BACKGROUND: There are no current Australian guidelines on the prevention of diabetes-related foot ulceration (DFU). A national expert panel aimed to systematically identify and adapt suitable international guidelines to the Australian context to create new Australian evidence-based guidelines on prevention of first-ever and/or recurrent DFU. These guidelines will include for the first-time considerations for rural and remote, and Aboriginal and Torres Strait Islander peoples.
METHODS: The National Health and Medical Research Council procedures were followed to adapt suitable international guidelines on DFU prevention to the Australian health context. This included a search of public databases after which the International Working Group on the Diabetic Foot (IWGDF) prevention guideline was deemed the most appropriate for adaptation. The 16 IWGDF prevention recommendations were assessed using the ADAPTE and GRADE systems to decide if they should be adopted, adapted or excluded for the new Australian guideline. The quality of evidence and strength of recommendation ratings were re-evaluated with reference to the Australian context. This guideline underwent public consultation, further revision, and approval by national peak bodies.
RESULTS: Of the 16 original IWGDF prevention recommendations, nine were adopted, six were adapted and one was excluded. It is recommended that all people at increased risk of DFU are assessed at intervals corresponding to the IWGDF risk ratings. For those at increased risk, structured education about appropriate foot protection, inspection, footwear, weight-bearing activities, and foot self-care is recommended. Prescription of orthotic interventions and/or medical grade footwear, providing integrated foot care, and self-monitoring of foot skin temperatures (contingent on validated, user-friendly and affordable systems becoming available in Australia) may also assist in preventing DFU. If the above recommended non-surgical treatment fails, the use of various surgical interventions for the prevention of DFU can be considered.
CONCLUSIONS: This new Australian evidence-based guideline on prevention of DFU, endorsed by 10 national peak bodies, provides specific recommendations for relevant health professionals and consumers in the Australian context to prevent DFU. Following these recommendations should achieve better DFU prevention outcomes in Australia.

The anthropology of linguistics, food, and nutrition sciences has a key role with regard to taking a critical look at the Guatemalan Food Guidelines (GFG). These GFG are communicated to native communities to interpret their eating patterns and the structural cognitive interpretation of these food groups in a cultural context. Our understanding of food is informed by cognitive structure represented by language. Since food is fundamental in human cultural identities, understanding food and food categories from the perspective of Mayan indigenous groups should be a fundamental pillar of health, food, and nutrition. The purpose of this research was to explore the GFG and compare them to K\'iche\' understandings of food groups in terms of cognitive structural similarities and differences. The research was carried out in the field by way of semi-structured interviews and participant observation among K\'iche\' Mayan families in Nahualá (Western Guatemala) to compare and contrast data collected on K\'iche\' food groups and corresponding cognitive structure with previously published findings on the GFG. These findings were confirmed through fieldwork, though some of the nuances of subcategories have changed, and significant stress was placed on 2 food groups: wa (corn-based food) and ri\'kil (non-corn-based food). The research concludes that the cognitive structure and understanding of food groups and their uses communicated through K\'iche\' language differ significantly from the hierarchical, technical description of food groups communicated through the GFG. In order to strengthen public health approaches to food and nutrition, indigenous knowledge must be respected, learned, and integrated into GFG.

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Randomized controlled trials demonstrate that timely introduction of peanut to infants reduces the risk of peanut allergy. However, much debate remains regarding how to best achieve earlier peanut introduction at the population level. Our previous study in 2007-2011 (HealthNuts, n = 5300) indicated that few infants were consuming peanut in the first year. Australian infant feeding guidelines were updated in 2016 to recommend introducing peanut before 12 months for all infants. There were no data available on the subsequent effect on peanut introduction or peanut reactions.
We sought to assess the consequences of a nonscreening approach to allergenic food introduction in a population-based sample of infants in their first year of life.
EarlyNuts is a population-based, cross-sectional study of 12-month-old infants in Melbourne, Australia, recruited by using an identical sampling frame and methods to HealthNuts (72% response rate vs 73% response rate in HealthNuts). We report here on the first 860 participants recruited between November 2016 and October 2018.
Most infants (88.6%; 95% CI, 86.1% to 90.7%) had introduced peanut by 12 months (median age, 6 months), an increase from 28.4% (95% CI, 27.2% to 29.7%) in the HealthNuts study. By 12 months, the majority of these (76.4%) had consumed peanut more than 4 times, and 28% were eating peanut more than once per week. Preliminary results on parent-reported reactions show that 4.0% of those consuming peanut by 12 months had possible IgE-mediated reactions.
There has been a striking shift toward earlier peanut introduction, with a 3-fold increase in peanut introduction by age 1 year in 2018 compared with 2007-2011.

