Author
Alexandra King
Other affiliations: Canadian Institutes of Health Research
Bio: Alexandra King is an academic researcher from Simon Fraser University. The author has contributed to research in topics: Indigenous & Population. The author has an hindex of 3, co-authored 5 publications receiving 491 citations. Previous affiliations of Alexandra King include Canadian Institutes of Health Research.
Topics: Indigenous, Population, Medicine, Infant mortality, Health indicator
Papers
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University of Melbourne1, University of Otago2, Australian Institute of Health and Welfare3, University of Oslo4, Simon Fraser University5, University of Sydney6, Oswaldo Cruz Foundation7, Cayetano Heredia University8, University of Chile9, Interamerican University of Puerto Rico10, Umeå University11, Aga Khan University12, University of Southern Denmark13, Central University of Venezuela14, Prince of Songkla University15, Peking Union Medical College16, Tibet University17, International Institute for Population Sciences18, Indian Council of Medical Research19, University of Hawaii at Manoa20, University of Nigeria, Nsukka21, Mahidol University22
TL;DR: Taking into account the UN Sustainable Development Goals, this study recommends that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.
649 citations
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15 citations
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TL;DR: Investigation of longitudinal changes in three HIV treatment indicators for IPLWH who use illicit drugs during a community‐wide treatment‐as‐prevention (TasP) initiative in British Columbia, Canada finds no significant differences between indigenous and non‐indigenous participants.
Abstract: Introduction : In many settings worldwide, members of indigenous groups experience a disproportionate burden of HIV. In Canada, there is an urgent need to improve HIV treatment outcomes for indigenous people living with HIV (IPLWH), to not only reduce HIV/AIDS-associated morbidity and mortality but also curb elevated rates of viral transmission. Thus, by comparing indigenous and non-indigenous participants in an ongoing longitudinal cohort of HIV-positive people who use illicit drugs, we sought to investigate longitudinal changes in three HIV treatment indicators for IPLWH who use illicit drugs during a community-wide treatment-as-prevention (TasP) initiative in British Columbia, Canada. Methods : We used data from the ACCESS study, an ongoing observational prospective cohort of HIV-positive illicit drug users recruited from community settings in Vancouver, British Columbia. Cohort data are linked to comprehensive retrospective and prospective clinical records in a setting of no-cost HIV/AIDS treatment and care. We used multivariable generalized estimating equations (GEE) to evaluate longitudinal changes in the proportion of participants with exposure to antiretroviral therapy (ART) in the previous 180 days, optimal adherence to ART (i.e. ≥95% vs. 0.1). Conclusions : In this large and long-term study involving community-recruited HIV-positive illicit drug users, we observed a substantial and increasing proportion of indigenous participants reach several important thresholds in HIV care at rates indistinguishable from non-indigenous participants. The current findings highlight the important role of TasP on vulnerable populations in this setting and contribute to the evidence base supporting the immediate scale-up of ART to address HIV/AIDS-associated morbidity, mortality and viral transmission. Keywords: HIV; AIDS; indigenous; highly active antiretroviral therapy; HAART; plasma HIV-1 RNA viral load; treatment-as-prevention. (Published: 18 April 2016) Citation: Milloy M-J et al. Journal of the International AIDS Society 2016, 19 :20617 http://www.jiasociety.org/index.php/jias/article/view/20617 | http://dx.doi.org/10.7448/IAS.19.1.20617
14 citations
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TL;DR: The theme of the 2016 symposium, “The authors're not done yet: remaining challenges in Hepatitis C,” was focused on identifying strategies to enhance prevention, diagnosis, and treatment of HCV to reduce disease burden and ultimately eliminate HCV in Canada.
Abstract: Hepatitis C virus (HCV) affects approximately 268,000 Canadians and results in more years of life lost than any other infectious disease in the country. Both the Canadian Institutes of Health Research (CIHR) and the Public Health Agency of Canada (PHAC) have identified HCV-related liver disease as a priority and supported the establishment of a National Hepatitis C Research Network. In 2015, the introduction of new interferon- (IFN-) free therapies with high cure rates (>90%) and few side effects revolutionized HCV therapy. However, a considerable proportion of the population remains undiagnosed and treatment uptake remains low in Canada due to financial, geographical, cultural, and social barriers. Comprehensive prevention strategies, including enhanced harm reduction, broader screening, widespread treatment, and vaccine development, are far from being realized. The theme of the 2016 symposium, “We’re not done yet: remaining challenges in Hepatitis C,” was focused on identifying strategies to enhance prevention, diagnosis, and treatment of HCV to reduce disease burden and ultimately eliminate HCV in Canada.
