Beverely Turner

Impact of monitoring technology in assisted living: outcome pilot

This paper describes a study designed to assess the acceptance and some psychosocial impacts of monitoring technology in assisted living. Monitoring systems were installed in 22 assisted living units to track the activities of daily living (ADLs) and key alert conditions of residents (15 of whom were nonmemory care residents). Activity reports and alert notifications were sent to professional caregivers who provided care to residents participating in the study. Diagnostic use of the monitoring data was assessed. Nonmemory care residents were surveyed and assessed using the Satisfaction With Life Scale (SWLS) instrument. Pre- and post-installation SWLS scores were compared. Older adult participants accepted monitoring. The results suggest that monitoring technologies could provide care coordination tools that are accepted by residents and may have a positive impact on their quality of life

A Passive and Portable System for Monitoring Heart Rate and Detecting Sleep Apnea and Arousals: Preliminary Validation

The National Institutes of Health (NIH) Sleep Disorders Research Plan expresses a need for methods that can non-invasively monitor sleep characteristics. Forty subjects were tested using a novel, passive ballistocardiography-based system during an overnight study. We examined our systems ability to measure heart rate as compared to EKG while we also investigated our systems apnea and arousal detection capabilities as compared to conventional polysomnography. We found a strong correlation (r=0.972, p<0.0001) in average heart rate computed over 480 thirty-second epochs when our method was compared to EKG. Additionally, we achieved a sensitivity of 89.2% and specificity of 94.6% in the automated detection of apneas. Similarly we attained a sensitivity of 77.3% and a specificity of 96.2% in the detection of arousals. These preliminary results demonstrate the effectiveness of our portable ballistocardiography-based system as compared to polysomnography and show promise that high quality sleep assessment can be performed in a home environment

A Non-Contact Imaging-Based Approach to Detecting Stage I Pressure Ulcers

This paper describes a non-contact imaging-based method to detect stage I pressure ulcers over a wide range of melanin levels. Two approaches were explored: the first used broad and narrow band visible spectrum imaging, and the second used near infrared (NIR) imaging. Preliminary results are presented together with results of numerical analysis of different erythema indices derived from the visible spectrum images. The results have shown that a low-cost imaging-based approach to detecting pressure ulcers is feasible and can yield promising results when applied to subjects with darker skin pigmentation

Improving the detection of stage I pressure ulcers by enhancing digital color images.

It has been observed in previous studies that the detection of stage I pressure ulcers becomes more difficult by unaided visual inspection and/or by using currently available techniques with darker skin subjects, due to increased melanin content. This difficulty is indicated by the elevated proportion of black and hispanic patients developing more serious stage III and IV pressure ulcers compared to white patients. The ultimate goal of this project, undertaken by MARC at the University of Virginia, is to develop a low-cost, non-contact imaging-based stage I pressure ulcer detection system for use by support staff in assisted living and skilled nursing facilities to increase the ulcer detection rate over a wide range of skin colors. This paper describes an image enhancement procedure that improves the detection of pressure ulcers when applied to the color images of ulcer sites. Preliminary results clearly indicate that the enhanced images exhibit higher contrast and make the pressure ulcer site more conspicuous to the examiner. The experiments show promising results even for subjects with black and dark brown skin colors

A novel BRCA1 mutation in an identical twin pair with similar clinical histories.

Factors affecting the penetrance and expression of BRCA1 are not understood. Breast cancer risk and ovarian cancer risk, in general, are known to be associated with non-Mendelian factors. However, whether and how these various factors influence tumor development in BRCA1 mutation carriers is not known. Here we report the breast and ovarian cancer syndrome in an identical twin pair. These female identical twins had remarkably similar clinical histories. Both twins developed histologically similar ovarian cancer in their mid-fifties. One twin was diagnosed with stage III disease and died of refractory metastatic disease. The other twin was diagnosed with stage I disease but ultimately died of recurrent disease. Neither twin developed breast or colon cancer. The twins have both similarities and differences in terms of nongenetic cancer-related risk factors. Results of BRCA1 analysis of DNA from both twins revealed a novel mutation, 2711delA, which resulted in a premature termination at codon 892. This report has intriguing implications concerning the role of genotype in the ultimate penetrance and expression of disease among BRCA1 mutation carriers.