ICCH14 Abstract Book

ABSTRACT BOOK
14th International Congress on

Circumpolar Health
Securing the IPY Legacy:
From Research to Action
July 11 – 16, 2009

Yellowknife, Northwest Territories, Canada
www.icch2009.com
Front Cover Art: “Top of the World” by Dawn Oman
Back Cover Art: “Inukshuks” by Dawn Oman
About the Artist: Dawn Oman was born in Yellowknife of Chipewyan and Welsh descent. Originals, Limited Edition Prints, and many other
exciting products featuring her exuberant work can be purchased or viewed at: www.dawnoman.com
14th International Congress on
Circumpolar Health
Abstract Book
Table of Contents: By Session & Venue 5
Table of Contents
By Session & Venue
Table of Contents ......................................................................................................................................................... 5

By Session & Venue ................................................................................................................................................................... 5
SESSION 1 .................................................................................................................................................................. 21
Sunday, July 12, 1:30-3:30 PM ..................................................................................................................................... 21
VENUE 1.................................................................................................................................................................................. 21
Mental Health & Wellness #1 – Holistic & Healing Community Programs ................................................................................. 21
DEVELOPING SÁMI MENTAL HEALTH SERVICE: FROM VISION TO IMPLEMENTATION .............................................................................................................21
FROM THE HEART PLACE - HOLISTIC HEALTH ..............................................................................................................................................................................21
THE UTILIZATION OF NATURE IN HEALING FOR CANADA’S ABORIGINAL PEOPLES .................................................................................................................21
THE EMERGING ISSUE OF CRYSTAL METHAMPHETAMINE USE IN FIRST NATIONS COMMUNITIES ........................................................................................21
HIGH RATE OF SELF-PERCEIVED HIV-RELATED STIGMA AMONG A COHORT OF INDIVIDUALS ACCESSING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY
IN BRITISH COLUMBIA ................................................................................................................................................................................................................... 22
VENUE 2 ................................................................................................................................................................................. 22
Indigenous Research #1 ........................................................................................................................................................... 22
JOURNEY OF AN OUTSIDER: IN SEARCH OF A RESPECTIVE RESEARCH PARADIGM ................................................................................................................. 22
CONSTRUCTING AN INDIGENOUS-CENTERED AND DECOLONIZING RESEARCH METHODOLOGY........................................................................................ 22
“IT’S NOT AS COOL AS SHOOTING BIRDS”: BUILDING RESEARCH RELATIONSHIPS WITH ABORIGINAL COMMUNITIES ...................................................... 22
QUALITATIVE RESEARCH FOR CULTURAL GROUPS REDEFINED ................................................................................................................................................23
THE ROLE OF ETHICAL GUIDELINES IN THE DELIVERY OF FRONTLINE MENTAL HEALTH AND ADDICTIONS PROGRAMMING IN CANADIAN INDIGENOUS
COMMUNITIES ................................................................................................................................................................................................................................23
VENUE 3.................................................................................................................................................................................. 23
Indigenous Health & Wellness #1 ............................................................................................................................................. 23
INCORPORATING TRADITIONAL KNOWLEDGE, TEACHINGS, AND PRACTICES TO REVIVE HEALTH AND WELLNESS IN A DENE COMMUNITY NORTH OF
60 .....................................................................................................................................................................................................................................................23
A LABRADOR COMMUNITY GRAMMAR: LANGUAGE HEALING ...................................................................................................................................................23
THE MEDICAL-SOCIAL AID TO THE ABORIGINES OF THE RUSSIAN NORTHERN TERRITORIES CONDUCTING TRADITIONAL VITAL ACTIVITY ................... 24
PAN-ARCTIC TV SERIES ON INUIT WELLNESS: PRELIMINARY EVALUATION FINDINGS AND LESSONS LEARNED ................................................................ 24
CULTURAL CONTINUITY AND RESILIENCE: INVESTIGATING THE WAYS THAT THREE GENERATIONS OF INUPIAQ OVERCOME HARDSHIPS .................... 24
ABORIGINAL SELF-GOVERNMENT AND SOCIAL SUFFERING ..................................................................................................................................................... 24
VENUE 4 ................................................................................................................................................................................. 24
Population Genetics - CPT1A P479L in the North: Risk Factor, Protective Factor, or Both? ....................................................... 24
INTRODUCTION AND OVERVIEW.................................................................................................................................................................................................. 25
CPT1 P479L IN NEWBORNS OF THE KIVALLIQ REGION OF NUNAVUT ....................................................................................................................................... 25
THE EXPERIENCE WITH CPT1 NEWBORN SCREENING IN ALASKA ............................................................................................................................................. 25
ESTIMATE OF BRITISH COLUMBIA CPT1P479L PREVALENCE AND REVIEW OF MEDICALLY ASCERTAINED PEDIATRIC AND SUDDEN DEATH CASES FROM
BC .................................................................................................................................................................................................................................................... 25
CPT1 P479L PREVALENCE IN LIVE NEWBORNS AND SUDDEN DEATH CASES IN YUKON, NORTHWEST TERRITORIES, AND NUNAVUT ............................. 25
CARNITINE PALYMITOYLTRANSFERASE IA POLYMORPHISM P479L IS COMMON IN GREENLAND INUIT AND IS ASSOCIATED WITH ELEVATED PLASMA
APOLIPOPROTEIN AI ..................................................................................................................................................................................................................... 25
COULD CPT1P479L INFLUENCE OBESITY IN ADULTS IN ALASKA? ............................................................................................................................................. 25
MANAGING UNCERTAINTY: IMPLICATIONS OF CPT1A P479L FOR ETHICS AND POLICY.......................................................................................................... 25
DISCUSSANT PANEL: (DISCUSSANTS FROM ALASKA, YUKON, NWT, NUNAVUT AND GREENLAND TBA) .............................................................................. 25
VENUE 5 ................................................................................................................................................................................. 25
6 Table of Contents: By Session & Venue
Community Participatory Research Methods #1 ...................................................................................................................... 25

UNDERSTANDING ABORIGINAL COMMUNITY-BASED RESEARCH IN CANADA ........................................................................................................................ 25
THE REALITIES ENCOUNTERED WHILE INTRODUCING THE COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH IN GREENLAND .................... 25
STRATEGIES FOR COMMUNICATING HEALTH RESEARCH FINDINGS TO MEMBERS OF AN ARCTIC ABORIGINAL COMMUNITY .......................................... 26
AN ABORIGINAL COMMUNITY INITIATIVE TO PARTNER WITH ACADEMICS: DEVELOPING EVIDENCE-BASED STRATEGIES TO IMPROVE THE HEALTH &
WELL-BEING ................................................................................................................................................................................................................................... 26
HOW GREENLAND ORGANIZED PREVENTATIVE AND HEALTH PROMOTION WORK ............................................................................................................... 26
A DAY IN THE LIFE OF THE IPY INUIT HEALTH SURVEY LAND TEAM: PREPARING COMMUNITIES .......................................................................................... 26
PARTICIPATORY APPROACHES FOR A COMMUNITY-BASED CHRONIC DISEASE PREVENTION PROGRAM IN TWO CANADIAN INUIT COMMUNITIES:
DEVELOPMENT OF HEALTHY FOODS NORTH ..............................................................................................................................................................................27
COMMUNITY-DRIVEN RESEARCH ON HELICOBACTER PYLORI INFECTION IN A CANADIAN ARCTIC HAMLET .......................................................................27
VENUE 6 .................................................................................................................................................................................. 27
Human Biology #1 ................................................................................................................................................................... 27
IODINE DEFICIENCY IN THE NORTH OF KRASNOYARSK TERRITORY..........................................................................................................................................27
FACTORS THAT INFLUENCE THE BIOCHEMICAL CHARACTERISTICS AND HORMONES OF HYPOPHYSEAL-THYROID-ADRENAL SYSTEM OF MEN .......... 28
RESULTS OF RESEARCH OF FREE RADICAL OXIDATION IN POPULATION OF YAMALO-NENETS AUTONOMOUS OKRUG (RUSSIA) ................................... 28
SYSTEM OF XENOBIOTYCS METABOLISM AMONG NATIVE PEOPLE ON FAR EAST. ROLE OF THIS SYSTEM IN THE DEVELOPMENT OF DISEASES .......... 28
THE IMPACT OF ARTIFICIAL AND NATURAL RADIOACTIVITY IN THE LICHEN -> CARIBOU -> HUMAN FOOD CHAIN ............................................................. 29
AN ESTIMATION OF COSMIC RAY BACKGROUND EXPOSURE IN NORTHERN TERRITORIES ................................................................................................... 29
POSTNATAL EXPOSURE, BUT NOT IN-UTERO EXPOSURE, TO MIXTURES OF NORTHERN CONTAMINANTS ALTERS THE ADULTHOOD GLUCOCORTICOID
STRESS RESPONSE IN MALE RATS ............................................................................................................................................................................................... 29
SOME FEATURES OF HEALTH STATE OF INDIGENOUS POPULATION’S CHILDREN IN THE NORTH OF RUSSIA ..................................................................... 29
NEW SERUM MARKERS OF AGING AND ATHEROSCLEROSIS: CHITOTRIOSIDASE, MATRIX METALLOPROTEASE ACTIVITY, AND CYSTATIN C
CONCENTRATION ...........................................................................................................................................................................................................................30
SESSION 2 .................................................................................................................................................................. 30
Sunday, July 12, 4-5:30 PM .......................................................................................................................................... 30
VENUE 1 .................................................................................................................................................................................. 30
Mental Health & Wellness #2 – Holistic & Healing Community Programs ................................................................................. 30
CANADIAN INUIT COMMUNITY ENGAGEMENT IN SUICIDE PREVENTION ..................................................................................................................................30
POSTPSYCHIATRY IN THE REGIONS OF RUSSIAN NORTH ...........................................................................................................................................................30
“THE WAY I SEE IT”: HOW STIGMA AND DEPRESSION AFFECT SELF-PERCEIVED BODY IMAGE AMONG HIV-POSITIVE INDIVIDUALS ON HAART .............. 31
MENTAL HEALTH PROMOTION AND PREVENTION IN 12-18 YEAR OLD INUIT YOUTH IN NUNAVIK ........................................................................................ 31
VENUE 2 .................................................................................................................................................................................. 31
Clinical Care #1 ........................................................................................................................................................................ 31
TRANSITION TO END OF LIFE CARE: THE INUIT EXPERIENCE IN MONTREAL ............................................................................................................................. 31
MY 11 YEARS TREATING SKIN DISEASES ON BAFFIN ISLAND, NU, CANADA. WHAT I SAW, WHAT I DID .................................................................................. 31
THE QUALITY AND COST OF WOUND DRESSING PROCEDURES BEFORE AND AFTER INSTITUTION OF A STANDARADIZED STERILE NO TOUCH
PROTOCOL ......................................................................................................................................................................................................................................32
IN-PATIENT CARE UTILIZATION AMONG SÁMI IN SWEDEN ........................................................................................................................................................32
FREQUENCY OF ATOPY IN THE ARCTIC STILL INCREASING ........................................................................................................................................................32
THE PARADOX OF ANEMIA WITH HIGH MEAT INTAKE: IS THERE MULTIFACTORIAL ETIOLOGY OF ANEMIA AMONG THE INUIT? ....................................... 33
VENUE 3 .................................................................................................................................................................................. 33
Social Determinants of Health #1 – Men’s Health ..................................................................................................................... 33
SOCIAL DETERMINANTS OF INUIT HEALTH .................................................................................................................................................................................. 33
DYNAMIC ATTITUDE TO HEALTH PROBLEMS IN THE MALE POPULATION DURING SOCIAL AND ECONOMIC CRISIS IN RUSSIA (WHO-MONICA-
PSYCHOSOCIAL PROGRAM)........................................................................................................................................................................................................... 33
MEN’S ATTITUDE TO OWN HEALTH UNDER THE MICROSCOPE ................................................................................................................................................. 33
THE SOCIAL ECONOMY AND HEALTH IN NORTHERN CANADA ................................................................................................................................................. 34
USING KNOWLEDGE SYNTHESIS, TRANSLATION, AND EXCHANGE TO PUT THE DETERMINANTS OF HEALTH INTO ACTION IN NORTHERN
COMMUNITIES ............................................................................................................................................................................................................................... 34
INUIT MEN TALK ABOUT HEALTH ................................................................................................................................................................................................. 34
VENUE 4 ................................................................................................................................................................................. 34
Database & Surveillance #1 ..................................................................................................................................................... 34
POPULATION HEALTH INDICATORS FOR FIRST NATIONS IN ALBERTA .................................................................................................................................... 34
MÉTIS HEALTH/WELL-BEING DATA COLLECTION: CONCEPTUAL SNAPSHOT OF FACTORS BEHIND DATA-PAUCITY AND ACTION STEPS........................ 34
COMMON DISEASES IN SIBERIAN NATIVES ..................................................................................................................................................................................35
USING HEALTH NEEDS ASSESSMENT TO INFORM PRIMARY HEALTH CARE PLANNING ..........................................................................................................35
ESTABLISHING AN INTERNATIONAL CIRCUMPOLAR COLLABORATIVE TUBERCULOSIS WORKING GROUP ..........................................................................35
THE GREENLANDIC NATIONAL INPATIENT REGISTER AS A TOOL FOR HEALTH MONITORING AND RESEARCH IN GREENLAND ........................................35
NORTHERN RSV SURVEILLANCE: OBJECTIVES, METHODS, AND PRELIMINARY RESULTS ...................................................................................................... 36
ESTABLISHING A SENTINEL SURVEILLANCE SYSTEM FOR HIV-ASSOCIATED RISK BEHAVIOURS AMONG ABORIGINAL POPULATIONS IN CANADA ....... 36
VENUE 5 ..................................................................................................................................................................................37
Community Participatory Research Methods #2 .......................................................................................................................37
CLIMATE CHANGE AND HEALTH ADAPTATION IN NORTHERN FIRST NATION AND INUIT COMMUNITIES PROGRAM .......................................................... 37
YOUTH DRIVEN PARTICIPATORY RESEARCH IN AKLAVIK, NWT ................................................................................................................................................. 37
COMMUNITY-BASED APPROACH TO HEALTH RESEARCH IN THE ARCTIC: A CASE STUDY FROM NUNAVUT, CANADA ........................................................ 37
WATCHING OUR YOUTH LISTEN TO OUR ELDERS: BUILDING YOUTH CAPACITY TO INVESTIGATE HEALTH IMPACTS OF CLIMATE CHANGE AND OIL AND
GAS DEVELOPMENT IN THE NWT .................................................................................................................................................................................................. 37
VENUE 6 ................................................................................................................................................................................. 38
Food Security #1 – Politics of Food .......................................................................................................................................... 38
ASSESSMENT OF CONTAMINANT AND DIETARY NUTRIENT INTERACTIONS IN THE INUIT HEALTH SURVEY ........................................................................38
MERCURY IN FISH AS A RESULT OF THE JAMES BAY HYDROELECTRIC DEVELOPMENT: PERCEPTIONS AND REALITIES ......................................................38
CONTAMINANTS, HEALTH, AND EFFECTIVE RISK ASSESSMENT & COMMUNICATION IN THE CIRCUMPOLAR NORTH.........................................................38
FOOD SECURITY REFERENCE GROUP: BUILDING THE EVIDENCE TO SUPPORT DECISION-MAKING AT POLICY AND COMMUNITY PLANNING LEVELS
AND IMPROVE FOOD SECURITY FOR FIRST NATIONS AND INUIT...............................................................................................................................................38
COMMUNICATION PATHWAYS: HOW YOUNG INUIT WOMEN IN NUNATSIAVUT GET INFORMATION ON NUTRITION, HEALTH, AND ENVIRONMENTAL
CONTAMINANTS ............................................................................................................................................................................................................................ 39
LEVELS OF ARSENIC, CADMIUM, LEAD, MERCURY, SELENIUM, AND ZINC IN VARIOUS TISSUES OF MOOSE HARVESTED IN THE DEHCHO, NORTHWEST
TERRITORIES .................................................................................................................................................................................................................................. 39
THE INFLUENCE OF PSYCHOSOCIAL FACTORS ON FOOD RELATED BEHAVIOURS AMONG INUIT COMMUNITIES IN NUNAVUT: RESULTS FROM
HEALTHY FOODS NORTH .............................................................................................................................................................................................................. 39
VENUE VIEWING ROOM ......................................................................................................................................................... 40

Video Session #1 ..................................................................................................................................................................... 40
“MAKKUKTUVUNGA, UPIMMAVUNGA” - I AM YOUNG AND I AM PROUD: A SCREENING OF A LIVE-TO-TAPE 2 HOUR CALL-IN PROGRAM ABOUT INUIT
YOUTH, COPING SKILLS, AND ENDURANCE ................................................................................................................................................................................ 40
SESSION 3 .................................................................................................................................................................. 40
Monday, July 13, 8:30-10:00 AM .................................................................................................................................. 40
VENUE 1.................................................................................................................................................................................. 40
Cancer #1 ................................................................................................................................................................................ 40
THE ROLE OF INTERLEUKIN-1 AND INTERLEUKIN RECEPTOR ANTAGONIST IN HEAD AND NECK SQUAMOUS CELL STUDIES: INITIAL STUDIES .............. 40
SURVIVAL OF HEAD AND NECK CANCER IN GREENLAND .......................................................................................................................................................... 40
DEVELOPING A TRADITIONAL FOOD GUIDE FOR ALASKA NATIVE CANCER PATIENTS ............................................................................................................41
THE PREVALENCE OF PROGNOSTIC AND TREATMENT FEATURES FOR BREAST CANCER SURVIVAL: ARE THEY DIFFERENT FOR FIRST NATIONS WOMEN
COMPARED TO OTHER WOMEN IN ONTARIO, CANADA? ............................................................................................................................................................41
VENUE 2 ................................................................................................................................................................................. 41
Indigenous Research #2 .......................................................................................................................................................... 41
THE NATIONAL INUIT COMMITTEE ON ETHICS AND RESEARCH (NICER) ...................................................................................................................................41
TOWARDS DEVELOPING PRINCIPLES OF ETHICAL RESEARCH IN MÉTIS COMMUNITIES ........................................................................................................ 42
WHEN SCIENCE OUTPACES NATIVE POLITICAL WILL ................................................................................................................................................................. 42
EXPLORING PROCESSES IN HEALTH RESEARCH ETHICS IN CANADA’S NORTH ....................................................................................................................... 42
IN PURSUIT OF AN ‘INDIGENOUS’ EDUCATION: STUDENT REFLECTIONS IN ABORIGINAL HEALTH RESEARCH IN CANADA ............................................... 42
VENUE 3 .................................................................................................................................................................................. 43
Indigenous Health & Wellness #2 ............................................................................................................................................. 43
BUILDING COMMUNITY CAPACITY - YUKON FIRST NATIONS’ HEALTH PROMOTION PLANNING SCHOOLS ......................................................................... 43
TLICHO COMMUNITY-BASED RESEARCH AND EVIDENCE-BASED INTERVENTIONS FOR STI PREVENTION .......................................................................... 43
HEALTH CARE DECISION-MAKING IN AN INUIT COMMUNITY .................................................................................................................................................... 43
THE DEVELOPMENT OF A HEALTH ACTION PLAN FOR CIRCUMPOLAR INUIT .......................................................................................................................... 43
WORKING ON THE LAND, WORKING OFF THE LAND .................................................................................................................................................................. 43
VENUE 4 ................................................................................................................................................................................. 44
Infectious Diseases #1 – HPV .................................................................................................................................................. 44
THE PREVALENCE OF HUMAN PAPILLOMAVIRUS AND ITS IMPACT ON CERVICAL DYSPLASIA IN NORTHERN CANADA ..................................................... 44
EVALUATING THE INTRODUCTION AND IMPACT OF THE HUMAN PAPILLOMAVIRUS VACCINE AMONG ALASKA NATIVE WOMEN ................................... 44
IMPROVING HPV PREVENTION AMONG ABORIGINAL PEOPLES ................................................................................................................................................ 44
INCIDENCE OF TYPE-SPECIFIC HPV IN A POPULATION OF INUIT WOMEN IN NUNAVIK, QUEBEC .......................................................................................... 45
HPV SURVEILLANCE: CORRELATION OF TYPE-SPECIFIC ONCOGENIC HPV WITH CERVICAL CANCER SCREENING FINDINGS IN NUNAVUT, CANADA ...... 45
VENUE 5 ..................................................................................................................................................................................45
Food Security #2 – Politics of Food ..........................................................................................................................................45
A COMMUNITY BASED INITIATIVE TOWARDS A SUSTAINABLE FOOD SECURITY STRATEGY FOR THE COMMUNITY OF OLD CROW, YUKON................... 45
WHAT DOES ‘FOOD SECURITY’ MEAN TO INUIT? INPUT INTO AN INUIT STRATEGY FOR INUIT OF NUNAAT ........................................................................ 45
FROM SURVIVAL TO NECESSITY: FOOD STORIES FROM THREE GENERATIONS OF LABRADOR INUIT-MÉTIS ...................................................................... 46
INDIGENOUS PEOPLES’ FOOD SYSTEMS FOR HEALTH: THREE CANADIAN INUIT AND FIRST NATIONS PROJECTS ............................................................. 46
ORAL HISTORY CONTRIBUTIONS TO UNDERSTANDING FOOD SECURITY TRENDS AND ADAPTATIONS: VUNTUT GWITCHIN FIRST NATION, YUKON,
CANADA.......................................................................................................................................................................................................................................... 46
PROMOTING HEALTHIER FOOD OPTIONS IN CONJUNCTION WITH HEALTH FOODS NORTH: A RETAIL PERSPECTIVE .........................................................47
BUILDING CULTURAL PRIDE WITH TRADITIONAL FOODS (VIDEO) .............................................................................................................................................47
VENUE 6 .................................................................................................................................................................................. 47
Health Promotion & Social Marketing ...................................................................................................................................... 47
DON’T BE A BUTTHEAD CAMPAIGN- 5 YEARS EXPERIENCE WITH A SOCIAL MARKETING CAMPAIGN TARGETED TO YOUTH TOBACCO REDUCTION ......47
CLOTH DIAPER PILOT .....................................................................................................................................................................................................................47
HEALTHY SMILE HAPPY CHILD: RESEARCH AND EVALUATION OF A CAPACITY BUILDING ORAL HEALTH PROMOTION INITIATIVE .................................. 48
YOUTH AND TOBACCO: WORKING WITH THE K’ÁLEMI DENE SCHOOL .................................................................................................................................... 48
NORTH STARSS (START THINKING ABOUT REDUCING SECONDHAND SMOKE) ...................................................................................................................... 48
VENUE 7 ................................................................................................................................................................................. 48
Clinical Care #2 ....................................................................................................................................................................... 48
PHYSIOTHERAPY IN NUNAVUT: OBSERVATIONS AND CHALLENGES FOR PRACTICE ............................................................................................................. 48
DEATH & DYING: PERSPECTIVES OF A FIRST NATIONS COMMUNITY IN THE NORTHWEST TERRITORIES ............................................................................. 48
ABORIGINAL PATIENT NAVIGATORS: FACILITATING ACCESS TO MAINSTREAM HEALTH SERVICES FOR ABORIGINAL PEOPLE ......................................... 49
PARTNERSHIPS IN HEALTH CARE INFRASTRUCTURE DEVELOPMENT IN NUNAVUT ............................................................................................................... 49
SESSION 4 .................................................................................................................................................................. 50
Monday, July 13, 1:30-3:30 PM .................................................................................................................................... 50
VENUE 1 ..................................................................................................................................................................................50
Indigenous Pedagogy in Mental Health Workshop: Healing Teachings for Mental Health Workers, Valuable Knowledge for
Clients .....................................................................................................................................................................................50
VENUE 2 ..................................................................................................................................................................................50
Education & Building Resource/Research Capacity #1 ..............................................................................................................50
DEVELOPING A PHYSICIAN SERVICES PROGRAM IN NUNAVUT 1999-2009 .............................................................................................................................. 50
PROPOSAL FOR A STANDARD PRIMARY CARE PHYSICIAN COMMUNITY COVERAGE MODEL FOR THE NORTHWEST TERRITORIES ...................................51
DISTRIBUTION OF PHYSICIANS, NURSES, AND PHARMACISTS IN NORTHERN CANADA ..........................................................................................................51
COMMUNITY-BASED HEALTH CARE IN ACTION ...........................................................................................................................................................................51
HEADING A SÁMI HEALTH INSTITUTION: EXPERIENCE AND CHALLENGES .............................................................................................................................. 52

LAND BASED EXPERIENTIAL INDIGENOUS CULTURE AND HEALTH TRAINING ........................................................................................................................ 52
IMPROVING ACCESS AND OUTCOMES IN CANADA’S NORTHERN TERRITORIES ...................................................................................................................... 52
VENUE 3.................................................................................................................................................................................. 52
Indigenous Wellness & Medical History #3 ............................................................................................................................... 52
HISTORICAL AND SOCIAL EFFECTS OF LEGISLATION AND POLICY IN ABORIGINAL HEALTH ................................................................................................. 52
A SOCIAL AND ENVIRONMENTAL HISTORY OF HEALTH CARE RELOCATIONS IN THE CANADIAN NORTH SINCE 1890 .........................................................53
“ARE YOU NOW A QALLUNAQ?” INUIT TUBERCULOSIS EVACUEES IN THE 1940S-1950S .........................................................................................................53
HISTORICAL AND SCIENTIFIC PERSPECTIVES ON HEALTH OF CANADA’S FIRST PEOPLES.......................................................................................................53
THE HEALTH OF FIRST NATIONS CHILDREN UPON ADMISSION TO A RESIDENTIAL SCHOOL IN A NORTHERN MANITOBA COMMUNITY ..........................53
MY GRANDMOTHER’S MOCCASINS ............................................................................................................................................................................................. 54
CAREGIVING IN CONFINEMENT: JAPANESE IMMIGRANT MIDWIVES DURING WORLD WAR II ................................................................................................ 54
VENUE 4 ................................................................................................................................................................................. 54
Infectious Diseases #2 – Tuberculosis ...................................................................................................................................... 54
HARMONY, BALANCE, AND RESILIENCE: ENHANCING ADHERENCE TO TB TREATMENT IN CANADIAN ABORIGINAL POPULATIONS ............................... 54
VITAMIN D RECEPTOR GENE POLYMORPHISMS IN A CANADIAN FIRST NATIONS POPULATION WITH TB ............................................................................ 54
REVIEW OF MANAGEMENT OF THE 2007 YELLOWKNIFE TB OUTBREAK ...................................................................................................................................55
TUBERCULOSIS AND VITAMIN D IN GREENLAND.........................................................................................................................................................................55
TUBERCULOSIS INFECTION AMONG INUIT CHILDREN IN GREENLAND .....................................................................................................................................55
MANITOBA'S ABORIGINAL PEOPLE AND TB: HOW SOCIAL CONDITIONS AND BEHAVIOURS CONTRIBUTE TO THE ELEVATED RATES ............................. 56
VENUE 5 ................................................................................................................................................................................. 56
Food Security #3 – Factors affecting Food Security .................................................................................................................. 56
FACTORS INFLUENCING DIET AND THE FOOD ENVIRONMENT IN TWO INUIT COMMUNITIES IN NUNAVUT: QUALITATIVE FORMATIVE RESEARCH
RESULTS FROM HEALTHY FOODS NORTH .................................................................................................................................................................................. 56
CLIMATE CHANGE IMPACTS AND ADAPTATION: IMPLICATIONS FOR DIET AND HEALTH IN TWO FIRST NATION COMMUNITIES IN THE YUKON, CANADA
......................................................................................................................................................................................................................................................... 56
CLIMATE CHANGE AND FOOD SECURITY AMONG FEMALES IN AN INUIT COMMUNITY ......................................................................................................... 56
INUIT WOMEN AND CLIMATE CHANGE ......................................................................................................................................................................................... 57
PREVALENCE AND DETERMINANTS OF FOOD SECURITY AMONG INUIT HOUSEHOLDS WITH PRESCHOOL AGED CHILDREN ............................................ 57
HEALTH BELIEFS AND DIETARY COMPOSITION AMONG INUIT LIVING IN NUNAVUT, CANADA .............................................................................................. 57
THE IMPACT OF HELIOPHYSICAL FACTORS ON MAN LIFESPAN IN THE CIRCUMPOLAR REGIONS. PERSPECTIVES OF USAGE OF THE HELIO-
GEROPROTECTORS ........................................................................................................................................................................................................................ 57
VENUE 6 ................................................................................................................................................................................. 58
Chronic Diseases #1 ................................................................................................................................................................ 58
INFLAMMATORY MARKERS FOR PATIENTS ISCHEMIC HEART DISEASE (IHD) IN THE CONDITIONS OF YAKUTIA ................................................................. 58
ASSOCIATION OF THE CONTENTS OF BASAL INSULIN WITH LIPIDE METABOLISM AND PREVALENCE OF CHOLELITHIASIS AND ISCHEMIC HEART
DISEASE IN POPULATION OF EASTERN SIBERIA ......................................................................................................................................................................... 58
VITAL EXHAUSTION AND MYOCARDION INFARCTION (EPIDEMIOLOGICAL RESEARCH ON BASIS OF PROGRAM WHO MONICA-PSYCHOLOGICAL) ....... 58
DO THE OBESE GREENLANDERS CONSIDER THEMSELVES OBESE? BODY SIZE PERCEPTION AND OBESITY IN RELATION TO DEMOGRAPHIC FACTORS58
STUDY OF LEFT VENTRICULAR STRUCTURALLY-FUNCTIONAL CONDITION IN PATIENTS WITH CORONARY ARTERY DISEASE AND ACCOMPANYING
ARTERIAL HYPERTENSION ............................................................................................................................................................................................................ 59
SPECTRUM OF FATTY ACIDS IN BLOOD SERUM AND PREVALENCE OF CHOLELITHIASIS IN MONGOLOIDS AND EUROPOIDS OF SIBERIA ....................... 59
ADAPTATION OF CARDIOVASCULAR SYSTEM AT HIGH PHYSICAL ACTIVITY IN THE NORTH ................................................................................................. 59
COMMUNITY DIABETES WORKERS COME TO LIFE ..................................................................................................................................................................... 60
TRADITIONAL DIET FOR OBESITY AND DIABETES IN A FIRST NATIONS COMMUNITY............................................................................................................. 60
VENUE 7 .................................................................................................................................................................................. 60
Injury Prevention ..................................................................................................................................................................... 60
DROWNING PREVENTION IN THE NWT & NUNAVUT: RESULTS FROM A THREE YEAR STUDY ................................................................................................ 60
FIRST NATIONS AND INUIT CHILDREN AND YOUTH INJURY INDICATORS PROJECT ................................................................................................................ 61
A SURVEY OF INJURIES PRESENTING TO HOSPITAL AND A COMMUNITY HEALTH CENTRE IN NUNAVUT, CANADA ........................................................... 61
WORKER FATALITIES IN THE ALASKA TOURISM INDUSTRY: 1990-2008 .................................................................................................................................... 61

HEALTH HAZARDS OF THE ARCTIC/SUBARCTIC MOOSE ............................................................................................................................................................ 62
HEALTH HAZARDS OF NORTH AMERICAN ANIMAL VEHICLE ACCIDENTS ................................................................................................................................ 62
THE CANADIAN RED CROSS EXPERIENCE IN INJURY PREVENTION ........................................................................................................................................... 62
COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH TO UNINTENTIONAL INJURY PREVENTION IN THE YUKON ................................................ 62
SESSION 5 .................................................................................................................................................................. 62
Monday, July 13, 4:00-5:30 PM .................................................................................................................................... 62
VENUE 1 ................................................................................................................................................................................. 62
Mental Health & Wellness #3 – Trauma at the Front Line ........................................................................................................ 62
MENTAL HEALTH AND ADDICTIONS IN THE NORTHWEST TERRITORIES: PERSPECTIVES FROM THE FRONTLINE SERVICE PROVIDERS ........................... 62
BEYOND VICARIOUS TRAUMA - HELPING OURSELVES AS WE HELP OTHERS .......................................................................................................................... 63
SECONDARY TRAUMA AND NORTHERN HELPING PRACTITIONERS ......................................................................................................................................... 63
ETHNIC DISCRIMINATION AND BULLYING IN THE SÁMI AND NON-SÁMI POPULATIONS IN NORWAY: THE SAMINOR STUDY ........................................... 63
MEASURING THE HEALTH EFFECTS OF HISTORICAL AND CONTEMPORARY CULTURAL LOSSES .......................................................................................... 63
VENUE 2 ................................................................................................................................................................................. 64
Sexual Health #1 ..................................................................................................................................................................... 64
LIFE QUALITY IN HIV-INFECTED GREENLANDERS ....................................................................................................................................................................... 64
AN ADOLESCENT FOCUS GROUP PROJECT ON SEXUALLY TRANSMITTED DISEASE, HIV/AIDS, AND UNPLANNED PREGNANCY ...................................... 64
COMING OF AGE: HOW YOUNG WOMEN IN THE NORTHWEST TERRITORIES UNDERSTAND BARRIERS AND FACILITATORS TO POSITIVE, EMPOWERED,
AND SAFER SEXUAL HEALTH ........................................................................................................................................................................................................ 64
HIV/AIDS AND THE LIFESAVERS CAMPAIGN: PREVENTION AND EDUCATION ACROSS INUIT NUNAAT................................................................................. 64
SOCIAL AND CULTURAL FACTORS INFLUENCING SEXUAL HEALTH IN GREENLAND .............................................................................................................. 65
THE IMPORTANCE OF COMMUNITY INVOLVEMENT IN IDENTIFYING BARRIERS TO CONTRACEPTIVE USE AMONG ADOLESCENTS IN RURAL AND
REMOTE SETTINGS ........................................................................................................................................................................................................................ 65
VENUE 3 ..................................................................................................................................................................................65
Genetics ..................................................................................................................................................................................65
ASSOCIATION BETWEEN PERIODONTITIS AND RHEUMATOID ARTHRITIS IN CREE AND OJIBWAY POPULATIONS: A STUDY OF GENE-ENVIRONMENT
EFFECTS .......................................................................................................................................................................................................................................... 65
EXPLORING THE IMPACT OF LONG QT SYNDROME IN A BRITISH COLUMBIA FIRST NATIONS COMMUNITY ........................................................................ 66
A REVIEW OF COMMUNITY-BASED PARTICIPATORY APPROACH TO GENETIC AND GENOMIC RESEARCH IN AMERICAN INDIAN/ALASKA NATIVE
POPULATION ................................................................................................................................................................................................................................. 66
GENETIC VARIABILITY IN CIRCADIAN RHYTHMS IN AN ARCTIC MAMMAL THAT MAY HAVE HEALTH IMPLICATIONS FOR PEOPLE LIVING IN
CIRCUMPOLAR REGIONS............................................................................................................................................................................................................... 66
GENETIC REGULATION OF CIRCULATING FATTY ACIDS IN ALASKAN ESKIMOS ....................................................................................................................... 66
INTERETHNIC DIFFERENCES IN FREQUENCY OF ALLELES AND GENOTYPES OF POLYMORPHIC MARKERS OF CARDIOVASCULAR DISEASES IN YAMALO-
NENETS AUTONOMOUS OKRUG (RUSSIA) ...................................................................................................................................................................................67
POLYMORPHISMS AND MUTATIONS IN GJB2 ASSOCIATED WITH HEREDITARY HEARING LOSS IN EAST GREENLANDERS .................................................67
APOLIPOPROTEIN E POLYMORPHISM IN NATIVE POPULATION OF MOUNTAIN SHORIA (WEST SIBERIA) AND ITS ASSOCIATION WITH SERUM GLUCOSE
LEVELS .............................................................................................................................................................................................................................................67
VENUE 4 ................................................................................................................................................................................. 68
Infectious Diseases #3 – Tuberculosis ...................................................................................................................................... 68
PREVALENCE OF LATENT TB INFECTION (LTBI) AMONG SCHOOL CHILDREN IN GREENLAND ............................................................................................... 68
TUBERCULOSIS AMONG CHILDREN AND YOUTH IN THE ARCTIC FROM GREENLAND POINT OF VIEW ................................................................................. 68
ASSESSING THE EPIDEMIOLOGICAL METHODS USED IN A TUBERCULOSIS OUTBREAK IN NORTHWEST TERRITORIES, CANADA ..................................... 68
THE DETERMINANTS OF TUBERCULOSIS TRANSMISSION IN THE CANADIAN-BORN POPULATION OF THE PRAIRIE PROVINCES: THE QUALITATIVE
FINDINGS IN MANITOBA................................................................................................................................................................................................................ 68
TUBERCULOSIS IN INDIGENOUS PEOPLE OF MURMANSK REGION, RUSSIA ............................................................................................................................ 69
RIDING THE WAVES OF RECENT TB & SYPHILIS OUTBREAKS IN YELLOWKNIFE, NT- PLANNING, PARTNERSHIPS, PERSISTENCE ...................................... 69
VENUE 5 ................................................................................................................................................................................. 69
Climate Change – Health Impacts............................................................................................................................................ 69
IS HEAT A MORTALITY RISK IN THE CANADIAN ARCTIC? WILL IT BE? ........................................................................................................................................ 69
CLIMATE CHANGE IMPACT ON PUBLIC HEALTH IN THE RUSSIAN ARCTIC- FIRST ASSESSMENT .............................................................................................70
CLIMATE CHANGE IMPACT ON HUMAN EXPOSURE TO PERSISTENT CONTAMINANTS IN ARCTIC RUSSIA ............................................................................70
CLIMATE CHANGE CHALLENGES TO ARCTIC HEALTH (AN EXAMPLE OF THE NORTHERN PEOPLES OF YAKUTIA) ...............................................................70
SEASONAL VARIATIONS OF MORTALITY FROM CLIMATE-RELATED CAUSES IN ARCTIC CITIES ..............................................................................................70
THE HEALTH OF ARCTIC POPULATIONS: DOES COLD MATTER? ................................................................................................................................................ 71
VENUE 6 ..................................................................................................................................................................................71
Pathways to Knowledge, Pathways to Health Workshop ..........................................................................................................71
VENUE VIEWING ROOM ..........................................................................................................................................................71
Video #2 ..................................................................................................................................................................................71
NUTARAQTAARNIQ NUNALINGNIRMIUNUT ALIANAIPPUQ- BIRTH A JOYOUS COMMUNITY EVENT: A SCREENING OF A LIVE-TO-TAPE 2-HOUR CALL-IN
PROGRAM ABOUT INUIT MATERNITY CARE ................................................................................................................................................................................. 71
SESSION 6 .................................................................................................................................................................. 72
Tuesday, July 14, 8:30-10:00 AM ................................................................................................................................. 72
VENUE 1.................................................................................................................................................................................. 72
Mental Health & Wellness #4 – Suicide & Addictions ............................................................................................................... 72
SUICIDE ATTEMPTS AND ALCOHOL DEPENDENCE IN GREENLAND...........................................................................................................................................72
SUICIDE AMONG INDIGENOUS SÁMI IN ARCTIC NORWAY 1970-1998 .........................................................................................................................................72
A CULTURAL MODEL OF SUICIDE PREVENTION FOR CARRIER FIRST NATIONS YOUTH ...........................................................................................................72
THE ETHNIC AND CULTURAL FEATURES OF COURSE OF ALCOHOLISM IN INDIGENOUS PEOPLES OF THE NORTH OF KHABROVSK TERRITORY ............. 73
GAMBLING: A NEW PLAYER IN GREENLANDIC PUBLIC HEALTH RESEARCH .............................................................................................................................. 73
VENUE 2 ..................................................................................................................................................................................73
Women’s & Family Health & Well-Being #1 – Fetal Alcohol Spectrum Disorder .........................................................................73
CULTURALLY APPROPRIATE RESPONSES TO FASD .................................................................................................................................................................... 73
VIEWING AND UNDERSTANDING FETAL ALCOHOL SPECTRUM DISORDER FROM A DISABILITY PERSPECTIVE..................................................................... 73
A COMPREHENSIVE APPROACH TO FETAL ALCOHOL SPECTRUM DISORDER ..........................................................................................................................74
AN EDUCATION OF HEART, HAND, MIND, AND SPIRIT- THE BLANKET TOSS TOOLS FOR SCREENING, ASSESSMENT, AND INTERVENTION OF FASD AND
OTHER DEVELOPMENTAL CONDITIONS- A RELATIONAL SYSTEMS APPROACH ......................................................................................................................74
PERSONAL ECOLOGY AND ENVIRONMENTAL STRUGGLES FOR BIRTH MOTHERS OF CHILDREN WITH FETAL ALCOHOL SPECTRUM DISORDER ............74
YUKON FAS DIAGNOSIS TEAM; DEVELOPMENT OF A TEAM- MOUNTAINS TO CLIMB, VALLEYS TO CROSS ..........................................................................74
VENUE 3.................................................................................................................................................................................. 74
Food Security #4 – How Are We Eating? .................................................................................................................................. 74
PEOPLE DO NOT EAT N-3 FATTY ACIDS, THEY EAT MEALS .........................................................................................................................................................74
DETERMINANTS OF CHANGE IN FAT CONSUMPTION PATTERNS IN NAIN, NEWFOUNDLAND ................................................................................................ 75
THE ASSESSMENT OF BONE MINERAL DENSITY, CALCIUM, AND VITAMIN D INTAKE AND EXPOSURE IN BRITISH ANTARCTIC SURVEY PERSONNEL ...... 75
AN ASSESSMENT OF DIETARY INTAKE IN AN INUVIALUIT POPULATION TO HIGHLIGHT FOODS FOR A NUTRITIONAL INTERVENTION PROGRAM TO
IMPROVE DIETARY INTAKE: RESULTS FROM HEALTH FOODS NORTH ...................................................................................................................................... 75
FOOD AND NUTRIENT INTAKE OF INUIT ADULTS AND THE DEVELOPMENT OF A QUANTITATIVE FOOD FREQUENCY QUESTIONNAIRE TO EVALUATE A
NUTRITIONAL AND LIFESTYLE INTERVENTION PROGRAM AIMED AT IMPROVING DIETARY INTAKE AND HEALTH: RESULTS FROM HEALTHY FOODS
NORTH .............................................................................................................................................................................................................................................76
QUALITY ASPECTS OF THE INUIT DIET IN GREENLAND ...............................................................................................................................................................76
INFLUENCE OF CASUAL WEAR AND EVERYDAY DIET ON HEALTH .............................................................................................................................................76
VENUE 4 ..................................................................................................................................................................................77
Infectious Diseases #4 – Hepatitis.............................................................................................................................................77
FREQUENCY AND DISTRIBUTION OF HEPATITIS B VIRUS GENOTYPES IN GREENLAND ASSOCIATION WITH PRECORE AND BASAL CORE PROMOTER
MUTATIONS .................................................................................................................................................................................................................................... 77
GENOTYPIC CHARACTERIZATION OF HEPATITIS B VIRUS FROM CHRONIC CARRIERS LIVING IN THE CANADIAN NORTH .................................................... 77
A POPULATION BASED PERSPECTIVE AND RETROSPECTIVE STUDY OF LIVER RELATED MORTALITY IN ALASKA NATIVE PEOPLE WITH HEPATITIS C
INFECTION ....................................................................................................................................................................................................................................... 77
ABORIGINAL IMMUNITY: POTENTIAL CONTRIBUTION TO THE OUTCOME OF HEPATIC INFECTION AND DISEASE ............................................................... 77
LONG-TERM PROTECTION AFTER HEPATITIS B IMMUNIZATION IN ALASKA NATIVE PEOPLE.................................................................................................78
MOLECULAR EPIDEMIOLOGY OF VIRAL HEPATITIS B, C, AND D IN THE CHUKOT REGION .......................................................................................................78
VENUE 5 .................................................................................................................................................................................. 78
Education and Building Resource/Research Capacity #2 ........................................................................................................... 78
BY THE NORTH FOR THE NORTH: A PAN-TERRITORIAL STRATEGY TO BUILD PUBLIC HEALTH CAPACITY.............................................................................78
PUBLIC HEALTH PROFESSIONAL DEVELOPMENT ONLINE: SUCCESSES AND CHALLENGES ...................................................................................................79
PUBLIC HEALTH SKILLS ONLINE: PILOT FOR NORTHERN ABORIGINAL WORKERS ...................................................................................................................79
CREATING HEALTH RESEARCH CAPACITY: THE ABORIGINAL HEALTH NETWORK PARTNERSHIPS FOR BRITISH COLUMBIA AND THE WESTERN ARCTIC79
THE NATIONAL COLLABORATING CENTRE FOR ABORIGINAL HEALTH: A CENTRE FOR SHARING KNOWLEDGE ................................................................. 80
SUSTAINING HEALTH RESEARCH ACTIVITIES IN CANADA’S NORTHERN TERRITORIES ........................................................................................................... 80
A PAN-ARCTIC COLLABORATIVE FOR E-HEALTH: NEED, VALUE, AND LESSONS ..................................................................................................................... 80
INTRODUCING INTERNET COMMUNICATIONS TECHNOLOGIES TO A NORTHERN HEALTH CONTEXT: BEST PRACTICES AND POTENTIAL IMPLICATIONS
......................................................................................................................................................................................................................................................... 80
SESSION 7 .................................................................................................................................................................. 81
Tuesday, July 14, 1:30-3:30 PM .................................................................................................................................... 81
VENUE 1 .................................................................................................................................................................................. 81
Housing & Infrastructure .......................................................................................................................................................... 81
HOUSING CONDITIONS AND TUBERCULOSIS: EXPLORING THE RELATIONSHIP BETWEEN DISEASE AND ENVIRONMENT IN NORTHERN FIRST NATIONS
COMMUNITIES ................................................................................................................................................................................................................................81
YOU JUST BLINK AND IT CAN HAPPEN: WOMEN’S HOMELESSNESS NORTH OF 60 ..................................................................................................................81
EVERYONE WANTS TO HAVE A PLACE?: UNDERSTANDING HOMELESSNESS AS HOUSING INSECURITY IN THE NORTHWEST TERRITORIES, CANADA ...81
ACUTE INFECTIOUS DIARRHEAL ILLNESS IN A FIRST NATIONS COMMUNITY IN NORTHERN MANITOBA, CANADA: EPIDEMIOLOGY AND THE IMPACT OF
WATER, SANITATION, AND HOUSING ...........................................................................................................................................................................................81
ALASKA’S GREAT THIRST: WATER, ENERGY, AND HEALTH IN IÑUPIAQ COMMUNITIES OF THE NORTHWEST ARCTIC BOROUGH ..................................... 82
THE ROLE OF HOUSING AS A DETERMINANT OF HEALTH FOR INUIT IN CANADA ................................................................................................................... 82
LESSONS FOR HERE AND NOW. PUVALLUTUQ: THE ESKIMO POINT TB EPIDEMIC OF 1963 AND THE CONTEMPORARY HOUSING CRISIS IN INUIT
COMMUNITIES ............................................................................................................................................................................................................................... 82
INDOOR AIR QUALITY ISSUES IN FIRST NATIONS AND INUIT COMMUNITIES IN CANADA ...................................................................................................... 82
VENUE 2 .................................................................................................................................................................................. 83
Women’s Health & Well-Being #2 ............................................................................................................................................ 83
CAN THE FETAL FIBRONECTIN ASSAY AT TERM BE USED TO SAFELY DELAY EVACUATION OF RURAL WOMEN FROM THEIR HOME COMMUNITIES? .....83
SPECIAL DELIVERY: TRANSPORTING IÑUPIAT MOTHERS AND BABIES IN NORTHWEST ALASKA ...........................................................................................83
ARE INCREASING NUMBERS OF CESAREAN SECTIONS PLACING A BURDEN ON CANADA’S HEALTH CARE SYSTEM? ..........................................................83
INUIT MIDWIFERY AND MATERNAL CHILD HEALTH .................................................................................................................................................................... 84
MÉTIS CONCEPTS OF HEALTHY PREGNANCY: A LOOK AT EFFECTIVE HEALTH PROMOTION, CULTURAL SAFETY, AND CONCEPTS OF WELL-BEING ..... 84
“KEEPING MYSELF WELL”: THE RELATIONSHIPS OF PERINATAL HEALTH BENEFITS AND HEALTH PROMOTION PRACTICES OF TLICHO WOMEN .......... 84
INTRODUCTION OF MIDWIFERY SERVICES AND CLIENT SATISFACTION .................................................................................................................................. 85
HISTORICAL NARRATIVES AND HUMAN KINDS: THE EVOLUTION OF INUIT CHILDBIRTH INTO THE 21ST CENTURY ............................................................ 85
VENUE 3 ..................................................................................................................................................................................85
Indigenous Health & Wellness #4 .............................................................................................................................................85
BILL C-51: PROPOSED FEDERAL REGULATION OF TRADITIONAL MEDICINE ............................................................................................................................ 85
ENHANCING EXISTING COMMUNITY HEALTH CAPACITY AND INFRASTRUCTURE BY FOCUSING ON THE INTEGRATION OF INUVIALUIT, GWICH’IN, AND
WESTERN MEDICINE APPROACHES TO PALLIATIVE CARE ......................................................................................................................................................... 85
INDIGENIZING CHILD WELFARE MODELS: METHODS AND OUTCOMES ................................................................................................................................... 85
GETTING IT RIGHT: USING POPULATION SPECIFIC, COMMUNITY-BASED RESEARCH TO ADVANCE THE HEALTH AND WELL-BEING OF FIRST NATIONS,
INUIT, AND MÉTIS IN CANADA ...................................................................................................................................................................................................... 86
GEGENOATATOLTIMG (SHARING THE KNOWLEDGE): A TRADITIONAL FIRST NATIONS GATHERING TO SUPPORT HEALTH AND HEALING IN CANADA 86
VENUE 4 ................................................................................................................................................................................. 86
Infectious Diseases #5 – H.Pylori, Superbugs, etc. ................................................................................................................... 86
EPIDEMIOLOGY OF HAEMOPHILUS INFLUENZAE SEROTYPE A FROM 2000-2007, AN EMERGING PATHOGEN IN NORTHERN CANADA AND ALASKA ..... 86
MYCOPLASMA GENITALIUM IN GREENLAND: PREVALENCE, MACROLIDE RESISTANCE, ETHICAL CONSIDERATIONS, AND POLICY IMPLICATIONS ........87
MONITORING AND MITIGATING PARASITIC RISKS TO HUMAN HEALTH IN AN INDIGENOUS COMMUNITY FROM NORTHERN SASKATCHEWAN..............87
SUPERBUGS IN THE NWT ...............................................................................................................................................................................................................87
CA-MRSA OUTBREAK IN NUNAVUT, CANADA: KNOWLEDGE OF SOCIAL NETWORKS IS KEY TO TARGETING CONTROL MEASURES ................................ 88
CA-MRSA IN A NORTHERN COMMUNITY DESCRIPTION OF OUTBREAK AND POSSIBLE CONTROL ....................................................................................... 88
METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS: A COMMUNITY-ASSOCIATED CONCERN IN LABRADOR ................................................................ 88
VENUE 5 ................................................................................................................................................................................. 88
Education and Building Resource/Research Capacity #3 .......................................................................................................... 88
PROVIDING LIBRARY SERVICES TO CONTRIBUTE TO CAPACITY BUILDING AND KNOWLEDGE TRANSLATION IN THE CANADIAN NORTH ....................... 88
KSTE AND THE NORTH: HOW KNOWLEDGE SYNTHESIS, TRANSLATION, AND EXCHANGE OF EVIDENCE CAN INFORM CIRCUMPOLAR HEALTH ............ 89
THE CIRCUMPOLAR HEALTH BIBLIOGRAPHIC DATABASE ......................................................................................................................................................... 89
THE ARCTIC HUMAN HEALTH INITIATIVE: THE ONLINE RESOURCE AT WWW.ARCTICHEALTH.ORG...................................................................................... 89
BRINGING EVIDENCE TO THE NORTH: CADTH’S LIAISON OFFICERS ASSIST WITH INFORMED DECISION MAKING............................................................... 90
A CONTENT ANALYSIS OF WEBSITES FEATURING INUIT HEALTH INFORMATION ................................................................................................................... 90
AN INTERNATIONAL PALLIATIVE CARE SYMPOSIUM: USING VIDEO TELECONFERENCING AND VIRTUAL TECHNOLOGY TO MEET THE NEEDS OF RURAL
HEALTH CARE PROVIDERS ............................................................................................................................................................................................................ 90
COLLABORATIVE PRACTICE: WALKING THE TALK ...................................................................................................................................................................... 90
VENUE 6 ................................................................................................................................................................................. 91
Chronic Diseases #2 ................................................................................................................................................................ 91
CVD AND ITS RELATION TO RISK FACTORS IN ALASKA ESKIMOS: THE GOCADAN STUDY ..................................................................................................... 91
HEART RATE IS ASSOCIATED WITH RED BLOOD CELL FATTY ACID CONCENTRATION: THE GOCADAN STUDY ................................................................... 91
RELATIONSHIPS AMONG LIPOPROTEIN SUBFRACTIONS AND CAROTID ATHEROSCLEROSIS: THE GOCADAN STUDY ....................................................... 91
CARDIOVASCULAR DISEASES IN NATIVE POPULATION OF YAMAL PENINSULA (RUSSIA) ...................................................................................................... 92
DIFFERENT TYPES OF CORONARY LESIONS AND THEIR IMPACT ON COURSE AND OUTCOMES OF EARLY ACUTE MYOCARDIAL INFARCTION IN THE
RUSSIAN NORTH ............................................................................................................................................................................................................................ 92
CARDIOVASCULAR DISEASES AND THEIR RISK FACTORS IN THE ASIAN PART OF RUSSIA ..................................................................................................... 92
NEW METHOD OF RESPIRATORY BIOFEEDBACK ........................................................................................................................................................................ 92
EPIDEMIOLOGY OF CORONARY HEART DISEASE IN A POPULATION OF THE CIRCUMPOLAR REGION (RUSSIA) .................................................................. 92
SESSION 8 .................................................................................................................................................................. 93
Tuesday, July 14, 4:00-5:30 PM ................................................................................................................................... 93
VENUE 1.................................................................................................................................................................................. 93
Mental Health & Wellness #5 – Children & Youth ..................................................................................................................... 93
THE INFLUENCE OF RELIGIOUS FACTORS ON DRINKING BEHAVIOUR AMONG YOUNG INDIGENOUS SÁMI AND NON-SÁMI PEERS IN NORTHERN
NORWAY ........................................................................................................................................................................................................................................ 93
SNUFF USE AND CIGARETTE SMOKING AMONG INDIGENOUS SÁMI AND NON-SÁMI 10TH GRADERS IN NORTHERN NORWAY 2003-2005 ...................... 93
CHALLENGING THE STEREOTYPE: A PORTRAIT OF HEALTHY INDIGENOUS YOUTH PARTICIPANTS AT THE COWICHAN (BRITISH COLUMBIA, CANADA)
2008 NORTH AMERICAN INDIGENOUS GAMES ........................................................................................................................................................................... 93
FAMILY HEALTH AND WELL-BEING: RESEARCH, RESPONSIBILITY, REACTION ........................................................................................................................ 94
THE APPLICATION OF STRENGTH BASED ASSESSMENTS AND INTERVENTIONS WITH CHILDREN AND ADOLESCENTS EXPERIENCING MENTAL HEALTH
DIFFICULTIES .................................................................................................................................................................................................................................. 94
THREE CHILDREN ON ONE BIKE: AN ANTHROPOLOGICAL STUDY WITH ON WHAT CHILDREN ARE CAPABLE OF AND WHAT CHILDREN WANT .............. 94
VENUE 2 ................................................................................................................................................................................. 94
Occupational Health ................................................................................................................................................................ 94
PSYCHODYNAMIC ANALYSIS OF ANTARCTIC INTERGROUPS RELATIONS ............................................................................................................................... 94
RASCH ANALYSIS OF THE OSWESTRY DISABILITY INDEX .......................................................................................................................................................... 94
OCCURRENCE AND RISK FACTORS OF FROSTBITES AT THE POPULATION LEVEL WITH A SPECIAL EMPHASIS ON WORKING LIFE .................................... 95
NUTRITION, VITAMINS, SERUM LIPIDS, AND CARDIOVASCULAR DISEASES RISK IN DRIVERS WORKED IN GAS INDUSTRY ON THE NORTH OF RUSSIA .. 95
PSYCHOPHYSIOLOGICAL ASPECTS OF ADAPTATION OF OIL SHIFT WORKERS ....................................................................................................................... 95
HUMAN HEALTH RISK ASSESSMENT AND BEYOND – THE COMMUNITY HEALTH ................................................................................................................... 96
VENUE 3.................................................................................................................................................................................. 96
Newborn & Child Health #1 – Birth Defects.............................................................................................................................. 96
THE INCIDENCE OF SEVERE CONGENITAL DEFECTS IN NORWAY AND NORTHWEST RUSSIA ................................................................................................ 96
CHART REVIEW ANALYSIS OF MATERNAL FACTORS AND MAJOR MALFORMATIONS ON BAFFIN ISLAND 2000-2005 ......................................................... 96
CONGENITAL ANOMALIES IN CANADA’S NORTHERN TERRITORIES ......................................................................................................................................... 96
RATES OF HOSPITALIZATION FOR LUNG INFECTION OF INUIT INFANTS FROM THE BAFFIN REGION AND ASSOCIATION WITH HEART DEFECTS 2000-
2005 ..................................................................................................................................................................................................................................................97
THE STATE OF BIRTH DEFECTS AND BIRTH OUTCOME SURVEILLANCE IN THE CIRCUMPOLAR REGIONS OF THE WORLD IN 2008 .....................................97
VENUE 4 .................................................................................................................................................................................. 97
Education and Building Resource/Research Capacity #4 ........................................................................................................... 97
THE SAFETY OF SMALL DRINKING WATER SYSTEMS IN CANADA: DISCUSSING THE NORTHERN PERSPECTIVE ...................................................................97
BUILDING INDIGENOUS CAPACITY TO MEET HEALTH NEEDS AND COMBAT HEALTH DISPARITIES: A MANITOBA (CANADA) EXPERIENCE ...................... 98
INCREASING HIV/AIDS COMMUNITY-BASED RESEARCH CAPACITY IN NORTHERN ABORIGINAL COMMUNITIES IN CANADA............................................. 98
YUKON FIRST NATION ................................................................................................................................................................................................................... 98
ANISHINABE HEALTH PLAN .......................................................................................................................................................................................................... 98
ONTARIO FIRST NATIONS PUBLIC HEALTH PROJECT: TRIPARTITE APPROACH ....................................................................................................................... 99
THE TRIPARTITE FIRST NATIONS HEALTH PLAN- A FUNDAMENTAL CHANGE IN GOVERNANCE OF HEALTH SERVICES FOR THE FIRST NATIONS OF
BRITISH COLUMBIA, CANADA ....................................................................................................................................................................................................... 99
COLLABORATIVE RESEARCH IN NUNAVUT: A CASE HISTORY ................................................................................................................................................... 99
VENUE 5 ................................................................................................................................................................................ 100

Community Participatory Methods #1 (workshop) ................................................................................................................. 100
COMMUNITY-BASED PARTICIPATORY RESEARCH – CBPR 101 FOR THE ARCTIC: OVERVIEW OF THE HISTORY, DISTINCTIVE FEATURES, ADVANTAGES,
AND PRACTICAL TIPS CONCERNING THIS EMERGING APPROACH IN HEALTH RESEARCH .....................................................................................................100
VENUE 6 ................................................................................................................................................................................ 100

Chronic Diseases #3 ............................................................................................................................................................... 100
WHAT AGE GROUPS AND WHICH CAUSE OF DEATH CONTRIBUTE MOST TO THE LOWER LIFE EXPECTANCY OF THE INUIT-INHABITED AREAS OF
CANADA? .......................................................................................................................................................................................................................................100
DIABETES AMONG ALASKA NATIVE PEOPLE – A 21 YEAR OVERVIEW ......................................................................................................................................100
THE EFFECT OF TRADITIONAL FOODS ON INSULIN RESISTANCE AMONG INUIT IN GREENLAND AND NUNAVIK ...............................................................100
DO-IT-YOURSELF DIABETES PREVENTION ACTIVITIES: AN INTERACTIVE MANUAL FOR COMMUNITY-BASED DIABETES EDUCATION ............................ 101
INDIVIDUAL SATURATED FATTY ACIDS ARE ASSOCIATED WITH DIFFERENT COMPONENTS OF INSULIN RESISTANCE AND GLUCOSE METABOLISM: THE
GOCADAN STUDY ......................................................................................................................................................................................................................... 101
TYPE II DIABETES MELLITUS IN GREENLAND: THE IMPACT OF ELECTRONIC DATABASE IMPLEMENTATION ON THE QUALITY OF DIABETES CARE ....... 101
A DESCRIPTION OF PHYSICAL ACTIVITY AND BODY MASS INDEX IN THREE INUVIALUIT COMMUNITIES: RESULTS FROM HEALTHY FOODS NORTH ....102
IMPLEMENTATION OF A PROGRAM TO PREVENT CHRONIC DISEASE RISK AMONG THE INUVIALUIT: PROCESS EVALUATION FINDINGS FROM HEALTHY
FOODS NORTH ..............................................................................................................................................................................................................................102
CONSUMPTION OF HIGH FAT, HIGH SUGAR FOODS BY INUVIALUIT ADULTS: RESULTS FROM HEALTHY FOODS NORTH .................................................102
VENUE VIEWING ROOM ........................................................................................................................................................ 102

Video #3 ................................................................................................................................................................................ 102
ANGUTIILLI QANUILIQPAT… HOW ARE WE AS MEN? A SCREENING OF A LIVE-TO-TAPE 2-HOUR CALL-IN PROGRAM ABOUT INUIT MEN’S HEALTH .....102
SESSION 9 .................................................................................................................................................................103
Wednesday, July 15, 8:30-10:00 AM ...........................................................................................................................103
VENUE 1 ................................................................................................................................................................................ 103
Mental Health & Wellness #6 – Children and Youth ................................................................................................................ 103
CAMP COHO: A CULTURALLY APPROPRIATE GRIEF CAMP FOR ALASKA NATIVE CHILDREN ................................................................................................. 103
THE ROLE OF MENTORING ABORIGINAL YOUTH PARTICIPANTS OF THE COWACHIN (BRITISH COLUMBIA, CANADA) 2008 NORTH AMERICAN
INDIGENOUS GAMES .................................................................................................................................................................................................................... 103
INFLUENCE OF ADVERSE ECOLOGICAL FACTORS ON PSYCHOPHYSIOLOGICAL AND EMOTIONAL CONDITION OF TEENAGERS LIVING IN THE
EUROPEAN NORTH OF RUSSIA .................................................................................................................................................................................................... 103
SEXISM/SEXUAL HARASSMENT IN SCHOOLS AND ITS CONNECTIONS WITH SEXUALIZED VIOLENCE IN INTIMATE RELATIONSHIPS IN ADULTHOOD...104
ON THE LAND CANOE TRIP FOR YOUTH AND ELDERS SUPPORTING MENTAL HEALTH AND WELLNESS ............................................................................104
VENUE 2 ................................................................................................................................................................................ 104

Service Delivery & Infrastructure #1 – Health Service Delivery ................................................................................................ 104
HEALTH TECHNOLOGY ASSESSMENTS ON TELEHEALTH ........................................................................................................................................................104

TELEHEALTH IN GREENLAND ......................................................................................................................................................................................................104
IMPLEMENTING ON E-HEALTH PROGRAM IN CANADA’S MOST CHALLENGED REGION ........................................................................................................105
EXPANDING CLINICAL TELEHEALTH IN ALBERTA FIRST NATIONS ...........................................................................................................................................105
TELESPEECH LANGUAGE PATHOLOGY ......................................................................................................................................................................................105
VIDEO RESUSCITATION SAVE LIVES IN REMOTE COMMUNITIES ..............................................................................................................................................105
VENUE 3................................................................................................................................................................................ 105

Education and Building Resource/Research Capacity #5 – Nursing Education ........................................................................ 105
NURSING IN THE ARCTIC: GREENLANDIC NURSE’ PERSPECTIVE ..............................................................................................................................................105
“I HAVE TOLD MY COLLEAGUES: WHEN I WORK I AM WHITE” ABOUT THE EXPERIENCES OF GREENLANDIC AND INUIT NURSES AND NURSING
STUDENTS .................................................................................................................................................................................................................................... 106
NURSES FOR NUNATSIAVUT ...................................................................................................................................................................................................... 106
THE NURSE AS CARE ASSESSOR AND PRACTITIONER IN GREENLAND ................................................................................................................................... 106
SHIFTING FROM CULTURAL COMPETENCE TO CULTURAL SAFETY ........................................................................................................................................ 106
PERSPECTIVES OF SOCIAL DETERMINANTS OF HEALTH: A COMPARATIVE ANALYSIS OF NURSING AND SOCIAL WORK EDUCATION ............................ 107
VENUE 4 ................................................................................................................................................................................107
Infectious Diseases #6 ............................................................................................................................................................ 107
PREVALENCE OF CHRONIC OTITIS MEDIA IN GREENLAND OVER A 25-YEAR PERIOD ............................................................................................................. 107
AKLAVIK H.PYLORI PROJECT TREATMENT PHASE: SEEKING AN EFFECTIVE THERAPY FOR A CANADIAN ARCTIC HAMLET ............................................... 107
GASTRIC EPITHELIAL CELL APOPTOSIS IN PATIENTS WITH CHRONIC HELICOBACTER PYLORI ASSOCIATION ANTRUM GASTRITIS AMONG NATIVE AND
ALIEN INHABITANTS OF EASTERN SIBERIA ................................................................................................................................................................................ 107
A HAART FULL OF LIFE: VARIATIONS IN QUALITY OF LIFE AMONG ABORIGINAL AND NON-ABORIGINAL PEOPLES EVER ON ANTIRETROVIRAL THERAPY
........................................................................................................................................................................................................................................................108
THE INCIDENCE RATES OF THE GASTRIC CANCER AND PREVALENCE OF HELICOBACTER PYLORI AT THE POPULATION OF EASTERN SIBERIA .............108
THE ASSOCIATION OF HELICOBACTER PYLORI CAG A STRAINS PREVALENCE WITH ULCER DISEASES IN SIBERIA MONGOLOIDS ...................................108
VENUE 5 ............................................................................................................................................................................... 109

Food Security #5 – Food Security and Indigenous Wellness: Knowledge to Action PART A..................................................... 109
SESSION 10 .............................................................................................................................................................. 109
Wednesday, July 15, 1:30-3:30 PM ............................................................................................................................. 109
VENUE 1................................................................................................................................................................................ 109
Focusing on Children and Families in Northern Canada: Moving Forward with University/Community Partnerships ............... 109
CHILD HEALTH RESEARCH IN A NORTHERN CANADIAN CONTEXT: ROLES AND RESPONSIBILITIES OF AN ACADEMIC DEPARTMENT OF PEDIATRICS . 109
OPTIMAL DRUG THERAPY FOR CHILDREN ................................................................................................................................................................................ 109
COMMUNITY-BASED INJURY SURVEILLANCE RESEARCH ........................................................................................................................................................ 109
FASD RESEARCH ACROSS THE PROVINCE ................................................................................................................................................................................. 109
COMMUNITY READINESS TO ENGAGE IN FASD RESEARCH ..................................................................................................................................................... 109
FIRST NATION-UNIVERSITY PARTNERSHIP: LAXGALTS’AP VILLAGE GOVERNMENT’S PARTNERSHIP WITH UNIVERSITY-BASED RESEARCHER ............. 109
A PARTICIPATORY APPROACH TO ADDRESSING LONG QT SYNDROME IN A LARGE NORTHERN BC COMMUNITY ........................................................... 109
VENUE 2 ............................................................................................................................................................................... 109

Indigenous Pedagogy on Mental Health Workshop ................................................................................................................ 109
VENUE 3................................................................................................................................................................................ 109
Newborn & Child Health #2 – Maternal Health & Surveillance ................................................................................................ 109
A DETAILED COMPARISON OF PERINATAL MORTALITY BETWEEN NORTHERN NORWAY AND MURMANSK COUNTRY (RUSSIA) ................................... 109
REMOTE MIDWIFERY IN NUNAVIK: PERINATAL OUTCOMES 2000-2007 ................................................................................................................................... 110
BIRTH OUTCOMES AMONG FIRST NATIONS, INUIT, AND NON-INDIGENOUS WOMEN IN NORTHERN QUEBEC .................................................................. 110
THE DEVELOPMENT OF A COMPREHENSIVE MATERNAL CHILD HEALTH SURVEILLANCE SYSTEM FOR NUNAVUT ........................................................... 110
THE ANAANA PROJECT: MATERNAL HEALTH SURVEY IN THE QIKIQTANI REGION OF NUNAVUT ........................................................................................ 110
BREASTFEEDING INITIATION, DURATION, AND DETERMINANTS AMONG CANADIAN INUIT IN NUNAVUT .......................................................................... 111
DEVELOPMENT OF A PERINATAL SURVEILLANCE SYSTEM FOR THE NORTHWEST TERRITORIES, CANADA ....................................................................... 111
VENUE 4 ................................................................................................................................................................................ 111

Infectious Diseases #5............................................................................................................................................................ 111
INTERNATIONAL CIRCUMPOLAR SURVEILLANCE OF INVASIVE NON-TYPEABLE HAEMOPHILUS......................................................................................... 111
COMPARISON OF INVASIVE PNEUMOCOCCAL DISEASE RATES IN ALASKA AND NORTHERN CANADA FOLLOWING PCV7 INTRODUCTION.................... 112
RESPIRATORY SYNCYTIAL VIRUS: POTENTIAL TRENDS IN INFECTION OF CHILDREN IN NUNAVUT, CANADA .................................................................... 112
A TWO-YEAR SURVEILLANCE OF RESPIRATORY VIRUS IN SICK AND HEALTHY CHILDREN IN GREENLAND ......................................................................... 112
INVASIVE PNEUMOCOCCAL DISEASE IN ALASKAN CHILDREN: THE ROLE OF WATER SUPPLY AND THE SEVEN VALENT PNEUMOCOCCAL CONJUGATE
VACCINE (PCV7) ............................................................................................................................................................................................................................. 113
A RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF HEAT RECOVERY VENTILATORS FOR THE PREVENTION OF LOWER RESPIRATORY TRACT ILLNESS
IN INUIT CHILDREN ....................................................................................................................................................................................................................... 113
VENUE 5 ................................................................................................................................................................................ 113

