Part 2: Health apps, wearables, and sensors: The advancing frontier of digital health

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Restaurants and other retailers across the United States are offering free or discounted items and service to the nation's military veterans Wednesday in honor of the annual Veterans Day holiday observance.
艾米卡兹明(Amy Kazmin)
10月份,中国居民消费价格总水平(CPI)同比涨幅降至1.3%,为今年5月以来的最低涨幅;环比下降0.3%,为今年5月以来的首次环比下降。
长期以来,中国增长数据的人为平稳广为人知,但以购买力平价汇率计算,如今中国毫无疑问是世界第一大经济体,因此这些统计数据传达的信息带来了更广泛的影响。
“Our goal is to produce as many units as we can and, at the same time, make sure that we do it in a way that maintains and enhances the health of neighborhoods,” said Carl Weisbrod, the director of the Department of City Planning.
London Business School has topped the European table for the third year running — but continental rivals lead the European schools in the individual rankings used to compile it.
Initial success was achieved in supply-side structural reform.
Russia regards itself as a great power - it is not in question anywhere inside the country.
Country's biggest stars gathered in Las Vegas on Sunday for the 2013 Academy of Country Music Awards.
Chris Washington, played by London-born Daniel Kaluuya, is drawn into the sinister underbelly of a small American community.
德布勒森是继首都布达佩斯之后的第二大城市,也是消费水平较低的匈牙利的中心地带。
It is unknown why there was still a Best Actress duplicate available when Beatty walked on stage.
First, the companies that gained the most consumer love ...
Length of program: 22 months
Sun said he tried to pry open the elevator door, but dismissed the idea and instead leaned against the wall concerned there could be a malfunction that would send the elevator in a free fall.
加快培育壮大新兴产业。
Christine "Lady Bird" MacPherson is a high school senior from the "wrong side of the tracks." She longs for adventure, sophistication, and opportunity, but finds none of that in her Sacramento Catholic high school. Lady Bird follows the title character's senior year in high school, including her first romance, her participation in the school play, and most importantly, her applying for college.
While both numbers came in below forecast, they show how the BoJ has a tough decision on its hands, with respect to potentially ramping up its quantitative easing programme. The monthly numbers look good, the yearly ones not so much.
答:我的一些作品也来到了美国,自己的作品能够在这里收到喜爱,对此我感到非常的开心和荣幸。
6. You dressed 10 times nicer than usual yesterday。
《星球大战:侠盗一号》预计2016年12月16日上映。
['striktli]
With the release of his book Conscious Capitalism, Whole Foods (WFM, Fortune 500) CEO John Mackey got business leaders thinking about a compelling idea: Companies work best when they create value for all their stakeholders -- not just investors. According to Mackey, key stakeholders include customers, employees, suppliers, society, and the environment. Highlighting companies like Costco, Southwest Airlines (LUV,Fortune 500), and Google (GOOG, Fortune 500), Mackey demonstrates that thinking about more than just the bottom line builds stronger and more efficient businesses.
中国商务部的最新数据不包含个人购买的房地产。有不少个人利用中国资本管制体系的漏洞来获取外汇。但外汇监管机构最近采取措施堵住了此类漏洞,尤其是收紧了对个人购汇的管控——按现行规定,中国公民每年可用人民币购买等值5万美元外汇。


Kobe Bryant
其他人将想方设法利用技术来帮助人们减少上网时间。谷歌(Google)前雇员特里斯坦哈里斯(Tristan Harris)发起的“时光莫虚度”(Time Well Spent)运动正在吸引人气,该运动鼓励设计者理解他们所控制的微妙的心理力量,以解决其所称的“数字注意力危机”。据Recode报道,曾经在Pinterest和Facebook工作的蒂姆肯德尔(Tim Kendall),计划成立一家专注于对抗设备上瘾的初创公司。
我的饮食健康吗?我们所吃的食物种类很大程度上会影响我们在身体和情绪上的感觉。食用过多垃圾食品会导致偏执,使人精力降低。反之,饮食健康则会使人有更好的情绪和更高涨的劲头。


With the increasing proliferation and sophistication of mobile phones, wearable devices such as smart watches, and sensors that can measure and gather a variety of data, public interest is growing in using consumer electronics to take ownership of personal health and wellness. A 2015 survey found that 66% of Americans age 66 and older want to use mobile technologies to improve their health by receiving medication reminders and tracking diet and nutrition, physical activity, and symptoms.[1

