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Background. International commitments exist for the safeguarding of health and the prevention of ill health. One of the earliest commitments is the Declaration of Alma-Ata (1978), which provides 5 principles guiding primary health care: equity, community participation, health promotion, intersectoral collaboration and appropriate technology. These broadly applicable international commitments are premised on the World Health Organization's multifaceted definition of health. The environment is one sector in which these commitments to safeguarding health can be applied. Giant Mine, a contaminated former gold mine in the Northwest Territories, Canada, represents potential threats to all aspects of health. Strategies for managing such threats usually involve an obligation to engage the affected communities through consultation. Objective. To examine the remediation and consultation process associated with Giant Mine within the context of commitments to safeguard health and well-being through adapting and applying the principles of primary health care. Methods. Semi-structured interviews with purposively selected key informants representing government proponents and community members were conducted. Results. In reviewing themes which emerged from a series of interviews exploring the community consultation process for the remediation of Giant Mine, the principles guiding primary health were mapped to consultation in the North: (a) "equity" is the capacity to fairly and meaningfully participate in the consultation; (b) "community participation" is the right to engage in the process through reciprocal dialogue; (c) "health promotion" represents the need for continued information sharing towards awareness; (d) "intersectoral collaboration" signifies the importance of including all stakeholders; and (e) "appropriate technology" is the need to employ the best remediation actions relevant to the site and the community. Conclusions. Within the context of mining remediation, these principles form an appropriate framework for viewing consultation as a means of meeting international obligations to safeguard health. [ABSTRACT FROM AUTHOR]

Background. The development and implementation of a remediation plan for the residual arsenic trioxide stored at the former Giant Mine site in the Canadian Northwest Territories has raised important issues related to trust. Social and individual trust of those responsible for making decisions on risks is critically important in community judgements on risk and the acceptability of risk management decisions. Trust is known to be affected by value similarity and confidence in past performance, which serve as interacting sources of cooperation in acting toward a common goal. Objective. To explore the elements of trust associated with the development and implementation of the Giant Mine Remediation Plan. Design. Semi-structured interviews were conducted with eight purposively selected key informants representing both various interested and affected parties and the two government proponents. Results. Five primary issues related to trust were identified by the participants: (1) a historical legacy of mistrust between the community (particularly Aboriginal peoples) and government; (2) barriers to building trust with the federal government; (3) limited community input and control over the decision-making process; (4) the conflicted and confounded role of the government agencies being both proponent and regulator, and the resulting need for independent oversight; and (5) distrust of the government to commit to the perpetual care required for the remediation option selected. Conclusions. The dual-mode model of trust and confidence was shown to be a useful framework for understanding the pivotal role of trust in the development of the Giant Mine Remediation Plan. Failure to recognize issues of trust based on value dissimilarity and lack of confidence based on past performance have resulted in a lack of cooperation characterized by delayed remediation and a prolonged and expensive consultation process. Government recognition of the importance of trust to these issues will hopefully improve future communication and public engagement endeavours. [ABSTRACT FROM AUTHOR]

Background: Approximately 50% of all youth-onset type 2 diabetes mellitus (T2DM) in Canada occurs in Indigenous children. In adults, cardiovascular disease is one of the leading causes of mortality in First Nations communities, and diabetes is a significant contributor to the risk of developing this disorder. The early onset of diabetes may predispose these children to premature cardiovascular disease and influence their longevity and quality of life. As a result, the implementation of culturally tailored obesity and T2DM primary prevention programs is vital. This systematic review aims to assess the effectiveness of existing traditional knowledge-based lifestyle intervention programs on preventing obesity and T2DM in Indigenous children in Canada. Methods: We will conduct database searches in MEDLINE, Embase, PsycINFO, SPORTDiscus, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, and the Cochrane Controlled Register of Trials. We will also conduct grey literature searches of central repository of trials (ClinicalTrials.gov), ProQuest Dissertations, Theses A&I, and Indigenous studies portal research tools. Reviewers will independently review titles, abstracts, and full-text articles retrieved from databases to assess potentially eligible studies, and relevant articles will be assessed for risk of bias and quality. The primary outcomes include the change in body mass index z-scores or a diagnosis of diabetes. The secondary outcomes include the change in measures of adiposity as well as lifestyle and metabolic profiles. A meta-analysis will be performed if two or more studies have used similar study designs, comparable intervention techniques , similar populations and measured similar outcomes. Discussion: This review will provide a summary of current interventions to prevent obesity and T2DM in Indigenous children in Canada and help determine the gaps in the literature so that interventions can be developed to control the surge in pediatric T2DM in Indigenous communities. Systematic review registration: PROSPERO CRD42017072781 [ABSTRACT FROM AUTHOR]