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Transforming health policy through machine learning

1] and social care for an entire population through preventive strategies, protection from disease, promotion of healthy lifestyles, and population screening through knowledge capture (typically in the form of big data). Overall governance will offer a patient-centred approach with the consideration of patient advocacy and workforce and resource management [2] (Fig 1). Herein, we will break down the role of ML in each of these areas.


https://doi.org/10.1371/journal.pmed.1002692.g001

3]. Here, the major limitation is access to large and high-quality population-level datasets with which to apply ML approaches. We feel that the unification of the United Kingdom National Health Service (NHS) dataset of over 66 million individuals in the form of EHRs or even patient health records (PHRs; in which patient data accompany the patients directly) can offer one of the largest datasets worldwide for analysis by ML. This could offer improved predictions for clinical outcomes from current records and could also provide novel hypothesis-generating concepts that may lead research to better understand disease behaviours and their treatments.

4] so that strategies to enhance uptake can be implemented. They can also be used to identify the illegal online sale of prescription opioids from global online vendors [5]. Environmental data from climate sensors can predict climate crises, ecosystem shifts, and pollution trends [6] with higher accuracy than current systems to allow preparation for emergency responses to climate situations or support ecological management strategies. Data from city transportation audits or integrated smart city sensors can also be applied to predict locations of injuries or trauma due to car crashes within towns and cities [7] and inform site-specific interventions to prevent urban vehicular accidents.

8]. The information for this can be obtained from EHRs with the consent and national regulatory adherence in order to target unhealthy behaviours such as buying tobacco-based products or the individual purchasing of alcohol- or sugar-based drinks.

9]. This test was utilised to help identify individuals at high risk of colorectal cancer who were noncompliant to a national screening programme; however, this technology may eventually have the capacity to offer full population screening (also allowing for personalised screening). Deep-learning image screening, for example, on mammography is currently being developed and has the potential to enhance health delivery by supporting scalable, cost-effective diagnostic decisions.

10] can result in the reinforcement of historical biases (and therefore discrimination), for example, in declining the opportunity of health insurance to individuals of a particular race/ethnic group or demographic because of an unrepresentative or biased data source. However, if applied judiciously, ML approaches have the potential to assess for disparities or unjustified data discrimination to ensure adherence to accepted guidelines and data health justice across society.

11]. This prospect has initiated a formidable societal controversy, as arguments over the benefits of AI in supporting resource deficits have also been countered with arguments that AI will lead to massive job losses—for example, in diagnostic radiology or pathology, for which an ML algorithm could appraise multitudes of images on a 24-hour work cycle. Many of these issues carry an impact beyond that of healthcare and have a bearing on national and international economic strategy as well as the wider public discourse on the exact role of AI in society. We suggest that AI’s first and least perilous role should be in resourcing healthcare. This will likely disrupt current work practices but will also generate new jobs and roles. More importantly, ML-based technologies may offer society ‘freed-up’ health practitioner time to focus on direct patient care.

12], will have a widespread and pervasive role within our society. Arguably the least explored area of AI in health policy is its role in governance, which ranges from legislation to strategy, financing, and accountability. Here, ML solutions could offer rapidly produced analytics and appraisal of policy statements. Using these, policy makers and politicians can drive the next generation of health policies. Although many of these ML systems remain experimental and theoretical, they could ultimately present the largest transformative role in health governance to date.

Article source: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002692

Vermont Department of Health commissioner publishes public health article

News Release — Vermont Department of Health
Nov. 8, 2018

Contact:
Ben Truman
802-951-5153
802-863-7281

“Elements of a Comprehensive Public Health Response to the Opioid Crisis” by Health Commissioner Mark Levine Published in Annals of Internal Medicine

BURLINGTON – In an article published in the Annals of Internal Medicine, Vermont Department of Health Commissioner Mark Levine, MD outlined six essential elements for addressing the nation’s opioid crisis.

