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The effects of intermittent fasting on cardiovascular health and blood pressure

Aug 7, 2023 | Intermittent fasting and time-restricted eating

Intermittent fasting (IF) has gained attention for its potential health benefits, including weight loss, improved blood sugar regulation, and enhanced cardiovascular health. In this article, we will discuss the effects of intermittent fasting on cardiovascular health and blood pressure, and explore recent research findings in this area.

Effects of Intermittent Fasting on Cardiovascular Health

Research has shown that intermittent fasting may have beneficial effects on cardiovascular health. One study published in the journal Nutrients found that participants who practiced IF experienced significant reductions in total cholesterol, LDL cholesterol, and triglyceride levels, which are all risk factors for heart disease. Another study published in the journal Aging found that IF improved the function of the endothelial cells, which are important for maintaining healthy blood vessels and preventing heart disease.

Additionally, intermittent fasting has been found to have anti-inflammatory effects, which can help reduce the risk of cardiovascular disease. A study published in the journal Cell Metabolism found that intermittent fasting reduced inflammation and improved cardiovascular health in mice.

Effects of Intermittent Fasting on Blood Pressure

Intermittent fasting may also have a positive effect on blood pressure. High blood pressure is a major risk factor for cardiovascular disease, and several studies have explored the impact of intermittent fasting on blood pressure.

A study published in the journal Nutrition and Healthy Aging found that participants who practiced IF experienced significant reductions in systolic blood pressure, which is the top number in a blood pressure reading and measures the pressure in the arteries when the heart beats. Another study published in the journal Nutrients found that IF was associated with improved blood pressure control and reduced arterial stiffness.

However, it is important to note that some studies have found mixed results when it comes to the impact of intermittent fasting on blood pressure. More research is needed to fully understand the relationship between intermittent fasting and blood pressure.

Conclusion

Intermittent fasting may have beneficial effects on cardiovascular health and blood pressure, although more research is needed to fully understand the mechanisms behind these effects. It is important to consult with a healthcare professional before beginning an intermittent fasting regimen, especially for individuals with pre-existing health conditions.

REFERENCES

  • Kalam F, Gabel K, Cienfuegos S, et al. Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction. Nutrients. 2021;13(6):1886.
  • Anton SD, Moehl K, Donahoo WT, et al. Flipping the metabolic switch: understanding and applying the health benefits of fasting. Obesity. 2018;26(2):254-268.
  • Tinsley GM, La Bounty PM. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev. 2015;73(10):661-674.
  • Gabel K, Hoddy KK, Haggerty N, et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
  • Rynders CA, Thomas EA, Zaman A, et al. Effectiveness of intermittent fasting and time-restricted feeding compared to continuous energy restriction for weight loss. Nutrients. 2019;11(10):2442.
  • Varady KA. Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss? Obes Rev. 2011;12(7):e593-e601.

Preventing complications of chronic conditions

Aug 7, 2023 | Chronic condition and their management

Preventing complications of chronic conditions is essential to improve the quality of life of individuals with chronic illnesses. This research-based article provides an overview of the latest findings on preventing complications of chronic conditions and examples of preventative measures.

Latest Research-Based Findings:

Recent research has identified several effective strategies to prevent complications of chronic conditions. These include:

Patient Education: Providing patients with information about their condition, including its management, symptoms, and potential complications, can improve self-management and reduce the risk of complications (1). Education can be delivered through various formats, such as group sessions, individual counseling, and online resources.

Medication Adherence: Adherence to prescribed medications is critical in preventing complications of chronic conditions. A recent meta-analysis found that improving medication adherence reduces the risk of hospitalization and mortality in patients with chronic conditions (2). Several interventions, such as medication reminders, simplified regimens, and pharmacist-led interventions, have been shown to improve adherence.

Lifestyle Modification: Adopting healthy lifestyle habits, such as regular physical activity, healthy eating, and smoking cessation, can reduce the risk of complications associated with chronic conditions. For instance, research has found that physical activity improves glycemic control and reduces the risk of cardiovascular complications in patients with diabetes (3). Additionally, smoking cessation has been shown to reduce the risk of respiratory complications in patients with chronic obstructive pulmonary disease (COPD) (4).

Regular Monitoring: Regular monitoring of chronic conditions, such as blood pressure, blood glucose, and lipid levels, can detect early signs of complications and allow for prompt intervention. Several digital health technologies, such as smartphone applications and wearable devices, have been developed to enable self-monitoring and remote monitoring of chronic conditions.

Preventative Measures:

Examples of preventative measures to prevent complications of chronic conditions include:

Regular Check-Ups: Regular check-ups with healthcare providers can help detect early signs of complications and allow for prompt intervention.

Patient Education: Patients should be provided with information about their condition, its management, and potential complications.

Medication Adherence: Patients should be encouraged to adhere to prescribed medications, and interventions such as medication reminders, simplified regimens, and pharmacist-led interventions should be implemented to improve adherence.

Lifestyle Modification: Patients should be advised to adopt healthy lifestyle habits, such as regular physical activity, healthy eating, and smoking cessation.

Regular Monitoring: Patients should be encouraged to regularly monitor their chronic condition, and digital health technologies such as smartphone applications and wearable devices can be used to enable self-monitoring and remote monitoring.

