551
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Frommer DJ, Fernandes D, Pawar G, Goud R. Gastrointestinal amyloidosis in Australian indigenous patients. Intern Med J 2014; 44:605-9. [PMID: 24946817 DOI: 10.1111/imj.12450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/08/2014] [Indexed: 12/01/2022]
Abstract
This study documents the symptoms, racial distribution, pathological findings and outcomes of patients diagnosed with gastrointestinal amyloidosis in Alice Springs Hospital. In a 4 year retrospective survey. 9 patients, all indigenous, 7F/2M, had biopsy proven gastrointestinal amyloidosis. Four out of four patients tested were found to have AA amyloidosis. Presenting symptoms included diarrhoea, bloody in some, vomiting and abdominal pain. All but one had diabetes mellitus, type 2. Multiple infections were common and most patients had low serum albumin and transferrin concentrations but high serum ferritin concentrations. Five of the patients died, and the gastrointestinal symptoms of the remaining 4 remitted. Gastrointestinal amyloidosis should be included in the differential diagnosis of indigenous patients presenting with chronic diarrhoea, vomiting or abdominal pain. It carries a grave prognosis, is probably secondary to chronic infections but is potentially reversible.
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Affiliation(s)
- D J Frommer
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
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552
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Eckhoff C, Kvernmo S. Musculoskeletal pain in Arctic indigenous and non-indigenous adolescents, prevalence and associations with psychosocial factors: a population-based study. BMC Public Health 2014; 14:617. [PMID: 24939210 PMCID: PMC4071791 DOI: 10.1186/1471-2458-14-617] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/09/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Pain is common in otherwise healthy adolescents. In recent years widespread musculoskeletal pain, in contrast to single site pain, and associating factors has been emphasized. Musculoskeletal pain has not been examined in Arctic indigenous adolescents. The aim of this study was to explore the prevalence of widespread musculoskeletal pain and its association with psychosocial factors, with emphasis on gender- and ethnic differences (Sami vs. non-Sami), and the influence of pain related functional impairment. METHODS This is a cross-sectional study based on The Norwegian Arctic Adolescent Health Study; a school-based survey responded by 4,881 10th grade students (RR: 83%) in North Norway, in 2003-2005. 10% were indigenous Sami. Musculoskeletal pain was based on reported pain in the head, shoulder/neck, back and/or arm/knee/leg, measured by the number of pain sites. Linear multiple regression was used for the multivariable analyses. RESULTS The prevalence of musculoskeletal pain was high, and significantly higher in females. In total, 22.4% reported 3-4 pain sites. We found a strong association between musculoskeletal pain sites and psychosocial problems, with a higher explained variance in those reporting pain related functional impairment and in females. There were no major differences in the prevalence of musculoskeletal pain in Sami and non-Sami, however the associating factors differed somewhat between the indigenous and non-indigenous group. The final multivariable model, for the total sample, explained 21.2% of the variance of musculoskeletal pain. Anxiety/depression symptoms was the dominant factor associated with musculoskeletal pain followed by negative life events and school-related stress. CONCLUSIONS Anxiety/depression, negative life events, and school-related stress were the most important factors associated with musculoskeletal pain, especially in those reporting pain related functional impairment. The most important sociocultural aspect is the finding that the indigenous Sami are not worse off.
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Affiliation(s)
- Christian Eckhoff
- Department of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital North Norway, Tromsoe N-9038, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; The Artic University of Norway, Tromsoe N-9037, Norway
| | - Siv Kvernmo
- Department of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital North Norway, Tromsoe N-9038, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; The Artic University of Norway, Tromsoe N-9037, Norway
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553
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Marley JV, Kitaura T, Atkinson D, Metcalf S, Maguire GP, Gray D. Clinical trials in a remote Aboriginal setting: lessons from the BOABS smoking cessation study. BMC Public Health 2014; 14:579. [PMID: 24912949 PMCID: PMC4064520 DOI: 10.1186/1471-2458-14-579] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 06/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited evidence regarding the best approaches to helping Indigenous Australians to stop smoking. The composite analysis of the only two smoking cessation randomised controlled trials (RCTs) investigating this suggests that one-on-one extra support delivered by and provided to Indigenous Australians in a primary health care setting appears to be more effective than usual care in encouraging smoking cessation. This paper describes the lessons learnt from one of these studies, the Be Our Ally Beat Smoking (BOABS) Study, and how to develop and implement an integrated smoking cessation program. METHODS Qualitative study using data collected from multiple documentary sources related to the BOABS Study. As the project neared completion the research team participated in four workshops to review and conduct thematic analyses of these documents. RESULTS Challenges we encountered during the relatively complex BOABS Study included recruiting sufficient number of participants; managing the project in two distant locations and ensuring high quality work across both sites; providing appropriate training and support to Aboriginal researchers; significant staff absences, staff shortages and high workforce turnover; determining where and how the project fitted in the clinics and consequent siloing of the Aboriginal researchers relating to the requirements of RCTs; resistance to change, and maintaining organisational commitment and priority for the project. The results of this study also demonstrated the importance of local Aboriginal ownership, commitment, participation and control. This included knowledge of local communities, the flexibility to adapt interventions to local settings and circumstances, and taking sufficient time to allow this to occur. CONCLUSIONS The keys to the success of the BOABS Study were local development, ownership and participation, worker professional development and support, and operating within a framework of cultural safety. There were difficulties associated with the BOABS Study being an RCT, and many of these are shared with stand-alone programs. Interventions targeted at particular health problems are best integrated with usual primary health care. Research to investigate complex interventions in Indigenous health should not be limited to randomised clinical trials and funding needs to reflect the additional, but necessary, cost of providing for local control of planning and implementation.
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Affiliation(s)
- Julia V Marley
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, Western Australia 6725, Australia
| | - Tracey Kitaura
- Derby Aboriginal Health Service, 1 Stanley Street, PO Box 1155, Derby, Western Australia 6728, Australia
| | - David Atkinson
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, Western Australia 6725, Australia
| | - Sue Metcalf
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, Western Australia 6725, Australia
| | - Graeme P Maguire
- School of Medicine and Dentistry, James Cook University, Cairns, Queensland 4870, Australia
- Baker IDI, Alice Springs, Northern Territory 0871, Australia
| | - Dennis Gray
- National Drug Institute, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
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554
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Copeland J, Allsop D. Dedicated 'cannabis only' treatment clinics in New South Wales, Australia: client and treatment characteristics and associations with first-time treatment seeking. Drug Alcohol Rev 2014; 33:565-71. [PMID: 24902861 DOI: 10.1111/dar.12166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/05/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND AIMS Over the past decade, there has been significant investment in dedicated cannabis-only treatment clinics in New South Wales. This study aims to describe the characteristics of clients and compares first-time treatment seeking history and treatment completion rates between dedicated and non-dedicated clinics. DESIGN AND METHODS An observational study of administrative information from 209,012 drug and alcohol treatment episodes from services reporting to the New South Wales Alcohol and Other Drug Treatment Services Minimum Dataset, July 2003-June 2008. RESULTS Across all episodes, cannabis was the second most prevalent primary drug of concern (17.8%, n = 37,242). The majority of clients primarily seeking treatment for cannabis were male (69.4%, 26,088), with a mean age of 29 years. Counselling was the most common cannabis treatment (34.1%, n = 12,713), with 11.6% (n = 1476) of those receiving counselling having done so at a cannabis clinic. Those treated in cannabis clinics were older (30.12 years vs. 27.95 years; P < 0.0001); had shorter episode durations (10.95 weeks vs. 12.71 weeks; P < 0.0001); and were more likely to be naïve to treatment (53.7% vs. 47.7%; P < 0.0001). Indigenous Australian treatment seekers were more likely to complete cannabis treatment in a dedicated cannabis clinic (49.6%) than in a non-dedicated clinic (40.5%; P < 0.05). DISCUSSION AND CONCLUSION Cannabis clinics have attracted groups traditionally difficult to attract and retain in treatment. As the cohort of daily cannabis users age, it is important that service models are attractive to older clients, new to treatment. Rigorous, prospective research examining client treatment outcomes are now warranted.
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Affiliation(s)
- Jan Copeland
- National Cannabis Prevention and Information Centre, UNSW Medicine, University of New South Wales, Sydney, Australia
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555
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Lemos EF, Alves AMDS, Oliveira GDC, Rodrigues MP, Martins NDG, Croda J. Health-service performance of TB treatment for indigenous and non-indigenous populations in Brazil: a cross-sectional study. BMC Health Serv Res 2014; 14:237. [PMID: 24885134 PMCID: PMC4049501 DOI: 10.1186/1472-6963-14-237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 05/07/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Health-service evaluation studies are fundamental for proposing interventions and ensuring improvements in healthcare quality. The present study assesses the performance of health services for indigenous and non-indigenous populations with regard to tuberculosis (TB) control. METHODS Interviews with TB patients who underwent treatment between 2009 and 2011 were conducted using the Primary Care Assessment Tool adapted for TB care in Brazil. RESULTS Primary healthcare (PHC) was the first treatment for most patients at symptom onset, and the diagnoses were typically performed by specialized services. Many patients experienced delayed TB diagnoses that required more than three medical appointments (51% and 47% for indigenous and non-indigenous populations, respectively). Indigenous people received social support, such as basic-needs grocery packages (2.19 ± 1.63 vs. 1.13 ± 0.49 for non-indigenous people, p < 0.01) and home visits from health professionals, with an emphasis on the performance of directly observed treatment strategies (DOT; 4.57 ± 0.89 vs. 1.68 ± 1.04 for non-indigenous people, p < 0.01). CONCLUSIONS Regardless of the differences between indigenous and non-indigenous populations, the time needed to receive a TB diagnosis was unsatisfactory for both groups. Furthermore, DOT must be performed with better coverage among non-indigenous patients.
