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Background: Sleep disturbance is prevalent among cancer patients. The quantification of this sleep disturbance is missing, especially in palliative care settings. Aim: The aim of this study was to study the sleep patterns of the patients undergoing palliative chemotherapy and radiotherapy for head and neck cancer (HNC) using a Fitbit Charge 4 sleep-tracking device. Design: Prospective observational study. Setting: A total of 110 HNC patients undergoing palliative chemotherapy and radiotherapy at a tertiary care teaching hospital in Central India. Results: Forty-four percent of patients had a poor sleep score (less than 60). Average sleep duration was 218.66 ± 139.05 min; non-rapid eye movement (NREM) sleep duration 197.7 ± 115.91 (light NREM 171.36 ± 104 and deep NREM 23.36 ± 16.73); REM sleep duration was 30.44 ± 34.14 min. The Pittsburgh Sleep Quality Index was 10.23 ± 3.45, which indicated sleep deprivation over the past 1 month. Moderate levels of anxiety, depression, confusion, and distress existed in the cohort. Statistically significant but weak correlation existed between sleep score, anxiety, and depression. Strong correlation existed between distress score and sleep score. Confusion score did not have a significant correlation with sleep score. Conclusion: HNC patients in palliative care settings were chronically sleep deprived. Sleep architecture was also disturbed. Moderate levels of anxiety, depression, confusion, and distress existed in the studied cohort; these psychosocial disturbances had a weak correlation with the sleep score and are likely to be multifactorial. Trial registration: Institutional Ethics Committee number: IHEC-LOP/2020/IM0349. The study has been registered with clinical trial registry of India with registration number CTRI/2021/03/032400 (http://www.ctri.in). [ABSTRACT FROM AUTHOR]

Physical activity or structured exercise is beneficial in a wide range of circumstances. Nevertheless, individual-level data on differential responses to various types of activity are not yet sufficient in scale, duration or level of annotation to understand the mechanisms of discrete outcomes nor to support personalized recommendations. The Apple Heart & Movement Study was designed to passively collect the dense physiologic data accessible on Apple Watch and iPhone from a large real-world cohort distributed across the US in order to address these knowledge gaps. [ABSTRACT FROM AUTHOR]

Context: Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete's development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. Objectives: This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. Evidence Acquisition: A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1) peer-reviewed article; (2) the population were Paralympic athletes; (3) evaluated during training or competition; (4) reported at least one external load measure; and (5) published in English, Portuguese, or Spanish. Evidence Synthesis: Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). Conclusions: Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports. [ABSTRACT FROM AUTHOR]

Brooklyn Hall is a first-grader who enjoys spending time on the tennis court. She has a diagnosis of Type 1 diabetes--an enormous burden for anyone, let alone a child. She [...]

The objective of this study was to evaluate the effect of skill modifications on head motion experienced during women's artistic gymnastics skills. Nine gymnasts (four beginner and five advanced) completed three trials of up to 24 skill progressions, each consisting of a skill and two progressive safety modifications. Gymnasts were instrumented with mouthpiece sensors embedded with an accelerometer and gyroscope collecting motion data at 200, 300, and 500 Hz during each skill performance. Peak-to-peak linear and rotational kinematics during contact phases and peak rotational kinematics during non-contact phases were computed. A mixed-effects model was used to compare differences in modification status nested within skill categories. Timer skills (i.e. drills that simulate performance of a gymnastics skill) resulted in the highest median ΔLA and ΔRA of all skill categories, and 132 skill performances exceeded 10 g ΔLA during a contact phase. Modifications were associated with significant reductions in head kinematics during contact phases of timers, floor skills, bar releases, and vault skills. Gymnasts can be exposed to direct and indirect head accelerations at magnitudes consistent with other youth contact sports, and common safety modifications may be effective at reducing head motion during contact and non-contact phases of gymnastics skills. [ABSTRACT FROM AUTHOR]

