Discomfort Scale Research Articles

Vocal Sensory Symptoms, Vocal Fatigue and Vocal Habits in University Professors

To identify vocal sensory symptoms, vocal fatigue, and vocal habits, compare and correlate them in university professors who have passed or failed a screening related to vocal symptoms. Cross-sectional, quantitative, non-randomized study. The professors responded to four vocal self-assessment Patient-Reported Outcome Measures (PROM): the Brazilian validated version of the Voice Symptom Scale (VoiSS), the Brazilian version (not validated) of the Vocal Tract Discomfort Scale, the Brazilian validated version of the Vocal Fatigue Index and the validated version of the Vocal Health and Hygiene Questionnaire ("Questionário de Saúde e Higiene Vocal - QSHV," in Portuguese). After the PROM's application, the professors were divided into two groups from the VoiSS cutoff point. G1 was formed by professors who passed in the VoiSS screening, that is, those who achieved a total score below 16 points, and G2, formed by professors who failed, that is, those who achieved 16 points or more. The Mann-Whitney U test was used to compare the values of PROM between G1 and G2 groups, and the Spearman correlation test was used to correlate the PROM with one another. One hundred and two professors filled in the PROM, 23 from G1 and 79 from G2. Results showed that the total scores of all PROM used exceeded their cutoff scores in the overall sample. It was also observed that professors who failed the screening through VoiSS presented higher scores of vocal sensory symptoms and vocal fatigue, however no differences regarding knowledge on vocal health and hygiene were noticed. In G1, the protocols showed significant correlations ranging from moderate to very strong with one another, but the QSHV showed no correlation with any of the instruments. In G2, the protocols presented weak to strong correlation ratios, and the QSHV reported correlation with all protocols, except for Vocal Fatigue Index. University professors presented scores higher than the cut-off point suggested by the literature for vocal sensory symptoms, vocal fatigue and knowledge on vocal health and hygiene. Professors who failed the screening performed through VoiSS achieved higher scores of vocal discomfort and fatigue, but also presented a high score for knowledge on vocal hygiene. There was a moderate to very strong statistical correlation among the vocal symptoms, discomforts, vocal fatigue and vocal habits in professors who failed the screening through VoiSS, however among those professors who passed the screening, knowledge on vocal health and hygiene showed no correlation with the PROM analyzed.

Clinical application of collagen membrane with umbilical cord-derived mesenchymal stem cells to repair nasal septal perforation

Objective. We aimed to investigate the clinical efficacy of collagen membrane with umbilical cord-derived mesenchymal stem cells in the endoscopic repair of nasal septal perforation. Methods. We performed a prospective clinical trial between March 2017 and October 2019. Nasal septal perforations were repaired by the endoscopic sandwich technique with the collagen membrane and umbilical cord-derived mesenchymal stem cells. These patients were followed up postoperatively. Their outcomes were comprehensively evaluated by assessing the healing process of the perforations, the visual analog scale (VAS) for nasal discomfort, and the nasal mucociliary transit time (MTT) for the regenerated nasal mucosa. Results. Our study included a total of eight patients with nasal septal perforation (six males and two females, age 36.6 ± 12.8 years, diameter of perforation 1.0 ± 0.2 cm). Seven patients successfully underwent surgical repair. These patients had significantly improved VAS scores 1 month after the operations (1.1 ± 0.4) compared with the preoperative period (5.9 ± 0.7) (P < 0.05). Although the nasal MTT in the nasal septum and the inferior turbinate surface were within the normal limits before the operation and at 1 month after the operation, the postoperative transit time (11.1 ± 2.0 m) was significantly shorter than the preoperative transit time (12.1 ± 2.4 m) (P < 0.05). There were no recurrences of perforation, scab formations, or epistaxis after the operation. Conclusions. The application of the collagen membrane with umbilical cord-derived mesenchymal stem cells is a simple and feasible endoscopic procedure to repair perforated nasal septa and restore satisfactory functional mucosa.

