M. Ebnali, A. Goldsmith, Barbara Burian, B. Atamna, N. Duggan, C. Fischetti, S. Yule, R. Dias
Space travel imposes significant risks to crew health due to physiological adaptations, exposure to physical and psychological stressors, and limited capabilities to provide medical care. When medical emergencies occur, appropriate use of diagnostic and procedural guidance tools are crucial countermeasures against the risks of injury and mission failure. Point-of-care ultrasound (POCUS) is the only portable imaging modality available during exploration missions that can provide critical and dynamic medical information. Developing competency in POCUS is time-consuming and it is usually achieved through years of medical residency or clinical fellowship training programs. Due to the amount of astronaut training currently required, it is not feasible to also provide them with in-depth POCUS training. Current cognitive aids for POCUS-based procedures are either paper-based or static electronic checklists, which can be cumbersome to use, non-intuitive, and sometimes distracting; applying their written guidance to real actions can be difficult. To overcome these limitations, we developed a proof of concept of an augmented reality (AR) Coach (AR-Coach) as an Augmented Clinical Tool (ACT): a hands-free virtual coach system that guides the crew in real-time on how to perform POCUS during medical emergencies in space. To better understand the context and design requirements for the proposed ACT, we applied a human-centered design approach as part of our wider space medicine research program. We convened a multidisciplinary expert panel (n=46), including astronauts, flight surgeons, clinicians, XR and AI experts, to identify essential capability requirements. Task analysis with five experts, including clinicians, human factors researchers, and an XR developer, was used to create a process model of a POCUS-guided procedure to diagnose a potentially life-threatening condition (i.e., pneumothorax) that could occur during space travel. An iterative design and prototyping process was conducted. Informed by the expert panel and task analysis, we created a proof of concept of the AR-Coach which includes holographic panels that guide the crew in confirming the diagnosis of pneumothorax using POCUS. The results of this study can be applied in advancing space technologies that support astronauts in managing medical events during space exploration missions, optimizing performance, and improving crew safety.
{"title":"AR-Coach: Using Augmented Reality (AR) for Real-Time Clinical Guidance During Medical Emergencies on Deep Space Exploration Missions","authors":"M. Ebnali, A. Goldsmith, Barbara Burian, B. Atamna, N. Duggan, C. Fischetti, S. Yule, R. Dias","doi":"10.54941/ahfe1002100","DOIUrl":"https://doi.org/10.54941/ahfe1002100","url":null,"abstract":"Space travel imposes significant risks to crew health due to physiological adaptations, exposure to physical and psychological stressors, and limited capabilities to provide medical care. When medical emergencies occur, appropriate use of diagnostic and procedural guidance tools are crucial countermeasures against the risks of injury and mission failure. Point-of-care ultrasound (POCUS) is the only portable imaging modality available during exploration missions that can provide critical and dynamic medical information. Developing competency in POCUS is time-consuming and it is usually achieved through years of medical residency or clinical fellowship training programs. Due to the amount of astronaut training currently required, it is not feasible to also provide them with in-depth POCUS training. Current cognitive aids for POCUS-based procedures are either paper-based or static electronic checklists, which can be cumbersome to use, non-intuitive, and sometimes distracting; applying their written guidance to real actions can be difficult. To overcome these limitations, we developed a proof of concept of an augmented reality (AR) Coach (AR-Coach) as an Augmented Clinical Tool (ACT): a hands-free virtual coach system that guides the crew in real-time on how to perform POCUS during medical emergencies in space. To better understand the context and design requirements for the proposed ACT, we applied a human-centered design approach as part of our wider space medicine research program. We convened a multidisciplinary expert panel (n=46), including astronauts, flight surgeons, clinicians, XR and AI experts, to identify essential capability requirements. Task analysis with five experts, including clinicians, human factors researchers, and an XR developer, was used to create a process model of a POCUS-guided procedure to diagnose a potentially life-threatening condition (i.e., pneumothorax) that could occur during space travel. An iterative design and prototyping process was conducted. Informed by the expert panel and task analysis, we created a proof of concept of the AR-Coach which includes holographic panels that guide the crew in confirming the diagnosis of pneumothorax using POCUS. The results of this study can be applied in advancing space technologies that support astronauts in managing medical events during space exploration missions, optimizing performance, and improving crew safety.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114714998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martina A. Clarke, Lisa L Neitzke, Kathryn M Cooper
Shared living providers (SLPs) have identified administrative burden as a major contributor to burnout and the decreased effectiveness of care delivery. SLPs are individuals that allow persons with I/DD to reside in their residential home while providing caregiving support in daily living activities, community integration, and many other activities. This project addresses health information technology (HIT)-related documentation burden, which is a critical barrier to progress in the intellectual and developmental disabilities (I/DD) support field. The aim of this study is to determine SLPs’ perception of documentation burden while caring for individuals with I/DD.MethodsSeventeen SLPs were surveyed to understand their perception of documentation burden to determine its role in burnout. The survey used to measure documentation burden was the Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey. The BurDoNsaM is a 28-item validated survey, categorized using 6 subscales, representing essential areas of documentation burden. Three of the six subscale in the BurDoNsaM survey was used in this study. The three subscales included were: (1) views about value of clinical documentation, (2) burden of documentation, and (3) time taken to complete documentation. Seventeen of the 28 survey items were relevant to SLP duties and was included in our pilot study. SLPs were recruited after their clinic visit from University of Nebraska Medical Center (UNMC) Munroe Meyer Institute (MMI) Adult I/DD clinic. Survey data was recorded and stored in a secure database. The data was summarized using descriptive statistics.DiscussionThis pilot study was able to identify the areas that cause documentation burden for SLPs. Respondents found value in clinical documentation. Despite its value, respondents reported that the documentation process complex and is time consuming. SLPs are required to comply with an increasing, wide-ranging body of requirements to deliver and receive payment for care of individuals with I/DD. The cost of compliance with these requirements has long term effects, such as, increased cognitive load and burnout. Limitations of this pilot study include a small sample size. Future research should include a larger sample size and qualitative data to further identify the specific areas that cause the most burden.
