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Cultural Considerations of Hand Use
Abstract
Although each of us has the same capacity for hand use based on musculoskeletal structure and physiology, the choice and meaning of hand usage and activity are unique to the individual and influenced by sociocultural values, beliefs, and expectations. Effective therapists provide culturally competent care. For the hand therapist, this involves understanding how patients use their hands and the meaning clients ascribe to that use. This article will provide a review of cross-cultural variations in hand use in activities of daily living, communication, and decoration.
... 14 The requirements of functional use of the upper limb and especially the hand is considerably different in South Asian culture. 15 Eating is an important difference. Eating is an activity performed with the fingers and the task of eating rice is complex with several components of in hand manipulation required to effectively achieve this function. ...
... Likewise grooming especially in women is often a complex task involving doing the hair into a bun or braiding long hair. 15,16 With these differences in mind, we believe that the CAHAI must be tested for the Indian population prior to using it as an assessment tool. The design was sequential explanatory design. ...
... Although CAHAI 13 gives an excellent report on reliability, the use of fork and knife does not predict the ability for an Indian person in eating. 15 since larger number of people in India use mobile phones, the use of a telephone box was not so appropriate. Dialling 911 does not predict the ability to function in emergency situations. ...
Background: One of the most common manifestations of stroke is hand function affectation. This can have a negative impact on daily, social and leisure activities. A formal evaluation protocol will be able to identify specific needs of a patient. The objective was to find out the stability of the Chedoke arm hand activity inventory in sub-acute and chronic stroke patients in India Method.
Methods: This was an observational study with sample size 29 and the sampling was convenience sampling. Participant criteria were sub-acute and chronic stroke patients, male and female, patients who follow commands, stable vitals, CMSA score of hand and leg function with stage 3, foot with stage 2, postural control with 6 or 7 and ability to walk 25 meters indoor. Recurrent stroke and hand dysfunction due to any reason other than stroke were excluded. Twenty-nine stroke patients, sub-acute and chronic where CMSA score taken prior to administration of CAHAI. A score of 1-7 for each task in CAHAI 13, total score of minimum 13 and maximum 91 with other considerations where “unsafe for the patient” was considered as score 1. Data analysis were done using SPSS version 22.0 and Pearson’s correlation coefficient.
Results: A total of 29 participants included where the test retest reliability was r=0.98 with significance <0.001.
Conclusions: CAHAI found to be a highly reliable outcome measure.
Keywords: Chedoke arm and hand activity inventory, Epidemiology of stroke, Stroke, Outcome measures, Upper limb function
... They view it as the most private aspect of human interaction, a divine gift, and a revered institution. According to Genesis 2 (18)(19)(20)(21)(22)(23)(24) of the Bible, God created Adam, a man in his own image. Noticing that the man is too lonely, the Lord God created a woman for his companionship. ...
... According to Chinese philosophy, your relationship with your partner is unshakeable, and wearing a wedding band on your ring finger symbolizes an everlasting partnership. (21) When getting married, both Chinese and Ethiopian people wear rings. The constant flow of love symbolized by the wedding ring is portrayed as a circle to signify that it lasts forever. ...
Marriage has been crucial to maintaining human reproduction, social progress, and cultural continuity. Countries have distinctive wedding traditions that reflect social life, morals, religion, values, sexual consciousness, and national psychology's development trends. The article evaluates and compares the variations between Chinese and Ethiopian wedding cultures from the perspectives of traditional values, religion, and wedding processes to understand the variances and similarities of marriage cultures in the process of cultural globalization. The approach adopted in this study is an integrative or narrative review which enables us to capture the practice of marriage culture in Ethiopian and Chinese people. The article revealed that Chinese and Ethiopian marriage practice is similar in terms of pride price, Wedding Ring, wedding banquet, wedding gift, and Wedding ceremony, but have different practice in dressing clothes color and Marriage Sense. But, the impact of cultural globalization is melting both countries’ wedding traditions into Western style.
... Different methods have been proposed to assess special functions of the hand, one of those is the grasp, used in daily tasks. The hand has an important role in the occupation and health, giving us the ability to reach out, touch, and grasp objects, materials, in-struments, people and built the world around us contributing to occupational performance giving sense and meaning to life [4]. On our daily activities, there are several tasks performed with different configurations of grasps and pinches. ...
... On our daily activities, there are several tasks performed with different configurations of grasps and pinches. The grasps configurations are much more than just positions of the hand to grab objects, they have intention, symbolism, they have a cultural meaning and purpose [4]. Grasping has been the focus of different studies being one of the interests the hand shape and its contact with the object, which constrain how they can interact [5]. ...
