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Psychological stress may cause various health problems. To prevent the potential chronic illness that long-term psychological stress could cause, it is important to detect and monitor the psychological stress at its initial stage. In this paper, we present a framework for remotely detecting and classifying human stress by using a KINECT sensor that is portable and affordable enough for ordinary users in everyday life. Unlike most of emotion recognition tasks in which respiratory signals (RSPS) are usually used only as an aiding analysis, the whole task proposed is based on RSPS. Thus, the main contribution of this paper is that not only the non-contact devices is used to identify human stress, but also the relationship between RSPS and stress recognition is analyzed in detail. Experimental results on 84 volunteers show that the recognition accuracy for recognizing psychological stress, physical stress, and relaxing state are 93.90%, 93.40%, and 89.05% respectively. These results suggest that the proposed framework is effective for monitoring human stress, and RSPS could be used for stress recognition.

Rational, aim, and objectives A positive patient safety culture in maternity units is linked to higher quality of care and better outcomes for mothers. However, safety culture varies across maternity units. Analyses of variation in safety culture using statistical process control (SPC) methods may help provider units to learn from each other's performance. This study aims to measure patient safety culture across maternity units in Oman using SPC methods. Methods The 36-item Safety Attitude Questionnaire (SAQ) was distributed to all doctors, nurses, and midwifes working in ten maternity care units in Oman's hospitals and analysed using SPC methods. The SAQ considers six domains: job satisfaction, perception of management, safety climate, stress recognition, teamwork, and work condition. Results Of the 892 targeted participants, 735 (82%) questionnaires were returned. The overall percentage of positive safety responses in all hospitals ranged from 53% to 66%, but no hospital had the targeted response of above 75%. Job satisfaction had the highest safety score (4.10) while stress recognition was the lowest (3.17). SPC charts showed that the overall percentage of positive responses in three maternity units (H1, H7, and H10) was above and one (H4) was below the control limits that represent special cause variation that merits further investigation. Conclusion Generally, the safety culture in maternity units in Oman is below target and suggests that considerable work is required to enhance safety culture. Several maternity units showed evidence of high/low special cause variation that may offer a useful starting point for understanding and enhancing safety culture.

According to the World Health Organization, stress is a considerable problem that affects both the mental well-being and physical health of people, so stress detection becomes an important task. Various stress detection methods based on the human brain and human behavior exist, but none of them uses both brain signals and heart signals together to detect stress. In this paper, a novel approach to detect stress using EEG and ECG signals is proposed. The proposed Stress Recognition by Neuroanalysis (Se.Re.Ne.) method is validated for k-nearest neighbors (KNN) and decision tree (DT) using the correlation method. Results evaluated using Se.Re.Ne. with KNN detect stress with a precision of 0.87, recall of 0.71, and f1-score of 0.78 with total accuracy of 68%, whereas Se.Re.Ne. with DT detects stress with a precision of 0.85, recall of 0.84, and f1-score of 0.84 with a total accuracy of 75%.

The computerized world has made individual depleted with PC stress which makes issue in day by day life. Stress causes medical problems like coronary illness, migraines, tension, melancholy, apprehensive harm and so on. We speak to stress recognition framework by applying methods of ML on some bio-signal information of individual. Stress is characterized as the difficulty in mental harmony. In setting of a clinical field, stress is mental factor that causes genuine or mental strain.Stress identification is a developing zone. Stress location can forestall numerous issues like cardiovascular variations from the norm identified with rythm or arrhythmia. The accessible natural signs are ECG, EMG, Respiration, GSR and so on and these signs changes when stress is instigated. Henceforth these signs can be utilized to recognize feelings of anxiety. As there are distinctive ECG extraction procedures are accessible, we use ECG signals for Biological sign examination. EDR(ECG determined Respiration) can be extricated from ECG. EDR is respiratory sign data. We can likewise infer RR span, QT stretch from ECG required being developed of the model.There are distinctive ML strategies for stress location. In this study we will talk about those strategies.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by early impairment in social and communication domains and autonomic nervous system unbalance. This study evaluated heart rate (HR) as a possible indicator of stress response in children with ASD as compared to children with language disorder (LD). Twenty-four patients [mean age = 42.62 months; SD = 8.14 months,12 with ASD (10 M/2F) and 12 with LD (8 M/4F)] underwent clinical [Leiter International Performance Scale-Revised, Autism Diagnostic Observation Schedule, second edition (ADOS-2)] and physiological evaluation (HR monitoring) during five interactive activities, while wearing an HR measurement device. IQ (ASD:IQ = 103.33 ± 12.85 vs. LD:IQ = 111.00 ± 8.88, p = 0.103) and fluid reasoning on the Leiter-R Scale were within the normal range in all subjects. Increased HR during the third activity (ADOS-2 bubble play) significantly correlated with autistic symptoms (r = 0.415; p = 0.044), while correlations between ADOS-2 total score and HR during the first activity (ADOS-2 free play; r = 0.368; p = 0.077), second activity (Leiter-R figure ground subscale; r = 0.373, p = 0.073), and fifth activity (ADOS-2 anticipation of a routine with objects; r = 0.368; p = 0.076) did not quite reach statistical significance. Applying a linear regression model, we found that the ADOS-2 total score significantly influenced HR variations (p = 0.023). HR monitoring may provide a better understanding of the stress-provoking situations for children with ASD. Furthermore, it could help clinicians detect the impact of the stressful condition on the autistic core and adress treatment strategy.

