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The intersection of social and Indigenous determinants of health for health system strengthening: a scoping review. 加强卫生系统的社会和土著健康决定因素的交叉:范围界定审查。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-17 DOI: 10.1080/22423982.2024.2401656
Christina E Oré,Madalyn Law,Tia Benally,Myra E Parker
The COVID-19 pandemic exposed long-standing gaps in health service systems and realities of environmental changes impacting Native nations and Indigenous communities in the US and circumpolar regions. Despite increased awareness and funding, there is limited research and few practical resources available for the work. This is a scoping review of the current literature on social determinants of health (SDOH) impacting Indigenous peoples, villages, and communities in the US and circumpolar region. The review used the York methodology to identify research questions, chart, and synthesize findings. Thirty-two articles were selected for full review and analysis. The articles were scoping reviews, evaluations, and studies. The methods used were 44% mixed (n = 14), 31% quantitative (n = 10) and 25% qualitative (n = 8). The synthesis identified four areas for discussion: 1) systemic and structural determinant study designs, 2) strengthening Indigenous health systems, 3) mapping the relationship of co-occurring health conditions and SDOH, and 4) emergent areas of inquiry. While the scoping review has limitations, it provides a snapshot of broad SDOH and shared Indigenous social determinants of health (ISDOH) to create tailored frameworks for use by tribal and urban Indigenous health organisations, with their partners, in public health and system strengthening.
COVID-19 大流行暴露了医疗服务体系中长期存在的差距,以及环境变化对美国和环极地区土著民族和土著社区的现实影响。尽管认识和资金都有所提高,但这方面的研究却很有限,可用于这项工作的实用资源也很少。这是对当前影响美国和环极地区原住民、村庄和社区健康的社会决定因素 (SDOH) 文献的一次范围界定审查。该综述采用约克方法来确定研究问题、绘制图表并综合研究结果。选取了 32 篇文章进行全面审查和分析。这些文章包括范围综述、评估和研究。所使用的方法有 44% 的混合方法(n = 14)、31% 的定量方法(n = 10)和 25% 的定性方法(n = 8)。综述确定了四个讨论领域:1)系统性和结构性决定因素研究设计;2)加强土著卫生系统;3)绘制共存健康状况与 SDOH 的关系图;4)新兴调查领域。虽然范围界定审查有其局限性,但它提供了广泛的 SDOH 和共同的土著健康社会决定因素 (ISDOH) 的概貌,以创建有针对性的框架,供部落和城市土著卫生组织与其合作伙伴在公共卫生和系统强化中使用。
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引用次数: 0
Levels and trends of persistent organic pollutants in human populations living in the Arctic. 生活在北极地区的人类体内持久性有机污染物的水平和趋势。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-17 DOI: 10.1080/22423982.2024.2392405
Bryan Adlard,Eva C Bonefeld-Jørgensen,Alexey A Dudarev,Kristin Olafsdottir,Khaled Abass,Maria Averina,Pierre Ayotte,James Berner,Sam Byrne,Élyse Caron-Beaudoin,Mallory Drysdale,Pierre Dumas,Joshua Garcia-Barrios,Irina Gyllenhammar,Brian Laird,Melanie Lemire,Amira Aker,Sanna Lignell,Manhai Long,Karin Norström,Sara Packull-McCormick,Maria Skaalum Petersen,Mylene Ratelle,Arja Rautio,Amalie Timmerman,Gunnar Toft,Pal Weihe,Therese Haugdahl Nøst,Maria Wennberg
The Arctic Monitoring Assessment Program (AMAP) is tasked with monitoring and assessing the status of environmental contaminants in the Arctic, documenting levels and trends, and producing science-based assessments. The objectives of this paper are to present the current levels of persistent organic pollutants (POPs) across the Arctic, and to identify trends and knowledge gaps as detailed in the most recent AMAP Human Health Assessment Report. Many Arctic populations continue to have elevated levels of these contaminants, and the highest levels of POPs were observed in populations from Greenland, Faroe Islands, and Nunavik (Canada), as well as populations in the coastal Chukotka district (Russia) for legacy POPs only. Concentrations of most POPs are declining in Arctic populations in regions where time trends data exist, although the declines are not consistent across all regions. The exceptions are per- and polyfluoroalkyl substances, with concentrations of some long-chain PFAS such as perfluorononanoic acid increasing in populations in Nunavik, Greenland and Sweden. This paper provides a more extensive summary of levels of contaminants in adults, pregnant women, and children across the Arctic than previous AMAP human health assessments, particularly for levels of long-chain PFAS, which are currently under consideration for inclusion in the Stockholm Convention.
