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Because the Chinese kinship and the Spanish one belong to the Sudanese type and Eskimo type respectively, there is a huge asymmetry and non-equivalence in the address terminologies. Although the Chinese kinship address terms, like the Spanish ones, have vocative function in the family context as well as in the non-family one, for the linguistic and cultural difference the Chinese kinship address terms have a wider and more complicated application. The comparison between 姐(姐)/jie(jie)/and its translation into Spanish in Sueño de las mansiones rojas has proved this peculiarity in the semantics and the pragmatics. [ABSTRACT FROM AUTHOR]

Among African tribes, Inuit, the Druze, Hinduism, Buddhism, Jainism, and Sikhism, a diversity of attitudes toward suicide exists. The meaning of suicide appears to be largely a reflection of the impact of the death on friends, family, and the broader community; the circumstances of the individual within their community; and the specific religious implications of suicide. The interpersonal impact is seen as consisting of the material impact of suicide; the spiritual and emotional burden endured by the community; and norms related to suicide. Individual factors include the degree of social integration; the social impact of suicide before death; and how the individual anticipates suicide affecting their afterlife. Taken together, the commonly repeated notion that reincarnation beliefs lend themselves to suicidal behavior finds little support, and instead it appears that social and pragmatic issues shape the meaning and interpretation of religious beliefs which in turn buffer or facilitate suicidal behavior. [ABSTRACT FROM AUTHOR]

This article presents an overview of past and current grief rituals and practices and existing grassroots and institutional initiatives seeking to address the complex, prolonged, and traumatic grief experienced by many Inuit living in Quebec. While conducting a study seeking to identify the strengths, resources, and challenges for Nunavik's Inuit communities related to end-of-life care, results emerged concerning how family caregivers' grief related to the dying process was compounded by the sequelae of historic loss experiences (e.g., losses related to Canada's federal policies, including residential schools, forced relocations, and dog slaughters) and by present loss experiences (e.g., tragic and sudden deaths in local communities). To better support caregivers, an understanding of these grief experiences and a vision of bereavement care inclusive of community mobilization efforts to develop bereavement training and support is needed. We conclude with a discussion of a community capacity approach to bereavement care. [ABSTRACT FROM AUTHOR]

While English as a second language is a component of the education programme in Nunavik, Canada, Inuit (Indigenous people of the Arctic) need to protect Inuktitut (Inuit language) as they navigate an online world where English is often the lingua franca on social media. Inuit qaujimajatuqangit (traditional knowledge) could provide the framework for decolonizing English as a second language education, as it has guided Inuit through centuries of change. This narrative literature review with commentary analysed 50 studies and related resources, summarizing Nunavik's colonial history of linguistic imperialism and how some Indigenous communities resisted colonialism by decolonizing their education programmes. This analysis found a gap in studies specific to decolonizing English as a second language education in the Inuit context; therefore, the findings extrapolated that Inuit can decolonize by decentralizing colonial practices and centralizing Inuit qaujimajatuqangit and Inuktitut. The literature review offers pedagogical recommendations for decolonizing English as a second language education in Nunavik and other Indigenous communities. [ABSTRACT FROM AUTHOR]

This scoping literature review examines the extent of research in second-language learning through intercultural communication on social media, specifically in Inuit (Indigenous people of the Arctic) communities. The investigation maps out gaps in the literature and explains the need for research in the Inuit context. Forty-seven studies and related resources are examined through a conceptual lens focused on the intersections between intercultural communication, social media, and Indigenous peoples, revealing concentrations on authentic interaction, Indigenous identity, language revitalization, and maintenance. Particular to the Inuit context, the analysis identifies the following gaps: (a) intercultural communication in second-language learning and Inuit; (b) second language learning through social media and Inuit; and (c) intercultural communication in second-language learning via social media and Inuit. None of the studies reviewed describe pedagogical applications for Inuit. This scoping literature review suggests future research and curriculum development that could be implemented in the Inuit context, particularly in Nunavik. [ABSTRACT FROM AUTHOR]

Background: Transferring pregnant women out of their communities for childbirth continues to affect Inuit women living in Nunavik—Inuit territory in Northern Quebec. With estimates of maternal evacuation rates in the region between 14% and 33%, we examine how to support culturally safe birth for Inuit families when birth must take place away from home. Methods: A participatory research approach explored perceptions of Inuit families and their perinatal healthcare providers in Montreal for culturally safe birth, or "birth in a good way" in the context of evacuation, using fuzzy cognitive mapping. We used thematic analysis, fuzzy transitive closure, and an application of Harris' discourse analysis to analyze the maps and synthesize the findings into policy and practice recommendations. Results: Eighteen maps authored by 8 Inuit and 24 service providers in Montreal generated 17 recommendations related to culturally safe birth in the context of evacuation. Family presence, financial assistance, patient and family engagement, and staff training featured prominently in participant visions. Participants also highlighted the need for culturally adapted services, with provision of traditional foods and the presence of Inuit perinatal care providers. Stakeholder engagement in the research resulted in dissemination of the findings to Inuit national organizations and implementation of several immediate improvements in the cultural safety of flyout births to Montreal. Conclusions: The findings point toward the need for culturally adapted, family‐centered, and Inuit‐led services to support birth that is as culturally safe as possible when evacuation is indicated. Application of these recommendations has the potential to benefit Inuit maternal, infant, and family wellness. [ABSTRACT FROM AUTHOR]

Beginning January of 2020, COVID-19 cases detected in Arctic countries triggered government policy responses to stop transmission and limit caseloads beneath levels that would overwhelm existing healthcare systems. This review details the various restrictions, health mandates, and transmission mitigation strategies imposed by governments in eight Arctic countries (the United States, Canada, Greenland, Norway, Finland, Sweden, Iceland, and Russia) during the first year of the COVID-19 pandemic, through 31 January 2021s31 January 2021. We highlight formal protocols and informal initiatives adopted by local communities in each country, beyond what was mandated by regional or national governments. This review documents travel restrictions, communications, testing strategies, and use of health technology to track and monitor COVID-19 cases. We provide geographical and sociocultural background and draw on local media and communications to contextualise the impact of COVID-19 emergence and prevention measures in Indigenous communities in the Arctic. Countries saw varied case rates associated with local protocols, governance, and population. Still, almost all regions maintained low COVID-19 case rates until November of 2020. This review was produced as part of an international collaboration to identify community-driven, evidence-based promising practices and recommendations to inform pan-Arctic collaboration and decision making in public health during global emergencies. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM), WHO grade IV, is the most common primary malignant brain tumour among adults with a devastating overall survival of 14–22 months. Standard treatment of GBM includes maximum safe resection, radiotherapy plus concomitant and adjuvant temozolomide (TMZ), given over a period of approximately 9 months. Treatment and follow-up for Greenlandic patients with GBM are managed at Rigshospitalet (RH), Copenhagen. Greenlandic GBM patients, therefore, travel back and forth to RH, often unaccompanied, and challenged by cognitive failure or other symptoms from their disease and/or treatment. Few Greenlandic patients are diagnosed with GBM annually, but considering the poor prognosis and short remaining lifespan, it would be preferable to limit their travels. TMZ is administrated as capsules. Health personnel at Queen Ingrid's Hospital (DIH), Nuuk, are trained in treating other oncological diseases and handling side effects. Hence, it could be investigated whether administration of adjuvant TMZ at DIH could be feasible after personnel education as well as economic consideration and compensation, in close collaboration with neuro oncologists at RH. In this article, we describe the Greenlandic cancer treatment, and the typical workflow from diagnosis of GBM to treatment to progression. [ABSTRACT FROM AUTHOR]

