When you talk about a low carb diet plan, it involves a diet eating natural and unprocessed foot containing minimal carbohydrates. It’s been proven scientifically that a low carb diet plan helps with weight loss while optimizing health and lowering the risk of any disease.

Basically, the amount of foods you can eat, and the foods you should eat depend on things like how healthy you are, the amount of weight you want to lose and the amount of exercise you do. Based on this, you can follow these general guidelines for a low carb diet plan:

You can eat fruits, nuts, healthy oils, vegetables, fish, meat, eggs, seeds, high-fat dairy and perhaps some tubers and non-gluten grains. The foods you should not eat while on this diet are wheat, trans fats, HFCS, sugar, highly processed foods, seed oils and ‘diet’ and low-fat products.

So in a more clearly defined aspect, you need to avoid these 7 foods:

1. Sugar – foods like agave, candy, ice-cream, soft drinks, fruit juices and many others.
2. Trans fats – hydrogenated and partially hydrogenated oils.
3. Gluten grains – barley, rye, wheat and spelt, and includes breads and pastas.
4. Artificial sweeteners – sucralose, aspartame, cyclamates, saccharin and Acesulfame Potassium. Instead, it’s better if you use Stevia.
5. Diet and low-fat products – dairy products, crackers and cereals.
6. High Omega-6 seed and vegetable oils – soybean, sunflower, cottonseed, safflower, corn, grape seed and canola oils.
7. Highly processed foods – avoid eating food processed in factories. Moreover, it’s even better if you maintain a habit of reading all ingredients’ lists of foods, especially ‘health foods’.

Your diet should be based on these real and unprocessed low-carb foods. This includes eggs, where the omega-3 enriched or pastured eggs are the best, meat like lamb, pork, chicken, beef and others where the grass-fed varieties are the best, nuts and seeds like walnuts, almonds and sunflower seeds and vegetables like broccoli, carrots, spinach and cauliflower.

In addition to this, you should eat more of nuts and seeds, fish like salmon, haddock and trout where the wild caught fishes are a better choice, fruits like apples, pears, strawberries, blueberries and oranges, high-fat dairy like cheese, heavy cream, yogurt and butter and fats and oils like coconut oil, olive oil, cod-fish liver oil, butter and lard.

Though you are permitted to eat these foods, if you are on a diet to lose weight, you need to be careful about eating cheese and nuts as you can easily overeat them. Don’t eat more than a piece of fruit every day.<

You can however afford to eat a bit more carbs if you are an active and healthy person who needn’t lose weight. You can eat tubers like sweet potatoes and potatoes, legumes like pinto beans, lentils and black beans and non-gluten grains like quinoa, oats and rice. You can also eat dark chocolates with 70% cocoa or higher and dry wines with no added sugar or carbs in moderation, if you want.

Though permissible, both dark chocolate and alcohol will hinder your progress if too much is consumed. You can however drink coffee, tea, water and carbonated soda without any artificial sweeteners when on a low-carb diet plan.

Hello young ladies, hope all are doing great. Today I would like to discuss with you the diet plan of female wrestlers in India. As we all know how the amazing ‘Phogat sisters’ made India proud with their atypical interest in ‘wrestling’ a predominantly male sport. The famous saying, “Behind every independent and successful woman is a father who blindly trusts their children and not the society” rightly describes the dedication and undying faith of an enthusiastic father for his children.

Now let’s discuss the detailed diet plan with health benefits:

Diet Plan In detail

First thing in the morning is a glass of water on an empty stomach followed by some stretching and warm up exercises. Drinking water in the morning helps cleanse your bowel, detoxify your body and helps boost immunity. It increases appetite and raises the BMR (Basal Metabolic Rate) by 24% thereby aiding in weight loss and muscle tone.

Breakfast:

Sprout salad: The sprout salad can be easily prepared by a variety of sprouts available such as gram sprouts, moong bean, kidney beans, split peas etc. Sprouts are naturally nutritious wonder food, a rich source of Vitamin A, Vitamin K, Biotin, Iron and Zinc.

Including sprouts in your diet has varied health benefits like rejuvenating your skin, enhances collagen production, helps in detoxification process and prevents premature aging. So, go ahead and enjoy the mix and match of various sprout recipes to reap its benefits.

Fresh Fruits, Vegetables: Consuming fruits and vegetable rich diet provides your body with all the necessary nutrients vital for maintaining a healthy lifestyle. Fresh vegetables are naturally low in calories and rich in dietary fibre, Vitamin A and C, Folic acid and Potassium.

