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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

Why is pain so exhausting?

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One of essentially the most common feelings related to chronic pain is fatigue, which may grow to be overwhelming. People with chronic pain may report feeling lacking in energy and motivation to interact with others or the world around them.

In fact, a UK study of individuals with chronic health problems found that pain and fatigue were the 2 biggest barriers for an energetic and meaningful life.

But why is long-term pain so debilitating? One clue lies in the character of pain and its powerful influence on our thoughts and behaviors.

Short-term pain can protect you

Contemporary ways of fascinated by pain emphasize its protective properties—the way in which it grabs our attention and forces us to alter our behavior to be able to protect an element of our body.

Try this. Slowly pinch the skin. As you increase the pressure, you’ll notice that the feeling changes until it becomes painful. The pain is what keeps you from squeezing harder, right? It’s how pain protects us.

When we’re injured, tissue damage or inflammation makes our pain system more sensitive. This pain stops us from mechanically stressing the injured tissue while it heals. For example, the pain of a broken leg or a cut under the foot means we avoid walking on it.

The concept that “pain protects us and promotes healing” is one of the crucial vital things that folks with chronic pain tell us. they learned what helped them recuperate.

However, long-term pain can overprotect you

In the short term, pain serves an especially effective protective function, and the longer our pain system is energetic, the more protection it provides.

But persistent pain may also help us prevent recovery. People affected by pain call it “hypersensitivity of the pain system”. Think of your pain system as being on alert. And that is where exhaustion is available in.

When pain becomes an on a regular basis experience, triggered or reinforced by an ever-widening range of activities, contexts, and cues, it becomes a relentless drain on resources. Living with pain requires significant and sustained effort, and this makes us drained.

About 80% of us are lucky enough to not know what it’s wish to be in pain, day in and day trip, for months or years. But take a moment to assume what it’s like.

Imagine having to pay attention hard, gather energy, and use distraction techniques to finish on a regular basis activities, let alone work, caregiving, or other responsibilities.

Whenever you’re feeling pain, you’re faced with a selection of whether and tips on how to act. Continually making that selection requires thought, effort, and strategy.

Mentioning your pain or explaining its impact on every moment, task, or activity is also tiring and difficult to speak when nobody else sees or feels your pain. For those listening, it could grow to be tedious, exhausting, or distressing.

The concentration, energy gathering, and distraction techniques required could make on a regular basis life exhausting.
PRPicturesProduction/Shutterstock

No wonder the pain is exhausting

In chronic pain, it’s not only the pain system that’s on alert. Increased inflammation throughout the body (immune system on alert), impaired production of the hormone cortisol (endocrine system on alert), and stiff and cautious movements (motor system on alert) are also hand in hand with chronic pain.

Each of those contributes to fatigue and exhaustion. So learning to administer and resolve chronic pain often involves learning tips on how to best manage the overactivation of those systems.

Losing sleep is also factor each in fatigue and pain. Pain causes sleep disruption, and sleep loss contributes to pain.

In other words, chronic pain is rarely “just” pain. It’s no wonder that long-term pain can grow to be overwhelming and debilitating.

What actually works?

People who are suffering from chronic pain include: stigmatized, rejected AND misunderstoodwhich may result in them not getting the care they need. Ongoing pain can prevent people from working, limit their social contacts and affect their relationships. This can result in a downward spiral of social, personal and economic drawback.

That’s why we want higher access to evidence-based care and high-quality education for individuals with chronic pain.

There is excellent news, nevertheless. Modern chronic pain care, which is based on first gaining a contemporary understanding of the biology underlying chronic pain, it helps.

The key appears to be recognizing and accepting that a hypersensitive pain system plays a key role in chronic pain. This makes a fast fix highly unlikely, but a program of gradual change—perhaps over months and even years—holds promise.

Understanding how pain works, how chronic pain becomes overprotective, how our brain and body adapt to training, after which learning recent skills and techniques to steadily rewire each the brain and body offers hope based on science; there is a powerful supporting evidence With clinical trials.

Any support is helpful

The best treatments for chronic pain require effort, patience, persistence, courage, and infrequently a very good coach. All of this is a fairly overwhelming proposition for somebody who is already exhausted.

So in the event you are among the many 80% of the population that doesn’t suffer from chronic pain, take into consideration what is needed and support your colleague, friend, partner, child or parent on this journey.