{"title":"Shared Living Providers (SLP) Experience Documentation Burden While Caring for Individuals with Intellectual and Developmental Disabilities (I/DD)","authors":"Martina A. Clarke, Lisa L Neitzke, Kathryn M Cooper","doi":"10.54941/ahfe1002095","DOIUrl":"https://doi.org/10.54941/ahfe1002095","url":null,"abstract":"Shared living providers (SLPs) have identified administrative burden as a major contributor to burnout and the decreased effectiveness of care delivery. SLPs are individuals that allow persons with I/DD to reside in their residential home while providing caregiving support in daily living activities, community integration, and many other activities. This project addresses health information technology (HIT)-related documentation burden, which is a critical barrier to progress in the intellectual and developmental disabilities (I/DD) support field. The aim of this study is to determine SLPs’ perception of documentation burden while caring for individuals with I/DD.MethodsSeventeen SLPs were surveyed to understand their perception of documentation burden to determine its role in burnout. The survey used to measure documentation burden was the Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey. The BurDoNsaM is a 28-item validated survey, categorized using 6 subscales, representing essential areas of documentation burden. Three of the six subscale in the BurDoNsaM survey was used in this study. The three subscales included were: (1) views about value of clinical documentation, (2) burden of documentation, and (3) time taken to complete documentation. Seventeen of the 28 survey items were relevant to SLP duties and was included in our pilot study. SLPs were recruited after their clinic visit from University of Nebraska Medical Center (UNMC) Munroe Meyer Institute (MMI) Adult I/DD clinic. Survey data was recorded and stored in a secure database. The data was summarized using descriptive statistics.DiscussionThis pilot study was able to identify the areas that cause documentation burden for SLPs. Respondents found value in clinical documentation. Despite its value, respondents reported that the documentation process complex and is time consuming. SLPs are required to comply with an increasing, wide-ranging body of requirements to deliver and receive payment for care of individuals with I/DD. The cost of compliance with these requirements has long term effects, such as, increased cognitive load and burnout. Limitations of this pilot study include a small sample size. Future research should include a larger sample size and qualitative data to further identify the specific areas that cause the most burden.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123441665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pattern recognition is a cornerstone of clinical care and public health practice. Historically, advances in medicine have relied on the ability of humans to detect patterns and make inferences. Modern healthcare challenges involve vast amounts of data and a level of complexity that require additional support to understand. The advancement of Artificial Intelligence has expanded our capability to detect, understand, and address patterns that were previously beyond our grasp. Artificial Intelligence has the capability to analyze otherwise insurmountable quantities of data in order to bring meaning and clarity to patterns that were previously deemed random or unintelligible. We, therefore, aim to charter a strategic path forward for innovative applications of Artificial Intelligence technology to understand and address pressing complex health challenges. The modelling capabilities of Artificial Intelligence have allowed for the simulation of potential viral mutations, as well as the development of therapeutic agents. The predictive analyses provided by Artificial Intelligence allow for a more holistic yet precise understanding of the aging process and the progression of disease, thereby allowing the extent and timing of treatments to be optimized. It has brought a new lens through which to identify malignant cells on imaging and to decode parts of the human genome previously labelled as sequences of unknown significance. On a global scale, Artificial Intelligence has given us the opportunity to better understand and anticipate the effects of climate change on health including the effects on displacement and the potential spillover and spread of new zoonotic infection diseases. We suggest how Artificial Intelligence is beginning to re-conceptualize our understanding of health and disease. The implementation of Artificial Intelligence is a pivotal time in developmental of other modern era of medical practice and public health strategies. Appropriate utilization of these new tools requires innovative thinking, critical appraisal, and tactful resource allocation to ensure issues are addressed in a timely and feasible manner.