Across Canada, the COVID-19 pandemic placed considerable stress on territorial and provincial healthcare systems. For Nunavut, the need to continue to provide access to critical care to its citizens meant that medical travel to provincial points of care (Edmonton, Winnipeg and Ottawa) had to continue through the pandemic. This complexity created challenges related to the need to keep Nunavut residents safe while accessing care, and to manage the risk of outbreaks in Nunavut resultant from patients returning home. A number of strategies were adopted to mitigate risk, including the expansion of virtual care, self-isolation requirements before returning from Winnipeg, and a level of cross-jurisdictional coordination previously unprecedented. Structural limitations in Nunavut however limited opportunities to expand virtual care, and to allow providers from Manitoba to access the Nunavut's electronic medical records of patients requiring follow up. Thus, known and long-standing issues exacerbated vulnerabilities within the Nunavut healthcare system. We conclude that addressing cross-jurisdictional issues would be well served by the development of a more formal Nunavut-Manitoba agreement (with similar agreements with Ontario and Alberta), outlining mutual obligations and accountabilities. [ABSTRACT FROM AUTHOR]

Eekeeluak Avalak, an 18-year-old Inuk wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015. Avalak openly attributed sport – specifically wrestling – to saving his own life. This story raises important questions about the role of sport and traditional games in Inuit suicide prevention strategies. Few studies have examined the role of sport or traditional games in Inuit suicide prevention strategies. In an attempt to reduce Inuit suicide rates, in addition to the National Inuit Prevention Strategy, three of the four land claim regions that constitute Inuit Nunangat have suicide prevention strategies. In this study, we used settler colonial theory, critical Inuit studies, and content analysis to examine if and how sport and Inuit traditional games are identified as prevention tools in these Inuit suicide prevention strategies. The results demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, evidence-based and community-driven approaches could be funded, created, implemented, and evaluated as culturally-safe Inuit mental health intervention models to address the disproportionately high suicide rates among Inuit in Inuit Nunangat. [ABSTRACT FROM AUTHOR]

We document community responses to the COVID-19 pandemic among Inuit living in the province of Manitoba, Canada. This study was conducted by the Manitoba Inuit Association and a Council of Inuit Elders, in partnership with researchers from the University of Manitoba. We present findings from 12 health services providers and decision-makers, collected in 2021.Although Public Health orders led to the closure of the Manitoba Inuit Association's doors to community events and drop-in activities, it also created opportunities for the creation of programming and events delivered virtually and through outreach. The pandemic exacerbated pre-existing health and social system's shortcomings (limited access to safe housing, food insecurity) and trauma-related tensions within the community. The Manitoba Inuit Association achieved unprecedented visibility with the provincial government, receiving bi-weekly reports of COVID-19 testing, results and vaccination rates for Inuit. We conclude that after over a decade of advocacy received with at best tepid enthusiasm by federal and provincial governments, the Manitoba Inuit Association was able effectively advocate for Inuit-centric programming, and respond to Inuit community's needs, bringing visibility to a community that had until then been largely invisible. Still, many programs have been fueled with COVID-19 funding, raising the issue of sustainability. [ABSTRACT FROM AUTHOR]

Inuit face worse cancer survival rates and outcomes than the general Canadian population. Persistent health disparities cannot be understood without examining the structural factors that create inequities and continue to impact the health and well-being of Inuit. This scoping review aims to synthesise the available published and grey literature on the structural factors that influence cancer care experienced by Inuit in Canada. Guided by Inuit input from Pauktuutit Inuit Women of Canada as well as the Joanna Briggs Institute scoping review methodology, a comprehensive electronic search along with hand-searching of grey literature and relevant journals was conducted. A total of 30 papers were included for analysis and assessment of relevance. Findings were organised into five categories as defined in the a priori framework related to colonisation, as well as health systems, social, economic, and political structures. The study results highlight interconnections between racism and colonialism, the lack of health service information on urban Inuit, as well as the need for system-wide efforts to address the structural barriers in cancer care. [ABSTRACT FROM AUTHOR]

Dental caries is considered the third most important scourge in the world. In North America, Inuit populations are the population the most severely affected by dental caries. It is often assumed that this situation can be explained by a combination of factors classical for Indigenous populations: remoteness (geographical distance), low economic status and low health literacy (cultural distance). Using a bibliographic approach, we tested this hypothesis of the "distance effect" by exploring the caries prevalence in other Indigenous populations living in high-income countries. Next, we tested whether the high prevalence of caries is due to population-specific characteristics by tracking caries prevalence over the past few centuries. In result, we showed that while other Indigenous populations are more impacted by caries than the general populations, the Inuit populations present the highest prevalence. Paradoxically, we showed also that past Inuit populations were almost immune to caries before 1950. These two elements suggest that the prevalence of caries observed presently is a recent maladaptation and that beyond the effect of cultural and geographical distance, specific biocultural factors have to be investigated. [ABSTRACT FROM AUTHOR]

Since the 1970s, suicide has been a major public health issue in Greenland. The World Health Organization has emphasised the importance of the identification of both risk and protective factors in relation to suicide. The aim of this paper was to identify scientific literature on risk and protective factors for suicide and suicidal behaviour among Greenland Inuit. Searches in PubMed and PsycInfo resulted in 420 studies that were screened by three of the authors. After screening, the authors included 15 studies that were subject to quality assessment and data extraction. All 15 studies reported on risk factors, and only three mentioned protective factors. Most reported risk factors were on an individual level and were related to socioeconomic status, mental health, alcohol and substance use, and life stress. Risk factors related to the family mainly related to adverse childhood experiences, while the community level concerned access to education, work, and conflicts. The results indicate a large knowledge gap about protective factors for suicide and suicidal behaviour. The few protective factors reported were related to men having a family, high socioeconomic status, and being born between 1901 and 1950. [ABSTRACT FROM AUTHOR]

