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This post is authored by guest contributor Professor Vishaal Kishore, the Executive Chair of the Cisco-RMIT Health Transformation Lab

The recent report of the Australian Royal Commission into Aged Care Quality and Safety tells us two critical things. First – something systemic is going on in aged care: the elements of the system are not working together to produce optimal outcomes. Second – the issue is one of respect: our system is not treating individuals the way that they ought to be treated.

Our challenge is to find a way to make the Australian aged care system simultaneously more connected, and more compassionate. And this is where technology has a crucial role to play – but the role is a complex one. Done right, technology can be core to making our system more respectful. Done poorly, technology can merely contribute to making a disrespectful system more efficient at being disrespectful.

At the Health Transformation Lab, we – along with Cisco – set out to explore the profound role that technology can play in reorienting our aged care systems around connection and respect. But those of us who work in innovation in the care economy know that words are not enough – so we set out not just to write about why technology can transform aged care, but also to demonstrate how. The end result is something of which we all are deeply proud – in a few short months RMIT and Cisco had been able to demonstrate how technology could be used to improve the experience of people in aged care and also free up much needed time for staff to focus on their core role: delivering care.

Perhaps most excitingly, these technologies all exist right now – our task is just to arrange them and deploy them in new and exciting ways.

In the coming months, the Health Transformation Lab is looking to work with industry partners, providers and others interested in doing something meaningful to improve the lives of people receiving aged care services in a multitude of settings. Based on our initial demonstrations I am confident that government and the sector broadly will start to understand that technology is not something to be balanced against ‘human-to-human’ care, but rather the very thing that enables it.

To learn more about how the collaboration with Cisco combines research and technology to address key recommendations, read our report on Transforming Aged Care.

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Sept. 19, 2022 — If you’re too stressed to sleep, taking time to practice a breathing regimen with ancient roots could help you find your way to slumberland.

The 4-7-8 breathing technique was popularized by Andrew Weil, MD, founder of the Andrew Weil center for Integrative Medicine at the University of Arizona, but it is based on pranayama, the yogic practice of breath regulation, CNN reported.

“What a lot of sleep difficulties are all about is people who struggle to fall asleep because their mind is buzzing,” Rebecca Robbins, a Harvard Medical School instructor and an associate scientist in the division of sleep and circadian disorders at Brigham and Women’s Hospital in Boston, told CNN. “But exercises like the 4-7-8 technique give you the opportunity to practice being at peace. And that’s exactly what we need to do before we go to bed.”

Weil’s website provides these instructions: Put the tip of your tongue behind your upper front teeth and keep it there during the whole exercise. That will make you exhale through your mouth around your tongue and inhale through your nose. Completely exhale with a whoosh sound, then inhale through your nose to a mental count of four. Hold your breath for a seven count. Exhale through your mouth with a whoosh sound for a count of eight.

Repeat this cycle three more times.

“If you have trouble holding your breath, speed the exercise up but keep to the ratio of 4:7:8 for the three phases,” Weil’s website says. “This breathing exercise is a natural tranquilizer for the nervous system.”

Raj Dasgupta, a clinical associate professor of medicine at the University of Southern California’s Keck School of Medicine, told CNN that the 4-7-8 technique appears to activate a person’s para sympathetic nervous system, which is responsible for resting and digesting. The technique reduces activity in the sympathetic nervous system, which is responsible for your fight-or-flight response.

While many people swear by the 4-7-8 technique, its effectiveness is not backed up by much scientific research.

Breathing exercises of all kinds help people relax and get to sleep, Kelly Waters, MD, a sleep medicine physician with Spectrum Health, told Prevention.

“The repetitive nature of breathing techniques is great for the last steps of settling,” she said. “The first stage of sleep is called the ‘hypnic’ stage, and these types of breathing techniques allow for a type of self-hypnosis.”

High blood pressure, heart disease, and diabetes are some of the most prevalent chronic conditions affecting many populations. This is largely so because age, family history, and gender make it nearly impossible for older persons to avoid becoming chronic disease statistics. However, an understanding of these illnesses and their connections can allow for better prevention and, better still, manage them adequately. 

What is High Blood Pressure? 

Blood pressure is the normal force that makes blood move in the circulatory system. Hence, it’s normal for everyone to have blood pressure, the rate at which blood flows in the body. During this flow, oxygen and other nutrients that nourish the organs and tissues in the body are pushed around. Therefore, it’s an essential part of the human body. Blood pressure also acts as an agent to deliver antibodies and white blood cells in the human body. 

