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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

an informative story of light healing

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For millennia, humans have had one obvious and reliable source of light – the Sun – and we’ve got known that the Sun is crucial to our survival.

Perhaps for this reason ancient religions – resembling those in Egypt, Greece, Middle East, India, AsiaAND Central AND South America – concerned the cult of the Sun.

Sun worship – resembling the worship of the Greek god Helios – was common in lots of cultures.
Enthusiast of neoclassicism/Wikimedia Commons, CC BY-NC-SA

Early religions were also common related to healing. Sick people turned to a shaman, priest or priestess for help.

Although ancient people used the Sun for healing, it might not be what you’re thinking that.

Since then, we’ve got used light for healing in some ways. Some of them chances are you’ll recognize today, others sound more like magic.

From warming ointments to tanning

Currently, there’s little evidence that ancient people believed that sunlight could cure disease. Instead, there’s more evidence that they used the Sun for healing.

Ebers Papyrus (reproduction)
The Ebers Papyrus from ancient Egypt contained recipes for ointments that needed to be heated by the sun.
Wellcome Collection

The Ebers Papyrus is an ancient Egyptian medical scroll created around 1500 BC. It accommodates a recipe for an ointment for “they make the tendons (…) flexible“. The ointment was constructed from wine, onions, soot, fruit and wood extracts, frankincense and myrrh. After application, the person was “exposed to sunlight.”

Other recipes, for instance for cough, involved putting the ingredients right into a container and leaving it within the sun. This might be to warm up the drink and permit it to brew stronger. Same technique occurs in medical writings attributed to the Greek physician Hippocrates, who lived around 450-380 BC

It was written by the physician Aretheus, who worked around 150 AD in what’s now Turkey sunlight could heal chronic cases of what he called “lethargy”, but today we might recognize depression:

The classical Islamic scholar Ibn Sina (980-1037 AD) described the health effects of tanning (at a time once we didn’t know of the link to skin cancer). In Book I Canon of medicine he said the new sun helps with all the pieces from flatulence and asthma to hysteria. He also said that the sun “refreshes the brain” and has a helpful effect on “cleansing the uterus.”

Sometimes it was hard to inform science from magic

All hardening methods described to this point depend more on the sun’s heat than on its light. What about light-only curing?

The healing power of sunlight Jakob Lorber
German mystic and visionary Jakob Lorber believed that sunlight healed almost all the pieces.
Merkur Pub Co/Biblio

The English scientist Sir Isaac Newton (1642-1727) knew that sunlight could possibly be “split” into rainbow spectrum of colours.

This and lots of other discoveries radically modified ideas about healing over the subsequent 200 years.

But sometimes it was hard to inform when latest ideas got here up learning from magic.

For example, the German mystic and visionary Jakob Lorber (1800-1864) believed that sunlight was one of the best cure for nearly all the pieces. His 1851 book “The Healing Power of Sunlight” read: still in print in 1997.

Public health reformer Florence Nightingale (1820-1910) he also believed in the facility of sunlight. In his famous book Notes on Nursingshe said about her patients:

second only to the necessity for fresh air is the necessity for light (…) not only light, but in addition direct sunlight.

Nightingale also believed that sunlight was the natural enemy of bacteria and viruses. It seems at the least partially right. Sunlight can kill some, but not all, bacteria and viruses.

Chromotherapy – a treatment method based on colours and light – appeared during this era. Some proponents claim that the origins of using coloured light for healing date back to ca ancient Egyptit’s hard to search out evidence of this now.

A page from The Principles of Light and Color
The 1878 book “Principles of Light and Color” paved the best way for people to be treated with light of different colours.
Getty Research Institute/Internet Archive Book Images/Flickr

Modern chromotherapy owes much to the fertile mind of Edwin Babbitt (1828-1905) from the United States. Babbitt’s 1878 book Principles of light and color he was based on experiments with coloured light and on his own visions and clairvoyant observations. It’s still in print.

Babbitt invented a conveyable stained glass window called Chromolumaimed toward restoring the balance of the body’s natural coloured energy. It is claimed that sitting under coloured light from a window for a certain period of time restores health.

