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At least 19 recordsLinked to original sources
PubMed2004

A political economy of oral health services in Nunavut.

OBJECTIVES: We wanted to consider what factors influence oral health care services and carried out an Ethnographic Case Study in Nunavut. METHODS: Participant observation, document review, stakeholder interviews. RESULTS: This study argues that four general factors influence oral health care in Nunavut. CONCLUSION: These factors delimit oral health and care in Nunavut by influencing people's oral health, their experiences with health and disease, and ultimately the positions and practices of individuals within this system of care. Thus these factors contribute to (or take away from) the ability for positive change in the oral health of Nunavut residents. It is in settling debates within the latter two factors that an appreciable difference can be made in the oral health and care of Nunavut residents.

Dental Health Services↗
PubMed2005

Costs associated with infant bronchiolitis in the Baffin region of Nunavut.

UNLABELLED: OBJECTIVE. Although infants living in the north of Canada have been reported to have one of the highest rates of hospital admission for bronchiolitis in the world, the economic effects of this condition have not been reported. Passive immunization against the Respiratory Syncytial Virus, the most common causative agent of infant bronchiolitis, is available. METHODS: We tabulated transportation, in-hospital care and family accommodation costs for infants of less than 12 months of age residing in the Baffin Region of Nunavut aged who were admitted to Baffin Regional Hospital in Iqaluit, Nunavut, and the Children's Hospital of Eastern Ontario in Ottawa, Ontario, with a primary diagnosis of bronchiolitis or viral pneumonia, over a 36-month period, between April 1999 and March 2002. RESULTS: One hundred fifty-nine infants were admitted a total of 210 times, with 196 admissions to Baffin Regional Hospital, and 14 to the Children's Hospital of Eastern Ontario, during the study period. The overall, annual, population-based admission rate for the Baffin Region of Nunavut was 197 admissions per thousand infants per year. Total costs were $2,997,373 ($2,357,747 for Baffin Regional Hospital, $639,625 for the Children's Hospital of Eastern Ontario). Overall average costs were $14,273 per admission, $12,029 for infants admitted to Baffin Regional Hospital and $45,688 for infants admitted to the Children's Hospital of Eastern Ontario. CONCLUSIONS: Infant bronchiolitis in the Baffin Region of Nunavut represents a significant burden on the territorial health care system.

Bronchiolitis, Viral↗
PubMed2004

Healthy living in Nunavut: an on-line nutrition course for inuit communities in the Canadian arctic.

OBJECTIVES: It is recognized that empowerment of Indigenous Peoples through training and education is a priority. The objective was to design a course that would provide an innovative training approach to targeted workers in remote communities and enhance learning related to the Nunavut Food Guide, traditional food and nutrition, and diabetes prevention. STUDY DESIGN: A steering committee was established at the outset of the project with representation from McGill University and the Government of Nunavut (including nutritionists, community nurses and community health representatives (CHRs), as well as with members of the target audience. Course content and implementation, as well as recruitment of the target audience, were carried out with guidance from the steering committee. METHODS: An 8-week long course was developed for delivery in January - March, 2004. Learning activities included presentation of the course content through stories, online self-assessment quizzes, time-independent online discussions and telephone-based discussions. Invitations were extended to all prenatal nutrition program workers, CHRs, CHR students, home-care workers, Aboriginal Diabetes Initiative workers and public health nurses in Nunavut. RESULTS: Ninety-six health-care workers registered for Healthy Living in Nunavut, with 44 actively participating, 23 with less active participation and 29 who did not participate. CONCLUSIONS: Despite having to overcome numerous technological, linguistic and cultural barriers, approximately 40% of registrants actively participated in the online nutrition course. The internet may be a useful medium for delivery of information to target audiences in the North.

Arctic Regions↗
PubMed2004

Development of a community-based medical rehabilitation programme in the Kivalliq Region of Nunavut, Canada.

OBJECTIVE: In 2000, the University of Manitoba and the Department of Health and Social Services of Nunavut, Canada, jointly embarked upon the development of a community-based medical rehabilitation programme in the Kivalliq Region of Canada's central Arctic. Two main objectives were identified in moving forward with the implementation of a rehabilitation programme. Firstly, to conduct a region wide community needs assessment for rehabilitation services for all age groups of all residents of the Kivalliq Region of Nunavut. Secondly, to provide information from which a community-based rehabilitation therapy programme could be developed. METHODS: A community needs assessment of the Kivalliq Region was carried out to guide the implementation of physiotherapy, occupational therapy and speech language pathology services. RESULTS: There are now two physiotherapists, one occupational therapist, and one speech language pathologist providing rehabilitation services to the residents of the Kivalliq Region of Nunavut. The results of this needs assessment, the challenges and successes of this medical rehabilitation programme are discussed. CONCLUSION: The total population of the service area is approximately 8,000 people, the significant majority of whom self-report as Inuit, and are widely dispersed over eight communities. Despite the challenges in terms of culture, geography and recruitment of introducing a rehabilitation program in Canada's north, the residents of the Kivalliq Region now have a viable model of receiving rehabilitative intervention in their home communities.