Conclusion:

Preventing complications of chronic conditions is critical in improving the quality of life of individuals with chronic illnesses. Patient education, medication adherence, lifestyle modification, and regular monitoring are effective strategies to prevent complications of chronic conditions. Healthcare providers should work with patients to develop personalized prevention plans and implement interventions that promote healthy habits and improve self-management.

REFERENCES

  • Viswanathan M, Golin CE, Jones CD, et al. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Ann Intern Med. 2012;157(11):785-795.
  • Nieuwlaat R, Wilczynski N, Navarro T, et al. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2014;11:CD000011.
  • Colberg SR, Sigal RJ, Fernhall B, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147-e167.
  • Tønnesen P, Carrozzi L, Fagerström KO, et al. Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy. Eur Respir J. 2007;29(2):390-417.

Common childhood illnesses and their treatment

Aug 7, 2023 | Children's Health

Research on common childhood illnesses has provided valuable insights into their treatment and management. This article highlights some of these findings, along with recommended treatments for specific childhood illnesses, supported by references.

Upper Respiratory Tract Infections (URTIs): URTIs, such as the common cold and flu, are prevalent in children. Research suggests the following treatment approaches:

a. Supportive care: Encourage rest, hydration, and adequate nutrition to help the child recover (1).

b. Symptom relief: Administer over-the-counter pain relievers, such as acetaminophen or ibuprofen, to alleviate fever, pain, and discomfort (2).

c. Nasal saline drops or sprays: These can help relieve nasal congestion in children who are unable to blow their noses effectively (3).

Gastroenteritis: Gastroenteritis, characterized by diarrhea and vomiting, is often caused by viral or bacterial infections.

Research supports the following treatment measures:

a. Fluid replacement: Encourage oral rehydration solutions (ORS) to prevent dehydration, especially in cases of mild to moderate gastroenteritis (4).

b. Probiotics: Some studies suggest that probiotics can help reduce the duration and severity of diarrhea in children (5).

c. Avoid certain foods and drinks: Temporarily avoid fatty foods, spicy foods, sugary drinks, and dairy products until symptoms subside (6).

Asthma: Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways. Research has provided insights into effective asthma management:

a. Inhaled corticosteroids: These medications are the most effective long-term control medications for managing asthma symptoms and reducing airway inflammation (7).

b. Short-acting bronchodilators: These quick-relief medications provide immediate relief during asthma attacks by relaxing the airway muscles (8).

c. Avoid triggers: Identify and avoid triggers that may worsen asthma symptoms, such as allergens, tobacco smoke, and air pollution (9). Otitis Media (Ear Infection): Otitis media, characterized by ear pain and inflammation, is a common childhood infection.

Research suggests the following treatment options:

a. Pain relief: Administer over-the-counter pain relievers, such as acetaminophen or ibuprofen, to alleviate ear pain (10).

b. Antibiotics: In cases of severe or persistent ear infections, antibiotics may be prescribed to clear the infection (11).

c. Observation: In certain cases, particularly in older children with mild symptoms, a watch-and-wait approach may be recommended (12).

It is important to note that treatment recommendations may vary based on the severity of the illness and individual patient characteristics. Consulting healthcare professionals for accurate diagnosis and tailored treatment plans is essential.

REFERENCES

  • Thompson, M., Vodicka, T. A., Blair, P. S., Buckley, D. I., Heneghan, C., Hay, A. D., & TARGET Programme Team. (2013). Duration of symptoms of respiratory tract infections in children: Systematic review. BMJ, 347, f7027.
  • Sarrell, E. M., Mandelberg, A., & Cohen, H. A. (2002). Efficacy of naturopathic extracts in the management of ear pain associated with acute otitis media. Archives of Pediatrics & Adolescent Medicine, 156(3), 224-227.
  • Singh, M., Das, R. R., & Zinc Investigators. (2013). Zinc for the common cold. The Cochrane Database of Systematic Reviews, 6, CD001364.
  • Guarino, A., Ashken eazi, S., Gendrel, D., Lo Vecchio, A., Shamir, R., Szajewska, H., & European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. (2014). European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: Update 2014. Journal of Pediatric Gastroenterology and Nutrition, 59(1), 132-152.
  • Szajewska, H., Guarino, A., Hojsak, I., Indrio, F., Kolacek, S., Shamir, R., … & Weizman, Z. (2020). Use of probiotics for management of acute gastroenteritis: A position paper by the ESPGHAN Working Group for Probiotics and Prebiotics. Journal of Pediatric Gastroenterology and Nutrition, 70(6), 800-811.
  • Global Initiative for Asthma (GINA). (2021). Global strategy for asthma management and prevention. Retrieved from https://ginasthma.org/
  • Kliegman, R. M., St. Geme, J. W., Blum, N. J., Shah, S. S., Tasker, R. C., & Wilson, K. M. (2020). Nelson textbook of pediatrics (21st ed.). Elsevier.
  • Mandel, E. M., Doyle, W. J., & Winther, B. (2005). Viral upper respiratory tract infection. Clinical Microbiology Reviews, 18(1), 1-22.
  • Little, P., Gould, C., Williamson, I., Warner, G., Gantley, M., Kinmonth, A. L., … & Moore, M. (2001). Pragmatic randomised controlled trial of two prescribing strategies for childhood acute otitis media. BMJ, 322(7282), 336-342.
  • Rovers, M. M., Glasziou, P., Appelman, C. L., Burke, P., McCormick, D. P., Damoiseaux, R. A., & Gaboury, I. (2004). Antibiotics for acute otitis media: A meta-analysis with individual patient data. The Lancet, 363(9407), 960-962.

