathy Screening Instrument adds independent prognostic information on cardiovascular outcomes

    Seferovic, Jelena P; Pfeffer, Marc A; Claggett, Brian

    2018-01-01

    AIMS/HYPOTHESIS: The self-administered Michigan Neuropathy Screening Instrument (MNSI) is used to diagnose diabetic peripheral neuropathy. We examined whether the MNSI might also provide information on risk of death and cardiovascular outcomes. METHODS: In this post hoc analysis of the Aliskiren...

  6. Toddler hand preference trajectories predict 3-year language outcome.

    Nelson, Eliza L; Gonzalez, Sandy L; Coxe, Stefany; Campbell, Julie M; Marcinowski, Emily C; Michel, George F

    2017-11-01

    A growing body of work suggests that early motor experience affects development in unexpected domains. In the current study, children's hand preference for role-differentiated bimanual manipulation (RDBM) was measured at monthly intervals from 18 to 24 months of age (N = 90). At 3 years of age, children's language ability was assessed using the Preschool Language Scales 5th edition (PLS™-5). Three distinct RDBM hand preference trajectories were identified using latent class growth analysis: (1) children with a left hand preference but a moderate amount of right hand use; (2) children with a right hand preference but a moderate amount of left hand use; and (3) children with a right hand preference and only a mild amount of left hand use. Stability over time within all three trajectories indicated that children did not change hand use patterns from 18 to 24 months. Children with the greatest amount of preferred (i.e., right) hand use demonstrated higher expressive language scores compared to children in both trajectories with moderate levels of non-preferred hand use. Children with the greatest amount of right hand use also had higher scores for receptive language compared to children with a right hand preference but moderate left hand use. Results support that consistency in handedness as measured by the amount of preferred hand use is related to distal language outcomes in development. © 2017 Wiley Periodicals, Inc.

  7. Hand osteoarthritis : natural course and determinants of outcome

    Bijsterbosch, Jessica

    2013-01-01

    We investigated the clinical and radiographic disease course of hand osteoarthritis as well as determinants of poor clinical outcome and radiographic progression over a period of six years in 289 patients with hand osteoarthritis. Because these patients had osteoarthritis at multiple joints this

  8. Hard Times: The Effects of Financial Strain on Home Care Services Use and Participant Outcomes in Michigan

    D'Souza, Jennifer C.; James, Mary L.; Szafara, Kristina L.; Fries, Brant E.

    2009-01-01

    Purpose: When government funding for long-term care is reduced, participant outcomes may be adversely affected. We investigated the effect of program resources on individuals enrolled in the Michigan Home- and Community-Based Services (HCBS) waiver program for elderly and disabled adults. Design and Methods: Using dates of major policy and budget…

  9. Accidental outcomes guide punishment in a "trembling hand" game.

    Fiery Cushman

    Full Text Available How do people respond to others' accidental behaviors? Reward and punishment for an accident might depend on the actor's intentions, or instead on the unintended outcomes she brings about. Yet, existing paradigms in experimental economics do not include the possibility of accidental monetary allocations. We explore the balance of outcomes and intentions in a two-player economic game where monetary allocations are made with a "trembling hand": that is, intentions and outcomes are sometimes mismatched. Player 1 allocates $10 between herself and Player 2 by rolling one of three dice. One die has a high probability of a selfish outcome, another has a high probability of a fair outcome, and the third has a high probability of a generous outcome. Based on Player 1's choice of die, Player 2 can infer her intentions. However, any of the three die can yield any of the three possible outcomes. Player 2 is given the opportunity to respond to Player 1's allocation by adding to or subtracting from Player 1's payoff. We find that Player 2's responses are influenced substantially by the accidental outcome of Player 1's roll of the die. Comparison to control conditions suggests that in contexts where the allocation is at least partially under the control of Player 1, Player 2 will punish Player 1 accountable for unintentional negative outcomes. In addition, Player 2's responses are influenced by Player 1's intention. However, Player 2 tends to modulate his responses substantially more for selfish intentions than for generous intentions. This novel economic game provides new insight into the psychological mechanisms underlying social preferences for fairness and retribution.

  10. The use of an iPad to collect patient-reported functional outcome measures in hand surgery.

    Yaffe, Mark; Goyal, Nitin; Kokmeyer, Daniel; Merrell, Gregory A

    2015-09-01

    The purpose of this study was to evaluate (1) patient preferences regarding iPad and paper-based questionnaires, (2) the efficacy of iPad and paper questionnaires in a hand surgery practice, (3) the influence of questionnaire length on patient preferences and data collection, and (4) patient characteristics associated with a preference for iPad-based questionnaires. Two hundred total patients in a single hand surgery practice were randomly assigned to one of four groups. Each group completed either the Michigan Hand Questionnaire (MHQ) or QuickDASH (QD) using either an iPad or pen and paper. Patient preferences, questionnaire completion and timing, and demographic data were analyzed. The use of an iPad was associated with a statistically stronger preference for the same delivery format in the future compared to paper for the MHQ (93.9 vs 52.1 %, p iPad group found the survey "physically easy" more often compared to the MHQ paper group, while no difference was found among QD groups. Questionnaire timing between iPad and paper groups was similar for the MHQ but statistically longer with the iPad for QD. A significantly higher proportion of patients who preferred the iPad were under the age of 50 compared to those who preferred paper. The addition of an iPad is an efficient and preferable questionnaire format for functional outcome assessment in a hand and upper extremity surgery practice setting. The iPad is particularly preferable for longer outcome questionnaires and for patients under the age of 50.

  11. Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

    Marks, Miriam

    2014-01-01

    The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

  12. Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome.

    Ferree, Steven; van der Vliet, Quirine M J; van Heijl, Mark; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

    2017-04-01

    Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. A single centre retrospective cohort study was performed at a level 1 trauma centre. Polytrauma was defined as patients with an Injury Severity Score of 16 or higher. Fractures and dislocations to the hand were determined. All eligible polytrauma patients with hand injuries were included and a Quick Disability of Arm, Shoulder and Hand questionnaire (QDASH) and Patient-Rated Wrist/Hand Evaluation (PRWHE) were administered. Patients were contacted 1-6 years after trauma. In a cohort of 2046 polytrauma patients 72 patients (3.5%) suffered a hand injury. The functional outcome scores of 52 patients (72%) were obtained. The Metacarpal (48%) and carpal (33%) bones were the most frequently affected. The median QDASH score for all patients with hand injury was 17 (IQR 0-31) and the PRWHE 14 (IQR 0-41). Patients with a concomitant upper extremity injury (p=0.002 for PRWHE, p0.006 for QDASH) and those with higher ISS scores (p=0.034 for PRWHE, QDASH not significant) had worse functional outcome scores. As an example, of the 5 patients with the worst outcome scores 3 suffered an isolated phalangeal injury, all had concomitant upper extremity injury or neurological injuries (3 plexus injuries, 1 severe brain injury). The incidence of hand injuries in polytrauma patients is 3.5%, which is relatively low compared to a general trauma population. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries (upper extremity injuries, neurological injuries and higher ISS). Copyright © 2017 Elsevier Ltd. All

  13. Fractures and dislocations of the hand in polytrauma patients : Incidence, injury pattern and functional outcome

    Ferree, Steven; van der Vliet, Quirine M J; van Heijl, Mark; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

    INTRODUCTION: Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence,

  14. Comparison of donor, and early and late recipient outcomes following hand assisted and laparoscopic donor nephrectomy.

    Lucas, Steven M; Liaw, Aron; Mhapsekar, Rishi; Yelfimov, Daniel; Goggins, William C; Powelson, John A; Png, Keng Siang; Sundaram, Chandru P

    2013-02-01

    While laparoscopic donor nephrectomy has encouraged living kidney donation, debate exists about the safest laparoscopic technique. We compared purely laparoscopic and hand assisted laparoscopic donor nephrectomies in terms of donor outcome, early graft function and long-term graft outcome. We reviewed the records of consecutive laparoscopic and hand assisted laparoscopic donor nephrectomies performed by a single surgeon from 2002 to 2011. Donor operative time and perioperative morbidity were compared. Early graft function for kidneys procured by each technique was evaluated by rates of delayed graft function, need for dialysis and recipient discharge creatinine. Long-term outcomes were evaluated by graft function. A total of 152 laparoscopic donor nephrectomies were compared with 116 hand assisted laparoscopic donor nephrectomies. Hand assisted procedures were more often done for the right kidney (41.1% vs 17.1%, p recipient outcomes were also similar. Delayed function occurred after 0% hand assisted vs 0.9% purely laparoscopic nephrectomies, dialysis was required in 0.9% vs 1.7% and rejection episodes developed in 9.7% vs 18.4% (p >0.05). At last followup the organ was nonfunctioning in 6.1% of hand assisted and 7.7% of purely laparoscopic cases (p >0.05). The recipient glomerular filtration rate at discharge home was similar in the 2 groups. Hand assisted laparoscopic donor nephrectomy had shorter warm ischemia time but perioperative donor morbidity and graft outcome were comparable. The choice of technique should be based on patient and surgeon preference. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.

    Aragon, Daleen; Sole, Mary Lou; Brown, Scott

    2005-01-01

    Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.

  16. Favorable Responsiveness of the Hand10 Questionnaire to Assess Treatment Outcomes for Lateral Epicondylitis.

    Nishizuka, Takanobu; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Yamamoto, Michiro; Onishi, Tetsuro; Hirata, Hitoshi

    2018-06-01

    The aim of our study was to compare the responsiveness of the Hand10 questionnaire and the Pain visual analogue scale (VAS) for the assessment of lateral epicondylitis. The standardized response mean and effect size were used as indicators of responsiveness, measured at baseline and after 6 months of treatment. Among the 54 patients enrolled, 28 were treated using a forearm band, compress and stretching, with the other 26 patients treated using compress and stretching. The standardized response mean and the effect size were 1.18 and 1.38, respectively, of the Hand10 and 1.39 and 1.75, respectively, for the Pain VAS. The responsiveness of both tests was considered to be large, based on Cohen's classification of effect size, supporting the use of the Hand10 questionnaire to assess treatment outcomes for lateral epicondylitis.

  17. Sexuality and fertility outcomes after hand sewn versus stapled ileal pouch anal anastomosis for ulcerative colitis.

    Harnoy, Yann; Desfourneaux, Véronique; Bouguen, Guillaume; Rayar, Michel; Meunier, Bernard; Siproudhis, Laurent; Boudjema, Karim; Sulpice, Laurent

    2016-01-01

    Ileal pouch anal anastomosis (IPAA) may alter sexuality and fertility in women. The laparoscopic approach seems to reduce infertility rates in women after IPAA. However, the impact of hand sewn versus stapled IPAA on sexuality and fertility has never been assessed in patients with ulcerative colitis (UC). The objective of this study was to analyze the impact of the IPAA technique on sexuality and fertility in UC. All UC patients who underwent an IPAA between May 1996 and April 2011 were included. The patients answered mailed questionnaires including sexuality validated questionnaires and fertility questionnaires. The risk factors of sexual dysfunction were explored. A total of 135 patients were included. Eighty-eight patients (65%) answered the questionnaires. Their mean age and follow-up were 37.2 ± 13.4 y and 109.7 ± 57.5 mo. The rates of female and male sexual dysfunction were 50% and 29%, respectively. Intestinal transit disorders were identified as risk factors in both men and women and anastomotic stricture in women sexual dysfunction, in univariate analyses. The IPAA technique did not impact sexual function in women but there was a trend for less erectile dysfunction after hand sewn IPAA (16.7% versus 44.4%). The fertility rate was 47% in women and 75% in men, with a trend for a better fertility in women after hand sewn IPAA (P = 0.07). In this preliminary study, the hand sewn or stapled IPAA technique did not impact the sexuality or fertility outcomes of UC patients, but there was a trend for better female fertility and male erectile function after hand sewn IPAA. Intestinal transit disorders contributed to male and female sexual dysfunction after IPAA. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. ADAPTATION OF DASH OUTCOME MEASURES TO SLOVENIAN POPULATION - FUNCTIONALITY OF ARM, SHOULDER AND HAND

    Katja Semprimožnik

    2015-04-01

    Full Text Available  ABSTRACT BackgroundIn Slovenia, there is no test for upper limb function, which would be uniform for all institutions and would allow comparison of results of the therapy and upper limb rehabilitation with medical centers. MethodsAfter reviewing the existing hand function tests and current literature we decided to translate the DASH test - Disabilities of arm, shoulder and hand. Adaptation was tested on patient population in outpatient hand clinic, General hospital Celje and showed good validity, reliability and responsiveness. Results and discussionAdaptation of DASH test to Slovene population is a procedure, where language and cultural differences must be considered. Testing the adapted DASH in the general population shows good validity, reliability and responsiveness of adapted test. ConclusionTranslations DASH test, QuickDASH test and instructions for scoring the DASH outcome measures are approved by the Institute for Work and Health. Translations are published on their site and available for use.

  19. Functional and cosmetic outcome of single-digit ray amputation in hand.

    Bhat, A K; Acharya, A M; Narayanakurup, J K; Kumar, B; Nagpal, P S; Kamath, A

    2017-12-01

    To assess patient satisfaction, functional and cosmetic outcomes of single-digit ray amputation in hand and identify factors that might affect the outcome. Forty-five patients who underwent ray amputation were evaluated, 37 males and eight females whose mean age was 36.6 years ranging between 15 and 67 years. Twenty-eight patients had dominant hand involvement. Twenty-one patients underwent primary ray amputation, and 24 patients had secondary ray amputation. Eight out of the 23 patients with central digit injuries underwent transposition. Grip strength, pinch strength, tactile sensibility and functional evaluation using Result Assessment Scale (RAS) and DASH score were analysed. Cosmetic assessment was performed using visual analogue scale (VAS) for cosmesis. Median time of assessment after surgery was 20 months. Average loss of grip strength and pinch strength was found to be 43.3 and 33.6%, respectively. Average RAS score was 3.75. Median DASH score was 23.4. Eighty-three percentage of patients had excellent or good cosmesis on the VAS. Transposition causes significant increase in DASH scores for central digit ray amputations but was cosmetically superior. Middle finger ray amputation had the maximum loss of grip strength, and index finger ray amputation had greater loss of pinch strength. Affection of neighbouring digits caused greater grip and pinch loss, and a higher DASH score. Primary ray resection decreased the total disability and eliminated the costs of a second procedure. Following ray amputation, one can predict an approximate 43.3% loss of grip strength and 33.6% loss of pinch strength. The patients can be counselled regarding the expected time off from work, amount of disability and complications after a single-digit ray amputation. Majority of the patients can return to the same occupation after a period of dedicated hand therapy. Therapeutic, Level III.

  20. An observational study of the hand hygiene initiative: a comparison of preintervention and postintervention outcomes

    Mukerji, Amit; Narciso, Janet; Moore, Christine; McGeer, Allison; Kelly, Edmond; Shah, Vibhuti

    2013-01-01

    Objectives To evaluate the impact of implementing a simple, user-friendly eLearning module on hand hygiene (HH) compliance and infection rates. Design Preintervention and postintervention observational study. Participants All neonates admitted to the neonatal intensive care unit (NICU) over the study period were eligible for participation and were included in the analyses. A total of 3422 patients were admitted over a 36-month span (July 2009 to June 2012). Interventions In the preintervention and postintervention periods (phases I and II), all healthcare providers were trained on HH practices using an eLearning module. The principles of the ‘4 moments of HH’ and definition of ‘baby space’ were incorporated using interactive tools. The intervention then extended into a long-term sustainability programme (phase III), including the requirement of an annual recertification of the module and introduction of posters and screensavers throughout the NICU. Primary and secondary outcome measures The primary outcome was HH compliance rates among healthcare providers in the three phases. The secondary outcome was healthcare-associated infection rates in the NICU. Results HH compliance rates declined initially in phase II then improved in phase III with the addition of a long-term sustainability programme (76%, 67% and 76% in phases I, II and III, respectively (pchallenging to implement and sustain with the need for ongoing reinforcement and education. PMID:23793705

  1. A retrospective outcomes study examining the effect of interactive metronome on hand function.

    Shank, Tracy M; Harron, Wendy

    2015-01-01

    Interactive Metronome (IM, The Interactive Metronome Company, Sunrise, Florida, USA) is a computer-based modality marketed to rehabilitation professionals who want to improve outcomes in areas of coordination, motor skills, self-regulation behaviors, and cognitive skills. This retrospective study examined the efficacy of IM training on improving timing skills, hand function, and parental report of self-regulatory behaviors. Forty eight children with mixed motor and cognitive diagnoses completed an average of 14 one-hour training sessions over an average of 8.5 weeks in an outpatient setting. Each child was assessed before and after training with the Interactive Metronome Long Form Assessment, the Jebsen Taylor Test of Hand Function, and a parent questionnaire. All three measures improved with statistical significance despite participants having no direct skill training. These results suggest an intimate relationship between cognition and motor skills that has potential therapeutic value. Level 4, Retrospective Case Series. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  2. The Takei Handheld Dynamometer: An Effective Clinical Outcome Measure Tool for Hand and Wrist Function in Boxing.

    Gatt, Ian; Smith-Moore, Sophie; Steggles, Charlie; Loosemore, Mike

    2018-05-01

    The aim of this article was to explore retrospectively the Takei dynamometer as a valid and reliable outcome measure tool for hand and wrist pathology in the Great Britain amateur boxing squad between 2010 and 2014. Longitudinal retrospective injury surveillance of the Great Britain boxing squad was performed from 2010 to 2014. The location, region affected, description, and duration of each injury were recorded by the team doctor and team physiotherapists. For each significant injury, we recorded hand grip scores using the Takei handheld dynamometer and compared the scores with baseline measures. At the hand, fractures and dislocations were highly detected with an average difference of 40.2% ( P 20% should be highly considered for significant pathology. The Takei dynamometer is a valid and reliable outcome measure tool for hand and wrist pathologies in boxing. Our study highlights the importance of appropriate clinical tools to guide injury management in this sport.

  3. Assessment of the University of Michigan's dental hygiene partnership with the Huron Valley Boys & Girls Club: a study of students' and staffs' perceptions and service learning outcomes.

    Christensen Brydges, Sarah; Gwozdek, Anne E

    2011-01-01

    The Boys & Girls Club of America (BGCA) requires a health curriculum be taught. With the assistance of the University of Michigan (UM) Dental Hygiene program, these requirements have been addressed at the Huron Valley Boys & Girls Club (HVBGC) through dental hygiene students presenting oral health education to club members throughout the year. This study assessed the outcomes and benefits of the service learning initiative between the UM Dental Hygiene Program and the HVBGC from both the students' and staffs' perceptions. Three surveys were distributed: one to the HVBGC staff, one to UM's Dental Hygiene class of 2012 (with no service learning experience at the HVBGC) and one to UM Dental Hygiene classes of 2010 and 2011 (most of whom had experience at the HVBGC). Qualitative and quantitative data were collected and evaluated. The respondents from the class of 2012 were less knowledgeable about the BGCA and access to care issues. The members of the classes of 2010 and 2011, 79% of whom had HVBGC experience, identified they had benefitted from this service learning experience. The HVBGC staff survey indicated a high level of satisfaction with the student presentations and felt their curricular requirements were being met. Future topics of safety, orthodontics and gardening/nutrition were identified. This study indicates the service learning initiative has been beneficial for both the UM Dental Hygiene students and the HVBGC. Future studies should use a longitudinal design to obtain baseline and post-service learning data.

  4. A randomized study comparing outcomes of stapled and hand-sutured anastomoses in patients undergoing open gastrointestinal surgery.

    Chandramohan, S M; Gajbhiye, Raj Narenda; Agwarwal, Anil; Creedon, Erin; Schwiers, Michael L; Waggoner, Jason R; Tatla, Daljit

    2013-08-01

    Although stapling is an alternative to hand-suturing in gastrointestinal surgery, recent trials specifically designed to evaluate differences between the two in surgery time, anastomosis time, and return to bowel activity are lacking. This trial compared the outcomes of the two in subjects undergoing open gastrointestinal surgery. Adult subjects undergoing emergency or elective surgery requiring a single gastric, small, or large bowel anastomosis were enrolled into this open-label, prospective, randomized, interventional, parallel, multicenter, controlled trial. Randomization was assigned in a 1:1 ratio between the hand-sutured group (n = 138) and the stapled group (n = 142). Anastomosis time, surgery time, and time to bowel activity were collected and compared as primary endpoints. A total of 280 subjects were enrolled from April 2009 to September 2010. Only the time of anastomosis was significantly different between the two arms: 17.6 ± 1.90 min (stapled) and 20.6 ± 1.90 min (hand-sutured). This difference was deemed not clinically or economically meaningful. Safety outcomes and other secondary endpoints were similar between the two arms. Mechanical stapling is faster than hand-suturing for the construction of gastrointestinal anastomoses. Apart from this, stapling and hand-suturing are similar with respect to the outcomes measured in this trial.

  5. Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

    Bianca Pinto Cunha

    Full Text Available Abstract Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax, maximal pinch grip strength (PGSMax, Jebsen-Taylor Hand Function Test (JTHFT and Nine Hole Peg Test (9-HPT. All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50 and between JTHFT and 9-HPT (r = 0.55. Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

  6. Functional and Psychosocial Outcomes of Hand Transplantation Compared with Prosthetic Fitting in Below-Elbow Amputees: A Multicenter Cohort Study.

    Stefan Salminger

    Full Text Available Hand-transplantation and improvements in the field of prostheses opened new frontiers in restoring hand function in below-elbow amputees. Both concepts aim at restoring reliable hand function, however, the indications, advantages and limitations for each treatment must be carefully considered depending on level and extent of amputation. Here we report our findings of a multi-center cohort study comparing hand function and quality-of-life of people with transplanted versus prosthetic hands.Hand function in amputees with either transplant or prostheses was tested with Action Research Arm Test (ARAT, Southampton Hand Assessment Procedure (SHAP and the Disabilities of the Arm, Shoulder and Hand measure (DASH. Quality-of-life was compared with the Short-Form 36 (SF-36.Transplanted patients (n = 5 achieved a mean ARAT score of 40.86 ± 8.07 and an average SHAP score of 75.00 ± 11.06. Prosthetic patients (n = 7 achieved a mean ARAT score of 39.00 ± 3.61 and an average SHAP score of 75.43 ± 10.81. There was no significant difference between transplanted and prosthetic hands in ARAT, SHAP or DASH. While quality-of-life metrics were equivocal for four scales of the SF-36, transplanted patients reported significantly higher scores in "role-physical" (p = 0.006, "vitality" (p = 0.008, "role-emotional" (p = 0.035 and "mental-health" (p = 0.003.The indications for hand transplantation or prosthetic fitting in below-elbow amputees require careful consideration. As functional outcomes were not significantly different between groups, patient's best interests and the route of least harm should guide treatment. Due to the immunosuppressive side-effects, the indication for allotransplantation must still be restrictive, the best being bilateral amputees.

  7. Advanced Myoelectric Control for Robotic Hand-Assisted Training: Outcome from a Stroke Patient.

    Lu, Zhiyuan; Tong, Kai-Yu; Shin, Henry; Li, Sheng; Zhou, Ping

    2017-01-01

    A hand exoskeleton driven by myoelectric pattern recognition was designed for stroke rehabilitation. It detects and recognizes the user's motion intent based on electromyography (EMG) signals, and then helps the user to accomplish hand motions in real time. The hand exoskeleton can perform six kinds of motions, including the whole hand closing/opening, tripod pinch/opening, and the "gun" sign/opening. A 52-year-old woman, 8 months after stroke, made 20× 2-h visits over 10 weeks to participate in robot-assisted hand training. Though she was unable to move her fingers on her right hand before the training, EMG activities could be detected on her right forearm. In each visit, she took 4× 10-min robot-assisted training sessions, in which she repeated the aforementioned six motion patterns assisted by our intent-driven hand exoskeleton. After the training, her grip force increased from 1.5 to 2.7 kg, her pinch force increased from 1.5 to 2.5 kg, her score of Box and Block test increased from 3 to 7, her score of Fugl-Meyer (Part C) increased from 0 to 7, and her hand function increased from Stage 1 to Stage 2 in Chedoke-McMaster assessment. The results demonstrate the feasibility of robot-assisted training driven by myoelectric pattern recognition after stroke.

  8. Outcomes of a pilot hand hygiene randomized cluster trial to reduce communicable infections among US office-based employees.

    Stedman-Smith, Maggie; DuBois, Cathy L Z; Grey, Scott F; Kingsbury, Diana M; Shakya, Sunita; Scofield, Jennifer; Slenkovich, Ken

    2015-04-01

    To determine the effectiveness of an office-based multimodal hand hygiene improvement intervention in reducing self-reported communicable infections and work-related absence. A randomized cluster trial including an electronic training video, hand sanitizer, and educational posters (n = 131, intervention; n = 193, control). Primary outcomes include (1) self-reported acute respiratory infections (ARIs)/influenza-like illness (ILI) and/or gastrointestinal (GI) infections during the prior 30 days; and (2) related lost work days. Incidence rate ratios calculated using generalized linear mixed models with a Poisson distribution, adjusted for confounders and random cluster effects. A 31% relative reduction in self-reported combined ARI-ILI/GI infections (incidence rate ratio: 0.69; 95% confidence interval, 0.49 to 0.98). A 21% nonsignificant relative reduction in lost work days. An office-based multimodal hand hygiene improvement intervention demonstrated a substantive reduction in self-reported combined ARI-ILI/GI infections.

  9. RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.

    Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon

    2017-06-01

    The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.

  10. A Randomized Study Comparing Outcomes of Stapled and Hand-Sutured Anastomoses in Patients Undergoing Open Gastrointestinal Surgery

    Chandramohan, S. M.; Gajbhiye, Raj Narenda; Agwarwal, Anil; Creedon, Erin; Schwiers, Michael L.; Waggoner, Jason R.; Tatla, Daljit

    2012-01-01

    Although stapling is an alternative to hand-suturing in gastrointestinal surgery, recent trials specifically designed to evaluate differences between the two in surgery time, anastomosis time, and return to bowel activity are lacking. This trial compared the outcomes of the two in subjects undergoing open gastrointestinal surgery. Adult subjects undergoing emergency or elective surgery requiring a single gastric, small, or large bowel anastomosis were enrolled into this open-label, prospectiv...

  11. Michigan Breast Reconstruction Outcomes Study

    Wilkins, Edwin

    1997-01-01

    ...: complication rates, aesthetic results, functional results, psychosocial status and costs. Study results will provide information to patients, providers, and payers for determining the procedure of choice...

  12. The use of joint mobilization to improve clinical outcomes in hand therapy: a systematic review of the literature.

    Heiser, Rick; O'Brien, Virginia H; Schwartz, Deborah A

    2013-01-01

    Systematic review. Joint mobilizations are used as an intervention for improving range of motion, decreasing pain and ultimately improving function in patients with a wide variety of upper extremity diagnoses. However, there are only a limited number of studies describing this treatment for conditions affecting the elbow, wrist, and hand. Furthermore, it is unclear as to the most effective joint mobilization technique utilized and the most beneficial functional outcomes gained. Examine the current evidence describing joint mobilizations for treatment of conditions of the elbow, wrist and hand, and offer informative practical clinical guidance. Twenty-two studies dated between 1980 and 2011 were included in the systematic review for analysis. The current evidence provides moderate support for the inclusion of joint mobilizations in the treatment of lateral epicondylalgia (LE). In particular, mobilization with movement as described by Mulligan is supported with evidence from nine randomized clinical trials as an effective technique for the treatment of pain. Other described techniques include those known as Kaltenborn, Cyriax physical therapy, and Maitland, but the evidence for these techniques is limited. There is also limited evidence for the joint mobilizations in the treatment of wrist and hand conditions. The current literature offers limited support for joint mobilizations of the wrist and hand, and moderate support for joint mobilizations of the elbow for LE. There is moderate support for mobilization with movement. . Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  13. Hands-On Open Access Broadband Wireless Technology Lab Mapping Course Outcomes to Lab Experiments

    Yazan Alqudah

    2012-10-01

    Full Text Available The unprecedented growth in wireless communication is offering opportunities and challenges for educators. Thanks to technology advances and job opportunities, more and more students are interested in wireless communications courses. However, bridging the gap between classroom and real-world experience remains a challenge. Advanced undergraduate communications courses typically focus more on theory. Some courses are given online, and lack hands-on experiments. Driven by feedback from industry and students, we propose practical laboratory experiments that attempt to bridge the gap between classroom and real world. The laboratory exercises take advantage of the infrastructure of deployed wireless networks and allow students to measure, and analyze data, as well as to interact. The proposed labs can be used even in online courses. This paper describes the experiments proposed, the procedures and typical results. The experiments are tied to course objective.

  14. Maternal Exposure to Second-hand Smoke and Super Ovulation Outcome for Assisted Reproduction

    Jila Ganji

    2009-01-01

    Full Text Available Background: The effect of smoking cigarettes is followed by diverse effects on ovaries anddeveloping follicles but the effect of passive smoking on ovarian function is unknown. On the otherhand, the ovarian response to induction is a very important step in assisted reproduction. The aimof this study is to compare ovarian response in passive smokers and non-passive smokers in anassisted reproductive program.Materials and Methods: In a cohort study at the Isfahan Fertility and Infertility Center, there were 72women in the passive smoker group and 72 women in the non-passive smoker group who underwentan assisted reproductive technology (ART program. The follicle number at administration of humanchorionic gonadotropin (HCG, number of gonadotropin ampoules and duration of super ovulationinduction were compared.Results: Statistical analyses indicated that the number of mature follicles in the passive smoker groupwas not different from the control group; but the number of unresponsive cycles to super ovulation inthe passive smoker group (33.3% was significantly higher than the control group (12.5%. Durationof induction and number of gonadotropin ampoules were not different between the two groups.Conclusion: The results of this study show that exposure to second-hand smoke increases the chanceof unresponsiveness to ovulation induction. This condition may be due to the result of decline inovarian reserve in second-hand smokers. The duration of induction and number of gonadotropinampules is similar in the two groups. Furthermore, the results show that exposure to cigarette smokedoes not clinically impact women with good ovarian reserve.

  15. Bathymetry of Lake Michigan

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Michigan has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  16. Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Debono, Deborah; Gospodarevskaya, Elena; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

    2014-01-01

    Objectives The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates. Design A retrospective, longitudinal, multisite comparative survey. Setting Acute public hospitals in New South Wales, Australia. Participants 96 acute hospitals with accreditation survey results from two surveys during 2009–2012 and submitted data for more than four hand hygiene audits between 2010 and 2013. Outcomes Our primary outcome comprised observational hand hygiene compliance data from eight audits during 2010–2013. The explanatory variables in our multilevel regression model included: accreditation outcomes and scores for the infection control standard; timing of the surveys; and hospital size and activity. Results Average hand hygiene compliance rates increased from 67.7% to 80.3% during the study period (2010–2013), with 46.7% of hospitals achieving target compliance rates of 70% in audit 1, versus 92.3% in audit 8. Average hand hygiene rates at small hospitals were 7.8 percentage points (pp) higher than those at the largest hospitals (phand hygiene rates, accreditation outcomes and infection control scores is less clear. Conclusions Our results indicate that accreditation outcomes and hand hygiene audit data are measuring different parts of the quality and safety spectrum. Understanding what is being measured when selecting indicators to assess the impact of accreditation is critical as focusing on accreditation results would discount successful hand hygiene implementation by smaller hospitals. Conversely, relying on hand hygiene results would discount the infection control related research and leadership investment by larger hospitals. Our hypothesis appears to be confounded by an accreditation programme that makes it more difficult for smaller hospitals to achieve high infection

  17. Design, implementation, and outcome of a hands-on arthrocentesis workshop.

    Barilla-Labarca, Maria-Louise; Tsang, James C; Goldsmith, Melissa; Furie, Richard

    2009-09-01

    During a 4-week rheumatology elective at our institution, opportunities for internal medicine residents to perform arthrocentesis were limited, particularly for sites other than the knee. Consequently, residents were inadequately prepared and had less self-confidence to perform such procedures. To overcome these educational deficiencies, an arthrocentesis workshop was developed. We report our quality improvement data that was collected during the first year of workshop implementation. We devised a structured half-day arthrocentesis workshop for rheumatology fellows as well as rotating internal medicine residents. This program consisted of a one hour lecture immediately followed by a hands-on workshop that used mannequin models for 5 anatomic sites. A self-assessment questionnaire and medical knowledge test were administered before and after each session. The accuracy of the self-assessment questionnaire was analyzed by comparing responses to an external objective measure of knowledge in the same content area. Finally, an optional postworkshop survey addressed resident satisfaction. Thirty-eight trainees participated in the workshop between July 2006 and June 2007. There were statistically significant improvements in self-confidence in 9 content areas (P knowledge test during the preworkshop analysis. In contrast, the postworkshop analysis displayed modestly higher concordance. All residents completing a postworkshop survey believed that it was a useful exercise, and 96% stated that they would change their practice habits. The arthrocentesis workshop provided a solid foundation from which trainees can learn key concepts of joint injection, increase their self-confidence and refine their motor skills. The accuracy of resident self-reported confidence is poor and should therefore be used only to complement other means of competency assessment and medical knowledge acquisition.

  18. Empirical yield tables for Michigan.

    Jerold T. Hahn; Joan M. Stelman

    1984-01-01

    Describes the tables derived from the 1980 Forest Survey of Michigan and presents ways the tables can be used. These tables are broken down according to Michigan's four Forest Survey Units, 14 forest types, and 5 site-index classes.

  19. Michigan forest statistics, 1980.

    Gerhard K. Raile; W. Brad Smith

    1983-01-01

    The fourth inventory of the timber resource of Michigan shows a 7% decline in commercial forest area and a 27% gain in growing-stock volume between 1966 and 1980. Highlights and statistics are presented on area, volume, growth, mortality, removals, utilization, and biomass.

  20. Notes on Michigan Boletaceae

    Smith, Alexander H.

    1973-01-01

    Studies have continued on the diversity of the Michigan bolete flora. During the season of 1972 a variety of Boletus affinis Peck having a reticulate stipe was discovered and abundant material of Boletus bicolor var. subreticulatus Smith & Thiers was obtained. Boletus hortonii Smith & Thiers was

  1. Cardiac surgeons and the quality movement: the Michigan experience.

    Prager, Richard L; Armenti, Frederick R; Bassett, Joseph S; Bell, Gail F; Drake, Daniel; Hanson, Eric C; Heiser, John C; Johnson, Scott H; Plasman, F B; Shannon, Francis L; Share, David; Theurer, Patty; Williams, Jaelene

    2009-01-01

    The Michigan Society of Thoracic and Cardiovascular Surgeons created a voluntary quality collaborative with all the cardiac surgeons in the state and all hospitals doing adult cardiac surgery. Utilizing this collaborative over the last 3 years and creating a unique relationship with a payor, an approach to processes and outcomes has produced improvements in the quality of care for cardiac patients in the state of Michigan.

  2. A three-arm (laparoscopic, hand-assisted, and robotic) matched-case analysis of intraoperative and postoperative outcomes in minimally invasive colorectal surgery.

    Patel, Chirag B; Ragupathi, Madhu; Ramos-Valadez, Diego I; Haas, Eric M

    2011-02-01

    Robotic-assisted laparoscopic surgery is an emerging modality in the field of minimally invasive colorectal surgery. However, there is a dearth of data comparing outcomes with other minimally invasive techniques. We present a 3-arm (conventional, hand-assisted, and robotic) matched-case analysis of intraoperative and short-term outcomes in patients undergoing minimally invasive colorectal procedures. Between August 2008 and October 2009, 70 robotic cases of the rectum and rectosigmoid were performed. Thirty of these were organized into triplets with conventional and hand-assisted cases based on the following 6 matching criteria: 1) surgeon; 2) sex; 3) body mass index; 4) operative procedure; 5) pathology; and 6) history of neoadjuvant therapy in malignant cases. Demographics, intraoperative parameters, and postoperative outcomes were assessed. Pathological outcomes were analyzed in malignant cases. Data were stratified by postoperative diagnosis and operative procedure. There was no significant difference in intraoperative complications, estimated blood loss (126.1 ± 98.5 mL overall), or postoperative morbidity and mortality among the groups. Robotic technique required longer operative time compared with conventional laparoscopic (P hand-assisted (P robotic approach results in short-term outcomes comparable to conventional and hand-assisted laparoscopic approaches for benign and malignant diseases of the rectum and rectosigmoid. With 3-dimensional visualization, additional freedom of motion, and improved ergonomics, this enabling technology may play an important role when performing colorectal procedures involving the pelvic anatomy.

  3. Michigan's Forests 2009

    Scott A. Pugh; Lawrence D. Pedersen; Douglas C. Heym; Ronald J. Piva; Christopher W. Woodall; Charles J. Barnett; Cassandra M. Kurtz; W. Keith. Moser

    2012-01-01

    The seventh inventory of Michigan's forests, completed in 2009, describes more than 19.9 million acres of forest land. The data in this report are based on visits to 7,516 forested plots from 2005 to 2009. Timberland accounts for 97 percent of this forest land, and 62 percent is privately owned. The sugar maple/beech/yellow birch forest type accounts for 18...

  4. Michigan's forests 2004

    Scott A. Pugh; Mark H. Hansen; Lawrence D. Pedersen; Douglas C. Heym; Brett J. Butler; Susan J. Crocker; Dacia Meneguzzo; Charles H. Perry; David E. Haugen; Christopher Woodall; Ed Jepsen

    2009-01-01

    The first annual inventory of Michigan's forests, completed in 2004, covers more than 19.3 million acres of forest land. The data in this report are based on visits to 10,355 forested plots from 2000 to 2004. In addition to detailed information on forest attributes, this report includes data on forest health, biomass, land-use change, and timber-product outputs....

  5. Whiting in Lake Michigan

    2002-01-01

    Satellites provide a view from space of changes on the Earth's surface. This series of images from the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) aboard the Orbview-2 satellite shows the dramatic change in the color of Lake Michigan during the summer. The bright color that appears in late summer is probably caused by calcium carbonate-chalk-in the water. Lake Michigan always has a lot of calcium carbonate in it because the floor of the lake is limestone. During most of the year the calcium carbonate remains dissolved in the cold water, but at the end of summer the lake warms up, lowering the solubility of calcium carbonate. As a result, the calcium carbonate precipitates out of the water, forming clouds of very small solid particles that appear as bright swirls from above. The phenomenon is appropriately called a whiting event. A similar event occured in 1999, but appears to have started later and subsided earlier. It is also possible that a bloom of the algae Microcystis is responsible for the color change, but unlikely because of Lake Michigan's depth and size. Microcystis blooms have occured in other lakes in the region, however. On the shore of the lake it is possible to see the cities of Chicago, Illinois, and Milwaukee, Wisconsin. Both appear as clusters of gray-brown pixels. Image courtesy the SeaWiFS Project, NASA/Goddard Space Flight Center, and ORBIMAGE

  6. Factors that Affected Functional Outcome After a Delayed Excision and Split-Thickness Skin Graft on the Dorsal Side of Burned Hands.

    Shichinohe, Ryuji; Yamamoto, Yuhei; Kawashima, Kunihiro; Kimura, Chu; Ono, Kentaro; Horiuchi, Katsumi; Yoshida, Tetsunori; Murao, Naoki; Hayashi, Toshihiko; Funayama, Emi; Oyama, Akihiko; Furukawa, Hiroshi

    Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury. The hands were divided into two functional categories: Functional category A, normal or nearly normal joint movements, and functional category B, abnormal joint movements. Demographic data were assessed statistically by a univariate analysis following a multiple regression analysis by a stepwise selection. A significant difference was observed between the groups in the number of days from grafting to complete wound healing of the graft site and with or without an escharotomy in the analysis. These parameters were statistically significant predictors of functional category B. The functional outcome of a burned hand after a delayed excision and split-thickness skin graft on the dorsal side became degraded depending on the number of days from grafting to complete wound healing. Cases that underwent an escharotomy also showed deterioration in function.

  7. Michigan E85 Infrastructure

    Sandstrom, Matthew M.

    2012-03-30

    This is the final report for a grant-funded project to financially assist and otherwise provide support to projects that increase E85 infrastructure in Michigan at retail fueling locations. Over the two-year project timeframe, nine E85 and/or flex-fuel pumps were installed around the State of Michigan at locations currently lacking E85 infrastructure. A total of five stations installed the nine pumps, all providing cost share toward the project. By using cost sharing by station partners, the $200,000 provided by the Department of Energy facilitated a total project worth $746,332.85. This project was completed over a two-year timetable (eight quarters). The first quarter of the project focused on project outreach to station owners about the incentive on the installation and/or conversion of E85 compatible fueling equipment including fueling pumps, tanks, and all necessary electrical and plumbing connections. Utilizing Clean Energy Coalition (CEC) extensive knowledge of gasoline/ethanol infrastructure throughout Michigan, CEC strategically placed these pumps in locations to strengthen the broad availability of E85 in Michigan. During the first and second quarters, CEC staff approved projects for funding and secured contracts with station owners; the second through eighth quarters were spent working with fueling station owners to complete projects; the third through eighth quarters included time spent promoting projects; and beginning in the second quarter and running for the duration of the project was spent performing project reporting and evaluation to the US DOE. A total of 9 pumps were installed (four in Elkton, two in Sebewaing, one in East Lansing, one in Howell, and one in Whitmore Lake). At these combined station locations, a total of 192,445 gallons of E85, 10,786 gallons of E50, and 19,159 gallons of E30 were sold in all reporting quarters for 2011. Overall, the project has successfully displaced 162,611 gallons (2,663 barrels) of petroleum, and reduced

  8. MICHIGAN: Cyclotron conference

    Anon.

    1984-01-01

    A sense of excitement was in the air as cyclotron physicists and engineers from 17 countries convened on 30 April for the opening of the Tenth International Conference on Cyclotrons and Their Applications. Some 50 years after its invention, the redoubtable cyclotron remains a topic of compelling current interest. Cyclotron experts gathered at Michigan State University's Kellogg Center to hear of latest developments, of progress and successes on new machines which had come into operation, of new projects which were underway, and of dreams which lay ahead

  9. MICHIGAN: Cyclotron conference

    Anon.

    1984-10-15

    A sense of excitement was in the air as cyclotron physicists and engineers from 17 countries convened on 30 April for the opening of the Tenth International Conference on Cyclotrons and Their Applications. Some 50 years after its invention, the redoubtable cyclotron remains a topic of compelling current interest. Cyclotron experts gathered at Michigan State University's Kellogg Center to hear of latest developments, of progress and successes on new machines which had come into operation, of new projects which were underway, and of dreams which lay ahead.

  10. The use of a measure of acute irritation to predict the outcome of repeated usage of hand soap products.

    Williams, C; Wilkinson, M; McShane, P; Pennington, D; Fernandez, C; Pierce, S

    2011-06-01

    Healthcare-associated infection is an important worldwide problem that could be reduced by better hand hygiene practice. However, an increasing number of healthcare workers are experiencing irritant contact dermatitis of the hands as a result of repeated hand washing. This may lead to a reduced level of compliance with regard to hand hygiene. To assess whether a measure of acute irritation by hand soaps could predict the effects of repeated usage over a 2-week period. In a double-blind, randomized comparison study, the comparative irritation potential of four different hand soaps was assessed over a 24-h treatment period. The effect of repeated hand washing with the hand soap products over a 2-week period in healthy adult volunteers on skin barrier function was then determined by assessment of transepidermal water loss (TEWL), epidermal hydration and a visual assessment using the Hand Eczema Severity Index (HECSI) at days 0, 7 and 14. A total of 121 subjects from the 123 recruited completed phase 1 of the study. All four products were seen to be significantly different from each other in terms of the irritant reaction observed and all products resulted in a significantly higher irritation compared with the no-treatment control. Seventy-nine of the initial 121 subjects were then enrolled into the repeated usage study. A statistically significant worsening of the clinical condition of the skin as measured by HECSI was seen from baseline to day 14 in those subjects repeatedly washing their hands with two of the four soap products (products C and D) with P-values of 0·02 and 0·01, respectively. Subclinical assessment of the skin barrier function by measuring epidermal hydration was significantly increased from baseline to day 7 after repeated hand washing with products A, B and D but overall no significant change was seen in all four products tested by day 14. A statistically significant increase in TEWL at day 14 was seen for product A (P = 0·02) indicating a

  11. Boosting the Motor Outcome of the Untrained Hand by Action Observation: Mirror Visual Feedback, Video Therapy, or Both Combined—What Is More Effective?

