The human body was born to move, and keeping active every day is a real boon for body and mind. Even if you have some minor aches and pains and even when you are no longer in your prime. But how? Among the various exercise options, there is one that is absolutely “natural,” requires very little effort and that everyone can do, at any age: walking.
Try this quiz to find out all the benefits and importance of walking. And then, straight out for four health walks.
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Heart attack (or stroke)
A heart attack occurs when the blood supply is severely reduced or interrupted.
Symptoms include tightness and pain in the center of the chest, pain radiating to the shoulders, neck, and arms, pallor, sweating, nausea, and shortness of breath.
What to do?
- Call an ambulance or go to the emergency room.
- Check vital parameters.
- Help the victim get into the least painful position (usually sitting with legs raised and knees bent).
- Check to see if the patient has any medicines prescribed by the doctor, and if the patient is conscious, help the patient to take them.
Source: Mediserve‘s Pocket Guide to First Aid.
Melatonin: are they always sweet dreams?
Melatonin supplements are increasingly being used to improve sleep in adults and children in a “physiological” way, that is, without forcing falling asleep with hypnoinducing drugs, but through improved functioning of the internal biological clock that regulates the sleep-wake cycle. Since it is also normally produced by the body in response to decreased external light, taking melatonin is usually considered safe and harmless. But is this really the case? Some information about this.
Children’s health at risk in cities without greenery
Children’s respiratory and ocular health is strongly influenced by where they live, says a study conducted in the city of Palermo by researchers from CNR, Ingv, Arpa Emilia-Romagna and DepLazio, entitled “Associations of greenness, greyness and air pollution exposure with children’s health: a cross-sectional study in Southern Italy” and published in the journal Environmental Health
The research analyzed the relationship between the presence of respiratory and allergic symptoms and the performance of three indicators: greenness (urban greenness), greyness (built-up areas) and nitrogen dioxide (NO2).
Source: Active Citizenship
Suffocation
Suffocation occurs when the upper airway is blocked and the victim cannot breathe. There are two options:
- If the adult is conscious but cannot speak, cough, or breathe, it is necessary to give up to 5 strokes on the abdomen. One must stand behind the victim, encircling the waist with the arms. Close one hand into a fist and place it on the victim’s navel. Press the fist into the abdomen with 5 quick blows, each of which should represent a separate effort to remove the object. After 5 blows, it is good to check the victim and repeat the 5 blows until the victim expels the object and begins to breathe. If the victim is a pregnant woman or an obese person put the arms under the armpits while standing behind them. Place the fist on the middle part of the sternum, grasp the fist with the other hand and exert the 5 compressions.
- If an adult is unconscious and mouth-to-mouth respiration has failed to get air into the lungs give 5 strokes on the abdomen. To do this, straddle the victim and place the lower part of your palm in the center of the victim’s abdomen. Overlap the other hand and press inward with 5 quick strokes on the abdomen. At this point use the thumb and other fingers to grasp the victim’s jaw and tongue. If the object is reached, grab it and remove it. If the airway remains obstructed, alternate 2 cycles of respiratory resuscitation and 5 abdominal compressions. Insist until the object is removed.
Source: Mediserve‘s Pocket Guide to First Aid.
Omega 3 saves heart
Two large studies presented at the American Heart Association Scientific Sessions 2018 and published in the prestigious New England Journal of Medicine save lives
Monza, Nov. 11, 2018 The Omega 3 fatty acid association. with cardiovascular health has been known for forty years now, and over the decades thousands of researches have accumulated a considerable body of data in favor of the hypothesis that they protect the heart and arteries, so much so that Efsa (the European Food Safety Authority) recommends taking at least 250 mg per day of Omega 3 Epa (eicosapentaenoic acid) and Dha (docosahexaenoic acid) to promote good heart function. Now new confirmation of the effectiveness of Omega 3 in protecting cardiovascular health comes from the American Heart Association’s Scientific Sessions 2018 underway in Chicago, Illinois, United States.
Bringing them are the results of two independent large-scale intervention studies. The first, christened REDUCE-IT(Reductionof Cardiovascular Events with Icosapent Ethyl – Intervention Trial), confirms the usefulness of taking adequate doses of Omega 3 to reduce the risk of serious cardiovascular events when living with above-normal triglyceride levels. His results put to rest the doubts raised by recent reviews of the randomized controlled trials on Omega 3, confirming the importance of using an adequate daily dosage of Omega 3 (which in several studies is instead below the amounts needed to observe a significant effect) and of reserving Omega 3 treatment for patients who can really benefit from it because of the cardiovascular risk they are exposed to (in this case, high triglyceride levels). In contrast, the second, VITAL(VITamin D and OmegA-3 TriaL), highlights theeffectiveness of Omega 3 in the primary prevention of myocardial infarction, regardless of the presence of predisposing risk factors.