However, human blood pressure can be dangerously low or high with every malfunction. High blood pressure will directly increase the risk of coronary heart disease and stroke. That is because when blood pressure is high, the arteries may be more resistant to blood flow, forcing the heart to work harder in pumping blood throughout the body.

What is Heart Disease?

Heart disease is any health condition that affects the cardiovascular system of the human body. Therefore, these heart conditions affect both the heart and the blood vessels. But it is also essential to note that there are different heart diseases. This is because these diseases also manifest and affect the body differently. 

For instance, coronary artery disease, the most common heart disease, affects the blood supply in the human body. This leads to the heart receiving less oxygen and nutrients than contained in normal blood pressure. Arrhythmia is another type of heart disease that occurs when the electrical impulses controlling the heartbeat become faulty. Hence, it causes the heart to beat too slowly, erratically, or quickly.

Diabetes

Diabetes is also a profound illness that affects humans. This disease occurs when the blood glucose or blood sugar is too high. This is so when the blood glucose, the main energy source, doesn’t get into the cells. Ideally, the blood glucose obtained from food should be helped by insulin, a hormone made by the pancreas to get to the cells for energy production. However, it may be a problem once the blood glucose stays in the blood and refuses to move to the cells. 

The connection between blood pressure, heart disease, and diabetes

One of the major connections that blood pressure, heart disease, and diabetes have is that they affect the blood vessels. Blood pressure, as the name implies, has to do with the flow of blood (mostly oxygen and nutrients) to the organs and tissues. Heart diseases and diabetes, on the other hand, also happen due to the malfunction of cells that have to do with the blood. Therefore, every human must pay attention to their heart health. 

Having a haven where you can safely talk about your health problems and how to prevent them is also essential. Ravkoo Health is one of the major healthcare marketplaces that can help you through this process. The reason is that online therapy and diabetes prevention services are available there. 

Another major link these three have is that most of the time, one occurrence often leads to the other. For instance, research shows that about two-thirds of adults with diabetes also use prescription medications to control their high blood pressure. That signifies a high chance of becoming hypertensive when an individual has diabetes. 

Also, there’s a high chance that someone with high blood pressure may eventually suffer from heart disease or stroke. Likewise, a person with diabetes and high blood pressure is more likely to develop heart disease or another condition. Hence, every human, especially adults, must go for regular health check-ups to know how to prevent and control any of these conditions. 

In essence, diabetes is generally a risk factor for any cardiovascular disease. That is because diabetes can cause damage to the nerves and blood vessels around the heart, resulting in heart disease. Most of the time, hypertension and diabetes often coexist, thus leading to more damage than the occurrence of each alone. 

Dealing With These Conditions

The longer an individual has diabetes, the more they are prone to developing a heart condition. Diabetes and high blood pressure are extremely deadly and can greatly increase your heart attack or stroke risk. That’s the reason anyone with diabetes has to go through certain treatments to help them regulate or control their blood glucose. Since diabetes has no cure, proper management from Ravkoo Health is essential to avoid other diseases, especially health-related ones.

Numerous lifestyle modifications can reduce your blood pressure. Most of them are nutritional; however, regular exercise is also advised. For example, most medical professionals recommend brisk walking for 30 to 40 minutes each day, although aerobic exercise can improve your heart health.

Exercise not only lowers blood pressure but also strengthens the heart muscle. It might lessen vascular stiffness as well. Although it usually comes faster due to type 2 diabetes, this occurs as people age. You get to better regulate your blood sugar levels by exercising. You may create a customized workout program by working closely with your physician.

Conclusion

Leading and living a healthy lifestyle is essential to help regulate these conditions. For instance, you should try to eat and maintain a balanced diet. You should also quit smoking and avoid exposure to second-hand smoke. In addition, regular exercise, reducing alcohol intake, maintaining a healthy weight, and engaging in activities that help relieve anxiety and stress are some essential coping techniques.

While the tips are essential, they are not substantial, and you will need professional help. However, there are services at Ravkoo Health that can help if you or someone you love is having trouble managing any of these chronic diseases. Participants in these programs can learn the skills needed to manage chronic diseases’ effects on their lives.

Disclaimer: The statements, opinions, and data contained in these publications are solely those of the individual authors and contributors and not of Credihealth and the editor(s). 

Call +91 8010-994-994 and talk to Credihealth Medical Experts for FREE. Get assistance in choosing the right specialist doctor and clinic, compare treatment costs from various centers, and timely medical updates

Gastric sleeve is a type of bariatric surgery for patients who are obese and their weight poses a significant risk to their health. It is also known as sleeve gastrectomy or vertical sleeve gastrectomy. This procedure reduces the amount of food a person can physically eat and fit inside their stomach. After the surgery, a person can expect to lose anywhere from fifty to ninety pounds in twelve months. 