Spectro-Chrome, circa 1925, at the Museum of Science and Industry in Chicago
Spectro-Chrome made one entrepreneur lots of money.
Daderot/Wikimedia Commons

Indian entrepreneur Dinshah Ghadiali (1873-1966) examine it, moved to the United States and invented his own instrument, the so-called Spectro-Chromein 1920.

The theory behind Spectro-Chrome was that the human body was composed of 4 elements – oxygen (blue), hydrogen (red), nitrogen (green), and carbon (yellow). When were these colours? imbalanceit caused the disease.

A couple of hour-long sessions with Spectro-Chrome could be enough restore balance and health. For example, through the use of green light, you’ll be able to supposedly help your pituitary gland, while yellow light helps with digestion.

By 1946, Ghadiali had created about one million dollars from sales of this device within the USA.

And today?

While some of these treatments sound strange, we already know that certain coloured lights treat certain diseases and disorders.

Blue light phototherapy it’s utilized in the hospital treatment of newborns with jaundice. People affected by seasonal affective disorder (sometimes called winter depression) may be treated by often exposing themselves to this medicine white or blue light. And ultraviolet light is used to treat skin diseases, resembling psoriasis.

Nowadays, light therapy is even utilized in the cosmetics industry. LED masks with star inscriptions, promise to fight pimples and reduce the signs of aging.

However, as with all forms of light, exposure to it comes with each risks and advantages. In the case of these LED face masks, they might disturb your sleep.


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

Ethnicity is a useful shortcut for identifying needs – without it, targeting public services will become more difficult

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Latest government news directive prioritizing public services “based on need rather than race” will make reaching New Zealanders with greater needs more difficult and take longer.

The directive’s give attention to ethnicity fails to acknowledge that many ‘surrogate’ needs – resembling age, gender, rural location and income – are routinely utilized in New Zealand and elsewhere allocate resources.

And this policy is contradictory relevant evidence that ethnicity is in truth an appropriate strategy to discover needs.

As well as making it more difficult to discover and reach New Zealanders most in need, these policies are more likely to exacerbate existing inequalities. There is also concern that it will put providers liable to financial failure because they don’t receive enough funding to cover patients with the best needs.

Effective shortcuts

Proxies resembling ethnicity, age, gender and placement are effective shortcuts to where the cash is going. The purpose of their use is to offer the proper resources at the proper place and time.

Take, for example, the major funding formula for primary care.

To ensure adequate funding for populations with higher needs, the fundamental services formula is as follows weighted to make sure a higher level of funding to specific population groups. These include children and older people, women, people using multiple services and folks living in rural areas.

From which the particular features used as proxies are taken tests which recognizes that certain groups use or need health services more than others.

Blunt instruments

Frankly, powers of attorney are relatively blunt instruments. However, given the challenges of pinpointing needs, these are the perfect we’ve got.

To determine population health needs without proxies, a nationwide survey of individuals’s health would should be conducted, making an allowance for a big selection of conditions and risk aspects.

Such a study would also must discover which health needs people consider most significant to find out which services might be prioritized. Collecting such information could be expensive and its validity period could be very short.

Mortality rates (by state) may provide data on health needs, but with some limitations – not every health condition causes death.

Other data may give attention to the usage of services (different proxy server). But this approach also has drawbacks. For example, it doesn’t reveal unmet needs for individuals who should not have or cannot access services.

There are serious gaps in our data sets. We have quite good data on hospital services, including diagnoses. However, data is not as available for other services, including the usage of primary care and mental health services.

And the information is virtually non-existent relating to understanding the needs of key population groups, resembling individuals with disabilities and the rainbow community.

Providing a solid analytical case for any resource allocation goal will be difficult in the present environment, particularly given recent public sector cuts.

Are all proxies problematic or only one?

The government has chosen ethnicity as a side of private identity that public sector agencies should use with the best caution as a proxy.

However, when all other aspects were taken under consideration (for example, age and rural location), Māori, Pacific Islanders and other ethnic groups worse health outcomes and access to health care.

In primary care, nevertheless, ethnicity is used only as a proxy measure when allocating a small pool of funding to enhance access to services.

