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How a culturally informed model of care helped First Nations patients with heart disease

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A First Nations baby born in Australia today can expect to live eight to nine years less than a non-native child born on the identical day.

They usually tend to have a heart attack over the course of their lives, and it happens on average 20 years younger than the non-Indigenous patient lying next to them within the hospital bed while they do it. Acute rheumatic fever, a disease virtually unknown amongst non-Indigenous Australians, can damage heart valves. They are more probable get sick and die from cancer, diabetes, kidney failure and lung disease.

A First Nation Australian can be more more likely to have a low household income, live in overcrowded housing, and 14 times more likely be imprisoned. We know that such socioeconomic inequalities cause health inequalities. There can be evidence that cultural aspects and experiences of racism make the issue worse.

Closing the health gap between First Nations people and non-Indigenous Australians is about national priority. One option to reduce health disparities is to enhance the care that Aboriginal and Torres Strait Islander people receive after being admitted to hospital.

Staff at Brisbane’s Princess Alexandra Hospital saw first-hand that our health care system was not providing the care First Nations patients needed. Therefore, they sought to develop a culturally informed model of care for First Nations heart disease patients.

We have all worked with this model and took part in a study to try it out. Our results, recently published in Lancet Global Healthindicate that this culturally based model of care eliminated the gap between First Nations and non-Indigenous patients once we checked out heart health outcomes after they left hospital.

Designing a culturally oriented care model

The model was developed for First Nations patients with acute coronary syndrome. This includes heart attacks and anginathat’s, chest pain attributable to disease of the arteries supplying blood to the heart.

The project was developed collaboratively with First Nations stakeholders. The training was tailored and delivered to construct cultural capability inside the cardiology department and increase staff knowledge of appropriate services available to First Nations patients outside the hospital setting.

Staff have established formal partnerships with local Aboriginal and Torres Strait Islander community-controlled health organizations. They improved the hospital environment with First Nations art and uniforms (displaying First Nations flags and art).

They assembled a Better Cardiac Care team, which included an Aboriginal and Torres Strait Islander hospital liaison officer, a cardiac nurse and a pharmacist. This team visited First Nations patients at their bedsides, providing additional support, counseling, education and care coordination.

The trial took place on the Princess Alexandra Hospital in Brisbane.
Albert Perez/AAP

Patients could confidently ask questions and talk in their very own words about their diagnosis and treatment, without feeling shame or embarrassment.

The team was focused on the patient’s needs. For example, they may coordinate the accommodation of a patient’s relative who traveled to the hospital from a distance. They could let the doctor know if the patient needed more time to speak or make a decision or a higher explanation. Before the patient left the hospital, the team was capable of liaise with the patient’s local pharmacy to stock his medicines and arrange a follow-up appointment with his GP.

How we tested the model

We examined the impact of the care model by taking a look at outcomes for First Nations and non-Indigenous patients admitted for heart attack and angina before and after implementation of the model.

Specifically, we collected data on 199 First Nations patients and 440 randomly chosen non-Indigenous patients treated within the 24 months before the beginning of the project and compared them with 119 First Nations patients and 467 non-Indigenous patients treated within the 12 months later.

We especially desired to know whether patients died, had one other heart attack, needed unexpected stent or coronary artery bypass surgery, or needed to return to the hospital urgently inside 90 days of discharge.

Before the model was introduced, 34% of First Nations patients had one of these negative outcomes, significantly higher than the 18% of non-Indigenous patients. Subsequently, these events occurred in 20% of each First Nations and non-Indigenous patients. This was a significant improvement for First Nations patients and eliminated the difference between the groups.

The most vital improvement was seen in urgent readmissions, but there have been also fewer heart attacks.

Two women are smiling and using a tablet computer.
The model improved outcomes for First Nations patients.
JohnnyGreig/Getty Images

Fewer heart attacks and hospital admissions are good, but we also needed to make sure patients felt culturally secure and had their social and emotional needs met.

AND related project patients and their families were asked about their experiences with the care model. The researchers found that the important thing to success will be the relational or connection between patients and the team, particularly Aboriginal and Torres Strait Islander staff.

A promising concept

Our study was not a randomized trial and the control group was a historical group. It is due to this fact possible that aspects aside from the care model influenced the outcomes. The study was also conducted in just one hospital.

