Predictors Of Comfort Research Articles

How patients distinguish between clinical and administrative predictive models in health care.

To understand patient perceptions of specific applications of predictive models in health care. Original, cross-sectional national survey. We conducted a national online survey of US adults with the National Opinion Research Center from November to December 2021. Measures of internal consistency were used to identify how patients differentiate between clinical and administrative predictive models. Multivariable logistic regressions were used to identify relationships between comfort with various types of predictive models and patient demographics, perceptions of privacy protections, and experiences in the health caresystem. A total of 1541 respondents completed the survey. After excluding observations with missing data for the variables of interest, the final analytic sample was 1488. We found that patients differentiate between clinical and administrative predictive models. Comfort with prediction of bill payment and missed appointments was especially low (21.6% and 36.6%, respectively). Comfort was higher with clinical predictive models, such as predicting stroke in an emergency (55.8%). Experiences of discrimination were significant negative predictors of comfort with administrative predictive models. Health system transparency around privacy policies was a significant positive predictor of comfort with both clinical and administrative predictivemodels. Patients are more comfortable with clinical applications of predictive models than administrative ones. Privacy protections and transparency about how health care systems protect patient data may facilitate patient comfort with these technologies. However, larger inequities and negative experiences in health care remain important for how patients perceive administrative applications ofprediction.

Comfort with varying levels of human supervision in self-driving cars: Determining factors in Europe

While numerous studies have investigated attitudes towards self-driving cars in general, less research attention has been focused on individuals' comfort with the presence (or absence) of third-party human supervision of this automation, and its potential correlates. In the present study we perform a secondary analysis of pre-existing data from The European Commission’s Eurobarometer 92.1, a large-scale European survey ( n = 27565) of expectations and concerns of connected and automated driving. By comparing responses to three levels of human supervision in self-driving cars, we aim to identify changes in the importance of predictors of comfort with automation. We find considerable heterogeneity in both individual attitudes, as well as in country-level attitudes in our descriptive analysis. We find a trend of decreasing comfort as external human supervision is reduced, although this effect differs between countries. We then investigate potential drivers of self-reported comfort with varying levels of external human supervision in a regression framework. Gender differences get stronger with decreasing supervision, suggesting a possible resolution to conflicting evidence in previous studies. Following this, we fit an ordinal random forest model to derive variable importance metrics, which enable us to compare the changing role predictor variables might play in shaping self-reported comfort, depending on varying levels of third-party supervision. Data privacy is highlighted as an important variable, regardless of level of supervision. Our findings provide confirmation for previous literature in a large sample, while also uncovering a number of novel associations, providing guidance for future policy-making and research efforts.

Telemedicine Use, Comfort, and Perceived Effectiveness in the Spinal Muscular Atrophy Community.

Background: Telemedicine may increase access to clinical care, particularly for mobility-limited communities such as the spinal muscular atrophy (SMA) community. However, much of the information on exposure to and attitudes toward telemedicine in neuromuscular diseases generally and SMA specifically is anecdotal or from focus groups. Gaining greater insight into patient perspectives is important, given telemedicine's potential for expanding access to care and growing use of telemedicine as a result of technology advances and the COVID-19 pandemic. Methods: Cure SMA collected information on the SMA community's exposure to, comfort with, and perceived effectiveness of telemedicine through its 2021 Community Update Survey. The final analytic sample represented 463 SMA-affected individuals, resident in the United States. Descriptive analyses, correlations, and ordered logit regression models were used to characterize the sample and identify predictors of exposure, comfort, and perceived effectiveness. Data were analyzed on weighted and unweighted bases to account for differences between the survey sample and the SMA community. Stratified analyses were used to compare self-completed surveys with caregiver-completed surveys. Results: 463 individuals answered questions about telemedicine. Approximately four-fifths of these respondents had used telemedicine previously. Factors predicting greater likelihood of prior telemedicine use included male gender, increasing income, having received drug treatment for SMA, history of mental illness, and having non-neutral views regarding comfort and perceived effectiveness of telemedicine. Several factors were also significant predictors of comfort with and perceived effectiveness of telemedicine. Stratified analyses indicated differences between self-completed and caregiver-completed surveys. Conclusion: These results can provide insight into patient experiences with telemedicine and can inform approaches to its use by health care professionals and clinical trial sponsors.

