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Many people don’t measure their blood pressure properly at home – here’s how to get accurate readings

<a href="https://theconversation.com/profiles/niamh-chapman-2262829">Niamh Chapman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/dean-picone-2264237">Dean Picone</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/eleanor-clapham-2264235">Eleanor Clapham</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Measuring your blood pressure at home means you can take readings over several days to get a better picture of your health, instead of one-off measurements at the doctor’s clinic. It’s important you follow specific steps to get an accurate reading. But <a href="https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.124.23678">our study</a> found most Australians do not measure their blood pressure correctly at home and very few were told the steps to follow. We have created <a href="https://bloodpressuretoolkit.com/">resources</a> to help people measure their blood pressure at home, understand their readings and take action with their health-care team. <h2>High blood pressure is a big issue</h2> High blood pressure is a major health problem in Australia and globally. <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.51350">One in three Australian adults</a> have high blood pressure, also called hypertension. This is when your <a href="https://www.heartfoundation.org.au/your-heart/blood-pressure-and-your-heart">blood pressure</a> is <a href="https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15026">at or above 140/90mmHg</a> (mmHg refers to millimetres of mercury, a standard measurement of blood pressure). High blood pressure is the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881002/">leading contributor</a> to preventable health issues and early death among Australians because it is the main risk factor for heart disease, stroke, dementia and kidney disease. <h2>Why measuring blood pressure is important</h2> High blood pressure often has no symptoms. So the only way to know if you have it is to measure it. You may also need to check if your blood pressure has lowered after starting medication or if you’re making changes to your lifestyle, such as doing more exercise, giving up smoking or reducing salt intake. Low blood pressure (<a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/blood-pressure-low-hypotension">hypotension</a>) can also be an issue. But blood pressure changes based on how we are feeling, what we’ve eaten or the activities we have just been doing. These normal responses mean our blood pressure can change from minute to minute and hour to hour. This is why there are specific, recommended steps to follow to reliably measure your blood pressure and to be able to compare readings taken days, months and years apart. <hr /> <iframe id="lBVm6" class="tc-infographic-datawrapper" style="border: 0px none currentcolor;" src="https://datawrapper.dwcdn.net/lBVm6/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>Mistakes are common</h2> We surveyed and interviewed 350 people (who were all measuring their blood pressure at home) from around Australia to find out how Australians measure blood pressure at home and if they receive any education to help them know what to do. Our study found no one followed all of the specific, recommended steps to measure their blood pressure. Instead they said they measured their blood pressure at different times of the day after doing different things. We found most people measured their blood pressure while sitting down (90%) and with the cuff on their bare arm (77%), which is the right thing to do. While 58% of people took two blood pressure measures each time, which is correct, only 40% used the average of the two blood pressure readings. Very few (15%) measured their blood pressure over several days in both the morning and evening. Only half of the people in our study used a blood pressure device that had been <a href="https://bloodpressuretoolkit.com/what_device_should_i_use">clinically validated</a>. This means the device has been <a href="https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.10237">tested for accuracy</a> by the manufacturer according to <a href="https://www.iso.org/sectors/health">international standards</a>, not just safety. <h2>Consultation and communication</h2> Regardless of whether or not a doctor had recommended they measure their blood pressure at home, most people (78%) reported their blood pressure readings to their doctor. These findings tell us doctors often use home blood pressure readings to help diagnose and manage high blood pressure. This emphasises how important it is to ensure people measure blood pressure correctly. Many people were measuring their blood pressure a few times a week or month. But most <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4671913/">guidelines</a> recommend blood pressure only needs to be measured at home: every day over a week, every six months; and ideally before you see your doctor and after you start or change blood pressure medication. Measuring blood pressure at home can bring peace of mind, which many study participants described. But measuring your blood pressure too often may create unnecessary stress, potentially leading to higher blood pressure readings. Instead, it’s better to agree with your doctor how often you should measure your blood pressure and to follow the recommended steps each time to make sure your readings are as accurate and useful as possible. <h2>Support for blood pressure measurement</h2> We found few people had received any education or guidance from health-care professionals about how to measure their blood pressure at home. Instead, many study participants looked for information online to help them know what their blood pressure numbers meant and changes they could make to lower their blood pressure. They were less interested in learning how to measure accurately. So we have worked with people who measure and manage their blood pressure at home to create a <a href="https://bloodpressuretoolkit.com/">simple guide</a> to help you choose a blood pressure device, measure your blood pressure accurately, understand your blood pressure readings and take action to control your blood pressure. <hr /> For more information about managing your blood pressure at home, <a href="https://bloodpressuretoolkit.com/">see our resources</a>. You can also check if your blood pressure device has been <a href="https://bloodpressuretoolkit.com/what_device_should_i_use">tested for accuracy</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/244161/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/niamh-chapman-2262829">Niamh Chapman</a>, Senior Research Fellow, Hypertension and Patient Engagement, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/dean-picone-2264237">Dean Picone</a>, Senior Research Fellow, Sydney School of Health Sciences, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/eleanor-clapham-2264235">Eleanor Clapham</a>, PhD candidate, School of Health and Medicine, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/many-people-dont-measure-their-blood-pressure-properly-at-home-heres-how-to-get-accurate-readings-244161">original article</a>.

