1
|
Martin J, Rueda A, Lee GH, Tassone VK, Park H, Ivanov M, Darnell BC, Beavers L, Campbell DM, Nguyen B, Torres A, Jung H, Lou W, Nazarov A, Ashbaugh A, Kapralos B, Litz B, Jetly R, Dubrowski A, Strudwick G, Krishnan S, Bhat V. Digital Interventions to Understand and Mitigate Stress Response: Protocol for Process and Content Evaluation of a Cohort Study. JMIR Res Protoc 2024; 13:e54180. [PMID: 38709554 PMCID: PMC11106701 DOI: 10.2196/54180] [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: 12/01/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Staffing and resource shortages, especially during the COVID-19 pandemic, have increased stress levels among health care workers. Many health care workers have reported feeling unable to maintain the quality of care expected within their profession, which, at times, may lead to moral distress and moral injury. Currently, interventions for moral distress and moral injury are limited. OBJECTIVE This study has the following aims: (1) to characterize and reduce stress and moral distress related to decision-making in morally complex situations using a virtual reality (VR) scenario and a didactic intervention; (2) to identify features contributing to mental health outcomes using wearable, physiological, and self-reported questionnaire data; and (3) to create a personal digital phenotype profile that characterizes stress and moral distress at the individual level. METHODS This will be a single cohort, pre- and posttest study of 100 nursing professionals in Ontario, Canada. Participants will undergo a VR simulation that requires them to make morally complex decisions related to patient care, which will be administered before and after an educational video on techniques to mitigate distress. During the VR session, participants will complete questionnaires measuring their distress and moral distress, and physiological data (electrocardiogram, electrodermal activity, plethysmography, and respiration) will be collected to assess their stress response. In a subsequent 12-week follow-up period, participants will complete regular assessments measuring clinical outcomes, including distress, moral distress, anxiety, depression, and loneliness. A wearable device will also be used to collect continuous data for 2 weeks before, throughout, and for 12 weeks after the VR session. A pre-post comparison will be conducted to analyze the effects of the VR intervention, and machine learning will be used to create a personal digital phenotype profile for each participant using the physiological, wearable, and self-reported data. Finally, thematic analysis of post-VR debriefing sessions and exit interviews will examine reoccurring codes and overarching themes expressed across participants' experiences. RESULTS The study was funded in 2022 and received research ethics board approval in April 2023. The study is ongoing. CONCLUSIONS It is expected that the VR scenario will elicit stress and moral distress. Additionally, the didactic intervention is anticipated to improve understanding of and decrease feelings of stress and moral distress. Models of digital phenotypes developed and integrated with wearables could allow for the prediction of risk and the assessment of treatment responses in individuals experiencing moral distress in real-time and naturalistic contexts. This paradigm could also be used in other populations prone to moral distress and injury, such as military and public safety personnel. TRIAL REGISTRATION ClinicalTrials.gov NCT05923398; https://clinicaltrials.gov/study/NCT05923398. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54180.
Collapse
Affiliation(s)
- Josh Martin
- Interventional Psychiatry Program, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Alice Rueda
- Interventional Psychiatry Program, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Gyu Hee Lee
- Interventional Psychiatry Program, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Vanessa K Tassone
- Interventional Psychiatry Program, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Haley Park
- Interventional Psychiatry Program, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Martin Ivanov
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Benjamin C Darnell
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Lindsay Beavers
- Allan Waters Family Simulation Program, Unity Health Toronto, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Douglas M Campbell
- Allan Waters Family Simulation Program, Unity Health Toronto, Toronto, ON, Canada
- Neonatal Intensive Care Unit, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Binh Nguyen
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Andrei Torres
- maxSIMhealth Group, Ontario Tech University, Oshawa, ON, Canada
| | - Hyejung Jung
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anthony Nazarov
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
| | - Andrea Ashbaugh
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Bill Kapralos
- maxSIMhealth Group, Ontario Tech University, Oshawa, ON, Canada
| | - Brett Litz
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Rakesh Jetly
- Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Adam Dubrowski
- maxSIMhealth Group, Ontario Tech University, Oshawa, ON, Canada
| | - Gillian Strudwick
- Centre For Addiction & Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Sridhar Krishnan
- Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
2
|
Fukumoto Y, Tsuji Y, Kakuda A, Hori R, Kudo S. Non-invasive evaluation of autonomic responses in patients with rotator cuff tear-related nocturnal pain. J Phys Ther Sci 2024; 36:111-116. [PMID: 38434993 PMCID: PMC10904215 DOI: 10.1589/jpts.36.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/25/2023] [Indexed: 03/05/2024] Open
Abstract
[Purpose] We aimed to determine the autonomic response in patients with rotator cuff tear-related nocturnal pain using nonlinear analysis of heart rate variability. [Participants and Methods] Twenty-eight patients with nocturnal pain who were diagnosed with a rotator cuff tear and received steroid injections, and whose nocturnal pain improved, were divided into a control group (14 patients) and a failure group (14 patients). Pulse wave was measured continuously using BACS Advance equipment (TAOS Co.) for a total of 17 min: 5 min before isometric hand grip, 2 min during isometric hand grip, 5 min after isometric hand grip, and 10 min after isometric hand grip. The autonomic nervous system activity was assessed using detrended fluctuation analysis and approximate entropy. [Results] The α1 values obtained from the detrended fluctuation analysis were significantly higher in the failure group than in the control group at each measurement period. The approximate entropy was normal in 12 (85%) patients in the control group and six (42%) patients in the failure group; it was abnormal in two (15%) patients in the control group and eight (58%) patients in the failure group. [Conclusion] Among patients experiencing nocturnal pain, several have abnormal autonomic response during isometric hand grip.