The study evaluates the outcome after surgery for pancreatic and periampullary tumors in Greenlandic Inuit with overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) as secondary outcome. Results were compared with Danish patients with an identical tumor stage and age operated at the same hospital during the same period from 31. January 1999 to 31. January 2021. Follow up was minimum one year. Preoperative health data shoved a higher rate of smoking among Greenlandic patients, but a lower preoperative comorbidity than in Danish patients. Patients from Greenland had a lower resection rate and a higher rate of palliative operations. Postoperative complications and in-hospital mortality were not significantly different. Adjuvant oncologic treatment was well accepted by Greenlandic patients but less common in a palliative setting than in Danish patients. The one, two, and five-year survival in Greenlandic and Danish patients after radical operation for PDAC was 54.4% vs. 74.6%, 23.4% vs. 48.6%, and 0.0% vs. 23.4%, respectively. The overall survival with non-resectable PDAC was 5.9 and 8.8 months, respectively. It is concluded that although patients from Greenland have the same access to specialized treatment, the outcome after treatment for pancreatic and periampullary cancer is less favorable than in Danish patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate prevalence of patients with asthma in Greenland according to age, gender and residence and to investigate the associated quality of care. The study was performed as a cross-sectional study with data extracted from the Greenlandic electronical medical record. A total of 870 patients aged 12 years or above were diagnosed with asthma at the end of 2022, corresponding to a prevalence of 1.9%. In 2020, the total prevalence was 0.2%. The prevalence of patients aged 12 years or above with asthma was highest among patients in Nuuk (3.3%) compared with patients in the remaining parts of Greenland (1.1%). More women than men were diagnosed with asthma, and the prevalence increased with age from 20 to 59 years. The prevalence of current smokers was high among the asthma population. The quality of care was significantly higher among patients living in Nuuk for all process indicators compared with patients from the remaining parts of Greenland. The prevalence of asthma in Greenland is low compared to other comparable populations and might be underestimated. Initiatives supporting increased focus on diagnosing asthma are thus warranted. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effect of diabetes and the diabetogenic TBC1D4 variant on kidney function in Greenland in a population-based setting. Health survey data and TBC1D4 genotypes from 5,336 Greenlanders were used to estimate odds ratios (ORs) of albuminuria (>30 mg/g creatinine) and chronic kidney disease (CKD, eGFR <60 ml/min/1.73m2), comparing individuals with and without diabetes, including the effect of TBC1D4 variant. Of the 3,909 participants with complete data, 9.3% had diabetes. Albuminuria was found in 27.6% and 9.5% and CKD was found in 10.8% and 6.3% among those with and without diabetes, respectively. Diabetes was cross-sectionally associated with an increased risk of albuminuria (OR (95% CI) = 2.37 (1.69,3.33); p < 0.001) and the TBC1D4 variant protected against albuminuria (OR (95% CI) = 0.44 (0.22,0.90); p = 0.02) in a multivariable model. Neither diabetes nor the TBC1D4 variant significantly associated with CKD. The presence/absence of diabetes did not predict changes in eGFR and UACR in longitudinal analyses. Diabetes conferred an increased risk of albuminuria, and the TBC1D4 variant was associated with a decreased risk of albuminuria, but neither was associated with CKD. The potential renoprotective association of the TBC1D4 variant on albuminuria calls for further studies. [ABSTRACT FROM AUTHOR]

To estimate the frequencies of self-reported middle ear and hearing complaints and vertigo/dizziness in adult Greenlanders. Furthermore, to examine if there has been a development in the frequency of these complaints within a 20-year period. A structured questionnaire concerning middle ear disease and related neuro-otological symptoms was mailed to 400 randomly selected adult Greenlanders between 18 and 60 years of age in 1995. In 2014, the questions were included for the same age group in the general Greenlandic Health Survey. The questionnaires contained a total of six identical questions. In 1995, 281 participants (70%) replied to the questionnaire. In 2014, 1,639 participants (78%) replied. We found that in 1995 the two youngest age groups (18–29- and 30–39-year-olds) had the highest relative number of ear discharge. Approximately one-third of the participants in these two age groups reported to have had ear discharge, while this was only reported by 17% of the 18–29-year-olds and 16% of the 30–39-year-olds in 2014 (95% CI [0.03, 0.3] and [0.1, 0.3], respectively). The oldest age group indicated the lowest relative number of experiences of ear discharge in both 1995 and 2014 (18% and 17%, respectively). In 1995, 30% in the age group 30–39-year-olds reported hearing loss, whereas only 18% reported hearing loss in 2014 (p < 0.05, 95% CI [-0.003,0.2]). There was no significant difference in reported ear discharge since childhood and otitis media in childhood among the age groups between 1995 and 2014. However, in 1995 significantly more females had experienced ear discharge in the age groups 18–29 and 30–39 year-olds compared to 2014. Females in the age group 18–29 year-olds also showed a significant difference in having experienced otitis media in childhood, where 32% answered "yes" in 1995, and 18% answered "yes" in 2014 (p < 0.05). In 2014, females reported more frequent complaints of vertigo compared to males, 16% and 9%, respectively (p < 0.05). In 1995, there was no significant difference in experienced vertigo between males and females. Ear and hearing health problems and vertigo are reported frequently in the Greenlandic population. Overall, a tendency of less complaints in 2014 compared to 1995 except for vertigo. It is important to follow this trend and increase the prophylactic efforts to reduce common health disabilities like early otitis media in childhood and noise created symptoms even more. [ABSTRACT FROM AUTHOR]

The purpose was to analyse the association of muscular strength, muscle pain and reduced mobility in daily life with mental wellbeing among older Inuit men and women in Greenland. Data (N = 846) was collected as part of a countrywide cross-sectional health survey in 2018. Hand grip strength and 30-seconds chair stand test were measured according to established protocols. Mobility in daily life was assessed by five questions about the ability to perform specific activities of daily living. Mental wellbeing was assessed by questions about self-rated health, life satisfaction and Goldberg's General Health Questionnaire. In binary multivariate logistic regression models adjusted for age and social position, muscular strength (OR 0.87–0.94) and muscle pain (OR 1.53–1.79) were associated with reduced mobility. In fully adjusted models, muscle pain (OR 0.68–0.83) and reduced mobility (OR 0.51–0.55) but were associated with mental wellbeing. Chair stand score was associated with life satisfaction (OR 1.05). With an increasingly sedentary lifestyle, increasing prevalence of obesity and increasing life expectancy the health consequences of musculoskeletal dysfunction are expected to grow. Prevention and clinical handling of poor mental health among older adults need to consider reduced muscle strength, muscle pain and reduced mobility as important determinants. [ABSTRACT FROM AUTHOR]

