The Sock Test for evaluating activity limitation in patients with musculoskeletal pain.
BACKGROUND AND PURPOSE: Assessment within rehabilitation often must reflect patients' perceived functional problems and provide information on whether these problems are caused by impairments of the musculoskeletal system. Such capabilities were examined in a new functional test, the Sock Test, simulating the activity of putting on a sock. SUBJECTS AND METHODS: Intertester reliability was examined in 21 patients. Concurrent validity, responsiveness, and predictive validity were examined in a sample of 337 patients and in subgroups of this sample. RESULTS: Intertester reliability was acceptable. Sock Test scores were related to concurrent reports of activity limitation in dressing activities. Scores also reflected questionnaire-derived reports of problems in a broad range of activities of daily living and pain and were responsive to change over time. Increases in age and body mass index increased the likelihood of Sock Test scores indicating activity limitation. Pretest scores were predictive of perceived difficulties in dressing activities after 1 year. CONCLUSION AND DISCUSSION: Sock Test scores reflect perceived activity limitations and restrictions of the musculoskeletal system. (+info)
The free-convective anomaly.
Persons exposed to high temperature, or to equivalent environmental factors, have quantifiable reactions, such as reducing the resistance to both heat and moisture flow in skin tissues and clothing needed to maintain thermal equilibrium. The one-to-one relationship between this resistance in the walking person and temperature, with the other factors neutral, is the basis for the apparent temperature scale and the derived heat index. When this approach is taken to assess the thermal environment for a still person exposed to heat in still air, there is a zone of ambient conditions in which there are three solutions to the heat-balance equation. Extraordinary thermal stress occurs, depending slightly on other conditions, at ambient temperatures near 41 degrees C, especially at high humidity, because of the difficulty in carrying sweat vapor from the person when free convection is minimal. This anomaly is examined for a range of ambient vapor pressures and extra radiation. The rapid rise in heat stress when ambient temperature just exceeds body temperature in still conditions may explain the severity of some observed distress. (+info)
Low doses of melatonin and diurnal effects on thermoregulation and tolerance to uncompensable heat stress.
This study examined whether the reported hypothermic effect of melatonin ingestion increased tolerance to exercise at 40 degrees C, for trials conducted either in the morning or afternoon, while subjects were wearing protective clothing. Nine men performed four randomly ordered trials; two each in the morning (0930) and afternoon (1330) after the double-blind ingestion of either two placebo capsules or two 1-mg capsules of melatonin. Despite significant elevations in plasma melatonin to over 1,000 ng/ml 1 h after the ingestion of the first 1-mg dose, rectal temperature (T(re)) was unchanged before or during the heat-stress exposure. Also, all other indexes of temperature regulation and the heart rate response during the uncompensable heat stress were unaffected by the ingestion of melatonin. Initial T(re) was increased during the afternoon (37.1 +/- 0.2 degrees C), compared with the morning (36.8 +/- 0.2 degrees C) exposures, and these differences remained throughout the uncompensable heat stress, such that final T(re) was also increased for the afternoon (39.2 +/- 0.2 degrees C) vs. the morning (39.0 +/- 0.3 degrees C) trials. Tolerance times and heat storage were not different among the exposures at approximately 110 min and 16 kJ/kg, respectively. It was concluded that this low dose of melatonin had no impact on tolerance to uncompensable heat stress and that trials conducted in the early afternoon were associated with an increased T(re) tolerated at exhaustion that offset the circadian influence on resting T(re) and thus maintained tolerance times similar to those of trials conducted in the morning. (+info)
Patients' attitude toward consultations by a physician without a white coat in Japan.
