International Journal of Circumpolar Health最新文献

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.

The Elders Advisory group in the northern Saskatchewan Cree community of Pelican Narrows (PN) and Peter Ballantyne Cree Nation (PBCN) directed researchers that access to paediatric rehabilitation services was an urgent priority for research collaboration. In partnership with PN and PBCN, a community needs assessment (CNA) was implemented to a) develop, sustain and nurture new and existing community-researcher relationships and b) identify community needs and preferences for paediatric rehabilitation. A community-based participatory action research approach incorporating Indigenous research principles was utilised. Community members and Elders were involved from conception through design, data collection and analysis. A mixed methods design was used. Descriptive statistics obtained using a demographic questionnaire found that all children in the study (n = 9) identified multiple developmental concerns that could benefit from rehabilitation services. Semi-structured interviews were used to gather lived experiences and stories from three healthcare providers and eight families. Analysis followed an iterative thematic approach using NVIVO software. "Family, Community and Culture" provided an overarching theme for additional themes: "Barriers to Care", "Service Needs", "Preferences for Pediatric Rehabilitation", and "Potential of Virtual Care". The results confirmed an urgent need for enhanced access to culturally-responsive, multi-disciplinary paediatric rehabilitation services and informed recommendations for future care models.

Cold baths have been used in various cultures for centuries, with modern scientific interest growing over the past few decades. The aim of this phenomenological hermeneutic study was to explore the meaning of outdoor cold bathing of people who regularly engage in that practice. Nine people, seven women and two men aged 44 to 70, who regularly cold bathed in Sweden participated in the study. They were interviewed during the winter-spring of 2025. Participants described cold bathing as a powerful coping mechanism during periods of stress and life transition, often beginning in midlife when facing personal or professional challenges. Cold bathing was described as a powerful practice that not only challenges the body but also uplifts the mind, often becoming a valued ritual for both physical recovery and emotional renewal. Being in nature was an important part of the holiness of the experience.

In northern Canada, medical travel - the movement of patients to a larger centre to access healthcare services outside their home community - is a dominant feature of the healthcare system. This qualitative study explored the medical travel experiences of Gwich'in living above the Arctic Circle in the Gwich'in Settlement Area in Northwest Territories (NT). Data collection in 2020 comprised storytelling sessions with 10 Gwich'in medical travellers (6 female, 4 male). Using inductive and deductive methods with continual critical reflexivity, and guided by Gwich'in values, concerns about access to healthcare were found to be at the heart of each story. A broad conceptualisation of access was applied to understand and interpret the results according to six dimensions: accessibility, availability, affordability, adequacy, acceptability, and awareness. Situated within a context of colonialism, structural inequities and other factors relevant across the Circumpolar North, the results suggest that the NT medical travel policy framework provides only partial access to care. This article illustrates a need for healthcare and other government systems to think about policy and programmes in a more wholistic, equitable and relationship-centred way, which would help not only to bridge distances across geography, but also between peoples.

Describing the epidemiology of colorectal cancer (CRC), Burkitt (1971) emphasised the increased incidence among developed, industrial populations consuming a more refined diet and proposed dietary fibre as the key to the lower CRC incidence noted in underdeveloped countries with less refined diets. Noting the increased incidence of CRC among Alaska Native (AN) peoples and seemingly low presence of fibre in some AN diets, investigators with the University of Pittsburgh and the Alaska Native Tribal Health Consortium proposed to test whether large amounts of fibre contained in a dietary supplement could lower CRC risk. We describe supplement tolerance as reported by AN participants completing a 4-week supplementation trial, which added 44.5 grams per day (g/d) total fibre (23.7 g/d resistant starch (RS)) to the diet of those assigned to the intervention arm and 1 g/d total fibre to those assigned to the control arm. Tolerance of the high fibre supplement would play a key role in protocol adherence as well as any recommendations for future use by the broader population. In this study, the daily RS intervention containing 44.5 g/d additional dietary fibre produced more flatulence than usual but fewer other symptoms were consistently reported compared to the digestible starch (DS) control.