{"id":29561,"date":"2024-02-28T01:40:30","date_gmt":"2024-02-28T01:40:30","guid":{"rendered":"https:\/\/academicwritersbay.com\/writings\/review-the-resources-and-select-one-current-national-healthcare-issue-stressor-to-focus-on-reflect-on-the-current-national-healthcare-issue-stressor-you-selected-and-think-ab\/"},"modified":"2024-02-28T01:40:30","modified_gmt":"2024-02-28T01:40:30","slug":"review-the-resources-and-select-one-current-national-healthcare-issue-stressor-to-focus-on-reflect-on-the-current-national-healthcare-issue-stressor-you-selected-and-think-ab","status":"publish","type":"post","link":"https:\/\/academicwritersbay.com\/writings\/review-the-resources-and-select-one-current-national-healthcare-issue-stressor-to-focus-on-reflect-on-the-current-national-healthcare-issue-stressor-you-selected-and-think-ab\/","title":{"rendered":"Review the Resources and select one current national healthcare issue\/stressor to focus on.   Reflect on the current national healthcare issue\/stressor you selected and think ab"},"content":{"rendered":"<div class='css-tib94n'>\n<div class='css-1lys3v9'>\n<div>\n<p><strong>To Prepare:<\/strong><\/p>\n<ul>\n<li>Review the Resources and select one current national healthcare issue\/stressor to focus on.<\/li>\n<li>Reflect on the current national healthcare issue\/stressor you selected and think about how this issue\/stressor may be addressed in your work setting.<\/li>\n<\/ul>\n<h3>BY DAY 3 OF WEEK 1<\/h3>\n<p><strong>Post<\/strong>\u00a0a description of the national healthcare issue\/stressor you selected for analysis, and explain how the healthcare issue\/stressor may impact your work setting.\u00a0Which social determinant(s) most affects this health issue?\u00a0Then, describe how your health system work setting has responded to the healthcare issue\/stressor, including a description of what changes may have been implemented. Be specific and provide examples.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<div class='css-6a9esh'>\n<div class='css-eql546'>\n<ul class='css-2imjyh'>\n<li class='css-1960nst'>\n<div class='css-1nylpq2'>\n<div class='css-1yqrwo0'>Personalized_Stress_Monitoring_AI_System_For_Healthcare_Workers.pdf<\/div>\n<\/p><\/div>\n<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<div>\n<p>2021 IEEE International Conference on Bioinformatics and Biomedicine (BIBM) <\/p>\n<p>978-1-6654-0126-5\/21\/$31.00 \u00a92021 IEEE 2992 <\/p>\n<p>PERSONALIZED STRESS MONITORING AI SYSTEM FOR HEALTHCARE WORKERS <\/p>\n<p>Raina Ghanshyam Bangani\u2020,Vineetha Menon\u2020,Emil Jovanov\u2021 <\/p>\n<p>\u2020 Department of Computer Science \u2021 Department of Electrical and Computer Engineering <\/p>\n<p>University of Alabama in Huntsville, USA <\/p>\n<p>ABSTRACT <\/p>\n<p>In the current COVID-19 pandemic scenario, healthcare workers, in particular nurses, face prolonged exposure to stress. This intense duress takes a toll on their health over- time, affects their quality of life, and in turn impacts the quality of care provided to the patients. Hence, real-time detection and monitoring of stress is extremely important for early detection of stress patterns, prevention of burnouts and chronic conditions in healthcare workers as well as facilitate improved patient-care outcomes. In this paper, we present a proof-of-concept case study using machine learning (ML) and artificial intelligence (AI)-based stress detection model that determines a personalized assessment of stress level us- ing heart rate, heart rate variability, and physical activity of the users. We used wearable electrocardiogram and iner- tial sensor to record heart activity and physical activity of nurses during their shifts. Our preliminary results indicate that the proposed stress tracking model can effectively pre- dict any stress occurrences. This study is a pivotal attempt to emphasize the significance of stress-detection and relief for healthcare workers and provide them a tool for an effective assessment of personalized stress levels. <\/p>\n<p>Index Terms\u2014 Personalized stress