Balanced meal planning and portion control

Aug 6, 2023 | Nutrition and healthy eating

Eating a balanced and healthy diet is essential for maintaining good health. Balanced meal planning involves ensuring that your meals consist of a variety of nutrient-dense foods from all food groups, including fruits, vegetables, whole grains, lean proteins, and healthy fats. Portion control is another important aspect of healthy eating, as overeating can lead to weight gain and other health problems. In this article, we will explore the benefits of balanced meal planning and portion control, as well as recent research and trends in the market.

Benefits of Balanced Meal Planning and Portion Control

Eating a balanced diet that is rich in nutrients can provide a wide range of health benefits. According to the Academy of Nutrition and Dietetics, a balanced diet can help maintain a healthy weight, reduce the risk of chronic diseases such as heart disease, diabetes, and some cancers, and promote overall health and well-being. By incorporating a variety of foods into your meals and practicing portion control, you can ensure that your body receives the nutrients it needs to function properly.

Recent research has highlighted the importance of balanced meal planning and portion control for maintaining good health. One study published in the Journal of the Academy of Nutrition and Dietetics found that individuals who followed a balanced meal plan had a lower risk of developing type 2 diabetes than those who did not follow a balanced meal plan. Another study published in the American Journal of Clinical Nutrition found that practicing portion control can help individuals lose weight and reduce their risk of obesity-related health problems.

In addition to the health benefits, there has been an increased interest in balanced meal planning and portion control in recent years, with a growing number of meal delivery services and meal planning apps available in the market. These services offer a convenient way to plan and prepare healthy meals, making it easier for individuals to stick to their dietary goals and maintain good health.

Tips for Balanced Meal Planning and Portion Control

Here are some tips for planning balanced meals and controlling portions:

a. Use the MyPlate method: MyPlate is a guide developed by the United States Department of Agriculture (USDA) that recommends filling half your plate with fruits and vegetables, a quarter with lean protein, and a quarter with whole grains. This helps ensure that you’re getting a balanced mix of nutrients in your meals.

b. Make sure you’re getting enough protein: Protein is important for building and repairing muscle, and it can help you feel fuller for longer. Aim to include a source of protein in each meal, such as chicken, fish, tofu, or beans.

c. Incorporate healthy fats: Healthy fats, like those found in nuts, seeds, avocado, and olive oil, are important for brain function and can help you feel satisfied after a meal.

d. Choose whole grains: Whole grains, like brown rice, quinoa, and whole wheat bread, provide fiber and important vitamins and minerals.

e. Use smaller plates and utensils: Research has shown that using smaller plates and utensils can help you eat less without feeling deprived.

f. Pay attention to portion sizes: Use measuring cups or a food scale to ensure that you’re eating appropriate portion sizes. For example, a serving of meat should be about the size of a deck of cards, and a serving of cooked pasta or rice should be about the size of a tennis ball.

g. Don’t skip meals: Skipping meals can lead to overeating later on, so aim to eat three meals and one or two snacks throughout the day.

By following these tips, you can plan balanced meals and control your portions to support your overall health and wellbeing.

In conclusion, balanced meal planning and portion control are important components of a healthy diet. By incorporating a variety of nutrient-dense foods into your meals and practicing portion control, you can help maintain a healthy weight, reduce the risk of chronic diseases, and promote overall health and well- being. With the growing availability of meal delivery services and meal planning apps, it has never been easier to adopt these healthy habits into your daily routine.

Anorexia nervosa: symptoms, causes, and treatment

Aug 4, 2023 | Eating disorders and disordered eating habits

Anorexia nervosa is a serious mental health condition characterized by restrictive eating habits and excessive weight loss. It primarily affects young women, but can also occur in men and people of all ages. Anorexia nervosa can have serious physical and psychological consequences, including organ damage, malnutrition, and depression. In this article, we will discuss the symptoms, causes, and treatment of anorexia nervosa, based on current research.

Symptoms of anorexia nervosa

The most prominent symptom of anorexia nervosa is significant weight loss, often to the point of being underweight. However, weight loss is not the only indicator of this condition. Individuals with anorexia nervosa may also exhibit a preoccupation with food, a fear of gaining weight, and a distorted body image.

Other common symptoms include:

Restricted eating habits, such as severely limiting food intake or avoiding certain food groups

Obsessive calorie counting or food weighing

Excessive exercise or other weight-loss behaviors

Refusal to eat in public or with others

Social withdrawal and isolation

Difficulty sleeping and fatigue

Absence of menstrual periods (amenorrhea) in women

Cold intolerance and low blood pressure

Causes of anorexia nervosa

The exact causes of anorexia nervosa are not fully understood, but research suggests that a combination of genetic, environmental, and psychological factors may play a role. Some factors that may contribute to the development of anorexia nervosa include:

Genetics: Studies have shown that certain genes may increase the risk of developing anorexia nervosa, although no specific gene has been identified as a cause.

Environmental factors: Cultural and societal pressures to be thin, such as those found in the fashion and entertainment industries, can contribute to the development of anorexia nervosa. Additionally, traumatic life events, such as abuse or a significant loss, can trigger the onset of the condition.

Psychological factors: Individuals with anorexia nervosa often have a history of anxiety, depression, or other mental health conditions. They may also have low self-esteem and a need for control.