    Florian Bähr

    2018-01-01

    Full Text Available Action observation (AO allows access to a network that processes visuomotor and sensorimotor inputs and is believed to be involved in observational learning of motor skills. We conducted three consecutive experiments to examine the boosting effect of AO on the motor outcome of the untrained hand by either mirror visual feedback (MVF, video therapy (VT, or a combination of both. In the first experiment, healthy participants trained either with MVF or without mirror feedback while in the second experiment, participants either trained with VT or observed animal videos. In the third experiment, participants first observed video clips that were followed by either training with MVF or training without mirror feedback. The outcomes for the untrained hand were quantified by scores from five motor tasks. The results demonstrated that MVF and VT significantly increase the motor performance of the untrained hand by the use of AO. We found that MVF was the most effective approach to increase the performance of the target effector. On the contrary, the combination of MVF and VT turns out to be less effective looking from clinical perspective. The gathered results suggest that action-related motor competence with the untrained hand is acquired by both mirror-based and video-based AO.

  12. Neglected post burns contracture of hand in children: Analysis of contributory socio-cultural factors and the impact of neglect on outcome.

    Gupta, Ravi Kumar; Jindal, Nipun; Kamboj, Kulbhushan

    2014-12-01

    No study has ever evaluated the causes and effect of neglect on the outcome of post burns contractures of hand in children. 66 hands in 61 children (mean age 12.22 years) with a mean neglect of 11.6 years (range 5-17 years) were assessed for the causes of neglect and the outcome of surgery. Average follow up was 6.6 years. The results were assessed in two groups of 5-10 years neglect as group I and >10 years neglect as group II. In a total number of 134 contracted rays in 66 hands, the surgical procedures included local Z/V-Y flap (51 rays), cross finger flap (48 rays), full thickness graft (35 rays). Additional external fixator with a distracter was used in 3 patients treated at a delay of 14, 16 and 17 years. 50 (81.96%) patients belonged to rural and slum areas. The reasons for delayed treatment included poverty - 33 patients, lack of awareness of surgical treatment - 16 patients; and indifference of parents - 12 patients. 44 (72.13%) children were illiterates. With treatment the average DASH score improved from 65.10 to 36.90 (p neglect in treatment of post burns contracture include poverty, lack of awareness and illiteracy. All the patients showed significant improvement in function after the surgery. Contractures with higher neglect had significantly inferior outcome.

  13. 75 FR 41895 - Inteva Products, LLC Adrian, Michigan; Inteva Products, LLC Troy, Michigan; Amended Certification...

    2010-07-19

    ... Products, LLC Adrian, Michigan; Inteva Products, LLC Troy, Michigan; Amended Certification Regarding... time period at the Troy, Michigan location of Inteva Products, LLC. The Troy, Michigan location.... Accordingly, the Department is amending the certification to include workers of the Troy, Michigan location of...

  14. All in: expansion of the acquisition of data for outcomes and procedure transfer (ADOPT) program to an entire SAGES annual meeting hands-on hernia course.

    Dort, Jonathan; Trickey, Amber; Paige, John; Schwarz, Erin; Cecil, Tom; Coleman, Mark; Dunkin, Brian

    2018-05-01

    Continuing professional development (CPD) for the surgeon has been challenging because of a lack of standardized approaches of hands-on courses, resulting in poor post-course outcomes. To remedy this situation, SAGES has introduced the ADOPT program, implementing a standardized, long-term mentoring program as part of its hernia hands-on course. Previous work evaluating the pilot program showed increased adoption of learned procedures as well as increased confidence of the mentored surgeons. This manuscript describes the impact of such a program when it is instituted across an entire hands-on course. Following collection of pre-course benchmark data, all participants in the 2016 SAGES hands-on hernia course underwent structured, learner-focused instruction during the cadaveric lab. All faculty had completed a standardized teaching course in the Lapco TT format. Subsequently, course participants were enrolled in a year-long program involving longitudinal mentorship, webinars, conference calls, and coaching. Information about participant demographics, training, experience, self-reported case volumes, and confidence levels related to procedures were collected via survey 3 months prior to 9 months after the course. Twenty surgeons participated in the SAGES ADOPT 2016 hands-on hernia program. Of these, seventeen completed pre-course questionnaires (85%), ten completed the 3-month questionnaire (50%), and four completed the 9-month questionnaire (20%). Nine of ten respondents of the 3-month survey (90%) reported changes in their practice. In the 9-month survey, significant increases in the annualized procedural volumes were reported for open primary ventral hernia repair, open components separation, and mesh insertion for ventral hernia repair (p ADOPT program to an entire hands-on hernia course is both feasible and beneficial, with evidence of Kirkpatrick Levels 1-4a training effectiveness. This expanded success suggests that it is a useful blueprint for the CPD of

  15. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China.

    Zhang, Hongyu; Huang, Shurong; Guo, Xiaolan; Zhao, Ningning; Lu, Yujing; Chen, Min; Li, Yingxia; Wu, Junqin; Huang, Lihua; Ma, Fenglan; Yang, Yuhong; Zhang, Xiaoli; Zhou, Xiaoyu; Guo, Renfei; Cai, Wenzhi

    2017-07-01

    the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012. In total, 1400 women were recruited and randomly allocated to either the experimental group (n=700, 446 completed the protocol) who delivered in hands-and-knees position and the control group (n=700, 440 completed the protocol) who delivered in supine position. Women who could not maintain the randomised position during the second stage of labour were allowed to withdraw from the study. The primary maternal outcome measured was rate of episiotomy. Secondary outcomes included degree of perineum laceration, rate of emergency caesarean section, rate of shoulder dystocia, and duration of labour, postpartum bleeding, neonatal Apgar score, and the rate of neonatal asphyxia. Because outcome data were only collected for women who gave birth in the randomised position, per-protocol analyses were used to compare groups. The primary outcome, episiotomy, was also compared between groups using logistic regression adjusting for maternal age,gestational age at birth, whether the woman was primiparous, the process of second stage of labour and birthweight. as compared with the control group, the experimental group had lower rates of episiotomy and second-degree perineum laceration (including episiotomy), and higher rates of intact perineum and first-degree perineum laceration, with a longer duration of second stage of labour. No significant differences were found in the amount of postpartum bleeding, shoulder dystocia, neonatal asphyxia and neonatal Apgar scores at 1minute and 5minutes. Adjusted for maternal age, gestational

  16. Stiff Hands

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Stiff Hands Email to a friend * required fields ...

  17. Hand Infections

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Hand Infections Email to a friend * required fields ...

  18. A combined hands-on teaching programme and clinical pathway focused on pleural ultrasound and procedure supervision transforms pleural procedure outcomes.

    Edwards, Timothy; Cook, Alistair; Salamonsen, Matthew; Bashirzadeh, Farzad; Fielding, David

    2017-11-01

    Management of pleural effusions is a common diagnostic and management problem. We reviewed the outcomes from pleural procedures after the instigation of pleural effusion management guidelines, focusing on pleural ultrasound and a hands-on teaching programme followed by procedure supervision that enabled many operators to perform such procedures. This is a retrospective analysis of all procedures performed for pleural effusions on medical patients. Outcomes were assessed prior to the instigation of pleural effusion management guidelines (pleural pathway) and hands-on teaching (January 2010 to June 2011) and following these interventions (January 2012 to June 2013). A total of 171 procedures involving 129 patients (pre-pathway group) and 146 procedures involving 115 patients (post-pathway group) was analysed. The rate of complications prior to the pleural pathway was 22.2% (38 of 171 procedures). Following the pathway, the rate of complications declined to 7.5% (11 of 146 procedures, P < 0.003). The use of pleural ultrasound increased dramatically (72.5 vs 90.2%). The number of patients who underwent repeated procedures (defined as ≥3) reduced dramatically (21 vs 7, P < 0.01). This improvement occurred using many supervised operators who completed the hands-on teaching programme (n = 32) and followed the pleural pathway (127 of 146 procedures). The instigation of a clinical pathway focused on the use of bedside pleural ultrasound, and teaching of drainage techniques with procedure supervision vastly improved patient outcomes. This not only allowed better quality of care for patients, it also provided the acquisition of new skills to medical staff, not limiting these skills to specialised staff. © 2017 Royal Australasian College of Physicians.

  19. Visual Literacy Skills of Students in College-Level Biology: Learning Outcomes Following Digital or Hand-Drawing Activities

    Bell, Justine C.

    2014-01-01

    To test the claim that digital learning tools enhance the acquisition of visual literacy in this generation of biology students, a learning intervention was carried out with 33 students enrolled in an introductory college biology course. This study compared learning outcomes following two types of learning tools: a traditional drawing activity, or…

  20. Hand Fractures

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... DESCRIPTION The bones of the hand serve as a framework. This framework supports the muscles that make the wrist and fingers move. When ...

  1. Grip and Pinch Strength Norms for Michigan Workers

    Joel M. Phillips M.S., OTRL

    2013-06-01

    Full Text Available The purpose of this study was to create a norm reference of current grip and pinch strength norms for working-age Michigan adults. This normative study included a convenience sample of 179 volunteers who were employees at car plants in South East Michigan or hospital sites in West Michigan. Participants’ ages ranged from between 20 and 62 years of age with a mean age of 49.15 years. There were 78 females (44% and 101 males (56%. Subjects were classified by gender and in the age categories of ages 20 to 49 years and ages 50-62 years. Grip and pinch strength norms were collected following the American Society of Hand Therapy protocol. The norms from these working adults were calculated with descriptive statistics for males and females in two age classifications: ages 20 to 49 and ages 50 to 62 years. Standard Errors (SE are better than the 1985 norms for both males and females ages 20 to 49 years. SEs are higher than the ages 20 to 49 years’ norms for the ages 50 to 62 years age categories in both males and females. These norms offer a point of comparison for clinicians to use for clients in Michigan who are ages 20 to 62 years and who have a goal to improve their grip strength. Clients’ grip and pinch strength could be compared to their age level or gender norms using the comparison for one standard deviation above, below, or at the means.

  2. Strengthening and stretching for rheumatoid arthritis of the hand (SARAH: design of a randomised controlled trial of a hand and upper limb exercise intervention - ISRCTN89936343

    Adams Jo

    2012-11-01

    Full Text Available Abstract Background Rheumatoid Arthritis (RA commonly affects the hands and wrists with inflammation, deformity, pain, weakness and restricted mobility leading to reduced function. The effectiveness of exercise for RA hands is uncertain, although evidence from small scale studies is promising. The Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH trial is a pragmatic, multi-centre randomised controlled trial evaluating the clinical and cost effectiveness of adding an optimised exercise programme for hands and upper limbs to best practice usual care for patients with RA. Methods/design 480 participants with problematic RA hands will be recruited through 17 NHS trusts. Treatments will be provided by physiotherapists and occupational therapists. Participants will be individually randomised to receive either best practice usual care (joint protection advice, general exercise advice, functional splinting and assistive devices or best practice usual care supplemented with an individualised exercise programme of strengthening and stretching exercises. The study assessors will be blinded to treatment allocation and will follow participants up at four and 12 months. The primary outcome measure is the Hand function subscale of the Michigan Hand Outcome Questionnaire, and secondary outcomes include hand and wrist impairment measures, quality of life, and resource use. Economic and qualitative studies will also be carried out in parallel. Discussion This paper describes the design and development of a trial protocol of a complex intervention study based in therapy out-patient departments. The findings will provide evidence to support or refute the use of an optimised exercise programme for RA of the hand in addition to best practice usual care. Trial registration Current Controlled Trials ISRCTN89936343

  3. Intersphincteric resection and hand-sewn coloanal anastomosis for low rectal cancer: Short-term outcomes in the Indian setting.

    Pai, Vishwas D; De Souza, Ashwin; Patil, Prachi; Engineer, Reena; Arya, Supreeta; Saklani, Avanish

    2015-01-01

    The rectum remains a predominant subsite of colorectal cancer in the Indian population. Unique to the Indian setting are significant social repercussions associated with a permanent stoma. On account of this, many patients who are advised abdominal perineal excision of the rectum (APER) default treatment. Accurate demonstration of the intersphincteric plane with magnetic resonance imaging has made intersphincteric resection (ISR) a viable option. This study is aimed at determining the feasibility and oncological adequacy of ISR in the Indian scenario. All patients with low rectal cancer who underwent an ISR at the Tata Memorial Centre, from July 2013 to December 2013 were included. Patients with invasion of the external sphincter and suboptimal preoperative sphincter function were excluded. Following standard preoperative staging, patients with a threatened circumferential resection margin (CRM) and/or mesorectal nodes were given preoperative chemoradiotherapy. The oncological adequacy of the procedure was evaluated in terms of margin positivity (distal and CRMs) and lymph node yield. Short-term perioperative outcomes included 30-day mortality, postoperative morbidity, anastomotic leaks, and length of hospital stay. Thirty-three patients with low rectal cancer and a median age of 38 years underwent ISR during the defined study period. Twenty-three patients (70 %) underwent open surgery whereas ten patients received a laparoscopic resection. The median blood loss and hospital stay was 300 mL and 7 days, respectively. Two patients had an involved CRM, but all distal margins were free of tumor. The quality of total mesorectal excision was satisfactory in all patients with a median lymph node yield of 9 nodes. Intersphincteric resection is feasible and oncologically safe in selected patients with low rectal cancer. Long-term functional and oncological outcomes are essential before it can be considered a viable alternative to APER.

  4. Clinical Outcomes of Living Liver Transplantation According to the Presence of Sarcopenia as Defined by Skeletal Muscle Mass, Hand Grip, and Gait Speed.

    Harimoto, N; Yoshizumi, T; Izumi, T; Motomura, T; Harada, N; Itoh, S; Ikegami, T; Uchiyama, H; Soejima, Y; Nishie, A; Kamishima, T; Kusaba, R; Shirabe, K; Maehara, Y

    2017-11-01

    Sarcopenia is an independent predictor of death after living-donor liver transplantation (LDLT). However, the ability of the Asian Working Group for Sarcopenia criteria for sarcopenia (defined as reduced skeletal muscle mass plus low muscle strength) to predict surgical outcomes in patients who have undergone LDLT has not been determined. This study prospectively enrolled 366 patients who underwent LDLT at Kyushu University Hospital. Skeletal muscle area (determined by computed tomography), hand-grip strength, and gait speed were measured in 102 patients before LDLT. We investigated the relationship between sarcopenia and surgical outcomes after LDLT performed in three time periods. The number of patients with lower skeletal muscle area has increased to 52.9% in recent years. The incidence of sarcopenia according to the Asian Working Group for Sarcopenia criteria was 23.5% (24/102). Patients with sarcopenia (defined by skeletal muscle area and functional parameters) had significantly lower skeletal muscle area and weaker hand-grip strength than did those without sarcopenia. Compared with non-sarcopenic patients, patients with sarcopenia also had significantly worse liver function, greater estimated blood loss, greater incidence of postoperative complications of Clavien-Dindo grade IV or greater (including amount of ascites on postoperative day 14, total bilirubin on postoperative day 14, and postoperative sepsis), and longer postoperative hospital stay. Multiple logistic regression analysis revealed sarcopenia as a significant predictor of 6-month mortality. The combination of skeletal muscle mass and function can predict surgical outcomes in LDLT patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Creating a Better Funding System for Michigan

    Quinn, Daniel

    2010-01-01

    In 1994, Michigan voters approved a ballot initiative that transferred the power in Michigan's education system from local communities to the state. Proposal A succeeded in slowing the growth of local property taxes and narrowing the gap between the richest and poorest districts in Michigan. However, due to a decade of sluggish economic growth,…

  6. A reactive nitrogen budget for Lake Michigan

    The reactive nitrogen budget for Lake Michigan was reviewed and updated, making use of recent estimates of watershed and atmospheric nitrogen loads. The updated total N load to Lake Michigan was approximately double the previous estimate from the Lake Michigan Mass Balance study ...

  7. Hand Therapy

    ... from conditions such as carpal tunnel syndrome and tennis elbow , as well as from chronic problems such as ... Tools Advice from a Certified Hand Therapist on Tennis Elbow Advice from a Certified Hand Therapist: Living with( ...

  8. Pollutant transformations over Lake Michigan

    Alkezweeny, A.J.; Arbuthnot, D.R.; Busness, K.M.; Easter, R.C.; Hales, J.M.; Lee, R.N.; Young, J.M.

    1979-01-01

    An aircraft, a chartered boat, and a constant altitude balloon were used to study pollutant transformations over Lake Michigan in a Lagrangian frame of reference. The experiments were conducted during the summer under strong atmospheric stability where diffusion and dry deposition of pollutants can be neglected

  9. Michigan School Privatization Survey 2013

    Hohman, James M.; Fryzelka, Evan E.

    2014-01-01

    Many of Michigan's public school districts are under substantial fiscal pressures from a combination of declining enrollment and increasing costs, particularly related to employee benefits, but most districts are responding to these challenges. One of the ways that districts can stretch their resources further is through competitive contracting…

  10. Residential Energy Efficiency Potential: Michigan

    Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-11-22

    Energy used by Michigan single-family homes that can be saved through cost-effective improvements. Prepared by Eric Wilson and Noel Merket, NREL, and Erin Boyd, U.S. Department of Energy Office of Energy Policy and Systems Analysis.

  11. Hand Anatomy

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy Bones Joints Muscles Nerves Vessels Tendons Anatomy The upper extremity is ...

  12. How Do Learning Outcomes, Assessments and Student Engagement in a Fully Online Geoscience Laboratory Compare to Those Of The Original Hands-on Exercise?

    Jones, F. M.

    2015-12-01

    In a third year geoscience elective for BSc majors, we adapted several active f2f learning strategies for an equivalent fully online version of the course. In particular, we converted a hands-on laboratory including analysis and interpretation of hand-specimens, sketching results and peer-to-peer discussion of scientific implications. This study compares learning outcomes in both formats and describes resources that make engaging, effective and efficient learning experiences for large classes in an asynchronous online environment. Our two hypotheses are: 1) a hands-on geology lab exercise can be converted for efficient fully online use without sacrificing feedback and assessment opportunities; 2) students find either the f2f or DE versions equally effective and enjoyable as learning experiences. Key components are an authentic context, interactive resources including sketching, strategies that enable efficient assessment and feedback on solo and group work, and asynchronous yet productive interaction with peers. Students in the f2f class handle real rock and fossil specimens, work with peers in the lab and classroom, and deliver most results including annotated figures on paper. DE students complete identical tasks using interactive high resolution figures and videos of specimens. Solo work is first delivered for automated assessment and feedback, then students engage asynchronously in small groups to improve results and discuss implications. Chronostratigraphy and other interpretations are sketched on prepared template images using a simple open-source sketching app that ensures equal access and consistent results that are efficient to assess by peers and instructors. Learning outcomes based on subsequent quizzes, sketches, and lab results (paper for f2f students and automated data entry for DE students), show that f2f and online students demonstrate knowledge and scientific interpretations of comparable quality. Effective engagement and group work are

  13. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

    Graves, Nicholas; Page, Katie; Martin, Elizabeth; Brain, David; Hall, Lisa; Campbell, Megan; Fulop, Naomi; Jimmeison, Nerina; White, Katherine; Paterson, David; Barnett, Adrian G.

    2016-01-01

    Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand

  14. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia.

    Nicholas Graves

    Full Text Available The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011-2012.No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.The Australian National Hand Hygiene Initiative was cost

  15. [Hand osteoarthritis].

    Šenolt, Ladislav

    Hand osteoarthritis (OA) is a common chronic disorder causing pain and limitation of mobility of affected joints. The prevalence of hand OA increases with age and more often affects females. Clinical signs obviously do not correlate with radiographic findings - symptomatic hand OA affects approximately 26 % of adult subjects, but radiographic changes can be found in up to two thirds of females and half of males older than 55 years.Disease course differ among individual patients. Hand OA is a heterogeneous disease. Nodal hand OA is the most common subtype affecting interphalangeal joints, thumb base OA affects first carpometacarpal joint. Erosive OA represents a specific subtype of hand OA, which is associated with joint inflammation, more pain, functional limitation and erosive findings on radiographs.Treatment of OA is limited. Analgesics and nonsteroidal anti-inflammatory drugs are the only agents reducing symptoms. New insights into the pathogenesis of disease should contribute to the development of novel effective treatment of hand OA.

  16. The copper deposits of Michigan

    Butler, B.S.; Burbank, W.S.

    1929-01-01

    The copper district of Keweenaw Point, in the northern peninsula of Michigan, is the second largest producer of copper in the world.  The output of the district since 1845 has been more than 7,500,000,000 pounds and showed a rather steady and consistent increase from the beginning of production to the end of the World War in 1918, since which there has been a marked decrease.

  17. Active Traffic Management in Michigan

    Johnson, Pat

    2018-01-01

    The US 23 Flex Route is the first active traffic management (ATM) project in the state of Michigan. This route utilizes overhead lane control gantries equipped with various intelligent transportation system (ITS) equipment to facilitate the following ATM strategies: dynamic shoulder use, dynamic lane control, variable speed advisories, and queue warning. The focus of this presentation is how the project team overcame several challenges during the planning, design, and system management phases...

  18. Electric industry restructuring in Michigan

    Anon.

    1997-01-01

    This Staff Report suggests a modified approach designed to significantly increase the ability of all customer classes to participate and share in the benefits of competition. The concepts discussed in this Report are designed to ensure that rates are not increased for any customers as a result of restructuring and, where possible, rates are reduced through the use of rate reduction bonds. The program outlined in this Report is designed to fulfill five objectives. First, it protects the interests of smaller customers, including low-income residential customers and senior citizens. Second, the program provides opportunities to strengthen Michigan's business community. Third, the program includes funding for employee retraining to assure that utility employees are not negatively impacted by restructuring. Fourth, the phase-in program provides the utilities with the opportunity to prepare for competition so that they remain Michigan-based companies. Fifth, the program is designed to foster competition upon a level playing field. The Commission has jurisdiction over all investor electric utilities and rural electric cooperatives in Michigan. Municipal electric utilities are not subject to Commission jurisdiction. Although this Report discusses details regarding Consumers Power and Detroit Edison, its concepts and principles are intended to apply to all jurisdictional electric utilities

  19. Robotic Hand

    1993-01-01

    The Omni-Hand was developed by Ross-Hime Designs, Inc. for Marshall Space Flight Center (MSFC) under a Small Business Innovation Research (SBIR) contract. The multiple digit hand has an opposable thumb and a flexible wrist. Electric muscles called Minnacs power wrist joints and the interchangeable digits. Two hands have been delivered to NASA for evaluation for potential use on space missions and the unit is commercially available for applications like hazardous materials handling and manufacturing automation. Previous SBIR contracts resulted in the Omni-Wrist and Omni-Wrist II robotic systems, which are commercially available for spray painting, sealing, ultrasonic testing, as well as other uses.

  20. Economic impacts of wine tourism in Michigan

    Mi-Kyung Kim; Seung Hyun Kim

    2003-01-01

    In Michigan, wine tourism is perceived as increasingly important concept because more and more tourists visit wineries and wine tasting rooms annually. However there have been few studies conducted concerning the economic impacts of wineries in Michigan even though the industry has been recognized as having significant economic impact potential. The primary purpose of...

  1. Michigan Health & Hospital Association Keystone Obstetrics: a statewide collaborative for perinatal patient safety in Michigan.

    Simpson, Kathleen Rice; Knox, G Eric; Martin, Morgan; George, Chris; Watson, Sam R

    2011-12-01

    Preventable harm to mothers and infants during labor and birth is a significant patient safety and professional liability issue. A Michigan Health & Hospital Association Keystone Center for Patient Safety & Quality Obstetric Collaborative Project involved perinatal teams from 15 Michigan hospitals during an 11-month period in 2009. The purpose of the project was to promote safe care practices during labor and birth using the Comprehensive Unit-based Safety Program (CUSP). Consistent with the CUSP model, this project's components included assessing and promoting a culture of safety; interdisciplinary team building; case review; learning from defects through multiple methods of education; team and individual coaching and peer encouragement; administrative support for the establishment of a fundamental safety infrastructure; and ongoing evaluation of care processes and outcomes. Study measures included 32 components of a perinatal patient infrastructure, 6 care processes during labor and birth, and 4 neonatal outcomes. Significant improvements were found in the safety culture (Safety Attitudes Questionnaire), the perinatal patient safety infrastructure components, and all care processes. Although the project was successful, getting buy-in from all members of the clinical team in each hospital for all of the measures was challenging at times. There was initial resistance to some of the measures and their various expected aspects of care. For example, some of the clinicians were initially reluctant to adopt the recommended standardized oxytocin protocol. Peer encouragement and unit-based feedback on progress in minimizing early elective births proved useful in many hospitals. A CUSP in obstetrics can be beneficial in improving the care of mothers and infants during labor and birth.

  2. Accuracy of outcome anticipation, but not gaze behavior, differs against left- and right-handed penalties in team-handball goalkeeping

    Florian eLoffing

    2015-12-01

    Full Text Available Low perceptual familiarity with relatively rarer left-handed as opposed to more common right-handed individuals may result in athletes’ poorer ability to anticipate the former’s action intentions. Part of such left-right asymmetry in visual anticipation could be due to an inefficient gaze strategy during confrontation with left-handed individuals. To exemplify, observers may not mirror their gaze when viewing left- vs. right-handed actions but preferentially fixate on an opponent’s right body side, irrespective of an opponent’s handedness, owing to the predominant exposure to right-handed actions. So far empirical verification of such assumption, however, is lacking. Here we report on an experiment where team-handball goalkeepers’ and non-goalkeepers’ gaze behavior was recorded while they predicted throw direction of left- and right-handed seven-meter penalties shown as videos on a computer monitor. As expected, goalkeepers were considerably more accurate than non-goalkeepers and prediction was better against right- than left-handed penalties. However, there was no indication of differences in gaze measures (i.e., number of fixations, overall and final fixation duration, time-course of horizontal or vertical fixation deviation as a function of skill group or the penalty-takers’ handedness. Findings suggest that inferior anticipation of left-handed compared to right-handed individuals’ action intentions may not be associated with misalignment in gaze behavior. Rather, albeit looking similarly, accuracy differences could be due to observers’ differential ability of picking up and interpreting the visual information provided by left- vs. right-handed movements.

  3. Accuracy of Outcome Anticipation, But Not Gaze Behavior, Differs Against Left- and Right-Handed Penalties in Team-Handball Goalkeeping

    Loffing, Florian; Sölter, Florian; Hagemann, Norbert; Strauss, Bernd

    2015-01-01

    Low perceptual familiarity with relatively rarer left-handed as opposed to more common right-handed individuals may result in athletes' poorer ability to anticipate the former's action intentions. Part of such left-right asymmetry in visual anticipation could be due to an inefficient gaze strategy during confrontation with left-handed individuals. To exemplify, observers may not mirror their gaze when viewing left- vs. right-handed actions but preferentially fixate on an opponent's right body side, irrespective of an opponent's handedness, owing to the predominant exposure to right-handed actions. So far empirical verification of such assumption, however, is lacking. Here we report on an experiment where team-handball goalkeepers' and non-goalkeepers' gaze behavior was recorded while they predicted throw direction of left- and right-handed 7-m penalties shown as videos on a computer monitor. As expected, goalkeepers were considerably more accurate than non-goalkeepers and prediction was better against right- than left-handed penalties. However, there was no indication of differences in gaze measures (i.e., number of fixations, overall and final fixation duration, time-course of horizontal or vertical fixation deviation) as a function of skill group or the penalty-takers' handedness. Findings suggest that inferior anticipation of left-handed compared to right-handed individuals' action intentions may not be associated with misalignment in gaze behavior. Rather, albeit looking similarly, accuracy differences could be due to observers' differential ability of picking up and interpreting the visual information provided by left- vs. right-handed movements. PMID:26648887

  4. Accuracy of Outcome Anticipation, But Not Gaze Behavior, Differs Against Left- and Right-Handed Penalties in Team-Handball Goalkeeping.

    Loffing, Florian; Sölter, Florian; Hagemann, Norbert; Strauss, Bernd

    2015-01-01

    Low perceptual familiarity with relatively rarer left-handed as opposed to more common right-handed individuals may result in athletes' poorer ability to anticipate the former's action intentions. Part of such left-right asymmetry in visual anticipation could be due to an inefficient gaze strategy during confrontation with left-handed individuals. To exemplify, observers may not mirror their gaze when viewing left- vs. right-handed actions but preferentially fixate on an opponent's right body side, irrespective of an opponent's handedness, owing to the predominant exposure to right-handed actions. So far empirical verification of such assumption, however, is lacking. Here we report on an experiment where team-handball goalkeepers' and non-goalkeepers' gaze behavior was recorded while they predicted throw direction of left- and right-handed 7-m penalties shown as videos on a computer monitor. As expected, goalkeepers were considerably more accurate than non-goalkeepers and prediction was better against right- than left-handed penalties. However, there was no indication of differences in gaze measures (i.e., number of fixations, overall and final fixation duration, time-course of horizontal or vertical fixation deviation) as a function of skill group or the penalty-takers' handedness. Findings suggest that inferior anticipation of left-handed compared to right-handed individuals' action intentions may not be associated with misalignment in gaze behavior. Rather, albeit looking similarly, accuracy differences could be due to observers' differential ability of picking up and interpreting the visual information provided by left- vs. right-handed movements.

  5. Hand eczema

    Ibler, K.S.; Jemec, G.B.E.; Flyvholm, M.-A.

    2012-01-01

    Background. Healthcare workers are at increased risk of developing hand eczema. Objectives. To investigate the prevalence and severity of self-reported hand eczema, and to relate the findings to demographic data, occupation, medical speciality, wards, shifts, and working hours. Patients/materials......Background. Healthcare workers are at increased risk of developing hand eczema. Objectives. To investigate the prevalence and severity of self-reported hand eczema, and to relate the findings to demographic data, occupation, medical speciality, wards, shifts, and working hours. Patients...... dermatitis, younger age, male sex (male doctors), and working hours. Eighty nine per cent of subjects reported mild/moderate lesions. Atopic dermatitis was the only factor significantly related to severity. Sick leave was reported by 8% of subjects, and notification to the authorities by 12%. Conclusions...... or severity, but cultural differences between professions with respect to coping with the eczema were significant. Atopic dermatitis was related to increased prevalence and severity, and preventive efforts should be made for healthcare workers with atopic dermatitis....

  6. Hand Osteoblastoma

    M. Farzan

    2006-06-01

    Full Text Available Background and Aim: Osteoblastoma is one of the rarest primary bone tumors. Although, small bones of the hands and feet are the third most common location for this tumor, the hand involvement is very rare and few case observations were published in the English-language literature. Materials and Methods: In this study, we report five cases of benign osteoblastoma of the hand, 3 in metacarpals and two in phalanxes. The clinical feature is not specific. The severe nocturnal, salicylate-responsive pain is not present in patients with osteoblastoma. The pain is dull, persistent and less localized. The clinical course is usually long and there is often symptoms for months before medical attention are sought. Swelling is a more persistent finding in osteoblastoma of the hand that we found in all of our patients. The radiologic findings are indistinctive, so preoperative diagnosis based on X-ray appearance is difficult. In all of our 5 cases, we fail to consider osteoblastoma as primary diagnosis. Pathologically, osteoblastoma consisting of a well-vascularized connective tissue stroma in which there is active production of osteoid and primitive woven bone. Treatment depends on the stage and localization of the tumor. Curettage and bone grafting is sufficient in stage 1 or stage 2, but in stage 3 wide resection is necessary for prevention of recurrence. Osteosarcoma is the most important differential diagnosis that may lead to inappropriate operation.

  7. Alignment of Outcome Instruments Used in Hand Therapy With the Occupational Therapy Practice Framework: Domain and Process and the International Classification of Functioning, Disability and Health: A Scoping Review.

    Lesher, Danielle Ann-Marie; Mulcahey, M J; Hershey, Peter; Stanton, Donna Breger; Tiedgen, Andrea C

    We sought to identify outcome instruments used in rehabilitation of the hand and upper extremity; to determine their alignment with the constructs of the International Classification of Functioning, Disability and Health (ICF) and the Occupational Therapy Practice Framework: Domain and Process; and to report gaps in the constructs measured by outcome instruments as a basis for future research. We searched CINAHL, MEDLINE, OTseeker, and the Cochrane Central Register of Controlled Trials using scoping review methodology and evaluated outcome instruments for concordance with the ICF and the Framework. We identified 18 outcome instruments for analysis. The findings pertain to occupational therapists' focus on body functions, body structures, client factors, and activities of daily living; a gap in practice patterns in use of instruments; and overestimation of the degree to which instruments used are occupationally based. Occupational therapy practitioners should use outcome instruments that embody conceptual frameworks for classifying function and activity. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  8. Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination.

    Ostlie, Kristin; Franklin, Rosemary J; Skjeldal, Ola H; Skrondal, Anders; Magnus, Per

    2011-10-01

    To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining self-assessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. postal questionnaires and clinical examinations. Norwegian ULA population. Clinical examinations performed at 3 clinics. Questionnaires: population-based sample (n=224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (n=70; 83.3% of those invited). SURVEY inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Not applicable. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0-48.4); and in unilateral amputees, 22.1 (95% CI, 19.8-24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]=-5.40, P=.033; vs students: aB=-13.88, P=.022), increasing postamputation time (aB=-.27, P=.001), and Norwegian ethnicity (aB=-14.45, P<.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (P<.006) and with reduced shoulder abduction strength (P=.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aB=12.19, P=.001) and shoulder abduction (ipsilateral: aB=12.01, P=.005; contralateral: aB=28.82, P=.004

  9. Hand-related physical function in rheumatic hand conditions

    Klokker, Louise; Terwee, Caroline; Wæhrens, Eva Elisabet Ejlersen

    2016-01-01

    INTRODUCTION: There is no consensus about what constitutes the most appropriate patient-reported outcome measurement (PROM) instrument for measuring physical function in patients with rheumatic hand conditions. Existing instruments lack psychometric testing and vary in feasibility...... and their psychometric qualities. We aim to develop a PROM instrument to assess hand-related physical function in rheumatic hand conditions. METHODS AND ANALYSIS: We will perform a systematic search to identify existing PROMs to rheumatic hand conditions, and select items relevant for hand-related physical function...... as well as those items from the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank that are relevant to patients with rheumatic hand conditions. Selection will be based on consensus among reviewers. Content validity of selected items will be established...

  10. Hand-related physical function in rheumatic hand conditions

    Klokker, Louise; Terwee, Caroline B; Wæhrens, Eva Ejlersen

    2016-01-01

    as well as those items from the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank that are relevant to patients with rheumatic hand conditions. Selection will be based on consensus among reviewers. Content validity of selected items will be established......INTRODUCTION: There is no consensus about what constitutes the most appropriate patient-reported outcome measurement (PROM) instrument for measuring physical function in patients with rheumatic hand conditions. Existing instruments lack psychometric testing and vary in feasibility...... and their psychometric qualities. We aim to develop a PROM instrument to assess hand-related physical function in rheumatic hand conditions. METHODS AND ANALYSIS: We will perform a systematic search to identify existing PROMs to rheumatic hand conditions, and select items relevant for hand-related physical function...

  11. Fish impingement at Lake Michigan power plants

    Sharma, R.K.; Freeman, R.F.; Spigarelli, S.A.

    1976-01-01

    A study was initiated in 1974 to survey the magnitude and to evaluate the impact of fish impingement at 20 power plants on the Great Lakes. Data on impingement rates, site characteristics, intake designs and operational features have been collected and analyzed. Interpretive analyses of these data are in progress. The objectives of this study were: to summarize fish impingement data for Lake Michigan (16/20 plants surveyed are on Lake Michigan); to assess the significance of total and source-related mortalities on populations of forage and predator species; and to expand the assessment of power plant impingement to include all water intakes on Lake Michigan. Data are tabulated

  12. The impact of second-hand tobacco smoke exposure on pregnancy outcomes, infant health, and the threat of third-hand smoke exposure to our environment and to our children.

    Merritt, T Allen; Mazela, Jan; Adamczak, Aleksandra; Merritt, Travis

    2012-01-01

    Smoking during pregnancy is associated with various adverse effects on pregnancy and fetal development, carries a lot of serious complications such as spontaneous abortion, placental abruption, and reduced birth weight of the newborn. Children of smoking mothers have an increased risk of premature birth, low birth weight, sudden infant death syndrome and respiratory diseases during infancy. Smoking also causes long-term risk of maternal health problems such as: heart disease, cancer, emphysema, chronic obstructive pulmonary disease and higher mortality rate. Because women are more likely to quit smoking during pregnancy than at any other time, there are attempts to increase motivation and help them to stop smoking at the procreative phase of their life. The article describes interventions that are carried out in Loma Linda, where the educational program "When You Smoke Your Baby Smokes" reminds parents about the health effects of smoking during pregnancy and harmful impact on child's health caused by second-hand smoke. Another threat to health and environment of our children, is the nicotine coming from indirect exposure to tobacco smoke. Residual nicotine that persists in high concentrations on the interior surfaces, including clothing, is forming in the reaction of nitric acid carcinogenic compounds of specific nitrosamines. In addition, ozone and related atmospheric oxidants react with nicotine smoke or smoke coming from the second-hand smoke, giving the smallest particles with high risk of asthma. Efforts towards reducing exposure to tobacco smoke coming from the passive and indirect smoking should be placed at a high priority throughout the European Union.

  13. Michigan transportation facts & figures : public transportation

    2002-08-16

    This on-line document is part of a series, Transportation Facts & Figures, by the Michigan Department of Transportation (MDOT). The Public Transit section of Transportation Facts & Figures cover such topics as intercity bus service, intercity rail se...

  14. Antimicrobial Drug-Resistant Shiga Toxin-Producing Escherichia coli Infections, Michigan, USA.

    Mukherjee, Sanjana; Mosci, Rebekah E; Anderson, Chase M; Snyder, Brian A; Collins, James; Rudrik, James T; Manning, Shannon D

    2017-09-01

    High frequencies of antimicrobial drug resistance were observed in O157 and non-O157 Shiga toxin-producing E. coli strains recovered from patients in Michigan during 2010-2014. Resistance was more common in non-O157 strains and independently associated with hospitalization, indicating that resistance could contribute to more severe disease outcomes.

  15. Are Expectations Alone Enough? Estimating the Effect of a Mandatory College-Prep Curriculum in Michigan

    Jacob, Brian; Dynarski, Susan; Frank, Kenneth; Schneider, Barbara

    2017-01-01

    This article examines the impacts of the Michigan Merit Curriculum (MMC), a statewide college-preparatory curriculum that applies to the high school graduating class of 2011 and later. Our analyses suggest that the higher expectations embodied in the MMC had slight impact on student outcomes. Looking at student performance in the ACT, the only…

  16. MICHIGAN FARM DATABASE NEW DIRECTIONS FOR 1995

    Nott, Sherrill B.; Hepp, Ralph E.

    1996-01-01

    The purpose of this paper is to provide financial and production performance data for Michigan farms in 1995. Separate sections report on the farm types of Cash Grain, Dairy, Fruit, General Crop, General Livestock, and Swine. This data can be used as a comparative data base for individual farmers to conduct a financial analysis of their own farm to identify strengths and weaknesses. This report can also provide information to those interested in the financial well being of Michigan agricultur...

  17. Analysis of the effects of hospitalization on fine hand functions compared to gross grip in patients with rheumatoid arthritis

    Zeynep Tuna

    2015-09-01

    Full Text Available Objective: Hospitalization process causes a variety of physical problems. The decrease of hand use in daily life during hospitalization brings hand dysfunction to mind in inpatients. The aim of this study is to compare the hand functions of hospitalized patients with Rheumatoid Arthritis (RA to outpatients in detail. Methods: Grip and pinch strengths of both hospitalized patients in rheumatology service and outpatients on the routine control day were measured. In addition, 9-Hole Peg Test was performed and the disability level was determined by the Turkish version of Michigan Hand Outcomes Questionnaire (MHOQ. Results: While grip strength and MHOQ scores were similar (p>0.05 in both groups, all three pinch strengths (lateral, bipod, tripod and 9HPT scores were lower (p<0.05 in hospitalized patients. Conclusion: Consequently, besides disease activity, hospitalization process also impairs fine hand functions in rheumatological patients. Evaluation of fine hand functions and appropriate rehabilitative interventions may prevent further disability in hospitalized patients. J Clin Exp Invest 2015; 6 (3: 228-232

  18. Enhancing Michigan's local public health accreditation program through participation in the multistate learning collaborative.

    Kushion, Mary L; Tews, Debra Scamarcia; Parker, Melody D

    2007-01-01

    This article presents Michigan's efforts and accomplishments as a result of its involvement with the Multi-State Learning Collaborative (MLC) project. The article gives a brief overview of Michigan's accreditation program. It outlines the two goals and six objectives associated with Michigan's MLC project, and describes the structure it used to implement the project plan. It further explains and illustrates the outcomes achieved from successfully meeting the goals and objectives. The article gives a sample of a proposed voluntary component for continuous quality improvement that local health departments can implement utilizing the Shewhart Cycle of "Plan, Do, Check, and Act" and National Association of City and County Health Officials' Operational Definition of a Functional Health Department.

  19. Developing Representative Michigan Truck Configurations for Bridge Load Rating

    2018-02-28

    The objective of this study is to recommend a rating process representative of Michigan load effects for legal and extended permit vehicles. For this study, high fidelity WIM data from 20 Michigan sites were analyzed. Using vehicle weight and configu...

  20. 27 CFR 9.79 - Lake Michigan Shore.

    2010-04-01

    ... Michigan Shore. (a) Name. The name of the viticultural area described in this section is “Lake Michigan... southeast along the winding course of the Kalamazoo River for approximately 35 miles until it intersects the...

  1. Market Barriers to Solar in Michigan

    Miller, E.; Nobler, E.; Wolf, C.; Doris, E.

    2012-08-01

    The solar industry in the United States is at a turning point; the cost of PV hardware has declined substantially in recent years, placing new attention on reducing the balance of system (BOS) costs of solar that now contribute to a growing percentage of installation expenses. How states address these costs through the creation of a favorable policy and regulatory environment is proving to be a critical determinant of a thriving statewide solar market. This report addresses the permitting and tax issues that may stimulate the solar market growth in Michigan. By making PV installations easier to complete through reduced BOS costs, Michigan would become a more attractive location for manufacturers and installers. As PV module costs decline and BOS costs make up a greater share of the cost of solar, action taken today on these issues will prove beneficial in the long term, providing Michigan an opportunity to establish a leadership position in the solar industry.

  2. Alternaria leaf spot in Michigan and fungicide sensitivity issues

    Since 2010 there has been an increase in identification of Alternaria leaf spot on sugar beet in Michigan and other growing regions in the US and Canada. In 2016, the disease was severe enough to cause economic losses in the Michigan growing region. Michigan isolates from sugar beet were examined ...

  3. The University of Michigan, Kellogg Building Expansion & Renovation, Ann Arbor, Michigan.

    Design Cost Data, 2001

    2001-01-01

    Presents design, construction, and cost data for the University of Michigan's Kellogg Building expansion and renovation project. A list of project manufacturers and suppliers is provided along with four photographs and four floor plans. (GR)

  4. Operability and location of Michigan's timber resource.

    Mark H. Hansen; Jerold T. Hahn

    1987-01-01

    Operability is the ease or difficulty of managing or harvesting timber because of physical conditions in the stand or on the site. Data collected during the 1980 Michigan statewide forest inventory were used to examine operability of the timber resource based on seven operability components.

  5. Michigan's forests, 2004: statistics and quality assurance

    Scott A. Pugh; Mark H. Hansen; Gary Brand; Ronald E. McRoberts

    2010-01-01

    The first annual inventory of Michigan's forests was completed in 2004 after 18,916 plots were selected and 10,355 forested plots were visited. This report includes detailed information on forest inventory methods, quality of estimates, and additional tables. An earlier publication presented analyses of the inventoried data (Pugh et al. 2009).

  6. Trypanosomes of Bufo americanus from northern Michigan.

    Werner, J K; Davis, J S; Slaght, K S

    1988-10-01

    Two hundred one American toads (Bufo americanus) from northern Michigan were examined for blood trypanosomes. Three species, Trypanosoma bufophlebotomi, T. schmidti-like sp. and T. pseudopodia, had prevalences of 27, 16 and 1%, respectively. Cross experimental inoculations showed that T. bufophlebotomi from toads is not the same as T. ranarum found in frogs of the family Ranidae of this region.