北极监测评估计划 (AMAP) 的任务是监测和评估北极地区的环境污染物状况,记录污染物水平和趋势,并进行科学评估。本文旨在介绍整个北极地区持久性有机污染物 (POP) 的当前水平,并确定最新的 AMAP 人类健康评估报告中详述的趋势和知识差距。许多北极地区的居民体内持久性有机污染物含量持续升高,其中格陵兰岛、法罗群岛和努纳维克(加拿大)居民体内的持久性有机污染物含量最高,楚科奇沿海地区(俄罗斯)居民体内的持久性有机污染物含量也仅次于传统持久性有机污染物。在有时间趋势数据的地区,大多数持久性有机污染物在北极种群中的浓度都在下降,但并非所有地区的下降趋势都一致。但全氟烷基和多氟烷基物质除外,在努纳维克、格陵兰和瑞典,一些长链 PFAS(如全氟壬酸)的浓度在增加。与以前的北极监测评价方案人类健康评估相比,本文件更广泛地概述了北极地区成人、孕妇和儿童的污染物水平,特别是长链全氟辛烷磺酸的水平,目前正在考虑将其纳入《斯德哥尔摩公约》。
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引用次数: 0
Regional, rural and remote medicine attracts students with a similar approach to learning in both the Northern and Southern hemisphere. 地区、农村和偏远地区的医学吸引了南北半球学习方法相似的学生。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-16 DOI: 10.1080/22423982.2024.2404274
Kylie J Mansfield,Anita Iversen,Maja-Lisa Løchen
Doctors who work in areas of workforce shortage, such as regional, rural and remote areas or areas of low socioeconomic means need to be more self-motivated, adaptable and self-directed than their metropolitan counterparts. This study aimed to examine the goal orientation and learning characteristics of students recruited into two medical programmes, one from the Northern hemisphere and one from the Southern hemisphere; both with a commitment to producing doctors to practice medicine in rural locations. Three survey tools were administered to 263 medical students: 1. achievement goal orientation survey; 2. learning characteristics survey and 3. the study process questionnaire. Medical students from both cohorts showed a learning goal orientation, which significantly increased with age (P0.007). In terms of learning characteristics, the students from the south had significantly higher scores for curiosity (P0.003), while the northern students had significantly higher scores for methodical (p < 0.001). Both cohorts were similar for adaptability and consciousness. Across the entire student cohort, three of the four learning disposition characteristics were also seen to correlate with learning goal orientation. In both cohorts of medical students deep learning scores exceeded surface learning scores. Selection of students with a learning goal orientation and learning characteristics of curiosity, adaptability and conscientiousness could potentially help students to flourish in rural placement environments.
在劳动力短缺地区工作的医生,如地区、农村和偏远地区或社会经济条件较差的地区,需要比大都市的医生更具有自我激励性、适应性和自我导向性。本研究旨在考察两个医学项目所招学生的目标定位和学习特点,一个来自北半球,一个来自南半球;这两个项目都致力于培养在农村地区行医的医生。对 263 名医科学生进行了三项调查:1.成就目标定位调查;2.学习特点调查;3.学习过程问卷。两届医学生均表现出学习目标取向,且随年龄增长而显著增加(P0.007)。在学习特征方面,南方学生的好奇心得分明显较高(P0.003),而北方学生的方法论得分明显较高(P < 0.001)。在适应能力和意识方面,两批学生的表现相似。从整个学生群体来看,四个学习倾向特征中有三个也与学习目标定向相关。在两批医学生中,深度学习得分均高于表面学习得分。选择具有学习目标导向以及好奇心、适应性和自觉性等学习特征的学生,可能有助于学生在农村实习环境中取得成功。
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引用次数: 0
Increasing our knowledge about the epidemiology of Helicobacter pylori in Nunavik's Inuit population (Québec, Canada) using Qanuilirpitaa? 2017 cross-sectional survey. 通过 Qanuilirpitaa? 2017 年横断面调查,增加我们对努纳维克因纽特人(加拿大魁北克省)幽门螺杆菌流行病学的了解。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-16 DOI: 10.1080/22423982.2024.2398864
Julie Ducrocq,Benoit Lévesque,Gaston De Serres,Véronique Boiteau,Cedric P Yansouni,Jean-François Proulx,Denis Talbot
