Multi-layered system design for classifying activities of daily living

Our overall aim in this research is to develop a health smart home design that can monitor activities of its occupants. Our design includes three stages: system physical layers and software, fusion of multi-layered data, and classification of activities of daily living. We review prior work, discuss design and implementation issues, and describe our validation approach

Use of serotonergic antidepressants and St John's wort in older Australians: A population-based cohort study

OBJECTIVE: The study investigated the use of serotonergic antidepressants (SSRIs: selective serotonin reuptake inhibitors; SNRIs: serotonin–norepinephrine reuptake inhibitors) and St John’s wort in a large NSW-based community sample, and sought to identify a potentially dangerous concomitant use of these medications. METHODS: Cross-sectional data from 266,848 participants from the ‘45 and Up’ study were used. The questionnaire captures self-reported treatment for depression or anxiety and antidepressant medications in the last four weeks. RESULTS: 5.8% of participants received treatment for depression or anxiety, with 4.7% taking an SSRI and 1.3% an SNRI. St John’s wort was taken by 0.3% of the participants. Use of SSRIs and SNRIs was reported more frequently by females than males (respectively, 64.1% vs 35.9%, 66.9% vs 33.1%). The gender difference was even more pronounced for St John’s wort (75.6% vs. 24.4%). Use of antidepressants decreased after the age of 65 years. One hundred and forty people reported concurrent use of an SSRI and an SNRI, and 11 people of an SSRI with St John’s wort. CONCLUSIONS: Around 7% of the study population aged 45–65 years reported the use of SSRIs or SNRIs, decreasing to 5% above 70 years of age. It is of concern that some individuals used an SSRI concurrently with St John’s wort.Syed Ziaur Rahman, Jim Basilakis, Anton Rahmadi, Sanja Lujic, Ian Musgrave, Louisa Jorm, Phillipa Hay, Gerald Münc

The application of decision support systems in home telecare

Rapid developments in healthcare provision have occurred in parallel with the growth of communications and information technologies. The emergence of both sectors has resulted in the genesis of a new area of healthcare services for the community - commonly known as home telecare. Home telecare can be broadly defined as the use of information, communications and monitoring technologies to evaluate health status and social care, and deliver remote healthcare services directly to the user, generally in their homes

An analysis of IoMT Vvtal signs measurement devices for practical and secure remote clinical monitoring

The increasing need to provide care outside of hospitals necessitates remote monitoring of basic vital signs of patients from places such as private homes and aged care facilities. While much exploratory research has been done on using Internet of Medical Things (IoMT) devices for remote monitoring, there is a requirement to examine the practicality associated with the mass use of affordable off-the-shelf devices in terms of usability, secure access to data, and integration into hospital-based information systems. This paper investigates various security aspects in nine vital signs sensor devices that can be purchased and used for homecare monitoring in Australia. Specifically, the security and privacy aspects of these devices and associated software, regulatory compliance, interoperability, and formats of the accessible data streams were investigated. It was found that the devices were not entirely secure, as personal health information could be accessed using appropriate tools. Only one vendor enabled encryption during data transmission and provided an API to access data. While the clinical use of these devices with integration into hospital systems for practical remote monitoring is not easily achievable, it is possible to use devices for day-to-day vital signs monitoring purposes in a home setting

Improving the quality and accuracy of non-invasive blood pressure measurement by visual inspection and automated signal processing of the Korotkoff sounds

Objective: In this study we investigate inter-operator differences in determining systolic and diastolic pressure from auscultatory sound recordings of Korotkoff sounds. We introduce a new method to record and convert Korotkoff sounds to a high fidelity sound file which can be replayed under optimal conditions by multiple operators, for the independent determination of systolic and diastolic pressure points. Approach: We have developed a digitised data base of 643 NIBP records from 216 subjects. The Korotkoff signals of 310 good quality records were digitised and the Korotkoff sounds converted to high fidelity audio files. A randomly selected subset of 90 of these data files, were used by an expert panel to independently detect systolic and diastolic points. We then developed a semi-automated method of visualising processed Korotkoff sounds, supported by simple algorithms to detect systolic and diastolic pressure points that provided new insights on the reasons for large differences recorded by the expert panel. Main Results: Detailed analysis of the 90 randomly selected records revealed that peak root mean square (RMS) energy of the Korotkoff sounds, ranged from 3.3 to 84 mV rms, with the lower bound below the audible range of 4–6 mV rms. The diastolic phase was below the minimum auditory threshold in only 47/90 records. This indicates that for approximately 50% of all records diastole could not be determined from Phase V silence. The maximum relative error recorded for systolic pressure between the two methods, auscultatory and visual/algorithmic, was 30.8 mmHg with a mean error of 8.0 ± 5.4 mmHg