-
International Emergency Nursing Mar 2019Emergency departments are primary health care entry points for Indigenous persons in Canada. They are also among the settings where Indigenous patients report access... (Review)
Review
BACKGROUND
Emergency departments are primary health care entry points for Indigenous persons in Canada. They are also among the settings where Indigenous patients report access barriers and discriminatory treatment. Cultural competency and cultural safety have been proposed as approaches to improving emergency care.
AIM
To identify and elaborate upon barriers and facilitators of cultural competency and safety in Canadian Emergency Departments.
METHODS
We conducted a scoping review to search published and grey literature to identify and extract data on definitions, measures, facilitators and barriers of cultural competency and safety.
RESULTS
Six articles met inclusion criteria. Studies presented perspectives from patients, care providers, health care organizations, and Indigenous knowledge holders. Key themes emerged across studies and stakeholders. These include: Interpersonal relationships between patients and care providers; cultural competency training; Emergency Department capacity; and racism and discrimination.
CONCLUSION
We recommend that Emergency Department cultural competency and safety initiatives i) be built upon post-colonial understanding and partnerships with local Indigenous communities ii) provide practitioners with competencies in relationship-building and self-awareness iii) orient ED resources and services to meet the needs of patients with limited access to non-emergency healthcare and iv) aim to prevent discrimination.
Topics: Canada; Cultural Competency; Emergency Service, Hospital; Humans; Patient Safety; Population Groups
PubMed: 30733006
DOI: 10.1016/j.ienj.2019.01.004 -
Lancet (London, England) Dec 2019
Topics: Brazil; Conservation of Natural Resources; Female; Human Rights; Humans; Indigenous Peoples; Male; Mining; Population Groups
PubMed: 31868629
DOI: 10.1016/S0140-6736(19)32620-0 -
International Journal of Circumpolar... 2015With the recognized need for health systems' improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all... (Review)
Review
With the recognized need for health systems' improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods' frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.
Topics: Cold Climate; Consensus; Health Services Research; Health Services, Indigenous; Humans; Population Groups; Program Evaluation; Quality Control
PubMed: 26004427
DOI: 10.3402/ijch.v74.27438 -
Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study.Substance Abuse Treatment, Prevention,... Sep 2014Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the... (Review)
Review
BACKGROUND
Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness.
METHODS
This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the "PICO" (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012.
RESULTS
The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies.
CONCLUSIONS
Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.
Topics: Adolescent; Adult; Culture; Female; Humans; Male; Population Groups; Substance-Related Disorders; Young Adult
PubMed: 25179797
DOI: 10.1186/1747-597X-9-34 -
PLoS Genetics Jan 2021Modern day Saudi Arabia occupies the majority of historical Arabia, which may have contributed to ancient waves of migration out of Africa. This ancient history has left...
Modern day Saudi Arabia occupies the majority of historical Arabia, which may have contributed to ancient waves of migration out of Africa. This ancient history has left a lasting imprint in the genetics of the region, including the diverse set of tribes that call Saudi Arabia their home. How these tribes relate to each other and to the world's major populations remains an unanswered question. In an attempt to improve our understanding of the population structure of Saudi Arabia, we conducted genomic profiling of 957 unrelated individuals who self-identify with 28 large tribes in Saudi Arabia. Consistent with the tradition of intra-tribal unions, the subjects showed strong clustering along tribal lines with the distance between clusters correlating with their geographical proximities in Arabia. However, these individuals form a unique cluster when compared to the world's major populations. The ancient origin of these tribal affiliations is supported by analyses that revealed little evidence of ancestral origin from within the 28 tribes. Our results disclose a granular map of population structure and have important implications for future genetic studies into Mendelian and common diseases in the region.
Topics: Africa; Arabia; Arabs; Asia; Europe; Female; Genome, Human; HapMap Project; Haplotypes; History, Ancient; Humans; Inbreeding; Male; Population Groups; Principal Component Analysis; Saudi Arabia
PubMed: 33428619
DOI: 10.1371/journal.pgen.1009210 -
American Journal of Public Health Sep 2022
Topics: Abortion, Induced; Abortion, Legal; Female; Health Services Accessibility; Humans; Incidence; Population Groups; Pregnancy; United States
PubMed: 35969818
DOI: 10.2105/AJPH.2017.304042r -
International Journal of Environmental... Mar 2020We assessed trends in physical fitness by age group and nutrition status among children and adolescents in Xinjiang during 1985-2014. The data of 49,357 participants...
We assessed trends in physical fitness by age group and nutrition status among children and adolescents in Xinjiang during 1985-2014. The data of 49,357 participants aged 7-18 were extracted in 1985, 1995, 2005, and 2014. Growth and nutritional status were defined using World Health Organization definitions. A physical fitness indicator (PFI) was calculated as the sum of six components measured in every survey. The relationship between body mass index (BMI) and PFI was investigated using nonlinear regression. Taking 1985 as a reference, PFI increased to 2 in 1995 and then fell sharply to -2.8 in 2005 and -3.8 in 2014. The prevalence of normal weight increased from 87.5% in 1985 to 89.4% in 1995 and then decreased to 75.2%, consistent with the change in PFI. The relationship between BMI and PFI showed an inverted U-shaped curve. The largest increment occurred in boys aged 13-15 and girls aged 16-18 during 1985-1995; the largest decline occurred in boys and girls aged 10-12 during 1995-2005. Our research provides a reference for local governments providing nutrition subsidies and projects in southern Xinjiang, indicating that greater attention is needed for children aged 7-12.