Expert comments
“The study showed very positive results in terms of both primary endpoints and major secondary endpoints,” said Deepak L. Bhatt, first name of the REDUCE-IT study.
“Those who benefited most from Omega 3 supplements were those who ate little fish“, JoAnn E. Manson, lead author of the VITAL study, explained instead. “We believe that the VITAL study showed no clear reason why those who are already taking fish oil supplements should stop taking them“, Manson added. “And for those who seem to be able to benefit-particularly, in terms of reducing heart attacks with Omega 3, for those who eat little fish-we think it makes sense to talk to your doctor about the possibility of taking these supplements“.
“The results are in line with indications that are about to be published as guidelines by the International Society for the Study of Fatty Acids and Lipids (ISSFAL), the scientific society that deals with Omega 3 internationally” explains Clemens von Schacky, a cardiologist at Ludwig Maximilian University in Munich, Germany, and a world expert on the relationship between Omega 3 and cardiovascular disease. According to von Schacky key parameter to be measured in this type of study is the so-called Omega 3 Index*, an indicator of the amount of Epa and Dha out of the total fatty acids in red blood cell membranes that should be measured before and during trials. “Otherwise ,it’s not clear what happened,” explains von Schacky “In the VITAL study, omega-3 was measured in plasma rather than red blood cells, and the dosage of omega-3 supplementation was not high enough to distinguish between the intervention group and placebo, as also explicitly stated by the authors. In REDUCE-IT, however, the dose of Epa was such that it increased blood levels of Epa by a factor of almost 6-clearly enough to differentiate between intervention and control groups. Of course, measuring the true Omega 3 Index would have provided a clearer picture of the situation“. And it is for this reason, the expert explains, that the REDUCE-IT study had sharper clinically relevant effects on both primary and secondary endpoints.
REDUCE-IT – the study
REDUCE-IT is a controlled clinical trial (i.e., in which the effect of the drug was compared with that of a placebo) randomized (i.e., in which participants were randomly assigned to either the group that took the drug or the group that took the placebo) double-blinded (i.e., in which neither the investigators nor the participants knew who would take the drug and who would take the placebo). Participants were characterized by high triglyceride levels (between 150 and 499 mg/dl), LDL cholesterol levels (the one considered hazardous to cardiovascular health) kept under control (between 41 and 100 mg/dl) by statin therapy, and a previous cardiovascular event or diagnosis of diabetes associated with at least one other cardiovascular risk factor. The first outcome considered was the incidence of death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke, coronary revascularization, or unstable angina.
The study, presented in Chicago last Saturday, November 10, and published simultaneously in the prestigious New England Journal of Medicine, involved 8,179 patients (mean age 64 years, 29% women) recruited from 473 centers in 11 different countries; mean triglyceride and cholesterol levels were 216 and 75 mg/dl, respectively, and 71% of participants were taking treatment for cardiovascular risk reduction. Each patient took either 4 grams of Omega 3 Epa or a placebo daily, and their health status was monitored for an average of 4.5 years. It was found that taking high doses of Omega 3 significantly reduced the risk of cardiovascular events in patients at risk due to high triglyceride levels.
As anticipated last September by Amarin Corporation plc, the manufacturer of the omega-3 drug tested in the study, the overall reduction in deaths from cardiovascular causes, nonfatal myocardial infarctions and nonfatal strokes, coronary revascularization or unstable angina requiring hospitalization was found to be 25 percent. The current event in Chicago was an opportunity to present more detailed results:
- During the first year of treatment, treatment with Omega 3 a reduced triglyceride levels by an average of 39 mg/dl, compared with an increase in the control group of an average of 4.5 mg/dl;
- Omega 3s were found to be effective regardless of triglyceride levels at the beginning of the study;
- With Omega 3, the overall risk of heart attack, stroke or death from cardiovascular causes decreases by 26 percent;
- Omega 3s reduce the risk of nonfatal heart attack or stroke and all-cause mortality by 23%;
- Omega 3 intake reduces the risk of fatal or nonfatal myocardial infarction by 31 percent, the risk of fatal or nonfatal stroke by 28 percent, the risk of urgent or emergent revascularization by 35 percent, the risk of unstable angina or hospitalization by 32 percent, the risk of dying from cardiovascular causes by 20 percent, and total mortality by 13 percent;
- Adverse effects were similar in the two groups. Hemorrhages (detected in 2.7 percent of Omega 3-treated patients and 2.1 percent of those taking placebo) were never fatal, and taking Omega 3 did not increase the incidence of hemorrhagic strokes. Other side effects noted included diarrhea and anemia (more frequent in the control group) and constipation, peripheral edema, and atrial fibrillation (more frequent with Omega 3 intake); hospitalizations for atrial fibrillation or flutter were more frequent among Omega 3-treated patients, but according to Bhatt this finding would be worrisome if the risk of stroke was increased, whereas instead it was found to be reduced by as much as 28 percent.
