First nations

第一民族
  • 文章类型: Journal Article
    音乐与改善原住民的社会和情感福祉有关,然而,很少有研究直接探索音乐和女同性恋的社会情感幸福之间的联系,同性恋,双性恋,变性人,Intersex,酷儿,无性,姐妹女孩,和兄弟男孩(LGBTIQA+SB)澳大利亚的第一民族。本文报道了对现有文献的混合范围叙事回顾,探讨了LGBTIQA+SB社会情感健康以及与音乐实践的潜在联系。比如听音乐,性能,和作曲。研究结果表明,音乐和创作实践可以与兴高采烈的感觉联系在一起,积极的自我评价,和安全。音乐和表演可以通过艺术和表演促进和庆祝酷儿原住民的多样性和复杂性,增强归属感和与社区的联系,产生骄傲的感觉,并促进知识共享。通过创意艺术和数字平台建立的社区联系被视为增强原住民女同性恋的社会情感福祉,同性恋,双性恋,变性人,Intersex,酷儿/提问,兄弟男孩,姐妹女孩。
    Music has been linked to improved social and emotional wellbeing for First Nations Peoples, yet little research directly explores the link between music and social emotional wellbeing of Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Asexual, Sistergirl, and Brotherboy (LGBTIQA+SB) First Nation Peoples in Australia. This article reports on a hybrid scoping narrative review of existing literature that explores LGBTIQA+SB social emotional wellbeing and potential links to music practices, such as music listening, performance, and composing. Findings suggest that music and creative practices can be linked to feelings of elation, positive self-regard, and safety. Music and performance can promote and celebrate the diversity and complexities of Queer First Nations people and identities through art and performance, enhancing a sense of belonging and links to community, generating feelings of pride, and contributing to knowledge sharing. Community connections built through creative arts and digital platforms are seen as enhancing social emotional wellbeing for First Nations Lesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning, Brotherboy, Sistergirl people.
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  • 文章类型: Journal Article
    肺癌是加拿大最常见的癌症之一,也是癌症死亡的主要原因。肺癌也会影响原住民,因纽特人和梅蒂斯人在加拿大显着,这值得进一步调查,因为在这个话题上存在文献空白。我们寻求对肺癌诊断有更深入的了解,发病率,死亡率,在第一民族中生存,因纽特人,和加拿大的梅蒂斯人。在书目数据库中进行了系统的搜索,以确定2000年1月至2023年3月之间发表的相关研究。使用人口/概念/背景(PCC)框架对文章进行了筛选和相关性评估。共有22篇文章被纳入最终分析,其中13个是因纽特人特有的,7是针对第一民族的,2个是梅蒂斯特有的。文献表明,比较发病率,死亡率,原住民患肺癌的相对风险更高,生存率更差,因纽特人和梅蒂斯人。肺癌对这些人群也有不同的影响,取决于性别,年龄,位置和其他因素。这篇综述表明,更全面的定量和定性研究对于进一步确定肺癌高发的结构性原因至关重要。
    Lung cancer is one of the most commonly diagnosed cancers in Canada and a leading cause of cancer mortality. Lung cancer also affects First Nations, Inuit and Métis peoples significantly in Canada, which deserves further investigation as there is a literature gap on this topic. We sought to develop a deeper understanding of lung cancer diagnosis, incidence, mortality, and survival in First Nations, Inuit, and Métis peoples in Canada. A systematic search was conducted in bibliographic databases to identify relevant studies published between January 2000 and March 2023. Articles were screened and assessed for relevance using the Population/ Concept/ Context (PCC) framework. A total of 22 articles were included in the final analysis, of which 13 were Inuit-specific, 7 were First Nations-specific, and 2 were Métis-specific. The literature suggests that comparative incidence, mortality, and relative risk of lung cancer is higher and survival is poorer in First Nations, Inuit and Métis peoples. Lung cancer also has varying impact on these population depending on sex, age, location and other factors. This review illustrates that more comprehensive quantitative and qualitative lung cancer research is essential to further identify the structural causes for the high incidence of the disease.