Effect of Mathieson Laryngeal Manual Therapy in Patients With Muscle Tension Dysphonia After a Therapeutic Course

Introduction: This study aimed to investigate the effect of Mathieson Laryngeal Manual Therapy (MLMT) following a therapeutic course in patients with primary Muscle Tension Dysphonia (MTD). Materials and Methods: Twelve patients with primary MTD participated in this study. At first, videostroboscopy and perceptual voice assessment was performed, and the Persian version of Vocal Tract Discomfort (VTDp) scale was completed. After two and a half weeks that patients received no treatment, the assessments were repeated to evaluate the effect of spontaneous recovery. For studying the effect of MLMT, it was presented in five sessions. Then, all assessments were repeated. The frequency of supraglottic activity was elicited. For the perceptual evaluation and VTDp, the Wilcoxon nonparametric test was used to study and compare the effect of spontaneous recovery and MLMT. Results: After spontaneous recovery, a significant difference was observed only in strain (P&lt;0.05). After MLMT, the frequency of supraglottic activity decreased, and perceptual voice parameters significantly changed (P&lt;0.05), but the VTDp showed no significant difference (P&gt;0.05). There was no significant difference between spontanous recovery and MLMT based on the paerceptual voice evaluation and VTDp scale (P&gt;0.05). Conclusion: The MLMT can remarkably improve the supraglottic activity and perceptual characteristics of voice in primary MTD after a therapeutic course. Further studies are recommended to confirm the effectiveness of MLMT on decreasing VTD sensations.

The effects of using an ergonomic aid on the physical workload and body discomfort reported by pre-adolescent farmers in West Bengal, India

BACKGROUND: Musculoskeletal disorders are one of the major health hazards among farmers. Pre-adolescents are mainly associated with agricultural work due to poor socioeconomic conditions. OBJECTIVES: This study aims to implement a new ergonomics aid for the betterment of job procedures and improvement of productivity, health, and safety of the preadolescent farmers. METHODS: 100 male and 100 female preadolescent farmers were randomly selected from the villages of Tarakeswar, West Bengal, India, to evaluate and reduce work-related musculoskeletal disorders, physiological stress. Modified Nordic questionnaires, Body Part Discomfort (BPD) scale, and handgrip strength were assessed before and after using the ergonomics aid. RESULTS: The results of the study show that there was a significant change (decrease) in discomfort in the lower back, wrists, shoulder, and hands among preadolescent farmers when using the newly designed ergonomic aid. Handgrip strength increased and physiological stress was decreased among preadolescent farmers in post-intervention than pre-intervention in just after work conditions. Productivity has been increased in farming by decreasing absenteeism from work with the use of ergonomic aid. CONCLUSION: This study concludes that productivity has been increased in farming by decreasing absenteeism from work as well as by using the ergonomic aid the discomfort feeling has been decreased markedly.

Spiritual Education Program for Managing Emotions in Intellectually Gifted Children

ABSTRACT Educational interventions with the intellectually gifted are increasingly focusing on social-emotional learning and techniques. Spiritual education programs are gaining prominence in working with gifted children. This article reports a study examining the effect of a spiritual education program (SEP) in managing emotions of intellectually gifted children. Post-SEP scores of the intervention group on the Frustration Discomfort Scale (FDS) were lower than the control group. Intervention group children from African and South American cities as compared to those from Asian cities and the control group, intervention group gifted boys, Christians, and whose mothers were their primary caregivers, reported lower frustration discomfort posttest. Attendance at the SEP lessons and self-practice mediated the association between participants’ socio-demographic characteristics and outcomes. The principal component analyses supported the four-factor structure of the FDS and mean scores on emotional intolerance and achievement frustration subscales were lower. Results support the SEP as a social-emotional learning tool for gifted children.