Helicobacter pylori is a bacterium that may colonise and proliferate in human stomachs, leading invariably to chronic inflammation and, to a lesser extent, to peptic ulcers and cancer. The main objective of this study is to describe the epidemiology surrounding H. pylori in Nunavik's Inuit population using the 2004 and 2017 Health Surveys. Estimated prevalences were 70.9% for bacterial colonisation using a stool antigens test (SAT), 72.5% for anti-H. pylori antibodies, 12.7% for faecal occult blood in participants aged ≥ 50 and respectively of 28.4%, 11.2% and 2.4% for a prior diagnosis of colonisation, gastritis and peptic ulcer in the medical charts, with under five cases of gastric cancer reported. Variables associated with higher SAT+ prevalence were the number of household members (prevalence ratio [PR] = 1.03) and age (quadratic relationship), whereas mainly drinking municipal (PR = 0.84) and natural water (PR = 0.72) compared to bottled water, and increasing alcohol consumption (PR = 0.96) were associated with reduced prevalence. Despite current regional guidelines targeting high risk individuals in the context of high prevalence, Nunavik's health authorities must remain vigilant by following gastric cancer incidence and the rapid evolution of guidelines, while considering local realities.
幽门螺杆菌是一种可在人类胃部定植和增殖的细菌,通常会导致慢性炎症,并在较小程度上导致消化性溃疡和癌症。本研究的主要目的是利用 2004 年和 2017 年的健康调查,描述努纳维克因纽特人中幽门螺杆菌的流行病学情况。通过粪便抗原检测(SAT),估计细菌定植率为 70.9%,抗幽门螺杆菌抗体为 72.5%,年龄≥50 岁的参与者粪便隐血率为 12.7%,病历中先前诊断为定植、胃炎和消化性溃疡的比例分别为 28.4%、11.2% 和 2.4%,报告的胃癌病例不足 5 例。与 SAT+ 患病率较高相关的变量是家庭成员数量(患病率比 [PR] = 1.03)和年龄(二次方关系),而与瓶装水相比,主要饮用市政水(PR = 0.84)和天然水(PR = 0.72)以及饮酒量增加(PR = 0.96)与患病率降低相关。尽管目前的地区指南针对的是高发病率下的高危人群,但努纳维克的卫生当局必须保持警惕,在考虑当地实际情况的同时,关注胃癌的发病率和指南的快速发展。
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引用次数: 0
Childhood conditions and mental health among youth and young adults in Greenland: a latent class analysis. 格陵兰岛青少年的童年状况与心理健康:潜类分析。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-16 DOI: 10.1080/22423982.2024.2400397
Charlotte Brandstrup Ottendahl,Peter Bjerregaard,Durita Lyngsø Svartá,Ivalu Katajavaara Seidler,Ingelise Olesen,Martine Stecher Nielsen,Christina Viskum Lytken Larsen
Poor mental health among youth in Greenland is a major challenge, childhood conditions are critical for mental health later in life. The study aimed to examine the clustering of childhood conditions by considering risk and protective factors for mental health among youth and young adults in Greenland and to explore the relationship between these clusters and mental health outcomes in youth. The study included 565 participants aged 15-34 living in Greenland. Seven indicators including childhood adversities (ACEs), childhood residence, language, and cultural indicators (protective factors) were used to define clusters via latent class analysis (LCA). The associations between clusters and mental health outcomes (satisfaction with life (Cantrill's ladder), self-esteem, self-efficacy, loneliness, psychological distress (General Health Questionnaire) and mental illness (Kessler 6)) were assessed by logistic regression. Four clusters were identified through LCA. While most participants reported positive childhoods, 40% (in two clusters) experienced ACEs. The two clusters differed as more participants in one cluster had experienced protective factors than the other. ACEs were associated with increased odds of negative aspects of mental health in youth. However, participants who faced high levels of adversity and few protective factors also had reduced odds of positive aspects of mental health in youth.
