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INTRODUCTION: Community-driven research in primary healthcare (PHC) may reduce the chronic disease burden in Indigenous peoples. This systematic review assessed the cultural safety of reports of research on PHC use by Indigenous peoples from four countries with similar colonial histories. METHODS: Medline, CINAHL and Embase were all systematically searched from 1st January 2002 to 4th April 2023. Papers were included if they were original studies, published in English and included data (quantitative, qualitative and/or mixed methods) on primary healthcare use for chronic disease (chronic kidney disease, cardiovascular disease and/or diabetes mellitus) by Indigenous Peoples from Western colonial countries. Study screening and data extraction were undertaken independently by two authors, at least one of whom was Indigenous. The baseline characteristics of the papers were analyzed using descriptive statistics. Aspects of cultural safety of the research papers were assessed using two quality appraisal tools: the CONSIDER tool and the CREATE tool (subset analysis). This systematic review was conducted in accordance with the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. RESULTS: We identified 35 papers from Australia, New Zealand, Canada, and the United States. Most papers were quantitative (n = 21) and included data on 42,438 people. Cultural safety across the included papers varied significantly with gaps in adequate reporting of research partnerships, provision of clear collective consent from participants and Indigenous research governance throughout the research process, particularly in dissemination. The majority of the papers (94%, 33/35) stated that research aims emerged from communities or empirical evidence. We also found that 71.4% (25/35) of papers reported of using strengths-based approaches by considering the impacts of colonization on reduced primary healthcare access. CONCLUSION: Research on Indigenous PHC use should adopt more culturally safe ways of providing care and producing research outputs which are relevant to community needs by privileging Indigenous voices throughout the research process including dissemination. Indigenous stakeholders should participate more formally and explicitly throughout the process to guide research practices, inclusive of Indigenous values and community needs.
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Povos Indígenas , Atenção Primária à Saúde , Humanos , Canadá , Serviços de Saúde do Indígena , Austrália , Nova Zelândia , Estados Unidos , Competência CulturalRESUMO
Newcastle disease virus (NDV) has caused significant outbreaks in South-East Asia, particularly in Indonesia in recent years. Recently emerged genotype VII NDVs (NDV-GVII) have shifted their tropism from gastrointestinal/respiratory tropism to a lymphotropic virus, invading lymphoid organs including spleen and bursa of Fabricius to cause profound lymphoid depletion. In this study, we aimed to identify candidate genes and biological pathways that contribute to the disease caused by this velogenic NDV-GVII. A transcriptomic analysis based on RNA-Seq of spleen was performed in chickens challenged with NDV-GVII and a control group. In total, 6361 genes were differentially expressed that included 3506 up-regulated genes and 2855 down-regulated genes. Real-Time PCR of ten selected genes validated the RNA-Seq results as the correlation between them is 0.98. Functional and network analysis of Differentially Expressed Genes (DEGs) showed altered regulation of ElF2 signalling, mTOR signalling, proliferation of cells of the lymphoid system, signalling by Rho family GTPases and synaptogenesis signalling in spleen. We have also identified modified expression of IFIT5, PI3K, AGT and PLP1 genes in NDV-GVII infected chickens. Our findings in activation of autophagy-mediated cell death, lymphotropic and synaptogenesis signalling pathways provide new insights into the molecular pathogenesis of this newly emerged NDV-GVII.
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Proteínas Aviárias/metabolismo , Doença de Newcastle/patologia , Vírus da Doença de Newcastle/patogenicidade , Doenças das Aves Domésticas/patologia , Baço/patologia , Animais , Proteínas Aviárias/genética , Galinhas , Indonésia , Doença de Newcastle/genética , Doença de Newcastle/virologia , Doenças das Aves Domésticas/genética , Doenças das Aves Domésticas/virologia , Baço/metabolismo , Baço/virologia , TranscriptomaRESUMO
INTRODUCTION: Chronic breathlessness is associated with poorer quality of life (QoL). This population study aimed to define dimensions of QoL and duration and dominant causes of breathlessness that most diminished QoL. METHODS: This cross-sectional, population-based, and randomized survey of adults (n = 2977) in South Australia collected data on demographics, modified Medical Research Council (mMRC) breathlessness, and QoL (EuroQoL five-dimension five-level [EQ-5D-5L] measure; Short Form 12 quality-of-life measure). Data weighted to the census were analyzed for relationships between EQ-5D-5L and its dimensions with mMRC. Regression models controlled for age, sex, education, rurality, and body mass index. RESULTS: About 2883 responses were analyzed: 49% were males; mean age was 48 years (SD 19). As mMRC worsened, EQ-5D-5L and its dimensions worsened. More severe chronic breathlessness was iteratively associated with lower mobility, daily activities, and worse pain/discomfort. For self-care and anxiety/depression, impairment was only with the most severe breathlessness. Respondents who had chronic breathlessness for two to six years had the worst QoL scores. People who attributed their breathlessness to cardiac failure had poorer QoL. Respondents who reported a cardiac cause for their breathlessness had worse mobility, poorer usual activities, and more pain than the other causes. The regression analyses showed that worse chronic breathlessness was associated with worsening QoL in each dimension of EQ-5D-5L, with the exception of the self-care, which only worsened with the most severe breathlessness. CONCLUSIONS: This is the first study to report on chronic breathlessness and impairment across dimensions of QoL and differences by its duration. Mobility, usual activity, and pain drive these reductions.