Current healthcare applications commonly incorporate the Internet of Things (IoT) and cloud computing ideas. IoT devices provide massive amounts of patient data in the healthcare industry. These data stored in the cloud are analyzed using mobile devices' built-in storage and processing power. The Internet of Medical Healthcare Things (IoMHT) integrates health monitoring components including sensors and medical equipment to remotely monitor patient records in order to provide more intelligent and sophisticated healthcare services. In this research, we analyze one of the deadliest illnesses with a high fatality rate worldwide, the chronic kidney disease (CKD), to provide the finest healthcare services possible to users of e-health and m-health applications by presenting the IoTC services based on healthcare delivery system for the prediction and observation of CKD with its severity level. The suggested architecture gathers patient data from linked IoT devices and saves it in the cloud alongside real-time data, pertinent medical records that are collected from the UCI Machine Learning Repository, and relevant medical documents. We further use a Deep Neural Network (DNN) classifier to predict CKD and its severity. To boost the effectiveness of the DNN classifier, a Particle Swarm Optimization (PSO)-based feature selection technique is also applied. We compare the performance of the proposed model using different classification measures utilizing different classifiers. A Quick Flower Pollination Algorithm (QFPA)- (DNN)-based IoT and cloud-based CKD diagnosis model, is presented in this paper. The CKD diagnosis steps in the QFPA- DNN model involve data gathering, preparation, feature selection and classification stages. [ABSTRACT FROM AUTHOR]

In an ageing society, the incidence of hard‐to‐heal wounds is rising. Chronic wound healing is a complex process, which requires specialised treatment. Clinical assessment of the wound is essential to establish care approaches but is usually based on visual evaluation and it remains challenging. Therefore, innovative quantitative methods for the assessment of chronic wounds are needed. We conducted a single‐centre observational study designed to assess the feasibility of a bioimpedance measurement method conducted with a multielectrode sensor array to monitor the wound healing process in patients with chronic wounds of venous, mixed venous–arterial and diabetic aetiology. In total, 104 measurements of bioimpedance were conducted in 18 ulcers during the study. Across all 7 patients analysed, the bioimpedance of the ulcers was consistently increasing as the wound surface was decreasing. The variables had significant (p < 0.001) and strong negative correlation (r = −0.86). We validated the feasibility of the bioimpedance measurement method for the monitoring of the wound healing process on the lower legs. It may be a promising quantitative method for monitoring the status of the wounds. However, long‐term measurements are needed to show the usability of the electrode dressing and bioimpedance measurement in the assessment of chronic wounds. [ABSTRACT FROM AUTHOR]

Introduction Coronavirus disease 2019 (COVID-19) had been declared a global pandemic, affecting millions and impacting St Vincent's Hospital Sydney as of March 2021. The outbreak caused significant disruption to the healthcare system and management of Ventricular Assist Device (VAD) patients. In response, the Mechanical Circulatory Support (MCS) Ventricular Assist Device (VAD) Team developed innovative care and management strategies. Aim We aimed to minimize the risk of VAD patients acquiring COVID-19 as inpatients and outpatients. We also sought to maintain optimal, patient-centred care through self-management monitoring systems and Telehealth, while ensuring ease of use for VAD recipients and caregivers. Method During March 2021 to March 2022 as MCS/VAD Coordinators ensured inpatients and their careers were educated via one-on-one training sessions on the use of monitoring equipment. Then they were transitioned to the use of a Personal VAD Folder for daily observations recording, for ongoing clinician monitoring. Conclusion Despite challenges, no VAD patients in our hospital contracted COVID-19 during March 2021 to March 2022. Self-monitoring systems, enhanced patient education and Telehealth appointments helped our patients avoid critical illness due during the initial pandemic. [ABSTRACT FROM AUTHOR]

Nurses play a key role in the healthcare system because of the specific care they provide to patients. The nursing profession is generally challenging and demanding, and this especially applies to work in intensive care units, including neurological intensive care units. The professional challenges faced by nurses employed in the intensive neurological treatment unit are numerous, and they relate to specific knowledge and skills related to patient monitoring and technical equipment, fatigue and reduced level of alertness, job dissatisfaction, stress, noise, moral sensitivity, emotional intelligence, effective communication, organizational aspects of nursing care and poor ergonomic conditions. Most people who join nursing as a profession have above average physical and mental endurance and are able to find a variety of ways to adapt to professional challenges. Until now, it is known that patients treated in the intensive neurological treatment unit can experience negative outcomes as a result of low-quality care, such as the occurrence of intrahospital infections, longer periods of hospitalization, and an increase in the mortality rate. In order to reduce and/or prevent such negative treatment outcomes, it is necessary to raise public awareness of the present problems, conduct more research, and put more effort into the proper distribution of nursing skills based on available evidence and health resources. [ABSTRACT FROM AUTHOR]

