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Sample records for neurology residents comfortable

  1. Adult neurology training during child neurology residency.

    Science.gov (United States)

    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.

  2. Education Research: Neurology resident education

    Science.gov (United States)

    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

  3. 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.)

  4. Neurocritical care education during neurology residency

    Science.gov (United States)

    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

  5. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

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

    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.

  6. Problem neurology residents: a national survey.

    Science.gov (United States)

    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.

  7. Education research: a case-based bioethics curriculum for neurology residents.

    Science.gov (United States)

    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.

  8. Residency Training: Work engagement during neurology training.

    Science.gov (United States)

    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.

  9. Are the French neurology residents satisfied with their training?

    Science.gov (United States)

    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.

  10. Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

    Science.gov (United States)

    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.

  11. Results of the American Academy of Neurology resident survey.

    Science.gov (United States)

    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.

  12. Challenges to neurology residency education in today's health care environment.

    Science.gov (United States)

    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.

  13. Child neurology residency: system implications of new training models.

    Science.gov (United States)

    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.

  14. Education in Neurology Resident Documentation Using Payroll Simulation.

    Science.gov (United States)

    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.

  15. Sleep and fatigue countermeasures for the neurology resident and physician.

    Science.gov (United States)

    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

  16. Comfort level of post graduate residents working in different clinical domains in managing common ophthalmic conditions

    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)

  17. Education Research: Neurology resident education: Trending skills, confidence, and professional preparation.

    Science.gov (United States)

    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.

  18. Residency Training: The need for an integrated diversity curriculum for neurology residency.

    Science.gov (United States)

    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.

  19. Neurocritical care education during neurology residency: AAN survey of US program directors.

    Science.gov (United States)

    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.

  20. Milestone-compatible neurology resident assessments: A role for observable practice activities.

    Science.gov (United States)

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

    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.

  1. International issues: Obtaining an adult neurology residency position in the United States: an overview.

    Science.gov (United States)

    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.

  2. The Preferred Learning Styles of Neurosurgeons, Neurosurgery Residents, and Neurology Residents: Implications in the Neurosurgical Field.

    Science.gov (United States)

    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.

  3. Interest in Providing Multiple Sclerosis Care and Subspecializing in Multiple Sclerosis Among Neurology Residents

    Science.gov (United States)

    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

  4. Neurology Didactic Curricula for Psychiatry Residents: A Review of the Literature and a Survey of Program Directors

    Science.gov (United States)

    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…

  5. Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016.

    Science.gov (United States)

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

    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.

  6. Residency Training: Quality improvement projects in neurology residency and fellowship: applying DMAIC methodology.

    Science.gov (United States)

    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.

  7. A dedicated scholarly research program in an adult and pediatric neurology residency program.

    Science.gov (United States)

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

    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.

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

    Directory of Open Access Journals (Sweden)

    Amoako AO

    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

  9. Residency Training: Determinants of burnout of neurology trainees in Attica, Greece.

    Science.gov (United States)

    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.

  10. Pilot trial of IOM duty hour recommendations in neurology residency programs: unintended consequences.

    Science.gov (United States)

    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.

  11. Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training.

    Science.gov (United States)

    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.

  12. Opinion and Special Articles: Amateur fundus photography with various new devices: Our experience as neurology residents.

    Science.gov (United States)

    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.

  13. Assessment of Medical Student and Resident/Fellow Knowledge, Comfort, and Training With Sexual History Taking in LGBTQ Patients.

    Science.gov (United States)

    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.

  14. Comfort constraints. Input for simulation of residents' behavior; Comforthinder. Input bij simulatie van bewonersgedrag

    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.

  15. Procedural Headache Medicine in Neurology Residency Training: A Survey of US Program Directors.

    Science.gov (United States)

    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

  16. Modeling and simulation of a phase change material system for improving summer comfort in domestic residence

    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

  17. What is the Future of Pediatric Neurology in Canada? Resident and Faculty Perceptions of Training and Workforce Issues.

    Science.gov (United States)

    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.

  18. Utility of Combining a Simulation-Based Method With a Lecture-Based Method for Fundoscopy Training in Neurology Residency.

    Science.gov (United States)

    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

  19. Effect of medical and biological factors on neurological manifestations of vertebral osteochondrosis in residents of the southern Altai Mountains.

    Science.gov (United States)

    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.

  20. Academicians and Neurologic Physical Therapy Residents Partner to Expand Clinical Reflection Using the SOLO Taxonomy: A Novel Approach.

    Science.gov (United States)

    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.

  1. Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program.

    Science.gov (United States)

    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.

  2. 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

  3. Thermal comfort

    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...

  4. 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.

  5. Thermal comfort

    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...

  6. The tablet device in hospital neurology and in neurology graduate medical education: a preliminary study.

    Science.gov (United States)

    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.

  7. Education Research: Neurology training reassessed

    Science.gov (United States)

    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

  8. Thermal comfort following immersion.

    Science.gov (United States)

    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.

  9. Current neurology

    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

  10. Robotic Comfort Zones

    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...

  11. Outdoor thermal comfort.

    Science.gov (United States)

    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.

  12. Smart grid voor comfort

    NARCIS (Netherlands)

    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

  13. Comfort measures: a concept analysis.

    Science.gov (United States)

    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.

  14. 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.

  15. Everyday Comfort Practice

    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...

  16. 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...

  17. Neurologic disorders

    International Nuclear Information System (INIS)

    Chakeres, D.W.

    1987-01-01

    There is a wide range of indications for radiographic evaluation of possible cerebrovascular disease, since a wide range of neurologic symptoms can be encountered secondary to ischemia. Frequently the diagnosis of cerebrovascular disease is clear on clinical grounds, but radiographic evaluation is essential both to quantify the extent of disease and establish the underlying cause (e.g., vasculitis, embolus) while excluding other causes so that the proper therapy can follow

  18. Why neurology? Factors which influence career choice in neurology.

    Science.gov (United States)

    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.

  19. International electives in neurology training

    Science.gov (United States)

    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

  20. The myth of comfort food.

    Science.gov (United States)

    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.

  1. 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.

  2. Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

    Science.gov (United States)

    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

  3. 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...

  4. Honeywell: Comfort and economy

    Energy Technology Data Exchange (ETDEWEB)

    Lukaszewski, J.

    1995-12-31

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

  5. Improving thermal comfort in office practice: biomimetic comfort profiles

    NARCIS (Netherlands)

    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

  6. 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

  7. Interactive drama in complex neurological disability management

    NARCIS (Netherlands)

    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

  8. Thermal comfort and older adults

    NARCIS (Netherlands)

    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

  9. Thermal comfort: research and practice

    NARCIS (Netherlands)

    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

  10. 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...

  11. 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.

  12. Psychosomatic Medicine for Non-Psychiatric Residents: Video Education and Incorporation of Technology.

    Science.gov (United States)

    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.

  13. Climate installations, comfort, health and productivity; Klimaatinstallaties, comfort, gezondheid en productiviteit

    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.

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

    Directory of Open Access Journals (Sweden)

    Hom B. Rijal

    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.

  15. Averting comfortable lifestyle crises.

    Science.gov (United States)

    Bilton, Rod

    2013-01-01

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

  16. Comfort and experience with online learning: trends over nine years and associations with knowledge.

    Science.gov (United States)

    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.

  17. Thermal comfort: research and practice.

    Science.gov (United States)

    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.

  18. Peer observation and feedback of resident teaching.

    Science.gov (United States)

    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.

  19. 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.

  20. Neurology and neurologic practice in China.

    Science.gov (United States)

    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.

  1. Special Report - USNS Comfort Underway

    Science.gov (United States)

    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

  2. FACT : forgiving agent comfort technology

    NARCIS (Netherlands)

    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

  3. Beyond Comfort in Built Environments

    NARCIS (Netherlands)

    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

  4. MIT-Skywalker: Evaluating comfort of bicycle/saddle seat.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Hom B. Rijal

    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.

  6. Effect of Kuwait oil field fires on human comfort and environment in Jubail, Saudi Arabia

    Science.gov (United States)

    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.

  7. Perception of pediatric neurology among non-neurologists.

    Science.gov (United States)

    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.

  8. Neurology at the bedside

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Waldemar, Gunhild

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

  9. Neurologic emergencies in sports.

    Science.gov (United States)

    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.

  10. 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...

  11. [Neurology! Adieau? (Part 2)].

    Science.gov (United States)

    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

  12. Thermal comfort assessment of buildings

    CERN Document Server

    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.

  13. An analysis of influential factors on outdoor thermal comfort in summer

    Science.gov (United States)

    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

  14. An analysis of influential factors on outdoor thermal comfort in summer.

    Science.gov (United States)

    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

  15. Neurology at the bedside

    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...

  16. Field study of thermal comfort in non-air-conditioned buildings in a tropical island climate.

    Science.gov (United States)

    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.

  17. The menagerie of neurology

    Science.gov (United States)

    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

  18. Thermal comfort assessment in civil aircraft cabins

    OpenAIRE

    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 ...

  19. 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)

  20. Neurologic complications of vaccinations.

    Science.gov (United States)

    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.

  1. Cardiomyopathy in neurological disorders.

    Science.gov (United States)

    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.

  2. Neurology in Asia.

    Science.gov (United States)

    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.

  3. Quantification In Neurology

    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.

  4. Neurology and international organizations.

    Science.gov (United States)

    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.

  5. William Shakespeare's neurology.

    Science.gov (United States)

    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.

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

    OpenAIRE

    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 ...

  7. Thermal comfort in residential buildings: Comfort values and scales for building energy simulation

    NARCIS (Netherlands)

    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

  8. Neurological sequelae of bacterial meningitis

    NARCIS (Netherlands)

    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

  9. 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...

  10. Affect asymmetry and comfort food consumption.

    Science.gov (United States)

    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.

  11. Thermal Comfort and Strategies for Energy Conservation.

    Science.gov (United States)

    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)

  12. 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 ...

  13. Neurologic complications in oncology

    Directory of Open Access Journals (Sweden)

    Andrea Pace

    2010-06-01

    Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

  14. 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.

  15. Wikipedia and neurological disorders.

    Science.gov (United States)

    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.

  16. Impact of a Pediatric and Adolescent Gynecology Curriculum on an Obstetrics and Gynecology Residency.

    Science.gov (United States)

    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.

  17. Toward a Resident Personal Finance Curriculum: Quantifying Resident Financial Circumstances, Needs, and Interests.

    Science.gov (United States)

    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

  18. Canadian Paediatric Neurology Workforce Survey and Consensus Statement.

    Science.gov (United States)

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

    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.

  19. Neurologic manifestations of achondroplasia.

    Science.gov (United States)

    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.

  20. [Neurology and literature].

    Science.gov (United States)

    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.

  1. Visual comfort evaluated by opponent colors

    Science.gov (United States)

    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.

  2. Quantitative Description of Medical Student Interest in Neurology and Psychiatry.

    Science.gov (United States)

    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

  3. Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

    Science.gov (United States)

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

    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

  4. Neurologic Complications of Transplantation.

    Science.gov (United States)

    Dhar, Rajat

    2018-02-01

    Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

  5. The popularity of neurology in Spain: An analysis of specialty selection.

    Science.gov (United States)

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

    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.

  6. 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....

  7. Dynamic thermal environment and thermal comfort.

    Science.gov (United States)

    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.

  8. American Academy of Neurology

    Science.gov (United States)

    ... on draft guideline manuscript on autism and sleep problems. Capitol Hill Report: Opioid Epidemic Declared Public Health Emergency Read the latest news on how the AAN is fighting for neurology in Washington DC. New Study: Virtual Reality Training May Be as Effective as Regular Therapy ...

  9. Wikipedia and neurological disorders

    NARCIS (Netherlands)

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

    2015-01-01

    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

  10. 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.

  11. Astroglia in neurological diseases

    Czech Academy of Sciences Publication Activity Database

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

    2013-01-01

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

  12. Neurology of cardiopulmonary resuscitation.

    Science.gov (United States)

    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.

  13. Neurologic abnormalities in murderers.

    Science.gov (United States)

    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.

  14. Individual thermal comfort. Measurements versus perceived level; Thermisch individueel comfort. Metingen versus beleving

    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.

  15. 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.

  16. Post dengue neurological complication

    Directory of Open Access Journals (Sweden)

    Hizlinda Tohid

    2015-12-01

    Full Text Available Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE followed by an upper respiratory tract infection (URTI weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

  17. Neurological legal disability

    Directory of Open Access Journals (Sweden)

    Radhakrishna H

    2006-01-01

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

  18. Vaccination and neurological disorders

    Directory of Open Access Journals (Sweden)

    Anastasia Gkampeta

    2015-12-01

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

  19. The Neurology of Proverbs

    Directory of Open Access Journals (Sweden)

    Diana Van Lancker

    1990-01-01

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

  20. 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, ...

  1. Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.

    Science.gov (United States)

    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

  2. Entropy generation method to quantify thermal comfort

    Science.gov (United States)

    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

  3. Palliative care and neurology

    Science.gov (United States)

    Boersma, Isabel; Miyasaki, Janis; Kutner, Jean

    2014-01-01

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

  4. 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.

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

    NARCIS (Netherlands)

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

    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

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

    NARCIS (Netherlands)

    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.

  7. 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.

  8. 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.

  9. 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)

  10. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

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

  11. 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...

  12. 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 ...

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

    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.

  14. 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....

  15. 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...

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

    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.

  17. Neurology and literature 2.

    Science.gov (United States)

    Iniesta, I

    2014-05-01

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

  18. Neurological Consequences of Obesity

    Science.gov (United States)

    O’Brien, Phillipe D.; Hinder, Lucy M.; Callaghan, Brian C.; Feldman, Eva L.

