Sample records for neurology residents comfortable

  1. Adult neurology training during child neurology residency. (United States)

    Schor, Nina F


    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  2. Education Research: Neurology resident education (United States)

    Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John


    Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

  3. Floor heating maximizes residents` comfort

    Energy Technology Data Exchange (ETDEWEB)

    Tirkkanen, P.; Wikstroem, T.


    Storing heat in floors by using economical night-time electricity does not increase the specific consumption of heating. According to studies done by IVO, the optimum housing comfort is achieved if the room is heated mainly by means of floor heating that is evened out by window or ceiling heating, or by a combination of all three forms of heating. (orig.)

  4. Neurocritical care education during neurology residency (United States)

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.


    Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

  5. Child Neurology Education for Pediatric Residents. (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D


    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  6. Problem neurology residents: a national survey. (United States)

    Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J


    Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

  7. Are neurology residents interested in headache? (United States)

    Gago-Veiga, A B; Santos-Lasaosa, S; Viguera Romero, J; Pozo-Rosich, P

    The years of residency are the pillars of the subsequent practice in every medical specialty. The aim of our study is to evaluate the current situation, degree of involvement, main interests, and perceived quality of the training received by Spanish residents of neurology, specifically in the area of headache. A self-administered survey was designed by the Headache Study Group of the Spanish Society of Neurology (GECSEN) and was sent via e-mail to all residents who were members of the Society as of May 2015. Fifty-three residents completed the survey (N = 426, 12.4%): 6% were first year residents, 25.5% second year, 23.5% third year, and 45% fourth year residents, all from 13 different Spanish autonomous communities. The areas of greatest interest are, in this order: Vascular neurology, headache, and epilepsy. Of them, 85% believe that the area of headache is undervalued. More than half of residents (52.8%) do not rotate in specific Headache Units and only 35.8% complete their training dominating anaesthetic block and toxin infiltration techniques. Of them, 81.1% believe that research is scarce or absent; 69.8% have never made a poster/presentation, 79.3% have not published and only 15% collaborate on research projects in this area. Lastly, 40% believe that they have not received adequate training. Headache is among the areas that interest our residents the most; however, we believe that we must improve their training both at a patient healthcare level and as researchers. Thus, increasing the number of available courses, creating educational web pages, involving residents in research, and making a rotation in a specialised unit mandatory are among the fundamental objectives of the GECSEN. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Education research: a case-based bioethics curriculum for neurology residents. (United States)

    Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth


    In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

  9. Residency Training: Work engagement during neurology training. (United States)

    Zis, Panagiotis; Anagnostopoulos, Fotios; Artemiadis, Artemios K


    Work engagement, defined as a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption, can ameliorate patient care and reduce medical errors. The purpose of this cross-sectional study was to investigate work engagement among neurology residents in the region of Attica, Greece. In total, 113 residents participated in this study. Demographic and work-related characteristics, as well as emotional exhaustion and personality traits (neuroticism), were examined via an anonymous questionnaire. Work engagement was measured by the Utrecht Work Engagement Scale. The study sample had a mean age of 34.6 ± 3.6 years, ranging from 26 to 45 years. Sixty-two (54.9%) participants were women and 45 (39.8%) were married. After adjusting for sex, emotional exhaustion, and neuroticism, the main factors associated with work engagement were autonomy and chances for professional development. Providing more chances for trainees' professional development as well as allowing for and supporting greater job autonomy may improve work engagement during neurology training. © 2016 American Academy of Neurology.

  10. Are the French neurology residents satisfied with their training? (United States)

    Codron, P; Roux, T; Le Guennec, L; Zuber, M


    There have been dramatic changes in neurology over the past decade; these advances require a constant adaptation of residents' theoretical and practical training. The French Association of Neurology Residents and the College of Neurology Teachers conducted a national survey to assess the French neurology residents' satisfaction about their training. A 16-item questionnaire was sent via e-mail to French neurology residents completing training in 2014. Data were collected and processed anonymously. Of eligible respondents, 126 returned the survey, representing approximately 40% of all the French neurology residents. Most residents (78%) rated their clinical training favorably. Seventy-two percent reported good to excellent quality teaching of neurology courses from their faculty. However, many residents (40%) felt insufficient their doctoral thesis supervision. All residents intended to enter fellowship training after their residency, and most of them (68%) planned to practice in a medical center. French neurology residents seemed satisfied with the structure and quality of their training program. However, efforts are required to improve management of the doctoral thesis and make private practice more attractive and accessible during the residency. In the future, similar surveys should be scheduled to regularly assess neurology residents' satisfaction and the impact of the forthcoming national and European reforms. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. A national survey of Canadian emergency medicine residents' comfort with geriatric emergency medicine. (United States)

    Snider, Tristan; Melady, Don; Costa, Andrew P


    Geriatric patients represent a large and complex subgroup seen in emergency departments (EDs). Competencies in geriatric emergency medicine (EM) training have been established. Our objectives were to examine Canadian postgraduate year (PGY)-5 EM residents' comfort with the geriatric EM competency domains, assess whether Canadian EM residents become more comfortable through residency, and determine whether geriatric educational exposures are correlated with resident comfort with geriatric EM. A national, cross-sectional study of PGY-1 and PGY-5 Royal College EM residents was conducted to determine their comfort in geriatric EM clinical competency domains. Residents reported their level of comfort in satisfying each competency domain using a seven-point Likert scale. Residents were also asked about the location of their medical education as well as the type and number of different geriatric exposures that they had received to date. Of the 141 eligible residents from across Canada, 77% (109) consented to participate. None of the PGY-1 EM residents and 34% (14) of PGY-5 EM residents reported that they were comfortable with all eight geriatric EM competency domains. PGY-5 EM residents were significantly more comfortable than PGY-1 EM residents. Residents reported a highly variable range of geriatric educational exposures obtained during training. No relationship was found between resident-reported comfort and the nature or number of geriatric exposures that they had received. Current Royal College EM residency training in Canada may not be adequately preparing graduates to be comfortable with defined competencies for the care of older ED patients.

  12. Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results. (United States)

    Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John


    To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

  13. Results of the American Academy of Neurology resident survey. (United States)

    Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R


    To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

  14. Family medicine residents' perceived level of comfort in treating common sports injuries across residency programs in the United States. (United States)

    Amoako, Adae O; Amoako, Agyenim B; Pujalte, George Ga


    Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7%) compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8%) respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively). Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, sports medicine contribute to residents' knowledge and comfort level in treatment of common sports injuries.

  15. Challenges to neurology residency education in today's health care environment. (United States)

    Bega, Danny; Krainc, Dimitri


    Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

  16. Perspectives on death and dying: a study of resident comfort with End-of-life care

    Directory of Open Access Journals (Sweden)

    Jessica M. Schmit


    Full Text Available Abstract Background Despite the benefits to early palliative care in the treatment of terminal illness, barriers to timely hospice referrals exist. Physicians who are more comfortable having end-of-life (EOL conversations are more likely to refer to hospice. However, very little is known about what factors influence comfort with EOL care. Methods An anonymous survey was sent to all the residents and fellows at a single institution. Self-reported education, experience and comfort with EOL care was assessed. Using multivariate logistic regression analysis, variables that influenced comfort with EOL conversations were analyzed. Results Most residents (88.1% reported little to no classroom training on EOL care during residency. EOL conversations during residency were frequent (50.6% reported > 10 and mostly unsupervised (61.9%. In contrast, EOL conversations during medical school were infrequent (3.7% reported >10 and mostly supervised (78.6%. Most (54.3% reported little to no classroom training on EOL care during medical school. Physicians that reported receiving education on EOL conversations during residency and those who had frequent EOL conversations during residency had significantly higher comfort levels having EOL conversations (p = 0.017 and p = 0.003, respectively. Likewise, residents that felt adequately prepared to have EOL conversations when graduating from medical school were more likely to feel comfortable (p = 0.030. Conclusions Most residents had inadequate education in EOL conversation skills during medical school and residency. Despite the lack of training, EOL conversations during residency are common and often unsupervised. Those who reported more classroom training during residency on EOL skills had greater comfort with EOL conversations. Training programs should provide palliative care education to all physicians during residency and fellowship, especially for those specialties that are most likely to encounter

  17. Medical residence in pediatric neurology in Brazil




    Apresentamos os resultados de pequisa sobre Residência Médica em Neurologia Infantil, catalogando dados atualizados sobre o ensino e treinamento nos vários centros de formação do Brasil. Foi possível constatar 17 Instituições com programação organizadas, sendo 6 credenciadas pela CNRM, 10 não credenciadas e, um em diligência. O conteúdo programático é desenvolvido em 3 ou 4 anos, incluindo o pré-requisíto, sendo a carga horária anual, variável, de 1900 a 2880 horas/ano.We present the results ...

  18. Neurology residency training in Europe: an Italian perspective. (United States)

    Facheris, Maurizio; Mancuso, Michelangelo; Scaravilli, Tomaso; Bonifati, Domenico Marco


    Education is the most important part of medical-science training. Assessment of training programmes and examination of trainees' skills are necessary to guarantee that trainees develop competence. Training programmes vary between and within countries. The impending integration of the medical-job market among European countries highlights the need for people training to be specialists to achieve a certain standard. Here, we review the neurological training programmes in Europe, principally those in Italy, and discuss the standardisation of the training of residents in Italy and the quality control of current residency training, or its absence, in Europe.

  19. Neurology residency training in Europe--the current situation. (United States)

    Struhal, W; Sellner, J; Lisnic, V; Vécsei, L; Müller, E; Grisold, W


    Little is known about neurological training curricula in Europe. A joint approach by the European Federation of Neurological Societies (EFNS), the Union of European Medical Specialists/European Board of Neurology and the European Association of Young Neurologist and Trainees was established to explore the spectrum of neurology training in Europe. In 2006, a questionnaire-based survey on neurology curricula as well as demographic data was designed by WS and WG and distributed by the EFNS to the national delegates of the EFNS, which comprises all European countries and Israel. By 2009, delegates from 31 of 41 countries (representing 76% of 505 million) had returned the questionnaire. A total of 24,165 specialists (46% women) were registered in the 31 countries. This corresponds to an average of 6.6 neurologists per 100,000 inhabitants (range 0.9-17.4/100,000 inhabitants). Duration of training in Europe was on average 4.9,years, ranging from 3 to 6,years. The number of residents interested in neurological training exceeded the amount of available training positions. Performance of neurological trainees was regularly assessed in 26 countries (84%), usually by recurrent clinical evaluation. Board examinations were held in 23 countries (74%). Interim examinations were performed in three countries, exit examinations in 14 and both interim and exit examination in 6. Considerable differences were also found in manpower (0.9-17.4 neurologists/100,000 inhabitants) and working conditions (e.g. average weekly working hours ranging from 30-80 h/month). We found a significant positive correlation between manpower and theoretical training hours. Considerable differences exist in training curricula of European countries. These data might provide the basis for European training and quality assurance initiatives. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  20. Knowledge and Comfort With Pessary Use: A Survey of US Obstetrics and Gynecology Residents. (United States)

    Kandadai, Padma; Mcvay, Samantha; Larrieux, Jean-Robert; OʼDell, Katharine

    This study aimed to determine factors associated with perceived comfort with pessary management among obstetrics and gynecology (OB/GYN) residents in the United States. A 31-item anonymous electronic survey regarding experience with, attitudes toward, and comfort with pessary management was distributed to US OB/GYN residents in all postgraduate years (PGYs). Demographic and program-specific data on pessary education were collected. Descriptive statistical analyses were performed. Single-predictor logistic regression analysis, followed by analysis of a multivariable model that included significant single predictors, was performed to determine factors associated with residents' perception of comfort. Results were stratified for junior (PGYs 1, 2), senior (PGYs 3, 4), and chief (PGY4) residents. Four hundred seventy-eight completed surveys were returned and analyzed. Mean age of respondents was 29.5 (±2.56) years. Training levels were distributed evenly (PGY1, 25%; PGY2, 28%; PGY3, 25%; PGY4, 22%). Twenty-eight percent had a urogynecology fellowship in the department. Factors associated with comfort were similar for all training levels and included working with advanced practitioners, a formal urogynecology rotation, experience with pessary fitting, and receiving formal pessary-specific didactics (P didactics on prolapse and incontinence. Gaining outpatient experience, especially with pessary fitting, along with formal didactics specific to pessary fitting and management may improve resident' confidence with pessary use.

  1. Education Research: Neurology resident education: Trending skills, confidence, and professional preparation. (United States)

    Jordan, Justin T; Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M; Engstrom, John


    To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. © 2016 American Academy of Neurology.

  2. Residency Training: The need for an integrated diversity curriculum for neurology residency. (United States)

    Rosendale, Nicole; Josephson, S Andrew


    Providing culturally responsive care to an increasingly multicultural population is essential and requires formal cultural humility training for residents. We sought to understand the current prevalence and need for this type of training within neurology programs and to pilot an integrated curriculum locally. We surveyed via email all program directors of academic neurology programs nationally regarding the prevalence of and need for formal cultural responsiveness training. Forty-seven program directors (36%) responded to the survey. The majority of respondents did not have a formalized diversity curriculum in their program (65%), but most (85%) believed that training in cultural responsiveness was important. We developed locally an integrated diversity curriculum as a proof of concept. The curriculum covered topics of diversity in language, religion, sexual orientation, gender identity/expression, and socioeconomic status designed to focus on the needs of the local community. Program evaluation included a pre and post survey of the learner attitudes toward cultural diversity. There is an unmet need for cultural responsiveness training within neurology residencies, and integrating this curriculum is both feasible and efficacious. When adapted to address cultural issues of the local community, this curriculum can be generalizable to both academic and community organizations. © 2017 American Academy of Neurology.

  3. Determining preferred educational methods for neurological surgery residents regarding organ donation. (United States)

    Taylor, G; McGaw, J


    Design and implementation of professional education, especially physician education, continues to challenge procurement professionals. At the request of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, the United Network for Organ Sharing undertook a project to develop educational materials for neurological surgery residents. A survey tool was developed and administered on site at 11 neurological surgery residency programs in the United States. The survey explored the types of learning environments, teaching methods, educational resources, and audiovisual aids that neurological surgery residents typically experience during their residency programs. In addition, the survey sought to uncover the residents' informational needs regarding organ and tissue donation presentations as well as their educational program preferences. Based on our findings, neurological surgery residents prefer presentations that are brief and to the point, that are easily understood, that require no reading, that contain limited important information, and that always include food.

  4. Family medicine residents’ perceived level of comfort in treating common sports injuries across residency programs in the United States (United States)

    Amoako, Adae O; Amoako, Agyenim B; Pujalte, George GA


    Background and objective Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. Methods This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Results Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7%) compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8%) respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively). Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, sports medicine contribute to residents’ knowledge and comfort level in treatment of common sports injuries. PMID:25848326

  5. Neurocritical care education during neurology residency: AAN survey of US program directors. (United States)

    Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W


    Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents.

  6. Milestone-compatible neurology resident assessments: A role for observable practice activities. (United States)

    Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J


    Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

  7. International issues: Obtaining an adult neurology residency position in the United States: an overview. (United States)

    Jordan, Justin T; Sellner, Johann; Struhal, Walter; Schneider, Logan; Mayans, David


    Around the world, there are marked differences in neurology training, including training duration and degree of specialization. In the United States, adult neurology residency is composed of 1 year of internal medicine training (preliminary year) and 3 years of neurology-specific training. Child neurology, which is not the focus of this article, is 2 years of pediatrics and 3 years of neurology training. The route to adult neurology residency training in the United States is standardized and is similar to most other US specialties. Whereas US medical graduates often receive stepwise guidance from their medical school regarding application for residency training, international graduates often enter this complex process with little or no such assistance. Despite this discrepancy, about 10%-15% of residency positions in the United States are filled by international medical graduates.(1,2) In adult neurology specifically, 35% of matched positions were filled by international graduates in 2013, 75% of whom were not US citizens.(1) In an effort to provide a preliminary understanding of the application process and related terminology (table 1) and thereby encourage international residency applicants, we describe the steps necessary to apply for neurology residency in the United States.

  8. An effective automated method for teaching EEG interpretation to neurology residents. (United States)

    Weber, Daniel; McCarthy, David; Pathmanathan, Jay


    EEG interpretation is a fundamental procedural skill in the practice of neurology, but there is no standardized method for educating residents. One-to-one instruction is commonly employed, but is time intensive for supervising physicians, provides arbitrary exposure to normal and abnormal EEG patterns, and often lacks immediate and detailed feedback on performance. Here, we investigated the effectiveness of a novel automated program to assist in educating neurology residents in EEG interpretation. An EEG teaching program was developed to provide neurology residents EEG training less dependent on attending supervision. Residents enter interpretations of full-length pre-selected EEGs and receive immediate feedback based on consensus interpretation of supervising epileptologists. Resident learning was assessed based on performance on matched pre- and post-tests covering common EEG findings including artifacts, normal variants, and abnormalities. Twenty residents were included in this analysis: 12 post-graduate year (PGY) 3 and eight PGY 4 neurology residents. All residents showed improvement, from a mean score of 42.7% (95% CI 36.9-48.5%) on the pre-test to 75.4% (95% CI 70.7-80.2%) on the post-test (pteaching module spread over a 3-week rotation. This pilot study demonstrated the effectiveness of an automated EEG teaching program used by neurology residents in training. This tool could serve as an effective method of supplementing resident education. Copyright © 2016 British Epilepsy Association. All rights reserved.

  9. The Preferred Learning Styles of Neurosurgeons, Neurosurgery Residents, and Neurology Residents: Implications in the Neurosurgical Field. (United States)

    Lai, Hung-Yi; Lee, Ching-Yi; Chiu, Angela; Lee, Shih-Tseng


    To delineate the learning style that best defines a successful practitioner in the field of neurosurgery by using a validated learning style inventory. The Kolb Learning Style Inventory, a validated assessment tool, was administered to all practicing neurosurgeons, neurosurgical residents, and neurology residents employed at Chang Gung Memorial Hospital, an institution that provides primary and tertiary clinical care in 3 locations, Linkou, Kaohsiung, and Chiayi. There were 81 participants who entered the study, and all completed the study. Neurosurgeons preferred the assimilating learning style (52%), followed by the diverging learning style (39%). Neurosurgery residents were slightly more evenly distributed across the learning styles; however, they still favored assimilating (32%) and diverging (41%). Neurology residents had the most clearly defined preferred learning style with assimilating (76%) obtaining the large majority and diverging (12%) being a distant second. The assimilating and diverging learning styles are the preferred learning styles among neurosurgeons, neurosurgery residents, and neurology residents. The assimilating learning style typically is the primary learning style for neurosurgeons and neurology residents. Neurosurgical residents start off with a diverging learning style and progress toward an assimilating learning style as they work toward becoming practicing neurosurgeons. The field of neurosurgery has limited opportunities for active experimentation, which may explain why individuals who prefer reflective observation are more likely to succeed in this field. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Neurology Didactic Curricula for Psychiatry Residents: A Review of the Literature and a Survey of Program Directors (United States)

    Reardon, Claudia L.; Walaszek, Art


    Objective: Minimal literature exists on neurology didactic instruction offered to psychiatry residents, and there is no model neurology didactic curriculum offered for psychiatry residency programs. The authors sought to describe the current state of neurology didactic training in psychiatry residencies. Methods: The authors electronically…

  11. Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016. (United States)

    Levin, Kerry H; Shanafelt, Tait D; Keran, Christopher M; Busis, Neil A; Foster, Laura A; Molano, Jennifer Rose V; O'Donovan, Cormac A; Ratliff, Jeffrey B; Schwarz, Heidi B; Sloan, Jeff A; Cascino, Terrence L


    To study prevalence of and factors contributing to burnout, career satisfaction, and well-being in US neurology residents and fellows. A total of 938 US American Academy of Neurology member neurology residents and fellows were surveyed using standardized measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016. Response rate was 37.7% (354/938); about 2/3 of responders were residents and 1/3 were fellows. Median age of participants was 32 years and 51.1% were female. Seventy-three percent of residents and 55% of fellows had at least one symptom of burnout, the difference largely related to higher scores for depersonalization among residents. For residents, greater satisfaction with work-life balance, meaning in work, and older age were associated with lower risk of burnout; for fellows, greater satisfaction with work-life balance and effective support staff were associated with lower risk of burnout. Trainees experiencing burnout were less likely to report career satisfaction. Career satisfaction was more likely among those reporting meaning in work and more likely for those working in the Midwest compared with the Northeast region. Burnout is common in neurology residents and fellows. Lack of work-life balance and lack of meaning in work were associated with reduced career satisfaction and increased risk of burnout. These results should inform approaches to reduce burnout and promote career satisfaction and well-being in US neurology trainees. © 2017 American Academy of Neurology.

  12. The comparison of vernacular residences' thermal comfort in coastal with that in mountainous regions of tropical areas (United States)

    Hermawan, Prianto, Eddy; Setyowati, Erni; Sunaryo


    Adaptive thermal comfort is the latest theory used to analyze thermal acceptability of the naturally ventilated buildings for occupants in tropical areas. Vernacular residences are considered capable to meet the thermal comfort for the occupants. The combination between adaptive and passive theory is still rarely conducted. This study aims to compare the adaptive and passive thermal comfort for occupants of vernacular residences in mountainous and coastal regions using AMV (Actual Mean Vote) and PMV (Predicted Mean Vote). This research uses a quantitative method with a statistical analysis on variables of air temperature, globe temperature, velocity, relative humidity, age, weight, and height. AMV data are collected based on questionnaires with ASHRAE (American Society of Heating, Refrigeration, Air conditioning Engineering) standards. The samples consist of 100 vernacular residences of both coastal and mountainous regions. The results show that there are AMV and PMV differences in each region. The AMV values in those vernacular residences in mountainous and coastal regions are respectively -0.4982 and 0.1673. It indicates that the occupants of vernacular residences in coastal regions accept the thermal conditions better. Thus, it can be concluded that vernacular residences in coastal areas comfort the occupants more.

  13. Family medicine residents’ perceived level of comfort in treating common sports injuries across residency programs in the United States

    Directory of Open Access Journals (Sweden)

    Amoako AO


    Full Text Available Adae O Amoako,1 Agyenim B Amoako,2 George GA Pujalte3 1Department of Family and Community Medicine, Penn State Hershey Medical Center, Hershey, PA, USA; 2Department of Family Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA; 3Sports Medicine, Divisions of Primary Care, and Orthopedics, Mayo Clinic Health System, Waycross, GA, USA Background and objective: Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. Methods: This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Results: Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7% compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8% respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively. Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, <0.0001, and 0.0001, respectively; comfort level, P=0.0016, <0.0001, 0.0897, and 0.0010, respectively. Conclusion: Medical education background, factors that affect training, and an interest in sports medicine contribute to residents' knowledge and comfort

  14. Residency Training: Quality improvement projects in neurology residency and fellowship: applying DMAIC methodology. (United States)

    Kassardjian, Charles D; Williamson, Michelle L; van Buskirk, Dorothy J; Ernste, Floranne C; Hunderfund, Andrea N Leep


    Teaching quality improvement (QI) is a priority for residency and fellowship training programs. However, many medical trainees have had little exposure to QI methods. The purpose of this study is to review a rigorous and simple QI methodology (define, measure, analyze, improve, and control [DMAIC]) and demonstrate its use in a fellow-driven QI project aimed at reducing the number of delayed and canceled muscle biopsies at our institution. DMAIC was utilized. The project aim was to reduce the number of delayed muscle biopsies to 10% or less within 24 months. Baseline data were collected for 12 months. These data were analyzed to identify root causes for muscle biopsy delays and cancellations. Interventions were developed to address the most common root causes. Performance was then remeasured for 9 months. Baseline data were collected on 97 of 120 muscle biopsies during 2013. Twenty biopsies (20.6%) were delayed. The most common causes were scheduling too many tests on the same day and lack of fasting. Interventions aimed at patient education and biopsy scheduling were implemented. The effect was to reduce the number of delayed biopsies to 6.6% (6/91) over the next 9 months. Familiarity with QI methodologies such as DMAIC is helpful to ensure valid results and conclusions. Utilizing DMAIC, we were able to implement simple changes and significantly reduce the number of delayed muscle biopsies at our institution. © 2015 American Academy of Neurology.

  15. A dedicated scholarly research program in an adult and pediatric neurology residency program. (United States)

    Robbins, Matthew S; Haut, Sheryl R; Lipton, Richard B; Milstein, Mark J; Ocava, Lenore C; Ballaban-Gil, Karen; Moshé, Solomon L; Mehler, Mark F


    To describe and assess the effectiveness of a formal scholarly activity program for a highly integrated adult and pediatric neurology residency program. Starting in 2011, all graduating residents were required to complete at least one form of scholarly activity broadly defined to include peer-reviewed publications or presentations at scientific meetings of formally mentored projects. The scholarly activity program was administered by the associate residency training director and included an expanded journal club, guided mentorship, a required grand rounds platform presentation, and annual awards for the most scholarly and seminal research findings. We compared scholarly output and mentorship for residents graduating within a 5-year period following program initiation (2011-2015) and during the preceding 5-year preprogram baseline period (2005-2009). Participation in scholarship increased from the preprogram baseline (24 of 53 graduating residents, 45.3%) to the postprogram period (47 of 57 graduating residents, 82.1%, p Neurology.

  16. Training opportunities for the nineteenth-century American neurologist: preludes to the modern neurology residency. (United States)

    Pappert, E J


    During the nineteenth century, two parallel developments, a surge in neuroscience discovery and the advent of medical specialization, resulted in new educational demands for advanced, postgraduate neurologic training in the United States. Archival data, including trustees' reports, school charters, and instructional plans from medical institutions in New York, Boston, Philadelphia, and Chicago, document three comparative models for early postgraduate neurologic training. First, senior physicians with an interest in neurologic disease incorporated postgraduates directly into their practice and as laboratory assistants; second, medical universities, as well as distinct postgraduate schools, organized advanced general medical curricula with optional opportunities for focused neurologic training; and third, separate neurologic hospitals provided physicians with full-time clinical instruction specifically in neurology. As a result, although neurology residencies were not established until the 1900s, postgraduate neurologic training was firmly institutionalized in nineteenth-century America. These programs provided doctors in the United States with advanced neurologic educational opportunities and expertise and fostered the development of a distinct American neurologic school.

  17. Mentoring in neurology: filling the residency gap in academic mentoring. (United States)

    Lee, Paul R; Marsh, Elisabeth B


    Effective academic mentoring significantly affects a physician's choice of career, academic productivity, and professional trajectory. The mentoring relationship is necessary for the continued success of medical training. It is critical to cultivate a climate in which mentoring can thrive. In order to improve the quality and outcomes of mentoring, we must adopt a comprehensive plan. There are interventions at every level of training that will ensure that the current cohort of neurologists receives the requisite expertise needed to flourish and inspire future trainees. Professional organizations must articulate a comprehensive vision of mentoring. Institutions must create an infrastructure to support mentors. Mentors should work in active partnerships with their mentees to forge sustained, productive relationships. Mentees must actively contribute to their own mentoring. Proper mentorship will ensure a bright future for academic neurology.

  18. Residency Training: Determinants of burnout of neurology trainees in Attica, Greece. (United States)

    Zis, Panagiotis; Artemiadis, Artemios K; Lykouri, Maria; Xirou, Sophia; Roussopoulou, Andromachi; Papageorgiou, Ermioni; Bakola, Eleni; Anagnostopoulos, Fotios


    The purpose of our cross-sectional study was to estimate the rate of burnout and identify its determinants among neurology residents in Attica, Greece. In total, 131 placements for neurology training over 18 hospitals were available. All residents were approached and were asked to participate in the study by anonymously completing a questionnaire. Job demands and resources (JD-R) were examined via a 31-item questionnaire assessing 8 factors based on the JD-R model. Burnout was measured with the Maslach Burnout Inventory (MBI). The emotional exhaustion + 1 criterion was used to distinguish respondents with and without burnout. A total of 116 residents participated in the study (response rate 88.5%). In total, 18.1% of the participants were experiencing burnout. Multivariate analysis showed that each increased point in the total score of the factor regarding opportunities for professional development was associated with lowering the odds of burnout by 28.7%. Burnout among neurology residents is associated with decreased professional development. Educators and program directors need to identify those residents at high risk of burnout and design interventions to promote residents' resilience and mental health. © 2015 American Academy of Neurology.

  19. Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training. (United States)

    Sun, Chenjing; Qi, Xiaokun


    Lumbar puncture (LP) is an essential part of adult neurology residency training. Technologic as well as nontechnologic training is needed. However, current assessment tools mostly focus on the technologic aspects of LP. We propose a training method-problem- and simulator-based learning (PSBL)-in LP residency training to develop overall skills of neurology residents. We enrolled 60 neurology postgraduate-year-1 residents from our standardized residents training center and randomly divided them into 2 groups: traditional teaching group and PSBL group. After training, we assessed the extent that the residents were ready to perform LP and tracked successful LPs performed by the residents. We then asked residents to complete questionnaires about the training models. Performance scores and the results of questionnaires were compared between the 2 groups. Students and faculty concluded that PSBL provided a more effective learning experience than the traditional teaching model. Although no statistical difference was found in the pretest, posttest, and improvement rate scores between the 2 groups, based on questionnaire scores and number of successful LPs after training, the PSBL group showed a statistically significant improvement compared with the traditional group. Findings indicated that nontechnical elements, such as planning before the procedure and controlling uncertainties during the procedure, are more crucial than technical elements. Compared with traditional teaching model, PSBL for LP training can develop overall surgical skills, including technical and nontechnical elements, improving performance. Residents in the PSBL group were more confident and effective in performing LP. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Methylmercury exposure and neurological outcomes in Taiji residents accustomed to consuming whale meat. (United States)

    Nakamura, Masaaki; Hachiya, Noriyuki; Murata, Ken-ya; Nakanishi, Ichiro; Kondo, Tomoyoshi; Yasutake, Akira; Miyamoto, Ken-ichiro; Ser, Ping Han; Omi, Sanae; Furusawa, Hana; Watanabe, Chiho; Usuki, Fusako; Sakamoto, Mineshi


    Methylmercury (MeHg) is a major environmental neurotoxicant that causes damage to the central nervous system. In Japan, industrial emission of MeHg has resulted in MeHg intoxication in Minamata and Niigata, the so-called Minamata disease. Humans are exposed to MeHg derived from natural sources, primarily fish and fish predators. Therefore, MeHg continues to be an environmental risk to human health, particularly in susceptible populations that frequently consume substantial amounts of fish or fish predators such as whale. This study aimed to investigate the health effects of MeHg exposure in adults. The subjects were 194 residents (117 males, 77 females; age 20-85 years) who resided in the coastal town of Taiji, the birthplace of traditional whaling in Japan. We analyzed hair for mercury content and performed detailed neurological examinations and dietary surveys. Audiometry, magnetic resonance imaging, and electromyography were performed to diagnose neurological defects. Whole blood mercury and selenium (Se) levels were measured in 23 subjects. The geometric mean of the hair mercury levels was 14.9 μg/g. Twelve subjects revealed hair mercury levels >50 μg/g (NOAEL) set by WHO. Hair mercury levels significantly correlated with daily whale meat intake. These results suggested that residents in Taiji were highly exposed to MeHg by ingesting MeHg-contaminated whale meat. Multivariate regression analysis demonstrated no significant correlations between hair mercury levels and neurological outcomes, whereas some of the findings significantly correlated with age. A significantly positive correlation between whole blood mercury and Se levels was observed and the whole blood mercury/Se molar ratios of all subjects were exposure in this study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. What is the Future of Pediatric Neurology in Canada? Resident and Faculty Perceptions of Training and Workforce Issues. (United States)

    Doja, Asif; Clarkin, Chantalle; Whiting, Sharon; Moharir, Mahendranath


    Pediatric neurology trainee numbers have grown considerably in Canada; recent research, however, has shown that the number of pediatric neurology graduates is outpacing the need for future pediatric neurologists. The purpose of this study was to seek the opinion of pediatric neurology program directors and trainees regarding possible solutions for this issue. Two focus groups were convened during the Canadian Neurological Sciences Federation annual congress in June 2012; one consisted of current and former program directors, and the other of current pediatric neurology trainees. Groups were asked for their perceptions regarding child neurology manpower issues in Canada as well as possible solutions. Focus groups were audio-recorded and transcribed for analysis. Theme-based qualitative analysis was used to analyze the transcripts. Major themes emerging from both focus groups included the emphasis on community pediatric neurology as a viable option for trainees, including the need for community mentors; recognizing the needs of underserviced areas; and establishing academic positions for community preceptors. The need for career mentoring and support structures during residency training was another major theme which arose. Program directors and trainees also gave examples of ways to reduce the current oversupply of trainees in Canada, including limiting the number of trainees entering programs, as well as creating a long-term vision of child neurology in Canada. A nationwide dialogue to discuss the supply and demand of manpower in academic and community pediatric neurology is essential. Career guidance options for pediatric neurology trainees across the country merit further strengthening.

  2. Utility of Combining a Simulation-Based Method With a Lecture-Based Method for Fundoscopy Training in Neurology Residency. (United States)

    Gupta, Deepak K; Khandker, Namir; Stacy, Kristin; Tatsuoka, Curtis M; Preston, David C


    Fundoscopic examination is an essential component of the neurologic examination. Competence in its performance is mandated as a required clinical skill for neurology residents by the American Council of Graduate Medical Education. Government and private insurance agencies require its performance and documentation for moderate- and high-level neurologic evaluations. Traditionally, assessment and teaching of this key clinical examination technique have been difficult in neurology residency training. To evaluate the utility of a simulation-based method and the traditional lecture-based method for assessment and teaching of fundoscopy to neurology residents. This study was a prospective, single-blinded, education research study of 48 neurology residents recruited from July 1, 2015, through June 30, 2016, at a large neurology residency training program. Participants were equally divided into control and intervention groups after stratification by training year. Baseline and postintervention assessments were performed using questionnaire, survey, and fundoscopy simulators. After baseline assessment, both groups initially received lecture-based training, which covered fundamental knowledge on the components of fundoscopy and key neurologic findings observed on fundoscopic examination. The intervention group additionally received simulation-based training, which consisted of an instructor-led, hands-on workshop that covered practical skills of performing fundoscopic examination and identifying neurologically relevant findings on another fundoscopy simulator. The primary outcome measures were the postintervention changes in fundoscopy knowledge, skills, and total scores. A total of 30 men and 18 women were equally distributed between the 2 groups. The intervention group had significantly higher mean (SD) increases in skills (2.5 [2.3] vs 0.8 [1.8], P = .01) and total (9.3 [4.3] vs 5.3 [5.8], P = .02) scores compared with the control group. Knowledge scores (6.8 [3

  3. Evaluation of the thermal comfort in conventional and innovative residences of “Projeto CASA”, Unioeste, Campus of Cascavel - doi: 10.4025/actascitechnol.v34i1.10875

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Camargo Nogueira


    Full Text Available This study aimed to compare the thermal comfort levels in conventional and innovative residences of Projeto CASA (Center of Alternative Energy System Analysis from UNIOESTE – campus of Cascavel. The measures of the thermal comfort parameters were accomplished using digital thermo-hygrometers, in all of the rooms of the residences and in the outer area, in different hours of the day. We used the Temperature and Humidity Index to compare the obtained results. The innovative residence presented lower values of Temperature and Humidity Index than the conventional residence, justifying its differentiated architecture in order to obtain a higher thermal comfort.

  4. Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program. (United States)

    Moradiya, Yogesh; Crystal, Howard; Valsamis, Helen; Levine, Steven R


    We aimed to compare the rates of thrombolysis utilization for acute ischemic stroke in hospitals with neurology residency (NR) to those of other teaching (OT) and nonteaching (NT) hospitals. A retrospective serial cross-sectional cohort study of a nationally representative sample of stroke patients was conducted. Accreditation Council for Graduate Medical Education-accredited NR program-affiliated hospitals in the United States were cross-matched to the hospitals in the Nationwide Inpatient Sample from 2000 to 2010. ICD-9-CM codes were used for case ascertainment. A total of 712,433 adult ischemic stroke patients from 6,839 hospital samples were included, of whom 10.1%, 29.1%, and 60.8% were treated in NR, OT, and NT hospitals, respectively. Stroke patients in NR received thrombolysis more frequently (3.74% ± 0.24% [standard error]) than in OT (2.28% ± 0.11%, p < 0.001) and NT hospitals (1.44% ± 0.06%, p < 0.001). The adjusted odds ratios (ORs) of thrombolysis rates in NR vs OT and NR vs NT increased with each decade increment in age. In multivariate analysis, NR was independently predictive of higher thrombolysis rate (adjusted OR 1.51; 95% confidence interval [CI] 1.44-1.59 [NR vs OT], and adjusted OR 1.82; 95% CI 1.73-1.91 [NR vs NT]). Acute stroke care in NR hospitals is associated with an increased thrombolytic utilization. The disparities between the thrombolysis rate in NR and that in OT and NT hospitals are greater among elderly patients.

  5. Navigating the Strait of Magellan: mapping a new paradigm for neurosurgical residency training. Presidential address to the Society of Neurological Surgeons, May 7, 2007. (United States)

    Popp, A John


    At the conclusion of his year as 81st president of the Society of Neurological Surgeons, the author delivered the following address at the 2007 annual meeting of the Society of Neurological Surgeons in San Francisco. In his address, Dr. Popp used the voyage of Ferdinand Magellan to illustrate the present climate affecting residency training and why the current training paradigm must be examined and, where necessary, changed. Based on this call to action the leaders of the American Association of Neurological Surgeons, The American Board of Neurological Surgeons, The Congress of Neurological Surgeons, The Council of State Neurosurgical Societies, The Residency Review Committee for Neurosurgery, The Society of Neurological Surgeons, and the Washington Committee for Neurosurgery agreed to hold an unprecedented Education Summit meeting to investigate a comprehensive approach to evaluating and changing the current neurosurgical residency training model.

  6. Clinical Identification of Dysarthria Types among Neurologists, Residents in Neurology and Speech Therapists

    NARCIS (Netherlands)

    van der Graaff, M.; Kuiper, T.; Zwinderman, A.; van de Warrenburg, B.; Poels, P.; Offeringa, A.; van der Kooi, A.; Speelman, H.; de Visser, M.


    Background: Classification of dysarthria types comprises flaccid, spastic, ataxic, hypo- and hyperkinetic and mixed dysarthria. This study focussed on the ability of neurologists to clinically identify the correct type of dysarthria in neurological patients. Methods: Eighteen patients with

  7. Clinical identification of dysarthria types among neurologists, residents in neurology and speech therapists.

    NARCIS (Netherlands)

    Graaff, M. Van der; Kuiper, T.; Zwinderman, A.; Warrenburg, B.P.C. van de; Poels, P.J.E.; Offeringa, A.; Kooi, A. van der; Speelman, H.D.; Visser, M. de


    BACKGROUND: Classification of dysarthria types comprises flaccid, spastic, ataxic, hypo- and hyperkinetic and mixed dysarthria. This study focussed on the ability of neurologists to clinically identify the correct type of dysarthria in neurological patients. METHODS: Eighteen patients with

  8. Ambulatory Care Skills: Do Residents Feel Prepared?

    Directory of Open Access Journals (Sweden)

    Denise Bonds


    Full Text Available Objective: To determine resident comfort and skill in performing ambulatory care skills. Methods: Descriptive survey of common ambulatory care skills administered to internal medicine faculty and residents at one academic medical center. Respondents were asked to rate their ability to perform 12 physical exam skills and 6 procedures, and their comfort in performing 7 types of counseling, and obtaining 6 types of patient history (4 point Likert scale for each. Self-rated ability or comfort was compared by gender, status (year of residency, faculty, and future predicted frequency of use of the skill. Results: Residents reported high ability levels for physical exam skills common to both the ambulatory and hospital setting. Fewer felt able to perform musculoskeletal, neurologic or eye exams easily alone. Procedures generally received low ability ratings. Similarly, residents’ comfort in performing common outpatient counseling was also low. More residents reported feeling very comfortable in obtaining history from patients. We found little variation by gender, year of training, or predicted frequency of use. Conclusion: Self-reported ability and comfort for many common ambulatory care skills is low. Further evaluation of this finding in other training programs is warranted.

  9. Thermal comfort

    DEFF Research Database (Denmark)

    d’Ambrosio Alfano, Francesca Romana; Olesen, Bjarne W.; Palella, Boris Igor


    Thermal comfort is one of the most important aspects of the indoor environmental quality due to its effects on well-being, people's performance and building energy requirements. Its attainment is not an easy task requiring advanced design and operation of building and HVAC systems, taking...... under specific conditions. At operation level, only few variables are taken into account with unpredictable effects on the assessment of comfort indices. In this paper, the main criteria for the design and assessment of thermal comfort are discussed in order to help building and HVAC systems designers...... into account all parameters involved. Even though thermal comfort fundamentals are consolidated topics for more than forty years, often designers seem to ignore or apply them in a wrong way. Design input values from standards are often considered as universal values rather than recommended values to be used...

  10. Thermal comfort

    CSIR Research Space (South Africa)

    Osburn, L


    Full Text Available wider range of temperature limits, saving energy while still satisfying the majority of building occupants. It is also noted that thermal comfort varies significantly between individuals and it is generally not possible to provide a thermal environment...

  11. The tablet device in hospital neurology and in neurology graduate medical education: a preliminary study. (United States)

    George, Pravin; Newey, Christopher R; Bhimraj, Adarsh


    There is limited literature on tablet devices for neurohospitalists and in neurological graduate medical education. This study evaluated utilization, benefits, and limitations of customized tablets on inpatient neurology practice and resident education. The hypothesis was the perception of the tablet would be positive, given their portability, convenience to accessing point-of-care reference, and accessibility to the electronic medical record. Second-generation iPads with neurology-specific applications and literature were provided to our in-hospital general, stroke, and consult neurology teams. After 1 year, residents on these teams were surveyed on demographic data, familiarity, and utilization of the iPad and their perceptions of the device. All 27 residents responded to the survey. Most participants (23 of 27) used a tablet while on inpatient service. Twelve regularly utilized the neurology-specific apps and/or accessed scientific articles. Technologically savvy residents felt significantly more comfortable using tablets and were more quickly acquainted with the features. Thirteen respondents wanted a formal orientation on the advanced features of the tablet independent of their familiarity with the device or level of technological comfort. Overall, the perception was that the tablet was beneficial for inpatient clinical care and as an educational reference. Participants became easily familiarized with the device features quickly, regardless of whether they owned one previously or not. Most physicians indicated interest in advanced features of tablets; however, a formal orientation may be beneficial for optimal utilization. A reliable network connection is essential to in-hospital use of tablet devices. Additional research pertaining to patient outcomes, objective educational benefit, and cost-effectiveness is necessary.

  12. Avaliação do conforto térmico nas residências convencional e inovadora do “Projeto CASA”, Unioeste, Campus de Cascavel=Evaluation of the thermal comfort in conventional and innovative residences of “Projeto CASA”, Unioeste, Campus of Cascavel

    Directory of Open Access Journals (Sweden)

    Naimara Vieira do Prado


    Full Text Available Este trabalho teve por objetivo comparar os níveis de conforto térmico nas residências convencional e inovadora do Projeto CASA (Centro de Análise de Sistemas Alternativos de Energia da Unioeste – campus de Cascavel, Estado do Paraná. As medidas dos parâmetros de conforto térmico foram realizadas com a utilização de termo-higrômetros digitais, nos diversos cômodos das residências e na área externa, em diferentes horas do dia. Foi utilizado o Índice de Temperatura e Umidade (ITU para comparar os resultados obtidos. Verificou-se que a residência inovadora apresentou Índices de Temperatura e Umidade menores que os verificados na casa convencional, justificando sua arquitetura diferenciada para a obtenção de um maior conforto térmico.This study aimed to compare the thermal comfort levels in conventional and innovative residences of Projeto CASA (Center of Alternative Energy System Analysis from UNIOESTE – campus of Cascavel. The measures of the thermal comfort parameters were accomplished using digital thermo-hygrometers, in all of the rooms of the residences and in the outer area, in different hours of the day. We used the Temperature and Humidity Index to compare the obtained results. The innovative residence presented lower values of Temperature and Humidity Index than the conventional residence, justifying its differentiated architecture in order to obtain a higher thermal comfort.

  13. Northern comfort

    DEFF Research Database (Denmark)

    Makkonen, Teemu


    -local networks are at least as important as local ones for this music genre to thrive in a particular location. In addition, record deals are more important than geographical scales in explaining variances in networking within the genre. Thus, contrary to the recent literature underlining the role......There is a limited geographical literature on the evolution of networks in distinct music genres. This gap is addressed here via an analysis of empirical evidence on the Finnish metal music genre, specifically utilising a questionnaire survey of Finnish metal music bands. The results show that......, in terms of networking, local buzz is more important for bands that reside in large cities compared to those from small localities. However, even small towns can host creative teams, as the bands in smaller (peripheral) localities network through extra-local (global) pipelines. Consequently, extra...

  14. Education Research: Neurology training reassessed (United States)

    Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John


    Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training. PMID:23091077

  15. [Comfort: a concept analysis]. (United States)

    Tsai, Jia-Ling; Lee, Ya-Ling; Hu, Wen-Yu


    Comfort is an important concept and core value of nursing. The defining attributes, antecedents and consequences of comfort need further analysis and exploration, even though the concept of comfort has been addressed previously in nursing literature. We employed the strategies of concept analysis as described by Walker&Avant (2005) to analyze the concept of comfort. The defining attributes of comfort include: 1) effective communication; 2) family and meaningful relationships; 3) maintaining functionality; 4) self-characteristics; 5) physical symptom relief, states, and interventions; 6) psychological, spiritual activities and states; and 7) a sense of safety and security. Antecedents consist of discomfort, distress and suffering. Consequences consist of (1) met/satisfied needs; (2) increased sense of control; (3) sense of inner peace; (4) a pleasant experience; (5) feeling cared for; (6) relief of symptoms; (7) reduced suffering; (8) decreased disequilibrium; and (9) absence of discomfort. We also outline the construction of cases, empirical references and comfort measurement tools. Analysis found comfort to have multiple dimensions and confirmed it as a clinical issue that should receive greater emphasis and valuation. Findings are hoped to increase nurse understanding of the concept of comfort and enable nurses to evaluate level of comfort and follow up on variations in such using empirical tools. Concept analysis can guide further comfort related interventions and research to benefit patients.

  16. Comfort food: A review


    Spence, C


    Everyone has heard of comfort foods, but what exactly are they, and what influence, if any, do they actually have over our mood? In this review, I summarize the literature on this important topic, highlighting the role that comfort foods play in alleviating loneliness by priming positive thoughts of previous social interactions, at least amongst those who are securely attached. The evidence concerning individual differences in the kinds of food that are likely to constitute comfort food for d...

  17. Cancer Patients Caregivers Comfort

    Directory of Open Access Journals (Sweden)

    Daniela de Araújo Lamino


    Full Text Available Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ to assess the caregivers’ comfort. The caregivers’ GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. Caregivers, who didn’t have a paid job or leisure’s activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers’ comfort, as well as needs that can be modified through health professionals’ interventions.

  18. Palliative or Comfort Care (United States)

    ... and communication among family members and providers of care. Palliative care can improve your quality of life when ... control Need help understanding your situation and coordinating care PALLIATIVE OR COMFORT CARE Often a team of specialists ...

  19. Comfort Foods and Mood (United States)


    Comfort Foods and Mood Tracy Sbrocco, Ph.D. Assoc. Prof. Dept Medical & Clinical Psychology Uniformed Services University QuickTime™ and a...ORGANIZATION NAME(S) AND ADDRESS(ES) Dept Medical & Clinical Psychology Uniformed Services University Bethesda, MD 8. PERFORMING ORGANIZATION REPORT NUMBER...Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Overview • Stress & eating • Does food improve mood? • Emotional eating • Comfort Foods

  20. Parental involvement in neonatal comfort care. (United States)

    Skene, Caryl; Franck, Linda; Curtis, Penny; Gerrish, Kate


    To explore how parents interact with their infants and with nurses regarding the provision of comfort care in a Neonatal Intensive Care Unit (NICU). Focused ethnography. A regional NICU in the United Kingdom. Eleven families (10 mothers, 8 fathers) with infants residing in the NICU participated in the study. Parents were observed during a caregiving interaction with their infants and then interviewed on up to four occasions. Twenty-five periods of observation and 24 semistructured interviews were conducted between January and November 2008. Five stages of learning to parent in the NICU were identified. Although the length and duration of each stage differed for individual parents, movement along the learning trajectory was facilitated when parents were involved in comforting their infants. Transfer of responsibility from nurse to parents for specific aspects of care was also aided by parental involvement in pain care. Nurses' encouragement of parental involvement in comfort care facilitated parental proximity, parent/infant reciprocity, and parental sense of responsibility. Findings suggest that parental involvement in comfort care can aid the process of learning to parent, which is difficult in the NICU. Parental involvement in infant comfort care may also facilitate the transfer of responsibility from nurse to parent and may facilitate antecedents to parent/infant attachment. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  1. Comfort measures: a concept analysis. (United States)

    Oliveira, Irene


    Reference to the concept of comfort measures is growing in the nursing and medical literature; however, the concept of comfort measures is rarely defined. For the comfort work of nurses to be recognized, nurses must be able to identify and delineate the key attributes of comfort measures. A concept analysis using Rodgers' evolutionary method (2000) was undertaken with the goal of identifying the core attributes of comfort measures and thereby clarifying this concept. Health care literature was accessed from the CINAHL and PubMed databases. No restrictions were placed on publication dates. Four main themes of attributes for comfort measures were identified during the analysis. Comfort measures involve an active, strategic process including elements of "stepping in" and "stepping back," are both simple and complex, move from a physical to a holistic perspective and are a part of supportive care. The antecedents to comfort measures are comfort needs and the most common consequence of comfort measures is enhanced comfort. Although the concept of comfort measures is often associated with end-of-life care, this analysis suggests that comfort measures are appropriate for nursing care in all settings and should be increasingly considered in the clinical management of patients who are living with multiple, chronic comorbidities.

  2. Broadening End-of-Life Comfort to Improve Palliative Care Practices in Long Term Care. (United States)

    Sussman, Tamara; Kaasalainen, Sharon; Mintzberg, Susan; Sinclair, Shane; Young, Laurel; Ploeg, Jenny; Bourgeois-Guérin, Valérie; Thompson, Genevieve; Venturato, Lorraine; Earl, Marie; Strachan, Patricia; You, John J; Bonifas, Robin; McKee, Margaret


    This study aimed to (1) explore how palliative care in long-term care (LTC) addresses the tensions associated with caring for the living and dying within one care community, and (2) to inform how palliative care practices may be improved to better address the needs of all residents living and dying in LTC as well as those of the families and support staff. This article reports findings from 19 focus groups and 117 participants. Study findings reveal that LTC home staff, resident, and family perspectives of end-of-life comfort applied to those who were actively dying and to their families. Our findings further suggest that eliciting residents' perceptions of end-of-life comfort, sharing information about a fellow resident's death more personally, and ensuring that residents, families, and staff can constructively participate in providing comfort care to dying residents could extend the purview of end-of-life comfort and support expanded integration of palliative principles within LTC.

  3. Acoustic comfort in eating establishments

    DEFF Research Database (Denmark)

    Svensson, David; Jeong, Cheol-Ho; Brunskog, Jonas


    The subjective concept of acoustic comfort in eating establishments has been investigated in this study. The goal was to develop a predictive model for the acoustic comfort, by means of simple objective parameters, while also examining which other subjective acoustic parameters could help explain...... the feeling of acoustic comfort. Through several layers of anal ysis, acoustic comfort was found to be rather complex, and could not be explained entirely by common subjective parameters such as annoyance, intelligibility or privacy. A predictive model for the mean acoustic comfort for an eating establishment...

