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1. Physiological Correlates of Time Stress During Game Play

   https://doi.org/10.1007/978-3-030-78635-9_17  

   Lee, D. (July 2021, Communications in computer and information science)

   Stephanidis C., Antona M. (Ed.)

   The objective of this study is to develop and use a virtual reality game as a tool to assess the effects of realistic stress on the behavioral and physiological responses of participants. The game is based on a popular Steam game called Keep Talking Nobody Explodes, where the players collaborate to defuse a bomb. Varying levels of difficulties in solving a puzzle and time pressures will result in different stress levels that can be measured in terms of errors, response times, and other physiological measurements. The game was developed using 3D programming tools including Blender and a virtual reality development kit (VRTK). To measure response times accurately, we added LSL (Lab Stream Layer) Markers to collect and synchronize physiological signals, behavioral data, and the timing of game events. We recorded Electrocardiogram (ECG) data during gameplay to assess heart rate and heart-rate variability (HRV) that have been shown as reliable indicators of stress. Our empirical results showed that heart rate increased significantly while HRV reduced significantly when the participants under high stress, which are consistent with the prior mainstream stress research. This VR game framework is publicly available in GitHub and allows researchers to measure and synchronize other physiological signals such as electroencephalogram, electromyogram, and pupillometry. 

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2. Pregnant women’s daily patterns of well-being before and during the COVID-19 pandemic in Finland: Longitudinal monitoring through smartwatch technology

   https://doi.org/10.1371/journal.pone.0246494  

   Niela-Vilén, Hannakaisa; Auxier, Jennifer; Ekholm, Eeva; Sarhaddi, Fatemeh; Asgari Mehrabadi, Milad; Mahmoudzadeh, Aysan; Azimi, Iman; Liljeberg, Pasi; Rahmani, Amir M.; Axelin, Anna (February 2021, PLOS ONE)

   Ryckman, Kelli K (Ed.)

   Background Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things–based system and smartwatch technology for monitoring women during pregnancy to explore variations in stress, physical activity and sleep. The aim of this study was to examine daily patterns of well-being in pregnant women before and during the national stay-at-home restrictions related to the COVID-19 pandemic in Finland. Methods A longitudinal cohort study design was used to monitor pregnant women in their everyday settings. Two cohorts of pregnant women were recruited. In the first wave in January-December 2019, pregnant women with histories of preterm births (gestational weeks 22–36) or late miscarriages (gestational weeks 12–21); and in the second wave between October 2019 and March 2020, pregnant women with histories of full-term births (gestational weeks 37–42) and no pregnancy losses were recruited. The final sample size for this study was 38 pregnant women. The participants continuously used the Samsung Gear Sport smartwatch and their heart rate variability, and physical activity and sleep data were collected. Subjective stress, activity and sleep reports were collected using a smartphone application developed for this study. Data between February 12 to April 8, 2020 were included to cover four-week periods before and during the national stay-at-home restrictions. Hierarchical linear mixed models were exploited to analyze the trends in the outcome variables. Results The pandemic-related restrictions were associated with changes in heart rate variability: the standard deviation of all normal inter-beat intervals (p = 0.034), low-frequency power (p = 0.040) and the low-frequency/high-frequency ratio (p = 0.013) increased compared with the weeks before the restrictions. Women’s subjectively evaluated stress levels also increased significantly. Physical activity decreased when the restrictions were set and as pregnancy proceeded. The total sleep time also decreased as pregnancy proceeded, but pandemic-related restrictions were not associated with sleep. Daily rhythms changed in that the participants overall started to sleep later and woke up later. Conclusions The findings showed that Finnish pregnant women coped well with the pandemic-related restrictions and lockdown environment in terms of stress, physical activity and sleep. 

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3. Engineering Students Coping With COVID-19: Yoga, Meditation, and Mental Health

   Beddoes, Kacey; Danowitz, Andrew (June 2021, 2021 ASEE Virtual Annual Conference Content Access)

   In 2020, we conducted a nationwide online survey of undergraduate engineering students in the United States to examine how the novel coronavirus pandemic was affecting engineering students’ mental health and what strategies they were using to cope with mental health challenges. The survey was a compilation of validated mental health instruments that screen for depression, anxiety, somatoform disorders, eating disorders, non-specific psychological distress, and post-traumatic stress disorder. Given that prior research has shown that yoga and meditation can help people suffering from anxiety, depression, and post-traumatic stress disorder, we were interested in exploring the subset of respondents who said that they were using yoga and/or meditation to cope with mental health challenges during the pandemic. The research questions addressed in this paper are: 1) What are the demographic characteristics of students who used yoga and/or meditation to cope with mental health challenges of the 2020 novel coronavirus pandemic? and 2) Does the mental health of the students who used these strategies differ in any from the mental health of students who did not use yoga and meditation coping strategies? Based on 669 responses from students at 140 different universities, we found that there were 20 survey items for which the yoga/meditation group fared statistically significantly differently than the non-yoga/meditation group. These 20 items appeared in the screens for depression, anxiety, somatoform disorders, eating disorders, non-specific psychological distress, and post-traumatic stress disorder. For example, yoga and meditation practitioners were significantly less likely to have experienced feelings of hopelessness during the prior 30 days, as well as to have experienced feelings of being so depressed that nothing could cheer them up. A causative relationship cannot be claimed, but the correlations we found align with prior research showing that yoga and meditation can support many aspects of mental health. 