{"title":"Drawing Connections: Artificial Intelligence to Address Complex Health Challenges","authors":"Patrick J Seitzinger, J. Kalra","doi":"10.54941/ahfe1002111","DOIUrl":"https://doi.org/10.54941/ahfe1002111","url":null,"abstract":"Pattern recognition is a cornerstone of clinical care and public health practice. Historically, advances in medicine have relied on the ability of humans to detect patterns and make inferences. Modern healthcare challenges involve vast amounts of data and a level of complexity that require additional support to understand. The advancement of Artificial Intelligence has expanded our capability to detect, understand, and address patterns that were previously beyond our grasp. Artificial Intelligence has the capability to analyze otherwise insurmountable quantities of data in order to bring meaning and clarity to patterns that were previously deemed random or unintelligible. We, therefore, aim to charter a strategic path forward for innovative applications of Artificial Intelligence technology to understand and address pressing complex health challenges. The modelling capabilities of Artificial Intelligence have allowed for the simulation of potential viral mutations, as well as the development of therapeutic agents. The predictive analyses provided by Artificial Intelligence allow for a more holistic yet precise understanding of the aging process and the progression of disease, thereby allowing the extent and timing of treatments to be optimized. It has brought a new lens through which to identify malignant cells on imaging and to decode parts of the human genome previously labelled as sequences of unknown significance. On a global scale, Artificial Intelligence has given us the opportunity to better understand and anticipate the effects of climate change on health including the effects on displacement and the potential spillover and spread of new zoonotic infection diseases. We suggest how Artificial Intelligence is beginning to re-conceptualize our understanding of health and disease. The implementation of Artificial Intelligence is a pivotal time in developmental of other modern era of medical practice and public health strategies. Appropriate utilization of these new tools requires innovative thinking, critical appraisal, and tactful resource allocation to ensure issues are addressed in a timely and feasible manner.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131963039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren R. Kennedy-Metz, R. Dias, Rithy Srey, Geoffrey Rance, K. Leissner, Suzana M Zorca, A. Shapeton, M. Zenati
The cardiac surgery operating room (OR) is a complex sociotechnical environment requiring the seamless integration of human-human and human-machine teams. Perfusionists in particular play a critical role in ensuring patient stability by operating the cardiopulmonary bypass (CPB) machine. Goal-directed perfusion (GDP) (oxygen delivery [DO2] ≥ 280 mL/min/m2 during CPB in cardiac surgery) is recommended given the positive results of the Goal-Directed Perfusion Trial (GIFT). However, the additional cognitive burden required by the perfusionist, and associated with the heightened vigilance needed to maintain the GDP threshold, is unknown. The objective of this study was to investigate the relationship between DO2 and perfusionists’ perceived cognitive workload in cardiac surgery.Methods: Experienced perfusionists indicated their perceived cognitive workload immediately after cardiac surgery procedures (N=15) using the validated SURG-TLX index dimensions (mental demands, physical demands, temporal demands, task complexity, situational stress, and distractions). A two-tailed Spearman’s correlation was calculated to investigate the relationship between DO2 and SURG-TLX. IRB approval and informed consent from all participants were obtained.Results: Cases analyzed included 13 coronary artery bypass graft and 2 aortic valve replacement procedures. Patients averaged 66.3 years (SD: 8.3 years) with an average 30-day predicted mortality of 1.03% and 30-day predicted morbidity of 9.36%. Average pump time was 113 minutes (range 77 minutes to 170 minutes). Average body surface area was 2.15 m2 (SD: 0.17 m2).Lower DO2 levels (averaged across the duration of total pump time) were significantly associated with higher overall perceived task load (rs(13) = -0.62, p = 0.014), mental demands (rs(13) = -0.73, p = 0.002), and situational stress (rs(13) = -0.62, p = 0.017) (Figure 1). No significant correlations were detected between average DO2 levels and remaining cognitive workload dimensions.Conclusions: This is the first study to evaluate human factors associated with achieving GDP in cardiac surgery. Self-reported measures indicate an elevation in mental demands and situational stress which correspond to lower DO2 values, supporting further investigation into perfusionists’ cognitive state to avoid episodes of cognitive overload and facilitate maintenance of GDP.
