The effect of mode of delivery on postpartum comfort level and breastfeeding self-efficacy: a systematic review and meta-analysis.

OBJECTIVE: This study was conducted to determine the effect of the mode of delivery on maternal postpartum comfort level and breastfeeding self-efficacy. METHODS: The study was conducted as a systematic review and a meta-analysis. Searching was performed from March to July 2022, on PubMed, National Thesis Center, Dergi Park, Google Scholar, Web of Science, and EBSCO search engines and we included studies from the last 10 years. The Joanna Briggs Institute Critical Appraisal tools used in cross-sectional studies were employed to appraise the methodological quality and performed meta-analyses using a random-effects model for all outcomes. Study data consisted of continuous variables calculated by Mean Difference. RESULTS: From 3732 records received, 21 cross-sectional studies involving 5266 participants were determined to be eligible. Meta-analysis results showed that cesarean section reduced postpartum comfort, albeit not statistically significant (MD: -0.87 95%: -1.98-0.24, Z = 1.53, p = 0.44), whereas the combined results of breastfeeding self-efficacy showed that delivery type did not affect breastfeeding self-efficacy. CONCLUSION: The results of this review have clinical implications for postpartum caregivers, as the effects of mode of delivery on postpartum comfort and breastfeeding self-efficacy have been well documented in previous studies. The authors recommend caregivers plan maternal care to increase their comfort, taking into account the factors that may affect postpartum comfort in the light of evidence-based practices.

Impact of fetal spine alignment according to maternal lateralization during early labor on maternal comfort and birth outcomes: A prospective cohort study in Kelantan, Malaysia.

INTRODUCTION: Maternal positioning during labor significantly influences maternal comfort. This study aims to identify the preferred maternal lateral position during the latent phase and examine the impact of alignment between maternal lateralization and fetal spine positioning during the active phase of the first stage of labor on maternal comfort. METHODS: Pregnant women in the first stage of labor beyond 37 weeks of gestation were recruited over six months from March to August 2020 for this prospective cohort study at Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. Eligible individuals were randomly allocated to align with the fetal spine (n=180) or oppose it (n=180). Fetal spine positions were confirmed via transabdominal ultrasound. Maternal mean comfort scores were assessed using the established Maternal Comfort Assessment Tool. Statistical analysis was performed using IBM SPSS version 27, with a p<0.05 considered significant. RESULTS: There was a significant association between the preferred maternal position during the latent phase and concordance with the same maternal lateralization-fetal spine alignment (p<0.001). Higher mean comfort scores were observed when the maternal lateral position matched the fetal spine alignment during the active phase of labor. There was a significant association of normal CTG tracings when the maternal position was aligned with the fetal spine (p<0.001). CONCLUSIONS: Parturients preferred lying in alignment with the fetal spine lateralization during the latent phase. This position also offers increased comfort during the active phase of labor. It highlights the importance of considering maternal-fetal alignment as a critical factor in intrapartum care.

Comprehensive study on zeolitepolyester composite coated sheet for eco-friendly solar panels for enhanced panel performance and reduced panel temperature.

Solar energy is the most promising source for generating residential, commercial, and industrial electricity. However, solar panels should be eco-friendly to increase sustainability during manufacturing and recycling. This study investigates the potential of using natural fibre composites as eco-friendly alternatives to conventional polyethylene terephthalate (PET) back sheets in solar panels. Furthermore, it examines the performance of sisal fibres coated with zeolite-polyester resin. The chemical composition, structural integrity, and crystalline properties of the composites were evaluated through extensive microstructural analysis. The results from the experimental analysis revealed significant improvements in voltage (8%) and current (6%) for the coated sisal fibre panels compared to conventional panels. Power output increased by 12%, and overall efficiency improved from 9.75 to 10.8%. Solar panels with sisal fibre sheets exhibit adequate tensile strength and impact resistance and reduce operating temperature by 2-3 °C, ensuring stable operation and minimizing heat loss. Statistical analysis confirmed the reliability and significance of these results. The life cycle analysis demonstrated a 60% reduction in CO2 emissions and a 50% decrease in energy consumption during the production, utilization and disposal of sisal fibre sheets. These findings underscore the viability of natural fibre composites in enhancing the performance and sustainability of solar panels.

Enhancement of rider comfort by magnetorheological elastomer based damping treatment at strategic locations of an electric two wheeler.