OBJECTIVE: To determine adherence to NHMRC eye examination guidelines for Indigenous and non-Indigenous Australian people with diabetes.
METHODS: Cross-sectional survey using multistage, random cluster sampling.
METHODS: Thirty randomly selected geographic sites in the five mainland Australian states and the Northern Territory, stratified by remoteness.
METHODS: 1738 Indigenous Australians aged 40-92 years and 3098 non-Indigenous Australians aged 50-98 years were recruited and examined between March 2015 and April 2016 according to a standardised protocol that included a questionnaire (administered by an interviewer) and a series of standard eye tests.
METHODS: Adherence rates to NHMRC eye examination guidelines; factors influencing adherence.
RESULTS: Adherence to screening recommendations was significantly greater among non-Indigenous Australians (biennial screening; 77.5%) than Indigenous Australians (annual screening; 52.7%; P < 0.001). Greater adherence by non-Indigenous Australians was associated with longer duration of diabetes (adjusted odds ratio [aOR], 1.19 per 5 years; P = 0.018), while increasing age was associated with poorer adherence in non-Indigenous Australians (aOR, 0.70 per decade; P = 0.011). For Indigenous Australians, residing in inner regional areas (aOR, 1.66; P = 0.007) and being male (aOR, 1.46; P = 0.018) were significant factors positively associated with adherence.
CONCLUSIONS: More than three-quarters of non-Indigenous Australians with diabetes and more than half of Indigenous Australians with diabetes adhere to the NHMRC eye examination guidelines. The discrepancy between the adherence rates may point to gaps in the provision or uptake of screening services in Indigenous communities, or a lack of awareness of the guidelines. A carefully integrated diabetic retinopathy screening service is needed, particularly in remote areas, to improve adherence rates.

With the recognized need for health systems\' improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods\' frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.

BACKGROUND: In recent decades many indigenous communities, policy makers and researchers worldwide have criticized the academic community for not being aware of the specific challenges these communities have faced and still are facing with regard to research. One result of the decades of discourse in indigenous communities is the development in many Western countries of indigenously sensitive ethical research guidelines. In 1997 the Sami Parliament (SP) in Norway reached a unanimous decision that ethical guidelines for Sami research had to be drawn up. Such guidelines are however still to be created.
OBJECTIVE: The objectives of this article are to enquire into what happened to the Norwegian SP\'s decision of 1997 and to reflect on why the issue seems to have disappeared from the SP\'s agenda. Finally, we consider whether research ethics is to be a subject for the research community only.
METHODS: A review of parliamentary white papers on research and SP documents relating to research ethics.
RESULTS: The response to the SP\'s decision in 1997 took place in two different channels, both of them national, namely the research ethics channel and the political channel. Thus, there were actually two parallel processes taking place. In spite of nearly two decades of reports, the concept of the participation of indigenous communities in research is still not an integral part of Norwegian ethical guidelines.
CONCLUSIONS: The issue of indigenously sensitive research ethics seems to have disappeared from the SP\'s agenda and the research ethics review system with regard to Sami research is with minor adjustments the same as when the SP asked for a revision.

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In this study the construct of a \'good life\' was explored among upper secondary school senior pupils and their parents and teachers by applying cultural consensus model analysis. A total of 469 students, 474 parents and 158 teachers from four Croatian cities participated in the study, which was conducted in 2011/2012. The information collected through interviewing and free-listing during the first phase of the study was used to create a set of structured questionnaire questions as a part of the survey in the second phase of data collection. The results are reported on two good-life sub-domains: \'health & well-being\' and \'migration & socioeconomic milieu\'. The results indicate heterogeneity of the sample groups, incomplete inter-generational transmission of cultural values and examples of two sub-groups that resist cultural norms and do not comply with the dominant \'competence-as-sharing\' paradigm. The value of testing the cultural consensus model based on the emic approach and locally significant phenomena is demonstrated for planning and conducting holistic anthropological research.

We investigate intrasocietal consensus and variation in affective meanings of concepts related to authority and community, two elementary forms of human sociality. Survey participants (n = 2,849) from different socioeconomic status (SES) groups in German society provided ratings of 909 social concepts along three basic dimensions of affective meaning. Results show widespread consensus on these meanings within society and demonstrate that a meaningful structure of socially shared knowledge emerges from organizing concepts according to their affective similarity. The consensus finding is further qualified by evidence for subtle systematic variation along SES differences. In relation to affectively neutral words, high-status individuals evaluate intimacy-related and socially desirable concepts as less positive and powerful than middle- or low-status individuals, while perceiving antisocial concepts as relatively more threatening. This systematic variation across SES groups suggests that the affective meaning of sociality is to some degree a function of social stratification.