Discomfort Factors Research Articles

What's the Impact of Safety Footwear on Workers Concerning Foot-Related Problems? A Systematic Review.

This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle-Ottawa Scale. Descriptive statistic was used to present data. The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal-toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.

Application of Hot Pack and Stretching Exercise In Treating Chronic Neck Pain Among University Students

Neck pain has a complicated etiology and is thought to arise from a biopsychosocial issue. Previous studies have identified a number of risk factors for neck discomfort, including gender, age, a greater BMI, smoking, excessive use of electronic devices, uncomfortable or prolonged positions, a lack of physical activity, negative emotional states, and a lack of social support.

Teacher’s attitudes

Teachers’ positive interactions with people with disabilities improve their awareness and advocacy for inclusion, which is an important policy and community goal worldwide. Therefore, to guide and shape inclusive efforts in Angola as well as to promote advances in research related to measurement of attitudes we conducted a study to analyzed the factor structure, validity, and reliability of the Interaction with People with Disability Scale (IDPS) for a sample of 1352 elementary teachers. Results of an exploratory factorial analysis showed a solution with factors of discomfort, coping, and vulnerability explaining 64.29% of the variance. A confirmatory factorial analysis suggested a model with good fit and convergent validity for discomfort and coping, and good evidence of discriminate validity for the three factors. We discussed and concluded with how this results and how exploring attitudes towards people with disabilities with the IDPS can be useful when promoting activities for teachers training in inclusive education.

Evaluating the surgical trainee ergonomic experience during minimally invasive abdominal surgery (ESTEEMA study)

Minimally invasive abdominal surgery (MAS) can exert a physical cost. Surgical trainees spend years assisting minimally-invasive surgeries, increasing the risk of workplace injury. This prospective questionnaire-based cohort study was conducted amongst general surgery residents in Singapore. Residents assisting major MAS surgery were invited to complete anonymous online survey forms after surgery. The Phase 1 survey assessed physical discomfort scores and risk factors. Intraoperative measures to improve ergonomics were administered and evaluated in Phase 2. During Phase 1 (October 2021 to April 2022), physical discomfort was reported in at least one body part in 82.6% (n = 38) of respondents. Over a third of respondents reported severe discomfort in at least one body part (n = 17, 37.0%). Extremes of height, training seniority, longer surgical duration and operative complexity were significant risk factors for greater physical discomfort. In Phase 2 (October 2022 to February 2023), the overall rate of physical symptoms and severe discomfort improved to 81.3% (n = 52) and 34.4% (n = 22) respectively. The ergonomic measure most found useful was having separate television monitors for the primary surgeon and assistants, followed by intraoperative feedback on television monitor angle or position. Close to 20% of survey respondents felt that surgeon education was likely to improve physical discomfort.

Percepción del confort en el paciente crítico desde el modelo teórico de Kolcaba

BackgroundThe stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ). ObjectivesTo determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors. MethodsCross-sectional descriptive observational prospective study. Population: 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16. ResultsThe mean age was 52.62 (16.21), 357 (61.6%) were male and 434 (74.8%) were believers. The type of admission was planned in 322 (55.5%) and the most prevalent reason for admission was surgical 486 (83.8%). The median pain score (NRS) was 3.00 [0-4] and severity score (APACHE II) was 13.26 (5.89), the median length of stay was 4.00 [2-7] days. The mean comfort level was 3.02 (0.31) showing the highest value for the Reanimation Unit 3.02 (0.30) and the lowest fort the Emergency and Trauma Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (P=.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (P=.000) OR: 4.361; IC: 2.184-8.707, mild pain (P=.000) OR: 4.007; IC: 2.068-7.763, moderate pain (P=.007) OR: 2.803; IC: 1.328-5.913, and the APACHE II score equal to or greater than 10 (P=.000) OR: 0.472; IC: 0.316-0.705. ConclusionsThe comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.