The grasp strength assessment is a global measure, and the current standardized assessment considers one configuration: the Hook Grasp corresponding to the second position of the dynamometer handle. The grasps configurations were recently classified in a new taxonomy sponsored by the European Commission and organized by the number of strength vectors, contact between the object and the hand, strength, and thumb position. The main objective of this work is to verify if it is possible to assess the grasp strength of the configurations, in this taxonomy, using the Biometrics E-Link® G200 Dynamometer. This experimental study analysed the grasp configurations compatible with the use of the dynamometer, in its five handle positions, maintaining the American Society of Hand
Therapists assessment protocol. A caliper was used to measure the diameter of the dynamometer and the results cross with the characteristics of the grasps, regarding their diameter. There were identified eight grasps, which complied with it. Then were verified the possibility to apply these grasp configurations assessment in 60 participants without (N=30) and with neuromusculoskeletal hand pathology (N=30). Eight grasp configurations can be assessed with the Dynamometer G200. The strength behavior was identical to the described in the literature in participants with and without hand pathology. This would be useful for clinicians and therapists working in hand rehabilitation, assessing, and relating grasps with their use in daily tasks considering their configuration. This approach is focused on the patient and his grasping problems. Recommendations for this assessment are made.
... This is very similar with how the ring ceremony began in the Malay culture as well. There are three stages in the evolution of the human marital status as written by the institutional writes; (1) wife capture, (2) purchase, and (3) mutual assent [3]. The family of the suitor will send to the family of the chosen one a ring of gold, silver, or copper according to its circumstances, an unmistakable sign that the family begs the hand of the woman. ...
... In the United States, engagement and wedding rings are used to denote status, with the engagement ring seen as a promise of marriage (Fig. 3.1) and a wedding ring worn to indicate a formal (and usually legal) alliance with another person [3] (Fig.3.2). This is a famous western culture that has been adapted in most western society. ...
The term ‘wedding ring’ is commonly used to describe the rings given by either or both the bride and groom during marital ceremony. The significance of wedding rings may differ in accordance to the people’s culture, history, and religion. Particularly among the Malays, there is no specific design or characteristic of a ring to portray their marital status. Unlike the westerners, wedding bands are most commonly used as wedding rings, which have a diagnostic characteristic, a matching pair for both bride and groom and systematically used on the left ring finger indicating its significance to portray one’s marital status. From this observation, we can see that wedding rings have been successfully recognized as a communication object to portray one’s marital status within the western society. However, it is not exclusive only to the western people. The idea of wedding rings is common among Christians of different races. In Malaysia, we can see there is an arising acceptance of the idea of wedding rings as a communication object to portray one’s marital status. This happens through the assimilations of wedding cultures among the multireligious/racial society in Malaysia. The openness of the Malays towards assimilation however is limited by the socially acceptable margin of good and bad. This research aims to discover the effectiveness of wedding rings as a communication object to portray marital status in the Malay society. The result will contribute in determining the designs of wedding rings that will be in demand in the Malaysian jewellery market and thus will enhance our local market by reaching to the target market. The method of research will be a descriptive research, and what to observe is the current Malay wedding culture and also the effectiveness of wedding rings as a communication object to portray one’s marital status. For this, the researcher will conduct a survey to gather information from the samples of target population.
... Moreover, every culture imposes a certain 'standard' for a member to carry out one's body movements in various social interactions, such as greeting, walking, sitting and eating manners. The ways we gesture or manipulate food with our hands or utensils are all associated with cultural norms [95]. People within each group will often implicitly imitate, and sometimes magnify, the unique features within the group to enhance their membership identity. ...
Each individual’s movements are sculpted by constant interactions between sensorimotor and sociocultural factors. A theoretical framework grounded in motor control mechanisms articulating how sociocultural and biological signals converge to shape movement is currently missing. Here, we propose a framework for the emerging field of ethnokinesiology aiming to provide a conceptual space and vocabulary to help bring together researchers at this intersection. We offer a first-level schema for generating and testing hypotheses about cultural differences in movement to bridge gaps between the rich observations of cross-cultural movement variations and neurophysiological and biomechanical accounts of movement. We explicitly dissociate two interacting feedback loops that determine culturally relevant movement: one governing sensorimotor tasks regulated by neural signals internal to the body, the other governing ecological tasks generated through actions in the environment producing ecological consequences. A key idea is the emergence of individual-specific and culturally influenced motor concepts in the nervous system, low-dimensional functional mappings between sensorimotor and ecological task spaces. Motor accents arise from perceived differences in motor concept topologies across cultural contexts. We apply the framework to three examples: speech, gait and grasp. Finally, we discuss how ethnokinesiological studies may inform personalized motor skill training and rehabilitation, and challenges moving forward.
This article is part of the theme issue ‘Minds in movement: embodied cognition in the age of artificial intelligence’.
... Indian norms can be formulated, however, this does not account for the cultural variations that may affect hand functioning, for example, Indians use their hand for eating as compared to their western counterparts. Meaning of hand gestures and functions may also differ across cultures (11).This has also been stated in an article by Mokashi which mentions that one of the widely used Jebsen hand function test may not be suitable to the Indian scenario (12). In addition to this, most of the commercially available tests are expensive, so procurement in all centers remains a challenge. ...
