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Teixeira JG, Lima LTB, Cunha EC, Marques da Cruz FODA, Carneiro KKG, Ribeiro LM, Brasil GDC. Association between cortisol levels and performance in clinical simulation: a systematic review. Rev Esc Enferm USP 2024; 58:e20230279. [PMID: 39058375 PMCID: PMC11277686 DOI: 10.1590/1980-220x-reeusp-2023-0279en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/28/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE To identify how stress measured by salivary cortisol during clinical simulation-based education, or simulation and another teaching method, impacts performance. METHOD Systematic review of the association between cortisol and performance in simulations. The following databases were used: PubMed, LIVIVO, Scopus, EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS) and Web of Science. Additional searches of gray literature were carried out on Google Scholar and Proquest. The searches took place on March 20, 2023. The risk of bias of randomized clinical trials was assessed using the Cochrane Collaboration Risk of Bias Tool (RoB 2). Inclusion criteria were: simulation studies with salivary cortisol collection and performance evaluation, published in any period in Portuguese, English and Spanish. RESULTS 11 studies were included which measured stress using salivary cortisol and were analyzed using descriptive synthesis and qualitative analysis. CONCLUSION Some studies have shown a relationship between stress and performance, which may be beneficial or harmful to the participant. However, other studies did not show this correlation, which may not have been due to methodological issues.
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Affiliation(s)
- Jackson Gois Teixeira
- Centro Universitário do Distrito Federal, Departamento de Enfermagem, Brasília, DF, Brazil
| | | | - Elaine Carvalho Cunha
- Centro Universitário do Distrito Federal, Departamento de Enfermagem, Brasília, DF, Brazil
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Queirolo L, Roccon A, Piovan S, Ludovichetti FS, Bacci C, Zanette G. Psychophysiological wellbeing in a class of dental students attending dental school: anxiety, burnout, post work executive performance and a 24 hours physiological investigation during a working day. Front Psychol 2024; 15:1344970. [PMID: 38845771 PMCID: PMC11154343 DOI: 10.3389/fpsyg.2024.1344970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/29/2024] [Indexed: 06/09/2024] Open
Abstract
Aim To the best of our knowledge, dental school students have never been evaluated for stress, anxiety, burnout, physiological indexes during a 24-h working day, and executive function performance post-work and post-work after returning from vacation; therefore, this research has been conducted. Methods Data were acquired at the Dental School of the University of Padua on 16 students in their 4th year, far from the exam session. While performing clinical activity on the dental chair and during a working day, electrodermal activity (EDA), heart rate variability (HRV), and heart rate (HR) were recorded. Participants' stress was measured with the Perceived Stress Scale (PSS-10 scale) and anxiety with the General Anxiety Disorder Questionnaire (GAD-7) and State-Trait Anxiety Inventory (STAI-Y-2), while burnout with the Maslach Burnout Inventory (MBI-HSS). Executive functions were evaluated using the Tower of London test (TOL-R). Results Three students (2F/1M) had a GAD-7 score ≥ 10. Five students (4F/1M) showed trait anxiety. Moderate levels of perceived stress were reported in 85% of participants. MBI-HSS showed that 7 participants scored high on emotional exhaustion and 7 on depersonalization. TOL-R performance (M = 15.85, SD = 4.01) was below the normative value p < 0.00001. A second test, after the holidays, showed normal values. EDA was higher during children's treatment (p < 0.05), ANOVA showed high HR during working time (p < 0.001), and HRV was higher in males (p < 0.001). Conclusion Based on the sample size evaluated, it is reported that being a dental student has a moderate impact on stress, anxiety, and burnout while a strong impact on executive functions buffered by rest.
