Mean Comfort Research Articles

Multi-objective ergonomics design model optimization for micro electric cars via response surface methodology

Despite advancements in ergonomic comfort assessments in automotive design, optimizing seat dimensions within the constrained spaces of micro-electric cars presents a substantial challenge. In this study, response surface methodology (RSM) is utilized for the ergonomics design of a micro electric car in the conceptual design phase. Specifically, five critical seat dimensions are analyzed: Seatback Angle, Seat Base Angle, Steering Wheel Height from Car Base, Distance from Seat Base to Pedals, and Distance from Seat Base to Steering Wheel. The analysis took place using a 2-level full factorial design L32 orthogonal array. The optimal dimensions are determined using RSM, such as the mean comfort level and signal-to-noise ratio are maximized, and the standard deviation for multiple drivers is minimized. Three regression models are formulated for the three responses, and their adequacy is checked using different methods. The optimal dimensions are obtained and verified through digital human modeling simulation. This research offers practical guidelines for the ergonomic seating design in micro-electric vehicles, enhancing comfort without compromising space efficiency.

Research on the mechanism and measures of riding comfort deterioration in a low floor tram

With the global widespread preference for low-floor trams, the expectation for tram riding comfort has been increasingly heightened. This paper identifies an abnormal riding comfort problem (ARCP, characterized by an excessive and W-shaped distribution of riding comfort) during dynamic field tests on a low-floor tram. To address ARCP, a multi-body dynamics model of the tram was constructed and validated its accuracy through dynamic field tests. By integrating track irregularities and wheel-rail contact analysis, the riding comfort index was assessed and reproduced the ARCP phenomenon. Linearization and time-domain integration studies were conducted on the mechanisms and measures to resolve the ARCP. The research findings reveal that the primary cause of the deterioration in the mean comfort index is the large amplitude of the track irregularity and the low equivalent conicity of the wheel-rail contact relationship. The main reason for the W-shaped distribution of riding comfort is the weaker inter-vehicle constraints and the lack of lateral energy-absorbing devices. Finally, optimization measures were proposed, including reducing the lateral stiffness of the second suspension, altering the carbody structural parameters, and modifying the inter-vehicle connection devices. This research enriches the study of tram dynamic performance and offers insights that may contribute to the resolution of ARCP.

Exploration of digital health literacy in the deep south.

385 Background: As technological advances are implemented in healthcare, cancer patients with low digital health literacy are at risk for inequities. Understanding the community’s comfort with using and teaching technology skills can be foundational for the application of digital healthcare tools. Methods: A cross-sectional survey was administered prior to community conversations about digital health literacy to understand community comfort with technology. Surveys measured self-reported personal comfort performing, personal comfort teaching, and perceived county-comfort completing technology-based tasks. Participants rated their comfort level on a 5-point Likert scale (1= not at all, 2 = slightly, 3 = somewhat, 4 = moderately, 5 = completely). Mean scores were calculated and mean comfort levels were compared across healthcare providers, lay navigators, community health advisors (CHAs), and community members using one-way ANOVA tests. Tukey's HSD post-hoc tests were used to explore group differences. Results: Between 8/2023-4/2024, 164 participants across Alabama and Mississippi completed the pre-survey, including 32 healthcare providers, 17 lay navigators, 31 community health advisors (CHAs), and 84 community members. The sample was primarily female (90%), Black (74%), and from Alabama (84%). ANOVA tests revealed significant group differences between personal comfort levels (p<0.001) comfort teaching (p<0.001), and perception of county-level comfort in technology-based tasks (p=0.043) with lay navigators and healthcare providers reporting higher personal comfort and comfort teaching others technology-based tasks compared to community members (post-hoc Tukey’s HSD). Conclusions: Digital health literacy gaps remain, with lay and clinical providers potentially overestimating comfort with technology. Baseline technology skills must be addressed as healthcare increases reliance on technology. Personal Comfort p-value Comfort Teaching Others p-value Perception of County Comfort p-value Using Search Engines 3.61 4.72 4.76 4.23 <.0001 2.95 4.19 4.88 3.48 <.0001 2.52 3.16 3.82 3.13 0.043 Searching Online for Health-Related Information 3.49 4.66 4.71 4.06 2.90 4.03 4.71 3.35 2.46 2.69 3.29 2.97 Scanning QR codes 2.80 4.47 4.65 3.77 2.55 3.84 4.76 3.13 2.38 2.44 2.71 2.81 Logging into their Patient Portal 3.27 4.44 4.59 3.87 2.75 3.94 4.76 3.03 2.44 2.59 3.00 2.65 Sending their Care-Team a Message 3.05 4.38 4.65 3.74 2.63 3.91 4.82 3.03 2.37 2.44 2.71 2.58 Personal comfort, comfort teaching, perception of community comfort with technology; 7/17 tasks shown; C = community, H = hospital, L = lay navigator, CHAs = community health advisors.