OBJECTIVE To evaluate awareness and attitudes of dental students and interns about patient safety culture in Dammam, Saudi Arabia. MATERIALS AND METHODS This cross-sectional study was conducted on 272 undergraduate dental students and interns using the Safety Attitudes Questionnaire (SAQ) from November 2019 to January 2020. The SAQ consists of six domains: teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions. The score of SAQ ranges from 0 to 100, and a cut-off ≥75 is considered a positive attitude of patient safety. RESULTS The study included 47.1% of males and 52.9% of females with a mean age of 22.58 ± 1.3 years. Few participants (9.9%) showed a positive attitude of patient safety culture. Nearly one-third of participants (35.7%) attended a course on patient safety and 31.6% reported experiencing adverse events by them or their families. Out of six domains, job satisfaction showed the highest mean score (70.25) and 75.4% of participants felt proud to practise in the dental clinic. Female students demonstrated a significantly higher mean score of stress recognition (64.28 ± 18.98) than male students (56.98 ± 22.53) (P 0.004). The mean SAQ score increased significantly from fourth year students to interns (P

Over the years, safety in maritime industries has been reinforced by many state-of-the-art technologies. However, the accident rate hasn't dropped significantly with the advanced technology onboard. The main cause of this phenomenon is human errors which drive researchers to study human factors in the maritime domain. One of the key factors that contribute to human performance is their mental states such as cognitive workload and stress. In this paper, we propose and implement an Electroencephalogram (EEG)-based psychophysiological evaluation system to be used in maritime virtual simulators for monitoring, training and assessing the seafarers. The system includes an EEG processing part, visualization part, and an evaluation part. By using the processing part of the system, different brain states including cognitive workload and stress can be identified from the raw EEG data recorded during maritime exercises in the simulator. By using the visualization part, the identified brain states, raw EEG signals, and videos recorded during the maritime exercises can be synchronized and displayed together. By using the evaluation part of the system, an indicative recommendation on ""pass"", ""retrain"", or ""fail"" of the seafarers' performance can be obtained based on the EEG-based cognitive workload and stress recognition. Detailed analysis of the demanding events in the maritime tasks is provided by the system for each seafarer that could be used to improve their training. A case study is presented using the proposed system. EEG data from 4 pilots were recorded when they were performing maritime tasks in the simulator. The data are processed and evaluated. The results show that one pilot gets a ""pass"" recommendation, one pilot gets a ""retrain"" recommendation, and the other two get ""fail"" results regarding their performance in the simulator.

This paper presents a novel approach to monitor office workers' behavioral patterns and heart rate variability. We integrated an EMFi sensor into a chair to measure the pressure changes caused by a user's body movements and heartbeat. Then, we employed machine learning methods to develop a classification model through which different work behaviors (body moving, typing, talking and browsing) could be recognized from the sensor data. Subsequently, we developed a BCG processing method to process the data recognized as 'browsing' and further calculate heart rate variability. The results show that the developed model achieved classification accuracies of up to 91% and the HRV could be calculated effectively with an average error of 5.77ms. By combining these behavioral and physiological measures, the proposed approach portrays work-related stress in a more comprehensive manner and could contribute an unobtrusive early stress detection system for future smart offices.

Background: Patient safety is a high priority for the healthcare system worldwide. It is considered an indicator of the quality of care. Objective: This research assesses Egyptian nurses’ attitude to patient safety and the factors that affect their attitude. Methods: A descriptive cross-sectional study. Data were collected using the staff information form and safety attitudes questionnaire. The study population was 350 nurses working in Mansoura University Hospital. Data were analyzed with frequency, percentage, mean, standard deviation, the Chi squire test, and ANOVA tests using SPSS. Results: None of the six domains of safety attitude – job satisfaction, teamwork, safety climate, the perception of management, stress recognition, and working conditions – were awarded a positive mean score above 75. 51.4% of the nurses had a neutral attitude toward patient safety. The main associated factors were educational level, experience, and attending training courses related to patient safety, which had a high effect on nurses’ attitude (p-value 0.05). Conclusions: The attitude of nurses towards patient safety at Mansoura University Hospital was neutral, and strongly associated with educational level, years of experience, and attending training courses on patient safety. Therefore, it is strongly recommended to develop strategies towards an increasingly successful patient safety culture.

Objective: to analyze the relationship between Burnout Syndrome and perceptions about safety climate among intensive care professionals. Methods: a cross-sectional study with 51 health professionals from a public hospital in northeastern Brazil. The following instruments were applied: the Maslach Burnout Inventory, the Safety Attitudes Questionnaire, and a Sociodemographic questionnaire. Descriptive, analytical (Spearman’s test) and inferential statistics were adopted. Results: there was a high level of emotional exhaustion (64.7%) and low levels of depersonalization (74.5%) and personal accomplishment (56.8%) in the Burnout assessment. The safety climate was considered satisfactory, with the Safe Behaviors domain having the highest average. There was a moderate correlation between the Stress recognition and Depersonalization subscales. Conclusion: there was a correlation between safety climate and Burnout in the Stress recognition and Depersonalization dimensions, with the latter being considered a consequence of stressful factors which distance professionals from patients. Objetivo: analisar a relação entre a Síndrome de Burnout e as percepções acerca do clima de segurança entre profissionais intensivistas. Métodos: estudo transversal, com 51 profissionais de saúde de hospital público do nordeste brasileiro. Aplicaram-se os instrumentos: Inventário de Burnout de Maslach, Questionário de Atitudes de Segurança e Questionário sociodemográfico. Adotaram-se estatísticas descritiva, analítica (teste de Spearman) e inferencial. Resultados: na avaliação do Burnout, constatou-se nível alto de exaustão emocional (64,7%) e níveis baixos de despersonalização (74,5%) e realização profissional (56,8%). O clima de segurança foi considerado satisfatório, sendo o domínio Comportamentos seguros o que obteve maior média. Evidenciou-se correlação moderada entre as subescalas Percepção do estresse e Despersonalização. Conclusão: constatou-se correlação entre clima de segurança e Burnout, nas dimensões Percepção do estresse e Despersonalização, sendo que esta segunda pode ser considerada consequência de fatores estressantes que distanciam o profissional do paciente.

Background and Objective Traditional methods to determine stress and anxiety in academic environments consist of the application of questionnaires, but the main disadvantage is that the results depend on the students’ self-perception. Being able to detect anxiety-related stress levels in a simple and objective way contributes greatly to dealing with low performance and school drop-out by students. Methods The main contribution of this study is to identify the physiological features that could be used as predictors of stressful activities and states of anxiety in academic environments using an Arduino board and low-cost sensors. A test with 21 students was conducted, and a stress-inducing protocol was proposed and 21 physiological features of five signals were analyzed. In addition, the State-Trait Anxiety Inventory (STAI) was used to assess the level of anxiety for each student. Four classifiers were compared to find the physiological feature subset that provides the best accuracy to identify states of stress and anxiety. Results The stress due to activities performed by students can be identified with an accuracy greater than 90% (Kappa = 0.84) using the k-Nearest Neighbors classifier, using data from heart rate, skin temperature and oximetry signals and four physiological features. Meanwhile, the identification of anxiety was achieved with an accuracy greater than 95% (Kappa = 0.90) using the SVM classifier with data from the galvanic skin response (GSR) signal and three physiological features. Conclusions The results provide a clue that anxiety detection in academic environments could be done using the analysis of physiological signals instead of STAI test scores. Besides, the results suggest that physiological features could be used to develop stress recognition systems to help teachers to identify the stressful tasks in an academic environment or to develop anxiety recognition systems to help students to control their level of anxiety when they are performing either academic tasks or exams.