Rigorous lung function prediction equations for the Inuit are lacking. We used spirometry from 351 Inuit and 29 people of other ancestry obtained during an occupational survey in Greenland to determine how to obtain valid lung function predictions for the Inuit using Global Lung Function Initiative (GLI) equations for Europeans. Standing height for the Inuit was used in the predictions as well as their height modified in line with the known differences in standing to sitting height ratio (SHR) for the Inuit. With recorded height in predicting lung function, mean±SD Inuit z-scores for FVC and FEV1 were significantly higher than predicted (0.81±1.20 and 0.53±1.36, respectively, p<0.0001) which was not true for the non-Inuit participants (-0.01±1.04 and 0.15±1.17, respectively). When using height modified for SHR the mean±SD Inuit z-scores for FVC and FEV1 were no longer significantly different from predicted (0.10±1.10 and -0.12±1.24, respectively). The mean±SD Inuit FEV1/FVC z-scores were not significantly different from the non-Inuit, being respectively -0.45±0.98 and -0.01±1.04. Modified height changed the mean±SD Inuit FEV1/FVC z-scores to -0.39±0.99. Representative lung function predictions from GLI equations can be made for Inuit by using standing height modified for the known differences in SHR between Inuit and those of European ancestry [ABSTRACT FROM AUTHOR]

Abstract Background Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions. Methods An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies’ contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews. Results Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance (“Indigenous-oriented”)(n = 6); and those based on Western academic knowledge and governance (“Western-oriented”)(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building. Conclusions There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed.

The harvest and consumption of country food is a cornerstone of Inuit culture, sovereignty, food security, and nutrition. Qilalugaq (beluga whales) (Delphinapterus leucas (Pallas, 1776)) are hunted across the Canadian Arctic and are an especially important food source for Inuit communities in Nunavik, northern Québec, Canada. The presence of environmental contaminants and nutrients in beluga has been the subject of recent research interest, including the role of selenoneine and its interactions with methylmercury. Using interviews conducted in Quaqtaq and analyses of beluga tissue samples harvested by hunters, this study aimed to bridge Inuit knowledge and scientific knowledge to understand how beluga hunting, preparation, and consumption practices may explain the different levels of selenoneine found in Nunavimmiut (Inuit from Nunavik). It also sought to characterize the health, social, and cultural importance of beluga and factors influencing its consumption. Research findings confirmed the important role of beluga in Nunavimmiut culture, food security, and nutrition. Findings documented gender-based consumption practices, including consumption of the selenoneine-rich beluga tail exclusively by women, which may explain previously documented gender differences in blood selenoneine levels. This study demonstrates the utility of weaving Inuit knowledge and scientific knowledge to inform future environmental health research, public health communications, and wildlife comanagement.

Reports on fermented, animal-sourced foods made by Inuit around the circumpolar North have lacked consideration for their unique microbiota and the geo-socio-cultural contexts in which they are made, often resulting in reinforced negative stereotypes. Deficit-based approaches to studying Inuit fermented foods overlook the fact that they have long been considered healthy and integral to Inuit diets. Inuit have deep knowledge on the harvesting, preparation, sharing, and consumption of fermented foods that research efforts must learn from and acknowledge. Our preliminary research into Inuit animal-sourced fermented foods expands current knowledge about the microorganisms needed to make them, and points to a potential to understand how these and other fermented foods impact the human gut microbiome. We provide recommendations for microbiological research on Inuit fermented foods that centers Inuit knowledge within the specific geographic, social, and cultural contexts in which these foods are made.

Atlantic Studies now enters its third decade, and the ecological consequences of human entanglement with (or whelmedness by) the ocean will only intensify environmentally, politically, and culturally. How does the "Atlantic" in Atlantic Studies figure in this expansion and acceleration? This provocation meditates on the scientific term "Atlantification." The Arctic Ocean has seen a significant strengthening of the inflow of Atlantic waters into the Arctic, which leads to the "Atlantification" of circumpolar seas. Atlantic water is warmer and saltier than Arctic water (icebergs, glaciers, and multiyear sea ice are freshwater, not salt), and Atlantification drives sea ice loss and profoundly disrupts the marine ecosystem. As Atlantic Studies looks to the future, the journal might respond to a charge of intellectual Atlantification: an ongoing, systemic study of the intermingling and deliquescence of boundaries between the human and the nonhuman, the past and the future, the Atlantic and the world. [ABSTRACT FROM AUTHOR]

In recent decades, there has been growing criticism that research has long been conducted ‘on’ Indigenous peoples rather than ‘with’ or ‘for’ them. In response to this, in 1999, Linda Tuhiwai Smith published a critical analysis of colonialism in Western research, arguing for the decolonisation of knowledge and the implementation of new co-constructed projects that respond to societal concerns, rely on methodologies rooted in local knowledge, and use participatory action research approaches. In a seven-year project (2010–17) in Nunavut, Canada, we adopted this approach, using participatory action research to co-construct research questions in collaboration with the Inuit community of Baker Lake (Qamani’tuaq) on issues that most concern them, such as mining impacts and youth future. This article discusses the TUKTU project, analysing its development and the advantages and limitations of Indigenous participatory action research, conceived and conducted by the people it concerns, and based on their vision of the world, valorising their knowledge and contributing to their empowerment.

In a changing territorial and geopolitical moment of the Arctic region, are the Indigenous Peoples Organizations heard at the regional level and are the Arctic states working to keep them safe and secure? To safeguard the human security of Arctic Indigenous peoples, Arctic states (and their governments) have to understand the needs and changes that are affecting their way of life as well as to be able to cooperate between them. In a comparative study of Canada’s and Finland’s Arctic policies—Canada’s Arctic and Northern Policy Framework (2019) and Finland’s Strategy for Arctic Policy (2021)—it is possible to identify the applicability of the human security approach, which is influenced by the truth and reconciliation process between Canada and Inuit and Finland and Sámi. This process is a main factor in having their human rights respected and their human security safeguarded, considering that the relation between the countries of the North and the South of the Arctic countries is a discovery of their diversity (linguistical and cultural) in the 21st century. In my perspective, and for a participative democracy to be applied as mentioned by the green political theory (following the views of scholars like Barry, Eckersley, and Goodin), states and governments need to be open and recognise the gaps identified by those communities and transnational organisations.