Few proven therapies exist for patients with idiopathic inflammatory myopathies (IIMs), partly due to the lack of reliable and valid outcome measures for assessing treatment responses. The current core set measures developed by the International Myositis Assessment and Clinical Studies group were developed to standardize assessments of disease activity and treatment effect. None of the current measures address functional improvement in muscle weakness. Therefore, supplemental measures to more objectively assess physical activity levels and fatiguability in free-living settings are needed to assess disease activity more comprehensively. Validated physical activity monitors (PAMs) have the potential to serve as an objective functional outcome measure in clinical trials and observational studies. This review examines the current evidence for the use of body-worn PAMs in clinical settings with IIM patients. A practical overview of methods for PAM use in clinical patient populations (including measurement details and data processing) that focuses on IIM patients is also presented. [ABSTRACT FROM AUTHOR]

Aim: To gain staff feedback on the implementation and impact of a novel ambulatory monitoring system to support coronavirus patient management on an isolation ward. Design: Qualitative service evaluation. Methods: Semi‐structured interviews were conducted with 15 multidisciplinary isolation ward staff in the United Kingdom between July 2020 and May 2021. Interviews were audio‐recorded, transcribed and analysed using thematic analysis. Findings: Adopting Innovation to Assist Patient Safety was identified as the overriding theme. Three interlinked sub‐themes represent facets of how the system supported patient safety. Patient Selection was developed throughout the pandemic, as clinical staff became more confident in choosing which patients would benefit most. Trust In the System described how nurses coped with discrepancies between the ambulatory system and ward observation machines. Finally, Resource Management examined how, once trust was built, staff perceived the ambulatory system assisted with caseload management. This supported efficient personal protective equipment resource use by reducing the number of isolation room entries. Despite these reported benefits, face‐to‐face contact was still highly valued, despite the risk of coronavirus exposure. Conclusion: Hospital wards should consider using ambulatory monitoring systems to support caseload management and patient safety. Patients in isolation rooms or at high risk of deterioration may particularly benefit from this additional monitoring. However, these systems should be seen as an adjunct to nursing care, not a replacement. Implications for the Profession and/or Patient Care: Nurses valued ambulatory monitoring as a means of ensuring the safety of patients at risk of deterioration and prioritizing their workload. Impact: The findings of this research will be useful to all those developing or considering implementation of ambulatory monitoring systems in hospital wards. Reporting Method: This manuscript follows the Consolidated criteria for Reporting Qualitative Research (COREQ) guidelines with inclusion of relevant SQUIRE guidelines for reporting quality improvement. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Measuring the physical demands of work is important in understanding the relationship between exposure to these job demands and their impact on the safety, health, and well-being of working people. However, work is changing and our knowledge of job demands should also evolve in anticipation of these changes. New opportunities exist for noninvasive long-term measures of physical demands through wearable motion sensors, including inertial measurement units, heart rate monitors, and muscle activity monitors. Inertial measurement units combine accelerometers, gyroscopes, and magnetometers to provide continuous measurement of a segment's motion and the ability to estimate orientation in 3-dimensional space. There is a need for a system-thinking perspective on how and when to apply these wearable sensors within the context of research and practice surrounding the measurement of physical job demands. In this paper, a framework is presented for measuring the physical work demands that can guide designers, researchers, and users to integrate and implement these advanced sensor technologies in a way that is relevant to the decision-making needs for physical demand assessment. We (i) present a literature review of the way physical demands are currently being measured, (ii) present a framework that extends the International Classification of Functioning to guide how technology can measure the facets of work, (iii) provide a background on wearable motion sensing, and (iv) define 3 categories of decision-making that influence the questions that we can ask and measures that are needed. By forming questions within these categories at each level of the framework, this approach encourages thinking about the systems-level problems inherent in the workplace and how they manifest at different scales. Applying this framework provides a systems approach to guide study designs and methodological approaches to study how work is changing and how it impacts worker safety, health, and well-being. [ABSTRACT FROM AUTHOR]