Sleeve gastrectomy is performed using laparoscopy in which several small incisions on the stomach, the laparoscope, and other instruments required for the surgery are inserted. The surgery removed most of the stomach and reshaped the stomach into a narrow tube known as a sleeve. Unlike other bariatric operations, the small intestine is not operated upon. 

However, this surgery is only reserved for people for whom dietary changes and food regulations do not significantly affect their weight. Gastric sleeve surgery is performed in patients with class 2 diabetes with a body mass index of between 35 to 40. This surgery can also help in other accompanying ailments caused due to obesity, like sleep apnea, high blood pressure, cardiovascular diseases, or diabetes. 

A gastric sleeve is usually the last resort as it does carry some risks like any other surgery. Some common ones include bleeding, infection, blood clots, and breathing problems from general anesthesia. Moreover, after the surgery, the body loses its ability to absorb nutrients like calcium, vitamin B12, vitamin D, etc. Gastric problems, heartburn, excessive burping after gastric sleeve, and acid reflux are also common complications noticed with this procedure. 

A person needs to start preparing months before the actual surgery takes place. Bariatric surgeries are not recommended for people abusing drugs or alcohol as they might not be able to commit to permanent changes to their diets for the rest of their lives. Before the surgery, a patient enrolls in an education program to prepare for the surgery and for life after it.

Several physical tests need to take place before the surgery commences. The person might also be told to reduce weight before the surgery as this decreases the liver’s size, significantly reducing the risk. Patients who smoke must stop months before the surgery, and pain medications like ibuprofen, crocin, aspirin, or any blood thinning medications must be stopped. 

How Does The Surgery Take Place?

This surgery is performed under general anesthesia, which makes the person lose consciousness. Several small incisions are made on the stomach through which the laparoscopy is inserted through the upper abdomen. Other tools required for the surgery are also inserted through other incisions made on the abdomen. After this, a tube is inserted that is passed down to the stomach, and a laparoscopic stapler is used to resize and create the sleeve. The remaining portion of the stomach is pulled out through one of the earlier incisions. 

Due to the surgery’s laparoscopic nature, patients can usually leave the hospital during the day of the surgery itself. The recovery period after the surgery is quite long as a liquid diet needs to be maintained for the first couple of weeks and then switched to pureed and solid foods afterward. 

Eating regular solid food before letting the body get used to the new sleeve leads to vomiting, nausea, and stomach pain. It’s advised to chew the food properly before swallowing to ensure no large chunks are swallowed by mistake. After the surgery, regular blood tests are mandatory to ensure the patient has no deficiencies. 

Anastomotic Leaking

Anastomotic leaking happens when food and other digestive fluids leak into the abdominal cavity due to complications after the surgery. Around 1.5 to 6% of bariatric patients face anastomotic leaks, which can vary depending on the type of bariatric surgery performed. The symptoms of this leak begin to surface after only three days of the surgery. 

Some symptoms include increased heart rate, fever, abdominal or stomach pain, shoulder pain, decreased blood pressure, and reduced urine output. 

Anastomotic leaking is also more common in people who are obese, and the heavier a person is, the more at risk they are of developing the leak. 

A CT scan is used to diagnose an anastomotic leak and involves swallowing a dye to see if it is leaking into the abdominal cavity or not. Even if a leak is not detected, the doctor might still recommend an emergency operation just to be safe. If a leak is detected, antibiotics are given through an intravenous line, and the patient is operated upon to drain the fluid surrounding the abdominal cavity and repair the anastomosis. A tube might be inserted connecting directly to the small intestine to supply food until the leak heals properly. 

Anastomotic leaks are not to be taken lightly and can be life-threatening due to the risk of infection and internal bleeding. Moreover, if undetected for a long time, they can also lead to ulcers, internal scarring, and a reduction in the anastomosis’s size, also known as a stricture. Some other risks include pneumonia and fistula, a drainage tract that develops between the gastric sleeve and stomach due to leaking. 

Conclusion

Anastomotic leaks are life-threatening complications that must be addressed as quickly as possible. Some common symptoms to look out for after the surgery are an increased heart rate of about 120 beats per minute or more, high fever, dizziness, and abdominal and shoulder pain. 

Other indicators of a leak might be revealed from blood work as an increased count of white blood cells, and C-reactive proteins are noticed in patients with anastomotic leaks. This is due to the fact that the body is actively trying to fight the infection. 

President Biden’s declaration that “the pandemic is over” could complicate the administration’s effort to battle COVID-19, public health experts say.

