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3-year results of a collaborative school-based oral health program in a remote First Nations community.

https://arctichealth.org/en/permalink/ahliterature157485
Source
Rural Remote Health. 2008 Apr-Jun;8(2):882
Publication Type
Article
Author
A J Macnab
J. Rozmus
D. Benton
F A Gagnon
Author Affiliation
University of British Columbia, Department of Pediatrics, Vancouver, British Columbia, Canada.
Source
Rural Remote Health. 2008 Apr-Jun;8(2):882
Language
English
Publication Type
Article
Keywords
Adolescent
British Columbia
Child
Cross-Sectional Studies
Dental Care for Children - methods
Health Education - methods
Health Knowledge, Attitudes, Practice
Humans
Indians, North American
Medically underserved area
Oral Hygiene - education - methods
School Health Services
Tooth Diseases - ethnology - prevention & control
Abstract
Surveys of dental health among Aboriginal children in Canada, using scales such as the Decayed, Missing, and Filled Teeth (DMFT) score, indicate that Aboriginal children have 2 to 3 times poorer oral health compared with other populations. A remote First Nations community approached requested assistance in addressing the health of their children. The objective was to work with the community to improve oral health and knowledge among school children. The hypothesis formulated was that after 3 years of the program there would be a significant decrease in dmft/DMFT (primary/permanent) score.
This was a cross-sectional study of all school-aged children in a small, remote First Nations community. Pre- and post- intervention evaluation of oral health was conducted by a dentist not involved in the study. The intervention consisted of a school-based program with daily brush-ins, fluoride application, educational presentations, and a recognition/incentive scheme.
Twenty-six children were assessed prior to the intervention, representing 45% of the 58 children then in the community. All 40 children in the community were assessed following the intervention. Prior to the intervention, 8% of children were cavity free. Following 3 years of the intervention, 32% were cavity free. Among the 13 children assessed both pre- and post-intervention, dmft/DMFT score improved significantly (p
PubMed ID
18444770 View in PubMed
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The 2009 H1N1 pandemic response in remote First Nation communities of Subarctic Ontario: barriers and improvements from a health care services perspective.

https://arctichealth.org/en/permalink/ahliterature130157
Source
Int J Circumpolar Health. 2011;70(5):564-75
Publication Type
Article
Date
2011
Author
Nadia A Charania
Leonard J S Tsuji
Author Affiliation
Department of Environment and Resource Studies, University of Waterloo, Waterloo, ON N2L 3G1, Canada. ncharani@uwaterloo.ca
Source
Int J Circumpolar Health. 2011;70(5):564-75
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Catchment Area (Health)
Federal Government
Female
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology - prevention & control
Information Dissemination
Male
Medically underserved area
Middle Aged
Ontario
Pandemics - prevention & control - statistics & numerical data
Patient Acceptance of Health Care - ethnology
Professional-Patient Relations
Retrospective Studies
Rural health services - organization & administration
Abstract
To retrospectively examine the barriers faced and opportunities for improvement during the 2009 H1N1 pandemic response experienced by participants responsible for the delivery of health care services in 3 remote and isolated Subarctic First Nation communities of northern Ontario, Canada.
A qualitative community-based participatory approach.
Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the 3 main sectors responsible for health care services (i.e., federal health centres, provincial hospitals and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis.
Primary barriers reported were issues with overcrowding in houses, insufficient human resources and inadequate community awareness. Main areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies and general community awareness regarding disease processes and prevention.
Government bodies should consider focusing efforts to provide more support in terms of human resources, monies and education. In addition, various government organizations should collaborate to improve housing conditions and timely access to resources. These recommendations should be addressed in future pandemic plans, so that remote western James Bay First Nation communities of Subarctic Ontario and other similar communities can be better prepared for the next public health emergency.
PubMed ID
22030007 View in PubMed
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Accessing maternity care in rural Canada: there's more to the story than distance to a doctor.

