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Indigenous initiative for the start-up of health services in urban areas: The Holistic Strategy Project 在城市地区开办保健服务的土著倡议:全面战略项目
IF 1.5 Pub Date : 2022-07-26 DOI: 10.32799/ijih.v17i2.36734
A. Leclerc
Background: The report of the Public Inquiry Commission on relations between Indigenous Peoples and certain public services in Québec (2019) reported problems in accessing health and social services, specifically in urban areas. In order to better serve their members, the Centre d’amitié autochtone de Trois-Rivières (CAATR) launched the Holistic Health Strategy Project. The objectives were: 1) to assess the needs of CAATR members and of the partners in health and social services, and 2) to create a directory of resources intended for the Indigenous people in the region. Methods: An assessment of health and services needs was completed through consultation with members of the community. A literature review was carried out to draw a portrait of the health and social care services and models intended for Indigenous people. Results: A total of 25 participants took part in the consultation. Better access to services (e.g., transport and daycare) and a need for liaison with non-native institutions (e.g., interpreters in hospitals and liaison officers with schools) are expressed. A directory of resources intended for Aboriginals has been created, bringing together more than 20 services and organizations. Conclusion: The results of the Holistic Health Strategy Project highlight the health needs and health particularities of Indigenous people living in urban areas. Measures adapted to the realities of Aboriginal people in urban areas must support and facilitate their access to services.
背景:公共调查委员会关于魁省土著人民与某些公共服务之间关系的报告(2019年)报告了在获得保健和社会服务方面存在的问题,特别是在城市地区。为了更好地为其成员提供服务,三河流域自治环境中心(CAATR)发起了全面保健战略项目。其目标是:1)评估土著居民协会成员和合作伙伴在保健和社会服务方面的需求;2)创建一个面向该地区土著人民的资源目录。方法:通过与社区成员协商完成健康和服务需求评估。进行了文献审查,以描绘为土著人民提供的保健和社会保健服务和模式。结果:共25名参与者参加了咨询。他们表示,有更好的机会获得服务(例如交通和日托),需要与非土著机构联络(例如医院的口译员和学校的联络官)。为土著居民创建了一个资源目录,汇集了20多个服务和组织。结论:全面保健战略项目的结果突出了生活在城市地区的土著人民的保健需求和保健特点。适应城市地区土著人民实际情况的措施必须支持和便利他们获得服务。
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引用次数: 0
Indigenous Strength: Braiding Culture, Ceremony and Community as a response to the COVID-19 Pandemic 本土力量:编织文化、仪式和社区以应对COVID-19大流行
IF 1.5 Pub Date : 2022-07-14 DOI: 10.32799/ijih.v17i1.36716
Autumn Watson, Eva Purkey, C. Davison, Minnie Fu, Dionne Nolan, D. Mitchell, Jennifer Kehoe, Sheldon Traviss, I. Bayoumi
Purpose: The COVID-19 pandemic has impacted the physical, mental, emotional and spiritual health of urban Indigenous Peoples. We sought to examine innovations and changes in service delivery by Indigenous service providers in the community who are addressing community needs based on an Indigenous worldview. Basic Procedures: The research was a collaboration between an academic team, an Indigenous research associate, and an Indigenous oversight committee. Fifteen in-depth interviews were conducted with Indigenous service organizations, non-Indigenous organizations with Indigenous programming, Indigenous volunteer-based organizations and Indigenous volunteers. Participants were recruited based on having mandates that focussed on mental and emotional wellbeing, education, chronic health conditions, women and children and Indigenous cultural needs. Major Findings: Health inequities for urban Indigenous Peoples were compounded during the pandemic. The lack of local infrastructure contributed to increased volunteerism to deliver and improve access to services. Service interruptions and access barriers triggered innovative programming and a strengths-based response with activities embedded on the land, braided with language, ceremony and culture. Unmet community service needs and capacity development priorities were identified. Conclusions: Access to land, infrastructure and cultural programming is key to wholistic health for the urban Indigenous community. Despite continued inequities, the urban-based Indigenous response exemplifies the strengths-based approaches that helped to address pandemic impacts and demonstrated how Indigenous ways of knowing build strength and foster innovative program adaptations based on culture, ceremony and creating space for community.