Biden made the remarks in a Sunday broadcast of 60 Minutes. “We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over,” he said. “If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And so I think it’s changing.”

The president’s comments come as public health officials are trying to convince Americans to get a new booster shot, and as the White House has worked unsuccessfully for months to convince Congress to provide more than $22 billion in new funding for the COVID-19 response. Since Sunday night, Republicans have already used his words to question vaccine mandates that are still in place for the nation’s military and other federally funded programs.

At the same time, nearly 400 Americans are dying each day of COVID, according to the Centers for Disease Control and Prevention.

Multiple public health experts called Biden’s remarks “unfortunate.”

“When you have the president of the U.S. saying the pandemic is over, why would people line up for their boosters? Why would Congress allocate additional funding for these other strategies and tools?” said Dr. Celine Gounder, an epidemiologist and senior fellow with the Kaiser Family Foundation. “I am profoundly disappointed. I think this is a real lack of leadership.”

The remarks could cause political difficulties

The White House is currently fighting an uphill battle in Congress to secure $22.4 billion in emergency COVID-19 funding to support vaccinations, testing and further research. Some Republican support is needed in the Senate to secure the funding, which the administration has been seeking since the spring. It has been hard to come by as some GOP lawmakers argue that there is still unspent money from earlier COVID-19 funding measures that can be used.

In announcing the funding request earlier this month, an official told reporters on a briefing call that there is not currently “enough funding to get through a surge in the fall.” The administration has already stopped the program to send free test kits to Americans because of a lack of funds.

The president’s words could undercut the effort to get this money further.

Republicans are already using the statement to question the justification for ongoing pandemic measures, including the military’s vaccine requirement and mandates for vaccines and masks in federally funded Head Start education programs.

“Biden admitted last night that the COVID pandemic is over. In other words, there is no ‘ongoing emergency’ to justify his proposal for student loan handouts,” said Sen. Marsha Blackburn of Tennessee.

Some public health experts agreed with Biden’s characterization of a “change” in the pandemic. “It is a reasonable thing to do as we collectively move on from this emergency footing that we’ve been on for the last couple of years, and try to navigate a new normal,” said Dr. Bob Wachter, chair of UCSF’s Department of Medicine. “It’s an appropriate way of thinking about the threat as it stands today.”

Acknowledging the shift shouldn’t stand in the way of funds for COVID-related efforts, said Dr. Tom Frieden, who led the CDC during the Obama administration.

“We don’t have a pandemic of Alzheimer’s disease or influenza or heart disease. But Congress still needs to fund programs to address those problems,” he said.

The ongoing booster campaign could face challenges

The Biden administration’s public health leaders have sometimes struggled at times to present a clear, unified message about COVID-19. His administration has at times been criticized for a lack of communication or issuing guidance that seemingly conflicts with available data.

Now, the president’s remarks have thrown another wrench into the mix at a crucial moment.

The administration has just rolled out a new bivalent booster shot designed to target the omicron subvariants that have dominated caseloads in the country in recent months, and the agency is working to convince Americans to go out and get it. (Since the CDC recommended the shot earlier this month, hundreds of thousands of Americans have received it.)

But health officials have long struggled to convince Americans to get their shots. Only 68% of Americans completed their original vaccine course, and fewer than half of those have gotten any booster shot.

Most troubling are booster rates for people over 65, said Jennifer Nuzzo, the director of Brown University’s Pandemic Center. Data from the CDC show that while the vast majority of older Americans got the original vaccines, far fewer – only about a quarter – have also taken the two original boosters.

“If we do nothing else to reduce the number of deaths from COVID, we need to make sure that people who are at the greatest risk of severe illness and death – and that’s people over the age of 65 – that they get their booster,” Nuzzo said. “I don’t want to inadvertently send the signal that that’s not something they need to do anymore.”

She and other public health experts pointed to the winter, when a surge of new cases is likely as cold weather pushes socialization indoors, and holidays prompt people to travel to visit family and friends. A winter wave of cases will require tests, vaccines and other efforts to combat COVID, they said.

“I would say, let’s not declare the pandemic over,” said Dr. Carlos Del Rio, an infectious disease specialist at Emory University. “Let’s say that we’re in a very good place, and we need to continue working hard in order to stay in that good place.”

NPR’s Arnie Siepel contributed reporting.

It’s well known that weightlifting can strengthen our biceps and quads. Now, there’s accumulating evidence that strengthening the muscles we use to breathe is beneficial too. New research shows that a daily dose of muscle training for the diaphragm and other breathing muscles helps promote heart health and reduces high blood pressure.