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Vida Independente , Qualidade de Vida , Adulto , Estudos Transversais , Dispneia/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The considerably lower average life expectancy of Aboriginal and Torres Strait Islander Australians, compared with non-Aboriginal and non-Torres Strait Islander Australians, has been widely reported. Prevalence data for chronic disease and health risk factors are needed to provide evidence based estimates for Australian Aboriginal and Torres Strait Islanders population health planning. Representative surveys for these populations are difficult due to complex methodology. The focus of this paper is to describe in detail the methodological challenges and resolutions of a representative South Australian Aboriginal population-based health survey. METHODS: Using a stratified multi-stage sampling methodology based on the Australian Bureau of Statistics 2006 Census with culturally appropriate and epidemiological rigorous methods, 11,428 randomly selected dwellings were approached from a total of 209 census collection districts. All persons eligible for the survey identified as Aboriginal and/or Torres Strait Islander and were selected from dwellings identified as having one or more Aboriginal person(s) living there at the time of the survey. RESULTS: Overall, the 399 interviews from an eligible sample of 691 SA Aboriginal adults yielded a response rate of 57.7%. These face-to-face interviews were conducted by ten interviewers retained from a total of 27 trained Aboriginal interviewers. Challenges were found in three main areas: identification and recruitment of participants; interviewer recruitment and retainment; and using appropriate engagement with communities. These challenges were resolved, or at least mainly overcome, by following local protocols with communities and their representatives, and reaching agreement on the process of research for Aboriginal people. CONCLUSIONS: Obtaining a representative sample of Aboriginal participants in a culturally appropriate way was methodologically challenging and required high levels of commitment and resources. Adhering to these principles has resulted in a rich and unique data set that provides an overview of the self-reported health status for Aboriginal people living in South Australia. This process provides some important principles to be followed when engaging with Aboriginal people and their communities for the purpose of health research.
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Cultura , Inquéritos Epidemiológicos/métodos , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Saúde Pública/estatística & dados numéricos , Adulto , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Austrália do Sul/epidemiologiaRESUMO
OBJECTIVE: The aim of the study was to create an algorithm to measure depression-related mental health literacy. METHOD: Participants were those recruited for the 1998 and 2004 South Australian Health Omnibus Surveys. Two unprompted questions were selected from a mental health literacy questionnaire and responses were quantified through allocation of scores agreed by a focus group of mental health professionals. RESULTS: An application of the algorithm resulted in findings consistent with those of other research, providing face validity for the method developed. The application allowed for examination of overall levels of depression-related mental health literacy, with improvement found between 1998 and 2004. Similarly, differences in overall literacy according to demographics were also uncovered. CONCLUSIONS: Tracking mental health literacy within populations is important as it has been shown to be related to individual help-seeking as well as provision of support for those with a mental disorder. The method devised in this study allows for comparisons of literacy levels to be made across populations and time. It also offers increased capacity for statistical application.
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Depressão , Letramento em Saúde , Saúde Mental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Austrália do Sul , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To identify changes in depression, its management and associated excess costs, between 1998 and 2004 in South Australia. METHODS: A face-to-face Health Omnibus Survey was conducted in 2004 among 3015 randomly selected participants aged 15 years and over, who were a random and representative sample of the South Australian population, and this was compared with a survey conducted in 1998 that used the same methodology. The main outcome measures were prevalence of depression detected by the Mood Module of the Primary Care Evaluation of Mental Disorders (PRIME-MD); use of health services; health-related quality of life assessed by the Assessment of Quality of Life; estimates of excess costs and demographic data. RESULTS: There was no significant change in the overall prevalence of depression, although there was a significant decrease in respondents with other depressions, and a non-significant increase in those with major depression. No significant differences in the mean number of PRIME-MD depression symptoms were reported. Greater use of predominantly non-medical treatment services and antidepressants were reported by both those with depression and those without depression. There was a marked increase in the associated excess costs of depression. CONCLUSIONS: There has been no significant improvement in the prevalence of depression and its associated morbidity and financial burden in the South Australian community between 1998 and 2004, despite a number of professional and community education programmes. It is possible that without these efforts and the increased treatment reported on in this survey, there may have been an increase in the prevalence of depression and an even greater financial burden. However, it is also possible that community services for the provision of treatment for depression have not been able to implement research strategies that have been demonstrated to be effective.
