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TechnoVascular Health

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Heart Technology

 

Cardiovascular disease (CVD) continues to be the number one cause of morbidity and mortality around the world (World Health Organization [WHO], 2015). It has been reported that over 17.5 million people died as result of CVD in 2012, which accounts to almost 1/3 (31%) of all deaths within that year (WHO, 2015). As a result, more emphasis has been placed on preventive strategies and health promotion. Thus screening for CVD risk has been recognized as a prime method for preventing morbidity and mortality (Surka et al., 2014). With the advancement of technology and its increasing use in health care, benefits have shown promise in preventing CVD (Surka et al., 2014). The article by Surka et al. (2014) discusses the use of a mobile CVD risk application tool and its benefits as a screening tool versus the paper-based screening assessment.

The basis of this study involved the creation of a CVD risk assessment application based on a paper-based screening tool (Surka et al., 2014). The paper-based screening tool assessed for six risk factors, which included age, sex, diabetes, smoking, systolic blood pressure, and body mass index (Surka et al., 2014). Twenty-four community health workers were chosen and trained to use the mobile application using mobile devices (smartphones) and 537 people were screened (Surka et al., 2014). Results indicated that training time for the mobile application-screening tool (3 hours) was about four times less than the paper-based screening training (12.3 hours) (Surka et al., 2014). The mean screening time for the mobile application (21 minutes) was about 1/3 less than the paper-based screening assessment (35.4 minutes) (Surka et al., 2014). Common themes that rose from this study indicated that the mobile application was easier to use, took less time to screen individuals, and resulted in fewer errors (Surka et al., 2014). Nonetheless, these results indicated that the mobile application was favored over the paper-based screening tool due to its ease of use, time efficiency, and avoidance of errors.

The growth of technology and increasing use in health care shows promise for future health considerations. I am excited for what the future holds and am willing to learn more about how technology can be used as an adjunct for patient care. Have a great weekend everyone!

References

Surka, S., Edirippulige, S., Steyn, K., Gaziano, T., Puoane, T., & Levitt, N. (2014). Evaluating      the use of mobile phone technology to enhance cardiovascular disease screening by community health workers. International Journal of Medical Informatics, 83(9), 648-654. http://dx.doi.org/10.1016/j.ijmedinf.2014.06.008

World Health Organization. (2015). Cardiovascular diseases. Retrieved from http://www.who.int/mediacentre/factsheets/fs317/en/

 

 

Cardiovascular Health & Technology

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grunge stethoscopeDuring my search on cardiovascular health and the new technology that is being put forth in order to decrease the dramatic occurrence of heart disease, I came across an extremely unique study currently being conducted by the University of California San Francisco (UCSF). The principal investigators of the study include Dr. Jeffrey E.Olgin, Professor of Medicine and Chief of Cardiology at UCSF; Dr. Mark J. Pletcher, Associate Professor of Epidemiology and Biostatistics and Medicine at UCSF; and Dr. Gregory M. Marcus, Associate Professor of Medicine and Director of Clinical Research for Cardiology at UCSF. According to the University a heart attack happens every 34 seconds here in the United States and although medical advancements in preventing poor cardiovascular health are arising, there is still tons of contributing factors about the heart that we still do not know (Olgin, Pletcher & Marcus, 2014). This study known as the Health eHeart study is different from others in that it relies on what they call BIG data. In other words this study plans on gathering more data about the cardiovascular system and its association with health from more people than any previous research has ever done before. How you might ask? TECHNOLOGY!

The original recruitment for the Health eHeart study is done through the website health-eheartstudy.org, which is supported by both UCSF and the American Heart Association. The study calls for all kinds of participants, those completely healthy, those who have heart disease, and even those that have heart disease that science is unable to treat, as long as they are over the age of 18 (Olgin, Pletcher & Marcus, 2014). Once members join and are participants of the study, they are then able to invite others to join the study through social media (Facebook or Twitter, etc). According to the University, “We’ve made it easy to ask friends and family to join the effort and, if you want, eventually you will be able to post information about the study and let people know how you’re helping to cure heart disease” (Olgin, Pletcher & Marcus, 2014).

