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Keck JW, Lacy ME, Bressler S, Blake I, Chukwuma U, Bruce MG. COVID-19 infection and incident diabetes in American Indian and Alaska Native people: a retrospective cohort study. Lancet Reg Health Am 2024; 33:100727. [PMID: 38590324 PMCID: PMC11000165 DOI: 10.1016/j.lana.2024.100727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/04/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
Background Evidence suggests an increased risk of new-onset diabetes following COVID-19 infection. American Indian/Alaska Native (AI/AN) people were disparately impacted by the COVID-19 pandemic and historically have had higher diabetes incidence than other racial/ethnic groups in the US. We measured the association between COVID-19 infection and incident diabetes in AI/AN people. Methods We conducted a retrospective cohort study using de-identified patient data from the Indian Health Service's (IHS) National Patient Information Reporting System. We estimated age-adjusted diabetes incidence rates, incidence rate ratios, and adjusted hazard ratios among three cohorts spanning pre-pandemic (1/1/2018-2/28/2020) and pandemic (3/1/2020-12/31/2021) timeframes: 1) pre-pandemic cohort (1,503,085 individuals); 2) no-COVID-19 pandemic cohort (1,344,339 individuals); and 3) COVID-19 cohort (176,483 individuals). Findings The COVID-19 cohort had an increased hazard of diabetes compared to the no-COVID-19 group (adjusted hazard ratio (aHR) = 1.56; 95% CI: 1.50-1.62) and the pre-pandemic group (aHR = 1.27; 95% CI: 1.22-1.32). The association between COVID-19 infection and new-onset diabetes was stronger in those with severe COVID-19 illness. A sensitivity analysis comparing the COVID-19 cohort to members of other cohorts that had acute upper respiratory infections showed an attenuated but higher risk of new-onset diabetes in those with COVID-19. Interpretation AI/AN people diagnosed with COVID-19 had an elevated risk of a new diabetes diagnosis when compared to the no-COVID-19 group and the pre-pandemic group. The increased diabetes risk in the COVID-19 group remained in a sensitivity analysis that limited the comparator groups to individuals with an AURI diagnosis. Funding US National Institute of Diabetes and Digestive and Kidney Diseases.
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Affiliation(s)
- James W. Keck
- Research Services Department, Alaska Native Tribal Health Consortium, and Centers for Disease Control and Prevention Guest Researcher, Anchorage, AK, USA
| | - Mary E. Lacy
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Sara Bressler
- Arctic Investigations Program, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Ian Blake
- Arctic Investigations Program, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Uzo Chukwuma
- Office of Public Health Support, Division of Epidemiology and Disease Prevention, Indian Health Service, Rockville, MD, USA
| | - Michael G. Bruce
- Arctic Investigations Program, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
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Whyte M, Daeninck F, Linton J, Fowler-Woods M, Fowler-Woods A, Shingoose G, Vergis A, He W, Hardy K. Experiences and Outcomes of Indigenous Patients Undergoing Bariatric Surgery: a Mixed-Method Scoping Review. Obes Surg 2024; 34:1343-1357. [PMID: 38400946 DOI: 10.1007/s11695-024-07089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/27/2024] [Accepted: 02/02/2024] [Indexed: 02/26/2024]
Abstract
Obesity and type 2 diabetes (T2D) are growing global health concerns. Evidence suggests that Indigenous peoples are at higher lifetime risk of obesity and its associated conditions. Obesity increases the risk of T2D, cardiovascular disease, and all-cause mortality. Bariatric surgery is the most sustained and effective intervention for treating obesity-associated medical problems. This review aims to explore the experiences and outcomes of Indigenous peoples undergoing bariatric surgery in Canada, the USA, Australia, and New Zealand (CANZUS). Analysis of quantitative data revealed that Indigenous patients had fewer bariatric procedures, poorer clinic attendance, similar weight loss outcomes and slightly higher post-operative complication rates. Qualitative data analysis revealed that Indigenous patients living with obesity have a desire to improve their health and quality of life.
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Affiliation(s)
- Marta Whyte
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Felicia Daeninck
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Melinda Fowler-Woods
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Amanda Fowler-Woods
- Ongomiizwin Indigenous Institute for Health and Healing, University of Manitoba, Winnipeg, MB, Canada
| | - Geraldine Shingoose
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ashley Vergis
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Wenjing He
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Krista Hardy
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
- St. Boniface General Hospital, Z3053-409 Taché Avenue, Winnipeg, MB, R2H 2A6, Canada.
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Vining R, Finn M. Why and how is photovoice used as a decolonising method for health research with Indigenous communities in the United States and Canada? A scoping review. Nurs Inq 2024; 31:e12605. [PMID: 37805822 DOI: 10.1111/nin.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/09/2023]
Abstract
Globally, including in North America, Indigenous populations have poorer health than non-Indigenous populations. This health disparity results from inequality and marginalisation associated with colonialism. Photovoice is a community-based participatory research method that amplifies the voices of research participants. Why and how photovoice has been used as a decolonising method for addressing Indigenous health inequalities has not been mapped. A scoping review of the literature on photovoice for Indigenous health research in the United States and Canada was carried out. Five electronic databases and the grey literature were searched, with no time limit. A total of 215 titles and abstracts and 97 full texts were screened resulting in 57 included articles. Analysis incorporated Lalita Bharadwaj's Framework For Building Research Partnerships with First Nations Communities. Photovoice was selected to improve knowledge mobilisation and participant empowerment and engagement. Studies incorporated relationship building, meaningful data collection, and public dissemination but had a lesser focus on the inclusion of Indigenous peer researchers or participant involvement in analysis. For photovoice to truly realise its decolonising potential, it must be incorporated into a broader participatory and decolonising research paradigm. In addition, more resources are required to support the involvement of Indigenous people in the research process.
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Affiliation(s)
- Rebecca Vining
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Department of Geography, Maynooth University, Kildare, Ireland
| | - Mairéad Finn
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland, Dublin, Ireland
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Sachett A, Strand E, Serrão-Pinto T, da Silva Neto A, Pinto Nascimento T, Rodrigues Jati S, Dos Santos Rocha G, Ambrósio Andrade S, Wen FH, Berto Pucca M, Vissoci J, Gerardo CJ, Sachett J, Seabra de Farias A, Monteiro W. Capacity of community health centers to treat snakebite envenoming in indigenous territories of the Brazilian Amazon. Toxicon 2024; 241:107681. [PMID: 38461896 DOI: 10.1016/j.toxicon.2024.107681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION The deaths from and morbidities associated with snakebites - amputations, loss of function in the limb, visible scarring or tissue damage - have a vast economic, social, and psychological impact on indigenous communities in the Brazilian Amazon, especially children, and represent a real and pressing health crisis in this population. Snakebite clinical and research experts have therefore proposed expanding antivenom access from only hospitals to include the community health centers (CHC) located near and within indigenous communities. However, there are no studies examining the capacity of CHCs to store, administer, and manage antivenom treatment. In response to this gap, the research team calling for antivenom decentralization developed and validated an expert-based checklist outlining the minimum requirements for a CHC to provide antivenom. METHODS The objective of this study was thus to survey a sample of CHCs in indigenous territories and evaluate their capacity to provide antivenom treatment according to this accredited checklist. The checklist was administered to nurses and doctors from 16 CHCs, two per indigenous district in Amazonas/Roraima states. RESULTS Our results can be conceptualized into three central findings: 1) most CHCs have the capacity to provide antivenom treatment, 2) challenges to capacity are human resources and specialized items, and 3) antivenom decentralization is feasible and appropriate in indigenous communities. CONCLUSION Decentralization would provide culturally and contextually appropriate care accessibility to a historically marginalized and underserved population of the Brazilian Amazon. Future studies should examine optimal resource allocation in indigenous territories and develop an implementation strategy in partnership with indigenous leaders. Beyond the indigenous population, the checklist utilized could be applied to community health centers treating the general population and/or adapted to other low-resource settings.
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Affiliation(s)
- André Sachett
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Eleanor Strand
- Department of Emergency Medicine, Duke University School of Medicine, Durham, United States
| | - Thiago Serrão-Pinto
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas, Manaus, Brazil
| | - Alexandre da Silva Neto
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Thais Pinto Nascimento
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Sewbert Rodrigues Jati
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil; Secretaria de Estado de Educação e Cultura de Roraima, Boa Vista, Brazil
| | - Gisele Dos Santos Rocha
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | | | | | - Manuela Berto Pucca
- Departamento de Análises Clínicas, Faculdade de Ciências Farmacêuticas de Araraquara, Universidade Estadual Paulista, Araraquara, Brazil
| | - João Vissoci
- Department of Emergency Medicine, Duke University School of Medicine, Durham, United States
| | - Charles J Gerardo
- Department of Emergency Medicine, Duke University School of Medicine, Durham, United States
| | - Jacqueline Sachett
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Altair Seabra de Farias
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Wuelton Monteiro
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil; Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.
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Kjerland TM, Schroeder S, Tofaeono V, Walls M, Gone JP. Increased community engagement of Indigenous Peoples in dementia research leads to higher context relevance of results. Dementia (London) 2024:14713012241233651. [PMID: 38445447 DOI: 10.1177/14713012241233651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. METHODS We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. RESULTS Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. DISCUSSION There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.
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Affiliation(s)
- Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, USA
| | | | | | - Melissa Walls
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Joseph P Gone
- Department of Anthropology, Harvard University, USA
- Department of Global Health and Social Medicine, Harvard Medical School, USA
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Martins LOM, Dos Reis MF, Chaoubah A, Rego G. Distributive justice and equity in resource allocation: a temporal analysis of hospitalization costs in indigenous populations in Brazil. Int J Equity Health 2024; 23:21. [PMID: 38317184 PMCID: PMC10845569 DOI: 10.1186/s12939-024-02102-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION In Brazil, a country of continental dimensions, the health needs of each region have an impact. In this context and the name of the principle of equity, the SUS organizes actions especially aimed at social groups such as the elderly, children, pregnant women, and indigenous peoples. The concept of justice proposed by John Rawls is one of equity, which is essential to this country. METHODS This is an ecological, descriptive study, which analyzed hospital spending on cardiovascular diseases in the Unified Health System (SUS) among the indigenous elderly population and other ethnicities/colors in Brazil, between 2010 and 2019. RESULTS Hospitalization costs and fatality rates for indigenous populations and other colors/ethnicities, between 2010 and 2019, were evaluated. A reduction in hospitalization costs for the indigenous population and an increase in other populations was observed throughout the historical series, while there was an increase in fatality rates for both groups. A comparison was made between hospitalization costs and the fatality rates of indigenous populations and other colors/ethnicities according to sex, between 2010 and 2019. It was observed that regardless of sex, there are significant differences (p<0.05) between hospitalization costs and fatality rates, with higher costs for patients of other colors/ethnicities and higher fatality rates for the indigenous population. CONCLUSIONS Hospitalization costs due to cardiovascular diseases in elderly people from indigenous populations were lower compared to other ethnicities in most federative units, which may suggest an unequal allocation of resources or access for this indigenous population to the SUS. Although there is no strong correlation between spending on hospital admissions and fatality rates, it was found that these rates increased between 2010 and 2019, while spending was reduced.
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Polidoro M, de Oliveira DC. Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01924-2. [PMID: 38300427 DOI: 10.1007/s40615-024-01924-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/02/2024]
Abstract
Tuberculosis (TB) among indigenous populations in Brazil poses a multifaceted public health challenge influenced by geographical, social, institutional, economic, and cultural factors. This study scrutinized the prevalence and spatial distribution of TB among Brazilian indigenous communities from 2002 to 2022. Employing a cross-sectional and descriptive approach, we analyzed data from the Notifiable Diseases Information System (SINAN) and conducted spatial autocorrelation tests to identify clusters and outliers. The findings uncovered substantial disparities in TB prevalence between the North and Central-West regions, in contrast to the South and Southeast, mirroring social, economic, and cultural inequalities in Brazil. It is concluded that public health strategies should not only consider the epidemiological aspects of TB but also encompass social and environmental determinants, notably the impact of climate change. Holistic and context-sensitive approaches are imperative for addressing TB within indigenous communities, underscoring the need for adaptive and culturally sensitive interventions in the public health landscape.
