Percepções e ações da equipe multiprofissional em saúde sobre a medicina tradicional indígena / Perceptions and actions of the multi-professional health team on traditional indigenous medicine / Percepciones y acciones del equipo multidisciplinario de salud sobre la medicina tradicional indígena

Objetivo: compreender as percepções e as ações de uma equipe multiprofissional em saúde quanto à prática da medicina tradicional indígena em uma Casa de Atenção à Saúde Indígena. Método: estudo qualitativo descritivo, realizado em uma de Casa de Apoio à Saúde Indígena em um município do Pará, que incluiu oito profissionais de uma equipe multiprofissional. A coleta de dados foi realizada no ano de 2018 e estes foram examinados pelo método da análise de conteúdo. Resultados: inserção e prática do cristianismo; ritos e lideranças xamânicas; e postura da equipe de multidisciplinar foram as categorias elencadas, que apontam os entendimentos e atuações da equipe multiprofissional e da organização espacial da Casa de Saúde do município. Considerações finais: há novos costumes e valores entre as etnias, em virtude da aproximação de grupos religiosos, cujas ações foram registradas e apreendidas pela equipe de trabalhadores em saúde.

Objective: understanding the perceptions and actions of a multi-professional health team regarding the practice of traditional indigenous medicine in an Indigenous Health Care Center. Method: this is a descriptive qualitative study carried out in an Indigenous Health Support Center in a municipality in the state of Pará, which included eight professionals from a multi-professional team. Data was collected in 2018 and examined using the content analysis method. Results: insertion and practice of Christianity; shamanic rites and leadership; and the attitude of the multidisciplinary team were the categories listed, which point to the understandings and actions of the multi-professional team and the spatial organization of the Health Center in the municipality. Final considerations: there are new customs and values among ethnic groups, due to the approach of religious groups, whose actions were recorded and apprehended by the team of health workers.

Objetivo: comprender las percepciones y acciones de un equipo multidisciplinario de salud sobre la práctica de la medicina tradicional indígena en una Casa de Atención para la Salud Indígena. Método: estudio descriptivo cualitativo, realizado en una Casa de Apoyo a la Salud Indígena de un municipio de Pará, que incluyó ocho profesionales de un equipo multidisciplinario. La recolección de datos se realizó en 2018 y los datos fueron sometidos al método de análisis de contenido. Resultados: inserción y práctica del cristianismo; ritos y líderes chamánicos; y actitud del equipo multidisciplinario fueron las categorías enumeradas, que indican la percepción y las acciones del equipo multidisciplinario y la organización espacial de la Casa de Salud del municipio. Consideraciones finales: existen nuevas costumbres y valores entre las etnias, debido a la presencia de grupos religiosos, el equipo de los trabajadores de la salud registró y aprendió las acciones de los indígenas.

The intersection of social and Indigenous determinants of health for health system strengthening: a scoping review.

The COVID-19 pandemic exposed long-standing gaps in health service systems and realities of environmental changes impacting Native nations and Indigenous communities in the US and circumpolar regions. Despite increased awareness and funding, there is limited research and few practical resources available for the work. This is a scoping review of the current literature on social determinants of health (SDOH) impacting Indigenous peoples, villages, and communities in the US and circumpolar region. The review used the York methodology to identify research questions, chart, and synthesize findings. Thirty-two articles were selected for full review and analysis. The articles were scoping reviews, evaluations, and studies. The methods used were 44% mixed (n = 14), 31% quantitative (n = 10) and 25% qualitative (n = 8). The synthesis identified four areas for discussion: 1) systemic and structural determinant study designs, 2) strengthening Indigenous health systems, 3) mapping the relationship of co-occurring health conditions and SDOH, and 4) emergent areas of inquiry. While the scoping review has limitations, it provides a snapshot of broad SDOH and shared Indigenous social determinants of health (ISDOH) to create tailored frameworks for use by tribal and urban Indigenous health organisations, with their partners, in public health and system strengthening.

Plants of the USA: recordings on native North American useful species by Alexander von Humboldt.

