Hand-to-mouth Research Articles

The use of accelerometers to assess upper limb function in patients with obstetric brachial plexus palsy

For half a century, the Mallet Scale (MS) has been utilized to assess upper limb function in patients with obstetric brachial plexus palsy (OBPP). However, the correct use of the MS requires trained personnel and the MS does not measure compensatory movements. For this reason, new methods are needed to compensate for these weaknesses. This study introduces an innovative method for objective functional motion analysis using accelerometers to measure upper limb movements in thirty patients with obstetric brachial plexus lesions. Five triaxial accelerometers were positioned on the chest and each upper limb. They recorded acceleration signals during repetitive everyday tasks: hand-to-mouth (HM), hand-to-neck (HN), and hand-to-spine (HS). From these signals, 54 features were extracted and subjected to linear correlation tests to identify 5 suitable features. An algorithm was then developed to categorize patients into five groups and compute an individual movement performance score (iMPScore) assessing the patient’s upper extremity function. By using the iMPScore more than 75% of all participants have been classified correctly with respect to their MS category. Identification of MS I category patients in general and assessing upper extremity function of MS I to III in HS tasks were most challenging. We conclude that the introduced approach is a valuable tool for gauging movement limitation of upper limbs in patients with obstetric brachial plexus palsy. Compared to other clinically established methods, it becomes possible to record and even quantify the extent of compensatory movements. In this way, an objective, user- and patient-friendly method is offered, which supports significantly physicians and therapists in their evaluation of OBPP.

Heterogeneous consumption behaviors and monetary policy in three ASEAN economies

This paper aims to theoretically investigate how the presence of heterogeneous consumption behaviors, namely hand-to-mouth (HtM) and habit formation (HF), affects the monetary policy effectiveness and empirically explore the responses of three Association of Southeast Asian Nations (ASEAN) economies to external shocks. We employ the Bayesian methodology to undertake the Dynamic Stochastic General Equilibrium (DSGE) estimation using quarterly data. Empirical results indicate a HtM parameter of 22% in Indonesia, 34% in the Philippines, and 27% in Thailand, with the HF parameter estimated at around 50%. Given the estimated parameters, a monetary shock would have standard effects on macroeconomic variables. Besides, incorporating HtM consumers into a standard DSGE model amplifies the adverse effects of monetary shock on aggregate consumption/output growth. Also, a higher ratio of HtM consumers exacerbates the negative effects of monetary shock, but it does not influence much the adverse impacts of demand and supply shocks on macroeconomic variables.

Fiscal multipliers, monetary efficacy, and hand-to-mouth households

The effectiveness of fiscal and monetary policy has been found to exhibit large heterogeneity across countries, and it hinges heavily on households’ marginal propensity to consume (MPC) in response to the policy shocks. This paper examines the role of households’ liquidity, saving, and credit constraints as microfactors that underpin households’ MPC and hence affect the macro level fiscal and monetary policy effectiveness.This paper presents a uniform framework to measure the degree of various constraints faced by consumers, and employs data from 20 European countries to examine their nexus with hand-to-mouth (HtM) households. Our findings demonstrate that (i) a higher ratio of HtM households generally enhances fiscal multipliers; in particular, the size of tax multipliers is enhanced by the wealthy-HtM ratio (HtM households that hold positive illiquid wealth), whereas the size of fiscal spending multipliers is enhanced by the poor-HtM ratio (households that hold no illiquid wealth); (ii) monetary efficacy is higher in countries with larger HtM ratios, especially those with higher wealthy-HtM ratios; (iii) sole liquidity-constrained HtM households (type-I HtM households) enhance the efficacy of fiscal and monetary policies, but triple constrained HtM households (type-II HtM households that are liquidity-, saving-, and credit-constrained) do not enhance the efficacy, or even do the opposite. The triple constrained case is true especially for the monetary efficacy due to the dampening effect of the credit constraint. This paper contributes to the literature by providing evidence for the heterogeneous impacts of liquidity vs. saving and credit constrained HtM households, and wealthy- vs. poor-HtM households on fiscal and monetary efficacy.

Is There Any Relationship between Upper and Lower Limb Impairments in People with Multiple Sclerosis? A Kinematic Quantitative Analysis.

