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Zakhari A, Nguyen DB, Papillon Smith J, Mansour FW, Krishnamurthy S. Hysteroscopy needs of indigenous communities in Northern Quebec: a retrospective cohort study. Int J Circumpolar Health 2024; 83:2359162. [PMID: 38801151 DOI: 10.1080/22423982.2024.2359162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
We aimed to determine the surgical output for patients from Nunavik undergoing transfer to an urban centre for hysteroscopy, and associated costs. We performed a retrospective chart review of all patients from the 14 villages of Nunavik transferred for hysteroscopic surgery from 2016 to 2021. Diagnoses, surgical intervention, and nature of the procedure were all extracted from the patient charts, and costs/length of stay obtained from logisticians and administrators servicing the Nunavik region. Over a 5-year period, 22 patients were transferred from Nunavik for hysteroscopy, of which all were elective save one. The most common diagnosis was endometrial or cervical polyp and the most common procedure was diagnostic hysteroscopy. The average cost for patient transfer and lodging to undergo hysteroscopy in Montreal ranged from $6,000 to $15,000 CDN. On average, 4-5 patient transfers occur annually for hysteroscopy, most commonly for management of endometrial polyps, at a cost of $6,000 to $15,000 CDN, suggesting the need to investigate local capacity building in Nunavik and assess cost-effectiveness.
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Affiliation(s)
- Andrew Zakhari
- Department of Obstetrics and Gynecology, Royal Victoria Hospital - Glen Site, McGill University Health Center (MUHC), Montreal Canada
| | - Dong Bach Nguyen
- Department of Obstetrics and Gynecology, Royal Victoria Hospital - Glen Site, McGill University Health Center (MUHC), Montreal Canada
| | - Jessica Papillon Smith
- Department of Obstetrics and Gynecology, Royal Victoria Hospital - Glen Site, McGill University Health Center (MUHC), Montreal Canada
| | - Fady W Mansour
- Department of Obstetrics and Gynecology, Royal Victoria Hospital - Glen Site, McGill University Health Center (MUHC), Montreal Canada
| | - Srinivasan Krishnamurthy
- Department of Obstetrics and Gynecology, Royal Victoria Hospital - Glen Site, McGill University Health Center (MUHC), Montreal Canada
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Fitzpatrick KM, Ody M, Goveas D, Montesanti S, Campbell P, MacDonald K, Crowshoe L, Campbell S, Roach P. Understanding virtual primary healthcare with Indigenous populations: a rapid evidence review. BMC Health Serv Res 2023; 23:303. [PMID: 36991410 PMCID: PMC10054202 DOI: 10.1186/s12913-023-09299-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Virtual care has become an increasingly useful tool for the virtual delivery of care across the globe. With the unexpected emergence of COVID-19 and ongoing public health restrictions, it has become evident that the delivery of high-quality telemedicine is critical to ensuring the health and wellbeing of Indigenous peoples, especially those living in rural and remote communities. METHODS We conducted a rapid evidence review from August to December 2021 to understand how high quality Indigenous primary healthcare is defined in virtual modalities. After completing data extraction and quality appraisal, a total of 20 articles were selected for inclusion. The following question was used to guide the rapid review: How is high quality Indigenous primary healthcare defined in virtual modalities? RESULTS We discuss key limitations to the delivery of virtual care, including the increasing cost of technology, lack of accessibility, challenges with digital literacy, and language barriers. This review further yielded four main themes that highlight Indigenous virtual primary healthcare quality: (1) limitations and barriers of virtual primary healthcare, (2) Indigenous-centred virtual primary healthcare, (3) virtual Indigenous relationality, (4) collaborative approaches to ensuring holistic virtual care. DISCUSSION For virtual care to be Indigenous-centred, Indigenous leadership and users need to be partners in the development, implementation and evaluation of the intervention, service or program. In terms of virtual models of care, time must be allocated to educate Indigenous partners on digital literacy, virtual care infrastructure, benefits and limitations. Relationality and culture must be prioritized as well as digital health equity. CONCLUSION These findings highlight important considerations for strengthening virtual primary healthcare approaches to meet the needs of Indigenous peoples worldwide.
