INTRODUCTION: A stay in the intensive care unit (ICU), although potentially life-saving, may cause considerable discomfort to patients. However, retrospective assessment of discomfort is difficult because recollection of stressful events may be impaired by sedation and severe illness during the ICU stay. This study addresses the following questions. What is the incidence of discomfort reported by patients recently discharged from an ICU? What were the sources of discomfort reported? What was the degree of factual recollection during patients' stay in the ICU? Finally, was discomfort reported more often in patients with good factual recollection?METHODS: All ICU patients older than 18 years who had needed prolonged (>24 hour) admission with tracheal intubation and mechanical ventilation were consecutively included. Within three days after discharge from the ICU, a structured, in-person interview was conducted with each individual patient. All patients were asked to complete a questionnaire consisting of 14 questions specifically concerning the environment of the ICU they had stayed in. Furthermore, they were asked whether they remembered any discomfort during their stay; if they did then they were asked to specify which sources of discomfort they could recall. A reference group of surgical ward patients, matched by sex and age to the ICU group, was studied to validate the questionnaire.RESULTS: A total of 125 patients discharged from the ICU were included in this study. Data for 123 ICU patients and 48 surgical ward patients were analyzed. The prevalence of recollection of any type of discomfort in the ICU patients was 54% (n = 66). These 66 patients were asked to identify the sources of discomfort, and presence of an endotracheal tube, hallucinations and medical activities were identified as such sources. The median (min-max) score for factual recollection in the ICU patients was 15 (0-28). The median (min-max) score for factual recollection in the reference group was 25 (19-28). Analysis revealed that discomfort was positively related to factual recollection (odds ratio 1.1; P < 0.001), especially discomfort caused by the presence of an endotracheal tube, medical activities and noise. Hallucinations were reported more often with increasing age. Pain as a source of discomfort was predominantly reported by younger patients.CONCLUSION: Among postdischarge ICU patients, 54% recalled discomfort. However, memory was often impaired: the median factual recollection score of ICU patients was significantly lower than that of matched control patients. The presence of an endotracheal tube, hallucinations and medical activities were most frequently reported as sources of discomfort. Patients with a higher factual recollection score were at greater risk for remembering the stressful presence of an endotracheal tube, medical activities and noise. Younger patients were more likely to report pain as a source of discomfort.
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Full text beschikbaar met HU-account. Since the 2010s, various companies have begun to manufacture wearable smartwatch devices, but the current sales of these products are not impressive. This study investigates how the limitations of the smartwatch are related to perceptual discomforts. Theoretically, this study evaluates the claim that the discomfort that users appear to have with the smartwatch stem from failed remediation. Users perceive the smartwatch more as a set of functional sensors rather than a watch or smartphone. Specifically, from the remediation perspective, the authors asked how users perceive the functions of the smartwatch. This study used dynamic topic modeling for topics on the smartwatch on Reddit. This study reports that the smartwatch has failed to provide a proper way to use the remediated content that it provides. Suggestions for future studies are addressed.
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OBJECTIVES: The main aim of this study was to assess the prevalence of Vocal Tract Discomfort (VTD) in the Flemish population without self-perceived voice disorders using the VTD scale and to examine the relationship between vocal load and VTD symptoms. In addition, consistency between the VTD scale and the Voice Handicap Index (VHI) and the Corporal Pain scale was evaluated. METHODS: A total of 333 participants completed the VTD scale, the VHI, and the Corporal Pain scale. Patient information about study and voice-related hobbies (for students), state of (non)professional voice user (for employees), smoking, shouting, allergy, and voice therapy was taken into account. RESULTS: A median number of three VTD symptoms was reported, and 88% of the participants showed at least one symptom of VTD. Dryness (70%), tickling (62%), and lump in the throat (54%) were the most frequently occurring symptoms. The frequency and severity of VTD were significantly higher in participants who followed voice-related studies, played a team sport, were part of a youth movement, shouted frequently, and received voice therapy in the past (P < 0.05). Finally, low correlations were obtained between frequency and severity of the VTD scale and total VHI score (r = 0.226-0.411) or frequency and intensity of the Corporal Pain scale (r = 0.016-0.408). CONCLUSIONS: The prevalence of VTD is relatively high in the Flemish population without self-perceived voice disorders, although the frequency and severity of the symptoms are rather low. Vocal load seems to influence the frequency and severity of VTD. Finally, the VTD scale seems to reveal clinically important information that cannot be gathered from any other protocol.
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Methodological challenges are rarely discussed in depth among outdoor adventure tourism scholars. Despite the prevailing qualitative approaches in this field, and the recognition that the fleetingness of the human experience and the non-linearity and unpredictability of the more-than-human world have the power to influence the research process, the messy, negotiated and often contested researcher’s role has been less considered. In addressing this, the aim here is to critically discuss the methodological approach to explorations of the outdoor experiences through deconstructing the researcher’s role. Through renderings of the existentialist propositions of being in the world and a poststructuralist philosophy of fluidity and flux, the attention is granted to embodied experiences as a way of generating knowledges. Being situated in the research setting, space is created for interrogation of the processual dimensions of commodified outdoor journeys from an emic, researcher-as-tourist perspective. Research in the outdoor scenaria is by no means a linear process but rather a messy, complex and often ruptured journey, further complicated by the ethical concerns, struggles and idiosyncrasies of the researcher. I thus discuss the nuances and complexities of doing the embodied research and the haphazard ways of data collection. In shifting attention to more existential aspects of being in the outdoors through the process of post-experiential reflections, discomfort emerged as a critical quality of the outdoor experience. I thus illuminate the significance of embodied research and epiphenomenal discoveries in the production of new knowledges, to which greater attention, both in theoretical and methodological conversations, should be paid in the future.