The vibrations generated in the two-wheeled vehicles like motorcycles due to road irregularities such as cracks, potholes, and bumps on the road cause discomfort for the rider as well as the pillion. These vibrations are reported to cause lower back pains, musculoskeletal effects, fatigue, and long-term health issues. Particularly, electric two-wheelers are more susceptible to these vibrations caused by the road and need attention. This paper presents an innovative technique for the reduction of vibrations at prominent locations in the electric two-wheeler to improve the rider's comfort. All measured accelerations are about vertical direction (along z-axis as per ISO 2631-1 standard). Passive and Semi-active damping treatments namely, Room temperature vulcanizing Silicone rubber and Magnetorheological elastomer (MRE) were applied on the test vehicle at strategic locations of vibration. Both were compared for their effectiveness in reducing the vibrations. Results showed that MRE based damping technique proved better vibration isolation at the strategic locations. The weighted root mean square acceleration as well as vibration dose values were found to decrease with the help of damping treatments thus improving the rider's overall comfort level.

Instruments to Assess the Comfort of Hospitalized Elderly People: A Scoping Review.

Background and Purpose: The purpose of this study was to map the instruments for assessing the comfort of hospitalized older adults in the scientific literature, identifying those instruments validated and transculturally adapted to the realities of Brazil. Methods: This was a scoping review of 14 articles and a website retrieved from the following databases: MEDLINE/PubMed, CINAHL, EMBASE, Web of Science, Scopus, Science Direct/Elsevier, and gray literature (Oasisbr, Catalog of Theses and Dissertations [CAPES], OATD, BDBTD, and The Comfort Line). Results: Seventeen instruments for assessing the comfort of hospitalized older adults were mapped; however, none were specifically designed for this population, as they were originally intended for adults or individuals with neuropsychiatric conditions. Among these, three have been validated and transculturally adapted to the Brazilian context. Conclusions: This study reveals the need for a specific instrument tailored for hospitalized older adults without neuropsychiatric conditions.

Evaluating the influence of ambient conditions in the cooking space of railway pantry car using selected thermal indices and physiological parameter.

BACKGROUND: Hot and humid indoor environment of the kitchen affects worker performance. The Indian Railway's pantry car culinary is one of them that cooks food for the on-board passengers, which could be bothered by the hot indoor climate. OBJECTIVE: The current study aimed to identify the indoor working environment of the railway "pantry car" using heat stress indices such as "Universal Thermal Climate Index-UTCI," "Wet-Bulb Globe Temperature-WBGT," "Discomfort Index-DI," "Tropical Summer Index-TSI," "Heat Index-HI," and Heart Rate-HR with clothing insulation. METHODS: The study was performed in 2018 (August-summer season) to collect field survey data on 6 railway pantry cars. Measurements were carried out during peak cooking times such as morning "7 : 00 am", day "11 : 30 am", evening "4 : 00 pm," and night "6 : 30 pm". This study's descriptive and Pearson's correlation analysis was accomplished using SPSS version 2016 software. RESULTS: The analysis results revealed that the average values were for UTCI (37.77±5.26°C), WBGT (30.42±2.28°C), DI (30.05±2.70°C), TSI (33.21±2.90°C), HI (48.53±4.86°C), correspondingly. During analysis, the strongest correlation association was observed between "TSI and DI" (r = 0.985, p < 0.000) and WBGT and TSI (r = 0.958, p < 0.000). A "significant correlation" was found between UTCI and HI (r = 0.637, p < 0.05). While no signification correlation was found between "heat stress indices and physiological parameters (p > 0.05)". CONCLUSION: In this study, all the heat stress index limit values showed highly harsh working conditions inside the pantry car, which created unfavorable circumstances for the culinarians. Inappropriate "ventilation design" could be a reason for discomfort in the railway pantry car.

Comparative analysis of visual-thermal perceptions and emotional responses in outdoor open spaces: Impacts of look-up vs. look-forward viewing perspectives.

