Discomfort Scale Research Articles

Repetition Performance, Rating of Perceived Discomfort, and Blood Lactate Responses to Different Rest Interval Lengths in Single-Joint and Multijoint Lower-Body Exercise.

Rosa, A, Coleman, M, Haun, C, Grgic, J, and Schoenfeld, BJ. Repetition performance, rating of perceived discomfort, and blood lactate responses to different rest interval lengths in single-joint and multijoint lower-body exercise. J Strength Cond Res 37(7): 1350-1357, 2023-The purpose of this study was to examine the effects of different rest interval lengths (RILs) on repetition performance, rating of discomfort, and blood lactate responses during lower-body single-joint and multijoint exercises. This study used a counterbalanced design where each subject performed the Smith machine back squat (BS) and leg extension (LE) using 3 different RIL configurations (1, 2, and 3 minutes) in a randomized fashion. Data collection occurred over the span of 3 separate days. Volunteers were randomly allocated to perform the independent variables (RILs and exercises) in 1 of 12 potential configurations. The initial session was allotted for familiarization with the rating of discomfort scale and 10 repetition maximum testing. The other 2 sessions involved training with the different configurations of RIL length using both the BS and LE. Randomization ensured that the BS was performed first in one of the training sessions and the LE was performed first in the other session. Results indicated that longer RILs had a small positive effect on repetition performance, with longer rest durations allowing for more repetitions compared with shorter durations. The largest difference in repetition performance between RILs was observed between 1 minute and 2-3 minutes rest; there were trivial differences in repetition performance between 2 and 3 minutes rest for both the BS and LE. Blood lactate levels were slightly higher with longer RILs. Overall, BS showed greater increases in blood lactate compared with LE, and these differences were magnified over time. Exercise selection and RIL both influenced rating of discomfort, with LE producing less discomfort than BS and longer RILs reducing perceived discomfort. Our findings suggest that RIL influences the repetition performance, blood lactate, and rating of discomfort responses between single-joint and multijoint exercises.

Comparison of Remote-Audiovisual Teaching and Face-to-Face Teaching on Factors Causing Teacher’s Voice Problems and Subjective Voice Evaluation

Objectives: Due to the global pandemic caused by the coronavirus (COVID-19), many remote-audiovisual teaching methods have been introduced. Remote-audiovisual teaching may lead to changes in teacher’s voice usage patterns. Therefore, it is necessary to compare between remote-audiovisual teaching and traditional face-to-face teaching methods in regards to the factors that affect teacher’s voice problems and subjective voice evaluation. Methods: This study investigated whether there was significant difference between two teaching methods on the risk factors (environment, physical, vocal use, psychological) causing voice problems and subjective voice evaluations (vocal effort ratings, vocal tract discomfort scale). Seventy-nine teachers in elementary, middle, and high schools participated in this study. Results: Face-to-face teaching had significantly higher scores when compared with remote-audiovisual teaching for environmental and voice use factors. For psychological factors, remote-audiovisual teaching showed significantly higher scores than face-to-face teaching. There were no significant differences in physical factors between the two teaching methods. In subjective voice evaluation, face-to-face teaching showed significantly higher scores compared to remote-audiovisual teaching in vocal effort ratings and frequency and severity of vocal tract discomfort scale. Conclusion: This study shows that teachers not only require more vocal loading and vocal effort in face-to-face teaching compared to remote-audiovisual teaching, but also experience high vocal discomfort. Therefore, that the results of this study suggest that the remote-audiovisual teaching method allows teachers to use their voice more comfortably in comparison to face-to-face teaching.

Psychometric Values of a New Scale: The Rett Syndrome Fear of Movement Scale (RSFMS).