Comparing the stigma experiences and comfort with disclosure in Dutch and English populations of people living with dementia.

People living with dementia can feel hesitant disclosing their diagnosis to social networks, partly due to stigma. Little attention has been paid to the measurement of disclosure decisions and stigma, and few standardised stigma tools have been validated in languages other than English. We investigated the psychometric properties of Dutch translations of three stigma measures, and explored the stigma experiences of Dutch and English people living with dementia as well as patterns and predictors of comfort with disclosure. Community-dwelling adults living with dementia in the Netherlands (n = 40) and England (n = 40) completed either the English versions or the Dutch translations of the Comfort with Disclosure scale and three stigma measures (Stigma Impact, Stigma Stress, and Secrecy Scale). We established the psychometric properties of the stigma measures and conducted correlation and regression analyses. Internal consistency was good to excellent for all measures in the Dutch sample. Small but significant differences were found between the Dutch and English samples on the total score of the Stigma Impact Scale and its subscale social isolation. Age was negatively associated with comfort disclosing to family, and desire for secrecy was negatively associated with comfort disclosing to both family and friends. The psychometric properties of the Dutch scales were satisfactory. Many people living with dementia would feel comfortable disclosing their diagnosis to family and friends, but stigma experiences can greatly affect this decision. Cross-cultural differences in stigma experiences in persons with dementia require further investigation.

Oncologists' responsibility, comfort, and knowledge managing hyperglycemia in patients with cancer undergoing chemotherapy: a cross sectional study.

To assess oncologists' responsibility, comfort, and knowledge managing hyperglycemia in patients undergoing chemotherapy. In this cross-sectional study, a questionnaire collected oncologists' perceptions about professionals responsible for managing hyperglycemia during chemotherapy; comfort (score range 12-120); and knowledge (score range 0-16). Descriptive statistics were calculated including Student t-tests and one-way ANOVA for mean score differences. Multivariable linear regression identified predictors of comfort and knowledge scores. Respondents (N = 229) were 67.7% men, 91.3% White and mean age 52.1years. Oncologists perceived endocrinologists/diabetologists and primary care physicians as those responsible for managing hyperglycemia during chemotherapy, and most frequently referred to these clinicians. Reasons for referral included lack of time to manage hyperglycemia (62.4%), belief that patients would benefit from referral to an alternative provider clinician (54.1%), and not perceiving hyperglycemia management in their scope of practice (52.4%). The top-3 barriers to patient referral were long wait times for primary care (69.9%) and endocrinology (68.1%) visits, and patient's provider outside of the oncologist's institution (52.8%). The top-3 barriers to treating hyperglycemia were lack of knowledge about when to start insulin, how to adjust insulin, and what insulin type works best. Women (ß = 1.67, 95% CI: 0.16, 3.18) and oncologists in suburban areas (ß = 6.98, 95% CI: 2.53, 11.44) had higher comfort scores than their respective counterparts; oncologists working in practices with > 10 oncologists had lower comfort scores (ß = -2.75, 95% CI: -4.96, -0.53) than those in practices with ≤ 10. No significant predictors were identified for knowledge. Oncologists expected endocrinology or primary care clinicians to manage hyperglycemia during chemotherapy, but long wait times were among the top barriers cited when referring patients. New models that provide prompt and coordinated care are needed.

Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation.

