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1.
Sci Total Environ ; 927: 172148, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38569957

RESUMEN

Boreal landscapes face increasing disturbances which can affect cultural keystone species, i.e. culturally salient species that shape in a major way the cultural identity of a people. Given their importance, the fate of such species should be assessed to be able to act to ensure their perennity. We assessed how climate change and forest harvesting will affect the habitat quality of Rhododendron groenlandicum and Vaccinium angustifolium, two cultural keystone species for many Indigenous peoples in eastern Canada. We used the forest landscape model LANDIS-II in combination with species distribution models to simulate the habitat quality of these two species on the territories of three Indigenous communities according to different climate change and forest harvesting scenarios. Climate-sensitive parameters included wildfire regimes as well as tree growth. Moderate climate change scenarios were associated with an increased proportion of R. groenlandicum and V. angustifolium in the landscape, the latter species also responding positively to severe climate change scenarios. Harvesting had a minimal effect, but slightly decreased the probability of presence of both species where it occurred. According to the modeling results, neither species is at risk under moderate climate change scenarios. However, under severe climate change, R. groenlandicum could decline as the proportion of deciduous trees would increase in the landscape. Climate change mitigation strategies, such as prescribed fires, may be necessary to limit this increase. This would prevent the decrease of R. groenlandicum, as well as contribute to preserve biodiversity and harvestable volumes.


Asunto(s)
Cambio Climático , Conservación de los Recursos Naturales , Ecosistema , Bosques , Rhododendron , Vaccinium , Agricultura Forestal , Árboles , Canadá
2.
Artículo en Inglés | MEDLINE | ID: mdl-38639473

RESUMEN

Indigenous peoples in Canada are disproportionately exposed to environmental contaminants and may face elevated health risks related to their unique cultural, spiritual, and economic relationships with the land, including the use of traditional food systems. However, to date, institutionalized approaches to assess risks to human and ecological health from contaminants have not been well developed or implemented with Indigenous community contexts in mind. There is regulatory interest in developing new approach methods for risk assessment, and thus an opportunity to increase their relevance to Indigenous communities in which they will be ultimately applied. Therefore, we conducted an anonymous mixed-methods survey of those involved with risk assessment in Indigenous communities in Canada to: (1) understand risk assessment practice in Indigenous communities, (2) explore challenges with conventional assessment methods and compare these across sectors, and (3) gather perspectives on the development of new approaches. In all, 38 completed survey responses were received (14% response rate). Respondents were from Indigenous community environment and health offices (21% of respondents), Indigenous governments (8%), federal and provincial governments (21%), and academia (45%). Risk communication was seen as the most challenging part of risk assessment (71% responded "difficult"), and nearly all respondents agreed that time (86%), cost (76%), and resource availability (86%) were "moderate" to "serious" problems. Few respondents (16%) had heard of "new approach methods" for risk assessment, and 76% of respondents (and 100% of community-based respondents) agreed on the need to develop improved risk assessment approaches. To modernize risk assessment, respondents recommended advancing cumulative risk assessment methods, improving risk communication, and promoting Indigenous leadership and Traditional Knowledge in assessment activities. Integr Environ Assess Manag 2024;00:1-16. © 2024 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

3.
Int J Circumpolar Health ; 83(1): 2336284, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38573784

RESUMEN

This paper outlines the methodological approaches to a multi-site Circumpolar case study exploring the impacts of COVID-19 on Indigenous and remote communities in 7 of 8 Arctic countries. Researchers involved with the project implemented a three-phase multi-site case study to assess the positive and negative societal outcomes associated with the COVID-19 pandemic in Arctic communities from 2020 to 2023. The goal of the multi-site case study was to identify community-driven models and evidence-based promising practices and recommendations that can help inform cohesive and coordinated public health responses and protocols related to future public health emergencies in the Arctic. Research sites included a minimum of 1 one community each from Canada (Nunavut,) United States of America (Alaska), Greenland, Iceland, Norway, Sweden, Finland. The approaches used for our multi-site case study provide a comprehensive, evidence-based account of the complex health challenges facing Arctic communities, offering insights into the effectiveness of interventions, while also privileging Indigenous local knowledge and voices. The mixed method multi-site case study approach enriched the understanding of unique regional health disparities and strengths during the pandemic. These methodological approaches serve as a valuable resource for policymakers, researchers, and healthcare professionals, informing future strategies and interventions.


