Sample records for neurology residents comfortable
-
Education research: a case-based bioethics curriculum for neurology residents.
Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth
2015-03-31
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.
-
Adult neurology training during child neurology residency.
Schor, Nina F
2012-08-21
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.
-
Education Research: Neurology resident education
Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John
2016-01-01
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
-
Neurocritical care education during neurology residency
Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.
2012-01-01
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
-
Child Neurology Education for Pediatric Residents.
Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D
2017-03-01
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.
-
Are the French neurology residents satisfied with their training?
Codron, P; Roux, T; Le Guennec, L; Zuber, M
2015-11-01
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.
-
Problem neurology residents: a national survey.
Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J
2011-06-14
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.
-
Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John
2012-10-23
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.
-
Results of the American Academy of Neurology resident survey.
Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R
2011-03-29
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.
-
Jordan, Justin T; Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M; Engstrom, John
2016-03-15
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.
-
George, Pravin; Newey, Christopher R; Bhimraj, Adarsh
2015-01-01
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.
-
Milestone-compatible neurology resident assessments: A role for observable practice activities.
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
2015-06-02
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.
-
Neurocritical care education during neurology residency: AAN survey of US program directors.
Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W
2012-05-29
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.
-
Ambulatory Care Skills: Do Residents Feel Prepared?
Directory of Open Access Journals (Sweden)
Denise Bonds
2002-10-01
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.
-
Challenges to neurology residency education in today's health care environment.
Bega, Danny; Krainc, Dimitri
2016-09-01
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.
-
Residency Training: Determinants of burnout of neurology trainees in Attica, Greece.
Zis, Panagiotis; Artemiadis, Artemios K; Lykouri, Maria; Xirou, Sophia; Roussopoulou, Andromachi; Papageorgiou, Ermioni; Bakola, Eleni; Anagnostopoulos, Fotios
2015-09-15
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.
-
Lai, Hung-Yi; Lee, Ching-Yi; Chiu, Angela; Lee, Shih-Tseng
2014-01-01
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.
-
Jordan, Justin T; Sellner, Johann; Struhal, Walter; Schneider, Logan; Mayans, David
2014-04-08
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.
-
Residency Training: Work engagement during neurology training.
Zis, Panagiotis; Anagnostopoulos, Fotios; Artemiadis, Artemios K
2016-08-02
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.
-
Education in Neurology Resident Documentation Using Payroll Simulation.
Liang, John W; Shanker, Vicki L
2017-04-01
Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. To improve the quality of neurology resident documentation through payroll simulation. A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback "paystubs" every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits ( P < .001), with a reduction in the financial loss to 6% ($1,880). Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.
-
Residency Training: The need for an integrated diversity curriculum for neurology residency.
Rosendale, Nicole; Josephson, S Andrew
2017-12-12
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.
-
Directory of Open Access Journals (Sweden)
Amoako AO
2015-03-01
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
-
International Nuclear Information System (INIS)
Jaffar, S.; Tayyab, A.; Shah, S.S.; Naseem, S.; Ghazanfar, H.
2016-01-01
Background: Ophthalmological conditions are frequently encountered in almost all clinical specialties. Assessing the adequacy of ophthalmology teaching in undergraduate medical education is important in order to diagnose and manage different ophthalmological conditions. The objective of this study was to determine the comfort level of post graduate residents working in different clinical domains in managing common ophthalmic conditions. Methods: A cross sectional survey involving 277 post graduate residents was carried out over a period of six months in both private and public tertiary care hospital. A questionnaire containing two sections and 17 variables in total were distributed among Medical Residents of different specialties except ophthalmology residents. Participants of the study were selected through consecutive non probability sampling. Results: Mean hours of classroom based ophthalmology instruction during during undergraduate program was 59.38 hours (55.9) and mean hours of clinical based ophthalmology instruction during undergraduate program was 62.73 hours (60.8) 54 percentage were either not comfortable or somewhat comfortable in managing common ophthalmic condition. Conclusion: Teaching hours in under graduate program meet or exceed requisite criteria. However graduating doctors generally feel that the time spent does not provide them with the comfort and skill level required to care for patients with ocular presentations. (author)
-
Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016.
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
2017-08-01
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.
-
Teixeira-Poit, Stephanie; Kane, Heather L.; Frost, A. Corey; Keating, Michael; Olmsted, Murrey
2014-01-01
Background: Although detailed knowledge regarding treatment options for multiple sclerosis (MS) patients is largely limited to neurologists, shortages in the neurologist workforce, including MS subspecialists, are predicted. Thus, MS patients may have difficulties in gaining access to appropriate care. No systematic evaluation has yet been performed of the number of neurology residents planning to pursue MS subspecialization. This study identifies factors affecting interest in providing MS patient care or MS subspecialization among current neurology residents. Methods: We randomly selected half of all Accreditation Council of Graduate Medical Education–certified neurology residency programs in the continental United States to receive the neurology resident survey. Completed surveys were received from 218 residents. Results: Residents were significantly more likely to have increased interest in MS care when they participated in MS research, were interested in teaching, and indicated that the “ability to improve patient outcomes and quality of life” was a positive factor influencing their desire to provide MS patient care. Residents who were interested in providing MS care, interested in teaching, and indicated that “research opportunities” was a positive factor for providing MS patient care were significantly more likely to express interest in MS subspecialization. Conclusions: Increasing opportunities to interact with MS patients, learn about MS care, and participate in MS research may increase interest in MS care and subspecialization among neurology residents. Opportunities to educate residents regarding MS patient care may affect residents’ attitudes. PMID:24688352
-
Reardon, Claudia L.; Walaszek, Art
2012-01-01
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…
-
Child neurology residency: system implications of new training models.
Heiser, Karen
2012-02-01
From limitations on residents' duty hours, to ways in which outcomes are measured, changes to graduate medical education are sweeping the nation. In this issue of the journal, Gilbert and Greenwood present thoughtful, if somewhat disparate, opinions on ways to improve the educational experience of child neurology trainees. As the Designated Institutional Officer of a large children's hospital, I have focused my commentary on "the big picture." That is, what systemwide impact can changes in child neurology trainees' education have.
-
A dedicated scholarly research program in an adult and pediatric neurology residency program.
Robbins, Matthew S; Haut, Sheryl R; Lipton, Richard B; Milstein, Mark J; Ocava, Lenore C; Ballaban-Gil, Karen; Moshé, Solomon L; Mehler, Mark F
2017-04-04
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.
-
Hayes, Victoria; Blondeau, Whitney; Bing-You, Robert G
2015-05-01
Sexual health is an important aspect of overall health. Barriers to taking an adequate patient sexual history exist. Few studies have explored medical learners' comfort, knowledge, and training surrounding taking sexual histories with lesbian, gay, bisexual, transgender, questioning/queer (LGBTQ) patients specifically. A 10-question survey was offered to medical students and resident/fellows at one US institution. Survey questions reflected participants' knowledge, comfort, and training related to sexual history taking with attention to LGBTQ care. A total of 159 surveys were returned (rate of 42%). A significantly lower level of comfort existed with taking sexual histories and managing sexual health issues in the LGBTQ segment of the patient population versus all patients, especially in the advanced training group. Participants recognized the importance of understanding their patients' overall sexual health, though medical students rated this as more important than the resident/fellow group did. A correlation existed between both comfort with taking sexual histories and discussing safe sexual practices and management of sexual issues, suggesting that further training would be helpful in this area. Twenty percent of the respondents reported receiving no training at all in eliciting sexual histories in LGBTQ patients. The most preferred format in this study for future training was interviewing standardized patients. Medical students and resident/fellows reported a significantly lower level of comfort with sexual history-taking and management of sexual issues in the LGBTQ population. A comprehensive training format that not only views sexual health as an integral part of overall patient health, but also integrates LGBTQ care, is needed in medical education.
-
Schuh, L A; Khan, M A; Harle, H; Southerland, A M; Hicks, W J; Falchook, A; Schultz, L; Finney, G R
2011-08-30
To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs. This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary. Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life. The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.
-
Gupta, Deepak K; Khandker, Namir; Stacy, Kristin; Tatsuoka, Curtis M; Preston, David C
2017-10-01
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
-
Sleep and fatigue countermeasures for the neurology resident and physician.
Avidan, Alon Y
2013-02-01
Fragmented sleep, prolonged work hours, misalignment of sleep-wake cycles, and an expectation to make medical decisions when alertness levels are reduced are pervasive in neurology residency training. Sleep loss in residency training can lead to cognitive and psychosocial impairment and accidents, compromise patient care, and reduce the trainee's quality of life. Neurology residents experience levels of hypersomnolence similar to residents in surgical specialties and have comparable subjective levels of sleepiness as persons with pathologic sleep disorders such as narcolepsy and obstructive sleep apnea. Over the past 2 decades, work-hour limitations were established to alleviate fatigue and sleepiness. However, the implementation of work-hour limitations alone does not guarantee alleviation of fatigue and may be insufficient without additional key measures to prevent, counteract, and control sleepiness when it strikes. This article provides effective strategies to combat sleepiness, such as modification of the on-call structure (night float), power naps, and caffeine, in neurologists in training and those who are at risk for excessive sleepiness. Despite two specific work-hour restrictions set by the Accreditation Council for Graduate Medical Education, the most recent in July 2011, little data exist about the efficacy of work-hour restrictions alone in improving fatigue and sleepiness. Curtailed work hours, while appearing attractive on the surface, have important financial, educational, and patient care imperfections and fail to address the core issue--sleepiness. Historically, sleepiness and fatigue place both residents and patients at risk. Excessive sleepiness in residency training occurs because of sleep deprivation and a spectrum of other factors, such as mood disorders or even the anxiety of anticipating being woken up. An effective model to counteract sleep deprivation and its consequences is a multiplayer approach that uniquely targets and addresses the
-
Sun, Chenjing; Qi, Xiaokun
2018-01-01
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.
-
Procedural Headache Medicine in Neurology Residency Training: A Survey of US Program Directors.
Robbins, Matthew S; Robertson, Carrie E; Ailani, Jessica; Levin, Morris; Friedman, Deborah I; Dodick, David W
2016-01-01
To survey neurology residency program directors (PDs) on trainee exposure, supervision, and credentialing in procedures widely utilized in headache medicine. Clinic-based procedures have assumed a prominent role in headache therapy. Headache fellows obtain procedural competence, but reliance on fellowship-trained neurologists cannot match the population eligible for treatments. The inclusion of educational modules and mechanisms for credentialing trainees pursuing procedural competence in residency curricula at individual programs is not known. A web-based survey of US neurology residency PDs was designed by the American Headache Society (AHS) procedural special interest section in collaboration with AHS and American Academy of Neurology's Headache and Facial Pain section leadership. The survey addressed exposure, training, and credentialing in: (1) onabotulinumtoxinA (onabotA) injections, (2) extracranial peripheral nerve blocks (PNBs), and (3) trigger point injections (TPIs). Fifty-five PDs (42.6%) completed the survey. Compared to noncompleters, survey completers were more likely to feature headache fellowships at their institutions (38.2% vs 10.8%, P=0.0002). High exposure (onabotA=90.9%, PNBs=80.0%, TPIs=70.9%) usually featured hands-on patient instruction (66.2%) and lectures (55.7%). Supervised performance rates were high (onabotA=65.5%, PNBs=60.0%, TPIs=52.7%), usually in continuity clinic (60.0%) or headache elective (50.9%). Headache specialists (69.1%) or general neurology (32.7%) faculty most commonly trained residents. Formal credentialing was uncommon (16.4-18.2%), mostly by documenting supervised procedures (25.5%). Only 27.3% of programs permitted trainees to perform procedures independently. Most PDs felt procedural exposure (80.0-90.9%) and competence (50.9-56.4%) by all trainees was important. Resident exposure to procedures for headache is high, but credentialing mechanisms, while desired by most PDs, are not generally in place. Implementation
-
Pinto Zipp, Genevieve; Maher, Catherine; Donnelly, Erin; Fritz, Brian; Snowdon, Lauren
2016-01-01
Creating curriculums that develop physical therapy (PT) students into evidenced-based, critically reflective, entry-level practitioners is one of the primary goals for PT programs. Academic faculty partnering with neurologic residency programs to design learning environments that capitalize upon the strengths of both can create insightful educational experiences for students during their didactic training. These partnerships support the development of critical thinking skills and provide mentorship for residents transitioning from their role as a clinician to that of an educator. Using the SOLO (structure of observed learning outcomes) taxonomy as a framework for developing learning experiences, Seton Hall University neurologic academic faculty and program directors from the Kessler Institute for Rehabilitation Residency in Neurologic Physical Therapy have built a partnership that seeks to develop critical reflection skills in both the neurologic resident and entry-level PT students. While integration of residents into entry-level PT curriculum may not be novel, we believe that utilizing the SOLO model within this partnership is unique. This paper describes the partnership and learning experiences rooted in the SOLO taxonomy theoretical framework and discusses perceived benefits of this learning experience across professional health science programs.
-
Floor heating maximizes residents` comfort
Energy Technology Data Exchange (ETDEWEB)
Tirkkanen, P.; Wikstroem, T.
1996-11-01
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.)
-
Education Research: Neurology training reassessed
Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John
2012-01-01
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
-
Zafar, Saman; Cardenas, Ylec Mariana; Leishangthem, Lakshmi; Yaddanapudi, Sridhara
2018-05-08
Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We were enthusiastic to replicate the success of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study in our neurology department, but encountered problems in terms of cost, setup, feasibility, and portability of the device. As neurology residents, we came up with 3 easier options. We present these 3 options as our personal experience, and hope to reignite enthusiasm among neurology trainees to find their own means of performing ophthalmoscopy routinely in the hospital, as it appears that the Internet market is now thriving with many other devices to make this examination easier and more rewarding. Of the options explored above, the Handheld Fundus Camera was a clear favorite among the residents, and we have placed one in our call room for routine use. It travels to the clinic, floor, intensive care unit, and ED when needed. It has enhanced the way we approach the fundus examination and been a fun skill to acquire. We look forward to further advances that will make it possible to carry such a device in a physician's pocket. © 2018 American Academy of Neurology.
-
Shmidt, I R; Sayapin, V S; Van, V Ch; Van, L V; Malevik, V F; Zhestikova, M G; Podkhomutnikova, O V
2003-05-01
We performed clinical and epidemiological study of 1508 residents living in the southern Altai Mountains and belonging to two subethnic groups (Telengite and Altai Kizhi). The incidence of neurological manifestations of vertebral osteochondrosis in people older than 17 years was 627.6 26.4%. The results show that genetic factors (hereditary polygenic predisposition) play a major role in the development of neurological manifestations of vertebral osteochondrosis. Premorbid state of the organism and diseases of various organs and systems promote the development of this neurological disorder.
-
Saunders, J; Gopalan, P; Puri, N; Azzam, P N; Zhou, L; Ghinassi, F; Jain, A; Travis, M; Ryan, N D
2015-12-01
Psychiatric education for non-psychiatric residents varies between training programs, and may affect resident comfort with psychiatric topics. This study's goals were to identify non-psychiatric residents' comfort with psychiatric topics and to test the effectiveness of a video intervention. Residents in various departments were given a survey. They were asked to rank their comfort level with multiple psychiatric topics, answer questions about medical decision making capacity (MDMC), watch a 15-min video about MDMC, and answer a post-test section. In total, 91 Internal Medicine, General Surgery, and Obstetrics and Gynecology residents responded to the study. Of the 91 residents, 55 completed the pre- and post-test assessments. There was no significant difference in correct responses. Residents' comfort levels were assessed, and a significant improvement in comfort level with MDMC was found. This study highlights potential opportunities for psychiatric education, and suggests brief video interventions can increase resident physicians' comfort with a psychiatric topic.
-
McKillip, Ryan; Ernst, Michael; Ahn, James; Tekian, Ara; Shappell, Eric
2018-04-26
Introduction Resident financial health has been linked to wellness and resiliency, yet financial literacy among residents is highly variable. While some medical school curricula include budgeting and student loan education, content on managing finances as a resident is usually lacking. We sought to quantitatively assess residents' financial circumstances, needs, and interests to inform the design of a resident personal finance curriculum. Methods Surveys were sent to residents in eight specialties at an academic medical center. Likert-type responses allowed respondents to rate their level of comfort (1 = Very Uncomfortable, 7 = Very Comfortable) and interest (1 = Very Uninterested, 7 = Very Interested) in various personal finance topics including budgeting, loan repayment, disability insurance, life insurance, home buying, and retirement planning. Details regarding financial circumstances, including assets, liabilities, and insurance, were also collected. Results of questions that utilized a Likert-type scale are reported as median (interquartile range). Results Of 346 residents surveyed, 144 (41.6%) responded. Residents were from Internal Medicine (56, 38.9%), Pediatrics (34, 23.6%), Emergency Medicine (18, 12.5%), and other specialties (36, 25.0%). Ninety-one (63.2%) reported educational loans, with an average balance of $191,730. Credit card balances exceeding $3,000 were reported by 11 (7.6%) respondents. One-hundred-two (70.1%) reported emergency savings, but only 65 (45.1%) reported having a retirement account (average balance $27,608). Respondents rated highest comfort levels with budgeting (5[4-6]), and lowest level of comfort with disability insurance (2[2-4]) and home buying (2[2-5]). Interest in learning each topic was high (6[5-7]), with retirement planning (6[5-7]), investing (6[5-7]), and home buying (6[5-7]) the topics of highest interest. Conclusion These results highlight the deficits in personal finance literacy among residents. Future work should
-
Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.
Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L
2016-04-01
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
-
International electives in neurology training
Lyons, Jennifer L.; Coleman, Mary E.; Engstrom, John W.
2014-01-01
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
-
Directory of Open Access Journals (Sweden)
Hom B. Rijal
2015-09-01
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.
-
Peer observation and feedback of resident teaching.
Snydman, Laura; Chandler, Daniel; Rencic, Joseph; Sung, Yung-Chi
2013-02-01
Resident doctors (residents) play a significant role in the education of medical students. Morning work rounds provide an optimal venue to assess resident teaching. The purpose of this study was to assess the feasibility of peer observation of resident work rounds, to evaluate resident perceptions of peer observation and to evaluate resident perceptions of peer feedback. Twenty-four internal medicine residents were simultaneously observed by an attending physician and a peer while teaching during work rounds (between August2008 and May 2009). At year-end, residents received a survey to characterise their attitudes towards peer observation and feedback. Twenty-one residents (87.5%) completed the survey. Half (52.4%) felt that participating in the peer observation study stimulated their interest in teaching during work rounds. Prior to participation in the study, fewer than half (42.9%) felt comfortable being observed by their peers, compared with 71.4 percent after participation (p=0.02). The proportion of residents who felt comfortable giving feedback to peers increased from 26.3 to 65.0percent (p=0.004), and the proportion of residents who felt comfortable receiving feedback from peers increased from 76.2 to 95.2 percent (p=0.02). Peer observation and feedback of resident teaching during work rounds is feasible and rewarding for the residents involved. Comfort with regards to being observed by peers, with receiving feedback from peers and with giving feedback to peers significantly increased after the study. Most residents reported changes in their teaching behaviour resulting from feedback. Residents felt that observing a peer teach on work rounds was one of the most useful activities to improve their own teaching on work rounds. © Blackwell Publishing Ltd 2013.
-
Doja, Asif; Clarkin, Chantalle; Whiting, Sharon; Moharir, Mahendranath
2016-07-01
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.
-
Why neurology? Factors which influence career choice in neurology.
Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V
2016-01-01
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.
-
The popularity of neurology in Spain: An analysis of specialty selection.
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
2017-12-23
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.
-
Energy Technology Data Exchange (ETDEWEB)
Boerstra, A.C.; Haans, L. [BBA Boerstra Binnenmilieu Advies, Rotterdam (Netherlands)
2004-08-01
Sometimes engineers lose sight of why both the private and business sectors are willing to spend so much money on heating and ventilation systems. The main drive for the average Dutch person's day-to-day investment in his or her indoor environment resides in the trinity of comfort, health and productivity. This article present an update on current ideas about the three unique selling points of HVAC systems. [Dutch] Soms wordt uit het oog verloren waarom zowel de particuliere als de zakelijke markt zoveel geld over heeft voor installaties. De grootste drijfveer die de gemiddelde Nederlander heeft voor zijn of haar dagelijkse binnenmilieu-investering, is te vinden in de drie-eenheid: comfort, gezondheid en productiviteit. In dit artikel wordt een overzicht gegeven van de laatste inzichten waar het deze drie aspecten van klimaatinstallaties betreft.
-
Palaszewski, Dawn M; Miladinovic, Branko; Caselnova, Petra M; Holmström, Shelly W
2016-12-01
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.
-
Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha
2015-10-16
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.
-
Health and thermal comfort: From WHO guidance to housing strategies
International Nuclear Information System (INIS)
Ormandy, David; Ezratty, Véronique
2012-01-01
There are many references to the WHO guidance on thermal comfort in housing, but not to the original source material. Based on archive material, this paper gives the evidential basis for the WHO guidance. It then reports on evidence that some groups may be more susceptible to high or low indoor temperatures than others. It examines different methods for measuring thermal comfort, such as air temperature measurement, assessing residents' perception, and predicting satisfaction. Resident's perception was used effectively in the WHO LARES project, showing that self-reported poor health was significantly associated with poor thermal comfort. Tools to inform strategies directed at dealing with cold homes and fuel poverty are considered, including Energy Performance Certificates, Fuel Poverty Indicators, and the English Housing Health and Safety Rating System. Conclusions from a WHO Workshop on Housing, Energy and Thermal Comfort are also summarised. The WHO view of thermal comfort, which is driven by protecting health from both high and low indoor temperatures, should be recognised in energy efficiency, fuel poverty and climate change strategies. While this is a major challenge, it could provide both health gains for individuals, and economic benefits for society. - Highlights: ► WHO guidance on thermal comfort is directed to protecting health in the home environment. ► In particular, the WHO guidance aims to protect the health of the most susceptible and fragile. ► Housing energy efficiency strategies protect health, and attack inequities. ► Housing energy efficiency strategies also have economic benefits for society.
-
MIT-Skywalker: Evaluating comfort of bicycle/saddle seat.
Goncalves, Rogerio S; Hamilton, Taya; Daher, Ali R; Hirai, Hiroaki; Krebs, Hermano I
2017-07-01
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.
-
Field study of thermal comfort in non-air-conditioned buildings in a tropical island climate.
Lu, Shilei; Pang, Bo; Qi, Yunfang; Fang, Kun
2018-01-01
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.
-
Comfort and experience with online learning: trends over nine years and associations with knowledge.
Cook, David A; Thompson, Warren G
2014-07-01
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.
-
Kassardjian, Charles D; Williamson, Michelle L; van Buskirk, Dorothy J; Ernste, Floranne C; Hunderfund, Andrea N Leep
2015-07-14
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.
-
Effectiveness of a 2-year menopause medicine curriculum for obstetrics and gynecology residents.
Christianson, Mindy S; Washington, Chantel I; Stewart, Katherine I; Shen, Wen
2016-03-01
Previous work has shown American obstetrics and gynecology (OB/GYN) residents are lacking in menopause training. Our objective was to assess the effectiveness of a 2-year menopause medicine curriculum in improving OB/GYN residents' knowledge and self-assessed competency in menopause topics. We developed a menopause medicine-teaching curriculum for OB/GYN residents at our academic hospital-based residency program. The 2-year curriculum was composed of year 1: four 1-hour lectures and one 2-hour lab with cases presentations, and year 2: three 1-hour lectures and one 2-hour lab. Core topics included menopause physiology, hormone therapy, breast health, bone health, cardiovascular disease, and autoimmune disease. Pre- and posttests assessed resident knowledge and comfort in core topics, and a pre- and postcurriculum survey assessed utility and learning satisfaction. From July 2011 to June 2013, 34 OB/GYN residents completed the menopause curriculum annually with an average attendance at each module of 23 residents. Pre-/posttest scores improved from a mean pretest score of 57.3% to a mean posttest score of 78.7% (P menopause patients with 75.8% reporting feeling "barely comfortable" and 8.4% feeling "not at all comfortable." After the 2-year curriculum, 85.7% reported feeling "comfortable/very comfortable" taking care of menopause patients. The majority of residents (95.2%) reported the menopause curriculum was "extremely useful." A 2-year menopause medicine curriculum for OB/GYN residents utilizing lectures and a lab with case studies is an effective modality to improve resident knowledge required to manage menopause patients.
-
Directory of Open Access Journals (Sweden)
Brenda J Walker
2012-12-01
Full Text Available Introduction: We determined if targeted education of emergency physicians (EPsregarding the treatment of mental illness will improve their comfort level in treatingpsychiatric patients boarding in the emergency department (ED awaiting admission.Methods: We performed a pilot study examining whether an educational interventionwould change an EP’s comfort level in treating psychiatric boarder patients (PBPs. Weidentified a set of psychiatric emergencies that typically require admission or treatmentbeyond the scope of practice of emergency medicine. Diagnoses included majordepression, schizophrenia, schizoaffective disorder, bipolar affective disorder, generalanxiety disorder, suicidal ideation, and criminal behavior. We designed equivalentsurveys to be used before and after an educational intervention. Each survey consistedof 10 scenarios of typical psychiatric patients. EPs were asked to rate their comfort levelsin treating the described patients on a visual analogue scale. We calculated summaryscores for the non intervention survey group (NINT and intervention survey group (INTand compared them using Student’s t-test.Results: Seventy-nine percent (33/42 of eligible participants completed the preinterventionsurvey (21 attendings, 12 residents and comprised the NINT group. Fiftyfivepercent (23/42 completed the post-intervention survey (16 attendings, 7 residentscomprising the INT group. A comparison of summary scores between ‘NINT’ and ‘INT’groups showed a highly significant improvement in comfort levels with treating thepatients described in the scenarios (P = 0.003. Improvements were noted on separateanalysis for faculty (P = 0.039 and for residents (P = 0.012. Results of a sensitivityanalysis excluding one highly significant scenario showed decreased, but still importantdifferences between the NINT and INT groups for all participants and for residents, butnot for faculty (all: P = 0.05; faculty: P = 0.25; residents: P = 0
-
Trends in neurology fellowship training
Institute of Scientific and Technical Information of China (English)
Jordan S.A. Williams; Trent S. Hodgson; Fernando D. Goldenberg; Rimas V. Lukas
2017-01-01
Aim:Aneed for Neurologists exists in the USA.The majority of Neurology residency graduates go on to additional subspecialty training. Methods: Data from the Accreditation Council for Graduate Medical Education from 2001-2014 and the United Council for Neurologic Subspecialties from was analyzed for trends in the number of Neurology subspecialty training programs and their composition. Results: There has been an overall trend of growth in the number of accredited Neurology subspecialty training programs and fellows. These trends vary between specific subspecialties. Conclusion: The authors provide an overview of the contemporary state of Neurology subspecialty training in the USA. A clearer understanding of subspecialty training allows for anticipation of workforce surpluses and deficits.
-
Materialities shape practices and notions of comfort in everyday life
DEFF Research Database (Denmark)
Madsen, Line Valdorff
2018-01-01
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...... 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...... 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...
-
Quantitative Description of Medical Student Interest in Neurology and Psychiatry.
Ramos, Raddy L; Cuoco, Joshua A; Guercio, Erik; Levitan, Thomas
2016-07-01
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, Pneurology and psychiatry 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 medical
-
Simulation-based education with mastery learning improves residents' lumbar puncture skills
Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.
2012-01-01
Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080
-
Directory of Open Access Journals (Sweden)
Rosemary Kennedy
2015-06-01
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.
-
Top five craniofacial techniques for training in plastic surgery residency.
Fan, Kenneth; Kawamoto, Henry K; McCarthy, Joseph G; Bartlett, Scott P; Matthews, David C; Wolfe, S Anthony; Tanna, Neil; Vu, Minh-Thien; Bradley, James P
2012-03-01
Despite increasing specialization of craniofacial surgery, certain craniofacial techniques are widely applicable. The authors identified five such craniofacial techniques and queried American Society of Plastic Surgeons members and plastic surgery program directors regarding their comfort level with the procedures and their opinion on resident training for these selected procedures. First, a select group of senior craniofacial surgeons discussed and agreed on the top five procedures. Second, active American Society of Plastic Surgeons were surveyed regarding their opinion on training and their comfort level with each procedure. Third, plastic surgery residency program directors were studied to see which of the top five procedures are taught as part of the plastic surgery residency curriculum. The top five widely applicable craniofacial procedures are technically described and include the following: (1) cranial or iliac bone graft for nasal reconstruction, (2) perialar rim bone graft, (3) lateral canthopexy, (4) osseous genioplasty, and (5) bone graft harvest for orbital floor defects. For practicing plastic surgeons, comfort level in all procedures increased with advancing years in practice (except those with 75 percent), especially those with craniofacial fellowship training, felt competent in all procedures except osseous genioplasty (53 percent). Plastic surgery program directors agreed that all top five procedures should be mastered by graduation. Although program directors felt that all five selected craniofacial procedures should be taught and mastered during residency training, plastic surgeons without craniofacial fellowship training were less comfortable with the techniques. Residency training goals should include competence in core craniofacial techniques.
-
Cosmetic Surgery Training in Plastic Surgery Residency Programs
Directory of Open Access Journals (Sweden)
Colton H. L. McNichols, MD
2017-09-01
Conclusions:. 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.
-
Interactive drama in complex neurological disability management
Fenech, Anne
2009-01-01
Purpose. To establish whether interactive drama has any effect on the responses of people with complex neurological disabilities resident in a long term care facility. Method. This was a service evaluation using interviews with a group of 31 independently consenting long term care residents, and 27
-
Perception of pediatric neurology among non-neurologists.
Jan, Mohammed M S
2004-01-01
Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.
-
The development and evaluation of a trauma curriculum for psychiatry residents.
Ferrell, Noor Jarun; Melton, Bengi; Banu, Sophia; Coverdale, John; Valdez, M Renee
2014-10-01
This study aims to briefly describe a curriculum on trauma in order to help other educators in their own planning and development of teaching on trauma. The 12-week course was offered to third-year psychiatry residents as part of their didactics scheduling. The classes included information on a wide variety of types of trauma including natural disasters, childhood trauma, refugee trauma, survivors of torture, intimate partner violence, and military sexual trauma. The course also offered techniques in therapy informed by transference and countertransference along with role-playing activities with the resident participants. Residents completed a pre- and postcourse survey in order to assess the attitudes, comfort, and knowledge in screening for trauma exposure. The proportion of residents who reported that it was very important to screen for trauma increased. Similarly, the proportion of residents who indicated they now screen for trauma increased as well. However, these were nonsignificant changes. There was no change in the proportion of residents who felt comfortable assessing for trauma before and after the curriculum. Even after the course, almost half of the respondents reported that they were still not comfortable in asking about refugee's experience of trauma or torture More residents reported that they screen for trauma after the curriculum. An ongoing development and evaluation of model curricula including possible expansion across specialties and health-care disciplines is warranted for this critically important topic area.
-
Canadian Paediatric Neurology Workforce Survey and Consensus Statement.
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
2016-05-01
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.
-
Pharmacy resident-led student mentoring program: A focus on developing mentoring skills.
Howard, Meredith L; Steuber, Taylor D; Nisly, Sarah A; Wilhoite, Jessica; Saum, Lindsay
2017-11-01
Formalized mentoring programs are often credited for influencing professional development of mentees. Unfortunately, little information exists regarding advancement of mentoring skills. We report the development and evaluation of a program to cultivate mentoring skills in pharmacy residents. Advanced pharmacy practice experience students and pharmacy residents were contacted for program participation. Resident mentors were paired with a student mentee for the program. Mentors were provided resources and support throughout the program. Sessions were held to facilitate mentoring relationships and to discuss professional development topics. Pre- and post-perception surveys were administered to mentors to measure changes in mentoring comfort and ability. Only matched pre- and post-surveys were included for analysis. The program was held and evaluated over two separate academic years FINDINGS: Fifty-three residents mentored 54 students over two cycles of the program. Mentors' matched perception surveys (n = 26) reported increased comfort in mentoring (p effectiveness in provision of written and oral feedback (p = 0.004 and p = 0.013 respectively). Mentors also reported heightened belief that serving as a student mentor will be beneficial to their long-term career goals (p = 0.034). Overall, this formal resident-led student mentoring program improved resident comfort serving in a mentoring role. Copyright © 2017 Elsevier Inc. All rights reserved.
-
Effects of climate change process on comfort climate of Shiraz station
Energy Technology Data Exchange (ETDEWEB)
Shakoor, A.; Roshan, G.R.; Khoshakhlagh, F.; Hejazizadeh, Z. [Islamic Azad Univ., Larestan (Iran)
2008-09-30
Dwelling in cities and city development together with quick increase of population and development of industrial activites with unplanned consumption of fossil fuels have intensively increased pollution with consequences whcih will cause different diseases in short periods, and will lead to some climatic oscillations and its environmental effects such as the change of desirable periods in view of comfort climate in long period. The objective point of view of this reasearch was to study the climate in Shiraz and its effect on comfort conditions for human physiology. In this research, using 55-year cliamtic data (1952-2006), the relative humidity and temperature through the application of Guni comfort climatic model, the desirable months for the comfort of human physiology have been determined in the five 11-year periods and the linear process of these changes have been estimated for the next 11 years. The results of this research show that the temperature trend in Shiraz station is increasing and most months have heating process in a way that it is expected in the future the cold months will have more favorable conditions for physiological comfort of residents and correspondingly in the warm months, heating tension will have remarkable increase.
-
Economize while improving comfort. It's possible... with natural gas
International Nuclear Information System (INIS)
Prescott, G.
1998-01-01
Increasing the amount of exterior air coming into a building, combined with a natural gas heating source has proven to be profitable. A study in a residence for handicapped people showed that doubling the amount of exterior air coming into the building actually improved the comfort level for the occupants while reducing the total electric energy bill by 21 per cent
-
International electives in neurology training: a survey of US and Canadian program directors.
Lyons, Jennifer L; Coleman, Mary E; Engstrom, John W; Mateen, Farrah J
2014-01-14
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
-
Singh, Mamta K; Einstadter, Douglas; Lawrence, Renee
2010-10-01
Multiple resident-related factors contribute to 'missed opportunities' in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience--all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams. To evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening. The WPHC, a multidisciplinary weekly clinic, focused on preventive services for women with chronic conditions. The alternating didactic and clinic sessions emphasised women's preventive health topics for IM residents. Sixty-three IM residents participated in WPHC between 2002 and 2005. Pre- and post-test design was used to assess resident knowledge and comfort levels. Cervical cancer screening rates of residents' patients were assessed pre- and post-WPHC initiation. There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period). The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.
-
Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties
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.
2010-01-01
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
-
Effect of Kuwait oil field fires on human comfort and environment in Jubail, Saudi Arabia
Riley, James J.; Hicks, Neal G.; Thompson, T. Lewis
1992-03-01
The plumes from the Kuwait oil field fires reduced hemispheric (total) solar radiation by 26 36% during January June 1991 in Jubail (300 km SE of Kuwait City), Saudi Arabia. Residents feel noticeably cooler even though air temperatures have not been lowered significantly (up to June 1991). These observations support human comfort theories and demonstrate the importance of shade to comfort. The desirability of complete solar radiation measurements, including those of diffuse radiation, is indicated.
-
Bioclimatic comfort and the thermal perceptions and preferences of beach tourists
Rutty, Michelle; Scott, Daniel
2015-01-01
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).
-
Bartel, Billie J
2014-08-01
This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.
-
Energy Technology Data Exchange (ETDEWEB)
Kamphuis, I.G; Warmer, C.J.; Bakker, E.J. [ECN Duurzame Energie in de Gebouwde Omgeving DEGO, Petten (Netherlands)
2005-03-01
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.
-
Miller, David C; Sullivan, Amy M; Soffler, Morgan; Armstrong, Brett; Anandaiah, Asha; Rock, Laura; McSparron, Jakob I; Schwartzstein, Richard M; Hayes, Margaret M
2018-01-01
We present a pilot study exploring the effects of a brief, 30-minute educational intervention targeting resident communication surrounding dying in the intensive care unit (ICU). We sought to determine whether simulation or didactic educational interventions improved resident-reported comfort, preparation, and skill acquisition. We also sought to identify resident barriers to using the word "dying." In this mixed-methods prospective study, second- and third-year medical residents were randomized to participate in a simulation-based communication training or a didactic session. Residents completed a pre-post survey after the sessions evaluating the sessions and reflecting on their use of the word "dying" in family meetings. Forty-five residents participated in the study. Residents reported increases in comfort (Mean [M]-pre = 3.3 [standard deviation: 0.6], M-post = 3.7 [0.7]; P educational intervention improves internal medicine residents' self-reported comfort and preparation in talking about death and dying in the ICU. Residents in simulation-based training were more likely to report they learned new skills as compared to the didactic session. Residents report multiple barriers to using the word "dying" EOL conversations.
-
Thermal comfort. Individual and time-dependent?; Thermisch comfort. Individueel en tijdafhankelijk?
Energy Technology Data Exchange (ETDEWEB)
Noom, P.; Zeiler, W.; Boxem, G. [Unit Building Physics and Systems, Faculteit Bouwkunde, Technische Universiteit Eindhoven TUE, Eindhoven (Netherlands); Haan, J.F.B.C.; Van der Velden, J. [Kropman Installatietechniek, Rijswijk (Netherlands)
2010-11-15
With respect to the perceived thermal comfort there are large individual differences, which also change during daytime. Therefore is worthwhile to determine the individual thermal comfort profiles during the day. The perceived thermal comfort level follows an individual day profile. By using these profiles as a leading principal to control the indoor temperatures an improvement of the perceived comfort is possible while at the same time it can reduce energy consumption. [Dutch] Nieuwe optimalisatiemogelijkheden voor energiegebruik voor het comfort zijn mogelijk door vanuit de actuele en toekomstige individuele behoefte aan comfort van de gebruiker de installatie optimaal aan te sturen. Dit artikel geeft inzicht in de efficiente afstemming van vraag en aanbod van energie voor thermisch comfort. In een kantoorgebouw zijn metingen gedaan, conform NEN-EN-ISO 7726 (Ergonomics of the thermal environment. Instruments for measuring physical quantities), en er is een enquete gehouden om het thermisch comfort individueel te kunnen bepalen gedurende de werkdag. Het doel van de metingen was de verschillen tussen de individuele beleving en de werkelijke klimaat omstandigheden te kunnen bepalen.
-
Directory of Open Access Journals (Sweden)
Hom B. Rijal
2014-08-01
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.
-
An analysis of influential factors on outdoor thermal comfort in summer
Yin, JiFu; Zheng, YouFei; Wu, RongJun; Tan, JianGuo; Ye, DianXiu; Wang, Wei
2012-09-01
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
-
An analysis of influential factors on outdoor thermal comfort in summer.
Yin, JiFu; Zheng, YouFei; Wu, RongJun; Tan, JianGuo; Ye, DianXiu; Wang, Wei
2012-09-01
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
-
Bioclimatic comfort and the thermal perceptions and preferences of beach tourists.
Rutty, Michelle; Scott, Daniel
2015-01-01
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).
-
Decision Factors Nurses Use to Assess Pain in Nursing Home Residents With Dementia.
Monroe, Todd B; Parish, Abby; Mion, Lorraine C
2015-10-01
Nurses caring for older people with various psychiatric illnesses face many obstacles when treating pain. One setting with a high percentage of psychiatric conditions is long-term care where more than half of residents have some form of dementia, and behavioral symptoms of dementia (BSDs) may mimic behavioral displays of pain. Furthermore, two-thirds of nursing home residents have pain. Thus, many nursing home residents with dementia have pain that may be confounded by BSDs. Since many people with dementia are at risk for poor pain management, determining current methods in which nurses assess and manage pain in nursing home residents will aid in recognizing potential barriers to using current pain management guidelines and help develop strategies to enhance nurses' assessment and management of pain in this vulnerable population. The aim of this study was to explore nursing home nurses' cues and practices to identify and alleviate pain in nursing home residents with dementia. Nurses use the constructs of 'comfort' and 'quality of life' as key components in their overall pain assessment strategy in people with dementia. Indeed, the extensive process they use involving frequent reassessment and application of interventions is geared towards "appearance of comfort." Nurses reported difficulty in ascertaining whether a person with dementia was in pain, and they expressed further difficulty determining the intensity associated with resident pain. Nurses further reported that residents with dementia who are not well know by the staff were are greater risk of poor pain management. It was not unusual for nurses to discuss the importance of conflict resolution among family members as well as allowing for open expression of family's concerns. Nurses had to focus not only on the resident's comfort, but also the families' level of comfort with pain management, especially at the end-of-life. Findings support further use and development of discomfort behavior scales to help
-
Effectiveness of cross-cultural education for medical residents caring for burmese refugees.
McHenry, Megan Song; Nutakki, Kavitha; Swigonski, Nancy L
2016-01-01
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.
-
Hariyono, Paulus
2017-12-01
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.
-
Teaching wound care to family medicine residents on a wound care service
Directory of Open Access Journals (Sweden)
Little SH
2013-08-01
Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development
-
Nowinski, W L; Chua, B C
2013-06-01
Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way.
-
Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan
2015-01-01
Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852
-
DEFF Research Database (Denmark)
d’Ambrosio Alfano, Francesca Romana; Olesen, Bjarne W.; Palella, Boris Igor
2014-01-01
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...... 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...... 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...
-
Using television shows to teach communication skills in internal medicine residency.
Wong, Roger Y; Saber, Sadra S; Ma, Irene; Roberts, J Mark
2009-02-03
To address evidence-based effective communication skills in the formal academic half day curriculum of our core internal medicine residency program, we designed and delivered an interactive session using excerpts taken from medically-themed television shows. We selected two excerpts from the television show House, and one from Gray's Anatomy and featured them in conjunction with a brief didactic presentation of the Kalamazoo consensus statement on doctor-patient communication. To assess the efficacy of this approach a set of standardized questions were given to our residents once at the beginning and once at the completion of the session. Our residents indicated that their understanding of an evidence-based model of effective communication such as the Kalamazoo model, and their comfort levels in applying such model in clinical practice increased significantly. Furthermore, residents' understanding levels of the seven essential competencies listed in the Kalamazoo model also improved significantly. Finally, the residents reported that their comfort levels in three challenging clinical scenarios presented to them improved significantly. We used popular television shows to teach residents in our core internal medicine residency program about effective communication skills with a focus on the Kalamazoo's model. The results of the subjective assessment of this approach indicated that it was successful in accomplishing our objectives.
-
Questionnaire survey on the process of specialty training in neurology in Japan.
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
2017-07-29
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.
-
Opinion and Special Articles: Neurology education at US osteopathic medical schools.
Freedman, Daniel A; Albert, Dara V F
2017-12-12
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.
-
CSIR Research Space (South Africa)
Osburn, L
2010-01-01
Full Text Available Thermal comfort is influenced by environmental parameters as well as other influences including asymmetric heating and cooling conditions. Additionally, some aspects of thermal comfort may be exploited so as to enable a building to operate within a...
-
Nikolopoulou, Marialena
2011-06-01
A review of the various approaches in understanding outdoor thermal comfort is presented. The emphasis on field surveys from around the world, particularly across Europe, enables us to understand thermal perception and evaluate outdoor thermal comfort conditions. The consistent low correlations between objective microclimatic variables, subjective thermal sensation and comfort outdoors, internationally, suggest that thermophysiology alone does not adequate describe these relationships. Focusing on the concept of adaptation, it tries to explain how this influences outdoor comfort, enabling us to inhabit and get satisfaction from outdoor spaces throughout the year. Beyond acclimatization and behavioral adaptation, through adjustments in clothing and changes to the metabolic heat, psychological adaptation plays a critical role to ensure thermal comfort and satisfaction with the outdoor environment. Such parameters include recent experiences and expectations; personal choice and perceived control, more important than whether that control is actually exercised; and the need for positive environmental stimulation suggesting that thermal neutrality is not a pre-requisite for thermal comfort. Ultimately, enhancing environmental diversity can influence thermal perception and experience of open spaces.
-
Comfort measures: a concept analysis.
Oliveira, Irene
2013-01-01
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.
-
Energy Technology Data Exchange (ETDEWEB)
Phaff, H. [TNO Bouw en Ondergrond, Delft (Netherlands)
2010-04-15
Buildings in reality, use more energy than predicted. Among many causes, occupant behaviour plays an important role. Better simulation of occupant behaviour, with respect to thermal comfort and energy use of buildings, opens the possibility to design better, comfortable buildings that have lower energy consumption in reality. Thermal discomfort, a dynamical version of Fanger's PPD, is proposed to be used as input to simulate occupant behaviour via a 'flexible task list' and two Markov processes. [Dutch] Simulatie van bewonersgedrag m.b.t. energiegebruik in gebouwen biedt de mogelijkheid om gebouwen en bijbehorende energie installaties zo te ontwerpen dat ze prettiger zijn om in te wonen en te werken. Thermisch discomfort, een dynamische versie van PPD (percentage of dissatisfied persons) wordt hier voorgesteld om via een Markov-proces en een takenlijst bewonersgedrag mee te simuleren.
-
Davis, Susan A; Braykov, Nikolay P; Lathrop, Eva; Haddad, Lisa B
2018-02-01
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; https://www.r-project.org). 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
-
Energy Technology Data Exchange (ETDEWEB)
Noom, P.; Zeiler, W.; Boxem, G. [Unit Building Physics and Systems, Faculteit Bouwkunde, Technische Universiteit Eindhoven TUE, Eindhoven (Netherlands); Haan, J.F.B.C.; Van der Velden, J. [Kropman Installatietechniek, Rijswijk (Netherlands)
2010-11-15
In a normal office building measurements according to NEN-EN-ISO 7726 (Ergonomics of the thermal environment. Instruments for measuring physical quantities) have been carried out and a survey was held to determine the perceived thermal comfort of individuals. A comparison between the objective determined thermal comfort and the perceived thermal comfort shows quite a difference. This result was also reached in earlier research by others in laboratories. Therefore it is necessary to take care of the differences when designing a specific comfort level and try to determine the perceived comfort level of the individual occupants. [Dutch] Nieuwe optimalisatiemogelijkheden voor energiegebruik voor het comfort zijn mogelijk door vanuit de actuele en toekomstige individuele behoefte aan comfort van de gebruiker de installatie optimaal aan te sturen. Dit artikel geeft inzicht in de efficiente afstemming van vraag en aanbod van energie voor thermisch comfort. In een kantoorgebouw zijn metingen gedaan, conform NEN-EN-ISO 7726 (Ergonomics of the thermal environment. Instruments for measuring physical quantities), en er is een enquete gehouden om het thermisch comfort individueel te kunnen bepalen gedurende de werkdag. Het doel van de metingen was de verschillen tussen de individuele beleving en de werkelijke klimaat omstandigheden te kunnen bepalen.
