The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Ellen L Toth - One of the best experts on this subject based on the ideXlab platform.
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cultural continuity traditional indigenous language and diabetes in alberta First Nations a mixed methods study
International Journal for Equity in Health, 2014Co-Authors: Richard T Oster, Maria Mayan, Angela Grier, Rick Lightning, Ellen L TothAbstract:Introduction: We used an exploratory sequential mixed methods approach to study the association between cultural continuity, self-determination, and diabetes prevalence in First Nations in Alberta, Canada. Methods: We conducted a qualitative description where we interviewed 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity, self-determination, and their relationship to health and diabetes, in the Alberta First Nations context. Based on the qualitative findings, we then conducted a cross-sectional analysis using provincial administrative data and publically available data for 31 First Nations communities to quantitatively examine any relationship between cultural continuity and diabetes prevalence. Results: Cultural continuity, or “being who we are”, is foundational to health in successful First Nations. Self-determination, or “being a self-sufficient Nation”, stems from cultural continuity and is seriously compromised in today’ sA lberta Cree and Blackfoot Nations. Unfortunately, First Nations are in a continuous struggle with government policy. The intergenerational effects of colonization continue to impact the culture, which undermines the sense of self-determination, and contributes to diabetes and ill health. Crude diabetes prevalence varied dramatically among First Nations with values as low as 1.2% and as high as 18.3%. Those First Nations that appeared to have more cultural continuity (measured by traditional Indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socio-economic factors (p =0.007).
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cultural continuity traditional indigenous language and diabetes in alberta First Nations a mixed methods study
International Journal for Equity in Health, 2014Co-Authors: Richard T Oster, Maria Mayan, Angela Grier, Rick Lightning, Ellen L TothAbstract:We used an exploratory sequential mixed methods approach to study the association between cultural continuity, self-determination, and diabetes prevalence in First Nations in Alberta, Canada. We conducted a qualitative description where we interviewed 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity, self-determination, and their relationship to health and diabetes, in the Alberta First Nations context. Based on the qualitative findings, we then conducted a cross-sectional analysis using provincial administrative data and publically available data for 31 First Nations communities to quantitatively examine any relationship between cultural continuity and diabetes prevalence. Cultural continuity, or "being who we are", is foundational to health in successful First Nations. Self-determination, or "being a self-sufficient Nation", stems from cultural continuity and is seriously compromised in today´s Alberta Cree and Blackfoot Nations. Unfortunately, First Nations are in a continuous struggle with government policy. The intergenerational effects of colonization continue to impact the culture, which undermines the sense of self-determination, and contributes to diabetes and ill health. Crude diabetes prevalence varied dramatically among First Nations with values as low as 1.2% and as high as 18.3%. Those First Nations that appeared to have more cultural continuity (measured by traditional Indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socio-economic factors (p =0.007). First Nations that have been better able to preserve their culture may be relatively protected from diabetes.
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diabetes in pregnancy among First Nations women in alberta canada a retrospective analysis
BMC Pregnancy and Childbirth, 2014Co-Authors: Richard T Oster, Malcolm King, Donald W Morrish, Maria Mayan, Ellen L TothAbstract:In addition to increasing the risk of adverse birth outcomes, diabetes in pregnancy is thought to be an important driver of the epidemic of type 2 diabetes affecting Canada’s First Nations population. The relative contributions of gestational diabetes mellitus (GDM) and pre-existing diabetes are not well understood. We generated a comprehensive epidemiological profile of diabetes in pregnancy over a 10-year period among the First Nations population of Alberta, Canada. De-identified administrative data for 427,058 delivery records were obtained for the years 2000–2009. Pregnancy risk factors and delivery outcomes were described and compared by ethnicity (First Nations vs. non-First Nations) and diabetes status. Age-adjusted prevalence values for GDM and pre-existing diabetes were calculated and were compared by ethnicity. Longitudinal changes over time were also examined. Predictors were explored using logistic regression analysis. First Nations women had more antenatal risk factors and adverse infant outcomes that were compounded by diabetes. First Nations descent was an independent predictor of diabetes in pregnancy (p < 0.001). GDM prevalence was significantly higher among First Nations (6.1%) compared to non-First Nations women (3.8%; p < 0.001), but prevalence values increased significantly over time only in non-First Nations women (4.5 average annual percent change; p < 0.05). The prevalence of pre-existing diabetes was stable over time in both groups, but First Nations women experienced a 2.5-fold higher overall prevalence compared with non-First Nations women (1.5% vs. 0.6%, respectively; p < 0.001). Although First Nations women experience a higher overall prevalence of diabetes in pregnancy, the lack of increase in the prevalence over time is encouraging. However, because high-risk pregnancies and poor outcomes are more common among First Nations women, particularly those with diabetes, strategies to improve perinatal care must be implemented.
