Webinar on
Critical Care and Emergency Medicine
Scientific Program
Keynote Session:
Oral Session 1:
- Critical Care | Emergency Medicine | Critical Care Nursing | Critical Care Medicine | Neuro Critical Care | Emergency Nursing
Title: Different insertion techniques of subclavian central lines, driven by POCUS
Biography:
Philipp Willingshofer has received his medical doctorate from the Medical Univesity in Graz in 2008. After having had worked in the Emergency Departement in Washington D.C., USA, he did his residency in Anaesthesia and Critical Care in Austria. During this time he was granted the “Trainee Exchange Programme” award of the European society of Anaesthesiology and was therefore able to do an internship in cardiac anaesthsia at the Royal Papworth Hospital in Cambridge, UK. He finished his residency in 2015 and received the European Diploma in Anaesthesia and Critical Care (EDAIC) and the European Diploma in Intensive Care Medicine (EDIC) in 2016 and 2019. He is therefore certified by the European Society of Anaesthesiology (ESA) and the European Society of Intensive Care Medicine (ESICM). He is finishing a postgraduate University Programme in Medical Law in July 2020. He is currently working at the Kepler University Clinic in Linz and as a prehospital Emergency Physician in Austria and his special interests are Intensive Care Medicine, Cardiac Anaesthesia, Emergency Medicine and the use of ultrasound in those fields.
Abstract:
The insertion technique of subclavian central lines has seen some variations since it`s early description. Many of these changes resulted from the increasingly popular use of POCUS (point of care ultrasound). My talk, at the 2020 International Conference on Critical Care and Emergency Medicine in Dubai, aims to give an overview over the different methods of subclavian central line insertion. It will cover the variations when using landmark based techniques, as well as ultrasound guided supraclavicular and infraclavicular approaches and the ultrasound based “PART” technique. It will conclude with an ultrasound-only way to confirm the correct position of central lines.
Title: Saudi nursing students’ attitudes towards patient safety and the influencing factors: A quantitative and qualitative study at the college of nursing-Jeddah
Biography:
Ebtsam Aly Abou Hashish has completed her PhD in the Faculty of Nursing at Alexandria University, Egypt. She is an Assistant Professor of Nursing Management and Leadership in College of Nursing at King Saud bin Abdul-Aziz University for Health Sciences, Jeddah, KSA, and an Assistant Professor of Nursing Administration in the Faculty of Nursing at Alexandria University, Egypt. She teaches many management and ethics courses for undergraduates and post graduates and as well as participated in supervising many theses and dissertations as an academic supervisor. She also acts as an Associated Trainer in the Faculty and Leadership Development Center (FLDC). She has published more than 15 papers in reputed journals and has been serving as an Editorial Board Member and Reviewer of reputed journals.
Abstract:
Background: Patient safety becomes a challenging discipline in educational institutions and healthcare organizations. With this growing recognition of the significance of patient safety, it is essential to assess nursing students’ attitude towards patient safety and factors influencing patient safety in order to reduce potential errors and promote quality of care.
Purpose: The main aim of this study was to assess the attitudes of undergraduate nursing students towards patient safety at the College of Nursing-Jeddah. Further, to identify the factors those influence their attitude towards patient safety.
Methods: Mixed methods research was conducted with a concurrent triangulation design. Attitude towards patient safety questionnaire was developed by the researchers and given to all undergraduate nursing students(N=300) who enrolled in the academic year 2017-2018 to collect quantitative data, while a qualitative investigation guided by in-depth interview using a developed guide was conducted with a purposive sampling of 14 undergraduate nursing students to identify the factors influencing nursing students’ attitude towards patient safety. Appropriate statistical analysis was applied while qualitative data were analyzed by content analysis approach.
Result: The present study concluded that Saudi nursing students manifested high and positive attitude level towards patient safety and indicated that their attitude not affected by the academic level or learning experience. Teaching patient safety issues, team functioning and patient involvement and perceived importance of patient safety scored as the highest dimensions of students’ attitude compared to the error disclosure and management dimensions which rated lower. Students’ attitude towards patient safety was influenced by many factors which extracted from qualitative data content analysis and identified as facilitators or barriers. These factors were thematically categorized as patient factors, staff factors and work environment factors with 25 subfactors under these three themes.