This article was originally published on : theconversation.com
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More than half of party drug users take ADHD medication without a prescription, new study finds

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Each 12 months, the National Drug and Alcohol Research Centre on the University of New South Wales in Sydney surveys a whole bunch of regular drug users in Australia to seek out out understand trends within the use of psychoactive substances throughout the country.

Today we published Report 2024during which 740 people from Australian capital cities who usually use ecstasy or other illegal stimulants were surveyed.

While the first focus of our research is illicit drugs and markets, we also monitor trends within the over-the-counter use of pharmaceutical stimulants, resembling ADHD medications.

This 12 months, 54% of people we spoke to had used pharmaceutical stimulants previously six months after they weren’t prescribed them, the best percentage now we have seen since we began asking people about this kind of drug use in 2007.

What are pharmaceutical stimulants?

Pharmaceutical stimulants include the drug methylphenidate (trade names Concerta and Ritalin), in addition to dexamfetamine and lisdexamfetamine (Vyvanse).

These medications are commonly prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsya chronic neurological disorder that causes excessive sleepiness and sudden sleep attacks through the day.

These drugs work in other ways depending on the kind. However, they treat ADHD by increasing levels of necessary chemicals (neurotransmitters) within the brain, including dopamine and norepinephrine.

However, as with many pharmaceutical substances, people also use these stimulants after they should not prescribed. There is range of reasons someone may select to make use of these medications without a prescription.

Tests University students have shown that these substances are sometimes used to extend alertness, concentration and memory. Studies conducted amongst wider populations have shown that they may also be used experimentor to get high.

All over the world, including in Australiawere significant increases within the prescription of ADHD medications lately, likely on account of increased identification and diagnosis of ADHD. As prescriptions increase, the danger of these substances being diverted to illegal drug markets increases.

Some people may seek pharmaceutical stimulants to extend alertness and concentration.
Ground Photo/Shutterstock

What we found

The percentage of people using stimulants without a prescription has tripled since monitoring began – from 17% of respondents in 2007 to 54% in 2024. It has remained at a similar level lately (52% in 2022 and 47% in 2023).

Frequency of use remained relatively low. Respondents typically reported using non-prescribed pharmaceutical stimulants monthly or less continuously.

In this study, participants most continuously reported using dexamfetamine, followed by methylphenidate and lisdexamfetamine. Most (79%) said it was “easy” or “very easy” to acquire these substances, just like 2022 and 2023.

Of course, provided that our study focused on regular drug users, the over-the-counter use of pharmaceutical stimulants doesn’t reflect their use in the final population.

In 2022–2023 National Household Drug Strategy Surveygeneral population survey of Australians aged 14 years and over, 2.1% of the population (comparable to about 400,000 people) reported using pharmaceutical stimulants for non-medical purposes within the previous 12 months. This was just like the proportion of people reporting using ecstasy.

What are the risks?

Pharmaceutical stimulants are considered to have a relatively secure toxicity profile. However, like all stimulants, these substances increase activity sympathetic nervous systemwhich controls various functions within the body during times of stress. This in turn increases heart rate, blood pressure and respiration rate.

These changes may cause acute cardiac events (resembling arrhythmias or irregular heartbeats) and, with repeated use of high doses, chronic changes in heart work.

Recent Australian research has documented increase in poisoning involving these substances, although a significant proportion of these seem like intentional poisonings. In the poisonings that involved only pharmaceutical stimulants, the drugs were mostly taken orally, with the median dose being more than ten times the everyday prescribed dose. The commonest symptoms were hypertension (hypertension), tachycardia (fast heart rate), and agitation.

In our study, individuals who took pharmaceutical stimulants most frequently took them in pill form, taking a dose barely higher than that typically prescribed.

However, about one in 4 people reported snorting as a route of administration. This can lead to physical harm, resembling damage to the sinuses, and will increase the potential risks of the drug because it will possibly come into effect faster within the body.

A hand holds a bag of white powder.
Snorting stimulants could also be more dangerous.
Author: DedMityay/Shutterstock

Some pharmaceutical stimulants are “long-acting,” released into the body throughout the day. So there may additionally be a risk of premature re-dosing if people unknowingly use these preparations more than once a day. That is, if people don’t experience desired effects They may take one other dose on the expected time, which can increase the danger of uncomfortable side effects.