EFFECTS OF SPORTS DRINK MOUTH RINSE ON CYCLING PERFORMANCE IN A WARM AND HUMID ENVIRONMENT AMONG JUNIOR CYCLISTS

The carbohydrate-electrolyte mouth rinse has been widely documented as one of the cooling strategies that attenuate the rise in core temperature and subsequently contribute to enhanced exercise performance. However, this is the first study investigating the effects of sports drink mouth rinse (100Plus® ) on trained junior cyclists during 15-min time trial performance in the warm-humid environment. This study aimed to investigate whether sports drink mouth-rinse (carbohydrateelectrolytes) conferred performance and thermoregulatory responses benefits while cycling in a hot and humid environment; and whether the timing (pre and during exercise) of rinses was of importance when compared with a control rinsing with plain water only. Eight male Kelantan state junior cyclists ages 17 ± 1.8 years old completed carbohydrate-electrolytes (100Plus® ) mouth rinse and control trial (plain water) during the fixed intensity cycling at 55% VO2max for 45-min and 15-min work-dependent selfpaced cycling time trial. Each cyclist rinsed his mouth with 25 ml bolus (100Plus® ) sports drink or plain water at every 15-min (15,30 and 45-min) for 10-second during the duration of fixed intensity cycling. Heart rate, rectal and skin temperatures, and Borg's rating of perceived exertion (RPE), thermal discomfort and sensation scale were recorded. Results showed that 100Plus® mouth rinse did not improve cycling performance in thermally stress and demonstrated a higher work completed in control (144.7 ± 15.8 kJ) compared to sports drink mouth-rinse (126.2 ± 20.2 kJ) trials. Thus, the most obvious finding from this study was that sports drink mouth-rinse before and during exercise were unable to improve exercise performance in a warm and humid environment.

Chilean validation of the frustration discomfort scale: relation between intolerance to frustration and discomfort and emotional intelligence

Chilean validation of the frustration discomfort scale: relation between intolerance to frustration and discomfort and emotional intelligence

Prevalence of Laryngopharyngeal Reflux Symptoms, Dysphonia, and Vocal Tract Discomfort in Amateur Choir Singers

IntroductionVocal tract discomfort (VTD), dysphonia, and laryngopharyngeal reflux (LPR) symptoms are complaints frequently reported by amateur singers. There are two aims of this study. The first is to evaluate the prevalence of these symptoms using validated questionnaires. The second is to correlate singing-related variables with the questionnaire responses. MethodsA total of 392 amateur choir singers (ACS) and 514 control subjects completed an online survey divided into four parts: (1) clinical and demographic characteristics, (2) training in singing and singing experience, (3) history of gastroesophageal reflux disease and LPR symptoms, (4) validated questionnaires. Specifically, the reflux symptom index (RSI), the vocal tract discomfort scale (VTDS), and the voice symptom scale (VoiSS) were included to analyze the actual burden related to LPR symptoms, VTD, and dysphonia. ResultsACS demonstrated a healthier lifestyle and a lower prevalence of gastroesophageal reflux disease symptoms in comparison with control subjects. ACS scored significantly higher in VTDS and VoiSS than control subjects, while no differences in the RSI results were found. Significant correlations among the questionnaires’ results were demonstrated. Occasional professional singing was the variable influencing VTDS and VoiSS results the most. ConclusionACS do not evidently manifest a higher impairment connected to LPR (RSI score), while they do report higher levels of voice (VoiSS score) and vocal tract (VTDS score) impairments, in comparison with control subjects. The relevant correlations among the PRO measures suggest that LPR symptoms, VTD, and dysphonia are related to each other. Given the relevant repercussion on the severity of VTD and dysphonia, providers should specifically ask about occasional professional singing when treating amateur singers.

O-136 Once-daily relugolix combination therapy results in sustained reduction in symptoms and improved quality of life in women with uterine fibroids treated over 52 weeks