  4. Why neurology? Factors which influence career choice in neurology. (United States)

    Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V


    To evaluate the factors which influence the decision to pursue a career in neurology. An anonymous survey was developed using a Likert scale to rate responses. The survey was sent to adult and child neurology faculty, residents and fellows, as well as medical students applying for neurology. Descriptive statistics were used to analyse the factors of influence. Respondents were subsequently categorized into pre-neurology trainees, neurology trainees, child neurologists and adult neurologists, and differences between the groups were analysed using Pearson's chi-square test. One hundred and thirty-three anonymous responses were received. The respondents were neurologists across all levels of training and practice. Across all respondents, the most common factor of high importance was intellectual content of specialty, challenging diagnostic problems, type of patient encountered and interest in helping people. Responses were similar across the groups; however, the earliest trainees cited interest in helping people as most important, while those in neurology training and beyond cite intellectual content of the specialty as most important. As trainees transition from their earliest levels of clinical experience into working as residents and faculty, there is a shift in the cited important factors. Lifestyle and financial factors seem to be the least motivating across all groups. Encouragement from peers, mentors, faculty and practicing physicians is considered high influences in a smaller number of neurologists. This may present an opportunity for practicing neurologists to make connections with medical students early in their education in an effort to encourage and mentor candidates.

  5. The myth of comfort food. (United States)

    Wagner, Heather Scherschel; Ahlstrom, Britt; Redden, Joseph P; Vickers, Zata; Mann, Traci


    People seek out their own idiosyncratic comfort foods when in negative moods, and they believe that these foods rapidly improve their mood. The purpose of these studies is to investigate whether comfort foods actually provide psychological benefits, and if so, whether they improve mood better than comparison foods or no food. Participants first completed an online questionnaire to indicate their comfort foods and a variety of comparison foods. During two lab sessions a week apart from each other (and at least a week after the online questionnaire, counterbalanced in order), participants watched films that induced negative affect. In one session, participants were then served their comfort food. In the other, participants were served an equally liked noncomfort food (Study 1), a neutral food (Study 2), or no food (Studies 3 and 4). Short-term mood changes were measured so that we could seek out psychological effects of these foods, rather than biochemical effects on mood from particular food components (e.g., sugars or vitamins). Comfort foods led to significant improvements in mood, but no more than other foods or no food. Although people believe that comfort foods provide them with mood benefits, comfort foods do not provide comfort beyond that of other foods (or no food). These results are likely not due to a floor effect because participants' moods did not return to baseline levels. Individuals may be giving comfort food "credit" for mood effects that would have occurred even in the absence of the comfort food.

  6. International electives in neurology training (United States)

    Lyons, Jennifer L.; Coleman, Mary E.; Engstrom, John W.


    Objective: To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. Background: There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. Methods: A survey was distributed to all program directors in the United States and Canada (December 2012–February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Results: Approximately half of responding programs (53%) allow residents to pursue global health–related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%–9% of residents (55% of programs) and 10%–19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. Conclusions: In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority

  7. Comfort model for automobile seat. (United States)

    da Silva, Lizandra da; Bortolotti, Silvana Ligia Vincenzi; Campos, Izabel Carolina Martins; Merino, Eugenio Andrés Díaz


    Comfort on automobile seats is lived daily by thousands of drivers. Epistemologically, comfort can be understood under the theory of complexity, since it emerges from a chain of interrelationships between man and several elements of the system. This interaction process can engender extreme comfort associated to the feeling of pleasure and wellbeing or, on the other hand, lead to discomfort, normally followed by pain. This article has for purpose the development of a theoretical model that favours the comfort feature on automobile seats through the identification of its facets and indicators. For such, a theoretical study is resorted to, allowing the mapping of elements that constitute the model. The results present a comfort model on automobile seats that contemplates the (physical, psychological, object, context and environment) facets. This model is expected to contribute with the automobile industry for the development of improvements of the ergonomic project of seats to increase the comfort noticed by the users.

  8. Materialities shape practices and notions of comfort in everyday life

    DEFF Research Database (Denmark)

    Madsen, Line Valdorff


    The development of residential energy technologies aims to ensure thermal comfort in an increasingly energy-efficient manner. This development influences everyday practices related to comfort in everyday life in dwellings. Therefore, an empirical analysis of interviews with residents in three types...... of Danish detached houses, related to the building age, is used to understand how changes in technologies influence residents’ practices and notions of comfort. Detached houses are the most widespread type of housing in Denmark, constituting 44% of the housing stock. The analysis focuses on differences...... in heating systems between the housing types and shows how changes in technologies and material structures shape the practices of heating and airing. A shift in technology from radiators to underfloor heating was found to make a clear difference in both how houses are heated and thermal comfort is perceived...

  9. Feeling Comfortable: A Humanbecoming Perspective. (United States)

    Dobrzykowski, Teresa M


    Feeling comfortable is a universal living experience. From the worldview of the humanbecoming paradigm, concept inventing is an appropriate method to expand understanding and knowledge of universal experiences. The purpose of this article is to provide a synthetic definition of feeling comfortable using the concept inventing process. Through concept inventing, a synthetic definition of feeling comfortable emerged as penetrating quietude amid potential upheaval arising with opportunities and restrictions with envisioning the familiar anew. Further development of the concept through qualitative research is recommended.

  10. Honeywell: Comfort and economy

    Energy Technology Data Exchange (ETDEWEB)

    Lukaszewski, J.


    The presentation of the Company starts with having it ranked among the ones operating on the customers` market or those acting on the professional market. But it is not so. Honeywell is beyond such simple criteria. We are a company supplying products, systems and services related with generally conceived automatic control engineering, yet the operational range does comprise so many apparently diversified fields, for instance automatic control in aeronautics, heavy power engineering, building of apartment buildings, detached houses, heat engineering and some others. Nevertheless, our targets are always the same: maximum increase in efficiency and reliability of the process lines controlled by our systems as well as securing the best comfort of work and rest for people who stay in the buildings controlled by our devices. Simultaneously, the utilization of energy sources and the natural environment resources must be as sensible as possible.

  11. Everyday Comfort Practice

    DEFF Research Database (Denmark)

    Jaffari, Svenja

    climate and technology. This thesis' basic point of departure is the triangular problematic between building design with standardized indoor climate, energy costs and inhabitants' behaviors. By convention sustainable buildings are developed to relatively seal inside building features and occupants from...... the outdoor. This can be seen, for instance, in 'tight' low-energy buildings that host indoor climate products, which are often controlled by automated systems, to deliver optimal comfort conditions (i.e. temperature, humidity, air quality, noise, and light) to occupants. Buildings' indoor climate is designed...... according to international building codes and standards, which are being based on engineering scientists' controlled experiments, classfiication and analysis. Since the last two decades, scholars from a diverse range of disciplines, such as sociology, anthropology, philosophy, adaptive engineering...

  12. Hoof Comfort for Horses (United States)


    Aquila Equine Enhancement Products, Inc., of Woburn, Massachusetts, developed magnetic hoof protector pads, called "Power Pads," which support and cushion the impact on a horse's hooves and legs to provide comfort and protection against injuries. The pads were tested by Marshall Space Flight Center's Materials and Processing Laboratory for strength and durability. Putting the pads on a horse does not interfere with its natural movement or flexibility and can be compared to a person changing into athletic shoes for a sporting event. The pads are cut to the appropriate size, and then mounted onto a horse's hooves using conventional shoeing methods. Once attached, the pads protect the hard and soft parts of the hoof by cushioning blows against the hard ground. The design also protects the vulnerable "heel" of the hoof. They are a cost-effective way to protect a horse's hooves since they can be reused.

  13. Program Director Survey: Attitudes Regarding Child Neurology Training and Testing. (United States)

    Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L


    As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program

  14. does knowledge influence their attitude and comfort in rendering care?

    African Journals Online (AJOL)


    experience, age and being a consultant or a senior resident influenced attitude, while male gender and knowing someone with AIDS influenced global comfort. Knowledge is weakly ... attitudes are biases and stereotypes and could only be mediated through the socialization process during training [1]. It is plausible that ...

  15. Improving the comfort of garments

    CSIR Research Space (South Africa)

    Hunter, L


    Full Text Available refers to the human body’s ability to maintain life. Psychological comfort refers to the mind’s ability to keep functioning satisfactorily without external help. Physical comfort refers to the effects of the external environment on the body’s...

  16. Thermal comfort: research and practice

    NARCIS (Netherlands)

    Mitja Mazej; Jan Hensen; Ir. Joost van Hoof


    Thermal comfort -the state of mind, which expresses satisfaction with the thermal environment- is an important aspect of the building design process as modern man spends most of the day indoors. This paper reviews the developments in indoor thermal comfort research and practice since the second half

  17. Combining thermal comfort models

    Energy Technology Data Exchange (ETDEWEB)

    Yigit, A.


    Two models commonly used in thermal comfort studies were combined to develop a two-dimensional computer model that estimates the resistance to dry and evaporative heat transfer for a clothing system from fabric resistance data, fabric thickness data, and information concerning the amount of body surface area covered by different fabric layers and the amount of air trapped between fabric layers. Five different clothing ensembles with different total thermal insulation and very different distributions of the insulation on the body were simulated with 16 sedentary subjects. This paper first evaluates total thermal insulation predictions from the Fanger steady-state model and then uses these data in the Gagge two-compartment (or two-node) model. The combined model uses the transient heat balance of each segment and the whole body. It estimates total insulation value and then uses this value to calculate transient temperature and wettedness. By application of the combined model, predictions of human responses to a wide range of thermal conditions are compared with the responses of human subjects as described in reports of laboratory experiments. Possible reasons for discrepancies between the observed data and predictions of the model are briefly discussed.

  18. Adaptive Thermal Comfort in Japanese Houses during the Summer Season: Behavioral Adaptation and the Effect of Humidity

    Directory of Open Access Journals (Sweden)

    Hom B. Rijal


    Full Text Available In order to clarify effect of humidity on the room temperatures reported to be comfortable, an occupant thermal comfort and behavior survey was conducted for five summers in the living rooms and bedrooms of residences in the Kanto region of Japan. We have collected 13,525 thermal comfort votes from over 239 residents of 120 homes, together with corresponding measurements of room temperature and humidity of the air. The residents were generally well-satisfied with the thermal environment of their houses, with or without the use of air-conditioning, and thus were well-adapted to their thermal conditions. The humidity was found to have very little direct effect on the comfort temperature. However, the comfort temperature was strongly related to the reported skin moisture. Behavioral adaptation such as window opening and fan use increase air movement and improve thermal comfort.

  19. Comfort and experience with online learning: trends over nine years and associations with knowledge. (United States)

    Cook, David A; Thompson, Warren G


    Some evidence suggests that attitude toward computer-based instruction is an important determinant of success in online learning. We sought to determine how comfort using computers and perceptions of prior online learning experiences have changed over the past decade, and how these associate with learning outcomes. Each year from 2003-2011 we conducted a prospective trial of online learning. As part of each year's study, we asked medicine residents about their comfort using computers and if their previous experiences with online learning were favorable. We assessed knowledge using a multiple-choice test. We used regression to analyze associations and changes over time. 371 internal medicine and family medicine residents participated. Neither comfort with computers nor perceptions of prior online learning experiences showed a significant change across years (p > 0.61), with mean comfort rating 3.96 (maximum 5 = very comfortable) and mean experience rating 4.42 (maximum 6 = strongly agree [favorable]). Comfort showed no significant association with knowledge scores (p = 0.39) but perceptions of prior experiences did, with a 1.56% rise in knowledge score for a 1-point rise in experience score (p = 0.02). Correlations among comfort, perceptions of prior experiences, and number of prior experiences were all small and not statistically significant. Comfort with computers and perceptions of prior experience with online learning remained stable over nine years. Prior good experiences (but not comfort with computers) demonstrated a modest association with knowledge outcomes, suggesting that prior course satisfaction may influence subsequent learning.

  20. Averting comfortable lifestyle crises. (United States)

    Bilton, Rod


    : alternative non-sugar sweeteners; toxic side-effects of aspartame. Stevia and xylitol as healthy sugar replacements; the role of food processing in dietary health; and beneficial effects of resistant starch in natural and processed foods. The rise of maize and soya-based vegetable oils have led to omega-6 fat overload and imbalance in the dietary ratio of omega-3 to omega-6 fats. This has led to toxicity studies with industrial trans fats; investigations on health risks associated with stress and comfort eating; and abdominal obesity. Other factors to consider are: diet, cholesterol and oxidative stress, as well as the new approaches to the chronology of eating and the health benefits of intermittent fasting.

  1. Exergy analysis of thermal comfort


    Prek, Matjaž


    Traditional methods of human thermal comfort are based on the first law of thermodynamics. These methods use an energy balance of the human body to determine heat transfer between the body and its environment. By contrast, thesecond law of thermodynamics introduces the concept of exergy. It enables the determination of exergy consumption within the human body dependent on personal and environmental factors. We show that the existing methods of comfort assessment could be further expanded by t...

  2. The Child Neurology Trainee-as-Teacher: A Clinical Teaching Curriculum Tailored to Learners' Needs and Developmental Roles. (United States)

    Bernson-Leung, Miya E; Urion, David K


    Clinical teaching skills programs for resident physicians are increasingly offered. Less attention has been devoted to the unique educational roles of specialty residents and subspecialty fellows, many of whom will become academic faculty physicians. These teaching roles, and therefore a trainee's learning needs and motivation, also change over the course of training. We designed and implemented a two-year longitudinal teaching curriculum for child neurology and neurodevelopmental disabilities residents using adult learning theory principles: experiential learning and immediate applicability to specific roles. Core modules included teaching in clinical settings, adult learning, and giving feedback. Training-year-specific modules for second-year residents (n = 11) and final-year residents (n = 10) included teaching through consultation and promoting clinical reasoning in supervisory roles. Learners completed an 11-item self-assessment before and after intervention. The overall program significantly increased residents' self-assessed knowledge of how to assess the level of a learner (P = 0.02, Cohen d = 0.84) and comfort and skill in giving feedback (P = 0.04, d = 0.64; P = 0.04, d = 0.71). The final-year-specific curriculum additionally increased self-assessed skill in teaching same-specialty residents (P = 0.05, d = 1.07) and in promoting clinical reasoning (P = 0.03, d = 1.14). The program was rated highly by trainees and faculty, and has been adopted as an ongoing part of our training program. Our experience offers a reproducible model and theoretical framework for child neurology, neurodevelopmental disabilities, and other specialty programs to develop customized trainee-as-teacher curricula with specialty- and training-year-specific content. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Advocacy in neurology

    National Research Council Canada - National Science Library

    Pauranik, Apoorva


    ...), launched the Neurological Alliance of Ireland, a nationwide coalition of patient advocacy groups and physicians and authored Standards of Care, the "blueprint" for the development of neurological...

  4. Evaluation of global comfort for train passengers


    Leonardi, Giovanni; Ferrara, Riccardo


    International audience; The aim of this study is to propose a method for the evaluation of railway passengers' comfort in relationship to temperature, noise, and vibration. Estimated the single comfort for every sensation considered, the global comfort is evaluated with the Hyper-Sphere Method proposed by Corriere & Lo Bosco [1]. The humanvehicle- infrastructure-environment variables which influence comfort are individuated. Thus their value and correspondent global comfort could be evaluated...

  5. Sports neurology topics in neurologic practice (United States)

    Conidi, Francis X.; Drogan, Oksana; Giza, Christopher C.; Kutcher, Jeffery S.; Alessi, Anthony G.; Crutchfield, Kevin E.


    Summary We sought to assess neurologists' interest in sports neurology and learn about their experience in treating sports-related neurologic conditions. A survey was sent to a random sample of American Academy of Neurology members. A majority of members (77%) see at least some patients with sports-related neurologic issues. Concussion is the most common sports-related condition neurologists treat. More than half of survey participants (63%) did not receive any formal or informal training in sports neurology. At least two-thirds of respondents think it is very important to address the following issues: developing evidence-based return-to-play guidelines, identifying risk factors for long-term cognitive-behavioral sequelae, and developing objective diagnostic criteria for concussion. Our findings provide an up-to-date view of the subspecialty of sports neurology and identify areas for future research. PMID:24790800

  6. Beyond Comfort in Built Environments

    NARCIS (Netherlands)

    Bazley, C.M.


    Every person on the planet lives a significant portion of his or her life in a built indoor environment. Ideally, the built environment serves as protection from the extremes of the outdoor environment and is preferably comfortable. The first ‘built environment’ was a painted cave. The cave served

  7. MIT-Skywalker: Evaluating comfort of bicycle/saddle seat. (United States)

    Goncalves, Rogerio S; Hamilton, Taya; Daher, Ali R; Hirai, Hiroaki; Krebs, Hermano I


    The MIT-Skywalker is a robotic device developed for the rehabilitation of gait and balance after a neurological injury. This device has been designed based on the concept of a passive walker and provides three distinct training modes: discrete movement, rhythmic movement, and balance training. In this paper, we present our efforts to evaluate the comfort of a bicycle/saddle seat design for the system's novel actuated body weight support device. We employed different bicycle and saddle seats and evaluated comfort using objective and subjective measures. Here we will summarize the results obtained from a study of fifteen healthy subjects and one stroke patient that led to the selection of a saddle seat design for the MIT-Skywalker.

  8. A Sexuality Curriculum for Gynecology Residents (United States)

    Levine, Stephen B.; And Others


    The summary report of an educational research program conducted with the obstetrics and gynecology residents at University Hospitals of Cleveland in 1976 is presented. The goals were to provide residents with basic knowledge about female sexual problems, assess skill and comfort in interviewing patients with sexual problems, document the effects…

  9. Neurology and neurologic practice in China. (United States)

    Shi, Fu-Dong; Jia, Jian-Ping


    In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions.

  10. Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training. (United States)

    Gil, Joseph A; Daniels, Alan H; Akelman, Edward


    Background Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures. Objective The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume. Methods Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends. Results The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group. Conclusions There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training.

  11. Investigation of Comfort Temperature and Occupant Behavior in Japanese Houses during the Hot and Humid Season

    Directory of Open Access Journals (Sweden)

    Hom B. Rijal


    Full Text Available In order to clarify the comfort temperature and to investigate the behavioral adaptation in Japanese houses, we have conducted a thermal comfort survey and occupant behavior survey in 30 living rooms during the hot and humid season in the Kanto region of Japan. We collected 3991 votes from 52 subjects. The comfort temperature was predicted by Griffiths’ method. They are analyzed according to humidity levels and compared with the adaptive model. The logistic regression analysis was conducted in order to understand occupant behavior. The mean comfort temperature in naturally ventilated mode is 27.6 °C which is within the acceptable zone of the adaptive model. The comfort temperature is related with skin moisture sensation. The results showed that the residents adapt to the hot and humid environments by increasing the air movement using behavioral adaptation such as window opening and fan use.

  12. Comfort conditions in a bioclimatic building; Condiciones de confort en un edificio bioclimatico

    Energy Technology Data Exchange (ETDEWEB)

    Monne, C.; Turegano, J. A.


    In the present article we show the conditions of comfort reached in the residence of Proyecto Hombre (Turegano y Monne, 1996), designed under bioclimatic concepts, this using the study of the temperatures and relative humidity measured in the building during a period of one year. In the carried out study we distinguish the behaviour of each zone of the building, considering every period of the year, indicating the high level of comfort reached and the obtained thermal stability. (Author)

  13. Portable+: A Ubiquitous And Smart Way Towards Comfortable Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Jain, Milan [IIIT-Delhi; Singh, Amarjeet [IIIT-Delhi; Chandan, Vikas [Pacific Northwest National Laboratory


    An air conditioner (AC) consumes a significant proportion of the total household power consumption. Primarily used in developing countries, decentralised AC has an inbuilt thermostat to cool the room to a temperature, manually set by the users. However, residents are incapable of specifying their goal through these thermostats - maximise their comfort or save AC energy. State-of-the-art portable thermostats emulate AC remotes and assist occupants in remotely changing the thermostat temperature, through their smartphones. We propose extending such thermostats to portable+ by adding a Comfort-Energy Trade-off (CET) knob, realised through an optimisation framework to allow users to balance their comfort and the savings without worrying about the right set temperature. Analysis based on real data, collected from a controlled experiment (across two rooms for two weeks) and an in-situ deployment (across five rooms for three months), indicates that portable+ thermostats can reduce residents’ discomfort by 23% (CET selection for maximal comfort) and save 26% energy when CET is set for maximising savings.

  14. The relationship between comfort and knee angles

    NARCIS (Netherlands)

    Oudenhuijzen, A.J.K.; Tan, T.K.; Morsch, F.


    With rising customer expectations, driver comfort will become more and more important for car manufacturers in distinguishing themselves from others. This creates a design challenge, since it is difficult to predict comfort, especially in early design stages. Today, comfort can only be assessed and

  15. Emergency medicine residents' knowledge of mechanical ventilation. (United States)

    Wilcox, Susan R; Seigel, Todd A; Strout, Tania D; Schneider, Jeffrey I; Mitchell, Patricia M; Marcolini, Evie G; Cocchi, Michael N; Smithline, Howard A; Lutfy-Clayton, Lucienne; Mullen, Marie; Ilgen, Jonathan S; Richards, Jeremy B


    Although Emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) residency curricula. The objective of this study was to quantify EM residents' education, experience, and knowledge regarding mechanical ventilation. We developed a survey of residents' educational experiences with ventilators and an assessment tool with nine clinical questions. Correlation and regression analyses were performed to evaluate the relationship between residents' scores on the assessment instrument and their training, education, and comfort with ventilation. Of 312 EM residents, 218 responded (69.9%). The overall correct response rate for the assessment tool was 73.3%, standard deviation (SD) ± 22.3. Seventy-seven percent (n = 167) of respondents reported ≤ 3 h of mechanical ventilation education in their residency curricula over the past year. Residents reported frequently caring for ventilated patients in the ED, as 64% (n = 139) recalled caring for ≥ 4 ventilated patients per month. Fifty-three percent (n = 116) of residents endorsed feeling comfortable caring for mechanically ventilated ED patients. In multiregression analysis, the only significant predictor of total test score was residents' comfort with caring for mechanically ventilated patients (F = 10.963, p = 0.001). EM residents report caring for mechanically ventilated patients frequently, but receive little education on mechanical ventilation. Furthermore, as residents' performance on the assessment tool is only correlated with their self-reported comfort with caring for ventilated patients, these results demonstrate an opportunity for increased educational focus on mechanical ventilation management in EM residency training. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. It All Depends on Who Does What: A Survey of Patient and Family Member Comfort With Surgical Trainees Operating. (United States)

    Petravick, Michael E; Edgington, Jonathan P; Idowu, Olumuyiwa A; Shi, Lewis L; Lee, Michael J

    To measure patient and family member comfort with surgical trainees of varying levels performing different portions of surgery. An electronic survey dividing surgery into 6 steps (prepping and positioning, initial incision, deep dissection, critical portions, deep suturing, and closing incision), differentiating surgical trainees by 4 levels of experience (medical student, intern, resident, and fellow), and specifying whether or not an attending surgeon is in the operating room (OR) was given to 200 patients and family members in the surgical waiting area of a single academic medical center. Responses were on a 7-point Likert scale from "Not Comfortable at All" to "Completely Comfortable". Patient and family member comfort significantly increased as trainee experience increased. It reached a nadir for all trainees performing "critical portions" of surgery. However, their average response was "Comfortable" for residents and fellows performing any surgical step when the attending surgeon is present in the OR. The percentage of "Comfortable" responses was significantly lower for all trainee levels performing any surgical step when the attending surgeon is absent from the OR. Patient and family member comfort with surgical trainees operating varies based on the trainee's level of experience, the step the trainee performs, and whether or not the attending surgeon is present in the OR. Patients and family members are on average "Comfortable" with surgical residents and fellows performing any surgical step when the attending surgeon is present. Copyright © 2017. Published by Elsevier Inc.

  17. [Neurorehabilitation, neurology, rehabilitation medicine]. (United States)

    Urbán, Edina; Szél, István; Fáy, Veronika; Dénes, Zoltán; Lippai, Zoltán; Fazekas, Gábor


    We have read several publications of great authority on the neurological profession in the last two years in which were expressed assessments of the current situation combined with opinions about neurology and the necessity to reorganize neurological patient care. These articles took up the question of neurorehabilitation too. The authors, who on a daily basis, deal with the rehabilitation of people with disabilities as a consequence of neurological conditions, summarize some important definitions of rehabilitation medicine and the present system of neurological rehabilitation, as it is defined by the rehabilitation profession.

  18. Neurology at the bedside

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Waldemar, Gunhild

    This updated and expanded new edition takes neurology trainees by the hand and guides them through the whole patient encounter - from an efficient neurological history and bedside examination through to differential diagnosis, diagnostic procedures and treatment. At each step the expert authors......, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training....... Medical students, general practitioners and others with an interest in neurology will also find invaluable information here....

  19. [Charles Miller Fisher: a giant of neurology]. (United States)

    Tapia, Jorge


    C. Miller Fisher MD, one of the great neurologists in the 20th century, died in April 2012. Born in Canada, he studied medicine at the University of Toronto. As a Canadian Navy medical doctor he participated in World War II and was a war prisoner from 1941 to 1944. He did a residency in neurology at the Montreal Neurological Institute between 1946 and 1948, and later on was a Fellow in Neurology and Neuropathology at the Boston City Hospital. In 1954 he entered the Massachusetts General Hospital as a neurologist and neuropathologist, where he remained until his retirement, in 2005. His academic career ended as Professor Emeritus at Harvard University. His area of special interest in neurology was cerebrovascular disease (CVD). In 1954 he created the first Vascular Neurology service in the world and trained many leading neurologists on this field. His scientific contributions are present in more than 250 publications, as journal articles and book chapters. Many of his articles, certainly not restricted to CVD, were seminal in neurology. Several concepts and terms that he coined are currently used in daily clinical practice. The chapters on CVD, in seven consecutive editions of Harrison's Internal Medicine textbook, are among his highlights. His death was deeply felt by the neurological community.

  20. Chapter 38: American neurology. (United States)

    Freemon, Frank R


    The great formative event in the history of North America, the Civil War of 1861 to 1865, was the stimulus for the development of clinical neurology and the neurosciences. The first neurological research center on the continent was the US Army hospital at Turner's Lane, Philadelphia, PA. Silas Weir Mitchell and his colleagues described causalgia (reflex sympathetic dystrophy), phantom limb sensation, and Horner's syndrome (before Horner). The medical leader of the Northern army was William Hammond. After the conclusion of hostilities, he began a huge clinical practice in New York City. In the United States, clinical neurology began in private practice, unlike Europe, where neurology began in institutions. Hammond's textbook, which first used the term athetosis, was used by a generation of physicians who encountered patients with neurological signs and symptoms. Early in the 20th century, neurological institutions were formed around universities; probably the most famous was the Montreal Neurological Institute founded by Wilder Penfield. The US federal government sponsored extensive research into the function and dysfunction of the nervous system through the Neurological Institute of Neurological Diseases and Blindness, later called the National Institute of Neurological Diseases and Stroke. The government officially classified the final 10 years of the 20th century as the Decade of the Brain and provided an even greater level of research funding.

  1. Comfort: exploration of the concept in nursing. (United States)

    Malinowski, Ann; Stamler, Lynnette Leeseberg


    Comfort is a substantive need throughout life. However, the rise of technological influence coupled with a desire to embrace the medical concept of cure has frequently relegated the importance of nursing comfort interventions to simple tasks that can be provided by non-professional caregivers rather than an integral part of health promotion at all levels. Comfort is a concept that has been explored by a number of authors. Various definitions have included comfort as an outcome of nursing, a function of nursing, a basic human need, and a process. No consensus on a definition of comfort was found in the literature. This investigation attempts to link the ideas of comfort presented in the literature with the theories of Watson (Human Care) and Leininger (Culture Care), and discovers the existence of an integral locus for comfort in both. Theory-based strategies for nursing education are offered. Further research is clearly required, research methodologies based on Watson and Leininger would be appropriate for additional exploration of this concept. Practice implications include reflecting on the meaning of comfort to the patient in the context of his/her cultural values, and using this one as one of the factors in planning and implementing nursing care. Given the current emphasis on health promotion and the importance of comfort to the process of healing, comfort is an indispensable element of holistic, culturally congruent human care.


    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina


    Full Text Available Neurological disorders in hypertensive patients can be caused by both brain injury and concomitant diseases. The elucidation of the causes of neurological disorders and their effective treatment contribute to hypertensive patients’ better adherence to long-term antihypertensive therapy, which normalizes blood pressure (BP and reduces the risk of cerebral complications Objective: to study of the causes of neurological disorders in hypertensive patients and the efficiency of their correction using a new dispersible vinpocetine formulation (Cavinton® Comforte in combined therapy.Patients and methods. A total of 80 patients (men (20% and women (80%; mean age 63±12.3  years with neurological complaints in the presence of hypertension were examined. All the patients were diagnosed with dyscirculatory encephalopathy or chronic brain ischemia, whether they had vascular cognitive impairment. The examination of patients revealed that the neurological complaints were mainly due to concomitant diseases, such as migraine (12%, tension-type headache (66%, and the latter concurrent with migraine (4%.Results and  discussion. The  effective treatment of concomitant diseases in  combination with antihypertensive therapy contributed to normalization of BP and regression of complaints. The most pronounced effect was noted in 40 patients whose combination therapy included Vinpocetine (Cavinton® Comforte 10 mg thrice daily.Conclusion. The therapy resulted in the less severity of both the symptoms of cerebrovascular disease (vascular cognitive impairment and comorbid neurological disorders (headache, dizziness, etc..

  3. Thermal comfort assessment of buildings

    CERN Document Server

    Carlucci, Salvatore


    A number of metrics for assessing human thermal response to climatic conditions have been proposed in scientific literature over the last decades. They aim at describing human thermal perception of the thermal environment to which an individual or a group of people is exposed. More recently, a new type of “discomfort index” has been proposed for describing, in a synthetic way, long-term phenomena. Starting from a systematic review of a number of long-term global discomfort indices, they are then contrasted and compared on a reference case study in order to identify their similarities and differences and strengths and weaknesses. Based on this analysis, a new short-term local discomfort index is proposed for the American Adaptive comfort model. Finally, a new and reliable long-term general discomfort index is presented. It is delivered in three versions and each of them is suitable to be respectively coupled with the Fanger, the European Adaptive and the American Adaptive comfort models.

  4. The State of Sleep Medicine Education in North American Psychiatry Residency Training Programs in 2013: Chief Resident's Perspective. (United States)

    Khawaja, Imran S; Dickmann, Patricia J; Hurwitz, Thomas D; Thuras, Paul D; Feinstein, Robert E; Douglass, Alan B; Lee, Elliott Kyung


    To assess the current state of sleep medicine educational resources and training offered by North American psychiatry residency programs. In June 2013, a 9-item peer-reviewed Sleep Medicine Training Survey was administered to 39 chief residents of psychiatry residency training programs during a meeting in New York. Thirty-four percent of the participating programs offered an elective rotation in sleep medicine. A variety of innovative approaches for teaching sleep medicine were noted. The majority of the chief residents felt comfortable screening patients for obstructive sleep apnea (72%), half felt comfortable screening for restless legs syndrome (53%), and fewer than half were comfortable screening for other sleep disorders (47%). This is the first report in the last decade to provide any analysis of current sleep medicine training in North American psychiatry residency training programs. These data indicate that sleep medicine education in psychiatry residency programs is possibly in decline.

  5. An analysis of influential factors on outdoor thermal comfort in summer (United States)

    Yin, JiFu; Zheng, YouFei; Wu, RongJun; Tan, JianGuo; Ye, DianXiu; Wang, Wei


    A variety of research has linked high temperature to outdoor thermal comfort in summer, but it remains unclear how outdoor meteorological environments influence people's thermal sensation in subtropical monsoon climate areas, especially in China. In order to explain the process, and to better understand the related influential factors, we conducted an extensive survey of thermally comfortable conditions in open outdoor spaces. The goal of this study was to gain an insight into the subjects' perspectives on weather variables and comfort levels, and determine the factors responsible for the varying human thermal comfort response in summer. These perceptions were then compared to actual ambient conditions. The database consists of surveys rated by 205 students trained from 6:00 am to 8:00 pm outdoors from 21 to 25 August 2009, at Nanjing University of Information Science & Technology (NUIST), Nanjing, China. The multiple regression approach and simple factor analysis of variance were used to investigate the relationships between thermal comfort and meteorological environment, taking into consideration individual mood, gender, level of regular exercise, and previous environmental experiences. It was found that males and females have similar perceptions of maximum temperature; in the most comfortable environment, mood appears to have a significant influence on thermal comfort, but the influence of mood diminishes as the meteorological environment becomes increasingly uncomfortable. In addition, the study confirms the strong relationship between thermal comfort and microclimatic conditions, including solar radiation, atmospheric pressure, maximum temperature, wind speed and relative humidity, ranked by importance. There are also strong effects of illness, clothing and exercise, all of which influence thermal comfort. We also find that their former place of residence influences people's thermal comfort substantially by setting expectations. Finally, some relationships

  6. Genetics of neurological disorders. (United States)

    Faghihi, Mohammad Ali; Mottagui-Tabar, Salim; Wahlestedt, Claes


    Neurological diseases are defined as an inappropriate function of the peripheral or central nervous system due to impaired electrical impulses throughout the brain and/or nervous system that may present with heterogeneous symptoms according to the parts of the system involved in these pathologic processes. Growing evidence on genetic components of neurological disease have been collected during recent years. Genetic studies have opened the way for understanding the underlying pathology of many neurological disorders. The outcome of current intense research into the genetics of neurological disorders will hopefully be the introduction of new diagnostic tools and the discovery of potential targets for new and more effective medications and preventive measures.

  7. Focal neurological deficits (United States)

    ... or head Electromyogram (EMG), nerve conduction velocities (NCV) MRI of the back, neck, or head Spinal tap Alternative Names Neurological deficits - focal Images Brain References Daroff RB, Jankovic ...

  8. Field study of thermal comfort in non-air-conditioned buildings in a tropical island climate. (United States)

    Lu, Shilei; Pang, Bo; Qi, Yunfang; Fang, Kun


    The unique geographical location of Hainan makes its climate characteristics different from inland areas in China. The thermal comfort of Hainan also owes its uniqueness to its tropical island climate. In the past decades, there have been very few studies on thermal comfort of the residents in tropical island areas in China. A thermal environment test for different types of buildings in Hainan and a thermal comfort field investigation of 1944 subjects were conducted over a period of about two months. The results of the survey data show that a high humidity environment did not have a significant impact on human comfort. The neutral temperature for the residents in tropical island areas was 26.1 °C, and the acceptable temperature range of thermal comfort was from 23.1 °C to 29.1 °C. Residents living in tropical island areas showed higher heat resistance capacity, but lower cold tolerance than predicted. The neutral temperature for females (26.3 °C) was higher than for males (25.8 °C). Additionally, females were more sensitive to air temperature than males. The research conclusions can play a guiding role in the thermal environment design of green buildings in Hainan Province. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Experiential reflective learning and comfort zone

    Directory of Open Access Journals (Sweden)

    Jan Nehyba


    Full Text Available The article deals with the issue of experiential reflective learning. Firstlyit aims to discuss the concept of comfort zone in this area. It goes beyond the usualdefinition of the domestic comfort zone and it reflects in terms of experiential reflectivelearning in the world. The conclusions point to possible parallels with the concept ofcomfort zones and K. Lewin theory. Overall, the article focuses on topics that help toexpand the view on the issue of comfort zone.

  10. Pediatric Program Leadership's Contribution Toward Resident Wellness. (United States)

    Carson, Savanna L; Perkins, Kate; Reilly, Maura R; Sim, Myung-Shin; Li, Su-Ting T


    Residency program leaders are required to support resident well-being, but often do not receive training in how to do so. Determine frequency in which program leadership provides support for resident well-being, comfort in supporting resident well-being, and factors associated with need for additional training in supporting resident well-being. National cross-sectional web-based survey of pediatric program directors, associate program directors, and coordinators in June 2015, on their experience supporting resident well-being. Univariate and bivariate descriptive statistics compared responses between groups. Generalized linear modeling, adjusting for program region, size, program leadership role, and number of years in role determined factors associated with need for additional training. 39.3% (322/820) of participants responded. Most respondents strongly agreed that supporting resident well-being is an important part of their role, but few reported supporting resident well-being as part of their job description. Most reported supporting residents' clinical, personal, and health issues at least annually, and in some cases weekly, with 72% spending >10% of their time on resident well-being. Most program leaders desired more training. After adjusting for level of comfort in dealing with resident well-being issues, program leaders more frequently exposed to resident well-being issues were more likely to desire additional training (pProgram leaders spend a significant amount of time supporting resident well-being. While they feel that supporting resident well-being is an important part of their job, opportunities exist for developing program leaders through including resident wellness on job descriptions and training program leaders how to support resident well-being. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Functional neurological disorders: imaging. (United States)

    Voon, V


    Functional neurological disorders, also known as conversion disorder, are unexplained neurological symptoms. These symptoms are common and can be associated with significant consequences. This review covers the neuroimaging literature focusing on functional motor symptoms including motor functioning and upstream influences including self-monitoring and internal representations, voluntariness and arousal and trauma. Copyright © 2014. Published by Elsevier SAS.

  12. Neurological Complications of AIDS (United States)

    ... the National Library of Medicine’s MedlinePlus Living with HIV/AIDS × What research is being done? The National Institute of Neurological ... the National Library of Medicine’s MedlinePlus Living with HIV/AIDS See More About Research The National Institute of Neurological Disorders and Stroke ( ...

  13. Challenges facing palliative neurology practice: A qualitative analysis. (United States)

    Gofton, T E; Chum, M; Schulz, V; Gofton, B T; Sarpal, A; Watling, C


    This study aimed to develop a conceptual understanding of the specific characteristics of palliative care in neurology and the challenges of providing palliative care in the setting of neurological illness. The study was conducted at London Health Sciences Centre in Canada using grounded theory methodology. Qualitative thematic analysis was applied to focus group (health care providers physicians, nursing, allied health, trainees) and semi-structured interview (patient-caregiver dyads) data to explore challenges facing the delivery of palliative care in neurology. Specific characteristics of neurological disease that affect palliative care in neurology were identified: 1) timelines of disease progression, 2) barriers to communication arising from neurologic disease, 3) variability across disease progression, and 4) threat to personhood arising from functional and cognitive impairments related to neurologic disease. Moreover, three key challenges that shaped and complicated palliative care in neurology were identified: 1) uncertainty with respect to prognosis, support availability and disease trajectory, 2) inconsistency in information, attitudes and skills among care providers, care teams, caregivers and families, and 3) existential distress specific to neurological disease, including emotional, psychological and spiritual distress resulting from loss of function, autonomy and death. These challenges were experienced across groups, but manifested themselves in different ways for each group. Further research regarding prognosis, improved identification of patients with palliative care needs, developing an approach to palliative care delivery within neurology and the creation of more robust educational resources for teaching palliative neurology are expected to improve neurologists' comfort with palliative care, thereby enhancing care delivery in neurology. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Pediatric Resident Training in Prepubertal Vulvar Conditions. (United States)

    Rosen, Monica; Alaniz, Veronica I; Kobernik, Emily K; Booms, Stephanie; Smith, Yolanda R; Quint, Elisabeth H


    To assess pediatric resident training in diagnosing and managing prepubertal gynecologic conditions. Voluntary 32-question survey emailed to participants. Email contact through the American Academy of Pediatrics listserve. 7075 U.S. pediatrics and combined internal medicine-pediatric residents. Descriptive analysis including Chi-square tests was performed on survey results. Residents' training experiences and comfort, confidence, and knowledge in evaluating pediatric gynecologic concerns. In the 866 of 7075 (12%) completed surveys, a greater proportion of residents reported they were "very" or "extremely" comfortable talking to parents about general pediatric topics compared to gynecologic topics (88.5% versus 30.4%, pgeneral pediatric conditions compared to prepubertal gynecologic conditions (87.6% versus 32.8%, pdidactics (34.7%), and conferences, meetings, and workshops (24.1%). Confidence examining, diagnosing, and treating vulvovaginits was associated with participation in any learning activity and exposure to greater than five patients with this concern. Additional education or training in prepubertal vulvovaginal conditions was requested by 97% of residents. Our findings suggest that pediatric residents are lacking in comfort, confidence, and knowledge of prepubertal vulvovaginal conditions, especially when compared to general pediatric topics. Although this improves during training, it remains low, and more education is indicated and desired by residents. Copyright © 2017. Published by Elsevier Inc.

  15. Medical Students' Comfort with Pregnant Women with Substance-Use Disorders: A Randomized Educational Study (United States)

    Albright, Brittany; Skipper, Betty; Riley, Shawne; Wilhelm, Peggy; Rayburn, William F.


    Objective: The study objective was to determine whether medical students' attendance at a rehabilitation residence for pregnant women with substance-use disorders yielded changes in their attitudes and comfort levels in providing care to this population. Methods: This randomized educational trial involved 96 consecutive medical students during…

  16. Recipients' Criteria for Evaluating the Skillfulness of Comforting Communication and the Outcomes of Comforting Interactions. (United States)

    Bippus, Amy M.


    Reports on a two-part investigation of undergraduate students' criteria for evaluating how skillful comforting behavior is, and the outcomes of comforting interactions for distressed persons. Discusses the results in terms of theories and research on coping, social support, and comforting messages. (SG)


    African Journals Online (AJOL)

    Prince Acheampong

    temperature and humidity levels constitutes a potential hazard to health and human comfort and accelerates many degradation processes and material damage. Subsequently, the amount of energy needed to maintain the condition of air in spaces at comfort levels keep increasing. It is therefore imperative that landlords ...

  18. Affect asymmetry and comfort food consumption. (United States)

    Dubé, Laurette; LeBel, Jordan L; Lu, Ji


    It is proposed that the emotional triggers of comfort food consumption can reliably be predicted by factors tied to affect asymmetry whereby negative affects dominate one's experience, decision making and behaviors in some instances while positive emotions prevail in others. Specifically, we relate three of these factors (age, gender, and culture) to differences in the emotional triggers of comfort food consumption and we further explore the possibility that the type of food eaten during comfort-seeking episodes can also be tied to affect asymmetry. Two hundred and seventy-seven participants completed a web-based survey conducted to assess the emotional antecedents and consequences of comfort food consumption. Consistent with expectations, results indicate that men's comfort food consumption was motivated by positive emotions whereas women's consumption was triggered by negative affects. Consumption of comfort foods alleviated women's negative emotions but also produced guilt. Positive affect was a particularly powerful trigger of comfort food consumption for older participants and for participants with French cultural background. Younger participants and participants with English background reported more intense negative emotions prior to consuming comfort foods. Foods high in sugar and fat content were more efficient in alleviating negative affects whereas low-calorie foods were more efficient in increasing positive emotions.

  19. The relationship between seat pressure and comfort

    NARCIS (Netherlands)

    Oudenhuijzen, A.J.K.; Hoof, J.F.A.M. van


    Tomorrow driver comfort will become more and more important for car manufacturers in distinguishing themselves from others. Today, comfort can only be assessed and tested very late in the design and construction process (often using prototypes). Potentially, biomechanic software provides a solution

  20. Selected Sports Bras: Overall Comfort and Support. (United States)

    Lawson, LaJean; Lorentzen, Deana

    This study evaluated currently marketed sports bras on subjective measures of comfort and support both within an entire group of women and within cup sizes, correlated the subjective measures of comfort and support with previously reported biomechanical findings of support on the same bras, and further developed empirically based guidelines for…

  1. Re-comfortization som anti-radikaliseringsstrategi

    DEFF Research Database (Denmark)

    Clausen, Lars


    Danmarks mentorforløb. Oplevelsesturen beskrives som forløb, der bringer deltagerne ud af deres comfort-zone og skaber rammer for at afprøve nye identitetsformer og adfærdspraksisser, der fører til re-comfortization blandt turens deltagere. Artiklen konkluderer, at det foreliggende projekt var socialt...

  2. Neurologic complications of vaccinations. (United States)

    Miravalle, Augusto A; Schreiner, Teri


    This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

  3. Cardiomyopathy in neurological disorders. (United States)

    Finsterer, Josef; Stöllberger, Claudia; Wahbi, Karim


    According to the American Heart Association, cardiomyopathies are classified as primary (solely or predominantly confined to heart muscle), secondary (those showing pathological myocardial involvement as part of a neuromuscular disorder) and those in which cardiomyopathy is the first/predominant manifestation of a neuromuscular disorder. Cardiomyopathies may be further classified as hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or unclassified cardiomyopathy (noncompaction, Takotsubo-cardiomyopathy). This review focuses on secondary cardiomyopathies and those in which cardiomyopathy is the predominant manifestation of a myopathy. Any of them may cause neurological disease, and any of them may be a manifestation of a neurological disorder. Neurological disease most frequently caused by cardiomyopathies is ischemic stroke, followed by transitory ischemic attack, syncope, or vertigo. Neurological disease, which most frequently manifests with cardiomyopathies are the neuromuscular disorders. Most commonly associated with cardiomyopathies are muscular dystrophies, myofibrillar myopathies, congenital myopathies and metabolic myopathies. Management of neurological disease caused by cardiomyopathies is not at variance from the same neurological disorders due to other causes. Management of secondary cardiomyopathies is not different from that of cardiomyopathies due to other causes either. Patients with neuromuscular disorders require early cardiologic investigations and close follow-ups, patients with cardiomyopathies require neurological investigation and avoidance of muscle toxic medication if a neuromuscular disorder is diagnosed. Which patients with cardiomyopathy profit most from primary stroke prevention is unsolved and requires further investigations. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Neurology in Asia. (United States)

    Tan, Chong-Tin


    Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.

  5. Neurology and international organizations. (United States)

    Mateen, Farrah J


    A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas.

  6. Impact of a Pediatric and Adolescent Gynecology Curriculum on an Obstetrics and Gynecology Residency. (United States)

    Palaszewski, Dawn M; Miladinovic, Branko; Caselnova, Petra M; Holmström, Shelly W


    To determine the effectiveness of a new pediatric and adolescent gynecology (PAG) curriculum for improving obstetrics/gynecology resident physician knowledge and comfort level in patient management and to describe the current deficiencies in resident physician knowledge and comfort level in PAG. A PAG curriculum was implemented for the obstetrics/gynecology resident physicians (n = 20) at the University of South Florida in July 2013. Before and after the curriculum was introduced, resident physicians and recent graduates of the residency program completed a survey to assess their comfort level and a knowledge assessment consisting of 20 case-based questions. University-based residency program. Resident physicians and recent resident physician graduates in the Department of Obstetrics and Gynecology. Introduction of a PAG curriculum during the 2013-2014 academic year. Improvement in resident physicians' comfort level and knowledge in PAG. After the curriculum was introduced, comfort increased in examining the genitals of a pediatric gynecology patient (median difference = 1.5; P = .003) and history-taking, physical examination skills, and management (median difference = 1; P = .002) compared with before the curriculum. There was no significant difference in overall quiz score (15.5 ± 1.87 vs 15.8 ± 1.3; P = .78). A curriculum in PAG did improve resident comfort level in managing PAG patients, but did not significantly improve knowledge of this topic. Copyright © 2016.

  7. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje


    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

  8. Correlates of Burnout Among Family Practice Residents. (United States)

    Lemkau, Jeanne P.; And Others


    A study of burnout among 67 residents in four programs found little relationship between burnout scores and situational and background factors, but numerous relationships were found among personality measures, burnout scores, and measures of regret about career choice, indicating the importance of interpersonal skills and comfort in mitigating…

  9. Neurological diseases and pain


    Borsook, David


    Chronic pain is a frequent component of many neurological disorders, affecting 20–40% of patients for many primary neurological diseases. These diseases result from a wide range of pathophysiologies including traumatic injury to the central nervous system, neurodegeneration and neuroinflammation, and exploring the aetiology of pain in these disorders is an opportunity to achieve new insight into pain processing. Whether pain originates in the central or peripheral nervous system, it frequentl...

  10. Wikipedia and neurological disorders. (United States)

    Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M


    Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a popular free online encyclopedia used by patients and physicians to search for health-related information. The following Wikipedia articles were considered: Alzheimer's disease; Amyotrophic lateral sclerosis; Dementia; Epilepsy; Epileptic seizure; Migraine; Multiple sclerosis; Parkinson's disease; Stroke; Traumatic brain injury. We analyzed information regarding the total article views for 90 days and the rank of these articles among all those available in Wikipedia. We determined the highest search volume peaks to identify possible relation with online news headlines. No relation between incidence or prevalence of neurological disorders and the search volume for the related articles was found. Seven out of 10 neurological conditions showed relations in search volume peaks and news headlines. Six out of these seven peaks were related to news about famous people suffering from neurological disorders, especially those from showbusiness. Identification of discrepancies between disease burden and health seeking behavior on Wikipedia is useful in the planning of public health campaigns. Celebrities who publicly announce their neurological diagnosis might effectively promote awareness programs, increase public knowledge and reduce stigma related to diagnoses of neurological disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Cosmetic Surgery Training in Plastic Surgery Residency Programs. (United States)

    McNichols, Colton H L; Diaconu, Silviu; Alfadil, Sara; Woodall, Jhade; Grant, Michael; Lifchez, Scott; Nam, Arthur; Rasko, Yvonne


    Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education-approved plastic surgery training programs in the United States. A 13 question survey was sent to the program directors at the same institutions. Both surveys were analyzed to determine the duration of training and comfort level with cosmetic procedures. Eighty-three residents (10%) and 11 program directors (11%) completed the survey. Ninety-four percentage of residents had a dedicated cosmetic surgery rotation (an increase from 68% in 2015) in addition to a resident cosmetic clinic. Twenty percentage of senior residents felt they would need an aesthetic surgery fellowship to practice cosmetic surgery compared with 31% in 2015. Integrated chief residents were more comfortable performing cosmetic surgery cases compared with independent chief residents. Senior residents continue to have poor confidence with facial aesthetic and body contouring procedures. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

  12. Canadian Paediatric Neurology Workforce Survey and Consensus Statement. (United States)

    Doja, Asif; Orr, Serena L; McMillan, Hugh J; Kirton, Adam; Brna, Paula; Esser, Michael; Tang-Wai, Richard; Major, Philippe; Poulin, Chantal; Prasad, Narayan; Selby, Kathryn; Weiss, Shelly K; Yeh, E Ann; Callen, David Ja


    Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.

  13. Visual comfort evaluated by opponent colors (United States)

    Sagawa, Ken


    This study aimed to evaluate psychological impression of visual comfort when we see an image of ordinary colored scene presented in a color display. Effects of opponent colors, i.e. red, green, yellow and blue component, on the subjective judgement on visual comfort to the image were investigated. Three kinds of psychological experiment were designed to see the effects and the results indicated that the red/green opponent color component was more affecting than the yellow-blue one, and red color in particular was the most affecting factor on visual comfort.

  14. [Neurology and literature]. (United States)

    Iniesta, I


    Literature complements medical literature in the academic and clinical development of neurologists. The present article explores the contributions of writers of fiction on neurology. Literary works of fiction with particular reference to neurology. A symbiosis between writers of fiction and doctors has been well recognised. From Shakespeare to Cervantes by way of Dickens and Cela to writer - physicians such as Anton Chekhov or António Lobo Antunes have contributed through their medically informed literature to the better understanding of neurology. Some writers like Dostoevsky, Machado de Assis and Margiad Evans have written about their own experiences with disease thus bringing new insights to medicine. Furthermore, some neurological disorders have been largely based on literary descriptions. For instance, Dostoevsky's epilepsy has been retrospectively analysed by famous neurologists including Freud, Alajouanine or Gastaut, whilst his writings and biography have prompted others like Waxman and Geschwind to describe typical behavioural changes in temporal lobe epilepsy, finding their source of inspiration in Dostoevsky. Likewise, Cirignotta et al have named an unusual type of seizure after the Russian novelist. Inspired by Lewis Carroll, Todd introduced the term Alice in Wonderland Syndrome to refer to visual distortions generally associated with migraine. Writers of fiction offer a humanised perception of disease by contributing new insights into the clinical history, informing about the subjective experience of the illness and helping to eradicate the stigma associated to neurological disorders.