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Affiliation(s)
| | - Meagan Ody
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Danika Goveas
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | | | - Paige Campbell
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Kathryn MacDonald
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Lynden Crowshoe
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Pamela Roach
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada.
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Nadeau L, Gaulin D, Johnson-Lafleur J, Levesque C, Fraser S. The challenges of decolonising participatory research in indigenous contexts: the Atautsikut community of practice experience in Nunavik. Int J Circumpolar Health 2022; 81:2087846. [PMID: 35979584 PMCID: PMC9397418 DOI: 10.1080/22423982.2022.2087846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Historically, research involving Indigenous peoples has been the scene of power imbalances between Indigenous communities and researchers. Indigenous peoples have often been put in the position of passive subjects of research rather than participants or collaborators with agency, a situation that the current movement of decolonisation of research and practices in the field of Indigenous health aims to counteract. Participatory research seeks a better balance of input, decision-making and power between research participants and research teams and values participants’ knowledges. As such, it is a particularly relevant approach for researchers to involve community members and support self-determination of Indigenous people. Yet, if its explicit intentions are aiming at a decolonising approach, the socio-structural context of participatory research initiatives in Indigenous communities brings obstacles to the approach’s success. The development and implementation of the participatory project Atautsikut: A Community of Practice in Youth Mental Health and Wellness in Nunavik, has been an occasion to document certain barriers that take place in participatory research. This article describes Atautsikut as a starting point for a reflection on the challenges of decolonising participatory research. It discusses how, despite intentions, structural barriers, blind spots and unexpected contextual elements may challenge the journey towards decolonising research.
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Affiliation(s)
- Lucie Nadeau
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Dominique Gaulin
- École de travail social, Université de Montréal, Montreal, QC, Canada
| | | | | | - Sarah Fraser
- Department of Psychoeducation, Université de Montréal, Montreal, QC, Canada
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Collaboration in Mental Healthcare for Indigenous Children and Youth: Using Actor-Network Analyses to Better Understand Dynamics, Strengths, and Ongoing Challenges in Collaboration. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00942-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Belaid L, Budgell R, Sauvé C, Andersson N. Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2021-008311. [DOI: 10.1136/bmjgh-2021-008311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BackgroundThe National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods.MethodsThis scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis.Results356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods.ConclusionsThe last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.
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Lauzière J, Fletcher C, Gaboury I. Cultural Safety as an Outcome of a Dynamic Relational Process: The Experience of Inuit in a Mainstream Residential Addiction Rehabilitation Centre in Southern Canada. QUALITATIVE HEALTH RESEARCH 2022; 32:970-984. [PMID: 35350939 PMCID: PMC9189595 DOI: 10.1177/10497323221087540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Few addiction treatment options are available in Arctic Canada, leading many Inuit to seek treatment programs in southern cities. We conducted a case study to understand what contributes to a culturally safe experience for Inuit in a mainstream addiction rehabilitation centre in Southern Canada. We carried out more than 700 hours of participant observation, in addition to semi-structured interviews and member-checking activities with 20 Inuit residents, 18 staff and four managers. Data were analysed using an inductive interpretative process. Throughout their journey in the program, Inuit navigated through contrasting situations and feelings that we grouped under six broad themes: having Inuit peers, having limitations imposed on one's ways of being and doing, facing ignorance and misperceptions, having conversations and dialogue, facing language barriers and being in a supportive and caring environment. This study highlights how cultural safety varies according to people, context and time, and relates to developing trustful relationships.