Aims and Objectives: A dental student in his/her life goes through several academic stresses. Mild stress may be beneficial in cognitive tasks and performance, while persistently high stress may lead to anxiety and depression. Thus, the aim is to compare the stress levels in students appearing for previva and postviva during university examinations. Materials and Methods: The study was carried out on 70 3rd year Bachelor of Dental Surgery students who were appearing for their university practical examination. Heart rate, oxygen saturation and stress levels were measured using Android S-HEALTH software. The data were compared and tabulated. Results obtained were statistically analyzed using paired “t”-test. Results: Heart rate, oxygen saturation and stress levels were statistically high in previva of all the students. Conclusion: It can be concluded that examination is a situational stress resulting in anxiety due to increased levels of plasma cortisol reflected by an increased heart rate, oxygen saturation and stress levels. It is important for students to use stress-reducing measures or to reduce them as much as possible to avoid factors that can affect themselves and their patients in stressful way.

Patient safety culture/climate in maternity units has been linked to better safety outcomes. Nurses have a crucial role in patient safety and represent the majority of staff in maternity units. In many countries, nurses are recruited from abroad, bringing their own perceptions of patient safety culture. Nonetheless, little is known about the relationship between perceptions of patient safety culture and nurses' nationality. Understanding this relationship will assist stakeholders in designing a responsive programme to improve patient safety culture.To investigate the association between nurses' nationality and their perceptions about patient safety culture in maternity units in Ministry of Health hospitals in Oman.In 2017, the Safety Attitude Questionnaire (SAQ) was distributed to all staff (892 distributed, 735 returned) in 10 maternity units.About three-quarters (74%, 541/735) of the returned SAQs were completed by nurses, of whom 34% were non-Omani, 21.8% were Omani and 44.7% did not report their nationality (missing). Overall, the mean safety score for non-Omani nurses was significantly higher than for the Omani nurses: 3.9 (SD 1.3) vs 3.6 (SD 1.2) (P0.001). The mean safety score for stress recognition was significantly lower for non-Omani nurses: 2.8 (SD 1.5) vs 3.2 (SD 1.3) (P0.001).Non-Omani nurses have a more positive perception of patient safety culture than Omani nurses except in respect of stress recognition. Decision-makers, directors, and clinicians should consider these differences when designing interventions to improve patient safety culture.الارتباط بين جنسية طواقم التمريض وبين ثقافة السلامة في وحدات الأمومة في عُمان.وليد الندابي، محمد فيصل، محمد أمين محمد.ارتبطت ثقافة/بيئة سلامة المرضى في وحدات الأمومة دائما بتحقيق مخرجات أفضل فيما يتعلق بالسلامة. وتلعب طواقم التمريض دورا حاسما في تحقيق سلامة المرضى حيث تمثل غالبية الموظفين العاملين في وحدات الأمومة. وفي كثير من البُلدان، تُعيَّ طواقم التمريض من خارج البلاد، ويكون لديها تصوراتها الخاصة حول ثقافة سلامة المرضى. وبالرغم من ذلك، فليس ثمة الكثير من المعلومات حول العلاقة بين التصورات المتعلقة بثقافة سلامة المرضى وجنسية طواقم التمريض. وسوف يساعد فهم تلك العلاقة الأطراف المعنية على تصميم برنامج استجابة يهدف إلى تحسين ثقافة سلامة المرضى.هدفت هذه الدراسة إلى استقصاء الارتباط بين جنسية طواقم التمريض وتصوراتهم بشأن ثقافة سلامة المرضى في وحدات الأمومة في المستشفيات التابعة لوزارة الصحة في عُمان.في عام 2017، وُزِّع "استبيان اتجاهات السلامة" على جميع العاملين (وُزِّع 892، وأُعيد 735) في 10 وحدات أمومة.استكملت طواقم التمريض ثلاثة أرباع (%74، 541 من 735) استبيانات اتجاهات السلامة التي أُعيدت بعد استكمالها، وكان من هؤلاء %34 غير عُمانيين، و%21.8 عُمانيين، و%44.7 لم يُبلغوا بجنسيتهم (معلومات ناقصة). وإجمالا، فقد كان متوسط درجة السلامة لدى طواقم التمريض غير العُمانية أعلى بكثير من طواقم التمريض العُمانية: 3.9 (انحراف معياري 1.3) في مقابل 3.6 (انحراف معياري 1.2) (0.001p)،. كما كان متوسط درجة السلامة بالنسبة للتعرف على التوتر أقل بكثير لطواقم التمريض العُمانية: 2.8 (انحراف معياري 1.5) في مقابل 3.2 (انحراف معياري 1.3) (0.001p).تحظى طواقم التمريض غير العُمانية بتصور أكثر إيجابية بشأن ثقافة سلامة المرضى من طواقم التمريض العُمانية، فيما عدا ما يتعلق بالتعرف على التوتر. ويتعين على صُناع القرار، والمديرين، والأطباء السريريين أخذ تلك الاختلافات في الحسبان عند تصميم التدخلات الرامية إلى تحسين ثقافة سلامة المرضى.Lien entre la nationalité des personnels infirmiers et la culture de sécurité dans les services de maternité dʹOman.Un lien a été établi entre la culture/le climat de sécurité des patients dans les services de maternité et de meilleurs résultats sur le plan de la sécurité. Les infirmiers(ères) jouent un rôle crucial dans la sécurité des patients et représentent la majorité du personnel des services de maternité. Dans de nombreux pays, les personnels infirmiers sont recrutés à l’étranger et apportent leurs propres perceptions de la culture de la sécurité des patients. Néanmoins, le lien entre les perceptions de la culture de la sécurité des patients et la nationalité des personnels infirmiers est mal connu. Comprendre ce lien aidera les parties prenantes à concevoir un programme pertinent pour améliorer la culture de sécurité des patients.La présente étude visait à examiner le lien entre la nationalité des personnels infirmiers et leurs perceptions de la culture de la sécurité des patients dans les services de maternité des hôpitaux du ministère de la Santé à Oman.En 2017, le « Safety attitudes Questionnaire » (SAQ) a été distribué à l’ensemble du personnel de dix services de maternité (892 questionnaires distribués, 735 questionnaires retournés).Près des trois quarts (74 %, 541/735) des questionnaires SAQ retournés ont été remplis par des infirmiers(ères), parmi lesquel(le)s 34 % n’étaient pas omanais(es), 21,8 % étaient omanais(es) et 44,7 % n’avaient pas indiqué leur nationalité (manquante). Globalement, le score de sécurité moyen pour les personnels infirmiers non omanais était beaucoup plus élevé que pour ceux qui étaient omanais : 3,9 (E.T. 1,3) contre 3,6 (E.T. 1,2) (p0,001). Le score de sécurité moyen concernant la reconnaissance du stress était beaucoup moins élevé pour les personnels infirmiers non omanais : 2,8 (E.T. 1,5) contre 3,2 (E.T. 1,3) (p0,001).Les personnels infirmiers non omanais ont une perception plus positive de la culture de la sécurité des patients que les ceux qui sont de nationalité omanaise, excepté pour la reconnaissance du stress. Les décideurs, les directeurs et les cliniciens devraient prendre en compte ces différences pour concevoir des interventions visant à améliorer la culture de la sécurité des patients.