Collapse
Affiliation(s)
- Yusuke Fukumoto
- Graduate School of Health Sciences, Morinomiya University
of Medical Sciences: 1-26-16 Nankoukita Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan
- Keimoto Orthopedic Rehabilitation and Osteoporosis Clinic,
Japan
| | - Yoshihiro Tsuji
- Graduate School of Health Sciences, Morinomiya University
of Medical Sciences: 1-26-16 Nankoukita Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan
- Department of Clinical Engineering, Morinomiya University
of Medical Sciences, Japan
- Inclusive Medical Science Research Institute, Morinomiya
University of Medical Sciences, Japan
| | - Akihiro Kakuda
- Graduate School of Health Sciences, Morinomiya University
of Medical Sciences: 1-26-16 Nankoukita Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan
- Inclusive Medical Science Research Institute, Morinomiya
University of Medical Sciences, Japan
| | - Ryuji Hori
- Graduate School of Health Sciences, Morinomiya University
of Medical Sciences: 1-26-16 Nankoukita Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan
- Inclusive Medical Science Research Institute, Morinomiya
University of Medical Sciences, Japan
| | - Shintarou Kudo
- Graduate School of Health Sciences, Morinomiya University
of Medical Sciences: 1-26-16 Nankoukita Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan
- Inclusive Medical Science Research Institute, Morinomiya
University of Medical Sciences, Japan
| |
Collapse
|
3
|
Wu Q, Miao X, Cao Y, Chi A, Xiao T. Heart rate variability status at rest in adult depressed patients: a systematic review and meta-analysis. Front Public Health 2023; 11:1243213. [PMID: 38169979 PMCID: PMC10760642 DOI: 10.3389/fpubh.2023.1243213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Purposes A meta-analysis was conducted to examine the differences in heart rate variability (HRV) between depressed patients and healthy individuals, with the purpose of providing a theoretical basis for the diagnosis of depression and the prevention of cardiovascular diseases. Methods To search China National Knowledge Infrastructure (CNKI), WanFang, VIP, PubMed, Web of Science, Science Direct, and Cochrane Library databases to collect case-control studies on HRV in depressed patients, the retrieval date is from the establishment of the database to December 2022. Effective Public Health Practice Project (EPHPP) scale was used to evaluate literature quality, and Stata14.0 software was used for meta-analysis. Results This study comprised of 43 papers, 22 written in Chinese and 21 in English, that included 2,359 subjects in the depression group and 3,547 in the healthy control group. Meta-analysis results showed that compared with the healthy control group, patients with depression had lower SDNN [Hedges' g = -0.87, 95% CI (-1.14, -0.60), Z = -6.254, p < 0.01], RMSSD [Hedges' g = -0.51, 95% CI (-0.69,-0.33), Z = -5.525, p < 0.01], PNN50 [Hedges' g = -0.43, 95% CI (-0.59, -0.27), Z = -5.245, p < 0.01], LF [Hedges' g = -0.34, 95% CI (-0.55, - 0.13), Z = -3.104, p < 0.01], and HF [Hedges' g = -0.51, 95% CI (-0.69, -0.33), Z = -5.669 p < 0.01], and LF/HF [Hedges' g = -0.05, 95% CI (-0.27, 0.18), Z = -0.410, p = 0.682] showed no significant difference. Conclusion This research revealed that HRV measures of depressed individuals were lower than those of the healthy population, except for LF/HF, suggesting that people with depression may be more at risk of cardiovascular diseases than the healthy population.
Collapse
Affiliation(s)
- Qianqian Wu
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| | | | - Yingying Cao
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| | - Aiping Chi
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| | - Tao Xiao
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| |
Collapse
|
4
|
Takahashi S, Sakurai N, Kasai S, Kodama N. Stress Evaluation by Hemoglobin Concentration Change Using Mobile NIRS. Brain Sci 2022; 12:brainsci12040488. [PMID: 35448019 PMCID: PMC9025147 DOI: 10.3390/brainsci12040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 02/01/2023] Open
Abstract
Previous studies have reported a relationship between stress and brain activity, and stress has been quantitatively evaluated using near-infrared spectroscopy (NIRS). In the present study, we examined whether a relationship exists between salivary amylase levels and brain activity during the trail-making test (TMT) using mobile NIRS. This study aimed to assess stress levels by using mobile NIRS. Salivary amylase was measured with a salivary amylase monitor, and hemoglobin concentration was measured using Neu’s HOT-2000. Measurements were taken four times for each subject, and the values at each measurement were evaluated. Changes in the values at the first–second, second–third, and third–fourth measurements were also analyzed. Results showed that the value of the fluctuations has a higher correlation than the comparison of point values. These results suggest that the accuracy of stress assessment by NIRS can be improved by using variability and time-series data compared with stress assessment using NIRS at a single time point.