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Affiliation(s)
- Maurício Polidoro
- Federal Institute of Rio Grande do Sul, Coronel Vicente St., Historic Center, Porto Alegre, Rio Grande do Sul, 90030-041, Brazil.
| | - Daniel Canavese de Oliveira
- Federal University of Rio Grande do Sul, São Manoel St., Rio Branco, Porto Alegre, Rio Grande do Sul, 90620-110, Brazil.
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Zhang L, Hou XY, Liu Y. Measuring Mental Health Service Accessibility for Indigenous Populations: a Systematic Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01899-6. [PMID: 38270837 DOI: 10.1007/s40615-023-01899-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/09/2023] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
Indigenous populations have experienced inequality of accessing mental health services compared with their non-Indigenous counterparts, although the way of measuring mental health service accessibility for Indigenous populations is unclear. This systematic review examines measures of mental health service accessibility for Indigenous people, including the diversity of mental health services that are available to them and the barriers to accessing mental healthcare. Using a systematic search procedure, we identified 27 studies that explored Indigenous populations' mental health service access. Our review shows that 18 studies used interview-based methods to explore how Indigenous people use mental health services, and only nine studies used quantitative methods to measure the uptake of mental health services. While advanced methods for quantifying geographical access to healthcare services are widely available, these methods have not been applied in the current literature to explore the potential access to mental health services by Indigenous populations. This is partially due to limited understanding of how Indigenous populations seek mental healthcare, barriers that prevent Indigenous people from accessing diverse types of mental health services, and scarcity of data that are available to researchers. Future research could focus on developing methods to support spatially explicit measuring of accessibility to mental health services for Indigenous populations.
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Affiliation(s)
- Lihong Zhang
- School of the Environment, The University of Queensland, Brisbane, Queensland, Australia
| | - Xiang-Yu Hou
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Yan Liu
- School of the Environment, The University of Queensland, Brisbane, Queensland, Australia.
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Aker A, Ayotte P, Furgal C, Kenny TA, Little M, Gauthier MJ, Bouchard A, Lemire M. Sociodemographic patterning of dietary profiles among Inuit youth and adults in Nunavik, Canada: a cross-sectional study. Can J Public Health 2024; 115:66-82. [PMID: 36482145 PMCID: PMC10830983 DOI: 10.17269/s41997-022-00724-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Country (traditional) foods are integral to Inuit culture, but market food consumption is increasing. The Qanuilirpitaa? 2017 Nunavik Health Survey (Q2017) reported similar country food consumption frequency compared to that in 2004; however, examining food items individually does not account for diet patterns, food accessibility, and correlations between food items. Our objective was to identify underlying dietary profiles and compare them across sex, age, ecological region, and food insecurity markers, given the links among diet, health, and sociocultural determinants. METHODS Food frequency and sociodemographic data were derived from the Q2017 survey (N = 1176). Latent profile analysis identified dietary profiles using variables for the relative frequencies of country and market food consumption first, followed by an analysis with those for country food variables only. Multinomial logistic regression examined the associations among dietary profiles, sociodemographic factors, and food insecurity markers (to disassociate between food preferences and food access). RESULTS Four overall dietary profiles and four country food dietary profiles were identified characterized by the relative frequency of country and market food in the diet. The patterns were stable across several sensitivity analyses and in line with our Inuit partners' local knowledge. For the overall profiles, women and adults aged 30-49 years were more likely to have a market food-dominant profile, whereas men and individuals aged 16-29 and 50+ years more often consumed a country food-dominant profile. In the country food profiles, Inuit aged 16-29 years were more likely to have a moderate country food profile whereas Inuit aged 50+ were more likely to have a high country food-consumption profile. A low country and market food-consumption profile was linked to higher prevalence of food insecurity markers. CONCLUSION We were able to identify distinct dietary profiles with strong social patterning. The profiles elucidated in this study are aligned with the impact of colonial influence on diet and subsequent country food promotion programs for Inuit youth. These profiles will be used for further study of nutritional status, contaminant exposure, and health to provide context for future public health programs.
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Affiliation(s)
- Amira Aker
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada
| | - Pierre Ayotte
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada
- Centre de toxicologie du Québec, Institut national de santé publique du Québec, Québec, Québec, Canada
| | - Chris Furgal
- Department of Indigenous Studies, Trent University, Peterborough, Ontario, Canada
| | - Tiff-Annie Kenny
- Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | | | - Amélie Bouchard
- Nunavik Regional Board of Health and Social Services, Kuujjuaq, Québec, Canada
| | - Mélanie Lemire
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.
- Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada.
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Québec, Québec, Canada.
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Jacklin K, Pitawanakwat K, Blind M, Ketcher D, Jones L, Piraino E, Bretzlaff M. PIECES of my RELATIONSHIPS: The Cultural Adaptation of a Biographical Assessment Tool for Indigenous Older Adults in Canada. Gerontologist 2023:gnad176. [PMID: 38150325 DOI: 10.1093/geront/gnad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Healthcare services are rarely designed to meet the needs of Indigenous people, resulting in culturally unsafe care and assessment tools. This paper describes a collaboration between North East Behavioural Supports Ontario (NEBSO), university researchers, and Indigenous communities to adapt a biographical assessment tool used by NEBSO to be culturally appropriate and safe for Indigenous older adults (55+) in long-term care facilities in Ontario, Canada. RESEARCH DESIGN AND METHODS Over 36 months, this project applied an Indigenized, community-based participatory research (CBPR) and cultural safety framework to the adaptation process. Qualitative data sources include the guidance of an Indigenous Elder, an Anishinaabe Language Expert Group, and focus groups conducted along the North Shore of Lake Huron, Sudbury, and Cochrane, Ontario. RESULTS The adapted tool shifts the focus from personhood to relationships, includes culturally relevant domains, and supports trauma-informed approaches. Five themes were identified during the adaptation process: (1) practicing a relational approach to care, (2) valuing Indigenous language, (3) understanding Indigenous trauma, (4) respecting cultural values and understandings, and (5) addressing systemic barriers to culturally safe care. DISCUSSION AND IMPLICATIONS Themes elucidated from this research process can inform future studies adapting mainstream practice tools and developing new tools for Indigenous populations. The collaboration and approach to this adaptation process demonstrated how cultural safety at systemic and practice levels can be addressed through CPBR partnerships between universities, organizations, and Indigenous communities. Findings support the need to evaluate the cultural safety of other assessments for older Indigenous adults in healthcare settings.
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Affiliation(s)
- Kristen Jacklin
- Memory Keepers Medical Discovery Team, Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Karen Pitawanakwat
- Naandwechige-Gamig Wikwemikong Health Centre, Wikwemikong, Ontario, Canada
| | - Melissa Blind
- Memory Keepers Medical Discovery Team, Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Dana Ketcher
- Memory Keepers Medical Discovery Team, Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
| | - Louise Jones
- Independent Researcher, Halifax, Nova Scotia, Canada
| | - Emily Piraino
- Psychogeriatric Resource Consultant, Algoma, NEBSO Indigenous Engagement Strategy lead, North Bay Regional Health Centre, North Bay, Ontario, Canada
| | - Monica Bretzlaff
- Behavioural Supports Ontario (Provincial & North East), Seniors' Mental Health Integrated Service, Seniors' Mental Health-Regional Consultation Service, North Bay Regional Health Centre, North Bay, Ontario, Canada
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11
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Abu-Saad K, Accos M, Ziv A, Collins F, Shepherd C, Eades S, Kalter-Leibovici O. Development and Functionality of a Parsimonious Digital Food Frequency Questionnaire for a Clinical Intervention among an Indigenous Population. Nutrients 2023; 15:5012. [PMID: 38068870 PMCID: PMC10707983 DOI: 10.3390/nu15235012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ's utility. The participants' median [IQR] reported energy intake (10,042 [6968-12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636-11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants' reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions.
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Affiliation(s)
- Kathleen Abu-Saad
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Moran Accos
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Arnona Ziv
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Fiona Collins
- South West Aboriginal Medical Service, Bunbury, WA 6230, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Carrington Shepherd
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
- Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Taylor K, Ratcliffe J, Bessarab D, Smith K. Valuing indigenous quality of life: A review of preference-based quality of life instruments and elicitation techniques with global older indigenous populations. Soc Sci Med 2023; 336:116271. [PMID: 37806146 DOI: 10.1016/j.socscimed.2023.116271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
Indigenous perspectives of quality of life (QoL) are different to that of non-Indigenous populations. Determining how to identify and value what is important to QoL for people from diverse cultural backgrounds is crucial for assessing effective outcomes for quality assessment and health economic evaluation to guide evidence-based decision making. This is particularly important for older Indigenous people who have complex care and support needs within health and aged-care systems. This scoping review aims to assess the existing literature in this field by firstly identifying preference based instruments that have been applied with older Indigenous peoples and secondly, exploring the extent to which existing preference based instruments applied with older Indigenous peoples encompass older Indigenous peoples QoL perspectives in their design and application. The inclusion criteria for the review were studies using preference based QoL instruments with an Indigenous population where the cohort was aged 50 years or over. This resulted in the critical analysis of 12 studies. The review identified that preference based QoL instruments have rarely been applied to date with older Indigenous populations with most instruments found to be designed for non-Indigenous adults. Typically, instruments have not incorporated Indigenous worldviews of QoL into either the content of the descriptive system or the elicitation techniques and corresponding value sets generated. To encapsulate Indigenous cultural perspectives accurately in economic evaluation, further research is required as to how QoL domains in preference based instruments for Indigenous peoples can be reflective of Indigenous perspectives. It is imperative that the QoL preferences of older Indigenous peoples are adequately captured within preference based QoL instruments applied with this population.
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Affiliation(s)
- Kevin Taylor
- Good Spirit Good Life Centre of Research Excellence, Centre for Aboriginal Medical and Dental Health, University of Western Australia, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia; School of Indigenous Studies, University of Western Australia, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia.
| | - Julie Ratcliffe
- Good Spirit Good Life Centre of Research Excellence, Centre for Aboriginal Medical and Dental Health, University of Western Australia, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia; Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt North (N206), GPO Box 2100, Adelaide, 5001, South Australia, Australia.
| | - Dawn Bessarab
- Good Spirit Good Life Centre of Research Excellence, Centre for Aboriginal Medical and Dental Health, University of Western Australia, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia; Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australian, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia.
| | - Kate Smith
- Good Spirit Good Life Centre of Research Excellence, Centre for Aboriginal Medical and Dental Health, University of Western Australia, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia; Centre for Aboriginal Medical and Dental Health, Medical School, University of Western Australian, M303, 35 Stirling Hwy Crawley, 6004, Perth, Western Australia, Australia.
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Calderon M, Cortez-Vergara C, Brown L, Lowe H, Abarca B, Rondon M, Mannell J. Assessing essential service provision for prevention and management of violence against women in a remote indigenous community in Amantaní, Peru. Int J Equity Health 2023; 22:204. [PMID: 37789397 PMCID: PMC10548644 DOI: 10.1186/s12939-023-02012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/13/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Women living in indigenous communities in Peru currently experience extremely high rates of intimate partner violence (IPV). Over the past 10 years, there has been a large multi-sectoral initiative to establish a national network of Centros de Emergencia de la Mujer (Women's Emergency Centres) that integrate health and police services, and substantial increase in efforts from non-governmental organisations in supporting survivors of violence. However, there is currently little evidence on how existing services meet the needs of indigenous women experiencing violence in Peru. METHODS As part of a broader mixed-methods participatory VAWG prevention study, we assessed existing service provision for women experiencing violence in an indigenous Quechua community from Amantaní, Peru. This involved 17 key informant interviews with legal, government, police, and civil society representatives. We used the UN Women Essential Services Package for Women and Girls Subject to Violence framework to guide our analysis. RESULTS Participants identified major gaps in existing services for indigenous women survivors of violence in Peru. They discussed survivors and perpetrators not being identified by the health system, a lack of IPV response training for health professionals, IPV not being prioritised as a health concern, and a lack of health services that are culturally appropriate for indigenous populations. Survivors who report to police are often treated poorly and discriminated against. Legal systems were perceived as insufficient and ineffective, with inadequate legal measures for perpetrators. While legal and policy frameworks exist, they are often not applied in practice. Service provision in this region needs to adopt an intercultural, rights based, gendered approach to IPV response and prevention, considering cultural and linguistic relevance for indigenous populations. CONCLUSION The role of structural violence in perpetuating indigenous women's experiences of violence and undermining their access to services must be central to designing and implementing appropriate policies and services if they are to meet the needs of indigenous women in Peru.