This study describes the creation and evaluation of a low-cost internet of things (IoT)-based health monitoring system for the continuous monitoring of vital signs such as temperature, pulse rate, oxygen saturation (SpO2) and blood pressure (BP) (both systolic and diastolic). Along with an organic light-emitting diode (OLED) display and an ESP8266 microcontroller, the system includes BP, non-contact temperature, SpO2 and electrocardiogram (ECG) sensors. Using the visual programming tool, Node-RED, the data from these sensors are gathered, processed and transmitted to the Google Cloud platform for archival and visualisation. The process involved mounting the sensors and microcontrollers on a special printed circuit board and designing the circuit with EasyEDA. The device measures systolic, diastolic and pulse rates from the BP sensor, as well as temperature, ECG and SpO2 values. The system works by using three push switches to read and display these values on demand. The gathered data are simultaneously shown on the OLED and sent to the Node-RED dashboard, where it is then sent to a Google Spreadsheet for archiving and analysis. This research article gives a thorough overview of the health monitoring system, the way it was implemented, and how it was successfully validated in a real-time setting. This study examines certain vital signs but additional health measures, such as respiration rate or glucose monitoring, could be included. Machine learning algorithms could also be used for predictive analytics. This would uncover data anomalies and trends early, improving healthcare management. [ABSTRACT FROM AUTHOR]

Background: New technologies, such as electronic monitoring systems, have been developed to promote increased adherence to hand hygiene among healthcare workers. However, challenges when implementing these technologies in clinical settings have been identified. Aim: The aim of this study was to explore healthcare workers' experiences when implementing an electronic monitoring system to assess hand hygiene in a clinical setting. Method: Interviews with healthcare workers (registered nurses, nurse assistants and leaders) involved in the implementation process of an electronic monitoring system (n = 17) were conducted and data were analyzed according to the grounded theory methodology formulated by Strauss and Corbin. Results: Healthcare workers' experiences were expressed in terms of leading and facilitating, participating and contributing, and knowing and confirming. These three aspects were merged together to form the core category of collaborating for progress. Leaders were positive and committed to the implementation of the electronic monitoring system, endeavouring to enable facilitation and support for their co-workers (registered nurses and nurse assistants). At the same time, co-workers were positive about the support they received and contributed by raising questions and demands for the product to be used in clinical settings. Moreover, leaders and co-workers were aware of the objective of implementing the electronic monitoring system. Conclusion: We identified dynamic collective work between leaders and co-workers during the implementation of the electronic monitoring system. Leadership, participation and knowledge were central aspects of enhancing a collaborative process. We strongly recommend involving both ward leaders and users of new technologies to promote successful implementation. [ABSTRACT FROM AUTHOR]

Background Isokinetic dynamometers are widely used when assessing neuromuscular function including knee extension kinetics. However, these dynamometers are often prohibitively expensive and are not portable. Thus strain-gauge technology has grown in popularity. Purpose The purpose of this study was to compare kinetic data captured via an isokinetic dynamometer against an affordable and portable strain-gauge with a treatment plinth during maximal isometric knee extensions. Study Design Cross-sectional study. Methods Healthy participants (8 males and 6 females; age 30.2±7.1 years) volunteered and performed knee extensions at a 90° knee angle on a dynamometer and a treatment plinth with a portable strain-gauge. Peak force (PF), peak rate of force development (PRFD), rate of force development (RFD2080) and impulse (IMP2080) from 20-80% of onset to peak force were assessed using both strain-gauge and isokinetic dynamometer. Between-device differences were evaluated by the Wilcoxon signed-rank test, Cohen's d effect sizes (ES), Pearson's correlation coefficients (r), and Bland-Altman plots. Results No significant or meaningful differences were identified between isokinetic and strain-gauge devices (all p≥0.268, ES≤0.35). However, slightly greater (2.5-9.5%) outputs were observed with the isokinetic dynamometer. Very large significant between-device correlations were found for PF (r=0.77, p=0.001) and PRFD (r=0.73, p=0.003), while small and moderate non-significant between-device correlations were found for RFD2080 (r=0.48, p=0.079) and IMP2080 (r=0.59, p=0.060). Bland-Altman plots did not reveal apparent biases from high to low performers. Conclusions These results indicate that the strain-gauge device can produce valid maximal and rapid force expression measurements. Similar results, such as those quantified via an isokinetic device, can be obtained without extreme rigour and constraint. The study's findings support using the practically relevant treatment plinth and strain-gauge combination as a suitable alternative to the isokinetic dynamometry for measuring PF and PRFD. Therefore, more rehabilitation and sports performance practitioners can confidently assess knee extension kinetics. Level of Evidence 3 [ABSTRACT FROM AUTHOR]