(1) Background: One of the characteristics associated with Rett syndrome (RTT) is a fear of movement (FOM). Despite the grave consequences on health, function, and the caregiver's burden associated with bradykinesia accompanying FOM, there is no specific FOM assessment tool for RTT. (2) Objective: To construct and assess the psychometric values of a scale evaluating FOM in RTT (Rett syndrome fear of movement scale-RSFMS). (3) Methods: Twenty-five girls aged 5-33, including a research group (N = 12 individuals with RTT) and control group (N = 13 typically developing girls at equivalent ages). The Pain and Discomfort Scale (PADS) and Facial Action Coding System (FACS) assessed the participants' behavior and facial expressions in rest and movement situations. (4) Results: Significant behavioral differences were recorded in these rest and movement situations within the research groups using the RSFMS (p = 0.003), FACS (p = 0.002) and PADS (p = 0.002). No differences in reactions were found within the control group. The new scale, RSFMS, was found to show a high inter- and intra-rater reliability (r = 0.993, p < 0.001; r = 0.958, p < 0.001; respectively), good internal consistency (α = 0.77), and high accuracy (94.4%). (5) Conclusions: The new scale for measuring FOM in RTT, the RSFMS, was validated using the FACS and PADS. The RSFMS was found to be a tool that holds excellent psychometric values. The new scale can help clinicians working with individuals with RTT to plan appropriate management strategies for this population.

#5172 ASSESSMENT OF THE RELATIONSHIP BETWEEN RENAL VOLUME, PAIN, DEPRESSION, AND ANXIETY IN PATIENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE

Abstract Background and Aims The most prevalent hereditary kidney disease is autosomal dominant polycystic kidney disease (ADPKD). Multiple cysts developing in the kidneys are a defining feature of this systemic, progressive disease. The quality of life, psychosocial load, and discomfort associated with renal volume in people with ADPKD have not been well studied. This study aimed to examine the relationship between renal volume, psychological issues brought on by pain and the burden of the disease, and deteriorating sleep quality in ADPKD patients. Method The study included sixty patients who were being treated in the nephrology clinic at the Bursa Uludag University Faculty of Medicine Hospital. The ADPKD Pain and Discomfort Scale (ADPKD-PDS), Beck Depression Inventory Questionnaire, Beck Anxiety Scale, Pittsburgh Sleep Quality Scale (PSQI), and Insomnia Severity Index (ISI) were assessed. The computed tomography ellipsoid formula was used to determine the total kidney volume, and kidney volume adjusted for body size was obtained for each patient. The eGFR values computed using the CKD-EPI algorithm and the patients' baseline biochemical parameters were recorded. Results The mean age at diagnosis was 31±13, and the mean total kidney volume (TKV) was 1526.35±1595.90. Eight (13.3%) individuals were determined to have mild mood disorders, whereas seven (11.7%) patients had borderline clinical depression. Four individuals (6.7%) were found to have severe anxiety. It was shown that 25% of the patients had poor sleep quality. There was no statistically significant difference in kidney volume between the depression groups or between the pain and discomfort scale sub-dimensions. (Table-1) Conclusion It was shown that, in accordance with the literature, the severity of depression increased as the patients' sleep quality declined in ADPKD patients. However, there was no significant relationship between kidney volume and the degree of anxiety, depression, pain or discomfort.

A mixed-method feasibility study of the use of the Complete Vocal Technique (CVT), a pedagogic method to improve the voice and vocal function in singers and actors, in the treatment of patients with muscle tension dysphonia: a study protocol