VITAL – the study
VITAL is also a double-blind randomized controlled clinical trial presented in Chicago last November 10 and simultaneously published in the New England Journal of Medicine. In his case, the 25,871 participants (men and women aged at least 50 and 55 years, respectively) had no significant cardiovascular risk and no history of prior cardiovascular disease. Thus, in this case, the effectiveness of Omega 3 was tested in terms of primary prevention, that is, in healthy individuals.
Omega 3 treatment included daily intake of 1g fish oil containing 840 mg Epa (460 mg) + Dha (380 mg). The average duration of treatment was 5.3 years. The primaryend point was the incidence of major cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes), while secondary end points included the incidence of the individual cardiovascular events considered. This resulted in a 28% reduction in the risk of myocardial infarction, a 50% reduction in the risk of fatal heart attacks, and a 17% reduction in the risk of coronary artery disease. Among participants who ate little fish, the reduction in heart attacks alone was as much as 40%, while the more general reduction in cardiovascular events was 19%.
Cranberry Harvest: the harvest
The fall harvest of ripe berries in the cranberry fields is a breathtaking event, thanks to the color impact offered by the berries surfacing at the water’s edge. Cranberry harvesting occurs once a year, beginning in mid-September and continuing until early November. There are two methods of collection: dry collection and water collection.
Dry collection
Dry harvesting is done by growers, who walk through the plantations, pushing carts equipped with mechanisms, which convey the berries detached from the bushes into crates. The fresh fruits are then transported to the farms where berry sorting takes place based on color and bounce ability. Dry or rotten berries and pier berries are discarded. This type of harvesting is mainly used for the fresh fruit market and for making culinary recipes.
Water collection
Water harvesting is another method by which bogs are flooded with about half a meter of water. “Whiskers,” special machines traverse the flooded fields creating eddies of water that help the fruit separate from the plant. At this point, the berries are easily gathered and harvested with suction pumps that perform an initial washing of the fruit. The cranberries, then, are transported to the farms for cleaning and subsequent stages of fresh product preparation. Blueberries harvested from flooded fields are used to make juice or sauces. In terms of volume, water harvesting yields more than dry harvesting, but tends to reduce the quality and shelf life of fruit in storage. Berries can be damaged when they are placed in water and crushed during mechanical harvesting. Usually the water-harvested berries are immediately frozen or dried and packed in packages of various sizes.
Source: Cranberry – A fruit that never ceases to amaze by Mediserve
Electronic cigarettes: how to help kids quit
Generally touted as a “harmless pleasure,” electronic cigarettes are very successful among teenagers, partly because the many flavors available make them seem very smart. But recent studies indicate that this way of smoking also carries risks and quitting is not as easy as one might believe, especially for teens. In fact, the nicotine they contain is addictive, and most pharmacological supports to break the habit are not suitable for the under-18s. A’
analysis of the problem
and possible solutions.
Peanut allergy: how to beat it
Roasted, salted or sugar-coated, everyone likes peanuts, but they are also one of the foods at greatest risk of triggering allergies. This is no small problem, since, often “hidden” or in trace amounts, they are contained in many industrially produced foods. A group of American allergologists has identified a simple way to make them tolerable by the immune system and avoid unpleasant episodes.
Resuscitation
IThe moment a motionless person is seen, it is necessary to test the person ‘s sensitivity by shaking the body slightly and giving small blows. Immediately afterwards, it is important to get active and call the local emergency number, usually 118.
