scholarly journals Wearable physiological monitoring for human thermal-work strain optimization

2018 ◽  
Vol 124 (2) ◽  
pp. 432-441 ◽  
Author(s):  
Mark J. Buller ◽  
Alexander P. Welles ◽  
Karl E. Friedl

Safe performance limits of soldiers and athletes have typically relied on predictive work-rest models of ambient conditions, average work intensity, and characteristics of the population. Bioengineering advances in noninvasive sensor technologies, including miniaturization, reduced cost, power requirements, and comfort, now make it possible to produce individual predictions of safe thermal-work limits. These precision medicine assessments depend on the development of thoughtful algorithms based on physics and physiology. Both physiological telemetry and thermal-strain indexes have been available for >50 years, but greater computing power and better wearable sensors now make it possible to provide actionable information at the individual level. Core temperature can be practically estimated from time series heart rate data and, using an adaptive physiological strain index, provides meaningful predictions of safe work limits that cannot be predicted from only core temperature or heart rate measurements. Early adopters of this technology include specialized occupations where individuals operate in complete encapsulation such as chemical protective suits. Emerging technologies that focus on heat flux measurements at the skin show even greater potential for estimating thermal-work strain using a parsimonious sensor set. Applications of these wearable technologies include many sports and military training venues where inexperienced individuals can learn effective work pacing strategies and train to safe personal limits. The same strategies can also provide a technologically based performance edge for experienced workers and athletes faced with novel and nonintuitive physiological challenges, such as health care providers in full protective clothing treating Ebola patients in West Africa in 2014. NEW & NOTEWORTHY This mini-review details how the application of computational techniques borrowed from signal processing and control theory can provide meaningful advances for the applied physiological problem of real-time thermal-work strain monitoring. The work examines the development of practical core body temperature estimation techniques and how these can be used in combination with current and updated thermal-work strain indexes to provide objective state assessments and to optimize work rest schedules for a given task.

2018 ◽  
Vol 1 (2) ◽  
pp. 79-86 ◽  
Author(s):  
David P. Looney ◽  
Mark J. Buller ◽  
Andrei V. Gribok ◽  
Jayme L. Leger ◽  
Adam W. Potter ◽  
...  

ECTemp™ is a heart rate (HR)-based core temperature (CT) estimation algorithm mainly used as a real-time thermal-work strain indicator in military populations. ECTemp™ may also be valuable for resting CT estimation, which is critical for circadian rhythm research. This investigation developed and incorporated a sigmoid equation into ECTemp™ to better estimate resting CT. HR and CT data were collected over two calorimeter test trials from 16 volunteers (age, 23 ± 3 yrs; height, 1.72 ± 0.07 m; body mass, 68.5 ± 8.1 kg) during periods of sleep and inactivity. Half of the test trials were combined with ECTemp™’s original development dataset to train the new sigmoid model while the other was used for model validation. Models were compared by their estimation accuracy and precision. While both models produced accurate CT estimates, the sigmoid model had a smaller bias (−0.04 ± 0.26°C vs. −0.19 ± 0.29°C) and root mean square error (RMSE; 0.26°C vs. 0.35°C). ECTemp™ is a validated HR-based resting CT estimation algorithm. The new sigmoid equation corrects lower CT estimates while producing nearly identical estimates to the original quadratic equation at higher CT. The demonstrated accuracy of ECTemp™ encourages future research to explore the algorithm’s potential as a non-invasive means of tracking CT circadian rhythms.


2020 ◽  
Vol 15 (6) ◽  
pp. 833-840
Author(s):  
Devin G. McCarthy ◽  
Kate A. Wickham ◽  
Tyler F. Vermeulen ◽  
Danielle L. Nyman ◽  
Shane Ferth ◽  
...  