Treatment of anorexia nervosa

Treatment for anorexia nervosa typically involves a combination of psychotherapy, medical management, and nutritional counseling. The primary goal of treatment is to restore the individual to a healthy weight and address any underlying psychological issues. Some common forms of psychotherapy used to treat anorexia nervosa include:

Cognitive-behavioral therapy (CBT): This form of therapy helps individuals change negative thought patterns and behaviors that contribute to anorexia nervosa.

Family-based therapy: This therapy involves the family in the treatment process and aims to promote healthy eating habits and a supportive home environment.

Interpersonal psychotherapy: This form of therapy focuses on improving interpersonal relationships and reducing the impact of negative life events.

In severe cases of anorexia nervosa, hospitalization or residential treatment may be necessary to ensure adequate nutrition and prevent medical complications.

Conclusion

Anorexia nervosa is a serious mental health condition that can have significant physical and psychological consequences. Understanding the symptoms, causes, and treatment options for anorexia nervosa is essential for early detection and effective management of the condition. Research in this field continues to shed light on the complex interplay of genetic, environmental, and psychological factors that contribute to anorexia nervosa, as well as the most effective treatment approaches.

REFERENCES

  • National Institute of Mental Health. (2021). Eating disorders. Retrieved from https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
  • Treasure, J., & Stein, D. (2015). Anorexia nervosa. The Lancet, 385(9982), 952-963. doi: 10.1016/S0140-6736(14)60211-3
  • Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731. doi: 10.1001/archgenpsychiatry.2011.74
  • Bulik, C. M., Reba, L., Siega-Riz, A. M., & Reichborn-Kjennerud, T. (2005). Anorexia nervosa: Definition, epidemiology, and cycle of risk. International Journal of Eating Disorders, 37(Suppl), S2-S9. doi: 10.1002/eat.20108
  • Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407-416. doi: 10.1016/S0140-6736(03)12378-1
  • Golden, N. H., Katzman, D. K., Sawyer, S. M., Ornstein, R. M., Rome, E. S., & Garber, A. K. (2015). Update on the medical management of eating disorders in adolescents. Journal of Adolescent Health, 56(4), 370-375. doi: 10.1016/j.jadohealth.2015.01.019

Ebola: Causes, Prevention and Management

Aug 3, 2023 | Infectious diseases and outbreaks

Ebola virus disease (EVD) is a severe, often fatal illness caused by the Ebola virus. The disease was first identified in 1976 in Sudan and the Democratic Republic of Congo (DRC) and is primarily spread through contact with bodily fluids of infected animals or humans. Outbreaks of EVD have occurred intermittently in several countries in Africa, with the largest outbreak in West Africa from 2014-2016 (1). Understanding the causes, prevention, and management of EVD is essential to effectively control its spread.

Causes of EVD:

EVD is caused by the Ebola virus, a member of the Filoviridae family. The virus is primarily transmitted through contact with bodily fluids, such as blood, vomit, or feces, of infected humans or animals. The virus can also be transmitted through direct contact with contaminated surfaces or objects (2).

Prevention of EVD:

Preventative measures play a crucial role in controlling the spread of EVD. Some examples of preventative measures include:

Avoiding contact with wild animals: Direct contact with bats, monkeys, or other wild animals should be avoided as they may be carriers of the Ebola virus (3).

Proper infection control measures: Healthcare workers should use appropriate personal protective equipment (PPE) when caring for EVD patients and follow strict infection control measures, including proper handling of contaminated materials and disposal of medical waste (4).

Safe burial practices: Proper handling and burial of infected bodies can help prevent the spread of EVD. Bodies of deceased patients should be handled by trained professionals and buried in a safe and dignified manner (5).

Vaccination: An effective vaccine for EVD has been developed, and vaccination has been shown to be effective in preventing the disease (6).

Management of EVD:

Early identification and management of EVD cases are critical to prevent further transmission. Some examples of management approaches include:

Isolation and supportive care: Patients with suspected or confirmed EVD should be isolated and provided with supportive care, including fluid and electrolyte replacement, management of complications, and treatment of any underlying medical conditions (7).

Contact tracing: Identifying and monitoring individuals who have come into contact with confirmed or suspected EVD cases is essential for preventing further transmission (8).

Use of experimental therapies: Several experimental therapies have been developed for the treatment of EVD, including monoclonal antibodies and antiviral drugs. These therapies are still under investigation, and their efficacy and safety need further evaluation (9).

Conclusion:

EVD is a severe disease with a high mortality rate, and preventative measures play a crucial role in controlling its spread. Avoiding contact with wild animals, practicing proper infection control measures, safe burial practices, and vaccination are some of the key preventative measures. Early identification and management of EVD cases, including isolation, supportive care, contact tracing, and use of experimental therapies, are essential for effective management of the disease. By following evidence-based practices and guidelines, communities can work towards reducing the impact of EVD outbreaks.

REFERENCES

Healthcare quality and safety

Aug 3, 2023 | Healthcare policy and reform

Introduction: Healthcare quality and safety are paramount considerations in providing effective and efficient healthcare services. Ensuring high-quality care and minimizing errors are essential for improving patient outcomes and building trust in healthcare systems. While efforts to improve healthcare quality have been a focus globally, it is crucial to explore specific strategies and implications in developing countries. This article examines recent research articles and their implications for enhancing healthcare quality and reducing errors in developing countries. Strengthening Healthcare Infrastructure: Developing countries often face challenges related to limited resources, infrastructure, and technology.

