{"title":"Reflecting on the use of <i>Etuaptmumk</i>/Two-Eyed seeing in a study examining hospital-based Indigenous wellness services in the Northwest Territories, Canada.","authors":"Sophie Isabelle Grace Roher, Kimberly Fairman","doi":"10.1080/22423982.2024.2406107","DOIUrl":"10.1080/22423982.2024.2406107","url":null,"abstract":"<p><p><i>Etuaptmumk</i>/Two-Eyed Seeing (E/TES) is a Mi'kmaw guiding principle that emphasises the importance of bringing together the strengths of Indigenous knowledges and Western knowledges to improve the world for future generations. Since its introduction to the academic community, E/TES has been taken up more frequently in Indigenous health research. However, as it is increasingly used, Elders and scholars have affirmed that it is at risk of being watered down or tokenised. This article reports on how E/TES was used in a community-engaged research study that examined hospital-based Indigenous wellness services in the Northwest Territories, Canada. As a living, relational, and spiritual principle, E/TES was used in the study in three interrelated ways. E/TES: (1) guided the study ontologically, shaping the research team's conceptualisation of knowledge and knowledge generation; (2) informed the research team's approach to relationship-building; and (3) guided reflexivity amongst team members. By reporting on how E/TES was used in the study, and critically reflecting on the strengths and challenges of the approach, this article seeks to contribute to growing scholarship about how E/TES is characterised and taken up in Indigenous health research.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maja Hykkelbjerg Nielsen, Annesofie Lunde Jensen, Michael Lynge Pedersen, Lene Seibæk
{"title":"Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland - a qualitative interpretive description study.","authors":"Maja Hykkelbjerg Nielsen, Annesofie Lunde Jensen, Michael Lynge Pedersen, Lene Seibæk","doi":"10.1080/22423982.2023.2296706","DOIUrl":"10.1080/22423982.2023.2296706","url":null,"abstract":"<p><p>Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (<i>n</i> = 24) were selected by purposeful sampling and recruited by phone. We conducted individual semi-structured interviews at the National Hospital in Nuuk and the four regional hospitals. Interviews were audio-recorded, transcribed verbatim, and analysed using interpretive description. Three themes emerged: shock and shame on receiving the diagnosis, coping with a changed life, and varying needs for care and communication. We found that being diagnosed with COPD or T2D required a rapid change in the participants' everyday lives and lifestyle behaviours. Some self-managed their disease well and were able to transfer their knowledge and integrate it into their daily lives, while others struggled to make lifestyle changes. Additionally, living with COPD or T2D could be related to silence and shame. The findings contribute to a better understanding of living with COPD or T2D in the Arctic region and the development of future, culturally-adapted patient education initiatives.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trine Jul Larsen, Maria Bråthen Pettersen, Helena Nygaard Jensen, Michael Lynge Pedersen, Henrik Lund-Andersen, Marit Eika Jørgensen, Stine Byberg
{"title":"The use of artificial intelligence to assess diabetic eye disease among the Greenlandic population.","authors":"Trine Jul Larsen, Maria Bråthen Pettersen, Helena Nygaard Jensen, Michael Lynge Pedersen, Henrik Lund-Andersen, Marit Eika Jørgensen, Stine Byberg","doi":"10.1080/22423982.2024.2314802","DOIUrl":"10.1080/22423982.2024.2314802","url":null,"abstract":"<p><p><b>Background:</b> Retina fundus images conducted in Greenland are telemedically assessed for diabetic retinopathy by ophthalmological nurses in Denmark. Applying an AI grading solution, in a Greenlandic setting, could potentially improve the efficiency and cost-effectiveness of DR screening.<b>Method:</b> We developed an AI model using retina fundus photos, performed on persons registered with diabetes in Greenland and Denmark, using Optos® ultra wide-field scanning laser ophthalmoscope, graded according to ICDR.Using the ResNet50 network we compared the model's ability to distinguish between different images of ICDR severity levels in a confusion matrix.<b>Results:</b> Comparing images with ICDR level 0 to images of ICDR level 4 resulted in an accuracy of 0.9655, AUC of 0.9905, sensitivity and specificity of 96.6%.Comparing ICDR levels 0,1,2 with ICDR levels 3,4, we achieved a performance with an accuracy of 0.8077, an AUC of 0.8728, a sensitivity of 84.6% and a specificity of 78.8%. For the other comparisons, we achieved a modest performance.<b>Conclusion:</b> We developed an AI model using Greenlandic data, to automatically detect DR on Optos retina fundus images. The sensitivity and specificity were too low for our model to be applied directly in a clinical setting, thus optimising the model should be prioritised.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10877649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felix N R Wood, Rosemary Hartley, Rebecca Boys, Timothy Parham, Jonathon Lowe, Matthew Warner