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  • 文章类型: Journal Article
    目标:自决在恢复澳大利亚原住民福祉中的重要性正在逐渐被理解。几千年来,土著妇女生下了乡村和祖母的传说和妇女的生意促进了地球上最古老的生活文明的生存。殖民之后,然而,土著和托雷斯海峡岛民的孕产妇和围产期护理做法被积极废除,土著人民的自决被摧毁。这对原住民和托雷斯海峡岛民的福祉及其文化和习俗具有重大影响。
    方法:对澳大利亚原住民和托雷斯海峡岛民妇女及其子女的分娩和围产期保健计划研究进行系统评价和荟萃分析的首选报告项目。审查的主要目的是评估项目开发和交付的文化背景,其次要目的是评估方案组成部分的文化适用性。电子数据库SCOPUS,PsycINFO,Medline,我们在2000年至2023年间在澳大利亚以英语发表的同行评审研究中搜索了CINAHL。
    结果:28篇出版物符合纳入标准。纳入研究的方法学特征进行了评估,生育支持特征,围产期护理和连续性护理的特点。总的来说,方案在满足妇女的文化需求方面受到限制,孩子们,个人社区。土著社区在识别,交付,审查方案也很有限。
    结论:研究结果阐明了自决在维持强大的土著文化和为土著妇女制定和提供文化上安全的围产期护理方案方面的重要性,孩子们,和社区。
    结论:供土著和托雷斯海峡岛民使用的方案和服务必须让土著和托雷斯海峡岛民及其社区参与方案规划进程,delivery,和审查。将计划或服务评估为“文化安全”代表服务用户根据其对该计划或服务的经验最适当地做出的决定。
    OBJECTIVE: The importance of self-determination in restoring the wellbeing of Australian First Nations peoples is becoming understood. For thousands of years, Aboriginal women gave birth on Country and Grandmothers\' Lore and Women\'s Business facilitated the survival of the oldest living civilisations on earth. Following colonisation, however, Aboriginal and Torres Strait Islander practices of maternal and perinatal care were actively dismantled, and self-determination by Aboriginal people was destroyed. This had significant implications for the wellbeing of Aboriginal and Torres Strait Islander people and their Cultures and practices.
    METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based systematic review of research about programmes of birthing and perinatal health care for Australian Aboriginal and Torres Strait Islander women and their children was undertaken. The review\'s primary aim was to assess the Cultural context of programme development and delivery, its secondary aim was to assess the Cultural appropriateness of programme components. Electronic databases SCOPUS, PsycINFO, Medline, and CINAHL were searched for peer-reviewed studies published in English in Australia between 2000 and 2023.
    RESULTS: Twenty-eight publications met inclusion criteria. Included studies were assessed for their methodological characteristics, birthing-support characteristics, perinatal care and continuity of care characteristics. Overall, programmes were limited in meeting the Cultural needs of women, children, and individual Communities. The role of Aboriginal Communities in identifying, delivering, and reviewing programmes was also limited.
    CONCLUSIONS: Findings articulate the importance of self-determination in maintaining strong Indigenous Cultures and informing the Culturally appropriate development and delivery of Culturally safe programmes of perinatal care for Aboriginal women, children, and Communities.
    CONCLUSIONS: Programmes and services for use by Aboriginal and Torres Strait Islander people must involve Aboriginal and Torres Strait Islander people and their Communities in processes of programme planning, delivery, and review. The evaluation of a programme or service as \"Culturally safe\" represents a determination that is most appropriately made by service users based on their experience of that programme or service.