Background: Hand function evaluations form an important element of extremity assessment, which helps to define the patient’s problem. Many functional hand evaluations described in the literature. However, cultural differences, expenses incurred, non-availability of Indian normative data makes clinical application of these tests difficult in Indian scenario. An attempt is made in the said study to construct an inexpensive, culture based, easy to administer, hand function test, which can be used for evaluation of the functioning of the upper extremity, for daily living tasks. Hence, the formulation of CAT (Comprehensive assessment tool) for evaluation of hand function. Objectives: To construct a simple, but comprehensive test for assessment of hand function. (CAT for hand function evaluation) 2. To check the reliability of the CAT test. Materials and methods: CAT test proforma was prepared based on available literature. The test that was constructed, consisted of 14 unilateral and 16 bilateral items. The study was conducted in the Occupational therapy department of a tertiary care hospital. Inclusion criteria were Normal, healthy individuals, between 20-60 years of age, with no known musculoskeletal upper extremity problems were recruited for the study. Total 30 people were evaluated on the newly constructed test and retested after a period of 3 weeks on the 30 test items after obtaining written informed consent. Standard method was employed while performance of the test. Scoring was done in time in seconds, and performance on CAT results noted. Results: Cronbach’s alpha values ranged from .798 to .976 suggesting excellent test-retest reliability for most test items. For bilateral test items, Cronbach’s alpha ranged from .573 to .941 suggesting from fair for some items and excellent test-retest reliability for most test items. Conclusion: The above findings suggest that the results of the CAT test are reproducible, hence CAT is a reliable test. Keywords: CAT test, Comprehensive test, Functional hand evaluation, Hand function
... Although not all morphemes have local Malay equivalents, one can grasp the speakers' understanding of them through in-depth interviews and elicitations with questions such as literal translations of the morphemes in different contexts (Himmelmann 1998). In addition, body gestures can help express meanings (Fast 2014;Black 2011). ...
This paper revisits four clitics of Pagu (a West-Papuan language spoken in North Halmahera, Indonesia) those that have been described as Tense and Aspect markers (Wimbish 1991): -oka, -ou -osi, and -uli. The first one is considered a tense marker for ‘non-future’ time, while the other three are aspect markers for ‘perfective’, ‘imperfective’, and ‘repetitive’ respectively. Following a metatypy approach (Ross 2006; 2001), I argue that while these clitics have the tense-aspect functions, at the same time under a unified analysis, each should have an extended function vis. a ‘locational marker of space and time’, ‘confirmative’, ‘durative’, and ‘repetitive presupposition marker’, respectively. These meanings and functions are based on the speakers’ interpretation of them in the local lingua franca (a variety of the North Maluku Malay). This supports Bowden’s (2012) argument that the indigenous languages of North Halmahera (Papuan) have influenced the present varieties of Malay spoken as the lingua franca in the region.
... Mehndi, known as henna in Western cultures, is the art of temporary skin decorations using the dye derived from henna plants. In a tradition dating back centuries, henna is applied to the hands to pray for happiness and good luck (Jo and Yoo 2004) and worn for special events such as weddings (Black 2011). The picture of the young woman engaging the researcher in her cultural traditions, and the creativity and artistry of her method, was arresting. ...
This article puts critical disability studies and global health into conversation around the phenomenon of scarf injury in Bangladesh. Scarf injury occurs when a woman wearing a long, traditional scarf called an orna rides in a recently introduced autorickshaw with a design flaw that allows the orna to become entangled in the vehicle’s driveshaft. Caught in the engine, the orna pulls the woman’s neck into hyperextension, causing a debilitating high cervical spinal cord injury and quadriplegia. The circumstances of the scarf injury reveal the need for more critical cultural analysis than the fields of global health and rehabilitation typically offer. First, the fatal design flaw of the vehicle reflects different norms of gender and dress in China, where the vehicle is manufactured, versus Bangladesh, where the vehicle is purchased at a low price and assembled on-site—a situation that calls transnational capitalist modes of production and exchange into question. Second, the experiences of women with scarf injuries entail many challenges beyond the injury itself: the transition to life with disability following the rehabilitation period is made more difficult by negative perceptions of disability, lack of resources and accessible infrastructure, and cultural norms of gender and class in Bangladesh. Our cross-disciplinary conversation about women with scarf injuries, involving critical disability studies, global health and rehabilitation experts, exposes the shortcomings of each of these fields but also illustrates the urgent need for deeper and more purposeful collaborations. We, therefore, argue that the developing subfield of global health humanities should include purposeful integration of a humanities-based critical disability studies methodology.
... The handshake is a gesture being exchanged when meeting or parting with someone (Hall and Hall, 1983;Black, 2011;Melnyk and Henaff, 2019). The handshake communicates goodwill, appreciation, empathy, and gratitude. ...
The handshake is the most acceptable gesture of greeting in many cultures throughout many centuries. To date, robotic arms are not capable of fully replicating this typical human gesture. Using multiple sensors that detect contact forces and displacements, we characterized the movements that occured during handshakes. A typical human-to-human handshake took around 3.63 s (SD = 0.45 s) to perform. It can be divided into three phases: reaching (M = 0.92 s, SD = 0.45 s), contact (M = 1.96 s, SD = 0.46 s), and return (M = 0.75 s, SD = 0.12 s). The handshake was further investigated to understand its subtle movements. Using a multiphase jerk minimization model, a smooth human-to-human handshake can be modelled with fifth or fourth degree polynomials at the reaching and return phases, and a sinusoidal function with exponential decay at the contact phase. We show that the contact phase (1.96 s) can be further divided according to the following subphases: preshake (0.06 s), main shake (1.31 s), postshake (0.06 s), and a period of no movement (0.52 s) just before both hands are retracted. We compared these to the existing handshake models that were proposed for physical human-robot interaction (pHRI). From our findings in human-to-human handshakes, we proposed guidelines for a more natural handshake movement between humanoid robots and their human partners.