This study investigated factors that affect stress recognition, depression, suicidal thoughts and health-related quality of life for diabetics over 50 years of age. Five hundred one diabetics were surveyed who participated in the 4th Korea National Health and Nutrition Examination Survey 2009. The data were analyzed with multiple regression analysis and Structural Equation Model to determine the factors. The results are as follows. Men, older and lower income groups, those not involved in economic activities, smokers, and drinkers showed a lower quality of life (p

Medical errors are being detected with increasing frequency in healthcare environment, in many cases leading to patient harm. Measurement and improvement of patient safety climate has been identified as a strategic effort towards addressing this vital issue.Safety Attitude Questionnaire (SAQ), validated by previous research was administered to 300 respondents in three tertiary care hospitals of India, the respondents representing various categories of healthcare workers and variations in safety scale score was analyzed by various statistical tools.No variation was observed in the Patient Safety Index score among the study hospitals. However, significant variations were observed among different categories of healthcare workers across dimensions of Teamwork, Perception of Management and Stress Recognition. Multiple Regression models identified Teamwork and Perception of Management to have significant correlation with Patient Safety Index Score.Patient Safety Climate can be effectively assessed and such assessment utilized for focused improvement efforts towards safety in healthcare organizations.

Many studies have shown that the majority of maritime accidents/incidents are attributed to human errors as the initiating cause. Efforts have been made to study human factors that can result in a safer maritime transportation. Among all techniques, Electroencephalogram (EEG) has the advantages such as high time resolution, possibility to continuously monitor brain states with high accuracy, recognition of human mental workload, emotion, stress, vigilance, etc. In this paper, we designed and carried out an experiment to collect the EEG signals to study stress and sharing of the mental workload among crew members during collaboration tasks performance on the ship's bridge virtual simulator. Four maritime trainees were monitored in the experiment. Each of them had a role such as an officer on watch, captain, pilot, or steersman. The results show that the captain had the highest stress and workload. However, the other three trainees experienced low workload and stress due to shared work and responsibility. The EEG is a promising evaluation tool to be used in the human factors study in the maritime domain. National Research Foundation (NRF) Singapore Maritime Institute (SMI) Accepted version This research is supported by Singapore Maritime Institute and by the National Research Foundation, Prime Minister’s Office, Singapore under its International Research Centres in Singapore Funding Initiative. We would like to acknowledge the final year project students of School of MAE of Nanyang Technological University and personally Lee Jian Wei for his contribution in this work.

This paper investigates the potential of stress recognition using the data from heterogeneous sources. Not only physiological signals but also reaction time (RT) is used to recognize different stress states. To acquire the data related to the stress of an individual, we design the experiments with two different stressors: visual stressor (Stroop test) and auditory stressor. During the experiments, the subjects perform RT task. Three physiological signals, Electrodermal activity (EDA), Electrocardiography (ECG) and Electromyography (EMG) as well as RTs are recorded. We develop the classifier based on the Support Vector Machines (SVM) for the stress recognition given the physiological signals and RT respectively. An overall good recognition performance of the SVM classifier is obtained. Besides, we present the strategy of recognition using the decision fusion. The recognition is thus achieved by fusing the classification results of physiological signals and RT with the voting method and a further improvement of recognition accuracy is observed. Results indicate that RT is efficient for stress recognition and the fusion of physiological signals and RT can bring in a more satisfied recognition performance.

Objective To determine operating room professionals'attitudes towards patient safety and the influencing factors. Methods This study was conducted in research hospitals in Izmir, Turkey using descriptive, cross-sectional and correlation research designs. The sample of this study consisted of 477 individuals including nurses, physicians and anesthesia technicians. Data were collected using the Sociodemographic and Working Characteristics Form and the Safety Attitudes Questionnaire. Descriptive statistics method, and Pearson's correlation and the multiple regression models were used for data analysis. Results Operating room professionals' attitudes towards patient safety were at moderate levels. Regarding the influencing factors, team cooperation obtained the highest score, whereas stress recognition obtained the lowest score. As a result of the regression analysis, age, male gender and receiving patient safety training explains 15.4% of the professionals' safety attitudes. Conclusions Receiving patient safety training was found to be the most important variable of all.