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Affiliation(s)
| | | | - Laura Brown
- Institute for Global Health, University College of London, London, UK
| | - Hattie Lowe
- Institute for Global Health, University College of London, London, UK
| | | | - Marta Rondon
- Instituto Nacional Materno Perinatal, Lima, Peru
| | - Jenevieve Mannell
- Institute for Global Health, University College of London, London, UK
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Seabra de Farias A, Saturnino Cristino J, Murta F, Sachett J, Monteiro W. Snakebites from the standpoint of an indigenous anthropologist from the Brazilian Amazon. Toxicon 2023; 234:107289. [PMID: 37717605 DOI: 10.1016/j.toxicon.2023.107289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
Conflicting attempts between indigenous caregivers trying to exercise their healing practices in hospitals have been recorded in the Brazilian Amazon. In this work, we present an interview with the Baniwa indigenous anthropologist Francy Baniwa. In an external and colonial interpretation, it was previously stated that indigenous people attribute the origin of snakebites as supernatural and that indigenous medicine, when it saves a patient from complications and death, has symbolic efficacy. In this interview, we observed that this form of interpretation is asymmetric because, for indigenous people, their understanding of nature is broader than ours, with more possibilities of ways of existence, including non-human entities as well or ill-intentioned as humans. The interaction of humans with these identities produces a form of existence with its own clinical reality, which is full of symbolism. Effective communication between health agents and indigenous patients and caregivers must undergo this exercise of otherness and interculturality.
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Affiliation(s)
- Altair Seabra de Farias
- School of Health Sciences, Universidade Do Estado Do Amazonas, Brazil; Department of Teaching and Research, Fundaçao de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Joseir Saturnino Cristino
- School of Health Sciences, Universidade Do Estado Do Amazonas, Brazil; Department of Teaching and Research, Fundaçao de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Felipe Murta
- School of Health Sciences, Universidade Do Estado Do Amazonas, Brazil; Department of Teaching and Research, Fundaçao de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Jacqueline Sachett
- School of Health Sciences, Universidade Do Estado Do Amazonas, Brazil; Department of Teaching and Research, Fundaçao de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Wuelton Monteiro
- School of Health Sciences, Universidade Do Estado Do Amazonas, Brazil; Department of Teaching and Research, Fundaçao de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil.
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Zhong A, Yin L, O'Sullivan B, Ruetz AT. Historical lessons for Canada's emerging national school food policy: an opportunity to improve child health. Health Promot Chronic Dis Prev Can 2023; 43:421-425. [PMID: 37707354 PMCID: PMC10578652 DOI: 10.24095/hpcdp.43.9.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Anthony Zhong
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of the History of Science, Harvard University, Cambridge, Massachusetts, USA
| | - Lillian Yin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brianne O'Sullivan
- Department of Health Information Science, Western University, London, Ontario, Canada
| | - Amberley T Ruetz
- Department of Community Health and Epidemiology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
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Cruise A, Ellsworth-Kopkowski A, Villezcas AN, Eldredge J, Rethlefsen ML. Academic health sciences libraries' outreach and engagement with North American Indigenous communities: a scoping review. J Med Libr Assoc 2023; 111:630-656. [PMID: 37483362 PMCID: PMC10361548 DOI: 10.5195/jmla.2023.1616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Objective We sought to identify trends and themes in how academic health sciences libraries in the United States, Canada, and Mexico have supported engagement and outreach with Native Americans, Alaska Natives, First Nations, and Indigenous peoples, in or from those same countries. We also sought to learn and share effective practices for libraries engaging with these communities. Methods We conducted a scoping review utilizing Arksey and O'Malley's framework for scoping reviews and followed principles from JBI Manual for Evidence Synthesis. We searched seven bibliographic databases, E-LIS (Eprints in Library and Information Science repository), and multiple sources of grey literature. Results were screened using Covidence and Google Sheets. We reported our review according to the PRISMA and PRISMA-S guidelines. We determined types of interventions used by academic health sciences libraries in engagement with our included populations, the level of public participation reached by these interventions, what partnerships were established, and what practices emerged. Results Database searching returned 2,020 unique results. Additional searching resulted in 211 further unique results. Full text screening of relevant articles found 65 reports meeting criteria for inclusion. Data extraction was conducted on these programs to identify partners, intervention type, and evaluation method. The programs were categorized using the IAP2 Spectrum of Public Participation. Conclusion Our scoping review found that many programs were health information trainings and did not move beyond informing the public with little further involvement. The need for sustained funding, greater community participation and more publishing on engagement and outreach are discussed.
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Affiliation(s)
- Allison Cruise
- , Health Sciences Library & Informatics Center, University of New Mexico, Albuquerque, NM
| | | | - A Nydia Villezcas
- , College of Population Health, University of New Mexico, Albuquerque, NM
| | - Jonathan Eldredge
- , Health Sciences Library & Informatics Center, University of New Mexico, Albuquerque, NM
| | - Melissa L Rethlefsen
- , Health Sciences Library & Informatics Center, University of New Mexico, Albuquerque, NM
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Monte N, Carla Gomes Rodrigues J, Wallacy Morikawa Souza Vinagre L, Favacho Pastana L, Leite de Alcântara A, Pereira Colares Leitão L, Maurício Ribeiro-Dos-Santos A, Rodrigues Fernandes M, Ribeiro-Dos-Santos Â, Farias Guerreiro J, Pimentel Assumpção P, Santos S, José de Souza S, Pereira Carneiro Dos Santos N. Epidemiological-molecular profile of variants associated with type 2 diabetes mellitus in indigenous populations from the Brazilian Amazon. Diabetes Res Clin Pract 2023; 199:110641. [PMID: 36966975 DOI: 10.1016/j.diabres.2023.110641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
AIMS While lifestyle factors are strongly associated with Type 2 diabetes (T2DM), genetic characteristics also play a role. However, much of the research on T2DM genetics focuses on European and Asian populations, leaving underrepresented groups, such as indigenous populations with high diabetes prevalence, understudied. METHODS We characterized the molecular profile of 10 genes involved in T2DM risk through complete exome sequencing of 64 indigenous individuals belonging to 12 different Amazonian ethnic groups. RESULTS The analysis revealed 157 variants, including four exclusive variants in the indigenous population located in the NOTCH2 and WFS1 genes with a modifier or moderate impact on protein effectiveness. Furthermore, a high impact variant in NOTCH2 was also found. Additionally, the frequency of 10 variants in the indigenous group showed significant differences when compared to other global populations that were evaluated. CONCLUSION Our study identified 4 novel variants associated with T2DM in the NOTCH2 and WFS1 genes in the Amazonian indigenous populations we studied. In addition, a variant with a high predicted impact in NOTCH2 was also observed. These findings represent a valuable starting point for conducting further association and functional studies, which could help to improve our understanding of the unique characteristics of this population.
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Affiliation(s)
- Natasha Monte
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil.
| | - Juliana Carla Gomes Rodrigues
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
| | - Lui Wallacy Morikawa Souza Vinagre
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
| | - Lucas Favacho Pastana
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
| | - Angélica Leite de Alcântara
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
| | - Luciana Pereira Colares Leitão
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
| | | | - Marianne Rodrigues Fernandes
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil; Hospital Ophir Loyola, 992, Belém, PA, Brazil
| | - Ândrea Ribeiro-Dos-Santos
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, 01, Belém, PA, Brazil.
| | - João Farias Guerreiro
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, 01, Belém, PA, Brazil.
| | - Paulo Pimentel Assumpção
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
| | - Sidney Santos
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil.
| | | | - Ney Pereira Carneiro Dos Santos
- Núcleo de Pesquisas em Oncologia, Instituto de Ciências Bio,lógicas, Universidade Federal do Pará, Hospital Universitário João de Barros Barreto, Unidade de Alta Complexidade em Oncologia, 4487, Belém, PA, Brazil
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Valenzuela-Oré F, Angulo-Bazán Y, Lazóriga-Sandoval LD, Cruz-Vilcarromero NL, Cubas-Sagardia CR. Factors influencing adherence to anti-retroviral therapy in amazonian indigenous people living with HIV/AIDS. BMC Public Health 2023; 23:497. [PMID: 36922774 PMCID: PMC10015934 DOI: 10.1186/s12889-023-15362-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/02/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Indigenous communities in Peru has been historically affected by high mortality rates attributable to HIV-AIDS infection, associated with a low access to health services, and socio-cultural barriers. In this context, the study aimed to describe factors associated with antiretroviral treatment adherence in people from Awajun and Wampis indigenous communities, living with HIV-AIDS in a Peruvian Amazonian region. METHODS A cross-sectional study was completed with a consecutive sample of people from indigenous communities (Awajun or Wampis) living with HIV, who were receiving antiretroviral treatment for at least the last three months. Participants were recruited between October 1 and December 30, 2021, from four districts of Bagua and Condorcanqui provinces in the Amazonian region. An ad-hoc questionnaire was used to collect information about demographic, economic, and socio-cultural factors and access to health services. The Simplified Medication Adherence Questionnaire (SMAQ) was used to evaluate adherence to antiretroviral therapy. Multivariate logistic regression analysis with backward stepwise was performed to explore factors that might influence adherence. RESULTS Of the 208 participants, 28.8% reported complete adherence to antiretroviral treatment. The multivariate logistic regression showed that occupation (aPR: 1.86; 95%CI 1.15-3.02), economic income (aPR: 0.64; 95%CI 0.41-0.99), and adverse reactions to antiretroviral therapy (aPR: 0.36; 95%CI 0.18-0.70) were related to complete adherence to medication. CONCLUSION Only a third of participants reported complete adherence to antiretroviral therapy. Factors associated with adherence to antiretroviral medication were related to socioeconomic conditions and adverse reactions to the therapeutic scheme. Interventions to improve adherence in indigenous people living with HIV should consider these factors in order to develop effective implementation strategies.
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Emmanuel R, Read UM, Grande AJ, Harding S. Acceptability and Feasibility of Community Gardening Interventions for the Prevention of Non-Communicable Diseases among Indigenous Populations: A Scoping Review. Nutrients 2023; 15:791. [PMID: 36771495 PMCID: PMC9921708 DOI: 10.3390/nu15030791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
Compared with non-Indigenous populations, Indigenous populations experience worse health across many outcomes, including non-communicable diseases, and they are three times more likely to live in extreme poverty. The objectives were to identify (1) the content, implementation, and duration of the intervention; (2) the evaluation designs used; (3) the outcomes reported; and (4) the enablers and the challenges. Using the PRISMA-ScR guidelines, a search of research databases and grey literature was conducted. Seven studies met the inclusion criteria. Papers reported on acceptability, nutrition knowledge, fruit and vegetable intake, self-efficacy, motivation, and preference concerning fruit and vegetable, diet, and gardening. No study measured all outcomes. All papers reported on acceptability, whether implicitly or explicitly. The evaluation used mostly pre- and post-intervention assessments. The effect of gardening on nutrition and gardening knowledge and fruit and vegetable intake was inconclusive, and was related to a general lack of robust evaluations. Applying the He Pikinga Waiora Framework, however, revealed strong evidence for community engagement, cultural centeredness, integrated knowledge translation and systems thinking in increasing the acceptability and feasibility of gardening in Indigenous communities. Despite environmental challenges, the evidence signaled that gardening was an acceptable intervention for the Indigenous communities.