Food Security #5 – Food Security and Indigenous Wellness: Knowledge to Action PART B ..................................................... 113
VENUE 6 ................................................................................................................................................................................ 113
Service Delivery & Infrastructure #2 – Health Service Delivery ................................................................................................ 113
SPEECH LANGUAGE PATHOLOGY TELESPEECH SERVICE DELIVERY MODEL FOR REMOTE COMMUNITIES ........................................................................ 113
THE MANITOBA FIRST NATIONS PATIENT WAIT TIME GUARANTEE PILOT PROJECT.............................................................................................................. 114
VIRTUAL COMMUNITIES AS LOCATIONS .................................................................................................................................................................................... 114
TRACKING PUBLIC HEALTH FROM ORBIT: CSA EO SUPPORT TO EMERGENCIES, DISASTERS, DISEASES, ENVIRONMENT ................................................. 114
MEDICAL IMAGING IN NORTHERN CANADA: A STUDY BY THE CANADIAN RADIOLOGICAL FOUNDATION.......................................................................... 114
ABORIGINAL NURSES ASSOCIATION OF CANADA – CHANGING THE PICTURE OF ABORIGINAL HEALTH ............................................................................. 115
VENUE 7 ................................................................................................................................................................................ 115

Social Determinants of Health #2 .......................................................................................................................................... 115
SOCIAL DETERMINANTS OF INDIGENOUS HEALTH: THE JOURNEY OF CANADA’S FIRST NATIONS, INUIT, AND MÉTIS VOICES AT THE INTERNATIONAL
LEVEL ............................................................................................................................................................................................................................................. 115
LOW PHYSICAL ACTIVITY AT WORK IS ASSOCIATED WITH SEX, OCCUPATION, AND COMMUNITY SIZE AMONG INUIT OF GREENLAND ......................... 115
REDUCING HEALTH DISPARITIES AND PROMOTING EQUITABLE ACCESS TO HEALTH CARE FOR ABORIGINAL PEOPLES ................................................. 116
SOCIAL CAPITAL AND THE WELL-BEING OF ABORIGINAL SINGLE MOTHERS ......................................................................................................................... 116
ROLE OF EDUCATION IN INFLUENCING COMMUNITY WELL-BEING ......................................................................................................................................... 116
SESSION 11 ...............................................................................................................................................................116
Thursday, July 16, 8:30 – 10:00 AM .............................................................................................................................116
VENUE 1 ................................................................................................................................................................................ 116
Mental Health & Wellness #7 – Attitudes and Experiences in Mental Health ........................................................................... 116
NATIONAL STRATEGY TO PREVENT ABUSE IN INUIT COMMUNITIES AND NATIONAL INUIT RESIDENTIAL SCHOOLS HEALING STRATEGY .................... 116
PSYCHOSOCIAL RISK FACTORS AMONG SÁMI WOMEN OF REINDEER HERDING FAMILIES ................................................................................................... 117
BORDERLANDS: A NARRATIVE INQUIRY INTO FIRST NATIONS’ WOMEN’S EXPERIENCES OF DEPRESSION ........................................................................ 117
EFFECTS OF CLIENT AND THERAPIST ETHNICITY AND ETHNIC MATCHING ............................................................................................................................. 117
AWARENESS OF THEIR HEALTH & HEALTH ATTITUDES IN MALES AND FEMALES AGED 25-64 YEARS DURING SOCIAL AND ECONOMIC CRISIS IN RUSSIA
(MONICA-PSYCHOSOCIAL PROGRAM)........................................................................................................................................................................................ 117
RESILIENCY AND INHALANT ABUSE TREATMENT ..................................................................................................................................................................... 118
MAKING THE PATH BY WALKING IT: A COMPREHENSIVE EVALUATION OF THE WOMEN AND CHILDREN’S HEALING AND RECOVERY PROGRAM ......... 118
VENUE 2 ................................................................................................................................................................................ 118

Sexual Health #2 ................................................................................................................................................................... 118
EVIDENCE-BASED STRATEGIES FOR SEXUAL HEALTH EDUCATION: ARE THEY CULTURALLY SAFE FOR ABORIGINAL COMMUNITIES? ........................... 118
PARTNERSHIP AND PROCESS IN COMMUNITY-BASED RESEARCH IN THE NORTH ................................................................................................................. 119
CONNECTING THE DOTS: SOCIAL DISPARITIES AMONG PEOPLE LIVING WITH HIV ON HAART ............................................................................................ 119
YOU’RE BREAKING MY HAART: HIV AND VIOLENCE AMONG A COHORT OF WOMEN ON TREATMENT IN BRITISH COLUMBIA, CANADA ........................ 119
REPORTING FROM GROUND ZERO: A SURVEY OF NUNAVUT HEALTH CARE PROFESSIONALS’ PERCEPTIONS ON SEXUALLY TRANSMITTED INFECTIONS
........................................................................................................................................................................................................................................................ 119
VENUE 3 ................................................................................................................................................................................ 120

Human Biology #2................................................................................................................................................................. 120

IMMUNE HOMEOSTASIS IN CHILDREN OF THE FAR NORTH AT DIFFERENT VARIANTS OF VEGETATIVE MAINTENANCE OF ACTIVITY .............................120
THE BLOOD LYMPHOCYTES METABOLISM IN STRANGE POPULATION OF EVENKIAY, HEALTHY, AND WITH IMMUNE REACTIVITY DISTURBANCES .....120
THE DISTURBANCE OF IMMUNE SYSTEM FUNCTION IN PATIENTS WITH ACUTE LEUKEMIA IN SIBERIA ..............................................................................120
IMMUNE STATE CHARACTERISTICS IN NATIVE (SCANTY) POPULATION OF THE RUSSIAN FAR NORTH (YAMALO-NENETS AUTONOMOUS OKRUG) ..... 121
MICRO ELEMENTAL STATUS AND STRUCTURE OF SICKNESS RATE......................................................................................................................................... 121
POPULATION AND SUB-POPULATION CONTENT OF BLOOD LYMPHOCYTE AND CYTOKIN PROPHILE UNDER DIFFERENT CLINICAL PATHOGENIC
FORMS OF ALLERY RHINOSINUSOPATHY .................................................................................................................................................................................. 121
THE BIOACTIVITY OF COMPLEX POP MIXTURES IN HUMAN SERUM AND THE POTENTIAL RELATION TO HEALTH EFFECTS .............................................122
VENUE 4 ............................................................................................................................................................................... 122

Database & Surveillance #2 ................................................................................................................................................... 122
IPY HEALTH SURVEY DATABASE MANAGEMENT SYSTEM AND META DATA 2007-2008 ........................................................................................................122
HEALTH SURVEILLANCE FOR FIRST NATIONS: DATA SOURCES AND LIMITATIONS ...............................................................................................................122
LINKING THE CANADIAN INDIAN REGISTRY SYSTEM TO THE MANITOBA PROVINCIAL HEALTH REGISTRY: LESSONS LEARNED ..................................... 123
MORTALITY OF MÉTIS CANADIAN AND REGISTERED INDIAN ADULTS: AN 11 YEAR FOLLOW-UP STUDY ............................................................................ 123
DOCUMENTATION CENTRE ON CHILDREN AND YOUTH IN GREENLAND ................................................................................................................................ 123
VENUE 5 ................................................................................................................................................................................123
Newborn & Child Health #3 – Child Health Determinants........................................................................................................123
MORTALITY AFTER ADMISSION IN THE PEDIATRIC EMERGENCY DEPARTMENT OF REPUBLIC SAKHA (YAKUTIA).............................................................. 123
EARLY CHILD DEVELOPMENT AS A DETERMINANT OF HEALTH: EXPLORING THE CONTRIBUTION OF HOME VISITING ....................................................124
THE MAIN PROBLEMS OF CHILDREN’S HEALTH IN THE RUSSIAN FAR NORTH ........................................................................................................................124
PROPOSING INDICATORS REGARDING CHILD HEALTH ON THE FOCUS AREAS IN THE GREENLANDIC PUBLIC HEALTH PROGRAM..................................124
UNDERSTANDING OF ABORIGINAL CHILDREN IN ALBERTA - AN ANALYSIS OF CANADIAN ABORIGINAL CHILDREN’S SURVEY ........................................125
CORRELATES OF EMERGING OBESITY AMONG PRESCHOOL AGED CHILDREN: NUNAVUT CHILD INUIT HEALTH SURVEY ................................................125
PROGRESS TOWARDS OPTIMAL PEDIATRIC DRUG THERAPY: A NORTHERN CHILD/YOUTH HEALTH IMPERATIVE ............................................................. 125
POSTER SESSIONS .................................................................................................................................................. 126

Tuesday & Wednesday, July 14-15, 12:15-3:30 PM ..................................................................................................... 126
A B C ..................................................................................................................................................................................... 126
DEVELOPMENT AND IMPLEMENTATION OF AN ABORIGINAL FRAMEWORK AND MEASURES OF COMMUNITY HEALTH IN NORTHERN SASKATCHEWAN,
CANADA........................................................................................................................................................................................................................................ 126
CULTURAL SAFETY AND KNOWLEDGE SHARING: WORK ON MENTAL WELLNESS AT THE INUIT TUTTARVINGAT OF NAHO ........................................... 126
BEHIND THE SCENES: MANAGEMENT OF LARGE EXTENDED FAMILY TREES FOR GENETIC ANALYSIS ............................................................................... 126
ARCTIC HEALTH WEB SITE: AN INFORMATION PORTAL TO ISSUES AFFECTING THE HEALTH AND WELL-BEING OF OUR PLANET’S NORTHERN-MOST
INHABITANTS ............................................................................................................................................................................................................................... 126
FRUIT AND VEGETABLE CONSUMPTION AMONG INUVIALUIT OF THE NORTHWEST TERRITORIES: RESULTS FROM HEALTHY FOODS NORTH ............. 127
CHALLENGES TO TUBERCULIN SCREENING AND FOLLOW-UP IN AN URBAN ABORIGINAL SAMPLE IN MONTREAL, CANADA.......................................... 127
KNOWLEDGE AND PERCEPTIONS OF TUBERCULOSIS AMONG A SAMPLE OF URBAN ABORIGINAL PEOPLE ...................................................................... 127
CENTRE FOR SÁMI HEALTH RESEARCH ......................................................................................................................................................................................128
ELECTRONIC BULLYING IN TWO PROVINCIAL NORTH ELEMENTARY SCHOOLS ....................................................................................................................128
AURORA COLLEGE’S INTRODUCTION TO ADVANCED PRACTICE PROGRAM: PRODUCING ADVANCED-PRACTICE NURSES WITH NORTHERN-SPECIFIC
SKILLS ............................................................................................................................................................................................................................................128
FOOD SECURITY IN NUNAVUT: A KNOWLEDGE SHARING TOOL FOR POLICY-MAKERS ........................................................................................................128
A RAPID, HIGHLY DISCRIMINATORY GENOTYPING METHOD FOR MYCOBACTERIUM TUBERCULOSIS ISOLATES IN MANITOBA, CANADA ......................128
PAN-TERRITORIAL PARTNERSHIP: SOCIAL MARKETING TOOLS IN SEXUAL HEALTH PROMOTION ..................................................................................... 129
D E F...................................................................................................................................................................................... 129
FOOD SOURCES AND DIETARY INTAKE OF VITAMIN D AND CALCIUM AMONG INUVIALUIT IN THE NWT: RESULTS FROM HEALTHY FOODS NORTH ... 129
RESILIENCY AND INHALANT ABUSE TREATMENT .................................................................................................................................................................... 129
PLACE OF RESIDENCE AND NEONATAL OUTCOME IN THE NORTHWEST TERRITORIES ........................................................................................................ 130
INTEGRATIVE APPROACHES TO INFECTIOUS DISEASE PREVENTION AND CONTROL IN CANADA’S NORTH ....................................................................... 130
PROVIDING LIBRARY SERVICES TO CONTRIBUTE TO CAPACITY BUILDING AND KNOWLEDGE TRANSLATION IN THE CANADIAN NORTH ...................... 130
A FOLLOW-UP STUDY OF BLOOD LEVELS OF PERSISTENT TOXIC SUBSTANCES (PTS) AMONG INDIGENOUS PEOPLE OF THE COASTAL CHUKOTKA,
RUSSIA, 2001-2007 ........................................................................................................................................................................................................................ 131
CADTH’S HEALTH TECHNOLOGY INQUIRY SERVICE .................................................................................................................................................................. 131
EVALUATION OF HELICOBACTER PYLORI INFECTION IN PATIENTS WITH PATHOLOGY OF THE GASTROINTESTINAL TRACT ........................................... 131
EVALUATING THE TOXIC EFFECTS OF METHYLMERCURY ON NEUROTROPHIN CONFORMATION ....................................................................................... 132
ASSESSMENT OF DIETARY INTAKE IN AN INUVIALUIT POPULATION: RESULTS FROM HEALTHY FOODS NORTH .............................................................. 132
CARDIOVASCULAR REACTIONS IN HYPERTENSIVE PERSONS IN THE FAR NORTH ................................................................................................................. 132
ENDOTHELIAL DYSFUNCTION AND MYOCARDIAL REMODELING IN HYPERTENSIVE PATIENTS IN THE FAR NORTH.......................................................... 132
INTERCONNECTION OF CARDIAC STRUCTURAL-FUNCTIONAL CHANGES IN HYPERTENSIVE PATIENTS IN THE FAR NORTH ............................................ 133
RESILIENCY OF VASCULAR WALL IN HYPERTENSIVE PATIENTS IN THE FAR NORTH .............................................................................................................. 133
FACTORS THAT INFLUENCE THE BIOCHEMICAL CHARACTERISTICS AND HORMONES OF HYPOPHYSEAL-THYROID-ADRENAL SYSTEM OF MEN ......... 133
G H I....................................................................................................................................................................................... 134
SLEEP DISTURBANCE AND RISK CARDIOVASCULAR DISEASES THE PERIOD OF 10 YEARS IN MEN 25-64 YEARS OF AGE IN RUSSIA ................................. 134
ARTERIAL HYPERTENSION AND PSYCHOSOCIAL FACTORS IN MALES AGED 25-64 YEARS IN RUSSIA (WHO MONICA-PSYCHOSOCIAL PROGRAM) ....... 134
AVERAGE LEVELS OF ARTERIAL PRESSURE AND PSYCHOSOCIAL FACTORS IN MALES AGED 25-64 YEARS IN RUSSIA (WHO MONICA-PSYCHOSOCIAL
PROGRAM) .................................................................................................................................................................................................................................... 134
EPIDEMIOLOGY OF INVASIVE BACTERIAL DISEASES IN NORTHERN CANADA, 1999 TO 2007 ................................................................................................ 134
INFLAMMATORY MARKERS FOR PATIENTS WITH ISCHEMIC HEART DISEASE (IHD) AFFECTED BY CONDITIONS IN YAKUTIA ............................................ 135
A MEASURE OF RURAL PARTURIENT WOMEN’S EXPERIENCES OF PREGNANCY .................................................................................................................... 135
PLANNING THE OPTIMAL LEVEL OF LOCAL MATERNITY SERVICE FOR SMALL RURAL COMMUNITIES: A SYSTEMS STUDY IN BRITISH COLUMBIA ........ 135
HYPERTENSION IN CHUKOTKA INDIGENOUS POPULATION DURING THE LAST 20 YEARS .................................................................................................... 136
FIERY AVENS GIRLS EMPOWERMENT GROUP ............................................................................................................................................................................ 136
RANGIFERINE BRUCELLOSIS ON SOUTHAMPTON ISLAND, NUNVUT ...................................................................................................................................... 136
CLIMATE CHANGE, WATER QUALITY, AND HUMAN HEALTH IN NUNATSIAVUT, CANADA .................................................................................................... 136
PREVALENCE, RISK FACTORS AND CONSEQUENCES OF VITAMIN D DEFICIENCY AMONG INUIT CHILDREN ....................................................................... 137
SHARING HEALTH RESEARCH KNOWLEDGE AMONG NORTHERN COMMUNITIES: A MULTI-PRONGED APPROACH .......................................................... 137
EXPLORING PROCESSES IN HEALTH RESEARCH ETHICS IN CANADA’S NORTH ...................................................................................................................... 137
USE OF THE FETAL FIBRONECTIN TEST FOR DETECTING PRE-TERM LABOUR IN NUNAVUT 2004-2007................................................................................ 138
“SAFE IN A SWIM VEST” – COMMUNITY HEALTH REPRESENTATIVES AS WATER SAFETY CHAMPIONS ............................................................................... 138
ACUTE MASTOIDITIS IN GREENLAND BETWEEN 1994-2007 ...................................................................................................................................................... 138
NUTRIENT INTAKE AMONG INUIT IN THE CANADIAN ARCTIC: RESULTS FROM HEALTHY FOODS NORTH........................................................................... 138
QAMANITUAP NIQISIALIRIJIQUTINGIIT NUTARAQSALINGNUT: A COMMUNITY BASED PROGRAM FOR PRENATAL NUTRITION IN BAKER LAKE,
NUNAVUT, CANADA ..................................................................................................................................................................................................................... 139
DEVIATIONS OF COGNITIVE FUNCTIONS IN OBESE HYPERTENSIVE PATIENTS ...................................................................................................................... 139
FINDING GENES FOR TYPE 2 DIABETES IN YAKUT POPULATION .............................................................................................................................................. 139
THE ARCTIC SOCIAL INDICATORS PROJECT ............................................................................................................................................................................... 139
J K L ....................................................................................................................................................................................... 140
MERCURY EXPOSURE AND LINKS TO HUMAN HEALTH IN A COMMUNITY IN TROMSØ, ARCTIC NORWAY ..........................................................................140
TRADITIONAL FOOD USE AND DIETARY ADEQUACY AMONG NUNAVUT PRESCHOOL CHILDREN .......................................................................................140
DEVELOPMENT OF A FOOD FREQUENCY QUESTIONNAIRE TO MEASURE DIETARY INTAKE IN AN ALASKAN NATIVE POPULATION ...............................140
THE FIRST HUMAN CASE OF Q FEVER IN THE ARCTIC - AN UNDERDIAGNOSED OR EMERGING INFECTION? ....................................................................... 141
A COST ANALYSIS OF THE UNIVERSITY OF MANITOBA NORTHERN MEDICAL UNIT’S DIABETIC RETINAL SCREENING PROGRAM FOR RURAL AND
REMOTE COMMUNITIES ............................................................................................................................................................................................................... 141
DIABETIC RETINAL SCREENING IN RURAL/REMOTE FIRST NATION COMMUNITIES IN MANITOBA: SUCCESSES AND CHALLENGES ................................. 141
THE INDICATORS OF LIPID METABOLISM FROM THE RESIDENTS OF YAKUTIA....................................................................................................................... 141
TRACKING RISK: A REVIEW OF INFECTIOUS DISEASES WITHIN CIRCUMPOLAR POPULATIONS ............................................................................................142
MÉTIS HEALTH/WELL-BEING DATA COLLECTION: CONCEPTUAL SNAPSHOT OF FACTORS BEHIND DATA PAUCITY AND ACTION STEPS .......................142
M N O .................................................................................................................................................................................... 142
A REVIEW OF INUIT ONCOLOGY PATIENTS TREATED AT THE OTTAWA HOSPITAL CANCER CENTRE ..................................................................................142
THE PSYCHOSOCIAL DETERMINANTS OF DIET-RELATED BEHAVIORS AMONG THE INUVIALUIT: RESULTS FROM HEALTHY FOODS NORTH .................142
ENVIRONMENTAL DETERMINANTS OF PERIPHERAL CIRCULATION IN NORTHERN AND SOUTHERN SIBERIAN POPULATIONS - A COMPARISON .......... 143
SHARING YOUTH PERSPECTIVES ON MENTAL HEALTH AND WELLNESS: PHOTOVOICE PROJECT ...................................................................................... 143
PREVALENCE OF CLINICAL RISK FACTORS FOR OSTEOPOROSIS IN WOMEN 50 TO 69 YEARS; THE BONE HEALTH NUNAVIK (BOHN) PROGRAM .......... 143
CLIMATE CHANGE IMPACTS ON DIETARY NUTRIENT STATUS OF INUIT IN NUNAVUT, CANADA ..........................................................................................144
FROM RESEARCH TO PREVENTION IN GREENLAND ..................................................................................................................................................................144
THE HEALTH OF SÁMI ...................................................................................................................................................................................................................144
INNOVATIONS IN KNOWLEDGE TRANSLATION: CHILD INUIT HEALTH SURVEY RESULTS DVD ............................................................................................144
NEGOTIATING PATHWAYS TO ADULTHOOD: SOCIAL CHANGE, MENTAL HEALTH AND INDIGENOUS CULTURE ............................................................... 145
PROGRESSION OF RESEARCH IN CANADA’S ARCTIC: INTRODUCTION OF INUIT RESEARCH ADVISORS ...............................................................................145
A REPORT OF THE JAPAN WORKSHOP ON ANTARCTIC MEDICAL RESEARCH AND MEDICINE – WE NEED A BROAD NETWORK OF ANTARCTIC MEDICAL
RESEARCH .....................................................................................................................................................................................................................................145
THE STATUS OF LIPID PEROXIDATION OF SPORTSMEN IN CONDITIONS PREVAILING IN YAKUTIA ..................................................................................... 146
THE CYTOTOXICITY OF INDUSTRIAL AEROSOLS FORMED IN DIAMOND ................................................................................................................................ 146
HORMONAL STATUS AND PREVALENCE OF ENDOCRINE DISEASES IN WORKERS OF GOLD COMPANY “POLE” ............................................................... 146
P Q R S ...................................................................................................................................................................................147
RISK FACTORS FOR IRON DEFICIENCY ANEMIA AMONG INUIT CHILDREN, AGES 3–5, LIVING IN NUNAVUT......................................................................... 147
A COST-CONSEQUENCE ANALYSIS OF THE NEW 10-VALENT PNEUMOCOCCAL NON-TYPEABLE HAEMOPHILUS INFLUENZAE PROTEIN-D CONJUGATE
VACCINE SYNFLORIX™ AND PREVNAR™, ON THE REDUCTION OF ACUTE OTITIS MEDIA IN CHILDREN .............................................................................. 147
BACTERIAL VS. VIRAL PATHOGENS: A SYSTEMATIC REVIEW OF THE ETIOLOGY OF ACUTE OTITIS MEDIA ......................................................................... 147
INVASIVE PNEUMOCOCCAL DISEASE CAUSED BY SEROTYPES 1, 5 AND 7F IN CIRCUMPOLAR REGIONS ............................................................................. 147
IMMUNE HOMEOSTASIS IN CHILDREN OF THE FAR NORTH AT DIFFERENT VARIANTS OF VEGETATIVE MAINTENANCE OF ACTIVITY .............................148
NUTRIENT INTAKES AND VITAMIN D STATUS IN INUIT WOMEN 40 YEARS OF AGE AND OLDER...........................................................................................148
ENVIRONMENTAL HEALTH – FROM EXPOSURE TO BIOMARKERS ...........................................................................................................................................148
DO PSYCHOLOGICAL STRENGTHS ACT AS PROTECTIVE FACTORS AGAINST EARLY ADOLESCENT BULLYING IN SCHOOLS? .......................................... 149
THE ASSOCIATION BETWEEN PSYCHOLOGICAL STRENGTHS AND THERAPEUTIC OUTCOME AMONG ADOLESCENTS RECEIVING RESIDENTIAL
TREATMENT FOR SUBSTANCE ABUSE AT PROGRAM COMPLETION AND THREE MONTH FOLLOW-UP .............................................................................. 149
A JOURNEY TO THE TEACHINGS: A COMMUNITY APPROACH TO INJURY PREVENTION (2009) ............................................................................................ 149
USING A DVD TO ADMINISTER INFORMED CONSENT: IPY CHILD INUIT HEALTH SURVEY .................................................................................................... 149
FOOD SECURITY IN NUNAVUT: PRELIMINARY RESULTS FROM THE IPY ADULT INUIT HEALTH SURVEY ..............................................................................150
A DAY IN THE LIFE OF THE IPY INUIT HEALTH SURVEY SHIP TEAM: PARTICIPANTS VISITING THE CCGS AMUNDSEN .........................................................150
THE PARTICIPATORY APPROACH TO THE IPY INUIT HEALTH SURVEY 2007/2008 ...................................................................................................................150
DECLINE IN THE PREVALENCE OF NEURAL TUBE BIRTH DEFECTS, ALASKA, 1996-2004 ........................................................................................................ 151
INCREASED RISK OF HIRSCHPRUNG’S DISEASE AMONG ALASKA NATIVES IDENTIFIED FOLLOWING VERIFICATION OF REPORTED CASES, 1996-2006 . 151
THE EPIDEMIOLOGY OF TUBERCULOSIS IN THE CIRCUMPOLAR REGION OF CANADA, 1997 TO 2006 .................................................................................. 151
WHAT’S IN YOUR FREEZER? TRADITIONAL FOOD USE IN TWO FIRST NATIONS COMMUNITIES IN YUKON, CANADA ........................................................152
DYNAMICS OF HEMATOLOGICAL INDICATORS AS CLINICO-DIAGNOSTIC TEST SPORTSMEN’S ADAPTATION OF YAKUTIA TO PHYSICAL EXERCISES ...152
COLLABORATION AND CONSULTATION IN INFECTIOUS DISEASE SURVEILLANCE AND PREVENTION IN CANADA’S NORTH ...........................................152
PHYSICAL DEVELOPMENT AS A FACTOR OF CHILDREN’S HEALTH IN THE FAR NORTH (RUSSIA) .........................................................................................152
ASSESSMENT OF INTELLECTUAL DEVELOPMENT IN NATIVE CHILDREN OF YAMALO-NENETS AUTONOMOUS OKRUG (RUSSIA) ................................... 153
THE SÁMI PSYCHIATRIC YOUTH TEAM: A CULTURAL SENSITIVE TREATMENT APPROACH OF SUICIDAL BEHAVIOUR PROBLEMS AND SUBSTANCE
ABUSE IN INDIGENOUS SÁMI ....................................................................................................................................................................................................... 153
PRIMARY BIRTHING ATTENDANTS AND BIRTH OUTCOMES IN REMOTE INUIT COMMUNITIES - A NATURAL “EXPERIMENT” IN NUNAVIK, CANADA ...... 153
ACTUAL NUTRITION AND CARDIOVASCULAR RISK FACTORS IN SIBERIA (1985-2005) ............................................................................................................154
SYSTEMATIC REVIEW OF EDUCATIONAL INTERVENTIONS TO INCREASE HIGH SCHOOL GRADUATION AMONG INDIGENOUS HIGH SCHOOL STUDENTS
........................................................................................................................................................................................................................................................154
T U V W X Y Z ........................................................................................................................................................................ 154
SOME DEMOGRAPHIC PECULIARITIES OF LONGEVITY IN THE INDIGENOUS MINORITIES OF RUSSIA NORTH-EAST REGIONS ..........................................154
THE CAREGIVER’S JOURNEY ........................................................................................................................................................................................................ 155
FEATURES OF THE CORONARY ARTERIES ATHEROSCLEROSIS AND ITS EVOLUTION IN INHABITANTS OF YAKUTIA FOR 40-YEAR PERIOD .................... 155
INFLUENCE OF MIGRATION AND DURATION OF RESIDING IN CONDITIONS OF THE NORTH ON ATHEROSCLEROTIC PROCESS CURRENT ...................... 155
THE BASIC DIRECTIONS OF WORK OF THE YAKUT SCIENCE CENTRE OF COMPLEX MEDICAL PROBLEMS SB RAMS ...........................................................156
WAY OF DEFINITION OF DEEP TISSUES TEMPERATURE AFTER COLD IMPACT IN PRE-REACTIVE PERIOD............................................................................156
HEALTH STATE OF SMALL IN NUMBERS PEOPLE CHILDREN OF THE NORTH OF YAKUTIA ....................................................................................................156
THE POPULATION HISTORY OF SAKHA (YAKUTS) IN CONNECTION WITH PREVALENCE OF SOME HEREDITARY DISEASES .............................................. 157
FEATURES OF CLINICAL -FUNCTIONAL CHANGES IN ABORIGINALS OF YAKUTIA WITH THE VERIFIED CORONARY ATHEROSCLEROSIS ......................... 157
IMPLEMENTING A NUTRITION INTERVENTION PROGRAM AMONG THE INUIT IN NUNAVUT: STORE-CENTERED ACTIVITIES OF HEALTHY FOODS NORTH
........................................................................................................................................................................................................................................................ 157
ETHICAL ASPECTS IN THE ENVIRONMENTAL HEALTH RESEARCH ........................................................................................................................................... 157
THE CLINICAL-MORPHOLOGICAL PECULIARITIES OF GASTRODUODENAL PATHOLOGY IN EVENKIAY CHILDREN ............................................................. 158
THE REASONS OF SUICIDAL BEHAVIOUR OF SIBERIA NATIVE POPULATION .......................................................................................................................... 158
CREATING MODELS FOR MOTHER’S WELLNESS THROUGH PARTNERSHIP RESEARCH: A COMMUNITY PARTNER EXPERIENCE .......................................158
NORTHERN BREASTFEEDING VIDEO ........................................................................................................................................................................................... 158
IMPACTS OF CLIMATE CHANGE ON INUIT DIET IN THE WESTERN ARCTIC: LINKS BETWEEN CLIMATE CHANGE, FOOD SECURITY AND NUTRITIONAL
HEALTH..........................................................................................................................................................................................................................................159
ETHICAL AND CULTURAL IMPLICATIONS OF SPECIMEN BANKING AMONG ALASKA NATIVE PEOPLE: HISTORICAL PROJECT. .........................................159
Presenters’ Index ...................................................................................................................................................... 160

By Initials & Surname ............................................................................................................................................................. 160
Notes ........................................................................................................................................................................ 165
SESSION 1: VENUE 1 21
natural world was something that humans were destined to conquer

and control. It is not surprising that many peoples of the earth have
forgotten that the natural world is a tremendous source of guidance,
SESSION 1 sustenance and healing. Aboriginal peoples of “turtle island” (North
America) have never forgotten that the earth teaches us how to lead a
Sunday, July 12, 1:30-3:30 PM good life, a healthy life. Examples of how nature provides us with
healthy healing resources will be provided in this presentation by such
teachers as the rivers, oceans, forests, mountains, the sky, trees, rocks,
VENUE 1 fire, open spaces, the wind, animals, birds, and fish. Some of the
Mental Health & Wellness #1 – Holistic & Healing outcomes of healing that can be obtained from these teachings will be
discussed such as: cleansing, perspective, connecting, grounding,
Community Programs
empowerment, and guidance.
Contact: Rod McCormick (rod.mccormick@ubc.ca)
DEVELOPING SÁMI MENTAL HEALTH SERVICE: FROM
VISION TO IMPLEMENTATION
THE EMERGING ISSUE OF CRYSTAL METHAMPHETAMINE
V. Stordahl
USE IN FIRST NATIONS COMMUNITIES
Sámi National Centre for Mental Health (SANKS)
J. Robbins
In the mid 1980s the county municipality of Finnmark, Norway,
First Nations Centre of the National Aboriginal Health Organization
decided with the chairman’s casting vote, to establish an institution
with a particular responibility to develop a mental health service for the Crystal methamphetamine use among people in some First Nations
Sámi people in the county. communities (both in Canada and the United States) has evolved into
an issue that is requiring more and more attention. Indicative of this, in
The vision of those arguing for the need of an mental health institution
July of 2005, the Assembly of First Nations (AFN) in Canada passed a
in the hearth of Sámiland was to develop a service that were
resolution specifically directed at this emerging issue.
responsive to the Sámi people’s need. Those who were against this
idea, politicians and pofessionals alike, either argued that this was As a result of this resolution, the AFN has identified the need for the
violating the Norwegian notion of equality or that it would be development of a First Nations National Task Force on Crystal Meth to
impossible to staff it with the required specialists/clinicians. develop a Strategic Action Plan to Address the Emerging issue of
Crystal Meth in First Nations Communities. Generally speaking, this
In 2002 the institution achieved status as a Sámi national centre for
paper provides basic information about crystal methamphetamine as
mental health. In twenty years time the institution had gone from a
well as information that is First Nations specific.
staff of 8, none of them specialists, to a staff of close to 120 staffed by
specialist as well as researchers, and a budget of 77 million Norwegian The first part of the paper discusses: what crystal meth is; who is using
kroner (11 million US Dollar). it; how it used; how it is made and; how it affects the body, mind,
relationships and the environment.
This paper identifies and analyses how the challenges in developing a
mental health service for the Sámi people integrated in the ordinary In Part II, interactions between governments (e.g.: health/drug
Norwegian health services, were met by the staff. strategies), large pharmaceutical companies and organized crime are
Contact: Vigdis Stordahl (vigdis.stordahl@helse-finnmark.no) examined (e.g.: production levels of amphetamines). The role that
these entities play in activities surrounding the production and sale of
crystal methamphetamine—with an emphasis on issues related to First
FROM THE HEART PLACE - HOLISTIC HEALTH Nations’ is articulated. First Nations crystal meth treatment strategies
M. Petit are also examined.
Churchill Regional Health Authority Part III, aspires to put a “human face” on the rising problem of crystal
methamphetamine addiction in First Nations communities. Tala
The present health care system of the High North can be argued is a
Tootoosis’ (Plains Cree/Nakota) story is briefly stated and the crystal
reflection on Southern Health Care principles which has failed the
meth addiction situation across the border on the Navajo Nation is
North at not fault of anyone. A new approach needs to be examined
commented upon. These examples aim to illustrate how crystal meth
one that reflects prevention and care plans that are designed by
addiction has negatively affected a First Nations individual and the
Northern Aboriginals. Therefore this presentation will focus on what
devastating impact the drug has had on one Native American
Northern Health means for Northern residence and look at the 5
community.
domains of Aboriginal health and Sothern care workers can
incorporate these five domains into health care plans. The reality is While the emergence and use of crystal meth is a relatively new
that a majority of health care is presently provided in Southern phenomenon (i.e.: compared to other mind altering agents), the issue
hospitals and clinics with little to no insight on the reality of the North. of addiction is nothing new. While it is important to focus on the
The five domains are Emotional Health, Mental, Physical and Spiritual specifics of how to most effectively deal with meth production and use,
Health which are defined in a wheel developed when I was a director of it is also just as important not to overly focus on it. For instance,
social services in Nunavut. Michael Siever of the Stonewall project in San Francisco notes that
Contact: Michel Petit (m.mpetit@gmail.com) even with the introduction of crystal methamphetamine into the
addiction picture, the crack cocaine problem is still as prevalent as
ever. Thus, just because crystal methamphetamine is now part of the
THE UTILIZATION OF NATURE IN HEALING FOR CANADA’S “addictions picture” does not mean addictive behaviours with regard to
ABORIGINAL PEOPLES other substances will magically go away. Thus, especially for First
R. McCormick Nations, effective holistic substance abuse strategies should be taken
into consideration.
University of British Columbia Contact: Julian Robbins (jrobbins@naho.ca)
“The earth does not belong to humans. Humans belong to the earth”.
Chief Seattle spoke these words when he addressed the United States
Government in 1854. It was the case even 155 years ago that many
humans thought that they owned the earth. It was thought that the
22 SESSION 1: VENUE 2
HIGH RATE OF SELF-PERCEIVED HIV-RELATED STIGMA process and analysis as I develop a research process that is mindful of
AMONG A COHORT OF INDIVIDUALS ACCESSING HIGHLY these issues.
Contact: Barbara Walberg (walberg@confederationc.on.ca)
ACTIVE ANTIRETROVIRAL THERAPY IN BRITISH COLUMBIA
1 1 1,2 3 1
D. Tzemis , E.F. Druyts , J.I. Forrest , T.R. Orchard , W. Zhang , K.A.
Fernandes1, E.K. Brandson1, J.S.G. Montaner1,4, R.S. Hogg1,2 CONSTRUCTING AN INDIGENOUS-CENTERED AND
1 2
British Columbia Centre for Excellence in HIV/AIDS, Faculty of Health DECOLONIZING RESEARCH METHODOLOGY
Sciences, Simon Fraser University, Burnaby BC, 3Faculty of Health G. Baikie
Sciences, University of Western Ontario, London ON, 4Department of
Dalhousie University (faculty), Memorial University (student)
Medicine, University of British Columbia, Vancouver BC
I wanted to investigate the traditional and contemporary Indigenous
Background: Research indicates that self-perceived stigma is an knowledge being used and created by an international group of
inhibitor to adhering to prescribed antiretroviral therapy and
Indigenous health professionals within their neocolonial practice
contributes to nondisclosure of HIV-positive status. Consequently, settings. This resulted in a number of challenges for the creation of an
stigma affects prevention and treatment efforts as well as significantly
appropriate qualitative research methodology:
impacting a person’s psychological well-being. We examine the
prevalence and factors associated with self-perceived HIV-related - What constitutes an Indigenous community and can a community
stigma among a cohort of individuals receiving HAART in British span international boundaries?
Columbia. - Can Indigenous knowledge be both localized and globalized?
- How to actually build a methodology that adheres to the
Methods: Data are drawn from the Longitudinal Investigation into principles of Indigenous ownership, control, access, and
Supportive and Ancillary Health Services (LISA) study. LISA
possession within the constraints of the academy and
participants completed an interviewer-administered survey, which requirements of a PhD thesis?
included questions on socio-demographics, stigma, depression, quality
- How to address the inadequacy of interview methods given that
of life, and perception of standard of living. Clinical variables, which cultural knowledge is typically tacit and beneath practitioner
included CD4 count, viral load, and adherence, were obtained through awareness?
the British Columbia HIV/AIDS Drug Treatment Program. Categorical
- How to discern Indigenous knowledge from Euro-western
variables were compared using Fisher’s Exact Test and continuous knowledge given the domination of Euro-western knowledge
variables were assessed using the Wilcoxon Rank-Sum Test. particularly within professions?
Multivariable logistic regression was performed to determine the
- How to ensure that the research process and product did not
independent predictors of self-perceived HIV-related stigma. inadvertantly contribute to the continued colonization of
Results: Forty-six percent of participants self-perceive HIV-related Indigenous peoples?
stigma. In the adjusted multivariate analysis depression was associated First and foremost, as both an academic and Indigenous researcher I
with perceiving stigma (adjusted odds ratio [AOR] 2.04, 95% CI 1.22- needed to create a methodology with integrity. In other words, the
3.41), along with four quality of life variables: health worries, financial
research needed to adhere to the spirit and intent of the principles
worries, disclosure worries and sexual function (AOR 0.72, 95% CI 0.64- underlying emerging ethical standards for research involving
0.82; AOR 0.89, 95% CI 0.80-0.99; AOR 0.61, 95% CI 0.53-0.70; and
Indigenous peoples . This lead to the construction of a research project
AOR 0.87, 95% CI 0.77-0.99). Participants who reported lower
that I termed “Indigenous-centered” as I explicitly privileged
standards of living compared to neighbours were more likely to Indigenous ways-of-knowing, values, attitudes, practices, protocols,
perceive stigma (AOR 0.40 95% CI 0.2.-0.80).
and concerns (Kovak, 2005; Smith, 1999).
Conclusion: Further efforts are needed to support the mental and Equally important was the need not to dismiss the growing critiques of
emotional well-being of those who access treatment. Our study both research and professional practice as colonizing endeavours. I
identifies depression, poor quality of life and poor standard of living as
paid considerable attention to constructing a research process which
independent variables associated with perceiving HIV-related stigma. was decolonizing is both process and product. I believed this could not
These factors must be addressed when implementing effective and
be achieved through traditional interviewing methods. This lead to the
sustainable programs designed to reduce stigma and improve the lives
evolution of a Decolonizing Critical Reflection research method as the
of people living with HIV/AIDS. primary means for data collection. This technique, through
Contact: Eirikka Brandson (ebrandson@cfenet.ubc.ca)
“decolonizing the mind” (Battiste, 1998), enables the generation of
decolonized data.
Contact: Gail Baikie (gail.baikie@dal.ca)
VENUE 2
Indigenous Research #1 “IT’S NOT AS COOL AS SHOOTING BIRDS”: BUILDING
RESEARCH RELATIONSHIPS WITH ABORIGINAL
JOURNEY OF AN OUTSIDER: IN SEARCH OF A RESPECTIVE COMMUNITIES
RESEARCH PARADIGM J. Bull
B. Walberg University of PEI
Athabasca University There is increasing awareness of the importance of community
In January 2006, I began to contemplate the development of my final consultation and meaningful relationships between researchers and
research project for the completion of my Masters of Arts in Integrated communities; however, very little literature provides wise practices or
Studies at Athabasca University. I wanted to work with an Indigenous successful projects that employed such practices. This presentation will
community, but knew that the past history of outsiders doing research be facilitated by a community based member and an academic
was a contentious issue. As a result, exploring the perspective of community based researcher with the goal of demystifying the
Indigenous peoples concerning the problems with past research in complexities of working within aboriginal communities and encourage
Indigenous communities, and reviewing the issues and suggestions for more “authentic” research relationships. We have built relationships on
appropriate protocols, considerations and methods for outsider the principles of respect and reciprocity. Through building these
research, became prerequisites for the development of my own relationships, we have been working together since 2006 on research
research project. This paper reviews the findings and explores my own in Labrador examining the use and uptake of the CIHR Guidelines for
Research Involving Aboriginal Peoples (2007) and the ethics review
mechanisms in place with the Labrador Innu, Inuit, and Métis. Our illustrated, a lack of ethical guidelines to direct the application of
experiences have been positive and rewarding and we would like to prevention programming makes vulnerable both individuals targeted
share our successes with others with the hope that we will encourage by the these programs, in this example impoverished First Nations
more researchers and communities to work together. women struggling with addictions, as well as the front-line workers and
Contact: Julie Bull (jbull@upei.ca) communities responsible for delivering the prevention programs. I
argue that with the introduction of ethical guidelines in health care
prevention programming, rates of prevention would increase, potential
QUALITATIVE RESEARCH FOR CULTURAL GROUPS harm to vulnerable populations would decrease, and higher levels of
REDEFINED trust between government health ministries and Aboriginal peoples at
C. DeCourtney all level of program delivery would be achieved.
Contact: Caroline Tait (caroline.tait@usask.ca)
Alaska Native Tribal Health Consortium
Focus groups are a standard tool to gather information from
prospective consumers when a new program/ services is being
developed. Designing a program without input from consumers can VENUE 3
lead to expensive redesign if consumer do not accept the program. Indigenous Health & Wellness #1
Gathering groups of consumer and conducting focus groups based on:
outside interviewer, standard questions, incentives, set timeframe can INCORPORATING TRADITIONAL KNOWLEDGE, TEACHINGS,
provide important product/ services information. For groups such as AND PRACTICES TO REVIVE HEALTH AND WELLNESS IN A
Alaska Natives living in remote settings and adhering to a traditional
DENE COMMUNITY NORTH OF 60
lifestyle, the standard model does not work. Over a period of 10 years
(1998-2008) the author conducted six focus groups with different J.C. Catholique
Alaska Native cultures to gather information about traditional death Łutsel K’e First Nation
and dying practices, the effect of Western medicine on these practices,
This project will look at traditional knowledge, teachings and practices
and current wishes. 200 Alaska Native elders participated in seven
to address health and wellness in the Dene communities. With the
different group meetings. How the focus groups evolved provided a
introduction of Western values and lifestyles, the Dene people of the
significant new understanding of the importance of qualitative
North have slowly been integrated into mainstream society. The
research based on modification of accepted tools in gathering
challenge faced by Dene people is to retain and to pass on the
information from indigenous cultures and other groups.
traditional knowledge of our ancestors in order to maintain our health
The focus groups confirmed the premise that most elders preferred to and wellness in this ever changing world. Managing this challenge and
remain in their village as the end of life approaches, just as their living in balance in today’s Northern communities where Dene people
parents did. The validity of the process was confirmed with the second are grounded in their traditions and successful in modern communities
set of focus groups (2005-2008). We remained flexible and adaptable, are the focus of this project.
took lessons learned from the first set of focus groups (1998-2001) and Contact: JC Catholique (jc_catholique@yahoo.ca)
applied them to the second series of focus groups. Interviewer
relationships with the communities proved to be critical in creating a
trusting atmosphere to allow Alaska Native elders to openly share their A LABRADOR COMMUNITY GRAMMAR: LANGUAGE
experiences. HEALING
The standard focus group model must be modified in order to ensure A. Johns
participation by indigenous elders. The importance of qualitative University of Toronto
research can not be over emphasized when working with underserved
The Inuttitut language in northern Labrador is in decline, as more and
groups such as Alaska Native elders who’s needs are not address by
more young Labrador Inuit grow up with English as their language.
mainstream research tools.
Contact: Christine DeCourtney (cdecourtney@anmc.org)
Communities across Labrador are well aware of this situation and are
taking steps to reverse this language shift through a language nest (via
the Head Start program) and publications of language materials
THE ROLE OF ETHICAL GUIDELINES IN THE DELIVERY OF (Andersen and Johns 2005).
FRONTLINE MENTAL HEALTH AND ADDICTIONS This paper reports on a project undertaken during IPY, which is one
PROGRAMMING IN CANADIAN INDIGENOUS COMMUNITIES component within a set of community responses to this loss. The
C. Tait project involves a university linguist working with the Nunatsiavut
Government through the Torngâsok Cultural Centre to create a body
University of Saskatchewan of information (a grammar) for use by language professionals
This paper seeks to explore the question, “If ethical standards similar to (language teacher, translators, etc.) across Labrador in their efforts to
those that shape university-based research practices were applied to maintain and promote Inuttitut. One novel aspect of the assembly of
the delivery of health prevention programming in Aboriginal this knowledge is that there is continual interaction through email and
communities, how would this change health care policy and program webpages with key members of the community. The major goal of this
delivery?” In this paper, I will outline my argument for ethically based interaction is to determine whether the written form of the
health care policy and programming in areas of front-line health information is comprehensible to local language professionals. If the
prevention services. In doing so I will draw upon a case example from materials are not immediately readable by language professionals
northern Saskatchewan of a government funded application of a “best without specialized training, their value will be considerably lessened.
practice” fetal alcohol syndrome prevention project. The importance of At the same time, Labrador language professionals are participating in
this case study is that it clearly illustrates that the moral foundation the production of the materials by passing on difficult language
upon which university research involving human subjects is based, questions from their high school students. This allows the linguist to
does not exist within front-line prevention programming targeting the address particular issues that are of immediate concern and interest
exact same populations. This paper questions why the ethical within an important population - young Labrador Inuit.
guidelines that frame research involving human subjects, or those that The efforts to revitalize the Inuttitut language in Labrador form part of
are adopted by professional bodies such as Colleges of Physician and a general effort to regain local control of governance, resources and
Surgeons, are not similarly applied to the application of best practices also to establish broad and public priorities regarding culture.
in the context of community prevention programming? As will be Regaining the language will strengthen intergenerational bonds and
aid the youth as they find their place within the Canadian and global provided feed back into the discussions of the issues and success
context. stories. Data from key informant interviews, surveys and site visits will
Contact: Alana Johns (ajohns@chass.utoronto.c) be used to describe and illustrate key results from the formative
evaluation of this innovative multi-media health communication
project. Focus will be on adaptation and achievement of planned
THE MEDICAL-SOCIAL AID TO THE ABORIGINES OF THE objectives, development and delivery of key messages, and lessons
RUSSIAN NORTHERN TERRITORIES CONDUCTING learned to date from both project developers and program
TRADITIONAL VITAL ACTIVITY participants.
L. Zubov1, A. Apicyn2, V. Peskov3, L. Abryutina4 Contact: Rhonda Johnson (Rhonda.Johnson@uaa.alaska.edu)
1 2
Northern State Medical University, Administration of the Nenets
autonomous area, Russian Federation, 3Association of Nenetz people, CULTURAL CONTINUITY AND RESILIENCE: INVESTIGATING
Russian Federation, 4Russian Association of Indigenous Peoples of the THE WAYS THAT THREE GENERATIONS OF INUPIAQ
North, Russian Federation OVERCOME HARDSHIPS
The following regional features of the Nenets autonomous area L. Wexler
influence the population health and organization of medical care:
severe climatic conditions, vast territories; nomadic indigenous University of Massachusetts Amherst
population; irregular development of healthcare network. In 2002- Although there have been many studies linking acculturation stress
2008 we study peculiarities of health state and carry out social- and identity struggles to youth health disparities in Indigenous
hygienic and medical examinations of the indigenous population of the communities 1-15, there has been little research exploring the ways
Russian northern territories. All the families of roaming reindeer that Native young people are creatively responding to the tensions of
breeders in the tundra of the peninsula Kanin have been examined. 356 growing up in a world that is markedly different from that of their
persons are observed, 176 of them children. In 42,7% of children the parents and grandparents. In the study region, the disparate growing
pathology is revealed. Pecularities of work, life and diet of families of up experiences of the last three generations has consequences for both
wandering reindeer breeders were studied. The main medico-social youth and their elders. The widening gaps between generations leaves
problems are: small availability of medical aid to the wandering many Indigenous Elders and adults, who traditionally helped young
population; absence of the adapted criteria of a complex estimation of people correctly enter adulthood, with pervasive feelings of
health of children of wandering reindeer breeders; preparation and disempowerment and uncertainty. In this paper, I will discuss a pilot
adaptation of children to school are not solved; partial or full isolation research project that created a platform for listening across age
of children from parents in boarding schools; education in the groups. The multi-phased project partnered with several Indigenous
conditions which are not taking into account features of culture, organizations and created opportunities for Elders and adults to talk to
physiology and psychology; change of a meal; destruction of the youth, and for youth to highlight what they learned by producing
ecological environment; the state cease the most necessary forms of digital stories. Digital stories are three to five-minute visual narratives
rendering of medical aid. The peculiarities of the indigenous people that synthesize images, video, audio recordings of voice and music,
public health state revealed by the doctors during the expedition and text to create personal stories. These productions encourage
studies, the worked out, approved and introduced new forms of the young people to (re)present themselves, their priorities and interests
roaming population’s medical service organization allow to solve many to their family and community. A few of these stories will be shared
medical-social problems of the northern indigenous peoples. The with the audience as will the preliminary findings (and future
results of the carried out long-term scientific and practical work for directions) of the project.
studying and preservation of health of the northern indigenous peoples Contact: Lisa Wexler (lwexler@schoolph.umass.edu)
ground the necessity of organization of a new direction in medicine –

ethnic medicine.
Contact: Leonid Zubov (lzubov@atnet.ru) ABORIGINAL SELF-GOVERNMENT AND SOCIAL SUFFERING
S. Irlbacher-Fox
PAN-ARCTIC TV SERIES ON INUIT WELLNESS: PRELIMINARY Fox Consulting

EVALUATION FINDINGS AND LESSONS LEARNED This paper examines the implications of social suffering for Aboriginal
self government, drawing from case studies in the Northwest
R. Johnson, D. Leavitt, R. Morales
Territories, Canada. Based on the author’s work over the last decade
University of Alaska Anchorage working on self government negotiations in the employ of indigenous
This session will provide preliminary findings and lessons learned to peoples (Irlbacher-Fox, 2009), the analysis draws on a social suffering
date from the ongoing evaluation of Qanuqtuurniq - Finding the framework (Farmer, 1999; Das 1995) to understand how Canadian
Balance TV series, an International Polar Year outreach project on Inuit Aboriginal policy silences suffering as a rationale for greater
wellness broadcast in May 2009 in the Inuit language with English indigenous autonomy, while simultaneously invoking suffering (in the
subtitles and simultaneously Web cast . A main objective of this series form of capacity deficits, social pathologies) as the basis for ongoing
was to adapt and test a “communications for change” model for government control of, and intervention into, indigenous collective
exchanging knowledge from different perspectives on several wellness and individual lives. This paper provides an account of how national
issues of concern to Inuit. . A project team supporting healthy northern policies determine both the approach to and in large part the
communities worked together to create the 3 day, interactive outcomes of negotiations, which the author contends will result in
circumpolar health series using multiple communication channels to agreements whose structure will ultimately perpetuate rather than
explore the issues and the success stories around youth coping and alleviate social suffering.
endurance/ resiliency, healthy men, and maternity care. The Contact: Stephanie Irlbacher-Fox (stephaniefox@theedge.ca)
interactive program included live broadcasts from Iqaluit, Nunavut

with panels of guests from the health and research communities
discussing the issues and then opening the phone lines to answer
questions from the communities across the north. In addition anyone
VENUE 4
could watch the program on a special webcast site and interact via Population Genetics - CPT1A P479L in the North: Risk
telephone or email. Supporting the program were several “community Factor, Protective Factor, or Both?
focus groups” including a youth focus group, representative of the Inuit L. Arbour1, B. Boyer2, W. Burke3, S. Collins1, C.R. Greenberg4, R.
regions of Canada, who watched the program live on television and Hegele5, D. Koeller3, T. Mala6, G. Sinclair1, H. Vallance1
1
University of British Columbia, 2University of Alaska Fairbanks,
3
University of Washington, 4University of Manitoba, 5University of VENUE 5
Western Ontario, 6Anchorage Native Primary Care Centre. Community Participatory Research Methods #1
CPT1 is a mitochondrial enzyme necessary in the transport of fatty
acids for the production of energy from fat when carbohydrate is not
UNDERSTANDING ABORIGINAL COMMUNITY-BASED
readily available. “Mild” CPT1A deficiency first came to clinical
attention after the infant of an Inuit woman presenting with acute fatty
RESEARCH IN CANADA
liver of pregnancy was confirmed to be affected. The responsible D. Allman, T. Myers
genetic variant, which alters the release and the activity of the enzyme, Dalla Lana School of Public Health, University of Toronto
was delineated after a 44 year old First Nation man from Vancouver
The year, 2009, marks a decade since the establishment of a dual
Island, BC presented with muscle cramps and rhabdomyolysis, now
Aboriginal/non-Aboriginal Community-Based Research (CBR) program
thought to be a coincidental association. Current research has revealed
within Canada’s federal government. In this time period, this approach
the presence of the genetic variant in northern and coastal Aboriginal
to research has come to be positioned within Canada as a form of
populations of Alaska, BC, NWT, Nunavut and Greenland. It is
knowledge creation and inquiry able to facilitate genuine participation
suspected that intercurrent illness may increase risk for hypoglycemia
and collaboration, and by extension, individual and community-level
in infants and young children homozygous for the variant, but
commitment to the research enterprise. It does this through the
paradoxically, there is also some evidence the variant may confer a
establishment of socially-just and methodologically-sound research
protective effect for adult onset cardiovascular disease. This workshop
tools and strategies which are understood as meaningful and ethical by
will provide a forum to present what is known, contemplate what is
communities and individual stakeholders alike.
unknown, consider ethical concerns related to research and clinical
screening, and hear the opinions of those in the populations affected. Aboriginal CBR specifically is defined as culturally-appropriate
processes for research, analysis, and dissemination which empower
and benefit the common collective. In Canada, processes for Aboriginal
INTRODUCTION AND OVERVIEW
CBR aim to develop research capacity among underdeveloped
L. Arbour, T. Mala communities in order to help prepare effective strategies for health
promotion and maintenance. As a philosophy and paradigm for the
CPT1 P479L IN NEWBORNS OF THE KIVALLIQ REGION OF development of meaningful knowledge discovery and dissemination,
NUNAVUT Canada’s Aboriginal CBR promotes principles of ownership, control,
access and possession (OCAP). When applied to research, and when
C. Greenberg understood within a post colonial framework, these principles reflect
the evolving importance of self-determination.
THE EXPERIENCE WITH CPT1 NEWBORN SCREENING IN Analytically, a case story approach to the analysis of Aboriginal CBR,
ALASKA when juxtaposed with other forms of community research, allows for
D. Koeller an understanding of the similarities and differences in how these
models of community-centred knowledge production have evolved in
Canada, as well as how colonization and Western-style democracy
ESTIMATE OF BRITISH COLUMBIA CPT1P479L PREVALENCE
have shaped a Canadian narrative of participation which has evolved
AND REVIEW OF MEDICALLY ASCERTAINED PEDIATRIC AND from a history of structural exclusion towards one of greater social
SUDDEN DEATH CASES FROM BC inclusion.
H. Vallance By contributing to a growing understanding of Aboriginal CBR within
the Canadian context, this paper reflects on the ways cultural self
CPT1 P479L PREVALENCE IN LIVE NEWBORNS AND SUDDEN determination, particularly when combined with best practices in
DEATH CASES IN YUKON, NORTHWEST TERRITORIES, AND research ethics and scientific rigour, can contribute to the success of
NUNAVUT public health sciences across the Circumpolar North.
Contact: Dan Allman (dan.allman@utoronto.ca)
S. Collins
CARNITINE PALYMITOYLTRANSFERASE IA POLYMORPHISM THE REALITIES ENCOUNTERED WHILE INTRODUCING THE

P479L IS COMMON IN GREENLAND INUIT AND IS COMMUNITY-BASED PARTICIPATORY RESEARCH
ASSOCIATED WITH ELEVATED PLASMA APOLIPOPROTEIN APPROACH IN GREENLAND
AI E. Rink, D. Gesink-Law, R. Montgomery-Andersen, U. Poppel, A.
Binzer, S. Montgomery-Andersen, A. Koch, G. Mulvad
R. Hegele
Montana State University
COULD CPT1P479L INFLUENCE OBESITY IN ADULTS IN Community consultation has been used to improve health studies
ALASKA? conducted in Greenland in the past. However, community based
participatory research (CBPR), where community members are
B. Boyer involved in the development, design, implementation, analysis,
interpretation, dissemination, and knowledge translation of study
MANAGING UNCERTAINTY: IMPLICATIONS OF CPT1A P479L results, has not been practiced in Greenland. In Canada and the United
FOR ETHICS AND POLICY States, CBPR has been identified as an effective method for
W. Burke conducting research with Inuit, American Indian, First Nations and
Métis communities, especially in the North, because of its emphasis on
community-academic partnerships to build mutual ownership of a
DISCUSSANT PANEL: (DISCUSSANTS FROM ALASKA, research project and because of its ability to empower communities or
YUKON, NWT, NUNAVUT AND GREENLAND TBA) groups to address their health disparities in a socially, culturally, and
Contact: Laura Arbour (larbour@uvic.ca) environmentally appropriate manner. However, the CBPR approach is
not without its challenges in Arctic countries, such as Greenland, where
research capacity, language, distance, time and cost become barriers
to remaining true to the purest form of CBPR. We will describe the assist with accomplishing the short-term aims of gathering data and
practical application of CBPR principles and methodologies to a sexual the long-term aims of developing evidence-based policy and practice
health project investigating sexually transmitted infections in to address the issues. This presentation will include data from the
Greenland. We will present initial challenges encountered in the health survey and a description of the advantages of the community-
beginning phases of the project and solutions to these challenges. We initiated academic-community partnerships.
also suggest recommendations for building capacity in Greenland to This is one of four communities who make up the Nisga’a Nation, the
conduct CBPR projects. first in the province of British Columbia to sign a modern-day lands
Contact: Elizabeth Rink (elizabeth.rink@montana.edu)
claim agreement with the Canadian government.
Contact: Anne George (ageorge@cw.bc.ca)
STRATEGIES FOR COMMUNICATING HEALTH RESEARCH