Conclusions & Recommendation: Nursing students are challenged by various factors that influence their attitude towards patient safety. Therefore, they should be supported by the provision of educational training about safe practice to enhance their safety attitude, knowledge and practice. Error reporting and disclosure culture should be a norm in nursing education and health care environment. Therefore, students should participate in the process of error analysis and management and should be provided with adequate clinical supervision. To maintain high levels of quality and safety in healthcare, all schools of nursing and faculties have to revise their curricula with more emphasis on theoretical and practical aspects of patient safety for bridging theory-practice gap. Furthermore, compliance to safety regulations and policies, blame-free environment for errors reporting, providing enough facilities and equipment, sufficient and efficient personnel by the hospital administrators are necessary so, students can practice in a safe environment and promote patient safety. In addition, this study encourages further research to achieve a more explicit understanding and comprehensive view of the factors that affect patient safety particularly from nurse educators’ perspective.
Title: Learning to learn: An exploration of the experience of overseas nurses undertaking higher education in the United Kingdom (UK)
Biography:
Michelle currently works a City, University of London as the Programme Director: Mentorship : Supporting & Assessing Learning in Practice Settings and Practice Lead for Adult nursing students. Michelle has previously worked as a Senior Lecturer at Buckinghamshire New University and Kingston University & St Georges University, London. This followed a successful nursing career as a District Nursing Sister and as an Intermediate Care Nurse. Michelle has taught a range of subjects latterly with a focus on Public Health, Culture & Diversity in Healthcare, Professional Nursing and Management of Long term conditions.Michelle has a MSc in Medical Anthropology and has a keen interest in culture, expressions of illness and how nurses cope with this. Michelle is currently in the final phase of her PhD exploring the experiences of Indian nurses coming to the UK to study and work.Michelle has an MSc Medical Anthropology; BSc Community Nursing (District Nurse); PGCE; Nurse Prescriber; Diploma In Nursing (Adult); BA (Hons) Business Studies.
Abstract:
The consensus exists that nursing is a global profession where much emphasis is placed on the transference of skills and knowledge. In reality the situation is more complex as each society attributes its own cultural constructs onto what is meant by the term nurse and how a nurse should be educated. This presentation will detail aspects of an ethnographic study exploring the lived experience of Indian Nurses who have undertaken programmes of study in the United Kingdom (UK). It will also draw an experience of teaching nurses whose primary education was not in the UK. Existing research examines the impact on the nurse as they enter the work force but there is a dearth of literature available on the experience of overseas nurses’ experience of a UK based education. The study has revealed that the concept of ‘learning to learn’ is paramount in the delivery and success of overseas nurses undertaking an education programme away from their home country. The Indian
nurses’ previous experience of didactic rote learning has little bearing on the ethos of a UK education with the emphasis on independent and reflective learning. The expectation is often on the overseas nurse to adapt their learning style to suit the institute they are attending. However the study has revealed the same should be said of the institute. In order to bridge this gap cultural sensitivity needs to be employed in the delivery of teaching and this should be a two way process between the institute and the overseas nurse with an emphasis on cultural competence, adaptation and partnership learning.
Title: How could technologies help to improve care and enhance nursing joy?
Biography:
Dirk F de Korne is currently the Deputy Director, Medical Innovation & Care Transformation at KK Women’s & Children’s Hospital (KKH). He also holds a position as Adjunct Assistant Professor at Duke-NUS Medical School Singapore and Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Netherlands. In KKH, he is responsible for the hospitals’ overall innovation strategy and execution, including the alignment and facilitaiton of initatives and projects pertaining to cross-departments, multi-disciplinary collaborations towards patient service integration with relevent stakeholders.
