Subjective Reports Of Discomfort Research Articles

Anterior Neck Resurfacing Using Multiple Free Flaps in Patients With Burn Sequelae of the Anterior Neck and Chest.

It has been established that patients with burn sequelae of the anterior neck and chest have a significant degree of flap descent and deficit in neck extension when resurfaced with a single free flap. A protocol was developed to avoid flap descent in these patients by resurfacing the neck with multiple free flaps. The purpose of this article is to present our protocol for treatment and long-term results of this technique. Twenty-five 25 patients with burn sequelae of the anterior neck and anterior thorax were retrospectively identified. Ten patients were treated with a single free flap (group 1), and 15 patients were treated with multiple free flaps (group 2). Patients were followed up for an average of 7 years after their definitive reconstructive procedure at which time measurements including flap descent from sternal notch, deficit of neck extension, and subjective reports of discomfort were obtained. Patients in group 1 demonstrated 8 cm (interquartile range [IQR], 1.75 cm) of flap descent, whereas patients in group 2 demonstrated 0.5 cm (IQR, 0 cm) of flap descent. Patients in group 1 demonstrated 12.5 degrees (IQR, 10 degrees) of deficit in neck extension, whereas patients in group 2 demonstrated 0 degrees (IQR, 0 degrees) of deficit in neck extension. Analysis demonstrated significantly greater descent and deficit in neck extension in group 1 compared with group 2. Patients with burn sequelae of the neck and anterior chest experience less flap descent and deficits in neck extension when resurfaced with multiple free flaps.

An Investigation of the Side Effects, Patient Feedback, and Physiological Changes Associated with Direct-Acting Antiviral Therapy for Hepatitis C.

Background: Hepatitis C virus (HCV) infection is one of the major causes of liver cirrhosis and hepatocellular carcinoma globally. The advent of direct-acting antivirals (DAAs) with high cure rates provides an opportunity to reduce the rising HCV disease burden. However, few studies have explored the side effects and physiological benefits of DAA therapy in rural areas. The aim of this study was to investigate the subjective reports of discomfort, patient feedback about the course of treatment, and physiological changes after DAA treatment in HCV patients. Methods: A descriptive, prospective, comparative cohort study was conducted from January to August 2019 in western coastal Yunlin County, Taiwan. Data regarding demographic characteristics, subjective discomfort levels, and physiological responses were collected through face to face interviews and from medical records by a cooperating hospital. Results: Six-hundred-and-twenty-three participants with an active HCV infection were identified; 555 (89.1%) had completed treatment, and sustained virologic response was achieved in 99.6% (n = 553). The mean age was 64.9 (standard deviation = 13.1) years, and 35% of patients experienced discomfort during DAA treatment, including fatigue, itching, and dizziness. After three months of treatment, physiological markers, including body weight (p < 0.001), waist circumference (p < 0.05), blood pressure (p < 0.001), alanine aminotransferase (p < 0.001), and aspartate aminotransferase (p < 0.001), had significantly improved. Almost all participants provided positive feedback about the treatment experience and reported manageable side effects. Conclusions: The findings showed that, in an endemic rural area, DAA treatment had a high cure rate and improved physiological markers with few discomforts. These results can be used to reduce the barriers HCV patients face in adopting new medications.

Effects of Anti-Fatigue Mats on Perceived Discomfort and Weight-Shifting During Prolonged Standing

The aim of this experiment was to investigate the effects of anti-fatigue mats on perceived discomfort and behavioral responses (weight-shifting between the feet) during prolonged standing. Prolonged standing is a common requirement in the workplace and is a well-known cause of discomfort. Anti-fatigue mats have been shown to reduce discomfort resulting from standing, but no study has identified a particular mat that performs better than others or examined the relationship between discomfort and weight-shifting. Participants stood for 4 hours on four commercially available "anti-fatigue" mats and a hard surface (control condition). Subjective ratings of discomfort were measured, and in-shoe pressure was recorded and used to evaluate weight-shifting during standing. Compared to the control condition, after 4 hours of standing discomfort was reduced by three of the four mats, but discomfort ratings did not significantly differ among mats. However, significant differences among mats were found in the frequency of weight-shifting, and weight-shifting was positively correlated to discomfort. These results suggest that subjective reports of discomfort were not sufficiently sensitive to detect differences among mats for the experimental conditions tested. Behavioral responses, specifically weight-shifting between feet, may provide a more sensitive alternative to subjective reports.

Assessing menstrual tampon irritation using the “Behind-The-Knee” test

Colposcopic inspection of the vagina is a routine component of the safety assessment of intravaginal products. However, colposcopic findings occur frequently in healthy women, raising questions about their relevance to intravaginal product safety. Practical disadvantages limit the utility of colposcopy for evaluating menstrual tampons, among them the presence of background microtrauma, the inability to assess effects during menstruation, and, importantly, the question of whether post hoc assessments are sufficiently sensitive to detect small inflammatory changes. The Behind-The-Knee (BTK) test is an alternative for evaluating inflammatory and tissue dryness effects of physical articles by their repeated application to the popliteal fossa under an elastic bandage. It enables concurrent parallel comparisons of experimental and control articles over time and substantially increases the sensitivity of detecting small changes in tissue inflammation. With the protocol, uncompressed experimental and control tampons yielded comparable relative and absolute erythema scores (after overnight recovery) as did colposcopic assessment of the lower genital tract 3-48 h after menstrual use. Scoring erythema in the BTK test immediately after product removal increased the level of visually discernible inflammation sixfold. In a study of commercial menstrual pads, subclinical inflammation visualized with cross-polarized light correlated with the frequency of subjective reports of discomfort during the test and discriminated the relative tolerability of the two products determined by market surveillance, providing added confidence in the predictive value of the test. We believe the BTK test can be a valuable alternative to colposcopy for assessing inflammation and dryness associated with menstrual tampons.

