Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders

Aims: This article seeks to address some of the factors, particularly cultural barriers, contributing to inequity in healthcare service provisions for indigenous Australians. Furthermore, this article presents ways for healthcare professionals to take action on culture-related health equity issues. Finally, this article addresses what nurses can do to support more operational interventions and enhance the quality of services for indigenous Australians and Torres Strait Islanders.Background: Recently, scholarly literature in Australia has focused on the issue of ensuring equitable access to healthcare for aboriginal Australians and Torres Strait Islanders, who are regarded as economically, socially, politically and culturally disadvantaged(Larkins et al, 2016; Lowell, 2013).^(1,2)However, in spite of significant efforts on the part of the Australian government, scholars, policy makers and communities to provide fair and equitable healthcare, this challenging and longstanding issue remains unresolved and needs to be addressed immediately(Australian Institute of Health and Welfare, 2015; Australian Bureau of Statistics(ABS), 2011).^(3,4)Data sources: Using the Population, Intervention and Outcome framework, several databases(PUBMED,MEDLINE, and SCOPUS) and government web-based literature resources were searched to identify original research articles published from 2000 to 2016.Discussion: Health inequity exists among aboriginal Australians and Torres Strait Islanders, and the cultural barriers are vital factors in addressing aboriginals' health inequity. Healthcare professionals could be part of an effective solution for diminishing racial/ethnic disparities in healthcare. Different types of nurses could play different roles in addressing aboriginal cultural barriers among aboriginal Australians and Torres Strait Islanders.Nurses are uniquely positioned to initiate and sustain contact with aboriginal Australians and Torres Strait Islanders in healthcare workplaces,as they can intervene at the points of greatest need in the community to address socially significant healthcare and social issues.Conclusions: The different roles of nurses in providing health and social care interventions to aboriginal Australians and Torres Strait Islanders could be utilized to increase equity in access to healthcare and help aboriginals attain better levels of health.

Ablation of steroid receptor coactivator-3 in mice impairsadipogenesis and enhances energy expenditure

Obesity is a medical condition in which excess body fat has accumulated to an extent and may have an adverse effect on health,leading to reduced life expec-tancy,impaired energy homeostasis and increased health problems.The p160 steroid receptor coactivator(SRC)gene family members have been suggested to be involved in energy homeostasis,but the impact of SRC-3 ablation on white and brown adipose tissue needs to be elucidated.In the current study,we collected in vivo data and carried out morphological studies on the effect of SRC-3 deficiency on white adipose tissue(WAT)and brown adipose tissue(BAT).Primary cells were cultured to investigate the differentiation ability of both adipocytes.Western blot was applied to detect the expression of master genes governing adipogenesis and thermogenesis.We observed that SRC-3^(–/–)mice were lean,with reduced WAT and decreased serum leptin levels,mainly due to the smaller white adipocyte size caused by impaired adipo-genesis,presented by decreased peroxisome proliferator activated receptor g(PPARg)expression.In the BAT,the lipid droplets decreased significantly in SRC-3^(–/–)mice as demonstrated by histological analysis and electron micro-scopic observation,which could be explained by enhanced thermogenesis.The expression of thermogenic marker gene PPARg coactivator 1αand uncoupling protein-1 increased in BAT of SRC-3^(–/–)mice,which proved our observations.Collectively,these results demonstrate that SRC-3 plays a key role in adipogenesis and energy expenditure.