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Indigenous Elder advisors in Pelican Narrows, a Cree community in Northern Saskatchewan, have indicated that Western pain scales may not be responsive tools for pain assessments within their community. This study employed a mixed methods research design that involved two phases. Phase one was the development of a pain scale in collaboration with an Elder and a Knowledge Keeper. Phase two was a pilot of the CDPS utilised during virtual physiotherapy sessions for chronic back pain. Twenty-seven participants completed the pre-physiotherapy treatment questionnaires, and 10 participants engaged in semi-structured interviews (9 community members; 1 healthcare provider). A weighted kappa analysis yielded k = 0.696, indicating a good agreement between the CDPS and Faces Pain Scale-Revised in terms of documenting participants' pain. Qualitative data from interviews with community members revealed three major themes: 1) Learnings Regarding Pain Scales, 2) Patient Centered Care; and 3) Strength-Based Solutions for Improving Pain Communication. Two themes were uncovered through conversations with the HCP: 1) Perspectives on CDPS and 2) Healthcare Provider Experiences Communicating about Pain. Moreover, a patient-centred approach is important to ensure comprehensive pain assessments. [ABSTRACT FROM AUTHOR]

Aim: To critically explore the value and challenges of combining a traditional methodology (constructivist grounded theory) with a newer approach (Patient-Oriented Research) in nursing research. Overview of the Issue: Researchers need to examine novel approaches to research which incorporate the thoughts and ideas of patients and stakeholders in order to ensure that the research is important to end users. However, it is essential to maintain the rigour of traditional methodologies. Therefore, there is a need to explore combining traditional methodologies with new approaches. Results: We combined a rigorous methodology with a modern approach to health promotion research that has not been described in the literature. There are numerous synergies between constructivist grounded theory and Patient-Oriented Research. However, tensions exist including pre-conceived knowledge, patients as researchers, and flexibility in research direction. Discussion: Constructivist grounded theory with a Patient-Oriented Research approach for use in health promotion research requires thought and intentionality. Consideration of the time and money needed to build relationships and include patient partners as full team members is critical to successful research. Additionally, points of synergy and tension between constructivist grounded theory and Patient-Oriented Research must be navigated with each study. Conclusion: Our findings indicate that constructivist grounded theory can be enhanced with a Patient-Oriented Research approach and may lead to increased depth in the development of the substantive grounded theory while also giving voice to the patient-partners. Implications for Profession: There is a need for researchers to actively engage patients and stakeholders in a Patient-Oriented Research process while retaining the core of traditional methodologies. Impact: This paper will provide researchers with an exemplar to incorporate patients as team members while conducting constructivist grounded theory research. [ABSTRACT FROM AUTHOR]

Background: Aerobic exercise is recommended for reducing blood pressure; however, recent studies indicate that stretching may also be effective. The authors compared 8 weeks of stretching versus walking exercise in men and women with high-normal blood pressure or stage 1 hypertension (ie, 130/85-159/99 mm Hg). Methods: Forty men and women (61.6 y) were randomized to a stretching or brisk walking exercise program (30 min/d, 5 d/wk for 8 wk). Blood pressure was assessed during sitting and supine positions and for 24 hours using a portable monitor before and after the training programs. Results: The stretching program elicited greater reductions than the walking program (P < .05) for sitting systolic (146 [9] to 140 [12] vs 139 [9] to 142 [12] mm Hg), supine diastolic (85 [7] to 78 [8] vs 81 [7] to 82 [7] mm Hg), and nighttime diastolic (67 [8] to 65 [10] vs 68 [8] to 73 [12] mm Hg) blood pressures. The stretching program elicited greater reductions than the walking program (P < .05) for mean arterial pressure assessed in sitting (108 [7] to 103 [6] vs 105 [6] vs 105 [8] mm Hg), supine (102 [9] to 96 [9] vs 99 [6] to 99 [7] mm Hg), and at night (86 [9] to 83 [10] vs 88 [9] to 93 [12] mm Hg). Conclusions: An 8-week stretching program was superior to brisk walking for reducing blood pressure in individuals with high-normal blood pressure or stage 1 hypertension. [ABSTRACT FROM AUTHOR]

