To examine the perceived feasibility, acceptability and effectiveness of regular singing for people with COPD. DesignQualitative element within a pre-test, post-test feasibility study. MethodsWritten comments collected at baseline, mid-point and end-point from participants engaged in a 36 week singing programme. FindingsParticipants noted limitations due to their respiratory condition but a large number expressed beliefs that singing had led to improvement and this appeared to be incremental over the time of the project.Other comments related to positive effects on physical health more broadly, on psychological wellbeing and on the social support gained through meeting others with COPD. Comments relating to the overall programme and the research itself were overwhelmingly positive. ConclusionsFindings suggest that singing is perceived as both acceptable and beneficial to people with COPD.Evidence from participants served as a useful supplement to the quantitative findings.

No abstract

Background: The pulse oximeter (PO) provides anesthesiologists with continuous visual and auditory information about a patient’s oxygen saturation (SpO2). However, anesthesiologists’ attention is often diverted from visual displays, and clinicians may inaccurately judge SpO2 values when relying on conventional PO auditory tones. We tested whether participants could identify SpO2 value (e.g., “97%”) better with acoustic enhancements that identified three discrete clinical ranges by either changing abruptly at two threshold values (stepped-effects) or changing incrementally with each percentage value of SpO2 (smooth-effects). Method: In all, 79 nonclinicians participated in a between-subjects experiment that compared performance of participants using the stepped-effects display with those who used the smooth-effects display. In both conditions, participants heard sequences of 72 tones whose pitch directly correlated to SpO2 value, and whose value could change incrementally. Primary outcome was percentage of responses that correctly identified the absolute SpO2 percentage, ±1, of the last pulse tone in each sequence. Results: Participants using the stepped-effects auditory tones identified absolute SpO2 percentage more accurately ( M = 53.7%) than participants using the smooth-effects tones ( M = 47.9%, p = .038). Identification of range and detection of transitions between ranges showed even stronger advantages for the stepped-effects display ( p < .005). Conclusion: The stepped-effects display has more pronounced auditory cues at SpO2 range transitions, from which participants can better infer absolute SpO2 values. Further development of a smooth-effects display for this purpose is not necessary.

Auditory alarms in hospitals are ambiguous and do not provide enough information to support doctors and nurses’ awareness of patient events. A potential alternative is the use of short segments of time-compressed speech, or spearcons. However, sometimes it might be desirable for patients to understand spearcons and sometimes not. We used reverse hierarchy theory to hypothesize that there will be a degree of compression where spearcons are intelligible for trained listeners but not for untrained listeners. In Experiment 1, spearcons were compressed to either 20% or 25% of their original duration. Their intelligibility was very high for trained participants, but also quite high for untrained participants. In Experiment 2 each word within each spearcon was compressed to a different degree based on the results of Experiment 1. This technique was effective in creating the desired difference in spearcon intelligibility between trained and untrained listeners. An implication of these results is that manipulating the degree of compression of spearcons “by word” can increase the effect of training so that untrained listeners reliably do not understand the content of the spearcons.

Background Continuous monitoring of patient vital signs may improve patient outcomes. Head-worn displays (HWDs) can provide hands-free access to continuous vital sign information of patients in critical and acute care contexts and thus may reduce instances of unrecognized patient deterioration. Objective The purpose of the study is to conduct a systematic review of the literature to evaluate clinical, surrogate, and process outcomes when clinicians use HWDs for continuous patient vital sign monitoring. Methods The review was registered with PROSPERO (CRD42019119875) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. A literature search was conducted for articles published between January 1995 and June 2020 using the following databases: PubMed, Embase, CINAHL, PsycINFO, and Web of Science. Overall, 2 reviewers independently screened titles and abstracts and then assessed the full text of the articles. Original research articles that evaluated the clinical, surrogate, or process outcomes of head-mounted displays for continuous vital sign monitoring in critical care or acute care contexts were included. Results Of the 214 records obtained, 15 (7%) articles met the predefined criteria and were included in this review. Of the 15 studies, 7 (47%) took place in a clinical context, whereas the remainder took place in a simulation environment. In 100% (7/7) of the studies that evaluated gaze behavior, changes were found in gaze direction with HWDs. Change detection improvements were found in 67% (2/3) of the studies evaluating changes in the participants’ ability to detect changes in vital signs. Of the 10 studies assessing the ease of use of the HWD, most participants of 7 (70%) studies reported that the HWD was easy to use. In all 6 studies in which participants were asked if they would consider using the HWD in their practice, most participants responded positively, but they often suggested improvements on the HWD hardware or display design. Of the 7 studies conducted in clinical contexts, none reported any clinical outcomes. Conclusions Although there is limited and sometimes conflicting evidence about the benefits of HWDs from certain surrogate and process outcomes, evidence for clinical outcomes is lacking. Recommendations are to employ user-centered design when developing HWDs, perform longitudinal studies, and seek clinical outcomes. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019119875; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119875