Intake of food rich in Potassium like Soybeans, spinach, Lentils and Kidney beans etc helps maintain normal blood pressure. Dietary Fibre from Most vegetables reduces blood cholesterol levels and helps in forming the roughage which aids digestion. Folic acid rich food like broccoli, avocado, lentils etc stimulates the formation of red blood cells. Vitamin C rich citrus fruits have wound healing properties.

Milk, Soybeans: Cow’s milk is considered the best diet for stronger bones and teeth as it offers a rich source of calcium and Vitamin D. It also has supplements like Potassium which helps in vaso-dilation thereby lowering your blood pressure. The most important dietary change a healthy person should opt for is reducing the intake of sodium and optimizing the intake of potassium. The optimal quantity of 4069 mg of Potassium per day reduces the risk of heart diseases by 50% approximately. Cow’s milk is also designed for muscle-building.

Whole Soy foods are an excellent source of fibre, Calcium, Vitamin B Complex and omega 3- fatty acids. It is the only complete non-animal protein as it is a plant source of eight of essential amino acids. These foods provide us with high quality protein and are very low in saturated fat making it a healthy and complete meal in itself. Whole soybeans are the best as they contain isoflavonoids, and a diet rich in isoflavone phytochemicals forms a base for a balanced diet.

Dry Fruits: Raisins are high energy food supplements for wrestlers. They are well-known for gaining weight in a healthy way. They are ideal food for maintaining an athletic body as they provide the wrestlers with powerful boosts of energy. The high content of Iron and copper in raisins helps in the formation of red blood cells.

Almonds are rich in unsaturated fatty acids and contain filling fiber which keeps you full for a longer time. They are best consumed as snacks in between meals to keep your hunger pangs at bay. These beloved nuts contain a unique and protective phyto-sterol antioxidants and a plant protein as well. When consumed along with raisins they complement each other.

Cheat days: Sometimes the wrestlers like to have breakfast of their choice like aaloo paratha with curd or other healthy variations. These cheat days are allowed to satisfy their cravings and follow the diet plan with utmost discipline.

So, this was all about the breakfast and snacks. Now let’s discuss the meals in detail.

Main Course Regular meals: Wrestlers are prompted to eat regular meals which constitute of ‘daal’ the nutritious and appetizing lentil preparation. These come under leguminous food, very rich in protein. It is advisable to include a mix of all dals in your diet without which a typical Indian meal is incomplete. White rice has some rich mineral content and can be consumed in moderate portion along with daal.

Various green leafy vegetables like spinach, broccoli, turnip etc are cooked by simple methods to retain their nutritional value, color and flavor of food. Some vegetables are preferred to be eaten in their raw form and mixed together to form various salad preparations.

Chicken is included in diet plan of wrestlers for its high protein content. Protein is made up of amino acids which are the building blocks of our muscles. 1 gram per kg of body weight is the recommended amount of daily protein. The best part of eating chicken regularly is its provides the wrestlers with high protein content for making their body more muscular and firm also keeping their body weight in control.

Indian whole wheat bread or Roti is consumed in dinner along with veggies, dal, chicken and salads for keeping fuller for longer time and still feeling active and light at the same time.

Mid Time Evening Snacks: A glass full of milk and seasonal fruits are good enough to keep your hunger pangs at bay. Almonds and raisins should be taken to give energy shots whenever required.

Pre Workout Diet: Milk and Seasonal fruits provide the wrestlers with the energy required for the rigorous workout sessions.

Post Workout Diet: A post work out meal of soy protein, fruits and lots of water is what required for replenishing the muscle glycogen depleted during workout. Fruits and water hydrates the dehydrated body tissues.

Last but not the least, a glass full of milk before bed time relaxes your tired muscles and makes you fall asleep like a baby. Milk contains Tryptophan (an amino acid which helps induce sleep) and melatonin (a hormone that regulates sleep cycle).

A wrestler’s diet is a versatile and balanced one devoid of high calorie and junk foods. Fresh and seasonal food is of much relevance. Wrestlers are advised to avoid food which is excessively sour and spiced like pickles, chutneys and chat as they are thought to cause lethargy and sensual arousal.

Hats off to the Dangal sisters for their taboo smashing move to become successful wrestlers and the unquenching thirst for achieving their goal. More power to you women, go ahead and catch your dreams.

Hey ladies, if you are in awe with the achievement of ‘Phogat sisters’, then lets take a look at the detailed diet plan of female wrestlers along with health benefits.

Vegetarianism and bodybuilding don’t mix, right? This may have been the consensus in the past, but today, an increasing number of people are choosing to become vegetarian, including bodybuilders, and athletes.

One of the first questions that people ask in regards to a body builder being vegetarian is:

“How do you get enough protein and calories in your diet to maintain your muscle mass?”

