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Cumbrera A, Calzada JE, Chaves LF, Hurtado LA. Spatiotemporal Analysis of Malaria Transmission in the Autonomous Indigenous Regions of Panama, Central America, 2015-2022. Trop Med Infect Dis 2024; 9:90. [PMID: 38668551 PMCID: PMC11054363 DOI: 10.3390/tropicalmed9040090] [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: 02/26/2024] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
Despite ongoing efforts for elimination, malaria continues to be a major public health problem in the Republic of Panama. For effective elimination, it is key that malaria foci and areas of high transmission are identified in a timely manner. Here, we study malaria transmission records for the 2015-2022 period, a time when cases have increased by a factor of ten. Using several methods to study spatial and spatiotemporal malaria confirmed case clusters at the level of localities, including LISA and scan, we found that cases are clustered across indigenous villages located within the autonomous indigenous regions of Ngäbe-Buglé, Guna Yala, and Embera, with the latter on the eastern border of Panama (with Colombia). We discuss the different factors that might be shaping the marked increase in malaria transmission associated with these clusters, which include an inflow of malaria-exposed migrating populations hoping to reach the USA, insufficient health services, and the lack of culturally sensitive actionable tools to reduce malaria exposure among the ethnically diverse and impoverished indigenous populations of Panama.
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Affiliation(s)
- Alberto Cumbrera
- Dirección de Investigación y Desarrollo Tecnológico, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City 0816-02593, Panama;
| | - José Eduardo Calzada
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City 0816-02593, Panama;
- Facultad de Medicina Veterinaria, Universidad de Panamá, Panamá City 0816-03366, Panama
| | - Luis Fernando Chaves
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN 47408, USA
- Department of Geography, Indiana University, Bloomington, IN 47408, USA
| | - Lisbeth Amarilis Hurtado
- Departamento de Análisis Epidemiológico y Bioestadística, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City 0816-02593, Panama
- Facultad de Ciencias Naturales y Exactas, Universidad de Panamá, Panamá City 0816-03366, Panama
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Kabous J, Esclassan R, Noirrit-Esclassan E, Alva O, Krishna Murti P, Paquet L, Grondin J, Letellier T, Pierron D. History of dental caries in Inuit populations: genetic implications and 'distance effect'. Int J Circumpolar Health 2023; 82:2252568. [PMID: 37643455 PMCID: PMC10467516 DOI: 10.1080/22423982.2023.2252568] [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: 02/21/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023] Open
Abstract
Dental caries is considered the third most important scourge in the world. In North America, Inuit populations are the population the most severely affected by dental caries. It is often assumed that this situation can be explained by a combination of factors classical for Indigenous populations: remoteness (geographical distance), low economic status and low health literacy (cultural distance). Using a bibliographic approach, we tested this hypothesis of the "distance effect" by exploring the caries prevalence in other Indigenous populations living in high-income countries. Next, we tested whether the high prevalence of caries is due to population-specific characteristics by tracking caries prevalence over the past few centuries. In result, we showed that while other Indigenous populations are more impacted by caries than the general populations, the Inuit populations present the highest prevalence. Paradoxically, we showed also that past Inuit populations were almost immune to caries before 1950. These two elements suggest that the prevalence of caries observed presently is a recent maladaptation and that beyond the effect of cultural and geographical distance, specific biocultural factors have to be investigated.
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Affiliation(s)
- Julie Kabous
- Équipe de Médecine Evolutive, EVOLSAN faculté de chirurgie dentaire, Université Toulouse III, Toulouse, France
| | - Rémi Esclassan
- CAGT UMR 5288 CNRS, Université Paul Sabatier, UFR Santé – 3 Chemin des Maraîchers, Toulouse, France
- Department of Prosthodontics, CHU de Toulouse, Hôtel-Dieu Saint Jacques, Toulouse, France
| | - Emmanuelle Noirrit-Esclassan
- Department of Prosthodontics, CHU de Toulouse, Hôtel-Dieu Saint Jacques, Toulouse, France
- ADES Laboratory UMR 7268 CNRS, Aix-Marseille Université, Faculté des Sciences Médicales et paramédicales Secteur Nord, Marseille Cedex, France
| | - Omar Alva
- Équipe de Médecine Evolutive, EVOLSAN faculté de chirurgie dentaire, Université Toulouse III, Toulouse, France
| | - Pawan Krishna Murti
- Équipe de Médecine Evolutive, EVOLSAN faculté de chirurgie dentaire, Université Toulouse III, Toulouse, France
| | - Liliane Paquet
- Department of Anthropology, Private practice in Kuujjuaq, Kuujjuaq, Canada
| | - Julie Grondin
- Department of Pedodontics, Private practice in L’Assomption, L'assomption, QC, Canada
| | - Thierry Letellier
- Équipe de Médecine Evolutive, EVOLSAN faculté de chirurgie dentaire, Université Toulouse III, Toulouse, France
| | - Denis Pierron
- Équipe de Médecine Evolutive, EVOLSAN faculté de chirurgie dentaire, Université Toulouse III, Toulouse, France
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Jose-Abrego A, Roman S, Laguna-Meraz S, Rebello-Pinho JR, Justo Arevalo S, Panduro A. Tracing the evolutionary history of hepatitis B virus genotype H endemic to Mexico. Front Microbiol 2023; 14:1180931. [PMID: 37293217 PMCID: PMC10244555 DOI: 10.3389/fmicb.2023.1180931] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Hepatitis B virus (HBV) spreads efficiently among all human populations worldwide. HBV is classified into ten genotypes (A to J) with their geographic distribution and clinical features. In Mexico, HBV genotype H is the leading cause of hepatitis B and has been detected in indigenous populations, suggesting that HBV genotype H may be native to Mexico. However, little is known about the evolutionary history of HBV genotype H. Thus, we aimed to determine the age of HBV genotype H in Mexico using molecular dating techniques. Ninety-two HBV sequences of the reverse transcriptase (RT) domain of the polymerase gene (~1,251 bp) were analyzed; 48 were genotype H, 43 were genotype F, and the oldest HBV sequence from America was included as the root. All sequences were aligned, and the most recent common ancestor (TMRCA) time was calculated using the Bayesian Skyline Evolutionary Analysis. Our results estimate a TMRCA for the genotype H in Mexico of 2070.9 (667.5-4489.2) years before the present (YBP). We identified four major diversification events in genotype H, named H1, H2, H3, and H4. The TMRCA of H1 was 1213.0 (253.3-2638.3) YBP, followed by H2 1175.5 (557.5-2424.2) YBP, H3 949.6 (279.3-2105.0) YBP, and H4 1230.5 (336.3, 2756.7) YBP. We estimated that genotype H diverged from its sister genotype F around 8140.8 (1867.5-18012.8) YBP. In conclusion, this study found that genotype H in Mexico has an estimated age of 2070.9 (667.5-4489.2) YBP and has experienced at least four major diversification events since then.
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Affiliation(s)
- Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico
- Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico
- Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Saul Laguna-Meraz
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico
- Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
- Molecular Biology in Medicine Doctorate Program, Guadalajara, Mexico
| | - João Renato Rebello-Pinho
- Department of Gastroenterology, Institute of Tropical Medicine and School of Medicine, LIM07, University of São Paulo, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Santiago Justo Arevalo
- Faculty of Biological Sciences, Ricardo Palma University, Lima, Peru
- Department of Biochemistry, Institute of Chemistry, University of São Paulo, São Paulo, Brazil
| | - Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde", Guadalajara, Jalisco, Mexico
- Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
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Fraser HSF, Zahiri K, Kim N, Kim C, Craig S. The Global Health Informatics landscape and JAMIA. J Am Med Inform Assoc 2023; 30:775-780. [PMID: 36869748 PMCID: PMC10018257 DOI: 10.1093/jamia/ocad024] [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: 06/02/2022] [Revised: 01/11/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Global Health Informatics (GHI) as a branch of health informatics has been established for 2 decades now. During that time, great strides have been made in the creation and implementation of informatics tools to improve healthcare delivery and outcomes in the most vulnerable and remote communities worldwide. In many of the most successful projects, innovation has been shared between teams in high- and low- or middle-income countries (LMICs). In this perspective, we review the state of the academic field of GHI and the work published in JAMIA in the last 6 1/2 years. We apply criteria for articles about LMICs, those on international health, and on indigenous and refugee population, and subtypes of research. For comparison, we apply those criteria to JAMIA Open and 3 other health informatics journals which publish articles on GHI. We make recommendations for future directions and the role that journals like JAMIA can play in strengthening this work worldwide.
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Affiliation(s)
- Hamish S F Fraser
- Brown Center for Biomedical Informatics, Brown University, Providence, Rhode Island, USA
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Keyana Zahiri
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Nicole Kim
- Brown Center for Biomedical Informatics, Brown University, Providence, Rhode Island, USA
| | - Chloe Kim
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Sansanee Craig
- Department of Biomedical and Health Informatics, Childrens Hospital of Pennsylvania, Philadelphia, Pennsylvania, USA
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Taylor E, Aguilar-Ancori EG, Banyard AC, Abel I, Mantini-Briggs C, Briggs CL, Carrillo C, Gavidia CM, Castillo-Neyra R, Parola AD, Villena FE, Prada JM, Petersen BW, Falcon Perez N, Cabezas Sanchez C, Sihuincha M, Streicker DG, Maguina Vargas C, Navarro Vela AM, Vigilato MAN, Wen Fan H, Willoughby R, Horton DL, Recuenco SE. The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era. Int Health 2023; 15:216-223. [PMID: 35896028 PMCID: PMC9384559 DOI: 10.1093/inthealth/ihac048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/19/2022] [Accepted: 06/23/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) disproportionately affect populations living in resource-limited settings. In the Amazon basin, substantial numbers of NTDs are zoonotic, transmitted by vertebrate (dogs, bats, snakes) and invertebrate species (sand flies and triatomine insects). However, no dedicated consortia exist to find commonalities in the risk factors for or mitigations against bite-associated NTDs such as rabies, snake envenoming, Chagas disease and leishmaniasis in the region. The rapid expansion of COVID-19 has further reduced resources for NTDs, exacerbated health inequality and reiterated the need to raise awareness of NTDs related to bites. METHODS The nine countries that make up the Amazon basin have been considered (Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Surinam and Venezuela) in the formation of a new network. RESULTS The Amazonian Tropical Bites Research Initiative (ATBRI) has been created, with the aim of creating transdisciplinary solutions to the problem of animal bites leading to disease in Amazonian communities. The ATBRI seeks to unify the currently disjointed approach to the control of bite-related neglected zoonoses across Latin America. CONCLUSIONS The coordination of different sectors and inclusion of all stakeholders will advance this field and generate evidence for policy-making, promoting governance and linkage across a One Health arena.
