America’s Other Growth Rate: What the U.S. Obesity Epidemic and Healthcare Cost Crisis Mean for the Rest of the World

Increasing obesity rates in the United States have fueled soaring healthcare costs and exacerbated recent fiscal and economic challenges. This phenomena, however, is not unique to the U.S. and many countries, including low and middle-income countries, are seeing increasing numbers of people who are obese or overweight. Finding ways for societies to achieve the benefits of economic growth without suffering concurrent epidemics of obesity and related diseases represents a central challenge to sustainable development. For countries where this epidemic has already taken hold, new policy thinking is needed to mitigate this burden. Meanwhile, emerging nations must define new pathways for development that bypass or minimize these pitfalls. Proactive public policies, innovations in healthcare delivery, and refashioning the lifestyles adopted with growth represent potential avenues through which countries can navigate this issue

Use of m-Health Technology for Preventive Interventions to Tackle Cardiometabolic Conditions and Other Non-Communicable Diseases in Latin America- Challenges and Opportunities

In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation.Fil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Diez Canseco, Francisco. Universidad Peruana Cayetano Heredia; PerúFil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Miranda, Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Ramirez Zea, Manuel. Institute of Nutrition of Central America and Panama; GuatemalaFil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Algorithms for automated diagnosis of cardiovascular diseases based on ECG data: A comprehensive systematic review

The prevalence of cardiovascular diseases is increasing around the world. However, the technology is evolving and can be monitored with low-cost sensors anywhere at any time. This subject is being researched, and different methods can automatically identify these diseases, helping patients and healthcare professionals with the treatments. This paper presents a systematic review of disease identification, classification, and recognition with ECG sensors. The review was focused on studies published between 2017 and 2022 in different scientific databases, including PubMed Central, Springer, Elsevier, Multidisciplinary Digital Publishing Institute (MDPI), IEEE Xplore, and Frontiers. It results in the quantitative and qualitative analysis of 103 scientific papers. The study demonstrated that different datasets are available online with data related to various diseases. Several ML/DP-based models were identified in the research, where Convolutional Neural Network and Support Vector Machine were the most applied algorithms. This review can allow us to identify the techniques that can be used in a system that promotes the patient’s autonomy.N/

Project Retrosight. Understanding the returns from cardiovascular and stroke research: Case Studies

Copyright @ 2011 RAND Europe. All rights reserved. The full text article is available via the link below.This project explores the impacts arising from cardiovascular and stroke research funded 15-20 years ago and attempts to draw out aspects of the research, researcher or environment that are associated with high or low impact. The project is a case study-based review of 29 cardiovascular and stroke research grants, funded in Australia, Canada and UK between 1989 and 1993. The case studies focused on the individual grants but considered the development of the investigators and ideas involved in the research projects from initiation to the present day. Grants were selected through a stratified random selection approach that aimed to include both high- and low-impact grants. The key messages are as follows: 1) The cases reveal that a large and diverse range of impacts arose from the 29 grants studied. 2) There are variations between the impacts derived from basic biomedical and clinical research. 3) There is no correlation between knowledge production and wider impacts 4) The majority of economic impacts identified come from a minority of projects. 5) We identified factors that appear to be associated with high and low impact. This report presents the key observations of the study and an overview of the methods involved. It has been written for funders of biomedical and health research and health services, health researchers, and policy makers in those fields. It will also be of interest to those involved in research and impact evaluation.This study was initiated with internal funding from RAND Europe and HERG, with continuing funding from the UK National Institute for Health Research, the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada and the National Heart Foundation of Australia. The UK Stroke Association and the British Heart Foundation provided support in kind through access to their archives

The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field

It\u27s my iPad! Protecting Critical Data on Personal Mobile Devices in the Medical Setting

The pervasiveness of mobile devices has forced many organizations to support connectivity of corporate and private devices. Corporate devices are highly configurable regarding authentication, encryption, and remote wiping. BlackBerry devices can be fully deployed and managed using a centralized Blackberry Enterprise Server, however when a user owned device connects to enterprise servers, data security becomes a concern. Introduce a litany of complex legislative rulings and laws concerning protected data across various business domains and now personal mobile devices become security risks. This paper will discuss current issues in securing personal mobile devices in the healthcare environment and present possible solutions

Creating a multivariable model to predict primary graft dysfunction after heart transplantation in the United Kingdom using the 2014 International Society of Heart and Lung Transplantation consensus definition

Heart failure places a global strain on healthcare provision. It has an increasing incidence and represents the endpoint of a variety of cardiovascular diseases. The preceding decades have carved out a clear management algorithm for the use of pharmacotherapies (neurohormonal antagonists), device-based therapies (Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies including left ventricular assist devices and heart transplantation. While heart transplantation remains the gold standard for the suitable few, the advancement of healthcare systems and improved working conditions and safety regulations have changed the demographics of the typical organ donor which traditionally were young brainstem death donors (DBD) with minimal other comorbidities. Nevertheless, transplantation confers a substantial survival benefit for selected patients with advanced heart failure, achieving a 1-year survival rate of ≥80%. The primary cause for early mortality in recipients remains primary graft dysfunction (PGD). The incidence of PGD throughout the UK and the world are variable due to the lack of a standardised definition until 2014. My research explored the true incidence of PGD throughout the UK using data collected from each of the 6 transplant centres alongside the National Health Service Blood and Transplant database. I then looked at risk factors for PGD which culminated in the largest PGD study recorded at the time of writing. I also looked into the role of mechanical circulatory support to bridge patients in cardiogenic shock post-myocardial infarction in Scotland. I finally developed 2 scoring systems, 1 for Primary Graft Dysfunction (PREDICTA) and 1 using the modified Delphi Method of a consensus agreement (GTS) to factor in elements of frailty which had been garnering increasing interest at conferences I had attended