Emerald Group Publishing Limited
Copyright © 2000, MCB UP Limited
Keywords: Automation, Cybernetics, Research, Technological developments
An innovative body vest that has been designed to monitor the wearer's health has been developed in California, USA. Called the LifeShirt, it continually checks and measures vital bodily functions such as blood pressure, heart rate, and breathing patterns. The current prototype vest has six battery-powered sensors that have been built into a cotton/lycra fabric and each one checks different parts of the body.
The information the sensors collect is then transferred to a small, hand-sized computer which is worn on the patient's belt. Gathering data in this way is, perhaps, not an unusual process in this technological age when similar belt-held sensors are attached with their computers, to monitor individual bodily functions such as blood pressure. What makes this new device innovative and important is that it collects so much data about the body in an acceptable manner. It is hardly as uncomfortable to wear as some of the present sensor/computer devices. It has the advantage, too, of being able to transmit the captured data via the Internet for analysis by doctors and technicians. They are then able to evaluate the data and contact the patient or his/her family should there be any cause for concern.
The vest weighs the same, we are told, as conventional clothing and will currently cost some £160, with a monitoring cost of about £19 a day. The developers of LifeShirt say that it can easily be worn under a shirt at work, at home, even in bed and during sporting activities. Of some importance is the fact that it is said to be handwashable and reusable. The developer of LifeShirt, Dr Marvin Sackner, is a lung specialist and in a recent interview said that:
LifeShirt will give a more accurate picture of a person's health than recordings taken during medical checkups. It is more like a film than snapshot. We can look at what is going on when you are at work in a stressful situation and when you are sitting at home in a relaxed environment. If you are anxious it can detect the number of sighs and the depth of your sighs as well as your heart rate.
No one is suggesting that the technology to monitor these functions does not exist in medical centres and hospitals, it is the miniaturised system, such as LifeShirt, that is both convenient, portable and consequently an attractive device. The potential uses of such an innovative system are many. In particular, those who are likely to benefit immediately include people with high blood pressure, those with anxiety problems and anyone in danger of heart failure. Asthmatics are also likely to make use of the system, and, indeed, any patient whose condition needs monitoring after an operation or who requires pain management.
The manufacturers of LifeShirt have provided the following details of their produce:
It works 24 hours a day, seven days a week and can predict a crisis before it happens. The six sensors that provide the body data are positioned from the neck to the abdomen, including a posture sensor, and four "plethysmograms", which assess various blood and respiratory flows, at the neck, ribcage, stomach and chest. They monitor 35 types of bodily function derived from heart activity, breathing patterns and blood pressure. It can even measure the difference in expansion between the left and right sides of the thorax, which is symptomatic of fluid in the lungs, and it can pinpoint cases of sleep apnoea - where people stop breathing many times during the night.
The actual processing of the data captured is from its storage in a digital recorder, currently downloaded every 24 hours and analysed.
Presumably there is no barrier, technically, for the data to be both monitored and transmitted, if necessary, at other time intervals. The system appears to be versatile and the information received, depending on the circumstances, can be despatched to a secure Website where it can be analysed and assessed by the appropriate medical team or, indeed, by the patient or his/her local doctor.
The product is, we are told, currently on sale and has been generally welcomed by medical associations and patient groups. Some doubts and warnings about its general use have been voiced. One main concern is the security of the information being sent over the Internet. This, however, is not a concern that is confined to medical information, but to Internet use in general. The other concern is that since the human body is a complex organism, what functions should be monitored?
The current six, which are: jugular pulse monitor; blood flow to chest monitor; posture sensor monitor; thoracocardiogram (measures changes in cardiac output ); respiratory rate and sigh counter; and abdominal sensor (to monitor volume of air expired), provide a great deal of information; other potential applications will demand many more.
A report in the journal Circulation (December 1999) suggests that by using gene therapy, heart failure may be reversible. It says that by inserting extra genes into heart muscle cells researchers were able to induce them to recapture their pumping abilities. The report does contain a word of caution and indicates that so far the therapy has worked only in hearts that have been removed from transplant patients. It would appear that getting a gene to "take" in a living body instead of isolated cells will need more research work. The team of researchers includes Dr Sian Harding (Imperial College, London, UK) and Dr Roger Hajjar (Massachusetts General Hospital, Boston, USA). It based its work on the gene SERCA2a which instructs cells to produce a protein involved in controlling the contraction of the heart muscle. We are told that within 24 hours of receiving the gene the cells from the failed hearts began beating and contracting at levels very similar to those seen in normal hearts.
It is the view of researchers in this area that many therapy projects have produced poor results mainly because it has been difficult delivering the genes into the right cells and getting them to stay there. Work is now concentrating on new gene delivery techniques to overcome the problem.
The New Industry Research Organisation (NIRO), Kobe, Japan has developed a remote healthcare sensor to be worn as a ring that is able to radio the wearer's pulse rate to a medical centre. Other systems, such as the sensor vest, can produce similar data but the convenience of wearing something as simple as a ring makes this system extremely attractive in many circumstances. There are, for example, many "call systems" designed to monitor the elderly or the housebound, but this device is able to be worn permanently with little inconvenience and is capable of transmitting other information about the wearer such as the rate of oxygen absorption. The sensor works by monitoring tiny changes in light absorption on the skin when blood capillaries extend or contract. It is 3cm in diameter and 3cm thick.
Chiaki Nagai provides biocyberneticians with some of the reasons why it has been developed. He says that:
The development came as a result of the Great Kansai Earthquake which hit Kobe in 1995. Many houses were destroyed and many, especially the elderly, had to move to unfamiliar places and some of them died without anyone realising. We hope this ring will prevent such future occurrences.
It is acknowledged that the device was first researched at the Massachusetts Institute of Technology (MIT), USA. It will start its trials later this year.
Biocybernetics and the ageing society.
Most industrialised societies are tackling the problems that ensue from population changes. In particular, where a society is ageing, great difficulties are experienced in providing care and other resources for looking after the old and infirm.
Countries are facing this challenge in many different ways, but one common factor is the increasing reliance on electronics and systems. Perhaps Japan has produced and publicised more devices and systems to deal with this new era than anywhere else. The government there has realised that 25 percent of the population is expected to be 65 or older by 2015, which is an increase from the current 17 percent. Japanese companies are in consequence encouraged to develop new devices for the new "elderly age". Robotic devices and electronic gadgets have been described in this section that are aimed especially at this social group.
One company, NEC, has, for example, developed a home-care robot. This device responds when called and is able to operate any household computers and electrical appliances. Other companies have developed robotic systems designed especially for the infirm who are hospitalised or in need of care. Unlike some Western societies the Japanese companies are enthusiastic about this type of project and are keen to perfect such innovative gadgets.
Few other countries would embark on a project to provide thousands of elderly people with an "electronic cat". The Japanese government has launched a new three-year project where thousands of its elderly citizens will receive a computerised, animatronic, interactive cat called Tama. It is not just a matter of pandering to the aged, because as well as serving as a companion to those living alone, it also acts as a communication terminal between its owner and local centres. For biocyberneticians this is surely the beginning of what will not only be a fascinating study to provide much needed assistance to vulnerable people but also an exercise in cybernetic communications and human interface techniques.