    2017-01-01

    Obesity, primarily a consequence of poor dietary choices and an increased sedentary lifestyle, has become a global pandemic that brings with it enormous medical, social, and economic challenges. Not only does obesity increase the risk of cardiovascular disease and certain cancers, but it is also recognized as a key driver of other metabolic syndrome (MetS) components. These components include insulin resistance, hyperglycemia with prediabetes or type 2 diabetes, dyslipidemia, and hypertension, and are underlying contributors to systemic metabolic dysfunction. More recently, obesity and diet-induced metabolic dysfunction have been identified as risk factors for the development of a wide variety of neurological disorders in both the central and peripheral nervous systems. An abundance of literature has shown that obesity is associated with mild cognitive impairment and altered hippocampal structure and function, and there is a robust correlation between obesity and Alzheimer’s type dementia. Similarly, many reports show that both the autonomic and somatic components of the peripheral nervous system are impacted by obesity. The autonomic nervous system, under control of the hypothalamus, displays altered catabolic and anabolic processes in obese individuals attributed to sympathetic-parasympathetic imbalances. A close association also exists between obesity and polyneuropathy, a complication most commonly found in prediabetic and diabetic patients, and is likely secondary to a combination of obesity-induced dyslipidemia with hyperglycemia. This review will outline the pathophysiological development of obesity and dyslipidemia, discuss the adverse impact of these conditions on the nervous system, and provide evidence for lipotoxicity and metabolic inflammation as the drivers underlying the neurological consequences of obesity. In addition, this review will examine the benefits of lifestyle and surgical interventions in obesity-induced neurological disorders. PMID

  19. Neurological Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Mohan Rudrappa

    2018-01-01

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

  20. History of Neurology in China

    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.

  1. Does Targeted Education of Emergency Physicians Improve Their Comfort Level in Treating Psychiatric 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

  2. 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.

  3. 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.

  4. 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...

  5. Human thermal comfort in urban outdoor spaces

    Science.gov (United States)

    Lee P. Herrington; J. S. Vittum

    1977-01-01

    Measurements of the physical environment of urban open spaces in Syracuse, New York, were used to compute the physiological responses of human users of the spaces. These calculations were then used to determine what environmental variables were both important to human comfort and susceptible to control by site design. Although air temperature and humidity are important...

  6. Recent upgrading of the modelling program COMFORT

    International Nuclear Information System (INIS)

    Hawkes, C.; Lee, M.

    1986-01-01

    The computer code COMFORT, developed for the online control of machine functions at the SLC, has recently undergone several modifications to overcome some of its limitations. This note describes the reasons for these changes, the methods employed, some test results and the applications of the new version of the program

  7. 42 CFR 413.79 - Direct GME payments: Determination of the weighted number of FTE residents.

    Science.gov (United States)

    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...

  8. Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders.

    Science.gov (United States)

    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.

  9. 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.)

  10. 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...

  11. Primary care perceptions of neurology and neurology services.

    Science.gov (United States)

    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/

  12. Top five craniofacial techniques for training in plastic surgery residency.

    Science.gov (United States)

    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.

  13. Neurology in the Vietnam War.

    Science.gov (United States)

    Gunderson, Carl H; Daroff, Robert B

    2016-01-01

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

  14. Simulation-based education with mastery learning improves residents' lumbar puncture skills

    Science.gov (United States)

    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

  15. Molecular genetics in neurology.

    Science.gov (United States)

    Martin, J B

    1993-12-01

    There has been remarkable progress in the identification of mutations in genes that cause inherited neurological disorders. Abnormalities in the genes for Huntington disease, neurofibromatosis types 1 and 2, one form of familial amyotrophic lateral sclerosis, fragile X syndrome, myotonic dystrophy, Kennedy syndrome, Menkes disease, and several forms of retinitis pigmentosa have been elucidated. Rare disorders of neuronal migration such as Kallmann syndrome, Miller-Dieker syndrome, and Norrie disease have been shown to be due to specific gene defects. Several muscle disorders characterized by abnormal membrane excitability have been defined as mutations of the muscle sodium or chloride channels. These advances provide opportunity for accurate molecular diagnosis of at-risk individuals and are the harbinger of new approaches to therapy of these diseases.

  16. Neurological complications of alcoholism

    Directory of Open Access Journals (Sweden)

    I. I. Nikiforov

    2017-01-01

    Full Text Available Nervous system lesions associated with chronic alcohol intoxication are common in clinical practice. They lead to aggravated alcoholic disease, its more frequent recurrences, and intensified pathological craving for alcohol. Neurological pathology in turn occurs with frequent exacerbations. The interaction of diseases, age, and medical  pathomorphism modifies the clinical presentation and course of the  major pathology, as well as comorbidity, the nature and severity of  complications, worsens quality of life in a patient, and makes the  diagnostic and treatment process difficult. The paper discusses the  classification, clinical variants, biochemical and molecular biological  aspects of various complications of alcoholic disease. It considers its  most common form, in particular alcoholic polyneuropathy, as well as its rarer variants, such as hemorrhagic encephalopathy with a subacute course (Gayet–Wernicke encephalopathy.

  17. Deja vu in neurology.

    Science.gov (United States)

    Wild, Edward

    2005-01-01

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

  18. Opinion and Special Articles: Neurology education at US osteopathic medical schools.

    Science.gov (United States)

    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.

  19. Neurology of ciguatera

    Science.gov (United States)

    Pearn, J

    2001-01-01

    Ciguatera is a widespread ichthyosarcotoxaemia with dramatic and clinically important neurological features. This severe form of fish poisoning may present with either acute or chronic intoxication syndromes and constitutes a global health problem. Ciguatera poisoning is little known in temperate countries as a potentially global problem associated with human ingestion of large carnivorous fish that harbour the bioaccumulated ciguatoxins of the photosynthetic dinoflagellate Gambierdiscus toxicus. This neurotoxin is stored in the viscera of fish that have eaten the dinoflagellate and concentrated it upwards throughout the food chain towards progressively larger species, including humans. Ciguatoxin accumulates in all fish tissues, especially the liver and viscera, of "at risk" species. Both Pacific (P-CTX-1) and Caribbean (C-CTX-1) ciguatoxins are heat stable polyether toxins and pose a health risk at concentrations above 0.1 ppb. The presenting signs of ciguatera are primarily neurotoxic in more than 80% of cases. Such include the pathognomonic features of postingestion paraesthesiae, dysaesthesiae, and heightened nociperception. Other sensory abnormalities include the subjective features of metallic taste, pruritis, arthralgia, myalgia, and dental pain. Cerebellar dysfunction, sometimes diphasic, and weakness due to both neuropathy and polymyositis may be encountered. Autonomic dysfunction leads to hypotension, bradycardia, and hypersalivation in severe cases. Ciguatoxins are potent, lipophilic sodium channel activator toxins which bind to the voltage sensitive (site 5) sodium channel on the cell membranes of all excitable tissues. Treatment depends on early diagnosis and the early administration of intravenous mannitol. The early identification of the neurological features in sentinel patients has the potential to reduce the number of secondary cases in cluster outbreaks.

 PMID:11118239

  20. Child Neurology Services in Africa

    Science.gov (United States)

    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

  1. 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)....

  2. A national survey of residents in combined Internal Medicine and Dermatology residency programs: educational experience and future plans.

    Science.gov (United States)

    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.

  3. 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.

  4. Heartwarming memories: Nostalgia maintains physiological comfort.

    Science.gov (United States)

    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.

  5. 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.

  6. THERMAL COMFORT IN VERNACULAR COURTYARD HOUSES: CASE STUDY -CHHATTISGARH

    OpenAIRE

    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...

  7. The electric comfort; Le confort electrique

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

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

  8. Eye cosmetic usage and associated ocular comfort.

    Science.gov (United States)

    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.

  9. Perceived Competence and Comfort in Respiratory Protection

    Science.gov (United States)

    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

  10. 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.

  11. 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.

  12. Design of outdoor urban spaces for thermal comfort

    Science.gov (United States)

    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...

  13. Comparison of thermal comfort and sensation scales : a case study

    NARCIS (Netherlands)

    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

  14. 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.

  15. 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

  16. 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 ...

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

    Science.gov (United States)

    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.

  18. The human thermoneutral and thermal comfort zones: Thermal comfort in your own skin blood flow.

    Science.gov (United States)

    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.

  19. In-situ real time measurements of thermal comfort and comparison with the adaptive comfort theory in Dutch residential dwellings

    NARCIS (Netherlands)

    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

  20. How "Does" the Comforting Process Work? An Empirical Test of an Appraisal-Based Model of Comforting

    Science.gov (United States)

    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…

  1. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    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.

  3. Research on seasonal indoor thermal environment and residents' control behavior of cooling and heating systems in Korea

    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)

  4. 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.

  5. Bioclimatic comfort and the thermal perceptions and preferences of beach tourists

    Science.gov (United States)

    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).

  6. Bioclimatic comfort and the thermal perceptions and preferences of beach tourists.

    Science.gov (United States)

    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).

  7. Developing Pokemon AI For Finding Comfortable Settings

    OpenAIRE

    Panumate, Chetprayoon; Iida, Hiroyuki

    2016-01-01

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

  8. Neurological Manifestations of Dengue Infection

    Directory of Open Access Journals (Sweden)

    Guo-Hong Li

    2017-10-01

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

  9. A century of Dutch neurology.

    Science.gov (United States)

    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

  10. Neurologic Complications of Smallpox Vaccination

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-06-01

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

  11. Neurological complication in HIV patients

    Science.gov (United States)

    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.

  12. Neurological complications following bariatric surgery

    Directory of Open Access Journals (Sweden)

    Yara Dadalti Fragoso

    2012-09-01

    Full Text Available OBJECTIVE: It was to report on Brazilian cases of neurological complications from bariatric surgery. The literature on the subject is scarce. METHOD: Cases attended by neurologists in eight different Brazilian cities were collected and described in the present study. RESULTS: Twenty-six cases were collected in this study. Axonal polyneuropathy was the most frequent neurological complication, but cases of central demyelination, Wernicke syndrome, optical neuritis, radiculits, meralgia paresthetica and compressive neuropathies were also identified. Twenty-one patients (80% had partial or no recovery from the neurological signs and symptoms. CONCLUSION: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications that should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

  13. Neurologic disorder and criminal responsibility.

    Science.gov (United States)

    Yaffe, Gideon

    2013-01-01

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

  14. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 28, No 1 (2009) >. Log in or Register to get access to full text downloads.

  15. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 31, No 2 (2012) >. Log in or Register to get access to full text downloads.

  16. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 29, No 2 (2010) >. Log in or Register to get access to full text downloads.

  17. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 31, No 1 (2012) >. Log in or Register to get access to full text downloads.

  18. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 30, No 1 (2011) >. Log in or Register to get access to full text downloads.

  19. 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.

  20. Passenger safety, health, and comfort: a review.

    Science.gov (United States)

    Rayman, R B

    1997-05-01

    Since the birth of aviation medicine approximately 80 yrs ago, practitioners and scientists have given their attention primarily to flight deck crew, cabin crew, and ground support personnel. However, in more recent years we have broadened our horizons to include the safety, health, and comfort of passengers flying commercial aircraft. This will be even more compelling as more passengers take to the air in larger aircraft and flying longer hours to more distant destinations. Further, we can expect to see more older passengers because people in many countries are living longer, healthier lives. The author first discusses the stresses imposed by ordinary commercial flight upon travelers such as airport tumult, barometric pressure changes, immobility, jet lag, noise/ vibration, and radiation. Medical considerations are next addressed describing inflight illness and medical care capability aboard U.S. air carriers. Passenger safety, cabin air quality, and the preventive medicine aspects of air travel are next reviewed in the context of passenger safety, health, and comfort. Recommendations are addressed to regulator agencies, airlines aircraft manufacturers, and the aerospace medicine community.

  1. 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

  2. Historical perspective of Indian neurology.

    Science.gov (United States)

    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

  3. 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

  4. 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?.

  5. Hippocrates: the forefather of neurology.

    Science.gov (United States)

    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.

  6. Possibilities to improve the aircraft interior comfort experience.

    Science.gov (United States)

    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.

  7. Effectiveness of a 2-year menopause medicine curriculum for obstetrics and gynecology residents.

    Science.gov (United States)

    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.

  8. Thermal Comfort in a Naturally-Ventilated Educational Building

    OpenAIRE

    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...

  9. Progress in thermal comfort research over the last twenty years

    OpenAIRE

    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...

  10. Progress in thermal comfort research over the last twenty years.

    Science.gov (United States)

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

    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.

  11. Regional differences in temperature sensation and thermal comfort in humans.

    Science.gov (United States)

    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.

  12. A hyperacute neurology team - transforming emergency neurological care.

    Science.gov (United States)

    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.

  13. Strategies for Sustainable Comfort in Buildings

    DEFF Research Database (Denmark)

    Nørgaard, Jørgen

    1997-01-01

    these goals include phasing out all use of electricity for space heating and for hot water supply. Furthermore building codes should require new buildings to be very well insulated, 30-40 cm mineral wool, for instance, and low energy windows. Similar codes, although not always as strict, should be applied......It is possible within some decades to achieve environmental sustainability in the building sector and at the same time provide a comfortable and healthy life for all Europeans as well as leaving that option open for other people in the world.Buildings are charcterized by having the longest lifetime...... of all capital in our societies, often more than a hundred years. For that reason they should never be designed on the bases of just present cheap energy supply and energy system, but with the long term outlook and risks in mind. New buildings can be designed to require essentially no space heating...

  14. Pedal force determination respect to ride comfort

    Science.gov (United States)

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

    2017-10-01

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

  15. Comfort parameters - Ventilation of a subway wagon

    Science.gov (United States)

    Petr, Pavlíček; Ladislav, Tříska

    2017-09-01

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

  16. Investigation of Comfort Properties of Knitted Denim

    Science.gov (United States)

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

    2017-12-01

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

  17. Thermal Comfort and Optimum Humidity Part 1

    Directory of Open Access Journals (Sweden)

    M. V. Jokl

    2002-01-01

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

  18. Thermal Comfort and Optimum Humidity Part 2

    Directory of Open Access Journals (Sweden)

    M. V. Jokl

    2002-01-01

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

  19. Are you sitting comfortably? Perspectives of the researchers and the researched on "being comfortable".

    Science.gov (United States)

    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.