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Affiliation(s)
- Everton Ferreira Lemos
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil
| | - Aline Mara da Silva Alves
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil
| | - Giovana de Castro Oliveira
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil
| | - Marcella Paranhos Rodrigues
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil
| | - Natália Daiane Garoni Martins
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil
| | - Julio Croda
- Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados – Itaúm. Km 12, Dourados, Mato Grosso do Sul 79804-970, Brazil
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556
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Bailie RS, Stevens M, McDonald EL. Impact of housing improvement and the socio-physical environment on the mental health of children's carers: a cohort study in Australian Aboriginal communities. BMC Public Health 2014; 14:472. [PMID: 24885617 PMCID: PMC4060879 DOI: 10.1186/1471-2458-14-472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mental health of carers is an important proximate factor in the causal web linking housing conditions to child health, as well as being important in its own right. Improved understanding of the nature of the relationships between housing conditions, carer mental health and child health outcomes is therefore important for informing the development of housing programs. This paper examines the relationship between the mental health of the carers of young children, housing conditions, and other key factors in the socio-physical environment. METHODS This analysis is part of a broader prospective cohort study of children living in Aboriginal communities in the Northern Territory (NT) of Australia at the time of major new community housing programs. Carer's mental health was assessed using two validated scales: the Affect Balance scale and the Brief Screen for Depression. The quality of housing infrastructure was assessed through detailed surveys. Secondary explanatory variables included a range of socio-environmental factors, including validated measures of stressful life events. Hierarchical regression modelling was used to assess associations between outcome and explanatory variables at baseline, and associations between change in housing conditions and change in outcomes between baseline and follow-up. RESULTS There was no clear or consistent evidence of a causal relationship between the functional state of household infrastructure and the mental health of carers of young children. The strongest and most consistent associations with carer mental health were the measures of negative life events, with a dose-response relationship, and adjusted odds ratio of over 6 for carers in the highest stress exposure category at baseline, and consistent associations in the follow up analysis. CONCLUSIONS The findings highlight the need for housing programs to be supported by social, behavioral and community-wide environmental programs if potential health gains are to be more fully realized, and for rigorous evaluation of such programs for the purpose of informing future housing initiatives.
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Affiliation(s)
- Ross S Bailie
- Menzies School of Health Research, Charles Darwin University, Tiwi, Darwin, Australia
| | - Matthew Stevens
- Menzies School of Health Research, Charles Darwin University, Tiwi, Darwin, Australia
| | - Elizabeth L McDonald
- Menzies School of Health Research, Charles Darwin University, Tiwi, Darwin, Australia
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557
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Marjerrison S, Pole JD, Sung L. Inferior survival among Aboriginal children with cancer in Ontario. Cancer 2014; 120:2751-9. [PMID: 24824592 DOI: 10.1002/cncr.28762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/17/2014] [Accepted: 04/01/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pediatric cancer distribution and outcomes have not been examined in Canadian Aboriginal children. The objective of this study was to describe the distribution, event-free survival, and overall survival of Aboriginal children with malignancies who reside in Ontario compared with non-Aboriginal children. METHODS This population-based study included 10,520 Ontario children (aged <18 years) who were diagnosed with cancer between 1985 and 2011. Patients were identified from the Pediatric Oncology Group of Ontario Networked Information System database. Aboriginal children were identified by self-reported ethnicity or postal code on a Native reserve at diagnosis. Descriptive statistics of the patients were presented and compared using the Fisher exact test. Event-free and overall survival probabilities were calculated for Aboriginal and non-Aboriginal children, described using Kaplan-Meier curves, and compared using log-rank tests. RESULTS In total, 65 Aboriginal children and 10,364 non-Aboriginal children with malignancy were identified. The distribution of malignancy type was similar between the 2 groups. There were no significant differences in baseline characteristics, presence of metastatic disease, or treatment approach (clinical trial, standard of care, or individualized protocol) between the groups. The 5e-year event-free survival rate (± standard error) was 56.3% ± 6.2% among Aboriginal children versus 72.8% ± 0.4% among non-Aboriginal children (P = .0042), and the 5-year overall survival rate was 64% ± 6.0% versus 79.3 ± 0.4% (P = .0017), respectively. The cause of death did not vary according to Aboriginal ethnicity. CONCLUSIONS Survival was significantly inferior among Aboriginal children who had cancer compared with non-Aboriginal children who had cancer in Ontario. Future studies are required to define the etiology of this disparity, evaluate the issue nationally, and create interventions to improve outcomes for Aboriginal children.
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Affiliation(s)
- Stacey Marjerrison
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
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558
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Parker S, McKinnon L, Kruske S. 'Choice, culture and confidence': key findings from the 2012 having a baby in Queensland Aboriginal and Torres Strait Islander survey. BMC Health Serv Res 2014; 14:196. [PMID: 24884930 PMCID: PMC4012088 DOI: 10.1186/1472-6963-14-196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 04/28/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To describe the maternity care experiences of Aboriginal and/or Torres Strait Islander women in Queensland, Australia and to identify areas for policy and practice improvements. METHODS A culturally-tailored survey requesting both quantitative and qualitative information was completed by respondents either independently (online or in hard copy) or with the assistance of a trained peer-interviewer. Data were analysed using descriptive statistics and thematic analysis.Eligible women were over 16 years of age, identified as Aboriginal and/or Torres Strait Islander, resided in Queensland, and had a live, singleton birth between the first of July 2011 and the first of July 2012. RESULTS 187 women of 207 respondents were included in analyses. Women reported high rates of stressful life events in pregnancy, low levels of choice in place of birth and model of care and limited options to carry out cultural practices. High levels of confidence in parenting were also reported. Women were less likely to report being treated with kindness, understanding and respect by maternity care staff than women answering a similar mainstream survey. CONCLUSIONS Aboriginal and Torres Strait Islander women have additional needs to mainstream Australian women. This study identified a number of recommendations to improve services including the need to enhance the cultural competence of maternity services; increase access to continuity of midwifery care models, facilitate more choices in care, work with the strengths of Aboriginal and Torres Strait Islander women, families and communities, and engage women in the design and delivery of care.
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Affiliation(s)
- Susan Parker
- Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Australia
| | - Loretta McKinnon
- Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Australia
| | - Sue Kruske
- Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Australia
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559
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Durey A, Wynaden D, O'Kane M. Improving forensic mental health care to Indigenous Australians: theorizing the intercultural space. J Psychiatr Ment Health Nurs 2014; 21:296-302. [PMID: 23981233 DOI: 10.1111/jpm.12105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2013] [Indexed: 11/29/2022]
Abstract
This paper uses the 'intercultural space' as an educational strategy to prepare nurses to work respectfully with Indigenous patients in a forensic mental health context; offers an educational approach that introduces nurses to Indigenous knowledge, beliefs and values, examines power relations in colonized countries between the dominant white cultural group and the Indigenous population and encourages nurses to critically reflect on their health care practice; and explores the intercultural space as a shared space between cultures fostering open and robust inquiry where neither culture dominates and new positions, representations and understandings can emerge. Given the disproportionately high number of Indigenous people imprisoned in colonized countries, this paper responds to research from Western Australia on the need to prepare forensic mental health nurses to deliver care to Indigenous patients with mental health disorders. The paper highlights the nexus between theory, research and education that can inform the design and implementation of programmes to help nurses navigate the complex, layered and contested 'intercultural space' and deliver culturally safe care to Indigenous patients. Nurses are encouraged to critically reflect on how beliefs and values underpinning their cultural positioning impact on health care to Indigenous patients. The paper draws on intercultural theory to offer a pedagogical framework that acknowledges the negative impacts of colonization on Indigenous health and well-being, repositions and revalues Indigenous cultures and knowledges and fosters open and robust inquiry. This approach is seen as a step towards working more effectively in the intercultural space where ultimately binary oppositions that privilege one culture over another and inhibit robust inquiry are avoided, paving the way for new, more inclusive positions, representations and understandings to emerge. While the intercultural space can be a place of struggle, tension and ambiguity, it also offers deep potential for change.
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Affiliation(s)
- A Durey
- School of Nursing and Midwifery, Curtin University, Perth, WA, Australia
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560
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Gribble MO, Around Him DM. Ethics and Community Involvement in Syntheses Concerning American Indian, Alaska Native, or Native Hawaiian Health: A Systematic Review. AJOB Empir Bioeth 2014; 5:1-24. [PMID: 25089283 DOI: 10.1080/21507716.2013.848956] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The objective of the research was to review reporting of ethical concerns and community involvement in peer-reviewed systematic reviews or meta-analyses concerning American Indian, Alaska Native, or Native Hawaiian (AI/AN/NH) health. METHODS Text words and indexed vocabulary terms were used to query PubMed, Embase, Cochrane Library, and the Native Health Database for systematic reviews or meta-analyses concerning AI/AN/NH health published in peer-reviewed journals, followed by a search through reference lists. Each article was abstracted by two independent reviewers; results were discussed until consensus was reached. RESULTS We identified 107 papers published from 1986-2012 that were primarily about AI/AN/NH health or presented findings separately for AI/AN/NH communities. Two reported seeking indigenous reviewer feedback; none reported seeking input from tribes and communities. Approximately 7% reported on institutional review board (IRB) approval of included studies, 5% reported on tribal approval, and 4% referenced the sovereignty of AI/AN tribes. Approximately 63% used evidence from more than one AI/AN/NH population study, and 28% discussed potential benefits to communities from the synthesis research. CONCLUSIONS Reporting of ethics and community involvement are not prominent. Systematic reviews and meta-analyses making community-level inferences may pose risks to communities. Future systematic reviews and meta-analyses should consider ethical and participatory dimensions of research.
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Affiliation(s)
- Matthew O Gribble
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Deana M Around Him
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health
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561
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Brock E, Charlton KE, Yeatman H. Identification and evaluation of models of antenatal care in Australia--a review of the evidence. Aust N Z J Obstet Gynaecol 2014; 54:300-11. [PMID: 24708182 DOI: 10.1111/ajo.12210] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 03/08/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Antenatal care has been routine practice throughout the world since early in the 20th century, and in most developed countries, antenatal care consists of a scheduled program of individual consultations with a healthcare practitioner, using a doctor or midwife. Women seek antenatal care that provides a physical review of the health and development of their unborn baby, the reassurance and ability to be listened to and the opportunity for their partner to be involved in their care. AIMS To identify the types of antenatal care services that are available to Australian women and investigate the views and opinions of Australian women related to these services. MATERIALS AND METHODS A systematic literature review using Scopus and Medline databases was used to find appropriate journal articles in January 2013. Articles were restricted to those in the Australian setting from the past 10 years with a focus on different models of antenatal care and the views and experiences of women during their antenatal care. RESULTS Eighteen relevant peer-reviewed journal articles were included. Emerging forms of antenatal care that are showing increasing levels of satisfaction from Australian women include continuity of carer, the midwifery-led care and group- or community-led care. These approaches are proving to be safe and successful. CONCLUSION Newer models of antenatal care in Australia may offer benefits over standard practice.
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Affiliation(s)
- Erin Brock
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
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562
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Calabria B, Clifford A, Rose M, Shakeshaft AP. Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery. BMC Public Health 2014; 14:322. [PMID: 24708838 PMCID: PMC3996136 DOI: 10.1186/1471-2458-14-322] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 03/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians' notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. METHODS Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. RESULTS Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. CONCLUSIONS The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of health care providers in CRA and CRAFT and the establishment of a local training and certification program.
