International Journal of Circumpolar Health最新文献

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.

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.