Sep 30, 2018 | News
The new technology, detailed in a paper in the journal Science Translational Medicine, also includes the discovery of a more convenient measurement point.
“We targeted a different artery, the transverse palmer arch artery at the fingertip, to give us better control of the measurement,” says lead author Anand Chandrasekhar, electrical and computer engineering doctoral student at Michigan State University. “We were excited when we validated this location. Being able to use your fingertip makes our approach much easier and more accessible.”
The approach uses two sensors: an optical sensor on top of a force sensor. The sensor unit and other circuitry are housed in a 1 centimeter-thick case attached to the back of the phone. Users turn on the app and press their fingertip against the sensor unit. With their finger on the unit, they hold their phone at heart level and watch their smartphone screen to make sure they’re applying the correct amount of finger pressure.
“A key point was to see if users could properly apply the finger pressure over time, which lasts as long as an arm cuff measurement,” says senior author Ramakrishna Mukkamala, electrical and computer engineering professor. “We were pleased to see that 90 percent of the people trying it were able to do it easily after just one or two practice tries.”
Internationally, thes device could be a game-changer, researchers say. While high blood pressure is treatable with lifestyle changes and medication, only around 20 percent of people with hypertension have their condition under control.
The new invention gives patients a convenient option, and keeping a log of daily measurements would produce an accurate average, discounting an occasional measurement anomaly, Mukkamala says.
The research team will continue to improve accuracy and hopes to pursue more comprehensive testing based on the standard protocol of the Association for the Advancement of Medical Instrumentation. The scientists are already making inroads to build improved hardware. Future iterations could be as thin as 1 millimeter and be part of a standard protective phone case.
Other researchers from Michigan State and from the University of Maryland contributed to the work. The National Institutes of Health and MSU supported the study.
Source: Michigan State University
Original Study DOI: 10.1126/scitranslmed.aap8674
A NEW APP MEASURES BLOOD PRESSURE WITH ACCURACY THAT MAY RIVAL ARM CUFF DEVICES.
Aug 28, 2018 | News
ALEXANDER G. LOGAN
Community programs for the prevention of cardiovascular disease have generally succeeded in lowering blood pressure (BP) and improving cardiovascular health in the general population. They have also met the challenge of raising awareness, increasing knowledge, and promoting changes in health behavior. Moreover, they have likely contributed to the improved rates of BP control among hypertensive patients in North America over the past 2 decades. Successful population-based interventions combined the power of mass media and other communication tools with screening and counselling activities. These targeted BP programs were firmly rooted in sound scientific evidence that interventions to lower BP improve health outcomes. The study by Salazar et al. adds another dimension to population-based programs by highlighting the importance of sustained public health activity to maintain good BP control. These investigators demonstrated that individuals whose BP rose during the community intervention were at higher risk of developing a cardiovascular event.
The new challenge for hypertension programs is maintaining community interest while reiterating the same health messages. A recent measles outbreak among unvaccinated adults in Canada has shown that in the absence of constant reminders, memories about serious preventable illnesses fade. To communicate effectively, community hypertension programs will need to borrow heavily from the world of technology about packaging messages to meet the changing ways that the general population consumes information. Public health interventions will need to take into account the new communication tools and fashion messages that fit the constraints of these instruments. It has amply been demonstrated that multiple approaches are required and communication strategies differ markedly among the target population to be reached. Interventions must also tap into risk factors that are products of the changing lifestyle of the community. It is apparent that lifestyle messages need to adapt to the reality of more prolonged periods of sitting at work, decreased time for meal preparation, financial constraints requiring dual-earner partnerships, and more fragmented and disrupted sleep. New public health approaches need to be rigorously evaluated to ensure that they are both cost-effective and applicable to large segments of the population. In the past, several well-thought-out, community-wide strategies for cardiovascular disease prevention, when properly evaluated, proved to have modest or no effect, leading the investigators to conclude that there was a need for new designs and new interventions.
