Calcium Sensor: Exciting Technology for Disease Detection

Key processes in the body are controlled by the concentration of calcium in and around cells. A team from the Technical University of Munich (TUM) and the Helmholtz Zentrum München have developed the first sensor molecule that is able to visualize calcium in living animals with the help of a radiation-free imaging technique known as optoacoustics. The method does not require the cells to be genetically modified and involves no radiation exposure.

Calcium waves -- a new sensor converts light to sound to visualize calcium fluxes in the body.Credit: B. van Rossum, G. Westmeyer / Technical University of Munich

Calcium is an important messenger in the body. In nerve cells, for example, calcium ions determine whether signals are relayed to other nerve cells. And whether a muscle contracts or relaxes depends on the concentration of calcium in the muscle cells. This is also true of the most vital muscle in our body -- the heart.

"Because calcium plays such an important role in essential organs such as the heart and brain, it would be interesting to be able to observe how calcium concentrations change deep within living tissues and in this way to improve our understanding of disease processes. Our sensor molecule is a small first step in this direction," says Gil Gregor Westmeyer, head of the study and Professor of Molecular Imaging at TUM and Research Group Leader at Helmholtz Zentrum München. In the study, which was published in in the Journal of the American Chemical Society, Professor Thorsten Bach of the TUM's Department of Chemistry was also involved. The researchers have already tested their molecule in the heart tissue and brains of living zebra fish larvae.

Calcium measurements also possible in deep tissue

The sensor can be measured using a relatively new, non-invasive imaging method known as optoacoustics, which makes it suitable for use in living animals -- and later possibly also in humans. The method is based on ultrasound technology, which is harmless for humans and uses no radiation. Laser pulses heat up the photoabsorbing sensor molecule in tissue. This causes the molecule to expand briefly, resulting in the generation of ultrasound signals. The signals are then sensed by ultrasound detectors and are translated into three-dimensional images.

As light passes through tissue, it is scattered. For this reason, images under a light microscope become blurred at depths of less than a millimeter. This highlights another advantage of optoacoustics: ultrasound undergoes very little scattering, producing sharp images even at depths of several centimeters. This is particularly useful for examining the brain, because existing methods only penetrate a few millimeters below the brain surface. But the brain has such a complex three-dimensional structure with various functional areas that the surface only makes up a small part of it. The researchers therefore aim to use the new sensor to measure calcium changes deep inside living tissue. They have already achieved results in the brains of zebrafish larvae.

Nontoxic and radiation-free

Additionally, the scientists have designed the sensor molecule so that it is easily taken up by living cells. Moreover, it is harmless to tissues and works based on a color change: as soon as the sensor binds to calcium, its color changes which in turn changes the light-induced optoacoustic signal.

Many imaging methods for visualizing calcium changes that are currently available require genetically modified cells. They are programmed, for example, to fluoresce whenever the calcium concentration in the cell changes. The problem with this, of course, is that it is not possible to carry out such genetic interventions in humans.

The new sensor overcomes this limitation, the scientists say. In the future, the researchers plan to refine the properties of the molecule further, allowing the sensor signals to be measured in even deeper tissue layers. To this end, the team headed by Gil Gregor Westmeyer must generate further variants of the molecule that absorb light of a longer wavelength than cannot be perceived by the human eye.

Story Source:

Materials provided by Technical University of Munich (TUM)

Journal Reference:

  1. Sheryl Roberts, Markus Seeger, Yuanyuan Jiang, Anurag Mishra, Felix Sigmund, Anja Stelzl, Antonella Lauri, Panagiotis Symvoulidis, Hannes Rolbieski, Matthias Preller, X. Luís Deán-Ben, Daniel Razansky, Tanja Orschmann, Sabrina C. Desbordes, Paul Vetschera, Thorsten Bach, Vasilis Ntziachristos, Gil G. Westmeyer. Calcium Sensor for Photoacoustic ImagingJournal of the American Chemical Society, 2017; DOI: 10.1021/jacs.7b03064

Technical University of Munich (TUM). "Visible signals from brain and heart: Imaging: New sensor visualizes calcium in living animals." ScienceDaily. ScienceDaily, 30 November 2017. <www.sciencedaily.com/releases/2017/11/171130112358.htm>.

45 Sleep Tips That Will Make You Fall Asleep In 7 Minutes Or Less

Do you struggle to get to sleep at night? Or do you find yourself dropping off around midnight only to be wide awake at 2 or 3am? If this sounds all too familiar to you then you could be searching for tips to help you sleep better.

Even if you usually sleep well, if you are a first time parent you might be struggling to get your baby to sleep through and need some tips for helping baby sleep through the night. As someone who can’t function without a solid 7-8 hours of sleep every night, a new baby completely changes your life and finding a way to get them to sleep through feels like the holy grail!

Lack of sleep can totally change your life and you could find yourself losing concentration at work, becoming short tempered and picking up every cough and cold that is going around the office. There’s a reason sleep disturbance was used as torture!

We’ve put together a list of tips to improve sleep – everything from getting your bedroom’s temperature right to little tricks to help you stay asleep until morning. So if you’re struggling with insomnia or struggling to get into a pattern while working night shifts, read on for some helpful advice and tips to sleep better.

 

#1 Get in a Routine

One of the simplest things you can do is make sure you have a set routine before bed. This doesn’t have to be complicated or long winded, just a set few things you do before switching off and laying down for the night. You could turn the TV off, go into the kitchen and finish up the dishes or any little chores in there then have a wash, brush your teeth and get into your pyjamas.

Even these few simple steps can trick your mind into feeling sleepy and if you repeat this pattern your body will get used to the signs it is ready for sleep. You can add in steps that suit you such as reading a few pages of a book or drinking a hot drink but generally doing these things in the same order night after night will eventually get your body into a routine and help you drop into a deep sleep.

If you really think about it, having a bedtime routine is something we learn when we are babies. There are plenty of newborn sleep tips out there but having a routine before bedtime is definitely the number one thing that helps them get to sleep quickly.

 

There are plenty of newborn sleep tips out there but having a routine before bedtime is definitely the number one thing that helps them get to sleep quickly. There’s a great YouTube video of a routine that you can use for your little one. You can pick up the signs your child is sleepy by watching them closely, if they start rubbing their eyes or their eyes look “glassy” then it is a sure sign bedtime is getting close!

