Perception Of Discomfort Research Articles

Mechanisms of thermal dysregulation in primary hyperhidrosis and hypohidrosis.

Mechanisms of thermal dysregulation in primary hyperhidrosis and hypohidrosis.

The impact of a modified electronic probe tip design on patient perception of discomfort during periodontal probing using standardized probing force: A randomized controlled trial

This study evaluated pain associated with electronic probing comparing two commercially available probe tip designs using standardized force. Twenty adult patients with slight-moderate chronic periodontitis received periodontal probing using controlled-force electronic probe at 2 visits. In visit 1, a random arch was probed with either a ball-end (0.6mm diameter, 408kPa; Test) or straight (0.45mm diameter, 726kPa; Control) probe tip. The opposing arch was then probed using the other probe tip. Discomfort associated with each probing episode was recorded using visual analogue scale (VAS). 7days later, tip assignments were alternated from visit 1 and VAS re-scored. VAS scores were compared by probe tip, arches and visits. Both tips provided similar VAS scores (median 13.5 for ball-end and 14 for straight, p=.3713). However, the straight tip was associated with decreased VAS scores in the maxilla (p=.01). Overall, VAS values did not differ by arch or study visit. Individual VAS scores showed high levels of correlation between study visits and between tips used (R2 =.86 and 0.64, respectively, p<.0001). Both probing approaches were associated with low levels of pain on probing. The straight tip may be perceived as more comfortable in the maxilla.

Do teenagers recover from traumatic situations? Identification of types of change and relationship with psychopathology and coping

Teenagers may experience potentially traumatic interpersonal and non-interpersonal events in everyday life that could cause discomfort. The general aim of this study was to explore changes over time in the perception of such discomfort and the psychopathological symptoms and coping linked to such change. The specific objectives were to: (a) describe the potentially traumatic life events (PTLEs) reported by participants; (b) analyze types of change in the distress experienced at the time that the event occurred and now according to gender and the time elapsed since the PTLE, and (c) assess psychopathological symptoms and coping styles according to four categories of change in distress (no-distress, permanence in initial distress, increased distress and decreased distress). MethodsA retrospective cross-sectional design was employed. Five hundred and fifty-three Spanish teenagers (13 to 19 years old; 60.6% female) completed the LITE-S, YSR and A-COPE-SP self-reports, which assess traumatic events, psychopathological symptoms and coping style, respectively. ResultsAmong the participants, 98.5% reported at least one PTLE, with non-interpersonal events more common than interpersonal events. Depending on the specific PTLE, 48% to 74% of teens reported reduced distress since the incident, a maximum of 16% reported increased distress, and between 6% and 56.5% reported permanence in the initial distress. Depending on the PTLE, anxiety and oppositional behaviors were higher in those showing increased distress, while affective and post-traumatic stress were lower in individuals showing decreased distress. Coping styles did not vary much between the types of change in distress, with the exception of searching for friendship, which was less common in adolescents who showed no distress over time. Being taken away from family caused the most persistent distress ConclusionsThis study provides a useful framework for understanding the experiences of adolescents exposed to PTLEs, indicating that adolescents generally show good ability to recover from trauma. However, teens with increased and permanent distress over time have been identified as an at-risk population, and are therefore likely to be cared for by psychological or psychosocial services.

Overcoming difficult conversations: Training medical professionals to discuss mental health with cancer survivors.

e19155 Background: Cancer survivors have overcome a significant health challenge, and now face the physical, social and emotional effects of surviving cancer. These psychosocial side-effects are often not addressed in the clinic due to time constraints, false perceptions of reimbursement and discomfort toward the subject from both the patient and medial professional. The National Association of Chronic Disease Directors, along with the Centers for Disease Control and Prevention and Kognito Solutions have developed a series of conversation simulations led by virtual human, digital characters to help medical professionals practice these patient interactions. Methods: The simulation was developed after an extensive literature review and interviews with cancer survivors and 12 professionals in oncology and primary care. Scripts were developed that included hundreds of conversation pathways for providers to choose from. Scripts were tested by subject matter experts in clinical psychology, oncology and survivorship. Three video interviews with survivors were included along with a didactic teaching segment to provide instruction to medical professionals participating in the simulation. Results: The resulting learning experience is a self-guided conversation pathway where the medical professional chooses responses to the virtual cancer survivor’s questions guiding the survivor toward a discussion focused on distress. The simulation offers feedback and suggests conversational improvements throughout the process. The simulation is now complete and freely available online. Full rollout and dissemination including CME credits will begin in March. To date,197 distinct users have engaged in the simulation. Users self-reported the simulation was high quality and resulted in them listening more, asking more open-ended questions, and discussing mental health issues routinely with patients. Conclusions: This innovative approach to learning offers an interactive and highly engaging way to practice difficult discussions with patients. Increasing the quality and frequency of mental health screenings with cancer survivors will empower survivors and improve their adherence to other health behaviors reducing the risk of recurrence. Increased use of the simulation after the national rollout will allow a more robust evaluation of future impact on patient mental health and changes in medical practice.