Asunto(s)
COVID-19 , Pandemias , Humanos , Regiones Árticas , Alaska/epidemiología , Canadá , Groenlandia
4.
Physiother Can ; 76(1): 137-153, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38465314

RESUMEN

Purpose: To identify the entry-level curricular content related to Indigenous health recommended for entry-level physiotherapy (PT) programs in Canada and other similar countries. Methods: Design: Scoping review. Procedures: Four electronic databases were searched using the terms physiotherapy, Indigenous health, entry-level curriculum, and their derivatives. Grey literature sources were hand searched and included Canadian PT professional documents, PT Program websites, Truth and Reconciliation Commission (TRC) sources, and a Google search. Data related to curriculum characteristics, methods of delivery, and barriers and facilitators to implementation were extracted from relevant references. Stakeholders reviewed study findings. Results: Forty-five documents were included. Documents focused on Indigenous peoples in Canada, Aboriginal and Torres Strait Islanders in Australia, and Maori in New Zealand. Canadian PT programs appeared to rely on passive teaching methods while programs in Australia and New Zealand emphasized the importance of partnering and engaging with Indigenous people. Barriers to incorporating indigenous health curriculum included an overcrowded curriculum and difficulty establishing relevance of Indigenous content (i.e., meaning). Conclusions: Similarities and differences were found between curricula content and approaches to teaching IH in Canada and the other countries reviewed. Strategies to promote greater engagement of Indigenous people in the development and teaching of IH is recommended.


Objectif: déterminer le contenu du cursus en santé autochtone recommandé pour les programmes d'entrée en pratique en physiothérapie au Canada et dans des pays semblables. Méthodologie: étude exploratoire. Méthode : les chercheurs ont fouillé quatre bases de données électroniques à l'aide des termes physiotherapy, Indigenous health, entry-level curriculum et leurs dérivés. Ils ont fouillé manuellement les sources de documentation parallèle et y ont inclus des documents professionnels canadiens sur la physiothérapie, les sites Web des programmes de physiothérapie, les sources de la Commission de vérité et réconciliation (CVR) et une recherche dans Google. Les données liées aux caractéristiques du cursus, aux modes de prestation et aux obstacles et incitatifs à la mise en œuvre provenaient de références pertinentes. Les intervenants ont examiné les résultats des études. Résultats: au total, 45 documents ont été retenus. Ils portaient sur les Autochtones du Canada, les Aborigènes et les insulaires du détroit de Torres en Australie et les Maori de la Nouvelle-Zélande. Les programmes de physiothérapie canadiens semblaient reposer sur des méthodes d'enseignement passives, tandis que ceux de l'Australie et de la Nouvelle-Zélande faisaient ressortir l'importance des partenariats et des relations avec les peuples autochtones. Les obstacles à l'intégration du cursus sur la santé autochtone incluaient un cursus surchargé et la difficulté à déterminer la pertinence du contenu sur les Autochtones (c'est-à-dire le sens). Conclusions: les chercheurs ont constaté des similarités et des différences de contenu entre les cursus et les approches d'enseignement de la santé autochtone au Canada et les autres pays analysés. Il est recommandé de trouver des stratégies pour favoriser une plus grande participation des peuples autochtones à la création et à l'enseignement de la santé autochtone.