BackgroundMuscle tension dysphonia (MTD) results from inefficient or ineffective voice production and is the cause of voice and throat complaints in up to 40% of patients presenting with hoarseness. Standard treatment is voice therapy (SLT-VT) delivered by specialist speech therapists in voice disorders (SLT-V). The Complete Vocal Technique (CVT) is a structured, pedagogic method which helps healthy singers and other performers optimise their vocal function enabling them to produce any sound required. The aim of this feasibility study is to investigate whether CVT administered by a trained, non-clinical CVT practitioner (CVT-P) can be applied to patients with MTD before progressing to a pilot randomised control study of CVT voice therapy (CVT-VT) versus SLT-VT.Methods/designIn this feasibility study, we use a mixed-method, single-arm, prospective cohort design. The primary aim is to demonstrate whether CVT-VT can improve the voice and vocal function in patients with MTD in a pilot study using multidimensional assessment methods. Secondary aims are to assess whether (1) a CVT-VT study is feasible to perform; (2) is acceptable to patients, the CVT-P and SLT-VTs; and (3) whether CVT-VT differs from existing SLT-VT techniques. A minimum of 10 consecutive patients with a clinical diagnosis of primary MTD (types I–III) will be recruited over a 6-month period. Up to 6 video sessions of CVT-VT will be delivered by a CVT-P using a video link. The primary outcome will be a change in pre-/post-therapy scores of a self-reported patient questionnaire (Voice Handicap Index (VHI)). Secondary outcomes include changes in throat symptoms (Vocal Tract Discomfort Scale), acoustic/electroglottographic and auditory-perceptual measures of voice. Acceptability of the CVT-VT will be assessed prospectively, concurrently and retrospectively both quantitatively and qualitatively. Differences from SLT-VT will be assessed by performing a deductive thematic analysis of CVT-P transcripts of therapy sessions.ConclusionThis feasibility study will provide important data to support whether to proceed with a randomised controlled pilot study focusing on the effectiveness of the intervention compared to standard SLT-VT. Progression criteria will be based on demonstrating a positive outcome in treatment, successful delivery of the pilot study protocol, acceptability to all stakeholders and satisfactory recruitment rates.Trial registrationClinicalTrials.gov website (NCT05365126 Unique Protocol ID: 19ET004). Registered on 06 May 2022.

Fostering positive attitudes towards interacting with young people with disability among health students: a stepped-wedge trial

Purpose To investigate if a 12-week community-based exercise program (FitSkills) fostered positive attitudes towards disability among university student mentors. Methods A stepped-wedge cluster randomised trial was completed with 4 clusters. Students were eligible to be a mentor if enrolled in an entry-level health degree (any discipline, any year) at one of three universities. Each mentor was matched with a young person with a disability and the pair exercised together at the gym twice a week for an hour (24 sessions total). At 7 times over 18 months, mentors completed the Disability Discomfort Scale to indicate their level of discomfort when interacting with people with disability. Data were analysed according to the intention to treat principles using linear mixed-effects models to estimate changes in scores over time. Results A total of 207 mentors completed the Disability Discomfort Scale at least once, of whom 123 participated in FitSkills. Analysis found an estimated reduction of 32.8% (95% confidence interval (CI) −36.8 to −28.4) in discomfort scores immediately after exposure to FitSkills across all four clusters. These decreases were sustained throughout the remainder of the trial. Conclusions Mentors reported more positive attitudes towards interacting with people with disability after completing FitSkills with changes retained for up to 15 months.

Development of the Thirst Discomfort Scale: A Validity and Reliability Study

Thirst is a sensation associated with a dry mouth and the desire or craving to drink water. Surgical patients are among those hospitalized individuals who are at high risk of developing both osmotic and hypovolemic thirst. To develop a new measurement tool for evaluating the thirst-related discomfort of surgical patients and to assess its validity and reliability. The study population consisted of patients admitted to the surgical clinics of a research hospital in Turkey between January and March 2022. The new measurement tool was developed in several stages: a pilot implementation phase with 51 patients and the main implementation phase with 198 patients. Data were collected by means of face-to-face interviews with patients. Exploratory factor and confirmatory factor analyses were performed using IBM SPSS Statistics, version 22, and IBM SPSS Amos. The final Thirst Discomfort Scale consisted of 12 items in 3 subdimensions. The Cronbach α values of the scale subdimensions ranged from 0.787 to 0.848, and the Cronbach α value for the scale as a whole was 0.886. The scale explained 66.237% of the total variance of the data. The Thirst Discomfort Scale consisting of 12 items and 3 subdimensions is a valid and reliable measurement tool for evaluating thirst-related discomfort of surgical patients.

