Comfortable Position Research Articles

THE USE OF AN ULTRASONIC TOOL TO CUT HUMAN BONE: CUTTING SPEED AND FORCES OF ORTHOPAEDIC SURGEONS

AbstractBackgroundUltrasonic cutting of bone boasts many advantages over alternatively powered surgical instruments, including but not limited to: elimination of swarf, reduced reaction forces, increased precision in cutting and reduced adjacent soft tissue damage, reduced post-operative complications such as bleeding and bone fracture, reduced healing time, reduced intra-operative noise and ease of handling. Despite ultrasonic cutting devices being well established in oral and maxillofacial surgery, applications in orthopaedic surgery are more niche and are not as well understood. The aim of this study was to investigate the cutting speed (mm/s) and cutting forces (N) of orthopaedic surgeons using a custom-designed state of the art ultrasonic cutting tool to cut fresh human bone samples.MethodsA setup based on the Robot Operating System (ROS) and AprilTag was designed to track and to record the real time position of the ultrasonic cutting tool in space. Synchronised load cell axial force readings of three separate orthopaedic surgeons during ultrasonic cutting were recorded. Each surgeon was asked to find a comfortable position that reflects as close as possible their clinical handling of a cutting instrument used in surgery, and to perform two cuts in each of three samples of human cortical bone. Bone samples were obtained following ethical approval from an institutional review board (ethics approval number: SR1342) and prior informed consent was obtained from all patients. Bone samples were extracted from the femoral neck region of three hip osteoarthritis patients. During cutting, surgeons were allowed a total cutting time of one minute and cutting was conducted using an ultrasonic tool with frequency of a 35kHz (35.7 µm peak to peak displacement amplitude) under constant irrigation using a MINIPULS® 3 Peristaltic pump (38 revolutions per minute) using Phosphate-Buffered Saline (PBS) at 25°C. From the recorded data, the average instantaneous cutting velocity was calculated and the maximum cutting force was identified.ResultsAll surgeons assumed a back-and-forth cutting motion, variation in the applied cutting force was observed. The average vertical cutting speed, axial cutting force and cutting depth across all surgeons and all samples was 1.64 mm/s, 1.91 N and 0.73 mm, respectively. While increasing the axial cutting force resulted in a deeper cut, overloading of the ultrasound transducer occurred when the tool advanced too quickly into the bone tissue during cutting. The exact force threshold, or the optimal speed at which the surgeon can maintain a constant force during cutting, requires further investigation.ConclusionsIn this study, all surgeons cut using a back-and-forth cutting motion, with variation in the applied cutting force which may ultimately inform which clinical applications in orthopaedic engineering are most suitable for this technology. Applying too much force caused overloading of the ultrasound transducer, which is a limitation with the current cutting tool. The results from this study may facilitate the eventual uptake of ultrasonic cutting tools for application in orthopaedic surgery.Declaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

The physiological effect of prone positioning and lateral decubitus in non-intubated patients with severe COVID-19: a prospective cohort study

Introduction: Prone positioning is one type of postural lung recruitment manoeuvre that has been widely studied regarding the benefits and physiological changes of the cardiorespiratory system. However, prone positioning is not very comfortable for the patients because they have to lie on their stomachs for a while when the oxygen therapy and other monitoring devices are still attached. Based on patient observations, some patients will change to more comfortable positions, namely using the right/left lateral decubitus position. The purpose of this research was to examine the physiological impact of prone and lateral decubitus position in non-intubated patients who were diagnosed with severe COVID-19. Methods: It was a prospective cohort study in subsequent people with severe COVID-19 who obtained a non-rebreathing mask or high-flow nasal cannula at a University Hospital between 1 June and 10 September 2021. The study lasted for a total of 2021 days and involved 48 patients. The patients assumed the prone positioning or lateral decubitus every morning and afternoon for 4 h and were measured for cardiorespiratory parameters and blood gas analysis. It has been reported in line with the STROCSS criteria. Results: Dynamic changes based on cardiorespiratory parameters and blood gas analysis parameters in patients with prone and lateral decubitus position in patients with severe COVID-19 receiving conventional oxygen therapy (via non-rebreathing mask) or high-flow nasal cannula did not show any significant difference. Conclusion: The physiological effect of prone positioning and lateral decubitus in non-intubated patients with severe COVID-19 are similar. Accordingly, lateral decubitus can be an alternative for postural lung recruitment manoeuvres and warrants further randomized trials.

