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PubMed1997

Effect of radiotherapy on the levels of secretory immunoglobulin A against indigenous and virulent streptococci.

It is well known that the frequency of upper respiratory infection is clinically increased after radiotherapy of the head and neck region. This study found higher antibacterial secretory immunoglobulin A (S-IgA) activity against three indigenous streptococci (Streptococcus mitis, S. salivarius, and S. sanguis I) and S. pneumoniae in patients who had undergone radiation therapy of the head and neck region than in control subjects. This showed no relation to the extent of the radiation field. Compared with before radiotherapy, the S-IgA titer against S. pneumoniae and its ratio to the activities against the indigenous streptococci were significantly higher in patients with fully irradiated major salivary glands. These results indicated that the radiotherapy promoted the antigen-specific S-IgA production of virulent streptococci in most patients with head and neck cancer, even more than 6 months after radiotherapy. The resulting altered balance in the S-IgA system of normal indigenous streptococci may also impair the ability to maintain the stable bacterial interference between normal indigenous and virulent streptococci in the oropharyngeal cavity.

Aged↗
PubMed2003

Assessment of the diagnosis and prevalence of asthma in Australian indigenous children.

BACKGROUND AND OBJECTIVE: Although the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire has been used in many countries and has been validated previously, it has not been used in Australian Indigenous communities. We endeavoured to assess its performance when administered in Aboriginal and Torres Strait Islander communities. METHODS: In a cross-sectional study, we assessed the ISAAC's questionnaire when administered face-to-face in Indigenous communities in the Torres Strait region, Australia. RESULTS: Comparing responses to the questionnaire with clinical assessment of 260 Indigenous children by a pediatric respiratory physician, sensitivity (87%) was high, but specificity (51%) and positive predictive value (33%) were low. Using a logistic regression model, we determined which questions were most useful in predicting a clinical diagnosis of asthma. Using a predictive equation, asthma was detected with 79% sensitivity and 77% specificity, and the calculated weighted estimate of asthma prevalence in the region was 16.3%. CONCLUSION: Our findings reveal that although the ISAAC questionnaire is a reasonably sensitive tool for both epidemiologic and clinical studies of asthma in Indigenous communities, its value is enhanced when used in conjunction with a predictive model. We have also shown that asthma is prevalent in the Torres Strait region.

Adolescent↗
PubMed2001

Assessing community health among indigenous populations in Ecuador with a participatory approach: implications for health reform.

Health reform is an important movement in countries throughout the region of the Americas, which could profoundly influence how basic health services are provided and who receives them. Goals of health sector reform include to improve quality, correct inefficiencies, and reduce inequities in current systems. The latter may be especially important in countries with indigenous populations, which are thought to suffer from excess mortality and morbidity related to poverty. The purpose of this paper is to report the results of a community health assessment conducted in 26 indigenous communities in the Province of Cotopaxi in rural Ecuador. It is hoped that this information will inform the health reform movement by adding to the current understanding of the health and socioeconomic situation of indigenous populations in the region while emphasizing a participatory approach toward understanding the social forces impacting upon health. This approach may serve as a model for empowering people through collective action. Recommended health reform strategies include: 1) Develop a comprehensive plan for health improvement in conjunction with stakeholders in the general population, including representatives of minority groups; 2) Conduct research on the appropriate mix between traditional medicine, primary health care strategies, and high technology medical services in relation to the needs of the general population; 3) Train local health personnel and traditional healers in primary health care techniques; 4) Improve access to secondary and tertiary health services for indigenous populations in times of emergency; and 5) Advocate for intersectoral collaboration among government institutions as well as non-governmental organizations and the private sector.

Community Health Planning↗
PubMed2002

Are indigenous personality dimensions culture specific? Philippine inventories and the five-factor model.