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Affiliation(s)
- Luca Queirolo
- Section of Clinical Dentistry, Department of Neurosciences, University of Padua, Padua, Italy
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Andrea Roccon
- Section of Clinical Dentistry, Department of Neurosciences, University of Padua, Padua, Italy
| | - Silvia Piovan
- Section of Clinical Dentistry, Department of Neurosciences, University of Padua, Padua, Italy
| | | | - Christian Bacci
- Section of Clinical Dentistry, Department of Neurosciences, University of Padua, Padua, Italy
| | - Gastone Zanette
- Section of Clinical Dentistry, Department of Neurosciences, University of Padua, Padua, Italy
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Peabody J, Ziesmann MT, Gillman LM. Comparing the stress response using heart rate variability during real and simulated crises: a pilot study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:465-475. [PMID: 37432495 DOI: 10.1007/s10459-023-10246-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 05/21/2023] [Indexed: 07/12/2023]
Abstract
Medical personnel often experience stress when responding to a medical emergency. A known stress-response is a measurable reduction in heart rate variability. It is currently unknown if crisis simulation can elicit the same stress response as real clinical emergencies. We aim to compare heart rate variability changes amongst medical trainees during simulated and real medical emergencies. We performed a single center prospective observational study, enrolling 19 resident physicians. Heart rate variability was measured in real time, using a 2-lead heart rate monitor (Bodyguard 2, Firstbeat Technologies Ltd) worn during 24 h critical care call shifts. Data was collected at baseline, during crisis simulation and when responding to medical emergencies. 57 observations were made to compare participant's heart rate variability. Each heart rate variability metric changed as expected in response to stress. Statistically significant differences were observed between baseline and simulated medical emergencies in Standard Deviation of the N-N interval (SDNN), Root mean square standard deviation of the N-N interval (RMSSD), Percentage of successive R-R intervals that differ by more than 50 ms (PNN50), Low Frequency (LF) and Low Frequency: High Frequency ratios (LF:HF). No statistically significant differences between simulated and real medical emergencies were identified in any heart rate variability metrics. We have shown using objective results, that simulation can elicit the same psychophysiological response as actual medical emergencies. Therefore, simulation may represent a reasonable way to practice not only essential skills in a safe environment but has the additional benefit of creating a realistic, physiological response in medical trainees.
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Affiliation(s)
- Jeremy Peabody
- Undergraduate Medical Education, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Markus T Ziesmann
- Section of General Surgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Section of Critical Care Medicine, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, GF439 - 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada
| | - Lawrence M Gillman
- Section of General Surgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Section of Critical Care Medicine, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, GF439 - 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada.
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Soula M, Messas NI, Aridhi S, Urbinelli R, Guyon A. Effects of trace element dietary supplements on voice parameters and some physiological and psychological parameters related to stress. Heliyon 2024; 10:e29127. [PMID: 38655294 PMCID: PMC11035998 DOI: 10.1016/j.heliyon.2024.e29127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
Trace elements, often used as dietary supplements, are widely accessible without prescription at pharmacies. Pronutri has pioneered Nutripuncture®, a methodology that utilizes orally consumed trace elements to elicit a physiological response akin to that of acupuncture. Pronutri has empirically observed that the user's voice becomes deeper following an exclusive ingestion procedure. Given that alterations in vocal characteristics are often linked to stress, the Pronutri researchers postulated that the pills have the capacity to promptly alleviate stress upon ingestion. Nevertheless, there is a lack of scientific substantiation about the impact of these supplements on voice (or stress) indicators. The aim of this research was to determine whether there is a consistent impact of trace element ingestion on vocal characteristics, namely the fundamental frequency of the voice, as well as other physiological and psychological stress measurements. In order to achieve this objective, we have devised a unique methodology to examine this hypothesis. This involves conducting a monocentric crossover, randomized, triple-blind, placebo-controlled trial with a sample size of 43 healthy individuals. This study demonstrates that compared to placebo tablets, consuming 10 metal traces containing tablets at once is enough to cause noticeable changes in the vocal spectrum in the direction of an improvement of the voice timbre "richness", and a decrease in the occurrence of spontaneous electrodermal activity, suggesting a stress reduction. However, there were no significant changes observed in the other parameters that were tested. These parameters include vocal measures such as voice frequency F0, standard deviation from this frequency, jitter, and shimmer. Additionally, physiological measures such as respiratory rate, oxygenation and heart rate variability parameters, as well as psychological measures such as self-assessment analogic scales of anxiety, stress, muscle tension, and nervous tension, did not show any significant changes. Ultimately, our research revealed that the ingestion of 10 trace elements pills may promptly elicit a targeted impact on both vocal spectrum and electrodermal activity. Despite the limited impact, these findings warrant more research to explore the long-term effects of trace elements on voice and stress reduction.