https://arctichealth.org/en/permalink/ahliterature155499
Source
Health Care Women Int. 2008 Sep;29(8):863-83
Publication Type
Article
Date
Sep-2008
Author
Rebecca Sutherns
Ivy Lynn Bourgeault
Author Affiliation
Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Source
Health Care Women Int. 2008 Sep;29(8):863-83
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alberta
Female
Health Care Surveys
Health Services Accessibility
Humans
Maternal Health Services - methods - trends
Medically underserved area
Needs Assessment
Ontario
Pregnancy
Prenatal Care - methods - trends
Quality of Health Care
Risk assessment
Rural Health Services - standards - trends
Rural Population
Abstract
Drawing upon a comparative, qualitative study of the experiences of rural women accessing maternity care in two Canadian provinces, we demonstrate that availability of services, having economic and informational resources to access the services offered, and the appropriateness of those services in terms of gender, continuity of care, confidentiality, quality of care, and cultural fit are key to an accurate understanding of health care access. We explore the implications of living rurally on each of these dimensions, thereby revealing both gaps in and solutions to rural maternity care access that narrower, proximity-based definitions miss.
PubMed ID
18726796 View in PubMed
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Source
Can Fam Physician. 1997 Jun;43:1047-8
Publication Type
Article
Date
Jun-1997
Author
D J Weinkauf
Source
Can Fam Physician. 1997 Jun;43:1047-8
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Family Practice - manpower
Health Services Accessibility - standards
Health Services Research - methods
Humans
Medically underserved area
Ontario
Primary Health Care - manpower
Notes
Cites: Can Fam Physician. 1997 Apr;43:677-83, 7339111984
Comment On: Can Fam Physician. 1997 Apr;43:677-83, 7339111984
PubMed ID
9189287 View in PubMed
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Access to ambulatory care for American Indians and Alaska Natives; the relative importance of personal and community resources.

https://arctichealth.org/en/permalink/ahliterature6151
Source
Soc Sci Med. 1995 Feb;40(3):393-407
Publication Type
Article
Date
Feb-1995
Author
P J Cunningham
L J Cornelius
Author Affiliation
Agency for Health Care Policy and Research, Rockville, MD 20852.
Source
Soc Sci Med. 1995 Feb;40(3):393-407
Date
Feb-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alaska - ethnology
Ambulatory Care - utilization
Female
Health Care Reform - standards
Health Services Accessibility - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
Hospitalization
Humans
Indians, North American - statistics & numerical data
Insurance, Health
Inuits - statistics & numerical data
Least-Squares Analysis
Male
Medically underserved area
Middle Aged
Multivariate Analysis
Rural Population
Socioeconomic Factors
Time Factors
Abstract
The debate on health care reform in the United States has been greatly influenced by various national studies showing a strong relationship between lack of public or private health care coverage and inadequate access to health services. There is also much concern about deficiencies in the availability and delivery of services to certain population groups--especially for those living in the most remote and sparsely populated areas of the country. However, national studies have generally not demonstrated that the use of health services is strongly associated with urban/rural residence or the supply of medical providers. In this study, we show that national studies can obscure the problems of certain population groups including American Indians and Alaska Natives. Using data from the 1987 National Medical Expenditure Survey, the findings show that the availability of medical providers as well as place of residence were strongly associated with the use of health care by American Indians and Alaska Natives. Although American Indians and Alaska Natives included in this study were eligible to receive health care free of charge from the Indian Health Service (IHS), financial factors were also significantly associated with use due to the use of services other than those provided or sponsored by IHS. Also, the results show that while geographic and supply factors have only modest effects on the average travel time to medical providers for the U.S. population as a whole, travel times are dramatically longer for American Indians and Alaska Natives living in rural areas and where there are few medical providers. In addition, there appear to be fewer hospitalizations in areas where there are IHS outpatient services. We conclude by discussing the need for health care reform to take into account the diversity of a large country such as the U.S., and the special needs of population groups that are usually not adequately represented in national studies.
PubMed ID
7899951 View in PubMed
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Source
J Am Dent Assoc. 2009 Jun;140(6):640, 642; author reply 642-3
Publication Type
Article
Date
Jun-2009
Author
Paul Benjamin
Source
J Am Dent Assoc. 2009 Jun;140(6):640, 642; author reply 642-3
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Alaska
Community health workers
Delivery of Health Care
Dental Auxiliaries
Dental Care
Health Services Accessibility
Humans
Medically underserved area
United States
Notes
Comment On: J Am Dent Assoc. 2008 Nov;139(11):1530-5; discussion 1536-918978392
PubMed ID
19491156 View in PubMed
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Accuracy of routine echocardiographic measurements made by an inexperienced examiner through tele-instruction.