5.
BMC Health Serv Res ; 24(1): 266, 2024 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-38429744

RESUMEN

INTRODUCTION: Indigenous people who use unregulated drugs (IPWUD) face significant barriers to care, including sparse availability of culturally safe health services. Integrating Indigenous traditional and cultural treatments (TCT) into health service delivery is one way to enhance culturally safe care. In a Canadian setting that implemented cultural safety reforms, we sought to examine the prevalence and correlates of client perceptions of primary care provider awareness of TCT among IPWUD. METHODS: Data were derived from two prospective cohort studies of PWUD in Vancouver, Canada between December 2017 and March 2020. A generalized linear mixed model with logit-link function was used to identify longitudinal factors associated with perceived provider awareness of TCT. RESULTS: Among a sample of 507 IPWUD who provided 1200 survey responses, a majority (n = 285, 56%) reported their primary care provider was aware of TCT. In multiple regression analyses, involvement in treatment decisions always (Adjusted Odds Ratio [AOR] = 3.6; 95% confidence interval [CI]: 1.6-7.8), involvement in treatment decisions most or some of the time (AOR = 3.3; 95% CI: 1.4-7.7), comfort with provider or clinic (AOR = 2.7; 95% CI: 1.5-5.0), and receiving care from a social support worker (AOR = 1.5; 95% CI: 1.0-2.1) were positively associated with provider awareness of TCT. CONCLUSION: We found high levels of perceived provider awareness of TCT and other domains of culturally safe care within a cohort of urban IPWUD. However, targeted initiatives that advance culturally safe care are required to improve healthcare and health outcomes for IPWUD, who continue to bear a disproportionate burden of substance use harms.


Asunto(s)
Atención a la Salud , Pueblos Indígenas , Humanos , Canadá/epidemiología , Estudios Prospectivos , Encuestas y Cuestionarios
6.
Med Hist ; 68(1): 22-41, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38494901

RESUMEN

Australia's approach to its biosecurity and borders has always been two-pronged - quarantine first, vaccination second. This article asks what this combination looked like in practice by exploring two neglected smallpox vaccination campaigns directed towards Indigenous peoples in the early twentieth century. We argue these were important campaigns because they were the first two pre-emptive, rather than reactionary, vaccination programs directed towards First Nations people. Second, both episodes occurred in Australia's northern coastline, where the porous maritime geography and proximity to Southeast Asia posed a point of vulnerability for Australian health officials. While smallpox was never endemic, (though epidemic), in Australia, it was endemic at various times and places across Southeast Asia. This shifting spectre of smallpox along the northern coastline was made even more acute for state and federal health officials because of the existing polyethnic relationships, communities, and economies. By vaccinating Indigenous peoples in this smallpox geography, they were envisioned and embedded into a 'hygienic' border for the protection of white Australia, entwining the two-prongs as one approach. In this article, we place public health into a recent scholarship that has 'turned the map upside down' to re-spatialise Australia's history and geography to the north and its global connections, while demonstrating how particular coastlines and their connections were drawn into a national imaginary through a health lens.


Asunto(s)
Viruela , Humanos , Australia , Vacunación , Pueblos Indígenas , Geografía
7.
Maturitas ; 183: 107962, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38461558

RESUMEN

OBJECTIVES: To explore the prevalence of frailty, association between frailty and mortality, and transitions between frailty states in urban- and regional-living First Nations Australians. STUDY DESIGN: Secondary analysis of longitudinal data from the Koori Growing Old Well Study. First Nations Australians aged 60 years or more from five non-remote communities were recruited in 2010-2012 and followed up six years later (2016-2018). Data collected at both visits were used to derive a 38-item Frailty Index (FI). The FI (range 0-1.0) was classified as robust (<0.1), pre-frail (0.1- < 0.2), mildly (0.2- < 0.3), moderately (0.3- < 0.4) or severely frail (≥0.4). MAIN OUTCOME MEASURES: Association between frailty and mortality, examined using logistic regression and transitions in frailty (the percentage of participants who changed frailty category) during follow-up. RESULTS: At baseline, 313 of 336 participants (93 %) had sufficient data to calculate a FI. Median FI score was 0.26 (interquartile range 0.21-0.39); 4.79 % were robust, 20.1 % pre-frail, 31.6 % mildly frail, 23.0 % moderately frail and 20.5 % severely frail. Higher baseline frailty was associated with mortality among severely frail participants (adjusted odds ratio 7.11, 95 % confidence interval 2.51-20.09) but not moderately or mildly frail participants. Of the 153 participants with a FI at both baseline and follow-up, their median FI score increased from 0.26 to 0.28. CONCLUSIONS: Levels of frailty in this First Nations cohort are substantially higher than in similar-aged non-Indigenous populations. Screening for frailty before the age of 70 years may be warranted in First Nations Australians. Further research is urgently needed to determine the factors that are driving such high levels of frailty and propose solutions to prevent or manage frailty in this population.


