Utilising the CREATE quality appraisal tool to analyse Aboriginal and Torres Strait Islander peoples' involvement and reporting of cancer research in Australia

OBJECTIVE

We aimed to evaluate Aboriginal and Torres Strait Islander involvement in research focusing on cancer experiences using an Aboriginal and Torres Strait Islander quality appraisal tool (the QAT).

METHODS

We conducted a systematic review of the peer-reviewed literature on Aboriginal and Torres Strait Islander peoples' experiences associated with cancer, recently published elsewhere. We then appraised articles for the inclusion of Aboriginal and Torres Strait Islander-led research, community consultation, and involvement.

RESULTS

91 articles were appraised. A lack of Aboriginal and Torres Strait Islander-led research and consultation was reported in the majority of articles, only 10 (11%) demonstrated success across seven (50%) or more questions of the QAT.

CONCLUSIONS

This review underscores the need for anti-racist research and publication practices that actively engage Aboriginal and Torres Strait Islander peoples and researchers. This approach is vital to enhance cancer outcomes within these communities.

IMPLICATIONS FOR PUBLIC HEALTH

To advance and prioritise appropriate involvement of Aboriginal and Torres Strait Islander peoples in cancer research, the onus must be on 'systems owners,' including academic journals and institutions, to require and report genuine engagement as standard practice. Researchers will produce higher-calibre research with a strengths-based focus, advancing the cause of equitable research.

Quantifying Area-Level Physical Activity Offerings in Social Context: A Novel Concept That Goes Beyond Walkability and Access to Open Spaces

BACKGROUND

Social support is a crucial factor influencing the sustainability of physical activity (PA). This proof-of-concept study presents the development of a Social Physical Activity Index for Area (SPAIFA) an indicator reflecting opportunities for individuals to actively participate as part of a group within which opportunities for social interaction can be developed.

METHODS

Six government councils in the state of New South Wales, Australia, were selected encompassing 174 suburbs. Using 2 search engines' map tools, we identified PA venues for each suburb (eg, park, studios, etc). To enumerate activities per suburb, we used (1) venue websites, (2) New South Wales Office of Sport website, (3) national websites of grassroots PA for nonorganized activity (eg, parkrun, meetup, etc), and (4) social media. The database was linked to the suburb demographic profile, the area disadvantage score, walkability and open space scores, and the proportion of insufficiently active residents. Spatial analysis techniques were used to identify SPAIFA clusters.

RESULTS

SPAIFA councils' average was 9.9 activities per 10,000 people (ranging from 6.6/10,000 to 16.2/10,000). SPAIFA-Old (ie, activities specific to older adults) varied significantly (ranging from 11.7/10,000 to 0.8/10,000 seniors). Disadvantaged areas and a high proportion of insufficiently active residents were associated with being classified as low SPAIFA (P < .01). Three clusters of low SPAIFA were identified, and 17 high-risk areas where low SPAIFA was compounded by poor environmental support.

CONCLUSIONS

SPAIFA can be used by councils and policymakers as an indicator for monitoring and intervening in areas where natural and/or urban design is not conducive for PA.

Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer

BACKGROUND

Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia.

METHODS

A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations.

RESULTS

Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings.

CONCLUSION

Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.

Integrin alpha1beta1 and transforming growth factor-beta1 play distinct roles in alport glomerular pathogenesis and serve as dual targets for metabolic therapy