Edukasi dan Pendampingan Ibu Bersalin Kala 1 dalam Melakukan Mobilisasi di Ruang Bersalin Puskesmas Paiton

Childbirth is the birth of the baby, placenta and amniotic membranes from the uterus to the outside world. Long labor causes mothers to experience stress and fatigue for longer so that pain will increase. The causes of labor pain are caused by various factors such as uterine muscle contractions, stretching of the pelvic floor muscles, episotomy and psychological conditions, namely anxiety which can increase the incidence of stress. To overcome prolonged labor, active labor techniques have been introduced. The active labor method has actually been implemented as one of the care services during the birth process, namely in terms of mobilization which encourages the mother to choose the position that is considered the most comfortable with the aim of minimizing pain and which can affect the length of labor. labor. first and second stages of labor. In reality, there are still many mothers who give birth who experience difficulty in mobilizing and positioning and only focus on the pain and are afraid to move so they only stay in one position during the birth process, this can make the muscles stiff and cause pain. it is difficult for the fetus to descend into the pelvis. Based on research, pregnant women who carry out mobilizations such as walking lightly and arranging a comfortable position can speed up the descent of the head and the opening of the cervix. This service takes the form of providing education about the benefits of mobilization for mothers during the first stage of labor and providing assistance with mobilization in the delivery room. Providing education and assistance can help mothers in labor empower themselves in undergoing labor so that it is hoped that labor can run smoothly. This community service can help mothers in labor to empower themselves to mobilize in an effort to speed up the descent of the fetal head, speed up opening and the mother can adjust to a comfortable position so that the birth runs smoothly.

The Magnitude of Physical and Sensory Impairments in Post-traumatic and Non-traumatic Cervicogenic Headaches: A Comparative Study.

Background Cervicogenic headaches can significantly deteriorate the quality of life of patients and decrease their productivity. Few studies have been conducted to assess the magnitude of physical impairments among patients with non-traumatic and post-traumatic cervicogenic headaches. Therefore, this study was conducted to examine and compare the magnitude of cervical physical impairments among patients with post-traumatic cervicogenic headaches in contrast to patients with non-traumatic cervicogenic headaches, migraine, and a group of sex- and age-matched controls who did not have headaches. Methodology This was a comparative study. A total of 104 patients and 30 sex- and age-matched controls were included. The patients were stratified into three groups: post-traumatic cervicogenic headaches (n = 42), non-traumatic cervicogenic headaches (n = 30), and migraines (n = 32). The cervical active range of motion and proprioception were assessed using a goniometer, the craniovertebral angle was measured while the heads of the subjects rested in a comfortable position, the strength of the cervical flexors and extensors was assessed using a hand-held dynamometer, and endurance of the short cervical flexors was assessed while the subjects were in a supine position with no pillow. Skin roll tests were performed in the trapezius and mandibular areas, and pain was measured using the McGill Pain Questionnaire-Short Form. Results Patients in the post-traumatic cervicogenic headache group reported a significantly higher number of headache days (p < 0.001) compared to the controls, patients with migraines, and those with non-traumatic cervicogenic headaches. Patients with post-traumatic cervicogenic headaches showed a significant reduction in total rotation, flexion and extension, lateral bending, and craniovertebral angle compared to the controls, patients with migraines, and those with non-traumatic cervicogenic headaches. On the other hand, the controls endured significantly longer and had stronger neck flexors and extensors compared to the patients in the migraine, non-traumatic, and post-traumatic cervicogenic headache groups, respectively. Patients with post-traumatic cervicogenic headaches significantly reported higher affective and total pain compared to the controls and patients in the migraine group. Conclusions Patients with post-traumatic cervicogenic headaches had significant deficits in the cervical active range of motion in the different planes, endurance, and strength of cervical flexors and extensors compared to the controls and patients with migraine and non-traumatic cervicogenic headaches. Similarly, patients with post-traumatic cervicogenic headaches reported higher affective pain compared to the controls and patients with migraines. The results of this study indicated that patients with post-traumatic cervicogenic headaches have significantly higher physical impairments compared to patients with non-traumatic cervicogenic headaches. These differences warrant caution when combining data from patients with non-traumatic and post-traumatic cervicogenic headaches.