The authors addressed the culture specificity of indigenous personality constructs, the generalizability of the 5-factor model (FFM), and the incremental validity of indigenous measures in a collectivistic culture. Filipino college students (N = 508) completed 3 indigenous inventories and the Filipino version of the Revised NEO Personality Inventory (NEO-PI-R). On the basis of the factor and regression analyses, they concluded that (a) most Philippine dimensions are well encompassed by the FFM and thus may not be very culture specific: (b) a few indigenous constructs are less well accounted for by the FFM: these constructs are not unknown in Western cultures, but they may be particularly salient or composed somewhat differently in the Philippines; (c) the structure of the NEO-PI-R FFM replicates well in the Philippines: and (d) Philippine inventories add modest incremental validity beyond the FFM in predicting selected culture-relevant criteria.

Adolescent↗
PubMed1999

Abdominal obesity reduction in indigenous men.

OBJECTIVES: To assess the effectiveness of a men's 'waist loss' program over one year in Indigenous men. DESIGN: Pre-and post-test measurements of 47 Indigenous men on four island groups in the Torres Strait region of Northern Australia involved in a version of the 'GutBuster' program, modified by and for Indigenous men. RESULTS: Weight, waist and hip size of 47 men, and body fat estimated from electrical impedence measures of 27 men, were compared at baseline, after approx 2 months, approx 6 months and approx one year. Average weight loss was 3.3 kg (3.5%), and waist loss 4.0 cm (3.5%). The average percentage decrease in fat mass (FM) was 10.8%. An environmental audit technique highlighted modifications needed to the environment to assist behaviour change. CONCLUSIONS: Education-behaviour change interventions of this kind may offer opportunities for health improvements in Indigenous men.

Abdomen↗
PubMed2000

Prevalence of hypertension in indigenous inhabitants of traditional communities from the north of Mexico.

The purpose of this study was to estimate the prevalence and risk factors of hypertension in adults indigenous to their traditional communities from the north of Mexico. The study was based on a cross- sectional survey of inhabitants from Mexicaneros, Huicholes and Tepehuanos communities, which have not been influenced by a western lifestyle. A home interview and clinical examination that included blood pressure and anthropometric measurements of 217 men and 598 non-pregnant women aged between 35 to 64 years was carried out. Eligible indigenous subjects must have had no migratory history to partially or totally urbanised areas. Target population represented approximately 100% of the indigenous people who have spent all their life time in the community of birthplace. Age and body mass index average was 48.9+/-12.9 years and 25.6+/-5.1 kg/m2. Hypertension was identified in 56 individuals, 45 women and 11 men (prevalence 6.87%, 95% confidence interval (CI) 5.1-8.6). Forty-one percent of the hypertensive subjects were aware of being hypertensive. Hypertensive subjects had a higher intake of saturated fats than non-hypertensives. Salt consumption was lower than 6 g per day in subjects with and without hypertension. High intake of saturated fats (odds ratio 6.4, 95% CI 2.1-12.3; P<0.01) was an independent predictor for hypertension. This study presents, for the first time, data concerning hypertension in adults who are indigenous to and living in traditional communities from Mexico. Prevalence of hypertension was lower than in the partly urbanised rural communities with a westernised lifestyle and the urban areas of Mexico.

Adult↗
PubMed2002

Developing strategies to gather information about the maternity experiences of indigenous women in an acute care setting.

This project emerged from the concerns of health care professionals at a large acute care hospital in the Northern Territory of Australia. The aim of the project was to develop educational resources through information and experiences provided by Aboriginal and Torres Strait Islander women and health care professionals. The objectives are to optimise collaboration and participation by Indigenous and Torres Strait Islander women in sharing their maternity experiences about the birthing of their baby either in hospital, or out of hospital before arrival. Stage one of a three stage project is reported here. In stage one a modified Delphi method was used to interview ten purposefully chosen professional Indigenous women with insight into the research process and changing social arrangements. Stage two involved the development of an interview schedule and face-to-face interviews. Stage three includes the development of a questionnaire to be answered by health care professionals. Discussion of the background to the study, reviewed literature and issues identified from interviews with the professional Indigenous women regarding best methods and appropriate data collection processes is presented. Research described here explores issues of concern for Indigenous women from the Northern Territory around their child birthing experiences in an acute care setting.