“Elements of a Comprehensive Public Health Response to the Opioid Crisis,” is co-authored with Dr. Michael Fraser, executive director of the Association of State and Territorial Health Officials (ASTHO). In their article, Drs. Levine and Fraser recommend application of six essential elements for a more coordinated and comprehensive approach to stemming opioid use than is currently employed in the U.S.

The six elements, which are fully explained in their paper, include leadership, partnership and collaboration, epidemiology and surveillance, education and prevention, treatment and recovery, and harm-reduction. According to the authors, the complex nature of the opioid epidemic and its broad, pervasive and substantial impact on communities and society at large justify a multi-pronged set of strategies and solutions.

While the six elements are essential, the authors recognize that a seventh element may also play an important role in addressing the opioid crisis – enforcement. Enforcement lies outside of the public health approach, but Drs. Levine and Fraser acknowledge that law enforcement must be engaged to impact the drug supply, trafficking, and criminal activity that is contributing to the crisis. They also acknowledge there is a limited evidence-base for many of the prevention, treatment, and recovery efforts that currently comprise local, state, and federal responses to the opioid crisis and that more evaluation and assessment is needed.

As head of the agency charged with protecting and promoting the health of Vermonters, Dr. Levine draws from the state’s efforts targeting opioid and drug use disorders. Vermont has focused on building a multi-faceted public and private agency and community partnership approach, from which evidence-based programs, legislation and policies were developed. Many of these programs, such as Vermont’s Hub and Spoke system of care, are being adopted as models by other states.

Learn more about Vermont’s approach to the opioid and substance use disorder prevention, treatment and recovery: healthvermont.gov/alcohol-drugs.

Article source: https://vtdigger.org/2018/11/13/vermont-department-health-commissioner-publishes-public-health-article/

To Your Good Health: Organ transplant, HIV-positive: Who should get Shingrix?

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Article source: https://www.roanoke.com/arts_and_entertainment/to_your_good_health/to-your-good-health-organ-transplant-hiv-positive-who-should/article_8bbcce8a-1680-5465-b960-558ebf87633d.html

Your Good Health: Woman with aches, pains has high iron levels

Dear Dr. Roach: I’m a 70-year-old woman. Last October, during my annual physical, blood tests showed that my iron levels were extremely high.

My doctor did additional blood tests for hemochromatosis and concluded that I didn’t have it.

She suggested that I donate blood every three months to keep the iron levels down, which I have been doing for a year.

Every time I donate, they comment on how high my iron levels are and ask if I’m taking iron supplements (I’m not) or eating a lot of iron-rich foods (no).

I am otherwise healthy, except for aches and pains, and being tired all the time.

Should I be concerned about the iron levels?

I know that with hemochromatosis, the iron is deposited in vital organs and causes damage.

Could this be happening to me?

P.C.

Hemochromatosis is a common but often unrecognized genetic condition caused by an inability to regulate iron absorption.

Iron is absorbed as much as possible, all the time, even if the body doesn’t need it.

You are right that the iron can affect many tissues of the body, particularly damaging the heart and liver, but also predisposing to certain infections and to diabetes.

Your aches and pains also are concerning for joint symptoms, common in hereditary hemochromatosis.

Women who are menstruating have a degree of protection from iron overload, since women lose a quantity of blood each month in menses.

Often, women do not become symptomatic until years after menopause. However, this protection is not perfect and there are clearly cases of severe disease in young women.

I don’t have enough information to comment on how likely it is that you might have hemochromatosis.

Blood tests can lead a doctor to suspect the diagnosis, and in some cases, can make the diagnosis with high certainty, such as in a person with iron overload by blood testing (a high ferritin level, and a high percentage of bound iron in the blood) combined with a positive genetic test.

The diagnosis also can be made by liver biopsy.

I am concerned that the frequent blood donations may have made it harder to make the diagnosis in you, and I’d recommend a consultation with a hemochromatosis expert.

I have known both gastroenterologists and hematologists with particular expertise in diagnosing this condition. Treatment is removing the blood, often through donation.

My first patient with this condition required 70 units of blood to be removed before his iron levels came back into the normal range.

Dear Dr. Roach: What is your opinion on a diet that tells you what to eat according to your blood type?

