Hokey Pokey!
Today was a very busy day for the Mashavu team since it was our last day to prepare before our first clinic, which will be held at the CYEC tomorrow. All teams were working fervently to tie up the necessary loose ends. Working with the students was a priority for all teams, as the students will play an integral role in the clinic.
One main goal for today was to thoroughly educate the students about Mashavu. The first step for this included breaking up the older CYEC students into groups of 4 or 5 in order to go over the basic Mashavu information. We reviewed an outline that specified what Mashavu is, who will go to a Mashavu kiosk, why people will go to a Mashavu kiosk, the chain of events that will happen throughout the entire Mashavu experience, what each biomedical device is and what it measures. We broke into groups to make the students feel more comfortable, in the hopes that they would then open up and talk more. It worked; many of the students became much more responsive. After about 25 minutes, the groups rejoined to play a game – speed Mashavu trivia. The first to answer the question got a point. This game really opened up the students and made it evident that most understood the concepts we had reviewed.
The students were then taught the Hokey Pokey game, which they thought was hilarious. Tara and Rene then acted out a short skit of the kiosk operator and patient, to walk the students through the details of asking the questions. As Rene acted out the parts, Tara narrated where different actions, such as using the biomedical devices, would take place.
After this game, Mashavu team members reviewed all “social and family history” and “medical” questions, that will be asked to the patients to make sure they understand everything that will be asked. These included terms like nauseous, nasal congestion, wheezing, and bruising.
The Systemic Assessment team met with Mary to go over all the interview and focus group questions. Wording and social appropriateness needed to be confirmed for all of the medical history questions, interview questions, and focus group question. They then integrated their assessment plan into the concept of operations so that tomorrow’s clinic will yield a large amount of data. Rachel, Tara, and Carey met with Samir and Roma from Concept of Operations to develop a way to evaluate the success rate of the devices. Excel sheets were made to log data after each kiosk and word documents to log interview and focus group information.
The BioE team worked on all devices. The main problem with the stethoscope was that the background noise could not be filtered out. Thus, the heart and lung sounds could not be heard clearly. Because there simply wasn’t enough time to fix it today, the stethoscope will not be used in the clinic tomorrow.
The blood pressure cuff had initial errors this morning but this was quickly fixed by tweaking the code. Right now both blood pressure cuffs are working. Both were tested on multiple Penn State students and then compared to values taken from off-the-shelf devices. Fortunately, the results were both reasonable and similar.
A huge mess was discovered when the spirometer’s code was analyzed. The old code was quickly scrapped in order to start from scratch. Pat Hoopes is currently working on writing the new code. Today he worked with Aaron to figure out the physics behind it, including fluid mechanics and other principles from Dr. Mannings BioE 409 class. Because the code is still being written, the spirometer will not be used tomorrow. It should be used for our future clinics.
The thermometer works! It has been working since yesterday. Alice Cheng found the calibration constants by heating a hot water bottle to various temperatures and compared these temperatures to those measured by a commercial thermometer. The average difference was found and then used to find the calibration constant. The instrument was adapted so that it no longer wraps around the head; instead it goes under the arm. The values were compared to off-the-shelf devices and the percent error was very small. Although one thermometer needs a bit of tweaking before the clinic tomorrow, we will have two functional thermometers by tomorrow.
The decision was made to nix the baby weighing scale and just use the adult weighing scale. Although both scales have the same circuit and code, for some reason (yet to be understood) the baby weighing scale is not working. If babies do need to be weighed, the cushioned basket from the baby weighing scale will be placed on top of the adult weighing scale, which will then be tared. However, this is not expected to be a big concern, as our expected patients are mainly adults. It was calibrated by weighing a 10 liter water jug on an off-the-shelf scale. This read 22 pounds while the adult weighing scale weighed 21 pounds. Although a more thorough calibration will be conducted in the future, this showed that the values are very comparable, for now.
The pulse oximeter is now working. A few tests were conducted to compare it to an off-the-shelf device. The IR light wave has no pattern. It is not sinusoidal and has no distinguishable pattern. It will be used tomorrow, mainly for heart rate, but oxygen level readings will also be monitored.
The BioE team showed the older CYEC students the entire Mashavu user interface with two devices – pulse oximeter and thermometer – attached. Every student acted as either the kiosk operator or the patient. Students took instrument measurements from each other and within only ten minutes some students were able to use the entire LabVIEW program, acting as the kiosk worker. One leading student then used Swahili to teach the other students how to work the program. This generated a lot more interest for the students and helped with clarification. It is estimated that at least 5 students can operate the kiosk smoothly, with minimal outside help.
Our CYEC champion Patrick showing another student how to use the system
The Concept of Operations team worked to iron out all kinks and plan every detail for tomorrow. We will be arriving at the CYEC at 8 am to have the clinic set up in the main orientation room by 9am. There will be three kiosks within the big room. At every kiosk there will be a BioE student, CYEC student, and Mashavu core team student. Once the contact information is filled out, the medical data will be taken by the devices. The rest of the information, which will be taken while the patients are in line, will be entered into the computer by the BioE student while the CYEC and core team students are greeting the patients.
The thermometers and spirometers will be cleaned by using either vinegar or rubbing alcohol. Once all the data has been gathered, the patient will be given a slip of paper with the template of the Mashavu stamp. This design includes the elephant emblem of the Mashavu experience and spaces for all of the data. After the patient leaves the kiosk, he or she will enter an interview or focus group for 15-20 minutes, if he or she gave consent while standing in the line. Afterwards, they will visit the doctors (Ross and Carol Reiffe and Susan Burriss), who will have already reviewed the medical information, which was sent to them via the internet. Although the doctors will have already made comments about the patient, based solely on the information collected by the devices, this will be the time for the doctors to compare their initial responses to those made after seeing the patients face-to-face.
Gillian went with Mike (from the EssentialDesign team) Khanjan, and two other men to the town of Nyeri in order to run errands. Although the ride wasn’t very long, the holes in the dusty road made the ride go much more slowly. The snow-capped top of Mount Kenya was a gorgeous sight with the cumulus clouds setting a fantastic backdrop. When they arrived in Nyeri, Gillian spent 3600 shillings grocery shopping for all the Penn State students while the men went to the hardware store to get estimates for the materials needed for the EDSGN projects. Gillian went with Khanjan and Andrew, from CYEC to a cyber cafe to make about 300 copies of surveys, consent forms, and other papers necessary for the near future. One computer was missing the enter button, and had just a small metal nub to push. There was a fake 1000 KSh note stuck on the wall. The woman behind the desk explained that counterfeit bills are determined by holding them up to the light to view the watermark. Fake bills have closed eyes on the face of the watermark, while real bills have the eyes open. One can say that it was an eye-opening experience!
Christ from the Essential Design team, after a day's field work and playing soccer with the CYEC kids