“The muscles we use to breathe atrophy, just like the rest of our muscles tend to do as we get older,” explains researcher Daniel Craighead, an integrative physiologist at the University of Colorado Boulder. To test what happens when these muscles are given a good workout, he and his colleagues recruited healthy volunteers ages 18 to 82 to try a daily five-minute technique using a resistance-breathing training device called PowerBreathe. The hand-held machine — one of several on the market — looks like an inhaler. When people breathe into it, the device provides resistance, making it harder to inhale.

How it works

“We found that doing 30 breaths per day for six weeks lowers systolic blood pressure by about 9 millimeters of mercury,” Craighead says. And those reductions are about what could be expected with conventional aerobic exercise, he says — such as walking, running or cycling.

A normal blood pressure reading is less than about 120/80 mmHg, according to the Centers for Disease Control and Prevention. These days, some health care professionals diagnose patients with high blood pressure if their average reading is consistently 130/80 mmHg or higher, the CDC notes.

The impact of a sustained 9 mmHg reduction in systolic blood pressure (the first number in the ratio) is significant, says Michael Joyner, a physician at the Mayo Clinic who studies how the nervous system regulates blood pressure. “That’s the type of reduction you see with a blood pressure drug,” Joyner says. Research has shown many common blood pressure medications lead to about a 9 mmHg reduction. The reductions are higher when people combine multiple medications, but a 10 mmHg reduction correlates with a 35% drop in the risk of stroke and a 25% drop in the risk of heart disease.

The training helps prevent high blood pressure too

“I think it’s promising,” Joyner says about the prospects of integrating strength training for the respiratory muscles into preventive care. It could be beneficial for people who are unable to do traditional aerobic exercise, he says, and the simplicity is appealing, too, given people can easily use the device at home.

“Taking a deep, resisted, breath offers a new and unconventional way to generate the benefits of exercise and physical activity,” Joyner concluded in an editorial that was published alongside a prior study in the Journal of the American Heart Association.

So, how exactly does breath training lower blood pressure? Craighead points to the role of endothelial cells, which line our blood vessels and promote the production of nitric oxide — a key compound that protects the heart. Nitric oxide helps widen our blood vessels, promoting good blood flow, which prevents the buildup of plaque in arteries. “What we found was that six weeks of IMST [inspiratory-muscle strength training] will increase endothelial function by about 45%,” Craighead explains.

Good for all ages, and could help athletes’ endurance

It has long been known that deep diaphragmatic breathing — often used during meditation or mindfulness practices — can help lower blood pressure too. Muscle training with the PowerBreathe device works in a similar way, engaging the breathing muscles and promoting the production of nitric oxide. The particular helpfulness of the IMST device, Craighead says, is that it requires less time to get the benefit because the small machine adds the resistance that gives the muscles a good workout. His research is funded by the National Institutes of Health.

The new study builds on the prior study and adds to the evidence that IMST — which is essentially strength training for the respiratory muscles — is beneficial for adults of all ages. “We were surprised to see how ubiquitously effective IMST is at lowering blood pressure,” Craighead says. Before the results came in, he’d suspected that young, healthy adults might not benefit as much. “But we saw robust effects,” he says, pointing to a significant decline in blood pressure for participants of all ages. He says the finding suggests IMST could help healthy young people prevent heart disease and the rise in blood pressure that tends to occur with aging.

There may also be benefits for elite cyclists, runners and other endurance athletes, he says, citing data that six weeks of IMST increased aerobic exercise tolerance by 12% in middle-aged and older adults.

“So we suspect that IMST consisting of only 30 breaths per day would be very helpful in endurance exercise events,” Craighead says. It’s a technique that athletes could add to their training regimens. Craighead, whose personal marathon best is 2 hours, 21 minutes, says he has incorporated IMST as part of his own training.

The technique is not intended to replace exercise, he cautions, or to replace medication for people whose blood pressure is so elevated that they’re at high risk of having a heart attack or stroke. Instead, Craighead says, “it would be a good additive intervention for people who are doing other healthy lifestyle approaches already.”

This is the way Theresa D. Hernandez, 61, sees the breathing exercises. She lives in Boulder, has a family history of high blood pressure and participated in the Colorado research. When the study began, she had blood pressure readings near the threshold at which doctors recommend medications.

“It was a surprise that something as simple could be so profound in terms of its impact,” says Hernandez of the six weeks of breathing exercises. “It took my blood pressure to under the threshold so that I would not need to take medication,” she says.

Her blood pressure dropped significantly, and she says she plans to stick with it — five minutes every day.

Analysis by Dr. Joseph Mercola
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Analysis by Dr. Joseph Mercola
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Analysis by Dr. Joseph Mercola
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