Clinical Pearls

During the pandemic, extracorporeal membrane oxygenation (ECMO) was instituted for patients with COVID-19 hypoxemia refractory to mechanical ventilation support. Although some patients had favorable outcomes, many who survived hospitalization were left with significant functional disability. Palliative care consultation with family members of ECMO patients has been studied, but the focus has primarily been on end-of-life care and not on overall care expectations.Siddiqui and colleagues implemented an early, scripted palliative care intervention for families of patients with COVID-19 receiving ECMO. After interviewing families, most within 24 to 72 hours of ECMO initiation, they identified these themes: Social isolation and related grief of not being at the patient’s bedsideHelping patients’ children adjust to a new normalCoping with multiple family members suffering from COVID-19Importance of faith and spiritualityNeed for hope and gratitudeFutility of prolonged ECMO therapyPalliative care has expanded to care for patients at all stages of chronic illness. The study findings support early family engagement and assistance for those dealing with COVID-19 and similar illnesses.See Article, pp 166-174Workplace stress can contribute to negative consequences for both staff and patients. Caring for critically ill patients adds additional stressors for intensive care nurses, which were further exacerbated by the COVID-19 pandemic. Although some interventions exist for nurse support, none focus on nurses taking time out to meet their own needs.Smith and colleagues assessed nurses’ perceptions of their stress and the usability of a Lavender Lounge—a quiet room with items and activities available to help them destress. They found The very factors that lead to burnout were the ones perceived as barriers to use of the Lavender Lounge. The authors suggest an approach that includes organizational change that supports reduced staff workload.See Article, pp 198-204Thirst is a complex symptom that affects between 49% and 98% of adult patients. Unrelieved thirst can become a distressing experience that overshadows other ailments. Although nurses can alleviate the distress caused by thirst, there are no standard protocols for accurate assessment and evaluation.Ciftci and colleagues developed and tested the Thirst Discomfort Scale to standardize measurement of thirst in adult patients. They found Although further study with other types of patients is warranted, the Thirst Discomfort Scale can be used to assess and evaluate the symptom of thirst in adult patients.See Article, pp 176-183Pressure injury (PI) prevention and treatment guidelines have historically been geared toward adult patients and adapted by pediatric providers. However, children with congenital heart disease (CHD) have unique factors that increase their susceptibility to PIs.To prevent PIs, Shields and colleagues explored the specific risk factors of the care and management of PIs in pediatric patients with CHD. They found This study adds to the limited literature on key risk factors for pediatric patients with CHD developing PIs. Clinicians providing care for these patients should use this knowledge to decrease the incidence of PIs.See Article, pp 216-220

Construction of a Musculoskeletal Discomfort Scale for the Lower Limbs of Workers: An Analysis Using the Multigroup Item Response Theory

Musculoskeletal symptoms are a major occupational health problem in workers, and these can affect all professional occupations. Previous studies have proposed metrics capable of evaluating the musculoskeletal discomfort experienced by workers. However, no study has developed a metric that considers professional groups. Thus, this study aimed to develop a scale for musculoskeletal discomfort in the lower limbs to compare self-reported symptoms among education, health, and industry professionals. The sample included 159 teachers, 167 health professionals, and 401 industrial operators who relayed their symptoms using a diagram of the hips, thighs, knees, lower legs, and feet. Factor and multigroup item response theory analyses were used to construct a musculoskeletal discomfort scale consisting of seven levels and to assess and compare the identified symptoms. The results showed that the progressive evolution of discomfort differed for each profession, demonstrating that each context and work environment affects workers differently, which may explain the different patterns of symptom responses among professional groups.

Handrim Wheelchair Propulsion Technique in Individuals With Spinal Cord Injury With and Without Shoulder Pain: A Cross-sectional Comparison.

