International Journal of Circumpolar Health最新文献

Indigenous Sámi women in Norway are entitled to equitable and culturally safe maternity care. However, research on the Sámi perspectives in maternity care is limited. To explore midwives' experiences with Sámi women in birthing units in Northern Norway, we conducted 11 interviews, which were analysed using reflexive thematic analysis. The main theme, "We are all Norwegians: We are all the same," reflects a recurring perception that equality in care means treating all women equally, regardless of their cultural background. This approach, while well-intentioned, risked obscuring the specific cultural needs of Sámi women. The analysis showed tensions between sameness and difference: some midwives emphasised individualised, woman-centred care without reference to cultural identity, while others recognised that Sámi women's backgrounds could shape communication, expectations, and needs in childbirth. Midwives with Sámi heritage described their background as influencing their understanding, even when they did not self-identify as Sámi. While midwives strive to provide individualised and equal care, this may unintentionally reproduce assimilative norms and contribute to culturally unsafe care by under-communicating difference. The findings underscore the importance of enhancing cultural safety in Norwegian midwifery through education, reflection on historical injustices, and acknowledgement of Sámi women's cultural identities.

Lack of in-home water service remains a persistent challenge in rural Alaska due to underfunding, high construction and operating costs, extreme cold, and environmental change. Alaska has the highest proportion of households in the U.S. lacking complete plumbing, resulting in self-hauling of water and waste, reuse of limited supplies, and higher rates of water-washed disease than in plumbed homes. During the COVID-19 response, the Alaska Native Tribal Health Consortium (ANTHC) and Silverline LLC developed and installed the Miniature Portable Alternative Sanitation System (Mini-PASS) in 14 unplumbed Alaska Native communities. To evaluate its impact on hand hygiene, water-hauling behaviors, and system use, we conducted seasonal interviews with 147 households. Among 139 households reporting handwashing methods, 63% (n=93) used the in-home handwashing station (HWS) as their primary method. Longer ownership was associated with greater HWS use and increased water hauling. Analysis of 163 interviews from 52 households showed a monthly rise of 0.08 gal/c/d (0.30 L/c/d) in water use following installation. These findings indicate that in-home HWS interventions such as the Mini-PASS improve hand hygiene, reduce wash-basin water reuse, and modestly increase household water use over time. Longitudinal monitoring is critical to assess sustained behavioral and WASH outcomes in unpiped communities.

The Oskâyak (Youth) Power Program (YPP) at Pakitahaw Sākahikan Iýiniwak (Sturgeon Lake First Nation) was co-created by and with youth to strengthen miyo-ayāwin (wellness) among oskinîkiwak (young men) and napêsisak (boys). Using a participatory empowerment evaluation grounded in a braided framework of community-based participatory research (CBPR), transformative learning, and ethical space, guided conversations were held with 14 youth supported by Kēhtēyak (Elders) and Kayāsi Kistēyihtamow Kanawēyihcikēw (Traditional Knowledge Keepers). Oskâyak (Youth) described how cultural teachings, land-based activities, and mentorship nurtured confidence, identity, and connection, cultivating hope, belonging, purpose, and meaning. The findings show how Nation-led, strength-based programs grounded in Indigenous knowledge can foster holistic miyo-ayāwin, agency, and community connectedness. The YPP illustrates the power of Indigenous youth-led, culturally grounded approaches to address health inequities while honoring self-determination and Ownership, Control, Access, and Possession (OCAP®) principles.

In Nunavut, Inuit territory in Canada, young people have suicide rates nine times higher than the overall Canadian rates. However, mental health services struggle to reach young people. Regional suicide prevention organizations call for improved services and a better continuum of care. Yet little research has explored young people's experiences with the services currently available. As part of a larger study on resilience in Inuit youth, we asked them to explain their lack of use of mental health and suicide prevention services. The study was conducted in Arviat and Pangnirtung and followed the Inuit methodology Aajiiqatigiingniq Research Methodology (ARM), a cultural process for consensus building and solution-seeking compatible with a qualitative research approach. Advisory boards were created in each community. Interviews were conducted with thirty-one Inuit youths age 15 to 24. Data were analyzed by a thematic analysis. Young Inuit expressed a general discomfort with available services, including uneasiness with the health center and the way services are provided, they lacked information about services, lamented inadequate outreach methods and expressed a feeling of mistrust. Our findings support the value of several ongoing initiatives based upon cultural traditions, and may inform the continuum of care for suicide prevention .

We compared a school-based portable and a clinic-based standard model for examining the oral health of school-age children in Finland. Two socioeconomically comparable regions were examined to discover the differences between these models for providing oral health examinations for primary school-age children in Finland. A retrospective registry study using patient records from the electronic health system (2020-2023) was conducted in two socioeconomically comparable regions: Nokia (portable model, n=481) and Tampere (standard model, n=538). The analysed variables included the number of visits, the longest gap between visits, diagnoses, oral health care procedures and recall intervals. The standard model exhibited significantly longer gaps between visits (median 25 vs. 11 months, p<0.001) and fewer individualised recall intervals (11.7% vs. 24.9%, p<0.001). Recall intervals were longer in the standard model (17 vs. 6 months, p<0.001). The standard model also showed higher prevalence of caries (21.1% vs. 11.7%, p<0.005), restorative treatments (41.3% vs. 33.1%, p<0.001) and tooth extractions (35.5% vs. 22.4%, p=0.005). The portable model had a higher proportion of children who received only a dentist's examination (35% vs. 9.6%, p<0.001) compared to hygienist-led examinations. Organisational factors play a more significant role than mere geographical accessibility in ensuring effective oral health care in Finland.