  20. The neurological basis of occupation.

    Science.gov (United States)

    Gutman, Sharon A; Schindler, Victoria P

    2007-01-01

    The purpose of the present paper was to survey the literature about the neurological basis of human activity and its relationship to occupation and health. Activities related to neurological function were organized into three categories: those that activate the brain's reward system; those that promote the relaxation response; and those that preserve cognitive function into old age. The results from the literature review correlating neurological evidence and activities showed that purposeful and meaningful activities could counter the effects of stress-related diseases and reduce the risk for dementia. Specifically, it was found that music, drawing, meditation, reading, arts and crafts, and home repairs, for example, can stimulate the neurogical system and enhance health and well-being, Prospective research studies are needed to examine the effects of purposeful activities on reducing stress and slowing the rate of cognitive decline.

  1. Residency Allocation Database

    Data.gov (United States)

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

  2. [Neurologic aspects of vibration syndrome].

    Science.gov (United States)

    Langauer-Lewowicka, H; Zajac-Nedza, M

    1997-01-01

    The authors present divergent opinions on the pathogenesis of vibratory syndrome, and primarily on its angio-neurological form, i.e. vascular, neurogenic and immunological theory. In the light of these concepts the clinical manifestations of vibratory syndrome are discussed in view of both systemic and local developments. The issues concerning neurological diagnostics with reference to the usefulness of electrophysiological methods are thoroughly analysed. Difficulties in early diagnosis and identification of symptoms that distinguish vibratory syndrome from other syndromes with similar manifestations are highlighted.

  3. Neurological manifestations in Fabry's disease

    DEFF Research Database (Denmark)

    Møller, Anette Torvin; Jensen, Troels Staehelin

    2007-01-01

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

  4. Neurological manifestation of colonic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Uzair Chaudhary

    2012-04-01

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

  5. 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.

  6. Quality and satisfaction of thermal comfort in Dutch offices

    NARCIS (Netherlands)

    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:

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

    NARCIS (Netherlands)

    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

  8. Energy and indoor temperature consequences of adative thermal comfort standards

    NARCIS (Netherlands)

    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

  9. Thermal comfort in hospital and healthcare facilities : a literature review

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  11. Improving comfort while hiking in a sailing boat

    NARCIS (Netherlands)

    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

  12. Pregnancy After Bariatric Surgery: National Survey of Obstetrician's Comfort, Knowledge, and Practice Patterns.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  14. 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...

  15. 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.

  16. Edgar Allan Poe and neurology

    Directory of Open Access Journals (Sweden)

    Hélio Afonso Ghizoni Teive

    2014-06-01

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

  17. [Neurology in medieval regimina sanitatis].

    Science.gov (United States)

    de Frutos González, V; Guerrero Peral, A L

    2011-09-01

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

  18. [Neurology of hysteria (conversion disorder)].

    Science.gov (United States)

    Sonoo, Masahiro

    2014-07-01

    Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

  19. Tabriz Bazaar: sustainability and human comfort

    Energy Technology Data Exchange (ETDEWEB)

    Nassehzadeh Tabriz, Shahram [Master of Department of Architecture, Islamic Azad University, Miyaneh Branch (Iran, Islamic Republic of)], email: sh_nassehzadeh@m-iau.ac.ir; Fard, Fariborz Mahdavi Tabatabaei [SABAT TARH CO. (Iran, Islamic Republic of)], email: sabat_arc@yahoo.com

    2011-07-01

    Sustainable developments in energy and the environment have become a main focus of many groups. The built environment has a great influence on environmental sustainability generally. Solutions that respond to the impact of human activities on the environment in urban areas are required. On one hand, averting resource depletion and environmental degradation caused by facilities and infrastructures over their life cycle is a principal goal. On the other hand, it is also a principal goal to create livable, comfortable, safe and productive built environments. Tabriz bazaar, in Iran, is an example of sustainable architecture. It is designed to be suited to the local climate and urban texture with spaces that are varied and have a strong connection to open space. The bazaar plays a significant role in creation of safe urban space as a cultural, social, commercial, educational and sanitarian area. It connects different activities and different people in a safe place. The purpose of this paper is to determine the sustainability of the Tabriz bazaar and the effect that the character of this commercial area has on the quality of human life.

  20. THE "COMFORT WOMEN" OF THE PACIFIC WAR

    Directory of Open Access Journals (Sweden)

    JULIA YURI OKAMOTO

    2013-12-01

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

  1. Use and utility of Web-based residency program information: a survey of residency applicants.

    Science.gov (United States)

    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

  2. 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.)

  3. 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.)

  4. Neurology

    International Nuclear Information System (INIS)

    Lubin, E.; Thom, A.F.

    1976-01-01

    The most used radiopharmaceuticals in encephaloscintigraphy are analysed, such as: sup(99m)Tc-pertechnetate, sup(113m)In- DTPA, 203 Hg-or 197 Hg-clormerodrine and 131 I-albumin. A comparative study is made of scintiscanning of normal brain and that of pathological states. The uses of 131 I-albumin, sup(113m)In-DTPA an 169 Y - DTPA are commented in liquor spaces scintiscanning and clinical indications are given [pt

  5. [Comfort and noise level in infants with helmet interface].

    Science.gov (United States)

    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.

  6. PET and SPECT in neurology

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-01

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

  7. PET and SPECT in neurology

    International Nuclear Information System (INIS)

    Dierckx, Rudi A.J.O.; Ghent Univ.; Vries, Erik F.J. de; Waarde, Aren van; Otte, Andreas

    2014-01-01

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

  8. Neurological complications of infective endocarditis

    International Nuclear Information System (INIS)

    Khan, Sonia A.A.; Yaqub, Basim A.; Al-Deeb, Saleh M.

    1996-01-01

    We reviewed the files of 80 successive patients with native and prosthetic valve endocarditis admitted to Riyadh Armed Forces Hospital. Neurolological complications (NC) occurred in 28 (35%) patients. The valves involved were mitral in 12 (43%), aortic in eight (29%), combined mitral and aortic lesions in six (21%) and others in two (7%). The common causative organisms were Streptococci in 12 (43%), Staphylococcus aureus and Staphylococcus epidermides, both occurring in four (14%). Compared to the 52 infective endocarditis patients with no neurological complications (NNC), the NC occurred more frequently in male patients, those with aortic valve lesion, those with atrial fibrillation, those with delayed therapy and those with causative organisms being Streptococci or Staphylococci. Eleven patients died (39%), 12 (43%) recovered with motor sequelae, six (21%) had seizure disorder and five (18%) had full recovery. The frequency of neurological complications and mortality is comparable to those reported in the literature: however, the frequency was higher in our patients. (author)

  9. Disease mongering in neurological disorders

    OpenAIRE

    Kochen, Sara Silvia; Córdoba, Marta

    2017-01-01

    “Diseases mongering”, than a simple definition would be enforced "to promote or sell disease". The main and common characteristhics of all these "diseases" is that they are amenable to treatment with drugs. So, the pharmaceutical industry redefining the concept of disease, the normal and pathological. In Neurology exploits the deepest atavistic fears of suffering and death. We select some diseases, the choise was based on lack or weak evidence in definition of disease; or cost benefit of trea...

  10. [Deficiency, disability, neurology and cinema].

    Science.gov (United States)

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

    2010-12-16

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

  11. Neurological Findings in Myeloproliferative Neoplasms

    Directory of Open Access Journals (Sweden)

    Semra Paydas

    2013-04-01

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

  12. Aphasia, Just a Neurological Disorder?

    OpenAIRE

    Mehmet Ozdemir

    2016-01-01

    Hashimoto%u2019s encephalopathy (HE) is a rare disorder associated with autoimmune thyroiditis. Etiology of HE is not completely understood. High levels of serum antithyroid antibodies are seen in HE. Presentation with otoimmune thyroiditis, cognitive impairment, psychiatric and neurologic symptoms and absence of bacterial or viral enfections are characteristics of HE. HE is a steroid responsive encephalopathy. 60 years old male patient admitted to hospital with forget fulness continuing for ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    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)

  14. VEGF Signaling in Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Joon W. Shim

    2018-01-01

    Full Text Available Vascular endothelial growth factor (VEGF is a potent growth factor playing diverse roles in vasculogenesis and angiogenesis. In the brain, VEGF mediates angiogenesis, neural migration and neuroprotection. As a permeability factor, excessive VEGF disrupts intracellular barriers, increases leakage of the choroid plexus endothelia, evokes edema, and activates the inflammatory pathway. Recently, we discovered that a heparin binding epidermal growth factor like growth factor (HB-EGF—a class of EGF receptor (EGFR family ligands—contributes to the development of hydrocephalus with subarachnoid hemorrhage through activation of VEGF signaling. The objective of this review is to entail a recent update on causes of death due to neurological disorders involving cerebrovascular and age-related neurological conditions and to understand the mechanism by which angiogenesis-dependent pathological events can be treated with VEGF antagonisms. The Global Burden of Disease study indicates that cancer and cardiovascular disease including ischemic and hemorrhagic stroke are two leading causes of death worldwide. The literature suggests that VEGF signaling in ischemic brains highlights the importance of concentration, timing, and alternate route of modulating VEGF signaling pathway. Molecular targets distinguishing two distinct pathways of VEGF signaling may provide novel therapies for the treatment of neurological disorders and for maintaining lower mortality due to these conditions.

  15. History of pediatric neurology in Poland.

    Science.gov (United States)

    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.

  16. African Journal of Neurological Sciences: Journal Sponsorship

    African Journals Online (AJOL)

    African Journal of Neurological Sciences: Journal Sponsorship. Journal Home > About the Journal > African Journal of Neurological Sciences: Journal Sponsorship. Log in or Register to get access to full text downloads.

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

    National Research Council Canada - National Science Library

    Ravina, Bernard

    2012-01-01

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

  18. Thermal sensation and comfort models for non-uniform and transient environments, part III: Whole-body sensation and comfort

    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)

  19. Neurohospitalists enhance resident perception of the educational and clinical value of a night float rotation.

    Science.gov (United States)

    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.

  20. Teaching Residents How to Talk About Death and Dying: A Mixed-Methods Analysis of Barriers and Randomized Educational Intervention.

    Science.gov (United States)

    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.

  1. Thermal sensation and comfort models for non-uniform and transient environments: Part III: whole-body sensation and comfort

    OpenAIRE

    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...

  2. 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.

  3. 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

  4. A correct enthalpy relationship as thermal comfort index for livestock.

    Science.gov (United States)

    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.

  5. Determination of thermal and acoustic comfort inside a vehicle's cabin

    Science.gov (United States)

    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.

  6. Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    ZHANG Ling

    2012-04-01

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

  9. 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

  10. 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

  11. From occupying to inhabiting - a change in conceptualising comfort

    Science.gov (United States)

    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

  12. Interobserver variability of the neurological optimality score

    NARCIS (Netherlands)

    Monincx, W. M.; Smolders-de Haas, H.; Bonsel, G. J.; Zondervan, H. A.

    1999-01-01

    To assess the interobserver reliability of the neurological optimality score. The neurological optimality score of 21 full term healthy, neurologically normal newborn infants was determined by two well trained observers. The interclass correlation coefficient was 0.31. Kappa for optimality (score of

  13. Paediatric Neurological Conditions Seen at the Physiotherapy ...

    African Journals Online (AJOL)

    Paediatric neurological conditions constitute a major cause of disability in childhood. However there seems to be an apparent dearth of published works on the patterns of neurological conditions seen in Nigerian physiotherapy clinics of rural locations. This study aimed at describing the spectrum of neurological conditions ...

  14. African Journal of Neurological Sciences: Editorial Policies

    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 ...

  15. Longing for homeliness: exploring mealtime experiences of patients suffering from a neurological disease.

    Science.gov (United States)

    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.

  16. 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

  17. Comfort in using hand tools : theory, design and evaluation

    OpenAIRE

    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 ...

  18. 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....

  19. 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....

  20. The development and evaluation of a trauma curriculum for psychiatry residents.

    Science.gov (United States)

    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.

  1. Peer Review in Radiology: A Resident and Fellow Perspective.

    Science.gov (United States)

    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.

  2. Introduction of handheld computing to a family practice residency program.

    Science.gov (United States)

    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.

  3. Impact of measurable physical phenomena on contact thermal comfort

    Science.gov (United States)

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

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

  4. 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)

  5. Regional thermal comfort zone in males and females.

    Science.gov (United States)

    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.

  6. 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

  7. Elevator ride comfort monitoring and evaluation using smartphones

    Science.gov (United States)

    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.

  8. 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.

  9. 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.

  10. Lubricant effects on low Dk and silicone hydrogel lens comfort.

    Science.gov (United States)

    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.

  11. Resident Characteristics Report

    Data.gov (United States)

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

  12. International electives in neurology training: a survey of US and Canadian program directors.

    Science.gov (United States)

    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

  13. Education Research: Bias and poor interrater reliability in evaluating the neurology clinical skills examination

    Science.gov (United States)

    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

  14. Passivhaus: indoor comfort and energy dynamic analysis.

    Science.gov (United States)

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

    2013-04-01

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

  15. The evaluation of the overall thermal comfort inside a vehicle

    Science.gov (United States)

    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.

  16. Thermal comfort study of hospital workers in Malaysia.

    Science.gov (United States)

    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.

  17. 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

  18. Neurological aspects of lead intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, H

    1980-05-08

    This study gives a survey over the medical and scientific literature on lead intoxications, which were published until 1979. Neurologic aspects are of particular interest. At present dramatic cases of lead intoxications occur only rarely. However, there are numerous studies about cases of chronical, partly subclinical intoxications. This chronical type of lead intoxication can become manifest clinically as relatively vague symptoms, for example vertigos, insomnia, headaches and weakness. Contrary to this, serious encephalopathies, even with fatal outcome, and polyneuropathies with typical paresis of the radial nerve are preferably observed in acute lead intoxications. Besides the numerous sources of intoxication, also the different opinions found in literature are discussed, concerning the effects of lead on the human body. The fact that there are differing opinions about the limiting value of the blood-lead level at which intoxication symptoms have to be expected, becomes apparent when the determined blood-lead level values are compared and evaluated. Besides the description of general intoxication effects, the discussion of the neurologic aspects found in literature - not only those concerning the central, but also the peripheral system - are preferably concerned. Reports about neuropsychical alterations due to lead exposure, which are mainly found in children, supplement the numerous descriptions of the macroscopic and microscopic alterations of the nervous system provoked by lead. Finally the therapeutic and prophylactic measures given in the literature are discussed.