 

#2 Avoid Drinking Alcohol Before Bed

 

Alcohol might help you drop off to sleep, but drinking alcohol before bed actually reduces your quality of sleep and can make you feel even more tired when you wake up. Have you ever noticed how you think you’ve slept soundly after a couple of glasses of wine but when you wake up in the morning it feels like you’ve hardly slept at all?

That is the stimulant in the alcohol that is keeping you in the wrong stage of sleep. It reduces the REM (rapid eye movement) sleep and studies have shown alpha brain wave patterns increase which is the brain pattern used when the brain is awake but resting.

So while you think you’re sleeping, your brain hasn’t actually “switched off” due to the alcohol. You might also wake in the middle of the night and feel wide awake.

This is due to the interference with your brain’s usual patterns and could cause insomnia. The odd drink before bed is fine, but if you’re finding yourself drinking night after night then you could be building up weeks of bad sleeping habits which will leave you feeling drained.

 

#3 Set an Alarm to Remind You to Sleep

 

This sounds weird, as usually we’re setting alarms to wake us up, but bear with me! Setting an alarmto remind you to sleep can actually mean you sleep better, and longer. We can all get caught up in the day and find ourselves lost in a good book or engrossed in a movie. This can lead to the time just slipping away from you and before you know it it’s 1am in the morning and you’ve missed your whole sleep routine and only have a few hours left to get some shut eye!

Set an alarm for around 30 minutes before bedtime to give yourself time to go through your sleep routine. You can even list your routine in order if you’re a bit forgetful (like me!). How many times have we looked at the clock and been shocked at the time? This will keep you on track to get your 8 hours and help you feel more refreshed in the morning.

 

#4 Keep Your Bedroom Dark

The Effects of Light to Sleep

Light can really affect how easily we fall to sleep and how deeply we actually sleep through the night. As you’ll know if you’ve ever stayed in a hotel in the middle of a city and there’s streetlights and light pollution streaming in through the window, it can really affect the quality of your sleep overall.

Making your bedroom dark is scientifically proven to help you get to sleep fast and stay asleep. It is all to do with your body’s circadian rhythm and how your body produces hormones and chemicals in reaction to light and dark. This rhythm literally controls your body’s sleep/wake cycle. Not just in humans but everything on the planet including plants and even fungi!

Artificial lights can trick your body into thinking it is daytime and keeps you awake. Although your bedside light isn’t as powerful as the sun, even that little bit of light can be enough to cause disruptions in your body’s natural rhythm. The answer is simple. Invest in a decent blackout blind or thick curtains and block out all that light pollution from outside.

Unless you are very lucky and live out in the wilds with no neighbours or street lights, you will deal with some form of light pollution. Try to keep lights in the rest of the house to a minimum – perhaps using a very dim light in the bathroom and turning everything else off.

For babies and infants though, a low level of light can help to soothe them back to sleep if they wake. A night light can help them feel safe and relaxed when they wake instead of being in complete darkness. There’s also the added bonus of being able to see where you are going when you have to go into them in the middle of the night.

 

#5  Make Your Bed Cozy and Comfortable

 

We should all be changing our sheets at least every two weeks – but honestly how many of us do? It isn’t as if we keep an internal calendar for these things, and often you can’t remember when you last had a bit of a spring clean. You should wash your bedding on a low setting and add a fabric softener for that just washed soft feeling.

Ideally, you should air dry your sheets outside but in the winter just use the tumble drier on a cool setting. Make sure your sheets are completely dry before you remake your bed, there’s nothing cozy about a damp bed!

So if you’re finding your bed isn’t sending you off to sleep, try washing and changing your sheets. Even the psychological benefit of sleeping in fresh sheets can help you have a better night’s sleep.

 

#6 Drink Something to Help You Sleep Better

 

Sometimes we really need something comforting before bed to help us drop off to sleep. Warm milk has been proven to boost sleep as it is rich in an amino acid called tryptophan. This is a sleep-inducing chemical which can help you get a better night’s rest. It can also have a psychological effect as many of us will be transported back to being a baby again and given a bottle of milk before bedtime. There are some great recipes out there to help you find a tasty and comforting bedtime drink.

If milk isn’t your thing, you can always add something to it and make a cocoa or even mix in some honey which also has soporific qualities as well as a range of other health benefits. And the great thing is they are suitable for dairy free diets as well; just use a soy, rice or almond milk instead of dairy. The added benefit with almond milk is that it has the same sleep inducing qualities as regular milk.

Herbal teas are also great for relaxing and dropping off to sleep. Chamomile is the most commonly used sleep aid as it boosts sleep, eases insomnia and even helps medical problems like menstrual cramps. This fragrant flower can be drunk on its own in a cup of hot water or mixed with other sleep inducing herbs like lavendervalerian or passion flower.

Not only does it taste great, but it eases anxiety and helps you calm your thoughts before bedtime. There is also a really old nighttime sleep remedy which is tart cherry juice. Although it sounds like a strange thing to drink, people swear by it for helping children and infants drop off to sleep. Other tried and tested remedies include banana smoothies, coconut water or a specially-blended bedtime tea.

 

#7 Drop into a Deep Sleep with a Sleep Mask

 

Night shift workers are some of the hardest hit by insomnia and bad sleeping patterns. So badly, that it has its own name – Shift Work Disorder. It stands to reason really, trying to sleep when the rest of the world is awake will set your body clock off on the wrong path.

But for some people in the emergency services or other demanding lines of work, night shifts are unavoidable. For these people it is even more important they are alert and on top of their game through the day or night so getting a proper night’s sleep is more important than ever. When I worked night shifts, I found a simple, free tip that worked miracles.

A sleep mask. Just one of those free eye masks you’re given on a long haul flight really changed my life. By blocking out all of the light, you can get to sleep much easier as your brain is tricked into thinking it is night time. By sleeping at the “right” time (or so your brain thinks) you get a deeper, better quality sleep and wake up feeling much more refreshed. There are lots of tips out there to help you sleep better on night shift but getting a good sleep mask is a great start. And even if you don’t work nights, this can work for you too – especially if you are sensitive to light.

 

 

#8 Make Your Bedroom an Electrical-Free Zone

We all know we should be cutting down on screen time through the day, but did you know it could be causing you to have a bad night’s sleep? Two thirds of adults take their smartphones to bed and the little blue light coming from your phone or tablet could be causing your sleep to deteriorate. Research shows this light actually suppresses melatonin – the chemical we need for sleep.