FINDINGS TO MEMBERS OF AN ARCTIC ABORIGINAL HOW GREENLAND ORGANIZED PREVENTATIVE AND
COMMUNITY HEALTH PROMOTION WORK
J. Huntington, K.J. Goodman, R. Munday, C. Fletcher, G. Gordon B.K. Poulsen
University of Alberta PAARISA, Public Health Center
In the predominantly Aboriginal hamlet of Aklavik, NWT, Canada, Objective: Greenland has built up a unique organization. Central and
residents have expressed concern about health risks from Helicobacter local preventive work is linked trough a preventive board and a
pylori infection. The Aklavik H. pylori Project, launched in 2007, aims to consultant in every town. PAARISA, the Public Health Center, is in the
describe the burden of disease, identify risk factors, evaluate clinical lead and has created an education for the local consultants. A new
management approaches, and effectively communicate research research is presented.
findings to address community concerns. Community members were
Aim: to describe and evaluate the local preventive work in Greenland in
included in the research process by means of a local committee. This
the period from 1996 to 2007. Main focus is on organization, leadership
report describes how community consultation provided ways to
and the new education for local consultants.
maximize the value of the research findings to the community.
Methods: Retrospective, descriptive and explorative casestudy
Community consultation was used to determine which methods of
supplemented with interviews.
disseminating project information would be most effective. A
qualitative research approach was used, including group discussion and Official documents as well as reports from municipalities and informal
key informant interviews, to identify local understanding of the letters were analyzed. Semi structured qualitative interviews with key-
research project, expectations, and preferred methods of knowledge persons, who have worked with or close to the local preventive
transfer. consultants. A seminar held in 2007. The consultants made their
recommendations to the future preventive and health promotion work
Community members’ expectations centered on learning about
in the coming larger communities
behaviors that could protect against ill health. Most informants
expressed satisfaction with the communication methods employed by Findings: The 57.000 inhabitants of Greenland lived in 17 municipalities
the project, including radio shows, announcements and regular flyers, with just as many cities and approximately 60 villages. Despite this,
but still expressed skepticism about the potential value of the research. PAARISA has succeeded reaching public health out to the local level. In
Radio was frequently mentioned as the best way to inform people, but every municipality a skilled prevention counselor is placed and an
most informants supported a proposal to create a video aimed at intersectorial preventive board is established. The education provided
revealing the process of conducting research and understanding the the counselors with tools to manage the superior coordination of
results; overall, informants thought the best approach would be preventive and public health projects in the municipality.
collaboration on visual media development between the research team Conclusions: The results shows, that to promote public health locally,
and community members, youth and elders in particular. you have to work cross-sectorial and be ready to coordinate and
Community-driven research should aim to provide community cooperate. This can be in form of networking, but formal partnerships
members recognizable benefits from participation. Community are recommended. To achieve success, you have to make connection
consultation in this Arctic hamlet suggested that efforts aimed at between central and local level. The results will now be used to
increased understanding of the process of conducting the research and optimize the health promotion work in Greenland. The researcher
what the results mean would maximize the benefit of the research to hopes to inspire Nunavut and Nunavik, who have similar health
the community. This component of the project identified a promising problems and geography.
Contact: Bodil Karlshøj Poulsen (bkp@gh.gl)
knowledge transfer strategy, the creation of a video to document the
research process.
Contact: Janis Huntington (janisgeary@gmail.com)
A DAY IN THE LIFE OF THE IPY INUIT HEALTH SURVEY LAND
TEAM: PREPARING COMMUNITIES
AN ABORIGINAL COMMUNITY INITIATIVE TO PARTNER I. Tensen, H. Nakimayak, L. Okalik, H. Saudny-Unterberger, G.M.
WITH ACADEMICS: DEVELOPING EVIDENCE-BASED Egeland, Qanuippitali Steering Committee (Inuvialuit), Qanuippitali
STRATEGIES TO IMPROVE THE HEALTH & WELL-BEING Steering Committee (Nunatsiavut), Qanuippitali Steering Committee
A. George, W. Martin (Nunavut)
University of British Columbia, Department of Pediatrics Centre for Indigenous Peoples’ Nutrition and Enviroment, McGill
University
The Chief and Council of the Laxgalts’ap Village Government (LVG)
have been concerned for a number of years about improving the health The International Polar Year (IPY) Inuit Health Survey involved
of its community with a on-reserve population of approximately 600. extensive consultations and logistical planning to prepare communities
During the past 3 years, the LVG intitiated three projects aimed at and to coordinate activities. The survey is a multifaceted participatory
improving the health and well-being of the community: gather data on health research project for those 18 years of age and above residing in
access to health care, and on health problems and possible sources of 3 Canadian Inuit jurisdictions and involving 3 steering committees.
community members; host an addictions forum with local, provincial Three separate land teams were trained and traveled to all coastal
and federal leaders to find a workable model for families faced with communities prior to the ship’s arrival, and in each community worked
addiction; and gather data on children’s educational capacities. These closely with health centers, local research assistants and drivers.
projects originated with the LVG who sought academic partnerships to Additional community liaisons traveled ahead of the land teams to
communities in which additional time was required for preparations. COMMUNITY-DRIVEN RESEARCH ON HELICOBACTER
Nearly 100 temporary staff was engaged each field season in PYLORI INFECTION IN A CANADIAN ARCTIC HAMLET
communities, traveling land teams or on board the CCGS Amundsen
K.J. Goodman, R. Munday, J. Huntington, J. Cheung, S. van Zanten, A.
during data collection activities in 2007 and 2008. Community research
Corriveau
assistants were trained and helped to recruit participants from
randomly selected households from which adults over 18 years of age CANHelp Working Group. University of Alberta, Northwest Territories
could participate. Because of the large number of communities and Health and Social Services
community assistants, an informed consent DVD was developed to In recent years, the health committee of the predominantly aboriginal
ensure that a consistent and understandable informed consent was hamlet of Aklavik, Northwest Territories (population ~600) identified
administered. A member of the household completed a home-based H.pylori infection and its link to gastric cancer as a priority concern and
questionnaire, nurses collected information on medicine and vitamins, advocated for research to address solutions. The resulting Aklavik
and clinic appointments were scheduled onboard the Amundsen. H.pylori Project is the start of a broader collaboration to investigate
Home visits were arranged for participants unable to board the ship. H.pylori infection in northern Canadian populations where gastric
The field work proceeded with invitations and collaboration in all 36 cancer rates are elevated and H.pylori infection is difficult to treat. This
communities in the Inuvialuit Settlement Region, Nunastsiavut, and research involves community members in planning and aims to
Nunavut. Three non-coastal communities were included in the survey. describe sociodemographic patterns of H.pylori infection and the
A total of 2796 randomly selected households were contacted of which associated burden of disease, identify effective treatment regimens,
1955 households (72%) accepted the invitation to participate. The generate evidence to inform local health care policy, and address
survey was a success in large part due to the motivation and community concerns regarding health risks. The present results pertain
commitment of members of the land teams, of the local research to community participation and initial screening by the 13C-urea
assistants and drivers and the dedication of the 3 steering committees breath test. Between November 2007 and December 2008, informed
for their oversight and planning. consent and clinical survey data were obtained from 314 Aklavik
Contact: Grace Egeland (grace.egeland@mcgill.ca) residents; 308 had a breath test; 205 consented to upper
gastrointestinal endoscopy and 197 attempted the procedure, with
biopsies for culture and histopathology obtained from 193. Breath-test
PARTICIPATORY APPROACHES FOR A COMMUNITY-BASED positivity was 58% and the reporting of this finding to the community
CHRONIC DISEASE PREVENTION PROGRAM IN TWO served as a strong catalyst for further participation. The high level of
CANADIAN INUIT COMMUNITIES: DEVELOPMENT OF community participation in this project coupled with the interest of
HEALTHY FOODS NORTH health authorities has generated media attention which has led to
other communities asking to be included. This ongoing community-
J. Gittelsohn, M. Kratsmann, C. Roache, E. Mead, J. Ogina, R. Reid, S.
driven project will seek effective strategies for addressing emerging
Sharma
community concerns in populations where H.pylori infection is difficult
Center for Human Nutrition, Bloomberg School of Public Health, Johns to treat.
Hopkins University, Baltimore, MD Contact: Karen Goodman (kgoodman@ualberta.ca)
Objective: To present a model for using formative research and

stakeholder participation to develop a community-based dietary
intervention program (Healthy Foods North) targeting Inuit in
Nunavut, Canada.
VENUE 6
Setting: Two remote Inuit communities in Nunavut, Canada.
Human Biology #1
Methods: Formative research included in-depth interviews (n=45) and
dietary recalls (n=42). Stakeholders, including community leaders,
IODINE DEFICIENCY IN THE NORTH OF KRASNOYARSK
health staff and store managers, contributed to intervention TERRITORY
development through formative research, systematic community I.V. Osokina, V.T. Manchuk
workshops, group feedback and implementation training. State Research Institute for Medical Studies of the North, Krasnoyarsk,
Results: Community members used multiple methods to access foods, Russia
including harvesting, purchasing in stores, and shipping via barge or State Scientific Research Institute for Medical Studies of the North
air. Key cultural themes included the perceived healthiness of country
foods, food sharing, and importance of family. During community Introduction: Siberia traditionally belonged to iodine-deficient regions.
workshops, six key problem foods for intervention were identified, Cessation of iodine prevention in the 1990’s, worsening of social and
including soda (22 votes), chips (22), sweetened drinks (17), white economic situation promoted the increase of iodine deficiency
bread (17), candy (16), and sugary snacks (8). Healthier as well as disorders (IDD) in Siberia.
culturally and economically acceptable alternatives were identified for Aim: to carry out a complex investigation of IDD in the North of
these foods by workshop participants. Behaviors for promotion were Krasnoyarsk territory.
identified and prioritized, including: Healthier cooking methods at Methods: We performed 8 expeditions in polar and northern regions of
home (30 votes), Eating and cooking together as a family (23), Using a the Krasnoyarsk territory: in the Igarsky, Turukhansky, Yenisseisky
shopping list/plan menus (21), and Eating country foods (15). Labeling regions. The assessment included clinical examination, measurement
healthy foods on shelves (20) and reducing prices of healthy foods (18) of weight and height; thyroid palpation and ultrasound scan; ; plasma
were identified as ways to help community members achieve these TSH, T4 and thyroglobulin (TG); urine samples collected in the field
goals. Stakeholder participation contributed to the development of a and processed for iodine using conventional technique; the analysis of
culturally appropriate intervention in stores, worksites, and other the results of neonatal TSH- screening.
community venues.
Results: The carried out investigations showed moderate iodine
Conclusions: This approach resulted in project acceptance, stakeholder deficiency - the median urinary iodine in prepubertal children varied
collaboration, and a culturally appropriate program for an Inuit from 30 to 42 mcg/l. According to thyroid palpation and ultrasound
population. scan the goiter prevalence in children varied from 42.5% to 58.4%. The
Acknowledgements: The research was supported by the American median serum TG varied from 14.7 to 31 mcg/1 and also corresponded
Diabetes Association Clinical Research Award Grant # 1-08-CR-57. to moderate iodine deficiency.
Contact: Joel Gittelsohn (jgittels@jhsph.edu)
IDD control programs: in all the examined regions iodized salt began to induced chemiluminescence. All measurements were done by
be used for mass iodine prophylaxis. In addition to it in Igarka we chemiluminometer BCHL-07 (Russia). The following, most important
introduced the method of bread iodization with potassium iodide. We indices were assessed: 1) Imax - maximal intensity - shows FRO
used the iodized oil (Lipiodol-200) in the remote settlements in Igarsky potential in a biological object, 2) S light-sum - shows content of
and Turukhansky regions. The IDD monitoring showed that median oxygen radicals (RO2), which correspond to break of FRO chain. This
urinary iodine in prepubertal children increased up to 115 mcg/1 vs 31 index makes it possible to assess the system of lipid peroxide oxidation
mcg/1. Thus, IDD prevention in these regions was effective. and antioxidative activity and other compensatory mechanisms of FRO
Conclusions: Our investigations show that in the North of Siberia there in an organism, 3) Tg2 - antioxidative potential of the given sample.
is a serious natural iodine deficiency influencing the health of the Analysis of FRO was done on the basis of comparison of the indices in
population and demanding continuous adequate iodine prevention. native and non-native residents. Imax did not appear to be significantly
Contact: Irina Osokina (osokina@rol.ru) different in these groups. At the same time, in natives light-sum (S)
was lower by 4,7% (p<0,05) and antioxidative response (Tg2) was
higher by 8,1% (p<0,05) when compared to non-natives. It is known
FACTORS THAT INFLUENCE THE BIOCHEMICAL that ratio coefficient of these indices is used for evaluation of
CHARACTERISTICS AND HORMONES OF HYPOPHYSEAL- prooxidative-antioxidative balance. Any shift characterizes
THYROID-ADRENAL SYSTEM OF MEN predominance of oxidative or antioxidative system activity.
Antioxidative potential can be expressed as Imax/S coefficient. S/Tg2a
R. Fedina
coefficient, showing the proportion of peroxide oxidation and
State Educational Institution of Higher Professional Education, antioxidative activity revealed that in natives this index was lower by
Novosibirsk State Medical University 8,9% (p<0,001) and antioxidative coefficient Imax/S was higher by
The purpose of the investigation: to determine the most significant 8,7% (p<0,001) when compared to those of non-native inhabitants. It is
factors that influence the biochemical and hormone characteristics of apparent from the present analysis, that in natives’ blood serum
hypophyseal-thyroid-adrenal system of men (HTAS). processes of antioxidative defense prevail over oxidative ones unlike in
non-native residents of the Far North.
The biochemical and hormone characteristics of HTAS in the
Contact: M.A. Buyack (hypertonia@yandex.ru)
population sample from 1058 almost healthy donor men at the age of
18-60 in the Novosibirsk megapolis were studied comprehensively. The
hormone status was determined using a radioimmunoassay technique; SYSTEM OF XENOBIOTYCS METABOLISM AMONG NATIVE
protein, carbohydrate and lipid metabolisms, by biochemical methods. PEOPLE ON FAR EAST. ROLE OF THIS SYSTEM IN THE
The parametric Student t-criterion and nonparametric Wilkinson-
DEVELOPMENT OF DISEASES
Mann-Whitney testing were applied. A multifactor variance analysis
revealed 15 factors that influence the biochemical characteristics and S. Suleymanov
hormones of HTAS. The comparison of biochemical characteristics We have results researching acethyl-reduction system among different
(crude protein, common lipids, total cholesterol, triglycerides, glucose, group of native people, who living on Far East. And we can fixed
unesterified fatty acid, and lipid peroxidation) and hormones frequency and course some diseases on patients from this contingent
(adrenocorticotropin, somatotrophic hormone, adrenocortical with different type of acethyl-reduction system.
hormone, triiodothyronine, thyroxine, and thyrotropic hormone) As known, acethyl-reduction system is one representative from
makes it possible to find the significant differences among the donors another xenobiotic biotransformation system, participant in earlier
(p > 0.003) who live in “clean” and “dirty” districts. Insufficient stability adaptation, necessary for oil acid synthesis, steroid synthesis, Krebs
to the urbanization factors starts to manifest at the age of 18-19. cycle – what’s why we choose her for researching.
The social-economic conditions in combination with ecological factors The acethyl-reduction system play impotent role in biotransformation
require the extreme tension of adaptive biological and of xenobiotics (medicines, industrial and home toxins). The
psychoemotional mechanisms. The combination and summation of acethylization to realize by enzyme N-acethyltransferase. The activity
different stress vectors under present conditions of life activity make of N-acethyltransferase depends from genotype, B2-adrenoreceptors
regulatory components of men adaptation vulnerable. This leads to the and metabolic reserve (pantothenic acid, pyridoxine, thyamine, lipoid
fast waste of reserves and dysaptation, first of all, of functionally acid).
deficient components in the organism, as well as the rapid progress of
diseases, and the lower lifetime of Russia men. The main factors that We need research activity of N-acethyltransferase for rational using
influence the biochemical characteristics and hormones of HTAS are as medicines, because many of them metabolisating by acethyl-reduction
follows: age, ecological conditions, and duration of living under such system. Especially it is important for izoniazid, because tuberculosis
conditions, year season, tobacco smoking, and alcohol drinking. very wide-spread among minority nationality of Far East.
Therefore, the obtained data can be used to examine men, to make The distribution “faster” and “slower” acethyl-reducers is very variable
prognosis as well as to reveal persons with risk factors, as well as a in different ethnic groups. This variation is especially strong between
regional norm for men in Novosibirsk. asian and europeoid race.
Contact: Roza Fedina (froza@ngs.ru) Our research of acethylasation velocity among native and migration
population on Far East reveal, what people from this group have
difference acethyl-reduction system. So, quantity “faster” acethyl-
RESULTS OF RESEARCH OF FREE RADICAL OXIDATION IN reducers among aboriginals North territory - 85%, among Europeans-
POPULATION OF YAMALO-NENETS AUTONOMOUS OKRUG around 50%.
(RUSSIA) In science literature we see information about different frequency of
M.A. Buyack, E.R. Mirdaleeva, E.G. Samsonova, Y.V. Vorobyova, E.B. morbidity between “faster” and “slower”acethyl-reducers.
Kudryashova For example, cancer of vesicle uterine meet in 2-3 time more often for
State Scientific Research Institute on Medical Problems of the Far North “slower”acethyl-reducers; colorectal cancer meet in 2 time more often
of RAMS for “faster” acethyl-reducers. We are define, what among children,
Aim of the survey was to analyze mean values of free radical oxidation suffering from pneumonia (in Khabarovsk): 2/3 - “faster” and only 1/3
in inhabitants of Yamalo-Nenets Autonomous Okrug. 1333 (582 native “slower”acethyl-reducers. “slower”acethyl-reducers have true more
and 751 non-native) residents (aged 20-59 years) of villages severity of disease and more duration of treatment.
Krasnoselkup, Samburg, Yar-Sale and Se-Yakha were examined. Free Among children, suffering from acute dysentery, more rarely meet
radical oxidation (FRO) was evaluated in blood serum by Fe-dependent “faster” acethyl-reducers (around 60%).
Contact: Salavat Suleymanov (passarudege@mail.ru)

from 0.27 to 0.84 mSv. In the three territories of northern Canada, the
population weighted average annual effective doses due to cosmic ray
THE IMPACT OF ARTIFICIAL AND NATURAL RADIOACTIVITY exposure are 0.29 mSv for Nunavut, 0.31 mSv for Northwest
Territories, and 0.40 mSv for Yukon. The population weighted average
IN THE LICHEN -> CARIBOU -> HUMAN FOOD CHAIN
dose for the three northern territories is 0.33 mSv, slightly higher than
T. Bliss the Canadian wide average, however within natural variation range
Radiation Protection Bureau 6302D1, Health Canada due to varying solar activities.
Contact: Jing Chen (jing_chen@hc-sc.gc.ca)
The radionuclides showing the greatest impact on northern
ecosystems are radiocesium, a fallout product from past nuclear
weapons testing, and lead-210 & polonium-210, decay products of POSTNATAL EXPOSURE, BUT NOT IN-UTERO EXPOSURE,
natural radon gas emanating from soil. All these radionuclides deposit TO MIXTURES OF NORTHERN CONTAMINANTS ALTERS THE
on slowly growing lichens which serve as food for caribou during the
ADULTHOOD GLUCOCORTICOID STRESS RESPONSE IN
long winter months. Caribou meat is the main source of protein in the
diets of many northerners. The transfer of this radioactivity through MALE RATS
the lichen –> caribou –> human food chain constitute the largest single D. Desaulniers, G. Hua-Xio
source of radiation exposure to northern peoples. Healthy Environments and Consumer Safety Branch, Health Canada
Between the years 1960-2000, over 1200 caribou, representing 20 Perinatal events can reprogram the expression of the glucocorticoid
herds from across the Arctic, were sampled for radiocesium by Health receptor (GR) for the entire lifespan, creating abnormal hormone levels
Canada and other agencies. The levels were highest in the early 1960s and suspected predispositions to metabolic and psychological
when atmospheric nuclear weapons testing was at its peak, but diseases. We tested the hypothesis of a link between perinatal
measurable concentrations have persisted up to the present time. An exposure to Northern contaminants and abnormal adulthood
ecological half-time of 6 years for cesium-137 was derived from these glucocorticoid (corticosterone: CS) stress response (GSR) in rats. The
results, which demonstrates the vulnerability and slow recovery time experiment included 9 treatment groups. From gestation-day 0 (day of
of Arctic ecosystems to fallout contamination. vaginal plug) and until postnatal day (PND) 20, dams were fed daily
From 1963-1969, radiocesium body-burdens were measured by Health cookies laced with corn oil (control) or a chemical Mixture (M:
Canada for more than 3000 people representing almost every Arctic polychlorinated biphenyls, organochlorine pesticides, and
community. This was carried out by a combination of urine collections methylmercury) at 0.5 or 1.0 mg/kg/day (0.5M, and M). At birth, some
and portable whole-body counting. At this time some northern control (C) and M litters were crossfostered to create 4 groups of pups
residents were receiving radiation doses of up to 5 millisieverts per with the following in utero/postnatal exposure: C/C, C/M, M/C, M/M.
year, five times the current public dose limit. In 1989-1990, five of Other dams received cookies with a dose of 1.7 ng/kg/day of a mixture
these communities – Baker Lake, Rae-Edzo, Old Crow, Aklavik, and of aryl hydrocarbon receptor agonists (AhR: non-ortho PCBs,
Fort McPherson were re-visited and whole-body counts completed on dibenzodioxins and furans) without or with 0.5M. Mixture effects on CS
over 1100 people. The radiocesium levels in these people had declined was assessed in male offspring at PND85 through a GSR induced by
significantly, by an amount greater than what would be predicted the collection of blood from the tail vein (Time 0) and monitoring the
based on the levels in caribou meat. This difference is attributable to CS decay from the trunk blood collected at decapitation 30 min later
the substitution of many traditional foods by store-bought foods over (T30). The concentrations of CS returned to normal at T30 in the group
this period. C, 0.5M, M, C/C and M/C, but it remained abnormally elevated in the
On the other hand, the naturally occurring radionuclides, lead-210 and group AhR, AhR+0.5M, C/M, and M/M. Interestingly, M had no effect
polonium-210, have remained at constant levels in the Arctic on its own but it prevented the CS drop in adulthood in the M/M group
environment and now dominate the radiation exposure from in which exposure is associated with the postnatal stress created by the
consumption of traditional foods. With climate change and melting crossfostering procedure, suggesting that rats can tolerate exposure to
permafrost, we are likely to see increased radon emanation from Arctic M with no consequences unless they are subjected to early postnatal
soils and consequent increases of these natural radionuclides in the stress. The liver is a metabolic target organ and the abundance of GR
environment. mRNA was significantly reduced by the C/M and MM treatments.
Contact: Tracey Bliss (impact-effets@hc-sc.gc.ca) Globally, the crossfostering procedure permitted us to demonstrate
that both the CSR and the abundance of the hepatic GR mRNA are
modified by the postnatal period of exposure to M and not by in utero
AN ESTIMATION OF COSMIC RAY BACKGROUND EXPOSURE exposure, and that “postnatal stress” modified the effects of exposure
IN NORTHERN TERRITORIES to chemicals. These results are important in our understanding of the
perinatal influence of contaminant exposure on stress-induced
J. Chen1, R. Timmins1, K. Verdecchia1, T. Sato2
1
diseases.
Healthy Environments and Consumer Safety Branch, Health Canada, Contact: Daniel Desaulniers (Daniel_Desaulniers@hc-sc.gc.ca)
2
Japan Atomic Energy Agency
The worldwide average exposure to cosmic rays contributes to about
16% of the annual effective dose from natural radiation sources. At
SOME FEATURES OF HEALTH STATE OF INDIGENOUS
ground level, doses from cosmic ray exposure depend strongly on the POPULATION’S CHILDREN IN THE NORTH OF RUSSIA
elevation above sea level, and weakly on geographical locations and P.I. Sidorov, N. Sibileva, L. Zubov
solar activities. PARMA is a simulation software to calculate the Northern State Medical University, Russia, Arkhangelsk
cosmic-ray spectra anywhere below the altitude of 20 km and anytime
after A.D. 1700. The accuracy of the simulation was well verified by We carry out social-hygienic and medical examinations of the
several experimental data of the terrestrial cosmic-ray spectra taken indigenous population of the Nenets autonomous area. The long-term
under various conditions. In this study, the analytical model PARMA monitoring among the native population shows that infant mortality of
was used to calculate annual effective doses due to cosmic ray the Nenets children exceeds 1,5-2 times the average total indices in the
exposure at ground level were calculated for more than 1500 region.
communities across Canada which cover more than 85% of the The health state of 176 children and adolescents in the reindeer
Canadian population. Generally speaking, Canadian population brigades has been studied. In the structure of the pathology in the
weighted average annual effective dose from cosmic ray exposure at nomadic children diseases of the locomotor system, diseases of the
ground level is 0.31 mSv. At different geographic locations and during respiratory system, diseases of respiratory organs, functional diseases
different solar activity periods, the annual effective dose could vary
of the cardiovascular system and the vegetative nervous system

prevailed. SESSION 2
A study has been carried out of the degree of iodine deficiency Sunday, July 12, 4-5:30 PM
pronouncedness, prevalence of endemic goiter and neonatal
hyperthyrotrophinemia in the area (clinical, instrumental and
laboratory examinations of 132 Nenets and Russian children at the
antepubertal age). The degree of iodine deficiency pronouncedness in
VENUE 1
the Russian children was described by the index of ioduria mediana Mental Health & Wellness #2 – Holistic & Healing
60,8 mkg/l what points at slight iodine deficiency, and in the Nenets Community Programs
children - 44,9 mkg/l (moderate iodine deficiency). Despite the
differences in iodine provision, in the children of both nationalities,
CANADIAN INUIT COMMUNITY ENGAGEMENT IN SUICIDE
thyromegalia was absent and goiter was registered poradically.
PREVENTION
According to the indicator of neonatal hyperthyrotrophinemia,
strumous endemia corresponds to the moderate degree of M.J. Kral1, P.K. Wiebe2, K. Nisbet1, C. Dallas3, L. Okalik3, N. Enuaraq1
seriousness. 1
University of Illinois at Urbana-Champaign & University of Toronto,
2
During complex evaluation of health of the native population children Health Canada, 3Inuit Tapiriit Kanatami
in the far North, it is necessary to take into account regional and ethnic Objectives: To review suicide patterns among Inuit in Canada and
features. highlight new developments in Inuit-driven and community-based
Contact: Pavel Sidorov (lzubov@atnet.ru)
suicide prevention.
Study Design: Narrative review of suicide among Inuit in Canada,
NEW SERUM MARKERS OF AGING AND ATHEROSCLEROSIS: strides toward Inuit autonomy, and community and government action
CHITOTRIOSIDASE, MATRIX METALLOPROTEASE ACTIVITY, toward suicide prevention.
AND CYSTATIN C CONCENTRATION Methods: Review of Inuit meanings of mental health, movements
toward Inuit control across Inuit Nunaat (the four Inuit regions) of
T. Korolenko, M.S. Cheranova
Canada, and of community and government action toward suicide
Institute of Physiology RAMS prevention.
The search of new serum markers of aging, atherosclerosis and Results: Economic advancement is occurring in Inuit Nunaat following
predictors of cardio-vascular catastrophes is important in land claims settlements, and territorial and provincial governments are
contemporary society, especially in regions and cities with high overseeing Inuit well-being. Inuit community engagement in suicide
mortality from cardio-vascular pathology ( Novosibirsk and prevention is taking place, and studies are being planned to evaluate
Novosibirsk Region). Activity of matrix metalloproteases (MMPs), the efficacy of such action for suicide prevention and community
chitotriosidase and cystatin C concentration were investigated in mental health. Initial evidence demonstrates that community control
serum of 25 practically healthy persons aged 20-45 and elder group (25 over suicide prevention itself can be effective toward preventing
persons, aged 50 - 65 years old, with arterial hypertension) and 25 suicide.
patients with atherosclerosis before the cardiosurgical operation
Conclusions: A new orientation is taking place in Canada in the name of
(Novosibirsk Regional Cardiovascular Unit). Cystatin C concentration
Aboriginal community empowerment. There is a new hope for the
was determined with help of commercial ELISA kits for quantitative
model of meaningful community engagement and partnership with
determination of human cystatin C (BioVendor, Czechia), activity of
the Canadian government in suicide prevention and well-being.
MMP and chitotriosidase by fluorescent methods – against MCA-Pro-
Contact: Patricia Wiebe (patricia_wiebe@hc-sc.gc.ca)
Leu-Gly-Leu-DpA-Ala-Arg-NH2 (American Peptide Co., USA) and 4-
methylumbelliferyl-β-D-N,N’,N”-triacetylchitotrioside (Guo et al.,
1995) as substrates correspondingly. Increased serum chitotriosidase POSTPSYCHIATRY IN THE REGIONS OF RUSSIAN NORTH
and MMP activity, cystatin C concentration in aged persons as well as
T. Korolenko
increased “basic” CRP-hs concentration (correlated with elevated
serum cholesterol and triglycerides level) was shown. Similar results Novosibirsk Medical University
were obtained in patients with atherosclerosis before the coronary The term of “postpsychiatry” is invented for the assessment and
shunting operation, in this group serum MMP activity was elevated treatment of the mental disorders of the postmodern culture. In the
more significantly comparatively to the persons of the same age with up-to date Russia the postmodern culture is present mostly in the
arterial hypertension. Statins treatment improved all indexes studied urban areas of the big towns and cities. It coexists with the big zones of
in elder group (not to the normal data). One can conclude that the traditional and modern culture. The impact of postmodern culture
increased chitotriosidase, MMP activity and cystatin C concentration on the population of North increases in the condition of the intensive
are early markers of aging and atherosclerosis development. migration processes. The traits of the postmodern culture include :
Contact: Tatyana Korolenko (T.A.Korolenko@physiol.ru) rapid changes in the areas of personal, social and professional life, the
weakening of the interpersonal links, the decrease of the intimacy,
callousness, moral numbing, indifference, hardness, “no time”
phenomenon, narrowing the scope of one’s moral universe. The
structure and functions of the postmodern society form the
predisposition for the development of the shadow forms of the
previously known mental disorders, and the appearance of the new
ones syndromes. The variants of the shadow syndromes of antisocial
and borderline personality disorders, the cases of as yet practically
unknown dissociation identity disorder, attention deficit disorder in
adults, Munchausen syndrome by proxy were assessed and described.
New situation in the field of the mental health that can not be treated
in the frame of the traditional biological approaches. The challenges of
the postmodernity demand the development of the new branch of
psychiatry which will utilize mainly psychological, social, and object
relation psychodynamic tools.
Contact: Tsezar Korolenko (lengyel@irs.ru)

examine the mental health promotion and prevention programs and
services aimed at 12 to 18 year-old Nunavimmiut presently
“THE WAY I SEE IT”: HOW STIGMA AND DEPRESSION implemented in Nunavik by government and community organizations
and the Nunavimmiut themselves; evaluate the mental health needs of
AFFECT SELF-PERCEIVED BODY IMAGE AMONG HIV-
12 to 18 year-old Nunavik youth in order to analyse how these services
POSITIVE INDIVIDUALS ON HAART and programs meet their needs and how to better adapt them; suggest
A.K. Palmer1, A. Tzemis1, W. Zhang1, E.K. Brandson1, J.S.G. recommendations based on the analysis of programs/services and
Montaner1,2, R.S. Hogg1,3 needs regarding youth mental health promotion and prevention
1
British Columbia Centre for Excellence in HIV/AIDS, 2Department of programs and services in an empowerment perspective.
Medicine, University of British Columbia, Vancouver BC, 3Faculty of The study’s context, objectives, methodology and its participatory
Health Sciences, Simon Fraser University, Burnaby BC approach will be presented and discussed in this talk. This project
Background: With significant reductions in AIDS-related morbidity and employs an interactive or deliberative approach, which involves critical
mortality, HIV is increasingly viewed as a chronic condition. However, thinking and a co-construction of the research process, the production
people on HAART are experiencing new challenges such as metabolic and the analysis of the results by the study partners and the involved
and morphological body changes, which may affect self-perceived community members, practitioners and decision-makers. A case study
body image. The concept of body image is complex and encompasses methodology will be adopted, where a village represents one case.
an individual’s perception of their existential self, physical self and the Various methods will be used such as: documentary analysis, individual
social interpretation of their body by others. interviews and a focus group with key decision-makers and
practitioners and photovoice with community youth, parents and
Methods: The LISA cohort is a prospective study of HIV+ persons on
elders.
HAART. An interview-administered survey collects information Contact: Georgia Vrakas (Georgia.Vrakas@inspq.qc.ca)
regarding body image, stigma, depression (CES-D 10), food insecurity,
and quality of life among other information. In univariate analysis, chi-
squared tests and the Wilcoxon rank sum test were used to compare
individuals reporting positive body image with those reporting VENUE 2
negative body image. In multivariate analysis, logistic regression was Clinical Care #1
used with odds ratio being the measure of the association between
positive body image and the covariates.
TRANSITION TO END OF LIFE CARE: THE INUIT EXPERIENCE
Results: Of 472 LISA participants, 57% reported positive body image.
The adjusted multivariate analysis showed that being male (AOR=
IN MONTREAL
2.09), employed (AOR=2.44), and having a suppressed viral load A. Robitaille1, M.L. Kelly2, B. Young1
(AOR=1.84) are associated with positive body image. Alternately, 1
Nunavik Centre, Innulitsivik Health Centre, McGill University Health
stigma (AOR=0.37) and depression (AOR=0.27) are associated with Centre, 2Ungava Tullatavik Health Centre
negative body image. The estimated probability of a person having
The Nunavik region situated north of the 55th parallel in Quebec has a
positive body image without stigma or depression is 80%. When
population of 10,000 Inuit. Persons of Inuit origin are provided medical
stigma is included alone, probability drops to 66%, and when
care in Montreal, situated at more than 2,000 km. A minority of these
depression is included alone probability drops to 53%. Depression and
patients are found to have an advanced terminal condition, such as
stigma combined result in a probability of 37%.
metastatic cancer for which treatment cannot be offered.
Conclusion: Further efforts are needed to address body image issues
Decisions about end of life care are always difficult to undertake. They
among people living with HIV. In order to lessen the impacts of
elicit fears of one’s imminent mortality, loss of hope, separation from
depression on body image, such issues must be addressed in
loved ones and abandonment by health professionals.
healthcare settings. Community interventions are also needed to
address stigma and reduce negative body image in an effort to The Inuit patient, though needing acute medical services, must also
improve the lives of people living with HIV. face the stress of being alone, immersed in a hospital environment,
Contact: Eirikka Brandson (ebrandson@cfenet.ubc.ca) using a second language, isolated from family and community. These
particular circumstances potentiate the chance of the Inuit having a
different understanding of the decision making process, withdrawing
MENTAL HEALTH PROMOTION AND PREVENTION IN 12-18 his participation and experiencing traumatic psychological distress.
YEAR OLD INUIT YOUTH IN NUNAVIK Little research has focused on the needs of the Inuit admitted to an
G. Vrakas1, L. Fournier2, S. Moller3, R. Levy-Powell3, J. Mesher4 urban hospital during the transition from curative to palliative care.
1
Transdisciplinary Training Program in Public and Population Health This is a multiphase nursing project having as goal to increase the
Research CIHR/RRSPQ; University of Montreal Health Center’s Research quality of life of the Inuit patient in transition to palliative care in an
Center; Institut national de santé publique; Center for Research and urban medical center. It includes a review of the literature exploring
Intervention on Suicide and Euthanasia (CRISE; UQAM), 2University of the Inuit’s perception of life threatening illness, their experience in
Montreal Health Center’s Research Center; Institut national de santé discussing end of life care and the cultural context in which such
publique du Québec, 3Kativik School Board, Nunavik, 4Saputiit Youth discussions are sanctioned.
Association, Nunavik A systematic chart review of adult Inuit from Nunavik who have died or
The population of Nunavik is very young (42 % is under 18 years of age who have been transferred to their northern community for end of life
versus 21 % for the province of Quebec) and presents certain mental care between January 2007 and June 2009 will be done. The literature
health issues. For example, the suicide rate of 15 to 19 year-olds is 40 and chart review will provide an overall perspective of the subject and
times higher than that of Quebec youth of the same age group. the complex concerns that are involved in providing culturally relevant
Research on health promotion has shown that initiatives promoting care to the Inuit patient at this most difficult stage of life.
community engagement are empowering and lead to better health Contact: Andréanne Robitaille (andreanne.robitaille@muhc.mcgill.ca)
outcomes than “top down” ones. The authors are partners in a

community-based participatory research project addressing the
following question: what mental health promotion and prevention MY 11 YEARS TREATING SKIN DISEASES ON BAFFIN ISLAND,
initiatives are put into place by the Nunavimmiut to meet the mental NU, CANADA. WHAT I SAW, WHAT I DID
health needs of their 12-18 year-old youth? Specifically, we propose to: R. Jackson
University of Ottawa IN-PATIENT CARE UTILIZATION AMONG SÁMI IN SWEDEN

Like Julius Caesar’s description of Gaul, this presentation is divided into S. Hassler1,2, P. Sj’lander2,3
three parts. 1
University West, Trollhättan, Sweden, 2Southern Lapland Research
The first deals with procedural items including the setting up of on-site Department, Vilhelmina, Sweden, 3Centre for Musculoskeletal Research,
dermatological clinics and how I use “store and forward” for University of Gävle, Umeå, Sweden
consultations. Also, how I arrange for consultations in Ottawa.
Objectives: The health care needed in different populations does not
The second tells of the medical aspects such as the diseases seen, their allways correspond directly to the rate of health care utilization.
numbers, interesting aspects, treatment, and a few comments on the Geography, socioeconomy, gender and culturally related factors also
use of punch biopsies. Details will be given on the methods used to influence the rate of utilization. Among the reindeer herding Sámi in
control the frequently seen atopic dermatitis. Sweden it has been shown that the confidence in primary health care
The third will outline the public relations effort to “spread the gospel” and psychiatry is significantly lower compared to non-Sámi controls.
on the “life and times” on Baffin Island, including mention of the first The objective of this study is to increase the knowledge on the
clinical medical meeting in Iqaluit., the capital of Nunavut. utilization of health care among Sámi by presenting and analyzing data
Contact: Robert Jackson (robertj@istar.ca) on in-patient health care with a special focus on gender.
Study Design: Register based epidemiological cohort study.
THE QUALITY AND COST OF WOUND DRESSING Methods: A study cohort of 37 039 Sámi (6 474 reindeer herders) was
PROCEDURES BEFORE AND AFTER INSTITUTION OF A followed regarding all in-patient care discharges registered in the
Hospital discharge register between 1999 and 2003. Hospital discharge
STANDARADIZED STERILE NO TOUCH PROTOCOL
rates and average length of stay were calculated and comparison made
T. Wuerz, G. Dow with a demographically matched control population of non-Sami.
Dalhousie University Results: In all populations the discharge rates of in-patient care was
Background: Current infection control practice for wound care, a daily lower among men than women but the gender difference was smaller
activity both in the hospital and in the community, is widely among reindeer herders than non-herders and controls. Among
inconsistent. Current literature surrounding various wound care women, reindeer herders have lower discharge rates (181/1000
procedures is extremely sparse, and there is ongoing debate as to persons) than non-herders (203/1000 persons) and non-Sámi controls
which techniques should best be employed. Partly due to the extreme (199/1000 persons) while the rates for men were similar for all groups.
paucity of evidence, there exists a wide variation in the current practice Non-Sámi men have the longest average length of stay (6.5 days) while
of wound care. Dressings change technique is performed under clean non-herding women have the shortest (5.6 days). Among the different
or sterile conditions; sterile technique can be done using sterile gloves, patient groups reindeer herding women have the lowest number of
or alternatively a “no touch” procedure whereby sterile dressings are admissions to in-patient care (2.2) while reindeer herding men have the
manipulated using forceps. We developed a protocol for using a no highest per patient admissions (3.0).
touch sterile technique, and will perform an audit of dressing change Conclusions: A lower than expected health care utilization among
technique before and after implementation of this technique. Given reindeer herding women may partly reflect a lower confidence in
the high incidence or trauma and diabetes in the North in general, the health care observed among reindeer herders. But other gender
results of this study will be highly applicable to practice in these areas. specific aspects that influence the behaviour related to health care
Study Population: Forty patients will be randomly audited during the among Sámi should also be considered.
time of their dressing changes before and after implementation of our Contact: Sven Hassler (sven.hassler@hv.se)
protocol. In each case, twenty of the patients included will have acute
surgical wounds and twenty will have chronic nonsurgical wounds.
FREQUENCY OF ATOPY IN THE ARCTIC STILL INCREASING
Inclusion criteria include patients 18 years or older with an acute or
chronic wound, as well as admission to a family practice, surgical and V. Kamper, M. Andersson, B. Kristensen, A. Koch
internal medicine ward. Burn patients as well as patients with VAC Department of Epidemiology Research, Statens Serum Institut
dressings will be excluded.
Introduction: Allergic diseases have previously appeared to be relatively
Intervention: No specific treatment will be carried out during the study less frequent in Greenland compared with western countries. However,
period. The standardized no-touch wound dressing protocol will be over a 10-year period the prevalence of atopy (defined as specific IgE in
introduced. All of the features of this protocol are contained in current serum as a marker for allergy) in unselected persons from western
nursing wound procedures. Greenland increased from 10% to 19%, an increase higher than seen
Procedures: The research study nurse performing the audit will visit elsewhere in the world. Using the same methodology we determined
participating medical and surgical floors each morning to identify the prevalence of atopy in 2008 in a cohort of school children in
enrolled patients who will be undergoing dressing changes. These Sisimiut, west Greenland.
dressing changes will be audited for hand-washing before and after, as Methods: A cohort of 169 children aged 9-15 years previously followed
well as contact of the wound and wound field with sterile, clean, and in young childhood for respiratory tract infections had blood samples
contaminated objects. drawn. Samples were tested for specific IgE towards inhalant and food
Outcomes: Primary outcomes prespecified for this study include the allergens using the Phadiatop and Fx5 assays. Information of risk
number of breaks in dressing protocol, handwashing before and after factors was obtained from questionnaires from 1996-98 and at
dressing change, dressing time, and dressing cost. Breaks in dressing present.
protocol is defined as any point in time during the dressing change Results: An overall prevalence of atopy of 30.6% was found among the
where a nonsterile or contaminated object comes into contact with the children. Compared with a prevalence of atopy in 1998 of 20.6%
wound. These variables will be compared before and after the dressing among a similar and age-matched group of children, the prevalence
protocol implementation. increased almost 50% from 1998 to 2008. The distribution of individual
Statistical Analysis: Continuous variables will be compared using allergens was the same in 1998 and 2008. Significant risk factors in
student’s t-test. Means will be computed with standard deviation. early childhood for later development of atopy was having furry pets,
Categorical variables will be measured using chi-square testing with having atopic parents, and suffering from many respiratory tract
Fisher’s exact test as indicated. Statistical analysis will be carried out infections in early childhood.
using SPSS statistical software. Conclusions: The marked increase in atopy in Greenland observed from
Contact: Terence Wuerz (terry.wuerz@gmail.com)
1987 to 1998 continues. The unchanged distribution in prevalence of
allergens from 1998 to 2008 indicates that the increase cannot be DYNAMIC ATTITUDE TO HEALTH PROBLEMS IN THE MALE
ascribed to particular allergens, but rather to a generally increased POPULATION DURING SOCIAL AND ECONOMIC CRISIS IN
atopic tendency among the children. Respiratory tract infections that RUSSIA (WHO-MONICA-PSYCHOSOCIAL PROGRAM)
are highly prevalent in young Greenlandic children are associated with
development of atopy, but may only explain a minor part. These V. Gafarov, E. Gromova, I. Gagulin, A. Gafarova, D. Santrapinsky, Y.
results suggest that the Greenlandic health system ought to be more Kabanov
aware of atopic diseases in the future. Collaborative laboratory of Epidemiology Cardiovascular Diseases SB
Contact: Vibe Kamper (ako@ssi.dk) RAMS
Aim: To evaluate changes for a decade in the attitude of men to health
THE PARADOX OF ANEMIA WITH HIGH MEAT INTAKE: IS problems during social and economic crisis in Russia.
THERE MULTIFACTORIAL ETIOLOGY OF ANEMIA AMONG Methods: A random representative sample of males (2149) aged 25 to
THE INUIT? 64 years from one district of Novosibirsk was examined within the
framework of the screening (1984,1988,1994) of the WHO “MONICA-
J.A. Jamieson1, H.V. Kuhnlein1, Qanuippitali Steering Committee psychosocial” program. Health self-assessment and attitude were
(Nunavut)2, G.M. Egeland1 studied by means of the questionnaire “Awareness and Attitude
1
Centre for Indigenous Peoples’ Nutrition & Environment; School of towards Health” the studied population.
Dietetics & Human Nutrition, McGill University, 2L. Gunn, Nunavut Results: Constant deterioration of a self-estimation of health in age
Association of Municipalities; L. Williamson, Nunavut Tunngavik group of 25-34 years is revealed (p<0,001) of 10-years research. In the
Incorporated; I. Sobol and G. Osborne, Government of Nunavut age of 35-44 years the same tendencies, as in younger age group were
Department of Health and Social Services; K. Young, University of observed, but less expressed (p<0,05). In too time, in the age of 45-54
Toronto in 1,9 times the number of answers “ health good “ has increased
Dietary iron intake is insufficient to explain the prevalence of anemia (p<0,05). In age group of 55-64 years the increase of number of the
among Inuit. men estimating the health is revealed “is positive” (p<0,001). Persons
Primary Objective: To document the dietary intake and prevalence of of young age groups are dependent on civil functions of a society, such
anemia, H. pylori infection and parasitosis among Inuit adults. as necessity of earning money for themselves and for maintenance of
family. And, accordingly, during economic instability (it is especial
Secondary Objectives: To characterize the type of anemia present and
1994) They are more vulnerable concerning health. Significant
identify the relative contribution of each potential contributing factor.
reduction of frequency of smoking is probably connected to
Methodology: Using good participatory research techniques, a cross-
deterioration of a self-estimation of health at this age also. But it is
sectional study of dietary intake, nutritional assessment and screening
necessary to tell, that in the senior age groups in 1994 consumption of
for anemia, parasitosis and H. pylori infection in adults over 18 years of
alcohol in reply to social and economic crisis has sharply increased.
age (n=2200) was carried out with a representative sample of Canadian
Inuit as part of Qanuippitali? The Inuit Health Survey. Venous blood Conclusion: Estimation of the health the population is objectively -
samples were collected for analysis of iron status (serum ferritin), subjective criterion of the general level of health a population.
parasites and H. pylori infection by standard methods. Anemia was Dynamics of this criterion during social and economic crisis in Russia
characterized by hemoglobin (Hgb) concentration (portable has shown significant deterioration of a state of health among men
Hemocue). Inflammation (C-reactive protein) was assessed to account young, middle-aged and growth of consumption of alcohol, smoking in
for potential effects on nutritional status. In Nunavut, 25% of females advanced age.
Contact: Valery Gafarov (gafarov@ngs.ru)
(n=700) and 21% of males (n=472) were classified as anemic (Hgb < 120
g/L and 130 g/L, respectively). Preliminary analyses will be presented.
Contact: Jennifer Jamieson (jennifer.jamieson2@mail.mcgill.ca)
MEN’S ATTITUDE TO OWN HEALTH UNDER THE
MICROSCOPE
G. Thunem
VENUE 3 KUN center for gender equality
Social Determinants of Health #1 – Men’s Health
Public health and mortality in Norway has strong gendered aspects,
with men on the negative side of the spectrum. Women have a life
SOCIAL DETERMINANTS OF INUIT HEALTH expectancy 5 years longer than that of men; there are differences in
C. Penney health and mortality that are not biological but rather products of
social relations, lifestyle and cultural expressions of masculinity and
Indian and Northern Affairs Canada
femininity.
Information on Inuit in Canada indicates disparities in a variety of
Focusing on men, more men than Women see their own health as
health measures, as well as in a wide range of socio-economic factors.
good or very good, but this is at odds with reality. Traditional
Using the 2001 and 2006 Aboriginal Peoples Survey, we look at which
expressions of masculinity emphasise agency and stoic disregard for
social, cultural and economic factors are most closely linked with
physical and mental pain. Lifestyle habits, diet, physical activity,
differences in self-reported health. Regression modelling allows us to
tobacco and drug use, sexual health and accident-prone behaviour all
study the effect of cultural and social factors while taking such things
contribute. Single men in particular seem to have difficulties reading
as age, sex and other physical indicators into account. These socio-
their own bodies and health indicators, and do not seek medical
cultural factors include Inuit-specific indicators taken from the APS
attention.
Arctic Supplement, as well as “standard” socio-economic factors such
as education, employment and income. The results of our study Tysfjord in Nordland county in Norway has a population of about 2000,
indicated that social and cultural factors contribute to the self-reported mainly of Norwegian and Lule Saami origin. This presentation
health of Inuit in Canada, including such things as social ties to people describes an attempt to focus on male health in public health discourse
in the community, and past attendance at a Residential School. and efforts organised, by the Árran Lulesami centre and the KUN
Contact: Chris Penney (penneyc@ainc-inac.gc.ca) centre for gender equality. The project has worked to organise public
information meetings, specialised information and awareness
campaigns focusing on men. Awareness of the impact of ethnicity and
gender relations and the specific challenges of public health work in a
rural setting has circumpolar parallels.
Contact: Gunhild Thunem (gunhild.thunem@kun.nl.no)

that Inuit men were not getting the help they needed. Those concerns
sparked a research project in which 19 Inuit men across the country
THE SOCIAL ECONOMY AND HEALTH IN NORTHERN were interviewed about their needs and views on health. The resulting
report, entitled Inuit Men Talking About Health, was released in 2009.
CANADA
The study provides a first in-depth look at health issues from an Inuk
C. Southcott male perspective. We hope that this study will give a stronger voice to
Lakehead University Inuit men, and will contribute to discussions about how health and
Northern communities are currently facing many social and economic social programs can be adapted to better serve them.
challenges. The non-profit, voluntary, and co-operative organizations The study reveals that the huge cultural transitions in the space of just
involved in the social economy sector are working to assist two generations have left Inuit men feeling powerless, lost, and unsure
communities deal with these challenges by empowering communities of their place in the family and community. Their level of distress is
through the development of social and human capital capacity. This is reflected in low school completion rates, high rates of incarceration
especially seen in the healthcare sector of Northern Canada. This paper and suicide. Yet services specifically oriented to male needs have
is part of an initial evaluation of the relationship between the social lagged behind those for women. In the study Inuit men discuss some of
economy and healthcare in the North. It seeks to offer an initial the major factors that underlie health — like education, income, and
description of this relationship through an examination of the results of use of health care — and also describe their experience and
a census of these organizations and a subsequent survey. The analysis perceptions of personal and family problems.
show that social economy organizations are particularly important to This presentation will provide highlights of the men’s perspectives and
healthcare in Northern communities. At the same time these solicit reactions and comments from the audience concerning priority
organizations are facing several important challenges that affect their needs among Inuit men, Inuit knowledge related to healing and
ability to assist these communities. promising practices to better reach and support men.
Contact: Chris Southcott (csouthco@lakeheadu.ca) Contact: Dianne Kinnon (dkinnon@naho.ca)
USING KNOWLEDGE SYNTHESIS, TRANSLATION, AND

EXCHANGE TO PUT THE DETERMINANTS OF HEALTH INTO VENUE 4
ACTION IN NORTHERN COMMUNITIES Database & Surveillance #1
H. Beanlands, C. Betker, A. MacLeod
National Collaborating Centre for Determinants of Health POPULATION HEALTH INDICATORS FOR FIRST NATIONS IN
The determinants of health are the factors that influence our health ALBERTA
and well-being. Health is impacted by many factors: our environment, N. Lachance
our genes, our relationships, what we eat, how active we are, and the
Health Canada
healthy personal behaviours we adopt. Moreover, our environment
reaches far beyond the natural world around us to include social, The presentation has been prepared using a population health
gender, economic, political, and work factors. Directly or indirectly it is approach and is expected to guide joint efforts in terms of health
these factors that determine the health of our citizens, their planning. As such, it has been widely presented to decision-makers in
communities and Canada’s population as a whole (NCCPH, 2008). The First Nations organizations and governments in Alberta. The
World Health Organization Commission on Social Determinants of presentation of the Population Health Indicators for First Nations in
Health (2007) noted that “the conditions in which people grow, live, Alberta provides a profile of the First Nations in Alberta by compiling
work and age have a powerful influence on health. Inequalities in these information on demographics, socio-economic determinants of health
conditions lead to inequalities in health.” Evidence indicates that social (education, income, employment and housing) as well as a number of
and economic circumstances are equally, and in some cases, more health indicators. The presentation has been developed by gathering
important to health status than medical care, health services and our information from a number of different sources including Statistics
personal health behaviours. Canada, Health Canada, Indian and Northern Affairs Canada, Assembly
of First Nations, Alberta Health & Wellness and the National Aboriginal
In light of this evidence, the National Collaborating Centre for
Health Organization. The presentation emphasizes the close
Determinants of Health recognizes that working toward improved
relationship between education, employment and income and their
health and reduced disparities requires a serious focus on the
impact on health status. It also shows how injuries, addictions, healthy
determinants of health. Therefore, this presentation will explore the
weight and the impact of young parenthood affect the socio-economic
determinants of health with a specific focus on how we can effectively
determinants of health.
take action in an intersectoral, evidence-informed and comprehensive Contact: Nathalie Lachance (nathalie_lachance@hc-sc.gc.ca)
manner. The goal of the presentation is to enhance the working
understanding and the application of the determinants of health in
public health policy and practice across Canada, with a particular focus MÉTIS HEALTH/WELL-BEING DATA COLLECTION:
on northern communities, to address health inequity. It will provide an CONCEPTUAL SNAPSHOT OF FACTORS BEHIND DATA-
opportunity to hear and respond to examples of where the PAUCITY AND ACTION STEPS
determinants of health have been addressed, including the
identification of opportunities and response to challenges. M. Kumar
Contact: Hope Beanlands (hbeanlan@stfx.ca) Métis Centre of the National Aboriginal Health Organization
Numerous reports, environmental scans and discussion papers allude
INUIT MEN TALK ABOUT HEALTH to the dearth of Métis health/well-being data. The shortcomings of the
current sources of data range from poor data quality,
D. Kinnon insufficient/inadequate data to a complete lack of data. These
National Aboriginal Health Organization deficiencies have serious consequences including an inadequate
In 2002, the Inuit Tuttarvingat (formerly the Ajunnginiq Centre) of the understanding of the true state of Métis health, the disparities and
National Aboriginal Health Organization held a series of community determinants, and insufficient funding for programs, all of which
workshops in Inuit regions to gather ideas about health and health- collectively perpetuate health/wellbeing disparities. In this paper we
related needs. At every workshop, participants stated their concern present some of the limitations of current sources of Métis data,
including surveys and peer-reviewed publications. Further, we
elucidate a conceptual snapshot of the factors behind the scarcity of The research methods used were a literature review, collection, review
data, with some emphasis on jurisdiction/exclusion issues. Following and analysis of official statistical information, key informant
this, some recommendations including potential approaches to interviews, focus group sessions, self-administered questionnaires and
achieving a wide-ranging set of Métis health/well-being data are development of community profiles.
discussed. A comprehensive collaborative strategy which may A total of twenty-six (26) communities participated in the process. Of
incorporate many of the outlined approaches is explored. those, only four (4) are considered non-isolated (meaning they have
Contact: Mohan Kumar (mkumar@naho.ca)
road accessibility) and are within three (3) hours of Sioux Lookout. The
remaining twenty-two (22) participating communities are accessible by
COMMON DISEASES IN SIBERIAN NATIVES air only.
M.I. Voevoda1, A.N. Romanova2, T.A. Romanova2, N.V. Makcharova2, Across the twenty-six (26) communities a total of two hundred ninety-
M.I. Tomskii2, O.V. Yanchenko1, M.Yu. Ogarkov1, L.A. Gyrgolkau1, Yu.I. eight (298) key informant interviews and twenty (20) focus group
Ragino1, E.V. Shakhtshneider1 sessions comprising an additional seventy-seven (77) informants were
1 conducted. In total three hundred eighty-five (385) informants
Institute of Internal Medicine, Russia Academy of Medical Science, participated in the consultation process.
Siberian Branch, Novosibirsk, Russia, 2Yakut Scientific Center, Russia
Academy of Medical Science, Siberian Branch, Russia - Yakutsk A high-level content analysis was carried out to identify similar themes
and concepts across the whole data set. This helped identify
At present common diseases become one of the leading causes of the community perceptions of the major health problems, causes of poor
death in native populations of Siberia and there are indications that health and gaps in current service delivery.
their prevalence will further grow. A rapid increase of diabetes mellitus Contact: Janet Gordon (Janet.Gordon@slfnha.com)
incidence also has been observed in some native populations.
The goal of this work was to study the prevalence of common diseases
risk factors in various ethnic groups of indigenous peoples of Siberia ESTABLISHING AN INTERNATIONAL CIRCUMPOLAR
and their relationship with coronary atherosclerosis. COLLABORATIVE TUBERCULOSIS WORKING GROUP
Materials: We examined the native population of Yakutia, Khakasia, T. Zulz1, D. Scholten2
1
Mountain Shoria and Mountain Altai. In Yakutia and Khakasia patients Centers for Disease Control/Arctic Investigations Program, 2Public
of native origin and newcomers with angiographically verified coronary Health Agency of Canada
atherosclerosis or myocardial infarction were also examined.
Background: The International Circumpolar Surveillance (ICS) project
Traditional risk factors, including blood lipids, blood pressure, body
was established in 1998 to create an infectious disease surveillance
mass, family history, glucose level, apolipoprotein E genotypes and
network throughout Arctic regions. ICS allows for the collection,
some other genetic markers were evaluated.
comparison and sharing of uniform laboratory and epidemiological
Results: The level of risk factors varies in different native populations. data on infectious diseases and assists in developing prevention and
Its prevalence gradually increases in all populations proportionally to control strategies. Collaborative surveillance initially focused on
westernization of life style. In all studied areas the frequency of risk invasive pneumococcal disease. In 2006, due to concerns about high
factors in the populations of indigenous people is still lower than that rates of tuberculosis (TB) in the Arctic, the ICS Steering Committee
of newcomers. Universal increase in prevalence of risk factors approved creation of a TB Working Group.
associated with metabolic syndrome is observed in patients with
Methods: An organizational meeting in 2006 with representatives from
coronary atherosclerosis in all studied native and nonnative ethnic
interested circumpolar regions was held in Yellowknife, NWT, Canada.
groups. Peculiarities of risk factor prevalence and expression is partly
A formative evaluation was conducted in 2007 which included a
determined by the ethnic specificity of the genetic factors.
literature review and questionnaire. The questionnaire was sent to all
Conclusion: The prevalence of common diseases in native populations ICS representatives. The literature review focused on TB surveillance
of Siberia is rapidly increased. An important role in this process belongs and epidemiology in circumpolar countries. Results were compared to
to metabolic syndrome. questionnaire answers to identify critical gaps to be addressed by the
Contact: Mikhail Voevoda (mvoevoda@ya.ru) program. Evaluation results were presented to working group
members. Further conference calls focused on procedural issues.
USING HEALTH NEEDS ASSESSMENT TO INFORM PRIMARY Results: Greenland, Canada and the U.S. Arctic (Alaska) were
HEALTH CARE PLANNING represented at the organizational meeting in Yellowknife. During the
evaluation, representatives from Sweden and the Russian Federation
J. Gordon, F. Tarrant indicated interest. The evaluation identified five goals for the group (1)
Sioux Lookout First Nations Health Authority improve surveillance of TB, (2) identify trends in TB epidemiology, (3)
The project conducted the needs assessment process that undertook assess the incidence of TB, (4) increase awareness of TB, and (5)
the collection of information in five major areas relevant to health collaborate on TB research. The group developed draft Terms of
planning for the First Nations communities in Northwestern Ontario. Reference, core data elements, case definition and a data sharing
Data was collected on population and health status, health agreement. A work group meeting is planned for July, 2009, in
determinants, community strengths, existing health care services, and conjunction with the International Congress on Circumpolar Health.
the vision for the future health care system. Conclusions: The ICS TB Working Group has great potential to
The primary intention of the needs assessment was to inform the influence public health in circumpolar countries. Continued
development of a comprehensive primary health care system for the collaboration will provide shared data that may identify common
region. While much research already exists on the health status of the issues and assist in developing strategies for TB detection and control.
Contact: Tammy Zulz (tsc3@cdc.gov)
aboriginal population within the area, it was dated and did not
necessarily reflect current health issues. This project was undertaken
to establish an up-to-date and/or current research base on the health THE GREENLANDIC NATIONAL INPATIENT REGISTER AS A
status, issues and priorities for the First Nation communities. It also
TOOL FOR HEALTH MONITORING AND RESEARCH IN
identified the gaps in primary health care service delivery and provide
the foundation for the development of an action plan to address those GREENLAND
gaps. M. Andersson1, N. Nielsen1, M. Melbye1, K. Ladefoged2, A. Koch1
1 Contact: Anna Banerji (anna.banerji@utoronto.ca)

Department of Epidemiology Research, Statens Serum Institut,
Copenhagen, Denmark, 2Department of Internal Medicine, Queen Ingrids
Hospital, Nuuk, Greenland ESTABLISHING A SENTINEL SURVEILLANCE SYSTEM FOR
Like in Denmark, all individuals in Greenland are assigned a personal HIV-ASSOCIATED RISK BEHAVIOURS AMONG ABORIGINAL
and unique identification number (CPR-number) at birth. This number POPULATIONS IN CANADA
follows the person from cradle to grave and identifies the individual in
a large number of nation-wide registers concerning health, social M. Aslam, S. Ogunnaike-Cooke, D. Boulos, C.P. Archibald, A-Track
factors, etc. Using the number as linkage these registers may be linked Working Group*
which has resulted in a large number of scientific health studies in Surveillance and Risk Assessment Division, Public Health Agency of
Denmark. In 1987 Greenland established the Greenlandic National Canada
Inpatient Register which until now contains information about all Background: Aboriginal peoples comprise 3.8% of the Canadian
(more than 240.000) hospitalizations in Greenland. Thus, the Register population, but in 2005 represented an estimated 7.5% of all prevalent
has a unique potential for insight in the health situation in Greenland HIV infections and 9% of all new HIV infections. The overall estimated
during the past 20 years and contains a large potential for HIV infection rate among Aboriginal persons in 2005 was about 2.8
comprehensive register-based research studies in Greenland. times higher than among non-Aboriginal persons. Available data from
However, the Register has never been used as a tool for neither routine surveillance are unable to adequately explain the current status
administrative nor scientific purposes, and has not undergone scientific and trends of HIV infection and related risk behaviours among
validation. As part of an agreement between the Greenland Aboriginal persons, and, therefore, additional data sources are
Directorate for Health and the Department of Epidemiology Research required. This paper outlines the framework to establish a sentinel HIV
(DER) at Statens Serum Institut, Copenhagen, Denmark, the DER got surveillance system among Aboriginal (First Nations, Métis, Inuit)
access to the Register with the aim of performing a scientific validation Canadians.
of the register to assess its quality, which is crucial before it can be
Methods: Public Health Agency of Canada is working with Aboriginal
used for health monitoring and research. A first look at the register
representatives to develop A-Track, a second-generation HIV/AIDS
using selected diagnoses that could be validated elsewhere (i.e. births
surveillance system. Work is underway to finalize the surveillance
and birth related hospitalizations) disclosed that there has been a
instruments and identify pilot site(s) in consultation with the ATrack
relatively stable rate of reporting of hospitalizations from the district
Working Group.
hospitals over the period and that the rate off falsely registered
diagnose codes has been low, but that there is a certain amount of Results: A national enhanced HIV surveillance system among
underreporting. Thus, the Register appears to be a promising resource Aboriginal populations envisages biological and behavioural
for health research in Greenland, but a more thorough validation surveillance via repeated cross-sectional surveys with consistent
process is needed. In the presentation the register and possible impact sampling strategy, data collection methods, and indicators to monitor
for health monitoring and research will be described. trends in HIV, related risk behaviours, HIV-testing history, access to
Contact: Mikael Andersson (ako@ssi.dk) healthcare services and knowledge and attitudes around HIV/AIDS
among Aboriginal Canadians over time. HIV testing is expected to be
optional whereas testing for other pathogens will be subject to validity
NORTHERN RSV SURVEILLANCE: OBJECTIVES, METHODS, of specimen collection and testing methods. The system underscores
AND PRELIMINARY RESULTS Aboriginal involvement at all stages, will recognize Aboriginal people’s
A. Banerji, M. Young, Northern RSV Surveillance Study Team shared control over jurisdictional data, respect Aboriginal customs and
practices, and is expected to yield information on prevalence of HIV
University of Toronto, Departments of Pediatrics & Dalla School of Public
infections and related risk behaviours among Aboriginal persons at the
Health
participating sentinel sites. The pilot survey is expected to go in field in
Objective: Inuit infants have the highest rates of admission for lower 2009.
respiratory tract infections (LRTI) in the world. The objective is to
Conclusions: Successful design and implementation of a sentinel HIV
present the rationale, objectives, methodology and initial results for
surveillance system among Aboriginal peoples requires community
the Northern RSV Surveillance. This study is a multi-site prospective
engagement, utilization of existing infrastructure, and enhanced
surveillance across most of Arctic Canada and Greenland, which
Aboriginal capacity-building. A better understanding of HIV-related
documents the rates of admission for LRTI, identifies Respiratory
risk behaviours and HIV prevalence over time will facilitate improved
Syncytial Virus (RSV) and other traditional and emerging viruses, and
policy and program interventions, at the local, provincial/territorial and
calculates the costs associated with admissions.
federal levels, to prevent and control HIV infection among Aboriginal
Methods: We describe a surveillance for admissions for LRTI in infants populations.
less than 1 year of age from Arctic Canada and Greenland who were
* A-Track Working Group (includes past members of Working Group):
admitted to regional and tertiary centres. RSV is identified by rapid
Chris P Archibald (Federal Co-Chair, Public Health Agency of Canada);
RSV testing usually on site, while the remaining specimen will be
Ken Clement (Community Co-Chair, National Aboriginal Council on
tested for a multiplex PCR panel assessing for 22 viruses. The rates of
HIV/AIDS); Margaret Akan, Fran Hyndman, Fred Andersen, Jeanette
LRTI and RSV admission per region will be calculated, as well as the
Doucet, and Joyce Seto (National Aboriginal Council on HIV/AIDS); Dawn
costs associated with the admission to hospital. The rationale,
Marsden (National Aboriginal Health Organization); Michelle George
challenges and preliminary data will be discussed. The potential policy
(Healing Our Spirit); Neil Andersson (Centro de Investigación de
implications of this research will be discussed.
Enfermedades Tropicales – Tropical Disease Research Centre); Ulrick
Results: Infants were enrolled from 9 hospitals in Canada and Auguste (First Nations and Inuit Health Branch, Health Canada); Kevin
throughout most of Greenland. We will describe the demographics of Barlow (Canadian Aboriginal AIDS Network).
all enrolled infants up to June 2009, as well as the RSV rates in each Contact: Aslam Mubeen (mubeen_aslam@phac-aspc.gc.ca)
region. The RSV season started later than the typical season in the
south. Most infants were born at term without underlying risk factors
for admission. We will present some of the more challenging aspects of
initiating Arctic-wide RSV surveillance, the importance of ongoing
surveillance and some lessons learned from our experience.
Conclusion: This study will collect valuable data on the epidemiology
and costs of RSV in the Canadian Arctic and Greenland, which is a
population that has been poorly studied up to this point.
COMMUNITY-BASED APPROACH TO HEALTH RESEARCH IN

VENUE 5 THE ARCTIC: A CASE STUDY FROM NUNAVUT, CANADA
Community Participatory Research Methods #2 D.P. Charette, S.G. Donaldson, N.C. Doubleday, T. Nancarrow, C.N. Da
Silva, T. Leech, A. Manning, B. Grimwood, M. Ip, E. Pootoogook, G.
CLIMATE CHANGE AND HEALTH ADAPTATION IN Pootoogook, J. Van Oostdam
NORTHERN FIRST NATION AND INUIT COMMUNITIES Healthy Environments and Consumer Safety Branch, Health Canada
PROGRAM Introduction: Community-based health research (CBHR) is considered
D. McClymont Peace, E. Myers to be one of the frameworks that can be used to engage researchers
and community organizations and members in research. This approach
First Nation and Inuit Health Branch, Environmental Health Research
is important to ensure that the research responds to community-level
Division, Health Canada
health needs and concerns.
This program is designed for Northern First Nations and Inuit
Objective: The objective of this paper is to outline a community-based
communities. It will support community-based research activities
methodological approach that was applied to a human health research
which are aimed at developing scientific expertise and relevant
project in Nunavut, Canada.
communication material to increase capacity/ improve decision-
making at the community, regional, and national levels with respect to Research Methodology: The research study relied on semi-directed and
human health in a changing climate. open-ended interviews and documentation of the entire research
process.
Much of the existing climate change research and program
development in Canada has focused on impacts to natural and built Results: The research showed the importance of community research
physical environments and on ways of mitigating or reducing green- partnerships, the involvement of community members in all phases of
house gases which contribute to climate change. Very little research research, the process that was employed to collect, analyze and
has been done on its implications to human health. To fill the gap, interpret the findings, and the mediums used to communicate the
Health Canada – First Nations and Inuit Health Branch has developed a research results.
community-based research program, which aims to integrate both Conclusion: The results of this paper provide a new foundation that
scientific studies and traditional knowledge, to help northern First could be used to build future community-based health research
Nations and Inuit increase their knowledge and capacity to develop projects in the circumpolar region.
health-adaptation strategies. Contact: Shawn Donaldson (Shawn_Donaldson@hc-sc.gc.ca)
The research examined the following issues across the North: ice
monitoring and safety, food security and gender analysis, landslides
WATCHING OUR YOUTH LISTEN TO OUR ELDERS: BUILDING
and their effects on water safety, and creating the link between climate
change and health issues from Elder’s traditional knowledge systems YOUTH CAPACITY TO INVESTIGATE HEALTH IMPACTS OF
and connecting them with scientists and youth through outreach. This CLIMATE CHANGE AND OIL AND GAS DEVELOPMENT IN
will be described in further detail at the Congress. THE NWT
The main outcome of this program is to build capacity in the North; E. Freeland-Ballantyne
this program is an opportunity to allow Northern community-based University of Oxford
researchers to develop their own research and find ideal solutions to
Canada’s Mackenzie Valley Delta is the fastest warming region in the
deal with their particular climate change and health issues. And by
circumpolar north. While communities experience day-to-day impacts
health we mean that projects can explore how the physical, mental,
of climate change, the region is in the midst of an oil and gas boom
and/or spiritual aspects of certain people or of the entire community is
precipitated by the proposed Mackenzie Gas Pipeline. With a focus on
being affected.
community health and wellness, a two-year youth-directed
The ultimate aim of this program is to develop scientific expertise and participatory video research investigation offers timely insights into
relevant messaging that will help in decision-making with respect to how a community research focus on health can lead to important
human health and a changing environment in Canada’s North. insights in the quest of building sustainable, healthy northern futures.
Contact: Erin Myers (erin_myers@hc-sc.gc.ca)
The paper details how participatory geography methods can support
community research goals while simultaneously building research
YOUTH DRIVEN PARTICIPATORY RESEARCH IN AKLAVIK, capacity, awareness, and monitoring action in communities affected
NWT by both climate change and oil and gas development. Presenting the
significance of a participatory youth-led methodology that fosters
S. Chatwood1, V. Illisiak2, D. Kurszewski1 youth-Elder and community-university cooperation, the paper details
1
Institute for Circumpolar Health Research, 2Moose Kerr School, Aklavik, the possibility that participatory research in health can serve as a
NT catalyst to inter-regional and intergenerational communication as well
The Moose Kerr School in partnership with the Aklavik Health as action to address the health and wellness impacts of climate change
Committee and the Arctic Health Research Network NT have lead a and oil and gas development. The paper discusses the importance of
research initiative to engage youth and elders via participatory sustainable community research in reaching this goal, the spaces for
methodologies to study issues related to food security and climate academic-community partnerships, and the importance of
change in the Beaufort Delta region of the Northwest Territories. The community-driven health research. I will then present the results of the
research projects have been integrated into the school curriculum. research, which indicate an alternative northern conception of health,
Students complied information on the topic area of interest, designed wellness and human security than those models currently represented
questionnaires and gathered information using video methods. Key in environmental impact assessment and economic development
findings from the dietary and climate change projects will be decisions in northern development. Offering an alternative approach
presented. to the current challenges of rapid change from a community health
Contact: Susan Chatwood (ahrn.ed@theedge.ca) orientation, this work details the possible courses of action detailed in
the research to support community health and sustainable
development.
Contact: Erin Freeland Ballantyne (erinfreeland@yahoo.ca)
toxicants; however, the fish in the James Bay Region predominately

VENUE 6 contain only mercury and fish is virtually the only source of the mercury
Food Security #1 – Politics of Food for humans; thus, this case is much simpler than multiple contaminants
in multiple foods as occurs in much of the circumpolar North. This case
emphasizes a holistic view of the potential risk of mercury exposure
ASSESSMENT OF CONTAMINANT AND DIETARY NUTRIENT versus the real risks in avoidance of fish.
INTERACTIONS IN THE INUIT HEALTH SURVEY Contact: Bill Roebuck (Bill.D.Roebuck@Dartmouth.edu)
L.H.M. Chan, L. Van Pelt, G.M. Egeland, Qanuippitali Steering