Few studies on epilepsy in Greenlandic children exist, and the results are inconsistent. The objective of this study was to estimate the burden of epilepsy in children in Greenland and Denmark and secondly to identify demographic risk factors. Third, the risk of epilepsy after febrile seizures should be estimated. A register-based cohort study of all children in Greenland and Denmark aged 0-15 years from 1987 to 2014 was conducted. Using the Greenlandic and Danish National Patient Register, cases were identified and coupled to demographics through the Civil Registration System. The outcomes were incidence rates (IR) per 100,000 person-years (PY) and hazard ratios (HR).The study showed an epilepsy IR of 150/100,000 PY (139-162) in Greenland and 110/100,000PY (108-111) in Denmark and an HR of 1.34. The IRs were very high in the first years of life. A significantly higher HR was found for male sex, Inuit ethnicity in Greenland and habitation in Greenland outside of the capital. The risk of epilepsy after the diagnosis of febrile seizures was almost doubled in Greenland compared with Denmark.

To investigate how the number of face-to-face office-hours nurse consultations changed in response to the continuously decreasing number of consultations with general practitioners (GPs) in the fourth largest city in Finland, Vantaa we performed a retrospective register-based follow-up cohort study in public primary health care. The number of monthly consultations per practitioner in public primary health care were examined and counted from all recorded face-to-face office-hour consultations with GPs, practical nurses (PNs), registered nurses (RNs), and public health (PHNs) nurses of Vantaa's public primary health care system between 1 January 2009 and 31 December 2014. Over the follow-up period, the monthly mean number of GP consultations adjusted per practitioner decreased from 159 (mean; SD 29) in 2009 to 135 (16) in 2014 (p<0.001), and the number of RN consultations decreased from 34 (14) to 27 (7; p<0.001). There was no significant decrease in the practitioner-adjusted median monthly number of office-hour consultations with PN or PHN. The total number of monthly office-hour consultations per practitioner decreased from 40 (11) to 34 (6; p<0.001). In public office-hours PHC, face-to-face medical consultations have not automatically shifted from GPs to nurses. Surprisingly, recorded RN consultations may even decrease, and the overall productivity of PHC may worsen.

Tonsillotomy (TT) has emerged as a less invasive alternative to tonsillectomy (TE), associated with lower bleeding risk. In Greenland, where access to ear, nose and throat specialists and emergency care is limited, postoperative bleeding is a significant concern. The objective of this study was to assess the feasibility of implementing TT across Greenland. A prospective case series was conducted at one central and two remote healthcare facilities. Children and adults with tonsillar hypertrophy, recurrent or chronic tonsillitis were eligible for inclusion. TT was performed using monopolar diathermy. Data were collected from medical records and structured interviews of patients and surgeons. Feasibility was assessed through procedure completion, logistics, patient satisfaction and surgeon feedback. Secondary outcomes included intraoperative parameters and postoperative morbidity. Ten patients underwent TT for tonsillar hypertrophy or recurrent tonsillitis. Inclusions at one facility were prevented by weather-related disruptions. Six surgeons performed the procedures without complications. Two patients were re-examined after discharge; one showed a self-limited bleeding. Patients reported overall satisfaction, and the surgeons noted only minor challenges. Implementation of TT in Greenland is feasible with the available resources. Acceptability is high and morbidity low. With guidelines and adjustments for mobile remote surgery, TT can be integrated into routine care.

Sauna bathing has gained increasing attention in medical and nursing research for its potential health-enhancing properties. It may be a valuable self-care practice for women, complementing conventional healthcare in prevention of diseases and promoting health and well-being. Since most studies focus on male participants, it is important to explore women's experiences with sauna bathing and its significance for their health and well-being. The aim of this study was to examine women's perceptions of sauna bathing and its impact on their health and well-being. A cross-sectional study was conducted using an online questionnaire comprising 17 items and four open-ended questions, which formed a subset of a larger questionnaire. A total of 384 women sauna users participated. Data was analyzed using descriptive statistics and qualitative content analysis. Women described a range of health and well-being experiences, with sauna bathing perceived as restorative and emotionally grounding, promoting improved sleep and reduced bodily pain, yet occasionally associated with social insecurity and counterproductive effects.

Indigenous food sovereignty (IFS) has the potential to reconnect Indigenous peoples in Canada to their food systems, reduce health problems and improve food security. Using PRISMA-ScR guidelines to search Medline, Web of Science, Embase and Cabi databases, this review sought to explore the characteristics of IFS promotion and the food environments involved through food and nutrition interventions in Indigenous communities in Canada. Data from 30 relevant studies published between 2004 and 2022 were included, analysed and synthesised using a thematic approach based on key IFS principles and a food environment typology. Most studies were conducted in urban contexts, mainly in provinces with the largest Indigenous populations. Local descriptions of IFS showed conceptual and operational similarities. Among the four key principles of IFS, the principle of participation was the most reported. Gardening, farming, hunting, fishing and gathering were the main food activities used to operationalise IFS in traditional and cultivated food environments. Several IFS facilitators and barriers were identified. The IFS movement that emerged from the literature in Canada advocates for a healthy and sustainable food system based on traditional beliefs and controlled by communities to ensure wellbeing and food security. This review provides evidence of converging visions for food autonomy despite the heterogeneity of Indigenous nations in Canada.