Body

Mum of four saved by her smartwatch

Ricki-Lee Wynne was gifted a smartwatch from her husband for her 40th birthday and she believes that without it, she wouldn’t be alive today. "There's no doubt that my smartwatch saved my life," she told 9news.com.au. Months prior to receiving the watch, Wynne had been experiencing strange health problems. "I was getting a pain over my shoulder blades and it hurt each time I breathed in," she said. Doctors were confused and Wynne was in and out of hospital having several X-rays, scans and blood tests in an attempt to find the underlying issue. Wynne also had an echocardiogram to test the functioning of her heart, all of which appeared normal. "The doctors were not sure what it was. They thought it could be a low-grade blood cancer," she said. The pain subsided for a little while but soon enough Wynne’s breathing problems returned. "I woke up one day and I couldn't breathe properly. I was just walking into work and I was thinking, 'Gosh, I can't get enough air into my lungs,'" she said. "I couldn't walk from one side of the room to the other without being short of breath. "I went to my GP and had an x-ray done, but nothing showed up.” That’s when Wynne noticed her smartwatch was acting up. "I'd been struggling with my watch for days to try and get the heart rate to show up," she said. The heart rate function of her smartwatch had never been an issue before, but now it was struggling to pick it up. "It was saying you need to change the position to measure a pulse," she said. "My chest was also feeling kind of wobbly for a couple of nights when I went to bed.” Despite her X-ray showing coming up clear, Wynne said she went back to see her GP and told him she was worried something was really wrong. "I just said to him, 'Even my heart rate isn't right, look at my watch,' and I showed it to him.” Wynne’s GP sent her off for an ECG which showed her heart rate had dropped to just 29 beats per minute, a major cause for concern. "As soon as I had the ECG, I had the doctor call me back and say you need to go straight to Box Hill Hospital," she said. "I was told at the hospital that if I hadn't come in I would have just died in my sleep. "I would not have woken up and my heart would have stopped.” Wynne was then fitted with an emergency pacemaker and eventually diagnosed with a rare auto-immune disorder called sarcoidosis, a condition that causes inflammation in different parts of the body, most commonly the lungs. Doctors believe Wynne's sarcoidosis moved from her lungs to her heart, causing her to become extremely ill. She still has the pacemaker in and combined with medication, her health has improved significantly. It’s safe to say Wynne won’t be taking off her smartwatch any time soon. Image credit: Shutterstock

Technology

A smart way to monitor melanoma

<div> <div class="copy"> Monitoring for a recurrent <a rel="noreferrer noopener" href="https://cosmosmagazine.com/science/biology/inside-a-melanoma-cell/" target="_blank">melanoma </a>may be as simple as using a smartphone, according to Australian and New Zealand <a rel="noreferrer noopener" href="https://doi.org/10.1001/jamadermatol.2021.4704" target="_blank">research,</a> published in JAMA Dermatology. This may provide feasible, patient-led follow-up care to monitor whether melanomas return. “People who have had one melanoma have an increased risk of developing an additional one, especially during the first few years,” says Professor Monika Janda of the University of Queensland, who was involved in the study. <h2>Pilot study shows promise</h2> A small pilot study of 100 patients found that using a skin-checker app and a magnifying device attached to a smartphone provided a safe way to monitor signs of cancer coming back after melanoma is removed. “We gave patients special devices for their mobile phones, which allows them to take really precise photographs of skin lesions,” says Janda. “These are all patients who have had melanoma before.” This group used the smartphone app at home, and they found more signs of melanoma compared to people who went in for hospital surveillance “We found that there were quite a number of additional signs found by people themselves at home, which was really interesting,” says Janda. <h2>Less travel for melanoma patients</h2> Normally, patients need to travel to their doctor or hospitals for surveillance, which can be difficult and time-consuming. The smartphone method provides a feasible alternative that could be conducted at home. “It could save some of the current visits to the doctor that people do regularly after they’ve had a melanoma,” says Janda, “That could be particularly beneficial for people who live far away from their treatment centre and have to undertake extensive travel to reach them.” As this was a pilot study, a larger, randomised clinical trial is required to see how this monitoring would relate to more patients in the long term. “It’s a pilot study, so it’s not yet definite. But we’re currently undertaking a bigger study,” says Janda. Image credits: Getty Images </div> <div id="contributors"> This article was originally published on <a rel="noopener" href="https://cosmosmagazine.com/health/body-and-mind/a-smart-way-to-monitor-melanoma/" target="_blank">cosmosmagazine.com</a> and was written by Deborah Devis. </div> </div>