The article assists with understanding the need to change the current accessible clinical resources; as well as gauging and sorting out the devices needed to provide food the uncommon requirements of the COVID-19 patients without trading off the smooth working of the medical services office without taking a chance with the security of the medical care experts conveying it. A primary objective of this study is to provide interim guidance for planning the medical equipment for an isolation facility in a way that satisfies the needs of patients in an exact manner. Additionally, to assist healthcare facility to follow the accreditation standards and plan the modifications necessary to ensure the safety of patients and employees. The documents reviewed for this study mainly focus on providing interim guidance, specifications, and essential devices for setting up of quarantine facilities in a COVID-19 healthcare facility. This study assists with understanding the rules to keep up with the current accessible clinical supplies and intending to procure more and usage of them at which departments to cater the extraordinary necessities of the COVID-19 patients without bargaining the smooth working of the medical care office and not taking a chance with the wellbeing of the medical care experts conveying it. [ABSTRACT FROM AUTHOR]

Apnea detection is critical to the management of infant apnea. Effective monitoring and management of apnea using apnea monitors is known to reduce complications and possible fatalities in infants. There is a need to determine the critical design considerations in apnea monitors. This article reviews the design and development of infant apnea monitors. We conducted a targeted literature review from different databases, including PubMed, ScienceDirect, and Google Scholar. We reviewed articles published between January 1995 and February 2023. The search was done using combinations of key terms, namely, “apnea,” “apnea monitors,” and “apnea monitor design.” Articles that met the inclusion criteria were extracted and analyzed. The review investigated common physiological parameters, sensor types, and validation results of apnea monitors. The review revealed important design considerations adopted in the literature as well as the different sensor types and methods of apnea detection. It was found that thoracic impedance pneumography, thermistors, respiratory inductance plethysmography, pneumotachograph, and MEMS accelerometer are the most common sensor types used to design apnea monitors. The review revealed that most apnea monitors were designed to measure multiple physiological parameters. Device validation results varied from one device to another, with sensitivity and specificity metrics ranging between 80% and 96%. With the high burden of infant apnea in developing countries and its associated mortality and morbidity, the design of functional infant apnea monitors has become increasingly important to complement the expensive and complex polysomnography technique. Therefore, we must use appropriate sensors and design approaches for effective detection of infant apnea. [ABSTRACT FROM AUTHOR]

In recent years, the surge in sport and exercise participation, particularly in running, has coincided with the widespread adoption of running-related technology, such as fitness trackers. This study investigates the correlation between the use of running-related technology and running-related injuries among recreational and elite long-distance runners. We conducted a quantitative, cross-sectional online survey of 282 adult runners. Data were analyzed using descriptive statistics and a multivariable logistic regression analysis. Participants, with an average age of 37.4 years, reported varied running experience, with 90.07% utilizing running-related technology during their runs to some degree, primarily smartwatches like Garmin and Apple Watch. Running-related technology users showed a higher likelihood of experiencing running-related injuries compared to non-users (OR = 0.31, p < 0.001). However, those who utilized the metrics obtained from running-related technology to guide their training decisions did not exhibit a higher risk of injury. This nuanced relationship highlights the importance of considering individual training behaviors and the potential psychological impacts of technology on running practices. The study underscores the need for future research integrating biomechanical and psychosocial factors into running-related technology to enhance injury prevention strategies. [ABSTRACT FROM AUTHOR]

