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PubMedDate not supplied

Potential factors that may affect acceptance of routine prenatal HIV testing.

BACKGROUND: Despite increasing advocacy for an "opt-out" strategy in routine prenatal HIV screening programs in Canada, no published studies have examined factors that may affect acceptance of prenatal HIV testing. METHODS: We included all pregnant women in Alberta who received prenatal care (N = 38,712) and their caregivers (N = 2,007) between January 1 and November 30, 2000. Factors associated with non-acceptance of HIV testing in both pregnant women and their caregivers were assessed using multivariate logistic regression. RESULTS: Overall, 1.5% of women declined HIV testing. First Nations women were about twice as likely to decline the test (adjusted odds ratio [OR(adj)] 1.91, 95% CI [1.42-2.58]) compared to non-First Nations women (p < 0.001). The proportion also increased with age (chi2 trend p < 0.001) in the general population. In First Nations women, however, most (3.2%) declined in the 20-24 year age group. No significant effect was seen for a socio-economic status marker or for the place of residence. The caregivers of women who declined HIV testing were more likely to be female (OR(adj) 1.56 [1.28-1.89]), midwives (OR(adj) 140.65 [58.61-337.49]), other non-obstetrical medical specialties (OR(adj) 4.92 [1.94-12.47]), and general practitioners (OR(adj) 3.44 [1.87-6.33]). CONCLUSION: In an "opt-out" routine prenatal HIV screening program, the characteristics of both the pregnant women and their caregivers may contribute to the non-acceptance of HIV testing. A higher likelihood of declining HIV testing among First Nations pregnant women and other pregnant women under the care of midwives and female physicians warrants further study.

AIDS Serodiagnosis↗
PubMed2005

Use of traditional Mi'kmaq medicine among patients at a First Nations community health centre.

INTRODUCTION: The provision of complete, effective, and culturally sensitive health care to First Nations communities requires a familiarity with and respect for patients' healing beliefs and practices. PURPOSE: This study addresses one aspect of cross-cultural care by attempting to understand the use of Mi'kmaq medicine among patients at a community health centre and their attitudes toward both Mi'kmaq and Western medicine. METHODS: A questionnaire was completed by 100 patients (14 men, 86 women) at the clinic. The majority (66%) of respondents had used Mi'kmaq medicine, and 92.4% of these respondents had not discussed this with their physician. Of those who had used Mi'kmaq medicine, 24.3% use it as first-line treatment when they are ill, and 31.8% believe that Mi'kmaq medicine is better overall than Western. Even among patients who have not used Mi'kmaq medicine, 5.9% believe that it is more effective than Western medicine in treating illness. CONCLUSION: These results have implications for the delivery of health care to First Nations patients, especially in terms of understanding patients' health care values and in meeting the need to provide effective cross-cultural care.

Adolescent↗
PubMed2005

The mutation G298A-->Ala100Thr on the coding sequence of the Duffy antigen/chemokine receptor gene in non-caucasian Brazilians.

Ala100Thr has been suggested to be a Caucasian genetic marker on the FY*B allele. As the Brazilian population has arisen from miscegenation among Portuguese, Africans, and Indians, this mutation could possibly be found in Euro- and Afro-Brazilians, or in Brazilian Indians. Fifty-three related individuals and a random sample of 100 subjects from the Brazilian population were investigated using the polymerase chain reaction and four restriction fragment length polymorphisms. Confirming the working hypothesis, among the related individuals three Afro-Brazilians (two of them a mother and daughter) and a woman of Amerindian descent had the Ala100Thr mutation on the FY*B allele. Five non-related Euro-Brazilians also carried the mutation. All nine individuals presented the Fy(a-b+) phenotype. We conclude that the Ala100Thr mutation can occur in populations other than Caucasians and that this mutation does not affect Duffy expression on red blood cells. Gene frequencies for this allele in the non-related individuals were in agreement with those of other populations. The Duffy frequencies of two Amerindian tribes were also investigated.

American Indian or Alaska Native↗
PubMed2005

[Possible health effects associated with Pre-Columbian metallurgy].

In the Old World, several researchers have indicated that adverse health effects were associated with exposure to arsenic, and that this influenced a change in the use of copper-arsenic alloys to others less toxic. This hypothesis was evaluated for three Pre-Columbian metallurgy traditions: Central Andes, Intermediate Area, and West Mexico. The metal artifacts from the Central Andes showed arsenic concentrations similar to those in the Old World (0.5%-1.0%). In the Intermediate Area the values were smallest; however, in West Mexico the arsenic content was very high (7%-25%). In Central Andes arsenical bronze was used initially, but copper-tin alloys when introduced were preferred and distributed throughout the Inca Empire. Osteological and artistic evidences of foot amputations among Moche individuals from Central Andes support the presence of "black foot disease" (a condition associated with arsenic poisoning) among Pre-Columbian populations. In conclusion, the adverse effects of arsenic have been observed in the New World, and that these effects promoted a change toward the use of less toxic alloys.

