Efficacy of an online video to promote health insurance literacy among students

This study describes the production and evaluation of an online video explaining health insurance functioning to university students in France. The video was produced by a multidisciplinary team following a design thinking approach. A qualitative evaluation was performed using semi-structured interviews with 30 students. Results showed that, after watching the video, students had remarkably improved their knowledge and obtained clear information on health insurance functioning. This study underscores the importance of using innovative digital communication tools to efficaciously promote health insurance literacy

Changes in blood pressure in a large cohort of elderly individuals: Study 3C

SummaryObjectiveAnalysis of changes in blood pressure with a two-year interval, and of factors associated with this change, in a large cohort of elderly individuals.MethodsFollow-up of a cohort of 9294individuals aged 65years and over recruited from the general population for Study 3C. Changes in blood pressure are defined as the difference in its averages between the inclusion visit and the follow-up visit at 2years. The factors associated with changes in systolic blood pressure were identified by univariate and multivariate analyses.ResultsSystolic and diastolic blood pressure decreased on average by 7.60mmHg and 4.45mmHg respectively in 7659individuals included in the study between the initial measurement and the follow-up at 2years. The analyses revealed that the initial high blood pressure level was the main factor for this decrease that would be explained by a phenomenon of regression towards the mean.ConclusionThese results confirm the importance of repeating blood pressure measurements during several examinations for a good estimate of individual blood pressure values in this age range. It is also important to consider this phenomenon in studies including specific blood pressure estimates only

A location-scale joint model for studying the link between the time-dependent subject-specific variability of blood pressure and competing events

Given the high incidence of cardio and cerebrovascular diseases (CVD), and its association with morbidity and mortality, its prevention is a major public health issue. A high level of blood pressure is a well-known risk factor for these events and an increasing number of studies suggest that blood pressure variability may also be an independent risk factor. However, these studies suffer from significant methodological weaknesses. In this work we propose a new location-scale joint model for the repeated measures of a marker and competing events. This joint model combines a mixed model including a subject-specific and time-dependent residual variance modeled through random effects, and cause-specific proportional intensity models for the competing events. The risk of events may depend simultaneously on the current value of the variance, as well as, the current value and the current slope of the marker trajectory. The model is estimated by maximizing the likelihood function using the Marquardt-Levenberg algorithm. The estimation procedure is implemented in a R-package and is validated through a simulation study. This model is applied to study the association between blood pressure variability and the risk of CVD and death from other causes. Using data from a large clinical trial on the secondary prevention of stroke, we find that the current individual variability of blood pressure is associated with the risk of CVD and death. Moreover, the comparison with a model without heterogeneous variance shows the importance of taking into account this variability in the goodness-of-fit and for dynamic predictions

Migraine and risk of haemorrhagic stroke in women: prospective cohort study

Objectives To examine the association between migraine and migraine aura status with risk of haemorrhagic stroke

Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study

Objective To study the relation between low walking speed and the risk of death in older people, both overall and with regard to the main causes of death

JMIR Serious Games

Background: Vaccine hesitancy is a growing threat to population health, and effective interventions are needed to reduce its frequency. Digital gamification is a promising new approach to tackle this public health issue. Objective: The purpose of this scoping review was to assess the amount and quality of outcomes in studies evaluating gamified digital tools created to increase vaccine knowledge and uptake. Methods: We searched for peer-reviewed articles published between July 2009 and August 2019 in PubMed, Google Scholar, Journal of Medical Internet Research, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, and SocINDEX. Studies were coded by author, year of publication, country, journal, research design, sample size and characteristics, type of vaccine, theory used, game content, game modality, gamification element(s), data analysis, type of outcomes, and mean quality score. Outcomes were synthesized through the textual narrative synthesis method. Results: A total of 7 articles met the inclusion criteria and were critically reviewed. Game modalities and gamification elements were diverse, but role play and a reward system were present in all studies. These articles included a mixture of randomized controlled trials, quasi-experimental studies, and studies comprising quantitative and qualitative measures. The majority of the studies were theory-driven. All the identified gamified digital tools were highly appreciated for their usability and were effective in increasing awareness of vaccine benefits and motivation for vaccine uptake. Conclusions: Despite the relative paucity of studies on this topic, this scoping review suggests that digital gamification has strong potential for increasing vaccination knowledge and, eventually, vaccination coverage

Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials

Objective To evaluate the effect of vitamin E supplementation on incident total, ischaemic, and haemorrhagic stroke