ABSTRACTEekeeluak Avalak, an 18-year-old Inuk wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015. Avalak openly attributed sport – specifically wrestling – to saving his own life. This story raises important questions about the role of sport and traditional games in Inuit suicide prevention strategies. Few studies have examined the role of sport or traditional games in Inuit suicide prevention strategies. In an attempt to reduce Inuit suicide rates, in addition to the National Inuit Prevention Strategy, three of the four land claim regions that constitute Inuit Nunangat have suicide prevention strategies. In this study, we used settler colonial theory, critical Inuit studies, and content analysis to examine if and how sport and Inuit traditional games are identified as prevention tools in these Inuit suicide prevention strategies. The results demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, evidence-based and community-driven approaches could be funded, created, implemented, and evaluated as culturally-safe Inuit mental health intervention models to address the disproportionately high suicide rates among Inuit in Inuit Nunangat.

ABSTRACTGlioblastoma (GBM), WHO grade IV, is the most common primary malignant brain tumour among adults with a devastating overall survival of 14–22 months. Standard treatment of GBM includes maximum safe resection, radiotherapy plus concomitant and adjuvant temozolomide (TMZ), given over a period of approximately 9 months. Treatment and follow-up for Greenlandic patients with GBM are managed at Rigshospitalet (RH), Copenhagen. Greenlandic GBM patients, therefore, travel back and forth to RH, often unaccompanied, and challenged by cognitive failure or other symptoms from their disease and/or treatment. Few Greenlandic patients are diagnosed with GBM annually, but considering the poor prognosis and short remaining lifespan, it would be preferable to limit their travels. TMZ is administrated as capsules. Health personnel at Queen Ingrid’s Hospital (DIH), Nuuk, are trained in treating other oncological diseases and handling side effects. Hence, it could be investigated whether administration of adjuvant TMZ at DIH could be feasible after personnel education as well as economic consideration and compensation, in close collaboration with neuro oncologists at RH. In this article, we describe the Greenlandic cancer treatment, and the typical workflow from diagnosis of GBM to treatment to progression.