In this work, real time stress level recognition from Electroencephalogram (EEG) signal is proposed. Stress is a mental condition that effects the brain electrical activity to be different from the normal state. A system is designed to classify three levels of stress; Low Stress, Moderate Stress and High Stress. Validation of algorithm is carried out using by Stroop color-word test as stimuli to induce various levels of stress. EEG signals are collected using EEG reusable electrodes, which are placed on forehead scalp during the experiment. Measure of stress is taken by means of questionnaires method. Discrete Wavelet Transform (DWT) is used for pre-processing and using Support Vector Machine (SVM) as the classifier. Further analysis of stress is done by using trained algorithm as reference. Signals collected are continually given to algorithm to verify stress, three levels of stress can be recognized. Stress levels of the person under test are seen on screen using graph.

The electroencephalogram (EEG) is a device for measuring the electrical activity of the brain; it has the ability to detect the waves at various frequencies. The device uses a small electrode to record the measurements. The EEG waves can be used to detect many activities in the brain, such as stress. This study identifies stress using EEG signals. Stress causes a certain range of frequencies in the range to change their activities, in which the changes can be analyzed. Test results were filtered properly, and the frequency bands measured. The data shows the difference in the ratio of beta waves and alpha waves in the brain as a result of stress. The changes in the ratio will be able to show the degree of stress encountered.

The detection of stress at early stages is beneficial to both individuals and communities. However, traditional stress detection methods that use physiological signals are contact-based and require sensors to be in contact with test subjects for measurement. In this paper, we present a method to detect psychological stress in a non-contact manner using a human physiological response. In particular, we utilize a hyperspectral imaging (HSI) technique to extract the tissue oxygen saturation (StO2) value as a physiological feature for stress detection. Our experimental results indicate that this new feature may be independent from perspiration and ambient temperature. Trier Social Stress Tests (TSSTs) on 21 volunteers demonstrated a significant difference ( $p\lt 0.005$ ) and a large practical discrimination (d = 1.37) between normalized baseline and stress StO2 levels. The accuracy for stress recognition from baseline using a binary classifier was 76.19 and 88.1 percent for the automatic and manual selections of the classifier threshold, respectively. These results suggest that the StO2 level could serve as a new modality to recognize stress at standoff distances.

Study Objective To measure the safety culture in the robotics surgery operating room before and after implementation of the Robotic Operating Room Computerized Checklist (RORCC). Design Prospective study. Subjects Gynecology surgical staff (n = 32). Setting An urban community hospital. Interventions The Safety Attitudes Questionnaire domains examined were teamwork, safety, job satisfaction, stress recognition, perceptions of management, and working conditions. Questions and domains were described using percent agreement and the Cronbach alpha. Paired t -tests were used to describe differences before and after implementation of the checklist. Measurements and Main Results Mean (SD) staff age was 46.7 (9.5) years, and most were women (78%) and worked full-time (97%). Twenty respondents (83% of nurses, 80% of surgeons, 66% of surgical technicians, and 33% of certified registered nurse anesthetists) completed the Safety Attitudes Questionnaire; 6 were excluded because of non-matching identifiers. Before RORCC implementation, the highest quality of communication and collaboration was reported by surgeons and surgical technicians (100%). Certified registered nurse anesthetists reported only adequate levels of communication and collaboration with other positions. Most staff reported positive responses for teamwork (48%; α = 0.81), safety (47%; α = 0.75), working conditions (37%; α = 0.55), stress recognition (26%; α = 0.71), and perceptions of management (32%; α = 0.52). No differences were observed after RORCC implementation. Conclusion Quality of communication and collaboration in the gynecology robotics operating room is high between most positions; however, safety attitude responses are low overall. No differences after RORCC implementation and low response rates may highlight lack of staff support.

Two hundred and eighty Health care; physicians, nurses and technicians were included in the study, 133 (47.5) from 6th discrete HCF, 54 (19.3%) from Duwaiqa and 93 (33.2%) from Al Haggana. Ages ranged between 22 and 59 years (35.14 ± 10.13), years of experience in the study group ranged between 1 and 35 years (8.72 ± 8.18) and years of work in group ranged between 1 & 40 years (10.43 ± 8.33). Doctors and nurses were males (72.55%) & females (86%) respectively while technicians were mostly males (60%). The teamwork climate score was 3.98 ± 0.87, 64.0% answered high or very high, 16.4% answered inadequate and 18% had answered few or very few. Safety climate score was 3.61 ± 0.63, 49.28% had high or very high score, 17.14% answered inadequate and 32.15% had answered few or very few. Job satisfaction score was 3.91 ± 0.80, 32.15% had answered few or very few, 17.14% answered inadequate and 49.28% answered high or very high. Stress recognition score was 3.61 ± 0.79, 25% had answered few or very few, 28.6% answered inadequate and 45.7% answered high or very high. Perception of management score was 3.48 ± 0.80, 23.2% had answered few or very few, 17.8% answered inadequate and 57.6% answered high or very high. Working condition score was 3.51 ± 0.84, 46.8% had answered few or very few, 17.1% answered inadequate and 35.7% answered high or very high. A significant difference regarding team work score, safety climate score, perception of management score, working condition score with highest value in doctors and lowest in technicians. On the other hand no significant difference was detected regarding job satisfaction score and stress recognition score. A significant difference regarding team work score, safety climate score and perception of management score with high values among older groups. No significant difference was detected regarding job satisfaction score, stress recognition score and working condition score. Also, a significant difference regarding team work score and safety climate score with higher value in males. Significant difference regarding job satisfaction score and working condition score was detected with higher value in females. No significant difference was detected regarding stress recognition score and perception of management scores.

The purpose of this study is to provide an academic basis regarding the necessity of managing depression and stress among metabolic syndrome patients by understanding 5 components of metabolic syndrome, perceived stress, and degree of depression, and by investigating their association using the national nutrition survey reference. This study was conducted by using mental health surveys and health screening test data of the 5th (2010∼2012) primitive data of the national health and nutrition survey. A total of 19,599 respondents over 19 years of age were selected for the final analysis. The level of depression and stress was set as the dependent variable to identify its connection with 5 components of the metabolic syndrome. For the stress recognition, none of the metabolic syndrome components showed a significant correlation. For experiencing the depression symptom, the fasting glucose among the factors showed a significant correlation (p ＜0.05) among the metabolic syndrome factors. When it falls within the criteria of fasting glucose of metabolic syndrome, it has a great probability of falling under the group who experienced greater depression symptoms. As a result of the analysis by controlling cardiovascular and cerebrovascular disease which is tightly related with metabolic syndrome and depression, this study observed that glucose out of 5 metabolic syndrome components is related with depression.