Unipolar and Bipolar Depressed Inpatients: correlations with Vitamin D and Cognitive Symptoms

Introduction Cognitive symptoms are the main factor of discomfort in depressed patients, persisting even during clinical remission (Conradi et al. Psychol Med 2011;41:1165-74) and inevitably compromising their quality of life (Fehnel et al. CNS Spectr 2013;25:1-10). Several studies have suggested the neuroprotective role of vitamin D, both through actions on the genome and rapid non-genomic mechanisms; so, low serum vitamin D levels are related to poorer cognitive performance (Goodwill et al. JAGS 2017;2:1-8), depressive disorders (Kjærgaard et al. Psyc Res 2011;190:221-225) and suicide risk (Umhau et al. PLoS One 2013;8:e51543).Objectivesto investigate relationships between serum vitamin D levels, depressive symptoms and cognitive performance in unipolar and bipolar depressed adults hospitalized for Major Depressive Episode (MDE).Methods80 patients (34 M and 46 F; average age 48,96±14,17 years; 40% with bipolar depression) were examined. Depression was investigated using Hamilton Rating Scale for Depression (HAM-D), while cognitive functions were explored by: Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure (ROCF) to assess verbal and visuospatial memory, respectively; Trail Making Test (TMT) and Stroop Color and Word Test to assess attention, spatial planning and cognitive flexibility. Venous blood sampling was used to determine serum Vitamin D levels (average level 15,67 ± 8,7 ng/ml).Results At first, the serum level of vitamin D was found to be inversely correlated with HAM-D scores (p=0,0079), so that lower concentrations of vitamin D is related to greater severity of depression. In addiction, there were strongly significative positive correlations between low vitamin D levels and poorer RAVLT and ROCF scores and strongly significative negative correlations between vitamin serum level and higher scores in TMT and STROOP test, so that calcidiol deficit is associated with poor cognitive performance. Similarly, patients with higher HAM-D scores were found to have a greater cognitive impairment (lower RAVLT e ROCF scores and higher TMT e STROOP scores).Conclusions In accordance with previous works, our study supports the close relationship between serum vitamin D levels and depressive morbidity. During MDE hypovitaminosis D is related to worse disease indices, such as severity of affective symptoms and cognitive impairment, without substantial differences between clinical manifestations of unipolar and bipolar depression, both in terms of affective and cognitive symptoms and disease severity. Considering that cognitive deficits are truly disabling because they may resist to common antidepressant treatments and, as a result, persist during stages of clinical remission, vitamin d supplementation, by minimizing cognitive dysfunction, could be a good strategy to reduce the risk of relapses and to improve patients’ functioning and quality of life.Disclosure of InterestNone Declared

Analysis of Thermal Comfort Among Workshop Users: At TVET Technical Institution

Thermal comfort is a part of indoor environmental quality that should be considered to ensure the occupants' well-being. Unconducive buildings not only bring occupants discomfort but also tend to affect health, disrupt the process of teaching and learning, and reduce work productivity. Thus, this study determines the thermal condition of existing workshop buildings used in Technical and Vocational Education and Training (TVET) implementation. ASHRAE Standard 55 (2017) is referred to in the determination of thermal comfort involving objective measurements and subjective measurements. Observation methods of environmental variables such as air temperature, radiant temperature, air velocity, relative humidity is observed. Evaluations of comfort are based on occupant surveys and environmental measurements. A total of 257 people completed a questionnaire distributed at three technical institutions in Kedah, Malaysia. According to the findings, the average thermal sensation vote is 1.85, which leads to 66.5% of respondents feeling discomfort. Meanwhile, the adaptive model analysis showed that the workshop environmental conditions were out of the comfort zone and did not comply with the ASHRAE 55 standard. Hence, the thermal discomfort factors from the occupants' perspective were identified and widely discussed. As a result, the research findings will benefit parties involved in new building construction or existing building renovations to improve indoor air quality.

Evaluation of Postoperative Discomfort After Strabismus Surgery Under General Anesthesia in Children: A Prospective Observational Study.