The COVID-19 pandemic increased disparities for communities burdened by structural barriers such as reduced affordable housing, with mental health consequences. Limited data are available on digital resources for public mental health prevention during the COVID-19 pandemic. The study aim was to evaluate engagement in and impact of free digital resources on the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website during COVID-19 in California. A pilot evaluation of T4W/Juntos was performed, with partner agencies inviting providers, clients, and partners to visit the website and complete surveys at baseline (September 20, 2021, to April 4, 2022) and at 4-6-week follow-up (October 22, 2021, to May 17, 2022). Website use was assessed by three engagement items (ease of use, satisfaction, relevance), comfort in use, and use of six resource categories. Primary outcomes at follow-up were depression and anxiety (scores≥3 on Patient Health Questionnaire-2 item [PHQ2] and Generalized Anxiety Disorder-2 item [GAD2] scales). Secondary outcomes were post-pre differences in PHQ2 and GAD2 scores, and use of behavioral health hotlines and services the month before follow-up. Of 366 eligible participants, 315 (86.1%) completed baseline and 193 (61.3%) completed follow-up surveys. Of baseline participants, 72.6% identified as female, and 21.3% identified as lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+). In terms of ethnicity, 44.0% identified as Hispanic, 17.8% as African American, 26.9% as non-Hispanic white, and 11.4% as other ethnicity. Overall, 32.7% had moderate anxiety or depression (GAD2/PHQ2≥3) at baseline. Predictors of baseline website engagement included being Hispanic versus other race/ethnicity (β=.27, 95% CI .10-.44; P=.002) and number of COVID-19-related behavior changes (β=.09, 95% CI .05-.13; P<.001). Predictors of comfort using the website were preferring English for website use (odds ratio [OR] 5.57, 95% CI 2.22-13.96; P<.001) and COVID-19-related behavior changes (OR 1.37, 95% CI 1.12-1.66; P=.002); receiving overnight behavioral health treatment in the prior 6 months (OR 0.15, 95% CI 0.03-0.69, P=.015) was associated with less comfort in website use. The main predictor of depression at follow-up (PHQ2≥3) was baseline depression (OR 6.24, 95% CI 2.77-14.09; P<.001). Engagement in T4W/Juntos was associated with lower likelihood of depression (OR 0.54, 95% CI 0.34-0.86; P=.01). Website use the month before follow-up was associated with a post-pre reduction in PHQ2 score (β=-.62, 95% CI -1.04 to -0.20; P=.004). The main predictor of GAD2≥3 at follow-up was baseline GAD2≥3 (OR 13.65, 95% CI 6.06-30.72; P<.001). Greater baseline website engagement predicted reduced hotline use (OR 0.36, 95% CI 0.18-0.71; P=.004). Ethnicity/language and COVID-19-related behavior changes were associated with website engagement; engagement and use predicted reduced follow-up depression and behavioral hotline use. Findings are based on participants recommended by community agencies with moderate follow-up rates; however, significance was similar when weighting for nonresponse. This study may inform research and policy on digital mental health prevention resources.

Social Service Workers’ Use of Social Media to Obtain Client Information: Current Practices and Perspectives on a Potential Informatics Platform

To gain insight into current use of social-media platforms in human services delivery, we systematically surveyed 172 social-service workers from six agencies in a Midwest US city to gather data about social-media usage among social-service providers, potential challenges and benefits of using social media, and whether a social-media-based informatics platform could be valuable. Quantitative analyses showed that approximately half of participants have used social media to collect client-related information; nearly one-quarter indicated “often” or “nearly daily” use. Adjusting for the effects of worker characteristics, social-media use was associated with the type of agency involved and with increased tenure in social services. Adjusted results also showed that participants’ comfort with using the potential application was greater in those agencies substantially involved with investigative/legal work. However, trust in the information collected by the potential application was a stronger, independent predictor of comfort using the tool. Qualitative analyses identified numerous challenges and ethical concerns, and positive and negative aspects of a social-media-based informatics platform. If the platform is to be created, work must be done carefully, fully considering ethical issues rightly raised by social service workers, existing agency policies, and professional standards. Future research should investigate ways to negotiate these complex challenges.

Comfort with and willingness to participate in COVID-19 contact tracing: The role of risk perceptions, trust, and political ideology

ObjectiveContact tracing (CT) can limit the spread of infectious diseases, however its effectiveness hinges on public participation. We evaluated perceptions of the financial and health risk posed by COVID-19 and trust in information about COVID-19 provided by the state health department that manages CT as predictors of comfort and willingness to comply with CT. We further examined the moderating effect of political ideology on these relationships. MethodsWe used structural equation modeling to test hypotheses in data from a cross-sectional survey completed by a representative sample of Michigan residents (N = 805) in 2020. ResultsPerceptions of the risk of COVID-19 to one's health (but not finances) was negatively related to comfort and willingness to participate in CT. Trust in information about COVID-19 and liberalism were positively related to comfort and willingness. There was also a moderating effect of political ideology, such that conservatives were less comfortable and willing at greater perceptions of health risk. ConclusionsConservatives and those who perceive a greater health risk may require targeted messaging and more deliberate engagement strategies to increase CT participation.