目的:2019冠状病毒病大流行影响了城市土著人民的身体、心理、情感和精神健康。我们试图检查社区中土著服务提供者在服务提供方面的创新和变化,他们基于土著世界观解决社区需求。基本程序:该研究是一个学术团队、一名土著研究助理和一个土著监督委员会之间的合作。与土著服务组织、有土著方案的非土著组织、土著志愿人员组织和土著志愿人员进行了15次深入访谈。招募参与者的依据是其任务侧重于精神和情感健康、教育、慢性健康状况、妇女和儿童以及土著文化需求。主要发现:大流行病期间,城市土著人民的卫生不平等现象更加严重。由于缺乏地方基础设施,提供和改善获得服务的志愿精神有所增加。服务中断和访问障碍引发了创新规划和基于优势的应对措施,这些活动嵌入在土地上,与语言、仪式和文化交织在一起。确定了未满足的社区服务需求和能力发展优先事项。结论:获得土地、基础设施和文化规划是城市土著社区整体健康的关键。尽管不平等现象依然存在,但以城市为基础的土著应对措施体现了以优势为基础的方法,有助于应对大流行病的影响,并展示了土著的认识方式如何在文化、仪式和为社区创造空间的基础上增强力量,促进创新的方案调整。
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引用次数: 3
Widening the Circle of Care 扩大关爱范围
IF 1.5 Pub Date : 2022-07-14 DOI: 10.32799/ijih.v17i2.36513
Chad Hammond, Roanne Thomas, Candida Rice
Caregiving has various connotations within diverse social and cultural settings. Within First Nations communities, caregiving may be understood as a central practice of reclaiming cultural identity and teachings from colonial systems of healthcare. Our community-based participatory research project explored the experiences, needs, and strengths of caregivers within the Mohawk Nation of Kahnawake in what is currently called Canada. Through a partnership with a local cancer support group and a local hospital, we recruited six caregivers to create digital stories of caring for others living with cancer in the community. We then screened and discussed the significance of the digital stories with community members at a world café event. The resulting themes of caregiving emerged from community responses: (1) gifts and teachings, (2) being there, being present, and (3) circle(s) of care. We discuss these themes and the community’s recommendations for strengthening and sustaining community-based caregiving in Kahnawake.
在不同的社会和文化背景下,照顾有不同的内涵。在原住民社区中,看护可以被理解为从殖民医疗保健系统中收回文化认同和教义的核心实践。我们以社区为基础的参与性研究项目探索了卡纳瓦克莫霍克族(现称加拿大)内看护者的经验、需求和优势。通过与当地癌症支持组织和当地医院的合作,我们招募了六名护理人员,在社区中创建照顾其他癌症患者的数字故事。然后,我们在一个世界咖啡馆活动中与社区成员筛选并讨论了数字故事的重要性。由此产生的关爱主题来自于社区的反应:(1)礼物和教导,(2)在场,在场,(3)关爱圈。我们讨论了这些主题和社区的建议,以加强和维持社区护理在卡纳瓦克。
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引用次数: 1
Implementing Indigenous Youth Peer Mentorship: Insights from the By Youth For Youth Project 实施土著青年同伴指导:青年为青年项目的启示
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v17i2.36491
J. Lund, C. Mushquash, Hugette Carty, Tina Bobinski, Sidney Lichtenstein, M. Daley, S. Kidd
Indigenous youth are disproportionately represented among youth experiencing homelessness in Canada and are at an increased risk for mental health and substance use problems compared to non-Indigenous youth experiencing homelessness. Research is needed that considers how best to support Indigenous youth in acquiring and maintaining stable housing. Indigenous youth peer mentorship is one possible mechanism that warrants consideration, as Indigenous youth who have previously been homeless can share experience with the barriers that other youth encounter as well as skills that may be well-suited to facilitate hope and understanding to other homeless youth. In the present study, we examined the process by which Indigenous peer mentors engage in a peer-driven project designed to support other Indigenous youth experiencing homelessness in Northwestern Ontario. This process was documented through qualitative interviews with three peer mentors and three staff, as well as ethnographic fieldnotes. Thematic analyses revealed that peer mentorship positions appear to be useful for the Indigenous youth who engage in them, as these positions provide them with a paid avenue to engage in advocacy and support others with similar experiences as them, while simultaneously increasing their cultural connectedness, confidence, self-esteem, self-awareness, and ability to advocate for their own needs. The present study also yielded important considerations for organizations implementing Indigenous youth peer mentorship positions, including offering training and providing opportunities for cultural engagement, avoiding tokenism, being cognizant of possible dual-relationships, and supporting peer mentors who may be grappling with personal difficulties outside of their roles.
