Evaluation of a wearable computer system for telemonitoring in a critical environment

This paper reports on the evaluation of a wearable computer system designed for use in a critical environment, namely the intensive care unit of a hospital. The nature of the application raised ethical issues for testing in a clinical environment and standard evaluation techniques could not easily be applied. The system was therefore evaluated by clinicians in a multi-tasking environment with a simulated set of patient scenarios. Measures of suitability and wearability were applied. The results were encouraging and the system was deemed suitable for further evaluation in the clinical setting, subject to ethical approval

Wearable continuous vital sign monitoring for deterioration detection and clinical outcomes in hospitalised patients

 Current practice uses physiological early warning scoring (EWS) systems to monitor “standard” vital signs, including heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturations (SpO2) and temperature, coupled with a graded response such as referral for a senior review or increasing monitoring frequency. Early detection of the deteriorating patient is a known challenge within hospital environments, as EWS is dependent on correct frequency of physiological observations tailored to specific patient needs, that can be time consuming for healthcare professionals, resulting in missed or incomplete observations. Wearable monitoring systems (WMS) may bring the potential to fill the gap in vital sign monitoring between traditional intermittent manual measurements and continuous automatic monitoring. However, evidence on the feasibility and impact of WMS implementation remains scarce. The virtual High Dependency Unit (vHDU) project was designed to develop and test the feasibility of deploying a WMS system in the hospital ward environment. This doctoral work aims to critically analyse the roadmap work of the vHDU project, containing ten publications distributed throughout 7 chapters. Chapter 1 (with 3 publications) includes a systematic review and meta-analysis identifying the lack of statistical evidence of the impact of WMS in early deterioration detection and associated clinical outcomes, highlighting the need for high-quality randomised controlled trials (RCTs). It also supports the use of WMS as a complement, and not a substitute, for standard and direct care. Chapter 2 explores clinical staff and patient perceptions of current vital sign monitoring practices, as well as their early thoughts on the use of WMS in the hospital environment through a qualitative interview study. WMS were seen positively by both clinical and patient groups as a potential tool to bridge the gap between manual observations and the traditional wired continuous automatic systems, as long as it does not add more noise to the wards nor replaces direct contact from the clinical staff. In chapter 3, the wearability of 7 commercially available wearables (monitoring HR, RR and SpO2) was assessed, advocating for the use of pulse oximeters without a fingertip probe and a small chest patch to improve worn times from the patients. Out of these, five devices were submitted to measurement accuracy testing (chapter 4, with 3 publications) under movement and controlled hypoxaemia, resulting in the validation of a chest patch (monitoring HR and RR) and proving the diagnostic accuracy of 3 pulse oximeters (monitoring pulse rate, PR and SpO2) under test. These results were timely for the final selection of the devices to be integrated in our WMS, namely vHDU system, explored in chapter 5, outlining the process for its development and rapid deployment in COVID-19 isolation wards in our local hospital during the pandemic. This work is now converging in the design of a feasibility RCT to test the impact of the vHDU system (now augmented with blood pressure and temperature monitoring, completing all 5 vital signs) versus standard care in an unbiased environment (chapter 6). This will also ascertain the feasibility for a multicentre RCT, that may in the future, contribute with the much-needed statistical evidence to my systematic review and meta-analysis research question, highlighted in chapter 1. Finally, chapter 7 includes a critical reflection of the vHDU project and overall doctoral work, as well as its contributions to the field of wearable monitoring.<p class="MsoNormal"/

Wearable design requirements identification and evaluation

: Wearable electronics make it possible to monitor human activity and behavior. Most of these devices have not taken into account human factors and they have instead focused on technological issues. This fact could not only affect human–computer interaction and user experience but also the devices’ use cycle. Firstly, this paper presents a classification of wearable design requirements that have been carried out by combining a quantitative and a qualitative methodology. Secondly, we present some evaluation procedures based on design methodologies and human–computer interaction measurement tools. Thus, this contribution aims to provide a roadmap for wearable designers and researchers in order to help them to find more efficient processes by providing a classification of the design requirements and evaluation tools. These resources represent time and resource-saving contributions. Therefore designers and researchers do not have to review the literature. It will no be necessary to carry out exploratory studies for the purposes of identifying requirements or evaluation tools either

Assessing the Usability of a Wearable Computer Interface with Split Button Configuration

A wearable computer interface with split button configuration was constructed using Arduino Lilypad components on the front of a vest with the goal of assessing its usability in an activity involving at least one hand. A sample of twelve men and eight women ages 18 to 62 participated in a usability study of the vest. The activity chosen for this study was a typing test during which users would control a media player remotely with the vest. The usability measures included ease of use, performance of the interface as determined by accuracy rates and time to task completion for both button pressing and the typing test, and comfort. Results indicate the participants found the vest easy to learn and use with no significant effect on the accuracy of the typing activity, but they often needed visual cues to locate the controls. Based on these findings, we offer suggestions for improving the design of the interface and future work we want to pursue after the modifications

Understanding the Interaction Between Animals and Wearables: The Wearer Experience of Cats

Animals can be negatively affected by wearable tracking devices, even those marketed as ‘animal friendly’ and increasingly used with companion animals, such as cats. To understand the wearer experience of cats fitted with popular GPS trackers, we measured the behavior of 13 feline participants while they were wearing the devices during a field study. The aim of our behavioral analysis was twofold: investigating potential signs of discomfort generated by the devices to evaluate the impact that such interventions have on cat wearers; identifying wearability flaws that might account for the observed impact and wearability requirements to improve the design of the devices. Based on our findings, we propose a set of requirements that should inform the design of trackers to afford better wearability and thus provide better wearer experience for cat wearers