  15. Suicide in Neurologic Illness. (United States)

    Arciniegas, David B.; Anderson, C. Alan


    The risk of attempted or completed suicide is increased in patients with migraine with aura, epilepsy, stroke, multiple sclerosis, traumatic brain injury, and Huntington's disease. Contrary to the general perception that the risk of suicide among patients with Alzheimer's disease and other dementing conditions is low, several reports suggest that the risk of suicide in these patients increases relative to the general population. Some patients at risk for neurologic disorders are also at increased risk for suicide; in particular, the risk of suicide is increased among persons at risk for Huntington's disease, independent of the presence or absence of the Huntington's gene mutation. The risk of attempted or completed suicide in neurologic illness is strongly associated with depression, feelings of hopelessness or helplessness, and social isolation. Additional suicide risk factors in persons with neurologic illness include cognitive impairment, relatively younger age (under 60 years), moderate physical disability, recent onset or change in illness, a lack of future plans or perceived meaning in life, recent losses (personal, occupational, or financial), and prior history of psychiatric illness or suicidal behavior. Substance dependence, psychotic disorders, anxiety disorders, and some personality disorders (eg, borderline personality disorder) may also contribute to increased risk of suicide among persons with neurologic illnesses. Identification and aggressive treatment of psychiatric problems, especially depression, as well as reduction of modifiable suicide risk factors among patients with neurologic illness is needed to reduce the risk of attempted and completed suicide in this population.

  16. Neurologic manifestations of achondroplasia. (United States)

    Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J


    Achondroplasia is the best described and most common form of the congenital short-limbed dwarfing conditions. Achondroplasia is apparent at birth and has a birth prevalence of 1 in 20000-30000 live-born infants. Achondroplasia is inherited as an autosomal dominant condition, although 80% of cases occur sporadically as new events in their families. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3). Patients with achondroplasia should be evaluated by a multidisciplinary team of clinicians including geneticists, neurologists, and orthopedists, since there are numerous bony and neurological complications. The most severe complication results from craniocervical stenosis and medullary and upper spinal cord compression, which can have devastating and even lethal sequelae during early childhood. In subsequent decades, including adolescence, spinal cord and nerve compression are more prominent. The neurological complications of achondroplasia have been recognized in adults for more than a century and are attributed to bony defects, connective tissue structures, or both. Similar neurological complications are now appreciated in infants, young children, and teenagers with achondroplasia. Defective connective tissue elements in achondroplasia frequently lead to ligamentous laxity, which can aggravate the complications associated with bony stenosis. Bony abnormalities are known to cause neurological morbidity and lead to a shortened lifespan. Neurological complications associated with achondroplasia are reviewed, including recommendations for the evaluation and management of these clinical problems. © 2014 Elsevier B.V. All rights reserved.

  17. Quantitative Description of Medical Student Interest in Neurology and Psychiatry. (United States)

    Ramos, Raddy L; Cuoco, Joshua A; Guercio, Erik; Levitan, Thomas


    Given the well-documented shortage of physicians in primary care and several other specialties, quantitative understanding of residency application and matching data among osteopathic and allopathic medical students has implications for predicting trends in the physician workforce. To estimate medical student interest in neurology and psychiatry based on numbers of applicants and matches to neurology and psychiatry osteopathic and allopathic residency programs. Also, to gauge students' previous academic experience with brain and cognitive sciences. The number of available postgraduate year 1 positions, applicants, and matches from graduating years 2011 through 2015 were collected from the National Matching Services Inc and the American Association of Colleges of Osteopathic Medicine for osteopathic programs and the National Resident Matching Program and the Association of American Medical Colleges for allopathic programs. To determine and compare osteopathic and allopathic medical students' interest in neurology and psychiatry, the number of positions, applicants, and matches were analyzed considering the number of total osteopathic and allopathic graduates in the given year using 2-tailed χ2 analyses with Yates correction. In addition, osteopathic and allopathic medical schools' websites were reviewed to determine whether neurology and psychiatry rotations were required. Osteopathic medical students' reported undergraduate majors were also gathered. Compared with allopathic medical students, osteopathic medical students had significantly greater interest (as measured by applicants) in neurology (χ21=11.85, Ppsychiatry (χ21=39.07, Ppsychiatry residency programs. Approximately 6% of osteopathic vs nearly 85% of allopathic medical schools had required neurology rotations. Nearly 10% of osteopathic applicants and matriculants had undergraduate coursework in brain and cognitive sciences. Osteopathic medical students demonstrated greater interest than allopathic

  18. Potential energy savings and thermal comfort

    DEFF Research Database (Denmark)

    Jensen, Karsten Ingerslev; Rudbeck, Claus Christian; Schultz, Jørgen Munthe


    The simulation results on the energy saving potential and influence on indoor thermal comfort by replacement of common windows with aerogel windows as well as commercial low-energy windows are described and analysed.......The simulation results on the energy saving potential and influence on indoor thermal comfort by replacement of common windows with aerogel windows as well as commercial low-energy windows are described and analysed....

  19. Human comfort in relation to sinusoidal vibration (United States)

    Jones, B.; Rao, B. K. N.


    An investigation was made to assess the overall subjective comfort levels to sinusoidal excitations over the range 1 to 19 Hz using a two axis electrohydraulic vibration simulator. Exposure durations of 16 minutes, 25 minutes, 1 hour, and 2.5 hours have been considered. Subjects were not exposed over such durations, but were instructed to estimate the overall comfort levels preferred had they been constantly subjected to vibration over such durations.

  20. [Neurological sleep disorders]. (United States)

    Khatami, Ramin


    Neurological sleep disorders are common in the general population and may have a strong impact on quality of life. General practitioners play a key role in recognizing and managing sleep disorders in the general population. They should therefore be familiar with the most important neurological sleep disorders. This review provides a comprehensive overview of the most prevalent and important neurological sleep disorders, including Restless legs syndrome (with and without periodic limb movements in sleep), narcolepsy, NREM- and REM-sleep parasomnias and the complex relationship between sleep and epilepsies. Although narcolepsy is considered as a rare disease, recent discoveries in narcolepsy research provided insight in the function of brain circuitries involved in sleep wake regulation. REM sleep behavioral parasomnia (RBD) is increasingly recognized to represent an early manifestation of neurodegenerative disorders, in particular evolving synucleinopathies. Early diagnosis may thus open new perspectives for developing novel treatment options by targeting neuroprotective substances.

  1. Dynamic thermal environment and thermal comfort. (United States)

    Zhu, Y; Ouyang, Q; Cao, B; Zhou, X; Yu, J


    Research has shown that a stable thermal environment with tight temperature control cannot bring occupants more thermal comfort. Instead, such an environment will incur higher energy costs and produce greater CO2 emissions. Furthermore, this may lead to the degeneration of occupants' inherent ability to combat thermal stress, thereby weakening thermal adaptability. Measured data from many field investigations have shown that the human body has a higher acceptance to the thermal environment in free-running buildings than to that in air-conditioned buildings with similar average parameters. In naturally ventilated environments, occupants have reported superior thermal comfort votes and much greater thermal comfort temperature ranges compared to air-conditioned environments. This phenomenon is an integral part of the adaptive thermal comfort model. In addition, climate chamber experiments have proven that people prefer natural wind to mechanical wind in warm conditions; in other words, dynamic airflow can provide a superior cooling effect. However, these findings also indicate that significant questions related to thermal comfort remain unanswered. For example, what is the cause of these phenomena? How we can build a comfortable and healthy indoor environment for human beings? This article summarizes a series of research achievements in recent decades, tries to address some of these unanswered questions, and attempts to summarize certain problems for future research. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties (United States)

    Faulkner, L.R.; Juul, D.; Pascuzzi, R.M.; Aminoff, M.J.; Crumrine, P.K.; DeKosky, S.T.; Jozefowicz, R.F.; Massey, J.M.; Pirzada, N.; Tilton, A.


    Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era. PMID:20855855

  3. The neurological disease ontology. (United States)

    Jensen, Mark; Cox, Alexander P; Chaudhry, Naveed; Ng, Marcus; Sule, Donat; Duncan, William; Ray, Patrick; Weinstock-Guttman, Bianca; Smith, Barry; Ruttenberg, Alan; Szigeti, Kinga; Diehl, Alexander D


    We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer's disease, multiple sclerosis, and stroke. ND is implemented in OWL 2 and currently has more than 450 terms that refer to and describe various aspects of neurological diseases. ND directly imports the development version of OGMS, which uses BFO 2. Term development in ND has primarily extended the OGMS terms 'disease', 'diagnosis', 'disease course', and 'disorder'. We have imported and utilize over 700 classes from related ontology efforts including the Foundational Model of Anatomy, Ontology for Biomedical Investigations, and Protein Ontology. ND terms are annotated with ontology metadata such as a label (term name), term editors, textual definition, definition source, curation status, and alternative terms (synonyms). Many terms have logical definitions in addition to these annotations. Current development has focused on the establishment of the upper-level structure of the ND hierarchy, as well as on the representation of Alzheimer's disease, multiple sclerosis, and stroke. The ontology is available as a version-controlled file at along with a discussion list and an issue tracker. ND seeks to provide a formal foundation for the representation of clinical and research data

  4. Neurologic Diseases and Sleep. (United States)

    Barone, Daniel A; Chokroverty, Sudansu


    Sleep disorders and neurologic illness are common and burdensome in their own right; when combined, they can have tremendous negative impact at an individual level as well as societally. The socioeconomic burden of sleep disorders and neurologic illness can be identified, but the real cost of these conditions lies far beyond the financial realm. There is an urgent need for comprehensive care and support systems to help with the burden of disease. Further research in improving patient outcomes in those who suffer with these conditions will help patients and their families, and society in general. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Neurologic Complications in Pregnancy. (United States)

    Cuero, Mauricio Ruiz; Varelas, Panayiotis N


    Pregnant women are subject to the same complications as the general population, as well to specific neurologic complications associated with pregnancy, such as preeclampsia or eclampsia. The hormonal and physiologic changes during pregnancy lead to altered incidences of these complications, which usually present during the late period of pregnancy, labor, or the puerperium. In addition, the treatment of these conditions is different from that of nonpregnant women, because special attention is paid to avoid any abnormalities or death of the fetus. This article discusses the most common of these neurologic complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The neurology literature 2016. (United States)

    Khoujah, Danya; Chang, Wan-Tsu W; Abraham, Michael K


    Emergency neurology is a complex and rapidly changing field. Its evolution can be attributed in part to increased imaging options, debates about optimal treatment, and simply the growth of emergency medicine as a specialty. Every year, a number of articles published in emergency medicine or other specialty journals should become familiar to the emergency physician. This review summarizes neurology articles published in 2016, which the authors consider crucial to the practice of emergency medicine. The articles are categorized according to disease process, with the understanding that there can be significant overlap among articles. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. The popularity of neurology in Spain: An analysis of specialty selection. (United States)

    Curbelo, J; Romeo, J M; Galván-Román, J M; Vega-Villar, J; Martinez-Lapiscina, E H; Jiménez-Fonseca, P; Villacampa, T; Sánchez-Lasheras, F; Fernández-Somoano, A; Baladrón, J


    Neurology is one of the medical specialties offered each year to residency training candidates. This project analyses the data associated with candidates choosing neurology residency programmes in recent years. Data related to specialty selection were obtained from official reports by the Spanish Ministry of Health, Social Services, and Equality. Information was collected on several characteristics of teaching centres: availability of stroke units, endovascular intervention, national reference clinics for neurology, specific on-call shifts for neurology residents, and links with medical schools or national research networks. The median selection list position of candidates selecting neurology training has been higher year on year; neurology was among the 4 most popular residency programmes in 2016. Potential residents were mainly female, Spanish, and had good academic results. The median number of hospitals with higher numbers of beds, endovascular intervention, stroke units, and national reference clinics for neurology is significantly lower. This is also true when centers are analysed by presence of specific on-call shifts for neurology residents and association with medical schools or national research networks. The centres selected by candidates with the highest median selection list position in 2012-2016 were the Clínico San Carlos, 12 de Octubre, and Vall d'Hebron university hospitals. Neurology has gradually improved in residency selection choices and is now one of the 4 most popular options. Potential residents prefer larger centres which are more demanding in terms of patient care and which perform more research activity. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Neurological aspects of eclampsia

    Directory of Open Access Journals (Sweden)

    Jovanović Dejana


    Full Text Available The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn’t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.

  9. Wikipedia and neurological disorders

    NARCIS (Netherlands)

    Brigo, Francesco; Igwe, Stanley C.; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, WM


    Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a

  10. Astroglia in neurological diseases

    Czech Academy of Sciences Publication Activity Database

    Verkhratsky, Alexei; Rodríguez Arellano, Jose Julio; Parpura, V.


    Roč. 8, č. 2 (2013), s. 149-158 ISSN 1479-6708 R&D Projects: GA ČR(CZ) GAP304/11/0184; GA ČR GA309/09/1696 Institutional support: RVO:68378041 Keywords : amyotrophic lateral sclerosis * Alzheimer's disease * Alexander disease Subject RIV: FH - Neurology

  11. Assessing occupant comfort in an iconic sustainable education building

    Directory of Open Access Journals (Sweden)

    Rick Best


    Full Text Available The building that houses the Mirvac School of Sustainable Development at Bond University is the first educational building to achieve a six Green Star rating from the Green Building Council of Australia. It has won numerous awards since opening in August 2008 including being judged the RICS (Royal Institution of Chartered Surveyors Sustainable Building of 2009. After more than two years in use a post-occupancy evaluation study was carried out to assess the performance of the building from the viewpoint of the users; both resident staff and transient students. Results for factors such as lighting, thermal comfort, noise and air quality. were compared to benchmarks established by the Usable Buildings Trust. The evaluation also assessed the occupants’ perceptions of the building’s impact on their own productivity. Users generally find the building provides a comfortable work environment although a number of areas of performance were noted as posing some concerns. These included intrusive noise in some parts of the building and some issues with glare in daylit teaching spaces. Such concerns were found to be in accord with the results of previous studies and they highlight some recurrent problems in “green” buildings designed to maximise the use of natural ventilation and natural light. These design challenges and how occupant satisfaction is to be measured and benchmarked are also discussed in the context of this comparative building study.

  12. Identifying factors of comfort in using hand tools

    NARCIS (Netherlands)

    Kuijt-Evers, L.F.M.; Groenesteijn, L.; Looze,; Vink, P.


    To design comfortable hand tools, knowledge about comfort/discomfort in using hand tools is required. We investigated which factors determine comfort/discomfort in using hand tools according to users. Therefore, descriptors of comfort/discomfort in using hand tools were collected from literature and

  13. Identifying predictors of comfort and discomfort in using hand tools

    NARCIS (Netherlands)

    Kuijt-Evers, L.F.M.; Twisk, J.; Groenesteijn, L.; Looze,; Vink, P.


    The aim of the study was to identify predictors of comfort and discomfort in using hand tools. For this purpose, the comfort questionnaire for hand tools (CQH) was developed based on the results of a previous study. In the current study, four screwdrivers were evaluated on comfort (expected comfort

  14. Interracial Social Comfort and Its Relationship to Adjustment to College (United States)

    McDonald, Scott D.; Vrana, Scott R.


    The present study examined the effects of interracial social comfort on college adjustment for 45 Black and 82 White students at a predominantly-White university. Black students reporting more comfort with Whites, regardless of level of comfort with Blacks, experienced better college adjustment. Furthermore, more social comfort with Blacks…

  15. Adaptive principles for thermal comfort in dwellings : From comfort temperatures to avoiding discomfort

    NARCIS (Netherlands)

    Alders, E.E.; Kurvers, S.R.; Van den Ham, E.R.


    Many theories on thermal comfort exist and there are many ways to deliver this in an energy efficient way. Both aspects are often studied in a static way and most of these studies only regard one of the aspects, seldom investigating what influence the way of delivering thermal comfort has on the

  16. Forty years of Fanger's model of thermal comfort: comfort for all?

    NARCIS (Netherlands)

    Ir. Joost van Hoof


    The predicted mean vote (PMV) model of thermal comfort, created by Fanger in the late 1960s, is used worldwide to assess thermal comfort. Fanger based his model on college-aged students for use in invariant environmental conditions in air-conditioned buildings in moderate thermal climate zones.

  17. Guide to Setting Thermal Comfort Criteria and Minimizing Energy Use in Delivering Thermal Comfort

    Energy Technology Data Exchange (ETDEWEB)

    Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)


    Historically thermal comfort in buildings has been controlled by simple dry bulb temperature settings. As we move into more sophisticated low energy building systems that make use of alternate systems such as natural ventilation, mixed mode system and radiant thermal conditioning strategies, a more complete understanding of human comfort is needed for both design and control. This guide will support building designers, owners, operators and other stakeholders in defining quantifiable thermal comfort parameters?these can be used to support design, energy analysis and the evaluation of the thermal comfort benefits of design strategies. This guide also contains information that building owners and operators will find helpful for understanding the core concepts of thermal comfort. Whether for one building, or for a portfolio of buildings, this guide will also assist owners and designers in how to identify the mechanisms of thermal comfort and space conditioning strategies most important for their building and climate, and provide guidance towards low energy design options and operations that can successfully address thermal comfort. An example of low energy design options for thermal comfort is presented in some detail for cooling, while the fundamentals to follow a similar approach for heating are presented.

  18. Self-Appraised Readiness of Senior and Graduating General Surgery Residents to Perform Thoracic Surgery. (United States)

    DeBoard, Zachary M; Paisley, Michael; Thomas, Donald D


    General surgeons perform up to 50% of noncardiac thoracic surgery (TS). Although data show consistent TS case volume during general surgery (GS) residency it is unknown whether this operative trend will persist given potentially limited subspecialty exposure. We sought to determine if certain aspects of residency programs and resident characteristics were associated with trainees' perceived comfort in performing certain basic TS procedures. An anonymous survey was distributed to GS residents regarding program characteristics, presence of a TS residency, and intent to pursue thoracic surgical training, and estimated case volumes of individual procedures. Comfort levels for performing video-assisted thoracoscopic surgical (VATS) procedures, open lobectomy, elective thoracotomy, and sternotomy were attained through a 5-point Likert-type scale. This survey was administered at 50 training programs with responses recorded via an online form. Fourth- and fifth-year GS residents in the United States. Of 272 respondents 58% were fourth-year residents, 62% of residents trained at university-affiliated programs, and 64% reported a TS residency program at their institution and 16% stated intent to pursue TS. Fifth-year residents performed significantly more cases than fourth-year residents despite no difference in median comfort levels. Residents intending to pursue TS performed significantly more cases and were more comfortable performing a thoracotomy, sternotomy, VATS wedge resection/biopsy, and VATS decortication/pleurodesis (p = 0.044, Surgery. Published by Elsevier Inc. All rights reserved.

  19. Skin-to-Skin Contact: A Comforting Place With Comfort Food. (United States)

    Ludington-Hoe, Susan M


    Birth and the newborn environment are stressful, especially for preterm infants who have to contend with medical conditions while adapting to the extrauterine world. Therefore, preterm newborns are excellent candidates for comforting measures. Skin-to-skin contact is the best way to provide comfort in several of the realms of Kolcaba's Comfort Theory. Evidence suggests that skin-to-skin contact between the mother and newborn changes the discomforting newborn environment into one that is profoundly comforting. Skin-to-skin contact promotes infant physiologic stability and warmth, helps in organizing infant sleep, reduces stress and pain, and makes breast milk readily available. Comfort to the newborn can be effectively accomplished by skin-to-skin contact.

  20. The neurology of proverbs. (United States)

    Van Lancker, D


    Although proverb tests are commonly used in the mental status examination surprisingly little is known about either normal comprehension or the interpretation of proverbial expressions. Current proverbs tests have conceptual and linguistic shortcomings, and few studies have been done to investigate the specific effects of neurological and psychiatric disorders on the interpretation of proverbs. Although frontal lobes have traditionally been impugned in patients who are "concrete", recent studies targeting deficient comprehension of non literal language (e.g. proverbs, idioms, speech formulas, and indirect requests) point to an important role of the right hemisphere (RH). Research describing responses of psychiatrically and neurologically classified groups to tests of proverb and idiom usage is needed to clarify details of aberrant processing of nonliteral meanings. Meanwhile, the proverb test, drawing on diverse cognitive skills, is a nonspecific but sensitive probe of mental status.

  1. The Neurology of Proverbs

    Directory of Open Access Journals (Sweden)

    Diana Van Lancker


    Full Text Available Although proverb tests are commonly used in the mental status examination surprisingly little is known about either normal comprehension or the interpretation of proverbial expressions. Current proverbs tests have conceptual and linguistic shortcomings, and few studies have been done to investigate the specific effects of neurological and psychiatric disorders on the interpretation of proverbs. Although frontal lobes have traditionally been impugned in patients who are “concrete”, recent studies targeting deficient comprehension of non literal language (e.g. proverbs, idioms, speech formulas, and indirect requests point to an important role of the right hemisphere (RH. Research describing responses of psychiatrically and neurologically classified groups to tests of proverb and idiom usage is needed to clarify details of aberrant processing of nonliteral meanings. Meanwhile, the proverb test, drawing on diverse cognitive skills, is a nonspecific but sensitive probe of mental status.

  2. Vaccination and neurological disorders

    Directory of Open Access Journals (Sweden)

    Anastasia Gkampeta


    Full Text Available Active immunization of children has been proven very effective in elimination of life threatening complications of many infectious diseases in developed countries. However, as vaccination-preventable infectious diseases and their complications have become rare, the interest focuses on immunization-related adverse reactions. Unfortunately, fear of vaccination-related adverse effects can led to decreased vaccination coverage and subsequent epidemics of infectious diseases. This review includes reports about possible side effects following vaccinations in children with neurological disorders and also published recommendations about vaccinating children with neurological disorders. From all international published data anyone can conclude that vaccines are safer than ever before, but the challenge remains to convey this message to society.

  3. [Vitamin D and neurology]. (United States)

    Thouvenot, Éric; Camu, William


    Vitamin D deficiency is associated with a higher risk of multiple sclerosis and also with a higher relapse rate as well as a higher number of MRI lesions. Elders with vitamin D deficiency have worse cognitive performance. Vitamin D deficiency is a risk factor for developing Alzheimer's disease. Ischemic stroke are more frequent and more severe in patients with low vitamin D levels. Carotid atherosclerosis is more frequent and more severe in patients with vitamin D deficiency. Vitamin D deficiency is associated with a higher risk and worse prognosis of Parkinson's disease. In the different neurological disorders discussed herein, gene polymorphisms that could alter vitamin D metabolism are also associated with a higher incidence or a worse disease prognosis. Despite the links between vitamin D deficiency and the risks of developing neurological disorders, there is, to date, no proof that supplementation could alter the course of these diseases. Copyright © 2013. Published by Elsevier Masson SAS.

  4. Neurological legal disability

    Directory of Open Access Journals (Sweden)

    Radhakrishna H


    Full Text Available Neurological disorders with a prolonged course, either remediable or otherwise are being seen increasingly in clinical practice and many such patients are young and are part of some organization or other wherein their services are needed if they were healthy and fit. The neurologists who are on the panel of these organizations are asked to certify whether these subjects are fit to work or how long they should be given leave. These certificates may be produced in the court of law and may be subjected to verification by another neurologist or a medical board. At present there are no standard guidelines in our country to effect such certification unlike in orthopedic specialty or in ophthalmology. The following is a beginning, based on which the neurologist can certify the neurological disability of such subjects and convey the same meaning to all neurologists across the country.

  5. Pediatric Palliative Care Pilot Curriculum: Impact of "Pain Cards" on Resident Education. (United States)

    Barnett, Michael D; Maurer, Scott H; Wood, Gordon J


    Prior research has shown that less than 40% of pediatric program directors believe their graduating residents competent in palliative care. While many curricula have been developed to address this need, few have demonstrated improved comfort and/or knowledge with palliative care principles. The purpose of this study was to test a pocket card educational intervention regarding resident knowledge and comfort with palliative care principles. Pocket reference cards were created to deliver fundamentals of pediatric palliative care to resident learners; didactics and case studies emphasized principles on the cards. Self-reported comfort and objective knowledge were measured before and after the curriculum among residents. Of 32 post-graduate year 2 (PGY2) residents, 23 (72%) completed the pre-test survey. The post-test was completed by 14 PGY2 residents (44%) and 16 of 39 PGY3/4 residents (41%). There was improvement in comfort with communication, as well as pain and symptom management among the residents. Knowledge of palliative care principles improved in part, with only a few survey questions reaching statistical significance. 100% of respondents recommended the cards be provided to their colleagues. This longitudinal curriculum, designed specifically for pediatric residents, was built into an existing training program and proved to be popular, feasible, and effective at improving comfort with basic palliative care principles. © The Author(s) 2015.

  6. Neurologic complications of alcoholism. (United States)

    Noble, James M; Weimer, Louis H


    This review serves as an overview of neurologic conditions associated with alcohol abuse or withdrawal, including epidemiology, clinical symptoms, diagnostic approach, and treatment. Frequent alcohol abuse and frank alcoholism are very common among adults in the United States. Although rates decline with each decade, as many as 10% of the elderly drink excessively. Given the ubiquitous nature of alcoholism in society, its complications have been clinically recognized for generations, with recent advances focusing on improved understanding of ethanol's biochemical targets and the pathophysiology of its complications. The chronic effects of alcohol abuse are myriad and include neurologic complications through both direct and indirect effects on the central and peripheral nervous systems. These disorders include several encephalopathic states related to alcohol intoxication, withdrawal, and related nutritional deficiencies; acute and chronic toxic and nutritional peripheral neuropathies; and myopathy. Although prevention of alcoholism and its neurologic complications is the optimal strategy, this article reviews the specific treatment algorithms for alcohol withdrawal and its related nutritional deficiency states.

  7. Palliative care and neurology (United States)

    Boersma, Isabel; Miyasaki, Janis; Kutner, Jean


    Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. PMID:24991027

  8. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade


    Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  9. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study (United States)

    Kolade, Victor O.; Staton, Lisa J.; Jayarajan, Ramesh; Bentley, Nanette K.; Huang, Xiangke


    Introduction The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results Thirteen junior (first- or second-year) resident responses reported that the chief residents elicited input from others (mean rating 6.8), were committed to the team (6.8), resolved conflict (6.7), ensured efficiency, organization and productivity of the team (6.7), participated actively (7.0), and managed resources (6.6). Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4) than with being chief resident (5.8). Conclusion The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year) chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs. PMID:25147630

  10. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher


    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  11. Residents’ Experiences of Privacy and Comfort in Multi-Storey Apartment Dwellings in Subtropical Brisbane

    Directory of Open Access Journals (Sweden)

    Rosemary Kennedy


    Full Text Available Dwellings in multi-storey apartment buildings (MSAB are predicted to increase dramatically as a proportion of housing stock in subtropical cities over coming decades. The problem of designing comfortable and healthy high-density residential environments and minimising energy consumption must be addressed urgently in subtropical cities globally. This paper explores private residents’ experiences of privacy and comfort and their perceptions of how well their apartment dwelling modulated the external environment in subtropical conditions through analysis of 636 survey responses and 24 interviews with residents of MSAB in inner urban neighbourhoods of Brisbane, Australia. The findings show that the availability of natural ventilation and outdoor private living spaces play important roles in resident perceptions of liveability in the subtropics where the climate is conducive to year round “outdoor living”. Residents valued choice with regard to climate control methods in their apartments. They overwhelmingly preferred natural ventilation to manage thermal comfort, and turned to the air-conditioner for limited periods, particularly when external conditions were too noisy. These findings provide a unique evidence base for reducing the environmental impact of MSAB and increasing the acceptability of apartment living, through incorporating residential attributes positioned around climate-responsive architecture.

  12. Neurologic Complications of Celiac Disease

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Patients with celiac disease (CD [n=l 11] and controls (n=211 were questioned regarding neurologic disorders, their charts were reviewed, and they received neurologic evaluations, including brain imaging or EEG if indicated, in a study of neurologic complications of CD at Carmel Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.

  13. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

  14. Predicting Human Thermal Comfort in Automobiles

    Energy Technology Data Exchange (ETDEWEB)

    Rugh, J.; Bharathan, D.; Chaney, L.


    The objects of this report are to: (1) increase national energy security by reducing fuel use for vehicle climate control systems; (2) show/demonstrate technology that can reduce the fuel used by LD vehicles' ancillary systems; and (3) develop tools to evaluate the effectiveness of energy-efficient systems including--comfort, cost, practicality, ease-of-use, and reliability.


    African Journals Online (AJOL)


    planning and constructing buildings for human habitation, a satisfactory thermal environment is an essential ... scale, as such the generation of heat energy tends to follow the trajectory and hence microclimate and human ..... energy conservation values and human thermal comfort of such planting are maintained over time.


    African Journals Online (AJOL)

    Elements of comfort and satisfaction in the office workspace. Drmsoh ity. Communication is one of the major factors related to the interpersonal relationships influ- enced by the furniture and office layout. Each individual takes a role within the organization and works with others to accomplish the set goals ofthe organization.

  17. Evaluating bicyclists comfort and safety perception

    NARCIS (Netherlands)

    Jain, Himani; Tiwari, Geetam; Zuidgeest, M.H.P.; Viegas, J.M.; Macario, R.


    Perception of safety and comfort of bicycle infrastructure is an important factor influencing the use of bicycles. Cyclists can be found all over India. In urban areas presently, mostly captive riders choose to bicycle as no other viable options of travel are available to them. This study discusses

  18. The Analysis of Thermal Comfort in Kitchen (United States)

    Ilma Rahmillah, Fety; Hotma Uli Tumanggor, Agustina; Dila Sari, Amarria


    Human also has a thermoreceptor which is a non-specialized sensory receptor that has relative changes in temperature. Thermal comfort is a very important element for human body. Kitchen as an important part of a home is often forgotten. Cooking in the kitchen is a routine activity which is done from the morning until the evening; begin with preparing breakfast, lunch and dinner. The problem in this study was the occurance of heat when cooking in the kitchen without air conditioning in tropical countries. This research analyzes thermal comfort while doing cooking activities in conventional kitchen with gas stoves in tropical dry season. Two residential kitchens are observed by measuring the temperature and humidity as well as analyze other possible factors. Psychometric chart is used to assess the comfort zone in the kitchen. This research is using Predicted Mean Vote (PMV) Index and Predicted Percentage Dissatisfied (PPD) Index. By using online psychometric chart, the sensation is in warm condition with the range value of PMV between 1.73 up to 2.36 and PPD 63% untill 90%. However, 71% respondents perceived morning kitchen thermal as comfortable.

  19. Neurology and literature 2. (United States)

    Iniesta, I


    Good literary fiction has the potential to move us, extend our sense of life, transform our prospective views and help us in the face of adversity. A neurological disorder is likely to be the most challenging experience a human being may have to confront in a lifetime. As such, literary recreations of illnesses have a doubly powerful effect. Study the synergies between neurology and fictional literature with particular reference to narrative based medicine (NBM). Doctors establish boundaries between the normal and the abnormal. Taking a clinical history is an act of interpretation in which the doctor integrates the science of objective signs and measurable quantities with the art of subjective clinical judgment. The more discrepancy there is between the patient's experience with the illness and the doctor's interpretation of that disease, the less likely the doctor-patient interaction is to succeed. NBM contributes to a better discernment of the meanings, thus considering disease as a biographical event rather than just a natural fact. Drawing from their own experience with disease, writers of fiction provide universal insights through their narratives, whilst neuroscientists, like Cajal, have occasionally devoted their scientific knowledge to literary narratives. Furthermore, neurologists from Alzheimer to Oliver Sacks remind us of the essential value of NBM in the clinic. Integrating NBM (the narrative of patients) and the classic holistic approach to patients with our current paradigm of evidence based medicine represents a challenge as relevant to neurologists as keeping up with technological and scientific advances. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  20. Neurological Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Mohan Rudrappa


    Full Text Available West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.

  1. Neurological complications of chickenpox

    Directory of Open Access Journals (Sweden)

    Girija A


    Full Text Available Aim: To assess the neurological complications of chickenpox with prognosis. Background: The neurological complications occur in 0.03% of persons who get chickenpox. There is no universal vaccination against chicken pox in India. Most patients prefer alternate modalities of treatment. Hence these complications of chickenpox are likely to continue to occur. Study Design: A prospective study was conducted for 2 years (from March 2002 on the admitted cases with neurological complications after chickenpox (with rash or scar. Patients were investigated with CT/MRI, CSF study, EEG and nerve conduction studies and hematological workup. They were followed-up for 1 year and outcome assessed using modified Rankin scale. Results: The latency for the neurological complications was 4-32 days (mean: 16.32 days. There were 18 cases: 10 adults (64% and 8 children (36%. Cerebellar ataxia (normal CT/MRI was observed in 7 cases (32% (mean age: 6.85 years. One patient (6 years had acute right hemiparesis in the fifth week due to left capsular infarct. All these cases spontaneously recovered by 4 weeks. The age range of the adult patients was 13-47 years (mean: 27 years. The manifestations included cerebellar and pyramidal signs (n-4 with features of demyelination in MRI who recovered spontaneously or with methylprednisolone by 8 weeks. Patient with encephalitis recovered in 2 weeks with acyclovir. Guillain Barre syndrome of the demyelinating type (n-2 was treated with Intravenous immunoglobulin (IVIG and they had a slow recovery by a modified Rankin scale (mRs score of 3 and 2 at 6 months and 1 year, respectively. One case died after hemorrhage into the occipital infarct. There were two cases of asymmetrical neuropathy, one each of the seventh cranial and brachial neuritis. Conclusion: Spontaneous recovery occurs in post-chickenpox cerebellar ataxia. Rarely, serious complications can occur in adults. The demyelinating disorders, either of the central or peripheral

  2. Radiology residents' experience with intussusception reduction. (United States)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang


    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  3. Neurological aspects of grief. (United States)

    Silva, Adriana C; de Oliveira Ribeiro, Natalia P; de Mello Schier, Alexandre R; Arias-Carrión, Oscar; Paes, Flavia; Nardi, Antonio E; Machado, Sergio; Pessoa, Tamires M


    Despite grief being a universal experience and the increased scientific attention paid to grief and bereavement in recent years, studies that seek to better understand the role of the neurological aspects of grief are still scarce. We found 5 studies that discussed the relationship between the neurological aspects of grief due to the death of a loved one. All studies showed an activation of common areas, i.e., the anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), prefrontal cortex (PFC), insula and amygdala. These findings could indicate that there is a group of areas working together and responding to generate the symptomatology of grief. Because grief is a universal experience, it is essential that the necessary and effective support can be provided to those who experience the loss of someone considered important in their lives, and this requires understanding grief's manifestation, its differential diagnosis in reference to other clinical conditions, mainly psychiatric ones, and adequate forms of intervention and treatment when necessary. Proper understanding and support can help prevent the emergence of more serious health problems.

  4. An Informed Consent Program Enhances Surgery Resident Education. (United States)

    Koller, Sarah E; Moore, Ryan F; Goldberg, Michael B; Zhang, Jeanette; Yu, Daohai; Conklin, Charles B; Milner, Richard E; Goldberg, Amy J

    First-year residents often obtain informed consent from patients. However, they typically receive no formal training in this area before residency. We wished to determine whether an educational program would improve residents' comfort with this process. Our institution created an informed consent educational program, which included a didactic component, a role-play about informed consent, and a simulation exercise using standardized patients. Residents completed surveys before and after the intervention, and responses to survey questions were compared using the signed-rank test. This study took place at Temple University Hospital, a tertiary care institution in Philadelphia, PA. First-year surgery and emergency medicine residents at Temple University Hospital in 2014 participated in this study. Thirty-two residents completed the preintervention survey and 27 residents completed the educational program and postintervention survey. Only 37.5% had ever received formal training in informed consent before residency. After participating in the educational program, residents were significantly more confident that they could correctly describe the process of informed consent, properly fill out a procedure consent form, and properly obtain informed consent from a patient. Their comfort level in obtaining informed consent significantly increased. They found the educational program to be very effective in improving their knowledge and comfort level in obtaining informed consent. In all, 100% (N = 27) of residents said they would recommend the use of the program with other first-year residents. Residents became more confident in their ability to obtain informed consent after participating in an educational program that included didactic, role-play, and patient simulation elements. Copyright © 2017. Published by Elsevier Inc.

  5. Educational interventions in neurology: a comprehensive systematic review. (United States)

    McColgan, P; McKeown, P P; Selai, C; Doherty-Allan, R; McCarron, M O


    A fear of neurology and neural sciences (neurophobia) may have clinical consequences. There is therefore a need to formulate an evidence-based approach to neurology education. A comprehensive systematic review of educational interventions in neurology was performed. BEI, Cochrane Library, Dialog Datastar, EBSCO Biomedical, EBSCO Psychology & Behavioral Sciences, EMBASE, ERIC, First Search, MDConsult, Medline, Proquest Medical Library and Web of Knowledge databases were searched for all published studies assessing interventions in neurology education among undergraduate students, junior medical doctors and residents up to and including July 2012. Two independent literature searches were performed for relevant studies, which were then classified for level of evidence using the Centre of Evidence-based Medicine criteria and four levels of Kirkpatrick educational outcomes. One systematic review, 16 randomized controlled trials (RCTs), nine non-randomized cohort/follow-up studies, 33 case series or historically controlled studies and three mechanism-based reasoning studies were identified. Educational interventions showed favourable evaluation or assessment outcomes in 15 of 16 (94%) RCTs. Very few studies measured subsequent clinical behaviour (two studies) and patient outcomes (one study). There is very little high quality evidence of demonstrably effective neurology education. However, RCTs are emerging, albeit without meeting comprehensive educational criteria. An improving evidence base in the quality of neurology education will be important to reduce neurophobia. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  6. The comfort triangles : A new tool for bioclimatic design

    NARCIS (Netherlands)

    Evans, J.M.


    This thesis presents a new graphic tool to identify and select bioclimatic strategies according to climate conditions and comfort requirements. The Comfort Triangle relates outdoor daily temperature variations with the modification of thermal performance achieved indoors, using two key variables,

  7. A national survey of residents in combined Internal Medicine and Dermatology residency programs: educational experience and future plans. (United States)

    Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha


    In response to a perceived erosion of medical dermatology, combined internal medicine and dermatology programs (med/derm) programs have been developed that aim to train dermatologists who take care of medically complex patients. Despite the investment in these programs, there is currently no data with regards to the potential impact of these trainees on the dermatology workforce. To determine the experiences, motivations, and future plans of residents in combined med/derm residency programs. We surveyed residents at all United States institutions with both categorical and combined training programs in spring of 2012. Respondents used visual analog scales to rate clinical interests, self-assessed competency, career plans, and challenges. The primary study outcomes were comfort in taking care of patients with complex disease, future practice plans, and experience during residency. Twenty-eight of 31 med/derm residents (87.5%) and 28 of 91 (31%) categorical residents responded (overall response rate 46%). No significant differences were seen in self-assessed dermatology competency, or comfort in performing inpatient consultations, cosmetic procedures, or prescribing systemic agents. A trend toward less comfort in general dermatology was seen among med/derm residents. Med/derm residents were more likely to indicate career preferences for performing inpatient consultation and taking care of medically complex patients. Categorical residents rated their programs and experiences more highly. Med/derm residents have stronger interests in serving medically complex patients. Categorical residents are more likely to have a positive experience during residency. Future work will be needed to ascertain career choices among graduates once data are available.

  8. Neurology in the Vietnam War. (United States)

    Gunderson, Carl H; Daroff, Robert B


    Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians. Their practice included exposure to unfamiliar disorders including cerebral malaria, Japanese B encephalitis, sleep deprivation seizures, and toxic encephalitis caused by injection or inhalation of C-4 explosive. They and neurologists at facilities in the United States published studies on all of these entities both during and after the war. These publications spawned the Defense and Veterans Head Injury Study, which was conceived during the Korean War and continues today as the Defense and Veterans Head Injury Center. It initially focused on post-traumatic epilepsy and later on all effects of brain injury. The Agent Orange controversy arose after the war; during the war, it was not perceived as a threat by medical personnel. Although soldiers in previous wars had developed serious psychological impairments, post-traumatic stress disorder was formally recognized in the servicemen returning from Vietnam. © 2016 S. Karger AG, Basel.

  9. Primary care perceptions of neurology and neurology services. (United States)

    Loftus, Angela M; Wade, Carrie; McCarron, Mark O


    Neurophobia (fear of neural sciences) and evaluation of independent sector contracts in neurology have seldom been examined among general practitioners (GPs). A questionnaire determined GPs' perceptions of neurology compared with other medical specialties. GP experiences of neurology services with independent sector companies and the local National Health Service (NHS) were compared. Areas of potential improvement in NHS neurology services were recorded from thematic analyses. Among 76 GPs neurology was perceived to be as interesting as other medical specialties. GPs reported less knowledge, more difficulty and less confidence in neurology compared with other medical specialties. There was a preference for a local NHS neurology service (pneurology services provided better patient satisfaction. GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  10. Improving comfort and health with personalized ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor


    The thermal environment and air quality in buildings affects occupants¿ health, comfort and performance. The heating, ventilating and air-conditioning (HVAC) of buildings today is designed to provide a uniform room environment. However, large individual differences exist between occupants in regard...... microenvironment. Furthermore, HVAC systems should be designed to protect occupants from airborne transmission of infectious agents that may be present in exhaled air. Personalized ventilation is a new development in the field of HVAC and has the potential to fulfil the above requirements. This paper reviews...... existing knowledge on performance of personalized ventilation (PV) and on human response to it. The airflow interaction in the vicinity of the human body is analysed and its impact on thermal comfort and inhaled air quality is discussed together with control strategies and the application of PV in practice...

  11. Deja vu in neurology. (United States)

    Wild, Edward


    The significance of deja vu is widely recognised in the context of temporal lobe epilepsy, and enquiry about deja vu is frequently made in the clinical assessment of patients with possible epilepsy. Deja vu has also been associated with several psychiatric disorders. The historical context of current understanding of deja vu is discussed. The literature reveals deja vu to be a common phenomenon consistent with normality. Several authors have suggested the existence of a "pathological" form of deja vu that differs, qualitatively or quantitatively, from "non-pathological" deja vu. The features of deja vu suggesting neurological or psychiatric pathology are discussed. Several neuroanatomical and psychological models of the deja vu experience are highlighted, implicating the perceptual, mnemonic and affective regions of the lateral temporal cortex, hippocampus and amygdala in the genesis of deja vu. A possible genetic basis for a neurochemical model of deja vu is discussed. Clinical approaches to the patient presenting with possible deja vu are proposed.

  12. Consciousness: A Neurological Perspective

    Directory of Open Access Journals (Sweden)

    Andrea E. Cavanna


    Full Text Available Consciousness is a state so essentially entwined with human experience, yet so difficult to conceptually define and measure. In this article, we explore how a bidimensional model of consciousness involving both level of arousal and subjective awareness of the contents of consciousness can be used to differentiate a range of healthy and altered conscious states. These include the different sleep stages of healthy individuals and the altered states of consciousness associated with neurological conditions such as epilepsy, vegetative state and coma. In particular, we discuss how arousal and awareness are positively correlated in normal physiological states with the exception of REM sleep, while a disturbance in this relationship is characteristic of vegetative state, minimally conscious state, complex partial seizures and sleepwalking.

  13. Neurology and diving. (United States)

    Massey, E Wayne; Moon, Richard E


    Diving exposes a person to the combined effects of increased ambient pressure and immersion. The reduction in pressure when surfacing can precipitate decompression sickness (DCS), caused by bubble formation within tissues due to inert gas supersaturation. Arterial gas embolism (AGE) can also occur due to pulmonary barotrauma as a result of breath holding during ascent or gas trapping due to disease, causing lung hyperexpansion, rupture and direct entry of alveolar gas into the blood. Bubble disease due to either DCS or AGE is collectively known as decompression illness. Tissue and intravascular bubbles can induce a cascade of events resulting in CNS injury. Manifestations of decompression illness can vary in severity, from mild (paresthesias, joint pains, fatigue) to severe (vertigo, hearing loss, paraplegia, quadriplegia). Particularly as these conditions are uncommon, early recognition is essential to provide appropriate management, consisting of first aid oxygen, targeted fluid resuscitation and hyperbaric oxygen, which is the definitive treatment. Less common neurologic conditions that do not require hyperbaric oxygen include rupture of a labyrinthine window due to inadequate equalization of middle ear pressure during descent, which can precipitate vertigo and hearing loss. Sinus and middle ear overpressurization during ascent can compress the trigeminal and facial nerves respectively, causing temporary facial hypesthesia and lower motor neuron facial weakness. Some conditions preclude safe diving, such as seizure disorders, since a convulsion underwater is likely to be fatal. Preventive measures to reduce neurologic complications of diving include exclusion of individuals with specific medical conditions and safe diving procedures, particularly related to descent and ascent. © 2014 Elsevier B.V. All rights reserved.

  14. Comfort and compressional characteristics of padding bandages. (United States)

    Kumar, Bipin; Singh, Jitender; Das, Apurba; Alagirusamy, R


    Padding bandage is an essential component of the multi-layer compression system used for chronic venous management. Padding plays a critical role in managing pressure over bony prominences and ensuring uniform pressure distribution around the limb circumference. Moreover, it helps in the management of heat, moisture and body fluids or exudates during the course of treatment to provide comfort to the patients. To study the effect of structural and constructional parameters on the compressional (pressure absorption or distribution) and comfort (air, moisture and heat transmission) characteristics of the padding. This research focuses on the examination of polypropylene based nonwoven padding samples. Critical factors, i.e., fiber linear density, needling density and mass per unit area, have been chosen for this study to find their significance on the performance of padding. Simple laboratory based methods have been proposed to examine pressure reduction and comfort characteristics of the padding. Pressure absorption by the padding decreases with increase in mass per unit area and needling density of the padding. A padding composed of thicker fiber absorbs more pressure compared to padding made from thinner fiber. On examining comfort, it was found that the air and moisture vapor transmission increase with decrease in mass per unit area and needling density but have opposite effects with fiber linear density (phealth practitioners, fabric engineers and manufactures to understand the significance of fibrous materials and their role in compression management, and could be further used as design consideration to optimized padding performance. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Eye cosmetic usage and associated ocular comfort. (United States)

    Ng, Alison; Evans, Katharine; North, Rachel; Purslow, Christine


    Eye cosmetics usage is commonplace and whilst some products such as eyeliner are applied with close proximity to the ocular surface, there is little knowledge of the short- and long-term ocular effects of eye cosmetic formulations. This study aimed to investigate the use of eye cosmetics and identify any relationships between ocular comfort and cosmetic usage. Results were collated from an online survey comprising 23 questions that recorded demographics, Ocular Surface Disease Index (OSDI) score, extent and range of eye cosmetic use and perceived comfort differences with and without eye cosmetics. The 1360 female respondents (median age 25, interquartile range 20-34 years) completed the survey; 83% reported using eye cosmetics regularly (≥ 3 times per week) with mascara being most commonly used. Fifty three per cent used at least three different eye cosmetics products regularly. OSDI scores of cosmetics users were similar to non-users (p = 0.083), but perceived comfort was greater when cosmetics were not used (p cosmetics users (use of products cosmetics were used. Median OSDI scores suggested a trend towards reduced comfort amongst eyeliner users (p = 0.07) although frequency and type of cosmetic products used did not appear to influence OSDI scores. This study shows the use of multiple eye cosmetics is extensive and associated with the perception of ocular discomfort. With such widespread use of these products, more research is required to assess the effect on the ocular surface and tear film, which may be underestimated. Ophthalmic & Physiological Optics © 2012 The College of Optometrists.

  16. Influence of textile properties on thermal comfort (United States)

    Marolleau, A.; Salaun, F.; Dupont, D.; Gidik, H.; Ducept, S.


    This study reports on the impact of textile properties on thermal comfort. The fabric weight, thickness, porosity, moisture regain, air permeability and density have been considered and correlated to the thermal and water vapour resistance, permeability index, thermal conductivity and effusivity, and moisture management capacity. Results suggest that moisture transfer is affected by thickness, density and moisture regain whereas thermal transfer by air permeability and density.

  17. Thermodynamical analysis of human thermal comfort


    Prek, Matjaž


    Traditional methods of human thermal comfort analysis are based on the first law of thermodynamics. These methods use an energy balance of the human body to determine heat transfer between the body and its environment. By contrast, the second law of thermodynamics introduces the useful concept of exergy. It enables the determination of the exergy consumption within the human body dependent on human and environmental factors. Human body exergy consumption varies with the combination of environ...

  18. The electric comfort; Le confort electrique

    Energy Technology Data Exchange (ETDEWEB)



    In the framework of the public information on the electric power utilization in the household, Electricite De France presented on april-may at Paris Meeting, the possibilities and the advantages of the electric comfort. The concerned domains are: the electric cheating, the air-conditioning, the hot water, the lighting and the electric household appliances. Information on prices and statistical data on electric heating are also provided. (A.L.B.)

  19. Viewing Race in the Comfort Zone


    Brenda L. Hughes


    Carter suggests the concept of a “comfort zone” to explain the inability of dramatic African American programs to be successful on television. He argues that a workable formula has been developed for successful African American series, “portray black people in a way that would be acceptable to the millions of potential purchasers (whites) of advertised products. That is, non-threatening and willing to ‘stay in their pl...

  20. History of neurologic examination books. (United States)

    Boes, Christopher J


    The objective of this study was to create an annotated list of textbooks dedicated to teaching the neurologic examination. Monographs focused primarily on the complete neurologic examination published prior to 1960 were reviewed. This analysis was limited to books with the word "examination" in the title, with exceptions for the texts of Robert Wartenberg and Gordon Holmes. Ten manuals met the criteria. Works dedicated primarily to the neurologic examination without a major emphasis on disease description or treatment first appeared in the early 1900s. Georg Monrad-Krohn's "Blue Book of Neurology" ("Blue Bible") was the earliest success. These treatises served the important purpose of educating trainees on proper neurologic examination technique. They could make a reputation and be profitable for the author (Monrad-Krohn), highlight how neurology was practiced at individual institutions (McKendree, Denny-Brown, Holmes, DeJong, Mayo Clinic authors), and honor retiring mentors (Mayo Clinic authors).

  1. Viewing Race in the Comfort Zone

    Directory of Open Access Journals (Sweden)

    Brenda L. Hughes


    Full Text Available Carter suggests the concept of a “comfort zone” to explain the inability of dramatic African American programs to be successful on television. He argues that a workable formula has been developed for successful African American series, “portray black people in a way that would be acceptable to the millions of potential purchasers (whites of advertised products. That is, non-threatening and willing to ‘stay in their place.’”. Using a data set constructed from television ratings and shares, this study examines “black-centeredness” within the context of program success and failure. The comfort zone concept argues Black-centered television series are only successful in a comedic genre because White audiences, who have the majority of the ratings power, will only watch Black-centered series with which they are comfortable. The findings suggest that, in general, race, that is Black-centeredness, did not negatively influence program ratings or shares.

