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Objective: To review available literature addressing the issue of whether smoking status of Indigenous Health Workers (IHWs) impedes provision of health information about smoking tobacco to their communities.
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Indigenous people around the world experience shorter life expectancy, poorer health outcomes, and on average have less social capital, than non-Indigenous people in their respective countries. While national goals are to lower mo...
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Indigenous people around the world experience shorter life expectancy, poorer health outcomes, and on average have less social capital, than non-Indigenous people in their respective countries. While national goals are to lower mortality and morbidity rates of Indigenous people, much evidence exists that indicates there is almost no Indigenous involvement in data collection, policy development, program implementation and development and measurement of services. A more holistic and culturally relevant framework is presented to improve services and outcomes for Indigenous populations.
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Abstract Objectives Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitat...
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Abstract Objectives Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitative systematic review aimed to build an understanding of IHW insights on oral health. Methods Two independent reviewers searched PubMed, EMBASE, Web of Science and Scopus using a pre‐established search strategy. Qualitative studies that included IHW illustrations about oral health were considered. The search was not limited by geographic setting. Included articles were critically appraised with the Joanna Briggs Institute appraisal tool for qualitative studies. Results The search identified 1856 articles eligible for inclusion; a total of 10 articles were included. Four synthesized findings were identified during the meta‐aggregation: oral health challenges in community, systemic barriers limiting IHW ability to support oral health, benefits of IHW involvement in oral health and avenues to increase IHW involvement in oral health. Conclusion The prioritization of Indigenous leadership in oral health has the potential to address many of the current challenges Indigenous communities face. Future works need to determine the capacity of IHW to provide oral health care and explore opportunities to create specific oral health roles for IHW.
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Purpose. To understand the health care practices related to children from birth to five years old in an Indigenous population of the state of Sao Paulo, Brazil. Design. The theoretical and ethnographic methodological framework and...
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Purpose. To understand the health care practices related to children from birth to five years old in an Indigenous population of the state of Sao Paulo, Brazil. Design. The theoretical and ethnographic methodological framework and the Observation-Participation Reflection model (OPR) were used for data collection. In total, 20 families with 24 children were observed. Results. The belief in the healing power of teas generally overlapped the use of drugs. Herbs in the form of extracts or oils were used in the umbilical stump dressing and baths. The Indigenous people were assisted by professionals in their own communities and nearby urban areas. Conclusion. The care in daily life of Indigenous families was still informal and provided by women, with beliefs and customs that should be considered by health care professionals in transcultural care.
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Objective: To compare rates and trends of HIV diagnoses among Indigenous peoples in Canada (First Nations, Metis, Inuit, and other non-specified), Australia (Aboriginal and Torres Strait Islanders), the USA (American Indian, Alask...
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Objective: To compare rates and trends of HIV diagnoses among Indigenous peoples in Canada (First Nations, Metis, Inuit, and other non-specified), Australia (Aboriginal and Torres Strait Islanders), the USA (American Indian, Alaska Native, Native Hawaiian, and Other Pacific Islanders), and New Zealand (Maori). Design: We employed publicly available surveillance data from 2009 to 2017 to estimate the rate per 100 000 of HIV diagnoses. Estimated annual percentage change (EAPC) in diagnosis rates was calculated using Poisson regression. Setting: The four countries have passive population-based HIV surveillance programs. Participants: Population estimates from respective census programs were used as rate denominators. Main outcome measures: Estimated annual HIV diagnosis rate per 100 000 and EAPC were calculated for total Indigenous peoples, women, and men. Results: As of 2017, rates of HIV were highest in Canada (16.22, 95% confidence interval (CI): 14.30--18.33) and lowest in New Zealand (1.36, 95% CI: 0.65--2.50). Australia had a rate of 3.81 (95% CI: 2.59--5.40) and the USA 3.22 (95% CI: 2.85--3.63). HIV diagnosis rates among the total Indigenous population decreased in Canada (-7.92 EAPC, 95% CI: -9.34 to -6.49) and in the USA (-4.25 EAPC, 95% CI: -5.75 to -2.73) but increased in Australia (5.10 EAPC, 95% CI: 0.39--10.08). No significant trends over time were observed in New Zealand (2.23 EAPC, 95% CI: -4.48 to 9.47). Conclusion: Despite limitations to conducting cross-national comparisons, there are substantial differences in HIV diagnosis rates in these four countries that may be reflective of divergent national policies and systems that affect the health status of Indigenous peoples.
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Health disparities between Indigenous and non-Indigenous populations exist in many countries, including those with well-developed statistical systems. The need to improve the measurement and understanding of Indigenous health disp...