It’s no secret that eating a large amount of protein (more than 1 gram of protein per pound of bodyweight per day) is vital to a bodybuilder’s success. We also know that to eat such a high amount of protein, bodybuilders need to eat a diet that is high in meat.

So, how do vegetarian bodybuilders do it? How do they maintain their physiques? How do they keep up their energy levels?

Here are 12 tips that will help vegetarian bodybuilders in the gym and in the kitchen:

1) Make sure you are eating enough calories: Keep track of the amount of calories you are consuming. Since fruits and vegetables tend to have fewer calories than meat, you will need to increase how much you eat.
2) Eat quality calories: Limit your consumption of refined and processed foods.
3) Eat more chickpeas and legumes: This is one of the key sources of protein for vegetarians.
4) Consume lots of egg whites: Egg whites are a great source of protein. They are diverse, can be cooked on their own, used in shakes, baking, and many other ways to boost your protein consumption.
5) Eat quinoa instead of rice: Quinoa is similar to rice with the added benefit of having more protein.
6) Eat more nuts: This is a perfect snack to boost your energy and consume healthy fats.
7) Watch your activity level: With it being more difficult for you to meet your protein consumption goals, limit your workouts to ensure you are not burning muscle mass.
8) Invest in BCAAs: This will help you maintain your muscle mass and prevent loss.
9) Increase consumption of essential fatty acids: Increase supplementation with Omega-3s, flaxseed oil and other EFAs to keep up your energy levels.
10) Supplement with iron: Meat is a main source of iron, and many vegetarians lack iron in their diet. Consider adding an iron supplement to your diet.
11) Research protein-rich foods: Meat is not the only source of protein. There are many other good sources of protein you can add to your diet, including tofu, soy, oatmeal, seeds, edamame, spinach, broccoli, peanut butter, and more.
12) Supplement, supplement, and supplement: Find a good protein supplement and use it regularly to ensure you are meeting your protein needs.

Skin is the largest organ of the human body and functions to protect internal organs from severe damage, which may result from the external environment. As aging advances, skin goes through many changes that affect its overall health, appearance as well as the complexion.

It has been found that environment and lifestyle choices contribute majorly towards premature skin aging. This has led to the introduction of numerous methods of eliminating aging signs such as surgical procedure and makeups, which might cause adverse effects on our general health.

Besides, facial appearance matters a lot, especially when defining one’s hygiene hence it is essential to pay extra attention while attending to it.

Some of the best anti-aging tips for youthful skin include:

1. Eating Healthy Food Rich in Antioxidants

According to dermatologists, just as healthy diet does wonders for the entire body, fruits and veggies that are comprised of antioxidants such as vitamins B and E are mainly great for skin. They play a significant role in protecting the skin from free radicals in the environment, which causes severe damages to skin cells.

Further, this prevents breaking down of collagen and elastin thereby avoiding the formation of fine lines and wrinkles. Individuals who stick to this diet throughout usually attain a youthful, vibrant and healthier skin irrespective of their skin type and background.

2. Avoid Smoking and Drinking of Alcohol

Smoking is known to destroy collagen and elastin that keeps the skin firm and strong. It subjects the skin to sagging thereby contributing to premature skin aging. On the other hand, excess alcohol consumption accelerates inflammation in the bloodstream, which can boost sagging over time.

Therefore, individuals who refrain from smoking and alcohol consumption are in a better position for retaining a healthy and youthful skin throughout their lives.

3. Manage Your Stress

Stressful situations affect not only mental health but also general skin health. Research suggests that stress associated hormones have aging effects, which starts at a cellular level. Moreover, when an individual is psychologically distressed, there is a likelihood of a substantial detrimental impact on the wear and tear of the body that leads to increased biological aging. To prevent facial wrinkles, it is advisable to take steps to get de-stressed to avoid ruining skin health and the appearance.

4. Exfoliate the Right Way

Exfoliation methods depend mainly on the skin type. Therefore, it is essential to consult a dermatologist to be sure of the best way to maintain a healthy, firm and youthful skin.

Most of the exfoliators aim at sloughing off dead skin thus leaving a smoother and glowing complexion. Further, regular and correct use of the right exfoliation help to build a strong and firm skin that cannot collapse easily.

5. Drink Plenty of Water

Estrogen is the hormone responsible for inducing oil and collagen production in the skin. As the aging advances, it tends to decline thereby resulting in drier and saggy skin. People are encouraged to drink plenty of water to maximize moisture level in their skin. This will help to nourish skin cells, which results in supple, smooth and youthful skin. Also, you can add particular fruits, beverages as well as vegetables to your daily routine.

