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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

After the surgery, I was given opioids to take at home. What do I need to know?

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Opioids are sometimes prescribed after discharge from the hospital after surgery to help relieve pain at home.

These strong painkillers may cause unwanted unintended effects or harm, reminiscent of constipation, drowsiness, or the risk of addiction.

However, you may take steps to minimize this harm and use opioids more safely after recovering from surgery.

What varieties of opioids are the most typical?

The mostly prescribed Post-operative opioids in Australia include oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).

In fact, about half latest oxycodone prescriptions in Australia, according to a recent hospital visit.

Most often, patients will receive immediate-release opioids for pain relief. These are fast-acting drugs and are used to treat short-term pain.

Because they work quickly, their dose could be easily adjusted to your current pain level. Your doctor gives you instructions on how to adjust your dose depending in your pain level.

Then there are slow-release opioids, that are specifically formulated to release your dose slowly over about half to a full day. They could also be marked on the carton as ‘prolonged release’, ‘controlled release’ or ‘prolonged release’.

Slow-release preparations are mainly used for chronic or long-term pain. Thanks to the slow-release form, the medicine doesn’t have to be taken as often. However, it takes longer to achieve effect compared to an immediate-release drug, so it is just not commonly used after surgery.

Controlling pain after surgery is necessary. This will assist you to rise up and move faster and get better faster. Moving early after surgery prevents muscle atrophy and harm related to immobility, reminiscent of pressure sores and blood clots.

Everyone’s pain level and pain medication needs are different. Pain levels also decrease as the surgical wound heals, so you might need to take less medication as you get better.

But there’s also risk

As mentioned above, unintended effects of opioids include constipation and feeling drowsy or nauseous. Drowsiness may additionally increase the risk of falling.

Opioids prescribed for pain relief at home after surgery are often prescribed for short-term use.

But to one in ten Australians proceed to take them up to 4 months after surgery. One study found that individuals didn’t understand how to safely stop taking opioids.

This long-term use of opioids can lead to addiction and overdose. It may additionally reduce the effectiveness of the medicine. This happens because the body gets used to the opioid and wishes more of it to get the same effect.

Addiction and unintended effects are also more common slow-release opioids than immediate-release opioids. This is because people normally take slow-release opioids for a very long time.

There are also concerns about “residual” opioids. One study found that 40% of participants were prescribed them greater than twice the amount they needed.

This leads to unused opioids remaining at home could be dangerous the person and his or her family. Storing leftover opioids at home increases the risk of taking an excessive amount of, sharing it inappropriately with others, and taking it without medical supervision.

Don’t keep leftover opioids in your medicine cabinet. Take them to the pharmacy for secure disposal.
Photo by Archer/Shutterstock

How to minimize risk

Before using opioids, talk to your doctor or pharmacist about using over-the-counter pain relievers reminiscent of acetaminophen or anti-inflammatory medicines reminiscent of ibuprofen (e.g. Nurofen, Brufen) or diclofenac (e.g. Voltaren, Fenac).

These could be quite effective in controlling pain and can reduce the need for opioids. They can often be used as a substitute of opioids, but in some cases a mixture of each is mandatory.

Other pain management techniques include physical therapy, exercise, heat or ice packs. Talk to your doctor or pharmacist to discuss which techniques will profit you most.

However, for those who do need opioids, there are a couple of ways to ensure that you might be using them safely and effectively: :

  • ask about immediate release as a substitute of slow-release opioids to reduce the risk of unintended effects

  • you must not drink alcohol or take sleeping pills while taking opioids. This may increase drowsiness and lead to decreased alertness and slower respiration

  • as you might be at greater risk of falls, remove trip hazards from your private home and ensure that you may safely get off the sofa or bed and go to the bathroom or kitchen

  • Before you begin using opioids, make a plan together with your doctor or pharmacist about how and when to stop using them. Opioids after surgery are best taken at the lowest possible dose for the shortest possible time.

Woman holding a hot water bottle (pink cover) on her stomach.
A heat pack may help relieve pain so that you need to use less painkillers.
New Africa/Shutterstock

If you might be concerned about unintended effects

If you might be concerned about the unintended effects of using opioids, talk to your pharmacist or doctor. Side effects include:

  • constipation – Your pharmacist will give you the chance to offer you lifestyle advice and recommend laxatives

  • drowsiness – do not drive or operate heavy machinery. If you are attempting to not sleep during the day but still go to sleep, the dose could also be too high and you must contact your doctor

  • weakness and slow respiration – this may occasionally be an indication of a more serious side effect, reminiscent of respiratory depression, which requires medical attention. Contact your doctor immediately.

If you might be having trouble withdrawing from opioids

If you could have difficulty coming off opioids, talk to your doctor or pharmacist. They can suggest alternative methods of relieving your pain and offer you advice on progressively reducing your dose.

Withdrawal symptoms reminiscent of agitation, anxiety and insomnia may occur, but your doctor and pharmacist can assist you to manage them.

What about leftover opioids?

When you stop using opioids, take any leftovers to your local pharmacy for secure and free disposal.

Do not share opioids with others and keep them away from others in your household who do not need them, because opioids could cause unintended harm if not used under medical supervision. This may include accidental ingestion by children.


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

The best tunnel look from Game 5 of the 2024 NBA Finals

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NBA

Last night, the Boston Celtics won the 2024 NBA Finals against the Dallas Mavericks on their home court. However, in matters of style, there have been several other winners before the match. The core members of the Celtics decided to decorate comfortably slightly than flashily as they’d done previously. For example, Jayson Tatum appeared in a tunnel look consisting of a chic striped sweater and slim pants. The moment was a bit laid back, nevertheless it was a sanitized tackle streetwear.