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Affiliation(s)
- Emma Taylor
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Elsa Gladys Aguilar-Ancori
- Instituto Universitario de Enfermedades Tropicales y Biomedicina de Cusco - Universidad Nacional de San Antonio Abad del Cusco, Cusco, 08003, Peru
| | - Ashley C Banyard
- Animal and PlantHealth Agency, WoodhamLane, New Haw, Weybridge, Surrey, KT15 3NB, United Kingdom
| | - Isis Abel
- Laboratório de Epidemiologia e Geoprocessamento, Instituto de MedicinaVeterinária, Universidade Federal do Pará, Castanhal, Pará, 68743-970, Brasil
| | - Clara Mantini-Briggs
- Berkeley Center for Social Medicine and the Institute for the Study of Societal Issues, University of California, Berkeley, 94720-5670, USA
| | - Charles L Briggs
- Berkeley Center for Social Medicine and the Department of Anthropology, University of California, Berkeley, 94720-5670, USA
| | - Carolina Carrillo
- Instituto de Ciencia y Tecnología Dr. Cesar Milstein, Fundación Pablo Cassará - ConsejoNacional de InvestigacionesCientíficas y Técnicas, Saladillo 2468 (C1440FFX) Ciudad de Buenos Aires, Argentina
| | - Cesar M Gavidia
- Facultad de MedicinaVeterinaria, Universidad Nacional Mayor de San Marcos, Lima, 15021, Perú
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, 19104-6021, USA
- One Health Unit, School of Public Health and Administration, Universidad PeruanaCayetano Heredia, Lima, 15102, Peru
| | - Alejandro D Parola
- Fundación Pablo Cassará. Instituto de Ciencia y Tecnología Dr. Cesar Milstein, Saladillo 2468 (C1440FFX) Ciudad de Buenos Aires, Argentina
| | - Fredy E Villena
- Asociaciónpara el Empleo y Bienestar Animal en Investigación y Docencia (ASOPEBAID), Lima, 15072, Peru
| | - Joaquin M Prada
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Brett W Petersen
- Poxvirus and Rabies Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, 30333, USA
| | - Nestor Falcon Perez
- Facultad de MedicinaVeterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, 15102, Perú
| | - Cesar Cabezas Sanchez
- Centro de InvestigacionesTecnologicas, Biomedicas y Medioambientales-CITBM, Universidad Nacional Mayor de San Marcos, Lima, 15081, Peru
| | | | - Daniel G Streicker
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
- MRC-University of Glasgow Centre for Virus Research, Glasgow, G61 1QH, UK
| | - Ciro Maguina Vargas
- Instituto de Medicina Tropical Alexander Von Humbolt, Universidad Peruana Cayetano Heredia, Lima, 15102, Perú
| | | | - Marco A N Vigilato
- Pan American Center for Foot and Mouth Disease and Veterinary Public Health, Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Rio de Janeiro, 25040-004, Brazil
| | - Hui Wen Fan
- Bioindustrial Center, InstitutoButantan, São Paulo, 05503-900, Brazil
| | | | - Daniel L Horton
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Sergio E Recuenco
- Centro de InvestigacionesTecnologicas, Biomedicas y Medioambientales-CITBM, Universidad Nacional Mayor de San Marcos, Lima, 15081, Peru
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Griffiths K, Davies L, Savage C, Shelling M, Dalziel P, Christy E, Thorby R. The Value of Recreational Physical Activity in Aotearoa New Zealand: A Scoping Review of Evidence and Implications for Social Value Measurement. Int J Environ Res Public Health 2023; 20:2906. [PMID: 36833603 PMCID: PMC9958888 DOI: 10.3390/ijerph20042906] [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] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
Internationally, there is rising interest in measuring the value of sport and physical activity to society. A critical step in valuing the sector is first establishing the relationship between engagement in sport and physical activity and the societal outcomes that ensue. This paper summarises the findings of a literature review carried out as part of a larger study on the Social Return on Investment (SROI) of recreational physical activity in Aotearoa New Zealand. The review aimed to synthesise existing evidence on the relationship between recreational physical activity and wellbeing outcomes for all New Zealanders, including tangata whenua (Māori, who are Aotearoa New Zealand's Indigenous population). The methodology took the format of a scoping review and included a series of searches for academic and grey literature, including literature concerning Māori that might have been overlooked in a traditional academic search. The findings are grouped into five outcome areas: physical health; subjective wellbeing; individual development; personal behaviour; and social and community development. The review found some compelling evidence which shows examples of the links between sport and physical activity and outcomes in each of these areas for specific population sub-groups. In particular, for Māori, the findings demonstrate a strong impact on social and community development through building social capital and enhancing cultural identity. However, in all outcome areas, there is mixed quality evidence, a small amount of evidence on which to base definitive conclusions, and limited evidence relating to the monetary value of outcomes. The review concludes that there is a need for further research to strengthen the evidence base for social impact measurement, particularly around the impact of sport and physical activity for indigenous populations.
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Affiliation(s)
- Kerry Griffiths
- Sport Industry Research Centre, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Larissa Davies
- Sport Industry Research Centre, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Catherine Savage
- Ihi Research, 518 Colombo Street, Christchurch 8011, New Zealand
| | | | - Paul Dalziel
- Agribusiness and Economics Research Unit, Lincoln University, P.O. Box 85084, Lincoln 7647, New Zealand
| | - Elizabeth Christy
- Sport Industry Research Centre, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Rebecca Thorby
- Sport New Zealand Ihi Aotearoa, P.O. Box 2251, Wellington 6140, New Zealand
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Triplett C, Fletcher BJ, Taitingfong RI, Zhang Y, Ali T, Ohno-Machado L, Bloss CS. Codesigning a community-based participatory research project to assess tribal perspectives on privacy and health data sharing: A report from the Strong Heart Study. J Am Med Inform Assoc 2022; 29:1120-1127. [PMID: 35349678 PMCID: PMC9093024 DOI: 10.1093/jamia/ocac038] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Broad health data sharing raises myriad ethical issues related to data protection and privacy. These issues are of particular relevance to Native Americans, who reserve distinct individual and collective rights to control data about their communities. We sought to gather input from tribal community leaders on how best to understand health data privacy and sharing preferences in this population. We conducted a workshop with 14 tribal leaders connected to the Strong Heart Study to codesign a research study to assess preferences concerning health data privacy for biomedical research. Workshop participants provided specific recommendations regarding who should be consulted, what questions should be posed, and what methods should be used, underscoring the importance of relationship-building between researchers and tribal communities. Biomedical researchers and informaticians who collect and analyze health information from Native communities have a unique responsibility to safeguard these data in ways that align to the preferences of specific communities.
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Affiliation(s)
- Cynthia Triplett
- Herbert Wertheim School of Public Health and Longevity Science, University of California, La Jolla, California, USA
- Center for Empathy and Technology, University of California, La Jolla, California, USA
| | - Burgundy J Fletcher
- Department of Ethnic Studies, University of California, La Jolla, California, USA
| | - Riley I Taitingfong
- Herbert Wertheim School of Public Health and Longevity Science, University of California, La Jolla, California, USA
| | - Ying Zhang
- Department of Biostatistics and Epidemiology, A Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Tauqeer Ali
- Department of Biostatistics and Epidemiology, A Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lucila Ohno-Machado
- Veteran Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Biomedical Informatics, University of California Health, La Jolla, California, USA
| | - Cinnamon S Bloss
- Herbert Wertheim School of Public Health and Longevity Science, University of California, La Jolla, California, USA
- Center for Empathy and Technology, University of California, La Jolla, California, USA
- Department of Biomedical Informatics, University of California Health, La Jolla, California, USA
- Department of Psychiatry, School of Medicine, University of California, La Jolla, California, USA
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Colussi C, Stafuza M, Nepote M, Mendicino D. Seroprevalence of Chagas disease in urban and rural indigenous populations of the south of Gran Chaco. Rev Soc Bras Med Trop 2022; 55:e04792021. [PMID: 35522808 PMCID: PMC9070071 DOI: 10.1590/0037-8682-0479-2021] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In Latin America, Chagas disease is endemic, with a high prevalence in rural indigenous communities and an increasing prevalence in urban areas owing to migration from rural areas with active vector transmission. This study aimed to assess differences in the prevalence of Chagas disease in urban and rural moqoit communities, one of the main ethnic indigenous groups in the south of Gran Chaco. METHODS A seroprevalence study was conducted in six moqoit populations in the Santa Fe province, Argentina. The variables studied were serology results for Chagas disease, residents of urban or rural areas, age, and sex. RESULTS The results showed that 9.26% of the 702 volunteers evaluated and 18.32% of the 131women of childbearing potential were seropositive. According to the calculated prevalence ratio, the prevalence of Chagas disease in urban communities was6.41 (95% confidence inverval: 3.73-11.02) times higher than that in rural communities: 21.59% in urban communities vs. 3.37%in rural communities. CONCLUSIONS The seroprevalence found in the moqoit community was higher than the estimated level for the general population of the same region, with a greater impact in urban areas than in rural areas. The urbanization of groups of people with poor socio-sanitary conditions in the second half of the 20th century could have caused this higher seroprevalence of Chagas disease.
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Affiliation(s)
- Carlina Colussi
- Universidad Nacional del Litoral, Facultad de Bioquímica y Ciencias Biológicas, Centro de Investigaciones sobre Endemias Nacionales. Santa Fe, Argentina
| | - Mariana Stafuza
- Ministerio de Salud de la Provincia de Santa Fe, Hospital Central de Reconquista. Reconquista, Argentina
| | - Marcelo Nepote
- Ministerio de Salud de la Provincia de Santa Fe, Programa Provincial de Control de la Enfermedad de Chagas. Santa Fe, Argentina
| | - Diego Mendicino
- Universidad Nacional del Litoral, Facultad de Bioquímica y Ciencias Biológicas, Centro de Investigaciones sobre Endemias Nacionales. Santa Fe, Argentina
- Consejo de Investigaciones Científicas y Técnicas. Buenos Aires, Argentina
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9
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Richer A, Roddy AL. Opioid use in indigenous populations: indigenous perspectives and directions in culturally responsive care. J Soc Work Pract Addict 2022; 22:255-263. [PMID: 37292386 PMCID: PMC10249962 DOI: 10.1080/1533256x.2022.2049161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this work, we outline the necessary components for culturally responsive treatment to opioid use disorders in Indigenous communities. First, we examine the context of historical trauma faced by Indigenous groups in the U.S. and how this context may affect successful implementation of treatment. We then outline the strategies of Penobscot Nation and Little Earth in developing holistic treatment regimens for Indigenous peoples, and list policy interventions suited to improve outcomes for Indigenous groups related to opioid use disorders. We conclude with suggestions for future directions in anticolonial strategies for addressing opioid use in Indigenous communities. The combination of culturally responsive treatment, tribal sovereignty in the treatment of opioid use disorders, and effective resource allocation is necessary to affect positive change in Indigenous substance use trajectories.
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Affiliation(s)
- Ariel Richer
- Pre-Doctoral Fellow, School of Social Work, Columbia University, New York, New York, USA
| | - Ariel L. Roddy
- Doctoral Candidate, School of Criminal Justice, Michigan State University, East Lansing, Michigan, USA
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Orellana JDY, Gatica-Domínguez G, Vaz JDS, Neves PAR, de Vasconcellos ACS, de Souza Hacon S, Basta PC. Intergenerational Association of Short Maternal Stature with Stunting in Yanomami Indigenous Children from the Brazilian Amazon. Int J Environ Res Public Health 2021; 18:9130. [PMID: 34501720 DOI: 10.3390/ijerph18179130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022]
Abstract
To describe the factors associated to stunting in <5-year-old Yanomami Brazilian children, and to evaluate the association of short maternal stature to their offspring’s stunting. A cross-sectional study carried out in three villages in the Yanomami territory. We performed a census, in which all households with children < 5-years-old were included. The length/height-for-age z-score <−2 standard deviations was used to classify the children as stunted. Short maternal height was defined as <145 cm for adult women, and <−2 standard deviations of the height-for-age z-score for adolescent women. We used adjusted Poisson regression models to estimate prevalence ratios (PR) along the 90% confidence interval. We evaluated 298 children. 81.2% of children suffered from stunting and 71.9% of the mothers from short stature. In the bivariate analysis, a significant association of stunting with short maternal stature, gestational malaria and child’s place of birth were observed. Considering the variables of the children under five years of age, there were significant associations with age group, the child’s caregiver, history of malaria, pneumonia, and malnutrition treatment. In the adjusted hierarchical model, stunting was 1.22 times greater in the offspring of women with a short stature (90% CI: 1.07–1.38) compared to their counterparts. Brazilian Amazonian indigenous children living in a remote area displayed an alarming prevalence of stunting, and this was associated with short maternal height, reinforcing the hypothesis of intergenerational chronic malnutrition transmission in this population. In addition, children above 24 months of age, who were born in the village healthcare units and who had had previous treatment in the past for stunting presented higher rates of stunting in this study.