Background:Since the decline in death rates from cardiovascular diseases has slowed down recently, promoting cardiovascular health in patients and the general public has become more important than ever, particularly for elder and rural patients. This study is a collaborative effort between a regional health network in Virginia and associated organizations to implement and assess telenursing and remote patient monitoring (RPM) to help home care patients better manage their own cardiovascular related diseases and promote sustainable health delivery options. Method:Eighty cardiovascular patients with diabetes, congestive heart failure, or both who had a recent disease-related hospital stay were enrolled in the RPM program to receive services, including care coordination, coaching, referral for behavioral health, and aging-related services for 90+ days. The program used telenursing and RPM through home care monitoring equipment to coach patients on effective measures to stay compliant with posthospitalization regimens, track and evaluate readmissions, and assess physiological status and mental health. Result:There was a decline in hospital admissions of 65%, 85% for observations and related inpatient services for enrolled CVD patients in the RPM program. In addition, the longer the patient was enrolled the less likely they were to readmit. The program saved ∼$615,127 in patient claims costs and had net savings of $390,296, ∼173% of the total program expenses. Discussion:Evidence showed that 90+ day enrollments are sufficient for realization of readmissions and Emergency Department reductions, increased health care access, and lower costs. This resulted from consistent monitoring using the technology to alert nurses and care coordinators who were able to respond and facilitate patients accessing care in the most helpful and generally less costly care environment. Conclusion: The study has confirmed that care coordination and RPM are effective in supporting self-management of chronic conditions and cost reductions through telenursing and RPM. [ABSTRACT FROM AUTHOR]

Aims Heart failure (HF) is a common cause of mortality and (re)hospitalizations. The NWE-Chance project explored the feasibility of providing hospitalizations at home (HH) supported by a newly developed digital health platform. The aim of this study was to explore the perceived usability by healthcare professionals (HCPs) of a digital platform in addition to HH for HF patients. Methods and results A prospective, international, multicentre, single-arm interventional study was conducted. Sixty-three patients and 22 HCPs participated. The HH consisted of daily home visits by the nurse and use of the platform, consisting of a portable blood pressure device, weight scale, pulse oximeter, a wearable chest patch to measure vital signs (heart rate, respiratory rate, activity level, and posture), and an eCoach for the patient. Primary outcome was usability of the platform measured by the System Usability Scale halfway and at the end of the study. Overall usability was rated as sufficient (mean score 72.1 ± 8.9) and did not differ between the measurements moments (P = 0.690). The HCPs reported positive experiences (n = 7), negative experiences (n = 13), and recommendations (n = 6) for the future. Actual use of the platform was 79% of the HH days. Conclusion A digital health platform to support HH was considered usable by HCPs, although actual use of the platform was limited. Therefore, several improvements in the integration of the digital platform into clinical workflows and in defining the precise role of the digital platform and its use are needed to add value before full implementation. Registration clinicaltrials.gov NCT04084964. [ABSTRACT FROM AUTHOR]

Peak expiratory flow rate (PEFR) is the volume of air forcefully exhaled at maximum speed. This can be measured using a peak flow meter or a spirometry device. Peak flow meters are portable, inexpensive and widely available. The technique is non-invasive, carries no risk to the person, can be taught and learned quickly, and can easily be mastered by the patient. Published evidence for the use of peak expiratory flow rate (PEFR) and peak flow monitoring in asthma is limited, despite the use of the peak flow meter being documented in national and international guidelines for many years. National and international guidelines recommend the use of easily calibrated spirometers, which can provide accurate results with good technique, along with fractional exhaled nitrous oxide (FeNO) testing, which requires a greater analysis and interpretation of the results. Is the use therefore of the peak flow meter redundant? This article discusses the indications for use of peak flow meters, technique and clinical context. [ABSTRACT FROM AUTHOR]