C.T.

There have been no good studies to show better outcomes for a particular type of diet based on blood type.

No matter your blood type, most people do better with fewer processed foods, less red meat, more fruits, vegetables and legumes, and for people who like them, fish and nuts.

The majority of grains should be whole grains, and simple sugars should be minimized.

Some of the dietary advice I have read suggesting individualized diet based on blood type are still better diets than a typical Western diet.

So changing a diet may not be bad, but I still would recommend choosing a diet based on preference rather than blood type.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

 

Article source: https://www.timescolonist.com/life/health/your-good-health-woman-with-aches-pains-has-high-iron-levels-1.23495743

Healthy Bod: Freeze your way to good health inside a Naples sauna-style cryotherapy chamber


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Derek Carlson receives whole body cryotherapy in the single room chamber on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples. Carlson has had two major injuries and says cryotherapy has helped his recovery immensely. They've put me back together, he said.Patrick Dearborn adjusts his mask before receiving whole body cryotherapy in the single room chamber on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples. Dearborn started receiving cryotherapy in August and comes in about five times a week.Patrick Dearborn leaves the single room chamber after receiving whole body cryotherapy on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples.Derek Carlson receives whole body cryotherapy in the single room chamber on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples.Chris Miller performs a localized cryotherapy treatment on Patrick Dearborn on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples.Patrick Dearborn, left, and Derek Carlson, right, receive NormaTec compression after their full body cryotherapy on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples. Carlson and Dearborn have known each other for over a decade, and Carlson is the one who pushed Dearborn to start receiving cryotherapy.

  • Derek Carlson receives whole body cryotherapy in the single room chamber on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples. Carlson has had two major injuries and says cryotherapy has helped his recovery immensely. They've put me back together, he said.1 of 6
  • Patrick Dearborn adjusts his mask before receiving whole body cryotherapy in the single room chamber on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples. Dearborn started receiving cryotherapy in August and comes in about five times a week.2 of 6
  • Patrick Dearborn leaves the single room chamber after receiving whole body cryotherapy on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples.3 of 6
  • Derek Carlson receives whole body cryotherapy in the single room chamber on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples.4 of 6
  • Chris Miller performs a localized cryotherapy treatment on Patrick Dearborn on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples.5 of 6
  • Patrick Dearborn, left, and Derek Carlson, right, receive NormaTec compression after their full body cryotherapy on Thursday, Nov. 8, 2018, at US Cryotherapy in North Naples. Carlson and Dearborn have known each other for over a decade, and Carlson is the one who pushed Dearborn to start receiving cryotherapy.6 of 6


Editor’s note: This is part of a new series looking at unique health and beauty treatments offered in Southwest Florida. 

Earlier version of the story reported US Cryotherapy uses liquid nitrogen as part of its whole body treatment, however the company only uses refrigerated cold air. 

You can rock to Queen’s “Bohemian Rhapsody” as subzero temps are blasted on your body inside a sauna-style, walk-in cryotherapy chamber. 

That’s what high school football coach Patrick Dearborn, 50, does about five days a week at US Cryotherapy in North Naples. Except, he chooses a different song every time. 

“When I walk out of here it’s like I’ve had five cups of coffee. I feel great, and I still sleep like a baby at night,” said Dearborn, who works in real estate and coaches at First Baptist Academy. 

He started coming to the center in August after years of suffering from pack pain, which he attributes to his days playing college rugby and serving in the Army. Dearborn does nearly every treatment provided at the center, including whole body cryotherapy. He’s also brought in many of his players after practices to recover. 

More: Healthy snacks in vending machines catches on

Dearborn was part of a steady flow of customers on a recent Thursday afternoon receiving different treatments at the health facility tucked inside the Shoppes at Vanderbilt. 

Near the entrance, a row of comfy recliners allows individuals to sit comfortably and undergo NormaTec therapy ($25 for 30 minutes), which uses a compression device around the legs designed for recovery and rehab

The whole body cryotherapy chamber ($40 per session) is visible from the front desk. There’s a private area to change clothes and two rooms for individuals to receive localized therapy (starting at $15) or facial rejuvenation ($35 per session).