Only after calling the ambulance, turn the victim on his back. If you think he or she has a neck injury, turn the victim over only if necessary and only after stabilizing the neck. Bend the victim’s head back, lift his chin with one hand and push his forehead down with the other hand. If an injury is suspected, it is best to lift the chin without bending the head.
If air does not enter in this way, tilt the head gently until it does. It is necessary to check the victim’s breathing by resting the ear on the mouth and nose of the person in question. Check the lifting and lowering movement of the chest and listen for breathing.
Practice mouth-to-mouth respiration. Keep head bent, chin raised and nose closed. Take a deep breath and keep the lips pressed against the victim’s mouth. In this way practice two breaths, 2 seconds each, and catch your breath. At this point you need to observe the lifting of the chest to see if air is entering the lungs. If these two breaths were not enough, fold your head back and try two more times. If mouth-to-mouth respiration is not effective, suffocation should be suspected and then other procedures should be implemented.
Check the pulse. If the latter is present, practice artificial respiration every 5-6 seconds. Stop every minute and check the pulse.
If the pulse is absent give CPR. It is necessary to find the correct hand position by sliding the fingers along the edge of the rib cage to the costo-sternal groove. Place the middle finger of the groove with the index finger next to it and the bottom of the palm of the other hand on the sternum. Then remove the hand from the groove, place it on the other hand, and interlace the fingers. At this point give 15 compressions, keeping the shoulders perpendicular to the hands on the chest. Count while compressing and have two short breaths follow the compressions. Continue in this way until the victim revives or until the ambulance arrives.
Source: Mediserve’s Pocket Guide to First Aid.
Preventing the flu to avoid brain stroke
Vaccinating against seasonal flu each year can help avoid certain illnesses, lost work days and, especially among the elderly and others at risk, severe and sometimes fatal complications, especially respiratory (pneumonia) and cardiovascular. New evidence adds yet another excellent reason to protect yourself early, with the vaccine, from the most typical and widespread cold illness: to reduce your risk of being affected by stroke. Here are the details of two recent studies reporting this dangerous association.
Bleeding: what to do?
In case of bleeding:
- Protect yourself from infection, wear latex gloves and if these are not available use different states of gauze or tissue.
- Cover the wound with a gauze pad or clean cloth and compress with your fingers or the palm of your hand.
- If the bleeding does not stop in 10 minutes, the compression may be too light, so it is necessary to compress for another 10 minutes more intensively. Blood-soaked dressings should not be removed, but more gauze should be overlaid.
- If bleeding continues compress a pressure point with fingers. The latter are located on the inner side of the arm and in the groin.
- When the bleeding has stopped apply a bandage to the wound. Wrap the bandage over the dressing and do not apply a bandage so compressive that it blocks circulation
- Treat shock by raising the legs 20-25 cm and cover the victim so as to keep him or her warm.
- When it is impossible to apply direct compression use a doughnut-shaped pad.
- Treat the wound and seek assistance if unable to stop the bleeding.
If internal bleeding is suspected, ABCHs should be checked. Keep the victim lying on the left side to prevent vomiting and do not give the victim anything to eat or drink.
If the victim does not vomit, lift the legs and cover the victim with a coat or blanket. It is necessary to call for an ambulance.
Source: Mediserve‘s Pocket Guide to First Aid.
The fruit of health: the Cranberry
NUTRITIONAL CHARACTERISTICS OF FRESH CRANBERRY
Cranberries have a high water content as well as a high sugar content. Berries contain fiber, minerals, and vitamins A, B, and C. The non-digestible fibrous compounds are able to regulate some metabolic functions. Due to their low sodium content and fair amount of potassium, cranberries have a fair diuretic effect. Within the American cranberry are several active ingredients: digestive tonic organic acids, myrtillin, flavonoids, proanthocyanidins and anthocyaninins, tannites, catechins, omega 3 and omega 6, phytosterols, tocopherols and tocotrienols. The organic acids that give the berries a sour taste represent a large blood spillover of alkaline bicarbonates, which counteract blood acidification. Another nutritional characteristic of cranberry is definitely the antioxidant capacity due to the presence of pigments, which accumulate in the outer layers of the berries. A number of dietary supplements, sold in supermarkets, pharmacies and herbalist shops, are also made from cranberries.
THE JUICE OF MULTIPLE VIRTUES
Almost all cranberry drinks contain about 25 percent pure juice. Undiluted natural juice has a pH of at least 2.5, and without the addition of sugar the taste tends to be unpleasant to the palate. Cranberry juice blended with agave extract has an excellent reputation as a nutraceutical because of its nutritional components. A dose of 70 ml of juice is recommended to enjoy the beneficial effects of cranberry. Regular intake turns out to be an easy and tasty aid to counteract arterial degeneration and osteoporosis.