Indonesian students’ religiousness, comfort, and anger toward God during the COVID-19 pandemic

During the COVID-19 pandemic, many religious college students have found comfort in God, while others may have developed anger toward God; however, no studies have systematically compared the multidimensional effects of religiousness on how Muslim and Christian students react to stressors such as COVID-19. This study addressed this gap in the literature by investigating which of the Four Basic Dimensions of Religiousness Scale (4-BDRS: believing, bonding, behaving, and belonging) were significant predictors for both taking comfort in and feeling anger toward God among Muslim ( n = 550) and Christian ( n = 334) college students in Indonesia, while also controlling for the influence of neuroticism, a known predictor for attitudes toward God. Muslims reported that all dimensions of the 4-BDRS were significant predictors of comfort, with bonding as a negative predictor (β = –.09, p = .04), while Christians reported that belonging (β = .07, p = .34) was the only insignificant predictor. Muslims reported that believing (β = –.22, p ⩽ .001) and behaving (β = –.19, p = .002) were negative predictors of anger, while Christians reported negative effects only for bonding (β = –.17, p = .04); however, bonding did not significantly predict anger when analyzed separately for men and women. Therefore, to decrease their anger toward and increase the comfort they find in God, Muslims must focus on their beliefs and exercise the commandments of Islam. Christians, though, must focus on increasing cognitive, affective, and behavioral aspects of religiousness to find comfort, while having better personal relationships with God could be key in reducing anger toward God.

Indoor environmental quality and global comfort: an in-field study in workspaces

The EN 16798-1 specifies the requirements to assess indoor environmental quality (IEQ) considering thermal, air quality, lighting and acoustics domains. A drawback of the standard is that it is based on an objective evaluation approach and does not account for the subjective perception. Also, the standard does not assess global IEQ nor comfort as a single index for the interaction of all the domains. This work tests the metrics proposed in the standard relating them to the occupants’ evaluations. An in-field monitoring campaign was performed in the ARPA headquarter in Aosta (Italy), acquiring quantities to be correlated with the subjective perception of IEQ gained through surveys. An insight on the possible approach to communicate IEQ and comfort feedbacks to the occupants was investigated to promote their awareness. Preliminary results show that the occupants’ perception can be predicted by adopting the approach proposed in EN 16798-1 in the case of thermal comfort, but limitations emerge about air quality, lighting and acoustics. Such result allows investigating how the environmental variables considered by the standard (e.g., the maximum sound pressure level or the maximum CO2 concentration) can be adopted as predictors of comfort, thus how new parameters and assessment methods should be introduced.

Preferences and perspectives on vaginal breech delivery in Ghana.

To evaluate obstetrician/gynecologist and midwife perspectives and experiences with vaginal breech deliveries in Ghana. Respondents completed a survey on their experiences, training, comfort levels, and decision making about vaginal breech deliveries. Comparisons were made across obstetricians/gynecologists and midwives. Multiple logistic regression explored predictors of comfort performing vaginal breech deliveries. Respondents comprised 93 (36.5%) obstetricians/gynecologists and 162 (63.5%) midwives. Most believed that some breech fetuses should be delivered vaginally, with higher agreement from obstetricians/gynecologists than from midwives (n = 86, 97.7% versus n = 207, 80.8%, P=0.001). Midwives were more likely to strongly agree that training was adequate for obstetricians/gynecologists (n = 65, 55.6% versus n = 8, 9.8%, P<0.001) and midwives (n = 60, 49.6% versus n = 6, 7.4%, P<0.001). Most (n = 192, 94%) respondents wanted more experience and/or training. Despite most providers performing only one ot five breech vaginal deliveries yearly, 77.4% (n = 199) were comfortable performing them and 79.5% (n = 202) were comfortable supervising them. Significant predictors of comfort performing vaginal breech delivery were perceived adequacy of training (odds ratio 8.74, 95% CI 3.39-22.52) and belief that vaginal breech deliveries should be performed (odds ratio 4.28, 95% CI 1.33-13.72). Respondents were more likely to feel comfortable performing breech vaginal deliveries if they felt that their training was adequate. Vaginal breech deliveries can only be offered as safe alternatives to cesarean delivery if training and experience are maintained in low-resource settings.