Acute Disease↗
PubMed2002

The maternity experiences of indigenous women admitted to an acute care setting.

This is the report of stage two of a three-stage project. The aim of the project is to develop educational resources through information and experiences provided by Aboriginal and Torres Strait Islander women and health care professionals. The objectives were to optimise collaboration and participation by Indigenous and Torres Strait Islander women in sharing their maternity experiences about the birthing of their babies either in hospital, or out of hospital before arrival. The descriptive research of stage two explores issues that existed for twelve Indigenous women during and after their birthing experiences in an acute care setting. The results will inform patient and professional educational programs and policy in order to enhance the experiences for Indigenous women admitted to the acute care setting before or following birth. The results show broad variation in responses related to antenatal care, preparation for hospital and for birth, coming into town, accommodation, family support, experiences while in hospital, relationship with hospital staff and being away from home. Miscommunication and lack of cultural and spiritual understanding by health care professionals generally is a constant theme. The need for preparation of Indigenous women generally, prior to admission to an acute care setting, is confirmed.

Acute Disease↗
PubMed2002

Evaluation of a New Zealand indigenous community injury prevention project.

OBJECTIVE: To evaluate the Turanganui-a-kiwa Community Injury Prevention Project, based in a provincial town on the North Island of New Zealand with an extensive indigenous population (Maori). METHOD: The evaluation design was quasi-experimental and included process, impact and outcome measures. RESULTS: Process evaluation findings indicated that adopting an holistic lifespan approach to injury prevention was successful in this Maori community. The three main areas of activities were: child road safety; safer alcohol use in the road, sporting and home environments for young people and adults; and fire safety for older people. Significant increases in awareness of injury prevention initiatives were found among Turanganui-a-kiwa whanau (families) (p < 0.001). A large increase in the take-up of car restraints among Maori young children was demonstrated (pre 10%, post 74%). The safe alcohol dual message approach also resulted in significant increases in the number of respondents wearing protective equipment for sports (p < 0.05). The results of the fire safety initiative was that 120 kaumatua homes now have correctly installed smoke alarms and there is now a commitment from the Fire Service to maintain these alarms. Outcome evaluation findings showed that there was a significant decrease in hospitalization injury rates across the lifespan in Turanganui-a-kiwa (p < 0.05). CONCLUSION: Despite the challenges associated with conducting community injury prevention projects the conduct of this evaluation provides previously unknown information on an indigenous (Maori) injury prevention programme. The success of the programme would appear to be that the project was perceived as an intervention for Maori operating within a Maori framework which addressed Maori aspirations. IMPLICATIONS: As so little is known about injury prevention initiatives in indigenous populations, the findings presented in this article will provide important information for the future development of other indigenous injury prevention programmes.

Accident Prevention↗
PubMedDate not supplied

The haematology of indigenous Australians.

Prior to European settlement indigenous Australians were hunter-gatherers who lived in geographically isolated small clan groups, also separated by elaborate totemic rules. Today they still reside in isolated communities throughout Australia but many have moved to the cities. They share a high incidence of a range of health problems including cardiovascular disease, renal disease and infectious diseases largely attributed to a change to a more sedentary lifestyle. This paper reviews the haematology of indigenous Australians, including blood count, frequency and causes of anaemia, inherited risk factors for thrombophilia, blood groups and the incidence and types of haematological malignancies. There are some significant genetic differences between indigenous and non-indigenous Australians particularly in the frequency of blood groups, factor V Leiden and prothrombin mutations and presence of -alpha3.7 kb thalassaemia. These findings may have practical therapeutic implications (e.g. HPA phenotype for transfusion therapy and pregnancy risk) and in predicting disease risk. Other differences are acquired, related to lifestyle and living conditions (e.g. eosinophilia secondary to parasitic infections; iron and folate deficiencies), and are largely preventable.

