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At least 775 records · Page 43Linked to original sources
PubMed2000

Thrombolysis in the air. Air-ambulance paramedics flying to remote communities treat patients before hospitalization.

PROBLEM ADDRESSED: First Nations* communities in the North have a high prevalence of coronary artery disease and type 2 diabetes and face an increasing incidence of myocardial infarction (MI). Many conditions delay timely administration of thrombolysis, including long times between when patients first experience symptoms and when they present to community nursing stations, delays in air transfers to treating hospitals, uncertainty about when planes are available, and poor flying conditions. OBJECTIVE OF PROGRAM: To develop a program for administration of thrombolysis on the way to hospital by air ambulance paramedics flying to remote communities to provide more rapid thrombolytic therapy to northern patients experiencing acute MIs. COMPONENTS OF PROGRAM: Critical care flight paramedics fly to northern communities from Sioux Lookout, Ont; assess patients; communicate with base hospital physicians; review an exclusion criteria checklist; and administer thrombolytics according to the Sioux Lookout District Health Centre/Base Hospital Policy and Procedure Manual. Patients are then flown to hospitals in Sioux Lookout; Winnipeg, Man; or Thunder Bay, Ont. CONCLUSION: This thrombolysis program is being pilot tested, and further evaluation and development is anticipated.

Adult↗
PubMed2000

Type 2 diabetes mellitus in Canada's first nations: status of an epidemic in progress.

This review provides a status report on the epidemic of type 2 diabetes mellitus that is affecting many of Canada's First Nations. We focus on the published literature, especially reports published in the past 2 decades, and incorporate data from the Aboriginal Peoples Survey and the First Nations and Inuit Regional Health Survey. We look at the extent and magnitude of the problem, the causes and risk factors, primary prevention and screening, clinical care and education, and cultural concepts and traditional knowledge. The epidemic of type 2 diabetes is still on the upswing, with a trend toward earlier age at onset. Genetic-environmental interactions are the likely cause. Scattered intervention projects have been implemented and evaluated, and some show promise. The current health and social repercussions of the disease are considerable, and the long-term outlook remains guarded. A national Aboriginal diabetes strategy is urgently needed.

American Indian or Alaska Native↗
PubMed2000

Child hunger in Canada: results of the 1994 National Longitudinal Survey of Children and Youth.

BACKGROUND: In Canada, hunger is believed to be rare. This study examined the prevalence of hunger among Canadian children and the characteristics of, and coping strategies used by, families with children experiencing hunger. METHODS: The data originated from the first wave of data collection for the National Longitudinal Survey of Children and Youth, conducted in 1994, which included 13,439 randomly selected Canadian families with children aged 11 years or less. The respondents were asked about the child's experience of hunger and consequent use of coping strategies. Sociodemographic and other risk factors for families experiencing hunger, use of food assistance programs and other coping strategies were analyzed by means of multiple logistic regression analysis. RESULTS: Hunger was experienced by 1.2% (206) of the families in the survey, representing 57,000 Canadian families. Single-parent families, families relying on social assistance and off-reserve Aboriginal families were overrepresented among those experiencing hunger. Hunger coexisted with the mother's poor health and activity limitation and poor child health. Parents offset the needs of their children by depriving themselves of food. INTERPRETATION: Physicians may wish to use these demographic characteristics to identify and assist families with children potentially at risk for hunger.

Activities of Daily Living↗
PubMedDate not supplied

Cultural sensitivity for aboriginal hemodialysis patients.

As the numbers of Aboriginal hemodialysis patients in Manitoba are dramatically escalating, we must explore ways of providing more culturally effective care. Knowledge and understanding of cultural differences are essential in that the potential for conflicting medical paradigms or explanatory models of illness may create obstacles to achieve this goal. We need to pay heed to Aboriginal communities that have developed effective programs, recognizing that Aboriginal input is critical to the success of any plan for Aboriginal people. In keeping with these understandings, Winnipeg's Health Sciences Centre has undertaken an initiative to improve the cultural sensitivity within the hemodialysis unit. The project is currently in the assessment phase and has undertaken a series of sharing circles or focus groups to solicit patient input. The following article will describe this cultural sensitivity initiative. It is hoped that this initiative will enhance a respectful and trusting relationship, allowing our Aboriginal patients to become partners in their care.

American Indian or Alaska Native↗
PubMed2001

Exploring racial variations in the spousal sex ratio of killing.