 

So instead of relaxing while you’re laying in bed scrolling through Facebook, you are actually waking yourself up. Watching videos, reading the news and just chatting with your friends on social media all stimulates your brain. So at the time you’re supposed to be winding down your brain is actually working as hard as it does through the day. And receiving a stressful email from your boss could keep you awake and tossing and turning all night. Switch off at least an hour before bed and you will start to notice the effects that technology has on sleep.

And definitely keep it on silent overnight. Using your bed as an extension of your office doesn’t make it seem like a place you want to go to sleep. If you associate your bed with work, is it any wonder you’ll find it hard to sleep?

 

#9 Cut Out the Caffeine

 

Coffee is great and, I don’t know about you, but I don’t think I’d get through the morning without it. However, drinking a cup of coffee too late in the day can keep you awake all night or leave you with disturbed sleep. Surprisingly, a study showed that even drinking caffeine 6 hours before bedtimereduced sleep.

It affects older people more as it takes them longer to get rid of the caffeine in their systems. Effects of caffeine can last for as long as 14 hours so if you’re finding it hard to sleep the try cutting it out altogether and see what happens to your sleep patterns. Three eight ounce cups of coffee is the “normal” amount but if you’re consuming this or fewer then it might be worth getting rid of the coffee altogether.

 

#10 Exercise During the Day

 

Did you know exercising near bedtime can actually wake you up, instead of tiring you out and making you sleep? Studies show that people who are active within two hours of their bedtime can suffer insomnia. This is because your body is releasing adrenaline and cortisol from the workout which acts as a mechanism to keep you awake.

While many people find exercise actually helps them sleep deeper, being at the gym a couple of hours before you want to go to sleep has the opposite effect. Post workout insomnia is real, so if you can squeeze your gym session in before going to work in the morning, or even grab a 30 minute session during your lunch hour, you will find your sleep will be greatly improved.

 

#11 Avoid Big Meals Late in the Day

 

Have you ever lain awake at night after a big meal feeling a little big sick and wishing you’d only had one helping of pie? Well eating late in the day can cause more than heartburn and an uncomfortable feeling – it could actually be keeping you awake!

Eating late at night, or through the night if you’re working on a night shift, can cause your body clock to change and even lead to weight gain. You may find you have a nasty acid reflux feeling when you lay down and if you’re suffering with that when it comes to bedtime it could be a sign you need to eat earlier in the evening. While your body is programmed to eat a large meal before rest, make sure you eat at least two hours before lying down to sleep so your body has time to digest.

 

#12 Transform Your Bedroom Decor

 

Is your bedroom needing an update? Some people paint their bedrooms garish colours or install fairy lights and other accessories which may look great but could be harming your sleep. A good bedroom design for sleep should be restful and peaceful. Make sure your bed is against a solid wall – not up against a window or door where drafts may get in.

Clear away piles of clothes, cluttered work surfaces and anything else which might add to a chaotic and overwhelming room. Your tabletops should be clear and the floor space around your bed should be easy to walk around. Good colours for bedrooms are pale and muted with a comforting vibe. Go for warm colours and neutrals to make your bedroom feel cozy and inviting. Think about finishing touches that bring you happiness and peace, a framed picture of your family or an image you took on a fantastic holiday will also help you feel calm and comforted when you are trying to get to sleep.

 

#13 Keep Your Bed for Sleep

In this constantly demanding world, it can be hard to reserve a space specifically for sleeping but if you can do it then it will improve the length and overall quality of your sleep.

It can be tempting to use your bedroom for many things (watching TV, entertaining your little ones and even eating!) but keeping one room reserved just for sleep can actually help you get better rest. If you can associate that room with peace and tranquility instead of answering emails or watching TV, then your body will automatically start to shut off when you go in and close the door.

 

#14 Is Your Room the Right Temperature?

Too hot? Too cold? Or, just right? It’s not just Goldilocks that struggled to find the right sleeping environment, many of us don’t realise how much temperature affects the quality of our sleep. A temperature of between 60 and 65 degrees Fahrenheit has been proven to aid sleep and many of us don’t have this set correctly.

If you go to check your thermostat right now, most of us would see it us set a few degrees higher than this and means it is not at the right level for sleep. If you do feel the cold, try to turn down your thermostat just before going to bed, say about 30 minutes before you would usually turn in, and then the temperature will cool down as you are winding down. If you’re too hot, stick your feet out of the covers as your body naturally uses your hands and feet to reduce heat. Too cold? Then putting on socks can help you feel cozy and warm.

 

#15 White Noise and Background Noise

This is a really helpful tip to help babies get to sleep. White noise can help to drown out other sudden noises or sounds that happen in the night and could disturb you. It does seem crazy to start making a noise on purpose when you’re trying to sleep but this method really works for some people.

If you are listening to white noise, it is just better noise than traffic, car horns or talking. Your hearing still works while you are sleeping which is why you get woken up by a banging door or a noisy car alarm. By using white noise, you are tuning your hearing into a consistent sound which means your brain is likely to ignore the other infrequent noises which it will consider “background” noise.

There are loads of great YouTube videos out there which play white noise for up to ten hours! So if you’re struggling to sleep, why not switch it on and give it a try?

 

#16 Ban Your Pets

We all love our dogs, cats and any other furry (or not so furry) pets in our home but when it comes to bedtime they really need to be banned. While they might be a lovely, cute ball of fluff to cuddle up to it could be leading to a disrupted night’s sleep. If you’ve ever watched your dog sleep, for example, you’ll see they take several naps throughout the day rather than the human way of sleeping all at once overnight.

This means in the night they may get up and down, head to the kitchen for a drink or a bite to eat and even bark at unusual sounds. Many dog trainers advocate keeping dogs off the bed as it helps them understand the pack hierarchy and know their place within the family.

As an aside, dogs can also bring in allergens on their fur such as pollen and other allergy-causing substances which could lead to breathing problems. Lastly, a big plus point is the avoidance of a slobbery wake up in the early hours of the morning when your pet thinks it’s time for breakfast!

 

#17 Does Your Mattress Need Replacing?

 

We spend a third of our lives asleep and yet so many people skimp on mattresses and don’t see it as an important investment. If you compare it to the other places you may spend a lot of time, like your car, you see how much your mattress is overlooked. But a lumpy, old mattress could be making you wake up through the night or toss and turn as you try to get comfortable.