Asunto(s)
Aborigenas Australianos e Isleños del Estrecho de Torres , Fragilidad , Anciano , Humanos , Australia/epidemiología , Anciano Frágil , Fragilidad/epidemiología , Evaluación Geriátrica
8.
Comp Migr Stud ; 12(1): 18, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38549877

RESUMEN

This study examines the potential economic and labour market impacts of a hypothetical but plausible migration scenario of 250,000 new migrants inspired by Austria's experience in 2015. Using the agent-based macroeconomic model developed by Poledna et al. (Eur Econ Rev, 151:104306, 2023. 10.1016/j.euroecorev.2022.104306, the study explores the detailed labour market outcomes for different groups in Austria's population and the macroeconomic effects of the migration scenario. The analysis suggests that Austria's economy and labour market have the potential to be resilient to the simulated migration influx. The results indicate a positive impact on GDP due to increased aggregate consumption and investment. The labour market experiences an increase in the unemployment rates of natives and previous migrants. In some industries, the increase in the unemployment rates is more significant, potentially indicating competition among different groups of migrants. This research provides insights for policymakers and stakeholders in Austria and other countries that may face the challenge of managing large-scale migration in the near future. Supplementary Information: The online version contains supplementary material available at 10.1186/s40878-024-00374-3.

9.
Environ Manage ; 73(5): 946-961, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38446188

RESUMEN

This Special Section explores the interplay between Indigenous peoples, industry, and the state in five proposed and active mining projects in Canada and Sweden. The overall aim is to identify factors shaping the quality of Indigenous community-industry-state interactions in mining and mine development. An ambition underlying the research is to develop knowledge to help manage mining related land-use conflicts in Sweden by drawing on Canadian comparisons and experience. This paper synthesizes the comparative research that has been conducted across jurisdictions in three Canadian provinces and Sweden. It focuses on the interplay between the properties of the governance system, the quality of interaction and governance outcomes. We combine institutional and interactive governance theory and use the concept of governability to assess how and why specific outcomes, such as mutually beneficial interaction, collaboration, or opposition, occurred. The analysis suggests there are measures that can be taken by the Swedish Government to improve the governability of mining related issues, by developing alternative, and more effective, avenues to recognize, and protect, Sámi rights and culture, to broaden the scope and increase the legitimacy and transparency of the EIAs, to raise the quality of interaction and consultation, and to develop tools to actively stimulate and support collaboration and partnerships on equal terms. Generally, we argue that Indigenous community responses to mining must be understood within a larger framework of Indigenous self-determination, in particular the communities' own assessments of their opportunities to achieve their long-term objectives using alternative governing modes and types of interactions.