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Affiliation(s)
- Maxime Soula
- Université Côte d'Azur, Institut Neuromod, Mod4NeuCog, France
| | | | - Slah Aridhi
- Sensoria Analytics, Sophia Antipolis, France
| | | | - Alice Guyon
- Université côte d'Azur, CNRS UMR 7275, Institut de Pharmacologie Moléculaire et Cellulaire, 660 route des Lucioles, 06560, Valbonne Sophia Antipolis, France
- Université Côte d'Azur, Institut Neuromod, Mod4NeuCog, France
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Regehr C, Birze A. Assessing the equivalency of face-to-face and online simulated patient interviews in an educational intervention. Adv Simul (Lond) 2024; 9:13. [PMID: 38581026 PMCID: PMC10998310 DOI: 10.1186/s41077-024-00286-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND In adapting to COVID-19, many health professional training programs moved abruptly from in-person to online simulated patient interviews for teaching and evaluation without the benefit of evidence regarding the efficacy of this mode of delivery. This paper reports on a multi-methods research project comparing in-person and online simulated patient interviews conducted by allied health professionals as part of an educational intervention offered at a large university teaching hospital. METHODS Twenty-three participants conducted two 15-min interviews with simulated patients using previously validated scenarios of patients presenting with suicide risk. In order to assess the equivalency of the two modalities, physiological and psychological stress were measured using heart rate variability parameters and the State-Trait Anxiety Inventory respectively, and then were compared across cohorts using t-tests. Reflective interviews elicited qualitative impressions of the simulations that were subject to thematic qualitative analysis. RESULTS There were no statistical differences in measures of psychological stress or physiological arousal of participant health care professionals who engaged with in-person versus online simulated interviews, suggesting they were equally effective in eliciting reactions commonly found in challenging clinical situations. In reflective interviews, participants commented on the realism of both modalities of simulated patient encounters and that simulated interviews provoked emotional and physiological responses consistent with actual patient encounters. CONCLUSIONS These findings provide developing evidence that carefully designed online clinical simulations can be a useful tool for the education and assessment of healthcare professionals.
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Affiliation(s)
- Cheryl Regehr
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
| | - Arija Birze
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
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Takhdat K, Rebahi H, Rooney DM, Ait Babram M, Benali A, Touzani S, Lamtali S, El Adib AR. The impact of brief mindfulness meditation on anxiety, cognitive load, and teamwork in emergency simulation training: A randomized controlled trial. NURSE EDUCATION TODAY 2024; 132:106005. [PMID: 37944276 DOI: 10.1016/j.nedt.2023.106005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Emergency simulation training may impose a heavy psychological burden on health professions students (HPS), evoking anxiety, and overwhelming their cognitive load. Mindfulness may have a positive impact on HPS' anxiety, cognitive load, and teamwork during simulation training. The effects of integration of a brief pre-briefing mindfulness meditation (MM) practice into emergency simulation training, on anxiety, cognitive load, and teamwork remain understudied. METHODS From November 2021 to June 2022, 70 undergraduate HPS participated in this pilot randomized controlled study. Participants were randomly assigned to the experimental group (EG, n = 24) that completed a brief in-person mindfulness meditation training program (MMTP) (2 h/week during 4 weeks) or a control group (CG, n = 46). Each group was comprised of teams (2 medical students and 1-2 nursing students). Measures of anxiety, mindfulness, cognitive load, and teamwork were collected at 4-time points: baseline, after the completion of the brief MMTP (for the EG only), at the first simulation assessment within one month later, and the second (6-month follow-up) simulation assessment. Student's t and Wilcoxon Mann-Whiney tests were used to compare the groups' measures and changes over time. A one-way repeated measures ANOVA was conducted to assess anxiety and mindfulness scores' changes over time among EG participants. RESULTS 52 participants completed all time-point assessments. EG participants recorded better state-anxiety, cognitive load, and teamwork scores than the CG participants in both simulation assessments. However, no statistically significant differences were recorded between the EG and the CG in trait-anxiety and mindfulness at the 6-month follow-up assessment. CONCLUSION Brief pre-briefing MM practice mitigates HPS' state-anxiety, and promotes cognitive load, and teamwork during emergency simulation training. Simulation instructors should consider MM practice in the emergency healthcare simulation instructional design.
