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The MAPA is the reference method to estimate the PA during the SAHOS. The MAPA can be recommended over 48 hours: indeed, the PA falls at the beginning of every apnea then increases gradually up to a pressif peak arising at the time of the ventilatoire resumption. These variations arise under the influence of 4 stimulus: the désaturation in O2, the rise of the PaCO2, the increase of the respiratory effort and the microawakening of the end of apnea who are at the origin of a sympathetic stimulation. Consequently a better diagnostic approach of the HTA (confirmation of a resistant HTA, an identification of the masked HTA and the patients " not dipper " by the MAPA), the identification of the SAHOS, and a better coverage) of the associated cardiovascular risk factors are essential and establish a stake in public health. To investigator's knowledge, no datum or study on the association HTA-SAHOS and its consequences was until then realized in the French overseas departments.
Social networks, social capital, i.e., network-accessed resources, and neighbourhood environments have been shown associated with a range of health behaviours and conditions, including obesity, physical activity, nutrition, and mental health. Research on social capital and health in Montreal has shown the importance of network social capital for a person's subjective health status, sense of control, self-reported physical activity, and obesity. Research has also shown high social capital to reduce health service use, mental health service use, and improve the management of chronic illnesses. Despite advances in the understanding of social capital and its link to health and health service use, most research on social capital is cross sectional and is unable to identify the causal pathways linking social networks and capital to health and health care use. Longitudinal research would strengthen the evidence base for designing interventions to prevent or delay the use of health services, particularly in older adults. This research has three main objectives: (1) transform the original sample of Montreal Neighbourhood Networks and Healthy Aging (MoNNET-HA) households (n=2707) into a panel study, (2) link the MoNNET-HA participant data to their Quebec Health Insurance Registry (Régie de l'assurance maladie (RAMQ)) information, and (3) assess the feasibility of extending the MoNNET-HA panel by one wave to include participant's core network members. Unique about the original MoNNET-HA sample is that it purposefully oversampled older adults (> 64 years old) but remains representative of Montreal adults at various ages and income levels. In addition, MoNNET-HA data is integrated into a GIS database which allows researchers to examine the effects of neighbourhood environmental characteristics on health. By linking MoNNET-HA data to RAMQ, researchers will be able to examine patterns of diagnosed health conditions, (e.g., fractures, depression), pharmaceutical use and adherence, and formal health care use over time. Transforming the cross-sectional study into a panel study would also allow researchers to examine longitudinally the dynamics of health and health care utilization among Panel participants over the life course, and the causal pathways linking neighbourhoods and networks to health and health care use.
This final evaluation intends to evaluate SMASH implementation outcomes and intervention effects through quantitative and qualitative assessment, and provide evidence for the national government to develop salt-reduction and blood-pressure lowering strategies in large scales.
This is a Phase I, multi-center, randomized, adaptive, investigator/patient-masked, placebo-controlled, parallel multiple-ascending dose study (Part A) with an extension including up to two selected doses from Part A and latanoprost 0.005% as active comparator (Part B).
The French E3N cohort was initiated in 1990 to investigate the risk factors associated with cancer and other major non-communicable diseases in women. The participants were insured through a national health system that primarily covered teachers, and were enrolled from 1990 after returning baseline self-administered questionnaires and providing informed consent. The cohort comprised nearly 100 000 women with baseline ages ranging from 40 to 65 years. Follow-up questionnaires were sent approximately every 2-3 years after the baseline and addressed general and lifestyle characteristics together with medical events (cancer, cardiovascular diseases, diabetes, depression, fractures and asthma, among others). The follow-up questionnaire response rate remained stable at approximately 80%. A biological material bank was generated and included blood samples collected from 25 000 women and saliva samples from an additional 47 000 women. Ageing among the E3N cohort provided the opportunity to investigate factors related to agerelated diseases and conditions as well as disease survival.
In this prospective long term feasibility study we examine whether a goal oriented therapeutic strategy that is able to preserve right ventricular function will result in improved clinical outcome in patients with pulmonary arterial hypertension. We hypothesize that right ventricular function can only be preserved when early and aggressive medical combination therapy not only reduces pulmonary vascular resistance but also pulmonary pressures.
This study will test whether a digital health intervention (DASH Cloud) using smartphones can improve diet quality among women at risk for cardiovascular disease. The DASH (Dietary Approaches to Stop Hypertension) Diet has been proven to lower blood pressure, yet dissemination efforts remain poor. This study aims to use technology to improve adherence to DASH.