即使我们把吉布森视作租赁合同并且他将在夏天离开,雷霆对这笔交易依然感觉良好。
该报告指出,代理商和投资机构的涌入导致世界第二大经济体的增长方式和平台发生了额外的变化。小米科技公司的投资人和创始人雷军、360董事长周鸿祎、中国首富王健林等众多互联网大咖都大力支持流媒体的网络直播,这强烈表明了投资网红经济的巨大利润。
Western states dominate the best states for projected job growth. Only two, Florida and Georgia, of the top 10 are located east of the Mississippi River. Rounding out the top five are Colorado (2.6% annual projected growth), North Dakota (2.5%) and Florida (2.5%).
Coming of age: in the modern banlieues of Paris and in San Francisco in the 1970s. These movies dramatize the harrowing, thrilling passage to womanhood with unsparing honesty and infinite compassion.

Health apps and wearables
Health apps and wearables can unobtrusively gauge physiological and emotional states and collect, quantify, and monitor data regarding a user’s day-to-day behaviors. This “quantified self” can increase users’ self-awareness regarding their behavior and encourage positive changes to their overall health and well-being.[2] These commercially available devices also integrate an array of features to provide motivation through reward systems, opportunities for social in-teraction, tools for self-improvement, and prompts. The novelty, affordability, practicality, and ease of use have resulted in increased consumer enthusiasm and the pervasiveness of these devices.[3,4] With this growing interest in personal health, members of the general public are becoming more involved in monitoring and improving their own health habits.[5-10

Undoubtedly, merely tracking data through a device is not enough to maintain good health-related behaviors long-term, and the software must also incorporate motivational constructs important for the adoption and habituation of behaviors. For instance, a systematic review of studies that considered the use of electronic activity monitor systems found short-term changes in physical activity with self-monitoring, but no demonstration of superiority when the systems were compared with other interventions.[11] Another review of studies on the viability of using mobile technology for measuring and influencing physical activity found that most apps allow users to document their activity, set goals, review real-time feedback, connect to a social support network, and access online expertise.[12] However, less common among these apps were prompts to act and opportunities for problem solving and action planning, which are crucial constructs that translate intention into long-term behavior change.[13]

Sensor technologies
Sensor technologies have begun to enter the telehealth landscape and are primarily focused on continuous monitoring and precise diagnostics to inform management of various health conditions and diseases.[14-17] Sensors can be integrated into a watch or arm band or adhesive bandages and clothing, and then programmed to collect data on cardiac rhythm, heart rate, blood pressure, respiration, oxygen saturation, galvanic skin response, glucose levels, body temperature, body motions, ambient temperature, and global positioning. For health care providers, sensor inputs can permit remote monitoring, real-time teleconferencing, and timely care for patients with chronic diseases. For both patients and clinicians, telehealth supported by sensors can have profound implications. Clinicians can provide timely and patient-centred care to those living at a distance with chronic disease and can coordinate care when multiple providers are involved, reducing costs to the health care system.

A current clinical example is the management of paroxysmal atrial fibrillation with a mobile ECG and app that monitors the patient’s electrical rhythm to detect frequency and patterns of arrhythmias, and may even allow patients to share ultrasound and electrocardiogram data with their health care provider.[18-20] Telemonitoring with sensors can also support self-management of chronic diseases and detect early signs of deterioration in health requiring immediate treatment and advice.[21] Studies to date have demonstrated some clinical promise for the use of home telemonitoring in the context of heart failure and diabetes. A recent Cochrane review found that telemonitoring was an effective way to lower levels of glycated hemoglobin and low-density lipoprotein.[22] Although several studies on heart failure have produced conflicting results regarding the overall benefits of home monitoring,[23-26] systematic reviews have suggested that home telemonitoring reduces all-cause mortality and hospitalizations, and improves quality of life compared with usual care.[22,27] In addition, features such as automated and mobile telemonitoring appear to be more effective compared with other forms of home telemonitoring.[27]

Further studies are needed to determine how home health monitoring can improve patient safety during the transition from acute care to community care, and to examine the impact of home monitoring on health care costs. TEC4Home (Telehealth for Emergency-Community Continuity of Care Connectivity via Home Tele-monitoring), an initiative of the University of British Columbia and Vancouver Coastal Health, is seeking to do this with prospective trials designed to uncover how telemonitoring can support the safety of heart failure patients discharged from hospital to home.[28]

Mobile apps, wearables, and sensors in the clinical setting
Even though mobile apps, wearables, and sensor technologies are promising, further research is needed to validate their use and long-term impact.[29] This research will require the collaboration of clinicians, health researchers, engineers, and computer scientists.[30] Understanding the possible risks of using these technologies, from physiological harm to breaching of privacy and confidentiality with insecure devices, and how to mitigate any risks is also important. Other important issues to consider include patient anxiety with overuse of technologies, health data piracy, self-diagnosis resulting from overreliance on self-monitoring, and patients not seeking help appropriately. These technologies should be used only as complementary tools in the treatment and prevention of health conditions and disease and should not be used in isolation by patients who self-diagnose and self-manage without consulting a health professional. 