monitoring, machine learning, CNN, AI, K-Means clustering, classification <\/p>\n<p>1. INTRODUCTION <\/p>\n<p>Stress represents our body\u2019s response to physical or psycho- physiological conditions that threatens (physical or per- ceived) homeostasis. A \u2018stressor\u2019 is a stimulus that disrupts homeostasis. In the US, one-third of employees report their job as stressful. As a reaction to stressful events our body releases hormones such as cortisol and adrenaline to make the person more alert. After the event has transpired, other hormones are then released to relax a person\u2019s body. This re- sponse is called as \u2018fight, flight or freeze\u2019 response. Long term <\/p>\n<p>We thank the Gulf Research Program of the National Academies of Sci- ences, Engineering, and Medicine for supporting this work. DISCLAIMER : \u201dThe content is solely the responsibility of the authors and does not necessar- ily represent the official views of the Gulf Research Program or the National Academies of Sciences, Engineering, and Medicine.\u201d <\/p>\n<p>exposure to stress leads to progressive increase in heart rate, elevated levels of stress hormones and blood pressure[1, 2]. <\/p>\n<p>Although the causes of stress may vary from one indi- vidual to another, some common causes include trauma, de- manding work schedules, juggling multiple responsibilities, etc. [1, 2]. Long-term exposure to stressful conditions can have adverse effects on health. It makes one more prone to conditions such as fatigue, high blood pressure, diabetes, stress-related heart conditions, obesity, mental disorders such as anxiety and depression [2]. Work environments are often one of the crucial contributing factors to observed stress lev- els in a person [3]. Especially healthcare workers like the nurses work in an intense stressful dynamic environment with utmost priority for patient-care which allows no margin of error. Such prolonged stressful work conditions can eventu- ally take a toll on the health and well-being of nursing and healthcare community at-large. Many studies have shown a definite correlation between the personal health of nurses and the quality of patient-care they provide [4\u20137]. Therefore, it is consequential to assist our frontline workers like the nurses and equip them with a stress monitoring tool that can detect early indications of stress. The proposed personalized stress monitoring system is an innovative life-saver biomedical tool can enable timely intervention and feedback in order to avert any long-term adverse health effects due to stress. <\/p>\n<p>In this novel work, we introduce an automated personal- ized stress detection and monitoring system using ML and AI techniques to determine and track personalized stress levels based on biophysical indicators such as heart rate and heart rate variability (HRV) in real-time for continuous monitoring and stress assessment [8]. It is important to note that occupa- tional environments, exposure to stress, and various physical and psychological factors determine the perceived personal- ized stress levels which are innately different for every indi- vidual. For the proposed stress monitoring system, we first extract a sequence of RR intervals as the time between two consecutive R peaks in the QRS signal of the Electrocardio- gram (ECG) signal to find the immediate heart rate and cal- culate measures of HRV such as RMSSD, NN50 and pNN50. Detailed discussion on ECG signal preprocessing and pro- posed personalized stress monitoring system is presented in Section 2. Preliminary analysis and results are discussed in <\/p>\n<p>20 21 <\/p>\n<p> IE EE <\/p>\n<p> In te <\/p>\n<p>rn at <\/p>\n<p>io na <\/p>\n<p>l C on <\/p>\n<p>fe re <\/p>\n<p>nc e  <\/p>\n<p>on  B <\/p>\n<p>io in <\/p>\n<p>fo rm <\/p>\n<p>at ic <\/p>\n<p>s a nd <\/p>\n<p> B io <\/p>\n<p>m ed <\/p>\n<p>ic in <\/p>\n<p>e  (B <\/p>\n<p>IB M <\/p>\n<p>) |  9 <\/p>\n<p>78 -1 <\/p>\n<p>-6 65 <\/p>\n<p>4- 01 <\/p>\n<p>26 -5 <\/p>\n<p>\/2 1\/ <\/p>\n<p>$3 1. <\/p>\n<p>00  \u00a9 <\/p>\n<p>20 21 <\/p>\n<p> IE EE <\/p>\n<p> |  D <\/p>\n<p>O I:  <\/p>\n<p>10 .1 <\/p>\n<p>10 9\/ <\/p>\n<p>B IB <\/p>\n<p>M 52 <\/p>\n<p>61 5. <\/p>\n<p>20 21 <\/p>\n<p>.9 66 <\/p>\n<p>93 21 <\/p>\n<p>Authorized licensed use limited to: Walden University. Downloaded on February 27,2024 at 04:02:05 UTC from IEEE Xplore.  