6. Wash the Face Before Bed

At the end of the day, the face collects dirt and impurities, which may clog pores thus altering the normal functioning of the skin. Skin usually regenerates during the night thereby leading to more youthful and healthy skin.

Dermatologists insist that it is also important to observe quality sleep since it helps to prevent the skin from becoming loose. Suitable ingredients should be applied after washing the face gently.

7. Embracing Sunscreen

Wearing sunscreen is considered the best anti-aging thing that can be done for the skin. Sun exposure causes discoloration that appears in the form of dark spots. Also, UV rays and free radicals usually cause damage to the skin and also speeds up the rate of aging. Therefore, incorporation of sunscreen can be helpful in maintaining youthful and healthy skin all through.

8. Consult a Dermatologist Regularly

Visiting a dermatologist frequently will ensure that you are up-to-date on the latest and suitable anti-aging skincare developments. Also, the dermatologist can recommend treatments for more desirable outcomes which results in youthful skin.

Further, one can gain knowledge on how to handle their skin once they identify their type. Always purpose to consult a dermatologist before taking any step since the skin is very sensitive.

9. Manage your Weight

Excess weight usually causes numerous health complications. It has been found to increase the levels of insulin and cortisol in the body, which later breaks down collagen leading to increased sagging of the skin.

In addition, gaining and losing weight has an adverse effect on skin elasticity, leaving behind undesirable stretch marks. Therefore, keeping the body fit will help to promote youthful and healthy skin.

10. Incorporate Healthy Fats in your Diet

Most fats, such as omega-3 fatty acids, enable the body to absorb essential vitamins that contribute to a super-healthy skin. They help by reducing inflammatory skin conditions thus leading to younger-looking skin and improved appearance. They are available at an affordable price and the user may consider consulting a medical professional before consumption.

Conclusion

Aging is inevitable, and it comes with various changes that interfere with the normal functioning of the body. It leads to the formation of aging signs although they can be addressed as soon as they appear. When the above tips are practiced regularly, it is possible to achieve healthy and youthful skin.

We go to great lengths taking care of our skin; by cleansing, toning and moisturising, then we spend lots of time applying expensive makeup, only to realise that unsightly facial hair is visible for everyone to see. Unwanted hair on the face is a common problem that affects lots of women, and there are a few things that cause this to happen. It could be hereditary or maybe because of your ethnic heritage, there are those who have excessive facial hair because of medical conditions or it could even be due to hormonal changes associated with the menopause.

Hair can appear on different areas of the face including;

• Lip
• Chin
• Jaw line
• Sideburns
• Eyebrows
• Cheeks

Facial hair that’s excessive, unsightly or unwanted is a cause for concern for lots of women which can lead to low self-esteem, and although it’s common, unwanted hair on the face can cause embarrassment to women and really affect their self-confidence. Removing the hair is the best solution, although you may find that waxing, threading and plucking hair can become irritating and painful, but if you’re not happy with these methods, then laser hair removal is worth considering as an alternative option, as it offers long-term results.

Remedies and treatments include;

• Using shaving, waxing, threading and plucking techniques which are time-consuming and temporary.
• Electrolysis permanently removes hair by using heat, but it’s an extremely slow and painful method and could leave behind some signs of scarring.
• Reducing the growth of unwanted facial hair using medicated creams can also be used, although side-effects such as skin rashes and irritation may occur when using this method.
• Another healthy remedy that can help to reduce unwanted hair is weight loss. There are some women who have noticed unnecessary facial hair growth when they are overweight, and losing excess weight could help with facial hair reduction.
• Long-lasting results can now be obtained with laser hair removal. This treatment is a better alternative, as small and large areas can easily be treated quickly and effectively, compared to other methods.

Taking away facial hair with laser treatment is a quick procedure that gives great results. The pigment in the hair follicle absorbs the laser energy and then this energy converts to heat, causing thermal damage to the follicle without causing any harm to the surrounding skin, and this stops the hair growing in the damaged follicle.

With laser treatment, there’s only minimal discomfort, usually just a minor stinging sensation to the skin upon application of the laser pulses, but topical anaesthetic cream can make any treatment more comfortable.

If you need help choosing a cosmetic procedure, we provide an extensive range of cosmetic procedures for the face and body: Botox, Vaser Lipo, Lip Augmentation, Dermal Fillers and many more treatments, to help create a younger, slimmer, more youthful looking you!