AbstractObjectives: Within the Qikiqtaaluk Region (Eastern Nunavut), pregnant women are required to travel outside their home communities for birthing care. This model differs from the prior norm of place-based, midwife-attended birth and impacts Inuit wellness. This research characterised Inuit women’s birthing experiences and perspectives on enriching the medical obstetric system through the lens of place, culture, and health, and explored how maternal health research methodologies might be increasingly place-based and locally-driven.Methods: Informed by a community-based approach, a team of Inuit and non-Inuit researchers conducted a case study with Inuit women in Iqaluit, Nunavut, Canada. A systematic critical review was completed to examine prior maternal health research methodology in Nunavut and underscored opportunities for maternal health research to be increasingly Inuit-led through all research stages. Sewing was explored as a locally-specific, arts-based approach for data gathering and was found to enhance data quality and participants’ research experience by creating space for voicing, sharing, relating, and embodying Inuit knowledge. Qualitative data were gathered (2017-2020) using: (1) focus groups (structured as two-part sewing sessions) (n = 5) with pregnant women (n = 19); and (2) conversational interviews with pregnant women, Inuit Elders, and other community members (n = 22); and validated in meetings with Inuit knowledge-holders (n = 4). Thematic analyses were iterative and guided by a grounded theory approach.Results: Participants described the importance of place-connections to Inuit birth experiences and the value of Inuit relational supports and knowledge-sharing throughout the birthing process. Inuit women voiced a desire for place-based birthing and further Inuit involvement and integration of Inuit birthing practices into obstetrical care. Women shared knowledge on stewarding birthing resources from the land and using skilled Inuit midwifery techniques: this knowledge connects to three Inuit Qaujimajatuqangit principles important for health system governance in Nunavut (Avatittinnik Kamatsiarniq, Inuuqatigiitsiarniq, and Pilimmaksarniq) and illustrates the importance of aligning the regional obstetric system with Inuit birthing values.Conclusions: This collaborative research emphasises how maternal health research and maternity care may be enriched by including