Since 2003, he has focused on quality improvement and organizational strategy in hospital care. His implementation, research, and teaching work focusses on understanding the diffusion of quality and patient safety innovations and include business process and systems design, telehealth, human factors & ergonomics, and performance benchmarking. Before his move to Singapore in 2013, he worked as Quality & Safety Consultant at The Rotterdam Eye Hospital. As lecturer he has been teaching health care quality and organizational sciences as well supervised bachelor and master graduates. He holds a MSc in Health Policy & Management from Erasmus University Rotterdam and a PhD in Public Health from University of Amsterdam
Abstract:
Today’s hospitals are rich and complex socio-technical environments where technology and human actions are closely interwoven and patient’s health outcomes are co-dependent on the success of this interaction. Moreover, it is increasingly recognized that the patient journey takes mostly place outside of the hospital. As medical and nursing care becomes more technology-dependent, many fear that sensors, robotics, digitalization, machine learning and
artificial intelligence will take the humanity out of health care. Do we need to worry? In this session, it is argued how ‘high tech’ can perform repetitive and redundant activities to enable nursing and medical staff to focus on ‘high touch’. Examples are taken from various area’s of women’s and children’s care, including smart health video consultation, pregancy chatbots, and real-time notifications for hand hygiene performance. If applied properly, new technologies could optimize patient health outcomes while enhancing nursing joy and career perspectives.
Title: The perceived and unmet needs of adult family members of patients in PACU
Biography:
Hana Kadhom has 35 years’ experience in nursing as a practitioner and educator. Her experience has been across the Middle East and UK. She obtained her PhD from the University of Hull (UK) in 1989 and she has completed her advanced postgraduate diplomas from British Universities in Nursing Education and Health and Safety. She is a former Senior lecturer and Director of Nursing Degree Bridging programme (RCSI) University of Royal College of Surgeon Bahrain and Saudi Aramco.
Abstract:
Background: The existence of specific and identifiable family needs of critically ill patients has been proven through research studies. However, little is known about the needs of family members of patients in Post Anesthesia Care Unit who may experience stress, anxiety, helplessness, and inability to cope. Aims of the research: The aim of the study is to (a) evaluate the perceived needs of adult family members of patients in Post Anesthesia Care Unit, (b) to know to what extend these needs are met, and (c) to identify whether the needs differ based on background characteristics.
Methodology and Research Design: A quantitative, descriptive design was utilized. A convenient sample of 100 adult family members of patients in Post Anesthesia Care Unit was selected at one of the tertiary hospitals in Bahrain. A questionnaire was used that include: a demographic data form, the Critical Care Family Needs Inventory (CCFNI),Â
and Needs Met Inventory (NMI).Descriptive and inferential statistics using SPSS version 20 was used for data analysis. Findings/ Results: The findings showed that the 10 most important needs identified by family members were related to “Assurance†and “Information†with mean score of 3.87. The need for “Assurance†was perceived as “always†met with mean score of 3.51. No significant differences due to gender, age, level of education, relationship to patient, and household were found.
Conclusion: The family members of patients in Post Anesthesia Care Unit considered the need to be reassured and kept informed during the immediate post-operative period as very important.
Recommendations: Nurses must direct their practice towards holistic care by implementing effective interventions to meet the family needs and enhance their ability to cope. Further study of visitation in post anesthesia care unit is needed that may guide change in departmental policies and procedures.
Title: Laparoscopic surgery; The current scenario
Biography:
Mushtaq Chalkoo is Working as Additional/associate professor at GMC Srinagar from 22 Oct,2017 Working as Assistant Professor Surgery at GMC, Srinagar from 2012- oct 2017 Worked as Permanent Lecturer Surgery at GMC, Srinagar from 2009 – 2012 Worked as Adhoc Lecturer Surgery at GMC, Srinagar from 2007 – 2009 Worked as Assistant Surgeon at SDH, Tangmarg from 2003–2007 Worked as Resident Surgeon at KSA from 2001 – 2003 Worked as Senior Resident Surgery & Allied Specialties at SKIMS from 1997 – 2001 Postgraduate Surgery, SKIMS from 1994 – 1997 House Surgeon from 1993 – 1994 Internship in GMC, Srinagar from 1992 – 1993.