  2. Domotics. Comfortable and energy efficient?; Domotica. Comfortabel en energiezuinig?

    Energy Technology Data Exchange (ETDEWEB)

    Van Wolferen, H.; Hendriksen, L.; Traversari, R. [TNO Milieu, Energie en Procesinnovatie TNO-MEP, Apeldoorn (Netherlands)


    Insight is given into the added value of domotics (home automation) in the handling and control of comfort installations, focusing on comfort and energy consumption. Costs are indicated. [Dutch] Een overzicht wordt gegeven van de toegevoegde waarde van domotica bij de bediening en regeling van comfortinstallaties. Hierbij wordt de meeste aandacht gegeven aan comfort en energiegebruik. De kosten worden alleen indicatief besproken.

  3. Design of outdoor urban spaces for thermal comfort (United States)

    Harriet J. Plumley


    Microclimates in outdoor urban spaces may be modified by controlling the wind and radiant environments in these spaces. Design guidelines were developed to specify how radiant environments may be selected or modified to provide conditions for thermal comfort. Fanger's human-thermal-comfort model was used to determine comfortable levels of radiant-heat exchange for...

  4. Comfort Indicators for the Assessment of Indoor Environmental Building Performance

    DEFF Research Database (Denmark)

    Brohus, Henrik; Bendtsen, A.; Sørensen, M.


    Indoor environmental building performance assessment requires efficient indicators of the indoor comfort. In order to be effective and useful the comfort indicators must be able to include the temporal variation of indoor comfort as well as the degree of discomfort perceived by the occupants...

  5. Comfort Indicators for the Assessment of Indoor Environmental Building Performance

    DEFF Research Database (Denmark)

    Brohus, Henrik; Bendtsen, A.; Sørensen, M.


    Indoor environmental building performance assessment requires efficient indicators of the indoor comfort. In order to be effective and useful the comfort indicators must be able to include the temporal variation of indoor comfort as well as the degree of discomfort perceived by the occupants. Thi...

  6. Opinion and Special Articles: Neurology education at US osteopathic medical schools. (United States)

    Freedman, Daniel A; Albert, Dara V F


    Osteopathic medical schools have a longstanding tradition of training primary care physicians (PCP). Neurologic symptoms are common in the PCP's office and there is an undersupply of neurologists in the United States. It is therefore crucial for osteopathic medical students to have a strong foundation in clinical neurology. Despite the importance, a mere 6% of osteopathic medical schools have required neurology clerkships. Furthermore, exposure to neurology in medical school through required clerkships has been correlated with matching into neurology residency. As osteopathic medical schools continue to expand, it will become increasingly important to emphasize the American Academy Neurology's published guidelines for a core clerkship curriculum. Practicing neurologists should take an active role in encouraging osteopathic medical schools to adopt these guidelines. © 2017 American Academy of Neurology.

  7. Forty years of Fanger's model of thermal comfort: comfort for all? (United States)

    van Hoof, J


    The predicted mean vote (PMV) model of thermal comfort, created by Fanger in the late 1960s, is used worldwide to assess thermal comfort. Fanger based his model on college-aged students for use in invariant environmental conditions in air-conditioned buildings in moderate thermal climate zones. Environmental engineering practice calls for a predictive method that is applicable to all types of people in any kind of building in every climate zone. In this publication, existing support and criticism, as well as modifications to the PMV model are discussed in light of the requirements by environmental engineering practice in the 21st century in order to move from a predicted mean vote to comfort for all. Improved prediction of thermal comfort can be achieved through improving the validity of the PMV model, better specification of the model's input parameters, and accounting for outdoor thermal conditions and special groups. The application range of the PMV model can be enlarged, for instance, by using the model to assess the effects of the thermal environment on productivity and behavior, and interactions with other indoor environmental parameters, and the use of information and communication technologies. Even with such modifications to thermal comfort evaluation, thermal comfort for all can only be achieved when occupants have effective control over their own thermal environment. The paper treats the assessment of thermal comfort using the PMV model of Fanger, and deals with the strengths and limitations of this model. Readers are made familiar to some opportunities for use in the 21st-century information society.

  8. Neurological sequelae of bacterial meningitis. (United States)

    Lucas, Marjolein J; Brouwer, Matthijs C; van de Beek, Diederik


    We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive impairment and epilepsy. Adults with pneumococcal meningitis have the highest risk of developing focal neurological deficits, which are most commonly caused by cerebral infarction, but can also be due to cerebritis, subdural empyema, cerebral abscess or intracerebral bleeding. Focal deficits may improve during clinical course and even after discharge, but a proportion of patients will have persisting focal neurological deficits that often interfere in patient's daily life. Hearing loss occurs in a high proportion of patients with pneumococcal meningitis and has been associated with co-existing otitis. Children and adults recovering from bacterial meningitis without apparent neurological deficits are at risk for long-term cognitive deficits. Early identification of neurological sequelae is important for children to prevent additional developmental delay, and for adults to achieve successful return in society after the disease. Neurological sequelae occur in a substantial amount of patients following bacterial meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive impairment and epilepsy. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  9. Perioperative Management of Neurological Conditions

    Directory of Open Access Journals (Sweden)

    Manjeet Singh Dhallu


    Full Text Available Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease. In this article, we emphasize on early diagnosis and management strategies of neurological disorders in the perioperative period to minimize morbidity and mortality of patients.

  10. Splicing Regulation in Neurologic Disease

    National Research Council Canada - National Science Library

    Licatalosi, Donny D; Darnell, Robert B


    .... It is becoming evident that alternative splicing plays a particularly important role in neurologic disease, which is perhaps not surprising given the important role splicing plays in generating...

  11. Cannabinoids in neurology – Brazilian Academy of Neurology

    Directory of Open Access Journals (Sweden)

    Sonia M. D. Brucki


    Full Text Available The use of cannabidiol in some neurological conditions was allowed by Conselho Regional de Medicina de São Paulo and by Agência Nacional de Vigilância Sanitária (ANVISA. Specialists on behalf of Academia Brasileira de Neurologia prepared a critical statement about use of cannabidiol and other cannabis derivatives in neurological diseases.

  12. Comfort-box controls individual level of comfort. Domotica home network for indoor climate management; Comfort-box regelt individueel comfort-niveau. Domotica-huisnetwerk voor beheer binnenklimaat

    Energy Technology Data Exchange (ETDEWEB)

    Kamphuis, I.G; Warmer, C.J.; Bakker, E.J. [ECN Duurzame Energie in de Gebouwde Omgeving DEGO, Petten (Netherlands)


    The Comfort-Box (or C-Box) project is an automatic and continuous control system for energy efficient and cost-effective thermal comfort in houses. In this article detailed information is given of the design and performance of the C-Box. [Dutch] De huidige regelsystemen voor het binnenklimaat in woningen zijn voor verbetering vatbaar. Met het Comfort-boxconcept is een regeling ontwikkeld die automatisch en continu het individuele comfortniveau regelt in woningen, waarbij afwegingen worden gemaakt tussen kosten en comfort. De Comfort-box blijkt in staat te zijn het binnencomfort op energie- en kostenefficiente wijze te beheren.

  13. Organ Support After Death by Neurologic Criteria in Pediatric Patients. (United States)

    Lewis, Ariane; Adams, Nellie; Chopra, Arun; Kirschen, Matthew P


    We sought to 1) evaluate how pediatricians approach situations in which families request continuation of organ support after declaration of death by neurologic criteria and 2) explore potential interventions to make these situations less challenging. A survey on management and personal experience with death by neurologic criteria was distributed electronically to pediatric intensivists and neurologists. We compared responses from individuals who practice in states with accommodation exceptions (accommodation states where religious or moral beliefs must be taken into consideration when declaring death: California, Illinois, New Jersey, New York) to those from non-accommodation states. United States. The survey was opened by 254 recipients, with 186 meeting inclusion criteria and providing data about the region in which they practice; of these, 26% were from accommodation states. None. More than half of physicians (61% from both accommodation states and non-accommodation states) reported they cared for a pediatric patient whose family requested continuation of organ support after declaration of death by neurologic criteria (outside of organ donation; range, 1-17 times). Over half of physicians (53%) reported they would not feel comfortable handling a situation in which a pediatric patient's family requested care be continued after declaration of death by neurologic criteria. Nearly every physician (98%) endorsed that something needs to be done to make situations involving families who object to discontinuation of organ support after declaration of death by neurologic criteria easier to handle. Respondents felt that public education, physician education, and uniform state laws about these situations are warranted. It is relatively common for pediatricians who care for critically ill patients to encounter families who object to discontinuation of organ support after death by neurologic criteria. Management of these situations is challenging, and guidance for medical

  14. [Neurological interpretation of dreams] . (United States)

    Pareja, J A; Gil-Nagel, A


    Cerebral cortical activity is constant throughout the entire human life, but substantially changes during the different phases of the sleep-wake cycle (wakefulness, non-REM sleep and REM sleep), as well as in relation to available information. In particular, perception of the environment is closely linked to the wake-state, while during sleep perception turns to the internal domain or endogenous cerebral activity. External and internal information are mutually exclusive. During wakefulness a neuronal mechanism allows attention to focus on the environment whereas endogenous cortical activity is ignored. The opposite process is provided during sleep. The function external attention-internal attention is coupled with the two modes of brain function during wakefulness and during sleep, providing two possible cortical status: thinking and dreaming. Several neurological processes may influence the declaration of the three states of being or may modify their orderly oscillation through the sleep-wake cycle. In addition, endogenous information and its perception (dreams) may be modified. Disturbances of dreaming may configurate in different general clinical scenarios: lack of dreaming, excess of dreaming (epic dreaming), paroxysmal dreaming (epileptic), nightmares, violent dreaming, daytime-dreaming (hallucinations), and lucid dreaming. Sensorial deprivation, as well as the emergence of internal perception may be the underlying mechanism of hallucinations. The probable isomorphism between hallucinations and dreaming is postulated, analyzed and discussed.

  15. Influence of foot, leg and shoe characteristics on subjective comfort. (United States)

    Miller, J E; Nigg, B M; Liu, W; Stefanyshyn, D J; Nurse, M A


    The purpose of this study was to determine the relationships between foot and leg characteristics, shoe characteristics, and the short-term subjective comfort of three different pairs of athletic shoes. Static measurements of foot dimension and leg angles were taken from eighteen subjects. Subjects rated the comfort of three different athletic shoes for standing, walking and running. The shoes were quantified by internal dimensions, hardness, flexibility and torsional stiffness. Average comfort ratings decreased from standing to walking to running. One shoe seemed suited for only a small group of subjects. In contrast, another shoe was generally comfortable for a large group. Skeletal alignment, specifically eversion angle, was related to comfort for one shoe. Therefore, fit of the shoe is not sufficient for comfort. Skeletal alignment, shoe torsional stiffness and cushioning seem to be mechanical variables which may be important for comfort.

  16. Advance Directives and Care Received by Older Nursing Home Residents. (United States)

    Manu, Erika R; Mody, Lona; McNamara, Sara E; Vitale, Caroline A


    Research shows variable success as to whether care provided aligns with individual patient preferences as reflected in their advance directives (AD). We aimed to study AD status and subsequent care received in older nursing home (NH) residents deemed at risk for infections and care transitions: those with a urinary catheter (UC), feeding tube (FT), or both. Design/participants/measurements: A subgroup analysis of a prospective cohort of 90 residents with a UC and/or FT from 15 NHs in southeast Michigan. Outcomes assessed at enrollment and at 30-day intervals were hospitalizations and antibiotic use. The ADs were divided as follows: (1) comfort oriented: comfort measures only, no hospital transfer; (2) palliative oriented: comfort focused, allowing hospital transfer (except intensive care unit), antibiotic use, but no cardiopulmonary resuscitation; (3) usual care: full code, no limitations to care. We calculated incidences for these outcomes. Seventy-eight (87%) residents had ADs: 18 (23%) comfort oriented, 32 (41%) palliative oriented, and 28 (36%) usual care. The groups did not differ regarding demographics, comorbidity, function, device presence, or time in study. Using the usual care group as comparison, the comfort-oriented group was hospitalized at a similar rate (Incidence rate [IR] = 15.6/1000 follow-up days vs IR = 8.8/1000 follow-up days, Incident rate ratio [IRR] 0.6 [95% confidence interval, CI, 0.3 -1.1], P value .09) but received fewer antibiotics (IR = 18.9/1000 follow-up days vs IR = 7.5/1000 follow-up days, IRR 0.4 [95% CI, 0.2-0.8], P value .005). Nursing home residents with comfort-oriented ADs were hospitalized at a rate similar to those with usual-care ADs but received fewer antibiotics, although the small sample size of this analysis suggests these findings deserve further study.

  17. Neurology Health Advocacy Curriculum: Needs Assessment, Curricular Content and Underlying Components. (United States)

    Abuzinadah, Ahmad Rida; Cooke, Lara


    Lack of a health advocacy curriculum and clarity are obstacles for effectively teaching neurology health advocacy (NHA) to neurology residents. Our purpose is to assess the need and develop content for a NHA curriculum and to describe its underlying components. This is a cross-sectional study with two steps. In step one, neurologists and neurology residents at University of Calgary were surveyed about their perception of teaching NHA and asked to rank 56 neurological diseases on a Likert scale based on how well they lend themselves to teaching health advocacy. In step two, curricular items were developed for the top five neurological diseases, using a modified Delphi procedure. The reliability of the survey instrument was determined by Cronbach's alpha. Exploratory factor analysis was used to identify the underlying components of NHA. Forty-six neurologists and 14 neurology residents were surveyed, with a response rate of 88.33%. Fifty-six percent of neurologists and 85% of residents believe that NHA curriculum is needed. The top five neurological presentations, that lend themselves easily to teaching NHA were: stroke/transient ischemic attacks, alcoholism, epilepsy, Alzheimer's disease, and multiple sclerosis. The survey instrument reliability was 0.97. Exploratory factor analysis revealed four factors that can explain the variability in the survey instrument: multidisciplinary approach to neurological disorders, prevention of recurrence of neurological disease, collaboration with other medical subspecialties, and communication with professions outside the medical field. Neurologists' and residents' responses support that NHA curriculum is needed. Four components of NHA were identified that can be used for teaching NHA as well as health advocacy in general practice.

  18. Interventional neurology: a reborn subspecialty. (United States)

    Edgell, Randall C; Alshekhlee, Amer; Yavagal, Dileep R; Vora, Nirav; Cruz-Flores, Salvador


    Neurologists have a long history of involvement in cerebral angiography; however, the roots of neurologist involvement in therapeutic endovascular procedures have not been previously documented. As outlined in this article, it has taken the efforts of several early pioneers to lay the ground work for interventional neurology, a specialty that has become one of the fastest growing neurological subspecialties. The ground work, along with a great clinical need, has allowed the modern interventional neurologist to tackle some of the most intractable diseases, especially those affecting the cerebral vasculature. The institutionalization of interventional neurology as a subspecialty was first advocated in 1995 in an article entitled, "Interventional Neurology, a subspecialty whose time has come." The institutions created in the wake of this article have provided the framework that has allowed interventional neurology to transition from "a subspecialty whose time has come" to a subspecialty that is here to stay and thrive. Copyright © 2010 by the American Society of Neuroimaging.

  19. Bioclimatic comfort and the thermal perceptions and preferences of beach tourists (United States)

    Rutty, Michelle; Scott, Daniel


    The largest market segment of global tourism is coastal tourism, which is strongly dependent on the destination's thermal climate. To date, outdoor bioclimatic comfort assessments have focused exclusively on local residents in open urban areas, making it unclear whether outdoor comfort is perceived differently in non-urban environments or by non-residents (i.e. tourists) with different weather expectations and activity patterns. This study provides needed insight into the perception of outdoor microclimatic conditions in a coastal environment while simultaneously identifying important psychological factors that differentiate tourists from everyday users of urban spaces. Concurrent micrometeorological measurements were taken on several Caribbean beaches in the islands of Barbados, Saint Lucia and Tobago, while a questionnaire survey was used to examine the thermal comfort of subjects ( n = 472). Universal Thermal Climate Index (UTCI) conditions of 32 to 39 °C were recorded, which were perceived as being "slightly warm" or "warm" by respondents. Most beach users (48 to 77 %) would not change the thermal conditions, with some (4 to 15 %) preferring even warmer conditions. Even at UTCI of 39 °C, 62 % of respondents voted for no change to current thermal conditions, with an additional 10 % stating that they would like to feel even warmer. These results indicate that beach users' thermal preferences are up to 18 °C warmer than the preferred thermal conditions identified in existing outdoor bioclimatic studies from urban park settings. This indicates that beach users hold fundamentally different comfort perceptions and preferences compared to people using urban spaces. Statistically significant differences ( p ≤ .05) were also recorded for demographic groups (gender, age) and place of origin (climatic region).

  20. What do residents need to be competent laparoscopic and endoscopic surgeons? (United States)

    Gardner, Aimee K; Willis, Ross E; Dunkin, Brian J; Van Sickle, Kent R; Brown, Kimberly M; Truitt, Michael S; Uecker, John M; Gentry, Lonnie; Scott, Daniel J


    Despite numerous efforts to ensure that surgery residents are adequately trained in the areas of laparoscopy and flexible endoscopy, there remain significant concerns that graduates are not comfortable performing many of these procedures. Online surveys were sent to surgery residents (98 items, PGY1-5 Categorical) and faculty (78 items, general surgery, and gastrointestinal specialties) at seven institutions. De-identified data were analyzed under an IRB-approved protocol. Ninety-five faculty and 121 residents responded, with response rates of 65 and 52 %, respectively. Seventy-three percent of faculty indicated that competency of their graduating residents were dramatically or slightly worse than previous graduates. Only 29 % of graduating residents felt very comfortable performing advanced laparoscopic (AL) cases and 5 % performing therapeutic endoscopy (TE) cases immediately after graduation. Over half of interns expressed a need for fellowship to feel comfortable performing AL and TE procedures, and this need did not decrease as residents neared graduation. For these procedures, residents receive only "little to some" autonomy, as reported by both faculty and PGY5s. Residents reported that current curricula for laparoscopy and endoscopy consist primarily of clinical experience. Both residents and faculty, though, reported considerable value in other training modalities, including simulations, live animal laboratories, cadavers, and additional didactics. These data indicate that both residents and faculty perceive significant competency gaps for both laparoscopy and flexible endoscopy, with the most notable shortcomings for advanced and therapeutic cases, respectively. Improvement in resident training methods in these areas is warranted.

  1. Developing Pokemon AI For Finding Comfortable Settings


    Panumate, Chetprayoon; Iida, Hiroyuki


    This paper explores an innovative way to find a comfortable setting of video games. Pokemon is chosen as benchmark and game refinement measure is employed for the assessment. The number of Pokemon that one trainer can carry (i.e., setting with n=6) has never been changed after the first episode of Pokemon was released in 1996. Pokemon battle is simulated and various AIs are developed for the experiments. The results show that the original setting is the best for many players of various levels.

  2. Energy savings and comfort changes in buildings

    Energy Technology Data Exchange (ETDEWEB)

    Krighaar, M. [COWI (Denmark); Ivanauskas, A. [Klaipedos Energija SPAB (Lithuania)


    This article presents the results from a demonstration project on building installations in the city Klaipeda, Lithuania. The project demonstrates the energy savings and increased comfort level achieved by installation of various energy saving measures and includes a cost benefit analysis. The demonstration area consists of eight typical buildings. The outcome of the project provides a valuable basis for future decisions to be made concerning reconstruction of heating installations and enables the results and experience to be transferred to 2,500 buildings in Klaipeda and buildings in Lithuania in general. (au)

  3. Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity. (United States)

    Buizer, A I; van Schie, P E M; Bolster, E A M; van Ouwerkerk, W J; Strijers, R L; van de Pol, L A; Stadhouder, A; Becher, J G; Vermeulen, R J


    In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort. To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions. Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m). All eligible patients (n = 24, years 2009-2014) were included. Mean age at SDR was 12y 4m (SD 4y 3m, range 2y 8m-19y 3m). Associated orthopaedic problems were frequent. Seven patients underwent scoliosis correction in the same session. Most improvements were reported in dressing (n = 16), washing (n = 12) and comfort (n = 10). Median score for satisfaction was 7 on a scale of 10 (range 1-9). SDR resulted in reduction of spasticity in leg muscles. In nine patients dystonia was recorded post-operatively, mainly in children with congenital malformations and syndromes. SDR is a single event intervention that can improve daily care and comfort in non-walking children with severe spasticity, and can safely be combined with scoliosis correction. Despite the improvements, satisfaction is variable. Careful attention is necessary for risk factors for dystonia, which may be unmasked after SDR. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  4. Neurological examination in small animals

    Directory of Open Access Journals (Sweden)

    Viktor Paluš


    Full Text Available This clinical review about the neurological examination in small animals describes the basics about the first steps of investigation when dealing with neurological patients. The knowledge of how to perform the neurological examination is important however more important is how to correctly interpret these performed tests. A step-by-step approach is mandatory and examiners should master the order and the style of performing these tests. Neurological conditions can be sometimes very distressing for owners and for pets that might not be the most cooperating. The role of a veterinary surgeon, as a professional, is therefore to collect the most relevant history, to examine a patient in a professional manner and to give to owners an educated opinion about the further treatment and prognosis. However neurological examinations might look challenging for many. But it is only the clinical application of neuroanatomy and neurophysiology to an every-day situation for practicing veterinarians and it does not require any specific in-to-depth knowledge. This clinical review is aimed not only to provide the information on how to perform the neurological examination but it is also aimed to appeal on veterinarians to challenge their daily routine and to start practicing on neurologically normal patients. This is the best and only way to differentiate between the normal and abnormal in a real situation.

  5. Footbed shapes for enhanced footwear comfort. (United States)

    Witana, Channa P; Goonetilleke, Ravindra S; Au, Emily Yim Lee; Xiong, Shuping; Lu, Xingfang


    A shoe wearer's comfort is related to the shape of the footbed of a shoe. Even though the footbed shape is important in footwear design, there exists no methodology to evaluate the existing guidelines used in last making. Thirty-two females participated in an experiment where heel seat length, heel seat inclination and heel height were investigated using the profile assessment device. The dependent variables were plantar pressure and perceived feeling of each participant. The results show that perceived feel is best for wedge angles of 4 degrees and 5 degrees at a heel height of 25 mm, 10 degrees and 11 degrees at a heel height of 50 mm and 16 degrees and 18 degrees at a heel height of 75 mm. A regression model was derived and this explained approximately 80% of the variation of perceived feeling with the contact area, peak plantar pressure and percentage of force acting on the forefoot region. Both heel wedge angle and heel seat length play an important role in the perceived feel of high-heeled shoes. This study, in relation to the load-bearing heel part of a shoe, highlights the importance of good footbed design. The findings can be used to design footwear with enhanced comfort.

  6. Influence of comfort and social stimuli on a comfort movement and a display derived from it

    NARCIS (Netherlands)

    Sebbel, P; Duttmann, H; Groothuis, T

    We tested the extent of emancipation of the Whistle-shake display of male shelducks, Tadorna tadorna, from causal factors controlling its presumed evolutionary precursor, the Body-shake, a comfort movement. Both motor patterns show similarities in form and alternate in a yearly rhythm. First, in an

  7. Neurological Manifestations of Dengue Infection

    Directory of Open Access Journals (Sweden)

    Guo-Hong Li


    Full Text Available Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS, peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

  8. The effect of education in hospice and palliative care on emergency medicine residents' knowledge and referral patterns. (United States)

    DeVader, Travis E; Jeanmonod, Rebecca


    To determine: (1) residents' knowledge base in key concepts in hospice and palliative care, (2) residents' comfort level in discussing end-of-life (EOL) care and managing EOL symptoms, and (3) if a brief educational intervention improves residents' knowledge of and comfort in dealing with EOL issues both immediately following and six months after the intervention. This prospective cohort study was performed at a level-1 community trauma center. A survey was developed regarding knowledge of palliative care and its emergency department (ED) utilization and administered to emergency medicine (EM) residents. Subsequently, residents underwent four hours of palliative care training. An identical post-education survey was administered immediately and then six months later. Education improved knowledge of hospice qualifying diagnoses which was maintained at six months. Improvement in residents' ability to convert between oral and intravenous formulations of opioids was not retained at six months. Education was not shown to improve EM residents' comfort in managing pain or dyspnea but it was shown to improve their comfort level in discussing EOL care with patients and families Inpatient hospice admissions from the ED increased 88% after the education. Identified barriers to providing palliative care in the ED decreased. There are gaps in EM residents' hospice and palliative care knowledge. Education is shown to improve and maintain knowledge of hospice qualifying diagnoses, comfort level in discussing EOL care with patients and families, and to increase inpatient hospice admissions from the ED.

  9. Investigation of Pedestrian Comfort with Wind Chill during Winter

    Directory of Open Access Journals (Sweden)

    Hyungkeun Kim


    Full Text Available Two types of methods are used to evaluate pedestrian comfort: pedestrian wind comfort and outdoor thermal comfort. To accurately ascertain the outdoor wind environment, wind speed is the only parameter considered. However, pedestrians may still feel discomfort when the perceived temperature is low, even though the wind comfort criterion has been satisfactorily fulfilled. The purpose of this study is, therefore, to investigate pedestrian comfort when the perceived temperature is low, especially in winter conditions. To achieve this, a pedestrian survey was conducted, and 588 respondents completed a questionnaire. The results show that pedestrians feel discomfort when the WCET (Wind Chill Equivalent Temperature is low, with almost 40 percent of respondents answering that they feel discomfort in these conditions. In conclusion, the threshold wind speed of the winter season could be determined to be lower than that of the existing comfort criteria by applying the WCET.

  10. Exploring comfort food preferences across age and gender. (United States)

    Wansink, Brian; Cheney, Matthew M; Chan, Nina


    Building on findings related to physiological and psychological motivations of food preference, this research develops a framework to examine preferences toward comfort foods. Study 1 used a North American survey of 411 people to determine favored comfort foods, and Study 2 quantified the preferences for these foods across gender and across age groups using a stratified sample of 1005 additional people. Consistent with hypotheses, the findings showed different comfort food preferences across gender and across age. Males preferred warm, hearty, meal-related comfort foods (such as steak, casseroles, and soup), while females instead preferred comfort foods that were more snack related (such as chocolate and ice cream). In addition, younger people preferred more snack-related comfort foods compared to those over 55 years of age. Associations with guilty feelings underscored how these different preferences between males and females may extend to areas of application.

  11. Demographic Factors Affect Ocular Comfort Ratings During Contact Lens Wear. (United States)

    Naduvilath, Thomas; Papas, Eric B; Lazon de la Jara, Percy


    To determine if rating of ocular comfort during soft contact lens wear is affected by demographic factors. Retrospective analysis of ocular comfort ratings during soft contact lens wear extracted from 44 nonrandomized similar clinical trials (n = 986). Subjects wore one of seven daily wear silicone hydrogels (SiHy) in combination with one of nine lens care products (LCP), and two daily disposables lenses. The effects on comfort rating of demographic factors were examined after adjusting for lens and LCP effects using general linear model. Males reported lower comfort on insertion than females (7.9 ± 1.6 vs. 8.1 ± 1.6, p = 0.001). Over 45 years old had higher comfort ratings than those between 26 and 45 or gender, lens wear experience, ethnicity, and refractive status can influence the rating of ocular comfort in clinical studies. The confounding effects of such demographic factors can be controlled by implementing randomization and appropriate multivariable statistical analysis.

  12. Neurological Diagnostic Tests and Procedures (United States)

    ... of diagnostic imaging techniques and chemical and metabolic analyses to detect, manage, and treat neurological disease. Some ... performed in a doctor’s office or at a clinic. Fluoroscopy is a type of x-ray that ...

  13. Neurological complications of underwater diving. (United States)

    Rosińska, Justyna; Łukasik, Maria; Kozubski, Wojciech


    The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers. Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  14. Neurologic Complications of Smallpox Vaccination

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Smallpox and smallpox vaccination is reviewed from the Departments of Neurology, Yale University School of Medicine, New Haven, CT, and University of New Mexico School of Medicine, Albuquerque.

  15. Neurological Complications of Bariatric Surgery. (United States)

    Goodman, Jerry Clay


    Obesity has attained pandemic proportions, and bariatric surgery is increasingly being employed resulting in turn to more neurological complications which must be recognized and managed. Neurological complications may result from mechanical or inflammatory mechanisms but primarily result from micro-nutritional deficiencies. Vitamin B12, thiamine, and copper constitute the most frequent deficiencies. Neurological complications may occur at reasonably predictable times after bariatric surgery and are associated with the type of surgery used. During the early post-operative period, compressive or stretch peripheral nerve injury, rhabdomyolysis, Wernicke's encephalopathy, and inflammatory polyradiculoneuropathy may occur. Late complications ensue after months to years and include combined system degeneration (vitamin B12 deficiency) and hypocupric myelopathy. Bariatric surgery patients require careful nutritional follow-up with routine monitoring of micronutrients at 6 weeks and 3, 6, and 12 months post-operatively and then annually after surgery and multivitamin supplementation for life. Sustained vigilance for common and rare neurological complications is essential.

  16. Neurologic disorder and criminal responsibility. (United States)

    Yaffe, Gideon


    Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other. © 2013 Elsevier B.V. All rights reserved.

  17. Historical perspective of Indian neurology

    Directory of Open Access Journals (Sweden)

    Shrikant Mishra


    Full Text Available Objective: To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. Background: The history of neurology in India is divided into two periods: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C. during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20 th century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation′s first allopathic medical colleges located in Madras (1835, Calcutta (1835 and Mumbai (1848. Prior to India′s independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI. Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN. Design/Methods: Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Results: Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930′s. Early pioneers and founders of the NSI (1951 include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991. The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in

  18. Historical perspective of Indian neurology (United States)

    Mishra, Shrikant; Trikamji, Bhavesh; Singh, Sandeep; Singh, Parampreet; Nair, Rajasekharan


    Objective: To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. Background: The history of neurology in India is divided into two periods: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C.) during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20th century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation's first allopathic medical colleges located in Madras (1835), Calcutta (1835) and Mumbai (1848). Prior to India's independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI). Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN). Design/Methods: Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Results: Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930's. Early pioneers and founders of the NSI (1951) include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991). The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in the amount of


    Directory of Open Access Journals (Sweden)



    Full Text Available In this study, the various thermal comfort parameters including temperature, relative humidity, air velocity, metabolic activity and clothing resistance and their effect to each other are examined. The heat transfer equations given for steady state energy balance between body and environment and the empirical equations which give thermal comfort and physiological control mechanisms of body are used. According to the ASHRAE Standard 55-1992, an environment can be assumed comfortable while Predicted Percentage of Dissatisfied (PPD is less than % 10. Considering this, thermal comfort zones in various conditions are studied and results are presented and discussed

  20. Progress in thermal comfort research over the last twenty years. (United States)

    de Dear, R J; Akimoto, T; Arens, E A; Brager, G; Candido, C; Cheong, K W D; Li, B; Nishihara, N; Sekhar, S C; Tanabe, S; Toftum, J; Zhang, H; Zhu, Y


    Climate change and the urgency of decarbonizing the built environment are driving technological innovation in the way we deliver thermal comfort to occupants. These changes, in turn, seem to be setting the directions for contemporary thermal comfort research. This article presents a literature review of major changes, developments, and trends in the field of thermal comfort research over the last 20 years. One of the main paradigm shift was the fundamental conceptual reorientation that has taken place in thermal comfort thinking over the last 20 years; a shift away from the physically based determinism of Fanger's comfort model toward the mainstream and acceptance of the adaptive comfort model. Another noticeable shift has been from the undesirable toward the desirable qualities of air movement. Additionally, sophisticated models covering the physics and physiology of the human body were developed, driven by the continuous challenge to model thermal comfort at the same anatomical resolution and to combine these localized signals into a coherent, global thermal perception. Finally, the demand for ever increasing building energy efficiency is pushing technological innovation in the way we deliver comfortable indoor environments. These trends, in turn, continue setting the directions for contemporary thermal comfort research for the next decades. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Comfort parameters - Ventilation of a subway wagon (United States)

    Petr, Pavlíček; Ladislav, Tříska


    Research and development of a ventilation system is being carried out as a part of project TA04030774 of the Technology Agency of the Czech Republic. Name of the project is "Research and Development of Mass-optimized Components for Rail Vehicles". Problems being solved are development and testing of a new concept for ventilation systems for public transport vehicles. The main improvements should be a reduction of the mass of the whole system, easy installation and reduction of the noise of the ventilation system. This article is focused on the comfort parameters in a subway wagon (measurement and evaluation carried out on a function sample in accordance with the regulations). The input to the project is a ventilator hybrid casing for a subway wagon, which was manufactured and tested during the Ministry of Industry and Trade project TIP FR-TI3/449.

  2. Air humidity requirements for human comfort

    DEFF Research Database (Denmark)

    Toftum, Jørn; Fanger, Povl Ole


    Upper humidity limits for the comfort zone determined from two recently presented models for predicting discomfort due to skin humidity and insufficient respiratory cooling are proposed. The proposed limits are compared with the maximum permissible humidity level prescribed in existing standards...... for the thermal indoor environment. The skin humidity model predicts discomfort as a function of the relative humidity of the skin, which is determined by existing models for human heat and moisture transfer based on environmental parameters, clothing characteristics and activity level. The respiratory model...... predicts discomfort as a function of the driving forces for heat loss from the respiratory tract, namely the air temperature and humidity of the surrounding air. An upper humidity limit based on a relative skin humidity of 0.54, corresponding to 20% dissatisfied, results in a maximum permissible humidity...

  3. Pedal force determination respect to ride comfort (United States)

    Mačužić, Slavica; Lukić, Jovanka; Glišović, Jasna; Miloradović, Danijela


    Automotive ergonomics is a set of knowledge which has a task to design a vehicle to make the passengers feel comfortable. Interior packaging represents an important stage in the vehicle design process, in order to enable the driver to every important aspect of movement. During the process of driving, the driver performs various movements of arms and legs, leading to a certain fatigue. Each seating position in the vehicle, contain certain boundary conditions, and for that reason it was necessary to examine how the seating position affects the driver possibilities. In this paper, the pedal forces were determined by application of Ramsis human model. Different human populations were taken into account. Correlation between subjects’ anthropometrics measures and the foot pedal force pedal was observed. Obtained results were significant input data for vehicle packaging.

  4. Strategies for Sustainable Comfort in Buildings

    DEFF Research Database (Denmark)

    Nørgaard, Jørgen


    , or at least achieve a reduction of 90%. These option are slightly lower for the excising building, typically a 70% reduction. Electricity use for lighting, ventilation and appliances can typically in WesternEurope be reduced by 80% and still provide the services needed. The strategies for achieving......It is possible within some decades to achieve environmental sustainability in the building sector and at the same time provide a comfortable and healthy life for all Europeans as well as leaving that option open for other people in the world.Buildings are charcterized by having the longest lifetime...... of all capital in our societies, often more than a hundred years. For that reason they should never be designed on the bases of just present cheap energy supply and energy system, but with the long term outlook and risks in mind. New buildings can be designed to require essentially no space heating...

  5. Investigation of Comfort Properties of Knitted Denim (United States)

    Akbar, Abdul R.; Su, Siwei; Khalid, Junaid; Cai, Yingjie; Lin, Lina


    Knitted denim was designed by using cross terry structure on circular knitting machine. Knitted denim looks like a denim fabric which has visual appearance like woven denim. Two type of cross terry structure 2/1 and 3/1 were used which gives twill effect with 2 and 3 floats respectively. Four types of materials, cotton, polyester, flax and polypropylene were used. With four materials and two structural combinations 8 samples were produced. Comfort properties of knitted denim including moisture management, air permeability, thermal, and bursting strength were tested. For checking the inherent anti-microbial property of materials anti-microbial test was also applied. Samples containing flax and polyester were found with best results and not even a single sample was found anti-microbial.

  6. Effects of radiant temperature on thermal comfort

    Energy Technology Data Exchange (ETDEWEB)

    Atmaca, Ibrahim; Kaynakli, Omer; Yigit, Abdulvahap [Uludag University, Bursa (Turkey). Faculty of Engineering and Architecture, Department of Mechanical Engineering


    The aim of this paper is to investigate the local differences between body segments caused by high radiant temperature, and to analyze the interior surface temperatures for different wall and ceiling constructions with their effect on thermal comfort. For the segment-wise thermal interactions between human body and its surrounding, simulations have been conducted by appropriately modifying Gagge 2-node model to multi-segment case to demonstrate the local differences. Simulation results are found to be in good agreement with experimental and simulation results reported in the literature. To calculate the interior surface temperatures of the wall and ceiling, the sol-air temperature approach is used for convenience. It is shown in the paper that the body segments close the relatively hot surfaces are more affected than others and interior surface temperatures of un-insulated walls and ceilings exposed to a strong solar radiation reach high levels, all of which cause thermal discomfort for the occupants in buildings. (author)

  7. Thermal Comfort and Optimum Humidity Part 1

    Directory of Open Access Journals (Sweden)

    M. V. Jokl


    Full Text Available The hydrothermal microclimate is the main component in indoor comfort. The optimum hydrothermal level can be ensured by suitable changes in the sources of heat and water vapor within the building, changes in the environment (the interior of the building and in the people exposed to the conditions inside the building. A change in the heat source and the source of water vapor involves improving the heat - insulating properties and the air permeability of the peripheral walls and especially of the windows. The change in the environment will bring human bodies into balance with the environment. This can be expressed in terms of an optimum or at least an acceptable globe temperature, an adequate proportion of radiant heat within the total amount of heat from the environment (defined by the difference between air and wall temperature, uniform cooling of the human body by the environment, defined a by the acceptable temperature difference between head and ankles, b by acceptable temperature variations during a shift (location unchanged, or during movement from one location to another without a change of clothing. Finally, a moisture balance between man and the environment is necessary (defined by acceptable relative air humidity. A change for human beings means a change of clothes which, of course, is limited by social acceptance in summer and by inconvenient heaviness in winter. The principles of optimum heating and cooling, humidification and dehumidification are presented in this paper.Hydrothermal comfort in an environment depends on heat and humidity flows (heat and water vapors, occurring in a given space in a building interior and affecting the total state of the human organism.

  8. Older Adult Residents' Perceptions of Daily Lives in Nursing Homes. (United States)

    Cho, Eunhee; Kim, Hyejin; Kim, Jeongah; Lee, Kyongeun; Meghani, Salimah H; Chang, Soo Jung


    This study aimed to explore older adults' perceptions of their daily lives in South Korean nursing homes. We employed a qualitative descriptive study using semistructured interviews. We conducted individual, semistructured interviews with 21 older adult residents from five nursing homes in South Korea and analyzed the data using thematic analysis. Five themes related to older adults' perceptions of their daily lives in nursing homes emerged: enhanced comfort, aspiring to maintain physical and cognitive functions as human beings, desire for meaningful interpersonal relationships, feelings of confinement and limited autonomy, and acceptance of and adaptation to life in a facility. These themes indicated the positive and negative aspects of nursing home residence, and facilitators and challenges to enhancing older adult residents' quality of life (QOL). Policy, practice, and research endeavors are required to improve older adult residents' QOL, such as adequate professional nursing care for physical and psychological comfort and residents' health and functional status, sufficient activity programs and meaningful relationships, person-centered care to enhance residents' autonomy, and homelike environments. This study demonstrates that healthcare providers, researchers, and policymakers should consider nursing home residents' QOL to examine the quality of care within the setting and facilitate the development of appropriate strategies to improve QOL among this population. © 2017 The Authors. Journal of Nursing Scholarship published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  9. Identifying clinically meaningful tools for measuring comfort perception of footwear. (United States)

    Mills, Kathryn; Blanch, Peter; Vicenzino, Bill


    Measures of comfort are important in the prescription and development of footwear. The purpose of our study was to examine three commonly used scales (visual analog scale (VAS), Likert scale, and ranking scale) to determine the most reliable, to calculate a minimal clinically important change in rating scales, and to explore dimensions of comfort important to the patient. Twenty subjects were allocated consecutively to two experiments consisting of five sessions of repeated measures. Using comfort measures from each subject's usual jogging shoe, experiment 1 examined the reliability of VAS and Likert scale over six dimensions of the foot, including overall comfort. The second experiment examined the reliability of ranking scale by assessing the ranked position of the shoe. Comfort measures were obtained in both walking and jogging. The ranking scale was the most stable scale. Mixed linear modeling found that VAS was more stable than the Likert scale. The VAS required two sessions to become reliable for all measures but those obtained from the heel, which required more. Using a data-derived approach, a clinically important change in comfort was 9.59 mm on the 100-mm VAS; using an anchor-based approach, it was 10.2 mm. Subjects identified arch comfort as the most important consideration in footwear comfort. Ranking scale and VAS are reliable measures of footwear comfort. Using the VAS, changes of 9.59 and 10.2 mm indicate a clinically relevant change in comfort. The most important dimensions to the patient are overall comfort and the arch.

  10. No calorie comfort: Viewing and drawing "comfort foods" similarly augment positive mood for those with depression. (United States)

    Privitera, Gregory J; Welling, Deeanna; Tejada, Gabriela; Sweazy, Nicole; Cuifolo, Kayla N; King-Shepard, Quentin W; Doraiswamy, P Murali


    Based on behavioral and neurobiological data, we tested the hypothesis that viewing/drawing visual images of comfort foods in the absence of eating will increase positive mood and that this effect is augmented for those with clinical symptoms of depression. A counterbalanced design was used for 60 participants with and without clinical symptoms in two variations: food image and food art. In each variation, participants viewed/drew foods high or low in fat/sugar; pre-post mood was recorded. Results show a consistent pattern: viewing/drawing comfort foods [food image (95% confidence interval): 2.72-4.85; food art (95% confidence interval): 2.65-4.62] and fruits [food image (95% confidence interval): 1.20-2.23; food art (95% confidence interval): 1.51-2.56] enhanced mood. For comfort foods, mood was augmented for those with clinical symptoms of depression [food image (95% confidence interval): 0.95-3.59; food art (95% confidence interval): 0.97-3.46]. Findings corroborate previous data and reveal a novel finding of augmented mood increases for those with clinical symptoms.

  11. Neurologic presentation of celiac disease. (United States)

    Bushara, Khalafalla O


    Celiac disease (CD) long has been associated with neurologic and psychiatric disorders including cerebellar ataxia, peripheral neuropathy, epilepsy, dementia, and depression. Earlier reports mainly have documented the involvement of the nervous system as a complication of prediagnosed CD. However, more recent studies have emphasized that a wider spectrum of neurologic syndromes may be the presenting extraintestinal manifestation of gluten sensitivity with or without intestinal pathology. These include migraine, encephalopathy, chorea, brain stem dysfunction, myelopathy, mononeuritis multiplex, Guillain-Barre-like syndrome, and neuropathy with positive antiganglioside antibodies. The association between most neurologic syndromes described and gluten sensitivity remains to be confirmed by larger epidemiologic studies. It further has been suggested that gluten sensitivity (as evidenced by high antigliadin antibodies) is a common cause of neurologic syndromes (notably cerebellar ataxia) of otherwise unknown cause. Additional studies showed high prevalence of gluten sensitivity in genetic neurodegenerative disorders such as hereditary spinocerebellar ataxia and Huntington's disease. It remains unclear whether gluten sensitivity contributes to the pathogenesis of these disorders or whether it represents an epiphenomenon. Studies of gluten-free diet in patients with gluten sensitivity and neurologic syndromes have shown variable results. Diet trials also have been inconclusive in autism and schizophrenia, 2 diseases in which sensitivity to dietary gluten has been implicated. Further studies clearly are needed to assess the efficacy of gluten-free diet and to address the underlying mechanisms of nervous system pathology in gluten sensitivity.

  12. Neurological aspects of vibroacoustic disease. (United States)

    Martinho Pimenta, A J; Castelo Branco, N A


    Mood and behavioral abnormalities are the most common early findings related to vibroacoustic disease (VAD). Other signs and symptoms have been observed in VAD patients. Brain MRI discloses small multifocal lesions in about 50% of subjects with more than 10 yr of occupational exposure to large pressure amplitude (> or = 90 dB SPL) and low frequency (< or = 500 Hz) (LPALF) noise. However, to date, there have been no studies globally integrating all the neurological, imaging and neurophysiological data of VAD patients. This is the main goal of this study. The 60 male Caucasians diagnosed with VAD were neurologically evaluated in extreme detail in order to systematically identify the most common and significant neurological disturbances in VAD. This population demonstrates cognitive changes (identified through psychological and neurophysiological studies (ERP P300)), vertigo and auditory changes, visual impairment, epilepsy, and cerebrovascular diseases. Neurological examination reveals pathological signs and reflexes, most commonly the palmo-mental reflex. A vascular pattern underlying the multifocal hyperintensities in T2 MR imaging, with predominant involvement of the small arteries of the white matter, is probably the visible organic substratum of the neurological picture. However, other pathophyisological mechanisms are involved in epileptic symptomatology.

  13. Comfort of workers in office buildings: The European HOPE project

    NARCIS (Netherlands)

    Bluyssen, P.M.; Aries, M.; Dommelen, P. van


    Previous studies have shown that building, social and personal factors can influence one's perceived health and comfort. The aim of the underlying study was to get a better understanding of the relationships between these factors and perceived comfort. Self-administered questionnaires from 5732

  14. Sitting comfort and discomfort and the relationships with objective measures

    NARCIS (Netherlands)

    de Looze, M.P.; Kuijt-Evers, L.F.M.; van Dieen, J.H.


    The concepts of comfort and discomfort in sitting are under debate. There is no widely accepted definition, although it is beyond dispute that comfort and discomfort are feelings or emotions that are subjective in nature. Yet, beside several subjective methodologies, several objective methods (e.g.

  15. Comfort and patient-centred care without excessive sedation

    DEFF Research Database (Denmark)

    Vincent, Jean-Louis; Shehabi, Yahya; Walsh, Timothy S


    and Delirium guidelines, is conveyed in the mnemonic eCASH-early Comfort using Analgesia, minimal Sedatives and maximal Humane care. eCASH aims to establish optimal patient comfort with minimal sedation as the default presumption for intensive care unit (ICU) patients in the absence of recognised medical...

  16. The adaptive approach to thermal comfort: A critical overview

    NARCIS (Netherlands)

    E Halawa; Joost van Hoof


    The adaptive approach to thermal comfort has gained unprecedented exposure and rising status recently among the thermal comfort community at the apparent expense of the heat balance approach for the evaluation of naturally ventilated buildings. The main appeal of this adaptive approach lies in its

  17. Improving comfort while hiking in a sailing boat

    NARCIS (Netherlands)

    Jansen, A.J.; Van Abbema, A.; Howe, C.


    The paper presents the changes in perceived comfort while hiking in a sailing boat (in this case the Laser, a single-handed Olympic dinghy) due to a new design of hiking pads. The project used a ‘research by design method’. The aim was to improve sailing comfort which leads to lower fatigue and

  18. Interior effects on comfort in healthcare waiting areas. (United States)

    Bazley, C; Vink, P; Montgomery, J; Hedge, A


    This study compared the effects of pre-experience and expectations on participant comfort upon waking, arrival to, and after an appointment, as well as the assessment of properly placed Feng Shui elements in three healthcare waiting rooms. Participants assessed comfort levels using self-report surveys. The researcher conducted 'intention interviews' with each doctor to assess the goals of each waiting area design, and conducted a Feng Shui assessment of each waiting area for properly placed Feng Shui elements. The waiting area designed by the Feng Shui expert rated 'most comfortable', followed by the waiting area design by a doctor, and the lowest comfort rating for the conventional waiting room design. Results show a sufficiently strong effect to warrant further research. Awareness of the external environment, paired with pre-experience and expectation, influences comfort for people over time. Fostering and encouraging a holistic approach to comfort utilizing eastern and western concepts and ergonomic principles creates a sense of "placeness" and balance in the design for comfort in built environments. This is new research information on the influences of the comfort experience over time, to include pre-experience, expectations and the placement of elements in the external environment.

  19. the comfort, measured by means of a sweating manikin (waltertm)

    African Journals Online (AJOL)


    Anton F Botha*, Marguerite E Stoffberg & Lawrance Hunter. ABSTRACT. With the growing importance of clothing comfort in South African and overseas markets for locally produced clothing, the Council for. Scientific Industrial Research (CSIR) acquired an advanced sweating fabric manikin for measuring clothing comfort.

  20. Human Comfort and the microclimatic drivers across different land ...

    African Journals Online (AJOL)

    The study identified spatially differentiated thermal human comfort conditions based on heat stress and microclimate data for specific urban built-up land use classes; and examined the influence of certain microclimatic elements on the observed human comfort levels within the coastal milieu of Port Harcourt metropolis.

  1. The End-State Comfort Effect in Young Children (United States)

    Adalbjornsson, Carola F.; Fischman, Mark G.; Rudisill, Mary E.


    The end-state comfort effect has been observed in recent studies of grip selection in adults. The present study investigated whether young children also exhibit sensitivity to end-state comfort. The task was to pick up an overturned cup from a table, turn the cup right side up, and pour water into it. Two age groups (N = 20 per group) were…

  2. New guidance for thermal comfort: Design primarily for females

    Energy Technology Data Exchange (ETDEWEB)

    Karjalainen, S., Email:


    Until now differences between male and female subjects in terms of thermal comfort requirements have been generally considered to be small and insignificant. However, the results of this extensive literature review show that females express considerably more dissatisfaction than males in the same thermal environments. The target should be to create energy-efficient and thermally comfortable conditions for both genders. (orig.)

  3. Comfort Food: Nourishing Our Collective Stomachs and Our Collective Minds (United States)

    Troisi, Jordan D.; Wright, Julian W. C.


    Food is a powerful motivator in human functioning--it serves a biological need, as emotional support, and as a cultural symbol. Until recently, the term "comfort food" has been inadequately and unscientifically defined. In addition, the popular media have oversimplified the concept of comfort food as purely unhealthy food, often consumed…

  4. Implications of climate change on human comfort in buildings ...

    African Journals Online (AJOL)

    A rise in temperature and humidity levels constitutes a potential hazard to health and human comfort and accelerates many degradation processes and material damage. Subsequently, the amount of energy needed to ... Keywords: climate change, greenhouse-effect, comfort zone. Journal of Science and Technology Vol.

  5. The aircraft interior comfort experience of 10,032 passengers

    NARCIS (Netherlands)

    Vink, P.; Mastrigt, S. van


    One airline strategy aimed at selling more tickets is to provide a superior comfort experience. However, only a small amount of public scientific information is available addressing the passenger’s opinion on comfort. In this study, 10,032 internet trip reports were used to gather opinions about

  6. Residency Allocation Database (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  7. Comfort evaluation as the example of anthropotechnical furniture design. (United States)

    Vlaović, Zoran; Bogner, Andrija; Grbac, Ivica


    Human health is becoming an increasingly important issue in contemporary hectic lifestyle imposed at work and by struggle to save time and money. Sitting comfort and quality of chairs which we use for the most of our time have, thus, become essential for healthy lifestyle. Sitting discomforts arise from prolonged sitting on the inappropriate chairs, which failing to provide sufficient support to the body cause discomfort and tiring. The studies of the office chair constructions have identified differences in perception of comfort provided by different types of seats. Four seat constructions and the comfort they provide to the sitters were compared by means of subjective indicators. After a two-day sitting on each of the studied chairs the subjects scored their perception of comfort and discomfort, using the questionnaire with 17 statements. Constructional forms and materials which contributed more to the sense of comfort by minimizing fatigue and pains developed by sitting were determined.