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Transtorno Depressivo/epidemiologia , Educação em Saúde , Serviços de Saúde Mental , Avaliação de Resultados em Cuidados de Saúde , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Efeitos Psicossociais da Doença , Transtorno Depressivo/economia , Transtorno Depressivo/terapia , Feminino , Custos de Cuidados de Saúde/tendências , Humanos , Masculino , Meios de Comunicação de Massa , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/normas , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida/psicologia , Austrália do Sul/epidemiologiaRESUMO
Previous studies using clinic or convenience samples have indicated that not only patients with arthritis are at increased risk of depression, but there may also be a link between depression and disability in people with arthritis. We examined the prevalence of psychological distress in a population sample with and without arthritis and the association with health-related quality of life. The WANTS Health and Well-being Survey was a population household telephone interview survey of adults (age > or =18 years) in three states of Australia. Data obtained were weighted to provide population-representative estimates. The survey included questions regarding arthritis, SF-12, the Kessler 10 index of psychological distress and presence of mental health conditions. A total of 7,473 interviews providing information on arthritis were completed, with 1,364 (18.3%) reporting arthritis. Self-reported mental health conditions were more frequent in those with arthritis (14.9 vs 12.0%, p = 0.004), and a higher proportion were at a medium or high risk for anxiety or depression (39.0 vs 31.0%, p < 0.001). People with arthritis had significantly lower scores on the SF-12 physical component summaries compared to those without arthritis. Among those with arthritis, those with coexisting psychological distress had significantly lower scores on the SF-12 physical component summary than those without psychological distress. Psychological distress is common among people with arthritis in the community. In arthritis, psychological distress makes a significant additional negative impact on the physical well-being. Physicians need to recognize and address this additional impact on physical functioning in patients with arthritis.
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Artrite/psicologia , Vigilância da População/métodos , Qualidade de Vida , Estresse Psicológico/etiologia , Adolescente , Adulto , Artrite/epidemiologia , Artrite/fisiopatologia , Austrália/epidemiologia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Psicologia , Índice de Gravidade de Doença , Estresse Psicológico/epidemiologiaRESUMO
OBJECTIVE: To assess the prevalence of bipolar I and II disorders in an Australian population. METHOD: The Mood Disorder Questionnaire (MDQ) was administered to 3015 respondents in a random and representative sample in South Australia. Health status, quality of life and demographic data were also collected. RESULTS: There was a 2.5% lifetime prevalence of bipolar I and II disorders delineated by the MDQ. Those people had a significantly greater use of services and a poorer health status and quality of life than those who were MDQ-negative. CONCLUSIONS: These results in an Australian population are consistent with other international studies showing a greater prevalence of bipolar disorders than hitherto appreciated.
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Transtorno Bipolar/epidemiologia , Inquéritos e Questionários , Adulto , Austrália/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Comportamento SocialRESUMO
OBJECTIVE: To determine the self-reported prevalence of domestic violence in South Australian adults and to examine the associated risk factors, demographic factors and related health issues using computer-aided telephone interviewing (CATI) methodology. SAMPLE: A representative random sample of South Australian adults aged 18 years and over selected from the Electronic White Pages. Overall, 6,004 interviews were completed (73.1% response rate). RESULTS: In total, 17.8% of adults in South Australia reported some form of domestic violence by a current or an ex-partner. Demographic factors such as low household income, unemployment or part-time employment and health variables such as poor to fair self-reported health status and alcohol abuse problems were found to have a significant relationship with domestic violence. CONCLUSIONS: Approximately one in five South Australian adults report physical and emotional abuse from current or ex-partners, of whom the majority are women who are separated, divorced or never married and on lower incomes. Telephone interviewing is a cost-effective method of identifying prevalence estimates of domestic violence when compared with data collection by way of police reports or hospital emergency statistics. IMPLICATIONS: Domestic violence is a serious public health concern often 'hidden' by the lack of appropriate data. This study has shown that domestic violence is frequent and has important social, economic and health consequences.