Review on Smart Water Heater Power Saver Using Detectors

Since water heating is a basic task of our day- to- day life, it has been turned into efficient technology through water geyser system. Water geyser is used for thermodynamically hotting water above its normal temperature. Its procedure incorporates in bathing, washing, cooking &amp; numerous where. So to corroborate the public demand, the crucial challenge is to make the system more cheap but effective, handy but less incorrect. To hold its performance as well as cost, we need to design such a system that will give us with exactly how we anticipate it to be. Although traditional electric storehouse tank water heaters( ESTWHs) are the most constantly used systems in the world, they're known to be among the loftiest energy consumers, due to their inefficiency in converting electrical energy to thermal energy. These systems have grown decreasingly hostile to consumers, as power prices have raised. thus, the need to reduce energy consumption of hot water product, while maintaining the druggies ’ thermal comfort position, has led to the development of further energy-effective technologies. In this paper, a review of renewable energy water heating systems i.e. solar panel, as well as the background literature of the studies on these systems. In this paper electric heater is safer, affordable, and effective and is the most constantly chosen option. In this paper, we proposed a system, which can give a way to maintain a moderate temperature and save energy. Representing spring heater rather of a rally geyser, we'd set a specific temperature range on it. After switching the system on for the first time, if the temperature of the water went below the preset range, the heater bus- rebooted and took the water into that range of heat. However, the whole system might be turned off regarding the possibilities that no consumption of water was going on, If the heater was on and sat idle for a veritably long time.

Reduction of patients' bed rest time after percutaneous renal biopsy evaluated by the Nursing Outcomes Classification: Randomized clinical trial.

To evaluate the reduction of patients' bed rest time after percutaneous renal biopsy (PRB) from 24 to 8h using the Nursing Outcomes Classification (NOC). This was a randomized clinical trial registered with Clinical Trials number NCT04629235. The sample comprised 16 patients in the intervention group and 18 in the control group. In the intervention group, the rest time was modified to 8h, and afterward, the patients were released to ambulate, whereas the control patients remained at absolute rest for 24h after PRB according to institutional protocol. All patients were observed for 24h and evaluated at five time points with the outcomes and indicators of the NOC: before the biopsy, immediately after, at the 8th hour, at the 12th hour, and at the 24th hour after the procedure. In the 170 evaluations performed, statistically significant differences were identified in the outcome Comfort status: physical and the indicators "physical well-being and comfortable position." None of the complications were related to reduced bed rest time. Reducing patients' bed rest time from 24 to 8h did not increase complications from PRB, and using the NOC provided a standardized and reliable assessment. Important evidence was identified for patient care after PRB, demonstrating the positive impact on patient comfort and the possibility of reducing costs to the institution and the workload of the multidisciplinary team. In addition, these findings may contribute to strengthening the use of NOC in clinical practice, teaching, and research.