Horizontal and vertical viewing perspectives exert varying influences on the environmental perceptions and emotional states of college students. Despite this, scant research addresses the impact on this demographic. We selected typical campus open spaces for comprehensive physical parameter assessments, encompassing meteorological and spatial characteristics. A cohort of 36 healthy college students participated in a questionnaire survey designed to ascertain shifts in visual comfort, thermal comfort, and emotional responses when viewing landscapes in look-forward and look-up orientations. Key findings following both viewing modalities included: 1) a notable rise in mean visual comfort vote (MVCV), by 1.22 for look-forward and 1.01 for look-up, with a pronouncedly higher sunlight sensation vote (SSV) for the latter orientation; 2) a significant increase in thermal comfort vote (TCV), although the difference in increments between the two viewing angles was minimal; 3) Positive affect (PA) exhibited considerable improvement in both viewing conditions, while negative affect (NA) was markedly reduced in the look-up condition relative to look-forward viewing; 4) The SSV was predominantly influenced by the trunk ratio and canopy-to-trunk ratio, with substantial weights of 31.47% and 32.15%, respectively. Landscape element diversity emerged as the most critical factor affecting visual comfort vote (VCV) and aesthetic assessment score (AAS), with overwhelming weights of 70.67% and 63.15%, respectively. Moreover, the leaf ratio was identified as the chief determinant of emotional responses. Our results provide insights into the design of campus spaces for enhanced student well-being.

The Role of Religious Comfort and Strain on Social Well-Being among Emerging Adults in Poland: Serial Mediation by Meaning Making Processes.

Religious struggles tend noticeably to influence the sphere of social well-being in emerging adulthood as individuals modify their religious beliefs and practices, form personal identity patterns, and rediscover new life purpose and values. The aim of the current study was to investigate whether meaning-making and meaning in life (presence and search) can serially mediate the hypothesized links between religious comfort vs. strain and social well-being. Self-report measures of religious struggles, meaning-making, meaning in life, and social well-being were completed by 368 emerging adults (aged 18 to 29, 52.2% female). The serial mediation analysis showed that the relationship between religious comfort vs. strain and social well-being was mediated by meaning-making and presence of meaning, but not by a search for meaning. These results suggest that religious struggles may represent unique aspects of developmental spiritual processes in emerging adulthood with implications for social well-being.

Discharging patients home from the intensive care unit: A new trend.

Discharging patients directly to home from the intensive care unit (ICU) is becoming a new trend. This review examines the feasibility, benefits, challenges, and considerations of directly discharging ICU patients. By analyzing available evidence and healthcare professionals' experiences, the review explores the potential impacts on patient outcomes and healthcare systems. The practice of direct discharge from the ICU presents both opportunities and complexities. While it can potentially reduce costs, enhance patient comfort, and mitigate complications linked to extended hospitalization, it necessitates meticulous patient selection and robust post-discharge support mechanisms. Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition. Through critical evaluation of existing literature, this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery. The insights provided contribute evidence-based recommendations for refining the direct discharge approach, fostering improved patient outcomes, heightened satisfaction, and streamlined healthcare processes. Ultimately, the review seeks to balance patient-centered care and effective resource utilization within ICU discharge strategies.

Cross-cultural adaptation and validation of Carolinas Comfort Scale to Brazilian Portuguese for inguinal hernia.

PURPOSE: Inguinal hernias are highly prevalent worldwide and its surgical repair is one of the most common procedures in general surgery. The broad use of mesh has decreased the recurrence rates of inguinal hernia to acceptable levels, thus centering the attention on Quality of Life as a pivotal postoperative outcome. Carolinas Comfort Scale is a well-studied questionnaire designed to identify Quality of Life changes following hernia repair with mesh techniques. The aim of this study is to validate the CCS in Brazilian Portuguese for inguinal hernias. METHODS: The original CCS was translated into Brazilian Portuguese according to cross-cultural adaptation guidelines. We conducted a cross-sectional study in individuals aged 18 and above who had undergone inguinal laparo-endoscopic hernia repair for at least 6 months prior, between January 2019 and August 2022, at a Brazilian tertiary hospital. Participants answered an online survey containing the Brazilian CCS and the generic Patient-Reported Outcome Measure (PROM) Short-Form Health 36 (SF-36). Participants answered the same questionnaires in the follow-up after at least three weeks, with an additional question about satisfaction with surgery results. RESULTS: The survey was completed by 115 patients, of whom 78 (67%) responded to the follow-up questionnaire after 3 to 10 weeks. CCS showed excellent internal consistency, with Cronbach's α of 0.94. Intraclass correlation coefficient ranged from 0.60 to 0.82 in the test-retest analysis. Compared to SF-36, a strong correlation was observed in the physical functioning dimension, and a moderate correlation was found in role-physical and bodily pain (Pearson's Coefficient Correlation = 0.502, 0.338 and 0.332 respectively), for construct analysis. The mean CCS score was significantly lower (p < 0.001) among satisfied patients compared to the unsatisfied ones. CONCLUSION: The Brazilian version of CCS is a valid and reliable method to assess long-term quality of life after inguinal laparo-endoscopic hernia repair.