The Selston Cosmetic Clinic is located in Selston, Nottingham, where we offer a bespoke service with a personalised touch and deliver high client satisfaction. We have been involved in the cosmetic industry for over 10 years

DASH stands for Dietary Approach to Stop Hypertension. DASH diet has been clinically proven to reduce blood pressure within 2 weeks in individuals following the diet. It is not only known to help manage the blood pressure but is also designed for weight loss programs, helps to prevent heart diseases, stroke, diabetes and some forms of cancer.

Who should follow a DASH eating plan?
In fact, a DASH eating plan can be a part of any healthy eating plan. Not only, will it help lower blood pressure but it will offer additional heart health benefits including lowering LDL cholesterol and inflammation.

How does the DASH eating plan work?
The diet consists of foods that are low in sodium and consists of a variety of foods that are rich in nutrients like potassium, calcium and magnesium are known to help lower blood pressure. The diet is rich in fibre that again helps to lower blood pressure and knock off the extra pounds which will in-turn assist in lowering blood pressure.

What should you eat on a DASH eating plan?

• Grains like whole wheat, brown rice, barley, oats, quinoa are packed with nutrients like proteins, B vitamins and trace minerals, fibre and antioxidants which has been shown to reduce the risk of several diseases. However, processed grains lack most nutrients and should be avoided.
• Include fat-free or low-fat milk, yoghurt, Greek yoghurt, paneer in your diet instead of full-fat options. For those who are lactose intolerant, lactose-free milk and milk products are an option.
• Nuts like almonds, walnuts, pistachios, etc, beans, dals and seeds like the sunflower seeds, melon seeds, etc are a part of a healthy eating DASH diet. They are rich in dietary fibre protein, omega 3 fatty acids, vitamins and minerals like zinc and magnesium, etc. Although nuts contain the healthy fats, it would be wise to eat them in restricted amounts as they are high in calories. Also, avoid salted or honey roasted nuts for their high sodium and sugar content.
• Lean meat, egg, poultry and fish in moderation rather than meats with high saturated fat content. Processed meats such as bacon, ham, sausages, salami, etc contain a significant amount of sodium, hence restrict the intake. Occasional intake of red meat is permitted.
• Fruits and vegetables are naturally rich in potassium which plays an important role in lowering blood pressure. If you are one who is not fond of fruits and vegetables make the change gradually. Add an extra fruit or vegetable in the day in addition to what you are currently having a start. Prefer a whole fruit to juices. Unsweetened dried fruits like raisins, cranberries, dried figs, etc. are good travel choices. Make sure there is a vegetable at each meal.
• The diet should be low in saturated fats and total fats. A diet high in saturated fats increases the risk of heart disease and hypertension. Fats are important for the absorption of fat-soluble vitamins and help in building the body’s immune system. Use of oils like olive oil, rice bran oil, mustard oil should be promoted in each meal and trans fats which are commonly found in processed and fried food should be avoided.

To make this diet work even better here are some additional tips:-

• Reducing alcohol intake may help reduce blood pressure. Hence, keep the alcohol intake under check.
• Aerobic exercise along with DASH diet works faster in lowering blood pressure.
• Read food labels to choose products that are lower in sodium.
• Stress can raise blood pressure even if the diet is healthy. Hence, stress management techniques like meditation, yoga, etc will help keep the blood pressure under check.
• Poor sleep increases blood pressure. So, 7-8 hours of sound sleep will help in keeping the blood pressure in control.
• If you are someone who smokes, then quitting it would help lower blood pressure.
• Take your medication as prescribed.
• Limit the salt intake to 1 teaspoon a day.

Making a lifestyle change is an effort. It is a long-term commitment which one has to make for good health. Making smaller changes will bring in faster results than making dramatic changes all at once and losing the commitment along the way. Before getting on to the DASH diet consult a nutritionist who can help you in chalking out an individual program for yourself.

“He who has health has hope, and he who has hope has everything”.
(Thomas Carlyle)

Health is far better than wealth. Better health is considered essential for human happiness and well-being. Persons who are physically and mentally healthy also play a very vital role in the economic growth of their country as they are more productive and live longer.

Being healthy is considered a dynamic process as our health changes with the course of time. Every one of us has times when we feel fit and healthy and then we have times when we feel sick and unwell.

Diet plays an important role in personal health it can be described as a pattern of eating and balanced diet provides nutrients that are considered necessary to maintain our health. Studies have revealed that diet is one of the sources through which diseases such as cancer, coronary heart disease, birth defects and cataracts can be prevented.

There are many food items which are suggested by doctors and experts that are considered healthy and must be included in every meal. Some of these food items are green tea, oats, curd, olive oil, salad etc.

We can also lose weight by adjusting some of our diet plans and eating habits.