BACKGROUND: The German naturalist Alexander von Humboldt conducted an expedition through the American continent, alongside Aimé Bonpland, from 1799 to 1804. Before finally returning to Europe, they decided to take a side trip to the USA between May 20 and July 7, 1804. Humboldt's most detailed account of his time in the USA consists of a manuscript entitled "Plantae des États-Unis" (1804), containing information on useful plants and timber of the country. The aim of this paper is to retrieve, for the first time, ethnobotanical information regarding North American plants and their uses inside this Humboldt's manuscript as well as to highlight the erasure and invisibilization of North American Indigenous knowledge within historical documents and bibliography, mainly during the nineteenth century. METHODS: "Plantae des États-Unis" (digitized version and its transcription) was carefully analyzed, and information on plant species mentioned in the manuscript (including botanical and vernacular names, traditional uses, and general observations) was retrieved. Traditional uses were correlated with ethnobotanical data from the Native American Ethnobotany Database and encyclopedic literature on North American plants from the nineteenth and early twentieth centuries, as well as recent pharmacological studies searched in scientific papers. RESULTS: In the manuscript are mentioned 28 species distributed in 15 botanical families, with Fagaceae (9 Quercus species) being the most representative. All species are USA natives, except for one undetermined species (only the genus was mentioned, Corylus). Four species were directly mentioned as medicinal (Toxicodendron radicans, Liriodendron tulipifera, Actaea racemosa, and Gillenia stipulata), while other four were described as tanning agents (astringent) (Cornus florida, Diospyros virginiana, Quercus rubra, and Quercus velutina). Two species were described as bitter (Xanthorhiza simplicissima and A. racemosa). Nine Quercus species were described, but five were reported as the most useful oaks for cultivation in Europe (Quercus bicolor, Quercus castanea, Quercus virginiana, Quercus michauxii, and Quercus alba); three of them were used for ship construction (Q. virginiana, Q. michauxii, and Q. alba), two as astringent (Q. rubra and Q. stellata), and one had wood of poor quality (Quercus phellos). One species was described as a yellow dye (Hydrastis canadensis), and the other was mentioned as toxic (Aesculus pavia). Ten species did not have any useful applications listed. CONCLUSIONS: Although "Plantae des États-Unis" is a brief collection of annotations, these data reveal a historical scenario of outstanding plants with social and economic interest in the USA at the beginning of the nineteenth century. The data highlight a clear process of suppression of the traditional knowledge of Native North American Indigenous peoples in past historical records and literature, due to the lack of acknowledgment by white European settlers and American-born explorers. This ethnobotanical inventory may help us understand the relationship between plants and Native North American Indigenous peoples, as well as European naturalists and settlers, and USA-born people in the past, and reflect on the importance of Indigenous traditional knowledge, bioeconomy, sustainable management, and conservation of biodiversity in the present and future.

An Indigenous-led buprenorphine-naloxone treatment program to address opioid use in remote Northern Canada.

Background/purpose: In response to the opioid use challenges exacerbated from the COVID-19 pandemic, Fort Albany First Nation (FAFN), a remote Cree First Nation community situated in subarctic Ontario, Canada, implemented a buprenorphine-naloxone program. The newly initiated program was collaboratively developed by First Nations' nurses and community leaders, driven by the community's strengths, resilience, and forward-thinking approach. Using the First Nations Information Governance Centre strengths-based model, this article examines discussions with four community leaders to identify key strengths and challenges that emerged during the implementation of this program. Methods: this qualitative study amplify the positive aspects and community strengths through the power of oral narratives. We conducted 20 semi-structured face-to-face interviews with community members who helped lead FAFN's COVID-19 pandemic response. Utilizing the Medicine Wheel framework, this work introduces a holistic model for the buprenorphine-naloxone program that addresses the cognitive, physical, spiritual, and emotional dimensions of well-being. Results: Recommendations to support this initiative included the need for culturally competent staff, customized education programs, and the expanding of the program. Additionally, there is a pressing need for increased funding to support these initiatives effectively and sustainably. The development of this program, despite challenges, underscores the vital role of community leadership and cultural sensitivity to address the opioid crisis in a positive and culturally safe manner. Conclusion: The study highlights the successes of the buprenorphine-naloxone program, which was developed in response to the needs arising from the pandemic, specifically addressing community members suffering from opioid addiction. The timely funding for this program came as the urgent needs of community members became apparent due to pandemic lockdowns and isolation. Holistic care, including mental health services and fostering community relations, is important. By centering conversations on community strengths and advocating for culturally sensitive mental health strategies that nurture well-being, resilience, and empowerment, these findings can be adapted and expanded to support other Indigenous communities contending with opioid addiction.

