The Association Between Mode of Delivery and Later Educational Outcomes

IntroductionA 2002 report described the gap in health status between First Nations (FN) and all other Manitobans (AOM). That report was widely quoted in the context of other initiatives recognizing the inequities in Canadian society. Objectives and ApproachWe analyzed linked administrative data held in the Manitoba Population Research Data Repository to determine the health status and health care use of First Nations people. To provide context to the findings we compared First Nations to all other Manitobans, disaggregated by on-reserve off-reserve status, and presented our findings by Region and Tribal Council area. The 35 indicators were chosen to address First Nations priorities and providecomparisons with the previous study. Results were age and sex adjusted. ResultsThe gap between FN and AOM has grown. Premature mortality rates are 3x higher for FN compared to AOM. Rates of death by suicides and suicide attempts are 5x higher for FN compared to AOM. Rates of opioid prescribing are 2.5x higher for single prescription, and 4.5x higher for multiple prescriptions for FN compared to AOM. Colorectal cancer screening rates are 2x higher among all other Manitobans compared to FN. Continuity of care is much lower in FN than in AOM. For FN, primary care is less likely to be provided close to home than for AOM Conclusion / ImplicationsDespite initiatives like the Truth and Reconciliation Commission, and Indian Residential School survivors pursuing healing, the gap in health outcomes has increased. Underlying causes such as ongoing systemic racism and colonialism within health governance should be addressed.

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A Principled Approach to Research Conducted with Inuit, Métis, and First Nations People: Promoting Engagement Inspired by the CIHR Guidelines for Health Research Involving Aboriginal People (2007-2010)

International Indigenous Policy Journal ◽

10.18584/iipj.2020.11.2.10635 ◽

2020 ◽

Vol 11 (2) ◽

Author(s):

Janet Jull ◽

Alexandra King ◽

Malcolm King ◽

Ian D. Graham ◽

Melody E. Morton Ninomiya ◽

...

Keyword(s):

First Nations ◽

Health Research ◽

Aboriginal People ◽

Truth And Reconciliation Commission ◽

Indigenous Populations ◽

Research Partnerships ◽

Consultation Process ◽

Research Guidelines ◽

First Nations People ◽

Health Burdens

Research to address the health burdens experienced by Indigenous populations is essential. In the Canadian context, the Truth and Reconciliation Commission of Canada determined that these health burdens are the result of policies that have undermined opportunities to address community-level health needs. The Canadian Institutes of Health Research Guidelines for Health Research Involving Aboriginal People (2007-2010), or“CIHR Guidelines,” were prepared in a national consultation process involving Inuit, Métis, and First Nations communities, researchers, and institutions. This paper asserts that the principles espoused in the CIHR Guidelines hold ongoing potential to guide health research with Indigenous people in ways that promote equitable research partnerships. We encourage those in research environments to engage with the spirit and content of the CIHR Guidelines.

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Ethical Data Linkage with Indigenous Communities: The Manitoba Experience

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1473 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Alan Katz ◽

Kathi Avery Kinew ◽

Leona Star

Keyword(s):

First Nations ◽

Indigenous Communities ◽

Well Being ◽

Data Repository ◽

Negative Stereotypes ◽

Indigenous Nations ◽

Unethical Research ◽

System Use ◽

First Nations People ◽

Interpretation Of Results

IntroductionIndigenous populations are known to have poor health and health outcomes in many countries. Indigenous peoples continue to be the subjects of unethical research. Research that is undertaken without their consent, involvement in the design, delivery and interpretation of results that perpetuates negative stereotypes ignoring the historical and ongoing impacts of colonialism. Objectives and ApproachIn order to understand the health status and health system use of First Nations people in Manitoba Canada we developed a partnership between the First Nations Social Secretariat of Manitoba and researchers to link First Nations identifiers with administrative data. This partnership was based on long-standing relationships with researchers who were affiliated with the Manitoba Centre for Health Policy. ResultsA tripartite data sharing agreement set out the parameters of sharing data that supported the linkage of the Federal Registered First Nations database to the Manitoba Population Research Data Repository. The DSA facilitated direct First Nations input into the indicators chosen, the reporting cohorts, the interpretation of results and the language of the report. Conclusion / ImplicationsDSAs can be used as a tool to facilitate partnerships with Non-indigenous researchers and Indigenous Nations that lead to meaningful partnerships and lay the foundation for respectful and ethical research. The research presents findings the health of First Nations and shines a light on the underlying colonialism and racism that contributes to the health inequities. These findings have the potential to influence health and well-being of First Nation peoples in Manitoba. This model of collaboration can be used a model in other jurisdictions.