心脏外科手术室(OR)是一个复杂的社会技术环境，需要人机团队的无缝集成。灌注师通过操作体外循环(CPB)机器在确保患者稳定方面发挥着至关重要的作用。鉴于目标定向灌注试验(GIFT)的阳性结果，建议进行目标定向灌注(GDP)(心脏手术CPB期间氧输送[DO2]≥280 mL/min/m2)。然而，灌注师所需的额外认知负担，以及与维持GDP阈值所需的高度警惕性相关的额外认知负担，尚不清楚。本研究的目的是探讨DO2与心脏手术灌注者认知负荷的关系。方法:经验丰富的灌注师在心脏手术后立即使用SURG-TLX指数维度(精神需求、身体需求、时间需求、任务复杂性、情境压力和分心)表明他们感知到的认知工作量。计算双尾Spearman相关来研究DO2和SURG-TLX之间的关系。获得了所有参与者的IRB批准和知情同意。结果:分析了13例冠状动脉旁路移植术和2例主动脉瓣置换术。患者平均年龄为66.3岁(SD: 8.3岁)，平均30天预测死亡率为1.03%，30天预测发病率为9.36%。平均泵送时间为113分钟(范围为77分钟至170分钟)。平均体表面积为2.15 m2 (SD: 0.17 m2)。较低的DO2水平(在整个泵时间内的平均水平)与较高的总体感知任务负荷(rs(13) = -0.62, p = 0.014)、心理需求(rs(13) = -0.73, p = 0.002)和情境压力(rs(13) = -0.62, p = 0.017)显著相关(图1)。平均DO2水平与剩余认知工作负荷维度之间没有显著相关性。结论:这是第一个评估与心脏手术实现GDP相关的人为因素的研究。自我报告的测量结果表明，心理需求和情境压力的升高与较低的DO2值相对应，这支持了对灌注者认知状态的进一步研究，以避免认知过载的发作，促进GDP的维持。
{"title":"Human Factors Analysis of Goal-Directed Perfusion in Cardiac Surgery","authors":"Lauren R. Kennedy-Metz, R. Dias, Rithy Srey, Geoffrey Rance, K. Leissner, Suzana M Zorca, A. Shapeton, M. Zenati","doi":"10.54941/ahfe1002120","DOIUrl":"https://doi.org/10.54941/ahfe1002120","url":null,"abstract":"The cardiac surgery operating room (OR) is a complex sociotechnical environment requiring the seamless integration of human-human and human-machine teams. Perfusionists in particular play a critical role in ensuring patient stability by operating the cardiopulmonary bypass (CPB) machine. Goal-directed perfusion (GDP) (oxygen delivery [DO2] ≥ 280 mL/min/m2 during CPB in cardiac surgery) is recommended given the positive results of the Goal-Directed Perfusion Trial (GIFT). However, the additional cognitive burden required by the perfusionist, and associated with the heightened vigilance needed to maintain the GDP threshold, is unknown. The objective of this study was to investigate the relationship between DO2 and perfusionists’ perceived cognitive workload in cardiac surgery.Methods: Experienced perfusionists indicated their perceived cognitive workload immediately after cardiac surgery procedures (N=15) using the validated SURG-TLX index dimensions (mental demands, physical demands, temporal demands, task complexity, situational stress, and distractions). A two-tailed Spearman’s correlation was calculated to investigate the relationship between DO2 and SURG-TLX. IRB approval and informed consent from all participants were obtained.Results: Cases analyzed included 13 coronary artery bypass graft and 2 aortic valve replacement procedures. Patients averaged 66.3 years (SD: 8.3 years) with an average 30-day predicted mortality of 1.03% and 30-day predicted morbidity of 9.36%. Average pump time was 113 minutes (range 77 minutes to 170 minutes). Average body surface area was 2.15 m2 (SD: 0.17 m2).Lower DO2 levels (averaged across the duration of total pump time) were significantly associated with higher overall perceived task load (rs(13) = -0.62, p = 0.014), mental demands (rs(13) = -0.73, p = 0.002), and situational stress (rs(13) = -0.62, p = 0.017) (Figure 1). No significant correlations were detected between average DO2 levels and remaining cognitive workload dimensions.Conclusions: This is the first study to evaluate human factors associated with achieving GDP in cardiac surgery. Self-reported measures indicate an elevation in mental demands and situational stress which correspond to lower DO2 values, supporting further investigation into perfusionists’ cognitive state to avoid episodes of cognitive overload and facilitate maintenance of GDP.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125169232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Premature infants are children born before the 37th week of gestation. They often need to be cared for in neonatal intensive care units (NICUs) after birth, where they are continuously exposed to noise that can affect sleep patterns and lead to growth and developmental delays. To date, there are no unified limits for the prevention of noise exposure in NICUs. Recommendations for maximal continuous sound levels vary - depending on the professional society - between 35 and 60 dB(A) for daytime values and 20 to 60 dB(A) for nighttime values. They span a range from quiet whispering to normal road traffic noise. Existing studies of noise measurements in NICUs indicate that these recommendations are generally not met. A limitation of previous work is their short time periods that noise measurements were made for, usually one or two hours. As a result, it is not possible to make statements about the diurnal cyclic change in noise exposure, which may have an influence on the circadian rhythm of premature infants, for example. The present work aims to determine the intensity and diurnal cyclic differences of noise exposure in a NICU. In addition, particularly noisy work activities are identified in order to derive suggestions for prevention.For this purpose, the continuous sound levels are recorded for 22 work shifts in a German level 1 perinatal center. Measurements are made in the patient room and the inside of an infant incubator. The mean daily noise exposure levels (LEX,8h) of the early, late and night shifts are calculated and the peak sound level (LpCpeak) is recorded. To test for a day-night rhythm, these are compared using one-factor ANOVA. Using the Contextual Inquiry method, work analyses are performed for 12 work shifts and the early, late and night shifts with the highest equivalent continuous sound level (LAeq) are examined for noise-intensive work activities as examples. The measurement results in LEX,8h and LpCpeak values of up to 49.7 dB(A) and 124.4 dB(C) inside the infant incubator and 55.4 dB(A) and 110.3 dB(C) in the patient room. A day-night rhythm of noise exposure could not be demonstrated. The most noise-intensive work activities included the suctioning of patients and the conversations conducted in the process, with an LAeq of 63 dB(A). In addition, numerous very high impulsive noise events are identified which contribute to the noise exposure of premature infants. The presented study proves that the noise exposure is too high, which is very likely to affect the sleep behavior of premature infants. The results correspond with the statements of comparable studies. It is remarkable that especially the high peak noise levels are mainly due to trivial causes, which can be avoided by simple preventive measures.