Learning chemistry of metals in the context of forging: An ethnographic case study of blacksmithing in Guji Oromo, Ethiopia.

This study explores the art of blacksmithing in Guji Oromo to locate underlying chemistry concepts, knowledge, and ways of knowing. The ethnographic case study design was employed, in which 11 blacksmiths were engaged through observation and semi-structured interviews. The data from the interview and observation were separately analyzed and triangulated against each other thematically. As a result, it was found that the blacksmiths in Guji use three mechanisms to identify the quality and suitability of metals collected for redesigning: textual, mechanical, and sparking tests. Besides, blacksmiths with no or little schooling have a remarkable conception of the fundamentals of metals and metallic bonding, malleability and ductility as a measure of metal qualities, rusting as threats to the existence of metals and how to prevent, metallic crystal and micro crystal rearrangement and thermal conductivity of metals. Moreover, the setting and underlying ways of knowing were found to be so constructivist because novices are allowed to explore and learn their way with minimal involvement from the experienced ones. Concerning the origin of blacksmithing, two themes of hypothesis were found in this study. One is that the origination of the art is among the ancestors of Guji themselves, and the other is that the explorers and metallurgists from other communities in Kenya or southern Ethiopia introduced the art. Thus, the narratives are controversial which call for further study. In conclusion, the findings revealed that the blacksmithing practice in Guji has utilizable chemistry contents and concepts that could enhance learning of chemistry by creating familiar context.

Assessment of antioxidant and antibacterial efficacy of some indigenous vegetables consumed by the Manipuri community in Sylhet, Bangladesh.

The rapid dietary changes experienced by indigenous people worldwide threaten the use of traditional foods, which are often undervalued. This study focused on evaluating the antioxidant and antibacterial efficacy of five vegetables typically consumed by the Manipuri ethnic groups in the Sylhet region of Bangladesh: Yongchak seed (Parkia speciosa), Telikadam seed (Leucaena leucocephala), Phakphai leaf (Persicaria odorata), Sheuli leaf (Nyctanthes arbor-tristis), and bamboo shoot (Bambusa spp.). The samples were dried and powdered to assess the antioxidant activity through total phenolic content (TPC), total flavonoid content (TFC), total tannin content (TTC), and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity. Antibacterial efficacy was determined by measuring the zone of inhibition (ZOI), minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC). Leafy vegetables exhibited higher TPC, TFC, and TTC than seeds and shoots, with N. arbor-tristis leaf showing the highest TPC (99.16 ± 2.07 mg GAE/g DW) and P. odorata leaf exhibiting the highest TFC (9.19 ± 0.7 mg QE/g) and TTC (3.59 ± 0.26 mg TAE/g). However, Bambusa spp. shoot extract showed the highest antioxidant potential (IC50: 1.66 ± 0.05 mg/mL). All samples exhibited higher ZOI against gram-positive bacteria (Bacillus spp. and Staphylococcus spp.), ranging from 10 ± 2.65 to 19.33 ± 2.08 mm. L. leucocephala seed extract showed the highest antibacterial activity against both the tested gram-positive bacteria with a MIC of 15.6 mg/mL. Conversely, the P. odorata leaf extract exerted the strongest antibacterial effect against gram-negative bacteria, with the lowest MIC values for Klebsiella spp. (31.25 mg/mL) and Escheria coli (62.5 mg/mL). The findings of this investigation suggest that the selected indigenous vegetables could be valuable sources of phytochemicals with potential antioxidant and antibacterial activities. Incorporating and promoting these traditional foods into the diet may improve food security, dietary diversity, and public health in Bangladesh.

Reckoning with rights: the Voice Referendum.

OBJECTIVE: Many Aboriginal and Torres Strait Islander Australians are dismayed by the rejection of the 2023 Voice Referendum and its amplification of social divisions. This article considers a recent article in Australasian Psychiatry in which matters of motivation, process and outcome are raised that provides the scaffolding to explore these issues. CONCLUSIONS: The breakdown of bipartisan political support and subsequent politicisation of the Referendum process resulted in claims regarding the reasons for and consequences of the Referendum that were not consistent with the process leading to the Uluru Statement. The outcome has been socially divisive and a cause of significant distress for many Aboriginal and Torres Strait Islander Australians, the majority of whom voted in support of the Voice.