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Affiliation(s)
- Rosana Emmanuel
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
| | - Ursula M Read
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Antonio Jose Grande
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
- Department of Medicine, Universidade Estadual de Mato Grosso do Sul-(UEMS), P.O. Box 351, Dourados 79804-970, Brazil
| | - Seeromanie Harding
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London SE1 1UL, UK
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Richer AMS, Roddy AL. Culturally tailored substance use interventions for Indigenous people of North America: a systematic review. J Ment Health Train Educ Pract 2023; 18:60-77. [PMID: 37292247 PMCID: PMC10248734 DOI: 10.1108/jmhtep-07-2021-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose– The purpose of the current study is to conduct a systematic review of peer-reviewed work on culturally tailored interventions for alcohol and drug use in Indigenous adults in North America. Substance use has been reported as a health concern for many Indigenous communities. Indigenous groups experienced the highest drug overdose death rates in 2015, the largest percentage increase in the number of deaths over time from 1999 to 2015 compared to any other racial group. However, few Indigenous individuals report participating in treatment for alcohol or drug use, which may reflect the limited engagement that Indigenous groups have with treatment options that are accessible, effective and culturally integrative. Design/methodology/approach– Electronic searches were conducted from 2000 to April 21, 2021, using PsycINFO, Cumulative Index to Nursing and Allied Health Literature, MEDLINE and PubMed. Two reviewers classified abstracts for study inclusion, resulting in 18 studies. Findings– Most studies were conducted in the USA (89%). Interventions were largely implemented in Tribal/rural settings (61%), with a minority implemented in both Tribal and urban contexts (11%). Study samples ranged from 4 to 742 clients. Interventions were most often conducted in residential treatment settings (39%). Only one (6%) intervention focused on opioid use among Indigenous people. Most interventions addressed the use of both drugs and alcohol (72%), with only three (17%) interventions specifically intended to reduce alcohol use. Originality/value– The results of this research lend insight into the characteristics of culturally integrative treatment options for Indigenous groups and highlight the need for increased investment in research related to culturally tailored treatment across the diverse landscape of Indigenous populations.
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Affiliation(s)
- Ariel M S Richer
- School of Social Work, Columbia University, New York City, New York, USA
| | - Ariel L Roddy
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
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Sjoblom E, Ghidei W, Leslie M, James A, Bartel R, Campbell S, Montesanti S. Centering Indigenous knowledge in suicide prevention: a critical scoping review. BMC Public Health 2022; 22:2377. [PMID: 36536345 PMCID: PMC9761945 DOI: 10.1186/s12889-022-14580-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Indigenous peoples of Canada, United States, Australia, and New Zealand experience disproportionately high rates of suicide as a result of the collective and shared trauma experienced with colonization and ongoing marginalization. Dominant, Western approaches to suicide prevention-typically involving individual-level efforts for behavioural change via mental health professional intervention-by themselves have largely failed at addressing suicide in Indigenous populations, possibly due to cultural misalignment with Indigenous paradigms. Consequently, many Indigenous communities, organizations and governments have been undertaking more cultural and community-based approaches to suicide prevention. To provide a foundation for future research and inform prevention efforts in this context, this critical scoping review summarizes how Indigenous approaches have been integrated in suicide prevention initiatives targeting Indigenous populations. METHODS A systematic search guided by a community-based participatory research (CBPR) approach was conducted in twelve electronic bibliographic databases for academic literature and six databases for grey literature to identify relevant articles. the reference lists of articles that were selected via the search strategy were hand-searched in order to include any further articles that may have been missed. Articles were screened and assessed for eligibility. From eligible articles, data including authors, year of publication, type of publication, objectives of the study, country, target population, type of suicide prevention strategy, description of suicide prevention strategy, and main outcomes of the study were extracted. A thematic analysis approach guided by Métis knowledge and practices was also applied to synthesize and summarize the findings. RESULTS Fifty-six academic articles and 16 articles from the grey literature were examined. Four overarching and intersecting thematic areas emerged out of analysis of the academic and grey literature: (1) engaging culture and strengthening connectedness; (2) integrating Indigenous knowledge; (3) Indigenous self-determination; and (4) employing decolonial approaches. CONCLUSIONS Findings demonstrate how centering Indigenous knowledge and approaches within suicide prevention positively contribute to suicide-related outcomes. Initiatives built upon comprehensive community engagement processes and which incorporate Indigenous culture, knowledge, and decolonizing methods have been shown to have substantial impact on suicide-related outcomes at the individual- and community-level. Indigenous approaches to suicide prevention are diverse, drawing on local culture, knowledge, need and priorities.
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Affiliation(s)
- Erynne Sjoblom
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Winta Ghidei
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Marya Leslie
- Métis Nation of Alberta, #100 Delia Gray Building, 11738 Kingsway Avenue NW, Edmonton, AB, T5G 0X5, Canada
| | - Ashton James
- Métis Nation of Alberta, #100 Delia Gray Building, 11738 Kingsway Avenue NW, Edmonton, AB, T5G 0X5, Canada
| | - Reagan Bartel
- Métis Nation of Alberta, #100 Delia Gray Building, 11738 Kingsway Avenue NW, Edmonton, AB, T5G 0X5, Canada
| | - Sandra Campbell
- Librarian, Health Sciences, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Stephanie Montesanti
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada.
- School of Public Health, University of Alberta, 3-266 Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
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Kader Maideen SF, Rashid A, Ahmad NI, Zahari SNA, Hamat RA. Sero-prevalence of malaria and the knowledge, attitudes and practices relating to the prevention of malaria among indigenous people living in the central forest spine in Peninsular Malaysia: a mixed-methods study. Malar J 2022; 21:281. [PMID: 36192733 PMCID: PMC9528153 DOI: 10.1186/s12936-022-04293-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 09/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background Malaria is still a major public health threat in some parts of the world. Many countries are targeting to achieve malaria free status country. This study aimed to determine the sero-prevalence of malaria and the knowledge, attitudes and practices relating to the prevention of malaria among the indigenous adults living in the central forest spine in Peninsular Malaysia. Methods A mixed method study was conducted in indigenous settlements in 2020. Blood film for malaria parasite (BFMP) was used to diagnose malaria in this study. A structured questionnaire was used to collect data from the participants. For the qualitative data, in-depth interviews were conducted and data was collected until data saturation was reached. Multiple linear regression was used to determine the predictors after adjusting for confounders. A p-value of < 0.05 is considered as statistically significant. Meaningful statements from the in-depth interviews were assigned to the relevant codes using NVivo version 12 software. Results A total of 284 indigenous people participated in the study. The prevalence of malaria in this study was 0%. Those in the middle age group between 25 and 41 years and tested positive for malaria previously were significantly more likely to have better knowledge and attitude scores. Significant correlations were also observed between knowledge-attitude and knowledge-practice. For the qualitative results, most of the respondents were unsure of monkey malaria, but all were aware of human malaria. Conclusion The present study highlighted the absence of malaria in the study population and relatively good knowledge, attitudes and practices relating to the prevention of malaria.
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Affiliation(s)
| | - Abdul Rashid
- Department of Public Health Medicine, RCSI and UCD Malaysia Campus, Penang, Malaysia
| | - Nur Indah Ahmad
- Department of Veterinary Pathology & Microbiology, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang, Malaysia
| | | | - Rukman Awang Hamat
- Department of Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Godfrey TM, Cordova-Marks FM, Jones D, Melton F, Breathett K. Metabolic Syndrome Among American Indian and Alaska Native Populations: Implications for Cardiovascular Health. Curr Hypertens Rep 2022; 24:107-114. [PMID: 35181832 PMCID: PMC9149125 DOI: 10.1007/s11906-022-01178-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW The latest national data reports a 55% prevalence of metabolic syndrome in American Indian adults compared to 34.7% of the general US adult population. Metabolic syndrome is a strong predictor for diabetes, which is the leading cause of heart disease in American Indian and Alaska Native populations. Metabolic syndrome and associated risk factors disproportionately impact this population. We describe the presentation, etiology, and roles of structural racism and social determinants of health on metabolic syndrome. RECENT FINDINGS Much of what is known about metabolic syndrome in American Indian and Alaska Native populations comes from the Strong Heart Study as there is scant literature. American Indian and Alaska Native adults have an increased propensity towards metabolic syndrome as they are 1.1 times more likely to have high blood pressure, approximately three times more likely to have diabetes, and have higher rates of obesity compared with their non-Hispanic White counterparts. Culturally informed lifestyle and behavior interventions are promising approaches to address structural racism and social determinants of health that highly influence factors contributing to these rates. Among American Indian and Alaska Native populations, there is scarce updated literature evaluating the underlying causes of major risk factors for metabolic syndrome, and progression to cardiometabolic disease. As a result, the actual state of metabolic syndrome in this population is not well understood. Systemic and structural changes must occur to address the root causes of these disparities.
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Affiliation(s)
- Timian M Godfrey
- College of Nursing, University of Arizona, 1305 North Martin Avenue, Tucson, AZ, 85721, USA
| | - Felina M Cordova-Marks
- College of Public Health, University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85724, USA
| | - Desiree Jones
- College of Public Health, University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85724, USA
| | - Forest Melton
- College of Public Health, University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85724, USA
| | - Khadijah Breathett
- College of Medicine, Division of Cardiovascular Medicine, Indiana University, 1800 South Capital Avenue, Indianapolis, IN, 46202, USA.
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24
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Fitzpatrick K, Sehgal A, Montesanti S, Pianarosa E, Barnabe C, Heyd A, Kleissen T, Crowshoe L. Examining the role of Indigenous primary healthcare across the globe in supporting populations during public health crises. Glob Public Health 2022; 18:2049845. [PMID: 35343868 DOI: 10.1080/17441692.2022.2049845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
When health systems are overwhelmed during a public health crisis regular care is often delayed and deaths result from lapses in routine care. Indigenous primary healthcare (PHC) can include a range of programmes that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health (SDoH) and a focus on redressing health inequities. We examined how Indigenous PHC mobilises and innovates during a public health crisis to address patient needs and the broader SDoH. A rapid review methodology conducted from January 2021 - March 2021 was purposefully chosen given the urgency with COVID-19, to understand the role of Indigenous PHC during a public health crisis. Our review identified five main themes that highlight the role of Indigenous PHC during a public health crisis: (1) development of culturally appropriate communication and education materials about vaccinations, infection prevention, and safety; (2) Indigenous-led approaches for the prevention of infection and promotion of health; (3) strengthening intergovernmental and interagency collaboration; (4) maintaining care continuity; and (5) addressing the SDoH. The findings highlight important considerations for mobilising Indigenous PHC services to meet the needs of Indigenous patients during a public health crisis such as the COVID-19 pandemic.
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Affiliation(s)
- Kayla Fitzpatrick
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Anika Sehgal
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Emilie Pianarosa
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Barnabe
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amber Heyd
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tessa Kleissen
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lynden Crowshoe
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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Vandiver KM, Erdei E, Mayer AG, Ricciardi C, O'Leary M, Burke K, Zelikoff JT. Building Environmental Health and Genomics Literacy among Healthcare Providers Serving Vulnerable Communities: An Innovative Educational Framework. Int J Environ Res Public Health 2022; 19:929. [PMID: 35055751 DOI: 10.3390/ijerph19020929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 12/10/2022]
Abstract
This study addresses healthcare providers’ knowledge deficits in environmental health and genetics, and primarily focuses on student nurses and nurses serving marginalized, low-income communities frequently exposed to environmental toxicants. Our approach to improve public health is unique, combining hands-on modeling exercises with case-based lessons in addition to three targeted 40 min lectures on toxicology. These lectures included the team’s community-based environmental health research among Indigenous peoples of the U.S. The hands-on approach employed DNA and protein molecular models designed to demonstrate normal and dysfunctional molecules, as well as genetic variants in world populations. The models provided learners with visuals and an experience of “learning by doing.” Increased awareness of the effects of environmental toxicants is the first step toward improving health care for exposed communities. We measured knowledge gains by pre- and post-tests among student nurses and nurses serving Native Americans living both in urban and rural areas of the U.S. (n = 116). The modeling lessons illustrated genetic variants in liver proteins common in Native peoples and their resulting health vulnerabilities. Participants were engaged and enthusiastic; and pre- and post-test results reported substantial knowledge gains and a greater understanding of genetic susceptibility (p < 0.0001). Our study demonstrates the utility of this framework across diverse populations and remote communities.
