Wearable proximity sensors for monitoring a mass casualty incident exercise: a feasibility study

Over the past several decades, naturally occurring and man-made mass casualty incidents (MCI) have increased in frequency and number, worldwide. To test the impact of such event on medical resources, simulations can provide a safe, controlled setting while replicating the chaotic environment typical of an actual disaster. A standardised method to collect and analyse data from mass casualty exercises is needed, in order to assess preparedness and performance of the healthcare staff involved. We report on the use of wearable proximity sensors to measure proximity events during a MCI simulation. We investigated the interactions between medical staff and patients, to evaluate the time dedicated by the medical staff with respect to the severity of the injury of the victims depending on the roles. We estimated the presence of the patients in the different spaces of the field hospital, in order to study the patients' flow. Data were obtained and collected through the deployment of wearable proximity sensors during a mass casualty incident functional exercise. The scenario included two areas: the accident site and the Advanced Medical Post (AMP), and the exercise lasted 3 hours. A total of 238 participants simulating medical staff and victims were involved. Each participant wore a proximity sensor and 30 fixed devices were placed in the field hospital. The contact networks show a heterogeneous distribution of the cumulative time spent in proximity by participants. We obtained contact matrices based on cumulative time spent in proximity between victims and the rescuers. Our results showed that the time spent in proximity by the healthcare teams with the victims is related to the severity of the patient's injury. The analysis of patients' flow showed that the presence of patients in the rooms of the hospital is consistent with triage code and diagnosis, and no obvious bottlenecks were found

Estimating Potential Infection Transmission Routes in Hospital Wards Using Wearable Proximity Sensors

Contacts between patients, patients and health care workers (HCWs) and among HCWs represent one of the important routes of transmission of hospital-acquired infections (HAI). A detailed description and quantification of contacts in hospitals provides key information for HAIs epidemiology and for the design and validation of control measures. We used wearable sensors to detect close-range interactions ("contacts") between individuals in the geriatric unit of a university hospital. Contact events were measured with a spatial resolution of about 1.5 meters and a temporal resolution of 20 seconds. The study included 46 HCWs and 29 patients and lasted for 4 days and 4 nights. 14037 contacts were recorded. The number and duration of contacts varied between mornings, afternoons and nights, and contact matrices describing the mixing patterns between HCW and patients were built for each time period. Contact patterns were qualitatively similar from one day to the next. 38% of the contacts occurred between pairs of HCWs and 6 HCWs accounted for 42% of all the contacts including at least one patient, suggesting a population of individuals who could potentially act as super-spreaders. Wearable sensors represent a novel tool for the measurement of contact patterns in hospitals. The collected data provides information on important aspects that impact the spreading patterns of infectious diseases, such as the strong heterogeneity of contact numbers and durations across individuals, the variability in the number of contacts during a day, and the fraction of repeated contacts across days. This variability is associated with a marked statistical stability of contact and mixing patterns across days. Our results highlight the need for such measurement efforts in order to correctly inform mathematical models of HAIs and use them to inform the design and evaluation of prevention strategies

Contact patterns among high school students

Face-to-face contacts between individuals contribute to shape social networks and play an important role in determining how infectious diseases can spread within a population. It is thus important to obtain accurate and reliable descriptions of human contact patterns occurring in various day-to-day life contexts. Recent technological advances and the development of wearable sensors able to sense proximity patterns have made it possible to gather data giving access to time-varying contact networks of individuals in specific environments. Here we present and analyze two such data sets describing with high temporal resolution the contact patterns of students in a high school. We define contact matrices describing the contact patterns between students of different classes and show the importance of the class structure. We take advantage of the fact that the two data sets were collected in the same setting during several days in two successive years to perform a longitudinal analysis on two very different timescales. We show the high stability of the contact patterns across days and across years: the statistical distributions of numbers and durations of contacts are the same in different periods, and we observe a very high similarity of the contact matrices measured in different days or different years. The rate of change of the contacts of each individual from one day to the next is also similar in different years. We discuss the interest of the present analysis and data sets for various fields, including in social sciences in order to better understand and model human behavior and interactions in different contexts, and in epidemiology in order to inform models describing the spread of infectious diseases and design targeted containment strategies.Comment: Supplementary Information at http://s3-eu-west-1.amazonaws.com/files.figshare.com/1677807/File_S1.pd

Can co-location be used as a proxy for face-to-face contacts?