Strengthening healthcare infrastructure is a critical step in improving healthcare quality. Research conducted in several developing countries has emphasized the importance of investing in robust healthcare systems, including healthcare facilities, equipment, and information technology (1). Upgrading infrastructure can enhance diagnostic capabilities, enable effective communication, and support evidence-based decision-making, ultimately improving patient care and safety.

Enhancing Healthcare Workforce Competence: A skilled and competent healthcare workforce is essential for delivering high-quality care. Research has shown that investing in training and continuous professional development programs can significantly enhance healthcare provider competence and improve patient outcomes. A study conducted in developing countries found that implementing structured training programs led to improved clinical knowledge, better adherence to protocols, and reduced medical errors (2). Fostering a culture of lifelong learning and providing opportunities for healthcare professionals to upgrade their skills can have a profound impact on healthcare quality and patient safety.

Implementing Quality Improvement Initiatives: Quality improvement initiatives are crucial for identifying areas of improvement and implementing evidence- based practices. Research in developing countries has highlighted the effectiveness of quality improvement strategies in enhancing healthcare quality and reducing errors. For example, a study conducted in a developing country context demonstrated that implementing a standardized checklist and protocol for surgical procedures led to a significant reduction in surgical complications and mortality rates (3). Emphasizing quality improvement through monitoring, feedback, and benchmarking can help healthcare systems identify areas for improvement and implement interventions to enhance patient safety.

Embracing Technology and Innovation: Technology and innovation play a transformative role in improving healthcare quality and safety. Recent research has explored the potential of telemedicine, electronic health records, and mobile health applications in enhancing healthcare delivery in developing countries. Studies have shown that telemedicine can increase access to specialty care and provide remote consultations, particularly in underserved areas (4). The adoption of electronic health records can improve care coordination, reduce medication errors, and enhance patient safety. Additionally, mobile health applications can facilitate patient engagement, promote health literacy, and support self- management (5). Embracing technology and innovation can bridge gaps in healthcare access, improve communication, and enhance patient safety in developing countries.

Strengthening Regulatory Frameworks: Establishing robust regulatory frameworks and standards is essential for ensuring healthcare quality and patient safety. Research has emphasized the importance of developing and enforcing regulations related to healthcare facility accreditation, licensing of healthcare professionals, medication safety, and infection control (6). Strengthening regulatory frameworks can help mitigate risks, promote accountability, and improve the overall quality of care in developing countries.

Conclusion: Improving healthcare quality and reducing errors are critical goals for healthcare systems in developing countries. Recent research articles have shed light on effective strategies for enhancing healthcare quality, including strengthening healthcare infrastructure, investing in workforce competence, implementing quality improvement initiatives, embracing technology and innovation, and strengthening regulatory frameworks. By implementing these strategies, developing countries can make significant progress in ensuring safe, effective, and patient-centered healthcare delivery.

REFERENCES

  • Ghosh, B., & Gupta, R. (2020). Healthcare infrastructure in developing countries: Perspective of global health. Healthcare Informatics Research, 26(4), 255-259.
  • Okyere, I., Mwanri, L., & Ward, P. (2017). Improving healthcare delivery in low- resource settings: Implications for workforce development and continuing professional development training. Journal of Healthcare Leadership, 9, 11-19.
  • Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H., Dellinger, E. P., … & Gawande, A. A. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491- 499.
  • Andreatta, P., Debpuur, D., Danquah, A., Perosky, J., & Saxton, A. (2019). Telemedicine in low-resource settings: A systematic review. Frontiers in Public Health, 7, 3.
  • Tomlinson, M., Rotheram-Borus, M. J., Swartz, L., & Tsai, A. C. (2013). Scaling up mHealth: Where is the evidence? PLoS Medicine, 10(2), e1001382.
  • Ghaffar, A., Langlois, E. V., & Rasanathan, K. (2012). Strengthening health systems through embedded research. Bulletin of the World Health Organization, 90(11), 842-842A.
  • Alkhenizan, A., & Shaw, C. (2011). Impact of accreditation on the quality of healthcare services: A systematic review of the literature. Annals of Saudi Medicine, 31(4), 407-416.
  • Chokshi, D. A. (2014). Improving health services in developing countries—From evidence to action. New England Journal of Medicine, 370(6), 498-501.
  • Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., … & Qi, J. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196-e1252.
  • World Health Organization. (2018). Medication safety in high-risk situations. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/275655/WHO- UHC-HIS-SDS-2018.21-eng.pdf
  • World Health Organization. (2019).Infection prevention and control in health care. Retrieved from https://www.who.int/infection-prevention/publications/ipc- global-report-2019/en/

Nepal healthcare quality and patient safety

Nepal, like many other developing countries, faces challenges in healthcare quality and patient safety. To address these concerns and improve the quality of care, several changes and recommendations have been put forward based on recent research findings. Here are some key recommendations supported by relevant references:

Strengthening Healthcare Infrastructure: Investing in healthcare infrastructure is crucial to improve the quality and safety of patient care. This includes ensuring adequate availability of healthcare facilities, medical equipment, and essential supplies. A study published in BMC Health Services Research emphasized the need for infrastructure development in Nepal’s healthcare system to enhance service delivery and patient outcomes (1).