https://arctichealth.org/en/permalink/ahliterature68989
Source
J Telemed Telecare. 1996;2(3):148-54
Publication Type
Article
Date
1996
Author
J E Afset
P. Lunde
K. Rasmussen
Author Affiliation
Department of Medicine, Kirkenes Hospital, Norway.
Source
J Telemed Telecare. 1996;2(3):148-54
Date
1996
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cost-Benefit Analysis
Echocardiography - economics - methods
Female
Humans
Male
Medically underserved area
Middle Aged
Norway
Reproducibility of Results
Research Support, Non-U.S. Gov't
Telemedicine - economics - methods
Video Recording
Abstract
The reproducibility and accuracy of routine echocardiographic measurements made by an inexperienced doctor using tele-instruction were evaluated. Thirty-eight patients were first examined at a local hospital by an inexperienced doctor instructed by a specialist 450 km away at a university hospital. The specialist then examined the patients at the local hospital using the same equipment, after an average of 50 days. The accuracy of M-mode and quantitative Doppler measurements was comparable to that observed in reproducibility studies made under normal examination conditions. There were no systematic measurement errors. No important M-mode information was missed except evidence of left ventricular hypertrophy in six patients. In the two-dimensional examination there were differences of clinical significance in only three patients. There were no clinically important differences in the Doppler quantification of mitral and aortic regurgitation. Tele-instructed echocardiography is also an excellent educational tool, allowing an inexperienced examiner gradually to take responsibility for the local echocardiographic service.
PubMed ID
9375049 View in PubMed
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Additional skills training for rural physicians. Alberta's rural physician action plan.

https://arctichealth.org/en/permalink/ahliterature169033
Source
Can Fam Physician. 2006 May;52:601-4
Publication Type
Article
Date
May-2006
Author
Ron Gorsche
John Hnatuik
Author Affiliation
Department of Family Medicine, Faculty of Medicine, University of Calgary. john.hnatuik@rpap.ab.ca
Source
Can Fam Physician. 2006 May;52:601-4
Date
May-2006
Language
English
Publication Type
Article
Keywords
Alberta
Education, Medical, Continuing - organization & administration
Family Practice - education - manpower
Humans
Medically underserved area
Personnel Selection
Preceptorship - organization & administration
Rural Health Services - manpower
Abstract
Rural physicians in Alberta identified access to special skills training and upgrading skills as an important practice requirement.
The Rural Physician Action Plan in Alberta developed an Enrichment Program to assist physicians practising in rural Alberta communities to upgrade their existing skills or gain new skills. The Enrichment Program aimed to provide a single point of entry to skills training that was individualized and based on the needs of rural physicians.
Two experienced rural physicians were engaged as "skills brokers" to help rural physicians requesting additional skills training or upgrading to find the training they required. Physicians interested in applying for the Enrichment Program consulted one of the brokers. Each applicant was assigned a preceptor. Preceptors confirmed learning objectives with trainees, provided the required training in keeping with agreed-upon learning objectives, and ensured trainees were evaluated at the end of the training.
The program has helped rural physicians upgrade their skills and gain new skills. More Alberta rural physicians are now able to pursue additional training and return to practise new skills in their rural and remote communities than in the past.
Notes
Cites: J Rural Health. 1994 Summer;10(3):183-9210138034
Cites: CMAJ. 1998 Feb 10;158(3):351-59484262
PubMed ID
16739833 View in PubMed
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Addressing health inequities through indigenous involvement in health-policy discourses.

https://arctichealth.org/en/permalink/ahliterature121593
Source
Can J Nurs Res. 2012 Jun;44(2):108-22
Publication Type
Article
Date
Jun-2012
Author
Alycia J Fridkin
Source
Can J Nurs Res. 2012 Jun;44(2):108-22
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Canada
Health Policy
Health Services, Indigenous - organization & administration - standards
Humans
Indians, North American
Medically underserved area
Transcultural Nursing - organization & administration - standards
Abstract
Although the health of Indigenous peoples is affected by structural inequities, interventions to address health inequities are often focused locally rather than at a structural level where they could play a transformative role. Addressing structural health inequities by involving Indigenous peoples in health-policy discourses can serve to address power imbalances that are implicit in policymaking processes. Using an analytical framework based on interdisciplinary perspectives rooted in critical and decolonizing approaches, the author presents a discussion of theoretical considerations for including Indigenous peoples in policy discourses as a means of addressing health inequities. She argues that the involvement of Indigenous peoples in health-policy discourses has the potential to mitigate epistemological colonialism, push forward an agenda of decolonization, and address health inequities caused by inequitable systems of power. The article concludes with suggestions for future research and implications for nursing and health professionals of addressing structural inequities through attention to policy discourses.
PubMed ID
22894009 View in PubMed
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460 records – page 1 of 46.