Effect of lidocaine pumped through hepatic artery to relieve pain of hepatic artery infusion chemotherapy.

Background: This study aims to explore the analgesic effect of lidocaine administered through the hepatic artery during hepatic artery infusion chemotherapy (HAIC) for hepatocellular carcinoma (HCC). Methods: A total of 45 HCC patients were randomly divided into a study group and a control group. Both groups received oxaliplatin (OXA) based FOLFOX protocol via electronic infusion pump. The study group was continuously infused with 100 mg of lidocaine during HAIC, while 5% glucose solution was infused in the same way as described above. Changes in vital signs, visual analogue score (VAS) and general comfort score (GCQ scale) were recorded before surgery (Time point 0), at the end of infusion (Time point 01), 1 h after HAIC (Time point 02), 3 h after HAIC (Time point 03) and 6 h after HAIC (Time point 04). Results: At each point of time from Time point 0 through Time point 04, the differences in MAP, RR and SPO2 between the two groups were not statistically significant (P > 0.05). At each point of time from Time point 01 through Time point 04, the mean VAS scores in the study group were smaller and GCQ scores were higher than those in the control group, and the differences were both statistically significant (P < 0.05). Conclusions: Lidocaine infusion through the hepatic artery during HAIC effectively reduces intraoperative and postoperative pain and improves patient satisfaction with pain management, making it a valuable technique for clinical practice.

Insights into climate change dynamics: A tourism climate index-based evaluation of Gilgit-Baltistan, Pakistan.

The tourism industry is a significant contribution to the economy of many countries, including Pakistan. However, its activities often have a negative impact on the environment, particularly related to climate change. Notably, Pakistan ranks fifth among countries most affected by climate change, which requires a targeted analysis of the tourism sector to determine its potential impacts. Despite the critical nature of this issue, there is currently a lack of research that examines how climate change specifically impacts Pakistan's tourism industry. This study aims to address this gap by using the Tourism Climate Index (TCI) to assess the impact of climate change on the suitability of different tourism locations across the country. Our results show that popular tourist destinations such as Gilgit-Baltistan experience their peak season in the warmer third quarter (summer), which corresponds to the highest observed TCI values. This suggests that warmer temperatures could boost tourism activity and spending in these regions. Furthermore, our analysis shows that air temperature plays a crucial role in determining tourist comfort levels and significantly influences tourists' TCI values and sensory experiences. The results of this study show that the TCI methodology can be an effective tool for further research into the geographical impacts of climate change on tourism. By identifying necessary changes due to climatic changes, future studies could provide valuable insights into how the tourism industry can adapt to and reduce its environmental footprint.

Can Long-Term Care Insurance Change Eldercare Patterns? Evidence from China.

Long-term Care Insurance (LTCI), providing care services and economic compensation to older adults with activity limitations, plays a crucial role in addressing the care needs of older adults and easing the burden on family caregivers. This article is based on the 2011-2018 China Health and Retirement Longitudinal Study (CHARLS) and uses China's LTCI pilot program as a quasi-experiment to examine the impact of LTCI on older adults' care patterns in China. It employs a staggered difference-in-differences (staggered DID) methodology to model the economic support, living arrangements and care, and spiritual comfort provided to older adults. Results indicate that LTCI significantly enhances the economic and emotional independence of older adults. On the one hand, LTCI effectively decreases the economic and emotional dependence of older adults on their children. On the other hand, LTCI raises the likelihood that older adults rely on social institutions and personnel for care. Additionally, LTCI is associated with achieving higher life satisfaction. Interestingly, the impact of LTCI varies significantly across sub-samples of different types of older adults and different policy regulations. Overall, findings indicate that LTCI shifts older adults' care patterns from family to socialized care, thereby reducing children's caregiving burden.

On urban microclimate spatial-temporal dynamics: Evidence from the integration of fixed and wearable sensing and mapping techniques.

