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PubMed2006

Cervical cancer services for Indigenous women: advocacy, community-based research and policy change in Australia.

Collaborative research undertaken in the state of Queensland, Australia, resulted in major changes in cervical cancer screening and treatment for Indigenous women. Guided by an Indigenous statewide reference group and with an Indigenous researcher playing a lead role, qualitative data were collected using interviews, focus groups, larger community meetings; and case studies were conducted with health workers and community members from diverse rural, remote and urban communities, to explore the different cultural and structural factors affecting understanding and awareness of cervical cancer and Indigenous women's use of and access to health services for screening, diagnosis and treatment. These data were supplemented by an analysis of clinical data and health service checklists. We discuss the methodology and summarize the key social and structural factors that discourage women from presenting for screening or returning for follow-up. These include women's misunderstanding of cervical cancer screening, fear of cancer, and distrust of health services, poor recall and follow-up systems, and the economic and social burden to women to presenting for treatment. We describe how the research process and subsequent activities provided Indigenous women with a vehicle for their own advocacy, resulting in important policy and program changes.

Community Health Planning↗
PubMed2000

[Cervical cancer screening among indigenous women in the Xingu Indian Reservation, central Brazil].

Although the literature presents worrisome data regarding the incidence of cervical cancer among indigenous populations, in Brazil there is very little information regarding the occurrence of this type of cancer among indigenous peoples. Therefore, the objective of the present descriptive study was to assess the prevalence of cervical cancer and of cervical and vaginal infections among 423 indigenous women living in the Xingu Indian Reservation, in the state of Mato Grosso, Brazil. These women were or had been sexually active. Data were collected between 1989 and 1996. Clinical and gynecological examinations were carried out prior to the collection of cervical specimens and to the performance of cytologic analyses. Upon detection of abnormalities, a colposcopy and a biopsy were also performed. Our results show that 1% of the women studied presented invasive carcinoma and that 3% presented premalignant lesions. In addition, 84% presented inflammatory atypia, resulting from sexually transmitted genital infections. The present findings are in accordance with the results of other international reports regarding the high prevalence of cervical conditions among indigenous populations, and they underscore the need to extend to the indigenous peoples of Brazil programs aiming at the control of sexually transmitted diseases and at the early detection and treatment of cervical cancer.

Adolescent↗
PubMed1997

Gambling and problem gambling among indigenous peoples.

This paper compares results from studies of gambling and problem gambling among indigenous groups in New Zealand and in North Dakota. The samples for each of these studies included substantial numbers of indigenous respondents, and the methods used in these studies were similar enough to allow comparisons of Caucasian and indigenous groups from these two distinct cultures. Analysis shows that gambling involvement, gambling expenditures, and gambling-related problems are far higher among indigenous respondents than among Caucasian respondents in both New Zealand and North Dakota. These comparisons suggest that differences between indigenous peoples and Caucasians in gambling behaviors may be due to factors distinct from culture or milieu.

Adolescent↗
PubMed2001

Lactobacillus casei strain Shirota-fermented milk stimulates indigenous Lactobacilli in the pig intestine.

The aim of this study was to determine the effect of a probiotic, i.e. fermented milk prepared with Lactobacillus casei strain Shirota, on indigenous Lactobacilli in the pig large intestine. This fermented milk was given as a probiotic to experimental pigs for 2 weeks. The fecal organic acid concentration increased with the fermented milk; acetate and propionate increased significantly (p<0.05). At the same time, lactate and butyrate tended to increase. The fecal pH was significantly reduced by the fermented milk (p<0.05). Although the number of bacteria of strain Shirota in the intestinal contents was much smaller than those of indigenous Lactobacilli, 10(4) vs 10(8) (cfu/g), the numbers of indigenous Lactobacilli and Bifidobacteria in the pig intestine appeared to increase with the fermented milk. In addition, the phenotypic diversity (phenotypic group numbers) of indigenous Lactobacilli increased from 3 to 8 with the fermented milk supplementation. Thus the fermented milk affected the indigenous Lactobacillus population and constitution.

