scholarly journals Improving Dementia Care for Gitxsan First Nations People

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gina Gaspard ◽  
David McAtackney ◽  
Debbie Sullivan ◽  
Mavis Sebastian
Keyword(s):  
First Nations ◽  
Knowledge Exchange ◽  
Ways Of Knowing ◽  
Dementia Care ◽  
Advisory Council ◽  
Community Members ◽  
Loss And Grief ◽  
Qualitative Approaches ◽  
Culturally Appropriate Care ◽  
First Nations People

This project originated from nursing staff’s learning need for knowledge, approach, attitude, and skills in dementia care that was identified by the Gitxsan Health Society. In collaboration with the First Nations Health Authority, the Gitxsan Health Society sought to educate nurses on how to provide culturally appropriate care to older Gitxsan persons living with dementia, and also to increase the understanding of nurses, family caregivers, and the wider community about dementia as a chronic condition. This project involved a mixed-methods approach (multiple qualitative approaches, as well as a quantitative component). The team was guided at each stage by a Cultural Advisory Council of four Elders recognized as Knowledge Holder from the community. The project involved a strong element of reciprocal co-learning and knowledge exchange. From discussions and exchange with community members, three large interlinking themes emerged to guide the researchers: (a) loss and grief; (b) relationality; and (c) access and connection. These themes gave voice to the gaps and needs in care, but also highlighted the potential areas of strength that can be built on to improve care for the older Gitxsan person living with dementia. Family and other community members identified the need for more information regarding dementia, the need to access in-community and external supports, and the need to inform nurses about what considerations are required when caring for Gitxsan people living with dementia. A better understanding of the Gitxsan ways of knowing about dementia can help nurses incorporate more culturally safe practices into the care of persons living with dementia.

scholarly journals Implementing participatory research within a northern Ontario First Nations community

2021 ◽  
Author(s):  
Christine Zupo
Keyword(s):  
First Nations ◽  
Cultural Values ◽  
Research Method ◽  
Evaluation Research ◽  
Participatory Evaluation ◽  
Community Members ◽  
Northern Ontario ◽  
Nations People ◽  
First Nations People ◽  
Nations Community

Participatory evaluation research (PER) is a research method that promotes decolonization among remote First Nations communities. Traditional methods of research have marginalized First Nations people while advancing western knowledge. As colonization worked to expunge First Nations cultural values from western mainstream knowledge, PER constructs new meaning derived from First Nations world perspectives. The present study explores the initial stages of implementing PER in a remote northern Ontario First Nations community. Community members are invited to form a research team to evaluate the outcomes of services available within the community. All levels of Canadian government are encouraged to embrace PER as a tactic for reducing racism so deeply rooted in policy.

Putting Indigenous Harm Reduction to Work: Developing and Evaluating “Not Just Naloxone”

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Andrea Medley ◽  
Sarah Levine ◽  
Alexa Norton
Keyword(s):  
Harm Reduction ◽  
First Nations ◽  
Access To Health Services ◽  
Community Members ◽  
Local Leadership ◽  
Train The Trainer ◽  
Nations People ◽  
Training Materials ◽  
First Nations People ◽  
The Impact

First Nations people and communities have long been championing the provision of holistic, self-determining, culturally safe, and responsive health care. In April 2016, a catastrophic rise in illicit drug overdose deaths in the province of British Columbia (BC), Canada, led to the declaration of a public health emergency. Due to the compounding historical and ongoing impacts of colonialism, including trauma and inequitable access to health services, First Nations people in BC are disproportionately impacted by this crisis. In response, the First Nations Health Authority created Not Just Naloxone (NJN), a train-the-trainer workshop designed to build Indigenous harm reduction knowledge and skills within First Nations communities. This article describes the NJN program and presents the results of a follow-up evaluation of 37 participants from six NJN workshops held between December 2017 and October 2018. Core strengths of the training included an Indigenized approach and the opportunity to build networks of support. Respondents reported increased knowledge and confidence presenting about harm reduction and feeling more prepared to respond to overdoses. Areas for improvement included maintaining up-to-date training materials and navigating emotional triggers for participants. Trainees went on to train over 2,400 community members in naloxone and Indigenous harm reduction, and reported that communities’ awareness and attitudes around harm reduction began to change. Challenges providing community trainings included buy-in from local leadership and persistent abstinence-based beliefs. This evaluation demonstrates the impact of holistic, culturally safe harm reduction training and the need for a connected community of Indigenous harm reduction champions.

