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The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic.

A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed.

Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered.

To the best of the authors’ knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.

This paper aims to investigate the eHealth ecosystem’s evolution during the coronavirus disease 2019 (COVID-19) pandemic and its effects on the progression of care for patients with chronic cardiovascular disease.

To attain the aim of the study, this study chose to adopt a qualitative method that matches the complexity of the issue. The study was conducted in a real context through 44 face-to-face semi-structured interviews of key informants at different levels of the Italian eHealth service ecosystem, via Microsoft Teams. The interviews were carried out from June 2020 to January 2021. In this research, we adopted an abductive approach that enabled a process where the theoretical framework and the data analysis evolved at the same time.

The study results were used to develop a conceptual framework that considers the key factors enabling and constraining the evolutionary process of the eHealth service ecosystem. In particular, the drivers that emerged from the study were actor role empowerment, actor–network engagement and resource reconfiguration while the inhibitors were inter- and intra-actor misalignment, resource myopia and the platformisation gap. The findings also revealed the pivotal role of the meso level in the development of the eHealth service ecosystem, boosted by the COVID-19 pandemic.

By adopting a service ecosystem perspective, this paper contributes, at both a theoretical and a managerial level, to a better understanding of the dynamics related to the diffusion of eHealth. The study identifies the main issues that researchers, managers and policymakers should address to support the evolution of the eHealth service ecosystem, with particular regard to chronic cardiovascular disease.

The world is shifting towards the fourth industrial revolution (Industry 4.0), symbolising the move to digital, fully automated habitats and cyber-physical systems. Industry 4.0 consists of innovative ideas and techniques in almost all sectors, including Smart health care, which recommends technologies and mechanisms for early prediction of life-threatening diseases. Cardiovascular disease (CVD), which includes stroke, is one of the world’s leading causes of sickness and deaths. As per the American Heart Association, CVDs are a leading cause of death globally, and it is believed that COVID-19 also influenced the health of cardiovascular and the number of patients increases as a result. Early detection of such diseases is one of the solutions for a lower mortality rate. In this work, early prediction models for CVDs are developed with the help of machine learning (ML), a form of artificial intelligence that allows computers to learn and improve on their own without requiring to be explicitly programmed.

The proposed CVD prediction models are implemented with the help of ML techniques, namely, decision tree, random forest, k-nearest neighbours, support vector machine, logistic regression, AdaBoost and gradient boosting. To mitigate the effect of over-fitting and under-fitting problems, hyperparameter optimisation techniques are used to develop efficient disease prediction models. Furthermore, the ensemble technique using soft voting is also used to gain more insight into the data set and accurate prediction models.

The models were developed to help the health-care providers with the early diagnosis and prediction of heart disease patients, reducing the risk of developing severe diseases. The created heart disease risk evaluation model is built on the Jupyter Notebook Web application, and its performance is calculated using unbiased indicators such as true positive rate, true negative rate, accuracy, precision, misclassification rate, area under the ROC curve and cross-validation approach. The results revealed that the ensemble heart disease model outperforms the other proposed and implemented models.

The proposed and developed CVD prediction models aims at predicting CVDs at an early stage, thereby taking prevention and precautionary measures at a very early stage of the disease to abate the predictive maintenance as recommended in Industry 4.0. Prediction models are developed on algorithms’ default values, hyperparameter optimisations and ensemble techniques.

The purpose of this paper is to discuss the role of psychosocial treatments to support families living with cardiovascular disease (CVD) and depression. The paper highlights that depression in people with CVD is a predictor of non-adherence to both medicines and cardiovascular rehabilitation programmes. The authors believe there is a clinical need to develop a programme of care to support the whole family to adhere to cardiovascular rehabilitation programmes.

A team of expert cardiovascular nurses, mental health nurses (MHN) and cardiologist clinical opinions and experiences. These opinions and experiences were supplemented by literature using MEDLINE as the primary database for papers published between December 2000 and December 2013.

People with CVD who become depressed are more likely to stop taking their medicine and stop working with their health care worker. Most people with heart and mood problems live with their families. Health workers could have a role in supporting families living with heart and mood problems to their care and treatment. The paper has highlighted the importance of working with families living with heart and mood problems to help them to stick with care and treatment.

Most people with heart and mood problems live with their families. The paper has highlighted the importance of working with families living with heart and mood problems to help them to persevere with care and treatment. MHN may have a role, though consideration should also be given to exploring the role of other health care workers and members of the community. As the population ages, clinicians and communities will need to consider the impact of depression on adherence when working with families living with CVD and depression.

Prisoners have an increased risk of cardiovascular disease (CVD) compared to the general population. Knowledge and risk perception of CVD can influence engagement in preventative behaviours that lower an individual’s CVD risk. This paper aims to explore prisoners’ knowledge of CVD, and prisoners and staff’s perceptions of prisoners’ CVD risk.

This was a qualitative study in which semi-structured interviews were conducted with 16 prisoners and 11 prison and National Health Services staff in a Scottish prison. Data were analysed thematically using the framework method.

Most prisoners had limited knowledge of CVD as they could not describe it or could only identify one or two risk factors or cardiovascular events. Both prisoners and staff viewed prisoners’ CVD risk as either pertaining to one individual, or pertaining to the general prisoner population. Unhealthy behaviours that were believed to increase CVD risk were linked to three perceived consequences of imprisonment: mental health problems, boredom and powerlessness.