  19. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina

    2015-01-01

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

  20. Neurological complications in hyperemesis gravidarum.

    Science.gov (United States)

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

    2012-02-01

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

  1. Effect of long-term acclimatization on summer thermal comfort in outdoor spaces: a comparative study between Melbourne and Hong Kong

    Science.gov (United States)

    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.

  2. 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.

  3. Decision Factors Nurses Use to Assess Pain in Nursing Home Residents With Dementia.

    Science.gov (United States)

    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

  4. [The carrier model of neurology in Hungary: a proposal for the solution until 2020].

    Science.gov (United States)

    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

  5. A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates.

    Science.gov (United States)

    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.

  6. 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

  7. 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.

  8. Evolution of perceived footwear comfort over a prolonged running session.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. 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.

  11. Pharmacy resident-led student mentoring program: A focus on developing mentoring skills.

    Science.gov (United States)

    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.

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

    NARCIS (Netherlands)

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

    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

  13. Microbiota and Neurological Disorders: A Gut Feeling.

    Science.gov (United States)

    Moos, Walter H; Faller, Douglas V; Harpp, David N; Kanara, Iphigenia; Pernokas, Julie; Powers, Whitney R; Steliou, Kosta

    2016-01-01

    In the past century, noncommunicable diseases have surpassed infectious diseases as the principal cause of sickness and death, worldwide. Trillions of commensal microbes live in and on our body, and constitute the human microbiome. The vast majority of these microorganisms are maternally derived and live in the gut, where they perform functions essential to our health and survival, including: digesting food, activating certain drugs, producing short-chain fatty acids (which help to modulate gene expression by inhibiting the deacetylation of histone proteins), generating anti-inflammatory substances, and playing a fundamental role in the induction, training, and function of our immune system. Among the many roles the microbiome ultimately plays, it mitigates against untoward effects from our exposure to the environment by forming a biotic shield between us and the outside world. The importance of physical activity coupled with a balanced and healthy diet in the maintenance of our well-being has been recognized since antiquity. However, it is only recently that characterization of the host-microbiome intermetabolic and crosstalk pathways has come to the forefront in studying therapeutic design. As reviewed in this report, synthetic biology shows potential in developing microorganisms for correcting pathogenic dysbiosis (gut microbiota-host maladaptation), although this has yet to be proven. However, the development and use of small molecule drugs have a long and successful history in the clinic, with small molecule histone deacetylase inhibitors representing one relevant example already approved to treat cancer and other disorders. Moreover, preclinical research suggests that epigenetic treatment of neurological conditions holds significant promise. With the mouth being an extension of the digestive tract, it presents a readily accessible diagnostic site for the early detection of potential unhealthy pathogens resident in the gut. Taken together, the data outlined

  14. Resident away rotations allow adaptive neurosurgical training.

    Science.gov (United States)

    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.

  15. Neurology of foreign language aptitude

    Directory of Open Access Journals (Sweden)

    Adriana Biedroń

    2015-01-01

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

  16. Epigenetic mechanisms in neurological disease.

    Science.gov (United States)

    Jakovcevski, Mira; Akbarian, Schahram

    2012-08-01

    The exploration of brain epigenomes, which consist of various types of DNA methylation and covalent histone modifications, is providing new and unprecedented insights into the mechanisms of neural development, neurological disease and aging. Traditionally, chromatin defects in the brain were considered static lesions of early development that occurred in the context of rare genetic syndromes, but it is now clear that mutations and maladaptations of the epigenetic machinery cover a much wider continuum that includes adult-onset neurodegenerative disease. Here, we describe how recent advances in neuroepigenetics have contributed to an improved mechanistic understanding of developmental and degenerative brain disorders, and we discuss how they could influence the development of future therapies for these conditions.

  17. Neurological problems of jazz legends.

    Science.gov (United States)

    Pearl, Phillip L

    2009-08-01

    A variety of neurological problems have affected the lives of giants in the jazz genre. Cole Porter courageously remained prolific after severe leg injuries secondary to an equestrian accident, until he succumbed to osteomyelitis, amputations, depression, and phantom limb pain. George Gershwin resisted explanations for uncinate seizures and personality change and herniated from a right temporal lobe brain tumor, which was a benign cystic glioma. Thelonious Monk had erratic moods, reflected in his pianism, and was ultimately mute and withdrawn, succumbing to cerebrovascular events. Charlie Parker dealt with mood lability and drug dependence, the latter emanating from analgesics following an accident, and ultimately lived as hard as he played his famous bebop saxophone lines and arpeggios. Charles Mingus hummed his last compositions into a tape recorder as he died with motor neuron disease. Bud Powell had severe posttraumatic headaches after being struck by a police stick defending Thelonious Monk during a Harlem club raid.

  18. [Autoantibodies in Paraneoplastic Neurological Syndrome].

    Science.gov (United States)

    Kawachi, Izumi

    2018-04-01

    Paraneoplastic neurological syndromes (PNS) are caused by immune responses against neuronal antigens expressed by the tumor. Based on the immunological pathomechanisms and responsiveness of treatments, onconeuronal antibodies are divided into two categories: 1) antibodies against neural intracellular antigens and 2) antibodies against neuronal surface or synaptic antigens. The recent discovery of onconeuronal antibodies have radically changed concepts of CNS autoimmunity, including PNS. The recognition of PNS provides a foundation for the early detection of underlying tumors and initiations of prompt treatments, which can result in substantial improvement. We here review the characteristic onconeuronal antibodies, including anti-Hu, anti-Ma2, and anti-N-methyl-D-aspartate receptor, and discuss the algorithm for the diagnosis of PNS.

  19. Aphasia, Just a Neurological Disorder?

    Directory of Open Access Journals (Sweden)

    Mehmet Ozdemir

    2016-02-01

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

  20. Prehospital neurological deterioration in stroke.

    Science.gov (United States)

    Slavin, Sabreena J; Sucharew, Heidi; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Adeoye, Opeolu; Flaherty, Matthew L; Ferioli, Simona; McMullan, Jason; Mackey, Jason; De Los Rios La Rosa, Felipe; Martini, Sharyl; Kissela, Brett M; Kleindorfer, Dawn O

    2018-04-27

    Patients with stroke can experience neurological deterioration in the prehospital setting. We evaluated patients with stroke to determine factors associated with prehospital neurological deterioration (PND). Among the Greater Cincinnati/Northern Kentucky region (population ~1.3 million), we screened all 15 local hospitals' admissions from 2010 for acute stroke and included patients aged ≥20. The GCS was compared between emergency medical services (EMS) arrival and hospital arrival, with decrease ≥2 points considered PND. Data obtained retrospectively included demographics, medical history and medication use, stroke subtype (eg, ischaemic stroke (IS), intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH)) and IS subtype (eg, small vessel, large vessel, cardioembolic), seizure at onset, time intervals between symptom onset, EMS arrival and hospital arrival, EMS level of training, and blood pressure and serum glucose on EMS arrival. Of 2708 total patients who had a stroke, 1092 patients (median (IQR) age 74 (61-83) years; 56% women; 21% black) were analysed. PND occurred in 129 cases (12%), including 9% of IS, 24% of ICH and 16% of SAH. In multivariable analysis, black race, atrial fibrillation, haemorrhagic subtype and ALS level of transport were associated with PND. Haemorrhage and atrial fibrillation is associated with PND in stroke, and further investigation is needed to establish whether PND can be predicted. Further studies are also needed to assess whether preferential transport of patients with deterioration to hospitals equipped with higher levels of care is beneficial, identify why race is associated with deterioration and to test therapies targeting PND. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. 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

  2. Nurses' comfort with touch and workplace well-being.

    Science.gov (United States)

    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.

  3. Preliminary research on virtual thermal comfort of automobile occupants

    Science.gov (United States)

    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.

  4. 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)

  5. Guidelines on Thermal Comfort of Air Conditioned Indoor Environment

    Science.gov (United States)

    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.

  6. 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.

  7. [Burnout in nursing residents].

    Science.gov (United States)

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

    2011-03-01

    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  8. 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.

  9. Assessing Thermal Comfort Due to a Ventilated Double Window

    Science.gov (United States)

    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.

  10. Health and comfort in office buildings; Gezondheid en comfort in kantoren

    Energy Technology Data Exchange (ETDEWEB)

    Bluyssen, P.M.; De Kluizenaar, Y. [TNO Bouw en Ondergrond, Delft (Netherlands)

    2011-07-15

    Relationships between indoor building conditions and well-being of occupants are complex; many indoor stressors can exert their effects additively or through complex interactions. It has been shown that exposure to these stressors can cause both short-term and long-term effects. Relevant relations between measurements of chemical and physical indoor environmental parameters and effects have been difficult to make. To increase the chance on successful assessment of cause-effect relationships in future indoor environmental quality investigations, there seems to be a need to improve procedures applied to gather the relevant information. [Dutch] Relaties tussen binnenmilieucondities enerzijds en gezondheid en comfort van kantoormedewerkers anderzijds zijn complex. Veel prikkels of stressoren kunnen zowel kortdurende als langdurende effecten veroorzaken. Maar het is ingewikkeld om relevante relaties te leggen tussen deze effecten en metingen van de chemische en fysische binnenmilieuparameters. Het lijkt noodzakelijk om de procedures voor binnenmilieuonderzoek te verbeteren. Dit kan de kans op een succesvolle bepaling van oorzaak/effect-relaties in toekomstige binnenmilieustudies vergroten.

  11. Where is the comfort in comfort foods? Mechanisms linking fat signaling, reward, and emotion.

    Science.gov (United States)

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

    2014-03-01

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

  12. Questionnaire survey on the process of specialty training in neurology in Japan.

    Science.gov (United States)

    Sonoo, Masahiro; Nishiyama, Kazutoshi; Ando, Tetsuo; Shindo, Katsuro; Kanda, Takashi; Aoki, Masashi; Kamei, Satoshi; Kikuchi, Seiji; Kusunoki, Susumu; Suzuki, Norihiro; Sobue, Gen; Nakashima, Kenji; Hara, Hideo; Hirata, Koichi; Mizusawa, Hidehiro; Murai, Hiroyuki; Murata, Miho; Mochizuki, Hideki; Takahashi, Ryosuke; Kira, Jun-Ichi

    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.

  13. Neurological Signs and Symptoms in Fibromyalgia

    Science.gov (United States)

    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

  14. Predictors of Final Specialty Choice by Internal Medicine Residents

    Science.gov (United States)

    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

  15. Analysis of Thermal Comfort in an Intelligent Building

    Science.gov (United States)

    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.

  16. Objective and subjective evaluation of the acoustic comfort in classrooms.

    Science.gov (United States)

    Zannin, Paulo Henrique Trombetta; Marcon, Carolina Reich

    2007-09-01

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

  17. 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....

  18. The Prevalence of Burnout Among US Neurosurgery Residents.

    Science.gov (United States)

    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

  19. Improving the Teaching Skills of Residents in a Surgical Training Program: Results of the Pilot Year of a Curricular Initiative in an Ophthalmology Residency Program.

    Science.gov (United States)

    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.

  20. In search of the comfortable indoor environment: A comparison of the utility of objective and subjective indicators of indoor comfort

    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)

  1. PNEUMONIA IN NURSING HOME RESIDENTS

    Directory of Open Access Journals (Sweden)

    Renato Eržen

    2002-10-01

    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  2. Education on, Exposure to, and Management of Vascular Anomalies During Otolaryngology Residency and Pediatric Otolaryngology Fellowship.

    Science.gov (United States)

    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

  3. Thermal sensation and thermal comfort in changing environments

    NARCIS (Netherlands)

    Velt, K.B.; Daanen, H.A.M.

    2017-01-01

    It is the purpose of this study to investigate thermal sensation (TS) and thermal comfort (TC) in changing environments. Therefore, 10 subjects stayed in a 30 °C, 50% relative humidity for 30 min in summer clothes and then moved to a 20 °C room where they remained seated for 30 min (Hot to Reference

  4. 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)

  5. Thermal comfort in naturally ventilated buildings in Maceio, Brazil

    Science.gov (United States)

    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.

  6. 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.

  7. 24 CFR 3280.511 - Comfort cooling certificate and information.

    Science.gov (United States)

    2010-04-01

    ... following shall be supplied in the Comfort Cooling Certificate: Air Conditioner Manufacturer Air Conditioner... Conditioner Manufacturer Certified Capacity ___ BTU/Hr. in accordance with the appropriate Air Conditioning... such air conditioners are rated at 0.3 inch water column static pressure or greater for the cooling air...

  8. Dew Point Evaporative Comfort Cooling: Report and Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Dean, J.; Herrmann, L.; Kozubal, E.; Geiger, J.; Eastment, M.; Slayzak, S.

    2012-11-01

    The project objective was to demonstrate the capabilities of the high-performance multi-staged IEC technology and its ability to enhance energy efficiency and interior comfort in dry climates, while substantially reducing electric-peak demand. The project was designed to test 24 cooling units in five commercial building types at Fort Carson Army Base in Colorado Springs, Colorado.

  9. Possibilities to improve the aircraft interior comfort experience

    NARCIS (Netherlands)

    Vink, P.; Bazley, C.; Kamp, I.; Blok, M.

    2012-01-01

    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

  10. Get a Little Closer: Further Examination of Nonverbal Comforting Strategies.

    Science.gov (United States)

    Bullis, Connie; Horn, Charlotte

    1995-01-01

    Tests whether a set of nonverbal comforting strategies and their relationships with affective orientation and gender in previous research are generalizable to a broader sample. Concludes gender differences in affective orientation, diversity and number of strategies, and use of specific strategies were supported. Finds that females were more…

  11. 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.

