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McIntyre M, Cullen J, Turner C, Bohanna I, Lakhini A, Rixon K. The development of a cognitive screening protocol for Aboriginal and/or Torres Strait Islander peoples: the Guddi Way screen. BRAIN IMPAIR 2024; 25:IB23058. [PMID: 39222469 DOI: 10.1071/ib23058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
Background Many Aboriginal and/or Torres Strait Islander peoples are exposed to risk factors for cognitive impairment. However, culturally appropriate methods for identifying potential cognitive impairment are lacking. This paper reports on the development of a screen and interview protocol designed to flag possible cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults over the age of 16years. Methods The Guddi Way screen includes items relating to cognition and mental functions across multiple cognitive domains. The screen is straightforward, brief, and able to be administered by non-clinicians with training. Results Early results suggest the Guddi Way screen is reliable and culturally acceptable, and correctly flags cognitive dysfunction among Aboriginal and/or Torres Strait Islander adults. Conclusions The screen shows promise as a culturally appropriate and culturally developed method to identify the possibility of cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults. A flag on the Guddi Way screen indicates the need for referral to an experienced neuropsychologist or neuropsychiatrist for further assessment and can also assist in guiding support services.
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Affiliation(s)
- Michelle McIntyre
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
| | - Jennifer Cullen
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
| | | | - India Bohanna
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
| | - Ali Lakhini
- La Trobe University, Melbourne, Vic 3086, Australia
| | - Kylie Rixon
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
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Cheok T, Bastick K, George D, Chan TS, Jaitly A, Jayasekera N, Bray L, Poonnoose PM, Williams K. A retrospective cohort study comparing outcomes following hip fractures in Australian indigenous patients with non-Australian indigenous patients. ANZ J Surg 2024; 94:1397-1403. [PMID: 38845600 DOI: 10.1111/ans.19120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/18/2024] [Accepted: 05/29/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Australian Indigenous (AI) populations face significant socioeconomic disadvantage and have poorer health outcomes when compared to their non-AI counterparts. There is a paucity of published literature on outcomes following hip fracture in the AI population. METHODS We performed a retrospective cohort study comparing outcomes following hip fracture in AI and non- AI patients presenting to a single regional trauma centre. The primary outcome of interest was all-cause mortality. Secondary outcomes of interest were the odds of postoperative delirium and length of stay in hospital. All outcomes were adjusted against collected baseline covariates. RESULTS One hundred and twenty-seven hip fractures were identified across 125 patients. There were 62 hip fractures in the AI group and 65 in the non-AI group. The adjusted hazard ratio (HR) for all-cause mortality was not statistically significant when comparing Indigenous versus non-Indigenous patients (HR = 2.37, P = 0.055). Adjusted odds of postoperative delirium was lower in Indigenous patients (OR = 0.12; P = 0.018). The AI cohort had a 4 day longer median length of stay, which was not statistically significant when adjusted for covariates. CONCLUSION AI patients with hip fractures were younger, had a higher Charlson Comorbidity Index Score and American Society of Anaesthesiologists grade, as well as a higher incidence of diabetes and associated end-organ sequalae. There was no difference in all-cause mortality. Odds of postoperative delirium was lower in the AI group. We did not find any difference in the length of hospital stay.