The starting temperature of high-flow nasal cannula and perceived comfort in critically ill patients: A pragmatic randomized controlled trial.

High-flow nasal cannula (HFNC) therapy is a non-invasive respiratory treatment characterized by high tolerability, which largely derives from the patient's comfort. The primary aim of this study was to explore whether the patient's perceived comfort was the same regardless of different approaches used to reach the target humidification temperature. The secondary aim was to assess the patient's perceived nasal dryness and humidity. This single-centre, pragmatic, randomized trial was registered at clinicaltrials.gov (NCT05688189). Patients in the intensive care unit (ICU) in need of HFNC therapy were randomly assigned to one of three study arms: a two-step increase (31 to 34 to 37°C), a one-step increase in temperature (34-37°C) or no temperature increase (started and remained at 37°C). The patients were asked to rate their perceived comfort, as well as their perceived nasal dryness and humidity on a scale from 1 (lowest value) to 5 (highest value). We enrolled 21 patients, aged 34-85 years. The mean (±1 standard deviation) comfort level was 3.3 (1.3) for patients who received a one-step increase, 3.1 (1.3) for those who received no increase and 2.7 (1.7) for those who received a two-step increase (p = .714). There was also no difference in nasal dryness (p = .05) or humidity (p = .612) across the study arms. Greater comfort was fairly correlated with less nasal humidity (ρ = -0.34, 95% confidence interval -0.68 to 0.07) but not with nasal dryness (ρ = 0.01, p = .94). After 30 min of HFNC therapy at a target temperature of 37°C, overall comfort was rated similarly in the three study arms. Additional studies are needed to accumulate evidence corroborating the findings of this study. The temperature of the mixture of air and oxygen is a fundamental component of HFNC therapy. A pragmatic approach irrespective of the initial temperature setting seems to yield a similar comfort score in hospitalized patients with mild respiratory failure because of extrapulmonary causes.

Impact of fetal spine alignment according to maternal lateralization during early labor on maternal comfort and birth outcomes: A prospective cohort study in Kelantan, Malaysia.

Maternal positioning during labor significantly influences maternal comfort. This study aims to identify the preferred maternal lateral position during the latent phase and examine the impact of alignment between maternal lateralization and fetal spine positioning during the active phase of the first stage of labor on maternal comfort. Pregnant women in the first stage of labor beyond 37 weeks of gestation were recruited over six months from March to August 2020 for this prospective cohort study at Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. Eligible individuals were randomly allocated to align with the fetal spine (n=180) or oppose it (n=180). Fetal spine positions were confirmed via transabdominal ultrasound. Maternal mean comfort scores were assessed using the established Maternal Comfort Assessment Tool. Statistical analysis was performed using IBM SPSS version 27, with a p<0.05 considered significant. There was a significant association between the preferred maternal position during the latent phase and concordance with the same maternal lateralization-fetal spine alignment (p<0.001). Higher mean comfort scores were observed when the maternal lateral position matched the fetal spine alignment during the active phase of labor. There was a significant association of normal CTG tracings when the maternal position was aligned with the fetal spine (p<0.001). Parturients preferred lying in alignment with the fetal spine lateralization during the latent phase. This position also offers increased comfort during the active phase of labor. It highlights the importance of considering maternal-fetal alignment as a critical factor in intrapartum care.