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a b s t r a c t Prolonged sitting can cause health problems and musculoskeletal discomfort. There is a need for objective and non-obstructive means of measuring sitting behavior. A ‘smart’ office chair can monitor sitting behavior and provide tactile feedback, aiming to improve sitting behavior. This study aimed to investigate the effect of the feedback signal on sitting behavior and musculoskeletal discomfort. In a 12- week prospective cohort study (ABCB design) among office workers (n ¼ 45) was measured sitting duration and posture, feedback signals and musculoskeletal discomfort. Between the study phases, small changes were observed in mean sitting duration, posture and discomfort. After turning off the feedback signal, a slight increase in sitting duration was observed (10 min, p ¼ 0.04), a slight decrease in optimally supported posture (2.8%, p < 0.01), and musculoskeletal discomfort (0.8, p < 0.01) was observed. We conclude that the ‘smart’ chair is able to monitor the sitting behavior, the feedback signal, however, led to small or insignificant changes. © 2017 Elsevier Ltd. All rights reserved.
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In operatiekamers heeft de luchtkwaliteit vanzelfsprekend de meeste aandacht in verband met het risico op postoperatieve wondinfecties bij de patiënt. Echter het belang van thermisch comfort moet niet onderschat worden. In dit onderzoek wordt subjectief (perceptie) en objectief (metingen) de situatie onderzocht in operatiekamers met verschillende ventilatiesystemen. Uitgangspunt is een vergelijk met de theorie.
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Kan bij verpleeghuisbewoners met dementie onrust worden tegengegaan door de Qwiek.up in te zetten? Een onderzoek naar de effecten van deze beeld- en geluidsinterventie.
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PURPOSE: To determine the impact of late radiation-induced toxicity on health-related quality of life (HRQoL) among patients with prostate cancer.PATIENTS AND METHODS: The study sample was composed of 227 patients, treated with external beam radiotherapy. Common Terminology Criteria for Adverse Events version 3.0 were used to grade late genitourinary and gastrointestinal toxicity. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire C30 (EORTC QLQ-C30) was used to assess HRQoL at baseline, and 6, 12 and 24 months after completion of radiotherapy. Statistical analysis was performed using a multivariate analysis of variance (MANOVA).RESULTS: Urinary incontinence and rectal discomfort significantly affected HRQoL. The impact of urinary incontinence on HRQoL was most pronounced 6 months after radiotherapy and gradually decreased over time. The impact of rectal discomfort on HRQoL was predominant at 6 months after radiotherapy, decreased at 12 months and increased again 2 years after radiotherapy. No significant impact on HRQoL was observed for any of the other toxicity endpoints, or non-toxicity related factors such as hormonal therapy, radiotherapy technique or age.CONCLUSION: Urinary incontinence and rectal discomfort have a significant impact on HRQoL. Prevention of these side effects may likely improve quality of life of prostate cancer patients after completion of treatment.
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Background: Home care professionals regularly observe drug-related problems during home care provision. Problems related to the process of the medication therapy could involve discrepancies in medication prescriptions between the hospital discharge letter and the medication administration record lists (MARL) or insufficient drug delivery. The objective of this study is to determine the potential clinical consequences of medication process problems observed by home care professionals, since those consequences have not been assessed before. Methods: A retrospective descriptive study design was performed. An expert panel performed an assessment procedure on the clinical consequences of medication process problems. Such problems were reported by home care professionals during routine care (May 2016 until May 2017) using the eHOME system, which is a digital system developed to assist in the reporting and monitoring of drug-related problems. Using a three-point scale, an expert panel assessed the potential clinical consequences of those medication process problems among older home care patients (aged 65 years and over). Results: 309 medication process problems in 120 out of 451 patients were assessed for potential discomfort or clinical deterioration. The problems involved the following: medication discrepancies (new prescription not listed on the MARL [n = 69, 36.7%]; medication stopped by the prescriber but still listed on the MARL [n = 43, 22.9%]; discrepant time of intake [n = 25, 13.3%]; frequency [n = 24, 12.8%]; and dose [n = 21, 11.2%], therapeutic duplication listed on the MARL [n = 5, 2.6%]; and discrepant information on route of administration [n = 1, 0.5%]); an undelivered MARL [n = 103, 33.3%]; undelivered medication [n = 16, 5.2%]; and excessive medication delivery [n = 2, 0.7%]. Furthermore, 180 (58.2%) out of 309 medication process problems were assessed as having the potential for moderate or severe discomfort or clinical deterioration in patients. Conclusions: The majority of medication process problems may result in patient discomfort or clinical deterioration.
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Het is algemeen bekend dat het binnenmilieu in gebouwen zoals in woningen, scholen en kantoren de gezondheid en het welzijn van de gebruikers beïnvloedt. Een slecht binnenmilieu leidt tot discomfort, verminderde alertheid, vermindering van de prestaties van gebruikers en veroorzaakt zelfs absenties als gevolg van gezondheidsklachten en ziektes. Helaas komen klachten met betrekking tot het binnenmilieu vaak voor. De vraag is hoe het binnenmilieu in klaslokalen kan worden verbeterd. Dit is belangrijk omdat in een ideaal binnenmilieu zowel de student als de docent optimaal kan functioneren en presteren.
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