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11
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Vivi-Oliveira VK, Junior AAP, Lacerda TEJ, Rozental T, Lemos ERSD, Espinosa MM, Zenazokenae LE, Nascimento VFD, Terças-Trettel ACP, Santos MAD. Serological evidence of Bartonellosis in an indigenous community in the Brazilian Legal Amazonia. Zoonoses Public Health 2021; 68:987-992. [PMID: 34259394 DOI: 10.1111/zph.12881] [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: 05/04/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Due to immunological susceptibility, close contact with the environment and way of life, indigenous communities are in a highly vulnerable condition to be affected by zoonoses, such as bartonellosis. METHODS Seventy three paired serum samples were collected from indigenous people from a region of the Brazilian Legal Amazon, in cohorts carried out in 2014 and 2015, with the performance of serological tests by indirect immunofluorescence to detect anti-Bartonella IgG antibodies. The interviews and laboratory results were double entered in the EpiInfo 7 software, and the data processing was performed in the MiniTab 17 software. RESULTS 5.47% of the indigenous people were seroreagent. The female gender was predominant (65.75%), aged between 20 and 39 years old (39.73%) with complete elementary school (42.47%). As for housing, wooden residences predominated (50.68%). Rodents were seen by 46.58% of the interviewees, and 55.88% of them reported that the animal was close to or inside the house. It was identified that each indigenous family, in its majority, had four to six cats, for the function of hunters of rodents. CONCLUSION The high concentration of domestic cats, the close contact of indigenous people with wild rodents and the lack of care and poor hygiene of both are aspects that imply the possibility of infection by Bartonella sp. Health surveillance through seroepidemiological studies is essential to find evidence of the circulation of bartonellosis in these populations.
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Affiliation(s)
| | | | | | - Tatiana Rozental
- Oswaldo Cruz Foundation, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | - Mariano Martinez Espinosa
- Collective Health Institute, Federal University of Mato Grosso, Cuiabá, Brazil.,Department of Statistics, Federal University of Mato Grosso, Cuiabá, Brazil
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Abstract
Indigenous communities across Canada have established principles to guide ethical research within their respective communities. Thorough cataloging and description of these would inform university research ethics boards, researchers, and scholars and facilitate meaningful research that respects Indigenous-defined ethical values. A scoping study was conducted of all relevant peer-reviewed literature and public-facing Indigenous research ethical guidelines from First Nations, Metis, and Inuit communities and organizations in Canada. A total of 20 different Indigenous research ethics boards, frameworks, and protocols were identified. Analysis resulted in three key themes: (1) balancing individual and collective rights; (2) upholding culturally-grounded ethical principles; and (3) ensuring community-driven/self-determined research. Findings demonstrate how employment of Indigenous ethical principles in research positively contributes to research outcomes.
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Affiliation(s)
- Ashley Hayward
- 8665University of Winnipeg, Winnipeg, Canada.,8664University of Manitoba, Winnipeg, Canada
| | - Erynne Sjoblom
- First Nations Health and Social Secretariat of Manitoba, Winnipeg, Canada
| | - Stephanie Sinclair
- 8664University of Manitoba, Winnipeg, Canada.,First Nations Health and Social Secretariat of Manitoba, Winnipeg, Canada
| | - Jaime Cidro
- 8665University of Winnipeg, Winnipeg, Canada
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13
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Chakraborty A, Howard NJ, Daniel M, Chong A, Slavin N, Brown A, Cargo M. Prioritizing Built Environmental Factors to Tackle Chronic and Infectious Diseases in Remote Northern Territory (NT) Communities of Australia: A Concept Mapping Study. Int J Environ Res Public Health 2021; 18:5178. [PMID: 34068201 PMCID: PMC8152969 DOI: 10.3390/ijerph18105178] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 12/31/2022]
Abstract
High prevalence of chronic and infectious diseases in Indigenous populations is a major public health concern both in global and Australian contexts. Limited research has examined the role of built environments in relation to Indigenous health in remote Australia. This study engaged stakeholders to understand their perceptions of the influence of built environmental factors on chronic and infectious diseases in remote Northern Territory (NT) communities. A preliminary set of 1120 built environmental indicators were systematically identified and classified using an Indigenous Indicator Classification System. The public and environmental health workforce was engaged to consolidate the classified indicators (n = 84), and then sort and rate the consolidated indicators based on their experience with living and working in remote NT communities. Sorting of the indicators resulted in a concept map with nine built environmental domains. Essential services and Facilities for health/safety were the highest ranked domains for both chronic and infectious diseases. Within these domains, adequate housing infrastructure, water supply, drainage system, reliable sewerage and power infrastructure, and access to health services were identified as the most important contributors to the development of these diseases. The findings highlight the features of community environments amenable to public health and social policy actions that could be targeted to help reduce prevalence of chronic and infectious diseases.
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Affiliation(s)
- Amal Chakraborty
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
| | - Natasha J. Howard
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Mark Daniel
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Alwin Chong
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA 5001, Australia;
| | - Nicola Slavin
- Environmental Health Branch, Department of Health, Northern Territory Government, Casuarina, NT 0810, Australia;
| | - Alex Brown
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Margaret Cargo
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (N.J.H.); (M.D.); (A.B.); (M.C.)
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
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14
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Dobbin EAF, Medeiros JAG, Costa MSCR, Rodrigues JCG, Guerreiro JF, Kroll JE, Souza SJ, de Assumpção PP, Ribeiro-Dos-Santos Â, Santos SEBD, Burbano RMR, Fernandes MR, Santos NPCD. Identification of Variants (rs11571707, rs144848, and rs11571769) in the BRCA2 Gene Associated with Hereditary Breast Cancer in Indigenous Populations of the Brazilian Amazon. Genes (Basel) 2021; 12:142. [PMID: 33499154 DOI: 10.3390/genes12020142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 12/09/2022] Open
Abstract
Estimates show that 5–10% of breast cancer cases are hereditary, caused by genetic variants in autosomal dominant genes; of these, 16% are due to germline mutations in the BRCA1 and BRCA2 genes. The comprehension of the mutation profile of these genes in the Brazilian population, particularly in Amazonian Amerindian groups, is scarce. We investigated fifteen polymorphisms in the BRCA1 and BRCA2 genes in Amazonian Amerindians and compared the results with the findings of global populations publicly available in the 1000 Genomes Project database. Our study shows that three variants (rs11571769, rs144848, and rs11571707) of the BRCA2 gene, commonly associated with hereditary breast cancer, had a significantly higher allele frequency in the Amazonian Amerindian individuals in comparison with the African, American, European, and Asian groups analyzed. These data outline the singular genetic profiles of the indigenous population from the Brazilian Amazon region. The knowledge about BRCA1 and BRCA2 variants is critical to establish public policies for hereditary breast cancer screening in Amerindian groups and populations admixed with them, such as the Brazilian population.
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15
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Juarez M, Dionicio C, Sacuj N, Lopez W, Miller AC, Rohloff P. Community-Based Interventions to Reduce Child Stunting in Rural Guatemala: A Quality Improvement Model. Int J Environ Res Public Health 2021; 18:ijerph18020773. [PMID: 33477580 PMCID: PMC7831302 DOI: 10.3390/ijerph18020773] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/07/2021] [Accepted: 01/14/2021] [Indexed: 12/30/2022]
Abstract
Rural Guatemala has one of the highest rates of chronic child malnutrition (stunting) in the world, with little progress despite considerable efforts to scale up evidence-based nutrition interventions. Recent literature suggests that one factor limiting impact is inadequate supervisory support for frontline workers. Here we describe a community-based quality improvement intervention in a region with a high rate of stunting. The intervention provided audit and feedback support to frontline nutrition workers through electronic worklists, performance dashboards, and one-on-one feedback sessions. We visualized performance indicators and child nutrition outcomes during the improvement intervention using run charts and control charts. In this small community-based sample (125 households at program initiation), over the two-year improvement period, there were marked improvements in the delivery of program components, such as growth monitoring services and micronutrient supplements. The prevalence of child stunting fell from 42.4 to 30.6%, meeting criteria for special cause variation. The mean length/height-for-age Z-score rose from −1.77 to −1.47, also meeting criteria for special cause variation. In conclusion, the addition of structured performance visualization and audit and feedback components to an existing community-based nutrition program improved child health indicators significantly through improving the fidelity of an existing evidence-based nutrition package.
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Affiliation(s)
- Michel Juarez
- Center for Research in Indigenous Health, Wuqu’ Kawoq|Maya Health Alliance 2a Avenida 3-48 Zona 3, Barrio Patacabaj, Tecpán, Chimaltenango 04006, Guatemala; (M.J.); (C.D.); (N.S.); (W.L.)
| | - Carlos Dionicio
- Center for Research in Indigenous Health, Wuqu’ Kawoq|Maya Health Alliance 2a Avenida 3-48 Zona 3, Barrio Patacabaj, Tecpán, Chimaltenango 04006, Guatemala; (M.J.); (C.D.); (N.S.); (W.L.)
| | - Neftali Sacuj
- Center for Research in Indigenous Health, Wuqu’ Kawoq|Maya Health Alliance 2a Avenida 3-48 Zona 3, Barrio Patacabaj, Tecpán, Chimaltenango 04006, Guatemala; (M.J.); (C.D.); (N.S.); (W.L.)
| | - Waleska Lopez
- Center for Research in Indigenous Health, Wuqu’ Kawoq|Maya Health Alliance 2a Avenida 3-48 Zona 3, Barrio Patacabaj, Tecpán, Chimaltenango 04006, Guatemala; (M.J.); (C.D.); (N.S.); (W.L.)
| | - Ann C. Miller
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave, Boston, MA 02115, USA;
| | - Peter Rohloff
- Center for Research in Indigenous Health, Wuqu’ Kawoq|Maya Health Alliance 2a Avenida 3-48 Zona 3, Barrio Patacabaj, Tecpán, Chimaltenango 04006, Guatemala; (M.J.); (C.D.); (N.S.); (W.L.)
- Division of Global Health Equity, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA
- Correspondence:
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Abstract
Gambling has never been investigated in Greenlandic adolescents. High prevalence of gambling problems and a relation to other addictive behaviours has been found in adult Greenlanders. Greenlandic adolescents are daily exposed to gambling, for example, by selling lottery tickets, through advertises and electronic devices. The aim of this study is to investigate how Greenlandic adolescents perceive gambling, and to pilot test the Lie/Bet screening-instrument.Ten semi-structured focus group interviews were conducted for 31 adolescents, aged 12–16, from 3 schools in Nuuk, Greenland.The 31 adolescents have experiences with gambling. Whether they define a game as gambling depends on: 1) Whether the game is about playing with or about money, 2) whether the game is about earning items, 3) the gain/loss, 4) who they lose money to, and 5) the purpose. If the purpose is to have fun, it is not necessarily seen as gambling. None mentioned bingo as gambling, arguing that bingo is about having fun. Two recent trends were found to have reached Greenland: The close link between sports and gambling, and skin-betting. Additionally, the Lie/Bet screen was, with slight modifications, found to be useful as a screening-instrument among Greenlandic adolescents and it is proposed to be used in future studies.