Committee (Inuvialuit), Qanuippitali Steering Committee
CONTAMINANTS, HEALTH, AND EFFECTIVE RISK
(Nunatsiavut), Qanuippitali Steering Committee (Nunavut)
ASSESSMENT & COMMUNICATION IN THE CIRCUMPOLAR
UNBC Community Health Sciences Program NORTH
The Inuit Health Survey (IHS) provides a snapshot and baseline data on K. Friendship1, C. Furgal2, Council of Yukon First Nations, Yukon
the health status of Inuit People across the North in Nunavut, Inuvialuit Contaminants Committee
and Nunatsiavut. This project was developed as a component of HIS 1
that would incorporate contaminants research within broader health Canadian Studies Indigenous Studies Graduate Program, Trent
research studies. We obtained funding support from the Northern University, 2Indigenous Environmental Studies Program, Trent University
Contaminant Program to measure the amount of environmental There is growing recognition of the importance of Indigenous
contaminants in the bodies of the participants, and to access the risks knowledge and the incorporation of Indigenous perspectives and
and benefits associated with the traditional food diet and the perceptions in environment and health research today. There have
relationship between contaminants and health outcomes of the been certain challenges when assessing and communicating
participants. Survey and sample collection was conducted in Nunavut environmental health risk information with northern communities in
on board of the Coast Guard research vessel Amundsen in 2007 and the past due to an incomplete understanding of how the information
2008. This is a participatory research with full partnership with the Inuit would be viewed by Indigenous communities. Differences in culture,
organizations and the regional health departments. All necessary language, the politicization of information, and cross-cultural
measures will be undertaken to increase the capacity of the misunderstandings can all act to undermine the best intentions of
communities and local health professionals. The key research question health and environment professionals. While there has been an
is “How do the diets and contaminants affect the health of the Inuit?” increasing awareness of these difficulties, this has not necessarily
Results of the study will provide useful information to assist health translated into more effective action taken to address these
professionals and policy makers at the Territorial, national and challenges. There is little research showing how environment and
international levels in developing environmental health policies and aid health benefit-risk assessment and communication has been
Inuit in making informed dietary choices. We will present an overview developed at the local level in communities, what things have been
of the project and discuss the significance of the expected results in affecting this process, or evaluation of the success of such efforts to
determining the well being of the Inuit in the Canadian Arctic. date. A CIHR funded Circumpolar review will conduct case study
Contact: Laurie Chan (lchan@unbc.ca) reviews on the topics of Indigenous environmental health benefit-risk
assessment and communication associated with contaminant
exposure through traditional food consumption in one community of
MERCURY IN FISH AS A RESULT OF THE JAMES BAY each of the following regions: Yukon, Alaska, Greenland, and the
HYDROELECTRIC DEVELOPMENT: PERCEPTIONS AND Russia North. It is hypothesized that common key factors at the
REALITIES individual and community scale influence the success (as measured by
B.D. Roebuck1, E.J. Virginia2 community reception, retention, comprehension, compliance to
1 messages and perception of issues) of risk assessment and
Department of Pharmacology and Toxicology, Dartmouth Medical
communication events related to contaminants, country foods, and
School, Hanover, NH, 2Dartmouth College, Hanover, NH
health in circumpolar Inuit communities. As well, identifying and
The hydroelectric development scheme known as the La Grande understanding these common factors can improve the assessment and
Complex began in the1970s in the James Bay region of QuÈbec, communication of health risks and benefits for environmental health
Canada. With flooding, pre-existing mercury associated with issues in Arctic regions.
vegetation and soils was mobilized, biologically methylated, and
This project also includes a Masters thesis subproject exploring: what
migrated through the aquatic food web. Mercury in some fish was
are the current and possible contributions of Indigenous knowledge to
above the existing Canadian and World Health Organization (WHO)
environmental health benefit-risk management processes in Northern
fish consumption guidelines. Considerable debate, rancor, and fear
Indigenous communities? The thesis research will focus on
within and between the several stakeholders resulted in much publicity
understanding how perceptions, assessment and communication of
and several measures to monitor and mitigate the potential health risk
benefits and risks associated with food safety issues are and can be
of fish consumption.
enriched by the involvement of Indigenous knowledge and
Unlike many contaminants (e.g., DDT and PCBs), mercury is also perspectives (e.g. exposure to long-range transport contaminants
naturally present in both the environment and the fish therein. through traditional diet).
Furthermore, mercury has a long and well publicized history with Contact: Katelyn Friendship (kafriendship@trentu.ca)
several catastrophic episodes of human poisoning from contaminated
foods.
FOOD SECURITY REFERENCE GROUP: BUILDING THE
This case examines three important issues. First, knowledge of an
elevated presence of mercury in fish in the James Bay Region, EVIDENCE TO SUPPORT DECISION-MAKING AT POLICY AND
particularly in the reservoirs and diverted water courses of the La COMMUNITY PLANNING LEVELS AND IMPROVE FOOD
Grande Complex, may or may not have been the direct cause of the SECURITY FOR FIRST NATIONS AND INUIT
decreased use of the fisheries by the Cree, as other societal changes A. Nahwegahbow, J. Cheechoo, M. Guyot
were occurring simultaneously. Second, irrespective of the cause for
First Nations and Inuit Health Branch, Health Canada
the decline in fish consumption, the avoidance of fish and thus mercury
is attended with increased consumption of nutritionally inferior foods Available data demonstrate that food insecurity is much higher among
and decreased intakes of n-3 polyunsaturated fatty acids. Third, many Aboriginal populations than non-Aboriginal populations in Canada, and
of the traditional foods in the Arctic contain multiple potential is of particular concern in northern and isolated communities. To date,
there has been little conceptualization of what food security might LEVELS OF ARSENIC, CADMIUM, LEAD, MERCURY,
mean for First Nations and Inuit, and little consideration of what SELENIUM, AND ZINC IN VARIOUS TISSUES OF MOOSE
policies or practices might enable the achievement of this important HARVESTED IN THE DEHCHO, NORTHWEST TERRITORIES
social determinant of health.
N.C. Larter1, K. Kandola2
To help address these needs, the Food Security Reference Group 1
(FSRG) was established in 2005. The FSRG brings together Inuit Tapiriit Department of Environment and Natural Resources, Government of the
Kanatami, the Assembly of First Nations, the federal government, Northwest Territories, 2Department of Health and Social Services,
academics, and others for the purposes of sharing information, Government of Northwest Territories
discussing strategies and opportunities, and setting priorities for Moose is an important traditional food for residents of the Dehcho who
collective action to improve food security in First Nations and Inuit want to know what the contaminant levels are in the country foods
communities. they consume. As part of moose monitoring program involving local
Achievements of the FSRG include a comprehensive literature review First Nations, between 1 September 2004 and 31 March 2007 we
and an evidence-based interventions framework, and review and collected a tooth, one kidney and a sample of liver from moose (n=46)
documentation of community-based initiatives. These outputs have harvested by local residents and teeth (n=17), kidney (n=18), liver
helped better define food security issues for First Nations and Inuit; (n=13) and muscle (n=7) samples from moose taken by sport hunters in
highlight policy and research gaps; and conceptualize how food the southern Mackenzie Mountains. We measured the levels of arsenic,
security can be promoted in First Nations and Inuit communities. cadmium, lead, mercury, selenium, and zinc in the tissue samples;
teeth were used to determine animal age. Levels of cadmium,
Future directions of the FSRG include identifying opportunities for mercury, and zinc were higher in moose harvested from the southern
advancing food security at both policy and community planning levels Mackenzie Mountains. In contrast, levels of arsenic were lower in
through positioning and building on the tools developed and moose harvested from the southern Mackenzie Mountains. For moose
information gathered by the FSRG, and continuing to build the harvested in the southern Mackenzie Mountains the mean level of
evidence to support decision making at these levels. cadmium in kidneys was 222.5 mg/g (wet wt) and for livers 30.9 mg/g
Contact: Melissa Guyot (melissa_guyot@hc-sc.gc.ca)
(wet wt). Contrastingly, for moose harvested in Mackenzie and Liard
River drainages the mean level of cadmium in the kidneys and livers
COMMUNICATION PATHWAYS: HOW YOUNG INUIT was 26.8 and 2.7 ug/g (wet wt), respectively. These findings resulted in
WOMEN IN NUNATSIAVUT GET INFORMATION ON a public health advisory for the consumption of moose organs. Levels
of cadmium in the muscle (0.1 mg/g, wet wt) and levels for all other
NUTRITION, HEALTH, AND ENVIRONMENTAL
elements were similar to those reported elsewhere and were not of a
CONTAMINANTS human health concern. There was a positive relationship of cadmium
L. Dean and zinc levels in moose organs with moose age. Bioaccumulation of
Dalhousie University, School for Resource & Environmental Studies cadmium by willows in areas with high naturally occurring geologic
sources of cadmium is a likely hypothesis for the high renal cadmium
Inuit are sustained by the animals, birds, plants and fish of their region.
levels reported in moose harvested in the southern Mackenzie
Research has shown that Inuit are exposed to contaminants via their
Mountains.
traditional diet of these wildfoods. Contaminants (chemicals / Contact: Kami Kandola (kami_kandola@gov.nt.ca)
compounds related to global industrial and agricultural activities) are
present in the local ecosystem and food web, eventually being
consumed by humans. Based on our current understanding, humans in THE INFLUENCE OF PSYCHOSOCIAL FACTORS ON FOOD
developmental phases (prenatal and neonatal) are at greatest risk from RELATED BEHAVIOURS AMONG INUIT COMMUNITIES IN
this exposure; any developmental anomalies may have significant NUNAVUT: RESULTS FROM HEALTHY FOODS NORTH
long-term impacts on health. This means that women who are in their
child-bearing years are vulnerable to contaminants. E. Mead, J. Gittelsohn, C. Roache, R. Reid, S. Sharma
The levels of contaminants in wildfood and the potential health effects University of North Carolina at Chapel Hill, Nutrition Research Institute
they may have are of concern to Inuit. These concerns threaten Objective: To describe the food acquisition and preparation behaviors
confidence in the safety and value of wildfood and affects food of the Inuit, and to address the gap in research on the psychosocial
security. Meanwhile, social and cultural benefits associated with a factors affecting these behaviors.
traditional diet and related activities are important to the fabric of Setting: Three remote communities in the Arctic region of Nunavut,
community life. Therefore it is vital that communication about the risks which vary in terms of size, isolation, and access to traditional foods.
of contaminant exposure be accurate, while recognizing the possibility
Methods: Cross sectional random household surveys were conducted
of unnecessarily raising fears. Poor risk communication has been linked
among Inuit adults. Descriptive statistics were generated for
to confusion, mistrust, and in some cases negative changes in diet
sociodemographic, psychosocial (i.e., food knowledge, self-efficacy,
behaviour.
and intentions), and behavioral (i.e., healthy food getting, unhealthy
This study reviewed risk communication networks in Nunatsiavut for food getting, and healthiness of food preparation) dependent and
the dissemination of information related to contaminants exposure independent variables. Their associations were analyzed using
through traditional food consumption. Key informant interviews, focus multivariate linear regression in Stata.
groups and document review were used to identify existing
Results: The response rate was approximately 70-90%. Among the 261
communication pathways (formal and informal) delivering this
participants (aged 19-89 years), unhealthy foods (e.g., potato chips,
information. Focus groups were carried out with young women to learn
pop) were obtained 2-3 times more frequently than healthier foods.
about their experience of the communication process around health
Neutral cooking methods and those adding fat were more frequently
and nutrition.
used than healthier methods that reduced fat content. Food intention
This research will inform new strategies for communicating about was the psychosocial factor most significantly associated with the food
health priorities with Inuit communities, so that Inuit can make behaviors. Intention was negatively correlated with healthiness of food
informed and balanced decisions that can positively influence their preparation methods (-0.95, p<0.05) and unhealthy food getting (-0.25,
health. The results are of interest to other circumpolar communities p<0.001), and positively associated with healthy food getting (0.23,
who are facing similar health communication challenges. p<0.001). Higher levels of food knowledge and self-efficacy were
Contact: Libby Dean (issuma@sympatico.ca)
associated with greater intentions (0.24, p<0.001, and 0.5, p<0.001),
respectively).
40 SESSION 3: VENUE VIEWING ROOM
Conclusions: These results fill the research gap on the impact of

psychosocial factors on food acquisition and preparation among SESSION 3
Nunavut Inuit. By incorporating food knowledge, self-efficacy, and
Monday, July 13, 8:30-10:00 AM
intentions into its nutrition educational activities, the community-
based Healthy Foods North (HFN) program will positively impact the
food acquisition and preparation behaviors of Inuit.
Acknowledgements: We would like to thank Ms. Annie Buchan and
VENUE 1
Rahabi Kamookak for their incredible work on the program. The Cancer #1
research was supported by the American Diabetes Association Clinical
Research Award Grant # 1-08-CR-57. THE ROLE OF INTERLEUKIN-1 AND INTERLEUKIN RECEPTOR
Contact: Erin Mead (sangita_sharma@unc.edu)
ANTAGONIST IN HEAD AND NECK SQUAMOUS CELL
STUDIES: INITIAL STUDIES
L. Nicholas-Figueroa1, Z. Chen2, C. Van Waes2, L. Duffy1
VENUE VIEWING ROOM 1
Department of Chemistry and Biochemistry, University of Alaska
Video Session #1 Fairbanks, 2National Institute of Deafness and Communication Disorders,
Bethesda, MD
“MAKKUKTUVUNGA, UPIMMAVUNGA” - I AM YOUNG AND I Head and neck squamous cell carcinoma (HNSCC) is the most
AM PROUD: A SCREENING OF A LIVE-TO-TAPE 2 HOUR prevalent malignancy in humans involving the upper aerodigestive
CALL-IN PROGRAM ABOUT INUIT YOUTH, COPING SKILLS, tract which affects, voice, speech, taste, smell, hearing, balance, and
AND ENDURANCE survival. HNSCC constitutively express cytokines and growth factors
including interleukin-1 (IL-1), IL-6, IL-8, granulocyte macrophage
C. Carry colony-stimulating factor (GM-CSF) and vascular endothelial growth
Inuit Tuttarvingat of the National Aboriginal Health Organization factor (VEGF) which promotes proliferation, inflammation, and
One of the greatest challenges to the well-being of Inuit across Inuit angiogenesis. These inflammatory responses are likely regulated by a
Nunaat is the spirit of despair that has been manifested particularly by signal transduction pathway, involving activation of nuclear factor-
Inuit youth. Inuit Tuttarvingat of the National Aboriginal Health kappa B (NF-кB) by IL-1. The expression and functions of IL-1, IL-1
Organization, with the National Inuit Youth Council and many other receptor (IL-1R) and IL-1 receptor antagonist (IL-1RA) in HNSCC are
participants, highlights a corresponding and uplifting reality. Through not well understood. In this study, the expression profiles of IL-1 and
the live interactive broadcast, with the assistance of a youth working related molecules provide the scientific basis for study of their
group, we share positive examples that are helping youth move functions in mediating intracellular signals regulating HNSCC tumor
forward in their personal development. progression. The IL-1 family protein productions were measured in a
panel of squamous cell carcinoma developed by the University of
The program:
Michigan (UMSCC) 1, 5, 9, 11A, 11B, and 38 and in normal keratinocytes
- discusses the challenges Inuit youth face within a historical and by enzyme linked immunosorbant analysis (ELISA). UMSCC 11B is the
development context. highest producer of IL-1α in the culture supernatant (>150 pg/ml),
- shows some types of information the Qanuippitali Inuit Health compared with IL-1α production by other cell lines (<50pg/ml). Adding
Survey collected from youth 18+ as well as results from other recombinant tumor necrosis factor-alpha (TNF-α) to cell supernatants
research. induced IL-1α production. In contrast, all cell lines produced IL-1β at
- explores opinions and ideas shared by youth and other panelists, the minimum level (1-14pg/ml) in their supernatants. Both IL-1α and
community focus groups and callers. IL-1β were found in the cytoplasm of all cell lines, and UMSCC 1, 11A,
- looks at community-based youth programs that promote self- and 11B cells retained higher levels. Detectable IL-1RA was measured
esteem, cultural pride and useful skills in Inuit Nunaat, Canada in all cell line cytoplasms but not in their supernatants. Significantly
and Alaska. higher levels of intracellular IL-RA were found in normal keratinocytes.
- offers suggestions for youth empowerment and for parents. The ratio of total IL-1 to IL-1RA is increased in 4 of 6 UMSCC cell lines.
- points to Web-based resources for follow-up. These observations suggest that an imbalance in the L-1 to IL-1RA may
This 2.5 hour session will open with an introduction to the overall promote tumorigenesis in HNSCC. (Funding: NIH 2U54-NS041069-
Qanuqtuurniq - Finding the Balance TV series, an International Polar 06A1 and UAF/NIDCD partnership)
Year outreach project on Inuit wellness broadcast on the Aboriginal Contact: Linda Nicholas-Figueroa (ftln@uaf.edu)
Peoples Television Network - North in May 2009 in the Inuit language

with English subtitles and simultaneously Web cast . A main objective
SURVIVAL OF HEAD AND NECK CANCER IN GREENLAND
of this series was to adapt and test a “communications for change”
model for exchanging knowledge from different perspectives on R.G. Jensen1, J. Friborg2, J. Rosborg3, L. Specht4, S. Brofeldt3, M.H.
several wellness issues of concern to Inuit. Following the screening of Therkildsen5, P. Homøe1
1
the youth program, evaluation highlights will be shared along with a Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet,
question and answer period and an opportunity to give feedback into University of Copenhagen, Denmark, 2The State Serum Institute,
the model’s evaluation process. Copenhagen, 3Dronning Ingrids Hospital, Nuuk, Greenland, 4Department
Contact: Catherine Carry (ccarry@naho.ca) of Oncology, Rigshospitalet, University of Copenhagen, Denmark,
5
Department of Pathology, Rigshospitalet, University of Copenhagen,
Denmark
Introduction: Head and neck cancer is frequent in the Inuit population
of Greenland and characterized by a very high incidence of Epstein-
Barr virus associated nasopharyngeal carcinoma (NPC). However,
information on the treatment and survival of Inuit head and neck
cancer patients is virtually non-existing. The aim of this study was
therefore to analyze the epidemiological pattern, time course and
survival of head and neck cancer patients in Greenland.
Material and Methods: Greenland is part of the kingdom of Denmark, Background: Previous work has demonstrated that survival after a
and population statistics from the Danish Civil Registration System and breast cancer diagnosis is poorer among First Nations women
The Danish Cancer Registry also cover Greenland. Using these compared to other women. The purpose of this study was to identify
registries, supplemented with hospital-based registries, all patients the distribution of prognostic features and treatment received among
resident in Greenland and diagnosed with head and neck cancer during First Nations and non-First Nations women with breast cancer.
the period 1994-2003 were identified and analyzed with regard to Methods: This study employed a case-case design using the cohort of
clinical characteristics, treatment delay, and survival. First Nations people in Ontario to identify 287 women diagnosed with
Results: A total of 125 patients were identified. The age standardized invasive breast cancer between 1995 and 2004. Concurrently, a
incidence rate for all head and neck cancers was 28/100,000 for males random sample of 671 non-First Nations women were selected through
and 19/100,000 for females. High incidence rates were found for NPC the population-based cancer registry and matched 2 to 1 on five-year
(males 9/100,000 and females 7/100,000) and oral cancers (males date of diagnosis, age at diagnosis, and Integrated Cancer Program
6/100,000 and females 7/100,000). Of all cancers 47% were stage IV at (ICP) first attended. Data on prognostic and treatment features were
the time of diagnosis, while 61% of all NPC’s were stage IV. The collected from medical charts. Descriptive analyses of the prognostic
median delay from date of first symptom to treatment was 248 days and treatment variables were calculated and stratified by First Nations
for all cancers. The overall crude 5-year survival for all sites together status.
was 35% and for NPC 20%. Findings: The methods of detection were significantly different
Conclusion: The Inuit pattern of head and neck cancers is characterized between the two groups, as fewer First Nations women had their
by a high incidence of NPC. Survival of head and neck cancer in cancer detected with routine mammography or another screening
Greenland is very low due to delays in treatment and inadequate program. The distributions of most of the tumour characteristics were
follow-up on treatment complications. The improvements in treating similar between the two populations. There were significant
NPC and other head and neck cancers over the last decades are yet to differences for TNM stage at diagnosis, with First Nations women
be seen in this Inuit population. being diagnosed at a higher stage compared to other Ontario women.
Contact: Ramon Gordon Jensen (ramon@dadlnet.dk) More non-First Nations women were disease free at their last contact
point with the ICP compared to the First Nations women. The
proportion of women who received any chemotherapy and/or any
DEVELOPING A TRADITIONAL FOOD GUIDE FOR ALASKA hormonal treatment was similar however; fewer First Nations women
NATIVE CANCER PATIENTS received any radiotherapy upon their breast cancer diagnosis
C. DeCourtney, K. Mitchell, D. Simeon compared to non-First Nations women.
Alaska Native Tribal Health Consortium Conclusions: These preliminary findings will be further explored and
Background: Maintaining a healthy diet is critical for cancer patients. controlled for variables such as socioeconomic status and distance to
However, during and after treatment, standard food recommendations the ICP. Once better understood, actions can be taken to improve the
can be foreign and unfamiliar to Alaska Natives who rely on traditional prognosis and treatment of First Nations women with breast cancer.
Contact: Amanda Ritchie (amanda.ritchie@utoronto.ca)
foods obtained through subsistence activities. Subsistence foods are a
source of nutritional and spiritual strength for Alaska Natives battling
cancer. When comfort foods are most needed, there are no tools that
discuss using traditional plants and animals to substitute for VENUE 2
recommended foods which may be unfamiliar, unavailable or
unaffordable in geographically isolated Alaska communities. There are
Indigenous Research #2
no easy-to-understand nutrition guidelines which emphasize Alaska
Native wild foods to help cancer survivors maintain a nutritious diet. THE NATIONAL INUIT COMMITTEE ON ETHICS AND
Methods: A literature search was conducted and resources gathered RESEARCH (NICER)
that addressed nutritional needs of cancer patients and the nutrient C. Knotsch, S. Nickels
content of Alaska wild foods. Nutritional data was compiled into a Inuit Tuttarvingat of NAHO
user-friendly 143 page guide. Information was gathered from Alaska
Native elders and previously conducted nutritional analyses. The guide During the past decade, the volume of research conducted in the Inuit
provides three innovative ways to understand a food’s nutritional value regions of Canada has increased considerably. At the same time,
(food label, narrative, and icon). efforts to create research guidelines for research involving Aboriginal
Peoples have grown to respond to the pressing needs of Inuit, First
Results: The food guide has been well received by both providers and Nations, and Métis communities. Ethical guidelines have been
patients. Extensive media coverage resulted in wide spread interest. It discussed by many research networks and in particular by those
is accepted as an important tool for diabetes, obesity and a healthy researchers working with small communities. Within the past ten
diet. Additional printings are anticipated. years, we have seen efforts to provide guidelines and policy statements
Conclusions: The availability of an easy-to-understand nutritional guide to guide research involving Inuit, First Nations and Métis in Canada.
focusing on traditional foods is an important resource for Alaska Native The recently created National Inuit Committee on Ethics and Research
cancer patients. It can be used as a model for underserved cultures to (NICER) plays an active role in helping provide Inuit involvement and
integrate healthy traditional foods into cancer survivorship nutrition positions on research and research ethics at the community, regional,
programs and other healthy nutrition programs. national, and international levels. In recognition of Inuit interests in
improving and maintaining appropriate research conduct and
processes, the National Inuit Committee on Ethics and Research will
THE PREVALENCE OF PROGNOSTIC AND TREATMENT develop effective responses to identified Canadian policy statements
and guidelines and prepare Inuit positions as necessary.
FEATURES FOR BREAST CANCER SURVIVAL: ARE THEY
DIFFERENT FOR FIRST NATIONS WOMEN COMPARED TO NICER is coordinated jointly by Inuit Tapiriit Kanatami (ITK) and Inuit
OTHER WOMEN IN ONTARIO, CANADA? Tuttarvingat (formerly known as the Ajunnginiq Centre) of the
National Aboriginal Health Organization (NAHO). Both organizations
A. Ritchie are committed to facilitating the participation of Inuit in discussions
University of Toronto about health and environment research in the Canadian Arctic, to
identifying emerging research priorities, to improving and enhancing
networking, and to facilitating knowledge translation.
This presentation will describe the recent development of NICER and Conclusion: Research is possible with Native communities and even
place it into the context of research in the Canadian Arctic. welcomed once basic ethical considerations are addressed and
Contact: Cathleen Knotsch (cknotsch@naho.ca) partnerships are developed based on consensus and respect.
Contact: Ted Mala (tmala@scf.cc)
TOWARDS DEVELOPING PRINCIPLES OF ETHICAL

RESEARCH IN MÉTIS COMMUNITIES EXPLORING PROCESSES IN HEALTH RESEARCH ETHICS IN
C. Graham CANADA’S NORTH
National Aboriginal Health Organization G.K. Healey1, J. Butler Walker2, S. Chatwood3
1
The concept of Métis-specific population health research, practiced in Qaujigartiit/Arctic Health Research Network – NU, 2Arctic Health
a way where Métis people are consulted and involved in the research, Research Network – YU, 3Institute for Circumpolar Health Research
has really only emerged in the last two decades. There has been little There exists a need throughout the North to increase capacity to
documentation on research ethics and guidelines specific to Métis. As a address issues of health research ethics, and in each territory, the
Métis-controlled, knowledge-based organization, the Métis Centre at needs are diverse.
the National Aboriginal Health Organization (NAHO) is uniquely The goals of this project were to:
situated to contribute to the ongoing dialogue, nationally and
internationally, on indigenous research ethics. In particular, the Métis - Develop a tri-territorial strategy for ethical review of health
Centre’s activities have focused on qualitative, community-based research involving Indigenous peoples
approaches to research, recognizing that mainstream or academic - Conduct a survey of existing ethical guidelines and literature that
research methodologies and ethics may not always address the distinct are relevant to northern populations.
perspectives, concerns and rights held by Métis, Inuit and First Nations - Evaluate community capacity to provide input on ethical review
peoples. Working with a broad range of partners, from the grassroots of health research projects by
level to academe, the Métis Centre encourages research that honours - To develop a draft of a Health Research Ethics Checklist for
traditional perspectives yet accounts for contemporary circumstances community proposal reviewers.
and needs. A guiding principle of the Métis Centre’s approach is that A review of literature and community ethical guidelines for health
the results are intended to be of use to the community where the research was conducted in 2007-08. Common themes in community
research is taking place and, on some level, to Métis generally. This ethics across the territories revealed in the review were related to:
presentation will outline challenges in and opportunities for licensing; principles of respect – for communities and for researchers;
undertaking collaborative research with Métis individuals, meaningful community engagement; the use of appropriate research
communities and organizations. It will include a detailed discussion on methods; use of data and ownership, control, access and
the current process being undertaken by the Métis Centre to develope protection/possession (OCAP) of data; sharing knowledge obtained
culturally appropriate research methods, sensitive to Aboriginal from research.
languages and cultural information, for the gathering, analysis and In January, 2009, a meeting of stakeholders from Yukon, NWT,
dissemination of information arising from qualitative research. Nunavut, Nunavik and Labrador met in Iqaluit, NU to discuss
Contact: Catherine Graham (cgraham@naho.ca)
opportunities to collaborate on health research ethics review for
northern communities. The result of this meeting was a commitment
WHEN SCIENCE OUTPACES NATIVE POLITICAL WILL to work across jurisdictions to meet the health research ethics needs of
communities and northern regions by working to build capacity for
T.A. Mala, M.K. Mau ethical review; to collaborate to share tools and resources; to provide
Southcentral Foundation education opportunities when possible; and to form a working group to
Objective: To provide the reader with some considerations for explore the possibility of developing a Northern Health Research Ethics
designing research around Native communities from the viewpoint of Council.
Contact: Gwen Healey (ahrn.nunavut@gmail.com)
two Alaska Native and a Native Hawaiian physicians.
Rationale: In the process of reviewing and writing many grants, the
perennial question arises of “how to do research in Native IN PURSUIT OF AN ‘INDIGENOUS’ EDUCATION: STUDENT
communities?” How have the rules changed? What are the REFLECTIONS IN ABORIGINAL HEALTH RESEARCH IN
expectations that Native people have and how might they influence CANADA
the nature of designing projects and implementing them once they are
A. Reeves
funded? A significant number of principal investigators have taken
their proposals to Institutional Research Boards and community groups University of Toronto
only to find their methodologies being rejected or questioned from the The environment typically modelled for most graduate students in
start. This has resulted in much frustration and elicited comments such Canada is one based on a few simple tenants, including the infamous
as “where can we find the guidelines for research with Native peoples law of ‘publish or perish’, as well as academic competition among
and how can we best address them?” colleagues. With the advent of the Institute of Aboriginal People’s
There is no one answer that covers all situations. Tribes are sovereign Health (IAPH) initiative through the Canadian Institutes of Health
entities with the right to govern their own destinies. The authors here Research (CIHR), graduate students researching Aboriginal health in
present their observations on the process with the hope that this paper Canada have been offered an opportunity to work in a new academic
will result in mutually beneficial discussions that will create model. Coordinating centres across Canada, the Network
partnerships and better understanding of one another’s needs. Environments for Aboriginal Health Research (NEAHR), offer regional
conferences and other graduate student gatherings, fostering a sense
This paper explores the design process based on community based
of partnership, mutual benefit and support among students. This
participatory research and its outcomes resulting in benefit to the
presentation focuses on the experiences of four graduate students,
populations being examined. Questions include who owns the data?
both Aboriginal and non-Aboriginal, who are currently part of this
How will it be used? How will the results be reported back to the
programme. These four stories describe student and community
community? How are ethical standards being applied? What is the role
engagement in an Aboriginal context, in both urban and rural areas,
of the community? What is the training and backgrounds of the
from the East Coast to the West Coast of Canada. The only programme
principal investigators? How will the outcomes affect the community in
of it’s kind in the world, this federal research agenda strengthens
the future? How to plan for future collaboration?
Aboriginal research by investing in students, not only through grants,
but through mentorship, student collaboration, and a strong exposure The purpose of this study was to identify and describe the health care
to Indigenous cultural events. This presentation highlights the impact decision-making of the Inuit of a small Inuit community, in Nunavut,
of this programme on graduate student development: from an initially Canada. An ethnographic research design was used which included
diverse group evolves a team of researchers with a shared vision to participant observation, formal and informal interviews and available
address health disparities in Aboriginal communities. data. Field notes, documents and informal interviews were analysis to
Contact: Allison Reeves (reeves.allison@gmail.com) identify behaviours, values and beliefs relating to health care decisions
within the sociocultural environment of the community and formal
taped interviews with key informants were used to clarify and verify
findings.
VENUE 3
The findings suggested two health decision-making processes: an
Indigenous Health & Wellness #2 illness orientated process and a health promotion/prevention process.
The illness-oriented decision-making process was similar to that
BUILDING COMMUNITY CAPACITY - YUKON FIRST identified by others with two exceptions: the Inuit have no choice as to
NATIONS’ HEALTH PROMOTION PLANNING SCHOOLS where to seek treatment and time is a major factor in their decision-
making. The Inuit have become reliant on the biomedical health care
J. Butler Walker1, N. Kassi1, L. Duncan2
1
system, which has replaced traditional healing practices. The health
Arctic Health Research Network – Yukon, 2Council of Yukon First Nation promotion/prevention decision-making process was consistent with
The Arctic Health Research Network-Yukon, in collaboration with the several of the health promotion and behaviour models. Health and
Council of Yukon First Nations, Yukon College and the Health wellness are closely associated with traditional values and activities
Promotion Centre, University of Toronto, hosted capacity building and many of the health issues and concerns are linked, at least to some
training programs in 2007 and 2008 with Yukon First Nations. A total of degree to a loss of traditional life skills and values.
54 Yukon First Nations front-line health resource workers from across Contact: nancy Edgecombe (nancy.edgecombe@dal.ca)
the Yukon worked together on issues of importance in their

communities. These priority issues included diabetes, food security,
residential school trauma, depression, substance use and injury
THE DEVELOPMENT OF A HEALTH ACTION PLAN FOR
prevention. Participants worked through a facilitated comprehensive CIRCUMPOLAR INUIT
planning process to identify and develop actions to address these M. Grey
issues in their communities, which will be described. Ethical Makivik Corporation
considerations in relation to CB processes and OCAP (Ownership,
Control, Access and Possession), partnership development and Although the last 100 years have seen some major improvements in
recommendations for further community capacity building will be health and survival for circumpolar Inuit, advances in some areas have
highlighted. been overshadowed by emerging problems. Major health concerns
Contact: Jody Butler Walker (jody@butlerwalker.ca) that are shared by all Inuit include mental health, suicide, substance
abuse and diseases such as cancer, diabetes, heart disease and
tuberculosis (TB). There is only limited Inuit-specific health data
TLICHO COMMUNITY-BASED RESEARCH AND EVIDENCE- available within national statistics, but for the data that is available,
BASED INTERVENTIONS FOR STI PREVENTION stark differences are visible between Inuit and national populations in
the circumpolar countries. For example, Inuit life expectancy is around
A. Daniels, R. Drybones, L. Lafferty, T. Moore, J. Naedzo, K. Edwards,
10 years less compared to that of national populations. Infant mortality
S. Mitchell
was between 1.5 and 2.9 times higher among Inuit in 2000-2004. Given
Tlicho Community Services Agency the prevailing differences and stark health issues confronting Inuit
This presentation will describe the community-led process of across the circumpolar region, when the Inuit Circumpolar Council
developing and implementing a research-based action plan within the (ICC) held its General Assembly in Barrow in 2004, Inuit health and
four Tlicho communities around resilience and sexual health. The wellness was identified as a priority for ICC action.
community leader is the Tlicho Community Services Agency (TCSA) Since 1977, the ICC has flourished and grown into a major international
whose goal is to develop and provide health, education and social non-government organization representing approximately 155 000
programs that integrate traditional values. The sexual health research Inuit of Alaska, Canada, Greenland and Chukotka (Russia). ICC has
project began in response to the leadership of the Tlicho Healing Wind offices in each of the four countries. ICC works on issues affecting pan-
Grassroots Advisory Committee (HWGAC), which ensures ethical and circumpolar Inuit, such as environment, human rights, and health. At
cultural appropriateness of programs around sexual health. Sixteen the General Assembly in Barrow in 2004, the importance of health was
community-based researchers were trained in research methods by expressed in the Utqiagvik Declaration. In response to it, ICC is working
CIET, an international non-government organization. The baseline on the development of a Circumpolar Inuit Health Action Plan, which
survey revealed the strengths of the Tlicho communities’ resources to will identify the health issues and mechanisms in which Inuit health
combat sexually transmitted infections (STIs). An outcome of the priorities can be advanced. To guide this work, a steering committee
survey was an evidence-based community action plan for addressing with representatives from each of the four country ICC offices was
knowledge gaps while continuing to support successful strategies. created. Their role is to help shape the Circumpolar Inuit Health Plan by
Community-based researchers (CBRs) both advise and implement the identifying ways for ICC to act as an advocate on behalf of the
research/communication program and action plan. Actions include Circumpolar Inuit.
youth focus groups to assess and adapt existing resource materials to
This presentation will introduce some information on the health
be culturally appropriate, and a pan-community youth conference to
concerns, and how the Health Action Plan can move forward to
communicate information based on traditional values. The
address the associated challenges.
presentation will describe the research outcomes, resulting action
Contact: Minnie Grey (mgrey@makivik.org)
plan, including outcomes and challenges.
Contact: Nancy Gibson (nancy.gibson@ualberta.ca)
WORKING ON THE LAND, WORKING OFF THE LAND

HEALTH CARE DECISION-MAKING IN AN INUIT COMMUNITY Z. Todd
N. Edgecombe University of Alberta
Dalhousie University, School of Nursing
Contact: Y. Anita Li (y._anita_li@phac-aspc.gc.ca)

During the environmental assessment of the proposed Mackenzie Gas
Project, Joint Review Panel members and others highlighted a lack of
contemporary evidence-based research about the effect of the wage EVALUATING THE INTRODUCTION AND IMPACT OF THE
economy on Inuvialuit land-based activities including hunting,
HUMAN PAPILLOMAVIRUS VACCINE AMONG ALASKA
trapping, and fishing. This research aims to address this gap by
studying how employment impacts harvesting activity (time spent on
NATIVE WOMEN
the land), as well as qualitative changes in the structure and use of time T. Hennessy1, N. Murphy2
and the social networks and sharing arrangements associated with 1
US Centers for Disease Control and Prevention (CDC) Arctic
time on the land. The study aims to identify implications for managing Investigations Program, 2Southcentral Foundation
the impacts of the proposed Mackenzie Gas Project and potential
The human papillomavirus (HPV) is one of the most common causes of
mineral extraction near Paulatuk, and suggest variables for
sexually transmitted diseases. Infection with some HPV genotypes can
consideration in a related health study. The study results will be useful
lead to genital warts or cancer. In 2006, a HPV vaccine was licensed
for addressing gaps in knowledge about the impact of the wage
and introduced into the routine vaccine schedule for young women in
economy on land-based livelihood activities in the region. There is no
the U.S. For Alaska Native women, HPV infection is common and
clear-cut answer to how participation in the wage economy impacts
cervical cancer is of high concern. We developed a comprehensive plan
traditional harvesting activities in Arctic communities. However,
to enhance HPV vaccine use and collect data necessary to understand
previous studies seem to indicate that the type work, the flexibility of
the health and economic impact over time. This plan includes: 1) an
employment opportunities to accommodate harvesting activities and
electronic vaccine registry to track vaccine uptake, 2) qualitative
the time of year during which employment opportunities will occur are
research methods to identify knowledge and attitudes about the
all important when considering the impacts of participation in the
vaccine to aid development of education materials, 3) combining data
wage economy on traditional harvesting activities. Furthermore,
from across Alaska to track the incidence of precancerous cervical
examination of household economic strategies and Women’s roles in
lesions and cancer, 4) establishing surveillance for the HPV genotypes
harvesting can inform future decisions regarding resource extraction
causing precancerous cervical lesions, 5) evaluating the safety,
projects—and their related employment opportunities—that may
immunogenicity and duration of protection of HPV vaccine among
impact traditional harvesting activities in the Inuvialuit Settlement
Alaska Native women, 6) determining the HPV genotypes in archived
Region. This becomes even more important when other pressures,
cervical cancer specimens from 1980 - 2008, 6) modeling the economic
such as the impacts of resource extraction on wildlife and the effects of
impact of HPV vaccine on direct medical costs. We will report on
climate change on traditional harvesting activities in the Arctic are
progress implementing this plan and data from vaccine uptake, public
considered.
Contact: Zoe Todd (ztodd@ualberta.ca)
perception of the vaccine and HPV genotypes in cervical cancer
specimens.
Contact: Thomas Hennessy (tbh0@cdc.gov)
VENUE 4 IMPROVING HPV PREVENTION AMONG ABORIGINAL

Infectious Diseases #1 – HPV PEOPLES
G. Wurtak1, B. Elias2
THE PREVALENCE OF HUMAN PAPILLOMAVIRUS AND ITS 1
International Centre for Infectious Diseases, 2University of Manitoba
IMPACT ON CERVICAL DYSPLASIA IN NORTHERN CANADA
Cervical cancer rates are two to six times higher in Aboriginal women
Y.A. Li, P. Brassard, T. Wong, A. Severini, A. Corriveau, S. Chatwood,
than the general population. The Human Papillomavirus (HPV) is the
G. Johnson, I. Sobol, B. Hanley, Y. Mao
leading cause of cervical cancer and anogenital warts, and is implicated
Centre for Chronic Disease Prevention and Control, Public Health Agency in numerous other cancers. On December 9, 2008 a consultative
of Canada, McGill University, GNWT Health and Social Services, workshop was arranged to discuss HPV issues affecting Canadian
Institute for Circumpolar Health Research Aboriginal populations. This workshop, involving approximately 50 key
Cervical cancer rates are higher among aboriginal populations than stakeholders representing 24 different organizations from across
among the general population in Canada. Human Papillomavirus (HPV) Canada, was hosted by the International Centre for Infectious Diseases
are highly associated with cervical cancer. in Winnipeg, Manitoba, and supported by PHAC and the MacArthur
Foundation. The workshop objectives were to 1) Share current
The objective of this project is to determine the prevalence,
information on HPV and related Aboriginal health issues; 2) Identify
distribution, and risk factors of type-specific HPV infections among
HPV research gaps and priorities; and 3) Identify implementation
women in northern Canada, Women living in the Northwest Territories
challenges and strategies for program improvement The presentation
(NT), Nunavut, and Yukon, at cervical cancer screening ages, and with
will a) highlight the process involved in bringing together a diverse
no cancer history are included in the study. Cervical sample collection
group of stakeholders from different sectors; b) share information on
is incorporated into the routine sample collection for Pap testing. A
HPV and cervical cancer prevention activities and research in different
questionnaire will collect socio-economic, demographic, and behaviour
regions of Canada; c) outline the major HPV related issues that arose
information of participants. HPV types are detected by using Luminex
through this consultation; and d) present participants’ suggestions for
assay at the National Microbiology Laboratory of Canada. Pap test
addressing HPV/cervical cancer. Information covering a range of
results, HPV types, and questionnaire data will be linked for analyses.
Aboriginal health and cultural issues will be presented. The issues,
The prevalence and distribution of HPV type-specific infections and needs, gaps, and activities that were suggested by different breakout
cervical dysplasia will be calculated with 95% confidence intervals. theme groups will be shared. Three broad themes will be discussed: 1)
Multivariate regression will be used to explore the associations Understanding HPV; 2) Developing a Population Level Understanding
between type-specific HPV infections and cervical dysplasia as well as of HPV; and 3) Developing Community Understanding and Program
the associations between risk factors and type-specific HPV infections. Implementation. The issues that arose will be highlighted: Improve
So far more than 7,000 samples from the NT and Nunavut have been awareness of HPV, consequences; HPV issues within the context of
tested for HPV types. The crude HPV positive rates are 26.9% and Women’s health; Capacity development, community & professional
33.9% of the NT and Nunavut, respectively. There are over 70% of the education ; Cultural and gender competency; Funding; Access to
HPV positive samples from both regions are positive with high-risk services; Sexual health awareness; Technology and infrastructure
types. The prevalence analyses will be completed in April 2009. More improvements; Data to inform decision-making; Protocol and
results will be available at the conference. algorithm standardization; and Potential demonstration projects.
Contact: George Wurtak (gwurtak@icid.com)

Luminex genotyping assay. Type-specific HPV results were correlated
with cervical cancer screening findings.
INCIDENCE OF TYPE-SPECIFIC HPV IN A POPULATION OF Results: Preliminary results from 1116 women (90% Inuit) suggest a
INUIT WOMEN IN NUNAVIK, QUEBEC 34.1% prevalence of any HPV type, 35.0% of whom had multiple HPV
types. The prevalence of any oncogenic HPV type was 24.4%, with
R. Bennett2, E. Coutle3,4, M. Roger4, E.L. Franco2,3, P. Brassard1,2
1
higher prevalence in younger females (37.5% in 15-24 year olds vs
Departments of Medicine, 2Epidemiology, Biostatistics & Occupational 26.4% in 25-34 year olds vs 9.9% in 35+ year olds). Prevalence of the
Health, and 3Oncology, McGill University; and of 4Microbiology, Centre oncogenic vaccine types 16, 18 were 7.3%, 2.1% respectively. The non-
Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada vaccine oncogenic HPV types 31 (4.3%) and 45 (2.3%) were more
Background: There is little information on incidence of human prevalent than type 18. 100% of women with high-grade squamous
papillomavirus(HPV) in Canadian populations, particularly regarding intraepithelial lesions (HSIL) were infected with one or more oncogenic
rural, remote, and northern communities. These communities may HPV types. In 12 women with HSIL, HPV16 was detected in 7 (58.3%),
have different patterns of HPV acquisition, and since Inuit women have HPV18 in 1 (8.3%), HPV45 in 2 (16.7%), HPV31, 35, 39, 52, 56, 58 and 66
higher rates of cervical cancer than non-Inuit women in Canada, in one each (8.3% each).
understanding the burden of HPV infection within this population is Conclusions: HPV infection is highly prevalent among women in
important, especially before the implementation of prevention Nunavut. HPV16 is the most common type, followed by HPV31. HPV16
strategies (e.g. vaccination). was detected in over half of the high-grade cervical lesions. Results to
Objective: We sought to study the incidence of infection by HPV type, date have informed evidence-based decision making regarding HPV
phylogenetic Alpha-papillomavirus species, and oncogenic risk immunization in Nunavut.
grouping among Inuit women in Nunavik, Quebec. Contact: Thomas Wong (tom_wong@phac-aspc.gc.ca)
Results: A cohort of 629 Women aged 15-69 was assembled between

January 2002 and December 2007 from four communities in Nunavik,
Quebec. Cervical specimens were collected both at enrolment and VENUE 5
during all subsequent visits. The median interval between visits was
11.8 (range: 1- 49.7) months. A total of 36 genital HPV genotypes were
Food Security #2 – Politics of Food
detected by PCR amplification using PGMY09-PGMY11 primers. 33.9%
(125/369) of women with more than one visit had an incident infection A COMMUNITY BASED INITIATIVE TOWARDS A
by at least one type during follow-up, resulting in 162 incident SUSTAINABLE FOOD SECURITY STRATEGY FOR THE
infections of any HPV type in total (overall incidence rate: 19.7 per 1000 COMMUNITY OF OLD CROW, YUKON
women-months (WM)). Incidence was based on the number of months
N. Kassi
from baseline to either the first positive test result for the infection of
interest or the end of follow-up if the woman remained negative. The Arctic Health Research Network – YU
incidence of HPV-16, HPV-18, and high-risk (HR) infections were 2.21, In this presentation we will describe the challenges the community of
1.18, and 6.54 per 1000 WM, respectively. Incidence for species α7 and Old Crow are facing in relation to “Our Changing Homelands, Our
α9 were similar (4.79 and 4.61 per 1000 WM, respectively). Changing Lives.” Old Crow is the northernmost community in the
Conclusions: Overall, HR-HPV, and HPV-16 incidence were lower in this Yukon, with a population of 280, of which 90-95% are Vuntut Gwitchin
population as compared with a population of Canadian university First Nation citizens. It is a small village situated 130 km above the
students though HPV-18 infections were acquired at a comparable Arctic Circle, home to the Vuntut Gwitchin people, which in the
rate. A greater proportion of this cohort acquired infection than in a Gwitchin language means “People of the Lakes”. The Gwitchin life and
cohort of randomly selected women in Ontario. culture have traditionally been based on the Porcupine Caribou herd,
Contact: Rachel Bennett (rachel.bennett@mail.mcgill.ca) the people’s main source of food, tools and clothing. Fish and other
animals have supplemented their diet in nutritionally and traditionally
important ways. This life is changing every day before their very eyes.
HPV SURVEILLANCE: CORRELATION OF TYPE-SPECIFIC The mainstay of their traditional diet - the caribou and the salmon, are
ONCOGENIC HPV WITH CERVICAL CANCER SCREENING rapidly declining in numbers. The cost of living is extremely high as
FINDINGS IN NUNAVUT, CANADA there are no roads to Old Crow, so all supplies must be flown in year
round. Changes to the land and water are taking their toll on the very
I. Sobol1, S. Totten2, A. Severini3, V. Goleski3, G. Johnson4, G.
existence of the Gwitchin people. The environment that the people
Jayaraman2, T. Wong2, Y. Mao5
1
traveled on, the waterways and the land have changed quite drastically
Nunavut Department of Health and Social Services, 2Centre for in a very few years. This research is linked to health in the most
Communicable Diseases and Infection Control, Public Health Agency of fundamental way – without sustainable and adequate nutrition, the
Canada, 3National Microbiology Laboratory, Public Health Agency of Vuntut Gwitchin will not survive. The primary research question is:
Canada, 4Cytopathology Laboratory, DynaLIFEDx, 5Centre for Chronic How will the Vuntut Gwitchin people of Old Crow adapt their food
Disease Prevention and Control, Public Health Agency of Canada security strategies to maintain their health in the face of declining
Background: The Nunavut Department of Health and Social Services in traditional food species resulting from climate change?
Canada has been gathering evidence to inform public health decision Contact: Norma Kassi (nkassi@whtvcable.com)
making pertaining to HPV vaccination and cervical cancer prevention.

Preliminary data suggested a suboptimal match between circulating
HPV types in Nunavut and types contained in the currently approved
WHAT DOES ‘FOOD SECURITY’ MEAN TO INUIT? INPUT
quadrivalent (6/11/16/18) HPV vaccine in Canada. Nunavut has a young, INTO AN INUIT STRATEGY FOR INUIT OF NUNAAT
mainly Inuit population of 30,000 that is sparsely distributed across 2 J. Cheechoo
million square kilometers in 28 communities. Inuit Tapiriit Kanatami
Objectives: To determine the prevalence and distribution of HPV types It is generally accepted that the term ‘food security’ means, in simplest
in Nunavut in association with cervical Pap test cytological outcomes terms “access to nutritious food.” Inuit health and well-being are
as part of a population-based surveillance program. directly linked to food security and in particular, their relationship to
Methods: Residual cervical specimens from routine liquid based cervical customary ‘country food’: community sharing, cultural continuity,
cytology testing were tested for 45 HPV types using an in-house intergenerational communication. References in the media relate food
(in)security to war and mass-migration related to political unrest.
Meanwhile, many Inuit face pervasive, systemic food insecurity within INDIGENOUS PEOPLES’ FOOD SYSTEMS FOR HEALTH:
Canada. THREE CANADIAN INUIT AND FIRST NATIONS PROJECTS
In Inuit Nunaat (“Inuit Homeland”) the increasing widespread impacts H. Kuhnlein1, B. Erasmus2, B. Tallio3, L. Okalik4
of climate change, concern over environmental contaminants, and
Inuit Tapiriit Kanatami
changing socio-economic conditions have all had a tremendous effect
1
on the ability of Inuit to access fresh and nutritious foods. Procuring Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill
country foods has become costly (money is required for vehicles, fuel, University, Montreal, QC, 2Dene Nation, Yellowknife, NT, 3Nuxalk Nation,
guns, ammunition) and the seasonal hunting cycle is not reflective of Bella Coola, BC, 4Inuit Tapiriit Kanatami, Ottawa, ON
work schedules and schooling. Meanwhile, food purchased at stores is Dr. Harriet Kuhnlein, Founding Director and Chief Bill Erasmus have led
also increasingly costly in the Arctic and can often be of poor quality a project on Indigenous Peoples’ food systems for health for twelve
and nutritional value. The impact of climate change on country food Indigenous Peoples from as far away as Japan, Thailand, India,
sources (e.g. changes in migration/birthing patterns of animals; Pohnepei, two African locations, Peru, and Columbia to home here in
instability of ice for travel) has been identified as a priority by Inuit. Canada: Gwichin in the Northwest Territories; Nuxalk Nation in British
Food security encompasses many aspects of well-being in Inuit Columbia to Inuit in Pangnirtung, Nunavut.
Nunaat, and therefore discussions on this topic cannot disregard the Research in each indigenous community area has an academic partner
interconnectedness of environment and health, as well as culture, and a community leader partner as Principal Investigators. We have
custom and, local economics. Under Inuit Tapiriit Kanatami (ITK), matched the scientific work and the Indigenous Peoples’ traditional
Canada’s national Inuit organization, has a unique oportunity to knowledge on foods of our ancestors past.
encourage the dialogue on food security in this broader context. The
We have been fortunate to have funding to bring us together once a
presentation will include a summary of the upcoming strategy on food
year to present and address our respective projects, and how we can
security, based on input from the Inuit regions of Inuvialuit, Nunavut,
link the work to policies, and further to create templates for
Nunavik and Nunatsiavut. The Food Security Team of ITK in
intervention.
partnership with representatives from communities in Inuit Nunaat will
share their direct experiences of how food security relates to them. With Dr. Harriet Kuhnlein introducing the background project, Chief
Contact: John Cheechoo (cheechoo@itk.ca) Bill Erasmus will present on the Fort MacPherson project in the NWT
with the Gwichin, Bill Tallio will present on the Nuxalk Nation project
and, Looee Okalik on the Baffin Island Inuit project - all in relation to
FROM SURVIVAL TO NECESSITY: FOOD STORIES FROM Indigenous Peoples’ food systems and health promotion.
THREE GENERATIONS OF LABRADOR INUIT-MÉTIS Contact: Looee Okalik (okalik@itk.ca)
D. Martin
Dalhousie University ORAL HISTORY CONTRIBUTIONS TO UNDERSTANDING
Research Question: This qualitative study posed the question: How do FOOD SECURITY TRENDS AND ADAPTATIONS: VUNTUT
people who live in one Labrador Inuit-Métis community experience and GWITCHIN FIRST NATION, YUKON, CANADA
understand their relationships to food in the context of global change? S. Wesche, L.H.M. Chan, M. Williams, C. Dickson
Objective: This presentation explores the influence of socio-economic, University of Northern British Columbia
political and environmental changes on the transmission of
generational knowledge surrounding traditional foods in one Labrador Climate change has been recognized as a key driver of traditional food
Inuit-Métis community. security for members of the Vuntut Gwitchin First Nation (VGFN)
whose subsistence is largely dependent on their close relationship with
Methods: Using an ethnographic approach, this study collected stories the land, and in particular the Porcupine Caribou herd. Northern
and photographs from three generations of men and women in one environmental systems have always been dynamic and Aboriginal
Labrador Inuit-Métis community. A total of ten one-on-one interviews, populations have shown a consistent ability to adapt. However, the
seven two-person interviews and one focus group session were increasing rate of climate change and the projected extent of impacts
conducted with twenty-four community members during the winter of both challenge these abilities and require concerted adaptation efforts
2008. to strengthen traditional food systems in times of high uncertainty.
Findings: The means through which food is obtained has changed Drawing on oral history provides insight into the resilient nature of
dramatically over the course of three generations of people who live in Aboriginal populations, illuminating past adaptation strategies and
one Labrador Inuit-Métis community. Where once a generation relied existing cultural assets. This study examines how the adaptability of
entirely upon their natural surroundings for survival, today, the VGFN members to changing food security has evolved over the past
activities associated with procuring foods remain a vital part of the century in the northern Yukon by analyzing key historical relationships
local culture, but the means to continue these activities are becoming between land, food, climate and adaptation. Methods include a
reliant upon a market economy. This presentation explores the way qualitative analysis of oral history transcripts recorded since the 1970s,
that knowledge about foods is passed on to younger generations when which form part of a database maintained and updated by the VGFN
they no longer have the same relationship with their natural Heritage Branch in Old Crow, Yukon. A subset of interviews was
surroundings as their parents and grandparents once did. selected for analysis based on the density of keywords relevant to food
Conclusions: Ultimately, food has always, and will continue to be, security as identified in the database index. Results provide insight into
necessary for survival. As such, the knowledge about food-related the factors that have challenged food security for community
activities held by older generations of Labrador Inuit-Métis is vital for members in the past (most specifically relating to food availability) and
understanding local ecologies in which foods are procured. Maintaining human adaptation strategies used to respond to food shortages.
and strengthening the transmission of generational knowledge related Existing cultural assets that support adaptive capacity are also
to food ensures that future generations remain connected to, and identified. In combination with other IPY research results relating to
respectful of, their natural surroundings. The challenge is to respect food security and wildlife trends, this work provides a foundation upon
and understand the different ways in which younger generations are which to forecast possible response strategies and identify important
interacting with their natural surroundings, while continuing to cultural assets for strengthening adaptive capacity in the face of future
strengthen and build upon the understandings of older generations. change.
Contact: Sonia Wesche (wesche@unbc.ca)
Contact: Debbie Martin (dhmartin@dal.ca)
Contact: Joyce Caines (joyceinthearctic@yahoo.ca)

PROMOTING HEALTHIER FOOD OPTIONS IN CONJUNCTION
WITH HEALTH FOODS NORTH: A RETAIL PERSPECTIVE
S. Hatjó, C. Reeve
The North West Company, Winnipeg, MB
VENUE 6
Health Promotion & Social Marketing
Objective: To measure the impact of Healthy Foods North (HFN) on
consumer purchasing patterns in select North West (NWC) company
stores. DON’T BE A BUTTHEAD CAMPAIGN- 5 YEARS EXPERIENCE
Background: Increasing consumption of healthier food options is an WITH A SOCIAL MARKETING CAMPAIGN TARGETED TO
integral part of influencing positive health outcomes for Indigenous YOUTH TOBACCO REDUCTION
populations in Northern Canada. The NWC, operating under the North M. Wideman1, E. Stewart2
Mart and Northern banners, is a key retailer supplying goods to remote 1
Department of Health & Social Services, GNWT, 2Department of
communities in Canada. NWC’s corporate Healthy Living (HL) team, Education, GNWT.
consisting of a dietitian and pharmacist, partnered with HFN to provide
support of the retail-based component of the intervention. The Tobacco use is a serious health concern in the NWT with youth
support provided by the team included: program planning, logistical smoking rates twice the national average and communities where
and operational support, marketing resources and program evaluation smoking among adults reaches 65%. This presentation will describe a
assistance. unique social marketing campaign aimed at strengthening the resolve
of young people aged 8–14 not to start smoking. A central element of
Setting: Two Northern and North Mart Grocery stores located in the the campaign involves youth making a written commitment to be
NWT and Nunavut. smoke free, and renewing that commitment on a yearly basis. Other
Methods: Consumption of targeted food products and ease of program elements have varied over the years but include media components,
implementation was measured in the four HFN program communities sports initiatives, a creative contest and other activities that spread the
and two delayed intervention communities. An internal database message that non-smoking is the new norm. The campaign relies
system was used to compile quantitative purchase data on the specific strongly on involvement and promotion at the community level,
products offered during the seven intervention phases. Direct particularly within the schools.
observation reports from HFN interventionists coupled with an online Two program evaluations and declining youth tobacco rates suggest
survey on program execution in the stores will be completed by NWC that the program has had an impact. The presentation will address the
management and staff. campaign’s successes as well as some of the challenges faced in
Results: It is anticipated that the presence of HFN in NWC stores will operating in the NWT’s unique cultural and geographical environment.
have a positive impact on the promoted items, with repeated items After five years of operation, and in light of diminishing funding, the
demonstrating greater impact. Results from the online survey will Butthead campaign now faces the challenge of becoming better
provide insight on operational execution of HFN in NWC stores. integrated into other healthy living initiatives aimed at young people in
Conclusions: Implications of these findings will be used to demonstrate the territory.
the importance of cross-institutional partnerships in influencing dietary Contact: Miriam Wideman (miriam_wideman@gov.nt.ca)
changes in the North. Holistically, these partnerships have the
synergistic ability to improve the impact and execution of community-
based programs such as Healthy Foods North. CLOTH DIAPER PILOT
Acknowledgements: We would like to thank the North West Marketing P. Zizman
Department, North West local store managers for their cooperation National Aboriginal Health Organization
and mostly the Healthy Foods North team for making this intervention This pilot project seeks to promote cloth diapers as an economical and
a reality. environmental health alternative for families in Inuit communities. We
Contact: Suzanne Hajto (shajto@northwest.ca)
hope that it becomes a catalyst for women and their families to create
a community movement raising awareness of the damaging effects of
BUILDING CULTURAL PRIDE WITH TRADITIONAL FOODS disposable diaper use. The diapers also serve a dual purpose: a
(VIDEO) promotional tool for the Inuit midwifery network.
Inuit Tuttarvingat of the National Aboriginal Health Organization
J. Caines, T. Heale, M. Fournier
offered to supply full sets of cloth diapers to interested families,
This is a film of Dene elders from the Yellowknives Dene and the Tlicho advertising in Inuit Nunaat communities via: our Governing
region cooking with educators from many of the regions of the Committee, radio, health centres and through Canada Prenatal
Northwest Territories in Canada. The elders are sharing their Nutrition Program Coordinators. Of the eighteen women who
knowledge about getting wild game and preparing it for eating in the responded with interest, nine were selected from several communities.
Ecole Sir John Franklin High School Foods’ lab. This was filmed during Inuit Tuttarvingat partnered with Arctic Cooperatives Limited (owned
the Northwest Territories Educators’ conference held in Yellowknife, and controlled by 31 community-based Co-operative business), who
February 16-18, 2009. supplied various products to the selected families to support their
One of the elders, Muriel Betsina, teaches the participants how her efforts.
father cooked caribou head and we see the process from the In addition to describing the methods and materials (including a fact
beginning, preparing the head for the oven to carving the cooked head sheet for northerners) used in this project, this presentation highlights
and eating it. Muriel also demonstrates different methods of cleaning the personal experiences and practical suggestions of the families that
fish: loch (freshwater cod) and whitefish, two fish that are harvested in participated. We also review some perceived impacts from the
Great Slave Lake in the Northwest Territories. She demonstrates the qualitative evaluation results finalized in June 2009 that could include:
cleaning and gutting method for drying fish which would hang on contrasts concerning the use of different water delivery services in
sticks or from lines during the early summer. Joyce Caines is the communities; garbage reduction among four families in one of the
nutrition educator for the event and she informs the discussion with communities; issues concerning motivation, finances and convenience;
the nutrient value of some of the game and some of the market food support and encouragement from community members and daycares;
additions used in the cooking methods. thoughts around returning to more traditional diapering methods; and
This was filmed by two students from École Sir John Franklin High whether the diapers intrigued participants to learn more about Inuit
school, Tyler Heale and Matthew Fournier.
midwifery. The presentation will close with next steps concerning process used by youth in deciding to smoke or not to smoke. Working
dissemination of the results to the Inuit public and beyond. with students produced better research results, developed research
Contact: Paani Zizman (pzizman@naho.ca) capacity and instilled interest in the research process.
Contact: Cindy Jardine (cindy.jardine@ualberta.ca)
HEALTHY SMILE HAPPY CHILD: RESEARCH AND

EVALUATION OF A CAPACITY BUILDING ORAL HEALTH NORTH STARSS (START THINKING ABOUT REDUCING
PROMOTION INITIATIVE SECONDHAND SMOKE)
R. Schroth, L. Harms, J. Edwards, M.E. Moffatt S. Duke
University of Manitoba Healthy Moms, Healthy Babies - Victoria Faulkner Women’s Centre
Introduction: Early Childhood Caries (ECC) is a growing concern among This presentation will provide an overview of the STARSS (Start
preschool children. This burden of ECC in Manitoba led to the Thinking About Reducing Secondhand Smoke) program that aims at
development of an inter-sectoral partnership, Healthy Smile Happy better understanding the role of smoking in Women’s lives and the use
Child (HSHC). HSHC uses community-development principles to assist of a harm reduction approach in reducing secondhand smoke exposure
communities in identifying solutions to improve early childhood oral for children.
health. Emphasis is placed on building capacity within existing Learning Objectives: At the end of this session, participants should be
programs and services to ensure sustainable oral health promotion. able to:
Methods: Research and evaluation has been a key pillar in this - Better understand the role of smoking in Women’s lives
initiative. HSHC has undertaken various research and evaluation - Know the importance of a harm reduction approach with
projects including epidemiological studies on the prevalence of and risk reducing secondhand smoke exposure for children
factors for ECC, assessing the effectiveness of community training - Discuss available resources and support for smoking moms and
workshops, as well as qualitative research with service providers, families
community members, and different cultural groups. - Use the STARSS model to work with smoking moms and families
Results: The prevalence of ECC was initially documented in 4 within their own work place
communities. Knowledge on prevalence and risk factors was then Participants will be engaged in the learning process through lecture,
transferred back to these communities. Results following 5 years of fun interactive games, use of program resources, and case studies
active community engagement reveal significant improvements in using the STARSS process.
parental knowledge, attitudes, and behaviours towards preschool oral
Attendees will learn more about the effects of secondhand smoke,
health and a significant reduction in the active dental caries rate.
what works to reduce secondhand smoke, how to set long and short
Findings from workshop evaluations show statistically significant
term goals to create change, strategies to reduce stress (for example:
increases in knowledge and awareness of service providers after
how to use deep breathing and muscle relaxation), how to use problem
receiving training. Focus groups results with service providers and
solving to plan ahead, and how to support smoking moms and families
community members show good understandings of oral health and
where they are at.
positive experiences with HSHC. Barriers to maintaining good oral Contact: Shannon Duke (s_duke@northwestel.net)
health and preventing ECC were also identified. Focus group interviews
with cultural groups identify cultural beliefs and practices pertaining to
preschool oral health and ECC, which can help tailor oral health
promotion. VENUE 7
Conclusions: The HSHC project has undertaken mixed research Clinical Care #2
methods to evaluate the success of this initiative. The project has
adhered to community-development and healthy living principles to
PHYSIOTHERAPY IN NUNAVUT: OBSERVATIONS AND
empower communities to develop capacity and knowledge to sustain
ongoing early childhood oral health promotion initiatives.
CHALLENGES FOR PRACTICE
Contact: Robert Schroth (umschrot@cc.umanitoba.ca) C. Kehler
J.A.Hildes Northern Medical Unit, University of Manitoba
YOUTH AND TOBACCO: WORKING WITH THE K’ÁLEMI DENE The role of a visiting physiotherapist in the Canadian arctic presents
SCHOOL unique challenges that will be explored in this paper. Patient
interaction involves the provision of consultative advice that can be
C. Jardine1, E. Erasmus2, M. Wideman3, L. Beaulieu4, A. Brockman, A.
implemented between visits, and which takes into account the
Abel4, C. Wild1
culturally specific activities of daily living, including hunting, fishing,
1
University of Alberta, 2K’álemì Dene School, 3GNWT Dept. of Health and skinning, clothing preparation, food preparation, child care practices
Social Services, 4Yellowknives Dene First Nation etc. Environmental challenges include those posed by the terrain,
Smoking is one of the biggest health problems in many First Nations housing characteristcs, and transportation needs. History taking and
communities today. Of particular concern is the high rate of smoking in interview techniques must be tailored to the local Inuit values
youth. Our research program was initiated to better understand why regarding the expression of pain and disability. While nursing and
some youth choose to take up smoking and some choose not to physician services have been provided for decades in the Canadian
smoke. We worked with the K’álemì Dene School in N’Dilo, training arctic, visiting physiotherapy services have been provided on a regular
older students to conduct the research with the younger students. basis in more recent years. Continuity of personnel and of service
Training sessions covered the research process, research ethics, and remains a challenge.
Contact: Carol Kehler (ckehler@rccinc.ca)
specific skills needed to conduct the research (such as interviewing
skills, interpretation skills, and data presentation skills). The student
researchers designed a series of questions about smoking and smoking
DEATH & DYING: PERSPECTIVES OF A FIRST NATIONS
behaviours that were used as the basis for initial interviews. We also
used a method called PhotoVoice, whereby students were asked to COMMUNITY IN THE NORTHWEST TERRITORIES
take pictures about smoking in their community and then to discuss R.A. Blake
their pictures with the researchers. The results obtained from this University of Regina, Regina, Saskatchewan
research process helped us to better understand the decision making
Contact: Linda Day (linda.day@vch.ca)