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  • 文章类型: Journal Article
    与非原住民人群相比,原住民人群的结直肠癌(CRC)生存率较差。虽然世界各地的第一民族人口是不同的,歧视和压迫的共同经历导致了持续的健康不平等。CRC筛查提高生存率,然而,原住民人群的筛查率描述不佳。这项研究旨在确定全球原住民人群中CRC筛查的参与率。
    对PubMed进行了系统的文献检索,Embase,科克伦图书馆,CINAHL,MEDLINE,灰色文学,国家注册管理机构和诊所试验.gov.从开始日期到2024年2月18日搜索了所有来源。如果研究报告了成人(≥18岁)原住民人群的CRC筛查率,则纳入研究。如果有足够的数据,我们的目标是进行荟萃分析。使用JoannaBriggs研究所(JBI)评估工具评估论文质量。这项研究在PROSPERO注册,CRD42020210181。
    文献检索确定了1723项可能符合条件的已发表研究。审查后,包括57项研究,50来自美国(US),澳大利亚的其余研究,Aotearoa新西兰(NZ),加拿大,多米尼加和危地马拉。此外,纳入了来自澳大利亚和新西兰国家计划的11份非索引报告。没有足够的数据进行荟萃分析,因此进行了系统回顾和叙事综合。CRC筛查定义各不相同,包括粪便筛查,乙状结肠镜检查和结肠镜检查。美国原住民的筛查率在4.0%至79.2%之间,澳大利亚报告10.6-35.2%,新西兰18.4-49%,加拿大22.4-53.4%,危地马拉2.2%和多米尼加4.2%。55项研究被评估为中等或高质量,2项被评估为低质量。
    我们的研究结果表明,在第一民族人群中,CRC筛查参与率存在很大差异。在直接比较组和纵向结果中缺乏筛查数据。需要对筛查数据进行分类,以更好地理解和解决《儿童权利公约》第一民族的结果不平等。
    无。
    UNASSIGNED: First Nations populations have poorer colorectal cancer (CRC) survival compared to non-First Nations populations. Whilst First Nations populations across the world are distinct, shared experiences of discrimination and oppression contribute to persistent health inequities. CRC screening improves survival, however screening rates in First Nations populations are poorly described. This study seeks to define participation rates in CRC screening in First Nations populations worldwide.
    UNASSIGNED: A systematic literature search was conducted of PubMed, Embase, Cochrane Library, CINAHL, MEDLINE, grey literature, national registries and ClinicalTrials.gov. All sources were searched from their inception date to 18 February 2024. Studies were included if they reported CRC screening rates in adult (≥18 years) First Nations populations. We aimed to undertake a meta-analysis if there were sufficient data. Quality of papers were assessed using the Joanna Briggs Institute (JBI) appraisal tool. The study was registered with PROSPERO, CRD42020210181.
    UNASSIGNED: The literature search identified 1723 potentially eligible published studies. After review, 57 studies were included, 50 from the United States (US), with the remaining studies from Australia, Aotearoa New Zealand (NZ), Canada, Dominica and Guatemala. Additionally, eleven non-indexed reports from national programs in Australia and NZ were included. There were insufficient data to undertake meta-analysis, therefore a systematic review and narrative synthesis were conducted. CRC screening definitions varied, and included stool-based screening, sigmoidoscopy and colonoscopy. US First Nations screening rates ranged between 4.0 and 79.2%, Australia reported 10.6-35.2%, NZ 18.4-49%, Canada 22.4-53.4%, Guatemala 2.2% and Dominica 4.2%. Fifty-five studies were assessed as moderate or high quality and two as low quality.
    UNASSIGNED: Our findings suggested that there is wide variation in CRC screening participation rates across First Nations populations. Screening data are lacking in direct comparator groups and longitudinal outcomes. Disaggregation of screening data are required to better understand and address First Nations CRC outcome inequities.
    UNASSIGNED: None.