Collapse
Affiliation(s)
- Shingo Takahashi
- Department of Healthcare Informatics, Faculty of Health and Welfare, Takasaki University of Health and Welfare, 37-1 Nakaorui-machi, Takasaki 370-0033, Japan;
| | - Noriko Sakurai
- Department of Radiological Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan; (N.S.); (S.K.)
| | - Satoshi Kasai
- Department of Radiological Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan; (N.S.); (S.K.)
| | - Naoki Kodama
- Department of Radiological Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan; (N.S.); (S.K.)
- Correspondence: ; Tel.: +81-25-257-4455
| |
Collapse
|
5
|
Psychological and Antibacterial Effects of Footbath Using the Lindera umbellata Essential Oil. Molecules 2021; 26:molecules26175128. [PMID: 34500561 PMCID: PMC8434156 DOI: 10.3390/molecules26175128] [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: 08/09/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 12/05/2022] Open
Abstract
Lindera umbellata (Lu) essential oil primarily contains linalool and has relaxation properties. We investigated the psychological and antibacterial effects of footbath with Lu essential oil. The participants included 20 women without medical history and received two intervention plans: footbath without any essential oil and footbath using Lu essential oil. Next, questionnaires regarding impressions and mood states were provided for them to answer. In addition, their autonomic nervous system activity was measured, and the aerobic viable of count on the feet was determined. The high-frequency value reflecting the parasympathetic nervous system activity significantly increased after footbath using Lu essential oil. In the questionnaire about the mood states, the subscale scores of tension–anxiety, depression, fatigue, and confusion after intervention were lower than those before intervention regardless of the use of the essential oil. Conversely, the anger–hostility score decreased only in the group using Lu essential oil. Furthermore, the decrease in aerobic viable count after intervention was not significantly different between the two groups. Footbath using Lu essential oil increased the parasympathetic nervous system activity and relieved anger. Taken together, we suggest that footbath using Lu essential oil has a relaxation effect.
Collapse
|
6
|
Ben Khelifa MM, Lamti HA, Hugel V. A Muscular and Cerebral Physiological Indices Assessment for Stress Measuring during Virtual Wheelchair Guidance. Brain Sci 2021; 11:274. [PMID: 33671722 PMCID: PMC7926415 DOI: 10.3390/brainsci11020274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 11/24/2022] Open
Abstract
The work presented in this manuscript has the purpose to assess the relationship between human factors and physiological indices. We discuss the relationship between stress as human factor and cerebral and muscular signals as features. Ten male paraplegic, right-handed subjects were volunteers for the experiment (mean age 34 ±6). They drove a virtual wheelchair in an indoor environment. They filled five missions where, in each one, an environmental parameter was changed. Meanwhile, they were equipped with Electromyography (EMG) sensors and Electroencephalography (EEG). Frequency and temporal features were filtered and extracted. Principal component analysis (PCA), Fisher's tests, repeated measure Anova and post hoc Tukey test (α = 0.05) were implemented for statistics. Environmental modifications are subject to induce stress, which impacts muscular and cerebral activities. While the time pressure parameter was the most influent, the transition from static to moving obstacles (avatars), tends to have a significant impact on stress levels. However, adding more moving obstacles did not show any impact. A synchronization factor was noticed between cerebral and muscular features in higher stress levels. Further examination is needed to assess EEG reliability in these situations.
Collapse
Affiliation(s)
- Mohamed Moncef Ben Khelifa
- Impact de l’Activite Physique sur la Sante (IAPS) Laboratory, South University, 83130 Toulon-Var, France
| | - Hachem A. Lamti
- Conception de Systemes Mecaniques et Robotiques (COSMER) Laboratory, South University, 83130 Toulon-Var, France; (H.A.L.); (V.H.)
| | - Vincent Hugel
- Conception de Systemes Mecaniques et Robotiques (COSMER) Laboratory, South University, 83130 Toulon-Var, France; (H.A.L.); (V.H.)
| |
Collapse
|
7
|
Celka P, Charlton PH, Farukh B, Chowienczyk P, Alastruey J. Influence of mental stress on the pulse wave features of photoplethysmograms. Healthc Technol Lett 2019; 7:7-12. [PMID: 32190335 PMCID: PMC7067056 DOI: 10.1049/htl.2019.0001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 06/30/2019] [Accepted: 08/19/2019] [Indexed: 01/20/2023] Open
Abstract
Mental stress is a major burden for our society. Invasive and non-invasive methods have been proposed to monitor and quantify it using various sensors on and off body. In this Letter, the authors investigated the use of the arm photoplethysmogram (PPG) to assess mental stress in laboratory conditions. Results were in correspondence with their previous in-silico study which guided the present study. Three wave shape parameters were identified for stress assessment from the PPG signal: (i) the time from dicrotic notch to end diastole; (ii) the time from pulse onset to systolic peak; and (iii) the ratio of diastolic to systolic area. The proposed in-vivo results showed that the two first parameters responded significantly to increased mental stress and to a breathing relaxation procedure, complementing heart rate, heart rate variability, and pulse transit time as indices of stress.