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Affiliation(s)
- Tim Cheok
- Department of Orthopaedic Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Kate Bastick
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Daniel George
- Department of Orthopaedic Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Teik Seng Chan
- Department of Orthopaedic Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Aayush Jaitly
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Narlaka Jayasekera
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
- Department of Orthopaedic Surgery, Wairau Hospital, Blenheim, New Zealand
| | - Linda Bray
- Aboriginal Liaison Services, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Pradeep Mathew Poonnoose
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
- Department of Orthopaedic Surgery, Christian Medical College Hospital, Vellore, India
| | - Kanishka Williams
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Orthopaedic Surgery, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
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Hindman E, Hassmén P, Orchard A, Radford K, Delbaere K, Garvey G. Clinicians' views on cognitive assessment with Aboriginal Australians. Aust N Z J Psychiatry 2024; 58:134-141. [PMID: 37353895 DOI: 10.1177/00048674231183354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
BACKGROUND A shortage of standardised cognitive assessment tools for use with Aboriginal Australians is evident. Clinicians also miss the range of guidelines necessary to inform test selection and interpretation for all Aboriginal clients. This mixed methods study examines clinicians' confidence, views and current practices when conducting cognitive assessments with Aboriginal Australian clients. METHODS Clinicians were asked about factors that influence their likelihood of using standardised testing in Aboriginal vs non-Indigenous Australian people. Twenty-one health professionals with experience conducting cognitive assessments with Aboriginal and non-Aboriginal Australians participated. Clinicians were presented with a series of different scenarios per the client's level of education and language of origin via an online survey. Clinicians rated their likelihood and confidence using standardised cognitive assessment for each scenario. Open-ended questions captured clinicians' views and information about their current clinical practices. RESULTS Clients' age, education and language of origin influence the likelihood of clinicians' use of standardised cognitive assessment measures with Aboriginal people. Overall, clinicians reported feeling only slightly more confident working with non-Indigenous clients than Aboriginal clients. Qualitative data indicate a lack of consistency regarding test selection. CONCLUSION Clinicians expressed concerns about the validity of available cognitive assessment tools for use with Aboriginal Australians and the absence of evidence to assist decision-making. Cited barriers included language, educational attainment and cultural factors.
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Affiliation(s)
- Emily Hindman
- Coffs Harbour Aboriginal Community Care Inc. (ABCARE), Coffs Harbour, NSW, Australia
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Peter Hassmén
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Abbey Orchard
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Kylie Radford
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, NSW, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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Bush SS, Dutt A, Fernández AL, Łojek E, McDonald S, Schrieff-Brown L. Ethical issues in clinical neuropsychology: International diversity perspectives. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-17. [PMID: 37972552 DOI: 10.1080/23279095.2023.2278153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Much of the information about the ethical practice of clinical neuropsychology has focused on North America. Additionally, of the scholarly publications on the intersection of ethical issues and cultural diversity practices in neuropsychology, most have focused on North America. The extent to which practitioners in other parts of the world are aware of, and find useful, such information is largely unknown. Similarly, the extent to which North American neuropsychologists are familiar with ethical issues and challenges encountered around the world is unknown. The purpose of this article is to advance the discussion of ethical issues in clinical neuropsychology from an international diversity perspective. METHOD The article presents, via a panel interview format, the thoughts and experiences of a small sample of neuropsychologists who represent all continents except North America (and Antarctica). RESULTS Neuropsychologists across continents share an ethical commitment to providing services that are beneficial, and not harmful, to the recipients of the services. Professional competence is at the heart of such services. CONCLUSIONS Through continued and expanded dialogue about ethical issues with neuropsychology colleagues around the world, the potential exists for improvement in the provision of effective and compassionate care in our own towns.
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Affiliation(s)
- Shane S Bush
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
- Long Island Neuropsychology, Lake Ronkonkoma, NY, USA
| | - Aparna Dutt
- Neuropsychology & Clinical Psychology Unit, Duttanagar Mental Health Centre, Kolkata, India
| | - Alberto Luis Fernández
- Universidad Católica de Córdoba, Córdoba, Argentina
- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Emilia Łojek
- Faculty of Psychology, Head of the Neuropsychological Section Polish Psychological Association, Vice-Dean for Research, University of Warsaw, Warsaw, Poland
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Zupan Z. Cognitive performance outcomes: considerations for drug development. J Patient Rep Outcomes 2023; 7:102. [PMID: 37855938 PMCID: PMC10587033 DOI: 10.1186/s41687-023-00644-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023] Open
Abstract
Ensuring that cognitive assessments are fit for purpose is critical in the evaluation of the clinical benefit of new therapeutic interventions. Although guidelines for Clinical Outcome Assessments (COA) are available, performance outcome (PerfO) assessments, and in particular those assessing cognition (Cog-PerfOs) are more complex and have additional requirements that need to be considered. I outline three areas where further discussion around validation methods for Cog-PerfOs and best practices is warranted: (1) content validity (2) ecological validity, and (3) construct validity in multinational contexts. I conclude with a discussion of several potential avenues for the improvement of validation of Cog-PerfOs used to evaluate the efficacy of medical products that target cognitive symptomatology. These include the involvement of cognitive psychologists in establishing content validity of Cog-PerfOs, evaluating the congruence of laypeople's and expert understanding of cognitive concepts, supplementing qualitative with quantitative evidence when establishing content validity, demonstrating ecological validity, and ensuring normative data are available in multinational contexts.