Body

Call for independent watchdog to monitor NZ government use of artificial intelligence

New Zealand is a leader in government use of artificial intelligence (AI). It is part of a <a href="https://www.digital.govt.nz/digital-government/international-partnerships/the-digital-9/">global network of countries</a> that use predictive algorithms in government decision making, for anything from the optimal scheduling of public hospital beds to whether an offender should be released from prison, based on their likelihood of reoffending, or the <a href="https://www.acc.co.nz/about-us/news-media/latest-news/acc-speeds-up-claims-approval/">efficient processing of simple insurance claims</a>. But the official use of AI algorithms in government has been <a href="https://www.data.govt.nz/assets/Uploads/Algorithm-Assessment-Report-Oct-2018.pdf">in the spotlight in recent years</a>. On the plus side, AI can enhance the accuracy, efficiency and fairness of day-to-day decision making. But concerns have also been expressed regarding transparency, meaningful human control, data protection and bias. In a <a href="https://www.cs.otago.ac.nz/research/ai/AI-Law/NZLF%20report.pdf">report</a> released, we recommend New Zealand establish a new independent regulator to monitor and address the risks associated with these digital technologies. AI and transparency There are three important issues regarding transparency. One relates to the inspectability of algorithms. Some aspects of New Zealand government practice are reassuring. Unlike some countries that use commercial AI products, New Zealand has tended to build government AI tools in-house. This means that we know how the tools work. But intelligibility is another issue. Knowing how an AI system works <a href="https://link.springer.com/article/10.1007/s13347-018-0330-6">doesn’t guarantee</a> the decisions it reaches will be understood by the people affected. The best performing AI systems are often extremely complex. To make explanations intelligible, additional technology is required. A decision-making system can be supplemented with an “explanation system”. These are additional algorithms “bolted on” to the main algorithm we seek to understand. Their job is to construct simpler models of how the underlying algorithms work – simple enough to be understandable to people. We believe explanation systems will be increasingly important as AI technology advances. A final type of transparency relates to public access to information about the AI systems used in government. The public should know what AI systems their government uses as well as how well they perform. Systems should be regularly evaluated and summary results made available to the public in a systematic format. New Zealand’s law and transparency Our <a href="https://www.cs.otago.ac.nz/research/ai/AI-Law/NZLF%20report.pdf">report</a> takes a detailed look at how well New Zealand law currently handles these transparency issues. New Zealand doesn’t have laws specifically tailored towards algorithms, but some are relevant in this context. For instance, New Zealand’s Official Information Act (<a href="http://legislation.govt.nz/act/public/1982/0156/107.0/DLM65628.html">OIA</a>) provides a right to reasons for decisions by official agencies, and this is likely to apply to algorithmic decisions just as much as human ones. This is in <a href="http://classic.austlii.edu.au/au/journals/SydLawRw/2015/22.html">notable contrast to Australia</a>, which doesn’t impose a general duty on public officials to provide reasons for their decisions. But even the OIA would come up short where decisions are made or supported by opaque decision systems. That is why we recommend that predictive algorithms used by government, whether developed commercially or in-house, must feature in a public register, must be publicly inspectable, and (if necessary) must be supplemented with explanation systems. Human control and data protection Another issue relates to human control. Some of the concerns around algorithmic decision-making are best addressed by making sure there is a “human in the loop,” with a human having final sign off on any important decision. However, we don’t think this is likely to be an adequate solution in the most important cases. A persistent theme of research in industrial psychology is that humans become overly trusting and uncritical of automated systems, especially when those systems are reliable most of the time. Just adding a human “in the loop” will not always produce better outcomes. Indeed in certain contexts, human collaboration will offer false reassurance, rendering AI-assisted decisions <a href="https://researchportal.bath.ac.uk/en/publications/effective-forecasting-and-judgmental-adjustments-an-empirical-eva">less accurate</a>. With respect to data protection, we flag the problem of “inferred data”. This is data inferred about people rather than supplied by them directly (just as when Amazon infers that you might like a certain book on the basis of books it knows you have purchased). Among other recommendations, our report calls for New Zealand to consider the legal status of inferred data, and whether it should be treated the same way as primary data. Bias and discrimination A final area of concern is bias. Computer systems might look unbiased, but if they are relying on “dirty data” from previous decisions, they could have the effect of “baking in” discriminatory assumptions and practices. New Zealand’s anti-discrimination laws are likely to apply to algorithmic decisions, but making sure discrimination doesn’t creep back in will require ongoing monitoring. The report also notes that while “individual rights” — for example, against discrimination — are important, we <a href="https://scholarship.law.duke.edu/dltr/vol16/iss1/2/">can’t entirely rely on them</a> to guard against all of these risks. For one thing, affected people will often be those with the least economic or political power. So while they may have the “right” not to be discriminated against, it will be cold comfort to them if they have no way of enforcing it. There is also the danger that they won’t be able to see the whole picture, to know whether an algorithm’s decisions are affecting different sections of the community differently. To enable a broader discussion about bias, public evaluation of AI tools should arguably include results for specific sub-populations, as well as for the whole population. A new independent body will be essential if New Zealand wants to harness the benefits of algorithmic tools while avoiding or minimising their risks to the public. Alistair Knott, James Maclaurin and Joy Liddicoat, collaborators on the <a href="https://www.cs.otago.ac.nz/research/ai/AI-Law/">AI and Law in New Zealand</a>project, have contributed to the writing of this piece. Written by John Zerilli and Colin Gavaghan. Republished with permission of <a href="https://theconversation.com/call-for-independent-watchdog-to-monitor-nz-government-use-of-artificial-intelligence-117589">The Conversation</a>.