OBJECT: To know how Japanese patients perceive their physicians without a white coat during consultations. SUBJECTS AND METHODS: The patients who visited a university clinic were divided into two groups: those seen by a physician in a white coat (the white-coat group) and those seen by a physician in private clothes (the private-clothes group). Questionnaires were distributed to the patients, which asked the tension and satisfaction of consultations as well as their preference for physician's attire. The answers of the white-coat group were compared with those of the private-clothes group. RESULTS: The percentage of new patients who felt tense during consultations was greater in the white-coat group (42%) than in the private-clothes group (33%). Seventy-one percent of the patients in the white-coat group preferred physicians in a white coat whereas only 39% preferred so in the private-clothes group (p<0.0001). However, the degree of patients' satisfaction for the consultation showed no statistical difference between the groups. Sixty-nine percent of the patients older than or equal to 70 years preferred a white coat while 52 percent of the patients younger than 70 years preferred so (p=0.002). CONCLUSION: Physician's white coats did not influence the satisfaction with the consultations for most Japanese patients in a university clinic, although elderly patients as well as those seen by a physician in a white coat tended to prefer the white coat to the private clothes. Furthermore, practice without a white coat might reduce patients' tension during their first consultation. (+info)
Clothing selection behavior of the aged women for thermal comfort.
Wearing behavior and thermoregulatory responses of five young women (YG; 20 +/- 1 yr) and five aged women (AG; 65 +/- 3 yr) to indoor cold in summer were investigated in this study. The subjects were exposed to 21.0 +/- 0.5 degrees C and 55 +/- 5% RH while seated during a 90-minute experiment. The subjects were allowed to select and wear for thermal comfort clothing whenever they needed additional clothing during the experiment. Rectal temperature (Tre) and temperatures of 7 sites (head, chest, forearm, hand, thigh, leg, foot) of the skin of the subjects were measured every 10 minutes. Mean skin temperature (Tsk) of the subject was obtained every 10 minutes. First selection time of additional clothing was monitored and weight of selected total clothing was calculated. The results for this study were as follows: Tre and Tsk gradually decreased in YG and AG, however Tre decreased less than Tsk which decreased greater in AG than YG (p < 0.01). AG's first selection of additional clothing and thermal sensation response were slower than YG's. Furthermore, total clothing weight was less in AG than YG. It was concluded that clothing selection behavior would modify the intrinsic thermoregulatory responses of the aged women to the cold stress in the summer. (+info)
A computer model of human thermoregulation for a wide range of environmental conditions: the passive system.
A dynamic model predicting human thermal responses in cold, cool, neutral, warm, and hot environments is presented in a two-part study. This, the first paper, is concerned with aspects of the passive system: 1) modeling the human body, 2) modeling heat-transport mechanisms within the body and at its periphery, and 3) the numerical procedure. A paper in preparation will describe the active system and compare the model predictions with experimental data and the predictions by other models. Here, emphasis is given to a detailed modeling of the heat exchange with the environment: local variations of surface convection, directional radiation exchange, evaporation and moisture collection at the skin, and the nonuniformity of clothing ensembles. Other thermal effects are also modeled: the impact of activity level on work efficacy and the change of the effective radiant body area with posture. A stable and accurate hybrid numerical scheme was used to solve the set of differential equations. Predictions of the passive system model are compared with available analytic solutions for cylinders and spheres and show good agreement and stable numerical behavior even for large time steps. (+info)
Conceptual model for assessment of dermal exposure.
Dermal exposure, primarily to pesticides, has been measured for almost half a century. Compared with exposure by inhalation, limited progress has been made towards standardisation of methods of measurement and development of biologically relevant exposure measures. It is suggested that the absence of a consistent terminology and a theoretical model has been an important cause of this lack of progress. Therefore, a consistent terminology based on a multicompartment model for assessment of dermal exposure is proposed that describes the transport of contaminant mass from the source of the hazardous substance to the surface of the skin. Six compartments and two barriers together with eight mass transport processes are described. With the model structure, examples are given of what some existing methods actually measure and where there are limited, or no, methods for measuring the relevant mass in a compartment or transport of mass. The importance of measuring the concentration of contaminant and not mass per area in the skin contaminant layer is stressed, as it is the concentration difference between the skin contamination layer and the perfused tissue that drives uptake. Methods for measuring uptake are currently not available. Measurement of mass, concentration, and the transport processes must be based on a theoretical model. Standardisation of methods of measurement of dermal exposure is strongly recommended. (+info)
Clothing for use in clean-air environments.
Disposable plastic two-piece suits were compared with conventional cotton suits, gowns, and plastic aprons by nurses in a burns unit. The plastic suits allowed fewer micro-organisms to be dispersed into the environment than the other garments but were less comfortable. (+info)