-
Roze, E; Flamand-Roze, C; Méneret, A; Ruiz, M; Le Liepvre, H; Duguet, A; Renaud, M-C; Alamowitch, S; Steichen, O
2016-01-01
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
-
Anderson, Kristen; Accurso, Erin C; Kinasz, Kathryn R; Le Grange, Daniel
2017-06-01
This study examined physician residents' and fellows' knowledge of eating disorders and their attitudes toward patients with eating disorders. Eighty physicians across disciplines completed a survey. The response rate for this survey across disciplines was 64.5 %. Participants demonstrated limited knowledge of eating disorders and reported minimal comfort levels treating patients with eating disorders. Psychiatry discipline (p = 0.002), eating disorder experience (p = 0.010), and having ≥4 eating disorder-continuing medical education credits (p = 0.037) predicted better knowledge of anorexia nervosa but not bulimia nervosa. Psychiatry residents (p = 0.041), and those who had treated at least one eating disorder patient (p = 0.006), reported significantly greater comfort treating patients with eating disorders. These results suggest that residents and fellows from this sample may benefit from training to increase awareness and confidence necessary to treat patients with eating disorders. Sufficient knowledge and comfort are critical since physicians are often the first health care provider to have contact with patients who have undiagnosed eating disorders.
-
Introduction of handheld computing to a family practice residency program.
Rao, Goutham
2002-01-01
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.
-
Improving thermal comfort in office practice: biomimetic comfort profiles
Zeiler, W.; Houten, van M.A.; Boxem, G.; Noom, P.; Velden, van der J.A.J.
2009-01-01
In the office building of Kropman in Utrecht a number of measurements were done, by means of NEN-EN-ISO 7726, to determine thermal comfort in the office building. Also two enquiries were held to determine the thermal comfort perception of the employees. The evaluation of the measurements and
-
Using television shows to teach communication skills in internal medicine residency
Directory of Open Access Journals (Sweden)
Ma Irene
2009-02-01
Full Text Available Abstract Background To address evidence-based effective communication skills in the formal academic half day curriculum of our core internal medicine residency program, we designed and delivered an interactive session using excerpts taken from medically-themed television shows. Methods We selected two excerpts from the television show House, and one from Gray's Anatomy and featured them in conjunction with a brief didactic presentation of the Kalamazoo consensus statement on doctor-patient communication. To assess the efficacy of this approach a set of standardized questions were given to our residents once at the beginning and once at the completion of the session. Results Our residents indicated that their understanding of an evidence-based model of effective communication such as the Kalamazoo model, and their comfort levels in applying such model in clinical practice increased significantly. Furthermore, residents' understanding levels of the seven essential competencies listed in the Kalamazoo model also improved significantly. Finally, the residents reported that their comfort levels in three challenging clinical scenarios presented to them improved significantly. Conclusion We used popular television shows to teach residents in our core internal medicine residency program about effective communication skills with a focus on the Kalamazoo's model. The results of the subjective assessment of this approach indicated that it was successful in accomplishing our objectives.
-
Peer Review in Radiology: A Resident and Fellow Perspective.
Grenville, Jeffrey; Doucette-Preville, David; Vlachou, Paraskevi A; Mnatzakanian, Gevork N; Raikhlin, Antony; Colak, Errol
2016-02-01
The purpose of this study was to explore Canadian radiology residents' and fellows' understanding, attitudes, opinions, and preferences toward peer review. An Internet-based anonymous questionnaire designed to understand one's familiarity, attitudes, opinions, and preferences toward peer review was distributed to radiology residents and fellows across Canada. Data were analyzed using descriptive statistics, and answers were stratified by level of training. A total of 136 trainees responded to the survey with 92 completed survey responses available for descriptive statistics. Approximately half of respondents are familiar with peer review (49%), and 39% of trainees are involved in peer review. Most respondents (92%) expressed an interest in learning more about peer review; believe that it should be incorporated into the residency training curriculum (86%), be mandatory (72%), and that current participation will increase odds of future participation (91%). Most trainees (80%) are comfortable advising one another about errors, but less comfortable advising staff (21%). Residents and fellows welcome the opportunity to learn more about peer review and believe it should be incorporated into the residency training curriculum. Understanding the attitudes and perceptions held by trainees regarding peer review is important, as a means to optimize education and maximize current and future participation in peer review. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
-
Chun, Robert; Jabbour, Noel; Balakrishnan, Karthik; Bauman, Nancy; Darrow, David H; Elluru, Ravindhra; Grimmer, J Fredrik; Perkins, Jonathan; Richter, Gresham; Shin, Jennifer
2016-07-01
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
-
Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program.
Moradiya, Yogesh; Crystal, Howard; Valsamis, Helen; Levine, Steven R
2013-12-03
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.
-
Use of a Self-Reflection Tool to Enhance Resident Learning on an Adolescent Medicine Rotation.
Greenberg, Katherine Blumoff; Baldwin, Constance
2016-08-01
Adolescent Medicine (AM) educators in pediatric residency programs are seeking new ways to engage learners in adolescent health. This mixed-methods study presents a novel self-reflection tool and addresses whether self-reflection enhanced residents' perception of the value of an adolescent rotation, in particular, its relevance to their future practice. The self-reflection tool included 17 Likert scale items on residents' comfort with the essential tasks of adolescent care and open-ended questions that promoted self-reflection and goal setting. Semi-structured, postrotation interviews encouraged residents to discuss their experiences. Likert scale data were analyzed using descriptive statistics, and interview notes and written comments on the self-reflection tool were combined for qualitative data analysis. Residents' pre-to post-self-evaluations showed statistically significant increases in comfort with most of the adolescent health care tasks. Four major themes emerged from our qualitative analysis: (1) the value of observing skilled attendings as role models; (2) the comfort gained through broad and frequent adolescent care experiences; (3) the career relevance of AM; and (4) the ability to set personally meaningful goals for the rotation. Residents used the self-reflection tool to mindfully set goals and found their AM education valuable and relevant to their future careers. Our tool helped make explicit to residents the norms, values, and beliefs of the hidden curriculum applied to the care of adolescents and helped them to improve the self-assessed quality of their rapport and communications with adolescents. We conclude that a structured self-reflection exercise can enhance residents' experiences on an AM rotation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
-
Simulation in Pre-departure Training for Residents Planning Clinical Work in a Low-Income Country
Directory of Open Access Journals (Sweden)
Kevin R. Schwartz
2015-12-01
Full Text Available Introduction: Increasingly, pediatric and emergency medicine (EM residents are pursuing clinical rotations in low-income countries. Optimal pre-departure preparation for such rotations has not yet been established. High-fidelity simulation represents a potentially effective modality for such preparation. This study was designed to assess whether a pre-departure high-fidelity medical simulation curriculum is effective in helping to prepare residents for clinical rotations in a low-income country. Methods: 43 pediatric and EM residents planning clinical rotations in Liberia, West Africa, participated in a simulation-based curriculum focused on severe pediatric malaria and malnutrition and were then assessed by survey at three time points: pre-simulation, post-simulation, and after returning from work abroad. Results: Prior to simulation, 1/43 (2% participants reported they were comfortable with the diagnosis and management of severe malnutrition; this increased to 30/42 (71% after simulation and 24/31 (77% after working abroad. Prior to simulation, 1/43 (2% of residents reported comfort with the diagnosis and management of severe malaria; this increased to 26/42 (62% after simulation and 28/31 (90% after working abroad; 36/42 (86% of residents agreed that a simulation-based global health curriculum is more useful than a didactic curriculum alone, and 41/42 (98% felt a simulator-based curriculum should be offered to all residents planning a clinical trip to a low-income country. Conclusion: High-fidelity simulation is effective in increasing residents’ self-rated comfort in management of pediatric malaria and malnutrition and a majority of participating residents feel it should be included as a component of pre-departure training for all residents rotating clinically to low-income countries.
-
Energy Technology Data Exchange (ETDEWEB)
Bae, Chihye; Chun, Chungyoon [Department of Housing and Interior Design, College of Human Ecology, Graduate School, Yonsei University, Seoul (Korea)
2009-11-15
Indoor thermal environments and residents' control behavior of cooling and heating systems were investigated in Seoul, Korea and compared with the results of previous studies. Twenty-four houses in summer, six houses in autumn and 36 houses in winter were used in this study. The measurement of temperature, humidity and air conditioner usage behavior was carried out. The clo-value, thermal comfort, sensation and basic data of the houses were also investigated. The indoor thermal environment in the summer had a high temperature and a high humidity ratio compare to standard comfort zone. Most of the indoor thermal environments at the time of starting the air conditioner in the summer were out of the comfort zone. Some of the data recorded while the air conditioner was stopped were in the comfort zone, but in many cases the temperature was relatively higher than comfort zone. Most indoor climate distributions in the winter were in the comfort zone and the indoor climate in autumn coincided well with the criteria of the comfort zone. Compared with results of previous studies in these 25 years, indoor ambient average temperature in winter has increased and the comfort temperature has increased in the heating period and decreased in the cooling period. This result indicates that the development of an HVAC system has created an expectation of comfort for residents and has shifted their thermal comfort zone warmer in winter and cooler in summer. (author)
-
Forty years of Fanger's model of thermal comfort: comfort for all?
van Hoof, J
2008-06-01
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.
-
Thermal comfort in residential buildings: Comfort values and scales for building energy simulation
Peeters, L.F.R.; Dear, de R.; Hensen, J.L.M.; D'Haeseleer, W.
2009-01-01
Building Energy Simulation (BES) programmes often use conventional thermal comfort theories to make decisions, whilst recent research in the field of thermal comfort clearly shows that important effects are not incorporated. The conventional theories of thermal comfort were set up based on steady
-
Directory of Open Access Journals (Sweden)
Victor O. Kolade
2014-07-01
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.
-
Thermal comfort in residential buildings: Comfort values and scales for building energy simulation
Energy Technology Data Exchange (ETDEWEB)
Peeters, Leen; D' haeseleer, William [Division of Applied Mechanics and Energy Conversion, University of Leuven (K.U.Leuven), Celestijnenlaan 300 A, B-3001 Leuven (Belgium); Dear, Richard de [Division of Environmental and Life Sciences, Macquarie University, Sydney (Australia); Hensen, Jan [Faculty of Architecture, Building and Planning, Technische Universiteit Eindhoven, Vertigo 6.18, P.O. Box 513, 5600 MB Eindhoven (Netherlands)
2009-05-15
Building Energy Simulation (BES) programmes often use conventional thermal comfort theories to make decisions, whilst recent research in the field of thermal comfort clearly shows that important effects are not incorporated. The conventional theories of thermal comfort were set up based on steady state laboratory experiments. This, however, is not representing the real situation in buildings, especially not when focusing on residential buildings. Therefore, in present analysis, recent reviews and adaptations are considered to extract acceptable temperature ranges and comfort scales. They will be defined in an algorithm, easily implementable in any BES code. The focus is on comfortable temperature levels in the room, more than on the detailed temperature distribution within that room. (author)
-
Smart grid for comfort; Smart grid voor comfort
Energy Technology Data Exchange (ETDEWEB)
Zeiler, W.; Van der Velden, J.A.J. [Kropman, Rijswijk (Netherlands); Vissers, D.R.; Maaijen, H.N. [Faculteit Bouwkunde, Technische Universiteit Eindhoven TUE, Eindhoven (Netherlands); Kling, W.L. [Faculteit Electrical Engineering, Technische Universiteit Eindhoven TUE, Eindhoven (Netherlands); Larsen, J.P. [Sense Observation Systems, Rotterdam (Netherlands)
2012-04-15
A new control strategy was developed based on the application of wireless sensor network with the connection to a smart grid to investigate if it is possible to save energy on the level of the user under the condition of maintaining the same or even improved level of individual comfort. By using different scenarios, for individual comfort and energy consumption, agents provide the steering of the process control This forms the basis of a new approach to optimize the energy consumption, after which the effect of it can be used on the level of residential building to optimize the interaction with the electrical infrastructure, the smart grid. [Dutch] Er vindt onderzoek plaats naar een nieuwe regelstrategie gebaseerd op de toepassing van een draadloos sensor netwerk dat is gekoppeld aan het smart grid. Doel van deze regelstrategie is om op gebruikersniveau energie te kunnen besparen met behoud of zelfs verbetering van het individueel comfort. Er zijn verschillende scenario's voor individueel comfort en energiegebruik van apparatuur met behulp van agents die voor de aansturing kunnen zorgen. Zo wordt de kern van de energievraag geoptimaliseerd. De doorwerking hiervan tot op het niveau van woninggebouw en de koppeling met het externe elektriciteitsnet kan vervolgens worden geoptimaliseerd.
-
Alders, E.E.; Kurvers, S.R.; Van den Ham, E.R.
2011-01-01
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 actual perceived thermal comfort. This paper analyses the knowledge of the different disciplines and integrates it to get a holistic image of comfort and its delivery systems as well as opportunities ...
-
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)
2012-08-01
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.
-
Greene, James G
2013-10-01
Neurology residency training programs have been profoundly impacted by recent changes in resident duty hours, workloads, and supervisory requirements. In response, many programs have adopted a night float coverage system to minimize the requirements for overnight call. The majority involves residents working a block of night shifts in what is typically a service-oriented rotation. Recently, concerns have arisen regarding the impact of this design on resident education and patient care. We have developed a novel on-site nighttime neurohospitalist model for the explicit purpose of steepening the initial learning curve for neurology residents in an effort to rapidly improve their neurological skills and, in conjunction, overnight patient care. We surveyed residents after the initiation of this system to assess their perception of the impact of direct overnight supervision on education and patient care. As part of ongoing quality improvement efforts, surveys were administered to neurology house staff at a tertiary academic medical center after they had completed service on the night float rotation both with and without an attending in the hospital using a retrospective pre/postdesign. There was a robust positive impact on resident's perception of overall quality, educational value, and clinical quality on the night float rotation with an attending on-site. Despite an overall perception that their autonomy was maintained, residents believed barriers to contact the attending were lower, and attending interaction during critical decision making was more frequent. Direct overnight supervision by a neurohospitalist enhances the educational value and care quality on overnight resident rotations.
-
Thermal comfort following immersion.
Guéritée, Julien; Redortier, Bernard; House, James R; Tipton, Michael J
2015-02-01
Unlike thermal comfort in air, little research has been undertaken exploring thermal comfort around water sports. We investigated the impact of swimming and cooling in air after swimming on thermal comfort. After 10 min of swimming-and-resting cycles in 28°C water, volunteers wearing two types of garments or in swim briefs, faced winds in 24°C air, at rest or when stepping. Thermal comfort was significantly higher during swimming than resting. Post-immersion, following maximum discomfort, in 45 of 65 tests thermal comfort improved although mean skin temperature was still cooling (0.26 [SD 0.19] °C·min(-1) - max was 0.89°C·min(-1)). When thermal comfort was re-established mean skin temperature was lower than at maximal discomfort in 39 of 54 tests (0.81 [SD 0.58] °C - max difference was 2.68°C). The reduction in thermal discomfort in this scenario could be due to the adaptation of thermoreceptors, or to reductions in cooling rates to levels where discomfort was less stimulated. The relief from the recent discomfort may explain why, later, thermal comfort returned to initial levels in spite of poorer thermal profiles. Copyright © 2014 Elsevier Inc. All rights reserved.
-
Wagner, Heather Scherschel; Ahlstrom, Britt; Redden, Joseph P; Vickers, Zata; Mann, Traci
2014-12-01
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.
-
Pfeifer, Kyle; Staib, Lawrence; Arango, Jennifer; Kirsch, John; Arici, Mel; Kappus, Liana; Pahade, Jay
2016-01-01
Reactions to contrast material are uncommon in diagnostic radiology, and vary in clinical presentation from urticaria to life-threatening anaphylaxis. Prior studies have demonstrated a high error rate in contrast reaction management, with smaller studies using simulation demonstrating variable data on effectiveness. We sought to assess the effectiveness of high-fidelity simulation in teaching contrast reaction management for residents, fellows, and attendings. A 20-question multiple-choice test assessing contrast reaction knowledge, with Likert-scale questions assessing subjective comfort levels of management of contrast reactions, was created. Three simulation scenarios that represented a moderate reaction, a severe reaction, and a contrast reaction mimic were completed in a one-hour period in a simulation laboratory. All participants completed a pretest and a posttest at one month. A six-month delayed posttest was given, but was optional for all participants. A total of 150 radiologists participated (residents = 52; fellows = 24; faculty = 74) in the pretest and posttest; and 105 participants completed the delayed posttest (residents = 31; fellows = 17; faculty = 57). A statistically significant increase was found in the one-month posttest (P < .00001) and the six-month posttest scores (P < .00001) and Likert scores (P < .001) assessing comfort level in managing all contrast reactions, compared with the pretest. Test scores and comfort level for moderate and severe reactions significantly decreased at six months, compared with the one-month posttest (P < .05). High-fidelity simulation is an effective learning tool, allowing practice of "high-acuity" situation management in a nonthreatening environment; the simulation training resulted in significant improvement in test scores, as well as an increase in subjective comfort in management of reactions, across all levels of training. A six-month refresher course is suggested, to maintain knowledge and comfort level in
-
Acoustic comfort in eating establishments
DEFF Research Database (Denmark)
Svensson, David; Jeong, Cheol-Ho; Brunskog, Jonas
2014-01-01
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...
-
Schuh, L A.; London, Z; Neel, R; Brock, C; Kissela, B M.; Schultz, L; Gelb, D J.
2009-01-01
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
-
Radiology residents' experience with intussusception reduction
International Nuclear Information System (INIS)
Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L.; Li, Chin-Shang
2011-01-01
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.)
-
Pesticide illness, farm practices, and neurological symptoms among farm residents in Colorado
International Nuclear Information System (INIS)
Stallones, Lorann; Beseler, Cheryl
2002-01-01
The purpose of this study is to evaluate the association between pesticides and neurological symptoms among a population exposed to organophosphate chemicals as a result of agricultural use. Chronic squealed of acute pesticide poisoning from organophosphate compounds include a variety of neurological symptoms including restlessness, irritability, and trouble sleeping. Individuals who have had an acute pesticide poisoning have been reported to suffer a wide range of neurological symptoms that occur from weeks to months after the initial episode. Data for this study came from a cross-sectional survey of farmers and their spouses conducted in an eight-county area in northeastern Colorado. Neurological characteristics were assessed to determine their relationship with previously reported pesticide-related illnesses. Symptoms that were significantly associated with previous poisoning were difficulty concentrating [OR 2.07, 95% confidence interval (CI) 1.22, 3.50]; relatives noticing person had trouble remembering things (OR 2.54, 95% CI 1.47, 4.39); making notes to remember things (OR .18, 95% CI 1.20, 3.97); finding it hard to understand the meaning of newspapers, magazines, and books (OR 1.90, 95% CI 1.01, 3.60); felt irritable OR 1.84, 95% CI 1.08, 3.12); felt depressed (OR 2.82, 95% CI 1.65, 4.81); ad heart palpitations without exertion (OR 2.83, 95% CI 1.22, 6.54); sleeping more than usual (OR 3.58, 95% CI 1.95, 6.58); difficulty moving fingers or grasping things (OR 2.08, 95% CI 1.06, 3.24); and headaches at least once a week (OR 1.85, 95% CI 1.06, 3.24). Stepwise regression was used o identify the best explanatory model of pesticide-related illness. Variables that were associated with increased odds of illness were being ale, being depressed, sleeping too much, and using crop organophosphates
-
Bonouvrié, Laura; Becher, Jules; Soudant, Dan; Buizer, Annemieke; van Ouwerkerk, Willem; Vles, Georges; Vermeulen, R Jeroen
2016-07-01
Intrathecal baclofen (ITB) treatment is applied in patients with spastic cerebral palsy (SCP), dystonic cerebral palsy (DCP) and progressive neurological disease (PND). Our aim was to investigate whether ITB treatment has a different effect on activities of daily life (ADL) in these groups. A retrospective and cross-sectional survey was conducted using a questionnaire to assess the qualitative effect of ITB (Likert scale) on different domains of functioning (mobility, personal care, communication, comfort) and satisfaction with the results. Groups were compared using non-parametric statistics. Questionnaires were completed for 68 patients (39 SCP, 13 DCP, 16 PND). Satisfaction scores were relatively high in all groups (7-8) and the positive effect on personal care and communication was similar in all groups. The PND group had the shortest follow-up and scored significantly less favourably for the effect on mobility and comfort. This is the first study to show that ITB treatment has similar effects on personal care and communication in stable and progressive neurological disease. The decrease in mobility in the PND group is likely due to the progressive nature of the disease. The different effect on comfort between groups is mainly due to the smaller effect on startles in the PND group. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
-
Thermal comfort in urban transitional spaces
Energy Technology Data Exchange (ETDEWEB)
Chungyoon Chun [Yonsei University, Seoul (Korea). College of Human Ecology, Department of Housing and Interior Design; Tamura, A. [Yokohama National University (Japan). Department of Architecture and Building Science
2005-05-15
This paper deals with thermal comfort in urban transitional spaces. This topic investigates thermal comfort during walking activities through transitional spaces-urban corridors, shopping streets, and open-ended passageways. The study involves a field study and a laboratory study with a sequenced walk through an environmental control chamber. Subjects in both studies wore the same clothing ensembles, walked the same speed, and evaluated their thermal comfort at 20 designated point in the field and in specific rooms in the control chamber. Air temperature, relative humidity, and air velocity were measured concurrently as the thermal comfort votes completed. Findings revealed that the previously experienced temperatures determined thermal comfort at the following point in the sequence. Because thermal comfort at a point can be influenced widely by relative placement of temperatures in sequence, thermal comfort in transitional spaces can be adapted very widely compared to comfort inside of buildings. Thermal comfort along the experimental courses was evaluated by averaging the temperature of a course. (author)
-
Forty years of Fanger's model of thermal comfort: Comfort for all?
Hoof, van J.
2008-01-01
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.
-
Comfort in times if climatic change; Comfort in tijden van klimaatverandering
Energy Technology Data Exchange (ETDEWEB)
Imsirovic, F.; Molenaar, R. [Techniplan Adviseurs, Rotterdam (Netherlands)
2011-10-15
A study with calculation software Vabi 114 shows that choosing a different climate year and comfort level requirements according to the Dutch standard NEN 5060 can lead to an increased cooling capacity of over 60%. When determining the climate year and comfort level in the program of requirements, it will have to be weighed if the increasing cost at the expense of the additional cooling capacity outweighs the increased level in comfort. [Dutch] Het is de laatste jaren een trend om andere klimaatjaren of andere comforteisen te hanteren. Het oude klimaatjaar1964-1965 wordt steeds vaker vervangen door jaren zoals 1995,1998 of nieuwe klimaatreferentiejaren conform de NEN 5060:2008. Ook de comforteisen veranderen. De eis van 150 gewogen overschrijdingsuren die de Rijksgebouwendienst jarenlang hanteerde, wordt steeds vaker vervangen door een eis met een maximale binnentemperatuur van 25C of adaptieve temperatuurgrenswaarden (ATG), zoals omschreven in ISSO-publicatie 74. Wat is de invloed van gewijzigde klimaatjaren en comforteisen op het comfort en het op te stellen koelvermogen?.
-
Beck, Malene; Poulsen, Ingrid; Martinsen, Bente; Birkelund, Regner
2018-03-01
Many patients suffering from a neurological disease experience eating difficulties during mealtimes in the hospital. Consequently, they often refrain from eating in public places to avoid potentially awkward situations. Eating is an essential part of life, providing patients with comfort during their hospitalisation. Therefore, attention should be paid to these patients, who encounter eating difficulties to foster a positive mealtime experience. To study what patients afflicted with a neurological disease experience and assign meaning when participating in mealtimes during hospitalisation. Ten semi-structured interviews with patients were conducted and recorded. After transcription the text was analysed, and interpreted compromising three methodological steps inspired by the French philosopher, Paul Ricouer. Three themes were identified through data analysis and interpretation: i) The missing feeling of homeliness, ii) The battle between socialisation vs. isolation, and iii) The sense of time, rhythm, and presence. To patients suffering from a neurological disease, mealtimes are not only a manageable task, but also a part of existential care that leads to positive experience. Aesthetic elements were shown to have the potential of making the patients feel comfortable and homely when hospitalised. This was important, as our study also identified that patients were longing for homeliness when participating in mealtimes during hospitalisation. Our findings emphasised the need of proceeding to interventions that includes mealtime assistance and protects the mealtime activity. Hence, it informs hospital organisations of the importance of restructuring mealtime environment, so that existential care can take place. © 2017 Nordic College of Caring Science.
-
The current and ideal state of mental health training: pediatric resident perspectives.
Hampton, Elisa; Richardson, Joshua E; Bostwick, Susan; Ward, Mary J; Green, Cori
2015-01-01
PHENOMENON: Mental health (MH) problems are prevalent in the pediatric population, and in a setting of limited resources, pediatricians need to provide MH care in the primary medical home yet are uncomfortable doing so citing a lack of training during residency as one barrier. The purpose of this study is to describe pediatric residents' experiences and perspectives on the current and ideal states of MH training and ideas for curriculum development to bridge this gap. A qualitative study using focus groups of pediatric residents from an urban academic medical center was performed. Audio recordings were transcribed and analyzed using a grounded theory approach. Twenty-six residents participated in three focus groups, which is when thematic saturation was achieved. The team generated five major themes: capabilities, comfort, organizational capacity, coping, and education. Residents expressed uncertainty at every step of an MH visit. Internal barriers identified included low levels of comfort and negative emotional responses. External barriers included a lack of MH resources and mentorship in MH care, or an inadequate organizational capacity. These internal and external barriers resulted in a lack of perceived capability in handling MH issues. In response, residents reported inadequate coping strategies, such as ignoring MH concerns. To build knowledge and skills, residents prefer educational modalities including didactics, experiential learning through collaborations with MH specialists, and tools built into patient care flow. Insights: Pediatric residency programs need to evolve in order to improve resident training in MH care. The skills and knowledge requested by residents parallel the American Academy of Pediatrics statement on MH competencies. Models of collaborative care provide similar modalities of learning requested by residents. These national efforts have not been operationalized in training programs yet may be useful for curriculum development and
-
The Comfortable Home and Energy Consumption
DEFF Research Database (Denmark)
Madsen, Line Valdorff
2017-01-01
This paper investigates relations between notions of comfort and notions of home, aiming at a better understanding of residential comfort and the related energy consumption. Residential comfort is examined through a practice-theoretical lens and as something that appears in between the social...... and material structures of a home. The approach considers different elements of comfort in homemaking practices, such as the body, materials and social meanings. The paper examines how conceptions of comfort and homeliness interrelate through homemaking practices and thereby redefine comfort within a framework...... of the home and social practices. This implies focus on “the comfortable home” as made up of homemaking practices that include knowhow, sensations and social norms. The empirical basis comprises interviews and visual data from a field study on detached housing on the outskirts of a Danish city. The paper...
-
Energy Technology Data Exchange (ETDEWEB)
Steen Larsen, T.; Lund Jensen, R.; Daniels, O.
2012-01-15
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)
-
Thermal comfort: research and practice.
van Hoof, Joost; Mazej, Mitja; Hensen, Jan L M
2010-01-01
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 of the 1990s, and groups these developments around two main themes; (i) thermal comfort models and standards, and (ii) advances in computerization. Within the first theme, the PMV-model (Predicted Mean Vote), created by Fanger in the late 1960s is discussed in the light of the emergence of models of adaptive thermal comfort. The adaptive models are based on adaptive opportunities of occupants and are related to options of personal control of the indoor climate and psychology and performance. Both models have been considered in the latest round of thermal comfort standard revisions. The second theme focuses on the ever increasing role played by computerization in thermal comfort research and practice, including sophisticated multi-segmental modeling and building performance simulation, transient thermal conditions and interactions, thermal manikins.
-
Lam, Cho Kwong Charlie; Lau, Kevin Ka-Lun
2018-04-01
The Universal Thermal Climate Index (UTCI) is an index for assessing outdoor thermal environment which aims to be applicable universally to different climates. However, the scale of UTCI thermal stress classification can be interpreted depending on the context. Previous studies validated the UTCI in individual cities, but comparative studies between different cities are scarce. This study examines the differences in thermal perception and clothing choices between residents from two climate zones over similar UTCI ranges in summer. We compared summer thermal comfort survey data from Melbourne (n = 2162, January-February 2014) and Hong Kong (n = 414, July-August 2007). We calculated the UTCI from outdoor weather station data and used t tests to compare the differences in thermal sensation and clothing between Hong Kong and Melbourne residents. When the UTCI was between 23.0 and 45.9 °C, Melbourne residents wore significantly more clothing (0.1 clo) than Hong Kong residents. Hong Kong residents reported neutral to warm sensation at a higher UTCI range compared with the dynamic thermal sensation (DTS) model. Moreover, Melbourne residents reported warm and hot sensation at a higher UTCI range than the DTS model. Respondents in Melbourne also exhibited different responses to the mean radiant temperature under shaded and sunny conditions, while such a trend was not observed in Hong Kong. It would be advisable to define different thermal sensation thresholds for the UTCI scale according to different climate zones for better prediction of the outdoor thermal comfort of different urban populations.
-
Lam, Cho Kwong Charlie; Lau, Kevin Ka-Lun
2018-04-12
The Universal Thermal Climate Index (UTCI) is an index for assessing outdoor thermal environment which aims to be applicable universally to different climates. However, the scale of UTCI thermal stress classification can be interpreted depending on the context. Previous studies validated the UTCI in individual cities, but comparative studies between different cities are scarce. This study examines the differences in thermal perception and clothing choices between residents from two climate zones over similar UTCI ranges in summer. We compared summer thermal comfort survey data from Melbourne (n = 2162, January-February 2014) and Hong Kong (n = 414, July-August 2007). We calculated the UTCI from outdoor weather station data and used t tests to compare the differences in thermal sensation and clothing between Hong Kong and Melbourne residents. When the UTCI was between 23.0 and 45.9 °C, Melbourne residents wore significantly more clothing (0.1 clo) than Hong Kong residents. Hong Kong residents reported neutral to warm sensation at a higher UTCI range compared with the dynamic thermal sensation (DTS) model. Moreover, Melbourne residents reported warm and hot sensation at a higher UTCI range than the DTS model. Respondents in Melbourne also exhibited different responses to the mean radiant temperature under shaded and sunny conditions, while such a trend was not observed in Hong Kong. It would be advisable to define different thermal sensation thresholds for the UTCI scale according to different climate zones for better prediction of the outdoor thermal comfort of different urban populations.
-
Falcone, John L; Claxton, René N; Marshall, Gary T
2014-01-01
The objective structured clinical examination (OSCE) can be used to evaluate the Accreditation Council for Graduate Medical Education Core Competencies of Professionalism and Interpersonal and Communication Skills. The aim of this study was to describe general surgery resident performance on a "difficult conversation" OSCE. In this prospective study, junior and senior residents participated in a 2-station OSCE. Junior stations involved discussing operative risks and benefits and breaking bad news. Senior stations involved discussing goals of care and discussing transition to comfort measures only status. Residents completed post-OSCE checklist and Likert-based self-evaluations of experience, comfort, and confidence. Trained standardized patients (SPs) evaluated residents using communication skill-based checklists and Likert-based assessments. Pearson correlation coefficients were determined between self-assessment and SP assessment. Mann-Whitney U tests were conducted between junior and senior resident variables, using α = 0.05. There were 27 junior residents (age 28.1 ± 1.9 years [29.6% female]) and 27 senior residents (age 32.1 ± 2.5 years [26.9% female]). The correlation of self-assessment and SP assessment of overall communication skills by junior residents was -0.32 on the risks and benefits case and 0.07 on the breaking bad news case. The correlation of self-assessment and SP assessment of overall communication skills by senior residents was 0.30 on the goals of care case and 0.26 on the comfort measures only case. SP assessments showed that junior residents had higher overall communication skills than senior residents (p = 0.03). Senior residents perceived that having difficult conversations was more level appropriate (p skills are correlated, and that skills-based training is needed across all residency levels. This well-received method may be used to observe, document, and provide resident feedback for these important skills. © 2014 Published by
-
Evaluation of Laparoscopic Curricula in American Urology Residency Training: A 5-Year Update.
Clements, Matthew B; Morrison, Kasey Y; Schenkman, Noah S
2016-03-01
Medical simulation offers the advantage of improving resident skill and comfort without impacting patient care. Five years ago, we identified trends in the use of robotic and laparoscopic simulation in 2008 and 2009 at American urology residency training programs. We seek to identify the changes in the use of simulators and the presence of formal curricula in the wake of technological advances and changes in graduate medical education. Attendees of the American Urological Association (AUA) Basic Sciences Course, mostly in their second or third year of residency, were surveyed on the availability and use of laparoscopic/robotic simulators at their program, the presence of a formal curriculum, and a Likert scale questionnaire regarding face and content validity. Over a 5-year period, the availability of virtual reality robotic simulators substantially increased from 14% to nearly 60% availability in 2013. Despite this increase, the frequency of simulator use remained unchanged (p = 0.40) and the reported presence of formal curricula decreased from 41% to 34.8%. There was no significant difference in simulator use between residents in programs with or without laparoscopic/robotic curricula (p = 0.95). There was also a decrease in the percentage of residents who felt official laparoscopic curricula (93%-81%) and simulators (82%-74%) should be involved in resident education. In the past 5 years, despite evidence supporting benefits from simulator use and increasing availability, self-reported resident use has remained unchanged and the reporting of presence of laparoscopic/robotic curricula has decreased. With more dedicated investment in formal curricula, residency training programs may receive greater returns on their simulator investments, improve resident skills and comfort, and ultimately improve the quality of patient care.
-
42 CFR 413.79 - Direct GME payments: Determination of the weighted number of FTE residents.
2010-10-01
... the initial residency period for a resident in an approved child neurology program is the period of... approved preventive medicine residency or fellowship program also may be counted as a full FTE resident for... in geriatric medicine, accredited by the appropriate approving body listed in § 415.152 of this...
-
Gonzalez, Nestor R; Dusick, Joshua R; Martin, Neil A
2012-07-01
Changes in neurosurgical practice and graduate medical education impose new challenges for training programs. We present our experience providing neurosurgical residents with digital and mobile educational resources in support of the departmental academic activities. A weekly mandatory conference program for all clinical residents based on the Accreditation Council for Graduate Medical Education competencies, held in protected time, was introduced. Topics were taught through didactic sessions and case discussions. Faculty and residents prepare high-quality presentations, equivalent to peer-review leading papers or case reports. Presentations are videorecorded, stored in a digital library, and broadcasted through our Website and iTunes U. Residents received mobile tablet devices with remote access to the digital library, applications for document/video management, and interactive teaching tools. Residents responded to an anonymous survey, and performances on the Self-Assessment in Neurological Surgery examination before and after the intervention were compared. Ninety-two percent reported increased time used to study outside the hospital and attributed the habit change to the introduction of mobile devices; 67% used the electronic tablets as the primary tool to access the digital library, followed by 17% hospital computers, 8% home computers, and 8% personal laptops. Forty-two percent have submitted operative videos, cases, and documents to the library. One year after introducing the program, results of the Congress of Neurological Surgeons-Self-Assessment in Neurological Surgery examination showed a statistically significant improvement in global scoring and improvement in 16 of the 18 individual areas evaluated, 6 of which reached statistical significance. A structured, competency-based neurosurgical education program supported with digital and mobile resources improved reading habits among residents and performance on the Congress of Neurological Surgeons
-
Affect asymmetry and comfort food consumption.
Dubé, Laurette; LeBel, Jordan L; Lu, Ji
2005-11-15
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.
-
An Innovative Clinical Skills “Boot Camp” for Dental Medicine Residents
Directory of Open Access Journals (Sweden)
Jenny Castillo
2017-05-01
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.
-
Improved competence after a palliative care course for internal medicine residents
Mulder, S. F.; Bleijenberg, G.; Verhagen, S. C.; Stuyt, P. M. J.; Schijven, M. P.; Tack, C. J.
2009-01-01
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
-
How "Does" the Comforting Process Work? An Empirical Test of an Appraisal-Based Model of Comforting
Jones, Susanne M.; Wirtz, John G.
2006-01-01
Burleson and Goldsmith's (1998) comforting model suggests an appraisal-based mechanism through which comforting messages can bring about a positive change in emotional states. This study is a first empirical test of three causal linkages implied by the appraisal-based comforting model. Participants (N=258) talked about an upsetting event with a…
-
Wang, Carolyn L; Schopp, Jennifer G; Petscavage, Jonelle M; Paladin, Angelisa M; Richardson, Michael L; Bush, William H
2011-06-01
The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.
-
Energy Technology Data Exchange (ETDEWEB)
Nanjo, K. [Mitsubishi Electric Corp., Tokyo (Japan)
1994-09-05
Taking up the home automation (HA) as the information facility of residence, business and technical trend of HA system together with its present and future condition are described. The service functions of HA system used for multiple dwelling houses are home telephone function, security function, control function and visual communication function. Besides, development concept of dormitory control system and service functions which are attractive to people like owner, manager and residents are described. As for its trend in foreign countries, though in France HA system under government guidance was applied in the 1980`s, it was not successful and market related to HA system was held in check. Since 1990`s, due to government policy for its introduction, this system is getting popular in the residences of disabled person, advanced age person and so forth. As for the development of HA system, more improvement not only indoor the home but also comfort, safety and so forth linking to the outdoor system is necessary. 6 figs.
-
Alders, E.E.; Kurvers, S.R.; Van den Ham, E.R.
2011-01-01
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
-
Matalon, Shanna A; Chikarmane, Sona A; Yeh, Eren D; Smith, Stacy E; Mayo-Smith, William W; Giess, Catherine S
2018-03-19
Increased attention to quality and safety has led to a re-evaluation of the classic apprenticeship model for procedural training. Many have proposed simulation as a supplementary teaching tool. The purpose of this study was to assess radiology resident exposure to procedural training and procedural simulation. An IRB-exempt online survey was distributed to current radiology residents in the United States by e-mail. Survey results were summarized using frequency and percentages. Chi-square tests were used for statistical analysis where appropriate. A total of 353 current residents completed the survey. 37% (n = 129/353) of respondents had never used procedure simulation. Of the residents who had used simulation, most did not do so until after having already performed procedures on patients (59%, n = 132/223). The presence of a dedicated simulation center was reported by over half of residents (56%, n = 196/353) and was associated with prior simulation experience (P = 0.007). Residents who had not had procedural simulation were somewhat likely or highly likely (3 and 4 on a 4-point Likert-scale) to participate if it were available (81%, n = 104/129). Simulation training was associated with higher comfort levels in performing procedures (P simulation training is associated with higher comfort levels when performing procedures, there is variable use in radiology resident training and its use is not currently optimized. Given the increased emphasis on patient safety, these results suggest the need to increase procedural simulation use during residency, including an earlier introduction to simulation before patient exposure. Copyright © 2018 Elsevier Inc. All rights reserved.
-
Smid, Marcela C; Dotters-Katz, Sarah K; Mcelwain, Cora-Ann; Volckmann, Eric T; Schulkin, Jay; Stuebe, Alison M
2017-09-01
The objective of this study is to survey a nationally representative sample of obstetricians regarding comfort, knowledge, and practice patterns of caring for pregnant women after bariatric surgery. We conducted an online survey of US obstetricians and describe obstetrician's demographics, practice settings, and practice patterns. We assessed respondent's knowledge and recommended practices. We compared provider knowledge by years since completing residency, scope of practice (generalist or specialist), and practice setting (academic setting or other). Statistical significance was set at p < 0.05. A total of 106 completed the survey (response rate of 54%). Respondents had a median age of 47 and median 17 years in practice. Sixty-two percent were generalists. Nearly all of the respondents (94%) had some experience with caring for pregnant women after bariatric surgery and 83% reported feeling "very comfortable" (48%) or "somewhat comfortable" (35%) providing care for this population. Most (74%) were aware of increased risk of small for gestational age after surgery. Only 13% were able to correctly identify all recommended nutritional labs and 20% reported that they "did not know" which labs are recommended. There were no differences in comfort, experience, knowledge, and practice patterns by physician characteristics and practice settings. While most obstetricians are aware of perinatal risks after bariatric surgery, a substantial percentage of obstetricians are unaware of recommended practices regarding nutrition and nutritional monitoring. As bariatric surgery becomes increasingly prevalent among reproductive age women, educational interventions to increase obstetricians' knowledge of optimal care of pregnant women after bariatric surgery are urgently needed.
-
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
2016-01-01
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......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...... modeling software. The model simulations show that increased thermal mass can decrease the risk of summer overheating in Alaskan residences. They also show that increased thermal mass does not significantly decrease the annual heat load in residences located in cold climates. These results indicate...
-
Neurology and neurologic practice in China.
Shi, Fu-Dong; Jia, Jian-Ping
2011-11-29
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.
-
Maddry, Joseph K; Varney, Shawn M; Sessions, Daniel; Heard, Kennon; Thaxton, Robert E; Ganem, Victoria J; Zarzabal, Lee A; Bebarta, Vikhyat S
2014-12-01
Simulation-based teaching (SIM) is a common method for medical education. SIM exposes residents to uncommon scenarios that require critical, timely actions. SIM may be a valuable training method for critically ill poisoned patients whose diagnosis and treatment depend on key clinical findings. Our objective was to compare medical simulation (SIM) to traditional lecture-based instruction (LEC) for training emergency medicine (EM) residents in the acute management of critically ill poisoned patients. EM residents completed two pre-intervention questionnaires: (1) a 24-item multiple-choice test of four toxicological emergencies and (2) a questionnaire using a five-point Likert scale to rate the residents' comfort level in diagnosing and treating patients with specific toxicological emergencies. After completing the pre-intervention questionnaires, residents were randomized to SIM or LEC instruction. Two toxicologists and three EM physicians presented four toxicology topics to both groups in four 20-min sessions. One group was in the simulation center, and the other in a lecture hall. Each group then repeated the multiple-choice test and questionnaire immediately after instruction and again at 3 months after training. Answers were not discussed. The primary outcome was comparison of immediate mean post-intervention test scores and final scores 3 months later between SIM and LEC groups. Test score outcomes between groups were compared at each time point (pre-test, post-instruction, 3-month follow-up) using Wilcoxon rank sum test. Data were summarized by descriptive statistics. Continuous variables were characterized by means (SD) and tested using t tests or Wilcoxon rank sum. Categorical variables were summarized by frequencies (%) and compared between training groups with chi-square or Fisher's exact test. Thirty-two EM residents completed pre- and post-intervention tests and comfort questionnaires on the study day. Both groups had higher post-intervention mean test
-
Study on indoor thermal environment in winter for rural residences in Yulin region
Yanjun, Li; Weixiao, Han
2018-02-01
Yulin region is located in the northern part of Shaanxi Province, China. The winter here is very cold and it has a long duration. In this paper, a rural residence which was located in Yulin region was taken as a study object. Indoor thermal environment of the rural residence were tested, including indoor air temperature and air relative humidity. Then, test data were analyzed. It was summarized that indoor thermal environment of test room can not fully meet human thermal comfort needs, and some tactics of regulation building thermal environment were proposed. This research contributes to improvement of indoor thermal environment for local rural residences and it provides reference for rural residences in other cold regions.
-
Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.
Pearl, Phillip L; McConnell, Emily R; Fernandez, Rosamary; Brooks-Kayal, Amy
2014-09-01
The optimal academic home for child neurology programs between adult neurology versus pediatric departments remains an open question. The Professors of Child Neurology, the national organization of child neurology department chairs, division chiefs, and training program directors, was surveyed to evaluate the placement of child neurology programs. Professors of Child Neurology members were surveyed regarding the placement of child neurology programs within adult neurology versus pediatric departments. Questions explored academic versus clinical lines of reporting and factors that may be advantages and disadvantages of these affiliations. Issues also addressed were the current status of board certification and number of clinics expected in academic child neurology departments. Of 120 surveys sent, 95 responses were received (79% response rate). The primary academic affiliation is in neurology in 54% of programs versus 46% in pediatrics, and the primary clinical affiliation is 45% neurology and 55% pediatrics. Advantages versus disadvantages of one's primary affiliation were similar whether the primary affiliation was in neurology or pediatrics. While 61% of respondents are presently board certified in pediatrics, only 2% of those with time-limited certification in general pediatrics plan to be recertified going forward. Typically six to eight half-day clinics per week are anticipated for child neurologists in academic departments without additional funding sources. Overall, leaders of child neurology departments and training programs would not change their affiliation if given the opportunity. Advantages and disadvantages associated with current affiliations did not change whether child neurology was located in neurology or pediatrics. Board certification by the American Board of Psychiatry and Neurology in child neurology is virtually universal, whereas pediatric board certification by the American Board of Pediatrics is being maintained by very few. Most academic
-
The human thermoneutral and thermal comfort zones: Thermal comfort in your own skin blood flow.
Schlader, Zachary J
2015-01-01
Human thermoregulation is achieved via autonomic and behavioral responses. Autonomic responses involve 2 synchronous 'components'. One counteracts large thermal perturbations, eliciting robust heat loss or gain (i.e., sweating or shivering). The other fends off smaller insults, relying solely on changes in sensible heat exchange (i.e., skin blood flow). This sensible component occurs within the thermoneutral zone [i.e., the ambient temperature range in which temperature regulation is achieved only by sensible heat transfer, without regulatory increases in metabolic heat production (e.g., shivering) or evaporative heat loss (e.g., sweating)].(1) The combination of behavior and sensible heat exchange permits a range of conditions that are deemed thermally comfortable, which is defined as the thermal comfort zone.(1) Notably, we spend the majority of our lives within the thermoneutral and thermal comfort zones. It is only when we are unable to stay within these zones that deleterious health and safety outcomes can occur (i.e., hypo- or hyperthermia). Oddly, although the thermoneutral zone and thermal preference (a concept similar to the thermal comfort zone) has been extensively studied in non-human animals, our understanding of human thermoregulation within the thermoneutral and thermal comfort zones remains rather crude.