We are now living in an age where telecommunication systems allow individuals easy access to reliable health information anytime, anywhere. Networks using 3G and 4G technology enable high-speed data transfer and support a wide variety of information technology platforms. This new technology provides patients with direct access to personal health records, web portals, and healthcare providers. Presently, it is unclear what system works best and whether there are differences between countries. There are trials demonstrating the benefits of telecommunication in both developed and developing countries.
Wireless connectivity is growing rapidly, and mobile devices are replacing landlines, desktop computers, and workstations as the preferred method of communication. The sale of smartphones with built-in messaging systems now outstrips that of cell phones. The recent flood of mobile healthcare devices and software applications has greatly expanded self-care capabilities across the spectrum of healthcare activities. Apart from ubiquitous educational materials, there is a cornucopia of self-help wellness and fitness programs for individuals interested in maintaining or improving their health. There is also a wide range of mobile services and solutions to prevent, diagnose, and treat diseases. Mobile health applications running on wireless devices facilitate disease monitoring.They enable remote monitoring of vital parameters to ensure health maintenance and provide early signals of potentially dangerous trends away from good health. Sleek wearable medical technology, now highly fashionable, allows individuals to monitor a wide array of vital signs and symptoms effortlessly and unobtrusively. Many such devices have built-in Bluetooth capabilities to transmit the data to a secure online database using a protected Internet connection, which in turn provides immediate feedback to users.
In the past decade, there has been a shift away from the traditional medical model of healthcare delivery to a more personalized system in which individuals are encouraged to participate in health maintenance activities and, for those with health problems, to work collaboratively with their healthcare providers. In the new paradigm, community resources, and policies are integrated more closely into the health system to ensure that programs have a broad reach yet provide needed support for targeted activities. The effectiveness of this combined approach was recently demonstrated in a randomized controlled trial of a multipronged, community-based health promotion and prevention program for cardiovascular disease. The intervention, which targeted older adults, engaged public health units, community physicians, and local health organizations, significantly improved cardiovascular risk factor management, and reduced morbidity at the population level. An essential element of the study’s intervention was self-management support.
There are many domains of health under personal control. Individuals can easily learn self-care skills, become more knowledgeable about health matters, modify poor lifestyle choices, use monitoring tools that track vital health parameters, and identify ways of preventing or mitigating the effects of the disease. Interactive technologies and online resources such as social networks, video chat, and instant messaging platforms facilitate these self-help behaviours and are successfully filling gaps in the current health systems. Through social media, individuals can find or create networks with peers to share common experiences, increase problem-solving skills and gain confidence in making life-improving changes. Such interactions build a strong sense of belonging and encourage participation in communal efforts to combat health problems in targeted groups. These developments are encouraged by the US Institute of Medicine and strongly endorsed by academic leaders in the United States.
If information technology is an important key to the future of community-based programs for chronic conditions such as hypertension, it faces many challenges. Foremost, it needs to appeal to all stakeholders, including organizations representing professionals, academic and research institutions, industry, and representatives from the general public. Age is a potential barrier in building successful interventions that use health information technology. The targeted population for hypertension is mostly aged >50 years and, in general, newly acquiring the skills to use the Internet and mobile devices. Nonetheless, the number of users in this age bracket is growing rapidly. A 2010 survey by the American Association of Retired Persons found that most were comfortable using a mobile phone and 7% even had a smartphone. Furthermore, older adults are interested in acquiring the skill to use a mobile health system to track vital signs such as BP and weight. For educators, it is important to recognize that many features of mobile devices are not intuitive for users aged >50 years and developing that intuition takes time. To increase acceptability of mobile health systems for older adults who are more likely to have a hearing, vision, cognition, and mobility problems, developers need to avoid design features such as small buttons and dim screens that impede usability. Apart from age and design issues, other impediments to the use of mobile health technology include affordability and availability that may reduce access. Such barriers are not insurmountable and are amenable to thoughtful solutions such as the use of publically available devices.