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Affiliation(s)
- Zorana Zupan
- Institute of Psychology, Faculty of Philosophy, University of Belgrade, Cika Ljubina 18/20, Belgrade, 11000, Serbia.
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6
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Waller M, Buckley RF, Masters CL, Nona FR, Eades SJ, Dobson AJ. Deaths with Dementia in Indigenous and Non-Indigenous Australians: A Nationwide Study. J Alzheimers Dis 2021; 81:1589-1599. [PMID: 33967039 DOI: 10.3233/jad-201175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The prevalence of dementia is generally reported to be higher among Indigenous peoples. OBJECTIVE The rates and coding of dementia mortality were compared between Indigenous and non-Indigenous Australians. METHODS De-identified individual records on causes of death for all people aged 40 years or more who died in Australia between 2006 and 2014 (n = 1,233,084) were used. There were 185,237 records with International Classification of Diseases, Tenth Revision, codes for dementia (Alzheimer's Disease, vascular dementia, or unspecified dementia) as the underlying cause of death or mentioned elsewhere on the death certificate. Death rates were compared using Poisson regression. Logistic regression was used to assess whether dementia was more likely to be classified as 'unspecified' type in Indigenous Australians. RESULTS The rates of death with dementia were 57% higher in Indigenous Australians, compared to non-Indigenous, relative rate (RR) 1.57, 95% confidence interval (CI) (1.48, 1.66), p < 0.0001. This excess of deaths was highest at ages below 75 (RRs > 2, test for interaction p < 0.0001), and among men (test for interaction p < 0.0001). When the underreporting of Indigenous status on the death certificate was taken into account the relative rate increased to 2.17, 95% CI (2.07, 2.29). Indigenous Australians were also more likely to have their dementia coded as 'unspecified' on their death certificate (Odds Ratio 1.92, 95% CI (1.66, 2.21), p < 0.0001), compared to the non-Indigenous group. CONCLUSION This epidemiological analysis based on population level mortality data demonstrates the higher dementia-related mortality rate for Indigenous Australians especially at younger ages.