Collapse
Affiliation(s)
- Patrick Celka
- Polar Electro Oy, Professorintie 5, 90440 Kempele, Finland
| | - Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London SE1 7EH, UK
| | - Bushra Farukh
- King's College London British Heart Foundation Centre, Department of Clinical Pharmacology, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, UK
| | - Philip Chowienczyk
- King's College London British Heart Foundation Centre, Department of Clinical Pharmacology, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, UK
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London SE1 7EH, UK.,Institute of Personalized Medicine, Sechenov University, Moscow, Russia
| |
Collapse
|
8
|
Terauchi M, Odai T, Hirose A, Kato K, Miyasaka N. Chilliness in Japanese middle-aged women is associated with anxiety and low n-3 fatty acid intake. Climacteric 2019; 23:178-183. [PMID: 31512534 DOI: 10.1080/13697137.2019.1653841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: This cross-sectional study investigated chilliness, which is the most prevalent sexual-vasomotor symptom in middle-aged Japanese women.Methods: First-visit records of 475 Japanese women (age 40-65 years) enrolled in the health and nutrition education program at a menopause clinic were analyzed. Chilliness was estimated based on responses to the Menopausal Symptom Scale. Effects of age, menopausal status, body composition, cardiovascular parameters, resting energy expenditure, physical fitness, menopausal symptoms, lifestyle, and estimated daily intake of nutrients were assessed using a multivariate logistic regression analysis.Results: Severe chilliness was found in 28.4% of women. It was not related to age, menopausal status, body mass index, or body fat percentage. The anxiety subscale score of the Hospital Anxiety and Depression Scale was the sole background characteristic independently associated with severe chilliness (adjusted odds ratio, 1.09; 95% confidence interval, 1.04-1.15 per point). Daily intakes of vitamin D and n-3 fatty acids were significantly lower in women with severe chilliness. Daily intake of n-3 fatty acids was negatively associated with severe chilliness after adjustment (odds ratio, 0.54; 95% confidence interval, 0.29-0.95 per g/1000 kcal intake).Conclusions: Chilliness is associated with anxiety and low intake of n-3 fatty acids.
Collapse
Affiliation(s)
- M Terauchi
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Odai
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
| | - A Hirose
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Kato
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - N Miyasaka
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
9
|
Ghazali DA, Breque C, Sosner P, Lesbordes M, Chavagnat JJ, Ragot S, Oriot D. Stress response in the daily lives of simulation repeaters. A randomized controlled trial assessing stress evolution over one year of repetitive immersive simulations. PLoS One 2019; 14:e0220111. [PMID: 31344077 PMCID: PMC6657860 DOI: 10.1371/journal.pone.0220111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/29/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Simulations in healthcare reproduce clinical situations in stressful conditions. Repeated stress exposure might influence the learning process in simulation as well as real-life. OBJECTIVES 1) To record heart rate and heart rate variability evolution during one-day simulation over one year; 2) To analyze the effect of repetitive high-fidelity simulations on the risk of post-traumatic stress disorder. STUDY DESIGN Single-center, investigator-initiated RCT. 48 participants were randomized in 12 multidisciplinary teams of French Emergency Medical Services to manage infant shock in high-fidelity simulations. In the experimental group, 6 multidisciplinary teams were exposed to 9 different simulation sessions over 1 year. In the control group, 6 multidisciplinary teams participated in only 3 simulation sessions, in common with those of the experimental group (initial, intermediate after 6 months, and finally after 1 year). Heart rate (HR) and heart rate variability (HRV) were analyzed on a 24-hour Holter from the day prior to simulation until the end of simulation. Questionnaires of Impact of Event Scale-Revised at 7 days and Post-traumatic Check-List Scale at 1 month were used to detect possible post-traumatic stress disorder in participants. p<0.05 was considered significant. RESULTS Stress increased during each simulation in the two groups. After analysis on the 24-hour period, there was no significant difference between the two groups during the initial simulation session in terms of heart rate and heart rate variability. In the 24-hour period of the intermediate and final simulation sessions, the level of stress was higher in the control group during the diurnal (p = 0.04) and nocturnal periods (p = 0.01). No participant developed post-traumatic stress disorder after the 72 simulation sessions. CONCLUSIONS Despite the stress generated by simulation, the more the sessions were repeated, the less were their repercussions on the daily lives of participants, reflected by a lower sympathetic activity. Moreover, repetition of simulations did not lead to post-traumatic stress disorder. TRIAL REGISTRATION ClinicalTrials.gov NCT02424890.