To the best of the authors’ knowledge, this is the first study to explore the CVD knowledge of prisoners, and perceptions of CVD risk from the perspectives of prisoners and prison staff. Findings from this study indicate that CVD education needs to be a priority for prisoners, addressing knowledge of CVD, its risk and risk perceptions. Additionally, the findings indicate that individual and socio-environmental factors linked to prisoners’ CVD risk need to be targeted to reduce this risk. Future research should focus on socio-environmental interventions that can lead to reducing the CVD risk of prisoners.

This study aims to analyze the pattern of deaths in detention in Northern Tunisia as well as the causes of death.

The authors conducted a cross-sectional retrospective study including all the casualties of death in detention examined in the legal medicine Department in the main teaching hospital from 2005 to 2019. The department covers 10 out of the 11 governorates of Northern Tunisia and 13 prisons.

Of a total of 197 casualties, only 2 were females. The mean age was 45.39 ± 14.43 years. A known medical history was reported in 63.5%, mainly cardiovascular disease, mental health disorders and diabetes. Half of the deaths occurred at the hospital. A total of 53 victims spent less than one year in custody before their death. Most deaths occurred due to disease-related causes (78.7%; n = 155); among these, 69 victims died from cardiovascular disease. Suicide accounted for 3.6% of the casualties and homicides for four cases.

Several missing data regarding the details of the detention circumstances as well as the absence in some cases of the toxicological and histopathology analysis results, which could bias the study findings.

Death in detention in Northern Tunisia involved mainly males between their 30s and their 50s who died mainly from cardiovascular or pulmonary disease. These results underscore the importance of empowering the penitentiary health system.

To the best of the authors’ knowledge, this study is one of largest studies with regard to the number of decedents and the number of prisons from the Arab countries allowing to draw a pattern of casualties of death in prison.

Body-packing means concealing packets of illicit psychoactive substances in the digestive or genital system. The purpose of this paper is to investigate profiles of body-packers and comorbidities associated with body-packing.

A retrospective study (2005–2016) was conducted among all patients hospitalized for suspicion of body-packing in the Geneva hospital prison unit (n=287). Data were extracted from medical records and included demographics, somatic/psychiatric diseases, suicidal ideation and psychological distress.

Body-packers were mostly young men (mean age=33.4). A total of 42.2 percent of the participants had at least one psychiatric or somatic comorbidity reported during incarceration (somatic: 28.2 percent, psychiatric: 18.8 percent). The most frequent somatic diseases were infectious (10.5 percent), cardiovascular (10.1 percent), and endocrinological (4.2 percent) diseases, and more precisely HIV (4.5 percent), hepatitis B (3.5 percent), hepatitis C (1.4 percent), high blood pressure (8.0 percent) and diabetes (4.2 percent). The most frequent psychiatric conditions were substance use disorders (10.5 percent) and mood disorders (8.0 percent). Depressed mood/psychological distress and suicidal ideation were frequently reported during hospitalization (27.2/6.6 percent). Comorbidities were associated with demographics: Females were more likely to have somatic and psychiatric diseases detected during hospitalization in detention and participants from Western, educated, industrialized, rich and democratic countries were more likely to report diseases known before detention.

Body-packers bear a heavy burden of disease and psychological distress. This vulnerable subgroup of incarcerated people has been overlooked in previous research and their health needs are not correctly understood. This study was a first step to improve their health care and reintegration.

While cardiovascular disease (CVD) is the leading cause of death globally, over 80% of the cases could be prevented through early lifestyle changes. From the perspective of quality management in healthcare, this may offer an effective prevention window if modifiable CVD risk factors are identified and treated in adolescence. The purpose of this research is to examine the negative emotions in adolescents and determine if it independently increases CVD risk later in life.

Longitudinal data from 12,350 participants of the Add Health study, which conducted a multi-wave survey for 14 years from adolescence (Wave 1) through adulthood (Wave 4), were used to test the research hypothesis. Four items (perception of life, self-reported depression, perceived loneliness and fearfulness) reflective of adolescent negative emotion were identified from the Wave 1 questionnaire, and factor analysis was conducted to confirm the hypothesized structure. The outcome variable, 30-year adulthood CVD risk category (high or low risk), was estimated using biomarkers, biological data and other factors collected during the 14-year follow-up in Wave 4. A logistic regression analysis was employed to assess the impact of adolescent negative emotions on adulthood CVD risk after adjusting for common risk factors such as sociodemographic characteristics, socioeconomic status and medical conditions in adolescence.

The results indicated adolescent negative emotion to be significantly associated with CVD risk category (p-value < 0.0001), even after controlling for common risk factors. A unit increase in the level of adolescent negative emotion increased the chance of being in the high CVD risk group in adulthood by 8% (odds ratio = 1.08 ± 0.03).

Healthcare providers and organizations could capitalize on the research findings by screening for negative emotions early in life through individual and societal interventions. The findings also provide an opportunity for implementing quality improvement initiatives to deliver robust preventive care, which, in turn, could improve the overall population health, reduce healthcare costs and improve care quality.

Although previous studies showed a strong link between adolescent physiological factors (e.g. obesity) and adulthood cardiovascular disease (CVD), the association between adolescent outlook/attitude (negative emotion) and CVD risk has not been examined.