  8. Neurologic considerations in propionic acidemia. (United States)

    Schreiber, John; Chapman, Kimberly A; Summar, Marshall L; Ah Mew, Nicholas; Sutton, V Reid; MacLeod, Erin; Stagni, Kathy; Ueda, Keiko; Franks, Jill; Island, Eddie; Matern, Dietrich; Peña, Loren; Smith, Brittany; Urv, Tiina; Venditti, Charles; Chakarapani, Anupam; Gropman, Andrea L


    Propionic acidemia (PA) is an organic acidemia which has a broad range of neurological complications, including developmental delay, intellectual disability, structural abnormalities, metabolic stroke-like episodes, seizures, optic neuropathy, and cranial nerve abnormalities. As the PA consensus conference hosted by Children's National Medical Center progressed from January 28 to 30, 2011, it became evident that neurological complications were common and a major component of morbidity, but the role of imaging and the basis for brain pathophysiology were unclear. This paper reviews the hypothesized pathophysiology, presentation and uses the best available evidence to suggest programs for treatment, imaging, and monitoring the neurological complications of PA. Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  9. Acupuncture application for neurological disorders. (United States)

    Lee, Hyangsook; Park, Hi-Joon; Park, Jongbae; Kim, Mi-Ja; Hong, Meesuk; Yang, Jongsoo; Choi, Sunmi; Lee, Hyejung


    Acupuncture has been widely used for a range of neurological disorders. Despite its popularity, the evidence to support the use of acupuncture is contradictory. This review was designed to summarize and to evaluate the available evidence of acupuncture for neurological disorders. Most of the reviewed studies suffer from lack of methodological rigor. Owing to paucity and poor quality of the primary studies, no firm conclusion could be drawn on the use of acupuncture for epilepsy, Alzheimer's disease, Parkinson's disease, ataxic disorders, multiple sclerosis, amyotrophic lateral sclerosis and spinal cord injury. For stroke rehabilitation, the evidence from recent high-quality trials and previous systematic reviews is not convincing. More rigorous trials are warranted to establish acupuncture's role in neurological disorders.

  10. Quality Metrics in Inpatient Neurology. (United States)

    Dhand, Amar


    Quality of care in the context of inpatient neurology is the standard of performance by neurologists and the hospital system as measured against ideal models of care. There are growing regulatory pressures to define health care value through concrete quantifiable metrics linked to reimbursement. Theoretical models of quality acknowledge its multimodal character with quantitative and qualitative dimensions. For example, the Donabedian model distils quality as a phenomenon of three interconnected domains, structure-process-outcome, with each domain mutually influential. The actual measurement of quality may be implicit, as in peer review in morbidity and mortality rounds, or explicit, in which criteria are prespecified and systemized before assessment. As a practical contribution, in this article a set of candidate quality indicators for inpatient neurology based on an updated review of treatment guidelines is proposed. These quality indicators may serve as an initial blueprint for explicit quality metrics long overdue for inpatient neurology. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. [Child neurology and multimedia technology]. (United States)

    Nihei, Kenji


    Methods of computer technology (intelligent technology, IT), such as multimedia and virtual reality, are utilized more and more in all medical fields including child neurology. Advances in the digitalization of individual medical data and multi-media technology have enabled patients to be able to obtain their own medical data by small media and to receive medical treatment at any hospitals even if they are located in distance place. Changes from a doctor oriented to patients oriented medicine is anticipated. It is necessary to store medical data from birth to adulthood and to accumulate epidemiological data of rare diseases such as metabolic diseases or degenerative diseases especially in child neurology, which highly require tele medicine and telecare at home. Moreover, IT may improve in the QOL of patients with neurological diseases and of their families. Cooperation of medicine and engineering is therefore necessary. Results of our experiments on telemedicine, telecare and virtual reality are described.

  12. Neurological manifestation of colonic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Uzair Chaudhary


    Full Text Available Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

  13. Neurological manifestations in Fabry's disease

    DEFF Research Database (Denmark)

    Møller, Anette Torvin; Jensen, Troels Staehelin


    . Neurological symptoms, such as burning sensations (occasionally accompanied by acroparesthesia) and stroke, are among the first to appear, and occur in both male and female patients. A delay in establishing the diagnosis of Fabry's disease can cause unnecessary problems, especially now that enzyme replacement...... treatment is available to prevent irreversible organ damage. Females with Fabry's disease who present with pain have often been ignored and misdiagnosed because of the disorder's X-linked inheritance. This Review will stress the importance of recognizing neurological symptoms for the diagnosis of Fabry...

  14. Sleep disorders in neurological practice

    Directory of Open Access Journals (Sweden)

    Mikhail Guryevich Poluektov


    Full Text Available Sleep disorders are closely associated with both nervous system diseases and mental disorders; however, such patients prefer to seek just neurological advice. Insomnia is the most common complaint in routine clinical practice. It is characterized by different impairments in sleep and daytime awakening. Obstructive sleep apnea syndrome is less common, but more clinically important because of its negative impact on the cardiovascular and nervous systems. The common neurological disorders are restless legs syndrome and REM sleep behavior disorder, as well as narcolepsy, the major manifestations of which are impaired nocturnal sleep and daytime awakening.


    Directory of Open Access Journals (Sweden)



    Full Text Available During the pacific war, about 80 to 200 thousand women were mobilized by the Japanese imperial army to sexually serve its soldiers, in one of world’s largest cases of human trafficking. Most of the victims, euphemistically known as "comfort women", came from Korea, Japan's colony at the time, and was attracted by false promises of employment or simply kidnapped by Japanese troops. Taken to military brothels throughout the pacific, they were subjected to repeated rape and beatings. Some of them, as young as age 12, were daily forced to have sex with Japanese soldiers, 10, 30, 50 times a day. The few women who survived and were able to return home at the end of the war continued to suffer for their past, through psychological trauma and social ostracism. They remained silent about their experience because of fear and shame. These women would have like to live in peace, being wives, mothers, sisters, grandmothers ... but this choice was denied to all. None received any compensation from the Japanese government official, who continues to evade its legal and moral responsibilities regarding war crime. Sixty-eight years later, they are still waiting for justice.

  16. Thermal comfort induced by Trombe walls

    Energy Technology Data Exchange (ETDEWEB)

    Abu-Dayyeh, A. [Society for Energy Conservation and Sustainable Environment, Amman (Jordan)


    In order to reduce heating costs and greenhouse gases, there is an interest in researching passive architectural design in low cost dwellings to eventually create sustainable dwellings with thermal comfort. This paper presented the results of a study that investigated the effect of Trombe walls in low-cost dwellings in Jordan. The study involved using the sun, a natural renewable source of energy in order to warm the thin walled structures. Experiments were performed on full-scale models in search of ways to raise the temperatures of the exterior walls through solar radiation as a green and renewable energy resource. A Trombe wall system was enhanced by a reflective membrane. It was tested on two full size chambers built with the same construction materials used in the Jordanian building industry. The paper discussed the study methodology and results. The expected heat loss was significant when the weather outside was cool amidst cloudy weather. A more effective Trombe wall system could be achieved by introducing automatic shutters which close once the sun is interrupted by clouds. 5 refs., 3 tabs., 3 figs.

  17. Keyboard data entry use among osteopathic medical students and residents. (United States)

    Helstrom, Julia M; Langenau, Erik E; Sandella, Jeanne M; Mote, Beth L


    Candidates taking the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) are currently evaluated on their ability to document clinical findings using a handwritten postencounter note. However, keyboard data entry is increasingly used for medical documentation. To determine the use and perception of keyboard data entry among osteopathic medical students and residents in educational and clinical settings. A Web-based survey regarding frequency of and preference for keyboard data entry was distributed to 9801 osteopathic medical students, 17,268 osteopathic residents, and 34 clinical deans of colleges of osteopathic medicine (COMs). In addition, 31 COMs' clinical skills center directors were contacted to participate in a telephone survey about the use of keyboard data entry in their centers. A total of 1711 students, 1198 residents, 14 clinical deans, and 17 clinical skills center directors responded to the surveys. The majority of students (872 [51%]) reported using electronic keyboard data entry at their COM's clinical skills center for postencounter notes. Among respondents, 379 students (23%), 77 residents (9%), and 1 clinical dean reported that electronic keyboard data entry is never or rarely used during clinical rotations. Most trainees (1592 students [93%], 864 residents [94%]) reported that they were either comfortable or very comfortable with typing. Given the option of recording methods for SOAP (subjective, objective, assessment, plan) note findings on the COMLEX-USA Level 2-PE, 7 clinical deans were unsure of their students' preferences, while the remaining favored keyboard data entry (5) over handwriting (2). The majority of student and resident respondents would choose keyboard data entry (1009 [60%] and 511 [55%], respectively). Osteopathic medical students and residents are comfortable with typing; they are exposed to and would prefer using an electronic form of entry for medical

  18. Residents as teachers: residents' perceptions before and after receiving instruction in clinical teaching. (United States)

    Wachtel, Julie K; Greenberg, Marna Rayl; Smith, Amy B; Weaver, Kevin R; Kane, Bryan G


    Residents play an integral role in educating junior residents, medical students, and patients. To determine how residents describe their training, proficiency, and comfort level in teaching before and after receiving instruction in clinical teaching. Emergency medicine residents at a 980-bed suburban hospital system filled out a 12-question survey on their training as teachers and their self-perceptions of themselves as teachers. The residents then participated in a 2-hour education session on adult learning principles, methods of clinical teaching, and how to give effective feedback. After the session, participants completed a second, 11-question survey on the effectiveness of the session. Thirty-seven residents completed the presession survey and 33 completed the postsession survey. In the presession survey, 23 residents (62%) identified their proficiency as a teacher and ability to give feedback as that of a novice or beginner. Fourteen (38%) felt competent or proficient as teachers. Twenty-six (70%) reported never receiving instruction in clinical teaching during their residency, and 33 (89%) were interested in learning these skills. In the postsession survey, 28 (85%) described the teaching module as very helpful to their training, and 33 (100%) reported feeling more prepared to teach. Twenty-six (79%) stated they were very likely to teach students more often, and 33 (100%) reported a better understanding of how to give effective feedback. The majority of the residents surveyed expressed an interest in learning teaching skills and felt that completing the training was helpful to their education. After instruction, this cohort of residents felt more prepared and reported they were more likely to teach.

  19. What Makes Residents Interested in Geriatric Psychiatry? A Pan-Canadian Online Survey of Psychiatry Residents. (United States)

    Rej, Soham; Laliberté, Vincent; Rapoport, Mark J; Seitz, Dallas; Andrew, Melissa; Davidson, Marla


    In spite of a rapidly increasing need, there remains a shortage of geriatric psychiatrists in North America. The factors associated with psychiatric residents' interest in geriatric psychiatry have not yet been examined in a nationally representative sample. Cross-sectional study. Web-based online survey of Canadian psychiatry residents. 207 psychiatry residents (24.3% response rate). The main outcome was interest in becoming a geriatric psychiatrist. Bivariate and multivariate analyses were performed to better understand what demographic, educational, and vocational variables were associated with interest in becoming a geriatric psychiatrist. A number of respondents had an interest in becoming a geriatric psychiatrist (29.0%, N = 60); in doing a geriatric psychiatry fellowship (20.3%, N = 42); or an interest in doing geriatric psychiatry as a part of the clinical practice (60.0%, N = 124). Demographic characteristics (age, gender, ethnicity) did not correlate with interest in geriatric psychiatry. The variables most robustly associated with interest in geriatric psychiatry were: 1) completion of geriatric psychiatry rotation(s) before the third year of residency (OR: 5.13, 95% CI: 1.23-21.4); 2) comfort working with geriatric patients and their families (OR: 18.6, 95% CI: 2.09-165.3); 3) positive experiences caring for older adults prior to medical school (OR: 12.4, 95% CI: 1.07-144.5); and 4) the presence of annual conferences in the resident's field of interest (OR: 4.50, 95% CI: 1.12-18.2). Exposing medical students and junior psychiatry residents to clinical geriatric psychiatry rotations that increase comfort in working with older adults may be potential future strategies to improve recruitment of geriatric psychiatrists. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. 'The Move', an innovative simulation-based medical education program using roleplay to teach neurological semiology: Students' and teachers' perceptions. (United States)

    Roze, E; Flamand-Roze, C; Méneret, A; Ruiz, M; Le Liepvre, H; Duguet, A; Renaud, M-C; Alamowitch, S; Steichen, O


    Neurological disorders are frequently being managed by general practitioners. It is therefore critical that future physicians become comfortable with neurological examination and physical diagnosis. Graduating medical students often consider neurological examination as one of the clinical skills they are least comfortable with, and they even tend to be neurophobic. One way to improve the learning of neurological semiology is to design innovative learner-friendly educational methods, including simulation training. The feasibility of mime-based roleplaying was tested by a simulation training program in neurological semiology called 'The Move'. The program was proposed to third-year medical students at Pierre and Marie Curie University in Paris during their neurology rotation. Students were trained to roleplay patients by miming various neurological syndromes (pyramidal, vestibular, cerebellar, parkinsonian) as well as distal axonopathy, chorea and tonic-clonic seizures. Using an anonymous self-administered questionnaire, the students' and teachers' emotional experience and views on the impact of the program were then investigated. A total of 223/365 students (61%) chose to participate in the study. Both students and teachers felt their participation was pleasant. Students stated that The Move increased their motivation to learn neurological semiology (78%), and improved both their understanding of the subject (77%) and their long-term memorization of the teaching content (86%). Although only a minority thought The Move was likely to improve their performance on their final medical examination (32%), a clear majority (77%) thought it would be useful for their future clinical practice. Both students (87%) and teachers (95%) thought The Move should be included in the medical curriculum. Mime-based roleplaying simulation may be a valuable tool for training medical students in neurological semiology, and may also help them to overcome neurophobia. Copyright © 2016

  1. Expanding the neurological examination using functional neurologic assessment: part II neurologic basis of applied kinesiology. (United States)

    Schmitt, W H; Yanuck, S F


    Functional Neurologic Assessment and treatment methods common to the practice of applied kinesiology are presented. These methods are proposed to enhance neurological examination and treatment procedures toward more effective assessment and care of functional impairment. A neurologic model for these procedures is proposed. Manual assessment of muscular function is used to identify changes associated with facilitation and inhibition, in response to the introduction of sensory receptor-based stimuli. Muscle testing responses to sensory stimulation of known value are compared with usually predictable patterns based on known neuroanatomy and neurophysiology, guiding the clinician to an understanding of the functional status of the patient's nervous system. These assessment procedures are used in addition to other standard diagnostic measures to augment rather than replace the existing diagnostic armamentarium. The proper understanding of the neurophysiologic basis of muscle testing procedures will assist in the design of further investigations into applied kinesiology. Accordingly, the neurophysiologic basis and proposed mechanisms of these methods are reviewed.

  2. Blog and Podcast Watch: Neurologic Emergencies

    Directory of Open Access Journals (Sweden)

    Andrew Grock


    Full Text Available Introduction: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of neurologic emergencies from the AIR series. Methods: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Director’s (CORD annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an honorable mention label, if the executive board agrees that the post is accurate and educationally valuable. Results: A total of 125 blog posts and podcasts were evaluated. Key educational pearls from the 14 AIR posts are summarized, and the 20 honorable mentions are listed. Conclusion: The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians with this installment focusing on neurologic emergencies.

  3. Neurocritical Care Education During Residency: Opinions (NEURON) Study. (United States)

    Lerner, David P; Kim, Jennifer; Izzy, Saef


    The American Academy of Neurology (AAN) has established a core curriculum of topics for residency training in neurocritical care. At present there is limited data evaluating neurology residency education within the neurological intensive care unit. This study evaluates learner concerns with the neurological intensive care unit. The Communication Committee and Resident & Fellow Taskforce within the Neurocritical Care Society (NCS) developed an online survey that consisted of 20 selection and free-text based questions. The survey was distributed to NCS members and then to neurology residency program directors. Statistical analysis of neurocritical care exposure were completed with t or Fisher exact test with p-value <0.05 considered significant. A total of 95 individuals from 32 different residency programs (36.5 % response rate) responded to the questionnaire. Most individuals train with neurocritical care attendings, fellows and advanced practitioners and have neurocritical care exposure during multiple years of residency training. 54 % of responders cite improvement in education as a means to improve neurocritical care training. Those that raised concern had no difference in time in the neurocritical care unit (9.4 weeks vs 8.8 weeks), exposure to trained neurointensivists, neurocritical care fellows or advanced providers (p value 0.53, 0.19, 0.83, respectively). There is significant learner concern regarding education within the neurointensive care unit. Although there are educational guidelines and focused neurocritical care educational materials, these alone do not satisfy residents' educational needs. This study demonstrates the need for educational changes, but it does not assess best strategies nor curricular content.

  4. Edgar Allan Poe and neurology

    Directory of Open Access Journals (Sweden)

    Hélio Afonso Ghizoni Teive


    Full Text Available Edgar Allan Poe was one of the most celebrated writers of all time. He published several masterpieces, some of which include references to neurological diseases. Poe suffered from recurrent depression, suggesting a bipolar disorder, as well as alcohol and drug abuse, which in fact led to his death from complications related to alcoholism. Various hypotheses were put forward, including Wernicke's encephalopathy.

  5. Edgar Allan Poe and neurology. (United States)

    Teive, Hélio Afonso Ghizoni; Paola, Luciano de; Munhoz, Renato Puppi


    Edgar Allan Poe was one of the most celebrated writers of all time. He published several masterpieces, some of which include references to neurological diseases. Poe suffered from recurrent depression, suggesting a bipolar disorder, as well as alcohol and drug abuse, which in fact led to his death from complications related to alcoholism. Various hypotheses were put forward, including Wernicke's encephalopathy.

  6. Proprioceptive reflexes and neurological disorders

    NARCIS (Netherlands)

    Schouten, A.C.


    Proprioceptive reflexes play an important role during the control of movement and posture. Disturbed modulation of proprioceptive reflexes is often suggested as the cause for the motoric features present in neurological disorders. In this thesis methods are developed and evaluated to quantify

  7. [Neurology in medieval regimina sanitatis]. (United States)

    de Frutos González, V; Guerrero Peral, A L


    In medical medieval literature some works about dietetics stand out. Dietetics, as a separate branch of medicine, includes not only food or drinks, but other environmental factors influencing on health. They are known as regimina sanitatis or salutis, and specially developed in the Christian west. They generally consisted of a balance between the Galenic "six non-natural things"; factors regulating health and its protection: environment, exercise, food, sleep, bowel movements and emotions. After reviewing the sources and defining the different stages of this genre, we have considered three of the most out-standing medieval regimina, the anonymous Regimen sanitatis salernitanum, Arnaldo de Vilanova's Regimen sanitatis ad regem aragonum and Bernardo de Gordon's Tractatus of conservatione vite humane. In them we review references to neurological disease. Though not independently considered, there is a significant presence of neurological diseases in the regimina. Dietetics measures are proposed to preserve memory, nerves, or hearing, as well as for the treatment of migraine, epilepsy, stroke or dizziness. Regimina are quiet representative among medical medieval literature, and they show medieval physicians vision of neurological diseases. Dietetics was considered useful to preserve health, and therapeutics was based on natural remedies. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  8. A comparison of arthrocentesis teaching tools: cadavers, synthetic joint models, and the relative utility of different educational modalities in improving trainees' comfort with procedures. (United States)

    Berman, Jessica R; Ben-Artzi, Ami; Fisher, Mark C; Bass, Anne R; Pillinger, Michael H


    Each year, rheumatology programs across the country teach incoming trainees the skill of arthrocentesis, but the relative effectiveness of various teaching techniques has not been assessed in a systematic way. We compared approaches to teaching arthrocentesis using cadavers versus anatomic models. In a pilot study, new rheumatology fellows (n = 7) from 2 academic institutions were surveyed at 3 points during arthrocentesis training: (1) before assuming patient care; (2) after lecture with handouts, followed by practice either on cadavers (group A) or on synthetic joint models (group B); and (3) 6 weeks into fellowship. Fellows rated their comfort levels for arthrocentesis of specific joints using 9-point Likert scales. Fellows also retrospectively rated the utility of individual teaching modalities in helping them to learn. As a follow-up study, internal medicine residents taking part in a month-long rheumatology rotation were similarly surveyed on their comfort level performing knee and shoulder arthrocentesis before a cadaver teaching laboratory and at the end of their month rotation. The initial mean comfort level performing arthrocentesis for all fellows was low (2.01). After the cadaver teaching session, group A fellows experienced an overall comfort level increase of 1.95, with the largest single increase reported for shoulder arthrocentesis (3.86). After the anatomic model teaching session, group B fellows reported a mean comfort increase of 1.29, with the largest increase reported for knee arthrocentesis (3.13). The subsequent study with residents confirmed significant increases in comfort after the cadaver laboratory. When surveyed, the learning experience fellows considered most effective was the opportunity to perform procedures under supervision and guidance, followed by training on cadavers. Although all teaching interventions for trainees learning arthrocentesis were helpful for increasing trainee's comfort with arthrocentesis, the use of cadavers

  9. Comfort experience in palliative care: a phenomenological study. (United States)

    Coelho, Adriana; Parola, Vitor; Escobar-Bravo, Miguel; Apóstolo, João


    Palliative care aims to provide maximum comfort to the patient. However it is unknown what factors facilitate or hinder the experience of comfort, from the perspective of inpatients of palliative care units. This lack of knowledge hinders the development of comfort interventions adjusted to these patients. The aim of this research is to describe the comfort and discomfort experienced by inpatients at palliative care units. A phenomenological descriptive study was undertaken. Ten inpatients were recruited from a Spanish palliative care unit and seven from a Portuguese palliative care unit. Data were collected using individual interviews and analysed following the method of Giorgi. Four themes reflect the essence of the lived experience: The Palliative Care as a response to the patient's needs with advanced disease, attempt to naturalize advanced disease, confrontation with their own vulnerability, openness to the spiritual dimension. Informants revealed that they experience comfort through humanized care, differentiated environment, symptomatic control, hope and relationships. The discomfort emerges from the losses and powerlessness against their situation. Even if such findings may seem intuitive, documenting them is essential because it invites us to reflect on our convictions about what it means to be comfortable for these patients, and allows incorporating this information in the design of focused interventions to maximize the comfort experience.

  10. Instruments to assess patient comfort during hospitalization: A psychometric review. (United States)

    Lorente, Sonia; Losilla, Josep-Maria; Vives, Jaume


    To analyse the psychometric properties and the utility of instruments used to measure patient comfort, physical, social, psychospiritual and/or environmental, during hospitalization. There are no systematic reviews nor psychometric reviews of instruments used to measure comfort, which is considered an indicator of quality in health care associated with quicker discharges, increased patient satisfaction and better cost-benefit ratios for the institution. Psychometric review. MEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations, Google. We limited our search to studies published between 1990-2015. The psychometric analysis was performed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN), along with the Quality Criteria for Measurement Properties. The utility of the instruments was assessed according to their cost-efficiency, acceptability and educational impact. Protocol registration in PROSPERO, CRD42016036290. Instruments reviewed showed moderate methodological quality and their utility was poorly reported. Thus, we cannot recommend any questionnaire without reservations, but the Comfort Scale, the General Comfort Questionnaire and their adaptations in adults and older patients, the Psychosocial Comfort Scale and the Incomfort des Patients de Reanimation are the most recommendable instruments to measure comfort. The methodology of the studies should be more rigorous and authors should adequately report the utility of instruments. This review provides a strategy to select the most suitable instrument to assess patient comfort according to their psychometric properties and utility, which is crucial for nurses, clinicians, researchers and institutions. © 2017 John Wiley & Sons Ltd.

  11. [Comfort and noise level in infants with helmet interface]. (United States)

    Medina, A; Alvarez Fernández, P; Rey Galán, C; Álvarez Mendiola, P; Álvarez Blanco, S; Vivanco Allende, A


    To evaluate comfort and noise intensity using the COMFORT scale in infants who receive respiratory support with a helmet interface. An observational descriptive study was conducted on all infants (1 to 12 months of age) admitted to a PICU from November 1st 2013 to March 31st 2014 and who received non-invasive ventilation with a helmet interface. Tolerance to the interface was assessed by use of the COMFORT scale. The intensity of the noise to which the infants were exposed was measured with a TES1350A HIBOK 412 sound-level meter. Three measurements were made every day. Twenty seven patients with bronchiolitis (median age: 54 days; range: 10 to 256) were included. Median COMFORT score in the first day was 21 points (14 - 28). An increase in patient comfort was found with a gradual decrease in the scores, with a maximum reduction of 22% from the first hours (score of 22) to the fifth day (score of 18). The minimum sound intensity registered was 42dB, and the maximum was 78dB. Background noise intensity was associated with noise intensity in the helmet. No differences were observed in COMFORT score and noise intensity between ventilator devices. Helmet interface was well tolerated by infants. COMFORT score results are an indicator that infants were comfortable or very comfortable. The measured noise intensity was in the safe range permitted by World Health Organization. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  12. A personalised thermal comfort model using a Bayesian network


    Auffenberg, Frederik; Stein, Sebastian; Rogers, Alex


    In this paper, we address the challenge of predicting optimal comfort temperatures of individual users of a smart heating system. At present, such systems use simple models of user comfort when deciding on a set point temperature. These models generally fail to adapt to an individual user’s preferences, resulting in poor estimates of a user’s preferred temperature. To address this issue, we propose a personalised thermal comfort model that uses a Bayesian network to learn and adapt to a user’...

  13. The Comfort Houses : measurements and analysis of the indoor environment and energy consumption in 8 passive houses 2008-2011

    Energy Technology Data Exchange (ETDEWEB)

    Steen Larsen, T.; Lund Jensen, R.; Daniels, O.


    The report is prepared in relation to the project ''demonstration of energy consumption and indoor climate in 10 Danish passive houses'' which was carried out from 2008 to 2012 in the Comfort Houses. The report presents the achieved results based on measurements of indoor climate and energy consumption, and it also suggests viable solutions for the future low-energy buildings. The Comfort House project was started in 2007 as a development project at the company Saint Gobain Isover A/S, who wanted to disseminate knowledge about low-energy buildings and the principles behind them. The present report mainly focuses on the results from the Comfort Houses, but it also includes references to other Danish experimental buildings and development projects. Furthermore, the analyses are supplemented with experiences from Swedish low-energy buildings found through literature reviews. The indoor climate analyses deal with the different physical parameters that impact the residents. The evaluation includes both thermal, atmospheric, daylight and acoustic climate. The energy consumption is evaluated together with some of the key parameters from the houses that are related to the energy consumption. Finally, the residents' behaviour impacting both energy consumption and indoor climate are analysed. (LN)

  14. Headache Interest in Academic Neurology Leadership: A Cross-Sectional Study. (United States)

    Robbins, Matthew S; Rosen, Noah L


    Headache disorders are exceedingly common, debilitating neurological conditions, and there is a striking paucity of headache specialists nationally. However, headache education is underrepresented in the curriculum of neurology residency programs and few neurology residents elect to pursue headache medicine fellowships. We aimed to explore the possibility that a low degree of headache interest among neurology department chairs and residency program directors (PDs) underlies this mismatch. We performed a cross-sectional analysis of chairs and PDs associated with ACGME neurology residency programs. Data sources included the ACGME program list, faculty profiles on institutional webpages, Doximity profiles, the American Headache Society (AHS) membership directory, and the roster of United Council for Neurologic Specialties (UCNS) headache diplomates. A headache interest was deemed to be present with the presence of a declared headache or concussion interest, completion of a headache fellowship, active AHS membership, or UCNS certification. Our review included 137 residency programs comprising 127 department chairs, 132 PDs, and 5 faculty who were both chairs and PDs. Of all faculty, 62 (23.5%) were women. Headache expertise was declared by 10 (7.6%) chairs and 13 (9.5%) PDs. Headache fellowship training was pursued by 1 (0.8%) chair and 5 (3.6%) PDs, and among all faculty was the 10th most common subspecialty fellowship pursued. Three (2.3%) chairs and 7 (5.1%) PDs were AHS members. Seven (5.3%) chairs and 10 (7.3%) PDs were UCNS headache certified. An overall headache interest was present in 29 (11.0%) faculty, including 14 (10.6%) chairs and 15 (10.9%) PDs. A graduate degree aside from an MD (eg, PhD, MPH) was more likely to be achieved in faculty without a headache interest (29.4%) than faculty with a headache interest (6.9%, P = .0076). Residency programs where either the chair or PD had a headache interest were just as likely to feature a UCNS headache

  15. Resident Perceptions of Palliative Care Training in the Emergency Department (United States)

    Meo, Nicholas; Morrison, R. Sean


    Abstract Objectives To characterize the level of formal training and perceived educational needs in palliative care of emergency medicine (EM) residents. Methods This descriptive study used a 16-question survey administered at weekly resident didactic sessions in 2008 to EM residency programs in New York City. Survey items asked residents to: (1) respond to Likert-scaled statements about the role of palliative care in the emergency department (ED); (2) quantify their level of formal training and personal comfort in symptom management, discussion of bad news and prognosis, legal issues, and withdrawing/withholding therapy; and (3) express their interest in future palliative care training. Results Of 228 total residents, 159 (70%) completed the survey. Of those surveyed, 50% completed some palliative care training before residency; 71.1% agreed or strongly agreed that palliative care was an important competence for an EM physician. However, only 24.3% reported having a “clear idea of the role of palliative care in EM.” The highest self-reported level of formal training was in the area of advanced directives or legal issues at the end of life; the lowest levels were in areas of patient management at the end of life. The highest level of self-reported comfort was in giving bad news and the lowest was in withholding/withdrawing therapy. A slight majority of residents (54%) showed positive interest in receiving future training in palliative care. Conclusions New York City EM residents reported palliative care as an important competency for emergency medicine physicians, yet also reported low levels of formal training in palliative care. The majority of residents surveyed favored additional training. PMID:21291326

  16. Neurologic manifestations of hypothyroidism in dogs. (United States)

    Bertalan, Abigail; Kent, Marc; Glass, Eric


    Hypothyroidism is a common endocrine disease in dogs. A variety of clinicopathologic abnormalities may be present; however, neurologic deficits are rare. In some instances, neurologic deficits may be the sole manifestation of hypothyroidism. Consequent ly, the diagnosis and management of the neurologic disorders associated with hypothyroidism can be challenging. This article describes several neurologic manifestations of primary hypothyroidism in dogs; discusses the pathophysiology of hypothyroidism-induced neurologic disorders affecting the peripheral and central nervous systems; and reviews the evidence for the neurologic effects of hypothyroidism.

  17. Coalescence of psychiatry, neurology, and neuropsychology: from theory to practice. (United States)

    Cunningham, Miles G; Goldstein, Martin; Katz, David; O'Neil, Sarah Quimby; Joseph, Anthony; Price, Bruce


    In a climate of renewed interest in the synergy between neurology and psychiatry, practitioners are increasingly recognizing the importance of exchange and collaboration between these two disciplines. However, there are few working models of interdisciplinary teams that freely share expertise in real time, while providing clinical and academic training to future physicians who specialize in the central nervous system. Over the past 11 years, the McLean Hospital Neuropsychiatry and Behavioral Neurology service has provided proof-of-principle for such collaboration, demonstrating that a team comprising psychiatrists, neurologists, and neuropsychologists can function effectively as a unit while maintaining the autonomy of these three disciplines and also synthesizing their combined knowledge. In addition to delivering enhanced patient care and promoting medical research, this clinical service has provided enriched cross-specialty training for fellows, residents, and medical students. The practical functioning of the team is described, and case vignettes are presented to illustrate the team's collaborative synergism in practice.

  18. Radiology residents' experience with intussusception reduction

    Energy Technology Data Exchange (ETDEWEB)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L. [University of California at Davis, Department of Radiology, Sacramento, CA (United States); Li, Chin-Shang [University of California at Davis, Department of Public Health Sciences, Division of Biostatistics, Davis, CA (United States)


    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P < 0.0001), and 336 (62.2%) thought they would benefit from a computer-assisted training model simulating intussusception reduction (P < 0.0001). Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model. (orig.)

  19. Importance of thermal comfort for library building in Kuching, Sarawak

    Energy Technology Data Exchange (ETDEWEB)

    Ibrahim, S.H.; Baharun, A.; Abdul Mannan, M.D.; Abang Adenan, D.A. [Department of Civil Engineering, Faculty of Engineering, University Malaysia Sarawak (UNIMAS), 94300 Kota Samarahan, Sarawak (Malaysia)


    Malaysian Government takes an initiative to provide library in housing areas to improve the quality of human capital. However, the government has to evaluate every aspect of their provision to ensure the services provided meet the demands of the users, including the aspect of thermal comfort in the building. For this study, a library constructed using Industrialised Building System (IBS) are selected for thermal comfort evaluation. The data were analyzed using Corrected Effective Temperature (CET) index. From the data analysis, it shows that thermal comfort in the library could not be achieved most of the time unless when the mechanical cooling is used. A series of technical design improvements are then recommended to improve the thermal comfort inside the library by incorporating construction details without increasing the cost.

  20. Thermal Comfort in a Naturally-Ventilated Educational Building

    Directory of Open Access Journals (Sweden)

    David Mwale Ogoli


    Full Text Available A comprehensive study of thermal comfort in a naturally ventilated education building (88,000 ft2 in a Chicago suburb will be conducted with 120 student subjects in 2007. This paper discusses some recent trends in worldwide thermal comfort studies and presents a proposal of research for this building through a series of questionnaire tables. Two research methods used inthermal comfort studies are field studies and laboratory experiments in climate-chambers. The various elements that constitute a “comfortable” thermal environment include physical factors (ambient air temperature, mean radiant temperature, air movement and humidity, personal factors(activity and clothing, classifications (gender, age, education, etc. and psychological expectations (knowledge, experience, psychological effect of visual warmth by, say, a fireplace. Comparisons are made using data gathered from Nairobi, Kenya.Keywords: Comfort, temperature, humidity and ventilation

  1. [Application of psychophysics to neurology]. (United States)

    Koyama, Shinichi


    Although psychophysics has already been used in many neurological evaluations including the visual and hearing tests, the use of psychophysics has been limited to the evaluation of sensory disorders. In this review paper, however, the author introduced recent attempts to apply psychophysics to the evaluation of higher cognitive functions such as perception of scenes and facial expressions. Psychophysics was also used to measure visual hypersensitivity in a patient with migraine. The benefits of the use of psychophysics in neurological and neuropsychological settings would be as follows. (1) We can evaluate higher cognitive functions quantitatively. (2) We can measure performance both above and below the normal range by the same method. (3) We can use the same stimulus and task as other research areas such as neuroscience and neuroimaging, and compare results between research areas.

  2. Neurological diseases in famous painters. (United States)

    Piechowski-Jozwiak, Bartlomiej; Bogousslavsky, Julien


    Visual art production involves multiple processes including basic motor skills, such as coordination of movements, visual-spatial processing, emotional output, sociocultural context, and creativity. Thus, the relationship between artistic output and brain diseases is particularly complex, and brain disorders may lead to impairment of artistic production in multiple domains. Neurological conditions may also occasionally modify artistic style and lead to surprisingly innovative features in people with an initial loss of creativity. This chapter focuses on anecdotal reports of various neurological disorders and their potential consequences on works produced by famous or well-established artists, including Carl Frederik Reutersward, Giorgio de Chirico, Krystyna Habura, Leo Schnug, Ignatius Brennan, and many others. © 2013 Elsevier B.V. All rights reserved.

  3. PET and SPECT in neurology

    Energy Technology Data Exchange (ETDEWEB)

    Dierckx, Rudi A.J.O. [Groningen University Medical Center (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium). Dept. of Radiology and Nuclear Medicine; Vries, Erik F.J. de; Waarde, Aren van [Groningen University Medical Center (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Otte, Andreas (ed.) [Univ. of Applied Sciences Offenburg (Germany). Faculty of Electrical Engineering and Information Technology


    PET and SPECT in Neurology highlights the combined expertise of renowned authors whose dedication to the investigation of neurological disorders through nuclear medicine technology has achieved international recognition. Classical neurodegenerative disorders are discussed as well as cerebrovascular disorders, brain tumors, epilepsy, head trauma, coma, sleeping disorders, and inflammatory and infectious diseases of the CNS. The latest results in nuclear brain imaging are detailed. Most chapters are written jointly by a clinical neurologist and a nuclear medicine specialist to ensure a multidisciplinary approach. This state-of-the-art compendium will be valuable to anybody in the field of neuroscience, from the neurologist and the radiologist/nuclear medicine specialist to the interested general practitioner and geriatrician. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences, the other volumes covering PET and SPECT in psychiatry and in neurobiological systems.

  4. Proust, neurology and Stendhal's syndrome. (United States)

    Teive, Hélio A G; Munhoz, Renato P; Cardoso, Francisco


    Marcel Proust is one of the most important French writers of the 20th century. His relationship with medicine and with neurology is possibly linked to the fact that his asthma was considered to be a psychosomatic disease classified as neurasthenia. Stendhal's syndrome is a rare psychiatric syndrome characterized by anxiety and affective and thought disturbances when a person is exposed to a work of art. Here, the authors describe neurological aspects of Proust's work, particularly the occurrence of Stendhal's syndrome and syncope when he as well as one of the characters of In Search of Lost Time see Vermeer's View of Delft during a visit to a museum. © 2014 S. Karger AG, Basel.

  5. From occupying to inhabiting - a change in conceptualising comfort (United States)

    Jaffari, Svenja D.; Matthews, Ben


    The concept of 'comfort' has been influential in shaping aspects of our built environment. For the construction industry, comfort is predominantly understood in terms of the balance between an ideal human physiological state and a finite number of measurable environmental parameters that can be controlled (temperature, humidity, air quality, daylighting, noise). It is such a notion of comfort that has informed the establishment of universally applied comfort standards and guidelines for the built environment. When buildings rigidly conform to these standards, they consume vast quantities of energy and are responsible for higher levels of GHG emissions. Recent researchers have challenged such instrumental definitions of comfort on moral and environmental grounds. In this paper, we address this issue from two different standpoints: one empirical, one related to the design of technology. Empirically, we present an analysis of ethnographic field material that has examined how, in what circumstances, and at what times ordinary users employ energy-intensive indoor climate technologies in their daily lives. We argue that when comfort is viewed as an achievement, rather than as a reified and static ideal homeostasis between humans and their environmental conditions, it becomes easier to appreciate the extent to which comfort is, for ordinary people, personally idiosyncratic, culturally relative, socially influenced and highly dependent on temporality, sequence and activity. With respect to design, we introduce a set of provocative designed prototypes that embody alternative conceptions of 'comfort' than those to which the building industry typically subscribes. Our discussion has critical implications for the types of technologies that result from a 'comfort standards' conception. Firstly, we show that comfort is not simply a homeostatic equilibrium-such a view is overly narrow, inflexible and ultimately an inaccurate conception of what comfort is for ordinary people

  6. Influence of sleeping pads on thermal comfort of sleeping bag


    Vinš, Jiří


    Name of thesis: Influence of sleeping pads on thermal comfort of sleeping bag Abstract: The goals: The objective is to test different types of sleeping pads using the same sleeping bag in the specific stable conditions. Find and state test results for every sleeping pads. Conclusion of the thesis contain desicion, which sleeping pad is the best for thermal comfort in sleeping bag. Methods: Testing was conducted at 5 different sleeping pads using the same sleeping bag for each of the pads. Fou...

  7. Thermal Comfort Studies in Naturally Ventilated Buildings in Jakarta, Indonesia


    Karyono, Tri; Sri, Elita; Sulistiawan, Jevi; Triswanti, Yenny


    Many thermal comfort studies have been conducted in offices, classrooms and dwellings, but few in public buildings such as cathedrals, museums and markets. A recent thermal comfort study has been conducted in three naturally ventilated (NV) buildings, a cathedral, a museum and a market, in Jakarta, between March and April 2014. There is a curiosity as to whether people doing slightly different activities with slightly different clothing insulation values, in different building types, might ha...

  8. Improvement of Thermal Comfort in a Naturally Ventilated Office

    DEFF Research Database (Denmark)

    Bjørn, Erik; Jensen, J.; Larsen, J.

    The paper describes the results of laboratory investigations in a mock-up of an office space with the purpose of investigating the impact of different opening strategies on thermal comfort conditions in the occupied zone. The results show that different window opening strategies result in quite...... different airflow and thermal comfort conditions. The conditions are a result of a multivariable impact, and detailed descriptions of the flows involved are complex....

  9. Indoor temperatures for optimum thermal comfort and human performance

    DEFF Research Database (Denmark)

    de Dear, R.; Arens, E. A.; Candido, C.


    A response by R. J. de Dear et al to a letter to the editor in response to their article "Progress in thermal comfort research over the last 20 years," published in a 2013 issue.......A response by R. J. de Dear et al to a letter to the editor in response to their article "Progress in thermal comfort research over the last 20 years," published in a 2013 issue....

  10. Neurological Findings in Myeloproliferative Neoplasms

    Directory of Open Access Journals (Sweden)

    Semra Paydas


    Full Text Available Myeloproliferative neoplasms (MPN arise from genetic deficiencies at the level of pluripotent stem cells. Each of these neoplasms is a clonal stem cell disorder with specific phenotypic, genetic and clinical properties. Age is one of the most important factors in the development of symptoms and complications associated with MPNs.High white blood cell counts in chronic myelocytic leukemia also known as leukocytosis may lead to central nervous system findings. Tumors developing outside the bone marrow named as extramedullary myeloid tumors (EMMT could be detected at the initial diagnosis or during the prognosis of the disease, which may cause neurological symptoms due to pressure of leukemic cell mass on various tissues along with spinal cord. Central nervous system involvement and thrombocytopenic hemorrhage may lead to diverse neurological symptoms and findings.Transient ischemic attack and thrombotic stroke are the most common symptoms in polycythemia vera. Besides thrombosis and hemorrage, transformation to acute leukemia can cause neurological symptoms and findings. Transient ischemic attack, thrombotic stroke and specifically hemorrage can give rise to neurological symptoms similar to MPN in essential thrombocytosis.Extramedullary hematopoiesis refers to hematopoietic centers arise in organ/tissues other than bone marrow in myelofibrosis. Extramedullar hematopoietic centers may cause intracranial involvement, spinal cord compression, seizures and hydrocephalia. Though rare, extramedullary hematopoiesis can be detected in cranial/spinal meninges, paraspinal tissue and intracerebral regions. Extramedullary hematopoiesis has been reported in peripheral neurons, choroid plexus, pituitary, orbits, orbital and lacrimal fossa and in sphenoidal sinuses. [Cukurova Med J 2013; 38(2.000: 157-169

  11. [Deficiency, disability, neurology and cinema]. (United States)

    Collado-Vázquez, Susana; Cano de la Cuerda, Roberto; Jiménez-Antona, Carmen


    Cinema has been defined in many different ways, but most of them agree that it should be considered both a technique and an art. Although films often depict fantasy stories, in many cases they also reflect day-to-day realities. In its earliest days cinema was already attracted to the world of health and sickness, and frequently addressed topics like medical practice, how patients lived with their illnesses, bioethical issues, the relationship between physician and patient or research. To review the presence of neurological pathologies in the cinema with a view to identifying the main neurological disorders that have been portrayed in films. Likewise it also intends to describe the medical praxis that is employed, the relationship between physician and patient, how the experiences of the patient and the family are represented, the adaptation to social and occupational situations, and the intervention of other health care professionals related with neurological patients. Some of the most significant films that have addressed these topics were reviewed and it was seen that in some of them the illness is dealt with in a very true-to-life manner, whereas others tend to include a greater number of inaccuracies and a larger degree of fiction. Cinema has helped to shape certain ways of thinking about the health care professionals who work with neurological patients, the importance of support from the family and the social role, among other things. This confirms that resorting to cinematographic productions is a fruitful tool for stimulating a critical interest in the past and present of medical practice.

  12. Resident satisfaction on their residence and environment (case study of Srondol Bumi Indah Housing of Semarang City) (United States)

    Hariyono, Paulus


    A piece of an architecture work will be meaningful if it meets the needs of the residents. Likewise, the design and natural environment of a residence will surely be meaningful if it is able to satisfy the residents. The degree of satisfaction can be referred to the theory of human need hierarchy proposed by Abraham Maslow. Although his theory is an old one, it is still a good one for a reference. Socio economic status (SES)also affects someone in understanding the comfort of his resident. This research has some purpose: 1) to know the satisfaction level of the residents, 2) to know the effects of socio economic status towards the residents, and 3) to know the natural environment aspect to resident satisfaction. The methode analysis used is qualitative analysis. The major finding are: 1)security factor is the main aspect of the human need residents; 2) upper and lowerclass residents have different knowledge and understanding regarding the natural environment satisfaction on the house they live.

  13. Prospects for neurology and psychiatry. (United States)

    Cowan, W M; Kandel, E R


    Neurological and psychiatric illnesses are among the most common and most serious health problems in developed societies. The most promising advances in neurological and psychiatric diseases will require advances in neuroscience for their elucidation, prevention, and treatment. Technical advances have improved methods for identifying brain regions involved during various types of cognitive activity, for tracing connections between parts of the brain, for visualizing individual neurons in living brain preparations, for recording the activities of neurons, and for studying the activity of single-ion channels and the receptors for various neurotransmitters. The most significant advances in the past 20 years have come from the application to the nervous system of molecular genetics and molecular cell biology. Discovery of the monogenic disorder responsible for Huntington disease and understanding its pathogenesis can serve as a paradigm for unraveling the much more complex, polygenic disorders responsible for such psychiatric diseases as schizophrenia, manic depressive illness, and borderline personality disorder. Thus, a new degree of cooperation between neurology and psychiatry is likely to result, especially for the treatment of patients with illnesses such as autism, mental retardation, cognitive disorders associated with Alzheimer and Parkinson disease that overlap between the 2 disciplines.

  14. Physical Environment Comfort Impacts on Office Employee’s Performance

    Directory of Open Access Journals (Sweden)

    Chua Shirley Jin Lin


    Full Text Available Office workplaces today is now no longer only consisting of passive and fixed activity but also towards a more flexible environment activity. The number of office workplaces is hiking from day to day which leads to the increase of the office workers. The productivity will be improved by providing optimum physical environment. The physical environment comfort in a workplace is claimed to be vital as it will encourages healthier, more productive and lower absenteeism rate among employees. The physical environment comfort encompassed optimum room temperature, relative humidity and illuminance level. This research intend to investigate the importance of physical environment comfort by evaluating the comfort based on the existing workplace and determine its effect on employee’s performance. Evaluation between the selected case studies are made in the aspects of employee’s comfort perceive health and absenteeism rate by wielding the elements of physical comfort consisting room temperature, relative humidity and illuminance level. Field study was carried out for 3 institutional building particularly management department. High correlations are found between room temperature, lighting and relative humidity with health related issue such as stuffy, easily tired and difficulty in concentration which affect employees’ productivity and work performances.

  15. Impact of measurable physical phenomena on contact thermal comfort

    Directory of Open Access Journals (Sweden)

    Fojtlín Miloš


    Full Text Available Cabin HVAC (Heating Ventilation and Air-conditioning systems have become an essential part of personal vehicles as demands for comfortable transport are still rising. In fact, 85 % of the car trips in Europe are shorter than 18 km and last only up to 30 minutes. Under such conditions, the HVAC unit cannot often ensure desired cabin environment and passengers are prone to experience thermal stress. For this reason, additional comfort systems, such as heated or ventilated seats, are available on the market. However, there is no straightforward method to evaluate thermal comfort at the contact surfaces nowadays. The aim of this work is to summarise information about heated and ventilated seats. These technologies use electrical heating and fan driven air to contact area in order to achieve enhanced comfort. It is also expected, that such measures may contribute to lower energy consumption. Yet, in real conditions it is almost impossible to measure the airflow through the ventilated seat directly. Therefore, there is a need for an approach that would correlate measurable physical phenomena with thermal comfort. For this reason, a method that exploits a measurement of temperatures and humidity at the contact area is proposed. Preliminary results that correlate comfort with measurable physical phenomena are demonstrated.

  16. Lubricant effects on low Dk and silicone hydrogel lens comfort. (United States)

    Ozkan, Jerome; Papas, Eric


    To investigate the influence of three lubricants of varying viscosity, on postinsertion and 6 h comfort with contact lens wear. Comfort and associated symptoms of dryness were assessed in 15 experienced contact lens wearers. Subjects wore a low Dk lens in one eye and a silicone hydrogel in the other and participated in four separate trials involving no lubricant (baseline), saline, and two commercially available lubricants of differing viscosity. The in-eye lubricants were used immediately following lens insertion and every 2 h postinsertion for a 6 h wear period. Postlens insertion comfort was significantly better for both lens types when lubricants or saline were used compared with no lubricant use. After 6 h lens wear, comfort was influenced by lens type and not by in-eye lubricant or saline use. Also after 6 h lens wear, less dryness sensation was reported for silicone hydrogel lenses when using lubricants but not saline. Although lubricant use does help reduce dryness symptoms with silicone hydrogel lens wear, there appears to be minimal longer-term benefit to comfort. Furthermore, increased lubricant viscosity did not lead to improved longer-term comfort.

  17. Adaptive comfort model for tree-shaded outdoors in Taiwan

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Reuy-Lung [Department of Architecture, National United University, 1 Lienda, Miaoli 360 (China); Lin, Tzu-Ping [Department of Leisure Planning, National Formosa University, 64 Wen-hua Road, Huwei, Yunlin 632 (China); Cheng, Ming-Jen; Lo, Jen-Hao [Department of Architecture, Feng Chia University, 100 Wen-hwa Road, Taichung 407 (China)


    Tree-shaded outdoors can reduce the heat effect by ameliorating the microclimate and enhancing the human thermal comfort outdoors; for this reason, they are main places for rest, recreation and social activity in Taiwan's cities. Field comfort surveys of 3839 interviewees were conducted in tree-shaded spaces throughout a year. The aims were to obtain a better understanding of human thermal comfort response outdoors and to propose an adaptive comfort model for tree-shaded spaces. A comfort zone, centering on neutral operative temperature which is an empirically derived linear function of mean monthly outdoor temperature, of 6 C for 90% acceptability and 8 C for 80% acceptability was suggested for tree-shaded spaces from surveyed data, adding that a non-linear function of the temperature difference between actual operative temperature and neutral operative temperature was established that aims to predict the percentage of heat or cold discomfort at a particular outdoor thermal condition. An application of the established adaptive comfort model on an actual tree-shaded space was demonstrated to show its practicality in long-term evaluation of a particular thermal environment. (author)

  18. Impact of measurable physical phenomena on contact thermal comfort (United States)

    Fojtlín, Miloš; Pokorný, Jan; Fišer, Jan; Toma, Róbert; Tuhovčák, Ján

    Cabin HVAC (Heating Ventilation and Air-conditioning) systems have become an essential part of personal vehicles as demands for comfortable transport are still rising. In fact, 85 % of the car trips in Europe are shorter than 18 km and last only up to 30 minutes. Under such conditions, the HVAC unit cannot often ensure desired cabin environment and passengers are prone to experience thermal stress. For this reason, additional comfort systems, such as heated or ventilated seats, are available on the market. However, there is no straightforward method to evaluate thermal comfort at the contact surfaces nowadays. The aim of this work is to summarise information about heated and ventilated seats. These technologies use electrical heating and fan driven air to contact area in order to achieve enhanced comfort. It is also expected, that such measures may contribute to lower energy consumption. Yet, in real conditions it is almost impossible to measure the airflow through the ventilated seat directly. Therefore, there is a need for an approach that would correlate measurable physical phenomena with thermal comfort. For this reason, a method that exploits a measurement of temperatures and humidity at the contact area is proposed. Preliminary results that correlate comfort with measurable physical phenomena are demonstrated.

