Academic literature on the topic 'Coronary heart disease Victoria Melbourne'

The Getting It Together Rural Health Promotion project was established by a group of community health providers in Gippsland, Victoria. The overall aim of Getting It Together was to extend and improve health promotion practice amongst participating organisations. This was achieved through collaboration around health promotion training and planning. Complementary strategies addressing Cardio-Vascular Disease (CVD) were developed across four Local Government Areas (LGAs). Central resourcing was provided for coordination of the project, and for marketing and network support tasks. The project was based on an integrated and coordinated health promotion model, which contained overlapping strategies combining to create a broadly based partnership of action. At the commencement of the project, health promotion workers from each LGA were provided with a three-day training course conducted by the Royal Melbourne Institute of Technology University (RMIT). Participants developed Action Plans based around the three driving strategies of community wide-strategies, targeted strategies and marketing. A special feature of Getting It Together was a common media strategy, to support and reinforce action at the local level. An overall slogan was adopted, 'Slicker Ticker - A Gippsland Healthy Heart Project'. Uniting themes included 'Stress Less Week' and 'Gippsland Get Up and Go'. Latrobe Community Health Service facilitated the project and senior managers from the partnering agencies formed a Steering Committee, which met at key intervals to monitor the project.

Objectives: Coronary artery disease (CAD), also known as ischemic heart disease or atherosclerotic cardiovascular disease (CVD), is one of the major causes of morbidity and mortality globally and has contributed to about 80% of sudden deaths. There have been advancements in the diagnosis and treatment of CAD, some of which are still going on to improve patient care, however, there is a dearth of information regarding the various challenges the patients go through after being diagnosed with CAD and so a qualitative study was conducted on cardiac patients in Mauritius to shine a light on the various aspects of life affected by CAD. This is the first qualitative study conducted on cardiac patients in Mauritius. Material and Methods: A phenomenological qualitative study was performed on 12 patients who were diagnosed with CAD, at the Cardiac Unit of Victoria Hospital, Mauritius. By the use of NVivo 12 (Windows) Plus software, after it was transcribed, codes/nodes and themes were generated. Results: Twenty-five different codes were inferred from the study done and from the respective codes, eight main themes were established. The main themes drawn from the study were as follows: Emotional factors, risk factors, optimistic factors, support, awareness of your health, consequences, lifestyle modifications, and the healthcare system. Conclusion: An event of CAD is an experience with multifaceted influences on innumerable aspects of the patient’s life. The study illuminated the immense sufferings and emotional bearings of those patients who were living with heart disease. They expressed their overbearing, insecurities, and a loss of control over various aspects of their lives. This study provided various thought-provoking themes that emerged after transcribing the qualitative interviews. It also highlighted the various challenges faced by patients and how the beliefs of patients with CAD were vital to sustaining them. Family support is a vital aspect in keeping the patient both motivated to follow their treatment and emotionally grounded.

IntroductionIt is important to ascertain the cost-effectiveness of alternative services to traditional cardiac rehabilitation while the economic credentials of the Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) programme among people with coronary heart disease (CHD) are unknown. This economic protocol outlines the methods for undertaking a trial-based economic evaluation of SCRAM in the real-world setting in Australia.Methods and analysisThe within-trial economic evaluation will be undertaken alongside a randomised controlled trial (RCT) designed to determine the effectiveness of SCRAM in comparison with the usual care cardiac rehabilitation (UC) alone in people with CHD. Pathway analysis will be performed to identify all the costs related to the delivery of SCRAM and UC. Both a healthcare system and a limited societal perspective will be adopted to gauge all costs associated with health resource utilisation and productivity loss. Healthcare resource use over the 6-month participation period will be extracted from administrative databases (ie, Pharmaceutical Benefits Scheme and Medical Benefits Schedule). Productivity loss will be measured by absenteeism from work (valued by human capital approach). The primary outcomes for the economic evaluation are maximal oxygen uptake (VO2max, mL/kg/min, primary RCT outcome) and quality-adjusted life years estimated from health-related quality of life as assessed by the Assessment of Quality of Life-8D instrument. The incremental cost-effectiveness ratio will be calculated using the differences in costs and benefits (ie, primary and secondary outcomes) between the two randomised groups from both perspectives with no discounting. All costs will be valued in Australian dollars for year 2020.Ethics and disseminationThe study protocol has been approved under Australia’s National Mutual Acceptance agreement by the Melbourne Health Human Research Ethics Committee (HREC/18/MH/119). It is anticipated that SCRAM is a cost-effective cardiac telerehabilitation programme for people with CHD from both a healthcare and a limited societal perspective in Australia. The evaluation will provide evidence to underpin national scale-up of the programme to a wider population. The results of the economic analysis will be submitted for publication in a peer-reviewed journal.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12618001458224).

Background Alternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. Objective The aim of this study is to compare the effects and costs of the innovative Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) intervention with usual care CR. Methods In this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. Results The trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. Conclusions The innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with diverse needs. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12618001458224; anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. International Registered Report Identifier (IRRID) DERR1-10.2196/15022