“We get everyone from 11- to 12-year-olds to 90-year-olds, and both men and women,” said Michelle Nolan, co-owner of US Cryotherapy in Naples.

For the past three years, she’s owned the franchise alongside her husband, Roger. US Cryotherapy is based out of California and has nearly 30 locations nationwide. Nolan and her husband said they saw firsthand the benefits of cryotherapy and, after moving from Dallas to Naples, they wanted to bring that service here. 

In the past decade, cryotherapy, especially the whole body treatment, has grown in popularity in the U.S. 

People like Los Angeles Lakers basketball player LeBron James and Hollywood movie star Mark Wahlberg have publicly shared their cryotherapy recovery regimen on social media.

The first whole body cryotherapy chamber was built in Japan in the late 1970s, and it was introduced to Europe in the ’80s before coming here. 

How does whole body cryotherapy work?  

Say goodbye to palm trees and sunshine and hello to winter.

Cryotherapy, also known as cold therapy, is the use of low temperatures in medical therapy.

Whole body cryotherapy uses subzero temperatures to activate a fight-or-flight response in the individual’s central nervous system. The cold air is said to release endorphins and enhance circulation, which results in pain relief, mood elevation and anti-inflammation. 

At US Cryotherapy in Naples, the 2½- to 3½-minute treatment helps with chronic pain, athletic injury and overall wellness. 

It works by blasting refrigerated cold air on an individual standing inside the chamber. It’s so cold that small ice flurries fall from the ceiling due to the mix of humidity.

You’re asked to wear minimal clothing to get the full effects. It’s recommended men wear shorts and women a crop top and shorts. 

Local health news: Three more groups sign on to Blue Zones Project in Southwest Florida

The facility provides everyone with thick gloves, slippers, tube socks, a face mask and ear protection to avoid cold-related injuries.

Before going in, individuals choose a song they want to listen to, which is then blasted through speakers inside the chamber. Some people stand still or stretch during the treatment.

The center’s staff monitors their body temperatures throughout the short treatment. 

Skin temperatures average around 90 degrees prior to treatment, Nolan said. 

“As long as temperature drops between 30 and 45 degrees inside the chamber then we know the central nervous system is activated,” Nolan said. 

The amount of time a person is allotted to spend in the chamber depends on body size and mass, Nolan said. 

Once Dearborn exited the chamber, his friend Derek Carlson, 45, arrived for therapy. Also a regular customer, he suffered from juvenile arthritis and is prone to inflammation, which is why he does the whole body treatment often.

“Going through this, it’s like I come out of it with more energy. My body doesn’t hurt as much,” Carlson said.

Other cryotherapy services available

  • Localized therapy: A three-minute spot treatment on the area of pain or inflammation. While cold air is applied to the area, skin temps are monitored by staff to prevent injury. The therapy helps treat a sore neck or back and can also help migraine sufferers. 
  • Facial rejuvenation: An eight-minute cold air facial that promotes blood flow, reduces pores, and helps with fine lines and wrinkles. 
  • Cryoskin 2.0: This skin therapy helps produce slimming and toning on different parts of the body. It complements dieting and exercising. 
  • NormaTec compression: A 10- to 30-minute session of pulsating compression using sleeve systems.

Benefits of cryotherapy

Nolan said individuals come in for a variety of reasons, and some visit more often than others. 

“Some people with autoimmune disorders come in every day,” she said. 

“We have athletes that come in a couple days a week for recovery, depending how much they’re pushing themselves.

“And then we have some people who come in occasionally to add it to their well-being regimen, and it helps them to feel better. It can also help with anti-aging and sleep.”

Who shouldn’t do this

Anyone who recently had a heart attack or suffers from a seizure disorder, chronic obstructive pulmonary disease or a serious cold allergy. 

Each individual is asked to sign a waiver before receiving any treatment, Nolan said, and clients have to be honest about any pre-existing conditions. 

