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Addressing tuberculosis among Inuit in Canada

https://arctichealth.org/en/permalink/ahliterature294606
Source
Canada Communicable Disease Report (CCDR) March 1, 2008; 44(3-4):82-85.
Publication Type
Article
Date
2018
did this happen? Using the Territory of Nunavut as a case example, the roots of this situation can largely be traced back to social determinants of health and challenges in access to health care. Half (52%) of all Nunavut residents live in social housing, often under overcrowded conditions. Many
  1 document  
Author
Patterson, M
Finn, S
Barker, K
Source
Canada Communicable Disease Report (CCDR) March 1, 2008; 44(3-4):82-85.
Date
2018
Language
English
Geographic Location
Canada
Publication Type
Article
File Size
812024
Keywords
Inuit
Nunavut
Tuberculosis
Abstract
The average annual rate of tuberculosis (TB) among Inuit in Canada is now more than 290 times higher than Canadian born non-Indigenous people. How did this happen? Using the Territory of Nunavut as a case example, the roots of this situation can largely be traced back to social determinants of health and challenges in access to health care. Half (52%) of all Nunavut residents live in social housing, often under overcrowded conditions. Many experience food insecurity, with food prices in Nunavut that are twice those in southern Canada. Sixty percent of Nunavut residents smoke. Challenges in health care delivery include the small isolated communities, with few roads and difficult weather conditions during the long winters, which impede the ability to reach or provide healthcare, staff that arrive with little TB experience or cultural knowledge, multiple competing health care demands, limited resources and high staff turnover. The housing shortage is not only a social determinant of health, it also impacts the ability to hire new staff or mount an effective response in the event of an outbreak. Yet despite these challenges, progress has been made. Tuberculosis care in Nunavut includes active case finding, contact tracing for all cases of infectious TB, and screening of school age children. Rapid testing with the GeneXpert© platform has resulted in a quicker diagnosis of active TB, earlier treatment (preventing progression of disease) and less transmission. Progressively, there has been a switch from plain film to digital x-rays reducing x-ray turnaround time from as long as two to three weeks to one or two days. Standard treatment protocols include quadruple therapy until sensitivities are known, the use of home isolation for active cases and directly observed treatment (DOT) for both latent and active TB. Special access to rifapentine (Priftin), and its use in combination therapy (3HP), requires only once weekly treatments that can be completed in 12 visits instead of 78 visits for isoniazid (INH) or 120 visits for rifampin, which increases adherence and greatly reduces the health care resources needed to treat TB. In October 2017, the Honourable Jane Philpott, then Minister of Health and now Minister of Indigenous Services, and Natan Obed, president of Inuit Tapiriit Kanatami (ITK) announced the establishment of a Task Force to develop an Inuit TB Elimination Action Framework, accompanied by regional action plans. It is hoped that the task force, and current efforts in Nunavut, will lead to the long term changes needed to ultimately eliminate TB among Inuit in Canada.
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Adequate nutrient intakes are associated with traditional food consumption in nunavut inuit children aged 3-5 years.