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  • 文章类型: Journal Article
    目的:虽然社会决定因素框架在澳大利亚有关原住民健康的研究中仍然很流行,越来越多的研究更喜欢健康模式的文化决定因素。文化决定因素模型提供了一个整体,基于强度的框架来解释健康和环境因素之间的联系,包括音乐的潜在作用及其对社会和情感福祉的影响。鉴于音乐之间的联系越来越受到国际认可,健康,以及通过世界卫生组织等机构的福祉,本文研究了在健康文献的原住民决定因素中是否以及如何承认音乐实践。
    方法:我们对来自五个数据库的文献进行了范围界定叙事回顾:Scopus,PsycInfo,CINAHL,PubMed和ProQuestCentral。该搜索返回了自2017年以来发表的60篇文章,我们在NVivo中分析了常见主题。
    结果:在两项研究中,音乐仅被明确确定为健康的决定因素。然而,五项研究的参与者认为音乐和歌曲直接影响他们的社交和情感福祉。当我们扩大分析框架以包括其他形式的表现文化实践时,四分之一的纳入研究在经验上承认表达性文化实践对社会和情感福祉的作用。
    结论:尽管最近的许多研究广泛地确定了原住民的表达方式的影响,他们错过了原住民音乐作为潜在独特文化的重要特征,社会,健康的政治和生态决定因素。所以呢?:未来的研究和健康决定因素建模有机会明确检查原住民音乐和其他创造性实践对社会和情感福祉的作用。
    OBJECTIVE: While social determinants frameworks are still popular in research about First Nations health in Australia, a growing body of research prefers cultural determinants of health models. Cultural determinants models provide a holistic, strength-based framework to explain connections between health and contextual factors, including the potential role of music and its impact on social and emotional well-being. Given the growing international recognition of links between music, health, and wellbeing through bodies such as the World Health Organisation, this article examines whether and how music practices are acknowledged in First Nations determinants of health literature.
    METHODS: We conducted a scoping narrative review of literature from five databases: Scopus, PsycInfo, CINAHL, PubMed and ProQuest Central. The search returned 60 articles published since 2017, which we analysed in NVivo for common themes.
    RESULTS: Music was only explicitly identified as a determinant of health in two studies. Yet, participants in five studies identified music and song as directly impacting their social and emotional well-being. When we broadened our frame of analysis to include other forms of expressive cultural practice, one quarter of included studies empirically acknowledged the role of expressive cultural practice for social and emotional well-being.
    CONCLUSIONS: While many recent studies identify the impact of First Nations\' expressive practices broadly, they miss important features of First Nations music as a potentially unique cultural, social, political and ecological determinant of health. SO WHAT?: There is an opportunity for future research and health determinant modelling to explicitly examine the role of First Nations music and other creative practices for social and emotional well-being.
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  • 文章类型: Journal Article
    背景:与非第一民族人民相比,第一民族的死胎率不成比例。以前的干预措施旨在减少第一民族的死产,并提供更好的丧亲关怀,而不一定了解人们的看法,可能影响干预和实施设计的知识和信念。
    目的:这篇综述的目的是了解人们的看法,有关美国原住民死产预防和丧亲的知识和信念,加拿大,Aotearoa/新西兰,和澳大利亚。
    方法:本综述是根据JBI方法进行的,用于会聚综合混合方法系统综述。这项审查由土著长者顾问委员会监督,研究人员,和临床医生。搜索八个数据库(PubMed,MEDLINE,PsycInfo,CINAHL,Embase,Emcare,论文和论文以及土著健康信息网)和灰色文献进行了研究。所有研究都进行了筛选,提取,并由两名评审人员进行质量评估,并对结果进行分类,叙述式总结。
    结果:本综述纳入了10项研究。他们的发现被总结为四类:保护婴儿,传统的分娩和悲伤的做法,丧亲摄影和验尸。结果表明感知的多样性,死产后主要围绕戒烟和丧亲行为的知识和信念。然而,现有的研究很少。
    结论:需要进一步的研究来理解这些看法,第一民族关于死产的知识和信念。如果没有这方面的研究,预防死产和支持死产后失去亲人的父母及其社区的干预措施可能面临实施障碍.
    BACKGROUND: First Nations Peoples endure disproportionate rates of stillbirth compared with non-First Nations Peoples. Previous interventions have aimed at reducing stillbirth in First Nations Peoples and providing better bereavement care without necessarily understanding the perceptions, knowledge and beliefs that could influence the design of the intervention and implementation.
    OBJECTIVE: The aim of this review was to understand the perceptions, knowledge and beliefs about stillbirth prevention and bereavement of First Nations Peoples from the US, Canada, Aotearoa/New Zealand, and Australia.