Background: Hypertension is the leading attributable risk factor for cardiovascular disease and death globally. In diagnosing and monitoring hypertensive patient population, home blood pressure monitoring (HBPM) has been shown to be superior to the office-based blood pressure (BP) measurement as a predictor of cardiovascular disease and total mortality. However, the conventional method of HBPM utilizing handwritten BP logbooks has known shortcomings, mainly attributable to inaccuracy and underreporting of data, as well as the failure to bring the logbooks to the regular outpatient appointments. In recent years, the availability of home BP devices with Bluetooth® technology on the market, the increasingly widespread use of smartphones, and the development of mobile applications (apps) that complement Bluetooth® enabled BP monitors have expanded the potential for an accurate log of BP data to be accessible to clinicians. Our study's primary aim is to compare the level of HBPM recording fidelity using smartphone app versus using a handwritten logbook among the multi-ethnic hypertensive patient population seen in a district polyclinic located in Pasir Ris, Singapore. Patient acceptability of the two recording modalities and the association between the home blood pressure recording fidelity and the patients' socio-demographic background, self-care profile, clinical factors, and level of exposure to technology is also assessed as exploratory aims. Our main hypothesis is that the level of fidelity in HBPM recording, defined as the proportion of scheduled number of home blood pressure readings that is successfully recorded, regimen compliant, and made available at the final follow up visit, would be higher for patients who use a smartphone app versus those who maintain a handwritten logbook. Methods/design: Open, randomized controlled trial of 80 patients seen at Pasir Ris Polyclinic randomized to either intervention or control arm and assessed after a 3-week follow up period Intervention arm: Participants randomized to intervention arm follow a 3-week HBPM regimen and wirelessly record the BP readings onto a smartphone app using Bluetooth® technology. Control arm: Participants randomized to control arm follow a 3-week HBPM regimen (identical to intervention arm) and manually record the BP readings onto a handwritten logbook. Participants: A convenience sample of 80 patients visiting the study polyclinic was obtained during the recruitment period (15 Mar 2017 - 15 June 2017). Outcomes: A trained outcomes assessor will assess each participant's home BP record brought to the final follow up visit at 3 weeks post-randomization. The primary outcome will be HBPM recording fidelity, defined as the proportion of scheduled number of home blood pressure readings that is successfully recorded, regimen compliant, and made available at the final follow up visit. The participants' level of discomfort during the study, their willingness to incorporate into their healthcare management the modality of HBPM to which they were assigned, and their overall impression on their study participation will be assessed by a participant acceptability questionnaire.
The barriers faced by people with intellectual and developmental disabilities (IDD) begin in their mid to late 20s and often mirror the experiences of older adults (50+) living in the U.S. While evidence for successful population-specific health promotion programs and training, such as the 12-Week HealthMatters Program has been documented, an urgent need exists for continuous, readily available, on-demand training in these programs. Online training can substantially aid the widespread translation of evidence-based programs into practice and policy. This proposal seeks to test the effectiveness of an enhanced mode of translating the HealthMatters program into practice through the use of an on-demand e-Learning platform (HealthMatters@24/7) for staff in community based organizations (CBOs) in one state; thereby advancing the science of translational research. HO1. More CBOs in the asynchronous training program will have developed Strategic Action Plans for Health and Wellness, established Wellness Committees, and have equal or more resources and improved culture for health promotion at 1 year compared to CBOs participating in the current live HealthMatters TtT Workshop webinar. HO2. Staff in the asynchronous training group will have improved levels of learner/instructor satisfaction (job productivity, job performance, job satisfaction, organizational commitment, convenience) toward the training immediately after completing the enhanced mode of training, HM@24/7 compared to staff trained using the current live HealthMatters TtT Workshop webinar.
The collected data from the Zurich Registry for pulmonary Hypertension (PH) are evaluated in a retrospective analysis. This study examines the number of patients and their exact diagnoses who are treated at the University Hospital of Zurich and potentially other participating in the Zurich Registry. Other demographic parameters such as age, gender and body-mass-index are also part of the evaluation. Furthermore, the analysis will focus on the newest guidelines on PH. Therefore, it will be checked how many patients would fulfill the therapeutic goals in terms of New York Heart Classification (NYHA), 6-minute walk distance, sign of right heart failure and N-terminal pro-brain-natriuretic peptide(NTproBNP). Additionally, the study examines on how the patients are treated. Despite the different kind of Drugs, the focus lies on the combination therapy (single, double, triple) and the impact the therapy had on the patients.