Animals↗
PubMed2004

Carrier status for Listeria monocytogenes and other Listeria species in free range farm and market healthy indigenous chickens and ducks.

BACKGROUND: Listeria organisms are documented to be zoonotic; one of the sources of infection is the domestic fowl where it could occur as in apparent infection. The carriage of Listeria monocytogenes and other Listeria in indigenous birds has not been documented in Kenya. OBJECTIVE: To establish whether healthy looking indigenous chickens and ducks could be carriers of Listeria monocytogenes and other Listeria species. DESIGN: Field survey of indigenous chickens and ducks in three districts of Kenya. SETTING: Embakasi and Dagoreti divisions in Nairobi district; Athi river division in Machakos district; and Ngong division in Kajiado district, in Kenya. SUBJECTS: One hundred and thirty six indigenous chickens and 39 ducks reared under free range scavenging system in Nairobi, Machakos and Kajiado districts, in Kenya, were sampled. METHODS: In surveying the birds, the cloacal and pharyngeal swabs were taken from each bird separately using sterile cotton--tipped applicator swabs. The swabs in saline were transported in a coolbox to the laboratory for bacterial isolation and characterization. INTERVENTIONS: None (only compared farmed and the traded birds). MAIN OUTCOME MEASURES: Isolation of Listeria species and pathogenicity of Listeria isolates. RESULTS: Two Listeria monocytogenes and seven other Listeria species were recovered from the oropharyngeal swab samples of farm and market chickens but none from respective cloacal swabs. No Listeria was recovered from either oropharyngeal or cloacal swabs of farmed duck and slaughter chickens. Traded chickens yielded more Listeria isolates as compared to farmed chickens. CONCLUSION: This study shows that indigenous chickens in Kenya are carriers of Listeria monocytogenes and other Listeria species.

Animals↗
PubMed2002

Voices from the margins Part 1: narrative accounts of indigenous family violence.

The needs of informal supporters of rural women surviving domestic violence from the supporter's perspective were explored through the use of storytelling. Eleven women were interviewed. Of those eleven, three informal supporters spoke about supporting Indigenous women in family violence. These three stories have been grouped as a separate cohort and are discussed in two papers. Of the women who told stories of supporting Aboriginal women, two were Indigenous and one was non Aboriginal, although her partner was Indigenous. It was clear from the stories told by these women that Indigenous family violence is situated in a context of a history and experience of colonisation and human rights abuses. Therefore, this article explores the context of Indigenous family violence and the second explores the strategies for strengthening support for Aboriginal families experiencing violence.

Adult↗
PubMed1999

Plasma homocysteine levels in indigenous Australians.

OBJECTIVES: To determine plasma homocysteine levels in indigenous Australians living in urban areas, and the relationship of these levels with other risk factors in this population. DESIGN: Cross-sectional study. SUBJECTS AND SETTING: 365 urban indigenous Australian subjects, 153 men and 212 women, mean (SE) age 42 (1) years, ascertained without regard to history of atherosclerotic disease, in collaboration with community-based health centres in five indigenous communities in south-east Queensland, 1997-1998. MAIN OUTCOME MEASURES: Plasma homocysteine levels, age, sex, smoking history, metformin therapy, history of atherosclerotic vascular disease, serum creatinine level, red cell folate and serum vitamin B12 levels. RESULTS: 89 subjects (24%) had plasma homocysteine levels 15 mumol/L or above. Homocysteine levels were higher in men than in women (men: 14.4 mumol/L; 95% confidence interval [CI], 13.6-15.2; women: 11.9 mumol/L; 95% CI, 11.4-12.5) (P < 0.001); correlated with age (P < 0.001); higher in current smokers (P = 0.02); higher in subjects taking metformin therapy (P = 0.007); and higher in subjects with a history of atherosclerotic vascular disease (P < 0.001). Homocysteine levels were also correlated with serum levels of creatinine (P < 0.001), red cell folate (P < 0.001), and vitamin B12 (P < 0.001). CONCLUSIONS: These data indicate that the high plasma levels of homocysteine of Australian indigenous subjects are associated with a history of vascular disease, and correlated with, among other things, smoking, and folate and vitamin B12 nutritional deficiency. These are potentially reversible risk factors, and our data suggest that focusing public health initiatives on these issues may reduce the high prevalence of cardiovascular disease in the Australian indigenous population.