Urban Heat Island (UHI) is acknowledged to generate harmful consequences on human health, and it is one of the main anthropogenic challenges to face in modern cities. Due to the urban dynamic complexity, a full microclimate decoding is required to design tailored mitigation strategies for reducing heat-related vulnerability. This study proposes a new method to assess intra-urban microclimate variability by combining for the first time two dedicated monitoring systems consisting of fixed and mobile techniques. Data from three fixed weather stations were used to analyze long-term trends, while mobile devices (a vehicle and a wearable) were used in short-term monitoring campaigns conducted in summer and winter to assess and geo-locate microclimate spatial variations. Additionally, data from mobile devices were used as input for Kriging interpolation in the urban area of Florence (Italy) as case study. Mobile monitoring sessions provided high-resolution spatial data, enabling the detection of hyperlocal variations in air temperature. The maximum air temperature amplitudes were verified with the wearable system: 3.3 °C in summer midday and 4.3 °C in winter morning. Physiological Equivalent Temperature (PET) demonstrated to be similar when comparing green areas and their adjacent built-up zone, showing up the microclimate mitigation contribution of greenery in its surrounding. Results also showed that mixing the two data acquisition and varied analysis techniques succeeded in investigating the UHI and the site-specific role of potential mitigation actions. Moreover, mobile dataset was reliable for elaborating maps by interpolating the monitored parameters. Interpolation results demonstrated the possibility of optimizing mobile monitoring campaigns by focusing on targeted streets and times of day since interpolation errors increased by 10% only with properly reduced and simplified input samples. This allowed an enhanced detection of the site-specific granularity, which is important for urban planning and policymaking, adaptation, and risk mitigation actions to overcome the UHI and anthropogenic climate change effects.

The impact of knitted linked seams on comfort and friction perception.

Friction from knitted clothing can cause discomfort and skin issues, underscoring the importance of tactile comfort for wearers. Seamless knitted garments are assumed to be comfortable to wear, yet there is little understanding of their tactile comfort in comparison to linked seams - the most common form of knitted garment. This novel study examines the influence of a garments knitted structural architecture on clothing comfort and wearability by investigating skin friction and tactile perception across ten body regions in both male and female participants, using two commonly utilised materials and seam designs: cotton and merino wool with plain and linked seams. The impact of seam design and regional factors on skin friction and tactile perception was analysed, revealing varying levels across tested body regions. Removing seams exposed a greater surface area to skin contact, leading to higher perceived friction levels. As such, structural elements in knitted garments enhance wearer comfort.

Seamless knitwear manufacturing offers a more environmentally conscious option compared to traditional cut-and-sew processes. This study investigated the impact of knitted garment material and structure on wearer comfort by analysing skin friction and tactile perception across ten upper body regions. Removing seams increased garment-to-skin contact leading to wearer discomfort.

Next-Generation Custom-Fit Reusable Respiratory Protective Device with Continuous Fit Monitoring - Part II: Continuous Fit Monitoring.

Filtering facepiece respirators (FFRs) are manufactured in discrete sizes, with some models being limited in accommodating the fit of some sex and race combinations. This study presents the development of a custom-fit respiratory protective device (RPD) which conforms to a user's facial features and flexes and moves with facial movements during use. Our design also integrates a pressure-sensing network, which continuously monitors fit and will alert the user when the fit is compromised. In this Part II of the three-part series, we design and incorporate a continuous fit monitoring system in the RPD designed in Part I to enhance its role in protecting users from inhalation hazards in an effective manner during its use. The fit monitoring system comprises a fabric-based sensor network integrated into the RPD and an Android-based App designed to alert the user when the pressure at the faceseal falls below a given threshold established during the initial configuration of the RPD for the user. We also develop algorithms for the incorporation of the sensor slots and data buses into the custom-fit RPD using the Taxonomy of Landmarks defined in Part I. We enhance the structure developed in Part I to secure the sensor network during the use of the RPD. We develop algorithms for customizing a fastening hub to suit the head profiles of individuals to enable them to don the RPD quickly, easily, effectively, and in a repeatable manner. We demonstrate the successful application of the total design methodology by creating digital prototypes for three individuals with different facial profiles and make further advances to our goal of ensuring equitable respiratory protection for all including children, for whom RPDs are currently limited.

Comfort evaluation and physiological effects/autonomic nervous system response of inflatable deep pressure vest in reducing anxiety.