HEALTH PROPERTIES OF CRANBERRY EXTRACT
Indians used the cranberry both as a food and as a medicine. Sailors, on the other hand, consumed blueberries to fight scurvy. There are so many recognized healing properties of cranberry that it has interested so many medical and scientific studies. Blueberry berries protect and strengthen vessel walls due to the presence of anthocyanosides. In addition, these small fruits are rich in an antioxidant first discovered in grapes that plays an important role in reducing “bad” cholesterol. The tannites in cranberry act on bacteria. This mechanism helps prevent infection. It is bound to the proanthocyanidin subfraction that contains oligomers in which epicatechin units are bound together.
THE ANTIOXIDANT CAPACITY OF ANTHOCYANINS
Anthocyani or anthocyanins are water-soluble plant pigments of the flavonoid family, found in plants in the form of glycosides. The production and quantity of flavonoid pigments, which are easily recognized in flowers, fruits, shrubs and leaves, depend on the type of plant and outdoor conditions. Anthocyanins are present in large amounts in fruits and inflorescences, but can also be found on leaves and roots. The color can vary from red to blue to violet, depending on the pH in the medium in which they are found and the formation of salts with heavy metals. Regarding antioxidant properties, anthocyanins are known for this characteristic and prevent cardiovascular disorders, obesity, inflammatory responses, and cancerous proliferations.
ROLE IN THE PREVENTION OF CHRONIC URINARY INFECTIONS
Cranberry is used as a natural antiseptic to prevent and treat urinary infections. Its benefits were initially attributed to urine acidification. Then, some researchers have shown that blueberry can inhibit bacterial adhesion to urinary epithelial cells. In 1998, Howell identified proanthocyandins as the active components of cranberry that can prevent the adhesion of fimbriae of uropathogenic Escherichia coli strains to the urinary epithelium, protecting it from infection.
THE MECHANICAL PREVENTIVE ACTION OF PROANTHOCYANIDINS
In urinary tract infections, the bacteria colonize the colon, pass through the periurethral/vaginal zonus, and ascend the urinary tract, bringing an infection to the bladder and then to the kidneys. Cranberry proanthocyanidins help prevent infection and bacterial colonization.
Source: The Cranberry – A fruit that never ceases to amaze by Mediserve
Social networks: happier with or without?
Social networks help keep in touch with distant friends and meet new ones. They make commuting on public transportation and waiting at the post office or supermarket checkout less tedious. They fill lazy evenings on the couch and days in bed with the flu. They help establish useful contacts for work. But they do not always improve the mood. In fact, they can make those who are lonely feel more lonely and those who are dissatisfied feel more frustrated. This is shown by a study
which warns: use social media sensibly, if you don’t times risk depression.
Fifty years, time of crisis: deal with it this way
The well-known “midlife crisis,” from which both men and women suffer, is not a decadent literary invention but a reality that many, if not all, face between the ages of 45 and 50. Trivializing or neglecting it is a big mistake, because it is a symptom of a profound psychophysical evolution that needs to be managed consciously to avoid depressive episodes and stress, maintain high self-esteem, and redefine the mind-body balance in a new perspective. Here are some useful tips.
Anaphylaxis: what to do?
Allergic reactions range from mild to severe. Sudden and imposing ones are known as anaphylaxis. Reactions can be caused by an insect bite, a food or a particular drug. Anaphylaxis if left untreated can be fatal within a maximum of 30 minutes.
What to do?
- Check vital parameters
- Adrenaline is the only life-saving therapy, so if the victim has an adrenaline auto-injector administer the drug immediately.
- Call for an ambulance.
- Keep the victim conscious by trying to keep him or her in an upright position so as to facilitate breathing.
- Keeping track of vital parameters.
Source: Mediserve‘s Pocket Guide to First Aid.
Cranberry botanical fact sheet
Taxonomy
Blueberry is the name for several wild shrub species in the genus vaccinium, including cranberry. These are semiligneous shrubs with oval leaves and white or pink pendulous flowers. The fruits, also known as blueberries, are a kind of berry. The genus vaccinium is divided into two subgenera and includes a total of 450 species, most of which live in the northern hemisphere with temperate and cold climates.