-
Directory of Open Access Journals (Sweden)
Dixon AC
2015-06-01
Full Text Available Andrew C Dixon Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Objectives: To determine the gaps in knowledge of Canadian pediatric emergency medicine residents with regards to acute fracture identification and management. Due to their predominantly medical prior training, fractures may be an area of weakness requiring a specific curriculum to meet their needs. Methods: A questionnaire was developed examining comfort level and performance on knowledge based questions of trainees in the following areas: interpreting musculoskeletal X-rays; independently managing pediatric fractures, physical examination techniques, applied knowledge of fracture management, and normal development of the bony anatomy. Using modified Dillman technique the instrument was distributed to pediatric emergency medicine residents at seven Canadian sites. Results: Out of 43 potential respondents, 22 (51% responded. Of respondents, mean comfort with X-ray interpretation was 69 (62–76 95% confidence interval [CI] while mean comfort with fracture management was only 53 (45–63 95% CI; mean comfort with physical exam of shoulder 60 (53–68 95% CI and knee 69 (62–76 95% CI was low. Less than half of respondents (47%; 95% CI 26%–69% could accurately identify normal wrist development, correctly manage a supracondylar fracture (39%; 95% CI 20%–61%, or identify a medial epicondyle fracture (44%; 95% CI 24%–66%. Comfort with neurovascular status of the upper (mean 82; 95% CI 75–89 and lower limb (mean 81; 95% CI 74–87 was high. Interpretation: There are significant gaps in knowledge of physical exam techniques, fracture identification and management among pediatric emergency medicine trainees. A change in our current teaching methods is required to meet this need. Keywords: pediatric, fractures, education, radiologic interpretation
-
Improving the comfort of garments
CSIR Research Space (South Africa)
Hunter, L
2014-11-01
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...
-
Energy Technology Data Exchange (ETDEWEB)
Hwang, Ruey-Lung; Shu, Shiu-Ya [Department of Architecture, National United University, 1, Lien-Da, Kung-Ching Li, Miaoli, 36003 (China)
2011-04-15
This paper presents an investigation of the effect of building envelope regulation on thermal comfort and on the energy-saving potential for PMV-based comfort control in glass facade buildings. Occurrences and severity of overheating, based on the PMV-PPD model contained in ISO 7730, were used for the thermal comfort assessment. Parametric study simulations for an actual building with a large glass facade were carried out to predict the changes in thermal comfort levels in a space due to different glazing types, depths of overhang and glazing areas, which are the key parameters of the building envelope regulation index, named ENVLOAD, in Taiwan. The result demonstrates that the ENVLOAD has significant effect on thermal comfort. Additionally, comparative simulations between PMV-based comfort control and conventional thermostatic control were performed to investigate the changes in the energy-saving potential of a thermal comfort-controlled space due to changes of its ENVLOAD. The results demonstrate that the energy-saving potential in a PMV-based controlled space increases with low ENVLOAD conditions. (author)
-
Thermal comfort: research and practice
Hoof, van J.; Mazej, M.; Hensen, J.L.M.
2010-01-01
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
-
[The carrier model of neurology in Hungary: a proposal for the solution until 2020].
Bereczki, Dániel; Csiba, László; Komoly, Sámuel; Vécsei, László; Ajtay, András
2011-11-30
Based on our previous survey on the capacities of neurological services and on the predictable changes in the neurologist workforce in Hungary, we present a proposal for the organization of the structure of neurological services in the future. We discuss the diagnostic groups treated by neurologists, the neurological services and their progressive organization. Using the current capacities as baseline, we propose patient groups to be treated by neurologists in the future, and the levels of services. Based on the tendencies seen in the last years we suggest to consider to allocate acute stroke services exclusively to stroke units in neurological departments, and we identify a few other diagnostic groups where neurology should have a larger share in patient care. We define three levels for inpatient care: university departments, regional/county hospitals, city hospitals. Instead of minimum criteria we assign outpatient and inpatient standards that are functional from the economic point of view as well. University departments cover all areas of neurological services, have a function in graduate and postgraduate training, and on a regional basis they participate in professional quality assurance activities at the county and city hospital levels, and would have a more independent role in residency training. As far as patient care is concerned, the task of the regional/county hospitals would be similar to that of university departments - without the exclusively university functions. A general neurological service would be offered at the city hospital level - the representation of all subspecialties of neurology is not required. Neurorehabilitation would be organized at special units of neurological wards at the city hospital level, at independent neurorehabilitation wards in regional/county hospitals, and also as an outpatient service offered at the patients' home. The most significant organizational change would affect the outpatient neurological services. In addition
-
Ioannou, A.; Itard, L.C.M.; Agarwal, Tushar
2018-01-01
Indoor thermal comfort is generally assessed using the PMV or the adaptive model. This research presents the results obtained by in-situ real time measurements of thermal comfort and thermal comfort perception in 17 residential dwellings in the Netherlands. The study demonstrates the new
-
Factors that affecting mothers’ postnatal comfort
Directory of Open Access Journals (Sweden)
Gül Pınar
2009-01-01
Full Text Available Aim: The comfort is defined as; “an expected result of a complex conformation of providing peace and help about individual’s needs in a physical, psycho-spiritual, social and environmental entity to overcome the problems”. The aim of this study was to determine the mother’s postnatal comfort and the affecting factors of it.Materials and Methods: This is a sectional and descriptive study. The study was performed on the mothers (n=150 who applied to the delivery service of the Başkent University Ankara Hospital between the date of 30.07.2008 to 31.12.2008. A questionnaire was developed by the investigators to collect data and determine patients’ postnatal comfort scores. Results: The mean age of women was 26.4±3.5 years, the majority of patients had an educational level of high school (68.7% and were multipara (66.0%. It was determined that the mothers had problems and needed help with the fatigue, pain, in standing up, the adverse effect of anesthesia, personal and perineal hygiene that affect their postnatal comfort. The comfort score of the mothers who had spontaneous vaginal birth was higher than those of underwent cesarean delivery (p<0.05.Conclusion: The mothers’ needs and expectations about themselves and their babies were generally supplied by midwifes and the nurses in the postnatal period. Opinion of the mothers about their comfort were influenced to a positive view and the comfort scores increased while the mothers’ satisfaction were augmented (p<0.05.
-
Primary care perceptions of neurology and neurology services.
Loftus, Angela M; Wade, Carrie; McCarron, Mark O
2016-06-01
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 http://www.bmj.com/company/products-services/rights-and-licensing/
-
Thermal comfort and older adults
Hoof, van J.; Hensen, J.L.M.
2006-01-01
The majority of the increasing number of older adults wishes to age-in-place. Appropriate and comfortable housing is of great importance to facilitate this desire. One of the aspects of concern is thermal comfort. This is normally assessed using the model of Fanger, however, one might ask if this
-
Use and utility of Web-based residency program information: a survey of residency applicants.
Embi, Peter J; Desai, Sima; Cooney, Thomas G
2003-01-01
The Internet has become essential to the residency application process. In recent years, applicants and residency programs have used the Internet-based tools of the National Residency Matching Program (NRMP, the Match) and the Electronic Residency Application Service (ERAS) to process and manage application and Match information. In addition, many residency programs have moved their recruitment information from printed brochures to Web sites. Despite this change, little is known about how applicants use residency program Web sites and what constitutes optimal residency Web site content, information that is critical to developing and maintaining such sites. To study the use and perceived utility of Web-based residency program information by surveying applicants to an internal medicine program. Our sample population was the applicants to the Oregon Health & Science University Internal Medicine Residency Program who were invited for an interview. We solicited participation using the group e-mail feature available through the Electronic Residency Application Service Post-Office application. To minimize the possibility for biased responses, the study was confined to the period between submission of National Residency Matching Program rank-order lists and release of Match results. Applicants could respond using an anonymous Web-based form or by reply to the e-mail solicitation. We tabulated responses, calculated percentages for each, and performed a qualitative analysis of comments. Of the 431 potential participants, 218 responded (51%) during the study period. Ninety-nine percent reported comfort browsing the Web; 52% accessed the Web primarily from home. Sixty-nine percent learned about residency Web sites primarily from residency-specific directories while 19% relied on general directories. Eighty percent found these sites helpful when deciding where to apply, 69% when deciding where to interview, and 36% when deciding how to rank order programs for the Match. Forty
-
Dynamic thermal environment and thermal comfort.
Zhu, Y; Ouyang, Q; Cao, B; Zhou, X; Yu, J
2016-02-01
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.
-
Predictors of Final Specialty Choice by Internal Medicine Residents
Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E
2006-01-01
BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, Pinternal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). CONCLUSION Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process. PMID:16836624
-
Crowley, R Webster; Asthagiri, Ashok R; Starke, Robert M; Zusman, Edie E; Chiocca, E Antonio; Lonser, Russell R
2012-04-01
Factors during neurosurgical residency that are predictive of an academic career path and promotion have not been defined. To determine factors associated with selecting and sustaining an academic career in neurosurgery by analyzing in-training factors for all graduates of American College of Graduate Medical Education (ACGME)-accredited programs between 1985 and 1990. Neurological surgery residency graduates (between 1985 and 1990) from ACGME-approved training programs were analyzed to determine factors associated with choosing an academic career path and having academic success. Information was available for 717 of the 720 (99%) neurological surgery resident training graduates (678 male, 39 female). One hundred thirty-eight graduates (19.3%) held full-time academic positions. One hundred seven (14.9%) were professors and 35 (4.9%) were department chairs/chiefs. An academic career path/success was associated with more total (5.1 vs 1.9; P female trainees (2.6 vs 0.9 publications; P career but not predictive of becoming professor or chair/chief (P > .05). Defined in-training factors including number of total publications, number of first-author publications, and program size are predictive of residents choosing and succeeding in an academic career path.
-
Energy Technology Data Exchange (ETDEWEB)
Zhang, Hui; Arens, Edward; Huizenga, Charlie [Center for the Built Environment, UC Berkeley (United States); Han, Taeyoung [General Motors Company (United States)
2010-02-15
A three-part series presents the development of models for predicting the local thermal sensation (Part I) and local thermal comfort (Part II) of different parts of the human body, and also the whole-body sensation and comfort (Part III) that result from combinations of local sensation and comfort. The models apply to sedentary activities in a range of environments: uniform and non-uniform, stable and transient. They are based on diverse findings from the literature and from body-part-specific human subject tests in a climate chamber. They were validated against a test of automobile passengers. The series is intended to present the models' rationale, structure, and coefficients, so that others can test them and develop them further as additional empirical data becomes available. A) The whole-body (overall) sensation model has two forms, depending on whether all of the body's segments have sensations effectively in the same direction (e.g warm or cool), or whether some segments have sensations opposite to those of the rest of the body. For each, individual body parts have different weights for warm versus cool sensations, and strong local sensations dominate the overall sensation. If all sensations are near neutral, the overall sensation is close to the average of all body sensations. B) The overall comfort model also has two forms. Under stable conditions, people evaluate their overall comfort by a complaint-driven process, meaning that when two body parts are strongly uncomfortable, no matter how comfortable the other body parts might be, the overall comfort will be near the discomfort level of the two most uncomfortable parts. When the environmental conditions are transient, or people have control over their environments, overall comfort is better than that of the two most uncomfortable body parts. This can be accounted for by adding the most comfortable vote to the two most uncomfortable ones. (author)
-
Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren
2009-04-01
The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must
-
Jagannathan, Jay; Vates, G Edward; Pouratian, Nader; Sheehan, Jason P; Patrie, James; Grady, M Sean; Jane, John A
2009-05-01
Recently, the Institute of Medicine examined resident duty hours and their impact on patient safety. Experts have suggested that reducing resident work hours to 56 hours per week would further decrease medical errors. Although some reports have indicated that cutbacks in resident duty hours reduce errors and make resident life safer, few authors have specifically analyzed the effect of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour limits on neurosurgical resident education and the perceived quality of training. The authors have evaluated multiple objective surrogate markers of resident performance and quality of training to determine the impact of the 80-hour workweek. The United States Medical Licensing Examination (USMLE) Step 1 data on neurosurgical applicants entering ACGME-accredited programs between 1998 and 2007 (before and after the implementation of the work-hour rules) were obtained from the Society of Neurological Surgeons. The American Board of Neurological Surgery (ABNS) written examination scores for this group of residents were also acquired. Resident registration for and presentations at the American Association of Neurological Surgeons (AANS) annual meetings between 2002 and 2007 were examined as a measure of resident academic productivity. As a case example, the authors analyzed the distribution of resident training hours in the University of Virginia (UVA) neurosurgical training program before and after the institution of the 80-hour workweek. Finally, program directors and chief residents in ACGME-accredited programs were surveyed regarding the effects of the 80-hour workweek on patient care, resident training, surgical experience, patient safety, and patient access to quality care. Respondents were also queried about their perceptions of a 56-hour workweek. Despite stable mean USMLE Step 1 scores for matched applicants to neurosurgery programs between 2000 and 2008, ABNS written examination scores for residents
-
The feasibility of establishing a free clinic for uninsured patients with neurologic disorders.
Taylor, Joseph J; Larrew, Thomas; Omole, Armina; Roberts, Mallory; Kornegay, Adam; Kornegay, Kelly; Yamada, Lidia; Revuelta, Gonzalo J; Sohn, Mimi; Hughes, Thomas; Edwards, Jonathan C
2015-08-01
The Dream Center Neurology Clinic (DCNC) is a free specialty clinic associated with the Medical University of South Carolina that provides health care for uninsured patients with neurologic disorders. Routine neurologic care is often neglected by free primary care clinics, leaving indigent and uninsured patients to suffer from treatable neurologic ailments. The DCNC was established by supplementing existing resources from a free primary care facility called the Dream Center. Our strategy of building a high-need specialty service into a preexisting primary care infrastructure may provide a blueprint for neurologists who are eager to address the neurologic needs of the underserved in their local communities. According to local charge estimates, the DCNC has provided roughly $120,000 worth of outpatient neurologic care over the past year. The clinic runs through the collaborative effort of medical students as well as academic and private health care providers. Donated services such as EEG, diagnostic lab work, botulinum toxin, supplies, and imaging are also critical to clinic operations. In addition to providing the uninsured with services that are normally inaccessible to them, the DCNC provides a unique educational opportunity for medical students, residents, and all volunteers who are eager to help and learn.
-
Visual comfort evaluated by opponent colors
Sagawa, Ken
2002-06-01
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.
-
Rhodes, Ramona L.; Tindall, Kate; Xuan, Lei; Paulk, M. Elizabeth; Halm, Ethan A.
2015-01-01
Background Despite increasing awareness about the importance of discussing end-of-life (EOL) care options with terminally ill patients and families, many physicians remain uncomfortable with these discussions. Objective The objective of the study was to examine perceptions of and comfort with EOL care discussions among a group of internal medicine residents and the extent to which comfort with these discussions has improved over time. Methods In 2013, internal medicine residents at a large academic medical center were asked to participate in an on-line survey that assessed their attitudes and experiences with discussing EOL care with terminally-ill patients. These results were compared to data from a similar survey residents in the same program completed in 2006. Results Eighty-three (50%) residents completed the 2013 survey. About half (52%) felt strongly that they were able to have open, honest discussions with patients and families, while 71% felt conflicted about whether CPR was in the patient’s best interest. About half (53%) felt strongly that it was okay for them to tell a patient/family member whether or not CPR was a good idea for them. Compared to 2006 respondents, the 2013 cohort felt they had more lectures about EOL communication, and had watched an attending have an EOL discussion more often. Conclusions Modest improvements were made over time in trainees’ exposure to EOL discussions; however, many residents remain uncomfortable and conflicted with having EOL care discussions with their patients. More effective training approaches in EOL communication are needed to train the next generation of internists. PMID:24418692
-
Rhodes, Ramona L; Tindall, Kate; Xuan, Lei; Paulk, M Elizabeth; Halm, Ethan A
2015-05-01
Despite increasing awareness about the importance of discussing end-of-life (EOL) care options with terminally ill patients and families, many physicians remain uncomfortable with these discussions. The objective of the study was to examine perceptions of and comfort with EOL care discussions among a group of internal medicine residents and the extent to which comfort with these discussions has improved over time. In 2013, internal medicine residents at a large academic medical center were asked to participate in an on-line survey that assessed their attitudes and experiences with discussing EOL care with terminally-ill patients. These results were compared to data from a similar survey residents in the same program completed in 2006. Eighty-three (50%) residents completed the 2013 survey. About half (52%) felt strongly that they were able to have open, honest discussions with patients and families, while 71% felt conflicted about whether CPR was in the patient's best interest. About half (53%) felt strongly that it was okay for them to tell a patient/family member whether or not CPR was a good idea for them. Compared to 2006 respondents, the 2013 cohort felt they had more lectures about EOL communication, and had watched an attending have an EOL discussion more often. Modest improvements were made over time in trainees' exposure to EOL discussions; however, many residents remain uncomfortable and conflicted with having EOL care discussions with their patients. More effective training approaches in EOL communication are needed to train the next generation of internists. © The Author(s) 2014.
-
Entropy generation method to quantify thermal comfort
Boregowda, S. C.; Tiwari, S. N.; Chaturvedi, S. K.
2001-01-01
The present paper presents a thermodynamic approach to assess the quality of human-thermal environment interaction and quantify thermal comfort. The approach involves development of entropy generation term by applying second law of thermodynamics to the combined human-environment system. The entropy generation term combines both human thermal physiological responses and thermal environmental variables to provide an objective measure of thermal comfort. The original concepts and definitions form the basis for establishing the mathematical relationship between thermal comfort and entropy generation term. As a result of logic and deterministic approach, an Objective Thermal Comfort Index (OTCI) is defined and established as a function of entropy generation. In order to verify the entropy-based thermal comfort model, human thermal physiological responses due to changes in ambient conditions are simulated using a well established and validated human thermal model developed at the Institute of Environmental Research of Kansas State University (KSU). The finite element based KSU human thermal computer model is being utilized as a "Computational Environmental Chamber" to conduct series of simulations to examine the human thermal responses to different environmental conditions. The output from the simulation, which include human thermal responses and input data consisting of environmental conditions are fed into the thermal comfort model. Continuous monitoring of thermal comfort in comfortable and extreme environmental conditions is demonstrated. The Objective Thermal Comfort values obtained from the entropy-based model are validated against regression based Predicted Mean Vote (PMV) values. Using the corresponding air temperatures and vapor pressures that were used in the computer simulation in the regression equation generates the PMV values. The preliminary results indicate that the OTCI and PMV values correlate well under ideal conditions. However, an experimental study
-
Possibilities to improve the aircraft interior comfort experience.
Vink, P; Bazley, C; Kamp, I; Blok, M
2012-03-01
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 trip reports and 153 passenger interviews were used to gather opinions about aspects which need to be improved in order to design a more comfortable aircraft interior. The results show clear relationships between comfort and legroom, hygiene, crew attention and seat/personal space. Passengers rate the newer planes significantly better than older ones, indicating that attention to design for comfort has proven effective. The study also shows that rude flight attendants and bad hygiene reduce the comfort experience drastically and that a high comfort rating is related to higher "fly again" values. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.
-
Identifying and Eliminating Deficiencies in the General Surgery Resident Core Competency Curriculum.
Tapia, Nicole M; Milewicz, Allen; Whitney, Stephen E; Liang, Michael K; Braxton, Carla C
2014-06-01
Although the Accreditation Council for Graduate Medical Education has defined 6 core competencies required of resident education, no consensus exists on best practices for reaching resident proficiency. Surgery programs must develop resourceful methods to incorporate learning. While patient care and medical knowledge are approached with formal didactics and traditional Halstedian educational formats, other core competencies are presumed to be learned on the job or emphasized in conferences. To test the hypothesis that our residents lack a foundation in several of the nonclinical core competencies and to seek to develop a formal curriculum that can be integrated into our current didactic time, with minimal effect on resident work hours and rest hours. Anonymous Likert-type scale needs assessment survey requesting residents within a large single general surgery residency program to rate their understanding, working knowledge, or level of comfort on the following 10 topics: negotiation and conflict resolution; leadership styles; health care legislation; principles of quality delivery of care, patient safety, and performance improvement; business of medicine; clinical practice models; role of advocacy in health care policy and government; personal finance management; team building; and roles of innovation and technology in health care delivery. Proportions of resident responses scored as positive (agree or strongly agree) or negative (disagree or strongly disagree). In total, 48 surgery residents (70%) responded to the survey. Only 3 topics (leadership styles, team building, and roles of innovation and technology in health care delivery) had greater than 70% positive responses, while 2 topics (negotiation and conflict resolution and principles of quality delivery of care, patient safety, and performance improvement) had greater than 60% positive responses. The remaining topics had less than 40% positive responses, with the least positive responses on the topics
-
Understanding the adaptive approach to thermal comfort
Energy Technology Data Exchange (ETDEWEB)
Humphreys, M.A. [Oxford Univ. (United Kingdom). Centre for the Study of Christianity and Culture; Nicol, J.F. [Oxford Brookes Univ. (United Kingdom). School of Architecture
1998-10-01
This paper explains the adaptive approach to thermal comfort, and an adaptive model for thermal comfort is presented. The model is an example of a complex adaptive system (Casti 1996) whose equilibria are determined by the restrictions acting upon it. People`s adaptive actions are generally effective in securing comfort, which occurs at a wide variety of indoor temperatures. These comfort temperatures depend upon the circumstances in which people live, such as the climate and the heating or cooling regime. The temperatures may be estimated from the mean outdoor temperature and the availability of a heating or cooling plant. The evaluation of the parameters of the adaptive model requires cross-sectional surveys to establish current norms and sequential surveys (with and without intervention) to evaluate the rapidity of people`s adaptive actions. Standards for thermal comfort will need revision in the light of the adaptive approach. Implications of the adaptive model for the HVAC industry are noted.
-
Chee, Yewlin E; Newman, Lori R; Loewenstein, John I; Kloek, Carolyn E
2015-01-01
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.
-
Zhang, Hui; Arens, Edward; Huizenga, Charlie; Han, Taeyoung
2009-01-01
A three-part series presents the development of models for predicting the local thermal sensation (Part I) and local thermal comfort (Part II) of different parts of the human body, and also the whole-body sensation and comfort (Part III) that result from combinations of local sensation and comfort. The models apply to sedentary activities in a range of environments: uniform and non-uniform, stable and transient. They are based on diverse findings from the literature and from body-part-specifi...
-
HUMAN COMFORT AND THE MICROCLIMATIC DRIVERS ...
African Journals Online (AJOL)
Osondu
mean heat stress (poor human comfort), followed by high density residential areas. A major attribute ... Key words: Heat stress, human comfort, microclimate, land use, urban, vegetation. Introduction ... defined by the meteorological Glossary as the physical state of .... which is the focus of the study is characterized by. Human ...
-
National Research Council Canada - National Science Library
Likhachev, Maxim; Arkin, Ronald C
2006-01-01
.... A review of the existing study of human comfort, especially regarding its presence in infants, is conducted with the goal being to determine the relevant characteristics for mapping it onto the robotics domain...
-
Ledford, Christy J W; Cafferty, Lauren A; Seehusen, Dean A
2015-01-01
Uncertainty is a central theme in the practice of medicine and particularly primary care. This study explored how family medicine resident physicians react to uncertainty in their practice. This study incorporated a two-phase mixed methods approach, including semi-structured personal interviews (n=21) and longitudinal self-report surveys (n=21) with family medicine residents. Qualitative analysis showed that though residents described uncertainty as an implicit part of their identity, they still developed tactics to minimize or manage uncertainty in their practice. Residents described increasing comfort with uncertainty the longer they practiced and anticipated that growth continuing throughout their careers. Quantitative surveys showed that reactions to uncertainty were more positive over time; however, the difference was not statistically significant. Qualitative and quantitative results show that as family medicine residents practice medicine their perception of uncertainty changes. To reduce uncertainty, residents use relational information-seeking strategies. From a broader view of practice, residents describe uncertainty neutrally, asserting that uncertainty is simply part of the practice of family medicine.
-
Comfort Indicators for the Assessment of Indoor Environmental Building Performance
DEFF Research Database (Denmark)
Brohus, Henrik; Bendtsen, A.; Sørensen, M.
2006-01-01
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....... This paper discusses and presents a number of comfort indicators that includes both the temporal variation and the degree of discomfort in the calculations. A test case comprising a ventilated office building is used to show the application of the various comfort indices. It is found that the new comfort...
-
DEFF Research Database (Denmark)
Jaffari, Svenja
engineering praxis only, in order to address these issues. The empirical work is based on a user-driven innovation project (Indoor Climate & Quality of Life), where engineers, designers, sociologists and anthropologists met in order to exchange their different perspectives and collaboratively form new ideas...... 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......, engineering scientists and practitioners still seem to struggle with the kinds of alternative processes and products that are needed to achieve sustainable comfort. This dissertation applies everyday practice-oriented design ethnography to a field that has traditionally been investigated by scientific...
-
Design of outdoor urban spaces for thermal comfort
Harriet J. Plumley
1977-01-01
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...
-
Neural computing thermal comfort index for HVAC systems
International Nuclear Information System (INIS)
Atthajariyakul, S.; Leephakpreeda, T.
2005-01-01
The primary purpose of a heating, ventilating and air conditioning (HVAC) system within a building is to make occupants comfortable. Without real time determination of human thermal comfort, it is not feasible for the HVAC system to yield controlled conditions of the air for human comfort all the time. This paper presents a practical approach to determine human thermal comfort quantitatively via neural computing. The neural network model allows real time determination of the thermal comfort index, where it is not practical to compute the conventional predicted mean vote (PMV) index itself in real time. The feed forward neural network model is proposed as an explicit function of the relation of the PMV index to accessible variables, i.e. the air temperature, wet bulb temperature, globe temperature, air velocity, clothing insulation and human activity. An experiment in an air conditioned office room was done to demonstrate the effectiveness of the proposed methodology. The results show good agreement between the thermal comfort index calculated from the neural network model in real time and those calculated from the conventional PMV model
-
Thermal comfort assessment in civil aircraft cabins
Pang Liping; Qin Yue; Liu Dong; Liu Meng
2014-01-01
Aircraft passengers are more and demanding in terms of thermal comfort. But it is not yet easy for aircraft crew to control the environment control system (ECS) that satisfies the thermal comfort for most passengers due to a number of causes. This paper adopts a corrected predicted mean vote (PMV) model and an adaptive model to assess the thermal comfort conditions for 31 investigated flights and draws the conclusion that there does exist an uncomfortable thermal phenomenon in civil aircraft ...
-
Creating high performance buildings: Lower energy, better comfort
International Nuclear Information System (INIS)
Brager, Gail; Arens, Edward
2015-01-01
Buildings play a critical role in the challenge of mitigating and adapting to climate change. It is estimated that buildings contribute 39% of the total U.S. greenhouse gas (GHG) emissions [1] primarily due to their operational energy use, and about 80% of this building energy use is for heating, cooling, ventilating, and lighting. An important premise of this paper is about the connection between energy and comfort. They are inseparable when one talks about high performance buildings. Worldwide data suggests that we are significantly overcooling buildings in the summer, resulting in increased energy use and problems with thermal comfort. In contrast, in naturally ventilated buildings without mechanical cooling, people are comfortable in much warmer temperatures due to shifting expectations and preferences as a result of occupants having a greater degree of personal control over their thermal environment; they have also become more accustomed to variable conditions that closely reflect the natural rhythms of outdoor climate patterns. This has resulted in an adaptive comfort zone that offers significant potential for encouraging naturally ventilated buildings to improve both energy use and comfort. Research on other forms for providing individualized control through low-energy personal comfort systems (desktop fans, foot warmed, and heated and cooled chairs) have also demonstrated enormous potential for improving both energy and comfort performance. Studies have demonstrated high levels of comfort with these systems while ambient temperatures ranged from 64–84°F. Energy and indoor environmental quality are inextricably linked, and must both be important goals of a high performance building
-
International Nuclear Information System (INIS)
Djongyang, Noel; Tchinda, Rene
2010-01-01
Investigations on thermal comfort have attracted authors for years throughout the world and the most important findings are now the basis of international thermal comfort standards. There is little information available concerning occupant comfort and residential thermal environment in the intertropical sub-Saharan Africa. Thus the purpose for this study is to conduct a field study on comfort and residential thermal environments in a typical intertropical climatic region. A field survey has been conducted during the Harmattan season in two cities from the two climatic regions of Cameroon concerned by that wind. Specific study objectives were to evaluate and characterize some thermal perceptions of occupants in their residence, compare observed and predicted percent of dissatisfied, and discern differences between the study area and other climate zones where similar studies have been performed. It was found that the thermoneutral temperatures in both climatic regions range from 24.69 deg. C to 27.32 deg. C and, in traditional living room, it differs from that of modern living room with approximately 1 deg. C.
-
MONITORING OF LOWER LIMB COMFORT AND INJURY IN ELITE FOOTBALL
Directory of Open Access Journals (Sweden)
Michael Kinchington
2010-12-01
Full Text Available The aim of the study was to examine the relation between lower limb comfort scores and injury and to measure the responsiveness of a lower limb comfort index (LLCI to changes over time, in a cohort of professional footballers. Lower limb comfort was recorded for each individual using a comfort index which assessed the comfort status of five anatomical segments and footwear. Specifically we tested the extent to which comfort zones as measured by the LLCI were related to injury measured as time loss events. The hypothesis for the study was that poor lower limb comfort is related to time loss events (training or match day. A total of 3524 player weeks of data was collected from 182 professional athletes encompassing three codes of football (Australian Rules, Rugby league, Rugby Union. The study was conducted during football competition periods for the respective football leagues and included a period of pre- season training. The results of regression indicated that poor lower limb comfort was highly correlated to injury (R2 =0.77 and accounted for 43.5 time loss events/ 1000hrs football exposure. While poor comfort was predictive of injury 47% of all time loss events it was not statistically relevant (R2 =0.18. The results indicate lower limb comfort can be used to assess the well-being of the lower limb; poor comfort is associated with injury, and the LLCI has good face validity and high criterion-related validity for the relationship between comfort and injury
-
THERMAL COMFORT IN VERNACULAR COURTYARD HOUSES: CASE STUDY -CHHATTISGARH
Swasti Sthapak*1, Dr. Abir Bandyopadhyay2
2017-01-01
The paper firstly introduces vernacular architecture and defines thermal comfort. The second section of this paper gives an account of the way vernacular houses respond to climate and achieve thermal comfort. Vernacular houses of Chhattisgarh, a central state of India are selected for this study to find the evidence that vernacular architecture is likely to be passively comfortable. Courtyards play a vital role in creating thermal comfort along with other social and cultural roles. Vernacular...
-
The Prevalence of Burnout Among US Neurosurgery Residents.
Shakir, Hakeem J; McPheeters, Matthew J; Shallwani, Hussain; Pittari, Joseph E; Reynolds, Renée M
2017-10-27
Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. Its prevalence among US physicians exceeds 50% and is higher among residents/fellows. This is important to the practice of neurosurgery, as burnout is associated with adverse physical health, increased risk of substance abuse, and increased medical errors. To date, no study has specifically addressed the prevalence of burnout among neurosurgery residents. To determine and compare the prevalence of burnout among US neurosurgery residents with published rates for residents/fellows and practicing physicians from other specialties. We surveyed 106 US neurosurgery residency training programs to perform a descriptive analysis of the prevalence of burnout among residents. Data on burnout among control groups were used to perform a cross-sectional analysis. Nonparametric tests assessed differences in burnout scores among neurosurgery residents, and the 2-tailed Fisher's exact test assessed burnout between neurosurgery residents and control populations. Of approximately 1200 US neurosurgery residents, 255 (21.3%) responded. The prevalence of burnout was 36.5% (95% confidence interval: 30.6%-42.7%). There was no significant difference in median burnout scores between gender (P = .836), age (P = .183), or postgraduate year (P = .963) among neurosurgery residents. Neurosurgery residents had a significantly lower prevalence of burnout (36.5%) than other residents/fellows (60.0%; P burnout than other residents/fellows and practicing physicians. The underlying causes for these findings were not assessed and are likely multifactorial. Future studies should address possible causes of these findings. Copyright © 2017 by the Congress of Neurological Surgeons
-
Elevator ride comfort monitoring and evaluation using smartphones
Zhang, Yang; Sun, Xiaowei; Zhao, Xuefeng; Su, Wensheng
2018-05-01
With rapid urbanization, the demand for elevators is increasing, and their level of safety and ride comfort under vibrating conditions has also aroused interest. It is therefore essential to monitor the ride comfort level of elevators. The traditional method for such monitoring depends significantly on regular professional inspections, and requires expensive equipment and professional skill. With this regard, a new method for elevator ride comfort monitoring using a smartphone is demonstrated herein in detail. A variety of high-precision sensors are installed in a smartphone with strong data processing and telecommunication capabilities. A series of validation tests were designed and completed, and the international organization for standardization ISO2631-1997 was applied to evaluate the level of elevator ride comfort. Experimental results indicate that the proposed method is stable and reliable, its precision meets the engineering requirements, and the elevator ride comfort level can be accurately monitored under various situations. The method is very economical and convenient, and provides the possibility for the public to participate in elevator ride comfort monitoring. In addition, the method can both provide a wide range of data support and eliminate data errors to a certain extent.
-
From occupying to inhabiting - a change in conceptualising comfort
International Nuclear Information System (INIS)
Jaffari, Svenja D; Matthews, Ben
2009-01-01
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
-
From occupying to inhabiting - a change in conceptualising comfort
Jaffari, Svenja D.; Matthews, Ben
2009-11-01
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
-
[Comfort and noise level in infants with helmet interface].
Medina, A; Alvarez Fernández, P; Rey Galán, C; Álvarez Mendiola, P; Álvarez Blanco, S; Vivanco Allende, A
2015-10-01
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.
-
Thermal Comfort and Strategies for Energy Conservation.
Rohles, Frederick H., Jr.
1981-01-01
Discusses studies in thermal comfort which served as the basis for the comfort standard. Examines seven variables in the human response to the thermal environment in terms of the ways in which they can be modified to conserve energy. (Author/MK)
-
Niimura, Manabu; Takai, Keisuke; Taniguchi, Makoto
2017-11-01
Early surgical education is required for neurosurgical residents to learn many surgical procedures. However, the participation of less experienced residents may increase perioperative complication rates. Perioperative complication studies in the field of neurosurgery are being increasingly published; however, studies have not yet focused on cervical laminoplasty. The study population included 193 consecutive patients who underwent cervical laminoplasty in Tokyo Metropolitan Neurological Hospital between 2008 and 2014. Patient and surgeon background factors, as well as perioperative complication rates were retrospectively compared between resident and board-certified spine neurosurgeon groups. Deteriorated or newly developed neurological deficits and surgical site complications within 30days of cervical laminoplasty were defined as perioperative complications. Out of 193 patients, 123 (64%) were operated on by residents as the first operator and 70 (36%) by board-certified spine neurosurgeons. No significant differences were observed in patient and surgeon factors between the two groups, except for hyperlipidemia (13 vs 17, p=0.02). Furthermore, no significant differences were noted in perioperative complication rates between the two groups (7 [5.7%] vs 4 [5.7%], p=1). Cervical laminoplasty performed in a standardized manner by residents who received their surgical training in our hospital did not increase perioperative complication rates, and ensured the safety of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.
-
Prevalence and Distribution of Neurological Disease in a Neurology ...
African Journals Online (AJOL)
Uche
Annals of Medical and Health Sciences Research – January 2011 – Vol. 1 N0.1. >>>63<<<. Prevalence and Distribution of Neurological Disease in a. Neurology Clinic in Enugu, Nigeria. Onwuekwe IO* and Ezeala-Adikaibe B*. *Neurology Unit, Department of Medicine,. University of Nigeria Teaching Hospital, Enugu, ...
-
Potential energy savings and thermal comfort
DEFF Research Database (Denmark)
Jensen, Karsten Ingerslev; Rudbeck, Claus Christian; Schultz, Jørgen Munthe
1996-01-01
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....
-
From occupying to inhabiting - a change in conceptualising comfort
Energy Technology Data Exchange (ETDEWEB)
Jaffari, Svenja D; Matthews, Ben, E-mail: svenja@mci.sdu.d, E-mail: matthews@mci.sdu.d [SPIRE Center for Participatory Innovation Research, Mads Clausen Institute, University of Southern Denmark, Alsion 2, 6400 Soenderborg, DK (Denmark)
2009-11-01
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
-
Air humidity requirements for human comfort
DEFF Research Database (Denmark)
Toftum, Jørn; Fanger, Povl Ole
1999-01-01
level near 100% rh. For respiratory comfort are the requirements much more stringent and results in lower permissible indoor air humidities. Compared with the upper humidity limit specified in existing thermal comfort standards, e.g. ASHRAE Addendum 55a, the humidity limit based on skin humidity......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...
-
Progress in thermal comfort research over the last twenty years.
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
2013-12-01
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.
-
Thermal Comfort in a Naturally-Ventilated Educational Building
David Mwale Ogoli
2012-01-01
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 constitu...
-
Investigating the scope of resident patient care handoffs within neurosurgery.
Babu, Maya A; Nahed, Brian V; Heary, Robert F
2012-01-01
Handoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. The issue of handoffs has not been studied in the neurosurgical literature. A validated, 20-question online-survey was sent to neurosurgical residents in all 98 accredited U.S. neurosurgery programs. Survey results were analyzed using tabulations. 449 surveys were completed yielding a 56% response rate. 63% of neurosurgical residents surveyed had not received formal instruction in what constitutes an effective handoff; 24% believe there is high to moderate variability among their co-residents in terms of the quality of the handoff provided; 55% experience three or more interruptions during handoffs on average. 90% of neurosurgical residents surveyed say that handoff most often occurs in a quiet, private area and 56% report a high level of comfort for knowing the potential acute, critical issues affecting a patient when receiving a handoff. There needs to be more focused education devoted to learning effective patient-care handoffs in neurosurgical training programs. Increasingly, handing off a patient adequately and safely is becoming a required skill of residency.
-
Investigating the scope of resident patient care handoffs within neurosurgery.
Directory of Open Access Journals (Sweden)
Maya A Babu
Full Text Available INTRODUCTION: Handoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. The issue of handoffs has not been studied in the neurosurgical literature. METHODS: A validated, 20-question online-survey was sent to neurosurgical residents in all 98 accredited U.S. neurosurgery programs. Survey results were analyzed using tabulations. RESULTS: 449 surveys were completed yielding a 56% response rate. 63% of neurosurgical residents surveyed had not received formal instruction in what constitutes an effective handoff; 24% believe there is high to moderate variability among their co-residents in terms of the quality of the handoff provided; 55% experience three or more interruptions during handoffs on average. 90% of neurosurgical residents surveyed say that handoff most often occurs in a quiet, private area and 56% report a high level of comfort for knowing the potential acute, critical issues affecting a patient when receiving a handoff. CONCLUSIONS: There needs to be more focused education devoted to learning effective patient-care handoffs in neurosurgical training programs. Increasingly, handing off a patient adequately and safely is becoming a required skill of residency.
-
International Nuclear Information System (INIS)
Borderon, Julien; Virgone, Joseph; Cantin, Richard
2015-01-01
Highlights: • Modeling of a PCM/air ventilation system. • Sizing of PCM system units. • Simulation in TRNSYS of the system connected to a house and enhancement of the summer comfort. - Abstract: In the current context of thermal improvement in the building sector, research of new solutions to integrate to the retrofitting process is an essential step in the way of saving energy. With the purpose of maintaining or improving the summer comfort after a retrofitting in a residential building, Phase Change Materials (PCM) could be used to bring enough inertia to use the freshness of night for cooling during the warmest hour in the day. Passive solutions of PCM integration have demonstrated their limited benefits. Using PCM in the way proposed in this article goes through the design of a PCM/air system able to store latent heat. This unit is coupled to the ventilation system to ensure that the heat transfers between the ventilated air and the PCM stock are forced convection and then higher than the ones with natural convection. The fusion and solidification temperature for the PCM needs to be carefully chosen to allow the latent heat storage. To analyze the behavior of such a system in a retrofitted house with the climate of 4 different French cities, simulations in different configurations have been carried out. According to these climates, we analyze the necessary conditions for the improvement of efficiency of PCM use. Also, the appropriate PCM melting temperature range is defined with corresponding existing PCM characteristics. After, optimal thickness is obtained considering the diurnal temperature evolutions. The TRNSYS software runs the modeled house, coupled with Matlab for the PCM/air system model. The number of units of such a system can be changed and adapted to the different climates. Results are expressed in terms of percentage of the time when the indoor operative temperature reaches a certain level. Comparisons are made with classical systems without
-
Regional thermal comfort zone in males and females.
Ciuha, Ursa; Mekjavic, Igor B
2016-07-01
Skin regions differ in their sensitivity to temperature stimuli. The present study examined whether such regional differences were also evident in the perception of thermal comfort. Regional thermal comfort was assessed in males (N=8) and females (N=8), by having them regulate the temperature of the water delivered to a water-perfused suit (WPS), within a temperature range considered thermally comfortable. In separate trials, subjects regulated the temperature of the WPS, or specific regions of the suit covering different skin areas (arms, legs, front torso and back torso). In the absence of subjective temperature regulation (TR), the temperature changed in a sinusoidal manner from 10°C to 50°C; by depressing a switch and reversing the direction of the temperature at the limits of the thermal comfort zone (TCZ), each subject defined TCZ for each body region investigated. The range of regulated temperatures did not differ between genders and skin regions. Local Tsk at the lower and upper limits of the TCZ was similar for both genders. Higher (pthermally comfortable conditions, the well-established regional differences in thermosensitivity are not reflected in the TCZ, with similar temperature preferences by both genders. Thermal comfort of different skin regions and overall body is not achieved at a single skin temperature, but at range of temperatures, defined as the TCZ. Copyright © 2016 Elsevier Inc. All rights reserved.
-
Thermal comfort study of hospital workers in Malaysia.
Yau, Y H; Chew, B T
2009-12-01
This article presents findings of the thermal comfort study in hospitals. A field survey was conducted to investigate the temperature range for thermal comfort in hospitals in the tropics. Thermal acceptability assessment was conducted to examine whether the hospitals in the tropics met the ASHRAE Standard-55 80% acceptability criteria. A total of 114 occupants in four hospitals were involved in the study. The results of the field study revealed that only 44% of the examined locations met the comfort criteria specified in ASHRAE Standard 55. The survey also examined the predicted percentage of dissatisfied in the hospitals. The results showed that 49% of the occupants were satisfied with the thermal environments in the hospitals. The field survey analysis revealed that the neutral temperature for Malaysian hospitals was 26.4 degrees C. The comfort temperature range that satisfied 90% of the occupants in the space was in the range of 25.3-28.2 degrees C. The results from the field study suggested that a higher comfort temperature was required for Malaysians in hospital environments compared with the temperature criteria specified in ASHRAE Standard (2003). In addition, the significant deviation between actual mean vote and predicted mean vote (PMV) strongly implied that PMV could not be applied without errors in hospitals in the tropics. The new findings on thermal comfort temperature range in hospitals in the tropics could be used as an important guide for building services engineers and researchers who are intending to minimize energy usage in heating, ventilating and air conditioning systems in hospitals operating in the tropics with acceptable thermal comfort level and to improve the performance and well-being of its workers.
-
Braking Control for Improving Ride Comfort
Directory of Open Access Journals (Sweden)
Lee Jonghyup
2018-01-01
Full Text Available While many vehicle control systems focus on vehicle safety and vehicle performance at high speeds, most driving conditions are very low risk situations. In such a driving situation, the ride comfort of the vehicle is the most important performance index of the vehicle. Electro mechanical brake (EMB and other brake-by-wire (BBW systems have been actively researched. As a result, braking actuators in vehicles are more freely controllable, and research on improving ride comfort is also possible. In this study, we develop a control algorithm that dramatically improves ride comfort in low risk braking situations. A method for minimizing the inconvenience of a passenger due to a suddenly changing acceleration at the moment when the vehicle is stopped is presented. For this purpose, an acceleration trajectory is generated that minimizes the discomfort index defined by the change in acceleration, jerk. A controller is also designed to track this trajectory. The algorithm that updates the trajectory is designed considering the error due to the phase lag occurring in the controller and the plant. In order to verify the performance of this controller, simulation verification is completed using a car simulator, Carsim. As a result, it is confirmed that the ride comfort is dramatically improved.
-
Regional differences in temperature sensation and thermal comfort in humans.
Nakamura, Mayumi; Yoda, Tamae; Crawshaw, Larry I; Yasuhara, Saki; Saito, Yasuyo; Kasuga, Momoko; Nagashima, Kei; Kanosue, Kazuyuki
2008-12-01
Sensations evoked by thermal stimulation (temperature-related sensations) can be divided into two categories, "temperature sensation" and "thermal comfort." Although several studies have investigated regional differences in temperature sensation, less is known about the sensitivity differences in thermal comfort for the various body regions. In the present study, we examined regional differences in temperature-related sensations with special attention to thermal comfort. Healthy male subjects sitting in an environment of mild heat or cold were locally cooled or warmed with water-perfused stimulators. Areas stimulated were the face, chest, abdomen, and thigh. Temperature sensation and thermal comfort of the stimulated areas were reported by the subjects, as was whole body thermal comfort. During mild heat exposure, facial cooling was most comfortable and facial warming was most uncomfortable. On the other hand, during mild cold exposure, neither warming nor cooling of the face had a major effect. The chest and abdomen had characteristics opposite to those of the face. Local warming of the chest and abdomen did produce a strong comfort sensation during whole body cold exposure. The thermal comfort seen in this study suggests that if given the chance, humans would preferentially cool the head in the heat, and they would maintain the warmth of the trunk areas in the cold. The qualitative differences seen in thermal comfort for the various areas cannot be explained solely by the density or properties of the peripheral thermal receptors and thus must reflect processing mechanisms in the central nervous system.
-
Environmental Comfort Indicators for School Buildings in Sustainability Assessment Tools
Directory of Open Access Journals (Sweden)
Tatiana Santos Saraiva
2018-06-01
Full Text Available Decades ago, the only requirement to construct a building was to give men the right conditions for the execution of their work or leisure activities. With the development of knowledge about the internal and external environments of buildings, other requirements have been added such as the issue of user comfort. New construction techniques have been incorporated and new products have been created to improve internal environment comfort. This research addressed the importance of using indicators related to environmental comfort in sustainability assessment tools applied to school buildings. It also considered the importance of environmental issues for the good performance of human beings, and the harmonious coexistence of the comfort indicators indoor air quality, thermal comfort, visual comfort, acoustic comfort and ergonomic comfort based on data gathered in research carried out with users of high schools (only students. This research was carried out in two different cities of different countries, Guimarães (Portugal and Juiz de Fora (Brazil, that have similar characteristics of teaching standards and climate conditions (temperature and air humidity. In this study, interviews were made through questionnaires and, later, the information collected was analyzed. This study demonstrates the need to include an ergonomic indicator for school buildings in sustainability assessment tools.
-
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)
2003-02-01
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.
-
Comparison of thermal comfort and sensation scales : a case study
Vesely, Michal; Zeiler, Wim; Li, Rongling; Loomans, M.G.L.C.; te Kulve, M.
2015-01-01
Thermal sensation is a conscious feeling that grades the thermal environment, while thermal comfort expresses satisfaction with this feeling. Multiple scales to quantify thermal sensation and comfort have been developed throughout the history of research on thermal comfort. In this paper, the most
-
Physical Environment Comfort Impacts on Office Employee’s Performance
Directory of Open Access Journals (Sweden)
Chua Shirley Jin Lin
2016-01-01
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.