Collapse
Affiliation(s)
- Daniel Aiham Ghazali
- Emergency Department and Emergency Medical Service, University Hospital of Bichat, Paris, France
- Ilumens, Simulation Center, University of Paris-Diderot, Paris, France
- * E-mail:
| | - Cyril Breque
- ABS Lab, Simulation Center, Faculty of Medicine, University of Poitiers, Poitiers, France
| | - Philippe Sosner
- Diagnosis and Therapeutic Center, University Hospital Hôtel-Dieu, Paris, France
| | - Mathieu Lesbordes
- Cardiology Department, University Hospital of Poitiers, Poitiers, France
| | | | - Stéphanie Ragot
- Statistical Department and Clinical Investigation Center (CIC 1402), INSERM (French National Health and Medical Research Institute), University Hospital of Poitiers, Poitiers, France
| | - Denis Oriot
- ABS Lab, Simulation Center, Faculty of Medicine, University of Poitiers, Poitiers, France
- Pediatric Emergency Department, University Hospital of Poitiers, Poitiers, France
| |
Collapse
|
10
|
Wu W, Pirbhulal S, Zhang H, Mukhopadhyay SC. Quantitative Assessment for Self-Tracking of Acute Stress Based on Triangulation Principle in a Wearable Sensor System. IEEE J Biomed Health Inform 2019; 23:703-713. [DOI: 10.1109/jbhi.2018.2832069] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
11
|
Fusion of heart rate variability and salivary cortisol for stress response identification based on adverse childhood experience. Med Biol Eng Comput 2019; 57:1229-1245. [DOI: 10.1007/s11517-019-01958-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/28/2019] [Indexed: 01/01/2023]
|
12
|
Castaldo R, Montesinos L, Melillo P, James C, Pecchia L. Ultra-short term HRV features as surrogates of short term HRV: a case study on mental stress detection in real life. BMC Med Inform Decis Mak 2019; 19:12. [PMID: 30654799 PMCID: PMC6335694 DOI: 10.1186/s12911-019-0742-y] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/10/2019] [Indexed: 11/24/2022] Open
Abstract
Background This paper suggests a method to assess the extent to which ultra-short Heart Rate Variability (HRV) features (less than 5 min) can be considered as valid surrogates of short HRV features (nominally 5 min). Short term HRV analysis has been widely investigated for mental stress assessment, whereas the validity of ultra-short HRV features remains unclear. Therefore, this study proposes a method to explore the extent to which HRV excerpts can be shortened without losing their ability to automatically detect mental stress. Methods ECGs were acquired from 42 healthy subjects during a university examination and resting condition. 23 features were extracted from HRV excerpts of different lengths (i.e., 30 s, 1 min, 2 min, 3 min, and 5 min). Significant differences between rest and stress phases were investigated using non-parametric statistical tests at different time-scales. Features extracted from each ultra-short length were compared with the standard short HRV features, assumed as the benchmark, via Spearman’s rank correlation analysis and Bland-Altman plots during rest and stress phases. Using data-driven machine learning approaches, a model aiming to detect mental stress was trained, validated and tested using short HRV features, and assessed on the ultra-short HRV features. Results Six out of 23 ultra-short HRV features (MeanNN, StdNN, MeanHR, StdHR, HF, and SD2) displayed consistency across all of the excerpt lengths (i.e., from 5 to 1 min) and 3 out of those 6 ultra-short HRV features (MeanNN, StdHR, and HF) achieved good performance (accuracy above 88%) when employed in a well-dimensioned automatic classifier. Conclusion This study concluded that 6 ultra-short HRV features are valid surrogates of short HRV features for mental stress investigation. Electronic supplementary material The online version of this article (10.1186/s12911-019-0742-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- R Castaldo
- School of Engineering, University of Warwick, CV47AL, Coventry, UK.,Institute of Advanced Studies, University of Warwick, CV47AL, Coventry, UK
| | - L Montesinos
- School of Engineering, University of Warwick, CV47AL, Coventry, UK
| | - P Melillo
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C James
- School of Engineering, University of Warwick, CV47AL, Coventry, UK
| | - L Pecchia
- School of Engineering, University of Warwick, CV47AL, Coventry, UK.
| |
Collapse
|
13
|
Sunwoo J, Chalacheva P, Khaleel M, Shah P, Sposto R, Kato RM, Detterich J, Zeltzer LK, Wood JC, Coates TD, Khoo MC. A novel cross-correlation methodology for assessing biophysical responses associated with pain. J Pain Res 2018; 11:2207-2219. [PMID: 30323655 PMCID: PMC6179586 DOI: 10.2147/jpr.s142582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose The purpose of this work was to noninvasively detect and quantify microvascular blood flow changes in response to externally applied pain in humans. The responsiveness of the microvasculature to pain stimulation might serve as an objective biomarker in diseases associated with altered pain perception and dysregulated vascular functions. The availability of such a biomarker may be useful as a tool for predicting outcome and response to treatments, particularly in diseases like sickle cell anemia where clinical manifestations are directly linked to microvascular perfusion. We, therefore, developed a method to distinguish the blood flow response due to the test stimulus from the blood flow measurement that also includes concurrent flow changes from unknown origins. Subjects and methods We measured the microvascular blood flow response in 24 healthy subjects in response to a train of randomly spaced and scaled heat pulses on the anterior forearm. The fingertip microvascular perfusion was measured using laser Doppler flowmetry. The cross-correlation between the heat pulses and the blood flow response was computed and tested for significance against the null distribution obtained from the baseline recording using bootstrapping method. Results We estimated correlation coefficients, response time, response significance, and the magnitude of vasoreactivity from microvascular blood flow responses. Based on these pain response indices, we identified strong responders and subjects who did not show significant responses. Conclusion The cross-correlation of a random pattern of painful stimuli with directly measured microvascular flow can detect vasoconstriction responses in a noisy blood flow signal, determine the time between stimulus and response, and quantify the magnitude of this response. This approach provided an objective measurement of vascular response to pain that may be an inherent characteristic of individual human subjects, and may also be related to the severity of vascular disorders.
