Voluntary self-disclosed Indigenous identity of patients in four Canadian health care settings: A multiple-site qualitative case study.

Objectives: The lack of Indigenous health care data in Canada makes it challenging to plan health care services and inform Indigenous leadership on the health care needs of their respective Nations and communities. Several Canadian health care organizations have implemented a voluntary Indigenous identifier of patients within their electronic medical records. This study examines facilitators and barriers to implementing such a voluntary self-reported Indigenous identifier, from the perspective of key stakeholders who work at four Canadian health providers where an Indigenous identifier has been implemented.

A Review of Wastewater-Based Epidemiology for the SARS-CoV-2 Virus in Rural, Remote, and Resource-Constrained Settings Internationally: Insights for Implementation, Research, and Policy for First Nations in Canada.

Wastewater-based epidemiology (WBE) is regarded as a support tool for detecting and assessing the prevalence of infectious diseases at a population level. For rural, remote, and resource-constrained communities with little access to other public health monitoring tools, WBE can be a low-cost approach to filling gaps in population health knowledge to inform public health risk assessment and decision-making. This rapid review explores and discusses unique considerations of WBE in key settings, with a focus on the detection of the SARS-CoV-2 virus, which has rapidly expanded WBE infrastructure globally.

Advancing health equity for Indigenous peoples in Canada: development of a patient complexity assessment framework.

Background: Indigenous patients often present with complex health needs in clinical settings due to factors rooted in a legacy of colonization. Healthcare systems and providers are not equipped to identify the underlying causes nor enact solutions for this complexity. This study aimed to develop an Indigenous-centered patient complexity assessment framework for urban Indigenous patients in Canada.

Colonial drivers and cultural protectors of brain health among Indigenous peoples internationally.

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care.

Indigenous identity identification in administrative health care data globally: A scoping review.

Objective: Both Indigenous and non-Indigenous governments and organizations have increasingly called for improved Indigenous health data in order to improve health equity among Indigenous peoples. This scoping review identifies best practices, potential consequences and barriers for advancing Indigenous health data and Indigenous data sovereignty globally.

Methods: A scoping review was conducted to capture the breadth and nature of the academic and grey literature.

Critically examining health complexity experienced by urban Indigenous peoples in Canada by exploring the factors that allow health complexity to persist: a qualitative study of Indigenous patients in Calgary, Alberta.

Objectives: This study aims to identify and critically examine the components of health complexity, and explore the factors that allow it to exist, among urban Indigenous peoples in Canada.

Design: Qualitative exploration with relational conversations.

Setting: Calgary, Alberta, Canada.

Truth and Reconciliation in Medical Schools: Forging a Critical Reflective Framework to Advance Indigenous Health Equity.

In 2015, the Truth and Reconciliation Commission (TRC) of Canada outlined 94 Calls to Action, which formalized a responsibility for all people and institutions in Canada to confront and craft paths to remedy the legacy of the country's colonial past. Among other things, these Calls to Action challenge medical schools to examine and improve existing strategies and capacities for improving Indigenous health outcomes within the areas of education, research, and clinical service. This article outlines efforts by stakeholders at one medical school to mobilize their institution to address the TRC's Calls to Action via the Indigenous Health Dialogue (IHD).

Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review.

Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied.

Forecasting and Optimizing Dual Media Filter Performance via Machine Learning.

Four different machine learning algorithms, including Decision Tree (DT), Random Forest (RF), Multivariable Linear Regression (MLR), Support Vector Regressions (SVR), and Gaussian Process Regressions (GPR), were applied to predict the performance of a multi-media filter operating as a function of raw water quality and plant operating variables. The models were trained using data collected over a seven year period covering water quality and operating variables, including true colour, turbidity, plant flow, and chemical dose for chlorine, KMnO, FeCl, and Cationic Polymer (PolyDADMAC). The machine learning algorithms have shown that the best prediction is at a 1-day time lag between input variables and unit filter run volume (UFRV).

A realist review of best practices and contextual factors enhancing treatment of opioid dependence in Indigenous contexts.

Objectives: The objective of this study was to examine international literature to identify best practices for treatment of opioid dependence in Indigenous contexts.

Methods: We utilized a systematic search to identify relevant literature. The literature was analysed using a realist review methodology supported by a two-step knowledge contextualization process, including a Knowledge Holders Gathering to initiate the literature search and analysis, and five consensus-building meetings to focus and synthesize relevant findings.

Novel Application of the World Health Organization Community-Based Rehabilitation Matrix to Understand Services' Contributions to Community Participation for Persons With Traumatic Spinal Cord Injury: A Mixed-Methods Study.

Purpose: The aim of the study is to use the World Health Organization community-based rehabilitation matrix for understanding services' contributions to foster community participation for people with traumatic spinal cord injury.

Methods: This study used a convergent mixed-methods design with a quantitative arm describing the frequency with which services contributed to 22 of the community-based rehabilitation-matrix elements and a qualitative arm involving document reviews and stakeholder interviews. Results were integrated following Onwuegbuzie and Teddlie's method (i.

Access, relationships, quality and safety (ARQS): a qualitative study to develop an Indigenous-centred understanding of virtual care quality.