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diabetes in pregnancy among First Nations women in alberta canada a retrospective analysis
BMC Pregnancy and Childbirth, 2014Co-Authors: Richard T Oster, Malcolm King, Donald W Morrish, Maria Mayan, Ellen L TothAbstract:Background In addition to increasing the risk of adverse birth outcomes, diabetes in pregnancy is thought to be an important driver of the epidemic of type 2 diabetes affecting Canada’s First Nations population. The relative contributions of gestational diabetes mellitus (GDM) and pre-existing diabetes are not well understood. We generated a comprehensive epidemiological profile of diabetes in pregnancy over a 10-year period among the First Nations population of Alberta, Canada.
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diabetes care and health status of First Nations individuals with type 2 diabetes in alberta
Canadian Family Physician, 2009Co-Authors: Richard T Oster, Shainoor Virani, David R Strong, Sandra Shade, Ellen L TothAbstract:OBJECTIVE To dcescribe the state of diabetes care among Alberta First Nations individuals with diabetes living on reserves. DESIGN Survey and screening for diabetes-related complications. SETTING Forty-three Alberta First Nations communities. PARTICIPANTS A total of 743 self-referred First Nations individuals with known diabetes. MAIN OUTCOME MEASURES Clinical measurements (glycated hemoglobin A1c levels, body mass index, waist circumference, total cholesterol, blood pressure, and the presence of kidney complications or proteinuria, retinopathy, and foot abnormalities), self-reported health services utilization, clinical history, and knowledge of and satisfaction with diabetes services. RESULTS Female participants tended to be more obese ( P < .05) and to have abnormal waist circumferences more often than men ( P < .05). Male participants, however, had a higher proportion of proteinuria ( P < .05), hypertension ( P < .05), limb complications ( P < .05), and retinopathy ( P < .05). Family physicians were the main diabetes care providers for most participants. Nearly half the participants felt they did not have care from a diabetes team. A total of 38% had never seen dietitians. Diabetes-related concerns were responsible for 24% of all hospitalizations and emergency department visits. Approximately 46% and 21% of participants had recommended hemoglobin A1c testing and foot examiNations, respectively. Only 24% of participants with kidney complications were receiving treatment. A considerable proportion of participants had undiagnosed complications of diabetes: kidney damage or proteinuria (23%), high cholesterol (22%), foot complications (11%), hypertension (9%), and retinopathy (7%). CONCLUSION Diabetes care is suboptimal in Alberta First Nations communities. Rural physicians caring for First Nations individuals on reserves should be involved, along with other members of diabetes health care teams, in strategies to improve diabetes care. Our results justify the need for community-based screening for diabetes control and complications in First Nation communities.
Anke S Kessler - One of the best experts on this subject based on the ideXlab platform.
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property rights on First Nations reserve land
Social Science Research Network, 2018Co-Authors: Fernando M Aragon, Anke S KesslerAbstract:This paper examines the economic effects of existing private property rights on First Nations' reserves. We focus on three forms of land tenure regimes: lawful possession, designated land, and permits. These land regimes have been used to create individual land holdings, and grant secure and transferable rights of use of reserve land to band and non-band members. Using confidential Census micro-data and rich administrative data, we find evidence of improvements in home ownership and housing conditions, as well as increments in band's public spending. However, we find no significant impact on Aboriginal household income nor employment outcomes. Instead, we document that individual land holdings are associated with sizeable increases in the non-Aboriginal population. Our findings suggest that some caution is warranted when discussing the potential economic benefits of property right reforms for First Nations' communities.