  19. Introduction of handheld computing to a family practice residency program. (United States)

    Rao, Goutham


    Handheld computers are valuable practice tools. It is important for residency programs to introduce their trainees and faculty to this technology. This article describes a formal strategy to introduce handheld computing to a family practice residency program. Objectives were selected for the handheld computer training program that reflected skills physicians would find useful in practice. TRGpro handheld computers preloaded with a suite of medical reference programs, a medical calculator, and a database program were supplied to participants. Training consisted of four 1-hour modules each with a written evaluation quiz. Participants completed a self-assessment questionnaire after the program to determine their ability to meet each objective. Sixty of the 62 participants successfully completed the training program. The mean composite score on quizzes was 36 of 40 (90%), with no significant differences by level of residency training. The mean self-ratings of participants across all objectives was 3.31 of 4.00. Third-year residents had higher mean self-ratings than others (mean of group, 3.62). Participants were very comfortable with practical skills, such as using drug reference software, and less comfortable with theory, such as knowing the different types of handheld computers available. Structured training is a successful strategy for introducing handheld computing to a residency program.

  20. Functional Disorders in Neurology : Case Studies

    NARCIS (Netherlands)

    Stone, Jon; Hoeritzauer, Ingrid; Gelauff, Jeannette; Lehn, Alex; Gardiner, Paula; van Gils, Anne; Carson, Alan

    Functional, often called psychogenic, disorders are common in neurological practice. We illustrate clinical issues and highlight some recent research findings using six case studies of functional neurological disorders. We discuss dizziness as a functional disorder, describing the relatively new

  1. Clinical trials in neurology: design, conduct, analysis

    National Research Council Canada - National Science Library

    Ravina, Bernard


    .... Clinical Trials in Neurology aims to improve the efficiency of clinical trials and the development of interventions in order to enhance the development of new treatments for neurologic diseases...

  2. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    Directory of Open Access Journals (Sweden)

    ZHANG Ling


    Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

  3. Adaptive thermal comfort explained by means of the Fanger-model; Adaptief thermisch comfort verklaard met Fanger-model

    Energy Technology Data Exchange (ETDEWEB)

    Van der Linden, W.; Loomans, M.G.L.C.; Hensen, J. [Technische Universiteit Eindhoven, Eindhoven (Netherlands)


    This article examines the relation between the adaptive thermal comfort (ATC) model and the Fanger model. The most important data collected were the value ranges of individual parameters in relation to ATC assessment. The ATC model uses a relatively simple indicator of thermal comfort. It treats the desired operational indoor temperature as a measure of thermal comfort in direct comparison to the outdoor temperature. This has the advantage of providing a relatively straightforward and transparent way of assessing occupant comfort. The Fanger model makes use of human thermal equilibrium, and is more flexible and more widely applicable. The results of the comparison show that, in a temperate climate like that of the Netherlands, the Fanger model is fully capable of explaining the results of the ATC model. [Dutch] In dit artikel is de relatie tussen het adaptief thermisch comfort (ATC) model en het Fanger-model nader onderzocht. Hierbij is vooral gekeken naar de ranges van waarden van de individuele parameters in relatie tot de ATC-beoordeling. Her ATC-model maakt gebruik van een minder complexe indicator om een uitspraak te doen over het thermisch comfort. Bij deze aanpak wordt de gewenste operatieve binnentemperatuur, als maat voor her thermisch comfort, direct gerelateerd aan de buitentemperatuur. Een voordeel hiervan is dat op een relatief eenvoudige en inzichtelijke manier een waardering van her comfort kan worden gegeven. Het Fanger-model maakt gebruik van de warmtebalans van de mens en is flexibeler en breder toepasbaar. De resultaten van de vergelijking laten zien dat voor een gematigd klimaat als in Nederland het Fanger-model goed in staat is om de resultaten van het ATC-model te verklaren.

  4. Burnout in nursing residents

    National Research Council Canada - National Science Library

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum


    .... The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years...

  5. Resident Characteristics Report (United States)

    Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

  6. 76 FR 69747 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings (United States)


    ... and evaluate grant applications. Place: National Institutes of Health, Neuroscience Center, 6001.../NIH/DHHS/Neuroscience Center, 6001 Executive Blvd., Suite 3208, MSC 9529, Bethesda, MD 20892, (301... Special Emphasis Panel; NINDS Research Education Programs for Residents and Fellows in Neurology...

  7. Neurological manifestaions among Sudanese patients with multiple ...

    African Journals Online (AJOL)

    The study demonstrated that the most common non- neurological symptoms was locomotor symptoms (24%) ,while the most common neurological symptoms were backache and neck pain .The most common neurological findings were cord compression (8%) followed by peripheral neuropathy (2%) and CVA (2%). 22% of ...

  8. Passivhaus: indoor comfort and energy dynamic analysis. (United States)

    Guida, Antonella; Pagliuca, Antonello; Cardinale, Nicola; Rospi, Gianluca


    The research aims to verify the energy performance as well as the indoor comfort of an energy class A+ building, built so that the sum of the heat passive contributions of solar radiation, transmitted through the windows, and the heat generated inside the building, are adeguate to compensate for the envelope loss during the cold season. The building, located in Emilia Romagna (Italy), was built using a wooden structure, an envelope realized using a pinewood sandwich panels (transmittance U = 0.250 W/m2K) and, inside, a wool flax insulation layer and thermal window frame with low-emissivity glass (U = 0524 W/m2K). The building design and construction process has followed the guidelines set by "CasaClima". The building has been modeled in the code of dynamic calculation "Energy Plus" by the Design Builder application and divided it into homogenous thermal zones, characterized by winter indoor temperature set at 20 ° (+ / - 1 °) and summer indoor temperature set at 26 ° (+ / - 1 °). It has modeled: the envelope, as described above, the "free" heat contributions, the air conditioning system, the Mechanical Ventilation system as well as home automation solutions. The air conditioning system is an heat pump, able to guarantee an optimization of energy consumption (in fact, it uses the "free" heat offered by the external environment for conditioning indoor environment). As regards the air recirculation system, it has been used a mechanical ventilation system with internal heat cross-flow exchanger, with an efficiency equal to 50%. The domotic solutions, instead, regard a system for the control of windows external screening using reeds, adjustable as a function of incident solar radiation and a lighting management system adjusted automatically using a dimmer. A so realized building meets the requirement imposed from Italian standard UNI/TS 11300 1, UNI/TS 11300 2 and UNI/TS 11300 3. The analysis was performed according to two different configurations: in "spontaneous

  9. A multimethod approach for cross-cultural training in an internal medicine residency program

    Directory of Open Access Journals (Sweden)

    Lisa J. Staton


    Full Text Available Background: Cultural competence training in residency is important to improve learners’ confidence in cross-cultural encounters. Recognition of cultural diversity and avoidance of cultural stereotypes are essential for health care providers. Methods: We developed a multimethod approach for cross-cultural training of Internal Medicine residents and evaluated participants’ preparedness for cultural encounters. The multimethod approach included (1 a conference series, (2 a webinar with a national expert, (3 small group sessions, (4 a multicultural social gathering, (5 a Grand Rounds presentation on cross-cultural training, and (6 an interactive, online case-based program. Results: The program had 35 participants, 28 of whom responded to the survey. Of those, 16 were white (62%, and residents comprised 71% of respondents (n=25. Following training, 89% of participants were more comfortable obtaining a social history. However, prior to the course only 27% were comfortable caring for patients who distrust the US system and 35% could identify religious beliefs and customs which impact care. Most (71% believed that the training would help them give better care for patients from different cultures, and 63% felt more comfortable negotiating a treatment plan following the course. Conclusions: Multimethod training may improve learners’ confidence and comfort with cross-cultural encounters, as well as lay the foundation for ongoing learning. Follow-up is needed to assess whether residents’ perceived comfort will translate into improved patient outcomes.

  10. International electives in neurology training: a survey of US and Canadian program directors. (United States)

    Lyons, Jennifer L; Coleman, Mary E; Engstrom, John W; Mateen, Farrah J


    To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. A survey was distributed to all program directors in the United States and Canada (December 2012-February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Approximately half of responding programs (53%) allow residents to pursue global health-related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%-9% of residents (55% of programs) and 10%-19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority of Canadian programs that responded allow international

  11. The evaluation of the overall thermal comfort inside a vehicle (United States)

    Neacsu, Catalin; Tabacu, Ion; Ivanescu, Mariana; Vieru, Ionel


    The thermal comfort is one of the most important aspects of the modern vehicles that can influence the safety, the fuel consumption and the pollutions regulation. The objective of this paper is to compare the global and absolute thermal comfort indexes for two vehicles with different distribution air systems inside the car cockpit, one using only front air vents, and the other using both front and rear air vents. The methodology of calculus consists in using the 3D model of the interior vehicle, generally in a CAD format. Then, using a meshing software to create the finite element model of the interior surfaces inside the cockpit and the volume of internal air. Using the obtained finite element geometry, there will be conducted a Theseus FE calculus using the given boundary conditions. The results of the numerical simulation are presented in terms of graphs and figures and also PMV, PPD and DTS thermal comfort indexes. With the obtained results, we will then create the graphs that allows us to evaluate the global and absolute thermal comfort indexes. The results of the evaluation show us that the use of the method allow us to evaluate with a greater accuracy the thermal comfort for the whole vehicle, not only for each passenger, like the standard methods. This shows us that in terms of general and absolute thermal comfort, the vehicle that use front and rear systems is better than the version that use only a front system. The thermal comfort is an important aspect to be taken into account from the beginning of the design stage of a vehicle, by choosing the right air conditioning system. In addition, by using the numerical simulation, we are able to reduce the time needed for preliminary tests and be able to provide the vehicle to the market earlier, at a lower development cost.

  12. Operators' perception of comfort in two tractor cabs. (United States)

    Ferrari, E; Cavallo, E


    Workspace characteristics affect the perceived comfort level of the operator and uncomfortable working conditions have been found to have a negative impact on productivity and safety. The comfort of the operator is increasingly recognized by manufacturers as a product's added value. Comfort can positively distinguish a product and increase its competitiveness. The concept of comfort is controversial, and a clear operational definition is missing. Nevertheless, it is widely accepted that comfort is a subjective phenomenon that can be evaluated by the final users. In this study, comfort aspects of the tractor workspace interior (i.e., the cab) were investigated. Users with various levels of expertise and two medium-power utility tractors of different brands were used in a 2 x 2 mixed-factorial experimental design. Participants were involved in a dynamic assessment of the cabs, and their opinions about the different workspaces were collected through a questionnaire. Additionally, objective measurements were taken on both tractors, and subjective data were compared with objective data. Results indicate significant differences in terms of the ease of locating and operating the controls (i.e., rear-mounted three-point linkage, hydraulic system, and power take-off), the ease of starting the tractor, the ease exiting the cab, the required level of concentration in executing the tasks, the adequacy of lateral visibility from the driving station, and the level of noise at the operator's position. This article provides guidance for improving the comfort of tractor workspace interiors. Agricultural machinery manufactures would benefit from research results, differentiating themselves from competitors.

  13. Introducing resident doctors to complexity in ambulatory medicine. (United States)

    Cook, David A; Beckman, Thomas J; Thomas, Kris G; Thompson, Warren G


    Medical education instructional methods typically imply one 'best' management approach. Our objectives were to develop and evaluate an intervention to enhance residents' appreciation for the diversity of acceptable approaches when managing complex patients. A total of 124 internal medicine residents enrolled in a randomised, crossover trial. Residents completed four web-based modules in ambulatory medicine during continuity clinic. For each module we developed three 'complex cases'. Cases were intended to be complex (numerous variables, including psychosocial and economic barriers) and to suggest multiple acceptable management strategies. Several experienced faculty members described how they would manage each case. Residents reviewed each case, answered the same questions, and compared their responses with expert responses. Participants were randomly assigned to complete two modules with, and two modules without complex cases. A total of 76 residents completed 279 complex cases. Residents agreed that complex cases enhanced their appreciation for the diversity of 'correct' options (mean +/- standard error of the mean 4.6 +/- 0.2 [1 = strongly disagree, 6 = strongly agree]; P complex cases (95% confidence interval for difference - 4.0 to 0.3; P = 0.09). Resident comments suggested that lack of time and cognitive overload impeded learning. Residents felt complex cases made a valuable contribution to their learning, although preference was neutral and knowledge scores were not affected. Methods to facilitate trainee comfort in managing medically complex patients should be further explored.

  14. Education Research: Bias and poor interrater reliability in evaluating the neurology clinical skills examination (United States)

    Schuh, L A.; London, Z; Neel, R; Brock, C; Kissela, B M.; Schultz, L; Gelb, D J.


    Objective: The American Board of Psychiatry and Neurology (ABPN) has recently replaced the traditional, centralized oral examination with the locally administered Neurology Clinical Skills Examination (NEX). The ABPN postulated the experience with the NEX would be similar to the Mini-Clinical Evaluation Exercise, a reliable and valid assessment tool. The reliability and validity of the NEX has not been established. Methods: NEX encounters were videotaped at 4 neurology programs. Local faculty and ABPN examiners graded the encounters using 2 different evaluation forms: an ABPN form and one with a contracted rating scale. Some NEX encounters were purposely failed by residents. Cohen’s kappa and intraclass correlation coefficients (ICC) were calculated for local vs ABPN examiners. Results: Ninety-eight videotaped NEX encounters of 32 residents were evaluated by 20 local faculty evaluators and 18 ABPN examiners. The interrater reliability for a determination of pass vs fail for each encounter was poor (kappa 0.32; 95% confidence interval [CI] = 0.11, 0.53). ICC between local faculty and ABPN examiners for each performance rating on the ABPN NEX form was poor to moderate (ICC range 0.14-0.44), and did not improve with the contracted rating form (ICC range 0.09-0.36). ABPN examiners were more likely than local examiners to fail residents. Conclusions: There is poor interrater reliability between local faculty and American Board of Psychiatry and Neurology examiners. A bias was detected for favorable assessment locally, which is concerning for the validity of the examination. Further study is needed to assess whether training can improve interrater reliability and offset bias. GLOSSARY ABIM = American Board of Internal Medicine; ABPN = American Board of Psychiatry and Neurology; CI = confidence interval; HFH = Henry Ford Hospital; ICC = intraclass correlation coefficients; IM = internal medicine; mini-CEX = Mini-Clinical Evaluation Exercise; NEX = Neurology Clinical

  15. An Innovative Clinical Skills “Boot Camp” for Dental Medicine Residents

    Directory of Open Access Journals (Sweden)

    Jenny Castillo


    Full Text Available During a 1-year hospital-based residency, dental residents are required to rotate through many departments including surgery, medicine, and emergency medicine. It became apparent that there was a gap between clinical skills knowledge taught in dental school curriculum and skills required for hospital-based patient care. In response, a simulation-based intensive clinical skill “boot camp” was created. The boot camp provided an intensive, interactive 3-day session for the dental residents. During the 3 days, residents were introduced to medical knowledge and skills that were necessary for their inpatient hospital rotations but were lacking in traditional dental school curriculum. Effectiveness of the boot camp was assessed in terms of knowledge base and comfort through presession and postsession surveys. According to resident feedback, this intensive introduction for the dental residents improved their readiness for their inpatient hospital-based residency.

  16. The Effect of Thermal Mass on Annual Heat Load and Thermal Comfort in Cold Climate Construction

    DEFF Research Database (Denmark)

    Stevens, Vanessa; Kotol, Martin; Grunau, Bruno


    Thermal mass in building construction refers to a building material's ability to absorb and release heat based on changing environmental conditions. In building design, materials with high thermal mass used in climates with a diurnal temperature swing around the interior set-point temperature have...... been shown to reduce the annual heating demand. However, few studies exist regarding the effects of thermal mass in cold climates. The purpose of this research is to determine the effect of high thermal mass on the annual heat demand and thermal comfort in a typical Alaskan residence using energy...... that while increased thermal mass does have advantages in all climates, such as a decrease in summer overheating, it is not an effective strategy for decreasing annual heat demand in typical residential buildings in Alaska. (C) 2015 American Society of Civil Engineers....

  17. Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows. (United States)

    Pisani, Anthony R; leRoux, Pieter; Siegel, David M


    Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

  18. [Neurological manifestations in riverine populations from areas exposed to mercury in the Brazilian Amazon]. (United States)

    Khoury, Eliana Dirce Torres; Souza, Givago da Silva; Silveira, Luiz Carlos de Lima; Costa, Carlos Araújo da; Araújo, Amélia A de; Pinheiro, Maria da Conceição Nascimento


    This study evaluated current levels of mercury exposure and sensory symptoms in adults from three riverine communities in Pará State, Brazil, two of which located in the Tapajós River basin and one in the Tocantins basin. Participants in this study included 78 residents in Barreiras (Tapajós), 30 in São Luiz do Tapajós (Tapajós), and 49 in Furo do Maracujá (Tocantins). Total hair mercury concentrations were quantified by atomic absorption spectrophotometry, and neurological evaluation was conducted by routine examination. Mercury concentrations in the Tapajós communities were higher than those in the Tocantins (p neurological changes showed no significant difference between the communities in exposed areas and control areas for the changes observed by conventional neurological examination, except for gait deviation (p mercury exposure levels, there was a low frequency of sensory alterations according to conventional neurological testing.

  19. The psychobiology of comfort eating: implications for neuropharmacological interventions. (United States)

    Gibson, E Leigh


    Comfort eating, that is eating induced by negative affect, has been a core theme of explanations for overeating and obesity. Psychobiological explanations and processes underlying comfort eating are examined, as well as its prevalence in clinical and nonclinical populations, to consider who may be susceptible, whether certain foods are comforting, and what the implications for treatment may be. Comfort eating may occur in a substantial minority, particularly in women and the obese. Human and animal theories and models of emotional or stress-induced eating show some convergence, and may incorporate genetic predispositions such as impulsivity and reward sensitivity, associated with dopamine dysregulation underlying incentive salience. Comfort eaters show vulnerability to depression, emotional dysregulation and a need to escape negative affect and rumination. During negative affect, they preferentially consume sweet, fatty, energy-dense food, which may confer protection against stress, evidenced by suppression of the hypothalamic-pituitary-adrenal axis response, although activation of the hypothalamic-pituitary-adrenal axis may itself drive appetite for these palatable foods, and the risk of weight gain is increased. Benefits to mood may be transient, but perhaps sufficient to encourage repeated attempts to prolong mood improvement or distract from negative rumination. Cognitive behavioural treatments may be useful, but reliable drug therapy awaits further pharmacogenomic developments.

  20. Coupling of the Models of Human Physiology and Thermal Comfort (United States)

    Pokorny, J.; Jicha, M.


    A coupled model of human physiology and thermal comfort was developed in Dymola/Modelica. A coupling combines a modified Tanabe model of human physiology and thermal comfort model developed by Zhang. The Coupled model allows predicting the thermal sensation and comfort of both local and overall from local boundary conditions representing ambient and personal factors. The aim of this study was to compare prediction of the Coupled model with the Fiala model prediction and experimental data. Validation data were taken from the literature, mainly from the validation manual of software Theseus-FE [1]. In the paper validation of the model for very light physical activities (1 met) indoor environment with temperatures from 12 °C up to 48 °C is presented. The Coupled model predicts mean skin temperature for cold, neutral and warm environment well. However prediction of core temperature in cold environment is inaccurate and very affected by ambient temperature. Evaluation of thermal comfort in warm environment is supplemented by skin wettedness prediction. The Coupled model is designed for non-uniform and transient environmental conditions; it is also suitable simulation of thermal comfort in vehicles cabins. The usage of the model is limited for very light physical activities up to 1.2 met only.

  1. Coupling of the Models of Human Physiology and Thermal Comfort

    Directory of Open Access Journals (Sweden)

    Jicha M.


    Full Text Available A coupled model of human physiology and thermal comfort was developed in Dymola/Modelica. A coupling combines a modified Tanabe model of human physiology and thermal comfort model developed by Zhang. The Coupled model allows predicting the thermal sensation and comfort of both local and overall from local boundary conditions representing ambient and personal factors. The aim of this study was to compare prediction of the Coupled model with the Fiala model prediction and experimental data. Validation data were taken from the literature, mainly from the validation manual of software Theseus–FE [1]. In the paper validation of the model for very light physical activities (1 met indoor environment with temperatures from 12 °C up to 48 °C is presented. The Coupled model predicts mean skin temperature for cold, neutral and warm environment well. However prediction of core temperature in cold environment is inaccurate and very affected by ambient temperature. Evaluation of thermal comfort in warm environment is supplemented by skin wettedness prediction. The Coupled model is designed for non-uniform and transient environmental conditions; it is also suitable simulation of thermal comfort in vehicles cabins. The usage of the model is limited for very light physical activities up to 1.2 met only.

  2. Evaluation of Bus Vibration Comfort Based on Passenger Crowdsourcing Mode

    Directory of Open Access Journals (Sweden)

    Hong Zhao


    Full Text Available Vibration comfort is an important factor affecting the quality of service (QoS of bus. In order to make people involved in supervising bus’s vibration comfort and improve passengers’ riding experience, a novel mode of passenger crowdsourcing is introduced. In this paper, comfort degree of bus vibration is calculated from bus’s vibration signals collected by passengers’ smartphones and sent through WiFi to the Boa web server which shows the vibration comfort on the LCD deployed in bus and maybe trigger alarm lamp when the vibration is beyond the threshold. Three challenges here have been overcome: firstly, space coordinate transformation algorithm is used to solve the constant drift of signals collected; secondly, a low-pass filter is designed to isolate gravity from signals real-timely via limited computing resources; thirdly, an embedded evaluation system is developed according to the calculation procedure specified by criterion ISO 2631-1997. Meanwhile, the model proposed is tested in a practical running environment, the vibration data in whole travel are recorded and analyzed offline. The results show that comfort degree of vibration obtained from the experimental system is identical with the truth, and this mode is proved to be effective.

  3. Thermal comfort findings: Scenario at Malaysian automotive industry

    Directory of Open Access Journals (Sweden)

    Ismail Ahmad Rasdan


    Full Text Available This paper discusses the findings of thermal comfort assessment at Malaysian automotive industry. Nine critical workstations were chosen as subjects for the study in order to determine the thermal comfort among workers at Malaysian automotive industry. The human subjects for the study comprises of the operators from tire receiving, dashboard assembly, drum tester, body assembly, seat assembly, door check assembly, stamping workstation, engine sub assembly and paint shop of the factory. The environmental factors such as Wet Bulb Globe Temperature (WBGT, relative humidity, air velocity, illuminance were measured using BABUC A apparatus and Thermal Comfort Measurement equipment. Through questionnaire survey, the demographic data of subjects and their perceptions on thermal comfort at each workstation were assessed based on ISO Standard 7730 and thermal sensation scale using Predicted Mean Vote (PMV. Then, Predicted Percentage of Dissatisfied (PPD is used to estimate the thermal satisfaction of occupants. The results indicated that most of the workstations of the automotive industry are considered as uncomfortable. Tire receiving station is considered having better working environment compared to other stations with lowest PMV index of 1.09 to 1.41 and PPD of 46%. Meanwhile, the engine sub assembly station and paint shop of assembly are considered the worst thermal environment with the PMV index values ranging between 2.1 to 2.9 and PPD values of 81% to 99%. Therefore, these two workstations are considered not comfortable because the thermal sensation scale is warm and almost hot.

  4. COMFORT: evaluating a new communication curriculum with nurse leaders. (United States)

    Goldsmith, Joy; Wittenberg-Lyles, Elaine


    Nursing faculty face increasing instructional demands to keep pace with mounting knowledge and competency requirements for student nurses. In the context of nursing practice, tasks and time pressures detract from the high skill and aptitude expectation of communication. The communication, orientation and opportunity, mindful presence, family, openings, relating, and team (COMFORT) curriculum, an acronym that represents 7 basic nursing communication principles, has been introduced into the communication module of the End-of-Life Nursing Education Consortium, which currently provides the only standardized undergraduate and graduate nurse training in hospice and palliative care. This study examines the potential efficacy of the COMFORT curriculum for everyday communication challenges experienced by members of the Georgia Organization of Nurse Leaders. Participants were prompted to describe communication barriers and then apply an aspect of the COMFORT curriculum to this barrier. Responses revealed primary communication barriers with co-workers and patient/families. Nurses predominantly identified directly correlating components in the COMFORT framework (C-communication, F-family) as solutions to the topics described as barriers. Based on confirmation of extant literature addressing generalist nurse communication challenges, there is support for the inclusion of COMFORT across the nursing curriculum to efficiently and effectively teach communication strategies to nurses. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Urban Outdoor Thermal Comfort of The Hot-Humid Region

    Directory of Open Access Journals (Sweden)

    Abu Bakar A.


    Full Text Available The study on outdoor comfort is becoming popular due to the fact that the thermoregulatory model is seen as inadequate in explaining outdoor thermal comfort conditions. Hot-humid region can be said as experiencing a critical environmental condition because of its constantly high temperature and humidity throughout the year. Thus, this study focus on the assessment of thermal comfort of outdoor urban spaces in Kuala Lumpur, Malaysia (3° 9’N and 101° 44’E. Survey on human response towards outdoor thermal comfort in hot-humid climate of Kuala Lumpur, Malaysia was carried out during day time between 0900h to 1800h along with measurement of environmental parameters such as air temperature (°C, wind velocity (m/s, radiant temperature (°C, relative humidity (% and solar radiation (lux. A total of 123 samples were involved in this study which took place within four sites around Kuala Lumpur. Survey results were then correlated with the environmental parameters to further develop the comfort zone for hot-humid outdoor environment specifically for Kuala Lumpur and, generally, for hot-humid regions.

  6. Evolution of perceived footwear comfort over a prolonged running session. (United States)

    Hintzy, F; Cavagna, J; Horvais, N


    The purpose of this study was to investigate the subjective perception of overall footwear comfort over a prolonged running session. Ten runners performed two similar sessions consisting of a 13-km trail run (5 laps of 2.6 km) as fast as possible. The overall footwear comfort was evaluated before running and at the end of each lap with a 150-mm visual analogic scale, as well as speed, heart rate and rate of perceived exertion. The results showed that both overall footwear comfort and speed decreased consistently during the run session, and significantly after 44 min of running (i.e. the 3rd lap). It could be hypothesized that the deterioration of overall footwear comfort was explained by mechanical and energetical parameter changes with time and/or fatigue occurring at the whole body, foot and footwear levels. These results justify the use of a prolonged running test for running footwear comfort evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Atypical Neurological Manifestations Of Hypokalemia

    Directory of Open Access Journals (Sweden)

    pal P K


    Full Text Available A part from the well-established syndrome of motor paralysis, hypokalemia may present with atypical neurological manifestations, which are not well documented in literature. Methods: We treated 30 patients of hypokalemia whose neurological manifestations improved after corrections of hypokalemia. A retrospective chart review of the clinical profile was done with emphasis on the evolution of symptoms and occurrence of unusual manifestations. Results: Twenty-eight patients had subacute quadriparesis with duration of symptoms varying from 10hrs to 7 days and two had slowly progressive quadriparesis. Fifty percent of patients had more than one attack of paralysis. Early asymmetric weakness (11, stiffness and abnormal posture of hands (7, predominant bibrachial weakness (4, distal paresthesias (4, hemiparesthesia (1, hyperreflexia(4, early severe weakness of neck muscles (3, chorea (1, trismus (1,and, retention of urine (1 were the unusual features observed. The means level of serum potassium on admission was 2.1+0.6mEq/L.and the serum creatine kinase was elevated in 14 out of 17 patients. All patients except two had complete recovery.

  8. Neurological complications in hyperemesis gravidarum. (United States)

    Zara, Gabriella; Codemo, Valentina; Palmieri, Arianna; Schiff, Sami; Cagnin, Annachiara; Citton, Valentina; Manara, Renzo


    Hyperemesis gravidarum can impair correct absorption of an adequate amount of thiamine and can cause electrolyte imbalance. This study investigated the neurological complications in a pregnant woman with hyperemesis gravidarum. A 29-year-old pregnant woman was admitted for hyperemesis gravidarum. Besides undernutrition, a neurological examination disclosed weakness with hyporeflexia, ophthalmoparesis, multidirectional nystagmus and optic disks swelling; the patient became rapidly comatose. Brain MRI showed symmetric signal hyperintensity and swelling of periaqueductal area, hypothalamus and mammillary bodies, medial and posterior portions of the thalamus and columns of fornix, consistent with Wernicke encephalopathy (WE). Neurophysiological studies revealed an axonal sensory-motor polyneuropathy, likely due to thiamine deficiency or critical illness polyneuropathy. Sodium and potassium supplementation and parenteral thiamine were administered with improvement of consciousness state in a few days. WE evolved in Korsakoff syndrome. A repeat MRI showed a marked improvement of WE-related alterations and a new hyperintense lesion in the pons, suggestive of central pontine myelinolysis. No sign or symptom due to involvement of the pons was present.

  9. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina


    Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.

  10. [Oliver Sacks and literary neurology]. (United States)

    Guardiola, Elena; Banos, Josep E


    Popular medical literature attempts to discuss medical topics using a language that is, as far as possible, free of all medical jargon so as to make it more easily understandable by the general public. The very complexity of neurology makes it more difficult for the stories dealing with this specialty to be understood easily by an audience without any kind of medical training. This paper reviews the works written by Oliver Sacks involving the field of neurology aimed at the general public, and the main characteristics and the clinical situation discussed by the author are presented. Some biographical notes about Oliver Sacks are also included and the 11 books published by this author over the last 40 years are also analysed. In each case they are put into a historical context and the most outstanding aspects justifying what makes them an interesting read are commented on. In most cases, the genesis of the work is explained together with its most significant features. The works of Sacks contain a wide range of very interesting clinical situations that are usually explained by means of a language that is readily comprehensible to the general public. It also provides neurologists with a holistic view of different clinical situations, together with a discussion of their biographical, historical and developmental components.

  11. A wrist-worn biosensor system for assessment of neurological status. (United States)

    Cogan, D; Pouyan, M Baran; Nourani, M; Harvey, J


    EEG based monitoring for the purpose of assessing a patient's neurological status is conspicuous and uncomfortable at best. We are analyzing a set of physiological signals that may be monitored comfortably by a wrist worn device. We have found that these signals and machine based classification allows us to accurately discriminate among four stress states of individuals. Further, we have found a clear change in these signals during the 70 minutes preceding a single convulsive epileptic seizure. Our classification accuracy on all data has been greater than 90% to date.

  12. Genetic mechanism for building evolution reflecting stress histories of residents and environmental factors (United States)

    Nishikawa, Saya; Mita, Akira


    Conventional architectural design has a lot to do with the intuition and experience of designers. And residences are not always suit to its residents and surrounding environment. If we can extract residents' preferences and demands about comfort of each resident from histories of past life and reflect these information in next design, it's possible to make living space more comfortable. This thesis proposes genetic and evolutional system for architectural design information, which is applied evolutionary adaption. Specifically, I applied genetic mechanism which base sequence of DNA plays a role, epigenetic mechanism which chemical modification plays a role and evolutionary mechanism with natural selection. Proposed system firstly accumulates discomfort of residents, shortcoming of living space and usage of equipment as "comfort stress", "safety stress" and "energy saving stress", and modifies performance value of related performance items of building depending on the stress accumulation. Then this system processes selection according to the characteristics of the site for candidates of next generation of architectural design information which are generated via crossing and mutation. The data-set selected in this way is regarded as the performance value of next architectural design, and system suggests architectural specification to the residents.

  13. Experiences of Resident Assistants with Potentially Suicidal Students: Identification, Referral, and Expectations (United States)

    Bender, Katherine M.


    Resident Assistants (RAs), living on campus and tasked with advising students while keeping them safe, are in a position to identify and refer students who may be at risk for suicide or other mental health issues. This study examined RA ability to identify students at risk for suicide, RA comfort in working with students at risk for suicide, RA…

  14. Training in a Clozapine Clinic for Psychiatry Residents: A Plea and Suggestions for Implementation (United States)

    Freudenreich, Oliver; Henderson, David C.; Sanders, Kathy M.; Goff, Donald C.


    Objective: The authors sought to develop a model educational clinic and curriculum for psychiatric residents, to increase knowledge and comfort about clozapine prescribing. This matters because clozapine is an important evidence-based treatment for refractory schizophrenia that remains underutilized in clinical practice. Method: This is a…

  15. Improved competence after a palliative care course for internal medicine residents

    NARCIS (Netherlands)

    Mulder, S. F.; Bleijenberg, G.; Verhagen, S. C.; Stuyt, P. M. J.; Schijven, M. P.; Tack, C. J.


    Residents report that they received inadequate teaching in palliative care and low levels of comfort and skills when taking care of dying patients. This study describes the effects of a problem-based palliative care course on perceived competence and knowledge in a representative Dutch cohort of

  16. Improved competence after a palliative care course for internal medicine residents.

    NARCIS (Netherlands)

    Mulder, S.F.; Bleijenberg, G.; Verhagen, C.A.H.H.V.M.; Stuyt, P.M.J.; Schijven, M.P.; Tack, C.J.J.


    Residents report that they received inadequate teaching in palliative care and low levels of comfort and skills when taking care of dying patients. This study describes the effects of a problem-based palliative care course on perceived competence and knowledge in a representative Dutch cohort of

  17. Nurses' comfort with touch and workplace well-being. (United States)

    Pedrazza, Monica; Minuzzo, Stefania; Berlanda, Sabrina; Trifiletti, Elena


    Touch is an essential part of caregiving and has been proved to be useful to reduce pain. Nevertheless, little attention has been paid to nurses' perceptions of touch. The aim of this article was to examine the relationship between nurses' feelings of comfort with touch and their well-being at work. A sample of 241 nurses attending a pain management training course completed a questionnaire, including the following measures: Comfort with Touch (CT) scale (task-oriented contact, touch promoting physical comfort, touch providing emotional containment), Maslach Burnout Inventory (MBI; emotional exhaustion, cynicism), and Job Satisfaction. Results of structural equation models showed that touch providing emotional containment was the main predictor of emotional exhaustion. Emotional exhaustion, in turn, was positively related to cynicism and negatively related to job satisfaction. In addition, the direct path from touch providing emotional containment to cynicism was significant. Practical implications of the findings are discussed. © The Author(s) 2014.

  18. Female high heel shoes: a study of comfort (United States)

    Broega, A. C.; Righetto, M.; Ribeiro, R.


    Protection was the basic principle underlying the creation of footwear, once humankind felt the need to protect feet from direct contact with soil, heat, cold and sharp objects. However, this accessory soon acquired cultural, aesthetic, symbolic significance, and apparently it was not related to comfort. This work aims to analyze comfort in women footwear, especially high heels shoe. We intended to understand the emotional relationship of consumers with this type of accessory, as well as to understand to what extent women are willing to give up comfort in favor of aesthetics. For this purpose, a questionnaire was designed, aimed at the female audience in order to understand the relevance of women’s footwear, their daily relationship with shoes, the specificity of heels and the problems caused by it.

  19. Evaluating comfort with varying temperatures: a graphic design tool

    Energy Technology Data Exchange (ETDEWEB)

    Evans, J.M. [Research Centre Habitat and Energy, Faculty of Architecture, Design and Urbanism, University of Buenos Aires, Ciudad Universitaria (Argentina)


    This paper considers the need to define comfort of indoor and outdoor spaces in relation to the daily variations of temperature. A graphical tool is presented, which indicates the daily swings of temperature, shown as a single point on a graph representing the average temperature and the maximum temperature swing. This point can be compared with the comfort zones for different activity levels, such as sedentary activity, sleeping, indoor and outdoor circulation according to the design proposals for different spaces. The graph allows the representation of climatic variables, the definition of comfort zones, the selection of bio climatic design resources and the evaluation of indoor temperatures, measured in actual buildings or obtained from computer simulations. The development of the graph is explained and examples given with special emphasis on the use of thermal mass. (author)

  20. Effectiveness of an Ultrasound Training Module for Internal Medicine Residents

    Directory of Open Access Journals (Sweden)

    McDonald Furman S


    Full Text Available Abstract Background Few internal medicine residency programs provide formal ultrasound training. This study sought to assess the feasibility of simulation based ultrasound training among first year internal medicine residents and measure their comfort at effectively using ultrasound to perform invasive procedures before and after this innovative model of ultrasound training. Methods A simulation based ultrasound training module was implemented during intern orientation that incorporated didactic and practical experiences in a simulation and cadaver laboratory. Participants completed anonymous pre and post surveys in which they reported their level of confidence in the use of ultrasound technology and their comfort in identifying anatomic structures including: lung, pleural effusion, bowel, peritoneal cavity, ascites, thyroid, and internal jugular vein. Survey items were structured on a 5-point Likert scales (1 = extremely unconfident, 5 = extremely confident. Results Seventy-five out of seventy-six interns completed the pre-intervention survey and 55 completed the post-survey. The mean confidence score (SD increased to 4.00 (0.47 (p Conclusion A simulation based ultrasound learning module can improve the self-reported confidence with which residents identify structures important in performing invasive ultrasound guided procedures. Incorporating an ultrasound module into residents' education may address perceived need for ultrasound training, improve procedural skills, and enhance patient safety.

  1. Adolescents’ comfort answering questions about sexuality asked by their physicians (United States)

    Hébert, Natacha; Beaulieu, Émilie; Tremblay, Marie-Michelle; Laflamme, Sophie


    OBJECTIVE: To evaluate the attitudes of adolescents toward communicating with their doctor about different aspects of their sexuality. METHODS: The present descriptive survey was conducted with the participation of teenagers from four high schools in Sherbrooke, Quebec. In each school, the students of two grade 8 classes (≤14 years of age) and two grade 10 classes (≥15 years of age) anonymously completed a self-administered questionnaire. Permission from the school board and parental consent for every participant was obtained. RESULTS: A total of 387 adolescents completed the self-administered questionnaire. The response rate for the study was 98%. Only 27% of the respondents remembered being questioned by their doctor about sexuality, and 17% of the respondents had already brought up the topic of sexuality themselves with their doctor. More than one-half (57%) of the adolescents reported they would be moderately comfortable to totally comfortable discussing sexuality with their doctor if they felt the need to. Overall, when asked to evaluate their degree of comfort if questioned on specific questions about their sexuality, 73.8% to 99.5% believed they would be moderately to totally comfortable responding. Nevertheless, there was a statistically significant difference between age groups, with the older age group being more comfortable than the younger age group (P<0.001). There was no difference between the level of comfort among boys and girls answering the same questions. Respondents believed that their treating physician should discuss sexuality with them (73.8%) and, in the majority of cases (78%), that he/she should initiate the conversation. CONCLUSION: Regardless of age or sex, teenagers considered themselves to be at ease discussing sexuality with their doctor and found it an important topic best brought up by their practitioner. PMID:24421673

  2. Assessing Thermal Comfort Due to a Ventilated Double Window (United States)

    Carlos, Jorge S.; Corvacho, Helena


    Building design and its components are the result of a complex process, which should provide pleasant conditions to its inhabitants. Therefore, indoor acceptable comfort is influenced by the architectural design. ISO and ASHRAE standards define thermal comfort as the condition of mind that expresses satisfaction with the thermal environment. The energy demand for heating, beside the building’s physical properties, also depend on human behaviour, like opening or closing windows. Generally, windows are the weakest façade element concerning to thermal performance. A lower thermal resistance allows higher thermal conduction through it. When a window is very hot or cold, and the occupant is very close to it, it may result in thermal discomfort. The functionality of a ventilated double window introduces new physical considerations to a traditional window. In consequence, it is necessary to study the local effect on human comfort in function of the boundary conditions. Wind, solar availability, air temperature and therefore heating and indoor air quality conditions will affect the relationship between this passive system and the indoor environment. In the present paper, the influence of thermal performance and ventilation on human comfort resulting from the construction and geometry solutions is shown, helping to choose the best solution. The presented approach shows that in order to save energy it is possible to reduce the air changes of a room to the minimum, without compromising air quality, enhancing simultaneously local thermal performance and comfort. The results of the study on the effect of two parallel windows with a ventilated channel in the same fenestration on comfort conditions for several different room dimensions, are also presented. As the room dimensions’ rate changes so does the window to floor rate; therefore, under the same climatic conditions and same construction solution, different results are obtained.

  3. Where is the comfort in comfort foods? Mechanisms linking fat signaling, reward, and emotion. (United States)

    Weltens, N; Zhao, D; Van Oudenhove, L


    Food in general, and fatty foods in particular, have obtained intrinsic reward value throughout evolution. This reward value results from an interaction between exteroceptive signals from different sensory modalities, interoceptive hunger/satiety signals from the gastrointestinal tract to the brain, as well as ongoing affective and cognitive processes. Further evidence linking food to emotions stems from folk psychology ('comfort foods') and epidemiological studies demonstrating high comorbidity rates between disorders of food intake, including obesity, and mood disorders such as depression. This review paper aims to give an overview of current knowledge on the neurophysiological mechanisms underlying the link between (fatty) foods, their reward value, and emotional responses to (anticipation of) their intake in humans. Firstly, the influence of exteroceptive sensory signals, including visual, olfactory ('anticipatory food reward'), and gustatory ('consummatory food reward'), on the encoding of reward value in the (ventral) striatum and of subjective pleasantness in the cingulate and orbitofrontal cortex will be discussed. Differences in these pathways and mechanisms between lean and obese subjects will be highlighted. Secondly, recent studies elucidating the mechanisms of purely interoceptive fatty acid-induced signaling from the gastrointestinal tract to the brain, including the role of gut peptides, will be presented. These studies have demonstrated that such subliminal interoceptive stimuli may impact on hedonic circuits in the brain, and thereby influence the subjective and neural responses to negative emotion induction. This suggests that the effect of foods on mood may even occur independently from their exteroceptive sensory properties. © 2014 John Wiley & Sons Ltd.

  4. Objective and subjective evaluation of the acoustic comfort in classrooms. (United States)

    Zannin, Paulo Henrique Trombetta; Marcon, Carolina Reich


    The acoustic comfort of classrooms in a Brazilian public school has been evaluated through interviews with 62 teachers and 464 pupils, measurements of background noise, reverberation time, and sound insulation. Acoustic measurements have revealed the poor acoustic quality of the classrooms. Results have shown that teachers and pupils consider the noise generated and the voice of the teacher in neighboring classrooms as the main sources of annoyance inside the classroom. Acoustic simulations resulted in the suggestion of placement of perforated plywood on the ceiling, for reduction in reverberation time and increase in the acoustic comfort of the classrooms.

  5. Assessing swine thermal comfort by image analysis of postural behaviors. (United States)

    Xin, H


    Postural behavior is an integral response of animals to complex environmental factors. Huddling, nearly contacting one another on the side, and spreading are common postural behaviors of group-housed animals undergoing cold, comfortable, and warm/hot sensations, respectively. These postural patterns have been routinely used by animal caretakers to assess thermal comfort of the animals and to make according adjustment on the environmental settings or management schemes. This manual adjustment approach, however, has the inherent limitations of daily discontinuity and inconsistency between caretakers in interpretation of the animal comfort behavior. The goal of this project was to explore a novel, automated image analysis system that would assess the thermal comfort of swine and make proper environmental adjustments to enhance animal wellbeing and production efficiency. This paper describes the progress and on-going work toward the achievement of our proposed goal. The feasibility of classifying the thermal comfort state of young pigs by neural network (NN) analysis of their postural images was first examined. It included exploration of using certain feature selections of the postural behavioral images as the input to a three-layer NN that was trained to classify the corresponding thermal comfort state as being cold, comfortable, or warm. The image feature selections, a critical step for the classification, examined in this study included Fourier coefficient (FC), moment (M), perimeter and area (P&A), and combination of M and P&A of the processed binary postural images. The result was positive, with the combination of M and P&A as the input feature to the NN yielding the highest correct classification rate. Subsequent work included the development of hardware and computational algorithms that enable automatic image segmentation, motion detection, and the selection of the behavioral images suitable for use in the classification. Work is in progress to quantify the

  6. Analysis of Thermal Comfort in an Intelligent Building (United States)

    Majewski, Grzegorz; Telejko, Marek; Orman, Łukasz J.


    Analysis of thermal comfort in the ENERGIS Building, an intelligent building in the campus of the Kielce University of Technology, Poland is the focus of this paper. For this purpose, air temperature, air relative humidity, air flow rate and carbon dioxide concentration were measured and the mean radiant temperature was determined. Thermal sensations of the students occupying the rooms of the building were evaluated with the use of a questionnaire. The students used a seven-point scale of thermal comfort. The microclimate measurement results were used to determine the Predicted Mean Vote and the Predicted Percentage Dissatisfied indices.

  7. Proceedings of 9th Windsor Conference Making Comfort Relevant



    Preface to the Proceedings of the 9th Windsor 2016 at Cumberland Lodge, Windsor\\ud \\ud For many the costs of providing acceptable indoor temperatures have become prohibitive. Around the world people already have to make stark choices on whether to spend money on heating and cooling or on eating. The science of comfort developed in the 20th century around the needs of the HVAC industry for whom comfort was a product, produced by machines to be sold to customers. Engineers and other building pr...

  8. Investigation and analysis of human body thermal comfort in classroom (United States)

    Zhai, Xue


    In this survey, we selected the 11th building of North China Electric Power University as the research object. Data were measured and distributed on each floor. We record the temperature of the classroom, humidity, wind speed, average radiation temperature and other environmental parameters. And we used spare time to create a questionnaire survey of the subjective feeling of the survey, to get everyone in the classroom TSV (hot feeling vote value) and TCV (thermal comfort vote). We analyzed the test data and survey data. What's more we discuss and reflect on the thermal comfort of the human body in different indoor temperature atmospheres.

  9. [Post-ischemia neurologic recovery]. (United States)

    Guiraud-Chaumeil, Bernard; Pariente, Jérémie; Albucher, Jean-François; Loubinoux, Isabelle; Chollet, François


    Stroke is one of the most common affliction of patients with neurological symptoms. Rehabilitation of stroke patients is a difficult task. Our knowledge on rehabilitation has recently improved with the emergence of data from new neuroimaging techniques. A prospective, double blind, cross over, placebo, controlled study on 8 patients with pure motor hemiparesia, is conducted to determine the influence of a single dose of fluoxetine on motor performance and cerebral activation of patients recovering from stroke. Each patient undergoes two functional magnetic resonance imaging (fMRI) examinations, one under fluoxetine and one under placebo. A single dose of fluoxetine is enough to modulate cerebral sensori-motor activation and significantly improves motor skills of the affected side. Further studies are required to investigate the effect of chronic administration of fluoxetine on motor function.

  10. Neurology of foreign language aptitude

    Directory of Open Access Journals (Sweden)

    Adriana Biedroń


    Full Text Available This state-of-the art paper focuses on the poorly explored issue of foreign language aptitude, attempting to present the latest developments in this field and reconceptualizations of the construct from the perspective of neuroscience. In accordance with this goal, it first discusses general directions in neurolinguistic research on foreign language aptitude, starting with the earliest attempts to define the neurological substrate for talent, sources of difficulties in the neurolinguistic research on foreign language aptitude and modern research methods. This is followed by the discussion of the research on the phonology of foreign language aptitude with emphasis on functional and structural studies as well as their consequences for the knowledge of the concept. The subsequent section presents the studies which focus on lexical and morphosyntactic aspects of foreign language aptitude. The paper ends with a discussion of the limitations of contemporary research, the future directions of such research and selec ed methodological issues.

  11. Aphasia, Just a Neurological Disorder?

    Directory of Open Access Journals (Sweden)

    Mehmet Ozdemir


    Full Text Available Hashimoto%u2019s encephalopathy (HE is a rare disorder associated with autoimmune thyroiditis. Etiology of HE is not completely understood. High levels of serum antithyroid antibodies are seen in HE. Presentation with otoimmune thyroiditis, cognitive impairment, psychiatric and neurologic symptoms and absence of bacterial or viral enfections are characteristics of HE. HE is a steroid responsive encephalopathy. 60 years old male patient admitted to hospital with forget fulness continuing for 9 months and speech loss starting 2 days ago. Strong positivity of antithyroid antibodies increases the odds for HE. Thyroid function tests showed severe hypothyroidism. Electroencephalography and magnetic resonance imaging results were compatible with HE. HE is diagnosed with differantial diagnosis and exclusion of other reasons. This uncommon disorder is not recognised enough. High titres of serum antithyroid antiboides are always needed for diagnosis. Correct diagnosis requires awareness of wide range of cognitive and clinical presentations of HE.

  12. Porphyria and its neurologic manifestations. (United States)

    Tracy, Jennifer A; Dyck, P James B


    Porphyrias are rare disorders resulting from a defect in the heme biosynthetic pathway. They can produce significant disease of both the peripheral and central nervous systems, in addition to other organ systems, with acute intermittent porphyria, hereditary coproporphyria, and variegate porphyria as the subtypes associated with neurologic manifestations. The presence of a motor-predominant peripheral neuropathy (axonal predominant), accompanied by gastrointestinal distress and neuropsychiatric manifestations, should be a strong clue to the diagnosis of porphyria. Clinical confirmation can be made through evaluation of urine porphyrins during an exacerbation of disease. While hematin is helpful for acute treatment, long-term effective management requires avoidance of overstimulation of the cytochrome P450 pathway, as well as other risk factor control. © 2014 Elsevier B.V. All rights reserved.

  13. Severe influenza among children and young adults with neurologic and neurodevelopmental conditions - Ohio, 2011. (United States)


    Children with neurologic and neurodevelopmental conditions are at increased risk for severe outcomes from influenza, including death. In April 2011, the Ohio Department of Health and CDC investigated an influenza outbreak that began in February 2011 in a residential facility for 130 children and young adults with neurologic and neurodevelopmental conditions. This report summarizes the characteristics and clinical courses of 13 severely ill residents with suspected or confirmed influenza; 10 were hospitalized, and seven died. Diagnosis is challenging in this population, and clinicians should consider influenza in patients with neurologic and neurodevelopmental conditions who have respiratory illness or a decline in baseline medical status when influenza is circulating in the community. Prompt testing, early and aggressive antiviral treatment, and antiviral chemoprophylaxis are important for these patients. When influenza is suspected, antiviral treatment should be given as soon as possible after symptom onset, ideally within 48 hours. Treatment should not wait for laboratory confirmation of influenza. During outbreaks, antiviral chemoprophylaxis should be provided to all residents of institutional facilities (e.g., nursing homes and long-term- care facilities), regardless of vaccination status. Residential facilities for patients with neurologic and neurodevelopmental conditions are encouraged to vaccinate all eligible residents and staff members against influenza.

  14. Improving the Teaching Skills of Residents in a Surgical Training Program: Results of the Pilot Year of a Curricular Initiative in an Ophthalmology Residency Program. (United States)

    Chee, Yewlin E; Newman, Lori R; Loewenstein, John I; Kloek, Carolyn E


    To design and implement a teaching skills curriculum that addressed the needs of an ophthalmology residency training program, to assess the effect of the curriculum, and to present important lessons learned. A teaching skills curriculum was designed for the Harvard Medical School (HMS) Residency Training Program in Ophthalmology. Results of a needs assessment survey were used to guide curriculum objectives. Overall, 3 teaching workshops were conducted between October 2012 and March 2013 that addressed areas of need, including procedural teaching. A postcurriculum survey was used to assess the effect of the curriculum. Massachusetts Eye and Ear Infirmary, a tertiary care institution in Boston, MA. Overall, 24 residents in the HMS Residency Training Program in Ophthalmology were included. The needs assessment survey demonstrated that although most residents anticipated that teaching would be important in their future career, only one-third had prior formal training in teaching. All residents reported they found the teaching workshops to be either very or extremely useful. All residents reported they would like further training in teaching, with most residents requesting additional training in best procedural teaching practices for future sessions. The pilot year of the resident-as-teacher curriculum for the HMS Residency Training Program in Ophthalmology demonstrated a need for this curriculum and was perceived as beneficial by the residents, who reported increased comfort in their teaching skills after attending the workshops. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Pediatric neurology of the dog and cat. (United States)

    Lavely, James A


    The neurologic examination in the puppy or kitten can be a challenging experience. Understanding the development of behavior reflexes and movement in puppies and kittens enables us to overcome some of these challenges and to recognize the neurologically abnormal patient. Subsequently,we can identify the neuroanatomic localization and generate a differential diagnosis list. This article first reviews the pediatric neurologic examination and then discusses diseases unique to these individuals.