Adult↗
PubMed2003

Issues in palliative care for Indigenous communities.

All Indigenous communities in Australia have a common heritage of loss. Indigenous death rates are much higher than those for white Australians. Indigenous people use healthcare services reluctantly, and palliative care services rarely. Cultural considerations that need to be respected include Indigenous understandings of disease causation, attributions of blame for sickness, the performance of ceremonies after death and the importance of dying on traditional lands. The involvement of Indigenous health workers in clinical care increases confidence in the healthcare system as a whole.

Attitude to Death↗
PubMed1999

The road to indigenous extinction: case study of resource exportation, disease importation, and human rights violations against the Urarina in the Peruvian Amazon.

Isolated Amazonian peoples such as the Urarina in Peru remain at risk of cultural and biological extinction from industrial exploitation and imported diseases. In the last seven years, many Urarina have died in epidemics of measles, cholera, pertussis, and malaria. The Peruvian government has encouraged oil exploration and logging in the Amazon without regard to Urarina rights, and the international treaty promoting indigenous rights that Peru ratified is not enforced. There are, however, two promising developments for indigenous survival. The first is the growing realization of biologists, ecologists, sociologists, and conservationists that conservation of biodiversity and global environmental protection are interconnected with indigenous rights. Secondly, the two declarations on the rights of indigenous peoples proposed by the Organization of American States and the United Nations are more specifically protective of indigenous rights than previous manifestos have been.

Communicable Diseases↗
PubMed2000

[Haplotypes of two diallelic Y chromosome loci in the indigenous and migrant populations of Siberia].

Two diallelic Y-chromosome markers, the Y Alu polymorphism (YAP) and the T-C transition (Tat), were analyzed in the indigenous (Tuvinian, Buryat, Northern Altaic, and Tatar) and migrant (Slavic) populations of Siberia. A high frequency of the allele C was revealed in several indigenous populations (25-55%) and in Russians (20.8%). The YAP+ allele occurred at a surprisingly high frequency (31.4%) and was completely linked with the C allele in Buryats. The YAP+ chromosome was also found in the Tuvinian population (1.5%). The two diallelic loci showed a marked linkage disequilibrium (D = 92.4%) in the total sample. The YAP-/T and YAP-/C haplotypes prevailed in both indigenous and migrant populations: their respective frequencies were 80.4 and 19.6% in the Slavic population and 71.8 and 19.9%, respectively, in the indigenous one. The YAP+/C (7.8%) and YAP+/T (0.5%) haplotypes were found only in the indigenous population. An appreciable heterogeneity in haplotype frequency distribution between regional subpopulations was revealed in Russians, Tuvinians, and Buryats. The origin and evolution of Y-chromosome lines in Northern Asia are considered.

Alleles↗
PubMed2002

End-stage renal disease in indigenous Australians: a disease of disadvantage.