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Quality of Care for First Nations People with Diabetes Living in Rural vs. Urban Locations in Alberta

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2014.07.148 ◽

2014 ◽

Vol 38 (5) ◽

pp. S54

Author(s):

Nathalie Saad

Keyword(s):

Quality Of Care ◽

First Nations ◽

Nations People ◽

First Nations People

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Suicide attempt and its associated factors amongst women who were pregnant as adolescents in Bangladesh: a cross-sectional study

Reproductive Health ◽

10.1186/s12978-021-01127-6 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jie Li ◽

Syeda Zerin Imam ◽

Zhengyue Jing ◽

Yi Wang ◽

Chengchao Zhou

Keyword(s):

Social Support ◽

Health Status ◽

Adolescent Pregnancy ◽

Young Women ◽

Associated Factors ◽

Suicide Attempts ◽

Perceived Social Support ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Abstract Background Adolescent pregnancy is a risk factor for suicide. We aimed to assess the prevalence of suicide attempts among young women with adolescent pregnancy in Bangladesh and to explore its associated factors. Methods In this cross-sectional study, we surveyed young women with adolescent pregnancy in urban and rural areas in Bangladesh to assess suicide attempts, socio-demographic and pregnancy-related characteristics, perceived health status, and perceived social support. Binary logistic regression analysis was conducted to explore the relationship between potentially related factors and suicide attempts. Results Of the participants, 6.5% (61/940) reported suicide attempts in the past 12 months, and the majority (88.5%) of the attempts happened within one year after the pregnancy. Participants with more years after first pregnancy (odds ratio (OR) = 0.47, 95% CI: 0.37–0.61) and more perceived social support from friends (OR = 0.69, 95% CI: 0.55–0.86) were less likely to have suicide attempts, and those perceived bad health status compared with good/fair health status (OR = 8.38, 95% CI: 3.08–22.76) were more likely to attempt suicide. Conclusions Women with adolescent pregnancy were at high risk of suicide attempts, especially those during the first postnatal year. The risk of suicide attempts attenuated with the time after pregnancy, and perceived social support from friends was a protective factor and perceived bad health status was a risk factor for suicide attempts among young women who have experienced adolescent pregnancy.

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Cultural safety for First Nations people in aged care

Contemporary Nurse ◽

10.1080/10376178.2021.1962378 ◽

2021 ◽

pp. 1-7

Author(s):

Linda Michelle Deravin ◽

Judith Anderson ◽

Nicole Mahara

Keyword(s):

First Nations ◽

Aged Care ◽

Cultural Safety ◽

Nations People ◽

First Nations People

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Patient/Consumer Codesign and Coproduction of Medical Curricula: A Possible Path Toward Improved Cultural Competence and Reduced Health Disparity

SAGE Open ◽

10.1177/21582440211016836 ◽

2021 ◽

Vol 11 (2) ◽

pp. 215824402110168

Author(s):

Warren Kealy-Bateman ◽

Georgina M. Gorman ◽

Adam P. Carroll

Keyword(s):