The effect of itching on sleep quality and comfort in patients with hemodialysis and renal transplantation: A multi-center cross-sectional study

BackgroundThe aim of this study was to determine the effect of itching on sleep quality and comfort in hemodialysis (HD) and renal transplant (Tx) patients with itching. MethodsThis descriptive, correlational seeking and cross-sectional study was conducted in four hospitals affiliated with a private health group in Istanbul between April and June 2021. The sample of the study consisted of 42 patients receiving HD treatment and 49 patients with renal transplantation. Data were collected using the Patient Information Form, 5-D Itch Scale, Richards-Campbell Sleep Questionnaire and General Comfort Questionnaire. ResultsThere was a significant difference between the HD and renal transplantation groups in the Direction (p = 0.01) and Disability dimension (p = 0.002) of the 5- D Itch scale in favor of the renal transplant group. The mean sleep quality and comfort scores of the groups were similar and moderate. Itching negatively affects sleep quality in patients receiving HD treatment, and 22 % of the change in sleep quality is explained by disability of itching (R2 = 0.22; p = 0.002). Itching negatively affects comfort in both groups. Itching explains 27 % of the change in comfort level in the HD group (R2 = 0.27; p = 0.002) and 25 % of the change in comfort level in the renal transplantation group (R2 = 0.25; p = 0.001). ConclusionsAccording the study results during the hemodialysis treatment process, itching is more intense in terms of distribution and disability and affects the quality of sleep of patients. Itching has a significant impact on patients' perception of comfort. Patients experience itching both during HD treatment and after renal transplantation, which significantly impairs their comfort. Therefore, itching should be carefully monitored during renal replacement therapy and its effects on patients should be evaluated.

The Effect of Active Warming Before Total Knee Arthroplasty on Intraoperative Body Temperature and Comfort: A Randomized Control Trial

PurposeThis study was conducted to determine the effect of active warming on intraoperative body temperature and comfort before total knee arthroplasty. DesignThis study was a randomized controlled trial designed according to the Consolidated Standards of Reporting Trials. MethodsThe study was conducted on 54 patients in a public hospital in Türkiye. In the study, patients in the intervention group were prewarmed for 30 minutes before surgery. The patients in the intervention and control groups were warmed with a warming bed during the surgery. FindingsIn this study, the first entry temperature to the operating room after anesthesia induction and the mean body temperature of the patients in the intervention group were higher than the control group. The mean comfort score of the patients in the intervention group was higher than the control group. ConclusionsAs a result of this study, we found that the combination of preoperative prewarming and intraoperative warming reduced the decrease in the patient's body temperature and increased the comfort.

Effect of a Novel Adaptive Handle Design on the Ergonomic Performance of Periodontal Curettes in Dental Hygienists with and without Musculoskeletal Disorders: A Pilot Clinical Study.

(1) Background: Musculoskeletal disorders (MSDs), discomfort, fatigue, pain, and other acute and chronic work-related injuries are common among dental clinicians. Hand instruments constitute a primary risk factor for these conditions. The overall goal of this study was to compare in dental hygienists with healthy hands, and in those with MSDs, the effect of three different handle designs on instrumentation-related muscle work, comfort, fatigue, and quality of tactile feedback. (2) Methods: Clinicians tested three periodontal curettes: one with a novel adaptive silicone handle, another with a rigid resin handle, and the third with a rigid silicone handle. Ten hygienists-five with MSDs and five without-each scaled three typodonts using the three different curettes. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey's post hoc test, and a significance level of p < 0.05 was implemented. (3) Results: On average, mean comfort and fatigue across all instruments were significantly worse in testers with MSDs, who also expended significantly more work to complete the same task. In all testers, a novel adaptive handle design was associated with significantly reduced total muscle work and post-instrumentation fatigue, as well as better comfort than conventional rigid handle designs. (4) Conclusions: An adaptive curette handle design demonstrated significantly better ergonomic outcomes than conventional rigid curette handle designs. Hygienists with MSDs expend significantly more muscle work during dental instrumentation.

Comparing cadaveric and 3D-printed laryngeal models in transcutaneous injection laryngoplasty.

There is increasing focus on the development of high-quality simulation models for medical education. Cadaveric models, although considered more realistic, may be difficult to obtain and costly. The advent of three-dimensional (3D) printing has offered a low-cost, reliable, and reproducible alternative. This study sought to compare the utility of 3D-printed to cadaveric models for training in transcutaneous injection laryngoplasty (TIL). A simulation course with a cross-over design was employed. Video laryngoscopes were utilized for both the 3D and cadaveric models to assess the accuracy of injection into the vocal fold. Pre-procedure and post-procedure surveys were administered to evaluate understanding and comfort level on a Likert scale of 1-10. Each model was also rated on a 1-5 Likert scale for self-efficacy, fidelity, and educational value. Pre- and post-survey data were completed by 15 otolaryngology residents and medical students. Mean pre-seminar understanding and comfort level were 3.7 and 2.2, respectively, compared to 6.9 and 5.9 (p < .05) following use of the 3D model and 6.4 and 4.7 (p < .05) following use of the cadaver model. When comparing 3D and cadaveric models, no significant differences were observed regarding self-efficacy, fidelity, and educational value. There was a similar mean increase in understanding and comfort following use of the 3D and cadaveric models. 3D-printing can provide an excellent adjunct to, and eventually a potential replacement for hands-on cadaveric training in medical education, particularly for TIL. Level III.