Art-based self-care during COVID-19

ABSTRACT Background The COVID-19 global pandemic was a profoundly traumatic experience, in which healthcare workers were stressed, anxious, and overwhelmed as they laboured amidst chaos, upheaval, and mounting death. During such challenging and uncertain times, it is imperative to prioritise self-care in order to maintain mental and emotional wellbeing. Aims This study explored the impact of an art-based self-care practice on the resilience of a healthcare worker during a 14-day quarantine on a trip to South Korea during COVID-19. Methods Interpretive phenomenological analysis (IPA) was employed to analyze written reflections of artwork created during my quarantine. I employed a grounding art therapy directive consisting of six steps: find a comfortable position, identify my feelings, allow thoughts or images to arise, create and respond to the images, engage in art dialogue with the artwork, and give a name to the whole process. Results Three phases emerged reflecting a journey in which states of powerlessness and confusion gave way to a release of frozen feelings and a renewal of body awareness. Elaborated healing images then emerged representing a return of hope, spirituality, growth, and a longing to reconnect with others. Conclusions Amidst such a chaotic overwhelming traumatic experience art-based self-care practices can be a way to regain a sense of control and self-efficacy. Implications for practice/policy/future research Art-based self-care practices can be valuable for healthcare workers during times of crisis and stress. Including semi-structured interviews inquiring into the experiences of a larger number of participants and controlled experimental designs would help validate these findings. Plain-language summary The COVID-19 global pandemic was a profoundly traumatic experience, affecting individuals worldwide and causing acute anxiety, stress, and sense of overwhelm. Healthcare workers, in particular, were stressed and exhausted due to work overload. During such challenging times, it is imperative to prioritise self-care to increase resilience. I had been working as art therapist in a psychiatric unit of a hospital for 9 months when I had to return to my birthplace of South Korea to attend to a family matter. Facing a 14-day quarantine, I decided to practice art-based self-care as a way to soothe and attend to my anxious emotional state. I wanted to understand the benefits of art-based self-care on resilience in healthcare workers. The directive consisted of six steps: find a comfortable position, identify my feelings, allow thoughts or images to arise, create and respond to the images, allow verbal responses to the images, and give a name to the whole process. I examined the written reflections of the artwork I created during daily self-care practice. The results reflect a journey, in which a state of fragmentation and exhaustion gave way under the exploration of my complex inner state, releasing diverse emotions, and leading to bodily awareness and emotional restoration. I rediscovered a sense of hope and a spiritual inclination to reconnect with others. Art-based self-care helped facilitate reconnection with myself, my needs, my body, and others, which in turn enabled me to prioritise self-care during the stresses of COVID-19. Policymakers and healthcare organisations should consider incorporating art-based self-care programmes for healthcare workers to support their resilience and emotional wellbeing. Future researchers should consider interviewing a larger number of healthcare workers who follow the grounding art-therapy directive I used. Stronger research designs could be used to further support my findings and inform future interventions for healthcare workers.

Performance Analysis of Motorized Object Lifting Toggle Jack

This study seeks to develop a motorized car jack with maximum lifting capacity of 1.5 tons. The principle of the existing car jack was modified by making adjustments and using a prime mover which is the electric motor to control the lifting operation of the jack. The design incorporates an electric motor that is powered by a 12-volt battery of a small vehicle and the device is connected through a cigarette lighter adapter in the vehicle. The common challenge with the currently available car jacks on the market is that they are manually operated and need a substantial amount of physical effort is required to lift the vehicle. In this work, human effort was eliminated in raising the jack by the use of the torque generated by the motor as it rotates. The use of long cablings to control the motorized operation assists the jack to be safe to use as the operator can use the jack in a comfortable position and as far away from the vehicle as possible. The performances of the machine at different loads were calculated. The approximate values and graphical relationships were established. Using MS Excel. It was established that, the machine had efficiency of about 53%. The investigation revealed that the minimal efficiency was as a result of the great frictional forces between the screw and the threaded base required to be overcome as well as the capacity of the DC motor and gear system.

Transcending Patriarchal and Cultural Construct in Bapsi Sidhwa’s The Pakistani Bride

This study aims to show how patriarchal civilizations physically, emotionally, and socially oppress and enslave women. Sidhwa has shown Pakistani gender-based class system quite effectively in her work. She discusses marginalized and double-colonized Pakistani women as victims of patriarchal culture who confront a variety of national and household challenges, and overcomes patriarchal and cultural constructs in order to be in peace with society and culture. This paper ‘Transcending Patriarchal and Cultural Construct in Bapsi Sidhwa’s The Pakistani Bride’, attempts to show how women in patriarchal cultures and societies suffer many issues in their lives and how they repress their needs, longings, and emotions in order to find a comfortable position in their households as well as in society at large.

Identifying core components of a radiotherapy comfort intervention package using nominal group technique

