Search Results (17)

Introduction: Hypoglossal nerve stimulation (HNS) “Inspire_© therapy” has garnered popularity among obstructive sleep apnea (OSA) patients seeking an alternative to continuous positive airway pressure (CPAP) therapy. The growth in HNS has been particularly high in older adults living with OSA. Consistent and proper use of HNS in the geriatric population faces unique age-associated barriers: a high rate of multiple chronic conditions (MCC) and polypharmacy (being on five or more drugs). Early recognition and patient-centered management of these barriers will allow older patients to obtain maximum benefits from HNS. HNS has distinct advantages in the geriatric population because it overcomes many concerns related to CPAP therapy adherence, such as mechanical limitations due to manual dexterity, maxillofacial anatomy, dental issues such as usage of dentures, allergy/otolaryngology-related disorders, and pre-existing post-traumatic stress disorder-related claustrophobia. This paper describes how we worked with older patients with OSA and their care partners to overcome these barriers so patients can continue to derive cardiovascular, neurologic, and quality of life benefits resulting from optimal OSA management. These benefits are especially important in the older population because of higher rates of comorbidities (dementia, coronary artery disease, and atrial fibrillation) exacerbated by sub-optimally treated OSA. In this article, we describe our clinical experience with elderly patients on Inspire_© therapy, with a focus on the everyday difficulties faced by these patients and the measures implemented to address and mitigate these barriers. Methods: A retrospective chart review was conducted to identify patients aged 65 and above who underwent hypoglossal nerve stimulator insertion. Experiences of older patients during and after the insertion procedure were documented and compared to a younger population of patients on HNS therapy. We specifically collected information on difficulties encountered during activation or follow-up visits and compared them between the different age groups. Using this information, we identified areas to improve treatment adherence from the patients’ perspectives. Results: We identified 43 geriatric (65 to 86 years old) patients who received the Inspire implant at a tertiary academic medical center and compared them to a younger population of 23 patients. Most common challenges noted—with a potential to impact adherence—included orofacial and lingual neuropraxia (ischemic or demyelination-induced neuropathy) at activation, cognitive dysfunction (memory problems), preexisting anxiety, and insomnia. Other difficulties that are less commonly reported but equally important to consistent and proper use of HNS included headaches, concerns of device malfunction, change in comfort levels after cardiac procedures, and general intolerance of the device. The older patient population had a statistically significant higher incidence of cognitive difficulties (30.2% vs. 4.4%) and a smaller social support system (62.8% vs. 91.3%) affecting device usage compared to the younger population. There were no statistically significant differences in the rates of other more commonly reported adverse effects such as headaches, dry mouth, and anxiety between the two age groups. Conclusion: Despite several challenges faced by geriatric patients, Inspire_© hypoglossal nerve stimulation remains a viable, alternative treatment option for OSA with improved tolerance and adherence compared to CPAP. After identifying less commonly reported barriers such as cognitive decline, sensory deficits, and decreased social support systems, minor adjustments and appropriate education on use allows older patients to correctly use and benefit from Inspire_© device therapy, with subsequent improvement in sleep and overall quality of life. Full article

Children with autism spectrum disorder (ASD) can have serious deficits in their social interactions, due to their limited social skills. There are many ways to use music as an intervention tool. One of them is by using musical instruments. Music emerges as a potential method of intervention, which can be used to address these deficits. The aims of this review are (a) to lay out internationally acclaimed and peer-reviewed studies, describing the elements of interventions with the use of musical instruments by children with autism, (b) to assess and analyze the effects of interventions with the use of musical instruments on the children’s social skills and (c) to provide recommendations to therapists, educators and researchers for future research and implementation. The process of article selection was carried out in strict adherence to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, ensuring methodological rigor and transparency in the systematic review process. A systematic search was conducted, using the following electronic databases: (a) PsycINFO, (b) Education Resources Information Center (ERIC), (c) Scopus and (d) Web of Science. Twelve studies were selected, with their results suggesting that the use of musical instruments, tangible or electronic ones, can have a positive effect on the social skills of children with autism. Inadequacies detected in the mentioned studies are also mentioned, as well as any important topics that should be gradually examined in future research. The present review is conducted within the framework of a doctoral thesis focusing on interventions that utilize music and technology as primary tools. Full article