Robotically assisted outflow graft anastomosis in minimally invasive left-ventricular assist device implantation: feasibility, surgeon comfort, and operative times in an anatomical study.

Upper hemi-sternotomy is a common approach for outflow graft anastomosis to the ascending aorta in minimally invasive left-ventricular assist device implantation. Right mini-thoracotomy may also be used, but use of robotic assistance has been reported only anecdotally. The aim of our study was to confirm the feasibility of robotically assisted suturing of the outflow graft anastomosis and to assess performance metrics for the robotic suturing part of the procedure. The procedure was carried out in eight cadaver studies by two surgeons. The assist device pump head was inserted through a left-sided mini-thoracotomy and the outflow graft was passed toward a right-sided second interspace mini-thoracotomy through the pericardium. After placement of a partial occlusion clamp on the ascending aorta, a longitudinal aortotomy was performed and the outflow graft to ascending aorta anastomosis was carried out robotically. The procedure was feasible in all eight attempts. The mean outflow graft anastomotic time was 20.1 (SD 6.8) min and the mean surgeon confidence and comfort levels to complete the anastomoses were 8.3 (SD 2.4) and 6.9 (SD2.2), respectively, on a ten-grade Likert scale. On open inspection of the anastomoses, there was good suture alignment in all cases. We conclude that suturing of a left-ventricular assist device outflow graft to the human ascending aorta is very feasible with good surgeon comfort. Anastomotic times are acceptable and suture placement can be performed with appropriate alignment.

Determining the relationship between gastrointestinal symptoms and comfort in inflammatory bowel patients

Aim: This study aimed to reveal the effect of gastrointestinal symptoms on comfort levels in patients diagnosed with inflammatory bowel disease. Methods: A cross-sectional study design was used. 115 patients diagnosed with inflammatory bowel disease between January 15, 2023, and May 15, 2023, were included in this study. Comfort level was evaluated using the General Comfort Scale Short Form. The data were analyzed using descriptive statistics, and regression analyses. Results: The mean age in the study was The mean age in the study was 41.29 (standard deviation (SD)= 12.81) year. The mean comfort level was 98.93 (SD=19.06). There was a difference between gastrointestinal symptom burden scores according to gender (t = 3.048, p = 0.003), marital status There was a difference between gastrointestinal symptom burden scores according to gender (independent sample t-test (t) = 3.048, p = 0.003), and the presence of chronic disease (t = -4.115, p &lt; 0.001). There is a weak negative relationship between age and comfort level There is a weak negative relationship between age and comfort level (pearson correlation (r) = -0.191, p = 0.041). Conclusion: This study emphasized that gastrointestinal symptom burden is an important determinant of comfort level in patients diagnosed with inflammatory bowel disease and comfort decreases as gastrointestinal symptom load increases.

Evaluation of Complications Associated with Fixed Partial Denture: A Prospective Study.

To assess complications, survival rates, and patient-reported outcomes associated with fixed partial dentures (FPDs). A cohort of 146 subjects, aged 18 and above, requiring FPD were recruited. Following comprehensive dental examinations, FPDs were fabricated. Complications, survival rates, and patient-reported outcomes were evaluated at 3, 6, 12, and 24 months. Complications such as marginal discrepancies and framework fractures showed low frequencies over short-, mid-, and long-term intervals. Survival rates were high at 98.6%, 96.2%, 93.7%, and 91.1% at all intervals, respectively. Patient-reported outcomes indicated a mean comfort level of 8.2 with speech difficulties (8.2%) and hygiene challenges (4.8%). Overall satisfaction was high, with a mean score of 9.0. This study provided evidence of favorable outcomes with low complication rates, high survival rates, and positive patient-reported experiences associated with FPDs.

Enhancing Oncologists' Comfort with Serious Illness Conversations: The Impact of Serious Illness Conversation Guide (SICG) Training.