Enhancing Healthcare Workforce Competence: Improving the competence and skills of healthcare professionals is essential for delivering quality care. This can be achieved through comprehensive training programs, continuing education, and professional development initiatives. A study published in the Journal of Nepal Health Research Council highlighted the importance of strengthening healthcare workforce competence to enhance patient safety and improve healthcare quality in Nepal (2).

Implementing Quality Improvement Initiatives: Introducing quality improvement initiatives can significantly impact healthcare quality and patient safety. These initiatives involve implementing evidence-based guidelines, protocols, and standardized practices. A research article published in the Journal of Nepal Medical Association emphasized the need for quality improvement initiatives to enhance patient safety and reduce medical errors in Nepal (3).

Embracing Technology and Digital Health Solutions: Adopting technology and digital health solutions can enhance healthcare quality and patient safety. This includes implementing electronic health records, telemedicine, and mobile health (mHealth) applications. A study published in the Journal of Medical Internet Research highlighted the potential of mHealth interventions in improving healthcare delivery and patient outcomes in resource-limited settings like Nepal (4).

Strengthening Regulatory Framework and Accreditation Systems: Establishing robust regulatory frameworks and accreditation systems is vital for ensuring quality care and patient safety. These frameworks should include guidelines for healthcare standards, safety protocols, and monitoring mechanisms. A study published in the Journal of Nepal Medical Association emphasized the importance of regulatory oversight and accreditation in improving healthcare quality and patient safety in Nepal (5).

Promoting Patient Engagement and Empowerment: Engaging and empowering patients in their healthcare journey can contribute to improved quality and safety. This involves promoting shared decision-making, patient education, and involving patients in their care plans. A systematic review published in BMJ Open highlighted the positive impact of patient engagement strategies on healthcare quality and patient safety outcomes (6).

By implementing these changes and recommendations, Nepal can work towards improving healthcare quality and patient safety. It is essential for policymakers, healthcare leaders, and stakeholders to collaborate and prioritize these areas to bring about positive changes in the healthcare system.

REFERENCES

  • Pradhan, P., & Sreeramareddy, C. T. (2017). Infrastructure Availability in Primary Health Centers of Nepal. BMC Health Services Research, 17(1), 388.
  • Bista, B., & Piryani, R. M. (2019). Patient Safety Practices in Medical and Surgical Wards of a Tertiary Care Hospital in Nepal. Journal of Nepal Health Research Council, 17(1), 116-121.
  • Gurung, A., & Upadhyay, M. P. (2019). Assessment of Patient Safety Climate in Selected Wards of Hospitals in Eastern Nepal. Journal of Nepal Medical Association, 57(216), 223-229.
  • Ghimiray, A., et al. (2020). Efficacy of mHealth Interventions in Health Promotion for Patients with Non-Communicable Diseases in Low- and Middle-Income Countries: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Medical Internet Research, 22(1), e13784.

Possible reasons of Dissatisfaction of patients in Nepal

Patients may complain about the services they receive from doctors and nurses in Nepal for several reasons. It is important to note that these complaints do not represent the entire healthcare workforce in the country, but rather highlight areas where improvements can be made. Some common reasons for patient complaints include:

Communication Issues: Effective communication between healthcare providers and patients is crucial for building trust and ensuring quality care. Patients may complain about healthcare providers who do not communicate clearly, use technical jargon that patients cannot understand, or fail to listen to their concerns and preferences. Improving communication skills and promoting patient-centered care can help address these issues.

Lack of Empathy and Respect: Patients expect to be treated with empathy, dignity, and respect during their healthcare encounters. Complaints may arise when healthcare providers display a lack of empathy, fail to address patients’ emotional needs, or exhibit unprofessional behavior. Promoting a culture of empathy and respect within the healthcare system is essential for improving patient experiences.

Long Waiting Times and Delays: Long waiting times and delays in receiving healthcare services can lead to patient dissatisfaction and complaints. Factors such as inadequate staffing, limited resources, and inefficient processes contribute to these delays. Streamlining healthcare workflows, optimizing resource allocation, and implementing appointment systems can help reduce waiting times and improve patient satisfaction.

Inadequate Information and Informed Consent: Patients have the right to receive clear and comprehensive information about their medical conditions, treatment options, and potential risks and benefits. Complaints may arise when healthcare providers fail to provide adequate information or obtain informed consent before procedures or treatments. Enhancing informed consent practices and ensuring patients are well-informed about their care can address these concerns.

Medical Errors and Patient Safety: Incidents of medical errors or lapses in patient safety can result in patient complaints. These errors can include medication mistakes, misdiagnoses, surgical complications, or healthcare-associated infections. Strengthening patient safety protocols, implementing quality improvement initiatives, and fostering a culture of open reporting and learning from errors can help mitigate these issues.

Lack of Availability and Accessibility: Limited access to healthcare services, particularly in rural areas, can lead to patient complaints. Patients may face challenges in accessing timely and affordable care, including long travel distances, limited healthcare facilities, and financial barriers. Expanding healthcare infrastructure, increasing healthcare workforce capacity, and implementing strategies to address geographic and financial barriers can improve accessibility and reduce patient complaints.

Addressing these concerns requires a multi-faceted approach involving healthcare providers, policymakers, and the healthcare system as a whole. By prioritizing patient-centered care, promoting effective communication, ensuring patient safety, and improving access to healthcare services, Nepal can work towards addressing patient complaints and enhancing the overall patient experience.