scholarly journals Canadian and Australian First Nations: Decolonising knowledge

2018 ◽  
pp. 3-20 ◽  
Author(s):  
Josie Arnold
Keyword(s):  
First Nations ◽  
Ways Of Knowing ◽  
Learning Processes ◽  
Standpoint Theory ◽  
Border Crossing ◽  
Slow Process ◽  
Nations People ◽  
Traditional Research ◽  
Practitioner Knowledge ◽  
First Nations People

This article explores Indigenous standpoint theory in Australia in the context of postcolonialism and some of its aspects influencing Canadian First Nations scholarship. I look at how cultural metanarratives are ideologically informed and act to lock out of scholarship other ways of knowing, being and doing. I argue that they influence knowledge and education so as to ratify Eurowestern dominant knowledge constructs. I develop insights into redressing this imbalance through advocating two-way learning processes for border crossing between Indigenous axiologies, ontologies and epistemologies, and dominant Western ones. In doing so, I note that decolonisation of knowledge sits alongside decolonisation itself but has been a very slow process in the academy. I also note that this does not mean that decolonisation of knowledge is always necessarily an oppositional process in scholarship, proposing that practice-led research (PLR) provides one model for credentialling Indigenous practitioner-knowledge within scholarship. The article reiterates the position of alienation in their own lands that such colonisation implements again and in an influential and ongoing way. The article further proposes that a PhD by artefact and exegesis based on PLR is potentially an inclusive model for First Nations People to enter into non-traditional research within the academy.

scholarly journals Implementing participatory research within a northern Ontario First Nations community

2021 ◽  
Author(s):  
Christine Zupo
Keyword(s):  
First Nations ◽  
Cultural Values ◽  
Research Method ◽  
Evaluation Research ◽  
Participatory Evaluation ◽  
Community Members ◽  
Northern Ontario ◽  
Nations People ◽  
First Nations People ◽  
Nations Community

Participatory evaluation research (PER) is a research method that promotes decolonization among remote First Nations communities. Traditional methods of research have marginalized First Nations people while advancing western knowledge. As colonization worked to expunge First Nations cultural values from western mainstream knowledge, PER constructs new meaning derived from First Nations world perspectives. The present study explores the initial stages of implementing PER in a remote northern Ontario First Nations community. Community members are invited to form a research team to evaluate the outcomes of services available within the community. All levels of Canadian government are encouraged to embrace PER as a tactic for reducing racism so deeply rooted in policy.

scholarly journals Re-Examining Treatment of Latent Tuberculosis Infection

2001 ◽  
Vol 12 (4) ◽  
pp. 211-214 ◽  
Author(s):  
B Lynn Johnston ◽  
John M Conly
Keyword(s):  
Infectious Diseases ◽  
First Nations ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
The United States ◽  
Consensus Conference ◽  
American Thoracic Society ◽  
Tuberculosis Infection ◽  
Advisory Council ◽  
First Nations People

In April 2000, the American Thoracic Society published guidelines for targeted tuberculin testing and the treatment of latent tuberculosis infection (LTBI) (1). These guidelines are a joint statement of the American Thoracic Society and the Centers for Disease Control and Prevention, and were endorsed by both the Infectious Diseases Society of America and the American Academy of Pediatrics. Similar recommendations were published by the Infectious Diseases Society of America in its guidelines for the treatment of tuberculosis (TB) (2). These updated guidelines were developed in recognition of the importance of treating LTBI as one component of eliminating TB in the United States - a goal reiterated in 1999 by the Advisory Council for the Elimination of Tuberculosis (3) - but also realizing the differing risks and benefits of treatment for patients based on their individual risks of developing active disease or drug toxicity (4). The 2000 edition of theCanadian Tuberculosis Standardsprovided similar recommendations for the treatment of LTBI (formerly known as chemoprophylaxis) and reminded us of the two major Canadian TB elimination initiatives: the National Tuberculosis Elimination Strategy (Medical Services Branch, 1992), with the aim of eliminating TB in First Nations people by 2010, and the National Consensus Conference on Tuberculosis (Health Canada, 1997), with an interim goal of a 5% reduction in the number of TB cases each year in Canada (5). Given the recent publication of the American guidelines and the updatedCanadian Tuberculosis Standards(Fifth Edition), it was considered timely to remind readers of the evidence supporting the use of antituberculous chemotherapy in the treatment of latent infection.

scholarly journals Cultural safety for First Nations people in aged care

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

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

SAGE Open ◽  
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.

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

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

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

1997 ◽  
Vol 97 (1-2) ◽  
pp. 107-118 ◽  
Author(s):  
Sara Hoover ◽  
Ryan Hill ◽  
Tom Watson
Keyword(s):  
First Nations ◽  
Nations People ◽  
First Nations People
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