OBJECTIVE: To determine the relation between area level indicators of socioeconomic disadvantage and the regional incidence of end-stage renal disease (ESRD) in indigenous Australians. DESIGN: Ecological study. SETTING: The 36 Aboriginal and Torres Strait Islander Commission regions of Australia. MAIN OUTCOME MEASURES: The relation between area-based measures of disadvantage and the standardized incidence of ESRD for 36 Australian regions was examined using non-parametric tests of correlation. RESULTS: Area-based measures of disadvantage showed a significant association with regional incidence of ESRD in indigenous Australians. (Early school leavers r = 0.68, P < .001, unemployment rate r = 0.72, P < .001, median household income r = -0.71, P < .001, number of persons per bedroom r = 0.84, P < .001, and low birthweight r = .49, P = .003). If it were possible to improve the health of all indigenous Australians to the level of that of the general Australian population, 87% of cases of ESRD could be avoided. CONCLUSIONS: Socioeconomic factors appear to be strongly associated with rates of ESRD among indigenous Australians. Therefore, reducing the burden of renal disease in indigenous Australians is likely to require interventions addressing socioeconomic disadvantage in conjunction with biomedical interventions.

Aged↗
PubMedDate not supplied

'Sometimes they run away, that's how scared they feel': the peadiatric hospitalisation experiences of Indigenous families from remote areas of Australia.

Hospitalisation can be a traumatic experience for any child and family but the experience can be significantly more so for Indigenous parents and children from remote areas of Australia. Despite the importance of this issue for child and family health and for Indigenous health, the hospitalisation experiences of Indigenous families and children have received almost no research attention. This paper describes selected findings from a recently completed Honours research study which used the participatory and collaborative Indigenous research approach of Dadirri to explore this question. Following a brief description of the methodology of Dadirri, the paper presents the participating families' depictions of their experiences of 'Coming Down' and 'Being in Hospital', where they revealed the extent and effects of marked culture shock. The significant cultural differences between staff and Indigenous families contributed to the parents' sense of fear, powerlessness and isolation from their child, home community and culture. For these families this isolation was not merely geographic but intricately linked to their health and wellbeing.

Adaptation, Psychological↗
PubMed2005

Prevalence of Helicobacter pylori in Indigenous Western Australians: comparison between urban and remote rural populations.

OBJECTIVES: To determine and compare the prevalence of Helicobacter pylori in an urban and a remote rural Western Australian Indigenous community. DESIGN: Cross-sectional study of Helicobacter pylori status determined by urea breath tests between mid-January 2003 and the end of June 2004. PARTICIPANTS: 520 self-selected fasting participants, comprising 270 members of the Martu community at Jigalong, Punmu and Parnngurr in the East Pilbara region (129 men, 141 women; age range, 2-90 years) and 250 people from the Perth Indigenous community (96 men, 154 women; age range, 3-75 years. RESULTS: The overall prevalence of H. pylori was 76%, but the prevalence in the remote rural community was 91%, compared with 60% in the urban community. The odds of having H. pylori were six times greater for rural than for urban participants (odds ratio [OR], 6.34; 95% CI, 3.89-10.33). Further, the overall odds of H. pylori infection in males (rural and urban combined) were greater than for females (OR, 1.61; 95% CI, 1.02-2.54). In both communities, the prevalence of infection remained relatively constant after the age of 10. CONCLUSIONS: The prevalence of H. pylori in the two Indigenous communities was two to three times higher than that in the non-Indigenous Australian population and higher than that shown in previous studies in Indigenous Australians.

Adolescent↗
PubMed2005

Media influences on body image and disordered eating among indigenous adolescent Australians.

There has been no previous investigation of body image concerns and body change strategies among indigenous Australians. This study was designed to investigate the level of body satisfaction, body change strategies, and perceived media messages about body change strategies among 50 indigenous (25 males, 25 females) and 50 non-indigenous (25 males, 25 females) Australian adolescents (mean age 14.05, SD = 1.05). Consistent with past studies, girls were more likely to be dissatisfied with their weight and engage in strategies to lose weight. However, contrary to expectations, indigenous adolescents engaged in more strategies to lose weight, increase weight, and increase muscles than did non-indigenous adolescents, despite perceiving fewer media messages about losing weight. Additional factors that may explain the findings and the need for further research with different cultural groups are highlighted.

