The effectiveness of ethno-specific and mainstream health services: an evidence gap map.

BACKGROUND: People of culturally and linguistically diverse (CALD) background face significant barriers in accessing effective health services in multicultural countries such as the United States, Canada, Europe and Australia. To address these barriers, government and nongovernment organisations globally have taken the approach of creating ethno-specific services, which cater to the specific needs of CALD clients. These services are often complementary to mainstream services, which cater to the general population including CALD communities. METHODS: This systematic review uses the Evidence Gap Map (EGM) approach to map the available evidence on the effectiveness of ethno-specific and mainstream services in the Australian context. We reviewed Scopus, Web of Science and PubMed databases for articles published from 1996 to 2021 that assessed the impact of health services for Australian CALD communities. Two independent reviewers extracted and coded all the documents, and discussed discrepancies until reaching a 100% agreement. The main inclusion criteria were: 1) time (published after 1996); 2) geography (data collected in Australia); 3) document type (presents results of empirical research in a peer-reviewed outlet); 4) scope (assesses the effectiveness of a health service on CALD communities). We identified 97 articles relevant for review. RESULTS: Ninety-six percent of ethno-specific services (i.e. specifically targeting CALD groups) were effective in achieving their aims across various outcomes. Eighteen percent of mainstream services (i.e. targeting the general population) were effective for CALD communities. When disaggregating our sample by outcomes (i.e. access, satisfaction with the service, health and literacy), we found that 50 % of studies looking at mainstream services' impact on CALD communities found that they were effective in achieving health outcomes. The use of sub-optimal methodologies that increase the risk of biased findings is widespread in the research field that we mapped. CONCLUSIONS: Our findings provide partial support to the claims of advocacy stakeholders that mainstream services have limitations in the provision of effective health services for CALD communities. Although focusing on the Australian case study, this review highlights an under-researched policy area, proposes a viable methodology to conduct further research on this topic, and points to the need to disaggregate the data by outcome (i.e. access, satisfaction with the service, health and literacy) when assessing the comparative effectiveness of ethno-specific and mainstream services for multicultural communities.

A social marketing perspective of young adults' concepts of eating for health: is it a question of morality?

BACKGROUND: Poor dietary choices are a risk factor for non-communicable diseases. Young adults have low levels of engagement towards their health and may not see the importance in the adoption of healthy eating behaviours at this stage in their lives. Here we utilise social marketing principles, digital ethnography and online conversations to gain insights into young adults' attitudes and sentiments towards healthy eating. METHODS: Young Australian adults who use social media at least twice a day were recruited by a commercial field house. Using a mixture of methods, combining online polls, forums and conversations, participants (n = 195, 18-24 years old) engaged in facilitated discussions over an extended 4 week period about health and eating-related topics. Data were analysed using thematic analysis constant comparison approach. A post-hoc conceptual framework related to religion was theorised and used as a metaphor to describe the results. RESULTS: Findings demonstrate that different segments of young adults with varying attitudes and interest towards healthy eating exist. We developed a conceptual framework based on consumer segmentation which adopted religious metaphors as a typology of 'consumers'. Some young adults practice and believe in the message of healthy eating (saints), whilst some oppose these messages and are not motivated to make any change (sinners), another segment are both aware of and interested in the issues but do not put healthy eating behaviours as a current priority (person in the pew). CONCLUSIONS: Consumer segmentation and social marketing techniques assist health professionals to understand their target audience and tailor specific messages to different segments. Segmentation provides insights on which groups may be most easily influenced to adopt the desired behaviours. The typology presented may be a useful tool for health professionals and social marketers to design strategies to engage young adults in healthy eating, particularly those in the pew who are contemplating a change but lacking the motivation. The utilisation of marketing segmentation in health promotion has the potential to enhance health messaging by tailoring messages to specific segments based on their needs, beliefs and intentions and therefore drive the efficient use of resources towards those most likely to change.

Intracellular dopamine oxidation mediates rotenone-induced apoptosis in PC12 cells.

AIM: To study the role of dopamine (DA) in rotenone-induced neurotoxicity in PC12 cells. METHODS: Cell viability was assessed by detecting the leakage of lactate dehydrogenase (LDH) into the medium. Apoptosis rate was measured by flow cytometry. Caspase-3-like activity was measured by fluorescence assay using the probe Ac-DEVD-AMC. The level of intracellular hydrogen peroxide and other peroxides in PC12 cells were quantified by loading cells with 2'-7'-Dichlorodihydrofluorescein diacetate (DCFH-DA) in fluorescence assay. Lactic acid was measured spectrophotometrically. The DA levels in PC12 cells were determined by HPLC-ECD. RESULTS: A 48-h incubation of PC12 cells with rotenone caused an apoptotic cell death and elevated intracellular reactive oxygen species (ROS) and lactic acid accumulation. Intracellular DA depletion with reserpine significantly attenuated rotenone-induced ROS accumulation and apoptotic cell death. No change was found in rotenone-induced ROS accumulation when cells were co-treated with deprenyl. Brief treatment with reserpine at the end of rotenone treatment had no effect on rotenone-induced neurotoxicity. However, when cells were first incubated with deprenyl, a monoamine oxidase-B inhibitor for 30 min then co-incubated with rotenone plus deprenyl, a brief treatment with reserpine enhanced cell injury. CONCLUSION: Rotenone-induced apoptosis in PC12 cells was mediated by intracellular dopamine oxidation.