Strabismus surgery is most commonly performed on children under general anesthesia. However, few studies have focused on the postoperative discomfort in children after strabismus surgery. This study aimed to evaluate postoperative discomfort and the associated risk factors in children who underwent strabismus surgery under general anesthesia. A single-center prospective observational study including 300 children who underwent strabismus surgery after general anesthesia was conducted. Patients' characteristics, preoperative anxiety, surgical and anesthesia data, discomfort within 24 hours after postanesthesia care unit were recorded. The primary outcome was the incidence of postoperative discomfort. Approximately 51.33% of the children complained of at least one of the following types of postoperative discomfort: postoperative nausea and vomiting (PONV) (23.00%), headache (4.33%), dizziness (20.33%) and emergence agitation (EA) (5.33%). Multivariate analysis indicated that history of motion sickness (P<0.001, odds ratio [OR]=3.72), and surgery in the dominant eye (P=0.010, OR=2.00) were independent predictors of postoperative discomfort; age was an independent predictor of EA (P<0.001, OR=0.36); prism diopter≥40 was an independent predictor of headache (P=0.005, OR=5.53); age (P=0.020, OR=1.12) and history of motion sickness (P=0.001, OR=2.80) were independent predictors of dizziness; history of motion sickness (P=0.001, OR=2.63) and surgery of inferior oblique anterior transposition (IOAT) (P=0.004, OR=3.10) were independent predictors of PONV. The most frequent postoperative symptoms in children after undergoing strabismus surgery under general anesthesia are PONV, dizziness, EA, and headache. Younger age, larger angle of strabismus, history of motion sickness, surgery on the dominant eye, and surgery of IOAT may be additional risk factors for postoperative discomfort.

The Role of Optimism and Discomfort in Increasing Innovation in Village Operators in Bondowoso Regency

Discoveries and advances in the fields of communication, computer and internet technology have opened up new opportunities and encouraged the development of innovation in various sectors. This research aims to analyze the influence of optimism and discomfort on innovation among village operators in Bondowoso Regency. This research uses the Diffusion of Innovation theory, Cognitive Dissonance Theory, and Digital Natives Theory to analyze the relationship between the variables in the research. The population of this research is all 209 village operators in Bondowoso Regency, all of whom were used as research samples. The research results show that optimism and discomfort have a positive and significant effect on innovation in village operators in Bondowoso Regency, partially or simultaneously. These findings can help the Bondowoso Regency Community and Village Empowerment Service in increasing innovation achievements by paying attention to optimism and discomfort factors in village operators. This research also makes a significant contribution to filling the knowledge gap in this area. Future research is recommended to explore more deeply the context and population characteristics that can influence the influence of optimism and discomfort on innovation. Further exploration into the moderating and mediating factors that may influence this relationship could also be a valuable research direction.

노인의 인지기능과 삶의 만족도 관계에서 구강건강관련 요인의 매개효과

Objective: This study was conducted to analyze the mediating effect of oral health factors in the relationship between cognitive function and life satisfaction in the elderly. Methods: This study analyzed 6,169 elderly people aged 60 years or older described in the 8th Korean Longitudinal Study on Aging (2020). The oral health factors of the elderly were divided into 'functional dimension factors,' 'psychosocial dimension factors,' and 'pain or discomfort factors' of the Geriatric Oral Health Assessment Index (GOHAI). To determine the mediating effect of each factor, a path analysis was conducted using Mplus 8.4. Results: Between cognitive function and life satisfaction, among the oral health factors in the elderly, the functional dimension factor showed the largest partial mediating effect at 23% (β = 0.207, 95% confidence interval; CI = 0.169, 0.207). The psychosocial dimension factor was 22% (β = 0.202, 95% CI = 0.171, 0.236), and the pain and discomfort factor was 16% (β = 0.146, 95% CI = 0.119, 0.175), showing a partial mediating effect. Conclusions: The influence of three oral health-related factors on cognitive function and life satisfaction was confirmed. Therefore, it is necessary to consider the cognitive level of the elderly and identify oral health factors in detail. Accordingly, it is necessary to establish a personalized rehabilitation treatment access strategy and increase the life satisfaction of the elderly.