... Although norms about displaying emotions differ between Western and collectivistic cultures, emotional experience itself seems to be similar across cultures, as indicated by a study about physiological arousal [82]. Gestures also vary by culture, and the same gesture can express friendliness in one country and an insult in another [5]. Beside these differences, basic emotions (anger, fear, sadness, surprise, disgust, and happiness) are considered universal and are displayed cross-culturally in the same manner [18]. ...
Detecting momentary relationship state and quality in romantic couples is an important endeavor for relationship research, couple therapy, and of course couples themselves. Yet current methods to achieve this are intrusive, asynchronous, plagued by ceiling effects, and only assess subjective responses to questionnaires while trying to capture the objective state of a relationship. According to social appraisal theory, human beings rely on emotional responses to assess interpersonal situations, a key element for relationship functioning in couples. Using couples is particularly advantageous as strong emotional reactions are triggered in romantic relationships. Here, we employ deep learning methods to assess the momentary relationship state of romantic couples from predominantly stock images via facial and bodily emotion expression and other features. Our new model, DeepConnection, comprises pre-trained residual neural networks, spatial pyramid pooling layers, and power mean transformations to extract relevant features from images for binary classification. With this, we achieved an average accuracy of nearly 97% on a separate validation dataset. We also engaged in model interpretation using Gradient-weighted Class Activation Mapping (Grad-CAM) to identify which features allow DeepConnection to detect binarized momentary relationship state. To demonstrate generalizability and robustness, we used DeepConnection to analyze videos of couples exhibiting a range of different postures and facial expressions. Here, we achieved an average accuracy of about 85% with a trained DeepConnection model. The work presented here could inform couples, advance relationship research, and find application in couple therapy to assist the therapist.
... Although norms about displaying emotions differ between Western and collectivistic cultures, emotional experience itself seems to be similar across cultures, as indicated by a study about physiological arousal (Tsai, Knutson, & Fung, 2006). Gestures also vary by culture, and the same gesture can express friendliness in one country and an insult in another (Black, 2011). Beside these differences, basic emotions (anger, fear, sadness, surprise, disgust, and happiness) are considered universal and are displayed crossculturally in the same manner (Ekman & Friesen, 1975). ...
Detecting relationship state and quality in romantic couples is an important endeavor for relationship research, couple therapy, and of course couples themselves. Yet current methods to achieve this are intrusive, asynchronous, plagued by ceiling effects, and only assess subjective responses to questionnaires while trying to capture the objective state of a relationship. According to social appraisal theory, human beings rely on emotional responses to assess interpersonal situations, a key element for relationship functioning in couples. Using couples is particularly advantageous as strong emotional reactions are triggered in romantic relationships. Prior research has repeatedly demonstrated that emotion expression in couple interactions is related to relationship satisfaction. Here, we employ deep learning methods to assess the relationship state of romantic couples from images via facial and bodily emotion expression and other features. Our model, DeepConnection, comprises pretrained residual neural networks, spatial pyramid pooling layers, and power mean transformations to extract relevant features from images for binary classification. With this, we achieved an average accuracy of nearly 97% on a separate validation dataset. We also engaged in model interpretation using Gradient-weighted Class Activation Mapping (Grad-CAM) to identify which features allow DeepConnection to detect relationship state. To demonstrate generalizability and robustness, we used DeepConnection to analyze videos of couples exhibiting a range of different postures and facial expressions. The work presented here could inform couples, advance relationship research, and find application in couple therapy to assist the therapist.
... 1,2 The ability to reach out, touch, and grasp allows people to explore, develop skills, and interact with the environment around them. 3 A traumatic hand injury can involve damage to a number of structures including skin, nerves, tendons, muscle bone, and soft tissue. 4 Impairments such as pain or stiffness and loss of range of motion can last for many years after a hand injury. ...
A traumatic hand injury can involve damage to a number of structures including skin, nerves, tendons, muscle bone, and soft tissue. Impairments such as pain or stiffness and loss of range of motion can last for many years and result in a moderate to extreme impact on a person’s day-to-day life. Work, leisure, financial security, and emotional well-being often most affected. This commentary provides an analysis of those factors that inhibit (barriers) and support (enablers) the provision of hand therapy rehabilitation in rural and remote areas. Providing a collaborative and flexible rehabilitation programme to rural and remote residents following a traumatic hand injury can be seen as a challenge due to issues such as a limited access to health care services. Established protocols that work in regional or metropolitan locations are unlikely to be effective and innovative and pragmatic strategies are required. The provision of a collaborative and flexible rehabilitation programme regardless of residential location is an important part of the therapist’s intervention plan.