Finally, non-prescribed stimulants can have negative effects when taken with other medications. This can include a “masking effect” (for instance, a stimulant may mask the symptoms alcohol poisoning).

So what should we do?

Pharmaceutical stimulants are necessary medications within the treatment of ADHD and narcolepsy, and when used as directed, they’re relatively secure. However, there are additional risks when people use these substances without a prescription.

Harm reduction campaigns that highlight these risks, including differences between formulations, will be useful. Ongoing monitoring, alongside more in-depth investigation of associated harms, can also be key.

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

Usher’s Groomer Shares His Skin Care Routine That Keeps Him in Shape at 45

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Kevin Mazur/Getty Images

Shortly after Labor Day, the consummate entertainer Usher played 4 consecutive sold-out shows in Brooklyn, New York, as a part of his . For two hours each night, he danced, sang, poured drinks for fans (you only needed to be there), and partied with special musical guests, all while his skin glowed. And not simply because he was sweating, although he was sweating loads. But also since the star, who has been around for 3 many years, has flawless skin at age 45. How does he do it?

With proper skincare and the assistance of hairdresser, Lola Okanlawon.

I had the chance, together with a gaggle of journalists and public opinion influencers, to hearken to the speech of Okanlawon, a famous make-up artist and licensed dermatologist DiAnne Davis, MDconcerning the tricks to having an unparalleled skincare routine, and all of it revolves around the suitable products. In addition to dancing with Usher, our presence that evening was also to have a good time the launch of a skincare brand Ceravelatest Eye cream with skin renewing vitamin Cwhich joins their popular Skin Renewing line. Usher uses it, and Davis says it’s best to too.

“Their whole Skin Renewing line really helps target some of the things that you might start to notice as you get a little older,” the plastic surgeon and skincare expert shared. “So maybe you’ve lost a little elasticity, or maybe your skin tone isn’t even, or maybe you’ve noticed a few fine lines and wrinkles here and there. That’s what this Skin Renewing line is all about.”

The key ingredients of the brand new eye cream are hyaluronic acid, which moisturizes, ceramides, which protect and moisturize the skin, caffeine, which reduces puffiness under the eyes, and five percent vitamin C, which brightens the skin across the eyes without irritating it.

(*45*) she says.

Okanlawon visited the artist before ending Usher’s pre-concert styling and opened up about her collaboration with the star, with whom she has been in a relationship for 3 years.

“I take care of all of his skin, from head to toe,” she told us, noting that they’re each fans of Cerave, which she uses often to prep him for the cameras and the massive stage.

“It’s important to have a skin prep routine before you go on stage. This man doesn’t play with his skin or his body,” she shared. “It’s nice to have a man who cares about his skin and cares about his appearance, buys products and asks me about them. ‘Hey, what about this? What about this?'”

The MUA star then delved into the practices and routines that keep her glowing, which include monthly facials (“This is not a game”) and a really, very clean food regimen.

“Of course, we start with a foaming cleanser because I do his stage makeup so that his hairline and certain things stay intact because he sweats a lot,” she says. “If you haven’t seen Usher perform, it’s like a waterfall. So I placed on some makeup that principally won’t come off together with his sweat. Moisturizing foaming cleansing oil It’s amazing since it breaks down product, it breaks down dirt, it breaks down oils, in order that’s definitely where we start.”

Next up is a brand new vitamin C eye cream. Okanlawon received the product ahead of its September launch and has been using it often on the star’s eyes for several months. She says it’s a must have in any skincare routine.

“Usher is a very good, handsome man. But he’s still 45, so eye cream is very important, and eye cream with vitamin C is amazing,” she says. “It’s preventative, so don’t wait until a certain age. Start using eye cream.”

Then they use Vitamin C Serum and finish your pre-makeup workout by moisturizing your body with Cerave Daily Moisturizing Balmwhich apply together.

“We use serum because serum is very important. Vitamin C helps brighten the skin,” she says. “His skin is very elastic because he takes good care of it. It’s easy, he’s easy.”

What Usher does night after night in front of packed audiences is not easy, but with guidance from Okanlawon and Cerave’s Skin Renewing line of beauty products, she all the time looks gorgeous when she does it.


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