https://arctichealth.org/en/permalink/ahliterature97085
Source
J Nutr. 2010 Jul;140(7):1311-6
Publication Type
Article
Date
Jul-2010
Author
Louise Johnson-Down
Grace M Egeland
Author Affiliation
Centre for Indigenous Peoples' Nutrition and Environment and School of Dietetics and Human Nutrition, McGill University, Macdonald Campus, Ste-Anne-de-Bellevue, Québec, H9X 3V9 Canada.
Source
J Nutr. 2010 Jul;140(7):1311-6
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Body mass index
Child, Preschool
Diet
Humans
Nunavut
Nutrition Assessment
Abstract
Dietary habits among Arctic preschoolers are unknown. A cross-sectional health survey of 388 Inuit, aged 3-5 y, was conducted in 16 communities in Canada's Nunavut Territory. Twenty-four-hour recall and FFQ with parents and primary caregivers quantified diet from market and traditional foods (TF). The Institute of Medicine's Dietary Reference Intakes estimated adequacy comparing intakes with Estimated Average Requirement or Adequate Intakes (AI). High-sugar and high-fat food and sugar beverage consumption and the extent to which dietary habits followed the Canadian Food Guide were evaluated. The children's mean age was 4.4 +/- 0.9 y and the mean BMI percentile was 90.2%. Consumption of nutrient-poor and energy-dense food and beverages contributed to 35% of energy. Most children met the requirements for many nutrients despite not eating the recommended servings from Eating Well with Canada's Food Guide First Nations, Inuit and Métis. Higher intake of TF resulted in higher intakes of cholesterol, vitamins A and D, iron, magnesium, and zinc. The percent above the AI for vitamin D was 43.1, 56.8, and 83.2% among no, low, and high TF consumers, respectively (chi2 test; P-trend
PubMed ID
20444949 View in PubMed
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Alcohol controls and violence in Nunavut: a comparison of wet and dry communities.

https://arctichealth.org/en/permalink/ahliterature136950
Source
Int J Circumpolar Health. 2011 Feb;70(1):19-28
Publication Type
Article
Date
Feb-2011
Author
Darryl S Wood
Author Affiliation
Program in Public Affairs, Washington State University Vancouver, Vancouver, WA 98686, USA. darrylwood@vancouver.wsu.edu
Source
Int J Circumpolar Health. 2011 Feb;70(1):19-28
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Alcohol Drinking - legislation & jurisprudence
Alcoholic Beverages - supply & distribution
Arctic Regions
Cross-Sectional Studies
Female
Humans
Inuits
Male
Nunavut
Retrospective Studies
Violence - prevention & control - statistics & numerical data
Young Adult
Abstract
The purpose of this study was to determine if communities in Nunavut that prohibit the importation of alcoholic beverages have less violence relative to communities that allow alcohol importation.
A retrospective cross-sectional study based on community-level records of violent crimes known to the police.
Violence was measured using community-level records of homicide, assault and sexual assault as reported to the Royal Canadian Mounted Police in 23 communities in Nunavut for the years 1986 to 2006. Crude-rate comparisons were made between wet communities (which allow alcohol importation) and dry communities (which prohibit alcohol importation) and contrasted with national rates for context.
Wet communities in Nunavut recorded rates of violent crime that were higher than the rates recorded by dry communities. Relative to dry communities, wet communities' overall sexual assault rate was 1.48 (95% CI = 1.38-1.60) times higher, the serious assault rate was 2.10 (95% CI = 1.88-2.35) times higher and the homicide rate was 2.88 (95% CI = 1.18-8.84) times higher. Although safer than wet communities, dry communities reported rates of violence that were higher than national rates including a serious assault rate that was double the national rate (3.25 per 1,000 vs. 1.44 per 1,000) and a sexual assault rate that was at least seven times as high as the national rate (7.58 per 1,000 vs. 0.88 per 1,000).
As elsewhere in the Arctic, communities in Nunavut that prohibited alcohol were less violent than those that allowed alcohol importation. Even with prohibition, dry communities recorded rates of violence much greater than the national average.
PubMed ID
21329578 View in PubMed
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An assessment of recent political development in Nunavut: the challenges and dilemma of Inuit self-government.