Patients' recollections of helmet-CPAP treatment during COVID-19 pandemic: A qualitative study.

During the pandemic outbreak, helmet continuous positive airway pressure (CPAP) was widely used as respiratory support for COVID-19 patients, inside and outside of intensive care units. The available literature suggests specific interventions to improve the comfort of patients treated with helmet-CPAP. Few reports are available on the experiences of patients undergoing this treatment. This qualitative study aimed to explore the views and recollections of COVID-19 patients undergoing helmet-CPAP. We conducted semi-structured interviews with thematic analysis. Participants were recruited from the follow-up programme for COVID-19 patients discharged from an Italian general intensive care unit. Participants were interviewed by telephone. Data analysis followed the principles of thematic synthesis approach. We conducted 29 phone calls in patients eligible for the study. Five participants declared that they did not remember the time spent in hospital on helmet-CPAP. Twenty-four patients were then included. Two themes and six subthemes were generated from their interview data: (1) The helmet-CPAP as a life-saving treatment (subthemes: recognition of the usefulness of treatment and resilience); (2) the negative feelings related to helmet-CPAP application (subthemes: communication problems, entrapment, mental confusion, fear of dying). Each patient's experience was unique, but some discomfort elements such as noise, gas flow turbulence, choking sensation and thirst were found to be very common. The application of helmet-CPAP treatment generated positive and negative memories and feelings in COVID-19 patients during the pandemic. The patients' experience has provided an overview of the main factors of discomfort. This can be a starting point for taking corrective measures to promote greater helmet tolerance and subsequent treatment success. This study has provided an insight into the patient's recollections about helmet-CPAP treatment during a worldwide pandemic. The findings suggested strict applications of interventions aimed to reduce some issues that participants reported, to improve their compliance to treatment. Results from this study could help nurses in understanding the needs of patients treated with helmet-CPAP and may foster a care focused on patient-centred outcomes.

Postoperative throat discomfort and associated factors among surgical patients at Ethiopian Teaching Hospitals: cross-sectional study

BackgroundThroat pain and airway discomfort are the most commonly upsetting conditions for patients’ wellbeing after surgery. However, little is known about the problem and associated factors, especially in developing countries like Ethiopia. Therefore, this work determined the magnitude, severity, and associated factors of throat discomfort within 24 h after elective surgery.ResultsThe majority (63.2%, or 211) of the participants were female, with a mean age of 35.7 ± 9.7 years. The overall postoperative throat discomfort was observed in 122 (36.5%) patients, and it was severe in 20.5% of them. However, the severity level declined over time to 21.9% (21/96), 15.3% (18/118), and 5.6% (5/89), respectively, on the 1st, 6th, and 24th hours, as indicated by participants. Utilization of a larger ETT (AOR = 6.26, CI 2.13–18.43, P = 0.001), surgery lasting two or more hours (AOR = 11.20, CI 3.53–35.50, P = 0.000), awake extubation (AOR = 0.16, CI 0.05–0.43 P = 0.000), frequent episodes of hypotension (AOR = 12.85, CI 4.56–36.18, P = 0.000), and a less experienced anesthetist (AOR = 18.10, CI 6.51–50.31, P = 0.000) were significantly associated with throat discomfort.ConclusionsPost-extubation throat discomfort complaints are high (36.5%). Due attention has to be given to minimize or prevent perioperative frequent episodes of hypotension, higher ETT size utilization, blood loss, and the duration of surgery as much as possible. Postoperative throat discomfort should not be ignored. And we recommend that patient reassurance and orientation with analgesia has to be considered during the postoperative period.