... Hence, the assessment of activities should cover the understanding of the values and beliefs of the person and be sensitive to the person's culture. 5 There are some outcome measures which are generally used in hand rehabilitation settings for measuring activity limitations. Disabilities of Arm, Shoulder and Hand 6 (henceforth named as DASH) and Michigan Hand Outcome Questionnaire 7 (henceforth named as MHQ) receive strong ratings, and the studies report reliability, validity, and responsiveness of these scales in upper extremity injuries. ...
Objective:
The aim of this study was to compare the activities listed in DASH, MHQ, QuickDASH with the activities listed in Canadian Occupational Performance Measure (COPM) in a Turkish patient population with hand injury.
Methods:
COPM questionnaire was administered to 163 participants (61 male and 102 female; mean age 40.72 ± 13.70 years). The activities that were stated in COPM were categorized and checked whether they were present in DASH-T, MHQ, QuickDASH.
Results:
The highest rated stated activities were "carrying a heavy object" (39.2%), "cleaning the house" (25.7%) and "writing" (15.9%). DASH reflects 30% whereas MHQ and QuickDASH reflect 16.32% and 10.2% of the problematic activities, respectively.
Conclusion:
None of three questionnaires have satisfactory results for reflecting the problematic activities among hand injured Turkish people. Open ended interviews should be irrevocable part of assessment process in order to describe a person-center treatment program.
... In the United States, engagement and wedding rings are used to denote status, with the engagement ring seen as a promise of marriage (Fig. 4) and a wedding ring worn to indicate a formal (and usually legal) alliance with another person [1] (Fig.5). This is a famous western culture that has been adapted in most western society. ...
the significance of wedding rings is strongly influenced by the culture of the people. In the Malaysian culture, rings are perceived as a gift from the groom to the bride and vice versa unlike wedding rings in the western culture which are perceived as a symbol of one's marital status. Thus, the design of a wedding ring or a pair of them differs in accordance to these perceptions. Malaysia, being a country that once upon a time was colonised by the western powers has moulded a local culture with a lot of assimilations from the colonization. Aside from that, the immigrants from India and China which made their way into the country have also influenced the culture of the Malays. These assimilations include the wedding cultures of the Malays. The openness for assimilations is however limited by the margin of good and bad. This publication seeks to determine the significance of wedding rings within the Malay culture currently which may have been assimilated with other cultures, specifically the westerns. The significance will strongly affect the designs of wedding rings that will be in demand. This will help in constructing prediction pattern for the jewellery designers in designing and marketing to enhance the local jewellery industry. The method of research will be descriptive research and what to observe is the current Malay culture, the wedding culture and also the perception of the society towards the significance of wedding rings. For this, the researcher will conduct a survey to gather information from the samples of target population.
... [18,19] Hand use and activity are unique to the individual and influenced by socio-cultural values, beliefs, and expectations. [20] Moreover, touch is related to age, gender, power, and social relationship. Seemingly, gender, age of both staff and patient during intimate task were found to have similarities and differences on staff nurse and patient perception of space and touch. ...
... However, adults with traumatic BPI and expert clinicians identified a small number of activities (n = 6) classified to an ICF domain (d335 -Producing nonverbal messages) not included in the CCS-HC. The way we use our hands to interact with our environment is unique to each individual and influenced by beliefs and expectations (31). Adults with a traumatic BPI reported that not being able to communicate with family and friends using arm and hand gestures altered their opinion of themselves as individuals. ...
To identify the range of activities limited following adult traumatic brachial plexus injury and triangulate these with existing patient-reported outcome measures identified from the literature.
A qualitative cross-sectional design.
Adults with traumatic brachial plexus injury and expert clinicians.
Using an International Classification of Functioning, Disability and Health (ICF) framework, participants identified day-to-day activities that are limited following traumatic brachial plexus injury. Two independent reviewers classified all reported activities into the Comprehensive ICF Core Set of Hand Conditions (CCS-HC) activity domains. Reported activities were triangulated with patient-reported outcome measures identified from the brachial plexus injury literature.
Fifty-one participants (21 adults with brachial plexus injury, 30 expert clinicians) generated a total of 522 items. The inter-rater reliability for classification to CCS-HC domains was excellent (k = 0.94, 95% confidence interval (95% CI) 0.92-0.96). Activities reported by patients and clinicians represented all 29 CCS-CH activity domains. Five activities (2%) could not be classified to any ICF domain. Fifteen CCS-HC activity domains were represented in the Disabilities of Arm, Shoulder and Hand (DASH) and ABILHAND, 2 measures currently used in the brachial plexus injury literature.
Adults with a brachial plexus injury report a range of activities that are limited following injury, and are under-represented in currently used patient-reported outcome measures. The activities reported in this study could be used to inform the development of a new brachial plexus injury targeted questionnaire.
... 23 For Middle Eastern Muslims and Eastern Indians, the left hand is ''unclean'' and used for toileting, not other ADLs. 24 In the United States, school children used to be forced to write with their right hand, regardless of preferred handedness. 25,26 In the section of the survey related to clinical strategies and decision making, although 76% agreed or strongly agreed that a clinical practice guideline (CPG) should be established, less than 10% selected ''no protocol'' for their reason for not initiating a hand dominance transfer. ...