Community Health Services↗
PubMed2001

Oncogenic human papillomavirus infection and cervical lesions in aboriginal women of Nunavut, Canada.

BACKGROUND: The high rate of cervical cancer among aboriginal women of northern Canada has prompted the search for more aggressive methods to augment Papanicolaou (Pap) screening in this population. Nearly all cervical cancers result from oncogenic human papillomavirus (HPV) infections. This has generated interest for incorporating HPV testing into the current screening program. GOALS: To determine the prevalence of oncogenic HPVs in Nunavut, and to assess the association between HPV and squamous intraepithelial lesions (SIL). STUDY DESIGN: A cross-sectional study was conducted on the Pap-screened populations in 19 communities of Nunavut, Canada. Liquid-based cytology was used to screen for SIL. HPV testing was performed using the Hybrid Capture II assay. Correlates of HPV infection and SIL were assessed by logistic regression with control for potential confounders. RESULTS: In 1290 women ages 13 to 79 years, the prevalence rate was 26% for oncogenic HPV and 6.9% for SIL. The odds ratio for the association between HPV and SIL was 37.9 (95% CI, 17.7-80.8) after multivariate adjustment. This association increased markedly with increasing viral load. More than 90% of the women with squamous intraepithelial lesions had positive test results for HPV. More than 75% of the women who had positive test results for HPV but negative test results for SIL were younger than 30 years. CONCLUSION: The results of this study form the basis for further evaluation of the role that liquid-based cytology and HPV testing plays and will contribute to the strategy for cervical cancer prevention in Nunavut.

Adolescent↗
PubMed2006

Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study.

Inuit infants have extremely high rates of lower respiratory tract infection (LRTI), but the causes for this are unclear. The aims of this study were to assess, in young Inuit children in Baffin Region, Nunavut, the feasibility of an epidemiologic study of the association between indoor air quality (IAQ) and respiratory health; to obtain data on IAQ in their housing; and to identify and classify risk factors for LRTI. Twenty houses in Cape Dorset, Nunavut with children below 2 years of age, were evaluated using a structured housing inspection and measurement of IAQ parameters, and a respiratory health questionnaire was administered. Twenty-five percent of the children had, at some time, been hospitalized for chest illness. Houses were very small, and had a median of six occupants per house. Forty-one percent of the houses had a calculated natural air change rate <0.35 air changes per hour. NO(2) concentrations were within the acceptable range. Smokers were present in at least 90% of the households, and nicotine concentrations exceeded 1.5 microg/m(3) in 25% of the dwellings. Particulates were found to be correlated closely with nicotine but not with NO(2) concentrations, suggesting that their main source was cigarette smoking rather than leakage from furnaces. Mattress fungal levels were markedly increased, although building fungal concentrations were low. Dust-mites were virtually non-existent. Potential risk factors related to IAQ for viral LRTI in Inuit infants were observed in this study, including reduced air exchange and environmental tobacco smoke exposure. Severe lower respiratory tract infection is common in Inuit infants. We found reduced air change rates and high occupancy levels in houses in Cape Dorset, which may increase the risk of respiratory infections. This suggests the measures to promote better ventilation or more housing may be beneficial. Further health benefits may be obtained by reducing bed sharing by infants and greater turnover of mattresses, which were found to have high levels of fungi.

Air Pollutants↗
PubMed2004

Human papillomavirus and cervical dysplasia in Nunavut: prelude to a screening strategy.

OBJECTIVES: To determine the prevalence of oncogenic human papillomavirus' (HPV) in Nunavut and to assess the association between HPV and squamous intraepithelial lesions (SIL) as a prelude to planning a better screening strategy. STUDY DESIGN: A cross-sectional study was conducted on the Pap-screened populations in 19 communities in Nunavut, Canada. SIL was determined using Liquid-based cytology, and HPV testing was done using the Hybrid Capture II assay. RESULTS: Prevalence of oncogenic HPVs in 1,290 women ages 13-79 was 26% and of Cervical Dysplasia was 7.2%. Over 90% of women with SIL had positive HPV tests. Over 75% of women who were HPV positive but SIL negative were under 30 years of age. CONCLUSION: Consideration should be given to using liquid-based cytology for Pap testing. Also consider concurrent HPV testing in those over 30 years old and reflex testing of HPV in those under 30 years old with a positive HPV test.