{"title":"Work-related noise exposure in a neonatal intensive care unit","authors":"C. Backhaus, Simon Siebers","doi":"10.54941/ahfe1002129","DOIUrl":"https://doi.org/10.54941/ahfe1002129","url":null,"abstract":"Premature infants are children born before the 37th week of gestation. They often need to be cared for in neonatal intensive care units (NICUs) after birth, where they are continuously exposed to noise that can affect sleep patterns and lead to growth and developmental delays. To date, there are no unified limits for the prevention of noise exposure in NICUs. Recommendations for maximal continuous sound levels vary - depending on the professional society - between 35 and 60 dB(A) for daytime values and 20 to 60 dB(A) for nighttime values. They span a range from quiet whispering to normal road traffic noise. Existing studies of noise measurements in NICUs indicate that these recommendations are generally not met. A limitation of previous work is their short time periods that noise measurements were made for, usually one or two hours. As a result, it is not possible to make statements about the diurnal cyclic change in noise exposure, which may have an influence on the circadian rhythm of premature infants, for example. The present work aims to determine the intensity and diurnal cyclic differences of noise exposure in a NICU. In addition, particularly noisy work activities are identified in order to derive suggestions for prevention.For this purpose, the continuous sound levels are recorded for 22 work shifts in a German level 1 perinatal center. Measurements are made in the patient room and the inside of an infant incubator. The mean daily noise exposure levels (LEX,8h) of the early, late and night shifts are calculated and the peak sound level (LpCpeak) is recorded. To test for a day-night rhythm, these are compared using one-factor ANOVA. Using the Contextual Inquiry method, work analyses are performed for 12 work shifts and the early, late and night shifts with the highest equivalent continuous sound level (LAeq) are examined for noise-intensive work activities as examples. The measurement results in LEX,8h and LpCpeak values of up to 49.7 dB(A) and 124.4 dB(C) inside the infant incubator and 55.4 dB(A) and 110.3 dB(C) in the patient room. A day-night rhythm of noise exposure could not be demonstrated. The most noise-intensive work activities included the suctioning of patients and the conversations conducted in the process, with an LAeq of 63 dB(A). In addition, numerous very high impulsive noise events are identified which contribute to the noise exposure of premature infants. The presented study proves that the noise exposure is too high, which is very likely to affect the sleep behavior of premature infants. The results correspond with the statements of comparable studies. It is remarkable that especially the high peak noise levels are mainly due to trivial causes, which can be avoided by simple preventive measures.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125104740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As the elderly get older, they often have problems such as a gradual decline in physical function, it may even lead to the risk of lower limb disability if they stay at home or sit for a long time without regular exercise. In order to prevent the lower limbs of the elderly from being disabled, stepping devices are often used as a kind of exercise, which can not only control the amount of exercise but also improve cardiopulmonary function, and can also reduce the risk of injury during training. However, the elderly cannot maintain regular exercise due to insufficient training motivation.To understand and explore the motivation of 360° real scenes-based virtual reality for the elderly to use the lower limb pedaling device, we created VBike, a system that combines 360° real scenes-based virtual reality based on a pedaling device and a heart rate watch connected with Bluetooth. From this study, we can understand the design steps and implementation methods of the combination of 360° real scenes-based virtual reality with pedaling devices and confirm that 360° real scenes video will affect the motivation of the elderly to use the pedaling device. In the future, this study suggests adding the design of guide signs and audio-visual guides to help the elderly see and explore more in-depth 360° real scenes-based virtual reality and increase the experience of pedaling by the elderly.