There is no shortage of blueberries in the mountains of tropical areas such as Madagascar, Hawaii, and Java. Bilberry, false blueberry, bog blueberry, and cranberry grow wild in Europe in forests and heaths up to 2,500 meters above sea level. For food distribution, giant blueberries with fruits twice the size of the wild species are usually cultivated.
The plant and the fruits
Vaccinium macrocarpon(i.e., cranberry) is a low-growing, upright developing plant. The shrub is characterized by small alternate oval leaves, with a bare stem at the bottom and full of branching at the top. The plant produces both vegetative and fruiting buds, and each fruiting bud can produce up to 7 flowers-most of these are formed from flowers on the shoots, but some berries also form from flowers on the end of horizontal branches. As for the leaves, their color is dark green during the growth period, and turns reddish brown during the dormant season. The fruits of the cultivated species are larger than those in the wild and consist of round red berries with a sour-tasting pulp.
The berries ripen in early fall and are harvested in October. Due to their hard skin they keep fresh for some time.
Source: The Cranberry – A fruit that never ceases to amaze by Mediserve
Acute abdomen: what to do?
At the time the acute abdomen occurs, surgical intervention is necessary. Abdominal pain is of different types depending on the etiology. General symptoms are visceral pain, pain from the peritoneum-parietal, and referred pain.
Immediate procedures:
- Incannulating a vein
- Hydration
- Nose-gastric probe
- Oxygen
Some laboratory tests, such as CBC +F +PLT, ESR, bilirubinemia, transaminases, amylasemia, blood glucose, ionogram; rectal exploration; chest X-ray; direct abdomen; abdominal ultrasonography, should be performed.
If peritonitis or perforation is suspected, contact the surgeon. In the absence of signs of peritonitis or perforation, antipyretics should be taken and possible antibiotic therapy initiated. Do not administer major painkillers or vagolytics because of the danger of covering up the clinical picture before diagnosis.
Source: Medical emergencies in pediatrics from Mediserve
Are you protecting your eyes?
Sight is the most valuable asset. And those who suffer from common vision disorders, such as myopia or presbyopia, or the annoying and increasingly common dry eye syndrome know that this is not just a popular saying. Seeing well is crucial to ensuring a good quality of life, so it is essential to take a few steps every day to protect your eyes and have regular checkups, especially during childhood and after age 40. How do you guys deal with it? Here is a test to find out.
Are you sure you know how to recognize depression?
Deep and lingering sadness. Apathy. Overly discouraged attitude in the present and pessimistic about the future, even when circumstances would not warrant it. Frequent urge to cry, especially among women. When faced with such manifestations, it is easy to think of depression. But, not infrequently, the disease also or mainly presents itself with other signs, which few can recognize. Here is a list of the main
symptoms
less known of depression and some advice on what to do if you recognize them in yourself, a family member, or a friend.
Keeping fit without a gym?
Do you hate the gym, don’t do any kind of sports continuously, but want to lose a few pounds and keep fit? Good news: you can. Just move every day and make movement a way of life. The ways are many: some easy to guess, others less so; often funny, sometimes downright pleasant.
Here are a few.
But to achieve appreciable effects, remember also to follow a healthy and balanced diet.
Vinegar of a thousand virtues: true or alleged?
Wine, red or white, balsamic, apple, pear, rice, coconut, honey or beer. These are just a few variants of vinegar much-loved food in all parts of the world and used for many different purposes. Seasoning, flavoring, cooking, preserving, disinfecting, and even achieving specific health benefits, from weight control to blood sugar control. But what is true among the many touted virtues?
Here is what is known
about this valuable fermentation product and what, on the other hand, remains to be proven.
Standards for ethical behavior: advocacy, caring, competence, responsibility
The concepts so far can be related to the code of ethics as follows:
Article 1.5 reads:
The midwife, who is responsible for training and updating his or her professional profile, independently and collaboratively promotes and implements field research (Competence).
Article 2.1 reads:
The midwife provides care while respecting the dignity and freedom of the person by promoting his or her awareness according to ethical, religious, cultural values, as well as, social conditions in the exclusive safeguarding of the health of his or her caregivers (Autonomy/Caring).
Article 2.13 reads:
The midwife advocates for global health while respecting fundamental human rights and is committed to cooperation to address inequalities in access to care and promote reproductive and gender health, worldwide (Caring/ Advocacy).