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Affiliation(s)
- Bianca Calabria
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia
| | - Anton Clifford
- School of Population Health, University of Queensland, Brisbane, Australia
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563
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Servan-Mori E, Torres-Pereda P, Orozco E, Sosa-Rubí SG. An explanatory analysis of economic and health inequality changes among Mexican indigenous people, 2000-2010. Int J Equity Health 2014; 13:21. [PMID: 24576113 PMCID: PMC3996059 DOI: 10.1186/1475-9276-13-21] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 02/19/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mexico faces important problems concerning income and health inequity. Mexico's national public agenda prioritizes remedying current inequities between its indigenous and non-indigenous population groups. This study explores the changes in social inequalities among Mexico's indigenous and non-indigenous populations for the time period 2000 to 2010 using routinely collected poverty, welfare and health indicator data. METHODS We described changes in socioeconomic indicators (housing condition), poverty (Foster-Greer-Thorbecke and Sen-Shorrocks-Sen indexes), health indicators (childhood stunting and infant mortality) using diverse sources of nationally representative data. RESULTS This analysis provides consistent evidence of disparities in the Mexican indigenous population regarding both basic and crucial developmental indicators. Although developmental indicators have improved among the indigenous population, when we compare indigenous and non-indigenous people, the gap in socio-economic and developmental indicators persists. CONCLUSIONS Despite a decade of efforts to promote public programs, poverty persists and is a particular burden for indigenous populations within Mexican society. In light of the results, it would be advisable to review public policy and to specifically target future policy to the needs of the indigenous population.
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Affiliation(s)
- Edson Servan-Mori
- National Institute of Public Health, Avenue Universidad 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, Mexico
| | - Pilar Torres-Pereda
- National Institute of Public Health, Avenue Universidad 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, Mexico
| | - Emanuel Orozco
- National Institute of Public Health, Avenue Universidad 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, Mexico
| | - Sandra G Sosa-Rubí
- National Institute of Public Health, Avenue Universidad 655, Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, Mexico
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564
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Anticona C, San Sebastian M. Anemia and malnutrition in indigenous children and adolescents of the Peruvian Amazon in a context of lead exposure: a cross-sectional study. Glob Health Action 2014; 7:22888. [PMID: 24560254 PMCID: PMC3925814 DOI: 10.3402/gha.v7.22888] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/13/2014] [Accepted: 01/15/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Indigenous children and adolescents of the Peruvian Amazon live in precarious conditions that could increase the risk of malnutrition. A particular problem in the Corrientes river communities is the high exposure to lead among children and adolescents. OBJECTIVE This study aimed to determine the nutritional status of children and adolescents in indigenous communities in the Corrientes river basin and examine risk factors for anemia, stunting, underweight, and wasting. DESIGN This was a cross-sectional assessment in children and adolescents aged 0-17 years from six communities (n=330). Data collection included measurement of hemoglobin levels, anthropometrics, blood lead levels (BLLs); a parental questionnaire including demographic and dwelling information; parents' occupation; and the child's duration of breastfeeding and food consumption. Analysis included univariate, bivariate, and logistic regression. RESULTS Overall, anemia prevalence was 51.0%, stunting (proxy for chronic malnutrition) 50.0%, and underweight 20.0%. Bivariate analysis showed that anemia and underweight prevalence was higher in the 0-4 years group (p<0.05). No association was found between anemia, stunting, or underweight with gender, community exposure to oil activity, or consumption of river water. Stunting prevalence was higher in the group whose BLLs were >5 µg/dL (p<0.05). In the logistic regression analysis, no variable was associated with anemia or underweight. The group 5-11 years and >12 years had 1.9 and 3.1 times higher risk of stunting than the group under five years, respectively. Children and adolescents with BLLs >5 µg/dL had twice the risk of stunting compared to those with lower BLLs. CONCLUSIONS Half of the study population was found with anemia and stunting. Anemia was more prevalent in the 0- to 5-year age group and stunting in the 12- to 17-year group. The association between stunting and BLLs might be attributed to a direct effect of lead on human growth. Also, poor nutrition and other socioeconomic-related factors may contribute to the simultaneous existence of stunting and elevated BLLs.
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Affiliation(s)
- Cynthia Anticona
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Fundación Cayetano Heredia, Casa Honorio Delgado, Lima, Perú;
| | - Miguel San Sebastian
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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565
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Abstract
OBJECTIVE To describe the design, implementation and outcomes of an innovative model for the early detection of mental illness among rural Aboriginal men. METHOD Through a collaborative effort between a University' Department of Rural and Indigenous Health, an Aboriginal organisation and a regional mental health service, an all-male team was set up which consisted of a doctor, a mental health nurse and four key individuals from the local Aboriginal community. Invitations to attend a Koorie Men's Health Day were distributed via flyers and posters. Using an assembly line technique and avoiding any reference to the term 'mental', all participants underwent a complete medical examination, a blood test for diabetes and a psychological assessment using the Kessler-10 schedule. RESULTS The event was attended by 20 men. Of the 17 participants whose data were available, seven scored significantly (25 or higher) on the psychological assessment and were offered follow-up. CONCLUSIONS When conducted on a regular basis, the Koorie Men's Health Day could be a useful method for the early detection of mental illness among rural Aboriginal men in Australia. Further research is needed to study the feasibility and sustainability of the model in different settings.
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Affiliation(s)
- Anton Isaacs
- Lecturer, Indigenous Health Unit, Department of Rural and Indigenous Health, Monash University, Moe, VIC, Australia
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Moore SP, Forman D, Piñeros M, Fernández SM, de Oliveira Santos M, Bray F. Cancer in indigenous people in Latin America and the Caribbean: a review. Cancer Med 2014; 3:70-80. [PMID: 24403278 PMCID: PMC3930391 DOI: 10.1002/cam4.134] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/20/2013] [Accepted: 08/17/2013] [Indexed: 12/29/2022] Open
Abstract
Cancer is a leading cause of death in Latin America but there have been few assessments of the cancer burden for the 10% of the population who are indigenous. Evidence from other world regions suggests cancer survival is poorer for indigenous people than for others due to a greater incidence of case-fatal cancers, later stage at diagnosis, and less cancer treatment. A status report on the cancer profile of indigenous people in Latin America and the Caribbean (LAC) is therefore clearly warranted. We undertook a systematic review of the peer-reviewed literature in academic databases, and considered evidence from cancer registries from 1980, to assess cancer epidemiology among indigenous people in LAC. We identified 35 peer-reviewed articles pertaining to cancer in indigenous people. Rates of cervical cancer in parts of Brazil, Ecuador, and Guyana, stomach cancer rates in regions of Chile and gallbladder rates in Chile and Bolivia, were higher for indigenous compared to others. Breast cancer rates were lower in Ecuador, Brazil, and Chile. Six cancer registries in Brazil provided incidence data but no other reports of incidence, mortality, or survival were identified. There was a paucity of data surrounding the cancer burden of indigenous people in LAC. In view of predicted increases in cancer rates in ensuing decades, and the disparities in burden already experienced by indigenous people in the region, it is imperative that cancer profiles are obtained and cancer control measures identified and prioritized.
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567
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Abstract
American Indians must negotiate the cultural and psychological legacy of colonialism as they construct coherent, purposive individual and communal narratives. Analysis of the life stories of highly generative members of these groups who have emerged as leaders offers important insights for psychological adaptation in the context of the historical legacy of colonialism. Based on an interpretive analysis of the life stories of two California Indian tribal leaders, we posit a resilient-strength-based approach to narrative identity development to complement and counter the historical trauma discourse. Native American identity emerged as the major source of psychological resilience in the life stories analyzed. This identity manifested and was supported through a commitment to the wellness of tribal community, spiritual practices, and beliefs. For these men, their relationship to their grandmothers was central in molding their identities and serving as a source of resilience throughout their lives. As leaders of a federally unrecognized tribal group, they have adopted a narrative of survivance (Vizenor, 2008), which appears to buffer psychosocial stress and provide a resilient narrative identity. Based on these findings, we theorize an indigenous California Native psychology of resilience.
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568
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Abstract
BACKGROUND Anxiety and depressive disorders occur in all stages of life and are the most common childhood disorders. However, only recently has attention been paid to mental health problems in indigenous children and studies of anxiety and depressive disorders in these children are still scarce. This study compares the prevalence of anxiety and depressive symptoms in Aymara and non-Aymara children. Among the Aymara children, the study examines the relations between these symptoms and the degree of involvement with Aymara culture. METHODS We recruited 748 children aged 9 to 15 years from nine schools serving low socioeconomic classes in the city of Arica, in northern Chile. The children were equally divided between boys and girls and 37% of the children were Aymara. To evaluate anxiety and depressive symptoms we used the Stress in Children (SiC) instrument and the Children Depression Inventory-Short version (CDI-S), and used an instrument we developed to assess level of involvement in the Aymara culture. RESULTS There was no significant difference between Aymara and non-Aymara children on any of the instrument scales. Dividing the Aymara children into high-involvement (n = 89) and low-involvement (n = 186) groups, the low-involvement group had significantly higher scores on the Hopelessness subscale of the CDI-S (p = 0.02) and scores of marginally higher significance in overall Anxiety on the SiC (p = 0.06). CONCLUSIONS Although Aymara children have migrated from the high Andean plateau to the city, this migration has not resulted in a greater presence of anxiety and depressive symptoms. Greater involvement with the Aymara culture may be a protective factor against anxiety and depressive symptoms in Aymara children. This point to an additional benefit of maintaining cultural traditions within this population.
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Affiliation(s)
- Alejandra Caqueo-Urízar
- Departamento de Filosofía y Psicología, Universidad de Tarapacá, Avenida 18 de Septiembre #2222, Arica, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Avenida Angamos, 0610 Antofagasta, Chile
| | - Koen De Munter
- Departamento de Antropología, Universidad Alberto Hurtado, Cienfuegos 41, Santiago, Chile
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569
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Lavoie JG. Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy. Int J Circumpolar Health 2013; 72:22690. [PMID: 24380077 PMCID: PMC3875351 DOI: 10.3402/ijch.v72i0.22690] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/25/2013] [Accepted: 11/03/2013] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? METHODS The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. RESULTS The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. CONCLUSION Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.
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Affiliation(s)
- Josée G Lavoie
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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570
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Glover M, Bosman A, Wagemakers A, Kira A, Paton C, Cowie N. An innovative team-based stop smoking competition among Māori and Pacific Island smokers: rationale and method for the study and its evaluation. BMC Public Health 2013; 13:1228. [PMID: 24365329 PMCID: PMC3882284 DOI: 10.1186/1471-2458-13-1228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 12/16/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Māori and Pacific Island people have significantly higher smoking rates compared to the rest of the New Zealand population. The main aim of this paper is to describe how knowledge of Indigenous people's practices and principles can be combined with proven effective smoking cessation support into a cessation intervention appropriate for Indigenous people. METHODS/DESIGN A literature review was conducted to identify what cultural principles and practices could be used to increase salience, and what competition elements could have an impact on efficacy of smoking cessation. The identified elements were incorporated into the design of a cessation intervention. DISCUSSION Cultural practices incorporated into the intervention include having a holistic family or group-centred focus, inter-group competitiveness, fundraising and ritual pledging. Competition elements included are social support, pharmacotherapy use, cash prize incentives and the use of a dedicated website and iPad application. A pre-test post-test will be combined with process evaluation to evaluate if the competition results in triggering mass-quitting, utilisation of pharmacotherapy and in increasing sustained smoking cessation and to get a comprehensive understanding of the way in which they contribute to the effect. The present study is the first to describe how knowledge about cultural practices and principles can be combined with proven cessation support into a smoking cessation contest. The findings from this study are promising and further more rigorous testing is warranted.