Internet survey.
To describe current practice patterns in hand therapy to 1) gain insights into beliefs of certified hand therapists (CHTs) related to initiating a hand dominance transfer, 2) describe CHTs' clinical decision-making strategies, and 3) describe research priorities related to hand dominance transfer in hand therapy.
Five hundred sixty-three members of the American Society of Hand Therapists.
The online Internet survey contained 30 questions related to four categories: 1) demographics of clinicians, 2) beliefs about hand dominance transfer, 3) clinical strategies and decision making, and 4) a research agenda related to hand dominance transfer. Data were sorted, compiled, and analyzed descriptively.
Respondents were primarily occupational therapists working as full-time staff therapists treating between nine and 15 patients per day with orthopedic injuries to the dominant upper extremity caused by trauma. The overwhelming majority of respondents (92.7%) believed that motivation is a factor in the success of the hand dominance transfer. Most respondents (83%) do not directly initiate a hand dominance transfer. The number one reason (64%) for not initiating a dominance transfer is that CHTs believe that their patients will regain full recovery of injured hand over time. If a transfer is initiated, the number one task addressed is handwriting (62%); the most commonly recommended piece of adaptive equipment was the handsfree can opener (63.8%); 72% educate on the risk of overuse injury to the noninjured (intact) limb. Most respondents agreed or strongly agreed that more research needs to be done related to hand dominance transfer, specifically related to return to work rates, interventions using virtual reality, and assessments using neuroimaging technologies.
3b.
This paper explores the connection between kinesthetic empathy, embodied cognition, and abstract thought and language as a form of extended cognition in audiences of inclusive dance. The exploration grounds itself in the analysis of primary data collected from interviews with audience members of an inclusive dance performance that studied their critical engagement with the concept of disability. Drawn from the interviews are specific choreographic moments and emotions evoked in those audience members, and associates the choreography and emotions with possible experiences of kinesthetic empathy and ways of understanding ability and disability in the context of dance. The analysis contributes to a greater understanding of the impact that takes place when watching inclusive dance performances, and other dance performances that resist or challenge dominant social identity categories. The research contributes to the reduction of the intrinsic instrumental divide in creative work, expanding the spaces into which cultural value can be considered.
Background:
The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure is a widely used patient reported outcome measure.
Objective:
The aim of this study is to evaluate the quality of translation procedures and assessment of the psychometric properties of cross-cultural adaptations of the DASH.
Methods:
We reviewed the literature to identify all published studies of cultural adaptations of the DASH questionnaire. For the quality assessment, we used Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures, Quality Criteria for Psychometric Properties of Health Status Questionnaire and COSMIN Checklist for Cross-Cultural Validity.
Results:
We included 25 articles with 26 versions of the DASH. Only the Puerto Rican version followed all six of the processes of cross-cultural adaptation. None of the versions assessed all eight measurement properties for Quality Criteria for Psychometric Properties of Health Status Questionnaire and none of them had a positive rating from agreement, internal consistency, responsiveness and interpretability. All the studies got a poor rating according to the COSMIN checklist.
Discussion:
None of the versions got a good rating from all three checklists. We observed that supplementary tests for the adaptations are necessary, especially for assessing agreement, responsiveness and interpretability. We concluded that all versions need more research on psychometric properties.
The prevention and treatment of hand injuries in low- to middle-income countries needs to be a priority. Surgical outreach trips are a primary avenue for patients to receive interventions. Challenges include language and cultural barriers, poor infrastructure, and limitations in a patient's ability to follow-up. Strategies to maximize patient functional outcomes include cultural competence, patient education resources, overcoming communication barriers, and using task-shifting strategies. Local therapists' knowledge and clinical skills can be enhanced. With improvements in data collection, therapists may contribute to gaining knowledge of outcomes in low- to middle-income countries.
Introduction
There have been calls for the occupational therapy profession to realign with its values around occupation. However, the profession faces challenges in practice areas that have historically been underpinned by a biomechanical approach, such as hand therapy. The aim of this scoping review was to describe what is known about an occupational perspective in the hand therapy literature.
Method
This scoping review utilised a recognised five-step approach. A search was conducted in four databases for papers published between 2005 and 2016. Numerical and thematic analyses were employed, using the Canadian Practice Process Framework as a theoretical framework.
Results
Fifty papers were included in the scoping review. Six themes were identified: the centrality of occupation; inconsistencies in terminology; where in the occupational therapy process?; informal discussion as a key occupational strategy; occupational therapists’ expectations of patients; and a bottom-up approach focusing on biomechanical strategies to implementing the plan.
Conclusion
Whilst there has been some integration of an occupational perspective into hand therapy literature, there are still challenges. Inconsistent terminology, the lack of an occupational perspective throughout the occupational therapy process and a bottom-up approach to interventions all demonstrate the continuing tensions between the biomechanical approach and an occupational perspective.