A low caffeine dose improves maximal strength, but not relative muscular endurance in either heavier-or lighter-loads, or perceptions of effort or discomfort at task failure in females.

BackgroundThe body of literature considering caffeine as an ergogenic aid has primarily considered typically aerobic based exercise, male participants and moderate-to large-caffeine doses. With this in mind the aim of this project was to explore the effects of a low-caffeine dose upon maximal voluntary contraction (MVC) and muscular endurance (time to task failure, TTF) at heavier-and lighter-loads.MethodsNineteen physically active, habitual caffeine consuming females randomly performed four testing conditions; two with a low-dose of caffeine (100 mg equating to mean = 1.5 ± 0.18 mg·kg−1) and two placebo conditions, where they performed a maximal strength test (MVC) knee extension at 45° followed by a task of relative muscular endurance (sustained isometric contraction for TTF) using either heavier-(70% MVC) and lighter-(30% MVC) loads. Each participant performed each load condition following both caffeine and placebo consumption. Immediately following cessation of the muscular endurance test participants were asked to report their rating of perceived effort (RPE) and rating of perceived discomfort (RPD).ResultsAnalyses revealed a significant effect for caffeine upon MVC compared to placebo (p = 0.007). We also found a significantly greater TTF for the lighter-compared to the heavier-load condition (p < 0.0001); however, there was no significant effect comparing caffeine to placebo (p = 0.2368), but insufficient precision of estimates to infer equivalence in either lighter-(p = 0.750) or heavier-load (p = 0.262) conditions. There were no statistically significant effects for caffeine compared with placebo, or lighter-compared with heavier-loads, for RPE and RPD (all p > 0.05). RPE was statistically equivalent between caffeine and placebo for both lighter-(p = 0.007) and heavier-load (p = 0.002) conditions and RPD for heavier-(p = 0.006) but not lighter-load (p = 0.136).DiscussionThis is the first study to demonstrate a positive effect on strength from a low caffeine dose in female participants. However, it is unclear whether caffeine positively impacts upon relative muscular endurance in either heavier-or lighter-loads. Further, both RPE and RPD appear to be relatively similar during isometric tasks performed to task failure independently of caffeine supplementation or load. These findings may have implications for persons wishing to avoid side-effects or withdrawal symptoms associated with larger caffeine doses whilst still attaining the positive strength responses.

Lighter-Load Exercise Produces Greater Acute- and Prolonged-Fatigue in Exercised and Non-Exercised Limbs

ABSTRACT Purpose: The present study compared the fatigue and perceptual responses to volume-load matched heavier- and lighter- load resistance exercise to momentary failure in both a local/exercised, and non-local/non-exercised limb. Methods: Eleven resistance-trained men undertook unilateral maximal voluntary contraction (MVC) testing for knee extension prior to and immediately, 24 hr- and 48 hr- post heavier (80% MVC) and lighter (40% MVC) load dynamic unilateral knee extension exercise. Only the dominant leg of each participant was exercised to momentary failure using heavier and lighter loads, and perceptions of discomfort were measured immediately upon exercise cessation. Results: Point estimates and confidence intervals suggested that immediately post-exercise there was greater fatigue in both the exercised and non-exercised legs for the lighter- load condition. At 24 hr the exercised leg under the heavier-load condition had recovered to pre-exercise strength; however, the exercised leg under lighter- load condition had still not fully recovered by 48 hr. For the non-exercised leg, only the lighter-load condition induced fatigue; however, recovery had occurred by 48 hr. Median discomfort ratings were statistically significantly different (Z = −2.232, p = .026) between lighter and heavier loads (10 [IQR = 0] and 8 [IQR = 3], respectively). Conclusions: This study suggests that lighter-load resistance exercise induces greater fatigue in both the exercised- and non-exercised limbs, compared to heavier-load resistance exercise. These findings may have implications for exercise frequency as it may be possible to engage in heavier-load resistance exercise more frequently than a volume-load matched protocol using lighter loads.Abbreviations CI: Confidence intervals: ES: Effect size: MVC: Maximum voluntary contraction; Nm:Newton meters; RM: Repetition maximum; SD: Standard deviation; SI: Strength index