SDMS CME Credit – Cross-disciplinary Prevalence and Associated Factors for Work-Related Discomfort in Users of Ultrasonography: Implications for Sonography Professionals and Health Care Administrators

SDMS CME Credit – Cross-disciplinary Prevalence and Associated Factors for Work-Related Discomfort in Users of Ultrasonography: Implications for Sonography Professionals and Health Care Administrators

A survey on the degree of eye discomfort caused by video terminal use among college students in different altitudes

ObjectiveTo analyze the risk factors associated with different levels of eye discomfort due to video terminal use among college students at different altitudes.MethodsThis cross-sectional study was conducted to assess the prevalence and extent of eye discomfort by distributing an questionnaire to university students via the Internet. To analyze the causes and risk factors of eye discomfort among college students at different altitudes after using video terminals.ResultsA total of 647 participants who met the criteria were included in this survey, of whom 292 (45.1%) were males and 355 (54.9%) were females. The results of the survey showed 194 (30.0%) participants without eye discomfort and 453 (70.0%) participants with eye discomfort. The results of the univariate comparison of the degree of eye discomfort in the study subjects with different characteristics showed that the differences in the degree of eye discomfort were statistically significant (P < 0.05) for the 7 groups of indicators: gender, region, wearing corneal contact lenses for more than 2 h per day, frequent use of eye drops, sleep time, total time of VDT use per day, and total time per VDT use, while the remaining indicators, including age, profession, and whether refractive surgery or other eye surgery was performed, whether frame glasses were worn for a long time, and duration of daily mask wear were not statistically significant. The results of multi-factor logistic analysis of the degree of eye discomfort in the study subjects with different characteristics showed that gender, region, frequent use of eye drops, sleep time, and total time of VDT use per day were the risk factors affecting the degree of eye discomfort.ConclusionsFemale, high altitude, frequent use of eye drops, shorter daily sleep duration and longer daily VDT use were associated risk factors for the development of severe eye discomfort, where the severity of eye discomfort was significantly negatively correlated with increased sleep duration and significantly positively correlated with increased total time of VDT use.

The influencing factors of functional somatic discomfort in clinical nurses

Objective: To investigate the functional somatic discomfort status, and to analyze the effect of job stress, hostile attribution bias and ego depletion on functional somatic discomfort in clinical nurses. Methods: In May 2019, 10 cities in Henan Province and Fujian Province were randomly selected as sampling cities. Using the stratified cluster sampling method, nurses of clinical nursing posts in 22 third class hospitals and 23 second class hospitals were selected as the research objects. The general information, job stress, hostile attribution bias, ego depletion and functional somatic discomfort of clinical nurses were investigated by self-designed general information questionnaire, Perceived Stress Scale, Social Information Processing-attribution Bias Questionnaire, Self-regulatory Fatigue Scale, Patient Health Questionnaire-15. 1200 clinical nurses included, and a total of 1159 valid questionnaires were collected, the effective rate of questionnaire collection was 96.6%. The t test was used to compare the difference of the functional somatic discomfort scores of clinical nurses with different demographic characteristicst. The influence of job stress, hostile attribution bias and ego depletion on functional somatic discomfort of clinical nurses were analyzed with Bootstrap. Results: The functional somatic discomfort score of clinical nurses was (8.95±4.38), of which 859 (74.12%) had functional somatic discomfort symptom. The functional somatic discomfort score of clinical nurses aged 36-50 years old was higher than that of 19-35 years old, the functional somatic discomfort score of clinical nurses with service age ≥5 years was higher than that of <5 years, the functional somatic discomfort score of non-permanent clinical nurses was higher than that of permanent clinical nurses, the functional somatic discomfort score of clinical nurses in tertiary hospitals was higher than that of secondary hospitals, the functional somatic discomfort score of clinical nurses in surgical departments were higher than those in non-surgical departments, and the differences were statistically significant (P<0.05). Job stress affected functional somatic discomfort through the single mediating role of hostile attribution bias, the single mediating role of ego depletion, and the chain mediating role of hostile attribution bias and ego depletion (β=0.17, 95%CI: 0.10-0.20; β=0.16, 95%CI: 0.10-0.20; β=0.07, 95%CI: 0.03-0.10; P<0.05) . Conclusion: The functional somatic discomfort symptoms of clinical nurses are significant and varied among different age, working age, employment form, hospital grade and department groups. They are affected by work stress directly and through the separate mediating effect of hostile attribution bias and ego depletion, and the chain mediating effect of hostile attribution bias and ego depletion.