Alloys↗
PubMed2006

Renal disease: environment, race, or genes?

Diabetic nephropathy is over-represented in people of color. This reflects both environmental and genetic factors. Numerous studies assess the effects of access to care and patient adherence in the development of kidney diseases. After correcting for these factors, genetic influences remain. Genetic approaches to discerning genes that predispose to diabetic nephropathy include candidate gene approaches, linkage analysis, mapping by admixture linkage disequilibrium, and transmission disequilibrium testing. Numerous candidate genes have been identified, although few have been confirmed apart from those representing genes in the renin-angiotensin system. The results of linkage analysis studies have similarly resulted in genomic regions purported to show linkage in a variety of ethnic groups that have most often not been confirmed in other ethnic groups, and sometimes in other groups of similar ethnicity but different phenotype definitions. The chromosomal regions determining glomerular filtration rate do not appear to be localized to the same chromosome as those related to proteinuria. Large cohorts of subjects have now been amassed by numerous research groups, and genome-wide scanning results involving much larger cohorts are anticipated to be published in the next few years. It is hoped that these strategies will ultimately identify chromosomsal regions and/ or genes that confer risk for diabetic nephropathy, and in so doing, provide clues to new therapies.

Black or African American↗
PubMedDate not supplied

[Evidence of facial palsy and facial malformations in pottery from Peruvian Moche and Lambayeque pre-Columbian cultures].

INTRODUCTION: Moche (100-700 AD) and Lambayeque-Sicán (750-1100 AD) are pre-Columbian cultures from Regional States Period, developed in Northern Peru. Information about daily life, religion and medicine has been obtained through the study of Moche ceramics found in lords and priests tombs, pyramids and temples. OBJECTIVE: To analyze archeological evidences of Moche Medicine and neurological diseases through ceramics. MATERIAL AND METHODS: Representations of diseases in Moche and Lambayeque iconography and Moche pottery collections exposed in Casinelli museum from Trujillo, and Brüning National Archeological museum from Lambayeque, Peru, were studied. The most representative cases were analyzed and photographed, previous authorization from authorities and curators of the museums. RESULTS: The following pathologies were observed in ceramic collections: peripheral facial palsy, facial malformations such as cleft lip, hemifacial spasm, legs and arm amputations, scoliosis and Siamese patients. Male and females Moche doctors were also observed in the ceramics in ritual ceremonies treating patients. CONCLUSIONS: The main pathologies observed in Moche and Lambayeque pottery are facial palsy and cleft lip. These are one of the earliest registries of these pathologies in pre-Columbian cultures in South-America.

American Indian or Alaska Native↗
PubMed1986

Otitis media in Greenland children: acute, chronic and secretory otitis media in three- to eight-year-olds.

The middle ear status was examined in 142 children aged three to eight years from Sukkertoppen and Kangamiut in Greenland. The investigation is based on social-pediatric and otologic histories and on objective examination using otomicroscopy and tympanometry. Three-fourths of the small children had a previous history of otitis, some with repeated instances. Otomicroscopic findings revealed suppurative, chronic otitis in 6% and sequelae of chronic otitis in 13%. Tympanometry disclosed a reduced middle ear pressure in another 26% of the ears examined. Comparison of children with healthy ears with the groups with affections of the middle ear showed a tendency to an increased risk of otitis in families at a low social stratum, whereas the mode of habitation seemed insignificant. Finally, a large milk intake both in connection with breast-feeding and later in life seemed to reduce the frequency of otitis. The investigation showed that acute otitis and chronic otitis media in particular are more prominent in Greenland than in Denmark. Attention is drawn to the handicap associated with a high incidence of chronic otitis media and the concomitant hearing loss to a population isolated in point of language. The successful achievements of a health information campaign and an active therapeutic program, which has reduced the prevalence of chronic otitis among the Innuit population native to Alaska and Canada, provides the rationale for an increased otologic effort in Greenland.

Acute Disease↗
PubMed1995

Human genetic diversity (immunoglobulin GM allotypes), linguistic data, and migrations of Amerindian tribes.

GM haplotype frequencies were examined in 49 Amerindian tribes (from North, Central, and South America) to investigate the congruence of genetic variation with that observed in language and geography. We used two approaches: (1) the mobile site method, which allows a two-dimensional representation of genetic variation where the distances between reference points (i.e., the locations of the populations in the geographic map after displacements) are close to the genetic distances, and (2) a multivariate analysis (factorial correspondence analysis), which permits a visual interpretation of the geographic distribution of GM haplotypes on a map, completed by a cluster analysis. The results show a strong gradient from the Bering Strait to South America. The Eskimo and Na-Dene are genetically different from all other Amerindians, reflecting their more recent migrations. The orientation of most trajectories of the tribes from Central and South America can be interpreted as earlier migrations along the Pacific and Atlantic coasts. We conclude that geographic and linguistic factors played a part in the genetic diversity of Amerindian tribes.