In order to gather relevant data from the population within the Health eHeart study multiple gadgets, smartphones and other innovations of the latest technology will be utilized. The first being electronic study visits, in which all data is collected over a secure website allowing data collection to be easier and less time consuming for the participants. Another interesting facet of data collection is the utilization of mobile apps that allow you take surveys, achieve real time measurements, track various behaviors and send in medical information (Olgin, Pletcher & Marcus, 2014). Some participants will even be given sensors to wear in order to monitor the health of their hearts. These sensors will then link up to their smartphones and take blood pressures, heart rate, ECG monitoring, sleep patterns, activities, and heart arrhythmias (Olgin, Pletcher & Marcus, 2014).

In addition to the goal of understanding the causes of heart disease and finding new ways of its prevention, the study also has set out to develop new and more accurate ways of predicting heart disease through measurements, genetics, behavior patterns and family and medical history (Olgin, Pletcher & Marcus, 2014). Additionally, the Health eHeart study has also established the goal of creating personalized tools for patients to use when the development of heart disease is already established (Olgin, Pletcher & Marcus, 2014). Listed below are seven main aspects of heart disease taken from the Health eHeart study that will be further evaluated over its course.
1. Can heart disease be predicted based on measurements, behavior patterns, and family and medical history? Can we look at everyday habits in real time to determine how they affect our cardiovascular health (Olgin, Pletcher & Marcus, 2014)?
2. Can we use technology to develop ways to improve cardiovascular health and rigorously test them to determine their effects on health? Or can we use technology to help people live a more heart-health lifestyle (Olgin, Pletcher & Marcus, 2014)?
3. Can we determine what causes episodes of atrial fibrillation? How do behaviors, diet, other diseases and genes interact to cause it (Olgin, Pletcher & Marcus, 2014)?
4. Can we use mobile technology and sensors to keep people with heart failure out of the hospital (Olgin, Pletcher & Marcus, 2014)?
5. Does being more connected with people improve heart health (Olgin, Pletcher & Marcus, 2014)?
6. Can we predict when heart disease, such as heart failure, coronary disease, or hypertension, will get worse before someone needs hospitalization (and even before the patient knows something is wrong)? Credit card companies use Big Data to alert you when your card has been stolen before you even realize it’s gone; Netflix can recommend movies you’ve never heard of before. Can’t we do something similar for heart disease (Olgin, Pletcher & Marcus, 2014)?
7. Are people with different kinds of genes more vulnerable to particular heart disease risks (Olgin, Pletcher & Marcus, 2014)?

In conclusion to the findings on the Health eHeart study being conducted through UCSF, the success of the study ultimately depends on the participants sticking with the study for many years in order to see who out of those involved become diagnosed with heart disease and who does not. Based on these results and the data collected on the comparing individuals health care professionals can better understand what affects our hearts when compared to others. As their motto states “it only take a few minutes to make a big difference” (Olgin, Pletcher & Marcus, 2014). Visit https://www.health-eheartstudy.org/ to learn more!

Reference
Olgin, J., Pletcher, M., & Marcus, G. (2014). Join the study to end heart disease. Retrieved February 7, 2015, from https://www.health-eheartstudy.org/

Technology is “Booming” for the Baby Boomers

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      Technology in medicine is evolving faster than ever before. Smaller devices, more effective medications and less invasive procedures are exploding on to the market. One technology on the rise is the use of bioresorbable stents. Up until this point, stents have been made of metal. The drawbacks associated with metal stents is that they are associated with acute and late thromobis, require the use of long-term dual anti-platelet therapy, prevent adequate CT or MRI tests, and interfere with vascular remodeling due to the metal scaffold in the artery. Metal stents also make future coronary artery bypass graft (CABG) procedures difficult, if not impossible (Fornell, 2014). 

