Abstract:
BACKGROUND:Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. OBJECTIVE:In order to target ways of improving the services provided in these contexts to individuals in Nunavik with depression or anxiety disorders, this research examines delays and disruptions in the continuum of care and clinical, individual and organizational characteristics possibly associated with their occurrences. DESIGN:A total of 155 episodes of care involving a common mental disorder (CMD), incident or recurring, were documented using the clinical records of 79 frontline health and social services (FHSSs) users, aged 14 years and older, living in a community in Nunavik. Each episode of care was divided into 7 stages: (a) detection; (b) assessment; (c) intervention; (d) planning the first follow-up visit; (e) implementation of the first follow-up visit; (f) planning a second follow-up visit; (g) implementation of the second follow-up visit. Sequential analysis of these stages established delays for each one and helped identify when breaks occurred in the continuum of care. Logistic and linear regression analysis determined whether clinical, individual or organizational characteristics influenced the breaks and delays. RESULTS:More than half (62%) the episodes of care were interrupted before the second follow-up. These breaks mostly occurred when planning and completing the first follow-up visit. Episodes of care were more likely to end early when they involved anxiety disorders or symptoms, limited FHSS teams and individuals over 21 years of age. The median delay for the first follow-up visit (30 days) exceeded guideline recommendations significantly (1-2 weeks). CONCLUSION:Clinical primary care approaches for CMDs in Nunavik are currently more reactive than preventive. This suggests that recovery services for those affected are suboptimal.
journal_name
Int J Circumpolar Healthjournal_title
International journal of circumpolar healthauthors
Lessard L,Fournier L,Gauthier J,Morin Ddoi
10.3402/ijch.v74.27186subject
Has Abstractpub_date
2015-05-14 00:00:00pages
27186eissn
1239-9736issn
2242-3982pii
27186journal_volume
74pub_type
杂志文章abstract:OBJECTIVES:To assess the distribution of blood lipids, lipoprotein and apoB/apoA-1 ratio in a multi-ethnic population of Sami, Kvens and Norwegians in Norway. Study design. A population-based cross-sectional study was carried out in 2003-2004 in an area with a mixed Sami, Kvens/Finns and Norwegian population, the SAMIN...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:2008-02-01 00:00:00
abstract::This paper describes the extent and variation in health disparities between Indigenous and non-Indigenous people within Alaska, Greenland and the northern regions of Canada, Russia and the Nordic countries. We accessed official health statistics and reviewed research studies. We selected a few indicators of health sta...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2020.1805254
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The prevalence of obesity and obesity-related conditions varies by population groups. Indigenous women of the circumpolar north are believed to be at high risk of obesity. OBJECTIVE:We studied, first the obesity prevalence in indigenous Arctic women, Nenets, compared to urban Russian women. Second, the asso...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v73.23859
更新日期:2014-07-24 00:00:00
abstract::Iceland is sparsely populated but social justice and equity has been emphasised within healthcare. The aim of the study is to examine healthcare services in Fjallabyggð, in rural northern Iceland, from users' perspective and evaluate social justice, access and quality of healthcare in an age of austerity. Mixed-method...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2017.1347476
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:The aim of the Tromstannen-Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v75.30169
更新日期:2016-02-19 00:00:00
abstract:BACKGROUND:Tobacco reduction is a major priority in Canadian Inuit communities. However, many Inuit frontline health workers lacked the knowledge, confidence and support to address the tobacco epidemic. Given vast distances, high costs of face-to-face training and previous successful pilots using distance education, th...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.21078
更新日期:2013-08-05 00:00:00
abstract:OBJECTIVES:To analyze the prevalence of poor oral health and selected determinants in First Nations (FN) and Caucasian samples in Manitoba, Canada. STUDY DESIGN:Cross-sectional survey, nested in a cohort study. METHODS:FN and Caucasian participants completed a questionnaire on socio-demographic variables, oral health...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v71i0.17394
更新日期:2012-03-19 00:00:00
abstract:OBJECTIVES:To evaluate NicAlert immunoassay test strips and liquid chromatography atmospheric-pressure ionization tandem mass spectrometry (LC/MS/MS) for the measurement of saliva cotinine levels in pregnant Alaska Native women. STUDY DESIGN:Cross-sectional study. METHODS:Pregnant women completed a questionnaire abou...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:The study aimed to estimate the prevalence of diabetes and impaired glucose intolerance (IGT) among Inuit migrants living in Denmark, and to compare with findings from Greenland. Further, we analyzed determinants for diabetes and impaired glucose metabolism. STUDY DESIGN:Cross-sectional, population-based ep...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v64i4.18013
更新日期:2005-09-01 00:00:00
abstract::A prevalence study methodology developed for use in rural and frontier settings is described. The general method was developed over a 15 year period and has been successfully adapted and used in studies of 14 different childhood onset developmental disorders. Subjects were the 168,000 school aged children from North D...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::The aim of this study was to reduce barriers that prevent implementation of evidence-based recommendations about single-fraction palliative radiotherapy (PRT) and to demonstrate that single-fraction PRT yields similar outcomes as long-course treatment (≥10 fractions) in patients with bone metastases from breast cancer...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2016.1270080
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To evaluate a community-based, not-for-profit medical group's effectiveness with diabetic management while using an electronic medical record and financial incentives. DESIGN:Descriptive retrospective study over 2 years with published reference standards. METHODS:There were 5,316 diabetic patients in the me...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v64i1.17951
更新日期:2005-02-01 00:00:00
abstract::The relationship between cell-mediated immunity and alcohol intake was studied in an Antarctic wintering group. Cell-mediated immune responses have previously been shown to be significantly lowered on the Antarctic Continent. The cause for this is yet to be elucidated. The cutaneous CMI Multitest was used to assess ce...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v61i3.17454