格陵兰青少年心理健康状况不佳是一项重大挑战,童年时期的状况对日后的心理健康至关重要。这项研究旨在通过考虑格陵兰青年和年轻成年人心理健康的风险和保护因素来研究童年状况的群集,并探讨这些群集与青年心理健康结果之间的关系。这项研究包括 565 名生活在格陵兰的 15-34 岁的参与者。通过潜类分析法(LCA),使用包括童年逆境(ACEs)、童年居住地、语言和文化指标(保护因素)在内的七个指标来定义聚类。聚类与心理健康结果(生活满意度(Cantrill's ladder)、自尊、自我效能、孤独、心理困扰(一般健康问卷)和精神疾病(Kessler 6))之间的关联通过逻辑回归进行评估。通过 LCA 确定了四个群组。虽然大多数参与者报告了积极的童年生活,但有 40%(在两个群组中)的人经历过 ACE。这两个群组不同之处在于,一个群组中经历过保护性因素的参与者多于另一个群组。ACE 与青少年心理健康消极方面的几率增加有关。然而,逆境程度高且保护因素少的参与者,其青少年心理健康积极方面的几率也会降低。
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引用次数: 0
Beyond COVID: towards a transdisciplinary synthesis for understanding responses and developing pandemic preparedness in Alaska. 超越 COVID:实现跨学科综合,了解阿拉斯加的应对措施并制定大流行病防备措施。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-16 DOI: 10.1080/22423982.2024.2404273
Taylor P van Doren,Ryan A Brown,Guangqing Chi,Patricia Cochran,Katie Cueva,Laura Eichelberger,Ruby Fried,Stacey Fritz,Micah B Hahn,Ron Heintz,Davin Holen,Noor Johnson,Josée Lavoie,Emily Maxwell,Lisa McNair,Todd Nicewonger,Robert W Orttung,Andrey N Petrov,James E Powell
Pandemics are regularly occurring events, and there are foundational principles of pandemic preparation upon which communities, regions, states, and nations may draw upon for elevated preparedness against an inevitable future infectious disease threat. Many disciplines within the social sciences can provide crucial insight and transdisciplinary thinking for the development of preparedness measures. In 2023, the National Science Foundation funded a conference of circumpolar researchers and Indigenous partners to reflect on COVID-19-related research. In this article, we synthesise our diverse social science perspectives to: (1) identify potential areas of future pandemic-related research in Alaska, and (2) pose new research questions that elevate the needs of Alaska and its people, pursuant of a specific body of pandemic knowledge that takes into account the ecological and sociocultural contexts of the region. In doing so, we highlight important domains of research in the social sciences from transdisciplinary perspectives, including the centering of Indigenous knowledges and needs, the contexts of risk perception and resilience, food and housing security, and more. We highlight the contributions of social sciences to pandemic knowledge and provide a foundation for future pandemic-related research in Alaska.
大流行病是经常发生的事件,社区、地区、州和国家可以借鉴大流行病防备的基本原则,加强防备,以应对未来不可避免的传染病威胁。社会科学中的许多学科可以为制定防备措施提供重要的洞察力和跨学科思维。2023 年,美国国家科学基金会资助召开了一次环北极研究人员和土著合作伙伴会议,对 COVID-19 相关研究进行反思。在本文中,我们综合了不同的社会科学观点,以:(1)确定阿拉斯加未来与大流行病相关研究的潜在领域;(2)根据考虑到该地区生态和社会文化背景的特定大流行病知识体系,提出提升阿拉斯加及其人民需求的新研究问题。在此过程中,我们从跨学科的角度强调了社会科学研究的重要领域,包括以土著知识和需求为中心、风险认知和抗灾能力、食品和住房安全等。我们强调了社会科学对大流行病知识的贡献,并为阿拉斯加未来的大流行病相关研究奠定了基础。
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引用次数: 0
Vision screening of school children in greenland 2017-2022: coverage and low vision prevalence. 2017-2022 年格陵兰学龄儿童视力筛查:覆盖率和低视力患病率。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-16 DOI: 10.1080/22423982.2024.2403221
Nick Duelund,Ivan Nisted,Ivalu Frederiksen,Marit Eika Jørgensen,Steffen Heegaard,Hanne Jensen
Vision screening during childhood is vital for the early detection and treatment of visual impairment that may significantly impact a child's development and quality of life. This nationwide cross-sectional study used data from Greenland's national electronic medical records, including 2,493 six-year-old children from July 2017 to July 2023, to evaluate the coverage rate of vision screening and the prevalence of low vision in Greenlandic schoolchildren. The participation rate in vision screening increased from 43% in 2017 to 61% in 2022, while referral rates to ophthalmologists decreased from 14% to 5%, despite a consistent prevalence of low vision. The mean prevalence of impaired vision (0.3 logMAR / ≤0.50 Snellen decimal) in the better-seeing eye at the vision screening throughout the study period was 3%. At the same time, it was 8% for the worse-seeing eyes, indicating a continuous need for ophthalmological evaluation of the Greenlandic children. This study highlights healthcare delivery challenges in Greenland's sparsely populated areas and emphasises the need for new national guidelines to optimise referral processes. Utilising other healthcare professionals, such as optometrists, for vision screenings and ensuring follow-ups are critical for improving the visual health outcomes of Greenlandic children.