Background In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. Nevertheless, they can severely affect the quality of life of pwMS. To date, it remains mostly unknown whether a relationship exists between upper and lower limb impairments. Aim To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Methods Twenty-eight pwMS with Expanded Disability Status Scale (EDSS) scores in the range of 1–6, and 21 healthy controls (HC) underwent a kinematic analysis of gait and HTM movement performed with a motion capture system. The spatiotemporal parameters for the two tasks were calculated and correlated using Spearman's rank correlation coefficients. Results The pwMS performed worse than HC on both tasks. Small to large correlations were found between the total HTM movement duration and most of the gait parameters (rho, 0.35–0.68; p < 0.05). Conclusions Both upper and lower limb motor abilities in pwMS worsen as disability increases. Nevertheless, their relationship is only moderate. This finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS.

Age-related changes in upper limb motion during typical development.

Background and aimUnderstanding the maturation of upper limb (UL) movement characteristics in typically developing (TD) children is key to explore UL deficits in those with neurodevelopmental disorders. Three-dimensional motion analysis (3DMA) offers a reliable tool to comprehensively evaluate UL motion. However, studies thus far mainly focused on specific pre-defined parameters extracted from kinematic waveforms. Here, we investigated age-related differences in UL movement characteristics over the entire movement cycle in TD children.Participants and methodsWe assessed the non-dominant UL of 60 TD children (mean age 10y3m±3y1m) using 3DMA during eight tasks: reaching (forwards (RF), upwards (RU), sideways (RS)), reach-to-grasp (sphere (RGS), vertical cylinder (RGV)) and activities-of-daily-living mimicking tasks (hand-to-head (HTH), hand-to-mouth (HTM), hand-to-shoulder (HTS)). We investigated differences between four age-groups (5-7y, 8-10y, 11-12y, 13-15y) in: (1) spatiotemporal parameters (movement duration, peak velocity, time-to-peak velocity and trajectory straightness), and (2) 12 UL joint angles, using Statistical Parametric Mapping (SPM).ResultsWe found that the 5-7y children moved with lower peak velocity and less straight trajectories compared to the 11-12y group (peak velocity: RS, HTS, p<0.01; trajectory: RU, RS, RGV, HTS, p<0.01) and the 13-15y group (peak velocity: RF, RS, RGS, RGV, HTH, HTS, p<0.01; trajectory, all tasks, p<0.01). The 5-7y children showed increased scapular protraction compared to older children (8-10y and 11-12y, HTS), as well as increased scapular medial rotation compared to the 13-15y group (RGS). During RU, the 5-7y children moved more towards the frontal plane (shoulder), unlike the 13-15y group. Lastly, the 5-7y group used less elbow flexion than older children (11-12y and 13-15y) during HTH and HTS.Discussion and conclusionIn conclusion, our results point toward a maturation in UL movement characteristics up to age 11-12y, when UL motion seemed to reach a plateau. The reference values provided in this study will help to further optimize the interpretation of UL deficits in children with neurodevelopmental disorders.

The Wealthy Hand-to-Mouth Households in South Korea

This study establishes the stylized facts on household balance sheets in South Korea and empirically investigates their macroeconomic implications based on the concept of ‘wealthy hand-to-mouth (HtM)’ households that hold little liquid wealth with owning large amount of illiquid assets. Using a household-level panel data for the period of 2000–2014, we find that (1) there are neither deleveraging of household debts nor a sharp decline in house price even during the financial crisis, (2) run-up in household debt in 2000s is led by high-income group, (3) regardless of net worth level, wealth is highly concentrated on illiquid assets such as housing and real estate, (4) the share of wealthy HtM households is very high compared to the cases of other advanced countries. We estimate the marginal propensity to consume out of a transitory shock and find that the consumption response of HtM households is larger compared to the non-credit-constrained group, posing a threat to macroeconomic stability. Using discrete choice models with fixed effects, we also find that a household that acquire more real estate assets is more likely to become wealthy HtM when its income is relatively lower or its indebtedness is relatively higher. We discuss the characteristics of HtM households and the role of macroprudential policy.

Using robot fully assisted functional movements in upper-limb rehabilitation of chronic stroke patients: preliminary results.