-
Energy Technology Data Exchange (ETDEWEB)
Steen Larsen, T.; Lund Jensen, R.; Daniels, O.
2012-01-15
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)
-
Intelligent multi-objective optimization for building energy and comfort management
Directory of Open Access Journals (Sweden)
Pervez Hameed Shaikh
2018-04-01
Full Text Available The rapid economic and population growth in developing countries, effective and efficient energy usage has turned out to be crucial due to the rising concern of depleting fossil fuels, of which, one-third of primary energy is consumed in buildings and expected to rise by 53% up to 2030. This roaring sector posing a challenge, due to 90% of people spend most of their time in buildings, requires enhanced well-being of indoor environment and living standards. Therefore, building operations require more energy because most of the energy is consumed to make the indoor environment comfortable. Consequently, there is the need of improved energy efficiency to decrease energy consumption in buildings. In relation to this, the primary challenge of building control systems is the energy consumption and comfort level are generally conflicting to each other. Therefore, an important problem of sustainable smart buildings is to effectively manage the energy consumption and comfort and attain the trade-off between the two. Thus, smart buildings are becoming a trend of future construction that facilitates intelligent control in buildings for the fulfillment of occupant’s comfort level. In this study, an intelligent multi-objective system has been developed with evolutionary multi-objective genetic algorithm (MOGA optimization method. The corresponding case study simulation results for the effective management of users’ comfort and energy efficiency have been carried out. The case study results show the management of energy supply for each comfort parameter and maintain high comfort index achieving balance between the energy consumption and comfort level. Keywords: Energy, Buildings, Comfort, Management, Optimization, Trade-off
-
the comfort, measured by means of a sweating manikin (waltertm)
African Journals Online (AJOL)
user
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, as ...
-
Thermal Comfort in a Naturally-Ventilated Educational Building
Directory of Open Access Journals (Sweden)
David Mwale Ogoli
2012-11-01
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
-
Hwang, R-L; Chen, C-P
2010-06-01
This study investigated the thermal sensation of elderly people in Taiwan, older than 60 years, in indoor microclimate at home, and their requirements for establishing thermal comfort. The study was conducted using both a thermal sensation questionnaire and measurement of indoor climatic parameters underlying the thermal environment. Survey results were compared with those reported by Cheng and Hwang (2008, J. Tongji Univ., 38, 817-822) for non-elders to study the variation between different age groups in requirements of indoor thermal comfort. The results show that the predominant strategy of thermal adaptation for elders was window-opening in the summer and clothing adjustment in the winter. The temperature of thermal neutrality was 25.2 degrees C and 23.2 degrees C for the summer and the winter, respectively. Logistically regressed probit modeling on percentage of predicted dissatisfied (PPD) against mean thermal sensation vote revealed that the sensation votes corresponding to a PPD of 20% were +/- 0.75 for elders, about +/- 0.10 less than the levels projected by ISO 7730 model. The range of operative temperature for 80% thermal acceptability for elders in the summer was 23.2-27.1 degrees C, narrower than the range of 23.0-28.6 degrees C reported for non-elders. This is likely a result of a difference in the selection of adaptive strategies. Taiwan in the last decade has seen a rapid growth in the elderly population in its societal structure, and as such the quality of indoor thermal comfort increasingly concerns the elderly people. This study presents the results from field-surveying elders residing in major geographical areas of Taiwan, and discusses the requirements of these elders for indoor thermal comfort in different seasons. Through a comparison with the requirements by non-elders, this study demonstrates the unique sensitivity of elders toward indoor thermal quality and the selection of adaptive strategies that need to be considered when a thermal
-
Directory of Open Access Journals (Sweden)
Noortje Alders
2016-08-01
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
-
Morris, Norma; Balmer, Brian
2006-01-01
In a study of volunteers in medical research, we found contrasting readings of "being comfortable" by the volunteer research subjects and the researchers. Although the experimental process (testing a new kind of diagnostic technology) involved some physical discomfort--and the researchers focused on this--the volunteers' concerns centred on feeling socially comfortable and managing feelings of embarrassment or isolation, and they generally made light of the physical aspects. The bias of volunteer concerns, which is understandable in terms of the different situations of researchers and volunteers and the different tensions they create, has potential implications for the engagement of researchers with their research subjects and prevailing standards for the ethical and accountable conduct of research.
-
Development of Pediatric Neurologic Emergency Life Support Course: A Preliminary Report.
Haque, Anwarul; Arif, Fehmina; Abass, Qalab; Ahmed, Khalid
2017-11-01
Acute neurological emergencies (ANEs) in children are common life-threatening illnesses and are associated with high mortality and severe neurological disability in survivors, if not recognized early and treated appropriately. We describe our experience of teaching a short, novel course "Pediatric Neurologic Emergency Life Support" to pediatricians and trainees in a resource-limited country. This course was conducted at 5 academic hospitals from November 2013 to December 2014. It is a hybrid of pediatric advance life support and emergency neurologic life support. This course is designed to increase knowledge and impart practical training on early recognition and timely appropriate treatment in the first hour of children with ANEs. Neuroresuscitation and neuroprotective strategies are key components of this course to prevent and treat secondary injuries. Four cases of ANEs (status epilepticus, nontraumatic coma, raised intracranial pressure, and severe traumatic brain injury) were taught as a case simulation in a stepped-care, protocolized approach based on best clinical practices with emphasis on key points of managements in the first hour. Eleven courses were conducted during the study period. One hundred ninety-six physicians including 19 consultants and 171 residents participated in these courses. The mean (SD) score was 65.15 (13.87%). Seventy percent (132) of participants were passed (passing score > 60%). The overall satisfaction rate was 85%. Pediatric Neurologic Emergency Life Support was the first-time delivered educational tool to improve outcome of children with ANEs with good achievement and high satisfaction rate of participants. Large number courses are required for future validation.
-
Resident away rotations allow adaptive neurosurgical training.
Gephart, Melanie Hayden; Derstine, Pamela; Oyesiku, Nelson M; Grady, M Sean; Burchiel, Kim; Batjer, H Hunt; Popp, A John; Barbaro, Nicholas M
2015-04-01
Subspecialization of physicians and regional centers concentrate the volume of certain rare cases into fewer hospitals. Consequently, the primary institution of a neurological surgery training program may not have sufficient case volume to meet the current Residency Review Committee case minimum requirements in some areas. To ensure the competency of graduating residents through a comprehensive neurosurgical education, programs may need for residents to travel to outside institutions for exposure to cases that are either less common or more regionally focused. We sought to evaluate off-site rotations to better understand the changing demographics and needs of resident education. This would also allow prospective monitoring of modifications to the neurosurgery training landscape. We completed a survey of neurosurgery program directors and query of data from the Accreditation Council of Graduate Medical Education to characterize the current use of away rotations in neurosurgical education of residents. We found that 20% of programs have mandatory away rotations, most commonly for exposure to pediatric, functional, peripheral nerve, or trauma cases. Most of these rotations are done during postgraduate year 3 to 6, lasting 1 to 15 months. Twenty-six programs have 2 to 3 participating sites and 41 have 4 to 6 sites distinct from the host program. Programs frequently offset potential financial harm to residents rotating at a distant site by support of housing and transportation costs. As medical systems experience fluctuating treatment paradigms and demographics, over time, more residency programs may adapt to meet the Accreditation Council of Graduate Medical Education case minimum requirements through the implementation of away rotations.
-
Impact of measurable physical phenomena on contact thermal comfort
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.
-
Impact of measurable physical phenomena on contact thermal comfort
Directory of Open Access Journals (Sweden)
Fojtlín Miloš
2017-01-01
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.
-
Directory of Open Access Journals (Sweden)
Maria L Bringas
2015-11-01
Full Text Available This study was a two-armed parallel group design aimed at testing real world effectiveness of a music therapy (MT intervention for children with severe neurological disorders. The control group received only the standard neurorestoration program and the experimental group received an additional MT Auditory Attention plus Communication (ACC protocol just before the usual occupational and speech therapy. Multivariate Item Response Theory (MIRT identified a neuropsychological status-latent variable manifested in all children and which exhibited highly significant changes only in the experimental group. Changes in brain plasticity also occurred in the experimental group, as evidenced using a Mismatch Event Related paradigm which revealed significant post intervention positive responses in the latency range between 308 and 400 ms in frontal regions. LORETA EEG source analysis identified prefrontal and midcingulate regions as differentially activated by the MT in the experimental group. Taken together, our results showing improved attention and communication as well as changes in brain plasticity in children with severe neurological impairments, highlight/comfort the importance of MT for the rehabilitation of patients across a wide range of dysfunctions.
-
Viewing Race in the Comfort Zone
Directory of Open Access Journals (Sweden)
Brenda L. Hughes
2014-08-01
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.
-
Comfort and hope in the preanesthesia stage in patients undergoing surgery.
Seyedfatemi, Naima; Rafii, Forough; Rezaei, Mahboubeh; Kolcaba, Katharine
2014-06-01
Comfort and hope have been identified as important components in the care of perianesthesia patients. The purpose of this study was to explore the relationship between comfort and hope in the preanesthesia stage in patients undergoing surgery. A descriptive cross-sectional survey was conducted with 191 surgical patients. Data were collected using the Perianesthesia Comfort Questionnaire and Herth Hope Index. Direct and significant relationships were observed between comfort and hope (P≤.001, r=0.65). Also, significant relationships were observed between educational level and marital status with comfort (P≤.01). The relationship between educational level and hope was significant (P≤.001). Significant relationships were also observed between gender and marital status with hope (P≤.01). Overall, this study showed that a significant relationship exists between comfort and hope. Additionally, some demographic characteristics influenced comfort and hope in these patients. Health care providers should arrange the environment in a way that allows the surgical patients to experience comfort and hope and recognize the impact of personal characteristics when caring for surgical patients, particularly in the preanesthesia stage. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
-
Exploring Holistic Comfort in Children Who Experience a Clinical Venipuncture Procedure.
Bice, April A; Hall, Joanne; Devereaux, Matthew J
2018-06-01
Children often experience the uncomfortable effects of invasive procedures as a part of primary care and during times of illness. Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child's perspective. In this study, holistic comfort related to an invasive venipuncture procedure was explored in children age 5 to 7 years and their caregivers of all ages. A qualitative descriptive design described by Sandelowski was used. The philosophical underpinnings of naturalistic inquiry of Guba and Lincoln were used. Semistructured interviews were conducted with 13 child and 15 caregiver participants. Children also drew pictures to help describe their perceptions. Traditional thematic content analysis described by Hsieh and Shannon yielded four overarching themes of holistic comfort related to venipuncture procedures in children: Body Comfort, Cognitive and Emotional Comfort, Comfort in the Procedure Surroundings, and Comfort Play. Numerous recommendations for future research are included. Implications for nursing and related health sciences, organizational and administrative policy, invasive procedures, theory, and methods were found and are discussed. Findings from this study will assist nurses in providing procedure management for children from a holistic care perspective.
-
Health effects on nearby residents of a wood treatment plant
International Nuclear Information System (INIS)
Dahlgren, James; Warshaw, Raphael; Thornton, John; Anderson-Mahoney, P.M.; Takhar, Harpreet
2003-01-01
Objectives: The aim of the study was to evaluate the health status of nearby residents of a wood treatment plant who had sustained prolonged low-level environmental exposure to wood processing waste chemicals. Methods: A population of 1269 exposed residents who were plaintiffs or potential plaintiffs in a lawsuit against the wood treatment plant were evaluated by questionnaire for a health history and symptoms. A representative sample of 214 exposed subjects was included in the analysis. One hundred thirty-nine controls were selected from 479 unexposed volunteers and matched to the exposed subjects as closely as possible by gender and age. Subjects and controls completed additional questionnaires and were evaluated by a physician for medical history and physical examination, blood and urine testing, neurophysiological and neuropsychological studies, and respiratory testing. Environmental sampling for wood processing waste chemicals was carried out on soil and drainage ditch sediment in the exposed neighborhood. Results: The exposed subjects had significantly more cancer, respiratory, skin, and neurological health problems than the controls. The subjective responses on questionnaires and by physician histories revealed that the residents had a significantly greater prevalence of mucous membrane irritation, and skin and neurological symptoms, as well as cancer. (Exposed versus unexposed, cancer 10.0% versus 2.08%, bronchitis 17.8% versus 5.8%, and asthma by history 40.5% versus 11.0%) There were significantly more neurophysiologic abnormalities in adults of reaction time, trails A and B, and visual field defects. Conclusions: Adverse health effects were significantly more prevalent in long-term residents near a wood treatment plant than in controls. The results of this study suggest that plant emissions from wood treatment facilities should be reduced
-
Directory of Open Access Journals (Sweden)
Netravati M
2005-01-01
Full Text Available There is a distinct shift of emphasis in clinical neurology in the last few decades. A few years ago, it was just sufficient for a clinician to precisely record history, document signs, establish diagnosis and write prescription. In the present context, there has been a significant intrusion of scientific culture in clinical practice. Several criteria have been proposed, refined and redefined to ascertain accurate diagnosis for many neurological disorders. Introduction of the concept of impairment, disability, handicap and quality of life has added new dimension to the measurement of health and disease and neurological disorders are no exception. "Best guess" treatment modalities are no more accepted and evidence based medicine has become an integral component of medical care. Traditional treatments need validation and new therapies require vigorous trials. Thus, proper quantification in neurology has become essential, both in practice and research methodology in neurology. While this aspect is widely acknowledged, there is a limited access to a comprehensive document pertaining to measurements in neurology. This following description is a critical appraisal of various measurements and also provides certain commonly used rating scales/scores in neurological practice.
-
Surgical resident technical skill self-evaluation: increased precision with training progression.
Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L
2017-10-01
Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.
-
Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie
2017-01-01
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.
-
Downar, James; McNaughton, Nancy; Abdelhalim, Tarek; Wong, Natalie; Lapointe-Shaw, Lauren; Seccareccia, Dori; Miller, Kim; Dev, Shelly; Ridley, Julia; Lee, Christie; Richardson, Lisa; McDonald-Blumer, Heather; Knickle, Kerry
2017-02-01
Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care. To determine whether standardized patient simulation offers benefit over didactic sessions alone for improving skill and comfort discussing goals of care. Single-blind, randomized, controlled trial of didactic teaching plus standardized patient simulation versus didactic teaching alone. First-year internal medicine residents. Changes in communication comfort and skill between baseline and 2 months post-training assessed using the Consultation and Relational Empathy measure. We enrolled 94 residents over a 2-year period. Both groups reported a significant improvement in comfort when discussing goals of care with patients. There was no difference in Consultation and Relational Empathy scores following the workshop ( p = 0.79). The intervention group showed a significant increase in Consultation and Relational Empathy scores post-workshop compared with pre-workshop (35.0 vs 31.7, respectively; p = 0.048), whereas there was no improvement in Consultation and Relational Empathy scores in the control group (35.6 vs 36.0; p = 0.4). However, when the results were adjusted for baseline differences in Consultation and Relational Empathy scores in a multivariable regression analysis, group assignment was not associated with an improvement in Consultation and Relational Empathy score. Improvement in comfort scores and perception of benefit were not associated with improvements in Consultation and Relational Empathy scores. Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose.
-
Perceptions of Pediatric Residents Regarding Counseling About Use of Social Networking Sites.
Banker, Sumeet L; Fenick, Ada M; Qin, Li; Talwalkar, Jaideep S
2018-04-01
Increasing use of social networking sites (SNS) among youth prompted professional organizations to urge pediatricians to promote healthy media use. Electronic questionnaires were distributed to 76 pediatric residents at one academic center measuring attitudes, practices, and familiarity with SNS. Of 43 respondents (response rate = 57%), most reported personal SNS use (98%) and familiarity with SNS used by youth (72%), and 88% agreed that pediatricians should provide counseling on SNS use. Only 5% felt they had adequate training on SNS use in children, and just 26% felt comfortable advising families. Residents were less likely to discuss SNS use than general media use (19% vs 56%, P = .007). Media counseling was correlated with SNS counseling ( r = .38, P = .01). Pediatric residents recognize the importance of guiding families on SNS use, yet do not routinely provide counseling despite high levels of personal SNS use and familiarity. Focused training is necessary for pediatricians to prioritize practical guidance.
-
Enthalpy estimation for thermal comfort and energy saving in air conditioning system
International Nuclear Information System (INIS)
Chu, C.-M.; Jong, T.-L.
2008-01-01
The thermal comfort control of a room must consider not only the thermal comfort level but also energy saving. This paper proposes an enthalpy estimation that is conducive for thermal comfort control and energy saving. The least enthalpy estimator (LEE) combines the concept of human thermal comfort with the theory of enthalpy to predict the load for a suitable setting pair in order to maintain more precisely the thermal comfort level and save energy in the air conditioning system
-
Thermal comfort in office buildings: Two case studies commented
Energy Technology Data Exchange (ETDEWEB)
Hens, Hugo S.L.C. [Laboratory of Building Physics, Department of Civil Engineering, K.U. Leuven, Kasteelpark Arenberg 40, B-3001 Leuven (Heverlee) (Belgium)
2009-07-15
Air conditioning in offices has become a current practice in North Western Europe. The main reasons for that are high internal loads, solar gains and increased comfort expectations. Hence, the move away from the naturally ventilated cellular office increased thermal comfort complaints. The paper presents two cases. In both the results of a comfort enquiry are compared with measurements. The enquiries gave numbers of dissatisfied at a PMV zero that were much higher than the standard PMV/PPD curve does. Measurements instead showed that in one of the two offices only comfort complaints could be expected in summer. But even then, the enquired severity of complaints could not be related to the measured data. Several hypotheses are forwarded to explain the results. Individuals interpret the -3 to +3 scale for thermal sensation differently, which has a direct impact on the number of dissatisfied. The standard curve further-on is a most significant mean of thousands of steady state comfort votes under well-controlled conditions while an on site enquiry involves much smaller numbers of people. These have a clear expectation: an improvement of comfort condition, thanks to the study. For that reason they may exaggerate their complaints when enquired. And finally, an alternative PMV versus PPD curve, published in literature, shows more people complaining at a given PMV than the standard curve forwards. (author)
-
Neurologic emergencies in sports.
Williams, Vernon B
2014-12-01
Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.
-
Progress in thermal comfort research over the last twenty years
DEFF Research Database (Denmark)
Dear, R. J. de; Akimoto, T.; Arens, E. A.
2013-01-01
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...... 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...
-
Tan, Chong-Tin
2015-02-10
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.
-
Understanding comfort and senses in social practices: Insights from a Danish field study
DEFF Research Database (Denmark)
Madsen, Line Valdorff; Gram-Hanssen, Kirsten
2017-01-01
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...... other aspects such as air, light and materials, more sustainable ideas of residential comfort might be developed. The paper takes a practice theoretical perspective but argues that the senses should be better incorporated into the approach to understand different aspects of comfort. The paper...... investigates how comfort can be understood as sensorial within theories of practice. This implies understanding how the senses are incorporated in embodied and routinised social practices, through which comfort is sensed and interpreted. Comfort is related to a range of everyday practices in the home...
-
Lubricant effects on low Dk and silicone hydrogel lens comfort.
Ozkan, Jerome; Papas, Eric
2008-08-01
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.
-
[Neurology! Adieau? (Part 2)].
Szirmai, Imre
2010-05-30
The education of neurologists is debilitated worldwide. University professors are engaged in teaching, research and patient-care. This triple challenge is very demanding, and results in permanent insecurity of University employees. To compensate for the insufficient clinical training, some institutes in the USA employ academic staff members exclusively for teaching. The formation of new subspecialties hinders the education and training of general neurologists. At present, four generations of medical doctors are working together in hospitals. The two older generations educate the younger neurologists who have been brought up in the world of limitless network of sterile information. Therefore their manual skills at the bedside and their knowledge of emergency treatment are deficient. Demographics of medical doctors changed drastically. Twice as many women are working in neurology and psychiatry than men. Integrity of neurology is threatened by: (1) Separation of the cerebrovascular diseases from general neurology. Development of "stroke units" was facilitated by the better reimbursement for treatment and by the interest of the pharmaceutical companies. Healthcare politics promoted the split of neurology into two parts. The independent status of "stroke departments" will reduce the rest of clinical neurology to outpatient service. (2) The main argumentation to segregate the rare neurological diseases was that their research will provide benefit for the diseases with high prevalence. This argumentation serves territorial ambitions. The separation of rare diseases interferes with the teaching of differential diagnostics in neurological training. The traditional pragmatic neurology can not be retrieved. The faculty of neurology could retain its integrity by the improvement of diagnostic methods and the ever more effective drugs. Nevertheless, even the progression of neurological sciences induces dissociation of clinical neurology. Neurology shall suffer fragmentation if
-
Thermal comfort assessment in a Dutch hospital setting – model applicability
Ottenheijm, E.M.M.; Loomans, M.G.L.C.; Kort, H.S.M.; Trip, A.
2016-01-01
SUMMARY Limited information is available on thermal comfort performance of the indoor environment in health care facilities both for staff and patients. Thermal comfort models such as Predicted Mean Vote (PMV) and Adaptive Thermal Comfort (ATC), have not been applied extensively for this setting. In
-
A literature review of comfort in the paediatric critical care patient.
Bosch-Alcaraz, Alejandro; Falcó-Pegueroles, Anna; Jordan, Iolanda
2018-03-08
To investigate the meaning of comfort and to contextualise it within the framework of paediatric critical care. The concept of comfort is closely linked to care in all health contexts. However, in specific settings such as the paediatric critical care unit, it takes on particular importance. A literature review was conducted. A literature search was performed of articles in English and Spanish in international health science databases, from 1992-March 2017, applying the quality standards established by the PRISMA methodology and the Joanna Briggs Institute. A total of 1,203 publications were identified in the databases. Finally, 59 articles which met the inclusion criteria were entered in this literature review. Almost all were descriptive studies written in English and published in Europe. The concept of comfort was defined as the immediate condition of being strengthened through having the three types of needs (relief, ease and transcendence) addressed in the four contexts of experience (physical, psychospiritual, social and environmental). Only two valid and reliable tools for assessing comfort were found: the Comfort Scale and the Comfort Behavior Scale. Comfort is subjective and difficult to assess. It has four facets: physical, emotional, social and environmental. High levels of noise and light are the inputs that cause the most discomfort. Comfort is a holistic, universal concept and an important component of quality nursing care. © 2018 John Wiley & Sons Ltd.
-
Siegler, James E; Finegan, Dan; Kasner, Scott E; Price, Raymond S
2017-10-01
Nonemergent communications between nursing staff and residents often occur randomly throughout the workday at teaching institutions, resulting in inefficiency and interruptions of scheduled resident educational conferences or periods of overnight rest. The aim of this study was to determine whether a quality improvement communication strategy can reduce interruptive notifications during scheduled resident didactic sessions. We conducted a prospective, mixed-methods trial of a communication strategy between nurses and residents in 3 neurology units of an academic institution. We measured content and volume of notifications from nurses to residents during scheduled conferences and overnight and categorized these notifications according to levels of urgency. We implemented an intervention requiring multidisciplinary evening work rounds between the on-call resident and charge nurse and batching of nonemergent communications. Survey data were collected. The total census during the 6-month study period was 728 patients. Of the 704 resident-reported nursing notifications, 50% could be safely deferred until change of shift. After the intervention, there was a 52% decrement of notifications (0.52 vs 0.25 notifications per patient, P communication system reduced interruptive calls during educational conferences and overnight by half. This intervention was perceived as safe and effective and resulted in higher satisfaction among participants.
-
Energy Technology Data Exchange (ETDEWEB)
Fransson, Niklas; Skoog, Jennie [Building Services Engineering, Department of Energy and Environment, Chalmers University of Technology, Gothenburg (Sweden); Vaestfjaell, Daniel [Department of Psychology, Goeteborg University (Sweden)
2007-05-15
Today, many procedures for assessing the indoor environment rely on both subjective and objective indicators (e.g. ANSI/ASHRAE 55-2004; ISO 10551). It is however unclear how these two types of measurements are related to perceived comfort. This article aims at assessing the relative utility of subjective (rating scale measures) and objective indicators of perceived comfort of indoor environments. In a hospital setting, physical environmental variables (e.g. temperature, relative humidity and noise level) were simultaneously measured as respondents (both patients and staff) rated their perception of the indoor environment. Regression analyses indicated that the subjective sensory ratings were significantly better than objective indicators at predicting overall rated indoor comfort. These results are discussed in relation to existing measurement procedures and standards. (author)
-
Improving comfort while hiking in a sailing boat
Jansen, A.J.; Van Abbema, A.; Howe, C.
2012-01-01
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
-
Yao, Y; Lian, Z; Liu, W; Jiang, C; Liu, Y; Lu, H
2009-04-01
Human thermal comfort researches mainly focus on the relation between the environmental factors (e.g. ambient temperature, air humidity, and air velocity, etc.) and the thermal comfort sensation based on a large amount of subjective field investigations. Although some physiological factors, such as skin temperature and metabolism were used in many thermal comfort models,they are not enough to establish a perfect thermal comfort model. In this paper,another two physiological factors, i.e. heart rate variation (HRV) and electroencephalograph (EEG), are explored for the thermal comfort study. Experiments were performed to investigate how these physiological factors respond to the environmental temperatures, and what is the relationship between HRV and EEG and thermal comfort. The experimental results indicate that HRV and EEG may be related to thermal comfort, and they may be useful to understand the mechanism of thermal comfort.
-
Effect of comfort pads and incubator design on neonatal radiography
Energy Technology Data Exchange (ETDEWEB)
Jiang, Xia; Baad, Michael; Reiser, Ingrid; Feinstein, Kate A.; Lu, Zhengfeng [University of Chicago Medicine, Department of Radiology, Chicago, IL (United States)
2016-01-15
There has been increasing interest in patient dose reduction in neonatal intensive care units. Removing comfort pads for radiography has been identified as a potential means to decrease patient dose. To assess the effect of comfort pads and support trays on detector entrance exposure (DEE) and image quality for neonatal radiography, and its implication for patient dose. Comfort pads and support trays from three incubator and warmer systems were examined. The attenuation of the primary beam by these structures was measured using a narrow beam geometry. Their effect on DEE and image quality was then assessed using typical neonatal chest radiography techniques with three configurations: (1) both the comfort pad and support included in the beam, (2) only the support tray included and (3) both the comfort pad and support tray removed. Comfort pads and support trays were found to attenuate the primary beam by 6-15%. Eliminating these structures from the X-ray beam's path was found to increase the detector entrance exposure by 28-36% and increase contrast-to-noise ratio by more than 21%, suggesting room for patient dose reduction when the same image quality is maintained. Comfort pads and tray support devices can have a considerable effect on DEE and image quality, with large variations among different incubator designs. Positioning the image detector directly underneath neonatal patients for radiography is a potential means for patient dose reduction. However, such benefit should be weighed against the risks of moving the patient. (orig.)
-
Effect of comfort pads and incubator design on neonatal radiography
International Nuclear Information System (INIS)
Jiang, Xia; Baad, Michael; Reiser, Ingrid; Feinstein, Kate A.; Lu, Zhengfeng
2016-01-01
There has been increasing interest in patient dose reduction in neonatal intensive care units. Removing comfort pads for radiography has been identified as a potential means to decrease patient dose. To assess the effect of comfort pads and support trays on detector entrance exposure (DEE) and image quality for neonatal radiography, and its implication for patient dose. Comfort pads and support trays from three incubator and warmer systems were examined. The attenuation of the primary beam by these structures was measured using a narrow beam geometry. Their effect on DEE and image quality was then assessed using typical neonatal chest radiography techniques with three configurations: (1) both the comfort pad and support included in the beam, (2) only the support tray included and (3) both the comfort pad and support tray removed. Comfort pads and support trays were found to attenuate the primary beam by 6-15%. Eliminating these structures from the X-ray beam's path was found to increase the detector entrance exposure by 28-36% and increase contrast-to-noise ratio by more than 21%, suggesting room for patient dose reduction when the same image quality is maintained. Comfort pads and tray support devices can have a considerable effect on DEE and image quality, with large variations among different incubator designs. Positioning the image detector directly underneath neonatal patients for radiography is a potential means for patient dose reduction. However, such benefit should be weighed against the risks of moving the patient. (orig.)
-
Zeiler, W.; Vissers, D.R.; Maaijen, H.N.; Kling, W.L.; Velden, van der J.A.J.; Larsen, J.P.
2012-01-01
Er vindt onderzoek plaats naar een nieuwe regelstrategie gebaseerd op de toepassing van een draadloos sensor netwerk dat is gekoppeld aan het smart grid. Doel van deze regelstrategie is om op gebruikersniveau energie te kunnen besparen met behoud of zelfs verbetering van het individueel comfort. Er
-
Neurology in a globalizing world: World Congress of Neurology, Vienna, 2013.
Hachinski, Vladimir
2013-06-11
The World Congress of Neurology (figure 1) theme "Neurology in a Globalizing World" acknowledges that science and increasingly medicine and neurology are becoming globalized. The best way to manage change is to shape it. It is becoming increasingly clear that brain diseases, particularly stroke and dementia, are projected to rise at a rate that could overwhelm our clinics and hospitals. Hence a new emphasis on prevention and the need to work across disciplines beyond our traditional roles. Neurologists are the guardians of the brain and need to take the lead role in advancing new approaches in stemming the tide of neurologic diseases.
-
Selection and ranking of patient video cases in paediatric neurology in relation to learner levels.
Balslev, Thomas; Muijtjens, Arno M M; Maarbjerg, Sabine Frølich; de Grave, Willem
2018-05-01
Teaching and learning with patient video cases may add authenticity, enhance diagnostic accuracy and improve chances of early diagnosis. The aim of this study is firstly to identify selection criteria for key Patient video cases (PVCs), secondly to identify trends in relevance of PVCs for learner levels and thirdly, to rank PVCs for learner levels. Based on a literature review, we identified criteria for key PVCs for use in paediatric neurology. We then performed a multi-round Delphi analysis to obtain agreement between 28 expert clinician teachers concerning key PVCs for four learner levels. We identified two major criteria: key PVCs should demonstrate key movements, and these movements should be subtle and/or difficult to note. The expert clinician teachers subsequently assessed a list of 14 topics for key PVCs. We found a clear, increasing trend in relevance scores, from medical students to young residents to experienced residents and specialists. For medical students and residents, epileptic spasms, Down syndrome, developmental delay, cerebral palsy and absence epilepsy were highly ranked. For specialists, conditions like chorea, focal seizures or eye movement disorders topped the ranking list, although ranking was less clear for this group of advanced learners. Key PVCs should demonstrate movements that are difficult to note for learners. Ranked lists of key PVCs for teaching and learning at different learner levels are now available and may help institutions build validated local libraries of PVCs. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
-
Influences of Carbody Vertical Flexibility on Ride Comfort of Railway Vehicles
Directory of Open Access Journals (Sweden)
Dumitriu Mădălina
2017-06-01
Full Text Available The article investigates the influence of the carbody vertical flexibility on the ride comfort of the railway vehicles. The ride comfort is evaluated via the comfort index calculated in three reference points of the carbody. The results of the numerical simulations bring attention to the importance of the carbody symmetrical vertical bending upon the dynamic response of the vehicle, mainly at high velocities. Another conclusion is that the ride comfort can be significantly affected as a function of the symmetrical bending frequency of the carbody. Similarly, there are improvement possibilities for the ride comfort when the best selection of the stiffness in the longitudinal traction system between the carbody and bogie and the vertical suspension damping is made.
-
Perceived health and comfort in relation to energy use and building characteristics
Energy Technology Data Exchange (ETDEWEB)
Roulet, C.-A.; Johner, N. [Ecole Polytechnique Federale, Lausanne (Switzerland); Foradini, F. [E4Tech S., Lausanne (Switzerland); Bluyssen, P.; Cox, C. [TNO Built Environment and Geosciences, Delft (Netherlands); Oliveira Fernandes, E. De [IDMEC-FUEP, Porto (Portugal); Mueller, B. [Technical University of Berlin, Berlin (Germany); Aizlewood, C. [Building Research Establishment, Watford (United Kingdom)
2006-09-15
Within the European research project Health Optimisation Protocol for Energy-efficient Building (HOPE), 96 apartment buildings and 64 office buildings (of which approximately 75% have been designed to be energy-efficient) were investigated. The building characteristics were assessed according to a checklist during a walk-through survey. Occupant questionnaires were used to determine satisfaction about comfort (thermal visual, acoustical and indoor air quality (IAQ)) and their health (Sick Building Syndrome and allergies). Building-averaged collected data are compared, looking for correlations between building characteristics on one hand, and perceived comfort and health on the other hand. Strong correlations are found between perceived IAQ, thermal, acoustic and lighting comfort, confirming results from other studies. Significant correlations between the perceived comfort and building related symptoms were also found, comfortable and healthier buildings being well distinct from uncomfortable ones. Differences of perceived comfort or health between low- and high-energy buildings show that it is possible to design buildings that are healthy, comfortable and energy efficient. (author)
-
Evolution of perceived footwear comfort over a prolonged running session.
Hintzy, F; Cavagna, J; Horvais, N
2015-12-01
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.
-
Measuring comfort in caregivers and patients during late end-of-life care.
Novak, B; Kolcaba, K; Steiner, R; Dowd, T
2001-01-01
The purpose of this study was to test several formats of end-of-life comfort instruments for patients and closely involved caregivers. Kolcaba's Comfort Theory was the theoretical framework utilized. Different response formats for two end-of-life (EOL) comfort questionnaires (for patients and caregivers, respectively), and horizontal and vertical visual analog scales for total comfort (TC) lines were compared in two phases. Evaluable data were collected from both members of 38 patient-caregiver dyads in each phase. Suitable dyads were recruited from two hospice agencies in northeastern Ohio. Cronbach's alpha for the EOL comfort questionnaire (six response Likert-type format) tested during phase I for patients was .98 and for caregivers was .97. Test-retest reliability for the vertical TC line tested during phase I for patients was .64 and for caregivers was .79. The implications of this study for nursing practice and research are derived from the American Nursing Association (ANA) position statement about EOL care, which states that comfort is the goal of nursing for this population. These instruments will be useful for assessing comfort in actively dying patients and comfort of their caregivers as well as for developing evidence-based practice for this population.
-
Determination of thermal and acoustic comfort inside a vehicle's cabin
Ene, Alexandra; Catalina, Tiberiu; Vartires, Andreea
2018-02-01
Thermal and acoustic comfort, inside a vehicle's cabin, are highly interconnected and can greatly influence the health of the passengers. On one hand, the H.V.A.C. system brings the interior air parameters to a comfortable value while on the other hand, it is the main source of noise. It is an intriguing task to find a balance between the two. In this paper, several types of air diffusers were used in order to optimize the ratio between thermal and acoustic interior comfort. Using complex measurements of noise and thermal comfort parameters we have determined for each type of air diffuser the sound pressure level and its impact on air temperature and air velocity.
-
Effects of Drains on Pain, Comfort and Anxiety in Patients Undergone Surgery
Directory of Open Access Journals (Sweden)
Ummu Yildiz Findik
2013-01-01
Full Text Available Backround: Surgical drains negatively affect patients’ comfort, cause anxiety along with pain, as they are used to promote healing after surgery.Purpose: This study aimed to determine pain, comfort and anxiety levels of patients with drains postoperatively.Methodology: Research was performed with 192 patients undergone abdominal, neck, breast and open heart surgery and had surgical and underwater chest drains at the postoperative period. Patient Information Form, Numerical Pain Scale, General Comfort Questionnaire and Trait Anxiety Scale was used for collection of data. In evaluating the data, we used the t-test, variance and correlation analysis, mean, percentage and frequency.Results: The patients’ mean score of pain was 4.67±2.93, comfort was 2.75±0.29 and anxiety was 39.31±9.21. It was found statistically significant that the comfort level decreases as the pain level increases and that the patients undergone open heart surgery and with underwater chest drains have higher pain levels. It was found statistically significant that, comfort level in patients undergone abdominal or cardiac surgery is lower than patients undergone breast or neck surgery, and that the comfort level decreases as the duration of drains increases. The increasing state anxiety while pain increases and comfort decreases was found statistically significant.Conclusions: Surgeries and drains applied after these procedures decrease the comfort level of the patients as increases the pain level. Also, pain and discomfort increase the patients’ anxiety. Nurses who providing care to these patients are suggested to improve measures about pain and anxiety reduction for maintaining of comfort.
-
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....
-
Sarkiss, Christopher A; Riley, Kyle J; Hernandez, Christopher M; Oermann, Eric K; Ladner, Travis R; Bederson, Joshua B; Shrivastava, Raj K
2017-06-01
Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database. An expanded PubMed and Scopus search was conducted for each resident through the present time. We tabulated all articles attributed to each resident. We then categorized the publications based on each neurosurgical subspecialty while in residency. A spreadsheet-based statistical analysis was performed. This formulated the average number of resident articles, h-indices, and most common subspecialty categories by training program. We analyzed 1352 current neurosurgery residents in 105 programs. There were a total of 10 645 publications, of which 3985 were resident first-author publications during the period of study. The most common subspecialties among all resident publications were vascular (24.9%), spine (16.9%), oncology (16.1%), pediatric (5.6%), functional (4.9%), and trauma (3.8%). The average resident published 2.9 first-author papers with average of 38.0 first-author publications by total residents at each program (range 0-241). The average h-index per resident is 2.47 ± 3.25. When comparing previously published faculty h-index program rankings against our resident h-index rankings, there is a strong correlation between the 2 datasets with a clear delineation between Top-20 productivity and that of other programs (average h-index 4.2 vs 1.7, respectively, P productivity on both the resident and faculty level (average h-index 1.6, 1.9, 3.9 for 1, 2, and
-
When dialogue fails. Music therapy with elderly with neurological degenerative diseases
DEFF Research Database (Denmark)
Wigram, Anthony Lewis
2004-01-01
day conversation is building on abilities to remember facts or episodes, to sustain attention, to listen, and to time a response. Without these fundamental cognitive abilities it is difficult to communicate with others – unless the communication is adjusted to the person. Clients with a neurological...... degenerative disease like e.g. dementia are often socially isolated because of their failing abilities to communicate. Even if they live in a facility and are surrounded by care staff and peer residents, they might experience the environment as chaotic and the people as non-comprehensible. A missing meaningful...
-
Ångström-Brännström, Charlotte; Norberg, Astrid
2014-01-01
Children with cancer often undergo a long course of treatment, described as painful, and associated with feelings of discomfort and need of comfort. The aim of this descriptive interview study was to investigate how children, aged 3 to 9 years, undergoing cancer treatment describe their experience of comfort. The children were interviewed and asked to make drawings. Data were content analyzed and four themes were constructed--enduring discomfort, expressing discomfort, finding comfort, and comforting others. The findings show that the children endured discomfort during treatment, and were sometimes able to express it. They found comfort especially from their family and from hospital staff. The children also described that they comforted family members. The findings are in accordance with previous research about children's and adults' accounts of comfort. An incidental finding is that parents were surprised when they listened to the children's accounts of their experience of discomfort and comfort and achieved a better understanding of their children.
-
The role of respondents’ comfort for variance in stated choice surveys
DEFF Research Database (Denmark)
Emang, Diana; Lundhede, Thomas; Thorsen, Bo Jellesmark
2017-01-01
they complete surveys correlates with the error variance in stated choice models of their responses. Comfort-related variables are included in the scale functions of the scaled multinomial logit models. The hypothesis was that higher comfort reduces error variance in answers, as revealed by a higher scale...... parameter and vice versa. Information on, e.g., sleep and time since eating (higher comfort) correlated with scale heterogeneity, and produced lower error variance when controlled for in the model. That respondents’ comfort may influence choice behavior suggests that knowledge of the respondents’ activity......Preference elicitation among outdoor recreational users is subject to measurement errors that depend, in part, on survey planning. This study uses data from a choice experiment survey on recreational SCUBA diving to investigate whether self-reported information on respondents’ comfort when...
-
The effect of human-mattress interface's temperature on perceived thermal comfort.
Califano, R; Naddeo, A; Vink, P
2017-01-01
In recent years, methods that allow for an objective evaluation of perceived comfort, in terms of postural, physiological, cognitive and environmental comfort, have received a great deal of attention from researchers. This paper focuses on one of the factors that influences physiological comfort perception: the temperature difference between users and the objects with which they interact. The first aim is to create a measuring system that does not affect the perceived comfort during the temperatures' acquisition. The main aim is to evaluate how the temperature at the human-mattress interface can affect the level of perceived comfort. A foam mattress has been used for testing in order to take into account the entire back part of the human body. The temperature at the interface was registered by fourteen 100 Ohm Platinum RTDs (Resistance Temperature Detectors) placed on the mattress under the trunk, the shoulders, the buttocks, the legs, the thighs, the arms and the forearms of the test subject. 29 subjects participated in a comfort test in a humidity controlled environment. The test protocol involved: dress-code, anthropometric-based positioning on mattress, environment temperature measuring and an acclimatization time before the test. At the end of each test, each of the test subject's thermal sensations and the level of comfort perception were evaluated using the ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) scale. The data analyses concerned, in the first instance, correlations between the temperature at the interface and comfort levels of the different parts of the body. Then the same analyses were performed independently of the body parts being considered. The results demonstrated that there was no strong correlation among the studied variables and that the total increase of temperature at interface is associated with a reduction in comfort. Copyright © 2016 Elsevier Ltd. All rights reserved.
-
Quality and satisfaction of thermal comfort in Dutch offices
Brink, Henk Willem; Mobach, Mark P.; Balslev Nielsen, S.; Jensen, P.A.
2016-01-01
Purpose: This field study analyses the quality of the actual thermal comfort and indoor air quality in Dutch office buildings. A linear regression analysis was used to determine how much these variables and demographic variables influenced the perceived thermal comfort of office workers. Approach:
-
Design for thermal sensation and comfort states in vehicles cabins
International Nuclear Information System (INIS)
Alahmer, Ali; Abdelhamid, Mahmoud; Omar, Mohammed
2012-01-01
This manuscript investigates the analysis and modeling of vehicular thermal comfort parameters using a set of designed experiments aided by thermography measurements. The experiments are conducted using a full size climatic chamber to host the test vehicle, to accurately assess the transient and steady state temperature distributions of the test vehicle cabin. Further investigate the thermal sensation (overall and local) and the human comfort states under artificially created relative humidity scenarios. The thermal images are calibrated through a thermocouples network, while the outside temperature and relative humidity are manipulated through the climatic environmental chamber with controlled soaking periods to guarantee the steady state conditions for each test scenario. The relative humidity inside the passenger cabin is controlled using a Total Humidity Controller (THC). The simulation uses the experimentally extracted boundary conditions via a 3-D Berkeley model that is set to be fully transient to account for the interactions in the velocity and temperature fields in the passenger compartment, which included interactions from turbulent flow, thermal buoyancy and the three modes of heat transfer conduction, convection and radiation. The model investigates the human comfort by analyzing the effect of the in-cabin relative humidity from two specific perspectives; firstly its effect on the body temporal variation of temperature within the cabin. Secondly, the Local Sensation (LS) and Comfort (LC) are analyzed for the different body segments in addition to the Overall Sensation (OS) and the Overall Comfort (OC). Furthermore, the human sensation is computed using the Fanger model in terms of the Predicted Mean Value (PMV) and the Predicted Percentage Dissatisfied (PPD) indices. The experimental and simulation results show that controlling the RH levels during the heating and the cooling processes (winter and summer conditions respectively) aid the A/C system to
-
Ride comfort analysis with physiological parameters for an e-health train.
Lee, Youngbum; Shin, Kwangsoo; Lee, Sangjoon; Song, Yongsoo; Han, Sungho; Lee, Myoungho
2009-12-01
Transportation by train has numerous advantages over road transportation, especially with regard to energy efficiency, ecological features, safety, and punctuality. However, the contrast in ride comfort between standard road transportation and train travel has become a competitive issue. The ride comfort enhancement technology of tilting trains (TTX) is a particularly important issue in the development of the Korean high-speed railroad business. Ride comfort is now defined in international standards such as UIC13 and ISO2631. The Korean standards such as KSR9216 mainly address physical parameters such as vibration and noise. In the area of ride comfort, living quality parameter techniques have recently been considered in Korea, Japan, and Europe. This study introduces biological parameters, particularly variations in heart rate, as a more direct measure of comfort. Biological parameters are based on physiological responses rather than on purely external mechanical parameters. Variability of heart rate and other physiological parameters of passengers are measured in a simulation involving changes in the tilting angle of the TTX. This research is a preliminary study for the implementation of an e-health train, which would provide passengers with optimized ride comfort. The e-health train would also provide feedback on altered ride comfort situations that can improve a passenger's experience and provide a healthcare service on the train. The aim of this research was to develop a ride comfort evaluation system for the railway industry, the automobile industry, and the air industry. The degree of tilt correlated with heart rate, fatigue, and unrelieved alertness.
-
Outdoor thermal comfort and behaviour in urban area
Inavonna, I.; Hardiman, G.; Purnomo, A. B.
2018-01-01
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.
-
Progress in thermal comfort research over the last twenty years
de Dear, R; Akimoto, T; Arens, E; Brager, G; Candido, C; Cheong, K.W.; Li, B; Nishihara, N; Sekhar, S.C.; Tanabe, S; Toftum, J; Zhang, H; Zhu, Y
2013-01-01
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 ta...
-
The aircraft interior comfort experience of 10,032 passengers
Vink, P.; Mastrigt, S. van
2011-01-01
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
-
The evaluation of (social-)psychological comfort in clothing, a possible approach
Matté, L. L.; Broega, A. C.
2017-10-01
This paper presents the first results of a PhD research on psychological comfort of clothing. In order to understand and conceptualize the psychological aspects of clothing comfort, a variation of the Delphi Method was used to seek opinions from experts. This method was chosen because of its consensus-building features. The results were obtained from a qualitative text analysis, conducted over the experts’ responses to the first round of questions. The analytic process shed some light on the formation of the psychological comfort concept as well as the potential attributes to be evaluated when assessing this comfort dimension.
-
Relationship between comfort and attenuation measurements for two types of earplugs
Directory of Open Access Journals (Sweden)
David C Byrne
2011-01-01
Full Text Available Noise-induced hearing loss is almost always preventable if properly fitted hearing protectors are worn to reduce exposure. Many individuals choose not to wear hearing protection because it may interfere with effective communication in the workplace or it may be uncomfortable. Hearing protector comfort has not received the same amount of attention as noise reduction capability. The present study was conducted to evaluate the comfort level of two different types of insert earplugs as well as the attenuation levels achieved by the earplugs. Attenuation levels were obtained with a commercially available earplug fit-test system, and the comfort ratings were obtained by questionnaire. The primary research objective was to determine whether hearing protector comfort was related to measured attenuation values. A linear mixed effects model provided evidence for an inverse relationship between comfort and attenuation.