Malay subethnic group in Peninsular Malaysia has a rich culture and tradition including historical knowledge and cultural heritage, which might be reflected in the current genetic makeup of its population. The genetic polymorphism of the Y chromosome at DYS 287 Y Alu Polymorphism (YAP) locus in Kelantan Malay and Jawa Malay subethnic groups in Peninsular Malaysia was analyzed. A total of 157 buccal cells from healthy unrelated males (115 Kelantan Malays and 42 Jawa Malays) from different regions of Peninsular Malaysia were scanned for the DYS 287 Y Alu locus from the genomic DNA. The PCR products were separated on 2 % agarose gel and visualized under UV light. It shows that Kelantan Malay and Jawa Malay subethnic groups are completely absent for the DYS 287 Y Alu Polymorphism. This study has provided the information on the distribution of DYS 287 Y Alu Polymorphism in Kelantan Malay and Jawa Malay sub-ethnic groups in Peninsular Malaysia. Further study will be taken up on more sample in Peninsular Malaysia to determine more DYS 287 Y Alu Polymorphism status.
This article presents a view of occupation as the principal means through which people develop and express their personal identities. Based on a review of theory and research, it proposes that identity is instrumental to social life because it provides a context for deriving meaning from daily experiences and interpreting lives over time. The article proposes that identity also provides a framework for goal-setting and motivation. It is asserted that competence in the performance of tasks and occupations contributes to identity-shaping and that the realization of an acceptable identity contributes to coherence and well-being.
Within this framework, it is postulated that performance limitations and disfigurement that sometimes result from illness or injury have identity implications that should be recognized by occupational therapy practitioners. By virtue of their expertise in daily living skills, occupational therapy practitioners are well positioned to help address the identity challenges of those whom they serve. In so doing, they make an important contribution to meaning and well-being.
SUMMARY The use of henna for body adornment goes back 5000 years. Allergic reactions to pure henna have hardly ever been reported. However, the recent addi- tion of certain dyes to henna, giving it a black colour and allowing it to stain more quickly and to last longer, has been associated with allergic reactions not only to the modified henna, but later to hair dyes containing the same chemical. Hairdressers should ask their clients whether they have ever had a henna tattoo on their skins. If so, they should warn their clients that an allergic reaction to hair dye is possible.
Many bilingual speakers believe they engage in different forms of thinking when they shift languages. This experience of entering different thought worlds can be explained with the hypothesis that languages induce different forms of `thinking-for-speaking'-- thinking generated, as Slobin (1987) says, because of the requirements of a linguistic code. "`Thinking for speaking' involves picking those characteristics that (a) fit some conceptualization of the event, and (b) are readily encodable in the language"[2] (p. 435). That languages differ in their thinking-for-speaking demands is a version of the linguistic relativity hypothesis, the proposition that language influences thought and that different languages influence thought in different ways.
This article presents a view of occupation as the principal means through which people develop and express their personal identities. Based on a review of theory and research, it proposes that identity is instrumental to social life because it provides a context for deriving meaning from daily experiences and interpreting lives over time. The article proposes that identity also provides a framework for goal-setting and motivation. It is asserted that competence in the performance of tasks and occupations contributes to identity-shaping and that the realization of an acceptable identity contributes to coherence and well-being. Within this framework, it is postulated that performance limitations and disfigurement that sometimes result from illness or injury have identity implications that should be recognized by occupational therapy practitioners. By virtue of their expertise in daily living skills, occupational therapy practitioners are well positioned to help address the identity challenges of those whom they serve. In so doing, they make an important contribution to meaning and well-being.
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Lamu today is composed of several ethnic groups with an affinity for gold: the Afro-Arab old families who intermarried with the BuSaid ruling class from Oman and Zanzibar; Hadrami newcomers from southern Arabia; and the slaves of these groups, all of whom came from central Africa. In addition, there are Bohra Indians (only a few remain of the two hundred or so earlier in the century), two Parsees, and one remaining Ismaili family whose origins in India dictate a desire for gold. Other people, such as Bajuni, are now living in Lamu; but most are poor and the few who have gold are those who have gone to Mombasa or away to school, and then returned. Some of them have married into the heretofore closed ranks of the old Afro-Arab families precisely because they have made money or can be expected to, and will provide gold. There are numbers of other ethnic groups in Lamu, including Africans from the Kenya mainland across the bay from Lamu island. Land, not gold, is important to them. The people of concern here are mainly the Bohra Indians, Afro-Arabs, and the Hadramis – all of whom covet gold. Marriages in Lamu were arranged along ethnic, class, and family lines at least since the nineteenth century. Gold for brides was a necessity – especially for the upper-class Afro-Arab (mixtures of local Africans, African slaves, and Arab traders) families and among the various Indian groups (historically Hindu, Dauudi Bohra, Ithnasharia, Ismaili, and Goans) then living and trading there.
Traditional anthropological participant-observation and cultural interpretation can provide insight into the relationship of dress to human individual and social experience that more expedient methodologies may ignore. This interpretation of female dress of the Karen, a hill tribe in northwest Thailand, relies primarily on anthropological symbolic theory. It suggests that dress may serve as a symbolic metaphor of the relationship of the individual to the cultural system. As such, dress can be an extremely powerful symbolic way of expressing and reinforcing subtle values, relationships, and meaning in human culture. Dress can contribute to the maintenance of cultural continuity by interaction with ritual to cause individuals to want to act as they must act in order to preserve their own cultural system.