在加拿大无家可归的青年中,土著青年的比例过高,与无家可归的非土著青年相比,他们面临心理健康和药物使用问题的风险更大。需要进行研究,考虑如何最好地支持土著青年获得和维持稳定的住房。土著青年同伴指导是一种值得考虑的可能机制,因为以前无家可归的土著青年可以分享其他青年遇到的障碍的经验,以及可能非常适合促进其他无家可归青年的希望和理解的技能。在本研究中,我们研究了土著同伴导师参与同伴驱动项目的过程,该项目旨在支持安大略省西北部其他无家可归的土著青年。这一过程通过对三名同行导师和三名工作人员的定性访谈以及民族志实地笔记进行了记录。专题分析显示,同伴指导职位似乎对参与其中的土著青年很有用,因为这些职位为他们提供了一个有偿的途径,让他们参与宣传和支持与他们有相似经历的其他人,同时增强他们的文化联系、信心、自尊、自我意识和倡导自己需求的能力。本研究还为实施土著青年同伴指导职位的组织提供了重要的考虑因素,包括提供培训和提供文化参与的机会,避免象征性的做法,认识到可能的双重关系,以及支持可能在工作之外遇到个人困难的同伴导师。
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引用次数: 0
Content Analysis Informing the Development of Adapted Harm Reduction Talking Circles (HaRTC) with Urban American Indians and Alaska Natives Experiencing Alcohol Use Disorder 内容分析为美国城市印第安人和阿拉斯加原住民酒精使用障碍的适应性减少伤害谈话圈(HaRTC)的发展提供信息
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v17i2.36677
L. Nelson, Annette Squetemkin-Anquoe, Tatiana Ubay, Victorio L. King, Emily M Taylor, Karissa Masciel, Lovella Black Bear, Shawn Buffalomeat, Xia Duffing-Romero, Celina Mahinalani-Garza, Seema L. Clifasefi, S. Collins
Prior studies with Native populations have highlighted concerns about the cultural acceptability of highly directive, Eurocentric approaches, such as cognitive behavioral therapy and 12-step programs in treating alcohol use disorder (AUD). When asked in a prior qualitative study how they would redesign AUD treatment, urban American Indian and Alaska Native (AI/AN) participants reported wanting more low-barrier, harm-reduction treatment options, Native treatment providers, and culturally relevant practices. Talking Circles, which are gatherings where people share what is on their hearts, were the most requested Native cultural practice. After developing and piloting its initial iteration, researchers, community members, and traditional health professionals collaborated on the present qualitative research study to further refine an adapted Harm Reduction Talking Circle (HaRTC) protocol to address AUD with urban AI/ANs. This study features a conventional content analysis of 31 patient interviews, 6 key informant interviews with management and traditional health professionals, and 5 staff and provider focus groups to inform the development of the HaRTC. Specifically, this study describes staff, management, traditional health professionals, provider, and patient participants’ a) perspectives on HaRTC, including potential benefits, risks and mitigating factors, b) preferred traditional medicines and practices, c) preferred approaches/Circle Facilitator stance for engagement and facilitation, and d) HaRTC logistics (e.g., timing, frequency). Analyses indicated a central tendency preference for 8, weekly HaRTC sessions. Although participants expressed concerns about the potential inclusion of intoxicated people in HaRTC sessions, a large majority of staff, management and patient participants felt it was important to have HaRTC be as inclusive and accepting of community members as possible. Participants provided suggestions for how to structure facilitation of the HaRTC and mitigate risks of intoxication and patient escalation. Participants preferred an approach that is acceptance-based, respects individuals’ autonomy and culture, and creates a safe space for recovery. Most participants felt the specific traditions and medicines applied in the HaRTC should be maximally inclusive to honor the diversity of tribal affiliations and backgrounds represented among urban AI/ANs. In conclusion, participants largely supported an integration of harm-reduction principles and the North American Indigenous tradition of the Talking Circle to provide a compassionate, culturally appropriate healing practice to a larger spectrum of AI/ANs with AUD. Future research is planned to test the efficacy of this community-informed approach.