Abstract Study question What is the effect of relugolix combination therapy (Relugolix-CT) on symptom burden and health-related quality-of-life (HR-QoL) in patients with uterine fibroids (UF) over 52 weeks? Summary answer Relugolix-CT demonstrated sustained, clinically meaningful improvement in patient-reported symptom severity and HR-QoL over 52 weeks in women with UF. What is known already In LIBERTY 1 and 2 randomized clinical trials, once-daily Relugolix-CT (40 mg relugolix, an oral gonadotropin-releasing hormone receptor antagonist, estradiol 1 mg, norethindrone acetate 0.5 mg) significantly reduced menstrual blood loss (MBL) and UF-associated pain versus placebo in women with UF and heavy menstrual bleeding (HMB), and was well tolerated, with bone mineral density (BMD) preservation through 24 weeks. In the LIBERTY long-term extension study, a sustained reduction in MBL was observed along with no new safety signals and BMD maintenance through 52 weeks. Relugolix-CT was previously shown to significantly improve patient-reported symptom severity and HR-QoL through 24 weeks. Study design, size, duration In the LIBERTY 1 and 2 studies, 770 premenopausal women with ultrasound-documented clinically significant UF and alkaline-hematin documented HMB were randomized 1:1:1 to Relugolix-CT for 24 weeks, relugolix 40 mg for 12 weeks followed by Relugolix-CT for 12 weeks, or placebo for 24 weeks. Women who completed the pivotal studies were eligible to enroll in the 28-week extension study (N = 477 enrolled). Patients included in the extension study received open-label once-daily Relugolix-CT. Participants/materials, setting, methods Changes from baseline to Weeks 24 and 52 in the Uterine Fibroid Symptom (UFS)-QoL symptom severity scale, Bleeding and Pelvic Discomfort scale (BPD; assessing distress due to HMB, passing blood clots, pelvic pressure/tightness); and HR-QoL (sub)scales were assessed. Higher symptom severity and BPD scores reflect higher severity and distress, respectively; higher HR-QoL scores indicate better outcomes. Least-squares mean changes were provided for the original pivotal-study randomized treatment groups Relugolix-CT and placebo. Main results and the role of chance A sustained improvement in symptom severity was observed for the Relugolix-CT group from baseline to Weeks 24 and 52, with LS mean changes of –36.9 and –37.3 points, respectively. In patients initially treated with placebo, small changes were observed at Week 24 (–10.8 points), whereas a greater reduction from baseline was demonstrated at Week 52 (–35.0 points) after transitioning to Relugolix-CT. Considering the BPD, measuring distress from key UF symptoms, LS mean changes of –50.9 and –51.3 points were observed in the Relugolix-CT group from baseline to Week 24 and 52, respectively. In patients initially treated with placebo, small changes were observed at Week 24 (–15.9 points), whereas a greater reduction from baseline was demonstrated at Week 52 (–48.6 points) after transitioning to Relugolix-CT. Treatment with Relugolix-CT also resulted in a sustained improvement in different aspects of HR-QoL. LS mean total HR-QoL score increased from baseline to Weeks 24 and 52 by 40.8 and 40.4 points, respectively. In patients initially treated with placebo, small changes were observed at Week 24 (11.4 points), whereas a greater increase from baseline was demonstrated at Week 52 (39.0 points) after transitioning to Relugolix-CT at Week 24. Limitations, reasons for caution The 28-week LIBERTY long-term extension study was non-comparative. Analyses were performed in a subset of patients who completed the LIBERTY pivotal studies and were eligible for the extension study. However, it is important to note that the demographic and baseline disease characteristics were similar between pivotal and long-term extension populations. Wider implications of the findings Relugolix-CT resulted in a sustained reduction in UF symptom burden, particularly in terms of distress from key UF symptoms, and a sustained improvement of HR-QoL over 52 weeks. Improvements observed after transitioning from placebo to Relugolix-CT at 24 weeks confirmed the positive effect of Relugolix-CT on UF-associated symptoms and HR-QoL. Trial registration number NCT03412890

Self-Reported Depressive Symptoms and Suicidality in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Bullying Involvement, Frustration Intolerance, and Hostility.