The aim of this study was to compare handrim wheelchair propulsion technique between individuals with spinal cord injury with and without shoulder pain. A cross-sectional study including 38 experienced handrim wheelchair users with spinal cord injury was conducted. Participants were divided into the "shoulder pain" ( n = 15) and "no-shoulder pain" ( n = 23) groups using the Local Musculoskeletal Discomfort scale. Kinetic and spatiotemporal aspects of handrim wheelchair propulsion during submaximal exercise on a motor-driven treadmill were analyzed. Data were collected using a measurement wheel instrumented with three-dimensional force sensors. After correction for confounders (time since injury and body height), linear regression analyses showed that the pain group had a 0.30-sec (95% confidence interval, -0.5 to -0.1) shorter cycle time, 0.22-sec (95% confidence interval, -0.4 to -0.1) shorter recovery time, 15.6 degrees (95% confidence interval, -27.4 to -3.8) smaller contact angle, and 8% (95% confidence interval, -15 to 0) lower variability in work per push compared with the no-pain group. Other parameters did not differ between groups. This study indicates that individuals with spinal cord injury who experience shoulder pain propel their handrim wheelchair kinematically differently from individuals with spinal cord injury without shoulder pain. This difference in propulsion technique might be a pain-avoiding mechanism aimed at decreasing shoulder range of motion.

Ergonomics-Related and Work-Related Musculoskeletal Disorders in A High-Hazard Factory in Hatay Region

Objectives: The most common work-related diseases are musculoskeletal system disease. This study aims to determine the prevalence of work-related musculoskeletal disorders (WMSDs) in a high-hazard factory and to determine sociodemographic, occupational, and ergonomic risks. Methods: The research is cross-sectional and was conducted in a high-hazard factory, in Hatay, in 2017. The research population was all factory employees (N=190), and it was aimed to reach the whole population. Of the (97.3%), 185 employees participated in the study. Anthropometric measurements, the Cornell Musculoskeletal Discomfort Scale, the observation-based Rapid Upper Limb Assessment (RULA) Ergonomic Risk Analysis Scale, and a questionnaire developed by the researchers are used for data collection. In the statistical analyses p&amp;lt;0,05was accepted as significant. Results According to the Cornell Scale, the frequency of WMSDs was 58.9%. The most common WMSDs were in the lumbar region (34.1%). According to the RULA Scale, 31.9% of the employees had 3rd and 4th-degree ergonomic risk. There were linear relationships between the Cornell Waist Score and each of the three RULA scores (p&amp;lt;0.001). The risk factors for WMSDs in the lumbar region were the presence of chronic disease (OR=5.35), hand tool use (OR=2.63), not having had a work accident (OR=0.04) and RULA scores (OR=1.61), Conclusion: Approximately one-third of the high-hazard factory employees had a high ergonomic risk. WMSDs existed in more than half of the employees. As the ergonomic risk increases, WMSDs increase.

Identification of Symptom Phenotypes of Hand Osteoarthritis Using Hierarchical Clustering: Results From the DIGICOD Cohort.

We aimed to delineate phenotypes in hand osteoarthritis (HOA) based on cardinal symptoms (pain, functional limitation, stiffness, and aesthetic discomfort). With data from the Digital Cohort Design (DIGICOD), we performed a hierarchical agglomerative clustering analysis based on Australian/Canadian Osteoarthritis Hand Index (AUSCAN) subscores for pain, physical function, stiffness, and visual analog scale for aesthetic discomfort. Kruskal-Wallis and post hoc analyses were used to assess differences between clusters. Among 389 patients, we identified 5 clusters: cluster 1 (n=88) and cluster 2 (n=91) featured low and mild symptoms; cluster 3 (n=80) featured isolated aesthetic discomfort; cluster 4 (n=42) featured a high level of pain, stiffness, and functional limitation; and cluster 5 (n=88) had the same features as cluster 4 but with high aesthetic discomfort. For clusters 4 and 5, AUSCAN pain score was >41 of 100, representing only one-third of our patients. Aesthetic discomfort (clusters 3 and 5) was significantly associated with erosive HOA and a higher number of nodes. The highly symptomatic cluster 5 was associated but not significantly with metabolic syndrome, and body mass index and C-reactive protein level did not differ among clusters. Symptom intensity was significantly associated with joint destruction as well as with physical and psychological burden. Patients' main expectations differed among clusters, and function improvement was the most frequent expectation overall. The identification of distinct clinical clusters based on HOA cardinal symptoms suggests previously undescribed subtypes of this condition, warranting further study of biological characteristics of such clusters, and opening a path toward phenotype-based personalized medicine in HOA.