      Most bioresorbable stents are made of polylactic acid, a naturally dissolvable material. Bioresorbable stents, as the name implies, break down and are absorbed by the body after a few years (Fornell, 2014). Since the stent is absorbed, it eliminates the risk of inflammation (which occurs with metal stents) that can lead to late-stent thrombosis and restenosis. Furthermore, once the stent disappears, the vessel returns to a natural state of physiologic functioning and does not interfere with any future procedures. Disadvantages to the using polymer include recoil after expansion, stent thickness causing maneuverability, and difficulty visualizing a non-metallic stent on fluoroscopy (Fornell, 2014). 

      There are nearly 15 bioresorbable stent programs in progress, with five in the advanced development stages. Samin Sharma, M.D., director of clinical and interventional cardiology at Mount Sinai Medical Center in New York stated, “Dissolvable stents may be a future game-changer for the way we treat coronary artery disease and heart attack in the United States if proven to show clinical benefit in this nationwide clinical trial” (Fornell, 2014).
Although clinical outcomes and recent data is promising, experts believe that more development and experience is needed before polymer stents become the primary device. Stay tuned…

Reference

Fornell, D. (2014, September). Bioresorbable stents are the way   of the future. Retrieved February 5, 2015, from http://dicardiology.com/article/bioresorbable-stents-are-way-future

Group Project Rules

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State a team name, letter of your group (A-F), and describe the reason the name was chosen:
Group 11 (Nikki, Carl, Janine)
COPD – we chose this name because it is the disease we chose to highlight in our project

Group Meeting time(s) and location(s) for the duration of the semester:

 Broome Library
Jan. 28 – Broome Library – delegated first portion of project
Feb 8 – Deadline for voicethread outline and powerpoint on Googledocs
Feb 13 – Nikki’s home – recording voicethread/PPT for 1st part of project

March – TBD
April – TBD

 

 

Role of each group member (Are there roles? Or delegated tasks?):

 Nikki – Leader
Voicethread assignment – Patho/Presentation of disease
Carl – Recorder/Online coordinator
Voicethread assignment – Interventions & related complications to disease process

Janine – Researcher
Voicethread assignment – Pharmacological interventions

 

Who will lead each meeting? If you will rotate, detail how this will occur?:

 Nikki Ives

 

Who will take minutes and record action items? If you will rotate, detail how this will occur?:

 Carl Eisenthal

 

What will your process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

 

-Missing meetings or being late is understandable with proper reason.
– First time offense will be excused and we will try to work on scheduling around
everyone’s schedule
– Repeat offenses will be communicated with member of the group alongside
all the members of the group
– If it is merely difficult to meet based on differing schedules we will attempt
to meet evenings utilizing Skype

 

What will your process be for dealing with distractions (side bar conversations, cell phone conversations, etc.) during a meeting? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

– First time: the group member will respectfully and courteously be asked to put
away distracting devices to have an efficient meeting

– Repeat offenses: will communicate to the member of the group how these
distractions affect other group members.

 

What will your process be for decision making? If you decide on a consensus vote, what will your process be for making a decision if consensus cannot be reached?:

 -We will democratically vote on an agreement.
– If consensus cannot be met, we will agree to compromise on other aspects of the
project in order to fairly reach agreement.

 

What will your process be for dealing with team member who does not fulfill his or her team assignment(s)? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?:

–       If a group member does not fulfill their assignment after expectations have been
communicated, an extension will be made so that they may be able to turn in
their portion of the assignment in time.
– If the offense continues, other group members will have to step in to complete
the assignment to receive credit by instructor. However, the group member’s
failure to cooperate and meet deadlines will be communicated to the professor.
The amount & quality of work (or lack thereof) will be evaluated by the group
alongside Dr. Jaime Hannans to designate the grade this group member merits.

 

What will your process be for resolving conflict within the group? Will the discussion happen one-on-one or as a group?:

 Conflict will be resolved using discussion and compromise by all group members.
If conflict is due to a group member underperforming, the process mentioned
above will be utilized. Discussion will occur as a group and will involve
respect of all group members and their opinions.

 

List any other applicable group norms that your group committed to:

 It was agreed by the group that constant communication and early deadlines will
be set throughout the course of the semester. Group deadlines will be prepared far
in advance of the class deadlines in order to control any unexpected
complications. All group members agreed to respect the early deadlines and
each others’ opinions.