Applying the capability, opportunity, motivation, and behavior model to identify opportunities to increase pharmacist comfort dispensing naloxone in Texas: A structural equation modeling approach

BackgroundThe prevalence of opioid use and misuse in the United States contributed to 48,000 opioid related deaths in 2018. Naloxone, a potent opioid reversal agent, can be dispensed by pharmacists without a prescription, however few do so. Previous studies on naloxone dispensing have contributed to our understanding of the determinants of naloxone in community pharmacy, however, none have focused on comprehensive behavioral change. This study utilized the Capability, Opportunity, Motivation, and Behavior (COM-B) model, a behavioral change and intervention design framework, to examine community pharmacists’ comfort dispensing naloxone. MethodsA 48-item questionnaire grounded in the COM-B and theoretical domains framework was developed and mailed to 1,000 community pharmacists in Texas, USA using a modified Dillman cross-sectional survey design. Confirmatory factor analysis was used to refine and establish dimensionality of the hypothesized scales and structural equation modeling was used to estimate the fit of the COM-B in explaining pharmacists’ comfort dispensing naloxone. ResultsThe usable response rate was 19.4%. Of surveyed pharmacists, 29.7% had ever had a patient request naloxone and 35.1% had dispensed naloxone without a prescription. Capability and opportunity explained 60% of the variance in motivation. Opportunity and motivation were the most salient predictors of comfort dispensing naloxone. Together, capability, opportunity, and motivation explained 78.1% of variance in pharmacists’ comfort dispensing naloxone, indicating that the COM-B model is useful in this setting. ConclusionDespite previous findings, policy interventions to increase naloxone dispensing should go beyond providing additional education to the pharmacy workforce. Rather, these results suggest that a complex intervention designed with pharmacist input that enables them to act autonomously and evaluate whether patients need naloxone may increase their comfort dispensing. Without collaboration from pharmacy and managed care corporations, dissemination efforts will continue to be limited.

Factors Influencing Comfort of OT Practitioners in Addressing Puberty in Adolescents With Autism Spectrum Disorder (ASD)

Abstract Date Presented 04/04/19 The understanding of the OT practitioner's role addressing puberty in adolescents with ASD is limited. This study explored predictors of comfort for practitioners through a descriptive survey. Through the survey, challenges, interventions, and comfort with puberty were identified. The data revealed correlations between education and experience influencing comfort. The results guide practitioners in addressing puberty in adolescents with ASD. Primary Author and Speaker: Sydney Larson Additional Authors and Speakers: Kelsey Hemberger, Sarah Nielsen Contributing Authors: Marilyn Klug

Vulvodynia attitudes in a sample of Canadian post-graduate medical trainees

Physicians play a critical role in addressing sexual health in medical practice, including pain during intercourse. Vulvodynia is a prevalent cause of pain, however, related training is limited and variable. In addition, physician attitudes toward pain and sexuality may affect behaviour and therefore patient outcomes. This study's objectives were to: 1) determine whether post-graduate trainees hold more positive attitudes toward women presenting with vulvovaginal pain with (versus without) an identifiable cause; and 2) examine attitudinal predictors of comfort treating vulvodynia and attitudes toward patients with this presentation. Residents in Canadian Obstetrics and Gynecology (OBGYN) and Family Medicine (FM) programs participated in an online survey (N=99). Respondents completed questionnaires related to demographics, sexuality-related training, sexual attitudes, and comfort treating and attitudes toward vulvovaginal pain and its symptoms. Residents reported significantly more positive attitudes toward patients with visible pathology versus no identifiable cause for vulvovaginal pain, regardless of medical specialty, p&lt;.001. In OBGYN residents, general comfort discussing sexuality in medical practice significantly predicted comfort treating vulvodynia and its symptoms (p&lt;.001), and attitudes toward women with vulvodynia (p&lt;.05). Demographic, training, and attitudinal variables did not significantly predict vulvodynia outcome measures in FM residents. This study of medical residents identified different attitudes based on vulvovaginal pain presentation, and identified predictors of attitudes and comfort treating vulvodynia in OBGYN residents. Findings suggest pathways by which health care experiences may influence outcomes in this population, and have important implications for resident training.