  7. Private timberland owners of Michigan, 1994.

    Earl C. Leatherberry; Neal P. Kingsley; Thomas W. Birch

    1998-01-01

    Identifies and profiles Michigan's private timberland owners. Estimates the number and distribution of private timberland owners by owner attitudes and objectives concerning forest ownership, management, and use. Provides 45 tables relating to owner and property characteristics for the state and its four survey units.

  8. Demographic characteristics and motivations of Michigan agritourists

    Deborah Che; Ann Veeck; Gregory Veeck

    2007-01-01

    Michigan agricultural producers, faced with declining commodity prices, rising production costs, and increased global competition, have looked at agritourism as a way to save the farm as well as provide customers with personalized service; high-quality, fresh food; and farm, nature, and family experiences. While previous research on agritourism indicates that it taps...

  9. Clean Hands Count

    Full Text Available ... has been rented. This feature is not available right now. Please try again later. Published on May ... 34 How The Clean Hands - Safe Hands System Works - Duration: 3:38. Clean Hands-Safe Hands 5, ...

  10. Broadening Pathways to Geosciences with an Integrated Program at The University of Michigan

    Dick, G.; Munson, J.

    2017-12-01

    Low participation of under-represented minorities (URM) in the geosciences is an acute issue at the University of Michigan (U-M), where the number of undergraduate URM students majoring in the Department of Earth and Environmental Sciences (EES) is typically 5% of total majors. The goal of our project is to substantially increase the number and success rate of underrepresented minorities majoring in EES at U-M. We are pursuing this goal with five primary objectives: (i) inspire and recruit high schools seniors to pursue geoscience at U-M, especially through hands-on experiences including field trips; (ii) establish infrastructure to support students interested in geosciences through the critical juncture between high school and college; (iii) increase the number of URM students transferring from community college; (iv) develop student interest in geosciences through research and field experiences; (v) expose students to career opportunities in the geosciences. To accomplish these objectives we are leveraging existing programs, including Earth Camp, Foundations for Undergraduate Teaching: Uniting Research and Education (FUTURE), M-Sci, and college academic advisors. Throughout our interactions with students from high-school through college, we expose them to career opportunities in the geosciences, including private industry, academia, and government agencies. Evaluation of the program revealed three main conclusions: (i) the program increased student interest in pursuing an earth science degree; (ii) participating students showed a marked increase in awareness about the various opportunities that are available with an earth science degree including pathways to graduate school and earth science careers; (iii) field trips were the most effective route for achieving outcomes (i) and (ii).

  11. Hand Surgery: Anesthesia

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Hand Surgery Anesthesia Email to a friend * required ...

  12. Mapping Lake Michigan Fish Catch Data

    Wodd, Jacob; Doucette, Jarrod; Höök, Tomas O.

    2014-01-01

    The only Great Lake completely contained in the U.S., Lake Michigan offers an abundance of recreational fishing. This project takes 20 years’ worth of salmonid fish catch data, and uses GIS to organize and visually represent the data in a way that is meaningful and helpful to local fisherman and researchers. Species represented included Brown Trout, Lake Trout, Rainbow Trout, Chinook Salmon, and Coho Salmon. The species are organized by both decadal and yearly spans, as well as catch per t...

  13. Plutonium and americium in Lake Michigan sediments

    Edgington, D.N.; Alberts, J.J.; Wahlgren, M.A.; Karttunen, J.O.; Reeve, C.A.

    1975-01-01

    The vertical distributions of 239 , 240 Pu, 238 Pu, and 137 Cs have been measured in sediment cores taken from Lake Michigan. Sections from a limited number of cores have been analyzed for 241 Am. In addition, grab samples from ten locations in the southern basin of the lake have been analyzed for phase distribution of 239 , 240 Pu using a sequential extraction technique. The results indicate that the 239 , 240 Pu, 238 Pu, and 137 Cs from weapons testing, and the 241 Am formed in situ are concentrated in the sediments. A comparison of the total deposition of 239 , 240 Pu and 137 Cs indicates that 137 Cs may be valuable as a monitor for 239 , 240 Pu deposition in the sediments. Values of the 238 Pu/ 239 , 240 Pu ratio are in agreement with values reported in Lake Ontario sediments (and Lake Michigan plankton) and show little variation with depth. 241 Am data support the concept of in situ production with little preferential mobility after formation. Studies of sedimentary phase distributions show that 239 , 240 Pu is associated with hydrous oxide phases which are chemically stable under the prevailing conditions in lake sediments. Since Lake Michigan sediments remain aerobic, relatively little 239 , 240 Pu is available for chemical mobilization from the hydrous oxide or organic phases present in the sediments

  14. Synthetic musk fragrances in Lake Michigan.

    Peck, Aaron M; Hornbuckle, Keri C

    2004-01-15

    Synthetic musk fragrances are added to a wide variety of personal care and household products and are present in treated wastewater effluent. Here we report for the first time ambient air and water measurements of six polycyclic musks (AHTN, HHCB, ATII, ADBI, AHMI, and DPMI) and two nitro musks (musk xylene and musk ketone) in North America. The compounds were measured in the air and water of Lake Michigan and in the air of urban Milwaukee, WI. All of the compounds except DPMI were detected. HHCB and AHTN were found in the highest concentrations in all samples. Airborne concentrations of HHCB and AHTN average 4.6 and 2.9 ng/m3, respectively, in Milwaukee and 1.1 and 0.49 ng/m3 over the lake. The average water concentration of HHCB and AHTN in Lake Michigan was 4.7 and 1.0 ng/L, respectively. A lake-wide annual mass budget shows that wastewater treatment plant discharge is the major source (3470 kg/yr) of the synthetic musks while atmospheric deposition contributes less than 1%. Volatilization and outflow through the Straits of Mackinac are major loss mechanisms (2085 and 516 kg/yr for volatilization and outflow, respectively). Concentrations of HHCB are about one-half the predicted steady-state water concentrations in Lake Michigan.

  15. J-pouch vs. side-to-end anastomosis after hand-assisted laparoscopic low anterior resection for rectal cancer: A prospective randomized trial on short and long term outcomes including life quality and functional results.

    Okkabaz, Nuri; Haksal, Mustafa; Atici, Ali Emre; Altuntas, Yunus Emre; Gundogan, Ersin; Gezen, Fazli Cem; Oncel, Mustafa

    2017-11-01

    To analyze the outcomes of j-pouch and side-to-end anastomosis in rectal cancer patients treated with laparoscopic hand-assisted low anterior resection. Prospective trial on cases randomized to have a colonic j-pouch or a side-to-end anastomosis after low anterior resection. Demographics, characteristics of disease and treatment, perioperative results, and functional outcomes and life quality were compared between the groups. Seventy four patients were randomized. Reservoir creation was withdrawn in 17 (23%) patients, mostly related to reach problem (n = 11, 64.7%). Anastomotic leakage rate was significantly higher in j-pouch group (8 [27.6%] vs. 0, p = 0.004). Stoma closure could not be achieved in 16 (28.1%) patients. Life quality and functional outcomes, measured 4, 8 and 12 months after the stoma reversal, were similar. Colonic j-pouch and side-to-end anastomosis are similar regarding perioperative measures including operation time, rates of postoperative complications, reoperation and 30-day mortality, and hospitalization period except anastomotic leak rate, which is higher in j-pouch group. Postoperative aspects are not different in patients receiving either technique including functional outcomes and life quality for the first year after stoma closure. In our opinion, both techniques may be preferred during the daily practice while performing laparoscopic surgery; but surgeons may be aware of a possibly higher anastomotic leak rate in case of a j-pouch. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Fast-Food Consumption and Obesity Among Michigan Adults

    Anderson, Beth; Lyon-Callo, Sarah; Fussman, Christopher; Imes, Gwendoline; Rafferty, Ann P.

    2011-01-01

    Introduction Consumption of meals eaten away from home, especially from fast-food restaurants, has increased in the United States since the 1970s. The main objective of this study was to examine the frequency and characteristics of fast-food consumption among adults in Michigan and obesity prevalence. Methods We analyzed data from 12 questions about fast-food consumption that were included on the 2005 Michigan Behavioral Risk Factor Survey, a population-based telephone survey of Michigan adul...

  17. Positron Emission Tomography-Scanner at Children`s Hospital of Michigan at Detroit, Michigan

    1992-12-31

    The Department of Energy has prepared an environmental assessment (EA), DOE/EA-0795, to support the DOE decision to provide a grant of $7,953,600 to be used in support of a proposed Positron Emission Tomography Scanner at Children`s Hospital of Michigan at Detroit, Michigan. Based upon the analysis in the EA, DOE has determined that the proposed action is not a major Federal action significantly affected the quality of the human environment within the meaning of the National Environmental Policy Act of 1969 (NEPA). Therefore, the preparation of an Environmental Impact Statement is not required and DOE is issuing this Finding of No Significant Impact (FONSI).

  18. Positron Emission Tomography-Scanner at Children's Hospital of Michigan at Detroit, Michigan

    1992-01-01

    The Department of Energy has prepared an environmental assessment (EA), DOE/EA-0795, to support the DOE decision to provide a grant of $7,953,600 to be used in support of a proposed Positron Emission Tomography Scanner at Children's Hospital of Michigan at Detroit, Michigan. Based upon the analysis in the EA, DOE has determined that the proposed action is not a major Federal action significantly affected the quality of the human environment within the meaning of the National Environmental Policy Act of 1969 (NEPA). Therefore, the preparation of an Environmental Impact Statement is not required and DOE is issuing this Finding of No Significant Impact (FONSI)

  19. Hands-on 2.0: improving transfer of training via the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program.

    Dort, Jonathan; Trickey, Amber; Paige, John; Schwarz, Erin; Dunkin, Brian

    2017-08-01

    Practicing surgeons commonly learn new procedures and techniques by attending a "hands-on" course, though trainings are often ineffective at promoting subsequent procedure adoption in practice. We describe implementation of a new program with the SAGES All Things Hernia Hands-On Course, Acquisition of Data for Outcomes and Procedure Transfer (ADOPT), which employs standardized, proven teaching techniques, and 1-year mentorship. Attendee confidence and procedure adoption are compared between standard and ADOPT programs. For the pilot ADOPT course implementation, a hands-on course focusing on abdominal wall hernia repair was chosen. ADOPT participants were recruited among enrollees for the standard Hands-On Hernia Course. Enrollment in ADOPT was capped at 10 participants and limited to a 2:1 student-to-faculty ratio, compared to the standard course 22 participants with a 4:1 student-to-faculty ratio. ADOPT mentors interacted with participants through webinars, phone conferences, and continuous email availability throughout the year. All participants were asked to provide pre- and post-course surveys inquiring about the number of targeted hernia procedures performed and related confidence level. Four of 10 ADOPT participants (40%) and six of 22 standard training participants (27%) returned questionnaires. Over the 3 months following the course, ADOPT participants performed more ventral hernia mesh insertion procedures than standard training participants (median 13 vs. 0.5, p = 0.010) and considerably more total combined procedures (median 26 vs. 7, p = 0.054). Compared to standard training, learners who participated in ADOPT reported greater confidence improvements in employing a components separation via an open approach (p = 0.051), and performing an open transversus abdominis release, though the difference did not achieve statistical significance (p = 0.14). These results suggest that the ADOPT program, with standardized and structured teaching

  20. Lake Michigan Offshore Wind Feasibility Assessment

    Boezaart, Arnold [GVSU; Edmonson, James [GVSU; Standridge, Charles [GVSU; Pervez, Nahid [GVSU; Desai, Neel [University of Michigan; Williams, Bruce [University of Delaware; Clark, Aaron [GVSU; Zeitler, David [GVSU; Kendall, Scott [GVSU; Biddanda, Bopi [GVSU; Steinman, Alan [GVSU; Klatt, Brian [Michigan State University; Gehring, J. L. [Michigan State University; Walter, K. [Michigan State University; Nordman, Erik E. [GVSU

    2014-06-30

    The purpose of this project was to conduct the first comprehensive offshore wind assessment over Lake Michigan and to advance the body of knowledge needed to support future commercial wind energy development on the Great Lakes. The project involved evaluation and selection of emerging wind measurement technology and the permitting, installation and operation of the first mid-lake wind assessment meteorological (MET) facilities in Michigan’s Great Lakes. In addition, the project provided the first opportunity to deploy and field test floating LIDAR and Laser Wind Sensor (LWS) technology, and important research related equipment key to the sitting and permitting of future offshore wind energy development in accordance with public participation guidelines established by the Michigan Great Lakes Wind Council (GLOW). The project created opportunities for public dialogue and community education about offshore wind resource management and continued the dialogue to foster Great Lake wind resource utilization consistent with the focus of the GLOW Council. The technology proved to be effective, affordable, mobile, and the methods of data measurement accurate. The public benefited from a substantial increase in knowledge of the wind resources over Lake Michigan and gained insights about the potential environmental impacts of offshore wind turbine placements in the future. The unique first ever hub height wind resource assessment using LWS technology over water and development of related research data along with the permitting, sitting, and deployment of the WindSentinel MET buoy has captured public attention and has helped to increase awareness of the potential of future offshore wind energy development on the Great Lakes. Specifically, this project supported the acquisition and operation of a WindSentinel (WS) MET wind assessment buoy, and associated research for 549 days over multiple years at three locations on Lake Michigan. Four research objectives were defined for the

  1. 76 FR 36152 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo...

    2011-06-21

    ...: Western Michigan University, Anthropology Department, Kalamazoo, MI; Correction AGENCY: National Park... human remains and associated funerary objects. Western Michigan University, Department of Anthropology... may contact the Western Michigan University, Department of Anthropology. Disposition of the human...

  2. 76 FR 28077 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

    2011-05-13

    ...: Western Michigan University, Anthropology Department, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: Western Michigan University, Department of Anthropology, has completed... contact the Western Michigan University, Department of Anthropology. Disposition of the human remains to...

  3. 76 FR 36149 - Notice of Inventory Completion: Western Michigan University, Department of Anthropology...

    2011-06-21

    ...: Western Michigan University, Department of Anthropology, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: Western Michigan University, Department of Anthropology, has completed... contact the Western Michigan University, Department of Anthropology. Disposition of the human remains and...

  4. Osteoarthritis of the Hand

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Osteoarthritis Email to a friend * required fields From * ...

  5. Hands in Systemic Disease

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... hands, being composed of many types of tissue, including blood vessels, nerves, skin and skin-related tissues, bones, and muscles/tendons/ligaments, may show changes that reflect a ...

  6. Denmark: HAND in HAND Policy Questionnaire

    Laursen, Hilmar Dyrborg; Nielsen, Birgitte Lund

    2018-01-01

    Som del af det internationale EU finansierede projekt Hand in Hand, der fokuserer på de såkaldte SEI-kompetencer (Social, Emotional, Intercultural), er dansk policy i relation til elevernes sociale, emotionelle og interkulturelle læring kortlagt i denne rapport. Der refereres bl.a. til "elevernes...

  7. Comparative analysis of discharges into Lake Michigan, Phase I - Southern Lake Michigan.

    Veil, J. A.; Elcock, D.; Gasper, J. R.; Environmental Science Division

    2008-06-30

    BP Products North America Inc. (BP) owns and operates a petroleum refinery located on approximately 1,700 acres in Whiting, East Chicago, and Hammond, Indiana, near the southern tip of Lake Michigan. BP provided funding to Purdue University-Calumet Water Institute (Purdue) and Argonne National Laboratory (Argonne) to conduct studies related to wastewater treatment and discharges. Purdue and Argonne are working jointly to identify and characterize technologies that BP could use to meet the previous discharge permit limits for total suspended solids (TSS) and ammonia after refinery modernization. In addition to the technology characterization work, Argonne conducted a separate project task, which is the subject of this report. In Phase I of a two-part study, Argonne estimated the current levels of discharge to southern Lake Michigan from significant point and nonpoint sources in Illinois, Indiana, and portions of Michigan. The study does not consider all of the chemicals that are discharged. Rather, it is narrowly focused on a selected group of pollutants, referred to as the 'target pollutants'. These include: TSS, ammonia, total and hexavalent chromium, mercury, vanadium, and selenium. In Phase II of the study, Argonne will expand the analysis to cover the entire Lake Michigan drainage basin.

  8. Project '80, Rural Michigan Now and in 1980; Michigan's Outdoor Recreation and Tourism.

    Milstein, David N.

    Michigan is widely recognized as a traditional leader in outdoor recreation and tourism. Its location and resources provide many comparative advantages toward attracting visitors. State spending for outdoor recreation amounted to $95 million over the decade ending in 1960. State and Federal policies and programs are likely to emphasize outdoor…

  9. Best Practices: The Neuroscience Program at Central Michigan University

    Dunbar, Gary L.

    2015-01-01

    The original design of our program at Central Michigan University (CMU) and its evolving curriculum were directly influenced by Faculty for Undergraduate (FUN) workshops at Davidson College, Oberlin College, Trinity College, and Macalester College. The course content, laboratory exercises, and pedagogy used were informed by excellent articles in the Journal of Undergraduate Neuroscience Education (JUNE) and presentations at these FUN workshops and meetings over the years. Like the program at Baldwin-Wallace College, which was a previous winner of the Undergraduate Neuroscience Program of the Year Award, as selected by the Committee on Neuroscience Departments and Programs (CNDP) of the Society for Neuroscience (SfN, our program stresses the importance of inquiry-based, hands-on research experience for our undergraduates and utilizes a peer-mentoring system. A distinct advantage that is employed at CMU is the use of graduate student mentors, which allows us to expand our peer-mentorship to distinct research teams that are focused on a specific research project. Developing our program was not easy. The present manuscript reviews the long and arduous journey (including ways in which we navigated some difficult internal political issues) we made to build a strong program. Hopefully, this description may prove helpful for other evolving programs, in terms of avoiding certain pitfalls and overcoming obstacles, as well as selecting practices that have proven to be successful at our institution. PMID:26240523

  10. Evaporite karst of northern lower Michigan

    Black, T.J.

    1997-01-01

    Michigan has three main zones of evaporite karst: collapse breccia in Late Silurian deposits of the Mackinac Straits region; breccia, collapse sinks, and mega-block collapse in Middle Devonian deposits of Northern Lower Michigan, which overlaps the preceding area; and areas of soil swallows in sinks of Mississippian deposits between Turner and Alabaster in Arenac and Iosco counties, and near Grand Rapids in Kent County. The author has focused his study on evaporite karst of the Middle Devonian deposits. The Middle Devonian depos its are the Detroit River Group: a series consisting of limestone, dolomite, shale, salt, gypsum, and anhydrite. The group occurs from subcrop, near the surface, to nearly 1400 feet deep from the northern tip of the Southern Peninsula to the south edge of the "solution front" Glacial drift is from zero to 350 feet thick. Oil and gas exploration has encountered some significant lost-circulation zones throughout the area. Drilling without fluid returns, casing-seal failures, and lost holes are strong risks in some parts of the region. Lost fluid returns near the top of the group in nearby areas indicate some karst development shortly after deposition. Large and irregular lost-circulation zones, linear and patch trends of large sink holes, and 0.25 mile wide blocks of down-dropped land in the northern Lower Peninsula of Michigan were caused by surface- and ground-water movement along faults into the Detroit River Group. Glaciation has removed some evidence of the karst area at the surface. Sinkhole development, collapse valleys, and swallows developed since retreat of the glacier reveal an active solution front in the Detroit River Group.

  11. Mortality Rates Among Arab Americans in Michigan

    Dallo, Florence J.; Schwartz, Kendra; Ruterbusch, Julie J.; Booza, Jason; Williams, David R.

    2012-01-01

    The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, ...

  12. Creating Safe and Healthy Futures: Michigan Youth Violence Prevention Center

    Morrel-Samuels, Susan; Zimmerman, Marc A.; Reischl, Thomas M.

    2013-01-01

    Youth are in the cross-fire of gun violence, and the highest rate in the nation is in Flint, Michigan. This article highlights six innovative strategies that prepare youth to solve problems at home and in their communities in peaceful ways. The Michigan Youth Violence Prevention Center (MI-YVPC) works with community groups to strengthen…

  13. Education Inputs, Student Performance and School Finance Reform in Michigan

    Chaudhary, Latika

    2009-01-01

    This paper estimates the impact of the Michigan school finance reform, "Proposal A," on education inputs and test scores. Using a difference-in-difference estimation strategy, I find that school districts in Michigan used the increase in educational spending generated through "Proposal A" to increase teacher salaries and reduce…

  14. Lake Michigan lake trout PCB model forecast post audit

    Scenario forecasts for total PCBs in Lake Michigan (LM) lake trout were conducted using the linked LM2-Toxics and LM Food Chain models, supported by a suite of additional LM models. Efforts were conducted under the Lake Michigan Mass Balance Study and the post audit represents th...

  15. Estimating Cause: Teacher Turnover and School Effectiveness in Michigan

    Keesler, Venessa; Schneider, Barbara

    2010-01-01

    The purpose of this paper is investigate issues related to within-school teacher supply and school-specific teacher turnover within the state of Michigan using state administrative data on Michigan's teaching force. This paper 1) investigates the key predictors of teacher turnover and mobility, 2) develops a profile of schools that are likely to…

  16. Unemployment Insurance Fund Insolvency and Debt in Michigan.

    Blaustein, Saul J.

    Without changes in Michigan's unemployment insurance law, the state's unemployment insurance debt will probably reach $3.8 billion by the end of 1985. Currently, Michigan's employers pay unemployment insurance tax rates that vary from 1 to 9 percent, depending upon the amount of benefits charged against their accounts. Beginning with the federal…

  17. Illness representations in patients with hand injury.

    Chan, Jeffrey C Y

    2009-07-01

    Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting.

  18. Tropical diabetic hand syndrome: a case report.

    Yeika, Eugene Vernyuy; Tchoumi Tantchou, Jacques Cabral; Foryoung, Joyce Bei; Tolefac, Paul Nkemtendong; Efie, Derrick Tembi; Choukem, Siméon Pierre

    2017-02-13

    Tropical diabetic hand syndrome describes a complex hand sepsis affecting patients with diabetes across the tropics and often results from a trivial hand trauma. The clinical presentation of this syndrome is variable and ranges from localised swelling and cellulitis, with or without ulceration of the hand to progressive fulminant hand sepsis, and gangrene affecting the entire limb which may be fatal. Tropical diabetic hand syndrome could lead to permanent disability and death as a result of delay in presentation, late diagnosis and late medical and surgical intervention. This indexed case acts as an eye opener for physicians to the existence of this hand sepsis. We report the case of a 57 year-old black African female diabetic who was referred to our centre for the management of a suppurating ulcer and swelling of the left hand of two weeks duration. On examination and work-up, the patient was found to have Lawal Group III left diabetic hand syndrome and was managed with parenteral antibiotics, radical debridement and the hand was eventually amputated. She died 7 days following amputation from overwhelming sepsis. Though tropical diabetic hand syndrome is a relatively rare complication of diabetes, it can be fatal as in this case report. Early diagnosis and proper management would yield better outcome. Initial management should include aggressive intravenous broad-spectrum antibiotics with anaerobic coverage. Classification of tropical diabetic hand syndrome will assist physicians and surgeons in decision making, proper management and easy communication.

  19. Robotic hand project

    Karaçizmeli, Cengiz; Çakır, Gökçe; Tükel, Dilek

    2014-01-01

    In this work, the mechatronic based robotic hand is controlled by the position data taken from the glove which has flex sensors mounted to capture finger bending of the human hand. The angular movement of human hand’s fingers are perceived and processed by a microcontroller, and the robotic hand is controlled by actuating servo motors. It has seen that robotic hand can simulate the movement of the human hand that put on the glove, during tests have done. This robotic hand can be used not only...

  20. Agreement Between Michigan State University and Lodge 141, Fraternal Order of Police, Michigan State University Division, July 1, 1974.

    Michigan State Univ., East Lansing.

    This agreement, entered into July 1, 1974, is between the Board of Trustees of Michigan State University and Lodge 141 of the Fraternal Order of Police, Michigan State University Division. It is the intent and purpose of this agreement to assure sound and mutually beneficial working and economic relationships between the parties, to provide an…

  1. Recruitment variability of alewives in Lake Michigan

    Madenjian, C.P.; Hook, T.O.; Rutherford, E.S.; Mason, D.M.; Croley, T.E.; Szalai, E.B.; Bence, J.R.

    2005-01-01

    We used a long-term series of observations on alewife Alosa pseudoharengus abundance that was based on fall bottom-trawl catches to assess the importance of various abiotic and biotic factors on alewife recruitment in Lake Michigan during 1962–2002. We first fit a basic Ricker spawner–recruit model to the lakewide biomass estimates of age-3 recruits and the corresponding spawning stock size; we then fit models for all possible combinations of the following four external variables added to the basic model: an index of salmonine predation on an alewife year-class, an index for the spring–summer water temperatures experienced by alewives during their first year in the lake, an index of the severity of the first winter experienced by alewives in the lake, and an index of lake productivity during an alewife year-class's second year in the lake. Based on an information criterion, the best model for alewife recruitment included indices of salmonine predation and spring–summer water temperatures as external variables. Our analysis corroborated the contention that a decline in alewife abundance during the 1970s and early 1980s in Lake Michigan was driven by salmonine predation. Furthermore, our findings indicated that the extraordinarily warm water temperatures during the spring and summer of 1998 probably led to a moderately high recruitment of age-3 alewives in 2001, despite abundant salmonines.

  2. 'Born in Michigan? You're in the biobank': engaging population biobank participants through Facebook advertisements.

    Platt, J E; Platt, T; Thiel, D; Kardia, S L R

    2013-01-01

    Despite a broad call for biobanks to use social media, data is lacking regarding the capacity of social media tools, especially advertising, to engage large populations on this topic. We used Facebook advertising to engage Michigan residents about the BioTrust for Health. We conducted a low-budget (social media campaign targeting Michigan residents aged 18-28. We placed 25 Facebook advertisements and analyzed their performance in terms of reach and cost across 3 engagement types: passive, active and interactive. We compared engagement before, during and after the campaign. The Facebook page was viewed 1,249 times during the month of the advertising campaign, versus once in the month prior. 779,004 Michigan residents saw ads an average of 25.8 times; 4,275 clicked ads; the average click-through-ratio was 0.021%. Interactions included 516 'likes' and 30 photo contest entries. Cost per outcome ranged from social media strategy to build public awareness about biobanking is not likely to be effective without a promotional 'push' to distribute content. Social media advertisements have the capacity to scale-up engagement on biobanking while keeping costs manageable. Facebook advertisements provide necessary access points for unaware participants, with implications for public trust. Copyright © 2013 S. Karger AG, Basel.

  3. Hand infections: a retrospective analysis

    Tolga Türker

    2014-09-01

    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  4. Clean Hands Count

    Full Text Available ... to promote or encourage adherence to CDC hand hygiene recommendations. It is a component of the Clean ... aims to address myths and misperceptions about hand hygiene and empower patients to play a role in ...

  5. Clean Hands Count

    Full Text Available ... intended to promote or encourage adherence to CDC hand hygiene recommendations. It is a component of the Clean ... also aims to address myths and misperceptions about hand hygiene and empower patients to play a role in ...

  6. Clean Hands Count

    ... intended to promote or encourage adherence to CDC hand hygiene recommendations. It is a component of the Clean ... also aims to address myths and misperceptions about hand hygiene and empower patients to play a role in ...

  7. Wash Your Hands

    ... hand sanitizers might not remove harmful chemicals like pesticides and heavy metals from hands. Be cautious when ... Health Promotion Materials Fact Sheets Podcasts Posters Stickers Videos Web Features Training & Education Our Partners Publications, Data & ...

  8. Hand hygiene strategies

    Yazaji, Eskandar Alex

    2011-01-01

    Hand hygiene is one of the major players in preventing healthcare associated infections. However, healthcare workers compliance with hand hygiene continues to be a challenge. This article will address strategies to help improving hand hygiene compliance. Keywords: hand hygiene; healthcare associated infections; multidisciplinary program; system change; accountability; education; feedback(Published: 18 July 2011)Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1: 72...

  9. About Hand Surgery

    ... Find a hand surgeon near you. © 2009 American Society for Surgery of the Hand. Definition developed by ASSH Council. Other Links CME Mission Statement and Disclaimer Policies and Technical Requirements Exhibits and Partners ASSH 822 W. Washington Blvd. ... 2018 by American Society for Surgery of the Hand × Search Tips Tip ...

  10. Guideline Implementation: Hand Hygiene.

    Goldberg, Judith L

    2017-02-01

    Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis. The key points address the necessity of keeping fingernails and skin healthy, not wearing jewelry on the hands or wrists in the perioperative area, properly performing hand hygiene and surgical hand antisepsis, and involving patients and visitors in hand hygiene initiatives. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  11. Robotic hand and fingers

    Salisbury, Curt Michael; Dullea, Kevin J.

    2017-06-06

    Technologies pertaining to a robotic hand are described herein. The robotic hand includes one or more fingers releasably attached to a robotic hand frame. The fingers can abduct and adduct as well as flex and tense. The fingers are releasably attached to the frame by magnets that allow for the fingers to detach from the frame when excess force is applied to the fingers.

  12. Measuring hand function in the young child.

    Ho, Emily S

    2010-01-01

    Assessing outcomes is vital in any hand therapy practice setting, as it is the primary method of determining whether or not a treatment program is working. In the pediatric population, determining improvements in hand function can be challenging. The author describes using a developmental perspective to evaluate hand function for infants and young children. The utilization of a consistent approach to play along with standard toys is described in this article as a method to evaluate the quality of hand function throughout developmental grasp patterns. Copyright © 2010 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  13. Environmental status of the Lake Michigan region. Volume 6. Zoobenthos of Lake Michigan

    Mozley, S.C.; Howmiller, R.P.

    1977-09-01

    This report summarizes Lake Michigan zoobenthic studies up to 1974, including reports of power-plant surveys. It describes ecologies of macroinvertebrate species and some microfauna, partly through use of data from other Great Lakes. The following are discussed: methodology of field surveys; zoobenthic indicators of pollution; zoobenthic effects on sediment-water exchanges; and numbers, biomass, and production of total macroinvertebrates. Prominent features of Lake Michigan zoobenthos include predominance of the amphipod Pontoporeia affinis, usefulness of tubificid oligochaetes in mapping environmental quality, and pronounced qualitative gradients in zoobenthos in relation to depth. Further research is needed on sampling methods, energy flow rates and pathways through benthic communities, factors limiting distribution of species near shore, and effects of macroinvertebrates on sediment chemistry and structure.

  14. Sarcoptic mange in raccoons in Michigan.

    Fitzgerald, Scott D; Cooley, Thomas M; Murphy, Alice; Cosgrove, Melinda K; King, Betty A

    2004-04-01

    Sarcoptic mange is a cause of pruritic skin disease in domestic dogs and a wide range of wildlife species. We describe sarcoptic mange in free-ranging raccoons (Procyon lotor). Three adult raccoons from upper Wayne County, Michigan (USA), were captured, killed, and submitted for diagnostic evaluation. The animals were intensely pruritic, and two had advanced alopecic and crusting lesions over their dorsum and hind limbs. Skin scrapings and skin biopsies revealed crusting and hyperkeratotic dermatitis with high numbers of Sarcoptes scabiei adults, larvae, nymphs, and eggs. These raccoons were not otherwise debilitated, with minimal internal parasites, good body condition, and no evidence of infectious bacterial or viral diseases. Because sarcoptic mange is highly contagious and affects many species, including humans, transiently, it is important that wildlife biologists and rehabilitators include sarcoptic mange in their differential list for raccoons exhibiting pruritus and alopecia.

  15. Thermal discharge residence by Lake Michigan Salmonids

    Romberg, G.P.; Prepejchal, W.

    1975-01-01

    Lake Michigan salmon and trout were tagged with a thermoluminescent dosimeter (TLD) temperature tag to estimate their thermal exposure and residence time at a warm water discharge. Fish were collected, tagged, and released at the Point Beach Nuclear Plant, Two Rivers, Wisconsin, in the fall of 1973 and 1974. Tags were recovered during the same season, primarily from fish recaptured at Point Beach. Average uniform temperature exposure and maximum possible discharge residence time were determined. Appropriate hourly intake and discharge temperatures were averaged to calculate mean temperature exposure for the case of maximum discharge residence. Lowest discharge temperature not included within the period of maximum residence was identified to serve as a possible indicator of avoidance temperature. Mean values for the above parameters were calculated for fish species for each tagging year and are reported with the accompanying range of intake and discharge temperatures

  16. Financial impact of hand surgery programs on academic medical centers.

    Hasan, Jafar S; Chung, Kevin C; Storey, Amy F; Bolg, Mary L; Taheri, Paul A

    2007-02-01

    This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. Fiscal year 2004 billing records for all patients (n = 671) who underwent hand surgery procedures were examined. The financial data were separated into professional revenues and costs (relating to the hand surgery program in the Section of Plastic Surgery) and into facility revenues and costs (relating to the overall University of Michigan Health System). Professional net revenue was calculated by applying historical collection rates to procedural and clinic charges. Facility revenue was calculated by applying historical collection rates to the following charge categories: inpatient/operating room, clinic facility, neurology/electromyography, radiology facilities, and occupational therapy. Total professional costs were calculated by adding direct costs and allocated overhead costs. Facility costs were obtained from the hospital's cost accounting system. Professional and facility incomes were calculated by subtracting costs from revenues. The net professional revenue and total costs were 1,069,836 and 1,027,421 dollars, respectively. Professional operating income was 42,415 dollars, or 3.96 percent of net professional revenue. Net facility revenue and total costs were 5,500,606 and 4,592,534 dollars, respectively. Facility operating income was 908,071 dollars, or 16.51 percent of net facility revenues. While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.

  17. Surficial geologic map of Berrien County, Michigan, and the adjacent offshore area of Lake Michigan

    Stone, Byron D.; Kincare, Kevin A.; O'Leary, Dennis W.; Newell, Wayne L.; Taylor, Emily M.; Williams, Van S.; Lundstrom, Scott C.; Abraham, Jared E.; Powers, Michael H.

    2017-12-13

    The surficial geologic map of Berrien County, southwestern Michigan (sheet 1), shows the distribution of glacial and postglacial deposits at the land surface and in the adjacent offshore area of Lake Michigan. The geologic map differentiates surficial materials of Quaternary age on the basis of their lithologic characteristics, stratigraphic relationships, and age. Drill-hole information correlated in cross sections provides details of typical stratigraphic sequences that compose one or more penetrated geologic map units. A new bedrock geologic map (on sheet 2) includes contours of the altitude of the eroded top of bedrock and shows the distribution of middle Paleozoic shale and carbonate units in the subcrop. A sediment thickness map (also on sheet 2) portrays the extent of as much as 150 meters of surficial materials that overlie the bedrock surface.The major physical features of the county are related principally to deposits of the last Laurentide ice sheet that advanced and then retreated back through the region from about 19,000 to 14,000 radiocarbon years before present. Glacial and postglacial deposits underlie the entire county; shale bedrock crops out only in the adjacent offshore area on the bottom of Lake Michigan. All glacial deposits and glacial meltwater deposits in Berrien County are related to the late Wisconsinan glacial advances of the Lake Michigan ice lobe and its three regional recessional moraines, which cross the county as three north-northeast-trending belts.From east to west (oldest to youngest), the three moraine belts are known as the Kalamazoo, Valparaiso, and Lake Border morainic systems. The till-ridge morainic systems (Lake Border and local Valparaiso morainic systems) consist of multiple, elongate moraine ridges separated by till plains and lake-bottom plains. Tills in ground and end moraines in Berrien County are distinguished as informal units, and are correlated with three proposed regional till units in southwestern Michigan

  18. Unusual case of cleft hand

    Sahasrabudhe Parag

    2007-01-01

    Full Text Available We present a case of a six-year-old male child with cleft hand deformity involving the dominant right hand. It was a rare case of atypical cleft hand with no missing tissue but cleft extending to metacarpal level and associated hypoplasia of thumb and index finger. As per Manske′s classification of cleft hand our patient belongs to the Class III variety. There was associated malposition of the index finger with absence of first web space and syndactly of thumb and index finger at the metacarpal level. A modified Snow-Littler procedure was planned. The surgical plan involved closure of cleft, release of thumb and index finger syndactly and reconstruction of the first web space. The functional outcome was good considering hypoplasia of the index finger and thumb. Depending upon the function of the thumb tendon transfers can be planned to augment thumb function at a later date along with correction of rotational deformities of the index and middle finger.

  19. The Avocado Hand

    Rahmani, G

    2017-11-01

    Accidental self-inflicted knife injuries to digits are a common cause of tendon and nerve injury requiring hand surgery. There has been an apparent increase in avocado related hand injuries. Classically, the patients hold the avocado in their non-dominant hand while using a knife to cut\\/peel the fruit with their dominant hand. The mechanism of injury is usually a stabbing injury to the non-dominant hand as the knife slips past the stone, through the soft avocado fruit. Despite their apparent increased incidence, we could not find any cases in the literature which describe the “avocado hand”. We present a case of a 32-year-old woman who sustained a significant hand injury while preparing an avocado. She required exploration and repair of a digital nerve under regional anaesthesia and has since made a full recovery.

  20. Lake Michigan Fish Acoustic Data from 2011 to 2016

    Department of the Interior — Each line in the file “Lake Michigan fish acoustic data from 2011 to 2016.csv” represents the acoustic data and estimated fish density for a single depth layer of...

  1. Michigan 2008 Lidar Coverage, USACE National Coastal Mapping Program

    Army Corps of Engineers, Department of the Army, Department of Defense — The Joint Airborne Lidar Bathymetry Technical Center of Expertise (JALBTCX) has performed a coastal survey along the MI coasts of Lake Superior, Lake Michigan and...

  2. Pavement subgrade MR design values for Michigan's seasonal changes : appendices.

    2009-07-22

    The resilient modulus (MR) of roadbed soil plays an integral role in the design of pavement systems. Currently, the various regions of the Michigan Department of Transportation (MDOT) use different procedures to determine the MR values. Most of these...

  3. Lake-wide distribution of Dreissena in Lake Michigan, 1999

    Fleischer, Guy W.; DeSorcie, Timothy J.; Holuszko, Jeffrey D.

    2001-01-01

    The Great Lakes Science Center has conducted lake-wide bottom trawl surveys of the fish community in Lake Michigan each fall since 1973. These systematic surveys are performed at depths of 9 to 110 m at each of seven index sites around Lake Michigan. Zebra mussel (Dreissena polymorpha) populations have expanded to all survey locations and at a level to sufficiently contribute to the bottom trawl catches. The quagga (Dreissena bugensis), recently reported in Lake Michigan, was likely in the catches though not recognized. Dreissena spp. biomass ranged from about 0.6 to 15 kg/ha at the various sites in 1999. Dreissenid mussels were found at depths of 9 to 82 m, with their peak biomass at 27 to 46 m. The colonization of these exotic mussels has ecological implications as well as potential ramifications on the ability to sample fish consistently and effectively with bottom trawls in Lake Michigan.

  4. Willow Run Laboratories: Separating from the University of Michigan

    Walsh, John

    1972-01-01

    Outlines the reasons for, and the problems involved in, separation of a research center from the University of Michigan in order to become an independent research organization contracting for private and military research. (AL)

  5. Hand eczema classification

    Diepgen, T L; Andersen, Klaus Ejner; Brandao, F M

    2008-01-01

    of the disease is rarely evidence based, and a classification system for different subdiagnoses of hand eczema is not agreed upon. Randomized controlled trials investigating the treatment of hand eczema are called for. For this, as well as for clinical purposes, a generally accepted classification system...... A classification system for hand eczema is proposed. Conclusions It is suggested that this classification be used in clinical work and in clinical trials....

  6. Coordination of hand shape.

    Pesyna, Colin; Pundi, Krishna; Flanders, Martha

    2011-03-09

    The neural control of hand movement involves coordination of the sensory, motor, and memory systems. Recent studies have documented the motor coordinates for hand shape, but less is known about the corresponding patterns of somatosensory activity. To initiate this line of investigation, the present study characterized the sense of hand shape by evaluating the influence of differences in the amount of grasping or twisting force, and differences in forearm orientation. Human subjects were asked to use the left hand to report the perceived shape of the right hand. In the first experiment, six commonly grasped items were arranged on the table in front of the subject: bottle, doorknob, egg, notebook, carton, and pan. With eyes closed, subjects used the right hand to lightly touch, forcefully support, or imagine holding each object, while 15 joint angles were measured in each hand with a pair of wired gloves. The forces introduced by supporting or twisting did not influence the perceptual report of hand shape, but for most objects, the report was distorted in a consistent manner by differences in forearm orientation. Subjects appeared to adjust the intrinsic joint angles of the left hand, as well as the left wrist posture, so as to maintain the imagined object in its proper spatial orientation. In a second experiment, this result was largely replicated with unfamiliar objects. Thus, somatosensory and motor information appear to be coordinated in an object-based, spatial-coordinate system, sensitive to orientation relative to gravitational forces, but invariant to grasp forcefulness.

  7. Prostate Cancer Clinical Trials Group: The University of Michigan Site

    2011-04-01

    2931 alhawary@umich.edu Stephanie Daignault, MS, Biostatistician, Biostatistics Core University of Michigan Comprehensive Cancer Center NI8D11...Consortium; The Cancer Institute of New Jersey/University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; Robert Wood Johnson Medical School...University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; University of Michigan, Ann Arbor, MI; University of Wisconsin Carbone

  8. Clean Hands Count

    Full Text Available ... 585 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,097 ... 089,212 views 4:50 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 26,032 views ...

  9. Mind the hand

    Davidsen, Jacob; Christiansen, Ellen Tove

    2014-01-01

    Apart from touching the screen, what is the role of the hands for children collaborating around touchscreens? Based on embodied and multimodal interaction analysis of 8- and 9-year old pairs collaborating around touchscreens, we conclude that children use their hands to constrain and control acce...

  10. Clean Hands Count

    Full Text Available ... 024 views 2:58 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 412,404 ... 2,805 views 3:13 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 25,574 views ...

  11. HAND INJURIES IN VOLLEYBALL

    BHAIRO, NH; NIJSTEN, MWN; VANDALEN, KC; TENDUIS, HJ

    We studied the long-term sequelae of hand injuries as a result of playing volleyball. In a retrospective study, 226 patients with injuries of the hand who were seen over a 5-year period at our Trauma Department, were investigated. Females accounted for 66 % of all injuries. The mean age was 26

  12. Clean Hands Count

    Full Text Available ... 585 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 412,760 ... 536,963 views 1:46 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 25,574 views ...

  13. Clean Hands Count

    Full Text Available ... today; no cure tomorrow - Duration: 3:10. World Health Organization 74,478 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 411,292 views 5:46 Hand Washing Technique - ...

  14. Clean Hands Count

    Full Text Available ... 029 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 412,404 ... 081,511 views 4:50 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 25,194 views ...

  15. Clean Hands Count

    Full Text Available ... today; no cure tomorrow - Duration: 3:10. World Health Organization 75,362 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 412,404 views 5:46 Hand Washing Technique - ...

  16. Clean Hands Count

    Full Text Available ... 585 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,097 ... 086,746 views 4:50 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 25,802 views ...

  17. Clean Hands Count

    Full Text Available ... 453 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,702 ... 28,656 views 3:40 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 26,480 views ...

  18. Clean Hands Count

    Full Text Available ... 362 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 412,404 ... 219,427 views 1:27 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 25,194 views ...

  19. Clean Hands Count

    Full Text Available ... 03. R Mayer 371,490 views 4:03 The psychological trick behind getting people to say yes - Duration: 8:06. PBS NewsHour 606,671 views 8:06 Should You Really Wash Your Hands? - Duration: 4:51. Gross Science 57,828 views 4:51 Healthcare Worker Hand ...

  20. Clean Hands Count

    Full Text Available ... 585 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,097 ... 28,656 views 3:40 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 26,032 views ...

  1. Clean Hands Count

    Full Text Available ... 5 Moments of Hand Hygiene - Duration: 1:53. Salem Health 13,972 views 1:53 Hand Hygiene ... Mode: Off History Help Loading... Loading... Loading... About Press Copyright Creators Advertise Developers +YouTube Terms Privacy Policy & ...

  2. "Puffy hand syndrome".