https://arctichealth.org/en/permalink/ahliterature294608
Source
The Canadian Journal of Native Studies XVIII, 2(1998):271-299.
Date
1998
AN ASSESSMENT OF RECENT POLITICAL DEVELOPMENT IN NUNAVUT: THE CHALLENGES AND DILEMMAS OF INUIT SELF-GOVERNMENT Andre Legare Department of Geography Queen's University Kingston, Ontario Canada, K7L 3N6 Abstract I Resume On April 1, 1999, the Nunavut Territory will be officially proclaimed. This
  1 document  
Author
Legare, Andre
Author Affiliation
Department of Geography, Queen's University, Kingston, Ontario
Source
The Canadian Journal of Native Studies XVIII, 2(1998):271-299.
Date
1998
Language
English
Geographic Location
Canada
File Size
1547383
Keywords
Nunavut
Inuit
History
Political structure
Self-government
Abstract
On April 1, 1999, the Nunavut Territory will be officially proclaimed. This paper presents a prospective analysis of the future legislative and administrative structures of the government of Nunavut and its financing. What kinds of political structures will Nunavut inherit in 1999? The author examines some of the political challenges and dilemmas generated by the emergence of Nunavut, and the reasons which motivated the federal government to establish this new political unit in Canada's north.
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cjnsv18no2_pg271-299.pdf

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An estimation of cosmic ray background exposure in Northern Territories

https://arctichealth.org/en/permalink/ahliterature96087
Source
Page 280 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Publication Type
Conference/Meeting Material
Date
2010
geographic locations and during different solar activity periods, the annual effective dose could vary from 0.27 to 0.84 mSv. In the three territories of northern Canada, the population weighted average annual effective doses due to cosmic ray exposure are 0.29 mSv for Nunavut, 0.31 mSv for Northwest
  1 document  
Author
Chen, J.
Timmins, R.
Verdecchia, K.
Sato, T.
Author Affiliation
Healthy Environments and Consumer Safety Branch, Health Canada
Japan Atomic Energy Agency
Source
Page 280 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Date
2010
Language
English
Geographic Location
Canada
Publication Type
Conference/Meeting Material
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
Cosmic rays
Natural radiation sources
Northwest Territories
Nunavut
PARMA simulation software
Solar activities
Yukon
Notes
Part of Abstracts: Oral presentations. Chapter 7. Human Biology.
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An IDEA for short term outbreak projection: nearcasting using the basic reproduction number.

https://arctichealth.org/en/permalink/ahliterature105416
Source
PLoS One. 2013;8(12):e83622
Publication Type
Article
Date
2013
Author
David N Fisman
Tanya S Hauck
Ashleigh R Tuite
Amy L Greer
Author Affiliation
The Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada ; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada ; The Decision Centre for Infectious Disease Epidemiology (DeCIDE), Toronto, Ontario, Canada.
Source
PLoS One. 2013;8(12):e83622
Date
2013
Language
English
Publication Type
Article
Keywords
Basic Reproduction Number - statistics & numerical data
Communicable Diseases - epidemiology
Disease Outbreaks - statistics & numerical data
Forecasting - methods
Humans
Incidence
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology
Models, Statistical
Nunavut - epidemiology
Abstract
Communicable disease outbreaks of novel or existing pathogens threaten human health around the globe. It would be desirable to rapidly characterize such outbreaks and develop accurate projections of their duration and cumulative size even when limited preliminary data are available. Here we develop a mathematical model to aid public health authorities in tracking the expansion and contraction of outbreaks with explicit representation of factors (other than population immunity) that may slow epidemic growth.
The Incidence Decay and Exponential Adjustment (IDEA) model is a parsimonious function that uses the basic reproduction number R0, along with a discounting factor to project the growth of outbreaks using only basic epidemiological information (e.g., daily incidence counts).
Compared to simulated data, IDEA provides highly accurate estimates of total size and duration for a given outbreak when R0 is low or moderate, and also identifies turning points or new waves. When tested with an outbreak of pandemic influenza A (H1N1), the model generates estimated incidence at the i+1(th) serial interval using data from the i(th) serial interval within an average of 20% of actual incidence.
This model for communicable disease outbreaks provides rapid assessments of outbreak growth and public health interventions. Further evaluation in the context of real-world outbreaks will establish the utility of IDEA as a tool for front-line epidemiologists.
Notes
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PubMed ID
24391797 View in PubMed
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Antibiotic resistance genes in municipal wastewater treatment systems and receiving waters in Arctic Canada.