Wind instrumentalists' work-related vocal tract discomfort.

Wind instrumentalist use the vocal tract intensively in their professional activities, which can lead to the development work-related voice disorders. To analyze the perception of vocal tract discomfort (VTD) by wind instrumentalists from Natal, Brazil. Cross-sectional study with 117 professional musicians and music students from six official bands/orchestras in the city of Natal. Both the Vocal Tract Discomfort Scale and a sample characterization questionnaire were applied. The Chi-square test, Fisher's exact test, and Mann-Whitney U test were applied in the statistical analysis of the variables. The most frequent and intense symptoms of VTD were sensitive throat and sore throat. There was a significant difference between the values of frequency and intensity of all symptoms both before and after playing the instrument. Dryness was the most intense symptom felt after playing the instrument. Musicians who report muscle pain and gastroesophageal reflux showed more VTD symptoms. Symptoms of VTD are experienced by wind instrumentalists and can be work-related since there was a difference in their perception after playing their instruments. There was also a relationship with gastroesophageal reflux and muscle pain, indicating that, in addition to collective issues, the individual musicians' health should be taken into account.

Evaluation of the efficacy and safety of conversion from the tacrolimus capsule to tablet in stable liver transplant recipients with maintenance therapy: a 24-week, open-label, single-center, phase IV exploratory clinical study.

The tablet form of tacrolimus is more convenient for drug ingestion than the capsule form. We examined the efficacy and safety of tacrolimus tablets and a satisfaction survey after formula conversion in liver transplant (LT) recipients. This study was an open-label, prospective clinical trial for tacrolimus formula 1:1 conversion from capsule to tablet in 41 adult LT recipients with tacrolimus maintenance therapy of more than 1 month. The primary endpoint was incidence of biopsy-proven acute rejection (BPAR) within 24 weeks. Surveys 1 week before and 4 weeks after formula conversion were conducted for total daily dose of medication, number, scale of discomfort and satisfaction. The overall incidence of BPAR was 0% and there was no graft loss or patient death. The incidence of adverse effects was 34.1% (n = 14) after formula conversion. The most common severe adverse effect was abnormal liver function test (n = 5): biliary complications (n = 4) and alcoholic recidivism (n = 1). Total daily dose and number of tacrolimus doses were significantly lower after formula conversion (P < 0.05) without changes in trough level. According to survey analysis, there was no significant difference in discomfort and satisfaction scales from capsule to tablet conversion (P < 0.05). The present study suggests that the new tablet formula can be a useful treatment option to maintain a consistent level of tacrolimus with a lower total daily dose and number in adult LT recipients.

Assessment of dyspnea, ADL, and QOL in the perioperative period in lung cancer patients treated with minimally invasive surgery.

Patients with lung cancer generally undergo minimally invasive surgery, such as video-assisted thoracoscopic surgery (VATS). This study examined the changes in health conditions and symptoms of patients with lung cancer using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ) C-30 questionnaires after surgery. This was a longitudinal descriptive study. One hundred and three patients with lung cancer who underwent lung resection at Tokushima University Hospital between 2012 and 2021 were eligible. They completed EORTC QLQ-C30, QLQ-LC13, the Cancer Dyspnea scale (CDS), and pulmonary-ADL (P-ADL) before and 1, 3, and 6 months after surgery. Regarding functional scale scores, impairments in physical and role functions persisted for 6 months after surgery. In symptom scale scores, fatigue, pain, dyspnea, and appetite loss continued for 6 months after surgery. In CDS, sense of effort, discomfort, and total dyspnea scale scores were elevated for 6 months after surgery. In P-ADL, most ADL were impaired 1 month after surgery, but recovered by 3 months. The dyspnea index of ADL was lower for 6 months after surgery. Impairments in health conditions and symptoms persisted for 6 months after surgery despite its minimally invasive nature. J. Med. Invest. 70 : 388-402, August, 2023.