Abstract:
Surgery is an art and this art of healing is learnt over a period of time. Early 1980’s brought a revolution in the field of surgery and there has been a continuous growth in this field due to rapid run of modifications and innovations that keep on happening for the patient good. Gone are the days when surgery would be abhorred by patients as a modality of treatment for their ailments. Currently patients look out for surgical treatments even for their medical ailments. Minimal access surgery and laparoscopy changed the whole scenario of surgery. The many do’s and don’ts got changed in surgery; amounting to up rise of a new religion in the field of surgery. The conventional surgery would explore a patient through a formal incision which would entail more of blood loss, paramount pain, exposure to lot of drugs, prolonged recovery time and lengthy hospital stay. Thanks to laparoscopy many surgical procedures have become ambulatory procedures, day care surgeries and office procedures. In today’s era, patient is operated through holes and video guided with a fast recovery, shortened hospital stay and early recovery. Laparoscopic staplers have revolutionised the dissection techniques in colorectal cancer surgeries. The staplers have not only reduced the operative time but also help in fashioning precise anatomises and decreased blood loss. There has been a tremendous advancement in instruementation, operational theatre technology and other surgical gadgets that have made the techniques and mode of surgery quite awesome. Laparoscopic management of incisional hernias have undergone a total metamorphosis and techniques like IPOM PLUS and component separation techniques have revolutionised the management of this
surgical ailment. There has been tremendous advancement in meshes used in incisional hernias that are patient friendly. Laparoscopic management of rectal tumours especially the low rectal tumours are now managed even without covering colostomies which many patients would not be ready to accept. The Robotic surgery is an extension of laparoscopic surgery and it has already invaded many fields of surgery with excellent outcome. What will be future in surgery cannot even be guessed.Telesurgery is already practiced at present. We have grown enormously in Kashmir valley with this patient friendly technique and laparoscopic gastrointestinal surgeries, especially laparoscopic colorectal and gastric surgeries and all kinds of hernias are managed laparoscopic ally at deptt.of surgery govt.medical college Srinagar. Every other day, there is a new blast of innovation in the field of laparoscopic surgery and it has become difficult to cope up with the advancement of this art of surgery. Technology has put us at cutting edge and it is mandatory to update yourself as we are medical teachers too. We at medical college have been working with laparoscopic surgery since late 1990’s and have come a long way ahead in this field. We have contributed our patents, techniques, modifications and chapters and publications in the field of laparoscopic surgery. The Chalkoo’S Point, The Chalkoos Single Finger Technique, The Chalkoos Modification, The Chalkoos Concepts etc. are worth mentioned here. We have presented our work nationally internationally as invited talks. It is a moral duty of all of us as medical teachers to decipher and disseminate this art of surgery to the upcoming young budding doctors who would carry on this legacy of surgery to the future progeny for the good of
Title: Nursing and mental health in liberia
Biography:
Gail Stuart is dean and a tenured Distinguished University Professor in the College of Nursing and a professor in the College of Medicine in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. She has been at MUSC since 1985 and has served as Dean of the College of Nursing since 2002. Prior to her appointment as Dean, she was the director of Doctoral Studies and coordinator of the Psychiatric-Mental Health Nursing Graduate Program in the College of Nursing. She was also the Associate Director of the Center for Health Care Research at MUSC and the administrator and Chief Executive Officer of the Institute of Psychiatry at the Medical University where she was responsible for all clinical, fiscal, and human operations across the continuum of psychiatric care. She received her Bachelor of Science degree in nursing from Georgetown University, her Master of Science degree in psychiatric nursing from the University of Maryland, and her doctorate in behavioral sciences from Johns Hopkins University, School of Hygiene and Public Health. Dr. Stuart has taught in undergraduate, graduate, and doctoral programs in nursing. She serves on numerous academic, corporate, and government boards and represents nursing on a variety of National Institute of Health policy and research panels, currently serving as President of the Board of Directors of the Annapolis Coalition of the Behavioral Health Workforce. Dr. Stuart also was a Visiting Professor at Kings College, Instuitute of Psychiatry in London England. She is a prolific writer and has published numerous articles, chapters, textbooks, and media productions. Most notable among these is her textbook, Principles and Practice of Psychiatric Nursing, now in its 10th edition, which has been honored with four Book of the Year Awards from the American Journal of Nursing and has been translated into 5 languages. She has received many awards, including the American Nurses Association Distinguished Contribution to Psychiatric Nursing Award, the Psychiatric Nurse of the Year Award from the American Psychiatric Nurses Association, and the Hildegard
Abstract:
After a decade of civil war, the people of Liberia had enormous mental health problems related to extensive physical and psychological violence. As there was only one psychiatrist in the country, the Liberian Ministry of Health requested the help of the Carter Center in Atlanta Georgia to address the country’s mental health needs. Nurses were the largest group of health care providers and a program was launched to prepare 150 nurses to become Mental Health Clinicians over five years. I was asked to create the curriculum for this program in partnership with the people of Liberia and to work with Liberian educators, clinicians and health care administrators to implement it in a “train the trainer” model. I have been involved in this project since 2010 without compensation.
