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BMC Public Health Nov 2022Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian...
Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.
Topics: Animals; Humans; Malaysia; Ethnicity; Socioeconomic Factors; Helminths; Population Groups
PubMed: 36384509
DOI: 10.1186/s12889-022-14449-2 -
Communications Biology Feb 2024Disparities in data underlying clinical genomic interpretation is an acknowledged problem, but there is a paucity of data demonstrating it. The All of Us Research...
Disparities in data underlying clinical genomic interpretation is an acknowledged problem, but there is a paucity of data demonstrating it. The All of Us Research Program is collecting data including whole-genome sequences, health records, and surveys for at least a million participants with diverse ancestry and access to healthcare, representing one of the largest biomedical research repositories of its kind. Here, we examine pathogenic and likely pathogenic variants that were identified in the All of Us cohort. The European ancestry subgroup showed the highest overall rate of pathogenic variation, with 2.26% of participants having a pathogenic variant. Other ancestry groups had lower rates of pathogenic variation, including 1.62% for the African ancestry group and 1.32% in the Latino/Admixed American ancestry group. Pathogenic variants were most frequently observed in genes related to Breast/Ovarian Cancer or Hypercholesterolemia. Variant frequencies in many genes were consistent with the data from the public gnomAD database, with some notable exceptions resolved using gnomAD subsets. Differences in pathogenic variant frequency observed between ancestral groups generally indicate biases of ascertainment of knowledge about those variants, but some deviations may be indicative of differences in disease prevalence. This work will allow targeted precision medicine efforts at revealed disparities.
Topics: Humans; Black People; Genetic Predisposition to Disease; Genomics; Hispanic or Latino; Population Health; United States; European People; African People
PubMed: 38374434
DOI: 10.1038/s42003-023-05708-y -
Australian Journal of General Practice Oct 2023The National Health and Medical Research Council's National Statement on Ethical Conduct in Human Research and updated Guidelines for Ethical Conduct in Aboriginal and...
BACKGROUND
The National Health and Medical Research Council's National Statement on Ethical Conduct in Human Research and updated Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research provide guidance for primary care researchers.
OBJECTIVE
This paper describes a step-by-step approach to ethics applications for research projects in primary care for new or inexperienced researchers, or those new to primary care research.
DISCUSSION
Domains that may enhance ethics applications include increased consumer involvement; comprehensive literature reviews; evidence of researcher training in ethical research and clinical trials; the use of online platforms for participant information, consent processes and surveys; and consideration of the risks of genomic research or research in subpopulations. This paper discusses steps required when preparing ethics applications to ensure the community, clinicians and researchers are protected.
Topics: Humans; Ethics Committees, Research; Biomedical Research; Population Groups
PubMed: 37788694
DOI: 10.31128/AJGP-02-23-6733 -
Pediatric Radiology Aug 2022In the 10-year period between the last two U.S. population censuses there have been significant changes in the U.S. population demography. The changes in self-reporting... (Review)
Review
In the 10-year period between the last two U.S. population censuses there have been significant changes in the U.S. population demography. The changes in self-reporting of racial and ethnic identity afforded by the most recent U.S. population census in 2020 have given citizens the opportunity to be represented in ways that truly reflect how they wish to be identified. At the same time, the diversity of the health care workforce in radiology has not reflected a similar change. While there have been small incremental changes for underrepresented groups (African Americans/Blacks, Hispanic ethnicity, and the group American Indian/Alaska Native/Native Hawaiian/Pacific Islander), these changes have not kept pace with the ever-changing demographics of the U.S. population. Part of the answer for these very modest gains must lie with our selection processes for identifying potential candidates from underrepresented in medicine groups (URiM) for acceptance to our medical schools, residency programs and employment opportunities as practicing physicians and faculty members. While the strategies employed have had some measure of success, our best efforts to increase diversity in our specialty, and in medicine in general, are being undermined by our biases and our traditional methods for identifying talents.
Topics: Black or African American; Ethnicity; Hispanic or Latino; Humans; Minority Groups; Radiology; United States
PubMed: 35732842
DOI: 10.1007/s00247-022-05416-5 -
Bundesgesundheitsblatt,... Jun 2021
Topics: Alcohol Drinking; Germany; Humans; Learning; Population Groups
PubMed: 34100968
DOI: 10.1007/s00103-021-03344-7 -
Preventing Chronic Disease Feb 2022Cardiovascular disease (CVD) is the leading of cause of death in Mississippi. We explored trends in CVD death rates among adults in Mississippi aged 35 years or older to...
