309 The Effect of 24 Hour Call on Fine Motor Dexterity, Cognition, and Mood

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 265-266
Author(s):  
Gary R Simonds ◽  
Cara Rogers ◽  
Chris Busch
Keyword(s):  
Work Hours ◽  
Fine Motor ◽  
Extensive Experience ◽  
Significant Decrement ◽  
Before And After ◽  
Overall Performance ◽  
Work Shifts ◽  
Motor Dexterity ◽  
Manual Performance ◽  
Limited Change

Abstract INTRODUCTION There continues much debate about optimal work hours for the neurosurgical resident in training. Multiple entities have asserted that cognitive and manual performance deteriorate with prolonged work shifts. We sought to study the effects of 24 hours of neurosurgical duty on manual dexterity, cognition, and mood. METHODS Subjects underwent multiple batteries of validated dexterity, cognitive, and mood evaluations before and after a 24 hour stint of neurosurgical duty. This included a night of neurosurgical call. All subjects were required to stay awake throughout their 24 hour stint. RESULTS >27 subjects underwent the full battery of testing before and after their 24 hours of neurosurgical activities. 13 were seasonedneurosurgical residents and P.A..’s- that is they had extensive experience with neurosurgical call. 14 were non-seasoned medical students who had no previous experience with 24 straight hours of medical activities. Overall performance of the group showed no significant decrement in performance in dexterity, cognition, or overall mood. When divided into a seasoned group and a non-seasoned group however, the non-seasoned group demonstrated statistically significant decrements in multiple functions in dexterity, cognitive, and mood testing. The seasoned group demonstrated no decrements in dexterity or cognition, and only limited change in isolated mood functions (no changes in overall mood). CONCLUSION We believe that this study raises interesting questions about neurosurgical training with respect to the alleged detrimental effects of prolonged work hours. The results suggest that fatigue-induced decrements in professional function can be ameliorated by experience. If this is the case, an argument can be made that we are turning the training paradigm upside down with the current ACGME restrictions. Since long and arduous hours are a fact of life in a neurosurgical career, learning how to recognize and manage fatigue during training will improve physician resilience and therefore patient care.

scholarly journals The Effect of 12 Weeks of Ski Training on Some Biometric Features of Girls

2018 ◽  
Vol 6 (3) ◽  
pp. 47
Author(s):  
Murat Taş ◽  
Elif Kiyici ◽  
Fatih Kiyici
Keyword(s):  
Motor Skills ◽  
Short Form ◽  
Fine Motor ◽  
Control Group ◽  
Fine Motor Skills ◽  
Testing Methods ◽  
Limb Coordination ◽  
Before And After ◽  
Package Program ◽  
Experimental Group

The aim of this study was to investigate the effect of skiing on the biomotoric characteristics of children with evaluating tests of girls between the ages of eight and 14 before and after the season. The experimental group of this study was 15 girls who had just started skiing and the control group of 30 girls. In total, 45 volunteers joined the study. To follow the development of the children in the study, the Bruininks biomotoric-Oseretsky proficiency testing of engines, Second Edition Short Form (BOT 2 brief) test: Fine Motor Precision, Fine Motor Integration, Manual Dexterity, Bilateral Coordination, Balance, Running Speed and Agility, Upper-Limb Coordination, and Strength was used and total scores were measured. All measurements observed changes in the first test by applying the latest testing methods. The Windows SPSS 17.0 statistical package program was used to analyze the data with Independent-Sample t-test to find the differences between the groups. Statistically meaningful levels resulted as p< 0.05 and p< 0.001. No meaningful differences were found in the comparison of the motoric features of the girls who ski and those who do not in their pre-test. A meaningful difference was found in fine motor skills, fine motor accord and total score after ski training. Ski training contributed to the fine motor skills, fine motor accord and total score of the girls.

A-170 Socioeconomic Status as a Predictor of Fine Motor and Graphomotor Outcomes in Patients with Pediatric Brain Tumor

2021 ◽  
Vol 36 (6) ◽  
pp. 1225-1225
Author(s):  
Viannae Carmona ◽  
Dianne Kong ◽  
Ashley M Whitaker
Keyword(s):  
Socioeconomic Status ◽  
Brain Tumor ◽  
Pediatric Brain Tumor ◽  
Fine Motor ◽  
Visual Motor Integration ◽  
Visual Motor ◽  
Motor Dexterity ◽  
Motor Outcomes ◽  
Pediatric Brain