Other cryotherapy centers in SWFL

» COOL Cryo Spa; 1575 Pine Ridge Road, Naples; 239-658-2665

» Orange Cryo Wellness; 4125 U.S. 41 N., Naples; 239-300-0841

» ApothiCare360; 6631 Orion Drive, Suite 112, Fort Myers; 239-690-7700

US Cryotherapy in Naples

Where: 2349 Vanderbilt Beach Road, Suite 504, North Naples

Hours: 10 a.m.-6 p.m. Mondays through Thursdays; 10 a.m.- 4 p.m. Fridays and Saturdays

Cost: First-time specials and package and membership deals available

Info: For prices or to book an appointment, call 239-325-9050 or visit www.uscryotherapy.com/location/naples-fl/

Article source: https://www.naplesnews.com/story/news/health/2018/11/13/naples-cryotherapy-center-promotes-freezing-your-way-good-health/1774062002/

HEALTHY LIVING: 5 things to know about adaptive indoor kayaking – Meriden Record

WALLINGFORD — Kayaking in open water may not be ideal this time of year, however indoor kayaking is an option for those with disabilities and injuries through an adaptive program at Gaylord Hospital.

  The Record-Journal talked with the instructors, as well as participants, during a recent introductory class. Here are five things to know about the activity.

Health benefits

The benefits associated with adaptive sports are physical and emotional.

Katie Kowalski, therapeutic recreation specialist at Gaylord Hospital and program specialist for Gaylord Hospital Sports Association, said the program gives participants the confidence to participate in sports they embraced before their injury or to try something new despite their disability.

“They’re able to build some physical endurance, work on some fine motor tasks and have that social experience as well with people that might have a similar disability,” she said.

Kayak instructors Judy and Brian Cooper said the adaptive kayak class gives participants the opportunity to look beyond their disability or injury.

“We’ve had several…return to do open water (kayaking) just because they like to get out and have that feeling of freedom,” Cooper said.

Kayaking also builds upper body muscles. For those that have limited mobility below the waist, kayaking is a way for them to fully enjoy a sport.

”Best thing I ever heard is ‘you put everyone in these kayaks and get them on the water, you don’t see the disability,’” Kowalski said.

Class

Adaptive kayaking classes are offered in November, February, April and June.

“The main goal is to allow the participants to figure out if they’re comfortable in a kayak and comfortable in the pool water because if that doesn’t happen then they’re not going to be comfortable in open water,” Cooper said.

Outings

After participants complete the program, they are able to try open water kayaking during summer outings through the sports association in collaboration with New Haven Parks and Recreation. Some places kayakers can practice their skills are Lighthouse Point and Wintergreen Lake in New Haven.

Participants

According to Kowalski, a lot of participants have not been in a pool since their injury and getting back in the water is a challenge. 

For Cheshire resident Kimberly Molaskey, kayaking is the latest of the adaptive sports she has tried in the last seven years. 

“It’s nice that they have these adaptive sporting events that I can still participate in,” she said. “I’m so thankful now that I can do it.”

Eileen Hasson of Rocky Hill said she was looking forward to getting back in a kayak. She previously was involved in dragon boating and had kayaked on vacation.

“It’s just nice being on the water because it’s very serene and in my case I had a stroke about two and a half years ago,” she said. “There’s something about being on the water that’s calm.”

Options

The adaptive sports program at Gaylord offers 15 different sports throughout the year including skiing, archery, cycling, curling, golf, rugby, rock climbing and others. 

More information can be found by calling 203-284-2772

Other local places, among others, that offer adaptive sports include The Hospital for Special Care’s Paralympic Sport Club and the Meriden YMCA’s adaptive summer camp for children.

akus@record-journal.com
203-317-2448
Twitter: @KusReporter

Article source: http://www.myrecordjournal.com/News/Lifestyle/Features/Healthy-Living/5-things-to-know-about-adaptive-indoor-kayaking.html

Healthy Living House Call: Vascular Health 101

Dr. Alan R. Wladis, a vascular surgeon at Florida Hospital, answered all your questions about vascular health.