  12. Thermal comfort of heterogeneous and dynamic indoor conditions - An overview

    NARCIS (Netherlands)

    Mishra, A.K.; Loomans, M.G.L.C.; Hensen, J.L.M.

    2016-01-01

    The buildings sector, being a leading energy consumer, would need to lead in conservation efforts as well. There is a growing consensus that variability in indoor conditions can be acceptable to occupants, improve comfort perception, and lower building energy consumption. This work endeavours to

  13. Outdoor thermal comfort and behaviour in urban area

    Science.gov (United States)

    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.

  14. Thermal comfort in residential buildings by the millions

    DEFF Research Database (Denmark)

    Østergård, Torben; Maagaard, Steffen; Jensen, Rasmus Lund

    2016-01-01

    In Danish building code and many design briefings, criteria regarding thermal comfort are defined for “critical” rooms in residential buildings. Identifying the critical room is both difficult and time-consuming for large, multistory buildings. To reduce costs and time, such requirement often...

  15. Effect of neck warming and cooling on thermal comfort

    Science.gov (United States)

    Williams, B. A.; Chambers, A. B.

    1972-01-01

    The potential use of local neck cooling in an area superficial to the cerebral arteries was evaluated by circulating cold or hot water through two copper disks held firmly against the neck. Subjective responses indicated that neck cooling improves the thermal comfort in a hot environment.

  16. Double face : Adjustable translucent system to improve thermal comfort

    NARCIS (Netherlands)

    Turrin, M.; Tenpierik, M.J.; De Ruiter, P.; Van der Spoel, W.H.; Chang Lara, C.; Heinzelmann, F.; Teuffel, P.; Van Bommel, W.

    2015-01-01

    The DoubleFace project aims at developing a new product that passively improves thermal comfort of indoor and semi-indoor spaces by means of lightweight materials for latent heat storage, while simultaneously allowing daylight to pass through as much as possible. Specifically, the project aims at

  17. Visual comfort of 3-D TV : models and measurements

    NARCIS (Netherlands)

    Lambooij, M.T.M.

    2012-01-01

    The embracing of 3-D movies by Hollywood and fast LCD panels finally enable the home consumer market to start successful campaigns to get 3-D movies and games in the comfort of the living room. By introducing three-dimensional television (3-D TV) and its desktop-counterpart for gaming and internet

  18. The correlation between thermal comfort in buildings and fashion products.

    Science.gov (United States)

    Giesel, Aline; de Mello Souza, Patrícia

    2012-01-01

    This article is about thermal comfort in the wearable product. The research correlates fashion and architecture, in so far as it elects the brise soleil - an architectural element capable of regulating temperature and ventilation inside buildings - as a study referential, in trying to transpose and adapt its mechanisms to the wearable apparel.

  19. Impact of management attitudes on perceived thermal comfort

    NARCIS (Netherlands)

    Derksen, T.; Franchimon, F.; Bronswijk, van J.E.M.H.

    2008-01-01

    Objectives This study examined the influence of some organizational and management characteristics on the perception of indoor environment qualities such as thermal comfort and related stress. Methods One open office in each of three organizations in Eindhoven was studied. An office environment

  20. Numerical human model for impact and seating comfort

    NARCIS (Netherlands)

    Hoof, J.F.A.M. van; Lange, R. de; Verver, M.M.

    2003-01-01

    This paper presents a detailed numerical model of the human body that can be used to evaluate both safety and comfort aspects of vehicle interiors. The model is based on a combination of rigid body and finite element techniques to provide an optimal combination of computational efficiency and

  1. The spatial comfort study of shophouse at Kampung Madras

    Science.gov (United States)

    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.

  2. 24 CFR 3280.507 - Comfort heat gain.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Comfort heat gain. 3280.507 Section... gain. Information necessary to calculate the home cooling load shall be provided as specified in this part. (a) Transmission heat gains. Homes complying with this section shall meet the minimum heat loss...

  3. A Series of Computational Neuroscience Labs Increases Comfort with MATLAB.

    Science.gov (United States)

    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.

  4. Affordable comfort 95 - investing in our energy future

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.

  5. End-state comfort trumps handedness in object manipulation.

    Science.gov (United States)

    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.

  6. Diverse Neurological Manifestations of Lead Encephalopathy ...

    African Journals Online (AJOL)

    Three patients with lead encephalopathy due to industrial poisoning are presented. They all showed a wide spectrum of neurological manifestations, which mimic other neurological presentations. It is emphasised that lead poisoning still occurs in industry, despite efforts at prevention. S. Afr. Med. J., 48, 1721 (1974) ...

  7. [Neurological syndromes associated with homocystein dismetabolism].

    Science.gov (United States)

    Shirokov, E A; Leonova, S F

    2006-01-01

    The article summarizes the results of clinical, neurological, and laboratory examination of patients with hyperhomocysteinemia. The data obtained suggest the existence of common pathobiochemical mechanisms of homocystein, cholesterol, and myelin dysmetabolism. The authors demonstrate that neurological manifestations of hyperhomocysteinemia are associated with the processes of demyelinization in the central and peripheral nervous systems.

  8. Neurological status in severely jaundiced Zimbabwean neonates

    NARCIS (Netherlands)

    Wolf, M. J.; Beunen, G.; Casaer, P.; Wolf, B.

    1998-01-01

    Neurological status was studied in 50 jaundiced infants with a total serum bilirubin of > 400 mumol/l (23.4 mg/dl). Infants were assessed in the neonatal period with the Neonatal Neurological Examination and 4 months of age with the Infant Motor Screen. Twenty-six (52 per cent) infants were

  9. Neurological complications following adult lung transplantation

    NARCIS (Netherlands)

    Mateen, F. J.; Dierkhising, R. A.; Rabinstein, A. A.; van de Beek, D.; Wijdicks, E. F. M.

    2010-01-01

    The full spectrum of neurologic complications and their impact on survival in lung recipients has not been reported. A retrospective cohort review of the Mayo Clinic Lung Transplant Registry (1988-2008) was performed to determine the range of neurologic complications in a cohort of adult lung

  10. Breastfeeding and neurological outcome at 42 months

    NARCIS (Netherlands)

    Patandin, S; Weisglas-Kuperus, N; Touwen, BCL; Boersma, ER

    1998-01-01

    This study investigated the effect of early feeding mode on the neurological condition at 42 months. For this purpose, healthy pregnant women were recruited in Groningen and Rotterdam, The Netherlands. Children were healthy and born at term. At 42 months, the children were neurologically examined by

  11. 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.

  12. Management of male neurologic patients with infertility

    DEFF Research Database (Denmark)

    Fode, Mikkel; Sønksen, Jens

    2015-01-01

    Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve...

  13. Residual neurologic sequelae after childhood cerebral malaria

    NARCIS (Netherlands)

    van Hensbroek, M. B.; Palmer, A.; Jaffar, S.; Schneider, G.; Kwiatkowski, D.

    1997-01-01

    Cerebral malaria is an important cause of pediatric hospital admissions in the tropics. It commonly leads to neurologic sequelae, but the risk factors for this remain unclear and the long-term outcome unknown. The purpose of this study was to identify the common forms of neurologic sequelae that

  14. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  15. Task analysis in neurosciences programme design - neurological ...

    African Journals Online (AJOL)

    Defining educational objectives is the key to achieving the goal of professional competence in students. The technique of task analysis was selected to determine components of competence in clinical neurology appropriate to the needs of primary care. A survey of neurological problems in general practice revealed that ...

  16. Diagnostic Exercise: Neurologic Disorder in a Cat

    Science.gov (United States)

    1989-12-21

    IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification) Diagnostic Exercise - Neurologic Disorder in a Cat 12...and identify by block number) This report documents the fifth reported occurrance of cerebral phaeophyphomycosis in cats . Because mycotic...Exercise: Neurologic Disorder in a Cat Ronald C. Bell United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick

  17. THE NEUROLOGICAL FACE OF CELIAC DISEASE.

    Science.gov (United States)

    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.

  18. Gluten sensitivity and neurological manifestations

    Directory of Open Access Journals (Sweden)

    Agostino Berio

    2015-12-01

    Full Text Available The authors report on six cases of gluten-sensitivity, also defined non-celiac gluten sensitivity, characterized by abdominal features (diarrhea, bloating, pain, genetic positivity for predisposition to celiac disease (DQB1* 02 in all cases; DQA1*05 in three; DQA1*02 in two, DQB1*03 in two, negative anti-t-Transglutaminase antibodies, normal mucosa on biopsy in four cases, type 1 of Marsh in one case. The subjects presented frequent central nervous system (CNS symptoms: headache in three patients, somnolence in one, electroencephalogram aspecific alterations in three (in two of them with previous seizures, leptomeningeal cyst in one, intracranial calcification in one, cerebral gliosis in two. After a gluten-free diet, all intestinal and clinical CNS features remitted, but re-appeared after gluten reintroduction. On the basis of the neurological signs, the authors stress the relevance of immune innate system in the pathogenesis of these cases with possible subsequent evolution on immune adaptive system involvement.

  19. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    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.

  20. Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents.

    Science.gov (United States)

    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

  1. The feasibility of establishing a free clinic for uninsured patients with neurologic disorders.

    Science.gov (United States)

    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.

  2. ESPEN guideline clinical nutrition in neurology.

    Science.gov (United States)

    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.

  3. 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

  4. Adaptive thermal comfort opportunities for dwellings: Providing thermal comfort only when and where needed in dwellings in the Netherlands

    Directory of Open Access Journals (Sweden)

    Noortje Alders

    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

  5. Analysis of bus passenger comfort perception based on passenger load factor and in-vehicle time.

    Science.gov (United States)

    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.

  6. [Neurological disease and facial recognition].

    Science.gov (United States)

    Kawamura, Mitsuru; Sugimoto, Azusa; Kobayakawa, Mutsutaka; Tsuruya, Natsuko

    2012-07-01

    To discuss the neurological basis of facial recognition, we present our case reports of impaired recognition and a review of previous literature. First, we present a case of infarction and discuss prosopagnosia, which has had a large impact on face recognition research. From a study of patient symptoms, we assume that prosopagnosia may be caused by unilateral right occipitotemporal lesion and right cerebral dominance of facial recognition. Further, circumscribed lesion and degenerative disease may also cause progressive prosopagnosia. Apperceptive prosopagnosia is observed in patients with posterior cortical atrophy (PCA), pathologically considered as Alzheimer's disease, and associative prosopagnosia in frontotemporal lobar degeneration (FTLD). Second, we discuss face recognition as part of communication. Patients with Parkinson disease show social cognitive impairments, such as difficulty in facial expression recognition and deficits in theory of mind as detected by the reading the mind in the eyes test. Pathological and functional imaging studies indicate that social cognitive impairment in Parkinson disease is possibly related to damages in the amygdalae and surrounding limbic system. The social cognitive deficits can be observed in the early stages of Parkinson disease, and even in the prodromal stage, for example, patients with rapid eye movement (REM) sleep behavior disorder (RBD) show impairment in facial expression recognition. Further, patients with myotonic dystrophy type 1 (DM 1), which is a multisystem disease that mainly affects the muscles, show social cognitive impairment similar to that of Parkinson disease. Our previous study showed that facial expression recognition impairment of DM 1 patients is associated with lesion in the amygdalae and insulae. Our study results indicate that behaviors and personality traits in DM 1 patients, which are revealed by social cognitive impairment, are attributable to dysfunction of the limbic system.

  7. Severe neurological complication following adjustable gastric banding.

    Science.gov (United States)

    Martines, G; Musa, N; Aquilino, F; Capuano, P

    2018-01-01

    In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately. We report the case of a 35 years-old male patient, affected by morbid obesity, anxious-depressive syndrome and alcohol use disorder, who after adjustable gastric banding implanted in another hospital developed a severe malnutrition and neurological syndrome. The patient showed poor adherence to the follow-up and to the dietary indications and after all, we needed to place a PEG for enteral nutrition in order to resolve the malnutrition condition and the neurological syndrome. Our experience emphasizes that preoperative selection and assessment of a patient's nutritional status according to guidelines, is required to identify potential problems, and that bariatric surgeons or physicians caring for patient who have undergone bariatric surgery should be familiar with the constellation of nutritional and neurological disorder that may occur after surgery. We want to remark the importance of preoperative selection of the patients, the follow-up and the cooperation between patient and physician in order to obtain the best result and avoid severe complications.

  8. Chapter 44: history of neurology in Italy.

    Science.gov (United States)

    Bentivoglio, Marina; Mazzarello, Paolo

    2010-01-01

    The chapter starts from the Renaissance (although the origins of Italian neurology can be traced back to the Middle Ages), when treatises of nervous system physiopathology still followed Hippocratic and Galenic "humoral" theories. In Italy, as elsewhere in Europe, the concepts of humoral pathology were abandoned in the 18th century, when neurology was influenced by novel trends. Neurology acquired the status of clinical discipline (as "clinic of mental diseases") after national reunification (declared in 1861 but completed much later). At the end of the 19th and first decades of the 20th century, eminent Italian "neuropsychiatrists" (including, among many others, Ugo Cerletti, who introduced electroconvulsive shock therapy in 1938) stimulated novel knowledge and approaches, "centers of excellence" flourished, and "Neurological Institutes" were founded. In the first half of the 20th century, the history of Italian neurology was dominated by World Wars I and II (which stimulated studies on the wounded) and the fascist regime in-between the Wars (when the flow of information was instead very limited). Italy became a republic in 1946, and modern neurology and its distinction from psychiatry were finally promoted. The chapter also provides detailed accounts of scientific societies and journals dedicated to the neurological sciences in Italy.

  9. Geriatric care: ways and means of providing comfort.

    Science.gov (United States)

    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

  10. Neurologic signs and symptoms in fibromyalgia.

    Science.gov (United States)

    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.

  11. Using television shows to teach communication skills in internal medicine residency.

    Science.gov (United States)

    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.

  12. 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.

  13. Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

    Science.gov (United States)

    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

  14. Use of a Self-Reflection Tool to Enhance Resident Learning on an Adolescent Medicine Rotation.

    Science.gov (United States)

    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.