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Affiliation(s)
- Julie Lauzière
- Département de médecine de famille et de médecine d’urgence, Université de Sherbrooke, Longueuil, QC, Canada
| | - Christopher Fletcher
- Département de médecine sociale et préventive, Université Laval, Quebec, QC, Canada
| | - Isabelle Gaboury
- Département de médecine de famille et de médecine d’urgence, Université de Sherbrooke, Longueuil, QC, Canada
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Ouellet L, Grandisson M, Fletcher C. Development of rehabilitation services in an Inuit sociocultural context: challenges, strategies and considerations for the future. Int J Circumpolar Health 2022; 81:2058694. [PMID: 35354359 PMCID: PMC8973344 DOI: 10.1080/22423982.2022.2058694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
In recent years, a new rehabilitation programme has been developed on the Hudson Bay coast of Nunavik. The purpose of this article is to reflect on the experience of an occupational and physical therapy programme development in an Inuit sociocultural context. To do so, the challenges encountered during the first years following the implementation of rehabilitation services and the strategies implemented by the professionals to overcome them were identified, examined in the light of the literature, and discussed with members of the rehabilitation team. The challenges encountered and strategies implemented were divided into 10 major themes: (1) diverse clinical needs; (2) communication issues; (3) acquisition of cross-cultural interaction and population-specific knowledge; (4) adaptation of clinical practice to Nunavimmiut; (5) client engagement in rehabilitation; (6) professional isolation; (7) lack of awareness around the objectives and scope of rehabilitation practice; (8) use of culturally safe assessment tools; (9) staff turnover; (10) large geographic area to be served. This exercise highlighted the need to adapt clinical rehabilitation practices to Nunavimmiut’s worldviews and culture, as well as to adopt a reflective practice in order to improve the quality, relevance and effectiveness of rehabilitation services.
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Affiliation(s)
- Lauriane Ouellet
- Département de réadaptation, Centre de santé Inuulitsivik, Nunavik, QC, Canada.,Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada.,Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, QC, Canada.,Axe santé des populations et pratiques optimales en santé, Centre de recherche du Centre hospitalier universitaire de Québec, Université Laval, Québec, QC, Canada
| | - Marie Grandisson
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, QC, Canada.,Département de réadaptation, Université Laval, Québec, QC, Canada
| | - Christopher Fletcher
- Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada.,Axe santé des populations et pratiques optimales en santé, Centre de recherche du Centre hospitalier universitaire de Québec, Université Laval, Québec, QC, Canada
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8
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Lévesque M. Une histoire des services de santé, des services sociaux et des services de protection de la jeunesse au Nunavik : portrait de la littérature (Note de recherche). ÉTUDES/INUIT/STUDIES 2022. [DOI: 10.7202/1096505ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Fraser SL, Parent V, Weetaltuk C, Hunter J. Families navigating community resources: understanding and supporting Nunavimmiut families. Int J Circumpolar Health 2021; 80:1935594. [PMID: 34596482 PMCID: PMC8491701 DOI: 10.1080/22423982.2021.1935594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 05/24/2021] [Accepted: 05/24/2021] [Indexed: 11/14/2022] Open
Abstract
In a project aiming to develop community-led resources for families in northern Quebec, Canada, members (Inuit and non-Inuit) of the project decided to meet with Inuit parents to hear their experiences and needs, and to better understand how family dynamics might be related to ways of using resources within communities. In this article, we present secondary analyses of interviews conducted in 2015 with 14 parents living in a community of Nunavik, northern Quebec, accompanied by participatory analysis sessions. A dual data analysis strategy was adopted. Non-Inuit researchers and research assistants with significant lived experience in Nunavik explored what they learned from the stories that Inuit parents shared with them through the interviews and through informal exchanges. Inuit partners then discussed the large themes identified by the research team to guide non-Inuit researchers in their analysis. The aim was to better inform non-Inuit service providers and people whose mandate it is to support community mobilisation in relation to the heterogeneous realities of Inuit families, and the ways in which they can be of support to families based on their specific realities and needs.
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Affiliation(s)
- Sarah L. Fraser
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, Canada
| | - Valérie Parent
- Communication, École de Communication, Université de Montréal, Montreal, Canada
| | | | - Jennifer Hunter
- Nunavik Regional Board of Health and Social Services, Québec, Canada
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10
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Fraser SL, Gaulin D, Fraser WD. Dissecting systemic racism: policies, practices and epistemologies creating racialized systems of care for Indigenous peoples. Int J Equity Health 2021; 20:164. [PMID: 34261500 PMCID: PMC8278742 DOI: 10.1186/s12939-021-01500-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/17/2021] [Indexed: 11/03/2022] Open
Abstract
In this paper we explore some of the ways systemic racism operates and is maintained within our health and social services. We look at a very specific context, that of Nunavik Quebec, land and home to 13,000 Nunavimmiut, citizens of Quebec and Canada, signatories of the James Bay and Northern Quebec Agreement. We operationalize some of the ways in which policies and practices create and support social hierarchies of knowledges, also called epistemic racism, and how it impacts our ability to offer quality care that Indigenous peoples can trust and use.