 

 

 

First and Last Name of all group members:
Nikki Ives
Carl Eisenthal
Janine Villanueva

Meal Check Assignment

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Breakfast:

  • 1 Banana (medium sized)

0.4g Fat (0.1g Saturated), 27g Carbs (14g Sugar), 1.3g Protein

  • 1 Cup of Oatmeal

3g Fat (0.5g saturated fat), 0mg cholesterol, 0mg sodium, 27g Carbs, protein 5g

  • 1 cup of 2% low fat milk

4.8g Fat (3.1g saturated), 20mg cholesterol, 100mg sodium, 12.3g Carbs, 8.1g Protein

  • 2 Tbsp of Peanut Butter

16g Fat (3g Saturated), 150mg Sodium, 6g Carbs, 7g Protein

  • 1 Serving of 100% Gold Standard Protein Supplement

1 g Fat, (0.5 saturated fat), 30mg cholesterol, 130mg sodium (5%), 1g sugar, 24g protein

After Gym:

  • 1 Serving of 100% Gold Standard Protein Supplement

1g Fat, (0.5 saturated fat), 30mg cholesterol, 130mg sodium (5%), 1g sugar, 24g protein

  • 20g of dextrose

20g Carbs (20g sugar)

  • 8 egg whites

0.1g Fat, 55mg Sodium, 0.2g Carbs, 3.6g Protein

  • 1 cup of oatmeal

3g Fat (0.5g saturated fat), 0mg cholesterol, 0mg sodium, 27g Carbs, protein 5g

  • 3 strawberries

3g Carbs (3g sugar)

  • 1 oz of almonds

14g Fat (1g saturated), 0mg cholesterol, 0mg sodium, 6g Carbs (1g sugar), 6g Protein

Snack:

  • 1 Serving of 100% Gold Standard Protein Supplement

1g Fat, (0.5 saturated fat), 30mg cholesterol, 130mg sodium (5%), 1g sugar, 24g protein

  • 1 Apple

0.3g Fat (0.1g saturated), 2mg sodium, 25g Carbs (14.4g sugar), 1g protein

  • 1 oz of almonds

14g Fat (1g saturated), 0mg cholesterol, 0mg sodium, 6g Carbs (1g sugar), 6g Protein

Lunch:

  • 8 oz Chicken Breast

11.12g Fat (3.12 saturated), 120mg cholesterol, 42g Protein

  • 2 cups of rice

3.6g Fat (0.8g Saturated), 20mg of sodium, 90g Carbs, 10g Protein

  • 1 oz almonds

14g Fat (1g saturated), 0mg cholesterol, 0mg sodium, 6g Carbs (1g sugar), 6g Protein

Dinner:

  • 8 oz Chicken Breast

11.12g Fat (3.12 saturated), 120mg cholesterol, 42g Protein

  • 1 cup of Rice

1.8g Fat (0.4 Saturated), 10mg of sodium, 45mg Carbs, 5g Protein

  • 1 Spring roll

Unknown but it contained vegetables and steamed shrimp

Bedtime Snack:

  • 1 Serving of Casein Protein Supplement

1g Fat (0.5 saturated), 30mg cholesterol, 150mg sodium, 24g protein

Overall, I believe I would not have trouble meeting a cardiac diet simply because I can consume meals that are low in sodium, fat, and cholesterol if need be. I am not sure I would be able to comply with a diet if protein was limited! As you can tell by the information above I consume about 200g of protein a day and some diets restrict it to less than 30g/day :(

AND YES I DO EAT A LOT!!!!!!!