The experience of facing death can be difficult for the terminally ill
patient and their family, and friends. This qualitative research project
sought to understand how the Gwich’in people of Fort McPherson, PARTNERSHIPS IN HEALTH CARE INFRASTRUCTURE
Northwest Territories (NT), historically perceived death and dying, and
DEVELOPMENT IN NUNAVUT
to document their current protocols regarding the same. This project
also explored participants’ views and experiences regarding end of life J. Jaud
care services. Preferred place of death was also explored in the study. FSC Architects and Engineers
The project took place in Fort McPherson, NT, between May 2008 and Health Care Projects: Arviat Health Centre, Kivalliq Health Centre,
December 2008, in which ten community members, most of whom are Qikiqtani General Hospital, Repulse Bay Health Centre, Arctic Bay
elders were interviewed. Relying on participants’ traditional Health Centre, Taloyoak Health Centre in Nunavut.
knowledge, perspectives, and experiences pertaining to death and
dying, the data analysis is identified in three primary categories: 1) Project Teams: Departments of Health and Social Services and
historical perspectives and practices, 2) contemporary perspectives Community and Government Services, Government of Nunavut, FSC
and practices, and 3) end of life care services experiences and Architects and Engineers, Qikiqtaaluk Corporation.
perspectives. Findings included the resilience and importance of The building industry advocates many ways to deliver health care
traditional values and customs, the importance of traditional food, the projects. Which is the most effective for your project? What are the
value of traditional medicine. Further, culturally relevant end of life parameters that must be understood in order to advance your project
care services needs to be developed, as the Gwich’in preferred place of beyond a community need?
death is at home. The problem has been to understand the dynamics of project delivery
Health and Social Services professionals who work in the realm of systems and reaching conclusions that will eventually actualize the
palliative care should have appropriate cross cultural training and project in the most effective way.
education, as cultures are diverse. Moreover, it is important for those in Our study reviews the development of Health Infrastructure projects in
the helping field to be aware of how historical and contemporary Nunavut and discovers the advantages and disadvantages of different
customs impact the Gwich’in people. End of life care issues needs to be project delivery models for remote community health care projects.
addressed accordingly.
Contact: Ruth Anne Blake (ruthablake@hotmail.com)
Our results also indicate that input into the projects from Hamlets and
staff of the health care facility result in buildings that are highly
functional and appreciated by community residents and health care
ABORIGINAL PATIENT NAVIGATORS: FACILITATING ACCESS staff and are an effective use of project funds.
TO MAINSTREAM HEALTH SERVICES FOR ABORIGINAL The most successful health care projects in the North are those that
PEOPLE have had community involvement as part of the planning, construction
L. Day, P. Vlahos and operational process.
Contact: Jerry Jaud (jerry@fsc.ca)
Vancouver Coastal Health Authority
The goal of the Vancouver Coastal Health Authority (VCHA) Aboriginal OUTCOMES FOR TELEPHONE CONSULTATIONS IN A
Patient Navigator (APN) program is to increase access to, and NORTHERN CANADIAN EMERGENCY DEPARTMENT
Aboriginal patients’ ability to navigate the mainstream health system, A. Hoechmann, B. Farrell
fostering connections with hospitals, long term care facilities, mental
Background: Family / Emergency physicians working at the Stanton
health and addiction programs and services, and encouraging a holistic
Regional Hospital in Yellowknife receive many calls from health care
and culturally inclusive approach to health care delivery. Additionally,
providers in remote areas regarding patients. Until recently, little was
APNs have supported and advocated on behalf of their clients by
known about the volume and acuity of calls, the characteristics of the
forging relationships with complementary systems, like justice, child
patients, and the effect on users.
and family services, and education. The APN Program has successfully
accomplished the goals outlined above by facilitating cultural In 2004, we collected records of all phone calls placed to the Stanton
requirements, networking with Aboriginal communities and external ER from the periphery during a 2 month time period. We then
Aboriginal Health Care service providers as well as facilitating compiled data on the volume and timing of calls, the presenting
communication between Aboriginal patients and health care providers. complaints, and some key patient demographics. As a result of that
Specific responsibilities of the VCHA Aboriginal APN’s include the analysis, a new record template was developed at the Stanton
following: Regional Hospital to facilitate in the documentation of calls, with a
view to ultimately improving patient care and safety.
- Provide support services to Aboriginal clients and their families in
their assigned acute care hospital and other facilities. Purpose: We wanted to know if patients who were initially managed
- Offer telephone consultation and advice to rural and/or other remotely by telephone required transfer from their home to the
urban acute care sites as needed. Stanton Regional Hospital for further care. The ultimate goal of course
- Work with clients and families to support them to feel was to provide a more effective, safer, and efficient service to the
comfortable with the culture of the hospital and provides northern Canadians and health care providers in places such as
consultation and assistance to the health care team regarding Yellowknife.
service provision and appropriate accommodations of Aboriginal Methods: This project is a descriptive study. It marks an attempt to
health practices and beliefs. provide a better understanding of the challenges of providing long
- Provide referral and advocacy support to clients, families and distance medical care in the remote environments of the Northwest
community service providers to facilitate continuity of care and Territories and western Nunavut. In the fall of 2004, we extracted data
access to appropriate health care and community services. from the call records into an Excel sheet. There are over 350 records in
- Provide input, recommendations, referrals, support and guidance the complete data set, each representing a complete telephone
for discharge planning. consultation. In the second phase of the project, we tried linked some
This presentation will briefly outline the community based of the records of phone calls with their corresponding records of visits
development approach of the VCHA APN Program, intake and to the Stanton Regional Hospital emergency room, inpatient
response and other APN program statistics, highlight some of the APN admissions and clinics. This was done by cross-referencing our existing
program successes and barriers by featuring two recent case studies, data with the hospital’s computerized Medipatient record system.
and describe the unique evaluation approach of the program. Results: On average, 6 calls were made from the nursing stations to the
Stanton Territorial Hospital Emergency Department each day.
Approximately 40% of calls resulted in the patient being transported, facet to this approach is a focus on the understanding and process of
most often by medevac. Admission rates and transfer rates were healing.
carried out on a subset of the available data. From this we were able to Relationship: The foundation to this counselling and counsellor training
determine that in many cases patient’s needs were met at least initially approach lies in relationship, and this will be discussed as the centre of
with a phone call alone. success for meaningful communication with students and clients. “Yet
only through communication can human life hold meaning” (Freire,
2003, p. 61). Further, a discussion of the relationship between
Indigenous peoples and colonial rule will occur in the context of mental
SESSION 4 health and healing (Gone, 2004; Mussell, Cardiff, & White, 2004;
Smith, 1999; Stewart, 2007).
Monday, July 13, 1:30-3:30 PM
Empowerment: Another important principal in my philosophy of
teaching and counselling is empowerment. And this has its roots in
Paolo Freire’s seminal work, Pedagogy of the Oppressed. From this
VENUE 1 point, I come from a humanist perspective in which my efforts as an
Indigenous Pedagogy in Mental Health Workshop: educator must be consistent with those of the students in order to
Healing Teachings for Mental Health Workers, Valuable engage in critical thinking and the quest for mutual humanization—my
goals in teaching and counselling. Freire (2003) states that the
Knowledge for Clients
educator’s efforts “must be imbued with a profound trust in people and
S. Stewart their creative power. To achieve this, they must be partners of the
Yellowknife Dene, OISE/University of Toronto students in their relations with them…The teacher's thinking is
Abstract: Indigenous pedagogy places mental health care, like authenticated only by the authenticity of the students' thinking. The
education, in the context of culture, values, relationship, and historical teacher cannot think for her students, nor can she impose her thought
on them. Authentic thinking, thinking that is concerned about reality,
realities. It is this understanding that provide the foundation of
“Indigenous Standpoint Pedagogy” (ISP), which is the “inherently does not take place in ivory tower isolation, but only in
political, reformative, relational, and deeply personal approach that is communication” (p.61). For me, education and healing through
located in the chaos of colonial and cultural interfaces” (Philips, counselling is based on traditional Indigenous values of sharing,
Whatman, Hart, & Winslett, 2005). ISP fundamentally identifies and supporting, and liberating, and that teaching is a practice of freedom,
not domination (Mussell, 2005; Mussell, Nichols, & Adler, 1993). For
embeds Indigenous community participation in the development and
teaching of Indigenous perspectives, or standpoints, and is a multi- me, a teacher and a counsellor assumes a leadership role in the
faceted process. This workshop identifies and explores ISP as a classroom or the session, not an expert stance, in order to be an
effective educator and helper. A helper must take responsibility and
valuable way to teach counsellors from diverse Native cultural
perspectives, and to use this approach in mental health support work leadership in pragmatic ways that reflect such traditional values of
with clients. Also provided is a rationale for ISP in curriculum for respect, incorporation of community, voice, trust, mutuality, authentic
Indigenous mental health workers as an integral way to promote and communication, and shared interest in learning (McCormick, 1996,
maintain mental health and healing. 1997).
Objectives for workshop: Attendees will learn to understand the
Workshop Outline: This session details my approach to mental health
worker (counsellors, psychologists, psychiatrists, social workers, child fundamental of Indigenous pedagogies and healing in mental health
and youth care) training and client contact, which is based on an teachings and practices (such as counselling, social work, nursing, etc)
and to evaluate its strengths and weakness as applicable to their own
Indigenous pedagogy that places education and mental health services
in the context of culture, values, relationship, and historical realities. personal teaching and helping philosophies and practices. Additionally,
those interested in policymaking will come away with a concrete
The session will be an interactive dialogue between the presenter and
audience that will invite reflexive listening and learning. Three main understanding and articulation of a rationale for indigenous
aspects of an Indigenous pedagogy will be discussed as they relate to pedagogies for counsellor educators and counsellors engaged in
professional helping (Erasmus & Ensign, 1998).
Indigenous counselling and healing practices and Indigenous
counsellor training: ISP theory, relationship, and empowerment. How attendees will be engaged: Participants will be invited to discuss
Possible Participants: This workshop is designed for mental health and dialogue amongst each other and with the presenter throughout
presentation of main ideas. This could include sharing of experiences,
trainers and mental health frontline workers (counsellors,
psychologists, psychiatrists, social workers, child and youth care ideas, and hopes regarding the presentation topic.
Contact: Suzanne Stewart (slstewart@oise.utoronto.ca)
workers).
ISP Theory: It is this theory of understanding of teaching and learning
that provides me with the foundation of what Philips, Whatman, Hart,
and Winslett (2005) have termed the “Indigenous Standpoint VENUE 2
Pedagogy” (ISP), which is described as being the “inherently political, Education & Building Resource/Research Capacity #1
reformative, relational, and deeply personal approach that is located in
the chaos of colonial and cultural interfaces”. ISP fundamentally
identifies and embeds Indigenous community participation in the
DEVELOPING A PHYSICIAN SERVICES PROGRAM IN
development and teaching of Indigenous perspectives, or standpoints, NUNAVUT 1999-2009
and is a multi-faceted process. It is mainly concerned with Native W.A. MacDonald
perspectives in education not as an alternative to western approaches Health and Social Services, Government of Nunavut
but as a legitimate form of education in and of itself. I bring this
perspective to my teaching by virtue of my identity and my desire to When Nunavut was established in 1999 the new Department of Health
work from an Indigenous perspective in all aspects of my teaching and Social Services inherited a health care delivery system organized
methods and goals. What this means in practice is that I value multiple around 3 regional health boards corresponding to the 3 administrative
perspectives on learning and teaching in my interaction with students regions of the new Territory: Baffin, Kivalliq and Kitikmeot.
and clients, such as linear and non-linear thinking, differing time This system was dismantled in 2000 and replaced with a more
orientation, holistic approaches and dualism, and community-based centralized Department and 3 adminstrative “regions”, each with an
and individual focussed connection. However, the most important Executive Director reporting directly to an Assistant Deputy Minister of
Operations.
The physician services aspect of the care delivery model was addressed DISTRIBUTION OF PHYSICIANS, NURSES, AND
by the appointment of a Director, Medical Affairs in 2001. This position PHARMACISTS IN NORTHERN CANADA
is responsible for physician services in Nunavut, and for the quality of
A. Porter-Chapman
care in the Territory.
Canadian Institute for Health Information
In 2001 there was no consistent administrative support structure for
the physician services’ program. Pay and hiring practices varied across Hypothesis: What does the geographic distribution of employed
the Territory and retention rates were very low. Compared to national physician, registered nurse, licensed practical nurse and pharmacist
averages Nunavut had about one-half the number of physicians to working in Canada’s northern territories resemble?
population. In 2007, Canada’s northern territories healthcare workforce included,
Since 2001, the number of funded physician positions has increased, but is not limited to, registered nurses, licensed practical nurses,
the number of full time specialist positions has increased, the pay and physicians (Family Medicine and Specialist) and pharmacists. Of these
contractual structures have been overhauled and standardized, an healthcare professionals, the majority of physicians (over 85%) and
aggressive recruitment campaign based on unique “testimonial” ads pharmacists (over 70%) are located in the capital cities. For regulated
has been initiated, and administrative support positions have been nurses the distribution varies by territory; ranging from 99% in the
created within the Department. Finally with all the above Yukon, 61% in the Northwest Territories and 33% in Nunavut.
developments in place the average length of stay of family physicians Methods: This study analyzed administrative data from the Regulated
in the Territory has increased significantly over earlier years. Future Nursing Professions Database, Scott’s Medical Database and the
plans include sponsoring medical school placements for qualified Inuit Pharmacist Database at the Canadian Institute for Health Information
students from Nunavut. (CIHI). These pan-Canadian databases contain demographic,
The goal of the program is to provide consistent, competent physician employment, education and geographic information for all physicians,
services to the population of Nunavut, and to create a work licensed practical nurses (LPNs), registered nurses and pharmacists in
environment for physicians which is conducive to long term practise. Canada.
Contact: W.Alexander Macdonald (wmacdonald2@gov.nu.ca)
A distribution analysis was developed for those professionals
employed in northern Canada in 2007. Geographical indicators about
the workforce were linked to current Canadian census divisions and
PROPOSAL FOR A STANDARD PRIMARY CARE PHYSICIAN
census subdivisions. These data were then compared to information
COMMUNITY COVERAGE MODEL FOR THE NORTHWEST from Statistics Canada’s Census.
TERRITORIES
Results: The distribution of physicians, regulated nurses and
E. Affleck pharmacists varies across professions in Canada’s northern territories
Yellowknife Health & Social Services Authority but in each case clustering in the cities is evident to varying degrees.
Objective: It is becoming more difficult to staff the remote While the geographic distribution is informative, the demographic,
communities of the Northwest Territories with physicians. There education, employment and mobility trends of healthcare
appear to be a number of causes underlying this staffing shortfall professionals shows us even more about the work lives of healthcare
including worldwide physician shortages. This shortfall in regular professionals employed in Canada’s northern territories.
physician community coverage has resulted in greater reliance on This examination of the distribution healthcare professionals currently
physician services in Yellowknife, and anecdotally in more medevac employed in Canada’s northern territories can assist territorial and
transfers of patients to the two territorial hospitals. Current trends in federal health planners in their recruitment and retention policies. The
physician coverage threaten the sustainability of the remote information in this presentation provides one more piece of
community service. understanding as to the shape of Canada’s northern healthcare
The objective of this study is to describe in detail the current state of workforce.
Contact: Andrea Porter-Chapman (APorter-Chapman@cihi.ca)
physician community coverage in the Northwest Territories by
examining coverage statistics and the model of service. Based on the
findings a new model of coordinated physician community coverage is COMMUNITY-BASED HEALTH CARE IN ACTION
proposed aimed at providing sustainable quality service.
A. Hache
Methods: Government of the Northwest Territories statistical and
demographic information is used to establish physician coverage rates Centre for Northern Families
by population and community. Rates of physician recruitment and This panel presentation explores the successes, challenges and
retention by health Authority, and rates and cost of medical outcomes of establishing a multi-disciplinary team in a community-
evacuation by community and territorially are examined. Lastly referral based health care clinic situated in a northern family resource drop-in
and remote physician coverage patterns are detailed. centre with an onsite emergency shelter that serves women who are
Results: There is a clear shortfall in primary care physician services in homeless. The clinic that partners several agencies including the
the Northwest Territories, particularly in the remote communities, Yellowknife Health and Social Services Authority, the Great Slave
bringing into question the very sustainability of remote community Community Health Care Clinic, Aurora College and the Centre for
physician service. Combined with a lack of standardization of Northern Families provides a concrete example of primary health care
community coverage and a lack of coordination and clear criteria for in action, delivering services to marginalized populations in a way that
medical transportation this results in what appear to be needless and meets their specific needs in an environment they feel comfortable
costly transportation. being in.
Discussion: A coordinated territorial community call coverage system is The clinic established 5 years ago approached health care from a social
proposed that will see three primary care physicians on call for the determinants perspective. It piloted the Family Physician and Nurse
Northwest Territories. Central to this service is standardization of care Practitioner dyad in a collaborative practice and was used as a base of
and coordination of medical transportation. A hybrid digital operation to develop the electronic medical record system giving
information system with simple store and forward Telehealth, patients and doctors easier and faster access to medical information
videoconferencing services, and digital documentation templates will they need for diagnosis and treatment.
support this service. The clinic operates one day a week and is open to the general public.
Contact: Ewan Affleck (ewan_affleck@gov.nt.ca) Women living in the emergency shelter attend regularly receiving the
first consistent health care service in their lives. On average 35 people
attend each session. In its first three months of operation there were a
total of 108 visits. The majority of patients were 19-29 years of age, IMPROVING ACCESS AND OUTCOMES IN CANADA’S
followed by those 40-59 years of age. Most were Inuit, closely followed NORTHERN TERRITORIES
by Dene.
S. Chatwood1,3, S. Law2, K. Young3, E. Affleck4, A. Cortinois5, C. Kirby2
The partnership worked because everyone focused on “the people we 1
Institute for Circumpolar Health Research, 2Canadian Health Services
were helping rather than our own fears, misperceptions and biases”.
Research Foundation, 3University of Toronto, Dalla Lana School of Public
The Women say:
Health, 4Yellowknife Health and Social Services Authority, 5Centre for
- I feel comfortable here. I don’t have to make an appointment; I Global eHealth Innovation
can just drop in.
New investments and opportunities for health and related programs in
- I feel judged when I go to the doctor’s office – here I don’t.
Contact: Arlene Hache (arleneh10@hotmail.com)
Canada’s northern territories have stimulated many training, research,
and service innovations that aim to improve access to healthcare and
health outcomes for northern and Aboriginal people. This presentation
HEADING A SÁMI HEALTH INSTITUTION: EXPERIENCE AND will provide an overview of projects underway in the Northwest
CHALLENGES Territories (NWT) and in Nunavut where different approaches to
introducing evidence-informed change have been adopted – but with
G.K. Heatha
hopefully similar outcomes.
The Sámi National Centre for Mental Health - SANKS
In the NWT, there have been major collaborative efforts (between
In this paper I will focus on the particular challenges a head of a Sámi researchers and decision makers) to promote the investment in
health institution in Norway may face when he or she is responsible for research and research infrastructure to advance health and healthcare.
developing an equal health service to the Sámi population. Partnerships exist between the Institute for Circumpolar Health
The paper builds on my Master degree in Business Administration. The Research, University of Toronto Dalla Lana School of Public Health, the
thesis, which takes an ethnographic approach, is based on my own Center for Global eHealth Innovation and territorial health authorities.
experiences, participatory observation, interviews and various health Infrastructure funds have been acquired from INAC to renovate
policy documents. existing office space within the health authority where, among other
research programs, a health services research program will be nested.
My study shows that those who head Sámi health institutions may
Health services research program development is ongoing and will
experience particular challenges. The challenges can be understood as
include health systems analysis and the development of eHealth
a consequence of the fact that majority or minority background has an
solutions including store and forward technologies and video
influence on the understanding and interpretation of concepts such as
enhancements for communications.
equal service, the ability to provide concrete examples of measures
and the willingness or ability to instigate concrete measures. In other In Nunavut, the Canadian Health Services Research Foundation
words, the idea of actually instigating measures that can result in an (CHSRF) is working with the Nunavut Department of Health and Social
equal service for the Sámi population can lead to difficult dilemmas for Services (DHSS) in a major project that brings experts in health human
persons from majority backgrounds. Among other things, the resources and health services organization and management together
dilemmas may be related to concerns that measures specifically with the relevant scientific evidence to work with DHSS staff to
targeting the Sámi population may be perceived as being unjust by identify improvements in access and outcomes across all communities.
other minorities and by the Norwegian population. It appears, on the The project plan includes an evaluation component that will assess the
other hand, that the place one grew up is significant in terms of choice effectiveness and impact of this approach as well as the longer-term
of strategy in relation to a concrete case. results of any changes in policy and practice to implement the final
recommendations (in 2010).
The responsible health authorities should consider other solutions than
the present ones because the survey shows that lack of knowledge It is anticipated that a comparison of the two approaches, and a
about the Sámi society can affect the ability to propose and instigate presentation of the progress and lessons learned to date may be of
measures aimed at creating an equal service for the Sámi population. wider interest to conference attendees from other jurisdictions.
Without concrete measures, we will never achieve an equal health Contact: Susan Chatwood (ahrn.ed@theedge.ca)
service for the Sámi population. All we will be left with is a large
number of reports and plans emphasising how important various
measures are.
Contact: Gunn Kristin Heatta (gunn.heatta@helse-finnmark.no)
VENUE 3
Indigenous Wellness & Medical History #3
LAND BASED EXPERIENTIAL INDIGENOUS CULTURE AND
HISTORICAL AND SOCIAL EFFECTS OF LEGISLATION AND
HEALTH TRAINING
POLICY IN ABORIGINAL HEALTH
M. Jong
C. Cook, D. Ballard, A.A. Roussin, K. Gray
Memorial University
Winnipeg Regional Health Authority
There is a need for culturally safe care if we are to improve the health
This paper will discuss the impact historic legislation and policies have
of indigenous peoples. We have been providing indigenous culture and
on the delivery of health services to Aboriginal Peoples and the efforts
health training for family medical residents, medical students and
underway to amend the legislation and policies in order to provide
allied health personnel for about 15 years. Training has evolved into a
better health care and services to Aboriginal Peoples. The present
land based experiential learning.
health services delivered to Aboriginal Peoples are a direct result of
Learning is through story telling and living with the elders in a tradition historic legislation and policies that directly or indirectly produced
setting in tents in the bush. It includes a walk through the country to jurisdictional barriers encountered by Aboriginal Peoples and health
share the experience of living on the land with the Innu and appreciate service providers when requesting these services. Health care providers
what the land means for them. are now beginning to address these jurisdictional barriers in an effort
Participants gave great evaluation of the training. to adequately provide Aboriginal Peoples with health services when
Contact: Michael Jong (mjong@hvgb.net) required. In Manitoba, jurisdictional barriers to the provision of health
care for Aboriginal Peoples are being addressed in the Legislative
Assembly of Manitoba in the form of a child first principle to resolving
jurisdictional disputes within and between federal and
provincial/territorial governments. This child first principle is presently research that focuses on peoples’ experiences and their perceptions is
before the Legislative Assembly of Manitoba as Bill 203 “The Jordan’s an important key to the root of the social and health concerns that
Principle Implementation Act” and came about as a result of the exist in Inuit communities both in the north and in the cities. The
evolution of historic legislation and policies that impacted the results of this study could be used to inform both governmental policy
provision of health services to Aboriginal Peoples. and intervention programs.
Contact: Dennis Ballard (dballard@wrha.mb.ca) Contact: Ebba Olofsson (ebba.olofsson@mcgill.ca)
A SOCIAL AND ENVIRONMENTAL HISTORY OF HEALTH HISTORICAL AND SCIENTIFIC PERSPECTIVES ON HEALTH
CARE RELOCATIONS IN THE CANADIAN NORTH SINCE 1890 OF CANADA’S FIRST PEOPLES
L. Piper R. Obomsawin
University of Alberta National Aboriginal Health Organization
This paper examines the origins, evolution and impact of relocating Historical perspectives and commentary on the forgotten legacy of the
people with infectious and chronic diseases from Canada’s northern outstanding health of Canada’s first peoples in the pre-contact era is
territories to southern health care facilities. Previous researchers have examined and documented from wide ranging historical sources.
focused upon Inuit relocation after 1945 (Grygier 1997; Tester and Principal factors underlying pre-contact outstanding health levels and
Kulchyski 1994), in particular as a result of tuberculosis infection. the key causes underlying its precipitous loss are addressed. Based on
However, relocations for health care began before 1900, involved the historical record and an alternate bio-medical model, widely
Aboriginal and non-Aboriginal people across the Canadian North, and disseminated medical assumptions about imported microbes infecting
temporarily or permanently removed individuals with disabilities, “virgin soils” and causing mass infectious disease in Aboriginal
mental illness, and cancer as well as those with infectious diseases such populations in the early post-contact era is challenged. More basic
as tuberculosis, syphilis, and gonorrhoea. Using federal and territorial causal factors for pandemic infectious disease patterns is presented for
government records from the Library and Archives Canada, the Yukon consideration. Patterns of traditional foods in relation to sustaining
Archives, and Northwest Territories Archives, records of religious health & preventing disease among the first Nations, Inuit and Métis
groups responsible for northern health care, and oral histories with populations is looked at. Correlative factors behind the increasing
indigenous communities in the eastern and western Arctic, this paper levels of degenerative disease among Aboriginal peoples in the
explores several key themes: First, how relocation policy was rooted in twentieth & twenty-first century is also explored. The historical
perceptions of northern environments as hazardous. Understandings progression of the Federal government in the field of health care for
of northern ecosystems changed over the 20th century, but Canada’s first peoples is described, including the recent policy of
nevertheless continued to reinforce the idea that the North was transfer of public sector health services to Aboriginal control. A
environmentally unsuited to the creation of local modern health number of scientific issues are documented and interpreted, including:
facilities. Second, the role of attitudes held by state and religious - Adverse impacts of modern civilization-globalization on the
officials that attached moral judgements to certain diseases, especially health of Indigenous peoples
gonorrhoea, syphilis, and tuberculosis. These individuals saw - Western medical services & Aboriginal health outcomes
intervention through relocation as a means of social education as well - The unbalanced dominance of western selective medicine & its
as an opportunity for treatment. Finally, this paper explores how iatrogenic impacts versus nature-based traditional healing
attitudes intersecting health, morality, and environment influenced the - Socio-economic factors & declines in infectious diseases
experience of relocation for Aboriginal and non-Aboriginal - Issues surrounding vaccine usage among First Nations & Inuit
northerners. This paper demonstrates that relocation policies arose not people
simply as a practical response to the challenges of health care provision - Nutrient intake levels of Canada’s first peoples when living on
across a large area with a small and widely dispersed population. traditional diets
Rather, this policy reflected complex understandings of northern - Medical concerns on milk usage of another species beyond
communities and environments and aspired to achieve specific social weaning
objectives for people in the North. - Vitamin prophylaxis & remediation of infectious diseases
Contact: Liza Piper (epiper@ualberta.ca)
- Bio-physical underpinnings of mental health
- Recent health regenerative successes in an Aboriginal community
Contact: Raymond Obomsawin (robomsawin@naho.ca)
“ARE YOU NOW A QALLUNAQ?” INUIT TUBERCULOSIS
EVACUEES IN THE 1940S-1950S
E. Olofsson, T. Holton, I. Partridge THE HEALTH OF FIRST NATIONS CHILDREN UPON
McGill University ADMISSION TO A RESIDENTIAL SCHOOL IN A NORTHERN
MANITOBA COMMUNITY
In the mid 1940s the Canadian government implemented a medical
mass-survey of Inuit and other indigenous peoples living in northern A. Woods
Canada and evacuated those suspected of having tuberculosis (TB) and University of Mantioba
other serious conditions. Hospital stays often lasted several years, and
For over a century, First Nations children were removed from their
while many Inuit patients were eventually returned to their home
families and communities and put into Residential schools. It is now
communities, others never returned, some because they chose to stay
known that thousands of children suffered physical, sexual, emotional
in the south and others because they did not survive their illness. The
and spiritual abuse while at the schools as well as neglect of their
current study is interested in how hospitalization in the south affected
needs. The abuse and neglect was damaging to the children during
the identity of Inuit patients, and in particular examines the
their time in the Residential schools and has continued to inflict
negotiation of identity as a form of resilience. This investigation is
enduring pain and difficulty in the lives of Residential school survivors.
accomplished through life history interviews with Inuit former
The negative effect of the abuse and neglect also continues to effect
evacuees living in Montreal and in different communities in Nunavik.
the successive generations of Residential school survivors, and is
We explore Inuit individuals’ experiences of departure, travel, and of
known as the intergenerational impact of the Residential school
their sojourn in an unfamiliar environment, as well as their lives after
experience. It is possible that there are connections between the
the hospital stay. The life histories are also supplemented with
experiences First Nations children had in Residential school and health
documentary research of archival material regarding the hospitals, and
problems experienced by First Nations people today. In order to better
interviews with some hospital personnel from the era. Oral historical
understand what happened to the children in Residential school in
terms of health, it is necessary to examine the health of the children at The forced relocation of Japanese Americans created a situation in
the time that they were admitted to Residential school. This research which a health care system had to be built from scratch to care for a
will examine the overall health of First Nations children at the time of vast population placed in desolate locations. In each of the ten U.S.
their admission to, and during their stay in, a Residential School. The camps, the government constructed and staffed a hospital. Yet, as
research design is an historical qualitative inquiry using a set of Toku’s story demonstrates, hospitals were not sufficient to meet the
Residential school records. By compiling the information from the requirements of people living in places of confinement.
documents, a better understanding will be gained of the health of This paper shows how Toku’s identity as a midwife shaped her
children when they first came to the school and if, and how, their contributions to camp life. It demonstrates how she aided community
health changed while they were at the school. As children from each of survival, and her own, through informal caregiving work. It reveals that
the three Aboriginal groups of Canada, First Nations, Métis, and Inuit, midwife practice has had public health dimensions not fully captured
were forced to attend Residential schools, this information will be by research that only focuses on the midwife’s contributions to birthing
useful for all Residential school survivors on their paths to healing from babies. The history of midwifery during the wartime incarceration
their Residential school experiences. shows that midwives have been central, if too often invisible, figures in
Contact: Amanda Woods (awoods00@hotmail.com)
health care promotion.
Contact: Susan Smith (Susan.L.Smith@ualberta.ca)
MY GRANDMOTHER’S MOCCASINS
L. Edge
University of Alberta VENUE 4
This study explores multiple perspectives of Indigenous Women’s Infectious Diseases #2 – Tuberculosis
participation in traditional cultural activities, such as beadwork, to
examine how participation in these activities may contribute to HARMONY, BALANCE, AND RESILIENCE: ENHANCING
identity formation, teacher/learner relationships, relationships to social ADHERENCE TO TB TREATMENT IN CANADIAN ABORIGINAL
and cultural environments and health and well-being. POPULATIONS
Indigenous ways of knowing and meaning are explored from an C. Lopez, P. Orr
Indigenous perspective through qualitative methods; critical inquiry;
ethnographic, historical and material culture; narrative and University of Manitoba
storytelling; and visual arts research and representation towards Adherence to tuberculosis (TB) therapy is necessary for the health of
expression of a conceptual framework and related contexts that offers the individual patient and his/her family as well as the community. It is
insight into beadwork as a traditional cultural activity. also a concern for all TB programs in Canada, including those that care
for aboriginal patients and populations which continue to be burdened
A personal narrative reflects and interprets learning experiences
through writing and digital media as a method to strengthen with high rates of TB infection and disease. Failure to adhere to TB
treatment regimens (medication and monitoring) may result in
alternative representation in research and enhance our understanding
morbidity and mortality of the patient, transmission to others, and
of methodologies and outcomes.
development of resistance. Drawing on the published experience of TB
The research draws our attention to the many contributions of First in indigenous populations in Canada and other countries, we examine
Nations and Métis women in the sub-arctic regions of northern Canada the personal, social, and health system factors that affect TB
whose legacy is a rich endowment of materials created and crafted by adherence in aboriginal populations. Program strategies that enhance
them from which current and future generations may continue to learn adherence are explored, including those that promote self-efficacy,
about Indigenous ways of being. “permeable” health services and a patient centred approach.
Analysis and reflection upon Indigenous ways of knowing may Community activism that challenges “dependent” thinking, use of
contribute to our understanding of Indigenous Women’s identity, traditional problem solving methods, integration of TB care with other
lifelong learning and the health and wellness of Indigenous people in health services that address patient needs are required. Holistic views
North America. of health as characterized by harmony and balance allow for the
Contact: Lois Edge (ledge@ualberta.ca) involvement of family and community in support of individuals for
whom adherence is difficult, and for the molding of TB programs in a
manner that promotes cultural safety and effectiveness.
CAREGIVING IN CONFINEMENT: JAPANESE IMMIGRANT Contact: Carmen Lopez (lopezhil@cc.umanitoba.ca)
MIDWIVES DURING WORLD WAR II
S. Smith
VITAMIN D RECEPTOR GENE POLYMORPHISMS IN A
Dept. of History and Classics, University of Alberta CANADIAN FIRST NATIONS POPULATION WITH TB
This paper draws on qualitative methods and historical sources, L. Larcombe, P. Orr, B. Martin, P. Nicherson
including government records, to provide an historical exploration of
the social determinants of health. This case study of one immigrant University of Manitoba
midwife in wartime, it reveals how health disparities are sometimes The Dené First Nations in northern Manitoba have one of the highest
produced by health policies. It shows that human health is a product of tuberculosis rates in the world (600 per 100,000). Historically, exposure
society, and the conditions of life, as much as biology. to UV light was used to treat patients with cutaneous tuberculosis with
This paper demonstrates the significance of caregiving labor for dramatic affect. Recently, it was proposed that sunlight catalyzes the
remote populations through the study of a Japanese immigrant conversion of vitamin D3 and in conjunction with the vitamin D
midwife during the mass incarceration of Japanese Americans in U.S. receptors (VDR) they enhance the cathelciden peptide, which has a
government camps during World War II. It draws on the diaries of Toku direct antimicrobial effect on Mycobacterium tuberculosis. Single
Shimomura, a midwife or sanba, who faced a harrowing process of nucleotide polymorphisms (SNPs) in the VDR gene affect transcription
what the U.S. government called “evacuation” and “relocation” from levels and may affect the downstream production of intrinsic
the west coast to remote inland camps in the 1940s. Toku’s wartime antimicrobial peptides. Four vitamin D receptor restriction site
diaries humanize a tragic moment and provide evidence of how people polymorphisms that are associated with disease susceptibility or
coped with harsh and unhealthy living conditions. resistance were analyzed in a Dené, Cree and Caucasian cohorts. The
Dené maintain a significantly higher frequency of the Fok1 and Taq1
alleles (87% and 98%) associated with disease as compared to a Cree
cohort (56%, 84%) and both cohorts significantly from the Caucasian vitamin D deficiency. A recent meta-analysis concluded that low serum
(36%, 34%) cohort. The Apa1 and Bsm1 alleles associated with lower vitamin D levels are associated with higher risk of active TB.
functional expression were found in higher frequency among the Dené Objective: To analyse the potential association between vitamin D and
(71%, 93%) as compared to the Caucasians (49%, 59%) and Cree (51%, TB in Greenland with the aim of assessing whether vitamin D
68%). Given the important role of vitamin D as an effecter of supplementation could have a beneficial effect on Greenlandic people
macrophage function in limiting infections like tuberculosis, the high in terms of bracing their immune system to respond more efficiently to
frequency of SNPs that may limit the downstream function of vitamin TB infection.
D in the Dené cohort may in part explain the high rate of tuberculosis in
this population. Methods: A case-control study was designed by identifying TB patients
Contact: Linda Larcombe (larcombe@mts.net)
and controls from 13 districts in Greenland. 72 patients and 72 controls
donated a blood sample and their serum con-centration of vitamin D
was determined. Associations between vitamin D and TB were as-
REVIEW OF MANAGEMENT OF THE 2007 YELLOWKNIFE TB sessed using multivariate regression analyses.
OUTBREAK Results: Individuals with vitamin D concentrations < 80 nmol/L had a
E. Affleck 7.4 times (95% CI: 2.0 - 28) higher risk of being TB infected as
compared to those with 80-140 nmol/L (reference). Interestingly,
Yellowknife Health & Social Services Authority
individuals with vitamin D concentrations >140 nmol/L also had a
Objective: Over the spring, summer and fall of 2007 The Yellowknife higher (6.9 times, 95% CI: 1.9 - 24) risk of being TB infected (P=0.0019).
Health & Social Services Authority (YHSSA) was faced with an
Conclusion: Both low and high serum concentrations of vitamin D
outbreak of Tuberculosis (TB) stemming from an index case diagnosed
appear to be strongly associated with TB in Greenland.
in March of 2007. This index case first came to the attention of health
Contact: Nina Nielsen (nij@ssi.dk)
officials in September of 2006 when a CXR of the individual was read as
suspicious for tuberculosis. The individual remained undiagnosed for 7
months after the initial CXR, during which time he had contact with TUBERCULOSIS INFECTION AMONG INUIT CHILDREN IN
over 500 people. As a direct consequence of this case there have been GREENLAND
19 active cases of Tuberculosis diagnosed.
B. Søborg, A. Koch, M. Melbye, V.Ø. Thomsen, K. Ladefoged, M.
The fallout from this TB case has proven significant, having a direct Andersson, A.B.M. Andersen
effect on the health of the community and staff workload. The
objective of this study was to analyze the management of the index Statens Serum Institut, Department of Epidemiology Research
case in the 2007 Yellowknife TB outbreak in order to identify possible Tuberculosis remains a major public health problem in Greenland. A
deficiencies in care and opportunities for improved TB management. world-record in tuberculosis incidence recorded in 1952 (2,200 per
Methods: Tracer methodology was used to follow the management of 100,000) launched a systematic effort that reduced the incidence to
the index TB case from first presentation through to ultimate diagnosis approximately 10 per 100,000 in the mid-1980’ies. However, the
and initiation of treatment. For comparative purposes the index case incidence increased markedly during the 1990’ies. To determine
from a similar but much less significant TB outbreak from 2003 was whether the reported increase represents active M. tuberculosis
also examined with tracer methodology. Lastly the findings of these transmission an M.tuberculosis screening survey were performed
analyses were reviewed in light of a series of recommendations made among school children in Greenland.
in a report commissioned after a 2001 TB related death in the Objectives: 1)Examine the prevalence of M.tuberculosis infection
Northwest Territories. among children in Greenland, 2) Examine if prevalence of
Results: The cause of the TB outbreak in Yellowknife can be traced to M.tuberculosis infection differ depending on whether the gold
the breakdown of health service along the continuum of care. There standard Tuberculin Skin test or the Interferon Gamma release assay
were multiple occasions when the index case could have been, but was QuantiFERON-TB Gold are used.
not apprehended for treatment. Central to this failure of service Methods: 2,231 school children aged 5-17 years (~25% of the population
appears to be affective communication protocols between levels of in the relevant age group) from five towns in west, south and east
care and clearly defined and understood roles and responsibilities. Greenland were tested for M. tuberculosis infection using tuberculin
Discussion: As a result of this study a series of clear recommendations skin test and the Interferon Gamma release assay QuantiFERON-TB
are made to address deficiencies in the TB management system. Gold.
Contact: Ewan Affleck (ewan_affleck@gov.nt.ca) Results: Overall, 11.4 % of the tested children had at least one positive
test result. 8.9% of the children presented a positive QuantiFERON-TB
Gold test and 9.2% a positive tuberculin skin test.
TUBERCULOSIS AND VITAMIN D IN GREENLAND
The prevalence of a positive test result increased with age from 8.1 %
N. Nielsen1, T. Skifte2, A. Koch1, M. Andersson1, K. Ladefoged3 in the youngest to 19.9% in the oldest age groups (trend p<0.001).The
1
Department of Epidemiology Research, Statens Serum Institut, positive rate varied substantially by location (~2% in west Greenland
Copenhagen, 2National Board of Health in Greeenland, Nuuk, 3Medical and ~20% in south Greenland). Annual risk of infection was estimated,
Department, Queen Ingrids Hospital, Nuuk on the basis of a concordant positive result in both tests, to 0.8% per
Background: Tuberculosis (TB) is a major cause of illness and death year.
worldwide. In Greenland one of the highest incidences (2300 per Conclusions: With an estimated annual risk of M.tuberculosis infection
100.000) was found after the Second World War. Due to significant at 0.8% and an a overall prevalence at 11.4%, active transmission
national efforts, this incidence decreased substantially and reached in seems to occur at alarmingly high rates in present day Greenland and
1985 the lowest registered level of 25 per 100.000. Since then the urge the need for public health interventions. The prevalence was high
incidence has increased again to averagely 133 per 100.000 throughout irrespectively of screening test used, and overall test concordance was
the last 10 years. good. The new IGRA test performed well in school age children, with a
The TB pathogen Mycobacterium tuberculosis resides within low rate (1%) of indeterminate results.
Contact: Bolette Søborg (bot@ssi.dk)
macrophages. Para-doxically, macrophage activity is the first type of
defence against M. tuberculosis infection. The active metabolite of
vitamin D, 1,25-dihydroxyvitamin D, is a modulator of macrophage
function improving the ability of macrophages to inhibit the growth of
the mycobacteria. Hence, susceptibility to TB may be increased by
MANITOBA'S ABORIGINAL PEOPLE AND TB: HOW SOCIAL other foods, such as long transportation and arctic temperatures. They
CONDITIONS AND BEHAVIOURS CONTRIBUTE TO THE also cited factors influencing their decisions to stock and discontinue
ELEVATED RATES stocking foods, such as customer request and media promotion of
foods.
V. Maud
Conclusions: Several factors inhibit healthy eating for Inuit populations
University of Saskatchewan living in remote communities as identified by multiple community
The focus of this presentation is to explore the contemporary problem stakeholders. To ensure effectiveness and sustainability, Healthy
of TB in Manitoba among Aboriginal peoples. Aboriginal people have Foods North will address these factors, as well as utilize those factors
continually had elevated rates of infectious disease compared to that promote healthy food acquisition and consumption.
dominant society Petrelli et al. (2004). Acknowledgements: The research was supported by the American
A more extensive examination of incidence rates within particular Diabetes Association Clinical Research Award Grant # 1-08-CR-57.
subgroups of the population reveals the true nature of the disease in Contact: Erin Mead (sangita_sharma@unc.edu)
Manitoba. The incidence rate for tuberculosis for Canadian-born

treaty-status individuals was 48.4 per 100,000, a value more than ten
times higher than among Canadian-born non-treaty-status {sic} CLIMATE CHANGE IMPACTS AND ADAPTATION:
individuals (3.3 per 100,000) and more than double compared to IMPLICATIONS FOR DIET AND HEALTH IN TWO FIRST
foreign-born individuals (22.0 per 100,000). Interestingly, the rate for NATION COMMUNITIES IN THE YUKON, CANADA
Canadian-born treaty-status individuals in selected northern L.H.M. Chan, P. Tobin, C. Dickson
communities soars to more than 490 per 100,000. (Petrelli, D., Sharma,
University of Northern British Columbia
K., Al-Azem, A., Hershfield, E., & Kabani, A.) Strain-related virulence of
the dominant Mycobacterium tuberculosis strain in the Canadian Northern Aboriginal communities are particularly vulnerable to climate
province of Manitoba (Tuberculosis (Edinb). 84, 318). change due to their reliance on traditional food. Climate change can
affect food security by influencing species distribution, population
With the obvious elevate rate of disease, we must question as to why
abundance, morphology, behaviour, and community structure of
the rate persists despite the significant resources available to control
animal and plant species. Studying the effects of climate change in the
this disease. Therefore, it is critical we understand how social
north on Aboriginal peoples’ ability to locate and procure physically,
conditions such as inadequate housing and overcrowded living
socially, spiritually, mentally and economically important food sources
conditions; as well as social behaviors such as poor nutrition and
is critical.
smoking increase the TB. Without understanding and addressing these
conditions, it is unlikely that Aboriginal communities within Manitoba This project aims to determine if there have been changes to diet and
will experience a decrease in TB; in fact the rate will most likely health as a result of climate change and if so, what strategies have
escalate. people used to adapt to these changes. Four focus groups with 21
Contact: Velvet Maud (metis_333@hotmail.com) participants were conducted in October 2007 in the community of Old
Crow and another 4 focus groups with 49 participants were conducted
in May 2008.
Data collected from the focus groups included traditional food
VENUE 5 consumption, availability and access of traditional food, self reporting
Food Security #3 – Factors affecting Food Security of changes in the traditional diet and reasons for these changes. In
addition, 41 individual interviews were completed in Old Crow and
FACTORS INFLUENCING DIET AND THE FOOD information on traditional food consumption and self perceived
ENVIRONMENT IN TWO INUIT COMMUNITIES IN NUNAVUT: reasons for change in diet were noted as were hunting, fishing,
QUALITATIVE FORMATIVE RESEARCH RESULTS FROM trapping, and gathering practices. All data from the interviews was
entered into Epi-Info version 3.4.3 for statistical analysis. Preliminary
HEALTHY FOODS NORTH
results from data collection were recently presented back to the
E. Mead, M. Kratzmann, C. Roache, R. Reid, J. Ogina, J. Gittelsohn, S. communities and are currently being finalized.
Sharma
Results of this study will be useful for the planning of adaptation
University of North Carolina at Chapel Hill, Nutrition Research Institute, strategies to improve food security in the communities as well as the
Kannapolis, NC region.
Objective: To explore multiple community perspectives on the barriers Contact: Pam Tobin (ptobin0@unbc.ca)
and enhancing factors affecting food procurement and food stocking

in stores for Inuit populations of Nunavut, which could be targeted by
CLIMATE CHANGE AND FOOD SECURITY AMONG FEMALES
Healthy Foods North, a community-based nutritional intervention
program. IN AN INUIT COMMUNITY
Setting: Two remote Inuit communities in the Arctic region of Nunavut. J.D. Ford, M. Beaumier
Methods: Observational data were collected, and semi-structured in- McGill University
depth interviews were conducted with Inuit adults representing key The territory of Nunavut has the highest incidence of food insecurity in
people in the communities. The data were analyzed using the Canada, where over 50% of Inuit households are believed to experience
qualitative statistical software program N6 QSR NUD*IST. difficulties in obtaining sufficient food. This significantly exceeds the
Results: Forty-five Inuit participants (29 from community A, 16 from Canadian average of 9.2 %. Food insecurity is manifest when food
community B) were interviewed. Traditional “country” foods acquired systems are stressed such that adequate nutrition is not accessible,
through harvesting were considered the healthiest by community available, and/or of sufficient quality. Several studies have reported
members, but multiple factors inhibited their procurement, including food systems to be negatively affected by economic, social and cultural
high cost of gas and loss of traditional knowledge. The main barriers transformation and climate change. Inuit women have been identified
perceived by community members to purchasing healthy foods at the to be particularly vulnerable to food insecurity and more at risk to
stores included expense and quality. The community leaders and climate change. Food insecurity can have serious implications for
health staff identified multiple barriers to eating healthy in the women’s physical and mental health, and social well-being resulting in
community, such as lack of skills to prepare store-bought foods. Store increased susceptibility to infection and chronic health afflictions. This
managers identified several challenges to providing fresh produce and paper explores ways in which a rapidly changing climate in the High
Arctic impacts the food security of Inuit females in the community of with young children and provide meaningful information on the risk
Igloolik, Nunavut. Using a community participatory research approach, factors for food insecurity in Arctic communities.
various determinants of food security were identified, and the role of Contact: Grace Egeland (grace.egeland@mcgill.ca)
current and future climate change was assessed. Over 30 Inuit women
from the community of Igloolik, Nunavut, were interviewed. Health
professionals, Hamlet representatives, store managers and local HEALTH BELIEFS AND DIETARY COMPOSITION AMONG
organization members were also interviewed to get different INUIT LIVING IN NUNAVUT, CANADA
perspectives on this complex and multi-disciplinary problematic. S.G. Donaldson, N.C. Doubleday, A. Kushwaha, M. Ip, T. Vlasova, R.
Preliminary results highlight multi-level interactions between Pearce, A. Manning, B. Adlard, D.P. Charette, B. Grimwood, J. Van
biophysical and human determinants of food security, with multiple Oostdam
stresses interacting to create acute food insecurity among certain Healthy Environments and Consumer Safety Branch, Health Canada
community members. The identification of pathways through which
climate affects female food insecurity in the context of other stresses is Health professionals are challenged to provide culturally appropriate
particularly important for policy responses to strengthen Inuit food and relevant dietary advice in response to a number of environmental
security. changes from climate change to environmental contaminants in
Contact: James D. Ford (james.ford@mcgill.ca) traditional foods. In order to provide culturally relevant and effective
dietary advice, health professionals must have the best available data.
The objective of this paper is to examine the relationship between
INUIT WOMEN AND CLIMATE CHANGE health beliefs and diet selection. In-depth semi-structured interviews
Pauktuutit Inuit Women of Canada (n=101) were conducted with residents of Nunavut. The results of this
study show that the consumption of a traditional diet as well as the
Pauktuutit Inuit Women of Canada facilitated a dialogue with Inuit
process associated with harvesting traditional food are integral to the
women from across Inuit Nunaat about how climate change is
Inuit concept of health and well-being. Access was identified as the
affecting their lives. This gathering, held in Iqaluit, Nunavut, in March
major barrier to traditional food consumption. The results of this
2009, created an opportunity for Inuit women from all regions to share
research complement existing studies and could be integrated to
their insights and stories about how their lives have been impacted.
develop more effective dietary advice and health promotion activities
The discussions were also intended to develop research questions on
for people living in Arctic Canada.
gender and climate change in the Canadian Arctic for further in-depth Contact: Shawn Donaldson (Shawn_Donaldson@hc-sc.gc.ca)
examination. This presentation will include major issues and research
questions that were identified by the participants such as the impacts
of climate change on food security, gender roles, traditional THE IMPACT OF HELIOPHYSICAL FACTORS ON MAN
knowledge and activities such as harvesting and clothing production, LIFESPAN IN THE CIRCUMPOLAR REGIONS. PERSPECTIVES
as well as recommendations for future actions. OF USAGE OF THE HELIO-GEROPROTECTORS
Contact: Pauktuutit Inuit Women of Canada (tohearn@pauktuutit.ca)
A. Trofimov
International Scientific Research Institute of Cosmic Anthropoecology
PREVALENCE AND DETERMINANTS OF FOOD SECURITY
There investigated the author’s hypothesis for amount of the solar
AMONG INUIT HOUSEHOLDS WITH PRESCHOOL AGED
activity during man organism prenatal development, detecting gene
CHILDREN expression responsible for the level of metabolism and age processes
G. Egeland1, A. Pacey1, C. Huet1, C. Zhirong1, Qanuippitali Steering can restrict man lifespan in the circumpolar regions. The 1st stage
Committee (Nunavut)2 comprised examination of the persons of different age (n= 200) using
1
Centre for Indigenous Peoples’ Nutrition and Environment (CINE) & the unique computer program “Helios” in the middle latitudes. The
School of Dietetics and Human Nutrition, McGill University, 2DHSS, Gov. significant age differences in the mean levels of the solar activity
Nunavut, Nunavut Tunngavik Inc, Nunavut Association of Municipalities, (according to the Wolf’s numbers) during prenatal development were
Iqaluit, NT shown. At the age of 51-70 years W=88,4±8,4, at the age of over 70
years W=36,7±4,5 (p<0,05). It seemed man lifespan in the Far North is
A high prevalence of food insecurity has been noted in the few Arctic
associated with state of the heliophysical medium in the prenatal
communities which have participated in a food security assessment
period. At the 2nd stage there have been examined 280 persons,
raising concerns regarding the prevalence of food security throughout
residing in the high latitude settlement Dixon (in latitude 730 30’North).
the Arctic where unemployment rates and market food costs are
It was shown that maximum polar length of service and possible man
extremely high. Therefore, the prevalence and determinants of food
health reserves are detected at minimum solar activity in the 1st (r= -
security was assessed using the child component of the IPY Inuit
0,170), 7th (r= - 0,160) months of the intrauterine development and
Health Survey.
during the 1st year after birth (r= -0,140) (p<0,05). Some water helio-
The child survey was a cross-sectional survey of preschool children, geroprotectors, patented in Russia, have been developed and tested
aged 3-5 years, recruited through local health centre vaccination lists. for inhabitants of the circumpolar regions with high prenatal
A total of 383 Inuit children and their parents/guardians from 16 heliophysical activity. There observed the anti-aging trends in animals
Nunavut communities participated in the survey between August 2007 (rats) (n=30) intrauterinely developed at the high solar activity and
and September 2008. Bilingual and trained interviewers conducted after using the water protectors for drinking within a month. They are
interviews with the child’s caregiver and completed questionnaires an increased content of stable isotope of carbon 13C in tissues (wool)
about the child’s diet, health history, household conditions and food (p<0,05), usually, decreased at aging, increased level of blood
security. Food security was assessed using a USDA questionnaire that testosterone as well as decreased organism functional dependence on
had been slightly modified by Indian and Northern Affairs Canada intensity of the heliophysical factors (protons, electrons) during the
through consultation with Inuit community members. Correlates of period of examination. Thus, helio-geroprotective effect, being
food insecurity evaluated included household crowding, age and important for health preservation and enhancing of man lifespan in the
gender distribution of household members, social assistance and other northern regions of the planet is possible.
socioeconomic indicators, access to and consumption of traditional Contact: Alexander Trofimov (isrica2@rambler.ru)
food, region, and measures of child growth.
Results are embargoed until presentation to communities is completed
in May of 2009. Full details of results will be provided at the ICCH. The
data highlight the prevalence of food insecurity for Artic households
higher in comparison with Evens and Evenks. In all populations

VENUE 6 hyperinsulinemia was correlated with risk factors of cholelithiasis and
Chronic Diseases #1 IHD and contents of lipids in blood and bile.
Conclusion: The lipid-hormonal interconnections play basic role in
pathogenesis of cholelithiasis and IHD, substantially determining
INFLAMMATORY MARKERS FOR PATIENTS ISCHEMIC
prevalence of this pathology in Eastern Siberia.
HEART DISEASE (IHD) IN THE CONDITIONS OF YAKUTIA Contact: Ellina Lukicheva (rsimpn@scn.ru)
A.S. Golderova, C.D. Efremova, E.A. Lexeeva, A.N. Romanova
Establishment of RAMS, Yakutsk Research Center of complex medical
VITAL EXHAUSTION AND MYOCARDION INFARCTION
problems SB RAMS
(EPIDEMIOLOGICAL RESEARCH ON BASIS OF PROGRAM
Research of some authors are established that for Yakuts smaller WHO MONICA-PSYCHOLOGICAL)
frequency and the area of atherosclerotic defeats, and also “the slowed
down” rate of development of an atherosclerosis in comparison with V. Gafarov, E. Gromova, I. Gagulin, Y. Kabanov, A. Gafarova
unradical inhabitants. In our day, we’d received some facts about a Collaborative laboratory epidemiology cardiovascular diseases SB RAMS
considerable role of an inflammation in mechanisms of development of Purpose: We sought to examine the relationship between vital
an atherosclerosis. It is known that citokins regulate intercellular exhaustions symptoms and the risk of development myocardial
interactions, support a system and local inflammation in an infarction in 10 years among men ages 25 to 64 years old.
atherosclerotic plaque. A research objective - the comparative
characteristic of the maintenance of inflammatory markers at patients Methods: Within the framework of program WHO MONICA-
IHDin dependence about a national identity. 72 men (Yakutsk - 35, psychosocial was examined representative sample of men 25-64 years
Russian - 37) with verified diagnosis IHD at the age from 45 till 67 years old (1994 year). Total sample was 657 persons. Response 82.5%. Vital
which were in cardiological branch of Clinical centre RB - 1 - NCM have exhaustions symptoms were measured at baseline with the use of the
been surveyed. In whey of blood sick by a method immunofermated MONICA - psychosocial Interview Vital Exhaustion scale. The incidence
analysis have been defined level of C-reactive protein (CRP), new myocardial infarction was ascertained under systematic
proinflammatory cytokines - TNFα, IL-6, IL-1b, γ-IFN, antibodies A, M surveillance the 10-year follow-up. Cox - proportional regression model
and G (sets of firm of Joint-Stock Company “the Vector-Best” was used for an estimation of relative risk (RR).
(Novosibirsk, Russia). Statistical processing has been spent with the Results: Prevalence of vital exhaustion in cohort of men with
using of package SPSS-11.5. At patients IHD depending on a myocardial infarction was 65.8% (21.1% men with developed
nationality authentic distinctions are revealed under maintenance CRP. myocardion infarction had high level of vital exhaustion and 44.7% - an
At 78,8 % of Yakutsk of patients IHD level CRP exceeding “base” value average level of vital exhaustion). 64% men with developed myocardial
of 5 mg ml whereas at Russian such values meet in 91,2 % is marked. infarction had high level of vital exhaustion amongmen ages 55 to 64
At comparison of both groups concentration CRP authentically above years; on 16 % to groups 35-44 and 45-54 years and 4 % - 25-34 years.
at Russian, than in Yakutsk (9,7 ± 0,61 and 7,76 ± 0,56, expediently, p The relative risk of development of myocardial infarction within 10
<0,035). Level proinflammatory citokin IL-6 at Russian tends to years in group of men with high level of vital exhaustion, in comparison
increase in comparison with Yakutsk (8,6 ± 1,7 and 5,3 ± 0,74 pg ml). with group of men with low level of vital exhaustion was 2 times
Yakutsk habitants have a high value of an antibody of M in comparison higher. At research of a social gradient of men with MI, appeared, that
with Russian (1,94 ± 0,17 and 1, 44 ± 0,13 is revealed, expediently, at p men with a vital exhaustion have only initial educational level, the
<0,035). The obtained data of the preliminary analysis of inflammatory majority of them - pensioners. Most the high level of a vital exhaustion
markers at patients IHD testifies to distinction depending on an ethnic was found in groups dissolved, widows, and concerning a category
accessory which demand the further studying. “was never married”.
Contact: Aitalina Golderova (hoto68@mail.ru)
Conclusions: The received data allow to draw a conclusion, that the risk
of occurrence of myocardial infarction of a myocardium is connected
ASSOCIATION OF THE CONTENTS OF BASAL INSULIN WITH to presence of a vital exhaustion which directly is connected to the
social and economic status.
LIPIDE METABOLISM AND PREVALENCE OF Contact: Valery Gafarov (gafarov@ngs.ru)
CHOLELITHIASIS AND ISCHEMIC HEART DISEASE IN
POPULATION OF EASTERN SIBERIA
DO THE OBESE GREENLANDERS CONSIDER THEMSELVES
E.V. Lukicheva, V.V. Tsukanov, K.G. Nozdrachev, Y.L. Tonkikh, E.Y.
Kupershtein, E.P. Bronnikova, S.A. Dogadin OBESE? BODY SIZE PERCEPTION AND OBESITY IN
RELATION TO DEMOGRAPHIC FACTORS
State Medical Research Institute for Northern Problems, Siberian Division
of Russia Academy of Medical Sciences, Krasnoyarsk, Russia A.B.S. Nielson, N.K. Larsen, P. Bjerregaard
Aim: To study the metabolic factors, protecting native inhabitants of Centre for Health Research in Greenland, National Institute of Public
northern regions of Siberia from cholelithiasis and ischemic heart Health, University of Southern Denmark, Denmark
disease (IHD). Background: A recent survey revealed 53.6% Greenlanders to be
Methods: The epidemiological research of cholelithiasis and IHD in overweight. As opposed to the Westernised world overweight is well-
eight settlements of Evenkia and Yakutia was done, during which was established among well-educated Greenlanders. The ideal body image
studied health status of 1154 Evens and Evenks and 1591 Europoids. in affluent populations is generally slim (especially among women),
The definition of insulin contents by radioimmunne method in blood while it is more voluptuous in populations, where periodical food
serum, lipid contents of bile and spectrum of cholic acids of bile, scarcity has been, or is common. Obesity problems among
contents of lipids, spectrum of lipoproteins, neutral lipids and Greenlanders should therefore also been addressed in a cultural
phospholipids in blood serum and plasma by biochemical and context. This paper examines body-size perception among
chromatographic methods. Greenlanders and its relation to socio-demographic factors.
Results: The prevalence of cholelithiasis in Europoids was 8,8%, IHD - Methods: Analyses included 2,247 West Greenlanders, age >18 years,
18,8%, among Mongoloids these parameters were 1,5% (p<0,001) and from a cross-sectional study comprising para-clinical examination, an
10,2% (p<0,001). The contents of basal insulin in Europoids was interview including socio-demographic conditions, and a question-
64,31+3,29 pmol/l, in Mongoloids 40,61+1,24 pmol/l (p<0,001). The naire including 9 silhouette drawings ranging from very thin to very
content of total cholesterol in blood serum in Europoids was much obese (0-10). The participants were asked to identify their body figure,
ideal body figure, and subjective perception of own body size. We tapped authentically more often (p=0,004; r=0,05). During studying
examined, split by sex, the bivariate effects of BMI on body-size interrelation of LV geometrical types with a degree of CA
perception, and analysed whether the relation depended on age, atherosclerotic leisure heaviness authentic distinctions are revealed.
education and residence. So, in the patients not having critical CA stenoses or having 1-vascular
Results: The bivariate analyses showed that the identified body figure CA leisure, II geometrical type of LV is tapped authentically less often,
rose by increasing BMI levels: men classified as normal-weight, pre- than I type (LV normal geometry). The interrelation of LV IV
obese (25<BMI<30) and obese (BMI>30) chose figures 3.4, 4.9 and 6.0 geometrical type with multivascular CA leisure is revealed. Therefore,
(mean), whereas women chose figures 3.5, 4.9 and 5.9. A similar in patients with CAD in a combination with AH, having two-vascular
association was found for ideal body figure and BMI among women: and three-vascular CA leisure, authentically less often I geometrical
3.6, 3.9 and 4.5. The figure best depicting the ideal body was similar for type of LV in comparison with IV type is determined (p=0,02; r=0,05).
pre-obese and obese men (mean 4.3 vs. 4.5, p=0.11), whereas ideal The comparative analysis of structurally geometrical and functional
body differed among normal-weight and obese men (mean 4.0 vs. 4.5, parameters of LV in patients with 2-vascular and 3 vascular CA leisure
p<0.0001). has not revealed authentic distinctions between patients of
indigenous, and non- indigenous nationality of Yakutia.
The multivariate analyses revealed only age to be associated with ideal
body figure among men: ideal body image was larger among younger Conclusions: In patients with CAD in combination with AH of both
age-groups as opposed to 60+ years. No socio-demographic factors indigenous and non- indigenous nationality IV geometrical type of LV,
were associated with the ideal body image among women: only BMI being an adverse disadaptive remodelling variant of LV, prevails. At 2-
was in-fluential. vascular and 3 vascular CA leisure, LV IV type is tapped authentically
more often, than I type (p=0,02; r=0,05).
Conclusion: A larger ideal body figure chosen by younger men was Contact: Tatiana Romanova (roman-sargy@mail.ru)
unexpected, but may reflect being over-weight is more common in
Greenland than decades ago. Women’s preference of an ideal body
figure reflecting their BMI may indicate that obesity is not seen as SPECTRUM OF FATTY ACIDS IN BLOOD SERUM AND
unattractive. PREVALENCE OF CHOLELITHIASIS IN MONGOLOIDS AND
Contact: Anni B.S. Nielsen (abn@niph.dk)
EUROPOIDS OF SIBERIA
V.V. Tsukanov, E.Y. Kupershtein, Y.L. Tonkikh, E.V. Lukicheva, E.P.
STUDY OF LEFT VENTRICULAR STRUCTURALLY- Bronnikova
FUNCTIONAL CONDITION IN PATIENTS WITH CORONARY State Medical Research Institute for Northern Problems, Siberian Division
ARTERY DISEASE AND ACCOMPANYING ARTERIAL of Russia Academy of Medical Sciences, Krasnoyarsk, Russia
HYPERTENSION Aim: To analyze spectrum of fatty acids in blood serum and prevalence
T.A. Romanova, I.R. Petrova, V.V. Antipina, L.V. Tarabukina of chole-lithiasis in native and alien inhabitants of Eastern Siberia.
National centre of medicine Methods: The epidemiological research was performed by ultrasonic
scanning in 3648 patients (1652 Evenks and 1996 Europoids) in Evenkia
The purpose of research was studying interrelation of structurally
and for 2191 patient (1179 Khakases and 1012 Europoids) in Khakasia.
geometrical and functional parameters of left ventricular with a degree
In 220 patients (124 natives, 96 aliens) in Khakasia and 184 patients in
of atherosclerotic leisure of coronary arteries in patients with coronary
Evenkia (88 natives, 96 aliens) spectrum and contents of fatty acids in
artery disease (CAD) and accompanied arterial hypertension of
blood serum was determined by gas-liquid chromatography.
indigenous and non-indigenous nationality of Yakutia.
Results: The prevalence of cholelithiasis was 3,4% in Mongoloids and
Methods: 135 patients with CAD, stenocardia (from 1 to IV FC on the
7,3% in Europoids in Khakasia (p<0,001); in Evenkia these parameters
Canadian classification, 1972), small-locused and large-locused
were 1,5% and 8,8% accordingly (p<0,001). The ratio of saturated and
myocardial infarction and an arterial hypertension have been taken
non-saturated fatty acids in Euro-poids with cholelithiasis in Khakasia
into research. All patients have been distributed into 2 groups. The first
was 1,16; in healthy persons – 0,8 (p<0,001), in Khakases with
group included patients of a native nationality of Yakutia - Yakuts
cholelithiasis – 0,85 and in healthy Khakases – 0,56 (p=0,005). The ratio
(n=55), 2 group included patients of non-indigenous nationality of
of saturated and non-saturated fatty acids in Europoids with
Yakutia - Russia (n=80). ECHOCG was executed to all the patients by a
cholelithiasis in Evenkia was 1,13; in healthy persons – 0,94 (p=0,003),
standard technique on Acuson-128/XP-10, HDI-3000 (USA). LV
in Evenks with cholelithiasis – 1,01, in healthy Evenks – 0,85 (p=0,001).
hypertrophy was diagnosed at increase of IVS - thickness and LVBW -
thickness in the end of diastole more than 1,1 sm. For an estimation of Conclusion: Despite of significant differences in prevalence of
expressiveness of a myocardial hypertrophy, LV mass was counted cholelithiasis in populations of Mongoloids and Europoids, among
under R.B. Deveroux formula. LV myocardium mass index (LVMMI) patients with cholelithiasis the ratio of saturated and non-saturated
was counted on Fremingem criterion. The top border of LVMMI norm fatty acids in blood serum was increased in all popula-tions, that allows
for men - 143 g/m, for women - 102 g/m. 4 LV geometrical types were to consider this parameter as universal marker of lipid metabolism
allocated: I type- normal geometry of LV, II type - concentric disturbance in biliary pathology.
remodelling of LV, III type-concentric LV hypertrophy, IV type - Contact: Vladislav Tsukanov (rsimpn@scn.ru)
eccentric LV hypertrophy. Coronary angiography and left-

ventriculography on 2 - projective angiographic system “Axiom Artis
ADAPTATION OF CARDIOVASCULAR SYSTEM AT HIGH
BA” Siemens (Germany) was executed to all patients. Patients of I and
II groups were comparable on age, gender, CAD and AH duration, PHYSICAL ACTIVITY IN THE NORTH
maximal systolic and diastolic AP, CAD risk factors. However, acute S.G. Kriroschekov1, I.A. Pinigina2
failure of cerebral blood circulation and burdened heredity in patients 1
Institute of Physiology SB RAMS, Siberia, 2Yakuts Centre of Science,
of II group (Russia) was met authentically more often, than in patients Yakutsk (SB RAMS)
of II group (Yakuts).
In order to study structurally functional changes of cardiovascular
Results of research: research has shown, that the greatest number of system and metabolic indicators at going in for sports in the North, 146
patients with CAD in combination with AH of both indigenous, and men of the Yakut nationality (18-29 years) living in Yakutsk city have
non- indigenous nationality had the IVth geometrical type of LV, i.e. been surveyed. The basic group - sportsmen of high level of skill: free-
eccentric LV hypertrophy, as adverse disadaptive variant of LV style wrestling & boxing (n=108), control - not sportsmen (n=38).
remodelling. In patients with CAD and accompanying AH of non-
indigenous nationality, the II and III geometrical types of LV were
Methods: Anthropometry, arterial pressure (AP), echocardiography, Learning curves and evaluations related to the training will be
rheography, biochemical analysis of blood serum. The basic group has presented.
been divided into 2 subgroups depending on level of AP (group A, Contact: Brenda Roos (brenda_roos@hc-sc.gc.ca)
APsys from 110 to 130, group B, APsys more than 130 mmHg).
Results: The total cholesterol and low density lipoprotein (LDL) levels TRADITIONAL DIET FOR OBESITY AND DIABETES IN A FIRST
were low in the basic group (p=0,001), the index atherogeneity was
NATIONS COMMUNITY
above in control group (p=0,04). It is revealed the big average indexes
of a thickness of heart interventricular septum, left ventricular end J. Wortman
(LVE) systolic volume and diameter, LVE diastolic volume and First Nations and Inuit Health Branch, Health Canada
diameter, mass of myocardium in the basic group vs. control. While Canadian Aboriginal populations have high rates of obesity and type 2
indexing to surface of a body, all structural indicators were diabetes. Prior to European contact, West Coast First Nations ate a diet
authentically more in the basic group. Sportsmen had lower HR, of game, seafood and edible wild plants. Most of their calories came
systolic, diastolic and an average AP. The shock volume of LV was from fats including a unique marine oil derived from Oolichan fish. The
more in control group (p=0,01) but after indexation to the surface of a modern diet consists of traditional foods plus market foods of poor
body it was disappeared. The minute blood volume and the heart index nutritional quality. Most calories in the modern diet are derived from
were the greatest in control group, coinciding with the raised body refined carbohydrates in contrast to the low carbohydrate content of
weight (p=0,001). The regional vessels resistance (RVR) did not differ the traditional diet. Recent studies in generalized populations have
between investigated groups, but RVR index was bigger in the basic demonstrated that low-carbohydrate diets reverse the signs and
group (p=0,001). The comparison of structural indicators between A symptoms of obesity, metabolic syndrome and type 2 diabetes. A trial
and B subgroups revealed increased index of LV mass (p=0,01) and RVR of a modern diet based on the traditional diet of the Namgis First
(p=0,05) in group B. Nation was done to determine if it would benefit people with obesity
Conclusion: Playing sports in the North leads to specialized changes of and type 2 diabetes.
functioning of cardiovascular system, concerned with point of view on Methods: The study diet consisted of traditional foods plus market
“adaptation of function” and “sports heart”. Conditions of the North foods of similar macronutrient value. Subjects were recruited from the
can promote occurrence of changes at separate sportsmen (risk group) Alert Bay, Canada. After providing informed consent, subjects had
who are shown by disorder of hemodynamic parameters at baseline measurements for WBC, HgA1c and lipid profile. Blood
preservation of normal values of indicators of blood lipid profile. pressure, height, weight, waist and hip measurements were done at
Contact: Sergey Krivoschekov (krivosch@physiol.ru)
baseline and repeated over a 12-month period. Bloods tests were
repeated at 3, 6 and 12 months. Subjects were instructed in the diet
COMMUNITY DIABETES WORKERS COME TO LIFE and compliance was encouraged through follow-up visits, support
groups, community dinners and instruction sessions by the lead
B. Roos
investigator.
Health Canada, First Nations & Inuit Health, Atlantic Region
Results: Analysis of 40 subjects who had followed the diet for an
In September, 2006, 10 First Nations community health workers from average of 7.6 months demonstrated mean weight loss of 10.1% of
Nova Scotia (NS) and New Brunswick (NB) gathered at Metepenagiag body weight. Significant improvements were achieved in waist hip
Lodge to start Yellowquill College’s Community Diabetes Prevention ratio, HDL, triglycerides, triglyceride HDL ratio and cholesterol HDL
Worker (CDPW) Training. The group had four one week in class ratio. Among diabetics, HgA1c dropped a percentage point (p < 0.047)
sessions between September and June. Assignments and while medications were reduced or discontinued.
presentations were completed within their community throughout the
Conclusion: A dietary intervention based on a traditional dietary
program. The Elder ensured a cultural focus was weaved through the
pattern can deliver a significant improvement in weight, type 2
training. Tests and assignments evaluated the students to confirm they
diabetes and metabolic syndrome over a 7.6-month period. This type
met the required CDPW Core Competencies and Yellowquill College
of approach, which correlates a lifestyle change to the local heritage,
program requirements. Pre-Test/Post-Test scores showed a
may be useful in reducing obesity, metabolic syndrome and type 2
knowledge growth between 8% – 50% with an average of 24%. Only
diabetes in affected populations.
one student did not complete due to family commitments. Based on Contact: Jay Wortman (jay_wortman@hc-sc.gc.ca)
recommendations, the course is now completed in a six modular
training program. Eight First Nations workers from NS, NB, and Prince
Edward Island (PEI) graduated in June 2008. Pre-Test/Post-Test scores
showed a knowledge growth between 4% - 40% with an average VENUE 7
growth of 23%. Two students did not complete, one due to community Injury Prevention
staffing shortage, the other due to personal illness. Nine First Nations
& Inuit students from NS, NB, and Nunavik are scheduled to graduate
in June 2009. DROWNING PREVENTION IN THE NWT & NUNAVUT:
RESULTS FROM A THREE YEAR STUDY
Working collaboratively with the Inuit Diabetes Network and the
Nunatsiavut Government, an Inuit specific CDPW training was initiated A. Giles1, A. Baker2, D. Rousell1, G. Stadig1, M. Matt-Stotyn1
1
in Nunatsiavut. The Inuit community workers completed the six week University of Ottawa, 2University of Calgary
modular program through Yellowquill College. Eight graduates (one
The Government of the Northwest Territories’ (NWT) Department of
from each of the Nunatsiavut Inuit communities along with the
Health and Social Services has found that despite efforts at various
Regional Health Educator) celebrated their success in July 2008. The
forms of safety education, “the NWT is a risky place to maintain an
knowledge growth among this group ranged between 10% - 48%, with
active lifestyle” (Helwig, 2000, p. 5); certainly, this statement is
an average growth of 29%.
especially true when it comes to aquatic settings. The drowning rate in
The presentation will provide an overview of the planning process used the NWT and Nunavut is up to ten times the national average, with
and course overview. The focus of the presentation will come from a Aboriginal peoples drowning more often than non-Aboriginal peoples
student from each of the graduating classes highlighting some of their (NWT Health and Social Services, 2004; Waldram et al., 2006).
learnings, successes, and challenges throughout the training. They will According to the 2004 Injury Report in the NWT, drowning is the
describe their community diabetes work since graduation. Elder Josie second leading cause of accidental death in the NWT and is one of the
Augustine will also share cultural teachings related to diabetes. top four leading causes of death by unintentional injury in every age
group from 0 to over 65 years of age. Drowning statistics are less
readily available for Nunavut after 1999; however, research in the important to have an understanding of the demographic factors,
Kivalliq region from 1987-1999 corroborates trends found in the Injury mechanism, type and body system involved with injuries presenting to
Report in the NWT, specifically that drowning was the second leading hospital and community health centre in Nunavut.
cause of accidental death during that time period (Macaulay et al., Methods: Data was obtained from three sources: the discharge
2003). Over the past three years, our team has conducted a qualitative abstract database comprising inpatient and surgery separations from
research study in an attempt to understand why drowning rates remain the Qikiqtani General Hospital (2000-2006), reports of death from the
so high in the NWT and Nunavut, especially in light of the 41 year Chief Coroner, Nunavut (1999-2007) and injury presentations to a
history of the NWT Above Ground Pool Program. Participant community health centre in Nunavut (Canadian Hospital Injury
observation, archival research, semi-structured interviews, focus Reporting and Prevention Program, Public Health Agency of Canada).
groups, and oral histories were all used to gather data with residents of
five NWT and two Nunavut communities. Our findings suggest that in Results: Data from Qikiqtani General Hospital revealed that
order to facilitate stronger uptake of aquatics safety, programs need to approximately 68% of all injuries presenting to hospital occur in the 13-
engage with a postcolonial framework. Our presentation will outline 45 age group. The highest rate of injury is in the 20-29 age group with
what such an approach would look like in a Northern aquatics setting, 74 and 67 injuries/1000 population for non-suicide and suicide related
and will offer concrete, practical suggestions for both policymakers injuries, respectively. The type of injury was stratified by mechanism
and practitioners alike. (eg. assault, use of a powered vehicle, etc…) and age. Approximately
Contact: Audrey Giles (agiles@uottawa.ca)
81% of individuals who died from injury were male with 37% of all
deaths due to injury being accidental. Deaths were stratified by
mechanism and age. The community health centre data was analysed,
FIRST NATIONS AND INUIT CHILDREN AND YOUTH INJURY with 25 injuries per 100 population presenting to the community health
INDICATORS PROJECT centre on a per year basis. Approximately 68% of all injuries in this
setting occurred in males. Almost all of these injuries (97%) were
I. Pike
treated without transfer to a hospital and most (85%) were
Department of Pediatrics, University of British Columbia unintentional. The nature of the injury, body system and mechanism
Introduction: First Nations and Inuit children and youth experience a are described.
significantly higher rate of injury related death and disability than Conclusion: There is a high rate of intentional and non-intentional
other young people in Canada. An accurate determination of the injury occurring in Nunavut. Information from this report will be used
factors related to injury, and the ability to monitor trends and patterns to develop relevant community-oriented injury prevention strategies in
among First nations children and youth, will assist in prevention. The Nunavut.
goal of this project is to support the development of a team that will Contact: Christopher Sikora (csikora@ualberta.ca)
identify and develop national injury indicators specific to children and
youth in First Nations and Inuit populations.
Methods: In a previous project, 34 indicators were developed for
WORKER FATALITIES IN THE ALASKA TOURISM INDUSTRY:
children and youth in Canada through the use of a modified Delphi 1990-2008
process involving Canadian and International experts in injury P. Anderson
prevention research, policy and practice. A similar broad-based Centers for Disease Control/National Institute for Occupational Safety
modified Delphi process was used in a parallel project to develop and Health
indicators specific to First Nations and Inuit children and youth.
Background: Tourism is the second leading economic driver of the
Results: Representatives from the Assembly of First Nations, Inuit Alaskan economy and Alaska’s fourth largest employer. Each year, the
Tapiriit Kanatami, First Nations and Inuit Health Branch and others Alaskan tourism industry employs approximately 26,000 workers,
gathered in the spring of 2007 to identify key injury issues and key services nearly 2 million visitors, and generates over 2 billion dollars in
indicators for First Nations and Inuit children and youth. At that state revenue. Despite the socioeconomic importance of tourism,
meeting, 62 indicators were suggested. Feedback was obtained by fatality trends among these workers remain uncharacterized.
meeting with the Manitoba Community Wellness Working Group, Understanding fatality trends is a critical first step towards protecting
AFN’s First Nations Regional Injury Prevention Working Group, First Alaska’s tourism workers and a vital state industry.
Nations Early Childhood Circle, Chiefs of Ontario, and National Inuit
Committee on Health. Currently, 27 indicators for First Nations and Methods: North American Industrial Classification System codes were
Inuit children and youth have been defined and specified. used to query the Alaska Occupational Injury Surveillance System for
fatal events between 1990 and 2008. A case definition was then used
Discussion and Conclusions: Wider representation is being sought from to further isolate tourism cases. Detailed record review was conducted
the First Nations and Inuit communities to participate in a modified- to code specific injury mechanisms and risk factors in order to identify
Delphi process to ensure that the indicators that have been chosen are areas for prevention.
useful, and will prompt action to prevent injuries in First Nations and
Inuit children and youth. Availability of Inuit data continues to be a Results: From 1990-2008, 124 work-related deaths occurred in Alaska’s
challenge. tourism industry a fatality rate of 17/100,000 workers, just over 4 times
Contact: Ian Pike (ipike@cw.bc.ca)
the national average of 4.0/100,000 for all U.S. workers. The majority
(78%) of deaths occurred during the high tourist season from May to
September. In addition, 87 tourists were killed in these events. Most
A SURVEY OF INJURIES PRESENTING TO HOSPITAL AND A deaths occurred among Pilots (49%), Guides (27%), and Conservation
COMMUNITY HEALTH CENTRE IN NUNAVUT, CANADA and Enforcement workers (17%). The leading causes of death were
aircraft crashes (54%), drowning (12%), and falls (8%). Those killed in
C. Sikora1, C. Gregson1, T. Neily1, P. Tchouaffi1, G. Osborne2
aircraft crashes were being flown to sites in pursuit of hunting, fishing,
University of Alberta, Edmonton Alberta, Canada and wilderness travel (67%), wildlife conservation and enforcement
1
Department of Medicine, Faculty of Medicine and Dentistry, University work (19%), or sightseeing (10%).
of Alberta, Edmonton, AB, 2Department of Health & Social Services, Conclusion: Recreational tourism workers in Alaska encounter a fatality
Government of Nunavut, Iqaluit Nunavut, Canada rate 4 times the national average for all U.S. workers. As a result,
Introduction: National data has suggested that injury, both intentional Pilots, Guides, and Conservation workers represent high-risk
and non-intentional , in the Arctic is more prevalent than elsewhere in occupational groups in the Alaska tourism industry. Flying for the
Canada. Both suicide and non-suicide-related injury can be prevented. purpose of hunting, fishing, and wilderness travel is a source of
In order to develop effective injury prevention strategies, it is significant mortality in Alaskan tourism. Analysis of plane crashes
related to these activities is needed to identify practical strategies for Through the delivery of first aid training, water safety and drowning
prevention. prevention initiatives , disaster preparedness and violence prevention
Contact: Paul Anderson (PJAnderson@cdc.gov) education, the Canadian Red Cross has an extensive history working at
a community level in injury prevention. During this session,
representatives will outline the historical and current work of the Red
HEALTH HAZARDS OF THE ARCTIC/SUBARCTIC MOOSE Cross in the three Canadian Territories. Additionally, we will examine
R.A. Dieter, R. Dieter Jr., R. Dieter, D. Dieter the movement forward, towards the development of sustainable,
The Center for Surgery collaborative partnerships for the future enhanced capacity of
communities’ injury prevention efforts.
Introduction: Large animals roam free over the North American Contact: The Canadian Red Cross, Presenter TBA Western Zone (becky.row@redcross.ca)
countries including Canada and Northern United States. The moose is
one of the largest wild animal groups seen and may pose a number of
hazards to the human population. COMMUNITY-BASED PARTICIPATORY RESEARCH
Project: A 6 year review of the various Canadian and U.S. territories, APPROACH TO UNINTENTIONAL INJURY PREVENTION IN
provinces, and state populated by moose was conducted. The various THE YUKON
health hazards to the human were studied including the highway J. Butler Walker1, B. Hanley2
incidents, direct charging and consumption concerns. Motor vehicle- 1
moose accidents occur daily and thus create a significant risk to the Arctic Health Research Network – YU, 2Ministry of Health, Yukon
motorist. Surveys were conducted of the regional highway, safety, and Injuries are the leading cause of death across the Canadian North, yet
environmental departments for data in Canada and the USA. the populations at risk, as well as risk factors, including cross cultural
Results: Across northern North America, in Canada, Alaska and Maine a influences, remain to be systematically investigated. This presentation
large number of moose-vehicle accidents occur each year. The death will describe the community-based participatory research approach
toll, injury, and property damage as a result of this long legged animal being implemented in the Yukon, with a focus on unintentional
crossing the highways is immense. For example, 600 or more such injuries.
Contact: Jody Butler Walker (jody@butlerwalker.ca)
accidents occur each year in Alaska with the possibility of injury or
death to the human. Automobile damage may run into the billions.
The results for each province or state were tabulated to demonstrate
the significant risk.
Conclusion: Health hazards of the Canadian and U.S. arctic and SESSION 5
subarctic motor-vehicle moose accidents persist. Better monitoring
and reporting systems are necessary to properly quantify this huge
Monday, July 13, 4:00-5:30 PM
risk. In addition, new and improved techniques to avoid the moose-
motor vehicle collisions are a requirement for the safety of the
northern inhabitants. VENUE 1
Contact: Raymond Dieter (tfato@centerforsurgery.com)
Mental Health & Wellness #3 – Trauma at the Front Line
HEALTH HAZARDS OF NORTH AMERICAN ANIMAL VEHICLE MENTAL HEALTH AND ADDICTIONS IN THE NORTHWEST
ACCIDENTS TERRITORIES: PERSPECTIVES FROM THE FRONTLINE
R. Dieter, R.A. Dieter Jr., L. Gulliver, L. Murawski, D. Carlino, B. Dieter SERVICE PROVIDERS
The Center for Surgery A. Kronstal
Introduction: Human transportation more and more depends on University of Victoria
motorized vehicles traveling at high speeds with little maneuverability Much attention has been paid in recent years to the impacts of rapid
in short time and space periods. Thus highway and air collisions change in the Canadian North. Discussions on this topic often turn to
continue to escalate in number and human risk. how social and economic changes may be affecting the health and
Study: Extensive highway records were developed to show the number social wellness of communities, particularly in terms of community
of miles traveled, animal collisions and relation to time of day. Further, mental health and rates of alcohol and other drug use.
air incidents were monitored as to the cause and result. It is within this context that I have undertaken exploratory research to
Results: Each day throughout Canada and northern USA, a large determine 1) the perspectives of community-based mental health and
number of accidents occur whether on land or in the air. Most such addiction professionals in the Northwest Territories (NWT),Canada on
accidents lead to no health nor serious physical damage. However, the state of mental health and wellness in communities; and, 2) how
these incidents may lead to serious health or death consequent to the such professionals conceive of current change in the territory in
trauma. Completion of these results and the billions of dollars involved relation to their professional practice.
show the continued high risk of large birds to airlines or animals on the In this presentation, I first provide an overview of the research
highway. Data demonstrates the health concerns. questions and methodological approach for this research as well as an
Summary: Daily human heath risks develop suddenly and account of findings from in-depth qualitative interviews with 16
unrepentantly on the road or in the air as a result of domestic wild community mental health and addiction professionals from across the
animals and birds. New programs and techniques are necessary to NWT conducted in the spring and summer of 2008. I also discuss key
reduce the incidence. themes emerging from interviews in the context of current policy and
Contact: Raymond Dieter (tfato@centerforsurgery.com) health infrastructure in the Northwest Territories.
My inquiry is part of a multi-disciplinary research program for
International Polar Year entitled “The impacts of oil and gas activity on
THE CANADIAN RED CROSS EXPERIENCE IN INJURY peoples in the Arctic using a multiple securities perspective” (GAPS).
PREVENTION Given that my research is undertaken as part of this larger initiative, I
Canadian Red Cross (Presenter TBA) also discuss the collaborative measures I took to ensure local priorities
The Canadian Red Cross are reflected in the wider multi-disciplinary, multi-country research
project.
Contact: Alana Kronstal (akronstal@gmail.com)