Alport syndrome is a genetic disorder resulting from mutations in type IV collagen genes. The defect results in pathological changes in kidney glomerular and inner-ear basement membranes. In the kidney, progressive glomerulonephritis culminates in tubulointerstitial fibrosis and death. Using gene knockout-mouse models, we demonstrate that two different pathways, one mediated by transforming growth factor (TGF)-beta1 and the other by integrin alpha1beta1, affect Alport glomerular pathogenesis in distinct ways. In Alport mice that are also null for integrin alpha1 expression, expansion of the mesangial matrix and podocyte foot process effacement are attenuated. The novel observation of nonnative laminin isoforms (laminin-2 and/or laminin-4) accumulating in the glomerular basement membrane of Alport mice is markedly reduced in the double knockouts. The second pathway, mediated by TGF-beta1, was blocked using a soluble fusion protein comprising the extracellular domain of the TGF-beta1 type II receptor. This inhibitor prevents focal thickening of the glomerular basement membrane, but does not prevent effacement of the podocyte foot processes. If both integrin alpha1beta1 and TGF-beta1 pathways are functionally inhibited, glomerular foot process and glomerular basement membrane morphology are primarily restored and renal function is markedly improved. These data suggest that integrin alpha1beta1 and TGF-beta1 may provide useful targets for a dual therapy aimed at slowing disease progression in Alport glomerulonephritis.

Risk factors associated with malnutrition in rural Jamaica

Risk factors associated with malnutrition were examined in rural Jamaica. Socioeconomic data were obtained on 63 well-nourished and 14 malnourished children. Risk factors associated with malnutrition were birth weight less than 2.5 kg (P < 0.01), maternal age equal to or greater than 25 years (P < 0.05) and landlessness (P < 0.05). Interventions aimed at reducing these factors can go a long way in reducing the malnutrition problem in developing countries.

Selective inhibition of luteinizing hormone action by ethanol in cultured human granulosa cells

To extend further our previous observations on the inhibition of luteinizing hormone (LH)-induced increases in steroid secretion by ethanol (EtOH) (Alcohol. Clin. Exp. Res. 14:522-527, 1990), cultured human granulosa cells were pretreated with several EtOH concentrations (0-100 mM), and cells were stimulated with human LH (25 ng/ml) or human follicle stimulating hormone (FSH) (100 ng/ml) and the secretion of 17-beta-estradiol (E2) and progesterone (P) was measured. EtOH significantly increased basal E2 secretion in a dose-related manner (0-20 mM); however, in the same concentration range EtOH did not produce consistent changes in FSH-stimulated E2 secretion. In contrast, EtOH decreased LH-stimulated E2 secretion between 0-20 mM such that at 20 mM EtOH, the positive effect of LH was abolished. EtOH increased P secretion by 40% at 20 mM and at 100 mM, there was a 100% increase. The FSH-stimulated P secretion was not consistently changed by EtOH, whereas LH-stimulated P secretion was decreased in a dose-dependent manner. LH/human chorionic gonadotropin (hCG) receptors in cells exposed to EtOH showed a 15% (p < 0.01) and a 47% decrease at 20 mM and 50 mM EtOH, respectively. At 50 mM EtOH, there was a decrease in LH/hCG receptor number from 2900/cell to 1670/cell, without a change in receptor affinity for hCG and 50 mM EtOH decreased LH/hCG receptors in intact granulosa cells in a time-dependent manner. These results indicate that the selective effects of EtOH on LH action in human granulosa cells may be mediated in part by an action on LH/hCG receptors.

Gonadotropins, estradiol, and growth factors regulate epithelial ovarian cancer cell growth

Indirect evidence suggests that gonadal steroids and gonadotropins may have a role in the genesis of epithelial ovarian cancer. In the studies reported herein, we established 17 beta-estradiol (E2) secreting cell cultures from an omental metastasis of an epithelial ovarian cancer. We demonstrate that human chorionic gonadotropin (hCG), human follicle-stimulating hormone, and epidermal growth factor (EGF) increased cell growth in a dose- and time-dependent manner, whereas E2 inhibited cell growth in the nanomolar range. Epidermal growth factor was able to partially block the negative effect of E2; a similar but quantitatively lesser effect was observed with hCG. These results provide direct evidence to support the view that gonadotropins, EGF, TGF beta (transforming growth factor), and estradiol may modulate growth of metastatic epithelial ovarian cancer cells.