Providers oftentimes need to have difficult conversations with patients facing a poor prognosis. Research indicates that providers generally feel ill prepared for these conversations and that bad conversations may lead to more anxiety for patients. Communication skills development training programs have shown improvement in providers' skills. Our cancer center embarked on skills development training to help providers improve their skills and comfort in having serious illness conversations. During our phased approach, about 500 physicians and advanced practice providers in the Division of Oncology were trained for over a year. Their level of comfort with serious illness conversations was measured before and after the training by using both quantitative and qualitative methods. We found that mean and median comfort scores increased from pre-training to post-training. The findings suggest that the improved comfort and confidence observed among providers who undergo communications skills training can lead to better provider-patient communication, more patient-centered care, and improved patient satisfaction.

Sports participation after craniosynostosis repair: the critical role of post-operative guidance in parental decision-making.

Despite previous research supporting patient safety in sports after craniosynostosis surgery, parental anxiety remains high. This study sought to evaluate the role of healthcare providers in guiding patients and families through the decision-making process. Parents of children with repaired craniosynostosis were asked to assess sports involvement and parental decision-making in children ages 6 and older. Questions were framed primarily on 5-point Likert scales. Sport categorizations were made in accordance with the American Academy of Pediatrics. Chi-squared, linear regression, and Pearson correlation tests were used to analyze associations between the questions. Forty-three complete parental responses were recorded. Mean ages at surgery and time of sports entry were 7.93 ± 4.73months and 4.76 ± 2.14years, respectively. Eighty-two percent of patients participated in a contact sport. Discussions with the primary surgeon were more impactful on parental decisions about sports participation than those with other healthcare providers (4.04 ± 1.20 vs. 2.69 ± 1.32). Furthermore, children whose parents consulted with the primary surgeon began participating in sports at a younger age (4.0 ± 1.0 vs. 5.8 ± 2.7years, p = 0.034). The mean comfort level with contact sports (2.8 ± 1.4) was lower than that with limited-contact (3.8 ± 1.1, p = 0.0001) or non-contact (4.4 ± 1.3, p < 0.0001) sports. This study underscores the critical role that healthcare professionals, primarily surgeons, have in guiding families through the decision-making process regarding their children's participation in contact sports.

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.

Evaluation of knowledge of healthcare professionals regarding tracheostomy care: a cross-sectional study at a tertiary care hospital in Pakistan

BackgroundTracheostomy is considered the oldest and the most effective operative procedure for patients admitted to intensive care units and in emergencies. The study’s objective was to evaluate healthcare providers’ knowledge regarding tracheostomy care.ResultsAll healthcare professionals directly involved in the provision of care to patients with tracheostomy were included and asked to fill out the questionnaire. The response rate was 87.63%. Out of 50, the mean comfort score was 37.69. 70.6% of participants reported having a comfort score equal to or more than 70%. Out of 10, the mean score was 5.29. Only 20.9% of participants were able to score equal to or more than 70%. The results demonstrate that healthcare professionals’ knowledge of tracheostomy care was below par. Only those who were experienced in this field were able to score above average.ConclusionThe assessment of knowledge in tracheostomy care highlights the significance of ongoing education and training in the healthcare field. As medical practices evolve, it is imperative for healthcare providers to stay updated with the latest guidelines and techniques to provide the highest standard of care.

Public perspectives on the use of different data types for prediction in healthcare.

Understand public comfort with the use of different data types for predictive models. We analyzed data from a national survey of US adults (n = 1436) fielded from November to December 2021. For three categories of data (identified using factor analysis), we use descriptive statistics to capture comfort level. Public comfort with data use for prediction is low. For 13 of 15 data types, most respondents were uncomfortable with that data being used for prediction. In factor analysis, 15 types of data grouped into three categories based on public comfort: (1) personal characteristic data, (2) health-related data, and (3) sensitive data. Mean comfort was highest for health-related data (2.45, SD 0.84, range 1-4), followed by personal characteristic data (2.36, SD 0.94), and sensitive data (1.88, SD 0.77). Across these categories, we observe a statistically significant positive relationship between trust in health systems' use of patient information and comfort with data use for prediction. Although public trust is recognized as important for the sustainable expansion of predictive tools, current policy does not reflect public concerns. Low comfort with data use for prediction should be addressed in order to prevent potential negative impacts on trust in healthcare. Our results provide empirical evidence on public perspectives, which are important for shaping the use of predictive models. Findings demonstrate a need for realignment of policy around the sensitivity of non-clinical data categories.

