In line with the UK’s strong leadership on accountability, human rights, and results, the UK government must leverage its leadership on HIV.
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Some of the starkest examples of inequalities come from life expectancy statistics. We can see differences over time (eg Scotland’s declining rank in global comparisons) and between areas and populations (eg differences between areas across the UK). The differences are even more apparent looking at healthy life expectancy. Looking at individual conditions (eg mental health), differences in life expectancy are even apparent in Scandinavian countries. Inequality is a challenge across the world.
Smokers should not rely on e-cigarettes to give up the habit due to a lack of evidence that they effectively help people to quit, the Health and Information and Quality Authority (Hiqa) has said.
Dove va il mondo? E cosa succederà nel 2017? Quali saranno i temi su cui puntare e quali le emergenze? Un buon modo per capirlo, senza la pretesa che sia la verità, è leggere i report che ormai da qualche anno sono realizzati dalla Fondazione Britannica Nesta e dalla Ford Motor Company . Entrambi guardano con (cauto) ottimismo al futuro perché negli ultimi cinque anni la creatività e lo spirito d’intraprendenza hanno guidato il mondo nell’innovazione del mercato e della società.
Background: Digital therapeutics are evidence-based behavioral treatments delivered online that can increase accessibility and effectiveness of health care. However, few studies have examined long-term clinical outcomes of digital therapeutics.
Objective: The objective of this study was to conduct a 2-year follow-up on participants in the Internet-based Prevent diabetes prevention program pilot study, specifically examining the effects on body weight and A1c, which are risk factors for diabetes development.
Methods: A quasi-experimental research design was used, including a single-arm pre- and post-intervention assessment of outcomes. Participants underwent a 16-week weight loss intervention and an ongoing weight maintenance intervention. As part of the program, participants received a wireless scale, which was used to collect body weight data on an ongoing basis. Participants also received A1c test kits at baseline, 0.5 year, 1 year, and 2-year time points.
Results: Participants previously diagnosed with prediabetes (n=220) were originally enrolled in the pilot study. A subset of participants (n=187) met Centers for Disease Control and Prevention (CDC) criteria for starting the program (starters), and a further subset (n=155) met CDC criteria for completing the program (completers) and were both included in analyses. Program starters lost an average of 4.7% (SD 0.4) of baseline body weight after 1 year and 4.2% (SD 0.8) after 2 years, and reduced A1c by mean 0.38% (SD 0.07) after 1 year and 0.43% (SD 0.08) after 2 years. Program completers lost mean 4.9% (SD 0.5) of baseline body weight after 1 year and 4.3% (SD 0.8) after 2 years, and reduced A1c by 0.40% (SD 0.07) after 1 year and 0.46% (SD 0.08) after 2 years. For both groups, neither 2-year weight loss nor A1c results were significantly different from 1-year results.
Conclusions: Users of the Prevent program experienced significant reductions in body weight and A1c that are maintained after 2 years. Contrary to the expected progression from prediabetes to diabetes over time, average A1c levels continued to show an average regression from within the prediabetic range (5.7%-6.4%) initially to the normal range (<5.7%) after 2 years. Further investigation is warranted to test digital therapeutics as a scalable solution to address national diabetes and cardiovascular disease prevention efforts.
The digital healthcare sector is currently undergoing an astonishing transformation. The advent of the Internet of Things (IoT), connected devices and wearables are enabling patients to make informed decisions in relation to their own health. Wearable technology is actively being used by healthcare providers to enhance the patient/clinician engagement process and improve healthcare outcomes for patients and sufferers of chronic diseases. Forward thinking healthcare providers are now looking for ways to leverage the power of mobile technology, and particularly wearables to provide meaningful answers to complex health problems. Today we’re exploring how wearable technology is transforming digital health.
A "truly tobacco-free NHS" needs to be created to help smoker patients quit their habit, health officials say.
Only one in 10 hospitals enforces a smoking ban outside health service buildings, and Public Health England (PHE) wants all hospitals to offer help to quit as part of patients' treatment.
More than a million smokers are admitted to NHS hospitals every year.
PHE chief executive Duncan Selbie said it was not about "forcing people" to quit, but was about "helping people".
A recent report by the British Thoracic Society said 25% of hospital patients were recorded as being "current smokers" - which is higher than rates in the general adult population (19%).
Its other results included:
Via Jeff French
Social marketing is a commonly used strategy in global health. Social marketing programmes may sell subsidized products through commercial sector outlets, distribute appropriately priced products, deliver health services through social franchises and promote behaviours not dependent upon a product or service. We aimed to review evidence of the effectiveness of social marketing in low- and middle-income countries, focusing on major areas of investment in global health: HIV, reproductive health, child survival, malaria and tuberculosis. We searched PubMed, PsycInfo and ProQuest, using search terms linking social marketing and health outcomes for studies published from 1995 to 2013.