-
Gonzalez, Jose L; Gilmer, Loise
2006-09-01
Obesity is a highly burdensome public health issue associated with premature death, multiple comorbid disabilities and staggering healthcare costs. Between 1980-2000, the prevalence of obesity among children and adolescents nearly tripled. Obesity subjects youth to social stigmatization and discrimination. These economic and personal burdens mandate targeted prevention and detection educational programs for all individuals at risk. The most cost-effective method of approaching this obesity epidemic is through education of health professionals. As part of an "Obesity Prevention in Pediatrics" curriculum, postgraduate-year (PGY)-2 residents first observed and then participated in the dietary evaluation and counseling of pediatric patients and their families. Attitudinal questionnaires, multiple-choice knowledge examinations and a pre-established checklist of desired skills and behaviors provided evaluation of the curriculum's effect on the participants' ability and willingness to manage actually obese or at-risk pediatric patients and their families. Attitudinal survey and knowledge test scores from control PGY-3 residents generally confirmed that their knowledge and counseling skills on obesity prevention and management were well below expectation. Following participation in the curriculum, study residents' knowledge tended to improve, as did their level of comfort in counseling obese and at-risk children, adolescents and their parents. Implementation of an "Obesity Prevention in Pediatrics" curriculum appears to improve participants' knowledge base as well as their skills and level of personal comfort in the recognition, evaluation and management, including counseling, of both obese and at-risk pediatric patients and their families.
-
Association between performance on Neurology In-Training and Certification Examinations
Flynn, Frederick G.; Gutmann, Laurie; Pascuzzi, Robert M.; Webb, Lynn; Massey, Janice M.; DeKosky, Steven T.; Foertsch, Mary; Faulkner, Larry R.
2013-01-01
Objective: This study analyzed the relationship between performance on the American Academy of Neurology Residency In-Service Training Examination (RITE) and subsequent performance on the American Board of Psychiatry and Neurology (ABPN) Certification Examination. Methods: Pearson correlation coefficients were used to examine the relationship between performance on the RITE and the Certification Examination for 2 cohorts of adult neurologists and 2 cohorts of child neurologists. The 2 cohorts represented test takers for 2008 and 2009. Results: For adult neurologists, the correlation between the total RITE and the Certification Examination scores was 0.77 (p < 0.01) in 2008 and 0.65 (p < 0.01) in 2009. For child neurologists, it was 0.74 (p < 0.01) in 2008 and 0.56 (p < 0.01) in 2009. Discussion: For 2 consecutive years, there was a significant correlation between performance on the RITE and performance on the ABPN Certification Examination for both adult and child neurologists. The RITE is a self-assessment examination, and performance on the test is a positive predictor of future performance on the ABPN Certification Examination. PMID:23296130
-
Thermal comfort and building energy consumption implications – A review
International Nuclear Information System (INIS)
Yang, Liu; Yan, Haiyan; Lam, Joseph C.
2014-01-01
Highlights: • We review studies of thermal comfort and discuss building energy use implications. • Adaptive comfort models tend to have a wider comfort temperature range. • Higher indoor temperatures would lead to fewer cooling systems and less energy use. • Socio-economic study and post-occupancy evaluation of built environment is desirable. • Important to consider future climate scenarios in heating, cooling and power schemes. - Abstract: Buildings account for about 40% of the global energy consumption and contribute over 30% of the CO 2 emissions. A large proportion of this energy is used for thermal comfort in buildings. This paper reviews thermal comfort research work and discusses the implications for building energy efficiency. Predicted mean vote works well in air-conditioned spaces but not naturally ventilated buildings, whereas adaptive models tend to have a broader comfort temperature ranges. Higher indoor temperatures in summertime conditions would lead to less prevalence of cooling systems as well as less cooling requirements. Raising summer set point temperature has good energy saving potential, in that it can be applied to both new and existing buildings. Further research and development work conducive to a better understanding of thermal comfort and energy conservation in buildings have been identified and discussed. These include (i) social-economic and cultural studies in general and post-occupancy evaluation of the built environment and the corresponding energy use in particular, and (ii) consideration of future climate scenarios in the analysis of co- and tri-generation schemes for HVAC applications, fuel mix and the associated energy planning/distribution systems in response to the expected changes in heating and cooling requirements due to climate change
-
A correct enthalpy relationship as thermal comfort index for livestock.
Rodrigues, Valéria Cristina; da Silva, Iran José Oliveira; Vieira, Frederico Márcio Corrêa; Nascimento, Sheila Tavares
2011-05-01
Researchers working with thermal comfort have been using enthalpy to measure thermal energy inside rural facilities, establishing indicator values for many situations of thermal comfort and heat stress. This variable turned out to be helpful in analyzing thermal exchange in livestock systems. The animals are exposed to an environment which is decisive for the thermoregulatory process, and, consequently, the reactions reflect states of thermal comfort or heat stress, the last being responsable for problems of sanity, behavior and productivity. There are researchers using enthalpy as a qualitative indicator of thermal environment of livestock such as poultry, cattle and hogs in tropical regions. This preliminary work intends to check different enthalpy equations using information from classical thermodynamics, and proposes a direct equation as thermal comfort index for livestock systems.
-
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)
2013-07-01
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.
-
Operating Comfort Prediction Model of Human-Machine Interface Layout for Cabin Based on GEP
Directory of Open Access Journals (Sweden)
Li Deng
2015-01-01
Full Text Available In view of the evaluation and decision-making problem of human-machine interface layout design for cabin, the operating comfort prediction model is proposed based on GEP (Gene Expression Programming, using operating comfort to evaluate layout scheme. Through joint angles to describe operating posture of upper limb, the joint angles are taken as independent variables to establish the comfort model of operating posture. Factor analysis is adopted to decrease the variable dimension; the model’s input variables are reduced from 16 joint angles to 4 comfort impact factors, and the output variable is operating comfort score. The Chinese virtual human body model is built by CATIA software, which will be used to simulate and evaluate the operators’ operating comfort. With 22 groups of evaluation data as training sample and validation sample, GEP algorithm is used to obtain the best fitting function between the joint angles and the operating comfort; then, operating comfort can be predicted quantitatively. The operating comfort prediction result of human-machine interface layout of driller control room shows that operating comfort prediction model based on GEP is fast and efficient, it has good prediction effect, and it can improve the design efficiency.
-
Operating Comfort Prediction Model of Human-Machine Interface Layout for Cabin Based on GEP.
Deng, Li; Wang, Guohua; Chen, Bo
2015-01-01
In view of the evaluation and decision-making problem of human-machine interface layout design for cabin, the operating comfort prediction model is proposed based on GEP (Gene Expression Programming), using operating comfort to evaluate layout scheme. Through joint angles to describe operating posture of upper limb, the joint angles are taken as independent variables to establish the comfort model of operating posture. Factor analysis is adopted to decrease the variable dimension; the model's input variables are reduced from 16 joint angles to 4 comfort impact factors, and the output variable is operating comfort score. The Chinese virtual human body model is built by CATIA software, which will be used to simulate and evaluate the operators' operating comfort. With 22 groups of evaluation data as training sample and validation sample, GEP algorithm is used to obtain the best fitting function between the joint angles and the operating comfort; then, operating comfort can be predicted quantitatively. The operating comfort prediction result of human-machine interface layout of driller control room shows that operating comfort prediction model based on GEP is fast and efficient, it has good prediction effect, and it can improve the design efficiency.
-
Institute of Scientific and Technical Information of China (English)
Wang Xinde
2000-01-01
@@In 1921, the first independent department of neurology was established in Beijing. Before 1949, all over China only 12 professional doctors lectured neurology in medical colleges. Only 30 medically trained personnel were engaged in the neurological departments. The neurological departments contained roughly 200 beds. The thesis on stroke was written by Zhang Shanlei and published in 1922. Author discussed the cerebral stroke on basis of Chinese traditional medicine and European medicine. The first Textbook of Neurology in China was written by Professor Cheng Yu-lin and was published in 1939. In 1952, the Chinese Society of Neurology and Psychiatry of Chinese Medical Association was established. In 1955, the first issue of the Chinese Journal of Neurology and Psychiatry was published.
-
Energy Technology Data Exchange (ETDEWEB)
Hwang, Ruey-Lung [Department of Occupational Safety and Health, China Medical University, 91 Huseh-Shin Road, Taichung 404 (China); Cheng, Ming-Jen [Department of Architecture, Feng Chia University, 100 Wen-Hwa Road, Seatwen, Taichung 407 (China); Lin, Tzu-Ping [Department of Leisure Planning, National Formosa University, 64 Wen-Hua Road, Huwei, Yunlin 632 (China); Ho, Ming-Chin [Architecture and Building Research Institute, Ministry of the Interior, 13F, No. 200, Sec. 3, Bei-sin Road, Sindian City, Taipei County 231 (China)
2009-06-15
A field study conducted in workplaces and residences in Taiwan is carried out to clarify two questions in detail: (1) do people in the tropical climate regions demonstrate a correlation between thermal sensation and thermal dissatisfaction the same as the PMV-PPD formula in the ISO 7730; and (2) does the difference in opportunities to choose from a variety of methods to achieve thermal comfort affects thermal perceptions of occupants? A new predicted formula of percentage of dissatisfied (PD) relating to mean thermal sensation votes (TSVs) is proposed for hot and humid regions. Besides an increase in minimum rate of dissatisfied from 5% to 9%, a shift of the TSV with minimum PD to the cool side of sensation scale is suggested by the new proposed formula. It also reveals that the limits of TSV corresponding to 80% acceptability for hot and humid regions are -1.45 and +0.65 rather than -0.85 and +0.85 suggested by ISO 7730. It is revealed in the findings that the effectiveness, availability and cost of a thermal adaptation method can affect the interviewees' thermal adaptation behaviour. According to the discussion of interviewees' idea about the trade-off between thermal comfort and energy saving, it is found that an energy-saving approach at the cost of sacrificing occupant's thermal comfort is difficult to set into action, but those ensure the occupant's comfort are more acceptable and can be easily popularized. (author)
-
Improving comfort and health with personalized ventilation
DEFF Research Database (Denmark)
Melikov, Arsen Krikor
2004-01-01
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...... 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...
-
Getting to value in neurological care: a roadmap for academic neurology.
Holloway, Robert G; Ringel, Steven P
2011-06-01
Academic neurology is undergoing transformational changes. The public investment in biomedical research and clinical care is enormous and there is a growing perception that the return on this huge investment is insufficient. Hospitals, departments, and individual neurologists should expect more scrutiny as information about their quality of care and financial relationships with industry are increasingly reported to the public. There are unprecedented changes occurring in the financing and delivery of health care and research that will have profound impact on the mission and operation of academic departments of neurology. With the passage of the Patient Protection and Affordable Care Act (PPACA) there will be increasing emphasis on research that demonstrates value and includes the patient's perspective. Here we review neurological investigations of our clinical and research enterprises that focus on quality of care and comparative effectiveness, including cost-effectiveness. By highlighting progress made and the challenges that lie ahead, we hope to create a clinical, educational, and research roadmap for academic departments of neurology to thrive in today's increasingly regulated environment. Copyright © 2011 American Neurological Association.
-
THERMAL COMFORT STUDY OF TEACHERS' ROOM AT SEKOLAH BINA MULIA PONTIANAK
Directory of Open Access Journals (Sweden)
Albert Suryajaya
2014-01-01
Full Text Available Thermal comfort is one of the important aspects to ensure the comfort of a building. School building, e.g. Sekolah Bina Mulia, Pontianak is used for education activities for about eight hours a day. The teachersfourth floor and still applies the natural air ventilation system while other rooms use mechanical ventilation system. It is interesting to see thermal comfort condition in the ort of the room depends on the environment. Because of its position on the fourth floor, the wind circulation can flow freely and the application of air ventilation is possible. The average temperature is 29.599ºC, 71.216% for relative humidity and 0.143 m/s for wind speed, and 29.482ºC for MRT. The average value of PMV is 1.615. The thermal comfort value, based on the average of PPS*(PMV calculation for three days observation is 0.130 and it is the neutral condition. This means the room is comfort for the users and it is mainly because of the windows, sun shading, and the building materials which support the natural air ventilation of the school Kenyamanan termal merupakan salah satu aspek penting untuk memastikan suatu bangunan dapat memberikan kenyamanan bagi penggunanya. Bangunan sekolah, seperti Sekolah Bina Mulia Pontianak merupakan bangunan pendidikan yang digunakan kurang lebih delapan jam dalam satu hari. Ruang guru pada sekolah Bina Mulia, yang terletak pada lantai empat masih menggunakan sistem ventilasi udara alami sementara ruangan lain menggunakan sistem penghawaan mekanikal. Kenyamanan termal pada ruangan tentu sangat tergantung pada Keadaan lingkungan. Karena posisinya yang cukup tinggi, pergerakan udara pada ruangan juga lebih bebas. Artinya, aplikasi ventilasi udara alami sangat memungkinkan. Nilai temperatur udara rata-rata pada ruangan adalah 29,599 ºC, kelembaban 71,216%, kecepatan udara 0,143 m/det dan nilai temperatur radiasi 29,482ºC. Nilai PMV rata-rata pada ruangan adalah 1,615. Nilai PPS*(PMV rata-rata pada ruangan
-
Preparing Emergency Medicine Residents to Disclose Medical Error Using Standardized Patients
Directory of Open Access Journals (Sweden)
Carmen N. Spalding
2017-12-01
Full Text Available Introduction Emergency Medicine (EM is a unique clinical learning environment. The American College of Graduate Medical Education Clinical Learning Environment Review Pathways to Excellence calls for “hands-on training” of disclosure of medical error (DME during residency. Training and practicing key elements of DME using standardized patients (SP may enhance preparedness among EM residents in performing this crucial skill in a clinical setting. Methods This training was developed to improve resident preparedness in DME in the clinical setting. Objectives included the following: the residents will be able to define a medical error; discuss ethical and professional standards of DME; recognize common barriers to DME; describe key elements in effective DME to patients and families; and apply key elements during a SP encounter. The four-hour course included didactic and experiential learning methods, and was created collaboratively by core EM faculty and subject matter experts in conflict resolution and healthcare simulation. Educational media included lecture, video exemplars of DME communication with discussion, small group case-study discussion, and SP encounters. We administered a survey assessing for preparedness in DME pre-and post-training. A critical action checklist was administered to assess individual performance of key elements of DME during the evaluated SP case. A total of 15 postgraduate-year 1 and 2 EM residents completed the training. Results After the course, residents reported increased comfort with and preparedness in performing several key elements in DME. They were able to demonstrate these elements in a simulated setting using SP. Residents valued the training, rating the didactic, SP sessions, and overall educational experience very high. Conclusion Experiential learning using SP is effective in improving resident knowledge of and preparedness in performing medical error disclosure. This educational module can be adapted
-
The evaluation of the overall thermal comfort inside a vehicle
Neacsu, Catalin; Tabacu, Ion; Ivanescu, Mariana; Vieru, Ionel
2017-10-01
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.
-
Predicting Comfort Temperature in Indonesia, an Initial Step to Reduce Cooling Energy Consumption
Directory of Open Access Journals (Sweden)
Tri Harso Karyono
2015-07-01
Full Text Available Indonesia has no reliable thermal comfort standard that is based on research works. The current national standard (SNI 6390:2011 states only a single range of comfort temperature that is 25.5 °C Ta, with a range of +1.5 °C Ta. Previous thermal studies in a number of different buildings in Indonesia showed that the neutral (comfort temperatures of subjects were about 27 to 28 °C, which is higher than the values stated in the standard. As a big country with various ambient temperatures, Indonesian needs a better and more reliable thermal comfort predictor which can be applied properly across the country. This study is an attempt to propose an initial Indonesian thermal predictor, in the form of a simple equation, which could predict comfort temperatures properly across the country. Reanalysing the previous comfort studies in Indonesia, a simple regression equation is constructed as to be used as the initial Indonesian comfort predictor. Using this predictor, the comfort temperatures in a lowland or coastal cities like Jakarta is found to be higher than the current comfort standard. It is expected that this predictor would help to provide a better indoor thermal environment and at the same reduce the cooling energy in air conditioning (AC building, thus reducing a building’s carbon emissions.
-
Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph
2013-09-04
There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a
-
Assessing Thermal Comfort Due to a Ventilated Double Window
Carlos, Jorge S.; Corvacho, Helena
2017-10-01
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.
-
Neurologic complications of vaccinations.
Miravalle, Augusto A; Schreiner, Teri
2014-01-01
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.
-
Testing thermal comfort of trekking boots: an objective and subjective evaluation.
Arezes, P M; Neves, M M; Teixeira, S F; Leão, C P; Cunha, J L
2013-07-01
The study of the thermal comfort of the feet when using a specific type of shoe is of paramount importance, in particular if the main goal of the study is to attend to the needs of users. The main aim of this study was to propose a test battery for thermal comfort analysis and to apply it to the analysis of trekking boots. Methodologically, the project involves both objective and subjective evaluations. An objective evaluation of the thermal properties of the fabrics used in the boots was developed and applied. In addition, the thermal comfort provided when using the boots was also assessed both subjective and objectively. The evaluation of the thermal comfort during use, which was simulated in a laboratory environment, included the measurement of the temperature and moisture of the feet. The subjective assessment was performed using a questionnaire. From the results obtained, it was possible to define an optimal combination of fabrics to apply to trekking boots by considering the provided thermal insulation, air permeability and wicking. The results also revealed that the subjective perception of thermal comfort appears to be more related to the increase in temperature of the feet than to the moisture retention inside the boot. Although the evaluation of knits used in the boots indicated that a particular combination of fibres was optimal for use in the inner layer, the subjective and objective evaluation of thermal comfort revealed that the evaluation provided by users did not necessarily match the technical assessment data. No correlation was observed between the general comfort and specific thermal comfort assessments. Finally, the identification of thermal discomfort by specific foot areas would be useful in the process of designing and developing boots. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.
-
Thermal comfort in naturally ventilated buildings in Maceio, Brazil
Djamila, Harimi
2017-11-01
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.
-
The spatial comfort study of shophouse at Kampung Madras
Ginting, Y. U. U.; Ginting, N.; Zahrah, W.
2018-03-01
This Research comes from the increasing quantity of shophouse in downtown Medan and the suburban area. The condition of shophouse tend to have narrowly spaced rooms, the middle area of the house are poorly lighted, and lots of space left unused. This research is supported by many spatial issues from previous studies. This study is conducted to determine the level of comfort of shophouse as a function of living space and focused on the spatial aspect namely anthropometry, indoor space circulation, space requirement and function, spatial design and indoor visual. This study uses the descriptive method with the qualitative and quantitative approach. Data collection technique is done by field observation, questionnaire method is also used to get the respondent perception of the spatial comfort of a shophouse. The result indicates that the level of spatial comfort of the shophouse is an uncomfort. So the improvements in the circulation of access to the building, spatial design, lighting, and aeration are needed to improve the spatial comfort of a shophouse.
-
Perceived Competence and Comfort in Respiratory Protection
Burgel, Barbara J.; Novak, Debra; Burns, Candace M.; Byrd, Annette; Carpenter, Holly; Gruden, MaryAnn; Lachat, Ann; Taormina, Deborah
2015-01-01
In response to the Institute of Medicine (2011) report Occupational Health Nurses and Respiratory Protection: Improving Education and Training, a nationwide survey was conducted in May 2012 to assess occupational health nurses’ educational preparation, roles, responsibilities, and training needs in respiratory protection. More than 2,000 occupational health nurses responded; 83% perceived themselves as competent, proficient, or expert in respiratory protection, reporting moderate comfort with 12 respiratory program elements. If occupational health nurses had primary responsibility for the respiratory protection program, they were more likely to perceive higher competence and more comfort in respiratory protection, after controlling for occupational health nursing experience, highest education, occupational health nursing certification, industry sector, Association of Occupational Health Professionals in Healthcare membership, taking a National Institute for Occupational Safety and Health spirometry course in the prior 5 years, and perceiving a positive safety culture at work. These survey results document high perceived competence and comfort in respiratory protection. These findings support the development of targeted educational programs and interprofessional competencies for respiratory protection. PMID:23429638
-
Financial and Time Burdens for Medical Students Interviewing for Residency.
Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan
2017-02-01
Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.
-
Determination of thermal and acoustic comfort inside a vehicle’s cabin
Directory of Open Access Journals (Sweden)
2018-01-01
Full Text Available Thermal and acoustic comfort, inside a vehicle’s cabin, are highly interconnected and can greatly influence the health of the passengers. On one hand, the H.V.A.C. system brings the interior air parameters to a comfortable value while on the other hand, it is the main source of noise. It is an intriguing task to find a balance between the two. In this paper, several types of air diffusers were used in order to optimize the ratio between thermal and acoustic interior comfort. Using complex measurements of noise and thermal comfort parameters we have determined for each type of air diffuser the sound pressure level and its impact on air temperature and air velocity.
-
A decision-tree-based model for evaluating the thermal comfort of horses
Directory of Open Access Journals (Sweden)
Ana Paula de Assis Maia
2013-12-01
Full Text Available Thermal comfort is of great importance in preserving body temperature homeostasis during thermal stress conditions. Although the thermal comfort of horses has been widely studied, there is no report of its relationship with surface temperature (T S. This study aimed to assess the potential of data mining techniques as a tool to associate surface temperature with thermal comfort of horses. T S was obtained using infrared thermography image processing. Physiological and environmental variables were used to define the predicted class, which classified thermal comfort as "comfort" and "discomfort". The variables of armpit, croup, breast and groin T S of horses and the predicted classes were then subjected to a machine learning process. All variables in the dataset were considered relevant for the classification problem and the decision-tree model yielded an accuracy rate of 74 %. The feature selection methods used to reduce computational cost and simplify predictive learning decreased model accuracy to 70 %; however, the model became simpler with easily interpretable rules. For both these selection methods and for the classification using all attributes, armpit and breast T S had a higher power rating for predicting thermal comfort. Data mining techniques show promise in the discovery of new variables associated with the thermal comfort of horses.
-
Influence of humidification on comfort during noninvasive ventilation with a helmet.
Ueta, Kazuyoshi; Tomita, Toshiji; Uchiyama, Akinori; Ohta, Noriyuki; Iguchi, Naoya; Goto, Yukiko; Fujino, Yuji
2013-05-01
To evaluate optimal humidifier water temperature when using a helmet for noninvasive ventilation. Twenty-eight healthy individuals underwent 8 cm H2O CPAP ventilation with FIO2 of 0.21 and 0.5. Each was sequentially tested in the following order: using the helmet without humidification at ambient temperature; with humidification with unheated chamber water; and with humidification with the chamber water at 31°C, 34°C, and 37°C. At each setting, after a 20 min stabilization period, measurements were taken. Comfort level at each setting was evaluated using a visual analog scale rated zero (least comfortable) to 10 (most comfortable). Temperature and relative and absolute humidity inside the helmet increased; however, the comfort scores significantly decreased as the humidification chamber water temperature increased. Regardless of the FIO2, statistically significantly highest comfort scores were obtained when humidification water, with and without active humidification, was at ambient temperature. Unacceptable absolute humidity was obtained only without humidification at room temperature when FIO2 was 0.5. With the clinical use of a helmet, for patient comfort and mucosal humidification during CPAP, the most desirable conditions are likely to be obtained by humidifying without heating, that is by leaving the water in the humidifier chamber at room temperature.
-
Eye cosmetic usage and associated ocular comfort.
Ng, Alison; Evans, Katharine; North, Rachel; Purslow, Christine
2012-11-01
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.
-
THERMAL COMFORT STUDY OF AN AIR-CONDITIONED DESIGN STUDIO IN TROPICAL SURABAYA
Directory of Open Access Journals (Sweden)
Agus Dwi Hariyanto
2005-01-01
Full Text Available This paper evaluates the current thermal comfort condition in an air-conditioned design studio using objective measurement and subjective assessment. Objective measurement is mainly to quantify the air temperature, MRT, relative humidity, and air velocity. Subjective assessment is conducted using a questionnaire to determine the occupants thermal comfort sensations and investigate their perception of the thermal comfort level. A design studio in an academic institution in Surabaya was chosen for the study. Results show that more than 80% of the occupants accepted the indoor thermal conditions even though both the environmental and comfort indices exceeded the limit of the standard (ASHRAE Standard 55 and ISO 7730. In addition, non-uniformity of spatial temperature was present in this studio. Some practical recommendations were made to improve the thermal comfort in the design studio.
-
Literature survey on how different factors influence human comfort in indoor environments
DEFF Research Database (Denmark)
Frontczak, Monika Joanna; Wargocki, Pawel
2011-01-01
examined the extent to which other factors unrelated to the indoor environment, such as individual characteristics of building occupants, building-related factors and outdoor climate including seasonal changes, influence whether the indoor environment is evaluated as comfortable or not. The results suggest...... environmental conditions influencing comfort in the built environment were surveyed: thermal, visual and acoustic, as well as air quality. The literature was surveyed to determine which of these conditions were ranked by building users as being the most important determinants of comfort. The survey also...... quality. Thermal comfort is ranked by building occupants to be of greater importance compared with visual and acoustic comfort and good air quality. It also seems to influence to a higher degree the overall satisfaction with indoor environmental quality compared with the impact of other indoor...
-
Reliability of an instrument to determine lower limb comfort in professional football
Directory of Open Access Journals (Sweden)
Michael Kinchington
2010-06-01
Full Text Available Michael Kinchington1, Kevin Ball1, Geraldine Naughton21School of Human Movement, Recreation and Performance, Victoria University, Melbourne, Australia; 2The Centre of Physical Activity Across the Lifespan (COPAAL, Australian Catholic University, Victoria, AustraliaAims and Objectives: This study extends previous work in the field of injury awareness using a novel lower limb comfort index (LLCI, which was developed to assess comfort in professional football. Participants rated comfort for designated anatomical segments of the lower limb utilizing a seven point Likert scale. The aims of the study were (i to assess the reliability of the LLCI in a competitive football environment (Australian Rules and Rugby League, and (ii to assess whether LLCI measurements were responsive to changes in lower limb comfort over time.Methods and Results: The reliability of the LLCI was observed in two professional football environments: Training Week (mean difference 0.1 point, intra-class correlation coefficient, ICC 0.99 for n = 41 participants; and Match Day (mean difference 0.2 points, ICC 0.97 for n = 22 players. Measurements of lower limb comfort were responsive to changes in comfort over time. Within-player differences were not significant for periods 0–8 hrs (P > 0.05 but, generally, significant for time periods 0–24 hrs (P < 0.05, and significant between 24–96 hrs (P < 0.01. The results indicate that the LLCI was reliable when tested for repeated measures and indicated how the index measures lower limb comfort changes over time.Conclusion: This study shows that the use of a lower limb comfort index, when used in a competitive football environment, is both reliable and responsive to change during both a training week and under match day conditions.Keywords: lower limb comfort, musculoskeletal, football, injury
-
Comfort of workers in office buildings: The European HOPE project
Bluyssen, P.M.; Aries, M.; Dommelen, P. van
2011-01-01
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
-
Stress-induced endocrine response and anxiety: the effects of comfort food in rats.
Ortolani, Daniela; Garcia, Márcia Carvalho; Melo-Thomas, Liana; Spadari-Bratfisch, Regina Celia
2014-05-01
The long-term effects of comfort food in an anxiogenic model of stress have yet to be analyzed. Here, we evaluated behavioral, endocrine and metabolic parameters in rats submitted or not to chronic unpredictable mild stress (CUMS), with access to commercial chow alone or to commercial chow and comfort food. Stress did not alter the preference for comfort food but decreased food intake. In the elevated plus-maze (EPM) test, stressed rats were less likely to enter/remain in the open arms, as well as being more likely to enter/remain in the closed arms, than were control rats, both conditions being more pronounced in the rats given access to comfort food. In the open field test, stress decreased the time spent in the centre, independent of diet; neither stress nor diet affected the number of crossing, rearing or grooming episodes. The stress-induced increase in serum corticosterone was attenuated in rats given access to comfort food. Serum concentration of triglycerides were unaffected by stress or diet, although access to comfort food increased total cholesterol and glucose. It is concluded that CUMS has an anorexigenic effect. Chronic stress and comfort food ingestion induced an anxiogenic profile although comfort food attenuated the endocrine stress response. The present data indicate that the combination of stress and access to comfort food, common aspects of modern life, may constitute a link among stress, feeding behavior and anxiety.
-
Outdoor thermal comfort in public space in warm-humid Guayaquil, Ecuador
Johansson, Erik; Yahia, Moohammed Wasim; Arroyo, Ivette; Bengs, Christer
2018-03-01
The thermal environment outdoors affects human comfort and health. Mental and physical performance is reduced at high levels of air temperature being a problem especially in tropical climates. This paper deals with human comfort in the warm-humid city of Guayaquil, Ecuador. The main aim was to examine the influence of urban micrometeorological conditions on people's subjective thermal perception and to compare it with two thermal comfort indices: the physiologically equivalent temperature (PET) and the standard effective temperature (SET*). The outdoor thermal comfort was assessed through micrometeorological measurements of air temperature, humidity, mean radiant temperature and wind speed together with a questionnaire survey consisting of 544 interviews conducted in five public places of the city during both the dry and rainy seasons. The neutral and preferred values as well as the upper comfort limits of PET and SET* were determined. For both indices, the neutral values and upper thermal comfort limits were lower during the rainy season, whereas the preferred values were higher during the rainy season. Regardless of season, the neutral values of PET and SET* are above the theoretical neutral value of each index. The results show that local people accept thermal conditions which are above acceptable comfort limits in temperate climates and that the subjective thermal perception varies within a wide range. It is clear, however, that the majority of the people in Guayaquil experience the outdoor thermal environment during daytime as too warm, and therefore, it is important to promote an urban design which creates shade and ventilation.
-
Research on optimization of test cycles for comfort to the special vehicles
Mitroi, Marian; Chiru, Anghel
2017-10-01
The comfort of vehicles, regardless of their type is represent a requirement to by fulfilled in the context of current technological developments special vehicles generally move under different soil, time, or season conditions, and the land in which the vehicles move is complex and varied in the physical structure. Due to the high level of involvement in the driveability, safety and comfort of automotive, suspension system is a key factor with major implications for vibration and noise, affecting the human body. The objective of the research is related to determining the test cycles of special vehicles that are approaching real situations, to determine the level of comfort. The evaluate of the degree of comfort will be realized on acceleration values recorded, especially the vertical ones that have the highest influence on the human body. Thus, in this way the tests can be established needed to determine the level of comfort required for each particular type of special vehicle. The utility of the test cycles to optimize comfort is given to the accurate identification of the specific test needs, depending on the each vehicle.
-
Thermal comfort in commercial kitchens (RP-1469)
DEFF Research Database (Denmark)
Simone, Angela; Olesen, Bjarne W.; Stoops, John L.
2013-01-01
The indoor climate in commercial kitchens is often unsatisfactory, and working conditions can have a significant effect on employees’ comfort and productivity. The type of establishment (fast food, casual, etc.) and climatic zone can influence thermal conditions in the kitchens. Moreover, the size...... and arrangement of the kitchen zones, appliances, etc., further complicate an evaluation of the indoor thermal environment in commercial kitchens. In general, comfort criteria are stipulated in international standards (e.g., ASHRAE 55 or ISO EN 7730), but are these standardized methods applicable...... dissatisfied (PMV/PPD) index is not directly appropriate for all thermal conditions in commercial kitchens....
-
Beh, Shin C.; Frohman, Teresa; Frohman, Elliot M.
2014-01-01
Summary Neurology is a field known for “eponymophilia.” While eponym use has been a controversial issue in medicine, animal-related metaphoric descriptions continue to flourish in neurologic practice, particularly with the advent of neuroimaging. To provide practicing and trainee neurologists with a useful reference for all these colorful eponyms, we performed a literature review and summarized the various animal eponyms in the practice of neurology (and their etiologic implications) to date. We believe that the ability to recognize animal-like attributes in clinical neurology and neuroradiology may be attributed to a visual phenomenon known as pareidolia. We propose that animal eponyms are a useful method of recognizing clinical and radiologic patterns that aid in the diagnostic process and therefore are effective aidesmémoire and communicative tools that enliven and improve the practice of neurology. PMID:29473555
-
A hyperacute neurology team - transforming emergency neurological care.
Nitkunan, Arani; MacDonald, Bridget K; Boodhoo, Ajay; Tomkins, Andrew; Smyth, Caitlin; Southam, Medina; Schon, Fred
2017-07-01
We present the results of an 18-month study of a new model of how to care for emergency neurological admissions. We have established a hyperacute neurology team at a single district general hospital. Key features are a senior acute neurology nurse coordinator, an exclusively consultant-delivered service, acute epilepsy nurses, an acute neurophysiology service supported by neuroradiology and acute physicians and based within the acute medical admissions unit. Key improvements are a major increase in the number of patients seen, the speed with which they are seen and the percentage seen on acute medical unit before going to the general wards. We have shown a reduced length of stay and readmission rates for patients with epilepsy. Epilepsy accounted for 30% of all referrals. The cost implications of running this service are modest. We feel that this model is worthy of widespread consideration. © Royal College of Physicians 2017. All rights reserved.
-
Curtis, Henry A; Trang, Karen; Chason, Kevin W; Biddinger, Paul D
2018-02-01
Introduction Great demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate Emergency Physicians in the ever-expanding body of disaster medicine knowledge. The authors sought to demonstrate that video-based learning (VBL) could be a promising alternative to traditional learning methods for teaching disaster medicine core competencies. Hypothesis/Problem The objective was to compare VBL to traditional lecture (TL) for instructing Emergency Medicine residents in the American College of Emergency Physicians (ACEP; Irving, Texas USA) disaster medicine core competencies of patient triage and decontamination. A randomized, controlled pilot study compared two methods of instruction for mass triage, decontamination, and personal protective equipment (PPE). Emergency Medicine resident learning was measured with a knowledge quiz, a Likert scale measuring comfort, and a practical exercise. An independent samples t-test compared the scoring of the VBL with the TL group. Twenty-six residents were randomized to VBL (n=13) or TL (n=13). Knowledge score improvement following video (14.9%) versus lecture (14.1%) did not differ significantly between the groups (P=.74). Comfort score improvement also did not differ (P=.64) between video (18.3%) and lecture groups (15.8%). In the practical skills assessment, the VBL group outperformed the TL group overall (70.4% vs 55.5%; Plearning vs traditional lecture for instructing emergency medicine residents in disaster medicine principles of mass triage, decontamination, and personal protective equipment. Prehosp Disaster Med. 2018;33(1):7-12.
-
The effects of vegetation on indoor thermal comfort
DEFF Research Database (Denmark)
Pastore, Luisa; Corrao, Rossella; Heiselberg, Per Kvols
2017-01-01
Highlights •A multi-scale simulation methodology to assess the effects of vegetation on thermal comfort is used. •It application is shown on a case of urban and building retrofit intervention. •The effect of plants on the microclimate and indoor environment is assessed. •A decrease of up to 4.8 °C...... in indoor temperature is registered. •The final impact on the indoor thermal comfort based on the adaptive model is determined....
-
Tomei, Krystal L; Nahass, Meghan M; Husain, Qasim; Agarwal, Nitin; Patel, Smruti K; Svider, Peter F; Eloy, Jean Anderson; Liu, James K
2014-07-01
The number of women pursuing training opportunities in neurological surgery has increased, although they are still underrepresented at senior positions relative to junior academic ranks. Research productivity is an important component of the academic advancement process. We sought to use the h-index, a bibliometric previously analyzed among neurological surgeons, to evaluate whether there are gender differences in academic rank and research productivity among academic neurological surgeons. The h-index was calculated for 1052 academic neurological surgeons from 84 institutions, and organized by gender and academic rank. Overall men had statistically higher research productivity (mean 13.3) than their female colleagues (mean 9.5), as measured by the h-index, in the overall sample (p0.05) in h-index at the assistant professor (mean 7.2 male, 6.3 female), associate professor (11.2 male, 10.8 female), and professor (20.0 male, 18.0 female) levels based on gender. There was insufficient data to determine significance at the chairperson rank, as there was only one female chairperson. Although overall gender differences in scholarly productivity were detected, these differences did not reach statistical significance upon controlling for academic rank. Women were grossly underrepresented at the level of chairpersons in this sample of 1052 academic neurological surgeons, likely a result of the low proportion of females in this specialty. Future studies may be needed to investigate gender-specific research trends for neurosurgical residents, a cohort that in recent years has seen increased representation by women. Copyright © 2013 Elsevier Ltd. All rights reserved.
-
Simulation of global warming effect on outdoor thermal comfort conditions
Energy Technology Data Exchange (ETDEWEB)
Roshan, G.R.; Ranjbar, F. [Univ. of Tehran (IR). Dept. of Physical Geography; Orosa, J.A. [Univ. of A Coruna (Spain). Dept. of Energy
2010-07-01
In the coming decades, global warming and increase in temperature, in different regions of the world, may change indoor and outdoor thermal comfort conditions and human health. The aim of this research was to study the effects of global warming on thermal comfort conditions in indoor ambiences in Iran. To study the increase in temperature, model for assessment of greenhouse-gas induced climate change scenario generator compound model has been used together with four scenarios and to estimate thermal comfort conditions, adaptive model of the American Society of Heating, Refrigerating and Air-Conditioning Engineers has been used. In this study, Iran was divided into 30 zones, outdoor conditions were obtained using meteorological data of 80 climatological stations and changes in neutral comfort conditions in 2025, 2050, 2075 and 2100 were predicted. In accordance with each scenario, findings from this study showed that temperature in the 30 zones will increase by 2100 to between 3.4 C and 5.6 C. In the coming decades and in the 30 studied zones, neutral comfort temperature will increase and be higher and more intense in the central and desert zones of Iran. The low increase in this temperature will be connected to the coastal areas of the Caspian and Oman Sea in southeast Iran. This increase in temperature will be followed by a change in thermal comfort and indoor energy consumption from 8.6 % to 13.1 % in air conditioning systems. As a result, passive methods as thermal inertia are proposed as a possible solution.
-
Data-driven public transport ridership prediction approach including comfort aspects
Van Oort, N.; Drost, M.; Brands, T.; Yap, M.
2015-01-01
The most important aspects on which passengers base their choice whether to travel by public transport are the perceived travel time, costs, reliability and comfort. Despite its importance, comfort is often not explicitly considered when predicting demand for public transport. In this paper, we
-
Comfort in High-Performance Homes in a Hot-Humid Climate
Energy Technology Data Exchange (ETDEWEB)
Poerschke, A. [IBACOS, Inc., Pittsburgh, PA (United States); Beach, R. [IBACOS, Inc., Pittsburgh, PA (United States)
2016-01-22
"9IBACOS monitored 37 homes during the late summer and early fall of 2014 in a hot and humid climate to better understand indoor comfort conditions. These homes were constructed in the last several years by four home builders that offered a comfort and performance guarantee for the homes. The homes were located in one of four cities: Tampa, Florida; Orlando, Florida; Houston, Texas; and San Antonio, Texas. Temperature and humidity data were collected from the thermostat and each room of the house using small, battery-powered data loggers. To understand system runtime and its impact on comfort, supply air temperature also was measured on a 1-minute interval. Overall, the group of homes only exceeded a room-to-room temperature difference of 6 degrees F for 5% of the time. For 80% of the time, the rooms in each house were within 4 degrees F of each other. Additionally, the impact of system runtime on comfort is discussed. Finally, measurements made at the thermostat were used to better understand the occupant operation of each cooling system's thermostat setpoint. Builders were questioned on their perceived impact of offering a comfort and performance guarantee. Their feedback, which generally indicates a positive perception, has been summarized in the report.
-
Evaluation of Bus Vibration Comfort Based on Passenger Crowdsourcing Mode
Directory of Open Access Journals (Sweden)
Hong Zhao
2016-01-01
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.
-
Coupling of the Models of Human Physiology and Thermal Comfort
Pokorny, J.; Jicha, M.
2013-04-01
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.
-
Coupling of the Models of Human Physiology and Thermal Comfort
Directory of Open Access Journals (Sweden)
Jicha M.
2013-04-01
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.
-
William Shakespeare's neurology.
Paciaroni, Maurizio; Bogousslavsky, Julien
2013-01-01
Many of Shakespeare's plays contain characters who appear to be afflicted by neurological or psychiatric disorders. Shakespeare, in his descriptive analysis of his protagonists, was contributing to the understanding of these disorders. In fact, Charcot frequently used Shakespearean references in his neurological teaching sessions, stressing how acute objective insight is essential to achieving expert clinical diagnosis. Charcot found in Shakespeare the same rigorous observational techniques for which he himself became famous. This chapter describes many of Shakespearean characters suffering from varied neurological disorders, including Parkinsonism, epilepsy, sleeping disturbances, dementia, headache, prion disease, and paralyses. © 2013 Elsevier B.V. All rights reserved.
-
FACT : forgiving agent comfort technology
Zeiler, W.; Wortel, W.; Kamphuis, I.G.; Akkermans, Hans; Jelsma, J.; Bakker, L.
2005-01-01
To further reduce energy consumption of office buildings, a new control technology is needed in which the end-user behaviour is integrated. Improvement of the energy consumption is offered by agent-based systems for energy management in buildings, as well as possibilities for enhancing the comfort
-
Blog and Podcast Watch: Neurologic Emergencies
Directory of Open Access Journals (Sweden)
Andrew Grock
2016-11-01
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.
-
Human thermal sensation and comfort in a non-uniform environment with personalized heating.
Deng, Qihong; Wang, Runhuai; Li, Yuguo; Miao, Yufeng; Zhao, Jinping
2017-02-01
Thermal comfort in traditionally uniform environment is apparent and can be improved by increasing energy expenses. To save energy, non-uniform environment implemented by personalized conditioning system attracts considerable attention, but human response in such environment is unclear. To investigate regional- and whole-body thermal sensation and comfort in a cool environment with personalized heating. In total 36 subjects (17 males and 19 females) including children, adults and the elderly, were involved in our experiment. Each subject was first asked to sit on a seat in an 18°C chamber (uniform environment) for 40min and then sit on a heating seat in a 16°C chamber (non-uniform environment) for another 40min after 10min break. Subjects' regional- and whole-body thermal sensation and comfort were surveyed by questionnaire and their skin temperatures were measured by wireless sensors. We statistically analyzed subjects' thermal sensation and comfort and their skin temperatures in different age and gender groups and compared them between the uniform and non-uniform environments. Overall thermal sensation and comfort votes were respectively neutral and just comfortable in 16°C chamber with personalized heating, which were significantly higher than those in 18°C chamber without heating (pthermal sensation and comfort was consistent in subjects of different age and gender. However, adults and the females were more sensitive to the effect of personalized heating and felt cooler and less comfort than children/elderly and the males respectively. Variations of the regional thermal sensation/comfort across human body were consistent with those of skin temperature. Personalized heating significantly improved human thermal sensation and comfort in non-uniform cooler environment, probably due to the fact that it increased skin temperature. However, the link between thermal sensation/comfort and variations of skin temperature is rather complex and warrant further
-
Thermal comfort assessment of buildings
Carlucci, Salvatore
2013-01-01
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.
-
Energy and indoor temperature consequences of adative thermal comfort standards
Centnerova, L.; Hensen, J.L.M.
2001-01-01
The intent of the presented study was to quantify the implications for energy demand of indoor temperature requirements based on a proposed adaptive thermal comfort standard (7) relative to a more traditional thermal comfort approach. The study focuses on a typical office situation in a moderate
-
Thermal comfort in hospital and healthcare facilities : a literature review
Sadrizadeh, S.; Loomans, M.G.L.C.
2016-01-01
Hospital and healthcare facilities need to provide a variety of indoor environments due to the diverse comfort and health needs of their patients and staff. Thermal comfort is an essential part of indoor environmental quality in the hospital work environment that affects both the patient’s own
-
A Series of Computational Neuroscience Labs Increases Comfort with MATLAB.
Nichols, David F
2015-01-01
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.
-
Cardiomyopathy in neurological disorders.
Finsterer, Josef; Stöllberger, Claudia; Wahbi, Karim
2013-01-01
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.
-
Beyond Comfort in Built Environments
Bazley, C.M.
2015-01-01
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
-
Nurses' comfort with touch and workplace well-being.
Pedrazza, Monica; Minuzzo, Stefania; Berlanda, Sabrina; Trifiletti, Elena
2015-06-01
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.
-
The urgent neurological consultation in the population of the province of Ferrara, Italy.
Govoni, Vittorio; Della Coletta, Elena; Fallica, Elisa; Cesnik, Edward
2018-05-01
In the province of Ferrara, Italy, the urgent neurological consultation (UNC) cases in the population correspond to the resident outpatients who undergo a UNC in the ER of the university hospital of Ferrara (UHFe). Thanks to this health organization a retrospective survey identified 612 UNC cases (range of age 7-102 years, median 67,5 years) in the study period giving a period prevalence rate of 173 per 100,000 (95% CI 159.3-187.3) which increased with age (χ 2 for trend = 178.4 p 0.70). The prevalence rate decreased with the distance between the patients' residence and the UHFe (χ 2 for trend = 82.9, p < 0.001). The commonest clinical conditions requiring UNCs were acute cerebrovascular disorders (28%), headache (14%), and vertigo (9%). The hospital admission rate was 32.5% which increased with age (χ 2 for trend = 35.8, p < 0.001). The commonest discharge diagnoses of the admitted cases were ischemic stroke (57.3%), epilepsy (7%), TIA (6%), and intraparenchymal hemorrhage (5.5%). Acute cerebrovascular disease accounted for 69% of the discharge diagnoses. The survey showed that the UNCs' demand was higher than previous Italian data confirming that acute cerebrovascular disease is the most frequent acute neurological condition requiring attention in the ER. It also suggested that the UNCs could be poorly appropriate. These findings would require the healthcare administrators attention.
-
Thermal comfort assessment in civil aircraft cabins
Directory of Open Access Journals (Sweden)
Pang Liping
2014-04-01
Full Text Available Aircraft passengers are more and demanding in terms of thermal comfort. But it is not yet easy for aircraft crew to control the environment control system (ECS that satisfies the thermal comfort for most passengers due to a number of causes. This paper adopts a corrected predicted mean vote (PMV model and an adaptive model to assess the thermal comfort conditions for 31 investigated flights and draws the conclusion that there does exist an uncomfortable thermal phenomenon in civil aircraft cabins, especially in some short-haul continental flights. It is necessary to develop an easy way to predict the thermal sensation of passengers and to direct the crew to control ECS. Due to the assessment consistency of the corrected PMV model and the adaptive model, the adaptive model of thermal neutrality temperature can be used as a method to predict the cabin optimal operative temperature. Because only the mean outdoor effective temperature ET∗ of a departure city is an input variable for the adaptive model, this method can be easily understood and implemented by the crew and can satisfy 80–90% of the thermal acceptability levels of passengers.