Robotic rehabilitation is promising to promote function in stroke patients. The assist as needed training paradigm has shown to stimulate neuroplasticity but often cannot be used because stroke patients are too impaired to actively control the robot against gravity. To verify whether a rehabilitation intervention based on robot fully assisted reaching against gravity (RCH) and hand-to-mouth (HTM) can promote upper-limb function in chronic stroke. Cohort study. Chronic stroke outpatients referring to the robotic rehabilitation lab of a rehabilitation centre. Ten chronic stroke patients with mild to moderate upper-limb hemiparesis. Patients underwent 12 sessions (3 per week) of robotic treatment using an end-effector robot Every session consisted of 20 minutes each of RCH and HtM; movements were fully assisted, but patients were asked to try to actively participate. The Fugl-Meyer Assessment (FMA) was the primary outcome measure; Medical Research Council and Modified Ashworth Scale were the secondary outcome measures. All patients, but one, show functional improvements (FMA section A-D, mean increment 7.2±3.9 points, P<0.008). This preliminary study shows that a robotic intervention based on functional movements, fully assisted, can be effective in promoting function in chronic stroke patients. These results are promising considering the short time of the intervention (1 month) and the time from the stroke event, which was large (27±20 months). A larger study, comprehensive of objective instrumental measures, is necessary to confirm the results. This intervention could be extended even to subacute stroke and other neurological disorders.

Wastewater use in urban agriculture: an exposure and risk assessment in Accra, Ghana

Wastewater use in urban agriculture is common as a result of rapid urbanisation and increasingcompetition for water. This study sought to assess critical exposures associated with the transmission of faecal pathogens among farmers and consumers of wastewater irrigated produce andto assess the adoption of the multiple-barrier approach advocated by the WHO guidelines tominimise health risks. From September 2012 to August 2013, 323 soil and irrigation water samples,and 501 raw produce and ready-to-eat salad samples were collected from fields, markets,and kitchens in Accra, Ghana. All samples were analysed for E. coli using standard procedures.In addition, 693 participants including farmers, vendors, and consumers were interviewed andobserved. The results showed that irrigation water was significantly more contaminated thanfarm soil, though exposure to soil was found to pose the key risk to farmers due to hand-to mouth events (10 events/day). Over 80% of the produce samples were found contaminated with E. coli, with street food salad found to be the most contaminated (4.23 Log E. coli/g). Risk factors identified for produce contamination included farm soil, wastewater use, and poor food and environmental hygiene. Awareness of the source of irrigation water was low, but despite the high awareness of health risk, consumers did not prioritize health indicators when buying produce.The study recommends the promotion of interventions that would result in more direct benefits to producers and vendors, together with hygiene education/inspection, hygiene certification, andenforcement of food safety byelaws in order to protect health.Keywords: Ghana, wastewater irrigation, produce, risk perceptions, multiple-barrier approach

The wealthy hand to mouth in Japan

This paper identifies hand-to-mouth (HtM) households and examines their characteristics in Japanese data. The share of HtM is about 13%, which is much smaller than other developed countries. The majority of them, nearly three-quarters, are considered wealthy HtM. The wealthy HtM households have similar income and consumption profiles to non-HtM households.

Limited asset market participation and the consumption‐real exchange rate anomaly

Abstract Under efficient consumption risk sharing, as assumed in standard international business cycle models, a country's aggregate consumption rises relative to foreign consumption, when the country's real exchange rate depreciates. Yet empirically, relative consumption and the real exchange rate are essentially uncorrelated. This paper shows that this ‘consumption‐real exchange rate anomaly’ can be explained by a simple model in which a subset of households trade in complete financial markets, while the remaining households lead hand‐to‐mouth (HTM) lives. HTM behaviour also generates greater volatility of the real exchange rate and of net exports, which likewise brings the model closer to the data.