[Effects of extremely low frequency electromagnetic fields on DNA of testicular cells and sperm chromatin structure in mice].

OBJECTIVE: To study the effects of 50 Hz electromagnetic fields (EMFs) on DNA of testicular cells and sperm chromatin structure in mice. METHODS: Mice were exposed to 50 Hz, 0.2 mT or 6.4 mT electromagnetic fields for 4 weeks. DNA strand breakage in testicular cells was detected by single-cell gel electrophoresis assay. Sperm chromatin structure was analyzed by sperm chromatin structure assay with flow cytometry. RESULTS: After 50 Hz, 0.2 mT or 6.4 mT EMFs exposure, the percentage of cells with DNA migration in total testicular cells increased from the control level of 25.64% to 37.83% and 39.38% respectively. The relative length of comet tail and the percentage of DNA in comet tail respectively increased from the control levels of 13.06% +/- 12.38% and 1.52% +/- 3.25% to 17.86% +/- 14.60% and 2.32% +/- 4.26% after 0.2 mT exposure and to 17.88% +/- 13.71% and 2.35% +/- 3.87% after 6.4 mT exposure (P < 0.05). Exposure to EMFs had not induced significant changes in S.D.alphaT and XalphaT, but COMPalphaT (cells outside the main population of alpha t), the percentage of sperms with abnormal chromatin structure, increased in the two exposed groups. CONCLUSION: 50 Hz EMFs may have the potential to induce DNA strand breakage in testicular cells and sperm chromatin condensation in mice.

[Effects of extremely low frequency electromagnetic fields on the level of c-fos mRNA in brain and liver of mouse].

OBJECTIVE: To study the effects of extremely low frequency electromagnetic fields (ELF EMFs) on c-fos gene expression in mouse brain and liver tissues. METHODS: Mice were exposed to 50 Hz sinusoidal 0.2 mT or 6.0 mT electromagnetic field for 2 weeks or 4 weeks. Competitive RT-PCR method was used to measure c-fos mRNA level. RESULTS: After exposure to 0.2 mT or 6.0 mT field for 2 weeks, c-fos mRNA levels in brain tissue [(0.0178 +/- 0.0076) amol/120 ng cDNA and (0.0092 +/- 0.0042) amol/120 ng cDNA respectively] were higher than that of control level [(0.0012 +/- 0.0005) amol/120 ng cDNA] (P < 0.05). In liver tissue c-fos mRNA levels [(0.0117 +/- 0.0055) amol/120 ng cDNA and (0.0148 +/- 0.0162) amol/120 ng cDNA respectively] were also higher than that of control level [(0.0005 +/- 0.0005) amol/120 ng cDNA] (P < 0.05). After exposure to 0.2 mT or 6.0 mT field for 4 weeks, c-fos mRNA levels in brain tissue [(0.0100 +/- 0.0054) amol/120 ng cDNA and (0.0198 +/- 0.0079) amol/120 ng cDNA respectively] were higher than that of control level [(0.0015 +/- 0.0008) amol/120 ng cDNA] (P < 0.05). In liver tissue the exposure induced much higher expression level [(0.0173 +/- 0.0122) amol/120 ng cDNA and (0.0133 +/- 0.0090) amol/120 ng cDNA respectively] while no expression was found in the control. CONCLUSION: Exposure to 50 Hz electromagnetic fields may induce up-regulation of c-fos transcription in mouse brain and liver tissue.

[Effects of extremely low frequency electromagnetic fields on apoptosis and cell cycle of mouse brain and liver cells].

OBJECTIVE: To study the effects of extremely low frequency electromagnetic fields (ELF EMFs) on apoptosis and cell cycle of mouse brain and liver cells. METHODS: Mice were exposed to 50 Hz, 0.2 mT or 6.0 mT electromagnetic fields for 2 weeks. TUNEL and flow cytometric methods were used to analyze apoptosis and cell cycle of brain and liver cells. RESULTS: After exposure to 0.2 mT and 6.0 mT ELF EMFs for 2 weeks, apoptosis rates of brain cells [(5.60 +/- 1.47)% and (4.73 +/- 0.48)% respectively] were higher than that of control [(2.90 +/- 0.75)%], and apoptosis rates of liver cells [(4.19 +/- 2.08)% and (3.38 +/- 0.65)% respectively] were higher than that of control [(1.84 +/- 0.76)%]. G0/G1 cell percentage of brain cells [(80.21 +/- 1.68)% and (79.54 +/- 0.56)% respectively] were higher than that of control [(76.85 +/- 0.83)%], and those of liver cells [(79.42 +/- 1.80)% and (80.47 +/- 1.79)% respectively] were higher than that of control [(73.36 +/- 3.10)%]. The above differences were all statistically significant as P < 0.05. At the same time S and G2 + M cell percentage of brain and liver cells were significantly decreased. CONCLUSION: Exposure to 50 Hz EMFs may alter cell cycle and induce apoptosis of mouse brain and liver cells.

