International journal of circumpolar health
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Int J Circumpolar Health · Dec 2004
Comparative StudyTelehealth in Alaska: delivery of health care services from a specialist's perspective.
Integrating store-and-forward telemedicine into the ANMC ENT practice for remotely located patients has improved access for care as well as the quality of care for our patients. The involvement of the ANMC ENT department in the design of the telemedicine system was critical. ⋯ Much of the current research in telemedicine appropriately focuses on the applicability of this modality to clinical problems. Our four years experience indicates that one of the challenges in the future will be to integrate telemedicine with the existing infrastructure of medicine so that it can more easily become part of mainstream practice.
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Int J Circumpolar Health · Mar 2004
Understanding death and dying in select first nations communities in northern Manitoba: issues of culture and remote service delivery in palliative care.
The purpose of this study was to delineate and describe the local palliative care services available to residents of remote Aboriginal communities in northern Manitoba; to identify attitudes and beliefs about death, dying and palliative care in these communities; and to explore obstacles related to palliative care service delivery from the perspectives of culture and geographic isolation. ⋯ Providing the equipment, supports and education necessary for home-based palliative care in remote Aboriginal communities can be an effective way of addressing the medical, psycho-social, and spiritual needs of these patients.
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Int J Circumpolar Health · Jan 2004
Respiratory tract infections in Greenland: results of an audit project.
To elucidate and improve quality of diagnosis and treatment of respiratory tract infections in Greenland. ⋯ The study showed that it is possible to carry out an APO audit in Greenland, and that there was a moderate difference in the diagnosis and treatment between Greenland and Denmark. An increased use of paraclinical tests may result in quality improvement.
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Int J Circumpolar Health · Jan 2004
Youth sexual health in Nunavut: a needs-based survey of knowledge, attitudes and behaviour.
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. ⋯ 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.
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Int J Circumpolar Health · Oct 2000
ReviewRewarming from hypothermia. Newer aspects on the pathophysiology of rewarming shock.
The fatal circulatory derangements often observed when resuscitating victims of accidental hypothermia by rewarming are recognized as a falling cardiac output and a sudden drop in blood pressure, termed "rewarming shock". The real cause of this rewarming shock, or rewarming collapse, is, so far, unknown. ⋯ Cellular calcium overload, disturbed calcium homeostasis, changes in myocardial myofilament responsiveness to intracellular calcium as well as impaired high energy phosphate homeostasis could all be proposed as important factors leading to the changes observed in the hypothermic heart. Together with alteration of capillary function, increased capillary leakage of plasma protein, changes in intra- and extravascular volume-homeostasis and alteration of autonomous vascular control they all contribute to a maintained low cardiac output during and after rewarming which is associated with a fatal outcome.