    Chouk, Mickaël; Vidon, Claire; Deveza, Elise; Verhoeven, Frank; Pelletier, Fabien; Prati, Clément; Wendling, Daniel

    2017-01-01

    Intravenous drug addiction is responsible for many complications, especially cutaneous and infectious. There is a syndrome, rarely observed in rheumatology, resulting in "puffy hands": the puffy hand syndrome. We report two cases of this condition from our rheumatologic consultation. Our two patients had intravenous drug addiction. They presented with an edema of the hands, bilateral, painless, no pitting, occurring in one of our patient during heroin intoxication, and in the other 2 years after stopping injections. In our two patients, additional investigations (biological, radiological, ultrasound) were unremarkable, which helped us, in the context, to put the diagnosis of puffy hand syndrome. The pathophysiology, still unclear, is based in part on a lymphatic toxicity of drugs and their excipients. There is no etiological treatment but elastic compression by night has improved edema of the hands in one of our patients. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  3. Ethical, financial, and policy considerations in hand transplantation.

    Chang, Jeff; Mathes, David W

    2011-11-01

    Currently, more than 65 hand transplants have been performed with studies demonstrating favorable cosmetic and functional outcomes and cortical reintegration of the transplanted hand. Due to such favorable outcomes, many view hand transplant as a potential gold standard for treatment of a double amputee. However, ethical debate continues regarding risks and benefits of this nonlifesaving procedure. Clinicians, patients, and society must agree on whether hand transplantation is ethical and affordable. If a decision is made to transplant a hand, this must be performed in a dedicated center that facilitates integration of multiple specialists, ethicists, pharmacists, and rehabilitationists. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Mortality rates among Arab Americans in Michigan.

    Dallo, Florence J; Schwartz, Kendra; Ruterbusch, Julie J; Booza, Jason; Williams, David R

    2012-04-01

    The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, all-cause and cause-specific mortality rates for Arab Americans were in the range of whites and blacks. However, Arab American men had lower mortality rates from cancer and chronic lower respiratory disease compared to both whites and blacks. Among women, Arab Americans had lower mortality rates from heart disease, cancer, stroke, and diabetes than whites and blacks. Arab Americans are growing in number. Future study should focus on designing rigorous separate analyses for this population.

  5. (In)Visible Hand(s)

    Predrag Zima

    2007-01-01

    In this paper, the author discusses the regulatory role of the state and legal norms, in market economy, especially in so-called transition countries. Legal policy, and other questions of the state and free market economy are here closely connected, because the state must ensure with legal norms that economic processes are not interrupted: only the state can establish the legal basis for a market economy. The free market’s invisible hand is acting in questions such as: what is to be produced,...

  6. Prevention of hand eczema

    Fisker, Maja H; Ebbehøj, Niels E; Vejlstrup, Søren Grove

    2018-01-01

    Objective Occupational hand eczema has adverse health and socioeconomic impacts for the afflicted individuals and society. Prevention and treatment strategies are needed. This study aimed to assess the effectiveness of an educational intervention on sickness absence, quality of life and severity...... of hand eczema. Methods PREVEX (PreVention of EXema) is an individually randomized, parallel-group superiority trial investigating the pros and cons of one-time, 2-hour, group-based education in skin-protective behavior versus treatment as usual among patients with newly notified occupational hand eczema...

  7. Environmental status of the Lake Michigan region. Volume 3. Chemistry of Lake Michigan

    Torrey, M S

    1976-05-01

    The report is a synoptic review of data collected over the past twenty years on the chemistry of Lake Michigan. Changes in water quality and sediment chemistry, attributable to cultural and natural influences, are considered in relation to interacting processes and factors controlling the distribution and concentration of chemical substances within the Lake. Temperature, light, and mixing processes are among the important natural influences that affect nutrient cycling, dispersal of pollutants, and fate of materials entering the Lake. Characterization of inshore-offshore and longitudinal differences in chemical concentrations and sediment chemistry for the main body of the Lake is supplemented by discussion of specific areas such as Green Bay and Grand Traverse Bay. Residues, specific conductance, dissolved oxygen, major and trace nutrients, and contaminants are described in the following context: biological essentiality and/or toxicity, sources to the Lake, concentrations in the water column and sediments, chemical forms, seasonal variations and variation with depth. A summary of existing water quality standards, statutes, and criteria applicable to Lake Michigan is appended.

  8. Environmental status of the Lake Michigan region. Volume 14. Birds of the Lake Michigan drainage basin

    Wallace, G.J.

    1977-07-01

    This report characterizes the bird life found in 100 counties of the four states peripheral to Lake Michigan. It discusses major habitats (the Lake Michigan shoreline, inland lakes, rivers and streams, marshes, fields and open spaces, and woodlots) and associates specific birds with habitats according to preferences for space and food. It also discusses the special attributes of state parks and lakeshores, refuges and sanctuaries, and other special areas which are attractive to avifauna. Patterns of historical occurrence and abundance, and the influence of pesticides and pollution, disease, and hunting pressure are explored to place present occurrence in a modern perspective. Migration patterns are discussed to explain increases and decreases which occur in nonresident avifauna of the Basin. The distribution and habits of birds that occur regularly in the Basin are described in an annotated list; a more complete list is presented in a table which encapsulates data for rapid and convenient reference. Separate sections deal with extinct, extirpated, and introduced species, and with endangered, threatened, and declining species.

  9. Hand dominance in orthopaedic surgeons.

    Lui, Darren F

    2012-08-01

    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  10. Driver hand-held cellular phone use: a four-year analysis.

    Eby, David W; Vivoda, Jonathon M; St Louis, Renée M

    2006-01-01

    The use of hand-held cellular (mobile) phones while driving has stirred more debate, passion, and research than perhaps any other traffic safety issue in the past several years. There is ample research showing that the use of either hand-held or hands-free cellular phones can lead to unsafe driving patterns. Whether or not these performance deficits increase the risk of crash is difficult to establish, but recent studies are beginning to suggest that cellular phone use elevates crash risk. The purpose of this study was to assess changes in the rate of hand-held cellular phone use by motor-vehicle drivers on a statewide level in Michigan. This study presents the results of 13 statewide surveys of cellular phone use over a 4-year period. Hand-held cellular phone use data were collected through direct observation while vehicles were stopped at intersections and freeway exit ramps. Data were weighted to be representative of all drivers traveling during daylight hours in Michigan. The study found that driver hand-held cellular phone use has more than doubled between 2001 and 2005, from 2.7% to 5.8%. This change represents an average increase of 0.78 percentage points per year. The 5.8% use rate observed in 2005 means that at any given daylight hour, around 36,550 drivers were conversing on cellular phones while driving on Michigan roadways. The trend line fitted to these data predicts that by the year 2010, driver hand-held cellular phone use will be around 8.6%, or 55,000 drivers at any given daylight hour. These results make it clear that cellular phone use while driving will continue to be an important traffic safety issue, and highlight the importance of continued attempts to generate new ways of alleviating this potential hazard.

  11. Clean Hands Count

    Full Text Available ... myths and misperceptions about hand hygiene and empower patients to play a role in their care by ... Copyright Creators Advertise Developers +YouTube Terms Privacy Policy & Safety Send feedback Test new features Loading... Working... Sign ...

  12. Clean Hands Count

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    Full Text Available ... Clean Hands Count Centers for Disease Control and Prevention (CDC) Loading... Unsubscribe from Centers for Disease Control and Prevention (CDC)? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 66K ...

  14. Tropical Diabetic Hand Syndrome

    2015 Annals of Medical and Health Sciences Research | Published by Wolters Kluwer - Medknow. 473. Introduction ... diabetes.[2,3] Tropical diabetic hand syndrome is a terminology .... the importance of seeking medical attention immediately.

  15. Clean Hands Count

    Full Text Available ... now. Please try again later. Published on May 5, 2017 This video for healthcare providers is intended ... 36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,702 views 5:46 ...

  16. Clean Hands Count

    Full Text Available ... reminding healthcare providers to clean their hands. See: https://www.cdc.gov/handhygiene/campa... . Comments on this ... are allowed in accordance with our comment policy: http://www.cdc.gov/SocialMedia/Tools/... This video can ...

  17. Clean Hands Count

    Full Text Available ... empower patients to play a role in their care by asking or reminding healthcare providers to clean ... It's in your hands - prevent sepsis in health care' A 5 May 2018 advocacy message from WHO - ...

  18. Clean Hands Count

    Full Text Available ... why Close Clean Hands Count Centers for Disease Control and Prevention (CDC) Loading... Unsubscribe from Centers for Disease Control and Prevention (CDC)? Cancel Unsubscribe Working... Subscribe Subscribed ...

  19. Clean Hands Count

    Full Text Available ... has been rented. This feature is not available right now. Please try again later. Published on May ... Wash your Hands - it just makes sense. - Duration: 1:36. Seema Marwaha 404,414 views 1:36 ...

  20. Clean Hands Count

    Full Text Available ... Washing Video from CDC called "Put Your Hands Together" - Duration: 3:40. Patrick Boshell 27,834 views ... Policy & Safety Send feedback Test new features Loading... Working... Sign in to add this to Watch Later ...

  1. Clean Hands Count

    Full Text Available ... Published on May 5, 2017 This video for healthcare providers is intended to promote or encourage adherence ... role in their care by asking or reminding healthcare providers to clean their hands. See: https://www. ...

  2. MICHIGAN/INDIANA: Siberian Snakes strike again

    Anon.

    1993-01-01

    Full text: Siberian snakes are showing themselves to be even more deadly than expected in killing their prey, the depolarizing resonances which would make it very difficult to accelerate polarized protons to TeV energies at accelerators such as the Tevatron, UNK, LHC, and SSC. The snake concept was proposed in the mid-1970s by Siberians Yaroslav Derbenev and Anatoly Kondratenko at Novosibirsk, but the snakes lay almost dormant until Owen Chamberlain, Ernest Courant, Alan Krisch, and the late Kent Terwilliger organized the 1985 Superconducting Supercollider (SSC) polarized beam workshop in Ann Arbor, which highlighted the need to test the concept. The idea is to rotate the spin through 180° on each turn in the ring. With such successive spin flips, the depolarizing effects seen in one turn should be cancelled by an equal and opposite perturbation on the subsequent turn. The new Cooler Ring at the Indiana University Cyclotron Facility then seemed an excellent test site for these eager but untested serpents. The Michigan/lndiana/Brookhaven team led by Krisch constructed the world's first snake and found that it could easily overcome its initial enemy, the imperfection depolarizing resonances caused by ring magnet imperfections (January/February 1990, page 20). In the next few years the growing team of ''herpetologists'' showed that Siberian snakes could overcome all kinds of depolarizing resonances, including the intrinsic kind (caused by the vertical betatron oscillations which keep the beam focused) and the synchrotron resonances (caused by synchrotron oscillations in energy). The team also discovered a new type of snake that was inadvertently built into the cooling section. This socalled type-3 snake rotates the spin around the vertical direction. A full type-1 snake (such as the team's superconducting solenoid magnet) rotates the spin by 180° around the beam direction; a type-2 snake rotates the spin around the radial direction

  3. Flood of April 1975 at Williamston, Michigan

    Knutilla, R.L.; Swallow, L.A.

    1975-01-01

    On April 18 between 5 p.m. and 12 p.m. the city of Williamston experienced an intense rain storm that caused the Red Cedar River and the many small streams in the area to overflow their banks and resulted in the most devastating flood since at least 1904. Local officials estimated a loss of \\$775,000 in property damage. Damage from flooding by the Red Cedar River was caused primarily by inundation, rather than by water moving at high velocity, as is common when many streams are flooded. During the flood of April 1975 many basements were flooded as well as the lower floors of some homes in the flood plain. Additional damage occurred in places when sewers backed up and flooded basements, and when ground water seeped through basement walls and floors—situations that affected many homes including those that were well outside of the flood plain.During the time of flooding the U.S. Geological Survey obtained aerial photography and data on a streamflow to document the disaster. This report shows on a photomosaic base map the extent of flooding along the Red Cedar River at Williamston, during the flood. It also presents data obtained at stream-gaging stations near Williamston, as well as the results of peak-flow discharge measurements made on the Red Cedar River at Michigan State Highway M-52 east of the city. Information on the magnitude of the flood can guide in making decisions pertaining to the use of flood-plains in the area. It is one of a series of reports on the April 1975 flood in the Lansing metropolitan area.

  4. The quality of care in occupational therapy: an assessment of selected Michigan hospitals.

    Kirchman, M M

    1979-07-01

    In this study, a methodology was developed and tested for assessing the quality of care in occupational therapy between educational and noneducational clinical settings, as measured by process and outcome. An instrument was constructed for an external audit of the hospital record. Standards drafted by the investigator were established as normative by a panel of experts for use in judging the programs. Hospital records of 84 patients with residual hemiparesis or hemiplegia in three noneducational settings and of 100 patients with similar diagnoses in two educational clinical settings from selected Michigan facilities were chosen by proportionate stratified random sampling. The process study showed that occupational therapy was of significantly higher quality in the educational settings. The outcome study did not show significant differences between types of settings. Implications for education and practice are discussed.

  5. Hand hygiene in reducing transient flora on the hands of healthcare workers: an educational intervention.

    Kapil, R; Bhavsar, H K; Madan, M

    2015-01-01

    Hand hygiene has now been recognised as one of the most effective intervention to control the transmission of infections in a hospital and education is an important tool to ensure its implementation. In order to convince the users and as a part of education, it is important to generate evidence on the role of hand hygiene in reducing the bacterial flora on their hands. The present study was undertaken in a tertiary care hospital to demonstrate the presence of bacterial flora on the hands of healthcare workers (HCW) in different categories, to teach them proper hand hygiene technique using alcohol-based hand rub and determine the outcome for reduction of bacteria. A total sample size of 60 subjects including resident doctors, medical students, nurses and hospital attendants were included in the study after obtaining informed consent. Each person was educated on the technique of hand hygiene with alcohol-based hand rub and hand impressions were cultured before and after hand hygiene. All the subjects were also given a questionnaire to assess their perception on hand hygiene. The WHO posters on proper hand hygiene were displayed in the appropriate areas of the hospital in addition, as an educational tool. Majority (42 out of 60) of the HCWs had bacterial count up to 100 colonies or more on both hands before the application of hand rub while working in the hospital. After use of alcohol hand rub with a proper hand hygiene technique, it was found that the percentage reduction was 95-99% among doctors and nurses, 70% among hospital attendants and 50% among sanitary attendants. Staphylococcus aureus was present on the hands of eight persons of which three were methicillin-resistant Staphylococcus aureus. The study demonstrates that transient bacteria are present on the hands of HCWs but majority could be removed by proper hand hygiene, which needs continuous education to be effective. It also shows that active education by demonstrating the proper hand hygiene technique

  6. Avoiding unfavorable results in postburn contracture hand

    Bhattacharya, Sameek

    2013-01-01

    Deformities of the hands are a fairly common sequel of burn especially in the developing world. This is because of high incidence of burns, limited access to standard treatment and rehabilitation. The best outcome of a burnt hand is when deformities are prevented from developing. A good functional result is possible when due consideration is paid to hands during resuscitation, excisional surgery, reconstructive surgery and physiotherapy. The post-burns deformities of hand develop due direct thermal damage or secondary to intrinsic minus position due to oedema or vascular insufficiency. During the acute phase the concerns are, maintenance circulation minimize oedema prevent unphysiological positioning and wound closure with autogenous tissue as soon as possible. The rehabilitation program during the acute phase starts from day one and goes on till the hand has healed and has regained full range of motion. Full blown hand contractures are challenging to correct and become more difficult as time passes. Long-standing cases often land up with attenuation of extensor apparatus leading to swan neck and boutonniere deformity, muscle shortening and bony ankylosis. The major and most common pitfall after contracture release is relapse. The treatment protocol of contracture is solely directed towards countering this tendency. This article aims to guide a surgeon in obtaining optimal hand function and avoid pit falls at different stages of management of hand burns. The reasons of an unfavourable outcome of a burnt hand are possible lack of optimal care in the acute phase, while planning and performing reconstructive procedure and during aftercare and rehabilitation. PMID:24501479

  7. 76 FR 36145 - Notice of Inventory Completion: Western Michigan University, Department of Anthropology...

    2011-06-21

    ...: Western Michigan University, Department of Anthropology, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: Western Michigan University, Department of Anthropology, has completed..., Department of Anthropology. Disposition of the human remains and associated funerary objects to the Indian...

  8. 75 FR 67998 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

    2010-11-04

    ... University, Anthropology Department, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice... objects in the possession of Western Michigan University, Anthropology Department, Kalamazoo, MI. The... anthropologist in the Anthropology Department at Western Michigan University, studied the remains. Native...

  9. 75 FR 5105 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

    2010-02-01

    ... University, Anthropology Department, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice... objects in the possession of Western Michigan University, Anthropology Department, Kalamazoo, MI. The... analysis. Dr. Robert Sundick, a physical anthropologist in the Anthropology Department at Western Michigan...

  10. 76 FR 28078 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

    2011-05-13

    ...: Western Michigan University, Anthropology Department, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: Western Michigan University, Anthropology Department, has completed an... University, Anthropology Department. Disposition of the human remains and associated funerary objects to the...

  11. 75 FR 36671 - Notice of Inventory Completion: Western Michigan University, Anthropology Department, Kalamazoo, MI

    2010-06-28

    ... University, Anthropology Department, Kalamazoo, MI AGENCY: National Park Service, Interior. ACTION: Notice... objects in the possession of Western Michigan University, Anthropology Department, Kalamazoo, MI. The... funerary objects should contact LouAnn Wurst, Department of Anthropology, Western Michigan University, 1005...

  12. Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Michigan

    Mendon, Vrushali V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhao, Mingjie [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Taylor, Zachary T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Poehlman, Eric A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The 2015 IECC provides cost-effective savings for residential buildings in Michigan. Moving to the 2015 IECC from the 2009 IECC base code is cost-effective for residential buildings in all climate zones in Michigan.

  13. Hands of early primates.

    Boyer, Doug M; Yapuncich, Gabriel S; Chester, Stephen G B; Bloch, Jonathan I; Godinot, Marc

    2013-12-01

    Questions surrounding the origin and early evolution of primates continue to be the subject of debate. Though anatomy of the skull and inferred dietary shifts are often the focus, detailed studies of postcrania and inferred locomotor capabilities can also provide crucial data that advance understanding of transitions in early primate evolution. In particular, the hand skeleton includes characteristics thought to reflect foraging, locomotion, and posture. Here we review what is known about the early evolution of primate hands from a comparative perspective that incorporates data from the fossil record. Additionally, we provide new comparative data and documentation of skeletal morphology for Paleogene plesiadapiforms, notharctines, cercamoniines, adapines, and omomyiforms. Finally, we discuss implications of these data for understanding locomotor transitions during the origin and early evolutionary history of primates. Known plesiadapiform species cannot be differentiated from extant primates based on either intrinsic hand proportions or hand-to-body size proportions. Nonetheless, the presence of claws and a different metacarpophalangeal [corrected] joint form in plesiadapiforms indicate different grasping mechanics. Notharctines and cercamoniines have intrinsic hand proportions with extremely elongated proximal phalanges and digit rays relative to metacarpals, resembling tarsiers and galagos. But their hand-to-body size proportions are typical of many extant primates (unlike those of tarsiers, and possibly Teilhardina, which have extremely large hands). Non-adapine adapiforms and omomyids exhibit additional carpal features suggesting more limited dorsiflexion, greater ulnar deviation, and a more habitually divergent pollex than observed plesiadapiforms. Together, features differentiating adapiforms and omomyiforms from plesiadapiforms indicate increased reliance on vertical prehensile-clinging and grasp-leaping, possibly in combination with predatory behaviors in

  14. Geology and salt deposits of the Michigan Basin

    Johnson, K.S.; Gonzales, S.

    1976-07-01

    The Silurian-age Salina salt, one of the greatest deposits of bedded rock salt in the world, underlies most of the Michigan basin and parts of the Appalachian basin in Ohio. Pennsylvania, New York, and West Virginia. Interest in this salt deposit has increased in recent years because there may be one or more areas where it could be used safely as a repository for the underground storage of high-level radioactive wastes. The general geology of the Michigan basin is summarized and the major salt deposits are described in the hope that these data will be useful in determining whether there are any areas in the basin that are sufficiently promising to warrant further detailed study. Distribution of the important salt deposits in the basin is limited to the Southern Peninsula of Michigan

  15. Hand eczema: An update

    Chembolli Lakshmi

    2012-01-01

    Full Text Available Eczema, the commonest disorders afflicting the hands, is also the commonest occupational skin disease (OSD. In the dermatology outpatient departments, only the severe cases are diagnosed since patients rarely report with early hand dermatitis. Mild forms are picked up only during occupational screening. Hand eczema (HE can evolve into a chronic condition with persistent disease even after avoiding contact with the incriminated allergen / irritant. The important risk factors for hand eczema are atopy (especially the presence of dermatitis, wet work, and contact allergy. The higher prevalence in women as compared to men in most studies is related to environmental factors and is mainly applicable to younger women in their twenties. Preventive measures play a very important role in therapy as they enable the affected individuals to retain their employment and livelihood. This article reviews established preventive and therapeutic options and newer drugs like alitretinoin in hand eczema with a mention on the etiology and morphology. Identifying the etiological factors is of paramount importance as avoiding or minimizing these factors play an important role in treatment.

  16. Fast-food consumption and obesity among Michigan adults.

    Anderson, Beth; Rafferty, Ann P; Lyon-Callo, Sarah; Fussman, Christopher; Imes, Gwendoline

    2011-07-01

    Consumption of meals eaten away from home, especially from fast-food restaurants, has increased in the United States since the 1970s. The main objective of this study was to examine the frequency and characteristics of fast-food consumption among adults in Michigan and obesity prevalence. We analyzed data from 12 questions about fast-food consumption that were included on the 2005 Michigan Behavioral Risk Factor Survey, a population-based telephone survey of Michigan adults, using univariate and bivariate analyses and multivariate logistic regression, and compared these data with data on Michigan obesity prevalence. Approximately 80% of Michigan adults went to fast-food restaurants at least once per month and 28% went regularly (≥2 times/wk). Regular fast-food consumption was higher among younger adults (mostly men) but was not significantly associated with household income, education, race, or urbanicity (in a multivariate framework). The prevalence of obesity increased consistently with frequenting fast-food restaurants, from 24% of those going less than once a week to 33% of those going 3 or more times per week. The predominant reason for choosing fast food was convenience. Although hypothetically 68% of adults who go to fast-food restaurants would choose healthier fast-food items when available, only 16% said they ever use nutritional information when ordering. The prevalence of fast-food consumption is high in Michigan across education, income, and racial groups and is strongly associated with obesity. Making nutritional information at fast-food restaurants more readily available and easier to use may help consumers to order more healthful or lower-calorie items.

  17. 40 CFR 81.67 - Lake Michigan Intrastate Air Quality Control Region.

    2010-07-01

    ... Quality Control Regions § 81.67 Lake Michigan Intrastate Air Quality Control Region. The Menominee-Escanaba (Michigan)-Marinette (Wisconsin) Interstate Air Quality Control Region has been renamed the Lake Michigan Intrastate Air Quality Control Region (Wisconsin) and revised to consist of the territorial area...

  18. 76 FR 28068 - Notice of Intent To Repatriate Cultural Items: Museum of Anthropology, University of Michigan...

    2011-05-13

    ... Cultural Items: Museum of Anthropology, University of Michigan, Ann Arbor, MI AGENCY: National Park Service... Museum of Anthropology, University of Michigan, Ann Arbor, MI, that meet the definition of unassociated... funerary objects should contact Carla Sinopoli, Museum of Anthropology, University of Michigan, Ann Arbor...

  19. 78 FR 45057 - Safety Zone; Alpena Area HOG Rally Fireworks, Alpena, Michigan

    2013-07-26

    ...-AA00 Safety Zone; Alpena Area HOG Rally Fireworks, Alpena, Michigan AGENCY: Coast Guard, DHS. ACTION... rally in Alpena, Michigan with a fireworks display. Fireworks will be launched near the end of Mason Street, South of State Avenue, approximately 50 yards west of Thunder Bay in Alpena, Michigan. The...

  20. Hand Hygiene: When and How

    Hand Hygiene When and How August 2009 How to handrub? How to handwash? RUB HANDS FOR HAND HYGIENE! WASH HANDS WHEN VISIBLY SOILED Duration of the ... its use. When? YOUR 5 MOMENTS FOR HAND HYGIENE 1 BEFORETOUCHINGA PATIENT 2 B P ECFLOER R ...

  1. HR diagrams derived from the Michigan Spectral Catalogue

    Houk, N.; Fesen, R.

    1978-01-01

    The authors present some HR diagrams constructed using data from the Michigan Spectral Catalogues. Houk (1975) has been systematically reclassifying the Henry Draper stars on the MK system, from the south pole northward. Objective-prism plates, with a reciprocal dispersion of 108 A/mm, have been taken with the Michigan Curtis Schmidt telescope at Cerro Tololo Inter-American Observatory in Chile. The spectra are classified visually from the plates, and the results are put onto IBM cards and magnetic tape from which the catalogues are produced. (Auth.)

  2. Tactile Sensing Reflexes for Advanced Prosthetic Hands

    2016-10-01

    Jeremy A. Fishel, Member, IEEE Figure 1. A) Custom NumaTac prosthetic fingertip sensor core and foam; B) Ottobock VariPlus Speed hand installed with two...oal – H ardw are P rototype D evelopm ent R   Identify alternatives for outcom e m easures R   E xplore sensor design param eters C Y16 G oals – C

  3. Monitoring Quality Across Home Visiting Models: A Field Test of Michigan's Home Visiting Quality Assurance System.

    Heany, Julia; Torres, Jennifer; Zagar, Cynthia; Kostelec, Tiffany

    2018-06-05

    Introduction In order to achieve the positive outcomes with parents and children demonstrated by many home visiting models, home visiting services must be well implemented. The Michigan Home Visiting Initiative developed a tool and procedure for monitoring implementation quality across models referred to as Michigan's Home Visiting Quality Assurance System (MHVQAS). This study field tested the MHVQAS. This article focuses on one of the study's evaluation questions: Can the MHVQAS be applied across models? Methods Eight local implementing agencies (LIAs) from four home visiting models (Healthy Families America, Early Head Start-Home Based, Parents as Teachers, Maternal Infant Health Program) and five reviewers participated in the study by completing site visits, tracking their time and costs, and completing surveys about the process. LIAs also submitted their most recent review by their model developer. The researchers conducted participant observation of the review process. Results Ratings on the MHVQAS were not significantly different between models. There were some differences in interrater reliability and perceived reliability between models. There were no significant differences between models in perceived validity, satisfaction with the review process, or cost to participate. Observational data suggested that cross-model applicability could be improved by assisting sites in relating the requirements of the tool to the specifics of their model. Discussion The MHVQAS shows promise as a tool and process to monitor implementation quality of home visiting services across models. The results of the study will be used to make improvements before the MHVQAS is used in practice.

  4. Collaboration between the University of Michigan Taubman Health Sciences library and the University of Michigan Medical School Office of Research.

    Black, Christine; Harris, Bethany; Mahraj, Katy; Schnitzer, Anna Ercoli; Rosenzweig, Merle

    2013-01-01

    Librarians have traditionally facilitated research development resulting in grants through performing biomedical literature searches for researchers. The librarians at the Taubman Health Sciences Library of the University of Michigan have taken additional steps forward by instituting a proactive approach to assisting investigators. To accomplish this, the librarians have taken part in a collaborative effort with the University of Michigan Medical School Office of Research. Through this partnership, both units have created and adopted various techniques intended to facilitate the submission of grants, thus allowing researchers more time to conduct their primary activities.

  5. Clean Hands Count

    Full Text Available ... CDC) 97,825 views 5:12 CDC Flu Education Video - Duration: 10:26. Nicole Shelton 213 views ... Infection Control Video - Duration: 20:55. Paramedical Services Education Page 4,735 views 20:55 Hand Washing ...

  6. Hand Eczema: Treatment options

    Lund, Tamara Theresia; Agner, Tove

    2017-01-01

    Hand eczema is a common disease, it affects young people, is often work-related, and the burden of the disease is significant for the individual as well as for society. Factors to be considered when choosing a treatment strategy are, among others, whether the eczema is acute or chronic, the sever...

  7. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 824 views 1:36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 409,492 ...

  8. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 786 views 1:36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,702 ...

  9. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 414 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Thomas Jefferson University & Jefferson ...

  10. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 869 views 1:36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 410,052 ...

  11. Wash Your Hands

    2010-03-08

    This video shows kids how to properly wash their hands, one of the most important steps we can take to avoid getting sick and spreading germs to others.  Created: 3/8/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/8/2010.

  12. Clean Hands Count

    Full Text Available ... no cure tomorrow - Duration: 3:10. World Health Organization 75,585 views 3:10 Wash 'Em - Hand ... soap and water - Duration: 1:27. World Health Organization 224,180 views 1:27 The five moments ...

  13. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 460 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Thomas Jefferson University & Jefferson ...

  14. Clean Hands Count

    Full Text Available ... action today; no cure tomorrow - Duration: 3:10. World Health Organization 75,362 views 3:10 Wash ' ... handwash? With soap and water - Duration: 1:27. World Health Organization 219,427 views 1:27 Hand ...

  15. Clean Hands Count

    Full Text Available ... action today; no cure tomorrow - Duration: 3:10. World Health Organization 74,478 views 3:10 Wash your Hands - ... handwash? With soap and water - Duration: 1:27. World Health Organization 215,487 views 1:27 Infection Control Video - ...

  16. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 741 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 410,052 ...

  17. Matching hand radiographs

    Kauffman, J.A.; Slump, Cornelis H.; Bernelot Moens, H.J.

    2005-01-01

    Biometric verification and identification methods of medical images can be used to find possible inconsistencies in patient records. Such methods may also be useful for forensic research. In this work we present a method for identifying patients by their hand radiographs. We use active appearance

  18. Clean Hands Count

    Full Text Available ... today; no cure tomorrow - Duration: 3:10. World Health Organization 72,885 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 410,052 views 5:46 'It's in your ...

  19. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 029 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 411,974 ...

  20. Clean Hands Count

    Full Text Available ... no cure tomorrow - Duration: 3:10. World Health Organization 78,256 views 3:10 Wash 'Em - Hand ... message from WHO - Duration: 10:07. World Health Organization 9,045 views 10:07 A very serious ...

  1. Hands-On Calculus

    Sutherland, Melissa

    2006-01-01

    In this paper we discuss manipulatives and hands-on investigations for Calculus involving volume, arc length, and surface area to motivate and develop formulae which can then be verified using techniques of integration. Pre-service teachers in calculus courses using these activities experience a classroom in which active learning is encouraged and…

  2. Clean Hands Count

    Full Text Available ... action today; no cure tomorrow - Duration: 3:10. World Health Organization 78,256 views 3:10 Wash ... handwash? With soap and water - Duration: 1:27. World Health Organization 230,361 views 1:27 Hand ...

  3. Hands-on Humidity.

    Pankiewicz, Philip R.

    1992-01-01

    Presents five hands-on activities that allow students to detect, measure, reduce, and eliminate moisture. Students make a humidity detector and a hygrometer, examine the effects of moisture on different substances, calculate the percent of water in a given food, and examine the absorption potential of different desiccants. (MDH)

  4. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 396 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Thomas Jefferson University & Jefferson ...

  5. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 094 views 1:19 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 411,974 ...

  6. Clean Hands Count

    Full Text Available ... starting stop Loading... Watch Queue Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with ... ads? Get YouTube Red. Working... Not now Try it free Find out why Close Clean Hands Count ...

  7. Clean Hands Count

    Full Text Available ... today; no cure tomorrow - Duration: 3:10. World Health Organization 69,414 views 3:10 Hand Washing ... Video - Duration: 5:46. Thomas Jefferson University & Jefferson Health 408,436 views 5:46 83 videos Play ...

  8. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 319 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 410,052 ...

  9. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 585 views 3:10 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,097 ...

  10. Clean Hands Count

    Full Text Available ... 14. Lake Health 14,415 views 3:14 Safety Demo: The Importance of Hand Washing - Duration: 2: ... Copyright Creators Advertise Developers +YouTube Terms Privacy Policy & Safety Send feedback Test new features Loading... Working... Sign ...

  11. Clean Hands Count

    Full Text Available ... action today; no cure tomorrow - Duration: 3:10. World Health Organization 72,319 views 3:10 Wash 'Em - Hand ... handwash? With soap and water - Duration: 1:27. World Health Organization 205,878 views 1:27 Germ Smart - Wash ...

  12. Hands On Earth Science.

    Weisgarber, Sherry L.; Van Doren, Lisa; Hackathorn, Merrianne; Hannibal, Joseph T.; Hansgen, Richard

    This publication is a collection of 13 hands-on activities that focus on earth science-related activities and involve students in learning about growing crystals, tectonics, fossils, rock and minerals, modeling Ohio geology, geologic time, determining true north, and constructing scale-models of the Earth-moon system. Each activity contains…

  13. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 384 views 1:19 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Thomas Jefferson University & Jefferson ...

  14. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 285 views 1:36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 410,052 ...

  15. Clean Hands Count

    Full Text Available ... Gorin 243,451 views 2:57 Hand Hygiene Dance - Duration: 3:15. mohd hafiz 34,146 views ... Language: English Location: United States Restricted Mode: Off History Help Loading... Loading... Loading... About Press Copyright Creators ...

  16. Clean Hands Count

    Full Text Available ... YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. Working... Not now Try ... Wash your Hands - it just makes sense. - Duration: 1:36. Seema Marwaha 400,493 views 1:36 ...

  17. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 033 views 1:36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 410,052 ...

  18. Clean Hands Count

    Full Text Available ... Em - Hand Hygiene Music Video - Duration: 5:46. Thomas Jefferson University & Jefferson Health 408,436 views 5: ... Prevention (CDC) 97,277 views 5:12 Loading more suggestions... Show more Language: English Location: United States ...

  19. Hands-On Hydrology

    Mathews, Catherine E.; Monroe, Louise Nelson

    2004-01-01

    A professional school and university collaboration enables elementary students and their teachers to explore hydrology concepts and realize the beneficial functions of wetlands. Hands-on experiences involve young students in determining water quality at field sites after laying the groundwork with activities related to the hydrologic cycle,…

  20. Clean Hands Count

    Full Text Available ... Queue __count__/__total__ It’s YouTube. Uninterrupted. Loading... Want music and videos with zero ads? Get YouTube Red. ... 043 views 1:36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 411,292 ...

  1. Clean Hands Count

    Full Text Available ... News 581,131 views 18:49 Just Good Music 24/7 ● Classic Live Radio classics. 1,406 ... 611,013 views 1:46 Hand hygiene FULL music video - Duration: 2:33. AlfredHealthTV 26,798 views ...

  2. Clean Hands Count

    Full Text Available ... 52 Hand Sanitizers and Soaps Put to the Test - Duration: 2:26. ABC News 42,006 views ... Developers +YouTube Terms Privacy Policy & Safety Send feedback Test new features Loading... Working... Sign in to add ...

  3. ‘Born in Michigan? You’re in the Biobank’: Engaging Population Biobank Participants through Facebook Advertisements

    Platt, J.E.; Platt, T.; Thiel, D.; Kardia, S.L.R.

    2016-01-01

    Background/Aims Despite a broad call for biobanks to use social media, data is lacking regarding the capacity of social media tools, especially advertising, to engage large populations on this topic. Methods We used Facebook advertising to engage Michigan residents about the BioTrust for Health. We conducted a low-budget (social media campaign targeting Michigan residents aged 18–28. We placed 25 Facebook advertisements and analyzed their performance in terms of reach and cost across 3 engagement types: passive, active and interactive. We compared engagement before, during and after the campaign. Results The Facebook page was viewed 1,249 times during the month of the advertising campaign, versus once in the month prior. 779,004 Michigan residents saw ads an average of 25.8 times; 4,275 clicked ads; the average click-through-ratio was 0.021%. Interactions included 516 ‘likes’ and 30 photo contest entries. Cost per outcome ranged from cost per click was USD 1.04. Conclusion A social media strategy to build public awareness about biobanking is not likely to be effective without a promotional ‘push’ to distribute content. Social media advertisements have the capacity to scale-up engagement on biobanking while keeping costs manageable. Facebook advertisements provide necessary access points for unaware participants, with implications for public trust. PMID:23796763

  4. Prognosis of occupational hand eczema

    Cvetkovski, Rikke Skoet; Zachariae, Robert; Jensen, Hans Henrik

    2006-01-01

    OBJECTIVE: To identify prognostic risk factors in patients with occupational hand eczema (OHE). DESIGN: Cohort study with 1-year follow-up. SETTING: Danish National Board of Industrial Injuries Registry. PATIENTS: All patients with newly recognized OHE (758 cases) from October 1, 2001, through...... it. MAIN OUTCOME MEASURES: Persistently severe or aggravated OHE, prolonged sick leave, and loss of job after 1-year follow-up. RESULTS: During the follow-up period, 25% of all patients with OHE had persistently severe or aggravated disease, 41% improved, and 34% had unchanged minimal or mild...... to moderate disease. Patients with atopic dermatitis fared poorly compared with other patients. Patients younger than 25 years fared clearly better than older groups. Furthermore, severe OHE, age 40 years or greater, and severe impairment of quality of life at baseline appeared to be important predictors...

  5. Hands-on physics displays for undergraduates

    Akerlof, Carl W.

    2014-07-01

    Initiated by Frank Oppenheimer in 1969, the Exploratorium in San Francisco has been the model for hands-on science museums throughout the world. The key idea has been to bring people with all levels of scientific background in contact with interesting and attractive exhibits that require the active participation of the visitor. Unfortunately, many science museums are now forced to cater primarily to very young audiences, often 8 years old or less, with predictable constraints on the intellectual depth of their exhibits. To counter this trend, the author has constructed several hands-on displays for the University of Michigan Physics Department that demonstrate: (1) magnetic levitation of pyrolytic graphite, (2) the varied magnetic induction effects in aluminum, copper and air, (3) chaotic motion of a double pendulum, (4) conservation of energy and momentum in a steel ball magnetic accelerator, (5) the diffraction pattern of red and green laser pointer beams created by CDs and DVDs, (6) a magnetic analog of the refraction of light at a dielectric boundary and (7) optical rotation of light in an aqueous fructose solution. Each of these exhibits can be constructed for something like $1000 or less and are robust enough to withstand unsupervised public use. The dynamic behavior of these exhibits will be shown in accompanying video sequences. The following story has a history that goes back quite a few years. In the late 70's, I was spending time at the Stanford Linear Accelerator Center accompanied by my family that included our two grade school children. Needless to say, we much enjoyed weekend excursions to all sorts of interesting sites in the Bay Area, especially the Exploratorium, an unusual science museum created by Frank Oppenheimer that opened in 1969. The notion that exhibits would be designed specifically for "hands-on" interactions was at that time quite revolutionary. This idea captivated a number of people everywhere including a friend in Ann Arbor, Cynthia

  6. Regional groundwater-flow model of the Lake Michigan Basin in support of Great Lakes Basin water availability and use studies

    Feinstein, D.T.; Hunt, R.J.; Reeves, H.W.

    2010-01-01

    . Lastly, it describes several categories of limitations and discusses ways of extending the regional model to address issues at the local scale. Results of the simulations portray a regional groundwater-flow system that, over time, has largely maintained its natural predevelopment configuration but that locally has been strongly affected by well withdrawals. The quantity of rainfall in the Lake Michigan Basin and adjacent areas supports a dense surface-water network and recharge rates consistent with generally shallow water tables and predominantly shallow groundwater flow. At the regional scale, pumping has not caused major modifications of the shallow flow system, but it has resulted in decreases in base flow to streams and in direct discharge to Lake Michigan (about 2 percent of the groundwater discharged and about 0.5 cubic foot per second per mile of shoreline). On the other hand, well withdrawals have caused major reversals in regional flow patterns around pumping centers in deep, confined aquifers - most noticeably in the Cambrian-Ordovician aquifer system on the west side of Lake Michigan near the cities of Green Bay and Milwaukee in eastern Wisconsin, and around Chicago in northeastern Illinois, as well as in some shallow bedrock aquifers (for example, in the Marshall aquifer near Lansing, Mich.). The reversals in flow have been accompanied by large drawdowns with consequent local decrease in storage. On the west side of Lake Michigan, groundwater withdrawals have caused appreciable migration of the deep groundwater divides. Before the advent of pumping, the deep Lake Michigan groundwater-basin boundaries extended west of the Lake Michigan surface-water basin boundary, in some places by tens of miles. Over time, the pumping centers have replaced Lake Michigan as the regional sink for the deep flow system. The regional model is intended to support the framework pilot study of water availability and use for the Great Lakes Basin (Reeves, in press).

  7. Michigan field artillery's 'Blackjacks' training in Latvia > National Guard

    Charles Smith, 1st Battalion, 119th Field Artillery, Michigan Army National Guard, set up the M67 GLPS for 24 years. 1st. Lt. Brice Masterson, and Sgt. 1st Class Charles Smith, 1st Battalion, 119th Field , Lithuania and the United States will participate in the exercise. The exercise takes place at Adazi Training

  8. Commentary on the Discovery of the Beautiful Style Michigan Madonna

    Hlobil, Ivo

    2016-01-01

    Roč. 64, 3/4 (2016), s. 256-260 ISSN 0049-5123 Institutional support: RVO:68378033 Keywords : gothic sculpture * Bohemian Beautiful Style * Madonna-torso * Museum Ann Arbor * Michigan ( USA ) Subject RIV: AL - Art, Architecture, Cultural Heritage

  9. Timber resource of Michigan's Southern Lower Peninsula Unit, 1980.

    Jerold T. Hahn

    1982-01-01

    The fourth inventory of the timber resource of Michigan's Southern Lower Peninsula Survey Unit shows a 12% decline in commercial forest area and a 26% gain in growing-stock volume between 1966 and 1980. Presented are highlights and statistics on area, volume, growth, mortality, removals, utilization, and biomass.

  10. The changing veneer and plywood industry of Michigan and Wisconsin.

    Gary R. Lindell; Lewis T. Hendricks

    1972-01-01

    Analyzes trends in the hardwood veneer and plywood industry of Michigan and Wisconsin between 1964 and 1969. In that period, red oak and hard maple replaced yellow birch as the major species used. Log supplies were adequate. Wall paneling was the major end market with doorskins next. Excess plywood producing capacity is a chronic problem.

  11. Understanding public opinion regarding transit in southeast Michigan.

    2015-04-01

    This report presents findings from a study on public opinion regarding transit in Southeast Michigan. The overall goals of this : study were to assess the nature of public opinion regarding regional transit and to understand its relation to socio-dem...

  12. National Uranium Resource Evaluation: Iron River Quadrangle, Michigan and Wisconsin

    Frishman, D

    1982-09-01

    No area within the Iron River 1/sup 0/ x 2/sup 0/ Quadrangle, Michigan and Wisconsin, appears to be favorable for the existence of a minimum of 100 tons of U/sub 3/O/sub 8/ at a grade of 0.01 percent or better.

  13. Digital Learning Compass: Distance Education State Almanac 2017. Michigan

    Seaman, Julia E.; Seaman, Jeff

    2017-01-01

    This brief report uses data collected under the U.S. Department of Education's National Center for Educational Statistics (NCES) Integrated Postsecondary Education Data System (IPEDS) Fall Enrollment survey to highlight distance education data in the state of Michigan. The sample for this analysis is comprised of all active, degree-granting…

  14. A post-Calumet shoreline along southern Lake Michigan

    Capps, D.K.; Thompson, T.A.; Booth, R.K.

    2007-01-01

    The southern shore of Lake Michigan is the type area for many of ancestral Lake Michigan's late Pleistocene lake phases, but coastal deposits and features of the Algonquin phase of northern Lake Michigan, Lake Huron, and Lake Superior are not recognized in the area. Isostatic rebound models suggest that Algonquin phase deposits should be 100 m or more below modern lake level. A relict shoreline, however, exists along the lakeward margin of the Calumet Beach that was erosional west of Deep River and depositional east of the river. For this post-Calumet shoreline, the elevation of basal foreshore deposits east of Deep River and the base of the scarp west of Deep River indicate a slightly westward dipping water plane that is centered at ???184 m above mean sea level. Basal foreshore elevations also indicate that lake level fell ???2 m during the development of the shoreline. The pooled mean of radiocarbon dates from the surface of the peat below post-Calumet shoreline foreshore deposits indicate that the lake transgressed over the peat at 10,560 ?? 70 years B.P. Pollen assemblages from the peat are consistent with this age. The elevation and age of the post-Calumet shoreline are similar to the Main Algonquin phase of Lake Huron. Recent isostatic rebound models do not adequately address a high-elevation Algonquin-age shoreline along the southern shore of Lake Michigan, but the Goldthwait (1908) hinge-line model does. ?? 2006 Springer Science+Business Media B.V.