Mentioned below are some diet tips to lose weight while staying healthy:
Eat fresh and organic foods. Recent research and studies have revealed that pesticide, herbicides and other chemicals used on food and vegetables are one huge cause of obesity and weight gain.

Bite slowly and chew it. This tip is very helpful as your brain gets the message that you are eating more than you actually are. One should use smaller plates and bowls for eating as it also one way to fool your brain into believing that you have eaten more.

Water is a very important essential element of human’s body. One should drink at least 8-10 glass of water per day. During a glass of water 15 minutes before having your meal as it makes you feel fuller without eating any kind of food.

Do not drink sodas, Pepsi; cola etc. as they are full of chemicals and sugar. One bottle of Pepsi contains at least 20 tablespoons of sugar so there is no point in drinking any of these.

Other things that can help you to lose weight without losing your health are:
1- Eat your favorite meal once in every 15 days it will help you in starting afresh for your upcoming days and you will not feel deprived.
2- Include salads and vegetables in your every meal.
3- Exercise daily and consistently. If you exercise with gaps it will lead you to nowhere. Instead, you will feel frustrated.

Eating healthy is important however one should not overlook the exact meaning of the statement. Eating to stay healthy does not mean suppressing your appetite; it means to eat “smartly”. A proper and balanced diet plan can also help you to reduce your weight without losing your health.

Several significant forces in the last several years have been changing the way healthcare has and will continue to be delivered. The emergence of more unique ways to deliver care such as clinics incorporated into businesses and factories, the increased use of mid-level providers (nurse practitioners & physician assistants), the increase integration of technologies such as telemedicine and robotics and the shift from interventional reimbursement to outcomes reimbursement are just a few examples.

Compounding these are the ever-increasing costs of healthcare, the strain of funding Medicare on the U.S. economy, and the complications of insurance and healthcare payments under the affordable care act, ACA.

This has led to changes in how businesses intend to interface with the healthcare system going forward. CVS’s acquisition of Aetna will try to leverage healthcare delivery through their pharmacy structure. United Healthcare’s acquisition of DaVita hopes to leverage cost containment and resource control by directly controlling physicians. And the recently announced collaboration among Berkshire Hathaway, Amazon and J.P. Morgan Chase presents a yet unknown structure whose stated goals is improved quality and less cost. How they will implement their strategy is yet to emerge.

The decline in hospital admission over the last several decades has further led to restructuring by hospital corporations such as Tenet. Premise Health has emerged as a company placing physicians and other healthcare providers directly in corporate/business offices.

The big question then with these new ventures are how do organizations know what works financially and how do they track performance… In other words, how do you track, measure and value the relationships between cost and outcomes?

How can the analyst measure which methods(s) may generate better or best outcomes?

A simple return on investment, ROI, calculation will not provide needed nor valid insights. However, the use of cost-effectiveness analysis (CEA) would provide quite useful, valid and actionable information. CEA uses decision tree models to compare not only cost outcomes but effectiveness outcomes of various treatments on patient health and even on future healthcare usage based on various current actions. It can further be used to determine how effective a set amount of money spent on a particular treatment or method will impact outcomes (i.e. willingness to pay calculation). CEA models are flexible and can incorporate a wide variety of scenarios. As opposed to Big Data, CEA makes use of Broad Data so that comparisons of treatment modalities can be evaluated using real life outcomes. It can compare effects on a discrete problem such as a cancer tumor, or on chronic ongoing diseases such as COPD or CHF.

As the delivery of effective yet profitable, or at least cost effective, healthcare becomes more challenging, methods for evaluating treatments and programs become more necessary if not essential. Methods must be implemented to evaluate these new treatments and programs once they are in place so adjustments can be made. CEA enable organizations to both initially evaluate and subsequently monitor new methods and programs in a meaningful way.

If your objective is to provide the best decision-making for your organization and take a global view of your business, expanding your sights beyond ROI, and educating other decision-makers, Cost Effectiveness Analysis can make your organization more competitive and more profitable.

In the June 2016 issue of the Journal of Applied Psychology the authors Eduardo Salas, Lauren Benishek, Megan Gregory and Ashley Hughes in an article titled “Saving Lives: A Meta-Analysis of Team Training in Healthcare” set out to answer the question as to whether team training is effective in healthcare, whether it leads to reduced mortality and improved health outcomes.

Their research stated that a preventable medical error occurs in one in every three hospital admissions and results in 98,000 deaths per year, a figure corroborated in To Err is Human. Teamwork errors through failure in communications accounts for 68.3% of these errors. Thus, effective team training is necessary to reduce errors in hospitals and ambulatory sites.