更新日期:2002-08-01 00:00:00
abstract::Ethical appraisal of medical protocols for research is now well accepted, and needed when research may carry side effects and risks that may be difficult to understand for the people invited to take part in research. We argue that time has come for Greenland to establish a formal medical research ethics committee with...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v63i0.17878
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Rickets was first described in the 17th century and vitamin D deficiency was recognized as the underlying cause in the early 1900s. Despite this long history, vitamin D deficiency remains a significant health concern. Currently, vitamin D supplementation is recommended in Canada for breast fed infants. There...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.20244
更新日期:2013-04-16 00:00:00
abstract:BACKGROUND:There is a dearth of literature to guide the development of community-based HIV and sexually transmitted infection (STI) prevention and sexual health promotion programs within Inuit communities. OBJECTIVE:The aim of this study was to create a dialogue with Inuit women to address the lack of information avai...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v75.32135
更新日期:2016-12-09 00:00:00
abstract::Data have been lacking on the prevalence of HIV and hepatitis B (HB) infections in the North American Indian population in Canada. In January 1992, surveillance was introduced into two residential First Nations alcohol and drug treatment centers in British Columbia as part of an AIDS/STD education program. Male and fe...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Subsistence norms are part of the "ecosophy" or ecological philosophy of Alaska Native Peoples in the sub-Arctic, such as the Inupiat of Seward Peninsula. This kind of animistic pragmatism is a special source of practical wisdom that spans over thousands of years and which has been instrumental in the Iñupia...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.21224
更新日期:2013-08-05 00:00:00
abstract::Under the auspices of Arctic Monitoring and Assessment Programme (AMAP), a Russian-Norwegian co-operation project was established to assess the exposure of delivering women to persistent organic pollutants (POPs) in Arctic areas of Russia. In the period 1993-95 blood and breast milk samples were collected from 94 deli...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the rate and causes of preterm (before 37 weeks gestation) and very preterm (before 32 weeks gestation) delivery among a population of Inuit living in Canada. STUDY DESIGN:Three-year retrospective cross-sectional review of charts for patients delivering in the Baffin Region of Canada. RESULTS:Th...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v63i0.17910
更新日期:2004-01-01 00:00:00
abstract::This study deals with the adaptation of the sympathoadrenal responses to an acute cold water immersion in ordinary winter swimmers. Hormonal responses were determined at the beginning of the winter swimming period in the autumn and after regular swimming for one and three months. Water temperature in the river was 10 ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Kivalina is a northwest Alaska barrier island village of 400 people vulnerable to storm surges exacerbated recently by delayed winter sea and shore ice formation. The village has no in-home piped water or sewage; the "washeteria" is the only structure providing public showers, laundry facilities and flush to...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.21233
更新日期:2013-08-05 00:00:00
abstract::Reliance on self-reported health status information as a measure of population health can be challenging due to errors associated with participant recall. We sought to determine agreement between self-reported and registry-recorded site-specific cancer diagnoses in a cohort of Alaska Native people. We linked cancer hi...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.1080/22423982.2019.1571383
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Tobacco use rates are exceptionally high among indigenous people in North America. Alaska Native, low socio-economic status (SES) and rural communities are high-priority populations for Alaska's Tobacco Control program. DESIGN:For the purpose of better informing tobacco control interventions, we conducted a...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.21582
更新日期:2013-08-05 00:00:00
abstract::Because Alaska does not have its own medical school, it has become part of WAMI (Washington, Alaska, Montana, Idaho), an educational agreement with the University of Washington School of Medicine (UWSM). Each year, 10 Alaskans are accepted into the entering class of UWSM and spend their first year at the University of...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Over the last decades, reindeer-herding management has experienced dramatic changes, e.g. increased motorization and socio-economic pressure. The aim of the present study was to investigate whether these changes have increased the risk of fatal, work-related accidents and suicide between 1961 and 2000. STUDY...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v63i0.17941
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:Experiences in one's family of origin, especially the relationship to one's parents, supposedly form the basis of relationships in adulthood. The connection between traumatic childhood events and later life has been studied intensively, whereas average childhood growth experiences have been given less attent...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v70i2.17805
更新日期:2011-04-01 00:00:00
abstract::The reasons for the rapidly increasing prevalence of diabetes (NIDDM) among Alaskan Eskimos are only partly understood. This study examines the association of fatty acid metabolism in 68 Alaskan Eskimos with NIDDM or impaired glucose tolerance (IGT) and 386 with normal glucose tolerance > 24 years old. The prevalence ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:To describe the background, approach and general results of the Center for Alaska Native Health Research (CANHR) study. STUDY DESIGN:This was a cross-sectional Community-Based Participatory Research (CBPR) study with one tribal group to assess risk and protection for obesity and the risk factors related to ...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v66i1.18219
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Cochlear implant (CI) treatment was introduced to the world in the 1980s and has become a routine treatment for congenital or acquired severe-to-profound hearing loss. CI treatment requires access to a highly skilled team of ear, nose and throat specialists, audiologists and speech-language pathologists for e...
journal_title:International journal of circumpolar health
pub_type: 杂志文章
doi:10.3402/ijch.v72i0.20974
更新日期:2013-08-05 00:00:00