{"title":"Repeated freezing to very low temperatures does not impact the amount ejected from EpiPen® and Jext® adrenaline autoinjectors.","authors":"Felix N R Wood, Rosemary Hartley, Rebecca Boys, Timothy Parham, Jonathon Lowe, Matthew Warner","doi":"10.1080/22423982.2024.2367273","DOIUrl":"10.1080/22423982.2024.2367273","url":null,"abstract":"<p><p>It has previously been shown that EpiPen® autoinjectors are likely to activate normally following up to five excursions to -25°C but data about the post-freezing performance of other brands of adrenaline autoinjectors has not previously been published. Additionally, conditions experienced by polar medics may be substantially colder than this and the performance of adrenaline autoinjectors following more extreme freeze-thaw cycles remains uncharacterised. Investigators in Antarctica and the United Kingdom performed laboratory testing on two brands of adrenaline autoinjector, EpiPen® and Jext® (12 devices of each type). A single freeze-thaw cycle involved freezing the device to -80°C then allowing it to come to room temperature. Devices were exposed to 0, 1, 5 or 15 freeze-thaw cycles. The mass of liquid ejected from each device, when activated, was then measured. No significant differences in the mass of the liquid ejected was found between the test groups. Multiple freeze-thaw cycles to -80°C are unlikely to significantly impact the amount of adrenaline solution expelled from EpiPen® and EpiPen® autoinjectors. This preliminary finding encourages further work investigating the safety and effectiveness of adrenaline autoinjectors after exposure to very low temperatures. This information would be valuable for future polar medics planning and delivering medical provision in extreme environments.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11182065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joo Roerholm Svendsen, Michael Lynge Pedersen, John Hauerberg, Ole Gredal
{"title":"Subarachnoid haemorrhage and intracranial aneurysms in Greenland in the period 2018-2021: incidence, outcome and familial disposition.","authors":"Joo Roerholm Svendsen, Michael Lynge Pedersen, John Hauerberg, Ole Gredal","doi":"10.1080/22423982.2024.2356889","DOIUrl":"10.1080/22423982.2024.2356889","url":null,"abstract":"<p><p>Subarachnoid haemorrhages (SAH) caused by rupture of intracranial aneurysms (IA) are a severe condition. Earlier studies found a higher incidence of SAH in Greenlandic patients compared to Danish patients, with familial aggregation also higher in Greenland. However, updated data is lacking. To investigate the contemporary incidence, outcome, and familial disposition of SAH/IA in Greenlandic patients in 2018-2021. Greenlandic patients diagnosed with ruptured or unruptured IA (UIA) during 2018-2021 were included. Data was obtained from patient files, x-ray department, and discharge registry. Incidence rates were estimated as cases/100,000/year. Direct age-standardised incidence rates were calculated using WHO 2000-2025 as standards. Of 30 SAH patients, 20 (66.7%) were females, 10 (33.3%) males. Of 36 UIA patients, 27 (75.0%) were females, 9 (25.0%) males. For SAH, crude incidence was 13.4/100,000/year, age-standardised incidence was 10.8/100,000/year. Familial history was observed in 30.0% of SAH patients. 5 patients (16.7%) died before treatment, 28-day case-fatality rate (CFR) for all patients was 23.3%. Overall and age-standardised incidence rates were similar to previous studies but higher among females and compared to neighbouring countries. A high occurrence of familial history was reported. SAH remains a serious condition in Greenland, as evidenced by five fatalities before treatment was administered.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Morgen Bertheussen, Mylene Riva, Brittany Wenniserí Iostha Jock, Christopher Fletcher, Pierre Ayotte, Gina Muckle, Natalia Poliakova, Richard Bélanger
{"title":"Using latent class analysis to operationalize a wholistic assessment of Inuit health and well-being.","authors":"Morgen Bertheussen, Mylene Riva, Brittany Wenniserí Iostha Jock, Christopher Fletcher, Pierre Ayotte, Gina Muckle, Natalia Poliakova, Richard Bélanger","doi":"10.1080/22423982.2024.2322186","DOIUrl":"10.1080/22423982.2024.2322186","url":null,"abstract":"<p><p>Many indigenous cultures conceptualize health wholistically, whereby physical, mental, spiritual and relational dimensions of health are interconnected. Yet, quantitative approaches to studying Indigenous health remain anchored in western perspectives, that separate the dimensions of health. This paper aims to operationalize a wholistic indicator of health based on the IQI model of Inuit health. Variables from the 2017 Nunavik Health Survey (<i>N</i> = 1196) were selected based on their representativeness of IQI model. Exploratory Latent Class Analysis (LCA) was used to identify wholistic health profiles. Once participants assigned to their health profile, sociodemographic characteristics were compared across profiles, and multinomial regression models were used to examine the relationship between community-level social determinants of health and the profiles. The LCA revealed three health profiles, labelled as \"<i>excellent\"</i>, \"<i>good\"</i> and \"<i>fair\"</i> based on the distribution of answers to the indicators. Nunavimmiut in \"<i>excellent\"</i> and \"<i>good\"</i> health were more likely to: rate their health positively; be over 30 years old; be in a relationship; and have participated or volunteered in community events. Nunavimmiut in \"<i>fair</i>\" health tended to report lower levels of community cohesion, family relationships, and emotional support. Intergrating culturally relevant models of health can support improved health status assessments and identify opportunities for health promotion.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10930148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Zakhari, Dong Bach Nguyen, Jessica Papillon Smith, Fady W Mansour, Srinivasan Krishnamurthy