Restrictions apply. <\/p>\n<\/p><\/div>\n<div>\n<p>2993 <\/p>\n<p>Section 3, and Section 4 summarizes our novel contributions in this work. <\/p>\n<p>2. PERSONALIZED STRESS MONITORING AND DETECTION SYSTEM <\/p>\n<p>Data Description: The case study presented in this paper uses an existing dataset from an experiment designed to moni- tor stress of nurses during a single work shift in 2011 [9]. This datasset consists of ECG and physical activity data of six sub- jects. The dataset is recorded using a wearable patch sensor BioStamp from mc10 [10]. The patch records person\u2019s elec- trocardiogram (ECG) signal data and 3 axis of acceleration of the inertial sensor. Although a machine learning algorithms would benefit from a much larger number of subjects, the existing dataset presents an unique opportunity to evaluate a proof-of-concept for a personalized stress assessment system. Moreover, our preliminary analysis indicate that the number of epochs during a whole day recording provides a sufficient dataset for training and analysis using machine learning algo- rithms. <\/p>\n<p>2.1. R-peak Detection <\/p>\n<p>The first step is offline preprocessing of the ECG signal ac- quired from biosensors to determine the R peaks and RR- intervals present in the data. For this, we perform R-peak detection in the wavelet domain to exploit its denoising and simultaneous time-frequency resolution properties. Discrete Wavelet Transform (DWT) decomposes any given signal into various components such that each level describes the change in the signal for a given frequency band. The maximal overlap discrete wavelet transform (MODWT) with \u2019sym4\u2019 wavelet was used to detect the wavelets till level 5. Matlab Signal Processing Toolbox is used to extract the R peak values and the corresponding RR-intervals are computed [11]. <\/p>\n<p>2.2. Proposed Stress Monitoring System <\/p>\n<p>Since the ECG signal and RR-interval data available are un- structured, K-Means clustering method is used to determine the initial stress clusters. The goal is to determine whether the nurse is stressed at any given point in time based on the sub- ject\u2019s RR-intervals and RMSSD data. The algorithm for the proposed stress monitoring techniques is detailed as follows: <\/p>\n<p>\u2022 Step 1: Wavelet domain R-peak detection: R-peaks are detected using MODWT technique with \u2018sym4\u2019 wavelet[11]. Corresponding RR-intervals are com- puted. <\/p>\n<p>\u2022 Step 2: Outlier detection: Outliers in the data were identified using matlab function \u2018rmoutliers()\u2019 and re- moved. This process removes datapoints that have value more than three median absolute deviation. This process was done in batches of 5000 RR-intervals. <\/p>\n<p>\u2022 Step 3: RMSSD calculations for HRV: Root Mean Square of Squared Differences (RMSSD) is computed from the RR intervals as below: <\/p>\n<p>RMSSD = <\/p>\n<p>\u221a\u221a\u221a\u221a 1 <\/p>\n<p>N \u2212 1 <\/p>\n<p>N\u22121\u2211 i\u22121 <\/p>\n<p>((R\u2212R)i+1 \u2212 (R\u2212R)i)2 <\/p>\n<p>(1) <\/p>\n<p>\u2022 Step 4: K-Means Clustering: K means clustering is used to categorize RR-interval vs RMSSD data into the three distinct stress categories: low, normal, and high stress clusters present in the data. The outliers xoutlier <\/p>\n<p>in each stress cluster category as depicted in Figure 1 is estimated as follows: <\/p>\n<p>xoutlier = \u221a <\/p>\n<p>(x(i, 1)\u2212 x(centroid, 1))2 (2) <\/p>\n<p>Fig. 1. K-Means-based cluster preprocessing of stress regions for all subjects <\/p>\n<p>The overlapping K-Means cluster centroids for all sub- jects are denoted by the black square marker in Figure 1. The distance from the centroids is used to measure the belongingness of all points to the respective stress clusters for a