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Affiliation(s)
- Kamal Takhdat
- Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco; Higher Institute of Nursing Professions and Health Techniques, Marrakesh, Morocco.
| | - Houssam Rebahi
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, 40000 Marakesh, Morocco
| | - Deborah M Rooney
- University of Michigan Medical School, Ann Arbor, MI, United States
| | | | - Abdeslam Benali
- The Research Team on Mental Health, Faculty of Medicine of Marrakesh, Morocco
| | - Saad Touzani
- Touzani Center for Training and Consulting, Marrakesh, Morocco
| | - Saloua Lamtali
- High Institute of Nursing Professions and Health Techniques, Marrakesh, Morocco
| | - Ahmed Rhassane El Adib
- Marrakesh Simulation and Innovation in Health Sciences Center, Faculty of Medicine and Pharmacy, Marakesh, Morocco
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Wespi R, Birrenbach T, Schauber SK, Manser T, Sauter TC, Kämmer JE. Exploring objective measures for assessing team performance in healthcare: an interview study. Front Psychol 2023; 14:1232628. [PMID: 37941756 PMCID: PMC10628530 DOI: 10.3389/fpsyg.2023.1232628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Effective teamwork plays a critical role in achieving high-performance outcomes in healthcare. Consequently, conducting a comprehensive assessment of team performance is essential for providing meaningful feedback during team trainings and enabling comparisons in scientific studies. However, traditional methods like self-reports or behavior observations have limitations such as susceptibility to bias or being resource consuming. To overcome these limitations and gain a more comprehensive understanding of team processes and performance, the assessment of objective measures, such as physiological parameters, can be valuable. These objective measures can complement traditional methods and provide a more holistic view of team performance. The aim of this study was to explore the potential of the use of objective measures for evaluating team performance for research and training purposes. For this, experts in the field of research and medical simulation training were interviewed to gather their opinions, ideas, and concerns regarding this novel approach. Methods A total of 34 medical and research experts participated in this exploratory qualitative study, engaging in semi-structured interviews. During the interview, experts were asked for (a) their opinion on measuring team performance with objective measures, (b) their ideas concerning potential objective measures suitable for measuring team performance of healthcare teams, and (c) their concerns regarding the use of objective measures for evaluating team performance. During data analysis responses were categorized per question. Results The findings from the 34 interviews revealed a predominantly positive reception of the idea of utilizing objective measures for evaluating team performance. However, the experts reported limited experience in actively incorporating objective measures into their training and research. Nevertheless, they identified various potential objective measures, including acoustical, visual, physiological, and endocrinological measures and a time layer. Concerns were raised regarding feasibility, complexity, cost, and privacy issues associated with the use of objective measures. Discussion The study highlights the opportunities and challenges associated with employing objective measures to assess healthcare team performance. It particularly emphasizes the concerns expressed by medical simulation experts and team researchers, providing valuable insights for developers, trainers, researchers, and healthcare professionals involved in the design, planning or utilization of objective measures in team training or research.
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Affiliation(s)
- Rafael Wespi
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Tanja Birrenbach
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefan K. Schauber
- Center for Educational Measurement (CEMO) and Unit for Health Sciences Education, University of Oslo, Oslo, Norway
| | - Tanja Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts, Northwestern Switzerland, Olten, Switzerland
- Division of Anesthesiology and Intensive Care, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Huddinge, Sweden
| | - Thomas C. Sauter
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Juliane E. Kämmer
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Social and Communication Psychology, University of Göttingen, Göttingen, Germany
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Figueroa C, Ayala A, Trejo LA, Ramos B, Briz CL, Noriega I, Chávez A. Measuring the Effectiveness of a Multicomponent Program to Manage Academic Stress through a Resilience to Stress Index. SENSORS (BASEL, SWITZERLAND) 2023; 23:2650. [PMID: 36904856 PMCID: PMC10007324 DOI: 10.3390/s23052650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
In this work, we evaluate the effectiveness of a multicomponent program that includes psychoeducation in academic stress, mindfulness training, and biofeedback-assisted mindfulness, while enhancing the Resilience to Stress Index (RSI) of students through the control of autonomic recovery from psychological stress. Participants are university students enrolled in a program of excellence and are granted an academic scholarship. The dataset consists of an intentional sample of 38 undergraduate students with high academic performance, 71% (27) women, 29% (11) men, and 0% (0) non-binary, with an average age of 20 years. The group belongs to the "Leaders of Tomorrow" scholarship program from Tecnológico de Monterrey University, in Mexico. The program is structured in 16 individual sessions during an eight-week period, divided into three phases: pre-test evaluation, training program, and post-test evaluation. During the evaluation test, an assessment of the psychophysiological stress profile is performed while the participants undergo a stress test; it includes simultaneous recording of skin conductance, breathing rate, blood volume pulse, heart rate, and heart rate variability. Based on the pre-test and post-test psychophysiological variables, an RSI is computed under the assumption that changes in physiological signals due to stress can be compared against a calibration stage. The results show that approximately 66% of the participants improved their academic stress management after the multicomponent intervention program. A Welch's t-test showed a difference in mean RSI scores (t = -2.30, p = 0.025) between the pre-test and post-test phases. Our findings show that the multicomponent program promoted positive changes in the RSI and in the management of the psychophysiological responses to academic stress.
