Relationships among biomechanical ergonomic factors, handwriting product quality, handwriting efficiency, and computerized handwriting process measures in children with and without handwriting difficulties.

OBJECTIVES: Handwriting is a work activity for children, hence it may be evaluated based on ergonomic factors. This study investigated whether nonproficient handwriters could be distinguished by biomechanical ergonomic factors during handwriting, as well as by measures of handwriting efficiency. Furthermore, the relationships among ergonomic factors, handwriting quality, efficiency, and measures of the handwriting process were examined. METHODS: Fifty proficient and 50 nonproficient third-grade handwriters performed a handwriting task on an electronic tablet. Biomechanical ergonomic factors, measures of handwriting quality, and efficiency were rated using the Hebrew Handwriting Evaluation. Handwriting process measures were obtained from a computerized system. RESULTS: Biomechanical ergonomic factors and handwriting efficiency measures significantly differentiated between the study groups. Significant correlations were found among ergonomic factors and handwriting quality, efficiency, and process measures. CONCLUSION: Nonproficient handwriting is a work activity that is often characterized by inferior biomechanical ergonomics, handwriting quality, efficiency, and significantly different handwriting process measures. Results provide insights that can assist in planning intervention.     

Family companions’ involvement during pre-surgical consent visits for major cancer surgery and its relationship to visit communication and satisfaction

Objective

To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction.

Prospective transfrontal sheep model of skull‐base reconstruction using vascularized mucosa

Background

No high‐fidelity animal model exists to examine prospective wound healing following vascularized reconstruction of the skull base. Such a model would require the ability to study the prospective behavior of vascularized mucosal repairs of large dural and arachnoid defects within the intranasal environment. The objective of this study was to therefore develop and validate a novel, in vivo, transfrontal sheep model of cranial base repair using vascularized sinonasal mucosa.

Methods

Twelve transfrontal craniotomy and 1.5‐cm durotomy reconstructions were performed in 60‐kg to 70‐kg Dorset/Ovis Aries sheep using vascularized mucosa with or without an adjunctive Biodesign? underlay graft (n = 6 per group). Histologic outcomes were graded (scale, 0 to 4) by a blinded veterinary histopathologist after 7, 14, and 28 days for a range of wound healing parameters.

Results

All sheep tolerated the surgery, which required 148 ± 33 minutes. By day 7, the mucosa was fully adherent with complete partitioning of the sinus and intracranial compartments. Fibroblast infiltration and flap neovascularization scores significantly increased between day 7 (0.3 ± 0.5 and 0.0 ± 0.0) and day 28 (4.0 ± 0.0, p = 0.01 and 2.0 ± 0.8, p = 0.01; respectively), while hemorrhage scores significantly decreased from 2.5 ± 0.6 to 0.0 ± 0.0 (p = 0.01). The inflammatory scores were not significantly different between the heterologous graft and control sides.

Conclusion

The described sheep model accurately reflects prospective intranasal wound healing following vascularized mucosal reconstruction of dural defects. This model can be used in future studies to examine novel reconstructive materials, tissue glues, and transmucosal drug delivery to the central nervous system.