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Affiliation(s)
| | - Trine Lenskjold
- a Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen N , Denmark
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17
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Thiede BC, Gray C. Characterizing the Indigenous Forest Peoples of Latin America: Results from Census Data. World Dev 2020; 125:10.1016/j.worlddev.2019.104685. [PMID: 32123463 PMCID: PMC7051013 DOI: 10.1016/j.worlddev.2019.104685] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indigenous populations in Latin America are central to regional and global efforts toward achieving socially and environmentally sustainable development. However, existing demographic research on indigenous forest peoples (IFPs) has many limitations, including a lack of comparable cross-national evidence. We address this gap by linking representative census microdata to satellite-derived tree cover estimates for nine countries in the region. Our analyses describe the demographic and socioeconomic characteristics of IFPs, and draw comparisons with reference groups. Our first goal is to examine within- and between-population variation in the age structure, human capital attainment, and economic status of IFPs. We then analyze patterns of fertility among indigenous forest-dwelling women and comparison groups. Finally, we examine the association between migration patterns and tree cover among indigenous and non-indigenous populations. Findings demonstrate that Latin America's IFPs are materially deprived and characterized by high fertility levels overall. Importantly for sustainable development efforts, we show that non-indigenous forest-dwellers outnumber IFPs by more than eight to one and that IFPs have lower fertility than their non-indigenous counterparts when other characteristics are accounted for. Additionally, we find that most in-migrants to heavily-forested areas are non-indigenous, and that in-migrants tend to settle in areas that are forested but have few indigenous inhabitants. These results provide new cross-national evidence on the state of IFPs in Latin America, and highlight the need to empower these groups in the face of growing social and environmental crises in the region.
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Affiliation(s)
- Brian C. Thiede
- Corresponding Author: Department of Agricultural Economics, Sociology, and Education, The Pennsylvania State University, 111A Armsby Building, University Park, PA 16802, , 814-865-2561
| | - Clark Gray
- The University of North Carolina at Chapel Hill
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18
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Coppell K, Freer T, Abel S, Whitehead L, Tipene-Leach D, Gray AR, Merriman T, Sullivan T, Krebs J, Perreault L. What predicts regression from pre-diabetes to normal glucose regulation following a primary care nurse-delivered dietary intervention? A study protocol for a prospective cohort study. BMJ Open 2019; 9:e033358. [PMID: 31822546 PMCID: PMC6924756 DOI: 10.1136/bmjopen-2019-033358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Pre-diabetes is a high-risk state for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Regression to normoglycaemia, even if transient, significantly reduces the risk of developing T2DM. The primary aim of this mixed-methods study is to determine if there are clinically relevant differences among those with pre-diabetes and excess weight who regress to normoglycaemia, those who have persistent pre-diabetes and those who progress to T2DM following participation in a 6-month primary care nurse-delivered pre-diabetes dietary intervention. Incidence of T2DM at 2 years will be examined. METHODS AND ANALYSIS Four hundred participants with pre-diabetes (New Zealand definition glycated haemoglobin 41-49 mmol/mol) and a body mass index >25 kg/m2 will be recruited through eight primary care practices in Hawke's Bay, New Zealand. Trained primary care nurses will deliver a 6-month structured dietary intervention, followed by quarterly reviews for 18 months post-intervention. Clinical data, data on lifestyle factors and health-related quality of life (HR-QoL) and blood samples will be collected at baseline, 6 months, 12 months and 24 months. Sixty participants purposefully selected will complete a semi-structured interview following the 6-month intervention. Poisson regression with robust standard errors and clustered by practice will be used to identify predictors of regression or progression at 6 months, and risk factors for developing T2DM at 2 years. Qualitative data will be analysed thematically. Changes in HR-QoL will be described and potential cost savings will be estimated from a funder's perspective at 2 years. ETHICS AND DISSEMINATION This study was approved by the Northern A Health and Disability Ethics Committee, New Zealand (Ethics Reference: 17/NTA/24). Study results will be presented to participants, published in peer-reviewed journals and presented at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12617000591358; Pre-results.
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Affiliation(s)
- Kirsten Coppell
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Sally Abel
- Kaupapa Consulting Ltd, Napier, New Zealand
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - David Tipene-Leach
- Faculty of Education, Humanities and Health Science, Eastern Institute of Technology, Napier, New Zealand
| | - Andrew R Gray
- Centre for Biostatistics, University of Otago, Dunedin, New Zealand
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jeremy Krebs
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Leigh Perreault
- Department of Medicine, University of Colorado, Denver, Colorado, USA
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19
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Matthews V, Longman J, Berry HL, Passey M, Bennett-Levy J, Morgan GG, Pit S, Rolfe M, Bailie RS. Differential Mental Health Impact Six Months After Extensive River Flooding in Rural Australia: A Cross-Sectional Analysis Through an Equity Lens. Front Public Health 2019; 7:367. [PMID: 31867302 PMCID: PMC6909816 DOI: 10.3389/fpubh.2019.00367] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/18/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Northern New South Wales in Australia is a “hotspot” for natural disaster declarations with recent extensive flooding in early 2017. With limited knowledge about how climate change affects mental health and resilience, robust local assessments are required to better understand long-term impact, particularly in communities prone to extreme weather events. Methods: Six months post-flood, a cross-sectional survey of adults living in the region during the flood was conducted to quantify associations between flood impact and psychological morbidity (post-traumatic stress (PTSD), anxiety, depression, suicidal ideation) for different exposure scenarios, and respondent groups. We adopted a community-academic partnership approach and purposive recruitment to increase participation from marginalized groups. Results: Of 2,180 respondents, almost all (91%) were affected by some degree of flood-related exposure at an individual and community level (ranging from suburb damage to home or business inundated). Socio-economically marginalized respondents were more likely to have their homes inundated and to be displaced. Mental health risk was significantly elevated for respondents: whose home/business/farm was inundated [e.g., home inundation: PTSD adjusted odds ratio (AOR) 13.72 (99% CI 4.53–41.56)]; who reported multiple exposures [e.g., three exposures: PTSD AOR 6.43 (99% CI 2.11–19.60)]; and who were still displaced after 6 months [e.g., PTSD AOR 24.43 (99% CI 7.05–84.69)]. Conclusion: The 2017 flood had profound impact, particularly for respondents still displaced and for socio-economically marginalized groups. Our community-academic partnership approach builds community cohesion, informs targeted mental health disaster preparedness and response policies for different sectors of the community and longer-term interventions aimed at improving community adaptability to climate change.
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Affiliation(s)
- Veronica Matthews
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Jo Longman
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Helen L Berry
- Centre for Health Systems and Safety Research, Macquarie University, Sydney, NSW, Australia
| | - Megan Passey
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - James Bennett-Levy
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Geoffrey G Morgan
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Sabrina Pit
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Margaret Rolfe
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Ross S Bailie
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
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20
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Gounder PP, Koch A, Provo G, Lovlie A, Ederth JL, Axelsson M, Archibald CP, Hanley B, Mullen A, Matheson M, Allison D, Trykker H, Hennessy TW, Kuusi M, Chulanov V, McMahon BJ. Summary of available surveillance data on hepatitis C virus infection from eight Arctic countries, 2012 to 2014. ACTA ACUST UNITED AC 2019; 23. [PMID: 30301489 PMCID: PMC6178586 DOI: 10.2807/1560-7917.es.2018.23.40.1700408] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We summarised available hepatitis C virus (HCV) surveillance data for 2012–14 from Arctic/sub-Arctic countries/regions. We sent a HCV data collection template by email to public health authorities in all jurisdictions. Population statistics obtained from census sources for each country were used to estimate rates of reported acute and chronic/undifferentiated HCV cases. Seven countries with Arctic regions (Canada, Denmark, Finland, Greenland, Norway, Sweden and the United States, represented by the state of Alaska), including three Canadian territories and one province, as well as 11 Russian subnational Arctic regions, completed the data collection template. Data on acute HCV infection during 2014 was available from three Arctic countries and all Russian Arctic regions (rate range 0/100,000 population in Greenland, as well as Nenets and Chukotka Automous Okrugs (Russian subnational Arctic regions) to 3.7/100,000 in the Russian Republic of Komi). The rate of people with chronic/undifferentiated HCV infection in 2014 ranged from 0/100,000 in Greenland to 171.2/100,000 in Alaska. In most countries/regions, the majority of HCV-infected people were male and aged 19–64 years. Differences in surveillance methods preclude direct comparisons of HCV surveillance data between Arctic countries/regions. Our data can inform future efforts to develop standardised approaches to HCV surveillance in the Arctic countries/regions by identifying similarities/differences between the surveillance data collected.
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Affiliation(s)
- Prabhu P Gounder
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention (CDC), Anchorage, Alaska, USA
| | - Anders Koch
- Lisimatusarfik, University of Greenland, Nuuk, Greenland.,Statens Serum Institut, Copenhagen, Denmark
| | - Ginger Provo
- Division of Public Health, State of Alaska, Anchorage, Alaska, USA
| | - Astrid Lovlie
- Department for Infectious Disease Registries, Norwegian Institute of Public Health, Oslo, Norway
| | - Josefine Lundberg Ederth
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Stockholm, Sweden
| | - Maria Axelsson
- Unit for Epidemiology & Health Economic, the Public Health Agency of Sweden, Stockholm, Sweden
| | - Chris P Archibald
- Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Canada
| | - Brendan Hanley
- Chief Medical Officer of Health, Whitehorse, Yukon, Canada
| | - Angie Mullen
- Department of Health, Government of Nunavut, Iqaluit, Nunavut, Canada
| | - Myrna Matheson
- Communicable Disease Control Unit, Department of Health and Social Services, Government of the Northwest Territories, Yellowknife, Northwest Territories, Canada
| | - David Allison
- Department of Health and Community Services, St. John's, Newfoundland and Labrador, Canada
| | | | - Thomas W Hennessy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention (CDC), Anchorage, Alaska, USA
| | - Markku Kuusi
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Vladimir Chulanov
- Central Research Institute of Epidemiology, Reference Center for Viral Hepatitis, Moscow, Russia
| | - Brian J McMahon
- Liver Diseases and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA.,Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention (CDC), Anchorage, Alaska, USA
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21
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Gott M, Robinson J, Moeke-Maxwell T, Black S, Williams L, Wharemate R, Wiles J. 'It was peaceful, it was beautiful': A qualitative study of family understandings of good end-of-life care in hospital for people dying in advanced age. Palliat Med 2019; 33:793-801. [PMID: 31027476 DOI: 10.1177/0269216319843026] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hospitals are important sites of end-of-life care, particularly for older people. A need has been identified to understand best practice in hospital end-of-life care from the service-user perspective. AIM The aim of this study was to identify examples of good care received in the hospital setting during the last 3 months of life for people dying in advanced age from the perspective of bereaved family members. DESIGN A social constructionist framework underpinned a qualitative research design. Data were analysed thematically drawing on an appreciative enquiry framework. SETTING/PARTICIPANTS Interviews were conducted with 58 bereaved family carers nominated by 52 people aged >80 years participating in a longitudinal study of ageing. Data were analysed for the 21 of 34 cases where family members were 'extremely' or 'very' satisfied with a public hospital admission their older relative experienced in their last 3 months of life. RESULTS Participants' accounts of good care aligned with Dewar and Nolan's relation-centred compassionate care model: (1) a relationship based on empathy; (2) effective interactions between patients/families and staff; (3) contextualised knowledge of the patient/family; and (4) patients/families being active participants in care. We extended the model to the bicultural context of Aotearoa, New Zealand. CONCLUSION We identify concrete actions that clinicians working in acute hospitals can integrate into their practice to deliver end-of-life care with which families are highly satisfied. Further research is required to support the implementation of the relation-centred compassionate care model within hospitals, with suitable adaptations for local context, and explore the subsequent impact on patients, families and staff.
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Affiliation(s)
- Merryn Gott
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Jackie Robinson
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand.,3 Auckland District Health Board, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Stella Black
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Lisa Williams
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Rawiri Wharemate
- 2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Janine Wiles
- 2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand.,4 School of Population Health, University of Auckland, Auckland, New Zealand
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Rouen C, Clough AR, West C. Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia. Crisis 2019; 40:422-428. [PMID: 30935241 DOI: 10.1027/0227-5910/a000589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15-24 and 25-34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.