A Medical Student Obstetric Curriculum Consisting of Online Modules and a Normal Spontaneous Vaginal Delivery Simulation Exercise.

In many medical schools, students are exposed to obstetrics for 2 weeks during the third-year obstetrics and gynecology clerkship. Hence, the purpose of this study was to evaluate the effectiveness of a curriculum combining online obstetric modules and a normal spontaneous vaginal delivery (NSVD) simulation on medical student knowledge and comfort pertaining to obstetrics at the start of the clerkship. Students completed the curriculum at the start of the clerkship. They completed questionnaires before and after each module and the simulation. The questionnaires assessed knowledge, management comfort level, and satisfaction with module/simulation. Comfort level and satisfaction scores were based on a 1-5 Likert scale (1 = very uncomfortable/unfavorable, 5 = very comfortable/favorable). Satisfaction scores for online modules were compared with those for a historical cohort of traditional lectures on the same topics. Students also rated satisfaction with the curriculum. Sixty students participated. Mean knowledge and comfort scores significantly increased from 7.2 to 9.2 (P < .001) and from 2.7 to 3.9 (P < .001) before and after the modules, respectively. Although satisfaction scores for traditional lectures were significantly higher than for online modules (4.7 vs. 4.4, P < .001), online modules were still favorably received. Mean satisfaction score for the NSVD simulation was 4.8. Overall, satisfaction score for the curriculum was 4.5. An obstetric curriculum consisting of online modules and simulation significantly increases medical student learner knowledge and comfort and is associated with a high level of satisfaction.

Gender difference regarding thermal comfort in Japanese residential building during free running mode

When experiencing a similar indoor environment, people's thermal comfort and sensation may differ, making it more difficult to create an appropriate thermal environment for each person who living in the same building or residence. In both shared and single-occupant constructed environments, personal or individual comfort models have been proven to more precisely forecast particular thermal comfort requirements than aggregated models, raising occupant tolerance and related energy advantages. Dealing with these issues can result in more balanced datasets and the expansion of personalized model applications into new environments. Therefore, from November 2015 to November 2017, a field measurement was carried out in a Japanese condominium. 53 selected houses with measured indoor air temperature and 21,502 thermal sensation votes (TSV) from thermal comfort survey for each participant during free running mode (FR) were gathered. The results showed that 98% of male and 96% of female voted within comfort band. The thermal comfort zone starts from 18 to 26 °C as 90% of the occupant voted 3, 4 and 5 for TSV (comfort zone). The mean comfort temperature for males was found to be significantly higher than females during summer at which males has 1.2 °C (June), 2.1 °C (July) and 2.2 °C (August) higher comfort temperatures. Clothing insulation for each gender proved to be an important role on how they choose their TSV and thus impacted the comfort temperature. The results can help the researchers in providing information when designing passive building system while contributing to improve the occupant behavior and thermal comfort.

Colposcopy and Loop Electrosurgical Excision Procedure: A Simulated Exercise.

Cervical intraepithelial neoplasia 3 is associated with a high degree of progression to cervical cancer. Its risk is markedly reduced after excisional treatment. Hence, it is critical that providers accurately diagnose and treat this condition. We present a simulation-based module focused on resident mastery of performance of colposcopy and loop electrosurgical excision procedure (LEEP). Learners were obstetrics and gynecology residents. Guidelines on performance of colposcopy and LEEP were presented prior to module participation. We used pelvic task trainers, kielbasa sausages, and routine equipment for performance of colposcopy and LEEP. Colposcopy and LEEP sessions each lasted 30 minutes. Learners completed questionnaires before and after regarding comfort level on aspects of colposcopy and LEEP performance and level of agreement with statements on performing procedures independently. Comfort levels and degrees of agreement were based on 5-point Likert scales (1 = very uncomfortable/strongly disagree, 3 = neither comfortable nor uncomfortable/neutral, 5 = very comfortable/strongly agree, respectively). Modules were held in November 2021 and May 2022. Thirty-four residents participated. Mean comfort scores significantly increased from 3.1 to 4.3 (p < .001) before and after the module for all steps. There was an increase in level of agreement with statements on being able to independently perform colposcopy (2.2 to 3.5, p < .01) and LEEP (2.9 to 3.6, p = .06). Simulation-based modules on performance of colposcopy and LEEP significantly increased resident learner comfort in the performance of these procedures. Comfort in performing these procedures is important in providing comprehensive gynecologic care.