{"title":"Hysteroscopy needs of indigenous communities in Northern Quebec: a retrospective cohort study.","authors":"Andrew Zakhari, Dong Bach Nguyen, Jessica Papillon Smith, Fady W Mansour, Srinivasan Krishnamurthy","doi":"10.1080/22423982.2024.2359162","DOIUrl":"10.1080/22423982.2024.2359162","url":null,"abstract":"<p><p>We aimed to determine the surgical output for patients from Nunavik undergoing transfer to an urban centre for hysteroscopy, and associated costs. We performed a retrospective chart review of all patients from the 14 villages of Nunavik transferred for hysteroscopic surgery from 2016 to 2021. Diagnoses, surgical intervention, and nature of the procedure were all extracted from the patient charts, and costs/length of stay obtained from logisticians and administrators servicing the Nunavik region. Over a 5-year period, 22 patients were transferred from Nunavik for hysteroscopy, of which all were elective save one. The most common diagnosis was endometrial or cervical polyp and the most common procedure was diagnostic hysteroscopy. The average cost for patient transfer and lodging to undergo hysteroscopy in Montreal ranged from $6,000 to $15,000 CDN. On average, 4-5 patient transfers occur annually for hysteroscopy, most commonly for management of endometrial polyps, at a cost of $6,000 to $15,000 CDN, suggesting the need to investigate local capacity building in Nunavik and assess cost-effectiveness.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sean A Hillier, Elias Chaccour, Hamza Al-Shammaa, Bernice Downey, Laura C Senese, Jill Tinmouth, Naana Afua Jumah
{"title":"Funding the pandemic response for Indigenous Peoples: an equity-based analysis of COVID-19 using a Health Equity Impact Assessment (HEIA) Indigenous lens tool.","authors":"Sean A Hillier, Elias Chaccour, Hamza Al-Shammaa, Bernice Downey, Laura C Senese, Jill Tinmouth, Naana Afua Jumah","doi":"10.1080/22423982.2024.2361987","DOIUrl":"10.1080/22423982.2024.2361987","url":null,"abstract":"<p><p>This study examines the allocation of COVID-19 funding for Indigenous Peoples in Canada, Australia, New Zealand, and the United States during the pandemic's first wave. Indigenous communities, already facing health disparities, systemic discrimination, and historical forces of colonisation, found themselves further vulnerable to the virus. Analysing the funding policies of these countries, we employed a Health Equity Impact Assessment (HEIA) tool and an Indigenous Lens Tool supplement to evaluate potential impacts. Our results identify three major funding equity issues: unique health and service needs, socioeconomic disparities, and limited access to community and culturally safe health services. Despite efforts for equitable funding, a lack of meaningful consultation led to shortcomings, as seen in Canada's state of emergency declaration and legal disputes in the United States. New Zealand stood out for integrating Māori perspectives, showcasing the importance of consultation. The study calls for a reconciliation-minded path, aligning with Truth and Reconciliation principles, the UN Declaration on the Rights of Indigenous Peoples, and evolving government support. The paper concludes that co-creating equitable funding policies grounded in Indigenous knowledge requires partnership, meaningful consultation, and organisational cultural humility. Even in emergencies, these measures ensure responsiveness and respect for Indigenous self-determination.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11172235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shelley Spurr, Meridith Burles, Shannon Hyslop, Jill Bally, Carol Bullin, Amanda Froehlich Chow, Helen Tootoosis, Sarah Oosman
{"title":"Preventing type 2 diabetes among Indigenous youth: A systematic review of community-based interventions.","authors":"Shelley Spurr, Meridith Burles, Shannon Hyslop, Jill Bally, Carol Bullin, Amanda Froehlich Chow, Helen Tootoosis, Sarah Oosman","doi":"10.1080/22423982.2024.2320449","DOIUrl":"10.1080/22423982.2024.2320449","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Key recommendations and research priorities of the 2021 AMAP human health assessment.","authors":"Cheryl Khoury, Pál Weihe","doi":"10.1080/22423982.2024.2408057","DOIUrl":"10.1080/22423982.2024.2408057","url":null,"abstract":"<p><p>Over the last three decades, the Arctic Monitoring and Assessment Programme has published five human health assessments. These assessments have summarised the current state of the science regarding environmental contaminants and human health in the Arctic. The 2021 Human Health Assessment Report had a particular focus on dietary transitions, in addition to human biomonitoring levels and trends, health effects, risk assessment methodologies, risk communication and multi-disciplinary approaches to contaminants research. The recommendations and research priorities identified in the latest assessment are summarised here to assist decision- and policy-makers in understanding and addressing the impacts of contaminants on human populations in the Arctic.</p>","PeriodicalId":13930,"journal":{"name":"International Journal of Circumpolar Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}