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Affiliation(s)
- Chris Rouen
- Nursing & Midwifery, James Cook University, Cairns, QLD, Australia
| | - Alan R Clough
- College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD, Australia
| | - Caryn West
- Nursing & Midwifery, James Cook University, Cairns, QLD, Australia
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Qiao R, Li X, Han X, Wang K, Lv G, Ren G, Li X. Population structure and genetic diversity of four Henan pig populations. Anim Genet 2019; 50:262-265. [PMID: 30883844 DOI: 10.1111/age.12775] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/22/2022]
Abstract
To investigate the population structure and genetic diversity of Henan indigenous pig breeds, samples from a total of 78 pigs of 11 breeds were collected, including four pig populations from Henan Province, three Western commercial breeds, three Chinese native pig breeds from other provinces and one Asian wild boar. The genotyping datasets were obtained by genotyping-by-sequencing technology. We found a high degree of polymorphism and rapid linkage disequilibrium decay in Henan pigs. A neighbor-joining tree, principal component analysis and structure analysis revealed that the Huainan and Erhualian pigs were clustered together and that the Queshan black pigs were clearly grouped together but that the Nanyang and Yuxi pigs were extensively admixed with Western pigs. In addition, heterozygosity values might indicate that Henan indigenous pigs, especially the Queshan black and Huainan pigs, were subjected to little selection during domestication. The results presented here indicate that Henan pig breeds were admixed from Western breeds, especially Nanyang and Yuxi pigs. Therefore, establishment of purification and rejuvenation systems to implement conservation strategies is urgent. In addition, it is also necessary to accelerate genetic resources improvement and utilization using modern breeding technologies, such as genomic selection and genome-wide association studies.
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Affiliation(s)
- R Qiao
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - X Li
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - X Han
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - K Wang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - G Lv
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - G Ren
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - X Li
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
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24
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Knox M. Creating a preference for prevention: the role of universal health care in the demand for preventive care among Mexico's vulnerable populations. Health Policy Plan 2018; 33:853-860. [PMID: 31222331 DOI: 10.1093/heapol/czy062] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2018] [Indexed: 11/12/2022] Open
Abstract
The introduction of Seguro Popular (SP)- providing health insurance to over 50 million Mexicans since the early 2000s-represents a large shift in health care delivery to the Mexican population. And yet, its impact on Mexico's marginalized communities has been little studied, and its impact on health is unclear. Using a survey of poor urban Mexicans and Mexican Ministry of Health administrative data, this article investigates SP's effect on those at the most risk for health disparities by looking at the impact of the programme on demand for preventive care services, especially among women, children and the indigenous. Three outcomes important to Mexico's burden of disease are explored: general physical exams, diabetes screening, and cervical cancer screening. Ordinary least square regressions show that the introduction of SP is associated with an increase in demand for all three services, but these results are likely biased due to selection into the programme. I then use the staggered geographic roll out of SP between 2004 and 2007 to identify the causal impact of the programme on demand. I use length of exposure to SP as an instrumental variable to predict SP affiliation in 2009. Two stage least squares estimates of the causal impact of SP on demand for preventive care services finds that SP affiliation increases adult demand for physicals, but does not affect demand for diabetes screening. Additionally, I find that female and child SP affiliates are less likely to demand physicals, while affiliates who identify as indigenous are less likely to demand physicals but more likely to demand cervical cancer screenings.
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Affiliation(s)
- Melissa Knox
- Department of Economics, University of Washington, Box 353330, 305 Savery Hall, Seattle, USA
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25
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Wilson A, Guillaumier A, George J, Denham A, Bonevski B. A systematic narrative review of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups (2010-2017). Expert Rev Respir Med 2017; 11:617-630. [PMID: 28608758 DOI: 10.1080/17476348.2017.1340836] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Tobacco remains the key modifiable risk factor for the development of a number of diseases, including cardiovascular disease, cerebrovascular disease, lower respiratory infections, chronic obstructive pulmonary disease, tuberculosis and cancer. Among priority populations, smoking prevalence remains high, smokers tend to relapse more often and earlier and fewer are able to sustain quit attempts. This systematic review provides an update on the literature. Areas covered: Twenty-four randomized controlled trials published from 2010-2017, in English language, were identified after searching on Medline, Ovid, Embase and PsycINFO databases. Studies reported on the effectiveness of smoking cessation interventions among six disadvantaged groups known to have high smoking rates: (i) homeless, (ii) prisoners, (iii) indigenous populations, (iv) at-risk youth, (v) people with low income, and (vi) those with a mental illness. Narrative review and assessment of methodological quality of included papers was undertaken. Expert commentary: There is a growing evidence base of methodologically robust studies evaluating a variety of behavioural smoking cessation interventions for priority populations. Multi-component interventions and those examining behavioural interventions incorporating mindfulness training, financial incentives, motivational interviewing and extended telephone-delivered counseling may be effective in the short-term, particularly for smokers on low incomes and people with a mental illness.
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Affiliation(s)
- Amanda Wilson
- a School of Nursing and Midwifery, Faculty of Health and Medicine , University of Newcastle , Callaghan , NSW , USA
| | - Ashleigh Guillaumier
- b School of Medicine and Public Health, Faculty of Health and Medicine , University of Newcastle & Hunter Medical Research Institute , Waratah , NSW , USA
| | - Johnson George
- c Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences , Monash University , Parkville , VIC , USA
| | - Alexandra Denham
- d School of Medicine and Public Health, Faculty of Health and Medicine , University of Newcastle & Hunter Medical Research Institute , Waratah , NSW , USA
| | - Billie Bonevski
- e School of Medicine and Public Health, Faculty of Health and Medicine , University of Newcastle & Hunter Medical Research Institute , Waratah , NSW , USA
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Abstract
Following World War II (WWII), there was a new emphasis within genetics on studying the genetic composition of populations. This probably had a dual source in the growing strength of evolutionary biology and the new international interest in understanding the effects of radiation on human populations, following the atomic bombings in Japan. These global concerns were shared by Mexican physicians. Indeed, Mexico was one of the leading centers of this trend in human genetics. Three leading players in this story were Mario Salazar Mallén, Adolfo Karl, and Rubén Lisker. Their trajectories and the international networks in human genetics that were established after WWII, paved the way for the establishment of medical and population genetics in Mexico. Salazar Mallén's studies on the distribution and characterization of ABO blood groups in indigenous populations were the starting point while Karl's studies on the distribution of abnormal hemoglobin in Mexican indigenous populations showed the relationships observed in other laboratories at the time. It was Lisker's studies, however, that were instrumental in the development of population genetics in the context of national public policies for extending health care services to the Mexican population. In particular, he conducted studies on Mexican indigenous groups contributing to the knowledge of the biological diversity of human populations according to international trends that focused on the variability of human populations in terms of genetic frequencies. From the start, however, Lisker was as committed to the reconstruction of shared languages and practices as he was to building networks of collaboration in order to guarantee the necessary groundwork for establishing the study of the genetics of human populations in Mexico. This study also allows us to place Mexican science within a global context in which connected narratives describe the interplay between global trends and national contexts.
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Bennett-Levy J, Singer J, DuBois S, Hyde K. Translating E-Mental Health Into Practice: What Are the Barriers and Enablers to E-Mental Health Implementation by Aboriginal and Torres Strait Islander Health Professionals? J Med Internet Res 2017; 19:e1. [PMID: 28077347 PMCID: PMC5266824 DOI: 10.2196/jmir.6269] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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] [Received: 06/26/2016] [Revised: 12/01/2016] [Accepted: 12/18/2016] [Indexed: 01/10/2023] Open
Abstract
Background With increasing evidence for the effectiveness of e-mental health interventions for enhancing mental health and well-being, a growing challenge is how to translate promising research findings into service delivery contexts. A 2012 e-mental health initiative by the Australian Federal Government (eMHPrac) has sought to address the issue through several strategies, one of which has been to train different health professional workforces in e-mental health (e-MH). Objective The aim of the study was to report on the barriers and enablers of e-MH uptake in a cohort of predominantly Aboriginal and Torres Strait Islander health professionals (21 Indigenous, 5 non-Indigenous) who occupied mainly support or case management roles within their organizations. Methods A 3- or 2-day e-MH training program was followed by up to 5 consultation sessions (mean 2.4 sessions) provided by the 2 trainers. The trainer-consultants provided written reports on each of the 30 consultation sessions for 7 consultation groups. They were also interviewed as part of the study. The written reports and interview data were thematically analyzed by 2 members of the research team. Results Uptake of e-MH among the consultation group was moderate (22%-30% of participants). There were significant organizational barriers to uptake resulting from procedural and administrative problems, demanding workloads, prohibitive policies, and a lack of fit between the organizational culture and the introduction of new technologies. Personal barriers included participant beliefs about the applicability of e-MH to certain populations, and workers’ lack of confidence and skills. However, enthusiastic managers and tech-savvy champions could provide a counter-balance as organizational enablers of e-MH; and the consultation sessions themselves appear to have enhanced skills and confidence, shifted attitudes to new technologies, and seeded a perception that e-MH could be a valuable health education resource. Conclusions A conclusion from the program was that it was important to match e-MH training and resources to work roles. In the latter stages of the consultation sessions, the Aboriginal and Torres Strait Islander health professionals responded very positively to YouTube video clips and apps with a health education dimension. Therapy-oriented apps and programs may fit less well within the scope of practice of some workforces, including this one. We suggest that researchers broaden their focus and definitions of e-MH and give rather more weight to e-MH’s health education possibilities. Developing criteria for evaluating apps and YouTube videos may empower a rather greater section of health workforce to use e-MH with their clients.
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Affiliation(s)
- James Bennett-Levy
- University Centre for Rural Health, University of Sydney, Lismore, Australia
| | - Judy Singer
- University Centre for Rural Health, University of Sydney, Lismore, Australia
| | - Simon DuBois
- University Centre for Rural Health, University of Sydney, Lismore, Australia
| | - Kelly Hyde
- University Centre for Rural Health, University of Sydney, Lismore, Australia
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28
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Riva M, Larsen CVL, Bjerregaard P. Association between individual-level and community-level socio-economic status and blood pressure among Inuit in Greenland. Int J Circumpolar Health 2016; 75:32757. [PMID: 27938632 PMCID: PMC5148804 DOI: 10.3402/ijch.v75.32757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 11/29/2022] Open
Abstract
Background Despite abundant evidence that socio-economic status (SES) is a fundamental determinant of health, there is a dearth of research examining association between SES, measured at the individual and community levels, and cardiovascular risk factors and morbidity among indigenous populations. Objectives To examine the influence of individual-level and community-level SES on systolic and diastolic blood pressure among Greenlandic Inuit. Methods Multilevel analysis of cross-sectional data from the Inuit Health in Transition – Greenland Survey, to which 3,108 Greenlandic Inuit aged 18 years and older participated. Blood pressure is measured using an automatic device, according to standardized protocol. Individual SES is measured by education. Community socio-economic conditions are measured using combined information on average disposable household income and settlement type. Results Education was not significantly associated with blood pressure. There was an inverse U-shape association between community socio-economic conditions and blood pressure with significantly lower SBP and DBP among participants living in remote traditional villages characterized by lower average disposable household income and in affluent more urbanized towns. Sex-stratified analyses demonstrate the salience of community conditions for men. Conclusions The association observed between blood pressure and community-level socio-economic conditions suggests that public health and social policies, programmes and interventions aiming to improve living conditions might improve cardiovascular health in Greenland. Studies are required to further examine social gradients in cardiovascular risk factors and morbidity among indigenous populations using different measures of SES.