IntroductionA comfortable treatment position in radiotherapy may promote patient stability and improve outcomes such as accuracy. The aim of this study was to identify, prioritise and determine the feasibility of delivery of intervention components as part of a radiotherapy comfort intervention package. MethodsPrior research, consisting of a systematic review and qualitative interviews with patient and therapeutic radiographers, was triangulated and 15 intervention components developed. An online nominal group technique consensus meeting with 7 patients who received radiotherapy exceeding 10 min for one of three anatomical cancer sites and 3 therapeutic radiographers (TRs) participated. Four activities were undertaken: 1) discussion of comfort intervention components; 2) initial vote; 3) prioritisation of intervention components; and 4) discussion of feasibility in radiotherapy and were analysed using established quantitative and qualitative methods. ResultsOne intervention component was added from initial discussions to the 15 pre-determined components being discussed. 11 components were recommended as ‘accepted’ (n = 5) or ‘accepted with caution’ (n = 6) to proceed to development. The highest scoring intervention components were ‘Compassionate & empathetic communication training for TRs’ and ‘Tailored information, e.g., TRs provide the required information only as part of preparation for treatment’. Anther that followed closely was ‘Adjustments & supports provided for arms or legs during treatment by TRs’. Those ‘accepted with caution’ included ‘Soft pads/mattress under the body to alleviate body discomfort managed by TRs’. Qualitative analysis highlighted concerns over the radiation environment and emphasised the importance of resources such as equipment, training, and time. ConclusionThe recommended comfort interventions have potential to improve patient comfort during radiotherapy and should be considered to incorporate into positioning and immobilisation guidelines. However, specific intervention strategies to address these components will need to be developed and robustly evaluated. Implications for practiceComfort interventions might help patients relax and stay still during treatment, which could improve treatment accuracy and efficacy. Introducing these comfort interventions in practice have potential to lead to a more positive patient experience and improved overall quality of care during radiotherapy.

A multicentric, single arm, prospective, stratified clinical investigation to evaluate MammoWave's ability in breast lesions detection.

Microwave imaging is a safe and promising new technology in breast radiology, avoiding discomfort of breast compression and usage of ionizing radiation. This paper presents the first prospective microwave breast imaging study during which both symptomatic and asymptomatic subjects were recruited. Specifically, a prospective multicentre international clinical trial was performed in 2020-2021, to investigate the capability of a microwave imaging device (MammoWave) in allowing distinction between breasts with no radiological finding (NF) and breasts with radiological findings (WF), i.e., with benign or malignant lesions. Each breast scan was performed with the volunteers lying on a dedicated examination table in a comfortable prone position. MammoWave output was compared to reference standard (i.e., radiologic study obtained within the last month and integrated with histological one if available and deemed necessary by responsible investigator) to classify breasts into NF/WF categories. MammoWave output consists of a selection of microwave images' features (determined prior to trials' start), which allow distinction between NF and WF breasts (using statistical significance p<0.05). 353 women were enrolled in the study (mean age 51 years ± 12 [SD], minimum age 19, maximum age 78); MammoWave data from the first 15 women of each site, all with NF breasts, were used for calibration. Following central assessor evaluation, 111 NF (48 dense) and 272 WF (136 dense) breasts were used for comparison with MammoWave output. 272 WF comprised 182 benign findings and 90 malignant histology-confirmed cancer. A sensitivity of 82.3% was achieved (95%CI: 0.78-0.87); sensitivity is maintained when limiting the investigation to histology-confirmed breasts cancer only (90 histology-confirmed breasts cancer have been included in this analysis, having sizes ranging from 3 mm to 60 mm). Specificity value of approximately 50% was achieved as expected, since thresholds were calculated (for each feature) using median value obtained after recruiting the first 15 women (of each site), all NF. This prospective trial may represent another step for introducing microwave imaging into clinical practice, for helping in breast lesion identification in asymptomatic women.

A human-centered framework to update digital twins

Developing a digital twin (DT) involves establishing (1) a predictive capability (a model) relevant to the application, (2) means to collect data from the physical counterpart, and (3) means to apply the collected data to the model. Ideally, with these three goals achieved, long periods of steady-state use of the DT might be interrupted only by failure of the sensors used to collect data from the physical counterpart. In reality, however, it can be difficult to confirm that the DT system occupies this comfortable steady-state position. Assessing uncertainty in the predictive model, and ensuring the relevance of data collected from the physical counterpart are design-time activities with unclear termination points. Distinguishing sensed change in the physical counterpart from sensor failure is a persistent challenge. In this short paper we describe early work towards a human-centered framework to establish, refine, and update digital twins. Condition-based maintenance and gear backlash in production equipment are used as examples.