先前对土著人口的研究强调了对高度指导性、以欧洲为中心的方法的文化可接受性的关注,例如认知行为疗法和治疗酒精使用障碍(AUD)的12步计划。在之前的一项定性研究中,当被问及他们将如何重新设计AUD治疗时,城市美洲印第安人和阿拉斯加原住民(AI/AN)参与者报告说,他们想要更多低障碍、减少伤害的治疗方案、本土治疗提供者和与文化相关的做法。“谈话圈”是人们分享心中所想的聚会,是最受欢迎的本土文化习俗。在开发和试行了最初的迭代之后,研究人员、社区成员和传统的卫生专业人员合作进行了目前的定性研究,以进一步完善经调整的减少伤害谈话圈(HaRTC)协议,以解决城市人工智能/网络的AUD问题。本研究的特点是对31名患者访谈的传统内容进行分析,对管理人员和传统卫生专业人员进行了6次关键信息提供者访谈,并对5个工作人员和提供者焦点小组进行了调查,以了解HaRTC的发展情况。具体而言,本研究描述了工作人员、管理层、传统卫生专业人员、提供者和患者参与者的a)对HaRTC的看法,包括潜在的好处、风险和缓解因素,b)首选的传统药物和做法,c)参与和促进的首选方法/循环调解人立场,以及d) HaRTC的后勤(例如,时间、频率)。分析表明,集中倾向倾向于每周8次的HaRTC会议。尽管与会者对可能将醉酒的人纳入康复中心会议表示关切,但绝大多数工作人员、管理人员和病人与会者认为,康复中心应尽可能包容和接受社区成员,这一点很重要。与会者就如何促进HaRTC的结构和减轻中毒和患者升级的风险提出了建议。参与者更喜欢一种基于接受的方法,尊重个人的自主权和文化,并为康复创造一个安全的空间。大多数与会者认为,HaRTC采用的具体传统和药物应最大限度地具有包容性,以尊重城市人工智能/人工智能中所代表的部落关系和背景的多样性。总之,参与者在很大程度上支持将减少伤害原则与北美土著谈话圈的传统相结合,为更大范围的患有AUD的AI/ANs提供富有同情心、文化上适当的治疗实践。未来的研究计划测试这种社区知情方法的有效性。
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引用次数: 1
Volume 17 Issue 2 Editorial 第17卷第2期社论
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v17i2.39009
S. Stewart
As a global population, Indigenous Peoples face multiple health barriers related to poverty, access to service, literacy weaknesses, racism and discrimination, language, geography, colonization, addictions and mental health, and the intergenerational trauma of colonial assaults and aggressions. To address these problems, and to attempt to answer the above question, the IJIH seeks to provide a voice in the academic publishing world to community-driven research and re- searchers who work, as much as possible, in western colonial academic systems, based in Indigenous paradigms.