Good mental health is important in our daily life. A person commonly finds stress as a barrier to enhance an individual’s performance. Be reminded that not all people have the same level of stress because different people have dissimilar problems in their life. In addition, different level of age and gender will affect unequal amount of stress. Electrocardiogram (ECG) signal is an electrical indicator of the heart that can detect changes of human response which relates to our emotions and reactions. Thus, this research proposed a non-intrusive detector to identify stress level for both gender and different classification of age using the ECG. A total of 30 healthy subjects were involved during the data acquisition stage. Data acquisition which initialize ECG data were divided into two conditions; which are normal and stress states. ECG data for normal state only need the participant to breath in and out normally. In other hand, the participants also need to undergo Stroop Colour word test as a stress inducer to represent ECG in stress state. Then, Sgolay filter was selected in the pre-processing stage to remove artifacts in the signal. The process was followed by feature extraction of the ECG signal and finally classified using RR Interval (RRI), different amplitudes of R peaks and Cardioid graph were used to evaluate the performance of the proposed technique. As a result, Class 5 (age range between 50-59 years old) marks the highest changes of stress level rather than other classes, while women are more affected by stress rather than men by showing tremendous percentage changes between normal and stress level over the proposed classifiers. The result proves that ECG signals can be used as an alternative mechanism to recognize stress more efficiently with the integration of gender and age variabilities.

Background: community-based midwifery practice has been promoted in the UK maternity policy over the last decade as a means of increasing continuity of care. However, there have been growing concerns to suggest that the community-based continuity model may not be sustainable due to the high levels of occupational burnout in midwives resulted by increased on-call work. Aims: this paper attempted to identify work factors associated with the levels of burnout in community midwives as compared to hospital midwives, aiming at contributing to the debate of organising sustainable midwifery care. Methods: a statistical analysis was conducted drawing on data from a survey of all midwives working at one Hospital Trust in England (n¼ 238). Occupational burnout was measured using the Maslach Burnout Inventory (MBI). Results: the sample midwives (n¼ 128, 54%) had significantly higher levels of burnout compared to the reference groups. Multiple regression analysis identified as follows: (1) high levels of occupational autonomy were a key protective factor of burnout, and more prevalent in the community, (2) working hours were positively associated with burnout, and community midwives were more likely to have higher levels of stress recognition, and (3) support for work-life-balance from the Trust had a significant protective effect on the levels of burnout. Conclusion: the results should be taken into account in the maternity policy in order to incorporate continuity of care and sustainable organisation of midwifery care.

Nowadays, electroencephalographic (EEG) recordings receive increasing attention in the field of emotions recognition with physiological variables. Moreover, the nonlinear nature of EEG signals suggests that nonlinear techniques could be more suitable than linear methodologies for the assessment of mental processes triggered under different emotions. One of the most relevant states is distress (the negative aspect of stress), because of its enormous influence in developed countries and its countless adverse effects in health. As a result, many researches have shown their interest in distress in the last few years. In the present study, a predictability-based entropy measure called amplitude-aware permutation entropy (AAPE) was applied to discern between calm and distress states. EEG signals from 32 channels were individually assessed to obtain the discriminatory ability of each single electrode. After that, only 2 out of 32 EEG channels were combined in a logistic regression model, reaching a global classification accuracy over 73%.

Estudo transversal, analítico e quantitativo, que objetivou avaliar o clima de segurança do paciente na perspectiva dos profissionais da equipe de Enfermagem dos setores de Clínica Médica e Cirúrgica. Participaram 52 profissionais. Os dados foram coletados utilizando-se o Safety Attitudes Questionnaire. Para análises foram utilizados os testes t de Student, análise de variância e correlação de Sperman (α= 0,05). O escore geral médio do instrumento foi 66,94 pontos. O domínio com melhor escore foi “percepção da gerência” (84,60) e os domínios com menor escore foram “condições de trabalho” (60,15) e “percepção do estresse” (55,59). Houve diferenças estatisticamente significantes entre os sexos, nível de escolaridade com o domínio Clima de Segurança. Não houve relação entre a atuação profissional, vínculo empregatício e categoria profissional. Observaram-se fragilidades na percepção da equipe em relação ao clima de segurança, o que remete à necessidade de instituição de estratégias para promoção de um ambiente seguro.

Thirty-one healthy participants performed five stressful HCI tasks (stimuli) while their skin conductance signals were monitored. The selected interaction tasks were most frequently listed as stressful by 15 interviewees, who were typical computer users. At the end of each task, participants expressed their perceived emotional experience using the dimensional Valence-Arousal (VA) rating space. The obtained VA ratings were used to define nine rectangular regions in the VA space, labeled as "stress". Next, five popular machine learning classifiers were employed to identify stress based on the associated skin conductance signals per tested region. Results showed sufficient cross-region stress recognition accuracy; L-SVM: Mean=62.3%, SD=9.3%. Our findings support that the VA scale may be used for stress self-assessments in the context of subtle interaction events, which are typically expected in most HCI tasks.

This study proposed a novel method of stress recognition using photopletysmogram (PPG) signal. PPG devices are now widely used because it is convenient, low powered, cheap and also easy to handle due to its small size. A total of 5 subjects were involved in this study. The PPG signals were taken in resting condition using pulse oximetry. The subject then goes through a stressor test in order to record the physiological changes. The data were collected before and after the test was conducted and later extracted. These samples were then categorised using classification techniques to differentiate between normal and stress condition. Based on the experimentation results, the systolic peak value differences of normal and stress conditions are evident.Therefore, the outcome of this study suggest the reliability of implementing PPG signal for stress recognition.