In summary, there is a growing body of evidence that community programs reduce BP and improve cardiovascular health in the general population. Assessments of cardiovascular risk factors by the World Health Organization MONICA project from the mid-1980s to mid-1990s and by the National Health and Nutrition Examination Survey from 1971 to 2010 provide additional support for population-based interventions. Both surveys showed a leftward shift in the frequency distribution of BP. Importantly, the decrease in BP occurred equally at all levels of readings, indicating that the change was not specifically related to better clinical management of hypertension and the increasing application of antihypertensive medications. This evidence, along with the new findings of Salazar et al., justifies supporting community efforts to improve the management of cardiovascular risk factors. For continued success, however, community programs will need to take into account the changing way healthcare is being delivered and incorporate the advances in mobile communication technology and social media in program planning.
REFERENCES: COMMUNITY HYPERTENSION PROGRAMS IN THE AGE OF MOBILE TECHNOLOGY AND SOCIAL MEDIA
Jul 15, 2018 | News
Written By: Amanda Menar
When a parent is diagnosed with a terminal illness, this new situation will affect the entire family, including the children. In these cases, one of the main concerns is how, when and if this news should be shared with the children. It is normal for parents to want to protect their child, but hiding the terminal illness can oftentimes make matters worse. Namely, withholding information can cause children to feel confused, angry and, many times, guilty.
How to Have the Conversation with Your Children
According to the American Society of Cancer, it is a good thing to tell your children about the terminal illness, but this news should be shared in stages and in a language that a child will be able to understand. Never give a child more information than they will be able to absorb and understand.
If you have a partner, it is best to share this news together; but if you are a single parent then you should tell them alone. A single parent’s greatest concern is to find a reliable person who will take care of their children after they are gone.
But when is the best time to tell your children about your terminal illness? You should talk to your child as soon as the diagnosis is definite. Children know more than parents may think, and they do understand when something is happening in their family, even if you think that you are good at hiding it. Be honest with your children and try to prepare them as much as you can for the future. Keeping your child away from the truth will just make them feel lonely, afraid and guilty.
Preparing Your Child for Loss
In many cases, families have been dealing with the disease for months or even years before it is known that the condition is terminal. In just a few cases, the disease is diagnosed in an advanced stage. This period will help you and your children prepare for the worst. No matter how long you have been dealing with the illness, when it comes to its terminal stage, it won’t be easy for anyone in your family to deal with.
Children have an abstract understanding of life. Young children especially will have difficulties understanding what death is, and the fact that their parent will be gone forever. Usually, after the age of 10, children do understand the meaning of death. Using the right words is very important. Be sure to explain to your child what death really means and that once you are gone, you will not be back. Don’t give hope to your child. Instead, explain to them that once someone has died, they will be physically gone and that the child will no longer see the loved person. In some cases, this conversation might need to be repeated a couple of times because children will usually have questions. Try to answer these as much as you can. For most children, it is very hard to cope throughout the process of losing a parent, especially if they are very young. But in time, the child will accept the reality.
In one way, telling your child the truth can help distract parents from dwelling on the illness. The more they know about the situation, the less afraid they will feel. If you are hospitalized, try to get in touch with your children as much as you can. Reassure your children that you love them and that the illness has no effect on your love for them. Let your child visit you while hospitalized only after you, your partner, a friend or a family member prepares them for this situation. It is not easy for children to see their parent in a terminal condition.
Remember, when a parent suffers from an illness, children will notice that something is going on. Being overprotective of them will just make the situation worse, so be honest. It is normal for you as a parent to not know all the answers, as well as to be unsure of what to say and how to explain the illness to your children. Seek help when necessary from a family member, friend or a professional.