A Wearer-Centred Framework to Design for Wearability in Animal Biotelemetry

In a technological era, monitoring animals for scientific, husbandry, or caring reasons is often done by using tracking systems attached to the animals’ bodies. Remote data acquisition from animals has enhanced the knowledge about their biology and ecology. However, there is evidence that carrying biotelemetry tags affects the welfare of animal wearers and interferes with the validity of recorded data. On welfare and scientific grounds, animal scientists have advocated for the re-design of physical and functional aspects of tags, proposing guidelines aimed at minimising device-induced impacts. However, such guidelines are dispersed and difficult to apply systematically. Hence, there is a need for an approach to systematising the design of animal-borne tags in order to minimise their impact on the wearer. This thesis addresses such a challenge. It draws on the concept of wearability and proposes it as a design goal to develop devices that afford a better wearer experience (WX) for animals. The thesis develops a wearer-centred design framework (WCF) and applies it to demonstrate its usefulness to systematically design for good wearability. Specifically, after the framework’s elements were derived by analysing relevant information in the biotelemetry and interaction design literature, the framework was administered to teams of workshop participants who implemented it to perform a requirements analysis for a cat-tracking device. Workshop requirements served to produce a feline-centred prototype which was tested with cat wearers to investigate their experience of wearing it and thus evaluate its wearability. Outcomes show improvements of the prototype in relation to off-the-shelf devices which were tested in a parallel study. This study established a baseline for investigating a cat WX and highlighted various wearability issues with the off-the-shelf tags. Lastly, this research demonstrates that designers can systematically design for wearability using the WCF therefore supporting the thesis that the reduction of device-related impacts is achievable

A Three-dimensional Finger Motion Measurement System of a Thumb and an Index Finger Without a Calibration Process

Various wearable systems have been investigated to measure hand motion, but some challenges remain. Many systems require a calibration process to map sensor signals to actual finger joint angles by the principle of measuring the length change of the finger, or bending sensors. Also, few studies have investigated how to measure thumb motion accurately using the wearable systems. This paper proposes an exoskeleton system with linear Hall sensors to measure three-dimensional hand motion without a calibration process. The calibration process is avoided by measuring finger joint angles through an absolute rotation measurement. A new wearing method with lower parts underneath the hand joints and rubber bands is proposed to fix the structure to the hand and adapt it for various hand sizes. As the thumb has a complex biomechanical feature at carpometacarpal (CMC) joint, a new measuring method of the CMC joint is proposed to directly calculate the orientation of the metacarpal. The prototype of the thumb and index finger was manufactured, and the performance was verified experimentally by using an optical motion capture system

Evaluating the Efficacy of an Active Compression Brace on Orthostatic Cardiovascular Responses

Orthostatic intolerance, one of the principle causes of syncope, can occur secondary to concomitant venous pooling and enhanced capillary filtration. We aimed to evaluate a prototype portable calf active compression brace (ACB) designed to improve orthostatic haemodynamic control. Fourteen healthy volunteers participated in a randomized, placebo controlled, cross-over, double-blind study. Testing consisted of head-upright tilting and walking on a treadmill conducted on two consecutive days with a pair of ACBs wrapped around both calves. The ACB was actuated on one test day, but not on the other (placebo). Wearability, comfort, and ambulatory use of the ACB were assessed using questionnaires. The average calf pressure exerted by the ACB was 46.3±2.2 mmHg and the actuation pressure was 20.7±1.7 mmHg. When considering the differences between ACB actuation and placebo during tilt after supine rest there were trends for a larger stroke volume (+5.20±2.34%, p = 0.05) and lower heart rate (-5.12±2.41%, p = 0.06) with ACB actuation, with no effect on systolic arterial pressure (+4.86±3.41%, p = 0.18). The decrease in stroke volume after ten minutes of tilting was positively correlated with the height:calf circumference (r = 0.464; p = 0.029; n = 22; both conditions combined). The increase in heart rate after ten minutes of tilting was negatively correlated with the height:calf circumference (r = -0.485; p = 0.022; n = 22; both conditions combined) and was positively correlated with the average calf circumference (r = 0.539; p = 0.009; n = 22; both conditions combined). Participants reported good ACB wearability and comfort during ambulatory use. These data verify that the ACB increased stroke volume during tilting in healthy controls. Active calf compression garments may be a viable option for the management of orthostatic intolerance

Evaluating the development of wearable devices, personal data assistants and the use of other mobile devices in further and higher education institutions

This report presents technical evaluation and case studies of the use of wearable and mobile computing mobile devices in further and higher education. The first section provides technical evaluation of the current state of the art in wearable and mobile technologies and reviews several innovative wearable products that have been developed in recent years. The second section examines three scenarios for further and higher education where wearable and mobile devices are currently being used. The three scenarios include: (i) the delivery of lectures over mobile devices, (ii) the augmentation of the physical campus with a virtual and mobile component, and (iii) the use of PDAs and mobile devices in field studies. The first scenario explores the use of web lectures including an evaluation of IBM's Web Lecture Services and 3Com's learning assistant. The second scenario explores models for a campus without walls evaluating the Handsprings to Learning projects at East Carolina University and ActiveCampus at the University of California San Diego . The third scenario explores the use of wearable and mobile devices for field trips examining San Francisco Exploratorium's tool for capturing museum visits and the Cybertracker field computer. The third section of the report explores the uses and purposes for wearable and mobile devices in tertiary education, identifying key trends and issues to be considered when piloting the use of these devices in educational contexts