International Journal of Circumpolar Health最新文献

Hearing disability constitutes a major health care issue especially among indigenous populations and in low- and middle-income countries (LMIC). The authors are engaged in organising audiological services in Greenland, where the geographical challenges highlight the potential of tele-audiology. The search strategy was created in the PubMed database combining keywords and MeSH Terms with "OR" in each domain: "Hearing" and "Telemedicine" and then combined using "AND". Telerehabilitation was defined as: Rehabilitation of patients with hearing loss enabled by one or more consultations with a specialist over a remote connection. The search was reproduced in Cochrane. The final search resulted in a total of 2,273 articles. After screening, 32 articles were reviewed. The included studies cover a broad variety of study designs, age groups, and countries. All included studies were analysed and summarised according to themes of relevance to an arctic setting. The review concludes that the technological development in tele-audiology has come far. Importantly, none of the studies reviewed provided clear evidence that tele-audiology delivers an inferior service, though further high-quality research is needed to confirm this. However, the evidence level in the studies was generally low. The usability of tele-audiology in cross-cultural settings and LMICstill need further investigation.

Country foods (i.e. wild traditional food) are associated with improved nutrition for northern populations. In response to community concerns, a project was implemented from 2019 to 2021 in the Sahtú region, Northwest Territories, Canada, to: 1) analyse nutrition biomarkers (vitamins A, B1, B2, B6, B12, D, E, folate, P, Na) in blood samples, in order to assess nutritional status and identify nutrient deficiencies, and 2) use a survey to document how access to country foods may improve food security in the community of Tulı́t'a. Findings from the nutritional biomarker assessments (n = 128) indicated that 94% of participants experienced clinical vitamin D deficiency (<20 ng/L of plasma 25-hydroxy-vitamin D3) and 9% had folate deficiency (<8.7 nmol/L total folate). In the previous 12 months, 71% of participants did not always have money to get more food when needed, but 92% of participants said they were not left hungry. Country foods were used to increase the quality or quantity of the diet. Increasing country food consumption, such as fatty fish and large game meat and organs could mitigate the vitamin D and folate deficiencies. Policies should be implemented to improve food security in the North by facilitating access to country food.

Ketchikan, Alaska is home to 13,754 residents and located on an island, presenting unique challenges of access and availability. Limited published research exists regarding traditional foods or food security in Alaska, and primary research on food security in Ketchikan is nonexistent. This study measured food security and analysed related variables in Ketchikan, Alaska using a retrospective cross-sectional study design. A total of 108 participants completed the surveys, all of whom were residents. Chi-square analyses determined significant associations between food security status and variables in the community. The food insecurity rate of the convenience sample was 49.1%. Facilitators of food security included receiving foods from others, culinary literacy, and adequate money to purchase food. Barriers to food security included the expense of food, government assistance ran out, availability of certain foods in the area, and transportation challenges. The study is the first known primary research measuring prevalence of food insecurity in the region and the corresponding factors that act as facilitators or barriers. These data help inform programme development to tackle key findings from a community needs assessment. Future work should include prevalence of food insecurity, and barriers and facilitators, of a representative sample in the region.

This article explores the challenges and opportunities for nursing students during clinical placements in rural areas with Indigenous and minority populations, specifically focusing on the Sami and Kven communities in Northern Norway. It highlights the importance of cultural sensitivity and competence in nursing education, as emphasised by the National Framework for Nursing and Health Professional Education. The Arctic Samprax project, utilising an action research approach, aims to develop sustainable practice models that integrate cultural sensitivity into nursing students' learning experiences. The study reveals that explicit supervision and reflective dialogue are crucial for students to understand and address cultural aspects in healthcare. Challenges such as staff shortages, inconsistent supervision, and lack of continuity hinder the learning process. The article emphasises the need for collaboration between educational institutions and rural practice sites to enhance students' cultural competence. Recommendations include developing preparatory programs focusing on the learning outcomes relevant for rural practice placements, as well as increasing practice placements in Indigenous areas. The study underscores the responsibility of educational institutions in circumpolar regions to contribute to inclusive and equitable healthcare services for diverse populations. We suggest a greater focus on cultural humility in the curriculum to align with the ethical guidelines for nurses.

