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The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan

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TLDR
A 'P4 Health Continuum' model is proposed as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.
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This article is published in Progress in Cardiovascular Diseases.The article was published on 2017-03-01 and is currently open access. It has received 164 citations till now. The article focuses on the topics: Health care & Integrated care.

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Monitoring wastewater for assessing community health: Sewage Chemical-Information Mining (SCIM).

TL;DR: This paper presents an update on the progress made with the development of the BioSCIM concept in the period of time since its original publication in 2012, as well as the next steps required for its continued development.
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Human genomics projects and precision medicine.

TL;DR: This review summarizes current sequencing technologies, concentrates on ongoing human genomics projects, and provides some examples in which precision medicine has already demonstrated clinical impact in diagnosis and/or treatment.
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A Review on the Role of Nano-Communication in Future Healthcare Systems: A Big Data Analytics Perspective

TL;DR: A first-time review of the open literature focused on the significance of big data generated within nano-sensors and nano-communication networks intended for the future healthcare and biomedical applications is presented.
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One Digital Health: A Unified Framework for Future Health Ecosystems.

TL;DR: The conceptual framework of the One Digital Health Steering Wheel is built around two keys (one health and digital health), three perspectives (individual health and well-being, population and society, and ecosystem), and five dimensions (citizens' engagement, education, environment, human and veterinary health care, and Healthcare Industry 4.0) as discussed by the authors.
References
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Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study

TL;DR: For example, this article found a strong relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
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Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study

TL;DR: Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions.
Journal ArticleDOI

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Stephen S Lim, +210 more
- 15 Dec 2012 - 
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
Journal ArticleDOI

Protective and Damaging Effects of Stress Mediators

TL;DR: The long-term effect of the physiologic response to stress is reviewed, which I refer to as allostatic load, which is the ability to achieve stability through change.
Related Papers (5)
Frequently Asked Questions (14)
Q1. What are the future works in this paper?

2016. 19. Auffray C, Charron D and Hood L. Predictive, preventive, personalized and participatory medicine: back to the future. 2009 ; 163:1135-43. 51. Auffray C, Chen Z and Hood L. Systems medicine: the future of medical genomics and healthcare. The future of aerobic exercise testing in clinical practice: is it the ultimate vital sign ? Promoting health and wellness in the workplace: a unique opportunity to establish primary and extended secondary cardiovascular risk reduction programs. 

Please cite this article as: Sagner Michael, McNeil Amy, Puska Pekka, Auffray Charles, Price Nathan D., Hood Leroy, Lavie Carl J., Han Ze-Guang, Chen Zhu, Brahmachari Samir Kumar, McEwen Bruce S., Soares Marcelo B., Balling Rudi, Epel Elissa, Arena Ross, The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan, Progress in Cardiovascular Diseases ( 2016 ), doi: 10. 

8-12 Monitoring and maintaining normal values for key health metrics, such as blood pressure (BP), lipids, and blood glucose also play a primary role in reducing chronic disease risk. 

The authors of this concept paper hope that the model proposed herein helps to spur the needed paradigm shift, with a focus on maintaining allostasis, wellness and prolonging the healthspan. 

54Certain factors can increase resilience against stressors and maintain anindividual in Stage A; healthy nutrition and physical activity can reduce the risk of cancer and CVD 55, 56 ; contemplative practices can modulate interception to attenuate affective and psychosomatic disorders 57 and reduce perceived stress and neurogenic inflammatory response 58 . 

the importance of a lower than sex/age predicted level in cardiorespiratory fitness and muscle strength/endurance are important predictors of future chronic disease risk and adverse events. 

65 As stressors accumulate and an individual manifests a greater number of unhealthy lifestyle characteristics, the signs of chronic disease risk that define Stage B become imminent. 

5, 44 Socio-economic determinants, especially poverty, also influence the generation, severity and management of chronic diseases. 

to make the impact needed in preventing and treating chronic disease, strong collaborations are required amongst stakeholders. 

This underperformance in exercise is partly due to the fact that a large percentage of the population, particularly those at greatest risk for one or more chronic diseases, leads a sedentary lifestyle, avoiding levels of exertion that would likely manifest an exertional Stage B sign (e.g. diminished cardiorespiratory fitness and muscle strength/endurance). 

128 Having an understanding of an individual’s literacy is of paramount importance to the participatory component of P4 medicine. 

The monitoring of such early warning signals can help predict the state of disease progression and the occurrence of abrupt transitions to a worsening state of health. 

The authors need a new approach, focusing on care that is preventive, predictive, personalized and participatory (P4) as core principles of the P4H continuum model. 

there is wide agreement that the stakeholders involved and the interventions and programming needed to combat chronic disease must expand and embrace a multisector approach.