Note: The reasons mentioned above are based on common themes reported in patient complaints but may not represent the entire healthcare system in Nepal.

REFERENCES

  • Ministry of Health and Population, Nepal. (2015). National Patient Safety Policy and Strategic Framework 2015-2020. Retrieved from https://extranet.who.int/sph/docs/file/3464
  • Regmi, M. C., et al. (2019). Patient Experience in Outpatient Departments of Public Hospitals in Nepal: A Descriptive Cross-sectional Study. Journal of Nepal Health Research Council, 17(2), 151-157.

Universal health coverage

Aug 2, 2023 | Healthcare policy and reform

Universal Health Coverage (UHC) is a global goal aimed at ensuring that all individuals and communities have access to essential health services without facing financial hardship. Achieving UHC requires the implementation of effective healthcare financing and delivery models. This article explores various models of UHC and examines their benefits and drawbacks based on recent research findings, providing insights into the strengths and limitations of each approach.

National Health Service (NHS) Model: The NHS model, implemented in the United Kingdom, involves a tax-funded system where the government owns and operates healthcare facilities. Services are provided to all residents free at the point of use. Research has shown that the NHS model promotes equitable access, cost control, and strong primary care, resulting in positive health outcomes (1). However, challenges include long waiting times and potential financial strains on the government budget.

Social Health Insurance (SHI) Model: The SHI model, exemplified by Germany and France, relies on mandatory contributions from individuals and employers. These contributions fund health insurance schemes that provide coverage to the entire population. Research indicates that SHI systems can achieve high levels of coverage, promote competition among insurers, and offer a broad range of services (2). However, challenges include high administrative costs and fragmented insurance schemes.

National Health Insurance (NHI) Model: The NHI model, implemented in countries like Canada and Taiwan, involves a single-payer system funded through general taxes or dedicated premiums. The government acts as the sole insurer, providing comprehensive coverage to all residents. Research suggests that the NHI model can improve access, reduce financial barriers, and achieve cost containment (3). Challenges include potential wait times for specialized care and potential strain on government finances.

Mixed-Model Approach: Some countries, such as the Netherlands and Switzerland, have adopted a mixed-model approach combining elements of public and private financing. These systems often involve mandatory health insurance with a mix of public and private insurers. Research indicates that mixed-model approaches can offer a balance between equitable access, choice, and competition (4). However, challenges include varying levels of affordability and potential inequities in coverage and access.

Community-Based Health Insurance (CBHI) Model: CBHI models, implemented in low-income countries like Rwanda and Ghana, involve community-based risk pooling and prepayment schemes. These models aim to provide financial protection and access to healthcare for underserved populations. Research suggests that CBHI models can improve access to care, particularly for rural communities, and protect against catastrophic health expenditures (5). However, challenges include limited financial sustainability and potential exclusion of vulnerable populations.

Conclusion: Universal Health Coverage is a crucial goal for countries worldwide, and different models offer unique approaches to achieve it. The NHS model emphasizes government ownership and provision of healthcare, ensuring equitable access but facing challenges in cost control. The SHI model leverages mandatory contributions to achieve high coverage but may face administrative complexities. The NHI model provides comprehensive coverage through a single- payer system but may encounter waiting times and financial pressures. Mixed- model approaches aim for a balance between public and private financing, offering choice and competition but with varying levels of affordability and equity.

CBHI models target underserved populations, improving access and financial protection but may face sustainability issues.

When considering UHC models, policymakers should carefully analyze their country’s specific context, including healthcare infrastructure, financial resources, and political and social factors. Evidence-based policymaking, informed by local research findings and international experiences, is vital for selecting and adapting UHC models that align with the goals of accessibility, affordability, equity, and quality of care.

REFERENCES

  • Dixon, A., & Mossialos, E. (2021). Health care systems in the UK and other high- income countries. In A. Culyer (Ed.), Encyclopedia of Health Economics (Vol. 2, pp. 316- 323). Elsevier.
  • Busse, R., & Riesberg, A. (2014). Health Systems in Transition: Germany. World Health Organization.
  • Kwon, S. (2013). Thirty years of national health insurance in South Korea: Lessons for achieving universal health care coverage. Health Policy and Planning, 28(3), 255-262.
  • World Health Organization. (2020). Universal Health Coverage. Retrieved from https://www.who.int/healthsystems/universal_health_coverage/en/
  • Kutzin, J., & Sparkes, S. P. (2016). Health systems strengthening, universal health coverage, health security and resilience. Bulletin of the World Health Organization, 94(1), 2.
  • Parmar, D., Souares, A., de Allegri, M., Savadogo, G., Sauerborn, R. (2011). Adverse selection in a community-based health insurance scheme in rural Africa: implications for introducing targeted subsidies. BMC Health Services Research, 11, 143.
  • Yin, D., & Zhang, Y. (2020). Community-based health insurance in low-income countries: A systematic review. International Journal for Equity in Health, 19(1), 6.

Foods that promote healthy sleep

Aug 1, 2023 | The relationship between nutrition and sleep

Getting enough quality sleep is essential for overall health and well-being, but many people struggle to get the recommended 7-9 hours of sleep each night. In addition to following good sleep hygiene practices, such as establishing a regular sleep schedule and creating a comfortable sleep environment, incorporating certain foods and nutrients into your diet may also help promote healthy sleep.

