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Objectives: To describe and compare caregiver perceptions of their emergency department (ED) experiences with and without child life specialist (CLS) involvement in their child's overall care. Study design: A descriptive cross-sectional survey of caregivers of children aged 0-17 years at a tertiary care pediatric ED was completed from March to August 2021. Survey themes included perceived experience and satisfaction and the impact of child life specialists. Results: A total of 179 caregivers completed the survey; mean age was 38.9 years (SD 8.4), and 68.1% (122/179) were mothers. Caregivers of children with CLS involvement (CLS+) ranked their overall experience (P = .021) and satisfaction (P = .009) greater than without CLS involvement (CLS–). More CLS+ caregivers ranked their experience (55.7%, 34/61) and their satisfaction (77.0%, 47/61) as excellent (5/5 Likert scale rating) compared with CLS– caregivers (34.8%, 40/115 and 52.2%, 60/115 respectively). CLS+ families were more likely to be offered nonpharmacologic interventions (eg, iPad, sensory lights, toys) (98.4% vs 31.3%, P = .003); they were also more likely to have a health care worker explore their feelings and fears (52.5% vs 27.0%, P = .0008), help them prepare for a procedure or examination (73.8% vs 31.3%, P

Objectives: To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians. Study design: We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool. Data sources: MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022. Results: The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi‐experimental study, and one repeated cross‐sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36–64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36–64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1c levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta‐analysis. Conclusions: Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed. Registration: PROSPERO CRD42021247496 (prospective). [ABSTRACT FROM AUTHOR]

Analysis of social inequality in the Pacific Island culture of the Etoro defies reconstructed Marxist interpretations. A prestige-stigma system is linked to the concept of symbolic capital and participation in ceremonial gift exchange. This semiautonomous social structure requires other theoretical constructs to examine the Etoro's ethnographic data.