INTRODUCTION
Cardiovascular disease (CVD) is the leading of cause of death in Mississippi. We explored trends in CVD death rates among adults in Mississippi aged 35 years or older to assess changes from 2000 through 2018.
METHODS
We extracted data from Mississippi Vital Statistics from 2000 through 2018. We used underlying cause-of-death codes from the International Classification of Diseases, Tenth Revision (ICD-10) to identify CVD deaths; we included all cases with codes I00-I09, I11, I13, I20-I51, I60-I69, and I70. We calculated age-adjusted CVD death rates for the overall population by age, race, sex, and race-by-sex groups.
RESULTS
Overall, the age-adjusted CVD death rate declined from 832.3 deaths per 100,000 population in 2000 to 550.5 deaths per 100,000 in 2018, a relative decline of 33.9% and an average annual decline of -2.3% (95% CI, -2.7% to -1.8%). Age-adjusted CVD death rates declined from 2000 through 2018 for all groups, but the magnitude of decline varied by subgroup (men, -2.0%; women, -2.6%; non-Hispanic Black, -2.4%; non-Hispanic White, -2.2%; non-Hispanic Black women, -3.0%; non-Hispanic White women, -2.5%; non-Hispanic Black men -2.1%; non-Hispanic White men -2.0%). Age-specific analysis indicated a significant average annual increase of 1.7% (95% CI, 0.6%-2.9%) from 2011 through 2018 for the group aged 55 to 64 years.
CONCLUSION
From 2000 through 2018, age-adjusted CVD death rates in Mississippi declined for all age/race/sex groups. However, the magnitude of decline varied by subgroup. Targeted interventions for CVD risk reduction are needed for adults aged 55 to 64 years in Mississippi, the only age group in which we observed a significant annual increase in CVD death rates.
Topics: Adult; Black People; Cardiovascular Diseases; Ethnicity; Female; Humans; International Classification of Diseases; Male; Mississippi
PubMed: 35201975
DOI: 10.5888/pcd19.210385 -
PloS One 2021There is conflicting evidence whether limb amputation (LA) disproportionately affects indigenous populations. To better understand this disparity, we compared the LA...
BACKGROUND
There is conflicting evidence whether limb amputation (LA) disproportionately affects indigenous populations. To better understand this disparity, we compared the LA incidence rate between First Nations persons registered under the Indian Act of Canada (RI) and the general population (GP) in Saskatchewan.
METHODS
We used Saskatchewan's retrospective administrative data containing hospital discharge LA cases, demographic characteristics (age and sex), and residents population reported in the database stratified by RI and GP from 2006-2019. The LA cases for each stratified group were first disaggregated into three broad categories: overall LA (all reported LA), primary LA (first reported LA), and subsequent LA (revision or contralateral LA), with each category further split into the level of amputation defined as major amputation (through/above the ankle/wrist joint) and minor amputation (below the ankle/wrist joint). LA rates were calculated using LA cases as the numerator and resident population as the denominator. Joinpoint and negative binomial regressions were performed to explore the trends further.
RESULTS
Overall, there were 1347 RI and 4520 GP LA cases reported in Saskatchewan from 2006-2019. Primary LA made up approximately 64.5% (869) of RI and 74.5% (3369) of GP cases, while subsequent LA constituted 35.5% (478) of RI and 25.5% (1151) of GP cases. The average age-adjusted LA rate was 153.9 ± 17.3 per 100,000 in the RI cohort and 31.1 ± 2.3 per 100,000 in the GP cohort. Overall and primary LA rates for the GP Group declined 0.7% and 1.0%, while subsequent LA increased 0.1%. An increased LA rate for all categories (overall 4.9%, primary 5.1%, and subsequent 4.6%) was identified in the RI group. Overall, minor and major LA increased by 6.2% and 3.3%, respectively, in the RI group compared to a 0.8% rise in minor LA and a 6.3% decline in major LA in the GP group. RI females and males were 1.98-1.66 times higher risk of LA than their GP counterparts likewise, RI aged 0-49 years and 50+ years were 2.04-5.33 times higher risk of LA than their GP cohort. Diabetes mellitus (DM) was the most prevalent amputation predisposing factor in both groups with 81.5% of RI and 54.1% of GP diagnosed with DM. Also, the highest proportion of LA was found in the lowest income quintile for both groups (68.7% for RI and 45.3% for GP).
CONCLUSION
Saskatchewan's indigenous individuals, specifically First Nations persons registered under the Indian Act of Canada, experience LA at a higher rate than the general population. This disparity exists for all variables examined, including overall, primary, and subsequent LA rates, level of amputation, sex, and age. Amplification of the disparities will continue if the rates of change maintain their current trajectories. These results underscore the need for a better understanding of underlying causes to develop a targeted intervention in these groups.