  15. An Interdisciplinary International Business Degree at Eastern Michigan University

    Victor, David A.

    2008-01-01

    In January 2006, the College of Business at Eastern Michigan University (EMU) instituted a cross-disciplinary program in international business (IB). Business communication is a major component of the program. Moreover, the need for business communication in other languages contributed greatly to the cross-disciplinary nature of the program. This…

  16. Importance-performance analysis: an application to Michigan's natural resources

    Gloria Sanders; Erin White; Lori Pennington-Gray

    2001-01-01

    In the state of Michigan, the nature-based tourist is becoming an increasingly important target market for providers of natural resources. To meet the demands of this growing market segment, evaluation strategies for nature-based sites are needed to maintain and improve customer satisfaction and loyalty. Evaluation strategies that incorporate consumer input can help to...

  17. Post Audit of Lake Michigan Lake Trout PCB Model Forecasts

    The Lake Michigan (LM) Mass Balance Study was conducted to measure and model polychlorinated biphenyls (PCBs) and other anthropogenic substances to gain a better understanding of the transport, fate, and effects of these substances within the system and to aid managers in the env...

  18. Michigan Physicians' Conference on Elder Abuse. Final Report.

    Sengstock, Mary C.; O'Brien, James G.

    The final report describes the Michigan Physicians' Conference on Elder Abuse project. The project conference had four major content areas, including: a general introduction to the problem of elder abuse; clinical symptoms of abuse; legal issues; and referral and case management techniques. Training techniques included lectures, group discussion,…

  19. Selected Collective Bargaining Agreements of Michigan Two-Year Colleges.

    National Education Association, Washington, DC.

    Collective bargaining agreements of 19 selected Michigan two-year colleges are presented, representing contracts in effect in 1987. Contracts for the following colleges are included: Alpena Community College, Bay de Noc Community College, Gogebic Community College, Grand Rapids Junior College, Kalamazoo Valley Community College, Kellogg Community…

  20. Telecommuting for Original Cataloging at the Michigan State University Libraries.

    Black, Leah; Hyslop, Colleen

    1995-01-01

    Working conditions in library technical services departments can be a problem for catalogers in need of a quiet work environment. Based on a successful program for indexers at the National Agriculture Library, a proposal for an experimental telecommuting program for original cataloging at the Michigan State University Libraries was developed and…

  1. Environmental indices for common Michigan trees and shrubs.

    Gary J. Brand

    1985-01-01

    Plants are indicators of environmental factors like moisture, nutrients, heat, and light. Semi-quantitative indices for these four factors were developed for 90 Michigan trees and shrubs. The indices and a tally of species present provide a simple evaluation of the environment of a forest stand and a useful management aid.

  2. The University of Michigan's Computer-Aided Engineering Network.

    Atkins, D. E.; Olsen, Leslie A.

    1986-01-01

    Presents an overview of the Computer-Aided Engineering Network (CAEN) of the University of Michigan. Describes its arrangement of workstations, communication networks, and servers. Outlines the factors considered in hardware and software decision making. Reviews the program's impact on students. (ML)

  3. Processing United Nations Documents in the University of Michigan Library.

    Stolper, Gertrude

    This guide provides detailed instructions for recording documents in the United Nations (UN) card catalog which provides access to the UN depository collection in the Harlan Hatcher Graduate Library at the University of Michigan. Procedures for handling documents when they are received include stamping, counting, and sorting into five categories:…

  4. Compact Dexterous Robotic Hand

    Lovchik, Christopher Scott (Inventor); Diftler, Myron A. (Inventor)

    2001-01-01

    A compact robotic hand includes a palm housing, a wrist section, and a forearm section. The palm housing supports a plurality of fingers and one or more movable palm members that cooperate with the fingers to grasp and/or release an object. Each flexible finger comprises a plurality of hingedly connected segments, including a proximal segment pivotally connected to the palm housing. The proximal finger segment includes at least one groove defining first and second cam surfaces for engagement with a cable. A plurality of lead screw assemblies each carried by the palm housing are supplied with power from a flexible shaft rotated by an actuator and output linear motion to a cable move a finger. The cable is secured within a respective groove and enables each finger to move between an opened and closed position. A decoupling assembly pivotally connected to a proximal finger segment enables a cable connected thereto to control movement of an intermediate and distal finger segment independent of movement of the proximal finger segment. The dexterous robotic hand closely resembles the function of a human hand yet is light weight and capable of grasping both heavy and light objects with a high degree of precision.

  5. Arthritis of the hand - Rheumatoid

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Rheumatoid Arthritis Email to a friend * required fields ...

  6. Michigan Pharmacists Transforming Care and Quality: Developing a Statewide Collaborative of Physician Organizations and Pharmacists to Improve Quality of Care and Reduce Costs.

    Choe, Hae Mi; Lin, Alexandra Tungol; Kobernik, Kathleen; Cohen, Marc; Wesolowicz, Laurie; Qureshi, Nabeel; Leyden, Tom; Share, David A; Darland, Rozanne; Spahlinger, David A

    2018-04-01

    Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan. As the MPTCQ Coordinating Center, Michigan Medicine established an infrastructure integrating clinical pharmacists into direct patient care within patient-centered medical home (PCMH) practices and provides direction and guidance for quality and process improvement across physician organizations (POs) and their affiliated physician practices. The primary goal of MPTCQ is to improve patient care and outcomes related to Medicare star ratings and HEDIS measures through integration of clinical pharmacists into direct patient care. The short-term goal is to adopt and modify Michigan Medicine's integrated pharmacist practice model at participating POs, with the long-term goal of developing a sustainable model of pharmacist integration at each PO to improve patient care and outcomes. Initially, pharmacists are delivering disease management (diabetes, hypertension, and hyperlipidemia) and comprehensive medication review services with future plans to expand clinical services. In 2015, 10 POs participated in year 1 of the program. In collaboration with the MPTCQ Coordinating Center, each PO identified 1 "pharmacist transformation champion" (PTC). The PTC implemented the integrated pharmacist model at 2 or 3 practice sites with at least 2 practicing physicians per

  7. The hot hand belief and framing effects.

    MacMahon, Clare; Köppen, Jörn; Raab, Markus

    2014-09-01

    Recent evidence of the hot hand in sport-where success breeds success in a positive recency of successful shots, for instance-indicates that this pattern does not actually exist. Yet the belief persists. We used 2 studies to explore the effects of framing on the hot hand belief in sport. We looked at the effect of sport experience and task on the perception of baseball pitch behavior as well as the hot hand belief and free-throw behavior in basketball. Study 1 asked participants to designate outcomes with different alternation rates as the result of baseball pitches or coin tosses. Study 2 examined basketball free-throw behavior and measured predicted success before each shot as well as general belief in the hot hand pattern. The results of Study 1 illustrate that experience and stimulus alternation rates influence the perception of chance in human performance tasks. Study 2 shows that physically performing an act and making judgments are related. Specifically, beliefs were related to overall performance, with more successful shooters showing greater belief in the hot hand and greater predicted success for upcoming shots. Both of these studies highlight that the hot hand belief is influenced by framing, which leads to instability and situational contingencies. We show the specific effects of framing using accumulated experience of the individual with the sport and knowledge of its structure and specific experience with sport actions (basketball shots) prior to judgments.

  8. Combat Casualty Hand Burns: Evaluating Impairment and Disability during Recovery

    2008-06-01

    impairment guidelines would correlate with disability as mea- sured by the DASH. However, a study by Mink van der Molen et al. found only a weak correlation (r...Mink van der Molen AB, Ettema AM, Hovius SER. Outcome of hand trauma: the hand injury severity scoring system (HISS) and subsequent impairment and...0.38) between AMA and DASH scores at six months after hand trauma.16 In another study, van Oosterom et al. reported no statistically significant

  9. Performance Comparison Between FEDERICA Hand and LARM Hand

    Carbone, Giuseppe; Rossi, Cesare; Savino, Sergio

    2015-01-01

    This paper describes two robotic hands that have been\\ud developed at University Federico II of Naples and at the\\ud University of Cassino. FEDERICA Hand and LARM Hand\\ud are described in terms of design and operational features.\\ud In particular, careful attention is paid to the differences\\ud between the above-mentioned hands in terms of transmission\\ud systems. FEDERICA Hand uses tendons and pulleys\\ud to drive phalanxes, while LARM Hand uses cross four-bar\\ud linkages. Results of experime...

  10. Second-hand signals

    Bergenholtz, Carsten

    2014-01-01

    Studies of signaling theory have traditionally focused on the dyadic link between the sender and receiver of the signal. Within a science‐based perspective this framing has led scholars to investigate how patents and publications of firms function as signals. I explore another important type...... used by various agents in their search for and assessment of products and firms. I conclude by arguing how this second‐hand nature of signals goes beyond a simple dyadic focus on senders and receivers of signals, and thus elucidates the more complex interrelations of the various types of agents...

  11. Hand grip strength

    Frederiksen, Henrik; Gaist, David; Petersen, Hans Christian

    2002-01-01

    in life is a major problem in terms of prevalence, morbidity, functional limitations, and quality of life. It is therefore of interest to find a phenotype reflecting physical functioning which has a relatively high heritability and which can be measured in large samples. Hand grip strength is known......-55%). A powerful design to detect genes associated with a phenotype is obtained using the extreme discordant and concordant sib pairs, of whom 28 and 77 dizygotic twin pairs, respectively, were found in this study. Hence grip strength is a suitable phenotype for identifying genetic variants of importance to mid...

  12. The hand and wrist

    Wood, M.B.; Berquist, T.H.

    1985-01-01

    Trauma is the most common etiologic factor leading to disability in the hand and wrist. Judicious radiographic evaluation is required for accurate assessment in practically all but the most minor of such injuries. Frequently serial radiographic evaluation is essential for directing the course of treatment and for following the healing process. A meaningful radiographic evaluation requires a comprehensive knowledge of the normal radiographic anatomy, an overview of the spectrum of pathology, and an awareness of the usual mechanisms of injury, appropriate treatment options, and relevant array of complications

  13. FINAL TECHNICAL REPORT FOR FORESTRY BIOFUEL STATEWIDE COLLABORATION CENTER (MICHIGAN)

    LaCourt, Donna M.; Miller, Raymond O.; Shonnard, David R.

    2012-04-24

    A team composed of scientists from Michigan State University (MSU) and Michigan Technological University (MTU) assembled to better understand, document, and improve systems for using forest-based biomass feedstocks in the production of energy products within Michigan. Work was funded by a grant (DE-EE-0000280) from the U.S. Department of Energy (DOE) and was administered by the Michigan Economic Development Corporation (MEDC). The goal of the project was to improve the forest feedstock supply infrastructure to sustainably provide woody biomass for biofuel production in Michigan over the long-term. Work was divided into four broad areas with associated objectives: • TASK A: Develop a Forest-Based Biomass Assessment for Michigan – Define forest-based feedstock inventory, availability, and the potential of forest-based feedstock to support state and federal renewable energy goals while maintaining current uses. • TASK B: Improve Harvesting, Processing and Transportation Systems – Identify and develop cost, energy, and carbon efficient harvesting, processing and transportation systems. • TASK C: Improve Forest Feedstock Productivity and Sustainability – Identify and develop sustainable feedstock production systems through the establishment and monitoring of a statewide network of field trials in forests and energy plantations. • TASK D: Engage Stakeholders – Increase understanding of forest biomass production systems for biofuels by a broad range of stakeholders. The goal and objectives of this research and development project were fulfilled with key model deliverables including: 1) The Forest Biomass Inventory System (Sub-task A1) of feedstock inventory and availability and, 2) The Supply Chain Model (Sub-task B2). Both models are vital to Michigan’s forest biomass industry and support forecasting delivered cost, as well as carbon and energy balance. All of these elements are important to facilitate investor, operational and policy decisions. All

  14. The ICF and Postsurgery Occupational Therapy after Traumatic Hand Injury

    Fitinghoff, Helene; Lindqvist, Birgitta; Nygard, Louise; Ekholm, Jan; Schult, Marie-Louise

    2011-01-01

    Recent studies have examined the effectiveness of hand rehabilitation programmes and have linked the outcomes to the concept of ICF but not to specific ICF category codes. The objective of this study was to gain experience using ICF concepts to describe occupational therapy interventions during postsurgery hand rehabilitation, and to describe…

  15. Back to basics: hand hygiene and surgical hand antisepsis.

    Spruce, Lisa

    2013-11-01

    Health care-associated infections (HAIs) are a significant issue in the United States and throughout the world, but following proper hand hygiene practices is the most effective and least expensive way to prevent HAIs. Hand hygiene is inexpensive and protects patients and health care personnel alike. The four general types of hand hygiene that should be performed in the perioperative environment are washing hands that are visibly soiled, hand hygiene using alcohol-based products, surgical hand scrubs, and surgical hand scrubs using an alcohol-based surgical hand rub product. Barriers to proper hand hygiene may include not thinking about it, forgetting, skin irritation, a lack of role models, or a lack of a safety culture. One strategy for improving hand hygiene practices is monitoring hand hygiene as part of a quality improvement project, but the most important aspect for perioperative team members is to set an example for other team members by following proper hand hygiene practices and reminding each other to perform hand hygiene. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  16. The Scholarly Communication Process within the University Research Corridor (Michigan State University, the University of Michigan, and Wayne State University): A Case Study in Cooperation

    Utter, Timothy; Holley, Robert P.

    2009-01-01

    The growth of open access publishing, the development of institutional repositories, and the availability of millions of digitized monographs and journals are rapidly changing scholarly communication. This case study looks at the current and possible uses of these tools by Michigan's three largest universities: Michigan State University, the…

  17. Unconstrained and contactless hand geometry biometrics.

    de-Santos-Sierra, Alberto; Sánchez-Ávila, Carmen; Del Pozo, Gonzalo Bailador; Guerra-Casanova, Javier

    2011-01-01

    This paper presents a hand biometric system for contact-less, platform-free scenarios, proposing innovative methods in feature extraction, template creation and template matching. The evaluation of the proposed method considers both the use of three contact-less publicly available hand databases, and the comparison of the performance to two competitive pattern recognition techniques existing in literature: namely support vector machines (SVM) and k-nearest neighbour (k-NN). Results highlight the fact that the proposed method outcomes existing approaches in literature in terms of computational cost, accuracy in human identification, number of extracted features and number of samples for template creation. The proposed method is a suitable solution for human identification in contact-less scenarios based on hand biometrics, providing a feasible solution to devices with limited hardware requirements like mobile devices.

  18. Unconstrained and Contactless Hand Geometry Biometrics

    Carmen Sánchez-Ávila

    2011-10-01

    Full Text Available This paper presents a hand biometric system for contact-less, platform-free scenarios, proposing innovative methods in feature extraction, template creation and template matching. The evaluation of the proposed method considers both the use of three contact-less publicly available hand databases, and the comparison of the performance to two competitive pattern recognition techniques existing in literature: namely Support Vector Machines (SVM and k-Nearest Neighbour (k-NN. Results highlight the fact that the proposed method outcomes existing approaches in literature in terms of computational cost, accuracy in human identification, number of extracted features and number of samples for template creation. The proposed method is a suitable solution for human identification in contact-less scenarios based on hand biometrics, providing a feasible solution to devices with limited hardware requirements like mobile devices.

  19. The upper hand on compartment syndrome.

    Dolan, Roisin T

    2012-11-01

    Metacarpal fractures are common injuries, accounting for approximately 30% to 40% of all hand fractures and with a lifetime incidence of 2.5%. Traditionally regarded as an innocuous injury, metacarpal fractures tend to be associated with successful outcomes after closed reduction and immobilization. Hand compartment syndrome (HCS) is a rare clinical entity with potential devastating consequences in terms of loss of function and quality-of-life outcomes. We discuss the case of a 44-year-old woman presenting with multiple closed metacarpal fractures as a result of low-energy trauma, complicated by acute HCS. We review the presentation, clinical assessment, and optimal surgical management of acute HCS with reference to international literature.

  20. Water resources of the Flint area, Michigan

    Wiitala, Sulo Werner; Vanlier, K.E.; Krieger, Robert A.

    1964-01-01

    sand and gravel also fill some of the valleys in the bedrock surface and yield moderate to large supplies of water. Production from public supply wells tapping the drift aquifers in the area ranges from about 50 to 1,200 gpm. The water from the drift aquifer is hard or very hard and commonly contains objectionable amounts of iron.The Saginaw formation is a source of water to wells supplying some of the small communities and industries in the county. The Saginaw, which is the uppermost bedrock formation in the area, underlies most of the county. It is composed of layers of sandstone, shale, and limestone and some beds of coal. The formation is composed principally of sandstone in some areas of the county, and shale in others. Production from wells tapping the Saginaw ranges from a few to about 500 gpm. The water produced is generally moderately hard or hard and commonly contains objectionable amounts of chloride. The quality of the water limits its development for water supply. Overdrafts from the Saginaw result in a lowering of the piezometric surface and commonly cause an upward migration of water high in chloride.The Michigan and Marshall formations are generally not sources of fresh water where they are overlain by the Saginaw formation. In the southern and eastern parts of the county where they are overlain by glacial deposits, they are a source of water of good quality. The quantity of water obtainable from these formations is not fully known. However, the Marshall may be a source of large supplies of water in the southeastern part of the county.An ample supply of water is available in lakes, ponds, and streams in the metropolitan area of Flint to meet requirements for domestic, sanitary, and firefighting use in civil defense emergencies. The extent of emergency use of water from these sources would depend upon the pumping, distribution, and treatment facilities available. Enough private industrial and commercial, and public wells are present in the area normally

  1. Recent geologic development of Lake Michigan (U.S.A.)

    Gross, D.L.; Cahill, R.A.

    1983-01-01

    The stresses placed on Lake Michigan since the advent of industrialization require knowledge of the sedimentology of the whole lake in order to make informed decisions for environmental planning. Sediment accumulation rates are low: areas of the lake receiving the most sediment average only 1 mm a-1; deep-water basins average 0.1 to 0.5 mm a-1; and large areas are not receiving any sediment. Sediment was deposited rapidly (typically 5 mm a-1), in the form of rock flour, during the deglaciation of both Lake Michigan and Lake Superior Basins. Then the rate of accumulation decreased by 80-90% and has remained relatively constant since final deglaciation. Because active sedimentation occurs mostly in the deep water areas of the lake, the sediment remains undisturbed and contains a record of the chemical history of the lake. ?? 1983 Dr W. Junk Publishers.

  2. Impact of cooling systems on Lake Michigan fishes

    Spigarelli, S.A.; Romberg, G.P.

    1976-01-01

    A comparison of data on fish mortalities due to impingement at thermal power plant water intakes on Lake Michigan with available estimates of standing crop biomass, commercial and sport fishery catches, and estimated predation mortality is presented. The striking features of these data are the proportions of total mortality due to predation and the lack of accurate basic population statistics such as standing crop biomass and natural mortality for important forage and human food fishes in Lake Michigan. Although this preliminary assessment would indicate that power plant and total impingement losses constitute an insignificant fraction of total forage biomass, the potentially unstable forage-predator ratios and the apparent high degree of annual fluctuations (year-classes) in alewife, smelt, and perch indicate the need for a more detailed assessment of cooling-system related impact on selected populations

  3. Acid rain stimulation of Lake Michigan phytoplankton growth

    Manny, Bruce A.; Fahnenstiel, G.L.; Gardner, W.S.

    1987-01-01

    Three laboratory experiments demonstrated that additions of rainwater to epilimnetic lake water collected in southeastern Lake Michigan stimulated chlorophyll a production more than did additions of reagent-grade water during incubations of 12 to 20 d. Chlorophyll a production did not begin until 3–5 d after the rain and lake water were mixed. The stimulation caused by additions of rain acidified to pH 3.0 was greater than that caused by additions of untreated rain (pH 4.0–4.5). Our results support the following hypotheses: (1) Acid rain stimulates the growth of phytoplankton in lake water; (2) phosphorus in rain appears to be the factor causing this stimulation. We conclude that acid rain may accelerate the growth of epilimnetic phytoplankton in Lake Michigan (and other similar lakes) during stratification when other sources of bioavailable phosphorus to the epilimnion are limited

  4. Hand Matters: Left-Hand Gestures Enhance Metaphor Explanation

    Argyriou, Paraskevi; Mohr, Christine; Kita, Sotaro

    2017-01-01

    Research suggests that speech-accompanying gestures influence cognitive processes, but it is not clear whether the gestural benefit is specific to the gesturing hand. Two experiments tested the "(right/left) hand-specificity" hypothesis for self-oriented functions of gestures: gestures with a particular hand enhance cognitive processes…

  5. 239 240Pu in Lake Michigan: 1971 to 1978

    Wahlgren, M.A.; Nelson, D.M.; Orlandini, K.A.; Kucera, E.T.

    1978-01-01

    The plutonium concentration data presented previously have consisted primarily of results from studies of short-term variations, i.e., the annual plutonium cycle conducted at Lake Michigan station ANL-5, 12 km SW of Grand Haven, Michigan. In this report, mean annual concentrations of total plutonium in unfiltered water from far off-shore (> 30 km) stations for the period 1971 through 1977, and from station ANL-5 (1975 through 1978) are summarized to establish the long-term trend in plutonium concentration in Lake Michigan. The results presented show that the mean annual concentration in the water column is similar at ANL-5 and at offshore stations and has decreased at the rate of only 6% per year during the period 1972 through 1978. The nearly constant concentration indicates that steady-state equilibria exist between plutonium inputs to the lake and the loss of plutonium from the water column. Observations suggest the existence of an active redox cycle for Pu in Lake Michigan. In this cycle, Pu IV atoms in solution are continually taken up by particulate materials but may be oxidized within microzones of the particles such as freshly deposited manganese coatings and also in solution by agents such as dissolved oxygen. In turn, the concentration of Pu VI in solution may be limited by reaction with reducing constituents of the coloidal-sized fraction (or decomposer organisms such as bacteria or fungi, which might have been present after filtration) and with planktonic organisms in the environment to produce Pu IV and thus maintain the cycle

  6. Prostate Cancer Clinical Trials Group: The University of Michigan Site

    2012-04-01

    Michigan Cancer Center, Ann Arbor, MI Abstract Disclosures Abstract: Background: Cabozantinib ( Cabo ) is an inhibitor of MET and VEGFR2. MET signaling...promotes tumor growth, invasion and metastasis. Methods: mCRPC patients (pts) with progressive measurable disease (mRECIST) received Cabo at 100 mg...qd PO over a 12 week (wk) lead-in stage. Response was assessed q6 wks. Treatment ≥ wk 12 was based on response: pts with PR continued open-label Cabo

  7. Passive solar homes in Michigan's Upper Peninsula

    Kindred, G.F. [Garfield Kindred Associates, Hancock, MI (United States)

    2001-07-01

    This paper discussed the construction and design of 3 affordable passive solar homes located in high latitudes: (1) the Kindred house located in a wooded subdivision in Hancock, Michigan; (2) the Autio house located in Laurium, Michigan; and the Mikkola house located in South Range, Michigan. The award-winning houses were part of the United States federal government's Energy Star program. The houses were constructed with common building materials in order to introduce the general public to the principles of energy-conscious passive solar design strategies and sustainable construction technologies. Super-insulation was used to retain solar heat gain in the houses. Air infiltration was minimized through the use of an airtight drywall sealing technique. Large windows were a prominent feature of the southern facades of the houses. The windows used fixed and casement low-e argon-filled insulated glazing. Average bills for the Kindred home are US$960 per year. It was concluded that passive solar design and construction strategies are now being used more often in the area as a result of the positive media coverage that the homes has received. 5 refs.

  8. Classification of hand eczema

    Agner, T; Aalto-Korte, K; Andersen, K E

    2015-01-01

    BACKGROUND: Classification of hand eczema (HE) is mandatory in epidemiological and clinical studies, and also important in clinical work. OBJECTIVES: The aim was to test a recently proposed classification system of HE in clinical practice in a prospective multicentre study. METHODS: Patients were...... recruited from nine different tertiary referral centres. All patients underwent examination by specialists in dermatology and were checked using relevant allergy testing. Patients were classified into one of the six diagnostic subgroups of HE: allergic contact dermatitis, irritant contact dermatitis, atopic...... system investigated in the present study was useful, being able to give an appropriate main diagnosis for 89% of HE patients, and for another 7% when using two main diagnoses. The fact that more than half of the patients had one or more additional diagnoses illustrates that HE is a multifactorial disease....

  9. Congenital hand anomalies in Upper Egypt

    Tarek Abulezz

    2016-01-01

    Full Text Available Background: Congenital hand anomalies are numerous and markedly variant. Their significance is attributed to the frequent occurrence and their serious social, psychological and functional impacts on patient's life. Patients and Methods: This is a follow-up study of 64 patients with hand anomalies of variable severity. All patients were presented to Plastic Surgery Department of Sohag University Hospital in a period of 24 months. Results: This study revealed that failure of differentiation and duplication deformities were the most frequent, with polydactyly was the most common anomaly encountered. The mean age of presentation was 6 years and female to male ratio was 1.46:1. Hand anomalies were either isolated, associated with other anomalies or part of a syndrome. Conclusion: Incidence of congenital hand anomalies in Upper Egypt is difficult to be estimated due to social and cultural concepts, lack of education, poor registration and deficient medical survey. Management of hand anomalies should be individualised, carefully planned and started as early as possible to achieve the best outcome.

  10. Wide Awake Hand Surgery.

    Lied, Line; Borchgrevink, Grethe E; Finsen, Vilhjalmur

    2017-09-01

    "Wide awake hand surgery", where surgery is performed in local anaesthesia with adrenaline, without sedation or a tourniquet, has become widespread in some countries. It has a number of potential advantages and we wished to evaluate it among our patients. All 122 patients treated by this method during one year were evaluated by the surgeons and the patients on a numerical scale from 0 (best/least) to 10 (worst/most). Theatre time was compared to that recorded for a year when regional or general anaesthesia had been used. The patients' mean score for the general care they had received was 0.1 (SD 0.6), for pain during lidocaine injection 2.4 (SD 2.2), for pain during surgery 0.9 (SD 1.5), and for other discomfort during surgery 0.5 (SD 1.4). Eight reported that they would want general anaesthesia if they were to be operated again. The surgeons' mean evaluation of bleeding during surgery was 1.6 (SD 1.8), oedema during surgery 0.4 (SD 1.1), general disadvantages with the method 1.0 (SD 1.6) and general advantages 6.5 (SD 4.3). The estimation of advantages was 9.9 (DS 0.5) for tendon suture. 28 patients needed intra-operative additional anaesthesia. The proportion was lower among trained hand surgeons and fell significantly during the study period. Non-surgical theatre time was 46 (SD 15) minutes during the study period and 55 (SD 22) minutes during the regional/general period (p theatre.

  11. Rheumatoid arthritis and hand surgery

    Peretz, Anne Sofie Rosenborg; Madsen, Ole Rintek; Brogren, Elisabeth

    2017-01-01

    Rheumatoid arthritis results in characteristic deformities of the hand. Medical treatment has undergone a remarkable development. However, not all patients achieve remission or tolerate the treatment. Patients who suffer from deformities and persistent synovitis may be candidates for hand surgery...

  12. Measurement properties of the QuickDASH (disabilities of the arm, shoulder and hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review.

    Kennedy, Carol A; Beaton, Dorcas E; Smith, Peter; Van Eerd, Dwayne; Tang, Kenneth; Inrig, Taucha; Hogg-Johnson, Sheilah; Linton, Denise; Couban, Rachel

    2013-11-01

    To identify and synthesize evidence for the measurement properties of the QuickDASH, a shortened version of the 30-item DASH (Disabilities of the Arm, Shoulder and Hand) instrument. This systematic review used a best evidence synthesis approach to critically appraise the measurement properties [using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)] of the QuickDASH and cross-cultural adaptations. A standard search strategy was conducted between 2005 (year of first publication of QuickDASH) and March 2011 in MEDLINE, EMBASE and CINAHL. The search identified 14 studies to include in the best evidence synthesis of the QuickDASH. A further 11 studies were identified on eight cross-cultural adaptation versions. Many measurement properties of the QuickDASH have been evaluated in multiple studies and across most of the measurement properties. The best evidence synthesis of the QuickDASH English version suggests that this tool is performing well with strong positive evidence for reliability and validity (hypothesis testing), and moderate positive evidence for structural validity testing. Strong negative evidence was found for responsiveness due to lower correlations with global estimates of change. Information about the measurement properties of the cross-cultural adaptation versions is still lacking, or the available information is of poor overall methodological quality.

  13. Answers to questions posed by the Michigan Governor's Nuclear Waste Disposal Task Force

    1976-01-01

    A general presentation of the National Waste Terminal Storage (NWTS) Program was given on July 26, 1976, to the Michigan Environmental Review Board and the Michigan Governor's Nuclear Waste Disposal Task Force. Following the presentation, Dr. William G. Taylor, Chairman of the Task Force, provided ERDA with a listing of questions which pertained to the NWTS program and ERDA/OWI's interest in northeast Michigan. This document contains copies of the information which was provided to Dr. Taylor in response to his inquiry

  14. Management of Atopic Hand Dermatitis

    Halling-Overgaard, Anne-Sofie; Zachariae, Claus; Thyssen, Jacob P

    2017-01-01

    This article provides an overview of clinical aspects of hand eczema in patients with atopic dermatitis. Hand eczema can be a part of atopic dermatitis itself or a comorbidity, for example, as irritant or allergic contact dermatitis. When managing hand eczema, it is important to first categorize...

  15. Hand Washing: Do's and Dont's

    ... hands frequently can help limit the transfer of bacteria, viruses and other microbes. Always wash your hands before: Preparing food or eating Treating wounds or caring for a sick person Inserting or removing contact lenses Always wash your hands after: Preparing food Using ...

  16. Hand aperture patterns in prehension.

    Bongers, Raoul M; Zaal, Frank T J M; Jeannerod, Marc

    2012-06-01

    Although variations in the standard prehensile pattern can be found in the literature, these alternative patterns have never been studied systematically. This was the goal of the current paper. Ten participants picked up objects with a pincer grip. Objects (3, 5, or 7cm in diameter) were placed at 30, 60, 90, or 120cm from the hands' starting location. Usually the hand was opened gradually to a maximum immediately followed by hand closing, called the standard hand opening pattern. In the alternative opening patterns the hand opening was bumpy, or the hand aperture stayed at a plateau before closing started. Two participants in particular delayed the start of grasping with respect to start of reaching, with the delay time increasing with object distance. For larger object distances and smaller object sizes, the bumpy and plateau hand opening patterns were used more often. We tentatively concluded that the alternative hand opening patterns extended the hand opening phase, to arrive at the appropriate hand aperture at the appropriate time to close the hand for grasping the object. Variations in hand opening patterns deserve attention because this might lead to new insights into the coordination of reaching and grasping. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. A framework for designing hand hygiene educational interventions in schools

    Appiah-Brempong, Emmanuel; Harris, Muriel J; Newton, Samuel

    2018-01-01

    OBJECTIVES: Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational...... (normative beliefs and motivation to comply). CONCLUSIONS: A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools....... of school-based hand hygiene educational interventions is summarized narratively. RESULTS: School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms...

  18. Environmental status of the Lake Michigan region. Volume 16. Amphibians and reptiles of the Lake Michigan drainage basin

    Pentecost, E.D.; Vogt, R.C.

    1976-07-01

    The focus of this report is on regional distribution of the herpetofauna of the Lake Michigan Drainage Basin. The introduction includes a brief discussion of plant communities and their associated herpetofauna, and the importance of hibernacula and migration routes. Some aspects of the status, distribution, habitat, and life history of the amphibians and reptiles of the Basin are described in an annotated checklist. Special attention is given to uncommon and endangered species. Species range is shown on distribution maps.

  19. Environmental status of the Lake Michigan region. Volume 16. Amphibians and reptiles of the Lake Michigan drainage basin

    Pentecost, E.D.; Vogt, R.C.

    1976-07-01

    The focus of this report is on regional distribution of the herpetofauna of the Lake Michigan Drainage Basin. The introduction includes a brief discussion of plant communities and their associated herpetofauna, and the importance of hibernacula and migration routes. Some aspects of the status, distribution, habitat, and life history of the amphibians and reptiles of the Basin are described in an annotated checklist. Special attention is given to uncommon and endangered species. Species range is shown on distribution maps

  20. Ground-water contamination and legal controls in Michigan

    Deutsch, Morris

    1963-01-01

    The great importance of the fresh ground-water resources of Michigan is evident because 90 percent of the rural and about 70 percent of the total population of the State exclusive of the Detroit metropolitan area are supplied from underground sources. The water-supply and public-health problems that have been caused by some cases of ground-water contamination in the State illustrate the necessity of protecting this vital resource.Manmade and natural contaminants, including many types of chemical and organic matter, have entered many of the numerous aquifers of the State. Aquifers have been contaminated by waste-laden liquids percolating from the surface or from the zone of aeration and by direct injection to the aquifer itself. Industrial and domestic wastes, septic tanks, leaking sewers, flood waters or other poor quality surface waters, mine waters, solids stored or spread at the surface, and even airborne wastes all have been sources of ground-water contamination in Michigan. In addition, naturally occurring saline waters have been induced into other aquifers by overpumping or unrestricted flow from artesian wells, possibly by dewatering operations, and by the deepening of surface stream channels. Vertical migration of saline waters through open holes from formations underlying various important aquifers also has spoiled some of the fresh ground waters in the State. In spite of the contamination that has occurred, however, the total amount of ground water that has been spoiled is only a small part of the total resource. Neither is the contamination so widespread as that of the surface streams of Michigan.Overall legal authority to control most types of ground-water contamination in the State has been assigned by the Michigan Legislature to the Water Resources Commission, although the Department of Conservation and the Health Department also exercise important water-pollution control functions. The Michigan Supreme Court, in an important case upholding the power

  1. Lake Michigan Wind Assessment Analysis, 2012 and 2013

    Charles R Standridge

    2017-03-01

    Full Text Available A study was conducted to address the wind energy potential over Lake Michigan to support a commercial wind farm.  Lake Michigan is an inland sea in the upper mid-western United States.  A laser wind sensor mounted on a floating platform was located at the mid-lake plateau in 2012 and about 10.5 kilometers from the eastern shoreline near Muskegon Michigan in 2013.  Range gate heights for the laser wind sensor were centered at 75, 90, 105, 125, 150, and 175 meters.  Wind speed and direction were measured once each second and aggregated into 10 minute averages.  The two sample t-test and the paired-t method were used to perform the analysis.  Average wind speed stopped increasing between 105 m and 150 m depending on location.  Thus, the collected data is inconsistent with the idea that average wind speed increases with height. This result implies that measuring wind speed at wind turbine hub height is essential as opposed to using the wind energy power law to project the wind speed from lower heights.  Average speed at the mid-lake plateau is no more that 10% greater than at the location near Muskegon.  Thus, it may be possible to harvest much of the available wind energy at a lower height and closer to the shoreline than previously thought.  At both locations, the predominate wind direction is from the south-southwest.  The ability of the laser wind sensor to measure wind speed appears to be affected by a lack of particulate matter at greater heights.   Keywords: wind assessment, Lake Michigan, LIDAR wind sensor, statistical analysis. Article History: Received June 15th 2016; Received in revised form January 16th 2017; Accepted February 2nd 2017 Available online How to Cite This Article: Standridge, C., Zeitler, D., Clark, A., Spoelma, T., Nordman, E., Boezaart, T.A., Edmonson, J.,  Howe, G., Meadows, G., Cotel, A. and Marsik, F. (2017 Lake Michigan Wind Assessment Analysis, 2012 and 2013. Int. Journal of Renewable Energy Development

  2. 76 FR 56635 - Tuberculosis in Cattle and Bison; State and Zone Designations; Michigan

    2011-09-14

    ... second zone, which is classified as modified accredited, comprises Alcona, Alpena, Montmorency, Oscoda...) A zone in Michigan that comprises Alcona, Alpena, Montmorency, and Oscoda Counties. * * * * * [[Page...

  3. Unimanual SNARC Effect: Hand Matters.

    Riello, Marianna; Rusconi, Elena

    2011-01-01

    A structural representation of the hand embedding information about the identity and relative position of fingers is necessary to counting routines. It may also support associations between numbers and allocentric spatial codes that predictably interact with other known numerical spatial representations, such as the mental number line (MNL). In this study, 48 Western participants whose typical counting routine proceeded from thumb-to-little on both hands performed magnitude and parity binary judgments. Response keys were pressed either with the right index and middle fingers or with the left index and middle fingers in separate blocks. 24 participants responded with either hands in prone posture (i.e., palm down) and 24 participants responded with either hands in supine (i.e., palm up) posture. When hands were in prone posture, the counting direction of the left hand conflicted with the direction of the left-right MNL, whereas the counting direction of the right hand was consistent with it. When hands were in supine posture, the opposite was true. If systematic associations existed between relative number magnitude and an allocentric spatial representation of the finger series within each hand, as predicted on the basis of counting habits, interactions would be expected between hand posture and a unimanual version of the spatial-numerical association of response codes (SNARC) effect. Data revealed that with hands in prone posture a unimanual SNARC effect was present for the right hand, and with hands in supine posture a unimanual SNARC effect was present for the left hand. We propose that a posture-invariant body structural representation of the finger series provides a relevant frame of reference, a within-hand directional vector, that is associated to simple number processing. Such frame of reference can significantly interact with stimulus-response correspondence effects, like the SNARC, that have been typically attributed to the mapping of numbers on a left

  4. Unimanual SNARC Effect: Hand Matters

    Marianna eRiello

    2011-12-01

    Full Text Available A structural representation of the hand embedding information about the identity and relative position of fingers is necessary to counting routines. It may also support associations between numbers and allocentric spatial codes that predictably interact with other known numerical spatial representations, such as the mental number line. In this study, 48 Western participants whose typical counting routine proceeded from thumb-to-little on both hands performed magnitude and parity binary judgments. Response keys were pressed either with the right index and middle fingers or with the left index and middle fingers in separate blocks. 24 participants responded with either hands in prone posture (i.e. palm down and 24 participants responded with either hands in supine (i.e. palm up posture. When hands were in prone posture, the counting direction of the left hand conflicted with the direction of the left-right mental number line, whereas the counting direction of the right hand was consistent with it. When hands were in supine posture, the opposite was true. If systematic associations existed between relative number magnitude and an allocentric spatial representation of the finger series within each hand, as predicted on the basis of counting habits, interactions would be expected between hand posture and a unimanual version of the Spatial-Numerical Association of Response Codes (SNARC effect. Data revealed that with hands in prone posture a unimanual SNARC effect was present for the right hand, and with hands in supine posture a unimanual SNARC effect was present for the left hand. We propose that a posture-invariant body structural representation of the finger series provides a relevant frame of reference, a within-hand directional vector, that is associated to simple number processing. Such frame of reference can significantly interact with stimulus-response correspondence effects that have been attributed to the mapping of numbers on a mental

  5. Body mass index and progressive hand osteoarthritis: data from the Oslo hand osteoarthritis cohort.

    Magnusson, K; Slatkowsky-Christensen, B; van der Heijde, D; Kvien, T K; Hagen, K B; Haugen, I K

    2015-01-01

    Few longitudinal studies have studied the association between body mass index (BMI) and hand osteoarthritis (OA). We aimed to explore the association between BMI and progressive hand OA in a longitudinal study of the Oslo hand OA cohort. Participants with existing hand OA had hand radiographs and BMI data taken at baseline and 7-year follow-up (n = 103). The radiographs were read according to the Kellgren-Lawrence (KL) scale. First, we examined the association between baseline BMI and incident OA (KL grade ≥ 2) in joints without OA at baseline (adjusted for age and sex) using generalized estimating equation (GEE) analyses. Second, we examined whether changes in BMI from baseline to follow-up were associated with increasing KL sum score from baseline to follow-up using linear regression. We repeated the analyses using changes in number of joints with symptomatic OA and patient-reported pain and physical function as the outcome. The mean (SD) age at baseline was 61.6 (5.6) years and 91 (94%) of the cohort were women. The mean (SD) BMI was 25.7 (4.0) kg/m(2) at baseline and the mean (SD) BMI change was 1.1 (2.0) kg/m(2). There was no relationship between baseline BMI and development of more joints with OA during follow-up. Similarly, there was no association between change in BMI and hand OA progression, increasing hand pain or disability. In the Oslo hand OA cohort, higher BMI was not related to hand OA progression.

  6. The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative.

    Chang, Victor; Schwalb, Jason M; Nerenz, David R; Pietrantoni, Lisa; Jones, Sharon; Jankowski, Michelle; Oja-Tebbe, Nancy; Bartol, Stephen; Abdulhak, Muwaffak

    2015-12-01

    OBJECT Given the scrutiny of spine surgery by policy makers, spine surgeons are motivated to demonstrate and improve outcomes, by determining which patients will and will not benefit from surgery, and to reduce costs, often by reducing complications. Insurers are similarly motivated. In 2013, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) established the Michigan Spine Surgery Improvement Collaborative (MSSIC) as a Collaborative Quality Initiative (CQI). MSSIC is one of the newest of 21 other CQIs that have significantly improved-and continue to improve-the quality of patient care throughout the state of Michigan. METHODS MSSIC focuses on lumbar and cervical spine surgery, specifically indications such as stenosis, disk herniation, and degenerative disease. Surgery for tumors, traumatic fractures, deformity, scoliosis, and acute spinal cord injury are currently not within the scope of MSSIC. Starting in 2014, MSSIC consisted of 7 hospitals and in 2015 included another 15 hospitals, for a total of 22 hospitals statewide. A standardized data set is obtained by data abstractors, who are funded by BCBSM/BCN. Variables of interest include indications for surgery, baseline patient-reported outcome measures, and medical history. These are obtained within 30 days of surgery. Outcome instruments used include the EQ-5D general health state score (0 being worst and 100 being the best health one can imagine) and EQ-5D-3 L. For patients undergoing lumbar surgery, a 0 to 10 numeric rating scale for leg and back pain and the Oswestry Disability Index for back pain are collected. For patients undergoing cervical surgery, a 0 to 10 numeric rating scale for arm and neck pain, Neck Disability Index, and the modified Japanese Orthopaedic Association score are collected. Surgical details, postoperative hospital course, and patient-reported outcome measures are collected at 90-day, 1-year, and 2-year intervals. RESULTS As of July 1, 2015, a total of 6397 cases

  7. The tropical diabetic hand syndrome: a surgical perspective.

    Nthumba, Peter; Cavadas, Pedro C; Landin, Luis

    2013-01-01

    Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with

  8. Robotically enhanced rubber hand illusion.

    Arata, Jumpei; Hattori, Masashi; Ichikawa, Shohei; Sakaguchi, Masamichi

    2014-01-01

    The rubber hand illusion is a well-known multisensory illusion. In brief, watching a rubber hand being stroked by a paintbrush while one's own unseen hand is synchronously stroked causes the rubber hand to be attributed to one's own body and to "feel like it's my hand." The rubber hand illusion is thought to be triggered by the synchronized tactile stimulation of both the subject's hand and the fake hand. To extend the conventional rubber hand illusion, we introduce robotic technology in the form of a master-slave telemanipulator. The developed one degree-of-freedom master-slave system consists of an exoskeleton master equipped with an optical encoder that is worn on the subject's index finger and a motor-actuated index finger on the rubber hand, which allows the subject to perform unilateral telemanipulation. The moving rubber hand illusion has been studied by several researchers in the past with mechanically connected rigs between the subject's body and the fake limb. The robotic instruments let us investigate the moving rubber hand illusion with less constraints, thus behaving closer to the classic rubber hand illusion. In addition, the temporal delay between the body and the fake limb can be precisely manipulated. The experimental results revealed that the robotic instruments significantly enhance the rubber hand illusion. The time delay is significantly correlated with the effect of the multisensory illusion, and the effect significantly decreased at time delays over 100 ms. These findings can potentially contribute to the investigations of neural mechanisms in the field of neuroscience and of master-slave systems in the field of robotics.