A Prospective Study of Thermal Comfort in Users in Technical Institution TVET: Workshop Facilities Space

Thermal comfort is a part of indoor environmental quality that should be considered to ensure the occupants' well-being. Unconducive buildings not only bring occupants discomfort but also tend to affect health, disrupt the process of teaching and learning, and reduce work productivity. Thus, this study determines the thermal condition of existing workshop buildings used in Technical and Vocational Education and Training (TVET) implementation. Evaluations of comfort are based on occupant surveys and environmental measurements. A total of 257 people completed a questionnaire distributed at three technical institutions in Kedah, Malaysia. According to the findings, the average thermal sensation vote is 1.85, which leads to 66.5% of respondents feeling discomfort. Meanwhile, the adaptive model analysis showed that the workshop environmental conditions were out of the comfort zone and did not comply with the ASHRAE 55 standard. Hence, the thermal discomfort factors from the occupants' perspective were identified and widely discussed. As a result, the research findings will benefit parties involved in new building construction or existing building renovations to improve indoor air quality.

Cross-disciplinary Prevalence and Associated Factors for Work-Related Discomfort in Users of Ultrasonography: Implications for Sonography Professionals and Health Care Administrators

Objective: Work-related discomfort is a pervasive issue among ultrasonography users. The Sonography Work Systems (SWS) framework was constructed as a means of examining relationships within and across components of the sonography work systems, work processes, and work/worker outcomes. A database of ultrasonography users was established as a foundation for a longitudinal survey study to examine worker health and well-being and explore the most salient work systems and process factors associated with work-related discomfort. Materials and Methods: An estimated 100 000 unique ultrasonography users were invited to complete the online questionnaire through an e-mail campaign. Snowball sampling occurred through social media posts and encouragement for respondents to share the survey link with colleagues. The questionnaire included items that examined participant demographics, selected constructs from the SWS, and the prevalence of work-related musculoskeletal discomfort, visual discomfort, and headaches. Individual and multi-factorial regression models were conducted to examine SWS factors associated with the likelihood of experiencing the three types of work-related discomfort. Results: A total of 3659 valid responses were included in the analysis, with 86% of respondents reporting that they regularly experienced musculoskeletal discomfort that they directly attributed to their work. About half (54.2%) of the respondents have engaged in sonography-related ergonomics training, and respondents indicated using adjustable equipment approximately 74% of the time. Workplace culture was rated as primarily positive, but respondents indicated that employers implement only two of seven commonly recommended ergonomic policies and procedures. Working in an organization with more policies, using adjustable equipment more frequently, taking more work breaks, engaging in a positive work culture, and minimizing interruptions to workflow were key factors associated with reduced likelihood of work-related discomfort. Conclusion: This study provides a new framework for examining and addressing factors that contribute to ultrasonography users’ experience of work-related discomfort. Despite increased participation in ergonomics training and the use of adjustable equipment, the prevalence of work-related discomfort remains high among ultrasonography users. The findings highlight the need for attention to be directed at organizational factors and work processes to identify and implement evidence-based solutions to improve the health and well-being of medical ultrasound users.

Spatial variability of diurnal temperature range and its associations with local climate zone, neighborhood environment and mortality in Los Angeles

Urbanization alters the Earth’s emissivity and leads to intraurban differences in temperature variations, including diurnal temperature range (DTR). Despite DTR as a factor of thermal discomfort and mortality risk worldwide, its spatial variability and intraurban associations with local climate zone (LCZ), neighborhood environment and mortality risk have not been investigated. This study first applied the LCZ framework to evaluate associations between climate-sensitive urban design and long-term DTR exposure in Los Angeles, a megacity with the largest DTR in the United States. Using fine-scale daytime and nighttime Landsat thermal imagery to quantify DTR, we found that compact low-rise areas had high DTR, high-rise areas with moderate DTR, and natural areas with the lowest. Young-age, non-white and low-income populations were vulnerable and exposed to high DTR. A spatial Bayesian Poisson regression confirmed that neighborhoods with higher DTR exhibited higher mortality risk after controlling for socioeconomic factors (relative risk: 1.047, 95% credibility interval 1.013–1.082). We did not observe a significant association between mean temperature and mortality in our study. As spatial variability of DTR induces heterogeneous exposure and the evidence that long-term DTR exposure is positively associated with mortality across neighborhoods, planners and policymakers should consider urban landscaping to mitigate large DTR for risk reduction.

