International Journal of Circumpolar Health最新文献

A systematic review was conducted to assess evidence on effectiveness of community-based interventions promoting wellbeing and prevention of type 2 diabetes (T2D) among Indigenous youth. A convergent, segregated, mixed methods approach was used, with six databases and four grey literature sites searched from inception to May 2022. Articles selected for inclusion were about community-based interventions related to T2D prevention with Indigenous youth that evaluated effectiveness or youth experience published in English. Reference lists were also searched for relevant sources. Seven quantitative research articles met the inclusion and quality assessment criteria. No qualitative articles were identified. The results were synthesised through narrative analysis, while meta-analysis was not possible due to heterogenous study designs. Common foci across interventions included promoting physical wellness, improving physical activity and healthy eating patterns, enhancing knowledge, and psychosocial wellness. Interventions deemed effective addressed multiple areas, were school-based, and operated for at least a year. Findings support multi-strategy, community-based interventions implemented over longer periods of time. However, gaps in research and reporting included the extent to which interventions are culturally informed and based on community-driven priorities. Future research should include Indigenous, mixed and qualitative methods and Indigenous-driven measures of success to better understand effectiveness in alignment with Indigenous worldviews.

Remote Arctic communities have often been depicted as being particularly vulnerable to the challenges of disasters, with their location and lack of infrastructure exacerbating risk. This study explores the characteristics of local resilience in the Arctic using the case study of the communities of the north-western Westfjords. A total of 42 semi-structured interviews were carried out with various community members, seeking to uncover the features of inbuilt resilience that contribute to successes and vulnerabilities. These were transcribed, coded, and categorised in relation to an integrated framework for assessing community resilience in disaster management, which groups topics via the themes of environmental, social, governance, economic, and infrastructure. All themes played a role in the success of local coping strategies, with easy access to the natural environment central to physical and mental well-being. Despite this, vulnerabilities of the community were evident, including insufficient local healthcare workers during a severe COVID-19 outbreak in a care home, the absence of a local quarantine hotel, and insufficient information in foreign languages for non-natives of Iceland. The general trend of following rules and expert advice was demonstrative of strong social capital, with locals trusting those in charge, nationally and locally, to manage the pandemic.

Rabies is often described as the quintessential One Health problem, linking especially animal health to human health. I examined how rabies is managed in the circumpolar North through semi-structured interviews of key informants in three cases: Alaska, Northwest Territories, and Svalbard. While rabies is controlled at the territorial or state level in the Northwest Territories and Alaska, respectively, the perception of where authority lies in rabies management is less evident in Norway concerning Svalbard than in the other two cases. Respondents generally characterised the working relationship between sectors and scales of governments as positive. However, coordination remains one of the main challenges to rabies management, with harsh environmental conditions and small remote communities adding additional challenges in all three cases. Rabies managers in Svalbard also face unique conditions, such as risks associated with hunting and the particular administrative structure of Svalbard. Due to limited veterinary services in dispersed small and remote communities, dogs present challenges to rabies management in Alaska and the Northwest Territories. Personal relationships are important in disease management across agencies, and the unique challenges in the far North will likely pose challenges in adopting approaches to disease management from temperate climates.

Since 1993, dietary assessment has been carried out in Greenland as part of recurrent population health surveys. In preparation for the next survey in 2024, 91 participants from the survey in 2018 were selected for a validation study of the Food Frequency Questionnaire (FFQ). The 91 participants were reinterviewed 38-50 months after the first FFQ and invited to complete a food diary. As part of the 2018 survey, blood was analysed for mercury. The food diary was completed by 65 participants. The agreement between the two FFQ interviews was very good for macronutrients and fatty acids (p > 0.20), whereas the calculated intake of mercury was 22% higher in the second FFQ (p = 0.04) due to a higher intake of whale meat and muktuk (whale skin). The agreement between the second FFQ and the food diary was good for local food, imported meat and cakes/sweets/snacks but fruit and vegetables, dairy products, beverages and added sugar were significantly underreported in the food diary. Food items not included in the FFQ were identified from the food diaries. The correlation between the intake of marine mammals and blood mercury was moderate (Spearman's rho = 0.41-0.50; p < 0.0001). The results will inspire future dietary studies in the circumpolar North.

The Nutrition North Canada (NNC) program, introduced in April 2011 is a federal strategy to improve access to perishable, nutritious foods for remote and isolated communities in northern Canada by subsidising retailers to provide price reductions at the point of purchase. As of March 2023, 123 communities are eligible for the program. To evaluate existing evidence and research on the NNC program to inform policy decisions to improve the effectiveness of NNC. A scoping review of peer-reviewed articles was conducted in ten databases along with a supplemental grey literature search of government and non-government reports published between 2011 and 2022. The search yielded 172 publications for screening, of which 42 were included in the analysis. Narrative thematic evidence synthesis yielded 104 critiques and 341 recommendations of the NNC program across eight themes. The most-identified recommendations focus on transparency, communication, and support for harvesting, hunting, and community food initiatives. This review highlights recommendations informed by the literature to address critiques of the NNC program to improve food security, increase access to perishable and non-perishable items, and support community-based food initiatives among eligible communities. The review also identifies priority areas for future policy directions such as additional support for education initiatives, communication and transparency amidst program changes, and food price regulations.