Healthcare personnel suffer from an increased risk of stress, burnout, and depression due to the challenges of the COVID-19 pandemic. Studies show that interactive smart textiles help people alleviate their emotions. In this research, we investigate how to utilise interactive textiles to help healthcare workers mitigate their negative feelings. We have designed a smart t-shirt that encourages its wearers to perform body movements to enhance their positive emotions, stimulated by vibrotactile and audio feedback mechanisms. We demonstrate our smart t-shirt's utility by asking healthcare workers (including physicians and nurses) to use it for five consecutive days. Our prototype design supports using it anywhere, including work, home, and other places. We evaluated our smart t-shirt prototype for emotion regulations at work for healthcare workers through an in-situ user study conducted at three hospitals. Results show that using the smart t-shirt positively impacts the healthcare workers' immediate emotion regulation when they experienced emotion fluctuation and provided a more positive attitude towards their work. We conclude by analysing the potential factors that influence emotions and outline the design space of e-textiles for emotion regulation in real-life use. [ABSTRACT FROM AUTHOR]

Background & Problems: Hemodynamic monitoring is an important part of nursing care in the intensive care unit. Recent advances in medical technology and the diversification of intensive care equipment have increased the variety of instruments used in clinical hemodynamic monitoring. Many nurses who use new hemodynamic monitors are not familiar with instrument care, resulting in patient safety incidents caused by nurses not identifying warnings of hemodynamic data change and notifying doctors to provide treatment. The accuracy of hemodynamic monitoring care in our ward of 74.0% motivated this improvement project. Purpose: To improve the accuracy of hemodynamic monitoring care to 98.3%. Resolution: Conduct educational training and plan professional education; establish an audit system to regularly monitor the accuracy of nursing care; provide tips to make the operation manual easier to read and understand; establish mobile learning to make learning immediate and more accessible; hold instrument operation practice sessions to improve nursing staff proficiency; monitor and upload data to the hospital information system. Result: After the improvement project, the accuracy of hemodynamic monitoring care increased to 98.7%. Conclusions: The impact achieved met expectations, and the improvement project will be extended to other intensive care units in the hospital. Our nurses are now more familiar with the operation methods and the significance of monitoring values and interpretation of data. Also, when a value changes or becomes abnormal, they immediately notify the doctor for further evaluation and interventions to improve patient safety. [ABSTRACT FROM AUTHOR]

BACKGROUND: A Polar heart rate monitor is a device that measures RR intervals, but has not been correlated to accurately measure the series of RR interval signals between the ECG and the Polar ® Heart Rate Monitor Interface (HRMI) Board at rest. OBJECTIVE: The aim of the study was to evaluate the temporal cross-correlations between the Polar ® HRMI Board and an ECG to measure the series of RR intervals at rest. METHODS: The sample consisted of eighteen healthy male subjects and they were instructed to lie in the supine position at rest while breathing normally and a time window of the last 2 min was recorded to analyse RR intervals were obtained for each subject with a Polar ® HRMI Board and an ECG. Cross-correlation analysis of RR interval signals between methods and reliability was expressed by Bland and Altman analysis. RESULTS: The cross-correlation was excellent, resulting in a mean of 0.98 ± 0.01 and no lag or delay between the signals. The bias was 0.03 ± 0.08 s or 8.0% for MeanRRi from Polar ® HRMI Board and ECG, no significant difference. CONCLUSIONS: The Polar ® HRMI Board is acceptable for assessment of serial RR intervals. The results support the reliability of the Mean RR interval compared to a resting ECG. [ABSTRACT FROM AUTHOR]

Background: Using third‐party resources to manage remote monitoring (RM) data from implantable cardiac electronic devices (CIEDs) can assist in device clinic workflows. However, each hospital‐acquired data is not used for further analysis as big data. Methods and results: We developed a real‐time and automatically centralized system of CIED information from multiple hospitals. If the extensive data‐based analysis suggests individual problems, it can be returned to each hospital. To show its feasibility, we prospectively analyzed data from six hospitals. For example, unexpected abnormal battery levels were easily illustrated without recall information. Conclusions: The centralized RM system could be a new platform that promotes the utilization of device data as big data, and that information could be used for each patient's practice. [ABSTRACT FROM AUTHOR]