  9. Modeling the problem of many hands in organisations

    Lima, de T.; Royakkers, L.M.M.; Dignum, F.P.M.; Coelho, H.; Studer, R.; Woodridge, M.J.

    2010-01-01

    In this paper we provide a formalism to reason about the problem of many hands in organisations. This is a problem that arises whenever the organisation is responsible for some undesirable outcome but none of its members can be held responsible for the outcome. The formalism proposed here is a logic

  10. HENRY'S "HAND OF GOD"

    Željko Kaluđerović

    2014-04-01

    Full Text Available In this paper the author discusses the views and statements of the French football player Thierry Henry he gave after his illegal play during the playoff match between France and the Republic of Ireland to claim one of the final spots in the World Cup 2010 in South Africa. First, by controlling the ball with his hand before passing it on for the goal Henry has shown disregard for the constitutive rules of football. Then, by stating that he is "not a referee" he demonstrated that for some players rules are not inherent to football and that they can be relativized, given that for them winning is the goal of the highest ontological status. Furthermore, he has rejected the rules of sportsmanship, thus expressing his opinion that the opponents are just obstacles which have to be removed in order to achieve your goals. Henry's action has disrupted major moral values, such as justice, honesty, responsibility and beneficence. The rules of fair play have totally been ignored both in Henry's action and in the Football Association of France's unwillingness to comment on whether a replay should take place. They have ignored one of the basic principles stated in the "Declaration of the International Fair Play Committee", according to which, fair play is much more than playing to the rules of the game; it's about the attitude of the sportsperson. It's about respecting your opponent and preserving his or her physical and psychological integrity. Finally, the author believes that the rules, moral values and fair play in football are required for this game to become actually possible to play

  11. HENRY'S "HAND OF GOD"

    Željko Kaluđerović

    2014-04-01

    Full Text Available In this paper the author discusses the views and statements of the French football player Thierry Henry he gave after his illegal play during the playoff match between France and the Republic of Ireland to claim one of the final spots in the World Cup 2010 in South Africa. First, by controlling the ball with his hand before passing it on for the goal Henry has shown disregard for the constitutive rules of football. Then, by stating that he is "not a referee" he demonstrated that for some players rules are not inherent to football and that they can be relativized, given that for them winning is the goal of the highest ontological status. Furthermore, he has rejected the rules of sportsmanship, thus expressing his opinion that the opponents are just obstacles which have to be removed in order to achieve your goals. Henry's action has disrupted major moral values, such as justice, honesty, responsibility and beneficence. The rules of fair play have totally been ignored both in Henry's action and in the Football Association of France's unwillingness to comment on whether a replay should take place. They have ignored one of the basic principles stated in the "Declaration of the International Fair Play Committee", according to which, fair play is much more than playing to the rules of the game; it's about the attitude of the sportsperson. It's about respecting your opponent and preserving his or her physical and psychological integrity. Finally, the author believes that the rules, moral values and fair play in football are required for this game to become actually possible to play.

  12. Commentary on "a matched comparison of perioperative outcomes of a single laparoscopic surgeon versus a multisurgeon robot-assisted cohort for partial nephrectomy." Ellison JS, Montgomery JS, Wolf Jr JS, Hafez KS, Miller DC, Weizer AZ, Department of Urology, University of Michigan, Ann Arbor, MI, USA: J Urol 2012;188(1):45-50.

    Kane, Christopher

    2013-02-01

    Minimally invasive nephron sparing surgery is gaining popularity for small renal masses. Few groups have evaluated robot-assisted partial nephrectomy compared to other approaches using comparable patient populations. We present a matched pair analysis of a heterogeneous group of surgeons who performed robot-assisted partial nephrectomy and a single experienced laparoscopic surgeon who performed conventional laparoscopic partial nephrectomy. Perioperative outcomes and complications were compared. All 249 conventional laparoscopic and robot-assisted partial nephrectomy cases from January 2007 to June 2010 were reviewed from our prospectively maintained institutional database. Groups were matched 1:1 (108 matched pairs) by R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to polar lines) nephrometry score, transperitoneal vs retroperitoneal approach, patient age and hilar nature of the tumor. Statistical analysis was done to compare operative outcomes and complications. Matched analysis revealed that nephrometry score, age, gender, tumor side and American Society of Anesthesia physical status classification were similar. Operative time favored conventional laparoscopic partial nephrectomy. During the study period robot-assisted partial nephrectomy showed significant improvements in estimated blood loss and warm ischemia time compared to those of the experienced conventional laparoscopic group. Postoperative complication rates, and complication distributions by Clavien classification and type were similar for conventional laparoscopic and robot-assisted partial nephrectomy (41.7% and 35.0%, respectively). Robot-assisted partial nephrectomy has a noticeable but rapid learning curve. After it is overcome the robotic procedure results in perioperative outcomes similar to those achieved with conventional laparoscopic partial nephrectomy done by an experienced surgeon. Robot

  13. 75 FR 26094 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago...

    2010-05-11

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... establishing a temporary safety zone from Brandon Road Lock and Dam to Lake Michigan. This temporary safety...

  14. Magnetotherapy in hand osteoarthritis: a pilot trial.

    Kanat, Elvan; Alp, Alev; Yurtkuran, Merih

    2013-12-01

    To evaluate the effectiveness of magnetotherapy in the treatment of hand osteoarthritis (HO). In this randomized controlled single-blind follow-up study, patients with HO were randomly assigned into 2 groups (G1 and G2). The subjects in G1 (n=25) received 25Hz, 450 pulse/s, 5-80G, magnetotherapy of totally 10 days and 20 min/day combined with active range of motion/strengthening exercises for the hand. G2 (n=25) received sham-magnetotherapy for 20 min/day for the same duration combined with the same hand exercises. Outcome measures were pain and joint stiffness evaluation, handgrip and pinchgrip strength (HPS), Duruöz and Auscan Hand Osteoarthritis Indexes (DAOI) and Short Form-36 Health Questionnaire (SF-36) administered at baseline, immediately after treatment and at the follow up. When the groups were compared with each other, improvement observed in SF-36 Pain (p<0.001), SF-36 Social Function (p=0.030), SF-36 Vitality (p=0.002), SF-36 General Health (p=0.001), Pain at rest (p<0.001), Pain at motion (p<0.001), Joint stiffness (p<0.001), DAOI (p<0.001) were in favor of G1. Changes in pain, function and quality of life scores showed significant advantage in favor of the applied electromagnetic intervention in patients with HO. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Injectable-antineoplastic-drug practices in Michigan hospitals.

    Cohen, I A; Newland, S J; Kirking, D M

    1987-05-01

    Practices related to parenteral (injectable) antineoplastic drugs (PADs) in Michigan hospitals were surveyed. All hospitals in Michigan were surveyed to assess compliance with American Society of Hospital Pharmacists (ASHP) and Occupational Safety and Health Administration (OSHA) recommendations related to PADs. Other PAD-related practice issues not covered within those guidelines were also studied. Surveys were mailed to the pharmacy directors of the state's 192 acute-care hospitals. Included were questions concerning policies and procedures for ordering, storing, preparing, handling, labeling, transporting, administering, and disposing of PADs. Questions concerning staff education, spill cleanup, and personnel issues were also included. A total of 169 questionnaires were returned, yielding a response rate of 88%. Of those respondents, 132 indicated that they prepare PAD doses for inpatients. Adherence rates were high for several of the PAD-preparation recommendations, including handwashing (97%) and gloving (98.5%). Rates for gowning (71.2%), labeling of PAD doses as biohazards (chemical hazards) (73.5%), and use of Class II biological-safety cabinets (71.2%) were less favorable. Practice areas with relatively poor adherence rates included use of plastic-backed absorbent pads under PAD preparation areas (53.8%), storing PADs separately from other drugs (48.5%), informing prospective employees of potential risks of handling PADs (36.4%), availability of spill kits (36.4%), and attaching and priming i.v. tubing before adding PADs to i.v. containers (5.4%). Many pharmacy departments in Michigan hospitals can substantially improve their adherence to ASHP and OSHA recommendations related to PADs.

  16. Estimation of alewife biomass in Lake Michigan, 1967-1978

    Hatch, Richard W.; Haack, Paul M.; Brown, Edward H.

    1981-01-01

    The buildup of salmonid populations in Lake Michigan through annual stockings of hatchery-reared fish may become limited by the quantity of forage fish, mainly alewives Alosa pseudoharengus, available for food. As a part of a continuing examination of salmonid predator-prey relations in Lake Michigan, we traced changes in alewife biomass estimated from bottom-trawl surveys conducted in late October and early November 1967–1978. Weight of adult alewives trawled per 0.5 hectare of bottom (10-minute drag) at 16 depths along eight transects between 1973 and 1977 formed a skewed distribution: 72 of 464 drags caught no alewives; 89 drags caught less than 1 kg; and 2 drags caught more than 100 kg (maximum 159 kg). Analysis of variance in normalized catch per tow indicated highly significant differences between the main effects of years and depths, and highly significant differences in the interactions of years and transects, years and depths, and transects and depths. Five geographic and depth strata, formed by combining parts of transects wherein mean catch rate did not differ significantly, were the basis for calculating annual estimates of adult alewife biomass (with 90% confidence intervals). Estimated biomass of alewives (±90% confidence limits) in Lake Michigan proper (Green Bay and Grand Traverse Bay excluded) rose gradually from 46,000 (±9,000) t in 1967 to 114,000 (±17,000) t in 1973, declined to 45,000 (±8,000) t in 1977, and rose to 77,000 (±19,000) t in 1978.

  17. Whistler mode startup in the Michigan Mirror Machine

    Booske, J.; Getty, W.D.; Gilgenbach, R.M.; Goodman, T.; Whaley, D.; Olivieri, R.; Pitcher, E.; Simonetti, L.

    1985-01-01

    Results of investigations of whistler mode ECRH plasma startup in the Michigan Mirror Machine are presented. Electron-velocity-distribution and plasma-spatial-distribution time evolution are characterized by measurements from axially and radially moveable Langmuir probes, an endloss current detector, an electron cyclotron emission radiometer, a foil-filtered X-ray detector, and a diamagnetic loop at the mirror midplane. Measurements of the buildup of both electron density and perpendicular pressure (nkT/sub perpendicular/) are compared to predictions from various numerical models. Both modeling and data suggest the creation of a highly anisotropic electron velocity distribution function with a ''sloshing electron'' axial density profile

  18. Comparison between polluted and clean air masses over Lake Michigan

    Alkezweeny, A.J.; Laulainen, N.S.

    1981-01-01

    Clean and polluted air masses, advected over Lake Michigan, were studied using instrumental aircraft during the summers of 1976 and 1978. The results show that regardless of the degree of pollution, the particle size distribution is bimodal. The concentrations of sulfate, nitrate and trace metals in a clean air mass are more than an order of magnitude lower than those in polluted air masses. Furthermore, these concentrations are comparable with those measured in remote areas of the world. In clean air the ratio of the total light scattering to Rayleigh scattering is very close to one, indicating very low concentrations of particulates in the optically active size classes

  19. History of the Trenton Albion-Scipio trend of Michigan

    Beghini, V G; Conroy, T R

    1966-01-01

    This discussion of the history of the Trenton Albion-Scipio trend in Michigan includes the location and development history, geology and reservoir characteristics, drilling and completion methods, production and history of both the Albion and Scipio Fields, production operation, and workover procedure. Maps, illustrations, and graphs of the topics discussed are included. The largest drilling problem encountered was lost circulation causing several blowouts, 2 of which resulted in spectacular fires. Production problems include paraffin deposition, corrosion and brine disposal. Well workovers have been performed in an attempt to correct one or more of 3 problems--high gas- oil ratio, high water cut, and low capacity.

  20. Neutron radiography at the University of Michigan's Phoenix Memorial Laboratory

    Lindsay, J.T.; Elam, S.; Koblish, T.; Lee, P.; McAuliffe, D.

    1990-01-01

    Real-time neutron radiography (RTNR) is rapidly becoming a valuable tool for nondestructive testing and basic research with a wide variety of applications. The Phoenix Memorial Laboratory (PML) at the University of Michigan has developed an RTNR facility and has been using this facility to study several phenomena of interest to researchers in many areas. These phenomena include imaging of the internal fluid flow in gas turbine engine nozzles and coking and debris deposition in several gas turbine nozzles. This paper presents a summary of the technique and facilities involved in these applications

  1. Surveillance for work-related skull fractures in Michigan.

    Kica, Joanna; Rosenman, Kenneth D

    2014-12-01

    The objective was to develop a multisource surveillance system for work-related skull fractures. Records on work-related skull fractures were obtained from Michigan's 134 hospitals, Michigan's Workers' Compensation Agency and death certificates. Cases from the three sources were matched to eliminate duplicates from more than one source. Workplaces where the most severe injuries occurred were referred to OSHA for an enforcement inspection. There were 318 work related skull fractures, not including facial fractures, between 2010 and 2012. In 2012, after the inclusion of facial fractures, 316 fractures were identified of which 218 (69%) were facial fractures. The Bureau of Labor Statistic's (BLS) 2012 estimate of skull fractures in Michigan, which includes facial fractures, was 170, which was 53.8% of those identified from our review of medical records. The inclusion of facial fractures in the surveillance system increased the percentage of women identified from 15.4% to 31.2%, decreased severity (hospitalization went from 48.7% to 10.6% and loss of consciousness went from 56.5% to 17.8%), decreased falls from 48.2% to 27.6%, and increased assaults from 5.0% to 20.2%, shifted the most common industry from construction (13.3%) to health care and social assistance (15.0%) and the highest incidence rate from males 65+ (6.8 per 100,000) to young men, 20-24 years (9.6 per 100,000). Workplace inspections resulted in 45 violations and $62,750 in penalties. The Michigan multisource surveillance system of workplace injuries had two major advantages over the existing national system: (a) workplace investigations were initiated hazards identified and safety changes implemented at the facilities where the injuries occurred; and (b) a more accurate count was derived, with 86% more work-related skull fractures identified than BLS's employer based estimate. A more comprehensive system to identify and target interventions for workplace injuries was implemented using hospital and

  2. Hand washing promotion for preventing diarrhoea

    Ejemot-Nwadiaro, Regina I; Ehiri, John E; Arikpo, Dachi; Meremikwu, Martin M; Critchley, Julia A

    2015-01-01

    syndrome (AIDS) (148 participants). Hand washing promotion (education activities, sometimes with provision of soap) at child day-care facilities or schools prevents around one-third of diarrhoea episodes in high income countries (rate ratio 0.70; 95% CI 0.58 to 0.85; nine trials, 4664 participants, high quality evidence), and may prevent a similar proportion in LMICs but only two trials from urban Egypt and Kenya have evaluated this (rate ratio 0.66, 95% CI 0.43 to 0.99; two trials, 45,380 participants, low quality evidence). Only three trials reported measures of behaviour change and the methods of data collection were susceptible to bias. In one trial from the USA hand washing behaviour was reported to improve; and in the trial from Kenya that provided free soap, hand washing did not increase, but soap use did (data not pooled; three trials, 1845 participants, low quality evidence). Hand washing promotion among communities in LMICs probably prevents around one-quarter of diarrhoea episodes (rate ratio 0.72, 95% CI 0.62 to 0.83; eight trials, 14,726 participants, moderate quality evidence). However, six of these eight trials were from Asian settings, with only single trials from South America and sub-Saharan Africa. In six trials, soap was provided free alongside hand washing education, and the overall average effect size was larger than in the two trials which did not provide soap (soap provided: rate ratio 0.66, 95% CI 0.56 to 0.78; six trials, 11,422 participants; education only: rate ratio: 0.84, 95% CI 0.67 to 1.05; two trials, 3304 participants). There was increased hand washing at major prompts (before eating/cooking, after visiting the toilet or cleaning the baby's bottom), and increased compliance to hand hygiene procedure (behavioural outcome) in the intervention groups than the control in community trials (data not pooled: three trials, 3490 participants, high quality evidence). Hand washing promotion for the one trial conducted in a hospital among high

  3. Multi-fingered robotic hand

    Ruoff, Carl F. (Inventor); Salisbury, Kenneth, Jr. (Inventor)

    1990-01-01

    A robotic hand is presented having a plurality of fingers, each having a plurality of joints pivotally connected one to the other. Actuators are connected at one end to an actuating and control mechanism mounted remotely from the hand and at the other end to the joints of the fingers for manipulating the fingers and passing externally of the robot manipulating arm in between the hand and the actuating and control mechanism. The fingers include pulleys to route the actuators within the fingers. Cable tension sensing structure mounted on a portion of the hand are disclosed, as is covering of the tip of each finger with a resilient and pliable friction enhancing surface.

  4. 76 FR 48751 - Security Zones; Captain of the Port Lake Michigan Zone

    2011-08-09

    ... Jardine Water Filtration Plant security zone would encompass all U.S. navigable waters of Lake Michigan... areas near shore to Chicago's water filtration plants; the security zones have been designed to allow.... 165.910 Security Zones; Captain of the Port Lake Michigan. (a) * * * (1) Jardine Water Filtration...

  5. 76 FR 80392 - Notice of Inventory Completion: University of Michigan Museum of Anthropology, Ann Arbor, MI

    2011-12-23

    ...: University of Michigan Museum of Anthropology, Ann Arbor, MI AGENCY: National Park Service, Interior. ACTION... Michigan officials and its Museum of Anthropology professional staff in consultation with representatives... accessioned into the Museum of Anthropology. Between 2007 and 2009 the remains were inventoried at the...

  6. 78 FR 34129 - Notice of Intent To Repatriate Cultural Items: University of Michigan, Museum of Anthropology...

    2013-06-06

    ... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NAGPRA-13042; PPWOCRADN0-PCU00RP14.R50000] Notice of Intent To Repatriate Cultural Items: University of Michigan, Museum of Anthropology... County, MI. In 1924, these items were sold to the University of Michigan, Museum of Anthropology, by Rev...

  7. Forging New Pathways: The Impact of the Breaking through Initiative in Michigan

    Schanker, Jennifer B.; Taylor, Judith C.

    2012-01-01

    The Michigan Center for Student Success commissioned this study to determine whether strategies employed to improve adult students' success at 41 Breaking Through colleges nationwide have taken root at Michigan's original colleges and spread beyond them. A statewide survey revisited four of the colleges profiled in previous publications, and the…

  8. Forging New Pathways: The Impact of the Breaking through Initiative in Michigan. Executive Summary

    Schanker, Jennifer B.; Taylor, Judith C.

    2012-01-01

    The Michigan Center for Student Success commissioned this study to determine whether strategies employed to improve adult students' success at 41 Breaking Through colleges nationwide have taken root at Michigan's original colleges and spread beyond them. A statewide survey revisited four of the colleges profiled in previous publications, and the…

  9. The Michigan high-level radioactive waste program: Final technical progress report

    1987-01-01

    This report comprises the state of Michigan's final technical report on the location of a proposed high-level radioactive waste disposal site. Included are a list of Michigan's efforts to review the DOE proposal and a detailed report on the application of geographic information systems analysis techniques to the review process

  10. 78 FR 65382 - Notice of Inventory Completion: University of Michigan, Ann Arbor, MI

    2013-10-31

    ....S.C. 3003, of the completion of an inventory of human remains under the control of the University of....R50000] Notice of Inventory Completion: University of Michigan, Ann Arbor, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The University of Michigan has completed an inventory of human...

  11. 78 FR 65369 - Notice of Inventory Completion: University of Michigan, Ann Arbor, MI

    2013-10-31

    ....S.C. 3003, of the completion of an inventory of human remains under the control of the University of....R50000] Notice of Inventory Completion: University of Michigan, Ann Arbor, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The University of Michigan has completed an inventory of human...

  12. 78 FR 65366 - Notice of Inventory Completion: University of Michigan, Ann Arbor, MI

    2013-10-31

    ....S.C. 3003, of the completion of an inventory of human remains under the control of the University of....R50000] Notice of Inventory Completion: University of Michigan, Ann Arbor, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The University of Michigan has completed an inventory of human...

  13. Factors Influencing School Closure and Dismissal Decisions: Influenza A (H1N1), Michigan 2009

    Dooyema, Carrie A.; Copeland, Daphne; Sinclair, Julie R.; Shi, Jianrong; Wilkins, Melinda; Wells, Eden; Collins, Jim

    2014-01-01

    Background: In fall 2009, many US communities experienced school closures during the influenza A H1N1 pandemic (pH1N1) and the state of Michigan reported 567 closures. We conducted an investigation in Michigan to describe pH1N1-related school policies, practices, and identify factors related to school closures. Methods: We distributed an online…

  14. Michigan State University Extension Educators' Perceptions of the Use of Digital Technology in Their Work

    Wells, Elizabeth Chase

    2009-01-01

    This research study examined Michigan State University Extension educators' perceptions of the use of digital technology in their work. It used a mixed method of research which included a mailed survey and interviews of selected respondents. A census survey using Dillman's Total Design method was sent to 290 field staff of Michigan State…

  15. Lake Michigan lake trout PCB model forecast post audit (oral presentation)

    Scenario forecasts for total PCBs in Lake Michigan (LM) lake trout were conducted using the linked LM2-Toxics and LM Food Chain models, supported by a suite of additional LM models. Efforts were conducted under the Lake Michigan Mass Balance Study and the post audit represents an...

  16. High Energy Theory Workshops and Visitors at the Michigan Center for Theoretical Physics FY16

    Pierce, Aaron [Univ. of Michigan, Ann Arbor, MI (United States)

    2017-08-04

    This award provided partial support for the Michigan Center for Theoretical Physics to host two workshops "Beyond the Standard Model 2016" in October 2016, and the "5th MCTP Symposium: Foundations of String Cosmology" in April 2017 on the University of Michigan campus.

  17. First report of Streptomyces stelliscabiei causing potato common scab in Michigan

    Streptomyces scabies has been reported as the predominant cause of potato scab in Michigan. In a 2007 survey of common scab in Michigan, however, isolates were collected from a field that did not fit the description for S. scabies. Tests using species-specific PCR primers indicated isolates were S. ...

  18. 78 FR 18336 - Public Water System Supervision Program Approval for the State of Michigan

    2013-03-26

    ... and Copper Rule Short Term Revisions, and the Lead and Copper Rule Minor Revisions. These rules better... defined in 18 U.S.C. 1151. By approving these rules, EPA does not intend to affect the rights of federally recognized Indian Tribes in Michigan, nor does it intend to limit existing rights of the State of Michigan...

  19. Improving Michigan STEM Teachers and Teaching: The W.K. Kellogg Foundation's Woodrow Wilson Teaching Fellowship

    Woodrow Wilson National Fellowship Foundation, 2016

    2016-01-01

    The W. K. Kellogg Foundation's Woodrow Wilson Michigan Teaching Fellowship successfully addressed the challenge of preparing and supporting effective teachers for Michigan's high-need classrooms, while helping transform teacher education across the state for the long term. This report analyzes the efforts of the W. K. Kellogg Foundation's Woodrow…

  20. Population increase in Kirtland's warbler and summer range expansion to Wisconsin and Michigan's Upper Peninsula, USA

    John R. Probst; Deahn Donner; Carol I. Bocetti; Steve Sjogren

    2003-01-01

    The threatened Kirtland`s warbler Dendroica kirtlandii breeds in stands of young jack pine Pinus banksiana growing on well-drained soils in Michigan, USA. We summarize information documenting the range expansion of Kirtland`s warbler due to increased habitat management in the core breeding range in the Lower Peninsula of Michigan...

  1. Maintenance Dredging of the Federal Navigation Channels in the Saginaw River and Saginaw Bay, Michigan.

    1975-12-01

    contact is Dr. Martha Bigelow, Director, Michigan History Division, Depar=int of State, Lansing, Michigan 48918. Te National Recister shoeuld also be...other low growth. Methylation - Change from an inorganic to an organic form usually as a result of bacterial action. For * example, the metal mercury

  2. 75 FR 32664 - Safety Zone; Milwaukee Air and Water Show, Lake Michigan, Milwaukee, WI

    2010-06-09

    .... ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a safety zone on Lake Michigan... of Lake Michigan due to a large-scale air show and a fireworks display. This temporary safety zone is... air show and fireworks display. DATES: This regulation is effective from 12:01 a.m. on June 10, 2010...

  3. Job-Embedded Professional Development Policy in Michigan: Can It Be Successful?

    Owens, Michael A.; Pogodzinski, Ben; Hill, William E.

    2016-01-01

    This paper evaluates Michigan's recently implemented job-embedded professional development policy using criteria of relevance, focus, goal orientation and social scope. The authors assert that while Michigan's policy does address all four criteria detailing effective professional development, there are limitations in the policy that may impact the…

  4. 76 FR 63202 - Security Zones; Captain of the Port Lake Michigan Zone

    2011-10-12

    ..., SE., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays... Filtration Plant security zone will encompass all U.S. navigable waters of Lake Michigan within an arc of a..., Illinois. It encompasses all U.S. navigable waters of Lake Michigan within the arc of a circle with a 100...

  5. Results of photochemical modeling sensitivity analyses in the Lake Michigan region: Current status of Lake Michigan Ozone Control Program (LMOP) modeling

    Dolwick, P.D. [Lake Michigan Air Directors Consortium, Des Plaines, IL (United States); Kaleel, R.J. [Illinois Environmental Protection Agency, Springfield, IL (United States); Majewski, M.A. [Wisconsin Dept. of Natural Resources, Madison, WI (United States)

    1994-12-31

    The four states that border Lake Michigan are cooperatively applying a state-of-the-art nested photochemical grid model to assess the effects of potential emission control strategies on reducing elevated tropospheric ozone concentrations in the region to levels below the national ambient air quality standard. In order to provide an extensive database to support the application of the photochemical model, a substantial data collection effort known as the Lake Michigan Ozone Study (LMOS) was completed during the summer of 1991. The Lake Michigan Ozone Control Program (LMOP) was established by the States of Illinois, Wisconsin, Michigan, and Indiana to carry out the application of the modeling system developed from the LMOS, in terms of developing the attainment demonstrations required from this area by the Clean Air Act Amendments of 1990.

  6. The human hand as an inspiration for robot hand development

    Santos, Veronica

    2014-01-01

    “The Human Hand as an Inspiration for Robot Hand Development” presents an edited collection of authoritative contributions in the area of robot hands. The results described in the volume are expected to lead to more robust, dependable, and inexpensive distributed systems such as those endowed with complex and advanced sensing, actuation, computation, and communication capabilities. The twenty-four chapters discuss the field of robotic grasping and manipulation viewed in light of the human hand’s capabilities and push the state-of-the-art in robot hand design and control. Topics discussed include human hand biomechanics, neural control, sensory feedback and perception, and robotic grasp and manipulation. This book will be useful for researchers from diverse areas such as robotics, biomechanics, neuroscience, and anthropologists.

  7. Primary bone tumours of the hand

    Kozlowski, K.; Azouz, E.M.; Campbell, J.; Marton, D.; Morris, L.; Padovani, J.; Sprague, P.; Beluffi, G.; Berzero, G.F.; Cherubino, P.; Adelaide Children's Hospital; Hospital for Children, Perth; Montreal Children's Hospital, Quebec; Saint Justine Hospital, Montreal, Quebec; Children's Hospital, Denver, CO; Hopital des Enfants, 13 - Marseille; Pavia Univ.; Pavia Univ.

    1988-01-01

    Twenty-one primary bone tumours of the hand in children from 8 paediatric hospitals are reported. Osteochondromas and enchondromas were not included. Our material consisted of 16 patients with common tumours (3 Ewing's sarcoma, 5 aneurysmal bone cyst, 6 osteoid osteoma and 2 epithelioma) and 5 patients with uncommon tumours (osteoma, simple bone cyst, haemangiopericytoma, capillary angiomatous tumour and benign ossifying fibroma or osteoblastoma). The X-ray diagnosis of the common tumours should have high concordance with histology, whereas that of uncommon tumours in much more difficult and uncertain. The characteristic features of Ewing's sarcoma are stressed as all our children with this tumour had a delayed diagnosis and a fatal outcome. Differential diagnosis with other short tubular bone lesions of the hand - specifically osteomyelitis - is discussed and the posibilities of microscopic diagnosis are stressed. (orig.)

  8. 76 FR 44947 - Notice of Intent To Repatriate Cultural Items: University of Michigan Museum of Anthropology, Ann...

    2011-07-27

    ... Cultural Items: University of Michigan Museum of Anthropology, Ann Arbor, MI AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The University of Michigan Museum of Anthropology, in consultation with... contact the University of Michigan Museum of Anthropology. DATES: Representatives of any Indian tribe that...

  9. 78 FR 17099 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago...

    2013-03-20

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including...

  10. 78 FR 49684 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2013-08-15

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago...

  11. 77 FR 20295 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago...

    2012-04-04

    ... Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines...

  12. 78 FR 65874 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2013-11-04

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including...

  13. 75 FR 73966 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2010-11-30

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines...

  14. 76 FR 23524 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2011-04-27

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago... safety zone from Brandon Road Lock and Dam to Lake Michigan. This proposed safety zone will cover 77.... This TIR established a 77 mile long safety zone from Brandon Road Lock to Lake Michigan in Chicago, IL...

  15. 78 FR 4071 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2013-01-18

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... Coast Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan...

  16. 78 FR 36091 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2013-06-17

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago...

  17. 77 FR 35854 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2012-06-15

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines...

  18. 75 FR 64673 - Safety Zone, Brandon Road Lock and, Dam to Lake Michigan Including Des Plaines River, Chicago...

    2010-10-20

    ... Zone, Brandon Road Lock and, Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and... Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Ship and...: The Coast Guard will enforce Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des...

  19. 78 FR 40635 - Safety Zone; Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2013-07-08

    ... Zone; Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... Coast Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan...

  20. 78 FR 36092 - Safety Zone; Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2013-06-17

    ... Zone; Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... Coast Guard will enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan...

  1. 77 FR 65478 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago...

    2012-10-29

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River...

  2. 76 FR 63199 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2011-10-12

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal...

  3. 76 FR 2829 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2011-01-18

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines...

  4. 75 FR 64147 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2010-10-19

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Ship and Sanitary Canal... . SUPPLEMENTARY INFORMATION: The Coast Guard will enforce Safety Zone, Brandon Road Lock and Dam to Lake Michigan...

  5. 75 FR 52462 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2010-08-26

    ... Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago Sanitary and Ship...; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago Sanitary and Ship Canal... enforce a segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines...

  6. 77 FR 60044 - Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago...

    2012-10-02

    ...-AA00 Safety Zone, Brandon Road Lock and Dam to Lake Michigan Including Des Plaines River, Chicago... the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River, Chicago... segment of the Safety Zone; Brandon Road Lock and Dam to Lake Michigan including Des Plaines River...

  7. Uranium and thorium occurrences in Precambrian rocks, Upper Peninsula of Michigan and northern Wisconsin, with thoughts on other possible settings

    Kalliokoski, J.

    1976-01-01

    The following areas are covered: Precambrian geology of northern Michigan; mode of occurrence of uranium and thorium in the Precambrian rocks of the Upper Peninsula of Michigan; selected stratigraphic relationships, Precambrian rocks of Michigan; mode of occurrence of uranium and thorium in Precambrian rocks of Wisconsin; and background data for geochemical exploration

  8. Hepatobiliary Hands of Hopkins.

    Pitt, Henry A

    2018-02-01

    This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training. Over the next 3 decades, he focused on the pancreas. As a result, many faculty and trainee hepatobiliary careers were launched. This perspective is based on 18 years of service as a surgical resident and faculty member at Johns Hopkins. An extensive literature search on the hepatobiliary publications of Halsted, Trimble, Blalock, Longmire, Zuidema, and Cameron was undertaken for this manuscript. Numerous hepatobiliary publications from Johns Hopkins from the 1970s, 1980s, 1990s, and early 2000s were also reviewed. John L. Cameron's early biliary interests included stones, infections, malignancies, and strictures. He was innovative with respect to portal hypertension and Budd-Chiari surgery and supportive when liver transplantation emerged in the 1980s. Volume-outcome studies in the 1990s included hepatic and complex biliary surgery. He supported and encouraged studies of biliary lithotripsy, laparoscopic cholecystectomy, clinical pathways, hepatobiliary cysts, and gallstone pathogenesis. Lessons learned by many who worked with John L. Cameron included the importance of mentorship, innovation, friendship, and collaboration. He taught leadership and change management by example. He fostered a multidisciplinary approach and encouraged randomized controlled trials.

  9. Candidate Quality Measures for Hand Surgery.

    2017-11-01

    Quality measures are tools used by physicians, health care systems, and payers to evaluate performance, monitor the outcomes of interventions, and inform quality improvement efforts. A paucity of quality measures exist that address hand surgery care. We completed a RAND/UCLA (University of California Los Angeles) Delphi Appropriateness process with the goal of developing and evaluating candidate hand surgery quality measures to be used for national quality measure development efforts. A consortium of 9 academic upper limb surgeons completed a RAND/UCLA Delphi Appropriateness process to evaluate the importance, scientific acceptability, usability, and feasibility of 44 candidate quality measures. These addressed hand problems the panelists felt were most appropriate for quality measure development. Panelists rated the measures on an ordinal scale between 1 (definitely not valid) and 9 (definitely valid) in 2 rounds (preliminary round and final round) with an intervening face-to-face discussion. Ratings from 1 to 3 were considered not valid, 4 to 6 as equivocal or uncertain, and 7 to 9 as valid. If no more than 2 of the 9 ratings were outside the 3-point range that included the median (1-3, 4-6, or 7-9), the panelists were considered to be in agreement. If 3 or more of the panelists' ratings of a measure were within the 1 to 3 range and 3 or more ratings were in the 7 to 9 range, the panelists were considered to be in disagreement. There was agreement on 43% (19) of the measures as important, 27% (12) as scientifically sound, 48% (21) as usable, and 59% (26) as feasible to complete. Ten measures met all 4 of these criteria and were, therefore, considered valid measurements of quality. Quality measures that were developed address outcomes (patient-reported outcomes for assessment and improvement of function) and processes of care (utilization rates of imaging, antibiotics, occupational therapy, ultrasound, and operative treatment). The consortium developed 10

  10. Giant lipomas of the hand

    Gokce Yildiran

    2015-04-01

    Conclusion: Giant lipomas of the hand are very rare and may cause compressions and other complications. Thus, they require a careful preoperative evaluation in order to make a proper differential diagnosis. [Hand Microsurg 2015; 4(1.000: 8-11

  11. Canadian hand dermatitis management guidelines

    Lynde, Charles; Guenther, Lyn; Diepgen, Thomas L

    2010-01-01

    Hand dermatitis (HD) is one of the most common skin conditions; however, it is not a homogeneous disease entity. The severity of HD may range from very mild cases to severe chronic forms, which may result in prolonged disability and, occasionally, refractory HD. Chronic hand dermatitis (CHD...

  12. Hand, Foot, and Mouth Disease

    Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.

  13. Michigan dioxin exposure study: planning phase and protocol development

    Adriaens, P. [Univ. of Michigan, Coll. of Engineering, Ann Arbor (United States); Garabrant, D.; Franzblau, A. [Univ. of Michigan, School for Public Health, Ann Arbor (United States); Gillespie, B. [Univ. of Michigan, Center for Statistics, Ann Arbor (United States); Lepowski, J. [Univ. of Michigan, Inst. for Social Research, Ann Arbor (United States)

    2004-09-15

    The University of Michigan has been commissioned to conduct one of the largest environmental epidemiology studies (700 residents) of dioxin exposure among the population of Michigan to describe the pattern of serum dioxin levels among adults and to understand the factors that explain variation in serum dioxin levels. The study is being undertaken (2004-2006) in response to concerns among the population of Midland and Saginaw Counties that dioxins from the Dow Chemical Company facilities in Midland have resulted in contamination of areas of the City of Midland and have contaminated the sediments in the Tittabawassee River flood plain. There is concern that body burdens of dioxins are elevated because of environmental contamination. The appropriate way to respond to these concerns is to measure the serum dioxin levels in a probability sample of the population in the region and to estimate each individual's past exposure to various factors that are believed to contribute to the body burden of dioxins. By measuring factors that reflect potential exposure to dioxins through air, water, soil, food intake, occupations, and various recreational activities, we can identify the factors that correlate with (and explain variation in) serum dioxin levels. The central goal of the study is to determine which factors explain variation in serum dioxin levels, and to quantify how much variation each factor explains. This paper provides information on the planning phase, study scope and objectives.

  14. Radiological survey results at 4400 Piehl Road, Ottawa Lake, Michigan

    Foley, R.D.; Johnson, C.A.

    1993-04-01

    At the request of the US Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted a radiological survey at 4400 Piehl Road in Ottawa Lake, Michigan. The survey was performed in September, 1992. The purpose of the survey was to determine if materials containing uranium from work performed under government contract at the former Baker Brothers facility in Toledo, Ohio had been transported off-site to this neighboring area. The radiological survey included surface gamma scans indoors and outdoors, alpha and beta scans inside the house and attached garage, beta-gamma scans of the hard surfaces outside, and the collection of soil, water, and dust samples for radionuclide analyses. Results of the survey demonstrated that the majority of the measurements on the property were within DOE guidelines. However, the presence of isolated spots of uranium contamination were found in two areas where materials were allegedly transported to the property from the former Baker Brothers site. Uranium uptake by persons on the property by ingestion is fairly unlikely, but inhalation is a possibility. Based on these findings, it is recommended that the residential property at 4400 Piehl Road in Ottawa Lake, Michigan be considered for inclusion under FUSRAP

  15. Time-Varying Value of Energy Efficiency in Michigan

    Mims, Natalie; Eckman, Tom; Schwartz, Lisa C.

    2018-04-02

    Quantifying the time-varying value of energy efficiency is necessary to properly account for all of its benefits and costs and to identify and implement efficiency resources that contribute to a low-cost, reliable electric system. Historically, most quantification of the benefits of efficiency has focused largely on the economic value of annual energy reduction. Due to the lack of statistically representative metered end-use load shape data in Michigan (i.e., the hourly or seasonal timing of electricity savings), the ability to confidently characterize the time-varying value of energy efficiency savings in the state, especially for weather-sensitive measures such as central air conditioning, is limited. Still, electric utilities in Michigan can take advantage of opportunities to incorporate the time-varying value of efficiency into their planning. For example, end-use load research and hourly valuation of efficiency savings can be used for a variety of electricity planning functions, including load forecasting, demand-side management and evaluation, capacity planning, long-term resource planning, renewable energy integration, assessing potential grid modernization investments, establishing rates and pricing, and customer service (KEMA 2012). In addition, accurately calculating the time-varying value of efficiency may help energy efficiency program administrators prioritize existing offerings, set incentive or rebate levels that reflect the full value of efficiency, and design new programs.

  16. Short-lived radionuclides program at the University of Michigan

    Wieland, D.M.

    1985-01-01

    The University of Michigan Nuclear Medicine Research Program, from instrumentation design through radiopharmaceutical development to clinical evaluation, is heavily dependent on the availability and use of iodine-123. Research activities at the University of Michigan can be divided into four major areas: instrumentation, radiochemistry, radiopharmaceutical development, and clinical evaluation. In the first category a new single-photon ring tomograph (SPRINT) has been built and is undergoing performance testing. SPRINT has been designed specifically for brain imaging with 123 I-labeled agents. In the area of radiochemistry, a simple radioiodide exchange technique has been developed for the rapid synthesis of 123 I-labeled aromatic compounds. In the radiopharmaceutical arena, a new agent, 123 I-meta-iodobenzyl-guanidine (MIBG), has been developed - the result of an extensive structure-distribution-relationship study. This radiopharmaceutical, a storage analog of norepinephrine, images organs with rich sympathetic innervation such as the heart and spleen. In the Nuclear Medicine Clinic three 123 I-labeled radiopharmaceuticals are undergoing evaluation

  17. Boom, Bust and Beyond: Arts and Sustainability in Calumet, Michigan

    Richelle Winkler

    2016-03-01

    Full Text Available Cycles of boom and bust plague mining communities around the globe, and decades after the bust the skeletons of shrunken cities remain. This article evaluates strategies for how former mining communities cope and strive for sustainability in the decades well beyond the bust, using a case study of Calumet, Michigan. In 1910, Calumet was at the center of the mining industry in the Upper Peninsula of Michigan, but in the century since its peak, mining employment steadily declined until the last mine closed in 1968, and the population declined by over 80%. This paper explores challenges, opportunities, and progress toward sustainability associated with arts-related development in this context. Methods are mixed, including observation, interviews, document review, a survey, and secondary data analysis. We follow Flora and Flora’s Community Capitals Framework to analyze progress toward sustainability. Despite key challenges associated with the shrunken city context (degraded tax base, overbuilt and aging infrastructure, diminished human capital, and a rather limited set of volunteers and political actors, we find the shrunken city also offers advantages for arts development, including low rents, less risk of gentrification, access to space, and political incentive. In Calumet, we see evidence of a spiraling up pattern toward social sustainability resulting from arts development; however impacts on environmental and economic sustainability are limited.

  18. Effect of hand sanitizer location on hand hygiene compliance.

    Cure, Laila; Van Enk, Richard

    2015-09-01

    Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Degloving injuries of the hand

    R Krishnamoorthy

    2011-01-01

    Full Text Available Avulsion of skin from the hand or fingers is an injury that has a dramatic presentation. The entire musculo-skeletal unit of the finger is intact, and the patient can often move the parts of his naked hand quite normally. The challenge for the reconstructive surgeon lies in resurfacing the hand or finger with a good quality pliable sensate skin cover while preserving the movements and function of the hand. Traditionally, skin grafting has been the standard method of reconstruction in such injuries. However, skin grafting does have many disadvantages, too. This article deals with the features of such injuries, management protocols and other reconstructive options available in the armamentarium of the hand surgeon.

  20. 3D Printed Robotic Hand

    Pizarro, Yaritzmar Rosario; Schuler, Jason M.; Lippitt, Thomas C.

    2013-01-01

    Dexterous robotic hands are changing the way robots and humans interact and use common tools. Unfortunately, the complexity of the joints and actuations drive up the manufacturing cost. Some cutting edge and commercially available rapid prototyping machines now have the ability to print multiple materials and even combine these materials in the same job. A 3D model of a robotic hand was designed using Creo Parametric 2.0. Combining "hard" and "soft" materials, the model was printed on the Object Connex350 3D printer with the purpose of resembling as much as possible the human appearance and mobility of a real hand while needing no assembly. After printing the prototype, strings where installed as actuators to test mobility. Based on printing materials, the manufacturing cost of the hand was $167, significantly lower than other robotic hands without the actuators since they have more complex assembly processes.

  1. The hand of Homo naledi

    Kivell, Tracy L.; Deane, Andrew S.; Tocheri, Matthew W.; Orr, Caley M.; Schmid, Peter; Hawks, John; Berger, Lee R.; Churchill, Steven E.

    2015-01-01

    A nearly complete right hand of an adult hominin was recovered from the Rising Star cave system, South Africa. Based on associated hominin material, the bones of this hand are attributed to Homo naledi. This hand reveals a long, robust thumb and derived wrist morphology that is shared with Neandertals and modern humans, and considered adaptive for intensified manual manipulation. However, the finger bones are longer and more curved than in most australopiths, indicating frequent use of the hand during life for strong grasping during locomotor climbing and suspension. These markedly curved digits in combination with an otherwise human-like wrist and palm indicate a significant degree of climbing, despite the derived nature of many aspects of the hand and other regions of the postcranial skeleton in H. naledi. PMID:26441219

  2. A multifaceted hospital-wide intervention increases hand hygiene compliance.

    Patel, B; Engelbrecht, H; McDonald, H; Morris, V; Smythe, W

    2016-03-07

    Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. To show an improvement in hand hygiene compliance using a multifaceted approach. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with non-intervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

  3. Hand in Hand - SEI Programmes for School Staff

    Nielsen, Birgitte Lund; Réol, Lise Andersen; Laursen, Hilmar Dyrborg

    2017-01-01

    This catalogue of research in the field of SEI programmes for the school staff’s and teachers’ SEI competencies is based on a review performed by the main researchers Birgitte Lund Nielsen, Lise Andersen Réol and Hilmar Dyrborg Laursen, VIA University College, Denmark, but discussed by the entire...... team of Hand in Hand partner countries and researchers. The aim was to identify the central aspects and elements concerning successful implementation, and school staff’s development of professional competencies in the specific field of supporting students’ social, emotional and intercultural (SEI......) competencies. Abstract: Framed by the EU-project Hand in Hand focusing on Social, Emotional and Intercultural (SEI) competencies among students and school staff, the paper discusses implementation and professional competencies based on a research review. The following five topics were identified: 1...