Australia↗
PubMed2001

A genomewide search for type 2 diabetes-susceptibility genes in indigenous Australians.

The prevalence of type 2 diabetes among Australian residents is 7.5%; however, prevalence rates up to six times higher have been reported for indigenous Australian communities. Epidemiological evidence implicates genetic factors in the susceptibility of indigenous Australians to type 2 diabetes and supports the hypothesis of the "thrifty genotype," but, to date, the nature of the genetic predisposition is unknown. We have ascertained clinical details from a community of indigenous Australian descent in North Stradbroke Island, Queensland. In this population, the phenotype is characterized by severe insulin resistance. We have conducted a genomewide scan, at an average resolution of 10 cM, for type 2 diabetes-susceptibility genes in a large multigeneration pedigree from this community. Parametric linkage analysis undertaken using FASTLINK version 4.1p yielded a maximum two-point LOD score of +2.97 at marker D2S2345. Multipoint analysis yielded a peak LOD score of +3.9 <1 cM from marker D2S2345, with an 18-cM 3-LOD support interval. Secondary peak LOD scores were noted on chromosome 3 (+1.8 at recombination fraction [theta] 0.05, at marker D3S1311) and chromosome 8 (+1.77 at theta=0.0, at marker D8S549). These chromosomal regions are likely to harbor novel susceptibility genes for type 2 diabetes in the indigenous Australian population.

Australia↗
PubMedDate not supplied

Climacteric symptoms among indigenous Australian women and a model for the use of culturally relevant art in health promotion.

OBJECTIVE: To evaluate climacteric symptoms among rural and remote, indigenous Australian women and to develop culturally relevant women's health midlife educational material. DESIGN: A cross-sectional pilot survey based on structured interviews of women older than 18 years of age who were available for interview and willing to participate. The study was conducted in the Kimberley region of Western Australia and southwestern Victoria between February and June 1999. Health issues central to the local community were identified by the structured survey. Development of culturally relevant information involved collaboration between indigenous women and indigenous artists, health workers, educators, and ourselves. Traditional health themes in art form were then linked with specific health issues to be addressed. Health messages were translated by Aboriginal women and health workers into both traditional language and vernacular, to target all women. RESULTS: Fifty-five women completed the survey. Thirty-eight were premenopausal, 4 were perimenopausal, and 13 were postmenopausal. The 4 perimenopausal women and 9 of the 13 postmenopausal women had climacteric symptoms, but none had been prescribed systemic or local hormonal therapy. Rates of obesity, diabetes mellitus, and hypertension were high. Midlife women's health booklets were produced in collaboration with Aboriginal elders and artists to communicate preventive health information in a visual context familiar to Aboriginal people of the Kimberley and surrounding communities. CONCLUSIONS: In contrast to the case in other non-Caucasian populations, climacteric symptoms seem to be common among Australian indigenous women and are apparently untreated. Aboriginal art and language has been employed in the development of culturally appropriate health promotion literature for Aboriginal communities in the Kimberley region of Western Australia. This process of collaboration provides a useful model for addressing women's health issues in other culturally diverse populations.

Adult↗
PubMed2002

Social capital from carbon property: creating equity for indigenous people.