Biological actions of monoclonal luteinizing hormone/human chorionic gonadotropin receptor antibodies

Several recent studies have elucidated the structure of the mammalian LH/hCG receptor; as reported in the present work, we have developed a series of monoclonal antibodies (mAbs) against the rat ovarian LH/hCG receptor using highly purified receptor as immunogen and by screening hybridomas with purified LH/hCG receptors. The mAbs were able to specifically immunoprecipitate LH/hCG receptors from solubilized preparations of rat ovarian membranes as well as from partially purified preparations. Western blotting with mAb P1B4 detected a probable receptor dimer and a receptor fragment in rat and porcine ovarian tissue but not in other tissues. This mAb also partially inhibited hCG binding to rat and porcine ovarian tissues. The receptor mAbs were able to inhibit hCG-induced progesterone synthesis in cultured human and porcine granulosa cells without affecting cAMP- and FSH-induced progesterone synthesis. The mAb P1B4 was used to demonstrate that the majority of ovarian receptors are internalized after hCG treatment and that in pseudopregnant rats receptors are present in the rough endoplasmic reticulum and in microvesicles. Bovine corpus luteal cells also contained P1B4 binding sites, as detected by immunohistochemical technique. Taken together, these results suggest that the mAbs are specific for the LH/hCG receptor, mAb P1B4 recognizes an epitope that is highly conserved among mammals, and this epitope is probably in the extracellular domain.

Human epithelial ovarian cancer cell steroid secretion and its control by gonadotropins

To elucidate the role of gonadotropins in regulating steroid metabolism in human epithelial ovarian carcinoma (OV Ca), cells were cultured from a number of OV Ca localized to the ovary. These cells uniformly secreted 17-beta-estradiol (E2), and cells from some OV Ca also secreted progesterone (P), as well as CA 125. Secretion rates decreased with time in culture and number of subcultures. In the original and first few subcultures, 1-10 pg/ml/microgram DNA/24 hr of E2 was secreted and P secretion varied from 1 to 8 ng/ml/microgram DNA/24 hr under basal conditions. Secretion rates for CA 125 were between 5 and 300 U/ml/day. Approximately 30% of the primary cultures from cystadenocarcinomas responded to hCG and hFSH and 70% of cultures responded to 8-Br-cAMP with 2- to 10-fold increases in secretion of E2. In one primary culture, hCG produced a dose-related increase in E2 production between 1 and 5 ng/ml, but the response declined to zero at 25 ng/ml. In the same cells, exposure to hCG and cAMP for 72 hr produced cell death, whereas hFSH had no such effect. Subculturing reduced steroidogenic responses to the hormones but the response to cAMP was maintained to a greater degree. These results suggest that some OV Ca-derived cells are steroidogenic in vitro and that some of these cells respond with increased E2 secretion to agents which are well-known stimulators of steroidogenesis in normal ovarian cells.

Ethanol has direct inhibitory effects on steroidogenesis in human granulosa cells: specific inhibition of LH action

We have evaluated the direct effects of ethanol (EtOH) on the production of progesterone (P) and estradiol-17 beta (E2) by cultured human granulosa cells obtained during in vitro fertilization procedures. On day 3 of culture, cells were divided into control and ethanol (20 mM) groups and stimulated by hFSH (50 ng/ml), hLH (0-50 ng/ml), FSH+LH, 8 Br-cAMP (0.25 mM) and androstenedione (10(-7) M). Experiments were terminated on days 7 and 9 and DNA, P, and E2 were measured. Ethanol inhibited P and E2 secretion stimulated by LH; however, there was no significant effect of ethanol on P and E2 production in the control group or when the cells were stimulated by FSH or cAMP. EtOH also had no effect on androstenedione stimulated E2 production. There was no significant difference in the DNA contents of the human granulosa cells in the ethanol group as compared with the control group. These results are the first demonstration of a direct effect of ethanol on cultured granulosa-lutein cells and suggest that ethanol may inhibit action of LH on the corpus luteum. A direct selective toxic effect of EtOH on the ovary may be responsible for some of the reproductive abnormalities observed in alcoholic women.