Collapse
Affiliation(s)
- John Sunwoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA,
| | - Patjanaporn Chalacheva
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA,
| | - Maha Khaleel
- Hematology Section, Children's Center for Cancer, Blood Disease and Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Payal Shah
- Hematology Section, Children's Center for Cancer, Blood Disease and Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Richard Sposto
- Children's Center for Cancer, Blood Disease and Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Roberta M Kato
- Division of Pediatric Pulmonology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jon Detterich
- Division of Pediatric Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lonnie K Zeltzer
- Pediatric Pain and Palliative Care Program, Department of Pediatrics, Division of Hematology-Oncology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | - John C Wood
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA, .,Division of Pediatric Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Thomas D Coates
- Hematology Section, Children's Center for Cancer, Blood Disease and Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michael Ck Khoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA,
| |
Collapse
|
14
|
Objective detection of chronic stress using physiological parameters. Med Biol Eng Comput 2018; 56:2273-2286. [PMID: 29911251 DOI: 10.1007/s11517-018-1854-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 05/28/2018] [Indexed: 10/14/2022]
Abstract
The aim of this study was to design a system to diagnose chronic stress, based on blunted reactivity of the autonomic nervous system (ANS) to cognitive load (CL). The system concurrently measures CL-induced variations in pupil diameter (PD), heart rate (HR), pulse wave amplitude (PWA), galvanic skin response (GSR), and breathing rate (BR). Measurements were recorded from 58 volunteers whose stress level was identified using the State-Trait Anxiety Inventory. Number-multiplication questions were used as CLs. HR, PWA, GSR, and PD were significantly (p < 0.05) changed during CL. CL-induced changes in PWA (16.87 ± 21.39), GSR (- 13.71 ± 7.86), and PD (11.56 ± 9.85) for non-stressed subjects (n = 36) were significantly different (p < 0.05) from those in PWA (2.92 ± 12.89), GSR (- 6.87 ± 9.54), and PD (4.51 ± 10.94) for stressed subjects (n = 22). ROC analysis for PWA, GSR, and PD illustrated their usefulness to identify stressed subjects. By inputting all features to different classification algorithms, up to 91.7% of sensitivity and 89.7% of accuracy to identify stressed subjects were achieved using 10-fold cross-validation. This study was the first to document blunted CL-induced changes in PWA, GSR, and PD in stressed subjects, compared to those in non-stressed subjects. Preliminary results demonstrated the ability of our system to objectively detect chronic stress with good accuracy, suggesting the potential for monitoring stress to prevent dangerous stress-related diseases. Graphical abstract Chronic stress degrads the autonomic nervous system reaction to cognitive loads. Measurement of reduced changes in physiological signals during asking math questions was useful to identify people with high STAI score (stressed subjects).
Collapse
|
15
|
Vazan R, Filcikova D, Mravec B. Effect of the Stroop test performed in supine position on the heart rate variability in both genders. Auton Neurosci 2017; 208:156-160. [DOI: 10.1016/j.autneu.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 09/04/2017] [Accepted: 10/26/2017] [Indexed: 12/17/2022]
|
16
|
Jang YS, Lee BH, Park HS. Lower amputation rate after fasciotomy by straight midline incision technique for a 22,900-V electrical injury to the upper extremities. Injury 2017; 48:2590-2596. [PMID: 28969851 DOI: 10.1016/j.injury.2017.09.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study is to compare the major amputation rate following two different fasciotomy techniques, conventional versus straight midline, in patients with high-voltage arc burn injury by electric currents of 22,900V to the upper extremities. METHODS A retrospective analysis of 230 patients (270 burned upper limbs) who underwent fasciotomy after high-voltage electrical injuries between 1996 and 2007 was performed. The patients were divided into two groups according to the fasciotomy method used. From 1996 to 2002, 158 patients (184 limbs) underwent conventional fasciotomy by Green's volar-ulnar incision (conventional fasciotomy group). From 2003 to 2007, 72 patients (86 limbs) underwent fasciotomy using a straight midline curved incision (midline fasciotomy group). The patients were also divided into two groups based on whether the fasciotomy procedure was performed early or late. Patients who underwent fasciotomies <8h after injury were classified as early, while those who underwent it >8h after injury were classified as late. Major amputation rates were compared between two fasciotomy methods and analyzed following fasciotomy timing. RESULTS The midline fasciotomy group had a significantly lower major amputation rate (33.7%) than the conventional fasciotomy group (59.2%) (p<0.001). A subsequently decreased major amputation rate of 27.8% was observed in the early fasciotomy subgroup of the midline fasciotomy group (p=0.025). CONCLUSION Early fasciotomy remarkably reduced the major amputation rate after high-voltage arc injury; in the setting of minimized vascular exposure after fasciotomy, a midline straight incision could ensure that various types of reconstructive microsurgical procedures and primary skin closures can be used to save limbs.