place-specific, locally-embedded methods and by providing space for Inuit women to shape the systems that affect them.INUKTITUT TRANSLATIONᐃᕐᓂᓱᒃᓰᓂᖅ ᐊᐅᒪᓂᖓ ᕿᑭᕐᑖᓗᖕᒥ ᓄᓇᕘᒥ: ᓄᓇᒋᔭᖏᓐᓃᓪᓗᑎᒃ ᖃᐅᔨᓇᓱᖕᓂᖅ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᕙᖕᓂᖏᑦ, ᐸᕿᓂᕐᒥᒃᓗ ᐊᒻᒪᓗ ᓇᔾᔨᔪᑦ ᖃᓄᐃᖏᓐᓂᖏᓐᓂᒃ ᖃᐅᔨᓴᕐᓂᖅᓚᐅᕆ ᔭᐃᓐ ᐳᕈᐸᐃᑯᕿᑭᕐᑖᓗᖕᒥ (ᑲᓇᖕᓇᖓᓂ ᓄᓇᕗᑦ), ᓇᔾᔨᔪᖅ ᐊᕐᓇᖅ ᐊᐅᓪᒪᕆᐊᖃᖃᑦᑕᕐᒪᑕ ᓄᓇᓕᖓᑕ ᓯᓚᑖᓄᑦ ᐃᕐᓂᔭᕐᑐᕐᓗᑎᒃ. ᑕᐃᒪᐃᑎᓪᓗᒍ ᐊᔾᔨᒌᖏᒻᒪᒍ ᐃᓕᖁᓯᐅᕙᓚᐅᕐᑐᓂᒃ ᐊᖏᕋᕐᓯᒪᓪᓗᑎᒃ ᓄᓇᒋᔭᖏᓐᓃᓪᖢᑎᒃ ᐃᕐᓂᓱᒃᓰᕙᓚᐅᕐᒪᑕ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖏᓐᓄᓪᓗ ᐃᒃᐱᖕᓇᐅᑎᖕᒪᑦ. ᑖᓐᓇ ᖃᐅᔨᓴᕐᓂᖅ ᑐᑭᓯᓇᓱᒃᖢᓂ ᐃᓄᐃᑦ ᐊᕐᓇᐃᑦ ᐃᕐᓂᓱᒃᑎᓪᓗᒋᑦ ᐊᑐᕐᓯᒪᔭᖏᓐᓂᒃ ᐊᒻᒪᓗ ᐃᓱᒪᒋᔭᖏᓐᓂᒃ ᐱᐅᓯᒋᐊᕐᑕᐅᔭᕆᐊᖃᕐᓂᖓᓂᒃ ᐃᕐᓂᓱᒃᓰᓂᖅ ᓄᓇᒋᔭᖓᓂᓪᓗᓂ, ᐃᓕᖁᓯᖓᒍᑦ, ᐊᒻᒪᓗ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖓᒍᑦ, ᐊᒻᒪᓗ ᖃᐅᔨᓇᓱᒃᓗᓂ ᖃᓄᖅ ᓇᔾᔨᔪᑦ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖏᓐᓂᒃ ᖃᐅᔨᓴᕐᓂᖅ ᐃᓕᖁᓯᐅᔪᑦ ᓄᓇᓕᒋᔭᖓᓂᑦ ᐊᒻᒪᓗ ᓄᓇᓕᐅᔪᓂᒃ ᐱᒋᐊᕐᑎᑕᐅᕙᓪᓕᐊᓕᕐᓂᖓᓂᒃ. ᑐᓴᐅᒪᑎᑕᐅᓪᓗᑕ ᓄᓇᓕᖕᓂᑦ ᐱᒋᐊᕐᑎᑕᐅᓯᒪᔪᓂᑦ, ᐃᓄᐃᑦ ᖃᓪᓗᓈᓪᓗ ᖃᐅᔨᓴᕐᑎᑦ ᖃᐅᔨᓇᓱᓚᐅᕐᒪᑕ ᐃᓄᐃᑦ ᐊᕐᓇᐃᑦ ᐃᖃᓗᖕᓂ, ᓄᓇᕗᑦ, ᑲᓇᑕ. ᕿᒥᕈᔭᐅᓚᐅᕐᑐᖅ ᐃᓕᖁᓯᐅᓯᒪᔪᑦ ᖃᓄᐃᓕᖓᖃᑦᑕᓚᐅᕐᒪᖔᑕ ᐃᓕᖁᓯᐅᔪᑦ ᐃᕐᓂᓱᕐᑐᓂᒃ ᓇᔾᔨᔪᓂᒃᓗ ᓄᓇᕗᒥ ᐊᒻᒪᓗ ᐊᑐᖏᑎᑕᐅᓗᐊᕐᓂᖏᓐᓂᒃ ᐱᕕᖃᕐᓂᐅᔪᑦ ᐃᓄᖕᓄᑦ ᐊᐅᓚᑕᐅᓗᑎᒃ ᖃᐅᔨᓴᕐᓂᖅ. ᒥᕐᓱᕐᑎᑦᑎᓂᒃᑯᑦ ᓄᓇᓕᖕᓂ ᐊᑐᕐᑕᐅᕙᒋᕐᑐᖅ, ᓴᓇᐅᒐᓕᕆᓂᕐᓗ ᑎᑎᕋᕐᑕᐅᕙᓪᓕᐊᓪᓗᑎᒃ ᐊᒻᒪᓗ ᑐᑭᓯᔾᔪᑕᐅᓚᐅᕐᑐᖅ ᐱᐅᓯᒋᐊᕈᑕᐅᓪᓗᓂᓗ ᐊᒻᒪᓗ ᐃᓚᐅᖃᑕᐅᔪᑦ ᖃᐅᔨᓴᕐᓂᕐᒥᒃ ᑐᑭᓯᓪᓗᑎᒃ ᓂᓪᓕᕈᓐᓇᕐᑎᑕᐅᓪᓗᑎᒃᓗ, ᐅᖃᐅᓯᖃᕈᓐᓇᕐᖢᑎᒃᓗ, ᐊᖏᖃᑎᖃᕈᓐᓇᕐᓗᑎᒃᓗ, ᐊᒻᒪᓗ ᐃᓄᐃᑦ ᖃᐅᔨᒪᔭᖏᓐᓂᒃ ᑐᑭᓯᕚᓪᓕᕐᖢᑎᒃ. ᐱᐅᑎᒋᓂᖓ ᑎᑎᕋᕐᓯᒪᔪᑦ ᑲᑎᑕᐅᓚᐅᕐᑐᑦ (2017-2020) ᐊᑐᕐᖢᑎᒃ: (1) ᑲᑎᒪᔨᕋᓛᖑᒧᓂᒃ (ᐋᕿᒃᓯᒪᓪᓗᑎᒃ ᒪᕉᓕᓪᓗᑎᒃ ᒥᕐᓱᑲᑕᕐᑐᑦ) (n = 5) ᓇᔾᔨᔪᓂᒃ ᐊᕐᓇᓂᒃ (n = 19); ᐊᒻᒪᓗ (2) ᐅᖃᓪᓚᖃᑎᒋᔭᐅᓪᓗᑎᒃ ᐊᐱᕐᓱᕐᑕᐅᕙᓪᓕᐊᓪᓗᑎᒃ ᓇᔾᔨᔪᑦ ᐊᕐᓇᐃᑦ. ᐃᓄᐃᑦ ᐃᓐᓇᐃᑦ, ᐊᓯᖏᓪᓗ ᐃᓄᐃᑦ (n = 22); ᓇᓗᓇᐃᕐᑕᐅᕙᓪᓕᐊᓗᑎᒃᓗ ᑲᑎᒪᑎᑦᑎᓪᓗᑎᒃ ᐃᓄᐃᑦ ᖃᐅᔨᒪᔭᑐᖃᖏᓐᓂᒃ ᑎᒍᒥᐊᕐᑎᐅᔪᓂᒃ (n = 4). ᖃᐅᔨᓴᕐᑕᐅᕙᒃᖢᑎᒃ ᑐᑭᓯᔭᐅᓇᓱᒃᖢᑎᒃ ᐊᒻᒪᓗ ᐊᑐᐊᒐᖃᕐᖢᑎᒃ ᐃᓱᒪᒋᔭᐅᓯᒪᔪᓂᒃ. ᐃᓚᐅᖃᑕᐅᔪᑦ ᐅᖃᐅᓯᖃᖃᑦᑕᓚᐅᕐᑐᑦ ᓄᓇᒥ ᐊᒃᑐᐊᓂᖓ ᐱᓪᓚᕆᐅᓂᖓᓂᒃ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᓂᖏᑦ ᖃᐅᔨᓯᒪᔭᖏᑦ ᐊᒻᒪ ᐊᑑᑎᖃᕐᓂᖓᓂᒃ ᐃᓄᐃᑦ ᐃᒪᒋᔭᖏᓐᓂᒃ ᐃᒪᐅᑎᑦᑎᓂᕐᒥᒃ ᐊᒻᒪᓗ ᖃᐅᔨᒪᔭᕐᒥᓂᒃ ᐅᖃᐅᓯᖃᖃᑦᑕᕐᓂᖅ ᐃᕐᓂᓱᒃᓰᓂᕐᒥᒃ. ᐃᓄᐃᑦ ᐊᕐᓇᐃᑦ ᐅᖃᖃᑦᑕᓚᐅᕐᑐᑦ ᓄᓇᒦᓪᓗᓂ ᐃᕐᓂᓲᖃᑦᑕᕈᒪᓪᓗᑎᒃ ᐊᒻᒪᓗ ᐃᓚᐅᑎᑕᐅᓂᕐᓴᐅᓗᓂ ᐃᓄᐃᑦ ᐊᒻᒪᓗ ᐱᖃᓯᐅᔾᔭᐅᖃᑦᑕᕐᓗᑎᒃ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᓂᖏᑦ ᐃᕐᓂᓱᒃᑐᓄᑦ.. ᐊᕐᓇᐃᑦ ᖃᐅᔨᒪᔭᕐᒥᓂᒃ ᐅᖃᐅᓯᖃᖃᑦᑕᓚᐅᕐᑐᑦ ᐃᕐᓂᓱᒃᑐᓄᑦ ᐃᓕᖁᓯᕆᔭᐅᓚᐅᕐᑐᓂᒃ ᐊᐅᓪᓚᕐᓯᒪᓪᓗᑎᒃ ᐊᑐᕐᑕᐅᓪᓗᑎᒃᓗ ᖃᐅᔨᒪᓂᖏᑦ ᐃᕐᓂᓱᒃᓰᕙᒃᑐᑦ ᐃᓄᐃᑦ. ᑖᓐᓇ ᖃᐅᔨᒪᓂᖏᑦ ᐊᒃᑐᐊᓂᕆᔭᐅᖕᒪᑦ ᐱᖓᓱᓄᑦ ᐃᓄᐃᑦ ᖃᐅᔨᒪᔭᑐᖃᖏᑦ ᐊᑐᐊᒐᐅᔪᓂᒃ ᐱᓪᓚᕆᐅᓪᓗᑎᒃᓗ ᐊᓐᓂᐊᖃᕐᑕᐃᓕᒪᓂᕐᒧᑦ ᐊᐅᓚᓂᖓᓄᑦ ᓄᓇᕘᒥ (ᐊᕙᑎᑦᑎᓐᓂᒃ, ᑲᒪᑦᓯᐊᕐᓂᖅ,ᐃᓅᖃᑎᒌᑦᓯᐊᕐᓂᖅ ᐊᒻᒪᓗ ᐱᓕᒻᒪᒃᓴᕐᓂᖅ) ᓇᓗᓇᐃᒃᑯᑕᐅᓪᓗᓂᓗ ᐱᓪᓚᕆᐅᓂᖓᓂᒃ ᐃᕐᓂᓱᒃᑐᑦ ᒪᓕᒃᑎᑕᐅᓗᑎᒃ ᐃᓄᐃᑦ ᐃᕐᓂᓱᒃᓰᓂᖏᑦ ᐅᒃᐱᕆᔭᖏᑦ. ᐃᑲᔪᕐᑎᒌᒃᓗᑎᒃ ᖃᐅᔨᓴᕐᓂᖅ ᓇᓗᓇᐃᕈᑕᐅᓚᐅᕐᑐᖅ ᐱᓪᒪᕆᐅᓂᖓᓂᒃ ᓇᔾᔨᔪᑦ ᖃᓄᐃᖏᑦᑎᐊᕐᓂᖏᓐᓂᒃ ᖃᐅᔨᓴᕐᓂᖅ ᐊᒻᒪᓗ ᓇᔾᔨᔪᑦ ᖃᓄᐃᓐᓂᖏᓐᓂᒃ ᑲᒪᒋᔭᐅᑦᑎᐊᕐᓂᖏᓐᓂᒃ ᐱᐅᓯᒋᐊᕐᑎᑕᐅᒧᓐᓇᕐᓂᖓᓂᒃ ᓄᓇᒥᒃ ᐃᓂᖃᕐᓗᑎᒃ, ᓄᓇᓕᖕᓂ ᐃᓚᐅᖃᑕᐅᓗᑎᒃ ᐊᑐᕐᑕᐅᔪᓄᑦ ᐊᒻᒪᓗᐱᕕᖃᕐᑎᑕᐅᓗᑎᒃ ᐊᕐᓇᐃᑦ ᐃᓄᐃᑦ ᐋᕿᒃᓱᐃᖃᑕᐅᓗᑎᒃ ᐃᓅᓯᖏᓐᓄᑦ ᐊᒃᑐᐊᔪᓂᒃ.

