Jeffrey D. Craighead

Field Evaluations of Tracking/locating Technologies for Prevention of Missing Incidents.

Background: Persons with dementia are at risk of a missing incident, which is defined as an instance in which a demented person’s whereabouts are unknown to the caregiver and the individual is not in an expected location. Since it is critical to determine the missing person’s location as quickly as possible, we evaluated whether commercially available tracking technologies can assist in a rapid recovery. Methods: This study examined 7 commercially available tracking devices: 3 radio frequency (RF) based and 4 global positioning system (GPS) based, employing realistic tracking scenarios. Outcome measures were time to discovery and degree of deviation from a straight intercept course. Results/Conclusion: Across all scenarios tested, GPS devices were found to be approximately twice as efficient as the RF devices in locating a “missing person.” While the RF devices showed reasonable performance at close proximity, the GPS devices were found to be more appropriate overall for tracking/locating missing persons over unknown and larger distances.

Movement Path Tortuosity Predicts Compliance With Therapeutic Behavioral Prompts in Patients With Traumatic Brain Injury

Objective:Rehabilitation of patients with traumatic brain injury typically includes therapeutic prompts for keeping appointments and adhering to medication regimens. Level of cognitive impairment may significantly affect a traumatic brain injury victims ability to benefit from text-based prompting. We tested the hypothesis that spatial disorientation as measured by movement path tortuosity during ambulation would be associated with poorer compliance with automated prompts by veterans actively being treated for traumatic brain injury. Setting:Clinical polytrauma center. Participants:Ten (1 female) veteran patients mean age = 35.4 (SD = 12.4) years. Design:Small group correlational study without random assignment. Main Measures:Fractal Dimension, a measure of movement path tortuosity derived from a GPS logging device used to record casual outdoor ambulation at the start of the study. Compliance with smart home machine-generated therapeutic prompts received during rehabilitation at the James A. Haley Veterans Administration Hospital Polytrauma Transitional Rehabilitation Program. A patient was compliant with a prompt if they transited from where the prompt was presented to the prescribed destination (both within the Polytrauma Transitional Rehabilitation Program) within 30 minutes. Noncompliance was failure to appear at the destination within the allotted time. Results:Fractal dimension was significantly inversely related to overall prompt compliance (r = −0.603, n = 10, P = .032; 1-tailed). Conclusions:The findings support the hypothesis that increased spatial disorientation adversely impacts compliance with automated prompts throughout therapy. The results are consistent with previous studies linking elevated path tortuosity to cognitive impairment and increased risk for falls in assisted living facility residents.

Multidrug-resistant organisms in a community living facility: Tracking patient interactions and time spent in common areas

Contact precautions in community living facilities (CLF) are used to reduce the transmission of multidrug-resistant organisms (MDRO). However, this policy does not address the contamination of shared spaces, devices (eg, wheelchairs), and interactions with other patients. Using a real-time surveillance system, this study examines the time MDRO-positive patients spend interacting with others in communal areas. The findings from this study may be used to tailor MDRO policies and practices to the specific needs of CLF.