Background: Among Indigenous peoples in Canada, access to high-quality healthcare remains an important determinant of health. The shift to virtual and remote-based approaches, expedited during the COVID-19 pandemic, influenced the ways in which individuals accessed care and the quality of care received. This study sought to determine which elements are required for effective and sustainable virtual care approaches for delivery of primary care to Indigenous patients and develop quality indicators grounded in Indigenous community and experience.

Propelled by the Pandemic: Responses and Shifts in Primary Healthcare Models for Indigenous Peoples.

The COVID-19 pandemic posed a significant risk to the health and well-being of First Nations and Métis communities in Alberta. Communities' self-determined and integrated responses with embedded cultural supports - in collaboration with governments, organizations and providers - were key to minimizing morbidity and mortality. Maintaining and building these relationships in the continued pandemic response, broadening approaches to healthcare delivery and continuing to include culture will support attainment of the Indigenous primary healthcare model while addressing logistical challenges in transforming and sustaining healthcare systems in the background of ongoing inequities in the social determinants of health.

Polymer leachates emulate naturally derived fluorescent dissolved organic matter: Understanding and managing sample container interferences.

Fluorescence spectroscopy has become a fundamental tool for the qualitative and quantitative fingerprinting of dissolved organic matter. Due to the inherent sensitivity of the technique, a strict sampling protocol should be followed to ensure sample integrity. A literature survey conducted as part of this research determined that 27% of fluorescence sampling has been conducted in polymeric containers, while 52% did not report.

Current knowledge in the field of algal organic matter adsorption onto activated carbon in drinking water treatment.

The increasing occurrence of algal and cyanobacterial blooms and the related formation of algal organic matter (AOM) is a worldwide issue that endangers the quality of freshwater sources and affects water treatment processes. The associated problems involve the production of toxins or taste and odor compounds, increasing coagulant demand, inhibition of removal of other polluting compounds, and in many cases, AOM acts as a precursor of disinfection by-products. Previous research has shown that for sufficient AOM removal, the conventional drinking water treatment based on coagulation/flocculation must be often accompanied by additional polishing technologies such as adsorption onto activated carbon (AC).

Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies.

Background: During public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions.

Indigenous Mentorship in the Health Sciences: Actions and Approaches of Mentors.

: Indigenous and non-Indigenous scholars have called for mentorship as a viable approach to supporting the retention and professional development of Indigenous students in the health sciences. In the context of Canadian reconciliation efforts with Indigenous Peoples, we developed an Indigenous mentorship model that details behavioral themes that are distinct or unique from non-Indigenous mentorship.: We used Flanagan's Critical Incidents Technique to derive mentorship behaviors from the literature, and focus groups with Indigenous faculty in the health sciences associated with the AIM-HI network funded by the Canadian Institutes of Health Research.

An equity-oriented admissions model for Indigenous student recruitment in an undergraduate medical education program.

Background: With the 2015 publication of the Truth and Reconciliation Commission of Canada's calls to action, health professional schools are left grappling with how to increase the recruitment and success of Indigenous learners. Efforts to diversify trainee pools have long looked to quota-based approaches to recruit students from underserved communities, though such approaches pose dilemmas around meaningfully dismantling structural barriers to health professional education. Lessons shared here from developing one multi-layered admissions strategy highlight the importance of equity-rather than equality-in any recruitment for learners from medically underserved communities.

The Indigenous primary health care and policy research network: Guiding innovation within primary health care with Indigenous peoples in Alberta.

In 2015, the Truth and Reconciliation Commission of Canada released its Final Report with 94 Calls to Action, several of which called upon the health care sector to reform based on the principles of reconciliation. In the province of Alberta, Canada, numerous initiatives have arisen to address the health legacy Calls to Action, yet there is no formal mechanism to connect them all. As such, these initiatives have resulted in limited improvements overall.

Participant-reported effect of an Indigenous health continuing professional development initiative for specialists.

Background: Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The 'Educating for Equity (E4E)' program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions.

Methods: The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged with and applied course content within an interactive format focusing on real-time feedback.

Adverse childhood experiences and health among indigenous persons experiencing homelessness.

Background: Current literature has established that adverse childhood experiences (ACEs) are associated with the onset of a variety of physical, mental, and behavioural illnesses. However, there are few studies that have thoroughly examined this association in low-income or marginalized groups.

Methods: To address this knowledge gap, this study used self-reported data on childhood experiences and adult health outcomes in a sample of 91 Indigenous persons experiencing homelessness.

An implementation history of primary health care transformation: Alberta's primary care networks and the people, time and culture of change.

Background: Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded through capitation, and operating as partnerships between the province's healthcare administration system and family physicians.

"There are still a lot of things that I need": a qualitative study exploring opportunities to improve the health services of First Nations People with arthritis seen at an on-reserve outreach rheumatology clinic.

Background: Arthritis is a highly prevalent disease and leading cause of disability in the Indigenous population. A novel model of care consisting of a rheumatology outreach clinic in an on-reserve primary healthcare center has provided service to an Indigenous community in Southern Alberta since 2010. Despite quality assessments suggesting this model of care improves accessibility and is effective in meeting treatment targets, substantial improvements in patient-reported outcomes have not been realized.