{"title":"Interface design for 360°real scenes-based virtual reality system with pedaling devices","authors":"P. Hsu, Yi Xiang Su, Chien-Hsu Chen","doi":"10.54941/ahfe1003475","DOIUrl":"https://doi.org/10.54941/ahfe1003475","url":null,"abstract":"As the elderly get older, they often have problems such as a gradual decline in physical function, it may even lead to the risk of lower limb disability if they stay at home or sit for a long time without regular exercise. In order to prevent the lower limbs of the elderly from being disabled, stepping devices are often used as a kind of exercise, which can not only control the amount of exercise but also improve cardiopulmonary function, and can also reduce the risk of injury during training. However, the elderly cannot maintain regular exercise due to insufficient training motivation.To understand and explore the motivation of 360° real scenes-based virtual reality for the elderly to use the lower limb pedaling device, we created VBike, a system that combines 360° real scenes-based virtual reality based on a pedaling device and a heart rate watch connected with Bluetooth. From this study, we can understand the design steps and implementation methods of the combination of 360° real scenes-based virtual reality with pedaling devices and confirm that 360° real scenes video will affect the motivation of the elderly to use the pedaling device. In the future, this study suggests adding the design of guide signs and audio-visual guides to help the elderly see and explore more in-depth 360° real scenes-based virtual reality and increase the experience of pedaling by the elderly.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127552220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The language of innovative agonology (IA) concerns three layers. One is the terminology, whose basic frame of reference is Tadeusz Kotarbiński’s general theory of struggle (agonology). The remaining ones are: the ambiguity of the same terms used in different sciences (some of which have been appropriated by the public media language); and the need to adapt key words (and even to create neologisms in English for the universal language of IA) which describes scientific discoveries of phenomena included the field of IA research, but originally published in languages other than English.Kotarbiński’s definition of struggle relates to people: “a struggle is any activity, in which at least two subjects participate (assuming that a team can be a subject), while at least one of the subjects hinders the other”. However, Jaroslaw Rudniański’s extension of the concept of ‘struggle’ means that in a certain category of combat (the fight against the pandemic), the parties may not only be human beings. Therefore, in the language of IA (that is, also in a methodology based on a complementary approach), it is legitimate to assume that the ‘material’ means the opponent (subject or thing) with whom the person (individually or in a group) fights.An example of the dilemmas with the ambiguity of using the same terms in different areas of communication is the semantic category ‘development’, elementary to IA (a term used only in a positive sense). The commonly accepted phrase ‘development of a disease’ is patently absurd. Even if the user explains that they meant ‘development in a negative sense’, all the more it shows that they are ignorant as to the semantics.One of the concepts originating from the Lviv-Warsaw school of the methodology of sciences is the term ‘wiedzotwórczy’, which has no equivalent in English. In many methodological arguments edited in Polish, it is a convenient combination of the words ‘knowledge’ and ‘creative’. Future IA professionals will undoubtedly face similar semantic dilemmas. Identifying, interpreting and formulating algorithms for phenomena that need to be effectively addressed (from micro to macro scales) in the areas of prevention, therapy and, in certain circumstances, call for undertaking a strong defense, requires unambiguous language that is understandable to experts in even distant fields.
{"title":"Language of Innovative Agonology: a Guide in Combining Micro and Macro Scales of Preventive, Therapeutic and Defensive Actions","authors":"Justyna Bagińska, Roman Maciej Kalina","doi":"10.54941/ahfe1003501","DOIUrl":"https://doi.org/10.54941/ahfe1003501","url":null,"abstract":"The language of innovative agonology (IA) concerns three layers. One is the terminology, whose basic frame of reference is Tadeusz Kotarbiński’s general theory of struggle (agonology). The remaining ones are: the ambiguity of the same terms used in different sciences (some of which have been appropriated by the public media language); and the need to adapt key words (and even to create neologisms in English for the universal language of IA) which describes scientific discoveries of phenomena included the field of IA research, but originally published in languages other than English.Kotarbiński’s definition of struggle relates to people: “a struggle is any activity, in which at least two subjects participate (assuming that a team can be a subject), while at least one of the subjects hinders the other”. However, Jaroslaw Rudniański’s extension of the concept of ‘struggle’ means that in a certain category of combat (the fight against the pandemic), the parties may not only be human beings. Therefore, in the language of IA (that is, also in a methodology based on a complementary approach), it is legitimate to assume that the ‘material’ means the opponent (subject or thing) with whom the person (individually or in a group) fights.An example of the dilemmas with the ambiguity of using the same terms in different areas of communication is the semantic category ‘development’, elementary to IA (a term used only in a positive sense). The commonly accepted phrase ‘development of a disease’ is patently absurd. Even if the user explains that they meant ‘development in a negative sense’, all the more it shows that they are ignorant as to the semantics.One of the concepts originating from the Lviv-Warsaw school of the methodology of sciences is the term ‘wiedzotwórczy’, which has no equivalent in English. In many methodological arguments edited in Polish, it is a convenient combination of the words ‘knowledge’ and ‘creative’. Future IA professionals will undoubtedly face similar semantic dilemmas. Identifying, interpreting and formulating algorithms for phenomena that need to be effectively addressed (from micro to macro scales) in the areas of prevention, therapy and, in certain circumstances, call for undertaking a strong defense, requires unambiguous language that is understandable to experts in even distant fields.