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Affiliation(s)
- Carlos Figueroa
- School of Health, Tecnologico de Monterrey, Ciudad de México 14380, Mexico
| | - Andrés Ayala
- Vicerrectoría de Innovación Educativa y Normatividad Académica, Tecnologico de Monterrey, Monterrey 64849, Mexico
| | - Luis A. Trejo
- School of Engineering and Sciences, Tecnologico de Monterrey, Atizapán 52926, Mexico
| | - Bertha Ramos
- Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | - Clara L. Briz
- Psychology Department, University of Los Andes, Bogotá 11605, Colombia
| | - Isabella Noriega
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey 64849, Mexico
| | - Alejandro Chávez
- School of Health, Tecnologico de Monterrey, Ciudad de México 14380, Mexico
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Mauriz E, Caloca-Amber S, Vázquez-Casares AM. Using Task-Evoked Pupillary Response to Predict Clinical Performance during a Simulation Training. Healthcare (Basel) 2023; 11:healthcare11040455. [PMID: 36832990 PMCID: PMC9956315 DOI: 10.3390/healthcare11040455] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Training in healthcare skills can be affected by trainees' workload when completing a task. Due to cognitive processing demands being negatively correlated to clinical performance, assessing mental workload through objective measures is crucial. This study aimed to investigate task-evoked changes in pupil size as reliable markers of mental workload and clinical performance. A sample of 49 nursing students participated in a cardiac arrest simulation-based practice. Measurements of cognitive demands (NASA-Task Load Index), physiological parameters (blood pressure, oxygen saturation, and heart rate), and pupil responses (minimum, maximum, and difference diameters) throughout revealed statistically significant differences according to performance scores. The analysis of a multiple regression model produced a statistically significant pattern between pupil diameter differences and heart rate, systolic blood pressure, workload, and performance (R2 = 0.280; F (6, 41) = 2.660; p < 0.028; d = 2.042). Findings suggest that pupil variations are promising markers to complement physiological metrics for predicting mental workload and clinical performance in medical practice.
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Affiliation(s)
- Elba Mauriz
- Department of Nursing and Physiotherapy, Universidad de León, Campus de Vegazana, s/n, 24071 León, Spain
- Institute of Food Science and Technology (ICTAL), La Serna 58, 24007 León, Spain
- Correspondence: ; Tel.: +34-987-293094
| | - Sandra Caloca-Amber
- Department of Nursing and Physiotherapy, Universidad de León, Campus de Vegazana, s/n, 24071 León, Spain
| | - Ana M. Vázquez-Casares
- Department of Nursing and Physiotherapy, Universidad de León, Campus de Vegazana, s/n, 24071 León, Spain
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Bravo-Arrabal J, Toscano-Moreno M, Fernandez-Lozano JJ, Mandow A, Gomez-Ruiz JA, García-Cerezo A. The Internet of Cooperative Agents Architecture (X-IoCA) for Robots, Hybrid Sensor Networks, and MEC Centers in Complex Environments: A Search and Rescue Case Study. SENSORS 2021; 21:s21237843. [PMID: 34883848 PMCID: PMC8659820 DOI: 10.3390/s21237843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/21/2021] [Indexed: 11/26/2022]
Abstract
Cloud robotics and advanced communications can foster a step-change in cooperative robots and hybrid wireless sensor networks (H-WSN) for demanding environments (e.g., disaster response, mining, demolition, and nuclear sites) by enabling the timely sharing of data and computational resources between robot and human teams. However, the operational complexity of such multi-agent systems requires defining effective architectures, coping with implementation details, and testing in realistic deployments. This article proposes X-IoCA, an Internet of robotic things (IoRT) and communication architecture consisting of a hybrid and heterogeneous network of wireless transceivers (H2WTN), based on LoRa and BLE technologies, and a robot operating system (ROS) network. The IoRT is connected to a feedback information system (FIS) distributed among multi-access edge computing (MEC) centers. Furthermore, we present SAR-IoCA, an implementation of the architecture for search and rescue (SAR) integrated into a 5G network. The FIS for this application consists of an SAR-FIS (including a path planner for UGVs considering risks detected by a LoRa H-WSN) and an ROS-FIS (for real-time monitoring and processing of information published throughout the ROS network). Moreover, we discuss lessons learned from using SAR-IoCA in a realistic exercise where three UGVs, a UAV, and responders collaborated to rescue victims from a tunnel accessible through rough terrain.