  15. Molecular imaging in neurology and neuroscience

    International Nuclear Information System (INIS)

    Schreckenberger, M.

    2007-01-01

    Molecular imaging in neurology and neuroscience is a suspenseful and fast developing tool in order to quantitatively image genomics and proteomics by means of direct and indirect markers. Because of its high-sensitive tracer principle, nuclear medicine imaging has the pioneering task for the methodical progression of molecular imaging. The current development of molecular imaging in neurology changes from the use of indirect markers of gene and protein expression to the direct imaging of the molecular mechanisms. It is the aim of this article to give a short review on the status quo of molecular imaging in neurology with emphasis on clinically relevant aspects. (orig.)

  16. Neurological aspects of acute radiation injuries

    International Nuclear Information System (INIS)

    Torubarov, F.S.; Bushmanov, A.Yu.

    1999-01-01

    Results of the most important clinical studies of human nervous system reactions to acute radiation, carried out at Neurology Clinic of the State Research Center of Russia - Institute of Biophysics are presented. Clinical picture of changes in the nervous system in acute radiation disease caused by homologous and heterologous external irradiation is described. Main neurological syndrome of extremely severe acute radiation disease: acute radiation encephalopathy, radiation toxic encephalopathy, and hemorrhagic syndrome of the central nervous system is distinguished. Relationship between neurological disorders and the geometry of exposure are considered [ru

  17. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand...... in a healthcare system. From our perspective, further sociological and pedagogical investigations in educational cultures across settings and specialties could inform our understanding of and knowledge about pitfalls in residents’ and doctors’ socialization into the healthcare system....

  18. Digital Footprint of Neurological Surgeons.

    Science.gov (United States)

    Kim, Christopher; Gupta, Raghav; Shah, Aakash; Madill, Evan; Prabhu, Arpan V; Agarwal, Nitin

    2018-05-01

    Patients are increasingly turning to online resources to inquire about individual physicians and to gather health information. However, little research exists studying the online presence of neurosurgeons across the country. This study aimed to characterize these online profiles and assess the scope of neurosurgeons' digital identities. Medicare-participating neurologic surgeons from the United States and Puerto Rico were identified using the Centers for Medicare and Medicaid Services (CMS) Physician Comparable Downloadable File. Each physician was characterized by his or her medical education, graduation year, city of practice, gender, and affiliation with an academic institution. Using a Google-based custom search tool, the top 10 search results for each physician were extracted and categorized as 1 of the following: 1) physician, hospital, or healthcare system controlled, 2) third-party or government controlled, 3) social media-based, 4) primary journal article, or 5) other. Among the physicians within the CMS database, 4751 self-identified as being neurosurgeons, yielding a total of 45,875 uniform resource locator search results pertinent to these physicians. Of the 4751 neurosurgeons, 2317 (48.8%) and 2434 (51.2%) were classified as academic and nonacademic neurosurgeons, respectively. At least 1 search result was obtained for every physician. Hospital, healthcare system, or physician-controlled websites (18,206; 39.7%) and third-party websites (17,122; 37.3%) were the 2 most commonly observed domain types. Websites belonging to social media platforms accounted for 4843 (10.6%) search results, and websites belonging to peer-reviewed academic journals accounted for 1888 (4.1%) search results. The frequency with which a third-party domain appeared as the first search result was higher for nonacademic neurosurgeons than for academic neurosurgeons. In general, neurosurgeons lacked a controllable online presence within their first page of Google Search results

  19. Children undergoing cancer treatment describe their experiences of comfort in interviews and drawings.

    Science.gov (United States)

    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.

  20. Features of determining the nonmanufacturing premises comfort level by the integrated microclimate quality criteria

    Science.gov (United States)

    Buhmirov, V. V.; Prorokova, M. V.

    2015-01-01

    The method of determining a microclimate comfort level have been developed, taking into account the main parameters influencing the microclimate in residential, public and administration buildings, their mutual influence on the comfort level, and air quality.

  1. Features of determining the nonmanufacturing premises comfort level by the integrated microclimate quality criteria

    Directory of Open Access Journals (Sweden)

    Buhmirov V.V.

    2015-01-01

    Full Text Available The method of determining a microclimate comfort level have been developed, taking into account the main parameters influencing the microclimate in residential, public and administration buildings, their mutual influence on the comfort level, and air quality.

  2. 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...

  3. Heart rate variation and electroencephalograph--the potential physiological factors for thermal comfort study.

    Science.gov (United States)

    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.

  4. Visitors' perception of thermal comfort during extreme heat events at the Royal Botanic Garden Melbourne

    Science.gov (United States)

    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.

  5. Neurological sequelae of the operation "baby lift" airplane disaster.

    Science.gov (United States)

    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.

  6. Neuromodulation of lower limb motor control in restorative neurology.

    Science.gov (United States)

    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.

  7. The current and ideal state of mental health training: pediatric resident perspectives.

    Science.gov (United States)

    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

  8. Comfort and patient-centred care without excessive sedation

    DEFF Research Database (Denmark)

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

    2016-01-01

    We propose an integrated and adaptable approach to improve patient care and clinical outcomes through analgesia and light sedation, initiated early during an episode of critical illness and as a priority of care. This strategy, which may be regarded as an evolution of the Pain, Agitation...... and Delirium guidelines, is conveyed in the mnemonic eCASH-early Comfort using Analgesia, minimal Sedatives and maximal Humane care. eCASH aims to establish optimal patient comfort with minimal sedation as the default presumption for intensive care unit (ICU) patients in the absence of recognised medical...... requirements for deeper sedation. Effective pain relief is the first priority for implementation of eCASH: we advocate flexible multimodal analgesia designed to minimise use of opioids. Sedation is secondary to pain relief and where possible should be based on agents that can be titrated to a prespecified...

  9. Thermal Comfort-CFD maps for Architectural Interior Design

    DEFF Research Database (Denmark)

    Naboni, Emanuele; Lee, Daniel Sang-Hoon; Fabbri, Kristian

    2017-01-01

    opportunities of movable interior partitions (operated by the users) could be estimated, providing a new layer of information to the designer. The applicability of the thermal maps within an architectural design process is discussed adopting standard energy simulation comfort outputs as a reference......Within the context of nearly Zero-Energy Buildings, it is debated that the energy-centred notion of design, proposed by regulatory frames, needs to be combined with a further focus toward users’ comfort and delight. Accordingly, the underlying theory of the research is that designers should take...... responsibility for understanding the heat flows through the building parts and its spaces. A design, which is sensible to the micro-thermal conditions coexisting in a space, allows the inhabitants to control the building to their needs and desires: for instance, maximising the benefits of heat gain from the sun...

  10. Climate and colored walls: in search of visual comfort

    Science.gov (United States)

    Arrarte-Grau, Malvina

    2002-06-01

    The quality of natural light, the landscape surrounds and the techniques of construction are important factors in the selection of architectural colors. Observation of exterior walls in differentiated climates allows the recognition of particularities in the use of color which satisfy the need for visual comfort. At a distance of 2000 kilometers along the coast of Peru, Lima and Mancora at 12° and 4° respectively, are well defined for their climatic characteristics: in Mancora sunlight causes high reflection, in Lima overcast sky and high humidity cause glare. The study of building color effects at these locations serves to illustrate that color values may be controlled in order to achieve visual comfort and contribute to color identity.

  11. The impact of glazing on energy consumption and comfort

    International Nuclear Information System (INIS)

    Stegou-Sagia, A.; Antonopoulos, K.; Angelopoulou, C.; Kotsiovelos, G.

    2007-01-01

    Given the importance of buildings on the energy balance in Greece, an attempt has been made to study their energy behaviour and thermal comfort. Our primary purpose is to provide an estimation of the building's energy consumption and examine how this affects the comfort conditions. This includes the definition of thermal conditions acceptable for various activities at different times of day during each month of the year. We cannot underestimate the value of real measurements and observations of the building's energy systems, but such data are not always available. The best opportunities for improving energy performance occur early in the design process. Our simulation results can give an indication on which end uses are the most energy consuming, the 'weaknesses' of a building and thus urge the owner or engineer to take effective conservation energy measures

  12. Balancing Machine Work, Comfort Work, and Sentimental Work

    DEFF Research Database (Denmark)

    Pedersen, Maria Ie; Hansen, Magnus; Hertzum, Morten

    2011-01-01

    and attention. We investigate ambulance care in three of Denmark’s five healthcare regions, which staff ambulances with emergency medical technicians, paramedics, and physicians. Using the concept of illness trajectory we analyse how the ambulance crews balance machine work, which involves continuously...... monitoring the equipment, comfort work, which is actions taken to relieve the pain or discomfort of the patient, and sentimental work, which is care for the patient’s physical and mental well-being, often verbal in nature. The analysis shows that comfort and sentimental work often takes priority over machine...... work, but also that this has negative consequences. Equipment for use in ambulances should aim at supporting the ambulance crews in competently and dynamically balancing the different types of work and should, consequently, avoid binding the crew’s attention for unbroken periods of time....

  13. Effect of warm air supplied facially on occupants' comfort

    DEFF Research Database (Denmark)

    Kaczmarczyk, J.; Melikov, Arsen Krikor; Sliva,, D.

    2010-01-01

    was supplied with a constant velocity of 0.4 m/s by means of personalized ventilation towards the face of the subjects. The airflow at 21 °C decreased the subjects' thermal sensation and increased draught discomfort, but improved slightly the perceived air quality. Heating of the supplied air by 6 K...... (temperature increase by 4 K at the target area) above the room air temperature decreased the draught discomfort, improved subjects' thermal comfort and only slightly decreased the perceived air quality. Elevated velocity and temperature of the localized airflow caused an increase of nose dryness intensity...... and number of eye irritation reports. Results suggest that increasing the temperature of the air locally supplied to the breathing zone by only a few degrees above the room air temperature will improve occupants' thermal comfort and will diminish draught discomfort. This strategy will extend...

  14. A comfort-based, energy-aware HVAC agent and its applications in the smart grid

    OpenAIRE

    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...

  15. Ecosystem Biomimicry: A way to achieve thermal comfort in architecture

    Directory of Open Access Journals (Sweden)

    H. Abaeian

    2016-10-01

    Full Text Available The strategies to reduce the consumption of non-renewable energies in buildings are becoming increasingly important. In the meantime, nature-inspired approaches have emerged as a new strategy to achieve thermal comfort in the interiors. However, the use of these approaches in architecture and buildings requires a proper understanding regarding the features of ecosystems. Although acquiring this knowledge requires a high degree of familiarity with the fields such as biology and environmental science, review of achievements made by the use of these features could facilitate the understanding of ecomimicry processes and thereby contribute to environmental sustainability in buildings. In other words, this paper concerns the relationship between these features and the thermal comfort inside the building. Biomimicry is an approach to innovation that seeks sustainable solutions to human challenges by emulating nature’s time-tested patterns and strategies. The objective of this paper is to use such review to provide an approach to the use of natural features for achieving thermal comfort in the buildings of hot and dry climates. In this review, the successful examples are analyzed to identify and examine the principles that influence the thermal comfort in both building and urban levels. The results show that the three elements of water, wind, sun are the effective natural resources that must be utilized in the design in a way proportional and consistent with the natural features. In addition, functional features of ecosystem can be of value only in the presence of a processual  relationship between them.

  16. Comfortably engaging: which approach to alcohol screening should we use?

    Science.gov (United States)

    Vinson, Daniel C; Galliher, James M; Reidinger, Carol; Kappus, Jennifer A

    2004-01-01

    We wanted to compare 2 screening instruments for problem drinking, the CAGE and a single question, assessing frequency of use, patient and clinician comfort, and patient engagement in change. The study was a crossover, cluster-randomized clinical trial with 31 clinicians in Missouri and 13 in the American Academy of Family Physicians (AAFP) National Network for Family Practice and Primary Care Research; 2,800 patients provided data. The clinician was the unit of randomization. Clinicians decided whether to screen each patient; if they chose to screen, they used the screening approach assigned for that block of patients. The clinician and patient separately completed questionnaires immediately after the office visit to assess each one's comfort with screening (and any ensuing discussion) and the patient's engagement in change. Missouri clinicians screened more patients when assigned the single question (81%) than the CAGE (69%, P = .001 in weighted analysis). There was no difference among AAFP network clinicians (96% of patients screened with the CAGE, 97% with the single question). Eighty percent to 90% of clinicians and 70% of patients reported being comfortable with screening and the ensuing discussion, with no difference between approaches in either network. About one third of patients who were identified as problem drinkers reported thinking about or planning to change their drinking behavior, with no difference in engagement between screening approaches. Clinicians and patients reported similar comfort with the CAGE questions and the single-question screening tools for problem drinking, and the 2 instruments were equal in their ability to engage the patient. In Missouri, the single question was more likely to be used.

  17. Development of Light Powered Sensor Networks for Thermal Comfort Measurement

    Directory of Open Access Journals (Sweden)

    Dasheng Lee

    2008-10-01

    Full Text Available Recent technological advances in wireless communications have enabled easy installation of sensor networks with air conditioning equipment control applications. However, the sensor node power supply, through either power lines or battery power, still presents obstacles to the distribution of the sensing systems. In this study, a novel sensor network, powered by the artificial light, was constructed to achieve wireless power transfer and wireless data communications for thermal comfort measurements. The sensing node integrates an IC-based temperature sensor, a radiation thermometer, a relative humidity sensor, a micro machined flow sensor and a microprocessor for predicting mean vote (PMV calculation. The 935 MHz band RF module was employed for the wireless data communication with a specific protocol based on a special energy beacon enabled mode capable of achieving zero power consumption during the inactive periods of the nodes. A 5W spotlight, with a dual axis tilt platform, can power the distributed nodes over a distance of up to 5 meters. A special algorithm, the maximum entropy method, was developed to estimate the sensing quantity of climate parameters if the communication module did not receive any response from the distributed nodes within a certain time limit. The light-powered sensor networks were able to gather indoor comfort-sensing index levels in good agreement with the comfort-sensing vote (CSV preferred by a human being and the experimental results within the environment suggested that the sensing system could be used in air conditioning systems to implement a comfort-optimal control strategy.