Background: Deep pressure therapy treats anxiety by triggering physiological responses and promoting calmness. Moreover, measuring user comfort can improve product quality. Objective: To investigate the physiological effects and subjective comfort level of inflatable deep pressure vests to enhance their calming effect. Methods: Experimental research was conducted with a one-group pretest-posttest design for physiological effects using pulse oximetry for peripheral pulse rate and a one-shot case study for three subscale parameters that help evaluate comfort (pressure, touch, and mobility) using the Numerical Rating Scale (NRS). Deep pressure intervention using the Inflatable Vest was performed for three sessions, each lasting 5 min. Results: This study was conducted with 46 participants (24 males, 22 females) aged 17-20 (19.52 ± 0.78). Although pulse rate consistently decreased in all sessions, session 1 showed a significant decrease (p = 0.014*, d = 0.379), whereas sessions 2 (p = 0.274, d = 0.163) and 3 (p = 0.597, d = 0.078) demonstrated non-significant decreases with small effect sizes. The pressure comfort subscale showed that 87.0 %, 4.3 %, and 8.7 % of the participants, and the touch comfort subscale test revealed that 82.6 %, 8.7 %, and 73.9 % of the participants rated it as comfortable, very comfortable, and less comfortable, respectively. The mobility subscale test showed that 73.9 % of the participants rated no limitation, 17.4 % rated somewhat limited, and only 8.7 % rated limitation. Decreased pulse rate and pressure comfort were significantly positively correlated (r = 0.282**, p < 0.01), whereas touch pressure and mobility were not (r = 0.160, p > 0.05; and r = 0.121, p > 0.05, respectively). Decreased pulse rate was also positively correlated with the overall score for the three aspects (r = 0.201*, p < 0.05). Conclusions: A comfortable inflatable deep pressure vest provides a physiologically calming effect for therapeutic modalities.

Impact of different concentration iodinated contrast media on pain and comfort in abdominal computed tomography.

OBJECTIVES: To investigate whether high concentration iodinated contrast media (CM), compared with low concentration CM, could reduce pain and discomfort levels in patients who had level II and III venous conditions. METHODS: This prospective, single-center study enrolled patients who had level II and III venous conditions and underwent abdominal contrast-enhanced CT scan between July 2021 and February 2022. The venous condition to establish peripheral venous access for CM injection was graded using the Intravenous Access Scoring system, of which level II and III indicated poor venous condition and difficult venous access. Patients received iomeprol 400 in high concentration group and ioversol 320 in low group at an identical iodine delivery rate of 1.12 gI/s. The primary outcomes were pain and comfort levels. The secondary outcomes included adverse events and image quality. Patients rated pain intensity via Numerical Rating Scale and comfort level via Visual Analogue Scale with higher scores indicating higher levels of pain and discomfort. Quantitative and qualitative image assessment were compared between two groups. Continuous variables were compared using Student's t test or Mann-Whitney U test. Categorical variables were compared using χ2 test, χ2 test for trend or Fisher's exact test. RESULTS: A total of 206 patients (mean age, 60.13 ± 12.14 years; 81 males) were included with 99 in the high concentration group and 107 in the low concentration group. The high group had significantly lower pain scores (median 1 [IQR: 0-2] vs 2 (IQR 2-4), p < 0.001) and comfort scores (1 [IQR: 0-3] vs 3 [IQR: 2-5], p < 0.001) than the low group. Incidence of CM extravasation did not significantly differ (1.0 % vs 4.5 %, p = 0.214). No hypersensitivity reaction was observed. Qualitative assessment showed higher clarity scores of intrahepatic hepatic artery and portal vein in the high group. Quantitative assessment results were comparable between two groups. CONCLUSION: High concentration iodinated CM could lower pain intensity and improve comfort levels without comprising image quality of CT scan. High concentration CM is a preferable choice in patients with poor venous conditions during contrast-enhanced CT scan.

Exploring the risk of heat stress in high school pre-season sports training, Johannesburg, South Africa.

There is growing concern over the increased risk of heat stress induced by the changing climate, with increased global temperatures expected to exacerbate conditions. Heat stress in school sports is a critically understudied research area in South Africa (SA). As demonstrated by several studies conducted in the global north, the stress elicited by meteorological conditions on students participating in physical education lessons and after-school sports activities could have serious consequences on their health. This paper represents the first research in the region to investigate the risk of heat stress to school students during physical activity. Meteorological data were collected at a school in Johannesburg between March and July, which encompasses the seasons of late summer, autumn, and winter. These were inputted into four heat stress indices: Humidex, Heat Index, Wet Bulb Globe Temperature, and the Universal Thermal Climate Index, together with the measured Wet Bulb Temperature to determine the level of risk of heat stress during physical education lessons and after-school sports activities between March and July. Of the 2700 index scores calculated over this period, 56% indicate some level of heat stress, with almost 6% indicating a high and very high level of risk. Heat stress is calculated to be most likely to occur between 11h00-15h00, and the danger of pre-season training, which takes place in the summer months, is demonstrated by these results. Additionally, this research finds that heat stress is far more likely on artificial surfaces than on natural grass. The findings of this research intimate that school stakeholders should consider the implications of heat stress when considering timetabling and policy-making in the interests of safeguarding their students.