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26
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Flores-Ramírez R, Berumen-Rodríguez AA, Martínez-Castillo MA, Alcántara-Quintana LE, Díaz-Barriga F, Díaz de León-Martínez L. A review of Environmental risks and vulnerability factors of indigenous populations from Latin America and the Caribbean in the face of the COVID-19. Glob Public Health 2021; 16:975-999. [PMID: 33966608 DOI: 10.1080/17441692.2021.1923777] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Latin America and the Caribbean (LAC) was declared a new epicentre of the coronavirus pandemic by the World Health Organization (WHO) on 22 May 2020. As of 13 January 2021, the numbers of deaths and cases caused by COVID-19 in LAC reported are 552,000 and 17'485,000 respectively. LAC concentrates the largest percentage of indigenous populations throughout the world. In this region, poverty is persistent and particularly rural indigenous peoples hold the steepest barriers to health services and experience profound discrimination based on ethnicity, poverty, and language, compared to their non-indigenous counterparts. The information regarding the health of indigenous populations, in general, is scarce, and this problem is aggravated in the face of the COVID-19 pandemic. Therefore, the main objective of this work is to address the overall scenario of indigenous peoples in the Latin American and Caribbean region from March 2020 to January 2021, in this manner gathering information regarding health problems, economic, social, cultural and environmental factors that make indigenous populations in LAC particularly vulnerable to serious health effects from the COVID-19 pandemic, as well as compiling the mitigation strategies implemented in indigenous communities.
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Affiliation(s)
- Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), San Luis Potosí, México
| | | | | | - Luz Eugenia Alcántara-Quintana
- CONACYT Research Fellow, Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), San Luis Potosí, México
| | - Fernando Díaz-Barriga
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), San Luis Potosí, México
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Abstract
BACKGROUND Appropriate search strategies are essential to ensure the integrity and reproducibility of systematic and scoping reviews, as researchers seek to capture as many relevant resources as possible. In the case of Indigenous health reviews, researchers are met with the special challenge of creating a search strategy that can encompass this large, diverse population group with no universally agreed upon identification criteria. MAIN BODY With an aim to promote improved review methodologies that uphold standards of justice, autonomy, and equity for Indigenous peoples and other heterogeneous populations, we describe critical gaps and approaches to close them. We report organizational and transparency issues around how Indigenous populations are indexed in several major databases, and draw on examples of published reviews and protocols to demonstrate the challenges inherent to creating a comprehensive search strategy. CONCLUSIONS The conduct and communication of results from health literature research on global Indigenous populations are compromised by challenges of methodology that are rooted in the complexities inherent to defining Indigenous peoples. These challenges must be urgently addressed to improve this important field of inquiry moving forward.
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Affiliation(s)
- Louise Harding
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, British Columbia, V6T 2B5, Canada
| | - Caterina J Marra
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, British Columbia, V6T 2B5, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, British Columbia, V6T 2B5, Canada.
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28
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Chakraborty A, Pearson O, Schwartzkopff KM, O'rourke I, Ranasinghe I, Mah PM, Adams R, Boyd M, Wittert G. The effectiveness of in-hospital interventions on reducing hospital length of stay and readmission of patients with Type 2 Diabetes Mellitus: A systematic review. Diabetes Res Clin Pract 2021; 174:108363. [PMID: 32771487 DOI: 10.1016/j.diabres.2020.108363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/20/2020] [Accepted: 07/30/2020] [Indexed: 01/04/2023]
Abstract
AIM This review aimed to assess the effectiveness of multifaceted in-hospital interventions for patients with type 2 diabetes mellitus on hospital readmission, hospital length of stay (LOS), and glycated haemoglobin (HbA1c). METHODS The search included MEDLINE, EMBASE, Emcare, Web of Science, PsycINFO and Google Scholar from 2007 to current date and restricted to English. The differences in outcome measures were calculated to determine the effectiveness. RESULTS The title and abstract of 3251 records were initially screened. Nine studies met the inclusion criteria. Most studies comprised of a wide range of intervention components and outcome measures. The reduction in hospital LOS ranged from 0.5 to 0.8 of a day. Clinically significant improvements in HbA1c concentration levels ranged from a mean reduction of -1.1 (±2.2) mmol/L to -2.8 (±2.7) mmol/L. There were no significant changes in hospital readmission rates and no evidence of the impact of HbA1c on hospital LOS and readmission. Common strategies in reducing hospital LOS and HbA1c were a dedicated care team, hospital wide approach, quality improvement focus, insulin therapy, early short-term intensive program, transition to primary care physicians, and on-going outpatient follow-up for at least 6-12 months. CONCLUSIONS The findings illustrate that multifaceted in-hospital intervention for patients diagnosed with type 2 diabetes can contribute to improvements in hospital LOS and HbA1c concentration.
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Affiliation(s)
- Amal Chakraborty
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; Research Centre for Palliative Care, Death and Dying, Flinders University, Bedford Park, SA 5042.
| | - Odette Pearson
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Kate M Schwartzkopff
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Iris O'rourke
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Isuru Ranasinghe
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Peak Mann Mah
- Northern Adelaide Local Health Network (NALHN), SA Health, SA 5000, Australia
| | - Robert Adams
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Mark Boyd
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia; Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia
| | - Gary Wittert
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia; Royal Adelaide Hospital, Adelaide, SA 5000, Australia
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29
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Affiliation(s)
- Christopher Mayes
- Alfred Deakin Institute, Faculty of Arts and Education, Deakin University, Geelong, VIC Australia
| | - Yin Paradies
- Alfred Deakin Institute, Faculty of Arts and Education, Deakin University, Geelong, VIC Australia
| | - Amanuel Elias
- Alfred Deakin Institute, Faculty of Arts and Education, Deakin University, Geelong, VIC Australia
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Barnabe C, Kherani RB, Appleton T, Umaefulam V, Henderson R, Crowshoe L. Participant-reported effect of an Indigenous health continuing professional development initiative for specialists. BMC Med Educ 2021; 21:116. [PMID: 33602213 PMCID: PMC7891014 DOI: 10.1186/s12909-021-02551-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The 'Educating for Equity (E4E)' program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions. METHODS The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged with and applied course content within an interactive format focusing on real-time feedback. The phase 1 workshop focused on skill development of E4E Framework concepts and principles. Phase 2 concentrated on building capacity for teaching of E4E content. Evaluation of the program's effectiveness was through longitudinal responses to the Social Cultural Confidence in Care Survey (SCCCS), self-reported strategies employed to address social issues and improve therapeutic relationships, engagement with teaching others, and satisfaction with the program. RESULTS Two cohorts of participants have participated in the program (n = 24 Phase 1, n = 10 Phase 2). For participants completing both phases of training, statistically significant improvements were observed in exploring social factors with patients, gaining knowledge and skills related to cultural aspects of care, improved communication and relationship building, and reflections on held stereotypes. Strategies to address social issues and build therapeutic relationships remained consistent throughout participation, while the training enhanced exploration and confidence to ask about cultural and traditional practices, and stronger communication strategies for exploring beliefs, expectations, social barriers, and residential school impacts on health. Participants reported feeling prepared to teach Indigenous health concepts to others and subsequently lead teaching with residents, fellows, and allied health professionals. Satisfaction with the delivery and content of the workshops was high, and participants valued interactions with peers in learning. CONCLUSIONS This CPD intervention had a beneficial impact on self-reported confidence and enhanced practice strategies to engage with Indigenous patients.
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Affiliation(s)
- Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
| | - Raheem B Kherani
- Department of Medicine, Faculty of Medicine, University of British Columbia, Richmond, BC, Canada
| | - Tom Appleton
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Valerie Umaefulam
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rita Henderson
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lynden Crowshoe
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Martinez Tyson D, Teran E, Đào LUL, Chee V, Hernández I, Flores M, Reina Ortiz M, Izurieta R, Baldwin JA. "Cancer is in style": lifestyle change and the perceived impact of globalization on Andean indigenous communities in Ecuador. Ethn Health 2021; 26:153-167. [PMID: 29973064 DOI: 10.1080/13557858.2018.1493437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
Introduction: There is a paucity of information on cancer among Indigenous populations in Latin America.Methods: Guided by tenets of community engaged research and syndemic theory, we conducted eight focus groups (n = 59) with Kichwa men and women in the province of Imbabura, Ecuador. Data were analyzed using applied thematic analysis techniques.Results: Cancer emerged as an important health problem and was reported as a growing concern. Kichwa participants in this study attributed the rise in cancer to (1) exposure to chemicals and pesticides, (2) urbanization and development, and (3) the rise of innutritious, westernized diets.Conclusion: Our findings suggest that the Kichwa are attuned to the global phenomena in which traditional diet has been replaced by western, processed foods and fast food, which result in higher levels of chronic diseases such as cancer. More research is needed to understand the cancer burden among Indigenous peoples in Latin America.
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Affiliation(s)
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Vanessa Chee
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Isabel Hernández
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
- Facultad de Enfermería, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Mercedes Flores
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Ricardo Izurieta
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Julie A Baldwin
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
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D'Angelo CS, Hermes A, McMaster CR, Prichep E, Richer É, van der Westhuizen FH, Repetto GM, Mengchun G, Malherbe H, Reichardt JKV, Arbour L, Hudson M, du Plessis K, Haendel M, Wilcox P, Lynch SA, Rind S, Easteal S, Estivill X, Thomas Y, Baynam G. Barriers and Considerations for Diagnosing Rare Diseases in Indigenous Populations. Front Pediatr 2020; 8:579924. [PMID: 33381478 PMCID: PMC7767925 DOI: 10.3389/fped.2020.579924] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
Advances in omics and specifically genomic technologies are increasingly transforming rare disease diagnosis. However, the benefits of these advances are disproportionately experienced within and between populations, with Indigenous populations frequently experiencing diagnostic and therapeutic inequities. The International Rare Disease Research Consortium (IRDiRC) multi-stakeholder partnership has been advancing toward the vision of all people living with a rare disease receiving an accurate diagnosis, care, and available therapy within 1 year of coming to medical attention. In order to further progress toward this vision, IRDiRC has created a taskforce to explore the access barriers to diagnosis of rare genetic diseases faced by Indigenous peoples, with a view of developing recommendations to overcome them. Herein, we provide an overview of the state of play of current barriers and considerations identified by the taskforce, to further stimulate awareness of these issues and the passage toward solutions. We focus on analyzing barriers to accessing genetic services, participating in genomic research, and other aspects such as concerns about data sharing, the handling of biospecimens, and the importance of capacity building.
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Affiliation(s)
- Carla S. D'Angelo
- IRDiRC Scientific Secretariat, National Institute for Health and Medical Research, Paris, France
| | - Azure Hermes
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT, Australia
| | | | - Elissa Prichep
- Precision Medicine, Platform on Shaping the Future of Health and Healthcare, World Economic Forum, San Francisco, CA, United States
| | - Étienne Richer
- Institute of Genetics, Canadian Institutes of Health Research, Government of Canada, Ottawa, ON, Canada
| | | | - Gabriela M. Repetto
- Facultad de Medicina, Center for Genetics and Genomics, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Gong Mengchun
- Institute of Health Management, Southern Medical University, Guangdong, China
| | - Helen Malherbe
- KwaZulu-Natal Research Innovation and Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa
- Rare Diseases South Africa, Johannesburg, South Africa
| | - Juergen K. V. Reichardt
- Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, QLD, Australia
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Victoria, BC, Canada
| | - Maui Hudson
- Faculty of Maori and Indigenous Studies, University of Waikato, Hamilton, New Zealand
| | | | - Melissa Haendel
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, OR, United States
| | - Phillip Wilcox
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Sally Ann Lynch
- National Rare Disease Office, Mater Misericordiae University Hospital, Dublin, Ireland
- Academic Centre on Rare Diseases, University College Dublin, Dublin, Ireland
| | - Shamir Rind
- Western Australian Register of Developmental Anomalies, Perth, WA, Australia
| | - Simon Easteal
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT, Australia
| | - Xavier Estivill
- Quantitative Genomics Laboratories (qgenomics), Esplugues de Llobregat, Barcelona, Spain
| | - Yarlalu Thomas
- Western Australian Register of Developmental Anomalies, Perth, WA, Australia
| | - Gareth Baynam
- Western Australian Register of Developmental Anomalies, Perth, WA, Australia
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
- Faculty of Health and Medicine, Division of Pediatrics, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Faculty of Medicine, University of Notre Dame, Fremantle, WA, Australia
- Faculty of Science and Engineering, Spatial Sciences, Curtin University, Perth, WA, Australia
- Faculty of Medicine, Notre Dame University, Perth, WA, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Taitingfong R, Bloss CS, Triplett C, Cakici J, Garrison N, Cole S, Stoner JA, Ohno-Machado L. A systematic literature review of Native American and Pacific Islanders' perspectives on health data privacy in the United States. J Am Med Inform Assoc 2020; 27:1987-1998. [PMID: 33063114 PMCID: PMC7727344 DOI: 10.1093/jamia/ocaa235] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Privacy-related concerns can prevent equitable participation in health research by US Indigenous communities. However, studies focused on these communities' views regarding health data privacy, including systematic reviews, are lacking. METHODS We conducted a systematic literature review analyzing empirical, US-based studies involving American Indian/Alaska Native (AI/AN) and Native Hawaiian or other Pacific Islander (NHPI) perspectives on health data privacy, which we define as the practice of maintaining the security and confidentiality of an individual's personal health records and/or biological samples (including data derived from biological specimens, such as personal genetic information), as well as the secure and approved use of those data. RESULTS Twenty-one studies involving 3234 AI/AN and NHPI participants were eligible for review. The results of this review suggest that concerns about the privacy of health data are both prevalent and complex in AI/AN and NHPI communities. Many respondents raised concerns about the potential for misuse of their health data, including discrimination or stigma, confidentiality breaches, and undesirable or unknown uses of biological specimens. CONCLUSIONS Participants cited a variety of individual and community-level concerns about the privacy of their health data, and indicated that these deter their willingness to participate in health research. Future investigations should explore in more depth which health data privacy concerns are most salient to specific AI/AN and NHPI communities, and identify the practices that will make the collection and use of health data more trustworthy and transparent for participants.