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Affiliation(s)
- Mylène Riva
- Institute for Health and Social Policy and Department of Geography, McGill University, Montreal, Canada;
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
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Molina JL, González Alemán G, Florenzano N, Padilla E, Calvó M, Guerrero G, Kamis D, Stratton L, Toranzo J, Molina Rangeon B, Hernández Cuervo H, Bourdieu M, Sedó M, Strejilevich S, Cloninger CR, Escobar JI, de Erausquin GA. Prediction of Neurocognitive Deficits by Parkinsonian Motor Impairment in Schizophrenia: A Study in Neuroleptic-Naïve Subjects, Unaffected First-Degree Relatives and Healthy Controls From an Indigenous Population. Schizophr Bull 2016; 42:1486-1495. [PMID: 26994395 PMCID: PMC5049519 DOI: 10.1093/schbul/sbw023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Neurocognitive deficits are among the most debilitating and pervasive symptoms of schizophrenia, and are present also in unaffected first-degree relatives. Also, multiple reports reveal parkisonian motor deficits in untreated subjects with schizophrenia and in first-degree relatives of affected subjects. Yet, the relation between motor and cognitive impairment and its value as a classifier of endophenotypes has not been studied. AIMS To test the efficacy of midbrain hyperechogenicity (MHE) and parkinsonian motor impairment (PKM) as predictors of neurocognitive impairment in subjects with or at risk for schizophrenia, that could be used to segregate them from first-degree relatives and healthy controls. METHOD Seventy-six subjects with chronic schizophrenia never exposed to antipsychotic medication, 106 unaffected first-degree relatives, and 62 healthy controls were blindly assessed for cognitive and motor function, and transcranial ultrasound. RESULTS Executive function, fluid intelligence, motor planning, and hand coordination showed group differences. PKM and MHE were significantly higher in untreated schizophrenia and unaffected relatives. Unaffected relatives showed milder impairment, but were different from controls. CONCLUSIONS PKM and MHE predict cognitive impairment in neuroleptic-naive patients with schizophrenia and their unaffected first-degree relatives and may be used to segregate them from first-degree relatives and healthy controls.
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Affiliation(s)
- Juan L. Molina
- Roskamp Laboratory of Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL
| | | | - Néstor Florenzano
- Unidad de Neurociencias, Dr. J.J. Naón, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Eduardo Padilla
- Hospital Neuropsiquiátrico Dr. Néstor Sequeiros, San Salvador de Jujuy, Argentina
| | - María Calvó
- Hospital Neuropsiquiátrico Dr. Néstor Sequeiros, San Salvador de Jujuy, Argentina
| | - Gonzalo Guerrero
- Hospital Neuropsiquiátrico Dr. Néstor Sequeiros, San Salvador de Jujuy, Argentina
| | - Danielle Kamis
- Roskamp Laboratory of Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL
| | - Lee Stratton
- Roskamp Laboratory of Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL
| | | | | | - Helena Hernández Cuervo
- Roskamp Laboratory of Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL
| | | | | | | | - Claude Robert Cloninger
- Departments of Psychiatry and Genetics, Washington University School of Medicine, St Louis, MO
| | - Javier I. Escobar
- Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Gabriel A. de Erausquin
- Roskamp Laboratory of Brain Development, Modulation and Repair, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL;,Division of Neurosciences and Department of Psychiatry and Neurology, UTRGV School of Medicine, Harlingen, TX,*To whom correspondence should be addressed; Division of Neurosciences and Department of Psychiatry and Neurology, UTRGV School of Medicine, 2102 Treasure Hills Blvd., Harlingen, TX 78550, US; tel: 956-296-1546, fax: 956-665-2450, e-mail:
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30
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Abstract
Introduction: Incidence rates of invasive Haemophilus influenzae serotype b disease have decreased significantly since the introduction of the Hib vaccine; however, the rates in indigenous populations remain disproportionately high, specifically in the paediatric population. Additionally, with the decline of type b invasive infections, there has been a rebound in the incidence of invasive infections caused by other strains of H. influenzae, particularly serotype a. Case presentation: We present a paediatric case of septic arthritis caused by H. influenzae type a in a toddler that was fully resolved following antibiotic therapy. This report adds to other reports of septic arthritis in indigenous populations as shown through a review of recently documented H. influenzae type a septic arthritis cases. Conclusion: Socio-economic risk factors for invasive H. influenzae type a disease, such as poverty, poor housing conditions, overcrowding, smoking and substance abuse during pregnancy, as well as the need for H. influenzae type a immunization of vulnerable populations, are discussed.
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Affiliation(s)
- Joelle Thorgrimson
- Northern Ontario School of Medicine , 955 Oliver Road, Thunder Bay, ON P7B 5E1 , Canada
| | - Marina Ulanova
- Northern Ontario School of Medicine , 955 Oliver Road, Thunder Bay, ON P7B 5E1 , Canada
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Gessner BD, Wood T, Johnson MA, Richards CS, Koeller DM. Evidence for an association between infant mortality and homozygosity for the arctic variant of carnitine palmitoyltransferase 1A. Genet Med 2016; 18:933-9. [PMID: 26820065 PMCID: PMC4965343 DOI: 10.1038/gim.2015.197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 11/17/2015] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Infant mortality in Alaska is highest among Alaska Native people from western/northern Alaska, a population with a high prevalence of a genetic variant (c.1436C>T; the arctic variant) of carnitine palmitoyltransferase 1A (CPT1A). METHODS We performed an unmatched case-control study to determine the relationship between the arctic variant and infant mortality. The cases were 110 Alaska Native infant deaths from 2006 to 2010 and the controls were 395 Alaska Native births from the same time period. In addition to the overall analysis, we conducted two subanalyses, one limited to subjects from western/northern Alaska and one limited to infants heterozygous or homozygous for the arctic variant. RESULTS Among western/northern Alaska residents, 66% of cases and 61% of controls were homozygous (adjusted odds ratio (aOR): 2.5; 95% confidence interval (CI): 1.3, 5.0). Among homozygous or heterozygous infants, 58% of cases and 44% of controls were homozygous (aOR: 2.3; 95% CI: 1.3, 4.0). Deaths associated with infection were more likely to be homozygous (OR: 2.9; 95% CI: 1.0-8.0). Homozygosity was strongly associated with a premorbid history of pneumonia, sepsis, or meningitis. CONCLUSION Homozygosity for the arctic variant is associated with increased risk of infant mortality, which may be mediated in part by an increase in infectious disease risk. Further studies are needed to determine whether the association we report represents a causal association between the CPT1A arctic variant and infectious disease-specific mortality.Genet Med 18 9, 933-939.
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Affiliation(s)
- Bradford D Gessner
- Alaska Division of Public Health, Anchorage, Alaska, USA
- Present address: EpiVac Consulting, Anchorage, Alaska, USA
| | - Thalia Wood
- Alaska Division of Public Health, Anchorage, Alaska, USA
- Present address: EpiVac Consulting, Anchorage, Alaska, USA
| | - Monique A Johnson
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon, USA
| | - Carolyn Sue Richards
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon, USA
| | - David M Koeller
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon, USA
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
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Povey J, Mills PPJR, Dingwall KM, Lowell A, Singer J, Rotumah D, Bennett-Levy J, Nagel T. Acceptability of Mental Health Apps for Aboriginal and Torres Strait Islander Australians: A Qualitative Study. J Med Internet Res 2016; 18:e65. [PMID: 26969043 PMCID: PMC4825593 DOI: 10.2196/jmir.5314] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [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] [Received: 11/15/2015] [Accepted: 01/04/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. OBJECTIVE This study aimed to explore Aboriginal and Torres Strait Islander community members' experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. METHODS Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. RESULTS Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. CONCLUSIONS When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health tools add an important element to public health approaches for improving the well-being of Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Josie Povey
- Darwin Remote Mental Health Service, Top End Mental Health Service, Northern Territory Department of Health, Darwin, Australia.
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Ferreira MU, Castro MC. No longer a deadly encounter? Pathog Glob Health 2016; 109:307-8. [PMID: 26750992 DOI: 10.1080/20477724.2015.1122916] [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: 10/22/2022] Open
Abstract
A careful analysis shows that the mortality rates associated with epidemics following the contact between Amazonian indigenous communities and the external word have decreased in recent years. However, whether isolated indigenous populations can be contacted safely is still open to debate; many will argue that these populations should remain uncontacted in order to survive.
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Affiliation(s)
- Marcelo U Ferreira
- 1 Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo , São Paulo, Brazil
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Pinedo M, Sim DEK, Giacinto RE, Zúñiga ML. An Exploratory Study of Internal Migration and Substance Use Among an Indigenous Community in Southern Mexico. Fam Community Health 2016; 39:24-30. [PMID: 26605952 PMCID: PMC4661784 DOI: 10.1097/fch.0000000000000085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 06/05/2023]
Abstract
The primary aim of this study was to explore the association between internal migration experience within Mexico and lifetime substance use among a sample of 442 indigenous persons from Yucatan, Mexico. Adjusting for potential confounding, correlates of lifetime substance use were assessed among participants with and without internal migration experience. Internal migration to a tourist destination was independently associated with higher odds (adjusted odds ratio: 2.1; 95% confidence interval: 1.3-3.4) of reporting lifetime substance use. Findings suggest that environmental contexts of internal migration may be of importance in shaping vulnerability to substance use.
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Affiliation(s)
- Miguel Pinedo
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- Alcohol Research Group, Emeryville, CA
| | - D. Eastern Kang Sim
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Rebeca Espinoza Giacinto
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - María Luisa Zúñiga
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
- School of Social Work, San Diego State University, San Diego, CA
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Dorfman EH, Brown Trinidad S, Morales CT, Howlett K, Burke W, Woodahl EL. Pharmacogenomics in diverse practice settings: implementation beyond major metropolitan areas. Pharmacogenomics 2015; 16:227-37. [PMID: 25712186 DOI: 10.2217/pgs.14.174] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 12/25/2022] Open
Abstract
AIM The limited formal study of the clinical feasibility of implementing pharmacogenomic tests has thus far focused on providers at large medical centers in urban areas. Our research focuses on small metropolitan, rural and tribal practice settings. MATERIALS & METHODS We interviewed 17 healthcare providers in western Montana regarding pharmacogenomic testing. RESULTS Participants were optimistic about the potential of pharmacogenomic tests, but noted unique barriers in small and rural settings including cost, adherence, patient acceptability and testing timeframe. Participants in tribal settings identified heightened sensitivity to genetics and need for community leadership approval as additional considerations. CONCLUSION Implementation differences in small metropolitan, rural and tribal communities may affect pharmacogenomic test adoption and utilization, potentially impacting many patients. Original submitted 3 September 2014; Revision submitted 3 December 2014.
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Affiliation(s)
- Elizabeth H Dorfman
- Institute for Public Health Genetics, University of Washington, Seattle, WA, USA
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Leandro-Reguillo P, Thomson-Luque R, Monteiro WM, de Lacerda MVG. Urban and architectural risk factors for malaria in indigenous Amazonian settlements in Brazil: a typological analysis. Malar J 2015; 14:284. [PMID: 26194898 PMCID: PMC4509690 DOI: 10.1186/s12936-015-0806-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/10/2015] [Indexed: 11/10/2022] Open
Abstract
In the Amazon, m alaria is highly endemic in indigenous populations, which are often considered one of the last barriers to malaria elimination due to geographic isolation. Although the improvement of housing conditions is a good strategy towards the control and prevention of vector-borne diseases, such as malaria, this preventive practice has been barely undertaken in Latin America. An analysis of the architectural and urban features of indigenous Amazonian populations is essential to define and adapt these vector control measures. A total of 32 villages of 29 different ethnicities were studied and mapped by reviewing literature and visual information, and using a geographic information system. The most important architectural and urban characteristics influencing malaria were analysed according to the following categories: number of households and dimensions, supporting area, openings, materials, lifespan and location. Housing typologies found were classified within each of these variables. The results of this typological analysis included an easy-to-handle working template and revealing of features that benefit or hamper the presence of malaria vectors in Amerindians communities. Among risk factors, presence of open eaves, permeable walls, open-side constructions, large number of sleepers indoors, temporary-ephemeral houses, linear villages along stream banks, houseboats villages, poor urban drainage and villages surrounded by anthropogenic environments were highlighted. Indigenous settlements very permissive for anophelines were identified in ethnic groups, such as the Yanomami, Palikur, Paumari, Waimiri-Atroari and Wajãpi. Positive features were also recognized, including opaque and closed houses, large radial villages on bare soil, highly elevated stilted houses and the fire indoors, found among the Yawalapiti, Ashaninka, and Gavião-Parkatejê tribes. However, as Amazonian indigenous settlement typologies vary greatly even among villages of the same ethnic group, it is imperative to undertake an individual study for each community. Using the working template in Amazonian settlements it is possible to obtain data that will help researchers not only understand how architectural and urban features affect transmission, but also define vector control measures easily applicable by health authorities and acceptable by these communities.