Abstract Objective As the field of neuropsychology strives to provide equitable care among diverse and disadvantaged populations, disparities in treatment and long-term outcomes continue to disproportionately impact individuals of lower socioeconomic status (SES). Motor deficits are common following pediatric brain tumor (PBT) diagnoses. However, while the relationship between SES and cognitive outcomes in this population is well documented, the role of SES in predicting more basic motor outcomes is not yet understood. This retrospective cross-sectional study was designed to determine the impact of SES on fine motor and graphomotor outcomes in PBT patients to ensure appropriate interventions and accommodations for those at higher risk. Method 225 patients with PBT (52.9% male; $ \overset{-}{\textrm{x}} $ age = 12 yrs; SD = 5.3 yrs) underwent neuropsychological evaluation, including assessment of graphomotor speed/coordination, visual-motor integration, and fine motor dexterity. Estimated median household income was used as a proxy for SES ($ \overset{-}{\textrm{x}} $=$71,543; SD = $23,480). Linear regression analyses were used to explore the role of SES in predicting motor outcomes. Results Lower SES predicted poorer graphomotor speed, F(1,96) = 5.205, p = 0.013, graphomotor coordination, F(1,60) = 3.890, p = 0.027, visual-motor integration, F(1,88) = 8.116, p = 0.003, and fine motor dexterity, F(1,166) = 3.755, p = 0.027. All analyses were significant even after implementing false discovery rates. Conclusions Consistent with lower SES predicting poorer cognitive late effects, SES also plays a role in motor-related outcomes of PBT. Unfortunately, lower SES is also associated with barriers in accessing formal evaluations and services required to mitigate such deficits. Therefore, patients with lower SES should be considered higher risk and receive interventions and accommodations even in the absence of formal assessment to prevent delays in care.

Cognitive Effects of Lyme Disease in Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 185-189
Author(s):  
Wayne V. Adams ◽  
Carlos D. Rose ◽  
Stephen C. Eppes ◽  
Joel D. Klein
Keyword(s):  
Lyme Disease ◽  
Cognitive Skills ◽  
Pediatric Population ◽  
Disease Stage ◽  
Controlled Study ◽  
Fine Motor ◽  
Information Processing Speed ◽  
Duration Of Symptoms ◽  
Healthy Sibling ◽  
Motor Dexterity

Objective. To measure possible cognitive sequelae of Lyme disease (LD) within a pediatric population. Design. Prospective, blinded, controlled study of cognitive skills in children who had been treated for LD. Setting. A children's hospital in an area endemic for LD. Patients. Forty-one children with strictly defined LD were compared with 14 control children who had subacute rheumatological diseases, and with 23 healthy sibling controls. Outcome measures. Neuropsychologic measures were administered to each child to assess the following cognitive areas: IQ, information processing speed, fine-motor dexterity, novel-problem solving and executive functioning, short-term and intermediate memory, and the ability to acquire new learning. Predisease and postdisease academic achievement test scores were also gathered. Impressions from parents concerning the disease's subsequent impact were also obtained. Results. No differences between LD and control groups were found for any of the numerous neuropsychologic measures. Analyses also failed to show differences between LD patients grouped with respect to the presence or absence of known neurologic involvement, disease stage, duration of symptoms before therapy, or type of antibiotic treatment. No predisease versus postdisease difference in academic performance was found. No perceived long-term deterioration in cognitive, social, or personality areas was reported by parents. Conclusion. Children appropriately treated for LD have an excellent prognosis for unimpaired cognitive functioning.

scholarly journals Effect of Various OR Noise on Fine Motor Skills, Cognition, and Mood

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Cara Marie Rogers ◽  
Hannah Palmerton ◽  
Brian Saway ◽  
Devin Tomlinson ◽  
Gary Simonds
Keyword(s):  
Operating Room ◽  
Verbal Learning ◽  
Mood States ◽  
Mood Disturbance ◽  
Fine Motor ◽  
Profile Of Mood States ◽  
Total Mood Disturbance ◽  
Motor Dexterity ◽  
The Impact ◽  
Surgeon Performance

Background. The amalgam of noises inherent to the modern-day operating room has the potential of diluting surgeon concentration, which could affect surgeon performance and mood and have implications on quality of care and surgeon resilience. Objective. Evaluate the impact of operating room environmental noises on surgeon performance including fine motor dexterity, cognition, and mood. Methods. 37 subjects were tested under three different environmental noise conditions including silence, a prerecorded soundtrack of a loud bustling operating room, and with background music of their choosing. We used the Motor Performance Series to test motor dexterity, neuropsychological tests to evaluate cognitive thinking, and Profile of Mood States to test mental well-being. Results. Our results showed that typical operating room noise had no impact on motor dexterity but music improved the speed and precision of movements and information processing skills. Neurocognitive testing showed a significant decrement from operating room noise on verbal learning and delayed memory, whereas music improved complex attention and mental flexibility. The Profile of Mood States found that music resulted in a significant decrease in feelings of anger, confusion, fatigue, and tension along with decreased total mood disturbance, which is a measure of psychological distress. Loud operating room noise had a negative impact on feelings of vigor but no increase in total mood disturbance. Conclusion. Our results suggest that loud and unnecessary environmental noises can be distracting to a surgeon, so every effort should be taken to minimize these. Music of the surgeons’ choosing does not negatively affect fine motor dexterity or cognition and has an overall positive impact on mood and can therefore be safely practiced if desired.

