The purpose of the research reported here is to help the community in Barrow, Alaska, clarify its vulnerability to extreme weather events, and devise better-informed policies for reducing that vulnerability and adapting to climate variability and change. We examine the worst disaster on record there - a storm that struck on 3 October 1963 - from different disciplinary perspectives and in the context of other severe storms. The major policy responses to date have been a beach nourishment program, a feasibility study of additional means of erosion control, and an emergency management plan. Additional possible responses have been identified in the community's cumulative experience of these storms, but have not yet been fully explored or implemented. Meanwhile, given inherent uncertainties, it is clear that sound policies will allow for corrective action if and when expectations based on the best available knowledge and information turn out to be mistaken. It is also clear that the people of Barrow are in the best position to understand the evolving situation and to decide what to do about it.
Consortium Library holds this periodical. Entire December issue focused on Arctic human dimensions research.
We studied the feasibility of using a humanoid robot as an assistant in the monitoring of nursing home residents. The robot can receive alarms via its wireless Internet connection and navigate independently to the room where the alarm originated. Once it has entered the room, the robot can transmit near real time images to the staff and also open a voice connection between the resident and the remote caregivers. This way the remote caregiver is able to check the situation in the room, and take appropriate actions. We tested the prototype robot in three private nursing homes in the Finnish county of South Ostrobothnia. During the testing, 2-4 alarms were produced by each participant and there were 29 alarms in total. The robot was able to navigate correctly to the room from which the alarm was sent and open the speech connection, as well as transmit images via the wireless Internet connection. The experiments provided evidence of the feasibility of using autonomous robots as assistants to nursing home staff in remote monitoring. The response from the nursing home residents was uniformly positive.
It is estimated that First Nations children living on reserves are 4.5 times more likely to be obese than Canadian children in general. Many First Nations children living on reserves have limited healthy food and physical activity options. Understanding how community factors contribute to First Nations children's lifestyle choices is an understudied area of research. Furthermore, rarely has health research elicited First Nations children's perspectives of their communities. The purpose of this study was to understand the external behavior-shaping factors that influence the lifestyle behaviors of First Nations' children. Asset mapping with children was used to understand how community resources impacted children's activity and eating options.
Alexander First Nation is in central Alberta. Asset mapping was one component of a research project in the community to identify risk factors for children developing diabetes. Participants were a convenience sample of two high school students working at the local health centre and seven grade six children. Maps, photographs, and a tour of the town site enabled participants to identify places and spaces where they were active or could obtain food. For each of these assets, a description of how it was used and how it could be modified for better usage was derived from notes and transcripts using content analysis. Assets were grouped into usage categories, which were then mapped onto a layout of the community and presented at a community meeting to address childhood obesity.
Twenty-five places and spaces were identified as being activity or food related. Breakfast and/or lunch, concession foods (snack foods, eg chocolate bars, potato crisps) were obtained at school; meals and snack foods where cultural gatherings occur; and snack foods at the local store. Healthy food choices were limited. Children and youth were active at different locations in town, with only two spaces beyond the town site identified as locations for activity. Youth recommended the construction of a leisure centre, that healthier food be sold at the local convenience store, and the development of a community garden and berry farm.
In the ecological framework, weight status is considered embedded within the larger ecology of individual lives because of interrelationships between an individual's personal dimensions and other components of an individual's external environment. Asset mapping with children and youth in Alexander First Nation helped to achieve an understanding of the community factors that shaped their health behaviors. Asset mapping not only produced a list of places and spaces where they played, met, and ate, but also showed where they most preferred to be. Further, the exercise enabled children to express how assets could be improved, and the assets they would like in their community, to promote healthy behaviors. The findings enabled adults to contextualize other community data collected about children (ie obesity prevalence, physical activity levels), to better understand how the presence and the condition of places and spaces in the community shaped the physical activity and eating behaviors of children and youth, and how local resources could be modified to be more health promoting.
The EQ-5D questionnaire of EuroQol is an important tool, not only for researchers, but also for quality registers. Until 2013, Sweden did not have a country-specific value set to convert the EQ-5D health states into a single index. Commonly, the UK time trade-off (UK TTO) value set has been used. The study reported here aimed to establish an easy to use tool for the bidirectional crosswalk of the mean EQ-5D values based on two different value sets: the UK TTO and the Swedish TTO value sets.
Using an artificial data set encompassing all possible EQ-5D outcomes, we calculated the EQ-5D index using both the UK TTO and Swedish TTO value sets. Thereafter we modelled the relationship between the two indices using least-squares regression and major axis regression. A series of simulations was run to assess the feasibility of the obtained crosswalk algorithms.
Major axis regression was superior to ordinary least-squares regression. Converting the mean EQ-5D values from the UK TTO scale to the Swedish TTO scale was more accurate than the inverse conversion. Values close to the floor and ceiling of the EQ-5D index were more challenging to crosswalk. CONCLUSIONS WE ESTABLISHED ALGORITHMS BASED ON MAJOR AXIS REGRESSION TO CROSSWALK EQ-5D VALUES BASED ON THE UK TTO AND THE SWEDISH TTO VALUE SETS THE PRESENTED ALGORITHM MAY FACILITATE COMPARISONS OF EQ-5D VALUES WHEN ONLY MEAN VALUES ARE AVAILABLE THE EXISTENCE OF A CROSSWALK ALGORITHM WILL EASE THE TRANSITION FROM THE UK TTO TO THE SWEDISH TTO VALUE SET.
Alaska may be ideally suited as a test site for telemedicine. It is by far the nation's largest state, with a population of only 550,000 clustered around a few cities and towns or widely spread across an area almost two and a half times as large as Texas. Its ratio of doctors to patients is the second lowest in the nation, and the cost of medical care exceeds that in the lower 48 states by 90%. Almost half of its residents are affiliated with the federal government in some way. Active duty and retired members of the military and their families (including children) represent 70,000 of the state's residents, and another 160,000 are affiliated with the Coast Guard, the Indian Health Service, and the Department of Veteran Affairs. In 1995, a telemedicine initiative was launched under the auspices of the 3rd Medical Center at Elmendorf Air Force Base. Its mission was to integrate video conferencing and store-and-forward technology into patient care. Brief but well-documented efforts yielded many valuable lessons on how relatively simple, low-bandwidth technology can be effectively used and its limitations. In addition, unexpected changes were observed in the way health care was delivered. This experience should provide valuable lessons for those embarking on this path to health care delivery.