Trauma affects children from all ethnicities, nationalities and socioeconomic backgrounds. However, indigenous children may experience trauma differently than their majority population peers due to traumatic histories of colonization and marginalization. This article reports on an exploratory qualitative study of how service providers in Western Montana and Northern Norway conceptualize Native American and Sámi children's experiences of trauma today. Findings reveal that participants relate current trauma experiences of indigenous youth to historical and intergenerational traumas.
Chair, Indigenous & Northern Health; Senior Scientist, Health Sciences North Research Institute; Scientific Director, Institute of Indigenous Peoples' Health, Canadian Institutes of Health Research, Sudbury, ON.
This commentary examines the inequitable access to healthcare services that Indigenous peoples in Canada face on a daily basis. It considers not only geographical or physical access but also culturally safe access to healthcare. Racism is cited as a major deterrent in not accessing mainstream health services. Three recent studies are cited that reveal that racism, discrimination, stigma, sexism and bias prevent Indigenous peoples from accessing mainstream health services. Cultural safety training is recommended, as well as recruitment and retention of Indigenous health professionals. Several recommendations to address physical and geographical access are also recommended, including self-governance and capacity building; enhanced partnerships and collaboration to address jurisdictional issues, particularly for First Nations communities, and a national strategy for access to healthy and affordable food in northern, remote and rural communities.
With the recognized need for health systems' improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods' frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.
Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples.
Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive synthesis and quantitative summary of measures for interventions.
To our knowledge, this study will contribute the first systematic review of documented barriers, supports, and interventions for vaccination in general and for HPV vaccination. The results of this study are expected to inform future research, policies, programs, and community-driven initiatives to enhance acceptability and uptake of HPV vaccination among Indigenous peoples.
American Indians/Alaska Natives (AIAN) experience a high burden of cardiovascular disease with rates for fatal and nonfatal heart disease approximately twofold higher than the U.S. population.
To determine if disparities exist in cardiac procedure rates among AIAN compared to non-Hispanic whites hospitalized in California for ischemic heart disease defined as acute myocardial infarction or unstable angina.
Cross-sectional study. EVENTS: A total of 796 ischemic heart disease hospitalizations among AIAN and 90971 among non-Hispanic whites in 37 of 58 counties in California from 1998-2002.
Cardiac catheterization, percutaneous cardiac intervention, and coronary artery bypass graft surgery procedure rates from hospitalization administrative data.
AIAN did not have lower cardiac procedure rates for cardiac catheterization and percutaneous cardiac intervention compared to non-Hispanic whites (unadjusted OR 1.00, 95% CI 0.87-1.16 and OR 1.04, 95% CI 0.90-1.20, respectively). Adjustment for age, sex, comorbidities, and payer source did not alter the results (adjusted OR 0.95, 95% CI 0.82-1.10 and OR 0.98, 95% CI 0.85-1.14, respectively). We found higher odds (unadjusted OR 1.36, 95% CI 1.09-1.70) for receipt of coronary artery bypass graft surgery among AIAN hospitalized for ischemic heart disease compared to non-Hispanic whites which after adjustment attenuated some and was no longer statistically significant (adjusted OR 1.26, 95% CI 1.00-1.58).
AIAN were not less likely to receive cardiac procedures as non-Hispanic whites during hospitalizations for ischemic heart disease. Additional research is needed to determine whether differences in specialty referral patterns, patients' treatment preferences, or outpatient management may explain some of the health disparities due to cardiovascular disease that is found among AIAN.
Cites: J Am Coll Cardiol. 2000 Mar 15;35(4):907-1410732887
Cites: N Engl J Med. 2007 Jun 7;356(23):2388-9817554120
Cites: Ann Intern Med. 2001 Sep 4;135(5):328-3711529696
Cites: Med Care. 2003 May;41(5):626-3612719687
Cites: Am J Public Health. 2003 Oct;93(10):1689-9314534223
Cites: Am J Public Health. 2003 Oct;93(10):1734-914534230
Cites: Med Care. 2003 Nov;41(11):1240-5514583687
Cites: J Am Coll Cardiol. 2004 Aug 4;44(3):503-815358011
Cites: Circulation. 1990 Nov;82(5):1629-462225367
Cites: JAMA. 1993 May 26;269(20):2642-68487447
Cites: Am J Public Health. 1995 Mar;85(3):352-67892918
Cites: Am J Cardiol. 1996 Nov 1;78(9):996-10018916477
Cites: N Engl J Med. 1997 Feb 13;336(7):480-69017942
Cites: Am J Public Health. 1997 Feb;87(2):263-79103107
Cites: Circulation. 1997 Oct 7;96(7):2162-709337185
Cites: Med Care. 1998 Jan;36(1):8-279431328
Cites: Am J Cardiol. 1998 Nov 1;82(9):1013-89817473
Cites: Ann Intern Med. 1999 Feb 2;130(3):183-9210049196
Cites: Circulation. 1999 May 11;99(18):2389-9510318659
Cites: Circulation. 2005 Mar 15;111(10):1250-615769765
Cites: Am Heart J. 2006 Apr;151(4):909-1416569561
Cites: MMWR Morb Mortal Wkly Rep. 2007 Feb 16;56(6):113-817301730
Cites: N Engl J Med. 2007 Apr 12;356(15):1503-1617387127
Cites: Am J Public Health. 2000 Jul;90(7):1128-3410897193
To conduct estimation of actual food among in digenous and arrived population of Yakutia of elderly and senile ages.