Asunto(s)
Gobierno , Minería , Canadá , Suecia , Conocimiento
10.
Scand J Pain ; 24(1)2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38497253

RESUMEN

BACKGROUND: Low back pain (LBP) represents a worldwide burden with rising disability, especially in low- and middle-income countries. Indigenous Peoples are exposed to many risk factors for LBP and seem to have overall worse health and higher mortality compared to non-Indigenous. This article aims to provide a topical overview of LBP in Indigenous Peoples. METHODS: A comprehensive search was done using the keywords "Indigenous" and "back pain." Secondly, a cross-reference search of the citations list of the included articles was conducted. RESULTS: LBP is a prevalent, disabling health condition among Indigenous Peoples that impacts activities of daily living, emotional well-being, and cultural identity. Indigenous Peoples face numerous and unique barriers to obtain Western health care. LBP in Indigenous Peoples is partly iatrogenic and available health care lacks a culturally secure setting. In combination with racism and discrimination by health care providers, this leads to miscommunication, frustration, and poor outcome in Indigenous patients around the world. CONCLUSION: Contextual considerations and interpretation of findings within the appropriate cultural context are needed in future research and treatment of LBP in Indigenous Peoples. However, our literature analysis exhibits disproportionate representation with the scarcity of studies of Indigenous Peoples of Asia and Africa. Addressing this gap in the literature could provide significant scientific value. Indigenous Peoples should not be forgotten in reducing the global burden for LBP.


Asunto(s)
Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Actividades Cotidianas , Factores de Riesgo , Pueblos Indígenas
11.
Toxics ; 12(3)2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38535945

RESUMEN

Widespread contamination of the Amazon basin with mercury has been reported to occur since at least the mid-80s due to heavy gold mining activity. Although initial studies have indicated that this may lead to deleterious neurological consequences to the indigenous populations living in the region, further research is needed to better characterize the neurological burden of such long-term exposure. With this aim, a cross-sectional exploratory study has been conducted with the Yanomami indigenous population residing in a northern Amazon region. All participants underwent a structured interview; detailed neurological examination, including assessment for cognitive, motor, coordination, and sensory functions; and laboratorial testing for serum hemoglobin, blood glucose, and methylmercury levels in hair samples. This study enrolled 154 individuals of 30.9 ± 16.8 years of age, of which 56.1% were female. Mean methylmercury levels in hair were 3.9 ± 1.7 µg/g. Methylmercury levels in hair > 6.0 µg/g were found in 10.3%. Among participants with hair methylmercury levels ≥ 6.0 µg/g, the prevalences of peripheral neuropathy and reduced cognitive performance were, respectively, 78.8% (95%CI 15-177%, p = 0.010) and 95.9% (95%CI 16-230.8%, p = 0.012) higher than those of individuals with lower levels. These results suggest that chronic mercury exposure may lead to significant and potentially irreversible neurotoxicity to Yanomami population living in the northern Amazon basin.

12.
Australas J Ageing ; 2024 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-38497228

RESUMEN

OBJECTIVES: The aim of this study was to validate the Kimberley Indigenous Cognitive Assessment-Cognitive Component (KICA-Cog) adapted for dementia screening in Torres Strait Islander Peoples. METHODS: Data were obtained from a broader dementia prevalence study completed in the Torres Strait and Northern Peninsula Area between 2015 and 2018. Modifications were made to items from the original KICA-Cog to ensure they were culturally appropriate for the Torres Strait. All participants completed a KICA-Cog and had a comprehensive dementia assessment with a geriatrician experienced in cross-cultural assessment. RESULTS: A total of 255 Torres Strait residents aged 45 years and over completed a KICA-Cog and underwent geriatric assessment. The adapted KICA-Cog showed good validity for dementia diagnosis with a cut point of 33/34 associated with a sensitivity of 81% and specificity of 92% with an area under the ROC curve of 0.91. CONCLUSIONS: The KICA-Cog, when modified for the Torres Strait, is a valid cognitive screening tool for dementia. Caution is required when interpreting test scores, as the adapted KICA-Cog had slightly lower sensitivity (ability to detect people with dementia) than the original KICA-Cog. As with all short cognitive tests, individuals with a low KICA-Cog scores should undergo further medical investigations before a dementia diagnosis is considered.