However, we’ve shown that a culturally informed model of care, developed with and for First Nations peoples, can improve clinical outcomes. Better cardiac care programs based on this idea have now turn into widespread other hospitals in Queensland.

We hope that similar results may be replicated in lots of hospitals and other medical specialties, as improving hospital outcomes is one of many essential steps needed to shut health disparities for First Nations people in Australia.

This article was originally published on : theconversation.com
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Health and Wellness

Willow Smith’s debut collection with Moncler is now available – Essence

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Moncler

Willow Smith’s debut collection with Moncler has been launched. The capsule is a mixture of the inside of a musician, actress, writer and creator. In it, a futuristic and unbelievable world is explored through clothes. Smith’s personal style was also showcased. The lineup was originally revealed in Shanghai.

Willow Smith's debut collection with Moncler is now available
Moncler

“Minimalism and utilitarianism. Femininity and masculinity. Black and white. “Putting ideas together in an elegant way is something that really excites me and I wanted to explore that with this collection,” Willow shared.

“Willow’s magnetic energy is captured in a series of images exploring the primary themes of the collection: clashing contrasts, rebirth and renewal, yin and yang, recent beginnings – inspired by Moncler’s mountain origins and love of nature. “Willow’s creativity influences every aspect of the videos and photos accompanying the collection: she not only drives the concept, but also models her designs, narrates the short film and provides the soundtrack,” the brand said in a press release. The launch is accompanied by black and white campaign photos – the dramatization of those photos ushers in an exciting era for Smith.

Willow Smith's debut collection with Moncler is now available
Moncler

The collection is dominated by knitwear perfect for layering, a down jacket and heavy sweatshirts created in shrunken proportions. The capsule is accomplished with extensive outerwear options and a brief-sleeved T-shirt with silver eyelet. The T-shirt is also available in an extended-sleeved version. The collection includes cream and black shades. The down vest with a hood and a brief cut stands out.

Salix leather boots are characterised by an interesting design. In addition to nodding to punk influences, this footwear option is designed with a Moncler logo on the toe, elastic panels on the front and a rubber sole.

Willow Smith's debut collection with Moncler is now available
Moncler

“I am incredibly passionate about the outdoors and exploring this wonderful land. I imagine these pieces can easily transition from overnight camping to fashionable evening wear,” Willow added, emphasizing the natural duality of the collection.

Moncler X Willow Smith is currently available in chosen Moncler stores and more moncler.com .

This article was originally published on : www.essence.com
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Health and Wellness

Women are less likely to undergo cardiopulmonary resuscitation than men. Training on breast mannequins could be helpful

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If someone’s heart suddenly stops beating, this may increasingly have happened minutes of life. Performing cardiopulmonary resuscitation may increase their probabilities of survival. Cardiopulmonary resuscitation keeps blood pumping, delivering oxygen to the brain and vital organs until specialized treatment arrives.

However, research shows that bystanders are less likely to intervene to perform cardiopulmonary resuscitation if the person is a girl. AND latest Australian study analyzed 4,491 cardiac arrest cases between 2017 and 2019 and located that bystanders were more likely to perform CPR on men (74%) than on women (65%).

Could this be partly because CPR training mannequins (so-called dummies) shouldn’t have breasts? Our recent research we checked out mannequins available all over the world to train people to perform CPR and located that 95% of them were flat-chested.

Anatomically, breasts don’t change the cardiopulmonary resuscitation technique. However, they’ll influence whether people try to accomplish that – and hesitation at these key moments could mean the difference between life and death.

Differences in heart health

Cardiovascular diseases – including heart disease, stroke and cardiac arrest – are probably the most common diseases important reason behind death for ladies all over the world.

But if a girl goes into cardiac arrest outside the hospital (meaning her heart stops pumping air properly), that is actually what happens. 10% less likely receive cardiopulmonary resuscitation than a person. Women too less likely survive cardiopulmonary resuscitation and are at greater risk of brain damage following cardiac arrest.

Bystanders are less likely to intervene if a girl needs cardiopulmonary resuscitation compared to a person.
Doublelee/Shutterstock

These are just among the many health inequalities experienced by women, in addition to transgender and non-binary people. Compared to men, their symptoms they are more likely to be rejected or misdiagnosed, or it could take longer to receive a diagnosis.