This study examined the relationships of cyberbullying and traditional bullying victimization and perpetration, perceived family function, frustration discomfort, and hostility with self-reported depressive symptoms and suicidality in adolescents diagnosed as having attention-deficit/hyperactivity disorder (ADHD). Both the self-reported severity of depressive symptoms on the Center for Epidemiological Studies Depression Scale and the occurrence of suicidal ideation or a suicide attempt on the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia were assessed in 195 adolescents with ADHD. The adolescents completed the Cyberbullying Experiences Questionnaire, Chinese version of the School Bullying Experience Questionnaire, Frustration–Discomfort Scale, Buss–Durkee Hostility Inventory, and Family APGAR Index. Caregivers completed the ADHD problems component of the Child Behavior Checklist for Ages 6–18. Multiple regression analyses were used to examine the correlates for each of self-reported depressive symptoms and suicidality. The results showed that after the effects of gender, age, ADHD symptoms, and family function were controlled, greater frustration discomfort and bullying perpetration significantly predicted self-reported depressive symptoms. Being cyberbullying victims and displaying hostility significantly predicted the risk of suicidality. Various types of bullying involvement, frustration intolerance, and hostility significantly predicted self-reported depressive symptoms and suicidality in adolescents with ADHD. By monitoring and intervening in these factors, we can reduce the risk of depression-related problems and suicidality in adolescents with ADHD.

Cultural contributors to negative emotionality: A multilevel analysis from the Joint Effort Toddler Temperament Consortium

This study advances the cross-cultural temperament literature by comparing temperament ratings of toddlers from 14 nations. Multilevel modeling (MLM) procedures were utilized to regress negative emotionality (NE) and component subscales on Hofstede’s cultural value dimensions while controlling for age and gender. More individualistic values were associated with lower NE, and component discomfort, fear, motor activity, perceptual sensitivity, and soothability scales. The discomfort subscale was negatively associated with power distance and positively associated with masculine cultural values. Higher ratings of shyness were related to a more long-term cultural orientation. Results illustrate the feasibility of an MLM approach to cross-cultural research and provide a new perspective on the intersection of culture and temperament development. Limitations and future implications are discussed.

Future Time Perspective and Frustration Intolerance in Medical students

Background: The future perception of students is affected by a series of events happening throughout their course of studies. The objective of this study is to measure the Future time perspective (FTP) and Future intolerance (FI) among medical students during the COVID-19 lockdown.Materials and Methods: It was a descriptive cross-sectional study done from January 15, 2020 to July 20, 2020 among MBBS students of Rawalpindi Medical University. The questionnaire consisted of 1) Socio-demographic details, 2) Future Time Perspective scale, and 3) Frustration Discomfort scale. An online survey was done using Google Forms. An ANOVA was run to check for differences in FTP and FI between the classes. Bivariate analysis for continuous variables was applied. The data were analysed using the Statistical Package for Social Sciences (SPSS) v.23.0 (IBM, Armonk, US). Results: Mean age of participants was 21.8 (SD=1.66) with majority females 331(58.4%). The mean FTP score and mean FI scores were 50.8(SD=19.43) and 91.46(SD=17.65) respectively. Final-year students had the highest mean score (Mean=57.94(SD=7.72)) for FI. On the other hand, mean scores for FDS were highest in first-year students (Mean=102.89 (SD=13.52)) while lowest in fourth-year students (Mean=81.73(SD=17.49)) with P=.005. There was a significant difference in the dimensions of Emotional Intolerance and achievement among females and males. Bivariate analysis showed a significant negative correlation was found between FTP and the dimension of discomfort intolerance (r = -0.158, p &lt; 0.001), while a significant positive correlation was found between FTP and the dimension of achievement (r = 0.225, p &lt; 0.001). Conclusion: Our study concludes that final-year students have a much higher tolerance level for adversities. Furthermore, they also have a much more positive perspective and a clearer vision regarding their future.

Compensatory Effects of Sequential 4-Channel Neuromuscular Electrical Stimulation for the Treatment of Acute, Subacute, and Chronic Dysphagia in a Prospective, Double-Blinded Randomized Clinical Trial