personalized stress cluster identification and processing for all subjects as described below: <\/p>\n<p>\u2013 Low Stress cluster (Green cluster in Figure 1) \u2013 outliers are values that are greater than 1\/4th of the average distance values in that cluster. <\/p>\n<p>\u2013 Normal Stress cluster (Blue) \u2013outliers are the val- ues that are greater than half of the average dis- tance values in that cluster. <\/p>\n<p>\u2013 High Stress cluster (Red) \u2013outliers are the values that are greater than 2\/7th of the average distance values in that cluster. <\/p>\n<p>Authorized licensed use limited to: Walden University. Downloaded on February 27,2024 at 04:02:05 UTC from IEEE Xplore.  Restrictions apply. <\/p>\n<\/p><\/div>\n<div>\n<p>2994 <\/p>\n<p>These thresholds were chosen empirically based on ex- pert input on density and generic spread of stress cluster data for all subjects. <\/p>\n<p>Fig. 2. The three stress regions identified for subject 1 <\/p>\n<p>\u2022 The stress cluster information from Figure 1 is used to identify the desired stress categories to obtain Figure 2 and generate corresponding stress labels as follows: <\/p>\n<p>\u2013 For \u2018Low Stress\u2019 cluster (green) in Figure 2: <\/p>\n<p>\u2217 Select the dense green cluster data and green outliers from Figure 1 that have RR-intervals < xgreen\u2212centroid and both RR-intervals and RMSSD values > xgreen\u2212centroid. <\/p>\n<p>\u2217 Select the blue outliers from Figure 1 that have RR-intervals > xblue\u2212centroid. <\/p>\n<p>\u2217 Select the red outliers from Figure 1 that have RR-intervals < xred\u2212centroid and \u2264 0.6 and RMSSD values > xred\u2212centroid. <\/p>\n<p>\u2013 For \u2018Normal Stress\u2019 cluster (Blue) in Figure 2: <\/p>\n<p>\u2217 Select green outliers from Figure 1 that have RR-intervals > xgreen\u2212centroid and RMSSD values \u2264 xgreen\u2212centroid. <\/p>\n<p>\u2217 Select blue cluster data from Figure 1. \u2217 Select red outliers from Figure 1 that have <\/p>\n<p>RR-intervals and RMSSD < xred\u2212centroid <\/p>\n<p>and in the range RR-intervals \u2208\u2264 0.6 and RR-intervals \u2208 {0.6\u2212 0.7}. <\/p>\n<p>\u2013 For \u2018High Stress\u2019 cluster (Red) in Figure 2: <\/p>\n<p>\u2217 Select blue outliers from Figure 1 that have RR-intervals \u2264 xblue\u2212centroid. <\/p>\n<p>\u2217 Select red cluster data from Figure 1, blue outliers that have RR-intervals > xred\u2212centroid <\/p>\n<p>and data values that have RR-intervals < <\/p>\n<p>xred\u2212centroid, RR-intervals \u2208 {0.6 \u2212 0.7} and RMSSD values > xred\u2212centroid. Also include blue outliers that have RR-intervals < xred\u2212centroid and > 0.7. <\/p>\n<p>These thresholds were empirically chosen based on the expert input and the outlier detection from step 2. The RR-intervals of 0.6 and 0.7 are chosen because the min- imum value of RR interval is given as 0.5 by the expert. <\/p>\n<p>\u2022 Step 5: Supervised Classification: Five ML and AI supervised classifiers are then trained on the obtained stress categories for stress detection and monitoring: <\/p>\n<p>Decision Tree \u2013It represents the rules learning in a tree- like structure where every internal node denotes a feature. Starting from root node, at every decision node, it chooses the branch to go to next level based on the value of an attribute. The leaf nodes represent the predicted class label. The rules (branching conditions) are learnt from the training data. <\/p>\n<p>Na\u0131\u0308ve Bayes Classifier \u2013It is a probabilistic classifier based on the Bayes Theorem. It assumes that the predictor variables are independent. The predicted class label is the class with maximum probability. <\/p>\n<p>Logistic Regression \u2013Logistic Regression is a binary classifier. It uses logistic function to map the relation be- tween the dependent and independent variables. In this work, we have used multinomial logistic regression classifier which predicts the probabilities for data points belonging to multi- ple classes. The predicted label is chosen as the class