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Affiliation(s)
- Sarah Louise Fraser
- School of Psychoeducation, University of Montreal, Pavillon Marie-Victorin, C. P. 6128, succursale Centre-ville, Montréal, QC, H3C 3J7, Canada.
- Centre de Recherche en Sante Publique (CReSP), University of Montreal and CIUSSS du Centre Sud-de-L'Île de Montreal, Montreal, Canada.
| | | | - William Daibhid Fraser
- Centre de Recherche en Sante Publique (CReSP), University of Montreal and CIUSSS du Centre Sud-de-L'Île de Montreal, Montreal, Canada
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11
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Galloway T, Horlick S, Cherba M, Cole M, Woodgate RL, Healey Akearok G. Perspectives of Nunavut patients and families on their cancer and end of life care experiences. Int J Circumpolar Health 2021; 79:1766319. [PMID: 32449489 PMCID: PMC7448904 DOI: 10.1080/22423982.2020.1766319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The present study arose from a recognition among service providers that Nunavut patients and families could be better supported during their care journeys by improved understanding of people's experiences of the health-care system. Using a summative approach to content analysis informed by the Piliriqatigiinniq Model for Community Health Research, we conducted in-depth interviews with 10 patients and family members living in Nunavut communities who experienced cancer or end of life care. Results included the following themes: difficulties associated with extensive medical travel; preference for care within the community and for family involvement in care; challenges with communication; challenges with culturally appropriate care; and the value of service providers with strong ties to the community. These themes emphasise the importance of health service capacity building in Nunavut with emphasis on Inuit language and cultural knowledge. They also underscore efforts to improve the quality and consistency of communication among health service providers working in both community and southern referral settings and between service providers and the patients and families they serve.
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Affiliation(s)
- Tracey Galloway
- Department of Anthropology, University of Toronto Mississauga , Mississauga, Ontario, Canada
| | | | - Maria Cherba
- Qaujigiartiit Health Research Centre , Iqaluit, Canada
| | | | - Roberta L Woodgate
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba , Winnipeg, Canada
| | - Gwen Healey Akearok
- Qaujigiartiit Health Research Centre , Iqaluit, Canada.,Northern Ontario School of Medicine, Laurentian University , Sudbury, Canada
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12
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Fraser SL, Moulin L, Gaulin D, Thompson J. On the move: exploring Inuit and non-Inuit health service providers' perspectives about youth, family and community participation in care in Nunavik. BMC Health Serv Res 2021; 21:94. [PMID: 33509188 PMCID: PMC7842054 DOI: 10.1186/s12913-021-06058-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/02/2021] [Indexed: 11/27/2022] Open
Abstract
Background Literature about participation in health and social services suggests that youth, and more specifically Indigenous youth, are difficult to engage within health and social services. Youth are less likely to access services or to actively participate in decision-making regarding their personal care. Service providers play a crucial role in engaging youth based on the ways in which they seek, establish, and maintain relationships with youth and their families. The way in which providers engage with youth will depend on various factors including their own perceptions of the roles and relationships of the various people involved in youth’s lives. In this article, we analyze health and social service providers’ perspectives, experiences and expectations regarding the roles of Indigenous youth, families and community in care settings in Nunavik, Quebec. Methods Using a snowball sampling approach, we recruited 58 interview participants (39 non-Inuit and 19 Inuit), including psychiatrists, general practitioners, nurses, social workers, school principals, teachers, student counsellors, representatives of local committees, and police officers. The interviews focused on three broad areas: 1) participants’ current and past positions and roles; 2) participants’ perceptions of the clientele they work with (youth and their families); and 3) participants’ understandings of how collaboration takes place within and between services and the community. We conducted inductive applied thematic analyses and then analyzed the interview transcripts of Inuit and non-Inuit participants separately to explore the similarities and differences in perceptions based on positionality. Results We organized the findings around three themes: I) the most commonly described interventions, II) different types of challenges to and within participation; and III) what successful participation can look like according to service providers. Participants identified the challenges that families face in moving towards services as well as the challenges that services providers face in moving towards youth and families, including personal, organizational and historical factors. Conclusion We adopt a critical lens to reflect on the key findings in order to tease out points of tension and paradoxes that might hinder the participation of youth and families, specifically in a social context of decolonization and self-governance of services.