https://arctichealth.org/en/permalink/ahliterature294222
Source
Sci Total Environ. 2017 Nov 15; 598:1085-1094
Publication Type
Journal Article
Date
Nov-15-2017
Author
Kara D Neudorf
Yan Nan Huang
Colin M Ragush
Christopher K Yost
Rob C Jamieson
Lisbeth Truelstrup Hansen
Author Affiliation
Department of Process Engineering and Applied Science, Dalhousie University, 1360 Barrington Street, Halifax B3H 4R2, Canada.
Source
Sci Total Environ. 2017 Nov 15; 598:1085-1094
Date
Nov-15-2017
Language
English
Publication Type
Journal Article
Keywords
Anti-Bacterial Agents
Drug Resistance, Bacterial - genetics
Environmental monitoring
Genes, Bacterial
Nunavut
Waste Water - microbiology
Abstract
Domestic wastewater discharges may adversely impact arctic ecosystems and local indigenous people, who rely on being able to hunt and harvest food from their local environment. Therefore, there is a need to develop efficient wastewater treatment plants (WWTPs), which can be operated in remote communities under extreme climatic conditions. WWTPs have been identified as reservoirs of antibiotic resistance genes (ARGs). The objective of this work was to quantify the presence of nine different ARG markers (int1, sul1, sul2, tet(O), erm(B), mecA, blaCTX-M, blaTEM, and qnr(S)) in two passive systems (waste stabilization ponds [WSPs]) and one mechanical filtration plant operating in two smaller and one large community, respectively, in Nunavut, Canada. Measurement of water quality parameters (carbonaceous oxygen demand, ammonia, total suspended solids, Escherichia coli and total coliforms) showed that the WWTPs provided only primary treatment. Low levels of the ARGs (2logcopies/mL) were observed in the effluent, demonstrating that bacteria residing in three northern WWTPs harbour ARGs conferring resistance to multiple clinically-relevant classes of antibiotics. Our results indicate that long-term storage in WSPs benefitted removal of organic material and some ARGs. However, one WSP system showed evidence of the enrichment of sul1, sul2, mecA, tet(O) and qnr(S). Further research is needed to fully understand if these ARG releases pose a risk to human health, especially in the context of traditional hunting and fishing activities.
PubMed ID
28482456 View in PubMed
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An ultra-clean firn core from the Devon Island Ice Cap, Nunavut, Canada, retrieved using a titanium drill specially designed for trace element studies.

https://arctichealth.org/en/permalink/ahliterature82660
Source
J Environ Monit. 2006 Mar;8(3):406-13
Publication Type
Article
Date
Mar-2006
Author
Zheng J.
Fisher D.
Blake E.
Hall G.
Vaive J.
Krachler M.
Zdanowicz C.
Lam J.
Lawson G.
Shotyk W.
Author Affiliation
GSC Northern Canada, Geological Survey of Canada, Natural Resources Canada, 601 Booth Street, Ottawa, Canada K1A 0E8. jzheng@nrcan.gc.ca
Source
J Environ Monit. 2006 Mar;8(3):406-13
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Air Pollutants - analysis
Arctic Regions
Cadmium - analysis
Environmental Monitoring - instrumentation - methods
Ice Cover - chemistry
Lead - analysis
Metals - analysis
Nunavut
Time Factors
Titanium
Abstract
An electromechanical drill with titanium barrels was used to recover a 63.7 m long firn core from Devon Island Ice Cap, Nunavut, Canada, representing 155 years of precipitation. The core was processed and analysed at the Geological Survey of Canada by following strict clean procedures for measurements of Pb and Cd at concentrations at or below the pg g(-1) level. This paper describes the effectiveness of the titanium drill with respect to contamination during ice core retrieval and evaluates sample-processing procedures in laboratories. The results demonstrate that: (1) ice cores retrieved with this titanium drill are of excellent quality with metal contamination one to four orders of magnitude less than those retrieved with conventional drills; (2) the core cleaning and sampling protocols used were effective, contamination-free, and adequate for analysis of the metals (Pb and Cd) at low pg g(-1) levels; and (3) results from 489 firn core samples analysed in this study are comparable with published data from other sites in the Arctic, Greenland and the Antarctic.
PubMed ID
16528426 View in PubMed
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Arctic permafrost active layer detachments stimulate microbial activity and degradation of soil organic matter.