with maximum probability. <\/p>\n<p>Support Vector Machine (SVM) \u2013Principle of SVM is that it finds a hyperplane that maximizes margin to divide classes in the most optimal manner. Since SVM is a binary classifier, for this work, we have used the one vs. one en- semble SVM training model. In a one vs one approach, 3 binary classifiers are trained as follows: class 1 (Low Stress) vs. class 2 (Normal Stress), class 2 (Normal Stress) vs. class 3 (High Stress) and for class 1(Low Stress) vs. class 3 (High Stress). The class that receives the maximum votes is chosen as the predicted label. <\/p>\n<p>Convolution Neural Network (CNN) \u2013CNNs are deep learning techniques which are widely used for image and text classification. It has multiple convolution layers fol- lowed by fully connected neural network. The input is given in the form of (2\u00d71) vectors (Average RR interval\/minute, RMSSD\/minute). Learning rate for the network is chosen as 0.01. A stochastic gradient descent with momentum (SGDM) optimizer is used in the network with number of epochs=50. The CNN architecture employed is illustrated in Figure 3. <\/p>\n<p>To summarize, the proposed personalized stress detection and monitoring system uses K-means clustering to determine the underlying stress clusters present in the data. The clus- ter centroids obtained from K-means clustering algorithm are further used to refine the desired stress categories, i.e., low, <\/p>\n<p>Authorized licensed use limited to: Walden University. Downloaded on February 27,2024 at 04:02:05 UTC from IEEE Xplore.  Restrictions apply. <\/p>\n<\/p><\/div>\n<div>\n<p>2995 <\/p>\n<p>Fig. 3. CNN Architecture used for stress detection <\/p>\n<p>normal and high stress. The normal stress region of the indi- vidual is extracted from the data adaptively based on the clus- ter centroids creating a personalized stress monitoring system. This categorized RMSSD vs RR-interval stress data is further used to train our ML\/AI classifiers. <\/p>\n<p>3. EXPERIMENTAL RESULTS In this section, we demonstrate the efficacy and proof-of- concept of our proposed case study for personalized stress detection and assessment system using five ML\/AI super- vised classification techniques, namely, decision tree, naive Bayes, logistic regression, SVM, and CNN. In this novel framework, we have employed a mix of supervised and un- supervised techniques for stress detection as discussed in Section 2 to generate class labels using K-Means clustering based on HRV bio-markers. We also determine two decision boundaries for stress levels: boundary 1: between low and normal stress, and boundary 2: between high and normal stress regions. This automated detection of stress regions based on personalized bio-markers is what makes this work novel and unique. <\/p>\n<p>Fig. 4. The three stress regions identified for subject 2 <\/p>\n<p>Fig. 5. The three stress regions identified for subject 3 <\/p>\n<p>The proposed model was trained using the data of sub- ject 1 and tested on the rest of the 5 subjects. The goal is to classify the given RR intervals Vs. RMSSD for a one-minute window to determine whether or a person is stressed or op- erating under normal conditions. Therefore, from the given ECG signal data, average RR intervals and RMSSD values were calculated over one minute window and the proposed al- gorithm steps described in Section 2 were followed. The HRV measures considered for this work are RMSSD and pNN50. RMSSD is the root mean square of successive differences of RR intervals as defined in equation 1. pNN50 is defined as the NN50(number of consecutive RR intervals that differ by more than 50 ms) divided by the total number of RR intervals [12]. Experimentally, RMSSD had better statistical distribu- tion properties than pNN50, hence RMSSD was chosen for all trials [12]. <\/p>\n<p>The stress regions and decision boundaries for subject 1 which was used to train the supervised classification model is shown in Figure 2. The performance of the proposed stress detection model for subjects 2-6 is depicted in Figures 4-8. Although the proposed model was not trained using subject <\/p>\n<p>Authorized licensed use limited to: Walden University. Downloaded on February 27,2024 at 04:02:05 UTC from IEEE Xplore.  