Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort-Results of an International Multicenter Randomized Controlled Trial.

INTRODUCTION: Consumption of green kiwifruit is known to relieve constipation. Previous studies have also reported improvements in gastrointestinal (GI) comfort. We investigated the effect of consuming green kiwifruit on GI function and comfort. METHODS: Participants included healthy controls (n = 63), patients with functional constipation (FC, n = 60), and patients with constipation-predominant irritable bowel syndrome (IBS-C, n = 61) randomly assigned to consume 2 green kiwifruits or psyllium (7.5 g) per day for 4 weeks, followed by a 4-week washout, and then the other treatment for 4 weeks. The primary outcome was the number of complete spontaneous bowel movements (CSBM) per week. Secondary outcomes included GI comfort which was measured using the GI symptom rating scale, a validated instrument. Data (intent-to-treat) were analyzed as difference from baseline using repeated measures analysis of variance suitable for AB/BA crossover design. RESULTS: Consumption of green kiwifruit was associated with a clinically relevant increase of ≥ 1.5 CSBM per week (FC; 1.53, P < 0.0001, IBS-C; 1.73, P = 0.0003) and significantly improved measures of GI comfort (GI symptom rating scale total score) in constipated participants (FC, P < 0.0001; IBS-C, P < 0.0001). No significant adverse events were observed. DISCUSSION: This study provides original evidence that the consumption of a fresh whole fruit has demonstrated clinically relevant increases in CSBM and improved measures of GI comfort in constipated populations. Green kiwifruits are a suitable dietary treatment for relief of constipation and associated GI comfort.

Child Nutrition in Disaster: A Scoping Review.

Disaster endangers the nutritional health of children with resulting effects on their mental, physical, and social well-being. Adequate infant and young child feeding (IYCF) in disaster prevents malnutrition and save lives. Although much progress has been made in nutritional support in disaster, malnutrition among children is still evident. This scoping review study was conducted to identify gaps in child nutrition in disaster. Published articles (1946-2020) in PubMed were sought primarily and were assessed with some additional relevant articles. Overall, 103 articles were included in the scope of this review. Increased morbidity and mortality from malnutrition (macro- and micro-nutrient deficiencies), communicable diseases and mental health issues are nutritional effects of disaster. Pre-disaster malnutrition, food insecurity, living environments in shelters, poor breast-feeding practices, sociocultural factors, and organizational and administrative challenges strongly affect child nutrition in disaster. The efforts and collaboration of relief agencies resulted in the development of standardized guidelines and codes represented as the Sphere Project and Operational Guideline for IYCF in Emergency. This study recommends a well-coordinated and explicit approach that includes preparedness, advocacy, development/updating of policies, and education of children, family and relief aid workers on nutrition. Periodic nutritional assessment of children and nutritional support in disaster by designated IYCF authority are necessary. Education and participation of the general population are also important. Future assessments must examine food allergies in children and nutrition effects on child mental health in disaster.

Scoping Review of Hospital Business Continuity Plans to Validate the Improvement after the 2011 Great East Japan Earthquake and Tsunami.

During a disaster, all hospitals are expected to function as "social critical institutions" that protect the lives and health of people. In recent disasters, numerous hospitals were damaged, and this hampered the recovery of the affected communities. Had these hospitals business continuity plans (BCPs) to recover quickly after the disaster, most of the damage could have been avoided. This study conducted a scoping review of the historical trend and regional differences in hospital BCPs to validate the improvement of the BCP concept based on our own experience at Tohoku University Hospital, which was affected by the 2011 Great East Japan Earthquake and Tsunami (GEJET). We searched PubMed by using keywords related to BCP and adapted 97 articles for our analysis. The number of articles on hospital BCPs has increased in the 2000s, especially after Hurricane Katrina in 2005. While there are regional specificity of hazards, there were many common topics and visions for BCP implementation, education, and drills. From our 2011 GEJET experience, we found that BCPs assuming region-specific disasters are applicable in various types of disasters. Thus, we suggest the following integral and universal components for hospital BCPs: (1) alternative methods and resources, (2) priority of operation, and (3) resource management. Even if the type and extent of disasters vary, the development of BCPs and business continuity management strategies that utilize the abovementioned integral components can help a hospital survive disasters in the future.