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Affiliation(s)
- Marewa Glover
- Centre for Tobacco Control Research, Social and Community Health, University of Auckland, Auckland, New Zealand
| | - Amber Bosman
- Master Health and Society, Wageningen University, Wageningen, Netherlands
| | - Annemarie Wagemakers
- Health and Society Group, Department of Social Sciences, Wageningen University, Wageningen, Netherlands
| | - Anette Kira
- Centre for Tobacco Control Research, Social and Community Health, University of Auckland, Auckland, New Zealand
| | - Chris Paton
- George Institute, University of Oxford, Oxford, UK
| | - Nathan Cowie
- Centre for Tobacco Control Research, Social and Community Health, University of Auckland, Auckland, New Zealand
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571
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Peters PA. An age- and cause decomposition of differences in life expectancy between residents of Inuit Nunangat and residents of the rest of Canada, 1989 to 2008. Health Rep 2013; 24:3-9. [PMID: 24363060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND This study quantifies differences in life expectancy between residents of Inuit Nunangat and people in the rest of Canada; estimates the contribution of specific causes of death to the differences; and examines these differences over time, by sex and by age group. DATA AND METHODS A geographic approach was used to decompose differences in life expectancy for residents of Inuit Nunangat, compared with people living outside this geographic area. Differences in life expectancy by cause, sex, and age group were calculated using the discrete method of decomposition and were applied to abridged life tables. Causes of death were classified according to Global Burden of Disease categories. Attributable causes of death were calculated for causes amenable to medical intervention and for smoking-related diseases. RESULTS The largest contributor to life expectancy differences between males in Inuit Nunangat and the rest of Canada was injury, particularly self-inflicted injury at ages 15 to 24. For females, the largest contributors were malignant neoplasm and respiratory disease at ages 65 to 79. INTERPRETATION The gap in life expectancy between residents of Inuit Nunangat and the rest of Canada can be attributed to specific groups of causes occurring within specific age ranges.
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Affiliation(s)
- Paul A Peters
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
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572
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Ijaz S, Said B, Boxall E, Smit E, Morgan D, Tedder RS. Indigenous hepatitis E in England and wales from 2003 to 2012: evidence of an emerging novel phylotype of viruses. J Infect Dis 2013; 209:1212-8. [PMID: 24273173 DOI: 10.1093/infdis/jit652] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Enhanced surveillance and molecular characterisation studies of hepatitis E virus (HEV) in England and Wales have been undertaken since 2003. The dynamics of hepatitis E have changed recently with an increase in the number of indigenous cases and an observed viral shift. METHODS HEV antibody and RNA data were analysed to ascertain the annual number of acute infections, the HEV genotype disposition and viral phylogeny. These data were investigated in the context of collected travel history and demographic data. RESULTS In total, 2713 acute hepatitis E cases were diagnosed, of which 1376 were indigenous infections. Travel associated cases remained steady and mainly associated with Genotype 1 infections. In contrast, major fluctuations were noted in indigenously-acquired cases with a dramatic year on year increase during 2010-2012. Molecular characterisation demonstrated indigenous infections to cluster into two distinct phylogenetic groups with the emergence of a novel group of Genotype 3 viruses coinciding with the recent increase in cases. CONCLUSIONS HEV infection rates are dynamic in England and Wales, influenced by changing trends in indigenously-acquired cases. The recent increase in indigenous cases and the emergence of indigenous viruses not commonly circulating prior to 2010 suggest that the risk of acquiring HEV has changed.
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Affiliation(s)
- Samreen Ijaz
- Blood Borne Virus Unit, MS-Colindale, Public Health England, London NW9 5EQ, United Kingdom
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573
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Pettersen T, Brustad M. Which Sámi? Sámi inclusion criteria in population-based studies of Sámi health and living conditions in Norway - an exploratory study exemplified with data from the SAMINOR study. Int J Circumpolar Health 2013; 72:21813. [PMID: 24282785 PMCID: PMC3838972 DOI: 10.3402/ijch.v72i0.21813] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 10/15/2013] [Accepted: 10/23/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In a situation where national censuses do not record information on ethnicity, studies of the indigenous Sámi people's health and living conditions tend to use varying Sámi inclusion criteria and categorizations. Consequently, the basis on which Sámi study participants are included and categorized when Sámi health and living conditions are explored and compared differs. This may influence the results and conclusions drawn. OBJECTIVE To explore some numerical consequences of applying principles derived from Norway's Sámi Act as a foundation for formalized inclusion criteria in population-based Sámi studies in Norway. DESIGN We established 1 geographically based (G1) and 3 individual-based Sámi example populations (I1-I3) by applying diverse Sámi inclusion criteria to data from 17 rural municipalities in Norway north of the Arctic Circle. The data were collected for a population-based study of health and living conditions in 2003-2004 (the SAMINOR study). Our sample consisted of 14,797 participants aged 36-79 years. RESULTS The size of the individual-based populations varied significantly. I1 (linguistic connection Sámi) made up 35.5% of the sample, I2 (self-identified Sámi) made up 21.0% and I3 (active language Sámi) 17.7%. They were also noticeably unevenly distributed between the 5 Sámi regions defined for this study. The differences for the other characteristics studied were more ambiguous. For the population G1 (residents in the Sámi language area) the only significant difference found between the Sámi and the corresponding non-Sámi population was for household income (OR=0.69, 95% CI: 0.63-0.74). For the populations I1-I3 there were significant differences on all measures except for I2 and education (OR=1.09, 95% CI: 0.99-1.21). CONCLUSIONS The choice of Sámi inclusion criterion had a clear impact on the size and geographical distribution of the defined populations but lesser influence on the selected characteristics for the Sámi populations relative to the respective non-Sámi ones.
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Affiliation(s)
- Torunn Pettersen
- Centre for Sámi Health Research, Department of Community Medicine, University of Tromsø, Norway ; Department of Social Sciences, Sámi University College, Guovdageaidnu/Kautokeino, Norway
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574
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Goraya K, Iqbal Z, Sajid MS, Muhammad G, Ain QU, Saleem M. Diversity of flora used for the cure of equine diseases in selected peri-urban areas of Punjab, Pakistan. J Ethnobiol Ethnomed 2013; 9:70. [PMID: 24283263 PMCID: PMC3851199 DOI: 10.1186/1746-4269-9-70] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 09/22/2013] [Indexed: 05/24/2023]
Abstract
BACKGROUND Plants have widely been used and documented for their therapeutic potential in many parts of the world. There are, however, few reports on the use of plants for the treatment of diseases of equines. To this end, participatory epidemiology and rapid rural appraisal techniques were used to document the plants having pharmacotherapeutic significance against different ailments of equines in selected population of Punjab, Pakistan. METHODS A survey was conducted to interview a total of 450 respondents (150 from each of the districts of Faisalabad, Lahore and Sargodha of Pakistan) to collect information about disease recognition of the equines and their treatment on a well - structured questionnaire. A total of 60 plants belonging to 40 families were documented. An inventory was developed depicting detailed information of plants used in treatment of different conditions of equines. RESULTS The top ten species of plants used were: Allium cepa, Zingiber officinale, Vernonia anthelmintica, Capsicum annum, Brassica campestris, Trachyspermum ammi, Anethum graveolens, Picrorhiza kurroa, Azadirachta indica, and Citrullus colocynthis. Seeds were the most frequently used (n = 16/60) parts, followed by leaves (n = 12/60) and fruits (n = 11/60) of plants. Based on the combination of different parts of plants used in different ratios and variation in their dose or mode of preparation led to a large number of recipes/remedies against wounds, lameness, bronchitis, colic, anorexia, dermatitis, weakness, parasitism (internal and external), fever, heat stress, urine retention, swelling, toxemia, and indigestion. CONCLUSIONS This study generated lot of data on phytomedicinal approach for the treatment of ailments in the equines in some selected areas. It would, therefore, be imperative to expand similar studies in other parts of Pakistan and elsewhere. Moreover, use of the documented plants may be validated employing standard scientific procedures, which may have their application in the drug discovery/development by the pharmaceutical industry.
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Affiliation(s)
- Khurram Goraya
- Department of Parasitology, University of Agriculture, Faisalabad 38040 Punjab, Pakistan
| | - Zafar Iqbal
- Department of Parasitology, University of Agriculture, Faisalabad 38040 Punjab, Pakistan
| | - Muhammad Sohail Sajid
- Department of Parasitology, University of Agriculture, Faisalabad 38040 Punjab, Pakistan
| | - Ghulam Muhammad
- Department of Veterinary Clinical Medicine and Surgery, University of Agriculture, Faisalabad 38040 Punjab, Pakistan
| | - Qurat ul Ain
- Department of Parasitology, University of Agriculture, Faisalabad 38040 Punjab, Pakistan
| | - Muhammad Saleem
- Brookes Hospital for Animals, Faculty of Veterinary Science, University of Agriculture, Faisalabad 38040 Punjab, Pakistan
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575
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Gates M, Hanning RM, Gates A, Isogai A, Tsuji LJS, Metatawabin J. A pilot comprehensive school nutrition program improves knowledge and intentions for intake of milk and milk alternatives among youth in a remote first nation. J Nutr Educ Behav 2013; 45:455-459. [PMID: 23414784 DOI: 10.1016/j.jneb.2012.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 10/20/2012] [Accepted: 12/03/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the impact of a pilot comprehensive school nutrition program modeled on Social Cognitive Theory on knowledge, intentions, self-efficacy, and intake of milk and milk alternatives (MMA) in First Nations youth. METHODS A pilot school nutrition program was implemented at Peetabeck Academy in Fort Albany, Ontario in May, 2010. The Knowledge, Self-Efficacy, and Intentions Questionnaire (KSIQ) and Waterloo Web-based Eating Behavior Questionnaire (WEB-Q) were used to assess change in attitudes and behavior from pre- to postprogram. RESULTS The KSIQ preprogram (n = 26), postprogram (n = 19); WEB-Q preprogram (n = 30), postprogram (n = 10). Improved knowledge (6.0 ± 1.5 vs. 6.9 ± 1.5, P = .05) and intention scores (9.6 ± 4.4 vs. 11.3 ± 4.1, P = .01) were observed. CONCLUSIONS AND IMPLICATIONS A comprehensive school nutrition program can improve knowledge and intentions for intake of MMA in First Nations youth. Environmental constraints beyond the school environment need to be addressed.
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Affiliation(s)
- Michelle Gates
- School of Public Health and Health Systems, University of Waterloo, Ontario, Canada.
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576
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Abstract
BACKGROUND The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown. OBJECTIVE To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control. METHODS A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide. RESULTS Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of <10/100000. New Zealand's Maori and Pacific Islanders had higher TB incidence rates than Australian Aborigines, but all were at greater risk of developing TB than non-indigenous groups. CONCLUSION Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.
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Affiliation(s)
- D Tollefson
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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577
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Abstract
Background The Alaska Native (AN) population has endured multiple historical traumatic events. This population has poorer health outcomes on nearly all factors compared with Alaska non-Natives with more than 75% reportedly being physically assaulted in their lifetime, and child sexual abuse nearly 6 times the national average. Objective This article describes the Pathway to Hope (PTH) program, which is an indigenous approach to ending silence and denial related to child sexual abuse and encourages multigenerational healing. Design PTH was developed by ANs who believe that each community is unique, thus strategies for ending denial and support for healing must be woven from the historical context, cultural strengths of individual communities. Strengths-based solutions built on truth, honesty, compassion and shared responsibility for healing and protecting today's children have been profound and successful. The PTH curriculum addresses child sexual abuse from a historical perspective; that the higher rates of sexual abuse among certain Tribes, regions and communities is linked in part to years of victimisation, but may also be perpetuated by internalised oppression and lateral violence among Tribal members. Results Data suggest that community-based dialogue and wisdom of Native elders and spiritual leaders paired with readiness of community service providers are necessary for sustained change. At all levels, this Indigenous model for learning, sharing, helping and healing brings hope for an end to denial and silence about child sexual abuse for Native people. Conclusion The PTH program utilises the wisdom and values that have sustained Native people for generations. Ending silence and denial about child sexual abuse and building upon strengths have assisted many Indigenous communities begin the journey toward wellness. Through the PTH, communities have taken steps to accept the challenges associated with establishing safety for children, supporting child victims in healing and to holding offenders accountable.
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Affiliation(s)
- Diane Payne
- Justice for Native Children, Chugiak, Alaska 99567-0818, USA.
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578
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Abstract
Background In preparation for the initial offering of the University of Alaska Fairbanks (UAF), Interior–Aleutians Campus Rural Nutrition Services (RNS) program, a literature review was conducted to establish the need for the proposed program and to substantiate the methodology for delivering integrated, culturally tailored postsecondary education and extension to Alaska Natives and rural Alaskans. There was a striking absence of peer-reviewed journal articles describing culturally tailored postsecondary health curricula for indigenous populations. Objective To complete and discuss a current (November 2012) literature review for culturally tailored postsecondary health curricula designed and delivered for indigenous populations. Methods/Design The author conducted an expanded online search that employed multiple configurations of key terms using Google and Google Scholar, as well as pertinent sources. The author located archived reports in person and contacted authors by email. Results The expanded search produced a modest amount of additional literature for review. A disappointing number of publications describing or evaluating culturally tailored postsecondary health curricula in mainstream institutions are available. Related resources on culturally tailored extension and resources for the development and delivery of culturally tailored nutrition and health curricula were identified. Conclusions The present results demonstrate a significant absence of literature on the topic, which may or may not indicate the absence of sufficient culturally tailored postsecondary health curricula for indigenous populations. There are indications that culturally tailored postsecondary health curricula for indigenous populations have the potential to effectively address certain issues of health literacy and health disparities.
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579
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Abstract
BACKGROUND Indigenous residents of Alaska's Bering Strait Region depend, both culturally and nutritionally, on ice seal and walrus harvests. Currently, climate change and resultant increases in marine industrial development threaten these species and the cultures that depend on them. OBJECTIVE To document: (a) local descriptions of the importance of marine mammal hunting; (b) traditional methods for determining if harvested marine mammals are safe to consume; and (c) marine mammal outcomes that would have adverse effects on community health, the perceived causes of these outcomes, strategies for preventing these outcomes and community adaptations to outcomes that cannot be mitigated. DESIGN Semi-structured interviews and focus groups were conducted with 82 indigenous hunters and elders from the Bering Strait region. Standard qualitative analysis was conducted on interview transcripts, which were coded for both inductive and deductive codes. Responses describing marine mammal food safety and importance are presented using inductively generated categories. Responses describing negative marine mammal outcomes are presented in a vulnerability framework, which links human health outcomes to marine conditions. RESULTS Project participants perceived that shipping noise and pollution, as well as marine mammal food source depletion by industrial fishing, posed the greatest threats to marine mammal hunting traditions. Proposed adaptations primarily fell into 2 categories: (a) greater tribal influence over marine policy; and (b) documentation of traditional knowledge for local use. This paper presents 1 example of documenting traditional knowledge as an adaptation strategy: traditional methods for determining if marine mammal food is safe to eat. CONCLUSIONS Participant recommendations indicate that 1 strategy to promote rural Alaskan adaptation to climate change is to better incorporate local knowledge and values into decision-making processes. Participant interest in documenting traditional knowledge for local use also indicates that funding agencies could support climate change adaptation by awarding more grants for tribal research that advances local, rather than academic, use of traditional knowledge.
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Affiliation(s)
- Lily Gadamus
- Natural Resources Division, Kawerak, Inc., Nome, Alaska AK-99762, USA.
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580
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Slater J, Larcombe L, Green C, Slivinski C, Singer M, Denechezhe L, Whaley C, Nickerson P, Orr P. Dietary intake of vitamin D in a northern Canadian Dené First Nation community. Int J Circumpolar Health 2013; 72:20723. [PMID: 23984265 PMCID: PMC3752286 DOI: 10.3402/ijch.v72i0.20723] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Increased awareness of the wide spectrum of activity of vitamin D has focused interest on its role in the health of Canada's Aboriginal peoples, who bear a high burden of both infectious and chronic disease. Cutaneous vitamin D synthesis is limited at northern latitudes, and the transition from nutrient-dense traditional to nutrient-poor market foods has left many Canadian Aboriginal populations food insecure and nutritionally vulnerable. OBJECTIVE The study was undertaken to determine the level of dietary vitamin D in a northern Canadian Aboriginal (Dené) community and to determine the primary food sources of vitamin D. DESIGN Cross-sectional study. METHODS Dietary vitamin D intakes of 46 adult Dené men and women were assessed using a food frequency questionnaire and compared across age, gender, season and body mass index. The adequacy of dietary vitamin D intake was assessed using the 2007 Adequate Intake (AI) and the 2011 Recommended Dietary Allowance (RDA) values for Dietary Reference Intake (DRI). RESULTS Mean daily vitamin D intake was 271.4 IU in winter and 298.3 IU in summer. Forty percent and 47.8% of participants met the vitamin D 1997 AI values in winter and summer, respectively; this dropped to 11.1 and 13.0% in winter and summer using 2011 RDA values. Supplements, milk, and local fish were positively associated with adequate vitamin D intake. Milk and local fish were the major dietary sources of vitamin D. CONCLUSIONS Dietary intake of vitamin D in the study population was low. Only 2 food sources, fluid milk and fish, provided the majority of dietary vitamin D. Addressing low vitamin D intake in this population requires action aimed at food insecurity present in northern Aboriginal populations.
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Affiliation(s)
- Joyce Slater
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Linda Larcombe
- Departments of Medical Microbiology, Medicine, and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Chris Green
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Caroline Slivinski
- Departments of Medical Microbiology, Medicine, and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew Singer
- Departments of Medical Microbiology, Medicine, and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Chris Whaley
- Departments of Medical Microbiology, Medicine, and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Peter Nickerson
- Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Orr
- Departments of Medical Microbiology, Medicine, and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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581
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Hunter E, Milroy H. Voices across the fence: commonality, difference and respectful practice across a half century of change. Australas Psychiatry 2013; 21:305-10. [PMID: 23935133 DOI: 10.1177/1039856213491992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe changes that have occurred in the field of indigenous mental health over the last 50 years. CONCLUSIONS The last half-century has seen major advances in psychiatry and in the roles and capacities of the Royal Australian and New Zealand College of Psychiatrists. Over the same period, Aboriginal and Torres Strait Islander Australia has been transformed by social and political forces that have brought both benefits and disappointments to Indigenous Australians. Indigenous mental health has evolved from a marginal interest in an 'exotic' area to a recognised field with its own issues, competencies and training needs. In this paper, two College Fellows consider these decades of change, presenting their reflections through voices that reflect different vantages despite a common destination.
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Affiliation(s)
- Ernest Hunter
- Remote Area Mental Health Service, and Adjunct Professor, James Cook University, Cairns, QLD, Australia.
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582
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Wyeth EH, Derrett S, Hokowhitu B, Samaranayaka A. Indigenous injury outcomes: life satisfaction among injured Māori in New Zealand three months after injury. Health Qual Life Outcomes 2013; 11:120. [PMID: 23866834 PMCID: PMC3720216 DOI: 10.1186/1477-7525-11-120] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 07/12/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Māori, the indigenous population of New Zealand, experience numerous and consistent health disparities when compared to non-Māori. Injury is no exception, yet there is a paucity of published literature that examines outcomes following a wide variety of injury types and severities for this population. This paper aims to identify pre-injury and injury-related predictors of life satisfaction three months after injury for a group of injured Māori. METHODS The Māori sample (n = 566) were all participants in the Prospective Outcomes of Injury Study (POIS). POIS is a longitudinal study of 2856 injured New Zealanders aged 18-64 years who were on an injury entitlement claims' register with New Zealand's no-fault compensation insurer. The well-known Te Whare Tapa Whā model of overall health and well-being was used to help inform the selection of post-injury life satisfaction predictor variables. Multivariable analyses were used to examine the relationships between potential predictors and life satisfaction. RESULTS Of the 566 Māori participants, post-injury life satisfaction data was available for 563 (99%) participants. Of these, 71% reported satisfaction with life three months after injury (compared to 93% pre-injury). Those with a higher injury severity score, not satisfied with pre-injury social relationships or poor self-efficacy pre-injury were less likely to be satisfied with life three months after injury. CONCLUSIONS The large majority of Māori participants reported being satisfied with life three months after injury; however, nearly a third did not. This suggests that further research investigating outcomes after injury for Māori, and predictors of these, is necessary. Results show that healthcare providers could perhaps put greater effort into working alongside injured Māori who have more severe injuries, report poor self-efficacy and were not satisfied with their pre-injury social relationships to ensure increased likelihood of satisfaction with life soon after injury.
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Affiliation(s)
- Emma H Wyeth
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Brendan Hokowhitu
- Faculty of Native Studies, University of Alberta, Edmonton, Alberta, Canada
| | - Ari Samaranayaka
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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583
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Abstract
BACKGROUND Fungal peritonitis is a recognized complication in patients with end-stage renal failure treated with peritoneal dialysis (PD). Most infections are attributable to Candida species. In approximately one third of cases, the causative fungus is a non-Candida species. Recent reports in the literature show a rising incidence of non-candidal fungal peritonitis (NCFP). We report a case series of NCFP, together with two hitherto unreported species of fungi causing peritonitis, from a tropical geographic area (Far North Queensland). METHODS This series of 10 cases of NCFP was identified from the PD peritonitis database in Far North Queensland between 1998 and 2010. All 10 patients were from the Aboriginal and Torres Strait Islander ethnic group, 8 of whom lived in remote locations. All but 1 patient had type 2 diabetes mellitus. Of the 10 cases, 7 occurred while the patients received continuous ambulatory PD. Only 1 patient avoided catheter removal, and 5 patients were permanently transferred to hemodialysis. No patient died as a result of the fungal infection. All 10 fungi represented different species. Most (6 of 10) were saprophytic; only 2 were normal skin flora. Two of the causative species (Chaetomium and Beauveria) have rarely been associated with any form of human infection. In 7 patients, the infection occurred during the wet season (November - April). All cases met clinical criteria for peritonitis. DISCUSSION AND CONCLUSIONS The NCFP cases described in this series involved a variety of previously known fungal species and also two new species that have not been reported to cause disease in humans. Indigenous patients from Far North Queensland are particularly predisposed to infection with these exotic fungi as a result of environmental and social factors. Further understanding is desirable to help devise preventive strategies to avoid the consequences of catheter failure.
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Affiliation(s)
- Richard A Baer
- Department of Renal Medicine, Cairns Base Hospital, Cairns, Australia
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584
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Thompson SL, Chenhall RD, Brimblecombe JK. Indigenous perspectives on active living in remote Australia: a qualitative exploration of the socio-cultural link between health, the environment and economics. BMC Public Health 2013; 13:473. [PMID: 23672247 PMCID: PMC3662620 DOI: 10.1186/1471-2458-13-473] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 05/08/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The burden of chronic disease in Indigenous Australia is more than double that of non-Indigenous populations and even higher in remote Northern Territory (NT) communities. Sufficient levels of physical activity are known to reduce the risk of chronic disease and improve the health of those already suffering from chronic disease. It has been identified that effective promotion of physical activity in Indigenous settings requires the diverse cultural perspectives and participation of Indigenous people. However, Indigenous concepts of physical activity are not represented in the public health literature and examples of Indigenous involvement in physical activity promotion are scarce. This study aimed to explore and describe local perspectives, experiences and meanings of physical activity in two remote NT Indigenous communities. METHODS Qualitative research methods guided by ethnographic and participatory action research principles were used. Semi-structured interviews conducted with 23 purposively selected community members were the main source of data, augmented by five commissioned paintings by community-based artists and observations recorded in a journal by the first author. RESULTS The findings reveal that in this cultural context the meaning of physical activity is embedded in socially significant and economically necessary physical engagement with the environment. Participants described physical activities associated with Indigenous natural and cultural resource management, customary spaces, seasonal timing and traditional education as creating and protecting health. These activities were viewed not only as culturally appropriate physical activities that contribute to health but as legitimate, physically active forms of social organisation, education and employment that help to build and maintain relationships, wealth, resources and the environment. CONCLUSION This different construction of physical activity in remote Indigenous communities highlights the importance of involving Indigenous people in the development and implementation of physical activity promotion. Physical activities associated with traditional Indigenous cultural practices and being active 'on country' need to be viewed as legitimate health promotion activities. Exploring further ways to enable Indigenous people in remote NT to be involved in creating viable active livelihoods on 'traditional country' needs to be considered as imperative to health improvement.
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Affiliation(s)
- Sharon L Thompson
- Menzies School of Health Research; Institute of Advanced Studies, Charles Darwin University, PO Box 41096, Casuarina, Northern Territory 0811, Australia
| | - Richard D Chenhall
- Menzies School of Health Research; Institute of Advanced Studies, Charles Darwin University, PO Box 41096, Casuarina, Northern Territory 0811, Australia
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, Victoria, 3010, Australia
| | - Julie K Brimblecombe
- Menzies School of Health Research; Institute of Advanced Studies, Charles Darwin University, PO Box 41096, Casuarina, Northern Territory 0811, Australia
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585
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Stoner L, Shultz SP, Lambrick DM, Krebs J, Weatherall M, Palmer BR, Lane AM, Kira G, Witter T, Williams MA. The Combating Obesity in Māori and Pasifika Adolescent School-Children Study: COMPASS Methodology and Study Protocol. Int J Prev Med 2013; 4:565-79. [PMID: 23930168 PMCID: PMC3733188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 03/03/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Lifestyle modifications including, physical activity can reduce obesity-related morbidity and subsequent cardiovascular disease in youth. This study will investigate the efficacy of a culturally-sensitive, non-contact, boxing-orientated training program on obesity and related cardio-metabolic conditions in Māori and Pasifika adolescents. Details of the methodological aspects of recruitment, inclusion criteria, randomization, cultural sensitivity, intervention program, assessments, process evaluation, and statistical analyses are described. METHODS This study will be a community based, New Zealand, randomized control trial (RCT). Male and female obese (body mass index >95(th) percentile) Māori and Pasifika adolescents aged 14-16 years will be recruited and the sample size will be confirmed through a feasibility study. Combating Obesity in Māori and Pasifika Adolescent School-children Study (COMPASS) is a 6-month, theory-based program, conducted 3-times/week in a culturally appropriate setting. Each session includes 40 min boxing-orientated training and 30 min resistance training. Assessments will be made at baseline, 3-months, 6-months, 12-months, and 24-months. Main outcomes include abdominal obesity, endothelial function, and insulin resistance. Other outcomes include arterial stiffness, lipid profile, inflammatory biomarkers, well-being, and aerobic fitness. Control measures include physical activity, sleep behavior, and dietary intake. RESULTS As a protocol paper there are no specific results to present, our purpose is to share our RCT design with the scientific community. CONCLUSIONS COMPASS will be used to provide direction for exercise prescription policy in at-risk Māori and Pasifika adolescents.
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Affiliation(s)
- Lee Stoner
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Sarah P. Shultz
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | | | - Jeremy Krebs
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Barry R. Palmer
- Institute of Food Nutrition and Human Health, Massey University, New Zealand
| | - Andrew M. Lane
- School of Sport, Performing Arts and Leisure, Wolverhampton University, United Kingdom
| | - Geoff Kira
- School of Sport and Exercise, Massey University, Palmerston North, New Zealand
| | - Trevor Witter
- School of Sport and Exercise, Massey University, Wellington, New Zealand
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586
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Chamberlain C, McNamara B, Williams ED, Yore D, Oldenburg B, Oats J, Eades S. Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States. Diabetes Metab Res Rev 2013; 29:241-56. [PMID: 23315909 PMCID: PMC3698691 DOI: 10.1002/dmrr.2389] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 12/13/2012] [Accepted: 12/20/2012] [Indexed: 12/16/2022]
Abstract
Recently proposed international guidelines for screening for gestational diabetes mellitus (GDM) recommend additional screening in early pregnancy for sub-populations at a high risk of type 2 diabetes mellitus (T2DM), such as indigenous women. However, there are criteria that should be met to ensure the benefits outweigh the risks of population-based screening. This review examines the published evidence for early screening for indigenous women as related to these criteria. Any publications were included that referred to diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States (n = 145). The risk of bias was appraised. There is sufficient evidence describing the epidemiology of diabetes in pregnancy, demonstrating that it imposes a significant disease burden on indigenous women and their infants at birth and across the lifecourse (n = 120 studies). Women with pre-existing T2DM have a higher risk than women who develop GDM during pregnancy. However, there was insufficient evidence to address the remaining five criteria, including the following: understanding current screening practice and rates (n = 7); acceptability of GDM screening (n = 0); efficacy and cost of screening for GDM (n = 3); availability of effective treatment after diagnosis (n = 6); and effective systems for follow-up after pregnancy (n = 5). Given the impact of diabetes in pregnancy, particularly undiagnosed T2DM, GDM screening in early pregnancy offers potential benefits for indigenous women. However, researchers, policy makers and clinicians must work together with communities to develop effective strategies for implementation and minimizing the potential risks. Evidence of effective strategies for primary prevention, GDM treatment and follow-up after pregnancy are urgently needed.
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Affiliation(s)
- Catherine Chamberlain
- International Public Health Unit, Department of Epidemiology and Preventive Medicine, School of Medicine, Nursing and Health Sciences, Monash University, Prahan, Victoria, Australia.
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587
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Langlois KA, Findlay LC, Kohen DE. Dietary habits of Aboriginal children. Health Rep 2013; 24:3-7. [PMID: 24258058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Based on the results of Statistics Canada's 2006 Aboriginal Children's Survey, this article presents an overview of how often First Nations children living off reserve, Métis children and Inuit children aged 2 to 5 consume various types of food, including foods considered traditional or country among Aboriginal people. The frequency with which First Nations children living off reserve and Métis children consumed items from major food groups tended to be similar. While lower percentages of Inuit children were reported to regularly consume items from these food groups, relatively high percentages of Inuit children consumed traditional or country foods. Around two-thirds of all Aboriginal children ate fast food and processed foods at least once a week, and just over half had salty snacks, sweets and desserts at least once a day. Consumption patterns varied, depending on whether children lived in a Census Metropolitan Area/Census Agglomeration.
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Affiliation(s)
- Kellie A Langlois
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
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588
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Abstract
This study examined the indigenous identities of urban American Indian youth using measures related to three theoretical dimensions of Markstrom's identity model: identification (tribal and ethnic heritage), connection (reservation ties), and involvement in traditional cultural practices and spirituality. Data came from self-administered questionnaires completed by 142 urban American Indian middle school students in a southwestern metropolitan area with the largest urban American Indian population in the United States. Using both quantitative and qualitative measures, descriptive statistics showed most youth were connected to all three dimensions of indigenous identity. Hierarchical regression analyses showed that youth with the strongest sense of American Indian ethnic identity had native fathers and were heavily involved in traditional cultural practices and spirituality. Although urban American Indians may face challenges in maintaining their tribal identities, the youth in this study appeared strongly moored to their native indigenous heritage. Implications for future research are discussed.
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589
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Spein AR, Pedersen CP, Silviken AC, Melhus M, Kvernmo SE, Bjerregaard P. Self-rated health among Greenlandic Inuit and Norwegian Sami adolescents: associated risk and protective correlates. Int J Circumpolar Health 2013; 72:19793. [PMID: 23396865 PMCID: PMC3567202 DOI: 10.3402/ijch.v72i0.19793] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 11/08/2012] [Accepted: 11/11/2012] [Indexed: 12/16/2022] Open
Abstract
Objectives Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami. Design Cross-sectional data were collected from “Well-being among Youth in Greenland” (WBYG) and “The Norwegian Arctic Adolescent Health Study” (NAAHS), conducted during 2003–2005 and comprising 10th and 11th graders, 378 Inuit and 350 Sami. Methods SRH was assessed by one single item, using a 4-point and 5-point scale for NAAHS and WBYG, respectively. Logistic regressions were performed separately for each indigenous group using a dichotomous measure with “very good” (NAAHS) and “very good/good” (WBYG) as reference categories. We simultaneously controlled for various socio-demographics, risk correlates (drinking, smoking, violence and suicidal behaviour) and protective correlates (physical activity, well-being in school, number of close friends and adolescent–parent relationship). Results A majority of both Inuit (62%) and Sami (89%) youth reported “good” or “very good” SRH. The proportion of “poor/fair/not so good” SRH was three times higher among Inuit than Sami (38% vs. 11%, p≤0.001). Significantly more Inuit females than males reported “poor/fair” SRH (44% vs. 29%, p≤0.05), while no gender differences occurred among Sami (12% vs. 9%, p≤0.08). In both indigenous groups, suicidal thoughts (risk) and physical activity (protective) were associated with poor and good SRH, respectively. Conclusions In accordance with other studies of indigenous adolescents, suicidal thoughts were strongly associated with poorer SRH among Sami and Inuit. The Inuit–Sami differences in SRH could partly be due to higher “risk” and lower “protective” correlates among Inuit than Sami. The positive impact of physical activity on SRH needs to be targeted in future intervention programs.
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Affiliation(s)
- Anna Rita Spein
- Centre for Sami Health Research, Faculty of Health Sciences, University of Tromsø, Karasjok, Norway.
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590
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Dingwall KM, Pinkerton J, Lindeman MA. "People like numbers": a descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory. BMC Psychiatry 2013; 13:42. [PMID: 23368850 PMCID: PMC3598474 DOI: 10.1186/1471-244x-13-42] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 01/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Achieving culturally fair assessments of cognitive functioning for Aboriginal people is difficult due to a scarcity of appropriately validated tools for use with this group. As a result, some Aboriginal people with cognitive impairments may lack fair and equitable access to services. The objective of this study was to examine current clinical practice in the Northern Territory regarding cognitive assessment for Aboriginal people thereby providing some guidance for clinicians new to this practice setting. METHOD Qualitative enquiry was used to describe practice context, reasons for assessment, and current practices in assessing cognition for Aboriginal Australians. Semi-structured interviews were conducted with 22 clinicians working with Aboriginal clients in central and northern Australia. Results pertaining to assessment methods are reported. RESULTS A range of standardised tests were utilised with little consistency across clinical practice. Nevertheless, it was recognised that such tests bear severe limitations, requiring some modification and significant caution in their interpretation. Clinicians relied heavily on informal assessment or observations, contextual information and clinical judgement. CONCLUSIONS Cognitive tests developed specifically for Aboriginal people are urgently needed. In the absence of appropriate, validated tests, clinicians have relied on and modified a range of standardised and informal assessments, whilst recognising the severe limitations of these. Past clinical training has not prepared clinicians adequately for assessing Aboriginal clients, and experience and clinical judgment were considered crucial for fair interpretation of test scores. Interpretation guidelines may assist inexperienced clinicians to consider whether they are achieving fair assessments of cognition for Aboriginal clients.
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Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia.
| | - Jennifer Pinkerton
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia
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591
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Jones EK, Jurgenson JR, Katzenellenbogen JM, Thompson SC. Menopause and the influence of culture: another gap for Indigenous Australian women? BMC Womens Health 2012; 12:43. [PMID: 23234340 PMCID: PMC3554544 DOI: 10.1186/1472-6874-12-43] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 12/07/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is great variation in experience of menopause in women around the world. The purpose of this study was to review current understanding of Australian Aboriginal and Torres Strait Islander (Indigenous) women's experiences of menopause. The literature pertaining to the perception, significance and experience of menopause from a number of cultural groups around the world has been included to provide context for why Indigenous women's experience might be important for their health and differ from that reported in other studies of Australian women and menopause. METHODS A search of databases including Ovid Medline, Pubmed, Web of Science, AUSThealth, AMED, EMBASE, Global Health and PsychINFO was undertaken from January 2011 to April 2011 using the search terms menopause, Indigenous, Aboriginal, attitudes, and perceptions and repeated in September 2012. RESULTS Considerable research shows significant variation across cultures in the menopausal experience. Biological, psychological, social and cultural factors are associated with either positive or negative attitudes, perceptions or experiences of menopause in various cultures. Comparative international literature shows that neither biological nor social factors alone are sufficient to explain the variation in experiences of the menopausal transition. However, a strong influence of culture on the menopause experience can be found. The variation in women's experience of menopause indicates that different cultural groups of women may have different understandings and needs during the menopausal transition. While considerable literature exists for Australian women as a whole, there has been little investigation of Australian Indigenous women, with only two research studies related to Indigenous women's experiences of menopause identified. CONCLUSIONS Differences in biocultural experience of menopause around the world suggest the importance of biocultural research. For the Indigenous women of Australia, the relative contribution of culture, social disadvantage and poor general health compared with non-Indigenous women to the experience of menopause is unknown. As such, further research and understanding of the experience of Indigenous women around Australia is needed. This information could assist individuals, families, cultural groups and healthcare providers to enhance management and support for Indigenous Australian women.
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Affiliation(s)
- Emma K Jones
- Faculty of Medicine and Dentistry, The University of Western Australia, Stirling Highway, Perth Western, Australia
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Western Australia
| | - Janelle R Jurgenson
- Faculty of Medicine and Dentistry, The University of Western Australia, Stirling Highway, Perth Western, Australia
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Western Australia
| | - Judith M Katzenellenbogen
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Western Australia
| | - Sandra C Thompson
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Western Australia
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592
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Abstract
BACKGROUND This project is a community-level study of equity of access to eye health services for Indigenous Australians. METHODS The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey.The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %). The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA). RESULTS The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO) guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. CONCLUSIONS There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people's access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
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Affiliation(s)
- Margaret Kelaher
- Centre for Health Policy, Programs and Economics School of Population Health, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne, 207 Bouverie st Parkville, Melbourne, 3010, Australia
| | - Angeline Ferdinand
- Centre for Health Policy, Programs and Economics School of Population Health, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne, 207 Bouverie st Parkville, Melbourne, 3010, Australia
| | - Hugh Taylor
- Indigenous Eye Health Unit School of Population Health, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne, 207 Bouverie st Parkville, Melbourne, 3010, Australia
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593
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Cheadle JE, Hartshorn KJS. Marijuana use development over the course of adolescence among North American Indigenous youth. Soc Sci Res 2012; 41:1227-40. [PMID: 23017929 PMCID: PMC3593240 DOI: 10.1016/j.ssresearch.2012.03.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 03/18/2012] [Accepted: 03/27/2012] [Indexed: 06/01/2023]
Abstract
This study investigated the links between marijuana use trajectories and marijuana abuse/dependence (DSM-IV) using five waves of data from 718 North American Indigenous adolescents between 10 and 17years from eight reservations sharing a common language and culture. Growth mixture models indicated that 15% of youth began using by 11-12years of age and that another 20% began shortly thereafter. These early users had odds of abuse/dependence 6.5 times larger than abstainers. Girls were also unexpectedly found to be particularly at risk of early use, and this did not reflect other background and psychosocial factors, including friend use. While the timing, patterns, and consequences of use were similar to those reported for alcohol use previously, the social influences on use differed in important ways.
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Affiliation(s)
- Jacob E. Cheadle
- The University of Nebraska – Lincoln, 737 Oldfather Hall, Lincoln, NE 68588-0324, United States
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594
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Abstract
The influenza epidemic of 1918 was the single worst outbreak of this disease known in history. This article examines an area of western India that was affected very badly-that of a tract inhabited by impoverished indigenous peoples, who are known in India as adivasis. The reasons for this are discussed. Some oral accounts help to bring out the enduring memory of that terrible time. The general health of the adivasis and the existing medical facilities in this area are examined. Attempts to check and treat the disease by the colonial government and its doctors, as well as missionary doctors and other non-governmental agencies, are considered to see why they had so little overall impact. Some comparisons are made with the fate of indigenous people in other parts of the world during the epidemic, in particular with the Inuits of Alaska.
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Affiliation(s)
- David Hardiman
- Department of History, University of Warwick, Coventry CV4 7AL, UK.
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595
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Steenkamp M, Rumbold A, Barclay L, Kildea S. A population-based investigation into inequalities amongst Indigenous mothers and newborns by place of residence in the Northern Territory, Australia. BMC Pregnancy Childbirth 2012; 12:44. [PMID: 22682627 PMCID: PMC3480936 DOI: 10.1186/1471-2393-12-44] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 05/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Comparisons of birth outcomes between Australian Indigenous and non-Indigenous populations show marked inequalities. These comparisons obscure Indigenous disparities. There is much variation in terms of culture, language, residence, and access to services amongst Australian Indigenous peoples. We examined outcomes by region and remoteness for Indigenous subgroups and explored data for communities to inform health service delivery and interventions. METHODS Our population-based study examined maternal and neonatal outcomes for 7,560 mothers with singleton pregnancies from Australia's Northern Territory Midwives' Data Collection (2003-2005) using uni- and multivariate analyses. Groupings were by Indigenous status; region (Top End (TE)/Central Australia (CA)); Remote/Urban residence; and across two large TE communities. RESULTS Of the sample, 34.1% were Indigenous women, of whom 65.6% were remote-dwelling versus 6.7% of non-Indigenous women. In comparison to CA Urban mothers: TE Remote (adjusted odds ratio [aOR] 1.47, 95%CI: 1.13, 1.90) and TE Urban mothers (aOR 1.36 (95% CI: 1.02, 1.80) were more likely, but CA Remote mothers (aOR 0.43; 95% CI: 0.31, 0.58) less likely to smoke during pregnancy; CA Remote mothers giving birth at >32 weeks gestation were less likely to have attended ≥ five antenatal visits (aOR 0.55; 95%CI: 0.36, 0.86); TE Remote (aOR 0.71; 95%CI: 0.53, 0.95) and CA Remote women (aOR 0.68; 95%CI: 0.49, 0.95) who experienced labour had lower odds of epidural/spinal/narcotic pain relief; and TE Remote (aOR 0.47; 95%CI: 0.34, 0.66), TE Urban (aOR 0.67; 95%CI: 0.46, 0.96) and CA Remote mothers (aOR 0.52; 95%CI: 0.35, 0.76) all had lower odds of having a 'normal' birth. The aOR for preterm birth for TE Remote newborns was 2.09 (95%CI: 1.20, 3.64) and they weighed 137 g (95%CI: -216 g, -59 g) less than CA Urban babies. There were few significant differences for communities, except for smoking prevalence. CONCLUSIONS This paper is one of few quantifying inequalities between groups of Australian Indigenous women and newborns at a regional level. Indigenous mothers and newborns do worse on some outcomes if they live remotely, especially if they live in the TE. Smoking prevention and high-quality antenatal care is fundamental to addressing many of the adverse outcomes identified in this paper.