The main objectives of the program were:
1) Prepare Liberian nurses/physician assistants as mental health clinicians.
2) Strengthen the knowledge and skills of “mental health trainers/ educators” in the existing Liberian educational and health care systems.
3) Enhance the teaching environment for mental health professionals/paraprofessionals.
I developed a six month curriculum in partnership with key members of the educational, practice and administrative sectors in Liberia. It was based on advanced practice psychiatric nursing content taught in the United States and consisted of five courses taught in a “train the trainer” model over a 6 month period of study. I held curriculum workshops in Liberia in which all courses were reviewed in detail and then revised, refined and reviewed again in a process of continuous interaction.
Outcomes:
1) There have been 166 graduates of the program with mental health clinicians placed in all 15 counties of Liberia.
2) The program facilitated the creation of a registered psychiatric nurse accreditation program by the Liberian Board of Nursing.
3) Content from the program was incorporated into pre-service nursing curricula in Liberian nursing schools. As this program ended, the ebola virus disease broke out in Liberia. The mental health clinicians provided much need education, support and care. In addition, the World Bank funded a new initiative to train 100 child and adolescent Nurse Mental Health Clinicians in three years. I created this curriculum and am continuing to work on implementing it in Liberia. To date 64 of the 100 nurses have graduated.
Title: Changes in sexual behaviors due to the utilization of PrEP as a preventive method for the transmission of HIV
Biography:
Michael Kaltenbach is a part-time lecturer at Rutgers University School of Social Work, teaching a course in Human Behavior in the Social Environment. He has previously taught BSW and MSW level courses in crisis intervention and brief therapy, clinical practice, intro. to social welfare / human services, communication in social work practice, human behavior and the social environment, and emotional disorders in childhood and adolescents at Temple University and the University of Southern California. Kaltenbach has been working in the field of psychology and social work for the past twenty-three years, and eighteen of those years have been since he received his master’s degree in Social Work. His doctoral dissertation research interest focused on how sexual behaviors have changed due to the usage of PrEP, as a HIV preventive method. His research data as interpreted through the theoretical / conceptual perspectives of cognitive-behavioral theory and relational-cultural therapy. Kaltenbach is a Licensed Clinical Social Worker in California, New York, and Pennsylvania, and has many years of experience providing psychotherapy, case management, and other social services in a variety of settings: hospitals, HIV outpatient clinics, schools, foster care agencies, group homes, etc. He has experience providing Clinical Supervision as well as Field Instruction to MSW level Social Workers and Interns from USC and UCLA. He formerly served as a Co-Facilitator for the LA County HIV Mental Health Task Force and has provided lectures on various mental health topics. Previously, he was a Teacher’s Assistant (T.A.) for a professor at the University of Pennsylvania School of Social Policy & Practice’s MSW level course on Post-colonial Social Work Practice: International Social Welfare in Kolkata, India. He enjoys traveling and learning about various cultures. After he obtained his bachelor’s degree he served as an US Peace Corps Volunteer in Senegal, West Africa. When Kaltenbach is not teaching, he currently provides psychotherapy in his private practice office located in Philadelphia, PA. He also provides psychotherapy on a fee-for-service basis at outpatient community counseling centers in West and South Philadelphia, and at a Senior Assisted Living Facilities in Bay Ridge, Brooklyn, NYC and Manhattan, NYC.
Abstract:
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), approximately 33.4 million individuals throughout the world have been affected by HIV/AIDS in the last 30 years or so (Bonacquisti & Geller, 2013). The medication, Truvada, otherwise known as PrEP has been introduced to serve as a harm reduction technique to combat the spread of HIV infection. PrEP is an antiretroviral drug that lowers the risk of HIV exposure. This is a qualitative study examining the sexual behaviors of gay and bisexual men prescribed PrEP as a preventive method for the transmission of HIV. I conducted 30 semi-structured in-depth interviews of people who had been prescribed PrEP for at least 30 days in three cities: Los Angeles, Philadelphia, and New York City. The results indicate that contextual factors shaped the sexual behaviors of participants on PrEP, leading them to lower risk at times, and elevate it at others. PrEP caused individuals to experience changes within their communication patterns with their medical providers and their sexual partners. The results shed light on the way people on PrEP engage in sexual and health-seeking behaviors and help to develop a blueprint for the way service providers engage with this community.
