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About

My name is Susana Rodrigues and I am a researcher in the area of Psychophysiology at BRAIN group. I hold a PhD degree in Psychology from Faculdade de Psicologia e Ciências da Educação da Universidade do Porto (FPCEUP) and I am a Chartered Psychologist with Ordem de Psicologos, with a specialization in clinical and health psychology. So far my research has concentrated in the areas of stress, fatigue, coping and engagement among first responders using ambulatory assessment methodologies. 

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Publications

2021

A systematic review on the use of immersive virtual reality to train professionals

Authors
Narciso, D; Melo, M; Rodrigues, S; Cunha, JP; Vasconcelos Raposo, J; Bessa, M;

Publication
MULTIMEDIA TOOLS AND APPLICATIONS

Abstract
The main goal of this systematic review is to synthesize existing evidence on the use of immersive virtual reality (IVR) to train professionals as well as to identify the main gaps and challenges that still remain and need to be addressed by future research. Following a comprehensive search, 66 documents were identified, assessed for relevance, and analysed. The main areas of application of IVR-based training were identified. Moreover, we identified the stimuli provided, the hardware used and information regarding training evaluation. The results showed that the areas in which a greater number of works were published were those related to healthcare and elementary occupations. In hardware, the most commonly used equipment was head mounted displays (HMDs), headphones included in the HMDs and handheld controllers. Moreover, the results indicated that IVR training systems are often evaluated manually, the most common metric being questionnaires applied before and after the experiment, and that IVR training systems have a positive effect in training professionals. We conclude that the literature is insufficient for determining the effect of IVR in the training of professionals. Although some works indicated promising results, there are still relevant themes that must be explored and limitations to overcome before virtual training replaces real-world training.

2020

Impact of Different Stimuli on User Stress During a Virtual Firefighting Training Exercise

Authors
Narciso, D; Melo, M; Rodrigues, S; Cunha, JPS; Bessa, M;

Publication
20th IEEE International Conference on Bioinformatics and Bioengineering, BIBE 2020, Cincinnati, OH, USA, October 26-28, 2020

Abstract
Training firefighters using Virtual Reality (VR) technology brings several benefits over traditional training methods including the reduction of costs and risks. The ability of causing the same level of stress as a real situation so that firefighters can learn how to deal with stress was investigated. An experiment aiming to study the influence that additional stimuli (heat, weight, smell and using personal protective equipment-PPE) have on user's stress level while performing a Virtual Environment (VE) designed to train firefighters was developed. Participants' stress and Heart Rate Variability (HRV) were obtained from electrocardiograms recorded during the experiment. The results suggest that wearing the PPE has the largest impact on user's stress level. The results also showed that HRV was able to evidence differences between two phases of the experiment, which suggests that it can be used to monitor users' quantified reaction to VEs. © 2020 IEEE.

2019

A wearable approach for intraoperative physiological stress monitoring of multiple cooperative surgeons

Authors
Pimentel, G; Rodrigues, S; Silva, PA; Vilarinho, A; Vaz, R; Silva Cunha, JPS;

Publication
International Journal of Medical Informatics

Abstract
It is known that excessive levels of occupational stress affect professionals’ technical and non-technical skills and surgeons are no exception. However, very few studies address this problem in neurosurgeons. A system for monitoring cardiovascular strain and autonomic imbalance during intracranial aneurysm procedures is proposed in order to obtain overall cardiac measures from those procedures. Additionally, this study also allows to detect stressful events and compare their impact with the surgeon's own appraisal. Linear and nonlinear heart rate variability (HRV) features were extracted from surgeon's electrocardiogram (ECG) signal using wearable ECG monitors and mobile technology during 10 intracranial aneurysm surgeries with two surgeons. Stress appraisal and cognitive workload were assessed using self-report measures. Findings suggest that the surgeon associated to the main role during the clipping can be exposed to high levels of stress, especially if a rupture occurs (pNN20 = 0%), while the assistant surgeon tends to experience mental fatigue. Cognitive workload scores of one of the surgeons were negatively correlated with AVNN, SDNN, pNN20, pNN50, 1 V, 2 L V, SD2 and CVI measures. Cognitive workload was positively related with stress appraisal, suggesting that more mentally demanding procedures are also assessed as more stressful. Finally, pNN20 seems to better mirror behavior during stress moments than pNN50. Additionally, a sympathovagal excitation occurs in one of the professionals after changing to main role. The present methodology shows potential for the identification of harmful events. This work may be of importance for the design of effective interventions in order to reduce surgeons stress levels. Furthermore, this approach can be applied to other professions. © 2019 Elsevier B.V.