作为全球人口,土著人民面临着多种健康障碍,包括贫困、获得服务、识字能力差、种族主义和歧视、语言、地理、殖民化、成瘾和心理健康,以及殖民袭击和侵略造成的代际创伤。为了解决这些问题,并试图回答上述问题,IJIH试图在学术出版界为社区驱动的研究和研究者提供一个声音,他们尽可能地在基于土著范式的西方殖民学术体系中工作。
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引用次数: 0
A Qualitative Study on the Perspectives of Young Adults in Iqaluit on School-based Sexual Health Education 伊魁特省青壮年对校本性健康教育看法的质性研究
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v17i2.36363
Sidney Horlick
Introduction:  Historical traumas led to the alteration of traditional education pathways, including education on sexual and reproductive health and healthy relationships. Parents no longer are the sole or majority source of information on these topics for youth; the education system and medical professionals have largely replaced parents to this regard. However, for many Inuit youth, parents largely remain the preferred source for this information. Methods: This narrative research study explores young people’s perspectives on the topic of sexual health education. Six sharing circles were conducted on six separate occasions in [community]. 12 youth aged 18 to 22 years participated, which included men (n=3), women (n=8), and non-binary persons (n=1). Four participants identified as LGBTQ+. Results: Sexual health education youth received was perceived to lack information they want and need to live sexually health lives. Peer networks were deemed a positive influence, however at times exerted pressure on youth to participate in sexual activities for which they were not ready. Parents were rarely a source of sexual health information, though youth overwhelmingly desired conversations on sexual health topics with their parents. Conclusion: Results show there is a need to implement community-based resources to address sexual education within Nunavut communities, and to educate parents on how to communicate sexual health information to their adolescent children. The development of a resource for adults could decrease the gap between youth and existing sexual health information including accessing support from family.
引言:历史创伤导致传统教育途径的改变,包括性健康和生殖健康以及健康关系教育。父母不再是青少年获得这些主题信息的唯一或主要来源;在这方面,教育系统和医疗专业人员在很大程度上取代了家长。然而,对于许多因纽特人青年来说,父母在很大程度上仍然是这些信息的首选来源。方法:本研究采用叙述性研究的方法,探讨青少年对性健康教育的看法。在[社区]的六个不同场合进行了六次分享。12名年龄在18至22岁之间的青年参加了此次活动,其中包括男性(n=3)、女性(n=8)和非二元人群(n=1)。四名参与者被认定为LGBTQ+。结果:接受性健康教育的年轻人被认为缺乏他们想要和需要的信息来过性健康的生活。同伴网络被认为是一种积极的影响,但有时会对年轻人施加压力,让他们参与他们还没有准备好的性活动。父母很少是性健康信息的来源,尽管绝大多数年轻人都希望与父母就性健康话题进行对话。结论:研究结果表明,有必要实施基于社区的资源,以解决努纳武特社区的性教育问题,并教育家长如何向青春期儿童传达性健康信息。为成年人开发资源可以缩小青年与现有性健康信息之间的差距,包括获得家庭支持。
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引用次数: 0
Indigenous Community Praxis and Programs during COVID-19 COVID-19期间土著社区的实践和方案
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v17i1.36713
Denica Dione Bleau, Melanie Lansall
The COVID-19 Pandemic has substantially affected Indigenous communities. Deterrence of physical and mental health within Indigenous communities has been prevalent through unjust social, environmental and economic factors, due to pre-existing health conditions, unsustainable and overcrowded housing, limited health care and mental health services, and inadequate access to clean drinking water (Independent Auditor’s Report, 2021). These factors have resulted in exacerbated mental health and trauma symptoms (Arriagada, et. al., 2020). Indigenous communities have needed to adapt methods of attaining mental health and medical services, in order to maintain personal and communal wellbeing. We offer a summary of the delivery of two programs: The Medicine Keeper Wellness Program and Creative Corner Program, which were conducted in Northern Central Interior and Southern Indigenous communities by Indigenous social workers, to continue individual and community wellness. These programs navigated the barriers presented as a result of COVID-19 and the restrictions therein, to accessing social work and therapeutic services.