Meal for a Day

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On February 2, 2015 I had:

  • 1 bowl (about 1 cup) of Reese’s puff cereal with whole milk: Serving size of Reese’s Puffs is 3/4 a cup. Without the milk, total fat is 3g and sodium is 160 mg. 1 cup of whole milk is 9 g of total fat and 130mg of sodium.
  • For lunch:
    • half a steak and white cheddar cheese panini sandwich from Panera bread: total fat 18g and sodium is 910mgOLYMPUS DIGITAL CAMERA
    • 1 regular sized (20 ounces) iced green tea. Total fat is 0g and sodium is 10mg.
  • Dinner: 1 1/2 cup of homemade Ham soup. I do not know the Fat content and sodium but most of the fat and sodium content would be from the Ham. No extra salt was added. Other ingredients (Carrots, onions, celery, potatoes, and elbow macaroni noodles).
  • Snack: 1 bag of mini nutter butters: 115mg of sodium and 6g of total fat
  • Other Beverages besides water: Arizona Green tea: 16 fl. oz. has a total fat of 0g and sodium 20mg

After looking through the American Heart Association Website, there are different recommendations on how to change lifestyle habits such as nutritional habits and exercising. The website also offers different languages such as Chinese and Spanish. Looking at what is recommended for a healthy lifestyle in relation to nutrition and exercise, the recommended sodium intake is 2,400 in order to reduce cholesterol; however, the recommended intake for lowering blood pressure is 1,500 mg. Looking at what I had yesterday, if I had eaten a whole panini sandwich for lunch, I have already eaten more than my recommended sodium intake if I were on a low-sodium diet. Furthermore, my patients may not only have poor blood pressure control, but may also have heart problems such as heart failure that may decrease the recommended sodium intake to about 1,200 mg. I think we ask a lot out of patients, to suddenly make changes in there life especially when it comes to eating habits or exercise. I think it is important to understand that we are asking them to make lifestyle changes and that it takes times. I think including the patient into plan of care is important because it will affect them in the long run. Asking them what they will be willing to cut down and what is possible for them to do now. Making smaller strides to conquer the huge milestone. I do not think I could change into a low-sodium, low-fat diet in one day. I think it would take time, but it’s important to find creative ways in order to conquer the smaller strides. For example, I do really exercise as much as I should and I noticed I would have a lot harder time breathing after a short walk up stairs. Also, my 4 year old sister could not walk far and would constantly complain. What I did, was I decided to walk to the farthest park in my community with my sister and son. After about a week, my sister would not complain walking to the far park nor after we played at the park to go home. Not only did I help build her endurance, I built my endurance back up as well. Maybe, our patients have a hard time walking and can only do minimal exercise, and that is where we as nurses have to be creative in order to help our patients make those small strides.

IMG_4828

Also, on the American Heart Association website, to maintain a healthy diet, control blood pressure and cholesterol, and maintain a healthy weight, a variety of fruits and vegetables should be consumed daily. Looking at my meal list, I need to tackle that better because there will be some days I eat a lot of fruits and vegetables and on some days it is very minimal the amount of fruits and vegetables I eat. Exploring the website, I have gained a better understanding the changes we are asking our patients to make and things that I have to take into consideration such as the patient’s culture and lifestyle.

healthyeater

Yesenia Rosas 2015-02-01 02:48:32

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Here is what I have eaten all day:

  1. Hot chocolate
  2. Fruit smoothie (spinach, 1 slice of cantaloupe, 1 slice of pineapple, ½ banana, and one orange)
  3. Sandwich (mayo, mustard, 2 slices of ham, spinach, and pickles) with one bag of hot cheetos :/
  4. Mexican cobb chicken salad
  5. Lots of water
  6. Hershey chocolate

If I were to have to change my diet to a low sodium/ low fat diet I do not think I would struggle a lot with the “low-sodium” part, because I do not like to eat a lot of salt in general. However, with respect to the “low- fat” part I might find it a bit challenging to adjust at first.

corazon

Advanced Directive Limmerick

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There once was an advanced directive
A measure most certainly corrective
You can fill it out yourself
To plan your future health
Not mandatory, but totally elective

Start of the Semester

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This is the first course that technology is truly being utilized into the classroom setting. I personally like it and wished we had CIKeys earlier in the program. I haven’t had the chance to really blog before so creating my page has been slightly challenging, but it has been fun learning along the way. I am excited to begin the semester and learn about what technology can offer me! :)

Just added a new category…

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It’s called nurs420