Top end perinatal mental health consultation service: evaluation of services, patient demographics and psychosocial contributors to mental ill-health.

OBJECTIVES: To understand the key descriptors of the Top End Mental Health Service, Northern Territory's, perinatal mental health consultation service (PMHCS). METHOD: A retrospective cross-sectional review of all referrals to the PMHCS in the 12 months period 1 January to 31 December 2021 inclusive was undertaken. The study was descriptive in nature. RESULTS: From January 2021 to December 2021, there were 266 women referred to the service. There was a large proportion of Aboriginal and Torres Strait Islanders. Mean age was 28.8 (SD = 6.04) years. A statistically significant difference was identified between the average age of the Aboriginal and Torres Strait Islander women (n = 53, M = 24.6 years, SD = 6.31) which was significantly less than Caucasian women (n = 161, M = 29.4037, SD = 4.982) and women of other cultural backgrounds (n = 52, M = 31.154, SD = 6.792), p < .00,001. Sixty two percent of patients managed had a history of trauma with significantly more service contact. CONCLUSION: This data gives insight into a unique population group. It also highlights the impact that trauma has on patient care and management.

Ear Problems Are Associated With Traumatic Dental Injuries Among Australian-Indigenous-Children.

BACKGROUND/AIM: The association between ear problems and traumatic dental injuries (TDIs) has not been examined in longitudinal cohort studies. The study aimed to estimate the effect of ear problems on TDIs in primary and permanent teeth among Australian Indigenous children. METHODS: The Longitudinal Study of Indigenous Children is a study of two representative cohorts of Indigenous Australian children, aged from 6 months to 2 years (baby cohort) or from 3.5 to 5 years (child cohort) at baseline (2008). The children's mother/primary carer undertook a face-to-face interview in 2008, repeated annually for the next 9 years. Ear problems included runny ears, perforated eardrum, total deafness, deaf in one ear, hearing loss/partially deaf, and other ear problems. TDIs were teeth and oral soft and hard tissue injuries. Multivariate survival analysis using Cox proportional regression models estimated hazards ratio (HR) were used in the analysis. RESULTS: A total of 870 from baby cohort and 668 from child cohort Indigenous children, who had no TDIs at baseline were included in the analysis. The prevalence of TDIs was 9.2%, 11.1%, and 6.6% in the total, baby, and child cohorts, respectively. Multivariable models for TDIs indicate children with ear problems had nearly four times (total: HR = 3.72, 95% CI: 1.82-6.77), five times (baby cohort: HR = 4.76, 95% CI: 1.59-11.63), and more than 15 times (child cohort: HR = 16.2, 95% CI: 4.78-49.28) the average hazard over time, than those without ear problems. After adjusting for all covariates, children with ear problems had more than 22 times (HR = 22.03, 95% CI: 4.50-87.07) TDIs than those without ear problems in the child cohort. Mothers/primary carers with lower educational level was positively associated with the incidence of TDIs. CONCLUSION: Ear problems were a risk indicator for the increased incidence of TDIs in two large cohorts of Indigenous Australian children. Mothers/primary carers' educational level was a significant risk factor for TDIs.

Indigenous Mothers' Perspective on Sexual Health in Northwest Territories, Canada: Results from the Maternal and Infant Health Project.

PURPOSE: In Northwest Territories (NWT), Canada, infection rates for chlamydia, gonorrhea, and syphilis are three to ten times higher than the national averages and have been steadily increasing. However, data are scarce on the socioeconomic, psychological, and behavioural factors associated with the proliferation of sexually transmitted infections (STIs) in NWT. To this extent, this study explores Indigenous mothers' perspectives on sexual health, STI risk factors and healthcare-seeking behaviours in NWT. METHODS: Quantitative and qualitative data were collected using a semi-structured questionnaire. Participants consisted of Indigenous mothers who were pregnant or had given birth within three years. RESULTS: Of the 161 participants, with a mean age of 29.61 years, 70.81% lived with a partner, and 93.17% had given birth within the previous three years. Participants felt STIs were a concern (68.32%) and felt comfortable asking a male partner for safe sexual relations (67.70%). The healthcare system was the main source of STI information for most participants (83.85%). The main STI risk factors participants mentioned were young age, unsafe sexual relations, and substance use. Participants reported embarrassment, protecting personal and familial well-being, and confidentiality as factors affecting STI healthcare-seeking behaviour. CONCLUSION: STIs result from an interaction between age, sexual behaviour, substance use, health literacy, and the historical and sociocultural contexts stigmatizing STIs and impacting women's abilities to demand safe sexual relations. Understanding these factors in a remote Indigenous context is vital to designing and implementing effective health and social interventions to reduce the prevalence of STIs in NWT.

