International Journal of Circumpolar Health最新文献

The objectives of the scoping review were to: (1) conduct a systematic search for published literature focused on American Indian/Alaskan Native/Indigenous (AI/AN/I) youth, (2) identify current interventions that are focused on reducing sugar-sweetened beverages (SSB) or increased water intake (3) draw an understanding of who is leading these programmes, and (4) identify the lenses being used in developing and implementing the interventions. High consumption of sugar-sweetened beverages (SSBs) among youth is associated with numerous health problems, such as obesity, tooth decay, type 2 diabetes, and heart disease. Unless addressed early, many of these problems extend into, and/or present with additional complications in, adulthood. A comprehensive search was conducted across 5 electronic databases for peer-reviewed articles published until 20 March 2024. Additionally, manual searches were performed in 10 AI/AN/I-focused health journals. Data extraction was performed by 4 reviewers. Data management and analysis were performed using DistillerSR Inc. software, with screening and extraction conducted at all stages. Discrepancies were resolved by consensus among reviewers. The protocol for this scoping review was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/MFZ8X). AI/AN/I youth, prenatal to 17 years of age, caregivers, and educators. The search yielded 13 studies that met the eligibility criteria. Interventions were predominantly implemented through school, community, and school-community approaches. Individuals with a range of skills and training levels delivered the interventions. Out of the 13 studies, only 2 studies in this scoping review comprise all 4 aspects of the cultural/spiritual, emotional, mental, and physical domains and characteristics of engaging Indigenous communities when conducting research. Interventions with AI/AN/I communities with strong community and Native Nation support have a greater chance of success regardless of community, home, or school settings. Importantly, AI/AN/I communities have distinct definitions of health, underscoring the importance of identifying these meanings and implementing them as appropriate within research designs.

Background: Sensory impairments, including hearing and vision loss, are common in older adults and can affect quality of life. This study examines the integration of hearing and vision assessments in preventive home visits (PHVs) for older adults in the Faroe Islands, comparing outcomes between urban and rural settings.Aim: To evaluate the feasibility of including sensory assessments in PHVs and compare sensory measurements between Tórshavn (urban) and rural districts.Methods: A cross-sectional study with 175 participants aged 76 was conducted in Tórshavn and five rural areas. Data included demographics, self-assessments, and clinical evaluations using standardized tools.Results: Visual impairments were slightly more prevalent in rural areas, while hearing impairments showed no significant differences. Discrepancies between self-reported and measured impairments emphasized the importance of objective assessments. Sensory acreenings during PHVs improved early detection and highlighted inequities in access to specialized services.Conclusion: Integrating sensory assessments in PHVs is feasible and beneficial, adressing disparities between urban and rural areas. These screenings support equitable healthcare and early intervention, promoting better quality of life for older adults across diverse settings.

The use of telemedicine has increased substantially worldwide prompting questions about its effect on health outcomes, utilisation rates, and healthcare costs. Using de-identified data from the Alaska Tribal Health System (ATHS) and Medicaid, we evaluate how spending patterns changed for a group of telemedicine users relative to a matched sample of non-users. We find that individuals tend to incur lower healthcare spending relative to the control group after first exposure to telemedicine. Our pre- ferred estimates show a 1.14% decrease for the Medicaid sample and a 0.7% decrease in the ATHS sample.

As the prevalence of type 2 diabetes increases in Iceland, more nurse-led diabetes clinics have been established in primary health. This study aimed to evaluate treatment outcomes in patients with type 2 diabetes at two rural nurse-led diabetes clinics and compare these outcomes with guidelines. A retrospective cohort study was conducted in primary care settings in Northern Iceland using secondary data from medical recording systems. The sample (n = 88) included patients with two glycated haemoglobin (HbA1c) measurements taken at least 6 months apart (Time 1 and 2). Between Time 1 and 2, HbA1c levels (p = 0.049), body mass index (p = 0.013), and systolic blood pressure (p = 0.040) decreased. At time 2, approximately 70% of patients reached clinical goals for HbA1c levels, 33% for body mass index, 56% for systolic blood pressure, and 49% for diastolic blood pressure. This finding is consistent with those of other European studies in diabetes care. Assessing healthcare outcomes is beneficial for small rural clinics, where work is often conducted in isolation. This programme evaluation study conducted in two nurse-led clinics in Iceland demonstrated improved diabetes outcomes with care aligned with clinical guidelines and provided a baseline for measuring future outcomes.

This study describes the development of the Asthma Symptom Score (ASS) and evaluates its accuracy and internal consistency in Greenlandic and Danish, using clinical interviews based on Global Initiative for Asthma guidelines as the gold standard. A cross-sectional study was conducted across all regions of Greenland, targeting citizens aged 12+, using data from the electronic medical record. The ASS (n = 94) was validated against clinical interviews using a receiver operating characteristic curve, yielding an area under the curve estimate of 0.91, indicating strong agreement. The ASS demonstrated a sensitivity of 83%, a specificity of 93%, and an overall agreement of 87%. Patients scoring 0-5 points were categorised as having controlled asthma, while those scoring 6-20 points were categorised as non-controlled. Among participants completing both the ASS and the clinical interview, 57% were classified as having non-controlled asthma. The ASS demonstrated acceptable internal consistency in both Greenlandic and Danish. These findings underscore the need for improved management of asthma in Greenland. The strong correlation between the ASS and clinical interviews suggests that the ASS may be a valuable tool in clinical practice for assessing asthma control among patients with a confirmed diagnosis. However, further validation including a larger study group, and test - retest reliability is recommended.