Influence of Background Spectral Distribution on Perceptions of Discomfort Glare

&lt;div class="section abstract"&gt;&lt;div class="htmlview paragraph"&gt;The advent of light-emitting diode (LED) technology for automotive lighting allows flexibility of the spectral distribution of forward headlighting systems, while meeting current requirements for “white” illumination. As vehicle headlights have become whiter (with more short-wavelength light output) over the past several decades, their potential impacts on visual discomfort for oncoming and preceding drivers have been hotly debated. It is known that a greater proportion of short-wavelength energy increases discomfort glare, and that increasing the background light level (e.g., through roadway lighting) will decrease perceptions of discomfort. More recently it has been demonstrated that the visual system exhibits enhanced short-wavelength sensitivity for perceptions of scene brightness. As a result, roads illuminated by light sources with higher correlated color temperatures (CCTs) will be judged as appearing to be brighter than those illuminated to the same light level by sources with lower CCTs. The present laboratory study was conducted to identify whether the increased scene brightness of a road illuminated with greater short-wavelength light helps to mitigate discomfort glare more than the same scene illuminated to the same light level, but with less short-wavelength light. The results indicate that the spectral distribution of the background plays little role in the degree to which it lessens discomfort glare. The implications of these results for vehicle and road lighting practices are discussed.&lt;/div&gt;&lt;/div&gt;

CALM scale – Assessment of the total comfort of the popular female jeans

The present paper consists on the experimental stage of a PhD research, on the study of the popular female jeans comfort, referring to the process of subjective evaluation of comfort to wear, specifically the comfort objective evaluation of the jeans to wear, using CALM scale. The popular jeans in study, refers to the jeans created, produced and consumed by the poor classes of Fortaleza, in the state of Ceará, Brazil. The purpose is to investigate the female jeans, with the objective of collecting information about the comfort / discomfort perceptions of the consumers of the Fortaleza popular markets. When the collected responses were correlated, it was found that the perception of comfort/discomfort of the jeans is directly related to the touch sensation.

Sala de espera: educação em saúde em um ambulatório de gestação de alto risco

O objetivo deste trabalho foi identificar as necessidades das gestantes referentes a assuntos que possam ser abordados em atividades de educação em saúde, no momento de espera, em um ambulatório de referência de gestação de alto risco. Trata-se de um estudo descritivo, qualitativo e de campo, utilizando a análise de conteúdo temática de Bardin. Participaram 35 gestantes presentes no dia da consulta de pré-natal. Emergiram então seis categorias: Percepção de desconforto durante o momento de espera; Sentimento de abandonado no momento de espera e preocupação com o retorno ao trabalho; Referência a sintomas de ordem física e emocional; Participação (ou não) de educação em saúde; Sugestão de desenvolvimento de atividades educativas no momento de espera; Proposição de oferta oportuna de lanches durante o momento de espera. Assim, a partir das necessidades identificadas, sugere-se a prática de educação em saúde como forma de otimizar o tempo de espera para a consulta de pré-natal deste serviço.

I'll Be a Caregiver-Employee: Aging of the Workforce and Family-to-Work Conflicts.