The following article examines differences in the social situation of intimate partners as an explanation of racial differences in the female to male ratio of spousal homicides in Canada. An analysis of homicide data from 1961 to 1983 generated by the Canadian Centre for Justice Statistics reveals that the ratio of women killing their husbands to men killing their wives is highest for Aboriginals and lowest for Blacks, with the ratio for Whites falling in between. The possible sources of racial differences in this ratio include the proportion of couples (a) in common-law relationships, (b) who are co-residing as opposed to being separated, and (c) for whom there is a substantial age disparity between the partners. These factors are related to the spousal sex ratio of killing more generally. An exploration of interracial homicide patterns and racial variation in jealousy-motivated homicides was also undertaken. The findings reveal that controlling for the above factors substantially reduces the importance of race in predicting the gender of the homicide victim.

Black or African American↗
PubMed2002

Breast cancer screening. First Nations communities in New Brunswick.

OBJECTIVE: To determine use of breast cancer screening and barriers to screening among women in First Nations communities (FNCs). DESIGN: Structured, administered survey. SETTING: Five FNCs in New Brunswick. PARTICIPANTS: One hundred thirty-three (96%) of 138 eligible women between the ages of 50 and 69 years. INTERVENTIONS: After project objectives, methods, and expected outcomes were discussed with community health representatives, we administered a 32-item questionnaire on many aspects of breast cancer screening. MAIN OUTCOME MEASURES: Rate of use of mammography and other breast cancer screening methods, and barriers to screening. RESULTS: Some 65% of participants had had mammography screening within the previous 2 years. Having mammography at recommended intervals and clinical breast examinations (CBEs) yearly were significantly associated with having had a physician recommend the procedures (P < .001). A family history of breast cancer increased the odds of having a mammogram 2.6-fold (P < .05, 95% confidence interval [CI] 1.03 to 6.54). Rates of screening differed sharply by whether a family physician was physically practising in the community or not (P < .05, odds ratio 2.68, 95% CI 1.14 to 6.29). CONCLUSION: Women in FNCs in one health region in New Brunswick have mammography with the same frequency as off-reserve women. A family physician practising part time in the FNCs was instrumental in encouraging women to participate in breast cancer screening.

Aged↗
PubMed2003

The molecular epidemiology of tuberculosis in western Canada.

OBJECTIVE: To define the molecular epidemiology of TB in western Canada, and in particular the risk factors for clustering. MEASUREMENTS: We prospectively identified all positive cultures from newly diagnosed cases of TB diagnosed between February 1995 and January 1997 and carried out restriction fragment length polymorphism (RFLP) testing on all isolates. RESULTS: Of 956 cases identified, 944 fulfilled the entry criteria. The mean age was 49.65 years (+/- 22.33), and 508 (53.6%) were males. Three hundred and three (32.1%) subjects were clustered; this varied from 20.2% of the foreign born, 48.4% of Canadian non-Aboriginal and 61.1% of all Aboriginal persons. Younger persons (P = 0.0001), males (P = 0.015), those with pulmonary disease (P < 0.001), living in a shelter in the past year (P < 0.001), drug-susceptible disease (P < 0.036), predisposing factors (P < 0.001), prior contact (P < 0.001), and prior skin test (P < 0.002) were more likely to cluster. Among specific risk factors, HIV infection, injection drug use, alcohol excess, and weight loss were all significant. CONCLUSIONS: In this description of the molecular epidemiology of TB in Western Canada, previous results have been confirmed and extended. These results highlight the importance of identifying specific high risk groups, especially in the context of renewed efforts to target persons for treatment of latent TB infection.

Adult↗
PubMed2003

Integrated environmental impact assessment: a Canadian example.

The Canadian federal process for environmental impact assessment (EIA) integrates health, social, and environmental aspects into either a screening, comprehensive study, or a review by a public panel, depending on the expected severity of potential adverse environmental effects. In this example, a Public Review Panel considered a proposed diamond mining project in Canada's northern territories, where 50% of the population are Aboriginals. The Panel specifically instructed the project proposer to determine how to incorporate traditional knowledge into the gathering of baseline information, preparing impact prediction, and planning mitigation and monitoring. Traditional knowledge is defined as the knowledge, innovations and practices of indigenous and/or local communities developed from experience gained over the centuries and adapted to local culture and environment. The mining company was asked to consider in its EIA: health, demographics, social and cultural patterns; services and infrastructure; local, regional and territorial economy; land and resource use; employment, education and training; government; and other matters. Cooperative efforts between government, industry and the community led to a project that coordinated the concerns of all interested stakeholders and the needs of present and future generations, thereby meeting the goals of sustainable development. The mitigation measures that were implemented take into account: income and social status, social support networks, education, employment and working conditions, physical environments, personal health practices and coping skills, and health services.

American Indian or Alaska Native↗