Even if you don’t wake fully, the lack of proper, deep sleep can make you feel groggy and tired the next morning. You may also find your mattress has become full of dust or allergens which can make it difficult to breathe properly or lead to sleep apnea. 20 million Americans are allergic to dust mites so if you’re not sleeping well then it might be time to clean or replace your mattress.

 

#18 Keep Napping to a Minimum

 

I know, I know, most people don’t have time for an afternoon nap but I’m sure at some point in your life you’ve found yourself getting 40 winks on a Sunday afternoon. For most people who nap regularly, it doesn’t affect their sleep at all as they’ve got into a routine over years. But for irregular nappers or people who try to “catch up” at weekends, this style of sleeping can cause more problems than you think. There is a really handy list of dos and don’ts which covers the best way to nap.

In short, keep them short (around 10 to 30 minutes maximum), take naps between 2pm and 3pm in the afternoon as it is less likely to interfere with your evening sleep and create a restful environment so the sleep you do get is good quality and will allow you to wake up feeling alert and refreshed.

 

#19 Try More Sheets or Blankets

Sure, these sheets might cost a little extra but as we mentioned above you’re going to be spending a lot of time asleep so you may as well invest a little. If you tend to get too hot when you’re sleeping, invest in a cooling material like Egyptian cotton or even buy some moisture wicking sheets to keep your sweat free.

As much as people don’t think about the mattress they are sleeping on, the type of blankets, duvet or sheets you use also doesn’t seem to be as important. But making sure you’ve got the right bedding can really help you get a proper night’s sleep. Invest in good quality bedding and sheets which feel soft and luxurious.

Always wash your new sheets before they go on your bed and do it thoroughly to remove any irritants or bits that may have gotten onto them during the manufacturing process. You should also check your detergent. If your bed linens are good quality but you’re getting itchy or irritated, it could be your washing powder. Switch it up or use a hypoallergenic version to see if that makes a difference to your sleep.

 

#20 Keep the Same Bedtime – Even on Weekends

 

Yes we all love to go out on a Friday and forget about the time, but if you’re battling insomnia then the worst thing to do is get out of a regular routine. This is particularly important for children as their sleep patterns aren’t as well adjusted as most adults.

One of the top mistakes most parents make is getting a child into a regular bedtime during the week (say 7pm in bed Monday to Friday) but then come the weekend it goes out of the window and they’re allowed up hours later on Friday and Saturday. Is it any wonder then that come Sunday night they’re wide awake at bedtime? Keeping the same bedtime at the weekend may feel mean if the rest of the family is staying awake but in the long run it will benefit your little ones.

 

#21 Write Down a “to do” List

 

Do you find yourself laying in bed with all the jobs for tomorrow swirling around your head? It can be difficult to switch off when your brain is trying to remember a million jobs and tasks that you have to do the next day. Get into the habit of keeping a pen and paper next to the bed and use it to write down anything you have to do tomorrow.

That way, your brain knows that everything you have to remember is safely contained in the notepad and it can stop trying to remind you constantly. This is one of the tricks used by some of the most successful people in the world as not only does it aid sleep but it also helps you to be more productive and complete more tasks.

 

#22 Keep a Journal

 

Many of us can lay awake thinking about what has happened that day. Maybe a meeting didn’t go as you’d planned or something upset you. By writing them down in a journal and coming up with a solution for these issues (even if it is just I will deal with it tomorrow) can help you consciously clear your mind and get ready for sleep.

 

#23 Meditation

 

Mindfulness and meditation can really help to tackle sleep problems. Clearing your mind is the key to getting a good night’s sleep and this works particularly well if you are feeling anxious. Meditation is also particularly helpful during pregnancy when many mums to be feel worried or unsure.

This not only helps to calm mum down but it can also be beneficial to the baby as they respond well to a calmer environment. Meditation can be done anywhere but if you are specifically trying to get to sleep, make sure the room is peaceful and you may want to play some soothing music to help you.

Not sure how to meditate or where to start? There’s some great guided meditation videos that can help you to learn how to meditate and relax before bed.

 

#24 Relax in a Warm Bath

Taking a bath has been scientifically proven to help you sleep better. When you are in a warm bath, your skin temperature increases. But as you get out and get into bed, the rapid cooling of your skin as it hits the outside air tricks your body into thinking it is bedtime. The body naturally wants to cool down before sleep so by faking this by taking a hot bath you are increasing the likelihood that you will be able to fall asleep quickly and stay asleep.

Think about taking a bath around an hour before you want to go to bed. Aromatherapy oils or scented bath products that include lavender or verbena can also release chemicals that aid sleep.

 

#25 Scatter Some Aromatherapy Scents in Your Bedroom

 

There are many calming scents you can use to make your bedroom a cozy haven for sleep. Lavender is the most commonly used aromatherapy oil and one of many natural sleep tips to boost sleep but you can also use sandalwood, marjoram and many other oils to help you feel sleepy and rested. As well as using oil burners to spread the scent in your room, you can also apply them to your pulse points and also sprinkle a few drops on your pillow. This works particularly well in infants and children.

Visit https://www.gotoilsupplies.com/blog/12-essential-oils-sleep/ for some ideas on which essential oils to use.

 

#26 Walk Around and Do Something Calming

This sounds wrong but if you’re laying in bed stressing about sleep – get up! If you know you’re unlikely to drop off after waking up in the middle of the night then moving from your bed into a chair to read or relax somewhere for a while will help you to dissociate your bed from a stressful night of tossing and turning. It means you can take 10 or 15 minutes away from your bed and then return to try again for sleep.

Resist the temptation to switch on the TV or pick up your phone though, the light from these devices can actually make you feel more awake and stop you from getting back to sleep. Try to keep the lights low and read a book, listen to music or just have a glass of water. By removing yourself from the bed for a little while you can go back in without laying there getting too wound up about your inability to sleep.

 

#27 Prep the Night Before

 

This will not only help you sleep but having a preparation checklist to complete before sleep can totally change your life. Lay out tomorrow’s clothes, including shoes, jewellery and any accessories so it is all in the same place and easy to grab and get dressed. Prep your breakfast, lunch and think about defrosting something for dinner if you need to. Pack a bag of gym clothes, get everything you need for the next day in one bag in one place and then set your alarms. You’re good to go!