The importance of communicating ideas about health, and facilitating learning and discussion amongst the public and particular interest groups, is an enduring component of the functioning of health systems across the world. Just as television and radio have become important vehicles of communicating health messages and concepts, the advent and exciting growth of digital media is set to revolutionise the way in which health information is communicated and gathered. Digital media has fundamentally altered the nature of the interactions around health issues. From a passive one-way transfer of information, often from health professionals to the public, digital media has democratized those interfaces with open dynamic dialogue taking place, often at a very fast pace and at all times of day. The propensity for ideas, information and comment to spread rapidly on digital media creates opportunities for health professionals and leaders to communicate and educate in new ways and to reach communities of interest that form and reform as issues develop.
The ability to gather data from digital media sources is growing rapidly. It can be used to track disease spread and mobilize responses to urgent and emerging problems. The opportunity to make data available on digital media in readily accessible forms can enhance the ability of individuals and communities to analyse, debate and understand health in new ways. The opportunity for healthcare and public health organizations to frame debates and communicate in a timely fashion with wide segments of the population using digital media will continue to grow. To take maximum advantage of these opportunities will require a new style of leadership however. Leaders will have to have an authentic presence in the world of digital media and have the confidence to interact with digital media, such as Twitter, as issues and debates develop. The managed face of media relations and the occasional press release will no longer suffice as the immediacy, intimacy and reach of digital media creates a new health commons of dynamic opportunity.
Our list of trends for digital media demonstrates the multi-faceted aspects of digital media and the growth opportunities we should expect to see on all sides—better informed programme planning, expansion of health information services, deeper relationship building, technology development, personalization of health issues, more robust and meaningful measurement and evaluation, and, ultimately, digital media as the singular driver of health changes.
Potential conflicts of interest: AB-G is an employee of Westat, an employee-owned corporation providing research services to agencies of the US Government, as well as businesses, foundations and state and local governments.
Background: Wearable activity trackers (trackers) are increasingly popular devices used to track step count and other health indicators. Trackers have the potential to benefit those in need of increased physical activity, such as adults who are older and face significant health challenges. These populations are least likely to purchase trackers and most likely to face challenges in using them, yet may derive educational, motivational, and health benefits from their use once these barriers are removed.
Objective: The aim of this pilot research is to investigate the use of trackers by adults with chronic medical conditions who have never used trackers previously. Specifically, we aim to determine (1) if participants would accept and use trackers to increase their physical activity; (2) if there were barriers to use besides cost and training; (3) if trackers would educate participants on their baseline and ongoing activity levels and support behavior change; and (4) if clinical outcomes would show improvements in participants’ health.
Methods: This study was conducted with patients (N=10) in a 12-week physician-led wellness group offered by Family Doctors, LLC. Patients were given trackers in the second week of The Wellness Group and were interviewed 2 to 4 weeks after it ended. The study investigators analyzed the interview notes to extract themes about the participants’ attitudes and behavior changes and collected and analyzed participants’ clinical data, including weight and low-density lipoprotein (LDL) cholesterol over the course of the study.
Results: Over the 12 to 14 weeks of tracker use, improvements were seen in clinical outcomes, attitudes towards the trackers, and physical activity behaviors. Participants lost an average of 0.5 lbs per week (SD 0.4), with a mean total weight loss of 5.97 lbs (P=.004). Other short-term clinical outcomes included a 9.2% decrease in LDL levels (P=.038). All participants reported an increase in well-being and confidence in their ability to lead more active lives. We identified the following 6 major attitudinal themes from our qualitative analysis of the interview notes: (1) barriers to tracker purchase included cost, perceived value, and choice confusion; (2) attitudes towards the trackers shifted for many, from half of the participants expressing excitement and hope and half expressing hesitation or trepidation, to all participants feeling positive towards their tracker at the time of the interviews; (3) trackers served as educational tools for baseline activity levels; (4) trackers provided concrete feedback on physical activity, which motivated behavior change; (5) tracker use reinforced wellness group activities and goals; and (6) although commitment to tracker use did not waver, external circumstances influenced some participants’ ongoing use.
Conclusions: Our findings suggest that adding trackers to wellness groups comprising primarily older adults with chronic medical conditions can support education and behavior change to be more physically active. The trackers increased participant self-efficacy by providing a tangible, visible reminder of a commitment to increasing activity and immediate feedback on step count and progress towards a daily step goal. While acceptance was high and attitudes ultimately positive, training and support are needed and short-term drop-off in participant use is to be expected. Future research will further consider the potential of trackers in older adults with chronic medical conditions who are unlikely to purchase them, and studies will use larger samples, continue over a longer period of time, and evaluate outcomes independent of a wellness group.