Technological advances have led to a strong increase in the number of data collection efforts aimed at measuring co-presence of individuals at different spatial resolutions. It is however unclear how much co-presence data can inform us on actual face-to-face contacts, of particular interest to study the structure of a population in social groups or for use in data-driven models of information or epidemic spreading processes. Here, we address this issue by leveraging data sets containing high resolution face-to-face contacts as well as a coarser spatial localisation of individuals, both temporally resolved, in various contexts. The co-presence and the face-to-face contact temporal networks share a number of structural and statistical features, but the former is (by definition) much denser than the latter. We thus consider several down-sampling methods that generate surrogate contact networks from the co-presence signal and compare them with the real face-to-face data. We show that these surrogate networks reproduce some features of the real data but are only partially able to identify the most central nodes of the face-to-face network. We then address the issue of using such down-sampled co-presence data in data-driven simulations of epidemic processes, and in identifying efficient containment strategies. We show that the performance of the various sampling methods strongly varies depending on context. We discuss the consequences of our results with respect to data collection strategies and methodologies

Study design and protocol for investigating social network patterns in rural and urban schools and households in a coastal setting in Kenya using wearable proximity sensors

Background: Social contact patterns shape the transmission of respiratory infections spread via close interactions. There is a paucity of observational data from schools and households, particularly in developing countries. Portable wireless sensors can record unbiased proximity events between individuals facing each other, shedding light on pathways of infection transmission. Design and methods: The aim is to characterize face-to-face contact patterns that may shape the transmission of respiratory infections in schools and households in Kilifi, Kenya. Two schools, one each from a rural and urban area, will be purposively selected. From each school, 350 students will be randomly selected proportional to class size and gender to participate. Nine index students from each school will be randomly selected and followed-up to their households. All index household residents will be recruited into the study. A further 3-5 neighbouring households will also be recruited to give a maximum of 350 participants per household setting. The sample size per site is limited by the number of sensors available for data collection. Each participant will wear a wireless proximity sensor lying on their chest area for 7 consecutive days. Data on proximal dyadic interactions will be collected automatically by the sensors only for participants who are face-to-face. Key characteristics of interest include the distribution of degree and the frequency and duration of contacts and their variation in rural and urban areas. These will be stratified by age, gender, role, and day of the week. Expected results: Resultant data will inform on social contact patterns in rural and urban areas of a previously unstudied population. Ensuing data will be used to parameterize mathematical simulation models of transmission of a range of respiratory viruses, including respiratory syncytial virus, and used to explore the impact of intervention measures such as vaccination and social distancing

Quantifying social contacts in a household setting of rural Kenya using wearable proximity sensors

International audienc

Exploring the Landscape of Ubiquitous In-home Health Monitoring: A Comprehensive Survey

Ubiquitous in-home health monitoring systems have become popular in recent years due to the rise of digital health technologies and the growing demand for remote health monitoring. These systems enable individuals to increase their independence by allowing them to monitor their health from the home and by allowing more control over their well-being. In this study, we perform a comprehensive survey on this topic by reviewing a large number of literature in the area. We investigate these systems from various aspects, namely sensing technologies, communication technologies, intelligent and computing systems, and application areas. Specifically, we provide an overview of in-home health monitoring systems and identify their main components. We then present each component and discuss its role within in-home health monitoring systems. In addition, we provide an overview of the practical use of ubiquitous technologies in the home for health monitoring. Finally, we identify the main challenges and limitations based on the existing literature and provide eight recommendations for potential future research directions toward the development of in-home health monitoring systems. We conclude that despite extensive research on various components needed for the development of effective in-home health monitoring systems, the development of effective in-home health monitoring systems still requires further investigation.Comment: 35 pages, 5 figure