13.
J Pediatr Surg ; 59(5): 908-917, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38413263

RESUMEN

PURPOSE: Indigenous children worldwide face healthcare disparities due, in part, to resource scarcity in remote settings which may be mitigated with technology. This study aims to determine the use of telehealth for this population, with respect to feasibility, acceptability, and the degree of patient/family involvement in reported interventions. We focused on the use of telehealth to support perioperative care. METHODS: To identify relevant studies, five databases were searched to find articles that focused on the role of telehealth in caring for Indigenous populations worldwide, with an emphasis on the pediatric population. Studies that lacked insight into those themes, as well as protocols and review articles, were excluded. Analysis was done according to the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, the Montreal Model (patient involvement), and the theoretical framework of acceptability (TFA). RESULTS: Of the 1690 articles screened, 34 met the eligibility criteria. The most frequent uses of telehealth for Indigenous children were in ENT and psychiatry. Most of those had a low degree of complexity across the NASSS framework domains, suggesting greater feasibility. In 13 articles, the patient involvement was limited to information (lowest level of involvement in the Montreal Model). Only 11 articles directly assessed patient/family-perceived acceptability. Finally, two articles addressed telehealth in the surgical context. CONCLUSIONS: The relative simplicity of the proposed telehealth applications may support their sustained impact and use in other settings such as for perioperative care. Early and longitudinal involvement of communities is essential for responsible telehealth development that addresses local needs. LEVEL OF EVIDENCE: Level V.


Asunto(s)
Telemedicina , Humanos , Niño , Telemedicina/métodos , Disparidades en Atención de Salud , Participación del Paciente
14.
Ethn Health ; 29(3): 371-394, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38297918

RESUMEN

OBJECTIVES: Despite growing interest in the health disparities associated with food insecurity, research focusing on Indigenous peoples has been limited, especially in studies using nationally representative samples. This study investigates the association between food insecurity and various health outcomes - self-rated general and mental health, chronic health conditions, suicidal ideation, and obesity - among Indigenous peoples in Canada. It also explores the potential moderating effects of culture-based resources, which include cultural identity affect, cultural group belonging, cultural engagement, and cultural exploration. DESIGN: The study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations individuals living off-reserve, Métis, and Inuit across Canada (N = 15,533). Logistic regression models were used to analyze the data. RESULTS: Food insecurity was negatively associated with all examined health outcomes. Culture-based resources demonstrated a mixture of anticipated and unexpected effects on these relationships. Consistent with the stress process model, cultural group belonging mitigated the negative impact of food insecurity on all health outcomes. A similar pattern was observed for cultural engagement. However, contrary to expectations from the stress-buffering perspective, little evidence was found to support the moderating effects of cultural identity affect and cultural exploration. CONCLUSION: The results underscore the detrimental effects of food insecurity on the health of Indigenous peoples in Canada and suggest that culture-based resources, particularly cultural group belonging, play a crucial role in mitigating health disparities.


Asunto(s)
Inseguridad Alimentaria , Pueblos Indígenas , Humanos , Factores Socioeconómicos , Encuestas y Cuestionarios , Evaluación de Resultado en la Atención de Salud , Canadá/epidemiología
15.
Int J Circumpolar Health ; 83(1): 2313255, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38346231

RESUMEN

The Nutrition North Canada (NNC) program, introduced in April 2011 is a federal strategy to improve access to perishable, nutritious foods for remote and isolated communities in northern Canada by subsidising retailers to provide price reductions at the point of purchase. As of March 2023, 123 communities are eligible for the program. To evaluate existing evidence and research on the NNC program to inform policy decisions to improve the effectiveness of NNC. A scoping review of peer-reviewed articles was conducted in ten databases along with a supplemental grey literature search of government and non-government reports published between 2011 and 2022. The search yielded 172 publications for screening, of which 42 were included in the analysis. Narrative thematic evidence synthesis yielded 104 critiques and 341 recommendations of the NNC program across eight themes. The most-identified recommendations focus on transparency, communication, and support for harvesting, hunting, and community food initiatives. This review highlights recommendations informed by the literature to address critiques of the NNC program to improve food security, increase access to perishable and non-perishable items, and support community-based food initiatives among eligible communities. The review also identifies priority areas for future policy directions such as additional support for education initiatives, communication and transparency amidst program changes, and food price regulations.