Article 3.1 reads:
The midwife protects the dignity and promotes women’s health at all ages by identifying situations of fragility, distress, deprivation, and violence, providing appropriate support, and ensuring referral to the appropriate authorities, to the extent of her competence (Caring/Advocacy).
Article 3.5
With the consent of the person concerned, the midwife promotes pain containment techniques for the woman and in the newborn as far as she is competent through clinically and ethically appropriate choice (Caring/ Autonomy).
The midwife’s code of ethics has articles where a reference to the concept of advocacy can be traced, but there is no use of this term. In particular, we believe that concepts compatible with the application of advocacy can be discerned in Chapter 3 concerning relations with the assisted person and Chapter 5 concerning relations with health care institutions and the college.
Relationships with the assisted person
3.1 The midwife protects the dignity and promotes women’s health at all ages by identifying situations of fragility, distress, deprivation and violence, providing appropriate support and ensuring referral to the appropriate authorities, to the extent of her competence.
3.2 The midwife promotes and is committed to ensuring continuity of care by accompanying and caring for the woman, the couple, and the unborn child during pregnancy, labor, delivery, and the puerperium, in order to ensure the overall health of those cared for.
3.3 The midwife takes action to ensure scientifically validated care appropriate to levels of need. Engages in the protection and surveillance of the physiological processes of sexuality, fertility and reproductive health of women and couples.
3.8 The midwife is committed to promoting the person’s global and reproductive health by providing correct, appropriate and personalized information with respect to lifestyles.
3.9 The midwife in compliance with multidisciplinary health programs, integrates the activities of her/his competence with those of other professionals and strives to provide complete and correct information on prevention, care/ treatment, rehabilitation and palliation programs, using effective communication methodologies conducive to the processes of understanding the person.
Relationships with health care institutions and the college
5.1 In the practice of the profession, the midwife/ midwife contributes through her or his efforts to ensure the efficiency of the service and the proper use of resources in accordance with the ethical principles of solidarity and subsidiarity.
Relationship between advocacy and case/care management and informed consent
Given the characteristics of the midwife practicing advocacy as the “core” of the communication process between the person being cared for, the family, the physician and other health care professionals, it is evident that this application is within the model of “case management,” and its overcoming that is “care management.”
In fact, from the direct application of advocacy, there also derives the managerial role of the midwife/ midwife as the de facto manager of the communication process, intervening and coordinating all steps in the care process.
The health worker becomes the leader of the care process and actually manages the effective communication act.
The introduction of this organizational model professionally enriched this professional figure: who by posing as a problem solver used a higher level of motivation and professional responsibility.
The midwife in the case manager simultaneously fulfills various operational roles:
– clinician;
– managerial;
– financial.
The next step that represents an evolution, namely “care management,” poses
as a response to changes in the subjects of the health care system, with the primary purpose of meeting the bio-psychosocial needs of the person.
Care manegement is thus a person-centered program, no longer a case-centered one that requires the intervention of a professional who views the individual holistically.
This evolution, is indicative of a maturing capacity of the midwifery profession, and with this structural and organizational substrate, one of the most obvious elements of this awareness united with these changes is the advocacy function, a distinctive quality of the Care Manager application.
Through the shift from case management to care management, there has been a shift from considering professional qualities to considering personal qualities, resulting in the centralization of the human resource in the company’s competitive dynamic. Here then, notional knowledge has given way to practical and interactive know-how.
One of the most important tools of nursing care management is empowerment, which aims to foster in the person being cared for the acquisition of power through the adoption of the inescapable human right of autonomy, which is embodied in the empowerment of individuals and groups to actively control their own lives.
One of the tools, of the realization of this empowerment is the right to informed consent for the patient, which turns into a duty for the midwife/ midwife.
WHAT DOES INFORMED CONSENT MEAN?
Informed consent has two key concepts in it:
– Inform before consent;
– the main party should not be the proposer but the recipient.
Failure to observe these principles has resulted in numerous complaints against health care professionals by patients who feel they have been harmed not by the consequences of treatment errors, but by the erroneous and failure to inform them about the risks and consequences of treatment.
The consent provided by the patient, for the service to which he or she is to undergo, becomes the means by which the principle of self-determination, that is, the right of every human being to freely dispose of his or her own choices, is exercised.
The direct involvement of the patient is necessary, therefore, for the fulfillment of his or her right to knowledge of the clinical data concerning him or her, but also to make him or her an active participant during the course of his or her care plan.
Reflexively, breach of the duty to inform may be a source of professional liability in the legal sphere and more specifically in civil or criminal law.