This study aimed to measure safety culture, examine variations among neonatal intensive care units (NICUs), and assess the associations with caregiver characteristics.A cross-sectional design was used, utilizing the Arabic version of the Safety Attitudes Questionnaire, administered to all 305 nurses and physicians working in the 16 NICUs in the West Bank.There were 204 participants, comprising of mainly nurses (80.4%), women (63%), 30 years or younger (62.6%), holding a bachelor's degree or more (66.7%), and with at least 5 years of experience in the profession (60.3%). Safety Attitudes Questionnaire mean domain scores ranged from 71.22 for job satisfaction to 63 for stress recognition on a 100-point scale; the scores varied significantly among NICUs (P.05). About 85% of the participants rated the safety grade either excellent or very good; 71.0% did not report any event in the past year.We found large variations in safety culture within and between a comprehensive sample of Palestinian NICUs. The findings suggest the need for a customized approach that builds on existing strengths and targets areas of opportunities for improvement to optimize health care delivery to the most vulnerable of patients, sick newborns in the NICU setting.

Background Effective communication skills in the operating room (OR) promote team behaviour and usually result in good patient outcomes. Communication and collaboration constitutes an integral role during this process both with patients and with inter-professionals when working in such a highly specialised setting as an OR. Patient and staff safety in the OR has never been investigated in Cyprus before. Methods One of the most often used tools to assess safety culture in an organisation is the Safety Attitudes Questionnaire (SAQ) (The Evidence Centre, 2011 & Sexton et al, 2006). SAQ is a psychometric instrument used for evaluating healthcare providers and especially operating nurses’ attitudes regarding patient safety and climate. Six major factors are measured through the use of modified SAQ: teamwork climate, job satisfaction, management perception, safety climate, working conditions and stress recognition. A random sample of 112 OR nurses was studied from Makarios III Hospital which is one of the two major public hospitals in Nicosia. Results The sample was comprised of 30 males and 82 females: the majority was working as permanent staff in the hospital and their experience varied from 0–25 years both in total as well as in the specific hospital. Overall participants believed that issues related to guidelines, teamwork and patient safety need further improvements. Males have significantly higher scores regarding experience with safety issues in the OR compared to their female counterparts. Interestingly, the lowest scores regarding nurses’ notions and opinions regarding OR safety were expressed by the most experienced participants, who had more than 25 years of work experience. This is an indication of the need for further improvements in the in-service training which currently takes place in the Cyprus health system. Conclusions More experienced staff might be in need for education regarding more recent safety procedures and techniques followed in the OR.

Background: The traditional medical Oath of ‘first do no harm’ is something that is very rarely breached either intentionally by a doctor, nurse or other health practitioner. Resident is health workers who perform services directly to patients that’s why their knowledge and attitudes towards patient safety are very useful Objective: To determine the relationship of the level of knowledge with the attitudes about patient safety in obstetrics and gynecology resident while services in delivery room at Dr DR Sardjito hospital. Method: Descriptive methods with cross sectional approach, accompanied by a qualitative research The study involved 90 residents of Obstetrics and Gynecology at Sardjito Hospital Yogyakarta , by filling out a questionnaire. Knowledge assessed based on the number of correct answers and categorized into good and bad. Attitudes toward patient safety was assessed using a Safety Attitude Questionnaire (SAQ) labor and delivery version. Reliability was measured using Cronbach’s alpha. The qualitative data collection (interviews) conducted to support the descriptive data. Result and Discussion: Cronbach’s Alpha value for SAQ= 0.862, and the question of knowledge = 0.702. Between 77 responden who had good level of knowlage, only 53,2% had a good level of attitudes, and between 13 who has bad level of knowlage, there were 10 responden with good level of attitudes (76,9%) (RP 0,69;95%CI 0,44-1,04; p= 0,11). Elements of stress recognition on the attitude were getting the lowest average value (3.50 ± 0.56). From the qualitative data were known that the resident had desire for a reduction in working hours as well as improved communication and collaboration between teams. Althogh most of resident had a good level of knowledge and attitudes about patient safety, there were no meaning because of p value was >0,05 (OR 2,69;95%CI 0,66-10,9; p= 0,17). Conclusion: Clinically, a good level of knowledge about patien safety improving a good level of attitude towards patient safety. Keywords: Knowledge- attitude- patient safety- resident obstetrics

This paper deals with speech signal under psychological stress. The investigation into the speaker’s stress is based on statistical analysis of smooth vowel spectra. In total, fifteen features based on formants, antiformants and inflexion points of spectral envelope were analysed and evaluated. The most effective features for stress detection across all speakers were as follows: frequency of the second formant of /a/, frequency of the first formant of /i/, and lower part of bandwidth of the third formant of /u/ and /a/. The results indicate that speakers tend to follow an individual trend and speaker dependent stress recognition might be more appropriate. DOI: http://dx.doi.org/10.5755/j01.eee.18.10.3059

Objectives To describe the authors' hospital-wide efforts to improve safety climate at a large academic medical centre. Design and setting A prospective cohort study used multiple interventions to improve hospital-wide safety climate. 144 clinical units in an urban academic medical centre are included in this analysis. Interventions The comprehensive unit-based safety programme included steps to identify hazards, partner units with a senior executive to fix hazards, learn from defects, and implement communication and teamwork tools. Hospital-level interventions were also implemented. Main outcome measures Safety climate was assessed annually using the safety attitudes questionnaire. The safety culture goal was to meet or exceed the 60% minimum positive score or improve the score by ≥10 points. Results Response rates were 77% (2006) and 79% (2008). For safety climate, 55% of units in 2006 and 82% in 2008 achieved the culture goal. For teamwork climate, 61% of units in 2006 and 83% in 2008 achieved the culture goal. The mean safety climate improvement (difference score) for 79 units at or above 60% in 2006 was 0.201 in 2008; the mean improvement for the 65 units below the threshold was 18.278. The mean teamwork climate improvement (difference score) for the 89 units at or above 60% in 2006 was 0.452 in 2008; the mean improvement for the 55 units below the threshold was 16.176. Climate scores improved significantly from 2006 to 2008 in every domain except stress recognition. Conclusions Hospital-wide interventions were associated with improvements in safety climate at a large academic medical centre.

Nine call center employees wore a skin conductance sensor on the wrist for a week at work and reported stress levels of each call. Although everyone had the same job profile, we found large differences in how individuals reported stress levels, with similarity from day to day within the same participant, but large differences across the participants. We examined two ways to address the individual differences to automatically recognize classes of stressful/non-stressful calls, namely modifying the loss function of Support Vector Machines (SVMs) to adapt to the varying priors, and giving more importance to training samples from the most similar people in terms of their skin conductance lability. We tested the methods on 1500 calls and achieved an accuracy across participants of 78.03% when trained and tested on different days from the same person, and of 73.41% when trained and tested on different people using the proposed adaptations to SVMs.