 

#28 Don’t Watch the Clock

 

We have all done it – try to calculate how many hours of rest you can get if you fall asleep right now! Instead of focusing on the time, you need to do some other tips on this list like meditating or completing your checklist. Staring at the clock will only leave you feeling anxious, which is the opposite feeling you need when trying to drift off into a good night’s sleep. If you use a clock as an alarm, simply try to have it face the wall so you are not tempted to peek at it all night long.

 

#29 Wear Socks to Bed

 

While some of you probably hate the concept of keeping your socks on through the night, this sleep tip might do the trick. If you want to fall asleep faster then you should keep your hands and feet a tad bit warmer. After all, have you realized that as soon as you climb into bed, you try to warm yourself up by wiggling your body around? Being cold and falling asleep is not as pleasant as the opposite. As annoying as it might seem, try to keep your socks on one night and see if it helps you experience rapid sleep onset.

 

#30 Dip Your Face in Freezing Water

 

Okay, so this item might seem like the exact opposite of the warm sock trick, but hear it out. Did you know your body triggers an involuntary response called mammalian dive reflex when you submerge your face in cold water? It’s true, and it allows you to help control your nerves to relax. The experience basically resets your nervous systems so you can take charge of your body. Try this sleep tip right before bed and your entire body should feel a bit more relaxed.

 

#31 Create a Dream Pillow

 

Have you ever heard of a dream pillow? It is a pillow that is infused with particular scents. You already know that aromatherapy can help create a better night’s sleep. So why not take this one step further and add it to your pillow? Essential oils such as peppermint, lavender, and chamomile not only help you fall asleep faster, but they can keep you in a deep sleep far longer. A good pillow is essential for neck and back support, too. Join the two together to get some well-needed rest. You can create your own or buy one online.

 

#32 Turn on Some Tunes

 

Jamming out to heavy metal or getting down to some R&B will not help you sleep better. However, binaural beats might have you falling asleep sooner. They are a particular sound wave that can help relax your brain in various states. All you have to do is listen to the sound waves through your headphones while you are resting. Binaural beats are a special music that might take you to sleepy town a little faster.

 

#33 Do the 4-7-8 Controlled Breathing Method

 

If you slow down your breathing, it can help you relax and fall asleep. This method, which is known as the 4-7-8 technique, can allow more oxygen to the brain. All you have to do is inhale in through your nasal passages slowly for about four seconds. Press your tongue to the roof of your mouth as you inhale. Keep your breath for roughly seven seconds and then let it out, slowly, for eight seconds. Repeat this breathing pattern to relax your body. It might feel a little strange, but you will get used to it and appreciate the benefits.

 

#34 Get a Massage

 

In order to unwind before you fall asleep, you should get a massage. Focus on your neck, back, and shoulders because that is where your muscles are the tensest. Believe it or not, having tension in these body parts can hinder your sleep. Ask your partner to rub your back, neck, and shoulders using small circular motions. A little bit can go a long way!

 

#35 Wear Some Comfy PJs

 

You already know you should have comfortable bedding and a newer mattress. However, have you ever considered what you are wearing to bed? It should always be something comfy and loose opposed to tight-fitting clothes that restrict your movement. Always try to wear cotton, too, because your skin can breathe easier. Satin and other materials will hold your sweat in leaving you uncomfortable. If you prefer to sleep in the nude, go for it!

 

#36 Read a Book

 

It’s a good idea to do something for about 15 to 20 minutes prior to going to bed. These activities should not include things like working out, playing video games, and staring at your phone because they will keep you up later. If you want a hobby that truly relaxes you, try reading a book before bed. Even if it’s a page-turner, you will find yourself dozing off within a half hour. If you don’t want to get into a good paperback, you can check out Kindle e-books, but be careful of the artificial light.

 

#37 Soak Up the Sun

 

During the morning, afternoon, and early evening, you should try to get a healthy amount of sun exposure. How can this help you fall asleep at night? Naturally, you can tire yourself out, but did you know that sunlight increases the production of serotonin, too? This hormone is produced by the body to keep you awake. After the serotonin in your body hits a peak level, it will cease and the melatonin production starts, which makes you sleepy. That old saying about waking up and going to bed with the sun is a great way to perfect your sleep schedule.

 

#38 Use FLUX

 

Have you ever heard of FLUX? It is a program that reduces blue light on your computer screen. Like other artificial light, this can confuse your brain to think you should be awake. The blue light your PC gives off simulates sunlight and your eyes cannot tell the difference. Therefore, your body continues to produce serotonin, which keeps you wide awake. Luckily, it’s easy to download the FLUX programand immediately change that eye-opening side effect.

 

#39 Get Busy Between the Sheets

 

Just before trying to fall asleep, you and your partner should have sex. Why? Because the act usually makes you feel tired, especially for men. Not only does the physical act wear you out, but having an orgasm has several health benefits including better sleep. The next time you are cuddling under the covers with your partner, try getting warm together and falling asleep faster.

 

#40 Cease All Snoring

 

Whether it is you or your partner making this pig-like noises, try your best to stop it. Not only is the sound enough to keep you awake, but snoring actually is a result of a blocked airway. Therefore, you can wake yourself up trying to catch your breath. There are several breathing techniques that can help reduce or stop your snoring as well as nose strips and other snoring aids. You and your partner will be grateful.

 

#41 Breathe Through the Left Nostril

 

This sleep tip might sound a little silly, but it’s worth a try. It’s not as effective as the 4-7-8 breathing method, but it’s worth a shot. As you are lying down in bed with your eyes closed, hold one nostril closed. Breathing through just one should simulate a relaxing effect although it is not proven. The method aims to calm your body and mind enough to drift off into a deep sleep.

 

#42 Stretch Your Muscles

 

Did you know that your muscles become tight and tense after being active all day? You don’t have to be a fitness buff or exercise guru for this to happen. Before you climb into bed, you should stretch your muscles to relax and fall asleep faster. A bath or massage can help achieve this, but so can a foam roller and a little yoga.

 

#43 Take Melatonin Before Bed

 

Your body naturally produces the melatonin in the brain. The levels of this particular hormone tend to rise and fall throughout the day in an effort to control your sleep and wake cycles. Melatonin can be altered, though, by artificial light and so on. You can eat foods with melatonin or take a supplement to help it kick in at the right hour. WebMD explains how the right amount of melatonin can help you sleep better at night.