Shakespeare and the Culture of Paradox by Peter G. Platt

528 Reviews on the food-related fates ofAaron and Tamora in Titus Andronicus (p. 124). More of a starter than a main course, Food in Shakespeare shows how far feeding and feeling, as Duke Orsino well knew, go hand in hand as well as hand tomouth in the diet of earlymodern drama. This is not rich repast, but its small portions are well seasoned. University of Glasgow Willy Maley Shakespeare and the Culture of Paradox. By Peter G. Platt. Farnham and Burlington, VT: Ashgate. 2009. ix+25ipp. ?55. ISBN 978-0-7546-6551-9. Ithas long been acknowledged thatparadox is central to Shakespeare's plays, nearly all ofwhich could be called problematic'. Theirmixed ideological messages, refusal to support any single idea, and general open-endedness are, arguably, what make them a source of continued interest and debate. As Norman Rabkin once claimed, polyvalence and polysemy are implicit governing principles inmany of the greatest works of literature.What is less known, however, is that Shakespeare's use of paradox is informed by and representative ofwhat Peter Platt terms 'theRenais sance culture of paradox. Adopting a New Historicist approach, Platt successfully situates Shakespearian paradox within the context of an age thatwas fixated with the unexpected, the uncertain, and the contradictory. The first chapter, '"New, Straunge, Incredible, and Repugnant to the Opinion of the Hearer": The Power of the Paradox in Early Modern Culture', highlights the chief versions of paradox that concerned (and often delighted) Renaissance thinkers: the literary-rhetorical and logical versions?whose roots are primarily classical?and the Christian versions. This chapter also discusses the effectiveness ofparadox as a political tool and itsability to 'transform themind' (p. 12). Claiming that critics of Shakespeare have not sufficiently recognized the power of paradox, Platt is of the opinion that paradox is connected more to activity than passivity (p. 15). He thereby positions himself against scholars, such as Gary Taylor, who consider paradox as ultimately paralysing and ineffectual. After setting the historical scene (Piatt's grasp of history and his extensive use of non-literary material is one of the book's main strengths) and outlining his theoretical standpoint, Platt goes on, in the following three chapters, to look at specific 'sites' of paradox: Venice; equity law and its courts; and the Shakespearian stage. In theVenice chapter Platt examines Renaissance accounts of Venice that establish itas a liminal space between East andWest, land and sea, Protestant and Catholic, before reading TheMerchant of Venice's and Othello's epistemological, ontological, racial, and sexual complexities through Venice's symbolic geography (p. 58). He then focuses attention on the complex issue of equity which led to the paradoxes surrounding legal judgement in Measure forMeasure and TheMerchant. As a law that appreciates the shifting, restless, and paradoxical nature of theworld, equity ends up, ironically, justifying rather thanmitigating the use of strict justice inboth plays. Piatt's last chapter, '"Double Dealing Ambodexters": The Paradoxes of Playing', MLR, 105.2, 2010 529 is almost twice as long as the preceding ones and by far themost ambitious. In it,he takes on themammoth task of examining the paradoxes of performance: the duality of the actor; the paradox of the boy actor; and the paradox of the relationship between audience and player. The Henriad and Hamlet are summoned in an exploration of the paradox of the actor in particular, while TwelfthNight and As You Like It are pivotal to Piatt's discussion of the boy actor and the paradoxes of gender identity.And finally, The Winters Tale and The Tempest are invoked in his analysis of the audience's encounters with the paradoxes of the stage: many antitheatricalists feared, after all, thatviewers could become what they saw, could be both spectator and actor. One suspects that the subject of Piatt's last chapter requires book-length study itself, for it is impossible to do it justice within the scope of sixty-eight pages. Despite this one criticism, this is a stimulating and enjoyable read as well as an important reappraisal of Rosalie L. Colie's Paradoxia Epidemica: The Renaissance Tradition ofParadox (Princeton: Princeton University Press, 1966) in the light of post-structuralism. Queen's University Belfast Adele Lee The Key of Green...

Limited Asset Market Participation and the Consumption-Real Exchange Rate Anomaly

Under efficient consumption risk sharing, as assumed in standard international business cycle models, a country’s aggregate consumption rises relative to foreign consumption, when the country’s real exchange rate depreciates. Yet, empirically, relative consumption and the real exchange rate are essentially uncorrelated. I show that this ‘consumption-real exchange rate anomaly’ can be explained by a simple model in which a subset of households trade in complete financial markets, while the remaining households lead hand-to-mouth (HTM) lives. HTM behavior also generates greater volatility of the real exchange rate and of net exports, which likewise brings the model closer to the data.