Collapse
Affiliation(s)
- Young-Soo Jang
- Department of Orthopaedic Surgery, Seonam Hospital, Seoul, Korea.
| | - Byung Hoon Lee
- Department of Orthopaedic Surgery, Kang-Dong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
| | - Hyun-Soo Park
- Department of Orthopaedic Surgery, Hanil General Hospital, Seoul, Korea.
| |
Collapse
|
17
|
Lamti HA, Gorce P. The effect of time pressure on stress levels during virtual wheelchair navigation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:1500-1503. [PMID: 28268611 DOI: 10.1109/embc.2016.7590994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this work stress is assessed based on EEG features. We focus our efforts on the correlation between subjective ratings and cerebral indices during virtual navigation scenarios. Ten male paraplegic subjects took part in the experiment and navigated in a virtual indoor environment. They had to fulfill two missions where time pressure parameter is introduced. Subjects were equipped with Electroencephalography sensors. Temporal and frequency data were filtered and extracted. A correlation study was conducted based on principal component analysis, Fisher's tests and ANOVA. The results showed that the introduction of time pressure has a significant impact on stress levels.
Collapse
|
18
|
Ghazali DA, Darmian-Rafei I, Nadolny J, Sosner P, Ragot S, Oriot D. Evaluation of stress response using psychological, biological, and electrophysiological markers during immersive simulation of life threatening events in multidisciplinary teams. Aust Crit Care 2017; 31:226-233. [PMID: 28756943 DOI: 10.1016/j.aucc.2017.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/18/2017] [Accepted: 07/05/2017] [Indexed: 01/05/2023] Open
Abstract
Stress might impair clinical performance in real life and in simulation-based education (SBE). Subjective or objective measures can be used to assess stress during SBE. This monocentric study aimed to evaluate the effects of simulation of life-threatening events on measurements of various stress parameters (psychological, biological, and electrophysiological parameters) in multidisciplinary teams (MDTs) during SBE. The effect of gender and status of participants on stress response was also investigated. Twelve emergency MDTs of 4 individuals were recruited for an immersive simulation session. Stress was assessed by: (1) self-reported stress; (2) Holter analysis, including heart rate and heart rate variability in the temporal and spectral domain (autonomic nervous system); (3) salivary cortisol (hypothalamic pituitary adrenal axis). Forty-eight participants (54.2% men, <7years of experience) were included. Measures were performed at baseline (T0), after simulation (T1), after debriefing (T2), and 30min after debriefing (T3). There was an increase in stress level at T1 (p<0.001) and a decrease at T2 (p<0.001). However, the variations of stress parameters induced by simulation (T0-T1 difference and T1-T2 difference) estimated by the three approaches were not correlated, while, as expected, Holter parameters were well-correlated to each other. Immersive SBE produced a change of stress level in all MDT members with no evidence for status effect but with gender difference. None developed a PTSD. These results support the hypothesis of a complementarity of the stress paths (collective reaction with increased stress level during simulation and a decrease during debriefing) but with relative independence of these paths (lack of correlation to each other). This study also suggests that because of the lack of correlation, stress response should be assessed by a combination of psychological, biological and electrophysiological parameters.
Collapse
Affiliation(s)
- Daniel Aiham Ghazali
- Emergency Department and EMS, University Hospital of Bichat, Paris, France; Ilumens - Simulation Laboratory, University of Paris-Diderot, Paris, France; ABS Lab - Simulation Laboratory, Faculty of Medicine, University of Poitiers, France; Clinical Investigation Center CIC-INSERM1402, University Hospital of Poitiers, France.
| | - Ivan Darmian-Rafei
- Emergency Medical Service, University Hospital of Necker, Paris, France; Clinical Investigation Center CIC-INSERM1402, University Hospital of Poitiers, France
| | - Jerome Nadolny
- ABS Lab - Simulation Laboratory, Faculty of Medicine, University of Poitiers, France; Anesthesiology and Critical Care Unit, Hospital of Saintes, France; Clinical Investigation Center CIC-INSERM1402, University Hospital of Poitiers, France
| | - Philippe Sosner
- Diagnosis and Therapeutic Center, University Hospital Hôtel-Dieu, Paris, France; Clinical Investigation Center CIC-INSERM1402, University Hospital of Poitiers, France
| | - Stephanie Ragot
- Emergency Medical Service, University Hospital of Necker, Paris, France; Clinical Investigation Center CIC-INSERM1402, University Hospital of Poitiers, France
| | - Denis Oriot
- ABS Lab - Simulation Laboratory, Faculty of Medicine, University of Poitiers, France; Clinical Investigation Center CIC-INSERM1402, University Hospital of Poitiers, France; Pediatric Emergency Department, University Hospital of Poitiers, France
| |
Collapse
|
19
|
MAAOUI CHOUBEILA, BOUSEFSAF FREDERIC, PRUSKI ALAIN. AUTOMATIC HUMAN STRESS DETECTION BASED ON WEBCAM PHOTOPLETHYSMOGRAPHIC SIGNALS. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416500391] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
One of the goals of affective computing field is to provide to computers the ability to recognize automatically the affective state of the user in order to have more intuitive human–machine communication. This paper aims to detect automatically the stress user when he is interacting with computer. The developed system is based on instantaneous pulse rate (PR) signal extracted from imaging photoplethysmography (PPG). Seven features from time and frequency domain are extracted from PR signal and processed by learning pattern recognition systems. Two methods based on Support Vector Machine (SVM) and Linear Discriminant Analysis (LDA) are used and compared to classify the user’s emotional state. A computer application based on “Stroop color word Test” is developed to elicit emotional stress in the subject. The proposed method can achieve the overall average classification accuracy of 94.42% and 91.10% with SVM and LDA, respectively. Current results indicate that our approach is effective for stress classification.