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Health disparities between Indigenous and non-Indigenous populations exist in many countries, including those with well-developed statistical systems. The need to improve the measurement and understanding of Indigenous health disparities led to the formation of the International Group for Indigenous Health Measurement (IGIHM), composed of Indigenous and non-Indigenous, government and non-government, statisticians, researchers and health professionals. Since its founding in 2005, the IGIHM has pursued activities to improve health measurement, which in turn have been used for improving the health of Indigenous populations and enhancing Indigenous health knowledge and data.
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Aboriginal and Torres Strait Islander peoples are disproportionately affected by hepatitis C, an infection that is curable with direct acting antivirals (DAAs). The Australian Government funded access to DAAs from March 2016 for a...
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Aboriginal and Torres Strait Islander peoples are disproportionately affected by hepatitis C, an infection that is curable with direct acting antivirals (DAAs). The Australian Government funded access to DAAs from March 2016 for all people with hepatitis C, with primary care physicians, along with clinical specialists, permitted to prescribe these treatments. The Victorian Aboriginal Health Service, in recognising the effect of liver disease from viral hepatitis within their community, and of the increased availability to DAAs, established a Liver Clinic to facilitate access to treatment for people attending the service. This study conducted semi-structured interviews to document the health service provider perspectives on the barriers and enablers to treatment; explored patients' experiences of hepatitis C treatment and cure; and sought to identify possible health system-level changes to facilitate increased access and uptake of treatment by Aboriginal people. The study found the success of the clinic was supported by the multidisciplinary and accessible nature of the health service, and the relationships built over time between clinic staff and people with, or at risk of, hepatitis C. For those treated, the individual effect of the cure not only eliminated the hepatitis C virus, but reduced shame and increased broader social participation.
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Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent am...
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Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent among Aboriginal and Torres Strait Islander children. Primary health care is at the frontline of appropriate prevention and treatment. Continuous quality improvement in the prevention and management of important causes of morbidity in client populations is accepted best practice in primary health care and now a requirement of Australian Government funding to services providing care for Aboriginal and Torres Strait Islander children. To date, there have been no indicators for continuous quality improvement in the prevention and management of otitis media and its sequelae in primary health care. Through an expert group consensus process, seven evidence-based indicators, potentially extractable from electronic health records, have been developed. The development process and indicators are described.
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Over the last decade, there has been no discernible reduction in Invasive Pneumococcal Disease (IPD) amongst Indigenous adults in the Northern Territory (NT) of Australia, despite increasing vaccination coverage. We examined the u...
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Over the last decade, there has been no discernible reduction in Invasive Pneumococcal Disease (IPD) amongst Indigenous adults in the Northern Territory (NT) of Australia, despite increasing vaccination coverage. We examined the utility of two common methods, the screening method and the indirect method, to determine the 23-valent pneumococcal polysaccharide vaccine effectiveness (VE) in prevention of IPD amongst Indigenous adults in this setting. VE was calculated for the period 2001-2005 across two distinct geographical areas where the disease burden was known to differ. VE against vaccine type IPD was 3.4% (95% CI -43, 35) for the NT. However, population vaccination coverage varied widely according to geographical region and where this was within the range appropriate for the use of the screening method, VE was within the expected range (67.2%,95% CI 47, 80). VE according to the indirect cohort appeared unreliable in this setting due to the analysis being based on a very limited number of non-vaccine-type IPD cases. Surveillance based estimates of VE such as these need to be considered with caution, but the results suggest failure to vaccinate is the most likely reason vaccine-type IPD has not reduced in this setting.
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Review of the burden of vision impairment and blindness and ocular disease occurrence in Indigenous Peoples of the Americas. We systematically reviewed findings of the frequency of vision impairment and blindness and/or frequency ...
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Review of the burden of vision impairment and blindness and ocular disease occurrence in Indigenous Peoples of the Americas. We systematically reviewed findings of the frequency of vision impairment and blindness and/or frequency of ocular findings in Indigenous groups. The database search yielded 2829 citations, of which 2747 were excluded. We screened the full texts of 82 records for relevance and excluded 16. The remaining 66 articles were examined thoroughly, and 25 presented sufficient data to be included. Another 7 articles derived from references were included, summing a total of 32 studies selected. When considering adults over 40 years old, the highest frequencies of vision impairment and blindness in Indigenous Peoples varied from 11.1% in high-income North America to 28.5% in tropical Latin America, whose rates are considerably higher than those in the general population. Most of the ocular diseases reported were preventable and/or treatable, so blindness prevention programs should focus on accessibility to eye examinations, cataract surgeries, control of infectious diseases, and spectacles distribution. Finally, we recommend actions in six areas of attention towards improving the eye health in Indigenous Peoples: access and integration of eye services with primary care; telemedicine; customized propaedeutics; education on eye health; and quality of data.
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