scholarly journals Measurement of Overall Performance Effectiveness in Setup Improvement

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Shye-Nee Low ◽  
Siu-Hou Chong ◽  
Hui-Yee Sim ◽  
Solehhudin Razalli ◽  
Shahrul Kamaruddin
Keyword(s):  
Injection Molding ◽  
Setup Time ◽  
Process Performance ◽  
Performance Effectiveness ◽  
Significant Time ◽  
Before And After ◽  
Overall Performance ◽  
Time Savings

This study aimed to improve the setup process of injection molding machines by using the developed setup improvement methodology. Overall performance effectiveness (OPE) was used to evaluate the setup improvement. A case study was tested on the application of the developed setup improvement methodology. A 50.1% reduction in setup time was attained by the developed methodology, and significant time savings were achieved with minimum investment. Comparisons between before and after improvement implementation were conducted through OPE to verify the improvement. In terms of OPE, the setup performance in the case study considered an acceptable value of 60.45%. The setup process performance of the developed setup improvement methodology was judged in terms of effectiveness. Results therefore indicate that OPE measurement is an effective way to analyze the efficiency of a single setup process.

scholarly journals Oral Glutamine Supplement Reduces Subjective Fatigue Ratings during Repeated Bouts of Firefighting Simulations

Safety ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. 38 ◽  
Author(s):  
Mary Moore ◽  
Terence A. Moriarty ◽  
Gavin Connolly ◽  
Christine Mermier ◽  
Fabiano Amorim ◽  
...  
Keyword(s):  
Stress Responses ◽  
Injury Risk ◽  
Work Performance ◽  
Physical Work ◽  
Biological Stress ◽  
Subjective Fatigue ◽  
Before And After ◽  
Work Shifts ◽  
Wildland Firefighting ◽  
Cell Expression

Wildland firefighting requires repetitive (e.g., consecutive work shifts) physical work in dangerous conditions (e.g., heat and pollution). Workers commonly enter these environments in a nonacclimated state, leading to fatigue and heightened injury risk. Strategies to improve tolerance to these stressors are lacking. Purpose: To determine if glutamine ingestion prior to and after consecutive days of firefighting simulations in the heat attenuates subjective ratings of fatigue, and evaluate if results were supported by glutamine-induced upregulation of biological stress responses. Methods: Participants (5 male, 3 female) ingested glutamine (0.15 g/kg/day) or a placebo before and after two consecutive days (separated by 24 h) of firefighter simulations in a heated chamber (35 °C, 35% humidity). Perceived fatigue and biological stress were measured pre-, post-, and 4 h postexercise in each trial. Results: Subjective fatigue was reduced pre-exercise on Day 2 in the glutamine group (p < 0.05). Peripheral mononuclear cell expression of heat shock protein 70 (HSP70) and serum antioxidants were elevated at 4 h postexercise on Day 1 in the glutamine trial (p < 0.05). Conclusions: Ingestion of glutamine before and after repeated firefighter simulations in the heat resulted in reduced subjective fatigue on Day 2, which may be a result of the upregulation of biological stress systems (antioxidants, HSPs). This response may support recovery and improve work performance.

The Effects of Left Hand Fatigue on Right Hand Performance

1980 ◽  
Vol 24 (1) ◽  
pp. 643-646
Author(s):  
Marian E. Benton ◽  
Robert P. Bateman
Keyword(s):  
Bicycle Ergometer ◽  
Tracking Performance ◽  
Experimental Conditions ◽  
Left Hand ◽  
Tracking Tasks ◽  
Significant Decrement ◽  
Crossover Fatigue ◽  
Before And After ◽  
Hand Performance ◽  
The Right

Twenty-five subjects performed tracking tasks with the right arm before and after cranking a bicycle ergometer with the left arm. Three experimental conditions consisted of cranking the ergo-meter for 60, 90, and 120 seconds. The results indicate there was a significant decrement in tracking performance the first ten seconds after each of the cranking periods. By thirty seconds after cranking, tracking performance returned to pre-cranking level for each of the conditions. The decrement was not attributable to heart rate or breathing rate increases which remained for periods of up to five minutes. The crossover fatigue effect warrants further study.