https://arctichealth.org/en/permalink/ahliterature97020
Source
Environ Sci Technol. 2010 Jun 1;44(11):4076-82
Publication Type
Article
Date
Jun-1-2010
Author
Brent G Pautler
André J Simpson
David J McNally
Scott F Lamoureux
Myrna J Simpson
Author Affiliation
Department of Chemistry, University of Toronto, Toronto, Ontario, Canada.
Source
Environ Sci Technol. 2010 Jun 1;44(11):4076-82
Date
Jun-1-2010
Language
English
Publication Type
Article
Keywords
Arctic Regions
Bacteria - metabolism
Fatty Acids - metabolism
Magnetic Resonance Spectroscopy
Nunavut
Soil Microbiology
Abstract
Large quantities of soil organic carbon in Arctic permafrost zones are becoming increasingly unstable due to a warming climate. High temperatures and substantial rainfall in July 2007 in the Canadian High Arctic resulted in permafrost active layer detachments (ALDs) that redistributed soils throughout a small watershed in Nunavut, Canada. Molecular biomarkers and NMR spectroscopy were used to measure how ALDs may lead to microbial activity and decomposition of previously unavailable soil organic matter (SOM). Increased concentrations of extracted bacterial phospholipid fatty acids (PLFAs) and large contributions from bacterial protein/peptides in the NMR spectra at recent ALDs suggest increased microbial activity. PLFAs were appreciably depleted in a soil sample where ALDs occurred prior to 2003. However an enrichment of bacterial derived peptidoglycan was observed by (1)H-(13)C heteronuclear multiple quantum coherence (HMQC) and (1)H diffusion edited (DE) NMR and enhanced SOM degradation was observed by (13)C solid-state NMR. These data suggest that a previous rise in microbial activity, as is currently underway at the recent ALD site, led to degradation and depletion of labile SOM components. Therefore, this study indicates that ALDs may amplify climate change due to the release of labile SOM substrates from thawing High Arctic permafrost.
PubMed ID
20459054 View in PubMed
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Assessment of contaminant and dietary nutrient interactions in the Inuit Health Survey

https://arctichealth.org/en/permalink/ahliterature96120
Source
Page 317 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Publication Type
Conference/Meeting Material
Date
2010
ASSESSMENT OF CONTAMINANT AND DIETARY NUTRIENT INTERACTIONS IN THE INUIT HEAL TH SURVEY L.H.M. Chan, L. Van Pelt, G.M. Egeland, Oanuippitali Steering Committee (lnuvialuit), Oanuippitali Steering Committee (Nunatsiavut), Oanuippitali Steering Committee (Nunavut) UNBC Community Health Sciences
  1 document  
Author
Chan, L.H.M.
Van Pelt, L.
Egeland, G.M.
Qanuippitali Steering Committee (Inuvialuit)
Qanuippitali Steering Committee (Nunatsiavut)
Qanuippitali Steering Committee (Nunavut)
Author Affiliation
UNBC Community Health Sciences Program
Source
Page 317 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Date
2010
Language
English
Geographic Location
Canada
Publication Type
Conference/Meeting Material
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
Canadian Arctic
Contaminants research
Environmental health policies
Inuit Health Survey (IHS)
Inuvialuit
Northern Contaminant Program
Nunatsiavut
Nunavut
Traditional food diet
Notes
Part of Abstracts: Oral presentations. Chapter 8. Food Security and Our Environments.
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229 records – page 1 of 23.