-
Design and comfort in office space
Directory of Open Access Journals (Sweden)
Michele M. Lepore
2017-12-01
Full Text Available The theme of office space is of particular interest because it is a sector strongly involved by technological development. The high concentration of plant engineering systems makes it essential to the attention to environmental parameters and to research on the quality of the relationship which binds man to artificial dimension of built space. In the design of office spaces, the general objective must be to be able to achieve a new working environment relationship. A ratio in which optimal balance is always sought in terms of igrothermal, acoustic and luminous comfort conditions, without noting that the psychological and sociological component plays an important role among the environmental factors, and this significantly interferes with the conditions of physiological comfort. The following work is an essay on the subject.
-
Quantifying the relevance of adaptive thermal comfort models in moderate thermal climate zones
Energy Technology Data Exchange (ETDEWEB)
Hoof, Joost van; Hensen, Jan L.M. [Faculty of Architecture, Building and Planning, Technische Universiteit Eindhoven, Vertigo 6.18, P.O. Box 513, 5600 MB Eindhoven (Netherlands)
2007-01-15
Standards governing thermal comfort evaluation are on a constant cycle of revision and public review. One of the main topics being discussed in the latest round was the introduction of an adaptive thermal comfort model, which now forms an optional part of ASHRAE Standard 55. Also on a national level, adaptive thermal comfort guidelines come into being, such as in the Netherlands. This paper discusses two implementations of the adaptive comfort model in terms of usability and energy use for moderate maritime climate zones by means of literature study, a case study comprising temperature measurements, and building performance simulation. It is concluded that for moderate climate zones the adaptive model is only applicable during summer months, and can reduce energy for naturally conditioned buildings. However, the adaptive thermal comfort model has very limited application potential for such climates. Additionally we suggest a temperature parameter with a gradual course to replace the mean monthly outdoor air temperature to avoid step changes in optimum comfort temperatures. (author)
-
Neurological sequelae of bacterial meningitis
Lucas, Marjolein J.; Brouwer, Matthijs C.; van de Beek, Diederik
2016-01-01
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
-
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)
2002-07-01
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)
-
Why do some women refuse to allow male residents to perform pelvic exams?
Rifkin, Julie I; Shapiro, Howard; Regensteiner, Judith G; Stotler, Jeanne K; Schmidt, Betty
2002-10-01
Many women who receive medical care in residency training clinics refuse to allow male residents to perform their pelvic exams. This study was conducted to identify which women were most likely to refuse and to learn their reasons for refusing. From January to March 1997, a questionnaire was given to all women entering a Tri-County Health office and a Planned Parenthood clinic, both in the Denver, Colorado, metropolitan area, who consented to participate in the study. Data from the questionnaire were analyzed using a statistical software package. A total of 1,437 women entered the clinics during the study period. Of these patients, 1,078 consented to complete the questionnaire. Seven of these 1,078 women did not complete the questionnaire. Women who did not know the training level of the resident performing the pelvic exam were more likely to refuse than were women who knew the training level of the resident (p =.001), but many women preferred a female physician regardless of the physician's training level. Fifty-eight percent said they would allow a male resident to observe a female attending physician perform the exam, compared with 36% who said they would allow a male resident to observe if the attending physician was a man. Common statements from those who would refuse were: "I am just more comfortable with a female," "Women do not want men to examine their private body parts," and "Women explain things better." A woman's knowledge of the resident's training level correlates with her willingness to have a pelvic exam performed by a male resident. Women who said they would refuse a pelvic exam performed by a male resident gave specific reasons for their decision.
-
Agent-based modelling to improve comfort and save energy in the built environment
Zeiler, W.; Boxem, G.; Houten, van M.A.; Velden, van der J.A.J.; Wortel, W.; Kamphuis, I.G.; Rangan, R; Proctor, F
2008-01-01
In Europe comfort in buildings needs 40% of the total energy. With effects of Global warming becoming more and more apparent there is a need to reduce this energy demand by comfort within the built environment. In comfort control strategy there is an exciting development based on inclusive design:
-
Iniesta, I
2010-10-01
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.
-
Special Report - USNS Comfort Underway
region. The Navy hospital ship will provide medical, dental, veterinary and engineering assistance in medical clinic set up during Continuing Promise 2009. Story» Air Force Band Member Enjoys Audience Alexis arrived at a medical clinic set up by the crew of USNS Comfort wearing her Sunday best in
-
Neuromodulation of lower limb motor control in restorative neurology.
Minassian, Karen; Hofstoetter, Ursula; Tansey, Keith; Mayr, Winfried
2012-06-01
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. Copyright © 2012 Elsevier B.V. All rights reserved.
-
Directory of Open Access Journals (Sweden)
Iacopo Golasi
2016-07-01
Full Text Available Outdoor thermal comfort is an essential factor of people’s everyday life and deeply affects the habitability of outdoor spaces. However the indices used for its evaluation were usually developed for indoor environments assuming still air conditions and absence of solar radiation and were only later adapted to outdoor spaces. For this reason, in a previous study the Mediterranean Outdoor Comfort Index (MOCI was developed, which is an empirical index able to estimate the thermal perception of people living in the Mediterranean area. In this study it was compared numerically (by using the data obtained through a field survey with other selected thermal indices. This comparison, performed in terms of Spearman’s rho correlation coefficient, association Gamma, percentage of correct predictions and cross-tabulation analysis, led to identify the MOCI as the most suitable index to examine outdoor thermal comfort in the interested area. As a matter of fact it showed a total percentage of correct predictions of 35.5%. Good performances were reported even in thermophysiological indices as the Physiological Equivalent Temperature (PET and Predicted Mean Vote (PMV. Moreover it was revealed that adaptation and acclimatization phenomena tend to have a certain influence as well.
-
Koehler, P J; Bruyn, G W; Moffie, D
1998-12-01
The Netherlands Society of Neurology evolved from the Society of Psychiatry founded in 1871. The name was changed into Netherlands Society of Psychiatry and Neurology (NSPN) in 1897. In the same year, the word neurology was also added to the name of the journal. The Society steadily blossomed, but in 1909 the first signs of dissatisfaction occurred: the Amsterdam Neurologists Society was founded. A few split-offs would follow. The number of members of the NSPN increased from 205 in 1920 to 585 in 1960. In the early 1960s, the Society was reorganised and would consist of two sections, one for psychiatry and one for neurology. However, this would not last, as a full separation was established in 1974. For several reasons, the name of the journal was changed four times until it assumed its present name in 1974. The 100th volume of CNN was not published, as expected. in 1996, but in 1998, because of two skipped publication years, one during WWII and another in the 1970s. During the last decades of the nineteenth century, teaching of neurology was mostly given within the frame of psychiatry, following the German tradition of 'brainpsychiatry' (organic or biologic psychiatry). The first official chair of psychiatry was founded at Utrecht, 1893 (Winkler). In Amsterdam, private teachers such as Delprat taught 'electro-therapy and nervous diseases' since the 1880s. The first extraordinary chair of neurology and electrotherapy was founded for his successor, Wertheim Salomonson in 1899. The first university clinic for psychiatry and neurology started at the Amsterdam Municipal University, when Winkler became professor of psychiatry and neurology in Amsterdam in 1896. Around the turn of the century, chairs of psychiatry and neurology were also founded in Groningen and Leiden. Separate chairs for neurology and psychiatry appeared in Amsterdam in 1923 and in Utrecht in 1936. Following an initiative of Brouwer, the first neurological university clinic opened its doors in
-
Geriatric care: ways and means of providing comfort.
Ribeiro, Patricia Cruz Pontifice Sousa Valente; Marques, Rita Margarida Dourado; Ribeiro, Marta Pontifice
2017-01-01
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
-
Indoor temperatures for optimum thermal comfort and human performance
DEFF Research Database (Denmark)
de Dear, R.; Arens, E. A.; Candido, C.
2014-01-01
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....
-
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....
-
End-state comfort trumps handedness in object manipulation.
Coelho, Chase J; Studenka, Breanna E; Rosenbaum, David A
2014-04-01
A goal of research on human perception and performance is to explore the relative importance of constraints shaping action selection. The present study concerned the relative importance of two constraints that have not been directly contrasted: (1) the tendency to grasp objects in ways that afford comfortable or easy-to-control final postures; and (2) the tendency to grasp objects with the dominant rather than the nondominant hand. We asked participants to reach out and grasp a horizontal rod whose left or right end was to be placed into a target after a 90° rotation. In one condition, we told participants which hand to use and let them choose an overhand or underhand initial grasp. In another condition, we told participants which grasp to use and let them choose either hand. Participants sacrificed hand preference to perform the task in a way that ensured a comfortable or easy to control thumb-up posture at the time of object placement, indicating that comfort trumped handedness. A second experiment confirmed that comfort was indeed higher for thumb-down postures than thumb-up postures. A third experiment confirmed that the choice data could be linked to objective performance differences. The results point to the importance of identifying constraint weightings for action selection and support an account of hand selection that ascribes hand preference to sensitivity to performance differences. The results do not support the hypothesis that hand preference simply reflects a bias to use the dominant hand.
-
Monitoring indices of cow comfort in free-stall-housed dairy herds.
Cook, N B; Bennett, T B; Nordlund, K V
2005-11-01
Indices of cow comfort are used widely by consultants in the dairy industry, with a general understanding that they are representative of lying behavior. This study examines the influence of stall base type (sand or a geotextile mattress filled with rubber crumbs) and time of measurement on 4 indices of comfort collected at hourly intervals in 12 herds, aligned by morning and afternoon milking. Stall base type significantly influenced all indices of comfort. For example, the least squares mean (SE) cow comfort index (proportion of cows touching a stall that are lying down) was 0.76 (0.015) in herds with mattresses compared with 0.86 (0.015) in herds with sand stalls. Significant hourly variation was also identified suggesting that timing of measurement is important. None of the indices of cow comfort derived from the high-yielding group pen was associated with the mean 24-h lying time of 10 sentinel cows whose time budgets were known in each herd. However, the cow comfort index was associated with the herd mean 24-h stall standing time, with the strongest relationships occurring 2 h before the morning and afternoon milking, when stall base type did not significantly influence the association. When measured at these times, we recommend use of the stall standing index (proportion of cows touching a stall that are standing), with values greater than 0.20 being associated with abnormally long herd mean stall standing times greater than 2 h/d.
-
Exploring the design of a lightweight, sustainable and comfortable aircraft seat.
Kokorikou, A; Vink, P; de Pauw, I C; Braca, A
2016-07-19
Making a lightweight seat that is also comfortable can be contradictory because usually comfort improvement means adding a feature (e.g. headrest, adjustable lumbar support, movable armrests, integrated massage systems, etc.), which makes seats heavier. This paper explores the design of an economy class aircraft seat that aims to be lightweight, comfortable and sustainable. Theory about comfort in seats, ergonomics, lightweight design, Biomimicry and Cradle to cradle was studied and resulted in a list of requirements that the new seat should satisfy. The design process resulted in a new seat that is 36% lighter than the reference seat, which showed that a significant weight reduction can be achieved. This was completed by re-designing the backrest and seat pan and integrating their functions into a reduced number of parts. Apart from the weight reduction that helps in reducing the airplane's environmental impact, the seat also satisfies most of the other sustainability requirements such as the use of recyclable materials, design for disassembly, easy to repair. A user test compared the new seat with a premium economy class aircraft seat and the level of comfort was similar. Strong points of the new design were identified such as the lumbar support and the cushioning material, as well as shortcomings on which the seat needs to be improved, like the seat pan length and the first impression. Long term comfort tests are still needed as the seat is meant for long-haul flights.
-
Dynamic indoor thermal comfort model identification based on neural computing PMV index
International Nuclear Information System (INIS)
Sahari, K S Mohamed; Jalal, M F Abdul; Homod, R Z; Eng, Y K
2013-01-01
This paper focuses on modelling and simulation of building dynamic thermal comfort control for non-linear HVAC system. Thermal comfort in general refers to temperature and also humidity. However in reality, temperature or humidity is just one of the factors affecting the thermal comfort but not the main measures. Besides, as HVAC control system has the characteristic of time delay, large inertia, and highly nonlinear behaviour, it is difficult to determine the thermal comfort sensation accurately if we use traditional Fanger's PMV index. Hence, Artificial Neural Network (ANN) has been introduced due to its ability to approximate any nonlinear mapping. Using ANN to train, we can get the input-output mapping of HVAC control system or in other word; we can propose a practical approach to identify thermal comfort of a building. Simulations were carried out to validate and verify the proposed method. Results show that the proposed ANN method can track down the desired thermal sensation for a specified condition space.
-
How to improve the comfort of Kesawan Heritage Corridor, Medan City
Tegar; Ginting, Nurlisa; Suwantoro, H.
2018-03-01
Comfort is indispensable to make a friendly neighborhood or city. Especially the comfort of the infrastructure in the corridor. People must be able to feel comfortable to act rationally in their physical environment. Existing infrastructure must able to support Kesawan as a historic district. Kesawan is an area that is filled with so many unique buildings. Without comfort, how good the existing buildings’ architecture cannot be enjoyed. It will also affect the identity of a region or city. The aim of this research is to re-design the public facilities from Kesawan corridor’s comfort aspect: orientation, traffic calming, vegetation, signage, public facilities (toilet, seating place, bus station, bins), information center, parking and pedestrian path. It will translate the design concept in the form of design criteria. This research uses qualitative methods. Some facilities in this corridor are unsuitable even some of them are not available. So, we need some improvements and additions to the existing facilities. It is expected that by upgrading the existing facilities, visitors who come to Kesawan will be able to enjoy more and able to make Medan city more friendly.
-
THERMAL COMFORT STUDY OF AN AIR-CONDITIONED DESIGN STUDIO IN TROPICAL SURABAYA
Agus Dwi Hariyanto
2005-01-01
This paper evaluates the current thermal comfort condition in an air-conditioned design studio using objective measurement and subjective assessment. Objective measurement is mainly to quantify the air temperature, MRT, relative humidity, and air velocity. Subjective assessment is conducted using a questionnaire to determine the occupants thermal comfort sensations and investigate their perception of the thermal comfort level. A design studio in an academic institution in Surabaya was chosen ...
-
Analysis of bus passenger comfort perception based on passenger load factor and in-vehicle time.
Shen, Xianghao; Feng, Shumin; Li, Zhenning; Hu, Baoyu
2016-01-01
Although bus comfort is a crucial indicator of service quality, existing studies tend to focus on passenger load and ignore in-vehicle time, which can also affect passengers' comfort perception. Therefore, by conducting surveys, this study examines passengers' comfort perception while accounting for both factors. Then, using the survey data, it performs a two-way analysis of variance and shows that both in-vehicle time and passenger load significantly affect passenger comfort. Then, a bus comfort model is proposed to evaluate comfort level, followed by a sensitivity analysis. The method introduced in this study has theoretical implications for bus operators attempting to improve bus service quality.
-
Arantes, Mavilde; Barbosa, Joselina Maria; Ferreira, Maria Amélia
2017-01-01
General practitioners are responsible for the management of an increasing number of patients with neurological illness, and thus a solid education in neurosciences is a necessary component of their training. This study examines the effects of an intensive clinical neuroanatomy course on twenty general practice residents' perceptions, attitudes,…
-
Thermal Comfort Level Assessment in Urban Area of Petrolina-PE County, Brazil
Directory of Open Access Journals (Sweden)
Pedro Vieira de Azevedo
Full Text Available Abstract This study evaluated the thermal conditions of urban areas in Petrolina-PE, from continuous data collected in urban and rural areas for the year of 2012. The results characterized urban heat islands (UHI with varying intensity in urban areas, especially UHI = 5.3 °C (high intensity occurred on April 28, 2012. It was evident that the constituent elements of urban areas contribute to the formation and expansion of UHI bringing thermal discomfort for its inhabitants. An adaptation to Thom’s equation for calculating the Thermal Discomfort Index (DIT, was used to obtain the maximum (DITx and minimum (DITm thermal discomfort. In the urban area, the DITm indicated thermal comfort in 23.0% of the days and partial comfort in 77.0% of days surveyed. Already, the DITx characterized 71.6% of days with partial comfort and 28.4% of days with thermal discomfort. In the rural area, The DITm indicated that 41.5% of days were thermally comfortable and 58.5% of days had partial comfort. However, the DITx pointed 87.7% of the days of this environment with partial thermal comfort and 12.3% of thermally uncomfortable days. Finally, the results showed that afforestation of urban area constitutes to an effective and efficient way to mitigate thermal discomfort.
-
A simplified tool for building layout design based on thermal comfort simulations
Directory of Open Access Journals (Sweden)
Prashant Anand
2017-06-01
Full Text Available Thermal comfort aspects of indoor spaces are crucial during the design stages of building layout planning. This study presents a simplified tool based on thermal comfort using predicted mean vote (PMV index. Thermal comfort simulations were performed for 14 different possible room layouts based on window configurations. ECOTECT 12 was used to determine the PMV of these rooms for one full year, leading to 17,808 simulations. Simulations were performed for three different climatic zones in India and were validated using in-situ measurements from one of these climatic zones. For moderate climates, rooms with window openings on the south façade exhibited the best thermal comfort conditions for nights, with comfort conditions prevailing for approximately 79.25% of the time annually. For operation during the day, windows on the north façade are favored, with thermal comfort conditions prevailing for approximately 77.74% of the time annually. Similar results for day and night time operation for other two climatic zones are presented. Such an output is essential in deciding the layout of buildings on the basis of functionality of the different rooms (living room, bedroom, kitchen corresponding to different operation times of the day.
-
International Nuclear Information System (INIS)
Liang, J.; Du, R.
2008-01-01
This paper presents the design of an intelligent comfort control system by combining the human learning and minimum power control strategies for the heating, ventilating and air conditioning (HVAC) system. In the system, the predicted mean vote (PMV) is adopted as the control objective to improve indoor comfort level by considering six comfort related variables, whilst a direct neural network controller is designed to overcome the nonlinear feature of the PMV calculation for better performance. To achieve the highest comfort level for the specific user, a human learning strategy is designed to tune the user's comfort zone, and then, a VAV and minimum power control strategy is proposed to minimize the energy consumption further. In order to validate the system design, a series of computer simulations are performed based on a derived HVAC and thermal space model. The simulation results confirm the design of the intelligent comfort control system. In comparison to the conventional temperature controller, this system can provide a higher comfort level and better system performance, so it has great potential for HVAC applications in the future
-
A Novel Exercise Thermophysiology Comfort Prediction Model with Fuzzy Logic
Directory of Open Access Journals (Sweden)
Nan Jia
2016-01-01
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.
-
History of pediatric neurology in Poland.
Steinborn, Barbara; Józwiak, Sergiusz
2010-02-01
This review presents the past and the present of pediatric neurology in Poland. Pediatric neurology has its roots in Polish general neurology represented by many outstanding scientists. The founder of Polish school of neurology at the end of 19th century was Edward Flatau, known as the author of Flatau's law. The most famous Polish neurologist was Joseph Babiński, recognized for the first description of pathological plantar reflex. First Polish publication related to child neurology was Brudziński's report on a new meningeal symptom (the flexion of lower limbs during passive neck flexion with pain in neck). Contemporary child neurology in Poland was created by Professor Zofia Majewska after the Second World War. Now 10 academic centers of child neurology exist in Poland fulfilling educational, scientific, and therapeutic roles. Polish Society of Child Neurology was established in 1991 and now there are about 580 members, including 300 child neurologists.
-
Child Neurology Services in Africa
Wilmshurst, Jo M.; Badoe, Eben; Wammanda, Robinson D.; Mallewa, Macpherson; Kakooza-Mwesige, Angelina; Venter, Andre; Newton, Charles R.
2013-01-01
The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level. PMID:22019842
-
The issue of thermal comfort of medical clothing in the operating room
Abreu, Isabel; Ribeiro, Patrícia; Abreu, Maria José
2017-01-01
Abstract Medical clothes have the primary function of protection. However this function must be correlated with a good comfort experience to the user. The comfort is a very important issue, since professionals are exposed to stress situations that can influence, negatively, their performance work. More specific, thermal comfort plays a crucial role for the best performance of OR medical clothing, involving heat regulation and mass transfer between a clothed body and the environment, once clot...
-
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 ...
-
Comfort as a determiner of treatment position in radiotherapy of the male pelvis
International Nuclear Information System (INIS)
Cox, J.; Davison, A.
2005-01-01
Purpose: A comfortable treatment position in radiotherapy may promote patient stability and contribute to the best possible patient experience. Patients receiving radical radiotherapy for prostate cancer lie supine or prone, but little evaluation has been made of the comfort of these positions. The purpose of this research was to evaluate the comfort of the prone and supine positions and to assess any influence of feelings of anxiety. Methods: Self-reported comfort and anxiety levels were measured using visual analogue scales in the first and last weeks of treatment for patients receiving radical prostatic radiotherapy. The subjects were from two hospitals, 23 routinely treated lying prone and 21 routinely treated lying supine. Six subjects from each group were interviewed in the first week of treatment. Results: Comfort levels were high and no significant difference was found between treatment positions or between the first and last weeks of treatment. Anxiety levels were low with no significant variation according to position or week of treatment. Little correlation was seen between reported anxiety and comfort levels. Interview data supported the quantitative findings. Supine subjects indicated the need for lateral elbow support to improve feelings of stability. Conclusions: For radiotherapy of male patients without pain or other complicating factors, selection between the prone and supine positions may be made without considering comfort. Supine patients should be provided with lateral elbow support. Further research is indicated into the comfort of these positions for females and the phenomenon of low reported anxiety in male cancer patients
-
Dinato, Roberto C; Ribeiro, Ana P; Butugan, Marco K; Pereira, Ivye L R; Onodera, Andrea N; Sacco, Isabel C N
2015-01-01
To investigate the relationships between the perception of comfort and biomechanical parameters (plantar pressure and ground reaction force) during running with four different types of cushioning technology in running shoes. Randomized repeated measures. Twenty-two men, recreational runners (18-45 years) ran 12km/h with running shoes with four different cushioning systems. Outcome measures included nine items related to perception of comfort and 12 biomechanical measures related to the ground reaction forces and plantar pressures. Repeated measure ANOVAs, Pearson correlation coefficients, and step-wise multiple regression analyses were employed (p≤0.05). No significant correlations were found between the perception of comfort and the biomechanical parameters for the four types of investigated shoes. Regression analysis revealed that 56% of the perceived general comfort can be explained by the variables push-off rate and pressure integral over the forefoot (p=0.015) and that 33% of the perception of comfort over the forefoot can be explained by second peak force and push-off rate (p=0.016). The results did not demonstrate significant relationships between the perception of comfort and the biomechanical parameters for the three types of shoes investigated (Gel, Air, and ethylene-vinyl acetate). Only the shoe with Adiprene+ technology had its general comfort and cushioning perception predicted by the loads over the forefoot. Thus, in general, one cannot predict the perception of comfort of a running shoe through impact and plantar pressure received. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
-
Peugnet, Frederic; Dubois, Patrick; Rouland, Jean-Francois
1998-06-01
Virtual reality is one of these recent technologies which can provide an efficient help in the field of surgical apprenticeship. We achieved an original training simulator for retinal photocoagulation destined to the residents of the ophthalmological department. This paper describes the comparison between this new training tool and the conventional practice. Two groups of residents, randomly selected, were trained exclusively by one of these methods. These two groups were under the responsibility of two distinct experts. A final evaluation was made by a third and different expert, ignoring the training mode practiced by each of the residents. The study lasted six months. The results show that this new training mode is at least as efficient as the current one in terms of elapsed time and efficiency. It may even reduce the training duration. These results confirm that a pedagogical simulator could give a new approach in the medical teaching, particularly in its management. Such a device may solve the problems of practitioner's lack of disponibility and of patients' safety and comfort during a conventional training. Furthermore, it could bring an objective way to value the students; practical ability. On the other hand, this preliminary study emphasizes the difficulties in introducing a new modality in a traditional teaching environment.
-
Neurology and international organizations.
Mateen, Farrah J
2013-07-23
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.
-
Hand hygiene of medical students and resident physicians: predictors of attitudes and behaviour.
Barroso, Violeta; Caceres, Wendy; Loftus, Pooja; Evans, Kambria H; Shieh, Lisa
2016-09-01
We measured medical students' and resident trainees' hand hygiene behaviour, knowledge and attitudes in order to identify important predictors of hand hygiene behaviour in this population. An anonymous, web-based questionnaire was distributed to medical students and residents at Stanford University School of Medicine in August of 2012. The questionnaire included questions regarding participants' behaviour, knowledge, attitude and experiences about hand hygiene. Behaviour, knowledge and attitude indices were scaled from 0 to 1, with 1 representing superior responses. Using multivariate regression, we identified positive and negative predictors of superior hand hygiene behaviour. We investigated effectiveness of interventions, barriers and comfort reminding others. 280 participants (111 students and 169 residents) completed the questionnaire (response rate 27.8%). Residents and medical students reported hand hygiene behaviour compliance of 0.45 and 0.55, respectively (p=0.02). Resident and medical student knowledge was 0.80 and 0.73, respectively (p=0.001). The attitude index for residents was 0.56 and 0.55 for medical students. Regression analysis identified experiences as predictors of hand hygiene behaviour (both positive and negative influence). Knowledge was not a significant predictor of behaviour, but a working gel dispenser and observing attending physicians with good hand hygiene practices were reported by both groups as the most effective strategy in influencing trainees. Medical students and residents have similar attitudes about hand hygiene, but differ in their level of knowledge and compliance. Concerns about hierarchy may have a significant negative impact on hand hygiene advocacy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
-
Numerical Analysis of Thermal Comfort at Urban Environment
Papakonstantinou, K.; Belias, C.
2009-08-01
The present paper refers to the numerical simulation of air velocity at open air spaces and the conducting thermal comfort after the evaluation of the examined space using CFD methods, taking into account bioclimatic principles at the architectural design. More specially, the paper draws attention to the physical procedures governing air movement at an open environment area in Athens (athletic park), named "Serafeio Athletic and Cultural Centre," trying to form them in such way that will lead to the thermal comfort of the area's visitors. The study presents a mathematical model, implemented in a general computer code that can provide detailed information on velocity, prevailing in three-dimensional spaces of any geometrical complexity. Turbulent flow is simulated and buoyancy effects are taken into account. This modelling procedure is intended to contribute to the effort towards designing open areas, such as parks, squares or outdoor building environments, using thermal comfort criteria at the bioclimatic design. A computer model of this kind will provide the architects or the environmental engineers with powerful and economical means of evaluating alternative spaces' designs.
-
Neurological abnormalities predict disability
DEFF Research Database (Denmark)
Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje
2014-01-01
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...
-
DEFF Research Database (Denmark)
Guo, Jingjing; Jensen, Christian D.; Ma, Jianfeng
2016-01-01
Mobile devices have become more powerful and are increasingly integrated in the everyday life of people; from playing games, taking pictures and interacting with social media to replacing credit cards in payment solutions. Some actions may only be appropriate in some situations, so the security...... of a mobile device is therefore increasingly linked to its context, such as its location, surroundings (e.g. objects in the immediate environment) and so on. However, situational awareness and context are not captured by traditional security models. In this paper, we examine the notion of Device Comfort......, 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...
-
SU-E-E-05: Initial Experience On Physics Rotation of Radiological Residents
International Nuclear Information System (INIS)
Zhang, J; Williams, D; DiSantis, D; Hardy, P; Oates, M
2014-01-01
Purpose: The new ABR core exam integrates physics into clinical teaching, with an emphasis on understanding image quality, image artifacts, radiation dose and patient safety for each modality and/or sub-specialty. Accordingly, physics training of radiological residents faces a challenge. A traditional teaching of physics through didactic lectures may not fully fulfill this goal. It is also difficult to incorporate physics teaching in clinical practice due to time constraints. A dedicated physics rotation may be a solution. This study is to evaluate a full week physics workshop developed for the first year radiological residents. Methods: The physics rotation took a full week. It included three major parts, introduction lectures, hand-on experiences and observation of technologist operation. An introduction of basic concepts was given to each modality at the beginning. Hand-on experiments were emphasized and took most of time. During hand-on experiments, residents performed radiation measurements, studied the relationship between patient dose and practice (i.e., fluoroscopy), investigated influence of acquisition parameters (i.g., kV, mAs) on image quality, and evaluated image quality using phantoms A physics test before and after the workshop was also given but not for comparison purpose. Results: The evaluation shows that the physics rotation during the first week of residency in radiology is preferred by all residents. The length of a full week of physics workshop is appropriate. All residents think that the intensive workshop can significantly benefit their coming clinical rotations. Residents become more comfortable regarding the use of radiation and counseling relevant questions such as a pregnant patient risk from a CE PE examination. Conclusion: A dedicated physics rotation, assisting with didactic lectures, may fulfill the requirements of physics of the new ABR core exam. It helps radiologists deeply understand the physics concepts and more efficiently use
-
SU-E-E-05: Initial Experience On Physics Rotation of Radiological Residents
Energy Technology Data Exchange (ETDEWEB)
Zhang, J; Williams, D; DiSantis, D; Hardy, P; Oates, M [University of Kentucky, Lexington, KY (United States)
2014-06-01
Purpose: The new ABR core exam integrates physics into clinical teaching, with an emphasis on understanding image quality, image artifacts, radiation dose and patient safety for each modality and/or sub-specialty. Accordingly, physics training of radiological residents faces a challenge. A traditional teaching of physics through didactic lectures may not fully fulfill this goal. It is also difficult to incorporate physics teaching in clinical practice due to time constraints. A dedicated physics rotation may be a solution. This study is to evaluate a full week physics workshop developed for the first year radiological residents. Methods: The physics rotation took a full week. It included three major parts, introduction lectures, hand-on experiences and observation of technologist operation. An introduction of basic concepts was given to each modality at the beginning. Hand-on experiments were emphasized and took most of time. During hand-on experiments, residents performed radiation measurements, studied the relationship between patient dose and practice (i.e., fluoroscopy), investigated influence of acquisition parameters (i.g., kV, mAs) on image quality, and evaluated image quality using phantoms A physics test before and after the workshop was also given but not for comparison purpose. Results: The evaluation shows that the physics rotation during the first week of residency in radiology is preferred by all residents. The length of a full week of physics workshop is appropriate. All residents think that the intensive workshop can significantly benefit their coming clinical rotations. Residents become more comfortable regarding the use of radiation and counseling relevant questions such as a pregnant patient risk from a CE PE examination. Conclusion: A dedicated physics rotation, assisting with didactic lectures, may fulfill the requirements of physics of the new ABR core exam. It helps radiologists deeply understand the physics concepts and more efficiently use
-
A comfort-based, energy-aware HVAC agent and its applications in the smart grid
Auffenberg, Frederik
2017-01-01
In this thesis, we introduce a novel heating, ventilation and air conditioning (HVAC) agent that maintains a comfortable thermal environmant for its users while minimising energy consumption of the HVAC system and incorporating demand side management (DSM) signals to shift HVAC loads towards achieving more desirable overall load profiles. To do so, the agent needs to be able to accurately predict user comfort, for example by using a thermal comfort model. Existing thermal comfort models are u...
-
Education in medical billing benefits both neurology trainees and academic departments.
Waugh, Jeff L
2014-11-11
The objective of residency training is to produce physicians who can function independently within their chosen subspecialty and practice environment. Skills in the business of medicine, such as clinical billing, are widely applicable in academic and private practices but are not commonly addressed during formal medical education. Residency and fellowship training include limited exposure to medical billing, but our academic department's performance of these skills was inadequate: in 56% of trainee-generated outpatient notes, documentation was insufficient to sustain the chosen billing level. We developed a curriculum to improve the accuracy of documentation and coding and introduced practice changes to address our largest sources of error. In parallel, we developed tools that increased the speed and efficiency of documentation. Over 15 months, we progressively eliminated note devaluation, increased the mean level billed by trainees to nearly match that of attending physicians, and increased outpatient revenue by $34,313/trainee/year. Our experience suggests that inclusion of billing education topics into the formal medical curriculum benefits both academic medical centers and trainees. © 2014 American Academy of Neurology.
-
Historical perspective of Indian neurology.
Mishra, Shrikant; Trikamji, Bhavesh; Singh, Sandeep; Singh, Parampreet; Nair, Rajasekharan
2013-10-01
To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. 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). Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. 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 basic, clinical and epidemiological research being
-
Psychiatrists' Comfort Using Computers and Other Electronic Devices in Clinical Practice.
Duffy, Farifteh F; Fochtmann, Laura J; Clarke, Diana E; Barber, Keila; Hong, Seung-Hee; Yager, Joel; Mościcki, Eve K; Plovnick, Robert M
2016-09-01
This report highlights findings from the Study of Psychiatrists' Use of Informational Resources in Clinical Practice, a cross-sectional Web- and paper-based survey that examined psychiatrists' comfort using computers and other electronic devices in clinical practice. One-thousand psychiatrists were randomly selected from the American Medical Association Physician Masterfile and asked to complete the survey between May and August, 2012. A total of 152 eligible psychiatrists completed the questionnaire (response rate 22.2 %). The majority of psychiatrists reported comfort using computers for educational and personal purposes. However, 26 % of psychiatrists reported not using or not being comfortable using computers for clinical functions. Psychiatrists under age 50 were more likely to report comfort using computers for all purposes than their older counterparts. Clinical tasks for which computers were reportedly used comfortably, specifically by psychiatrists younger than 50, included documenting clinical encounters, prescribing, ordering laboratory tests, accessing read-only patient information (e.g., test results), conducting internet searches for general clinical information, accessing online patient educational materials, and communicating with patients or other clinicians. Psychiatrists generally reported comfort using computers for personal and educational purposes. However, use of computers in clinical care was less common, particularly among psychiatrists 50 and older. Information and educational resources need to be available in a variety of accessible, user-friendly, computer and non-computer-based formats, to support use across all ages. Moreover, ongoing training and technical assistance with use of electronic and mobile device technologies in clinical practice is needed. Research on barriers to clinical use of computers is warranted.
-
Psychiatrists’ Comfort Using Computers and Other Electronic Devices in Clinical Practice
Fochtmann, Laura J.; Clarke, Diana E.; Barber, Keila; Hong, Seung-Hee; Yager, Joel; Mościcki, Eve K.; Plovnick, Robert M.
2015-01-01
This report highlights findings from the Study of Psychiatrists’ Use of Informational Resources in Clinical Practice, a cross-sectional Web- and paper-based survey that examined psychiatrists’ comfort using computers and other electronic devices in clinical practice. One-thousand psychiatrists were randomly selected from the American Medical Association Physician Masterfile and asked to complete the survey between May and August, 2012. A total of 152 eligible psychiatrists completed the questionnaire (response rate 22.2 %). The majority of psychiatrists reported comfort using computers for educational and personal purposes. However, 26 % of psychiatrists reported not using or not being comfortable using computers for clinical functions. Psychiatrists under age 50 were more likely to report comfort using computers for all purposes than their older counterparts. Clinical tasks for which computers were reportedly used comfortably, specifically by psychiatrists younger than 50, included documenting clinical encounters, prescribing, ordering laboratory tests, accessing read-only patient information (e.g., test results), conducting internet searches for general clinical information, accessing online patient educational materials, and communicating with patients or other clinicians. Psychiatrists generally reported comfort using computers for personal and educational purposes. However, use of computers in clinical care was less common, particularly among psychiatrists 50 and older. Information and educational resources need to be available in a variety of accessible, user-friendly, computer and non-computer-based formats, to support use across all ages. Moreover, ongoing training and technical assistance with use of electronic and mobile device technologies in clinical practice is needed. Research on barriers to clinical use of computers is warranted. PMID:26667248
-
The effects of power, leadership and psychological safety on resident event reporting.
Appelbaum, Nital P; Dow, Alan; Mazmanian, Paul E; Jundt, Dustin K; Appelbaum, Eric N
2016-03-01
Although the reporting of adverse events is a necessary first step in identifying and addressing lapses in patient safety, such events are under-reported, especially by frontline providers such as resident physicians. This study describes and tests relationships between power distance and leader inclusiveness on psychological safety and the willingness of residents to report adverse events. A total of 106 resident physicians from the departments of neurosurgery, orthopaedic surgery, emergency medicine, otolaryngology, neurology, obstetrics and gynaecology, paediatrics and general surgery in a mid-Atlantic teaching hospital were asked to complete a survey on psychological safety, perceived power distance, leader inclusiveness and intention to report adverse events. Perceived power distance (β = -0.26, standard error [SE] 0.06, 95% confidence interval [CI] -0.37 to 0.15; p leadership practices build psychological safety and minimise power distance between low- and high-status members in order to support greater reporting of adverse events. © 2016 John Wiley & Sons Ltd.
-
Sakellaris, Ioannis A; Saraga, Dikaia E; Mandin, Corinne; Roda, Célina; Fossati, Serena; de Kluizenaar, Yvonne; Carrer, Paolo; Dimitroulopoulou, Sani; Mihucz, Victor G; Szigeti, Tamás; Hänninen, Otto; de Oliveira Fernandes, Eduardo; Bartzis, John G; Bluyssen, Philomena M
2016-04-25
Indoor environmental conditions (thermal, noise, light, and indoor air quality) may affect workers' comfort, and consequently their health and well-being, as well as their productivity. This study aimed to assess the relations between perceived indoor environment and occupants' comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 "modern" office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain). Occupants assessed indoor environmental quality (IEQ) using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality), and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor) of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants' comfort. The highest association with occupants' overall comfort was found for "noise", followed by "air quality", "light" and "thermal" satisfaction. Analysis of detailed parameters revealed that "noise inside the buildings" was highly associated with occupants' overall comfort. "Layout of the offices" was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index), and building characteristics (office type and building's location). Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants.
-
THE NEUROLOGICAL FACE OF CELIAC DISEASE.
Işikay, Sedat; Kocamaz, Halil
2015-01-01
Several neurological disorders have also been widely described in celiac disease patients. The 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. This prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed. In 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. It is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.
-
Guidelines on Thermal Comfort of Air Conditioned Indoor Environment
Miura, Toyohiko
The thermal comfort of air conditioned indoor environment for workers depended, of course, on metabolic rate of work, race, sex, age, clothing, climate of the district and state of acclimatization. The attention of the author was directed to the seasonal variation and the sexual difference of comfortable temperature and a survey through a year was conducted on the thermal comfort, and health conditions of workers engaged in light work in a precision machine factory, in some office workers. Besides, a series of experiments were conducted for purpose of determinning the optimum temperature of cooling in summer time in relation to the outdoor temperature. It seemed that many of workers at present would prefer somewhat higher temperature than those before the World War II. Forty years ago the average homes and offices were not so well heated as today, and clothing worn on the average was considerably heavier.
-
Experimental investigation of radiation effect on human thermal comfort by Taguchi method
International Nuclear Information System (INIS)
Arslanoglu, Nurullah; Yigit, Abdulvahap
2016-01-01
Highlights: • Radiation heat flux from lighting lamps on human thermal comfort is studied. • The effect of posture position on thermal comfort is investigated. • The effect of clothing color on thermal comfort is examined. • Radiation heat flux from halogen reflector lamp increase skin temperature more. • Posture position effect on thermal comfort is less than the other parameters. - Abstract: In this study, the effect of radiation heat flux of lighting lamps on human thermal comfort was investigated by using Taguchi method. In addition, at indoor conditions, clothing color and posture position under the radiation effect on thermal comfort were also investigated. For this purpose, experiments were performed in an air conditioned laboratory room in summer and autumn seasons. The amount of temperature rise on the back was considered as performance parameter. An L8 orthogonal array was selected as an experimental plan for the third parameters mentioned above for summer and autumn seasons. The results were analyzed for the optimum conditions using signal-to-noise (S/N) ratio and ANOVA method. The optimum results were found to be clear halogen lamp as lighting lamp, white as t-shirt color, standing as posture position, in summer season. The optimum levels of the lighting lamp, t-shirt color and posture position were found to be clear halogen lamp, white, sitting in autumn season, respectively.
-
Hippocrates: the forefather of neurology.
Breitenfeld, T; Jurasic, M J; Breitenfeld, D
2014-09-01
Hippocrates is one of the most influential medical doctors of all times. He started observing and experimenting in times of mysticism and magic. He carried a holistic and humanitarian approach to the patient with examination as the principal approach-inspection, palpation and auscultation are still the most important tools in diagnosing algorithms of today. He had immense experience with the human body most likely due to numerous wound treatments he had performed; some even believe he performed autopsies despite the negative trend at the time. Hippocrates identified the brain as the analyst of the outside world, the interpreter of consciousness and the center of intelligence and willpower. Interestingly, Hippocrates was aware of many valid concepts in neurology; his treatise On the Sacred Disease was the most important for understanding neurology and epilepsy. His other ideas pioneered modern day neurology mentioning neurological diseases like apoplexy, spondylitis, hemiplegia, and paraplegia. Today, 10 % of neurological Pubmed and 7 % of neuroscience Scopus reviews mention Corpus Hippocraticum as one of the sources. Therefore, Hippocrates may be considered as the forefather of neurology.
-
Analysis of Thermal Comfort in an Intelligent Building
Majewski, Grzegorz; Telejko, Marek; Orman, Łukasz J.
2017-06-01
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.
-
Wikipedia and neurological disorders.
Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M
2015-07-01
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.
-
Heartwarming memories: Nostalgia maintains physiological comfort.
Zhou, Xinyue; Wildschut, Tim; Sedikides, Constantine; Chen, Xiaoxi; Vingerhoets, Ad J J M
2012-08-01
Nostalgia, a sentimental longing or wistful affection for the past, is a predominantly positive and social emotion. Recent evidence suggests that nostalgia maintains psychological comfort. Here, we propose, and document in five methodologically diverse studies, a broader homeostatic function for nostalgia that also encompasses the maintenance of physiological comfort. We show that nostalgia--an emotion with a strong connotation of warmth--is triggered by coldness. Participants reported stronger nostalgia on colder (vs. warmer) days and in a cold (vs. neutral or warm) room. Nostalgia, in turn, modulates the interoceptive feeling of temperature. Higher levels of music-evoked nostalgia predicted increased physical warmth, and participants who recalled a nostalgic (vs. ordinary autobiographical) event perceived ambient temperature as higher. Finally, and consistent with the close central nervous system integration of temperature and pain sensations, participants who recalled a nostalgic (vs. ordinary autobiographical) event evinced greater tolerance to noxious cold.
-
Towards predicting the (dis)comfort performance by modelling: methods and findings
Naddeo, A.
2017-01-01
The research work underlying this thesis starts from a societal issue: A comfortable artefact helps people to improve their well-being and can be sold easier.
In order to fulfil these two requirements (wellbeing and companies’ profit) a comfort-driven human-centred design method is -
A comparison of suit dresses and summer clothes in the terms of thermal comfort.
Ekici, Can; Atilgan, Ibrahim
2013-12-19
Fanger's PMV equation is the result of the combined quantitative effects of the air temperature, mean radiant temperature, relative air velocity, humidity, activity level and clothing insulation. This paper contains a comparison of suit dresses and summer clothes in terms of thermal comfort, Fanger's PMV equation. Studies were processed in the winter for an office, which locates in Ankara, Turkey. The office was partitioned to fifty square cells. Humidity, relative air velocity, air temperature and mean radiant temperature were measured on the centre points of these cells. Thermal comfort analyses were processed for suit dressing (Icl = 1 clo) and summer clothing (Icl = 0.5 clo). Discomfort/comfort in an environment for different clothing types can be seen in this study. The relationship between indoor thermal comfort distribution and clothing type was discussed. Graphics about thermal comfort were sketched according to cells. Conclusions about the thermal comfort of occupants were given by PMV graphics.
-
An evaluation method on seat comfort based on optical motion capture
Directory of Open Access Journals (Sweden)
Qing TAO
2015-10-01
Full Text Available To research the sitting posture comfort evaluation method, through the example of comfort evaluation of the ergonomic seat and standard office seat, a methodology is introduced to evaluate the sitting posture comfort combining ergonomics theory. The proposed method is based on optical motion capture system, pressure sensor and JACK software, and TRC file is acquired by using EVART real-time capture software for identifying the spatial motion trail of human body. Then MATLAB software is used to analyze the human body motion data, and the sitting posture angle difference data for human body in different seats is acquired. TRC file is loaded into JACK software, and with the TAT REPORTER of JACK software, muscle force, moment of force and fatigue data, etc. are output, which are compared with the actual measured data from experiments, and ergonomics method is used for the evaluation. The result shows that the method of considering joint angles combining JACK software for data output is effective for evaluating sitting comfort.
-
A Comparison Study on the Assessment of Ride Comfort for LRT Passengers
Tengku Munawir, Tengku Imran; Abqari Abu Samah, Ahmad; Afiq Akmal Rosle, Muhammad; Azlis-Sani, Jalil; Hasnan, Khalid; Sabri, S. M.; Ismail, S. M.; Yunos, Muhammad Nur Annuar Mohd; Yen Bin, Teo
2017-08-01
Ride comfort in railway transportation is very mind boggling and it relies on different dynamic performance criteria as well as subjective observation from the train passengers. Vibration discomfort from different elements such as vehicle condition, track area condition and working condition can prompt poor ride comfort. However, there are no universal applicable standards to analyse the ride comfort. There are several factors including local condition, vehicle condition and the track condition. In this current work, level of ride comfort by previous Adtranz-Walker light rapid transit (LRT) passengers at Ampang line were analysed. A comparison was done via two possible methods which are BS EN 12299 (2009) and Sperling’s Ride Index equation. BS EN 12299 standard is used to measure and evaluate the ride comfort of seating (Nvd) and standing (Nva) of train passenger in three different routes. Next, Sperling’s ride comfort equation is used to conduct validation and comparison between the obtained data. The result indicates a higher extent of vibration in the vertical axis which impacts the overall result. The standing position demonstrates a higher exposure of vibration in all the three tested routes. Comparison of the ride comfort assessment of passenger in sitting and standing position for both methods indicates that all the track sections exceeds “pronounced but not unpleasant (medium)” limit range. Nevertheless, the seating position at track section AU did not exceed the limit and stayed at the comfortable zone. The highest discomfort level achieved for both methods for seating position are 3.34 m/s2 for Nva and 2.63 m/s2 respectively, which is at route C uptrack that is from Chan Sow Lin station to Sri Petaling station. Meanwhile, the highest discomfort level achieved for both methods for standing are 3.80 m/s2 for Nvd and 2.88 m/s2 for Wz respectively, at uptrack section which is from Sri Petaling station to Chan Sow Lin station. Thus, the highest
-
Perioperative Management of Neurological Conditions
Directory of Open Access Journals (Sweden)
Manjeet Singh Dhallu
2017-06-01
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.