 

#44 Restrict Video Games

 

Unless you want to have lucid dreams, you should cut down on the amount of time you play video games, especially before bed. Use your amazing hand-eye coordination when it is still light outside. If you reduce your time on video games to the afternoon or early evening, it might be easier for you to unwind right before bed.

 

#45 Imagine Walking Down a Staircase

 

You probably heard of the counting sheep trick, but have you ever tried to visualize yourself walking down a staircase? It might help you fall asleep at night. After getting into bed, all you have to do to relax is close your eyes and picture yourself taking each step. As you go the staircase, allow your body and mind to feel more and more relaxed.

 

Conclusion

So if you’re struggling to get to sleep (and maybe even reading this in the middle of the night!) then hopefully these healthy sleep tips will give you the information you need to get back to sleep. Whether you need to revamp your bedroom, get prepared for the day ahead or just switch on some white noise there are plenty of things you can do to make sure you’re getting a better night’s sleep.

If you find this article helpful, then please share it with your friends and if you got any tips for better sleep add them in the comments below. I hope you find this helpful and cheers to a better night’s sleep for everyone!

This article originally appeared on www.thesleepjudge.com and was written by Candace Osmond

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Personal Responsibility: A 'Manifesto' For Self-Care

The World Health Organization (WHO) Constitution states: ‘the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being’. Reducing vulnerability to ill-heath implies human rights to the basic pre-requisites of health including access to information, education, nutrition and clean water1. Where these elements are in place, vulnerability to ill health is determined to an important degree by the choices of the individual. It is, of course, perfectly possible to be living without disease but leading an unhealthy lifestyle which makes future disease more likely or even inevitable.

This paper focusses on the responsibilities and even duties that healthy people have to maintain their own health, through self-care. Self-care for health has many elements including appropriate nutrition, sufficient physical activity and the avoidance of risks such as tobacco consumption2. Through self-care an individual can remain healthy into their seventh, eighth and ninth decades, prevent or delay ‘lifestyle’ diseases, and maintain mental health. Conversely, without successful self-care the emerging epidemic of lifestyle diseases threatens to swamp healthcare systems around the world.

The reasonable responsibilities of the average healthy citizen to care for themselves and help prevent lifestyle diseases are therefore of great interest, but have received relatively little attention. There is a substantial literature on the duties of healthcare professionals, rather less on the duties of the patient, and very little on the duties of the healthy individual3.

Individuals have a right to information and education on how to maintain good health but ultimately they bear the responsibility to take action. The environment in which we live and the support we receive from healthcare professionals can help determine our lifestyle choices, but we alone can make them. Therefore we propose that a manifesto for self-care is needed. This fundamental expression of the responsibilities of individuals to take care of their own health could serve as a touchstone to guide the development of enabling tools and policies.

SELF-CARE AND THE LIFESTYLE DISEASES CHALLENGE

The need for people to undertake self-care to prevent or delay ‘lifestyle’ diseases (also called non-communicable diseases) is particularly pressing. The incidence of these diseases – particularly heart attack and stroke, cancer, chronic lung diseases and diabetes – has reached epidemic proportions in most countries around the world. Worldwide, 63% of all deaths annually, an estimated 36 million people, are as a result of lifestyle diseases4. The proportion is much higher in the most developed countries – 88% of deaths in the UK and 87% in the USA for example5. Lifestyle diseases are projected to increase by 15% globally between 2010 and 2020. These diseases are often particularly costly to the individual and healthcare systems because of their chronic nature.

Lifestyle diseases are strongly associated with, and causally linked to, four behaviours: physical inactivity, unhealthy diet, tobacco use and the harmful use of alcohol. Up to 80% of heart disease, stroke and type-2 diabetes, and over a third of cancers could be prevented by modifying these behaviours4,6. If people were to undertake more self-care, the benefits to themselves, their families, and to the health systems that serve them would be enormous. However for this to happen there are significant challenges to be overcome.

Firstly people have to recognise what is healthy and unhealthy and, having recognised that they are at risk through their lifestyle choices, possess sufficient knowledge to know what action to take. With some behaviours (e.g. smoking) the risks are relatively well known and the action to be taken clear, however difficult. For others the judgements involved can be more difficult and influenced by evolving societal norms.

A warning lesson is provided by the trend towards the ‘normalisation’ of being overweight. A substantial proportion of overweight men and women think they are ‘about the right weight’7,8. Manufacturers of clothes have increased the space in clothes without changing the label size – ‘size inflation’ in clothing9. A recent study showed that 79% of parents of overweight children did not recognise that their offspring were overweight10, and of those who did, 41% did not perceive this to be a health risk.

The implication of evolving societal attitudes is that being overweight or even obese could become ‘normalised’, rather than approached as a serious but preventable personal and public health problem. People can only accept responsibility for their health if they can agree about what is unhealthy.

The medical consequences of being overweight are clear: the risk of coronary heart disease, ischaemic stroke and type 2 diabetes grows steadily with increasing body mass, as do the risks of cancers of the breast, colon, prostate and other organs. Chronic overweight contributes to osteoarthritis, a major cause of disability. Globally, 44% of diabetes burden, 23% of ischaemic heart disease burden and 7-41% of certain cancer burdens are attributable to overweight and obesity6.

Even when a problem is recognised, knowing how to deal with it can be demanding. People may recognise that they lead an unhealthy lifestyle through inactivity or an unhealthy diet, but may still struggle to know what action to take. Mixed messages in the mass media and the plethora of biased information online may contribute to lack of clarity about what constitutes a healthy lifestyle.

There is no shortage of sound, practical, evidence-based advice on healthy lifestyles11,12,13, but this guidance is often assumed to be aimed primarly at those with responsibility for supporting individuals to change behaviours, rather than to the individuals themselves. To be effective at a population level, these initiatives have to change societal attitudes to what is accepted as normal and this necessarily involves everyone11.

We suggest that an important part of this change is attitudinal and involves people accepting responsibility for their own lifestyle rather than devolving responsibility for their future health to health care professionals or the government.

ACCEPTING RESPONSIBILITY FOR SELF-CARE: THE MORAL GROUNDING

The moral imperative to keep healthy through self-care is based in part on responsibility to others, primarily:

1. Other users of public healthcare services i.e. to current and future patients, and
2. Future generations, including one’s own children.