The ranking rates the best 100 programmes worldwide for working senior executives.

Instant Heart Rate by Azumio.[31] A free app downloadable to both Apple and Android operating systems that measures heart rate and displays a monitoring strip. As well as helping users accurately track their heart rates, the app is capable of detecting irregular rhythms when palpitations occur. 

Sleep Time by Azumio.[32] A free app that monitors sleep patterns, sleep efficiency, and also acts as an alarm clock. Users can know how often they go into light and deep sleep, and recognize how much of these types of sleep will be necessary for them to feel rested, thereby quantifying the amount of true sleep they need and not just how long they should stay in bed. 

Bellybio Interactive Breating by RelaxLine.[33] A free app that helps users pace their breathing to achieve calmness. Placing the mobile phone against the abdomen, users can follow the sounds emitted to practise deep, abdominal breathing using this simple yet surprisingly effective tool. 

我们发展出人工记录声音的技术已经有几十年了,但是人工植入器官在耳朵这一领域没有任何改变。你可能认为生长在头两边的肉块极易替换,因为它们只是皮和软骨,而不是复杂的器官。事实上,科学家在制作假耳上并没有做得非常出色。传统的替代耳朵看起来或感觉起来都像塑料玩具。
Whatever the underlying cause, last year’s extreme warmth in the West meant that Alaska, Arizona, California and Nevada all set temperature records. Some parts of California essentially had no winter last year, with temperatures sometimes running 10 to 15 degrees above normal for the season. The temperature in Anchorage, Alaska’s largest city, never fell below zero in 2014, the first time that has happened in 101 years of record-keeping for the city.

在第七十届戛纳电影节的第一天,像艾米莉·拉塔基科斯基、阿德里亚娜·利马、莉莉·唐纳森以及皮德拉·尼姆科娃这样的人最终称霸红毯一点也不奇怪。
Yes. The government hasn’t won a vertical merger case in decades. According to the Department of Justice’s own review guidelines, “vertical mergers” between content owners like Time Warner and distributors like AT&T are much less worrisome than horizontal ones. Meanwhile, the Fang companies — Facebook, Amazon, Netflix and Google — now dominate the digital entertainment landscape, which makes the government’s argument that the merger of two old-media firms would fundamentally alter competition even harder to make.
On the sales front, General Motors and Ford F -0.13% lost market share to Chrysler, which leveraged its Jeep brand to previously unimagined heights – and then, metaphorically left its heritage behind when it established legal domicile in the Netherlands and changed its name to FCA US LLC.
为提高中国足球在国际赛场上的竞争力,中国政府日前公布了最新的足球发展计划,将在2017年开设20000所足球专业学校,用于训练年轻球员、培养人才。
由于州政府和市政府试图打击不法的旅馆经营者,明年可能会出台一项规定。而与此同时,房产租赁网站Airbnb将游说政府改变法规。“你会看到,规范这一市场的要求会变得更加迫切。”代表租户的律师塞缪尔·J·希莫尔斯泰因(Samuel J. Himmelstein)说。
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Discernment to determine whether a particular app, wearable, or sensor can be effective.
Expertise and experience to guide patients on the use of technology.
Partnership with patients in pursuit of optimal health through technology use.
Trials to closely monitor benefits and drawbacks.
Humility to recognize that patients may know and invest much more time than physicians in looking for these tools.34

Conclusions
Based on today’s rapid pace of development and public enthusiasm for the technology marketplace, health apps, wearables, and sensors will soon become integral to our patients’ pursuits of good health and will need to be integrated in clinical practice. Physicians must be active agents in these evolutionary times, guiding patients, advocating for evidence to support the use of technologies, and participating in the development and incorporation of technology in patient wellness journeys. Through clinical stewardship and partnership with patients, physicians can use their expertise and experience to guide the growth of innovations into mainstream health care.