Additional Helpful Resources
TALKING TO YOUR KIDS ABOUT YOUR TERMINAL ILLNESS: A GUIDE FOR PARENTS
Jul 15, 2018 | News
Written by Sarah Gehrke, MSN, RN
According to the Center for Disease Control and Prevention (CDC), more than a third of US adults have obesity—this dietary driven disease kills more than twice as many people as infectious disease.
Obesity is a growing problem among people from all walks of life—this is especially true with children since the convenience of technology usage has limited their physical activity, and the availability of overly processed foods, such as pizza, sugary snacks, other fast food, have made children overweight.
Physicians have correlated, through recent studies, that obesity can be attributed to some diseases including diabetes, heart problems, and even some forms of cancer. These non-communicable chronic diseases will cost our global economy $47 trillion over the next 20 years.
Fortunately, preventative measures can be taken to help combat obesity, and with a few lifestyle changes, people of all ages can lose weight, be healthier, and live a longer and fuller life.
WHO: Obesity and Overweight – CDC provides key facts and global estimates about the obese and overweight population
The Global Economic Burden of Non-communicable Diseases – a snapshot of the five major non-communicable diseases and summary of the global economic impact
Provide Healthy Eating Experiences
Offering a healthy eating experience is an excellent way to help prevent obesity. Replacing white flour with whole grains and wheat bread to increase fiber intake is an improvement; however, keep in mind that two slices of whole wheat bread are shown to raise a person’s blood sugar, or blood glucose, more than two tablespoons of table sugar. Bread and packaged food, in general, may have added sugar.
Vegetable and fruit snacks provide a stable energy source. Fresh fruits instead of cake or candy bars are great alternatives for both kids and adults.
The National Institutes of Health (NIH) recommend low-fat dairy in a healthy eating plan. A 2016 study published in Circulation may have a strong influence on policymakers, in the future, to re-evaluate their position against full-fat dairy. Researchers found that out of 3,300 people, the individuals with the highest intake of full-fat dairy products had a 46% decrease in the risk of developing type 2 diabetes compared to people with low-fat dairy.
Science debunked the idea that a diet with high-fat foods is not good for you, in fact, saturated fat is liberated from the do not consume category. Even eggs are back in. Even though the new USDA Dietary Guidelines Committee said that cholesterol is no longer restricted, the guidelines continue to propose a person consume an eating pattern low in added sugars, saturated fats, and sodium. This includes:
A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
Fruits, especially whole fruits
Grains, at least half of which are whole grains
Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
Oils
A healthy eating pattern limits:
Saturated fats and trans fats, added sugars, and sodium
Water or a sparkling mineral water without added sugar instead of soda can make a positive impact on weight and overall health.
With a few simple, healthy eating alternatives, people can lose weight and feel better about themselves. Diets rich in fiber and vitamins can also reduce the risk of heart disease.
Glycaemic Index Tables – compilation of reliable tables of the glycaemic load associated with the consumption of different foods
Dairy Fat and Risk of Diabetes Mellitus – an interesting perspective on dairy consumption and the potential health effects of dairy fat
The Guidelines – an executive summary of the dietary guidelines from the Office of Disease Prevention and Health Promotion
Obesity Basics – definition and overview of obesity risk factors and complications
Choose My Plate – answers to your questions about the 2015–2020 dietary guidelines
Choose My Plate (Multiple Languages) – answers to your questions about the 2015–2020 dietary guidelines in multiple languages
Teach Healthy Eating Habits
Most people who are at their proper weight have a lower risk for diabetes and numerous other health problems. Teaching children healthy habits increases the likelihood that they will be an appropriate weight when they get older.
Acquiring a healthy diet can include encouraging kids to eat fruits instead of candy, limiting sodas, and ingesting whole foods. Teaching people healthy eating habits can be fun! Promoting new things like seafood or different vegetables can send someone on a food adventure that will keep them on the right track for their whole life.
Opportunities to teach and improve food choices exist throughout the day and in varied settings. If small shifts made over time, it can add up to real improvements in long-term eating patterns.