Centre of Sámi Health Reserach, University of Tromseo
Objectives: To investigate the prevalence of self-reported experiences
BEYOND VICARIOUS TRAUMA - HELPING OURSELVES AS of ethnic discrimination and bullying among Sámi and non-Sámi
WE HELP OTHERS adults.
J. De Luce Methods: SAMINOR is a population-based study of health and living
conditions that was administered in 2003(4) in 24 different Norwegian
Private Practitioner
and Sámi populated municipalities within central and northern
There exists unfixable suffering. Those of us who have trained and Norway. This analysis was based on 12265 men and women aged 36-79
chosen the helping professions will see it. We will also at some point years. Ethnic distribution was Sámi (33 .1%), Kvens (7.8%) and the
experience vicarious trauma as a result of exposure to unfixable ethnic Norwegian majority (59.1%).
suffering as a part of our chosen professional life. How can we provide
Results: Overall, Sámi and Kven respondents reported more ethnic
care to those affected by these life tragedies and still maintain our
discrimination and bullying in general than ethnic Norwegians
ability to care, our zest for life and our desire to work creatively in
(p<0.001). The reporting was highest among the younger participants
highly challenging circumstances? How might one accomplish this? Is
(p<0.001). Men reported more ethnic discrimination than women,
transcendence possible? What is transcendence when facing unfixable
while women reported more bullying. Respondents with the strongest
suffering? How do we work with those areas that are amenable to
Sámi affiliation reported higher levels of ethnic discrimination outside
intervention knowing some may never be, without feeling demoralized
the Administrative Area, while respondents with weak Sámi affiliation,
or as though we have lost a part of our soul? The speaker will discuss
Kvens and ethnic Norwegians, reported higher levels inside this
what she has learned from her clinical practice, the research of others
district. Among the respondents that reported bullying previously, the
and her own research that helps us do more than survive in difficult
most common type was discriminating remarks and the most common
times, it may be possible to thrive despite unfixable suffering.
Contact: Jamie De Luce (jamie1952@shaw.ca)
location was public schools. For those who reported bullying in the past
year, the most common types were gossiping and discriminating
remarks, and the most common locations were at work and in the local
SECONDARY TRAUMA AND NORTHERN HELPING community. Two out of three of those reporting ethnic discrimination,
PRACTITIONERS independent of ethnicity, also reported bullying.
L. O’ Neill Conclusions: The findings from this study show that the Sámi and Kven
population more often experience bullying and ethnic discrimination
University of Northern British Columbia
than ethnic Norwegians. These results are consistent with experiences
Secondary Trauma and Northern Helping Practitioners from other minority and marginalized groups that experienced
This research study considered the experience of northern helping colonization. More research is needed to understand the role bullying
practitioners in providing trauma support in isolated communities in and ethnic discrimination play in the wellbeing and health of the Sámi
northern BC and Yukon. In these communities, access to specialists in and Kven population.
Contact: Ketil Lenert Hansen (ketil.lenert.hansen@ism.uit.no)
the field of trauma counselling is severely restricted due to distance
from main centres. Economic and cultural factors leave the support of
survivors of trauma to helping practitioners in various fields with
MEASURING THE HEALTH EFFECTS OF HISTORICAL AND
varying levels of training and supervision (Boone, Minore, Katt, &
Kinch, 1997; Trippany, Kress, & Wilcoxon, 2004). Many northern
CONTEMPORARY CULTURAL LOSSES
communities have experienced historical trauma and continue to L. Whitbeck
experience intergenerational trauma, contributed to by current University of Nebraska-Lincoln
psychosocial conditions linked to the legacy of colonization (Brave
Measuring the Health Effects of Historical and Contemporary Cultural
Heart, 2003; Duran, Duran, Brave Heart & Davis-Yellow Horse, 1998;
Losses Les B. Whitbeck University of Nebraska-Lincoln Rapid cultural
Tafoya & Del Vecchio, 1996). In remote communities, helping
changes induced by climate change and infringement on traditional
practitioners may be working in their home communities, sometimes
circumpolar cultures by the outside are likely to have consequences on
sharing similar trauma experiences to that of their clients (Morrissette
the well-being of Indigenous adults and adolescents. These
& Naden, 1998). Helping practitioners in the North are also hired from
consequences may include psychological and substance use problems,
“outside” to provide service to communities, arriving with limited
suicidal ideation and behaviors, and stress-related physical illnesses.
knowledge of the specific context of the communities. These helping
Yet the measurement of cultural losses is still in its earliest stages.
practitioners may be put at personal and professional risk of
There is a need to develop and share measures of cultural loss across
developing secondary traumatic symptoms from repeated exposure to
Indigenous cultures so that a cumulative body of research can be
clients’ trauma in the helping relationship (Baird & Jenkins, 2003).
developed. Using measures we developed to assess the stress effects
Using a narrative inquiry process, the stories of eight helping of historical losses among North American Indigenous people as a
practitioners were analyzed using a three phase analysis based starting point, we propose the development of uniform measures of
developed by Lieblich, Tuval-Mashiach, and Zilber (1998). The historical and contemporary cultural losses. This presentation will
narratives were summarized into experience portraits that were then describe our measure of historical loss and provide an overview of its
analyzed for content and change processes. The themes that emerged factor structure for adults and adolescents. Our approach has been to
from the data indicated the effects on practitioners and the strategies focus on recalled historical losses and the degree to which recurring or
used by practitioners in maintaining their ability to practice under intrusive thoughts about these losses impinge on moods and behaviors
challenging conditions. Ten categories provided a structure for (Whitbeck, Adams, Hoyt, & Chen, 2004). We dealt with the problem of
arranging the data. Five metathemes were interpreted from the history in terms of specific past losses identified in focus groups with
narratives: helping takes over life, humanity, respectful engagement, Indigenous elders. Then, similar to measures of stress-related trauma,
invested and embedded, profoundly affected, and belief. we asked how often the individual thinks about these losses: Never,
Contact: Linda O’Neill (loneill@unbc.ca)
yearly or only at special times, monthly, weekly, daily or several times
a day. The underlying assumption is that thoughts pertaining to losses
daily or several times a day may be intrusive and affect moods. The
ETHNIC DISCRIMINATION AND BULLYING IN THE SÁMI AND
presentation will conclude with mental health, substance abuse, and
NON-SÁMI POPULATIONS IN NORWAY: THE SAMINOR health correlates of the measure among Indigenous people and the
STUDY potential for use of similar methods for assessing the effects of
K.L. Hansen, M. Melhus, A. Høgmo, E. Lund progressive cultural losses among circumpolar Indigenous peoples.
Contact: Les Whitbeck (lwhitbeck2@unlnotes.unl.edu)

hear messages promoting STD/HIV testing and condom use; easier
access to condoms is needed; there is a basic understanding of sexual
health, but adolescents have a lot of unanswered questions pertaining
VENUE 2 to STD/HIV; alcohol and drug use affect sexual behavior and risk
taking; and issues of confidentiality and embarrassment affect
Sexual Health #1 healthcare seeking behaviors for sexual health issues.
Conclusions: One of the fundamental principles of public health
LIFE QUALITY IN HIV-INFECTED GREENLANDERS practice is community participation, which asserts that success in
M. Rydbacken, K. Ladefoged achieving change is enhanced by the active participation of the
Medical Department, Queen Ingrid’s Hospital, Nuuk, Greenland intended audience in defining their own high-priority solutions. Our
findings—driven by the youth themselves—will be critical in designing
Greenland is a huge country with approximately 56000 inhabitants and implementing future sexual health interventions and could
living in small towns and settlements scattered along the coastline. promote greater community involvement and acceptance.
Since 1986 all HIV infected patients in Greenland have been Contact: Jessica Leston (jdleston@anmc.org)
anonymously registered in a central database at the Chief Medical
Office in Nuuk. This cohort comprises 152 patients. Ninety-four % of
the patients were Inuit, and 84% were infected in Greenland. Thirty-six COMING OF AGE: HOW YOUNG WOMEN IN THE
% were women, 83% were heterosexually infected, 15% homosexually NORTHWEST TERRITORIES UNDERSTAND BARRIERS AND
infected and 2% were infected by i.v. drug abuse. The median age at FACILITATORS TO POSITIVE, EMPOWERED, AND SAFER
diagnosis was 52 years. Treatment with HAART was commenced in SEXUAL HEALTH
1996 and treatment schedule follows international recommended
C. Lys
guidelines. Compliance has been a great problem and, although
improving, treatment results are still not quite as good as e.g. in Dalhousie University
Denmark. It has been an impression that the main part of HIV infected Compared to other Canadian youth, young people in the Northwest
Greenlanders belongs to socially marginalized subpopulations Territories (NWT) suffer disproportionately from more negative sexual
burdened with poverty, unemployment and alcoholism, but a specific health outcomes, such as high rates of Sexually Transmitted Infections
study of living conditions and life quality in these patients has never (STIs) and adolescent pregnancy. Although numerous quantitative
been performed. In 2008 there were 65 surviving HIV infected patients. studies measure indicators of sexual health amongst NWT youth, little
Most patients were living in the two major cities Nuuk and Sisimiut. qualitative research explores the barriers and facilitators that impede
The survivors were included in a life quality survey. Based on interviews or support their ability to achieve positive, empowered, or safer sexual
a questionnaire was fulfilled with registration of demographic data, health outcomes. The purpose of this study was to explore the self-
housing conditions, educational background, employment status, perceived barriers and facilitators that impact female youth in the
financial situation, social life, impact of the HIV diagnosis on NWT, as this demographic has one of the highest vulnerabilities for
psychological well-being and on relation to friends and family, alcohol STIs and unintended pregnancies and represents the fastest growing
and tobacco consumption, sex life and sexual issues, health and population for HIV/AIDS transmission in Canada. Recruited through
treatment, contact with health services etc. purposive sampling, 12 female participants aged 15-19 who live in the
The study will be completed during the spring 2009. The result will be NWT and mostly or always have relationships with male partners
presented and discussed. participated in audio taped, semi-structured, face-to-face interviews
Contact: Karin Ladefoged (kala@peqqik.gl) that followed a constructivist framework. Using qualitative data
analysis software, inductive coding and thematic analysis of
transcribed data occurred. Results of this research increase
AN ADOLESCENT FOCUS GROUP PROJECT ON SEXUALLY understanding of the self-perceived barriers and facilitators to positive
TRANSMITTED DISEASE, HIV/AIDS, AND UNPLANNED sexual health for young women in the NWT, thus potentially aiding in
PREGNANCY the development of appropriate and effective health promotion
initiatives and programs for this population.
J. Leston
Contact: Candice Lys (candice.lys@gmail.com)
Background: The disparity in sexually transmitted disease (STD) rates
HIV/AIDS AND THE LIFESAVERS CAMPAIGN: PREVENTION
between Alaska Native and non-Native populations, particularly
among young adults and females, is significant and concerning. Many AND EDUCATION ACROSS INUIT NUNAAT
factors may contribute to high rates of STD, including social and Pauktuutit Inuit Women of Canada.
cultural factors, geography, and access to care. However, there is Pauktuutit has been a leader in innovative and creative approaches to
limited published data on the contribution of these factors to sexual raising awareness and addressing these issues in an Inuit-specific
health and STD transmission in Alaska Native populations. To better context, and has become a credible and valued partner to many Inuit
understand the impact of different factors on sexual health and STD in communities, organizations and governments. One notable and very
this population, the Alaska Native Tribal Health Consortium (ANTHC) successful initiative is the multi-faceted ‘Livesavers” project, which
STD Program conducted a series of focus groups to guide the continues to raise awareness about HIV and AIDS in Inuit communities.
development of culturally appropriate, community driven sexual health Products since the mid-1990s have included school-based HIV/AIDS
interventions. Fairs, posters and ‘country food’ flavours of condom covers. Policy and
Methods: A convenience sample of Alaska Native adolescents (n=105) substantive direction is provided by the Canadian Inuit HIV/AIDS
from five rural communities in Alaska, ages 15-24, participated in 21 Network (CIHAN), a nationally representative community and
focus groups. Focus group participants were divided by sex and age. regionally-based advisory committee comprised of Inuit policy and
We assessed themes related to knowledge and beliefs about STD, program experts, community activists and Inuit living with HIV and
HIV/AIDS, and unplanned pregnancy, as well as perceptions of how AIDS. The focus to date has been on individuals and communities,
adolescents prefer to learn about sexual health issues. front line workers and health service providers, as well as provincial,
Results: The major themes identified were: STD/HIV and unplanned territorial and federal policy and decision makers. Emerging issues
pregnancy messages are viewed within a framework of disease include sexual health in relation to resource extraction and economic
prevention and health protection activities; sexual health messages development initiatives across the Arctic, and urban issues such as the
should be delivered via the internet and school; young adults want to need for interventions targeted to Inuit in the sex trade, and
intravenous drug use. Pauktuutit will provide an overview of more than (population 2,000). During 8 weeks of participant observation, in-depth
a decade of advocacy and prevention and education strategies, as well interviews were conducted with 20 female and 20 male English-
as challenges and future opportunities to prevent the spread of HIV in speaking adolescents (aged 15 – 19 years) with varied socio-cultural
Inuit communities, including urban communities, in Canada. and economic backgrounds and diverse contraceptive experiences.
Contact: Pauktuutit Inuit Women of Canada (tohearn@pauktuutit.ca) Interviews were also conducted with 9 health care and social service
providers. Findings suggest the presence of barriers that are related to
both individual knowledge, attitudes and decision-making as well as to
SOCIAL AND CULTURAL FACTORS INFLUENCING SEXUAL social interactions and constraints within the healthcare setting. These
HEALTH IN GREENLAND barriers include lack of timely and appropriate information on
D. Gesink-Law, E. Rink, R. Montgomery-Andersen, S. Montgomery- contraception, myths regarding side effects of contraception, lack of
Andersen, U. Poppel, A. Binzer, A. Koch, S. Skov-Jensen, G. Mulvad convenient clinic appointment times, scarcity of physicians for
University of Toronto prescribing contraception, lack of interpersonal skills related to
negotiating contraception use, high cost of contraception and
Background: Our objective was to identify the social, cultural, and geographic barriers to health service access are negatively impacting
behavioural factors influencing sexual health and sexually transmitted contraception use among northern adolescents. In conjunction with
infections (STIs) in Greenland. the local health authority, city council, Aboriginal leaders, the non-
Methods: 149 Nuuk residents between 15 and 65 years of age were profit agency OPTions for Sexual Health and local community
recruited to answer an interviewer-administered sexual health survey members, we are facilitating the identification and implementation of
and be tested for chlamydial infection, gonorrhea, and mycoplasm creative adolescent-oriented contraception-related interventions that
genitalium. Descriptive statistics were used to summarize sexual are sustainable, realistic and most importantly, community driven.
health responses and STI Results: Regression modeling was used to Contact: Judith Soon (jasoon@interchange.ubc.ca)
determine which factors were associated with infection.

Results: 18% of participants tested positive for an STI at the time of
interview (8% Chlamydia, 7% mycoplasm, 3% gonorrhea). 75% of the VENUE 3
male cases were Greenlandic although only 45% of all male
participants were Greenlandic. This imbalance did not exist for
Genetics
Greenlandic women. 70% of women and 58% of men had an STI
previously. 60% of women and men totally trusted their partners and ASSOCIATION BETWEEN PERIODONTITIS AND
the primary reason why participants had not used a condom in the past RHEUMATOID ARTHRITIS IN CREE AND OJIBWAY
was because they “felt connected to that partner and trusted partner POPULATIONS: A STUDY OF GENE-ENVIRONMENT
was safe”. Men were more likely to drink and have sex than women. EFFECTS
Men were also more likely to report that their decision to have sex was
influenced by being drunk. Women more frequently reported that H. El-Gabalawy
alcohol affected their ability to make good sexual decisions. The University of Manitoba
majority of both men and women were 15 to 16 years old when they Background: Indigenous North American native populations have
first had sex. 30% of women and 17% of men had experienced forced amongst the highest prevalence rates of rheumatoid arthritis (RA) in
sex in their lifetime. When Nuuk adolescents and adults were asked the world. In populations such as the Cree and Ojibway tribes, RA is
where they learned about contraception, HIV and other STIs, home familial, starts at a young age, and is clinically severe and progressive.
ranked third, after school or work (1st) and out in the community (2nd). Anti-citrullinated protein antibodies (ACPA) are specific for
Conclusions: Social and cultural norms around sexual health rheumatoid arthritis (RA), and precede the onset of clinically
communication, trust, drinking and sex appear to influence individual detectable disease. Periodontitis is a prevalent oral chronic disease
sexual behaviours and risk for STIs. that has long been associated with RA. The pathogen porphyromonas
Contact: Dionne Gesink Law (dionne.gesinklaw@utoronto.ca) gingivalis (PG), a common etiologic agent of periodontitis, has been
proposed to be involved in breaking tolerance to citrullinated antigens.
To address this hypothesis, we studied a cohort of Cree and Ojibway
THE IMPORTANCE OF COMMUNITY INVOLVEMENT IN First Nations RA patients and their first degree relatives (FDR) in
IDENTIFYING BARRIERS TO CONTRACEPTIVE USE AMONG Central Canada, looking for associations between anti-PG antibodies,
ADOLESCENTS IN RURAL AND REMOTE SETTINGS RA antibodies, predisposing HLA-DRB1 alleles, and symptoms of oral
J. Soon1, J. Shoveller2, J. Reade1, M.E. Kelm3, N. Hanlon4, J. Johnson5 and articular pathology.
1
University of British Columbia Faculty of Pharmaceutical Sciences, Methods: Cree and Ojibway RA patients (n=82) from Central Canada
2
University of British Columbia School of Population and Public Health, and their FDR (n=205) were evaluated with questionnaires and joint
3
Simon Fraser University History Department, 4University of Northern examination. Questions regarding oral hygiene and joint symptoms
British Columbia Geography Department, 5University of British Columbia were included. Serum samples were tested for anti-CCP2 antibodies
School of Nursing (IgM, IgA, IgG1-4 isotypes) by ELISA, IgM and IgA RF by nephlometry
and ELISA, respectively. IgG antibodies to PG lipopolysaccharide (anti-
Across Canada, many adolescents experience serious health and social
PG) were tested by ELISA. HLA-DRB1 testing was performed by
problems related to early unintended pregnancy and sexually
sequencing.
transmitted infections. Despite public health initiatives, pregnancy
rates among teens in northern British Columbia are 60% higher than Results: Demographics of RA vs. FDR: age=47 vs. 37, p<0.001;
the provincial average. Determining the barriers to the use of females=90% vs. 72% p<0.01. Autoantibodies in RA vs. FDR: ACPA
contraception among teens at risk of unwanted pregnancy has (any isotype)=91% vs. 19%; IgM RF=82% vs. 17%; IgA RF=48% vs. 22%,
important health policy implications. Barriers such as social attitudes, all comparison p<0.001. Of the individuals who were seropositive for
beliefs about risk-taking, and where adolescents live can affect their ACPA and/or RF, the mean titers of the autoantibodies were
experiences accessing contraception. Our project involves addressing significantly higher in RA compared to FDR. Titers of anti-PG
and removing these barriers by working with community members to antibodies were also higher in RA vs. FDR (p=0.002), and were higher in
create sustainable and relevant interventions. Thus, this study utilized ACPA + vs. ACPA- RA (p=0.02) and FDR (p=0.002). In contrast, anti=PG
qualitative research methods grounded in participatory action, with titers were comparable in RF+ and RF- patients and FDR. Analysis of
ongoing meetings with the community-based advisory group. self-reported symptoms of poor oral hygiene did not demonstrate an
Ethnographic fieldwork was employed in a northern rural community association between these symptoms and ACPA, RF, or anti-PG.
ACPA+ FDR tended to see a dentist less frequently than those without indigenous populations. After the introduction of the Human Genomic
this autoantibody. Hand symptoms potentially suggestive of early RA Diversity Project in 1991, indigenous communities around the world
were present in 54% of FDR, although these symptoms did not are demanding more input and control over the research conducted
correlate with autoantibodies or oral hygiene symptoms. Analysis of with and within their communities, especially when related to genetics
HLA-DRB1 allele status indicated that 81% and 73% of RA and FDR or genomics. Researchers are no longer allowed to conduct studies in
respectively, were shared epitope (SE) positive (p=NS). FDR with 2 these populations without the development of close mutual
alleles were much more likely to have ACPA (OR 10.6 p=0.001), relationships. However, the spectrum of participation and
although there was no association between SE status and anti-PG collaboration varies widely. The goal of this paper is to review
immune response. published American Indian and Alaska Native community based
Conclusions: In a high risk population of the relatives of First Nations participatory research related to genetics and genomics. Community
RA patients with a predisposing genetic background, anti-PG based participatory approaches will be integrated with international
antibodies were associated with ACPA, although not with RF or SE ethical principles, while public health/ genomic initiatives will be
alleles. These findings suggest that ACPA and immune responses to considered for recommendations for future genetic/genomic research
PG antigens may develop in parallel, although the role of PG in in these Indigenous communities.
Contact: Darlene Perkins (perkinsd@mail.nih.gov)
breaking tolerance to citrullinated antigens needs further study.
Contact: Hani El-Gabalawy (elgabalh@cc.umanitoba.ca)
GENETIC VARIABILITY IN CIRCADIAN RHYTHMS IN AN

EXPLORING THE IMPACT OF LONG QT SYNDROME IN A ARCTIC MAMMAL THAT MAY HAVE HEALTH IMPLICATIONS
BRITISH COLUMBIA FIRST NATIONS COMMUNITY FOR PEOPLE LIVING IN CIRCUMPOLAR REGIONS
L.A. Huisman1, L. Arbour1, R. McCormick2 A. Bult-Ito
1 2
Department of Medical Genetics and Department of Counseling University of Alaska Fairbanks
Psychology, University of British Columbia About 24-hour (circadian) rhythms are expressed by most organisms
Background: Some First Nations families in Northwest, BC are affected on earth, including humans. As a result, the adaptive significance of
by the same novel genetic mutation that predisposes them to Long QT circadian rhythms has been almost universally assumed but has rarely
syndrome (LQTS) - a genetic heart disease putting individuals at been tested. For circadian rhythms to be evolutionarily relevant, they
increased risks for irregular heart rhythms and sudden death. have to reveal genetic variability that natural selection can act upon.
Unfortunately, natural variation in genes regulating circadian rhythms
Previous studies on LQTS in this community focused on biological
in natural mammalian populations is a virtually unexplored field. My
aspects. This study explores the personal impact of LQTS, with the
research lab has developed selected lines of wild-caught Alaskan
understanding that results will inform genetic counseling. Western
northern red-back voles, Clethrionomus rutilus, for circadian
counseling techniques may not be entirely appropriate for First Nations
organization of wheel-running activity. We have now completed 5-6
patients, who have significantly different notions of healing and unique
generations of selection for strong circadian activity rhythms in
worldviews. This project explores what facilitates and hinders
constant dark conditions (DD), i.e., the circadian line, and for loss of
resiliency when learning about a LQTS diagnosis, adding psychological
circadian rhythms in DD, i.e., non-circadian line. This selection has
support dimensions to the existing clinical study.
resulted in a 2.5-fold difference in circadian robustness of circadian
Aims: activity rhythms in DD between the circadian and non-circadian vole
- Characterize health and psychological needs of lines. Therefore, circadian organization of locomotor activity in voles
individuals/families shows considerable natural genetic variability that artificial or natural
- Explore what facilitates or hinders resiliency and coping for selection can act upon.
individuals/families. Circadian rhythms are very important for human health. Circadian
- From a cultural context, understand the impact of having LQTS rhythm dysfunction is associated with seasonal affective disorder
and concerns for the next generation. (SAD), depression, and other mental illnesses. Suicides and depression
Methods: Three participatory research methods were available to the are disproportionately higher in circumpolar regions and, therefore,
participants. The first invited the participants to be interviewed to investigating the role of circadian rhythms is crucial.
explore the impact of LQTS on their lives. Interviews were recorded, Contact: Abel Bult-Ito (ffab@uaf.edu)
transcribed, and analyzed. Participants were also invited to create

Photovoice stories, using photographs and written narration to portray
GENETIC REGULATION OF CIRCULATING FATTY ACIDS IN
their stories. Thirdly, Talking Circles, enabled validation of the
interview analysis and participation from others preferring not to ALASKAN ESKIMOS
partake in the first two methods. A.G. Comuzzie, V.S. Voruganti, S.A. Cole, S.O.E. Ebbesson, M.E.
Results: Some of the emerging themes that facilitate resiliency include: Tejero, H.H.H. Garing, S. Laston, K. Haack, R.B. Devereux, R.R. Fabsitz,
family, faith, and knowledge. However an inability to understand the J.W. MacCluer, B.V. Howard
biological or clinical aspects of the condition hindered the resiliency Southwest Foundation for Biomedical Research
process. These issues will be expanded upon, and recommendations to Alteration in plasma fatty acid composition has been linked to
improve genetic counseling within First Nations communities will be metabolic abnormalities related to type 2 diabetes and cardiovascular
discussed. disease. The main aim of this study was to investigate genetic factors
Contact: Lee-Anna Huisman (huisman@interchange.ubc.ca)
influencing the variation in circulating fatty acid distribution in Alaskan
Eskimos participating in the Genetics of Coronary Artery Disease in
A REVIEW OF COMMUNITY-BASED PARTICIPATORY Alaska Natives (GOCADAN) study. For this analysis, data were
available for 761 adult related-individuals (all over 35 years of age).
APPROACH TO GENETIC AND GENOMIC RESEARCH IN
Fatty acid distribution in total plasma fatty acids was measured by gas
AMERICAN INDIAN/ALASKA NATIVE POPULATION chromatography. Quantitative genetic analyses were conducted using
D. Perkins a variance components decomposition approach implemented in the
National Institute of Nursing Research software package SOLAR. All fatty acids were significantly heritable (p
< 0.001), with heritabilities ranging from 0.33 to 0.66. A genome-wide
The use of a community based participatory approach to research is
scan conducted to identify chromosomal regions affecting the
becoming an expected standard for scientific research projects with
variation in plasma fatty acids localized a 20cM region on chromosome
8 (p12- p21) with a quantitative trait locus (QTL) for monounsaturated Denmark, 6Department of Epidemiology Research, Statens Serum
fatty acids (MUFAs) (logarithm of odds (LOD) score = 3.8, p < 0.00001). Institut, Denmark
The same region had a QTL for polyunsaturated fatty acids (PUFAs) Objectives: Hearing impairment is prevalent in the indigenous
(LOD = 2.6, p < 0.001). Interestingly, this region has four important populations in the Arctic. It has mainly been ascribed to noise trauma
candidate genes, beta-3 adrenergic receptor (ADRB3), lipoprotein and chronic otitis media. The frequency of autosomal recessive hearing
lipase (LPL), macrophage scavenger receptor1(MSR1) and tumor loss is high and the allele frequencies of associated gene mutations
necrosis factor receptor superfamily, member 10b (TNFRSF10B), all of vary between populations from 1-5%. The prevalence of hearing
which have important roles in fatty acid metabolism. These results disorder with genetic etiology among the Inuit populations in the
indicate that there is strong genetic influence on the variation in Arctic is unknown and unexplored. Clinically, many Greenlanders show
circulating fatty acid distribution, and that a major susceptibility locus a mixed (conductive/sensorineural) hearing loss. We have therefore
for plasma unsaturated fatty acids appears to be present on performed a selected cross-sectional pilot study in East Greenlanders
chromosome 8. by sequencing of the GJB2 gene in order to identify mutations
Contact: Anthony Comuzzie (tony@sfbrgenetics.org)
associated with hereditary hearing impairment. Patients and Methods:
From 166 East Greenlanders who had an audiogram taken in 2004, we
INTERETHNIC DIFFERENCES IN FREQUENCY OF ALLELES selected those with sensorineural hearing loss or combined hearing
loss. Available patient samples were sequenced. The study was
AND GENOTYPES OF POLYMORPHIC MARKERS OF
approved by the local ethical committee in Greenland. All participants
CARDIOVASCULAR DISEASES IN YAMALO-NENETS gave informed consent. In addition blood samples from an unselected
AUTONOMOUS OKRUG (RUSSIA) number of East Greenlanders without known hearing loss were
E.V. Shinkaruk, N.V. Golubeva examined similarly as controls. Results: Forty-eight index persons were
State Scientific Research Institute on Medical Problems of the Far North included, 25 males and 23 females. The median age was 36 years
of RAMS (range: 5-76 years). No DNA was detected in three samples, leaving 45
samples for evaluation. All audiograms showed combined conductive
Human genetic diversity appeared during extended period of evolution sensorineural hearing loss except one showing sensorineural profound
of numerous groups and tribes. People, living in different regions of hearing loss. We found one index person who was homozygous for
Earth, differ by many features: language, appearance, genetic 35delG in agreement also with profound hearing loss. One index
characteristics. Every separate species has a set of genes responsible person was heterozygous for 35delG. Three index persons were
for its unique features. Aim of our study was to evaluate interethnic heterozygous for the p.V27I mutation and one patient was
differences in allele frequency and genotypes of polymorphic markers heterozygous for the p.V153I mutation, both known as polymorphisms
of cardiovascular diseases in samples of non-native and aboriginal not associated with disease. We detected no 235delC mutations. The
inhabitants of the Russia Far North. 426 persons aged 20-59 years were results of the control specimens will also be reported. Conclusion: Gene
examined. DNA was extracted by “RIBO-prep” kits (“AmpliSens”, mutations in the GJB2 gene occur, but with low frequency in East
Russia). Polymerase chain reaction was done in 23 microlitres of Greenlanders. Still, the main reasons for the frequent hearing
reaction mix, which contained 2 microlitres of DNA sample. impairment in this population are chronic otitis media, noise traumas,
Amplification was carried out by Rotor Gene 3000 (“Corbett Research”, and/or unidentified genetic causes.
Australia). Assessment of results was done by computer plotting of Contact: Preben Homøe (phom@rh.regionh.dk)
melting curves. Interethnic differences of frequency of genotypes and
alleles of 1) ACE gene (I/D polymorphism), 2) PON1 gene (Q192R) and
3) MTHFR (C677T) were studied. For the first studied gene, allele APOLIPOPROTEIN E POLYMORPHISM IN NATIVE
frequencies in non-native and aboriginal inhabitants were the same POPULATION OF MOUNTAIN SHORIA (WEST SIBERIA) AND
(x2=0,014, p=0,905); it evidences the absence of differences in groups ITS ASSOCIATION WITH SERUM GLUCOSE LEVELS
by I/D polymorphism of ACE. For the second studied gene, RR
M.I. Voevoda, E.V. Shakhtshneider, O.L. Barbarash, M.J. Ogarkov, I.V.
genotype was found in aboriginal inhabitants in 27,3% of cases and in
Kulikov, V.A. Baum, N.S. Yudin, V.F. Kobzev, A.G. Romashchenko
non-natives in 19,7% of cases. QQ genotype did not differ between the
groups. For the third studied gene, C allele prevailed (95,1%) over T Institute of Internal Medicine, SB RAMS, Novosibirsk, Russian Federation
allele (4,9%) in aboriginal inhabitants. In non-natives C allele Objective: we investigated apolipoprotein E gene polymorphism and its
dominated in 73,3% (T allele was found in 26,7%). Heterozygote influence on a serum glucose levels in native population of Mountain
number in non-natives was significantly higher (38,5%) than in Shoria (West Siberia).
aborigines (9,8%). Thus, we can conclude that by I/D polymorphism of
Methods: The study included 40 men and 80 women aged 25-64. The
ACE, allele frequencies are identical in native and non-native
apolipoprotein E polymorphism was analyzed by original method using
population of the Far North. In PON1 (Q192R) and MTHFR (C677T) we
Hixson’s approach. The serum glucose levels were determined by
revealed some particular differences in allele frequencies, which can be
standard enzymatic assays.
conditioned by ethnicity.
Contact: E.V. Shinkaruk (hypertonia@yandex.ru) Results: The frequencies of ε2, ε3, ε4 alleles in men were 6.5%, 80.4%,
13.1% and in women – 7.6%, 72.6%, 19.8% respectively. The
frequencies of genotypes ε2/ε4, ε2/ε3, ε3/ε3, ε3/ε4, ε4/ε4 in men and
POLYMORPHISMS AND MUTATIONS IN GJB2 ASSOCIATED women together were 1.8%, 12.4%, 51.8%, 31.2% and 2.9%. Mean
WITH HEREDITARY HEARING LOSS IN EAST fasting serum glucose levels in case of genotypes ε2/ε4, ε2/ε3, ε3/ε3,
GREENLANDERS ε3/ε4 and ε4/ε4 were 4.6 0.3mg/dl, 4.6 0.1mg/dl, 4.0 0.1mg/dl,
P. Homøe1, L. Tranebjærg2, N.D. Rendtorff2, M. Lodahl2, T. Andersen3, 4.7 0.1mg/dl, 5.8 0.3mg/dl (рGLM=0,000) in man and 4.7 0.3mg/dl,
S. Andersen4, H. Eiberg5, I. Nielsen5, A. Koch6 4.7 0.1mg/dl, 4.1 0.1mg/dl, 4.9 0.1mg/dl, 5.9 0.2mg/dl in women
1 (рGLM=0,000). After glucose tolerance test mean serum glucose levels
Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet, in case of genotypes ε2/ε4, ε2/ε3, ε3/ε3, ε3/ε4 and ε4/ε4 were
University of Copenhagen, Denmark, 2Department of Audiology,
6.0 0.6mg/dl, 6.1 0.3mg/dl, 5.2 0.2mg/dl, 6.4 0.2mg/dl,
Bispebjerg Hospital and Wilhelm Johannsen Centre of Functional
8.4 0.5mg/dl (рGLM=0,000) in man and 6.2 0.6mg/dl, 6.1 0.2mg/dl,
Genomics Department of Cellular and Molecular Medicine, ICMM,
5.5 0.1mg/dl, 6.7 0.1mg/dl, 8.6 0.5mg/dl (рGLM=0,000) in women.
University of Copenhagen, Denmark, 3Department of Audiology, Odense
University Hospital, Denmark, 4Department of Endocrinology, Aalborg Conclusions: The native population of Mountain Shoria is characterized
Hospital, Århus University Hospital, Denmark, 5Institute for Cellular and by relatively high frequencies of ε4 alleles. The allele ε4 prevails in
Molecular Medicine, ICMM, Panum Institute, University of Copenhagen,
women. The genotype ε4/ε4 has been associated with higher serum correlation between living-conditions and TB. Occurrence of many
glucose level. infected children indicates active spreading of the disease, and the
Contact: Mikhail Voevoda (mvoevoda@ya.ru) infected children may be a source of future TB transmission.
Contact: Turid B. Skifte (tbs@gh.gl)
VENUE 4 ASSESSING THE EPIDEMIOLOGICAL METHODS USED IN A

Infectious Diseases #3 – Tuberculosis TUBERCULOSIS OUTBREAK IN NORTHWEST TERRITORIES,
CANADA
PREVALENCE OF LATENT TB INFECTION (LTBI) AMONG C. Case
SCHOOL CHILDREN IN GREENLAND Government of the Northwest Territories
T. Rendal, K. Ladefoged, I. Kleist Objective: To review the standard epidemiological methods used to
Medical Department, Queen Ingrids Hospital prevent and control the transmission of tuberculosis (TB) during a
recent outbreak among the homeless population in the Northwest
With an average of 76 cases of active tuberculosis per year over the last
Territories (NWT).
5 years (equal to 135 cases per 100.000 inhabitants), tuberculosis
remains a challenge in Greenland. Methods: Methods used to assess the transmission of TB included:
conventional contact tracing, social networking (particularly among
Earlier studies have shown that the prevalence of LTBI among children
contacts residing in a homeless shelter), and genotyping using
in Greenland is alarmingly high, a sure indication that active TB
restriction fragment length polymorphism (RFLP) and drug
transmission is an ongoing problem. Identifying individuals with LTBI,
susceptibility patterns of isolates. Initial contact tracing focused on
particularly young individuals, is an essential part of TB control and
high-risk contacts of the index case (highly infectious pulmonary TB)
elimination.
which included 326 contact and included moderate- and low-risk
An annual screening of schoolchildren for LTBI has been implemented contacts(total was 850). Analysis on social networking patterns
as a part of Greenland’s national strategy to fight tuberculosis. The focused on the number of nights each resident slept in the same room
children screened are those in the first and last grade of our mandatory or adjacent room with the index. Network analysis also included
primary school system (1st grade and 10th/11th grade). The children contact’s number of exposures to cases.
are tested using whole-blood interferon gamma (IFN-gamma) assay,
Results: Conventional contact tracing revealed 21 cases identified from
the QuantiFERON Gold test.
this outbreak investigation, which include index (primary), 16
The screening in the year 2008 involved 1839 tested schoolchildren secondary and 4 tertiary cases. Genotype patterns revealed 14 of the
from 16 districts. In total 148 (8.0%) tested positive. 5.7% of all the 15 isolates analyzed were identical to the index. The case with a
tested 1st graders were positive, ranging from 0 in some small districts different genotype was identified as a low risk contact with other risk
to 11.1% in other areas. 9.7% of all the tested 10th/11th graders were factors such as excessive alcohol consumption and incarceration in a
positive (0 - 44.4%). As expected the prevalence of LTBI was highest in correctional facility. Social networking identified one secondary case
the districts with a high incidence of active TB. Other influencing who had shared a minimum of three nights in the same room with the
factors such as BCG status are being estimated. index. Focused screening on high-risk contacts with multiple (more
Contact: Thomas Rendal (Thre@peqqik.gl)
than 3) with cases revealed one case. All 21 isolates were susceptible to
first-line antibiotics with identical susceptibility patterns.
TUBERCULOSIS AMONG CHILDREN AND YOUTH IN THE Conclusions: Social networking and genotyping analysis confirmed the
ARCTIC FROM GREENLAND POINT OF VIEW concentrated efforts on high-risk contacts through conventional
contact tracing method were an accurate direction for this
T. Skifte investigation. Genotyping will be used as an epidemiology tool for
The National Board of Health In Greenland subsequent cases known or unknown through conventional analysis.
Introduction: Tuberculosis is still a disease to be taken seriously in Molecular epidemiological findings may offer information regarding
Greenland. Over the last 10 years the occurrence has been high with transmission among populations with neighbouring territories,
133 cases yearly per 100,000, in spite of BCG-vaccination of new-borns, provinces and circumpolar countries.
Contact: Cheryl Case (cheryl_case@gov.nt.ca)
and a persistent effort regarding contact tracing, control of treatment,
preventive interventions and tracking sources of infection.
Objectives: To examine how the occurrence of TB among children and THE DETERMINANTS OF TUBERCULOSIS TRANSMISSION IN
young people in Greenland has developed over time. To compare the THE CANADIAN-BORN POPULATION OF THE PRAIRIE
TB-incidence among Greenlanders to Inuit populations in Alaska and PROVINCES: THE QUALITATIVE FINDINGS IN MANITOBA
Canada. To examine whether the TB-infected children and young
people differed from the population in general in relation to social C. Lopez1, S. Abonyi2, K. McMullin2, J. Boffa3, M. Mayan3, R. Long3, P.
background and living-conditions. Orr1
1
Methods: Notifications of TB-cases from 1988-92 and from 2002-06 University of Manitoba, 2University of Saskatchewan, 3University of
were compared. Register data from Alaska and Canada were related to Alberta
data from Greenland. Data from a case-control study were analysed, While the rates of tuberculosis (TB) in the Canadian-born non-
consisting of notification forms, questionnaires regarding social aboriginal population of Canada are declining overall, the rate in the
conditions and living-conditions, plus information about BCG from Canadian-born aboriginal population is not declining. Prevention of
case records. transmission must include the development of strategies informed by
Results and Conclusion: In the period 1988-92 there were 185 TB cases, the experiences and real life contexts of individuals who contract TB.
in 2002-06, 407 cases, corresponding to an incidence of 67 to 141 Failure to understand and incorporate the individual and population
incidents per l00,000 respectively. In the regions examined, Inuits have health determinants, and their interplay (e.g. social disparities, socio-
a strongly increased TB-incidence compared to the remaining cultural influences, environmental factors, co-infections and co-
population, and the incidence was highest in Greenland. In Greenland morbidities) in health programs has much to do with the re-emergence
27 % of TB patients were below 19 years old, only surpassed by of TB as a serious public health issue for aboriginal people. This
Nunavut (33 %). Due to the small population involved, the results of the presentation reports on an innovative research program that was
case-control study were not statistically significant, but they support a conducted across the Prairie Provinces of Canada. This presentation
reports on the preliminary findings of the Manitoba qualitative study addictions, the working poor and those with special needs or in crisis.
component. Extensive consultation with aboriginal organizations and Many cannot easily access the traditional health and social services
ethics bodies was undertaken to ensure a respectful approach to, and system. Non-governmental organizations (NGOs) provide supportive
inclusion of, community leaders and health centres. Provincial Network services to the same populations.
Committees (PNCs) with stakeholder representation were established The TB outbreak of 2007-2008 centred around men using the Salvation
for consultation on the development of collection tools for both Army’s shelter. Since the diagnosis of the index case at the end of
quantitative and qualitative instruments, and for assistance with the March 2007, PHNs have managed 15 persons with pulmonary TB and
interpretation of findings. The qualitative team undertook semi started another 9 on INH prophylaxis. They also carried out follow-up
structured interviews with adult Canadian-born persons diagnosed and investigation of more than 800 contacts.
with smear-positive pulmonary TB between January, 2007 and
December, 2008. This comprised 53 aboriginal persons across the The syphilis outbreak in Yellowknife began the third week of
Prairies of whom 18 were from Manitoba. Coding and preliminary December 2008 when the number of cases rose from three to
analysis of transcripts was undertaken through a peer team approach seventeen over 2 weeks. To date, the epidemiology of this outbreak is
and member-checked with PNCs. Our interviews have revealed rich not fully understood. The public health unit, in partnership with GNWT
and complex narratives of loss, belonging, resilience, and strength, Health and Social Services, local physicians, nurse practitioners and
manifest in the experience of TB. This approach and the findings will corrections nurses, developed a proactive approach to managing this
help identify and understand the vulnerabilities in transmission virulent communicable disease.
pathways and contribute to the consideration of new approaches to TB The goals of communicable disease outbreak control and management
prevention. are to prevent harm to infected persons and their contacts and control
Contact: Carmen Lopez (lopezhil@cc.umanitoba.ca) TB and syphilis at the population level. In addition to conventional
approaches to achieving these goals, public health staff used some
unique strategies for case finding, such as public education, enhanced
TUBERCULOSIS IN INDIGENOUS PEOPLE OF MURMANSK access to testing, a street worker, links with NGOs and North Slave
REGION, RUSSIA Correctional Centre and outreach. Strategies for case management
R. Platonova included dedicated staff, screening, appropriate assessment and
treatment and counselling.Health care providers used diverse and
Murmansk Region TB Dispensary
persistent approaches and repeat interviews of cases to improve
In the Murmansk Region a programme to control tuberculosis among contact tracing.
its residents including indigenous peoples has been developed and
Best practices included: a public health outbreak team; a dedicated
introduced. This programme is aimed at implementation of the
coordinator; communications; partnerships with the Salvation Army,
national TB and its complications control policy, introduction of
Centre for Northern Families, the Tree of Peace Friendship Centre and
effective TB prevention measures into medical practice, early
the John Howard Society; social networking; trust building with
detection and treatment.
specific at-risk populations; outreach; and, incentives.
There has been an increase in TB morbidity on the territory of the
Challenges included: limited resources; case finding; stigma; and,
region since 1990. By 1997 the incidence per 100 thousand doubled and
follow-up.
reached 32.2 compared to that of 15.7 in 1990. In addition, TB mortality
Contact: Joanne Mackinnon (joanne_mackinnon@gov.nt.ca)
per 100 thousand rose fourfold. Corresponding TB morbidity and TB
mortality indicators for the indigenous peoples are considerably worse.
As regards TB morbidity, at present the epidemiological welfare in the
region has not been reached yet. VENUE 5
The number of TB mortality cases increased from 11.4 to 12.3 per 100 Climate Change – Health Impacts
thousand in 2007 compared to 2006. In 2005 this figure was 13.0. TB
mortality in the Russia in 2006 was 19.5 per 100 thousand. The IS HEAT A MORTALITY RISK IN THE CANADIAN ARCTIC?
percentage of those who died of TB within one-year medical WILL IT BE?
observation is still high - 38.8%. Corresponding figures in 2005 and
2006 are 44.0 and 42.5 accordingly. T. Kosatsky
The measures taken to timely detect TB cases among the indigenous British Columbia Centre for Disease Control
peoples are not at the sufficiently high level yet. While heat waves have been recognised as a significant risk to life in
The significant pool of unknown infection sources is mainly centred warm and even temperate climates, the effect of heat on the health of
among the socially disadvantaged population sections. Northern residents has been shown only recently. In Moscow, a V-
shaped function applies when daily temperature is plotted against the
Social and economic efficiency which will resulted from level of daily deaths, with the “V’s” notch at 18 degrees C. Similar
implementation of the programme will represent life quality mortality nadirs have been shown for Finland and Stockholm as well,
improvement and increase in life expectancy of the indigenous but at 12 and 11 degrees respectively. Large within-day temperature
peoples, retention of their employment ability, healthier lifestyle, shifts present as an independent risk factor in the Moscow analyses.
reduction in social and economic tension caused by the threat of
spreading TB. Heat-mortality functions have been constructed for several Canadian
Contact: Rimma Platonova (plari08@mail.ru) cities: stronger effects have been shown for the elderly, for high
temperatures occurring earlier during the summer, and for built areas
with less shade. So far, no such analyses have been conducted for
RIDING THE WAVES OF RECENT TB & SYPHILIS OUTBREAKS northern Canadian settlements.
IN YELLOWKNIFE, NT- PLANNING, PARTNERSHIPS, Temperature-mortality relationships for Prince George, BC will be
PERSISTENCE presented, based on a time series from 1087-2007, along with similar
J. MacKinnon, H. Leslie, N. Trotter analyses for Yellowknife and Whitehorse, given data availability.
Yellowknife Health and Social Services Authority Pan-European studies have modeled the effect of a warmer climate on
the basis of documented population responses to summers warmer
Yellowknife has a diverse population of about 20,000 representing First
than the mean. Coupling these mortality responses with climate
Nations, Inuit and Métis groups, non-Aboriginals and immigrants. “At-
change model predictions will allow for estimation of heat-related
risk” populations include the homeless, those with mental illness and
mortality in northern settlements should warming continue to follow of those persistent contaminants coming into the Arctic mostly
its rapid current course. through the global transfer such as DDT, HCH, chlordanes, toxiphens
Contact: Tom Kosatsky (tom.kosatsky@bccdc.ca) and mirex. In the same time an obvious increase in levels of
contaminants presumably originated from local sources such as PCBs
is observed among children and men. Enhancement of surface/air
CLIMATE CHANGE IMPACT ON PUBLIC HEALTH IN THE exchange, altered contaminant fractionation, corrosion of metallic
RUSSIAN ARCTIC- FIRST ASSESSMENT containers/drums/tanks leading to accelerated mobilization of
B. Revich contaminants from wastes buried in permafrost lands are discussed to
Institute of Forecasting be contributing factors to increased human exposure associated with
climate change impact.
Negative impacts of climate change for public health in Arctic region Contact: Valery Chashchin (valerych05@mail.ru)
are more pronounced than in other territories. UN Arctic Initiative, with
support of UNDP, WHO, UNEP, and AMAP, organized the first
meeting of experts for analysis of this problem in 2008. Russian Arctic CLIMATE CHANGE CHALLENGES TO ARCTIC HEALTH (AN
(RA) supports more inhabitants (6.7 million people) than any other EXAMPLE OF THE NORTHERN PEOPLES OF YAKUTIA)
Arctic territory. There are 46 cities and rural settlements, large S. Vyacheslav
metallurgy plants, mines and other industrial facilities in RA. Russian
Arctic is characterized by large social and economic disparities. Most Researcher, Institute of Humanities and North Indigenous Peoples
climate change models predict considerable warming of Arctic climate. Researchers of communities of indigenous people of Yakutia
For example, air temperature in Yakutia may rise by 2.7 ºC by 2020. (chukchees, yukaghirs, evens, evenkis) have shown, that there were
Climate warming will bring about rise of temperature of permafrost, new threats in condition of climate change and its influence on health
which may lead to major break-downs of water mains and sanitation of the northern peoples.
networks. This, in turn, may cause outbreaks of enteric fevers. Breaks Growth of death rate because of increase of natural cataclysms:
of oil pipelines causes contamination of drinking water supplies flooding, strong heat, sharp pressure differences. Last years very often
[Kochina, Kushnikova, 2008]. Climate warming causes northward shifts there are flooding, thus each 3-rd year with catastrophic consequences
of habitats of tick-borne encephalitis. The periods of activity of tick and deaths. The number of hits in hospitals because of sunstrokes,
become longer. One study reported causal link between climate pressure differences, etc. In the most risky position there were older
change and numbers of tick in Krasnoyarsk region. The incidence of persons and the small children, already suffering any diseases (first of
tick-borne encephalitis has increased in Archangelsk region. When all, cardiovascular and respiratory). Here it is necessary to specify and
annual average temperature increases by 1.5 ºC or more, the number increase in accidents with fishermen and hunters in connection with
of people bitten by tick sharply increases (Tronin et al, 2008). late icing and thickness of an ice.
Hemorrhagic fevers steadily propagate further north. Isolated cases of
West Nile fever have been registered in Novosibirsk region [Platonova 1. Deterioration of water. Last years pollution of superficial waters
et al, 2006]. Climate warming is a risk factor for proliferation of has amplified. Rise in temperature will promote also to
dangerous infections, which previously existed in RA. There are more duplication in water of bacteria, microbes and etc, and it
than 200 burial grounds of cattle died from Siberian plague in Yakutia becomes the reason of gastroenteric diseases. Recently the
Republic, where this disease has been registered in 240 settlements number increases in Yakutia ill oncological diseases. Some
(Kershengoltz et al, 2008). There are potential pockets of tularemia, experts connect it with more intensive chlorination because of
leptospirosis, listeriosis and pseudo-tuberculosis in Russian Arctic. deterioration of water. Long influence of the raised concentration
Coordinated efforts of experts in different sciences are needed during of chlorine and its components, in opinion of doctors, increases
development of programs for prevention and liquidation of negative risk of cancer diseases.
impacts of climate change on public health in Russian Arctic. 2. Deterioration of traditional food. Major factors of it include
Contact: Boris Revich (brevich@yandex.ru)
deterioration of conditions of its storage (glaciers, untimely
delivery are filled in, etc.) and
3. growth of parasitic diseases among fishes and animals (trichinella
CLIMATE CHANGE IMPACT ON HUMAN EXPOSURE TO at bears, worms at fishes, a salmonellosis at birds, etc.).
PERSISTENT CONTAMINANTS IN ARCTIC RUSSIA 4. Parasites and infectious diseases. Warming has expanded areas
of distribution of diseases which messengers are insects or ticks
V. Chashchin
whom new territories extend on all.
Northwest Public Health Research Center 5. The probability of washout of burial grounds of the cattle which
2/3 of Russia’s territory is represented by permafrost lands populated has died of many years from the Siberian ulcer, and an ancient
by 11 million residents. About 0.5% of those are formally entitled to cemetery with burials of the people who have lost from
indigenous minorities. Over 20% of Russia’s GNP is provided by the epidemics of a plague and a smallpox grows. I.e. there is a threat
economy of arctic regions based on enormous concentration of unique of occurrence of the centers of distribution of viruses of
natural resources. Some past mining, industrial and transport activities dangerous illnesses.
were associated with large environmental pollutions involving 6. Distribution on the north of new kinds of trees and grassy plants.
persistent contaminants. Although the presence of elevated human In this connection there is a threat of growth of allergic reactions
exposure to POPs in the arctic regions are confirmed by many because of impracticality of an organism of people to pollen of
international studies, the ecotoxicological and consequences especially new plants.
those associated with climate change impact still remain largely 7. Deterioration of conditions of duly rendering of medical aid. The
unknown. Human reproduction appears to be of greater concern in reason of it is washing out of small villages because of what it is
terms of the exposure to certain contaminants such as PCBs. impossible to make sanitary flights for export of patients in time.
Contact: Shadrin Vyacheslav (odul_shadrin@mail.ru)
There are a number of urgent questions to be clarified: How large is the
climate change impact on global transfer, behavior, fate, distribution,
exposure intensity and health effects of POPs? How significant such SEASONAL VARIATIONS OF MORTALITY FROM CLIMATE-
impact is? What should be done to reduce risks associated with the RELATED CAUSES IN ARCTIC CITIES
climatically modified human exposure to POPs?
B. Revich, D. Shaposhnikov
A limited follow-up study of an arctic indigenous cohort of 30 mother-
child pairs and 30 male adults for the period from 2001 to 2007 showed Institute of Forecasting
that there is a statistically significant decrease in blood concentrations
Climate change may influence morality rates in Arctic in many different The development of effective programs and policies requires access to,
ways. Public health experts have hypothesized that mortality from and the use of, the most complete information available. In the past,
climate-related causes might both increase and decrease. To test these this was thought to be the most current or leading edge research or
hypotheses, one needs to conduct a preliminary exploratory analysis of expert opinion. Currently, there is more and more recognition that to
seasonal patterns of morality rates. For this purpose, we analyzed be truly balanced, complete, and potentially useful multiple sources of
76,500 deaths in four cities in Russian Arctic, from Norwegian border information require consideration. This session will discuss the links
(Murmansk) to West Siberia (Norilsk) and East Siberia (Yakutsk and between research in policy and science, Indigenous science, and
Magadan). We analyzed several cardio-respiratory causes and all-cause evidence based decision making. Some of the specific questions that
mortality, in age groups 30-64 years and 65+. Seasonal variations were will be considered include:
measured after smoothening of daily mortality counts with a 60-day - What are the differences between traditional and Indigenous
moving window. For example, in Yakutsk, seasonal variations of daily knowledge?
mortality have been established for all causes, except respiratory - What are Indigenous science and Indigenous knowledge
diseases in the age group 65+. Two principally different annual methods?
distribution of mortality were established: single-modal and bimodal. - What are systematic reviews and how do they fit into western
A single-modal distribution (established for the two respiratory causes) science?
has a smooth profile which consists of the two sinusoidal half-waves. - What is evidence-based decision making?
The half-wave of elevated mortality lasts from September to January, - Where can you find health information?
and annual maximum of daily mortality is observed in the beginning of - What are the challenges in finding and accessing reliable
autumn, instead of mid-winter. The half-period of reduced mortality is information (traditional, Indigenous and non-traditional)?
observed from February till August, and daily mortality reaches its - What are some of the protocols, ethics and responsibilities for
minimum in the middle of summer. Bimodal distribution (established accessing traditional knowledge?
for all other studied causes) has two maximums and two minimums
each year. The greater maximum is observed in late summer or early In considering these questions, this session will explore how
Fall; the secondary maximum takes place in winter. Such peaks Indigenous, traditional, and western research can be used together to
coincide with summer and winter temperature extremes in Yakutsk. improve the health of people in the North.
The greater maximum in the age group 65+ precedes the same This panel presentation will include various perspectives on knowledge
maximum in the age group 30-64, by 1 or 2 months. In prospect, we are development, communication, translation, and use, including a
planning to employ regression analysis of time-series of daily mortality university-based researcher, a traditional knowledge expert, an Elder,
to quantify its relationships with meteorological factors. and a health care provider.
Contact: Boris Revich (brevich@yandex.ru) Contact: Mark Buell (mbuell@naho.ca)
THE HEALTH OF ARCTIC POPULATIONS: DOES COLD