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Affiliation(s)
- Michael Waller
- University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Queensland, Australia
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience, The University of Melbourne, Melbourne, Victoria, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience, The University of Melbourne, Melbourne, Victoria, Australia
| | - Francis R Nona
- University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Queensland, Australia
| | - Sandra J Eades
- Curtin Medical School, Curtin University, Western Australia, Australia
| | - Annette J Dobson
- University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Queensland, Australia
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Stolwyk RJ, Evans L, O'Halloran C, Evans J, Gooden JR. Comparing cognitive assessment service provision between Aboriginal and Torres Strait Islanders and non-Indigenous Australians at a metropolitan health service. Health Promot J Austr 2020; 32:541-547. [PMID: 32686249 DOI: 10.1002/hpja.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/14/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Aboriginal and Torres Strait Islander populations are at a significantly higher risk of neurological and cognitive impairment from a range of aetiologies. In order to better identify and support Indigenous Australians with cognitive impairment, culturally appropriate screening, management and referral processes are critical. The primary aim of this study was to investigate the frequency of presentations and type of cognitive screening conducted with Indigenous Australians presenting to health services. METHODS Hospital data for 30 Indigenous Australians presenting with neurological symptoms to Emergency Departments within a large metropolitan health service were compared with a group of 30 non-Indigenous, Australian-born, English-speaking, age-, gender- and diagnosis-matched individuals. RESULTS Only two individuals, one from each group, received cognitive screening. This was likely related to a surprisingly large proportion of Indigenous Australians presenting to hospital with headache and migraine. Significantly more Indigenous Australians (36.7%) were consulted by a member of the multidisciplinary team compared to 10% of the non-Indigenous group. No differences in follow-up referrals were observed. CONCLUSIONS Results indicated a lack of cognitive screening practices being undertaken in both groups. It was encouraging to see Indigenous Australians receiving consultations from multidisciplinary team members at a higher rate, with a similar follow-up pathway being observed. This study further highlights the need for adoption of screening practices in primary health care settings and the development and use of culturally appropriate cognitive screening measures. SO WHAT?: This study investigates the cognitive screening practices of a metropolitan health service and highlights the need for culturally appropriate cognitive screening methods to be developed and implemented to facilitate the identification of cognitive impairment in Indigenous Australians presenting for treatment.
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Affiliation(s)
- Renerus J Stolwyk
- Turner Institute for Brain and Mental, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,Monash-Epworth Rehabilitation Research Centre, Richmond, VIC, Australia
| | | | | | | | - James R Gooden
- Turner Institute for Brain and Mental, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,Monash-Epworth Rehabilitation Research Centre, Richmond, VIC, Australia.,Eastern Health, Box Hill, VIC, Australia
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Chen MC, Huang HL, Chiu YC, Yip PK, Wu SM, Hsu WC, Wang WS, Huang YF, Shyu YIL. Experiences of Living in the Community for Older Aboriginal Persons With Dementia Symptoms in Taiwan. THE GERONTOLOGIST 2020; 60:525-534. [PMID: 31091307 DOI: 10.1093/geront/gnz013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Improving quality of life for community-dwelling older persons with dementia symptoms (PWDS) and family caregivers requires promoting dementia-friendly communities (DFC). However, little is known regarding older Taiwanese Aboriginal PWDS' experiences of living in the community. We explored these experiences for older Atayal PWDS and their families in Taiwan. RESEARCH DESIGN AND METHODS This grounded theory research used in-depth interviews to explore the perspectives of older PWDS (n = 4), their family members (n = 3), and key persons (n = 10) in an Atayal community in northern Taiwan. Data were analyzed using constant comparative analysis. Participants were interviewed between January and May 2015. RESULTS Participants' experiences were captured by the overarching concept of "low dementia awareness, high family-like ambience in the community." Despite the low/absent community awareness of dementia, older Atayal PWDS functioned as freely in the community as at home due to a family-like supportive environment. Aboriginal PWDS and their families also faced environmental challenges, e.g., environmental constraints and barriers to transportation access. DISCUSSION AND IMPLICATIONS Our results suggest that this Aboriginal community and culture offer important DFC components, and these strengths could be further studied to enhance DFC models elsewhere. Despite these strengths in supporting PWDS, environmental challenges to transportation access still cause difficulties for PWDS and their families and need improvement. The Atayal community's low dementia awareness suggests that services introduced must be culturally appropriate and nondisruptive to existing supportive helping systems. Our study can be a model for future studies to understand and identify PWDS' needs in Indigenous communities.
