Search

Inuit living in the northern region of Nunavik continue to experience significant health inequalities, which are rooted in colonialism that still have repercussions on their health-related perceptions and practices, including vaccination. This study aimed to explore the perceptions and determinants of routine vaccination among the Inuit of Nunavik by describing factors influencing vaccination decisions from the perspective of community members and health professionals. Semi-structured interviews focusing on the perception of vaccination and experience with vaccination and health services were conducted with 18 Inuit and 11 non-Inuit health professionals. Using the socio-ecological model, factors acting at the community and public policy (e.g. rumours and misinformation about vaccination, language barrier), organisational (e.g. complexity of the vaccination process, staff turnover, lack of specialised vaccination workers and interpreters), and intrapersonal and interpersonal (e.g. past experiences with vaccination, vaccine attitudes, social norms) levels were identified as having an impact on vaccination decisions. Improving vaccination coverage in Nunavik requires a more global reflection on how to improve and culturally adapt the health care and services offered to the Inuit population. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this study was to meet a small, remote emergency department's need to reflect on the minimum threshold of services to offer. The study's main objectives were to I 1) provide a statistical profile of the emergency services in Fermont, Quebec, 2) assess the staff's and users' perception of the threshold of services offered and 3) propose solutions for improving care and services. Methods: This case study was conducted with a participatory approach and a mixed methodology. I We compared the results from a questionnaire on the emergency services that was validated during a previous study with the results concerning the other rural emergency services in Quebec as well as with national and provincial recommendations. The questionnaire concerned users' sociodemographic characteristics, the hospital's and the emergency services' descriptors, the services available locally, and the physician and nurse staff. Interviews were also carried out with 33 people (health care professionals, policy-makers and citizens). Results: Fermont's emergency department is smaller than the average rural emergency department in Quebec. They have resources that are in some respects comparable to those of other emergency departments and in line with the recommendations; in other respects, their resources are rather limited. Respondents emphasized how important it is to take into account the environment's specific features when establishing the minimum threshold of services. The proposed solutions would promote collaboration, break down silos within professional practice and focus on training. Conclusion: Fermont's case aside, this exploratory case study highlights how important it is to adopt a pluralistic, participatory and local approach in order to support reflection on the threshold of services in remote emergency departments and to improve their overall performance. Introduction : Cette etude visait a repondre au besoin d'une petite urgence eloignee d'assoir sa reflexion autour d'un seuil minimum de services a offrir. Les principaux objectifs de l'etude I etaient de : 1) dresser le portrait statistique de l'urgence de Fermont, Quebec, 2) evaluer la perception du personnel et des usagers en lien avec le seuil de services offert et 3) enoncer des solutions permettant d'ameliorer les soins et les services. Methodes : Cette etude de cas a ete realisee avec une approche participative et une methodologie mixte. Nous avons comparee les donnees d'un questionnaire sur l'urgence qui a ete valide lors d'une etude precedente aux donnees des autres urgences rurales quebecoises et a des recommandations nationales et provinciales. Le questionnaire portait sur les caracteristiques sociodemographiques des usagers, les descripteurs du centre hospitalier et de l'urgence, les services disponibles localement et les effectifs medicaux et infirmiers. Des entrevues ont aussi ete realisees aupres de 33 personnes (professionnels de la sante, decideurs et citoyens). Resultats : L'urgence de Fermont est plus petite que la moyenne des urgences rurales quebecoises et dotee de ressources a certains egards comparables aux autres urgences et aux recommandations et a d'autres egards limites. Les repondants ont souligne l'importance de tenir compte des particularites du milieu dans l'etablissement d'un seuil minimum de services. Les solutions proposees concernent l'importance de favoriser la collaboration, de decloisonner la pratique professionnelle et de miser sur la formation. Conclusion : Au-dela du cas de Fermont, cette etude de cas exploratoire a permis de souligner l'importance d'adopter une approche pluraliste, participative et locale pour soutenir la reflexion autour du seuil minimum de services a offrir dans les urgences eloignees et pour ameliorer la performance generale des urgences rurales., INTRODUCTION La medecine d'urgence en milieu rural et eloigne est assuree majoritairement par des medecins de famille, qui sont confrontes a plusieurs defis particuliers (1). Ils doivent notamment composer avec [...]

The article presents a case study of a 46-year-old woman who had underwent bariatric surgery and suffered from diarrhea, nausea, and steatorrhea following the surgery. She was diagnosed with celiac disease (CeD). She was treated with gluten-free diet (GFD), loperamide, and supplementation of pancreatic enzymes. It talks about the presence of CeD in the patient before her surgery and CeD development following the malabsorptive surgery. Risks of untreated CeD in bariatric patients is also noted.