The authors used a meta-analysis research method to determine whether there are effective training methods in the healthcare setting that can have a significant impact on medical errors, which would in turn improve outcomes and reduce costs by eliminating the costs associated with the errors. A meta-analysis is a broad research of existing literature to answer the research questions posed by the research team or authors.

The research team posed three questions to answer:

1. Is team training in healthcare effective?

2. Under what conditions is healthcare team training effective?

3. How does healthcare team training influence bottom-line organizational outcomes and patient outcomes?

The team limited its meta-analysis to healthcare teams even though there is a great deal of research available about the effectiveness of team training in other industries and service organizations. The team believes that healthcare teams differ significantly from teams in other areas in as much that there can be much greater team fluidity in healthcare. That is, team membership is not always static, especially at sites such as hospitals and outpatient surgical centers. There are more handoffs at these sites.

Although there is greater fluidity in team membership at healthcare sites, roles are well defined. For instance, a medical assistant’s role at a primary care site is well defined even though different MA’s may be working with one physician. These roles are further defined and limited by state licensure. As the research team stated in their article, “these features make healthcare team training a unique form of training that is likely to be developed and implemented differently than training in more traditional teams… “

The team assessed their research of articles using Kirkpatrick’s model of training effectiveness, a widely used framework to evaluate team training. It consists of four areas of evaluation:

1. Trainee reactions

2. Learning

3. Transfer

4. Results

Reaction is the extent to which the trainee finds the instruction useful or the extent to which he enjoys it. Learning is defined as a relatively permanent change in knowledge, skills and abilities. The authors note that team training is not a hard skill, as learning to draw blood. Rather, it is a soft knowledge skill. Some researchers question whether it is possible to measure the acquisition of these soft team skills effectively. The team of authors effectively argue that it can.

Transfer is the use of trained knowledge, skills and abilities at the work site. That is, can team training be effectively applied in the work setting? Results are the impacts of the training on patient health, the reduction of medical errors, the improved satisfaction of patients and a lowering of costs in providing care.

In order to assure that the changes in these four areas were ‘real’ the team only used literature that had both pre-assessments and post-assessments to see if there were statistically significant changes in the four areas.

Using this assessment rubric the team was able to answer the three questions that it posited. First, team training in healthcare is effective. Healthcare team training closely matches training in other industries and service organizations.

Secondly, training is effective, surprisingly, regardless of training design and implementation, trainee characteristics and characteristics of the work environment. The use of multiple learning strategies versus a single training strategy does not matter. Simulations of a work environment are not necessary. Training can occur in a standard classroom.

Training is effective for all staff members regardless of certification. Training of all clinical personnel as well as administrative staff is effective. Team training also is effective across all care settings.

Lastly, the team’s meta-analysis shows that within the Kirkpatrick rubric team training is effective in producing the organizational goals of better care at lower costs with higher patient satisfaction. In the rubric trainee reactions are not nearly as important as learning and transfer in producing results. It is important that trainers use both pre-training assessments and post-training assessments to measure whether there learning of skills, knowledge and abilities were learned and whether these were transferred to the work site. Effectiveness of training should always be assessed in order that training programs can be consistently improved.

In my September 2017 newsletter “Team Meetings” I described the elements of good team training as well as provided a link to the American Medical Associations team training module as part of Stepsforward series of learning modules. You can find this newsletter online here. With these training instructions as a beginning healthcare providers can learn to work more effectively as teams and thus produce better care at a lower cost with higher satisfaction of both patients and providers.

In my thirty-some years in practice, I’ve treated people from all walks of life, for a laundry list of symptoms. While most conditions have several causes, the singular most common cause I’ve seen is stress. One common example is migraines, which can be caused by food sensitivities, hormonal imbalances, cranial structural misalignments, and relationship discord, to name a few – yet, invariably stress is part of the clinical picture.

The pervasive effects of stress are our minds, bodies and spirits is nothing new. In the 1920s, Hungarian endocrinologist Hans Selye described what he called “General Adaptation Syndrome,” or the body’s response to demands placed upon it. He detailed how stress induces hormonal autonomic responses which, over time, can lead to high blood pressure, arteriosclerosis, arthritis, kidney disease, and allergic reactions. At the time, the notion that there is a connection between stress and physical disease was groundbreaking, and controversial.

From the earliest days of my career, I saw evidence of this connection. In those days, I only treated back pain, neck pain, and headaches, and when I gave a patient a full spinal adjustment and applied some physical therapy modality, I helped release their stress and initiated physical relief.