Background. The precise mechanism of 2-channel neuromuscular electrical stimulation (NMES) treatment is unknown, and controversy remains over its efficacy. The sequential 4-channel NMES was newly developed based on normal contractile sequences of swallowing-related muscles. Objective. To assess the clinical efficacy of sequential 4-channel NMES during swallowing. Methods. In this prospective RCT, 52 inpatients with dysphagia (acute, subacute, and chronic state) after stroke, brain tumor, or encephalitis were enrolled. Participants who underwent a videofluoroscopic swallowing study (VFSS) and clinical evaluation were enrolled and were randomly assigned to the 4-channel NMES or sham group. The 4-channel NMES and sham groups swallowed thin and honey-like fluids under NMES (sequential stimulation on suprahyoid and infrahyoid) and sham stimulation, respectively. The procedures were evaluated with the VFSS. Pre- and post-treatment evaluations were performed with the videofluoroscopic dysphagia scale (VDS), penetration–aspiration scale (PAS), Likert scale, and kinematic analysis. Results. The 4-channel NMES group showed significantly greater improvements than the sham group with respect to oral VDS, pharyngeal VDS, total VDS, and PAS (P < .05). Furthermore, the Likert scale for satisfaction, easiness, and discomfort for swallowing showed favorable results for the 4-channel NMES group (P < .05). In the kinematic analysis, the peak speed point, distance, and velocity of hyoid movement were significantly greater in the 4-channel NMES group (P < .05). Conclusions. Sequential 4-channel NMES activating the suprahyoid, thyrohyoid, and other infrahyoid muscles during swallowing showed significant clinical improvement with respect to VDS, PAS, and kinematic analysis. Therefore, sequential 4-channel NMES is a potential new functional electrical stimulation system for the treatment of dysphagia.

Dysphonia and dysphagia consequences of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS)

ImportancePaediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) is a novel disease first identified in 2020. Recent cohort studies have described the complex presentation and symptomatology. This paper provides detailed description of the dysphagia and dysphonia symptoms, management, and outcome. ObjectiveTo describe dysphagia and dysphonia in PIMS-TS. DesignRetrospective cohort study. SettingSingle tertiary and quaternary children's hospital. ParticipantsAll 50 children treated for paediatric multisystem inflammatory disease between April and June 2020 were included in this study. Main Outcome(s) and Measure(s)Dysphonia: GRBAS Perceptual Severity Scores, Vocal Handicap Index scores and the Vocal Tract Discomfort Scale. Dysphagia: Functional Oral Intake Scale. ResultsFifty children met the diagnostic criteria for PIMS-TS. 33 (66%) were male. Median age was 10 years (range: 1–17). 36 (72%) were of Black, Asian or minority ethnic background. Nine (18%) required specialist assessment and management of dysphagia and/or dysphonia. Five (55%) were male with a median age of 9 years 7 months (range: 1–15 years). Symptoms typically resolved within three months. Two children presented with persisting dysphonia three months post-presentation. Neurological, inflammatory, and iatrogenic causes of dysphagia and dysphonia were identified. Conclusions and RelevanceDysphonia and dysphagia are present in children with PIMS-TS. Further data is required to understand pathophysiology, estimate incidence, and determine prognostic factors. This preliminary data highlights the need for dysphagia and dysphonia screening and timely referral for specialist, multidisciplinary assessment and treatment to ensure short-term aspiration risk is managed and long-term, functional outcomes are optimised.

Performance Appraisal: Appraiser’s Discomfort and Stress

Performance appraisal comprehensively evaluates employee performance with regard to his or her performance on the job and his/her potential for development. Providing someone a sincere candid evaluation based on the measurement is a taxing experience for most evaluators. Combative behaviour on the part of the person acting as an evaluator is frequent. Workplace stress then is the harmful physical and emotional response that can happen when there is a conflict between job demands and the amount of control an appraiser has on the employee. This study examines the correlation between discomfort and general work stress among managers and senior managers during the period of appraisal (N=76, Sample location: Delhi NCR, Experience: 8-10 years). The study follows a cross-sectional research design. For the purpose of this study the two statistical tools employed were Performance Appraisal Discomfort Scale and General Work Stress Scale. A moderate correlation was established between discomfort and stress, experienced by appraisers, which highlighted their substantial relationship. It preaches extensive knowledge and awareness of the discomfort experienced from the employers’ point of view when administering performance appraisal.