Reluctance of the witness

There can also be growth evidence women are less likely to start cardiopulmonary resuscitation compared to men.

This may be partly due to the concerns of those being accused of sexual harassmentworry may cause damage (in some cases based on the assumption that ladies are more “fragile”) and discomfort related to touching women’s breasts.

Bystanders may also get into trouble recognition the lady has a cardiac arrest.

Even in simulated scenarios, researchers found that interveners were less likely to remove women’s clothing prepare for resuscitationcompared to men. And there have been women less likely to receive Cardiopulmonary resuscitation or defibrillation (an electrical charge to restart the center) – even when the training was in the shape of a web based game that didn’t require touching anyone.

There is evidence of how people behave in resuscitation training scenarios reflects what they do in real emergency situations. This means it is amazingly vital to train people to recognize cardiac arrest and prepare for intervention, no matter gender or body type.

Attached to men’s bodies

Very Cardiopulmonary resuscitation training resources depict male bodies or don’t specify gender. If bodies shouldn’t have breasts, it’s a male default.

For example, the 12 months 2022 test taking a look at CPR training in North, Central, and South America, it was found that nearly all of available mannequins were white (88%), male (94%), and slim (99%).

The woman's hands press the torso of a mannequin wearing a blue jacket.
It is amazingly rare for a mannequin to have breasts or a bigger body.
M Isolation photo/Shutterstock

This research reflects what we see in our work once we train other healthcare professionals to perform cardiopulmonary resuscitation. We noticed that every one the mannequins available for training are flat chested. One of us (Rebecca) had difficulty finding training mannequins with breasts.

Single mannequin with breasts

Our recent research we checked what cardiopulmonary resuscitation mannequins are available and the way diverse they are. In 2023, we identified 20 cardiopulmonary resuscitation mannequins in the worldwide market. Mannequins are often torsos with no head and without arms.

Of the 20 available, five (25%) were sold as “female”, but only considered one of them had breasts. This implies that 95% of obtainable CPR training mannequins were flat-chested.

We also checked out other diversity characteristics, including skin tone and bigger bodies. We found that 65% had more than one skin tone available, but just one had a bigger body. Further research is required on the impact of those elements on bystanders when performing CPR.

Breasts don’t change cardiopulmonary resuscitation technique

Cardiopulmonary resuscitation technique doesn’t change when someone has breasts. The barriers are cultural. And although you could feel uncomfortable, starting cardiopulmonary resuscitation as soon as possible can save your life.

Signs that somebody may have cardiopulmonary resuscitation include not respiration properly or completely or not responding to you.

Perform effective cardiopulmonary resuscitationit’s best to:

  • place the heel of your hand in the middle of your chest

  • place your second hand on top of the primary and interlace your fingers (keep your arms straight)

  • press firmly to a depth of about 5 cm before releasing

  • press your chest with a frequency of 100-120 beats per minute (you may sing a song) in your head to show you how to keep time!)

An example of performing cardiopulmonary resuscitation – using a flat-chest manikin.

What a couple of defibrillator?

You haven’t got to remove someone’s bra to perform CPR. But you could need to accomplish that if a defibrillator is required.

AND defibrillator is a tool that uses an electrical charge to restart the center. An underwired bra may cause minor skin burns when the debrillator pads apply an electrical charge. However, in case you cannot take your bra off, don’t let it delay your care.

What should change?

Our research highlights the necessity for a big selection of breast CPR training mannequins, in addition to a wide range of body sizes.

Training resources need to higher prepare people to intervene and perform CPR on individuals with breasts. We also need greater education on the chance of developing and dying from heart disease in women.

This article was originally published on : theconversation.com
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Health and Wellness

Ant stings can be painful. Here’s how to avoid getting stung this summer (and what to do if it happens)

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The starting of summer is just a couple of days away, and plenty of of us will be looking forward to long, sunny days spent on the beach, by the pool, camping or having a picnic within the park.

Insects love summer too. Most of them right then grow and feed. However, this shared appreciation of the season can sometimes lead to conflict.