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Hochard KD, Hulbert-Williams L, Ashcroft S, McLoughlin S. Acceptance and values clarification versus cognitive restructuring and relaxation: A randomized controlled trial of ultra-brief non-expert-delivered coaching interventions for social resilience. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Effect of Psychophysiological Stress and Socio-Emotional Competencies on the Clinical Performance of Nursing Students during a Simulation Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105448. [PMID: 34069709 PMCID: PMC8160605 DOI: 10.3390/ijerph18105448] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023]
Abstract
Psychophysiological stress can affect the cognitive response and effective learning of students during medical simulation practices. This study aimed to explore the effect of psychophysiological stress and socio-emotional competencies on clinical performance during a simulation experience. A pre-test/post-test design was used to assess physiological (blood pressure, heart rate and blood oxygen saturation) and psychological parameters (stress and anxiety) as well as socio-emotional skills (cognitive load, self-efficacy and motivation) in nursing students (n = 40) before and after the simulation of a cardiopulmonary resuscitation practice. Physiological responses showed statistically significant differences between pre-test and post-test conditions for blood pressure and heart rate (p < 0.0001). Moderate and significant correlations were also observed when comparing self-efficacy with stress (r = −0.445, p = 0.004), anxiety (r = −0.467, p = 0.002) and motivation (r = −0.406, p = 0.009) measures. Similarly, cognitive-load dimensions were significantly associated with either physiological (r = −0.335, p = 0.034) or psychological (r = −0.448, p = 0.004) indicators. The analysis of multiple regression models revealed a relationship between the effectiveness of the simulated experience, post-test blood oxygen saturation, heart rate, workload and self-efficacy (R2 = 0.490; F (3, 39) = 8.305; p < 0.0001; d = 1.663). Therefore, the evaluation of psychophysiological parameters and socio-emotional skills seems to provide a promising framework for predicting the quality of simulated clinical practices.
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Vavrinsky E, Stopjakova V, Kopani M, Kosnacova H. The Concept of Advanced Multi-Sensor Monitoring of Human Stress. SENSORS (BASEL, SWITZERLAND) 2021; 21:3499. [PMID: 34067895 PMCID: PMC8157129 DOI: 10.3390/s21103499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/23/2022]
Abstract
Many people live under stressful conditions which has an adverse effect on their health. Human stress, especially long-term one, can lead to a serious illness. Therefore, monitoring of human stress influence can be very useful. We can monitor stress in strictly controlled laboratory conditions, but it is time-consuming and does not capture reactions, on everyday stressors or in natural environment using wearable sensors, but with limited accuracy. Therefore, we began to analyze the current state of promising wearable stress-meters and the latest advances in the record of related physiological variables. Based on these results, we present the concept of an accurate, reliable and easier to use telemedicine device for long-term monitoring of people in a real life. In our concept, we ratify with two synchronized devices, one on the finger and the second on the chest. The results will be obtained from several physiological variables including electrodermal activity, heart rate and respiration, body temperature, blood pressure and others. All these variables will be measured using a coherent multi-sensors device. Our goal is to show possibilities and trends towards the production of new telemedicine equipment and thus, opening the door to a widespread application of human stress-meters.