A growing number of companies are developing or using wearable sensor technologies that can monitor, analyse and transmit data from humans in real time that can be used by the sporting, biomedical and media industries. To explore this phenomenon, we describe and review two high-profile sporting events where innovations in wearable technologies were trialled: the Tokyo 2020 Summer Olympic Games (Tokyo 2020, Japan) and the 2022 adidas Road to Records (Germany). These two major sporting events were the first time academic and industry partners came together to implement real-time wearable solutions during major competition, to protect the health of athletes competing in hot and humid environments, as well as to better understand how these metrics can be used moving forwards. Despite the undoubted benefits of such wearables, there are well-founded concerns regarding their use including: (1) limited evidence quantifying the potential beneficial effects of analysing specific parameters, (2) the quality of hardware and provided data, (3) information overload, (4) data security and (5) exaggerated marketing claims. Employment and sporting rules and regulations also need to evolve to facilitate the use of wearable devices. There is also the potential to obtain real-time data that will oblige medical personnel to make crucial decisions around whether their athletes should continue competing or withdraw for health reasons. To protect athletes, the urgent need is to overcome these ethical/data protection concerns and develop wearable technologies that are backed by quality science. The fields of sport and exercise science and medicine provide an excellent platform to understand the impact of wearable sensors on performance, wellness, health, and disease. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess the feasibility of scaling advanced care at home (ACAH) (otherwise known as hospital at home) within an integrated health care delivery system. STUDY DESIGN: Retrospective cohort study of patients qualified for hospital-level care who were admitted to either ACAH or a traditional hospital. METHODS: From April 29, 2020, to November 14, 2021, patients requiring hospital-level care received Kaiser Permanente at Home or traditional hospital care. In a subgroup of patients, we compared outcomes for Kaiser Permanente at Home vs traditional hospital care using regression models. RESULTS: A total of 1005 patients were admitted to Kaiser Permanente at Home. Average daily census (ADC) was intentionally increased over time in stages, from 7.2 to 8.8, then to 12.7. The maximum daily census was 22, with a peak ADC of 16, representing 9% of the total hospital inpatient medicine service census. During this time, there were numeric decreases in Kaiser Permanente at Home escalation rates (17.5% to 10.8%), median length of stay (7.43 days to 5.46 days), and readmission rates (9.79% to 9.24%). A subgroup of Kaiser Permanente at Home patients contributed to the comparative analyses, which showed that patients admitted to Kaiser Permanente at Home were 64% less likely to experience delirium than patients admitted for traditional hospital care (OR, 0.36; 95% CI, 0.15-0.88; P = .026). Comparisons of quality metrics across stages of implementation (readmissions, escalations, length of stay) were inconclusive. CONCLUSION: In an integrated delivery system, ACAH care can be scaled and can create hospital capacity. However, our data were inconclusive regarding quality throughout scaling due to the small effective sample size, necessitating replication in a larger prospective study with adequate power/precision. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) technologies for dysphagia management may allow patients to complete rehabilitation exercises from home and their clinicians to remotely monitor them. However, clinicians are rarely formally consulted in the early stages of ideation. This study aimed to determine necessary elements to be included in a clinician web portal that would allow for remote monitoring of patients completing dysphagia exercises using mHealth equipped with surface electromyography (sEMG). Ten dysphagia clinicians were consulted individually using convergent interviewing. Interviews were transcribed and analysed using thematic analysis to identify themes and sub-themes. Themes identified included: perceived benefits of an mHealth system; clinical uptake of an mHealth system; clinical targets desired; preferred communication method; notification style and frequency; and user interface considerations. There was no consensus regarding clinical targets to display, notification frequency, method of clinician-patient communication, or layout for the user interface. Agreement existed on the importance of the simplicity and customisability for the clinician web portal user interface. Lack of consensus on specific elements to be included in a clinician web portal could reflect low clinical exposure to sEMG. This study provides an example of formal end user feedback in the ideation phase of design. [ABSTRACT FROM AUTHOR]