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property rights on First Nations reserve land
Research Papers in Economics, 2017Co-Authors: Fernando M Aragon, Anke S KesslerAbstract:This paper examines the economic effects of existing private property rights on First Nations’ reserves. We focus on three forms of land tenure regimes: lawful possession, designated land, and permits. These land regimes have been used to create individual land holdings, and grant, secure and transferable, rights of use of reserve land to band and non-band members. Using confidential Census micro-data and rich administrative data, we find evidence of improvements in home ownership and housing conditions, as well as increments in band’s public spending. However, we do not find significant effects on household income nor employment outcomes. Instead, we document a sizeable increase in non-Aboriginal population. Our findings suggest that some caution is warranted when discussing the potential economic benefits of property rights reforms for First Nations’ communities.
Richard T Oster - One of the best experts on this subject based on the ideXlab platform.
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cultural continuity traditional indigenous language and diabetes in alberta First Nations a mixed methods study
International Journal for Equity in Health, 2014Co-Authors: Richard T Oster, Maria Mayan, Angela Grier, Rick Lightning, Ellen L TothAbstract:Introduction: We used an exploratory sequential mixed methods approach to study the association between cultural continuity, self-determination, and diabetes prevalence in First Nations in Alberta, Canada. Methods: We conducted a qualitative description where we interviewed 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity, self-determination, and their relationship to health and diabetes, in the Alberta First Nations context. Based on the qualitative findings, we then conducted a cross-sectional analysis using provincial administrative data and publically available data for 31 First Nations communities to quantitatively examine any relationship between cultural continuity and diabetes prevalence. Results: Cultural continuity, or “being who we are”, is foundational to health in successful First Nations. Self-determination, or “being a self-sufficient Nation”, stems from cultural continuity and is seriously compromised in today’ sA lberta Cree and Blackfoot Nations. Unfortunately, First Nations are in a continuous struggle with government policy. The intergenerational effects of colonization continue to impact the culture, which undermines the sense of self-determination, and contributes to diabetes and ill health. Crude diabetes prevalence varied dramatically among First Nations with values as low as 1.2% and as high as 18.3%. Those First Nations that appeared to have more cultural continuity (measured by traditional Indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socio-economic factors (p =0.007).
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cultural continuity traditional indigenous language and diabetes in alberta First Nations a mixed methods study
International Journal for Equity in Health, 2014Co-Authors: Richard T Oster, Maria Mayan, Angela Grier, Rick Lightning, Ellen L TothAbstract:We used an exploratory sequential mixed methods approach to study the association between cultural continuity, self-determination, and diabetes prevalence in First Nations in Alberta, Canada. We conducted a qualitative description where we interviewed 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity, self-determination, and their relationship to health and diabetes, in the Alberta First Nations context. Based on the qualitative findings, we then conducted a cross-sectional analysis using provincial administrative data and publically available data for 31 First Nations communities to quantitatively examine any relationship between cultural continuity and diabetes prevalence. Cultural continuity, or "being who we are", is foundational to health in successful First Nations. Self-determination, or "being a self-sufficient Nation", stems from cultural continuity and is seriously compromised in today´s Alberta Cree and Blackfoot Nations. Unfortunately, First Nations are in a continuous struggle with government policy. The intergenerational effects of colonization continue to impact the culture, which undermines the sense of self-determination, and contributes to diabetes and ill health. Crude diabetes prevalence varied dramatically among First Nations with values as low as 1.2% and as high as 18.3%. Those First Nations that appeared to have more cultural continuity (measured by traditional Indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socio-economic factors (p =0.007). First Nations that have been better able to preserve their culture may be relatively protected from diabetes.