Competing interests
Dr Ho receives no personal financial compensation as the principal investigator of TEC4Home (Telehealth for Emergency-Community Continuity of Care Connectivity via Home Tele-monitoring), a project funded by a Canadian Institutes of Health Research grant. This grant is matched by the Michael Smith Foundation for Health Research and the BC Ministry of Health, with additional support provided by TELUS Health and Sentrian. TELUS Health, Cisco, and Avizia have also provided equipment for display in Dr Ho’s Demonstration and Simulation Studio for Health (DaSSH) at UBC. Mr Yao and Dr Lauscher have no competing interests to declare.


购房信贷松绑改变楼市预期 买房人边看边等


References

1. Cision PR Newswire. Fifth annual Pulse of Online Health survey finds 66% of Americans eager to leverage digital tools to manage personal health. Posted 24 February 2015. Accessed 28 August 2017. www.prnewswire.com/news-releases/fifth-annual-pulse-of-online-health-survey-finds-66-of-americans-eager-to-leverage-digital-tools-to-manage-personal-health-300039986.html.

2. Swan M. Emerging patient-driven health care models: An examination of health social networks, consumer personalized medicine and quantified self-tracking. Int J Environ Res Public Health 2009;6:492-525.

3. Gao Y, Li H, Luo Y. An empirical study of wearable technology acceptance in healthcare. Ind Manag Data Syst 2010;115:1704-1723.

4. Kim KJ, Shin DH. An acceptance model for smart watches: Implications for the adoption of future wearable technology. Internet Res 2015;25:527-541.

5. West JH, Hall PC, Hanson CL, et al. There’s an app for that: Content analysis of paid health and fitness apps. J Med Internet Res 2012;14:e72.

6. Abroms LC, Padmanabhan N, Thaweethai L, Phillips T. iPhone apps for smoking cessation: A content analysis. Am J Prev Med 2011;40:279-285.

7. Cowan LT, Van Wagenen SA, Brown BA, et al. Apps of steel: Are exercise apps providing consumers with realistic expectations? A content analysis of exercise apps for presence of behavior change theory. Health Educ Behav 2013;40:133-139.

8. Azar KM, Lesser LI, Laing BY, et al. Mobile applications for weight management. Am J Prev Med 2013;45:583-589.

9. Breland JY, Yeh VM, Yu J. Adherence to evidence-based guidelines among diabetes self-management apps. Transl Behav Med 2013;3:277-286.

10. Lyons EJ, Lewis ZH, Mayrsohn BG, Rowland JL. Behavior change techniques implemented in electronic lifestyle activity monitors: A systematic content analysis. J Med Internet Res 2014;16:e192.

11. Lewis ZH, Lyons EJ, Jarvis JM, Baillargeon J. Using an electronic activity monitor system as an intervention modality: A systematic review. BMC Public Health 2015;15:585.

12. Bort-Roig J, Gilson ND, Puig-Ribera A, et al. Measuring and influencing physical activity with smartphone technology: A systematic review. Sports Med 2014;44:671-686.

13. Rhodes RE, Yao CA. Models accounting for intention-behavior discordance in the physical activity domain: A user’s guide, content overview, and review of current evidence. Int J Behav Nutr Phys Act 2015;12:1-14.

14. Chen M, Gonzalez S, Vasilakos A, et al. Body area networks: A survey. Mob Networks Appl 2011;16:171-193.

15. Appelboom G, Camacho E, Abraham ME, et al. Smart wearable body sensors for patient self-assessment and monitoring. Arch Public Health 2014;72:28.

16. Chan M, Estève D, Fourniols JY, et al. Smart wearable systems: Current status and future challenges. Artif Intell Med 2012;56:137-156.

17. Alemdar H, Ersoy C. Wireless sensor networks for healthcare: A survey. Comput Networks 2010;54:2688-2710.

18. Haberman ZC, Jahn RT, Bose R, et al. Wireless smartphone ECG enables large-scale screening in diverse populations. J Cardiovasc Electrophysiol 2015;26:520-526.

19. Ferdman DJ, Liberman L, Silver ES. A smartphone application to diagnose the mechanism of pediatric supraventricular tachycardia. Pediatr Cardiol 2015;36:1452-1457.

20. Baquero GA, Banchs JE, Ahmed S, et al. Surface 12 lead electrocardiogram recordings using smart phone technology. J Electrocardiol 2015;48:1-7.

21. Wootton R. Twenty years of telemedicine in chronic disease management—An evidence synthesis. J Telemed Telecare 2012;18:211-220.