Jaylen Brown, the 2024 Finals MVP, wore an all-black outfit: His outfit consisted of a black t-shirt and one other long-sleeved version underneath. He paired these pieces with elegant tailored trousers and leather shoes.

An additional look I liked was PJ Washington of the Dallas Mavericks. He wore a striped shirt and crisp dark blue jeans. This tunnel kit was an elevated version of the game day uniform.

Before the game, Tim Hardaway of the Dallas Mavericks wore a yellow sweater with a white T-shirt underneath and dark brown pants. His teammate Kyrie Irving wore an identical cream long-sleeved ensemble that stood out.

Check out the best tunnel looks from Game 5 of the 2024 NBA Finals below.

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

Do you suffer from mental illness? Why some people say yes even if they haven’t been diagnosed

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Mental illnesses akin to depression and anxiety disorders have gotten more common, especially amongst people young people. The demand for treatments is increasing, and some of them can be found on prescription psychiatric drugs They climbed up.

These rising trends within the prevalence of mental illness are accompanied by a rise in public interest in mental illness. Mental health messages saturate traditional and social media. Organizations and governments are increasingly urgent in developing awareness-raising, prevention and treatment initiatives.

The culture’s growing interest in mental health has obvious advantages. It increases awareness, reduces stigma and promotes help-seeking.

However, this will involve costs. Critics are nervous social media mental illnesses breed in these places and that extraordinary unhappiness becomes pathologized by the overuse of diagnostic concepts and “therapy says“.

British psychologist Lucy Foulkes argues that trends in attention growth and adoption are related. Her “prevalence inflation hypothesis” suggests that growing awareness of mental illness may lead some people to be misdiagnosed when they experience relatively mild or transient problems.

Foulkes’ hypothesis suggests that some people have too broad conceptions of mental illness. Our research confirms this view. In a brand new study we show that lately, the concepts of mental illnesses have broadened – we call this phenomenon “concept creep“- and that people are different when it comes to their concept of mental illness.

Why do people self-diagnose mental illnesses?

In our recent one testwe examined whether people with a broad understanding of mental illness are in actual fact more prone to self-diagnose.

We defined self-diagnosis as an individual’s belief that she or he has a disease, whether or not she or he received a diagnosis from a specialist. We assessed people as having a “broad understanding of mental illness” if they considered a wide selection of experiences and behaviors to be disorders, including relatively mild conditions.

We asked a nationally representative sample of 474 American adults whether they believed they had a mental disorder and whether they had received a diagnosis from a health care skilled. We also asked about other possible aspects and demographics.

Mental illness was common in our sample: 42% said they self-diagnosed it, and most of them received it from a health care skilled.

People with greater knowledge about mental health and fewer stigmatizing attitudes were more prone to report a diagnosis.
Mental Health America/Pexels

It is due to this fact not surprising that the strongest predictor of reporting a diagnosis was experiencing relatively severe stress.

The second most vital factor, after distress, was the broad concept of mental illness. When anxiety levels were the identical, people with broad concepts were significantly more prone to report a current diagnosis.

The chart below illustrates this effect. It divides the sample by levels of distress and shows the share of people at each level who report a current diagnosis. People with broad conceptions of mental illness (the best fourth of the sample) are represented by the dark blue line. People with a narrow definition of mental illness (lowest fourth of the sample) are marked with a light-weight blue line. People with broad views were way more prone to report mental illness, especially when their distress was relatively high.

The percentage of participants with a broad (dark blue) or narrow (light blue) conceptualization of mental illness who self-diagnosed various levels of distress.
Provided by the authors

People with greater mental health knowledge and fewer stigmatizing attitudes were also more prone to report a diagnosis.

Our study results in two further interesting conclusions. People who self-diagnosed but didn’t receive an expert diagnosis tended to have a broader understanding of the disease than those that diagnosed it.

Additionally, younger and politically progressive people were more prone to report the diagnosis, which is consistent with some opinions previous researchand held broader conceptions of mental illness. Their tendency to carry more expansive concepts partially explained their higher diagnosis rates.

Why does this matter?

Our findings support the view that expansive conceptions of mental illness encourage self-diagnosis and should thus increase the apparent incidence of mental sick health. People who’ve a lower threshold for outlining distress as a disorder usually tend to discover as having a mental illness.

Our findings do indirectly show that people with broad concepts overdiagnose and people with narrow concepts underdiagnose. They also don’t prove that having broad concepts of self-diagnosis or leads to a rise in mental illness. Nevertheless, the findings raise serious concerns.

First, they suggest that increasing awareness of mental health can come for a price. In addition to increasing knowledge about mental health, this will increase the likelihood that people mistakenly recognize their problems as pathologies.

Incorrect self-diagnosis could have opposed consequences. Diagnostic labels could be identity-defining and self-limiting when people begin to imagine that their problems are everlasting. difficult to manage facets of who they are.

The woman is crying
Some people may misidentify their problems as mental illness.
Karolina Grabowska/Pexels

Second, unfounded self-diagnosis can lead people experiencing relatively mild levels of hysteria to hunt help that’s unnecessary, inappropriate, and ineffective. Last Australian research found that people with relatively mild distress who received psychotherapy were more prone to worsen than to get well.

Third, these effects could also be particularly problematic for young people. They are most prone to broad conceptions of mental illness, partially because social media consumptionand comparatively often experience poor mental health. Time will tell whether expansive conceptions of illness play a job within the mental health crisis amongst young people.

Continuous cultural changes favor increasingly expansive definitions of mental illness. These changes will likely have mixed blessings. By normalizing mental illness, they may help remove its stigma. However, pathologizing some types of on a regular basis suffering could have an unintended downside.

As we grapple with the mental health crisis, it’s critical that we discover ways to boost awareness of mental sick health without inadvertently increasing it.

This article was originally published on : theconversation.com
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