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"380 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127588704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the medical field, more than half of people will choose antibiotics for self-medication, they believe that antibiotics can be used for illnesses such as colds and fevers, or even for viral infections, which accelerates bacterial immunity to antibiotics. Misuse of antibiotics is not only unhelpful, but can damage the organism in a variety of ways that can lead to drug resistance, drug toxicity and allergic reactions. Worldwide, hundreds of thousands of people die each year due to bacterial resistance. In China, the use of antibiotics is even higher in outpatient and inpatient settings. The misuse of antibiotics poses a serious threat to the effectiveness of their use. In order to raise awareness of the dangers of antibiotic misuse, reduce people's choice of non-essential antibiotic medication, and expand and improve monitoring of health care institutions, this study introduces the SAPAD model and AHP to tap into users' real needs and complete a study of users' service design system for antibiotic drug purchase.The article uses observation method, user interview method and questionnaire method in the early stage to get the process of users' medicine purchase in common flu. Based on the SAPAD model framework, the user behavior is disassembled, and the people and things involved in the drug purchase process are listed to complete the mapping of behavior-object-meaning. The study obtained meaning clusters by clustering analysis of meaning layers, and combined with AHP to calculate the weight of each meaning cluster to derive core meaning clusters. The SAPAD model is a user-centered model framework for solving practical problems, which can start from the user's behavior, analyze, cluster and reorganize the meaning behind the behavior layer by layer, and finally dig into the user's real needs; the AHP method combines qualitative and quantitative analysis, and is highly logical and scientific, which can be applied to this topic The effective combination of SAPAD model and hierarchical analysis can gradually quantify the qualitative analysis and obtain more objective research results, which provides new ideas for the theoretical research framework of service design.This study completes the construction of meaning-based objects through the mapping of core meaning clusters to objects. The research process analyzes the key behaviors of users in purchasing drugs in common influenza, and obtains four semantic level meaning clusters through cluster analysis, namely "want to buy drugs quickly and correctly", "want to fully understand the effects of drugs", "want doctors to provide advice on appropriate medication" and "want to raise awareness of antibiotic medications". The study used AHP to analyze the meaning clusters and calculated the weights of each level to obtain the core meaning clusters of "buy the right medicine quickly", "get the right medication diagnosis", and "understand the effect of the medicine".The study reconstructed the service design syst
{"title":"Analysis of antibiotic purchasing service design based on SAPAD-AHP method","authors":"Miao Liu, Wenjun Wang","doi":"10.54941/ahfe1002124","DOIUrl":"https://doi.org/10.54941/ahfe1002124","url":null,"abstract":"In the medical field, more than half of people will choose antibiotics for self-medication, they believe that antibiotics can be used for illnesses such as colds and fevers, or even for viral infections, which accelerates bacterial immunity to antibiotics. Misuse of antibiotics is not only unhelpful, but can damage the organism in a variety of ways that can lead to drug resistance, drug toxicity and allergic reactions. Worldwide, hundreds of thousands of people die each year due to bacterial resistance. In China, the use of antibiotics is even higher in outpatient and inpatient settings. The misuse of antibiotics poses a serious threat to the effectiveness of their use. In order to raise awareness of the dangers of antibiotic misuse, reduce people's choice of non-essential antibiotic medication, and expand and improve monitoring of health care institutions, this study introduces the SAPAD model and AHP to tap into users' real needs and complete a study of users' service design system for antibiotic drug purchase.The article uses observation method, user interview method and questionnaire method in the early stage to get the process of users' medicine purchase in common flu. Based on the SAPAD model framework, the user behavior is disassembled, and the people and things involved in the drug purchase process are listed to complete the mapping of behavior-object-meaning. The study obtained meaning clusters by clustering analysis of meaning layers, and combined with AHP to calculate the weight of each meaning cluster to derive core meaning clusters. The SAPAD model is a user-centered model framework for solving practical problems, which can start from the user's behavior, analyze, cluster and reorganize the meaning behind the behavior layer by layer, and finally dig into the user's real needs; the AHP method combines qualitative and quantitative analysis, and is highly logical and scientific, which can be applied to this topic The effective combination of SAPAD model and hierarchical analysis can gradually quantify the qualitative analysis and obtain more objective research results, which provides new ideas for the theoretical research framework of service design.This study completes the construction of meaning-based objects through the mapping of core meaning clusters to objects. The research process analyzes the key behaviors of users in purchasing drugs in common influenza, and obtains four semantic level meaning clusters through cluster analysis, namely \"want to buy drugs quickly and correctly\", \"want to fully understand the effects of drugs\", \"want doctors to provide advice on appropriate medication\" and \"want to raise awareness of antibiotic medications\". The study used AHP to analyze the meaning clusters and calculated the weights of each level to obtain the core meaning clusters of \"buy the right medicine quickly\", \"get the right medication diagnosis\", and \"understand the effect of the medicine\".The study reconstructed the service design syst","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"330 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122097162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A non-medical facemask is one of the health care products used to prevent harmful substances from entering the human body. In the wake of COVID-19 outbreak, the effect of wearing a facemask has been researched all over the world. However, the comfort based on fit while wearing a facemask in the community setting continues to be an issue. Therefore, we have been studying the fit and comfort of non-medical facemasks in an effort to develop our own design. In this presentation, we report the filtration efficiency (FE) of our prototype facemask based on the patterns with four sizes. The patterns were analysed in an earlier study. The FEs of the facemasks against particles with a particle size of 0.3–5.0 µm, from smallest to largest size, were 45.4%, 95.2%, 98.0%, and 98.3%. The prototype facemask with larger sizes statistically demonstrated a high FE. The FE depended on the area of the facemask and fit against the facial surface. The patterns were useful from the viewpoints of protection against particles.