The inherent requirements of valid consent are:
1. the quality of communication;
2. the understanding of information;
3. freedom of decision-making on the part of the assisted person;
4. decision-making ability.
Proposable information standards can be professional, average, subjective. The first (professional type) gives information that meets the criterion of technical correctness according to the state of medical knowledge, resulting in possible misunderstanding by the recipient of the information.
The average standard should be related to what a person might understand about the procedure that concerns him or her.
The subjective standard, in which the caregiver wants or can understand what he or she believes to be of greatest significance to him or her, resulting in a personalization of what was said to him or her.
Informed consent in the midwifery code.
The physician, is no longer the only professional called upon to deal with information and informed choices with respect to health interventions; with him, all other professionals, and not only social and health professionals, are called upon to place their intervention in a scenario of consensual decision-making, in which professionals and the assisted, in collaboration with each other, formulate diagnostic-therapeutic-assistance choices with respect to the various possible options.
Particularly in informing the caregiver, the midwife figure is involved. Carefully reviewing the articles of the midwifery code, particularly those concerning the
relationship with the person being cared for, resonate words such as: therapeutic alliance, conscious and understandable choice of the patient, use of communication methodologies characterized, by effectiveness, comprehensibility, multidisciplinarity, and completeness of information.
And again, they echo themes regarding women’s active participation, in programs
diagnostic and therapeutic, to the right to conscious and responsible procreation.
All these issues contribute to the definition of an overarching category inherent in informed consent, which is expressly referred to in Article 3.5 and 3.10:
– 3.5 – With the consent of the person concerned, the midwife promotes the techniques of containment
of pain in women and the newborn as far as it is within its competence through a
clinically and ethically appropriate choice.
– 3.10 – The midwife, outside emergency-urgency cases, before undertaking on the person any professional act, ensures adequate information in order to obtain informed consent, based on a true therapeutic alliance with the person. Clinical information should not, in fact, be understood as exclusively medical: in fact, clinical is a common field for many professions, for example, midwifery.
Thus, they are among the clinical information needed by the patient, at least as much as medical diagnosis, planning of diagnostic-therapeutic pathways in the obstetric-gynecological-neonatal area, and prescriptions for activities aimed at ensuring continuity of care (pregnancy, labor, delivery, puerperium).
Information about the diagnostic-therapeutic program should be timely and understandable to the patient.
Consent, should be expressed mainly in writing, with special attention to the need for summarization of informed consent in cases where, in the course of the implementation of the treatment plan, changes not previously considered become necessary.
In this regard, in the information phase prior to the health care intervention, one can make use of the following
Of tools such as pamphlets and brochures. The most widely used method is the construction of
written information sheets, which will then be supplemented by a follow-up interview to check the understanding by the assisted person and possibly offer him or her personalized explanations. After this stage, it is appropriate to allow the caregiver time for reflection, deepening, and research, which should also be shared with reference persons. Only after this period of time does the assisted person’s signature to express consent acquire
sense.
There are some individuals who are unable to express their consent:
– Subjects in a critical clinical condition (such as a soporific state/coma);
– Individuals with severe mental disabilities;
– Individuals with conditions such as Alzheimer’s disease.
These are conditions in which the patient is unable to participate in informed consent because he or she is incompetent on this side.
On the health care side, decision-making capacity is defined as that person who:
– Is able to understand the circumstances in which he or she finds himself or herself and the information useful for making a decision regarding treatment and care choices;
– Knows the foreseeable consequences of a given decision;
– Communicates its will in a consistent, clear and understandable way.
It is well established that while the assessment of the patient’s psychological competence is the responsibility of the physician, no assessment can be ascribed to him or her regarding the patient’s capacity to understand, a parameter of exclusive legal relevance.
Source: ” Mediserve‘s Intrapartum Care Models,” by Vittorio Artiola, Simona Novi, Salvatore Paribello, Ferdinando Pellegrino, Giuseppina Piacente, Andrea Vettori
Drug allergies: uncommon, but not rare
When taking a drug, alongside the desired therapeutic effects, one may experience one or more discomforts related to characteristic and non-eliminable side actions of the active ingredients it contains or to an individual hypersensitivity to one or more excipients. Generally, however, these are not allergic reactions. Drug allergies are a much rarer and more serious phenomenon, which should prompt immediate discontinuation of use of the responsible drug and no further use thereafter. But which drugs are at greatest risk on this front?
Find out by clicking here
.