Asunto(s)
Alimentos , Estado Nutricional , Humanos , Canadá , Abastecimiento de Alimentos , Costos y Análisis de Costo
16.
Int J Equity Health ; 23(1): 28, 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38347516

RESUMEN

BACKGROUND: Despite considerable investment in maternal-child programs in Canada, there has been little positive impact on the health of Indigenous mothers and their children. The reasons for this are unclear and there is a need to identify how such programs can be successfully implemented. Community input is essential for successful programs; however, it is unclear what the contributions of frontline workers have been in the health program process, i.e., program development, delivery, and evaluation. Based on these identified gaps, this scoping review aimed to: (1) identify factors of success and barriers to successful Indigenous maternal-child community health programs for mothers and their children aged 0-6 years; and (2) explore how frontline workers are included in the program process. METHODS: This scoping review was completed using the Arksey and O'Malley framework, informed by Levac et al. Four data bases (Medline, CINAHL, Embase, and Scopus), grey literature, and reference lists were searched for relevant materials from 1990-2019. Data was extracted from included articles and analysed using descriptive statistics, thematic analysis with the Braun and Clarke framework, and a Principal Component Analysis. RESULTS: Forty-five peer-reviewed and grey articles were included in the review. Factors of program success included: relationship building; cultural inclusion; knowledge transmission styles; community collaboration; client-centred approaches; Indigenous staff; and operational considerations. Barriers included: impacts of colonization; power structure and governance; client and community barriers to program access; physical and geographical challenges; lack of staff; and operational deficits. Frontline workers were found to have a role in program delivery (n = 45) and development (n = 25). Few (n = 6) had a role in program evaluation. CONCLUSION: Although a better understanding of the frontline worker role in maternal-child health programs was obtained from the review, in a large proportion of literature the authors could not determine if the role went beyond program delivery. In addition, no direct input from frontline workers and their perspectives on program success or barriers were identified, suggesting areas to explore in future research. This review's findings have been applied to inform a community-based participatory research project and may also help improve the development, delivery, and evaluation of Indigenous maternal-child health programs.


Asunto(s)
Salud Infantil , Humanos , Niño , Canadá
17.
Transcult Psychiatry ; : 13634615231225158, 2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38356281

RESUMEN

Despite the universal nature of suffering, few studies have examined how Indigenous ethnic minorities in non-western regions understand and respond to adversity. This study explored the epistemology of suffering among the Temiar ethnic group of Peninsular Malaysia using participant observation and semi-structured interviews. Interview transcripts of 43 participants were coded through inductive thematic analysis and a consensual qualitative approach. Three-tier themes were defined and named after subsequent analysis of core ideas and domains in the data. Major adversities reported included a lack of basic needs, lack of land-rights and unjust treatment from authorities, destruction of the forest environment and livelihood, and lack of accessibility and facilities, which were attributed to authorities' negligence of responsibilities, increasing human-animal conflict, environmental threats and imposed lifestyle changes. Faced with adversity, the Temiar endeavoured to survive by working crops and gathering forest resources. They utilized resources from family, fellow villagers, external agencies and spiritual-religious traditions. Theoretical mapping of attribution styles into the Ecological Rationality Framework revealed predominantly external-focused and concrete-perceptual rationalities privileged by strong-ties societies. These findings pointed to the resilience of a strong-ties community while adapting to the systemic suffering and risk factors stemming from a rationality mismatch with modernization and globalization trends. To conclude, we advocate for culture-sensitive mental health and psychiatric practices, as well as sustainable development for the well-being of Indigenous communities locally and globally.