La decisione della Regione Emilia Romagna di consentire per legge solo ai bambini vaccinati l'accesso agli asili nido ha suscitato nuove polemiche su un tema cruciale per la salute di tutti e già troppo inquinato da pregiudizi e false "verità" sulla presunta pericolosità delle vaccinazioni, in netto calo già da alcuni anni. Daniela Minerva, responsabile di Repubblica Salute, ne ha parlato con il professor Walter Ricciardi, presidente dell'Istituto Superiore di Sanità, per fare chiarezza e rispondere alle vostre domande.
Digital tech allowing patients to manage long-term health conditions is saving the NHS cash and transforming lives.
In a shed next to his Portsmouth home, former soldier Paul Quinn plugs into state-of-the-art technology, costing only £20 and operated through his iPad, to manage his chronic, life-threatening respiratory disease. He exercises there with his wife Elizabeth, guided by printouts of routines he has pasted to the walls.
What’s the first thing you do when you wake up in the morning? If you’re like millions of Americans, you roll over, grab your phone, check your email and visit your favorite social media sites.
Many use social media sites like Facebook, Twitter, Instagram and LinkedIn for entertainment, to network for business, as their daily news sources or as a way to keep in touch with friends and family. It should come as no surprise, then, that physicians are utilizing social media as a means to connect, share and learn from other physicians. As a physician yourself, if you have a moment throughout your day to engage in social media, you may want to strongly consider learning about the following five most popular social media sites for those in your position:
Doximity is like Facebook for physicians, connecting physicians to other physicians they already know. The company claims to be the largest medical professional network in the United States, with more than 60 percent of clinicians as members. The site boasts functionalities and features such as HIPAA-secure communication, a job board, tools to earn and track CME credits and data on compensation trends for a provider’s specialty and geographic area.
Sermo is one of the biggest, most successful social networks for doctors to collaborate globally. It’s a physician-only site that is often called a “virtual doctors’ lounge,” allowing providers to anonymously ask questions about anything and everything, including the practice of medicine and business management.
DailyRounds is a clinical case site for doctors and medical students. DailyRounds presents clinical cases in a journal-like manner so that physicians can read about short cases and even share some of their own.
Ozmosis verifies the identities of its members to ensure that only U.S. licensed physicians join. Once members, physicians can access knowledge feeds that are similar to Facebook’s friend feed. These knowledge feeds provide continuous updates of new journal clubs, cases, questions and videos.
QuantiaMD is an online community with more than 200,000 registered members. An active community, these physicians learn from faculty members who teach at some of the top medical institutions. Physicians can participate in short expert presentations and collaborate with each other to deliver better care for the patients they serve.
Online communities provide physicians with access to countless resources, including articles, experts in the field, colleagues and networks. These sites also give clinicians a place to share cases, disseminate research and engage in health advocacy. As technology is constantly changing and social media sites tend to come and go, some sites will likely die out and be replaced with newer, more robust solutions. No matter how long these sites last, however, social media sites can play an important role in the advancement of healthcare and will undoubtedly shape the way physicians share information, ideas and career interests.
LONDON, United Kingdom — Stocked with cold pressed juices, fresh salads and healthy snacks, Mother’s innovative vending machines are turning the notion of convenience food on its head.
Launched in 2014 in London, the ground-breaking machines, filled with healthy and nutritionally-balanced food, can be found in various locations across the capital, including Amazon’s headquarters and Tower 42.
Using bespoke technology to produce a streamlined and interactive experience for users, the intuitive 22 inch touch screen found on each machine, displays high-res images that reflect the physical location of the items on offer as well as showing their dietary values, which can be filtered to meet the requirements of each customer.
Pour Arièle Billat, patiente à l'institut Paoli-Calmettes, il est essentiel d'instaurer un dialogue soutenu avec les équipes soignantes afin d'exercer, à certaines étapes du parcours de soin, son libre choix.
Suis-je la mieux placée pour décider de ce qui est bon pour moi? Selon d’où l’on entend cette question, on peut y voir soit une évidence – qui rejoindrait en quelque sorte l’adage selon lequel on n’est jamais si bien servi que par soi même – ou, au contraire, si l’on se met dans la position d’une patiente atteinte de cancer, on aura pour premier réflexe de trouver cette question nulle et non avenue: le cancer est une maladie trop grave et compliquée pour que moi, femme et malade, confrontée à ce séisme dans ma vie, je puisse imaginer avoir les cartes en main. On se dit d’emblée que l’équipe soignante, l’hôpital à qui je confie mon corps malade et mon incertain avenir, savent mieux que moi ce qui est bon pour moi. Autonomie et maladie ne font pas bon ménage…
Via catherine cerisey
Patients seem to embrace the idea that more frequent communication with their provider via digital tools could lead to improved health. If given the option, 64 percent of survey respondents said they would submit personal, real-time healthcare information to their provider, although that willingness to share online varies between ages.