For more information visit:  FloridaHospitalHouseCalls.com

 

 

 

 

 

Article source: http://www.fox35orlando.com/health/healthy-living-house-calls/healthy-living-house-call-vascular-health-101

Healthy Living: Battling Addiction With Virtual Reality

The numbers are staggering.

More than 72,000 people died from a drug overdose last year alone.

That’s 200 a day.

One person every eight minutes.

And the vast majority of those overdoses were opioids. 

In the face of an ongoing health crisis, in Healthy Living we take a look at one cutting edge treatment designed to have people face their addiction head-on.

The VR headset will be available within the next six months for clinical use.

From his research on using virtual reality for addiction, Professor Bordnick is now looking to use virtual reality to empower children and adults with autism with job interviewing skills and social interaction.


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Article source: https://www.9and10news.com/2018/11/12/healthy-living-battling-addiction-with-virtual-reality/

Major traumatic injury can increase suicide risk-details inside

Traumatic injury

Washington DC: Findings of a recent study suggest that a major traumatic injury – such as car crashes and falls – could increase the risk of mental health diagnoses and even suicide. The research has been published in CMAJ (Canadian Medical Association Journal).

“Major trauma was associated with a 40 per cent increased rate of hospital admission for 1 or more mental health diagnoses,” writes Dr Christopher Evans of Queen’s University, Kingston, Ontario, with co-authors. “The most common mental health diagnoses were alcohol abuse, other drug abuse disorders and major depressive disorders.”

There is little evidence on the link between major injury and later mental health issues. This large study, based on more than 19 000 patients in Ontario, contributes to the literature on this important topic. Most participants who had experienced major trauma were male (70.7 per cent), lived in urban areas (82.6 per cent) and had accidental (89 per cent) rather than intentional injuries.

Male sex, low socioeconomic status, rural residence, accidental injuries and surgery for these injuries were associated with higher admissions for mental health issues. Researchers found that children and youth under 18 years of age had the largest increase in admissions for 1 or more mental health issues after injury.

Suicide is also higher in people with major physical injury, with 70 suicides per 100 000 patients per year compared to 11.5 suicides per 100 000 patients in the general population. “Patients who suffer major injuries are at significant risk of admissions to hospital with mental health diagnoses in the years after their injury and of having high suicide rates during this period,” write the authors.

The authors urge that mental health support should be offered to all trauma victims, with special attention to high-risk patients, including children and youth. 

Article source: https://www.timesnownews.com/health/article/major-traumatic-injury-can-increase-suicide-risk-details-inside/312762

Health tips: Obese teenagers can face pancreatic cancer risk


Health tips: Obese teenagers can face pancreatic cancer risk

Obesity can often lead to several health disorders if not controlled on time. Obesity can affect negatively on people of any age group. If your teenager or young adult child is obese, he or she can be at four-times the risk of developing pancreatic cancer later in life, new research warned. Researchers from the Tel Aviv University analysed 1,087,358 Jewish men and 707,212 women between 16 to 19 years for the study published in the journal CANCER.

It showed that overweight and even higher weight within the “normal” weight range in men may increase pancreatic cancer risk in a graded manner. 

Compared with normal weight, obesity was associated with a 3.67-times higher cancer risk among men and a 4.07-times higher risk among women, the report said.

In addition, high-normal BMI and overweight men were associated with 49 per cent and 97 per cent higher risks for cancer, respectively, as compared to those with low-normal BMI.

Pancreatic cancer is the sixth most common cause of cancer-related deaths in the world and adult obesity has been linked with an increased risk for its occurrence. 

It has an extremely low survival rate which has barely improved over the last 40 years. 

The combination of complex chemical, biological, bio-mechanical and structural factors found in pancreatic cancer tissues makes it difficult to treat.

Systemic inflammation caused by obesity is a potential driver behind the development of pancreatic cancer. Thus, managing weight could help reduce the risk, the researchers noted.

(With IANS Inputs)

Article source: https://www.indiatvnews.com/lifestyle/health-health-tips-obese-teenagers-can-face-pancreatic-cancer-risk-482009