Relationships between anti-stigma programme awareness, disclosure comfort and intended help-seeking regarding a mental health problem.

BackgroundAnti-stigma programmes should aim to increase disclosure to those who can support someone with a mental health problem and appropriate professional help-seeking.AimsWe investigated associations among public awareness of England's Time to Change anti-stigma campaign and: (a) comfort envisaged in disclosing a mental health problem to family and friends; (b) comfort in disclosing to an employer; and (c) intended professional help-seeking from a general practitioner, i.e. a physician working in primary care.MethodUsing data from a survey of a nationally representative sample of adults, we created separate logistic regression models to test for campaign awareness and other variables as predictors of comfort in disclosure and intended help-seeking.ResultsWe found positive relationships between campaign awareness and comfort in disclosing to family and friends (odds ratio (OR) = 1.27, 95% CI 1.14–1.43) and to a current or prospective employer (OR=1.20, 95% CI 1.06–1.35); and likelihood of help-seeking (OR=1.18 95% CI 1.03–1.36).ConclusionsAwareness of an anti-stigma campaign was associated with greater comfort in disclosing a mental health problem and intended help-seeking.

Veteransʼ Attitudes Towards De-intensification of Surveillance Colonoscopy for Low-Risk Adenomas: 2016 ACG Fellows-In-Training Award (CRC Prevention Category) 2016 ACG Presidential Poster Award

Introduction: Patients with low risk adenomas (LRAs - i.e., 1-2 small tubular adenomas) are at low risk for colorectal cancer (CRC). As a result, current U.S. Multi-Society Task Force guidelines recommend a surveillance interval of up to 10 years in such patients. But endoscopists rarely recommend an interval greater than 5 years, even in those who are unlikely to benefit (e.g., those with limited life expectancy). The purpose of this study was to assess Veterans' attitudes towards de-intensification of surveillance (i.e., less frequent surveillance) for LRAs. Methods: We developed a 39-item multiple-choice, scenario-based survey to assess patient attitudes towards de-intensification of surveillance colonoscopy. Inclusion criteria were: (1) age 60-89; and, (2) LRAs on screening colonoscopy performed at a single academic VA center from 2010-2015. Patients with any other indication for colonoscopy or those at increased risk for CRC (i.e., history of CRC, inflammatory bowel disease, or a polyposis syndrome), were excluded. The primary outcome was comfort waiting 10 years (versus 5 years) for surveillance colonoscopy (measured on a 7-point unidirectional Likert-type scale). Multivariable linear regression was used to identify predictors of comfort with waiting. The survey was mailed with a $10 gift card incentive. Results: 345 of 491 surveys (70%) were returned for analysis. Respondents were predominantly white (88%) and male (98%). The median age was 68 years and 63% completed education beyond high school. Health literacy was adequate in 90%. The vast majority of respondents (85%) were interested in undergoing routine surveillance at a 5-year interval if recommended by their physician. Despite this high interest in 5-year surveillance, nearly half (45%) reported that they would also be comfortable waiting 10 years. In multivariable linear regression, trust in physician was associated with more comfort waiting 10 years. Concern about developing CRC and perceived effectiveness of screening were both associated with less comfort waiting 10 years. No other factors, including demographics, education, or health literacy, were associated with comfort waiting. Conclusion: Patients with LRAs have diverse preferences for when to undergo surveillance colonoscopy. Given the clinical uncertainty about the optimal surveillance interval in these patients, decisions about the timing of surveillance should incorporate patient preferences rather than simply enforce the preferences of endoscopists.

Predictors of Comfort and Confidence Among Medical Students in Providing Care to Patients at Risk of Suicide.