In this conceptual paper, we present a discussion of how we have embraced two challenges, posed by Aukerman and Schuldt, in their call for a more socially just science of reading, to which this special issue is responsive. Specifically, we share lessons learned from years of designing texts that (a) advance knowledge-building in the context of project-based science teaching and (b) advance readers’ textual dexterity. Our research is conducted in the context of project-based learning in science, and we approach our inquiry from multiple theoretical perspectives. We argue for the importance of text in science instruction. We present theories, empirical support, and national standards consistent with the integration of text in science. We discuss the role that texts can play in project-based science instruction. We also illustrate the design and optimization of texts and tasks, as well as the role of the teacher in this instruction. Full article

As the global prevalence of motor disabilities continues to rise, there is a pressing need for advanced solutions in physical rehabilitation. This systematic review examines the progress and challenges of implementing robotic technologies in the motor rehabilitation of patients with physical disabilities. The integration of robotic technologies such as exoskeletons, assistive training devices, and brain–computer interface systems holds significant promise for enhancing functional recovery and patient autonomy. The review synthesizes findings from the most important studies, focusing on the clinical effectiveness of robotic interventions in comparison to traditional rehabilitation methods. The analysis reveals that robotic therapies can significantly improve motor function, strength, co-ordination, and dexterity. Robotic systems also support neuroplasticity, enabling patients to relearn lost motor skills through precise, controlled, and repetitive exercises. However, the adoption of these technologies is hindered by high costs, the need for specialized training, and limited accessibility. Key insights from the review highlight the necessity of personalizing robotic therapies to meet individual patient needs, alongside addressing technical, economic, social, and cultural barriers. The review also underscores the importance of continued research to optimize these technologies and develop effective implementation strategies. By overcoming these challenges, robotic technologies can revolutionize motor rehabilitation, improving quality of life and social integration for individuals with motor disabilities. Full article

Numerous studies have examined the role of socio-economic status on physical activity, obesity, and cognitive performance in youth or older adults, but few studies have examined the role of neighborhood socio-economic status (NSES) on motor or cognitive performance in kindergarten children. This study aimed to examine whether lower NSES (measured by the social data atlas) was associated with lower motor and inhibitory control performance in kindergarten children. One hundred twenty-nine preschoolers were recruited from eight kindergartens in low and high NSES areas in Stuttgart, one of Germany’s largest metropolitan areas. Motor functioning (Movement Assessment Battery for Children, MABC-2; Manual Dexterity, Aiming and Catching, and Balance) and inhibitory control (Flanker Task, Go/NoGo Task) were assessed in a sample of 3- to 6-year-old children within a cross-sectional study. Children from a low NSES background showed the expected difficulties in inhibitory control and motor performance, as indicated by poorer performance than children from a high NSES background. Sex-specific analysis revealed girls from low NSES areas to have the lowest fine motor control; children with low NSES reach a Developmental Coordination Disorder at-risk status of 13% (boys and girls), in contrast to children with high SES (boys 9.1%, girls 0.0%). Motor performance and inhibitory control correlated positively with regard to the group from a low NSES background. Researchers and practitioners are advised to develop a more nuanced picture of motor and academic achievement in heterogeneous neighborhoods when designing early intervention programs, particularly with regard to sex differences, with the most significant disadvantage to girls with lower NSES. Full article

The main objective of this study was to describe the cortical patterns of brain activity during a gross dexterity task and develop a behavioral profile of children experiencing isolation. A cross-sectional assessment was conducted during one visit. Sample: Four pediatric patients who had undergone isolation within a hospital comprised the full data collection. During the collection, participants completed the Box and Blocks Test of gross manual dexterity while undergoing imaging of the motor cortex using functional near-infrared spectroscopy. Participants also completed a Behavioral Assessment System for Children, Third Edition (BASC-3) self-report, which was analyzed along with a parent report to quantify their emotional and social behaviors. All participants displayed lower gross dexterity levels than normative data. Furthermore, three out of the four participants displayed ipsilateral dominance of the motor cortex during the dexterity task. Three of the participants displayed behavioral measures reported within clinically significant or at-risk scores. Clinically significant behavioral scores coupled with lower than expected manual dexterity values and ipsilateral hemispheric dominance indicate that neuroplastic changes can occur in populations undergoing hospitalized isolation. While the impacts of the treatments and isolation in this case cannot be separated, further studies should be conducted to understand these impacts of isolation. Full article