Fast Food Alternatives – how to make careful menu choices
Tips for Healthy Eating On the Go or at Home – tip sheets for eating healthy when dining out and shopping
Nutritional Songs – songs for healthy eating habits
Win Over Picky Eaters – tips to keep in mind when your child or other picky eater only wants to eat French fries or pizza for all meals
Healthy Eating Lesson Plan – an empowering lesson plan for teaching students healthy eating choices (adaptable for grades K–5)
Teaching Veterans Healthy Food Choices – this Healthy Teaching Kitchen YouTube channel aims to improve the health of veterans and their families
Living the Total Body Diet Lifestyle – a total body diet designed from the Academy of Nutrition and Dietetics to get people into a wellness state of mind
Fight Belly Fat Foods – a general overview of obesity in American and tips on foods that help with fighting belly fat
Promote Physical Activity
Getting kids or even sedentary adults to become active can be a challenge. However, some things can be done to help promote physical activity.
Walking groups with friends or co-workers are a great way to encourage each other, hold each other accountable, and get people to stay active. Nature walks are also a wonderful way to get outdoors, be active and enjoy the weather.
Taking the stairs at work instead of the elevator and parking your car further away from shopping centres can add up to your health and wellness over time.
You can create fun, loving connections by adding movement into your daily routine—the whole family will benefit. Most early childhood interactions involve movement. Let’s face it; our world is based on movement.
Boosting activity needs taught and encouraged, in the same way awareness does. Keep in mind children learn their behaviours from adults.
Here are some ideas to choose from that inspire activity:
Limit screen time, such as video games, TV, and other electronic devices.
Make activity cards and use them as a game—paste a picture of physical activity on one side of the card. Then, the child, or adult, chooses the card and demonstrates the movement.
Teach posture alignment and silly stretches using helium balloons. Clip the balloon on the back of everyone’s shirt as a gentle reminder to sit up straight during dinner. Or, encourage a fun activity of arm stretching by tying balloons to each wrist.
Read or write a short story that promotes activity as a part of the story.
You do not have to be a full-time athlete to take part in physical activity. Just a few simple changes can make a difference in one’s overall health, and you might even lose a few unflattering pounds in the process.
Physical Activity for Everyone – the CDC explains the benefits of boosting physical activity
Helping Kids be Physically Active – eleven ways to encourage your child to be physically active
Active Resources – the US Department of Health and Human Services provide different ways to be physically active
Staying Active – Harvard School of Public Health reviews why physical activity is just as important as eating nutritious foods
Adults Aged 50+ Staying Active – the CDC explains why adults older than 50 need more physical activity
Exercise Aspects of Obesity Treatment – a review of the negative impact of obesity, heart disease risk factors, and the treatment of obesity
Provide Emotional Support
Often, people who are overweight have a low sense of self-esteem. Exercising might be a little bit embarrassing or awkward.
Commonly, this is why people who are overweight stay overweight, particularly those without the help and support of family and friends. Providing some emotional support and positive reinforcement can do wonders for those trying to lose weight and live a healthier life.
A study in the Journal of Developmental and Behavioural Paediatrics examined the relationship between social support and health-related quality of life in obese youth. Overall, the study found that obese youth perceive varying levels of support. Their greatest level of social support comes from parents and close friends. Interestingly, a classmate’s support has the strongest influence on health-related quality of life, yet obese youth perceive the least amount of support from classmates.
Both children and adults can benefit from support groups—just lending an ear to those who need it are useful ways to give people who are obese some encouragement and steer them in the right direction.