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diabetes in pregnancy among First Nations women in alberta canada a retrospective analysis
BMC Pregnancy and Childbirth, 2014Co-Authors: Richard T Oster, Malcolm King, Donald W Morrish, Maria Mayan, Ellen L TothAbstract:In addition to increasing the risk of adverse birth outcomes, diabetes in pregnancy is thought to be an important driver of the epidemic of type 2 diabetes affecting Canada’s First Nations population. The relative contributions of gestational diabetes mellitus (GDM) and pre-existing diabetes are not well understood. We generated a comprehensive epidemiological profile of diabetes in pregnancy over a 10-year period among the First Nations population of Alberta, Canada. De-identified administrative data for 427,058 delivery records were obtained for the years 2000–2009. Pregnancy risk factors and delivery outcomes were described and compared by ethnicity (First Nations vs. non-First Nations) and diabetes status. Age-adjusted prevalence values for GDM and pre-existing diabetes were calculated and were compared by ethnicity. Longitudinal changes over time were also examined. Predictors were explored using logistic regression analysis. First Nations women had more antenatal risk factors and adverse infant outcomes that were compounded by diabetes. First Nations descent was an independent predictor of diabetes in pregnancy (p < 0.001). GDM prevalence was significantly higher among First Nations (6.1%) compared to non-First Nations women (3.8%; p < 0.001), but prevalence values increased significantly over time only in non-First Nations women (4.5 average annual percent change; p < 0.05). The prevalence of pre-existing diabetes was stable over time in both groups, but First Nations women experienced a 2.5-fold higher overall prevalence compared with non-First Nations women (1.5% vs. 0.6%, respectively; p < 0.001). Although First Nations women experience a higher overall prevalence of diabetes in pregnancy, the lack of increase in the prevalence over time is encouraging. However, because high-risk pregnancies and poor outcomes are more common among First Nations women, particularly those with diabetes, strategies to improve perinatal care must be implemented.
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diabetes in pregnancy among First Nations women in alberta canada a retrospective analysis
BMC Pregnancy and Childbirth, 2014Co-Authors: Richard T Oster, Malcolm King, Donald W Morrish, Maria Mayan, Ellen L TothAbstract:Background In addition to increasing the risk of adverse birth outcomes, diabetes in pregnancy is thought to be an important driver of the epidemic of type 2 diabetes affecting Canada’s First Nations population. The relative contributions of gestational diabetes mellitus (GDM) and pre-existing diabetes are not well understood. We generated a comprehensive epidemiological profile of diabetes in pregnancy over a 10-year period among the First Nations population of Alberta, Canada.
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diabetes care and health status of First Nations individuals with type 2 diabetes in alberta
Canadian Family Physician, 2009Co-Authors: Richard T Oster, Shainoor Virani, David R Strong, Sandra Shade, Ellen L TothAbstract:OBJECTIVE To dcescribe the state of diabetes care among Alberta First Nations individuals with diabetes living on reserves. DESIGN Survey and screening for diabetes-related complications. SETTING Forty-three Alberta First Nations communities. PARTICIPANTS A total of 743 self-referred First Nations individuals with known diabetes. MAIN OUTCOME MEASURES Clinical measurements (glycated hemoglobin A1c levels, body mass index, waist circumference, total cholesterol, blood pressure, and the presence of kidney complications or proteinuria, retinopathy, and foot abnormalities), self-reported health services utilization, clinical history, and knowledge of and satisfaction with diabetes services. RESULTS Female participants tended to be more obese ( P < .05) and to have abnormal waist circumferences more often than men ( P < .05). Male participants, however, had a higher proportion of proteinuria ( P < .05), hypertension ( P < .05), limb complications ( P < .05), and retinopathy ( P < .05). Family physicians were the main diabetes care providers for most participants. Nearly half the participants felt they did not have care from a diabetes team. A total of 38% had never seen dietitians. Diabetes-related concerns were responsible for 24% of all hospitalizations and emergency department visits. Approximately 46% and 21% of participants had recommended hemoglobin A1c testing and foot examiNations, respectively. Only 24% of participants with kidney complications were receiving treatment. A considerable proportion of participants had undiagnosed complications of diabetes: kidney damage or proteinuria (23%), high cholesterol (22%), foot complications (11%), hypertension (9%), and retinopathy (7%). CONCLUSION Diabetes care is suboptimal in Alberta First Nations communities. Rural physicians caring for First Nations individuals on reserves should be involved, along with other members of diabetes health care teams, in strategies to improve diabetes care. Our results justify the need for community-based screening for diabetes control and complications in First Nation communities.