The “behind-the-knee” test for menstrual tampon irritation

Colposcopic inspection of the vagina is a routine component of the safety assessment of intravaginal products. However, colposcopic findings occur frequently in healthy women, raising questions about their relevance to intravaginal product safety. Practical disadvantages limit the utility of colposcopy for evaluating menstrual tampons, among them the presence of background microtrauma, the inability to assess effects during menstruation, and, importantly, the question of whether post-hoc assessments are sufficiently sensitive to detect small inflammatory changes. The Behind-the-knee (BTK) test is an alternative for evaluating inflammatory and tissue dryness effects of physical articles by their repeated application to the popliteal fossa under an elastic bandage. It enables concurrent parallel comparisons of experimental and control articles over time and substantially increases the sensitivity of detecting small changes in tissue inflammation. With this protocol, uncompressed experimental and control tampons yielded comparable relative and absolute erythema scores (after overnight recovery) as did colposcopic assessment of the lower genital tract 3 to 48 hours after menstrual use. Scoring erythema in the BTK test immediately after product removal increased the level of visually discernible inflammation 6-fold. In a study of commercial menstrual pads, subclinical inflammation visualized with cross-polarized light correlated with the frequency of subjective reports of discomfort during the test and discriminated the relative tolerability of the two products determined by market surveillance, providing added confidence in the predictive value of the test. We believe the BTK test to be a valuable alternative to colposcopy for assessing inflammation and dryness associated with menstrual tampons.

The (In)Accuracy of Estimations of Our Own Visual Acuity in the Presence of Glare

Headlights must balance two conflicting goals: maximizing visibility for the driver and minimizing glare to other drivers. Yet, recent increases in the number of complaints about headlights indicate a consumer focus on glare discomfort and not on poor visibility - a known causal factor of nighttime crashes. This study, as part of a series of experiments, explored the relationship between subjective and objective consequences of glare. Twenty-four participants used a psychophysically based technique to estimate their visual acuity in the presence of three different glare intensities. Actual acuity and subjective reports of discomfort were also assessed. Observers' estimates of acuity significantly worsened as glare intensity increased, yet actual acuity was unaffected. Overall, estimates of the disabling effects of glare were more tightly correlated with subjective reports of glare-induced discomfort than with actual visual performance. These results, which are consistent with data obtained in the field - using vehicle headlights as the glare source - may help explain drivers' reluctance to use their high beams. The results also underscore the need to collect data on disability glare, not just discomfort glare, when evaluating new lighting technologies. Language: en

The effect of duty cycle and frequency on muscle torque production using kilohertz frequency range alternating current

We investigated the frequency and duty cycle dependence of maximal electrically induced torque (MEIT) of the wrist extensors. Fifty hertz burst modulated sinusoidal alternating current (AC) in the frequency range 0.5–20 kHz was used, with duty cycles ranging from a minimum (one cycle) to maximum (continuous AC). MEITs were similar at low frequencies but decreased markedly above 2.5 kHz. MEITs also decreased markedly above a 20% duty cycle. Subjective reports of discomfort were fewest at 4 kHz and at duty cycles in the range 20–25%. Our conclusion is that for maximum torque production, a frequency of 1 kHz and a duty cycle of 20% are indicated. When comfort is a major consideration, a frequency of 2.5 kHz provides an acceptable trade-off between MEIT and comfort. The findings also suggest that low duty cycle, burst modulated AC stimulation may be more effective than stimulation using conventional low-frequency pulsed current.

Reader-Controlled Computerized Presentation of Text

In five experiments new methods of computer-supported reading were introduced and tested. Self-pacing was permitted in rapid serial visual presentation (RSVP), in which words are presented sequentially at a fixed locus. In Experiments 2 through 5 regressions were also allowed in RSVP. Larger regressions yielded slower reading. Regressions back to the beginning of the sentence were more frequent than regressions back two words. There was no difference in reading speed or comprehension caused by the nature, analogue (mouse), or digital (keystroke) of the control over reading speed, but there was a greater tendency to change speed in the analogue condition than in the digital condition. In Experiment 5 subjects read for over two hours in an RSVP condition with self-pacing and regressions or in a normal page condition: subjective reports of discomfort were not different in the two conditions, but reading speed in the RSVP condition was approximately half that in the page condition. Overall these results indicate that permitting reader control in RSVP is feasible but that permitting regressions sometimes results in slow reading.

Evaluation of Discomfort Experienced while Operating Cadd Worksystems

The study reported herein compared the design of workstations used by Computer-aided design and drafting (CADD) operators and those used by each of two other occupational groups against reports of physical and visual discomforts. Evaluation Procedures included subjective reports of discomfort and objective analyses of individual workstations. Results indicated that body discomfort varied among occupational groups and that particular discomforts could be linked to specific aspects of workstation design.