Statistics Canada uses two self-report measures - Ancestry and Identity - in the Canadian Census to identify First Nations, Inuit and Métis (FNIM) peoples. How these measures are employed alone or in combination to assess definitional impact on the reporting of health conditions has not been investigated. To illustrate, we assessed how these measures, alone or in combination, estimate colorectal cancer rates. A working group comprised of Indigenous and non-Indigenous academics assessed the response patterns to the Identity and Ancestry questions in the 2006 Canadian Census Health and Environment Cohort and categorised the responses into groups: A) Identity only; B) Ancestry only; C) any Ancestry or Identity; D) both Ancestry and Identity. We then assessed concordance, and subsequently examined the way these groupings may impact the reporting of colorectal cancer rates (2010-2015). FNIM responses varied across the different combinations of the Ancestry and Identity questions. Concordance for FNIM was 76%, 81%, and 18% respectively for single responses, which impacted the estimation of colorectal cancer rates. To improve health reporting, it is essential that research teams choose the most appropriate definition in partnership with FNIM and urban Indigenous organisations to ensure the right data are analysed to align with community priorities.

There is an association between local cold injuries and Raynaud's phenomenon (RP) in the scientific literature, but the time relation and anatomical correlation have not been established. During military training in an Arctic setting, a previously healthy man in his early twenties sustained a freezing cold injury affecting mainly his right index finger. He subsequently developed Raynaud's phenomenon limited to only the part of the index finger that was originally affected by the cold injury. Medical investigation also revealed findings suggestive of subclinical peripheral neuropathy. This case demonstrates that Raynaud's phenomenon can develop secondary to local cold injury affecting the hand. It also suggests that cold exposure could be related to peripheral neuropathy.

Safe drinking water is key to individual and community health. Water safety is often evaluated based on whether or not a community's drinking water meets the quality standards specified by a governing authority. These water quality standards address many microbial and chemical water safety risks but may not capture risks that are difficult to quantify or community-specific needs and preferences. Water safety planning, first introduced by the World Health Organization, is a more holistic approach that aims to integrate water system stakeholders, system mapping, hazard identification and matrices to better characterise risk. In this study, we documented previous efforts to apply water WSPs in Arctic jurisdictions and evaluated existing risk scoring systems for potential application to Nunavut, an Arctic territory in Canada. The observations from the evaluation informed the development of a preliminary WSP framework for Nunavut which considers both past frequency and the existing hazard barriers in place when determining the likelihood score.

Children from circumpolar regions must travel long distances to southern tertiary care centres for specialised care. While there are initiatives underway to support care closer to home, medical travel remains a necessity for many families. The Aakuluk clinic has been operating since 2019 at a tertiary hospital in Ottawa, Canada, to provide care to children from Nunavut. The clinic team includes nurse case managers, physicians, social workers, interpreters, and several community partners. This project aimed to identify the strengths and the challenges of the clinic from the perspectives of parents and healthcare providers. The study was conducted in collaboration with healthcare professionals and community members and was guided by Inuit research approaches. Fifty-one participants (parents and healthcare providers) in Nunavut and Ottawa were interviewed. The main strengths and challenges of the clinic that were reported are related to the following themes: access to holistic care, supporting the role of Inuit professionals as part of the care team, and resources needed to continue offering programmes such as Aakuluk to Inuit families. From the perspectives of parents and healthcare providers, there are several components of the Aakuluk model that can be considered when developing services for Inuit families in other tertiary care centres.

This study examines the portrayal of contaminants in pilot whale in Faroese media from 1977 to 2022. Pilot whale is integral to Faroese culture but has come under scrutiny due to health concerns linked to contaminants. Given the role of media in shaping public understanding of health risks, our research assesses how four main Faroese media outlets have presented the issue to the public. We analysed 227 newspaper articles, radio, and television news stories, focusing on contaminants, mentioning of scientific studies or researchers, the demographic groups identified as at risk, and mentions of government advisories on whale meat consumption. Our findings indicate a predominant portrayal of contaminants as harmful, with a substantial emphasis on the risks to developing foetuses and children. Scientific studies, particularly those led by the Department of Occupational Medicine and Public Health in the Faroe Islands, were frequently cited. Despite varying advisories over the years, the narrative consistently highlighted the health risks associated with pilot whale consumption. This study contributes to broader discussions on environmental health communication by illustrating how localised media coverage can shape public risk perception, offering insights relevant to communities facing similar dilemmas between traditional hunting and public health.