494 DISCOMFORT IN PEOPLE WITH DEMENTIA ADMITTED TO AN ACUTE GENERAL MEDICAL HOSPITAL: A HOSPITAL CROSS SECTIONAL STUDY OF PREVALENCE

Abstract Introduction The acute hospital is a challenging place for a person with dementia whose ability to communicate discomfort and need is impaired. Their discomfort may go unnoticed due to insufficient staffing and time resources in this acute environment. Concerns have been raised about the consequences of these overlooked discomfort (e.g. distress and agitation), and hence how we can correctly identify their sources and severity. This study aimed to describe the source of discomfort and challenging behaviours in people with dementia (PwD) in UK acute hospital. Method A cross-sectional observational study of 49 patients with dementia admitted to a NHS acute hospital. Their discomfort was detected and its sources were identified (Sources of Discomfort Scale) during an hour observation when they were at rest and moved by staff. Their challenging behaviours were also recorded (Neuropsychiatric Inventory) through interviewing with the ward staff, as well as documentation of severity of dementia and presence of delirium. Results The overall prevalence of discomfort was 98%, with excessively sleepy or tired being the commonest; 39 (80%) participants experienced three or more type of discomfort. The commonest sources of discomfort were physical (e.g. constipation) and environmental (e.g. physically restrained), affecting up to 43 (88%) and 42 (83%) participants respectively. There was also evidence of an association between delirium and sleepiness or tiredness’s discomfort, meaning that PwD with delirium were nearly triply as likely to feel uncomfortable because of sleepiness or tiredness. Challenging behaviours affected over 80% of our participants, with agitation or aggression being the commonest. On average, these behaviours were moderately severe. Conclusion Discomfort and challenging behaviours were very common in PwD admitted to acute hospitals. Patients and staff would benefit from more accurate and frequent detection of discomfort by focusing on non-pain-related discomfort and using observational scales.

Lithotomy versus prone position for perianal surgery: a randomized controlled trial.

PurposeStudies objectively comparing lithotomy and prone positions regarding surgeon comfort, ergonomics, patient comfort, and position related complications are scarce.MethodsThe patients posted for surgery of either fistula in ano, hemorrhoids, or were included in this study. Subjective Mental Effort Questionnaire (SMEQ) and Local Experienced Discomfort (LED) scale were used to score the level of mental and physical stress among the operating surgeon, assistants, and the scrub nurse. Other parameters studied were the exposure of the operative site, patient comfort level, and position-related complications.ResultsThirty patients were operated in each position. Mean ± standard deviation of jackknife prone vs. lithotomy surgeon SMEQ score (15.6 ± 10.4 vs. 107.0 ± 11.5, P < 0.05) and LED score (1.8 ± 1.5 vs. 6.7 ± 0.5, P < 0.05) were found to be statistically significant. Prone vs. lithotomy assistant SMEQ score (29.1 ± 13.1 vs. 100.6 ± 8.7, P < 0.05) and LED score (4.6 ± 1.1 vs. 7.4 ± 0.8, P < 0.05) were also found to be statistically significant. SMEQ (10.0 ± 0.0 vs. 20.6 ± 2.5, P < 0.05) and LED scores (1.1 ± 0.3 vs. 3.3 ± 0.5, P < 0.05) of scrub nurses and LED scores (2.5 ± 0.5 vs. 6.3 ± 0.7, P < 0.05) of patients were also statistically significant. Exposure of the operative site was significantly better in the prone position (5.0 vs. 2.1, P < 0.05).ConclusionSignificantly better SMEQ, LED, and exposure score suggests the superiority of jackknife prone position over the lithotomy in terms of significantly less mental and physical stress to the operating surgeon, assistant, and scrub nurse; better ergonomics, and excellent exposure.

Relationships Between School Bullying and Frustration Intolerance Beliefs in Adolescence: A Gender-Specific Analysis

The purpose of this study was to address frustration intolerance related to bullying among adolescents. We investigated how sociodemographic characteristics and intolerance frustration beliefs are related to four bullying roles (pure victim, bully-victim, pure bully and noninvolved). This cross-sectional study featured a sample of 1124 French adolescents (616 girls and 508 boys), who completed the revised Olweus Bully/Victim Questionnaire and Frustration Discomfort scales. Results revealed that adolescents involved in bullying expressed more irrational frustration intolerance beliefs than their noninvolved peers. Entitlement, emotional intolerance and achievement frustration were positively associated with victimization, but only entitlement emerged as a significant predictor of victim status in a logistic regression analysis. Entitlement and achievement frustration were positively associated with bullying perpetration, but entitlement only emerged as a significant predictor of bully status in the regression analysis. The present findings show that entitlement is the type of frustration intolerance belief that contributes the most to bullying involvement. Interventions targeting irrational entitlement beliefs and reinforcing rational ones could be considered when dealing with adolescent bullying.