  18. A Comparison of the Comfort of Seats for Sonarmen

    Science.gov (United States)

    1987-07-07

    Barkla , 1964; Mandal, 1982; Life and Pheasant, 1984; Grandjean, et al, 1984; Branton, 1984; Corlett and Eklund, 1984). The interest in chair design has...the chair at the end of the day. Such ratings are often obtained after a much shorter exposure. Barkla (1964) claimed that subjects reported...chair developed in Denmark. Appl. Ergon. 7, 185-186. Barkla , D. M. (1964). Chair angles, duration of sitting, and comfort ratings. Ergonomics 7, 297

  19. Room air conditioner load control under summer comfort constraint

    OpenAIRE

    Da Silva , David; Brancaccio , M; Duplessis , Bruno; Adnot , J

    2010-01-01

    International audience; Load control options interest is growing because it can represent a response to future network investments and to congestion problems. In this frame, the present paper gives a methodology to quantify the value of load control for heat pumps (room air conditioners), in small tertiary and residential buildings, considering the occupant's comfort and the electrical grid needs for load shift. This methodology was applied to a small office building where simulations were ma...

  20. Beyond the classic thermoneutral zone: Including thermal comfort.

    Science.gov (United States)

    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.

  1. Development of a method for rating climate seat comfort

    Science.gov (United States)

    Scheffelmeier, M.; Classen, E.

    2017-10-01

    The comfort aspect in the vehicle interior is becoming increasingly important. A high comfort level offers the driver a good and secure feeling and has a strong influence on passive traffic safety. One important part of comfort is the climate aspect, especially the microclimate that emerges between passenger and seat. In this research, different combinations of typical seat materials are used. Fourteen woven and knitted fabrics and eight leathers and its substitutes for the face fabric layer, one foam, one non-woven and one 3D spacer for the plus pad layer and for the support layer three foam types with variations in structure and raw material as well as one rubber hair structure were investigated. To characterise this sample set by thermo-physiological aspects (e.g. water vapour resistance Ret, thermal resistance Rct, buffering capacity of water vapour Fd) regular and modified sweating guarded hotplates were used according to DIN EN ISO 11092. The results of the material characterisation confirm the common knowledge that seat covers out of textiles have better water vapour resistance values than leathers and its substitutes. Subject trials in a driving simulator were executed to rate the subjective sensation while driving in a vehicle seat. With a thermal, sweating Manikin (Newton Type, Thermetrics) objective product measurements were carried out on the same seat. Indeed the subject trials show that every test subject has his or her own subjective perception concerning the climate comfort. The results of the subject trials offered the parameters for the Newton measuring method. Respectively the sweating rate, sit-in procedure, ambient conditions and sensor positions on and between the seat layers must be comparable with the subject trials. By taking care of all these parameters it is possible to get repeatable and reliable results with the Newton Manikin. The subjective feelings of the test subjects, concerning the microclimate between seat and passenger, provide

  2. Electric heating provides a high level of home comfort - economically

    Energy Technology Data Exchange (ETDEWEB)

    Haapakoski, M.

    1997-11-01

    Research and development at IVO in the area of electric heating boasts a tradition going back almost thirty years. Research aimed at further progress is continuing. IVO and power companies launched the `Electrically heated houses of the century` project four years ago. The first results show that electric heating continues to be very competitive with other heating systems. It is an economical way of heating the home and it also increases the comfort of those living there

  3. An analysis of thermal comfort in primary schools in Vietnam

    OpenAIRE

    Le, Thi Ho Vi; Gillott, Mark C.; Rodrigues, Lucélia Taranto

    2017-01-01

    There is a trend of installing air conditioning systems in public primary schools that are currently naturally ventilated in Vietnam. A previous study conducted by the authors provided evidence that there is limited need for air conditioning in Vietnamese mid-season and the hottest season.\\ud \\ud In this study, the authors investigated thermal comfort and users’ perceptions in three primary schools in Ho Chi Minh City during the hottest season (April 2016) and the coldest season (December 201...

  4. Neurologic deficit after resection of the sacrum.

    Science.gov (United States)

    Biagini, R; Ruggieri, P; Mercuri, M; Capanna, R; Briccoli, A; Perin, S; Orsini, U; Demitri, S; Arlecchini, S

    1997-01-01

    The authors describe neurologic deficit (sensory, motor, and sphincteral) resulting from sacrifice of the sacral nerve roots removed during resection of the sacrum. The anatomical and functional bases of sphincteral continence and the amount of neurologic deficit are discussed based on level of sacral resection. A large review of the literature on the subject is reported and discussed. The authors emphasize how the neurophysiological bases of sphincteral continence (rectum and bladder) and of sexual ability are still not well known, and how the literature reveals disagreement on the subject. A score system is proposed to evaluate neurologic deficit. The clinical model of neurologic deficit caused by resection of the sacrum may be extended to an evaluation of post-traumatic deficit.

  5. African Journal of Neurological Sciences: Submissions

    African Journals Online (AJOL)

    African Journal of Neurological Sciences (AJNS) is owned and controlled by ... Decisions about acceptable or rejected manuscripts may take within 8 to 10 weeks. ... The abstract must be clear, precise and concise (no more than 250 words) ...

  6. LEARNERS SATISFACTION FACTORS IN NEUROLOGY RELATED MOOCs

    Directory of Open Access Journals (Sweden)

    Ionela MANIU

    2017-12-01

    Full Text Available The aim of this article is to investigate the factors that are influencing student satisfaction in case of neurology related massive open online courses (MOOCs. We analyzed data collected from learners enrolled in 40 neurology related MOOCs, by manually looking for information in these courses reviews. The main identified satisfaction factors can be grouped into the following categories: content related factors: course content, additional materials, assignments, external research and teaching - learning related factors (teacher presentation techniques / style: engaging, clear, coherent, knowledgeable, sharing / explanation, interactive, excitement, considering student’s needs, inspiring, sense of humor. Competences, skills and objectives pursued by neurology related MOOCs are also discussed. Analyzing these factors can be useful in new courses management (design and implementation and also in understanding the needs (motivation, behaviors, perception of 21st century learners interested in neurology related fields.

  7. Neurological Complications Of Chronic Myeloid Leukaemia: Any ...

    African Journals Online (AJOL)

    , of the neurological deficits complicating chronic myeloid leukaemia. Method: Using patients\\' case folders and haematological malignancy register all cases of chronic myeloid leukaemia seen in Jos University Teaching Hospital between July ...

  8. Editorial | Dechambenoit | African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 34, No 2 (2015) >. Log in or Register to get access to full text downloads.

  9. Neurological findings in triosephosphate isomerase deficiency

    NARCIS (Netherlands)

    Poll-The, B. T.; Aicardi, J.; Girot, R.; Rosa, R.

    1985-01-01

    Two siblings with hemolytic anemia caused by triosephosphate isomerase deficiency developed a progressive neurological syndrome featuring dystonic movements, tremor, pyramidal tract signs, and evidence of spinal motor neuron involvement. Intelligence was unaffected. The findings in these patients

  10. Numerical Analysis of Thermal Comfort at Urban Environment

    Science.gov (United States)

    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.

  11. Numerical Analysis of Thermal Comfort at Open Air Spaces

    Science.gov (United States)

    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.

  12. The zone of comfort: Predicting visual discomfort with stereo displays

    Science.gov (United States)

    Shibata, Takashi; Kim, Joohwan; Hoffman, David M.; Banks, Martin S.

    2012-01-01

    Recent increased usage of stereo displays has been accompanied by public concern about potential adverse effects associated with prolonged viewing of stereo imagery. There are numerous potential sources of adverse effects, but we focused on how vergence–accommodation conflicts in stereo displays affect visual discomfort and fatigue. In one experiment, we examined the effect of viewing distance on discomfort and fatigue. We found that conflicts of a given dioptric value were slightly less comfortable at far than at near distance. In a second experiment, we examined the effect of the sign of the vergence–accommodation conflict on discomfort and fatigue. We found that negative conflicts (stereo content behind the screen) are less comfortable at far distances and that positive conflicts (content in front of screen) are less comfortable at near distances. In a third experiment, we measured phoria and the zone of clear single binocular vision, which are clinical measurements commonly associated with correcting refractive error. Those measurements predicted susceptibility to discomfort in the first two experiments. We discuss the relevance of these findings for a wide variety of situations including the viewing of mobile devices, desktop displays, television, and cinema. PMID:21778252

  13. Hygrothermal response of a dwelling house. Thermal comfort criteria

    Directory of Open Access Journals (Sweden)

    Adrian IACOB

    2015-12-01

    Full Text Available The use of local natural materials in order to reduce the environmental negative impact of buildings has become common practice in recent years; such buildings are to be found in all regions of the planet. The high level of thermal protection provided by the envelope elements made from natural materials such as straw bale insulation, hemp insulation or sheep wool, and their lack of thermal massiveness require a more complex analysis on their ability to keep interior comfort without accentuated variations. This paper proposes a comparative analysis between different solutions for a residential building located near a Romanian city, Cluj-Napoca. The elements of the building envelope are designed in three alternative solutions, using as substitute to classical solutions (concrete and polystyrene, masonry and polystyrene, straw bales and rammed earth for enclosing elements. For this purpose there are conducted numerical simulations of heat and mass transfer, using a mathematical model that allows the analysis of indoor comfort, by comparing both objective factors (air temperature, operative temperature and relative humidity and subjective factors, which are needed to define interior thermal comfort indices PPD and PMV. Finally, a set of conclusions are presented and future research directions are drawn.

  14. Comfortable synchronization of cyclic drawing movements with a metronome.

    Science.gov (United States)

    Repp, Bruno H

    2011-02-01

    Continuous circle drawing is considered a paragon of emergent timing, whereas the timing of finger tapping is said to be event-based. Synchronization with a metronome, however, must to some extent be event-based for both types of movement. Because the target events in the movement trajectory are more poorly defined in circle drawing than in tapping, circle drawing shows more variable asynchronies with a metronome than does tapping. One factor that may have contributed to high variability in past studies is that circle size, drawing direction, and target point were prescribed and perhaps outside the comfort range. In the present study, participants were free to choose most comfortable settings of these parameters for two continuously drawn shapes, circles and infinity signs, while synchronizing with a regular or intermittently perturbed metronome at four different tempi. Results showed that preferred circle sizes were generally smaller than in previous studies but tended to increase as tempo decreased. Synchronization results were similar for circles and infinity signs, and similar to earlier results for circles drawn within a fixed template (Repp & Steinman, 2010). Comparison with tapping data still showed drawing to exhibit much greater variability and persistence of asynchronies as well as slower phase correction in response to phase shifts in the metronome. With comfort level ruled out as a factor, these differences can now be attributed more confidently to differences in event definition and/or movement dynamics. Copyright © 2010 Elsevier B.V. All rights reserved.

  15. The end-state comfort effect in bimanual grip selection.

    Science.gov (United States)

    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.

  16. Evaluation of the thermal comfort of ceramic floor tiles

    Directory of Open Access Journals (Sweden)

    Carmeane Effting

    2007-09-01

    Full Text Available In places where people are bare feet, the thermal sensation of cold or hot depends on the environmental conditions and material properties including its microstructure and crustiness surface. The uncomforting can be characterized by heated floor surfaces in external environments which are exposed to sun radiation (swimming polls areas or by cold floor surfaces in internal environments (bed rooms, path rooms. The property named thermal effusivity which defines the interface temperature when two semi-infinite solids are putted in perfect contact. The introduction of the crustiness surface on the ceramic tiles interferes in the contact temperature and also it can be a strategy to obtain ceramic tiles more comfortable. Materials with low conductivities and densities can be obtained by porous inclusion are due particularly to the processing conditions usually employed. However, the presence of pores generally involves low mechanical strength. This work has the objective to evaluate the thermal comfort of ceramics floor obtained by incorporation of refractory raw materials (residue of the polishing of the porcelanato in industrial atomized ceramic powder, through the thermal and mechanical properties. The theoretical and experimental results show that the porosity and crustiness surface increases; there is sensitive improvement in the comfort by contact.

  17. Indoor Air Quality and Thermal Comfort in School Buildings

    Science.gov (United States)

    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.

  18. Dataset on daytime outdoor thermal comfort for Belo Horizonte, Brazil.

    Science.gov (United States)

    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.

  19. Wearable Sweat Rate Sensors for Human Thermal Comfort Monitoring.

    Science.gov (United States)

    Sim, Jai Kyoung; Yoon, Sunghyun; Cho, Young-Ho

    2018-01-19

    We propose watch-type sweat rate sensors capable of automatic natural ventilation by integrating miniaturized thermo-pneumatic actuators, and experimentally verify their performances and applicability. Previous sensors using natural ventilation require manual ventilation process or high-power bulky thermo-pneumatic actuators to lift sweat rate detection chambers above skin for continuous measurement. The proposed watch-type sweat rate sensors reduce operation power by minimizing expansion fluid volume to 0.4 ml through heat circuit modeling. The proposed sensors reduce operation power to 12.8% and weight to 47.6% compared to previous portable sensors, operating for 4 hours at 6 V batteries. Human experiment for thermal comfort monitoring is performed by using the proposed sensors having sensitivity of 0.039 (pF/s)/(g/m 2 h) and linearity of 97.9% in human sweat rate range. Average sweat rate difference for each thermal status measured in three subjects shows (32.06 ± 27.19) g/m 2 h in thermal statuses including 'comfortable', 'slightly warm', 'warm', and 'hot'. The proposed sensors thereby can discriminate and compare four stages of thermal status. Sweat rate measurement error of the proposed sensors is less than 10% under air velocity of 1.5 m/s corresponding to human walking speed. The proposed sensors are applicable for wearable and portable use, having potentials for daily thermal comfort monitoring applications.

  20. 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)

  1. Thermal perceptions, general adaptation methods and occupant's idea about the trade-off between thermal comfort and energy saving in hot-humid regions

    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)

  2. An investigation into thermal comfort and residential thermal environment in an intertropical sub-Saharan Africa region: Field study report during the Harmattan season in Cameroon

    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.