{"title":"Pilot study on the filtration efficiency of non-medical facemasks according to fit","authors":"Mika Morishima, Momoka Fujii","doi":"10.54941/ahfe1003496","DOIUrl":"https://doi.org/10.54941/ahfe1003496","url":null,"abstract":"A non-medical facemask is one of the health care products used to prevent harmful substances from entering the human body. In the wake of COVID-19 outbreak, the effect of wearing a facemask has been researched all over the world. However, the comfort based on fit while wearing a facemask in the community setting continues to be an issue. Therefore, we have been studying the fit and comfort of non-medical facemasks in an effort to develop our own design. In this presentation, we report the filtration efficiency (FE) of our prototype facemask based on the patterns with four sizes. The patterns were analysed in an earlier study. The FEs of the facemasks against particles with a particle size of 0.3–5.0 µm, from smallest to largest size, were 45.4%, 95.2%, 98.0%, and 98.3%. The prototype facemask with larger sizes statistically demonstrated a high FE. The FE depended on the area of the facemask and fit against the facial surface. The patterns were useful from the viewpoints of protection against particles.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126266926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luciana Armijos, Betzabé Tello, C. Sevilla, Isaac Cano, Johanna Fonseca, Luis Vivas, María F. Rivadeneira, R. Jimbo, Xavier Sánchez, Nancy Santillán, I. Duenas Espin
Background: In Ecuador, the neonatal mortality rate has increased from 4.1 to 6.0 per 1000 live births between 2014 and 2019. We aimed to develop and validate a health risk assessment tool for predicting neonatal mortality and to reach a nationwide consensus on stratified management. Methods: We retrospectively analyzed all neonatal deaths registered by the Ministry of Public Health between 2014 and 2017 in Ecuador. We developed a health risk assessment tool by using the information of deceased neonates between 2014 and 2016, and subsequently validated it using the information of deceased neonates in 2017. Several perinatal predictors were tested. The score was qualitatively refined by ~70 healthcare professionals in five Ecuadorian cities, and it was transformed into a web-based calculator with stratified suggestions of care. Results: Survival estimates differed significantly across the risk bands. The resulting Score Bebé® is available at https://scorebebe.com/ and includes stratified suggestions for care.
{"title":"Development of a web-based tool –The Score Bebé ®– for enhancing neonatal risk stratification: A nationwide retrospective study","authors":"Luciana Armijos, Betzabé Tello, C. Sevilla, Isaac Cano, Johanna Fonseca, Luis Vivas, María F. Rivadeneira, R. Jimbo, Xavier Sánchez, Nancy Santillán, I. Duenas Espin","doi":"10.54941/ahfe1002102","DOIUrl":"https://doi.org/10.54941/ahfe1002102","url":null,"abstract":"Background: In Ecuador, the neonatal mortality rate has increased from 4.1 to 6.0 per 1000 live births between 2014 and 2019. We aimed to develop and validate a health risk assessment tool for predicting neonatal mortality and to reach a nationwide consensus on stratified management. Methods: We retrospectively analyzed all neonatal deaths registered by the Ministry of Public Health between 2014 and 2017 in Ecuador. We developed a health risk assessment tool by using the information of deceased neonates between 2014 and 2016, and subsequently validated it using the information of deceased neonates in 2017. Several perinatal predictors were tested. The score was qualitatively refined by ~70 healthcare professionals in five Ecuadorian cities, and it was transformed into a web-based calculator with stratified suggestions of care. Results: Survival estimates differed significantly across the risk bands. The resulting Score Bebé® is available at https://scorebebe.com/ and includes stratified suggestions for care.","PeriodicalId":389399,"journal":{"name":"Healthcare and Medical Devices","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128052632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：