-
DEFF Research Database (Denmark)
Kondziella, Daniel; Waldemar, Gunhild
, 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...
-
Three experiments to support the design of lightweight comfortable vehicle seats
Vink, P.; Franz, M.; Kampa, I.; Zenk, R.
2012-01-01
Seats need to be more lightweight for airplanes, cars, busses and even trains to contribute to a better environment and to reduce energy consumption. However, a reduction in comfort due to weight reduction is not preferable, which opens a new area of research: improving comfort with a minimum of
-
Neurological examination in small animals
Directory of Open Access Journals (Sweden)
Viktor Paluš
2014-03-01
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.
-
Directory of Open Access Journals (Sweden)
Christian Wiegel
2017-10-01
Full Text Available Preparation for fossil fuel substitution in the building sector persists as an essential subject in architectural engineering. Since the building sector still remains as one of the three major global end energy consumer – climate change is closely related to construction and design. We have developed the archetype sun space to what it is today : a simple but effective predominant naturally ventilated sun trap and as well as living space enlargement. With the invention of industrial glass orangery’s more and more changed from frost protecting envelopes to living spaces from which we meantime expect thermal comfort in high quality. But what level of thermal comfort provide sun spaces? And to what extend may sun spaces manage autarkic operation profiting from passive solar gains and, beyond that, surplus energy generation for energy neutral conditioning of aligned spaces? We deliver detailed information for this detected gap of knowledge. We know about limited thermal comfort in sun spaces winter times. This reasons the inspection of manifold collector technologies, which enable to be embedded in facades and specifically in sun space envelopes. Nonetheless, effective façade integrated collectors are ineffective in seasons with poor irradiation. Hence, the mismatch of offer and demand we have experienced with renewable energies ignites thinking about appropriate seasonal energy storages, which enlarges the research scope of this work. This PhD thesis project investigates on both, a yearly empirical test set up analysis and a virtual simulation of different oriented and located sun spaces abroad Germany. Both empirical and theoretical evaluation result in a holistic research focusing on a preferred occupation time in terms of cumulative frequencies of operational temperature and decided local discomfort, of potential autarkic sun space operation and prospective surplus exergy for alternative heating of aligned buildings. The results are mapped
-
Comfort in using hand tools : theory, design and evaluation
Kuijt-Evers, L.F.M.
2007-01-01
Everyone uses hand tools in their daily life, like knife and fork. Moreover, many people use hand tools in their profession as well as during leisure time. It is important that they can work with hand tools that provide comfort. Until now, the avoidance of discomfort was emphasized during the design process of hand tools, like screwdrivers, hand saws and paint brushes. In the near future, the focus will shift towards providing comfort. However, some questions need to be answered to make this ...
-
THE NEUROLOGICAL FACE OF CELIAC DISEASE
Directory of Open Access Journals (Sweden)
Sedat IŞIKAY
2015-09-01
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.
-
Historical perspective of Indian neurology
Directory of Open Access Journals (Sweden)
Shrikant Mishra
2013-01-01
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
-
In-situ Study of Seating Static Comfort in Passenger Vehicles
Directory of Open Access Journals (Sweden)
Seraj Umi Salmah
2018-01-01
Full Text Available In today’s automotive market, comfort is huge selling point of a vehicle. Priority is given by buyers to how comfortable a seat feels during purchase decisions. The measure of comfort is harmonious mix of many aspects such as human ergonomics and physiological factors. However, a gap still exists between objective and subjective measures due to lack of emphasis by past researchers. This is particularly obvious in the lumbar support feature that has still not been able to address the health problems related to driving. This project focuses on bridging the gap by giving users the ability to define true preferred posture in realistic settings. This is done by the creation of a apparatus that allows users to individually manipulate the seat contour for optimum support in more segments than just lumbar area. The experiment is performed in 3 parts, where in each part different segments of the apparatus are manipulatable (lumbar segment, sacral & thoracic segment, and all segments. Sixty human subjects’ statistics are recorded (gender, age, BMI and height and the subjects are palpated to locate internal joints. These joints are marked and postural angles between them are measured using a goniometer. In each seat configuration, the angles are measured and a comfort rating is taken to be compared. It was found that the posture angles are different among the 3 experiments, and there is a change in comfort felt. Some human factors have also been proven to contribute heavily to angles chosen by occupants.
-
Negotiating comfort in low energy housing: The politics of intermediation
International Nuclear Information System (INIS)
Grandclément, Catherine; Karvonen, Andrew; Guy, Simon
2015-01-01
Optimising the energy performance of buildings is technically and economically challenging but it also has significant social implications. Maintaining comfortable indoor conditions while reducing energy consumption involves careful design, construction, and management of the built environment and its inhabitants. In this paper, we present findings from the study of a new low energy building for older people in Grenoble, France where conflicts emerged over the simultaneous pursuit of energy efficiency and comfort. The findings contribute to the contemporary literature on the sociotechnical study of buildings and energy use by focusing on intermediation, those activities that associate a technology to end users. Intermediation activities take many forms, and in some cases, can result in the harmonisation or alignment of energy efficiency goals and comfort goals. In other cases, intermediation is unsuccessful, leading to the conventional dichotomy between optimising technical performance and meeting occupant preferences. By highlighting the multiple ways that comfort and energy efficiency is negotiated, we conclude that buildings are provisional achievements that are constantly being intermediated. This suggests that building energy efficiency policies and programmes need to provide opportunities for intermediaries to negotiate the desires and preferences of the multiple stakeholders that are implicated in low energy buildings. -- Highlights: •Energy efficiency and comfort are two possibly contradictory aims of buildings. •We study the pursuit of these aims at the occupation stage of a new building. •Aligning these aims involve negotiating them with occupants. •Intermediation processes are key to such negotiations. •Intermediation processes involve both actors and technical devices
-
Directory of Open Access Journals (Sweden)
NICA-BADEA Delia
2012-05-01
Full Text Available The paper considers this issue matters as of interference noise of the ordinary activity of the population owing to its cause and its presence in all departments of life. Noise pollution is a major problem in all countries where we are witnessing a phenomenon of magnification levels of noise having effects more or less aggressive about comfort and even health. Are presented arguments relating to the characterization of noise as a risk factor in the induction of pathologies such as: auditory disorders, hypertension, ischemic heart disease aggravation, discomfort, sleep disorders and decreasing school performance in children. For the evaluation and management of ambient noise has developed a study aimed at assessing the state of comfort and subjective reactions of residents in order to fundamentarii measures for reducing the levels of exposure and prevention of the effects of population exposed to noise in the street. In areas with heavy traffic confirm the existence of risk perception of 56% of the people who accuse the discomfort caused by noise in homes during the day and during the night rate is 40%. The age groups most affected are 51-65 years and over 65 years old, because they spend most of the time period in the home.
-
Data on the interaction between thermal comfort and building control research.
Park, June Young; Nagy, Zoltan
2018-04-01
This dataset contains bibliography information regarding thermal comfort and building control research. In addition, the instruction of a data-driven literature survey method guides readers to reproduce their own literature survey on related bibliography datasets. Based on specific search terms, all relevant bibliographic datasets are downloaded. We explain the keyword co-occurrences of historical developments and recent trends, and the citation network which represents the interaction between thermal comfort and building control research. Results and discussions are described in the research article entitled "Comprehensive analysis of the relationship between thermal comfort and building control research - A data-driven literature review" (Park and Nagy, 2018).
-
Preliminary research on virtual thermal comfort of automobile occupants
Horobet, Tiberiu; Danca, Paul; Nastase, Ilinca; Bode, Florin
2018-02-01
Numerical simulation of climate conditions in automotive industry for the study of thermal comfort had become more and more prominent in the last years compared with the classical approach which consists in wind tunnel measurements and field testing, the main advantages being the reduction of vehicle development time and costs. The study presented in this paper is a part of a project intended to evaluate different strategies of cabin ventilation for improving the thermal comfort inside vehicles. A virtual thermal manikin consisting of 24 parts was introduced on the driver seat in a vehicle. A heat load calculated for summer condition in the city of Cluj-Napoca, Romania was imposed as boundary condition. The purpose of this study was to elaborate a virtual thermal manikin suitable for our research, introduction of the manikin inside the vehicle and to examine his influence inside the automobile. The thermal comfort of the virtual manikin was evaluated in terms of temperature and air velocity.
-
Toy, Süleyman; Kántor, Noémi
2017-01-01
Human thermal comfort conditions can be evaluated using various indices based on simple empirical approaches or more complex and reliable human-biometeorological approaches. The latter is based on the energy balance model of the human body, and their calculation is supplemented with computer software. Facilitating the interpretation of results, the generally applied indices express the effects of thermal environment in the well-known temperature unit, just like in the case of the widely used index, the physiologically equivalent temperature (PET). Several studies adopting PET index for characterizing thermal components of climate preferred to organize the resulted PET values into thermal sensation categories in order to demonstrate the spatial and/or temporal characteristics of human thermal comfort conditions. The most general applied PET ranges were derived by Central European researchers, and they are valid for assumed values of internal heat production of light activity and thermal resistance of clothing representing a light business suit. Based on the example of Erzurum city, the present work demonstrates that in a city with harsh winter, the original PET ranges show almost purely discomfort and they seem to be less applicable regarding cold climate conditions. Taking into account 34-year climate data of Erzurum, the annual distribution of PET is presented together with the impact of application of different PET categorization systems, including 8°- and 7°-wide PET intervals. The demonstrated prior analyses lack any questionnaire filed surveys in Erzurum. Thus, as a next step, detailed field investigations would be required with the aim of definition of new PET categorization systems which are relevant for local residents who are adapted to this climatic background, and for tourists who may perform various kinds of winter activities in Erzurum and therefore may perceive the thermal environment more comfortable.
-
Epilepsy monitoring - The patients' views: A qualitative study based on Kolcaba's Comfort Theory.
Egger-Rainer, Andrea; Trinka, Eugen; Höfler, Julia; Dieplinger, Anna Maria
2017-03-01
The aim of this qualitative study was to determine which perception of personal comfort patients name in the context of their hospitalization in an Austrian Epilepsy Monitoring Unit (EMU). Problem-centred interviews with twelve inpatients were conducted. Data analyses were done according to Mayring's qualitative content analyses following the technique of structuring-deductive category assignment. Patients experienced different kinds of comfort along with their hospitalization in the EMU. Comfort-decreasing factors were bed rest, boredom, and waiting for possible seizures. As comfort-increasing factors, hope for enhanced seizure control, support by family and staff, and intelligible information about the necessity of restrictive conditions were identified. The study results should assist health care professionals, enabling them to design comfort enhancing interventions for patients undergoing video-electroencephalography (EEG) investigations in an EMU. Some of these seem to be simple and obtainable without high financial or technical effort. Others are more complex and have to be further assessed for their feasibility. Copyright © 2016 Elsevier Inc. All rights reserved.
-
Comfort of the patient's family in an Intensive Care Unit related to welcoming
Directory of Open Access Journals (Sweden)
Mariana de Almeida Moraes Gibaut
2013-10-01
Full Text Available This study aimed to identify the level of comfort of families of patients in a critical health condition related to the welcoming practices performed by the hospital staff. Interviews were conducted with 250 relatives in hospitals of the state Bahia, using a Likert scale. Data were analyzed as percentages and quartiles. For nine of the 12 statements of the scale, most relatives scored their comfort level between very and totally comfortable, median of 4,revealing kindness, tranquility and friendly communication with family members. More than half of the sample scored its level as not at all to more or less comfortable, median of 3, for statements about demonstration of interest towards the relative by the staff and flexible visiting of the patient. The necessity of greater interest of the team in the condition and needs of the family was observed. Promoting comfort from the dimension of welcoming demands interdisciplinary actions grounded in humanistic philosophy, in which the nurse has an important role to play.
-
Mazzola, Catherine A; Lobel, Darlene A; Krishnamurthy, Satish; Bloomgarden, Gary M; Benzil, Deborah L
2010-08-01
Neurosurgical residency training paradigms have changed in response to Accreditation Council for Graduate Medical Education mandates and demands for quality patient care. Little has been done to assess resident education from the perspective of readiness to practice. To assess the efficacy of resident training in preparing young neurosurgeons for practice. In response to Resolution V-2007F of the Council of State Neurosurgical Societies, a survey was developed for neurosurgeons who applied for oral examination, Part II of the American Board of Neurological Surgery boards, in 2002 through 2007 (N = 800). The survey was constructed in "survey monkey" format and sent to 775 of 800 (97%) neurosurgeons for whom e-mail addresses were available. The response rate was 30% (233/775). Most neurosurgeons were board certified (n = 226, 97%). General neurosurgical training was judged as adequate by a large majority (n = 188, 80%). Sixty-percent chose to pursue at least 1 additional year of fellowship training (n = 138, 60%). Surgical skills training was acceptable, but 6 skill-technique areas were reported to be inadequate (endovascular techniques, neurosurgical treatment of pain, stereotactic radiosurgery, epilepsy surgery, cranial base surgery, and stereotactic neurosurgery). Respondents also noted inadequate education in contract negotiation, practice evaluation, and management. The study suggests that neurosurgeons believed that they were well trained in their surgical skills except for some areas of subspecialization. However, there is a significant need for improvement of resident training in the areas of socioeconomic and medicolegal education. Continued evaluation of the efficacy of neurosurgical education is important.
-
Comfort in High-Performance Homes in a Hot-Humid Climate
Energy Technology Data Exchange (ETDEWEB)
Poerschke, A. [IBACOS, Inc., Pittsburgh, PA (United States); Beach, R. [IBACOS, Inc., Pittsburgh, PA (United States)
2016-01-01
IBACOS monitored 37 homes during the late summer and early fall of 2014 in a hot and humid climate to better understand indoor comfort conditions. These homes were constructed in the last several years by four home builders that offered a comfort and performance guarantee for the homes. The homes were located in one of four cities: Tampa, Florida; Orlando, Florida; Houston, Texas; and San Antonio, Texas. Temperature and humidity data were collected from the thermostat and each room of the house using small, battery-powered data loggers. To understand system runtime and its impact on comfort, supply air temperature also was measured on a 1-minute interval. Overall, the group of homes only exceeded a room-to-room temperature difference of 6 degrees Fahrenheit for 5% of the time.
-
Impact of Manually Controlled Solar Shades on Indoor Visual Comfort
Directory of Open Access Journals (Sweden)
Jian Yao
2016-07-01
Full Text Available Daylight plays a significant role in sustainable building design. The purpose of this paper was to investigate the impact of manual solar shades on indoor visual comfort. A developed stochastic model for manual solar shades was modeled in Building Controls Virtual Test Bed, which was coupled with EnergyPlus for co-simulation. Movable solar shades were compared with two unshaded windows. Results show that movable solar shades have more than half of the working hours with a comfortable illuminance level, which is about twice higher than low-e windows, with a less significant daylight illuminance fluctuation. For glare protection, movable solar shades increase comfortable visual conditions by about 20% compared to low-e windows. Moreover, the intolerable glare perception could be reduced by more than 20% for movable solar shades.
-
ComfortPower - System improvements and long-term evaluation
Energy Technology Data Exchange (ETDEWEB)
Silversand, Fredrik [Catator AB, Lund (Sweden)
2011-11-15
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
-
The First "Comfort Houses" in Denmark
DEFF Research Database (Denmark)
Brunsgaard, Camilla; Knudstrup, Mary-Ann; Heiselberg, Per
2009-01-01
The "Comfort Houses" is the most ambitious building project in passive houses in Denmark until today. Eight single family houses are built and designed by seven different consortiums. Besides fulfilling the German passive house standard the goal was to build the houses according to Danish tradition...
-
Beyond the classic thermoneutral zone: Including thermal comfort.
Kingma, Boris Rm; Frijns, Arjan Jh; Schellen, Lisje; van Marken Lichtenbelt, Wouter D
2014-01-01
The thermoneutral zone is defined as the range of ambient temperatures where the body can maintain its core temperature solely through regulating dry heat loss, i.e., skin blood flow. A living body can only maintain its core temperature when heat production and heat loss are balanced. That means that heat transport from body core to skin must equal heat transport from skin to the environment. This study focuses on what combinations of core and skin temperature satisfy the biophysical requirements of being in the thermoneutral zone for humans. Moreover, consequences are considered of changes in insulation and adding restrictions such as thermal comfort (i.e. driver for thermal behavior). A biophysical model was developed that calculates heat transport within a body, taking into account metabolic heat production, tissue insulation, and heat distribution by blood flow and equates that to heat loss to the environment, considering skin temperature, ambient temperature and other physical parameters. The biophysical analysis shows that the steady-state ambient temperature range associated with the thermoneutral zone does not guarantee that the body is in thermal balance at basal metabolic rate per se. Instead, depending on the combination of core temperature, mean skin temperature and ambient temperature, the body may require significant increases in heat production or heat loss to maintain stable core temperature. Therefore, the definition of the thermoneutral zone might need to be reformulated. Furthermore, after adding restrictions on skin temperature for thermal comfort, the ambient temperature range associated with thermal comfort is smaller than the thermoneutral zone. This, assuming animals seek thermal comfort, suggests that thermal behavior may be initiated already before the boundaries of the thermoneutral zone are reached.
-
Roth, Craig S; Burgess, Diana J
2008-10-01
To determine if a pilot phase workshop influenced residents' beliefs and concerns about using opioids for chronic noncancer pain. Pre- and post-survey questionnaire. University residency program. Seventy-two Medicine and Medicine-Pediatrics residents. Participation in a 4-hour workshop based on adult learning theory. Residents' pre- and post-workshop concerns, feelings, and beliefs about the efficacy and safety of opioids for chronic noncancer pain (low back pain), and barriers to prescribing them (paired t-tests). On a scale of 1 = least to 10 = most, residents' concerns about addiction risk from opioids in patients with chronic noncancer pain dropped significantly (P changes were observed regarding concerns about abuse (5.61 to 3.92), side effects (4.88 to 2.88), limiting use of other treatments (5.41 to 3.60), sanctioning (State Board; 4.27 to 3.71; Legal 4.22 to 3.43), and drawing criticism from attending staff (4.50 to 2.77), with P beliefs about efficacy and safety of opioids for chronic noncancer pain increased (Pre 4.96 to Post 7.40), and they were more comfortable prescribing them (4.30 to 6.82), with P beliefs and concerns about using opioids for chronic noncancer pain changed after participating in a 4-hour interactive workshop.
-
Passenger thermal comfort and behavior: a field investigation in commercial aircraft cabins.
Cui, W; Wu, T; Ouyang, Q; Zhu, Y
2017-01-01
Passengers' behavioral adjustments warrant greater attention in thermal comfort research in aircraft cabins. Thus, a field investigation on 10 commercial aircrafts was conducted. Environment measurements were made and a questionnaire survey was performed. In the questionnaire, passengers were asked to evaluate their thermal comfort and record their adjustments regarding the usage of blankets and ventilation nozzles. The results indicate that behavioral adjustments in the cabin and the use of blankets or nozzle adjustments were employed by 2/3 of the passengers. However, the thermal comfort evaluations by these passengers were not as good as the evaluations by passengers who did not perform any adjustments. Possible causes such as differences in metabolic rate, clothing insulation and radiation asymmetry are discussed. The individual difference seems to be the most probable contributor, suggesting possibly that passengers who made adjustments had a narrower acceptance threshold or a higher expectancy regarding the cabin environment. Local thermal comfort was closely related to the adjustments and significantly influenced overall thermal comfort. Frequent flying was associated with lower ratings for the cabin environment. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
-
Hands-on Physics Education of Residents in Diagnostic Radiology.
Zhang, Jie; Hardy, Peter A; DiSantis, David J; Oates, M Elizabeth
2017-06-01
questions improved from 13.6 ± 2.4 to 19 ± 1.2. The survey shows that the physics rotation during the first week of residency is favored by all residents and that 1 week's duration is appropriate. All residents are of the opinion that the intensive workshop would benefit them in upcoming clinical rotations. Residents acknowledge becoming more comfortable regarding the use of radiation and providing counsel regarding radiation during pregnancy. An immersive, short-duration, clinically oriented physics rotation is well received by new or less experienced radiology trainees, correlates basic physics concepts with their relevance to clinical imaging, and more closely parallels expectations of the American Board of Radiology Core Examination. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
-
Sensor design for outdoor racing bicycle field testing for human vibration comfort evaluation
International Nuclear Information System (INIS)
Vanwalleghem, Joachim; De Baere, Ives; Van Paepegem, Wim; Loccufier, Mia
2013-01-01
This paper is concerned with the vibrational comfort evaluation of the cyclist when cycling a rough surface. Outdoor comfort tests have so far only been done through instrumenting the bicycle with accelerometers. This work instruments a racing bicycle with custom-made contact force sensors and velocity sensors to acquire human comfort through the absorbed power method. Comfort evaluation is assessed at the hand–arm and seat interface of the cyclist with the bicycle. By means of careful finite-element analysis for designing the force gauges at the handlebar and the seat combined with precise calibration of both force and velocity sensors, all sensors have proven to work properly. Initial field tests are focused on the proper functioning of the designed sensors and their suitability for vibration comfort measurements. Tests on a cobblestone road reveal that the outcome of the absorbed power values is within the same range as those from laboratory tests found in the literature. This sensor design approach for outdoor testing with racing bicycles may give a new interpretation on evaluating the cyclist's comfort since the vibrational load is not only quantified in terms of acceleration but also in terms of force and velocity at the bicycle–cyclist contact points. (paper)
-
Neurology of cardiopulmonary resuscitation.
Mulder, M; Geocadin, R G
2017-01-01
This chapter aims to provide an up-to-date review of the science and clinical practice pertaining to neurologic injury after successful cardiopulmonary resuscitation. The past two decades have seen a major shift in the science and practice of cardiopulmonary resuscitation, with a major emphasis on postresuscitation neurologic care. This chapter provides a nuanced and thoughtful historic and bench-to-bedside overview of the neurologic aspects of cardiopulmonary resuscitation. A particular emphasis is made on the anatomy and pathophysiology of hypoxic-ischemic encephalopathy, up-to-date management of survivors of cardiopulmonary resuscitation, and a careful discussion on neurologic outcome prediction. Guidance to practice evidence-based clinical care when able and thoughtful, pragmatic suggestions for care where evidence is lacking are also provided. This chapter serves as both a useful clinical guide and an updated, thorough, and state-of-the-art reference on the topic for advanced students and experienced practitioners in the field. © 2017 Elsevier B.V. All rights reserved.
-
Children thermal comfort in primary schools in Ho Chi Minh City in Vietnam
Le, Thi Ho Vi; Gillott, Mark C.; Rodrigues, Lucélia Taranto
2017-01-01
Indoor environmental quality significantly impacts on students’ performance and productivity, particularly thermal comfort levels. Currently in Vietnam, very few studies have dealt with the issue and the current trend is to install energy-intensive air-conditioning in primary schools as this is perceived as more comfortable. In this study, the authors investigated the users’ perceptions of thermal comfort in three primary schools in Ho Chi Minh City during the mid-season (September 2015) and ...
-
Thermal comfort in urban green spaces: a survey on a Dutch university campus.
Wang, Yafei; de Groot, Rudolf; Bakker, Frank; Wörtche, Heinrich; Leemans, Rik
2017-01-01
To better understand the influence of urban green infrastructure (UGI) on outdoor human thermal comfort, a survey and physical measurements were performed at the campus of the University of Groningen, The Netherlands, in spring and summer 2015. Three hundred eighty-nine respondents were interviewed in five different green spaces. We aimed to analyze people's thermal comfort perception and preference in outdoor urban green spaces, and to specify the combined effects between the thermal environmental and personal factors. The results imply that non-physical environmental and subjective factors (e.g., natural view, quiet environment, and emotional background) were more important in perceiving comfort than the actual thermal conditions. By applying a linear regression and probit analysis, the comfort temperature was found to be 22.2 °C and the preferred temperature was at a surprisingly high 35.7 °C. This can be explained by the observation that most respondents, who live in temperate regions, have a natural tendency to describe their preferred state as "warmer" even when feeling "warm" already. Using the Kruskal-Wallis H test, the four significant factors influencing thermal comfort were people's exposure time in green spaces, previous thermal environment and activity, and their thermal history. However, the effect of thermal history needs further investigation due to the unequal sample sizes of respondents from different climate regions. By providing evidence for the role of the objective and subjective factors on human thermal comfort, the relationship between UGI, microclimate, and thermal comfort can assist urban planning to make better use of green spaces for microclimate regulation.
-
Changes in communication skills of clinical residents through psychiatric training.
Yutani, Motoki; Takahashi, Megumi; Miyaoka, Hitoshi
2011-10-01
The objective of this study was to clarify whether the communication skills (CS) of clinical residents change before and after psychiatric training and, if so, what factors are related to the change. The 44 clinical residents who agreed to participate in this study were provided with an originally developed self-accomplished questionnaire survey on CS (communication skills questionnaire [CSQ]) and a generally used questionnaire on self-esteem, anxiety, and depressive mood considered to be related to CS at the start and end of a 2-month psychiatric training session. Statistical analysis was conducted for the 34 residents who completed both questionnaires. The CSQ score (t[32]: -2.17, P self-esteem and negatively with anxiety and depressive tendency. The amount of change in assertive CS score showed a weakly positive correlation with self-esteem. The results suggested that CS, including assertive CS and cooperative CS, were improved by the psychiatric training. Increasing self-esteem and reducing the tendency toward depression and anxiety are considered to be useful for further improving CS. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.
-
Thermal comfort study of plastics manufacturing industry in converting process
Directory of Open Access Journals (Sweden)
Sugiono Sugiono
2017-09-01
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.
-
Directory of Open Access Journals (Sweden)
Ioannis A. Sakellaris
2016-04-01
Full Text Available Indoor environmental conditions (thermal, noise, light, and indoor air quality may affect workers’ comfort, and consequently their health and well-being, as well as their productivity. This study aimed to assess the relations between perceived indoor environment and occupants’ comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 “modern” office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain. Occupants assessed indoor environmental quality (IEQ using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality, and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants’ comfort. The highest association with occupants’ overall comfort was found for “noise”, followed by “air quality”, “light” and “thermal” satisfaction. Analysis of detailed parameters revealed that “noise inside the buildings” was highly associated with occupants’ overall comfort. “Layout of the offices” was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index, and building characteristics (office type and building’s location. Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants.
-
Sakellaris, Ioannis A.; Saraga, Dikaia E.; Mandin, Corinne; Roda, Célina; Fossati, Serena; de Kluizenaar, Yvonne; Carrer, Paolo; Dimitroulopoulou, Sani; Mihucz, Victor G.; Szigeti, Tamás; Hänninen, Otto; de Oliveira Fernandes, Eduardo; Bartzis, John G.; Bluyssen, Philomena M.
2016-01-01
Indoor environmental conditions (thermal, noise, light, and indoor air quality) may affect workers’ comfort, and consequently their health and well-being, as well as their productivity. This study aimed to assess the relations between perceived indoor environment and occupants’ comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 “modern” office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain). Occupants assessed indoor environmental quality (IEQ) using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality), and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor) of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants’ comfort. The highest association with occupants’ overall comfort was found for “noise”, followed by “air quality”, “light” and “thermal” satisfaction. Analysis of detailed parameters revealed that “noise inside the buildings” was highly associated with occupants’ overall comfort. “Layout of the offices” was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index), and building characteristics (office type and building’s location). Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants. PMID:27120608
-
Optimizing visual comfort for stereoscopic 3D display based on color-plus-depth signals.
Shao, Feng; Jiang, Qiuping; Fu, Randi; Yu, Mei; Jiang, Gangyi
2016-05-30
Visual comfort is a long-facing problem in stereoscopic 3D (S3D) display. In this paper, targeting to produce S3D content based on color-plus-depth signals, a general framework for depth mapping to optimize visual comfort for S3D display is proposed. The main motivation of this work is to remap the depth range of color-plus-depth signals to a new depth range that is suitable to comfortable S3D display. Towards this end, we first remap the depth range globally based on the adjusted zero disparity plane, and then present a two-stage global and local depth optimization solution to solve the visual comfort problem. The remapped depth map is used to generate the S3D output. We demonstrate the power of our approach on perceptually uncomfortable and comfortable stereoscopic images.
-
Street greenery and its physical and psychological impact on outdoor thermal comfort
Klemm, W.; Heusinkveld, B.G.; Lenzholzer, S.; Hove, van B.
2015-01-01
This study focuses on the benefits of street greenery for creating thermally comfortable streetscapes in moderate climates. It reports on investigations on the impact of street greenery on outdoor thermal comfort from a physical and psychological perspective. For this purpose, we examined nine
-
Wong, Victoria S S; Strowd, Roy E; Aragón-García, Rebeca; Moon, Yeseon Park; Ford, Blair; Haut, Sheryl R; Kass, Joseph S; London, Zachary N; Mays, MaryAnn; Milligan, Tracey A; Price, Raymond S; Reynolds, Patrick S; Selwa, Linda M; Spencer, David C; Elkind, Mitchell S V
2017-01-01
There is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality. A partially blinded, randomized, controlled multi-center study was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts. Sixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (-8.5%) and non-mentored (-13.9%) residents ( p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non
-
Designing for an imagined user: Provision for thermal comfort in energy-efficient extra-care housing
International Nuclear Information System (INIS)
Lewis, Alan
2015-01-01
Regarded as one solution to the problem of how to enable older people to retain their independence, extra-care housing, where each resident has their own self-contained dwelling and access to communal facilities and to care, has received extensive funding in recent years. Implicit in the concept of specialist housing is the notion of ‘special’ occupants, imagined older people. Adopting a socio-technical approach, this paper considers how ideas about ageing inform those aspects of extra-care-housing-design that relate to thermal comfort. The paper draws on semi-structured interviews with 13 people involved in the design, development and management of UK-based extra-care housing. Participants characterised imagined occupants as vulnerable to cold, at risk from fuel poverty and liable to be burned by hot surfaces or fall from high windows. These user representations were reportedly inscribed into the design of extra-care housing schemes through the inclusion of building features such as communal heating, under-floor heating, restricted window opening and heated corridors. The utilisation of stereotypical user representations of older people raises questions, given that older people's thermal comfort needs can be highly diverse. The paper explores the implications for energy demand. -- Highlights: •Explores the factors that condition energy demand in older people's housing. •Considers how user representations are scripted into building design. •Older occupants characterised as vulnerable to cold and having low incomes. •These user representations affect selection of thermal technologies. •Priority given to keeping occupants warm, leading to possible risk of overheating
-
Lam, Cho Kwong Charlie; Loughnan, Margaret; Tapper, Nigel
2018-01-01
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.
-
Human thermal comfort conditions and urban planning in hot-humid climates-The case of Cuba.
Rodríguez Algeciras, José Abel; Coch, Helena; De la Paz Pérez, Guillermo; Chaos Yeras, Mabel; Matzarakis, Andreas
2016-08-01
Climate regional characteristics, urban environmental conditions, and outdoors thermal comfort requirements of residents are important for urban planning. Basic studies of urban microclimate can provide information and useful resources to predict and improve thermal conditions in hot-humid climatic regions. The paper analyzes the thermal bioclimate and its influence as urban design factor in Cuba, using Physiologically Equivalent Temperature (PET). Simulations of wind speed variations and shade conditions were performed to quantify changes in thermal bioclimate due to possible modifications in urban morphology. Climate data from Havana, Camagüey, and Santiago of Cuba for the period 2001 to 2012 were used to calculate PET with the RayMan model. The results show that changes in meteorological parameters influence the urban microclimate, and consequently modify the thermal conditions in outdoors spaces. Shade is the predominant strategy to improve urban microclimate with more significant benefits in terms of PET higher than 30 °C. For climatic regions such as the analyzed ones, human thermal comfort can be improved by a wind speed modification for thresholds of PET above 30 °C, and by a wind speed decreases in conditions below 26 °C. The improvement of human thermal conditions is crucial for urban sustainability. On this regards, our study is a contribution for urban designers, due to the possibility of taking advantage of results for improving microclimatic conditions based on urban forms. The results may enable urban planners to create spaces that people prefer to visit, and also are usable in the reconfiguration of cities.
-
Neurological Signs and Symptoms in Fibromyalgia
Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.
2009-01-01
Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM. PMID:19714636
-
Neurologic signs and symptoms in fibromyalgia.
Watson, Nathaniel F; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G
2009-09-01
To determine the type and frequency of neurologic signs and symptoms in individuals with fibromyalgia (FM). Persons with FM (n = 166) and pain-free controls (n = 66) underwent systematic neurologic examination by a neurologist blinded to disease status. Neurologic symptoms lasting at least 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurologic symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Age- and sex-adjusted estimates revealed that compared with the control group, the FM group had significantly more neurologic abnormalities in multiple categories, including greater dysfunction in cranial nerves IX and X (42% versus 8%) and more sensory (65% versus 25%), motor (33% versus 3%), and gait (28% versus 7%) abnormalities. Similarly, the FM group had significantly more neurologic symptoms than the control group in 27 of 29 categories, with the greatest differences observed for photophobia (70% versus 6%), poor balance (63% versus 4%), and weakness (58% versus 2%) and tingling (54% versus 4%) in the arms or legs. Poor balance or coordination, tingling or weakness in the arms or legs, and numbness in any part of the body correlated with appropriate neurologic examination findings in the FM group. This blinded, controlled study demonstrated neurologic physical examination findings in persons with FM. The FM group had more neurologic symptoms than did the controls, with moderate correlation between symptoms and signs. These findings have implications for the medical evaluation of patients with FM.
-
Reddy, Shalini T; Zegarek, Matthew H; Fromme, H Barrett; Ryan, Michael S; Schumann, Sarah-Anne; Harris, Ilene B
2015-06-01
Despite the importance of feedback, the literature suggests that there is inadequate feedback in graduate medical education. We explored barriers and facilitators that residents in anesthesiology, emergency medicine, obstetrics and gynecology, and surgery experience with giving and receiving feedback during their clinical training. Residents from 3 geographically diverse teaching institutions were recruited to participate in focus groups in 2012. Open-ended questions prompted residents to describe their experiences with giving and receiving feedback, and discuss facilitators and barriers. Data were transcribed and analyzed using the constant comparative method associated with a grounded theory approach. A total of 19 residents participated in 1 of 3 focus groups. Five major themes related to feedback were identified: teacher factors, learner factors, feedback process, feedback content, and educational context. Unapproachable attendings, time pressures due to clinical work, and discomfort with giving negative feedback were cited as major barriers in the feedback process. Learner engagement in the process was a major facilitator in the feedback process. Residents provided insights for improving the feedback process based on their dual roles as teachers and learners. Time pressures in the learning environment may be mitigated by efforts to improve the quality of teacher-learner relationships. Forms for collecting written feedback should be augmented by faculty development to ensure meaningful use. Efforts to improve residents' comfort with giving feedback and encouraging learners to engage in the feedback process may foster an environment conducive to increasing feedback.
-
Medical-grade footwear: the impact of fit and comfort.
Hurst, Bessie; Branthwaite, Helen; Greenhalgh, Andrew; Chockalingam, Nachiappan
2017-01-01
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
-
[Comfort and discomfort: the role of emotions in GPs' prescription practices].
Henriksen, Kristin; Hansen, Ebba Holme
2005-12-05
The role of emotions in GPs' prescribing has been ignored. The present article describes 20 GPs' reflections about what precedes comfort and discomfort in prescribing situations. In-depth interviews were done with 20 GPs who contributed with examples on an open comfort-discomfort scale. Analysis of the data was inspired by grounded theory. The GPs experienced a broad spectrum of emotions when prescribing. In every prescribing situation, conditions could pull towards both comfort and discomfort. Comfort appeared when the indication was correct and the patient's condition was serious, when the patient experienced the problem as serious, when the situation was acute and the medicine effective, and when the GP experienced himself as competent. Medicines were placed between comfort and discomfort when prescribing was perceived as indifferent, unproblematic and easy, when the GP was concerned about inflicting a sick role on the patients, and when patients were not convinced about the appropriateness of the medication. Discomfort appeared when there was a great risk of dependence, when GPs experienced and gave in to pressure, when they had to convince patients, and when they prescribed addictive medicine regularly. The totality of conditions in the situation determined the emotional state in the prescribing situation. The GPs' emotions reflected how they evaluated the appropriateness of their prescribing. This should be taken advantage of in rational pharmacotherapy. Future interventions should address both the rationality of GPs and their emotions.
-
Real-Time Monitoring of Occupants’ Thermal Comfort through Infrared Imaging: A Preliminary Study
Directory of Open Access Journals (Sweden)
Boris Pavlin
2017-02-01
Full Text Available Thermally comfortable indoor environments are of great importance, as modern lifestyles often require people to spend more than 20 h per day indoors. Since most of the thermal comfort models use a variety of different environmental and personal factors that need to be measured or estimated, real-time and continuous assessment of thermal comfort is often not practically feasible. This work presents a cheap and non-invasive approach based on infrared imaging for monitoring the occupants’ thermal sensation and comfort in real time. Thanks to a mechatronic device developed by the authors, the imaging is performed on the forehead skin, selected because it is always exposed to the environment and, thus, facilitating the monitoring activity in a non-invasive manner. Tests have been performed in controlled conditions on ten subjects to assess the hypothesis that the forehead temperature is correlated with subjects’ thermal sensation. This allows the exploitation of this quantity as a base for a simple monitoring of thermal comfort, which could later be tuned with an extensive experimental campaign.
-
Towards comfortable and efficient man-machine interaction in the cabins of vehicles
Looze, M.P. de; Roetting, M.; Vink, P.; Luczak, H.
2000-01-01
The comfort of the operators in the cabins of vehicles is getting an increasingly important issue. At first glance, the cabins of professional machines (earth-moving equipment, busses, harvesting equipment) might look modern and highly comfortable. However, this does not imply that the cabins
-
Indoor Air Quality and Thermal Comfort in School Buildings
Juhásová Šenitková, Ingrid
2017-12-01
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.
-
Numerical Analysis of Thermal Comfort at Open Air Spaces
Papakonstantinou, K.; Belias, C.; Pantos-Kikkos, S.; Assana, A.
2008-09-01
The present paper refers to the numerical simulation of air velocity at open air spaces and the conducting thermal comfort after the evaluation of the examined space using CFD methods, taking into account bioclimatic principles at the architectural design. More specially, the paper draws attention to the physical procedures governing air movement at an open environment area in Athens (urban park), named "Attiko Alsos," trying to form them in such way that will lead to the thermal comfort of the area's visitors. The study presents a mathematical model, implemented in a general computer code that can provide detailed information on velocity, prevailing in three-dimensional spaces of any geometrical complexity. Turbulent flow is simulated and buoyancy effects are taken into account. This modelling procedure is intended to contribute to the effort towards designing open areas, such as parks, squares or outdoor building environments, using thermal comfort criteria at the bioclimatic design. A computer model of this kind will provide the architects or the environmental engineers with powerful and economical means of evaluating alternative spaces' designs.
-
The end-state comfort effect in bimanual grip selection.
Fischman, Mark G; Stodden, David F; Lehman, Davana M
2003-03-01
During a unimanual grip selection task in which people pick up a lightweight dowel and place one end against targets at variable heights, the choice of hand grip (overhand vs. underhand) typically depends on the perception of how comfortable the arm will be at the end of the movement: an end-state comfort effect. The two experiments reported here extend this work to bimanual tasks. In each experiment, 26 right-handed participants used their left and right hands to simultaneously pick up two wooden dowels and place either the right or left end against a series of 14 targets ranging from 14 to 210 cm above the floor. These tasks were performed in systematic ascending and descending orders in Experiment 1 and in random order in Expiment 2. Results were generally consistent with predictions of end-state comfort in that, for the extreme highest and lowest targets, participants tended to select opposite grips with each hand. Taken together, our findings are consistent with the concept of constraint hierarchies within a posture-based motion-planning model.
-
Evaluation technology of clothing comfortableness; Ifuku tekigosei hyoka gijutsu
Energy Technology Data Exchange (ETDEWEB)
Niwaya, H.
1999-10-26
Modern apparel industries are required to supply many kinds of products corresponding to various needs of consumers. Among consumers' needs, comfortableness to wear such as size-fitness is primarily important. To facilitate apparel industries, it is expected to develop a new technology of pattern designing of comfortable garment and measuring garment pressure distribution. Our research is aimed at developing technology that uses computer simulation to predict and evaluate wear comfort, including size suitability, without the need to actually sew up a garment. First, we developed a basic system to predict wearing silhouette, garment pressure, and ease looseness of the garment. Using this system, we carried on the following study. The 3-dimensional distributions of the garment pressure and ease looseness were reversely mapped on the paper pattern in order to indicate the preferable modification. The system was extended for several poses, e.g. twist, bend. From various parameters, we examined the factors of garment pressure and ease looseness. In addition, we selected the parameters for the size-fit indicators and investigated size-fit evaluation indicators. (author)
-
International Nuclear Information System (INIS)
Djongyang, Noël; Tchinda, René; Njomo, Donatien
2012-01-01
Highlights: ► Thermal comfort in sleeping environments in the sub-Saharan Africa is presented. ► Comfort charts for the dry-tropical regions were established. ► Total insulation values for bedding systems range between 0.81 clo and 0.94 clo. ► Thermoneutral operative temperature ranges between 29.5 °C and 31.7 °C. ► Thermoneutral air temperature ranges between 27.1 °C and 29.6 °C. - Abstract: A human being spends approximately one-third of his/her life in sleep. For an efficient and peaceful rest, he/she therefore needs some level of comfort. This includes acceptable environmental parameters as well as suitable bedding systems. While the theories of thermal comfort in workplaces at daytime are currently well established, research on thermal comfort for sleeping environment at night is limited. Further studies in relation with sleep are needed. This paper presents an investigation on thermal comfort in sleeping environments in the sub-Saharan Africa region. The comfort equation used is based on the energy balance of the human body derived from Fanger’s comfort model. Comfort charts for the dry-tropical sub-Saharan Africa region were established using indoor climatic conditions collected over five years in Ouagadougou (12°22′N, 1°32′W). Results obtained show that the suitable monthly total insulation values for bedding systems in the dry-tropical regions range between 0.81 clo and 0.94 clo. The thermoneutral operative temperature range between 29 °C and 32 °C, while the thermoneutral air temperature range between 27 °C and 30 °C.
-
Effect of three different liposomal eye sprays on ocular comfort and tear film.
Pult, Heiko; Gill, Felicity; Riede-Pult, Britta H
2012-10-01
To evaluate the effect of three different liposomal eye sprays on ocular comfort and tear film stability. OptrexActiMist (AM, Optima-Pharma, Germany) was applied onto one, randomly selected eye of 80 subjects (female=49; mean age=49 years±18.6 SD) in a multi-centred, double-masked study. DryEyesMist (DEM, Boots) or TearMist (TM, Tesco) was applied onto the contralateral eye in randomized order. Over-all symptoms were investigated using the Ocular Surface Disease Index (OSDI). Ocular comfort (visual-analogue scale 0-100 [100=perfect]) and non-invasive tear film stability (NIBUT) of each eye was evaluated before application (randomized order) and were again measured 10 min after application. Effects of products on ocular comfort and NIBUT were calculated as "factor" (=after-treatment/before-treatment). Differences between measurements were analysed by ANOVA repeated measurements and differences between groups by the dependent t-test (or the non-parametric equivalent). OSDI-scores (mean=8.1±9.0 SD), comfort (65±24) and NIBUT (12 s±12.3) were statistically similar between centres (p>0.400). Comfort and NIBUT were not different (p>0.14) between product groups before application. Comfort and NIBUT improved significantly after application of AM (p<0.001) but worsened with the comparing products (p<0.058). Comfort improved by a mean factor of 1.5 (±0.82 SD) after application of AM but decreased after application of the comparing products (DEM: 0.9±0.33; TM: 0.9±0.34). Both factors were significantly better in AM (p<0.027). The original liposomal eye-spray 'OptrexActiMist' significantly improved ocular comfort and tear film stability while 'TearMist' or 'DryEyesMist' worsened both criteria. The latter two products may not be clinically effective in the treatment of dry eye. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
-
Understanding thermal comfort perception of nurses in a hospital ward work environment.
Derks, M.T.H.; Mishra, A.K.; Loomans, M.G.L.C.; Kort, H.S.M.
2018-01-01
In indoor comfort research, thermal comfort of care-professionals in hospital environment is a little explored topic. To address this gap, a mixed methods study, with the nursing staff in hospital wards acting as participants, was undertaken. Responses were collected during three weeks in the summer
-
International Nuclear Information System (INIS)
Appel, S.H.
1988-01-01
The topics covered in this book include: Duchenne muscular dystrophy: DNA diagnosis in practice; Central nervous system magnetic resonance imaging; and Magnetic resonance spectroscopy of neurologic diseases
-
Human Thermal Comfort In Residential House Buildings Of Jimma Town Southwest Ethiopia.
Directory of Open Access Journals (Sweden)
Chali Yadeta
2015-08-01
Full Text Available Indoor human thermal comfort is an important factor in indoor air quality assessment. Thermal comfort affects human health work efficiency and overall wellbeing. Thermal discomfort in indoors lowers the emotional and physical health of the occupants. This paper targets to explore human thermal comfort in residential house buildings of Jimma town and state some possible mechanisms to improve the existing thermal discomfort in large number the houses. For the study 303 structured questionnaires were distributed to the residential houses in thirteen places of the town based on predetermined criteria. The study reveals that human thermal discomfort in residential houses Jimma town are mainly from poor architectural design and improper use of heat generating appliances in indoors. The uses architectural design that suites the present climatic conditions and use of materials that facilitates ventilations will enhance the realization of the required human thermal comfort in residential houses of the study area.
-
Neurological aspects of eclampsia
Directory of Open Access Journals (Sweden)
Jovanović Dejana
2003-01-01
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.
-
Lowenstein, Daniel H
2011-10-01
Daniel H Lowenstein, MD, is the Robert B and Ellinor Aird Professor and Vice-Chairman of Neurology, Director of the Epilepsy Center, and Director of Physician-Scientist Education and Training at the University of California, San Francisco (UCSF). He received his BA in Mathematics from the University of Colorado and MD from Harvard Medical School. He completed his neurology residency training at UCSF. Dr Lowenstein is a clinician-scientist who has studied both basic science and clinical aspects of epilepsy. In recent years, he has been an organizer of a large-scale, international effort to study the complex genetics of epilepsy, known as the Epilepsy Phenome/Genome Project. He has been actively involved in advancing the cause of epilepsy at the national and international level. Dr Lowenstein served as President of the American Epilepsy Society from 2003 to 2004 and the National Institute of Neurological Diseases and Stroke (NINDS) Advisory Council from 2000 to 2004, and has overseen the development of the NINDS Epilepsy Research Benchmarks since their inception in 2000.