American Indian or Alaska Native↗
PubMedDate not supplied

AIDS and the aboriginal community.

A concise portrait of HIV and AIDS within the Aboriginal community is difficult to present. Just as there are different customs and traditions among tribes, so are there different ways by which this issue is being addressed. The response to HIV/AIDS in the Aboriginal community is the process of moving from an individual or personal perspective to an immediate and extended family approach through the community, nation or society, and finally to the greater picture, Mother Earth. We don't necessarily move through in this order, rather we go back and forth as the need arises. When we deal with HIV or AIDS, it is important to view how this will affect our whole life: physical, mental, emotional and spiritual aspects of ourselves as well as financial, psychosocial and other dimensions. The teachings and study of children, youth, adults and elders are also discussed. We recognize the work we do in this area now will be a tool for survival in the future.

Acquired Immunodeficiency Syndrome↗
PubMed1996

The importance of social and cultural effects of mercury on aboriginal peoples.

Environmental contaminants, including mercury, often by-products of industrialization land development projects, frequently have far-reaching consequences for Aboriginal people, who often receive little benefit from such projects. In trying to understand the full impact of environmental mercury on Aboriginal people, therefore, research endeavours must consider the social and cultural impacts, and not simply focus on the direct clinical effects resulting from exposure. This paper explores some of the key areas in developing such an understanding. Aboriginal peoples' understanding of mercury contamination is influenced by their holistic concepts of health and environment. Whether or not scientific assessment reveals direct clinical health effects from exposure to mercury, this holistic viewpoint may lead to an effect on both individuals and communities. Perceptions of changes and the disruption of the special relationship that Aboriginal people perceive themselves to have with the environment have a considerable impact on their social, cultural, spiritual and economic well-being. These qualitative impacts are not easily measured with standard social indicators. The involvement of communities in the identification and measurement of Aboriginal community indicators which reflect the reality of their situation is essential in order to establish a better understanding of the extent and importance of social and cultural effects of exposure to mercury. Toxicologists, policy makers and others concerned with setting risk levels which may lead to formal guidelines should be aware of the impacts that their actions and decisions may have on the lifestyle, and therefore on the health, of Aboriginal peoples.

American Indian or Alaska Native↗
PubMed1996

Limb-girdle muscular dystrophy and Miyoshi myopathy in an aboriginal Canadian kindred map to LGMD2B and segregate with the same haplotype.

We report the results of our investigations of a large, inbred, aboriginal Canadian kindred with nine muscular dystrophy patients. The ancestry of all but two of the carrier parents could be traced to a founder couple, seven generations back. Seven patients presented with proximal myopathy consistent with limb girdle-type muscular dystrophy (LGMD), whereas two patients manifested predominantly distal wasting and weakness consistent with Miyoshi myopathy (distal autosomal recessive muscular dystrophy) (MM). Age at onset of symptoms, degree of creatine kinase elevation, and muscle histology were similar in both phenotypes. Segregation of LGMD/MM is consistent with autosomal recessive inheritance, and the putative locus is significantly linked (LOD scores >3.0) to six marker loci that span the region of the LGMD2B locus on chromosome 2p. Our initial hypothesis that the affected patients would all be homozygous by descent for microsatellite markers surrounding the disease locus was rejected. Rather, two different core haplotypes, encompassing a 4-cM region spanned by D2S291-D2S145-D2S286, segregated with the disease, indicating that there are two mutant alleles of independent origin in this kindred. There was no association, however, between the two different haplotypes and clinical variability; they do not distinguish between the LGMD and MM phenotypes. Thus, we conclude that LGMD and MM in our population are caused by the same mutation in LGMD2B and that additional factors, both genetic and nongenetic, must contribute to the clinical phenotype.

Adolescent↗
PubMedDate not supplied

The Feather of Hope Aboriginal AIDS Prevention Society: a community approach to HIV/AIDS prevention.

Infection with the human immunodeficiency virus (HIV) is a complex and challenging issue for Aboriginal people in Canada. There is a need for HIV/AIDS prevention programs that address the specific needs of Canadian Aboriginal communities in a culturally accepted manner. The Feather of Hope Aboriginal AIDS Prevention Society provides culturally sensitive HIV prevention programs to Aboriginal communities in Alberta. The community development approach used by the Society emphasizes empowerment at the individual and group level. This approach is congruent with the shift to self-determination by Aboriginal people throughout Canada.

Alberta↗