Via VAB Traductions
The internet has transformed our lives, particularly in the way we access information and communicate with each other. Today academic physicians have more tools than ever in the form of social networking and other online resources to disseminate their scholarly work worldwide. Some of these sites even provide analytics that can help academic physicians measure and report their reach, and these metrics may be useful when filing for promotion.
The plan, which is supported by the Royal College of Midwives, is part of a wider drive to discourage cigarettes at hospitals
Millions of people will receive devices and apps free on the NHS to help them manage conditions such as diabetes and heart disease in an major drive to use technology to reduce patient deaths.
NHS England’s chief executive, Simon Stevens, has backed the move as a significant expansion of self-care that could help prevent patients becoming seriously unwell and needing hospital treatment.
He wants people who already use apps such as Uber or Airbnb to show the same willingness to embrace digital technology that could alert them to the possible onset of a stroke, heart attackor deadly infection. The NHS will start making them available to patients in England from next year. If widely adopted, they could save tens of thousands of lives a year, Stevens said.
Technology is revolutionizing our understanding and treatment of disease, says the founding director of the Icahn Institute for Genomics and Multiscale Biology at New York’s Mount Sinai Health System.
Most companies make a conscious and deliberate decision to embrace digitization and the information revolution. Yet the role of big data in medicine seems almost to compel organizations to become involved. In this interview, Dr. Eric Schadt, the founding director of the Icahn Institute for Genomics and Multiscale Biology at New York’s Mount Sinai Health System, tells McKinsey’s Sastry Chilukuri how data-driven approaches to research can help patients, in what ways technology has the potential to transform medicine and the healthcare system, and how the Icahn Institute is building its talent base. An edited transcript of Schadt’s remarks follows
New “public service” advertising from a Swedish foundation features the brilliant physicist and cosmologist Stephen Hawking. But the advertising is more public nuisance than public service. Its objective appears to be promoting obesity awareness. The message is tired and false:
We eat too much and move too little. Fortunately, the solution is simple – more physical activity, a change in diet. It’s not rocket science. And for what it’s worth, how being sedentary has become a major health problem is beyond my understanding.
The most enlightening part of this ad was the honesty of this brilliant man in admitting that he has no understanding of obesity. The ad prompted exasperation from people who know better.
“Clearly being a genius in one area doesn’t translate to others,” said the University of Ottawa’s Yoni Freedhoff.
“Despite admitting he doesn’t know about obesity, he proceeds to make tired recommendations. Unacceptable,” said Andrew Brown of the University of Alabama at Birmingham.
“A brilliant cosmologist…is a brilliant cosmologist. Not a brilliant obesity expert. Even the brightest minds have some gaps in knowledge about what obesity is, and what it isn’t,” said Texas Tech’s Emily Dhurandhar.
“OK. Fine. I will stick to obesity, and stop expressing my views about the cosmos,” said Nikhil Dhurandhar, a past president of the Obesity Society.
Awareness of obesity is not much of a problem. People with obesity have mirrors. Even without mirrors, plenty of bystanders offer up daily insults about weight and body image. Rude, insulting, and stigmatizing behavior is not helping. It’s hurting. So obesity awareness “public service” advertising is really just a public nuisance.
The only awareness that’s lacking is awareness of the complexity of obesity and the need for evidence-based solutions that actually work. Hawking inadvertently proved that point with his ad. Tired advice to eat less and move more has been tried by virtually everyone who has struggled with excess weight. More often than not, it doesn’t cure the complex, chronic disease of obesity.
For that we will need more curiosity, more research, and better obesity care.
Pre-diabetes: a helpful concept?
There is no doubt that a lot of later-onset diabetes can be prevented simply by encouraging people to eat less and do more. But just as the pressures of commerce encourage us to eat more food and buy more cars, so the same pressures operating through pharmaceutical companies seek to create a vast market for drugs which offer people the prospect of avoiding diabetes while carrying on with their usual lifestyles. For this reason they have constructed a concept called “pre-diabetes”, to identify a group of people who are at added risk of developing type 2 diabetes. And since there is every incentive to make this group as large as possible, it now includes over half the adult population of China, and around one third of the population in the USA and the UK. Proponents of the “pre-diabetes” concept point out that diabetes is the leading cause of blindness, kidney failure and amputations in the population, and now accounts for 12% of NHS spending.......
Pre-diabetes is a classic case of an artificial diagnosis, a form of disease-mongering that is often now called “overdiagnosis”. For further discussion of pre-diabetes, watch John Yudkin’s brilliantly clear and entertaining lecture below.