MATTER? VENUE VIEWING ROOM
1
K. Young , T.M. Mäkinen 2 Video #2
1 2
Dalla Lana School of Public Health, University of Toronto, Institute of
Health Sciences, University of Oulu, Finland NUTARAQTAARNIQ NUNALINGNIRMIUNUT ALIANAIPPUQ-
Background: The effects of cold on human health and performance is BIRTH A JOYOUS COMMUNITY EVENT: A SCREENING OF A
well documented. With climate change increasingly affecting the LIVE-TO-TAPE 2-HOUR CALL-IN PROGRAM ABOUT INUIT
Arctic, the association between climate and population health status in MATERNITY CARE
Arctic regions is of public health significance. C. Carry
Objective: To examine whether cold temperatures are associated with Inuit Tuttarvingat of the National Aboriginal Health Organization
poorer health in diverse Arctic populations.
Good maternity care = better birth outcomes. It is also now well
Methods: The mean January and July temperatures were determined understood that being supported by care providers from your own
for 27 Arctic regions based on weather station data for the period 1961- culture who speak your language is a best practice. In Inuit maternity
1990 and their association with a variety of health outcomes assessed care, this degree of cultural competency along with the knowledge
by correlation and multiple linear regression analyses. about your family and community can improve the birthing experience
Results: Mean January temperature was inversely associated with and Results: Many people including elders also report substantial
infant and perinatal mortality rate, age-standardized mortality rate benefits when babies can be born in their own communities.
from respiratory diseases, and age-specific fertility rate for teens and Through the live interactive broadcast, Inuit Tuttarvingat of the
directly associated with life expectancy at birth in both males and National Aboriginal Health Organization, along with many partners,
females, independent of a variety of socioeconomic, demographic, and shares encouraging examples that are helping move Inuit maternity
health care factors. Mean July temperature was also associated with care forward.
infant mortality and mortality from respiratory diseases, and with total
The 2-hour program:
fertility rate.
- discusses the history and development of Inuit maternity care.
Conclusions: Cold temperatures are significantly associated with higher
- highlights maternity care programs in Alaska, Inuit Nunaat and
mortality and fertility of Arctic populations and should be recognised in
Greenland with a focus on the development of culturally
public health planning and health risk management.
Contact: Kue Young (kue.young@utoronto.ca)
appropriate services.
- discusses research, such as the “Qanuippitali? Inuit Health
Survey,” that focuses on child and family health.
- explores opinions and ways forward shared by the panelists,
VENUE 6 community focus groups and callers.
Pathways to Knowledge, Pathways to Health Workshop - points to Web-based resources for follow-up.
This 2.5 hour session will open with an introduction to the overall
M. Buell
Qanuqtuurniq - Finding the Balance TV series, an International Polar
National Aboriginal Health Organization and the Canadian Cochrane Year outreach project on Inuit wellness broadcast on the Aboriginal
Network and Centre Peoples Television Network - North in May 2009 in the Inuit language
with English subtitles and simultaneously Web cast . A main objective Suicide mortality was examined in a cohort of 19, 801 persons
of this series was to adapt and test a “communications for change” categorized as Sámi in Arctic Norway between 1970-1998, stratified by
model for exchanging knowledge from different perspectives on age, gender, cultural context, and traditional Sámi core management.
several wellness issues of concern to Inuit. Following the screening of The results indicated that there was a significant moderate increased
the maternity care program, evaluation highlights will be shared along risk for suicide among indigenous Sámi (SMR=1.27, 95 %, CI: 1.02-1.56)
with a question and answer period and an opportunity to give feedback compared to the reference population. In the study period, 89 suicides
into the model’s evaluation process. occurred (70 men and 19 women) with increased suicide mortality both
Contact: Catherine Carry (ccarry@naho.ca) for indigenous Sámi males (SMR=1.27; 95% CI: 0.99-1.61) and females
(SMR=1.27; 95% CI: 0.77-1.99). The results showed a significant
increased suicide mortality among Sámi aged 15-24 for both males
(SMR=1.82; 95% CI: 1.13-2.78) and females (SMR=3.17; 95% CI: 1.17-
SESSION 6 6.91). Significant increased suicide mortality was found for indigenous
Sámi males residing in Sámi core area (SMR= 1.54; 95% CI: 1.04-2.20)
Tuesday, July 14, 8:30-10:00 AM and for indigenous Sámi males not belonging to semi-nomadic
reindeer herding (SMR=1.30; 95% CI: 1.00-1.65). Moreover, Sámi
belonging to semi-nomadic reindeer herding household did not have
significant increased suicide mortality.
VENUE 1
In conclusion, the finding of a significant increased risk of suicide
Mental Health & Wellness #4 – Suicide & Addictions among Sami, is consistent with the general findings among other
indigenous groups. However, compared to several others indigenous
SUICIDE ATTEMPTS AND ALCOHOL DEPENDENCE IN groups the suicide rates found among Sámi is moderate and may be
GREENLAND explained by better living conditions and subsequently lower
C.P. Pedersen, P. Bjerregaard prevalence of general risk factors. Furthermore, several common
features concerning indigenous suicide have been identified among
Centre for Health Research in Greenland, National Institute of Public the Sami, such as within group variation, age distribution, gender
Health, University of Southern Denmark differences, cluster of suicides and frequent use of violent methods.
Objectives: Greenland has an alarming record in suicide rates. Alcohol is Contact: Anne Silviken (anne.silviken@ism.uit.no)
an important risk factor for suicidal behaviour. A recent survey

revealed that the prevalence of alcohol dependence in Greenland has
increased from 22% in 1999 to 30% in 2005-2007. The purpose of this A CULTURAL MODEL OF SUICIDE PREVENTION FOR
study is to examine suicide attempts in relation to alcohol dependence. CARRIER FIRST NATIONS YOUTH
Method: Analyses were based on data from a cross-sectional H. Harder
population survey of 2247 Inuit in Greenland (2005-2007). Participants University of Northern British Columbia
age>18 years answered a self-administered questionnaire including Carrier Sekani First Nations Peoples have their own institutions for
questions on their childhood, suicidal behaviour and alcohol maintaining language, governance, health and knowledge related to
consumption and an interview including socio-demographic all aspects of life. Carrier legal systems, such as the bah’lats, are
conditions. The association between suicide attempts and alcohol situated to address governance of knowledge generated from within
dependence, measured by the CAGE questionnaire, was analysed for their communities and provide mechanisms for the protection of
men and Women’separately, using logistic regression and adjusted for individual and community knowledge. In addition to traditional
socio-demographic factors and childhood conditions. mechanisms, Carrier Sekani Family Services, an institution responsible
Results: Women more often than men reported ever having attempted for health, social, and legal services to eleven First Nations
suicide (17% and 11%, respectively (p<0.001)). Men (38%) were more communities in the Central Interior of British Columbia has developed
often than woman (26%) CAGE positive (p<0.001). Being CAGE a research department and research ethics policy and in doing so has
positive was associated with suicide attempts (OR=2.91 (CI 2.0-4.2) for become a leader in community-based research.
women and OR=1.56 (CI 1.0-2.5) for men). Multivariate analysis The youth suicide research project is an example of a partnership with
revealed no association between suicide attempts and alcohol the University of Northern British Columbia (UNBC), funded by the
dependence when adjusted for socio-demographic factors and Canadian Institutes for Health Research (CIHR), Institute for Aboriginal
childhood conditions. Suicide attempts was associated with neglect Peoples Health, that directly responds to goals of ethical research
during childhood, with frequent alcohol problems at home (OR=3.34 conducted in First Nations’ communities. The project investigates the
(CI 1.7-6.4) for women and OR=2.8 (CI 1.3-6.0) for men), having been effectiveness of community-based interventions in preventing suicide
sexual abused as a child (OR=5.88 (CI 3.5-9.8) for women and OR=4.6 and tracks youth views of self-esteem, depression and other indicators
(CI 2.4-8.7) for men), suicide by family members or close friends over the course of the project. The knowledge gained from this
(OR=2.35 (CI 1.3-4.2) for women and OR=2.0 (CI 1.1-3.6) for men). research project will help guide CSFS and its member communities in
Conclusion: No association between suicide attempts and alcohol offering programs and services that will assist in reducing the number
dependency were found when adjusted for socio-demographic factors of suicides in our communities.
and childhood conditions for men and women. The association This presentation will focus on how this research is reflective of the
between suicide and alcohol dependency is complex, however the needs of community including development of a community steering
results indicate that suicide attempts are associated with underlying committee, community ownership of information, involvement of
factors related to a troubled childhood. community in all aspects of the project and the use of interventions
Contact: Cecila Petrine Pedersen (cpe@niph.dk)
such as culture camps that provide direct community benefit from the
onset of the research. In addition, we will present our findings
SUICIDE AMONG INDIGENOUS SÁMI IN ARCTIC NORWAY regarding pre testing, design of the intervention model, community
1970-1998 overviews and results from culture camps.
Contact: Henry Harder (harderh@unbc.ca)
A. Silviken, T. Haldorsen, S. Kvernmo
Center for Sámi Health Research, Department of Community Medicine,
University of Tromsø, Norway
THE ETHNIC AND CULTURAL FEATURES OF COURSE OF childhood conditions, education, occupation, income and assets can be
ALCOHOLISM IN INDIGENOUS PEOPLES OF THE NORTH OF used as measures of socioeconomic position. These measures have not
KHABROVSK TERRITORY been sufficiently validated in an Arctic context and the quality of the
variables is there for unknown. The validity of different measures of
P. Lubov socioeconomic position among Greenland Inuit will be discussed in
Regional Association of Indigenous Peoples of the North of Khabarovsk relation to pathological gambling.
Contact: Christina V. L. Larsen (cll@niph.dk)
Alcoholism is one of the topical and terrible health problems among
IPs.
Alcoholism is one of the grave problems that needs to be solved
urgently especially with regard to IPs rather than other people, VENUE 2
because life of IPs is at stake. High level of suicides is directly related to Women’s & Family Health & Well-Being #1 – Fetal
alcoholism.
Alcohol Spectrum Disorder
The indigenous reindeer herders, fishers and hunters lived in
conjunction with nature note breaking natural sustainability. Forced
sedentary way of life implied indigenous peoples had to be forcibly CULTURALLY APPROPRIATE RESPONSES TO FASD
engaged in non-indigenous trades and occupations, new forms of work Pauktuutit Inuit Women of Canada
relations, new ways of behaviour . As a result they felt psychological Pauktuutit Inuit Women of Canada has been at the forefront in
tension and emotional depression that they could ease with the help of examining FASD throughout Inuit Nunaat. Through education and
alcohol. Long chronic stress caused by rude intrusion of civilization that community-based involvement, Pauktuutit has created a variety of
was imposed on indigenous cultures. resources and tools for Inuit women to address this completely
Causes of Destructive changes affecting health: preventable condition. From a culturally relevant calendar to ensure
- Destruction of traditional way of life and change of food as a Inuit women have a tool to chart their way through a healthy
result pregnancy to a handbook on FASD, Pauktuutit is actively promoting
- Lack of qualified medical care because the villages are situated healthy lifestyles to ensure healthy babies. Research in the general
far away from towns and cities. population shows that children who are affected by FASD have much
- Hospitals are closed in indigenous settlements better outcomes if interventions occur early. Pauktuutit is identifying
- Loss of religious and spiritual roots and language quality practices used in Inuit day care centers to work with FASD
- New work relations have been introduced affected children. These practices will be shared with the other centers
to ensure all children’s healthy development across all developmental
In some villages the medical measures were undertaken in order to domains and that family is supported in their role as primary
cure alcoholism, however as the reality showed, the effect was short if caregivers. Related issues include the inherent danger of labelling
ill people did not receive social rehabilitation. children incorrectly through assessment and diagnostic tools that are
Contact: Passar Lubov (passarudege@mail.ru)
not culturally appropriate, the compounded issues of FASD-affected
mothers of FASD-affected children, as well as the costs associated with
GAMBLING: A NEW PLAYER IN GREENLANDIC PUBLIC providing a broad range of services to assist children and their families
in small communities. Pauktuutit will discuss its community-based
HEALTH RESEARCH
research on quality practices that may be used when working with
C.V.L. Larsen, P. Bjerregaard FASD-affected children in a culturally sensitive manner, successful
Greenland Institute of Health Research and Centre for Health Research in Inuit-specific projects, lessons learned, and the challenges and
Greenland, National Institute of Public Health, University of Southern opportunities ahead.
Denmark Contact: Pauktuutit Inuit Women of Canada (tohearn@pauktuutit.ca)
Background: A growing public and professional awareness of

pathological gambling combined with the acknowledgement of a VIEWING AND UNDERSTANDING FETAL ALCOHOL
yearly increase in revenues among gambling suppliers, has led to an SPECTRUM DISORDER FROM A DISABILITY PERSPECTIVE
interest in gambling in public health research in the Arctic.
D. Reid
This paper aims to analyse gambling patterns and the prevalence of
pathological gambling among Inuit in Greenland and its association Government of the Northwest Territories
with socioeconomic position and childhood conditions. The underlying An examination of Fetal Alcohol facets promotes the perspective that
hypothesis is the social epidemiological assumption of an uneven this disorder should be viewed from a disability perspective. This view
distribution of gambling problems among different social groups in may result in an increased willingness by members of society to
society corresponding to the social inequality in health. In order to identify individuals who have or may have FASD, accommodate their
analyze inequality we need to know more about how to best define needs, and advocate for assessment and diagnosis. An individual born
social groups in Greenland today. with an FASD must live with this primary disability for his or her
Methods: Analyses include 1331 Inuit from Greenland, ~18 years, from a lifetime. Adequate and appropriate supports and interventions can,
cross-sectional study conducted in 2005-2007. Data were collected by and should be put in place to help ease challenges and limitations for
an interview and a self-administered questionnaire. The participants individuals as early as possible and throughout every stage of life. If
reported time and money spent regarding four different types of such measures are not in place, individuals with this disorder are quite
gambling. Four questions addressed pathological gambling. The likely to encounter secondary disabilities. While it is much easier for
questionnaires also included questions on current socioeconomic service providers, professionals, community and family members to
conditions as well as childhood conditions. focus on visible aspects of this disability, it is imperative that efforts be
concentrated on the invisible aspects; the organic brain injury. FASD
Results and Discussion: Preliminary analysis showed that 77 % of the
can be accompanied by approximately 60 other co-occurring
participants had engaged in gambling activities during the last year. No disabilities and disorders. Accommodation and supports for individuals
difference was found between men and women but gambling varied
with this disorder will also help individuals with other disabilities or
according to age group (p<0,001). The relevance and validity of
barriers. Finally, in 2006, the Supreme Court of Canada ruled
socioeconomic position and childhood condition as social addictions, one contributing factor of FASD, is a disability.
determinants for gambling require a methodological study, which has
not previously been carried out in Greenland. Besides sex and age,
Topics to be examined include: definition of disability, people with this This paper will look at this relational system approach to the problem
disability have strengths, the spectrum of a disability, the normalcy of of maintaining cultural identity in the screening, prevention and
living with FASD, the speed of information delivery and processing, intervention of FASD and other developmental disorders caused by
what is it like to have FASD, and what we can do to support individuals trauma and pre-natal exposures. Tools include Blanket Toss Student
with this disability. The session will utilize lecture, interactive, Index, Blanket Toss Community Development Tool, Blanket Toss
discussion and Q & A formats. Difference Game Cards, Blanket Toss Developmental History Tool and
Contact: Doreen Reid (doreen_reid@gov.nt.ca) Blanket Toss Basic Skills Check List. A DVD of the original program in
First Nation community in the south is available on the CAPHC,
Canadian Association of Pediatric Health Centers website
A COMPREHENSIVE APPROACH TO FETAL ALCOHOL Contact: Lori Vitale Cox (Lsdcox@nbnet.nb.ca)
SPECTRUM DISORDER
S.K. Clarren, A. Salmon
PERSONAL ECOLOGY AND ENVIRONMENTAL STRUGGLES
The Canada Northwest FASD Research Network Central Office at the FOR BIRTH MOTHERS OF CHILDREN WITH FETAL ALCOHOL
Child and Family Research Institute, Vancouver, British Columbia
SPECTRUM DISORDER
The governments of the Northern Territories and Western Provinces of
D. Badry
Canada created the Canada Northwest FASD Research Network to
comprehensively approach the prevention, diagnosis, and treatment of University of Calgary, Canada Northwest FASD Research Network
Fetal Alcohol Spectrum Disorder. FASD is a lifetime condition that (Network Action Team on Women’s Health)
needs to be understood across the life span. The Network believes that The birth of children with Fetal Alcohol Spectrum Disorder (FASD)
positive and efficient progress in understanding and acting on FASD represents a life phenomenon with serious repercussions for children,
will only come when government policy makers, researchers, clinicians, families, community and society. Alcohol misuse contributes to an
communities, families, and individuals with FASD can work together. ecology where families and children live on the fringes of society with
To support this goal, Network Action Teams (NATs) conduct research limited opportunities to fully engage and thrive in the community. The
that bridge knowledge gaps according to priorities identified by each personal ecology of women who give birth to children with FASD is
of these stakeholder groups. In this presentation we will summarize important to understand in order to bring about systemic change in
the advances in knowledge achieved by the Network. The NAT on relation to responses to women, and in the interest of decreasing the
Diagnosis has: 1) established accurate multiethnic norms for palpebral incidence of FASD. This presentation will offer a philosophical
fissure measurements; 2) established a clinical standard for assessment perspective based on current research by Dr. Badry and colleagues on
of the diffuse brain dysfunction typically found in people with FASD; mentorship, the lives of birth mothers and support programs. A depth
and 3) developed a common multi-site set of forms for medical understanding of birth mothers of children with FASD offer a
information in order to increase consistency in clinical sites. The NATs foundation from which to examine issues from individual and systemic
on Prevention are evaluating: 1) the effectiveness of primary perspectives. FASD is a global problem and increasing awareness of
prevention campaigns regarding alcohol use in pregnancy; 2) the women’s issues are critical in a discourse of change.
outcomes of mentoring programs that work with women who have Contact: Dorothy Badry (badry@ucalgary.ca)
had alcohol-exposed pregnancies, 3) the most effective means of
incorporating FASD prevention into the range of systems and
programs that serve women with substance use problems. Finally, the YUKON FAS DIAGNOSIS TEAM; DEVELOPMENT OF A TEAM-
NAT on Invention is determining the availability and effectiveness of MOUNTAINS TO CLIMB, VALLEYS TO CROSS
the recommendations made by FASD diagnostic clinics in education, B. Grueger
mental health, social service, justice, and related systems. They are
University of Alberta and University of Calgary
also developing a lifelong developmental trajectory for understanding
the multi-faceted needs of people with FASD across the lifespan. This is a description and discussion around the development of an
Contact: Sterling Clarren (sclarren@cw.bc.ca) FASD diagnostic team in the north. It highlights barriers and difficulties
encountered and successes, and describes the development of a team.
A short overview of the work done during the last 4 years will be
AN EDUCATION OF HEART, HAND, MIND, AND SPIRIT- THE provided. It is designed to provide a baseline to start discussion about
BLANKET TOSS TOOLS FOR SCREENING, ASSESSMENT, FASD diagnostic services in the north.
AND INTERVENTION OF FASD AND OTHER Contact: Barbara Grueger (b_grueger2002@yahoo.ca)
DEVELOPMENTAL CONDITIONS- A RELATIONAL SYSTEMS

APPROACH
L.V. Cox VENUE 3
Elsipogtog First Nation New Brunswick Food Security #4 – How Are We Eating?
The Blanket Toss Tools for Northern Communities provide a wholistic
community based approach to the screening, prevention and PEOPLE DO NOT EAT N-3 FATTY ACIDS, THEY EAT MEALS
intervention of FASD and other developmental disorders. They were P. Bjerregaard, C. Jeppesen
adapted from tools chosen by PHAC, the Public Health Agency of
Canada and FNIB, First Nation and Inuit Health Branch for National Institute of Public Health, University of Southern Denmark and
development nationally after consultations with community members Department of Family and Health, Greenland Government
and a panel of experts. These tools grew out of work in an indigenous Introduction: In studies of the effects of diet on cardiovascular disease
community in the south, bridging the gap between traditional ways of and diabetes among the Inuit there has for years been a tendency to
knowing and a modern scientific perspective. One elder in the reduce the variation paradigm of Inuit diets to a simple question of
community spoke of two-eyed seeing – if we use one eye to look more or less intake of marine fatty acids. This approach somewhat
through traditional lens and the other a scientific lens we get a much arbitrarily focuses on the role of n-3 fatty acids and does not
more in-depth perspective. This approach led to wholistic interventions sufficiently acknowledge the fact that a traditional food pattern is
in the community and school that significantly increased rates of composed of many nutrients with specific effects on cardiovascular
literacy and decreased rates of youth crime in the community. health and diabetes. Food patterns are also associated with many non-
Members of Northern Inuit communities in Labrador and Nunavit dietary risk factors.
participated in consultations to adapt the tools for a northern context.
Design: In a cross sectional design, we studied diet and risk factors for THE ASSESSMENT OF BONE MINERAL DENSITY, CALCIUM,
cardiovascular disease and diabetes among 2247 Inuit in Greenland. AND VITAMIN D INTAKE AND EXPOSURE IN BRITISH
From a 67 item Food Frequency Questionnaire, six dietary patterns ANTARCTIC SURVEY PERSONNEL
were identified by factor and cluster analysis. The intake of n-3 fatty
acids, saturated fat, fruit, vegetables, alcohol, sugar, fibres, and the D. Boon, I. Grant, L. Gawn, S. Cross, K. Knapp, G. Vivian, C. Moniz, G.
glycemic load was computed. Non-dietary risk factors included Rees, P. Marquis
obesity, physical activity, hypertension, smoking, socioeconomic The British Antarctic Survey & SCAR Expert Group
position, and Inuit ancestry. Associations were analysed in General In order to maintain correct bone mineralization, adequate amounts of
Linear Models and logistic regression adjusted for age and sex. vitamin D, calcium and exercise are required. Although vitamin D can
Results: The six dietary patterns comprised two patterns with be found in food products such as oily fish, the primary source of our
significant shares of traditional food (N=548) and four patterns with intake is from sun exposure (photoactivation). It is estimated that
predominantly imported food (N=1485). All dietary and non-dietary worldwide a billion people are vitamin D deficient, where latitude and
risk factors, except hypertension, differed significantly among the six subsequent sun exposure are playing a significant role in the
dietary groups (p<0.001 to 0.01). A traditional diet differed significantly epidemiology of this problem.
from an imported diet with respect to the intake of n-3 fatty acids, In order to establish how reduced sun exposure is affecting the bone
fruit, vegetables, dietary fibres, sugar, and glycemic load. A traditional mineral density (BMD) of healthy individuals, this research will look at
diet was furthermore associated with a high level of physical activity, healthy personnel based in the sun-deprived continent of Antarctica in
high prevalence of smoking, poverty, and Inuit ancestry. the winter months, and compare the subsequent BMD loss incurred
Conclusion: Some risk factors associated with a traditional diet reduce against a healthy UK based control group. Vitamin D deficiency as a
and some increase the risk for cardiovascular disease and diabetes. result of a lack of sun exposure has never been studied in British
Epidemiological studies of the association of diet with cardiovascular Antarctic Survey (BAS) personnel before. The possible health
disease and diabetes among the Inuit must take the complexities of implications for such a deficiency are potentially huge.
the diet and the confounding by non-dietary risk factors into Antarctica is a unique environment, where fit and healthy medically
consideration. screened BAS employees spend up to 2 years on the continent. Their
Contact: Peter Bjerregaard (pb@niph.dk)
exposure to UVB radiation as well as their diet and exercise levels will
be monitored. Blood tests assessing bone turnover markers will be
DETERMINANTS OF CHANGE IN FAT CONSUMPTION taken every 3 months. Furthermore, DXA bone scans will be
undertaken prior to leaving, and on their return from Antarctica,
PATTERNS IN NAIN, NEWFOUNDLAND
allowing the effects of a low vitamin D status on BMD to be assessed.
S. Bernier, C. Furgal, K. Winters, E. Dewailly, the Nunatsiavut This group can therefore provide valuable information regarding the
Government. extent to which latitude and sun exposure are truly influencing vitamin
Nasivvik Centre for Inuit Health and Changing Environments D status.
Inuit communities are reporting changes in individual attitudes It is hoped that the International Congress on Circumpolar Health will
towards traditional fats and contemporary fats. Given the potential provide a forum to discuss the possibility of running parallel studies in
health effects of these changes, a better understanding of how choices the Arctic, where the BMD of people residing at high northern latitudes
are made is needed. can be assessed alongside those in Antarctica.
Contact: Daranee Boon (daranee.boon@phnt.swest.nhs.uk)
This study is investigating the changing nature of perspectives on
traditional and contemporary fats and the impacts of these
perspectives on diet and other behaviours among Inuit in one AN ASSESSMENT OF DIETARY INTAKE IN AN INUVIALUIT
community of the Nunatsiavut Settlement area, Canada. POPULATION TO HIGHLIGHT FOODS FOR A NUTRITIONAL
This research project supports the role of Inuit health organizations in INTERVENTION PROGRAM TO IMPROVE DIETARY INTAKE:
providing information and nutrition education tailored to local needs RESULTS FROM HEALTH FOODS NORTH
and preferences, on matters of food, nutrition and health. This project
is being conducted in collaboration with the Nunatsiavut Government S. Sharma, E. De Roose, X. Cao, J. Gittelsohn, A. Corriveau
under the IPY funded project on marine fats and Inuit health: URQSUK. University of North Carolina at Chapel Hill, Nutrition Research Institute,
The project aims to develop and apply a survey tool to increase our Kannapolis, NC
understanding of fat choice behavior and to determine what Inuit Objectives: 1) To characterize food and nutrient intake; 2) to highlight
residents believe is necessary and possible to ensure food security for foods for a nutritional intervention program; and 3) to develop a
future generations. Quantitative Food Frequency Questionnaire (QFFQ) to evaluate the
To build this tool, in July 2008, 9 focus groups were conducted with program and monitor nutrition transition for the Inuvialuit population
participants 14-70 years of age (23 women, 26 men). 78% participated in the Northwest Territories (NWT), Canada.
in harvesting activities. Setting: Two communities in the NWT: one larger but less traditional
Preliminary results indicate that participants have noticed changes in and one smaller and more traditional.
fat thickness in country food species over time. Observations were Methods: A cross-sectional dietary study was conducted among
primarily associated with caribou and birds. Differences in thickness of Inuvialuit adults using 24 hour dietary recalls.
seal fat were attributed to seasonal changes and possibly, climate Results: 48 men and 53 women (mean age 49 and 45 yrs, respectively)
variations. Contrary to our preliminary hypothesis, it is not only among aged 19-88 years completed the recalls. The response rate was
younger participants that behaviors to cut down or stay away from approximately 70-90%. Mean energy intake was 2,352 kcal and 1,739
“fat” in the diet were mentioned but in fact more so among kcal for men and women, respectively. Mean daily intakes of many
participants 30 years and over. Furthermore, participants reported that nutrients including dietary fiber, calcium, and vitamins A, C and E, and
fat was cut off from store foods but very rarely from country foods. total folate were much lower than recommended. Mean daily intake of
Based on these results a quantitative survey is being developed to fruits and vegetables was low. The greatest contributors to energy
investigate the representation of these perspectives among the were sugar added to tea and coffee, sweetened juices/drinks and pop.
community population in 2009. Butter and margarine were the highest contributors to total fat intake.
Contact: Susie Bernier (susie.bernier@crchul.ulaval.ca)
Traditional foods were only significant contributors to protein, iron and
zinc. A 145-item QFFQ was developed based on the dietary recall data.
Conclusions: This study has provided dietary intake data previously Methods: Data are from a cross-sectional study among Inuit >18 years
unavailable for this population, and highlighted nutrients and foods to in west Greenland. Data were collected by food frequency
be targeted for the nutritional intervention program. The QFFQ questionnaire and interviews. In the analyses we included men and
developed for Inuvialuit is culturally appropriate and up-to-date. women with a daily consumption of 3350-17 000 kJ and 2100-15 000 kJ,
Acknowledgements: We thank Andrew Applejohn for his incredible respectively. Eligible individuals totalled 2034 (43% men). We
assistance and guidance, as well the participating communities. We constructed a dietary quality index based (range 0-100, 100=best
would also like to thank the Aurora Research Institute for their quality) on: gram dietary fibre/MJ and energy percentage of saturated
tremendous support of our work. The research was supported by the fat. The dietary quality score (DQS) was calculated for each item based
American Diabetes Association Clinical Research Award Grant # 1-08- on the dietary content of the component compared to the Danish
CR-57. nutritional recommendations. By logistic regression we examined
Contact: Sangita Sharma (sangita_sharma@unc.edu) whether age, sex, urbanization and occupation influenced DQS
constructed as a dichotomised variable: the highest 25% of DQS, and
the lowest 25% of DQS.
FOOD AND NUTRIENT INTAKE OF INUIT ADULTS AND THE Results: Women had significant higher chance of a high DQS than men
DEVELOPMENT OF A QUANTITATIVE FOOD FREQUENCY (OR=2.4; 95%CI: 1.8-3.2). Inuit living in towns had the highest dietary
QUESTIONNAIRE TO EVALUATE A NUTRITIONAL AND quality (OR=1.3; 95%CI: 1.0-1.9) compared to the capital and villages.
LIFESTYLE INTERVENTION PROGRAM AIMED AT Fishermen and hunters (OR=0.2; 95%CI: 0.1-0.5), and the unemployed
IMPROVING DIETARY INTAKE AND HEALTH: RESULTS (OR=0.5; 95%CI: 0.3-0.8), had significantly higher risk of a low DQS
FROM HEALTHY FOODS NORTH compared to those employed where education at middle-high level
was required.
S. Sharma, X. Cao, C. Roache, R. Reid, J. Gittelsohn
Conclusions: Like in other populations women had a higher DQS than
University of North Carolina at Chapel Hill, Nutrition Research Institute, men. It seems that not having a continuously occupation leads to a
Kannapolis, NC higher risk of low dietary quality. Analysis could be expanded with data
Objectives: To characterize the diets of adult Inuit, to highlight foods on household income in order to investigate this association further.
for a nutritional and lifestyle intervention program, and to develop a Preferably, we should test other dietary quality indexes in order to find
Quantitative Food Frequency Questionnaire (QFFQ) to evaluate the the best suitable index for an Inuit population.
program and monitor changes in dietary intake in this population over Contact: Charlotte Jeppesen (chj@niph.dk)
time.
Setting: Two remote communities in Nunavut, Canada.
INFLUENCE OF CASUAL WEAR AND EVERYDAY DIET ON
Methods: A dietary survey using single 24 hour dietary recalls was HEALTH
conducted among randomly selected Inuit adults.
V. Dekabrina
Results: A total of 87 (42 men and 45 women) Inuit adults aged 19-87
Institute of Humanities and North Indigenous Peoples SB RAS
years participated with a response rate of approximately 70-90%. The
mean energy intake for men and women was 2,278 and 1,658 kcal The research was carried out in December 2008 among the students of
respectively. The intakes of dietary fiber and the majority of vitamins the Institute of Physical Culture and Sports of Yakut State University.
and minerals examined (especially vitamins A, D and E, total folate and 32 students (among them 12 girls) were offered to write a free-format
calcium) were far below those recommended. The most commonly short story on themselves. The story had to touch upon three things:
reported items were all store-bought foods including coffee, white what they wear in winter, where and what they eat, what they do when
bread, sugar, juice, tea, butter or margarine, coffee mate, chips and ail or ill. The analysis was based on comparing students’ “ideals” and
pops which were reported by between 29%-70% of respondents at their everyday practice.
least once per day. Traditional foods contributed 40% and 42%, By students’ admission, during winter term they often get cold, their
respectively, to protein and iron intakes. We highlighted foods high in chronic diseases (kidney, joints, heart etc.) become more acute. Chill is
fat and sugar that will be targeted and replaced by healthier, more considered an ordinary thing, and they stay on their feet or practice
nutrient dense alternatives to address the dietary inadequacies as part autotherapy. Among usual reasons for ignoring medical assistance
of the Healthy Foods North nutritional intervention program. A 153- there are lack of time, queues in clinics, unwillingness to fail to attend
item QFFQ was developed and pilot tested based on the recall data. classes, a doctor in the family, relatives’ and friends’ advice, possibility
Conclusions: These findings highlighted foods to be targeted for a of self-treatment (taking advertised drugs).
nutritional intervention program aimed at improving dietary intake However, majority of students are not inclined to connect their health
and health. problems with wearing synthetic fabric clothes, though many
Acknowledgements: We are grateful to Ms. Annie Buchan and Ms. mentioned the necessity of warm winter clothing and the fact of being
Rahabi Kamookak for their incredible guidance and hard work on the cold in their casual wear.
project. The research was supported by the American Diabetes The analyses makes it possible to conclude on differences between
Association Clinical Research Award Grant # 1-08-CR-57. imagined and usual practice. At first, dietary regime and ration
Contact: Sangita Sharma (sangita_sharma@unc.edu)
difference cannot be explained only by lack of money. The possible
reasons include defects both in curriculum (timetable of classes and
coaching) and in everyday life of an individual student. Secondly, we
QUALITY ASPECTS OF THE INUIT DIET IN GREENLAND
must take in mind the choice of the modern wear made of synthetic
C. Jeppesen, P. Bjerregaard fabric that is of little use in winter climate conditions in the area of
Centre for Health Research in Greenland Directorate of Health and permafrost.
National Institute of Public Health Contact: Vinokurova Dekabrina (dorofdm1@yandex.ru)
Background: Greenland undergoes a dietary transition, which together

with other factors has led to an increasing prevalence of obesity and
life style diseases among the Inuit. Dietary quality indexes have been
found to be an useful indicator of nutritional quality of diet in many
populations. This study aims to investigate how the dietary quality
varies by sex, age, urbanization, and occupational level.
Geographic and demographic attributes were observed to be divided

VENUE 4 among the various HBV genotypes.
Infectious Diseases #4 – Hepatitis Conclusions: The observation of a very high prevalence of HBV/B6
within the Canadian Arctic, along with our recent finding of a relatively
benign clinical outcome in patients infected with B6, presents the
FREQUENCY AND DISTRIBUTION OF HEPATITIS B VIRUS
possibility of a reduced impact of health burden related to HBV
GENOTYPES IN GREENLAND ASSOCIATION WITH PRECORE infection among Aboriginal populations in this region.
AND BASAL CORE PROMOTER MUTATIONS Contact: Carla Osiowy (carla_osiowy@phac-aspc.gc.ca)
M.L. Børresen1, H. Krarup2, A. Koch1

1
Department of Epidemiology Research, Statens Serum Institut, A POPULATION BASED PERSPECTIVE AND RETROSPECTIVE
Copenhagen, 2Department of Clinical Biochemistry, Ålborg University
STUDY OF LIVER RELATED MORTALITY IN ALASKA NATIVE
Hospital, Ålborg, Denmark
PEOPLE WITH HEPATITIS C INFECTION
Based on interdivergence of 8% or more in the complete hepatitis B
B.J. McMahon1,2, D. Bruden2, M. Bruce2, S. Livingston1, C. Christensen1,
virus (HBV) DNA-strain, HBV has been classified into eight genotypes
C. Homan1,2, J. Williams1, D. Sullivan3, H. Rosen4, T. Hennessy2, D.
(A-H) and many sub-genotypes with distinct geographical distribution.
Gretch3
Recent studies have found an association between different genotypes
1
and the clinical outcome as well as therapeutic response. Greenland is Liver Disease and Viral Hepatitis Program, Alaska Native Tribal Health
an HBV high-endemic country and between 5-10% of the population Consortium, Anchorage, AK. 2Arctic Investigations Program, Centers for
are chronic carriers. There is little knowledge of the genetic variability Disease Control and Prevention, Anchorage, AK, 3University of
and molecular evolution of the HBV strains in Greenland. We therefore Washington, School of Medicine, Seattle, Washington, 4University of
carried out a study to characterize the distribution of HBV Utah, School of Medicine, Denver, Colorado
genotypes/subgenotypes as well their association with basal core Hepatitis C virus (HCV) infection is a cause of significant morbidity and
promoter and precore mutations in a cohort of 150 HBsAg positive mortality in Alaska Native People. Risk factors associated with adverse
individuals from the Southwest and South of Greenland. Genotypes outcome are not well elucidated. We conducted a prospective
were determined via a nested PCR of a region of the S-gene. We found population-based study from 1/1/1994 to 12/31/05 examining the
four different genotypes, A, B, C and D, with 60% being genotype D2, incidence of and risk factors associated with the development of
24% genotype A, 15% genotype B6 and 1% genotype C. To endstage liver disease (ESLD) and liver related death.
characterize the Greenlandic genotype distribution and clustering a
Methods: Retrospective computerized medical records and stored sera
phylogenetic tree will be constructed and compared to genome
were available on most patients. Univariate and multivariate analysis
sequences of different variants of HBV from the GenBank database.
was performed and survival models developed to examine factors
Furthermore types and rates of mutations of the genotypes will be
statistically associated with development of liver-related death.
presented.
Contact: Malene Landbo Børresen (mlb@ssi.dk) Results: 1114 persons were followed prospectively for an average of 7
years and another 12 years of retrospective data were available. 695
persons had chronic HCV and 214 had recovered spontaneously. ESLD
GENOTYPIC CHARACTERIZATION OF HEPATITIS B VIRUS and liver-related death occurred in 80 and 50 persons respectively. The
FROM CHRONIC CARRIERS LIVING IN THE CANADIAN liver related death rate (per 100 person years of follow-up) among
NORTH persons who drank > 50 grams of alcohol/day on average was 2.28 in
C. Osiowy1, B. Larke2, E. Giles1 chronically infected person vs. 3.50 in recovered HCV patients (p=.34).
1
Among those who drank < 50 grams/day, rates were 0.77 and 0.09
Public Health Agency of Canada, National Microbiology Laboratory, (p=0.01). For persons who had recovered from HCV, the mortality rate
2
Yukon Department of Health and Social Services, Canada was 20 times higher in those who continued to consume > 50
Introduction: Chronic infection with hepatitis B virus (HBV) is the most grams/day of alcohol vs. those who did not. On univariate analysis,
common cause of primary liver cancer worldwide. Very little is known heavy alcohol usage, older age at infection, AFP > 8 ng/ml, AST/ASL >
regarding the molecular characterization of HBV in Canadian Inuit and 1, viral load > 800,000 IU/ml, and genotypes 1 and 3 vs. genotype 2
other Northern Indigenous populations, where HBV was considered were associated with greater risk of developing ESLD; however,
endemic prior to the introduction of hepatitis B vaccination programs. diabetes, obesity, route of infection (intravenous drug use vs. blood
This study expands upon an HBV seroepidemiological study conducted transfusion), anti-HBc and or anti-HBs without HBsAg were not.
between 1983 and 1985 throughout the Canadian Arctic in order to Conclusion: Heavy alcohol use is associated with the highest risk of
further characterize HBV in these populations. liver-related death or ESLD, regardless of whether persons are
Methods: HBsAg-positive sera collected during the original study were chronically infected or have recovered from HCV.
extracted and amplified to detect HBV DNA. Sequence and Contact: Brian McMahon (bdm9@cdc.gov)
phylogenetic analyses were performed to determine nucleotide

variations, viral genotype and phylogenetic groupings. Associations
between the HBV genotype and demographic and geographic ABORIGINAL IMMUNITY: POTENTIAL CONTRIBUTION TO
attributes were also analysed. THE OUTCOME OF HEPATIC INFECTION AND DISEASE
Results: A total of 14,198 individuals living within the Canadian Arctic J. Rempel
participated in the original serosurvey. Archived sera from 401 HBsAg- University of Manitoba
positive participants were tested for HBV DNA. Sixty-nine percent of One of the main tasks of the immune system is to defend the body
samples (277/401) were DNA positive, with the majority having very against infectious disease. Our laboratory has been evaluating First
low viral load (median IU/ml: 1.87E +03). The predominant HBV Nation (primarily Ojibwa/Cree) immunity against hepatitis C virus
genotype was genotype B (HBV/B, 76%), followed by HBV/D (23%) and (HCV) because of the high prevalence of acute HCV infection, and
HBV/A (1%). Following phylogenetic analysis, all HBV/B strains therefore, chronic HCV infection, relative to other Canadian
clustered within subgenotype B6, a newly recognized HBV genotype populations. However, recent studies by Minuk et al and other groups
among Inuit and other Aboriginal people living within western suggest that First Nations clear acute HCV infection more effectively
circumpolar regions. The majority of HBV carriers had mutations than other peoples, perhaps partially mitigating the chronic HCV
associated with loss of the HBeAg marker, whereas very few had burden. Our studies found differences between First Nation and
mutations associated with development of hepatocellular carcinoma. Caucasian immune activity that may explain these clinical findings.
Pairing genetic and cellular assays, differences were observed in Introduction: Genotypes of hepatitis viruses B and D can be clinically
immune responses that are responsible for either activating or and epidemiologically relevant. We studied prevalence of genotypes of
inhibiting the immune system. First Nations appeared to develop these viruses in the Chukot region.
responses that associate with a more activated immunity, as Materials and Methods: Serum samples from 124 chronic hepatitis B
determined by the genetic tendency and cellular ability to produce (CHB) patients (65 males, 59 females) from the Chukot region were
certain cytokines (immune regulatory proteins). In addition, included. 113 (91%) were natives (103 Chukchi, 10 Eskimo), and 11 non-
differences in the presence of receptors (killer Ig like receptors, KIR) natives. Samples were studied by PCR for HBV and HDV. HBV
that modulate immune responses were found. These immune trends genotyping was performed by subtype-specific PCR. 59 HBV and 48
observed in First Nation relative to Caucasian individuals parallel trends HDV isolates were sequenced. Phylogenetic analysis was performed by
from studies evaluating immunity upon spontaneous HCV clearance ML and NJ algorithms with bootstrap analysis (1000 repeats).
relative to chronic HCV infection. Thus, our data support the
observation that First Nation immunity is more capable of clearing Results: HBV DNA was amplified in 92 cases (74.2%). In 65 patients
HCV infection than other peoples. On a cautionary note, these same (70.6%) genotype D was detected, in 24 (26.1%) — genotype C, and in 3
immune responses that protect the body from viral infections can also samples (3.3%) were found to be D/C recombinants. Among sequenced
predispose an individual to develop certain other conditions that are samples 32 were subtype D3, 2 — D2, and 1 — D1. Subtypes D1 and D2
more common in the First Nation People, such as autoimmune were isolated only from non-native patients, subtype D3 — mainly
disorders. from natives (91%). Genotype C was prevalent in natives and belonged
Contact: Julia Rempel (jdrempel@cc.umanitoba.ca)
to C1 subtype. D/C recombinants were found in natives only. 62
samples (50%) were found to be HDV positive. HDV was detected in all
D/C recombinants, in 59% of genotype D and in 13% genotype C
LONG-TERM PROTECTION AFTER HEPATITIS B samples. 47 (98%) of HDV isolates were of genotype I and 1 (2%) — of
IMMUNIZATION IN ALASKA NATIVE PEOPLE genotype II.
B. McMahon, L. Bulkow, J. Williams, D. Bruden, M. Snowball, S. Negus, Conclusion: HBV genotype C and subtype D3 are much more prevalent
D. Hurlburt, C. Zanis, K. Boyd-Hummel, E. Dunaway, R. Singleton, C. in Chukot region than in the other regions of Russia and were shown to
Homan, A.J. Parkinson, M. Bruce, T. Hennessy be endemic for Chukot natives. Half of CHB patients are co-infected
with HDV. HDV is presented by two genotypes — I and II, with obvious
Alaska Native Tribal Health Consortium & the Arctic Investigations
predominance of genotype I. Significant difference in prevalence of
Program, Centers for Disease Control, Anchorage Alaska
HDV among patients with genotypes D and C of HBV could be due to
Routine immunization for hepatitis B virus (HBV) was initiated in the different time and routes of their introduction into Chukot region.
early 1980s. Several studies were established to determine long-term Contact: Fast E.V. (Labryut@yandex.ru)
protection in cohorts of Alaska Native People and non-Natives who
received a three dose primary series of hepatitis B vaccine.
Methods: Beginning in the early 1980s, 1,864 persons (334 immunized
starting at birth and 1,530 immunized as children and adults) were
VENUE 5
followed for 15 to 23 years with HBV seromarkers. Booster doses were Education and Building Resource/Research Capacity #2
administered to persons who lost protective antibody to hepatitis B
antigen (anti-HBs) to determine anamnestic response. BY THE NORTH FOR THE NORTH: A PAN-TERRITORIAL
Results: In persons immunized as children (>6 months of age) or adults, STRATEGY TO BUILD PUBLIC HEALTH CAPACITY
the proportion of persons with anti-HBs > 10mIU/ml fell from 94% 6 M. Bell
months after primary series to 66% at 15 years and 59% at 23 years of
follow-up. In the cohort immunized beginning at birth, only 8% had Skills Enhancement for Public Health: Core Competencies for Public
anti-HBs levels > 10 mIU/ml at 10 years. Anti-HBc-positive Health in Canada & Skills Online, Public Health Agency of Canada
breakthrough infections were seen in 29/1,864 (1.6%) long-term Note: This is the first of 3 topics in a Panel discussing the Skills
vaccine follow-up participants. Of those, eight had HBV DNA present Enhancement for Public Health programme. Other presenters are
transiently, including one with 142R escape mutant. None had acute Jamie Rossiter/Laurie Parton and Tom Axtell.
symptomatic hepatitis or became a chronic carrier. Booster dose Following extensive consultation, the Public Health Agency of Canada
studies performed in those immunized as children or adults showed launched the Core Competencies for Public Health in Canada: Release
that >80% whose levels of anti-HBs had fallen to <10 mIU/ml 1.0 in September, 2007. Core Competencies define the essential
responded and the overall protective efficacy of this vaccine 23 years knowledge, skills, and attitudes necessary for effective public health
later was 94%. In contrast, response to booster dose was less vigorous practice. They are foundational for public health human resource
in those immunized as neonates, as by 15 years only 50% had a booster planning and workforce development. The Core Competencies are
response despite the evidence that there were no clinically apparent being used in a variety of settings to inform the development of
breakthrough infections. orientation and performance assessment tools, identify continuing
Conclusion: Long-term protection lasts at least 23 years in those education needs, influence public health curriculum, and assist in
immunized as children or adults and at least 15 years in those human resource planning.
immunized as neonates. Also, there is no evidence that vaccine escape Since 2002, the Agency’s Skills Online program has offered Internet-
mutants are replacing wild type HBV in this population. based continuing education in English and French to interdisciplinary,
Contact: Brian McMahon (bdm9@cdc.gov)
front line public health professionals through a series of accessible,
competency-based modules. Participation in the modules helps
MOLECULAR EPIDEMIOLOGY OF VIRAL HEPATITIS B, C, practitioners to acquire and maintain the Core Competencies, and
contributes to the increased capacity of Canada’s public health
AND D IN THE CHUKOT REGION
workforce, which is widely distributed both geographically and
I.V. Karandashova1, A.D. Neverov1, E.V. Fast2, V.A. Dolgin1, S.I. organizationally.
Braslavskaya1, V.P. Chulanov1
While public health human resource capacity is a challenge nationally
Russian Association of Indigenous Peoples of the North (Raipon), 1Central and globally, these challenges are particularly acute in the North where
Research Institute of Epidemiology, Moscow, Russia, 2Chukot Regional recruitment and retention of public health professionals can be linked
Hospital, Anadyr, Russia to many quality of life factors. There are not enough skilled public
health professionals and training and professional development
opportunities are limited. However, there are significant strengths in in public health without a Health Sciences diploma or degree, it is
the North including strong, community developed and driven essential.
approaches to health and wellness. Through Health Canada’s Aboriginal Health Transition Fund, the
Following northern consultations on the Core Competencies, the Skills National Aboriginal Health Organization is building a Web-based
Enhancement for Public Health program engaged stakeholders from clearinghouse of health-related statistics to enable the four Inuit land
the three Canadian territories to partner in the development of a claim organizations and governments to further their knowledge of the
strategic plan, tailored to the specific needs of the North, to address determinants of health. Inuit Health Data Analysts must ensure that
workforce development challenges. The pan-territorial strategy statistics are presented in a way that makes sense to Inuit audiences.
focuses on building capacity through education and training, targeted The Naasautit (the Inuit word for meaningful numbers): Inuit Health
communications, and organizational support within the northern Statistics project choose the Public Health Agency of Canada’s Skills
reality. The collaborative process illuminates insights and directions for Online Introduction to Epidemiological Concepts (EPI 1) module
putting the plan into action in Canada’s diverse North. delivered to the desktop as the best way for staff to gain this
Contact: Marnie Bell (marnie_bell@phac-aspc.gc.ca) knowledge in the context in which it would be applied, their
workplaces.
PUBLIC HEALTH PROFESSIONAL DEVELOPMENT ONLINE: In the fall of 2008, three Inuit and First Nations learners enrolled in the
first Northern health worker pilot; two completed. Support through
SUCCESSES AND CHALLENGES
weekly teleconference meetings was the only adaptation to the
J. Rossiter1, L. Parton2 module delivery for Northern learners. The meetings with an
1
Skills Enhancement for Public Health: Core Competencies for Public epidemiologist from the First Nations and Inuit Health Branch provided
Health in Canada & Skills Online, Public Health Agency of Canada, an oral learning component where knowledge was co-constructed with
2
Yellowknife Health & Social Services Authority, Yellowknife, NT a mentor, co-workers, and peers. This oral communication provided
The Public Health Agency of Canada’s Skills Online program offers some essential social support while shaping the learner’s identity as a
continuing education to front-line public health professionals. This public health practitioner.
competency-based program contributes to strengthening capacity of The piloting of EPI1 has opened the door for effective online learning
Canada’s diverse public health workforce. To date, nine modules have for Northern aboriginal health workers. Examples from the pilot
been developed covering basic epidemiological concepts and various describes the successes and challenges to learning in a remote setting
public health topics. Since 2002, over 2,800 practitioners have and outlines areas for further adaptation to suit the needs of this
completed at least one module. In addition to Canadian learners, there audience. A larger second pilot in May 2009 will continue exploring
have been participants from Africa and the Caribbean. Several modules module content and delivery adaptations for northern aboriginal
have been adapted for use by universities in Canada and Australia. workers.
Evaluations indicate benefits to both individual practitioners and their Contact: Tom Axtell (Taxtell@naho.ca)
organizations.
Modules are offered three times per year over eight weeks. For each CREATING HEALTH RESEARCH CAPACITY: THE ABORIGINAL
module, a trained facilitator who is knowledgeable in the subject HEALTH NETWORK PARTNERSHIPS FOR BRITISH
matter leads a cohort of 15 to 20 participants. Learning activities are
COLUMBIA AND THE WESTERN ARCTIC
delivered through an online asynchronous learning management
system. As well as textual materials, modules contain video clips, links J. Reading
to important sources, assignments, discussion forums, and self-test Centre for Aboriginal Health Research at University of Victoria
questions. A demonstration of the format and use of the modules will
The CIHR-Institute of Aboriginal Peoples’ Health (IAPH) is dedicated to
be provided.
reducing the burden of illness in the Aboriginal Peoples of Canada
Modules are developed cooperatively by respected epidemiologists, through a program of advanced research. The CIHR-IAPH has funded
health educators, experts in the field, and front line practitioners. nine Network Environments for Aboriginal Health Research (NEAHR)
Materials are reviewed regularly by a national task group to keep them across Canada. In British Columbia, the Michael Smith Foundation for
current with respect to content, e-learning and adult-learning Health Research (MSFHR) has funded eight Health of Population
practices. Networks one of which is the Network Environments for Aboriginal
Recent research examined adaptations of modules at the University of Research BC (NEARBC) which is dedicated to linking together the
Saskatchewan, and in the Caribbean. Results indicate that adaptations expertise of all individuals with an interest and expertise in Aboriginal
into new settings face pedagogical, technological, content health research. The Centre for Aboriginal Health Research (CAHR) is a
development, and cultural hurdles. These challenges can be addressed group of researchers at the University of Victoria with an interest in
through learning designs that considers appropriate learning Aboriginal Health Research.
objectives, skills of the learners, access to the Internet, and In April 2008, funding from CIHR-IAPH and MSFHR was merged to
appreciation of cultural factors. These issues are especially important create the entity called NEARBC. NEARBC is composed of three
in the North where health care workers may not have the necessary staffed geographical nodes, an oversight committee comprised of 18
public health background, education or experience, Internet experts in Aboriginal Health in BC and over 1000 members. Its main
accessibility issues are common and a range of different cultures are outputs are: Annual Aboriginal Health Student Fellowships and
represented. Awards, Seed Grants and Travel Bursaries, Complementary Training
Contact: Jamie Rossiter (jamie_rossiter@phac-aspc.gc.ca) (i.e. workshops and conferences), Aboriginal Health Abstract
Database, Website, Weekly e-news, Online Aboriginal Health Video
Gallery, and Searchable Members’ Database. Task Groups: Complex
PUBLIC HEALTH SKILLS ONLINE: PILOT FOR NORTHERN
Interactions in Chronic Disease, Ethics, Infectious Disease, Northern
ABORIGINAL WORKERS Health, Traditional Knowledge.
T. Axtell Contact: Jeff Reading (jreading@uvic.ca)
Inuit Tuttarvingat, National Aboriginal Health Organization

Knowledge of epidemiologic concepts is essential to the practice of
effective public health. Not all Inuit, First Nations and Métis in the
North need to understand epidemiology, but for those who obtain jobs
1
THE NATIONAL COLLABORATING CENTRE FOR Global eHealth Research and Training Program, University of Calgary,
2
ABORIGINAL HEALTH: A CENTRE FOR SHARING Pan Asian Collaboration for evidence-based ehealth Adoption and
KNOWLEDGE Application
G. Thomas, M. Greenwood eHealth (application of information and communications technologies

(ICTs) to facilitate health, healthcare, and health related education and
University of Northern British Columbia research), has become an accepted tool in addressing health issues,
The Public Health Agency of Canada established six national and has been stated to be “the single most important healthcare
collaborating centres in public health to support the federal strategy to system revolution, on a par with the use of modern medicines, vaccines
strengthen public health in Canada. One of those centres is the or even such healthcare measures as sanitation or clean water.”
National Collaborating Centre for Aboriginal Health (NCCAH) which is Similarly, networked research activities have noted benefits, including
hosted at the University of Northern British Columbia in Prince George, broader sharing of knowledge, increased scope for research activities,
British Columbia. Since its inception in 2005, the NCCAH has played a greater capacity building, and administrative resilience. Yet, no Arctic
key role in supporting networks and facilitating dialogues focused on focussed eHealth research network exists, and the International
Aboriginal public health in Canada. Journal of Circumpolar Health shows only sporadic and low ehealth
The long term goal of the NCCAH is to support a Canadian public publication, with just 26 eHealth-related publications between 1988
health system that recognizes, and is respectful of, the needs of First and 2008, 19 of which were in the 2004 issue (following a special call
Nations, Inuit and Métis peoples. In order to achieve this goal, its and conference).
mandate is threefold: 1) to translate existing knowledge in Aboriginal Given the importance of eHealth, the value of networked research
public health into action; 2) to identify and address gaps in Aboriginal undertakings, and the poor publication record for focussed Arctic
public health; and 3) to support networks that enhance the synthesis, eHealth research, introduction of a Pan-Arctic eHealth research
transfer and exchange of knowledge in Aboriginal public health in network initiative may be appropriate. To highlight the value and
Canada. challenges of such an initiative, the genesis and present day
This presentation will demonstrate how the NCCAH has successfully performance of PANACeA (Pan Asian Collaboration for evidence-
brought First Nations, Inuit and Métis organizations together to based ehealth Adoption and Application) will be described, together
address their public health issues along with strategies the NCCAH has with experience from other network research activities.
undertaken to support them in addressing the challenges and issues PANACeA is successfully generating evidence for eHealth within the
they face. From the start, the work of the NCCAH was founded on a set Asian context through a network of researchers and research projects
of guiding principles that respects the diversity of First Nations, Inuit from developing Asian countries. They perform multinational projects
and Métis peoples and facilitates the inclusion of their voices in the to evaluate e-Health solutions in the field and to generate evidence
work of the NCCAH, thereby ensuring its relevance to their through methodologically sound research. This evidence is intended to
communities. be scalable and generaliseable to other developing countries, and will
Participants will be encouraged to lend their voices to a dialogue about be used to advocate for ehealth policies in Asian countries.
public health and the needs of circumpolar peoples. Participants will A networked research approach that focuses on eHealth
also be invited to discuss activities that the NCCAH could undertake implementation in the Arctic would lead to more rapid accrual of
that would support them in realizing their health agendas. benefit from “technologically appropriate and culturally sensitive”
Contact: Ginette Thomas (thomasg@unbc.ca) ehealth solutions.
Contact: Richard Scott (rescott@ucalgary.ca)
SUSTAINING HEALTH RESEARCH ACTIVITIES IN CANADA’S

NORTHERN TERRITORIES INTRODUCING INTERNET COMMUNICATIONS
S. Chatwood TECHNOLOGIES TO A NORTHERN HEALTH CONTEXT: BEST
PRACTICES AND POTENTIAL IMPLICATIONS
Institute for Circumpolar Health Research
R. Rawat
In Canada’s northern territories there have been a number of pan
northern initiatives and programs over the past three years which have York University, Arctic Health Research Network - NT
focused on health research. These programs include the International In the last decade, internet communications technologies (ICTs) have
Polar Year Activities, the CIHR team in circumpolar health research, Tri rapidly emerged as a key aspect of health service provision in the
territory health access programs and INAC Arctic Research Initiatives. developing world. From telehealth and knowledge management
All initiatives have created a stimulus for northern based health systems to community youth projects and personal blogs on patient
research activities and have created forums for further discussion as to and caregiver experiences, ICTs have seen widescale adoption. In the
what is entailed in health research and how one should proceed and Circumpolar north, increasing internet access and bandwidth has
make health research activities sustainable in our northern regions. allowed these technological practices to penetrate remote
These activities have also supported the creation of the Arctic Health communities, although their use as aids to communications and
Research Network and the Institute for Circumpolar Health Research. information sharing have yet to be evaluated. This presentation will
Through this development observations have been made around serve two purposes. For those organizations seeking to implement
operational components which make up the health research process their own internet technologies strategies, the presentation will review
and the current capacity and gaps in our northern regions. This the latest in open source software packages from content
presentation will summarize some of these observations and provide a management systems to collaborative groupware. It will also provide a
platform to discuss next steps required to continue the development of list of best practices for non-profit, service-oriented organizations to
a sustainable northern health research structure. minimize costs, guarantee accessibility, and produce dynamic content.
Contact: Susan Chatwood (ahrn.ed@theedge.ca) In support of this goal, insight from over ten years experience in
designing, implementing, and managing ICTs in a health and social
advocacy context will be shared. The second goal will take a broader
A PAN-ARCTIC COLLABORATIVE FOR E-HEALTH: NEED,
look at the social and psychological implications of the introduction of
VALUE, AND LESSONS ICTs. As powerful harbingers of global influences on highly localized
R.E. Scott1, S. Khoja1, H. Durrani2 populations, their manifold and complex impacts will necessarily have
to become a field of inquiry. This presentation will take the tentative
first steps in this area.
Contact: Rajiv Rawat (rajiv@yorku.ca)

environments in the three territories; and relevant best practices.
Research findings are presented alongside anthologies of homeless
Women’s narratives giving equal value to the experiences and voices of
participating homeless women.
SESSION 7 Two main conclusions: all Northern women can be considered at risk of
homelessness because a small change in their circumstances can
Tuesday, July 14, 1:30-3:30 PM jeopardize the fragile structure of their lives and, homelessness is
largely hidden and easily ignored. Sixteen recommendations were
generated for all three territories and recommendations specific to
VENUE 1 each territory.
Housing & Infrastructure We propose to lead an interactive workshop exploring our unique
collaborative process, research process and notable findings; the
HOUSING CONDITIONS AND TUBERCULOSIS: EXPLORING impact of the research on services, awareness; ways the research has
been used by communities. Participants will have an understanding of
THE RELATIONSHIP BETWEEN DISEASE AND
the dynamics of Northern Women’s homelessness and the
ENVIRONMENT IN NORTHERN FIRST NATIONS power/synergy of trans-boundary work.
COMMUNITIES Contact: Arlene Hache (arleneh10@hotmail.com)
L. Larcombe, P. Orr
University of Manitoba EVERYONE WANTS TO HAVE A PLACE?: UNDERSTANDING
Housing conditions are used as socio-economic indicators for health HOMELESSNESS AS HOUSING INSECURITY IN THE
and well-being. Poor housing quality and overcrowding are associated NORTHWEST TERRITORIES, CANADA
with poverty, with specific ethnic groups, and with increased
J. Christensen
susceptibility to diseases. Crowding, poor air quality within homes as a
result of inadequate ventilation, and the presence of mold and smoke McGill University Department of Geography
contribute to poor respiratory health in general and have been Homelessness in the Northwest Territories (NWT) is commonly
implicated in the spread and/or outcome of tuberculosis. Qualitative regarded as a recent phenomenon, and one that is growing and
and quantitative data were collected in two First Nation communities changing in ways particular to the northern context. The proposed
regarding housing conditions and tuberculosis. The single most Mackenzie Gas Project is expected to stimulate economic growth, as
important housing characteristic associated with the presence of well as have other impacts, throughout the Beaufort-Delta region of
tuberculosis (latent and disease) was the number of square feet per the NWT. One area of social concern in the regional centre, Inuvik, is
person. The presence of mold was recorded in over 50% of the houses the possible consequences of resulting economic and social change on
but no statistically significant association was found between mold and homelessness in the community.
the tuberculosis. It is hypothesized however, that the occurrence of
Through this research, I explore the relationship between housing
mold in the houses may negatively affect the required cell-mediated
(in)security and pathways to homelessness in Inuvik; and then,
(Th1) immune response to Mycobacterium tuberculosis (MTB) by
examine the consequences of economic change on this relationship.
priming a Th2 immune response. In addition, the Dené and Cree study
The housing (in)security approach is rooted in an human security
cohorts maintain a high frequency of gene polymorphisms that may
framework for studying the impacts of change on northern peoples.
result in a less effective cell-mediated immune response to MTB than
This research makes an important contribution to the small, but
the Caucasian cohort. The a priori association between tuberculosis,
growing, body of research on the dynamics of homelessness in
poverty and inadequate housing needs to be more thoroughly
northern communities.
investigated if we are to alleviate the burden of disease in northern
Indigenous populations. Adopting a community-based research approach, I collaborate with
Contact: Linda Larcombe (larcombe@mts.net) community members to develop a framework for understanding the
meaning and context of housing (in)security in Inuvik. Using
biographical interviews and housing histories, I explore the ways in
YOU JUST BLINK AND IT CAN HAPPEN: WOMEN’S which pathways to homelessness can be understood as reflections of
HOMELESSNESS NORTH OF 60 deepening housing insecurity. Conversely, I also examine the factors
A. Hache that contribute to housing security and their potential for building
pathways out of homelessness.
Centre for Northern Families
In this presentation, I discuss findings from qualitative fieldwork
Women have been identified as the fastest growing group in the conducted in Inuvik through 2008 and 2009. I explore the housing
homeless and at-risk populations. Few Northerners realize the full insecurity framework and provide a “place-based” understanding of
extent of the problem or understand the complex factors involved. pathways to homelessness. In particular, I examine the ways in which
Southern Canadians have less awareness. Realities of life in the North
patterns of colonization, government intervention and rapid
differ from those in southern Canada necessitating Northern research sociocultural change shape geographies of homelessness in the North.
by Northerners. A pan-Northern consortium of Women’s groups, two Policy recommendations aimed at strengthening housing security are
from each Territory and Four Worlds Centre for Development worked
also presented. This project is a sub-project under the IPY Project: the
closely together researching Women’s homelessness in each territory Impacts of Oil and Gas Activity on Arctic Peoples Using a Multiple
to inform policy and decision makers, social justice advocates and Securities Perspective (GAPS).
fellow Canadians of the reality of Women’s homelessness north of 60; Contact: Julia Christensen (julia.christensen@mail.mcgill.ca)
to inspire political and social action.
A naturalistic research method that drew on feminist and grounded
theory was used which privileged the voices of Northern homeless ACUTE INFECTIOUS DIARRHEAL ILLNESS IN A FIRST
women, the research process remained iterative, participatory and NATIONS COMMUNITY IN NORTHERN MANITOBA,
action-oriented. Findings include: the demographics and incidence of CANADA: EPIDEMIOLOGY AND THE IMPACT OF WATER,
homelessness; the determinants of homelessness; the impact of SANITATION, AND HOUSING
homelessness on women in the three territories; policy and
P. Hayward, B. Martin, P. Hazelton, E. Rubinstein, P. Orr
bureaucratic practice environments related to homelessness; service
University of British Columbia
This prospective study was undertaken in partnership with a First Crowded living conditions influence the physical and mental well-being
Nations (FN) Oji-Cree community in northern Manitoba in order to and also many social behaviours. According to the 2006 Census,
describe the epidemiology and infrastructure determinants of acute crowding rates for the four Inuit regions combined were many times
infectious diarrhea (AID), and also to build capacity within FN higher than the rate for the non-Aboriginal population in the region.
communities to engage in research in order to answer questions of For example, crowding has been linked to poor self-reported mental
importance to them. In collaboration with the community (population and physical health, in addition to increasing an individual’s risk for
3418), the Four Arrows Regional Health Authority and the J.A. Hildes bacterial ear infections and scabies skin infestation.
Northern Medical Unit of the University of Manitoba, persons It is believed that overcrowding plays a role in high rates of spousal
experiencing AID were recruited over a 12 month period from 2006- abuse, interpersonal violence and crime in general, as tight living
2007. One hundred forty-two stool samples and questionnaires were conditions leave people (especially youth) feeling frustrated and angry.
collected. Mapping of water, sewage and housing infrastructure was Crowding is also negatively impacting the level of education among
performed. Microbiologic analysis of stool identified Bacillus cereus Inuit. According to the 2006 census, 40 per cent of Inuit children aged
(5.8% of samples) and Campylobacter jejuni (5.8%) as the most 14 and under resided in crowded homes. This results in little to no quiet
common bacterial pathogens; Norovirus (19.7%) was the most study space and some households sleeping in shifts to accommodate
common viral agent. Rotavirus was found in only 1.4% of samples. The everyone.
presence of stool pathogens was significantly (p=0.01 for each)
associated with lack of accessible clean water, and crowded housing. This paper presents findings from parts of a larger project that
Toilets in some houses were found to be non-functional; those who did documents housing and homelessness realities of Inuit in Canada and
not have access to an outhouse were more likely to have stool positive aims to contribute to our understanding of relations between Inuit
for Aeromonas and B. cereus. Additional concerns that were identified housing and various health and social indicators.
Contact: Cathleen Knotsch (cknotsch@naho.ca)
relate to maintenance and use of chlorination systems, cisterns, home
water containers and lake water; the latter receives sewage effluent.
The results were shared with the community through presentations to LESSONS FOR HERE AND NOW. PUVALLUTUQ: THE
community leaders. In this presentation we explore the meaning of ESKIMO POINT TB EPIDEMIC OF 1963 AND THE
these results within the larger context of the relationship between
CONTEMPORARY HOUSING CRISIS IN INUIT COMMUNITIES
infrastructure problems and the health of FN individuals and
communities. F. Tester1, P. McNicoll1, N. Lauster2
1
Contact: Punam Hayward (punamhayward@gmail.com) School of Social Work, University of British Columbia, 2Department of
Sociology, University of British Columbia
ALASKA’S GREAT THIRST: WATER, ENERGY, AND HEALTH In February of 1963 an outbreak of tuberculosis in Eskimo Point (Arviat)
IN IÑUPIAQ COMMUNITIES OF THE NORTHWEST ARCTIC resulted in the evacuation of a significant portion of the Inuit
population for treatment. This costly event, which caught the
BOROUGH
imagination of the southern Canadian press, was subsequently
L. Eichelberger thoroughly investigated by the Indian and Northern Health Service.
University of Arizona The outbreak was clearly related to housing conditions in the
The cost of energy affects every facet of life in the Iñupiaq Eskimo community. Wood frame housing was first introduced in 1959 under a
communities of Alaska’s Northwest Arctic Borough, from traditional “rent-to-own” policy that made tiny plywood box-style housing
subsistence practices to health and household economy. This paper available to Inuit, increasingly relocating to settlements of the eastern
demonstrates the links between the cost of energy and water Arctic. The paper uses historical and archival documents to revisit
insecurity within this arctic environment. I combine the theoretical these events, focusing on the role of public servants in both identifying
frameworks of political ecology and critical medical anthropology with the problem and advocating for change. This outbreak of tuberculosis
the participatory methods of photovoice and community mapping to clearly established, for the first time in northern Canada, the
examine the local experiences that connect water scarcity, energy relationship between health and the suitability and adequacy of the
issues, and health. The energy crisis that continues to affect Alaska housing being provided to Inuit families. The event contributed to a
makes existing water scarcity more pronounced in rural villages dramatic change in the policies and procedures for providing Inuit
without in-home piped water. Improving household access to domestic housing, and to the introduction of the first social housing policy
water supplies requires thinking about the basic utilities necessary for designed to meet Inuit needs. The paper compares and contrasts the
protecting public health. I use the term utility scarcity to underscore events and concerns reported in the 1963 epidemic with the current
this relationship. Throughout, I examine how Iñupiaq residents conditions in Inuit communities, illustrated by circumstances in
experience and make sense of these connections, as well as local Kinngait (Cape Dorset). These were determined by original and
strategies to address these concerns. participatory action research conducted with the community. Given
Contact: Laura Eichelberger, MA (lpeichel@email.arizona.edu)
the complex relationship between health indicators and housing
conditions, the importance of phenomenological data in determining
these relationships is suggested. The paper asks important questions
THE ROLE OF HOUSING AS A DETERMINANT OF HEALTH about advocacy and the role of communities and public officials in
FOR INUIT IN CANADA bringing about change – then and now – recognizing housing and
housing policy as an important structural and environmental
C. Knotsch
determinant of Inuit health.
Inuit Tuttarvingat of NAHO Contact: Frank Tester (ftester@interchange.ubc.ca)
Overcrowding, sanitation and basic housing quality are often discussed