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Affiliation(s)
- Sarah Louise Fraser
- School of Psychoeducation, University of Montreal, Pavillon Marie-Victorin, C. P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada. .,Centre de Recherche en Santé Publique (CReSP), University of Montreal and CIUSSS du centre Sud-de-l'Île de Montreal, Montreal, Canada.
| | - Louise Moulin
- School of Psychoeducation, University of Montreal, Pavillon Marie-Victorin, C. P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada
| | | | - Jennifer Thompson
- Centre de Recherche en Santé Publique (CReSP), University of Montreal and CIUSSS du centre Sud-de-l'Île de Montreal, Montreal, Canada
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Ingemann C, Hansen NF, Hansen NL, Jensen K, Larsen CVL, Chatwood S. Patient experience studies in the circumpolar region: a scoping review. BMJ Open 2020; 10:e042973. [PMID: 33020108 PMCID: PMC7537463 DOI: 10.1136/bmjopen-2020-042973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Patient experiences with health systems constitute a crucial pillar of quality care. Across the Arctic, patients' interactions with the healthcare system are influenced by challenges of access, historical inequities and social determinants. This scoping review sought to describe the range and nature of peer-reviewed literature on patient experience studies conducted within the circumpolar region. DESIGN In a partnership between Danish/Greenlandic, Canadian and American research teams, a scoping review of published research exploring patient experiences in circumpolar regions was undertaken. DATA SOURCES Seven electronic databases were queried: MEDLINE, Embase, Scopus, 'Global Health 1910 to 2019 Week 11', CINAHL, PsycINFO and SveMed+. ELIGIBILITY CRITERIA Articles were eligible for inclusion if they (a) took place in the circumpolar region, (b) reported patients' perspective and (c) were focussed primarily on patient experiences with care, rather than satisfaction with treatment outcome. DATA EXTRACTION AND SYNTHESIS Title and abstract screening, full-text review and data extraction was conducted by four researchers. Bibliometric information such as publication date and country of origin was extracted, as was information regarding study design and whether or not the article contained results relevant to the themes of Indigenous values, rural and remote context, telehealth and climate change. Two researchers then synthesised and characterised results relevant to these themes. RESULTS Of the 2824 articles initially found through systematic searches in seven databases, 96 articles were included for data extraction. Findings from the review included unique features related to Indigenous values, rural and remote health, telehealth and climate change. CONCLUSIONS The review findings provide an overview of patient experiences measures used in circumpolar nations. These findings can be used to inform health system improvement based on patient needs in the circumpolar context, as well as in other regions that share common features. This work can be further contextualized through Indigenous methodologies such as sharing circles and community based participatory methods.
