Abstract:Introduction: In 2005, NHMRC published an outline of processes to guide services on improving cardiac rehabilitation (CR) for Indigenous Australians. This recognised the increased incidence and mortality from cardiovascular causes in Indigenous Australians with onset occurring at a younger age then in other Australians Methods: Site visits and interviews with CR staff in 15 mainstream CR/secondary prevention services (hospitals plus community health) across WA and 9 Aboriginal Community Controlled Health Services. Qualitative and quantitative data regarding CR provision to Indigenous people with CVD, involvement of Aboriginal Health workers, adaptation to local settings, cultural competency and interagency collaboration was collected by a CR nurse (+/-an Aboriginal nurse) using semistructured interviews. Results: Within tertiary hospitals the processes for identifying Indigenous patients were suboptimal, there were few Indigenous staff and processes for linking Indigenous patients into CR services at discharge were suboptimal. Many CR services are private and others operate for very limited hours and see very few Aboriginal clients. Of public CR services, many were unaware of the NHMRC guidelines and no mainstream service had fully implemented its recommendations. Workforce turnover and capacity issues severely constrain efforts to improve CR service delivery. Conclusions: Substantial deficits were identified in linking Aboriginal people post cardiac event into CR services that offer a comprehensive approach to reduce subsequent cardiac events and hospitalisation. Alternative approaches are needed. We recommend further development of CR partnerships between Aboriginal and mainstream services. Programs with a focus on cardiovascular risk reduction should be an important component of the government focus on improving self-management and strengthening community based care for chronic disease
Creative Commons License el 1955 Torino si presentava come una piccola città di provincia, ma negli anni successivi la sua fisionomia fu trasformata dall'espansione della Fiat, che divenne il volano dello sviluppo economico italiano. La città assistette ad una dilatazione che fu "spontanea" nelle forme in cui si realizzò, ma non nelle cause, frutto di precise scelte industriali riconducibili ad una specifica direzione aziendale 1. Dal 1953, la fabbrica di automobili investì nella catena di
This paper aims at chronicle the relations between catholic workers movement and immigration from Southern Italy. The point of view is Turin during the ‘60s. It underlines the interest showed by Cisl and Acli concerning that phenomenon. It underscore evolution in Cisl's interpretative paradigms and Acli's increasing criticism towards consumerism. It shows the relations between action for integration of immigrants, will of attract them and interest in studying factory and urban changes. The thesis of this essay is that different ideological traditions could come closer resting upon the approach of trade unions to inner migration and socio-urban analysis and that the job actions of the '70s will be based on this refreshed unity.
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