  4. The Marble-Hand Illusion.

    Senna, Irene; Maravita, Angelo; Bolognini, Nadia; Parise, Cesare V

    2014-01-01

    Our body is made of flesh and bones. We know it, and in our daily lives all the senses constantly provide converging information about this simple, factual truth. But is this always the case? Here we report a surprising bodily illusion demonstrating that humans rapidly update their assumptions about the material qualities of their body, based on their recent multisensory perceptual experience. To induce a misperception of the material properties of the hand, we repeatedly gently hit participants' hand with a small hammer, while progressively replacing the natural sound of the hammer against the skin with the sound of a hammer hitting a piece of marble. After five minutes, the hand started feeling stiffer, heavier, harder, less sensitive, unnatural, and showed enhanced Galvanic skin response (GSR) to threatening stimuli. Notably, such a change in skin conductivity positively correlated with changes in perceived hand stiffness. Conversely, when hammer hits and impact sounds were temporally uncorrelated, participants did not spontaneously report any changes in the perceived properties of the hand, nor did they show any modulation in GSR. In two further experiments, we ruled out that mere audio-tactile synchrony is the causal factor triggering the illusion, further demonstrating the key role of material information conveyed by impact sounds in modulating the perceived material properties of the hand. This novel bodily illusion, the 'Marble-Hand Illusion', demonstrates that the perceived material of our body, surely the most stable attribute of our bodily self, can be quickly updated through multisensory integration.

  5. Energy density of lake whitefish Coregonus clupeaformis in Lakes Huron and Michigan

    Pothoven, S.A.; Nalepa, T.F.; Madenjian, C.P.; Rediske, R.R.; Schneeberger, P.J.; He, J.X.

    2006-01-01

    We collected lake whitefish Coregonus clupeaformis off Alpena and Tawas City, Michigan, USA in Lake Huron and off Muskegon, Michigan USA in Lake Michigan during 2002–2004. We determined energy density and percent dry weight for lake whitefish from both lakes and lipid content for Lake Michigan fish. Energy density increased with increasing fish weight up to 800 g, and then remained relatively constant with further increases in fish weight. Energy density, adjusted for weight, was lower in Lake Huron than in Lake Michigan for both small (≤800 g) and large fish (>800 g). Energy density did not differ seasonally for small or large lake whitefish or between adult male and female fish. Energy density was strongly correlated with percent dry weight and percent lipid content. Based on data from commercially caught lake whitefish, body condition was lower in Lake Huron than Lake Michigan during 1981–2003, indicating that the dissimilarity in body condition between the lakes could be long standing. Energy density and lipid content in 2002–2004 in Lake Michigan were lower than data for comparable sized fish collected in 1969–1971. Differences in energy density between lakes were attributed to variation in diet and prey energy content as well as factors that affect feeding rates such as lake whitefish density and prey abundance.

  6. Evaluating Michigan's community hospital access: spatial methods for decision support

    Varnakovida Pariwate

    2006-09-01

    Full Text Available Abstract Background Community hospital placement is dictated by a diverse set of geographical factors and historical contingency. In the summer of 2004, a multi-organizational committee headed by the State of Michigan's Department of Community Health approached the authors of this paper with questions about how spatial analyses might be employed to develop a revised community hospital approval procedure. Three objectives were set. First, the committee needed visualizations of both the spatial pattern of Michigan's population and its 139 community hospitals. Second, the committee required a clear, defensible assessment methodology to quantify access to existing hospitals statewide, taking into account factors such as distance to nearest hospital and road network density to estimate travel time. Third, the committee wanted to contrast the spatial distribution of existing community hospitals with a theoretical configuration that best met statewide demand. This paper presents our efforts to first describe the distribution of Michigan's current community hospital pattern and its people, and second, develop two models, access-based and demand-based, to identify areas with inadequate access to existing hospitals. Results Using the product from the access-based model and contiguity and population criteria, two areas were identified as being "under-served." The lower area, located north/northeast of Detroit, contained the greater total land area and population of the two areas. The upper area was centered north of Grand Rapids. A demand-based model was applied to evaluate the existing facility arrangement by allocating daily bed demand in each ZIP code to the closest facility. We found 1,887 beds per day were demanded by ZIP centroids more than 16.1 kilometers from the nearest existing hospital. This represented 12.7% of the average statewide daily bed demand. If a 32.3 kilometer radius was employed, unmet demand dropped to 160 beds per day (1

  7. Hand-assisted laparoscopic splenectomy

    Bemelman, W. A.; de Wit, L. T.; Busch, O. R.; Gouma, D. J.

    2000-01-01

    Laparoscopic splenectomy is performed routinely in patients with small and moderately enlarged spleens at specialized centers. Large spleens are difficult to handle laparoscopically and hand-assisted laparoscopic splenectomy might facilitate the procedure through enhanced vascular control, easier

  8. Animal Bites of the Hand

    ... Therapist? Media Find a Hand Surgeon Home Anatomy Animal Bites Email to a friend * required fields From * ... key to prevent problems from a bite. CAUSES Animal Bites Millions of animal bites occur in the ...

  9. Hand and foot contamination monitor

    Jakati, R.K.; Kaptral, R.S.; Ananthkrishnan, T.S.; Pansare, M.G.

    1989-01-01

    In order to make quick measurements of beta and gamma contaminations on hands and feet of personnel working in radioactive environments, hand and foot contamination monitors are widely used. This paper describes such a monitor system designed with Intel 8085 based microcomputer. The monitoring and warning system is designed to perform measurement of activity spread over surface of hands and soles of shoes or feet. Even though the system has many features to aid testing and maintainance operation, it is easy to use for unskilled persons. In order to check the contamination, the person stands on platform and inserts both his hands into detector assemblies thereby actuating the sensing switches. After a preset interval, annunciation of clean or contaminated status is declared by the system. (author)

  10. The Plastic Surgery Hand Curriculum.

    Silvestre, Jason; Levin, L Scott; Serletti, Joseph M; Chang, Benjamin

    2015-12-01

    Designing an effective hand rotation for plastic surgery residents is difficult. The authors address this limitation by elucidating the critical components of the hand curriculum during plastic surgery residency. Hand questions on the Plastic Surgery In-Service Training Exam for six consecutive years (2008 to 2013) were characterized by presence of imaging, vignette setting, question taxonomy, answer domain, anatomy, and topic. Answer references were quantified by source and year of publication. Two hundred sixty-six questions were related to hand surgery (22.7 percent of all questions; 44.3 per year) and 61 were accompanied by an image (22.9 percent). Vignettes tended to be clinic- (50.0 percent) and emergency room-based (35.3 percent) (p < 0.001). Questions required decision-making (60.5 percent) over interpretation (25.9 percent) and recall skills (13.5 percent) (p < 0.001). Answers focused on interventions (57.5 percent) over anatomy/pathology (25.2 percent) and diagnoses (17.3 percent) (p < 0.001). Nearly half of the questions focused on the digits. The highest yield topics were trauma (35.3 percent), reconstruction (24.4 percent), and aesthetic and functional problems (14.2 percent). The Journal of Hand Surgery (American volume) (20.5 percent) and Plastic and Reconstructive Surgery (18.0 percent) were the most-cited journals, and the median publication lag was 7 years. Green's Operative Hand Surgery was the most-referenced textbook (41.8 percent). These results will enable trainees to study hand surgery topics with greater efficiency. Faculty can use these results to ensure that tested topics are covered during residency training. Thus, a benchmark is established to improve didactic, clinical, and operative experiences in hand surgery.

  11. Hand, Foot, and Mouth Disease

    2013-08-08

    Hand, foot, and mouth disease is a contagious illness that mainly affects children under five. In this podcast, Dr. Eileen Schneider talks about the symptoms of hand, foot, and mouth disease, how it spreads, and ways to help protect yourself and your children from getting infected with the virus.  Created: 8/8/2013 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 8/8/2013.

  12. Answers to questions posed by the Michigan Governor's Nuclear Waste Disposal Task Force

    1976-09-30

    A general presentation of the National Waste Terminal Storage (NWTS) Program was given on July 26, 1976, to the Michigan Environmental Review Board and the Michigan Governor's Nuclear Waste Disposal Task Force. Following the presentation, Dr. William G. Taylor, Chairman of the Task Force, provided ERDA with a listing of questions which pertained to the NWTS program and ERDA/OWI's interest in northeast Michigan. This document contains copies of the information which was provided to Dr. Taylor in response to his inquiry.

  13. Hand Grasping Synergies As Biometrics.

    Patel, Vrajeshri; Thukral, Poojita; Burns, Martin K; Florescu, Ionut; Chandramouli, Rajarathnam; Vinjamuri, Ramana

    2017-01-01

    Recently, the need for more secure identity verification systems has driven researchers to explore other sources of biometrics. This includes iris patterns, palm print, hand geometry, facial recognition, and movement patterns (hand motion, gait, and eye movements). Identity verification systems may benefit from the complexity of human movement that integrates multiple levels of control (neural, muscular, and kinematic). Using principal component analysis, we extracted spatiotemporal hand synergies (movement synergies) from an object grasping dataset to explore their use as a potential biometric. These movement synergies are in the form of joint angular velocity profiles of 10 joints. We explored the effect of joint type, digit, number of objects, and grasp type. In its best configuration, movement synergies achieved an equal error rate of 8.19%. While movement synergies can be integrated into an identity verification system with motion capture ability, we also explored a camera-ready version of hand synergies-postural synergies. In this proof of concept system, postural synergies performed well, but only when specific postures were chosen. Based on these results, hand synergies show promise as a potential biometric that can be combined with other hand-based biometrics for improved security.

  14. Hand Grasping Synergies As Biometrics

    Ramana Vinjamuri

    2017-05-01

    Full Text Available Recently, the need for more secure identity verification systems has driven researchers to explore other sources of biometrics. This includes iris patterns, palm print, hand geometry, facial recognition, and movement patterns (hand motion, gait, and eye movements. Identity verification systems may benefit from the complexity of human movement that integrates multiple levels of control (neural, muscular, and kinematic. Using principal component analysis, we extracted spatiotemporal hand synergies (movement synergies from an object grasping dataset to explore their use as a potential biometric. These movement synergies are in the form of joint angular velocity profiles of 10 joints. We explored the effect of joint type, digit, number of objects, and grasp type. In its best configuration, movement synergies achieved an equal error rate of 8.19%. While movement synergies can be integrated into an identity verification system with motion capture ability, we also explored a camera-ready version of hand synergies—postural synergies. In this proof of concept system, postural synergies performed well, but only when specific postures were chosen. Based on these results, hand synergies show promise as a potential biometric that can be combined with other hand-based biometrics for improved security.

  15. The validity of the Michigan Alcoholism Screening Test (MAST)

    Storgaard, H; Nielsen, S D; Gluud, C

    1994-01-01

    This review examines the validity of the Michigan Alcoholism Screening Test (MAST) as a screening instrument for alcohol problems. Studies that compare the MAST-questionnaire with other defined diagnostic criteria of alcohol problems were retrieved through MEDLINE and a cross-bibliographic check....... A total of 20 validity studies were included. The studies varied considerably regarding the prevalence of alcohol problems, the diagnostic criteria, and the examined patient categories. The MAST compared with other diagnostic criteria of alcohol problems gave validity measures with the following span...... and the specificities show substantial variations. The variables that seem to have the largest influence on the PVpos seem to be the prevalence of alcohol problems, the diagnostic method against which the MAST-questionnaire is validated, and the populations on which the MAST is applied. The MAST should in the future...

  16. Arsenic species and chemistry in groundwater of southeast Michigan

    Kim, M.-J.; Nriagu, Jerome; Haack, Sheridan

    2002-01-01

    Most of the arsenic detected was arsenite [As(III)]. - Groundwater samples, taken from 73 wells in 10 counties of southeast Michigan in 1997 had arsenic concentrations in the range of 0.5 to 278 μg/l, the average being 29 μg/l. About 12% of these wells had arsenic concentrations that exceeded the current USEPA's maximum contaminant level of 50 μg/l. Most (53-98%) of the arsenic detected was arsenite [As(III)] and other observations supported the arsenic species distribution (low redox potential and DO). In shallow groundwater ( 15 m), the concentration of arsenic is possibly controlled by reductive dissolution of arsenic-rich iron hydroxide/oxyhydroxide and dissolution of arsenic sulfide minerals

  17. University of Michigan Comprehensive Cancer Center opportunities for improvement project.

    Breslin, Tara M; Waldinger, Marcy; Silver, Samuel M

    2014-02-01

    The University of Michigan Comprehensive Cancer Center (UMCCC) Opportunities for Improvement project involved a detailed patient-level medical record review, feedback to medical providers and clinical leadership, and discussion of potential predictors of discordant or delayed care. The medical record review revealed that reasons for discordant or delayed care were well documented by clinical providers, and medical comorbidity was the most common predisposing factor. Another common theme was the difficulty in obtaining treatment records for patients who received a portion of their care outside UMCCC. The project provided a valuable opportunity to examine established processes of care and data collection and consider how the newly implemented electronic health record might support future efforts aimed at improving efficiency and communication among providers.

  18. Psychometric Evaluation of the Revised Michigan Diabetes Knowledge Test (V.2016) in Arabic: Translation and Validation

    Alhaiti, Ali Hassan; Alotaibi, Alanod Raffa; Jones, Linda Katherine; DaCosta, Cliff

    2016-01-01

    Objective. To translate the revised Michigan Diabetes Knowledge Test into the Arabic language and examine its psychometric properties. Setting. Of the 139 participants recruited through King Fahad Medical City in Riyadh, Saudi Arabia, 34 agreed to the second-round sample for retesting purposes. Methods. The translation process followed the World Health Organization's guidelines for the translation and adaptation of instruments. All translations were examined for their validity and reliability. Results. The translation process revealed excellent results throughout all stages. The Arabic version received 0.75 for internal consistency via Cronbach's alpha test and excellent outcomes in terms of the test-retest reliability of the instrument with a mean of 0.90 infraclass correlation coefficient. It also received positive content validity index scores. The item-level content validity index for all instrument scales fell between 0.83 and 1 with a mean scale-level index of 0.96. Conclusion. The Arabic version is proven to be a reliable and valid measure of patient's knowledge that is ready to be used in clinical practices. PMID:27995149

  19. An EMG-Controlled Robotic Hand Exoskeleton for Bilateral Rehabilitation.

    Leonardis, Daniele; Barsotti, Michele; Loconsole, Claudio; Solazzi, Massimiliano; Troncossi, Marco; Mazzotti, Claudio; Castelli, Vincenzo Parenti; Procopio, Caterina; Lamola, Giuseppe; Chisari, Carmelo; Bergamasco, Massimo; Frisoli, Antonio

    2015-01-01

    This paper presents a novel electromyography (EMG)-driven hand exoskeleton for bilateral rehabilitation of grasping in stroke. The developed hand exoskeleton was designed with two distinctive features: (a) kinematics with intrinsic adaptability to patient's hand size, and (b) free-palm and free-fingertip design, preserving the residual sensory perceptual capability of touch during assistance in grasping of real objects. In the envisaged bilateral training strategy, the patient's non paretic hand acted as guidance for the paretic hand in grasping tasks. Grasping force exerted by the non paretic hand was estimated in real-time from EMG signals, and then replicated as robotic assistance for the paretic hand by means of the hand-exoskeleton. Estimation of the grasping force through EMG allowed to perform rehabilitation exercises with any, non sensorized, graspable objects. This paper presents the system design, development, and experimental evaluation. Experiments were performed within a group of six healthy subjects and two chronic stroke patients, executing robotic-assisted grasping tasks. Results related to performance in estimation and modulation of the robotic assistance, and to the outcomes of the pilot rehabilitation sessions with stroke patients, positively support validity of the proposed approach for application in stroke rehabilitation.

  20. Spatial Distribution of Black Bear Incident Reports in Michigan.

    McFadden-Hiller, Jamie E; Beyer, Dean E; Belant, Jerrold L

    2016-01-01

    Interactions between humans and carnivores have existed for centuries due to competition for food and space. American black bears are increasing in abundance and populations are expanding geographically in many portions of its range, including areas that are also increasing in human density, often resulting in associated increases in human-bear conflict (hereafter, bear incidents). We used public reports of bear incidents in Michigan, USA, from 2003-2011 to assess the relative contributions of ecological and anthropogenic variables in explaining the spatial distribution of bear incidents and estimated the potential risk of bear incidents. We used weighted Normalized Difference Vegetation Index mean as an index of primary productivity, region (i.e., Upper Peninsula or Lower Peninsula), primary and secondary road densities, and percentage land cover type within 6.5-km2 circular buffers around bear incidents and random points. We developed 22 a priori models and used generalized linear models and Akaike's Information Criterion (AIC) to rank models. The global model was the best compromise between model complexity and model fit (w = 0.99), with a ΔAIC 8.99 units from the second best performing model. We found that as deciduous forest cover increased, the probability of bear incident occurrence increased. Among the measured anthropogenic variables, cultivated crops and primary roads were the most important in our AIC-best model and were both positively related to the probability of bear incident occurrence. The spatial distribution of relative bear incident risk varied markedly throughout Michigan. Forest cover fragmented with agriculture and other anthropogenic activities presents an environment that likely facilitates bear incidents. Our map can help wildlife managers identify areas of bear incident occurrence, which in turn can be used to help develop strategies aimed at reducing incidents. Researchers and wildlife managers can use similar mapping techniques to

  1. Project U-Turn: increasing active transportation in Jackson, Michigan.

    TenBrink, David S; McMunn, Randall; Panken, Sarah

    2009-12-01

    Jackson, Michigan, is a medium-sized city suffering from a bad economy and obesity-related health issues. Nearly 20% of the 36,000 residents live below the poverty line. It is a relatively young city (median age of 30 years) with a mixed ethnicity (20% black, 73% white, 4% Hispanic). The city offers many structured, active recreational opportunities, but has not integrated physical activity into daily life. Project U-Turn aimed to increase active transportation (e.g., biking, walking, and transit use) through an integrated approach to Active Living by Design's community action model and the Michigan Safe Routes to School model. Resources were focused on active living promotions and programs; partnership meetings were the source of changes in policy and physical projects. Each initiative was designed to introduce each of the 5Ps (preparation, promotion, programs, policy, and physical projects) to build support for the partnership's overall work. The partnership collected snapshot data of community walking and biking behavior, percentage of students walking to school, participation in events and programs, and new physical projects. Jackson saw a vast improvement in physical infrastructure and policy and a related increase in walking and biking in the community. The project engaged in purposeful partnership building to implement effective programs and promotions that built support for policy and physical projects. Limited resources were best used by encouraging partners to contribute and coordinate activities using existing staff, funding, and resources. Jackson has seen a shift toward awareness of the benefits of active living on community health, economic development, and environmental awareness.

  2. Spatial Distribution of Black Bear Incident Reports in Michigan.

    Jamie E McFadden-Hiller

    Full Text Available Interactions between humans and carnivores have existed for centuries due to competition for food and space. American black bears are increasing in abundance and populations are expanding geographically in many portions of its range, including areas that are also increasing in human density, often resulting in associated increases in human-bear conflict (hereafter, bear incidents. We used public reports of bear incidents in Michigan, USA, from 2003-2011 to assess the relative contributions of ecological and anthropogenic variables in explaining the spatial distribution of bear incidents and estimated the potential risk of bear incidents. We used weighted Normalized Difference Vegetation Index mean as an index of primary productivity, region (i.e., Upper Peninsula or Lower Peninsula, primary and secondary road densities, and percentage land cover type within 6.5-km2 circular buffers around bear incidents and random points. We developed 22 a priori models and used generalized linear models and Akaike's Information Criterion (AIC to rank models. The global model was the best compromise between model complexity and model fit (w = 0.99, with a ΔAIC 8.99 units from the second best performing model. We found that as deciduous forest cover increased, the probability of bear incident occurrence increased. Among the measured anthropogenic variables, cultivated crops and primary roads were the most important in our AIC-best model and were both positively related to the probability of bear incident occurrence. The spatial distribution of relative bear incident risk varied markedly throughout Michigan. Forest cover fragmented with agriculture and other anthropogenic activities presents an environment that likely facilitates bear incidents. Our map can help wildlife managers identify areas of bear incident occurrence, which in turn can be used to help develop strategies aimed at reducing incidents. Researchers and wildlife managers can use similar mapping

  3. Nudging to improve hand hygiene.

    Caris, M G; Labuschagne, H A; Dekker, M; Kramer, M H H; van Agtmael, M A; Vandenbroucke-Grauls, C M J E

    2018-04-01

    Hand hygiene is paramount to prevent healthcare-associated infections, but improving compliance is challenging. When healthcare workers seldom encounter healthcare-associated infections, they will consider the odds of causing infections through poor hand hygiene negligible. Cognitive biases such as these may induce non-compliance. Nudging, 'a friendly push to encourage desired behaviour', could provide an easily implemented, inexpensive measure to address cognitive biases and thus support hand hygiene interventions. To investigate whether behavioural nudges, displayed as posters, can increase the use of alcohol-based hand rub. We developed nudges based on a systematic review of previously described cognitive biases, and tested these through a cross-sectional survey among the target audience. We then conducted a controlled before-after trial on two hospital wards, to assess the effect of these nudges on the use of alcohol-based hand rub, measured with electronic dispensers. Poisson regression analyses adjusted for workload showed that nudges displayed next to dispensers increased their overall use on one ward [poster 1: relative risk: 1.6 (95% confidence interval: 1.2-2.2); poster 2: 1.7 (1.2-2.5)] and during doctor's rounds on both wards [poster 1: ward A: 1.7 (1.1-2.6); ward B: 2.2 (1.3-3.8)]. Use of dispensers without adjacent nudges did not increase. Nudges based on cognitive biases that play a role in hand hygiene, and displayed as posters, could provide an easy, inexpensive measure to increase use of alcohol-based hand rub. When applying nudges to change behaviour, it is important to identify the right nudge for the right audience. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  4. The impact of the Hand Hygiene New Zealand programme on hand hygiene practices in New Zealand's public hospitals.

    Freeman, Joshua; Dawson, Louise; Jowitt, Deborah; White, Margo; Callard, Hayley; Sieczkowski, Christine; Kuriyan, Ron; Roberts, Sally

    2016-10-14

    To detail the progress made by Hand Hygiene New Zealand (HHNZ) since 2011 and also describe the challenges experienced along the way and the factors required for delivery of a successful hand hygiene programme at a national level. HHNZ is a multimodal culture-change programme based on the WHO '5 moments for hand hygiene' approach. The key components of the programme include clinical leadership, auditing of hand hygiene compliance with thrice yearly reporting of improvement in hand hygiene practice, biannual reporting of the outcome marker, healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB), effective communication with key stakeholders and the use of the front-line ownership (FLO) principles for quality improvement. The nationally aggregated hand hygiene compliance has increased from 62% in June 2012 to 81% in March 2016. There has been improvement across all 'moments', all healthcare worker groups and a range of different clinical specialties. The rate of HA-SAB has remained stable. The HHNZ programme has led to significant improvements in hand hygiene practice in DHBs throughout New Zealand. The principles of FLO are now widely used to drive hand hygiene improvement in New Zealand DHBs.

  5. Hand washing promotion for preventing diarrhoea.

    Ejemot-Nwadiaro, Regina I; Ehiri, John E; Arikpo, Dachi; Meremikwu, Martin M; Critchley, Julia A

    2015-09-03

    provision of soap) at child day-care facilities or schools prevents around one-third of diarrhoea episodes in high income countries (rate ratio 0.70; 95% CI 0.58 to 0.85; nine trials, 4664 participants, high quality evidence), and may prevent a similar proportion in LMICs but only two trials from urban Egypt and Kenya have evaluated this (rate ratio 0.66, 95% CI 0.43 to 0.99; two trials, 45,380 participants, low quality evidence). Only three trials reported measures of behaviour change and the methods of data collection were susceptible to bias. In one trial from the USA hand washing behaviour was reported to improve; and in the trial from Kenya that provided free soap, hand washing did not increase, but soap use did (data not pooled; three trials, 1845 participants, low quality evidence).Hand washing promotion among communities in LMICs probably prevents around one-quarter of diarrhoea episodes (rate ratio 0.72, 95% CI 0.62 to 0.83; eight trials, 14,726 participants, moderate quality evidence). However, six of these eight trials were from Asian settings, with only single trials from South America and sub-Saharan Africa. In six trials, soap was provided free alongside hand washing education, and the overall average effect size was larger than in the two trials which did not provide soap (soap provided: rate ratio 0.66, 95% CI 0.56 to 0.78; six trials, 11,422 participants; education only: rate ratio: 0.84, 95% CI 0.67 to 1.05; two trials, 3304 participants). There was increased hand washing at major prompts (before eating/cooking, after visiting the toilet or cleaning the baby's bottom), and increased compliance to hand hygiene procedure (behavioural outcome) in the intervention groups than the control in community trials (data not pooled: three trials, 3490 participants, high quality evidence).Hand washing promotion for the one trial conducted in a hospital among high-risk population showed significant reduction in mean episodes of diarrhoea (1.68 fewer) in the intervention

  6. Impact of prior authorization on the use and costs of lipid-lowering medications among Michigan and Indiana dual enrollees in Medicaid and Medicare: results of a longitudinal, population-based study.

    Lu, Christine Y; Law, Michael R; Soumerai, Stephen B; Graves, Amy Johnson; LeCates, Robert F; Zhang, Fang; Ross-Degnan, Dennis; Adams, Alyce S

    2011-01-01

    been little use of nonpreferred medications before the policy was implemented (3.3%). The policies were associated with an immediate reduction of $24,548 in prescription expenditures in Michigan and an immediate reduction of $16,070 in Indiana. The PA policy was associated with substantially lower use of nonpreferred lipid-lowering drugs in Michigan, offset by increases in the use of preferred medications, but there was less change in Indiana. Data limitations did not permit the evaluation of the impact of policy-induced switching on clinical outcomes such as cholesterol levels. The monetary benefit of PA policies for lipid-lowering agents should be weighed against administrative costs and the burden on patients and health care providers. Copyright © 2011 Elsevier HS Journals, Inc. Published by EM Inc USA. All rights reserved.

  7. Myelopathy hand in cervical radiculopathy

    Hosono, Noboru; Mukai, Yoshihiro; Takenaka, Shota; Fuji, Takeshi; Sakaura, Hironobu; Miwa, Toshitada; Makino, Takahiro

    2010-01-01

    The so-called 'myelopathy hand', or characteristic finger paralysis, often recognized in cervical compression myelopathy, has been considered a unique manifestation of cervical myelopathy. We used our original grip and release test, a 15-second test in which finger motion is captured with a digital camera, to investigate whether cervical radiculopathy has the same characteristics as myelopathy hand. Thirty patients with pure radiculopathy, id est (i.e.), who had radiating arm pain and evidence of corresponding nerve root impingement on X-ray images or MRI scans, but did not have spinal cord compression, served as the subjects. In contrast to other radiculopathies, C7 radiculopathy was manifested by a significant reduction in the number of finger motion cycles on the affected side in comparison with the unaffected side, the same as in myelopathy hand. Uncoordinated finger motion was significantly more frequent on the affected side in C6 radiculopathy than on the unaffected side. These findings contradict the conventional notion that myelopathy hand is a unique manifestation of cervical myelopathy, but some radiculopathies manifested the same kinds of finger paralysis observed in myelopathy hand. (author)

  8. Improving mobility and transportation options for Michigan's rural seniors : research spotlight.

    2012-12-01

    Mobility challenges faced by older adults in : rural Michigan include long travel distances to obtain basic services or medical : care, and the limited availability of public, : private or volunteer transportation providers. Because of these challeng...

  9. 75 FR 70595 - Limited Service Domestic Voyage Load Lines for River Barges on Lake Michigan

    2010-11-18

    ... similar request for an eastern Lake Michigan route between Chicago, IL, and Muskegon, MI. The motivation... tow loaded with wheat departed from Milwaukee and traveled southbound for Chicago. Although the 48...

  10. Weatherization is a Hit in Michigan: Weatherization Assistance Close-Up Fact Sheet

    2001-01-01

    Michigan demonstrates its commitment to technology and efficiency through the Weatherization Program. Weatherization uses advanced technologies and techniques to reduce energy costs for low-income families by increasing the energy efficiency of their homes

  11. Societal costs of traffic crashes and crime in Michigan : 2011 update.

    2011-06-01

    "Cost estimates, including both monetary and nonmonetary quality-of-life costs specific to Michigan, were : estimated for overall traffic crashes and index crimes by experts in the field of economics of traffic crashes : and crimes. These cost estima...

  12. 75 FR 29189 - Emerald Ash Borer; Addition of Quarantined Areas in Kentucky, Michigan, Minnesota, New York...

    2010-05-25

    ..., Indiana, Minnesota, Michigan, Ohio, Pennsylvania, West Virginia, and Wisconsin have already been..., Henry, Jefferson, Jessamine, Kenton, Oldham, Owen, Pendleton, Scott, Shelby, Trimble, and Woodford.... Shelby County. The entire county. Trimble County. The entire county. Woodford County. The entire county...

  13. Preventing industrial pollution at its source: the final report of the Michigan source reduction initiative

    None

    1999-09-01

    This report describes a collaborative effort between NRDC, Dow Chemical, and Michigan Environmental Groups. The effort resulted in the identification and implementation of 17 pollution prevention projects that reduced substantial quantities of wastes and emissions and saved Dow considerable money.

  14. Preventing industrial pollution at its source: the final report of the Michigan source reduction initiative; FINAL

    None

    1999-01-01

    This report describes a collaborative effort between NRDC, Dow Chemical, and Michigan Environmental Groups. The effort resulted in the identification and implementation of 17 pollution prevention projects that reduced substantial quantities of wastes and emissions and saved Dow considerable money

  15. 137Cs as a tracer of recent sedimentary processes in Lake Michigan

    Cahill, R.A.; Steele, J.D.

    1986-01-01

    To determine recent sediment movement, we measured the levels of 137Cs (an artificial radionuclide produced during nuclear weapons testing) of 118 southern Lake Michigan samples and 27 in Green Bay. These samples, taken from 286 grab samples of the upper 3 cm of sediment, were collected in 1975 as part of a systematic study of Lake Michigan sediment. 137Cs levels correlated well with concentrations of organic carbon, lead, and other anthropogenic trace metals in the sediment. 137Cs had a higher correlation with silt-sized than with clay-sized sediment (0.55 and 0.46, respectively). Atmospherically derived 137Cs and trace metals are being redistributed by sedimentary processes in Lake Michigan after being incorporated in suspended sediment. We determined a distribution pattern of 137Cs that represents areas of southern Lake Michigan where sediment deposition is occurring. ?? 1986 Dr W. Junk Publishers.

  16. Total and methyl mercury, moisture, and porosity in Lake Michigan surficial sediment

    U.S. Environmental Protection Agency — Total and methyl mercury, moisture content (%), and porosity were measured in Lake Michigan sediment by the U.S. Environmental Protection Agency/Office of Research...

  17. 78 FR 65380 - Notice of Inventory Completion: University of Michigan, Ann Arbor, MI

    2013-10-31

    ... the University of Michigan, Ann Arbor, MI. The human remains were removed from Alpena, Isabella, Grand... removed from the Devil River Mound site (20AL1) in Alpena County, MI. A resident of Ossineke, MI...

  18. Michigan State Briefing Book for low-level radioactive waste management

    1980-11-01

    The Michigan State Briefing Book is one of a series of state briefing books on low-level radioactive waste management practices. It has been prepared to assist state and federal agency officials in planning for safe low-level radioactive waste disposal. The report contains a profile of low-level radioactive waste generators in Michigan. The profile is the result of a survey of NRC licensees in Michigan. The briefing book also contains a comprehensive assessment of low-level radioactive waste management issues and concerns as defined by all major interested parties including industry, government, the media, and interest groups. The assessment was developed through personal communications with representatives of interested parties, and through a review of media sources. Lastly, the discussion of relevant government agencies and activities, all of which may impact waste management practices in Michigan

  19. 76 FR 13508 - Ninth Coast Guard District Sector Realignment; Northern Lake Michigan and Lake Huron

    2011-03-14

    ... Station Alpena from Group Sault Ste. Marie to Sectors Lake Michigan and Detroit, respectively. That... boundary adjustment is that Stations Charlevoix and Alpena will be reassigned to Sector Sault Ste. Marie...

  20. Social Vulnerability Index (SoVI) for Michigan based on 2000 Census Block Groups

    National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Michigan census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

  1. 76 FR 36151 - Notice of Inventory Completion: Museum of Anthropology, University of Michigan, Ann Arbor, MI

    2011-06-21

    ... made by Museum of Anthropology, University of Michigan, professional staff in consultation with... picked up on the plains near Fort Rice Dakota.'' No known individual was identified. No associated...

  2. Pavement subgrade MR design values for Michigan's seasonal changes : final report.

    2009-07-22

    The resilient modulus (MR) of roadbed soil plays an integral role in the design of pavement systems. Currently, the : various regions of the Michigan Department of Transportation (MDOT) use different procedures to determine the : MR values. Most of t...

  3. Pavement subgrade MR design values for Michigan's seasonal changes : table E4.

    2009-07-22

    The resilient modulus (MR) of roadbed soil plays an integral role in the design of pavement systems. Currently, the various regions of the Michigan Department of Transportation (MDOT) use different procedures to determine the MR values. Most of these...

  4. Pavement subgrade MR design values for Michigan's seasonal changes : table E5.

    2010-06-22

    The resilient modulus (MR) of roadbed soil plays an integral role in the design of pavement systems. Currently, the various regions of the Michigan Department of Transportation (MDOT) use different procedures to determine the MR values. Most of these...

  5. Birth defects and genetic disorders among Arab Americans--Michigan, 1992-2003.

    Yanni, Emad A; Copeland, Glenn; Olney, Richard S

    2010-06-01

    Birth defects and genetic disorders are leading causes of infant morbidity and mortality in many countries. Population-based data on birth defects among Arab-American children have not been documented previously. Michigan has the second largest Arab-American community in the United States after California. Using data from the Michigan Birth Defects Registry (MBDR), which includes information on parents' country of birth and ancestry, birth prevalences were estimated in offspring of Michigan women of Arab ancestry for 21 major categories of birth defects and 12 congenital endocrine, metabolic, and hereditary disorders. Compared with other non-Hispanic white children in Michigan, Arab-American children had similar or lower birth prevalences of the selected types of structural birth defects, with higher rates of certain hereditary blood disorders and three categories of metabolic disorders. These estimates are important for planning preconception and antenatal health care, genetic counseling, and clinical care for Arab Americans.

  6. Association between percutaneous hemodynamic support device and survival from cardiac arrest in the state of Michigan.

    Pressman, Andrew; Sawyer, Kelly N; Devlin, William; Swor, Robert

    2018-05-01

    The role of circulatory support in the post-cardiac arrest period remains controversial. Our objective was to investigate the association between treatment with a percutaneous hemodynamic support device and outcome after admission for cardiac arrest. We performed a retrospective study of adult patients with admission diagnosis of cardiac arrest or ventricular fibrillation (VF) from the Michigan Inpatient Database, treated between July 1, 2010, and June 30, 2013. Patient demographics, clinical characteristics, treatments, and disposition were electronically abstracted based on ICD-9 codes at the hospital level. Mixed-effects logistic regression models were fit to test the effect of percutaneous hemodynamic support device defined as either percutaneous left ventricular assist device (pLVAD) or intra-aortic balloon pump (IABP) on survival. These models controlled for age, sex, VF, myocardial infarction (MI), and cardiogenic shock with hospital modeled as a random effect. A total of 103 hospitals contributed 4393 patients for analysis, predominately male (58.8%) with a mean age of 64.1years (SD 15.5). On univariate analysis, younger age, male sex, VF as the initial rhythm, acute MI, percutaneous coronary intervention, percutaneous hemodynamic support device, and absence of cardiogenic shock were associated with survival to discharge (each p<0.001). Mixed-effects logistic regressions revealed use of percutaneous hemodynamic support device was significantly associated with survival among all patients (OR 1.8 (1.28-2.54)), and especially in those with acute MI (OR 1.95 (1.31-2.93)) or cardiogenic shock (OR 1.96 (1.29-2.98)). Treatment with percutaneous hemodynamic support device in the post-arrest period may provide left ventricular support and improve outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Cisco (Coregonus artedii) mortalities in a southern Michigan lake, July 1968

    Colby, Peter J.; Brooke, Larry T.

    1969-01-01

    Cisco die-offs are common in the summer in certain lakes of northern Indiana and southern Michigan, along the southern boundary of the national distribution of coregonine fishes. Although numerous cisco die-offs have been reported, few, if any, have been accompanied by environmental information at the time of the die-off. On 31 July and 1 August 1968, we investigated a cisco die-off on Halfmoon Lake, on the border of Washtenaw and Livingston Counties, Michigan.

  8. Hand-Based Biometric Analysis

    Bebis, George (Inventor); Amayeh, Gholamreza (Inventor)

    2015-01-01

    Hand-based biometric analysis systems and techniques are described which provide robust hand-based identification and verification. An image of a hand is obtained, which is then segmented into a palm region and separate finger regions. Acquisition of the image is performed without requiring particular orientation or placement restrictions. Segmentation is performed without the use of reference points on the images. Each segment is analyzed by calculating a set of Zernike moment descriptors for the segment. The feature parameters thus obtained are then fused and compared to stored sets of descriptors in enrollment templates to arrive at an identity decision. By using Zernike moments, and through additional manipulation, the biometric analysis is invariant to rotation, scale, or translation or an in put image. Additionally, the analysis utilizes re-use of commonly-seen terms in Zernike calculations to achieve additional efficiencies over traditional Zernike moment calculation.

  9. Natural control capabilities of robotic hands by hand amputated subjects.

    Atzori, Manfredo; Gijsberts, Arjan; Caputo, Barbara; Muller, Henning

    2014-01-01

    People with transradial hand amputations who own a myoelectric prosthesis currently have some control capabilities via sEMG. However, the control systems are still limited and not natural. The Ninapro project is aiming at helping the scientific community to overcome these limits through the creation of publicly available electromyography data sources to develop and test machine learning algorithms. In this paper we describe the movement classification results gained from three subjects with an homogeneous level of amputation, and we compare them with the results of 40 intact subjects. The number of considered subjects can seem small at first sight, but it is not considering the literature of the field (which has to face the difficulty of recruiting trans-radial hand amputated subjects). The classification is performed with four different classifiers and the obtained balanced classification rates are up to 58.6% on 50 movements, which is an excellent result compared to the current literature. Successively, for each subject we find a subset of up to 9 highly independent movements, (defined as movements that can be distinguished with more than 90% accuracy), which is a deeply innovative step in literature. The natural control of a robotic hand in so many movements could lead to an immediate progress in robotic hand prosthetics and it could deeply change the quality of life of amputated subjects.

  10. Urunana Audiences at Home and Away: Together 'Hand in Hand'?

    H.M. Hintjens (Helen); F. Bayisenge

    2011-01-01

    textabstractUrunana (‘Hand in Hand’) is Rwanda’s first radio soap opera. The production emerged during the late 1990s from a three-way transnational production partnership between: The Great Lakes section of the BBC World Service; the Well Woman Media Project of the London-based NGO, Health

  11. Case-Cohort Studies: Design and Applicability to Hand Surgery.

    Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J

    2018-04-24

    Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  12. Diagnostic imaging of the hand

    Schmitt, Rainer [Hospital for Cardiovascular Diseases, Bad Neustadt an der Saale (Germany). Dept. of Radiology; Lanz, Ulrich [Perlach Hospital, Munich (Germany). Dept. of Hand Surgery

    2008-07-01

    With its complex anatomy and specialized biomechanics, the human hand has always presented physicians with a unique challenge when it comes to diagnosing and treating the diseases that afflict it. And while recent decades have seen a rapid increase in the number of therapeutic options, many diseases and injuries of the hand are still commonly misinterpreted. In diagnostic imaging of the hand, an interdisciplinary team, comprisingspecialists in radiology, surgery, and rheumatology, presents a comprehensive,reliable guide to this topographically intricate area. Highlights include: - More than 1000 high-quality illustrations - All state-of-the-art imaging modalities-including multidetector CT, with 2D displays and 3D reconstructions, and contrast-enhanced MRI with multi-channel, phased-array coils - An overview of all currently used methods of examination - A detailed presentation of the anatomic and functional foundations necessary for diagnosis - Full coverage of all disorders of the hand - Systematic treatment of each disease's definition, pathogenesis, and clinical symptoms, according to a graduated diagnostic plan - Easy-to-use format, featuring crisp images and line drawings seamlessly integrated with concise text, summary tables, and handy checklists - A heavily cross-referenced appendix of differential diagnosis tables - Emphasis on interdisciplinary consultation throughout designed to help both radiologists and clinicians develop the most efficient and effective strategies for evaluating and treating patients, Diagnostic imaging of the hand will leave specialists of all levels with a fresh appreciation for - and a richer understanding of - the expanding array of cutting-edge alternatives for diagnosing and treating disorders of the hand. (orig.)

  13. Diagnostic imaging of the hand

    Schmitt, Rainer; Lanz, Ulrich

    2008-01-01

    With its complex anatomy and specialized biomechanics, the human hand has always presented physicians with a unique challenge when it comes to diagnosing and treating the diseases that afflict it. And while recent decades have seen a rapid increase in the number of therapeutic options, many diseases and injuries of the hand are still commonly misinterpreted. In diagnostic imaging of the hand, an interdisciplinary team, comprisingspecialists in radiology, surgery, and rheumatology, presents a comprehensive,reliable guide to this topographically intricate area. Highlights include: - More than 1000 high-quality illustrations - All state-of-the-art imaging modalities-including multidetector CT, with 2D displays and 3D reconstructions, and contrast-enhanced MRI with multi-channel, phased-array coils - An overview of all currently used methods of examination - A detailed presentation of the anatomic and functional foundations necessary for diagnosis - Full coverage of all disorders of the hand - Systematic treatment of each disease's definition, pathogenesis, and clinical symptoms, according to a graduated diagnostic plan - Easy-to-use format, featuring crisp images and line drawings seamlessly integrated with concise text, summary tables, and handy checklists - A heavily cross-referenced appendix of differential diagnosis tables - Emphasis on interdisciplinary consultation throughout designed to help both radiologists and clinicians develop the most efficient and effective strategies for evaluating and treating patients, Diagnostic imaging of the hand will leave specialists of all levels with a fresh appreciation for - and a richer understanding of - the expanding array of cutting-edge alternatives for diagnosing and treating disorders of the hand. (orig.)

  14. EthoHand: A dexterous robotic hand with ball-joint thumb enables complex in-hand object manipulation

    Konnaris, C; Gavriel, C; Thomik, AAC; Aldo Faisal, A

    2016-01-01

    Our dexterous hand is a fundmanetal human feature that distinguishes us from other animals by enabling us to go beyond grasping to support sophisticated in-hand object manipulation. Our aim was the design of a dexterous anthropomorphic robotic hand that matches the human hand's 24 degrees of freedom, under-actuated by seven motors. With the ability to replicate human hand movements in a naturalistic manner including in-hand object manipulation. Therefore, we focused on the development of a no...

  15. Intrinsic contractures of the hand.

    Paksima, Nader; Besh, Basil R

    2012-02-01

    Contractures of the intrinsic muscles of the fingers disrupt the delicate and complex balance of intrinsic and extrinsic muscles, which allows the hand to be so versatile and functional. The loss of muscle function primarily affects the interphalangeal joints but also may affect etacarpophalangeal joints. The resulting clinical picture is often termed, intrinsic contracture or intrinsic-plus hand. Disruption of the balance between intrinsic and extrinsic muscles has many causes and may be secondary to changes within the intrinsic musculature or the tendon unit. This article reviews diagnosis, etiology, and treatment algorithms in the management of intrinsic contractures of the fingers. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Lionfish envenomation of the hand.

    Patel, M R; Wells, S

    1993-05-01

    Lionfish (Pterois volitans) envenomation of the hand causes excruciating pain and occurs in three grades: (1) erythematous reaction, (2) blister formation, and (3) dermal necrosis. The initial treatment in all cases is to soak the hand in nonscalding water (45 degrees C) until the pain subsides by denaturing the thermolabile venom proteins. The blisters should be immediately excised to prevent dermal necrosis, inasmuch as the blister fluid contains residual active venom. To prevent a hypersensitivity reaction, any further contact with the fish should be avoided.