Adolescent↗
PubMed2004

Youth sexual health in Nunavut: a needs-based survey of knowledge, attitudes and behaviour.

OBJECTIVES: This study attempts to address the need for culturally specific data on beliefs and behaviours in order to design and implement appropriate public health interventions. The goal of the health promotion booklet that followed the study is to give youth a tool that will promote healthy choices and give non-judgmental information about sexuality. STUDY DESIGN AND METHODS: Knowledge gaps and beliefs about birth control, healthy sexuality and sexual health education were assessed through a written survey of young adults in three schools on Baffin Island. The sexual health survey was four pages long and written in simple language. The survey was voluntary, consensual and confidential, and it was administered by teachers. RESULTS: Some of the findings from the Iqaluit high school student survey (n=71) are reported with references to results from a smaller Iqaluit college student group (n=31). CONCLUSIONS: In Nunavut, teen pregnancy and sexually transmitted infection rates exceed national averages and continue to have devastating health and social consequences--particularly for Inuit girls and women. Using the data and a participatory approach, a culturally appropriate, bilingual booklet about sexual health is being developed for Nunavut youth.

Adolescent↗
PubMed2006

Heavy metal accumulation in arctic hares (Lepus arcticus) in Nunavut, Canada.

Accumulation of cadmium, mercury, lead, copper and zinc was studied in muscle, liver and kidney of 9 adult and 7 juvenile arctic hares (Lepus arcticus), collected in 2003 in the southwestern part of Nunavut, Canada. Our objective was to determine the level of heavy metal accumulation, and distribution among age groups and tissue. Concentrations of all metals varied among tissues, and concentrations of Cd, Hg and Zn were higher in adults compared to juveniles. We found correlations in metal content among tissues, and among metals in kidneys. We also found the hares to have low concentration of most heavy metals except cadmium. We suggest that the high cadmium levels might be caused by the local geology, and the hares being adapted to these levels. The low levels of the other metals are probably due to low input of atmospheric contaminants. Only one of the individuals had Cd content slightly above the maximum contaminant levels recommended for human consumption of meat. There were no levels in meat above the recommended maximum for the rest of the metals surveyed. However the Cd levels in liver and kidney are orders of magnitude higher than the recommended maximum, and consumption of these organs should be avoided.

Animals↗
PubMed2006

An ultra-clean firn core from the Devon Island Ice Cap, Nunavut, Canada, retrieved using a titanium drill specially designed for trace element studies.

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.

Air Pollutants↗
PubMed2004

Mortality in the Kivalliq Region of Nunavut, 1987-1996.

INTRODUCTION: The Kivalliq region of Nunavut, Canada, had a 1996 population of 7,131, of which 87% were Inuit. An attempt was made to characterize patterns of mortality in the region. STUDY DESIGN: Descriptive regional mortality study, based on 10-year retrospective review of health records data. METHODS: All deaths and stillbirths of Kivalliq residents during the study period were identified. Available health records data were reviewed for each death, including medical charts, death certificates and coroner's reports where applicable. Age-standardized mortality rates, both overall and cause-specific, were calculated and compared to both Canadian national rates and territorial rates from the same time period. RESULTS: The infant mortality rate was 32.3/1,000 live births, five times Canada's rate. Leading causes of infant deaths were prematurity and Sudden Infant Death Syndrome (SIDS). The overall mortality rate was 1.8 times that of Canada, with leading causes of death being cancers (especially lung cancer), circulatory disease, respiratory disease, unintentional injury and suicide. CONCLUSIONS: Identified areas of concern included mortality due to premature birth, SIDS, unintentional injuries, suicides, respiratory disease and lung cancer. It is hoped that this study's results will assist territorial leaders, health workers and citizens in health planning activities.

Death Certificates↗
PubMed2004

Community based physiotherapy services in the Kivalliq Region of Nunavut, Canada.

OBJECTIVES: Community based physiotherapy services are an integral component of the recent implementation of a medical rehabilitation program in the Kivalliq Region of Nunavut. Since the year 2000, the Inuit people of Canada's central Arctic have had direct access to physiotherapy in their home communities. STUDY DESIGN: A quantitative review of physiotherapy services from January 1, 2001 to December 31, 2002. METHODS: Workload measurement data gathered by the physiotherapists in the field will be utilized to present information on referral sources, location of services provided, client diagnoses and average duration of treatment provided. Administrative data will provide information on staffing complements and challenges to date. The need for physiotherapy referrals out of the Kivalliq Region will be reviewed. RESULTS: Referral sources to physiotherapy services are varied, the majority of diagnoses are musculoskeletal in nature, followed by neurological and cardiovascular. Recruitment of the physiotherapy positions has been successful to date. Referrals out of the region for physiotherapy services have been rare since community based services have begun. CONCLUSIONS: Access to physiotherapy services by the residents of the Kivalliq Region has been significantly enhanced since the implementation of the medical rehabilitation program.