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Affiliation(s)
- Mei-Chen Chen
- Department of Public Health, Taoyuan City Government, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ping-Keung Yip
- Neurological Center, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Suh-Mian Wu
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Woan-Shyuan Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yueh-Fang Huang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Rock D, Price IR. Identifying culturally acceptable cognitive tests for use in remote northern Australia. BMC Psychol 2019; 7:62. [PMID: 31514741 PMCID: PMC6740030 DOI: 10.1186/s40359-019-0335-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background A lack of culturally appropriate tests hampers accurate assessment of cognition in remote Australian Aboriginal communities. In Arnhem Land, this study employed a community consultation process to evaluate commonly used Western tests of executive function, memory, attention, and visuospatial function. Methods An initial consultation process and a follow-up pilot study resulted in the rejection of some common tests, the development of new tests, and culturally adapted versions of others. In the subsequent 30-person main trial, adult Aboriginal volunteers were examined on nine tests, plus the Kimberly Indigenous Cognitive Assessment screen, and a brief literacy test. Results Executive function, memory, and attention tests were found to group separately after an exploratory principal components analysis. Correlations between new tests and similar Kimberly screen items were not significant, but ceiling effects may be relevant. Six of 13 test scores were found to correlate with the literacy measure. Conclusions A selection of cognitive tests were identified that Aboriginal people found culturally acceptable and engaging. In particular, Self-Ordered Pointing, Trail-Making, a verbal-switching task, and a new test “Which car?” show promise for further development. This work may contribute to the need for culturally appropriate cognitive testing in Aboriginal communities. Electronic supplementary material The online version of this article (10.1186/s40359-019-0335-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Deborah Rock
- University of New England, Armidale, NSW, 2351, Australia
| | - Ian R Price
- University of New England, Armidale, NSW, 2351, Australia.
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Reeve RA, Reynolds F, Paul J, Butterworth BL. Culture-Independent Prerequisites for Early Arithmetic. Psychol Sci 2018; 29:1383-1392. [DOI: 10.1177/0956797618769893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In numerate societies, early arithmetic development is associated with visuospatial working memory, executive functions, nonverbal intelligence, and magnitude-comparison abilities. To what extent do these associations arise from cultural practices or general cognitive prerequisites? Here, we administered tests of these cognitive abilities (Corsi Blocks, Raven’s Colored Progressive Matrices, Porteus Maze) to indigenous children in remote northern Australia, whose culture contains few counting words or counting practices, and to nonindigenous children from an Australian city. The indigenous children completed a standard nonverbal addition task; the nonindigenous children completed a comparable single-digit addition task. The correlation matrices among variables in the indigenous and nonindigenous children showed similar patterns of relationships, and parallel regression analyses showed that visuospatial working memory was the main predictor of addition performance in both groups. Our findings support the hypothesis that the same cognitive capacities promote competence for learners in both numerate and nonnumerate societies.
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Affiliation(s)
- Robert A. Reeve
- Melbourne School of Psychological Sciences, The University of Melbourne
| | - Fiona Reynolds
- Melbourne School of Psychological Sciences, The University of Melbourne
| | - Jacob Paul
- Melbourne School of Psychological Sciences, The University of Melbourne
| | - Brian L. Butterworth
- Melbourne School of Psychological Sciences, The University of Melbourne
- Institute of Cognitive Neuroscience, University College London
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11
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Ridley N, Batchelor J, Draper B, Demirkol A, Lintzeris N, Withall A. Cognitive screening in substance users: Diagnostic accuracies of the Mini-Mental State Examination, Addenbrooke's Cognitive Examination-Revised, and Montreal Cognitive Assessment. J Clin Exp Neuropsychol 2017; 40:107-122. [PMID: 28436744 DOI: 10.1080/13803395.2017.1316970] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Despite the considerable prevalence of cognitive impairment in substance-using populations, there has been little investigation of the utility of cognitive screening measures within this context. In the present study the accuracy of three cognitive screening measures in this population was examined-the Mini-Mental State Examination (MMSE), the Addenbrooke's Cognitive Examination-Revised (ACE-R), and the Montreal Cognitive Assessment (MoCA). METHOD A sample of 30 treatment-seeking substance users and 20 healthy individuals living in the community were administered the screening measures and a neuropsychological battery (NPB). Agreement of classification of cognitive impairment by the screening measures and NPB was examined. RESULTS Results indicated that the ACE-R and MoCA had good discriminative ability in detection of cognitive impairment, with areas under the receiver-operating characteristic (ROC) curve of .85 (95% confidence interval, CI [.75. .94] and .84 (95% CI [.71, .93]) respectively. The MMSE had fair discriminative ability (.78, 95% CI [.65, .93]). The optimal cut-score for the ACE-R was 93 (impairment = score of 92 or less), at which it correctly classified 89% of individuals as cognitively impaired or intact, while the optimal cut-score for the MoCA was <26 or <27 depending on preference for either specificity or sensitivity. The optimal cut-score for the MMSE was <29; however, this had low sensitivity despite good specificity. CONCLUSIONS These findings suggest that the MoCA and ACE-R are both valid and time-efficient screening tools to detect cognitive impairment in the context of substance use.