Restrictions apply. <\/p>\n<\/p><\/div>\n<div>\n<p>2996 <\/p>\n<p>Fig. 6. The three stress regions identified for subject 4 <\/p>\n<p>2, it is seen that the proposed model provided good identifica- tion of stress regions for all the subjects under consideration. Thus, it was able to extract personalized stress regions for monitoring and assessment for all 6 subjects. The overall pre- diction accuracy for all the test subjects across all the methods using cross validation is as shown in Figure 9. It can be ob- served that decision tree has the highest overall classification accuracy and outperformed all methods for all subjects even at low training sizes as 10%. Overall decision tree and logis- tic regression classifiers perform better than others in com- parison. Therefore, we have experimentally substantiated the proof-of-concept of our proposed stress detection and moni- toring system. This work is an inspiring attempt to provide early stress detection and intervention support to healthcare workers and community at-large. <\/p>\n<p>4. CONCLUSIONS In this paper, we have proposed a case study and proof-of- concept for a personalized stress detection and assessment system based on AI\/ML techniques to provide a continu- ous stress monitoring and assessment. Overall decision tree classifier-based stress model gave superior stress detection accuracy over 95% for low training sizes in comparison to others. The motivation behind this work was that the health- care workers like nurses tend to have elevated stress levels that could significantly influence their personal health and quality of patient care they provide. <\/p>\n<p>5. FUTURE WORK <\/p>\n<p>For future work, we would like to extend the scope of our pro- posed AI-based stress monitoring and prediction system and integrate it with physical activity for a more comprehensive personalized stress analysis of healthcare workers. We hope <\/p>\n<p>Fig. 7. The three stress regions identified for subject 5 <\/p>\n<p>that this research will sponsor more active efforts in under- standing the stress induced burnout in healthcare workers in this COVID-19 pandemic scenario. <\/p>\n<p>6. ACKNOWLEDGMENT <\/p>\n<p>This research work was supported by an Early Career Re- search Fellowship from the Gulf Research Program of the National Academies of Sciences, Engineering, and Medicine for supporting this work. DISCLAIMER: \u201cThe content is solely the responsibility of the authors and does not neces- sarily represent the official views of the Gulf Research Pro- gram of the National Academies of Sciences, Engineering, and Medicine.\u201d <\/p>\n<p>7. REFERENCES <\/p>\n<p>[1] A. S. Jansen, X. Van Nguyen, V. Karpitskiy, T. C. Met- tenleiter, and A. D. Loewy, \u201cCentral command neurons of the sympathetic nervous system: basis of the fight-or- flight response,\u201d Science, vol. 270, no. 5236, pp. 644\u2013 646, 1995. <\/p>\n<p>[2] L. R. Murphy, \u201cStress management in work settings: A critical review of the health effects,\u201d American journal of health promotion, vol. 11, no. 2, pp. 112\u2013135, 1996. <\/p>\n<p>[3] J. Siegrist, M. Wahrendorf, and Siegrist, Work stress and health in a globalized economy. Springer, 2016. <\/p>\n<p>[4] A. Najimi, A. M. Goudarzi, and G. Sharifirad, \u201cCauses of job stress in nurses: A cross-sectional study,\u201d Ira- nian journal of nursing and midwifery research, vol. 17, no. 4, pp. 301\u2013305, 2012. <\/p>\n<p>Authorized licensed use limited to: Walden University. Downloaded on February 27,2024 at 04:02:05 UTC from IEEE Xplore.  