John D O Neil - One of the best experts on this subject based on the ideXlab platform.
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type 2 diabetes mellitus in canada s First Nations status of an epidemic in progress
Canadian Medical Association Journal, 2000Co-Authors: Kue T Young, Brenda Elias, Jeff Reading, John D O NeilAbstract:THIS REVIEW PROVIDES A STATUS REPORT ON THE EPIDEMIC of type 2 diabetes mellitus that is affecting many of Canada’s First Nations. We focus on the published literature, especially reports published in the past 2 decades, and incorporate data from the Aboriginal Peoples Survey and the First Nations and Inuit Regional Health Survey. We look at the extent and magnitude of the problem, the causes and risk factors, primary prevention and screening, clinical care and education, and cultural concepts and traditional knowledge. The epidemic of type 2 diabetes is still on the upswing, with a trend toward earlier age at onset. Genetic‐environmental interactions are the likely cause. Scattered intervention projects have been implemented and evaluated, and some show promise. The current health and social repercussions of the disease are considerable, and the long-term outlook remains guarded. A national Aboriginal diabetes strategy is urgently needed.
Kue T Young - One of the best experts on this subject based on the ideXlab platform.
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obesity and lowered cognitive performance in a canadian First Nations population
Obesity, 2009Co-Authors: Jennifer H Fergenbaum, Anthony J Hanley, Sharon Bruce, Wendy Lou, Carol E Greenwood, Kue T YoungAbstract:The association between obesity, other cardiovascular risk factors, and cognitive function in a Canadian First Nations population was investigated using a cross-sectional design. Eligible individuals were aged >/=18 years, without a history of stroke, nonpregnant, with First Nations status, and who had undergone cognitive function assessment by the Clock Drawing Test (CDT) and Trail Making Test Parts A and B. Parts A and B were combined into an Executive Function Score (TMT-exec). Hypertension, a previous history of cardiovascular disease, dyslipidemia, metabolic syndrome, insulin resistance, and the presence and duration of diabetes were examined in addition to obesity. In the case of TMT-exec only, obese individuals were at an approximately fourfold increased risk for lowered cognitive performance compared to those who were not obese in multivariable models (odds ratio (OR): 3.77, 95% confidence interval (CI): 1.46-9.72) whereas there was no effect for overweight individuals compared to those with a normal weight in unadjusted analysis. Those having an increased waist circumference also had 5 times the risk compared to those without an increased waist circumference (OR: 5.41, 95% CI: 1.83-15.99). Adjusted for age, sex, and insulin resistance, individuals having the metabolic syndrome were at an approximately fourfold increased risk compared to those without the metabolic syndrome (OR: 3.67, 95% CI: 1.34-10.07). No other cardiovascular risk factors were associated. Obesity and metabolic syndrome were associated with lowered cognitive performance. These results highlight the importance of studying the health effects of obesity beyond traditional disease endpoints, even in a relatively youthful population.
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type 2 diabetes mellitus in canada s First Nations status of an epidemic in progress
Canadian Medical Association Journal, 2000Co-Authors: Kue T Young, Brenda Elias, Jeff Reading, John D O NeilAbstract:THIS REVIEW PROVIDES A STATUS REPORT ON THE EPIDEMIC of type 2 diabetes mellitus that is affecting many of Canada’s First Nations. We focus on the published literature, especially reports published in the past 2 decades, and incorporate data from the Aboriginal Peoples Survey and the First Nations and Inuit Regional Health Survey. We look at the extent and magnitude of the problem, the causes and risk factors, primary prevention and screening, clinical care and education, and cultural concepts and traditional knowledge. The epidemic of type 2 diabetes is still on the upswing, with a trend toward earlier age at onset. Genetic‐environmental interactions are the likely cause. Scattered intervention projects have been implemented and evaluated, and some show promise. The current health and social repercussions of the disease are considerable, and the long-term outlook remains guarded. A national Aboriginal diabetes strategy is urgently needed.