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Affiliation(s)
- Nicole Ridley
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia
| | - Jennifer Batchelor
- b Department of Psychology , Macquarie University , North Ryde , NSW , Australia
| | - Brian Draper
- c School of Psychiatry, Faculty of Medicine , UNSW Australia , NSW , Sydney , Australia.,d Academic Department for Old Age Psychiatry , Prince of Wales Hospital , Randwick , NSW , Australia
| | - Apo Demirkol
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,e School of Public Health & Community Medicine, Faculty of Medicine , UNSW Australia , Sydney , NSW , Australia
| | - Nicholas Lintzeris
- a Drug and Alcohol Services , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,f Discipline of Addiction Medicine, Central Clinical School , Sydney Medical School, The University of Sydney , Sydney , NSW , Australia
| | - Adrienne Withall
- e School of Public Health & Community Medicine, Faculty of Medicine , UNSW Australia , Sydney , NSW , Australia
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Shepherd SM, Ogloff JRP, Shea D, Pfeifer JE, Paradies Y. Aboriginal prisoners and cognitive impairment: the impact of dual disadvantage on Social and Emotional Wellbeing. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:385-397. [PMID: 28054417 DOI: 10.1111/jir.12357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/31/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Negligible information is available regarding the Social and Emotional Wellbeing (SEWB) needs of Aboriginal Australian individuals in custody with cognitive impairment. This is problematic given that Aboriginal people with cognitive impairment often experience dual disadvantage in the context of the justice system. This study sought to ascertain the relationship between cognitive impairment and mental health/cultural needs (SEWB) Aboriginal and Torres Strait Islander people in custody. METHOD A sample of 122 Aboriginal and Torres Strait Islander people were administered a culturally themed semi-structured questionnaire in custodial settings in Victoria, Australia. The questionnaire included measures of cognitive impairment, SEWB and forensic needs. Analyses were performed to determine differences in the presence of SEWB and unmet custodial needs by level of cognitive impairment. RESULTS Findings revealed a diminished level of wellbeing for cognitively impaired participants across several factors. Cognitive impairment was associated with poorer coping mechanisms, additional experiences of racism, difficulties handling emotions, discomfort around non-Aboriginal people and reduced access to meaningful activities in custody. All participants regardless of their level of impairment recognised the importance of cultural engagement; however, cognitively impaired participants had greater difficulty accessing/practicing cultural activities. CONCLUSIONS Culturally responsive disability assistance should be available at all phases of the justice system for Indigenous people with cognitive impairment to ensure that equitable care is accessible and needs are addressed.
