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

Much joy to you in the up coming year. May the warmest wishes, happy thoughts and friendly greetings come at New Year and stay with you all the year through.
“Brands that are known for going it alone are partnering with unexpected allies,” Gilbert says. “If you dig into Apple’s investment, the special projects team reads like a who’s who list of some of the best talent in the world coming from every sector imaginable.”
He and his girlfriend wrote to each other when he was studying science, he said.They did eventually marry and have four children.
US president Donald Trump’s zero-sum, Art-of-the-Deal approach to negotiation will give comfort to old-fashioned incumbents. I am hoping 2018 will provide an opportunity for positive, problem-solving new leaders to emerge. But change could stall if business chiefs, disheartened by the poor quality of political leadership, turn inwards instead.
Czech model Petra Nemcova went for a dress in white, which featured an extremely plunging neckline and thigh-high split. Ensuring that both her lithe legs were highlighted to the max, the stunning blonde made sure all eyes were on her as she sashayed down the red carpet.
根据美国国会预算办公室(Congressional Budget Office)的数据,税收增加与支出削减将2013年的经济增速拉低了约1.5个百分点。许多预测人士认为,2014年财政因素对经济增速的拖累幅度将是2013年的三分之一或更低。牛津经济研究院(Oxford Economics)的美国经济学家达科(Gregory Daco)称,今年政治方面的确定性更高。
China Hyundai dealers seek up to $135 million compensation
或许纯粹是巧合,但Magento首位产品经理蒂姆o舒尔茨也刚刚加入Bigcommerce,出任产品管理高级副总裁。舒尔茨近年来担任谷歌Shopping Express、Wallet等服务的战略合伙和商业发展高管,未来将专注于Bigcommerce的一站式体验,将电子商务和实体零售更好地结合起来。“消费者想要无缝化体验,”他说。
But despite the anticipation, it seems the underwear brand's debut in the Chinese city is not going entirely to plan.
今年由美国电影学会的电影评审总监是Tom Pollock,担任电视剧评审总监的是Richard Frank。评审团的其他成员还包括Judd Apatow, Halle Berry, Jamie Lee Curtis, Leonard Maltin,来自知名大学的著作家,学者,公认的电影艺术家,还有像媒体NPR,Rolling Stone, TV Guide, 华盛顿邮报对于电视电影的评论家们。
Frankly, this is unlikely to be ready in time for next year, but we'll include it just in case. The second film from Laszlo Nemes, who won the foreign language Oscar earlier this year for Son of Saul, is a coming-of-age drama set in Budapest just before the first world war.
电池电力可能最终被证明是一种过渡性技术。最近电池成本的降低速度已经放慢了,特斯拉曾经承诺要在2017年生产出价格在35,000美元左右的Model 3。要实现这个目标,特斯拉的电池成本需要下降30%。相比之下,丰田(Toyota)最近的举动非常出人意料。它与特斯拉签订的电池供应协议即将期满,但丰田并未续约,而是准备加倍投入研发氢燃料电池。燃料电池的成本下降速度要快于普通电池。而且燃料电池的拥趸们认为,车主肯定会更喜欢充电速度相对更快的燃料电池,而不是要为充电等上好几个小时。
9. Am I spending too much? Overspending can lead to stress, clutter, and financial complications. It can also turn into a nasty habit over time. Saving money is an excellent practice and you will more than likely be glad you did in case of an emergency.


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. 


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. 

Bernard Baumohl 作为Economic Outlook Group的首席经济学家,表示他甚至更乐观的认为接下来的两年将会成为至少近十年以来形势最好的两年,他还称“有很多证据充分的表明了经济正在恢复的势头”。

The survey is based on costs of over 160 items ranging from food and clothing, to domestic help, transport and utilities.
For: The National Board of Review gave it their best film, actor and actress awards.

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.

儿童家具多如牛毛 老年家具凤毛麟角


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.

Perhaps just as important, stable or falling prices will boost the inflation-adjusted pay of U.S. workers and gives them more bang for their buck. "It's an unambiguous positive for household demand," said Neil Dutta, head of economics at Renaissance Macro Research. "People will have more money to spend."
You know the old guy who's been at the company forever and still can't figure out email? If you don't get up to speed on social media in 2014, you'll be that guy. Compared to last year, there are 13 times as many jobs advertised on that mention the use of social media. "We are seeing an increased demand for social savvy candidates across the business -- from human resources to product to customer service, " Amy Crow, Indeed's communication director told Quartz earlier this year. Not only are departments like marketing, sales, and customer service expected to be on Twitter (TWTR) and Facebook, teams as diverse as R&D, logistics, and HR are increasingly using internal networks like Yammer to streamline operations. Social media has grown so critical to the workplace, in fact, that major universities are beginning to offer certificate programs for socially inept corporate types to get up to speed.
*Guest Actor in a Drama Series: Hank Azaria, “Ray Donovan”
A total of 61 IPOs were launched on the Shanghai and Shenzhen stock exchanges, down 67 percent on the same period last year. About 28.8 billion yuan (4.3 billion U.S.dollars) was raised, down by 80 percent.

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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5.Effective decision makers
China's box office sales hit a record high in 2015, by pulling in 44 billion yuan, or some 6.8 billion US dollars, with domestic films accounting for a large chunk of that growth.


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Victoria's Secret angel Candice Swanepoel comes 4th amongst 10 most beautiful women of 2015. This South African beauty came in 10th on the Forbes top-earning models list last year. She was voted No. 61 in 2010, No. 62 in 2011, and No. 75 in 2013 in FHM's annual “100 Sexiest Women in the World” poll and No. 1 in 2014 Maxim's "Hot 100 List".

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