Is eHealth Research with or on Our People?: Lessons Learned Using the Aboriginal and Torres Strait Islander Quality Appraisal Tool.

There is growing evidence for the benefits of eHealth interventions with Aboriginal and Torres Strait Islander people. Yet, there is a lack of guidance for culturally safe, relevant, and sustainable initiatives with Aboriginal and Torres Strait Islander peoples and organisations. To this end a research program was established to develop a roadmap for eHealth with Aboriginal and Torres Strait Islander peoples. The current phase of the research program is a review of the literature aimed at identifying the important characteristics of eHealth interventions with Aboriginal and Torres Strait Islander people. Thirty-nine publications reporting on a variety of eHealth modalities with Aboriginal and Torres Strait Islander people were identified. To assess the cultural quality of the final papers, the authorship applied the Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Results from the appraisal demonstrated significantly higher QAT scores between studies, including more Indigenous authors. This further substantiates the importance Aboriginal and Torres Strait Islander ways of knowing, doing, and being incorporating Indigenous worldviews and leadership have on the cultural quality of eHealth research studies.

Use of commercial or indigenous yeast impacts the S. cerevisiae transcriptome during wine fermentation.

Grapes have been cultivated for wine production for millennia. Wine production involves a complex biochemical process where sugars in grape must are converted into alcohol and other compounds by microbial fermentation, primarily by the yeast Saccharomyces cerevisiae. Commercially available S. cerevisiae strains are often used in winemaking, but indigenous (native) strains are gaining attention for their potential to contribute unique flavors. Recent advancements in high-throughput DNA sequencing have revolutionized our understanding of microbial communities during wine fermentation. Indeed, transcriptomic analysis of S. cerevisiae during wine fermentation has revealed a core gene expression program and provided insights into how this yeast adapts to fermentation conditions. Here, we assessed how the age of vines impacts the grape fungal microbiome and used transcriptomics to characterize microbial functions in grape must fermented with commercial and native S. cerevisiae. We discovered that ~130-year-old Zinfandel vines harbor higher fungal loads on their grapes compared to 20-year-old Zinfandel vines, but fungal diversity is similar. Additionally, a comparison of inoculated and uninoculated fermentations showed distinct fungal dynamics, with uninoculated fermentations harboring the yeasts Metschnikowia and Pichia. Transcriptomic analysis revealed significant differences in gene expression between fermentations inoculated and not inoculated with a commercial S. cerevisiae strain. Genes related to metabolism, stress response, and cell adhesion were differentially expressed, indicating varied functionality of S. cerevisiae in these fermentations. These findings provide insights into S. cerevisiae function during fermentation and highlight the potential for indigenous yeast to contribute to wine diversity. IMPORTANCE: Understanding microbial functions during wine fermentation, particularly the role of Saccharomyces cerevisiae, is crucial for enhancing wine quality. While commercially available S. cerevisiae strains are commonly used, indigenous strains can offer unique flavors, potentially reflecting vineyard terroir. By leveraging high-throughput DNA sequencing and transcriptomic analysis, we explored the impact of vine age on the grape mycobiome and characterized microbial functions during grape fermentation. Our findings revealed that older vines harbor higher fungal loads, but fungal diversity remains similar across vine ages. Additionally, uninoculated fermentations exhibited diverse fungal dynamics, including the beneficial wine yeasts Metschnikowia and Pichia. Transcriptomic analysis uncovered significant differences in S. cerevisiae gene expression between inoculated and uninoculated fermentations, highlighting the potential of indigenous yeast to enhance wine diversity and inform winemaking practices.

Experiences of ecosystem changes on food services of mopane woodland communities in Vhembe, South Africa.