Adolescent↗
PubMed2003

Compliance, culture, and the health of Indigenous people.

From the medical literature of the 70's to recent research, compliance has been named as an issue in the management of chronic disease, particularly in Indigenous contexts. Compliance can also be thought of as a universal problem that has different names in different contexts. In this paper compliance is described as a measure, with a numerator and a denominator, and progress towards better compliance is discussed in terms of manipulation of each element. The numerator is adherence, which has proven resistant to significant improvement, and the denominator is the advice and treatment, based on Western scientific medicine. Reduced to its most elemental terms, compliance compares the beliefs of patients with those of Western medicine. Proposed solutions to improve compliance have included moving to 'concordance' by reaching shared understanding of treatment goals, or forgetting compliance altogether and concentrating on institutional and organisational change to better align services with expectations of the population of interest. Indigenous Australian health care has been particularly beset with treatment failure as a result of 'poor compliance'. This paper suggests that compliance per se is not the problem. Rather, the extent to which it is apparent is a measure of dissonance between the belief systems. This gap between the culture of Western medicine and Indigenous culture should not be narrowed by the extinction of Indigenous belief, but by the development of a shared knowledge which includes Indigenous health beliefs and practices.

Journal Article↗
PubMedDate not supplied

[Relationships between the probiotic and host indigenous lactobacilli under the conditions of mixed cultivation in vitro].

Relationships between 5 Lactobacillus manufacturing strains, 458 cultures of indigenous lactobacilli isolated from the human digestive and vaginal tracts and 98 isolates from the feces of white rats and mice were under study. The study demonstrated that under the conditions of mixed in vitro cultivation of paired cultures, probiotic strains inhibited more than 60% of the indigenous lactobacilli isolates. L. acidophilus strain K3 III 24 had the widest spectrum of antagonistic activity. Antagonistic relationships between indigenous lactobacilli depended on the origin, individual features and the anatomical sites of the culture isolation. Based on these results it has to be suggested that probiotic lactobacilli are capable of inducing disbalance in the host indigenous lactoflora. While choosing probiotics the character of relationships between probiotic microorganisms and the indigenous lactobacilli of the future recipient is recommended to be preliminarily tested in vitro.

Animals↗
PubMed2002

Indigenous suicide in Australia, New Zealand, Canada, and the United States.

This paper reviews literature on self-harm and suicide among Indigenous populations in four nations with histories of British colonization, with a more detailed exploration of patterns and primary care considerations in Australian Aboriginal and Torres Strait Islander populations. Issues of definition, under-reporting, lack of reporting, varying coronial practices and the influence of race on investigative procedures make comparisons of suicide rates among indigenous populations problematic. However, international interpretations highlight the impact of the breakdown of cultural structures and historical processes associated with colonization. Recent studies suggest that the predisposition to suicide by vulnerable young people is influenced not only by absolute living standards but also how they view their circumstances relative to those around them. The complexity of associations with mental disorder, alcohol use and 'meaning' in an indigenous context are considered. Responses in terms of prevention and treatment are presented, highlighting the importance of hospital-based practitioners as the likely first point of contact. The article concludes by outlining considerations in the primary care management of indigenous self-harm.

Adolescent↗
PubMed1979

Psychotherapy in the goldfish bowl: the role of the indigenous therapist.

The therapeutic advantages and liabilities that accrue to the indigenous therapist (be he professional or paraprofessional) because of the indigenous state were explored, utilizing the five-year experience of ten indigenous therapists in Boston's North End. The current and historical proximity of therapists who live in the same neighborhood as their patients do provides both with increased access to, longitudinal knowledge about, and a blurred role concept of the other that may help or hinder the therapeutic process. Similarities in culture and values can foster alliance formation, differentiation of psychopathology, and therapeutic interventions, but also may interfere when therapy abuts culturally shared blind spots. These data are relevant to the private general psychiatrist as an indigenous therapist in non-metropolitan America.

Allied Health Personnel↗