Investigation of factors affecting musculoskeletal pain and quality of life in university students

Aim: In this study, we aimed to examine the factors affecting musculoskeletal pain and quality of life in university students experiencing musculoskeletal pain. Material and Methods: Two hundred-eighteen (F:120;M:98) (X=21.22±1.9) university students studying at Pamukkale University School of Physical Therapy and Rehabilitation were included in the study. Due to the Covid-19 pandemic, the study was conducted over the phone and online. The correlation between the Cornell Musculoskeletal Discomfort Scale and the Nottingham Health Profile with gender, age, BMI, smoking habit, exercise habit, and time spent in front of a desk-computer-TV was examined. Results: Age parameter was correlated with back musculoskeletal pain in the trunk region (p<0.05). Body Mass Index parameter was correlated with back, lower back and shoulder musculoskeletal pain (p<0.05). Smoking habit was found to be correlated with musculoskeletal pain in the right hand and wrist (p<0.05). Exercise habits were found to be correlated with musculoskeletal pain in all regions except both hands and wrists and both lower legs (p<0.05). There was a correlation between time spent sitting at the desk-computer-TV and musculoskeletal system pains in the neck, back, low back, shoulder and hip (p<0.05). Quality of life was moderately correlated with smoking habits (p<0.05) and was positively correlated with exercise habits (p<0.05). Significant correlations were found between the duration of sitting at the desk-computer-TV and the quality of life parameters (p<0.05). Discussion: University students suffer from musculoskeletal pain due to a relatively intense training program based on practice and some harmful habits, and their quality of life is negatively affected by this situation. Students should take precautions to protect their musculoskeletal systems and gain regular exercise habits.

Cross-Validation and Normative Values for the German Vocal Tract Discomfort Scale.

Purpose The Vocal Tract Discomfort Scale (VTD Scale) is a self-rating questionnaire investigating physical symptoms in the larynx associated with vocal pathology. The aim of this work was to investigate the reliability, validity, sensitivity, and specificity of the first German version and to provide normative data with thresholds for pathology and a scaling scheme. Study Design A retrospective multicenter study was performed. Method A total of 571 participants (409 female and 162 male), with a mean age of 47.2 years, were recruited at three German centers; of these, there were 447 participants with voice disorder and 124 vocally healthy participants. The clinical examination consisted of patient history, visual laryngeal examination, acoustic and aerodynamic assessment, perceptual analysis by the Grading-Roughness-Breathiness-Asthenia-Strain Scale, and subjective evaluation using the VTD Scale and the Voice Handicap Index (VHI). Statistics included group comparisons (t test and analysis of variance), Pearson correlation coefficient (between VTD Scale and VHI), and Cronbach's alpha to assess validity and reliability. Analysis of receiver operating characteristics was performed to examine VTD Scale's discriminatory ability and provide a cutoff score. Additionally, percentiles were applied to provide VTD Scale ranges. Results There were highly significant differences between healthy participants and participants with voice disorder regarding the total score and both subscales of the VTD Scale. Internal consistency was excellent (α = .928). We found moderate, positive correlation between the VTD Scale and VHI (ρ = .596, p < .001). Receiver operating characteristics analysis showed an area under the curve of 0.876 (p < .001, 95% confidence interval [0.846, 0.906]). VTD Scale ranges were no (score: 0-13), mild (score: 14-26), moderate (score: 27-40), and severe (score: 41-96) disorder. Conclusions Results confirm an excellent reliability and validity of the German VTD Scale. It provides additional and independent diagnostic information and is a useful instrument to complement voice assessment. The scaling into four severity subgroups allows the tool to be used for screening patients and considers a transferral to a voice specialist.