Mopane woodlands have been shifting. While it is important to understand the spatial patterns that characterise this phenomenon, it is even more important to understand the impacts of shifting Mopane woodlands on rural communities that rely on them. This study sought to establish the impacts of shifting mopane woodlands on the production of indigenous plant food in Ward 12 of Musina local municipality in the Vhembe District municipality in the Limpopo province of South Africa. To accomplish this, the study utilised a hybrid inductive approach involving thematic-based questionnaire interviews and an exploratory view to gain insight into the narratives of focus group participants. Results revealed that seven (7) out of eleven (11) indigenous plant foods are becoming extinct, thereby limiting food sources of indigenous and local people who used to rely on them. The spatial pattern of the plant foods that are still available has now changed as they no longer grow within the reach of local communities. The community members are struggling to adapt to these changes. From these observations, we recommend that local and regional levels' policies related to natural resource management should consider the unique challenges faced by communities experiencing disruptive ecosystem changes and provide the necessary support for sustainable adaptation.

Comparative Profiling of Milk Somatic Cells Proteomes Revealed Key Players in Mammary Immune Mechanisms During Mastitis in Tropical Sahiwal (Bos indicus) Cows.

PURPOSE: Bovine mastitis poses a significant economic burden on the dairy industry worldwide. This pioneering proteomic study conducted a comparative profiling of milk somatic cell (SC) proteins contributing to mammary immune defense during subclinical and clinical mastitis (CM) in Sahiwal (Bos indicus) cows. EXPERIMENTAL DESIGN: Based on California mastitis test (CMT) scores, milk SC counts, differential leukocyte counts (DLCs), and bacteriological culture results, quarter milk SC samples were categorized into healthy (H), subclinical mastitis (SCM), and CM groups. Comparative proteome profiling of milk SCs was done using a label-free liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) proteomic approach. RESULTS: The identified upregulated proteins in mastitis groups such as Vanin 2, Thioredoxin reductase-like selenoprotein T, Ceramidase, Lymphocyte antigen 75, Misshapen-like kinase 1 (MINK1), Thrombospondin 1, Macrophage scavenger receptor 1, Leupaxin, and Lipoamide acyltransferase, involved in immune responses. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed immune functions and pathways like antigen processing, complement cascades, extracellular matrix receptor interaction, efferocytosis, leukocyte migration, chemokine, peroxisome proliferator-activated receptors (PPARs), and transforming growth factor (TGF)-beta signaling. CONCLUSIONS AND CLINICAL RELEVANCE: These findings provide essential information on proteomic profiling in milk SCs and contribute valuable insights into immune-related proteins regulated during mastitis in dairy cows. Further, validated proteins (Vanin 2, MINK1, and Thrombospondin 1) offer potential inflammatory biomarkers for early mastitis detection in dairy cows.

Inequity in cardiometabolic hospital admissions and blood screening in New Zealand Indigenous Maori with psychosis.

BACKGROUND: People with psychosis experience worse cardiometabolic health than the same-aged general population. In New Zealand, Indigenous Maori experiencing psychosis have greater risk of cardiometabolic and other physical health problems. AIMS: To identify a cohort of adults accessing secondary mental health and addiction services in New Zealand, with a previous psychosis diagnosis as of 1 January 2018, and compare odds of hospital admission outcomes, mortality and receipt of cardiometabolic blood screening between Maori and non-Maori in the following 2 years. METHOD: Crude and adjusted logistic regression models compared odds of hospital admission outcomes, mortality and receipt of cardiometabolic blood screening (lipids and haemoglobin A1c) between Maori and non-Maori, occurring between 1 January 2018 and 31 December 2019. RESULTS: A cohort (N = 21 214) of Maori (n = 7274) and non-Maori (n = 13 940) was identified. Maori had higher adjusted risk of mortality (odds ratio 1.26, 95% CI 1.03-1.54), and hospital admission with diabetes (odds ratio 1.64, 95% CI 1.43-1.87), cardiovascular disease (odds ratio 1.54, 95% CI 1.25-1.88) and any physical health condition (odds ratio 1.07, 95% CI 1.00-1.15) than non-Maori. Around a third of people did not receive recommended cardiometabolic blood screening, with no difference between Maori and non-Maori after covariate adjustment. CONCLUSIONS: Maori experiencing psychosis are more likely to die and be admitted to hospital with cardiovascular disease or diabetes than non-Maori. Because of the higher cardiometabolic risk borne by Maori, it is suggested that cardiometabolic screening shortfalls will lead to worsening physical health inequities for Maori experiencing psychosis.