2019

The effect of seizure type on ictal and early post-ictal Heart Rate Variability in patients with focal resistant epilepsy

Authors
Faria, MT; Rodrigues, S; Dias, D; Rego, R; Rocha, H; Sa, F; Oliveira, A; Campelo, M; Pereira, J; Rocha Goncalves, F; Cunha, JPS; Martins, E;

Publication
EUROPEAN HEART JOURNAL

Abstract
Abstract Background Seizures commonly affect the heart rate and its variability. The increased interest in this area of research is related to the possible connection with sudden unexpected death in epilepsy (SUDEP). Generalized tonic-clonic seizures (GTCS) are reported as the most consistent risk factor for SUDEP. However, the general risk of seizures (and their type) on cardiac function still remains uncertain. Purpose To evaluate the influence of seizure type (GTCS vs non-GTCS) on ictal and early post-ictal Heart Rate Variability (HRV) in patients with refractory epilepsy. Methods From January 2015 to July 2018, we prospectively evaluated 121 patients admitted to our institution's Epilepsy Monitoring Unit with focal resistant epilepsy. All patients underwent a 48-hour Holter recording. We included only patients who had both GTCS and non-GTCS during the recording and selected the first seizure of each type to analyze. HRV (AVNN, SDNN, RMSSD, pNN50, and LF/HF) was evaluated by analyzing 5-min-ECG epochs, starting with the seizure onset (ictal and early post-ictal period). The study was approved by our Institution Ethics Committee and all patients gave informed consent. Results Fourteen patients were included (7 Females, 4 patients with Temporal Lobe Epilepsy). The median age was 39 years (min-max, 18–57). Thirty-six percent presented cardiovascular risk factors without known cardiac disease. A significant statistical reduction was found for AVNN (p=0.013), RMSSD (p=0.008), pNN50 (p=0.005) and HF (p=0.003), during GTCS when compared with non-GTCS (Wilcoxon test, p<0.05; two tailed). Conclusion Our study shows a significant reduced vagal tone during GTCS when compared with non-GTCS. Hence, GTCS had a more pronounced impact on HRV changes than other seizure types, which can be associated with higher SUDEP risk after GTCS.

2019

The influence of tonic-clonic seizures on heart rate variability in patients with refractory epilepsy

Authors
Faria, MT; Rodrigues, S; Dias, D; Rego, R; Rocha, H; Sa, F; Oliveira, A; Campelo, M; Pereira, J; Rocha Goncalves, F; Cunha, JPS; Martins, E;

Publication
EUROPEAN HEART JOURNAL

Abstract
Abstract Background Heart Rate Variability (HRV) is an increasing area of interest in patients with epilepsy. The effects of epilepsy on the autonomic control of the heart are not completely understood and that autonomic dysfunction has been implicated in some cases of Sudden Unexpected Death in Epilepsy (SUDEP). Objective To study the influence of generalized tonic-clonic seizures (GTCS) on HRV of patients with focal refractory epilepsy. Method We prospectively evaluated (January 2015 to July 2018) 121 patients admitted to our institution's Epilepsy Monitoring Unit. All patients performed a 48-hour Holter recording. Patients who had GTCS during the recording were included and we selected the first GTCS as the index seizure. HRV (AVNN, SDNN, RMSSD, pNN50, and LF/HF) was evaluated by analyzing 5-min-ECG epochs during inter-ictal and post-ictal periods: baseline, pre-ictal (5 min before the GTCS seizure), post-ictal (5 min after the seizure), and late post-ictal (>5 hours after the seizure). We compared HRV data from these patients with normative values for a healthy population (controlling age and gender). The study was approved by our Institution Ethics Committee and all patients gave informed consent. Results Twenty three patients were included (mean age: 38.61±11.58; 70% Female). Thirty percent presented cardiovascular risk factors without known cardiac disease. We found significant differences between the analyzed periods for all but one (LF/HF) HRV metrics (using Friedman test, p<0.05, two-tailed). Specifically during the post-ictal period, we found a significant reduction for AVNN, SDNN, RMSSD and pNN50 (Wilcoxon test, p<0.05; two-tailed). LF/HF was increased during this period, but changes were not statistically significant. There was also a tendency for a reduction of AVNN, SDNN, RMSSD and pNN50 and an increase of LF/HF in our patients during all the analyzed periods when compared to normative healthy population values. Conclusion Our work shows reduced HRV after a GTCS in patients with focal resistant epilepsy, both in inter-ictal and post-ictal periods, when compared to normative healthy population values. These results might reflect long term structural changes in autonomic centers. The HRV changes were significant particularly during the post-ictal period, and should prompt further investigation, giving this period is critical for SUDEP.