During play, ice hockey goaltenders routinely dehydrate through sweating and lose ≥2% body mass, which may impair thermoregulation and performance. Purpose: This randomized, crossover study examined the effects of mild dehydration on goaltender on-ice thermoregulation, heart rate, fatigue, and performance. Methods: Eleven goaltenders played a 70-minute scrimmage followed by a shootout and drills to analyze reaction time and movements. On ice, they either consumed no fluid (NF) and lost 2.4% (0.3%) body mass or maintained body mass with water (WAT) or a carbohydrate–electrolyte solution (CES). Save percentage, rating of perceived exertion, heart rate, and core temperature were recorded throughout, and a postskate questionnaire assessed perceived fatigue. Results: Relative to NF, intake of both fluids decreased heart rate (interaction: P = .03), core temperature (peak NF = 39.0°C [0.1°C], WAT = 38.6°C [0.1°C], and CES = 38.5°C [0.1°C]; P = .005), and rating of perceived exertion in the scrimmage (post hoc: P < .04), as well as increasing save percentage in the final 10 minutes of scrimmage (NF = 75.8% [1.9%], WAT = 81.7% [2.3%], and CES = 81.3% [2.3%], post hoc: P < .04). In drills, movement speed (post hoc: P < .05) and reaction time (post hoc: P < .04) were slower in the NF versus both fluid conditions. Intake of either fluid similarly reduced postskate questionnaire scores (condition: P < .0001). Only CES significantly reduced rating of perceived exertion in drills (post hoc: P < .05) and increased peak movement power versus NF (post hoc: P = .02). Shootout save percentage was similar between conditions (P = .37). Conclusions: Mild dehydration increased physiological strain and fatigue and decreased ice hockey goaltender performance versus maintaining hydration. Also, maintaining hydration with a CES versus WAT may further reduce perceived fatigue and positively affect movements.


2021 ◽  
pp. 019394592110276
Author(s):  
Ebru Cayir ◽  
Tim Cunningham ◽  
Ryne Ackard ◽  
Julie Haizlip ◽  
Jeongok Logan ◽  
...  

Contemplative practices promote well-being, work engagement and resilience among health care providers. We examined the impact of The Pause, a brief contemplative intervention, on health care providers’ physiological stress response. Participants were randomly assigned to either The Pause or the control group. They participated in a high-fidelity, stressful medical simulation. Following the simulation, intervention group practiced The Pause. Outcome measures were heart rate variability, heart rate, and blood pressure. We adjusted for baseline physiological variables, sociodemographic variables, self-care practices, and perceived stress. Participants in the intervention group had a standard deviation of the normal-to-normal RR intervals (heart rate variability indicator) that was 13.8 (95% CI 4.0, 23.5; p < .01) points higher than those in the control group. There were no significant effects of The Pause on heart rate or blood pressure. The Pause may reduce stress reactivity, increase heart rate variability, and enhance resilience in health care providers.


2021 ◽  
Vol 3 ◽  
Author(s):  
Mostafa Kamal Mallick ◽  
Sarah Biser ◽  
Aathira Haridas ◽  
Vaishnavi Umesh ◽  
Olaf Tönsing ◽  
...  

The world of healthcare constantly aims to improve the lives of people while nurturing their health and comfort. Digital health and wearable technologies are aimed at making this possible. However, there are numerous factors that need to be addressed such as aging, disabilities, and health hazards. These factors are intensified in palliative care (PC) patients and limited hospital capacities make it challenging for health care providers (HCP) to handle the crisis. One of the most common symptoms reported by PC patients with severe conditions is dyspnoea. Monitoring devices with sufficient comfort could improve symptom control of patients with dyspnoea in PC. In this article, we discuss the proof-of-concept study to investigate a smart patch (SP), which monitors the pulmonary parameters: (a) breathing rate (BR) and inspiration to expiration ratio (I:E); markers for distress: (b) heart rate (HR) and heart rate variability (HRV), and (c) transmits real-time data securely to an adaptable user interface, primarily geared for palliative HCP but scalable to specific needs. The concept is verified by measuring and analyzing physiological signals from different electrode positions on the chest and comparing the results achieved with the gold standard Task Force Monitor (TFM).


2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 775-783
Author(s):  
Emily A Ricker ◽  
Carl W Goforth ◽  
Amelia S Barrett ◽  
Patricia A Deuster ◽  
Sarah J de la Motte