There is high prevalence of the genetic SI variant c.273_274delAG in the sucrase-isomaltase-encoding gene in Greenland, resulting in congenital sucrase-isomaltase deficiency and thereby an inability to digest sucrose, the most common dietary sugar. There are no studies of Greenlanders' everyday experiences of sucrose intolerance related to this genetic variant. This study therefore explored, how Greenlandic people experience sucrose intolerance influences life and their attitudes towards research in health and genetics. The study is qualitative, using semi-structured focus groups and/or individual telephone interviews. The analysis was based on the phenomenological-hermeneutic approach of Paul Ricoeur, consisting naïve reading, structural analysis, interpretation and discussion. We identified two themes; "Sucrose intolerance impacts daily living", dealt with physical and emotional reactions and coping with social adaption to activities. And "openness to participate in genetic and health research" were caused by participants wanting more knowledge to improve their people and family's life. The study concluded that most of the participants with symptoms of sucrose intolerance experienced the impact in their daily life, both physically, emotionally, and socially. Further, they expressed openness to participate in health and genetic research. There is a need for more accessible health knowledge and support from health care to manage sucrose intolerance.

There is growing awareness and recognition of the importance of the One Health paradigm to address existing environmental threats and recognise emerging ones at an early stage among Arctic residents, public health agencies, and wildlife resource managers. The One Health approach, emphasising the interconnectedness of human, animal, and ecosystem health, plays a pivotal role in addressing these multifaceted issues. Warming climate and permafrost thaw may influence both contaminant exposure and the spread of zoonotic infectious diseases and have impacts on water and food security. Migration from rural regions to larger communities and urban centres along with increased tourism may be accompanied by changes in exposure to contaminants and zoonotic diseases. Universities have developed educational programmes and research projects on One Health in the Arctic, and under the Arctic Council there is running a project of One Arctic, One Health. These arctivities have produced interdisciplinary information and practical solutions for local communities, decision-makers, and in scientific forums. There is a need for epidemiological zoonotic/human disease models, as well as new approaches to integrate existing and future surveillance data to climatic and environmental data. This requires not only regional and international collaboration but also multi-agency and transdisciplinary research.

Lung cancer is one of the most commonly diagnosed cancers in Canada and a leading cause of cancer mortality. Lung cancer also affects First Nations, Inuit and Métis peoples significantly in Canada, which deserves further investigation as there is a literature gap on this topic. We sought to develop a deeper understanding of lung cancer diagnosis, incidence, mortality, and survival in First Nations, Inuit, and Métis peoples in Canada. A systematic search was conducted in bibliographic databases to identify relevant studies published between January 2000 and March 2023. Articles were screened and assessed for relevance using the Population/ Concept/ Context (PCC) framework. A total of 22 articles were included in the final analysis, of which 13 were Inuit-specific, 7 were First Nations-specific, and 2 were Métis-specific. The literature suggests that comparative incidence, mortality, and relative risk of lung cancer is higher and survival is poorer in First Nations, Inuit and Métis peoples. Lung cancer also has varying impact on these population depending on sex, age, location and other factors. This review illustrates that more comprehensive quantitative and qualitative lung cancer research is essential to further identify the structural causes for the high incidence of the disease.

Poor indoor air quality poses significant health risks. This study addresses the gap in knowledge regarding the prevalence of indoor air pollutants in remote and rural First Nation communities in north-central British Columbia, Canada. Dust samples from 75 homes were collected and analysed for house dust mites, pet allergens, mould antigens, and bacterial endotoxins. Indoor air quality parameters, including carbon monoxide, carbon dioxide, particulate matter, temperature, and humidity, were measured. A detailed questionnaire on household characteristics and potential pollutant sources was administered. Homes exhibited exposure to multiple pollutants, with wood stove smoke identified as a primary source. Felis domesticus (cat allergen) and Canis familiaris (dog allergen) were prevalent, with detectable levels in 64% and 60% of homes, respectively. Bacterial endotoxins were present in all households. One-third of homes exceeded recommended thresholds for 3 or more pollutants. This study provides critical insights into the prevalence and magnitude of indoor air pollutants, contributing to a broader initiative to characterise respiratory health in First Nations communities. While many homes in First Nations communities had acceptable air quality, one-third of homes exceeded thresholds for 3 or more pollutants. The results can guide ongoing community efforts to address housing concerns and advocate for increased federal funding.

Preventing and managing Type 2 diabetes (T2D) involves adopting healthy lifestyle habits such as balanced nutrition and regular exercise. Maturity Onset Diabetes of The Young (MODY) shares diagnostic characteristics with T2D, but exercise responses in MODY remain unclear. In Greenland, MODY is 4-5 times more common than in other countries. No established exercise regimen exists for either T2D or MODY in Greenland. This study assessed the feasibility of a 12-week supervised exercise programme for MODY and T2D in Greenland, focusing on attendance, satisfaction, and effects on cardiovascular disease (CVD) risk factors and quality of life (QoL). Conducted as an experimental, two-armed, controlled trial, nine participants (4 with MODY) engaged in prescribed training sessions twice weekly for 45-60 minutes, while another nine (4 with MODY) formed the control group. Key outcomes included adherence rates, satisfaction levels, changes in HbA1c, body composition, aerobic fitness, blood pressure, CVD risk factors, and SF-12 scores. Although training adherence was modest at 56%, participant satisfaction remained high. Notable findings included a slight decrease of -0.3 mmol/l in HDL-cholesterol and a 5.7-point increase in the mental component (MCS) of SF-12 within the intervention group. However, the study underscores the need to refine the study design before supervised exercise programmes can be widely implemented in clinical settings in Greenland.