Hardware Prototype for Wrist-Worn Simultaneous Monitoring of Environmental, Behavioral, and Physiological Parameters

We designed a low-cost wrist-worn prototype for simultaneously measuring environmental, behavioral, and physiological domains of influencing factors in healthcare. Our prototype continuously monitors ambient elements (sound level, toxic gases, ultraviolet radiation, air pressure, temperature, and humidity), personal activity (motion tracking and body positioning using gyroscope, magnetometer, and accelerometer), and vital signs (skin temperature and heart rate). An innovative three-dimensional hardware, based on the multi-physical-layer approach is introduced. Using board-to-board connectors, several physical hardware layers are stacked on top of each other. All of these layers consist of integrated and/or add-on sensors to measure certain domain (environmental, behavioral, or physiological). The prototype includes centralized data processing, transmission, and visualization. Bi-directional communication is based on Bluetooth Low Energy (BLE) and can connect to smartphones as well as smart cars and smart homes for data analytic and adverse-event alerts. This study aims to develop a prototype for simultaneous monitoring of the all three areas for monitoring of workplaces and chronic obstructive pulmonary disease (COPD) patients with a concentration on technical development and validation rather than clinical investigation. We have implemented 6 prototypes which have been tested by 5 volunteers. We have asked the subjects to test the prototype in a daily routine in both indoor (workplaces and laboratories) and outdoor. We have not imposed any specific conditions for the tests. All presented data in this work are from the same prototype. Eleven sensors measure fifteen parameters from three domains. The prototype delivers the resolutions of 0.1 part per million (PPM) for air quality parameters, 1 dB, 1 index, and 1 °C for sound pressure level, UV, and skin temperature, respectively. The battery operates for 12.5 h under the maximum sampling rates of sensors without recharging. The final expense does not exceed 133€. We validated all layers and tested the entire device with a 75 min recording. The results show the appropriate functionalities of the prototype for further development and investigations

WELCOME – Innovative Integrated Care platform using Wearable Sensing and Smart Cloud Computing for COPD patients with Comorbidities

We propose WELCOME, an innovative integrated care platform using wearable sensors and smart cloud computing for Chronic Obstructive Pulmonary Disease (COPD) patients with co-morbidities. WELCOME aims to bring about a change in the reactive nature of the management of chronic diseases and its comorbidities, in particular through the development of a patient centred and proactive approach to COPD management. The aim of WELCOME is to support healthcare services to give early detection of complications (potentially reducing hospitalisations) and the prevention and mitigation of comorbidities (Heart Failure, Diabetes, Anxiety and Depression). The system incorporates patient hub, where it interacts with the patient via a light vest including a large number of non-invasive chest sensors for monitoring various relevant parameters. In addition, interactive applications to monitor and manage diabetes, anxiety and lifestyle issues will be provided to the patient. Informal carers will also be supported in dealing with their patients. On the other hand, welcome smart cloud platform is the heart of the proposed system where all the medical records and the monitoring data are managed and processed via the decision support system. Healthcare professionals will be able to securely access the WELCOME applications to monitor and manage the patient’s conditions and respond to alerts on personalized level

Devices and Data Workflow in COPD Wearable Remote Patient Monitoring: A Systematic Review

Background: With global increase in Chronic Obstructive Pulmonary Disease (COPD) prevalence and mortality rates, and socioeconomical burden continuing to rise, current disease management strategies appear inadequate, paving the way for technological solutions, namely remote patient monitoring (RPM), adoption considering its acute disease events management benefit. One RPM’s category stands out, wearable devices, due to its availability and apparent ease of use. Objectives: To assess the current market and interventional solutions regarding wearable devices in the remote monitoring of COPD patients through a systematic review design from a device composition, data workflow, and collected parameters description standpoint. Methods: A systematic review was conducted to identify wearable device trends in this population through the development of a comprehensive search strategy, searching beyond the mainstream databases, and aggregating diverse information found regarding the same device. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed, and quality appraisal of identified studies was performed using the Critical Appraisal Skills Programme (CASP) quality appraisal checklists. Results: The review resulted on the identification of 1590 references, of which a final 79 were included. 56 wearable devices were analysed, with the slight majority belonging to the wellness devices class. Substantial device heterogeneity was identified regarding device composition type and wearing location, and data workflow regarding 4 considered components. Clinical monitoring devices are starting to gain relevance in the market and slightly over a third, aim to assist COPD patients and healthcare professionals in exacerbation prediction. Compliance with validated recommendations is still lacking, with no devices assessing the totality of recommended vital signs. Conclusions: The identified heterogeneity, despite expected considering the relative novelty of wearable devices, alerts for the need to regulate the development and research of these technologies, specially from a structural and data collection and transmission standpoints.Introdução: Com o aumento global das taxas de prevalência e mortalidade da Doença Pulmonar Obstrutiva Crónica (DPOC) e o seu impacto socioeconómico, as atuais estratégias de gestão da doença parecem inadequadas, abrindo caminho para soluções tecnológicas, nomeadamente para a adoção da monitorização remota, tendo em conta o seu benefício na gestão de exacerbações de doenças crónicas. Dentro destaca-se uma categoria, os dispositivos wearable, pela sua disponibilidade e aparente facilidade de uso. Objetivos: Avaliar as soluções existentes, tanto no mercado, como na área de investigação, relativas a dispositivos wearable utilizados na monitorização remota de pacientes com DPOC através de uma revisão sistemática, do ponto de vista da composição do dispositivo, fluxo de dados e descrição dos parâmetros coletados. Métodos: Uma revisão sistemática foi realizada para identificar tendências destes dispositivos, através do desenvolvimento de uma estratégia de pesquisa abrangente, procurando pesquisar para além das databases convencionais e agregar diversas informações encontradas sobre o mesmo dispositivo. Para tal, foram seguidas as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), e a avaliação da qualidade dos estudos identificados foi realizada utilizando a ferramenta CASP (Critical Appraisal Skills Programme). Resultados: A revisão resultou na identificação de 1590 referências, das quais 79 foram incluídas. Foram analisados 56 dispositivos wearable, com a ligeira maioria a pertencer à classe de dispositivos de wellness. Foi identificada heterogeneidade substancial nos dispositivos em relação à sua composição, local de uso e ao fluxo de dados em relação a 4 componentes considerados. Os dispositivos de monitorização clínica já evidenciam alguma relevância no mercado e, pouco mais de um terço, visam auxiliar pacientes com DPOC e profissionais de saúde na previsão de exacerbações. Ainda assim, é notória a falta do cumprimento das recomendações validadas, não estando disponíveis dispositivos que avaliem a totalidade dos sinais vitais recomendados. Conclusão: A heterogeneidade identificada, apesar de esperada face à relativa novidade dos dispositivos wearable, alerta para a necessidade de regulamentação do desenvolvimento e investigação destas tecnologias, especialmente do ponto de vista estrutural e de recolha e transmissão de dados

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference