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Haitana T, Pitama S, Cormack D, Clark MTR, Lacey C. "If we can just dream…" Māori talk about healthcare for bipolar disorder in New Zealand: A qualitative study privileging Indigenous voices on organisational transformation for health equity. Int J Health Plann Manage 2022; 37:2613-2634. [PMID: 35460284 PMCID: PMC9546144 DOI: 10.1002/hpm.3486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives This paper identifies barriers to equity and proposes changes to improve the organisation of healthcare in New Zealand for Māori with bipolar disorder (BD) and their families. Design A qualitative Kaupapa Māori methodology was used. Twenty‐four semi‐structured interviews were completed with Māori with BD and members of their family. Structural and descriptive coding was used to organise and analyse the data, including an analytic frame that explored participants' critique of attributes of the organisation of healthcare and alignment with Māori health policy. Results Transformation to the organisation of healthcare is needed to achieve health equity. Executive management must lead changes to organisational culture, deliver an equity partnership model with Māori, embed cultural safety and redesign the organisation of healthcare to improve wellbeing. Healthcare incentive structures must diversify, develop and retain a culturally competent health workforce. Information management and technology systems must guide continued whole system improvements. Conclusion This paper provides recommendations that should be considered in planned reforms to the organisation of healthcare in New Zealand. The challenge remains whether resourcing for an equitable healthcare organisation will be implemented in partial fulfilment of promises of equity in policy. Indigenous health equity requires the organisation of healthcare to transform. Executive management must lead changes to organisational culture. Change to healthcare culture will then support organisational re‐design. Evaluation, technologies, and incentives will support continued equity gains.
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Affiliation(s)
- Tracy Haitana
- Department of Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | | | - Donna Cormack
- Department of Public Health, Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington, New Zealand
| | - Mau Te Rangimarie Clark
- Department of Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
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Bullied Because of Their Teeth: Evidence from a Longitudinal Study on the Impact of Oral Health on Bullying Victimization among Australian Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094995. [PMID: 35564388 PMCID: PMC9101169 DOI: 10.3390/ijerph19094995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 02/01/2023]
Abstract
Making life better for Indigenous peoples is a global priority. Although bullying and oral health have always been a topic of concern, there is limited information regarding the impact of this problem on the general population, with no evidence in this regard among the Australian Indigenous population. Thus, we aimed to quantify the relationship between bullying victimization and oral health problems by remoteness among 766 Australian Indigenous children aged between 10−15-years using data from the LSIC study. Bivariate and multilevel mixed-effect logistic regression analyses were employed. Findings indicated children self-reported bullying more than parents reported their children were being bullied (44% vs. 33.6%), with a higher percentage from rural/remote areas than urban areas. Parents reported that oral health problems increased the probability (OR 2.20, p < 0.05) of being bullied, in Indigenous children living in urban areas. Racial discrimination, lower level of parental education and poor child oral hygiene increase the risk of bullying victimization. Parental happiness with life and a safe community were associated with a lower risk of bullying. Dental problems are linked with Australian Indigenous children experiencing bullying victimization. Cultural resilience and eliminating discrimination may be two modifiable paths to ameliorating health issues associated with bullying in the Australian Indigenous community.
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153
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Comparison of Study Quality as Determined by Standard Research and Community Engagement Metrics: A Pilot Study on Breast Cancer Research in Urban, Rural, and Remote Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095008. [PMID: 35564401 PMCID: PMC9102080 DOI: 10.3390/ijerph19095008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
The purpose of this review is to compare research evaluation tools to determine whether the tools typically used for assessing the quality of research adequately address issues of Indigenous health and culture, particularly when the studies are intended to benefit Indigenous peoples in urban, regional, rural, and remote settings. Our previously published systematic review evaluated studies about breast cancer using a modified Indigenous community engagement tool (CET). In this study, we evaluated the same studies using two commonly used tools: the Critical Appraisal Skills Programme (CASP) for qualitative research; and the Effective Public Health Practice Project (EPHPP) for quantitative research. The results were then compared to ascertain whether there was alignment between performances in terms of engagement and the CASP/EPHPP metrics. Of the 15 papers, 3 papers scored weakly on both metrics, and are therefore the least likely to offer reliable findings, while 2 papers scored strongly on both metrics, and are therefore the most likely to offer reliable findings. Beyond this summation, it was clear that the results did not align and, therefore, could not be used interchangeably when applied to research findings intended to benefit Indigenous peoples. There does not appear to be a pattern in the relationship between the reliability of the studies and the study settings. In order to address disparities in health outcomes, we must assess research through a typical research quality and cultural engagement and settings lens, ensuring that there is rigour in all aspects of the studies.
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154
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Sreedevi A, Vijayakumar K, Najeeb SS, Menon V, Mathew MM, Aravindan L, Anwar R, Sathish S, Nedungadi P, Wiwanitkit V, Raman R. Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study. BMJ Open 2022; 12:e055325. [PMID: 35414552 PMCID: PMC9006194 DOI: 10.1136/bmjopen-2021-055325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group. DESIGN Community-based cross-sectional study. SETTING Community development blocks in a predominantly tribal district of Wayanad in Kerala, India. PARTICIPANTS Women in the reproductive age group (15-49 years) from the tribal groups in the district numbering 2495. OUTCOME MEASURES PRIMARY: Prevalence of contraceptive use and its determinants. SECONDARY Knowledge regarding contraceptives in general, oral contraceptives and fertility intentions. RESULTS The mean age of the study participants was 30.8 years (SD=9.8) and belonged to various tribal groups such as Paniya (59.2%), Kurichiyar (13.6%) and Adiya (10.9%). Current use of contraceptive was reported by about a fourth, 658 (26.4%) (95% CI 27.9 to 24.9) of women. Following logistic regression, belonging to Paniya tribe (adjusted OR (aOR) 2.67, 95% CI 1.49 to 4.77; p<0.001) and age at menarche >13 years (aOR 1.69, 95% CI 1.14 to 2.52; p<0.009) had significantly higher use of contraceptives whereas social vulnerability as indicated by staying in a kutcha house had a lesser likelihood of use of contraceptive (aOR 0.55, 95% CI 0.31 to 0.95; p<0.03). Oral contraceptive use was low (4.8%) among this population and no abuse was observed.Less than half (47%) of the respondents had an above average knowledge on contraception. Multivariable logistic regression indicated that above average knowledge was 2.2 times more likely with higher education (95% CI 1.2 to 3.9), lesser among those who desired more than two children (aOR 0.59; 95% CI 0.38 to 0.94; p<0.02).Two children per family was the preferred choice for 1060 (42.5%) women. No gender bias in favour of the male child was observed. CONCLUSION Awareness and use of contraceptives are poor though the fertility is not commensurately high. Along with developing targeted responses to contraceptive use among Indigenous people with indigenous data, awareness also requires attention. Ethnographic studies are also necessary to determine the differences in contraceptive use including traditional methods among the various Indigenous groups.
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Affiliation(s)
- Aswathy Sreedevi
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | | | | | - Vishnu Menon
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | - Minu Maria Mathew
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | - Lakshmi Aravindan
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | - Rithima Anwar
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | - Syama Sathish
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | - Prema Nedungadi
- Community Medicine, Amrita Institute of Medical Sciences, Cochin, India
| | - Viroj Wiwanitkit
- Department of Community Medicine, Dr D Y Patil Vidyapeeth University, Pune, Maharashtra, India
| | - Raghu Raman
- Amrita Create, Amrita Vishwa Vidyapeetham Amrita School of Engineering Amritapuri, Kollam, Kerala, India
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155
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Rocha AS, de Cássia Ribeiro-Silva R, Fiaccone RL, Paixao ES, Falcão IR, Alves FJO, Silva NJ, Ortelan N, Rodrigues LC, Ichihara MY, de Almeida MF, Barreto ML. Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort. BMC Med 2022; 20:111. [PMID: 35392917 PMCID: PMC8991880 DOI: 10.1186/s12916-022-02313-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB. METHODS We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB. RESULTS A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (Pdifference <0.05) between incident and recurrent PTB. The following were associated with an increased chance for PTB incidence, but not recurrent: household overcrowding (OR 1.09), maternal race/ethnicity [(Black/mixed-OR 1.04) and (indigenous-OR 1.34)], young maternal age (14 to 19 years-OR 1.16), and cesarean delivery (OR 1.09). The following were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85 vs 0.90), reduced number of prenatal visits [(no visit-OR 2.56 vs OR 2.16) and (1 to 3 visits-OR 2.44 vs OR 2.24)], short interbirth interval [(12 to 23 months-OR 1.04 vs OR 1.22) and (<12 months, OR 1.89, 95 vs OR 2.58)], and advanced maternal age (35-49 years-OR 1.42 vs OR 1.45). For most risk factors, the point estimates were higher for incident PTB than recurrent PTB. CONCLUSIONS The risk factors for PTB in the second pregnancy differed according to women's first pregnancy PTB status. The findings give the basis for the development of specific prevention strategies for PTB in a subsequent pregnancy.
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Affiliation(s)
- Aline S Rocha
- School of Nutrition, Federal University of Bahia, Salvador, Brazil. .,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Enny S Paixao
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ila R Falcão
- School of Nutrition, Federal University of Bahia, Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Flavia Jôse O Alves
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Natanael J Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Barcelona Institute for Global Health, Hospital Clínic, Barcelona, Spain
| | - Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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156
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Blunden S, Yiallourou S, Fatima Y. Sleep health and its implications in First Nation Australians: A systematic review. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 21:100386. [PMID: 35199075 PMCID: PMC8844889 DOI: 10.1016/j.lanwpc.2022.100386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Understanding the state of sleep health in First Nations Australians offers timely insight into intervention and management opportunities to improve overall health and well-being. This review explored the determinants and burden of poor sleep in First Nations Australians. A systematic search was conducted to identify studies published until August 2020 in First Nations Australian adults. Nine studies (n = 2640) were included, three in community settings, six in clinical populations. Across studies compared with non-Indigenous people, 15–34% of First Nations Australians experience less than recommended hours (<7 h/night), 22% reported fragmented, irregular, and unrefreshing sleep with a high prevalence of OSA in clinical populations (39-46%). Findings show First Nations Australians are significantly more likely to report worse sleep health than Non-Indigenous Australians in all measured domains of sleep. Co-designed sleep programs and service delivery solutions are necessary to ensure timely prevention and management of sleep issues in First Nations communities which to date have been underserved. Funding No external funding was provided for this work.
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Affiliation(s)
- Sarah Blunden
- Appleton Institute of Behavioural Science, Central Queensland University, 44 Greenhill Rd Wayville Adelaide, South Australia, Australia
- Corresponding author.
| | - Stephanie Yiallourou
- Baker Heart and Diabetes Institute and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Yaqoot Fatima
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia
- Centre for Rural and Remote Health, James Cook University, Queensland, Australia
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157
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Ost K, Berrang-Ford L, Bishop-Williams K, Charette M, Harper SL, Lwasa S, Namanya DB, Huang Y, Katz AB, Ebi K. Do socio-demographic factors modify the effect of weather on malaria in Kanungu District, Uganda? Malar J 2022; 21:98. [PMID: 35317835 PMCID: PMC8939205 DOI: 10.1186/s12936-022-04118-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 03/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is concern in the international community regarding the influence of climate change on weather variables and seasonality that, in part, determine the rates of malaria. This study examined the role of sociodemographic variables in modifying the association between temperature and malaria in Kanungu District (Southwest Uganda). Methods Hospital admissions data from Bwindi Community Hospital were combined with meteorological satellite data from 2011 to 2014. Descriptive statistics were used to describe the distribution of malaria admissions by age, sex, and ethnicity (i.e. Bakiga and Indigenous Batwa). To examine how sociodemographic variables modified the association between temperature and malaria admissions, this study used negative binomial regression stratified by age, sex, and ethnicity, and negative binomial regression models that examined interactions between temperature and age, sex, and ethnicity. Results Malaria admission incidence was 1.99 times greater among Batwa than Bakiga in hot temperature quartiles compared to cooler temperature quartiles, and that 6–12 year old children had a higher magnitude of association of malaria admissions with temperature compared to the reference category of 0–5 years old (IRR = 2.07 (1.40, 3.07)). Discussion Results indicate that socio-demographic variables may modify the association between temperature and malaria. In some cases, such as age, the weather-malaria association in sub-populations with the highest incidence of malaria in standard models differed from those most sensitive to temperature as found in these stratified models. Conclusion The effect modification approach used herein can be used to improve understanding of how changes in weather resulting from climate change might shift social gradients in health. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04118-5.
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Affiliation(s)
- Katarina Ost
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | | | - Margot Charette
- Department of Geography, McGill University, Montreal, Canada
| | | | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Indigenous Health Adaptation To Climate Change, Research Team, Edmonton, Canada.,Uganda Martyrs University, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Yi Huang
- Department of Atmospheric and Ocean Sciences, McGill University, Montreal, Canada
| | - Aaron B Katz
- Department of Health Services, University of Washington, Seattle, USA
| | | | | | - Kristie Ebi
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Priestley International Centre for Climate, University of Leeds, Leeds, UK.,School of Interdisciplinary Science, McMaster University, Hamilton, Canada.,Department of Geography, McGill University, Montreal, Canada.,School of Public Health, University of Alberta, Edmonton, Canada.,Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda.,Indigenous Health Adaptation To Climate Change, Research Team, Edmonton, Canada.,Uganda Martyrs University, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.,Department of Atmospheric and Ocean Sciences, McGill University, Montreal, Canada.,Department of Health Services, University of Washington, Seattle, USA.,Bwindi Community Hospital, Kanungu, Uganda.,Center for Health and the Global Environment, University of Washington, Seattle, USA
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158
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Wright K, Tapera RM, Stott NS, Sorhage A, Mackey A, Williams SA. Indigenous health equity in health register ascertainment and data quality: a narrative review. Int J Equity Health 2022; 21:34. [PMID: 35279132 PMCID: PMC8917744 DOI: 10.1186/s12939-022-01635-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background Health registers play an important role in monitoring distribution of disease and quality of care; however, benefit is limited if ascertainment (i.e., the process of finding and recruiting people on to a register) and data quality (i.e., the accuracy, completeness, reliability, relevance, and timeliness of data) are poor. Indigenous peoples experience significant health inequities globally, yet health data for, and about, Indigenous peoples is often of poor quality. This narrative review aimed to (i) identify perceived barriers for the ascertainment of Indigenous peoples on health registers, and (ii) collate strategies identified and used by health registers to support comprehensive ascertainment and high-quality data for Indigenous peoples. Methods A Kaupapa Māori theoretical framework was utilized to guide this work. Four electronic databases were systematically searched for original articles and screened for eligibility. Studies involving health registers with Indigenous population(s) identified were included if either ascertainment or data quality strategies were described. Data extraction focused on the reporting of research involving Indigenous peoples using the CONSIDER checklist domains, ascertainment, and data quality. Results Seventeen articles were included spanning publication between 1992 and 2020. Aspects of four of eight CONSIDER domains were identified to be included in the reporting of studies. Barriers to ascertainment were themed as relating to ‘ethnicity data collection and quality’, ‘systems and structures’, ‘health services/health professionals’, and ‘perceptions of individual and community-level barriers’. Strategies to support ascertainment were categorized as ‘collaboration’, ‘finding people’, and ‘recruitment processes’. Categorized strategies to support data quality were ‘collaboration’, ‘ethnicity data collection and quality’, ‘systems-level strategies’, and ‘health service/health professional-level strategies’. Conclusions Poor-quality data for Indigenous peoples in health registers prevents the achievement of health equity and exemplifies inaction in the face of need. When viewed through a critical structural determinants lens, there are visible gaps in the breadth of strategies, particularly relating to the inclusion of Indigenous peoples in health register and research governance, and actions to identify and address institutional racism. Indigenous led research, meaningful collaboration, and a sharing of knowledge and experiences between health registers is recommended to enable research and health registers that support Indigenous self-determination and health equity.
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159
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Paine SJ, Walker R, Lee A, Signal TL. Inequities in maternal stressful life events between Indigenous and non-Indigenous women – evidence from a prospective cohort study in New Zealand. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2050184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sarah-Jane Paine
- Tōmaiora Māori Health Research Group, Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rhiannon Walker
- Tōmaiora Māori Health Research Group, Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Arier Lee
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - T Leigh Signal
- Sleep/Wake Research Centre, College of Health, Massey University, Wellington, New Zealand
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160
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Firoz T, Gross T, Banerjee A, Magee LA. Addressing racial disparities: Time for action. Obstet Med 2022; 15:3-5. [PMID: 35444723 PMCID: PMC9014539 DOI: 10.1177/1753495x221087171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Tyra Gross
- Department of Public Health Sciences, Xavier University of Louisiana
| | - Anita Banerjee
- Women's Services, Guys and St Thomas’ Hospitals NHS
Foundation Trust
| | - Laura A. Magee
- Department of Women and Children's Health, School of Life
Course Sciences, King's College London
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161
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Jia SS, Liu Q, Allman-Farinelli M, Partridge SR, Pratten A, Yates L, Stevens M, McGill B. The Use of Portion Control Plates to Promote Healthy Eating and Diet-Related Outcomes: A Scoping Review. Nutrients 2022; 14:nu14040892. [PMID: 35215542 PMCID: PMC8874720 DOI: 10.3390/nu14040892] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 01/17/2023] Open
Abstract
The role of portion control plates in achieving healthy diets is unclear. The aim of this scoping review was to systematically map findings from peer reviewed and grey literature to provide evidence for the use of portion control plates to promote healthy eating and nutrition-related knowledge in children and adults. A secondary aim was to review the design characteristics of portion control plates. The search was conducted in four databases, including Medline, CINAHL, Embase, and PsycInfo, and grey literature sources following the PRISMA scoping review guidelines. A total of 22 articles comprising 23 intervention studies and 8 from grey literature were included. It was found that the various two-dimensional and three-dimensional portion control plates examined were effective tools for better portion size selection in healthy children and adults. Most portion control plates dedicated half the plate to vegetables, a quarter to protein, and a quarter to carbohydrates. The use of portion control plates in nutrition interventions appears to promote weight loss among those with overweight and obesity and/or type 2 diabetes. However, portion control plates were mostly used as part of multicomponent interventions and the effectiveness of the portion control plate as a stand-alone educational resource or portion control tool alone was uncertain. Further interventional research is indicated to investigate portion plates as tools to improve dietary behaviours and food consumption at the population level.
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Affiliation(s)
- Si Si Jia
- Engagement and Co-Design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Correspondence: ; Tel.: +61-2-8627-1697
| | - Qingzhou Liu
- Charles Perkins Centre, School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney 2006, Australia;
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
| | - Stephanie R. Partridge
- Engagement and Co-Design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Charles Perkins Centre, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
| | - Amy Pratten
- New South Wales Ministry of Health, Centre for Population Health, St Leonards, Sydney 2065, Australia; (A.P.); (L.Y.); (M.S.)
| | - Lisa Yates
- New South Wales Ministry of Health, Centre for Population Health, St Leonards, Sydney 2065, Australia; (A.P.); (L.Y.); (M.S.)
| | - Matthew Stevens
- New South Wales Ministry of Health, Centre for Population Health, St Leonards, Sydney 2065, Australia; (A.P.); (L.Y.); (M.S.)
| | - Bronwyn McGill
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
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162
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Deacon-Crouch M, Skinner I, Tucci J, Begg S, Wallace R, Skinner T. Association between indigenous status and Body Mass Index (BMI) in Australian adults: Does sleep duration affect the relationship? PLoS One 2022; 17:e0263233. [PMID: 35171935 PMCID: PMC8849483 DOI: 10.1371/journal.pone.0263233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background Overweight/obesity is a well-defined risk factor for a variety of chronic cardiovascular and metabolic diseases. Sleep duration has been associated with overweight/obesity and other cardio metabolic and neurocognitive problems. Notably, overweight/obesity and many of the associated comorbidities are prevalent in Indigenous Australians. Generally, sleep duration has been associated with BMI for Australian adults but information about Australian Indigenous adults’ sleep is scant. A recent report established that sleep is a weak predictor of obesity for Indigenous Australian adults. Aim To determine whether sleep remains a predictor of obesity when physical activity, diet and smoking status are accounted for; and to determine whether sleep duration plays a mediating role in the relationship between Indigenous status and BMI. Methods Statistical analyses of 5,886 Australian adults: 5236 non-Indigenous and 650 Indigenous people aged over 18 years who participated in the Australian Health Survey 2011–2013. Demographic and lifestyle characteristics were described by χ2 and t-tests. ANOVA was used to determine the variables that significantly predicted BMI and sleep duration. Stepwise regression analyses were performed to determine the strongest significant predictors of BMI. Sleep duration was self-reported; BMI was calculated from measurement. Results The study revealed two main findings: (i) short sleep duration was an independent predictor of obesity (adjusted-R2 = 0.056, p <0.0001); and (ii) controlling for sleep duration and other possible confounders, Indigenous status was a significant predictor of BMI overweight/obesity. Sleep duration played a weak, partial mediator role in this relationship. Increased BMI was associated with lower socioeconomic status and level of disadvantage of household locality for non-remote Indigenous and non-Indigenous people. Conclusion Indigenous status strongly predicted increased BMI. The effect was not mediated by the socioeconomic indicators but was partially mediated by sleep duration.
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Affiliation(s)
- Melissa Deacon-Crouch
- Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- * E-mail:
| | - Isabelle Skinner
- Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Joseph Tucci
- Department of Pharmacy and Biomedical Science, La Trobe Institute for Molecular Science, La Trobe University, Victoria, Australia
| | - Steve Begg
- Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Ruth Wallace
- College of Indigenous Futures, Education & the Arts, Charles Darwin University, Northern Territory, Australia
| | - Timothy Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Serna-Gutiérrez A, Castro-Juarez AA, Romero-Martínez M, Alemán-Mateo H, Díaz-Zavala RG, Quihui-Cota L, Álvarez-Hernández G, Gallegos-Aguilar AC, Esparza-Romero J. Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey. BMC Public Health 2022; 22:308. [PMID: 35164732 PMCID: PMC8845338 DOI: 10.1186/s12889-022-12702-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico. METHODS A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling. RESULTS The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (β = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (β = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (β = -0.14, p = 0.017) were associated with a lower BMI. CONCLUSIONS The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.
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Affiliation(s)
- Araceli Serna-Gutiérrez
- Sociocultural Department, Technological Institute of Sonora, 85137, Cd. Obregón, Sonora, México
| | - Alejandro Arturo Castro-Juarez
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México
| | - Martín Romero-Martínez
- Evaluation and Surveys Research Center, National Institute of Public Health, 62100, Cuernavaca, Morelos, México
| | - Heliodoro Alemán-Mateo
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD. A.C.), 83304, Hermosillo, Sonora, México
| | - Rolando Giovanni Díaz-Zavala
- Nutrition Health Promotion Center, Department of Chemical and Biological Sciences, University of Sonora, 83000, Hermosillo, Sonora, México
| | - Luis Quihui-Cota
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD. A.C.), 83304, Hermosillo, Sonora, México
| | | | - Ana Cristina Gallegos-Aguilar
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México
| | - Julián Esparza-Romero
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México. .,Diabetes Research Unit, Deparment of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), Carretera Gustavo Enrique Astiazarán Rosas No. 46, Col. La Victoria, 83304, Hermosillo, Sonora, México.
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Maclennan B, Wyeth E, Samaranayaka A, Derrett S. Predictors of EQ-5D-3L outcomes amongst injured Māori: 1-year post-injury findings from a New Zealand cohort study. Qual Life Res 2022; 31:1689-1701. [PMID: 35076826 PMCID: PMC8787030 DOI: 10.1007/s11136-022-03085-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Māori, the Indigenous population of New Zealand (NZ), are at higher risk of problems with health-related quality of life (HRQoL) 12 months following injury. This paper examines pre-injury sociodemographic and health characteristics and injury-related factors, including healthcare access, and their association with HRQoL outcomes 12 months after injury. METHODS The Prospective Outcomes of Injury Study recruited 2856 injured New Zealanders aged 18-64 years from the entitlement claims register of the country's no-fault injury insurance agency. One-fifth (n = 566) of the cohort were Māori. Information on predictors and outcomes, with the exception of injury and hospitalisation, was obtained directly from participants at approximately 3 and 12 months post-injury. The outcomes of interest were responses to the five dimensions of the EQ-5D-3L and a dichotomous measure obtained by summing scored responses to each question. Modified Poisson regression was used to identify predictors of each outcome at 12 months post-injury. RESULTS Predictors differed by outcome. Being female, experiencing EQ-5D-3L problems pre-injury, having ≥ 2 chronic conditions pre-injury, perceiving one's injury to be a threat of long-term disability, and having trouble accessing health services for injury were common predictors of EQ-5D-3L problems at 12 months post-injury for Māori. CONCLUSION Opportunities exist to improve HRQoL outcomes by identifying individuals in the early stages of injury recovery who may benefit from further treatment and support.
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Affiliation(s)
- Brett Maclennan
- Department of Preventive and Social Medicine, Dunedin School of Medicine, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Emma Wyeth
- Department of Preventive and Social Medicine, Dunedin School of Medicine, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Ari Samaranayaka
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, Dunedin School of Medicine, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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Brown ADH, Crengle S, Tewhaiti-Smith J, Westhead S, Bingham B, Brown N, Cassidy-Matthews C, Clark T, Finlay SM, Hansen KL, Harwood M, Niia KSH, Iversen KN, Knapp JMF, Kvernmo S, Lee C, Watts RLT, Nadeau M, Pearson O, Reading J, Sarre ÁMF, Seljenes A, Stoor JPA, Eckhoff C, Saewyc E, San Sebastian M, Elliott S, Larsen CVL, Sise A, Azzopardi PS. The health and wellbeing of Indigenous adolescents: a global collective for an equitable and sustainable future. Lancet 2022; 399:341-343. [PMID: 34951950 DOI: 10.1016/s0140-6736(21)02719-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/20/2021] [Indexed: 01/08/2023]
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Handsley-Davis M, Kapellas K, Jamieson LM, Hedges J, Skelly E, Kaidonis J, Anastassiadis P, Weyrich LS. Heritage-specific oral microbiota in Indigenous Australian dental calculus. Evol Med Public Health 2022; 10:352-362. [PMID: 36032329 PMCID: PMC9400808 DOI: 10.1093/emph/eoac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/26/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and objectives
Aboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience a high burden of chronic non-communicable diseases (NCDs). Increased NCD risk is linked to oral diseases mediated by the oral microbiota, a microbial community influenced by both vertical transmission and lifestyle factors. As an initial step towards understanding the oral microbiota as a factor in Indigenous health, we present the first investigation of oral microbiota in Indigenous Australian adults.
Methodology
Dental calculus samples from Indigenous Australians with periodontal disease (PD; n = 13) and non-Indigenous individuals both with (n = 19) and without PD (n = 20) were characterized using 16S ribosomal RNA gene amplicon sequencing. Alpha and beta diversity, differentially abundant microbial taxa and taxa unique to different participant groups were analysed using QIIME2.
Results
Samples from Indigenous Australians were more phylogenetically diverse (Kruskal–Wallis H = 19.86, P = 8.3 × 10−6), differed significantly in composition from non-Indigenous samples (PERMANOVA pseudo-F = 10.42, P = 0.001) and contained a relatively high proportion of unique taxa not previously reported in the human oral microbiota (e.g. Endomicrobia). These patterns were robust to stratification by PD status. Oral microbiota diversity and composition also differed between Indigenous individuals living in different geographic regions.
Conclusions and implications
Indigenous Australians may harbour unique oral microbiota shaped by their long relationships with Country (ancestral homelands). Our findings have implications for understanding the origins of oral and systemic NCDs and for the inclusion of Indigenous peoples in microbiota research, highlighting the microbiota as a novel field of enquiry to improve Indigenous health.
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Affiliation(s)
- Matilda Handsley-Davis
- Australian Centre for Ancient DNA (ACAD), School of Biological Sciences, University of Adelaide , Adelaide, SA, Australia
- Centre for Australian Biodiversity and Heritage (CABAH), University of Adelaide , Adelaide, SA, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | - Emily Skelly
- Australian Centre for Ancient DNA (ACAD), School of Biological Sciences, University of Adelaide , Adelaide, SA, Australia
| | - John Kaidonis
- Adelaide Dental School, University of Adelaide , Adelaide, SA, Australia
| | | | - Laura S Weyrich
- Australian Centre for Ancient DNA (ACAD), School of Biological Sciences, University of Adelaide , Adelaide, SA, Australia
- Centre for Australian Biodiversity and Heritage (CABAH), University of Adelaide , Adelaide, SA, Australia
- Department of Anthropology and Huck Institutes of the Life Sciences, The Pennsylvania State University , University Park, PA, USA
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Gassmann F, de Groot R, Dietrich S, Timar E, Jaccoud F, Giuberti L, Bordon G, Fautsch-Macías Y, Veliz P, Garg A, Arts M. Determinants and drivers of young children's diets in Latin America and the Caribbean: Findings from a regional analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000260. [PMID: 36962164 PMCID: PMC10021987 DOI: 10.1371/journal.pgph.0000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
Abstract
The Latin America and Caribbean region exhibit some of the lowest undernutrition rates globally. Yet, disparities exist between and within countries and countries in the region increasingly face other pressing nutritional concerns, including overweight, micronutrient deficiencies and inadequate child feeding practices. This paper reports findings from a regional analysis to identify the determinants and drivers of children's diets, with a focus on the complementary feeding window between the age of 6-23 months. The analysis consists of a narrative review and descriptive data analysis, complemented with qualitative interviews with key informants in four countries: Guatemala, Paraguay, Peru and Uruguay. Findings indicate that poverty and inequality (disparities within countries by wealth and residence), unequal access to services, inadequate coverage of social programmes and lack of awareness on appropriate feeding practices are important drivers for inadequate diets. We conclude that countries in the region need to invest in policies to tackle overweight and micronutrient deficiencies in young children, considering inequalities between and within countries, enhance coverage of social protection programmes, improve coordination between sectors to improve children's diets and expand the coverage and intensity of awareness campaigns on feeding practices, using iterative programme designs.
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Affiliation(s)
| | | | | | - Eszter Timar
- UNU-MERIT, Maastricht University, Maastricht, Netherlands
| | | | | | - Giulio Bordon
- UNU-MERIT, Maastricht University, Maastricht, Netherlands
| | - Yvette Fautsch-Macías
- UNICEF Latin America and Caribbean Regional Office, New York, New York, United States of America
| | - Paula Veliz
- UNICEF Latin America and Caribbean Regional Office, New York, New York, United States of America
| | - Aashima Garg
- UNICEF, New York, New York, United States of America
| | - Maaike Arts
- UNICEF Latin America and Caribbean Regional Office, New York, New York, United States of America
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Liabsuetrakul T. Disparities in universal health coverage for maternal and newborn care in ethnic minorities in South-East Asia. WHO South East Asia J Public Health 2022; 11:1-2. [PMID: 36308266 DOI: 10.4103/2224-3151.358074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Tippawan Liabsuetrakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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169
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Kidd J, Came H, Doole C, Rae N. A critical analysis of te Tiriti o Waitangi application in primary health organisations in Aotearoa New Zealand: Findings from a nationwide survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e105-e112. [PMID: 33970523 DOI: 10.1111/hsc.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/04/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Primary health is at the forefront of efforts to address health inequities. Effective primary health care keeps people well and improves longevity and quality of life. The persistence of health inequities, particularly between Indigenous peoples and non-Indigenous peoples globally, suggests that there is a need to strengthen policy and practise. Unique to Aotearoa (New Zealand) is te Tiriti o Waitangi, a treaty negotiated in 1840 between the British Crown and hapū (Māori [Indigenous] subtribes). This treaty is foundational to public policy in Aotearoa and requires the Crown (New Zealand government) to uphold a set of responsibilities around protecting and promoting Māori health. This paper examines to what extent Primary Health Organisations are upholding te Tiriti o Waitangi. The study utilises data from a nationwide telephone survey of public health providers conducted in 2019-2020 recruited from a list on the Ministry of Health website. This paper focuses on data about te Tiriti application from 21 Primary Health Organisations from a sample size of thirty. Critical te Tiriti analysis, an emerging methodology, was used to assess to what extent the participating primary health organisations were te Tiriti compliant. The critical te Tiriti analysis found poor to fair compliance with most elements of te Tiriti but good engagement with equity. Suggestions for strengthening practise included examining relationships with Māori, utilising a planned approach, structural mechanisms, normalising Māori world views and consistency in application. The onus needs to be on non-Māori to contribute to the cultural change and power-sharing required to uphold te Tiriti. Critical te Tiriti analysis is a useful methodology to review te Tiriti compliance and could be used in other contexts to review alignment with Indigenous rights and aspirations.
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Affiliation(s)
- Jacquie Kidd
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Heather Came
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Claire Doole
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010261. [PMID: 35010521 PMCID: PMC8751189 DOI: 10.3390/ijerph19010261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
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171
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Patterson K, Sargeant J, Yang S, McGuire-Adams T, Berrang-Ford L, Lwasa S, Communities B, Steele V, Harper SL. Are Indigenous research principles incorporated into maternal health research? A scoping review of the global literature. Soc Sci Med 2021; 292:114629. [PMID: 34896728 DOI: 10.1016/j.socscimed.2021.114629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/05/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Indigenous women world-wide are diverse and heterogenous, yet many have similar experiences of colonization, land dispossession, and discrimination. These experiences along with inequitable access to, and quality of, maternal healthcare increase adverse maternal health outcomes. To improve health outcomes for Indigenous women, studies must be conducted with Indigenous involvement and reflect Indigenous research principles. Objectives/Aim: The aim of this review was to explore the range, extent, and nature of Indigenous maternal health research and to assess the reporting of Indigenous research principles in the global Indigenous maternal health literature. METHODS Following a systematic scoping review protocol, four scholarly electronic databases were searched. Articles were included if they reported empirical research published between 2000 and 2019 and had a focus on Indigenous maternal health. Descriptive data were extracted from relevant articles and descriptive analysis was conducted. Included articles were also assessed for reporting of Indigenous research principles, including Indigenous involvement, context of colonization, Indigenous conceptualizations of health, community benefits, knowledge dissemination to participants or communities, and policy or intervention recommendations. RESULTS Four-hundred and forty-one articles met the inclusion criteria. While studies were conducted in all continents except Antarctica, less than 3% of articles described research in low-income countries. The most researched topics were access to and quality of maternity care (25%), pregnancy outcome and/or complications (18%), and smoking, alcohol and/or drug use during pregnancy (14%). The most common study design was cross-sectional (49%), and the majority of articles used quantitative methods only (68%). Less than 2% of articles described or reported all Indigenous research principles, and 71% of articles did not report on Indigenous People's involvement. CONCLUSIONS By summarizing the trends in published literature on Indigenous maternal health, we highlight the need for increased geographic representation of Indigenous women, expansion of research to include important but under-researched topics, and meaningful involvement of Indigenous Peoples.
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Affiliation(s)
- Kaitlin Patterson
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Jan Sargeant
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Seungmi Yang
- Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada.
| | - Tricia McGuire-Adams
- Faculty of Education, University of Ottawa, 145 Jean-Jacques-Lussier Private, Ottawa, Ontario, K1N 6N5, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, United Kingdom.
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Arts Building, South Wing Ground Floor, P.O Box, 7062, Kampala, Uganda.
| | | | - Vivienne Steele
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada; School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
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Fa JE, Nasi R, Funk SM. The COVID-19 Pandemic Endangers Africa's Indigenous Pygmy Populations. ECOHEALTH 2021; 18:403-405. [PMID: 34041645 PMCID: PMC8154106 DOI: 10.1007/s10393-021-01528-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/07/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Julia E Fa
- Department of Natural Sciences, School of Science and the Environment, Manchester Metropolitan University, Manchester, M1 5GD, UK
- Center for International Forestry Research (CIFOR), CIFOR Headquarters, Bogor, 16115, Indonesia
| | - Robert Nasi
- Center for International Forestry Research (CIFOR), CIFOR Headquarters, Bogor, 16115, Indonesia
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Chando S, Howell M, Young C, Craig JC, Eades SJ, Dickson M, Howard K. Outcomes reported in evaluations of programs designed to improve health in Indigenous people. Health Serv Res 2021; 56:1114-1125. [PMID: 33748978 PMCID: PMC8586489 DOI: 10.1111/1475-6773.13653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To assess the outcomes reported and measured in evaluations of complex health interventions in Indigenous communities. DATA SOURCES We searched all publications indexed in MEDLINE, PreMEDLINE, EMBASE, PsycINFO, EconLit, and CINAHL until January 2020 and reference lists from included papers were hand-searched for additional articles. STUDY DESIGN Systematic review. DATA COLLECTION/EXTRACTION METHODS We included all primary studies, published in peer-reviewed journals, where the main objective was to evaluate a complex health intervention developed specifically for an Indigenous community residing in a high-income country. Only studies published in English were included. Quantitative and qualitative data were extracted and summarized. PRINCIPAL FINDINGS Of the 3523 publications retrieved, 62 evaluation studies were included from Australia, the United States, Canada, and New Zealand. Most studies involved less than 100 participants and were mainly adults. We identified outcomes across 13 domains: clinical, behavioral, process-related, economic, quality of life, knowledge/awareness, social, empowerment, access, environmental, attitude, trust, and community. Evaluations using quantitative methods primarily measured outcomes from the clinical and behavioral domains, while the outcomes reported in the qualitative studies were mostly from the process-related and empowerment domains. CONCLUSION The outcomes from qualitative evaluations, which better reflect the impact of the intervention on participant health, remain different from the outcomes routinely measured in quantitative evaluations. Measuring the outcomes from qualitative evaluations alongside outcomes from quantitative evaluations could result in more relevant evaluations to inform decision making in Indigenous health.
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Affiliation(s)
- Shingisai Chando
- University of SydneySydneyNew South WalesAustralia
- Centre for Kidney ResearchThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Martin Howell
- University of SydneySydneyNew South WalesAustralia
- Centre for Kidney ResearchThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | | | - Jonathan C. Craig
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
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A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312669. [PMID: 34886396 PMCID: PMC8657270 DOI: 10.3390/ijerph182312669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
While much is known about the health implications of low birthweight for infants and adults, there is limited information about the health implications in childhood, particularly for Indigenous children. The aim of this systematic review was to assess associations between low birthweight (LBW) and/or small for gestational age (SGA) and the developmental, physical or mental health outcomes for Australian, Canadian and New Zealand Indigenous children (5-12 years), including the potential mediating role of cultural connections. The review was guided by an Aboriginal Advisory Group established to guide the Aboriginal Families Study. Four databases were investigated with pre-determined inclusion/exclusion criteria. The search identified 417 articles after independent screening by two authors. Eight studies assessing six child outcomes were included. The review identified limited evidence, although the review suggested possible links between LBW and/or SGA and childhood asthma, lower body mass index (BMI) and poorer academic performance. Links between LBW, SGA and disability, global health and developmental vulnerability were inconclusive. One study identified cultural-based resilience as protective against perinatal adversity. In summary, research on the relationship between adverse birth outcomes and Indigenous children's health and development is limited. Further investigation and collaboration with Indigenous communities is required to drive optimised health and social services responses and equitable system reform.
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Batal M, Kenny TA, Johnson-Down L, Ing A, Fediuk K, Sadik T, Chan HM, Willows N. Development of an optimal grocery list based on actual intake from a cross-sectional study of First Nations adults in Ontario, Canada. Appl Physiol Nutr Metab 2021; 47:379-394. [PMID: 34826224 DOI: 10.1139/apnm-2020-0950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A multi-stage sampling strategy selected 1387 on-reserve First Nations adults in Ontario. Foods from a 24-hour dietary recall were assigned to the 100 most common food groups for men and women. Nutrients from market foods (MF) and traditional foods (TF) harvested from the wild as well as MF costs were assigned based on the proportions of total grams consumed. Linear programming was performed imposing various constraints to determine whether it was possible to develop diets that included the most popular foods while meeting Institute of Medicine guidelines. Final models were obtained for both sexes with the top 100 food groups consumed while limiting the nutrient-poor foods to no more than the actual observed intake. These models met all nutrient constraints for men but those for dietary fibre, linoleic acid, phosphorus, and potassium were removed for women. MF costs were obtained from community retailers and online resources. A grocery list was then developed and MF were costed for a family of four. The grocery list underestimated the actual weekly food cost because TF was not included. Contemporary observed diets deviated from healthier historic First Nations diets. A culturally appropriate diet would include more traditional First Nations foods and fewer MF. Novelty ● Linear programming is a mathematical approach to evaluating the diets of First Nations ● The grocery list is representative of food patterns within Ontario First Nations and can be used as an alternative to the nutritious food basket used for public health food costing.
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Affiliation(s)
- Malek Batal
- CP 6128 succ Centre-Ville, Département de nutrition, Montréal, Quebec, Canada.,Centre de recherche en santé publique [CReSP], Département de nutrition, Montréal, Quebec, Canada;
| | - Tiff-Annie Kenny
- Université Laval, 4440, Département de médecine sociale et préventive, Quebec, Quebec, Canada;
| | - Louise Johnson-Down
- CP 6128 succ Centre-Ville, Département de nutrition, Montréal, Quebec, Canada;
| | - Amy Ing
- CP 6128 succ Centre-Ville, Département de nutrition, Montréal, Quebec, Canada;
| | - Karen Fediuk
- University of Ottawa, 6363, Ottawa, Canada, K1N 6N5;
| | - Tonio Sadik
- Assembly of First Nations, Ottawa, Ontario, Canada;
| | - Hing Man Chan
- University of Ottawa, 6363, Department of Biology, Ottawa, Canada, K1N 6N5;
| | - Noreen Willows
- University of Alberta, 3158, Food & Nutri Sci Dept, Edmonton, Canada, T6G 2R3;
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176
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Lin CY, Hung HJ, Chung CJ, Huang CT, Wu TN, Chen CY. Ethnic disparity in metabolic syndrome and related obesity and health behavior: a community study in Taiwan. Diabetol Metab Syndr 2021; 13:134. [PMID: 34789325 PMCID: PMC8597312 DOI: 10.1186/s13098-021-00751-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/29/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND As studies on ethnic disparities in metabolic syndrome and its risk factors in Taiwan are still rare, the aims of this study were: (1) to detect the differences in the rates of metabolic syndrome, obesity and health behaviors between two ethnic groups (indigenous Tsou and nonindigenous Han) living in the same area and with similar age and sex distributions; (2) to examine whether ethnicity per se plays a significant role in the occurrence of metabolic syndrome, while taking other risk factors including sociodemographic characteristics, obesity and health behaviors into consideration. METHODS This is a cross-sectional study using data from a community survey conducted in Chiayi County in southwestern Taiwan. A frequency matching strategy by age and sex with a ratio of 1 (Tsou) to 3 (Han) was applied to select a comparable sample between both ethnic groups (667 Tsou and 2001 Han) from among the survey participants. Furthermore, participants with cardiometabolic diseases diagnosed before the surveyed day were excluded to avoid confounding any associated risk factors for developing metabolic syndrome (MS). A final analytic sample of 1482 remained. The used information included sociodemographic characteristics, medical histories, health behaviors, and the concentrations of triglycerides, cholesterol, and glucose. RESULTS Indigenous Tsou had significantly higher rates of metabolic syndromes, obesity and unhealthy behaviors than their Han counterparts (MS: 54.0% vs. 29.1%, obesity: 54.0% vs. 23.2%, drinking alcohol: 17.5% vs. 13.6%, and higher intake of fried food: 6.4% vs. 4.4%), even though they were similar in age and sex distributions. The significant risk factors for subsequently developing MS included being indigenous Tsou (adjusted POR = 2.62, P < 0.001), older, single, and obese. Stratified analyses on the risk factors for developing MS by health behaviors and by obese problems also indicated increased risks of being indigenous Tsou. CONCLUSIONS There existed ethnic differences in the rates of metabolic syndrome, obesity, and health behaviors. Ethnicity per se did play a significant role in developing MS; in particular indigenous Tsou people had increased risks, suggesting possible biological reasons rooted in their origins that need further exploration. In addition, unhealthy behaviors may potentially have an indirect effect on developing MS via their effect on obesity.
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Affiliation(s)
- Chih-Ying Lin
- Department of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 40604 Taiwan
| | - Hui-Jung Hung
- Department of Nursing and Graduate Institute of Nursing, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung, 41354 Taiwan
| | - Chi-Jung Chung
- Department of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 40604 Taiwan
| | - Chia-Ti Huang
- Medical Affairs Section, Public Health Bureau, Taitung County, No. 336, Bo’ai Rd., Taitung City, Taitung County 95043 Taiwan
| | - Trong-Neng Wu
- Department of Healthcare Administration, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung, 41354 Taiwan
| | - Chiu-Ying Chen
- Department of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 40604 Taiwan
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, No.91, Hsueh-Shih Rd., Taichung, 40402 Taiwan
- Department of Senior Citizen Service Management, College of Health, National Taichung University of Science and Technology, No. 193, Sec. 1, Sanmin Rd., Taichung, 40401 Taiwan
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177
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Oliveira MVG, Abreu ÂMM, Welch JR, Coimbra CEA. Coping with Hypertension among Indigenous Peoples in Brazil and the Role of the Primary Care Nurse: A Critical Review from a Transcultural Perspective. NURSING REPORTS 2021; 11:942-954. [PMID: 34968280 PMCID: PMC8715468 DOI: 10.3390/nursrep11040086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/27/2022] Open
Abstract
Our objective is to critically review the literature addressing the strategic role of nurses in the daily primary care of arterial hypertension in Indigenous communities in Brazil. We selected studies based on an initial keyword search of major bibliographic indexing databases for the years 2000 to 2020 and manual search. Further selection was based on topical, methodological, and thematic relevance, as well as evaluation of scholarship quality and pertinence to our chosen narrative. The literature demonstrates Indigenous peoples do not receive health services that measure up to national standards in large part due to a marked lack of academic and employer preparation for nurses operating in transcultural settings. Inequities were apparent in recurrent reports of victim-blaming, deficient clinical communication with patients, clinical malpractice, devaluation of hypertension as a problem for Indigenous peoples, insufficient intercultural training for nurses, and discrimination against Indigenous students in nursing education programs. This systemic problem needs to be addressed by universities and the Indigenous Health Care Subsystem in Brazil.
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Affiliation(s)
| | - Ângela Maria Mendes Abreu
- Escola de Enfermagem Anna Nery, Universidade Federal de Rio de Janeiro, Rio de Janeiro 20211-130, Brazil;
| | - James R. Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro 21041-210, Brazil; (J.R.W.); (C.E.A.C.J.)
| | - Carlos E. A. Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro 21041-210, Brazil; (J.R.W.); (C.E.A.C.J.)
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178
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Shah S, Desai S, Desai T, Szkwarko D, Desai G. Trends and risk factors in tribal vs nontribal preterm deliveries in Gujarat, India. AJOG GLOBAL REPORTS 2021; 1:100026. [PMID: 36277462 PMCID: PMC9563542 DOI: 10.1016/j.xagr.2021.100026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although risk factors of preterm deliveries across the world have been extensively studied, the trends and risk factors of preterm deliveries for the population of rural India, and specifically tribal women, remain unexplored. OBJECTIVE The aim of this study was to assess and compare the preterm delivery rates among women from a rural area in Gujarat, India, based on socioeconomic and clinical factors. The second aim of the study was to assess and identify predictors or risk factors for preterm deliveries. STUDY DESIGN This was a retrospective medical record review study investigating deliveries that took place at the Kasturba Maternity Hospital in Jhagadia, Gujarat, from January 2012 to June 2019 (N=32,557). We performed odds ratio and adjusted odds ratio analyses of preterm delivery risk factors. Lastly, we also considered the neonatal outcomes of preterm deliveries, both overall and comparing tribal and nontribal mothers. RESULTS For the study period, the tribal preterm delivery rate was 19.7% and the nontribal preterm delivery rate was 13.9%; the rate remained consistent for both groups over the 7-year study period. Adjusted odds ratios indicated that tribal status (adjusted odds ratio, 1.16; 95% confidence interval, 1.08–1.24), maternal illiteracy ((adjusted odds ratio, 1.29, 95% confidence interval, 1.18–1.42), paternal illiteracy (adjusted odds ratio, 1.27; 95% confidence interval, 1.15–1.410), hemoglobin <10 g/dL (adjusted odds ratio, 1.41; 95% confidence interval, 1.32–1.51), and a lack of antenatal care (adjusted odds ratio, 2.15; 95% confidence interval, 1.94–2.37) are significantly associated with higher odds of preterm delivery. The overall stillbirth rate among tribal women was 3.06% and 1.73% among nontribal women; among preterm deliveries, tribal women have a higher proportion of stillbirth outcomes (11.77%) than nontribal women (8.86%). CONCLUSION Consistent with existing literature, risk factors for preterm deliveries in rural India include clinical factors such as a lack of antenatal care and low hemoglobin. In addition, sociodemographic factors, such as tribal status, are independently associated with higher odds of delivering preterm. The higher rates of preterm deliveries among tribal women need to be studied further to detail the underlying reasons of how it can influence a woman's delivery outcome.
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Affiliation(s)
- Shital Shah
- Warren Alpert Medical School of Brown University, Providence, RI (Ms Shah)
- Corresponding author: Shital Shah, MPA.
| | - Shrey Desai
- Society for Education Welfare and Action (SEWA) Rural, Jhagadia, Gujarat, India (Drs S Desai, T Desai, and G Desai)
| | - Tushar Desai
- Society for Education Welfare and Action (SEWA) Rural, Jhagadia, Gujarat, India (Drs S Desai, T Desai, and G Desai)
| | - Daria Szkwarko
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI (Dr Szkwarko)
| | - Gayatri Desai
- Society for Education Welfare and Action (SEWA) Rural, Jhagadia, Gujarat, India (Drs S Desai, T Desai, and G Desai)
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179
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Baum F. How can health promotion contribute to pulling humans back from the brink of disaster? Glob Health Promot 2021; 28:64-72. [PMID: 34711103 DOI: 10.1177/17579759211044074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Health promotion has evolved over the last decades from a primary focus on behaviour change to establishing an ambitious goal of creating healthy, fair and sustainable environments in a manner which realises the rights of all people to health and well-being while protecting the health of our planet and its ecosystems. This paper argues that in order to contribute to this ambitious goal, health promotion must address three key tasks. The first is the need to take planetary health more seriously and move away from reductionist thinking to an approach that sees the planet as a complex system and values more harmony with nature, protects biodiversity and prevents global warming. The second task is to advocate and support governments to govern for health. The key to doing this is putting health and equity before profit, creating healthy urban environments, encouraging participatory decision-making, advocating for healthy economic models and assessing the ways in which corporate determinants of health operate. The third task is to ensure that moves to professionalise health promotion do not come at the expense of health promotion advocacy to powerful people and organisations. Health promotion is well placed to support civil society movements arguing for social and economic change that will benefit health such as the Black Lives Matter and environment movements.
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Affiliation(s)
- Fran Baum
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
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180
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Nath S, Poirier B, Ju X, Kapellas K, Haag D, Jamieson L. Periodontal disease inequities among Indigenous populations: A systematic review and meta-analysis. J Periodontal Res 2021; 57:11-29. [PMID: 34655251 DOI: 10.1111/jre.12942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 01/06/2023]
Abstract
The prevalence of periodontal disease varies considerably between Indigenous and general populations. The aim of this systematic review was to assess the global prevalence of periodontal disease among Indigenous populations in comparison with non-Indigenous populations. A systematic electronic search of databases and grey literature sources was conducted of all records through to February 2021. Study selection criteria included original data that reported the prevalence of periodontal diseases among an Indigenous population and compared with a non-Indigenous population, without any restriction on age, sex, language or geographical location. Critical appraisal was conducted with the Joanna Briggs Institute (JBI) tool for prevalence studies. A random-effects model using standardised mean difference (SMD) as the effect measure was used to estimate the pooled prevalence of periodontitis. Subgroup analysis of study location and publication source was also performed. Publication bias was assessed using Egger's test, and funnel plots were used for visualisation. A total of 19 articles were included for descriptive and meta-analysis. The overall prevalence of periodontitis was 35% (95% CI: 0.18, 0.52) higher among the Indigenous population than the non-Indigenous population. The pooled prevalence of periodontitis was consistently higher among the Indigenous populations when stratified according to periodontitis definition employed, study location and publication source. Indigenous populations have a higher prevalence of periodontitis than non-Indigenous populations. To decrease oral health inequities, more emphasis should be given to oral health promotion and specific culturally safe interventions working in partnership with Indigenous populations.
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Affiliation(s)
- Sonia Nath
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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181
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de Campos MB, Santos RV, Vilela EM, de Noronha CLA, da Silva LO, Coimbra Jr CEA, Bastos JL, Welch JR. Indigenous migration patterns in Brazil based on the 2010 national demographic census: analysis and critical reflection. SN SOCIAL SCIENCES 2021; 1:257. [PMID: 34723200 PMCID: PMC8549969 DOI: 10.1007/s43545-021-00264-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Research in several Latin American countries points to violence, loss of traditional territories, and seeking education, health, and wage labor as key variables in triggering rural-urban migration among Indigenous people. This study presents an analysis of the migration patterns of Indigenous people in Brazil, compared to non-indigenous people, based on data from the most recent national census, conducted in 2010. Migration characteristics related to lifetime migration and recent migration were investigated by means of descriptive and multivariable logistic regression analyses. The findings pointed to complex mobility scenarios according to migrants' Indigenous status and geographical regions of origin and destination. Indigenous people living in urban areas presented high levels of mobility (approximately 50% lived in different municipalities from those where they were born), which were more pronounced than those of non-Indigenous people. Indigenous people living in rural areas presented the lowest levels of migration (approximately 90% residing in their municipality of birth). Statistical modeling confirmed the patterns observed in descriptive analysis, highlighting the marked mobility of Indigenous subjects in urban areas. We emphasize the limitations of using census data for characterizing Indigenous mobility profiles, although no other nationally representative data are available. The finding that the Indigenous population living in urban areas presents rates of migration higher than their non-Indigenous counterparts is particularly important for the planning and implementation of a broad range of public policies aimed at ethnic minorities in the country, including health, education, and housing initiatives.
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Affiliation(s)
- Marden Barbosa de Campos
- Faculdade de Filosofia e Ciências Humanas, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
| | | | - Elaine Meire Vilela
- Faculdade de Filosofia e Ciências Humanas, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
| | | | | | | | - João Luiz Bastos
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, SC Brazil
| | - James R. Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ Brazil
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182
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Rashid P, Ronald M, Kong K. Cultural safety and racism. ANZ J Surg 2021; 91:2829-2832. [PMID: 34608738 DOI: 10.1111/ans.17250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Prem Rashid
- Department of Urology, Port Macquarie Base Hospital, The University of New South Wales, Port Macquarie, New South Wales, Australia.,Rural Clinical School, Faculty of Medicine, The University of New South Wales, Port Macquarie, NSW, 2444, Australia
| | - Maxine Ronald
- Department of General Surgery, Whangarei Hospital, Aotearoa, New Zealand
| | - Kelvin Kong
- Department of Otolaryngology, Head & Neck Surgery, John Hunter Hospital, Newcastle, NSW, Australia.,Department of Linguistics, Faculty of Medicine, Health and Health Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hearing For Learning Initiative, Menzies School of Health Research, Casuarina, NT, Australia
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183
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Bjerregaard P, Larsen CVL. Social determinants of dietary patterns, food basket costs and expenditure on alcohol and tobacco amongst Greenland Inuit. Public Health Nutr 2021; 24:4975-4984. [PMID: 33461645 PMCID: PMC11082809 DOI: 10.1017/s1368980020005133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/25/2020] [Accepted: 12/07/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Dietary transition, obesity and risky use of alcohol and tobacco are challenges to public health among indigenous peoples. The aim of the article was to explore the role of social position in dietary patterns and expenditures on food and other commodities. DESIGN Countrywide population health survey. SETTING Greenland. PARTICIPANTS 2436 Inuit aged 15+ years. RESULTS Less than half of the expenditures on commodities (43 %) were used to buy nutritious food, and the remaining to buy non-nutritious food (21 %), alcoholic beverages (18 %) and tobacco (18 %). Participants were classified according to five dietary patterns. The cost of a balanced diet and an unhealthy diet was similar, but the cost per 1000 kJ was higher and the energy consumption was lower for the balanced diet. Participants with low social position chose the unhealthy pattern more often than those with high social position (40 % v. 24 %; P < 0·0001), whereas those with high social position more often chose the balanced alternative. Participants with low social position spent less money on the total food basket than those with high social position but more on non-nutritious food, alcohol and tobacco. CONCLUSIONS Cost seems to be less important than other mechanisms in the shaping of social dietary patterns and the use of alcohol and tobacco among the Inuit in Greenland. Rather than increasing the price of non-nutritious food or subsidising nutritious food, socially targeted interventions and public health promotion regarding food choice and prevention of excessive alcohol use and smoking are needed to change the purchase patterns.
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Affiliation(s)
- Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark
- University of Greenland, Nuussuaq, Greenland
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184
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Griffiths KE, Blain J, Vajdic CM, Jorm L. Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10318. [PMID: 34639617 PMCID: PMC8508308 DOI: 10.3390/ijerph181910318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022]
Abstract
There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.
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Affiliation(s)
- Kalinda E. Griffiths
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Tiwi, NT 0812, Australia
- Centre for Health Equity, University of Melbourne, Parkville, VIC 3010, Australia
| | - Jessica Blain
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
| | - Claire M. Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia; (J.B.); (C.M.V.); (L.J.)
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185
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Nagaraj SH, Toombs M. The Gene-Drug Duality: Exploring the Pharmacogenomics of Indigenous Populations. Front Genet 2021; 12:687116. [PMID: 34616423 PMCID: PMC8488351 DOI: 10.3389/fgene.2021.687116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
While pharmacogenomic studies have facilitated the rapid expansion of personalized medicine, the benefits of these findings have not been evenly distributed. Genomic datasets pertaining to Indigenous populations are sorely lacking, leaving members of these communities at a higher risk of adverse drug reactions (ADRs), and associated negative outcomes. Australia has one of the largest Indigenous populations in the world. Pharmacogenomic studies of these diverse Indigenous Australian populations have been hampered by a paucity of data. In this article, we discuss the history of pharmacogenomics and highlight the inequalities that must be addressed to ensure equal access to pharmacogenomic-based healthcare. We also review efforts to conduct the pharmacogenomic profiling of chronic diseases among Australian Indigenous populations and survey the impact of the lack of drug safety-related information on potential ADRs among individuals in these communities.
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Affiliation(s)
- Shivashankar H. Nagaraj
- Centre for Genomics and Personalised Health, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Maree Toombs
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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186
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Two-Eyed Seeing and developmental origins of health and disease studies with indigenous partners. J Dev Orig Health Dis 2021; 13:417-423. [PMID: 34498558 DOI: 10.1017/s2040174421000507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Globally, mortality of Indigenous persons is greater than that of their non-Indigenous counterparts, which has been shown to be disproportionately attributable to non-communicable diseases. The historically subordinate position that Indigenous Knowledge (IK) held in comparison to Western science has shifted over the last several decades, with the credibility and importance of IK now being internationally recognized. Herein, we examine how Marsahall's (2014) Two-Eyed Seeing can foster collaborative and culturally relevant Developmental Origins of Health and Disease (DOHaD) studies for health and well-being by using '..the best in Indigenous ways of knowing…[and] the best in Western (or mainstream) ways of knowing…and learn to use both these eyes for the benefit of all.' At its core, Two-Eyed Seeing also includes the principles of ownership, control, access and possession, and Community-Based Participatory Research, which further reinforces the critical role of Indigenous peoples taking active roles in DOHaD research. Additionally, we also present a partnership model for working with Indigenous communities that includes the principles of respect, equity and empowerment. As researchers begin to fill the gap in Indigenous health, we outline how Two-Eyed Seeing should form the basis of DOHaD studies involving Indigenous communities. This model can be used to develop and guide projects that result in robust and meaningful participatory partnerships that have impactful uptake of research findings.
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187
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Onifade OM, Pringle KG, Rollo ME, Collins CE, Schumacher T, Rae KM. Dietary intake of Indigenous Australian infants and young children in the Gomeroi gaaynggal cohort. Nutr Diet 2021; 78:386-396. [PMID: 33908693 PMCID: PMC8518589 DOI: 10.1111/1747-0080.12673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/20/2021] [Accepted: 03/25/2021] [Indexed: 01/12/2023]
Abstract
AIM The nutritional quality of foods consumed by infants and young children to complement breastfeeding or formula feeding influences growth and development. The aim of this study was to identify the dietary intake of Indigenous infants and young children in the Gomeroi gaaynggal cohort, and evaluate the nutritional adequacy of their intake compared with Australian recommendations. METHODS Dietary intake was assessed using diet recalls at approximately 9-, 12- and 24-month visits. Nutrient values of foods were obtained from AUSNUT 2011-13 and nutrient intake compared to the Australian Nutrient Reference Values. Foods were categorised into food groups and intakes compared to the Australian Guide to Healthy Eating. RESULTS A total of 206 infants and young children were included in the study. Of these, 95 individual children had dietary data collected between 7.6 and 24.7 months. Infant formula and breastfeeding rates were highest among infants (70% and 20%, respectively). Cow's milk intake was highest among young children (75%). Infants and young children in the cohort met most macro- and micronutrient intake recommendations. Few young children met recommendation for iron (42%), no infant met recommendation for omega-3 fatty acids and almost all exceeded recommendation for sodium. Most young children met daily dairy and fruit recommendations although intake of discretionary foods was high. CONCLUSIONS This study found that diets of Indigenous infants and young children met most key nutrient reference targets. Potential target areas that require dietary optimisation have been identified and will be the focus of community-led strategies in adequate infant nutrition promotion.
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Affiliation(s)
- Oyepeju M. Onifade
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNew South WalesAustralia
- Pregnancy and Research ProgramHunter Medical Research InstituteNewcastleNew South WalesAustralia
| | - Kirsty G. Pringle
- Pregnancy and Research ProgramHunter Medical Research InstituteNewcastleNew South WalesAustralia
- School of Biomedical Science and PharmacyUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Megan E. Rollo
- School of Health SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Clare E. Collins
- School of Health SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Tracy Schumacher
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
- Department of Rural HealthUniversity of NewcastleTamworthNew South WalesAustralia
- Priority Research Centre for Health BehavioursUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kym M. Rae
- Mater Research InstituteAubigny PlaceBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandHerstonQueenslandAustralia
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Intergenerational Association of Short Maternal Stature with Stunting in Yanomami Indigenous Children from the Brazilian Amazon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179130. [PMID: 34501720 PMCID: PMC8430951 DOI: 10.3390/ijerph18179130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022]
Abstract
To describe the factors associated to stunting in <5-year-old Yanomami Brazilian children, and to evaluate the association of short maternal stature to their offspring’s stunting. A cross-sectional study carried out in three villages in the Yanomami territory. We performed a census, in which all households with children < 5-years-old were included. The length/height-for-age z-score <−2 standard deviations was used to classify the children as stunted. Short maternal height was defined as <145 cm for adult women, and <−2 standard deviations of the height-for-age z-score for adolescent women. We used adjusted Poisson regression models to estimate prevalence ratios (PR) along the 90% confidence interval. We evaluated 298 children. 81.2% of children suffered from stunting and 71.9% of the mothers from short stature. In the bivariate analysis, a significant association of stunting with short maternal stature, gestational malaria and child’s place of birth were observed. Considering the variables of the children under five years of age, there were significant associations with age group, the child’s caregiver, history of malaria, pneumonia, and malnutrition treatment. In the adjusted hierarchical model, stunting was 1.22 times greater in the offspring of women with a short stature (90% CI: 1.07–1.38) compared to their counterparts. Brazilian Amazonian indigenous children living in a remote area displayed an alarming prevalence of stunting, and this was associated with short maternal height, reinforcing the hypothesis of intergenerational chronic malnutrition transmission in this population. In addition, children above 24 months of age, who were born in the village healthcare units and who had had previous treatment in the past for stunting presented higher rates of stunting in this study.
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Russell D, Mathew S, Fitts M, Liddle Z, Murakami-Gold L, Campbell N, Ramjan M, Zhao Y, Hines S, Humphreys JS, Wakerman J. Interventions for health workforce retention in rural and remote areas: a systematic review. HUMAN RESOURCES FOR HEALTH 2021; 19:103. [PMID: 34446042 PMCID: PMC8393462 DOI: 10.1186/s12960-021-00643-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/10/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Attracting and retaining sufficient health workers to provide adequate services for residents of rural and remote areas has global significance. High income countries (HICs) face challenges in staffing rural areas, which are often perceived by health workers as less attractive workplaces. The objective of this review was to examine the quantifiable associations between interventions to retain health workers in rural and remote areas of HICs, and workforce retention. METHODS The review considers studies of rural or remote health workers in HICs where participants have experienced interventions, support measures or incentive programs intended to increase retention. Experimental, quasi-experimental and observational study designs including cohort, case-control, cross-sectional and case series studies published since 2010 were eligible for inclusion. The Joanna Briggs Institute methodology for reviews of risk and aetiology was used. Databases searched included MEDLINE (OVID), CINAHL (EBSCO), Embase, Web of Science and Informit. RESULTS Of 2649 identified articles, 34 were included, with a total of 58,188 participants. All study designs were observational, limiting certainty of findings. Evidence relating to the retention of non-medical health professionals was scant. There is growing evidence that preferential selection of students who grew up in a rural area is associated with increased rural retention. Undertaking substantial lengths of rural training during basic university training or during post-graduate training were each associated with higher rural retention, as was supporting existing rural health professionals to extend their skills or upgrade their qualifications. Regulatory interventions requiring return-of-service (ROS) in a rural area in exchange for visa waivers, access to professional licenses or provider numbers were associated with comparatively low rural retention, especially once the ROS period was complete. Rural retention was higher if ROS was in exchange for loan repayments. CONCLUSION Educational interventions such as preferential selection of rural students and distributed training in rural areas are associated with increased rural retention of health professionals. Strongly coercive interventions are associated with comparatively lower rural retention than interventions that involve less coercion. Policy makers seeking rural retention in the medium and longer term would be prudent to strengthen rural training pathways and limit the use of strongly coercive interventions.
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Affiliation(s)
- Deborah Russell
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia.
| | - Supriya Mathew
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia
| | - Michelle Fitts
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia
| | - Zania Liddle
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia
| | - Lorna Murakami-Gold
- Poche SA & NT, Flinders Northern Territory, Flinders University, Alice Springs, Australia
| | - Narelle Campbell
- Flinders Northern Territory, Flinders University, Darwin, Australia
| | - Mark Ramjan
- Northern Territory Department of Health, Darwin, Australia
| | - Yuejen Zhao
- Northern Territory Department of Health, Darwin, Australia
| | - Sonia Hines
- Flinders Northern Territory, Flinders University, Alice Springs, Australia
- The Centre for Remote Health: A Joanna Briggs Institute Affiliated Group, Alice Springs, Australia
| | | | - John Wakerman
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia
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McVicar JA, Poon A, Caron NR, Bould MD, Nickerson JW, Ahmad N, Kimmaliardjuk DM, Sheffield C, Champion C, McIsaac DI. Issues postopératoires chez les Autochtones au Canada: revue systématique. CMAJ 2021; 193:E1310-E1321. [PMID: 34426452 PMCID: PMC8412424 DOI: 10.1503/cmaj.191682-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 11/20/2022] Open
Abstract
Contexte: Il existe d’importantes iniquités en matière de santé chez les populations autochtones au Canada. La faible densité de la population canadienne et les populations en région éloignée posent un problème particulier à l’accès et à l’utilisation des soins chirurgicaux. Aucune synthèse des données sur les issues chirurgicales chez les Autochtones au Canada n’avait été publiée jusqu’à maintenant. Méthodes: Nous avons interrogé 4 bases de données pour recenser les études comparant les issues chirurgicales et les taux d’utilisation chez les adultes des Premières Nations, inuits et métis et chez les adultes non autochtones au Canada. Des évaluateurs indépendants ont réalisé toutes les étapes en parallèle. L’issue primaire était la mortalité; les issues secondaires comprenaient le taux d’utilisation des chirurgies, les complications et la durée du séjour à l’hôpital. Nous avons effectué une méta-analyse pour l’issue primaire à l’aide d’un modèle à effets aléatoires. Nous avons évalué les risques de biais à l’aide de l’outil ROBINS-I. Résultats: Vingt-huit études ont été analysées, pour un total de 1 976 258 participants (10,2 % d’Autochtones). Aucune étude ne portait précisément sur les populations inuites et métisses. Quatre études portant sur 7 cohortes ont fourni des données corrigées sur la mortalité pour 7135 participants (5,2 % d’Autochtones); les Autochtones présentaient un risque de décès après une intervention chirurgicale 30 % plus élevé que les patients non autochtones (rapport de risque combiné 1,30; IC à 95 % 1,09–1,54; I2 = 81 %). Les complications étaient aussi plus fréquentes chez le premier groupe, notamment les infections (RC corrigé 1,63; IC à 95 % 1,13–2,34) et les pneumonies (RC 2,24; IC à 95 % 1,58–3,19). Les taux de différentes interventions chirurgicales étaient plus faibles, notamment pour les transplantations rénales, les arthroplasties, les chirurgies cardiaques et les accouchements par césarienne. Interprétation: Les données disponibles sur les issues postopératoires et le taux d’utilisation de la chirurgie chez les Autochtones au Canada sont limitées et de faible qualité. Elles suggèrent que les Autochtones ont de plus hauts taux de décès et d’issues négatives postchirurgicales et qu’ils font face à des obstacles dans l’accès aux interventions chirurgicales. Ces conclusions indiquent qu’il y a un besoin de réévaluer en profondeur les soins chirurgicaux prodigués aux Autochtones au Canada pour leur assurer un accès équitable et améliorer les issues. Numéro d’enregistrement du protocole: PROSPERO-CRD42018098757.
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Affiliation(s)
- Jason A McVicar
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont.
| | - Alana Poon
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Nadine R Caron
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - M Dylan Bould
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Jason W Nickerson
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Nora Ahmad
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Donna May Kimmaliardjuk
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Chelsey Sheffield
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Caitlin Champion
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
| | - Daniel I McIsaac
- Départements d'anesthésiologie et de médecine de la douleur (McVicar, Poon, Bould, McIsaac) et de chirurgie (Kimmaliardjuk), Faculté de médecine (Ahmad, pendant l'étude); Centre de droit, politique et éthique de la santé (Nickerson), Université d'Ottawa; L'Hôpital d'Ottawa (McVicar, Poon, Kimmaliardjuk, McIsaac); Centre hospitalier pour enfants de l'est de l'Ontario (Bould); Institut de recherche Bruyère (Nickerson), Ottawa, Ont.; Département de chirurgie et Programme de médecine en région nordique (Caron), Université de la Colombie-Britannique, Prince George, C.-B.; Centre d'excellence en santé autochtone (Caron), Université de la Colombie-Britannique, Vancouver, C.-B.; Département d'anesthésiologie et de médecine de la douleur (Ahmad, au moment de la rédaction), Université de Toronto, Toronto, Ont.; Hôpital général Qikiqtani (Sheffield), Iqaluit (Nunavut); Centre de santé West Parry Sound (Champion), Parry Sound, Ont.; Département de chirurgie (Champion), École de médecine du Nord de l'Ontario, Sudbury, Ont
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Barriers and Enablers to Older Indigenous People Engaging in Physical Activity-A Qualitative Systematic Review. J Aging Phys Act 2021; 30:340-352. [PMID: 34407505 DOI: 10.1123/japa.2020-0465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/16/2021] [Accepted: 04/18/2021] [Indexed: 11/18/2022]
Abstract
The objective of this qualitative systematic review was to synthesize all evidence to understand the barriers and enablers to older Indigenous peoples (aged 40 years and older) engaging in physical activity. Four databases were searched. Study quality was assessed from an Indigenous perspective, using an Aboriginal and Torres Strait Islander quality appraisal tool. Data were analyzed using thematic synthesis. There were 4,246 articles screened with 23 articles and one report included from over 30 Indigenous communities across four countries. Cultural Safety and Security was a key enabler, including developing physical activity programs which are led by Indigenous communities and preference Indigenous values. Colonization was a key barrier that created mistrust and uncertainty. Social Determinants of Health, including cost, were supported by successful programs, but if not addressed, were demotivators of engagement. Older Indigenous peoples identified barriers and enablers that can direct the development of sustainable, culturally appropriate physical activity programs.
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192
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Bussalleu A, Pizango P, King N, Ford J, Team IHACCR, Harper SL. Kaniuwatewara (when we get sick): understanding health-seeking behaviours among the Shawi of the Peruvian Amazon. BMC Public Health 2021; 21:1552. [PMID: 34399726 PMCID: PMC8365975 DOI: 10.1186/s12889-021-11574-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background Detailed qualitative information regarding Indigenous populations’ health-seeking behaviours within Peru’s plural healthcare system is lacking. Such context-specific information is prerequisite to developing evidence-based health policies and programs intended to improve health outcomes for Indigenous populations. To this end, this study aimed to characterize health-seeking behaviours, factors affecting health-seeking behaviours, and barriers to obtaining healthcare in two Indigenous Shawi communities in Peru. Methods Community-based approaches guided this work, and included 40 semi-structured interviews and a series of informal interviews. Data were analysed thematically, using a constant comparative method; result authenticity and validity were ensured via team debriefing, member checking, and community validation. Results Shawi health-seeking behaviours were plural, dynamic, and informed by several factors, including illness type, perceived aetiology, perceived severity, and treatment characteristics. Traditional remedies were preferred over professional biomedical healthcare; however, the two systems were viewed as complementary, and professional biomedical healthcare was sought for illnesses for which no traditional remedies existed. Barriers impeding healthcare use included distance to healthcare facilities, costs, language barriers, and cultural insensitivity amongst professional biomedical practitioners. Nevertheless, these barriers were considered within a complex decision-making process, and could be overridden by certain factors including perceived quality or effectiveness of care. Conclusions These findings emphasize the importance of acknowledging and considering Indigenous culture and beliefs, as well as the existing traditional medical system, within the professional healthcare system. Cultural competency training and formally integrating traditional healthcare into the official healthcare system are promising strategies to increase healthcare service use, and therefore health outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11574-2.
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Affiliation(s)
- Alejandra Bussalleu
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Honorio Delgado, 430, Lima, Peru.
| | - Pedro Pizango
- Communidad Nativa Balsapuerto, Alto Amazonas, Communidad Nativa, Loreto, Peru
| | - Nia King
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada.,Department of Medicine, Queen's University, 99 University Avenue, Kingston, Ontario, Canada
| | - James Ford
- Priestly International Centre for Climate, University of Leeds, Leeds, UK.,Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Patricia Garcia, Shuaib Lwasa, Didacus B. Namanya, Edmonton, Canada
| | - I H A C C Research Team
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Patricia Garcia, Shuaib Lwasa, Didacus B. Namanya, Edmonton, Canada
| | - Sherilee L Harper
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Patricia Garcia, Shuaib Lwasa, Didacus B. Namanya, Edmonton, Canada.,School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, Alberta, Canada
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193
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Co-Designing Health Service Evaluation Tools That Foreground First Nation Worldviews for Better Mental Health and Wellbeing Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168555. [PMID: 34444319 PMCID: PMC8394671 DOI: 10.3390/ijerph18168555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/08/2021] [Indexed: 11/29/2022]
Abstract
It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a previously co-designed engagement framework. Through a series of co-design workshops, tools were built using innovative collaborative processes that foregrounded Aboriginal worldviews. The workshops resulted in the development of a three-way survey that records the service experiences related to cultural safety from the perspective of Aboriginal clients, their carer/s, and the service staff with whom they work. The surveys centralise the role of relationships in client-service interactions, which strongly reflect their design from an Aboriginal worldview. This paper provides new insights into the reciprocal benefits of engaging community Elders and service leaders to work together to develop new and more meaningful ways of servicing Aboriginal families. Foregrounding relationships in service evaluations reinstates the value of human connection and people-centred engagement in service delivery which are central to rebuilding historically fractured relationships between mainstream services and Aboriginal communities. This benefits not only Aboriginal communities, but also other marginalised populations expanding the remit of mainstream services to be accessed by many.
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194
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Currie GM. Yindyamarra Winhanganha: a Conduit to Indigenous Cultural Proficiency. J Nucl Med Technol 2021; 50:66-72. [PMID: 34330810 DOI: 10.2967/jnmt.121.262436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/12/2021] [Indexed: 11/16/2022] Open
Abstract
The first nation peoples in the USA, Canada, Australia and around the world are substantially disadvantaged by colonialization including health inequity. For nuclear medicine, cultural competence of staff and cultural proficiency of the institution, are important minimum expectations. This can be achieved through a scaffold of Indigenous cultural training and immersion programs that allow the nuclear medicine department to be a culturally safe environment for Indigenous patients. This requires careful planning and inclusivity of Indigenous people as the key stakeholders but, done appropriately, can positively drive the Indigenous equity pipeline. Central to this is an understanding of Indigenous ways of learning and the nexus of these ways of learning and learning taxonomies. There remain substantial gaps between the most culturally insightful and the least insightful (individuals and institutions) that could be addressed, in part, by rich immersive professional development activities in nuclear medicine targeting cultural proficiency and creating culturally safe clinical environments. The opportunity lies before us to provide leadership in nation building and in living respectfully while creating a world worth living in; yindyamarra winhanganha.
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195
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de M Pontes AL, Santos RV. Health reform and Indigenous health policy in Brazil: contexts, actors and discourses. Health Policy Plan 2021; 35:i107-i114. [PMID: 33165584 PMCID: PMC7649663 DOI: 10.1093/heapol/czaa098] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 11/14/2022] Open
Abstract
Given the challenges related to reducing socio-economic and health inequalities, building specific health system approaches for Indigenous peoples is critical. In Brazil, following constitutional reforms that led to the universalization of health care in the late 1980s, a specific health subsystem was created for Indigenous peoples in 1999. In this paper, we use a historical perspective to contextualize the creation of the Indigenous Health Subsystem in Brazil. This study is based on data from interviews with Indigenous and non-Indigenous subjects and document-based analysis. In the 1980s, during the post-dictatorship period in Brazil, the emergence of Indigenous movements in the country and the support for pro-Indigenous organizations helped establish a political agenda that emphasized a broad range of issues, including the right to a specific health policy. Indigenous leaders established alliances with participants of the Brazilian health reform movement, which resulted in broad debates about the specificities of Indigenous peoples, and the need for a specific health subsystem. We highlight three main points in our analysis: (1) the centrality of a holistic health perspective; (2) the emphasis on social participation; (3) the need for the reorganization of health care. These points proved to be convergent with the development of the Brazilian health reform and were expressed in documents of the Indigenist Missionary Council (CIMI) and the Union of Indigenous Nations (UNI). They were also consolidated in the final report of the First National Conference on the Protection of Indigenous Health in 1986, becoming the cornerstone of the national Indigenous health policy declared in 1999. Our analysis reveals that Indigenous people and pro-Indigenous groups were key players in the development of the Indigenous Health Subsystem in Brazil.
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Affiliation(s)
- Ana Lucia de M Pontes
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil
| | - Ricardo Ventura Santos
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil.,Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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196
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Mudd-Martin G, Cirino AL, Barcelona V, Fox K, Hudson M, Sun YV, Taylor JY, Cameron VA. Considerations for Cardiovascular Genetic and Genomic Research With Marginalized Racial and Ethnic Groups and Indigenous Peoples: A Scientific Statement From the American Heart Association. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2021; 14:e000084. [PMID: 34304578 DOI: 10.1161/hcg.0000000000000084] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Historically marginalized racial and ethnic groups and Indigenous peoples are burdened by significant health inequities that are compounded by their underrepresentation in genetic and genomic research. Of all genome-wide association study participants, ≈79% are of European descent, despite this group constituting only 16% of the global population. For underrepresented populations, polygenic risk scores derived from these studies are less accurate in predicting disease phenotypes, novel population-specific genetic variations may be misclassified as potentially pathogenic, and there is a lack of understanding of how different populations metabolize drugs. Although inclusion of marginalized racial and ethnic groups and Indigenous peoples in genetic and genomic research is crucial, scientific studies must be guided by ethical principles of respect, honesty, justice, reciprocity, and care for individuals and communities. Special considerations are needed to support research that benefits the scientific community as well as Indigenous peoples and marginalized groups. Before a project begins, collaboration with community leaders and agencies can lead to successful implementation of the study. Throughout the study, consideration must be given to issues such as implications of informed consent for individuals and communities, dissemination of findings through scientific and community avenues, and implications of community identity for data governance and sharing. Attention to these issues is critical, given historical harms in biomedical research that marginalized groups and Indigenous peoples have suffered. Conducting genetic and genomic research in partnership with Indigenous peoples and marginalized groups guided by ethical principles provides a pathway for scientific advances that will enhance prevention and treatment of cardiovascular disease for everyone.
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197
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Huria T, Pitama SG, Beckert L, Hughes J, Monk N, Lacey C, Palmer SC. Reported sources of health inequities in Indigenous Peoples with chronic kidney disease: a systematic review of quantitative studies. BMC Public Health 2021; 21:1447. [PMID: 34301234 PMCID: PMC8299576 DOI: 10.1186/s12889-021-11180-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To summarise the evidentiary basis related to causes of inequities in chronic kidney disease among Indigenous Peoples. METHODS We conducted a Kaupapa Māori meta-synthesis evaluating the epidemiology of chronic kidney diseases in Indigenous Peoples. Systematic searching of MEDLINE, Google Scholar, OVID Nursing, CENTRAL and Embase was conducted to 31 December 2019. Eligible studies were quantitative analyses (case series, case-control, cross-sectional or cohort study) including the following Indigenous Peoples: Māori, Aboriginal and Torres Strait Islander, Métis, First Nations Peoples of Canada, First Nations Peoples of the United States of America, Native Hawaiian and Indigenous Peoples of Taiwan. In the first cycle of coding, a descriptive synthesis of the study research aims, methods and outcomes was used to categorise findings inductively based on similarity in meaning using the David R Williams framework headings and subheadings. In the second cycle of analysis, the numbers of studies contributing to each category were summarised by frequency analysis. Completeness of reporting related to health research involving Indigenous Peoples was evaluated using the CONSIDER checklist. RESULTS Four thousand three hundred seventy-two unique study reports were screened and 180 studies proved eligible. The key finding was that epidemiological investigators most frequently reported biological processes of chronic kidney disease, particularly type 2 diabetes and cardiovascular disease as the principal causes of inequities in the burden of chronic kidney disease for colonised Indigenous Peoples. Social and basic causes of unequal health including the influences of economic, political and legal structures on chronic kidney disease burden were infrequently reported or absent in existing literature. CONCLUSIONS In this systematic review with meta-synthesis, a Kaupapa Māori methodology and the David R Williams framework was used to evaluate reported causes of health differences in chronic kidney disease in Indigenous Peoples. Current epidemiological practice is focussed on biological processes and surface causes of inequity, with limited reporting of the basic and social causes of disparities such as racism, economic and political/legal structures and socioeconomic status as sources of inequities.
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Affiliation(s)
- Tania Huria
- Māori Indigenous Health Institute, University of Otago Christchurch, 2 Riccarton Ave, Christchurch, 8140, New Zealand.
| | - Suzanne G Pitama
- Māori Indigenous Health Institute, University of Otago Christchurch, 2 Riccarton Ave, Christchurch, 8140, New Zealand
| | - Lutz Beckert
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | | | - Nathan Monk
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Cameron Lacey
- Māori Indigenous Health Institute, University of Otago Christchurch, 2 Riccarton Ave, Christchurch, 8140, New Zealand
| | - Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
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198
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Gilbert E, Avery J, Bartlett R, Campbell S, Joham A, Rumbold A, Boyle J. The Prevalence of Clinical Characteristics of Polycystic Ovary Syndrome among Indigenous Women: A Systematic Search and Review of the Literature. Semin Reprod Med 2021; 39:78-93. [PMID: 34273900 DOI: 10.1055/s-0041-1730021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women; however, to date there has been no synthesis of the burden of PCOS specifically among indigenous women. We aimed to systematically identify and collate studies reporting prevalence and clinical features of PCOS among indigenous women worldwide. We performed a comprehensive search of six databases (Ovid MEDLINE, MEDLINE In Process & Other Non-Indexed Citations, EMBASE, EBM reviews, CINAHL, and SCOPUS) supplemented by gray literature searches and the screening of reference lists. A narrative synthesis was conducted. Fourteen studies met inclusion criteria; however, one was excluded as it assessed only children and adolescents younger than 15 years, with limited clinical relevance. Studies examined indigenous women from Australia, Sri Lanka, New Zealand, and the United States. Prevalence of PCOS was reported in only four studies and ranged from 3.05% for women in Sri Lanka to 26% for women in Australia. All included studies reported on at least one clinical feature of PCOS. Of the studies that reported on a comparison group from the same country, there was evidence of more severe features in indigenous women from New Zealand and the United States. The limited evidence available warrants further investigation of the burden of PCOS in indigenous women to build the knowledge base for effective and culturally relevant management of this condition.
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Affiliation(s)
- Emily Gilbert
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Jodie Avery
- Adelaide Medical School, The University of Adelaide, South Australia, Australia
| | - Rebeccah Bartlett
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Sandra Campbell
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Queensland, Australia
| | - Anju Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Alice Rumbold
- South Australian Health and Medical Research Institute, South Australia, Australia
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
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199
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Kingsley J, Munro-Harrison E, Jenkins A, Thorpe A. Developing a framework identifying the outcomes, principles and enablers of 'gathering places': Perspectives from Aboriginal people in Victoria, Australia. Soc Sci Med 2021; 283:114217. [PMID: 34256253 DOI: 10.1016/j.socscimed.2021.114217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/14/2021] [Accepted: 07/06/2021] [Indexed: 11/26/2022]
Abstract
Aboriginal 'gathering places' have been described as cultural hubs, healing centres, and social meeting places. This article explores a gap in the literature on the health and wellbeing outcomes of gathering places from the perspectives of Aboriginal people who attend them. The aim of this study was to develop a framework to articulate the enablers, principles, and outcomes of 'successful' Aboriginal gathering places. In this study, sixty-nine (n = 69) community members participated in qualitative interviews or focus group discussions across thirteen gathering place sites in Victoria (Australia). The research found that gathering places address social health disparities through the provision of a broad range of health and wellbeing programs that benefit Aboriginal community members accessing them. Gathering places were described by participants as providing connections to place, Aboriginal culture, and healing and mainstream health services that enhanced wellbeing. These findings contribute to a better understanding of how Aboriginal gathering places function and offer strategies for creating culturally safe and welcoming settings for Aboriginal peoples, with potential for consideration in international contexts. This research informed a best-practice framework and outlines different models for developing community empowering and culturally affirming gathering places for improving Aboriginal people's access to culturally appropriate health and support services, while simultaneously reducing health and social inequalities. Key elements of this framework that contribute to a successful gathering place include the people, place (location/facilities), programs and community themselves, whilst the principles that enable these places include elements like self-determination, respect of culture, sustainability and strong governance.
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Affiliation(s)
- Jonathan Kingsley
- School of Health Sciences, Swinburne University of Technology, 12 Wakefield Street (Swinburne Place West), Hawthorn, Victoria, 3122, Australia; Centre of Urban Transitions, Swinburne University of Technology, 12 Wakefield Street (Swinburne Place West), Hawthorn, Victoria, 3122, Australia.
| | - Emily Munro-Harrison
- School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3010, Australia; Intergenerational Health, Murdoch Children's Research Centre, Flemington Rd, Parkville, Victoria, 3052, Australia
| | - Anne Jenkins
- Oonah Health & Community Services Aboriginal Corporation, 1A Badger Creek Road, Healesville, Victoria, 3777, Australia
| | - Alister Thorpe
- School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3010, Australia
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200
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Engnes JI, Sivertsen N, Bongo BA, Mehus G. Sámi and Norwegian nurses' perspectives on nursing care of Sámi patients: a focus group study on culturally safe nursing. Int J Circumpolar Health 2021; 80:1948246. [PMID: 34210235 PMCID: PMC8253172 DOI: 10.1080/22423982.2021.1948246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Sámi people report less satisfaction with healthcare services than the majority population in Norway, and report that they seldom encounter culturally adapted health services. This study investigates Sámi and Norwegian nurses’ perspectives on culturally respectful and appropriate caring for Sámi patients in northern Norway. Six focus groups were conducted: three with Sámi-speaking nurses (n = 13) and three with Norwegian-speaking nurses (n = 10). Data were collected and analysed in line with Thorne’s interpretive descriptive methodology. Three overarching themes emerged from the interviews: (i) the importance nurses gave to establishing a connection and building trust with Sámi patients; (ii) nurses’ perceptions that in comparison to Norwegian patients Sámi patients could be less confrontational and direct, but that differences weren’t always apparent and (iii) the importance nurses described to understanding the cultural context of their Sámi patients. This study showed that Sámi and Norwegian nurses working in northern Norway were largely perceptive about and respectful of cultural differences between Sámi and Norwegian patients. Some emphasised, though, that Sámi patients were diverse and that interpersonal differences were as or more important than cultural differences. Some also felt that more understanding of Sámi culture would be helpful for enabling culturally respectful nursing care.
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Affiliation(s)
- Janne Isaksen Engnes
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT the Arctic University of Norway, Hammerfest, Norway
| | - Nina Sivertsen
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT the Arctic University of Norway, Hammerfest, Norway.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Berit Andersdatter Bongo
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT the Arctic University of Norway, Hammerfest, Norway
| | - Grete Mehus
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT the Arctic University of Norway, Hammerfest, Norway
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