Effect of heat stress on semen characteristics and genetics in Thai native grandparent roosters.

Grandparent roosters are crucial in poultry breeding programs and significantly influence future bird generations' genetic makeup and performance. However, these roosters face considerable challenges from heat stress, which can adversely affect their reproductive performance, semen quality, and overall health and welfare. Our study aimed to investigate the effects of heat stress on the genetics of semen characteristics, identify the appropriate temperature and humidity indices (THI), and determine the threshold point of heat stress to prevent thermal stress. We analyzed data from 3,895 records of 242 Thai native grandparent roosters in conjunction with the THI using 7 THI functions and the regression method. The threshold point of heat stress, genetic parameters, rate of decline of semen characteristics per level of THI, estimated breeding values and selection index values were analyzed using the multivariate test-day model in the AIREML and BLUPF90 programs. Based on the regression coefficient and statistical criteria of the lowest -2logL and AIC values, the results showed that a THI of 78 was considered the threshold point of heat stress. The estimated heritability values ranged from 0.023 to 0.032, 0.066 to 0.069, 0.047 to 0.057, and 0.022 to 0.024 for mass movement, semen volume, sperm concentration, and the semen index, respectively. The reduction rates of mass movement, semen volume, sperm concentration, and semen index at a THI of 78 were -0.009, -0.003, -0.170, and -0.083 per THI, respectively. The genetic correlations among the semen traits were moderately to strongly positive and ranged from 0.562 to 0.797. The genetic correlations between semen traits and heat stress were negative and ranged from -0.437 to -0.749. The permanent environmental correlations among the semen traits (0.648-0.929) were positive and greater than the genetic correlations. Permanent environmental correlations between semen traits and heat stress were negative and ranged from -0.539 to -0.773. The results of the selection indices showed that the higher the selection intensity was, the greater the degree to which the selection index corresponded to genetic progress. The recommendation for animal genetic selection is that the top 10% is appropriate because it seems most preferred. Therefore, using a multivariate test-day model and selection index for the high genetic potential of semen traits and heat tolerance in Thai native grandparent roosters makes it possible to achieve genetic assessment in a large population.

Vision loss and diabetic retinopathy prevalence and risk among a cohort of Indigenous and non-Indigenous Australians with type 2 diabetes receiving renal haemodialysis treatment: The retinopathy in people currently on renal dialysis (RiPCORD) study.

AIMS: Diabetic nephropathy, vision loss and diabetic retinopathy (DR) are frequent comorbidities among individuals with type 2 diabetes (T2D). The Retinopathy in People Currently On Renal Dialysis (RiPCORD) study sought to examine the epidemiology and risk of vision impairment (VI) and DR among a cohort of Indigenous and non-Indigenous Australians with T2D currently receiving haemodialysis for end-stage renal failure (ESRF). METHODS: A total of 106 Indigenous and 109 non-Indigenous Australians were recruited in RiPCORD across five haemodialysis centres in urban and remote settings. Clinical assessments, questionnaires and medical record data determined the rates of ocular complications and risk factor profiles. RESULTS: Prevalence rates include unilateral VI, 23.5 %; bilateral VI, 11.7 %; unilateral blindness, 14.2 %; and bilateral blindness, 3.7 %, with no significant differences between sub-cohorts (p=0.30). DR prevalence rates were 78.0 % among non-Indigenous Australians and 93.1 % among Indigenous Australians (p=<0.001). Non-Indigenous ethnicity (OR: 0.28) and pre-dialysis diastolic blood pressure (OR: 0.84 per 10-mmHg) were protective, while peripheral vascular disease (OR: 2.79) increased DR risk. CONCLUSIONS: Ocular complications among individuals with T2D and ESRF are disproportionately high, especially for Indigenous Australians, and beyond what can be accounted for by risk factor variation. Findings suggest a need to improve screening and preventative efforts within this high-risk population group.

Stores Licensing Scheme in remote Indigenous communities of the Northern Territory, Australia: a meta-evaluation.