  17. Hand-it-on”

    Dieckmann, Gerhard Peter; Graae Zeltner, Louise; Helsø, Anne-Mette

    2016-01-01

    Non-technical skills (NTS) are an integral part of the abilities healthcare professionals need to optimally care for patients. Integrating NTS into the already complex tasks of healthcare can be a challenge for clinicians. Integrating NTS into simulation-based training increases the demands...... and where they can apply them in their work. It complements existing approaches to teaching NTS by limiting the complexity of the game and by removing medical content, allowing learners to concentrate on NTS. Hand-it-on is relevant for groups and teams working across the range of different healthcare...... and the replication of Hand-it-on by many simulation teams support its value....

  18. Discovering Hands - México

    Salamanca Cárdenas, Daniela; Castelblanco Domínguez, Junio Andrés; Aguilar Ardila, Laura Andrea

    2016-01-01

    El modelo de Discovering Hands ha sido reconocido internacionalmente como un proyecto innovador que se ha expandido por diferentes países del mundo, como Austria, y se ha empezado a estudiar la propuesta en países como República Checa, India y Colombia. (Discovering Hands, 2016). Esto se debe a que no solo mejora el tratamiento de cáncer de mama, sino que también reduce los costos totales de tratamiento de la enfermedad y aumenta la fuerza laborar de los países donde esté presente. Al represe...

  19. Interventions to improve patient hand hygiene: a systematic review.

    Srigley, J A; Furness, C D; Gardam, M

    2016-09-01

    Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HCAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Ten studies were included, most of which were uncontrolled before-after studies (N=8). The majority of interventions (N=7) were multi-modal, with components similar to healthcare worker hand hygiene programmes, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HCAI outcomes and four studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. In conclusion, interventions to improve patient hand hygiene may reduce the incidence of HCAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Establishing MICHCARB, a geological carbon sequestration research and education center for Michigan, implemented through the Michigan Geological Repository for Research and Education, part of the Department of Geosciences at Western Michigan University

    Barnes, David A. [Western Michigan Univ., Kalamazoo MI (United States); Harrison, William B. [Western Michigan Univ., Kalamazoo MI (United States)

    2014-01-28

    The Michigan Geological Repository for Research and Education (MGRRE), part of the Department of Geosciences at Western Michigan University (WMU) at Kalamazoo, Michigan, established MichCarb—a geological carbon sequestration resource center by: • Archiving and maintaining a current reference collection of carbon sequestration published literature • Developing statewide and site-specific digital research databases for Michigan’s deep geological formations relevant to CO2 storage, containment and potential for enhanced oil recovery • Producing maps and tables of physical properties as components of these databases • Compiling all information into a digital atlas • Conducting geologic and fluid flow modeling to address specific predictive uses of CO2 storage and enhanced oil recovery, including compiling data for geological and fluid flow models, formulating models, integrating data, and running the models; applying models to specific predictive uses of CO2 storage and enhanced oil recovery • Conducting technical research on CO2 sequestration and enhanced oil recovery through basic and applied research of characterizing Michigan oil and gas and saline reservoirs for CO2 storage potential volume, injectivity and containment. Based on our research, we have concluded that the Michigan Basin has excellent saline aquifer (residual entrapment) and CO2/Enhanced oil recovery related (CO2/EOR; buoyant entrapment) geological carbon sequestration potential with substantial, associated incremental oil production potential. These storage reservoirs possess at least satisfactory injectivity and reliable, permanent containment resulting from associated, thick, low permeability confining layers. Saline aquifer storage resource estimates in the two major residual entrapment, reservoir target zones (Lower Paleozoic Sandstone and Middle Paleozoic carbonate and sandstone reservoirs) are in excess of 70-80 Gmt (at an overall 10% storage efficiency factor; an approximately

  1. Characterizing hand-piled fuels

    Clinton S. Wright; Paige C. Eagle; Cameron S. Balog

    2010-01-01

    Land managers throughout the West pile and burn surface fuels to mitigate fire hazard in dry forests. Whereas piling was historically conducted with heavy machinery following commercial harvesting operations, land managers are increasingly prescribing the use of hand piling and burning to treat surface fuels created by thinning and brush cutting. An estimate of the...

  2. Right-handed fossil humans.

    Lozano, Marina; Estalrrich, Almudena; Bondioli, Luca; Fiore, Ivana; Bermúdez de Castro, José-Maria; Arsuaga, Juan Luis; Carbonell, Eudald; Rosas, Antonio; Frayer, David W

    2017-11-01

    Fossil hominids often processed material held between their upper and lower teeth. Pulling with one hand and cutting with the other, they occasionally left impact cut marks on the lip (labial) surface of their incisors and canines. From these actions, it possible to determine the dominant hand used. The frequency of these oblique striations in an array of fossil hominins documents the typically modern pattern of 9 right- to 1 left-hander. This ratio among living Homo sapiens differs from that among chimpanzees and bonobos and more distant primate relatives. Together, all studies of living people affirm that dominant right-handedness is a uniquely modern human trait. The same pattern extends deep into our past. Thus far, the majority of inferred right-handed fossils come from Europe, but a single maxilla from a Homo habilis, OH-65, shows a predominance of right oblique scratches, thus extending right-handedness into the early Pleistocene of Africa. Other studies show right-handedness in more recent African, Chinese, and Levantine fossils, but the sample compiled for non-European fossil specimens remains small. Fossil specimens from Sima del los Huesos and a variety of European Neandertal sites are predominately right-handed. We argue the 9:1 handedness ratio in Neandertals and the earlier inhabitants of Europe constitutes evidence for a modern pattern of handedness well before the appearance of modern Homo sapiens. © 2017 Wiley Periodicals, Inc.

  3. Exposures related to hand eczema

    Ibler, K.S.; Jemec, G.B.E.; Agner, T.

    2012-01-01

    Background. Hand eczema is common in healthcare workers, owing to intensive exposure to wet work and skin irritants. Targeted interventions and vocational guidance based on documented exposures and risk factors are needed. Objectives. The aims of the study were to investigate the relationship bet...

  4. A natural human hand model

    Van Nierop, O.A.; Van der Helm, A.; Overbeeke, K.J.; Djajadiningrat, T.J.P.

    2007-01-01

    We present a skeletal linked model of the human hand that has natural motion. We show how this can be achieved by introducing a new biology-based joint axis that simulates natural joint motion and a set of constraints that reduce an estimated 150 possible motions to twelve. The model is based on

  5. Hand-held medical robots.

    Payne, Christopher J; Yang, Guang-Zhong

    2014-08-01

    Medical robots have evolved from autonomous systems to tele-operated platforms and mechanically-grounded, cooperatively-controlled robots. Whilst these approaches have seen both commercial and clinical success, uptake of these robots remains moderate because of their high cost, large physical footprint and long setup times. More recently, researchers have moved toward developing hand-held robots that are completely ungrounded and manipulated by surgeons in free space, in a similar manner to how conventional instruments are handled. These devices provide specific functions that assist the surgeon in accomplishing tasks that are otherwise challenging with manual manipulation. Hand-held robots have the advantages of being compact and easily integrated into the normal surgical workflow since there is typically little or no setup time. Hand-held devices can also have a significantly reduced cost to healthcare providers as they do not necessitate the complex, multi degree-of-freedom linkages that grounded robots require. However, the development of such devices is faced with many technical challenges, including miniaturization, cost and sterility, control stability, inertial and gravity compensation and robust instrument tracking. This review presents the emerging technical trends in hand-held medical robots and future development opportunities for promoting their wider clinical uptake.

  6. Hands-On Nuclear Physics

    Whittaker, Jeff

    2013-01-01

    Nuclear science is an important topic in terms of its application to power generation, medical diagnostics and treatment, and national defense. Unfortunately, the subatomic domain is far removed from daily experience, and few learning aids are available to teachers. What follows describes a low-tech, hands-on method to teach important concepts in…

  7. Early intensive hand rehabilitation after spinal cord injury ("Hands On": a protocol for a randomised controlled trial

    Hsueh Ya-Seng

    2011-01-01

    Full Text Available Abstract Background Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. Methods/design A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. Discussion The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. Trial registration NCT01086930 (12th March 2010 ACTRN12609000695202 (12th August 2009

  8. Early intensive hand rehabilitation after spinal cord injury ("Hands On"): a protocol for a randomised controlled trial.

    Harvey, Lisa A; Dunlop, Sarah A; Churilov, Leonid; Hsueh, Ya-Seng Arthur; Galea, Mary P

    2011-01-17

    Loss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation. A multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete) undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009. The results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation. NCT01086930 (12th March 2010)ACTRN12609000695202 (12th August 2009).

  9. Hands as markers of fragmentation

    A. Barnard

    2005-07-01

    Full Text Available Margaret Atwood is an internationally read, translated, and critiqued writer whose novels have established her as one of the most esteemed authors in English (McCombs & Palmer, 1991:1. Critical studies of her work deal mainly with notions of identity from psychoanalytical perspectives. This study has identified a gap in current critical studies on Atwood’s works, namely the challenging of textual unity which is paralleled in the challenging of the traditional (single narrative voice. The challenging of textual unity and the single narrative voice brings about the fragmentation of both. This article will focus on the role that hands play as markers of fragmentation in “The Blind Assassin” (2000. In the novel, the writing hand destabilises the narrative voice, since it is not connected to the voice of a single author. If the author of the text – the final signified – is eliminated, the text becomes fragmentary and open, inviting the reader to contribute to the creation of meaning. Hands play a signficant role in foregrounding the narrator’s fragmented identity, and consequently, the fragmentation of the text. We will investigate this concept in the light of Roland Barthes’ notion of the scriptor, whose hand is metaphorically severed from his or her “voice”. Instead of the text being a unified entity, it becomes unstable and it displays the absence of hierarchical textual levels. Based mainly on Barthes’ writings, this article concludes that hands foreground the narrator’s fragmented identity, which is paralleled in the fragmented text.

  10. Survey of Michigan dentists and radiation oncologists on oral care of patients undergoing head and neck radiation therapy.

    Patel, Yoshita; Bahlhorn, Hannah; Zafar, Saniya; Zwetchkenbaum, Samuel; Eisbruch, Avraham; Murdoch-Kinch, Carol Anne

    2012-07-01

    dental respondents said that they did not feel adequately trained in dental school to treat patients who have had head and neck radiation therapy. Most respondents (radiation oncologists 67%; dentists 72%) were interested in CDE and CME on this topic. These results suggest a need for CDE and CME for Michigan dentists and radiation oncologists on the oral management of HNC patients. Improved training and communication between health professionals could improve patient outcomes and more consistent application of clinical care guidelines.

  11. Observations of cocooned Hydrobaenus (Diptera: Chironomidae) larvae in Lake Michigan

    Tucker, Taaja R.; Hudson, Patrick L.; Riley, Stephen

    2016-01-01

    Larvae of the family Chironomidae have developed a variety of ways to tolerate environmental stress, including the formation of cocoons, which allows larvae to avoid unfavorable temperature conditions, drought, or competition with other chironomids. Summer cocoon formation by younger instars of the genus Hydrobaenus Fries allows persistence through increased temperatures and/or intermittent dry periods in arid regions or temporary habitats, but this behavior was not observed in the Great Lakes until the current study. Cocoon-aestivating Hydrobaenus sp. larvae were found in benthic grab samples collected in 2010–2013 near Sleeping Bear Dunes National Lakeshore in northern Lake Michigan with densities up to 7329/m2. The aestivating species was identified as Hydrobaenus johannseni (Sublette, 1967), and the associated chironomid community was typical for an oligotrophic nearshore system. Hydrobaenus cocoon formation in the Great Lakes was likely previously unnoticed due to the discrepancies between the genus' life history and typical benthos sampling procedures which has consequences for describing chironomid communities where Hydrobaenus is present.

  12. Complicating Counterspaces: Intersectionality and the Michigan Womyn's Music Festival.

    McConnell, Elizabeth A; Todd, Nathan R; Odahl-Ruan, Charlynn; Shattell, Mona

    2016-06-01

    The counterspaces framework articulated by Case and Hunter (2012), follows from community psychology's long-standing interest in the potential for settings to promote well-being and liberatory responses to oppression. This framework proposes that certain settings (i.e., "counterspaces") facilitate a specific set of processes that promote the well-being of marginalized groups. We argue that an intersectional analysis is crucial to understand whether and how counterspaces achieve these goals. We draw from literature on safe spaces and present a case study of the Michigan Womyn's Music Festival (Michfest) to illustrate the value of an intersectional analysis and explore how these processes operate. Based on 20 in-person interviews, 23 responses to an online survey, and ethnographic field notes, we show how Michfest was characterized by a particular intersection of identities at the setting level, and intersectional diversity complicated experiences at the individual level. Moreover, intersectional identities provided opportunities for dialogue and change at the setting level, including the creation of counterspaces within counterspaces. Overall, we demonstrate the need to attend to intersectionality in counterspaces, and more broadly in how we conceptualize settings in community psychology. © Society for Community Research and Action 2016.

  13. Body burdens of heavy metals in Lake Michigan wetland turtles.

    Smith, Dayna L; Cooper, Matthew J; Kosiara, Jessica M; Lamberti, Gary A

    2016-02-01

    Tissue heavy metal concentrations in painted (Chrysemys picta) and snapping (Chelydra serpentina) turtles from Lake Michigan coastal wetlands were analyzed to determine (1) whether turtles accumulated heavy metals, (2) if tissue metal concentrations were related to environmental metal concentrations, and (3) the potential for non-lethal sampling techniques to be used for monitoring heavy metal body burdens in freshwater turtles. Muscle, liver, shell, and claw samples were collected from painted and snapping turtles and analyzed for cadmium, chromium, copper, iron, lead, magnesium, manganese, and zinc. Turtle tissues had measurable quantities of all eight metals analyzed. Statistically significant correlations between tissue metal concentrations and sediment metal concentrations were found for a subset of metals. Metals were generally found in higher concentrations in the larger snapping turtles than in painted turtles. In addition, non-lethal samples of shell and claw were found to be possible alternatives to lethal liver and muscle samples for some metals. Human consumption of snapping turtles presents potential health risks if turtles are harvested from contaminated areas. Overall, our results suggest that turtles could be a valuable component of contaminant monitoring programs for wetland ecosystems.

  14. Effects of repealing the motorcycle helmet law in Michigan.

    Hothem, Zachary; Simon, Robert; Barnes, Wesley; Mohammad, Azmath; Sevak, Shruti; Ziegler, Kathryn; Iacco, Anthony; Janczyk, Randy

    2017-09-01

    In 2012, Michigan repealed its universal helmet law. Our study assessed the clinical impact of this repeal. Our trauma database was queried retrospectively for 2 motorcycle riding seasons before and 3 seasons after repeal. On-scene death data was obtained from the Medical Examiner. Helmet use in hospitalized patients decreased after the helmet law repeal. Non-helmeted patients had a significant increased rate of head injury. Non-helmeted patients were more likely to die during hospitalization. While, helmet use and drugs/alcohol status significantly affected the risk for head injury, only drug/alcohol had a significant effect on overall mortality. Following helmet law repeal, helmet use has decreased. Helmet status and drug/alcohol use was found to significantly increase risk of head injury. Although overall mortality was only affected by drug/alcohol use, non-helmeted patients did have a higher inpatient mortality. These findings deserve furthermore study and may provide a basis for reinstating the universal helmet law. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Bovine tuberculosis in free-ranging carnivores from Michigan.

    Bruning-Fann, C S; Schmitt, S M; Fitzgerald, S D; Fierke, J S; Friedrich, P D; Kaneene, J B; Clarke, K A; Butler, K L; Payeur, J B; Whipple, D L; Cooley, T M; Miller, J M; Muzo, D P

    2001-01-01

    During a survey of carnivores and omnivores for bovine tuberculosis conducted in Michigan (USA) since 1996, Mycobacterium bovis was cultured from lymph nodes pooled from six coyotes (Canis latrans) (four adult female, two adult male), two adult male raccoons (Procyon lotor), one adult male red fox (Vulpes vulpes), and one 1.5-yr-old male black bear (Ursus americanus). One adult, male bobcat (Felis rufus) with histologic lesions suggestive of tuberculosis was negative on culture but positive for organisms belonging to the Mycobacterium tuberculosis complex when tested by polymerase chain reaction. All the tuberculous animals were taken from three adjoining counties where M. bovis is known to be endemic in the free-ranging white-tailed deer (Odocoileus virginianus) population. There were two coyotes, one raccoon, one red fox, and one bobcat infected in Alpena county. Montmorency County had two coyotes and one raccoon with M. bovis. Two coyotes and a bear were infected from Alcona County. These free-ranging carnivores/omnivores probably became infected with M. bovis through consumption of tuberculous deer. Other species included in the survey were opossum (Didelphis virginiana), gray fox (Urocyon cinereoargenteus), and badger (Taxidea taxus); these were negative for M. bovis.

  16. Notable decomposition products of senescing Lake Michigan Cladophora glomerata

    Peller, Julie R.; Byappanahalli, Muruleedhara N.; Shively, Dawn A.; Sadowsky, Michael J.; Chun, Chan Lan; Whitman, Richard L.

    2013-01-01

    Massive accumulations of Cladophora, a ubiquitous, filamentous green alga, have been increasingly reported along Great Lakes shorelines, negatively affecting beach aesthetics, recreational activities, public health and beachfront property values. Previously, the decomposition byproducts of decaying algae have not been thoroughly examined. To better understand the negative consequences and potential merit of the stranded Cladophora, a three month mesocosm study of the dynamic chemical environment of the alga was conducted using fresh samples collected from southern Lake Michigan beaches. Typical fermentation products, such as organic acids, sulfide compounds, and alcohols were detected in the oxygen–deprived algae. Short chain carboxylic acids peaked on day seven, in correspondence with the lowest pH value. Most low molecular mass carbon compounds were eventually consumed, but 4-methylphenol, indole, and 3-methylindole were detected throughout the incubation period. Natural oils were detected in fresh and decomposing algae, indicating the stable nature of these compounds. The mesocosm experiment was validated by directly sampling the fluid within decomposing Cladophora mats in the field; many of the same compounds were found. This study suggests that the problematic Cladophora accumulations may be harvested for useful byproducts, thereby reducing the odiferous and potentially harmful mats stranded along the shorelines.

  17. Ethical Issues in Public Health Practice in Michigan

    Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

    2009-01-01

    Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

  18. Travel to, and use of, twenty-one Michigan trails.

    Price, Anna E; Reed, Julian A; Grost, Lisa; Harvey, Christina; Mantinan, Karah

    2013-03-01

    This study examined trail use among 857 trail users on 21 trails in Michigan from 2008 to 2011 using a valid and reliable intercept survey. Most of the 857 participants traveled to the trail from their home (92.6%), lived within 15 min of the trails (74.8%), and used active transport to travel to the trails 69.7%. The odds of active transport to the trails were greater among those who had not graduated high school (OR=3.49; 95% CI=1.02, 11.99) and high school graduates (OR=7.432; 95% CI=2.02, 27.30) compared to college graduates. Whites and adults also had greater odds of active transport than non-Whites (OR=3.160, 95% CI: 1.65, 6.05), and older adults (OR=1.75; 95% CI: 1.20, 2.54). The majority of respondents (89.7%) reported using trails for recreational purposes. A significantly greater proportion of females (73.3%) compared to males (64.7%) reported using the trail with others. The findings from this study might enable health and parks and recreation professionals to better promote physical activity on trails. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Die Sprache der Hande zu den Handen sprechen (Talking the Language of the Hands to the Hands). DB-LINK.

    Miles, Barbara

    This paper examines the importance of hands for the person who is deafblind, reviews hand development, and identifies specific teaching skills that facilitate hand development and expressiveness in persons who are deafblind. It notes that the hands of a deafblind individual serve not only as tools but also as sense organs (to compensate for their…

  20. Lean and Green Hand Surgery.

    Van Demark, Robert E; Smith, Vanessa J S; Fiegen, Anthony

    2018-02-01

    Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2.8 billion pounds, produced directly by operating rooms. Waste disposal also accounts for up to 20% of a hospital's annual environmental services budget. Since 1992, waste production by hospitals has increased annually by a rate of at least 15%, due in part to the increased usage of disposables. Reduction in operating room waste would decrease both health care costs and potential environmental hazards. In 2015, the American Association for Hand Surgery along with the American Society for Surgery of the Hand, American Society for Peripheral Nerve Surgery, and the American Society of Reconstructive Microsurgery began the "Lean and Green" surgery project to reduce the amount of waste generated by hand surgery. We recently began our own "Lean and Green" project in our institution. Using "minor field sterility" surgical principles and Wide Awake Local Anesthesia No Tourniquet (WALANT), both surgical costs and surgical waste were decreased while maintaining patient safety and satisfaction. As the current reimbursement model changes from quantity to quality, "Lean and Green" surgery will play a role in the future health care system. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Tools used for hand deburring

    Gillespie, L.K.

    1981-03-01

    This guide is designed to help in quick identification of those tools most commonly used to deburr hand size or smaller parts. Photographs and textual descriptions are used to provide rapid yet detailed information. The data presented include the Bendix Kansas City Division coded tool number, tool description, tool crib in which the tool can be found, the maximum and minimum inventory requirements, the cost of each tool, and the number of the illustration that shows the tool.

  2. Hand osteoarthritis: diagnosis, pathogenesis, treatment

    R. M. Balabanova

    2018-01-01

    Full Text Available Due to the development of synovitis, early-stage hand osteoarthritis (HOA mimics hand joint injury in rheumatoid arthritis (RA. However, the topography of synovitis is diverse in these diseases:  distal interphalangeal and thumb joints are involved in the process in HOA. In the latter, tests are negative for immunological markers  (anti-cyclic citrullinated peptide antibodies, which is typical of RA.  The differences between HOA and RA are prominent, as evidenced  by hand X-rays and magnetic resonance imaging. Investigations  suggest that cytokine profile imbalance is implicated in the  pathogenesis of osteoarthritis, which brings it closer to RA. However, therapy for HOA has not been practically developed; there are only a few works on the use of disease-modifying antirheumatic drugs and  biological agents in these patients. It is necessary to work out Russian guidelines for the treatment of HOA.

  3. The hands of the projectionist.

    Cartwright, Lisa

    2011-09-01

    This essay considers the work of projection and the hand of the projectionist as important components of the social space of the cinema as it comes into being in the nineteenth century and the early decades of the twentieth. I bring the concept ofMaurice Merleau-Ponty on the place of the body as an entity that applies itself to the world "like a hand to an instrument" into a discussion of the pre-cinematic projector as an instrument that we can interpret as evidence of the experience of the work of the projectionist in the spirit of film theory and media archaeology, moving work on instrumentation in a different direction from the analysis of the work of the black box in laboratory studies. Projection is described as a psychological as well as a mechanical process. It is suggested that we interpret the projector not simply in its activity as it projects films, but in its movement from site to site and in the workings of the hand of its operator behind the scenes. This account suggests a different perspective on the cinematic turn of the nineteenth century, a concept typically approached through the study of the image, the look, the camera, and the screen.

  4. Effect of the Intelligent Health Messenger Box on health care professionals' knowledge, attitudes, and practice related to hand hygiene and hand bacteria counts.

    Saffari, Mohsen; Ghanizadeh, Ghader; Fattahipour, Rasoul; Khalaji, Kazem; Pakpour, Amir H; Koenig, Harold G

    2016-12-01

    We assessed the effectiveness of the Intelligent Health Messenger Box in promoting hand hygiene using a quasiexperimental design. Knowledge, attitudes, and self-reported practices related to hand hygiene as well as hand bacteria counts and amount of liquid soap used were measured. The intervention involved broadcasting preventive audio messages. All outcomes showed significant change after the intervention compared with before. The Intelligent Health Messenger Box can serve as a practical way to improve hand hygiene. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Creating World-Class Gathering Places for People and Wildlife along the Detroit Riverfront, Michigan, USA

    John H. Hartig

    2015-11-01

    Full Text Available Metropolitan Detroit, Michigan, USA is the automobile capital of the world, part of the industrial heartland and Rust Belt, and a major urban area. For over two centuries, the Detroit River was perceived as a working river that supported commerce and industry. Like many other large North American cities, the Motor City made the Detroit River its back door, with businesses facing inland and away from the river. Compounding the problem, Detroit became indifferent to the water pollution that was perceived as a necessary by-product of industrial progress. By the 1960s, the Detroit River was one of the most polluted rivers in North America. Today, the cleanup and recovery of the Detroit River represent one of the most remarkable ecological recovery stories in North America with the return of bald eagles, peregrine falcons, osprey, lake sturgeon, lake whitefish, mayflies, and more. Out of this recovery has come two transformational projects—the Detroit River International Wildlife Refuge and the Detroit RiverWalk—that are helping change the perception of the region from that of a Rust Belt city to one of a leader of urban sustainability that reconnects people to nature, improves quality of life, promotes sustainable redevelopment, and enhances community pride. Key lessons learned include: recruit a well-respected champion; ensure broad support from key stakeholder groups; establish core delivery team, focused on outcomes; build trust; adopt a strategic approach to community engagement, creating a connected community; evoke a sense of place; and measure and celebrate successes to sustain momentum.

  6. A framework for designing hand hygiene educational interventions in schools.

    Appiah-Brempong, Emmanuel; Harris, Muriel J; Newton, Samuel; Gulis, Gabriel

    2018-03-01

    Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational intervention in schools. We sought to suggest a framework underpinned by psychosocial theories towards bridging this knowledge gap. Furthermore, we sought to propound a more comprehensive definition of hand hygiene which could guide the conceptualisation of hand hygiene interventions in varied settings. Literature search was guided by a standardized tool and literature was retrieved on the basis of a predetermined inclusion criteria. Databases consulted include PubMed, ERIC, and EBSCO host (Medline, CINAHL, PsycINFO, etc.). Evidence bordering on a theoretical framework to aid the design of school-based hand hygiene educational interventions is summarized narratively. School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms (normative beliefs and motivation to comply). A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools.

  7. Use of a verbal electronic audio reminder with a patient hand hygiene bundle to increase independent patient hand hygiene practices of older adults in an acute care setting.

    Knighton, Shanina C; Dolansky, Mary; Donskey, Curtis; Warner, Camille; Rai, Herleen; Higgins, Patricia A

    2018-03-01

    We hypothesized that the addition of a novel verbal electronic audio reminder to an educational patient hand hygiene bundle would increase performance of self-managed patient hand hygiene. We conducted a 2-group comparative effectiveness study randomly assigning participants to patient hand hygiene bundle 1 (n = 41), which included a video, a handout, and a personalized verbal electronic audio reminder (EAR) that prompted hand cleansing at 3 meal times, or patient hand hygiene bundle 2 (n = 34), which included the identical video and handout, but not the EAR. The primary outcome was alcohol-based hand sanitizer use based on weighing bottles of hand sanitizer. Participants that received the EAR averaged significantly more use of hand sanitizer product over the 3 days of the study (mean ± SD, 29.97 ± 17.13 g) than participants with no EAR (mean ± SD, 10.88 ± 9.27 g; t 73  = 5.822; P ≤ .001). The addition of a novel verbal EAR to a patient hand hygiene bundle resulted in a significant increase in patient hand hygiene performance. Our results suggest that simple audio technology can be used to improve patient self-management of hand hygiene. Future research is needed to determine if the technology can be used to promote other healthy behaviors, reduce infections, and improve patient-centered care without increasing the workload of health care workers. Published by Elsevier Inc.

  8. Symptoms and treatment of mental illness among prisoners: a study of Michigan state prisons.

    Fries, Brant E; Schmorrow, Angela; Lang, Sylvia W; Margolis, Philip M; Heany, Julia; Brown, Greg P; Barbaree, Howard E; Hirdes, John P

    2013-01-01

    This study reports on a representative sample of prisoners in Michigan correctional facilities to determine the prevalence of psychiatric illness and the delivery of mental health (MH) services. Mental health assessments were conducted with 618 incarcerated subjects using the interRAI Correctional Facilities (interRAI CF). Subjects were randomly sampled based on four strata: males in the general population, males in administrative segregation, males in special units, and females. The interRAI CF assessments were merged with secondary data provided by the Michigan Department of Corrections (MDOC) containing information on MH diagnoses or services that the subjects were receiving within the facilities, demographics, and sentencing. Study results show that 20.1% of men and 24.8% of women in Michigan prisons have a substantial level of MH symptoms and that 16.5% and 28.9%, respectively, are receiving MH services. However, when compared with Michigan Department of Corrections MH care records, 65.0% of prisoners who are experiencing symptoms of mental illness are not currently receiving any psychiatric services. The mis-match between symptoms and service delivery suggests the need for improved procedures for identifying and measuring psychiatric symptoms within Michigan correctional facilities to ensure that appropriate individuals receive needed care. It is recommended that a standardized assessment process be implemented and conducted at regular intervals for targeting and improving psychiatric care in the prison system. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Nuclear power plant emergency preparedness: results from an evaluation of Michigan's potassium iodide distribution program.

    Zwolinski, Laura R; Stanbury, Martha; Manente, Susan

    2012-10-01

    In 2009, the Michigan Department of Community Health (MDCH) made potassium iodide (KI), a nonprescription radio-protective drug, available by mailing vouchers redeemable at local pharmacies for KI tablets, at no cost to residents living within 10 miles of Michigan's 3 nuclear power plants (NPPs). MDCH conducted an evaluation of this program to determine Michigan's KI coverage and to assess general emergency preparedness among residents living near the NPPs. KI coverage was estimated based on redeemed voucher counts and the 2010 Census. Telephone surveys were administered to a random sample (N = 153) of residents living near Michigan's NPPs to evaluate general emergency preparedness, reasons for voucher use or nonuse, and KI knowledge. Only 5.3% of eligible residences redeemed KI vouchers. Most surveyed residents (76.5%) were aware of living near an NPP, yet 42.5% reported doing "nothing" to plan for an emergency. Almost half of surveyed voucher users did not know when to take KI or which body part KI protects. Among voucher nonusers, 48.0% were either unaware of the program or did not remember receiving a voucher. Additional efforts are needed to ensure that all residents are aware of the availability of KI and that recipients of the drug understand when and why it should be taken. Minimal emergency planning among residents living near Michigan's NPPs emphasizes the need for increased emergency preparedness and awareness. Findings are particularly salient given the March 2011 Fukushima Daiichi Nuclear Power Plant emergency in Japan.

  10. Study of the behaviour of transuranics and possible chemical homologues in Lake Michigan water and biota

    Wahlgren, M.A.; Alberts, J.J.; Nelson, D.M.; Orlandini, K.A.

    1976-01-01

    Concentration factors for Pu, Am and U in Lake Michigan biota are compared to those of a number of stable trace elements that have short residence times in Lake Michigan water. The relative order of uptake for these nuclides in Lake Michigan biota is Am>Pu much>U. Evidence is summarized which suggests that the predominant oxidation state of 239 , 240 Pu in Lake Michigan water is 4+. Concentrations of 239 , 240 Pu in net plankton, filterable particulate matter, sediment trap, and benthic floc samples indicate that sorption by biogenic detritus, and settling of this material, can account for the reduced concentration of 239 , 240 Pu observed in surface waters during summer stratification, but that deposition into the sediments is primarily non-biological. Concentrations of 7 Be, 144 Ce and 137 Cs in sediment trap samples show the effect of spring convective mixing and demonstrate the resuspension of mineral-rich surficial sediments during the summer months. The effect on the concentration of dissolved plutonium in the water column, of varying degrees of resuspension of sedimentary floc, is described using a simple mass-action model. A radiochemical method for the determination of americium and uranium in Lake Michigan environmental samples is also presented. (author)

  11. Outbreak of cryptosporidiosis associated with a firefighting response - Indiana and Michigan, June 2011.

    2012-03-09

    On June 20, 2011, the Indiana Department of Homeland Security notified the Indiana State Department of Health (ISDH) of an Indiana fire station that reported gastrointestinal illness among a substantial percentage of their workers, causing missed workdays and one hospitalization as a result of cryptosporidiosis. All ill firefighters had responded to a barn fire in Michigan, 15 miles from the Michigan-Indiana border on June 6; responding firefighters from Michigan also had become ill. ISDH immediately contacted the Michigan Department of Community Health (MDCH) concerning this outbreak. The investigation was led by MDCH in partnership with ISDH and the Michigan local health department (LHD). Among 34 firefighters who responded to the fire, 33 were interviewed, and 20 (61%) reported gastrointestinal illness ≤12 days after the fire. Cryptosporidium parvum was identified in human stool specimens, calf fecal samples, and a swimming pond. Based on these findings, the following public health recommendations were issued: 1) discontinue swimming in the pond, 2) practice thorough hygiene to reduce fecal contamination and fecal-oral exposures, and 3) decontaminate firefighting equipment properly. No additional primary or secondary cases associated with this exposure have been reported. The findings highlight a novel work-related disease exposure for firefighters and the need for public education regarding cryptosporidiosis prevention.

  12. Prolonged disengagement from distractors near the hands

    Daniel B Vatterott

    2013-08-01

    Full Text Available Because items near our hands are often more important than items far from our hands, the brain processes visual items near our hands differently than items far from our hands. Multiple experiments have attributed this processing difference to spatial attention, but the exact mechanism behind how spatial attention near our hands changes is still under investigation. The current experiments sought to differentiate between two of the proposed mechanisms: a prioritization of the space near the hands and a prolonged disengagement of spatial attention near the hands. To differentiate between these two accounts, we used the additional singleton paradigm in which observers searched for a shape singleton among homogenously shaped distractors. On half the trials, one of the distractors was a different color. Both the prioritization and disengagement accounts predict differently colored distractors near the hands will slow target responses more than differently colored distractors far from the hands, but the prioritization account also predicts faster responses to targets near the hands than far from the hands. The disengagement account does not make this prediction, because attention does not need to be disengaged when the target appears near the hand. We found support for the disengagement account: Salient distractors near the hands slowed responses more than those far from the hands, yet observers did not respond faster to targets near the hands.

  13. Strategy and your stronger hand.

    Moore, Geoffrey A

    2005-12-01

    There are two kinds of businesses in the world, says the author. Knowing what they are--and which one your company is--will guide you to the right strategic moves. One kind includes businesses that compete on a complex-systems model. These companies have large enterprises as their primary customers. They seek to grow a customer base in the thousands, with no more than a handful of transactions per customer per year (indeed, in some years there may be none), and the average price per transaction ranges from six to seven figures. In this model, 1,000 enterprises each paying dollar 1 million per year would generate dollar 1 billion in annual revenue. The other kind of business competes on a volume-operations model. Here, vendors seek to acquire millions of customers, with tens or even hundreds of transactions per customer per year, at an average price of relatively few dollars per transaction. Under this model, it would take 10 million customers each spending dollar 8 per month to generate nearly dollar 1 billion in revenue. An examination of both models shows that they could not be further apart in their approach to every step along the classic value chain. The problem, though, is that companies in one camp often attempt to create new value by venturing into the other. In doing so, they fail to realize how their managerial habits have been shaped by the model they've grown up with. By analogy, they have a "handedness"--the equivalent of a person's right- or left-hand dominance--that makes them as adroit in one mode as they are awkward in the other. Unless you are in an industry whose structure forces you to attempt ambidexterity (in which case, special efforts are required to manage the inevitable dropped balls), you'll be far more successful making moves that favor your stronger hand.

  14. Glass Foreign Body Hand Radiograph

    Hamid Ehsani-Nia, DO

    2018-04-01

    Full Text Available History of present illness: A 27-year-old female sustained an injury to her left hand after she tripped and fell on a vase. She presented to the emergency department (ED complaining of pain over the laceration. Upon examination, patient presented with multiple small abrasions of the medial aspect of the left 5thdigit that are minimally tender. Additionally, she has one 0.5cm linear laceration of the medial aspect of the 5thmetacarpal with severe tenderness in the area and palpable underlying foreign body. Significant findings: Left hand plain radiography demonstrated a subcutaneous foreign body medial to the 5thmetacarpal that is radiopaque, trapezoidal in shape, and measures approximately 11mm x 3mm. Discussion: Laceration repairs are amongst the most common procedures in the emergency department; however, consideration for foreign body is often underdiagnosed. Imaging is performed in only about 11% of all traumatic wounds in the ED.1 Of those injuries relating to the hand that are subsequently imaged, about 15% are found to have a foreign body.2,3 Additionally, it is estimated that foreign bodies are present in 7% to 8.7% of all wounds caused by glass objects.4,5 Glass is among the most common foreign bodies in lacerations, and fortunately they are radiopaque and relatively well visualized radiographically. It has been demonstrated that 2mm glass foreign bodies have a 99% detection rate with radiography, and 1mm glass foreign bodies an 83% detection rate.6 Patient perception of foreign body has a positive predictive value of 31%, making it a poor source in influencing clinical decision-making to obtain wound radiographs.3 Clinicians should have a high suspicion for foreign body in lacerations, particularly those caused by glass, and utilize close physical examination and imaging for evaluation. Topics: Radiography, glass, foreign body, trauma

  15. Hand protection from ultraviolet exposure

    Khazova, M.; O'Hagan, J.B.

    2006-01-01

    Full text of publication follows: A number of industrial applications and public services involve exposure to ultraviolet radiation (U.V.R.) from a variety of lamps and lasers, for example, in forensic examination, biological trans-illuminators, dentistry, laser material processing, microelectronics, etc. The proposed European Union Directive on Optical Radiation would place specific requirements on employers to provide adequate safety measures to reduce exposure to U.V.R., including gloves for hand protection. The selection of gloves should be based on a risk assessment and on the performance characteristics of the gloves for the task. However, current International and national standards do not describe evaluation procedures of disposable gloves for hand protection against non-ionising radiation. A methodology for assessment of the UV protection level for disposable gloves and a simple measurement protocol are proposed, based on a common approach with UV protection by clothing and sunscreens. Glove Ultraviolet Protection Factor is defined as a time-scale increase in exposure permitted for the hand protected by a glove with respect to an unprotected hand. However, the wide variety of U.V.R. sources and the real-life conditions of glove use (stretching and wetting the surface by liquids) bring substantial challenges to the assessment method. Our study of ∼ 50 samples of widely used disposable gloves made of different materials (nitrile, vinyl, latex and chloroprene) showed that for all tested gloves a change in U.V.R. attenuation with stretching is characteristic for the type of glove material and can be included as a scaling factor in the definition of U.V.R. protection. Glove material has a bigger effect on U.V.R. protection level than variations in the glove thickness or its colour. The following approaches are suggested to overcome the problem of variable U.V.R. sources: - Worst case scenario minimal protection level, most restrictive case - Application

  16. Hand protection from ultraviolet exposure

    Khazova, M.; O' Hagan, J.B. [Health Protection Agency, Radiation Protection Division, Chilton, Did cot (United Kingdom)

    2006-07-01

    Full text of publication follows: A number of industrial applications and public services involve exposure to ultraviolet radiation (U.V.R.) from a variety of lamps and lasers, for example, in forensic examination, biological trans-illuminators, dentistry, laser material processing, microelectronics, etc. The proposed European Union Directive on Optical Radiation would place specific requirements on employers to provide adequate safety measures to reduce exposure to U.V.R., including gloves for hand protection. The selection of gloves should be based on a risk assessment and on the performance characteristics of the gloves for the task. However, current International and national standards do not describe evaluation procedures of disposable gloves for hand protection against non-ionising radiation. A methodology for assessment of the UV protection level for disposable gloves and a simple measurement protocol are proposed, based on a common approach with UV protection by clothing and sunscreens. Glove Ultraviolet Protection Factor is defined as a time-scale increase in exposure permitted for the hand protected by a glove with respect to an unprotected hand. However, the wide variety of U.V.R. sources and the real-life conditions of glove use (stretching and wetting the surface by liquids) bring substantial challenges to the assessment method. Our study of {approx} 50 samples of widely used disposable gloves made of different materials (nitrile, vinyl, latex and chloroprene) showed that for all tested gloves a change in U.V.R. attenuation with stretching is characteristic for the type of glove material and can be included as a scaling factor in the definition of U.V.R. protection. Glove material has a bigger effect on U.V.R. protection level than variations in the glove thickness or its colour. The following approaches are suggested to overcome the problem of variable U.V.R. sources: - Worst case scenario minimal protection level, most restrictive case - Application

  17. Students' clinical learning in an emerging dental school: an investigation in international collaboration between Michigan and Ghana.

    Peters, Mathilde C; Adu-Ababio, Francis; Jarrett-Ananaba, Nejay P; Johnson, Lynn A

    2013-12-01

    The dearth of dental faculty members is a widely known problem that is exacerbated in countries that are attempting to begin dental education programs. This collaboration between Kwame Nkrumah University of Science and Technology and the University of Michigan investigated if dental students who have just started their clinical dental education can learn the knowledge and skills required for identifying and restoring cavitated caries lesions through compact course delivery. There were three instructional blocks: 1) didactic seminar; 2) seminar, simulated hands-on skills instruction, and clinical observation/assisting with treatment of schoolchildren; and 3) seminar, simulated skills training, and application to schoolchildren. Each dental student completed a questionnaire measuring knowledge and perceptions of knowledge, experience, and confidence at five points in time. The dental students' knowledge increased significantly as well as their perceived knowledge, experience, and confidence (p<0.0001). In general, the students showed proficiency in delivering simple treatments. The project showed that an integrated compact course delivery model may assist emerging dental schools to cope with the challenging shortage of resident faculty members.

  18. Shell-free biomass and population dynamics of dreissenids in offshore Lake Michigan, 2001-2003

    French, J. R. P.; Adams, J.V.; Craig, J.; Stickel, R.G.; Nichols, S.J.; Fleischer, G.W.

    2007-01-01

    The USGS-Great Lakes Science Center has collected dreissenid mussels annually from Lake Michigan since zebra mussels (Dreissena polymorpha) became a significant portion of the bottom-trawl catch in 1999. For this study, we investigated dreissenid distribution, body mass, and recruitment at different depths in Lake Michigan during 2001-2003. The highest densities of dreissenid biomass were observed from depths of 27 to 46 m. The biomass of quagga mussels (Dreissena bugensis) increased exponentially during 2001-2003, while that of zebra mussels did not change significantly. Body mass (standardized for a given shell length) of both species was lowest from depths of 27 to 37m, highest from 55 to 64 m, and declined linearly at deeper depths during 2001-2003. Recruitment in 2003, as characterized by the proportion of mussels biomass in Lake Michigan.

  19. Descriptive Epidemiology of Bovine Tuberculosis in Michigan (1975–2010: Lessons Learned

    Chika C. Okafor

    2011-01-01

    Full Text Available Despite ongoing eradication efforts, bovine tuberculosis (BTB remains a challenge in Michigan livestock and wildlife. The objectives of this study were to (1 review the epidemiology of BTB in Michigan cattle, privately owned cervids, and wildlife between 1975 and 2010 and (2 identify important lessons learned from the review and eradication strategies. BTB information was accessed from the Michigan BTB Eradication Project agencies. Cattle herds (49, privately owned deer herds (4, and wild white-tailed deer (668 were found infected with BTB during the review period. BTB has occurred primarily in counties located at the northern portion of the state's Lower Peninsula. Currently used BTB eradication strategies have successfully controlled BTB spread. However additional changes in BTB surveillance, prevention, and eradication strategies could improve eradication efforts.

  20. Robotic approaches for rehabilitation of hand function after stroke.

    Lum, Peter S; Godfrey, Sasha B; Brokaw, Elizabeth B; Holley, Rahsaan J; Nichols, Diane

    2012-11-01

    The goal of this review was to discuss the impairments in hand function after stroke and present previous work on robot-assisted approaches to movement neurorehabilitation. Robotic devices offer a unique training environment that may enhance outcomes beyond what is possible with conventional means. Robots apply forces to the hand, allowing completion of movements while preventing inappropriate movement patterns. Evidence from the literature is emerging that certain characteristics of the human-robot interaction are preferable. In light of this evidence, the robotic hand devices that have undergone clinical testing are reviewed, highlighting the authors' work in this area. Finally, suggestions for future work are offered. The ability to deliver therapy doses far higher than what has been previously tested is a potentially key advantage of robotic devices that needs further exploration. In particular, more efforts are needed to develop highly motivating home-based devices, which can increase access to high doses of assisted movement therapy.