Cultural Competence ◽

First Nations ◽

Minority Groups ◽

Traditional Approach ◽

Learning Experience ◽

Transgender People ◽

Medical Practitioners ◽

Education Professionals ◽

First Nations People ◽

Diverse Groups

There is often a sociocultural distance between medical practitioners and patients. We bridge that gap in the therapeutic alliance via improved cultural competence and an understanding of the person in their context. The traditional approach in medical education has been of learning via expert-designed curricula, which may tend to mirror the knowledge and needs of the experts. This places individuals at risk who come from culturally and linguistically diverse groups (CALD) with known health disparities: minority groups (e.g., African American); First Nations’ people; immigrants and refugees; people who speak nondominant languages; and lesbian, gay, bisexual, transgender people. The authors briefly review the complex area of cultural competency and teaching delivery. The authors survey the Australian population to provide a tangible example of complex cultural diversity amid curriculum challenges. An evidence-based approach that recognizes specific health inequity; the inclusion of CALD stakeholders, students, care professionals, and education professionals; and codesign and coproduction of curriculum components is recommended. This method of people’s own stories and collaboration may be applied in any international context, correctly calibrating the learning experience. The aim is for medical students to improve their knowledge of self, others, others within groups, and recognition of unconscious biases to achieve better health outcomes within their specific communities.

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SAT0585 GEO-EPIDEMIOLOGY OF AUTOANTIBODIES IN RA: DIFFERENT PREVALENCES IN FOUR ETHNICALLY DIVERSE RA POPULATIONS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3146 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1251.1-1252

Author(s):

E. C. De Moel ◽

V. Derksen ◽

L. A. Trouw ◽

C. Terao ◽

M. Tikly ◽

...

Keyword(s):

First Nations ◽

Meta Analysis ◽

Ethnically Diverse ◽

Research Support ◽

South Africans ◽

Autoantibody Response ◽

Black South Africans ◽

Genetic And Environmental Factors ◽

First Nations People ◽

Citrullinated Protein

Background:Rheumatoid arthritis (RA) has been described in virtually every ethnic population. Most RA patients harbor anti-modified protein antibodies (AMPAs), including anti-citrullinated protein (ACPA), anti-carbamylated protein (anti-CarP), anti-malondialdehyde acetaldehyde (anti-MAA), and anti-acetylated protein antibodies (AAPA). However, it is unclear whether differences exist in the AMPA response between different ethnic groups. Such differences could provide new clues to genetic and environmental factors contributing to autoantibody development.Objectives:To investigate the prevalence of different AMPA in four ethnically diverse RA populations, and their association with smoking.Methods:Enzyme-linked immunosorbent assays were used to measure anti-CarP IgG, anti-MAA IgG (both in-house), and anti-acetylated vimentin IgG (Orgentec) in ACPA-positive sera of Dutch (NL, n=103), Japanese (JP, n=174), Canadian First Nations People (FN, n=100), and black South Africans (SA, n=67) fulfilling the 1987 ACR classification criteria for RA. Ethnicity-matched local healthy controls were used to calculate cohort-specific cut-offs. Logistic regression was used to identify whether ever-smoking was associated with AMPA seropositivity in each cohort, corrected for age, gender, and disease duration. Random-effects meta-analysis was used to pool the resulting odds ratios (OR).Results:For all three AMPAs, median levels were higher in FN and especially SA than NL and JP patients (Figure 1). The median autoantibody levels in arbitrary units (in % of patients positive) for NL, JP, FN and SA RA patients were: anti-CarP IgG: 1157 (47%), 994 (43%), 1642 (58%) and 2336 (76%) (p<0.001); anti-MAA IgG: 131 (29%), 179 (22%), 251 (29%) and 257 (53%) (p<0.001); AAPA: 133 (20%), 136 (17%), 153 (38%) and 316 (28%) (p<0.001). Prevalence, meaning positivity, also differed significantly between cohorts for all AMPAs (p<0.001).There were also marked differences in total IgG levels in mean (SD) g/L: 13 (4) for NL, 17 (6) for JP, 18 (6) for FN, and 25 (8) for SA (p<0.001). When the autoantibody levels were normalized to total IgG, the differences in became less pronounced between cohorts (Figure 2). The median arbitrary units per g/L Total IgG for NL, JP, FN and SA RA patients were: anti-CarP IgG: 54, 25, 53, and 79; anti-MAA IgG: 6, 5, 8, and 9; and AAPA: 2, 2, 2, and 3, suggesting that autoantibody level differences may partly correspond to cohort-specific differences in total IgG, although the overall trend of higher levels in SA persisted. There was no association between smoking and anti-CarP or anti-MAA positivity, with pooled OR (95% CI) of 1.31 (0.79-2.18) and 0.85 (0.46-1.56), respectively. However, smoking was positively and consistently associated with AAPA positivity in each cohort: pooled OR (95% CI) of 2.01 (1.06-3.81).Conclusion:In these ACPA-positive ethnically diverse RA populations, levels and prevalence of various AMPAs differ, suggesting that ethnic background and environment may influence the development of the autoantibody response in RA. Despite these differences, our results imply smoking as a consistent risk factor for AAPA across different ethnic backgrounds.Disclosure of Interests:Emma C. de Moel: None declared, Veerle Derksen: None declared, Leendert A Trouw: None declared, Chikashi Terao: None declared, Mohammed Tikly: None declared, Hani El-Gabalawy: None declared, Holger Bang Grant/research support from: Employee of Orgentec Diagnostika, Thomas Huizinga Grant/research support from: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Consultant of: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Rene Toes: None declared, Diane van der Woude: None declared