Since that time, stress has increased exponentially. But why? Back in the 1980s, people had financial stress, just as they do now. People suffered from relationship stress since the beginning of time. After 9/11, however, I noticed a dramatic uptick in stress that has only seemed to get more intense and deeper as time passed. And, as I became a better practitioner, I also began to attract harder cases, meaning those with more complex symptoms and disorders. I learned how to do emotional adjustments to counter the underlying triggers that keeps the stress stuck and the body holding onto it. Then I discovered how to turn off chronic stress. People who have prolonged stress get to the point where the cortisol from their adrenals is elevated not only in “fight or flight” situations, but continuously – meaning it never rests. This causes weight gain, lousy sleep, anxiety, and chronic restlessness. It also contributes to all the disorders I see, such as depression, diabetes, autoimmune disease, fatigue, fibromyalgia, Irritable Bowel Syndrome (IBS), chronic pain, acid reflux, and vertigo, to mention a few.

Again this reaction to stress is not new, so why are people getting these ailments with increasing regularity? What has really changed is the pace of society and attitudinal polarization. When we were kids, we would hear periodically about some tragedy in our city or town. Now we are spoon fed global misery and tragedies on a minute-by-minute basis via the twenty-four-hour news cycle and social media. I could go on and on, but you already know this. Angst has become a staple in the American diet, and nearly every person today suffers from some degree of stress and anxiety. The commercial, I will listen, states one in four Americans are experiencing mental health challenges!

According to a 2012 nationwide study, one in 20 teens suffers from anxiety or depression. One in three of our children have illness such as ADHD, asthma and allergies. One in sixty has autism; this is up from one in 10,000 in the 1960s. America’s kids have fifty vaccines by the age of six, so why are they so sick? One likely reason is that they are internalizing the negative energy of a world they have little control over. Their illnesses, in turn, affect their parents’ mental and physical health.

Prescriptions for medications that suppress symptoms (but do not touch the underlying cause(s) of them) have exponentially and dramatically increased, and opioids have become an epidemic, killing more people than our current wars. It is not just America, either; a recent study from Ontario shows that in 2015, one in every six deaths of people aged twenty-five to thirty-four was opioid-related.

We claim to understand that chronic stress is harmful and must be reduced, yet we still tend to underestimate its effects on us. We may take a yoga class here and there or try some other relaxation technique, but at the end of the day we still accept anxiety as a part of life. We look at brain scans, MRIs, and blood tests to find a tumor or other pathology, yet oftentimes we overlook the chronic stress that just might be the cause of the unexplained symptoms. The medical tests can show changes in the brain and in the heart, but we’re not seeing the source of those changes.

DNA doesn’t really change, but epigenetics – the study of the effect environmental and other factors have on our genes – can explain why we manifest illness. For instance, children of holocaust survivors may get cancer even though there is no cancer in the family tree. The stress and trauma of being in a concentration camp prior to the children’s birth altered the parents’ DNA and “turns on” the cancer gene. Another factor is the food we eat, which over time has become more artificial and processed with sugar in everything, plus more genetically modified food with more pesticides, herbicides, and insecticides on and in it. Such chemicals can turn on symptoms such as gastrointestinal distress; Several factors can lead to epigenetic stress that is pass down to future generations.

The good news is that just as these genes could be turned on, they can be turned back off. In this situation, I combine two techniques – EMDR (eye movement desensitization and reprocessing) and NAET (Nambudripad’s allergy elimination technique)

First I muscle test a patient’s strong arm response to stress. If it weakens, I put stress vials (cortisol) in their hands and do a slow motion EMDR maneuver, which takes two minutes. Often I’ll see the patient’s eyes quiver, which indicates stress is affecting their nervous system and thought processes. Then I retest the patient’s strength to make sure there is no weakness in the muscles due to stress. It usually takes twenty-four hours for the patient to completely process the treatment and for the nervous system to integrate the treatment. As a result the patient will start to be more relaxed in everyday situations and the myriad of symptoms healing is initiated. Stress may not cause the approximately 7000 known rare diseases, but having a rare disease is stressful. Having any disease causes stress, therefore addressing stress without medicating it – is beneficial. That said, there are natural remedies that can help (i.e. science has shown dark chocolate (70% cacao) reduces stress and inflammation).

Our changing world necessitated my going deeper to figure out why some folks don’t respond to treatments. In the process I discovered that this isn’t a mental thing, but at the core of our humanity, the soul. I believe the soul is sacred and for a long time avoided confronting any therapeutic intervention. But now it has evolved naturally, and I utilize a gentle approach to release stress that is affecting a patient’s soul. Patients seem to be responding well, and the only side-effects being decreased anxiety, improve relaxation, and a feeling of joy. You can’t ask for a better and gentler procedure than that!