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Affiliation(s)
- Christine Ingemann
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
- Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | | | - Nanna Lund Hansen
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
| | - Kennedy Jensen
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark Faculty of Health Sciences, Copenhagen, Denmark
- Institute of Nursing and Health Sciences, University of Greenland, Nuuk, Greenland
| | - Susan Chatwood
- University of Alberta School of Public Health, Edmonton, Alberta, Canada
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Paquin V, Sandy G, Perrault-Sullivan G, Fortin G, Cauchon M, Fletcher C, Ouellet J, Lemire M. Twenty "must-read" research articles for primary care providers in Nunavik: scoping study and development of an information tool. Int J Circumpolar Health 2020; 78:1578638. [PMID: 30831057 PMCID: PMC6407590 DOI: 10.1080/22423982.2019.1578638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
While health needs in Nunavik are distinct, there is a scarcity of knowledge transfer intended for local primary care providers. We aimed to build an information tool in the form of a newsletter and a website to share with them a selection of relevant research articles. To identify such articles, a scoping study of Inuit health research published between 2012 and 2017 was conducted. Selection criteria were adapted from the framework of information mastery. After a database search yielding 2896 results, publications were screened for eligibility. Next, the 226 eligible articles were evaluated and scored for their relevance, their methods (including community participation), their local applicability and their clinical utility. The 20 highest-scored articles were selected for dissemination in a newsletter. They were summarised and presented in 6 thematic emails: Child Development, Infectious Diseases, Traditional and Modern Medicine, Metabolism, Nutrition and Contaminants, and Inuit Perspectives. The newsletter was sent to over 190 health workers and regional stakeholders in Nunavik and was also published online. We hope that this project will foster knowledge sharing and inter-sectorial collaboration between research, public health and clinical care. Trends in Inuit health research are discussed.
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Affiliation(s)
- Vincent Paquin
- a Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec , Université Laval , Québec , QC , Canada
| | - Glenda Sandy
- a Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec , Université Laval , Québec , QC , Canada
| | - Gentiane Perrault-Sullivan
- a Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec , Université Laval , Québec , QC , Canada
| | - Gabriel Fortin
- b Medical Department , Inuulitsivik Health Center , Inukjuak , QC , Canada
| | - Michel Cauchon
- c Département de médecine familiale et de médecine d'urgence , Université Laval , Québec , QC , Canada
| | - Christopher Fletcher
- a Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec , Université Laval , Québec , QC , Canada.,d Département de médecine sociale et préventive , Université Laval , Québec , QC , Canada
| | - Jean Ouellet
- c Département de médecine familiale et de médecine d'urgence , Université Laval , Québec , QC , Canada
| | - Mélanie Lemire
- a Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec , Université Laval , Québec , QC , Canada.,d Département de médecine sociale et préventive , Université Laval , Québec , QC , Canada
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Squarzoni P, Duran FLS, Busatto GF, Alves TCTDF. Reduced Gray Matter Volume of the Thalamus and Hippocampal Region in Elderly Healthy Adults with no Impact of APOE ɛ4: A Longitudinal Voxel-Based Morphometry Study. J Alzheimers Dis 2019; 62:757-771. [PMID: 29480170 DOI: 10.3233/jad-161036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Many cross-sectional voxel-based morphometry (VBM) investigations have shown significant inverse correlations between chronological age and gray matter (GM) volume in several brain regions in healthy humans. However, few VBM studies have documented GM decrements in the healthy elderly with repeated MRI measurements obtained in the same subjects. Also, the extent to which the APOE ɛ4 allele influences longitudinal findings of GM reduction in the healthy elderly is unclear. OBJECTIVE Verify whether regional GM changes are associated with significant decrements in cognitive performance taking in account the presence of the APOE ɛ4 allele. METHODS Using structural MRI datasets acquired in 55 cognitively intact elderly subjects at two time-points separated by approximately three years, we searched for voxels showing significant GM reductions taking into account differences in APOE genotype. RESULTS We found global GM reductions as well as regional GM decrements in the right thalamus and left parahippocampal gyrus (p < 0.05, family-wise error corrected for multiple comparisons over the whole brain). These findings were not affected by APOE ɛ4. CONCLUSIONS Irrespective of APOE ɛ4, longitudinal VBM analyses show that the hippocampal region and thalamus are critical sites where GM shrinkage is greater than the degree of global volume reduction in healthy elderly subjects.
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Affiliation(s)
- Paula Squarzoni
- Department of Psychiatry, Laboratory of Psychiatric Neuroimaging (LIM 21), Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
| | - Fabio Luis Souza Duran
- Department of Psychiatry, Laboratory of Psychiatric Neuroimaging (LIM 21), Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
| | - Geraldo F Busatto
- Department of Psychiatry, Laboratory of Psychiatric Neuroimaging (LIM 21), Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
| | - Tania Correa Toledo de Ferraz Alves
- Department of Psychiatry, Laboratory of Psychiatric Neuroimaging (LIM 21), Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
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