[Effects of extremely low frequency electromagnetic fields on male reproduction in mice].

OBJECTIVE: To investigate the effects of extremely low frequency electromagnetic fields (ELF EMFs) on male reproduction in mice. METHODS: 94 adult male mice were exposed to 50 Hz sinusoidal electromagnetic fields of 0.2, 3.2 or 6.4 mT for 2 weeks or 4 weeks. Testicular histology and weight, sperm amount, sperm motility and morphology were measured. The percentages of different ploidy cells and cell phases, and DNA content of testis cells were estimated by flow cytometry. The micronucleus rate of bone-marrow cell was also observed. RESULTS: The testicular weight of the mice exposed to 6.4 mT for 4 weeks [(76.06 +/- 32.25) mg] was significantly lower than that of the control [(111.44 +/- 19.99) mg, P < 0.05]; no significant histopathological changes were observed on the testis in EMFs exposed mice;the sperm amount was decreased after EMFs exposure for 4 weeks, and those of the mice exposed to 0.2 mT and 6.4 mT for 4 weeks [(4.87 +/- 0.94) x 10(6)/ml and (4.30 +/- 1.89) x 10(6)/ml respectively] were significantly lower than that of the control [(6.67 +/- 0.70) x 10(6)/ml, P < 0.05]; the rates of sperm motility also showed a decline. After 0.2, 3.2 or 6.4 mT EMFs exposure for 2 weeks, the deformity rates of sperm [(7.416 +/- 3.352)%, (6.862 +/- 2.947)% and (8.112 +/- 4.615)% respectively] were significantly higher than that of the control [(4.098 +/- 2.028)%, P < 0.01]. Similarly, those of the mice exposed for 4 weeks [(10.267 +/- 3.836)%, (11.027 +/- 7.059)%, (8.814 +/- 3.678)% respectively] were higher than that of the control [(3.714 +/- 1.830)%]. After 6.4 mT exposure for 2 weeks, the percentages of 1C testis cells [(69.56 +/- 4.07)%] was significantly lower than that of the control [(73.45 +/- 3.10)%, P < 0.05]. There were not any remarkable changes in those of 2C, 4C cells. DNA content in different ploidy cells of the mice exposed to 6.4 mT was decreased. Moreover, the cell percentage in S phase was increased significantly (P < 0.01). CONCLUSION: ELF EMFs exposure may have some adverse effects on reproduction in mice.

[Effects of extremely low frequency electromagnetic field and its combination with lead on the antioxidant system in mouse].

OBJECTIVE: To study the effects of extremely low frequency electromagnetic field(ELF EMF) and its combination with lead on the antioxidant system in mouse brain and liver tissues. METHOD: Mice were exposed to a 50 Hz sinusoidal 0.2 mT or 6.0 mT EMF for 2 weeks. At the same time, some groups were exposed to lead(50 mg/kg). After the exposure, the antioxidant system and cell membrane fluidity in brain and liver were measured. RESULTS: Malondiadehyde(MDA) content in brain and liver increased from the control levels of (1.33 +/- 0.12) and (3.95 +/- 0.21) nmol/mg pro to (1.35 +/- 0.09) and (6.15 +/- 0.28) nmol/mg pro respectively following 0.2 mT exposure, and to (3.98 +/- 0.10) and (6.50 +/- 0.79) nmol/mg pro respectively following 6.0 mT exposure. Total antioxidant capability(T-AOC) in brain and liver decreased from the control levels of (4.39 +/- 0.48) and (2.45 +/- 0.21) U/mg pro to (3.99 +/- 0.39) and (1.92 +/- 0.32) U/mg pro respectively following 0.2 mT, and to (3.12 +/- 0.37) and (1.57 +/- 0.14) U/mg pro respectively following 6.0 mT. GSH content decreased only in liver tissue from the control level of (194.60 +/- 20.93) mg/g pro to (189.24 +/- 5.61) mg/g pro(0.2 mT) and (153.04 +/- 1.18) mg/g pro(6.0 mT). Cellular membrane fluidity decreased from the control levels of (1.396 +/- 0.040) and (2.899 +/- 0.552) to (1.224 +/- 0.190) and (1.894 +/- 0.0761) (0.2 mT), (1.159 +/- 0.179) and (1.516 +/- 0.204)(6.0 mT) respectively. Compared with single EMF exposure(6.0 mT), EMF combined with lead exposure induced remarkable increase in MDA, GSH content and T-AOC and decrease in cell membrane fluidity both in the brain and liver, and increase in SOD activity only in liver. CONCLUSION: ELF EMF might alter the metabolism of free radicals, decrease anti-oxidant capability and enhance lipid peroxidation. The combination of EMF with lead showed synergic effects on lipid peroxidation.