The efficacy of three-ball breathing apparatus exercise based on the concept of pulmonary rehabilitation in patients after lung cancer surgery

BackgroundPostoperative patients with lung cancer mostly experience different degrees of dyspnea and decreased activity tolerance, and these symptoms all significantly affect postoperative quality of life. The concept of pulmonary rehabilitation applicable to patients with chronic respiratory diseases is also applicable to patients with postoperative lung cancer. The current application of postoperative pulmonary rehabilitation for lung cancer is inconsistent, and reliable guidelines are lacking. The purpose of this study was to further verify the efficacy and feasibility of postoperative pulmonary rehabilitation for lung cancer patients, and to find a suitable local pulmonary rehabilitation program for postoperative patients with lung cancer that is clinically promoted in our department through this study.MethodsWe collected the clinical data of patients undergoing video-assisted thoracoscopic surgery (VATS) wedge resection or lobectomy. The patients were divided into rehabilitation group (using three-ball breathing apparatus after discharge) and control group (routine follow-up after discharge) according to whether the patients were trained with three-ball breathing apparatus after operation. The detailed method using three-ball apparatus is as follows. To begin with, patients are required to put themselves in a comfortable position. Then, after the three-ball breathing apparatus put on the same plane of their eyes, patients hold the tube in their mouth closely and control their breath slowly. When patients inhale to their largest extent, the balls will rise up accordingly. Then they exhale. The evaluation results of pulmonary function, activity tolerance, anxiety scores and others were collected. All data was gathered at the First Affiliated Hospital of Soochow University. The effects of pulmonary rehabilitation training on wedge resection and lobectomy were compared.ResultsA total of 210 patients were included in this study, including 126 patients with VATS wedge resection and 84 patients with VATS lobectomies. No discrepancy was noticed when FEV1 loss between two groups were compared in the wedge resection patients, and the same results were also shown in patients undergoing lobectomy (12.8% ± 2.0% vs. 12.7% ± 1.9%, P = 0.84, wedge resection; 12.6% ± 2.9% vs. 12.1% ± 1.8%, P = 0.37, lobectomy). The loss of FVC in the control group was greater than that in the rehabilitation group for patients undergoing lobectomy (11.7% ± 5.2%, vs. 17.1% ± 5.6%, P < 0.001, lobectomy). No difference was found in the wedge resection patients between the control and rehabilitation groups (6.6% ± 2.8%, vs. 6.4% ± 3.2%, P = 0.76, lobectomy). Moreover, all patients showed no significant difference in 6MWD regardless of surgical procedure and with or without breathing exercises at T3 (392.6 ± 50.6 m, rehabilitation group vs. 394.0 ± 46.6 m, control group. P = 0.87, wedge resection; 381.3 ± 38.9 m, rehabilitation group vs. 369.1 ± 49.3 m, control group. P = 0.21, lobectomy).ConclusionsFor patients after thoracoscopic pulmonary wedge resection, the use of three-ball apparatus did not significantly improve postoperative pulmonary function and activity tolerance, dyspnea, and anxiety symptoms. In patients after thoracoscopic lobectomy, respiratory trainers were able to improve postoperative lung function but were unable to significantly improve dyspnea and anxiety symptoms. There was a significant benefit for the use of three-ball apparatus in patients after thoracoscopic lobectomy, whereas there was no significant benefit for the use of respiratory trainers after wedge resection.Registry: Medical Ethics Committee of the First Affiliated Hospital of Soochow University. Registration number: no. 2022455.

Grip selection without tool knowledge: end-state comfort effect in familiar and novel tool use.

A well-known phenomenon for the study of movement planning is the end-state comfort (ESC) effect: When they reach and grasp tools, individuals tend to adopt uncomfortable initial hand postures if that allows a subsequent comfortable final posture. In the context of tool use, this effect is modulated by tool orientation, task goal, and cooperation. However, the cognitive bases of the ESC effect remain unclear. The goal of this study was to determine the contribution of semantic tool knowledge and technical reasoning to movement planning, by testing whether the ESC effect typically observed with familiar tools would also be observed with novel tools. Twenty-six participants were asked to reach and grasp familiar and novel tools under varying conditions (i.e., tool's handle downward vs. upward; tool transport vs. use; solo vs. cooperation). In our findings, the effects of tool orientation, task goal and cooperation were replicated with novel tools. It follows that semantic tool knowledge is not critical for the ESC effect to occur. In fact, we found an "habitual" effect: Participant adopted uncomfortable grips with familiar tools even when it was not necessary (i.e., to transport them), probably because of the interference of habitual movement programming with actual movement programming. A cognitive view of movement planning is proposed, according to which goal comprehension (1) may rely on semantic tool knowledge, technical reasoning, and/or social skills, (2) defines end-state configuration, which in turn (3) calibrates beginning-state comfort and hence the occurrence of the ESC effect.