BackgroundThe double role of caregiver-employee (CE) defines those workers who simultaneously serve as an informal, unpaid care provider for sick, disabled, or elderly relatives, and it is a situation that is on the increase in most western countries. Providing informal caregiving can lead to detrimental effects on emotional well-being and several physical and psychological diseases (e.g., caregiver-burden). CEs can suffer double discomfort (at work and at home), but, first of all, they can be exposed to a high level of home-to-work conflict (HWI). In this study, we analyzed the CE phenomenon in a typical Italian public company, where the mean age of workers is particularly high.MethodsAn online questionnaire related to the perception of HWI, well-being, and discomfort at work (depression, emotional exhaustion, job engagement) in relation to the family load (none, parents with <12 children to care for, caregiver to other adults, or children and older adults to care for/old/children to care for employees) was answered by 1704 administrative workers.ResultsMore than 20% of our sample was included in the elder caregiver condition or in the double role or “sandwiched” condition with older adults and children to care for. The family load changed significantly between the different age groups: for workers aged between 55 and 64 years, the percentage was nearly 27%. CEs had higher levels of HWI and of personal and job discomfort and lower levels of engagement, when compared with non-CEs. Having “only” older adults to care for (the typical CE condition) was associated with having the most negative results.ConclusionThis study confirms and underlines the increasing number of CEs in western organizations and their higher levels of HWI, work disengagement, emotional exhaustion, and depression. As the general population and workforce experience increased “graying,” and many more workers become CEs out of necessity, stable caregiver-friendly workplace policies (CFWPs) should be developed.

Discomfort/Pain and Tissue Oxygenation at the Lower Limb During Circumferential Compression: Application to Soft Exoskeleton Design.

To establish the relationship between circumferential compression on the lower limb during simulated ramp and staircase profile loading, and the resultant relationship with discomfort/pain and tissue oxygenation. Excessive mechanical loading by exoskeletons on the body can lead to pressure-related soft tissue injury. Potential tissue damage is associated with objective oxygen deprivation and accompanied by subjective perception of pain and discomfort. Three widths of pneumatic cuffs were inflated at the dominant thigh and calf of healthy participants using two inflation patterns (ramp and staircase), using a computer-controlled pneumatic rig. Participants rated discomfort on an electronic visual analog scale and deep tissue oxygenation was monitored using near infrared spectroscopy. Circumferential compression with pneumatic cuffs triggered discomfort and pain at lower pressures at the thigh, with wider cuffs, and with a ramp inflation pattern. Staircase profile compression caused an increase in deep tissue oxygenation, whereas the ramp profile compression decreased it. Discomfort and pain during circumferential compression at the lower limb is related to the width of pneumatic cuffs, the inflation pattern, and the volume of soft tissue at the assessment site. The occurrence of pain is also possibly related to the decrease in deep tissue oxygenation during compression. Our findings can be used to inform safe and comfortable design of soft exoskeletons to avoid discomfort and possible soft tissue injury.

A comparison between mometasone furoate nasal spray and intranasal glycyrrhetic acid in patients with allergic rhinitis: a preliminary study in clinical practice.

Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction consequent to the exposure to the causal allergen. Glycyrrhetic acid (GlyAc) is a natural compound extracted from the liquorice that exerts anti-inflammatory activity. This real-life study compared intranasal GlyAc, present in a medical device containing also glycerol and mannitol, with mometasone furoate nasal spray (MFNS) in 50 adult outpatients with AR. Both treatments lasted 2 months. Endoscopic signs, perception of symptom severity, assessed by VAS, and nasal function measured by rhinomanometry were evaluated at baseline (T0), after one (T1) and two (T2) months. The intergroup analysis showed that at T1 there was no significant difference between groups about the use of decongestants and antihistamines, turbinate hypertrophy and pale mucosa, perception of olfaction and snoring. At T2 there was no significant difference between groups about use of relievers, all endoscopic signs, and perception of nasal discomfort, nasal obstruction, olfaction, and snoring. The intragroup analysis showed that in MFNS group there was a significant change during the entire period of treatment for all parameters except watery rhinorrhea (sign) and ocular discomfort; in GlyAc group there was a significant change during the entire period of treatment for all parameters. In conclusion, this preliminary study, conducted in clinical practice, evidenced that intranasal CysAC plus mannitol was able to significantly improve nasal endoscopic signs, perception of symptoms, and nasal function in patients with AR. Therefore, GlyAc could be a reasonable therapeutic option to control allergic inflammation. (www.actabiomedica.it)

Effects of Different Dispositions of Resistance Exercises on Subjective Perception of Effort, Discomfort and Affectivity in Older Women