Background: North American indigenous populations experience higher rates of obesity and chronic disease compared with nonindigenous populations. Improvements in musculoskeletal fitness can mitigate negative health outcomes, but is not well understood among indigenous populations. This review examines musculoskeletal fitness measures among North American indigenous populations. Methods: A total of 1632 citations were evaluated and 18 studies were included. Results: Comparisons of musculoskeletal fitness measures between North American indigenous men and boys and women and girls were generally not reported. The greatest left and right combined maximal grip strength and maximal leg strength among Inuit boys and men and girls and women were observed among 20-29 years age group. Maximal combined right and left grip strength declined from 1970 to 1990, by an average of 15% among adults and 10% among youth. Maximal leg extension among Inuit has declined even further, averaging 38% among adults and 27% among youth from 1970 to 1990. Inuit men demonstrate greater grip strength and lower leg strength than Russian indigenous men, whereas Inuit women demonstrate greater leg strength. Conclusions: Further research is needed to better understand physical fitness among indigenous peoples and the potential for improving health and reducing chronic disease risk for indigenous peoples through physical fitness. [ABSTRACT FROM AUTHOR]

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Background: Cardiovascular disease disproportionately affects North American Indigenous populations. Ethnic differences in cardiac responses to exercise are known, though Indigenous populations response is unknown. To evaluate cardiac responses to aerobic exercise among Canadian Indigenous and European adults. Methods: Indigenous (N = 12, 4 females, 1 male incomplete) and European (N = 12, all completed) Canadian age and sex-matched adults 19-40 years and free of cardiovascular disease or diabetes completed a cycle ergometer maximal aerobic power test and 30 min at 60% maximal aerobic capacity on two separate days. Echocardiographic assessments preceded and immediately followed exercise. Results: Responses to maximal exercise were similar among ethnicities including decreases in stroke volume index, cardiac output index and ejection fraction, and increases in arterial-ventricular coupling. However, following submaximal exercise, only Indigenous adults demonstrated reductions in end systolic volume, end diastolic volume (154.8 ± 40.6 mL to 136.5 ± 33.0 mL, p = 0.01, vs. 149.4 ± 22.4 mL to 147.1 ± 27.0 mL; p = 0.81), stroke volume index (44.9 ± 8.7 mL m−2 to 38.0 ± 6.5 mL m−2, p = 0.002, vs. 46.4 ± 7.1 mL m−2 to 44.0 ± 6.5 mL m−2; p = 0.28) and arterial compliance. Conclusion: Indigenous and European adults demonstrated similar cardiac responses to maximal exercise, though only Indigenous adults demonstrated cardiac responses to submaximal exercise. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Emerging adulthood, a potential critical period, is an understudied period of fat mass accrual. The aim of this study was to describe patterns of fat mass accrual, and weight status, from adolescence, through emerging adulthood, into young adulthood. Methods: One‐hundred‐eighteen participants (59 male) were measured repeatedly for 20 years. Annual measures of height, weight, and body composition (DXA) were taken. Calculated measures included: peak height velocity (PHV), biological age (BA; years from PHV), body mass index (BMI), and percent total body fat (%TBF). Weight status groupings (normal NW, and overweight/obese OWO) were created using age and sex specific BMI and %TBF cut‐offs. Analysis included t‐tests and logistic regression. Results: BMI and %TBF increased significantly until 8 years post PHV (P < .05), plateaued for 7 years (P > .05), and then began increasing again (P < .05). At PHV, 9% of males and 14% of females were OWO rising to 65% and 32% respectively 15 years post PHV. OWO status at PHV did not predict OWO status in early adulthood (P > .05). Conclusions: During emerging adulthood, the prevalence of OWO increased. Being NW at PHV was not protective against being overweight in young adulthood. Emerging adulthood appears to be a potential critical period for fat accrual and warrants further attention. [ABSTRACT FROM AUTHOR]