Parental holding to manage children’s anxiety with venipuncture: experiences from Qatar

ABSTRACT Objective The purpose of this randomized control trial with a pretest-posttest design was to compare the outcomes in one group of children (n = 56) being held upright in a comfortable position by a parent or family member during venipuncture procedures, with the second group of children (n = 51) lying flat (supine) on an exam table or bed. Material and Methods The three outcomes in both groups were: (a) The children’s behavior before, during, and after the venipuncture procedure using the distress scores measured with the Procedure Behavior Rating Scale (PBRS-R); (b) parent-reported satisfaction; (c) Nurses rated their satisfaction with the child’s position and reported the attempted number of needle-pricking attempts. Results The comfort position was more successful than the supine position in reducing the distress of venipuncture procedures. The satisfaction levels of the nurses and parents measured with quantitative and qualitative methods were contradictory. The number of needle-pricking attempts was not higher when using the comfort position. Conclusion Observational measurement found children less distressed in comfort than in the supine position. Responses to open-ended questions also suggested that the nurses and parents preferred the comfort position.

Canine gastrointestinal parasites perceptions, practices, and behaviours: A survey of dog owners in Australia

Many species of canine gastrointestinal (GI) parasites are known to be zoonotic meaning that dog owners' management and practices are key to preventing exposure of humans and dogs as well as contamination of the environment. As Australia has one of the highest rates of pet ownership in the world, we administered an online questionnaire to dog owners across the nation to assess their perceptions, practices, and behaviours towards canine GI parasites. Descriptive analysis was performed to summarise perceptions and management practices. Factors associated with the suitability of parasiticide treatments applied were investigated using uni- and multivariable ordinal regression. Just over a half of dog owners considered parasites as very or extremely important for their dog's health (59%) and less than a half as very or extremely important for human health (46%). Although the majority of dog owners stated that they deworm their dogs (90%), only the 28% followed best practice guidelines, i.e. administered a monthly prophylactic treatment all-year round. A large proportion of respondent dog owners administered prophylactic treatment at an inappropriate frequency (48%) or did not treat for canine GI parasites at all (24%).Attending vet visits at least once a year or once every six months and having a very comfortable or prosperous financial position were significantly associated with following best deworming prophylaxis guidelines. This study demonstrates that a proportion of dog owners in Australia is not complying with best practice regarding the control of canine GI parasites and is potentially exposing themselves and their dogs to the risk of infections. Veterinarians are called to implement dog owner's education, raise their awareness on the threats canine parasitic diseases pose to both dogs and humans and finally, encourage them to follow a monthly prophylactic treatment for canine GI parasites all year round.

Nursing Experience of Using Caring Theory in Caring for an Patient in Isolation Facing Bereavement

A nursing experience using caring theory to care for the grief experienced by a patient with COVID-19 during their period of isolation from June 4 to June 15, 2021 is described in this article. The patient was assessed using physical, psychological, social, and spiritual framework assessments. Data were collected using care, observation, interviews, and medical records. The healthcare problems were identified as inefficient breathing patterns, anxiety, and grief. The patient transmitted COVID-19 to her father, who subsequently died of related respiratory failure. During the nursing process, we used a mobile application (app) to provide the patient with information about novel coronavirus pneumonia to relieve her anxiety. When the patient was physically unwell, we delivered drugs and oxygen, and provided comfortable prone position and breathing training to resolve her low-efficiency breathing patterns. Also, we cooperated with the psychological and spiritual team to resolve the patient's psychological problems, used hand-painted illustrations and words to provide encouragement, and provided information on the hospital's funeral services provider to help complete her father's funeral arrangements to reduce her sense of grief. It is suggested that, in the clinical care of similar patients, nurses should pay more attention to their psychological problems. In addition, nurses may use the concepts of caring theory to integrate a holistic approach, provide patient-specific resources, and accompanying the patient through the process of grief. This nursing experience may be used as a reference in the future care of similar patients to improve the quality of clinical nursing care.

Antenatal cardiotocography in primary midwife-led care: Women's satisfaction.