  3. Comfort Women in Human Rights Discourse: Fetishized Testimonies, Small Museums, and the Politics of Thin Description

    Science.gov (United States)

    Joo, Hee-Jung Serenity

    2015-01-01

    In the last two decades, the issue of comfort women--the women and girls who were forced into sex slavery for the Japanese army before and during WWII--has risen to global attention. Tens of thousands of comfort women (the average estimate is anywhere between 80,000 and 200,000) were confined at comfort stations managed by the Japanese Imperial…

  4. Agent-based modelling to improve comfort and save energy in the built environment

    NARCIS (Netherlands)

    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:

  5. Thermal comfort assessment in a Dutch hospital setting – model applicability

    NARCIS (Netherlands)

    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

  6. Functional MRT in psychiatry and neurology

    International Nuclear Information System (INIS)

    Schneider, F.; Fink, G.R.

    2007-01-01

    Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives

  7. Interprovider Communication Using a Scheduled Provider Alert-Response Communication System in 3 Inpatient Neurology Units.

    Science.gov (United States)

    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.

  8. Burnout Syndrome During Residency.

    Science.gov (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  9. The effect of intrathecal baclofen treatment on activities of daily life in children and young adults with cerebral palsy and progressive neurological disorders.

    Science.gov (United States)

    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.

  10. 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.

  11. The Role of Magnesium in Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Anna E. Kirkland

    2018-06-01

    Full Text Available Magnesium is well known for its diverse actions within the human body. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. It also functions in a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity, and has been implicated in multiple neurological disorders. Due to these important functions within the nervous system, magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders. Current literature is reviewed for migraine, chronic pain, epilepsy, Alzheimer’s, Parkinson’s, and stroke, as well as the commonly comorbid conditions of anxiety and depression. Previous reviews and meta-analyses are used to set the scene for magnesium research across neurological conditions, while current research is reviewed in greater detail to update the literature and demonstrate the progress (or lack thereof in the field. There is strong data to suggest a role for magnesium in migraine and depression, and emerging data to suggest a protective effect of magnesium for chronic pain, anxiety, and stroke. More research is needed on magnesium as an adjunct treatment in epilepsy, and to further clarify its role in Alzheimer’s and Parkinson’s. Overall, the mechanistic attributes of magnesium in neurological diseases connote the macromineral as a potential target for neurological disease prevention and treatment.

  12. 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

  13. Neurologic sequelae associated with foscarnet therapy.

    Science.gov (United States)

    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.

  14. Chapter 50: history of tropical neurology.

    Science.gov (United States)

    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.

  15. Feasibility study of context-awareness device Comfort calculation methods and their application to comfort-based access control

    DEFF Research Database (Denmark)

    Guo, Jingjing; Jensen, Christian D.; Ma, Jianfeng

    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...

  16. 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

  17. Medical-grade footwear: the impact of fit and comfort.

    Science.gov (United States)

    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

  18. Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.

    Science.gov (United States)

    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

  19. Changes in medicine: residency

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-07-01

    Full Text Available No abstract available. Article truncated at 150 words. The most important time in a physician’s educational development is residency, especially the first year. However, residency work and responsibility have come under the scrutiny of a host of agencies and bureaucracies, and therefore, is rapidly changing. Most important in the alphabet soup of regulatory agencies is the Accreditation Council for Graduate Medical Education (ACGME which accredits residencies and ultimately makes the governing rules.Resident work hours have received much attention and are clearly decreasing. However, the decline in work hours began in the 1970’s before the present political push to decrease work hours. The residency I entered in 1976 had every third night call during the first year resident’s 6-9 months on general medicine or wards. It had changed from every other night the year before. On wards, we normally were in the hospital for our 24 hours of call and followed this with a 10-12 hour day before …

  20. Field study on behaviors and adaptation of elderly people and their thermal comfort requirements in residential environments.

    Science.gov (United States)

    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

  1. Thermal Perception in the Mediterranean Area: Comparing the Mediterranean Outdoor Comfort Index (MOCI to Other Outdoor Thermal Comfort Indices

    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.

  2. Neurology in a globalizing world: World Congress of Neurology, Vienna, 2013.

    Science.gov (United States)

    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.

  3. Effectiveness of cross-cultural education for medical residents caring for burmese refugees.

    Science.gov (United States)

    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.

  4. Investigating the scope of resident patient care handoffs within neurosurgery.

    Science.gov (United States)

    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.

  5. 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.

  6. Status of neurology medical school education

    Science.gov (United States)

    Ali, Imran I.; Isaacson, Richard S.; Safdieh, Joseph E.; Finney, Glen R.; Sowell, Michael K.; Sam, Maria C.; Anderson, Heather S.; Shin, Robert K.; Kraakevik, Jeff A.; Coleman, Mary; Drogan, Oksana

    2014-01-01

    Objective: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. Methods: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Results: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were “very satisfied” or “somewhat satisfied,” but more than half experienced “burnout” and 35% had considered relinquishing their role. Conclusion: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. PMID:25305155

  7. Integration of human physiology. Individual Thermal comfort in thermal comfort models; Integratie van de menselijke fysiologie. Individueel thermisch comfort in thermische comfortmodellen

    Energy Technology Data Exchange (ETDEWEB)

    Frijns, A. [Faculteit Werktuigbouwkunde, Technische Universiteit Eindhoven, Eindhoven (Netherlands); Van Marken Lichtenbelt, W.; Kingsma, B. [Department of Human Biology, Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht (Netherlands)

    2011-09-15

    When designing climate installations, the PMV (Predicted Mean Vote) and PPD (Predicted Percentage Dissatisfied index) values are used as guidelines. Installations are designed in such a way that the 'average' user in a 'steady-state' condition experiences thermal comfort. Studies show that individual physiological processes might be suitable for integration in the design models. [Dutch] Bij het ontwerp van klimaatinstallaties worden de PMV/PPD-waarden van Fanger (PMV staat voor de Predicted Mean Vote index en PPD is de Predicted Percentage Dissatisfied index) als richtlijn gebruikt. Installaties worden zodanig ontworpen dat een 'gemiddelde' persoon in een 'steady-state' conditie deze als thermisch comfortabel ervaart. Studies wijzen uit dat individuele fysiologische processen mogelijk ook in ontwerpmodellen inpasbaar zijn.

  8. 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

  9. Effect of long-term acclimatization on summer thermal comfort in outdoor spaces: a comparative study between Melbourne and Hong Kong.

    Science.gov (United States)

    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.

  10. High-Fidelity Contrast Reaction Simulation Training: Performance Comparison of Faculty, Fellows, and Residents.

    Science.gov (United States)

    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

  11. Standards in Neurological Rehabilitation, June 1997

    Directory of Open Access Journals (Sweden)

    Michael P. Barnes

    1997-01-01

    Full Text Available The European Federation of Neurological Societies (EFNS Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1 produce a report on the state of neurological rehabilitation across Europe; and (2 recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1 A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2 The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3 The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4 The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5 The Task Force supports a two-tier system of

  12. Intervertebral Disc Characteristic on Progressive Neurological Deficit

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    Farid Yudoyono

    2017-09-01

    Full Text Available Objective: To examine the intervertebral disc characteristic on magnetic resonance imaging (MRI in lumbar herniated disc (LHD patients with progressive neurological deficit. Methods: Patients were collected retrospectively from Dr. Hasan Sadikin General Hospital Database from 2011–2013 with LHD, had neurological deficit such as radiculopathy and cauda equine syndrome for less than four weeks with a positive sign confirmed by neurological examination and confirmatory with MRI examination. Results: A total of 14 patients with lumbar herniated disc disease (10 males, 4 females suffered from progressive neurological deficit with an average age of (52.07±10.9 years old. Early disc height was 9.38±0.5 mm and progressive neurological deficit state disc height was 4.03±0.53 mm, which were significantly different statisticaly (p<0.01. Symptoms of radiculopathy were seen in 11 patients and cauda equine syndrome in three patients. Modic changes grade 1 was found in five patients, grade 2 in eight patients,grade 3 in one patient, Pfirmman grade 2 in eleven patients and grade 3 in three patients. Thecal sac compression 1/3 compression was seen in four patients and 2/3 compression in ten patients. Conclusions: Neurosurgeon should raise concerns on the characteristic changes of intervertebral disc in magnetic resonance imaging examination to avoid further neural injury in lumbar herniated disc patients.

  13. [Deficiency, disability, neurology and television series].

    Science.gov (United States)

    Collado-Vázquez, Susana; Martínez-Martínez, Ariadna; Cano-de-la-Cuerda, Roberto

    2015-06-01

    The portrayal of neurological disability and deficiency on television has not always been approached in the same way, but has instead tended to reflect the standpoint taken by society with regard to these issues and how they are dealt with according to the prevailing conceptions and values at each particular time. To address the appearance of neurological pathologies in television series and to ponder on the image they have in such contexts. Deficiency and disability of neurological origin have often been depicted on television in series, telefilms and documentaries, and in a wide variety of ways. Here we examine different television series and how they have dealt with neurological pathology, its diagnosis and its treatment, as well as the figure of the healthcare professional and social-familial adaptation. Examples cited include series such as House MD, Glee, American Horror Story, Homeland or Game of Thrones. Television series are a useful tool for making some neurological pathologies better known to the public and for dispelling the myths surrounding others, provided that the pathologies are dealt with in a realistic manner, which is not always the case. More care should be taken with regard to the way in which health professionals are portrayed in television series, as it is not always done correctly and may mislead viewers, who take what they see on the TV as being real.

  14. Neurology and the Internet: a review.

    Science.gov (United States)

    Moccia, Marcello; Brigo, Francesco; Tedeschi, Gioacchino; Bonavita, Simona; Lavorgna, Luigi

    2018-06-01

    Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.

  15. Feeding problems in children with neurological disorders.

    Science.gov (United States)

    Jamroz, Ewa; Głuszkiewicz, Ewa; Grzybowska-Chlebowczyk, Urszula; Woś, Halina

    2012-01-01

    The aim of this study was to evaluate the prevalence of selected risk factors of weight deficiency in children with chronic metabolic diseases. The study group involved 160 children, from 2 months to 15 years (mean age 3.14 years), with diseases of the nervous system and body weight deficiency. According to the type of neurological disease the following groups of patients were separated: static encephalopathies, progressive encephalopathies, disorders of mental development of undetermined etiology, genetically determined diseases. As the exponent of malnutrition, z-score of weight-for-age standards was used. An inclusion criterion for the study group was z-score of weight-for-age children, neurological disorders, oral motor dysfunction, diseases of other organs, gastrointestinal motility disorders (oral cavity, esophagus, intestines) and type of nutritional therapy. The most advanced malnutrition was in children with progressive encephalopathies and genetically determined diseases. Seizures and muscular hypotonia were most common neurological disorders. Oral motor dysfunctions were observed in 40% of patients. Malnutrition in children with neurological disorders is associated mainly with neurological deficits. In this group of children monitoring of somatic development and early nutritional intervention are necessary.

  16. Neurology referrals to a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Fitzgerald, P

    2012-02-03

    The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

  17. Dengue: a new challenge for neurology

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    Marzia Puccioni-Sohler

    2012-11-01

    Full Text Available Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world’s population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial.

  18. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Optimal bus temperature for thermal comfort during a cool day.

    Science.gov (United States)

    Velt, K B; Daanen, H A M

    2017-07-01

    A challenge for electric buses is to minimize heating and cooling power to maximally extend the driving range, but still provide sufficient thermal comfort for the driver and passengers. Therefore, we investigated the thermal sensation (TS) and thermal comfort (TC) of passengers in buses during a cool day (temperature 13.4 ± 0.5 °C, relative humidity (RH) 60 ± 5.8%) typical for the Dutch temperate maritime climate. 28 Males and 72 females rated TS and TC and gave information on age, stature, body weight and worn garments. The temperature in the bus of 22.5 ± 1.1 °C and RH of 59.9 ± 5.8% corresponded to a slightly warm feeling (TS = 0.85 ± 1.06) and TC of 0.39 ± 0.65. TS related significantly to bus temperature, clothing insulation and age. Linear regression based on these parameters showed that the temperature in the bus corresponding to TC = 0 and TS = 0 would have been 20.9 ± 0.6 °C. In conclusion, a 1.6 °C lower bus temperature during the investigated cool day probably would have led to less thermal discomfort and energy savings of electrical busses. The methodology to relate climatic measurements to subjective assessments is currently employed in a wider climatic range and may prove to be useful to find a better balance between thermal comfort and energy savings of the bus. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. EXAMINING COMFORT PROPERTIES OF LEATHER and ARTIFICIAL LEATHER COVER MATERIALS

    Directory of Open Access Journals (Sweden)

    ÇETİN Münire Sibel

    2016-05-01

    Full Text Available The analysis and regulation of workplace, working instruments, the comfort of office chair, business environment (sound, lighting, climate, vibration, temperature, and humidity, work and break times, analysis and editing of the organization, are some of the topics of interest of ergonomics. Environmental impact and conditions have important role on the employee’s working comfortably and efficiently. Therefore these conditions need to be aligned to the human body nature. Unsuitable working conditions (noise, etc. cause additional load, which the human body endures, and this additional load reveals the signs of tiredness in the body. Even an office environment, unsuitable physical environment impairs health of workers and reduces the performance. Therefore, office climate, environmental factors such as lighting and noise must be harmonized with the employee’s body nature in all working environments. Seating comfort is one of the important factors affecting the performance of employees in the office environment. There are so many studies about chair dimensions and the disorders on human body which were caused by the inappropriate chair dimensions and sitting positions. However, there are a spot of studies about the surface of the chair and the discomfort caused by the chair cover and its negative performance effects. In this study, some results of seat cover analysis for the design of an ergonomic chair. Recently, ease of cleaning, low cost advantages caused the increasing of the use of artificial leather especially on the surface of the seat used in offices. The physical properties of natural leather and artificial leather were compared as the candidate covers to be used on the design of an ergonomic office chair.