Relational Work Is the Work: Virtual Healthcare Transformation for Rural, Remote and First Nations Communities in British Columbia.

The healthcare crisis across unceded First Nations' territories in rural, remote and Indigenous communities in British Columbia (BC) is marked by persistent barriers to accessing care and support close to home. This commentary describes an exceptional story of how technology, trusted partnerships and relationships came together to create an innovative suite of virtual care programs called "Real-Time Virtual Support" (RTVS). We describe key approaches, learnings and future considerations to improve the equity of healthcare delivery for rural, remote and First Nations communities. The key lessons include the following: (1) moving beyond a biomedical model - the collaboration framework for health service design incorporated First Nations' perspective on health and wellness; (2) relational work is the work - the RTVS collaboration was grounded in building connections and relationships to prioritize cultivating trust in the partnership over specific outputs; and (3) aligning to the core values of co-creation - working from a commitment to do things differently and applying an inclusive approach of engagement to integrate perspectives across different sectors and interest groups.

Mining sick: Creatively unsettling normative narratives about industry, environment, extraction, and the health geographies of rural, remote, northern, and Indigenous communities in British Columbia.

Rural, remote, northern, and Indigenous communities on Turtle Island are routinely-as Cree Elder Willie Ermine says-pathologized. Social science and health scholarship, including scholarship by geographers, often constructs Indigenous human and physical geographies as unhealthy, diseased, vulnerable, and undergoing extraction. These constructions are not inaccurate: peoples and places beyond urban metropoles on Turtle Island live with higher burdens of poor health; Indigenous peoples face systemic violence and racism in colonial landscapes; rural, remote, northern, and Indigenous geographies are sites of industrial incursions; and many rural and remote geographies remain challenging for diverse Indigenous peoples. What, however, are the consequences of imagining and constructing people and places as "sick"? Constructions of "sick" geographies fulfill and extend settler (often European white) colonial narratives about othered geographies. Rural, remote, northern, and Indigenous geographies are discursively "mined" for narratives of sickness. This mining upholds a sense of health and wellness in southern, urban, Euro-white-settler imaginations. Drawing from multi-year, relationship-based, cross-disciplinary qualitative community-informed experiences, and anchored in feminist, anti-colonial, and anti-racist methodologies that guided creative and humanities-informed stories, this paper concludes with different stories. It unsettles settler-colonial powers reliant on constructing narratives about sickness in others and consequently reframes conversations about Indigenous well-being and the environment.

Les communautés autochtones, nordiques et rurales de Turtle Island sont, comme le dit l'aîné cri Willie Ermine, couramment considérées comme pathogènes. Le discours professoral en sciences sociales et en santé, y compris chez les géographes, conçoit souvent les géographies autochtones, tant humaines que physiques, comme étant malsaines, malades, vulnérables et soumises à l'extraction. Ces conceptions ne sont pas erronées: les gens et les endroits en dehors des agglomérations urbaines sur Turtle Island sont davantage exposés à un état de santé précaire, les Autochtones font face à une violence et un racisme systémique dans les milieux coloniaux, les géographies autochtones, nordiques et rurales sont le siège d'incursions industrielles et de nombreux contextes territoriaux ruraux et éloignés continuent de présenter un défi pour diverses populations autochtones. Toutefois, quelles sont les conséquences d'imaginer et de concevoir les gens et les endroits comme étant « malades ¼? Le concept de territoires « malades ¼ favorise et consolide les récits coloniaux (souvent le blanc européen) sur l'état d'autres territoires, lesquels seraient dans une situation plus favorable. Les géographies autochtones, nordiques et rurales sont alors « minées ¼ de manière discursive par les récits sur leur caractère pathogène. Ce minage soutient une impression de santé et de bien­être dans l'imaginaire colonial, blanc européen et urbain des populations du sud. S'inspirant d'expériences communautaires qualitatives éclairées interdisciplinaires pluriannuelles axées sur les relations et ancrées dans les méthodologies féministes, anticoloniales et antiracistes qui ont guidé les discours créatifs inspirés par les sciences humaines, le présent texte se termine avec des récits différents. Ceux­ci déstabilisent les pouvoirs coloniaux qui se fondent sur le concept de territoire pathogène et, par conséquent, ré­interprètent les perceptions et les affirmations sur l'environnement et le bien­être des Autochtones.

Influences for Gender Disparity in Academic Family Medicine in North American Medical Schools.

Background Women physicians continue to comprise the minority of leadership roles in Academic Family Medicine (AFM) faculty across North American medical schools. Our study quantified the current state of gender disparity by analyzing academic position, leadership ranking, and research productivity. Methods We generated a database for 6,746 AFM faculty members. Gender and academic profiles were obtained for 2,892 academic ranks and 1,706 leadership roles by searching faculty listings enlisted in Fellowship and Residency Electronic Interactive Database (FREIDA) and Canadian Resident Matching Service (CaRMS). To measure research productivity, we obtained bibliometric data: h-index, citations, and tenure from 2,383 faculty members using Elsevier's SCOPUS archives. Data analysis and h-index were formulated using Stata version 14.2 (StataCorp LP, College Station, TX). Results Our results indicated that women hold 46.11% (3,110/6,746) of faculty positions. The proportional composition decreased with increasing academic ranking (49.84% assistant, 46.78% associate, and 41.5% full professor). The same decreasing trend was demonstrated with leadership rank (57.14% minor leadership, 47.65% second-in-command, and 36.61 first-in-command). Compared to their gender counterparts, women in AFM demonstrated lower publication productivity as measured by citation number (p=0.04) and years of study (p=0.008). The final prediction equation model after multivariable analyses included gender, publications, citations, country of graduation, and years of active research (p<0.05). Conclusions The composition of academic family medicine faculty members included in this study demonstrated gender disparity. Inclusivity initiatives and policies to tackle the issue of female retention, promotion, and recruitment need to be further explored.