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Affiliation(s)
- Malinda Steenkamp
- University Centre for Rural Health North Coast, School of Public Health, University of Sydney, Lismore, Australia
| | - Alice Rumbold
- Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide and Services Systems and Society Division, Menzies School of Health Research, Darwin, Australia
| | - Lesley Barclay
- University Centre for Rural Health North Coast, School of Public Health, University of Sydney, Lismore, Australia
| | - Sue Kildea
- Australian Catholic University and Mater Medical Research Institute, Women's Health and Newborn Services (Maternity), Mater Health Services, Brisbane, Australia
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596
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Marley JV, Atkinson D, Nelson C, Kitaura T, Gray D, Metcalf S, Murray R, Maguire GP. The protocol for the Be Our Ally Beat Smoking (BOABS) study, a randomised controlled trial of an intensive smoking cessation intervention in a remote Aboriginal Australian health care setting. BMC Public Health 2012; 12:232. [PMID: 22439653 PMCID: PMC3349500 DOI: 10.1186/1471-2458-12-232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 03/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Australian Aboriginal peoples and Torres Strait Islanders (Indigenous Australians) smoke at much higher rates than non-Indigenous people and smoking is an important contributor to increased disease, hospital admissions and deaths in Indigenous Australian populations. Smoking cessation programs in Australia have not had the same impact on Indigenous smokers as on non-Indigenous smokers. This paper describes the protocol for a study that aims to test the efficacy of a locally-tailored, intensive, multidimensional smoking cessation program. METHODS/DESIGN This study is a parallel, randomised, controlled trial. Participants are Aboriginal and Torres Strait Islander smokers aged 16 years and over, who are randomly allocated to a 'control' or 'intervention' group in a 2:1 ratio. Those assigned to the 'intervention' group receive smoking cessation counselling at face-to-face visits, weekly for the first four weeks, monthly to six months and two monthly to 12 months. They are also encouraged to attend a monthly smoking cessation support group. The 'control' group receive 'usual care' (i.e. they do not receive the smoking cessation program). Aboriginal researchers deliver the intervention, the goal of which is to help Aboriginal peoples and Torres Strait Islanders quit smoking. Data collection occurs at baseline (when they enrol) and at six and 12 months after enrolling. The primary outcome is self-reported smoking cessation with urinary cotinine confirmation at 12 months. DISCUSSION Stopping smoking has been described as the single most important individual change Aboriginal and Torres Strait Islander smokers could make to improve their health. Smoking cessation programs are a major priority in Aboriginal and Torres Strait Islander health and evidence for effective approaches is essential for policy development and resourcing. A range of strategies have been used to encourage Aboriginal peoples and Torres Strait Islanders to quit smoking however there have been few good quality studies that show what approaches work best. More evidence of strategies that could work more widely in Indigenous primary health care settings is needed if effective policy is to be developed and implemented. Our project will make an important contribution in this area. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12608000604303).
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Affiliation(s)
- Julia V Marley
- The Rural Clinical School of Western Australia, The University of Western Australia, Cnr Anne & Dora Street, PO Box 1377, Broome, WA, 6725, Australia
- Kimberley Aboriginal Medical Services Council, Cnr Anne & Dora Street, PO Box 1377, Broome, WA 6725, Australia
| | - David Atkinson
- The Rural Clinical School of Western Australia, The University of Western Australia, Cnr Anne & Dora Street, PO Box 1377, Broome, WA, 6725, Australia
- Kimberley Aboriginal Medical Services Council, Cnr Anne & Dora Street, PO Box 1377, Broome, WA 6725, Australia
| | - Carmel Nelson
- Kimberley Aboriginal Medical Services Council, Cnr Anne & Dora Street, PO Box 1377, Broome, WA 6725, Australia
| | - Tracey Kitaura
- Derby Aboriginal Health Service, 1 Stanley Street, PO Box 1155, Derby, WA 6728, Australia
| | - Dennis Gray
- National Drug Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Sue Metcalf
- Kimberley Aboriginal Medical Services Council, Cnr Anne & Dora Street, PO Box 1377, Broome, WA 6725, Australia
| | - Richard Murray
- School of Medicine and Dentistry, James Cook University, Cairns, Queensland 4870, Australia
| | - Graeme P Maguire
- School of Medicine and Dentistry, James Cook University, Cairns, Queensland 4870, Australia
- Baker IDI, Alice Springs, Northern Territory 0871, Australia
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597
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Sköld P, Axelsson P, Karlsson L, Smith L. Infant mortality of Sami and settlers in Northern Sweden: the era of colonization 1750-1900. Glob Health Action 2011; 4:GHA-4-8441. [PMID: 22043216 PMCID: PMC3204212 DOI: 10.3402/gha.v4i0.8441] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 10/05/2011] [Accepted: 10/05/2011] [Indexed: 11/14/2022] Open
Abstract
The study deals with infant mortality (IMR) that is one of the most important aspects of indigenous vulnerability.
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Affiliation(s)
- Peter Sköld
- Centre for Sami Research, Umeå University, Umeå, Sweden.
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598
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Ward NJ, Jowsey T, Haora PJ, Aspin C, Yen LE. With good intentions: complexity in unsolicited informal support for Aboriginal and Torres Strait Islander peoples. A qualitative study. BMC Public Health 2011; 11:686. [PMID: 21888670 PMCID: PMC3176222 DOI: 10.1186/1471-2458-11-686] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 09/04/2011] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Understanding people's social lived experiences of chronic illness is fundamental to improving health service delivery and health outcomes, particularly in relation to self-management activity. In explorations of social lived experiences this paper uncovers the ways in which Aboriginal and Torres Strait Islander people with chronic illness experience informal unsolicited support from peers and family members. METHODS Nineteen Aboriginal and Torres Islander participants were interviewed in the Serious and Continuing Illness Policy and Practice Study (SCIPPS). Participants were people with Type 2 diabetes (N = 17), chronic obstructive pulmonary disease (N = 3) and/or chronic heart failure (N = 11) and family carers (N = 3). Participants were asked to describe their experience of having or caring for someone with chronic illness. Content and thematic analysis of in-depth semi-structured interviews was undertaken, assisted by QSR Nvivo8 software. RESULTS Participants reported receiving several forms of unsolicited support, including encouragement, practical suggestions for managing, nagging, growling, and surveillance. Additionally, participants had engaged in 'yarning', creating a 'yarn' space, the function of which was distinguished as another important form of unsolicited support. The implications of recognising these various support forms are discussed in relation to responses to unsolicited support as well as the needs of family carers in providing effective informal support. CONCLUSIONS Certain locations of responsibility are anxiety producing. Family carers must be supported in appropriate education so that they can provide both solicited and unsolicited support in effective ways. Such educational support would have the added benefit of helping to reduce carer anxieties about caring roles and responsibilities. Mainstream health services would benefit from fostering environments that encourage informal interactions that facilitate learning and support in a relaxed atmosphere.
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Affiliation(s)
- Nathaniel J Ward
- Australian Primary Health Care Research Institute, Australian National University, Ian Potter house, Cnr Marcus Clarke and Gordon streets, Acton 0200 Canberra, Australia
| | - Tanisha Jowsey
- Australian Primary Health Care Research Institute, Australian National University, Ian Potter house, Cnr Marcus Clarke and Gordon streets, Acton 0200 Canberra, Australia
- Menzies Centre for Health Policy, Australian National University, John Curtin School of Medical Research, Garran Road, Acton 0200 Canberra, Australia
| | - Penny J Haora
- Australian Primary Health Care Research Institute, Australian National University, Ian Potter house, Cnr Marcus Clarke and Gordon streets, Acton 0200 Canberra, Australia
| | - Clive Aspin
- Menzies Centre for Health Policy, Australian National University, John Curtin School of Medical Research, Garran Road, Acton 0200 Canberra, Australia
- Poche Centre for Health Research, University of Sydney, Sydney Medical School, Edward Ford Building A27, 2006 NSW, Australia
| | - Laurann E Yen
- Australian Primary Health Care Research Institute, Australian National University, Ian Potter house, Cnr Marcus Clarke and Gordon streets, Acton 0200 Canberra, Australia
- Menzies Centre for Health Policy, Australian National University, John Curtin School of Medical Research, Garran Road, Acton 0200 Canberra, Australia
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599
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Abstract
BACKGROUND The aim of the study was to undertake a six-year analysis from 1999/00 to 2004/05, of the demographic characteristics of hospitalisations for the surgical removal of impacted teeth in Western Australia under general anaesthesia. METHOD Data for the current analysis was obtained from the Western Australian Hospital Morbidity Data System (HMDS). Gender, age, indigenous status, place of residence, type of hospital admitted, insurance status, and Diagnostic Related Group (DRG) cost estimates for the procedure were analysed. RESULTS A total of 37.6% of all oral health-related hospitalisations in Western Australia over the six years were for the removal of impacted teeth. Admitted patients were predominantly females (58.8%) and very few Indigenous people were hospitalised (0.2%). The average age of patients was 21.4 years (sd=9.9). Metropolitan patients were hospitalised 1.5 times more than rural patients for this condition. The majority of patients were hospitalised at a private metropolitan hospital and were insured. The total cost of hospitalisation for this condition contributes to 27% of all the oral health condition-related hospitalisation costs. CONCLUSION This study suggests that the hospital-based removal of impacted teeth in Western Australia is associated with factors such as indigenous status, age, gender and private hospital access along with insurance status raising interesting questions over the equity of provision of this service.
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600
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Ulturgasheva O, Wexler L, Kral M, Allen J, Mohatt GV, Nystad K. Navigating International, Interdisciplinary, and Indigenous Collaborative Inquiry: Phase 1 in the Circumpolar Indigenous Pathways to Adulthood Project. J Community Engagem Scholarsh 2011; 4:50-59. [PMID: 22866196 PMCID: PMC3410398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This report describes how multiple community constituents came together to work with university researchers on developing a shared agenda for studying young indigenous people in five international circumpolar communities. The paper focuses on the set up and process of an initial face-to-face methodological planning workshop involving youth and adult community members and academics. Members of Yup'ik, Inupiat, Eveny, Inuit and Sámi communities from Siberia to Norway participated in the workshop and engaged in negotiations to arrive at shared research interests. This was essential since the ultimate goal of the research is translational and transformative, spurring social action in communities. Describing the beginning stage of this project and the underlying participatory methodology offers reader insight into the how the approach engaged community members with varying degrees of sustained interest and practical success. It, therefore, articulates a methodological approach for those interested in doing community-based participatory research in international contexts.
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