Insects have long been preyed upon by many species, including birds, mammals, amphibians, and other insects. Accordingly, quite a lot of defense mechanisms have evolved – perhaps none more familiar to humans than the sting.

Many ants have a stinger on their rear end which they use to deliver venom. It will not be the sting itself that causes pain, but relatively venom. Ant venom accommodates a mix of various chemicals, a few of which have evolved specifically to manipulate the nerve endings in our skin to cause pain.

Let’s take a have a look at the several ant stings chances are you’ll experience this summer in Australia and how to respond.

Bull ants

Bull ants (also often called bulldog ants, jumper ants, or jumper ants) are large for an ant. Some species can grow to length 4 centimeters. They are easily identified by their large eyes, long mandibles (jaws), and aggressive nature.

Their sting is immediate, hot, sharp and unambiguous, similar to that of a honey bee. The intense pain will only last a couple of minutes before being replaced by redness and swelling across the sting site.

There are many differing kinds of bull ants in Australia.
Sam Robinson

Green-headed ants

Green-headed ants are also called green ants (but not to be confused with green ants). green tree ants northern Australia, which do not sting). Green-headed ants are common and love our lawns.

About Length 6 millimetersthey’re much smaller than bull ants. They can be recognized by their shiny green-purple exoskeleton.

Green-headed ants are frequently less aggressive than bull ants, but they can still deliver a big sting. The pain from a green ant sting can construct up step by step and cause intense, sticky pain.

Green-headed ant.
Green-headed ants can be identified by their color.
Sam Robinson

Fire ants

Fire ants (or imported red fire ants) are native to South America. They were detected first in Brisbane in 2001it probably moved in containers and has since spread across south-east Queensland.

Fire ants are reddish brown and black and range in size from Length 2–6 millimeters.

You will almost certainly encounter fire ants of their nests, which appear like a pile of loose dirt. A hearth ant nest has no obvious entrance, which is way to distinguish it from other similar ant nests.

Disturbing a hearth ant nest will awaken an offended mass of a whole bunch of ants and expose you to being stung.

The initial pain from a single sting seems like an intense, hot itch, although it can be controlled. However, fire ant stings rarely occur in the only digits. One ant can sting multiple times, and plenty of ants can sting one person, which can lead to a whole bunch of stings. A hearth ant sting can cause pus-filled ulcers and scarring in the next days.

If you reside in an area where fire ants are present, it’s price taking a couple of minutes to learn how to do this recognize and report their.

Electric ants

Electric ants is one other nasty random import, coming from Central and South America. Currently limited to Cairns and surroundingsthese are tiny (1.5 millimeters long) yellow ants.

Like fire ants, these ants are frequently defensive, so lots of them will sting without delay. Their sting is more painful than you’ll expect from such a tiny creature. I compare it to being showered with red, hot sparks.

If you think that you see electric ants, please report it Biosecurity in Queensland.

Australian ants should not the worst

You may be surprised to hear that Australian ants don’t even make it to the rostrum when it comes to essentially the most painful ant stings. The winners include: harvester ants (North and South America), which cause severe, sticky pain, comparable to a drill slowly rotating in a muscle – for up to 12 hours.

The gold medal goes to the sting of the South and Central American bullet ant, which has been described How:

Pure, intense, sensible pain. It’s like walking on burning charcoal with a 3-inch nail stuck in your heel.

How to avoid getting stung (and what to do if you do)

Fortunately, the answer is frequently quite simple. Look around before you sit on the bottom or unfolded a picnic blanket, avoiding places where you see ant nests or a lot of foraging ants.

The selection of footwear might also be necessary. In my experience, most stings occur on the feet of those wearing thongs.

If you get stung, generally the situation will improve by itself. The pain often subsides after a couple of minutes (sometimes slightly longer within the case of a green ant sting). The redness, swelling and itching that sometimes follows may last for several days.

In the meantime, if mandatory, ice pack it will help with the pain. If it’s particularly bad, a topical numbing cream containing lidocaine may provide temporary relief. You can get it over-the-counter at a pharmacy.

A small proportion of individuals may experience an allergic response to ant stings. In very severe cases this may include respiratory problems or ingestion. If you or a loved one experiences these symptoms after an ant sting, you need to seek urgent medical attention.

This article was originally published on : theconversation.com
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