8 citations
Cited by
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Deakin University1, University of Auckland2, Virginia Tech3, Commonwealth Scientific and Industrial Research Organisation4, Catholic University of Leuven5, Public Health Foundation of India6, Imperial College London7, Australian National University8, Washington University in St. Louis9, Brookings Institution10, University of Stirling11, University of London12, Harvard University13, University of Hertfordshire14, McGill University15, Drexel University16, Tehran University of Medical Sciences17, George Washington University18, Newcastle University19, Wellington Management Company20, Huazhong University of Science and Technology21, World Bank22, University of Cape Town23, University of Amsterdam24, University of Newcastle25
TL;DR: This work aims to demonstrate the efforts towards in-situ applicability of EMMARM, which aims to provide real-time information about concrete mechanical properties such as E-modulus and compressive strength.
1,480 citations
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TL;DR: This conceptual model is intended to provide guidance to researchers and policy makers in identifying the current stage of the obesity transition in a population, anticipating subpopulations that will develop obesity in the future, and enacting proactive measures to attenuate the transition, taking into consideration local contextual factors.
533 citations
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TL;DR: A definition for cultural safety is proposed that is more fit for purpose in achieving health equity, and the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development are clarified.
Abstract: Eliminating indigenous and ethnic health inequities requires addressing the determinants of health inequities which includes institutionalised racism, and ensuring a health care system that delivers appropriate and equitable care. There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care. Some jurisdictions have included cultural competency in health professional licensing legislation, health professional accreditation standards, and pre-service and in-service training programmes. However, there are mixed definitions and understandings of cultural competency and cultural safety, and how best to achieve them. A literature review of 59 international articles on the definitions of cultural competency and cultural safety was undertaken. Findings were contextualised to the cultural competency legislation, statements and initiatives present within Aotearoa New Zealand, a national Symposium on Cultural Competence and Māori Health, convened by the Medical Council of New Zealand and Te Ohu Rata o Aotearoa – Māori Medical Practitioners Association (Te ORA) and consultation with Māori medical practitioners via Te ORA. Health practitioners, healthcare organisations and health systems need to be engaged in working towards cultural safety and critical consciousness. To do this, they must be prepared to critique the ‘taken for granted’ power structures and be prepared to challenge their own culture and cultural systems rather than prioritise becoming ‘competent’ in the cultures of others. The objective of cultural safety activities also needs to be clearly linked to achieving health equity. Healthcare organisations and authorities need to be held accountable for providing culturally safe care, as defined by patients and their communities, and as measured through progress towards achieving health equity. A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development. The unintended consequences of a narrow or limited understanding of cultural competency are discussed, along with recommendations for how a broader conceptualisation of these terms is important.
391 citations
01 Jan 2015
TL;DR: This report gives the latest information on how Aboriginal and Torres Strait Islander people in the Northern Territory are faring according to a range of measures of health status and outcomes, determinants of health and health system performance.
Abstract: 'This report gives the latest information on how Aboriginal and Torres Strait Islander people in the Northern Territory are faring according to a range of measures of health status and outcomes, determinants of health and health system performance. Indicators are based on the Aboriginal and Torres Strait Islander Health Performance Framework. The report highlights the main areas of improvement and continuing concern.' - Back cover
260 citations
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TL;DR: The CONSIDER statement provides a checklist for the reporting of health research involving Indigenous peoples to strengthen research praxis and advance Indigenous health outcomes.
Abstract: Research reporting guidelines are increasingly commonplace and shown to improve the quality of published health research and health outcomes. Despite severe health inequities among Indigenous Peoples and the potential for research to address the causes, there is an extended legacy of health research exploiting Indigenous Peoples. This paper describes the development of the CONSolIDated critERtia for strengthening the reporting of health research involving Indigenous Peoples (CONSIDER) statement. A collaborative prioritization process was conducted based on national and international statements and guidelines about Indigenous health research from the following nations (Peoples): Australia (Aboriginal and Torres Strait Islanders), Canada (First Nations Peoples, Metis), Hawaii (Native Hawaiian), New Zealand (Māori), Taiwan (Taiwan Indigenous Tribes), United States of America (First Nations Peoples) and Northern Scandinavian countries (Sami). A review of seven research guidelines was completed, and meta-synthesis was used to construct a reporting guideline checklist for transparent and comprehensive reporting of research involving Indigenous Peoples. A list of 88 possible checklist items was generated, reconciled, and categorized. Eight research domains and 17 criteria for the reporting of research involving Indigenous Peoples were identified. The research reporting domains were: (i) governance; (ii) relationships; (iii) prioritization; (iv) methodologies; (v) participation; (vi) capacity; (vii) analysis and findings; and (viii) dissemination. The CONSIDER statement is a collaborative synthesis and prioritization of national and international research statements and guidelines. The CONSIDER statement provides a checklist for the reporting of health research involving Indigenous peoples to strengthen research praxis and advance Indigenous health outcomes.
159 citations