Introduction: To explore the impact of the lockdown and social distancing measures, applied for one year, due to the COVID-19 pandemic on Activities of Daily Living in patients with Parkinson’s disease, as well as to determine the association between daily performance and tasks requiring more manipulative dexterity. Methods: Data collection was carried out between 18 January and 22 March 2021 through telephone interviews. Patients were recruited from associations of patients with Parkinson’s disease in Spain. A questionnaire was designed including items from standardized tools of the Activities of Daily Living Questionnaire to measure the level of independence and from the Dexterity Questionnaire for manipulative dexterity. Results: There were 126 participants aged 36–89 years, 58% of whom were male. The results of our study reveal a significant decline in almost all the ADLs assessed. There is a moderate correlation between the degree of dependence in ADLs and the difficulty in performing activities requiring manipulative dexterity. Conclusions: Social isolation related to the COVID-19 pandemic and its consequences may have contributed to an increase in the deterioration of manipulative ability, leading to a loss of ability to perform ADLs. These results show specific needs to be considered in the rehabilitation treatment of these patients. Full article

We call for a paradigm shift in engineering education. We are entering the era of the Fourth Industrial Revolution (“4IR”), accelerated by Artificial Intelligence (“AI”). Disruptive changes affect all industrial sectors and society, leading to increased uncertainty that makes it impossible to predict what lies ahead. Therefore, gradual cultural change in education is no longer an option to ease social pain. The vast majority of engineering education and training systems, which have remained largely static and underinvested for decades, are inadequate for the emerging 4IR and AI labour markets. Nevertheless, some positive developments can be observed in the reorientation of the engineering education sector. Novel approaches to engineering education are already providing distinctive, technology-enhanced, personalised, student-centred curriculum experiences within an integrated and unified education system. We need to educate engineering students for a future whose key characteristics are volatility, uncertainty, complexity and ambiguity (“VUCA”). Talent and skills gaps are expected to increase in all industries in the coming years. The authors argue for an engineering curriculum that combines timeless didactic traditions such as Socratic inquiry, mastery-based and project-based learning and first-principles thinking with novel elements, e.g., student-centred active and e-learning with a focus on case studies, as well as visualization/metaverse and gamification elements discussed in this paper, and a refocusing of engineering skills and knowledge enhanced by AI on human qualities such as creativity, empathy and dexterity. These skills strengthen engineering students’ perceptions of the world and the decisions they make as a result. This 4IR engineering curriculum will prepare engineering students to become curious engineers and excellent collaborators who navigate increasingly complex multistakeholder ecosystems. Full article

Manual dexterity is essential for performing daily life tasks, becoming a primary means of interaction with the physical, social, and cultural environment. In this respect, the Nine Hole Peg Test (NHPT) is considered a gold standard for assessing manual dexterity. Bibliometrics is a discipline that focuses on analyzing publications to describe, evaluate, and predict the status and development trends in certain fields of scientific research. We performed a bibliometric analysis to track research results and identify global trends regarding the use of the NHPT. The bibliographic data were retrieved from the Web of Science database and then analyzed using the Bibliometrix R package, resulting in the retrieval of a total of 615 publications from 1988 to 2021. Among the 263 journals investigated, the most prolific were the Multiple Sclerosis Journal, Clinical Rehabilitation, and Multiple Sclerosis and Related Disorders. North America and Europe were the areas with the highest production of publications, with the United States (n = 104) ranking first in terms of the number of publications, followed by the United Kingdom (n = 62) and Italy (n = 62). The analysis of keywords revealed that there were two main lines of research, with one related to the study of recovery and disability of the upper limbs caused by certain diseases and another related to the study of reliability and validity. Structured information can be useful to understand the research trajectory and the uses of this tool. Full article

Digital literacy is a term that traditionally describes the extent to which a person is able to use interactive digital devices for living and working, such as computers and smartphones, as well as services delivered through these devices. The advent of the digital society at large and electronic business, specifically in the past decades, has broadened the use of digital devices beyond the isolated uses of working and simple communication; this advent has created digital ecosystems in which workers and consumers are embedded to various degrees, such as social media platforms or integrated shopping and media platforms. This embedding implies that a traditional, narrow notion of digital literacy needs to be extended and made more precise. For this purpose, we use the related notions of digital dexterity, digital proficiency and digital awareness. The term digital dexterity describes the extent to which an individual can handle or operate digital devices or services from a physical perspective. The term digital proficiency describes the extent to which an individual can use digital means to effectively and efficiently facilitate their living and working. The term digital awareness describes the extent to which individuals can understand what their position in digital ecosystems is, including the opportunities and threats of participating in these ecosystems. Digital literacy in the modern, broad interpretation is then the combination of digital dexterity, digital proficiency and digital awareness. Full article