    METHODS: This review was conducted in accordance with the JBI methodology for a convergent integrated mixed method systematic review. This review was overseen by an advisory board of Aboriginal Elders, researchers, and clinicians. A search of eight databases (PubMed, MEDLINE, PsycInfo, CINAHL, Embase, Emcare, Dissertations and Theses and Indigenous Health InfoNet) and grey literature was conducted. All studies were screened, extracted, and appraised for quality by two reviewers and results were categorised, and narratively summarised.
    RESULTS: Ten studies were included within this review. Their findings were summarised into four categories: safeguarding baby, traditional practices of birthing and grieving, bereavement photography and post-mortem examination. The results indicate a diversity of perceptions, knowledge and beliefs primarily around smoking cessation and bereavement practices after stillbirth. However, there was a paucity of research available.
    CONCLUSIONS: Further research is needed to understand the perceptions, knowledge and beliefs about stillbirth among First Nations Peoples. Without research within this area, interventions to prevent stillbirth and support bereaved parents and their communities after stillbirth may face barriers to implementation.
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  • 文章类型: Systematic Review
    目的:本系统评价旨在确定澳大利亚原住民对癌症护理服务的需求和偏好。
    方法:综合综述。
    方法:进行了综合综述。使用了广泛的搜索词来提高电子数据库中搜索的敏感性和特异性。方法学质量评估,数据提取,由两名审稿人独立进行,并进行了叙事综合。
    结果:纳入42项研究。共有2965名澳大利亚原住民成年人,不同年龄的男人和女人,有代表;研究中没有受癌症影响的第一民族儿童。出现了三个主题,包括:(1)歧视,种族主义和创伤,由于殖民,直接影响了第一国民的癌症护理体验;(2)文化认知方式,做和做对于原住民如何参与癌症护理服务至关重要;(3)原住民需要以文化安全为中心的癌症护理服务,以满足实际需求。
    结论:本综述中的大多数参与者都经历了歧视,种族主义和创伤,由于殖民,这直接对原住民的癌症护理体验产生了负面影响。虽然几年前在澳大利亚推出了最佳癌症路径(OCP),癌症患者可能会继续经历痛苦的未满足的护理需求。
    我们的团队包括原住民,非原住民研究人员和医疗保健专业人员在癌症护理方面的专业知识。研究人员采用非殖民化的恢复性方法来确保声音,尊重,在这次审查工作中的问责制和互惠性。
    结论:包括护士和政策制定者在内的多学科团队成员应反思这些发现,确保他们接受最新的文化安全培训,并与土著和非土著癌症领导人站在一起,采取积极措施消除和消除对健康的压迫,并安全地实施OCP。
    OBJECTIVE: This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people.
    METHODS: Integrative review.
    METHODS: An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted.
    RESULTS: Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people\'s cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs.
    CONCLUSIONS: Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples\' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs.
    UNASSIGNED: Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work.
    CONCLUSIONS: Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.