儿童时期的视力筛查对于早期发现和治疗视力障碍至关重要,因为视力障碍可能会严重影响儿童的发育和生活质量。这项全国范围的横断面研究利用格陵兰全国电子病历中的数据(包括2017年7月至2023年7月期间的2493名6岁儿童),评估了格陵兰学龄儿童视力筛查的覆盖率和低视力患病率。视力筛查的参与率从 2017 年的 43% 上升到 2022 年的 61%,而眼科医生的转诊率则从 14% 下降到 5%,尽管低视力的流行率始终保持不变。在整个研究期间,视力筛查中视力较好的眼睛视力受损(0.3 logMAR / ≤0.50 Snellen decimal)的平均发生率为 3%。与此同时,视力较差眼睛的视力不良率为 8%,这表明格陵兰儿童需要持续接受眼科评估。这项研究凸显了格陵兰岛人口稀少地区在提供医疗保健服务方面所面临的挑战,并强调了制定新的国家指导方针以优化转诊流程的必要性。利用验光师等其他医疗保健专业人员进行视力筛查并确保后续跟踪,对于改善格陵兰儿童的视力健康状况至关重要。
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引用次数: 0
A roadmap for assessing the diagnostic usefulness of neurosensory testing and an updated method for exposure assessment among vibration-exposed workers in northern Sweden 评估神经感觉测试诊断作用的路线图和瑞典北部受振动影响工人暴露评估的最新方法
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-12 DOI: 10.1080/22423982.2024.2403793
Hans Pettersson, Ingrid Liljelind, Tohr Nilsson, Albin Stjernbrandt
Workers who use handheld vibrating machines such as grinders, hammers and chainsaws expose themselves to hand-arm vibration (HAV). Exposure to HAV may cause injuries to both the neurological and th...
使用磨床、锤子和电锯等手持振动机器的工人会受到手臂振动 (HAV) 的影响。暴露于手臂振动可能会对神经和肌肉造成伤害。
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引用次数: 0
Barriers to and facilitators of breast, cervical and colorectal cancer screening and cancer screening histories of Métis people in Alberta, Canada 加拿大艾伯塔省梅蒂斯人乳腺癌、宫颈癌和结直肠癌筛查的障碍和促进因素以及癌症筛查史
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-19 DOI: 10.1080/22423982.2024.2368766
Amanda Andrew, June Kima, Chinmoy Rahul, Angeline Letendre, Ashton James, Bonnie Chiang, Brittany Shewchuk, James Newsome, Momtafin Khan, Huiming Yang, Reagan Bartel, Karen A. Kopciuk
Comprehensive evaluation of cancer screening activities based on individual experiences is urgently needed to address the burden of cancer among Métis people. In this co-designed and co-led study, ...
迫切需要根据个人经验对癌症筛查活动进行全面评估,以解决梅蒂斯人的癌症负担问题。在这项共同设计和领导的研究中,...
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引用次数: 0
IJCH – COVID-19 in the Arctic: special issue IJCH - 北极的 COVID-19:特刊
IF 1.3 4区 医学 Q2 Social Sciences Pub Date : 2024-04-26 DOI: 10.1080/22423982.2024.2341990
Gwen Healey Akearok
The Circumpolar region, comprising the Arctic territories encircling the North Pole, is home to diverse Indigenous cultures facing unique socio-economic challenges. Indigenous communities such as t...
北极圈地区由环绕北极的北极领土组成,是面临独特社会经济挑战的各种土著文化的家园。北极圈内的原住民社区,如...
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引用次数: 0
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International Journal of Circumpolar Health
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