The aim of this study was to identify factors associated with comfort and confidence in providing care to patients at risk of suicide, in a sample of Australian medical students. An online cross-sectional survey was completed by 116 current medical students (42% male) aged between 20 and 41years (M = 25, SD = 3.8). Greater personal experience of suicide and previous contact with patients with psychiatric problems were significantly associated with both increased perceived comfort and increased confidence in providing care for individuals with suicidal thoughts or behaviors, based on self-report. However, these effects may not reflect objective measures of competency and additional research is needed to assess generalizability of the findings due to the sampling method. Increasing medical student contact with patients at risk of suicide through the implementation of psychiatry placements, gateway programs, and early year exposure to patients with psychiatric problems may increase perceived confidence and comfort in providing care to individuals at risk of suicide. Further research should evaluate the impact of such programs on behavioral indices of clinical competency.

Comparing Public Perceptions of Alternative Water Sources for Potable Use: The Case of Rainwater, Stormwater, Desalinated Water, and Recycled Water

This research investigated how people’s perceptions of alternative water sources compare with their perceptions of other technologies, and identified significant predictors of comfort with different alternative water sources. We drew on data from four questionnaire survey studies with a total sample of more than 1200 Australian participants. Relative levels of comfort with the alternative water sources was consistent across the four studies: comfort was always highest for drinking rainwater and lowest for drinking recycled water, with comfort with drinking treated stormwater and desalinated water sitting between these two. Although comfort with drinking recycled water was always lowest of the four alternative water sources, participants were significantly more comfortable with drinking recycled water than they were with nuclear energy, or with using genetically modified plants and animals for food. In general, demographic variables were less important predictors of comfort with alternative water sources than were psychological variables; only age and gender emerged as relatively consistent predictors for recycled water, stormwater, and desalinated water, with older participants and males more comfortable with drinking these water sources. Of the psychological variables, participants’ comfort with technology in general, trust in science and trust in government emerged consistently as significant positive predictors of comfort with drinking recycled water, stormwater, and desalinated water.

An adaptive thermal comfort model for the tropical climatic regions of India (Köppen climate type A)

Adaptive comfort standards have been gaining wider acceptance and are now considered an integral part of main stream comfort research. Several adaptive comfort equations have been developed, some as part of international comfort standards and some for specific climatic regions. In the current work, an attempt was made to find a best fit among available comfort equations for predicting occupant comfort in the tropical climatic regions of India. Comfort temperatures found in surveys done across tropical India were compared to comfort temperatures computed from five different adaptive comfort equations. Additionally, to estimate energy savings possible through implementation of adaptive comfort standards, adaptive comfort degree days (ACDD) were calculated across seven Indian cities using comfort temperature predictions from the five equations. Put together, results from these two analyses showed that the comfort equation from EN15251 may be used as a reasonable predictor of comfort in naturally ventilated buildings of hot–humid Indian regions and such use would also result in major energy savings. It is proposed that till further studies in India provide more detailed results, the EN15251's standard for naturally ventilated buildings may be used as a suitable option for Indian conditions. Formalisation of appropriate adaptive comfort standards for India would be a significant asset to the sustainable development of this country.

Comparison of subjective comfort ratings between anatomically shaped and cylindrical handles

Most authors have provided diameter recommendations for cylindrical handle design in order to increase performance, avoid discomfort, and reduce the risk of cumulative trauma disorders. None of the studies has investigated the importance of determining the correct handle shape on the subjective comfort ratings, which could further improve the handles' ergonomics. Therefore, new methods based on a virtual hand model in its optimal power grasp posture have been developed in order to obtain customised handles with best fits for targeted subjects. Cylindrical and anatomically shaped handles were evaluated covering ten subjects by means of an extensive subjective comfort questionnaire. The results suggest large impact of the handle shape on the perceived subjective comfort ratings. Anatomically shaped handles were rated as being considerably more comfortable than cylindrical handles for almost all the subjective comfort predictors. They showed that handle shapes based on optimal power grasp postures can improve subjective comfort ratings, thus maximising performance. Future research should consider real conditions, since the comfort ratings can vary based on the specific task and by the tool selected for the task.