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  • 文章类型: Systematic Review
    背景:在全球范围内,糖尿病影响大约5亿人,预计到2045年将影响多达7亿人。在澳大利亚,殖民地化的持续影响导致第一民族人民的医疗保健提供不平等和医疗保健结果不平等,糖尿病发病率是非土著澳大利亚人的4倍。循证临床实践已被证明可以减少糖尿病相关足部疾病的并发症,包括溃疡和截肢,50%。然而,缺乏获得文化安全护理等因素,地理偏远,与亲自护理相关的高昂费用是第一民族人民获得循证护理的主要障碍,导致开发创新的移动健康(mHealth)应用程序,以增加获得健康服务的机会并改善糖尿病患者的知识和自我护理管理。
    目的:本研究旨在评估在澳大利亚原住民和全球非土著居民中使用mHealth应用程序评估和管理糖尿病相关足部健康的研究。
    方法:PubMed,Informit的土著收藏数据库,OvidMEDLINE,Embase,CINAHL完成,和Scopus从成立到2022年9月8日进行了搜索。手动搜索灰色文献和纳入研究的参考列表。描述为评估和管理与糖尿病相关的足部健康而开发的mHealth应用程序的研究符合资格。研究必须包括对mHealth应用程序的评估(定性或定量)。没有语言,出版日期,或使用了发布状态限制。质量评估是使用修订后的Cochrane偏见风险工具进行随机试验和健康证据公告威尔士检查表进行观察,队列,和定性研究。
    结果:没有确定具体包括澳大利亚第一民族的研究。纳入了非土著居民的六项研究,有361名参与者。足部护理教育是所有mHealth应用程序的主要组成部分。在6个mHealth应用程序中,2(33%)为参与者提供了输入健康相关数据的功能;1(17%)包括消息传递界面。随访时间为1-6个月。在6项研究中,1%(17%)报告说,糖尿病患者和糖尿病专家对mHealth应用程序内容的自我护理接受程度很高;其余5%(83%)报告说,参与者在使用mHealth应用程序后,与糖尿病相关的知识和自我管理技能得到了改善。
    结论:本系统评价的结果概述了在mHealth应用程序中部署的功能,并表明这种类型的干预措施可以提高非土著糖尿病患者的知识和自我护理管理技能。未来的研究需要关注针对服务提供不足或无效的人群的mHealth应用程序,包括原住民和生活在偏远地区的人,以及评估对糖尿病相关足部疾病结局的直接影响。
    背景:PROSPEROCRD42022349087;https://tinyurl.com/35u6mmzd。
    Globally, diabetes affects approximately 500 million people and is predicted to affect up to 700 million people by 2045. In Australia, the ongoing impact of colonization produces inequity in health care delivery and inequality in health care outcomes for First Nations Peoples, with diabetes rates 4 times those of non-Indigenous Australians. Evidence-based clinical practice has been shown to reduce complications of diabetes-related foot disease, including ulceration and amputation, by 50%. However, factors such as a lack of access to culturally safe care, geographical remoteness, and high costs associated with in-person care are key barriers for First Nations Peoples in accessing evidence-based care, leading to the development of innovative mobile health (mHealth) apps as a way to increase access to health services and improve knowledge and self-care management for people with diabetes.
    This study aims to evaluate studies investigating the use of mHealth apps for the assessment and management of diabetes-related foot health in First Nations Peoples in Australia and non-Indigenous populations globally.
    PubMed, Informit\'s Indigenous Collection database, Ovid MEDLINE, Embase, CINAHL Complete, and Scopus were searched from inception to September 8, 2022. Hand searches of gray literature and reference lists of included studies were conducted. Studies describing mHealth apps developed for the assessment and management of diabetes-related foot health were eligible. Studies must include an evaluation (qualitative or quantitative) of the mHealth app. No language, publication date, or publication status restrictions were used. Quality appraisal was performed using the revised Cochrane risk-of-bias tool for randomized trials and the Health Evidence Bulletins Wales checklists for observational, cohort, and qualitative studies.
    No studies specifically including First Nations Peoples in Australia were identified. Six studies in non-Indigenous populations with 361 participants were included. Foot care education was the main component of all mHealth apps. Of the 6 mHealth apps, 2 (33%) provided functionality for participants to enter health-related data; 1 (17%) included a messaging interface. The length of follow-up ranged from 1-6 months. Of the 6 studies, 1 (17%) reported high levels of acceptability of the mHealth app content for self-care by people with diabetes and diabetes specialists; the remaining 5 (83%) reported that participants had improved diabetes-related knowledge and self-management skills after using their mHealth app.
    The findings from this systematic review provide an overview of the features deployed in mHealth apps and indicate that this type of intervention can improve knowledge and self-care management skills in non-Indigenous people with diabetes. Future research needs to focus on mHealth apps for populations where there is inadequate or ineffective service delivery, including for First Nations Peoples and those living in geographically remote areas, as well as evaluate direct effects on diabetes-related foot disease outcomes.
    PROSPERO CRD42022349087; https://tinyurl.com/35u6mmzd.
