Preface

Advances in modern medicine have enabled the ability to significantly prolong the average lifespan expectancy. The development of this knowledge ensures unprecedented possibilities in terms of explaining the causes of diseases and effective treatment. However, increased capabilities create new issues. Both, researchers and clinicians, as well as managers of healthcare units face new challenges: increasing validity and reliability of clinical trials, effectively distributing medical products, managing hospitals and clinics flexibly, and managing treatment processes efficiently.

In the past decades, the development of a new, fascinating discipline of science has been observed. This discipline is called "health management". For the purposes of this book, the report by the Canadian Minister of National Health and Welfare, Marc LaLonde, has been taken as a point of reference. The report proclaimed in 1974 is considered to be ʺthe first modern government document in the western world to acknowledge that our emphasis upon a biomedical health care system is wrong, and that we need to look beyond the traditional health care (sick care) system if we wish to improve the health of the publicʺ. It has offered new prospects for the issues of health care. It emphasizes the responsibility of an individual in developing behaviors conducive to keeping her/him in good health.

LaLonde assumes that there are four main factors of health: human biology, the environment, the lifestyle, and health care services. He contended that health cannot be secured only by development of medical sciences, but by making wise and rational decisions by individuals and the whole society too. His legacy includes a recommendation according to which health care interventions should focus on groups at risk of a disease development and point health inequalities out. LaLondeʹs work widened significantly as the range of actions related to health care services by incorporating categories had not been associated with it before. At present, thanks to LaLonde, health management strategies are highly differentiated with respect to its recipients and dimensions of constituting areas of their activities.

Many great authors have contributed to this book. Their work is divided in the three following sections:

	- 1. **Wellness and Lifestyle** In this section, readers will find chapters describing interventions that are designed to support the generally healthy before they exhibit symptoms of chronic or catastrophic disease.
	- 2. **Disease Management** Programs requiring the identification of population sub‐groups that are already exhibiting some elements of chronic disease are put here. The interventions described in this section are less individualized and should tend to address the characteristics of the larger population with risk factors.
	- 3. **General Issues** Readers interested in methodology of clinical trials and general findings that widen our understanding of human health determinants should pay special attention to this section.

This book is a direct legacy of Marc LaLondeʹs report. The aim of it is to present issues relating to health management in a way that would be satisfying to academicians and practitioners. The book is designed to be a forum for the experts in the thematic area to exchange viewpoints, and to present health managementʹs state‐of‐art as a scientific and professional domain. I hope it will provide readers with new valuable information and they will enjoy reading it.

> **Dr. Krzysztof Śmigórski** Medical University of Wroclaw Research Institute for Dementia‐Related Diseases Poland

X Preface

risk factors.

and they will enjoy reading it.

1. **Wellness and Lifestyle** – In this section, readers will find chapters describing interventions that are designed to support the generally healthy before they

2. **Disease Management** – Programs requiring the identification of population sub‐groups that are already exhibiting some elements of chronic disease are put here. The interventions described in this section are less individualized and should tend to address the characteristics of the larger population with

3. **General Issues** – Readers interested in methodology of clinical trials and general findings that widen our understanding of human health

This book is a direct legacy of Marc LaLondeʹs report. The aim of it is to present issues relating to health management in a way that would be satisfying to academicians and practitioners. The book is designed to be a forum for the experts in the thematic area to exchange viewpoints, and to present health managementʹs state‐of‐art as a scientific and professional domain. I hope it will provide readers with new valuable information

> **Dr. Krzysztof Śmigórski** Medical University of Wroclaw

> > Poland

Research Institute for Dementia‐Related Diseases

exhibit symptoms of chronic or catastrophic disease.

determinants should pay special attention to this section.

**Part 1** 

**Wellness and Lifestyle** 

**Part 1** 

**Wellness and Lifestyle** 

**1** 

*France* 

**A Future for Integrated Diagnostic Helping** 

Medical systems used for exploration or diagnostic helping impose high applicative constraints such as real time image acquisition and displaying. This is especially the case when they are used in surgical room where a high reactivity is required from operators. Large computing capacity is required in order to obtain valuable results. Integrators mainly prefer the use of general purpose architectures such as workstations (Gomes, 2011). They have to cope with manufacturing cost and setup simplicity. As general purpose devices need a large amount of space, the main part of the processing is deported from the handled diagnostic tools to an external unit. For example, this is the case of endoscopic device. Today, dedicated rooms are usually used for this purpose in many hospitals. Their associated external computers that are used for diagnostic system are cumbersome and are also energy consumers. These issues are too problematic to use efficiently these systems in a limited space. Indeed, they restrain the movements of the medical staff and complexify the deployment on the ground for military or humanitarian operations. Therefore it seems logical to integrate the maximum computing capacities diagnostic into helping devices

A large part of computing requirement of these systems is devoted to image processing. They can be quite simple like images reconstruction and enhancement, features detector or 3D reconstruction. Today, a large part of these processing is mainly embedded inside handled consumer's devices such as digital cameras or advanced driving assistance systems (ADAS). By the analysis of both medical and consumer's applications systems, it is possible to notice that they rely on similar algorithmic approaches. Also, most of integration constraints are similar if someone wants to miniaturize these consumer devices. This mainly concerns the chips silicon areas, their power consumption and their computing capacities. For example, a digital video sensor and image processor integrated to a cell phone cannot reach more than a half watt of power consumption for a silicon area of less than a dozen square millimeters. This is also the case for one of the most integrated medical diagnostic device which is the endocapscule. It form factor (Harada, 2008) limits components size while its autonomy is driven by energies efficiency. The whole device may not exceed a Watt of power consumption. About a half Watt is devoted to the part dedicated to computation for diagnostic, especially based on image processing. However, this part depends on the device features, such as communication systems and mechanical elements that may be used for mobility or biopsy. Integrators also demands versatility in order to design unique products that can be used for different targets. For example, endoscopic exploration of larynx or intestinal and lung exploration do not uses the same devices, but these applications are all based on similar

**1. Introduction** 

themselves to make them completely handleable.

Mathieu Thevenin and Anthony Kolar *CEA, LIST, Embedded Computing Laboratory* 