Māori and Pacific peoples particularly proceed to face barriers to accessing health care that might be removed – if ethnicity influenced resource allocation decisions more, not less.

Māori and Pasifika people in New Zealand proceed to struggle with poorer health outcomes.
Fiona Goodall/Getty Images

The issue of human rights

The coalition government formulates its aversion to “racial policy” around human rights – particularly Art. 1.4 of the Act International Convention on the Elimination of All Forms of Racial Discrimination.

This allows states to take special measures (only) when essential to adequately protect the rights of specific ethnic groups. This signifies that the measures taken in Aotearoa have gone beyond what was essential.

However, the UN Committee on the Elimination of Racial Discrimination said New Zealand’s health policy was insufficient to satisfy Māori needs. The commission found there was a structural bias against Māori, which meant it was difficult for Māori to access health care on an equal footing with other New Zealanders.

It also found that Māori service providers are marginalized and should not paid for their work at the identical level as other service providers. She also expressed concern in regards to the poorer health outcomes that Māori and Pasifika proceed to face.

In a context of persistent, well-documented inequality and discrimination, the coalition government desires to pretend that ethnicity is not related to need.

If agencies are forced to overlook the role that ethnicity plays in health needs, we will expect a lot of wasted work by back-office employees trying to assemble evidence about what we already know to justify targeted services. Or a lot of wasted money, ensuring services widely available and targeting much more profitable.

Proxies, including those based on ethnicity, play a crucial role in a fair and equitable resource allocation system. They should not random, lazy, or the results of prejudice. They are based on available evidence of demand at population level.



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

This new podcast is exclusively for Black women who want to embrace their baldness

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Brennan Johnson

Ladies, now is the time, greater than ever, to embrace your skin, including the hairstyles you select to wear.

Brennan Nevada Inc.New York’s only Black, female-led PR and media agency serving technology corporations, startups and enterprise capitalists, today is excited to announce the new podcast show “Bald & Buzzed with Brennan” founded by Brennan Nevada Johnson. A media specialist, this podcast continues and expands our work to reach new and diverse area of interest audiences. Brennan is a descendant of Carter G. Woodson, the founding father of Black History Month, who created the Association for the Study of Negro Life and History, launched an educational profession, and published greater than 20 books on Black history. Brennan Nevada Inc., PR and media agencies are keeping Woodson’s legacy alive by telling Black and BIPOC stories to corporations that do not typically have access to best-in-class PR and storytelling services.

This new media enterprise will create content and space exclusively for people without hair who haven’t yet been accepted or celebrated due to outdated beliefs, stigmas and stereotypes imposed by society. With the premiere of the primary season in November, Brennan will host thought-provoking conversations in a news program format, in addition to interviews with inspiring people who have shaved their heads to discuss a wide selection of topics related to business, culture, love, sports, entertainment and sweetness, fashion, personal funds and more.

This podcast will showcase Brennan’s passion for storytelling while instilling confidence and reinforcing the advantages of being bald and engaged in every aspect of on a regular basis life. Bald by selection for over 13 years, Brennan has been published in lifestyle and consumer media akin to , promoting this unique and powerful hairstyle while debunking and debunking myths about having no hair.

“I’m so excited in regards to the official debut of Bald and Buzzed with Brennan. I’m obsessive about baldness, fashionable hairstyles and the media. Why not mix it and supply listeners with the perfect conversations and experiences by rewriting the narrative on how media, society and types interact with bald people? Our mission is to turn what has all the time been portrayed as negative or frankly depressing into positive! Having little or no hair is a life-style, sexy, luxurious and attitude that can be the most important focus of our show. The world needs to know the way cool it is to shave your head.”

Podcast listeners can subscribe and tune in each week as Brennan updates you on every little thing you wish to know to stay awake to date with the most recent news. In addition, Brennan will interview bald and fit pioneers from various industries to encourage viewers to live beautifully and boldly with a bald head. As the name of the podcast suggests, it’s an entendre because buzz can mean many things – haircuts, news, being drunk, gossip, etc.

For more on Baldy and Buzzed with Brennan, subscribe to them YouTube pageto watch the most recent episodes.

This article was originally published on : www.essence.com
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