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

Rolling ahead with a team that's .500 through November isn't at all tanking — this is seriously a potential playoff team — but it's the same type of conversation the rebuilding squads are having. Leverage assets and playing time to win more now, or stay focused on sustainability?
9.The Company Isn't Doing Well
Despite our global economy, only 20 percent of Americans speak another language. Sixty Vocab is aiming to change that with it’s online foreign language game. Based on the premise that 2000 words equals 60 percent of a foreign language, Sixty Vocab is aiming to make learning essential vocabulary fun. The games teach the words most commonly used in conversation and applies time-based discipline — the faster you guess the word, the more rapidly you move on to the next one. Bridging the gap between your high school classes and a pricey foreign language program, Sixty Vocab is offering a unique option for those who want to learn a foreign language during their morning coffee or commute.
According to Brett Mills, senior lecturer in film and television studies at the University of East Anglia in the UK, Friends was the first sitcom that directly addressed the problems faced by twenty-somethings. Watching the show feels like reading the story of a young person’s life.
现代中国经销商Wang Rongzhen7月20日向路透社指出,现代汽车已经缩减提供给中国进口经销商的产品阵容,仅提供一款车型供销售,而在中国国产的车型不断增加。
1)Thank You: Common courtesy? Sure. But tell me this: When was the last time you forgot (or rejected) gratitude? Whether given in private or public, a sincere ‘thanks’ creates goodwill. Don’t forget your mother’s advice: “Say please.” People are always happier doing a favor than taking an order.
单词popular 联想记忆:
On our increasingly human-dominated planet we can still learn much from the lives of other species. The discovery this year that the Greenland shark lives for 400 years, making it the longest-living vertebrate, puts our hectic lives into perspective.
It is reported that Karl Lagerfeld, the artistic director for Chanel, died aged 85 in Paris, leaving the fashion world reeling at the loss of the man.
“People claim he has a cool exterior but he’s a very passionate guy and he stands up for what he believes in,” says Bob Iger, Walt Disney chief executive and Apple board member since 2011. “That is in both his personal life and at Apple.”
Rounding out the top-performing sectors of 2014 was an unlikely pair: tech (+16%) and consumer staples (+13.2%)—the most aggressive and most defensive areas of the market, running side-by-side toward the finish line, with confounded spectators struggling to concoct a narrative for this. Why would the least cyclical sectors—healthcare, staples and utilities—lead the markets in a year in which unemployment plummeted and GDP growth gained momentum? Much to the chagrin of the pundit class, sometimes there are no satisfying answers. To quote Kurt Vonnegut:
Fortunately, the rules are changing. The proposal of China's Central Economic Conference in early December to give rural residents permanent urban residency sent a strong signal. Premier Wen Jiabao's call in late December for the reform of the household registration system will surely speed up the process.
如果Lloyd Grossman有机会进入奥斯卡得主们的家中,他将会在很多不同的地方看到他们各自的小金人,从高级房产的壁炉台到积尘良久的壁橱深处,都可能看到它的身影。
'One of the challenges of writing the book was that attitude that a heterosexual man can change a woman's life and make her go weak at the knees.
"We hold ourselves to a very high standard," Curry said. "We didn't put any pressure on them defensively in the third quarter. We were sloppy on a couple of possessions offensively and gave them life. Those are things we need to improve on. Everyone likes to learn those lessons in wins."
In an effort to protect China's role in the global economy as a manufacturing hub, the central bank devalued the currency in August, in the biggest drop in decades. Later in the year, after the International Monetary Fund added the renminbi to its group of global reserve currencies, the value of the currency fell further, possibly reflecting capital outflows.

Sectors: out of favour
For years, slow emissions declines in the West have been swamped by rising emissions in the East, and the trend continued in 2013. China's emissions grew 4.2 percent and India's 5.1 percent. Both countries have been constructing coal-burning power plants at a breakneck pace.

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


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. 

adj. 最初的,原始的,有独创性的,原版的

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. 

Americans: While you're here, why not pretend to be Canadian? Very few Britons can tell the difference, and it will allow you to rescue yourself from awkward conversations about the death penalty.
Singapore tops the list as the most expensive city for the third time in a row, but in a year when costs around the world have been highly volatile.