AbstractThe purpose of the study was to verify the effect of two dispositions of resistance exercises on rate of perceived of effort (RPE), discomfort and affectivity in older women. Twenty older women (68.0±6.6 years, 69.8±12.7 kg, and 155.9±7.0 cm) performed in a balanced and randomized design two experimental conditions, namely: a circuit (CIRC) fashion and another in a traditional (TRAD) fashion. In both conditions, six resistance exercises in the following order were performed: push press with kettlebell, swing with kettlebell, plantar flexion, squatting, ladder displacement and shoulder flexion with naval rope, with the same load and three sets of 15 repetitions/exercise. In the CIRC condition, the exercises were performed in stations, with no interval among them, and at the end of the last exercise, a three-minute interval was performed. For the TRAD condition the exercises were performed in consecutive sets, with intervals of 90s between the sets and the exercises. After 15 min of the closure of each session, the RPE (OMNI), feeling (Hardy and Rejeski) and a discomfort scale were applied. There was no significant difference (P&gt;0.05) among the sessions for PSE (TRAD = 6.0±1.2 vs. CIRC = 6.1±0.9), feeling (TRAD = 3.7±1.6 vs. CIRC = 3.6±1.2) and discomfort (TRAD = 5.2±1.4 vs. CIRC = 5.1±1.3). The results suggest that PSE, discomfort and affective response to resistance exercises are similar when performed in CIRC or TRAD in older women. Keywords: Exercise. Aging. Physical exertion. ResumoO objetivo do estudo foi verificar o efeito de duas diferentes disposições de execução de exercícios resistidos sobre a percepção subjetiva de esforço (PSE), o desconforto e a afetividade em mulheres idosas. Vinte mulheres idosas (68,0±6,6 anos, 69,8±12,7 kg e 155,9±7,0 cm) foram distribuídas de forma balanceada e aleatorizada para duas condições experimentais: disposição de circuito (CIRC) e disposição tradicional (TRAD). Em ambas as condições, seis exercícios resistidos foram executados na seguinte ordem: push press com kettlebell, swing com kettlebell, flexão plantar, agachamento, deslocamento em escada e flexão de ombros com corda naval, com mesma carga e três séries de 15 repetições/exercício. Na condição CIRC os exercícios foram executados em forma de estações, sem intervalo entre os exercícios e, ao final de cada série foi concedido intervalo de três minutos. Para condição TRAD os exercícios foram executados em séries consecutivas, com intervalos de 90s entre os exercícios e as séries. Após 15 min do termino de cada sessão foram aplicadas as escalas de PSE (OMNI), sentimento (Hardy e Rejeski) e desconforto. Não ocorreram diferenças significativas (P&gt;0,05) entre as sessões para PSE (TRAD = 6,0±1,2 vs CIRC = 6,1±0,9), sentimento (TRAD = 3,7±1,6 vs CIRC = 3,6±1,2) e desconforto (TRAD = 5,2±1,4 vs CIRC = 5,1±1,3). Os resultados sugerem que a PSE, o desconforto e a resposta afetiva aos exercícios resistidos são semelhantes quando realizados em CIRC ou TRAD em mulheres idosas. Palavras-chave: Exercício Físico. Envelhecimento. Esforço Físico.

Modelling postural discomfort perception using CHAID decision tree algorithm

Developing quantitative models that predict discomfort levels of working postures has been an important ergonomics research topic. Such modeling not only has practical applications, but also may serve as a useful research method to improve our understanding of the human postural discomfort perception process. While the existing models have focused on achieving high prediction accuracy, less attention has been given to model interpretability, which is vital for understanding a process through modeling. Research is needed to identify the model types or modeling methods that offer high interpretability as well as good prediction accuracy. The goal of this study was to evaluate the utility of the Chi-square Automatic Interaction Detector (CHAID) decision tree modeling method in developing postural discomfort prediction models. Ten individual-specific decision tree models were developed, which predicted overall upper-body discomfort from local body part discomfort ratings. The prediction models were found to achieve high prediction accuracy and interpretability. (150 words)

Physiological and neuromotor changes induced by two different stand-walk-sit work rotations