Current and future patients.
In a resource-constrained healthcare system, medical treatment offered to one patient represents an opportunity cost to other patients with potentially more pressing healthcare needs. We have a duty to others whenever our choices impact on them. People leading healthy lifestyles and practising self-care for self-limiting conditions will consume fewer healthcare resources, leaving more capacity to treat those requiring those resources most.

People readily accept responsibilities that recognise the needs of others in many spheres of society. Cars and properties have to be maintained so as to be at least minimally safe with regard to others as well as to the primary user. Smoking bans in public spaces are now ubiquitous and widely accepted public health measures. The excessive consumption of alcohol, tobacco smoking, an inactive lifestyle or an unhealthy diet may all appear to be purely personal choices but as the cause of lifestyle diseases which consume a large proportion of constrained healthcare resources, their impact on others should be similarly recognised.

Future generations.
Parents have a major influence on the lifestyle habits of their children, making parents suitable agents for change14. Children of parents who engage in physical exercise such as sports, who try to eat ‘5-a-day’ fruit and vegetables and who do not smoke are more likely to be aware of, and adopt, healthy habits when they are adults (and parents) themselves.

There is also a need to improve parental self-awareness of their children’s health determinants. As mentioned, it is well documented that parents are often unaware that their child is overweight10,15, or that their child’s weight poses a risk to their health16,17. Parents are, at least initially, primarily responsible for the lifestyle choices of their offspring and therefore for the consequences of those choices.

POTENTIAL OBJECTIONS TO THE IDEA OF PERSONAL RESPONSIBILITY FOR HEALTH

The ‘nanny state’ argument.
One possible objection to governments (local or national) encouraging more individual responsibility for health is that this implies some interference with personal choice. However, the healthy person who takes no steps to avoid lifestyle diseases will ultimately consume more healthcare resources than someone leading a healthy lifestyle. These resources are not just scarce but are also commonly held, being publicly funded. It does not seem unreasonable for society as a whole to expect individuals to behave responsibly when they have the opportunity to do so.

Popular opinion seems to support this approach – in 2004, The King’s Fund, an independent think tank, conducted a survey of more than 1,000 people and found that most favoured policies that combatted behaviour such as eating a poor diet and public smoking18. The ‘nanny state’ argument may have lost some force given the positive results of self-care enhancing policies such as public place smoking bans, mandated vehicle seatbelt and motorcycle helmet use.

The budget argument.
Some critics have suggested that promotion of self-care is driven by the vested interest of governments to curb their healthcare budgets by shifting responsibility to the individual. But even if healthcare resources were abundant, people would still benefit personally from self-care. Within a financially constrained system, responsible use of resources is intrinsically important and has ethical weight. The disadvantaged in society may need more support to achieve self-care, but whatever their socio-economic status, giving the healthy the means and responsibility to take care of themselves frees resources to constantly improve the care of those that become ill. The moral imperative to conserve shared resources remains, irrespective of the size of those resources. And the moral imperative towards the next generation is much more than an issue of funding.

Objections on societal grounds.
There is a practical objection that placing duties or responsibilities upon people should take into account the societal context and external environment in which the individual lives. It is more difficult for an inner-city tower block resident to take exercise than it is for a person living near green spaces. There is a positive association between the density of unhealthy food outlets in a neighbourhood and the prevalence of overweight and obesity in children19.

It is clear that there may be structural circumstances that inhibit positive self-care behaviours, but these difficulties do not dissolve the responsibility for self-care. The disadvantaged in society may have particular difficulties in adopting a healthy lifestyle and will require more support from the community, and from the healthcare system, than those with more physical or financial resource available to them. Giving people the means to make healthy choices is a legitimate obligation for govenments and their agents. However this does not change the priniciple that ultimately the individual is responsible for the choices that they do make.

Goverments may try to ‘enforce’ self-care responsibilities.
An important question arises as to whether fulfilling self-care responsibilities will come to be seen as an expectation (assuming that monitoring behaviours is even possible).

Denying provision of healthcare services to people who have neglected to lead a healthy lifestyle would be highly contentious, and in the context of societal inequalities that skew the ability to adopt such a lifestyle, morally indefensible. Nevertheless, there are clearly adverse consequences for the individual who adopts an unhealthy lifestyle, apart from ultimate ill-health. Those that smoke or drink heavily pay considerable taxes in the process. If one seeks health insurance, smoking, drinking alcohol to excess and evidence of being overweight will all have a marked effect on the level of premium paid.

Disincentives to an unhealthy lifestyle therefore already exist, and are a legitimate tool of government policy.

DEVELOPING PUBLIC POLICY APPROACHES

Establishing the principle of individual responsibilities in health leads to the question of what mechanisms and supports could be provided to help people with a potentially challenging objective.

Some general policy directions are clear. Policies which focus on supporting positive behaviours in healthy people are more appropriate and useful than those which penalise sick people. Policies which are universal in their application are also likely to be better accepted than those that appear to target individuals. For example, if the evidence continues to mount for the role of sugar in causing obesity and diabetes, then a general ‘sugar tax’ has clear advantages compared with penalising the obese.

The influence of public policies on the ability of people to self-care is extensive. Self-care may be substantially outside the reach of health and social systems, but many government policy decisions have a bearing on the practice. The UN 2011 resolution on Noncommunicable Diseases, Article 3620 illustrates this:

…(We) recognize that effective non-communicable disease prevention and control require leadership and multisectoral approaches for health at the government level, including, as appropriate, health in all policies and whole-of-government approaches across such sectors as health, education, energy, agriculture, sports, transport, communication, urban planning, environment, labour, employment, industry and trade, finance, and social and economic development…

Many programmes and policies which impact on self-care and lifestyle behaviours have already been implemented around the world. However, the results of these programmes have not been assessed and organised systematically. A consolidation of programme documentation and outcomes would provide a valuable reference database for policymakers and programme managers, and provide the basis for planning a comprehensive, articulated research strategy. In addition to providing evidence for policy-makers, a systematic review of such data could help to identify practical ways and means which could help individuals to undertake lifestyle changes.

THE SELF-CARE RESPONSIBILITIES OF HEALTHY PEOPLE

We suggest that healthy people should aim to preserve and promote their own health and wellbeing so far as it is reasonably open to them so to do. They should follow a healthy lifestyle through being aware of, and following, health promotion guidelines. This means that they should eat a healthy diet and avoid inactivity. They should not put their health at risk, for example, through smoking or consuming excess alcohol. They should seek to understand the risk factors for chronic diseases particularly relevant to them, and address them as far as possible.