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Affiliation(s)
- Erik Vavrinsky
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia;
- Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Sasinkova 2, 81272 Bratislava, Slovakia;
| | - Viera Stopjakova
- Institute of Electronics and Photonics, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovicova 3, 81219 Bratislava, Slovakia;
| | - Martin Kopani
- Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Sasinkova 2, 81272 Bratislava, Slovakia;
| | - Helena Kosnacova
- Department of Simulation and Virtual Medical Education, Faculty of Medicine, Comenius University, Sasinkova 4, 81272 Bratislava, Slovakia
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences, Dúbravská Cesta 9, 84505 Bratislava, Slovakia
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14
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Zohdi H, Egli R, Guthruf D, Scholkmann F, Wolf U. Color-dependent changes in humans during a verbal fluency task under colored light exposure assessed by SPA-fNIRS. Sci Rep 2021; 11:9654. [PMID: 33958616 PMCID: PMC8102618 DOI: 10.1038/s41598-021-88059-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/01/2021] [Indexed: 02/03/2023] Open
Abstract
Light evokes robust visual and nonvisual physiological and psychological effects in humans, such as emotional and behavioral responses, as well as changes in cognitive brain activity and performance. The aim of this study was to investigate how colored light exposure (CLE) and a verbal fluency task (VFT) interact and affect cerebral hemodynamics, oxygenation, and systemic physiology as determined by systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS). 32 healthy adults (17 female, 15 male, age: 25.5 ± 4.3 years) were exposed to blue and red light for 9 min while performing a VFT. Before and after the CLE, subjects were in darkness. We found that this long-term CLE-VFT paradigm elicited distinct changes in the prefrontal cortex and in most systemic physiological parameters. The subjects' performance depended significantly on the type of VFT and the sex of the subject. Compared to red light, blue evoked stronger responses in cerebral hemodynamics and oxygenation in the visual cortex. Color-dependent changes were evident in the recovery phase of several systemic physiological parameters. This study showed that the CLE has effects that endure at least 15 min after cessation of the CLE. This underlines the importance of considering the persistent influence of colored light on brain function, cognition, and systemic physiology in everyday life.
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Affiliation(s)
- Hamoon Zohdi
- University of Bern, Institute of Complementary and Integrative Medicine, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Rahel Egli
- University of Bern, Institute of Complementary and Integrative Medicine, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Daniel Guthruf
- University of Bern, Institute of Complementary and Integrative Medicine, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Felix Scholkmann
- University of Bern, Institute of Complementary and Integrative Medicine, Fabrikstrasse 8, 3012, Bern, Switzerland
- Biomedical Optics Research Laboratory, Neonatology Research, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland
| | - Ursula Wolf
- University of Bern, Institute of Complementary and Integrative Medicine, Fabrikstrasse 8, 3012, Bern, Switzerland.
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15
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Merkle F, Kurtovic D, Matschke A, Haupt B, Falk V, Starck C. Simulation-based training of critical events during cardiopulmonary bypass: importance of a critical events checklist. Perfusion 2020; 36:239-247. [DOI: 10.1177/0267659120937125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Evaluation of critical events training for clinical perfusionists is necessary to improve this educational approach. Critical events checklists are effective in reducing clinical complications, but should be tested in a simulation environment first. Individual behavior and stress response of clinical perfusionists during simulated critical events on cardiopulmonary bypass have not been evaluated yet. This study focuses on the evaluation of critical events training and critical events checklists in simulated cardiopulmonary bypass. Methods: A total of 19 clinical perfusionists from a single hospital took part in two simulated critical event scenarios. Clinical perfusionist behavior and physiological responses were recorded using eye tracking, heart rate variability, video, and audio. In addition, workloads were determined and participants were interviewed. Results: Relevant areas of interest were identified for each simulation phase. During critical event detection and subsequent decision-making, areas of interest hits and fixation durations varied with the use of a critical events checklist. Times to decision were shorter, decision quality was higher, and temporal workload was increased when the checklist was used. Evaluation of selected heart rate variability measures revealed a good correlation with pupil diameters. Conclusion: Evaluation of critical events during simulated cardiopulmonary bypass shows that the scenario is realistic and relevant for clinical practice. Integrating a critical events checklist improves the probability of correct decision-making and shortens the correct decision time. Temporal workload is increased when using a checklist. Eye tracking and heart rate variability are well suited to evaluate participants’ behaviors and stress levels. All participants welcomed simulation training for critical incidents.
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Affiliation(s)
- Frank Merkle
- Deutsches Herzzentrum Berlin, Academy for Perfusion, Berlin, Germany
| | - Dino Kurtovic
- Deutsches Herzzentrum Berlin, Academy for Perfusion, Berlin, Germany
| | - Andreas Matschke
- Deutsches Herzzentrum Berlin, Academy for Perfusion, Berlin, Germany
| | - Benjamin Haupt
- Deutsches Herzzentrum Berlin, Academy for Perfusion, Berlin, Germany
| | - Volkmar Falk
- Deutsches Herzzentrum Berlin, Academy for Perfusion, Berlin, Germany
| | - Christoph Starck
- Deutsches Herzzentrum Berlin, Academy for Perfusion, Berlin, Germany
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