Community Health Centers↗
PubMed2004

Speech language pathology services in Kivalliq Region of Nunavut, Canada.

OBJECTIVES: To provide a review of Speech Language Pathology services in the Kivalliq Region of Nunavut, Canada, since its inception. Referral sources, reasons for referral and discharge will also be shown for seven of the communities in the Kivalliq Region. STUDY DESIGN: A quantitative and qualitative survey of the services received for the 26-month time period from January 2001 to February 28th, 2003. METHODS: A record review of Speech Language Pathology services was conducted. Referral sources in each community, the rate of referrals, reasons for discharge and changes in abilities of three clients were examined. RESULTS: The rate of referrals increased as the service became more familiar. Small increases in client abilities were noted over the specified time period. CONCLUSION: Speech Language Pathology services are being utilized more effectively as the referral sources become more familiar with the program.

Humans↗
PubMedDate not supplied

Iron deficiency and anemia prevalence and associated etiologic risk factors in First Nations and Inuit communities in Northern Ontario and Nunavut.

BACKGROUND: Anemia is common among children in Aboriginal communities in Canada. The objectives of this study were to determine the prevalence of anemia and to identify its associated risk factors among young children in Aboriginal communities in northern Ontario and Nunavut. METHODS: 115 children from one Inuit and two Cree First Nations communities participated. We collected information on demographic and dietary factors and measured hemoglobin (Hb), ferritin (SF), serum transferrin receptor (sTfR) and Helicobacter pylori IgG antibodies. Odds ratios and 95% confidence intervals were determined to examine risk factors associated with anemia and iron deficiency (ID) and further analyzed using stepwise regression procedures. RESULTS: Prevalence of anemia (Hb<110 g/L) was 36.0%. Iron deficiency (sTfR>8.5 mg/L) was present in 27.6% of the study population. Approximately 53.3% had depleted iron stores (SF<12 microg/L). Consumption of cow/evaporated milk was the only independent risk factor associated with anemia. Infection with H. pylori and prolonged consumption of breastmilk were also associated, although not independently, with anemia. Formula intake was negatively associated with ID. INTERPRETATION: The prevalence of anemia in Aboriginal children was eight times higher than among similar populations in urban Canada and was especially high among Inuit children. ID was the major cause of anemia, but not the only one, since 10% of anemic children were not iron deficient. Given that the consumption of cow/evaporated milk was found to be a significant independent risk factor associated with anemia, public health strategies should include promotion of breastfeeding, combined with iron-rich complementary foods, while addressing socio-economic conditions that may be preventing these practices from being adopted. H. pylori may be a major contributing factor to anemia, thus improvements in water quality and sanitation also need to be considered.

Anemia, Iron-Deficiency↗
PubMed2006

"It's not that simple": A collaborative comparison of sea ice environments, their uses, observed changes, and adaptations in Barrow, Alaska, USA, and Clyde River, Nunavut, Canada.

The Arctic environment, including sea ice, is changing. The impacts of these changes to Inuit and Iñupiat ways of life vary from place to place, yet there are common themes as well. The study reported here involved an exchange of hunters, Elders, and others from Barrow, Alaska, USA, and Clyde River, Nunavut, Canada, as members of a larger research team that also included visiting scientists. Although the physical environments of Barrow and Clyde River are strikingly different, the uses of the marine environment by residents, including sea ice, had many common elements. In both locations, too, extensive changes have been observed in recent years, forcing local residents to respond in a variety of ways. Although generally in agreement or complementary to one another, scientific and indigenous knowledge of sea ice often reflect different perspectives and emphases. Making generalizations about impacts and responses is challenging and should therefore be approached with caution. Technology provides some potential assistance in adapting to changing sea ice, but by itself, it is insufficient and can sometimes have undesirable consequences. Reliable knowledge that can be applied under changing conditions is essential. Collaborative research and firsthand experience are critical to generating such new knowledge.

Adaptation, Physiological↗
PubMed2006

A political economic history of medical and dental care in Nunavut, Canada.

OBJECTIVES: To describe the historical development of medical and dental care in the territory of Nunavut, Canada. STUDY DESIGN: Ethnographic case study using political economy as a mode of explanation. METHODS: Participant observations, document reviews and stakeholder interviews, conducted over a four-year period. RESULTS: There is a clear and now long-term movement from state and professionally controlled health care delivery to Indigenous control over care. CONCLUSIONS: Indigenous groups increasingly hold control over health care delivery through a complex form of management that straddles both public and private organisational spheres.

Anthropology, Cultural↗