  16. Questionnaire survey on the process of specialty training in neurology in Japan. (United States)

    Sonoo, Masahiro; Nishiyama, Kazutoshi; Ando, Tetsuo; Shindo, Katsuro; Kanda, Takashi; Aoki, Masashi; Kamei, Satoshi; Kikuchi, Seiji; Kusunoki, Susumu; Suzuki, Norihiro; Sobue, Gen; Nakashima, Kenji; Hara, Hideo; Hirata, Koichi; Mizusawa, Hidehiro; Murai, Hiroyuki; Murata, Miho; Mochizuki, Hideki; Takahashi, Ryosuke; Kira, Jun-Ichi


    Documentation of the current status of specialty training to become a neurologist in Japan would represent an important basis for constructing better neurology training program in the planned reform of the specialty training system in Japan. The committee for future neurology specialty system of Japanese Society of Neurology (JSN) conducted a questionnaire survey on the process of specialty training of each trainee for neurology in board-certified educational facilities and semi-educational facilities throughout Japan. The response rate was 46.2% in all facilities and 87.5% in medical universities. The training process of 905 trainees over 5 grades was clarified, which was estimated to be about 80% of all the relevant subjects. Specialty training dedicated to neurology was started at the 3rd year of residency in 87.8% of subjects. During the 3 years following junior residency, 51.3% of subjects ran the rotation training between university and city hospital, whereas 36.5% was trained within the same institution throughout the 3 years of training period.

  17. Sleep Disorders in Childhood Neurological Diseases

    Directory of Open Access Journals (Sweden)

    Abdullah Tolaymat


    Full Text Available Sleep problems are frequently addressed as a primary or secondary concern during the visit to the pediatric neurology clinic. Sleep disorders can mimic other neurologic diseases (e.g., epilepsy and movement disorders, and this adds challenges to the diagnostic process. Sleep disorders can significantly affect the quality of life and functionality of children in general and those with comorbid neurological diseases in particular. Understanding the pathophysiology of sleep disorders, recognizing the implications of sleep disorder in children with neurologic diseases and behavioral difficulties, and early intervention continue to evolve resulting in better neurocognitive outcomes.

  18. Challenges in neurological practice in developing countries. (United States)

    Pandey, Sanjay


    The burden of neurological illness is much higher in developing countries. Neurological disorders in these countries are mainly due to poverty and malnutrition. Spectrums of diseases are also different in comparison with developed countries. Lack of resources, ignorance, and overpopulation make it very difficult and challenging to tackle this problem. Majority of the patients are seen by general practitioners who have little knowledge about neurological illnesses. Most of the countries have very few or no neurologist. There is a greater need of taking neurological care at primary care level where majority of the patients struggle with epilepsy, stroke and neuroinfections.

  19. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    Residents work for between 80 and 168 hours per week (median, 92 hours), excluding call duty. Sixty-two ... of the current training program and the working conditions in the country, consultants should make .... introduction of the 1-year elective posting abroad. This elective posting had helped bridge the gap between our ...

  20. Education on, Exposure to, and Management of Vascular Anomalies During Otolaryngology Residency and Pediatric Otolaryngology Fellowship. (United States)

    Chun, Robert; Jabbour, Noel; Balakrishnan, Karthik; Bauman, Nancy; Darrow, David H; Elluru, Ravindhra; Grimmer, J Fredrik; Perkins, Jonathan; Richter, Gresham; Shin, Jennifer


    The field of vascular anomalies presents diverse challenges in diagnosis and management. Although many lesions involve the head and neck, training in vascular anomalies is not universally included in otolaryngology residencies and pediatric otolaryngology (POTO) fellowships. To explore the education in, exposure to, and comfort level of otolaryngology trainees with vascular anomalies. A survey was distributed to 39 POTO fellows and 44 residents in postgraduate year 5 who matched into POTO fellowships from April 22 through June 16, 2014. Survey responses from trainees on exposure to, education on, and comfort with vascular anomalies. Forty-four residents in postgraduate year 5 who applied to POTO fellowships and 39 POTO fellows were emailed the survey. Fourteen respondents were unable to be contacted owing to lack of a current email address. Thirty-six of 69 residents and fellows (18 fellows and 18 residents [52%]) responded to the survey. Twenty-seven trainees (75%) reported no participation in a vascular anomalies clinic during residency; 6 of these 27 individuals (22%) trained at institutions with a vascular anomalies clinic but did not participate in the clinic, and 28 of the 36 respondents (78%) reported that they had less than adequate or no exposure to vascular anomalies in residency. Among POTO fellows, 11 of 17 (65%) did not participate in a vascular anomalies clinic during fellowship, even though 8 of the 11 had a vascular anomalies clinic at their fellowship program. During fellowship training, 12 of 18 fellows (67%) reported that they had adequate exposure to vascular anomalies. Only 20 respondents (56%) felt comfortable distinguishing among diagnoses of vascular anomalies, and only 4 residents (22%) and 9 fellows (50%) felt comfortable treating patients with vascular anomalies. All fellows believed that training in vascular anomalies was important in fellowship, and 100% of respondents indicated that increased exposure to diagnosis and management of

  1. Dew Point Evaporative Comfort Cooling: Report and Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Dean, J.; Herrmann, L.; Kozubal, E.; Geiger, J.; Eastment, M.; Slayzak, S.


    The project objective was to demonstrate the capabilities of the high-performance multi-staged IEC technology and its ability to enhance energy efficiency and interior comfort in dry climates, while substantially reducing electric-peak demand. The project was designed to test 24 cooling units in five commercial building types at Fort Carson Army Base in Colorado Springs, Colorado.

  2. End-State Comfort in Bimanual Object Manipulation

    NARCIS (Netherlands)

    Weigelt, M.; Kunde, W.; Prinz, W.G.


    The present experiment investigated the sensitivity for end-state comfort in a bimanual object manipulation task. Participants were required to simultaneously reach for two bars and to place the objects' ends into two targets on the table. The design of the experiment allowed to dissociate the

  3. A Novel Exercise Thermophysiology Comfort Prediction Model with Fuzzy Logic

    Directory of Open Access Journals (Sweden)

    Nan Jia


    Full Text Available Participation in a regular exercise program can improve health status and contribute to an increase in life expectancy. However, exercise accidents like dehydration, exertional heatstroke, syncope, and even sudden death exist. If these accidents can be analyzed or predicted before they happen, it will be beneficial to alleviate or avoid uncomfortable or unacceptable human disease. Therefore, an exercise thermophysiology comfort prediction model is needed. In this paper, coupling the thermal interactions among human body, clothing, and environment (HCE as well as the human body physiological properties, a human thermophysiology regulatory model is designed to enhance the human thermophysiology simulation in the HCE system. Some important thermal and physiological performances can be simulated. According to the simulation results, a human exercise thermophysiology comfort prediction method based on fuzzy inference system is proposed. The experiment results show that there is the same prediction trend between the experiment result and simulation result about thermophysiology comfort. At last, a mobile application platform for human exercise comfort prediction is designed and implemented.

  4. Structural Properties of Dwelling and Thermal Comfort in Tropical ...

    African Journals Online (AJOL)

    The structural properties of dwelling units, in particular “window types” in 1, 250 apartments and their indoor temperature levels were collected. One hypothesis was formulated: (HO) There is no significant variation in effective temperature index and thus thermal comfort between dwellings built with wooden windows and ...

  5. Tecnology innovation related to comfort on commercial vehicles. (United States)

    Martini, M; Ferrero, D


    The scope of this article is to show the Iveco activity in terms of comfort improvement in all its product Portfolio, focusing on innovation research and realization of tools to get better the life of the driver on commercial vehicles. Comfort related to the ergonomics, thermal, vibrational comfort and after-treatment system in order to improve the life of driver and passengers. It is to remember that Commercial vehicles have different use from a car. For example an heavy truck cabin is not only a place where to drive 8 hours a day, but it is at the same time, an office, a place where to eat, where to sleep and to have a rest. The effort in the last 10 years of Iveco is to improve the comfort of the life of the drivers, utilizing continuous research in standards and innovative systems in order to increase the security and life improvement, focusing also on worldwide legislation as a partner in European committees for health and safety.

  6. Improvement of thermal comfort by cooling clothing in warm climate

    DEFF Research Database (Denmark)

    Sakoi, Tomonori; Melikov, Arsen Krikor; Kolencíková, Sona


    comfort compared to convective cooling alone. The supply of a small amount of water allowed the cooling clothing to provide a continuous cooling effect, whereas the effect of convective cooling alone decreased as sweat dried. However, the controllability of the cooling clothing needs to be improved....

  7. Analysis of thermal comfort in Lagos, Nigeria | Komolafe | Global ...

    African Journals Online (AJOL)

    A set of multiple linear regression equations relating comfort votes with the variations of air temperature and relative humidity has been developed. Other regression equations that describe how external climate is altered indoor by the building fabrics have also been derived. Maximum and minimum values of temperature ...

  8. Outdoor thermal comfort and behaviour in urban area (United States)

    Inavonna, I.; Hardiman, G.; Purnomo, A. B.


    Outdoor comfort is important due to the public spaces functions. Open spaces provide thermal comfort and a pleasant experience to improve the city life quality effectively. The influence of thermal comfort in outdoor activities is a complex problem. This paper presents a literature review and discussion of aspects of physical, psychology, and social behaviour toward outdoor thermal comfort. The valuation is determined not only by the “physical state” but also by the “state of mind”. The assessment is static and objective (i.e., physical and physiological characteristics) that it should be measured. Furthermore, an effective model to provide the knowledge of climatic conditions, as well as the dynamic and subjective aspects (i.e., psychological and social characteristics and behaviour), requires a comprehensive interview and observation. The model will be examined to describe the behaviour that is a reflection of perception and behaviour toward the environment. The adaptation process will constantly evolve so that it becomes a continuous cause between human behaviour and the spatial setting of the formation, which is eventually known as places and not just spaces. This evolutionary process is a civic art form.

  9. Affordable comfort 95 - investing in our energy future

    Energy Technology Data Exchange (ETDEWEB)



    This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.

  10. Thermal comfort analysis of hostels in National Institute of ...

    Indian Academy of Sciences (India)

    Thermal comfort study was carried out in the hostels of National Institute of Technology Calicut,Kerala, which is located in a warm humid climatic zone of India. Measurements of ambient temperature, globe temperature, relative humidity, air velocity and illuminance were carried out in eight hostels, and in parallel a ...

  11. Effect of urban albedo surfaces on thermal comfort | Mansouri ...

    African Journals Online (AJOL)

    They have addressed this issue in order to identify the main causes that generate the warming of urban areas and therefore contribute to the degradation of the exterior and interior thermal comfort of the inhabitants. It turns out that the reflectivity of materials known as the albedo, plays a leading role in this degradation.

  12. The correlation between thermal comfort in buildings and fashion products. (United States)

    Giesel, Aline; de Mello Souza, Patrícia


    This article is about thermal comfort in the wearable product. The research correlates fashion and architecture, in so far as it elects the brise soleil - an architectural element capable of regulating temperature and ventilation inside buildings - as a study referential, in trying to transpose and adapt its mechanisms to the wearable apparel.

  13. Analysis of thermal comfort in Lagos, Nigeria | Komolafe | Global ...

    African Journals Online (AJOL)

    This paper reports a thermal comfort survey conducted in three locations in Lagos between July 1996 and June 1997 in which 50 fully acclimatized subjects cast over 6,000 individual votes of their subjective assessments of the thermal environments. The survey covered only residential buildings constructed of sandcrete ...

  14. 24 CFR 3280.511 - Comfort cooling certificate and information. (United States)


    ... calculation of cooling loads at various locations, window exposures and shadings are provided in chapter 22 of... home necessary to complete the cooling load calculations. The comfort cooling information shall include... efficiently and economically, a cooling load (heat gain) calculation is required. The cooling load is...

  15. Three different anesthesia techniques for a comfortable prostate biopsy

    Directory of Open Access Journals (Sweden)

    Adnan Sahin


    Discussion: Enabling pain and discomfort control in patients is very important during TRUS-guided prostate biopsy. In our study, we observed that the periprostatic block enables more comfortable compared with patient groups with intrarectal lidocaine gel and pudendal block and better reduction in pain scores.

  16. Development of Light Powered Sensor Networks for Thermal Comfort Measurement. (United States)

    Lee, Dasheng


    Recent technological advances in wireless communications have enabled easy installation of sensor networks with air conditioning equipment control applications. However, the sensor node power supply, through either power lines or battery power, still presents obstacles to the distribution of the sensing systems. In this study, a novel sensor network, powered by the artificial light, was constructed to achieve wireless power transfer and wireless data communications for thermal comfort measurements. The sensing node integrates an IC-based temperature sensor, a radiation thermometer, a relative humidity sensor, a micro machined flow sensor and a microprocessor for predicting mean vote (PMV) calculation. The 935 MHz band RF module was employed for the wireless data communication with a specific protocol based on a special energy beacon enabled mode capable of achieving zero power consumption during the inactive periods of the nodes. A 5W spotlight, with a dual axis tilt platform, can power the distributed nodes over a distance of up to 5 meters. A special algorithm, the maximum entropy method, was developed to estimate the sensing quantity of climate parameters if the communication module did not receive any response from the distributed nodes within a certain time limit. The light-powered sensor networks were able to gather indoor comfort-sensing index levels in good agreement with the comfort-sensing vote (CSV) preferred by a human being and the experimental results within the environment suggested that the sensing system could be used in air conditioning systems to implement a comfort-optimal control strategy.

  17. A novel medical bandage with enhanced clothing comfort (United States)

    Oğlakcioğlu, N.; Sari, B.; Bedez Üte, T.; Marmarali, A.


    Compression garments are special textile products which apply a pressure on needed body zones for supporting medical, sport or casual activities. Medical bandages are a group of these garments and they have a very common usage for compression effect on legs or arms. These bandages are generally produced by using synthetic raw materials such as polyamide or polyester fibres. Medical bandages are in contact with skin. Even if the synthetic fibres are used, they may cause both comfort and health problems like allergies. Nowadays in textile sector, the expectations of clients include using of natural fibres as far as possible in all garments. Natural fibres have good advantages such as breathability, softness, moisture management ability, non-allergenic and ecologic structure and these characteristics present optimum utilization conditions. In this study, tubular medical bandages were manufactured by using core spun yarns (sheath fibres are selected as tencel, bamboo and cotton, core material is elastane) and their pressure and comfort (air and water vapour permeability) characteristics were investigated. The results indicated that the bandages have good comfort abilities beside adequate pressure values for compression effect. These garments can constitute a new production field for medical bandages with their comfort properties in addition to pressure characteristics.

  18. Towards green design guidelines for thermally comfortable streets

    NARCIS (Netherlands)

    Klemm, W.; Lenzholzer, S.; Heusinkveld, B.G.; Hove, van B.


    Creating thermally comfortable streetscapes is a rather new challenge for urban designers in The Netherlands and other countries with moderate climates. This is due to the lack of evidence based design guidelines. By combining research methods from micrometeorology and landscape architecture, we

  19. Possibilities to improve the aircraft interior comfort experience

    NARCIS (Netherlands)

    Vink, P.; Bazley, C.; Kamp, I.; Blok, M.


    Comfort plays an increasingly important role in the interior design of airplanes. Although ample research has been conducted on airplane design technology, only a small amount of public scientific information is available addressing the passenger's opinion. In this study, more than 10,000 internet

  20. A Series of Computational Neuroscience Labs Increases Comfort with MATLAB. (United States)

    Nichols, David F


    Computational simulations allow for a low-cost, reliable means to demonstrate complex and often times inaccessible concepts to undergraduates. However, students without prior computer programming training may find working with code-based simulations to be intimidating and distracting. A series of computational neuroscience labs involving the Hodgkin-Huxley equations, an Integrate-and-Fire model, and a Hopfield Memory network were used in an undergraduate neuroscience laboratory component of an introductory level course. Using short focused surveys before and after each lab, student comfort levels were shown to increase drastically from a majority of students being uncomfortable or with neutral feelings about working in the MATLAB environment to a vast majority of students being comfortable working in the environment. Though change was reported within each lab, a series of labs was necessary in order to establish a lasting high level of comfort. Comfort working with code is important as a first step in acquiring computational skills that are required to address many questions within neuroscience.

  1. Double face : Adjustable translucent system to improve thermal comfort

    NARCIS (Netherlands)

    Turrin, M.; Tenpierik, M.J.; De Ruiter, P.; Van der Spoel, W.H.; Chang Lara, C.; Heinzelmann, F.; Teuffel, P.; Van Bommel, W.


    The DoubleFace project aims at developing a new product that passively improves thermal comfort of indoor and semi-indoor spaces by means of lightweight materials for latent heat storage, while simultaneously allowing daylight to pass through as much as possible. Specifically, the project aims at

  2. Thermal comfort in naturally ventilated buildings in Maceio, Brazil (United States)

    Djamila, Harimi


    This article presents the results from thermal comfort survey carried out in classrooms over two different seasons in Maceio, Brazil. The secondary data were collected from thermal comfort field study conducted in naturally ventilated classrooms. Objective and subjective parameters were explored to evaluate thermal comfort conditions. The potential effect of air movement on subjects' vote under neutrality was evaluated. Overall, the indoor climate of the surveyed location was classified warm and humid. Conflicting results were depicted when analyzing the effect of air movements on subjects' vote. The mean air temperature for subjects feeling hot was found to be lower than those feeling warm. A reasonable approach to tackle these two unpredictable results was suggested. Correlation matrix between selected thermal comfort variables was developed. Globe temperature recorded the highest correlation with subjects' response on ASHRAE seven-point scale. The correlation was significant at the 0.01 level. On the other hand, the correlation between air movement and subjects' response on ASHRAE seven-point scale was weak but significant. Further field studies on the current topic were recommended.

  3. Progress in thermal comfort research over the last twenty years

    DEFF Research Database (Denmark)

    Dear, R. J. de; Akimoto, T.; Arens, E. A.


    developed, driven by the continuous challenge to model thermal comfort at the same anatomical resolution and to combine these localized signals into a coherent, global thermal perception. Finally, the demand for ever increasing building energy efficiency is pushing technological innovation in the way we...

  4. Thermal comfort in residential buildings by the millions

    DEFF Research Database (Denmark)

    Østergård, Torben; Jensen, Rasmus Lund; Maagaard, Steffen


    In Danish building code and many design briefings, criteria regarding thermal comfort are defined for “critical” rooms in residential buildings. Identifying the critical room is both difficult and time-consuming for large, multistory buildings. To reduce costs and time, such requirement often cau...

  5. Design of healthy, comfortable, and energy-efficient buildings

    NARCIS (Netherlands)

    Roulet, C.A.; Bluyssen, P.M.; Müller, B.; Oliveira Fernandes, E. de


    The HOPE European research project aimed to look at a possible relationship between the energy performance of a building and the well-being (health and comfort) of their occupants. An interdisciplinary survey resulted in guidelines to increase the number of energy-efficient buildings that are at the

  6. Evaluation of the Indoor Environment in the Comfort Houses

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Heiselberg, Per; Knudstrup, Mary-Ann


    and in a process of doing so, it is important to maintain a good and healthy indoor environment and not on the expense of it. One way of saving energy is to build passive houses. This paper presents the result of a case study of some of the first certified passive houses in Denmark, called the Comfort Houses...

  7. Elements of Comfort and Satisfaction in the Office Workspace ...

    African Journals Online (AJOL)

    A survey was conducted in offices in Accra and Kumasi to investigate comfort conditions in the workspace. Office staff indicated their satisfaction with conditions in the immediate work environment. Storage space generates the highest level of dissatisfaction in respondents. Privacy, image of the workplace, and overall ...

  8. Evaluation of human body comfortableness under vibrate condition ...

    African Journals Online (AJOL)

    To efficiently evaluate the influences on human body comfortableness under different vibrative condition, the paper comprehensively applied the surface electromyography (SEMG) and near infrared spectroscopy (NIRS) technology and obtained the relationship between mean power frequency (MPF) and regional tissue ...

  9. Numerical human model for impact and seating comfort

    NARCIS (Netherlands)

    Hoof, J.F.A.M. van; Lange, R. de; Verver, M.M.


    This paper presents a detailed numerical model of the human body that can be used to evaluate both safety and comfort aspects of vehicle interiors. The model is based on a combination of rigid body and finite element techniques to provide an optimal combination of computational efficiency and

  10. Evaluating thermophysiological comfort using the principles of sensory analysis. (United States)

    Cubrić, Ivana Salopek; Skenderi, Zenun


    Thermophysiological comfort applies to the way in which clothing lets through or retains heat and moisture and helps the body retain heat balance in rest position or at various levels of activities. In this paper, the principles of sensory analysis are used to define the protocol of new method for the evaluation of thermophysiological comfort wearing different garments. Sensory analysis was chosen because as a scientific discipline that applies experiment principles using human senses is used for the evaluation of consumer goods. Test protocol using assessors described in this paper consists of the following steps: defining the interview content, finding potential assessors and making an interview, creating a survey, conducting a survey, group discussion, test and group discussion scoring, selection of assessors, assessment preparation and subjective assessment. On average the most distinctive increase in the sensation of warmth was recorded for the polyester clothing ensemble, and the lowest one for the cotton clothing ensemble. Concerning the average grades of comfort given by assesors, the most comfortable clothing ensemble is the one made of viscose. It was also found out that the method is especially suitable if a representative group of assessors is formed.

  11. Multicriteria analysis of health, comfort and energy efficiency in buildings

    NARCIS (Netherlands)

    Roulet, C.A.; Flourentzou, F.; Foradini, F.; Bluyssen, P.; Cox, C.; Aizlewood, C.


    In order to comply with sustainable development policy, the minimum that buildings should achieve are a healthy, comfortable and energy-efficient environment. Criteria for individually assessing each of the many criteria are known: the occupant's perceived health; the provided thermal, visual and

  12. Aspects of seat modelling for seating comfort analysis

    NARCIS (Netherlands)

    Verver, M.M.; Lange, R. de; Hoof, J.F.A.M. van; Wismans, J.S.H.M.


    The development of more comfortable seats is an important issue in the automotive industry. However, the development of new car seats is very time consuming and costly since it is typically based on experimental evaluation using prototypes. Computer models of the human-seat interaction could

  13. Ductless Mini-Split Heat Pump Comfort Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Roth, K. [Fraunhofer Center for Sustainable Energy Systems, Cambridge, MA (United States); Sehgal, N. [Fraunhofer Center for Sustainable Energy Systems, Cambridge, MA (United States); Akers, C. [Fraunhofer Center for Sustainable Energy Systems, Cambridge, MA (United States)


    Field tests were conducted in two homes in Austin, TX, to evaluate the comfort performance of ductless minisplit heat pumps (DMSHPs), measuring temperature and relative humidity measurements in four rooms in each home before and after retrofitting a central HVAC system with DMSHPs.

  14. Ductless Mini-Split Heat Pump Comfort Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Roth, K.; Sehgal, N.; Akers, C.


    Field tests were conducted in two homes in Austin, TX to evaluate the comfort performance of ductless mini-split heat pumps (DMSHPs), measuring temperature and relative humidity measurements in four rooms in each home before and after retrofitting a central HVAC system with DMSHPs.

  15. Effects of Yaw Motion on Driving Behaviour, Comfort and Realism

    NARCIS (Netherlands)

    Hogema, J.H.; Wentink, M.; Bertollini, G.P.


    The use of large displacement yaw cueing is becoming more common as a part of the motion cueing in driving simulators. It is expected that driving behaviour, comfort and realism will be positively affected by adding a yaw table, especially during low-speed turning manoeuvres. We used TNO's advanced

  16. Thermal comfort study of plastics manufacturing industry in converting process

    Directory of Open Access Journals (Sweden)

    Sugiono Sugiono


    Full Text Available Thermal comfort is one of ergonomics factors that can create a significant impact to workers performance. For a better thermal comfort, several environment factors (air temperature, wind speed and relative humidity should be considered in this research. The object of the study is a building for converting process of plastics manufacturing industry located in Malang, Indonesia. The maximum air temperature inside the building can reach as high as 36°C. The result of this study shows that heat stress is dominantly caused by heat source from machine and wall building. The computational fluid dynamics (CFD simulation is used to show the air characteristic through inside the building. By using the CFD simulation, some scenarios of solution are successfully presented. Employees thermal comfort was investigated based on predicted mean vote model (PMV and predicted percentage of dissatisfied model (PPD. Existing condition gives PMV in range from 1.83 to 2.82 and PPD in range from 68.9 to 98%. Meanwhile, modification of ventilation and replacing ceiling material from clear glass into reflective clear glass gave significant impact to reduce PMV into range from 1.63 to 2.18 and PPD into range from 58.2 to 84.2%. In sort, new design converting building process has more comfortable for workers.

  17. Shoe preference based on subjective comfort for walking and running. (United States)

    Kong, Pui Wah; Bagdon, Miranda


    Subjective comfort of footwear is important for shoe and orthosis design. This study compared shoe preferences between walking and running, using subjective comfort as an outcome tool. Forty-one participants walked and ran 20 times each along a runway in three types of footwear (cushioning, lightweight, and stability) and chose the model that they preferred most for walking and running separately based on subjective comfort. More participants preferred the cushioning model (walking, 34%; running, 41%) or the lightweight model (walking, 44%; running, 41%) over the stability model (walking, 22%; running, 17%). χ² tests revealed no differences between walking and running, runners and nonrunners, and lighter and heavier individuals. Women were more likely (odds ratio = 4.09) to prefer the lightweight model, whereas men preferred the cushioning (odds ratio = 2.05) and stability (odds ratio = 3.19) models. Most participants (71%) chose the same model for both activities. Shoe preference varies among individuals and is influenced by sex. Most people feel comfortable walking and running in the same shoe model.

  18. A Comfort Index for Statistical Inference-Making. (United States)

    Brewer, James K.


    An index that measures the degree of comfort a researcher has relative to statistical inference application is proposed. The index is calculated by selecting and weighting components inherent in the conduct of hypothesis tests and confidence intervals, and its values range from zero to one. To organize the components of the index, inference…

  19. Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents. (United States)

    Davis, Susan A; Braykov, Nikolay P; Lathrop, Eva; Haddad, Lisa B


    To assess familiarity with long-acting reversible contraceptives (LARC) among current obstetrics and gynecology (OB/GYN), family medicine (FM), and pediatrics senior residents in the United States. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We selected 156 OB/GYN, FM, and pediatrics residency programs using the American Medical Association Freida database. Senior residents completed a survey addressing any training they had received on LARC, and rated their comfort level counseling about and inserting LARC. Residents rated their likelihood of recommending LARC to an adolescent, nulliparous patient, and indicated whether they would like additional training on LARC. Descriptive and analytic statistics were generated using R statistical software (The R Project for Statistical Computing; The survey was completed by 326 of 1,583 residents (20.6% response rate); at least 1 resident completed the survey at 105 (67.3%) of the residency programs contacted. Most programs (84.8%) provided some training on LARC. Residents in OB/GYN programs were comfortable counseling about and inserting contraceptive implants (97%, 83%), copper intrauterine devices (IUDs; 100%, 86%), and levonorgestrel (LNG) IUDs (100%, 86%). In FM programs, fewer residents were comfortable counseling about and inserting contraceptive implants (71%, 47%), copper IUDs (68%, 21%), and LNG IUDs (79%, 18%). Residents in pediatrics programs had low comfort levels counseling about contraceptive implants (14%), copper IUDs (14%), and LNG IUDs (25%); no pediatrics residents were comfortable inserting LARC. OB/GYN residents were significantly more likely to recommend a LARC to an adolescent, nulliparous patient (P = .019). Most pediatric and FM residents desired additional training on LARC (82.7% and 60.7%, respectively). This study shows that knowledge gaps exist regarding LARC among FM and pediatrics residents. Copyright © 2017 North American Society for

  20. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment. (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie


    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Renato Eržen


    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  2. Thermal comfort assessment in Moscow during the summer 2010 (United States)

    Malinina, Elizaveta; Konstantinov, Pavel


    Biometeorological indices are used to asses thermal comfort conditions and evaluate the influence of the weather on the human organism and health. Despite of the fact, that some biometeorological indices are already used in weather forecast, the assessment of these indices is especially important during the extreme weather conditions like continuous heat or cold waves. One of the very urgent issues in the applied climatology is the assessment of thermal comfort conditions in the urban areas, because nowadays more than half population of the planet lives there. Especially important is to study thermal comfort conditions in biggest and, thus, densely populated cities, because the effect of heat waves becomes stronger by the urban heat island effect. In July and August 2010 in the biggest city in Russia - Moscow, where more than 11 million people live, the longest and the strongest heat wave as well as the warmest day (29th of July 2010) were recorded since the meteorological observations in Russian capital were started. The main objective of this work is to evaluate the thermal comfort conditions of the warmest day in Moscow. For that purpose several biometeorological indices, particularly PET (physiological equivalent temperature), were analyzed and calculated for the warmest day in Russian capital. The calculations were done for the certain city canyon on the territory of the Moscow State University as well as for the places with natural vegetation. The results were compared with each other and, thus, the complex thermal comfort assessment was done. Also, the results of the calculations for the 29th of July 2010 were compared with the mean meteorological data for this period.

  3. Driving Rhythm Method for Driving Comfort Analysis on Rural Highways

    Directory of Open Access Journals (Sweden)

    Bo Yu


    Full Text Available Driving comfort is of great significance for rural highways, since the variation characteristics of driving speed are comparatively complex on rural highways. Earlier studies about driving comfort were usually based on the actual geometric road alignments and automobiles, without considering the driver’s visual perception. However, some scholars have shown that there is a discrepancy between actual and perceived geometric alignments, especially on rural highways. Moreover, few studies focus on rural highways. Therefore, in this paper the driver’s visual lane model was established based on the Catmull-Rom spline, in order to describe the driver’s visual perception of rural highways. The real vehicle experiment was conducted on 100 km rural highways in Tibet. The driving rhythm was presented to signify the information during the driving process. Shape parameters of the driver’s visual lane model were chosen as input variables to predict the driving rhythm by BP neural network. Wavelet transform was used to explore which part of the driving rhythm is related to the driving comfort. Then the probabilities of good, fair and bad driving comfort can be calculated by wavelets of the driving rhythm. This work not only provides a new perspective into driving comfort analysis and quantifies the driver’s visual perception, but also pays attention to the unique characteristics of rural highways.

  4. Understanding comfort and senses in social practices: Insights from a Danish field study

    DEFF Research Database (Denmark)

    Madsen, Line Valdorff; Gram-Hanssen, Kirsten


    Thermal comfort is central to energy consumption in housing and one of the main drivers behind worldwide GHG emissions. Research on residential energy consumption has therefore addressed comfort in relation to indoor temperatures. This paper argues that by widening the focus of comfort to include......, and the paper describes how aspects of comfort are perceived differently within different practices. The study is based on qualitative interview data from a Danish field study. However, the findings on how comfort in houses can be understood have a broader relevance as well. It is argued that this nuanced...... perspective on comfort can contribute to widening the debate and policy on residential energy consumption....

  5. Adaptive thermal comfort opportunities for dwellings: Providing thermal comfort only when and where needed in dwellings in the Netherlands

    Directory of Open Access Journals (Sweden)

    Noortje Alders


    Full Text Available The aim of the research presented in this thesis is to design the characteristics of an Adaptive Thermal Comfort System for Dwellings to achieve a significantly better energy performance whilst not compromising the thermal comfort perception of the occupants. An Adaptive Thermal Comfort System is defined as the whole of passive and active comfort components of the dwelling that dynamically adapts its settings to varying user comfort demands and weather conditions (seasonal, diurnal and hourly depending on the aspects adapted, thus providing comfort only where, when and at the level needed by the user, to improve possibilities of harvesting the environmental energy (e.g. solar gain and outdoor air when available and storing it when abundant. In order to be able to create an Adaptive Thermal Comfort System to save energy knowledge is needed as to where, when, what kind and how much energy is needed to provide the thermal comfort. Therefore, this research aimed to gain insight in the dynamic behaviour of the weather and the occupant and the opportunities to design the characteristics of an Adaptive Thermal Comfort System for Dwellings to achieve a significantly better energy performance whilst not compromising the thermal comfort perception of the occupants answering the main research question;  What are the most efficient strategies for delivering thermal comfort in the residential sector with respect to better energy performances and an increasing demand for flexibility in use and comfort conditions? To answer the main research question three steps were taken, which also represent the three parts of the research: 1. The dynamic information of the factors influencing the thermal heat balance of the dwelling was gathered in order to determine their opportunities for adaptivity. A multidisciplinary approach to Thermal Comfort Systems is followed taking into account the dynamic of occupancy profiles, weather, building physics, HVAC and controls. A

  6. Adaptive thermal comfort opportunities for dwellings: Providing thermal comfort only when and where needed in dwellings in the Netherlands

    Directory of Open Access Journals (Sweden)

    Noortje Alders


    Full Text Available The aim of the research presented in this thesis is to design the characteristics of an Adaptive Thermal Comfort System for Dwellings to achieve a significantly better energy performance whilst not compromising the thermal comfort perception of the occupants. An Adaptive Thermal Comfort System is defined as the whole of passive and active comfort components of the dwelling that dynamically adapts its settings to varying user comfort demands and weather conditions (seasonal, diurnal and hourly depending on the aspects adapted, thus providing comfort only where, when and at the level needed by the user, to improve possibilities of harvesting the environmental energy (e.g. solar gain and outdoor air when available and storing it when abundant.In order to be able to create an Adaptive Thermal Comfort System to save energy knowledge is needed as to where, when, what kind and how much energy is needed to provide the thermal comfort. Therefore, this research aimed to gain insight in the dynamic behaviour of the weather and the occupant and the opportunities to design the characteristics of an Adaptive Thermal Comfort System for Dwellings to achieve a significantly better energy performance whilst not compromising the thermal comfort perception of the occupants answering the main research question; What are the most efficient strategies for delivering thermal comfort in the residential sector with respect to better energy performances and an increasing demand for flexibility in use and comfort conditions?To answer the main research question three steps were taken, which also represent the three parts of the research:1. The dynamic information of the factors influencing the thermal heat balance of the dwelling was gathered in order to determine their opportunities for adaptivity. A multidisciplinary approach to Thermal Comfort Systems is followed taking into account the dynamic of occupancy profiles, weather, building physics, HVAC and controls

  7. Indoor Air Temperature and Agitation of Nursing Home Residents With Dementia. (United States)

    Tartarini, Federico; Cooper, Paul; Fleming, Richard; Batterham, Marijka


    This study aimed to determine the specific correlation between indoor air temperature and agitation of nursing home residents with dementia. Agitated behaviors of 21 residents, living in 1 nursing home, were assessed for a 10-month period using the Cohen-Mansfield Agitation Inventory (CMAI). The CMAI Total Frequency scores were found to increase significantly when indoor average temperatures deviated from 22.6°C. In addition, cumulative exposure to temperatures higher than 26°C and lower than 20°C was linearly correlated with CMAI Total Frequency scores. Results showed that agitated behaviors not only affected the person manifesting them but were found to be disruptive for other residents and the delivery of care. Agitation can, therefore, be potentially reduced by limiting the range of indoor air temperature variations, and aged care providers should ensure that a thermally comfortable environment is provided in nursing homes to enhance comfort and well-being of all occupants.


    Directory of Open Access Journals (Sweden)

    N. N. Zavadenko


    Full Text Available Treatment of developmental disorders, correction of learning disabilities and behavioral problems in children should be prompt, complex and include pharmacotherapy with nootropic agents. The results of recent studies shown in this review proved effectiveness of pharmacotherapy with pyritinol in children with perinatal injury of central nervous system and its consequences, psychomotor and speech development delay, dyslexia, attention deficit/hyperactivity disorder, cognitive disorders and learning disabilities (including manifestations of epilepsy, chronic tic disorders and Tourette syndrome. Due to its ability to optimize metabolic processes in central nervous system, pyritinol is used in treatment of vegetative dysfunction in children and adolescents, especially associated with asthenical manifestations, as well as in complex therapy of exertion headache and migraine. The drug is effective in treatment of cognitive disorders in children and adolescents with epilepsy, pyritinol was administered without changing of the basic anticonvulsive therapy and no deterioration (increase of severity of seizures or intensity of epileptiform activity on electroencephalogramms was observed. Significant nootropic effect of pyritinol, including neurometabolic, neuroprotective, neurodynamic and other mechanisms, in association with safety and rare side effects of this drug determines its wide usage in pediatric neurology.

  9. Toward a Neurology of Loneliness (United States)

    Cacioppo, Stephanie; Capitanio, John P.; Cacioppo, John T.


    Social isolation has been recognized as a major risk factor for morbidity and mortality in humans for more than a quarter century. The brain is the key organ of social connections and processes, however, and the same objective social relationship can be experienced as caring and protective or as exploitive and isolating. We review evidence that the perception of social isolation (i.e., loneliness) impacts brain and behavior and is a risk factor for broad-based morbidity and mortality. However, the causal role of loneliness on neural mechanisms and mortality is difficult to test conclusively in humans. Mechanistic animal studies provide a lens through which to evaluate the neurological effects of a member of a social species living chronically on the social perimeter. Experimental studies show that social isolation produces significant changes in brain structures and processes in adult social animals. These effects are not uniform across the brain or across species but instead are most evident in brain regions that reflect differences in the functional demands of solitary versus social living for a particular species. The human and animal literatures have developed independently, however, and significant gaps also exist. The current review underscores the importance of integrating human and animal research to delineate the mechanisms through which social relationships impact the brain, health, and well-being. PMID:25222636

  10. Gluten sensitivity and neurological manifestations

    Directory of Open Access Journals (Sweden)

    Agostino Berio


    Full Text Available The authors report on six cases of gluten-sensitivity, also defined non-celiac gluten sensitivity, characterized by abdominal features (diarrhea, bloating, pain, genetic positivity for predisposition to celiac disease (DQB1* 02 in all cases; DQA1*05 in three; DQA1*02 in two, DQB1*03 in two, negative anti-t-Transglutaminase antibodies, normal mucosa on biopsy in four cases, type 1 of Marsh in one case. The subjects presented frequent central nervous system (CNS symptoms: headache in three patients, somnolence in one, electroencephalogram aspecific alterations in three (in two of them with previous seizures, leptomeningeal cyst in one, intracranial calcification in one, cerebral gliosis in two. After a gluten-free diet, all intestinal and clinical CNS features remitted, but re-appeared after gluten reintroduction. On the basis of the neurological signs, the authors stress the relevance of immune innate system in the pathogenesis of these cases with possible subsequent evolution on immune adaptive system involvement.

  11. Endocannabinoid System in Neurological Disorders. (United States)

    Ranieri, Roberta; Laezza, Chiara; Bifulco, Maurizio; Marasco, Daniela; Malfitano, Anna M


    Several studies support the evidence that the endocannabinoid system and cannabimimetic drugs might have therapeutic potential in numerous pathologies. These pathologies range from neurological disorders, atherosclerosis, stroke, cancer to obesity/metabolic syndrome and others. In this paper we review the endocannabinoid system signaling and its alteration in neurodegenerative disorders like multiple sclerosis, Alzheimer's disease, Parkinson's disease and Huntington's disease and discuss the main findings about the use of cannabinoids in the therapy of these pathologies. Despite different etiologies, neurodegenerative disorders exhibit similar mechanisms like neuro-inflammation, excitotoxicity, deregulation of intercellular communication, mitochondrial dysfunction and disruption of brain tissue homeostasis. Current treatments ameliorate the symptoms but are not curative. Interfering with the endocannabinoid signaling might be a valid therapeutic option in neuro-degeneration. To this aim, pharmacological intervention to modulate the endocannabinoid system and the use of natural and synthetic cannabimimetic drugs have been assessed. CB1 and CB2 receptor signaling contributes to the control of Ca2+ homeostasis, trophic support, mitochondrial activity, and inflammatory conditions. Several studies and patents suggest that the endocannabinoid system has neuro-protective properties and might be a target in neurodegenerative diseases.


    Directory of Open Access Journals (Sweden)

    Sedat IŞIKAY


    Full Text Available BackgroundSeveral neurological disorders have also been widely described in celiac disease patients.ObjectiveThe aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature.MethodsThis prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed.ResultsIn neurological evaluation, totally 40 (13. 5% of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations.ConclusionIt is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

  13. Task analysis in neurosciences programme design - neurological ...

    African Journals Online (AJOL)

    Defining educational objectives is the key to achieving the goal of professional competence in students. The technique of task analysis was selected to determine components of competence in clinical neurology appropriate to the needs of primary care. A survey of neurological problems in general practice revealed that ...

  14. Archives: African Journal of Neurological Sciences

    African Journals Online (AJOL)

    Items 1 - 28 of 28 ... Archives: African Journal of Neurological Sciences. Journal Home > Archives: African Journal of Neurological Sciences. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue ...

  15. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  16. Neurological and neurosurgical manifestations of human ...

    African Journals Online (AJOL)

    adults in Abidjan, Cote d'Ivoire and in Kinshasa and among inpatients in Ugandan hospitals. Ninety per cent of deaths ... various parts of the continent. Neurological manifestations. The spectrum of neurological diseases reported in ... Primary effects of HIV. HEADACHE. Case report. A Malawian 46-year-old male senior ...

  17. Observations on burnout in family medicine and psychiatry residents. (United States)

    Woodside, Jack Richard; Miller, Merry Noel; Floyd, Michael R; McGowen, K Ramsey; Pfortmiller, Debi T


    To investigate the relationship between burnout, work environment, and a variety of personal variables, including age, gender, marital, parental and acculturation status within a population of family medicine and psychiatry resident physicians. Between 2002 and 2005, 155 residents in family medicine and psychiatry at East Tennessee State University College of Medicine were surveyed at intervals using the Maslach Burnout Inventory and Work Environment Scale, form R, to assess their current state of emotional health and job satisfaction. Female residents had lower scores on the Depersonalization scale of the Maslach Burnout Inventory (t=3.37, p=0.001). Parenting was associated with lower Depersonalization (t=3.98, pburnout than family medicine residents on the Depersonalization and Emotional Exhaustion scales (t=2.49, p=0.014: t=2.05, p=0.042) and higher Physical Comfort on the Work Environment Scale (t=-2.60, p=0.011); while family medicine residents reported higher Peer Cohesion, Supervisor Support, and Autonomy (t=3.41, p=0.001; t=2.38, p=0.019; t=2.27, p=0.025). This study design, using well established, standard, and valid measures, identified important issues for further exploration: the relationship between acculturation to burnout, the potential role of parenting as a protective factor from burnout, and the recognition that women residents may not be as vulnerable to burnout as previously reported.

  18. Communication skills of residents to families with Down syndrome babies. (United States)

    Dogan, Derya G; Kutluturk, Yesim; Kivilcim, Meltem; Canaloglu, Sinem K


    Generally, pediatricians are the first health caregivers to deliver initial diagnosis of Down syndrome (DS) to the families. However, most of the parents are not satisfied with the contents and how they receive information when their child is born with DS. Pediatric residents should target educational interventions to help parents to overcome with these issues and to provide accurate information. The objective is to assess comfort levels and training requirements of pediatric residents to communicate with parents of babies born with Down syndrome. Diagnostic Situations Inventory (DSI) is a rating scale which included ten questions to assess discomfort level. A survey was sent via mobile, websites and all the social media which were available to all pediatrics residents in the country. Socio-demographic factors including information about training requirement were collected as well. From the 326 participants, total mean discomfort level was 30.22 in DSI out of 50 which was the highest score. Discomfort level was significantly increased in female participants (p= 0.033). Being female (p= 0.014), having less residency level (p= 0.028), examining less number of patients with Down syndrome (p= 0.025) and having higher discomfort levels (p= 0.001) were found to be related with increased training requirement. From the residents, 84% declared the need for additional training. This study showed that pediatric residents had a high level of discomfort when communicating with parentes of newborn with Down Syndrome. Female residentes had a discomfort level significantly higher than male residentes.

  19. Geriatric care: ways and means of providing comfort. (United States)

    Ribeiro, Patricia Cruz Pontifice Sousa Valente; Marques, Rita Margarida Dourado; Ribeiro, Marta Pontifice


    To know the ways and means of comfort perceived by the older adults hospitalized in a medical service. Ethnographic study with a qualitative approach. We conducted semi-structured interviews with 22 older adults and participant observation of care situations. The ways and means of providing comfort are centered on strategies for promoting care mobilized by nurses and recognized by patients(clarifying/informing, positive interaction/communication, music therapy, touch, smile, unconditional presence, empathy/proximity relationship, integrating the older adult or the family as partner in the care, relief of discomfort through massage/mobilization/therapy) and on particular moments of comfort (the first contact, the moment of personal hygiene, and the visit of the family), which constitute the foundation of care/comfort. Geriatric care is built on the relationship that is established and complete with meaning, and is based on the meeting/interaction between the actors under the influence of the context in which they are inserted. The different ways and means of providing comfort aim to facilitate/increase care, relieve discomfort and/or invest in potential comfort. Conhecer os modos e formas de confortar percecionadas pelos idosos hospitalizados num serviço de medicina. Estudo etnográfico com abordagem qualitativa. Realizamos entrevistas semiestruturadas com 22 doentes idosos e observação participante nas situações de cuidados. Os modos e formas de confortar centram-se em estratégias promotoras de conforto mobilizadas pelo enfermeiro e reconhecidas pelos doentes (informação/esclarecimento, interação/comunicação positiva, toque, sorriso, presença incondicional, integração do idoso/família nos cuidados e o alívio de desconfortos através da massagem/mobilização/terapêutica) e em momentos particulares de conforto (contato inaugural, visita da família., cuidados de higiene e arranjo pessoal), que se constituem como alicerces do cuidar

  20. [Neurological disease and facial recognition]. (United States)

    Kawamura, Mitsuru; Sugimoto, Azusa; Kobayakawa, Mutsutaka; Tsuruya, Natsuko


    To discuss the neurological basis of facial recognition, we present our case reports of impaired recognition and a review of previous literature. First, we present a case of infarction and discuss prosopagnosia, which has had a large impact on face recognition research. From a study of patient symptoms, we assume that prosopagnosia may be caused by unilateral right occipitotemporal lesion and right cerebral dominance of facial recognition. Further, circumscribed lesion and degenerative disease may also cause progressive prosopagnosia. Apperceptive prosopagnosia is observed in patients with posterior cortical atrophy (PCA), pathologically considered as Alzheimer's disease, and associative prosopagnosia in frontotemporal lobar degeneration (FTLD). Second, we discuss face recognition as part of communication. Patients with Parkinson disease show social cognitive impairments, such as difficulty in facial expression recognition and deficits in theory of mind as detected by the reading the mind in the eyes test. Pathological and functional imaging studies indicate that social cognitive impairment in Parkinson disease is possibly related to damages in the amygdalae and surrounding limbic system. The social cognitive deficits can be observed in the early stages of Parkinson disease, and even in the prodromal stage, for example, patients with rapid eye movement (REM) sleep behavior disorder (RBD) show impairment in facial expression recognition. Further, patients with myotonic dystrophy type 1 (DM 1), which is a multisystem disease that mainly affects the muscles, show social cognitive impairment similar to that of Parkinson disease. Our previous study showed that facial expression recognition impairment of DM 1 patients is associated with lesion in the amygdalae and insulae. Our study results indicate that behaviors and personality traits in DM 1 patients, which are revealed by social cognitive impairment, are attributable to dysfunction of the limbic system.

  1. Neurology advanced practice providers: A position paper of the American Academy of Neurology. (United States)

    Schwarz, Heidi B; Fritz, Joseph V; Govindarajan, Raghav; Penfold Murray, Rebecca; Boyle, Kathryn B; Getchius, Thomas S D; Freimer, Miriam


    There are many factors driving health care reform, including unsustainable costs, poor outcomes, an aging populace, and physician shortages. These issues are particularly relevant to neurology. New reimbursement models are based on value and facilitated by the use of multidisciplinary teams. Integration of advanced practice providers (APPs) into neurology practice offers many advantages with new models of care. Conversely, there are many and varied challenges financially and logistically with these practice models. The American Academy of Neurology has formed a Work Group to address the needs of both neurologists and neurologic APPs and monitor the effect of APPs on quality and cost of neurologic care.

  2. Evaluating nonphysician staff members' self-perceived ability to provide multisource evaluations of residents. (United States)

    Nikels, Susan Michelle; Guiton, Gretchen; Loeb, Danielle; Brandenburg, Suzanne


    Multisource evaluations of residents offer valuable feedback, yet there is little evidence on the best way to collect these data from a range of health care professionals. This study evaluated nonphysician staff members' ability to assess internal medicine residents' performance and behavior, and explored whether staff members differed in their perceived ability to participate in resident evaluations. We distributed an anonymous survey to nurses, medical assistants, and administrative staff at 6 internal medicine residency continuity clinics. Differences between nurses and other staff members' perceived ability to evaluate resident behavior were examined using independent t tests. The survey response rate was 82% (61 of 74). A total of 55 respondents (90%) reported that it was important for them to evaluate residents. Participants reported being able to evaluate professional behaviors very well (62% [36 of 58] on the domain of respect to staff; 61% [36 of 59] on attire; and 54% [32 of 59] on communication). Individuals without a clinical background reported being uncomfortable evaluating medical knowledge (60%; 24 of 40) and judgment (55%; 22 of 40), whereas nurses reported being more comfortable evaluating these competencies. Respondents reported that the biggest barrier to evaluation was limited contact (86%; 48 of 56), and a significant amount of feedback was given verbally rather than on written evaluations. Nonphysician staff members agree it is important to evaluate residents, and they are most comfortable providing feedback on professional behaviors. A significant amount of feedback is provided verbally but not necessarily captured in a formal written evaluation process.

  3. A randomized comparative study assessing efficacy of pain versus comfort scores

    Directory of Open Access Journals (Sweden)

    Richa Jain


    Conclusions: Assessment of pain using positive word like comfort decreases its incidence with no effect on its severity when measured by comfort score and also affects patient's postsurgical perceptions.

  4. Visitors' perception of thermal comfort during extreme heat events at the Royal Botanic Garden Melbourne (United States)

    Lam, Cho Kwong Charlie; Loughnan, Margaret; Tapper, Nigel


    Outdoor thermal comfort studies have mainly examined the perception of local residents, and there has been little work on how those conditions are perceived differently by tourists, especially tourists of diverse origins. This issue is important because it will improve the application of thermal indices in predicting the thermal perception of tourists. This study aims to compare the differences in thermal perception and preferences between local and overseas visitors to the Royal Botanic Garden (RBG) in Melbourne during summer. An 8-day survey was conducted in February 2014 at four sites in the garden (n = 2198), including 2 days with maximum temperature exceeding 40 °C. The survey results were compared with data from four weather stations adjacent to the survey locations. One survey location, `Fern Gully', has a misting system and visitors perceived the Fern Gully to be cooler than other survey locations. As the apparent temperature exceeded 32.4 °C, visitors perceived the environment as being `warm' or `hot'. At `hot' conditions, 36.8 % of European visitors voted for no change to the thermal conditions, which is considerably higher than the response from Australian visitors (12.2 %) and Chinese visitors (7.5 %). Study results suggest that overseas tourists have different comfort perception and preferences compared to local Australians in hot weather based at least in part on expectations. Understanding the differences in visitors' thermal perception is important to improve the garden design. It can also lead to better tour planning and marketing to potential visitors from different countries.

