Suchergebnisse

Increased exposure to green space has many health benefits. Scottish Green Health Partnerships (GHPs) have established green health referral pathways to enable community-based interventions to contribute to primary prevention and the maintenance of health for those with established disease. This qualitative study included focus groups and semi-structured telephone interviews with a range of professionals involved in strategic planning for and the development and provision of green health interventions (n = 55). We explored views about establishing GHPs. GHPs worked well, and green health was a good strategic fit with public health priorities. Interventions required embedding into core planning for health, local authority, social care and the third sector to ensure integration into non-medical prescribing models. There were concerns about sustainability and speed of change required for integration due to limited funding. Referral pathways were in the early development stages and intervention provision varied. Participants recognised challenges in addressing equity, developing green health messaging, volunteering capacity and providing evidence of success. Green health interventions have potential to integrate successfully with social prescribing and physical activity referral. Participants recommended GHPs engage political and health champions, embed green health in strategic planning, target mental health, develop simple, positively framed messaging, provide volunteer support and implement robust routine data collection to allow future examination of success.

Increased exposure to green space has many health benefits. Scottish Green Health Partnerships (GHPs) have established green health referral pathways to enable community-based interventions to contribute to primary prevention and the maintenance of health for those with established disease. This qualitative study included focus groups and semi-structured telephone interviews with a range of professionals involved in strategic planning for and the development and provision of green health interventions (n = 55). We explored views about establishing GHPs. GHPs worked well, and green health was a good strategic fit with public health priorities. Interventions required embedding into core planning for health, local authority, social care and the third sector to ensure integration into non-medical prescribing models. There were concerns about sustainability and speed of change required for integration due to limited funding. Referral pathways were in the early development stages and intervention provision varied. Participants recognised challenges in addressing equity, developing green health messaging, volunteering capacity and providing evidence of success. Green health interventions have potential to integrate successfully with social prescribing and physical activity referral. Participants recommended GHPs engage political and health champions, embed green health in strategic planning, target mental health, develop simple, positively framed messaging, provide volunteer support and implement robust routine data collection to allow future examination of success.

Background Although attention is focused on addressing the acute situation created by the COVID-19 illness, it is imperative to continue our efforts to prevent cardiovascular morbidity and mortality, particularly during a period of prolonged social isolation which may limit physical activity, adversely affect mental health and reduce access to usual care. One option may be to deliver healthcare interventions remotely through digital healthcare solutions. Therefore, the aim of this paper is to bring together the evidence for remote healthcare during a quarantine situation period to support people living with cardiovascular disease during COVID-19 isolation. Methods The PubMed, CINAHL and Google Scholar were searched using telehealth OR digital health OR mHealth OR eHealth OR mobile apps AND COVID-19 OR quarantine search terms. We also searched for literature relating to cardiovascular disease AND quarantine. Results The literature search identified 45 potentially relevant publications, out of which nine articles were included. Three overarching themes emerged from this review: (1) preparing the workforce and ensuring reimbursement for remote healthcare, (2) supporting mental and physical health and (3) supporting usual care. Conclusion To support people living with cardiovascular disease during COVID-19 isolation and to mitigate the effects of quarantine and adverse effect on mental and physical well-being, we should offer remote healthcare and provide access to their usual care.

Introduction: Despite cardiac rehabilitation (CR) being recommended in clinical practice guidelines internationally these services are under-utilised, programs are not standardised and quality improvement methods and outcomes are rarely published. National registries are an important strategy to characterise service delivery, quality and outcomes, yet the number, type and components of national CR registries has not been reported. Aims: To identify and describe national and international CR registries internationally, and summarise their key features. Methods: The literature reporting on CR registries used to monitor the quality of CR at a national and international-level was systematically reviewed. A search of four databases was conducted in July 2016, with two reviewers independently screening title/abstracts and full-texts for inclusion. Data were extracted from included studies, independently checked by a second reviewer and synthesised qualitatively. Results: Eleven articles were included in the review comprising seven national registries and one international registry (of 12 European countries) for a total sample of 265,608 patients. Data were most commonly provided to the registry via a web-based application, and included individual-level data (i.e., sociodemographic characteristics, medical history, and clinical measurements). When reported, service-level data most commonly included wait times, program enrolment and completion. The overarching governance, funding modes (e.g., industry (n=2), government (n=1)), and incentives for registry participation (e.g., benchmarking, financial reimbursement, or mandatory requirement) varied widely. Conclusion: The use of national and international registries for characterising CR and providing a benchmark for quality improvement is in its early stages but shows promise for national and global benchmarking. Keywords: Acute coronary syndrome; cardiovascular disease, health information systems; quality Improvement

Background: Understanding Atrial Fibrillation (AF) management in Scotland was identified as a key priority at the Cross Party Group (CPG) for Heart Disease and Stroke which meets regularly at the Scottish Parliament. Therefore, a national inquiry was launched to provide clear recommendations to government to improve health for people living with AF. Methods: An advisory panel was convened comprising major third sector representatives, academics, clinicians, Members of Scottish Parliament (MSPs), and people living with AF. Two questionnaires, one for clinicians; one for people living with AF were circulated through multiple channels and four roundtable events were held. Results: In total there were 262 responses to the questionnaires (n=203 clinician; n=59 people living with AF) and roundtables were attended by 35 people, including members of the advisory panel, MSPs, clinicians, academics and people living with AF. Ten key recommendations emerged relating to Detection and diagnosis of atrial fibrillation; Initial treatment and subsequent management of atrial fibrillation; The use of data to improve detection, diagnosis and treatment of atrial fibrillation in Scotland; and patient information and public awareness. Conclusions: It is hoped that the results of this inquiry will provide the blueprint for change that will improve AF management across Scotland

Commercially available health technologies such as smartphones and smartwatches, activity trackers and eHealth applications, commonly referred to as wearables, are increasingly available and used both in the leisure and healthcare sector for pulse and fitness/ activity tracking. The aim of the Position Paper is to identify specific barriers and knowledge gaps for the use of wearables, in particular for heart rate and activity tracking, in clinical cardiovascular healthcare to support their implementation into clinical care. The widespread use of heart rate and fitness tracking technologies provides unparalleled opportunities for capturing physiological information from large populations in the community, which has previously only been available in patient populations in the setting of healthcare provision. The availability of low-cost and high-volume physiological data from the community also provides unique challenges. While the number of patients meeting healthcare providers with data from wearables is rapidly growing, there are at present no clinical guidelines on how and when to use data from wearables in primary and secondary prevention. Technical aspects of heart rate tracking especially during activity need to be further validated. How to analyze, translate, and interpret large datasets of information into clinically applicable recommendations needs further consideration. While the current users of wearable technologies tend to be young, healthy and in the higher sociodemographic strata, wearables could potentially have a greater utility in the elderly and higher risk population. Wearables may also provide a benefit through increased health awareness, democratization of health data and patient engagement. Use of continuous monitoring may provide opportunities for detection of risk factors and disease development earlier in the causal pathway, which may provide novel applications in both prevention and clinical research. However, wearables may also have potential adverse consequences due to unintended ...