Topics: Adolescent; Body Mass Index; Child; China; Female; Humans; Male; Nutritional Status; Physical Fitness; Population Groups; Population Growth; Prevalence
PubMed: 32218289
DOI: 10.3390/ijerph17072195 -
Public Health Nov 2019The aim of this article is to explore perceptions of weight and racism towards Māori, as an indigenous group, and the association between the two. We then propose... (Review)
Review
OBJECTIVES
The aim of this article is to explore perceptions of weight and racism towards Māori, as an indigenous group, and the association between the two. We then propose indigenous solutions as pathways out of fat shaming.
STUDY DESIGN
This is a conceptual article supported by a review of literature in the fields of weight stigma, racism and indigenous (Māori) health.
METHODS
This article is taken from the perspective of three researchers involved in Māori health research, studies on institutional and societal racism and critical research on weight stigma and the weight loss industry. Indigenous peoples in developed nations are more likely to be overweight, obese and disproportionately affected by the comorbidities and physical disorders associated with weight when compared with their counterparts. Beyond the physical ailments are a variety of psychological, emotional and social issues, which are associated with being 'fat' and/or overweight and/or from subsequent stigmatisation.
RESULTS
Long before this world's populations reached the current alarming level of obesity, indigenous peoples in colonised countries were stigmatised because of the colour of their skin, their beliefs and their culture. Stigma is nothing new to indigenous peoples, and so when Māori, or any other indigenous groups are told they are fat and less productive (or moral) because of 'fatness', there is no surprise because they have been told the same thing (albeit for a different reason) for generations. Considering the relatively high proportion of indigenous people in New Zealand, North America and beyond who do not fit the 'recommended weight range', the justification for racist sentiment is seemingly strengthened.
CONCLUSIONS
A weight loss-centred approach to health has not improved the health of indigenous people. Initiatives that draw on, or are underpinned by local, traditional knowledge are more relevant for indigenous peoples and could lead to better health outcomes for these groups.
Topics: Health Promotion; Humans; New Zealand; North America; Population Groups; Public Health; Racism; Shame; Weight Prejudice
PubMed: 30352699
DOI: 10.1016/j.puhe.2018.08.013 -
Revista Espanola de Quimioterapia :... Apr 2023The Health Sciences Foundation has assembled a multidisciplinary group around a series of questions about the impact of the COVID-19 pandemic on the mental health of the... (Review)
Review
The Health Sciences Foundation has assembled a multidisciplinary group around a series of questions about the impact of the COVID-19 pandemic on the mental health of the general population and specific groups within that population, particularly healthcare workers. In the general population, the most prevalent mental disorders have been anxiety, sleep disorders and affective disorders, primarily depression. There has been a considerable increase in suicidal behavior, especially in young women and men over 70 years of age. There has been an increase in alcohol abuse and nicotine, cannabis and cocaine use. In contrast, the use of synthetic stimulants during periods of confinement has decreased. With regard to non-substance addictions, gambling was very limited, pornography consumption increased significantly and there was an increase in compulsive shopping and the use of video games. Particularly vulnerable groups include adolescents and patients with autism spectrum disorders. Healthcare workers suffered an increase in depression, anxiety and post-traumatic stress, especially those who were exposed during the early stages of the pandemic. Female sex, being a nurse, proximity to patients with COVID-19, working in a rural environment and having previous psychiatric or organic illnesses were some of the most frequently repeated factors in various studies in this population group. The media have shown a good degree of knowledge about these problems and have dealt with them frequently and from the point of view of ethics, crisis situations, such as the one experienced, have triggered not only physical but also moral claudications.
Topics: Male; Adolescent; Humans; Female; Aged; Aged, 80 and over; COVID-19; Mental Health; Pandemics; SARS-CoV-2; Population Groups; Health Personnel
PubMed: 36800778
DOI: 10.37201/req/018.2023 -
BMJ Open Feb 2020Throughout the world, indigenous peoples share traumatic colonial experiences that have caused gross inequalities for them and continue to impact every aspect of their... (Review)
Review
INTRODUCTION
Throughout the world, indigenous peoples share traumatic colonial experiences that have caused gross inequalities for them and continue to impact every aspect of their lives. The effect of intergenerational trauma and other health disparities have been remarkable for Indigenous children and adolescents, who are at a greater risk of adverse mental health and addiction outcomes compared with non-indigenous people of the same age. Most indigenous children are exposed to addictive substances at an early age, which often leads to early initiation of substance use and is associated with subsequent physical and mental health issues, poor social and relational functioning, and occupational and legal problems. The aim of this paper is to report the protocol for the scoping review of school-based interventions for substance use prevention in Indigenous children ages 7-13 living in Canada, the USA, Australia and New Zealand. This scoping review seeks to answer the following questions: (1) What is known about indigenous school-based interventions for preventing substance use and (2) What are the characteristics and outcomes of school-based interventions for preventing substance use?
METHODS AND ANALYSIS
This scoping review will use steps described by Arksey and O'Malley and Levac: (1) identifying the research question(s); (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; (5) collating, summarising and reporting the results and (6) consulting with experts. Our findings will be reported according to the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
ETHICS AND DISSEMINATION
Ethics review approval is not required for this project. Findings from this study will be presented to lay public, at scientific conferences and published in a peer-reviewed journal.
Topics: Adolescent; Australia; Canada; Child; Humans; New Zealand; Population Groups; School Mental Health Services; Substance-Related Disorders; United States
PubMed: 32051315
DOI: 10.1136/bmjopen-2019-034032