22. Flodgren G, Rachas A, Farmer A, et al. Interactive telemedicine: Effects on professional practice and health care outcomes. Cochrane Database System Rev 2015;(9):CD002098.

23. Mortara A, Pinna GD, Johnson P, et al. Home telemonitoring in heart failure patients: The HHH study (Home or Hospital in Heart Failure). Eur J Heart Fail 2009;11:312-318.

24. Dar O, Riley J, Chapman C, et al. A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: Results of the Home-HF study. Eur J Heart Fail 2009;11:319-325.

25. Chaudhry SI, Mattera JA, Curtis JP, et al. Telemonitoring in patients with heart failure. N Engl J Med 2010;363:2301-2309.

26. Koehler F, Winkler S, Schieber M, et al. Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: The Telemedical Interventional Monitoring in Heart Failure study. Circulation 2011;123:1873-1880.

27. Kitsiou S, Pare G, Jaana M. Effects of home telemonitoring interventions on patients with chronic heart failure: An overview of systematic reviews. J Med Internet Res 2015;17:e63.

28. TEC4Home Healthcare Innovation Community. Supporting heart failure patient transitions from acute to community care with home telemonitoring technology: A protocol for a provincial randomized controlled trial (TEC4Home). JMIR Res Protoc 2016;5:e198. 

29. Yao C, Ho K. Mobile sensors and wearable technologies. In: Amelung VE, Stein V, Goodwin N, et al., editors. Handbook integrated care. Cham, Switzerland: Springer; 2017.

30. Ho K, Borycki E, Kushniruk A, et al. The health perspective in using digital media for health and wellness. Presented at the IEEE International Digital Media Industry Forum, Boston, MA, 4-6 July 2016.

31. Azumio Inc. Instant heart rate. Accessed 28 August 2017. www.azumio.com/s/instantheartrate/index.html. 

32. Azumio Inc. Sleep time. Accessed 28 August 2017. www.azumio.com/s/sleeptime/index.html. 

33. RelaxLine. BellyBio. Accessed 28 August 2017. https://itunes.apple.com/ca/app/bellybio-interactive-breathing/id353763955?mt=8.

34. Ho K. How health information technologies are enhancing health of patients and their doctors. Presentation at the Alberta Medical Association 2015 Spring Representatives Forum, Edmonton, AB, 13 March 2015.


n. 舒适,安逸,安慰,慰藉
报告显示,去年国内手机总出货量为5.6亿部,同比增长8%。
v. 结带子,饰以花边
地球大气中的二氧化碳浓度超过了百万分之400个单位
STEP 2: STIM
['uld?]
projected
Amy Poehler made out with Bono, Tina Fey mocked George Clooney's taste in women and Matt Damon emerged, bizarrely, as the night's recurring gag.
Everyone has both, but people tend to be most attached to their “best” identity — the one that offers the most social status or privileges. Successful professionals, for example, often define their identities primarily through their careers.
[h?b]

Kendall Ho, MD, FRCPC, Christopher Yao, MSc, Helen Novak Lauscher, PhD. Part 2: Health apps, wearables, and sensors: The advancing frontier of digital health. BCMJ, Vol. 59, No. 10, December, 2017, Page(s) 503-506 - Clinical Articles.



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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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*Writing for a Variety Series: “Last Week Tonight With John Oliver”
他做出了不从事企业战略工作的战略性转变,尽管他自己的学校曾经建议他别从事教育方面的职业,虽然他担任过私人教师。
这样生意繁忙时,调酒师就能腾出手来多做几杯酒。
As the fashion world mourns Lagerfeld, his beloved cat Choupette is one of a number who could be set to inherit his £150million fortune.

尽管郭晶晶没有宣布自己的退役时间,但在12月份的东亚运动会上,她发表的关于有可能休战一年的声明,却又向人们透露着讯息。种种迹象表明,她与霍启刚的感情已经迈入一个新阶段。除非他们俩对中国农历里所讲的2010年是“寡妇年”这一说法深信不疑,不然我们很有能看到郭小姐变成霍太太。

  • Only the first three authors are listed, followed by "et al."
  • 北京超额完成今年各类保障性住房建设任务
  • 科学引导小农户合理利用土地


The first is to view Asia as a market that has proved resistant to rapid development and will require significant structural and regulatory change before taking off. The second sees the possibility of sudden upside surprise.
库迪斯认为,这一点在预防21世纪的泡沫和破灭方面具有重要的监管意义。

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