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Affiliation(s)
- S M Shepherd
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Australia
| | - J R P Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Victorian Institute of Forensic Mental Health (Forensicare), Australia
| | - D Shea
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Victorian Institute of Forensic Mental Health (Forensicare), Australia
| | - J E Pfeifer
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Australia
| | - Y Paradies
- Alfred Deakin Research Institute for Citizenship and Globalisation, Deakin University, Australia
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Abstract
BACKGROUND Indigenous populations may be at increased risk, compared with majority populations, for the development of dementia due to lower education levels and socio-economic status, higher rates of diabetes, hypertension, cardiovascular disease and alcohol abuse, an aging population structure, and poorer overall health. This is the first systematic review investigating the prevalence and incidence of dementia in indigenous populations worldwide. METHODS This systematic review was conducted in accordance with PRISMA guidelines. We searched MEDLINE, Embase, and PsycInfo for relevant papers published up to April 2015. Studies were included if they reported prevalence or incidence, the disease typically occurred after the age of 45, the study population included indigenous people, and the study was conducted in the general population. RESULTS Fifteen studies representing five countries (Canada, Australia, the USA, Guam, Brazil) met the inclusion criteria. Dementia prevalence ranged from 0.5% to 20%. Retrospective studies relying on medical records for diagnoses had much lower prevalence rates and a higher risk of bias than population-based prospective studies performing their own diagnoses with culturally appropriate cognitive assessment methods. CONCLUSIONS The prevalence of dementia among indigenous populations appears to be higher than it is for non-indigenous populations. Despite a building body of evidence supporting the need for dementia research among indigenous populations, there is a paucity of epidemiological research, none of which is of high quality.
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Dingwall KM, Delima JF, Gent D, Batey RG. Hypomagnesaemia and its potential impact on thiamine utilisation in patients with alcohol misuse at the Alice Springs Hospital. Drug Alcohol Rev 2015; 34:323-8. [DOI: 10.1111/dar.12237] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Kylie Maree Dingwall
- Menzies School of Health Research; Institute of Advanced Studies; Charles Darwin University; Alice Springs Australia
| | - Jennifer Flavia Delima
- Alice Springs Hospital; Northern Territory Government; Department of Health; Alice Springs Australia
| | - Debra Gent
- Menzies School of Health Research; Institute of Advanced Studies; Charles Darwin University; Alice Springs Australia
| | - Robert Gordon Batey
- Alice Springs Hospital; Northern Territory Government; Department of Health; Alice Springs Australia
- Department of Medicine; Flinders University; Alice Springs Australia
- Central Clinical School; Sydney University; Sydney Australia
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15
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Bohanna I, Catherall J, Dingwall K. Ensuring Indigenous Australians with acquired brain injuries have equitable access to the National Disability Insurance Scheme. Aust N Z J Public Health 2014; 37:587. [PMID: 24892159 DOI: 10.1111/1753-6405.12120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Krohne K, Torres S, Slettebø Å, Bergland A. Everyday uses of standardized test information in a geriatric setting: a qualitative study exploring occupational therapist and physiotherapist test administrators' justifications. BMC Health Serv Res 2014; 14:72. [PMID: 24528609 PMCID: PMC3927824 DOI: 10.1186/1472-6963-14-72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 02/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health professionals are required to collect data from standardized tests when assessing older patients' functional ability. Such data provide quantifiable documentation on health outcomes. Little is known, however, about how physiotherapists and occupational therapists who administer standardized tests use test information in their daily clinical work. This article aims to investigate how test administrators in a geriatric setting justify the everyday use of standardized test information. METHODS Qualitative study of physiotherapists and occupational therapists on two geriatric hospital wards in Norway that routinely tested their patients with standardized tests. Data draw on seven months of fieldwork, semi-structured interviews with eight physiotherapists and six occupational therapists (12 female, two male), as well as observations of 26 test situations. Data were analyzed using Systematic Text Condensation. RESULTS We identified two test information components in everyday use among physiotherapist and occupational therapist test administrators. While the primary component drew on the test administrators' subjective observations during testing, the secondary component encompassed the communication of objective test results and test performance. CONCLUSIONS The results of this study illustrate the overlap between objective and subjective data in everyday practice. In clinical practice, by way of the clinicians' gaze on how the patient functions, the subjective and objective components of test information are merged, allowing individual characteristics to be noticed and made relevant as test performance justifications and as rationales in the overall communication of patient needs.
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Affiliation(s)
- Kariann Krohne
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo 0130, Norway.
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