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Affiliation(s)
| | - Richard Thomson-Luque
- Department of Global Health and Infectious Diseases, College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Wuelton M Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.
| | - Marcus V G de Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.
- Universidade do Estado do Amazonas, Av. Pedro Teixeira, 25, Dom Pedro, Manaus, AM, 69040-000, Brazil.
- Instituto de Pesquisas Leônidas and Maria Deane, Fundação Oswaldo Cruz, Rua Terezina, 476, Adrianópolis, Manaus, AM, 69057-070, Brazil.
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Fohner AE, Robinson R, Yracheta J, Dillard DA, Schilling B, Khan B, Hopkins S, Boyer B, Black J, Wiener H, Tiwari HK, Gordon A, Nickerson D, Tsai JM, Farin FM, Thornton TA, Rettie AE, Thummel KE. Variation in genes controlling warfarin disposition and response in American Indian and Alaska Native people: CYP2C9, VKORC1, CYP4F2, CYP4F11, GGCX. Pharmacogenet Genomics 2015; 25:343-353. [PMID: 25946405 PMCID: PMC4461509 DOI: 10.1097/fpc.0000000000000143] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 11/25/2022]
Abstract
OBJECTIVES Pharmacogenetic testing is projected to improve health outcomes and reduce the cost of care by increasing therapeutic efficacy and minimizing drug toxicity. American Indian and Alaska Native (AI/AN) people historically have been excluded from pharmacogenetic research and its potential benefits, a deficiency we sought to address. The vitamin K antagonist warfarin is prescribed for prevention of thromboembolic events, although its narrow therapeutic index and wide interindividual variability necessitate close monitoring of drug response. Therefore, we were interested in variation in CYP2C9, VKORC1, CYP4F2, CYP4F11, and GGCX, which encode enzymes important for the activity of warfarin and synthesis of vitamin K-dependent blood clotting factors. METHODS We resequenced these genes in 188 AI/AN people in partnership with Southcentral Foundation in Anchorage, Alaska and 94 Yup'ik people living in the Yukon-Kuskokwim Delta of southwest Alaska to identify known or novel function-disrupting variation. We conducted genotyping for specific single nucleotide polymorphisms in larger cohorts of each study population (380 and 350, respectively). RESULTS We identified high frequencies of the lower-warfarin dose VKORC1 haplotype (-1639G>A and 1173C>T) and the higher-warfarin dose CYP4F2*3 variant. We also identified two relatively common, novel, and potentially function-disrupting variants in CYP2C9 (M1L and N218I), which, along with CYP2C9*3, CYP2C9*2, and CYP2C9*29, predict that a significant proportion of AI/AN people will have decreased CYP2C9 activity. CONCLUSION Overall, we predict a lower average warfarin dose requirement in AI/AN populations in Alaska than that seen in non-AI/AN populations of the USA, a finding consistent with clinical experience in Alaska.
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Affiliation(s)
- Alison E Fohner
- Department of Pharmaceutics, University of Washington, Seattle, WA
| | | | - Joseph Yracheta
- Department of Pharmaceutics, University of Washington, Seattle, WA
| | | | | | | | - Scarlett Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK
| | - Bert Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK
| | - Jynene Black
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK
| | - Howard Wiener
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Hemant K Tiwari
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Adam Gordon
- Department of Genome Sciences, University of Washington, Seattle WA
| | | | - Jesse M Tsai
- Department of Environmental and Occupational Health Sciences, University of Washington
| | - Federico M Farin
- Department of Environmental and Occupational Health Sciences, University of Washington
| | | | - Allan E Rettie
- Department of Medicinal Chemistry, University of Washington
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Woodahl EL, Lesko LJ, Hopkins S, Robinson RF, Thummel KE, Burke W. Pharmacogenetic research in partnership with American Indian and Alaska Native communities. Pharmacogenomics 2015; 15:1235-41. [PMID: 25141898 DOI: 10.2217/pgs.14.91] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Pharmacogenetics is a subset of personalized medicine that applies knowledge about genetic variation in gene-drug pairs to help guide optimal dosing. There is a lack of data, however, about pharmacogenetic variation in underserved populations. One strategy for increasing participation of underserved populations in pharmacogenetic research is to include communities in the research process. We have established academic-community partnerships with American Indian and Alaska Native people living in Alaska and Montana to study pharmacogenetics. Key features of the partnership include community oversight of the project, research objectives that address community health priorities, and bidirectional learning that builds capacity in both the community and the research team. Engaging the community as coresearchers can help build trust to advance pharmacogenetic research objectives.
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Affiliation(s)
- Erica L Woodahl
- Department of Biomedical & Pharmaceutical Sciences, University of Montana, 32 Campus Drive, Missoula, MT 59812, USA
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Benjelloun B, Alberto FJ, Streeter I, Boyer F, Coissac E, Stucki S, BenBati M, Ibnelbachyr M, Chentouf M, Bechchari A, Leempoel K, Alberti A, Engelen S, Chikhi A, Clarke L, Flicek P, Joost S, Taberlet P, Pompanon F. Characterizing neutral genomic diversity and selection signatures in indigenous populations of Moroccan goats (Capra hircus) using WGS data. Front Genet 2015; 6:107. [PMID: 25904931 PMCID: PMC4387958 DOI: 10.3389/fgene.2015.00107] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [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: 12/17/2014] [Accepted: 03/02/2015] [Indexed: 12/15/2022] Open
Abstract
Since the time of their domestication, goats (Capra hircus) have evolved in a large variety of locally adapted populations in response to different human and environmental pressures. In the present era, many indigenous populations are threatened with extinction due to their substitution by cosmopolitan breeds, while they might represent highly valuable genomic resources. It is thus crucial to characterize the neutral and adaptive genetic diversity of indigenous populations. A fine characterization of whole genome variation in farm animals is now possible by using new sequencing technologies. We sequenced the complete genome at 12× coverage of 44 goats geographically representative of the three phenotypically distinct indigenous populations in Morocco. The study of mitochondrial genomes showed a high diversity exclusively restricted to the haplogroup A. The 44 nuclear genomes showed a very high diversity (24 million variants) associated with low linkage disequilibrium. The overall genetic diversity was weakly structured according to geography and phenotypes. When looking for signals of positive selection in each population we identified many candidate genes, several of which gave insights into the metabolic pathways or biological processes involved in the adaptation to local conditions (e.g., panting in warm/desert conditions). This study highlights the interest of WGS data to characterize livestock genomic diversity. It illustrates the valuable genetic richness present in indigenous populations that have to be sustainably managed and may represent valuable genetic resources for the long-term preservation of the species.
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Affiliation(s)
- Badr Benjelloun
- Laboratoire d'Ecologie Alpine, Université Grenoble-Alpes Grenoble, France ; Laboratoire d'Ecologie Alpine, Centre National de la Recherche Scientifique Grenoble, France ; National Institute of Agronomic Research (INRA Maroc), Regional Centre of Agronomic Research Beni-Mellal, Morocco
| | - Florian J Alberto
- Laboratoire d'Ecologie Alpine, Université Grenoble-Alpes Grenoble, France ; Laboratoire d'Ecologie Alpine, Centre National de la Recherche Scientifique Grenoble, France
| | - Ian Streeter
- European Molecular Biology Laboratory, European Bioinformatics Institute Hinxton, UK
| | - Frédéric Boyer
- Laboratoire d'Ecologie Alpine, Université Grenoble-Alpes Grenoble, France ; Laboratoire d'Ecologie Alpine, Centre National de la Recherche Scientifique Grenoble, France
| | - Eric Coissac
- Laboratoire d'Ecologie Alpine, Université Grenoble-Alpes Grenoble, France ; Laboratoire d'Ecologie Alpine, Centre National de la Recherche Scientifique Grenoble, France
| | - Sylvie Stucki
- Laboratory of Geographic Information Systems (LASIG), School of Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Mohammed BenBati
- National Institute of Agronomic Research (INRA Maroc), Regional Centre of Agronomic Research Beni-Mellal, Morocco
| | - Mustapha Ibnelbachyr
- Regional Centre of Agronomic Research Errachidia, National Institute of Agronomic Research (INRA Maroc) Errachidia, Morocco
| | - Mouad Chentouf
- Regional Centre of Agronomic Research Tangier, National Institute of Agronomic Research (INRA Maroc) Tangier, Morocco
| | - Abdelmajid Bechchari
- Regional Centre of Agronomic Research Oujda, National Institute of Agronomic Research (INRA Maroc) Oujda, Morocco
| | - Kevin Leempoel
- Laboratory of Geographic Information Systems (LASIG), School of Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Adriana Alberti
- Centre National de Séquençage, CEA-Institut de Génomique Genoscope, Évry, France
| | - Stefan Engelen
- Centre National de Séquençage, CEA-Institut de Génomique Genoscope, Évry, France
| | - Abdelkader Chikhi
- Regional Centre of Agronomic Research Errachidia, National Institute of Agronomic Research (INRA Maroc) Errachidia, Morocco
| | - Laura Clarke
- European Molecular Biology Laboratory, European Bioinformatics Institute Hinxton, UK
| | - Paul Flicek
- European Molecular Biology Laboratory, European Bioinformatics Institute Hinxton, UK
| | - Stéphane Joost
- Laboratory of Geographic Information Systems (LASIG), School of Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Pierre Taberlet
- Laboratoire d'Ecologie Alpine, Université Grenoble-Alpes Grenoble, France ; Laboratoire d'Ecologie Alpine, Centre National de la Recherche Scientifique Grenoble, France
| | - François Pompanon
- Laboratoire d'Ecologie Alpine, Université Grenoble-Alpes Grenoble, France ; Laboratoire d'Ecologie Alpine, Centre National de la Recherche Scientifique Grenoble, France
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Shepherd M, Fleming T, Lucassen M, Stasiak K, Lambie I, Merry SN. The design and relevance of a computerized gamified depression therapy program for indigenous māori adolescents. JMIR Serious Games 2015; 3:e1. [PMID: 25736225 PMCID: PMC4392467 DOI: 10.2196/games.3804] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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] [Received: 08/24/2014] [Revised: 11/10/2014] [Accepted: 11/25/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression is a major health issue among Māori indigenous adolescents, yet there has been little investigation into the relevance or effectiveness of psychological treatments for them. Further, consumer views are critical for engagement and adherence to therapy. However, there is little research regarding indigenous communities' opinions about psychological interventions for depression. OBJECTIVE The objective of this study was to conduct semistructured interviews with Māori (indigenous New Zealand) young people (taitamariki) and their families to find out their opinions of a prototype computerized cognitive behavioral therapy (cCBT) program called Smart, Positive, Active, Realistic, X-factor thoughts (SPARX), a free online computer game intended to help young persons with mild to moderate depression, feeling down, stress or anxiety. The program will teach them how to resolve their issues on their own using Cognitive Behavioural Therapy as psychotherapeutic approach. METHODS There were seven focus groups on the subject of the design and cultural relevance of SPARX that were held, with a total of 26 participants (19 taitamarki, 7 parents/caregivers, all Māori). There were five of the groups that were with whānau (family groups) (n=14), one group was with Māori teenage mothers (n=4), and one group was with taitamariki (n=8). The general inductive approach was used to analyze focus group data. RESULTS SPARX computerized therapy has good face validity and is seen as potentially effective and appealing for Māori people. Cultural relevance was viewed as being important for the engagement of Māori young people with SPARX. Whānau are important for young peoples' well-being. Participants generated ideas for improving SPARX for Māori and for the inclusion of whānau in its delivery. CONCLUSIONS SPARX computerized therapy had good face validity for indigenous young people and families. In general, Māori participants were positive about the SPARX prototype and considered it both appealing and applicable to them. The results of this study were used to refine SPARX prior to it being delivered to taitamariki and non-Māori young people. TRIAL REGISTRATION The New Zealand Northern Y Regional Ethics Committee; http://ethics.health.govt.nz/home; NTY/09/003; (Archived by WebCite at http://www.webcitation/6VYgHXKaR).
