These include, but are not limited to: local Indigenous management bodies: Several successful programs have established Indigenous management bodies e. These bodies were responsible for any major decisions relating to a program or intervention and were successful at acting as conduits for community perspectives, liaising with government agencies Campbell et al.
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Source: Smith et al. Box 3: Dhimurru Land Management Aboriginal Corporation Dhimurru Land Management Aboriginal Corporation Dhimurru is an Indigenous not-for-profit community-based organisation that is committed to sustainable management of traditional lands near Nhulunbuy in the Northern Territory. Source: Dhimurru , ; Hoffmann et al. Box 4: A community-managed program using a community development approach The Warlpiri Education and Training Trust uses Indigenous royalties to support education and training programs in the Central Australian communities of Yuendumu, Lajamanu, Willowra and Nyirrpi.
Source: Hunt ; Kelly Barriers to successful Indigenous community management Numerous studies indicate a range of barriers to Indigenous communities being able to successfully manage their own programs and services. Internal factors include: Indigenous community organisations lacking the human capital and capacity that underwrites economic development e. Conclusion This paper indicates many Indigenous organisations are successfully managing programs and services for their communities. Further reading The table below contains a list of selected research and evaluations that were the key pieces of evidence used in this paper.
Indigenous men taking their rightful place in society? Beyond bandaids: Exploring the underlying social determinants of Aboriginal health Campbell D. Community development interventions to improve Aboriginal health: Building an evidence base Campbell, D. Organising for success: Policy report. Achieving highly successful multiple agency collaborations in a cross-cultural environment: Experiences and lessons from Dhimurru Aboriginal Corporation and partners Hoffmann, B. Improving Indigenous community governance through strengthening Indigenous and government organisational capacity Tsey, K.
Australian Bureau of Statistics.
ABS cat. Canberra: ABS. Successful strategies in Indigenous organisations. Biddle, N. Bin-Sallik, M. Australian Journal of Indigenous Education, 32, Burchill, M. Family Matters, 75, Campbell, D. Community development interventions to improve Aboriginal health: Building an evidence base.
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Health Sociology Review, 16 , Community development and empowerment: A review of interventions to improve Aboriginal health. Anderson, F. Bentley Eds. Beyond bandaids: Exploring the underlying social determinants of Aboriginal health Chapter 9. Campbell, L. Walpiri Elders work with petrol sniffers. Indigenous Law Bulletin, 5 9 , Central Land Council. The Central Land Council community development framework. Alice Springs: Central Land Council. Couzos, S. Ethnicity and Health, 10 2 , Department of Social Services. Canberra: Department of Social Services.
Dhimurru Aboriginal Corporation. Annual report Nhulunbuy: Dhimurru. Dodson, M. Foley, D. Jus Sanguinis: The root of contention in determining what is an Australian Aboriginal business.
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Indigenous Law Bulletin, 8 8 , Furneaux, C. Australian Indigenous entrepreneurship: A capital-based view. International Journal of Entrepreneurship and Innovation, 9 2 , Community development approaches to safety and wellbeing of Indigenous children Resource Sheet no. Produced for the Closing the Gap Clearinghouse. Hoffmann, B. Achieving highly successful multiple agency collaborations in a cross-cultural environment: Experiences and lessons from Dhimurru Aboriginal Corporation and partners.
Ecological Management and Restoration, 13 1 , Hunt, J.
Hunter, B. Kelly, L. Kenny, S. Developing communities for the future 4th edn. Melbourne: Cengage Learning. Mansuri, G. By confronting and understanding them, we are better able to ameliorate any inappropriate behavior. The mind is a wonderful servant, but a poor master.
Go into your heart space for the most accurate information. There is an evolutionary process that seems to seek the higher good.
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And, in the end, we often find that which we resisted most eventually produced incredibly positive results. This article is written by Ione Jenson, an educator and counselor in both public and private school systems. She was also an owner and director of a Holistic Retreat and Spiritual Counseling Center for over 23 years.