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4. Contrasting Electroencephalography-Derived Entropy and Neural Oscillations With Highly Skilled Meditators

   https://doi.org/10.3389/fnhum.2021.628417  

   Young, Jacob H; Arterberry, Martha E; Martin, Joshua P (April 2021, Frontiers in Human Neuroscience)

   Meditation is an umbrella term for a number of mental training practices designed to improve the monitoring and regulation of attention and emotion. Some forms of meditation are now being used for clinical intervention. To accompany the increased clinical interest in meditation, research investigating the neural basis of these practices is needed. A central hypothesis of contemplative neuroscience is that meditative states, which are unique on a phenomenological level, differ on a neurophysiological level. To identify the electrophysiological correlates of meditation practice, the electrical brain activity of highly skilled meditators engaging in one of six meditation styles (shamatha, vipassana, zazen, dzogchen, tonglen, and visualization) was recorded. A mind-wandering task served as a control. Lempel–Ziv complexity showed differences in nonlinear brain dynamics (entropy) during meditation compared with mind wandering, suggesting that meditation, regardless of practice, affects neural complexity. In contrast, there were no differences in power spectra at six different frequency bands, likely due to the fact that participants engaged in different meditation practices. Finally, exploratory analyses suggest neurological differences among meditation practices. These findings highlight the importance of studying the electroencephalography (EEG) correlates of different meditative practices. 

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5. Physician Stress During Electronic Health Record Inbox Work: In Situ Measurement With Wearable Sensors

   https://doi.org/10.2196/24014  

   Akbar, Fatema; Mark, Gloria; Prausnitz, Stephanie; Warton, E Margaret; East, Jeffrey A; Moeller, Mark F; Reed, Mary E; Lieu, Tracy A (January 2021, JMIR Medical Informatics)

   null (Ed.)

   Background Increased work through electronic health record (EHR) messaging is frequently cited as a factor of physician burnout. However, studies to date have relied on anecdotal or self-reported measures, which limit the ability to match EHR use patterns with continuous stress patterns throughout the day. Objective The aim of this study is to collect EHR use and physiologic stress data through unobtrusive means that provide objective and continuous measures, cluster distinct patterns of EHR inbox work, identify physicians’ daily physiologic stress patterns, and evaluate the association between EHR inbox work patterns and physician physiologic stress. Methods Physicians were recruited from 5 medical centers. Participants (N=47) were given wrist-worn devices (Garmin Vivosmart 3) with heart rate sensors to wear for 7 days. The devices measured physiological stress throughout the day based on heart rate variability (HRV). Perceived stress was also measured with self-reports through experience sampling and a one-time survey. From the EHR system logs, the time attributed to different activities was quantified. By using a clustering algorithm, distinct inbox work patterns were identified and their associated stress measures were compared. The effects of EHR use on physician stress were examined using a generalized linear mixed effects model. Results Physicians spent an average of 1.08 hours doing EHR inbox work out of an average total EHR time of 3.5 hours. Patient messages accounted for most of the inbox work time (mean 37%, SD 11%). A total of 3 patterns of inbox work emerged: inbox work mostly outside work hours, inbox work mostly during work hours, and inbox work extending after hours that were mostly contiguous to work hours. Across these 3 groups, physiologic stress patterns showed 3 periods in which stress increased: in the first hour of work, early in the afternoon, and in the evening. Physicians in group 1 had the longest average stress duration during work hours (80 out of 243 min of valid HRV data; P=.02), as measured by physiological sensors. Inbox work duration, the rate of EHR window switching (moving from one screen to another), the proportion of inbox work done outside of work hours, inbox work batching, and the day of the week were each independently associated with daily stress duration (marginal R2=15%). Individual-level random effects were significant and explained most of the variation in stress (conditional R2=98%). Conclusions This study is among the first to demonstrate associations between electronic inbox work and physiological stress. We identified 3 potentially modifiable factors associated with stress: EHR window switching, inbox work duration, and inbox work outside work hours. Organizations seeking to reduce physician stress may consider system-based changes to reduce EHR window switching or inbox work duration or the incorporation of inbox management time into work hours. 

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