Title: Screening for violence in the home: mHealth Technology Versus Paper?
Biography:
Phyllis Sharps, PhD, RN, FAAN, Elsie M. Lawler Endowed Chair, Professor of Nursing and Associate Dean for Community Programs and Initiatives, at the Johns Hopkins University School of Nursing. She is internationally known for her research, leadership of interdisciplinary research teams and her advocacy for violence against pregnant and parenting women. She has published more than 90 articles on reducing violence among African American women, specifically, the physical and mental health consequences of violence against pregnant and parenting women, infants, and very young children. She has been the principal investigator for 2 NIH funded grants, totaling more than $8M.
Abstract:
Globally, the prevalence of intimate partner violence (IPV) during pregnancy ranges from 4%-29%. Screening and identifying abused pregnant women continues to be a challenge, especially for home visiting programs. Computer-assisted technology has been effective for screening sensitive issues such as depression and substance use. The purpose of this presentation is to describe the effectiveness of two different methods (paper-pencil vs. computer-assisted) for screening for IPV in perinatal home visit programs Pregnant women (N=416) participating in the “Perinatal Home Visiting Program Enhanced with mHealth Technology”, (1 R01 HD 071771 NICHD/NIH) in urban, suburban and rural settings were randomized to either traditional paper-pencil IPV screening or IPV screening on hand-held tablets. Screening data were examined for IPV prevalence rates comparing paper-pencil vs. tablet. Variables included settings and ethnic/racial background. The prevalence rates were similar using paper was 21.8% versus 24.5% using tablets (p=.507). Although there were no significant differences between paper versus tablet the prevalence rates were higher using tablets (Urban –paper=15.6% vs. tablet=16.3%, p=.881; Suburban paper=30.6% vs. tablet=34.5%, p=.634; Rural-paper=22.9% vs. tablet=31.7%, p=0.390). Prevalence rates were not significantly different between the two screening methods; however paper screening had a slightly higher prevalence (Af. Am.–paper=28.8% vs. tablet=24.5 % -p=0.62q; Euro Am - paper=20.7% vs. tablet=20.0%, p=.895). This study’s result provides evidence that women will reveal their abuse status regardless how asked or strategies used to screen for IPV. The important strategy is having protocols and training that prepare health care providers to screen for IPV. Health care providers in all settings that provide care to women should screen and then connect women to resources in order to improve pregnancy outcomes.
Title: Investigation of brain activity during type II communication of the elderly by near infrared spectroscopy
Biography:
She has engaged in education and research on deontological nursing and home care nursing. Her research themes are the desirable communication between the elderly and the care staff and the effective way of support for the elderly ADL independence. In particular, her research on the elderly communication is garnering attention around the world. Her article (Fukaya ,et al .2016) will be published as a chapter in eBook "Top 10 Contributions on Nursing & Health Care".
Abstract:
In our previous studies, we clarified that there were two types of linguistic communication between elderly people in need of long-term care and care providers: “Type I communication: Task oriented communication†and “Type II communication: Life worldly communicationâ€. In geriatric care facilities, the average speech duration per day was 4 minutes, which was extremely short. It was caused by the fact that about 75% of the conversation was occupied by type I communication and the speech of the elderly was restricted. On the other hand, type II communication was proved to increase the elderly speech duration. It was also proved that the lack of type II communication not only affected the quality of life of the elderly but also may affect the deterioration of the mental activity and the occurrence of dementia of the elderly. However, it has not been clarified how these types of communication affect the brain activity. Therefore, this study is aimed to measure the brain activity during type I and type II communication by Near Infrared Spectroscopy (NIRS) and to analyze the difference between them. The subjects were 25 elderly people aged 65 years or older who did not suffer from dementia. The 16 channels of NIRS system (NIRO200NX, Hamamatsu Photonics K.K., Japan) were applied for each participant. We conducted communication with the elderly using communication guides of each types. Changes in the concentrations of oxygenated hemoglobin (oxy HB), deoxygenated hemoglobin (deoxy HB) and total hemoglobin(total HB) were measured using NIRS to observe the brain activity during the communication. The video recording was also performed with NIRS.
