Majd Alwan

A Smart and Passive Floor-Vibration Based Fall Detector for Elderly

Falls are very prevalent among the elderly. They are the second leading cause of unintentional-injury death for people of all ages and the leading cause of death for elders 79 years and older. Studies have shown that the medical outcome of a fall is largely dependent upon the response and rescue time. Hence, a highly accurate automatic fall detector is an important component of the living setting for older adult to expedite and improve the medical care provided to this population. Though there are several kinds of fall detectors currently available, they suffer from various drawbacks. Some of them are intrusive while others require the user to wear and activate the devices, and hence may fail in the event of user non-compliance. This paper describes the working principle and the design of a floor vibration-based fall detector that is completely passive and unobtrusive to the resident. The detector was designed to overcome some of the common drawbacks of the earlier fall detectors. The performance of the detector is evaluated by conducting controlled laboratory tests using anthropomorphic dummies. The results showed 100% fall detection rate with minimum potential for false alarms

Development and Preliminary Validation of Heart Rate and Breathing Rate Detection Using a Passive, Ballistocardiography-Based Sleep Monitoring System

Techniques such as ballistocardiography (BCG) that can provide noninvasive long-term physiological monitoring have gained interest due to a growing recognition of adverse effects from poor sleep and sleep disorders. The noninvasive analysis of physiological signals (NAPS) system is a BCG-based monitoring system developed to measure heart rate, breathing rate, and musculoskeletal movement that shows promise as a general sleep analysis tool. Overnight sleep studies were conducted on 40 healthy subjects during a clinical trial at the University of Virginia. The NAPS systems measures of heart rate and breathing rate were compared to ECG, pulse oximetry, and respiratory inductance plethysmography (RIP). The subjects were split into a training dataset and a validation dataset, maintaining similar demographics in each set. The NAPS system accurately detected heart rate, averaged over the prescribed 30-s epochs, to within less than 2.72 beats per minute of ECG, and accurately detected breathing rate, averaged over the same epochs, to within 2.10 breaths per minute of RIP bands used in polysomnography.

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

Impact of Blood Pressure Telemonitoring on Hypertension Outcomes: A Literature Review

We searched five databases (PubMed, CINAHL, PsycINFO, EMBASE, and ProQuest) from 1995 to September 2009 to collect evidence on the impact of blood pressure (BP) telemonitoring on BP control and other outcomes in telemonitoring studies targeting patients with hypertension as a primary diagnosis. Fifteen articles met our review criteria. We found that BP telemonitoring resulted in reduction of BP in all but two studies; systolic BP declined by 3.9 to 13.0 mm Hg and diastolic BP declined by 2.0 to 8.0 mm Hg across these studies. These magnitudes of effect are comparable to those observed in efficacy trials of some antihypertensive drugs. Although BP control was the primary outcome of these studies, some included secondary outcomes such as healthcare utilization and cost. Evidence of the benefits of BP telemonitoring on these secondary outcomes is less robust. Compliance with BP telemonitoring among patients was favorable, but compliance among participating healthcare providers was not well documented. The potential role of BP telemonitoring in the reduction of BP is discussed and suggestions on priority populations that can benefit from this technology are presented.

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

Characterization of Infrared Range-Finder PBS-03JN for 2-D Mapping

This paper presents a characterization study of the HOKUYO PBS-03JN Infrared range-finder and compares it to the characterization of the SICK LMS-200 laser range-finder for use in indoor 2-D mapping. Many parameters that could affect the performance of the sensor including warm-up time, divergence of the detection beam, usable detection range in the azimuth, target surface, color, and size properties, incidence angle at the target, and the mixed pixels problem have been studied. This characterization, quantification of errors, and 3-D confidence in the distance readings of the sensor is vital for practical applications. These characteristics are compared to the counterpart characteristics of the laser range-finder. The PBS-03JN is a cost effective alternative to laser range-finders in indoor environments. The sensor is attractive due to lower power consumption, and its lightweight.

Use of health information technology in home health and hospice agencies: United States, 2007

OBJECTIVE This report provides updated estimates on use of electronic medical records (EMRs) in US home health and hospice (HHH) agencies, describes utilization of EMR functionalities, and presents novel data on telemedicine and point of care documentation (PoCD) in this setting. DESIGN Nationally representative, cross-sectional survey of US HHH agencies conducted in 2007. MEASUREMENTS Data on agency characteristics, current use of EMR systems as well as use of telemedicine and PoCD were collected. RESULTS In 2007, 43% of US HHH agencies reported use of an EMR system. Patient demographics (40%) and clinical notes (34%) were the most commonly used EMR functions among US HHH agencies. Only 20% of agencies with EMR systems had health information sharing functionality and about half of them used it. Telemedicine was used by 21% of all HHH agencies, with most (87%) of these offering home health services. Among home health agencies using telemedicine, greater than 90% used telephone monitoring and about two-thirds used non-video monitoring. Nearly 29% of HHH agencies reported using electronic PoCD systems, most often for Outcome and Assessment Information Set (OASIS) data capture (79%). Relative to for-profit HHH agencies, non-profit agencies used considerably more EMR (70% vs 28%, p<0.001) and PoCD (63% vs 9%, p<0.001). CONCLUSIONS Between 2000 and 2007, there was a 33% increase in use of EMR among HHH agencies in the US. In 2007, use of EMR and PoCD technologies in non-profit agencies was significantly higher than for-profit ones. Finally, HHH agencies generally tended to use available EMR functionalities, including health information sharing.

Passive in-home health and wellness monitoring: Overview, value and examples

Modern sensor and communication technology, coupled with advances in data analysis and artificial intelligence techniques, is causing a paradigm shift in remote management and monitoring of chronic disease. In-home monitoring technology brings the added benefit of measuring individualized health status and reporting it to the care provider and caregivers alike, allowing timely and targeted preventive interventions, even in home and community based settings. This paper presents a paradigm for geriatric care based on monitoring older adults passively in their own living settings through placing sensors in their living environments or the objects they use. Activity and physiological data can be analyzed, archived and mined to detect indicators of early disease onset or changes in health conditions at various levels. Examples of monitoring systems are discussed and results from field evaluation pilot studies are summarized. The approach has shown great promise for a significant value proposition to all the stakeholders involved in caring for older adults. The paradigm would allow care providers to extend their services into the communities they serve.

Passive derivation of basic walker-assisted gait characteristics from measured forces and moments

This work describes a method that passively assesses basic walker-assisted gait characteristic, including heel strikes, toe-off events, as well as stride time, double support and right & left single support phases using only force-moment measurements from the walkers handles. The passively derived gait characteristics were validated against motion capture gait analysis and showed good correlations. This research is part of an effort that aims to identify user intent, from measuring forces and moments exerted on the handles of the walker as well as from perceiving the environment, and to incorporate identified intent into a passive shared steering control system for the walker. The primary focus of the work leading to This work is to identify the double support phase, and to engage the steering control at the beginning of this phase to maximize the users stability. However, the application of the method presented and the instrumented walker can be extended to longitudinal outside the lab Gait assessment.

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