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Affiliation(s)
- Riley Taitingfong
- Department of Communication, University of California San Diego, La Jolla, California, USA
| | - Cinnamon S Bloss
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, California, USA
- Center for Wireless and Population Health Systems, Calit2, University of California San Diego, La Jolla, California, USA
| | - Cynthia Triplett
- Qualcomm Institute Calit2, University of California San Diego, La Jolla, California, USA
| | - Julie Cakici
- San Diego Joint Doctoral Program in Public Health, San Diego State University/University of California, San Diego, California, USA
| | - Nanibaa’ Garrison
- Institute for Society and Genetics, University of California, Los Angeles, California, USA
- Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Shelley Cole
- Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Julie A Stoner
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lucila Ohno-Machado
- Department of Biomedical Informatics, School of Medicine, University of California, San Diego, La Jolla, California, USA
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Matthews V, Longman J, Bennett-Levy J, Braddon M, Passey M, Bailie RS, Berry HL. Belonging and Inclusivity Make a Resilient Future for All: A Cross-Sectional Analysis of Post-Flood Social Capital in a Diverse Australian Rural Community. Int J Environ Res Public Health 2020; 17:E7676. [PMID: 33096716 DOI: 10.3390/ijerph17207676] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 11/16/2022]
Abstract
In 2017, marginalised groups were disproportionately impacted by extensive flooding in a rural community in Northern New South Wales, Australia, with greater risk of home inundation, displacement and poor mental health. While social capital has been linked with good health and wellbeing, there has been limited investigation into its potential benefits in post-disaster contexts, particularly for marginalised groups. Six months post-flood, a cross-sectional survey was conducted to quantify associations between flood impact, individual social capital and psychological distress (including probable post-traumatic stress disorder). We adopted a community-academic partnership approach and purposive recruitment to increase participation from socio-economically marginalised groups (Aboriginal people and people in financial hardship). These groups reported lower levels of social capital (informal social connectedness, feelings of belonging, trust and optimism) compared to general community participants. Despite this, informal social connectedness and belonging were important factors for all participant groups, associated with reduced risk of psychological distress. In this flood-prone, rural community, there is a pressing need to build social capital collectively through co-designed strategies that simultaneously address the social, cultural and economic needs of marginalised groups. Multiple benefits will ensue for the whole community: reduced inequities; strengthened resilience; improved preparedness and lessened risk of long-term distress from disaster events.
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Ortiz-Prado E, Simbaña-Rivera K, Gómez-Barreno L, Tamariz L, Lister A, Baca JC, Norris A, Adana-Diaz L. Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach. BMC Med Ethics 2020; 21:100. [PMID: 33069227 PMCID: PMC7568418 DOI: 10.1186/s12910-020-00542-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/06/2020] [Indexed: 01/22/2023] Open
Abstract
Background Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior health research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples. Methods We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities about their experiences and perceptions of participating in biomedical research projects. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work. Results A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani native community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples in Waorani indigenous people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project. Conclusion Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological material, including genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de Las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador.
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Medicine, Universidad de Las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador
| | - Lenin Gómez-Barreno
- One Health Research Group, Faculty of Medicine, Universidad de Las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador
| | - Leonardo Tamariz
- Division of Population Health and Computational Medicine, University of Miami, Florida, USA
| | - Alex Lister
- Public Health Program, Faculty of Medicine, University of Southampton, Southampton, England
| | - Juan Carlos Baca
- Grassland Group, Technical University of Munich, Munich, Germany
| | | | - Lila Adana-Diaz
- Faculty of Psychology, Universidad de Las Americas, Quito, Ecuador
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Gottschlich A, Rivera-Andrade A, Bevilacqua K, Murchland AR, Isak E, Alvarez CS, Ogilvie G, Carey TE, Prince M, Dean M, Mendoza-Montano C, Meza R. Using self-collection HPV testing to increase engagement in cervical cancer screening programs in rural Guatemala: a longitudinal analysis. BMC Public Health 2020; 20:1406. [PMID: 32933512 PMCID: PMC7493167 DOI: 10.1186/s12889-020-09478-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 08/31/2020] [Indexed: 11/30/2022] Open
Abstract
Background Cervical cancer is a leading cause of death in low- and middle-income countries. Self-collection testing for human papillomavirus (HPV) is an alternative form of cervical cancer screening that can be completed privately and at home. Understanding how the use of HPV testing influences follow-up care in low-resourced settings is crucial before broad implementation. This study aimed to identify if access to self-collection HPV testing impacts participation in established cervical cancer screening programs among women in two rural communities in Guatemala. Methods A cohort of 956 women was recruited in 2016 and followed for 2 years for the HPV Multiethnic Study (HPV MES). At baseline, women answered a questionnaire assessing cervical cancer screening history and were offered self-collection HPV testing. Women were re-contacted yearly to determine receipt of additional screening. Statistical changes in screening behavior before and throughout study participation, stratified by self-collection status, were assessed using McNemar pair tests for proportions. Alluvial plots were constructed to depict changes in individual screening behavior. The odds of changes in Pap-compliance (screened in past 3 years), given collection status, were assessed using multivariate logistic regressions. Results Reported screening rates increased 2 years after enrollment compared to rates reported for the 3 years before study entry among women who collected a sample (19.1% increase, p < 0.05), received results of their test (22.1% increase, p < 0.05), and received positive (24.2% increase, p < 0.1) or negative results (21.7% increase, p < 0.05). However, most increases came from one community, with minimal changes in the other. The adjusted odds of becoming Pap compliant were higher for women who collected a sample vs. did not (OR: 1.48, 95% CI: 0.64, 3.40), received their result vs. did not (OR: 1.29, 95% CI: 0.52, 3.02), and received a positive result vs. negative (OR: 2.43, 95% CI: 0.63, 16.10). Conclusions Participation in self-collection HPV testing campaigns may increase likelihood of involvement in screening programs. However, results varied between communities, and reporting of screening histories was inconsistent. Future work should identify what community-specific factors promote success in HPV testing programs and focus on improving education on existing cervical cancer interventions.
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Affiliation(s)
- Anna Gottschlich
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA. .,, Vancouver, Canada.
| | - Alvaro Rivera-Andrade
- Institute of Nutrition of Central America and Panama-INCAP, Guatemala City, Guatemala
| | - Kristin Bevilacqua
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Audrey R Murchland
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ergest Isak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Christian S Alvarez
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Gina Ogilvie
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Thomas E Carey
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA.,Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA
| | - Mark Prince
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA
| | - Michael Dean
- Laboratory of Translational Genomics, Division of Cancer, Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD, USA
| | | | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Abstract
PURPOSE OF THE REVIEW Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Kelly Skinner
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Breanna Phillipps
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ziwa Yu
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS, B3H 4R2, Canada
| | - Debbie Martin
- School of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada
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Shrivastava R, Couturier Y, Girard F, Papineau L, Emami E. Two-eyed seeing of the integration of oral health in primary health care in Indigenous populations: a scoping review. Int J Equity Health 2020; 19:107. [PMID: 32605562 PMCID: PMC7329486 DOI: 10.1186/s12939-020-01195-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous people experience significant poor oral health outcomes and poorer access to oral health care in comparison to the general population. The integration of oral health care with primary health care has been highlighted to be effective in addressing these oral health disparities. Scoping studies are an increasingly popular approach to reviewing health research evidence. Two-eyed seeing is an approach for both Western and Indigenous knowledge to come together to aid understanding and solve problems. Thus, the two-eyed seeing theoretical framework advocates viewing the world with one eye focused on Indigenous knowledge and the other eye on Western knowledge. This scoping review was conducted to systematically map the available integrated primary oral health care programs and their outcomes in these communities using the two-eyed seeing concept. METHODS This scoping review followed Arksey and O'Malley's five-stage framework and its methodological advancement by Levac et al. A literature search with defined eligibility criteria was performed via several electronic databases, non-indexed Indigenous journals, Indigenous health organizational websites, and grey literature. The charted data was classified, analyzed, and reported using numeral summary and qualitative content analysis. The two-eyed seeing concept guided the interpretation and synthesis of the evidence on approaches and outcomes. RESULTS A total of 29 publications describing 30 programs conducted in Australia and North America from 1972 to 2019 were included in the final analysis. The following four program categories emerged from the analysis: oral health promotion and prevention programs (n = 13), comprehensive dental services (n = 13), fly in, fly out dental services (n = 3), and teledentistry (n = 1). Biomedical approaches for integrated primary oral health care were leadership and governance, administration and funding, capacity building, infrastructure and technology, team work, and evidence-based practice. Indigenous approaches included the vision for holistic health, culturally appropriate services, community engagement, shared responsibility, and cultural safety. The program outcomes were identified for biological, mental, and emotional dimensions of oral health; however, measurement of the spiritual dimension was missing. CONCLUSION Our results suggest that a multiple integrated primary oral health care approach with a particular focus on Indigenous culture seems to be efficient and relevant in improving Indigenous oral health.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Sherbrooke, J1H 4C4, Québec, Canada
| | - Felix Girard
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Lucie Papineau
- Cree Board of Health and Social Services of James Bay, Oujé-Bougoumou Healing Centre, Oujé-Bougoumou, Québec, G0W 3C0, Canada
| | - Elham Emami
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, H3C 3J7, Canada. .,Faculty of Dentistry, McGill University, Montreal, Québec, H3A 1G1, Canada.
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Carlson B, Frazer R, Farrelly T. "That makes all the difference": Aboriginal and Torres Strait Islander health-seeking on social media. Health Promot J Austr 2020; 32:523-531. [PMID: 32485025 DOI: 10.1002/hpja.366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/27/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Little is known about the complex relationships between Australian Indigenous people's use of social media and "health-seeking" - seeking help for issues related to health and well-being. This paper has emerged from a broader sociological research project focusing on the help-seeking and help-giving practices of Aboriginal and Torres Strait Islander people on social media, specifically aiming to unlock its potential to create vital and creative connections between help-seekers and help-givers. METHODS Semi-structured interviews were conducted with 52 Indigenous Facebook users from five sites across Australia. RESULTS The use of grounded theory and Indigenous-centred methodologies for analysis showed clearly that users draw on the connections made possible through Facebook to health-seek. We identify five primary health-seeking strategies that differ in form, purpose and directness: soliciting health-related information, gaining emotional support, producing social health-seeking collectives, engaging in motivational and "eudaimonic" content, and connecting with formal health sources. CONCLUSION While far from being a panacea to health disparities, these findings show that Facebook does provide unique opportunities for many Indigenous help-seekers and help-givers in times of need. SO WHAT?: Social media offers pathways for health-seeking both beyond and outside the dominant western biomedical models of public health promotion. These already-existing pathways should be considered by people working on social media public health promotion campaigns for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
| | - Ryan Frazer
- Macquarie University, Sydney, NSW, Australia
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Meneses-Navarro S, Freyermuth-Enciso MG, Pelcastre-Villafuerte BE, Campos-Navarro R, Meléndez-Navarro DM, Gómez-Flores-Ramos L. The challenges facing indigenous communities in Latin America as they confront the COVID-19 pandemic. Int J Equity Health 2020; 19:63. [PMID: 32381022 PMCID: PMC7203711 DOI: 10.1186/s12939-020-01178-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 11/10/2022] Open
Abstract
The coronavirus disease 2019 (COVID-2019) pandemic struck Latin America in late February and is now beginning to spread across the rural indigenous communities in the region, home to 42 million people. Eighty percent of this highly marginalized population is concentrated in Bolivia, Guatemala, Mexico and Peru. Health care services for these ethnic groups face distinct challenges in view of their high levels of marginalization and cultural differences from the majority. Drawing on 30 years of work on the responses of health systems in the indigenous communities of Latin America, our group of researchers believes that countries in the region must be prepared to combat the epidemic in indigenous settings marked by deprivation and social disparity. We discuss four main challenges that need to be addressed by governments to guarantee the health and lives of those at the bottom of the social structure: the indigenous peoples in the region. More than an analysis, our work provides a practical guide for designing and implementing a response to COVID-19 in indigenous communities.