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Estimating risks from exposure to methylmercury: Application to first nations people in Canada

Water Air & Soil Pollution ◽

10.1007/bf02409649 ◽

1997 ◽

Vol 97 (1-2) ◽

pp. 107-118 ◽

Cited By ~ 1

Author(s):

Sara Hoover ◽

Ryan Hill ◽

Tom Watson

Keyword(s):

First Nations ◽

Nations People ◽

First Nations People

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Attempted suicide attention at an emergency room: A hospital-based descriptive approach

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2252 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S603-S603

Author(s):

D. Torres ◽

G. Martinez-Ales ◽

M. Quintana ◽

V. Pastor ◽

M.F. Bravo

Keyword(s):

Emergency Room ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Hospitalization ◽

Study Results ◽

History Of ◽

Competing Interest ◽

Reported Data ◽

Medium Cost ◽

Rule Out

IntroductionSuicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use.ObjectiveTo describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis.AimsTo identify individual features potentially useful to improve both emergency treatments and resource investment.MethodsA descriptive study including data from 2894 patients treated in a general hospital's emergency room after a suicidal attempt between years 2006 and 2014.ResultsSixty-nine percent of the population treated after an attempted suicide were women. Mean age was 38 years old. Sixty-six percent had familiar support; 48.5% had previously attempted a suicide (13% did not answer this point); 72.6% showed a personal history of psychiatric illness. Drug use was present in 38.3% of the patients (20.3% did not answer this question); 23.5% were admitted to an inpatient psychiatric unit. Medium cost of a psychiatric hospitalization was found to be 4900 euros.ConclusionThis study results agree with previously reported data. Further observational studies are needed in order to bear out these findings, rule out potential confounders and thus infer and quantify causality related to each risk factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Missiological implications for Taylor Seminary arising from Canada’s Truth and Reconciliation Commission’s recommendations

Missiology An International Review ◽

10.1177/0091829617712579 ◽

2017 ◽

Vol 45 (4) ◽

pp. 407-413

Author(s):

Allan Effa

Keyword(s):

First Nations ◽

Truth And Reconciliation Commission ◽

Final Report ◽

Cooperative Effort ◽

Truth And Reconciliation ◽

Cultural Genocide ◽

The Government ◽

Government Of Canada ◽

Set Up

In 2015 the Truth and Reconciliation Commission of Canada concluded a six-year process of listening to the stories of Canada’s First Nations, Inuit and Métis peoples. More than 6000 witnesses came forth to share their personal experiences in listening sessions set up all across the country. These stories primarily revolved around their experience of abuse and cultural genocide through more than 100 years of Residential Schools, which were operated in a cooperative effort between churches and the government of Canada. The Commission’s Final Report includes 94 calls to action with paragraph #60 directed specifically to seminaries. This paper is a case study of how Taylor Seminary, in Edmonton, is seeking to engage with this directive. It explores the changes made in the curriculum, particularly in the teaching of missiology, and highlights some of the ways the seminary community is learning about aboriginal spirituality and the history and legacy of the missionary methods that have created conflict and pain in Canadian society.

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