2019冠状病毒病大流行严重影响了土著社区。由于先前存在的健康状况、不可持续和过度拥挤的住房、有限的保健和心理健康服务以及无法充分获得清洁饮用水,不公正的社会、环境和经济因素在土著社区内普遍存在对身心健康的威慑(独立审计员报告,2021年)。这些因素加剧了心理健康和创伤症状(Arriagada等人,2020年)。土著社区需要调整获得心理健康和医疗服务的方法,以保持个人和社区的福祉。我们总结了两个项目的实施情况:医药守护者健康项目和创意角项目,这两个项目是由土著社会工作者在北部、中部、内陆和南部土著社区开展的,以继续促进个人和社区的健康。这些方案克服了COVID-19造成的障碍及其限制,使他们能够获得社会工作和治疗服务。
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引用次数: 1
A Microcosm of Tobacco Research: An American Indian Northern Plains Review 烟草研究的微观世界:美国印第安人北部平原评论
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v17i2.37131
Nicole Redvers, Mia Wilkinson, Sarah Larson, Kalisi ‘Ulu’ave
Objectives: Despite decades of continued commercial tobacco prevention and control efforts, smoking rates in Northern Plains American Indian (AI) communities within the United States continues to be remarkably high. We sought to take a microcosmic view of AI tobacco research in the Northern Plains region to identify the types of tobacco-related research that has been completed, and to critically examine whether the four areas of community importance outlined as best practice for tobacco programming in AI communities has been represented in the literature to date. Design: A systematic search of multiple databases was executed utilizing an established scoping review framework that was adapted to fit within an Indigenous worldview. A consequent title and abstract review of tobacco-related research published with AI Northern Plains communities was completed. Structured deductive content analysis was carried out on each article utilizing a matrix of analysis developed from existing literature on best practices in AI communities. Results: Of the 916 published studies identified, 50 met the inclusion criteria and were represented within five identified categorical themes: (1) commercial tobacco smoking as a risk factor, (2) commercial tobacco-related disease outcomes, (3) tobacco policy, (4) commercial tobacco smoking cessation, and (5) cultural or traditional tobacco use. The matrix analysis identified substantial variation in the number of studies carried out with community-identified best practices in place, including 22 of the 50 (44%) articles containing one or none of the four areas of importance noted as best practice. Conclusions: We identified a substantial lack of community and culturally informed tobacco-related research being carried out in the Northern Plains region. Community-based and culturally grounded efforts that consider colonization, historical trauma, and ACEs when planning research, funding mechanism, and health programming activities in the region are urgently needed to decrease commercial tobacco use and consequent health disparities.
目标:尽管几十年来一直在努力预防和控制商业烟草,但美国北部平原美洲印第安人社区的吸烟率仍然非常高。我们试图对北部平原地区的人工智能烟草研究进行微观观察,以确定已完成的与烟草相关的研究类型,并批判性地检查迄今为止的文献中是否有四个社区重要性领域概述为人工智能社区烟草规划的最佳实践。设计:利用已建立的范围审查框架对多个数据库进行系统搜索,该框架经过调整以适应土著的世界观。随后完成了与AI北部平原社区发表的烟草相关研究的标题和摘要综述。利用从人工智能社区最佳实践的现有文献中开发的分析矩阵,对每篇文章进行结构化演绎内容分析。结果:在确定的916项已发表的研究中,有50项符合纳入标准,并在五个确定的分类主题中进行了代表:(1)商业烟草吸烟作为风险因素,(2)商业烟草相关疾病结局,(3)烟草政策,(4)商业烟草戒烟,以及(5)文化或传统烟草使用。矩阵分析发现,采用社区确定的最佳做法开展的研究数量存在很大差异,包括50篇(44%)文章中的22篇(44%)包含或不包含被认为是最佳做法的四个重要领域中的一个。结论:我们发现在北部平原地区进行的社区和文化知情的烟草相关研究严重缺乏。在规划该区域的研究、筹资机制和卫生规划活动时,迫切需要以社区为基础和以文化为基础的努力,考虑殖民、历史创伤和ace,以减少商业烟草使用和由此造成的健康差距。
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引用次数: 0
LAND-BASED HEALING THROUGH ADVENTURE 通过冒险进行陆上治疗
IF 1.5 Pub Date : 2022-07-12 DOI: 10.32799/ijih.v18i2.36754
S. Priest
Based on 40 years of living and travelling with indigenous populations around the world, the author shares the repeating patterns of common lessons learned about adventure and land-based healing.
基于40年来与世界各地土著居民的生活和旅行,作者分享了关于冒险和陆地治疗的共同经验教训的重复模式。
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International Journal of Indigenous Health
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