Psychological Effects of Being Obese – the American Psychological Foundation examine whether people’s internalized societal attitudes about being overweight
How to be a Good Support Team – the article explains ways to help a loved one lose weight without hurting their feelings
Perceived Social Support and Quality of Life – an in-depth review of the association between social support and perceived quality of life in obese youth
Self Esteem, Insecurity, and Obesity – the Obesity Action Coalition discusses the role of self-esteem from birth and the awareness of the continuous stream of negative feedback that can shape self-confidence
Support, Wellbeing, and Energy Balance – key resources from the CDC to promote an energy balance in schools
Community Strategies – the CDC explains community efforts to reverse the obesity epidemic
The Health Effects of Obesity
People who are obese, compared to individuals with a healthy weight, are at risk for many serious health conditions, which include the following:
All-causes of death (mortality)
High blood pressure (Hypertension)
High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)
Type 2 diabetes
Coronary heart disease
Stroke
Gallbladder disease
Osteoarthritis (a breakdown of cartilage and bone within a joint)
Sleep apnea and breathing problems
Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
Low quality of life
Mental illness such as clinical depression, anxiety, and other mental disorders
Body pain and difficulty with physical functioning
Note. List of diseases and health conditions are retrieved from the Centers for Disease Control and Prevention.
ACLS HEART HEALTHY GUIDE TO PREVENTING OBESITY
Jul 15, 2018 | News
JYOTI SINGH
A new study found that training available workforce such as Accredited Social Health Activists (ASHAs) could be effective in rural areas.
Hypertension has emerged as a major health problem in India with one in four Indians suffering from it. Early detection and management of hypertension is necessary to prevent complications such as cardiovascular disease. However, it is a challenge given the shortfall of a trained health workforce, particularly in rural areas.
A new study done by Indian and Australian researchers has found that training available workforce such as Accredited Social Health Activists (ASHAs) could be effective in rural areas.
Researchers led by Amanda Thrift from Monash University developed a training package for health workers and evaluated its effectiveness. The training module helps health workers identify and control hypertension in the community. The study measured the effectiveness of the tool in terms of knowledge, skills, and perception of health workers.
The study was conducted at Thiruvananthapuram in Kerala, West Godavari, and Rishi Valley in Andhra Pradesh. “We selected these places based on the quality of health workforce available there. Thiruvananthapuram has good healthcare facilities, while West Godavari has average and Rishi Valley has poor facilities,” Pallab Kumar Maulik, a member of the research team, said while speaking to India Science Wire.
As part of the study, 15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. They then led community-based education support groups for three months. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and measuring blood pressure and body weight. “We have introduced some very simple lifestyle interventions like how to talk with people, how to measure blood pressure, risks of hypertension, the utility of measuring blood pressure etc.,” Maulik said.
The training was designed to provide ASHAs with knowledge regarding hypertension and its factors, strategies to manage hypertension via knowledge about healthy lifestyle and adherence to medications, and skill in the facilitation of group meetings. Health workers were also taught to deliver community group-based education, and provide support for individuals with hypertension. After the training, researchers found that ASHAs’ knowledge of hypertension improved from a mean score of 64 percent before training to 76 percent post-training and 84 percent after the three-month intervention.
Dr.Maulik said results of the study would be shared with Ithe Indian Council of Medical Research (ICMR). “We hope the government will further use this to improve health facilities particularly in rural areas,” he added. According to him, it was not only health workers but communities also responded positively.
The research team included Marwa Abdel, Clara K. Chow, Pallab Kumar Maulik, Rama Guggilla, Rohina Joshi (George Institute, Australia and India); Amanda Gay Thrift, Michaela Riddell, Oduru Suresh, Roger George Evans (Monash University); Ajay Mahal, Brian Oldenburg (University of Melbourne); Kavumpurathu Raman Thankappan, Gomathyamma Krishnakurup Mini (Sree Chitra Tirunal Institute for Medical Sciences and Technology); Kartik Kalyanram and Kamakshi Kartik (Rishi Valley Rural Health Centre) and Nihal Thomas (Christian Medical College, Vellore). The study has been published in the journal BMC Health Services Research.
Source: India Science Wire.
TRAINING HEALTH WORKERS CAN HELP MANAGE HYPERTENSION IN RURAL AREAS