The use of automation and robotics technologies for caregiving and assistance has become a very interesting research topic in the field of robotics. The spread of COVID-19 has highlighted the importance of social distancing in hospitals and health centers, and collaborative robotics can bring substantial improvements in terms of sparing health workers basic operations. Thus, researchers from Politecnico di Torino are working on Paquitop.arm, a mobile robot for assistive tasks. The purpose of this paper is to present a system composed of an omnidirectional mobile platform, a 6 DOF robot arm, and a depth camera. Task-oriented considerations are made to estimate a set of mounting parameters that represents a trade-off between the exploitation of the robot arm workspace and the compactness of the entire system. To this end, dexterity and force transmission indexes are introduced to study both the kinematic and the static behavior of the manipulator as a function of the mounting parameters. Finally, to avoid singularities during the execution of the task, the platform approach to the task workspaces is studied. Full article

Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During recent decades, laparoscopic abdominal procedures have emerged as effective tools for the treatment of rectal prolapse, with the advantages of faster recovery, lower morbidity, and shorter length of stay. Robotic surgery represents the latest evolution in the field of minimally invasive surgery, with the benefits of enhanced dexterity in deep narrow fields such as the pelvis, and may potentially overcome the technical limitations of conventional laparoscopy. Robotic surgery for the treatment of rectal prolapse is feasible and safe. It could reduce complication rates and length of hospital stay, as well as shorten the learning curve, when compared to conventional laparoscopy. Further prospectively maintained or randomized data are still required on long-term functional outcomes and recurrence rates. Full article

Background: Basic activities of daily living (BADLs) are those related to self-care. Their performance depends on the development of sensorimotor and cognitive skills, as well as social and environmental aspects. A good performance in BADLs is required for independence and social participation, so they play an important role in early education and early care. We aim to create a tool for BADLs assessment for Spanish preschoolers. Methods: The tool was administered to 303 participants (48.5% boys and 51.5% girls) between three and six years of age. Analyses to find out the factorial structure and internal consistency was carried out. Results: The instrument was composed of 84 items in four scales (eating, personal hygiene, dressing, and daily functioning) with nine factors (oral sensitivity, good manners, manual dexterity, brushing teeth, toilet management, hygiene and grooming, dressing, higher-order and core executive function). Reliability values were from acceptable to preferred (0.74–0.94). Conclusions: The instrument could be useful and shows preliminary good indicators in construct validity and reliability. Full article

Migration has produced many ethnic minority communities worldwide owing to sea-borne trade, religious evangelicalism, and colonialism. For centuries, these communities have existed alongside other cultures, creating multiethnic societies. However, changes in political, economic, and sociocultural conditions have caused these communities, typically with varying degrees of social alignment and sociocultural adaptation, to re-strategize their inter-ethnic interactions. One such minority community is the “Chitty” of Melaka, a distinct Tamil community that migrated to Melaka, a coastal port city that has flourished in trade and commerce since the late 14th century. This paper investigates the historiography, its hybridity and adaptation, and the concerns of ethnic invisibility faced by this community throughout its 700-year history. Through historical analysis and ethnographic observations, the study finds that the Chitty community has contributed significantly to the sociocultural, economic, and political fabrics of Melaka in different periods of history. Secondly, the Chitty’s hybridity nature enabled them greater dexterity to socioculturally adapt to the changing surroundings and dynamics in Melaka for the last seven centuries. Thirdly, the study finds that due to their marginality in numbers and the mass arrival of new Indian migrants, the ethnic visibility of the Chitty has diminished in the new Malaysian demographic. Full article

The loss of a hand can significantly affect one’s work and social life. For many patients, an artificial limb can improve their mobility and ability to manage everyday activities, as well as provide the means to remain independent. This paper provides an extensive review of available biosensing methods to implement the control system for transradial prostheses based on the measured activity in remnant muscles. Covered techniques include electromyography, magnetomyography, electrical impedance tomography, capacitance sensing, near-infrared spectroscopy, sonomyography, optical myography, force myography, phonomyography, myokinetic control, and modern approaches to cineplasty. The paper also covers combinations of these approaches, which, in many cases, achieve better accuracy while mitigating the weaknesses of individual methods. The work is focused on the practical applicability of the approaches, and analyses present challenges associated with each technique along with their relationship with proprioceptive feedback, which is an important factor for intuitive control over the prosthetic device, especially for high dexterity prosthetic hands. Full article