In modern industrialized countries coronary heart disease is the single most important cause of death and disability as well as the biggest cause of premature death. There are known global geographical variations in the incidence of coronary heart disease with currently the Eastern European countries having the highest mortality rates, Australia in the middle of the range and Spain, France and Japan having the lowest. Coronary heart disease still remains to be a leading cause of death in Australia, despite its decline in the past 25 years, which is mainly attributed to the improvements in medical management and to the lower prevalence of behaviours which increase the risk of heart disease. Australia is a multicultural society and a country where one person in five is born overseas thus, its national health profile is significantly determined by the health of its immigrants. It is evident from the literature that the mortality rate from CHD amongst immigrant groups in Australia is lower than that of the Australian-born. This is explained by the stringent selection processes involved in migration approvals where only healthy strong immigrants are selected to come to Australia. However, there is increasing incidence of coronary heart disease amongst migrant Australians. Some of the identified factors that may be influencing this increase are mainly those associated with the stress of migration and settlement, loss of status and socioeconomic disadvantage, limited access to health information as well as changes of life style which occur with increased acculturation as the duration of residence in Australia increases. This study was designed to examine the cardiovascular health profile, health knowledge, attitudes, beliefs, and health behaviours, perceptions and barriers to behavioural change of an adult sample of a non-English speaking background community in Melbourne namely, the Australian-Lebanese. The health practices of this migrant group had never been studied and to date there is a paucity of literature regarding their health needs. This study provided information on the demographic and physical characteristics, life style factors, health and associated behaviours in relation to cardiovascular risk factors. The summary of findings below highlights a number of points of interest, and where possible comparisons were made with national figures derived from the 1989 National Heart Foundation Risk Factor Prevalence Study (NHF, 1990). The main findings were: Blood pressure and hypertension: The proportion of men and women who were hypertensive in this study increased steadily with age. 12.5% men and 7% of the women were found to have a diastolic blood pressure above 95mmHg. This is higher than the national figures of the 1989 NHFRFPS that were 11% of Australian men and 5% of Australian women had a diastolic blood pressure above 95 mmHg. High blood cholesterol: The proportion of men and women who had high blood cholesterol levels increased steadily with age. 8% of the men and 10% of the women reported having blood cholesterol levels greater than 6.5mmol/L. This is lower than the 1989 national figures where 16% of the men and 14% of the women had cholesterol levels greater than 6.5mmol/L (NHF, 1990). Smoking behaviour: 44% of the Australian-Lebanese men and 25% of Australia- Lebanese women in this study were smokers compared with 24% of men and 21% of women of the 1989 NHFRFPS (NHF, 1990). All the Australian-Lebanese women smokers were in the middle and younger age groups (less than 44 years). Exercise for recreation sport or health fitness: Lack of exercise for recreation was prevalent among the Australian-Lebanese, about 55% of the men and 47% of the women had no exercise of any kind during leisure time in the preceding fortnight, as compared with 27% of Australian men and women according to the national figures (NHF, 1990). Overweight and obesity: Overweight and obesity were prevalent among the Australian-Lebanese. 71% of the men and 67% of the women were found to be either overweight or obese. This ratio is much higher than the national figures (NHF, 1990) with 60% of the men and 50% of the women being overweight or obese. The prevalence of overweight and obesity in this study increased with age for both sexes. 48% of the total Australian-Lebanese sample were overweight and 24% were obese. 41% of men and 38% of women were overweight and 21% of men and 37% of women were obese. Alcohol intake: Drinking alcohol was not a major risk factor among the Australian- Lebanese sample since most were occasional drinkers. 43% of men and 77% of women said they never drank any alcoholic beverages. This is quite a low ratio compared with the national figures where 87% of the men and 75% of the women drank alcohol. Dietary behaviour: 96% of men and 90% of women did not follow any kind of special diet. A fat-modified diet to lower blood fat was followed by one man and 3 women. One man and one woman reported following a diabetic diet. Five women followed a weight-reduction diet. 61% of men and 68% of women rarely ate fat on meat. 80% of men and 86% of women rarely added salt to cooked food compared to 49% of Australian men and 58% of Australian women who rarely or never added salt to their food (NHF, 1990). Major risk factors: A multiple forward logistic regression was conducted to assess which demographic factors predicted having a major risk factor or not. The strongest predictor was gender, with males more likely to have a major risk factor. The second strongest predictor was age with those in the older age group (45-69 years) being more likely to have a major risk factor and the next strongest predictor was education with those who have no formal education or primary school education only, being more likely to have a major risk factor. These cross-sectional observations provide the basis for interventional-type studies and should lead to appropriate recommendations regarding health promotion and education programs that can contribute to reducing the risks of cardiovascular disease in this non-English speaking background community.

Three types of blood cells exist in the human body: red blood cells, white blood cells, and platelets, in addition to plasma, which takes up 55 percent of the blood’s volume. Red blood cells take up approximately 45 percent of the blood’s volume. They transport oxygen from the lungs to other body parts. White cells defend us against bacterial and viral invasions. Platelets (less than 1 percent of the blood), the third type of blood cells, are sticky little cell fragments that are involved in helping the blood clot, a process known as coagulation. Without platelets (even though they constitute less than 1 percent of blood), our blood would not be able to clot, and we would have uncontrolled bleeding. However, formation of blood clots is a double-edged sword. Clots are beneficial because they heal cuts and wounds; blood clots in the bloodstream are harmful because they block coronary arteries, constrict vital oxygen supplies, and cause heart attacks and strokes, more and more frequent modern maladies as the baby boomers get older. Whenever the body is cut or injured and blood comes into contact with cells outside the bloodstream, a tissue factor on these cells encounters a particular protein within the blood, which triggers the clotting process. In the same vein, a series of other blood factors then come into action and amplify one another to quickly form a jelly-like blood clot. Blood clots form when an enzyme called thrombin marshals fibrin (a blood protein) and platelets (tiny cells that circulate in the blood) to coagulate at the site of an injury. Individuals with no ability to clot have a genetic condition called hemophilia; such people are also known as “bleeders.” Queen Victoria was hemophilic, and she passed on her genes to her many heirs who ruled Europe for over a century. This is why hemophilia is sometimes known as the royal disease. Symptoms of hemophilia manifest only in male offspring. People with hemophilia must periodically administer a clotting factor to their blood to prevent constant bleeding.