Effect of remote ischemic conditioning on heart rate responses to walking in people with multiple sclerosis

Remote ischemic conditioning (RIC), exposure of body parts to brief periods of circulatory occlusion and reperfusion, has been shown to improve cardiovascular responses to exercise in healthy individuals but its effects in people with MS are unknown. This study aimed to assess the effect of RIC on heart rate responses to walking in people with MS. Double blind randomized controlled trial. Multiple sclerosis clinic of tertiary care center teaching hospital in the United Kingdom. Three cycles of RIC were delivered by occluding the upper arm with a blood pressure cuff inflated to a pressure of 30 mmHg above the systolic blood pressure. In the sham group, the blood pressure cuff was inflated to 30 mmHg below diastolic blood pressure. Heart rate responses to the 6-minute walk test (6MWT), the tolerability of RIC using a numerical rating scale for discomfort (0-10), and adverse events were studied. Seventy-five participants (RIC -38 and Sham-37) completed the study. RIC was well tolerated. Compared to sham, RIC significantly decreased the rise in heart rate (P = 0.04) and percentage of predicted maximum heart rate (P = 0.016) after the 6MWT. RIC was well tolerated and improved the heart rate response to walking in people with MS. Further studies on RIC in the management of MS are needed.

Speech handicap and vocal tract discomfort with different types of face masks in the COVID-19 era

Purpose: Compulsory use of masks is recommended to prevent droplet infection during the COVID-19 pandemic. This can alter optimal communication in daily life. This study compared the self-perceived speech handicap and vocal tract discomfort when wearing and not wearing a face mask and different types of face masks in a healthy population.Methods: This is a cross-sectional study conducted via an online questionnaire. Speech Handicap Index (SHI) and Vocal Tract Discomfort Scale (VTDS) scores were collected via Google forms (Google, Mountain View, California) from 128 healthy Korean populations with and without face masks and different types of face masks.Results: While speaking with a face mask, subjects were identified with a significant lack of air, unclear articulation, and reduced speech intelligibility in a noisy situation. Although total SHI and VTDS scores exhibited slightly higher with a face mask, no significant differences were found between with and without mask conditions. For mask type, individuals who frequently wore KF94 masks subjectively perceived significantly higher speech handicap and vocal tract discomfort than surgical or fabric masks.Conclusions: In the current study, wearing a face mask did not have a significant impact on speech handicap and vocal tract discomfort in a healthy adult population during the COVID-19 pandemic period, implying people already adapted to wearing a face mask. In terms of speech problems and frequency, the severity of sensation or symptoms of vocal discomfort significantly differed depending on which face mask type they used. Future research should address self-evaluation of their feeling or experience due to face mask use, considering the elderly and patients with communication disorders who suffer more with communication in daily life.

Assessment of Factor Affecting the Quality of Life in Children with Juvenile Idiopathic Arthritis