Healthcare providers in the American medical system may find that patients from different cultures bring unfamiliar expectations, anxieties, and needs into the examination room. To provide optimal care for all patients, it is important to see differences from the patient's perspective and to work with patients from a range of demographics. Caring for Patients from Different Cultures has been a vital resource for nurses and physicians for more than twenty years, offering hundreds of case studies that illustrate crosscultural conflicts or misunderstandings as well as examples of culturally competent health care. Now in its fifth edition, Caring for Patients from Different Cultures covers a wide range of topics, including birth, end of life, communication, traditional medicine, mental health, pain, religion, and multicultural staff challenges. This edition includes more than sixty new cases with an expanded appendix, introduces a new chapter on improving adherence, and updates the concluding chapter with examples of changes various hospitals have made to accommodate cultural differences. Grounded in concepts from the fields of cultural diversity and medical anthropology, Caring for Patients from Different Cultures provides healthcare workers with a frame of reference for understanding cultural differences and sound alternatives for providing the best possible care to multicultural communities.
The bride's henna ritual was the principal rite of passage for women in Yemen. This ritual was an important stage in preparing the bride for her new life, as she changed from a girl-youth into a man's wife, became separated from her family, and went to live in her husband's home. It expressed a rigid gender separation and a non-egalitarian system in which femininity was shackled in structural inferiority. After immigrating to Israel and becoming exposed to a western society with egalitarian messages, Yemenite women became less dependent and subservient and more empowered. However, they also maintained traditional thought patterns. The change in their status, as well as the mixed trends towards change and preservation in communal tradition, influenced the performance of the henna ritual in Israel, and it became syncretic. During the last few decades, as part of the process of Mizrahi young people return to their roots, the custom of holding a henna ritual has been revived among young Yemenite Jews in Israel, mainly as a symbol of their ethnic identity. Today, however, the ritual is characterized by a breaking of the social order and hierarchy. It is focused on the couple, and its importance as a female rite of passage has diminished.
Culturally derived ambivalences of social identity lie at the heart of much that is communicated by clothing and fashion. In the West gender, age, sexual and social status identities are all subject to such vacillating clothing impulses and representations. In the instance of social status a culturally encoded tension generated by, at one end, a class based system of invidious distinctions and, at the other, a Judeo-Christian ethic of asceticism and modesty has for some seven hundred years now propelled an ongoing identity dialectic of status claims and status demurrals in clothing. Sartorial issues of ostentation vs. understatement, overdressing vs. underdressing, conspicuous poverty and the commission of disingenuous mistakes in dress reflect this underlying tension. In particular, the maid-inspired little black dress of the 1920s and 30s and, more recently, the fluctuating status symbolism attaching to blue jeans afford dramatic evidence of the play of status ambivalences in clothing. Identity ambivalence, in general, constitutes an important symbolic resource for fashion''s constant forays upon established dress codes.
The extremity in teenagers’ attitudes and actions coupled with the opportunities of mobile communication creates new behaviors and re-shapes existing ones. But, however meaningful the phone is in teenagers’ lives, it is not designed to support their need for emotional communication and group identity. The BuddyBeads project suggests alternative communication forms among teenagers, which emphasize their social structures, behaviors and needs. BuddyBeads are techno-jewelry items that facilitate non-verbal and emotional communication among group members, through codes and signals which the group decided upon together. Each group member has a matching jewelry piece and can use it to communicate her emotional state to the other group members.
To evaluate theory, concepts with that theory must be identified, analyzed and defined. The aim of this concept analysis of cultural competence is to clarify and differentiate the term as it is used in health care and nursing literature and to separate cultural competence from its measurement. Before the question of what is cultural competence can be answered, culture and competence--as separate terms--must be understood. Components of the cultural competence concept are identified along with its antecedents and consequences. Additionally, terms closely related to cultural competence are described and differentiated from the cultural competence concept. To add meaning to the analysis, a cultural competence model case and contrary case are supplied along with outcome measures and empirical referents for cultural competence. Finally, a concluding definition based on extensive review of literature sources such as archeology, anthropology, history, psychology, policy, criminal justice, occupational therapy, medicine, nursing, and education is provided.
Culturally competent healthcare systems-those that provide culturally and linguistically appropriate services-have the potential to reduce racial and ethnic health disparities. When clients do not understand what their healthcare providers are telling them, and providers either do not speak the client's language or are insensitive to cultural differences, the quality of health care can be compromised. We reviewed five interventions to improve cultural competence in healthcare systems-programs to recruit and retain staff members who reflect the cultural diversity of the community served, use of interpreter services or bilingual providers for clients with limited English proficiency, cultural competency training for healthcare providers, use of linguistically and culturally appropriate health education materials, and culturally specific healthcare settings. We could not determine the effectiveness of any of these interventions, because there were either too few comparative studies, or studies did not examine the outcome measures evaluated in this review: client satisfaction with care, improvements in health status, and inappropriate racial or ethnic differences in use of health services or in received and recommended treatment.
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The handshake. The most accurate gauge of manliness.
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