-
Editorial: Comfort and discomfort studies demonstrate the need for a new model
Vink, P.; Hallbeck, S.
2012-01-01
The term comfort is often seen relating to the marketing of products like chairs, cars, clothing, hand tools and even airplane tickets, while in the scientific literature, the term discomfort shows up often, since it is used in research. Few papers explain the concept of a localized comfort
-
Amin, Rucha; Teli, Despoina; James, Patrick; Bourikas, Leonidas
2016-01-01
Adaptive comfort theory states that over time people adapt to their normal environment. Therefore, people from different climates are expected to have different thermal preferences and behaviours, which could lead to ‘performance gap’ in buildings with occupants of diverse climate backgrounds. This study investigates the influence of occupants’ thermal history on use of controls and indoor temperature preference in a newly built halls of residence building complex in Southampton, UK, which pr...
-
Affective disorders in neurological diseases
DEFF Research Database (Denmark)
Nilsson, F M; Kessing, L V; Sørensen, T M
2003-01-01
OBJECTIVE: To investigate the temporal relationships between a range of neurological diseases and affective disorders. METHOD: Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two...... of affective disorder was lower than the incidence in the control groups. CONCLUSION: In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases)....
-
Wu, Zhibin; Li, Nianping; Cui, Haijiao; Peng, Jinqing; Chen, Haowen; Liu, Penglong
2017-09-21
Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments' conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm) and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC) located in the hot summer and cold winter (HSCW) climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET*) was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*.
-
Directory of Open Access Journals (Sweden)
Zhibin Wu
2017-09-01
Full Text Available Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC located in the hot summer and cold winter (HSCW climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET* was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*.
-
CFD Modeling of Thermal Manikin Heat Loss in a Comfort Evaluation Benchmark Test
DEFF Research Database (Denmark)
Nilsson, Håkan O.; Brohus, Henrik; Nielsen, Peter V.
2007-01-01
for comfort evaluation. The main idea is to focus on people. It is the comfort requirements of occupants that decide what thermal climate that will prevail. It is therefore important to use comfort simulation methods that originate from people, not just temperatures on surfaces and air.......Computer simulated persons (CSPs) today are different in many ways, reflecting various software possibilities and limitations as well as different research interest. Unfortunately, too few of the theories behind thermal manikin simulations are available in the public domain. Many researchers...
-
Radiating comfort in prestigious condo units
Energy Technology Data Exchange (ETDEWEB)
Barber, R.
2001-08-01
Advantages of the type of electric floor heating installed in an exclusive condominium development in Whistler, a winter sports resort community in British Columbia, are discussed. Quality, comfort, strict limits on the amount of available electricity, and reduced maintenance, were the principal reasons for installing this type of heating system, according to the designer of the complex. Floor heating, being a radiant heating system, eliminates wasteful stratification of heat in a given heated space, thus helping to achieve comfortable ambient temperature at a lower level than would be required with conventional heating systems, reducing the power requirements by as much as 25 per cent. The system maintains a uniform temperature without any movement of air, dust and germs, providing occupants with a clean and pleasant atmosphere. The Flexterm system can be used under a variety of floor coverings -- natural stone, ceramic, marble, carpets, vinyl tiles, or wood flooring. It can be used selectively in different rooms of a housing unit, while other parts (in this instance the bedrooms), are heated by small electric baseboard heaters.
-
Thermodynamical analysis of human thermal comfort
International Nuclear Information System (INIS)
Prek, Matjaz
2006-01-01
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 environmental (room) conditions. This process is related to human thermal comfort in connection with temperature, heat, and mass transfer. In this paper a thermodynamic analysis of human heat and mass transfer based on the 2nd law of thermodynamics in presented. It is shown that the human body's exergy consumption in relation to selected human parameters exhibits a minimal value at certain combinations of environmental parameters. The expected thermal sensation also shows that there is a correlation between exergy consumption and thermal sensation. Thus, our analysis represents an improvement in human thermal modelling and gives more information about the environmental impact on expected human thermal sensation
-
Tandem bike design for apartment residents as an idea to reduce air pollution
Directory of Open Access Journals (Sweden)
Iskandriawan Bambang
2017-01-01
Full Text Available Vertical housing is recently popular in urban areas since the availability of land is very limited. A strong preference for living in the city is mainly due to the home to work travel that is relatively close for those who work in the city. While residing in the vertical housing (i.e. apartment can be an advantage, several accommodation facilities are often provided at their minimum standards. As such, a special design of bicycle for apartment residents may an effective solution. Multi-function bike, ridden either by one or two riders and its aesthetic part of interior element can be an attractive offer. Identification of marketing objectives and observation of comparable products were a crucial step in the initial process of tandem bike design. The use of bicycle in urban areas can overcome a number of motorized vehicles operating wherever the using of them may create issues such as traffic jam and air pollution. This study aims to adjust the tandem bike which can be produced commercially for the apartment residents. Stated in the research problems, the design process was successfully fulfilled. Fabrication and product testing were positively completed. A concise and comfortable bike to carry from the lobby to the apartment unit, or vice versa, was successfully created.
-
Neurological complication in HIV patients
Ritarwan, K.
2018-03-01
Human Immunodeficiency Virus (HIV) is neurotropic and immunotropic, making themassive destruction of both systems. Although their amount has been reduced, there is still neurological presentations and complications of HIV remain common in the era of combination antiretroviral therapy (cART). Neurological opportunistic infections (OI) occur in advanced HIV diseases such as primary cerebral lymphoma, cryptococcal meningitis, cerebral toxoplasmosis, and progressive multifocal encephalopathy. Neurological problem directly related to HIV appear at any stage in the progress of HIV disease, from AIDS-associated dementia to the aseptic meningitis of primary HIV infection observed in subjects with an immune deficiency. The replication of peripheral HIV viral is able to be controlled in the era of effective antiretroviral therapy. Non-HIV-related neurological disease such as stroke increased important as the HIV population ages.
-
Neurology as career option among postgraduate medical students
Directory of Open Access Journals (Sweden)
Namit B Gupta
2013-01-01
Full Text Available Background: In the context of inadequacy of neurology workforce in India, it is important to understand factors that post-graduate medical students consider for and against choosing neurology as their career option. Understanding these factors will help in planning strategies to encourage students to pursue a career in neurology. At present, there is a paucity of studies addressing this issue in India. Aims and Objectives: (1 To analyze factors, which post-graduate students consider for and against choosing neurology as a career specialty. (2 To access the level and quality of neurology exposure in the current MBBS and MD curricula. Materials and Methods: Statewide questionnaire based study was conducted in the state of Maharashtra for students eligible to take DM neurology entrance examination (MD Medicine and MD Pediatrics. Results: In this survey, 243 students were enrolled. Factors bringing students to neurology were - intellectual challenge and logical reasoning (72%, inspired by role model teachers (63%, better quality-of-life (51% and scope for independent practice without expensive infrastructure (48%. Factors preventing students from taking neurology were - perception that most neurological diseases are degenerative (78%, neurology is mainly an academic specialty (40%, neurophobia (43% and lack of procedures (57%. Inadequate exposure and resultant lack of self-confidence were common (31%, 70-80%. 84% of the students felt the need for a short term certification course in neurology after MD. Conclusions: To attract more students to neurology, "role model" teachers of neurology could interact and teach students extensively. Neurologists′ efforts to shed their diagnostician′s image and to shift their focus to therapeutics will help change the image of neurology. Out-patient neurology clinics should be incorporated early in the student′s career. Procedures attract students; hence, they should be made conversant with procedures and
-
Neurologic manifestations of achondroplasia.
Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J
2014-01-01
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.
-
Johnson, C. E.
2018-01-01
The moral economy of comfortable living: Negotiating individualism and collectivism through housing in Belgrade Charlotte E Johnson First Published February 28, 2018 Research Article Download PDFPDF download for The moral economy of comfortable living: Negotiating individualism and collectivism through housing in Belgrade Article information No Access Please click here for full access options Abstract Comfort in the home depends on material and social connections. From pipes and wires to lega...
-
Experimental Measures of Bus Comfort Levels Using Kinematic Parameters Recorded by Smartphone
Energy Technology Data Exchange (ETDEWEB)
Aquila, S. dell'
; Eboli, L.; Futia, G.; Mazzulla, G.; Pungillo, G. 2016-07-01
Comfort on board plays an essential role in the levels of satisfaction of a bus service perceived by passengers. The aim of this paper is to propose a measure of comfort based on two kinds of data: perceptions of passengers (subjective data) and accelerations of bus (objective data). For the collection of subjective data a questionnaire was addressed to a sample of university students, while a smartphone, equipped with GPS device and 3-axis accelerometer, was used to record the accelerations. Based on the recorded parameters, we determined the thresholds of the acceleration values beyond which the level of comfort cannot be considered as good.. (Author)
-
Relative importance of different surface regions for thermal comfort in humans.
Nakamura, Mayumi; Yoda, Tamae; Crawshaw, Larry I; Kasuga, Momoko; Uchida, Yuki; Tokizawa, Ken; Nagashima, Kei; Kanosue, Kazuyuki
2013-01-01
In a previous study, we investigated the contribution of the surface of the face, chest, abdomen, and thigh to thermal comfort by applying local temperature stimulation during whole-body exposure to mild heat or cold. In hot conditions, humans prefer a cool face, and in cold they prefer a warm abdomen. In this study, we extended investigation of regional differences in thermal comfort to the neck, hand, soles, abdomen (Experiment 1), the upper and lower back, upper arm, and abdomen (Experiment 2). The methodology was similar to that used in the previous study. To compare the results of each experiment, we utilized the abdomen as the reference area in these experiments. Thermal comfort feelings were not particularly strong for the limbs and extremities, in spite of the fact that changes in skin temperature induced by local temperature stimulation of the limbs and extremities were always larger than changes that were induced in the more proximal body parts. For the trunk areas, a significant difference in thermal comfort was not observed among the abdomen, and upper and lower back. An exception involved local cooling during whole-body mild cold exposure, wherein the most dominant preference was for a warmer temperature of the abdomen. As for the neck and abdomen, clear differences were observed during local cooling, while no significant difference was observed during local warming. We combined the results for the current and the previous study, and characterized regional differences in thermal comfort and thermal preference for the whole-body surface.
-
Energy and comfort in contemporary open plan and traditional personal offices
International Nuclear Information System (INIS)
Shahzad, Sally; Brennan, John; Theodossopoulos, Dimitris; Hughes, Ben; Calautit, John Kaiser
2017-01-01
Highlights: • User satisfaction is compared in offices with high and low thermal control. • Thermal control is secondary in British and main system in Norwegian approach. • Individual thermal control in Norway improved satisfaction (35%) and comfort (20%). • The energy use is much higher in the Norwegian than British case studies. • A balance is required between energy efficiency and providing thermal comfort. - Abstract: Two office layouts with high and low levels of thermal control were compared, respectively traditional cellular and contemporary open plan offices. The traditional Norwegian practice provided every user with control over a window, blinds, door, and the ability to adjust heating and cooling. Occupants were expected to control their thermal environment to find their own comfort, while air conditioning was operating in the background to ensure the indoor air quality. In contrast, in the British open plan office, limited thermal control was provided through openable windows and blinds only for occupants seated around the perimeter of the building. Centrally operated displacement ventilation was the main thermal control system. Users’ perception of thermal environment was recorded through survey questionnaires, empirical building performance through environmental measurements and thermal control through semi-structured interviews. The Norwegian office had 35% higher user satisfaction and 20% higher user comfort compared to the British open plan office. However, the energy consumption in the British practice was within the benchmark and much lower than the Norwegian office. Overall, a balance between thermal comfort and energy efficiency is required, as either extreme poses difficulties for the other.
-
Neurologic sequelae associated with foscarnet therapy.
Lor, E; Liu, Y Q
1994-09-01
To report three cases of possible foscarnet-induced neurologic sequelae. We report two cases of seizures and one case of hand cramping and finger paresthesia after starting foscarnet therapy with no evidence of predisposing risk factors, such as serum laboratory abnormalities, renal dysfunction, or known central nervous system (CNS) involvement. All three patients had stable laboratory values during therapy and when the neurologic adverse effects occurred. All patients were receiving appropriate dosages of foscarnet. The incidence of seizures in AIDS patients was reviewed. A history of CNS lesions, infections, and/or AIDS per se may increase the risk of a neurologic adverse effect while receiving foscarnet therapy. Acute ionized hypocalcemia may cause these neurologic adverse effects. Ionized hypocalcemia is transitory, is related to the rate of foscarnet infusion, and may not be reflected as a change in total serum calcium concentration. Foscarnet probably contributed to the neurologic adverse effects reported here. Foscarnet may need to be administered at a slower rate than is recommended by the manufacturer. Electrolytes must be monitored closely; however, a neurologic adverse effect may not be foreseen.
-
Neurological Disorders in Adult Celiac Disease
Directory of Open Access Journals (Sweden)
Hugh J Freeman
2008-01-01
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.
-
Neurological manifestations of dengue viral infection
Directory of Open Access Journals (Sweden)
Carod-Artal FJ
2014-10-01
Full Text Available Francisco Javier Carod-Artal1,21Neurology Department, Raigmore hospital, Inverness, UK; 2Universitat Internacional de Catalunya (UIC, Barcelona, Spain Abstract: Dengue is the most common mosquito-borne viral infection worldwide. There is increased evidence for dengue virus neurotropism, and neurological manifestations could make part of the clinical picture of dengue virus infection in at least 0.5%–7.4% of symptomatic cases. Neurological complications have been classified into dengue virus encephalopathy, dengue virus encephalitis, immune-mediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain–Barré syndrome, neuritis brachialis, acute cerebellitis, and others, neuromuscular complications (hypokalemic paralysis, transient benign muscle dysfunction and myositis, and dengue-associated stroke. Common neuro-ophthalmic complications are maculopathy and retinal vasculopathy. Pathogenic mechanisms include systemic complications and metabolic disturbances resulting in encephalopathy, direct effect of the virus provoking encephalitis, and postinfectious immune mechanisms causing immune-mediated syndromes. Dengue viruses should be considered as a cause of neurological disorders in endemic regions. Standardized case definitions for specific neurological complications are still needed. Keywords: encephalitis, encephalopathy, dengue fever, neurological complications
-
Neural computing thermal comfort index PMV for the indoor environment intelligent control system
Liu, Chang; Chen, Yifei
2013-03-01
Providing indoor thermal comfort and saving energy are two main goals of indoor environmental control system. An intelligent comfort control system by combining the intelligent control and minimum power control strategies for the indoor environment is presented in this paper. In the system, for realizing the comfort control, the predicted mean vote (PMV) is designed as the control goal, and with chastening formulas of PMV, it is controlled to optimize for improving indoor comfort lever by considering six comfort related variables. On the other hand, a RBF neural network based on genetic algorithm is designed to calculate PMV for better performance and overcoming the nonlinear feature of the PMV calculation better. The formulas given in the paper are presented for calculating the expected output values basing on the input samples, and the RBF network model is trained depending on input samples and the expected output values. The simulation result is proved that the design of the intelligent calculation method is valid. Moreover, this method has a lot of advancements such as high precision, fast dynamic response and good system performance are reached, it can be used in practice with requested calculating error.
-
Neurological sequelae of the operation "baby lift" airplane disaster.
Cohen, M; Conners, C K; Brook, I; Feldman, S; Mason, J K; Dugas, M; Collis, L; Copeland, B; Lewis, O; Denhoff, E
1994-01-01
The aircraft disaster of the first flight of Operation "Baby Lift", which departed from Saigon, Vietnam, April 4, 1975, was survived by 149 orphaned children on their way to adoptive homes in the West. It had 157 passenger fatalities. The aircraft disaster exposed the surviving children to a complex disaster environment in which subatmospheric decompression, hypoxia, and deceleration were experienced, many children suffered a transient unconsciousness. We examined 135 surviving children between 1978 and 1985. The U.S. resident children were examined in the years 1979 to 1982 at an average age of 8 years and 6 months. They displayed the following symptomatology: attention deficit (> 75%), hyperactivity (> 65%), impulse disorder (> 55%), learning disabilities (> 35%), speech and language pathology (> 70%), and soft neurological signs (> 75%). The European children were examined in the years 1983 to 1985. On arrival at the adoptive home, 2 weeks after the accident they displayed the following symptomatology: muscle hypotonia (26%), seizures (2.5%), and regressed developmental milestones (33%). At the time of the diagnostic evaluations (1983 to 1985) the average age was 11 years and 8 months. They displayed the following symptomatology: attention deficit (59%), hyperactivity (52%), impulse disorder (48%), learning disabilities (43%), soft neurological signs (43%), epilepsy (16%), and speech and language pathology (34%). We conclude that a complex disaster environment can cause brain damage in children without prolonged unconsciousness, and that victims of disasters require a thorough evaluation from a multidisciplinary team.
-
The Relationship of Cow Comfort and Flooring to Lameness Disorders in Dairy Cattle.
Endres, Marcia I
2017-07-01
Cow comfort and flooring contribute to lameness incidence in dairy herds. The trigger factors for lameness can all be exacerbated by poor cow comfort. Reduced cow comfort influences lameness incidence by increasing the risk for development of new cases and the time it takes for a cow to recover. Reduction in resting time will increase the cow's exposure to hard flooring surfaces. Many factors are associated with lameness prevalence. Housing and management factors should be optimized to reduce lameness incidence on dairy farms. Copyright © 2017 Elsevier Inc. All rights reserved.
-
Dataset on daytime outdoor thermal comfort for Belo Horizonte, Brazil.
Hirashima, Simone Queiroz da Silveira; Assis, Eleonora Sad de; Nikolopoulou, Marialena
2016-12-01
This dataset describe microclimatic parameters of two urban open public spaces in the city of Belo Horizonte, Brazil; physiological equivalent temperature (PET) index values and the related subjective responses of interviewees regarding thermal sensation perception and preference and thermal comfort evaluation. Individuals and behavioral characteristics of respondents were also presented. Data were collected at daytime, in summer and winter, 2013. Statistical treatment of this data was firstly presented in a PhD Thesis ("Percepção sonora e térmica e avaliação de conforto em espaços urbanos abertos do município de Belo Horizonte - MG, Brasil" (Hirashima, 2014) [1]), providing relevant information on thermal conditions in these locations and on thermal comfort assessment. Up to now, this data was also explored in the article "Daytime Thermal Comfort in Urban Spaces: A Field Study in Brazil" (Hirashima et al., in press) [2]. These references are recommended for further interpretation and discussion.
-
Understanding of Danish passive houses based on pilot project Comfort Houses
Energy Technology Data Exchange (ETDEWEB)
Brunsgaard, C.
2010-12-15
The aim of the research is to investigate the notion of passive houses in Denmark. When this PhD thesis was initiated, the Danish building industry has just started to become interested in the passive house concept, but the knowledge was very limited. To be able to speed up the process of constructing Danish passive houses or other low energy concepts Saint-Gobain Isover Scandinavia took the initiative to the pilot project of the Comfort Houses, ten single-family houses constructed as passive houses, and wanted to share the knowledge with the building industry and other interested. This PhD thesis was a part of the strategy. If the concept of passive houses should be successfully promoted and achieve a significant sale in Denmark, it is believed that it is necessary to do a holistic approach. Besides energy savings and new structural solutions more qualitative aspects like architecture, everyday life and the future ways of living needs to be integrated in the future understanding of passive houses. This Ph.D. thesis therefore studies the following research question: What can the experience from the Comfort Houses enlighten about the future production and use of Danish passive houses? This understanding is achieved through studies of different study fields to be able to create a more holistic understanding of the concept both covering qualitative and quantitative analysis. The main focus will be on the study fields Design Process, Architecture and Everyday Life and the Indoor environment, which will answer the following sub-research questions: 1) How has the consortiums behind the Comfort Houses approached the design process according to teamwork, method and tools? And what barriers and possibilities lie within the approaches? 2) How do the occupants of the Comfort Houses experience the passive house architecture and the technical service systems? And has their everyday life changed by moving into a passive house? If so, how? 3) To what extent do the Comfort Houses
-
Cross-cultural psychiatric residency training: the Oregon experience.
Boehnlein, James K; Leung, Paul K; Kinzie, John David
2008-01-01
The purpose of this article is to describe the goals and structure of cross-cultural psychiatric training at Oregon Health and Science University (OHSU). This training in core knowledge, skills, and attitudes of cultural psychiatry over the past three decades has included medical students, residents, and fellows, along with allied mental health personnel. The curriculum includes both didactic sessions devoted to core topics in the field and varied clinical experiences in community settings and the Intercultural Psychiatric Program under the supervision of experienced academic faculty. The authors review the central elements of the training experiences and include a detailed description of the core clinical settings and experiences. At the conclusion of their clinical experiences, trainees have specialized cross-cultural psychiatric knowledge and skills, including treatment of refugees and immigrants, sociocultural variables that influence the assessment and treatment of a wide range of psychiatric conditions, and comfort with cultural dynamics that influence both the doctor/patient relationship and collaboration with a wide range of mental health professionals. Because of rapid demographic changes in the U.S. population, providing cross-cultural training for students, residents, and fellows is an essential foundation for the education of the next generation of clinicians and health care leaders. OHSU has provided a long-term model for this training in a busy clinical and academic setting that places an emphasis on multidisciplinary and multicultural collaboration.
-
ESPEN guideline clinical nutrition in neurology.
Burgos, Rosa; Bretón, Irene; Cereda, Emanuele; Desport, Jean Claude; Dziewas, Rainer; Genton, Laurence; Gomes, Filomena; Jésus, Pierre; Leischker, Andreas; Muscaritoli, Maurizio; Poulia, Kalliopi-Anna; Preiser, Jean Charles; Van der Marck, Marjolein; Wirth, Rainer; Singer, Pierre; Bischoff, Stephan C
2018-02-01
Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs. The present evidence- and consensus-based guideline addresses clinical questions on best medical nutrition therapy in patients with neurological diseases. Among them, management of oropharyngeal dysphagia plays a pivotal role. The guideline has been written by a multidisciplinary team and offers 88 recommendations for use in clinical practice for amyotrophic lateral sclerosis, Parkinson's disease, stroke and multiple sclerosis. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
-
Neurologic abnormalities in murderers.
Blake, P Y; Pincus, J H; Buckner, C
1995-09-01
Thirty-one individuals awaiting trial or sentencing for murder or undergoing an appeal process requested a neurologic examination through legal counsel. We attempted in each instance to obtain EEG, MRI or CT, and neuropsychological testing. Neurologic examination revealed evidence of "frontal" dysfunction in 20 (64.5%). There were symptoms or some other evidence of temporal lobe abnormality in nine (29%). We made a specific neurologic diagnosis in 20 individuals (64.5%), including borderline or full mental retardation (9) and cerebral palsy (2), among others. Neuropsychological testing revealed abnormalities in all subjects tested. There were EEG abnormalities in eight of the 20 subjects tested, consisting mainly of bilateral sharp waves with slowing. There were MRI or CT abnormalities in nine of the 19 subjects tested, consisting primarily of atrophy and white matter changes. Psychiatric diagnoses included paranoid schizophrenia (8), dissociative disorder (4), and depression (9). Virtually all subjects had paranoid ideas and misunderstood social situations. There was a documented history of profound, protracted physical abuse in 26 (83.8%) and of sexual abuse in 10 (32.3%). It is likely that prolonged, severe physical abuse, paranoia, and neurologic brain dysfunction interact to form the matrix of violent behavior.
-
International Nuclear Information System (INIS)
Baldi, Simone; Karagevrekis, Athanasios; Michailidis, Iakovos T.; Kosmatopoulos, Elias B.
2015-01-01
Highlights: • Energy efficient operation of photovoltaic-equipped interconnected microgrids. • Optimized energy demand for a block of heterogeneous buildings with different sizes. • Multiobjective optimization: matching demand and supply taking into account thermal comfort. • Intelligent control mechanism for heating, ventilating, and air conditioning units. • Optimization of energy consumption and thermal comfort at the aggregate microgrid level. - Abstract: Electrical smart microgrids equipped with small-scale renewable-energy generation systems are emerging progressively as an alternative or an enhancement to the central electrical grid: due to the intermittent nature of the renewable energy sources, appropriate algorithms are required to integrate these two typologies of grids and, in particular, to perform efficiently dynamic energy demand and distributed generation management, while guaranteeing satisfactory thermal comfort for the occupants. This paper presents a novel control algorithm for joint energy demand and thermal comfort optimization in photovoltaic-equipped interconnected microgrids. Energy demand shaping is achieved via an intelligent control mechanism for heating, ventilating, and air conditioning units. The intelligent control mechanism takes into account the available solar energy, the building dynamics and the thermal comfort of the buildings’ occupants. The control design is accomplished in a simulation-based fashion using an energy simulation model, developed in EnergyPlus, of an interconnected microgrid. Rather than focusing only on how each building behaves individually, the optimization algorithm employs a central controller that allows interaction among the buildings of the microgrid. The control objective is to optimize the aggregate microgrid performance. Simulation results demonstrate that the optimization algorithm efficiently integrates the microgrid with the photovoltaic system that provides free electric energy: in
-
Thermal Comfort: An Index for Hot, Humid Asia. Educational Building Digest 12.
United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and Oceania.
The sensation of thermal comfort is determined by a combination of air temperature, humidity of the air, rate of movement of the air, and radiant heat. This digest is intended to assist architects to design educational facilities that are as thermally comfortable as is possible without recourse to mechanical air conditioning. A nomogram is…
-
Advanced cabin design : how to improve comfort and performance by progressive cabin design
Bronkhorst, R.E.; Looze, M.P. de
2005-01-01
In the automotive industry comfort has become an important issue. In the last decade, the word has entered the world of professional equipment builders like earthmoving machines (wheel loaders, excavators), forklift trucks, cranes, trucks, busses etcetera. comfort nowadays is the buzzword in all
-
A review of human thermal comfort experiments in controlled and semi-controlled environments
Craenendonck, Van Stijn; Lauriks, Leen; Vuye, Cedric; Kampen, Jarl
2018-01-01
There are three main methods to improve thermal comfort in existing buildings: modeling, experiments and measurements. Regarding experiments, no standardized procedure exists. This article provides an answer to the question: “What is the most common practice for human thermal comfort experiments in
-
Chapter 50: history of tropical neurology.
Ogunniyi, Adesola
2010-01-01
Tropical neurology began less than two centuries ago. Consumption of dietary toxins predominated at the beginning and gave birth to the geographic entity. The story moved from lathyrism through Jamaican neuropathy to cassava-induced epidemic neuropathy, which was contrasted with Konzo, also associated with cassava. Other tropical diseases enumerated with chronological details include: Chaga's diseases, kwashiorkor, Madras type of motor neuron disease, atlanto-axial dislocation, Burkitt's lymphoma and Kuru, associated with cannibalism among the Fore linguistic group in New Guinea. More recent documentation includes the Cuban neuropathy in 1991 with an epidemic of visual loss and neuropathy, Anaphe venata entomophagy in Nigeria presenting as seasonal ataxia, and neurological aspects of the human immunodeficiency virus infection complete the picture. With time, professional associations were formed and the pioneers were given prominence. The World Federation of Neurology featured Geographic Neurology as a theme in 1977 and Tropical Neurology was given prominence at its 1989 meeting in New Delhi, India. The situation remains unchanged with regards to rare diseases like Meniere's, multiple sclerosis, hereditary disorders. However, with westernization and continued urbanization, changing disease patterns are being observed and tropical neurology may depart from dietary toxins to more western world-type disorders.
-
Improving comfort levels in a traditional high altitude Nepali house
Energy Technology Data Exchange (ETDEWEB)
Fuller, R.J. [School of Architecture and Building, Deakin University, Geelong, Vic. 3217 (Australia); Zahnd, A.; Thakuri, S. [Department of Mechanical Engineering, Kathmandu University and RIDS-Nepal (Nepal)
2009-03-15
Humla Province is a remote mountainous region of northwest Nepal. The climate is harsh and the local people are extremely poor. Most people endure a subsistence culture, living in traditional housing. Energy for cooking and heating comes from fuelwood, supplies of which are diminishing. In order to improve the indoor environment and reduce fuelwood use, smokeless stoves are being introduced to replace the open fire in Humli homes. There is some concern, however, that comfort levels may not be as acceptable with these stoves. The aim of this research was therefore to investigate ways in which the comfort levels in traditional Humli housing might be improved using simple and low cost strategies. Temperature data was recorded in four rooms of a traditional Humli home over a 12-day period and used with fuelwood data to validate a TRNSYS simulation model of the house. This model was then used to evaluate the impact on comfort levels in the house of various energy conservation strategies using PMV and PPD indicators. As a single strategy, it was found that reducing infiltration of outside air was likely to be more effective than increasing the insulation level in the ceilings. The most successful strategy, however, was the creation of sunspaces at the entrances to the living rooms. This strategy increased average internal temperatures by 1.7 and 2.3 C. In combination with increased insulation levels, the sunspaces reduced comfort dissatisfaction levels by over 50%. (author)
-
A foreground object features-based stereoscopic image visual comfort assessment model
Jin, Xin; Jiang, G.; Ying, H.; Yu, M.; Ding, S.; Peng, Z.; Shao, F.
2014-11-01
Since stereoscopic images provide observers with both realistic and discomfort viewing experience, it is necessary to investigate the determinants of visual discomfort. By considering that foreground object draws most attention when human observing stereoscopic images. This paper proposes a new foreground object based visual comfort assessment (VCA) metric. In the first place, a suitable segmentation method is applied to disparity map and then the foreground object is ascertained as the one having the biggest average disparity. In the second place, three visual features being average disparity, average width and spatial complexity of foreground object are computed from the perspective of visual attention. Nevertheless, object's width and complexity do not consistently influence the perception of visual comfort in comparison with disparity. In accordance with this psychological phenomenon, we divide the whole images into four categories on the basis of different disparity and width, and exert four different models to more precisely predict its visual comfort in the third place. Experimental results show that the proposed VCA metric outperformance other existing metrics and can achieve a high consistency between objective and subjective visual comfort scores. The Pearson Linear Correlation Coefficient (PLCC) and Spearman Rank Order Correlation Coefficient (SROCC) are over 0.84 and 0.82, respectively.
-
Directory of Open Access Journals (Sweden)
Israr Ullah
2017-11-01
Full Text Available In the smart home environment, efficient energy management is a challenging task. Solutions are needed to achieve a high occupant comfort level with minimum energy consumption. User comfort is measured in terms of three fundamental parameters: (a thermal comfort, (b visual comfort and (c air quality. Temperature, illumination and CO 2 sensors are used to collect indoor contextual information. In this paper, we have proposed an improved optimization function to achieve maximum user comfort in the building environment with minimum energy consumption. A comprehensive formulation is done for energy optimization with detailed analysis. The Kalman filter algorithm is used to remove noise in sensor readings by predicting actual parameter values. For optimization, we have used genetic algorithm (GA and particle swarm optimization (PSO algorithms and performed comparative analysis with a baseline scheme on real data collected for a one-month duration in our lab’s indoor environment. Experimental results show that the proposed optimization function has achieved a 27 . 32 % and a 31 . 42 % reduction in energy consumption with PSO and GA, respectively. The user comfort index was also improved by 10 % i.e., from 0 . 86 to 0 . 96 . GA-based optimization results were better than PSO, as it has achieved almost the same user comfort with 4 . 19 % reduced energy consumption. Results show that the proposed optimization function gives better results than the baseline scheme in terms of user comfort and the amount of consumed energy. The proposed system can help with collecting the data about user preferences and energy consumption for long-term analysis and better decision making in the future for efficient resource utilization and overall profit maximization.
-
Maza Solano, Juan Manuel; Benavente Bermudo, Gustavo; Estrada Molina, Francisco José; Ambrosiani Fernández, Jesús; Sánchez Gómez, Serafín
2017-08-10
and objectives We have evaluated the training capacity of the Spanish resident training book as an electronic portfolio to achieve the learning objectives of otorhinolaryngology (ENT) residents. A multi-method qualitative investigation with transversal characteristics, temporal and retrospective guidance was performed on Spanish ENT residents using a structured questionnaire, a semi-structured interview, and a computer application on the FORMIR website. A 56.5% of ENT-residents specialising in one of the 63 accredited Spanish hospitals between 2009-2012 participated in the study. The results obtained show that the ENT residents who used the e-portfolio were better able to implement self-guided study, were more aware of their learning objectives, fulfilled the training programme more efficiently, identified the causes of learning gaps more clearly, and considered FORMIR in e-portfolio format to be an ideal training tool to replace the resident training book in paper format. The ENT residents greatly appreciated the training benefits of FORMIR as an e-portfolio, especially its simple and intuitive interface, the ease and comfort with which they could record their activities, the automatic and numeric feedback on the acquisition of their competencies (which facilitates self-guided learning), its storage capacity for evidence, and its ability to be used as UEMS logbook as well as a standard curriculum vitae. All these features make FORMIR a training and evaluation tool that outperforms similar instruments available to ENT residents. They do not hesitate to identify it as the ideal resident training book for facilitating their specialised training. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.
-
Bhattacharya, Pratik; Van Stavern, Renee; Madhavan, Ramesh
2010-12-01
Use of resident case logs has been considered by the Residency Review Committee for Neurology of the Accreditation Council for Graduate Medical Education (ACGME). This study explores the effectiveness of a data-mining program for creating resident logs and compares the results to a manual data-entry system. Other potential applications of data mining to enhancing resident education are also explored. Patient notes dictated by residents were extracted from the Hospital Information System and analyzed using an unstructured mining program. History, examination and ICD codes were obtained and compared to the existing manual log. The automated data History, examination, and ICD codes were gathered for a 30-day period and compared to manual case logs. The automated method extracted all resident dictations with the dates of encounter and transcription. The automated data-miner processed information from all 19 residents, while only 4 residents logged manually. The manual method identified only broad categories of diseases; the major categories were stroke or vascular disorder 53 (27.6%), epilepsy 28 (14.7%), and pain syndromes 26 (13.5%). In the automated method, epilepsy 114 (21.1%), cerebral atherosclerosis 114 (21.1%), and headache 105 (19.4%) were the most frequent primary diagnoses, and headache 89 (16.5%), seizures 94 (17.4%), and low back pain 47 (9%) were the most common chief complaints. More detailed patient information such as tobacco use 227 (42%), alcohol use 205 (38%), and drug use 38 (7%) were extracted by the data-mining method. Manual case logs are time-consuming, provide limited information, and may be unpopular with residents. Data mining is a time-effective tool that may aid in the assessment of resident experience or the ACGME core competencies or in resident clinical research. More study of this method in larger numbers of residency programs is needed.
-
IMPLICATIONS OF CLIMATE CHANGE ON HUMAN COMFORT
African Journals Online (AJOL)
Prince Acheampong
industrial activities, electricity generation and transportation release more CO2 ... The relation of the four factors that determine the comfort zone is illustrated on the Bioclimatic chart, ... Architectural Consulting firms, Technical Experts of the Architectural and Engineering Services Limited ... touch to the walls by painting them.
-
The continuous end-state comfort effect: weighted integration of multiple biases.
Herbort, Oliver; Butz, Martin V
2012-05-01
The grasp orientation when grasping an object is frequently aligned in anticipation of the intended rotation of the object (end-state comfort effect). We analyzed grasp orientation selection in a continuous task to determine the mechanisms underlying the end-state comfort effect. Participants had to grasp a box by a circular handle-which allowed for arbitrary grasp orientations-and then had to rotate the box by various angles. Experiments 1 and 2 revealed both that the rotation's direction considerably determined grasp orientations and that end-postures varied considerably. Experiments 3 and 4 further showed that visual stimuli and initial arm postures biased grasp orientations if the intended rotation could be easily achieved. The data show that end-state comfort but also other factors determine grasp orientation selection. A simple mechanism that integrates multiple weighted biases can account for the data.
-
Virtual alternative to the oral examination for emergency medicine residents.
McGrath, Jillian; Kman, Nicholas; Danforth, Douglas; Bahner, David P; Khandelwal, Sorabh; Martin, Daniel R; Nagel, Rollin; Verbeck, Nicole; Way, David P; Nelson, Richard
2015-03-01
The oral examination is a traditional method for assessing the developing physician's medical knowledge, clinical reasoning and interpersonal skills. The typical oral examination is a face-to-face encounter in which examiners quiz examinees on how they would confront a patient case. The advantage of the oral exam is that the examiner can adapt questions to the examinee's response. The disadvantage is the potential for examiner bias and intimidation. Computer-based virtual simulation technology has been widely used in the gaming industry. We wondered whether virtual simulation could serve as a practical format for delivery of an oral examination. For this project, we compared the attitudes and performance of emergency medicine (EM) residents who took our traditional oral exam to those who took the exam using virtual simulation. EM residents (n=35) were randomized to a traditional oral examination format (n=17) or a simulated virtual examination format (n=18) conducted within an immersive learning environment, Second Life (SL). Proctors scored residents using the American Board of Emergency Medicine oral examination assessment instruments, which included execution of critical actions and ratings on eight competency categories (1-8 scale). Study participants were also surveyed about their oral examination experience. We observed no differences between virtual and traditional groups on critical action scores or scores on eight competency categories. However, we noted moderate effect sizes favoring the Second Life group on the clinical competence score. Examinees from both groups thought that their assessment was realistic, fair, objective, and efficient. Examinees from the virtual group reported a preference for the virtual format and felt that the format was less intimidating. The virtual simulated oral examination was shown to be a feasible alternative to the traditional oral examination format for assessing EM residents. Virtual environments for oral examinations
-
Energy Technology Data Exchange (ETDEWEB)
De Keizer, I.; Van Swigchem, J.
2002-03-01
The aim of the study on the title subject is to determine the environmental impact of so-called sustainable and environment-friendly comfort services which are offered to individual consumers from a central point. The comfort services discussed in this report are a laundry service, delivery or messenger service, and a meal service or domestic caterer. [Dutch] Mensen die werk en prive(of zorg) combineren, leiden een druk bestaan, waardoor de behoefte bestaat om bijvoorbeeld huishoudelijke taken efficient in te richten. Verhoging van gemak en comfort gaat echter vaak gepaard met een toename van de milieudruk: meer apparatuur, dus hogere energieverbruik, en meer behoefte aan mobiliteit. Voor het Ministerie van VROM ligt de uitdaging in het zoeken naar kansen die zowel gemak opleveren als winst voor het milieu. en mogelijk concept hiervoor wordt gezien in zogenaamde 'duurzame gemaksdiensten', zoals een was-, boodschappen- en een maaltijdservice, die aangeboden worden op een centraal punt: het dienstenknooppunt. Elk van deze services blijkt kansen te bieden, varierend van reducties in energiegebruik (max. 36% per huishouden per jaar) tot een (forse) reductie van het aantal gereden autokilometers. oordat deze kansen echter optimaal benut kunnen worden, is een aantal aspecten van belang om verder te onderzoeken: de werkelijke vraag naar duurzame gemaksdiensten vanuit de consument, de locatie van het dienstenknooppunt en het vervoer op en rondom het knooppunt.
-
Toward a national consensus: teaching radiobiology to radiation oncology residents
International Nuclear Information System (INIS)
Zeman, Elaine M.; Dynlacht, Joseph R.; Rosenstein, Barry S.; Dewhirst, Mark W.
2002-01-01
Purpose: The ASTRO Joint Working Group on Radiobiology Teaching, a committee composed of members having affiliations with several national radiation oncology and biology-related societies and organizations, commissioned a survey designed to address issues of manpower, curriculum standardization, and instructor feedback as they relate to resident training in radiation biology. Methods and Materials: Radiation biology instructors at U.S. radiation oncology training programs were identified and asked to respond to a comprehensive electronic questionnaire dealing with instructor educational background, radiation biology course content, and sources of feedback with respect to curriculum planning and resident performance on standardized radiation biology examinations. Results: Eighty-five radiation biology instructors were identified, representing 73 radiation oncology residency training programs. A total of 52 analyzable responses to the questionnaire were received, corresponding to a response rate of 61.2%. Conclusion: There is a decreasing supply of instructors qualified to teach classic, and to some extent, clinical, radiobiology to radiation oncology residents. Additionally, those instructors with classic training in radiobiology are less likely to be comfortable teaching cancer molecular biology or other topics in cancer biology. Thus, a gap exists in teaching the whole complement of cancer and radiobiology curricula, particularly in those programs in which the sole responsibility for teaching falls to one faculty member (50% of training programs are in this category). On average, the percentage of total teaching time devoted to classic radiobiology (50%), clinical radiobiology (30%), and molecular and cancer biology (20%) is appropriate, relative to the current makeup of the board examination. Nevertheless large variability exists between training programs with respect to the total number of contact hours per complete radiobiology course (ranging from
-
Estimating a just-noticeable difference for ocular comfort in contact lens wearers.
Papas, Eric B; Keay, Lisa; Golebiowski, Blanka
2011-06-21
To estimate the just-noticeable difference (JND) in ocular comfort rating by human, contact lens-wearing subjects using 1 to 100 numerical scales. Ostensibly identical, new contact lenses were worn simultaneously in both eyes by 40 subjects who made individual comfort ratings for each eye using a 100-point numerical ratings scale (NRS). Concurrently, interocular preference was indicated on a five-point Likert scale (1 to 5: strongly prefer right, slightly prefer right, no preference, slightly prefer left, strongly prefer left, respectively). Differences in NRS comfort score (ΔC) between the right and left eyes were determined for each Likert scale preference criteria. The distribution of group ΔC scores was examined relative to alternative definitions of JND as a means of estimating its value. For Likert scores indicating the presence of a slight interocular preference, absolute ΔC ranged from 1 to 30 units with a mean of 7.4 ± 1.3 (95% confidence interval) across all lenses and trials. When there was no Likert scale preference expressed between the eyes, absolute ΔC did not exceed 5 units. For ratings of comfort using a 100-point numerical rating scale, the inter-ocular JND is unlikely to be less than 5 units. The estimate for the average value in the population was approximately 7 to 8 units. These numbers indicate the lowest level at which changes in comfort measured with such scales are likely to be clinically significant.
-
Combining several thermal indices to generate a unique heat comfort assessment methodology
Directory of Open Access Journals (Sweden)
Wissam EL Hachem
2015-11-01
Full Text Available Purpose: The proposed methodology hopes to provide a systematic multi-disciplinary approach to assess the thermal environment while minimizing unneeded efforts. Design/methodology/approach: Different factors affect the perception of the human thermal experience: metabolic rate (biology, surrounding temperatures (heat balance and environmental factors and cognitive treatment (physiology.This paper proposes a combination of different multidisciplinary variables to generate a unique heat comfort assessment methodology. The variables at stake are physiological, biological, and environmental. Our own heat analysis is thoroughly presented and all relevant equations are described. Findings: Most companies are oblivious about potential dangers of heat stress accidents and thus about methods to monitor and prevent them. This methodology enables the company or the concerned individual to conduct a preliminary assessment with minimal wasted resources and time in unnecessary steps whilst providing a guideline for a detailed study with minimal error rates if needed. More so, thermal comfort is an integral part of sound ergonomics practices, which in turn are decisive for the success of any lean six sigma initiative. Research limitations/implications: This methodology requires several full implementations to finalize its design. Originality/value: Most used heat comfort models are inherently uncertain and tiresome to apply. An extensive literature review confirms the need for a uniform assessment methodology that combines the different thermal comfort models such as the Fanger comfort model (PMV, PPD and WGBT since high error rates coupled with tiresome calculations often hinder the thermal assessment process.
-
Enhancement of stereoscopic comfort by fast control of frequency content with wavelet transform
Lemmer, Nicolas; Moreau, Guillaume; Fuchs, Philippe
2003-05-01
As the scope of virtual reality applications including stereoscopic imaging becomes wider, it is quite clear that not every designer of a VR application thinks of its constraints in order to make a correct use of stereo. Stereoscopic imagery though not required can be a useful tool for depth perception. It is possible to limit the depth of field as shown by Perrin who has also undertaken research on the link between the ability of fusing stereoscopic images (stereopsis) and local disparity and spatial frequency content. We will show how we can extend and enhance this work especially on the computational complexity point of view. The wavelet theory allows us to define a local spatial frequency and then a local measure of stereoscopic comfort. This measure is based on local spatial frequency and disparity as well as on the observations made by Woepking. Local comfort estimation allows us to propose several filtering methods to enhance this comfort. The idea to modify the images such as they check a "stereoscopic comfort condition" defined as a threshold for the stereoscopic comfort condition. More technically, we seek to limit high spatial frequency content when disparity is high thanks to the use of fast algorithms.
-
Evaluating Thermal Comfort in a Naturally Conditioned Office in a Temperate Climate Zone
Directory of Open Access Journals (Sweden)
Andrés Gallardo
2016-07-01
Full Text Available This study aims to determine the optimal approach for evaluating thermal comfort in an office that uses natural ventilation as the main conditioning strategy; the office is located in Quito-Ecuador. The performance of the adaptive model included in CEN Standard EN15251 and the traditional PMV model are compared with reports of thermal environment satisfaction surveys presented simultaneously to all occupants of the office to determine which of the two comfort models is most suitable to evaluate the thermal environment. The results indicate that office occupants have developed some degree of adaptation to the climatic conditions of the city where the office is located (which only demands heating operation, and tend to accept and even prefer lower operative temperatures than those considered optimum by applying the PMV model. This is an indication that occupants of naturally conditioned buildings are usually able to match their comfort temperature to their normal environment. Therefore, the application of the adaptive model included in CEN Standard EN15251 seems like the optimal approach for evaluating thermal comfort in naturally conditioned buildings, because it takes into consideration the adaptive principle that indicates that if a change occurs such as to produce discomfort, people tend to react in ways which restore their comfort.
-
Young people's comfort receiving sexual health information via social media and other sources.
Lim, Megan Sc; Vella, Alyce; Sacks-Davis, Rachel; Hellard, Margaret E
2014-12-01
Social media are growing in popularity and will play a key role in future sexual health promotion initiatives. We asked 620 survey participants aged 16 to 29 years about their time spent using social media and their comfort in receiving information about sexual health via different channels. Median hours per day spent using social network sites was two; 36% spent more than 2 hours per day using social network sites. In multivariable logistic regression, being aged less than 20 years and living in a major city (compared to rural/regional Australia) were associated with use of social media more than 2 hours per day. Most participants reported being comfortable or very comfortable accessing sexual health information from websites (85%), followed by a doctor (81%), school (73%), and the mainstream media (67%). Fewer reported being comfortable getting information from social media; Facebook (52%), apps (51%), SMS (44%), and Twitter (36%). Several health promotion programmes via social media have demonstrated efficacy; however, we have shown that many young people are not comfortable with accessing sexual health information through these channels. Further research is needed to determine how to best take advantage of these novel opportunities for health promotion. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.