Restrictions apply. <\/p>\n<\/p><\/div>\n<div>\n<p>2997 <\/p>\n<p>Fig. 8. The three stress regions identified for subject 6 <\/p>\n<p>Fig. 9. Overall prediction accuracy of the proposed AI-based personalized stress monitoring system for all subjects <\/p>\n<p>[5] H. K. Spence Laschinger and M. P. Leiter, \u201cThe impact of nursing work environments on patient safety outcomes: the mediating role of burnout\/engagement,\u201d The Journal of nursing administration, vol. 36, no. 5, p. 259\u2014267, May 2006. [Online]. Available: https:\/\/doi.org\/10.1097\/00005110-200605000-00019 <\/p>\n<p>[6] N. Talaee, M. Varahram, H. Jamaati, A. Salimi, M. Attarchi, M. Kazempour Dizaji, M. Sadr, S. Hassani, B. Farzanegan, F. Monjazebi et al., \u201cStress and burnout in health care workers during covid-19 pandemic: vali- dation of a questionnaire,\u201d Journal of Public Health, pp. 1\u20136, 2020. <\/p>\n<p>[7] M. Milosevic, E. Jovanov, K. H. Frith, J. Vincent, and E. Zaluzec, \u201cPreliminary analysis of physiological changes of nursing students during training,\u201d in 2012 Annual International Conference of the IEEE Engineer- ing in Medicine and Biology Society. IEEE, 2012, pp. 3772\u20133775. <\/p>\n<p>[8] W. D. Scherz, R. Seepold, N. M. Madrid, P. Crippa, and J. A. Ortega, \u201cRR interval analysis for the distinction between stress, physical activity and no activity using a portable ecg,\u201d in 2020 42nd Annual International Con- ference of the IEEE Engineering in Medicine &#038; Biology Society (EMBC). IEEE, 2020, pp. 4522\u20134526. <\/p>\n<p>[9] E. Jovanov, K. Frith, F. Anderson, M. Milosevic, and M. T. Shrove, \u201cReal-time monitoring of occupational stress of nurses,\u201d in 2011 Annual International Confer- ence of the IEEE Engineering in Medicine and Biology Society, 2011, pp. 3640\u20133643. <\/p>\n<p>[10] Biostamp wearable patch sensor. [Online]. Available: https:\/\/www.mc10inc.com\/ <\/p>\n<p>[11] MATLAB. R wave detection in the ecg. [Online]. Available: https:\/\/www.mathworks.com\/help\/wavelet\/ ug\/r-wave-detection-in-the-ecg.html <\/p>\n<p>[12] M. Malik, J. T. Bigger, A. J. Camm, R. E. Kleiger, A. Malliani, A. J. Moss, and P. J. Schwartz, \u201cHeart rate variability: Standards of measurement, physiological in- terpretation, and clinical use,\u201d European Heart Journal, vol. 17, no. 3, pp. 354\u2013381, 03 1996. <\/p>\n<p>Authorized licensed use limited to: Walden University. Downloaded on February 27,2024 at 04:02:05 UTC from IEEE Xplore.  Restrictions apply. <\/p>\n<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>To Prepare: Review the Resources and select one current national healthcare issue\/stressor to focus on. Reflect on the current national healthcare issue\/stressor you selected and think about how this issue\/stressor may be addressed in your work setting. BY DAY 3 OF WEEK 1 Post\u00a0a description of the national healthcare issue\/stressor you selected for analysis, and &#8230; <a title=\"Review the Resources and select one current national healthcare issue\/stressor to focus on.   Reflect on the current national healthcare issue\/stressor you selected and think ab\" class=\"read-more\" href=\"https:\/\/academicwritersbay.com\/writings\/review-the-resources-and-select-one-current-national-healthcare-issue-stressor-to-focus-on-reflect-on-the-current-national-healthcare-issue-stressor-you-selected-and-think-ab\/\" aria-label=\"Read more about Review the Resources and select one current national healthcare issue\/stressor to focus on.   Reflect on the current national healthcare issue\/stressor you selected and think ab\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-29561","post","type-post","status-publish","format-standard","hentry","category-essaywr"],"_links":{"self":[{"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/posts\/29561","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/comments?post=29561"}],"version-history":[{"count":0,"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/posts\/29561\/revisions"}],"wp:attachment":[{"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/media?parent=29561"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/categories?post=29561"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/academicwritersbay.com\/writings\/wp-json\/wp\/v2\/tags?post=29561"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}