New incentives for protection and in situ use of forests and the services they provide raise hopes for the reversal of tropical and temperate deforestation. Past management of forests appropriated the rights of forest communities, providing incentives to convert natural forest into financial capital through logging, while destroying the underlying physical property. Carbon trading aims to provide a means to convert the forest property into financial capital, while protecting the physical property of forests, thereby providing new incentives for in situ forest management. The potential for carbon-emission trading as a contributor to these new incentives is tempered by concerns that it is another tool for capitalists to exploit the indigenous communities of the developing world. Estimates of annual emission trading amounting to US $200 billion raise alarm bells about the effect of such trade in the developing world. People are right to be concerned, as the history of exploitation of indigenous people, the appropriation of their rights, the loss of forests and their benefits is well documented. This exploitation resulted in the exclusion of forest communities from the basic tenets for development created by the wealth generated by traded property. However, one virtue of trade is that it can be made subject to constraints. Through international treaties and agreements, trade can be constrained and national governments obliged to observe the rules of trade. The value of tradable carbon credits will be discounted or invalid if they do not meet these criteria, providing all parties with strong incentives to achieve the necessary performance standards relating to both processes and contracts. For carbon trading to develop social capital from natural capital requires the admission of forest communities into the polity and management of forest resources. In this paper we argue for responsible carbon-emission trading based on the clear and appropriate definition of carbon entitlements, with the proviso that trading respects the rights and needs of indigenous people. We adopt this position as emissions trading now seems inevitable and there should be proper rules to control this trade where it affects forests and their inhabitants. It is imperative that the poor and indigenous people are not excluded from these systems. Trading systems and the property systems they depend on need to be more accountable, transparent and inclusive of those features which we propose.

Capitalism↗
PubMed2004

The role of indigenous yeasts in traditional Irish cider fermentations.

AIMS: To study the role of the indigenous yeast flora in traditional Irish cider fermentations. METHODS AND RESULTS: Wallerstein laboratory nutrient agar supplemented with biotin, ferric ammonium citrate, calcium carbonate and ethanol was employed together with PCR-restriction fragment length polymorphism analysis of the region spanning the internal transcribed spacers (ITS1 and ITS2) and the 5.8S rRNA gene in the identification of indigenous yeasts at the species level, from traditional Irish cider fermentations. By combining the molecular approach and the presumptive media it was possible to distinguish between a large number of yeast species, and to track them within cider fermentations. The Irish cider fermentation process can be divided into three sequential phases based on the predominant yeast type present. Kloeckera/Hanseniaspora uvarum type yeasts predominate in the initial 'fruit yeast phase'. Thereafter Saccharomyces cerevisiae type yeast dominate in the 'fermentation phase', where the alcoholic fermentation takes place. Finally the 'maturation phase' which follows, is dominated by Dekkera and Brettanomyces type yeasts. H. uvarum type yeast were found to have originated from the fruit. Brettanomyces type yeast could be traced back to the press house, and also to the fruit. The press house was identified as having high levels of S. cerevisiae type yeast. A strong link was noted between the temperature profile of the cider fermentations, which ranged from 22 to 35 degrees C and the yeast strain population dynamics. CONCLUSIONS: Many different indigenous yeast species were identified. The mycology of Irish cider fermentations appears to be very similar to that which has previously been reported in the wine industry. SIGNIFICANCE AND IMPACT OF THE STUDY: This study has allowed us to gain a better understanding of the role of indigenous yeast species in 'Natural' Irish cider fermentations.

Alcoholic Beverages↗
PubMed2005

Relationship between physiochemical properties, aggregation and u.v. inactivation of isolated indigenous spores in water.

AIMS: The objective of the study was to compare ultraviolet (u.v.) inactivation kinetics of indigenous aerobic spores in surface water with their laboratory-cultured spore isolates and to investigate the relationship between physicochemical characteristics and u.v. inactivation kinetics of spore isolates. METHODS AND RESULTS: Lake water samples were analysed for the presence of indigenous aerobic spores. Different bacterial isolates from the heterogeneous indigenous population were genetically characterized, resporulated and examined for hydrophobicity, surface charge, particle size distribution and survival at different u.v. 254 nm fluence levels. Cultured isolated spores exhibited a three-stage inactivation curve consisting of shoulder, first order and tailing regions whereas indigenous spores exhibited only one stage of linear kinetics. Hydrophobicity of the Bacillus spore isolates was inversely related to the extent of u.v. inactivation before tailing occurred. CONCLUSIONS: Tailing in the u.v. inactivation curves results from aggregation of a portion of the spore population because of hydrophobic interactions, supporting the link between aggregation of spores, hydrophobicity and u.v. inactivation. SIGNIFICANCE AND IMPACT OF THE STUDY: Evidence of the link between spore physicochemical parameters and u.v. disinfection performance furthers the understanding of factors that affect inactivation of microbes in natural waters supplied to drinking water treatment plants.