The potential of rotating postures to alleviate the effects of prolonged standing and sitting postures has been advocated to attenuate the accumulation of muscle fatigue, considered a precursor to musculoskeletal disorders. We aimed to evaluate the effects of two posture rotations, both including standing, walking, sitting, on physiological and neuromotor measures. Twenty-two participants followed two posture rotations, with different rest-break distributions, for 5.25 h. Lower-leg muscle twitch force, volume, force control and discomfort perception were evaluated during and after work exposure on two non-consecutive days. Significant changes in all measures indicate a detrimental effect in lower-leg long-lasting muscle fatigue, oedema, performance and discomfort after 5 h for both exposures. However, for both exposures recovery was significant 1 h and 15 h post-workday. Differences between the two rotation schedules were not significant. Hence, stand-walk-sit posture rotation promotes recovery of the tested measures and is likely to better prevent muscle fatigue accumulation. Practitioner summary: Lower-leg muscle twitch force, volume, force control, and discomfort were quantified during and after 5 h of stand-walk-sit work rotations with two different rest-break distributions. Measures revealed similar significant effects of work exposures regardless of rotation; which did not persist post-work. This beneficial recovery contrasts with the standing only situations. Abbreviations: MSDs: musculoskeletal disorders; MTF: muscle twitch force; RMSE: root mean square error; MVC: maximum voluntary contraction; M: mean; SE: standard error

Spinal shrinkage, sagittal alignment and back discomfort changes in manufacturing company workers during a working day

Prolonged standing and lifting heavy loads are risk factors for the appearance of low back pain in work. The aim of this study was to observe changes in the height, spinal sagittal alignment, and the lumbar and dorsal discomfort perception in assembly line workers. Cross-sectional study, 40 assembly line workers (6 females). Height, sitting height, grades of thoracic kyphosis and lumbar lordosis and perceived spine discomfort, before and after the working day, were determined. Thoracic and lumbar sagittal alignment was compared between discomfort developers and no developers. There was a significant decrease in the height and sitting height of the workers at the end of the day. Thoracic and lumbar curvature increased significantly, as did the perceived lumbar discomfort. Workers on the assembly line, in a prolonged standing work, suffer an increase in lumbar discomfort, and changes in height and thoracic and lumbar curvatures. Practitioner summary: Spinal shrinkage, sagittal alignment and back discomfort (upper and lower back), were analysed in assembly line workers in prolonged standing during a workday. Assembly line workers suffer a decrease in height, an increase in their thoracic and lumbar curvature, and in lumbar discomfort throughout their workday.

Physical fitness, musculoskeletal disorders and body mass index in transport drivers from Barranquilla, Colombia

Introduction: Sedentary work activities in urban transport drivers are associated with overweight and obesity, an increase in musculoskeletal discomfort related to work and a decrease in physical fitness.Objective: To determine physical fitness and musculoskeletal discomfort in urban transport drivers from Barranquilla, Colombia, based on their body mass index (BMI).Material and Methods: Cross-sectional study conducted in 231 urban transport drivers. Healthy physical fitness and presence of musculoskeletal symptoms were measured using the AFISAL-INEFC test battery and the Nordic Questionnaire developed by Kuorinka, respectively.Results: There were significant differences between drivers with normal BMI and overweight/obese drivers in abdominal strength and endurance (21.4±8.9 vs. 19.6±8.8 stooped, p=0.04), flexibility (36.1±7.3 cm vs. 33.6±7.1 cm, p=0.02), and aerobic capacity (1537.5±704.8 meters vs. 1249.1±346.6 meters, p=0.0001). Increased frequency of musculoskeletal discomfort was observed in subjects with BMI &gt;25 kg/m2.Conclusions: Overweight and obesity are associated with poor physical fitness and the perception of musculoskeletal discomfort, which has negative implications for the personal and occupational well-being of these workers, generating a burden for companies and the Colombian health system.

Sweat distribution and perceived wetness across the human foot: the effect of shoes and exercise intensity