  5. Visitors' perception of thermal comfort during extreme heat events at the Royal Botanic Garden Melbourne (United States)

    Lam, Cho Kwong Charlie; Loughnan, Margaret; Tapper, Nigel


    Outdoor thermal comfort studies have mainly examined the perception of local residents, and there has been little work on how those conditions are perceived differently by tourists, especially tourists of diverse origins. This issue is important because it will improve the application of thermal indices in predicting the thermal perception of tourists. This study aims to compare the differences in thermal perception and preferences between local and overseas visitors to the Royal Botanic Garden (RBG) in Melbourne during summer. An 8-day survey was conducted in February 2014 at four sites in the garden ( n = 2198), including 2 days with maximum temperature exceeding 40 °C. The survey results were compared with data from four weather stations adjacent to the survey locations. One survey location, `Fern Gully', has a misting system and visitors perceived the Fern Gully to be cooler than other survey locations. As the apparent temperature exceeded 32.4 °C, visitors perceived the environment as being `warm' or `hot'. At `hot' conditions, 36.8 % of European visitors voted for no change to the thermal conditions, which is considerably higher than the response from Australian visitors (12.2 %) and Chinese visitors (7.5 %). Study results suggest that overseas tourists have different comfort perception and preferences compared to local Australians in hot weather based at least in part on expectations. Understanding the differences in visitors' thermal perception is important to improve the garden design. It can also lead to better tour planning and marketing to potential visitors from different countries.

  6. Thermal Comfort-CFD maps for Architectural Interior Design

    DEFF Research Database (Denmark)

    Naboni, Emanuele; Lee, Daniel Sang-Hoon; Fabbri, Kristian


    Within the context of nearly Zero-Energy Buildings, it is debated that the energy-centred notion of design, proposed by regulatory frames, needs to be combined with a further focus toward users’ comfort and delight. Accordingly, the underlying theory of the research is that designers should take...... responsibility for understanding the heat flows through the building parts and its spaces. A design, which is sensible to the micro-thermal conditions coexisting in a space, allows the inhabitants to control the building to their needs and desires: for instance, maximising the benefits of heat gain from the sun...... moving a series of internal partitions so as to avoid the danger of over-heating. It is thus necessary that existing simulation software tools are tested to the purpose of modelling and visualizing the indoor thermal environment complexity. The research discusses how thermal comfort maps, which...

  7. Effect of warm air supplied facially on occupants' comfort

    DEFF Research Database (Denmark)

    Kaczmarczyk, J.; Melikov, Arsen Krikor; Sliva,, D.


    (temperature increase by 4 K at the target area) above the room air temperature decreased the draught discomfort, improved subjects' thermal comfort and only slightly decreased the perceived air quality. Elevated velocity and temperature of the localized airflow caused an increase of nose dryness intensity...... and number of eye irritation reports. Results suggest that increasing the temperature of the air locally supplied to the breathing zone by only a few degrees above the room air temperature will improve occupants' thermal comfort and will diminish draught discomfort. This strategy will extend...... was supplied with a constant velocity of 0.4 m/s by means of personalized ventilation towards the face of the subjects. The airflow at 21 °C decreased the subjects' thermal sensation and increased draught discomfort, but improved slightly the perceived air quality. Heating of the supplied air by 6 K...

  8. Improved Generalized Force Model considering the Comfortable Driving Behavior

    Directory of Open Access Journals (Sweden)

    De-Jie Xu


    Full Text Available This paper presents an improved generalized force model (IGFM that considers the driver’s comfortable driving behavior. Through theoretical analysis, we propose the calculation methods of comfortable driving distance and velocity. Then the stability condition of the model is obtained by the linear stability analysis. The problems of the unrealistic acceleration of the leading car existing in the previous models were solved. Furthermore, the simulation results show that IGFM can predict correct delay time of car motion and kinematic wave speed at jam density, and it can exactly describe the driver’s behavior under an urgent case, where no collision occurs. The dynamic properties of IGFM also indicate that stability has improved compared to the generalized force model.

  9. Detection of comfortable temperature based on thermal events detection indoors (United States)

    Szczurek, Andrzej; Maciejewska, Monika; Uchroński, Mariusz


    This work focussed on thermal comfort as the basis to control indoor conditions. Its objective is a method to determine thermal preferences of office occupants. The method is based on detection of thermal events. They occur when indoor conditions are under control of occupants. Thermal events are associated with the use of local heating/cooling sources which have user-adjustable settings. The detection is based on Fourier analysis of indoor temperature time series. The relevant data is collected by temperature sensor. We achieved thermal events recognition rate of 86 %. Conditions when indoor conditions were beyond control were detected with 95.6 % success rate. Using experimental data it was demonstrated that the method allows to reproduce key elements of temperature statistics associated with conditions when occupants are in control of thermal comfort.

  10. Vision Influence on Whole-Body Human Vibration Comfort Levels

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Machado Duarte


    Full Text Available The well being of people needs to be a priority in the modern world. In that respect, vibration cannot be one more cause of stress. Besides that, vibration comfort is very important, since high levels may cause health or even tasks' accomplishment problems. Several parameters may influence the levels of vibration a human being supports. Among them, one can mention the influence of gender, age, corporeal mass index (CMI, temperature, humor, anxiety, hearing, posture, vision, etc. The first three parameters mentioned were already investigated in previous studies undertaken by GRAVI (Group of Acoustics and Vibration researchers. In this paper, the influence of vision is evaluated. The main objective with this series of tests performed is to try to quantify in a future the influence of each parameter in a global vibration comfort level. Conclusions are presented for the parameter investigated.

  11. Analysis of ocular surface area for comfortable VDT workstation layout. (United States)

    Sotoyama, M; Jonai, H; Saito, S; Villanueva, M B


    This paper proposes a comfortable visual display terminal (VDT) workstation layout based on an analysis of ocular surface area (OSA). A large OSA induces eye irritation and eye fatigue because the eye surface is highly sensitive to various stimuli. The authors considered that OSA must be one of the useful indices of visual ergonomics and applied it to evaluate VDT workstation layout. Each subject was asked to perform a word processing task using four different VDT workstation layouts. It was found that the main factor affecting OSA was not cathode ray tube (CRT) height itself but the distance between the CRT and keyboard. Thus the following workstation layout is recommended to realize comfortable VDT operation: (1) the desk height should be adjusted to the user's height; and (2) the CRT display should be set closer to the keyboard to provide a smaller OSA.

  12. Using outgroup comfort to predict Black students' college experiences. (United States)

    Cole, Elizabeth R; Yip, Tiffany


    This study investigated whether Black students' social comfort with Whites, termed outgroup comfort (OC), predicted outcomes related to academics and mental health. Surveys administered to Black college students near the beginning and end of their first year showed OC measured in the fall predicted outcomes assessed in the spring, including contact with other races, academic concerns among men, and psychological well-being among women. A subsample selected on the basis of high or low OC scores participated in two weeks of experience sampling, revealing students high in OC reported less state anxiety than those low in OC when in academic settings; in nonacademic settings, anxiety did not differ by OC. System-justifying ideology favoring the outgroup was controlled, thus OC is distinct from internalized oppression. Results are discussed in relation to gender differences in racial identity and college student development. 2008 APA

  13. A heating agent using a personalised thermal comfort model to Save energy


    Auffenberg, Frederik; Stein, Sebastian; Rogers, Alex


    We present a novel, personalised thermal comfort model anda heating agent using this model to reduce energy consump-tion with minimal comfort loss. At present, heating agentstypically use simple models of user comfort when decidingon a set point temperature for the heating or cooling system.These models however generally fail to adapt to an individ-ual user's preferences, resulting in poor performance. Toaddress this issue, we propose a personalised thermal com-fort model using a Bayesian net...

  14. Energy efficient thermal comfort control for cyber-physical home system


    Cheng, Zhuo; Shein, Wai Wai; Tan, Yasuo; Lim, Azman Osman


    Technology advances allow us to design smart home system for the purpose to achieve high demands on occupants’comfort. In this research, we focus on the thermal comfort control (TCC) system to build an energy efficient thermal comfort control (EETCC) algorithm, which is based on the cyber-physical systems (CPS) approach. By optimizing the actuators; air-conditioner, window and curtain, our proposed algorithm can acquire the desired comfort level with high energy efficiency. Through the raw da...

  15. Instituting Ultrasound-Guided FNA for Thyroid Nodules into a General Surgery Residency Program: What We Learned. (United States)

    Davis, James R; Hale, Allyson L; Ewing, Joseph A; Lokey, Jonathan S


    Evaluation of a thyroid nodule is a common referral seen by surgeons and frequently requires ultrasound-guided fine needle aspiration (US-guided FNA). While surgical residents may have sufficient exposure to thyroid surgery, many lack exposure to office-based procedures, such as US-guided FNA. General surgery residents should be provided with knowledge and practical skills in the application of diagnostic and interventional neck ultrasound to manage the common workup of a thyroid nodule. This study sought to instruct and measure surgical residents' performance in thyroid US-guided FNA and evaluate their views regarding instituting such a formal curriculum. Twelve (n = 12) senior residents completed a written pretest and questionnaire, then watched an instructional video and practiced a simulated thyroid US-guided FNA on our created model. Then residents were evaluated while performing actual thyroid US-guided FNAs on patients in our clinic. Residents then completed the same written exam and questionnaire for objective measure. Eight of the chief residents (62%) felt "not comfortable" with the procedure on the pre-course survey; this was reduced to 0% on the post-course survey. Moderate comfort level increased from 15% to 50% and extreme comfort increased from 0% to 8%. From the 11 residents who completed the pre- and post-test exam, 82% (n = 9) significantly improved their score through the curriculum (pre-test: 40.9 vs. post-test: 61.8; p = 0.05). With focused instruction, residents are able to learn ultrasound-guided thyroid biopsy with improvement in subjective confidence level and objective measures. Resident feedback was positive and emphasized the importance of such training in surgical residency curriculum. Published by Elsevier Inc.

  16. Relation between Ocular Comfort, Arachidonic Acid Mediators, and Histamine. (United States)

    Masoudi, Simin; Zhao, Zhenjun; Willcox, Mark


    Contact lenses are associated with discomfort during wear. This may be the result of stimulation of the ocular surface and production of pro-inflammatory mediators which are then released into the tears. This study examined changes in the concentration in tears of arachidonic acid metabolites (AAM) prostaglandins, cysteinyl leukotrienes, and resolvin-D1, as well as histamine in a general contact lens population in the morning and evening. Tears were collected twice a day (morning and evening) for up to 10 days on two different occasions (with and without contact lens wear) from 30 experienced contact lens wearers for analysis of AAM and a separate group (N = 33) for analysis of histamine. Ocular comfort was rated subjectively on an ordinal scale at each time of tear collection. Tears were analyzed using commercial immunoassay-based kits. Statistical analysis was performed using linear mixed model test. Ocular comfort decreased from morning to evening with and without contact lenses (p = 0.001), and the difference in comfort in the evening was greater with contact lens wear (80.9 ± 16.2 vs. 75.5 ± 16.8; p = 0.008). The total concentration of PGs (10.7 ± 10.8 ng/ml), cysteinyl leukotrienes (8.7 ± 0.38 ng/ml), resolvin-D1 (1.6 ± 0.5 ng/ml), or histamine 13.8 ± 10.4 ng/ml) did not change during the day or during contact lens wear (p > 0.05). Prostaglandins, cysteinyl leukotrienes, resolvin-D1, or histamine concentrations did not alter in relation to changes in comfort of the eye during the day or during contact lens wear. These results suggest that release of these mediators is not responsible for contact lens discomfort.

  17. Chronic stress and obesity: a new view of "comfort food". (United States)

    Dallman, Mary F; Pecoraro, Norman; Akana, Susan F; La Fleur, Susanne E; Gomez, Francisca; Houshyar, Hani; Bell, M E; Bhatnagar, Seema; Laugero, Kevin D; Manalo, Sotara


    The effects of adrenal corticosteroids on subsequent adrenocorticotropin secretion are complex. Acutely (within hours), glucocorticoids (GCs) directly inhibit further activity in the hypothalamo-pituitary-adrenal axis, but the chronic actions (across days) of these steroids on brain are directly excitatory. Chronically high concentrations of GCs act in three ways that are functionally congruent. (i) GCs increase the expression of corticotropin-releasing factor (CRF) mRNA in the central nucleus of the amygdala, a critical node in the emotional brain. CRF enables recruitment of a chronic stress-response network. (ii) GCs increase the salience of pleasurable or compulsive activities (ingesting sucrose, fat, and drugs, or wheel-running). This motivates ingestion of "comfort food." (iii) GCs act systemically to increase abdominal fat depots. This allows an increased signal of abdominal energy stores to inhibit catecholamines in the brainstem and CRF expression in hypothalamic neurons regulating adrenocorticotropin. Chronic stress, together with high GC concentrations, usually decreases body weight gain in rats; by contrast, in stressed or depressed humans chronic stress induces either increased comfort food intake and body weight gain or decreased intake and body weight loss. Comfort food ingestion that produces abdominal obesity, decreases CRF mRNA in the hypothalamus of rats. Depressed people who overeat have decreased cerebrospinal CRF, catecholamine concentrations, and hypothalamo-pituitary-adrenal activity. We propose that people eat comfort food in an attempt to reduce the activity in the chronic stress-response network with its attendant anxiety. These mechanisms, determined in rats, may explain some of the epidemic of obesity occurring in our society.

  18. Ecosystem Biomimicry: A way to achieve thermal comfort in architecture

    Directory of Open Access Journals (Sweden)

    H. Abaeian


    Full Text Available The strategies to reduce the consumption of non-renewable energies in buildings are becoming increasingly important. In the meantime, nature-inspired approaches have emerged as a new strategy to achieve thermal comfort in the interiors. However, the use of these approaches in architecture and buildings requires a proper understanding regarding the features of ecosystems. Although acquiring this knowledge requires a high degree of familiarity with the fields such as biology and environmental science, review of achievements made by the use of these features could facilitate the understanding of ecomimicry processes and thereby contribute to environmental sustainability in buildings. In other words, this paper concerns the relationship between these features and the thermal comfort inside the building. Biomimicry is an approach to innovation that seeks sustainable solutions to human challenges by emulating nature’s time-tested patterns and strategies. The objective of this paper is to use such review to provide an approach to the use of natural features for achieving thermal comfort in the buildings of hot and dry climates. In this review, the successful examples are analyzed to identify and examine the principles that influence the thermal comfort in both building and urban levels. The results show that the three elements of water, wind, sun are the effective natural resources that must be utilized in the design in a way proportional and consistent with the natural features. In addition, functional features of ecosystem can be of value only in the presence of a processual  relationship between them.

  19. Vision Influence on Whole-Body Human Vibration Comfort Levels


    Duarte, Maria Lúcia Machado; de Brito Pereira, Matheus


    The well being of people needs to be a priority in the modern world. In that respect, vibration cannot be one more cause of stress. Besides that, vibration comfort is very important, since high levels may cause health or even tasks' accomplishment problems. Several parameters may influence the levels of vibration a human being supports. Among them, one can mention the influence of gender, age, corporeal mass index (CMI), temperature, humor, anxiety, hearing, posture, vision, etc. The first th...

  20. Urban microclimate and thermal comfort modelling: strategies for urban renovation


    Tumini, Irina; Higueras García, Esther; Baereswyl Rada, Sergio


    The urban microclimate plays an important role in building energy consumption and thermal comfort in outdoor spaces. Nowadays, cities need to increase energy efficiency, reduce pollutant emissions and mitigate the evident lack of sustainability. In light of this, attention has focused on the bioclimatic concepts use in the urban development. However, the speculative unsustainability of the growth model highlights the need to redirect the c...

  1. Development of Light Powered Sensor Networks for Thermal Comfort Measurement

    Directory of Open Access Journals (Sweden)

    Dasheng Lee


    Full Text Available Recent technological advances in wireless communications have enabled easy installation of sensor networks with air conditioning equipment control applications. However, the sensor node power supply, through either power lines or battery power, still presents obstacles to the distribution of the sensing systems. In this study, a novel sensor network, powered by the artificial light, was constructed to achieve wireless power transfer and wireless data communications for thermal comfort measurements. The sensing node integrates an IC-based temperature sensor, a radiation thermometer, a relative humidity sensor, a micro machined flow sensor and a microprocessor for predicting mean vote (PMV calculation. The 935 MHz band RF module was employed for the wireless data communication with a specific protocol based on a special energy beacon enabled mode capable of achieving zero power consumption during the inactive periods of the nodes. A 5W spotlight, with a dual axis tilt platform, can power the distributed nodes over a distance of up to 5 meters. A special algorithm, the maximum entropy method, was developed to estimate the sensing quantity of climate parameters if the communication module did not receive any response from the distributed nodes within a certain time limit. The light-powered sensor networks were able to gather indoor comfort-sensing index levels in good agreement with the comfort-sensing vote (CSV preferred by a human being and the experimental results within the environment suggested that the sensing system could be used in air conditioning systems to implement a comfort-optimal control strategy.

  2. Electric heating provides a high level of home comfort - economically

    Energy Technology Data Exchange (ETDEWEB)

    Haapakoski, M.


    Research and development at IVO in the area of electric heating boasts a tradition going back almost thirty years. Research aimed at further progress is continuing. IVO and power companies launched the `Electrically heated houses of the century` project four years ago. The first results show that electric heating continues to be very competitive with other heating systems. It is an economical way of heating the home and it also increases the comfort of those living there

  3. Development of a method for rating climate seat comfort (United States)

    Scheffelmeier, M.; Classen, E.


    The comfort aspect in the vehicle interior is becoming increasingly important. A high comfort level offers the driver a good and secure feeling and has a strong influence on passive traffic safety. One important part of comfort is the climate aspect, especially the microclimate that emerges between passenger and seat. In this research, different combinations of typical seat materials are used. Fourteen woven and knitted fabrics and eight leathers and its substitutes for the face fabric layer, one foam, one non-woven and one 3D spacer for the plus pad layer and for the support layer three foam types with variations in structure and raw material as well as one rubber hair structure were investigated. To characterise this sample set by thermo-physiological aspects (e.g. water vapour resistance Ret, thermal resistance Rct, buffering capacity of water vapour Fd) regular and modified sweating guarded hotplates were used according to DIN EN ISO 11092. The results of the material characterisation confirm the common knowledge that seat covers out of textiles have better water vapour resistance values than leathers and its substitutes. Subject trials in a driving simulator were executed to rate the subjective sensation while driving in a vehicle seat. With a thermal, sweating Manikin (Newton Type, Thermetrics) objective product measurements were carried out on the same seat. Indeed the subject trials show that every test subject has his or her own subjective perception concerning the climate comfort. The results of the subject trials offered the parameters for the Newton measuring method. Respectively the sweating rate, sit-in procedure, ambient conditions and sensor positions on and between the seat layers must be comparable with the subject trials. By taking care of all these parameters it is possible to get repeatable and reliable results with the Newton Manikin. The subjective feelings of the test subjects, concerning the microclimate between seat and passenger, provide

  4. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh


    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand...... in a healthcare system. From our perspective, further sociological and pedagogical investigations in educational cultures across settings and specialties could inform our understanding of and knowledge about pitfalls in residents’ and doctors’ socialization into the healthcare system....

  5. Standardized patient outcomes trial (SPOT in neurology

    Directory of Open Access Journals (Sweden)

    Joseph E. Safdieh


    Full Text Available Background: The neurologic examination is a challenging component of the physical examination for medical students. In response, primarily based on expert consensus, medical schools have supplemented their curricula with standardized patient (SP sessions that are focused on the neurologic examination. Hypothesis-driven quantitative data are needed to justify the further use of this resource-intensive educational modality, specifically regarding whether using SPs to teach the neurological examination effects a long-term benefit on the application of neurological examination skills. Methods: This study is a cross-sectional analysis of prospectively collected data from medical students at Weill Cornell Medical College. The control group (n=129 received the standard curriculum. The intervention group (n=58 received the standard curriculum and an additional SP session focused on the neurologic examination during the second year of medical school. Student performance on the neurologic examination was assessed in the control and intervention groups via an OSCE administered during the fourth year of medical school. A Neurologic Physical Exam (NPE score of 0.0 to 6.0 was calculated for each student based on a neurologic examination checklist completed by the SPs during the OSCE. Composite NPE scores in the control and intervention groups were compared with the unpaired t-test. Results: In the fourth year OSCE, composite NPE scores in the intervention group (3.5±1.1 were statistically significantly greater than those in the control group (2.2±1.1 (p<0.0001. Conclusions: SP sessions are an effective tool for teaching the neurologic examination. We determined that a single, structured SP session conducted as an adjunct to our traditional lectures and small groups is associated with a statistically significant improvement in student performance measured 2 years after the session.

  6. [Validity and reliability study of sedation diagnosis method comfort scale]. (United States)

    Beytut, Dilek; Başbakkal, Zümrüt; Karapınar, Bülent


    The aim of the present methodological descriptive study was to test the validity and reliability of the COMFORT scale. The study was conducted at a pediatric critical care unit at a university hospital between February 2009 and June 2010. Study sample included 84 pediatric patients (n=37) receiving mechanical ventilation. Data were collected via child information form, COMFORT scale, and visual analog scale (VAS). Having been assured of the language and context validity of the scale, researchers conducted reliability tests (Cronbach's alpha coefficient, item analysis), inter- and intra-observer reliability tests, and correlation analyses based on the data obtained during their own observations. Cronbach's alpha coefficient was 0.77. Results of the item analysis indicated that item-total correlations were satisfactorily high. Significance of inter-observer agreement was analyzed for each item, and it was found that weighted kappa values varied between 0.703 and 0.888. Convergent validity tests demonstrated a positive strong correlation between COMFORT scale scores of the primary researcher and the assistant researchers (r= 0.961, pVAS (r= 0.775, pvalid and reliable method of measuring sedation levels of children receiving mechanical ventilation and being sedated in a pediatric critical care unit.

  7. Indoor Air Quality and Thermal Comfort in School Buildings (United States)

    Juhásová Šenitková, Ingrid


    This paper presents results to thermal comfort and environment quality questions in 21 school building rooms. Results show that about 80% of the occupants expressed satisfaction with their thermal comfort in only 11% of the buildings surveyed. Air quality scores were somewhat higher, with 26% of buildings having 80% or occupant satisfaction. With respect to thermal comfort and air quality performance goals set out by standards, most buildings appear to be falling far short. Occupant surveys offer a means to systematically measure this performance, and also to provide diagnostic information for building designers and operators. The odours from building materials as well as human odours were studied by field measurement. The odour intensity and indoor air acceptability were assessed by a sensory panel. The concentrations of total volatile organic compounds and carbon dioxide were measured. The odours from occupancy and building materials were studied under different air change rate. The case study of indoor air acceptability concerning to indoor odours and its effect on perceived air quality are also presented in this paper.

  8. Hygrothermal response of a dwelling house. Thermal comfort criteria

    Directory of Open Access Journals (Sweden)

    Adrian IACOB


    Full Text Available The use of local natural materials in order to reduce the environmental negative impact of buildings has become common practice in recent years; such buildings are to be found in all regions of the planet. The high level of thermal protection provided by the envelope elements made from natural materials such as straw bale insulation, hemp insulation or sheep wool, and their lack of thermal massiveness require a more complex analysis on their ability to keep interior comfort without accentuated variations. This paper proposes a comparative analysis between different solutions for a residential building located near a Romanian city, Cluj-Napoca. The elements of the building envelope are designed in three alternative solutions, using as substitute to classical solutions (concrete and polystyrene, masonry and polystyrene, straw bales and rammed earth for enclosing elements. For this purpose there are conducted numerical simulations of heat and mass transfer, using a mathematical model that allows the analysis of indoor comfort, by comparing both objective factors (air temperature, operative temperature and relative humidity and subjective factors, which are needed to define interior thermal comfort indices PPD and PMV. Finally, a set of conclusions are presented and future research directions are drawn.

  9. The zone of comfort: Predicting visual discomfort with stereo displays (United States)

    Shibata, Takashi; Kim, Joohwan; Hoffman, David M.; Banks, Martin S.


    Recent increased usage of stereo displays has been accompanied by public concern about potential adverse effects associated with prolonged viewing of stereo imagery. There are numerous potential sources of adverse effects, but we focused on how vergence–accommodation conflicts in stereo displays affect visual discomfort and fatigue. In one experiment, we examined the effect of viewing distance on discomfort and fatigue. We found that conflicts of a given dioptric value were slightly less comfortable at far than at near distance. In a second experiment, we examined the effect of the sign of the vergence–accommodation conflict on discomfort and fatigue. We found that negative conflicts (stereo content behind the screen) are less comfortable at far distances and that positive conflicts (content in front of screen) are less comfortable at near distances. In a third experiment, we measured phoria and the zone of clear single binocular vision, which are clinical measurements commonly associated with correcting refractive error. Those measurements predicted susceptibility to discomfort in the first two experiments. We discuss the relevance of these findings for a wide variety of situations including the viewing of mobile devices, desktop displays, television, and cinema. PMID:21778252

  10. Evaluation of the thermal comfort of ceramic floor tiles

    Directory of Open Access Journals (Sweden)

    Carmeane Effting


    Full Text Available In places where people are bare feet, the thermal sensation of cold or hot depends on the environmental conditions and material properties including its microstructure and crustiness surface. The uncomforting can be characterized by heated floor surfaces in external environments which are exposed to sun radiation (swimming polls areas or by cold floor surfaces in internal environments (bed rooms, path rooms. The property named thermal effusivity which defines the interface temperature when two semi-infinite solids are putted in perfect contact. The introduction of the crustiness surface on the ceramic tiles interferes in the contact temperature and also it can be a strategy to obtain ceramic tiles more comfortable. Materials with low conductivities and densities can be obtained by porous inclusion are due particularly to the processing conditions usually employed. However, the presence of pores generally involves low mechanical strength. This work has the objective to evaluate the thermal comfort of ceramics floor obtained by incorporation of refractory raw materials (residue of the polishing of the porcelanato in industrial atomized ceramic powder, through the thermal and mechanical properties. The theoretical and experimental results show that the porosity and crustiness surface increases; there is sensitive improvement in the comfort by contact.

  11. Wearable Sweat Rate Sensors for Human Thermal Comfort Monitoring. (United States)

    Sim, Jai Kyoung; Yoon, Sunghyun; Cho, Young-Ho


    We propose watch-type sweat rate sensors capable of automatic natural ventilation by integrating miniaturized thermo-pneumatic actuators, and experimentally verify their performances and applicability. Previous sensors using natural ventilation require manual ventilation process or high-power bulky thermo-pneumatic actuators to lift sweat rate detection chambers above skin for continuous measurement. The proposed watch-type sweat rate sensors reduce operation power by minimizing expansion fluid volume to 0.4 ml through heat circuit modeling. The proposed sensors reduce operation power to 12.8% and weight to 47.6% compared to previous portable sensors, operating for 4 hours at 6 V batteries. Human experiment for thermal comfort monitoring is performed by using the proposed sensors having sensitivity of 0.039 (pF/s)/(g/m 2 h) and linearity of 97.9% in human sweat rate range. Average sweat rate difference for each thermal status measured in three subjects shows (32.06 ± 27.19) g/m 2 h in thermal statuses including 'comfortable', 'slightly warm', 'warm', and 'hot'. The proposed sensors thereby can discriminate and compare four stages of thermal status. Sweat rate measurement error of the proposed sensors is less than 10% under air velocity of 1.5 m/s corresponding to human walking speed. The proposed sensors are applicable for wearable and portable use, having potentials for daily thermal comfort monitoring applications.

  12. Comfortable synchronization of cyclic drawing movements with a metronome. (United States)

    Repp, Bruno H


    Continuous circle drawing is considered a paragon of emergent timing, whereas the timing of finger tapping is said to be event-based. Synchronization with a metronome, however, must to some extent be event-based for both types of movement. Because the target events in the movement trajectory are more poorly defined in circle drawing than in tapping, circle drawing shows more variable asynchronies with a metronome than does tapping. One factor that may have contributed to high variability in past studies is that circle size, drawing direction, and target point were prescribed and perhaps outside the comfort range. In the present study, participants were free to choose most comfortable settings of these parameters for two continuously drawn shapes, circles and infinity signs, while synchronizing with a regular or intermittently perturbed metronome at four different tempi. Results showed that preferred circle sizes were generally smaller than in previous studies but tended to increase as tempo decreased. Synchronization results were similar for circles and infinity signs, and similar to earlier results for circles drawn within a fixed template (Repp & Steinman, 2010). Comparison with tapping data still showed drawing to exhibit much greater variability and persistence of asynchronies as well as slower phase correction in response to phase shifts in the metronome. With comfort level ruled out as a factor, these differences can now be attributed more confidently to differences in event definition and/or movement dynamics. Copyright © 2010 Elsevier B.V. All rights reserved.

  13. Objective and subjective thermal comfort evaluation in Hungary

    Directory of Open Access Journals (Sweden)

    Kajtar Laszlo


    Full Text Available Thermal comfort sensation can be predicted in the most exact way based on Fanger’s predicted mean vote (PMV model. This evaluation method takes all the six influencing factors into consideration: air temperature and humidity, air velocity, mean radiant temperature of surrounding surfaces, clothing insulation, and occupants’ activities. Fanger’s PMV method was developed for temperate climate and European people, with the participation of university students as subjects. Many researchers had investigated its validity in different geographic locations (i. e. climatic conditions, people and under non-laboratory circumstances. The results were summarised by van Hoof which had been published in the scientific references. The articles gave us the idea to elaborate the former measurement results. During the last decades thermal comfort was evaluated by our research team using subjective scientific questionnaires and applying the objective Fanger’s model in several office buildings in Hungary. The relation between the PMV and actual mean vote values were analysed based on these results. Investigations were carried out under steady-state conditions in winter time. We performed objective thermal comfort evaluations based on instrumental measurements using the PMV theory. Parallel to this we assessed the subjective thermal sensation using scientific questionnaires. The mathematical relationship between the actual mean vote and PMV was defined according to the evaluated thermal environment: AMV = PMV + 0.275, (arg. –1.7 ≤ PMV ≤ +0.5.

  14. Comfort Women in Human Rights Discourse: Fetishized Testimonies, Small Museums, and the Politics of Thin Description (United States)

    Joo, Hee-Jung Serenity


    In the last two decades, the issue of comfort women--the women and girls who were forced into sex slavery for the Japanese army before and during WWII--has risen to global attention. Tens of thousands of comfort women (the average estimate is anywhere between 80,000 and 200,000) were confined at comfort stations managed by the Japanese Imperial…

  15. The comfort, measured by means of a sweating manikin (WalterTM ...

    African Journals Online (AJOL)

    With the growing importance of clothing comfort in South African and overseas markets for locally produced clothing, the Council for Scientific Industrial Research (CSIR) acquired an advanced sweating fabric manikin for measuring clothing comfort. This preliminary investigation covers the comfort related properties, ...

  16. Neurological examination: pioneering authors and their books

    Directory of Open Access Journals (Sweden)

    Péricles Maranhão-Filho


    Full Text Available The objective of this article is to highlight some of the most important pioneering books specifically focused on the neurological examination and their authors. During the XIX Century, Alexander Hammond, William Gowers and Charles Mills pioneered the neurological literature, followed in the XX Century by Aloysio de Castro, Monrad-Krohn, Derek Denny-Brown, Robert Wartenberg, Gordon Holmes, and Russel DeJong. With determination and a marked sense of observation and research, they competently developed and spread the technique and art of the neurological exam.

  17. Education of a child neurologist: developmental neuroscience relevant to child neurology. (United States)

    Johnston, Michael V


    Developmental neuroscience is increasingly relevant to clinical child neurology, and study of advances in neurobiology, neurochemistry and neurogenetics should be part of the curriculum of residency training. The profile of synaptic development is especially relevant to neurodevelopmental disorders such as autism, Fragile X syndrome, and early epileptic encephalopathies. This knowledge is increasingly being translated into therapies for previously untreatable disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Neuromodulation of lower limb motor control in restorative neurology (United States)

    Minassian, Karen; Hofstoetter, Ursula; Tansey, Keith; Mayr, Winfried


    One consequence of central nervous system injury or disease is the impairment of neural control of movement, resulting in spasticity and paralysis. To enhance recovery, restorative neurology procedures modify altered, yet preserved nervous system function. This review focuses on functional electrical stimulation (FES) and spinal cord stimulation (SCS) that utilize remaining capabilities of the distal apparatus of spinal cord, peripheral nerves and muscles in upper motor neuron dysfunctions. FES for the immediate generation of lower limb movement along with current rehabilitative techniques is reviewed. The potential of SCS for controlling spinal spasticity and enhancing lower limb function in multiple sclerosis and spinal cord injury is discussed. The necessity for precise electrode placement and appropriate stimulation parameter settings to achieve therapeutic specificity is elaborated. This will lead to our human work of epidural and transcutaneous stimulation targeting the lumbar spinal cord for enhancing motor functions in spinal cord injured people, supplemented by pertinent human research of other investigators. We conclude that the concept of restorative neurology recently received new appreciation by accumulated evidence for locomotor circuits residing in the human spinal cord. Technological and clinical advancements need to follow for a major impact on the functional recovery in individuals with severe damage to their motor system. PMID:22464657

  19. High-rise buildings and neurologically favorable outcome after out-of-hospital cardiac arrest. (United States)

    Kobayashi, Daisuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Nishiyama, Chika; Hayashida, Sumito; Fujii, Tomoko; Izawa, Junichi; Shimamoto, Tomonari; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Katayama, Yusuke; Kiguchi, Takeyuki; Kawamura, Takashi; Iwami, Taku


    The number of people living in high-rise buildings has recently been increasing in Japan, and delayed transport time by emergency-medical-service (EMS) personnel from higher floors could lead to lower survival after out-of-hospital cardiac arrest (OHCA). However, there are no clinical studies assessing the association between the floor where patients reside and neurologically favorable outcome after OHCA. This was a prospective, population-based study conducted in Osaka City, Japan that enrolled adults aged >=18years suffering an OHCA of cardiac origin before EMS arrival between 2013 and 2014. The primary outcome measure was one-month survival with neurologically favorable outcome. We divided OHCA patients into the following groups: those residing on >=3 floors (the high floor group) and <3 floors (the low floor group). Multiple logistic regression analysis was used to assess factors associated with neurologically favorable outcome. A total of 2979 patients were eligible for analysis. Of them, 1885 (62.3%) occurred below the third floor and 1094 (37.4%) occurred at or above the third floor. The proportion of neurologically favorable outcome after OHCA was significantly lower in the high floor group than in the low floor group (2.7% [30/1094] versus 4.8% [91/1885], P=0.005). In a multivariate analysis, neurologically favorable outcome after OHCA was significantly lower in the high floor group than in the low floor group (adjusted odds ratio, 0.59 [95% confidence interval, 0.37-0.96]). In this population, one-month survival with neurologically favorable outcome from OHCA was lower in the high floor group than in the low floor group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. ComfortPower - System improvements and long-term evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Silversand, Fredrik [Catator AB, Lund (Sweden)


    Catator has previously developed a novel heating system abbreviated ComfortPower in a RandD-programme supported by Catator, Swedish Gas Centre (SGC), Swedish Defence Materiel Administration (FMV), Skanska, Nibe and Alfa Laval. The ComfortPower unit comprises a multi fuel reformer system tied to a high-temperature polymer electrolyte fuel cell (HT-PEM) and a heat pump system. Since the residual heat from the fuel cell system can be utilized in a very effective way, it is possible to reach high thermal efficiencies. Indeed, the thermal efficiency in the unit has previously been shown to reach values as high as 175 - 200 % based on the lower heating value of the fuel. In addition to heat, ComfortPower can supply comfort cooling and surplus electricity. This project phase has focused on the following elements: 1. System improvements to further enhance the efficiency with existing fuel cell (HT-PEM). 2. System simplifications (e.g. DC-compressor system) to manage issues with start-up currents. 3. Tests with biogas qualities (various levels of CO{sub 2}) and biogas/air. 4. Long-term test with biogas quality (upgraded biogas). 5. Additional tests with liquid fuels (alcohols and diesel). 6. Map the need for cooling and heating in various applications. 7. Investigate how ComfortPower can reduce the primary energy consumption and reduce the environmental impact. 8. Study the possibility with a SOFC-based system with internal reforming. It was found that the Optiformer technology can be used to derive a suitable reformate gas for the HT-PEM unit from a wide range of fuels. Even if operation with fuel gases is the natural choice in most cases, it is possible also to use alcohols and other liquid fuels (e.g. in Campus applications). The heat pump system was equipped with a 24 V DC-compressor provided by Nibe. The compressor could be directly powered by the accumulator system and start-up currents, harmful to the inverter, could be avoided. Some improvements were made on the

  1. Medical-grade footwear: the impact of fit and comfort. (United States)

    Hurst, Bessie; Branthwaite, Helen; Greenhalgh, Andrew; Chockalingam, Nachiappan


    Pressure-related skin lesions on the digits are a significant cause of discomfort. Most foot pain related to ill-fitting shoes occurs in the forefoot and digital areas. Pain has been associated with poor shoe fit, reduced toe box volume, as well as contour and shape of the shoe Off-the-shelf medical-grade footwear is designed as an intervention for chronic lesions on the digits. These shoes are designed with a flexible neoprene fabric upper that is thought to reduce pressure on the forefoot and reduce discomfort associated with ill-fitting shoes. The aim of this study was to investigate the effect of an off-the-shelf, medical-grade shoe on dorsal digital pressure and perceived comfort when compared to participant's own preferred shoe. Thirty participants (18 females, 12 males) scored their perceived comfort whilst wearing each footwear style using a visual analog comfort scale. Dorsal digital and interdigital pressures were measured in using the WalkinSense® in-shoe pressure system. Sensors were placed on predetermined anatomical landmarks on the digits. Participants were randomly assigned the test shoe and their own shoe. Once wearing the shoe, the participants walked across a 6 m walkway and pressure data from each sensor was collected and processed to obtain peak pressure, time to peak pressure and contact time. Participants scored the test shoe with higher comfort points than their own footwear. Overall peak pressure, pressure time integral and contact time decreased, whilst the time taken to reach peak pressure increased across all anatomical landmarks whilst wearing the test shoe. Statistically significant changes were observed for all of the measured variables relating to pressure on the medial border of the first metatarsophalangeal joint. The test shoe provided greater comfort and reduced the amount of pressure on the forefoot. The medical-grade footwear therefore, is a viable alternative to custom made prescription footwear and is more suitable than a

  2. Feasibility study of context-awareness device Comfort calculation methods and their application to comfort-based access control

    DEFF Research Database (Denmark)

    Guo, Jingjing; Jensen, Christian D.; Ma, Jianfeng


    , which captures a device's ability to secure and reason about its environment. Specifically, we study the feasibility of two device comfort calculation methods we proposed in previous work. We do trace driven simulations based on a large body of sensed data from mobile devices in the real world...... enforcement framework and show how to enforce our two methods using an existing security policy specification language....

  3. Efficacy of a novel educational curriculum using a simulation laboratory on resident performance of hysteroscopic sterilization. (United States)

    Chudnoff, Scott G; Liu, Connie S; Levie, Mark D; Bernstein, Peter; Banks, Erika H


    To assess whether a novel educational curriculum using a simulation teaching laboratory improves resident knowledge, comfort with, and surgical performance of hysteroscopic sterilization. An educational prospective, pretest/posttest study. The Montefiore Institute of Minimally Invasive Surgery Laboratory. PATIENT(S)/SUBJECT(S): Thirty-four OB/GYN residents in an academic medical center. Hysteroscopic sterilization simulation laboratory and a brief didactic lecture. Differences in scores on validated skill assessment tools: Task specific checklist, Global Rating Scale (GRS), pass fail assessment, and a multiple-choice examination to evaluate knowledge and attitude. In the entire cohort improvements were observed on all evaluation tools after the simulation laboratory, with 31% points (SD+/-11.5, 95% confidence interval [CI] 27.3-35.3) higher score on the written evaluation; 63% points (SD+/-15.7, 95% CI 57.8-68.8) higher score on the task specific checklist; and 54% points (SD+/-13.6, 95% CI 48.8-58.3) higher score on the GRS. Higher PGY status was correlated with better pretest performance, but was not statistically significant in posttest scores. Residents reported an improvement in comfort performing the procedure after the laboratory. Simulation laboratory teaching significantly improved resident knowledge, comfort level, and technical skill performance of hysteroscopic sterilization. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Burnout Syndrome During Residency. (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender


    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  5. Adapting residency training. Training adaptable residents. (United States)

    Bowen, J L


    Graduate medical education has been criticized for failing to adequately prepare young physicians to enter the workforce upon completion of their training. In addressing this criticism, the author makes arguments both for and against this assertion. Broad qualitative changes (graduate medical education training position allocation, subspecialists' role in health care delivery, educational quality, faculty development, and faculty promotion) that graduate medical education has undergone and is undergoing are discussed. Population health management, clinical resource management, teamwork, continuous quality improvement, ethics, and evidence-based medicine are addressed as important curricular elements for residency training. Innovations in graduate medical education that are being introduced as well as those that should be tried are discussed. Finally, the author asserts that although residency education should not be vocationally driven by the needs of managed care organizations, a powerful opportunity exists for collaborative educational research between academic medicine and managed care organizations. In a health care environment undergoing rapid changes, the primary goals of graduate medical education have not significantly changed: to produce compassionate physicians with a passion for lifelong learning who have leadership skills, are critical thinkers, skilled at self-assessment, and able to adapt to the needs of the health care marketplace.


    Directory of Open Access Journals (Sweden)

    Ionela MANIU


    Full Text Available The aim of this article is to investigate the factors that are influencing student satisfaction in case of neurology related massive open online courses (MOOCs. We analyzed data collected from learners enrolled in 40 neurology related MOOCs, by manually looking for information in these courses reviews. The main identified satisfaction factors can be grouped into the following categories: content related factors: course content, additional materials, assignments, external research and teaching - learning related factors (teacher presentation techniques / style: engaging, clear, coherent, knowledgeable, sharing / explanation, interactive, excitement, considering student’s needs, inspiring, sense of humor. Competences, skills and objectives pursued by neurology related MOOCs are also discussed. Analyzing these factors can be useful in new courses management (design and implementation and also in understanding the needs (motivation, behaviors, perception of 21st century learners interested in neurology related fields.

  7. [Voice disorders caused by neurological diseases]. (United States)

    Gamboa, J; Jiménez-Jiménez, F J; Mate, M A; Cobeta, I

    To review voice disorders in neurological diseases, with special emphasis to acoustic analysis. In the first part of this article we describe data regarding neural control of voice, physiology of phonation, and examination of the patient with voice disturbances, including the use of voice laboratory, acoustic analysis fundamentals, phonetometric measures and aerodynamic measures. In the second part, we review the voice disturbances associated to neurological diseases, emphasizing into movement disorders (specially Parkinson s disease, essential tremor, and spasmodic dysphonia). A number of neurological diseases causing alterations of corticospinal pathway, cerebellum, basal ganglia and upper and/or lower motoneurons can induce voice disturbances. Voice examination using ear, nose & throat examination, endoscopy and videorecording of laryngeal movements, acoustic analysis, elecroglottography, laryngeal electromyography, and aerodynamic measures, could be useful in the clinical examination of some neurological diseases.

  8. Axon guidance proteins in neurological disorders

    NARCIS (Netherlands)

    Van Battum, Eljo Y.; Brignani, Sara; Pasterkamp, R. Jeroen|info:eu-repo/dai/nl/197768814


    Many neurological disorders are characterised by structural changes in neuronal connections, ranging from presymptomatic synaptic changes to the loss or rewiring of entire axon bundles. The molecular mechanisms that underlie this perturbed connectivity are poorly understood, but recent studies

  9. Ketogenic diets, mitochondria, and neurological diseases

    National Research Council Canada - National Science Library

    Gano, Lindsey B; Patel, Manisha; Rho, Jong M


    The ketogenic diet (KD) is a broad-spectrum therapy for medically intractable epilepsy and is receiving growing attention as a potential treatment for neurological disorders arising in part from bioenergetic dysregulation...

  10. Transient Neurological Symptoms after Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Zehra Hatipoglu


    Full Text Available Lidocaine has been used for more than 50 years for spinal anesthesia and has a remarkable safety record. In 1993, a new adverse effect, transient neurologic toxicity was described in patients recovering from spinal anesthesia with lidocaine. Transient neurological symptoms have been defined as pain in the lower extremities (buttocks, thighs and legs after an uncomplicated spinal anesthesia and after an initial full recovery during the immediate postoperative period (less than 24 h. The incidence of transient neurological symptoms reported in prospective, randomized trials varies from 4% to 37%. The etiology of transient neurological symptoms remains unkonwn. Despite the transient nature of this syndrome, it has proven to be difficult to treat effectively. Drug or some interventional therapy may be necessary. [Archives Medical Review Journal 2013; 22(1.000: 33-44

  11. Severe hypernatremia: survival without neurologic sequelae

    National Research Council Canada - National Science Library

    Borrego Domínguez, R R; Imaz Roncero, A; López-Herce Cid, J; Seriñá Ramírez, C


    .... She had a convulsive crisis without subsequent neurologic impairment. The second patient, a 3-year-old girl with pseudohypoaldosteronism type I and encephalopathy, had hypernatremia (203 mEq/l...

  12. Diabetic cachectic neuropathy: An uncommon neurological ...

    African Journals Online (AJOL)

    access article is distributed under. Creative Commons licence CC-BY-NC 4.0. CASE REPORT. Diabetic cachectic neuropathy: An uncommon neurological complication of diabetes. A Iyagba, MBBS, FWACP, FMCP; A Onwuchekwa, MBBS, FMCP.

  13. Neurological Complications Of Chronic Myeloid Leukaemia: Any ...

    African Journals Online (AJOL)

    , of the neurological deficits complicating chronic myeloid leukaemia. Method: Using patients\\' case folders and haematological malignancy register all cases of chronic myeloid leukaemia seen in Jos University Teaching Hospital between July ...

  14. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested


    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...

  15. Dermatology referrals in a neurological set up


    Deeptara Pathak Thapa; Amit Thapa


    Introduction: Dermatology is a specialty, which not only deals with dermatological problems with outpatient but also inpatients referrals. The importances of Dermatologist in hospital setting are rising due to changing condition of medical care. Since no peer-reviewed articles are available for dermatological problems in a neurological set up, we conducted this study to know about pattern of skin disorders in neurological patients. Material and Methods: The present study was a prospectiv...


    African Journals Online (AJOL)

    Les principaux diagnostics étaient: un Accident vasculaire cérébral (42,1%), un abcès cérébral (17,9%) et une méningo-encéphalite (ME) dans 11,9%. ... Death risk was in the one hand higher for neurological infectious than for stroke and in the second hand higher for neurological infectious than for all other diseases.

  17. Chicken soup really is good for the soul: "comfort food" fulfills the need to belong. (United States)

    Troisi, Jordan D; Gabriel, Shira


    Theories of social surrogacy and embodied cognition assume that cognitive associations with nonhuman stimuli can be affectively charged. In the current research, we examined whether the "comfort" of comfort foods comes from affective associations with relationships. Two experiments support the hypotheses that comfort foods are associated with relationships and alleviate loneliness. Experiment 1 found that the consumption of comfort foods automatically activates relationship-related concepts. Experiment 2 found that comfort foods buffer against belongingness threats in people who already have positive associations with relationships (i.e., are secure in attachment style). Implications for social surrogacy, need to belong, embodied cognition, and eating behavior are discussed.

  18. Effectiveness of cross-cultural education for medical residents caring for burmese refugees. (United States)

    McHenry, Megan Song; Nutakki, Kavitha; Swigonski, Nancy L


    Limited resources are available to educate health professionals on cultural considerations and specific healthcare needs of Burmese refugees. The objective of this study was to determine the effectiveness of a module focused on cross-cultural considerations when caring for Burmese refugees. A brief educational module using anonymously tracked pre- and post-intervention, self-administered surveys was developed and studied. The surveys measured pediatric and family medicine residents' knowledge, attitudes, and comfort in caring for Burmese refugees. Paired t-tests for continuous variables and Fisher's exact tests for categorical variables were used to test pre- and post-intervention differences. We included open-ended questions for residents to describe their experiences with the Burmese population. The survey was available to 173 residents. Forty-four pre- and post-intervention surveys were completed (response rate of 25%). Resident comfort in caring for Burmese increased significantly after the module (P = 0.04). Resident knowledge of population-specific cultural information increased regarding ethnic groups (P = 0.004), appropriate laboratory use (P = 0.04), and history gathering (P = 0.001). Areas of improved resident attitudes included comprehension of information from families (P = 0.03) and length of time required with interpreter (P = 0.01). Thematic evaluation of qualitative data highlighted four themes: access to interpreter and resources, verbal communication, nonverbal communication, and relationship building with cultural considerations. A brief intervention for residents has the potential to improve knowledge, attitudes, and comfort in caring for Burmese patients. Interventions focused on cultural considerations in medical care may improve cultural competency when caring for vulnerable patient populations.

  19. Neurological Disorders in Adult Celiac Disease

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman


    Full Text Available Celiac disease may initially present as a neurological disorder. Alternatively, celiac disease may be complicated by neurological changes. With impaired nutrient absorption, different deficiency syndromes may occur and these may be manifested clinically with neurological changes. However, in patients with deficiency syndromes, extensive involvement of the small intestine with celiac disease is often evident. There are a number of reports of celiac disease associated with neuropathy, ataxia, dementia and seizure disorder. In these reports, there is no clear relationship with nutrient deficiency and a precise mechanism for the neurological changes has not been defined. A small number of patients have been reported to have responded to vitamin E administration, but most do not. In some, gluten antibodies have also been described, especially in those with ataxia, but a consistent response to a gluten-free diet has not been defined. Screening for celiac disease should be considered in patients with unexplained neurological disorders, including ataxia and dementia. Further studies are needed, however, to determine if a gluten-free diet will lead to improvement in the associated neurological disorder.

  20. EEG in Sarcoidosis Patients Without Neurological Findings. (United States)

    Bilgin Topçuoğlu, Özgür; Kavas, Murat; Öztaş, Selahattin; Arınç, Sibel; Afşar, Gülgün; Saraç, Sema; Midi, İpek


    Sarcoidosis is a multisystem granulomatous disease affecting nervous system in 5% to 10% of patients. Magnetic resonance imaging (MRI) is accepted as the most sensitive method for detecting neurosarcoidosis. However, the most common findings in MRI are the nonspecific white matter lesions, which may be unrelated to sarcoidosis and can occur because of hypertension, diabetes mellitus, smoking, and other inflammatory or infectious disorders, as well. Autopsy studies report more frequent neurological involvement than the ante mortem studies. The aim of this study is to assess electroencephalography (EEG) in sarcoidosis patients without neurological findings in order to display asymptomatic neurological dysfunction. We performed EEG on 30 sarcoidosis patients without diagnosis of neurosarcoidosis or prior neurological comorbidities. Fourteen patients (46.7%) showed intermittant focal and/or generalized slowings while awake and not mentally activated. Seven (50%) of these 14 patients with EEG slowings had nonspecific white matter changes while the other half showed EEG slowings in the absence of MRI changes. We conclude that EEG slowings, when normal variants (psychomotor variant, temporal theta of elderly, frontal theta waves) are eliminated, may be an indicator of dysfunction in brain activity even in the absence of MRI findings. Hence, EEG may contribute toward detecting asymptomatic neurological dysfunction or probable future neurological involvement in sarcoidosis patients. © EEG and Clinical Neuroscience Society (ECNS) 2016.