Available at book stores and Amazon. Notes: a Intraclass coefficient correlation; b kappa index. Figure 2 Correlation between standard screening and self-screening measures of cardiovascular risk. Figure 3 Distribution of participants by cardiovascular risk category according to standard screening and self-screening results.
The likelihood ratio for a positive test The diagnostic accuracy was also high, pointing out a marked proportion of correctly classified subjects. The estimation of cardiovascular risk is acknowledged as the first step in cardiovascular prevention, enabling application of the most efficient preventive strategy in each individual. The innovative self-screening method proposed empowers the individual to measure and record the eight health variables blood pressure, lipid profile, glycated hemoglobin, age, sex, tobacco consumption, diabetes required to assess cardiovascular risk, with minimal supervision by a health professional.
As results obtained were similar to the gold-standard clinical method, healthy people who do not frequent clinical settings could increase their awareness and avoid preventable cardiovascular disease by conducting their own risk assessment at their convenience. Population empowerment is considered a key principle of health promotion by the World Health Organization. This focus on lifestyle choices and personal responsibility has the potential to change how healthy people avoid preventable cardiovascular diseases as well as other chronic diseases and could indirectly promote choices of healthful activities.
Recent reports have identified two approaches, improvement of individual patient skills and transfer of power and decision-making authority about interventions to patients, as effective empowerment strategies. As in previous studies, lifetime risk increased exponentially after 55 years of age according to the number of cardiovascular risk factors above the recommended levels. Our solution could be used together with usual office consultation and remote patient monitoring to implement a health care model including personalized health care delivery with an early diagnosis and treatment if needed.
Although our self-screening method is not the first to be described in the literature, 23 , 24 its novelty is the self-collection of objective variables e. Numerous innovations in health information technology are empowering individuals to assume a more active role in monitoring and managing their health and wellness, as well as their chronic conditions and therapeutic regimens. The present crossover clinical trial validates a new self-screening system that aims to empower individuals to assess their own cardiovascular risk.
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This device also could be used to estimate the risk of other chronic diseases such as cancer 34 — 36 or cognitive decline 37 in which the assessed comorbidities hypertension, diabetes, obesity, dyslipidemia play a crucial role. The added value of this validated procedure is the stratification of population risk, as users become aware about their own health and the most efficient strategies for preventing chronic diseases. Self-screening for cardiovascular risk yielded remarkable specificity and negative predictive values compared with the gold standard.
In addition, there was high concordance between methods in the estimated cardiovascular risk category. Risk estimation is considered the best tool to prioritize primary prevention strategies. Participants were randomized to one of two sequences of risk assessment i.
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Selection bias may affect the present study, but is likely to be modest because it was population-based and participants were not selected on the basis of cardiovascular risk. Despite the availability of a cardiovascular risk score with no laboratory and blood pressure determinations that has been validated for the Spanish population, 39 we preferred to validate the self-screening procedure using the more accurate Framingham-REGICOR cardiovascular risk chart. However, we did not test whether the self-screening had an effect on health outcomes. Further randomized clinical trials should be performed to answer this question.
Finally, although our aim is to empower individuals to monitor their cardiovascular health, preferably at home, the blood capillary extraction and analysis must be supervised by a health care professional. Thus, the present version of the system must be implemented at a centralized location that is readily accessible to the target population e.
This self-screening system encourages users to take responsibility for their own health and well-being. Although health care professionals are ideally positioned to provide advice and education on risk factors and lifestyle modifications to people living with chronic conditions, a large part of the healthy population seldom visits a health care provider. Thus, a validated self-management system based on objective measurements empowers healthy people to avoid preventable cardiovascular and other chronic diseases. Our innovative method makes it possible to expand screening coverage to healthy populations, encouraging personal empowerment and increasing self-awareness of individual risk.
A feedback strategy could be combined with tailored lifestyle recommendations to improve adherence to healthier habits and encourage effective disease prevention strategies.