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Affiliation(s)
- Sergio Meneses-Navarro
- CONACYT/Center for Health Systems Research, Center for Population Health Research, National Institute of Public Health, Universidad No. 655, C.P, 62100, Cuernavaca, Morelos, Mexico
| | - María Graciela Freyermuth-Enciso
- Center for Research and Advanced Studies in Social Anthropology, Southeast Campus, Carretera a San Juan Chamula kilómetro 3.5, Barrio La Quinta San Martín, CP. 29247, San Cristóbal de Las Casas, Chiapas, Mexico
| | | | - Roberto Campos-Navarro
- National Autonomous University of Mexico, Circuito Escolar 411A, Copilco Universidad, Coyoacán, 04360, Ciudad de México, Mexico
| | - David Mariano Meléndez-Navarro
- Committee for the Promotion of Safe Motherhood in Mexico, Carretera a San Juan Chamula kilómetro 3.5, Barrio La Quinta San Martín, CP. 29247, San Cristóbal de Las Casas, Chiapas, Mexico
| | - Liliana Gómez-Flores-Ramos
- CONACYT/Center for Population Health Research, National Institute of Public Health, Universidad No. 655, C.P. 62100, Cuernavaca, Morelos, Mexico.
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Tinkelman NE, Spratlen MJ, Domingo-Relloso A, Tellez-Plaza M, Grau-Perez M, Francesconi KA, Goessler W, Howard BV, MacCluer J, North KE, Umans JG, Factor-Litvak P, Cole SA, Navas-Acien A. Associations of maternal arsenic exposure with adult fasting glucose and insulin resistance in the Strong Heart Study and Strong Heart Family Study. Environ Int 2020; 137:105531. [PMID: 32059145 PMCID: PMC7521956 DOI: 10.1016/j.envint.2020.105531] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/19/2020] [Accepted: 01/25/2020] [Indexed: 05/06/2023]
Abstract
Experimental and prospective epidemiologic evidence suggest that arsenic exposure has diabetogenic effects. However, little is known about how family exposure to arsenic may affect risk for type 2 diabetes (T2D)-related outcomes in adulthood. We evaluated the association of both maternal and offspring arsenic exposure with fasting glucose and incident T2D in 466 participants of the Strong Heart Family Study. Total arsenic (ΣAs) exposure was calculated as the sum of inorganic arsenic (iAs) and methylated (MMA, DMA) arsenic species in maternal and offspring baseline urine. Median maternal ΣAs at baseline (1989-91) was 7.6 µg/g creatinine, while median offspring ΣAs at baseline (2001-03) was 4.5 µg/g creatinine. Median offspring glucose in 2006-2009 was 94 mg/dL, and 79 participants developed T2D. The fully adjusted mean difference (95% CI) for offspring glucose was 4.40 (-3.46, 12.26) mg/dL per IQR increase in maternal ΣAs vs. 2.72 (-4.91 to 10.34) mg/dL per IQR increase in offspring ΣAs. The fully adjusted odds ratio (95%CI) of incident T2D was 1.35 (1.07, 1.69) for an IQR increase in maternal ΣAs and 1.15 (0.92, 1.43) for offspring ΣAs. The association of maternal ΣAs with T2D outcomes were attenuated with adjustment for offspring adiposity markers. Familial exposure to arsenic, as measured in mothers 15-20 years before offspring follow-up, is associated with increased odds of offspring T2D. More research is needed to confirm findings and better understand the importance of family exposure to arsenic in adult-onset diabetes.
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Affiliation(s)
- Naomi E Tinkelman
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA; Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Miranda Jones Spratlen
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Arce Domingo-Relloso
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Maria Tellez-Plaza
- National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Maria Grau-Perez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | - Barbara V Howard
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA; MedStar Health Research Institute, Hyattsville, MD, USA
| | - Jean MacCluer
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Kari E North
- Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
| | - Jason G Umans
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA; MedStar Health Research Institute, Hyattsville, MD, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Shelley A Cole
- Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
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Chow S, Bale S, Sky F, Wesley S, Beach L, Hyett S, Heiskanen T, Gillis KJ, Paroschy Harris C. The Wequedong Lodge Cancer Screening Program: implementation of an opportunistic cancer screening pilot program for residents of rural and remote Indigenous communities in Northwestern Ontario, Canada. Rural Remote Health 2020; 20:5576. [PMID: 32088964 DOI: 10.22605/rrh5576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The rural and remote nature of many First Nations communities in Northwestern Ontario, Canada poses unique obstacles to physically accessing health care, in addition to other barriers. Indigenous peoples face similar challenges globally. First Nations communities experience significant health inequities, including cancer burden, which can be attributed to complex factors associated with colonization and Westernization. One potentially promising intervention to decrease the burden of advanced cancers is the provision of accessible, convenient and culturally sensitive cancer screening services, leading to early detection and treatment. The Wequedong Lodge Cancer Screening Program (WLCSP) was a pilot project aiming to provide cancer screening education and opportunistic cancer screening to residents from rural and remote First Nations communities while accessing health services in the urban center of Thunder Bay, Ontario, Canada. METHODS Cancer screening education and opportunistic breast, cervical and colorectal cancer screening appointments were offered to individuals and their travel escorts already staying at Wequedong Lodge. Program uptake was determined primarily by education participation, and secondarily by client participation in screening. RESULTS In total, the WLCSP booked 1033 appointments, with 841 being attended. Over the program's 3 years there was an increase in clients each year. Specifically, 22% (60/275) of age-eligible women completed a mammogram. Pap tests were provided to 8% (45/554) of age-eligible females. Finally, 32% (106/333) of all age-eligible service participants were given a fecal occult blood test kit. An evaluation survey (n=396) demonstrated overall client satisfaction with the program. CONCLUSION The WLCSP aimed to provide education about, access to and uptake of cancer screening services for First Nations people from rural and remote communities in Northwestern Ontario by targeting inequalities in accessing cancer screening opportunities. Therefore, program uptake may provide helpful numerical comparisons for similar future programs globally. Other entities working to improve cancer screening rates in remote and/or rural populations and/or amongst Indigenous peoples may find consideration of the WLCSP processes, successes and challenges helpful to their efforts.
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Affiliation(s)
- Sara Chow
- Prevention and Screening Services Health Promotion and Communications Planner, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
| | - Susan Bale
- Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
| | - Fred Sky
- Wequedong Lodge, 435 Balmoral Street, Thunder Bay, ON P7C 5N4, Canada
| | - Shannon Wesley
- Previous address: Regional Indigenous Cancer Leader, Cancer Care Ontario. Current address: Faculty at Northern Ontario School of Medicine; and Aurora Family Health Clinic, 971 Carrick St., Thunder Bay, ON P7B 6L9, Canada
| | - Lauren Beach
- Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
| | - Sarah Hyett
- Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
| | - Tarja Heiskanen
- Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
| | - Kelly-Jo Gillis
- Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
| | - Cathy Paroschy Harris
- Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada
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Miller H, Trujillo-Trujillo J, Mutebi F, Feldmeier H. Efficacy and safety of dimeticones in the treatment of epidermal parasitic skin diseases with special emphasis on tungiasis: an evidence-based critical review. Braz J Infect Dis 2020; 24:170-177. [PMID: 32105621 PMCID: PMC9392017 DOI: 10.1016/j.bjid.2020.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
Epidermal parasitic skin diseases encompass scabies, pediculosis, cutaneous larva migrans, myiasis, and tungiasis. Tungiasis is probably the most neglected of all Neglected Tropical Diseases (NTD). It occurs in South America, the Caribbean and Sub-Saharan Africa and affects marginalized populations where people live in extreme poverty. In endemic communities the prevalence can be up to 30% in general population and 85% in children. Over time, chronic pathology develops characterized by hyperkeratosis, edema around the nail rim, fissures, ulcers, deformation and loss of nails. This leads to a pattern of disabilities, eventually resulting in impairment of mobility. Dimeticones are a family of silicon oils with a potential to kill parasites located on top or inside the epidermis by a physical mode of action. They are considered the treatment of choice for pediculosis capitis and pediculosis pubis. With regard to tungiasis, the so called rear abdominal cone of the parasites has been identified as a target for treatment with dimeticones. NYDA®, a mixture of two dimeticones with different viscosity, is the only dimeticone product for which data on the mode of action, efficacy and safety with regard to tungiasis exists. The product has been shown highly effective against embedded sand fleas, even in very intense infection with more than 500 parasites situated on top of each other. A randomized controlled trial showed that seven days after a targeted application of NYDA® 97% (95% CI 94–99%) of the embedded sand fleas had lost all signs of viability. Comprehensive toxicological investigations on the dimeticones contained in NYDA® showed that there is practically no risk of embryotoxicity, fetotoxicity, teratogenicity, and other toxicity. The safety of dimeticones was also demonstrated in clinical trials with a total of 106 participants with tungiasis, in which not a single adverse event was observed.
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Affiliation(s)
| | | | - Francis Mutebi
- Makerere University, Animal Resources and Biosecurity, College of Veterinary Medicine, Kampala, Uganda
| | - Hermann Feldmeier
- Charité University Medicine, Institute of Microbiology and Infection Immunology, Berlin, Germany
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Abstract
Health disparities exact a devastating toll upon Indigenous people in the USA. However, there has been scant research investment to develop strategies to address these inequities in Indigenous health. We present a case for increased health promotion, prevention, and treatment research with Indigenous populations, providing context to the recent NIH investment in the Intervention Research to Improve Native American Health (IRINAH) network. We discuss the disproportionate costs and consequences of disparities borne by Indigenous groups, the limited evidence base on effective intervention for this population, how population uniqueness often makes transfer of existing intervention models difficult, and additional challenges in creating interventions for Indigenous settings. Given the history of colonial disruption that has included genocide, forced removal from lands, damaging federal, state and local policies and practices, environmental contamination, and most recently, climate change, we conclude research that moves beyond minor transformations of existing majority population focused interventions, but instead truly respects Indigenous wisdom, knowledge, traditions, and aspirations is needed, and that investment in intervention science to address Indigenous health disparities represent a moral imperative.