He was under the impression people clicking on the adverts would earn him money. But instead he was charged every time someone clicked on the link.
But the economic picture has brightened considerably in Arizona, as the housing market stabilized and unemployment hit a post-recession low of 7.8% in May. As part of Forbes’ annual Best States for Business, we look at 35 factors to determine the best and worst states, including projected employment. Arizona is expected to have the fastest job growth at 3% annually over the next five years, according to Moody’s Analytics. The job gains are projected to boost household incomes 3.6% annually through 2017, which ranks second best in the U.S. after Illinois. The added jobs also go hand-in-hand with the state’s economic growth, which Moody’s forecasts to expand at a U.S.-best 4.6% annually.
Facebook CEO Mark Zuckerberg
Are Some Molds Dangerous?

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

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.

一线不冷三四线不热 二线城市猴年或迎暖春


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.

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. 

32. Azumio Inc. Sleep time. Accessed 28 August 2017. 

33. RelaxLine. BellyBio. Accessed 28 August 2017.

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.

The names of some of these public Facebook groups, Mic reported, were "Harvard Memes for Elitist 1% Tweens", "UCLA Memes for Sick AF Tweens" and "USC Memes for Spoiled Pre-Teens".
“许多公司在过去几年中大量裁员,不少团队超负荷运转,为了减轻它们的负担,公司纷纷开始招兵买马,”罗伯特哈夫公司董事会主席兼首席执行官麦克斯?麦斯默尔(Max Messmer)指出。“有些机构是出于眼下的需要才增加人手,但很多企业也是在为2011年有望出现的经济增长做好人才储备。”
The mega-retailer didn't have a whole lot to complain about in fiscal 2010. Profits were up and, thanks to its sales, the company once again climbed to the top of the Fortune 500. Same-store sales were about flat for the year, but compared with Target's 2.5% decline, flat is good. Most remarkable was Wal-Mart's image overhaul. It helped that former CEO Lee Scott beefed up health care coverage for employees, thought more about the environment and became a public presence. Certain critics will never be placated and fiscal first-quarter results weren't the greatest. But there's no denying Scott left new CEO Mike Duke a company in fighting form.
Across all European schools, the average salary of alumni three years after graduation ranges from $143,000 for executive MBA graduates to $54,000 for MiM graduates. MBA graduates earned on average $123,000. Spanish and German MiM graduates enjoyed the highest salary three years after graduation, both $70,000 on average. French MBA graduates and Swiss EMBA graduates top their salary scale, with average salaries of $137,000 and $166,000 respectively.
Someone might tell you to ‘Be yourself' in the interview. Don't be yourself. That's the worst advice ever. We don't want people who are neurotic and quirky and whatever else. All we care about is your skill and experience.
During a town hall hosted by MSNBC on last Monday night, host Rachel Maddow asked Clinton whether she would match a campaign promise Canadian Prime Minister Justin Trudeau made good on earlier this year.
Mr Crabb has taken no exposure to Hong Kong’s property market since setting up in Asia 18 months ago, because he says prices are too high and affordability too low.

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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'I think the situation will somewhat moderate in future as society becomes more diverse. But it will take quite a bit of time until we get there,' he told the reporters.
8. 赤脚能够提高记忆力
5. 《在杰克逊高地》(In Jackson Heights)。杰出的弗里德里克·怀斯曼(Frederick Wiseman)带来的三个多小时的新作;这或许可以解释为什么奥斯卡奖的蠢材们再一次没有把他加入候选名单。
Lopez Short is the name of the game, judging from the red carpet looks of Beyoncé and Jennifer Lopez. Both divas went for thigh-high dresses to show off their gams4, with strategically cut out neck and shoulder detail, but where Beyoncé opted to stand out in fire engine red, J. Lo went for soft and satiny earth tones.


  • Only the first three authors are listed, followed by "et al."
  • 楼市新政出台 业内称热点城市房价或迎温和上涨
  • 雷曼股份7.8亿收购华视新文化 未来三年净利润不低于2.4亿

While Jaws's story is extremely unrealistic, it was based on a real series of deaths attributed to a single shark in 1916. In what has been dubbed the "most unique set of shark attacks that ever have occurred," the Jersey Shore saw four people die from shark bites over the course of two weeks. The offending shark was reportedly caught with body parts still in its digestive tract, although leading scientists still aren't sure what drove it to attack so many people.
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