A form of food retail regulation called the Stores Licensing Scheme was introduced by the Australian Government in 2007-2022 to ensure food security in remote Indigenous communities of the Northern Territory. We examined evaluations of this Scheme implemented under the Northern Territory National Emergency Response and Stronger Futures Northern Territory Acts. Grey literature search identified nine primary source evaluations. Reported outcomes were extracted and thematic analysis utilised to determine barriers and enablers. Outcomes included improved availability and quality of groceries, financial structures, and retail practices, albeit not consistently reported. Governance and food cost were perceived barriers. Future policy aimed to improve food security through community stores should consider food cost subsidy, measures to incentivise all stores to improve standards, and improved governance arrangements enabling self-determination for Aboriginal and Torres Strait Islander Store Directors.

Views and perspectives toward implementing the Global Spine Care Initiative (GSCI) model of care, and related spine care program by the people in Cross Lake, Northern Manitoba, Canada: a qualitative study using the Theoretical Domain Framework (TDF).

BACKGROUND: Back pain is very common and a leading cause of disability worldwide. Due to health care system inequalities, Indigenous communities have a disproportionately higher prevalence of injury and acute and chronic diseases compared to the general Canadian population. Indigenous communities, particularly in northern Canada, have limited access to evidence-based spine care. Strategies established in collaboration with Indigenous peoples are needed to address unmet healthcare needs, including spine care (chiropractic and movement program) services. This study aimed to understand the views and perspectives of Cross Lake community leaders and clinicians working at Cross Lake Nursing Station (CLNS) in northern Manitoba regarding the implementation of the Global Spine Care Initiative (GSCI) model of spine care (MoC) and related implementation strategies. METHOD: A qualitative exploratory design using an interpretivist paradigm was used. Twenty community partners were invited to participate in semi-structured interviews underpinned by the Theoretical Domains Framework (TDF) adapted to capture pertinent information. Data were analyzed deductively and inductively, and the interpretation of findings were explored in consultation with community members and partners. RESULTS: Community leaders (n = 9) and physicians, nurses, and allied health workers (n = 11) emphasized: 1) the importance of contextualizing the MoC (triaging and care pathway) and proposed new services through in-person community engagement; 2) the need and desire for local non-pharmacological spine care approaches; and 3) streamlining patient triage and CLNS workflow. Recommendations for the streamlining included reducing managerial/administrative duties, educating new incoming clinicians, incorporating follow-up appointments for spine pain patients, and establishing an electronic medical record system along with a patient portal. Suggestions regarding how to sustain the new spine care services included providing transportation, protecting allocated clinic space, resolving insurance coverage discrepancies, addressing misconceptions about chiropractic care, instilling the value of physical activity for self-care and pain relief, and a short-term (30-day) incentivised movement program which considers a variety of movement options and offers a social component after each session. CONCLUSION: Community partners were favorable to the inclusion of a refined GSCI MoC. Adapting the TDF to unique Indigenous needs may help understand how best to implement the MoC in communities with similar needs.

Access to land and nature as health determinants: a qualitative analysis exploring meaningful human-nature relationships among Indigenous youth in central Canada.

BACKGROUND: Human relationships with and connections to nature and the "land" are a commonly accepted Social Determinant of Health. Greater knowledge about these relationships can inform public health policies and interventions focused on health equity among Indigenous populations. Two research questions were explored: (1) what are the experiences of meaningful human-nature relationships among Indigenous youth within central Canada; and (2) how do these relationships function as a determinant of health and wellness within their lives. METHODS: Drawing from three community-based participatory research (CBPR) projects within two urban centers in Saskatchewan and Manitoba, the integrated qualitative findings presented here involved 92 interviews with 52 Indigenous youth that occurred over a period of nine years (2014-2023). Informed by "two-eyed seeing," this analysis combined Indigenous Methodologies and a Constructivist Grounded Theory approach. RESULTS: Our integrative analysis revealed three cross-cutting themes about meaningful human-nature relationships: (1) promoting cultural belonging and positive identity; (2) connecting to community and family; and (3) supporting spiritual health and relationships. The experiences of young people also emphasized barriers to land and nature access within their local environments. DISCUSSION: Policies, practices, and interventions aimed at strengthening urban Indigenous young peoples' relationships to and connections with nature and the land can have a positive impact on their health and wellness. Public Health systems and healthcare providers can learn about leveraging the health benefits of human-nature relationships at individual and community levels, and this is particularly vital for those working to advance health equity among Indigenous populations.