Collapse
Affiliation(s)
- CHOUBEILA MAAOUI
- Laboratoire de Conception, Optimisation et Modélisation des Systèmes (LCOMS), University of Lorraine, Metz, France
| | - FREDERIC BOUSEFSAF
- Laboratoire de Conception, Optimisation et Modélisation des Systèmes (LCOMS), University of Lorraine, Metz, France
| | - ALAIN PRUSKI
- Laboratoire de Conception, Optimisation et Modélisation des Systèmes (LCOMS), University of Lorraine, Metz, France
| |
Collapse
|
20
|
May RW, Sanchez-Gonzalez MA, Seibert GS, Samaan JS, Fincham FD. Impact of a motivated performance task on autonomic and hemodynamic cardiovascular reactivity. Stress 2016; 19:280-6. [PMID: 27295199 DOI: 10.1080/10253890.2016.1191467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Motivated performance (MP) tasks include mental stressors characterized by a high degree of motivation, individual engagement, and sympathetic overstimulation. It is therefore important to document the independent influence of motivation apart from engagement on markers of cardiovascular autonomic modulation, including vasomotor tone (low-frequency systolic blood pressure, LFSBP), blood pressure homeostasis (baroreflex sensitivity, BRS), and myocardial oxygen consumption (rate pressure product, RPP). Accordingly, an arithmetic task (AT) was used to manipulate motivation to evaluate its impact on cardiovascular reactivity. Forty-two young adults (Mage = 20.21 years, SD = 2.09) qualified for the study. After a 10-min resting period, electrocardiogram and finger beat-to-beat blood pressure were recorded at three distinct 5-min stages: baseline (BASE), AT, and recovery (REC). Prior to AT initiation, participants were randomized into two groups based on directions stating that the AT task was either designed to be entertaining and fun (low MP, LMP) or a test diagnostic of one's intelligence (high MP, HMP). Independent of task engagement ratings, motivation to complete the AT task as well as solution success was significantly greater in the HMP than the LMP condition. Regarding physiological parameters, two (LMP vs. HMP) × three (BASE, AT, REC) repeated measures ANOVAs revealed no significant baseline differences but a significant higher order interaction indicating that in comparison to LMP, individuals in the HMP condition had significantly higher vasomotor tone and myocardial oxygen consumption but not BRS. Greater motivation during a performance task may provide the substrate for the development of adverse cardiovascular events by increasing sympathetic activity and ultimately increasing myocardial oxygen demand which could lead to acute coronary syndromes.
Collapse
Affiliation(s)
- Ross W May
- a Family Institute, Florida State University , Tallahassee , FL , USA
| | - Marcos A Sanchez-Gonzalez
- a Family Institute, Florida State University , Tallahassee , FL , USA
- b Division of Clinical & Translational Research , Larkin Community Hospital , South Miami , FL , USA
| | - Gregory S Seibert
- a Family Institute, Florida State University , Tallahassee , FL , USA
| | - John S Samaan
- b Division of Clinical & Translational Research , Larkin Community Hospital , South Miami , FL , USA
- c Department of Psychiatry , Larkin Community Hospital , South Miami , FL , USA
| | - Frank D Fincham
- a Family Institute, Florida State University , Tallahassee , FL , USA
| |
Collapse
|
21
|
Computerized assessment of communication for cognitive stimulation for people with cognitive decline using spectral-distortion measures and phylogenetic inference. PLoS One 2015; 10:e0118739. [PMID: 25803586 PMCID: PMC4372422 DOI: 10.1371/journal.pone.0118739] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/06/2015] [Indexed: 01/07/2023] Open
Abstract
Therapeutic communication and interpersonal relationships in care homes can help people to improve their mental wellbeing. Assessment of the efficacy of these dynamic and complex processes are necessary for psychosocial planning and management. This paper presents a pilot application of photoplethysmography in synchronized physiological measurements of communications between the care-giver and people with dementia. Signal-based evaluations of the therapy can be carried out using the measures of spectral distortion and the inference of phylogenetic trees. The proposed computational models can be of assistance and cost-effectiveness in caring for and monitoring people with cognitive decline.
Collapse
|