ABSTRACT Introduction Service women face female-specific challenges that present physiological and logistical burdens and may impact readiness. The stress of training can change menstrual patterns and symptoms, and limited access to hygienic, private facilities can hinder menstrual management. Therefore, suppressing menses with continuous hormonal contraception may be of interest. Materials and Methods The 9-item “Military Women’s Attitudes Toward Menstrual Suppression.” questionnaire was administered to female officers upon entry (baseline) and graduation (post) from a 6-month secondary training course. Respondents rated their attitudes about menstruation and the stress of training, the desire for menstrual suppression, and the logistical burden of menstruation on a 1 (strongly agree) through 5 (strongly disagree) scale. Wilcoxon Signed Rank Tests determined changes in the distribution of responses from baseline to post. Results Female officers (n = 108) completed baseline and post questionnaires (age 25.2 ± 0.3 years). At baseline, the majority disagreed/strongly disagreed that the stress of training “makes periods worse than usual” (n = 77, 71%), “increases menstrual symptoms and bleeding” (n = 77, 71%), or “magnifies premenstrual syndrome” (PMS; n = 69, 64%). Although 50% (n = 54) agreed/strongly agreed that “stopping periods while women are training is a good idea,” 37% (n = 40) disagreed/strongly disagreed. The majority agreed/strongly agreed that menstrual suppression would prevent “the worry about menstrual supplies” (n = 75, 70%) and “the inconvenience of having a period during training” (n = 69, 64%). Many agreed/strongly agreed that it is difficult to deal with periods during training because “there is no privacy” (n = 52, 48%), “the inability to find adequate facilities” (n = 70, 65%), and “the lack of opportunity to use adequate facilities” (n = 52, 48%). Opinions remained largely consistent from baseline to post. Conclusions The desire for menstrual suppression among service women during training is high. Military health care providers should be prepared to counsel service women about strategies to manage menstruation, including the efficacy of continuous hormonal contraception for menstrual suppression. Future studies investigating benefits or risks of continuous hormonal contraception for menstrual suppression in service women should inform the clinical recommendations.


2019 ◽  
Vol 96 (4) ◽  
pp. 402-404 ◽  
Author(s):  
A. N. Pavlova ◽  
I. A. Mishkich ◽  
V. S. Luchkevich ◽  
A. N. Chechura ◽  
V. V. Zarudnaya

In the first one and a half decades of the 21st century, there is observed an intensive development of the medical prevention in health care facilities. New preventive treatment facilities and subdivisions were created and a new feature - preventive counseling was imputed to a wide range of doctors. This work included the evaluation of the preventive activity, lifestyle and health state of 221 health care providers, analysis of results of the preventive check-up of 154 nurses and analysis of the workplace assessment of 200 health workers. The results of the work showed just doctors to perform most of the preventive health care for patients. Only half of the surveyed physicians and one third of nurses noted that they gained knowledge about medical prevention in the process of training in a medical school. Most health care providers stated that they keep a healthy lifestyle. At once, a quarter of surveyed nurses answered that they smoke and more often do it at work. It should be noted that there was much less smokers among doctors. Nurses and doctors justified the cause of smoking by to the necessity to relieve work-related stress. A large part of health care providers noted a lack of physical activity, poor diet and insufficient sleep. An objective assessment of working conditions based on the analysis of workplaces assessment showed the increased work intensity and low lighting at the workplace of health care providers. Based on the findings it can be concluded health care providers to be motivated to perform work on preventive medicine. However, the training of physicians and nurses in the field of health lifestyle promotion and disease prevention requires the improvement. The personal commitment of health workers to the disease prevention for their own health preserving cannot be considered to be sufficient. A comprehensive approach to the training of health professionals and the organization of their work will allow to enhance of the professional activity health of care providers in the field of the disease prevention and improving their health.


1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.


Author(s):  
Pauline A. Mashima

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.


2013 ◽  
Vol 22 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Debora Downey ◽  
Mary Beth Happ

Abstract Hospitalized patients across the age continuum often present with complex communication needs (CCN) due to motor, sensory, cognitive, and linguistic barriers they may experience during their admission. Although hospitals recognize the need to enhance communication to improve quality and safety for all patients, the emphasis has been primarily on improving ”care coordination” amongst the health care providers the patient encounters across all points of admission. Most hospitals have yet to focus on improving the patient-provider communication experience, especially for patients with CCN. However, this population no longer can be ignored, as new standards mandate efforts to improve communication for patients with CCN. Nurses, as the team members responsible for continuous care during hospital stays, and speech-language pathologists, as communication disorders specialists, are positioned distinctively to facilitate patient communication and prevent miscommunications between patients and care providers. This article highlights the need to enhance the patient-provider communication experience for patients with CCN. We review the state of nurse training for patients with CCN, discuss the role speech-language pathologists can play in developing and implementing nurse training protocols, and outline basic elements nurse training modules should include.


2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.


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