Technology

Five-foot goanna found in Australian backyard

Eric Holland, from Thurgoona in New South Wales, Australia, got the surprise of his life earlier this week when he came across a monster lizard in his backyard. "I was just doing a repair job in my shed when I opened the door and I saw this huge thing run across the ground and out of sight," Mr Holland said. "I went inside after I saw it in the backyard and heard a banging noise coming from the side of the house," "When I went outside I saw him on the side of the house with his tail hitting the drain pipe." Having never seen anything like it in the 18 years he has lived in his home, Mr Holland reveals, "It was a big surprise really. I sometimes get blue tongues and lizards in the backyard but never anything quite like this." The goanna quickly left Mr Holland's property and he has not sighted the reptile since. The reptile in question is a lace monitor, also known as lace goannas, and can grow to around two-metres in length and weigh up to 20 kilograms. <a href="/news/news/2015/12/baby-goat-learns-to-hop-video/"> </a>

News

Specially designed high-tech apartment to monitor health of elderly

Engineers at the University of Texas at Arlington have teamed up with Christian Care Senior Living Communities to design and build a “smart care” apartment with the aim of improving the lives, safety and overall health of its residents. Built in an 86 square-metre apartment donated by Christian Care, the new design was unveiled in May as a prototype it’s hoped will change the lives of seniors, as well as people with disabilities who wish to remain independent. How will it help? With in-built state-of-the-art technology and clever design, of course. The project received federal funding from the US Government to the tune of US$600,000 over five years, allowing extensive research in a collaborative effort involving faculty from the UT Arlington College of Nursing and Health Innovation and the College of Engineering. This development period has led to the following technologies being incorporated into the design: <ul> <li>Under-floor sensors that allow researchers to measure and evaluate changes in walking gait, balance and weight. It is hoped that this feature will help give early indication of illness or injury.</li> <li>A lift chair to help residents stand.</li> <li>LG brand appliances in the kitchen that communicate with each other.</li> <li>Exercise equipment like a recumbent bike and an interactive X-Box Kinect system.</li> <li>A camera embedded in the bathroom mirror to monitor day-to-day heart rate, skin colour, and facial expressions. Changes in these features can be revealing about aspects of overall health, as well as the amount oxygen present in the blood.</li> <li>A special mug that interacts with the coffee table to record blood pressure readings.</li> </ul> Now that the design has been unveiled, the search is on for a couple within the Lakewood Village Senior Living Community, who will live in the apartment for at least 12 months so researchers can study the effectiveness of the design, and receive feedback on the usability.

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