18.
Proc Natl Acad Sci U S A ; 121(7): e2311703121, 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38315863

RESUMEN

Global polls have shown that people in high-income countries generally report being more satisfied with their lives than people in low-income countries. The persistence of this correlation, and its similarity to correlations between income and life satisfaction within countries, could lead to the impression that high levels of life satisfaction can only be achieved in wealthy societies. However, global polls have typically overlooked small-scale, nonindustrialized societies, which can provide an alternative test of the consistency of this relationship. Here, we present results from a survey of 2,966 members of Indigenous Peoples and local communities among 19 globally distributed sites. We find that high average levels of life satisfaction, comparable to those of wealthy countries, are reported for numerous populations that have very low monetary incomes. Our results are consistent with the notion that human societies can support very satisfying lives for their members without necessarily requiring high degrees of monetary wealth.


Asunto(s)
Renta , Satisfacción Personal , Humanos , Pobreza , Sociedades , Problemas Sociales
19.
Artículo en Inglés | MEDLINE | ID: mdl-38320254

RESUMEN

Historical factors including colonization and ongoing socioeconomic inequities impact Indigenous Peoples' ability to mitigate chronic disease risks such as achieving recommended physical activity (PA) levels. Reliably assessing, reflecting, and promoting PA participation among Indigenous Peoples may be impacted by a lack of culturally appropriate assessment methods and meaningful engagement with Indigenous communities throughout the research process. The objectives of this scoping review were to examine: (1) How PA research with Indigenous Peoples used community-specific PA measures developed with and/or for Indigenous Peoples in Canada, Australia, and New Zealand; and (2) How the studies utilized community-based participatory research (CBPR) principles to engage communities. A systematic search was conducted in four electronic databases (Web of Science, Medline, University of Saskatchewan Indigenous Portal, and ProQuest Dissertations and Theses Global). Thirty-one (n = 31) articles were identified and data extracted for narrative synthesis. Studies using community-specific PA measures have been increasing over time. Adapting questionnaires to traditional Indigenous activities such as cultural dances, ceremonies, and food-gathering activities were the most frequent adjustments undertaken to use community-specific measures. There are, however, gaps in research partnering with communities with only 6% of studies including all eight CBPR principles. Practical ways researchers can engage Indigenous communities and build capacity such as training and employing community members were highlighted. More needs to be done to facilitate community self-determination and develop long-term sustainable initiatives. Using culturally appropriate and relevant methodologies including partnering with Indigenous communities may help identification and implementation of culturally relevant and sustainable health-promoting initiatives.

20.
Int J Circumpolar Health ; 83(1): 2308944, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38320112

RESUMEN

Telerehabilitation is proposed as a promising avenue to enhance service accessibility for Indigenous communities, yet its application for Indigenous children remains relatively unexplored. This scoping review followed the PRISMA-ScR framework to explore current knowledge on the use of telerehabilitation for Indigenous children. Ten scholarly databases, seven grey literature databases, reference searches, and expert consultations were utilised to identify relevant studies. Included articles discussed the use of telerehabilitation provided by rehabilitation professionals (e.g. occupational therapist (OT), physical therapist (PT), speech and language pathologist (SLP) to Indigenous children and/or caregivers. Seven studies were included. Telerehabilitation was explored in different ways, the most common being real-time videoconferencing by SLPs. While some studies explicitly acknowledged cultural responsiveness within both the research process and the intervention, most were not designed for Indigenous children and their caregivers; rather, these participants were included with non-Indigenous participants. Successful implementation and sustainability of telerehabilitation services requires addressing technological limitations, understanding, and respecting diverse worldviews, and co-developing services to meet the unique needs of Indigenous families. Telerehabilitation has been rarely used with Indigenous children and when it was, little attention was given to cultural considerations. These findings emphasise that future telerehabilitation interventions should be truly community-led to ensure cultural relevance.


Asunto(s)
Telemedicina , Niño , Humanos , Comunicación por Videoconferencia , Cuidadores
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