The healthy person should not put at risk the health and safety of others when this can be avoided. Examples include not smoking in spaces shared with others, good hygiene practices in hand washing, in food preparation and when coughing or sneezing.

It is the responsibility of a healthy person to consume healthcare resources in a responsible way and therefore to self-care whenever possible for self-limiting illnesses.

People should also promote health and wellbeing in their families, not least their own children. Examples include encouraging their children to exercise, teaching them about healthy and unhealthy foods, and having them vaccinated.

There are clearly many qualifications and reservations in these proposed responsibilities. Questions obviously arise as to the meaning of ‘aim to’, ‘avoidable’ and so on. However, these are questions of scope and extent, which are open to debate, rather than matters of principle.

Figure 1: A Self Care Manifesto: Responsibilities and Expectations in Self-Care.

 

A MANIFESTO FOR SELF-CARE

Taken together, the responsibilities of the individual can be seen as  defining a ‘manifesto’ for self-care (Fig. 1). These responsibilities interact with, and are interdependent on those of healthcare professionals, and society as a whole, through government policy at a national and community level. This manifesto is proposed as an agenda and framework for discussion. There are gaps in our knowledge of what works in changing behaviour at the  level of the individual and thus a clear need for research to underpin future policy within this conceptual framework.

CONCLUSION

The Declaration of Alma-Ata, the International Conference on Primary Health Care in 197821 stated that ‘The people have the right and duty to participate individually and collectively in the planning and implementation of their health care’.

To a large extent the maintenance of good health is not a ‘gift’ of a government or a healthcare system, but a ‘purchase’ that each individual makes by expending some effort. There is an urgent need to accept the duty we owe to ourselves and each other to maintain our health through self-care. A world in which we believe that we have important duties in this regard, even where they are difficult to achieve, will differ materially from a world in which we continue to delegate the responsibility for our health to others.

We propose the ‘Self-Care Manifesto’ as a conceptual framework to consider a new alignment of responsibilities, whereby the healthy assume the principal responsibility for maintaining their own health, and other agencies and resources work to enable this to happen.

 

Correspondence to: David Webber, International Self-Care Foundation (www.isfglobal.org),
davidwebber@isfglobal.org

Acknowledgements: The authors are grateful to Professor H. Martyn Evans for comments.

Statement of Interests: The authors have no conflict of interest relating to the publication of this paper.

Funding: The International Self-Care Foundation is a charity registered in the UK.

References

  1. The WHO constitution: http://www.who.int/governance/eb/who_constitution_en.pdf Accessed December 2014
    REFERENCE LINK
  2. David Webber, Zhenyu Guo, Stephen Mann. Self-Care in Health: We can define it, but should we also measure it? SelfCare 2013;4(5):101-106.
  3. Evans HM. Do patients have duties? Journal of medical ethics. 2007;33(12):689-94.
  4. World Health Organisation. Global status report on noncommunicable diseases 2010. WHO 2011a. http://www.who.int/nmh/publications/ncd_report_full_en.pdf Accessed December 2014
    REFERENCE LINK
  5. World Health Organisation. Noncommunicable Diseases Country Profiles 2011. http://www.who.int/nmh/publications/ncd_profiles_report.pdf Accessed December 2014
    REFERENCE LINK
  6. World Health Organisation. Global health risks: mortality and burden of disease attributable to selected major risks. WHO 2009. http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf Accessed December 2014
    REFERENCE LINK
  7. Duncan DT, Wolin KY, Scharoun-Lee M, Ding EL, Warner ET, Bennett GG. Does perception equal reality? Weight misperception in relation to weight-related attitudes and behaviors among overweight and obese US adults. The international journal of behavioral nutrition and physical activity. 2011;8:20.
  8. Johnson F, Beeken RJ, Croker H, Wardle J. Do weight perceptions among obese adults in Great Britain match clinical definitions? Analysis of cross-sectional surveys from 2007 and 2012. BMJ open. 2014;4(11):e005561.
  9. The Economist, daily chart, Size inflation 4th April 2012: http://www.economist.com/blogs/graphicdetail/2012/04/daily-chart-1 Accessed December 2014
    REFERENCE LINK
  10. Saxena S, Laverty AA. Confronting child obesity in primary care. The British journal of general practice : the journal of the Royal College of General Practitioners. 2014;64(618):10-1.
  11. Public Health England: Everybody active, every day: a framework to embed physical activity into daily life. http://www.gov.uk/government/publications/everybody-active-every-day-a-framework-to-embed-physical-activity-into-daily-life Accessed December 2014
    REFERENCE LINK
  12. NICE Guidance ph 49: Behaviour change: individual approaches. https://http://www.nice.org.uk/guidance/ph49 Accessed December 2014
    REFERENCE LINK
  13. Knowledge and attitudes towards healthy eating and physical activity published May 2011. http://www.noo.org.uk/NOO_about_obesity/lifestyle Accessed December 2014
    REFERENCE LINK
  14. Birch LL, Davison KK. Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatric clinics of North America. 2001;48(4):893-907.
  15. Rietmeijer-Mentink M, Paulis WD, van Middelkoop M, Bindels PJ, van der Wouden JC. Difference between parental perception and actual weight status of children: a systematic review. Maternal & child nutrition. 2013;9(1):3-22.
  16. Lampard AM, Byrne SM, Zubrick SR, Davis EA. Parents' concern about their children's weight. International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity. 2008;3(2):84-92.
  17. Park MH, Falconer CL, Saxena S, Kessel AS, Croker H, Skow A, et al. Perceptions of health risk among parents of overweight children: a cross-sectional study within a cohort. Preventive medicine. 2013;57(1):55-9.
  18. Coote A. Prevention rather than cure : making the case for choosing health. London: King's Fund; 2004.
  19. Cetateanu A, Jones A. Understanding the relationship between food environments, deprivation and childhood overweight and obesity: evidence from a cross sectional England-wide study. Health & place. 2014;27:68-76.
  20. United Nations General Assembly. Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. 2011. Document A/66/L.1. http://www.un.org/en/ga/ncdmeeting2011/pdf/NCD_draft_political_declaration.pdf Accessed December 2014
    REFERENCE LINK
  21. Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978. http://www.who.int/publications/almaata_declaration_en.pdf Accessed December 2014

This article originally appeared on the Self Care Journal and was written by D E Webber*, Z Guo*, S Mann**