ABSTRACTBeginning January of 2020, COVID-19 cases detected in Arctic countries triggered government policy responses to stop transmission and limit caseloads beneath levels that would overwhelm existing healthcare systems. This review details the various restrictions, health mandates, and transmission mitigation strategies imposed by governments in eight Arctic countries (the United States, Canada, Greenland, Norway, Finland, Sweden, Iceland, and Russia) during the first year of the COVID-19 pandemic, through 31 January 2021s31 January 2021. We highlight formal protocols and informal initiatives adopted by local communities in each country, beyond what was mandated by regional or national governments. This review documents travel restrictions, communications, testing strategies, and use of health technology to track and monitor COVID-19 cases. We provide geographical and sociocultural background and draw on local media and communications to contextualise the impact of COVID-19 emergence and prevention measures in Indigenous communities in the Arctic. Countries saw varied case rates associated with local protocols, governance, and population. Still, almost all regions maintained low COVID-19 case rates until November of 2020. This review was produced as part of an international collaboration to identify community-driven, evidence-based promising practices and recommendations to inform pan-Arctic collaboration and decision making in public health during global emergencies.

ABSTRACTThe study evaluates the outcome after surgery for pancreatic and periampullary tumors in Greenlandic Inuit with overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) as secondary outcome. Results were compared with Danish patients with an identical tumor stage and age operated at the same hospital during the same period from 31. January 1999 to 31. January 2021. Follow up was minimum one year. Preoperative health data shoved a higher rate of smoking among Greenlandic patients, but a lower preoperative comorbidity than in Danish patients. Patients from Greenland had a lower resection rate and a higher rate of palliative operations. Postoperative complications and in-hospital mortality were not significantly different. Adjuvant oncologic treatment was well accepted by Greenlandic patients but less common in a palliative setting than in Danish patients. The one, two, and five-year survival in Greenlandic and Danish patients after radical operation for PDAC was 54.4% vs. 74.6%, 23.4% vs. 48.6%, and 0.0% vs. 23.4%, respectively. The overall survival with non-resectable PDAC was 5.9 and 8.8 months, respectively. It is concluded that although patients from Greenland have the same access to specialized treatment, the outcome after treatment for pancreatic and periampullary cancer is less favorable than in Danish patients.

ABSTRACTInuit face worse cancer survival rates and outcomes than the general Canadian population. Persistent health disparities cannot be understood without examining the structural factors that create inequities and continue to impact the health and well-being of Inuit. This scoping review aims to synthesise the available published and grey literature on the structural factors that influence cancer care experienced by Inuit in Canada. Guided by Inuit input from Pauktuutit Inuit Women of Canada as well as the Joanna Briggs Institute scoping review methodology, a comprehensive electronic search along with hand-searching of grey literature and relevant journals was conducted. A total of 30 papers were included for analysis and assessment of relevance. Findings were organised into five categories as defined in the a priori framework related to colonisation, as well as health systems, social, economic, and political structures. The study results highlight interconnections between racism and colonialism, the lack of health service information on urban Inuit, as well as the need for system-wide efforts to address the structural barriers in cancer care.

ABSTRACTDental caries is considered the third most important scourge in the world. In North America, Inuit populations are the population the most severely affected by dental caries. It is often assumed that this situation can be explained by a combination of factors classical for Indigenous populations: remoteness (geographical distance), low economic status and low health literacy (cultural distance). Using a bibliographic approach, we tested this hypothesis of the “distance effect” by exploring the caries prevalence in other Indigenous populations living in high-income countries. Next, we tested whether the high prevalence of caries is due to population-specific characteristics by tracking caries prevalence over the past few centuries. In result, we showed that while other Indigenous populations are more impacted by caries than the general populations, the Inuit populations present the highest prevalence. Paradoxically, we showed also that past Inuit populations were almost immune to caries before 1950. These two elements suggest that the prevalence of caries observed presently is a recent maladaptation and that beyond the effect of cultural and geographical distance, specific biocultural factors have to be investigated.

ABSTRACTSince the 1970s, suicide has been a major public health issue in Greenland. The World Health Organization has emphasised the importance of the identification of both risk and protective factors in relation to suicide. The aim of this paper was to identify scientific literature on risk and protective factors for suicide and suicidal behaviour among Greenland Inuit. Searches in PubMed and PsycInfo resulted in 420 studies that were screened by three of the authors. After screening, the authors included 15 studies that were subject to quality assessment and data extraction. All 15 studies reported on risk factors, and only three mentioned protective factors. Most reported risk factors were on an individual level and were related to socioeconomic status, mental health, alcohol and substance use, and life stress. Risk factors related to the family mainly related to adverse childhood experiences, while the community level concerned access to education, work, and conflicts. The results indicate a large knowledge gap about protective factors for suicide and suicidal behaviour. The few protective factors reported were related to men having a family, high socioeconomic status, and being born between 1901 and 1950.

ABSTRACTThe aim of this study was to estimate prevalence of patients with asthma in Greenland according to age, gender and residence and to investigate the associated quality of care. The study was performed as a cross-sectional study with data extracted from the Greenlandic electronical medical record. A total of 870 patients aged 12 years or above were diagnosed with asthma at the end of 2022, corresponding to a prevalence of 1.9%. In 2020, the total prevalence was 0.2%. The prevalence of patients aged 12 years or above with asthma was highest among patients in Nuuk (3.3%) compared with patients in the remaining parts of Greenland (1.1%). More women than men were diagnosed with asthma, and the prevalence increased with age from 20 to 59 years. The prevalence of current smokers was high among the asthma population. The quality of care was significantly higher among patients living in Nuuk for all process indicators compared with patients from the remaining parts of Greenland. The prevalence of asthma in Greenland is low compared to other comparable populations and might be underestimated. Initiatives supporting increased focus on diagnosing asthma are thus warranted.

ABSTRACTThe purpose was to analyse the association of muscular strength, muscle pain and reduced mobility in daily life with mental wellbeing among older Inuit men and women in Greenland. Data (N = 846) was collected as part of a countrywide cross-sectional health survey in 2018. Hand grip strength and 30-seconds chair stand test were measured according to established protocols. Mobility in daily life was assessed by five questions about the ability to perform specific activities of daily living. Mental wellbeing was assessed by questions about self-rated health, life satisfaction and Goldberg’s General Health Questionnaire. In binary multivariate logistic regression models adjusted for age and social position, muscular strength (OR 0.87–0.94) and muscle pain (OR 1.53–1.79) were associated with reduced mobility. In fully adjusted models, muscle pain (OR 0.68–0.83) and reduced mobility (OR 0.51–0.55) but were associated with mental wellbeing. Chair stand score was associated with life satisfaction (OR 1.05). With an increasingly sedentary lifestyle, increasing prevalence of obesity and increasing life expectancy the health consequences of musculoskeletal dysfunction are expected to grow. Prevention and clinical handling of poor mental health among older adults need to consider reduced muscle strength, muscle pain and reduced mobility as important determinants.

ABSTRACTTo estimate the frequencies of self-reported middle ear and hearing complaints and vertigo/dizziness in adult Greenlanders. Furthermore, to examine if there has been a development in the frequency of these complaints within a 20-year period. A structured questionnaire concerning middle ear disease and related neuro-otological symptoms was mailed to 400 randomly selected adult Greenlanders between 18 and 60 years of age in 1995. In 2014, the questions were included for the same age group in the general Greenlandic Health Survey. The questionnaires contained a total of six identical questions. In 1995, 281 participants (70%) replied to the questionnaire. In 2014, 1,639 participants (78%) replied. We found that in 1995 the two youngest age groups (18–29- and 30–39-year-olds) had the highest relative number of ear discharge. Approximately one-third of the participants in these two age groups reported to have had ear discharge, while this was only reported by 17% of the 18–29-year-olds and 16% of the 30–39-year-olds in 2014 (95% CI [0.03, 0.3] and [0.1, 0.3], respectively). The oldest age group indicated the lowest relative number of experiences of ear discharge in both 1995 and 2014 (18% and 17%, respectively). In 1995, 30% in the age group 30–39-year-olds reported hearing loss, whereas only 18% reported hearing loss in 2014 (p