AEVUM: Personalized Health Monitoring System

Advancement in the field of sensors and other portable technologies have resulted in a bevy of health monitoring devices such as blue-tooth and Wi-Fi enabled weighing scales and wearables which help individuals monitor their personal health. This collected information provides a plethora of data points over intervals of time that a primary care physician can utilize to gain a holistic understanding of an individual’s health and provide a more effective and personalized treatment. A drawback of the existing health monitoring devices is that they are not integrated with the professional medical infrastructure. With the wealth of information collected, it is also not feasible for a physician to look through all the data to obtain relevant information or patterns from multiple health monitoring systems. Therefore, it would be beneficial to have a single platform of hardware devices to monitor and collect data and a software application to securely store the collected information, identify patterns for analysis, and summarize the data for the physician and the patient. The aim of this study was to design and develop an unobtrusive, user friendly system, Aevum, which would integrate technology, adapt itself to changes in consumer behavior and integrate with the existing healthcare infrastructure to help an individual monitor their health in a customized manner. Aevum is a multi-device system consisting of a smart, puck-shaped hardware product, a wristband and a software application available to the patient as well as the physician. In addition to monitoring vitals such as heart rate, blood pressure, body temperature and weight, Aevum can monitor environmental factors that affect an individual’s health and uses personalized metrics such as precise calorie intake and medication management to monitor health. This allows the user to personalize Aevum based on their health condition. Finally, Aevum identifies patterns of anomalies in the collected data and compiles the information which can be accessed by the physician to assist in their treatment

Using Sensors in Organizational Research-Clarifying Rationales and Validation Challenges for Mixed Methods

Sensor-based data are becoming increasingly widespread in social, behavioral, and organizational sciences. Far from providing a neutral window on 'reality,' sensor-based big-data are highly complex, constructed data sources. Nevertheless, a more systematic approach to the validation of sensors as a method of data collection is lacking, as their use and conceptualization have been spread out across different strands of social-, behavioral-, and computer science literature. Further debunking the myth of raw data, the present article argues that, in order to validate sensor-based data, researchers need to take into account the mutual interdependence between types of sensors available on the market, the conceptual (construct) choices made in the research process, and the contextual cues. Sensor-based data in research are usually combined with additional quantitative and qualitative data sources. However, the incompatibility between the highly granular nature of sensor data and the static, a-temporal character of traditional quantitative and qualitative data has not been sufficiently emphasized as a key limiting factor of sensor-based research. It is likely that the failure to consider the basic quality criteria of social science measurement indicators more explicitly may lead to the production of insignificant results, despite the availability of high volume and high-resolution data. The paper concludes with recommendations for designing and conducting mixed methods studies using sensors

Trends in virtual reality technologies for the learning patient

NextMed convened the Medicine Meets Virtual Reality 22 (MMVR 22) conference in 2016. Since 1992, the conference has brought together a diverse group of researchers to share creative solutions for the evolving challenge of integrating virtual reality tools into medical education. Virtual reality (VR) and its enabling technologies utilize hardware and software to simulate environments and encounters where users can interact and learn. The MMVR 22 symposium proceedings contain projects that support a variety of learners: medical students, practitioners, soldiers, and patients. This report will contemplate the trends in virtual reality technologies for patients navigating their medical and healthcare learning. The learning patient seeks more than intervention; they seek prevention. From virtual humans and environments to motion sensors and haptic devices, patients are surrounded by increasingly rich and transformative data-driven tools. Applied data enables VR applications to simulate experience, predict health outcomes, and motivate new behavior. The MMVR 22 presents investigations into the usability of wearable devices, the efficacy of avatar inclusion, and the viability of multi-player gaming. With increasing need for individualized and scalable programming, only committed open source efforts will align instructional designers, technology integrators, trainers, and clinicians. Curriculum and InstructionCurriculum and Instructio