In the Netherlands, antenatal cardiotocography (aCTG), used to assess fetal well-being, is performed in obstetrician-led care. To improve continuity of care, an innovation project was designed wherein primary care midwives perform aCTGs for specific indications. The aim of this study was to examine the satisfaction and experiences of pregnant women who received an aCTG in primary midwife-led care and explore which factors were associated with high satisfaction. Data were collected through a self-administered questionnaire based on the Consumer Quality Index. The primary outcome was general satisfaction on a 10-point scale, with a score above nine indicating participants were "highly satisfied". In total, 1227 women were included in the analysis. The study showed a mean general satisfaction score of 9.2. Most women were highly satisfied with receiving an aCTG in primary midwife-led care (77.4%). On the Consumer Quality Index, the mean satisfaction level varied from 3.98 (SD ± 0.11) for the subscale "client satisfaction" to 3.87 (SD ± 0.32) for the subscale "information provision" on a 4-point scale. Women at between 33 and 36 weeks' gestation were more likely to be highly satisfied (adjusted OR [aOR] = 3.35). Compared with a completely comfortable position during the aCTG, a mostly comfortable or somewhat comfortable level had decreased odds of being associated with a ranking of highly satisfied (aOR 0.24 and 0.19, respectively). This study shows that pregnant women are satisfied with having an aCTG in midwife-led care. Providing aCTG in midwife-led care can increase access to continuity of care.

Assessing the effects of sway-back posture on global and regional spinal sagittal angles using inertial measurement units.

Sway-back posture in the sagittal profile is a commonly adopted poor standing posture. Although the terms, definitions, and adverse health problems of sway-back posture are widely used clinically, few studies have quantified sway-back posture. To investigate spinal sagittal alignment in sway-back posture while standing based on global and regional angles using inertial measurement units (IMUs). This cross-sectional study recruited 30 asymptomatic young adults. After measuring the sway angle while standing, the participants were divided into sway-back and non-sway-back groups (normal thoracic group). Each participant stood in a comfortable posture for 5 seconds with IMUs at the T1, T7, T12, L3, and S2 levels. Then, we measured the global and regional lumbar and thoracic angles and sacral inclination in the standing position. Although there was no difference in the global lumbar angle, there was a difference in regional lumbar angles between the two groups. The normal thoracic group had balanced lumbar lordosis between the upper and lower lordotic arcs, whereas the sway back group tended to have a flat upper lumbar angle and increased lower lumbar angle. It is useful to assess the global and regional angles in the spinal sagittal assessment of individuals with sway-back posture.

Experiences of maintaining awake prone positioning in non-intubated patients with COVID-19: A qualitative study.

Patient compliance is crucial to maintaining the awake prone position, which has been found to be intolerable by several patients. Addressing patients' compliance while being treated with awake prone positioning and prolonging its duration may be prerequisites for further research. This study was conducted to explore the personal experiences of non-intubated patients during the implementation of awake prone positioning. We conducted a qualitative study recruiting a purposive sample of twelve adult patients diagnosed with COVID-19 who were previously treated with awake prone positioning. They were recruited from an intermediate care unit (that provides pre- and post-intensive care) in a COVID-19-designated hospital in Nanjing, China from July 15, 2021, to September 20, 2021. Data were collected through individual in-depth interviews and then analysed using Colaizzi's phenomenological method. Content analysis of the interviews revealed two main themes, each containing three and four sub-themes, respectively, as follows: (1) barriers to the implementation of awake prone positioning, including (i) generalised discomfort, (ii) a lack of both understanding and trust, and (iii) low satisfaction with the implementation plan; (2) factors promoting the implementation of awake prone positioning, including (i) health education and supervision, (ii) self-motivation and support from healthcare staff and family members, (iii) finding a comfortable position and having access to entertainment, and (iv) symptom improvement. Healthcare staff should clarify the mechanism underlying the effectiveness of the awake prone position to patients to eliminate any doubts that they may have. Psychological support and appropriate supervision should be emphasised. Pain relief programmes should also be established, including the use of a comfortable prone posture in conjunction with access to entertainment. Finally, individualised awake prone positioning protocols should be formulated according to patients' living habits and attempted in combination with out-of-bed activities. These measures may help to enhance the experience and compliance of patients undergoing the treatment. For future instances involving the implementation of awake prone positioning, several measures should be established and implemented alongside it, including a health education programme, supervision programme, support system, and pain relief programme. Personalisation should also be considered during its implementation. These measures may help to enhance the compliance of patients and prolong the duration of the awake prone position.