QS54. Use of a Computerized Surgical Simulator to Evaluate Gross and Fine Motor Dexterity

2008 ◽  
Vol 144 (2) ◽  
pp. 291
Author(s):  
Aaron Goldberg ◽  
Stephanie R. Goldberg ◽  
James P. Neifeld
Keyword(s):  
Fine Motor ◽  
Surgical Simulator ◽  
Motor Dexterity

scholarly journals Cognitive Performance following Carotid Endarterectomy or Stenting in Asymptomatic Patients with Severe ICA Stenosis

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Livio Picchetto ◽  
Gianfranco Spalletta ◽  
Barbara Casolla ◽  
Claudia Cacciari ◽  
Michele Cavallari ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Cognitive Functions ◽  
Verbal Fluency ◽  
Stroke Risk ◽  
Brain Functions ◽  
Immediate Recall ◽  
Asymptomatic Patients ◽  
Before And After ◽  
Overall Performance ◽  
Ica Stenosis

Background. Endarterectomy (CEA) or stenting (CAS) of a stenotic carotid artery is currently undertaken to reduce stroke risk. In addition removal of the arterial narrowing has been hypothesized to improve cerebral hemodynamics and provide benefits in cognitive functions, by supposedly resolving a “hypoperfusion” condition. Methods. In this study we sought to test whether resolution of a carotid stenosis is followed by measurable changes in cognitive functions in 22 subjects with “asymptomatic” stenosis. Results. A main finding of the study was the statistically significant pre-post difference observed in the performance of phonological verbal fluency and Rey’s 15-word immediate recall. Remarkably, there was a significant interaction between phonological verbal fluency performance and side of the carotid intervention, as the improvement in the verbal performance, a typical “lateralized” skill, was associated with resolution of the left carotid stenosis. Conclusion. The results reflect a substantial equivalence of the overall performance at the before- and after- CEA or CAS tests. In two domains, however, the postintervention performance resulted improved. The findings support the hypothesis that recanalization of a stenotic carotid could improve brain functions by resolving hypothetical “hypoperfusion” states, associated with the narrowing of the vessels.

Case history: Use of the Nintendo Wii to increase fine motor dexterity post cerebral vascular accident

2009 ◽  
Vol 8 (3) ◽  
pp. 41-46 ◽  
Author(s):  
Karen Drexler, MS, LRT/CTRS
Keyword(s):  
Therapeutic Recreation ◽  
Veterans Affairs ◽  
Fine Motor ◽  
Cerebral Vascular Accident ◽  
Nintendo Wii ◽  
Right Hand ◽  
Motor Dexterity ◽  
The Right ◽  
The Brain

Use of the low cost commercially available gaming console (Nintendo Wii) is a current trend in the rehabilitation environment. Released in 2006 by Nintendo, Veterans Affairs Medical Centers across the country are just setting one, Wii is being used as a physical, social, and cognitive tool. This case report seeks to provide evidence of its use as a rehabilitation tool for individuals who have experienced a recent stroke. By using whole body movements, the Wii sports games help in both gross motor and fine motor skills as well as in hand–eye coordination. This case study involves an older adult who is recovering from a cerebral vascular accident (CVA) and how using the Wii bowling game assisted to increase his fine motor strength and dexterity. CVA or stroke also called a “brain attack” can affect various parts of the brain. There are various signs and symptoms of CVA and these vary in each individual. Some of the signs that an individual having CVA shows are: sudden numbness or weakness of the face, arm or leg (especially on one side of the body), sudden confusion, trouble speaking, or understanding speech, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination, sudden severe headache with no known cause. This case study involved an older adult who experienced a CVA involving hemorrhage in the right cerebellum as revealed in a CT scan. This CVA affected the right hand of this individual. Hemorrhagic stroke occurs when a blood vessel in the brain ruptures. This lets blood to spill into nearby brain tissue, which damages the cells. Some brain cells die because their normal blood supply is cut off. Certified Therapeutic Recreation Specialist and Author of this case article utilized the Salisbury Veterans Affairs Medical Center Recreational Therapy initial intake assessment and discovered per patient’s report that he had decreased strength and fine motor dexterity in the fingers of his right hand status post CVA. This patient reported that after his stroke, he was not able to hold a utensil in his right hand. This case study speaks the use of the Nintendo Wii in assisting patient to regain use of the fingers of the hand that was affected by the CVA. This article can provide information for other Certified Therapeutic Recreation Specialists as to the use of the Nintendo Wii™ as a treatment modality. This device can demonstrate outcomes of improving fine motor dexterity for those who are recovering from a CVA.

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