In the work results of epidemiological research with analysis of actual food of the population of Yakutia at the age of 60 years and over are presented. On the basis of a list of candidates with use of random selection a representative sample of men and women of Yakutsk at the age of 60 years and more has been generated. In total 775 foreheads were surveyed, the middle age has made 75.7 Â± 9.4 years. For the analysis of actual food 575 people (244 men and 331 women) have been included. Among the surveyed there were 244 respondents of the in digenous population (the Yakuts) and 331 arrived respondents (the Russians, the Ukrainians, the Byelorussians, the Poles, the Germans, the Jews). The estimation of actual food is conducted by means of a frequency questionnaire.
High content of general fat, sated fat acids, polyunsaturated fat acids and refined sugar due to low consumption of general carbohydrates is revealed. At the analysis of food package of the indigenous population in comparison with the newly arrived some distinctions in consumption of following products are revealed: fresh, tinned and frozen vegetables, potatoes, eggs, horsemeat, venison, koumiss, fresh fruit and berries, oil and fats, bean, juice and drinks, sugar, chocolate and confectionery products.
daily food intake of the indigenous population of elderly and senile ages is notable for lower daily caloric content, greater general fat, SFA, less consumption of refined sugar on the background of significantly lower content of general carbohydrates, starch and food proteins. In diets at theYakuts there is considerably lower consumption of fresh and tinned vegetables, potatoes, eggs, fresh fruit and berries, bean, nuts, sugar, chocolate and confectionery products and higher consumption of meat products (horsemeat, venison), oil and fats.
Hemorrhagic stroke (HS) has higher incidence in Asian population compared to Caucasian. The reason for this phenomenon is not clearly understood.
To investigate the contribution of cerebral vascular anomalies in hemorrhagic stroke structurein different racial groups of Yakutia.
The study group included 1078 consecutively hospitalized patients with acute HS. A comparative analysis of demographic data and frequency of CVA, which were identified as a cause of HS, was carried out between the group of indigenous patients of Asian race and the group of Caucasian patients.
The proportion of hemorrhage due to rupture of cerebralarterial aneurysms (CAA) in the hospital HS structure was higher in Asians, compared to Caucasians (p = 0.001; OR = 1.7; 95% CL: 1.2-2.4). No difference in the arteriovenous malformations' (AVM) frequency was found between groups (p = 0.345), as well as in age and gender distribution (p = 0.052 and p = 0.759, respectively). The CAA frequency was higher among female patients compared to male in both racial groups (p
To determine the risk factors for pulmonary colonization by non-tuberculous mycobacteria (NTM).
Retrospective study of subjects colonized by NTM from 1990 to 2006. Subjects without mycobacterial disease and with at least three negative cultures served as controls.
Mycobacterium avium complex (MAC) species were the most common NTM. Risk factors of colonization included age > or = 60 years (aOR 2.3), female sex (aOR 1.2), residency in Canada for at least 10 years (aOR 3.8), Canadian-born aboriginal (aOR 1.8), and Canadian-born non-aboriginal (aOR 1.4). Predictors of MAC colonization included White race (aOR 1.6) and residency in Canada for at least 10 years, which was the strongest predictor (aOR 6.7). Aboriginal origin was associated with non-MAC colonization (aOR 1.8), and Canadian-born people from the East/South-East Asian ethnic groups were protected from MAC colonization (aOR 0.2), all aOR P
INTRODUCTIOD: Over the past 15 years, the relative frequency of detection of erosive form of GERD has increased from 3,1 to 16%. Manifestations of GERD in different ethnic populations of Yakutia are not well understood.
Studying kliniko-endoscopic and the morfofunktsionalnykh of features of GERD in various ethnic groups living in conditions of Yakutia.
The study included 168 patients with GERD of different ethnic origins. Yakuts, Evens and Evenks, were considered as indigenous people and newcomers were all persons of other nationalities, who arrived at different times from other regions of Russia. The average age was 41.75 ± 24.73 years.
Clinical manifestations of GERD in different ethnic groups living in Yakutia. Leukoplakia of the esophagus was detected in the indigenous population are four times more likely than newcomers. With GERD associated with thyroid disorders prevalent low level of contamination of Helicobacter pylori. Helicobacter pylori infection in patients with GERD in Yakutia was higher among immigrants than among the indigenous, with a high degree of contamination of Helicobacter pylori was detected more frequently in immigrants than among the indigenous. Pathological gastroesophageal reflux during the daily pH-metry of the esophagus was detected more frequently in patients visiting than among the indigenous.
The found features of a current of GERD can be further the basis for the individualized and differentiated approaches to treatment of this disease.