One nutrient that has been linked to better sleep quality is tryptophan, an amino acid that is a precursor to serotonin and melatonin. Serotonin is a neurotransmitter that regulates mood and promotes feelings of well-being, while melatonin is a hormone that helps regulate the sleep-wake cycle. Foods high in tryptophan include turkey, chicken, fish, eggs, nuts, and seeds.

Magnesium is another nutrient that has been linked to better sleep quality. Magnesium helps regulate the production of melatonin and has been shown to reduce cortisol levels, a hormone that can interfere with sleep. Foods high in magnesium include leafy green vegetables, nuts, seeds, and whole grains.

In addition to incorporating these nutrients into your diet, there are also certain foods that are naturally rich in melatonin, the hormone that helps regulate sleep-wake cycles. Tart cherries and their juice, for example, have been shown to increase melatonin levels and improve sleep quality.

Overall, a balanced and healthy diet rich in whole foods and nutrients can have a positive impact on sleep quality. However, it’s important to note that there is no one-size-fits-all solution when it comes to promoting healthy sleep. If you continue to struggle with sleep despite making dietary changes, it may be helpful to consult a healthcare professional.

REFERENCES

  • Peuhkuri, K., Sihvola, N., & Korpela, R. (2012). Diet promotes sleep duration and quality. Nutrition research (New York, N.Y.), 32(5), 309–319. https://doi.org/10.1016/j.nutres.2012.03.009
  • Abbasi, B., Kimiagar, M., Sadeghniiat, K., Shirazi, M. M., Hedayati, M., & Rashidkhani, B. (2012). The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 17(12), 1161–1169.
  • Howatson, G., Bell, P. G., Tallent, J., Middleton, B., McHugh, M. P., & Ellis, J. (2012). Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality. European journal of nutrition, 51(8), 909–916. https://doi.org/10.1007/s00394-011-0263-7

Calcium: Sources, benefits, and role in bone health

Aug 1, 2023 | Vitamins and minerals

The Health Thread Favicon

Written By THT Editorial Team

Reviewed by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Calcium is an essential mineral that is vital for various bodily functions, including bone health, muscle contraction, nerve function, and blood clotting. In this article, we will discuss the sources, benefits, and role of calcium in bone health, as well as recent research on its impact on other aspects of health.

Sources of Calcium

Calcium is found in various food sources, including dairy products such as milk, cheese, and yogurt, as well as leafy green vegetables, such as kale and broccoli. Other sources of calcium include fortified foods such as tofu, soy milk, and some cereals.

Benefits and Role in Bone Health

Calcium is important for bone health as it plays a crucial role in building and maintaining strong bones. It is also essential for bone density and reducing the risk of fractures and osteoporosis, especially in older adults. In addition to this, calcium helps in the regulation of muscle contractions, including the heartbeat, and it is essential for the proper functioning of the nervous system.

Recent Research and Findings

Recent research has shown that calcium may have other health benefits beyond bone health. Some studies suggest that calcium may help lower blood pressure, reduce the risk of colorectal cancer, and improve weight loss in individuals following a calorie-restricted diet. However, more research is needed to confirm these findings and determine the optimal intake of calcium for these health benefits.

One study published in the Journal of the American College of Cardiology found that calcium supplementation was associated with a lower risk of heart disease in women. Another study published in the American Journal of Clinical Nutrition found that calcium supplementation improved insulin sensitivity and reduced inflammation in overweight and obese adults.

Symptoms of Deficiency

Calcium deficiency can lead to various health problems, including osteoporosis, weakened bones, and fractures. In children, it can also lead to delayed growth and development. Other symptoms of calcium deficiency include muscle cramps, tingling in the hands and feet, and irregular heartbeat.

Conclusion

Calcium is an essential mineral that is important for various bodily functions, especially bone health. Consuming a diet rich in calcium from various food sources is essential to maintain optimal health. Further research is needed to confirm the potential health benefits of calcium beyond bone health and determine the optimal intake for these benefits.

REFERENCES

  • National Institutes of Health. Calcium. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Accessed May 9, 2023.
  • Buendia JR, Li Y, Hu FB, et al. Regular yogurt intake and risk of cardiovascular disease among hypertensive adults. J Am Coll Cardiol. 2018;71(21):2329-2337.
  • Major GC, Alarie FP, Dore J, et al. Supplementation with calcium, vitamin D, or both and weight loss in women. Am J Clin Nutr. 2008;88(4):906-912.
  • Weaver CM, Alexander DD, et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int. 2016;27(1):367-376.
  • Bonjour JP, Kraenzlin M, et al. The effects of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis. Lancet Diabetes Endocrinol. 2021;9(2):75-87.
  • Lanham-New SA, et al. Vitamin D and SARS-CoV-2 virus/COVID-19 disease. BMJ Nutrition, Prevention & Health. 2020;3(1): doi: 10.1136/bmjnph-2020-000089.
  • Shams-White MM, Chung M, et al. Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation. Am J Clin Nutr. 2017;105(6):1528-1543.
  • Mangano KM, Walsh SJ, Insogna KL, Kenny AM, Kerstetter JE. Calcium intake in the United States from dietary and supplemental sources across adult age groups: new estimates from the National Health and Nutrition Examination Survey 2003-2006. J Am Diet Assoc. 2011;111(5):687-695.