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Affiliation(s)
- Linda R Stanley
- Tri-Ethnic Center for Prevention Research, Colorado State University, Sage Hall, 1879 Campus Delivery, Fort Collins, CO, 80523-1879, USA.
| | - Randall C Swaim
- Tri-Ethnic Center for Prevention Research, Colorado State University, Sage Hall, 1879 Campus Delivery, Fort Collins, CO, 80523-1879, USA
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, 96813, USA
| | - Kathleen J Kelly
- Department of Marketing, Colorado State University, 1278 Campus Delivery, Fort Collins, CO, 80523, USA
| | - Annie Belcourt
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, 59812, USA
| | - James Allen
- Department of Biobehavioral Health and Population Sciences, University of Minnesota-Duluth, Duluth, MN, 55812, USA
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Whitesell NR, Mousseau A, Parker M, Rasmus S, Allen J. Promising Practices for Promoting Health Equity Through Rigorous Intervention Science with Indigenous Communities. Prev Sci 2020; 21:5-12. [PMID: 30443847 PMCID: PMC6778005 DOI: 10.1007/s11121-018-0954-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research in indigenous communities is at the forefront of innovation currently influencing several new perspectives in engaged intervention science. This is innovation born of necessity, involving efforts to create health equity complicated by a history of distrust of research. Immense diversity across indigenous cultures, accompanied by variation in associated explanatory models, health beliefs, and health behaviors, along with divergent structural inequities add further complexity to this challenge. The aim of this Supplemental Issue on Promoting Health Equity through Rigorous, Culturally Informed Intervention Science: Innovations with Indigenous Populations in the United States is to highlight the promising new approaches and perspectives implemented by a group of engaged researchers and their community partners, as they seek to move intervention research forward within indigenous communities. Case studies presented are from projects led by members of the National Institutes of Health Intervention Research to Improve Native American Health (IRINAH) consortioum, investigators who conduct health promotion and disease prevention research among American Indians, Alaska Natives, and Native Hawaiians. The promising practices profiled include new strategies in (a) community partnerships, engagement, and capacity building; (b) integration of indigenous and academic perspectives; (c) alignment of interventions with indigenous cultural values and practices; and (d) implementation and evaluation of multilevel interventions responsive to complex cultural contexts. The IRINAH projects illustrate the evolution of an intervention science responsive to the needs, realities, and promise of indigenous communities, with application to health research among other culturally distinct health inequity groups.
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Affiliation(s)
- Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, MS F800, 13055 E. 17th Avenue, Room 333, Aurora, CO, 80045, USA.
| | - Alicia Mousseau
- National Native Children's Trauma Center, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Myra Parker
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, 1100 NE 45th Street, Suite 300, Seattle, WA, 98105, USA
| | - Stacy Rasmus
- Center of Alaska Native Health Research, University of Alaska Fairbanks, PO Box 757000, Fairbanks, AK, 99775-7000, USA
| | - James Allen
- Department of Family Medicine and Biobehavioral Health & Memory Keepers Medical Discovery Team - American Indian and Rural Health Equity, University of Minnesota Medical School Duluth Campus, 624 E. 1st St., Suite 201, Duluth, MN, 55805, USA
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Yung K, Neathway C. Community Champions for Safe, Sustainable, Traditional Food Systems. Curr Dev Nutr 2020; 4:49-52. [PMID: 32258999 PMCID: PMC7101485 DOI: 10.1093/cdn/nzz119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 10/01/2019] [Accepted: 10/18/2019] [Indexed: 11/14/2022] Open
Abstract
Access to traditional Indigenous foods is a priority to improve food security and recognize the role of food in sustaining cultural and social connections. First Nations Health Authority (FNHA) is Canada's first province-wide, Indigenous-led health authority and delivers services in a community-driven manner. FNHA collaborated with First Nations to implement a Community Champion model, whereby each Nation could identify an individual who worked in food programming to attend a train-the-trainer workshop on safe food preservation methods. The Champions then took this knowledge, along with provided resources, to lead canning workshops in their home communities. Throughout the first year, a community of practice was nurtured, and a gathering of this community was held at the end of the first year. Nations were able to meet food safety considerations through interactive learning, and access to traditional Indigenous foods was strengthened. The Community Champion model supports capacity building and creates a community of practice.
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Affiliation(s)
- Kathleen Yung
- Wellness Program Services, First Nations Health Authority, Vancouver, British Columbia, Canada
| | - Casey Neathway
- Environmental Public Health Services, First Nations Health Authority, Kamloops, British Columbia, Canada
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Lambert M, Wyeth EH, Brausch S, Harwood MLN, Anselm D, Wright-Tawha T, Metzger B, Ellison P, Derrett S. "I couldn't even do normal chores": a qualitative study of the impacts of injury for Māori. Disabil Rehabil 2019; 43:2424-2430. [PMID: 31846590 DOI: 10.1080/09638288.2019.1701102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS To investigate the rehabilitation experiences of Māori who were still reporting disability 24 months after an injury resulting in hospitalisation. METHODS Participants had been hospitalised for an Accident Compensation Corporation (New Zealand's no-fault injury compensation insurer) entitlement claim injury between 2007 and 2009, and were experiencing disability 24 months post-injury. In-depth kanohi ki te kanohi (face-to-face) qualitative interviews with 12 participants aged between 37 and 71 years at the time of interviews were conducted. Interpretive analyses of interview transcripts, focused on the impacts of injury was conducted with the aid of NVivo software. RESULTS The overarching theme identified during the analysis was "Impact" with four sub-themes of: Impact on daily life; Impact on relationships, Impact on employment; and, long-term or ongoing impacts. CONCLUSIONS For Māori living with disability 24 months after hospitalisation for injury, adjusting to life after the injury and the rehabilitation process was challenging. Participants discussed frustration with feeling dependent on others, being bored and feeling unfulfilled after their injury, and that many aspects of their lives were impacted on and not always in the expected directions. Many reported longer lasting impacts even after rehabilitation was completed. Implications for rehabilitation programmes e.g., strengthening programmes by taking into account issues discussed by participants, recognising the long-term impacts on both those injured and their whānau (family), and further investigations required are also discussed.IMPLICATIONS FOR REHABILITATIONDisability after injury can have long term impacts for injured Māori and their relationships.Social impacts can be perceived as more debilitating than the physical impacts after injury.Experiences of employment changes and future prospects are often difficult to navigate for Māori returning to work after an injury.
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Affiliation(s)
- Michelle Lambert
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Shawnee Brausch
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Matire L N Harwood
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Deborah Anselm
- Accident Compensation Corporation of New Zealand, Wellington, New Zealand
| | | | - Barbara Metzger
- Ngā Kete Mātauranga Pounamu Charitable Trust, Invercargill, New Zealand
| | - Peter Ellison
- WellSouth Primary Health Network, Dunedin, New Zealand
| | - Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Nieblas-Bedolla E, Bream KDW, Rollins A, Barg FK. Ongoing challenges in access to diabetes care among the indigenous population: perspectives of individuals living in rural Guatemala. Int J Equity Health 2019; 18:180. [PMID: 31752908 PMCID: PMC6873569 DOI: 10.1186/s12939-019-1086-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Indigenous persons living in Latin America suffer from a higher prevalence of type 2 diabetes compared to their non-indigenous counterparts. This difference has been attributed to a wide range of factors. Future interventions could be influenced by a deeper understanding of the challenges that impact care in rural regions and in other low-income settings. Methods This study was conducted using a modified grounded theory approach. Extended observations and fifteen interviews were performed with adult male and female residents of three rural Mayan towns in Sololá Department, Guatemala using purposive sampling. Questions focused on the perceptions of individuals living with type 2 diabetes and their caregivers regarding disease and treatment. Results Across interviews the most common themes that emerged included mistreatment by healthcare providers, mental health comorbidity, and medication affordability. These perceptions were in part influenced by indigeneity, poverty, and/or gender. Conclusions Both structural and cultural barriers continue to impact diabetes care for indigenous communities in rural Guatemala. The interviews in this study suggest that indigenous people experience mistrust in the health care system, unreliable access to care, and mental health comorbidity in the context of type 2 diabetes care. These experiences are shaped by the complex relationship among poverty, gender, and indigeneity in this region. Targeted interventions that are conscious of these factors may increase their chances of success when attempting to address similar health disparities in comparable populations.
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Affiliation(s)
- Edwin Nieblas-Bedolla
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. .,Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. .,School of Medicine, University of Washington, Seattle, WA, USA.
| | - Kent D W Bream
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.,Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Allison Rollins
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Frances K Barg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.,Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
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Zhang C, Gao Y, Ning Z, Lu Y, Zhang X, Liu J, Xie B, Xue Z, Wang X, Yuan K, Ge X, Pan Y, Liu C, Tian L, Wang Y, Lu D, Hoh BP, Xu S. PGG.SNV: understanding the evolutionary and medical implications of human single nucleotide variations in diverse populations. Genome Biol 2019; 20:215. [PMID: 31640808 PMCID: PMC6805450 DOI: 10.1186/s13059-019-1838-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/26/2019] [Indexed: 12/23/2022] Open
Abstract
Despite the tremendous growth of the DNA sequencing data in the last decade, our understanding of the human genome is still in its infancy. To understand the implications of genetic variants in the light of population genetics and molecular evolution, we developed a database, PGG.SNV ( https://www.pggsnv.org ), which gives much higher weight to previously under-investigated indigenous populations in Asia. PGG.SNV archives 265 million SNVs across 220,147 present-day genomes and 1018 ancient genomes, including 1009 newly sequenced genomes, representing 977 global populations. Moreover, estimation of population genetic diversity and evolutionary parameters is available in PGG.SNV, a unique feature compared with other databases.
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Affiliation(s)
- Chao Zhang
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
- Present Address: Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Yang Gao
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Zhilin Ning
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Yan Lu
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Xiaoxi Zhang
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Jiaojiao Liu
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Bo Xie
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Zhe Xue
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Xiaoji Wang
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Kai Yuan
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Xueling Ge
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Yuwen Pan
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Chang Liu
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Lei Tian
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Yuchen Wang
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Dongsheng Lu
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
| | - Boon-Peng Hoh
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China
- Faculty of Medicine and Health Sciences, UCSI University, Jalan Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Shuhua Xu
- Chinese Academy of Sciences (CAS) Key Laboratory of Computational Biology, Max Planck Independent Research Group on Population Genomics, CAS-MPG Partner Institute for Computational Biology (PICB), Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, CAS, Shanghai, 200031, China.
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, 650223, China.
- Collaborative Innovation Center of Genetics and Development, Shanghai, 200438, China.
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Xu MJ, Su D, Deboer R, Garcia M, Tahir P, Anderson W, Kinderman A, Braunstein S, Sherertz T. Palliative Oncologic Care Curricula for Providers in Resource-Limited and Underserved Communities: a Systematic Review. J Cancer Educ 2019; 34:205-215. [PMID: 29264703 DOI: 10.1007/s13187-017-1310-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Familiarity with principles of palliative care, supportive care, and palliative oncological treatment is essential for providers caring for cancer patients, though this may be challenging in global communities where resources are limited. Herein, we describe the scope of literature on palliative oncological care curricula for providers in resource-limited settings. A systematic literature review was conducted using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Med Ed Portal databases, and gray literature. All available prospective cohort studies, case reports, and narratives published up to July 2017 were eligible for review. Fourteen articles were identified and referenced palliative care education programs in Argentina, Uganda, Kenya, Australia, Germany, the USA, or multiple countries. The most common teaching strategy was lecture-based, followed by mentorship and experiential learning involving role play and simulation. Education topics included core principles of palliative care, pain and symptom management, and communication skills. Two programs included additional topics specific to the underserved or American Indian/Alaskan Native community. Only one program discussed supportive cancer care, and no program reported educational content on resource-stratified decision-making for palliative oncological treatment. Five programs reported positive participant satisfaction, and three programs described objective metrics of increased educational or research activity. There is scant literature on effective curricula for providers treating cancer patients in resource-limited settings. Emphasizing supportive cancer care and palliative oncologic treatments may help address gaps in education; increased outcome reporting may help define the impact of palliative care curriculum within resource-limited communities.
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Affiliation(s)
- Melody J Xu
- Department of Radiation Oncology, University of California San Francisco, 1600 Divisadero St, San Francisco, CA, 94115, USA
- International Cancer Expert Corps, New York, NY, USA
| | - David Su
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rebecca Deboer
- Department of Internal Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Michael Garcia
- Department of Radiation Oncology, University of California San Francisco, 1600 Divisadero St, San Francisco, CA, 94115, USA
| | - Peggy Tahir
- Department of Library, University of California San Francisco, San Francisco, CA, USA
| | - Wendy Anderson
- Department of Internal Medicine, Division of Hospital Medicine and Palliative Care, University of California San Francisco, San Francisco, CA, USA
| | - Anne Kinderman
- Department of Internal Medicine, Division of Hospital Medicine and Palliative Care, University of California San Francisco, San Francisco, CA, USA
- Supportive and Palliative Care Service, San Francisco General Hospital and Trauma Center, San Francisco, CA, USA
| | - Steve Braunstein
- Department of Radiation Oncology, University of California San Francisco, 1600 Divisadero St, San Francisco, CA, 94115, USA
| | - Tracy Sherertz
- Department of Radiation Oncology, University of California San Francisco, 1600 Divisadero St, San Francisco, CA, 94115, USA.
- International Cancer Expert Corps, New York, NY, USA.
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