Bacillus↗
PubMed2004

Barriers to access by Indigenous Australians to kidney transplantation: the IMPAKT study.

Although Indigenous Australians represent less than 2% of the national population, they account for 8-10% of new patients commencing treatment for end-stage renal disease (ESRD). Almost half come from remote regions lacking renal disease treatment services. In those regions, their incidence of ESRD is up to 30 times the incidence for all Australians. Kidney transplantation is the optimal treatment for ESRD. Compared with long-term dialysis, it results in better quality of life, longer life expectancy and lower costs of health care. Indigenous Australians with ESRD receive transplants at approximately one-third the rate of non-Indigenous patients. There are similar disparities in access to kidney transplants for Native Americans, Aboriginal Canadians and New Zealander Maori. The reasons for such disparities have not been studied in any detail. IMPAKT (Improving Patient Access to Kidney Transplantation) is an NHMRC-funded study, involving eight major renal units. It aims to identify the reasons for Indigenous Australians' poor access to transplantation. It will systematically examine each of the steps a new dialysis patient must negotiate in order to receive a transplant. Each of these steps can become a barrier.

Australia↗
PubMed2006

Optic nerve head parameters of an indigenous population living within Central Australia.

PURPOSE: Clinical examination of the optic disc is an essential element in the assessment of its health. Previous work has described normal optic disc appearance among different races. No such description of optic discs exists for indigenous Australians, who are at low risk of developing glaucoma. This study was designed to evaluate optic disc parameters of indigenous Australians. METHODS: A sample of 208 indigenous Australians were recruited as they presented to remote clinics in Central Australia. Each subject underwent optic disc photography using a Topcon TRC-NW100 digital fundus camera. Optic discs were measured and analysed with Topcon ImageNet 2000 software. RESULTS: Among other parameters, mean vertical disc diameter and disc area were 2.13 +/- 0.21 mm (mean +/- SD) and 3.13 +/- 0.57 mm2, respectively, for right eyes and 2.14 +/- 0.21 mm and 3.16 +/- 0.58 mm2 for left eyes. When compared with published studies, these parameters were significantly larger than Caucasians, but similar to African individuals. CONCLUSION: Our results suggest that indigenous Australians have optic discs that are larger than those of Caucasians, but similar to those of Africans who are considered to at a greater risk of glaucoma. Factors other than optic disc area are likely to underlie the higher prevalence of primary open angle glaucoma among African individuals.

Female↗
PubMed2005

Colorectal carcinoma among Indigenous people: a public hospital-based study in Townsville and Cairns, North Queensland, Australia.

INTRODUCTION: There are very little clinical and pathological data on colorectal cancer among Indigenous people in Australia. METHODS: A retrospective study on Indigenous patients treated for colorectal cancer at the Townsville and Cairns Base Hospitals from 1999 to 2004 was carried out in order to better characterise this disease in the Indigenous population. RESULTS: There were 25 patients (12 M, 13 F) with a median age of 57.3 years. The majority (56%) of the tumours were left-sided, being in the sigmoid colon, rectosigmoid junction and rectum. Of the patients, 60% had American Joint Committee on Cancer (AJCC) staging system Stage I and II disease at presentation. There was a relatively high proportion of poorly differentiated adenocarcinomas (40%). Six patients died of the disease. The median follow-up was 20.5 months (range 2-51). CONCLUSIONS: Comparisons were made with available data on colorectal cancer in the general Australian population. The limitations and deficiencies of the study, as well as problems of data collection on Indigenous people were discussed.

Adult↗