Topics: Amputation, Surgical; Confidence Intervals; Data Management; Female; Hospitalization; Humans; Incidence; Male; Population Groups; Retrospective Studies; Saskatchewan
PubMed: 34252158
DOI: 10.1371/journal.pone.0254543 -
Archives of Disease in Childhood Jan 2022To describe social and ethnic group differences in children's use of healthcare services in England, from 2007 to 2017.
OBJECTIVE
To describe social and ethnic group differences in children's use of healthcare services in England, from 2007 to 2017.
DESIGN
Population-based retrospective cohort study.
SETTING/PATIENTS
We performed individual-level linkage of electronic health records from general practices and hospitals in England by creating an open cohort linking data from the Clinical Practice Research Datalink and Hospital Episode Statistics. 1 484 455 children aged 0-14 years were assigned to five composite ethnic groups and five ordered groups based on postcode mapped to index of multiple deprivation.
MAIN OUTCOME MEASURES
Age-standardised annual general practitioner (GP) consultation, outpatient attendance, emergency department (ED) visit and emergency and elective hospital admission rates per 1000 child-years.
RESULTS
In 2016/2017, children from the most deprived group had fewer GP consultations (1765 vs 1854 per 1000 child-years) and outpatient attendances than children in the least deprived group (705 vs 741 per 1000 child-years). At the end of the study period, children from the most deprived group had more ED visits (447 vs 314 per 1000 child-years) and emergency admissions (100 vs 76 per 1000 child-years) than children from the least deprived group.In 2016/2017, children from black and Asian ethnic groups had more GP consultations than children from white ethnic groups (1961 and 2397 vs 1824 per 1000 child-years, respectively). However, outpatient attendances were lower in children from black ethnic groups than in children from white ethnic groups (732 vs 809 per 1000 child-years). By 2016/2017, there were no differences in outpatient, ED and in-patient activity between children from white and Asian ethnic groups.
CONCLUSIONS
Between 2007 and 2017, children living in more deprived areas of England made greater use of emergency services and received less scheduled care than children from affluent neighbourhoods. Children from Asian and black ethnic groups continued to consult GPs more frequently than children from white ethnic groups, though black children had significantly lower outpatient attendance rates than white children across the study period. Our findings suggest substantial levels of unmet need among children living in socioeconomically disadvantaged areas. Further work is needed to determine if healthcare utilisation among children from Asian and black ethnic groups is proportionate to need.
Topics: Adolescent; Asian People; Black People; Child; Child, Preschool; Cohort Studies; Emergency Service, Hospital; England; Ethnicity; General Practice; Hospitalization; Humans; Infant; Infant, Newborn; Patient Acceptance of Health Care; Racial Groups; Referral and Consultation; Retrospective Studies; Socioeconomic Factors
PubMed: 34244166
DOI: 10.1136/archdischild-2020-321045 -
Nutrients Oct 2023Proper nutrition and a balanced diet are factors that influence the growth and development of children and adolescents, as well as body weight and health throughout life...
Proper nutrition and a balanced diet are factors that influence the growth and development of children and adolescents, as well as body weight and health throughout life [...].
Topics: Child; Adolescent; Humans; Nutritional Status; Diet; Population Groups; Surveys and Questionnaires; Feeding Behavior; Life Style
PubMed: 37960262
DOI: 10.3390/nu15214609 -
PloS One 2021Our scoping review sought to consider how Etuaptmumk or Two-Eyed Seeing is described in Indigenous health research and to compare descriptions of Two-Eyed Seeing between... (Review)
Review
Our scoping review sought to consider how Etuaptmumk or Two-Eyed Seeing is described in Indigenous health research and to compare descriptions of Two-Eyed Seeing between original authors (Elders Albert and Murdena Marshall, and Dr. Cheryl Bartlett) and new authors. Using the JBI scoping review methodology and qualitative thematic coding, we identified seven categories describing the meaning of Two-Eyed Seeing from 80 articles: guide for life, responsibility for the greater good and future generations, co-learning journey, multiple or diverse perspectives, spirit, decolonization and self-determination, and humans being part of ecosystems. We discuss inconsistencies between the original and new authors, important observations across the thematic categories, and our reflections from the review process. We intend to contribute to a wider dialogue about how Two-Eyed Seeing is understood in Indigenous health research and to encourage thoughtful and rich descriptions of the guiding principle.
Topics: Ecosystem; Health Services, Indigenous; Humans; Inuit; Language; Population Groups; Research Design
PubMed: 34283831
DOI: 10.1371/journal.pone.0254612