Abstract&#x0D; Introduction and Objectives: Juvenile idiopathic arthritis (JIA) is a frequently seen chronic rheumatoid disease in childhood, which may cause disability and severely affect quality of life (QoL). The aim of present study was to assess relationships between disease activation and socio-cultural status of family, QoL, anxiety level, and depression level in patients with JIA and their parents.&#x0D; Methods: The study included 100 patients with JIA. The socio-demographic data were obtained from all patients. Child- and parent-reported PedsQL, Beck depression inventory (BDI), Kovacs' Child Depression Inventory (CDI), SCARED child version, CHAQ discomfort and disability scales were applied and JADAS-27 score was calculated in a cross-sectional manner. Then, we compared the characteristics of patients with the scales’ results.&#x0D; Results: JADAS-27, BDI, and CHAQ discomfort scores were higher and child- and parent-reported PedsQL scores were lower in patients with active disease than patients on remission (p&lt;0.05). The SCARED score was higher in girls than boys. The CHAQ disability score was high in children aged 8-12 years (p&lt;0.05). JADAS-27 and CHAQ disability scores were significantly low in patients with better compliance to treatment. Parental statements about changes in mental health after diagnosis were consistent with results of depression and anxiety scales of children.&#x0D; Conclusions: Quality of life is adversely affected in children with JIA, which may result in depression and anxiety. In management of JIA, one of our goals should be maintaining QoL. Further comprehensive studies in relationships between QoL and depression, anxiety, socio-demographic parameters, disease activation and social circle of patient are needed.

Modelling the Probability of Discomfort Due to Glare at All Levels: The Case of Outdoor Lighting

ABSTRACT To limit glare, lighting engineers need to estimate the level of discomfort produced by a lighting installation. Outdoor, most discomfort glare models predict a mean level of discomfort on a judgment scale, which corresponds to a “mean road user.” However, in real life, the inter-individual variability of the sensitivity to glare is large; predicting the mean discomfort does not describe the full pattern of responses in a population. We propose a methodology to model the Discomfort Level, computing the probabilities that an observer reports any of the levels of a discomfort scale. This methodology is demonstrated for outdoor lighting, where no probabilistic model is available. Using a dedicated psychophysical experiment, we extend the results of a previous study where a formula was proposed to compute the Glare Excitation due to a multi-source stimulus, at the Borderline between Comfort and Discomfort (BCD), with a background luminance consistent with outdoor lighting. This formula is first extended to other discomfort levels and background luminance levels, and strengthened thanks to a different experimental protocol and to the use of up to 10 glare sources simultaneously. From this experiment, a formula of the Glare Excitation is proposed in the range of outdoor lighting. Then, a probabilistic model of the Discomfort Level is proposed, allowing computing the probability of ratings at each level of an ordinal scale from the Glare Excitation computed with our formula. It is hoped that the proposed model avoids most of the modeling methodological caveats of previous discomfort glare models.

Moxibustion with Walnut Shell Spectacles Could Improve the Objective Symptoms and Tear Film Stability of Patients with Dry Eye Disease: A Randomized Controlled Trial.

This study aims to evaluate the efficacy and acceptability of moxibustion with walnut shell spectacles in treating dry eye disease (DED) patients and to provide treatment options. 126 DED patients were randomly allocated into the moxibustion group (treated by moxibustion with walnut shell spectacles, 64 cases) and the artificial tears group (treated with sodium hyaluronate eye drops, 62 cases). Evaluate the changes in the ocular surface disease index (OSDI), the visual analogue scale (VAS) of ocular discomfort, the tear film break-up time (TBUT), corneal fluorescein staining (CFS), and the Schirmer I test during the trial at baseline and after 1-week, 2-week, 3-week, and 4-week treatment. Evaluate the OSDI scale and the ocular symptom VAS scale one month after the end of treatment. There were no significant differences in baseline characteristics between the two groups. For OSDI scores, the results showed that the efficacy of the moxibustion group was no less than that of the artificial tear group. For VAS of ocular discomfort, both groups significantly reduced their score compared with baseline, and for the moxibustion group, the decrease was more significant. For TBUT, FAS, and PPS, results showed that the efficacy of the moxibustion group was significant in both eyes after 4 weeks of treatment, but the right eye was in the artificial tear group. For CFS and Schirmer I test scores, there was no significant effect for both groups. Moxibustion with walnut shell spectacles could improve the clinical symptoms and tear film stability of DED patients; however, it has no significant efficacy on improving corneal injury and tear secretion, just the same as sodium hyaluronate eye drops. Nevertheless, moxibustion with walnut shell spectacles may have better effects on the self-assessment of ocular discomfort than sodium hyaluronate eye drops.