This paper examines the development and implementation of the Inuit Holistic Service Delivery Model, designed by Qaujigiartiit Health Research Centre and currently being piloted through the Inuusirvik Community Wellness Hub in Iqaluit, Nunavut. The model represents a paradigm shift away from siloed Western service delivery frameworks towards an integrated approach grounded in Inuit epistemology, language, and cultural practices. Drawing on Indigenous methodologies and community-based approaches, this paper articulates how the model's eight interconnected components create a comprehensive wellness system that honours Inuit Qaujimajatuqangit (Inuit knowledge) while addressing contemporary community needs. The innovative approach offers valuable insights for other jurisdictions seeking to decolonise service delivery systems and develop culturally responsive alternatives. This paper contributes to growing scholarship on Arctic Indigenous health and wellness frameworks by demonstrating how the Inuit Holistic Service Delivery Model deserves recognition in academic discourse as a unique and innovative approach to community wellbeing.

Shared decision-making supports person-centred care. Our team of Inuit-led and/or -focused organizations and researchers field-tested a strategy called Not Deciding Alone to support health decision-making. Guided by aajiiqatigiingniq, a principle of collective decision-making and consensus-building, we co-produced a mixed-methods study to: (1) train Qikiqtani region community health representatives (CHRs) with a workshop, (2) develop a radio show and survey, and (3) assess the radio show with Inuit community members in the health system. We evaluated participant experiences using forms, case studies, and an online survey. The workshop was delivered to 13 CHRs; seven (54%) provided evaluation data. All (100%) reported positive experiences with the content, activities, and facilitation. One (14%) said the workshop was too short; four (57%) agreed there was enough discussion time. Six (86%) reported new learning. Three radio show events were held with 33 survey respondents, the majority women (n = 25, 76%). Most found the show informative (n = 29, 88%) and helpful for future decision-making (n = 27, 82%), and said it would improve their confidence (n = 27, 82%). Not Deciding Alone was found to be an acceptable, useful, and relevant strategy for supporting health decision-making among Inuit community members.

Accelerated climate warming in the Arctic threatens the food security of Indigenous peoples, including the Sámi in Finland. As temperatures rise nearly four times faster than the global average, ecosystems that support traditional Sámi practices, such as reindeer herding, fishing, hunting, and gathering, are increasingly disrupted. These practices are central to Sámi identity, knowledge systems, and social cohesion. However, despite these predictive narratives, the question of how these changes will affect overall food security among the Sámi remains unclear. This study aimed to: 1) investigate how climate change affects Sámi food security, 2) map concerns about anticipated impacts, and 3) assess the effectiveness of Finnish national policies. We addressed four dimensions of food security: availability, access, utilisation, and stability. Data were gathered through semi-structured interviews (N = 10), alongside a policy analysis. Findings indicate that climate change compromises the stability of the Sámi food systems and has broad implications on food security in terms of availability, accessibility, and utilisation. Current policy responses lack sufficient attention to the Sámi's cultural-ecological ties and offer limited support for Arctic-specific adaptation. These results underscore the urgency of culturally responsive and place-based policy action to strengthen Sámi food security in a rapidly changing climate.

Community-based participatory research (CBPR) is a framework to improve social equity by engaging communities as equal partners in research design, conduct, and knowledge creation. While CBPR has seen increasing application in Arctic regions, its use in Greenland has been limited by logistical, linguistic, and historical challenges, including community fatigue from extractive research practices. This manuscript details a CBPR-informed approach used to conduct an exploratory study on fertility, reproductive health, and climate adaptation in the Kalaallit community of Paamiut. The study aimed to understand the socio-environmental factors influencing fertility decisions amid economic and environmental changes. We report on nine strategies used to conduct equitable health and socio-ecological research in Greenland guided by the principles of CBPR. Using CBPR principles improved trust, participant recruitment, and the creation of community-valued research products in Paamiut. While time and funding limitations constrained full implementation of CBPR best practices, this study highlights the potential of CBPR to improve equity in Greenlandic research. Using CBPR principles to guide community-engaged research in Greenland provides a concrete and actionable way for students or early-career researchers to promote equitable relationships despite resource limitations. The methods described can be applied across other research disciplines to continue building trust and sustainability in international research partnerships in Greenland.

Rates of respiratory tract infections for children living in remote First Nations communities in the Sioux Lookout Zone in Northwestern Ontario are elevated and associated with poor indoor environmental quality including high exposures to endotoxin and serious dampness and mould damage. The studies also revealed a high prevalence of cigarette smoking and most houses have wood stoves, of variable quality. Depending on structure, polycyclic aromatic hydrocarbons (PAH) are carcinogens, immunotoxins and/or inflammatory mediators that are byproducts of the incomplete combustion of organic materials. Indoor sources of PAHs include tobacco smoke, cooking, and burning wood and/or fossil fuels for house heating. Twelve PAHs were measured in the <300 µm fraction of settled house dust by GC-MS in 59 houses. Nine PAHs were detected in all 59 houses, and median concentrations of individual PAHs measured ranged from 66 to 804 ng/g. PAHs associated with environmental tobacco smoke and with wood smoke dominated the PAH profile. Limiting tobacco smoking indoors and upgrading to low emission airtight wood stoves would improve indoor air quality and the respiratory health of children in this remote region of Ontario.