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Affiliation(s)
- Matthew Shepherd
- School of Counselling, Human Services and Social Work, Department of Education, University of Auckland, Auckland, New Zealand.
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Pike I, McDonald RJ, Piedt S, Macpherson AK. Developing injury indicators for First Nations and Inuit children and youth in Canada: a modified Delphi approach. Chronic Dis Inj Can 2014; 34:203-209. [PMID: 25408179] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The purpose of this research was to take the initial step in developing valid indicators that reflect the injury issues facing First Nations and Inuit children and youth in Canada. METHODS Using a modified-Delphi process, relevant expert and community stakeholders rated each indicator on its perceived usefulness and ability to prompt action to reduce injury among children and youth in indigenous communities. The Delphi process included 5 phases and resulted in a refined set of 27 indicators. RESULTS Indicators related to motorized vehicle collisions, mortality and hospitalization rates were rated the most useful and most likely to prompt action. These were followed by indicators for community injury prevention training and response systems, violent and inflicted injury, burns and falls, and suicide. CONCLUSION The results suggest that a broad-based modified-Delphi process is a practical and appropriate method, within the OCAP™ (Ownership, Control, Access and Possession) principles, for developing a proposed set of indicators for injury prevention activity focused on First Nations and Inuit children and youth. Following additional work to validate and populate the indicators, it is anticipated that communities will utilize them to monitor injury and prompt decisions and action to reduce injuries among children and youth.
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Affiliation(s)
- I Pike
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; B.C. Injury Research and Prevention Unit, Child and Family Research Institute, B.C. Children's Hospital, Vancouver, British Columbia, Canada; First Nations and Inuit Children and Youth Injury Indicators Working Group
| | - R J McDonald
- First Nations and Inuit Children and Youth Injury Indicators Working Group; Katenies Research and Management Services, Akwesasne Mohawk Territory, Cornwall, Ontario, Canada
| | - S Piedt
- B.C. Injury Research and Prevention Unit, Child and Family Research Institute, B.C. Children's Hospital, Vancouver, British Columbia, Canada; First Nations and Inuit Children and Youth Injury Indicators Working Group
| | - A K Macpherson
- First Nations and Inuit Children and Youth Injury Indicators Working Group; School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
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TSANG RSW, BRUCE MG, LEM M, BARRETO L, ULANOVA M. A review of invasive Haemophilus influenzae disease in the Indigenous populations of North America. Epidemiol Infect 2014; 142:1344-54. [PMID: 24598220 PMCID: PMC9151223 DOI: 10.1017/s0950268814000405] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [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: 11/12/2013] [Revised: 01/30/2014] [Accepted: 02/04/2014] [Indexed: 11/06/2022] Open
Abstract
Historically, the highest incidence rates of invasive Haemophilus influenzae disease in the world were found in North American and Australian Indigenous children. Although immunization against H. influenzae type b (Hib) led to a marked decrease in invasive Hib disease in countries where it was implemented, this disease has not been eliminated and its rates in Indigenous communities remain higher than in the general North American population. In this literature review, we examined the epidemiology of invasive H. influenzae disease in the pre-Hib vaccine era, effect of carriage on disease epidemiology, immune response to H. influenzae infection and Hib vaccination in Indigenous and Caucasian children, and the changing epidemiology after Hib conjugate vaccine has been in use for more than two decades in North America. We also explored reasons behind the continued high rates of invasive H. influenzae disease in Indigenous populations in North America. H. influenzae type a (Hia) has emerged as a significant cause of severe disease in North American Indigenous communities. More research is needed to define the genotypic diversity of Hia and the disease burden that it causes in order to determine if a Hia vaccine is required to protect the vulnerable populations.
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Affiliation(s)
- R. S. W. TSANG
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - M. G. BRUCE
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, U.S. Centers for Disease Prevention and Control (CDC), Anchorage, AK, USA
| | - M. LEM
- Fraser Health Authority, Abbotsford, BC, Canada
| | - L. BARRETO
- Human Health Therapeutics Portfolio, National Research Council of Canada, Ottawa, ON, Canada
| | - M. ULANOVA
- Medical Sciences Division, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
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Lavoie JG. Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy. Int J Circumpolar Health 2013; 72:22690. [PMID: 24380077 PMCID: PMC3875351 DOI: 10.3402/ijch.v72i0.22690] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/25/2013] [Accepted: 11/03/2013] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? METHODS The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. RESULTS The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. CONCLUSION Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.
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Affiliation(s)
- Josée G Lavoie
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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Rohde K, Boles M, Bushore CJ, Pizacani BA, Maher JE, Peterson E. Smoking-related knowledge, attitudes, and behaviors among Alaska Native people: a population-based study. Int J Circumpolar Health 2013; 72:21141. [PMID: 23984275 PMCID: PMC3753121 DOI: 10.3402/ijch.v72i0.21141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Several studies have shown that Alaska Native people have higher smoking prevalence than non-Natives. However, no population-based studies have explored whether smoking-related knowledge, attitudes, and behaviors also differ among Alaska Native people and non-Natives. Objective We compared current smoking prevalence and smoking-related knowledge, attitudes, and behavior of Alaska Native adults living in the state of Alaska with non-Natives. Methods We used Alaska Behavioral Risk Factor Surveillance System data for 1996 to 2010 to compare smoking prevalence, consumption, and cessation- and second-hand smoke-related knowledge, attitudes, and behaviors among self-identified Alaska Native people and non-Natives. Results Current smoking prevalence was 41% (95% CI: 37.9%–44.4%) among Alaska Native people compared with 17.1% (95% CI: 15.9%–18.4%) among non-Natives. Among current every day smokers, Alaska Natives were much more likely to smoke less than 10 cigarettes per day (OR=5.0, 95% CI: 2.6–9.6) than non-Natives. Compared with non-Native smokers, Alaska Native smokers were as likely to have made a past year quit attempt (OR=1.4, 95% CI: 0.9–2.1), but the attempt was less likely to be successful (OR=0.5, 95% CI: 0.2–0.9). Among current smokers, Alaska Natives were more likely to believe second-hand smoke (SHS) was very harmful (OR=4.5, 95% CI: 2.8–7.2), to believe that smoking should not be allowed in indoor work areas (OR=1.9, 95% CI: 1.1–3.1) or in restaurants (OR=4.2, 95% CI: 2.5–6.9), to have a home smoking ban (OR=2.5, 95% CI: 1.6–3.9), and to have no home exposure to SHS in the past 30 days (OR=2.3, 95% CI: 1.5–3.6) than non-Natives. Conclusion Although a disparity in current smoking exists, Alaska Native people have smoking-related knowledge, attitudes, and behaviors that are encouraging for reducing the burden of smoking in this population. Programs should support efforts to promote cessation, prevent relapse, and establish smoke-free environments.
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Affiliation(s)
- Kristen Rohde
- Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland, OR, USA.
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Gould GS, McEwen A, Watters T, Clough AR, van der Zwan R. Should anti-tobacco media messages be culturally targeted for Indigenous populations? A systematic review and narrative synthesis. Tob Control 2013; 22:e7. [PMID: 22918939 DOI: 10.1136/tobaccocontrol-2012-050436] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [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: 11/04/2022]
Abstract
OBJECTIVE To summarise published empirical research on culturally targeted anti-tobacco media messages for Indigenous or First Nations people and examine the evidence for the effectiveness of targeted and non-targeted campaigns. METHODS Studies were sought describing mass media and new media interventions for tobacco control or smoking cessation in Indigenous or First Nations populations. Studies of any design were included reporting outcomes of media-based interventions including: cognitions, awareness, recall, intention to quit and quit rates. Then, 2 reviewers independently applied inclusion criteria, which were met by 21 (5.8%) of the studies found. One author extracted data with crosschecking by a second. Both independently assessed papers using Scottish Intercollegiate Guidelines Network (SIGN; quantitative studies) and Daly et al (qualitative studies). RESULTS A total of 21 studies were found (4 level 1 randomised controlled trials (RCTs), 11 level 2 studies and 6 qualitative studies) and combined with narrative synthesis. Eight evaluated anti-tobacco TV or radio campaigns; two assessed US websites; three New Zealand studies examined mobile phone interventions; five evaluated print media; three evaluated a CD-ROM, a video and an edutainment intervention. CONCLUSIONS Although Indigenous people had good recall of generic anti-tobacco messages, culturally targeted messages were preferred. New Zealand Maori may be less responsive to holistic targeted campaigns, despite their additional benefits, compared to generic fear campaigns. Culturally targeted internet or mobile phone messages appear to be as effective in American Indians and Maori as generic messages in the general population. There is little research comparing the effect of culturally targeted versus generic messages with similar message content in Indigenous people.
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Affiliation(s)
- Gillian Sandra Gould
- School of Public Health,Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville,Queensland, Australia.
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Jamieson LM, Divaris K, Parker EJ, Lee JY. Oral health literacy comparisons between Indigenous Australians and American Indians. Community Dent Health 2013; 30:52-57. [PMID: 23550508 PMCID: PMC3709981] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To compare oral health literacy (OHL) levels between two profoundly disadvantaged groups, Indigenous Australians and American Indians, and to explore differences in socio-demographic, dental service utilisation, self-reported oral health indicators, and oral health-related quality of life (OHRQoL) correlates of OHL among the above. METHODS OHL was measured using REALD-30 among convenience samples of 468 Indigenous Australians (aged 17-72 years, 63% female) and 254 female American Indians (aged 18-57 years). Covariates included socio-demography, dental utilisation, self-reported oral health status (OHS), perceived treatment needs and OHRQoL (prevalence, severity and extent of OHIP-14 'impacts'). Descriptive and bivariate methods were used for data presentation and analysis, and between-sample comparisons relied upon empirical contrasts of sample-specific estimates and correlation coefficients. RESULTS OHL scores were: Indigenous Australians - 15.0 (95% CL=14.2, 15.8) and American Indians--13.7 (95% CL=13.1, 14.4). In both populations, OHL strongly correlated with educational attainment, and was lower among participants with infrequent dental attendance and perceived restorative treatment needs. A significant inverse association between OHL and prevalence of OHRQoL impacts was found among American Indians (rho=-0.23; 95% CL = -0.34, -0.12) but not among Indigenous Australians. CONCLUSIONS Our findings indicate that OHL levels were comparable between the two groups and lower compared to previously reported estimates among diverse populations. Although the patterns of association of OHL with most examined domains of correlates were similar between the two groups, this study found evidence of heterogeneity in the domains of self-reported OHS and OHRQoL.
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Affiliation(s)
- L M Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, South Australia, Australia.
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Braun KL, Kagawa-Singer M, Holden AEC, Burhansstipanov L, Tran JH, Seals BF, Corbie-Smith G, Tsark JU, Harjo L, Foo MA, Ramirez AG. Cancer patient navigator tasks across the cancer care continuum. J Health Care Poor Underserved 2012; 23:398-413. [PMID: 22423178 DOI: 10.1353/hpu.2012.0029] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services.
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Affiliation(s)
- Kathryn L Braun
- Public Health, University of Hawai‘i, Honolulu, HI 96813, USA.
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