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  • 文章类型: Systematic Review
    背景:共享决策促进了患者和医疗保健提供者之间的合作,以做出明智的健康决策。我们的审查确定了支持土著人民做出健康决定的干预措施。目标是综合证据并确定影响共享决策干预措施使用的因素。
    方法:由服务提供商和学术研究人员组成的因纽特人和非因纽特人团队使用集成的知识翻译方法和框架综合来共同进行系统综述。我们开发了一个概念框架来组织和描述共同的决策过程,并指导确定描述干预措施以支持土著人民做出健康决策的研究。我们从2012年9月至2022年3月对电子数据库进行了全面搜索,并进行了灰色文献检索。对两名独立的团队成员进行了筛选,并对质量进行了评估,其中包括有关研究对共同决策和土著自决的贡献的优势和相关性的研究。对调查结果进行了与概念框架相关的描述性分析,并使用准则进行报告,以确保报告的透明度和完整性,并进行面向公平的系统审查。
    结果:在筛选的5068篇引文中,10份出版物中报道的9项研究符合纳入条件.我们将这些研究分为以下几类:包括土著知识和治理(\“面向土著”)(n=6);以及基于西方学术知识和治理(\“面向西方”)(n=3)。这些研究被发现对共同决策和自决的贡献具有不同的质量,以本土为导向的研究总体上比西方为导向的研究质量更高。四个主题反映在更新的概念框架中:1)共享决策发生影响决策机会的地方,2)对参与共享决策过程的医疗保健提供者的特征知之甚少,3)社区是共同决策的伙伴,4)共享决策过程涉及建立信任。
    结论:很少有研究报告和评估与土著人民共同的决策干预措施。总的来说,面向土著的研究力求使卫生保健系统更适合土著人民的共同决策,而面向西方的研究将共同决策与医疗保健环境分开。需要进一步研究以解决方案为重点并支持土著自决。
    BACKGROUND: Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions.
    METHODS: An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies\' contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews.
    RESULTS: Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance (\"Indigenous-oriented\")(n = 6); and those based on Western academic knowledge and governance (\"Western-oriented\")(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building.
    CONCLUSIONS: There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed.
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  • 文章类型: Systematic Review
    背景:痴呆症是全球土著人民的紧急健康优先事项,然而,对疾病驱动因素和保护因素知之甚少。
    方法:2022年3月进行了数据库搜索,以确定有关风险的原始出版物,保护,遗传,神经放射学,与涉及土著人民的痴呆和认知障碍相关的生物学因素。
    结果:多项研究中的可修改风险因素包括童年逆境,听力损失,受教育程度低,不熟练的工作历史,中风,头部受伤,癫痫,糖尿病,高血压,高脂血症,抑郁症,低BMI,流动性差,和尿失禁问题。不可改变的风险因素包括年龄增加,性别,和遗传多态性。教育,戒烟,身体和社会活动,文化或宗教习俗的参与被强调为潜在的保护因素。关于涉及土著人民的痴呆症生物标志物的研究很少。
    结论:对痴呆症的可改变因素和生物标志物的更多了解可以帮助建立基于力量的模型来促进土著人民的健康衰老和认知。
    Dementia is an emergent health priority for Indigenous peoples worldwide, yet little is known about disease drivers and protective factors.
    Database searches were conducted in March 2022 to identify original publications on risk, protective, genetic, neuroradiological, and biological factors related to dementia and cognitive impairment involving Indigenous peoples.
    Modifiable risk factors featured across multiple studies include childhood adversity, hearing loss, low education attainment, unskilled work history, stroke, head injury, epilepsy, diabetes, hypertension, hyperlipidemia, depression, low BMI, poor mobility, and continence issues. Non-modifiable risk factors included increasing age, sex, and genetic polymorphisms. Education, ex-smoking, physical and social activity, and engagement with cultural or religious practices were highlighted as potential protective factors. There is a paucity of research on dementia biomarkers involving Indigenous peoples.
    Greater understanding of modifiable factors and biomarkers of dementia can assist in strength-based models to promote healthy ageing and cognition for Indigenous peoples.
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