This study investigates foot sweat distribution with and without shoes and the relationship between foot sweat distribution and perceived wetness to enhance guidance for footwear design. Fourteen females performed low-intensity running with nude feet and low- and high-intensity running with shoes (55%VO2max and 75%VO2max, respectively) on separate occasions. Right foot sweat rates were measured at 14 regions using absorbent material applied during the last 5 min of each work intensity. Perceptual responses were recorded for the body, foot and four foot regions. Foot sweat production was 22% greater nude (p < .001) and with shoes did not increase with exercise intensity (p = .14). Highest sweat rates were observed at the medial ankle and dorsal regions; lowest sweat rates at the toes. Perceptions of wetness and foot discomfort did not correspond with regions of high sweat production or low skin temperature but rather seemed dominated by tactile interactions caused by foot movement within the shoe. Practitioner summary: This study provides a detailed view of foot sweat distribution for female runners with and without shoes, providing important guidance for sock and footwear design. Importantly, perceptions of wetness and foot discomfort did not correspond with areas of high sweat production. Instead tactile interactions between the foot, sock/shoe play an important role. Abbreviations: VO2max: maximal oxygen consumption; HR: heart rate; RH: relative humidity; GSL: gross sweat loss; Nude-I1: without socks and shoes, low intensity running; Shod-I1: with socks and shoes, low intensity running; Shod-I2: with socks and shoes, high intensity running

Use of Voice Handicap Index (VHI) as Predictor of Outcome of Non-surgical Treatment in Vocal Nodules

Introduction&#x0D; Vocal Nodule is commonest benign vocal cord lesion which causes varying degree of dysphonia having serious impact on personal and professional well being. Voice Handicap Index (VHI) is a psychometrically validated tool for measuring pshycosocial handicapping effect of voice disorder.&#x0D; &#x0D; Materials and Methods&#x0D; From data available since last 18 months, patients who had undergone treatment for vocal nodule were selected as study population. In Group A, 50 patients were selected who required surgery and Group B, 50 patients who responded to medical treatment. Patients filled in VHI-30 form at time of diagnosis and subjected to voice therapy and adjunctive medical treatment for 1 month and reassessed using VHI-30. Successful treatment consisted of absence of pathology by laryngoscopy and decrease of VHI total score ≥18.&#x0D; &#x0D; Results&#x0D; The cut-off score was calculated using Receiver Operating Characteristics (ROC). VHI cut-off of total score was 45 (Sensitivity 94%, Specificity76%). The cut-off score for functional, physical and emotional domains are 14(Sensitivity 94%, Specificity 64%) , 15(Sensitivity 92%, Specificity 60%) and 15(Sensitivity 90%, Specificity 66%) respectively.&#x0D; &#x0D; Discussion &#x0D; Hard consistency of nodules can explain refractoriness to speech therapy and higher VHI score. The physical subscale of VHI was higher among both groups indicating patients’ perceptions of laryngeal discomfort and voice output affected them more. According to our study patients with higher VHI score should be counselled for MLS at earliest instead of speech therapy for one month which would not have given good outcome.&#x0D; &#x0D; Conclusion&#x0D; These scores give a good idea about categories of patients who will not benefit by non-surgical treatment and hence early surgical intervention will obviate the duration of handicap and delay in appropriate treatment.

Multimodal Magnetic Resonance Imaging reveals alterations of sensorimotor circuits in restless legs syndrome.

Integrated information on brain microstructural integrity and iron storage and its impact on the morphometric profile is not available in restless legs syndrome (RLS). We applied multimodal magnetic resonance imaging (MRI) including diffusion tensor imaging, the transverse relaxation rate (R2*), a marker for iron storage, as well as gray and white matter volume measures to characterize RLS-related MRI signal distribution patterns and to analyze their associations with clinical parameters. Eighty-seven patients with RLS (mean age 51, range 20-72 years; disease duration, mean 13 years, range 1-46 years, of those untreated n = 30) and 87 healthy control subjects, individually matched for age and gender, were investigated with multimodal 3T MRI. Volume of the white matter compartment adjacent to the post- and precentral cortex and fractional anisotropy (FA) of the frontopontine tract were both significantly reduced in RLS compared to healthy controls, and these alterations were associated with disease duration (r = 0.25, p = 0.025 and r = 0.23, p = 0.037, respectively). Corresponding gray matter volume increases of the right primary motor cortex in RLS (p < 0.001) were negatively correlated with the right FA signal of the frontopontine tract (r = -0.22; p < 0.05). Iron content evaluated with R2* was reduced in the putamen as well as in temporal and occipital compartments of the RLS cohort compared to the control group (p < 0.01). Multimodal MRI identified progressing white matter decline of key somatosensory circuits that may underlie the perception of sensory leg discomfort. Increases of gray matter volume of the premotor cortex are likely to be a consequence of functional neuronal reorganization.