Objectives To describe the authors' hospital-wide efforts to improve safety climate at a large academic medical centre. Design and setting A prospective cohort study used multiple interventions to improve hospital-wide safety climate. 144 clinical units in an urban academic medical centre are included in this analysis. Interventions The comprehensive unit-based safety programme included steps to identify hazards, partner units with a senior executive to fix hazards, learn from defects, and implement communication and teamwork tools. Hospital-level interventions were also implemented. Main outcome measures Safety climate was assessed annually using the safety attitudes questionnaire. The safety culture goal was to meet or exceed the 60% minimum positive score or improve the score by ≥10 points. Results Response rates were 77% (2006) and 79% (2008). For safety climate, 55% of units in 2006 and 82% in 2008 achieved the culture goal. For teamwork climate, 61% of units in 2006 and 83% in 2008 achieved the culture goal. The mean safety climate improvement (difference score) for 79 units at or above 60% in 2006 was 0.201 in 2008; the mean improvement for the 65 units below the threshold was 18.278. The mean teamwork climate improvement (difference score) for the 89 units at or above 60% in 2006 was 0.452 in 2008; the mean improvement for the 55 units below the threshold was 16.176. Climate scores improved significantly from 2006 to 2008 in every domain except stress recognition. Conclusions Hospital-wide interventions were associated with improvements in safety climate at a large academic medical centre.

Purpose: The aim of this study was to assess health-related behavior of pregnant women and breastfeeding mothers by investigating relevant risk factors. Methods: Data of 10,396 women (age 19 to 49 years) from the Korea National Health and Nutrition Examination Survey report from 2007 to 2012 was used to analyze factors associated with health-related behavior. The subjects were divided into pregnant women; breastfeeding mothers; and non-pregnant women. Bottle feeding mothers were excluded. Results: Current smoking rate including self-reported smoker and/or positive cotinine urine test were lower for pregnant or breast-feeding group than non-pregnant group. Heavy-drinking was not different among groups while monthly drinking rate was higher in non-pregnant group. Rate of stress recognition was lower in pregnant and breast-feeding group than non-pregnant group. Rate of experience for depressive symptoms and rate of suicidal ideation were not different among groups. Conclusion: Pregnant women and breast-feeding mothers maintain a good pattern of health- related behavior compared to non-pregnant women. However, substantial proportion of pregnant women and breast-feeding mothers continue to drink and smoke. This shows the need for a plan that will modify health-related behavior.

Background Our previous analyses using the Stress Recognition subscale of the Safety Attitudes Questionnaire (SAQ) resulted in significant effect estimates with equally opposing explanations. We suspected construct validity issues and investigated such using our own data and correlation matrices of previous published studies. Methods The correlation matrices for each of the SAQ subscales from two previous studies by Speroff and Taylor were replicated and compared. The SAS Proc Factor procedure and the PRIORS = SMC option were used to perform Common Factor Analysis. Results The correlation matrices of both studies were very similar. Teamwork, Safety Climate, Job Satisfaction, Perceptions of Management and Working Conditions were well-correlated. The correlations ranged from 0.53 to 0.76. For Stress Recognition correlations ranged from -0.15 to 0.03. Common Factor Analysis confirmed the isolation of Stress Recognition. CFA returned a strong one-factor model that explained virtually all of the communal variance. Stress Recognition loaded poorly on this factor in both instances, and the CFA indicated that 96.4-100.0% of the variance associated with Stress Recognition was unique to that subscale, and not shared with the other 5 subscales. Conclusions We conclude that the Stress Recognition subscale does not fit into the overall safety climate construct the SAQ intended to reflect. We recommend that this domain be omitted from overall safety climate scale score calculations, and clearly identified as an important yet distinct organizational construct. We suggest that this subscale be investigated for its true meaning, characterized as such, and findings conveyed to SAQ end users. We make no argument against Stress Recognition as an important organizational metric, rather we suggest that as a stand-alone construct its current packaging within the SAQ may be misleading for those intent on intervention development and evaluation in healthcare settings if they interpret Stress Recognition results as emblematic of safety climate.

Purpose: This study was conducted to examine the factors associated with work related injuries of nurses in small and medium sized hospitals. Method: A cross-sectional survey was conducted with nurses in eight hospitals from October 2007 to January 2008. A questionnaire was designed to collect information on nurses' wo rk related injuries, and individual and job related characteristics. The response rate was 65.1%. Data from 294 nurses were analyzed. Multiple logistic regression analysis was performed to determine factors associated with work related injuries. Result: Of the 294 nurses, 19.1% (n=56) responded as having at least one injury during their job performance. The logistic regression analysis revealed that the significant factors influencing work related injuries were job satisfaction, stress recognition, and hospital's location. Nurses with a higher job satisfaction were less likely to experience work related injuries (OR=0.58). Nurses with a higher stress recognition (OR=2.57) and those working at hospitals in metropolitan cities (OR=3.28) were more likely to experience work related injuries. Conclusions: The result of this study indicated that a substantial proportion of nurses in small and medium sized hospitals had experienced injuries related to nursing job. Interventions to prevent work related injuries among nurses should take into account the job satisfaction, stress recognition, and hospital characteristics.

Our aim is to improve the performance of the early recognition of chronic stress, through more effective monitoring of physiological signals produced as people live their daily lives (as opposed to monitoring during brief examination periods when physical activity is controlled). Physiological signals are influenced not only by responses to stress but also by physical activities, and it is necessary to distinguish between these two types of influence. There are basically two approaches to doing this. One is to separate the signals in terms of states of physical activity, such as sitting, walking, or running (the “Activity State” approach), and the other is to separate the signals in terms of the magnitude of physical activity (the “Activity Magnitude” approach). To determine which approach leads to better stress recognition performance, we performed evaluations using a database of 64 subjects and compared results for the two approaches. Results showed that the “Activity State” approach was, to a statistically significant degree, superior to the “Activity Magnitude” approach in the recognition of chronic stress.