Creating and Testing a Model to Predict Postoperative Discomfort in Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolisation

Background: Abdominal pain is a frequent adverse event in patients with hepatocellular carcinoma (HCC) after transarterial chemoembolisation (TACE). However, there remains uncertainty regarding the determinants of post-TACE pain. Objectives: We aimed to create and verify a prediction model for postoperative pain in patients with HCC after TACE treatment. Methods: This prospective study included all patients with HCC undergoing TACE in our hospital. According to the time of treatment, the dataset was divided into two cohorts (development and validation) in a 3: 2 ratio. After TACE, the participants used a visual analog scale to quantify their pain level at rest over a 24-hour period. The age, gender, tumor location, tumor size and number, medication administration route, and presence of portal vein tumor thrombosis (PVTT) were recorded in all patients. Results: In total, 137 (mean age: 60.3 ± 10.1 years; 78.1% male) and 91 (mean age: 61.1 ± 10.5 years; 73.6% male) patients were included in the development and validation cohorts, respectively. Furthermore, 46.0% and 39.6% of the patients experienced acute moderate to severe pain after TACE in the development and validation cohorts, respectively. The tumor location, the drug delivery method, and the presence of PVTT were independently associated with post-TACE pain, all of which were combined to develop a prediction model based on a logistic equation. The discrimination of this risk score was satisfactory in both the development (area under the curve (AUC): 0.693, 95% confidence interval (CI): 0.609 to 0.769, P &lt; 0.001) and validation (AUC: 0.652, 95% CI: 0.544 to 0.748, P = 0.002) cohorts. There was no significant difference between the two cohorts (difference: 0.042, 95% CI: -0.081 to 0.164, P = 0.506). The risk score had good specificity for predicting post-TACE pain in both the development (83.8% (95% CI: 73.4% to 91.3%)) and validation (76.4% (95% CI: 63.0% to 86.8%)) cohorts. Conclusions: The presence of PVTT, the tumor location, and the drug administration method were risk factors for post-TACE discomfort. A prediction model based on these risk factors was useful for identifying patients who were vulnerable to post-TACE pain. However, further studies are required to validate these findings and optimize the model’s performance.

Multimodal perioperative management programme on postoperative discomfort among clients undergoing abdominal surgery at a selected hospital in Mangaluru

Introduction and Aim: Apart from pain, numerous causes contribute to discomfort during the postoperative period. Hence, early postoperative nursing care should focus on reducing this discomfort. The present study aimed to find the effect of a management programme on postoperative discomfort (MPMP) among patients undergoing abdominal surgery. Materials and Methods: This quasi-experimental study was conducted in a selected tertiary care hospital and included 183 adult patients who underwent laparotomy. The MPMP includes preoperative education, early ambulation, deep breathing exercises, and incentive spirometry. The participants were randomized into two interventional and one control group. The Intervention Group I patients performed deep breathing exercises and early ambulation after preoperative education, while Group II patients practiced incentive spirometry and early ambulation with preoperative education. The study included a control group who received routine nursing care. The primary outcome variable is postoperative discomfort (measured on days 1,3, and 5). Results: The MPMP showed a significant difference in discomfort factors like pain during day1(p=0.007) and days 3 and 5 (p&lt;0.001). Non-pain symptoms such as nausea, vomiting, movement restriction discomfort due to IV drips, and feeling cold showed higher significance for Groups I and II on days 3 and 5. Similarly, dry mouth, abdominal distension, and constipation showed a significant difference (p&lt;0.05) on days 3 and 5 between the groups at a 5% significance level. Conclusion: This study showed that postoperative discomforts could be minimized by the early practice of the MPMP program in patients undergoing surgery.