in research literature as aspects that link poor housing to poor health
outcomes. Considering publicly available information on
INDOOR AIR QUALITY ISSUES IN FIRST NATIONS AND INUIT
overcrowding, suicide, infant mortality, hospital admissions for infants COMMUNITIES IN CANADA
with lower respiratory tract infections, infant mortality and S. Verhille, T. Marsden, M. Shum
tuberculosis, we observe that Inuit experience the highest rates in National Collaborating Centre for Environmental Health
Canada in these indicators. There is a significant body of research
addressing the relationship between housing and health; however few In 2006, Aboriginals accounted for 3.8% of the total population of
studies are specific to Inuit. Canada. The majority of Aboriginal people belong to the North
American Indian community, also called First Nations people, which
represent 60% of the Aboriginal population. About 50,000 of particularly the positive and negative predictive values with confidence
Aboriginals identify themselves as Inuit, who mostly live in the area limits.
across Canada’s North from Labrador to the Northwest Territories. The pilot study is now underway in Nunavut and the results will be
First Nations population increased 29% between 1996 and 2006 while presented at the conference.
the Inuit experienced a population growth of 26%. This rapid increase Contact: W. Alexander Macdonald (wmacdonald2@gov.nu.ca)
in population (about 3.5 times the increase of the non-Aboriginal
population), has aggravated the existing shortage of housing within
these communities. Some of the indoor air issues arising in First SPECIAL DELIVERY: TRANSPORTING IÑUPIAT MOTHERS
Nations and Inuit communities stem from overcrowding, poor AND BABIES IN NORTHWEST ALASKA
ventilation, inappropriate housing, chemical contaminants, L. Schwarzburg
environmental tobacco and wood smoke, and mould. Health effects
related to indoor air quality are not well understood due to the University of Alaska-Fairbanks
complex interplay of numerous factors; such as, the nature and Alaska Native mothers give birth in a health care system unique among
concentration of ubiquitous biological contaminants, and the ability of all others in the world. How did the Alaska Native Maternal Transport
the indoor environment to amplify, disseminate and sometimes Policy—a 30-year-old protocol of flying mothers and babies in and out
concentrate these contaminants. Other factors like host susceptibility, of Anchorage—come to pass? What have been the economic, social
exposure and physiologic or pathologic responses to these and cultural forces involved in its advancement? And, what have been
contaminants may also play a role. However, it is well accepted that some of the tangible and intangible outcomes and impacts of the
poor housing increases rates of asthma, respiratory and other lung policy on those involved?
diseases. First Nations and Inuit children have higher rates of Tackling these questions has led to design of an Anthropological-based
respiratory tract infections as well as severe otitis media (middle ear set of policy analysis tools that are participant-driven and sustainable
infection) than non-Aboriginal children. Also, overcrowding in for policy development over time. I am looking at childbirth practices
conjunction with poor ventilation contributes to the transmission of as an element in the Iñupiat Eskimo society of Kotzebue and
communicable diseases; such as, tuberculosis, skin infections, surrounding villages, which have changed from traditional community-
shigellosis and other intestinal diseases. In this presentation, we will based practices to participation in a more westernized medical model
present the current state of the evidence on indoor air quality issues in of childbirth. This will provide researchers with a new method of
First Nations and Inuit communities, identify some of the gaps in measuring social impact of policies, and evaluating costs and benefits
research, outline some of the challenges of conducting new research in of each childbirth practice (traditional and present-day) in a
these communities, and discuss methods of surmounting some of the comparative analysis.
challenges in order to conduct further research.
Contact: Sophie Verhille (sophie.verhille@bccdc.ca)
Studies have found positive impacts of inclusion of cultural values in a
mother’s birthing plan, and others have explored the negative impacts
(higher reliance on interventions and drugs, higher C-section rates)
involved when practitioners handling a non-western or religious
VENUE 2 childbirth client ignore cultural norms. This study will add to this body
Women’s Health & Well-Being #2 from an Arctic standpoint as Alaska Native cultural identity is explored.
This creative policy assessment tool might open doors to modern
CAN THE FETAL FIBRONECTIN ASSAY AT TERM BE USED TO obstetric and neonatological literature including a more realistic look
at the impact of medical birth and merits of non-medicalized birth
SAFELY DELAY EVACUATION OF RURAL WOMEN FROM
(WHO, 2005; Wagner, 2001) in other areas, specifically from
THEIR HOME COMMUNITIES? indigenous Women’s perspectives. Insight may also be gained from
W.A. MacDonald, G.K. Healey, W. Hogg, J. Kornelsen, S. Gryzbowski this investigation’s use of film and participant-analysis methodology to
Health and Social Services, Government of Nunavut further future revitalization movements, or more culturally appropriate
health care promotions within this and other Arctic communities.
The fetal fibronectin (fFN) test is used to predict the likelihood of Contact: Lisa Schwarzburg (lisa@schwarzburg.org)
preterm labour in parturient women with symptoms of labour between
24 and 36 weeks estimated gestational age. The (fFN) test has been in
use in Nunavut since 2004 and currently is available in most ARE INCREASING NUMBERS OF CESAREAN SECTIONS
community health centres in the Territory. It has been used extensively PLACING A BURDEN ON CANADA’S HEALTH CARE SYSTEM?
and has proven itself reliable and to be easy to use by clinicians.
N.C. Agnew
As many as 5000 women in Canada each year live more than two hours
University of Manitoba
from the nearest facility offering birthing services. Many must leave
their homes to wait to deliver their babies in a referral community for The rate of cesarean section delivery has continued to rise in most
up to 6 weeks. This imposes a significant financial and social cost on developed countries, including Canada. . In 1993, Canada’s cesarean
the women, their families and the health care delivery system. There is section rate was 17.6 percent, this increased to 26.3 percent in 2006.
a lack of research examining the potential of fFN testing at term to Pregnancy, labor, and delivery are natural human physiological events
predict labour or not. that should be allowed to transpire as a natural progression. Labor
should only require intervention if there is question about the safe and
The purpose of this pilot study is to investigate the negative predictive
healthy outcome for mother or baby.
value of the fast reacting fetal fibronectin (fFN) test at term. If the test
proves reliable in predicting the absence of labour at term women The aim of this paper is to review literature that relates to Women’s
might safely be able to stay home later in the pregnancy. preferences or requests for cesarean sections and review trends in
elective cesarean sections. As well as examine available evidence of
This pilot study will use a prospective cohort study design to examine
potential risks and benefits to the mother and infant receiving this
the negative predictive value of the fFN test at term. Study
delivery procedure. Through an examination of the trends in relation to
participants will be recruited from the population of parturient women
the risks and benefits of elective cesarean sections one is able to assess
in Nunavut and Northern British Columbia with uncomplicated
the “appropriateness of care”, as an indicator of the Canadian health
pregnancies in the study areas and asked to consent to the test starting
care systems performance.
at 36 weeks. Up to 30 participants will be recruited.
This topic is filled with controversy and ethical dilemmas, displaying a
Descriptive statistics will summarize the cohort experience. The
struggle between patient autonomy and the health care system to act
diagnostic properties of the fFN test at term will be defined,
in patients’ best interests. Autonomy is defined as the right to self- irreplaceable information which is included in a broad scope of work
govern and act “freely in accordance with a self-chosen plan.” Are we related to improving pre- and post-natal care and birthing options for
ignoring a woman’s basic right to choose her own course of action if all Inuit women. This collected knowledge has sparked many issues
she asks for a caesarean section and is refused? The law states that that need to be addressed including but not limited to: protections and
everyone has the right to refuse medical treatment, but does it give practical uses for the knowledge and data; promoting knowledge of
them the right to demand it? Does this not give her the right to refuse and cultural pride in Inuit midwifery and the collective Inuit birthing
vaginal delivery or is she forced into that? Can it be argued then that heritage; promoting healthy pregnancies and healthy lifestyles among
women who request caesarean sections are not demanding an young women; training more Inuit midwives; and promoting the
operation, or simply refusing the alternative? transfer of knowledge from elders to youth.
Contact: Pauktuutit Inuit Women of Canada (tohearn@pauktuutit.ca)
Paternalism on the other hand, defined as “overriding or ignoring the
preferences of patients in order to benefit them or enhance their
welfare.” The paternalistic doctor will decide the treatment plan for the MÉTIS CONCEPTS OF HEALTHY PREGNANCY: A LOOK AT
patient, and provide it without further discussion. Her autonomy is not
EFFECTIVE HEALTH PROMOTION, CULTURAL SAFETY, AND
thus respected, she should be explained the reason for the preferred
treatment and if not in agreement, be given the right to refuse. Here
CONCEPTS OF WELL-BEING
one faces the slippery slope of an ethical and medical dilemma. Is it M. Dyck
possible to uphold ones oaths of beneficence and non-maleficence and The Métis Centre of the National Aboriginal Health Organization
while maintaining the patient’s autonomy? In certain situations I think
The Métis Centre of the National Aboriginal Health Organization and
not! I believe cesarean section should only be carried out when
the Métis Women of BC, of the Métis Nation British Columbia (MNBC),
medically indicated, unless of course I believe the woman would truly
collaborated on a project looking at pregnancy messaging.
be negatively affected by not having a cesarean section.
In 2007 and 2008, 12 focus groups were held with Métis women across
If Canada does not improve maternity services particularly in rural, and
British Columbia. Various printed health promotion materials for
northern areas, the numbers of cesarean sections will continue to rise.
pregnancy were used to elicit discussion around health promotion,
Lack of training, poor or non-existant facilities will ultimately lead to
cultural safety and wellbeing.
fewer health care practitioners skilled in managing prenatal care, labor
and delivery. This has also been recognized by the Society of Analysis of the data began in early August of 2008 and the final report
Obstetricians and Gynecologists of Canada who believe “it is time for was completed by December 2008. Discussion within the focus groups
healthcare professionals who are able to support the birthing process elicited responses around several themes, which were grouped under
(obstetricians, family physicians, nurses and midwives) to adopt a more theme thematic areas: identity, support networks and product design.
collaborative approach to maternity care” they also add that “the While all participants spoke to identity in some regard, it was most
government of Canada must recognize that there is a problem in the often in the context of Métis identity as contrasted to First Nations
delivery of maternity care in Canada.” This burden will flow into other identity. Less frequently, Métis identity was described in comparison to
areas of the health care system, unnecessary major surgery means less non-Aboriginal identity.
access to essential care.
Support networks was a common theme expressed throughout all of
At present, because hard evidence of net benefit does not exist, the groups, however, it took many varying forms. Most often, support
performing cesarean sections for non-medical reasons is not ethically networks included a broad range of relationships, and were not limited
justified. The luxury of women choosing a cesarean section means to the nuclear family. Comments most often included the importance
other women may be dying of cancer, not detected because specialists of men, elders, the community, and Women’supporting women.
are experiencing patient overload, or funds for cancer screening
Comments within the product design section included specific
programs are depleted. As a medical student and future physician, I
recommendations regarding the design of posters and other health
believe the choice on who should live should be decided upon, through
promotion items. Participants had strong views on the appearance of
the investigation of evidence based medicine, rather than
products used to target Métis.
convenience.
Contact: Nicole C. Agnew (umtsagar@cc.umanitoba.ca) For the Métis Centre and the MNBC, the findings of this project will
help to guide promotional campaigns for pregnancy and for maternal
child health, and will help to identify gaps in Métis maternal child
INUIT MIDWIFERY AND MATERNAL CHILD HEALTH health. The data from the focus groups will provide greater insight into
Pauktuutit Inuit Women of Canada issues of Métis identity, of Métis concepts of maternal child health and
of cultural safety.
Pauktuutit Inuit Women of Canada is well-known for its role in Contact: Miranda Dyck (mdyck@naho.ca)
advocating for traditional Inuit midwifery. Inuit women from all across
Inuit Nunaat are often flown to southern cities to give birth rather than
in their home community or even within their geographic region. Since “KEEPING MYSELF WELL”: THE RELATIONSHIPS OF
Pauktuutit’s inception in 1984, Inuit women have expressed concern PERINATAL HEALTH BENEFITS AND HEALTH PROMOTION
about the displacement of Inuit midwives, the loss of knowledge, and PRACTICES OF TLICHO WOMEN
the loss of community-based birthing. It is well-documented that the
legacy of modern medical intervention and this evacuation policy has P. Moffitt
not been in the best interest of Inuit women, our families, and our University of Calgary
cultural heritage. Today’s elders are among the last generation of Inuit Traditional knowledge is recognized as salient to Women’s health and
to have experienced giving birth on the land with the help of midwives to the provision of culturally safe health care. However, health beliefs
and family members. Their skill and knowledge are no longer being and health promotion practices evolve with culture that is not static.
passed on to younger women. Inuit women have expressed concern The dynamic, complex and diverse contexts of Women’s lives are
regarding the loss of these traditional birthing practices. With this in influenced by historical, social, political and environmental factors. The
mind, Pauktuutit started the project Documentation of Traditional intersection of these factors is portrayed in the lifeways of pregnant
Practices Related to Pregnancy and Childbirth. The intent of this Tlicho women. This presentation emanates from a focused
participatory research project was to gather the elders’ knowledge and ethnographic doctoral study that explored the relationship of perinatal
to use it to support community-based birthing centres and to promote health beliefs and health promotion practices with 14 pregnant Tlicho
greater cultural sensitivity to Inuit preferences/practices for healthy women from a remote community in the Northwest Territories.
pregnancies. Pauktuutit gathered a great deal of invaluable and Photovoice was used within the design of the research to promote
discourse between the women and create opportunity to share

personal meaning of their circumstance and priorities through VENUE 3
photographs and stories. Three domains emerged from participant Indigenous Health & Wellness #4
observation, interviews, photographs and stories that were related to
the Women’s pregnancies and lifeways. Domains included keep myself
well, risk discourse and perinatal travel and upside down world. BILL C-51: PROPOSED FEDERAL REGULATION OF
Understanding the relationship of health beliefs and health promotion TRADITIONAL MEDICINE
practices of pregnant Aboriginal women can provide a basis for the P. Orr
creation and implementation of culturally safe health promotion
Independent Legislative Counsel
programs and policy development.
Contact: Pertice Moffitt (pmoffitt@auroracollege.nt.ca) Bill C-51 was introduced in Parliament in 2008. The Bill included
changes to the Canadian Food and Drugs Act that some argue would
have a significant effect on the delivery of Traditional Medicine by
INTRODUCTION OF MIDWIFERY SERVICES AND CLIENT Aboriginal healers in Canada. Although the Bill has “died on the order
SATISFACTION paper”, it is likely to be reintroduced by the present government in
G. Becker, L. Paulette substantially the same form. The paper intends to identify the
elements of the proposed changes in the federal government’s policy
Fort Smith Health and Social Services Authority towards the practice of Traditional Medicine, as contained in the
The return of midwives to the community and the introduction of proposed legislation, discuss their possible effects on the practice of
regulated midwifery practice provided the practice framework for the Traditional Medicine, and assess the potential ramifications on the
renewal of community birthing in one community of the Northwest rights of Aboriginal persons to practice Traditional Medicine.
Territories. Since April 2005, two registered midwives have been Contact: Patrick Orr (lawdraft@magma.ca)
employed by the Fort Smith Health and Social Services Authority. The
midwives provide full-scope maternity care: prenatal, intrapartum, and
postpartum care, with informed choice of birthplace. Women can birth ENHANCING EXISTING COMMUNITY HEALTH CAPACITY
either at the Fort Smith Health Centre, the woman’s home, or at AND INFRASTRUCTURE BY FOCUSING ON THE
Stanton Territorial Hospital. A renovated area within the hospital has INTEGRATION OF INUVIALUIT, GWICH’IN, AND WESTERN
created a maternity centre with a birthing room and birth tub, a MEDICINE APPROACHES TO PALLIATIVE CARE
midwifery office, and a prenatal assessment room.
J.E. Smith, S. Bauhaus, C. Lennie
The authors provide a review of the first four years of a program
Beaufort Delta Health and Social Services Authority
introducing midwifery services in Fort Smith, Northwest Territories.
The presentation focuses on the client evaluation of midwifery care Life expectancy of Aboriginal Canadians has increased by over 8 years
and how client satisfaction contributes to midwives’ reflective since 1980, and more elders are living past the age of 70 years,
practices thus ensuring that the practice responds to the needs of resulting in many chronic health problems that eventually require
clients and community. The study presents a summary of completed palliative care. Cultural traditions and beliefs define what is considered
Midwifery Program Satisfaction Questionnaires. legitimate care. However, the current practice of implementing
Contact: Gisela Becker and Lesley Paulette Gisela Becker and Lesley Paulette (gisela_becker@gov.nt.ca) western health practice in aboriginal communities has not promoted
the development of community specific needs, identified by the
community, for the community. A common misconception is that
HISTORICAL NARRATIVES AND HUMAN KINDS: THE cultural traditions, values, and spirituality are the same in our northern
EVOLUTION OF INUIT CHILDBIRTH INTO THE 21ST communities. Research implemented in southern aboriginal
CENTURY communities does not support this misconception, and we expect the
same findings will be demonstrated in the remote regions of the
V. Douglas
Beaufort Delta Health and Social Services Authority (BDHSSA).
University of Alberta Palliative care is a difficult area of practice for many health
Objectives: To construct a theoretical framework within which the professionals, compounded when providing care in a cultural context
historical evolution of Inuit childbirth practices may be situated. foreign to their own culture and beliefs. At the same time, the constant
Study Design: This study applies narrative analysis to a historical study. flow of health providers in many northern communities is prohibitive in
the development of a trusting relationship with health professionals.
Methods: Semi-structured oral interviews conducted with participants
in the Arctic communities of Puvurnituq, Inukjuaq, and Rankin Inlet Funds were obtained through the Aboriginal Health Transition Fund to
were analysed and compared with historical literature on Inuit develop knowledge in this area within the BDHSSA. Documentation of
childbirth practices in order to create a historical narrative of Inuit traditional palliative care practices was initiated in January, 2009 in
childbirth practices. each community in the Beaufort Delta. From this information
educational, community specific resources for health professionals and
Results: Inuit childbirth is not characterised by specific practices, beliefs for community members will be developed. In this presentation we will
or rituals. These have all undergone a process of historical evolution. present preliminary findings from the interviews conducted with
However, applying Hacking’s concepts of human kinds and historical community members and permanent health professionals who
ontology to Inuit childbirth constructs its identity without fixing it to practice in the BDHSSA.
specific practices at any particular place in time or space.
Through the collection and documentation of current community
Conclusions: Inuit childbirth retains a historical continuity and cultural beliefs and values related to death and dying, levels of understanding,
integrity that is expressed through Inuit culture itself, and must be awareness and perceived access to palliative care in each community
understood as reflective of it. can be achieved so as to promote culturally sensitive palliative health
Contact: Vasiliki Douglas (vasiliki@ualberta.ca)
care “North of 60”.
Contact: Jane Smith (jane_smith@gov.nt.ca)
INDIGENIZING CHILD WELFARE MODELS: METHODS AND

OUTCOMES
N. Wedzin, M.A. Mackenzie, G. Gibson
Tlicho Community Services Agency - Traditional and Western Medicine Discussion Circle
Nora Wedzin, Mary Adele Mackenzie and Ginger Gibson - Daily Ceremonies (sweat lodges)
- Traditional healing sessions (ongoing)
The Tlicho Government will shortly assume control over child - Medicine Harvesting and teaching sessions
protection services in the Tlicho region of the NWT. With a high rate of - Various Elder directed traditional teaching sessions (e.g.: rites of
children in care, the Tlicho Community Services Agency is working with passage, mental health, traditional foods, prophecies )
elders, children, foster families, and parents to design services that - Shaking Tent ceremony
meet the needs of indigenous families. This research, based in the
narratives, stories and histories of Tlicho elders, aims to revise the The outcome of the event was twofold: (1) The provision of additional
GNWT model of child welfare management. Some of the products will knowledge of First Nations “medicine” to traditional First Nations
include custom care models, protocols and guides for social workers healers; and (2) The engagement of FNC of NAHO to advance First
and RCMP, and training for social workers. The research is based in a Nations knowledge to improve the health of First Nations by means of
model that has been termed “Strong Like Two People”, which promoting and sharing health information.
combines indigenous and non-indigenous researchers in teams to Hosting gatherings/conferences which involve actualizing the use of
tackle these complex questions. This presentation will discuss this traditional First Nations knowledge demonstrates a concrete
model, review some of the outcomes, and discuss the main findings of commitment to such knowledge rather than merely engaging in
this ongoing research. discussions around it and/or simply building an awareness of its
Contact: Ginger Gibson (vgibson@interchange.ubc.ca) existence. Collaboration of a large research focused organization such
as the FNC of NAHO and a local community is feasible, efficient and
effective in attaining common goals among both parties. The structure
GETTING IT RIGHT: USING POPULATION SPECIFIC, and planning used in Gegenoatatoltimg could be used as a model by
COMMUNITY-BASED RESEARCH TO ADVANCE THE HEALTH other interested Aboriginal organizations and communities in
AND WELL-BEING OF FIRST NATIONS, INUIT, AND MÉTIS IN conducting similar gatherings in Canada and abroad.
CANADA Contact: Julian Robbins (jrobbins@naho.ca)
M. Buell, P.C. Tremblay

National Aboriginal Health Organization
The National Aboriginal Health Organization (NAHO) was created in VENUE 4
2000 to have a positive impact on the health and well-being of the Infectious Diseases #5 – H.Pylori, Superbugs, etc.
three constitutionally recognized Indigenous Peoples in Canada: First
Nations, Inuit and Métis. Each of these groups is distinct, and NAHO’s EPIDEMIOLOGY OF HAEMOPHILUS INFLUENZAE SEROTYPE
structure ensures it successfully engages with First Nations, Inuit and
A FROM 2000-2007, AN EMERGING PATHOGEN IN
Métis communities to address health disparities through research,
knowledge translation and knowledge-based activities.
NORTHERN CANADA AND ALASKA
NAHO believes this population-specific approach, and by taking a M. Bruce1, S. Desai2, T. Zulz1, M. Garner2, Boyd K. Hummel1, D.
broader determinants approach to health, is central to effectively Hurlburt1, D. Bruden1, K. Rudolph1, C. DeByle1, R. Tsang3, International
addressing the health and well-being of Aboriginal Peoples, as Circumpolar Surveillance Working Group
1
population-specific statistics and research are key to addressing the Arctic Investigations Program, National Center for Infectious Diseases,
unique needs of First Nations, Inuit and Métis individuals, families and Centers for Disease Control and Prevention, Anchorage, Alaska,
2
communities. Immunization and Respiratory Infections Division, Public Health Agency
To illustrate NAHO’s successful approach, three case studies will be of Canada, 3National Microbiology Laboratory, Winnipeg, Manitoba,
explored: suicide prevention, the protection and promotion of Canada
traditional healing practices and supporting Aboriginal midwifery. Background: Prior to introduction of the Haemophilus influenzae type b
Contact: Mark Buell (mbuell@naho.ca) (Hib) conjugate vaccines, rates of Hib disease among indigenous
people living in Alaska (AK) and Northern Canada (N Can) were among
the highest reported in the world. Routine vaccination has reduced
GEGENOATATOLTIMG (SHARING THE KNOWLEDGE): A these rates to very low levels; however, serotype replacement with
TRADITIONAL FIRST NATIONS GATHERING TO SUPPORT non-type b strains is of concern.
HEALTH AND HEALING IN CANADA Methods: We identified cases of invasive Hi disease in AK and N Can
J. Robbins1, M. Porter1, R. Obomsawin1, E. Nowgesic1, E. Sock2 from 2000-2007 through the International Circumpolar Surveillance
1
First Nations Centre of the National Aboriginal Health Organization, (ICS) network. Medical charts were reviewed on laboratory-confirmed
2
Elsipogtog Health and Wellness Centre cases using standardized forms to verify clinical presentation. AK and
N Can estimated populations as of 2006 were 670,053 and 132,956
The word “Gegenoatatoltimg”, when translated from Mi’kmaq to respectively; aboriginal peoples comprised 20% of the population in
English, means “Sharing the Knowledge”; used for the name of a AK and 60% in N Can.
national traditional health and healing gathering conducted from
September 8 to 15, 2008 in Elsipogtog, New Brunswick, Canada. The Results: During the study period, a total of 198 cases of invasive Hi
event was co-hosted by the First Nations Centre (FNC) of the National disease were reported from AK (110) and N Can (88). Among the 127
Aboriginal Health Organization (NAHO) based in Canada, and the (67%) invasive Hi cases with serotype information available; 59 (46%)
Elsipogtog Health and Wellness Centre (EWHC). The event was were serotype a, 36 (28%) were serotype b, 17 (13%) were serotype f.
primarily attended by First Nation Elders, and youth, First Nation Among Hia isolates, 51 (86%) occurred in indigenous people; median
community members, and staff from FNC, NAHO, and EWHC. age was 1.0 year (range 3 mo-74 years); 61% were male. Three Hia
cases (one adult/2 children) were fatal. Common clinical presentations
The objective of the gathering was to engage in dialogue about the included: meningitis (32%), pneumonia (27%), and septic arthritis
retention and transfer of traditional knowledge respective to health, (12%). There were no cases of epiglotittis. Overall annual Hia incidence
medicines and healing. The following activities took place at the was 0.3, and 4.6 cases/100,000 population in AK and N Can,
gathering: respectively. Annual incidence rates among indigenous children <2
- Elders Circle on Grief and Healing years old in AK and N Can were 22 and 115 cases/100,000 persons,
- Youth and Elders Dialogue Circle respectively.
- Youth Circle Gathering
Conclusion: Serotype a is now the most common Hi serotype seen in parasite eggs shed in the feces of dogs, and dogs can become infected
the North American Arctic, with the highest rates among indigenous through consumption of infected rodents, or organs from infected
children. Further research is needed to investigate regional differences moose, caribou, elk, or deer.
in rates, and to determine sequelae, risk factors, and the utility of This case raised community concerns about the risk and sources of
chemoprophylaxis. hydatid disease. For this reason, an interdisciplinary team was
Contact: Michael Bruce (zwa8@cdc.gov)
established, which included animal and human health professionals, as
well as members of the affected community, in order to determine the
MYCOPLASMA GENITALIUM IN GREENLAND: PREVALENCE, prevalence of Echinococcus spp. exposure in humans and dogs and the
risk factors that influence infection in this community. This study, the
MACROLIDE RESISTANCE, ETHICAL CONSIDERATIONS,
results of which will be presented, has broad relevance because there is
AND POLICY IMPLICATIONS a paucity of recent Canadian information on this parasitic zoonotic
D. Gesink-Law, G. Mulvad, R. Montgomery-Andersen, S. Montgomery- disease, which has historically been a significant public health concern
Andersen, U. Poppel, A. Binzer, F. Stenz, E. Rink, A. Koch, J.S. Jensen in indigenous Canadians, and world-wide remains a “zoonosis of global
University of Toronto concern… and one of the most costly [parasitic diseases] to treat and
prevent in terms of public health” (WHO). The ultimate goal is to
Objective: Currently, Mycoplasma genitalium (Mg) is not tested for in
facilitate the implementation of effective, community-based
Greenland. Our objective was to determine the presence and
management of Echinococcosis using the information generated by
prevalence of Mg infection in Nuuk, Greenland.
the study.
Methods: Between July 2008 and October 2008, 149 Nuuk residents
Overall, this project supports the benefits of an interdisciplinary
between the ages of 15 and 65 years of age were enrolled in the
approach to the study and management of zoonotic disease, and may
Greenland Sexual Health Project (Inuulluataarneq). Participants
contribute to a better understanding of the complex interaction of
completed an interviewer administered sexual health survey and
factors associated with Echinococcus spp. ecology, which is necessary
provided self-collected, first-void, urine samples (men and women) and
to reduce the risk of hydatid disease in Canada.
vaginal swabs (women) for Mg testing. Mg was detected with real-time Contact: Emily Jenkins (emily.jenkins@usask.ca)
PCR targeting the MgPa-gene. Macrolide resistance mediating
mutations in the Mg positives were detected by a molecular assay.
Results: Ten (7%) of the 149 participants tested positive for Mg SUPERBUGS IN THE NWT
infection. In nine cases, sufficient DNA allowed analysis for macrolide W. White
resistance, and all nine carried macrolide resistance determinants. The
DHSS, GNWT
prevalence of Mg was not different for women (n=8, 9% prevalence
(95%CI: 5%, 17%)) and men (n=2, 3% prevalence (95%CI: 0.9% to The Northwest Territories (NWT) Community Associated Methicillin
11%)). On average, Mg cases were younger (21 years) than non-cases Resistant Staphylococcus aureus (CA MRSA), commonly known as a
(28 years) and younger when they first had sex (cases averaged 14.6 superbug, rates are increasing. MRSA has been reportable in the NWT
years; non-cases averaged 16.3 years). The odds of having had an STI since 2002. There has been considerable difficulty categorizing MRSA
before were 5.3 times higher for cases than non-cases (95% CI: 0.7,240, according to case definition for Community Associated and Hospital
p=0.10). Cases and non-cases did not differ significantly on ever having Associated MRSA. A study was undertaken using isolates from MRSA
had forced sex (OR: 2.1, 95% CI: 0.4,9.4, p=0.27). infections submitted to Stanton Territorial Hospital (STH), Yellowknife
between May, 2007 and October, 2008 to identify subtyping and to aid
Conclusions: We found both a high prevalence of Mg infection and
classification. MRSA was confirmed using real-time PCR to detect the
resistance to azithromycin treatment in Nuuk. These findings raised
nuc, mecA, and pvl genes. Isolates were typed using pulsed-field gel
important ethical considerations for the project and may have
electrophoresis and spa typing using previously published
significant impact on Greenlandic public health policy and the
methodologies.
Greenlandic health care system, especially around Mg testing,
treatment, and prevention of persistent/recurrent infections. A total of 70 MRSA isolates were identified over the study period from
Contact: Dionne Gesink Law (dionne.gesinklaw@utoronto.ca) individuals from 12 communities in the NWT. Cases of MRSA increased
from 15 (21%) in the last 8 months of 2007 to 55 (79%) in the first 10
months of 2008. The predominant clone in this region was CMRSA10,
MONITORING AND MITIGATING PARASITIC RISKS TO which represented 70% of all MRSA isolates [2007, n=12 (80%); 2008,
HUMAN HEALTH IN AN INDIGENOUS COMMUNITY FROM n=38 (69%)].
NORTHERN SASKATCHEWAN In response to the high rates of CA MRSA, the NWT has initiated an
C.G. Himsworth1, E. Jenkins2, M. Nsungu3, M. Ndao4, R.C.A. ongoing Superbug Education Campaign targeting both the public and
Thompson5, A. McConnell6, S. Skinner6 health care providers. It includes: enhanced education to both groups,
1 efforts to promote more judicious use of antibiotics, implementation of
Department of Veterinary Pathology and 2Veterinary Microbiology,
infection control standards and practices, promoting stringent
Western College of Veterinary Medicine, University of Saskatchewan,
3 handwashing and general sanitation in at risk environments.
Northern Inter-tribal Health Authority (Nsungu), 4National Reference
Centre for Parasitology (Ndao), Department of Medicine, Division of Conclusion: CMRSA10 is the dominant MRSA strain causing infections
Infectious Diseases, Research Institute of the McGill University Heath in the NWT, the molecular epidemiology is different from other
Centre, 5School of Veterinary and Biomedical Sciences, Murdoch northern communities, such as Nunavut, where reports suggest
University, Australia, 6Department of Infectious Disease, College of CMRSA7 is the dominant strain. The NWT has ramped up its efforts to
Medicine, University of Saskatchewan control MRSA and will continue to monitor epidemiology, including
subtypes and the results of its superbug campaign.
In May 2008, a 5 year-old girl from Northern Saskatchewan was found
Contact: Wanda White (wanda_white@gov.nt.ca)
to have an Echinococcus spp. cystic hydatid in her brain, which caused
significant neurological impairment and required extensive medical
and surgical treatment. Echinococcosis, or hydatid disease, is caused
by zoonotic Echinococcus spp. tapeworms. In humans, infection with
this parasite can result in the formation of fluid filled cysts in the
internal organs that may cause problems if they grow very large or
occur in an unexpected location (e.g. the brain). Humans most
commonly become infected through accidental consumption of
CA-MRSA OUTBREAK IN NUNAVUT, CANADA: KNOWLEDGE be attempted. Follow up measurements will include: monitoring of
OF SOCIAL NETWORKS IS KEY TO TARGETING CONTROL SSTI’s antibiotic use, clinic visits, documented other infections,
MEASURES hospitalizations and a monthly follow up of microbilological nostril
cultures with genetic investigation of isolated MRSA. It is hoped that
T.L. Stuart1, M. Lindegger1, D. Nibgoarsi2, O. Anoee2, L. Angalik2, L. we will be able to identify which of the intervention steps was
Shah1, J. Spika3, I. Sobol4, C. Palacios4, M.R. Mulvey5, D. Gravel3, M. efficacious and which were not, and if the approach of household
Ofner3, L. Panaro6 intervention is effective
1
Canadian Field Epidemiology Program, 2Nunavut Health Centre, 3Public Contact: Ethan Rubinstein (rubinste@cc.umanitoba.ca)
Health Agency of Canada, 4Nunavut Department of Health and Social

Services, 5National Microbiology Laboratory, 6Director Canadian Field
Epidemiology Program METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS: A
COMMUNITY-ASSOCIATED CONCERN IN LABRADOR
Background: A community-associated methicillin-resistant
Staphylococcus aureus (CA-MRSA) outbreak investigation in Nunavut M. Ar-Rushdi, S. Keefe, H. Dyson
used social network analysis and mapping to optimize interventions. At Labrador-Grenfell Health
the time, control efforts targeted symptomatic individuals at point of
Background: The province of Newfoundland and Labrador put
care. Methicillin Resistant Staphylococcus aureus (MRSA) on the Reporting
Methods: CA-MRSA cases were defined as those having a positive of Notifiable Diseases List as List B disease in 2006, then as List C for
MRSA culture between August 1, 2006 and December 31, 2007 with no reporting in 2007. The province developed a document for passive
hospitalization, surgery or dialysis in the past year and no indwelling surveillance with descriptive criteria for hospital associated (HA-MRSA)
catheters or percutaneous devices. Households with MRSA and CA- and community-associated (CA-MRSA), to be implemented in 2009.
MRSA cases were mapped. Social network analysis of CA-MRSA and Objective: It is hypothesized that the distinction between MRSA types
non-community acquired cases was conducted using information
might be difficult in rural and remote communities where the majority
obtained from health staff and 15 in-depth interviews. Household of care is delivered through community clinics, and hospitals are
densities of CA-MRSA cases were determined and compared to census largely staffed by community members. We look at MRSA data from
data.
2003-2008 in two geographically distinct regions of the Labrador-
Results: From August 2006 to December 2007, 132 CA-MRSA cases Grenfell Health Authority, and try to correlate MRSA designations with
were identified. Geographical mapping revealed cases were distributed results of molecular typing.
throughout the community. Of the 85 homes with at least one CA-
Methods: All cultures positive for MRSA reported to the communicable
MRSA case, 67 (79%) were found within one social network. The disease nurses, were logged with information including community,
average household density of homes affected by CA-MRSA was 6.29
age, sex, and type of diagnosis. MRSA cases would be designated as
persons/house (range 1-12); whereas the 2006 Statistics Canada HA-MRSA or CA-MRSA using the proposed provincial criteria. Previous
community household density was 4.5 persons/house. Sixty-two samples held either at the provincial Public Health Laboratory (for
percent of affected homes had one CA-MRSA case, 25% had two cases
Labrador), or on site at the Curtis Memorial Hospital microbiology
and 13% had 3 or 4 cases. Over half (55%) of newly diagnosed cases in laboratory for the Grenfell area, were referred for molecular typing the
January 2008 had a previously diagnosed family member.
results and will be compared to the MRSA designations.
Conclusions: Geographically, CA-MRSA affected homes were
Results: Preliminary results show an initial increase in MRSA in both
distributed throughout the community but social network analysis regions, likely due to the mandatory reporting as of 2006. There is a
revealed that affected homes were linked. It is not where you live but
doubling of cases between 2007 and 2008 in both regions. Most cases
with whom you interact that underlies CA-MRSA transmission in this were diagnosed in the middle aged or elderly, and no differences noted
community. Overcrowding is a commonality among affected homes. by sex in either region. Soft tissue and wound infections predominated.
Family-based interventions, rather than focusing only on the patient,
The proportion of HA-MRSA to CA-MRSA is yet to be determined for
should be the target of control efforts. Social network analysis can help each region. Referral of MRSA cultures to reference laboratories for
with the prioritization of at risk individuals for education, screening and
molecular typing is also underway.
infection control measures.
Contact: Tammy L. Stuart (tammylstuart@gmail.com) Conclusions: The Inuit and Innu of Labrador live in remote communities
where overcrowding, and poor hygiene practices are associated with
their lower socioeconomic status, and are known risk factors for
CA-MRSA IN A NORTHERN COMMUNITY DESCRIPTION OF transmission of MRSA. An increase of MRSA cases in the Grenfell
OUTBREAK AND POSSIBLE CONTROL region, with a rural Caucasian population and better socioeconomic
E. Rubinstein status, suggests other factors may be involved in transmission.
Distinction between HA-MRSA and CA-MRSA if it exists in a given
University of Manitoba population is important for development of targeted public health
CA-MRSA started in a Nunavut community in 2003-4 manifesting as programs. This is yet to be determined for the Labrador-Grenfell
Skin and Soft Tissue Infections (SSTI) in predominantly younger region.
individuals , at its peak ca. 25% of the community household and ca. Contact: Muna ar-Rushdi (muna.arrushdi@lghealth.ca)
10% of the population were afflicted. As a result, an epidemiological

survey was carried out in the community. Microbilogical survey
revealed 2 predominant CA MRSA types namely CMRSA 7 (USA 400)
and CA MRSA 10 (USA 300) circulating in one wave after another. One VENUE 5
child age 4 years died of septic shock complicating MRSA septic Education and Building Resource/Research Capacity #3
artritis. As the infection is so widespread it was decided to conduct an
experimental randomized cross-over intervention study in which whole PROVIDING LIBRARY SERVICES TO CONTRIBUTE TO
house holds of afflicted patients will undergo an intervention for 18
CAPACITY BUILDING AND KNOWLEDGE TRANSLATION IN
months whilest the control group will continue with regular care. At 18
THE CANADIAN NORTH
months the control group will become the interventio group and
followed for additional 18 months. The intervention will include A. Ducas, J. Linton, K. Young, L. Friesen
enforcement of hygenic measures, distribution of soap, alcohol- Neil John Maclean Health Sciences Library, University of Manitoba
chlorhexidin swabs, individuals towels etc. In cases that fail these
measures, decontamination with antibiotics, topical and systemic will
Program Objective: Bringing academic health sciences library services - provide examples of how KSTE activities that were
to community-based partners in Canada’s northern territories of developed at the national level could be relevant to public
Nunavut, NWT, and the Yukon. health in a circumpolar health context.
Contact: Philip Girvan (pgirvan@stfx.ca)
Setting: The Neil John Maclean Health Sciences Library (NJMHSL),
located in Winnipeg, Manitoba, Canada has been building an
Aboriginal Health Collection and Information Services component, THE CIRCUMPOLAR HEALTH BIBLIOGRAPHIC DATABASE
including outreach services to health care providers in the Kivalliq
Region of Nunavut since 1999. This model has been so successful that R. Goodwin
the NJMHSL was invited to join the Canadian Institutes of Health Arctic Institute of North America, University of Calgary
Research (CIHR) Team in Circumpolar Health by team leader, Kue The Circumpolar Health Bibliographic Database (CHBD) contains 4700
Young. Several team research projects are being undertaken between records describing publications about all aspects of human health in
2006 and 2011. the circumpolar region. The database is a project of the Canadian
Participants: CIHR Team members and community partners include Institutes of Health Research (CIHR) Team in Circumpolar Health
Canadian academics, international partners, and community-based Research. The CHBD includes all types of publications, both peer-
researchers. reviewed and gray literature. It can be searched using words from titles
Program: Key elements of the CIHR Teams’ projects rely on developing and abstracts, names of diseases or conditions, types of people,
community partnerships. The NJM Library provides services to geographic regions, authors, years, and special groups of publications
enhance the skills of community-based researchers, giving more such as all publications of the members of the CIHR Team. Search
equitable access to the professional literature similar to that enjoyed results can be sorted by year or by first author. The records in the
by most Canadian academic researchers. Librarians provide CHBD contain citations, abstracts, subject and geographic indexing
consultation, research and information services to enhance knowledge terms, library symbols, and links to 1800 online publications. As part of
translation, scholarly communication, open access initiatives and the CHBD project, server space is available to make PDF files of
evidence-based practice. publications available online. Records created for the CHBD also
appear in the Arctic Science and Technology Information System
Conclusion: The NJM Library provides outreach services to community (ASTIS), the international Arctic & Antarctic Regions database, and in
partners including literature searches, document delivery, and training relevant Canadian regional databases such as the Inuvialuit Settlement
in using open access databases like PubMed. Providing library services Region Database, the Nunavut Environmental Database and the
at no-cost to the end user enhances partnership building, creating Nunavik Bibliography. The CHBD’s coverage is far from
more equitable relationships between academic researchers and comprehensive, but the database includes many publications not
community partners. Partnerships between academics and indexed elsewhere, such as gray literature from Canada’s northern
community-based researchers are found in most Canadian universities. territories, all human health publications from the Northern
Academic libraries have a role to play in supporting the information Contaminants Program, and International Polar Year health
needs of all researchers involved in such exciting partnerships. publications.
Contact: Janice Linton (janice_linton@umanitoba.ca)
Contact: Ross Goodwin (rgoodwin@ucalgary.ca)
KSTE AND THE NORTH: HOW KNOWLEDGE SYNTHESIS, THE ARCTIC HUMAN HEALTH INITIATIVE: THE ONLINE
TRANSLATION, AND EXCHANGE OF EVIDENCE CAN RESOURCE AT WWW.ARCTICHEALTH.ORG
INFORM CIRCUMPOLAR HEALTH
S.A. Rolin, S. Smith, A.J. Parkinson
H. Beanlands, F. Benoit, M. Fast, D. Ciliska, R. Copes, M. Greenwood
Arctic Investigations Program, Centers for Disease Control & Prevention,
National Collaborating Centres for Public Health Anchorage, Alaska, US, and Department of Health Sciences, University
The International Union for Circumpolar Health has noted that “there of Alaska, Anchorage, US
has been a long-standing need for the exchange of medical knowledge, The Arctic Human Health Initiative (AHHI) is an Arctic Council
as well as the results of recent research and demonstrated solutions to International Polar Year (IPY) coordinating project that highlights
problems for the benefit of humankind.” In what way can the human health concerns of the Arctic people. AHHI’s goal is to build on
knowledge coming out of recent research projects such as the existing Arctic Council and International Union for Circumpolar Health
International Polar Year be best utilized to advance the health needs of human health research. One important component of AHHI is its
northern communities? website, www.arctichealth.org/ahhi/, which serves a significant role in
The National Collaborating Centres for Public Health (NCCPH) are a establishing cooperation and coordination in Arctic human health
network of six centres across Canada providing a national focus for the research. The AHHI website is a subpage of www.arctichealth.org,
synthesis, translation and exchange of scientific evidence and other which is a portal to information concerning the northern environment
relevant knowledge to improve and sustain evidence-based informed and the health of the Arctic people. Funding for the AHHI website was
decisions by public health practitioners and policymakers. provided in part through the NIH National Library of Medicine, and the
The NCCPH defines knowledge translation as “the exchange, synthesis website is hosted by the University of Alaska Anchorage’s Department
and ethically sound application of research findings within a complex of Health Sciences. This website was created at the start of the IPY and
system of relationships among researchers and knowledge users; the it has been an important international resource throughout the IPY for
incorporation of research knowledge into policies and practice, thus researchers, government officials, students, and the public. In addition
translating knowledge into improved health of the population.” to providing introductory information about the IPY and AHHI, the
website lists all of the human health related proposals submitted for
This presentation will provide an overview of the NCCPH program with the IPY, categorized by topic area. This includes updates and contact
a focus on its mandate of knowledge synthesis, translation and information for each proposal. Other information available on the
exchange (KSTE) and provide practical examples of how KSTE works. website includes details about IPY events, opportunities for people to
The presentation will: get involved, and publications related to AHHI and the IPY. In
- identify the National Collaborating Centres for Public particular, fellowships for young polar scientists have been advertised
Health and demonstrate how they work as a resource for in order to increase awareness of available training opportunities. The
public health practitioners; and, website also caters to people wanting to learn more about human
health concerns of the Arctic people, with photos on the website that
link to captions providing detailed information about important health
issues. Examples of highlighted topics include the changing diets and language, health promotion and preventative strategies. While the
lifestyles of Arctic people, gastric cancer, and invasive pneumococcal existing websites each have elements of strength and utility for an Inuit
disease. The captions also provide details of ongoing AHHI-IPY audience, at this point health information is not systematically
projects currently addressing those issues. available in this format. The diversity of health issues each site
Contact: Stephanie Alexia Rolin (srolin@cdc.gov) addresses, the variability in how the information is framed, and the
different orientations they adopt as to what constitutes health, speak
to the challenges of using the Internet to respond to health
BRINGING EVIDENCE TO THE NORTH: CADTH’S LIAISON information needs. Consequently, this paper focuses on directions
OFFICERS ASSIST WITH INFORMED DECISION MAKING forward in maximizing the potential of the Internet as source of health
D. Priestly information for Inuit.
Contact: Christopher Fletcher (christopher.fletcher@ualberta.ca)
CADTH - Canadian Agency for Drugs and Technologies in Health
Recognizing that health service structures and health technology
assessment (HTA) capacity are different in each of Canada’s provinces AN INTERNATIONAL PALLIATIVE CARE SYMPOSIUM: USING
and territories (P/T), the Canadian Agency for Drugs and Technologies VIDEO TELECONFERENCING AND VIRTUAL TECHNOLOGY
in Health (CADTH) established a network of Liaison Officers to help TO MEET THE NEEDS OF RURAL HEALTH CARE PROVIDERS
meet local needs.
C. DeCourtney, K. Morgan, J. Muller, S. Kelley
Liaison Officers are familiar with the needs of their particular regions
and the approach within their jurisdictions is geared to local
stakeholders. The Palliative Care Symposium is a core educational strategy in a
multi-faceted, five-year palliative care education program funded by a
Dawn Priestley, CADTH’s Liaison Officer (LO) for the Territories, has
National Institutes of Health National Cancer Institute grant awarded
been in place since October 2007.
to the Alaska Native Tribal Health Consortium in Anchorage, AK. The
The northern LO has assisted with the expansion in use of CADTH’s symposium theme, Joining Together to Share Palliative Care
Health Technology Inquiry Service (HTIS) by providing health Knowledge and Resources, reflects the partnership of separate
practitioners across the north with relevant, timely information on healthcare organizations represented on the planning and
medical technologies and pharmaceuticals. implementation committee for the event.
The LO also provides educational workshops to physicians, In 2009, the last year of the education grant award, the symposium
pharmacists, nurse practitioners and nurses in the territories to assist was offered internationally through technologies including Web-based
them when making decisions about adopting new technologies, streaming and video teleconferencing. Virtual marketing was used to
purchasing new medical devices, changing policies or clinical increase social marketing outreach for the event, as well as website
guidelines, adopting best practices or providing evidence for decision- development which included outreach capabilities beyond the annual
making about patient care. event. This unique and technologically advanced training delivery
Introduction of the Proton Pump Inhibitor project by CADTH’s method was developed as a potential way of reducing costs, increasing
Canadian Optimal Medication Prescribing and Utilization Service access to information and creating a “virtual community” for future
(COMPUS), partnering with the Governments of Yukon, Northwest palliative care conference delivery beyond the existing funding.
Territories, and Nunavut and in conjunction with NIHB, promotes The conference focused on various aspects of interdisciplinary care.
optimal drug therapy by providing strategies, tools and services to Topic areas included lectures and multidisciplinary panel discussions,
bring this class of drug in line with the evidence. as well as facilitator packets for individual sites to discuss local issues
The northern LO has also been instrumental in identifying common post conference. The primary target audiences were healthcare
areas of interest among the northern territories and assisting in provider teams (physicians, nurses, social workers, and pharmacists)
making linkages with those contacts. from the Alaska Tribal Health System, private sector providers from
across Alaska, IHS or Tribal health staff and clinicians from the Lower
As a local advocate, the LO for the Territories assists in bridging the
gap between acquiring evidence and ensuring information is relevant 48. International participants included Canada, Australia, New
Zealand, and India.
to decision makers.
Contact: Dawn Priestley (dawnp@cadth.ca)
A CONTENT ANALYSIS OF WEBSITES FEATURING INUIT COLLABORATIVE PRACTICE: WALKING THE TALK
HEALTH INFORMATION J-A., Hubert, J. Christensen, L. Harrison, A. Tumchewics
C. Fletcher, C. Alton, C.Y. Jean Yellowknife Health & Social Services Authority
University of Alberta If you work in the health and social services industry you have read and
heard of the importance of collaboration. In today’s world, the concept
Health information is vitally important for Inuit communities.
of collaboration has moved beyond achieving an understanding within
Understanding factors that influence what sources people use and
each discipline to become a necessity across many groups.
trust, as well as how information circulates, can contribute to individual
and community health generally. We would expect that people rely on Yellowknife Health and Social Services Authority (YHSSA) provide
the advice of Elders, friends and family, and their health care providers services to the communities of Dettah, Fort Resolution, Łutsel K’e,
(CHRs, nurses, doctors). Secondary sources like pamphlets, popular N’Dilo and Yellowknife. Over this vast geographical space, the number
medical literature and media, and the Internet also play a role in health and variety of health care providers differs in each community as does
information flows. Evidence from other parts of Canada suggests that the range of services. Recognizing the obvious challenges to delivering
as the availability and familiarity of the Internet increases it is likely health care services in this area also provides opportunity for creative
that people in the north are turning to this source for health solutions. YHSSA believes collaboration is the heart of our integrated
information with greater frequency. As a first step in addressing the service delivery model. Working together each health care provider
importance of Internet health information in Inuit communities we maintains their distinct practice while enhancing services to their
have undertaken a content analysis of 11 health-oriented websites that clients.
directly address an Inuit audience. Our analysis focuses on how the In this presentation will bring the theoretical concepts of collaboration
sites are organized with respect to definition of the intended audience, to reality as we share with you some of our lessons learned and the
health issues addressed, visual content, navigation ease, culture and practical application of collaboration. Some of these include a grass
roots approach to promoting awareness of drug addictions; a benefits are is related to reducing risk for arrhythmia. Since the latter is
community based strategy to prevent a pandemic influenza outbreak; inversely related to heart rate (HR) we have here examined the
the role of a Medical Social Worker with persons with chronic disease, association between red blood cell (RBC) omega-3 FAs with HR. The
disabilities, elderly, marginalized, low-income, addictions and study was conducted among a population of Eskimos currently
unidentified trauma; and a multisystem collaboration to enhance client experiencing an acculturation that involves a dietary shift from highly
access to health care programs and services. unsaturated to more saturated fats.
Let us share with you where we have been, where we are now and our Methods and Results: We compared HR with RBC FA content in 316
visions for a better tomorrow. men and 391 women 35 to 74 years old participating in the Genetics of
Contact: Jo-Anne Hubert (jo-anne_hubert@gov.nt.ca) Coronary Artery Disease in Alaska Natives Study (GOCADAN).
Multivariate linear regression analyses of individual FAs with HR as the
dependent variable and specific FAs as covariates, revealed
independent negative associations between HR and docosahexaenoic
VENUE 6 acid (22:6n-3; p<0.004) and eicosapentaenoic acid (20:5n-3; p=0.009)
Chronic Diseases #2 and independent positive associations between HR and select
monounsaturated and omega-6 FAs palmitoleic acid (16:1n-7; p=0.021)
CVD AND ITS RELATION TO RISK FACTORS IN ALASKA eicosanoic acid (20:1n9; p=0.007) and with dihomo-gamma-linolenic
ESKIMOS: THE GOCADAN STUDY acid (DHLA; 20:3n-6; p=0.021). Analysis for associations between HR
and groups of FAs derived by factor analysis gave similar results in that
B.V. Howard, A.G. Comuzzie, R.B. Devereux, S.O.E. Ebbesson, R.R. the main components of factor 1 (omega-3 FAs 20:5, 22:5 and 22:6)
Fabsitz, W.J. Howard, S. Laston, J.W. MacCluer, A. Silverman, H. were negatively associated with HR (p=0.003). Factor 1 also included
Wang, N.J. Weissman, C.R. Wenger positively associated 18:1, 20:1 and 20:3.
MedStar Research Institute Conclusion: Omega 3 FAs derived from fish oils are associated with
Background: Alaska Eskimos, like other populations, are undergoing lower HR, which may in turn reduce risk for arrhythmia and sudden
lifestyle change. Unlike others, a significant proportion report death, whereas several non-omega-3 FAs are associated with higher
substantial physical activity and traditional diets. While State and HR, independent of covariates. Palmitoleic acid (16:1) and DHLA
Indian Health Service data suggest a high proportion of CVD deaths, no (20:3n-6) have been identified as directly related to cardiovascular
risk factor association analyses have been done. mortality.
Contact: Sven Ebbesson (ffsoe@uaf.edu)
Methods: A population-based sample of 1,214 predominantly Inupiat
Eskimos (537 men, 677 women) age 18 or older from Alaska’s Norton
Sound Region were examined in 2000-2004 for CVD and associated RELATIONSHIPS AMONG LIPOPROTEIN SUBFRACTIONS
risk factors. Anthropometry, blood pressures, and ECG were measured AND CAROTID ATHEROSCLEROSIS: THE GOCADAN STUDY
using standardized criteria; behavioral risk factors assessed by
validated questionnaires; and lipoproteins, glucose, and CRP assessed M. Masulli, L. Patti, G. Riccardi, O. Vaccaro, G. Annuzzi, S.O.E.
in fasting blood samples. Prevalent CVD (MI, PTCA/CABG, stroke, CHF) Ebbesson, R.R. Fabsitz, W.J. Howard, J.D. Otvos, M.J. Roman, H.
was determined via medical record review with standardized criteria. Wang, N.J. Weissman, B.V. Howard, A.A. Rivellese
These analyses focused on the 214 men and 285 women >age 45. MedStar Research Institute
Results: Average age was 58 yrs; rates of diabetes were low (3% and 8% Background: Studies have been inconsistent as to whether measures of
in men and women, respectively) and HDL concentrations were lipoprotein particle subfractions are useful indicators of cardiovascular
relatively high (57mg/dL and 69mg/dL), but a high proportion smoked risk. This study evaluated the relationship between lipoprotein
(56% and 47%) and had high concentrations of CRP and pathogen subfraction particle concentrations and size, analyzed by nuclear
burden. Thirteen percent of men and 5% of women met criteria for magnetic resonance (NMR) spectroscopy, and measures of carotid
definite CVD; rates were significantly higher in men (PR 2.4 [1.3-4.9]). atherosclerosis in a population of Alaska Eskimos at high
Six percent of men and 2% of women had documented stroke (PR 3.46 cardiovascular risk but with low frequency of hyperlipidemia.
[1.25-9.56]). CHD (MI plus CABG/PTCA) was documented in 6% (men) Methods and Results: In this cross-sectional, population-based sample
and 2% (women) (PR 2.47[1.00-1.69]). In univariate analyses of CVD of Alaska Eskimos ~35yrs (n=656), higher carotid intimal medial
(n=46) age, male gender, hypertension, diabetes, high LDL-C, high thickness (IMT) was associated with higher levels of low-density
apoB, low HDL-C, and smoking were significantly related. In a lipoprotein cholesterol (LDL-C) (p=0.03) and total LDL particle
multivariate model, CVD was independently related to age (OR/yr 1.06 concentration (LDL-P) (p=0.04), independently of other traditional
[1.02-1.09]), hypertension (5.10 [2.00-12.5]), high LDL-C (3.54 [1.73- cardiovascular risk factors (age, body mass index, systolic blood
7.24]), and male gender 3.40[1.60-7.26]). pressure, and current smoking); there was a significant interaction
Conclusion: Prevalence rates support the public health data indicating between LDL-C and LDL-P and greater IMT (p=0.015). Carotid plaque
that despite traditional lifestyles, CVD rates, particularly for stroke, are was associated with higher levels of LDL-C (p=0.01), higher
high in Alaska Eskimos. Aggressive blood pressure and lipid lowering concentrations of large LDL particles (p=0.003), and a reduction in the
and smoking cessation are warranted. size of the very-low-density lipoprotein (VLDL) particles (p=0.03). A
Contact: Barbara V. Howard (Barbara.V.Howard@medstar.net) significant interaction was observed between LDL-C and large LDL and
carotid plaque score (p=0.006). IMT and plaque score were not
associated with high-density lipoprotein cholesterol (HDL-C) or HDL
HEART RATE IS ASSOCIATED WITH RED BLOOD CELL FATTY subfractions.
ACID CONCENTRATION: THE GOCADAN STUDY
Conclusions: Carotid IMT was associated with higher LDL particle
R.B. Devereux, J.C. Lopez-Alvarenga, P.M. Okin, M.E. Tejero, W.S. concentrations, and the association was strongest in those with higher
Harris, L.O.E. Ebbesson, J.W. MacCluer, C.R. Wenger, S. Laston, R.R. LDL-C levels; the presence and extent of plaque was associated with
Fabsitz, W.J. Howard, B.V. Howard, A.G. Comuzzie higher concentrations of LDL-C, large LDL particles, and smaller VLDL
Norton Sound Health Corporation, Alaska particles. It may be beneficial to add determination of lipoprotein
Background: Consumption of omega-3 fatty acids (FAs) in fish oils is subfractions to traditional measures of cardiovascular risk, particularly
associated with reduced death rate from coronary heart disease (CHD), in populations with low prevalence of hyperlipidemia.
Contact: Barbara V. Howard (Barbara.V.Howard@medstar.net)
arrhythmia and sudden death. Although these FAs were originally
thought to be anti-atherosclerotic, recent evidence suggests that their
CARDIOVASCULAR DISEASES IN NATIVE POPULATION OF CARDIOVASCULAR DISEASES AND THEIR RISK FACTORS IN
YAMAL PENINSULA (RUSSIA) THE ASIAN PART OF RUSSIA
M.A. Romanyuk Y. Nikitin
State Scientific Research Institute on Medical Problems of the Far North Institute of Internal Medicine Siberian Branch of Russian Academy of
of RAMS Medical Science
Epidemiologic trials in circumpolar regions showed that cardiovascular Siberia and the Far East is part of the Russian Federation with a
diseases occupy the first place in mortality. Aim of the present survey population of over 30 million of people. The most of the population are
was to study the prevalence of cardio-vascular diseases in native europeoids.
employable Yamal population at the age of 20-59 years. In the structure of total mortality more than the half of deaths is
Methods: cross-sectional epidemiologic study was carried out. because of cardiovascular and cerebrovascular diseases. According the
Coronary heart disease (CHD) and body mass were diagnosed by WHO data of epidemiologic screenings the frequency of coronary heart
criteria, stress angina pectoris was stated by the Rose’s cardiologic disease in 30-60 year old population (Novosibirsk, Chukotka, Yakutia,
questionnaire, electrocardiogram interpretation was done according to Altay) is 10-15%. Stroke morbidity is about 216-450 : 100 000 (both
Minnesota code, atherogenic index was evaluated by sexes and all ages). The highest levels of stroke morbidity and
recommendations of All-Russia National Cardiologic Society. During mortality is registered in south-east regions of Asian part of Russia.
our research it was stated that CHD prevailed in 11,8% of native The prevalence of hypertension is quite high - 22-41% (blood pressure
population, mainly in men (12,4% vs. 10,8%), arterial hypertension was higher than 160/90). Also we studied the lipid profile, anthropometric
registered in 9,5%, mainly in women (13,5% vs. 9,5%). Prevalence of parameters, Diabetes Mellitus, nutrition peculiarities, alcohol
dyslipidemia comprised 38,3%, mainly in men (46,3% vs. 30,6%, consumption and a number of other parameters. Some differences in
p<0,01), among it: hypercholesterolemia was registered in 30,8%, studied parameters were registered in indigenous Siberian population.
increased level of low density lipoproteids in 26,9%, decreased level of Trends of cardiovascular mortality fro 1985-2005 years were studied in
high density lipoproteids in 19,8%, hypertriglyceridemia in 0,5%. Novosibirsk an some other Siberian regions.
29,8% of tundra native residents smoked, mainly they were men Contact: Yuri Nikitin (nikitin@iimed.ru)
(47,7% vs. 10,9%, p<0,001). Obesity prevailed in women (23,5% vs.
4,6%, p<0,001). Thus, we can conclude that changes in traditional
nutrition and nomadic lifestyle worsen health of Yamal natives. NEW METHOD OF RESPIRATORY BIOFEEDBACK
Nowadays prevalence of cardiovascular diseases in aboriginal O. Grishin
population comes closer to the level which is characteristic to modern
The Institute for Physiology MAC-SB
urban society.
Contact: M.A. Romanyuk (hypertonia@yandex.ru) We have developed a novel technology of respiratory Biofeedback
(BFB) for the treatment of functional respiratory disorders (FRD) in
pediatrics. The method is based on the computer game that is
DIFFERENT TYPES OF CORONARY LESIONS AND THEIR managed by the patient’s breathing. To achieve it, initially we used
IMPACT ON COURSE AND OUTCOMES OF EARLY ACUTE only two capnography parameters: end-tidal CO2 fraction (FetCO2)
MYOCARDIAL INFARCTION IN THE RUSSIAN NORTH and breath frequency (f). That version of BFB has successfully passed
A.S. Iakovleva, O.A. Mirolyubova clinical trials concerning the treatment of hyperventilation syndrome
(HVS) in children with asthma. However, in our first game version the
Northern State Medical University, Arkhangelsk, Russia. pattern of breath could not be controlled. Our studies have shown that
Introduction: Coronary angiography (CAG) in young, affected patients FRD correction is accompanied by reliable changes in breathing
is of important diagnostic value as it enables to reveal the type of pattern. Respiratory cycle duration increased by an average of 15%,
coronary lesion and predict the prognosis of acute myocardial and exhalation plus subsequent pause time increased by 25%. On the
infarction (AMI). The aim of this research work was to assess the other hand, the time of inhalation de-creased by 8 %. In view of the
extension and types of the coronary lesions and their influence on the data obtained, a new version of BFB game was developed. We radically
outcomes in patients surviving an early AMI. altered the plot; this one was named “The Flight of Breath”. In our new
Material and methods: The trial enrolled 45 patients under 45 years development the bird’s flight depends on FetCO2 as well as temporal
who were treated for AMI in Arkhangelsk Clinical Hospital in 2006- characteristics of the breathing pattern: time of inhale, exhale, and
2008. The results of CAG were evaluated taking into consideration the post-exhale pause. New BFB game technology has improved potenti-
number and diameter of involved arteries, the significance of stenosis alities of FRD correction due to the acquisition of controlled
and its extension. parameters.
Contact: Oleg Grishin (ovg@physiol.ru)
Results: CAG was performed in 30 adults on admission. There were no
lesions of heart vessels in 2 patients who developed AMI of II and III
Killip Class. Significant reduction in luminal diameter was revealed in EPIDEMIOLOGY OF CORONARY HEART DISEASE IN A
72.0% of adults, the extension of stenosis varied from 0.3 cm to 2.0 cm POPULATION OF THE CIRCUMPOLAR REGION (RUSSIA)
(mean 1.2±0.11 cm). One large vessel was involved in 45.0% of cases,
E.V. Moshkova
two large vessels in 15.2% of cases. Multivascular coronary lesions
were revealed in 7.4% of adults. The majority of those who had 1 Coronary heart disease (CHD) is the main cause of mortality in
vessel’s lesion developed II Killip Class, patients with 2 vessels’ lesion III population of circumpolar regions. Aim of the survey was to study the
Killip Class. Adults with multivascular coronary lesion developed IV prevalence of CHD in employable population (aged 20-59 years) of the
Killip Class preferably. Reinfarction occurred in 5 such patients (11.1%). northern part of Yamal peninsula (70-72 degrees of northern latitude)
The majority of adults with 2-3 vessels lesions (25 cases) developed in arctic climatic zone. Material and Methods: cross-sectional
cardiomegaly due to the results of predischarge ECHO. epidemiologic study was carried out in Se-Yakha village (Yamal
peninsula, Russia) in 2008. CHD, arterial hypertension were diagnosed
Conclusion: Thus, 72.0% of patients had severe coronary lesion
by WHO criteria (1999), hypercholesterolemia was evaluated by
regardless young age. III-IV Killip Class (62.3%), reinfarction (11.1%)
recommendations of All-Russia National Cardiologic Society (2004).
and cardiomegaly (55.5%) occurred more frequently in adults with 2-3
Electrocardiogram interpretation was done according to Minnesota
vessels’ lesion. The data obtained may be applied to predict the
code by strict and non-strict criteria, effort angina was stated by the
severity of an early AMI.
Contact: Anna Iakovleva (fox_anyut@mail.ru)
Rose’s cardiologic questionnaire. The results of our study revealed that
CHD prevalence by extensive criteria comprised 14,0%: 9,0% – by non-
strict criteria and 5,0% – by strict ones. Prevalence of effort angina in Objectives: The presentation summarise snuff use and cigarette
population was defined as 3,2%. By strict criteria painless CHD was smoking rates and combined snuff/tobacco users among Sámi and
stated in 1,4% of population, myocardial infarction – in 0,4%. By non- non-Sámi 10th graders in Northern Norway. This is the first study
strict criteria painless CHD was revealed in 5,7%, probable CHD investigating snuff use among indigenous Sami. Study Design: Data
diagnosis was stated for 3,4% of inhabitants. Analysis of the main risk- were collected from the “Youth & Health in North Norway”, a cross-
factors of CHD showed that 48,8% of residents suffered sectional, school based study, conducted in 2003-2005.
hypercholesterolemia, 16,5% had arterial hypertension, smoking was Methods: The total sample included 4,880 participants (response rate:
stated for 28,8% of examined people. On the basis of these studies it 83%). Sámi comprised 9 % (N= 450), and females 50 % (N=2,442) of
seems justified to conclude that epidemiologically defined CHD has a the total sample.
great prevalence in rural population of high latitudes.
Hypercholesterolemia is the most prevalent among the main risk- Results: The proportion of current (occasional and daily) snuff users
factors of CHD. were 19% (N=907), and gender (males 29% vs. females 9%; p<.001)
Contact: E.V. Moshkova (hypertonia@yandex.ru)
differences occurred. No significant ethnic differences existed.
Similarly, the proportion of current (occasional and daily) smokers was
27% (N=1,295), and gender (females 33% vs. males 22%; p<.001) and
ethnic (Sami: 33% vs. non-Sami: 25%; p<.001) differences existed.
Mean age for initiating smoking averaged 13 year, with males and Sámi
SESSION 8 being slightly younger. Sámi more often non-Sámi reported living
together with a smoking siblings (19% vs. 12%, p.001), while
Tuesday, July 14, 4:00-5:30 PM no ethnic differences occurred for living with a smoking mother (37%)
or father (30%). The number of combined cigarette and snuff users
were: 10% (N=503), and gender (males: 14% vs. females 7%; p<.001)
VENUE 1 and ethnic (Sami: 13% vs. non-Sami: 10%, p<.05) differences occurred.
Mental Health & Wellness #5 – Children & Youth Conclusions: After the millennium, decreasing smoking rates has been
notated among Norwegian youth, while snuff use rates has increased
THE INFLUENCE OF RELIGIOUS FACTORS ON DRINKING considerably. Findings from the 1990s generally indicated similar
smoking rates among Sámi and non-Sámi. Compared to these earlier
BEHAVIOUR AMONG YOUNG INDIGENOUS SÁMI AND NON-
findings (Spein et al., 2002) the preliminary results of more Sámi 10th
SÁMI PEERS IN NORTHERN NORWAY graders being current smokers in 2003-05 suggest a less positive
A.R. Spein1, M. Melhus1, R. Kristiansen2, S. Kvernmo3 smoking development among young Sámi when compared to regional
1
Center for Sámi Health Research, Karasjojk, 2Department of Religious and national Norwegian trends. The findings are further discussed in
Studies, University of Tromsø, Norway, 3Child and Adolescent Psychiatric light of sociodemographics, education plans, and risk-taking behaviour
Department, University Hospital of North Norway/Regional Center fo, variables.
Contact: Anna Rita Spein (annas@ism.uit.no)
Norway
Objectives: This is the first longitudinal survey investigating the
influence of religious revival movement (Laestadianism or evangelics) CHALLENGING THE STEREOTYPE: A PORTRAIT OF
and importance (personal Christian) on drinking behavior among HEALTHY INDIGENOUS YOUTH PARTICIPANTS AT THE
indigenous Sámi and non-Sámi adolescents and young adults in COWICHAN (BRITISH COLUMBIA, CANADA) 2008 NORTH
Northern Norway. Study Design: A two wave longitudinal
AMERICAN INDIGENOUS GAMES
epidemiological questionnaire study including 2,950 respondents (675
Sami); 15-19 year; RR: 85% (T1:1994/95) and 1,510 follow-up M. Kelly, R. Link, J. Reading
respondents (360 Sami) 18-22 year; RR: 57% (T2: 1997/98). Results: Centre for Aboriginal Health Research at University of Victoria
More Sámi were Laestadians (10% vs. 3%) and personal Christians
Objective: Existing literature frequently and persistently portrays
(14% vs. 7%) than non-Sámi (p<.001) at T1. Generally, significant
Aboriginal youth as having poor health and engaging in multiple risky
negative associations were noted for religiousness and abstinence,
behaviours. Reports of higher rates of accidents, injuries, substance
drinking frequency and style (drunkenness), and it also influenced
abuse, sexual transmitted infections, school dropouts, and suicides
youth drinking context at both assessments. Ethnicity and ethnic
among Indigenous youth are widespread. Using survey results, the
context (region) moderated the effect of religion on drinking. The less
purpose of this study is to challenge the unhealthy portrayal of
drinking earlier noted among young Sámi may partly be explained by
Indigenous youth by exploring the role of sport in the health and
ethnic differences in religiosity, as the effect of ethnicity generally
resiliency of participants at the 2008 North American Indigenous
became non-significant when adjusted for sociodemograhpics, ethnic
Games (NAIG).
context, family and school factors. Conclusions: Generally, religious
factors had strong protective effect upon drinking behavior. Methods: The Aboriginal Youth Lifestyle Survey was designed to
Laestadianis’s profound impact on Sámi culture and strong anti- inquire about youth tobacco use and other health related factors and
alcohol norms may have contributed to a religious-socio-cultural was used to survey youth at the 2002 NAIG. The same survey, with
context of abstinence, explaining the higher abstinence rate and lower minor revisions, was used in this study to survey Aboriginal youth
drinking rates found among Sami. athletes at the 2008 NAIG.
Contact: Anna Rita Spein (annas@ism.uit.no) Results: There were 277 survey participants who met the inclusion
criteria. Of those for whom smoking status could be assessed, 238
(93.7%) were currently non-smokers. Qualifying to compete at the
SNUFF USE AND CIGARETTE SMOKING AMONG NAIG suggests a certain level of physical fitness, but in addition, over
INDIGENOUS SÁMI AND NON-SÁMI 10TH GRADERS IN half (55.1%) of the athletes also reported participating in physical
NORTHERN NORWAY 2003-2005 activity without an instructor four or more times a week. Nearly three-
A.R. Spein1, M. Melhus1, L. Grøtvedt2, S. Kvernmo3 quarters (73.3%) of participants reported very good or excellent health.
1 In addition, the participants also scored high on self-esteem and
Center for Sámi Health Research, Karasjojk, 2Norwegian Institute of
positive peer group indicators.
Public Health, Norway, 3Child and Adolescent Psychiatric Department,
University Hospital of North Norway/Regional Center fo, Norway Discussion: These findings indicate that the athlete participants of the
2008 NAIG are a healthy population of Indigenous youth and are
consistent with the findings from the 2002 NAIG survey. This suggests
that Indigenous athletes are healthier than their Indigenous and look at themselves? Are they aware of classifications or are other
mainstream North American counterparts and that sport may act as a factors and values involved?
protective health factor for Indigenous youth. Further research into the This study focuses on children’s resources and competences instead of
benefits of sport may be a crucial step in closing the gap in health on privation or social inequality. The study deals with what children are
status that currently exists between Indigenous and non-Indigenous concerned about and looks at children as interpreters of their own
people. lives.
Contact: Rachel Link (rlink@uvic.ca)
Our study has been in progress since November 2007. The study has
taken place in the capital, Nuuk, and in Qaanaaq the most northern
FAMILY HEALTH AND WELL-BEING: RESEARCH, town in Greenland. The focus group is schoolchildren in different public
RESPONSIBILITY, REACTION places. The playing and moving children bring us to a tense field
between the past and the modern time.
G. Mulvad
We want to show, how we are applying qualitative anthropological
Center of Primary Health
methods like participant observation, interviews and observations in
During the last decade, research have given a lot of knowledge about our fieldwork. We will take you to the places where we find the children
health and well-being in the family of the Arctic. I many Arctic region, and to places children have shown us through their pictures.
we have to say that the data about “well-being” gives a lot of
In this presentation we would like to show you our pathways. Pictures
responsibility for the community. Responsibility to handle the
from our fieldwork will be helpers in the presentation.
knowledge about, alcohol abuse, suicide, sexual abuse, infectious
Contact: Klara Thorsen (klth@peqqik.gl, gwbe@peqqik.gl)
diseases, inequality in health and well-being. The research, the data,
and the responsibility have to be discussed between the research team
and the society. Research have shown the problems, but not a way to
go, handling the knowledge about the well or not well-being in the VENUE 2
Arctic Family. The responsibility have to be taken. A family
Occupational Health
responsibility, a community responsibility, our responsibility. New
reaction have to be planed. Involvement of the society and the family
to cope and react on the new knowledge, will be discussed. Start with PSYCHODYNAMIC ANALYSIS OF ANTARCTIC INTERGROUPS
the children, the family in formative period, when the child start in RELATIONS
kinder garden, and in school reaction have to be taken. Research, G. Cobra
Responsibility and Reaction, we can find solution.
Contact: Gert Mulvad (gm@peqqik.gl)
Escola Nacional de Saúde Pública (ENSP) - FIOCRUZ
This qualitative research was developed through indirect observation
(NELSON, 1973) of 20 Brazilian researchers from Rio de Janeiro and
THE APPLICATION OF STRENGTH BASED ASSESSMENTS São Paulo who went to Antarctica on the years of 2005, 2006 and 2007.
AND INTERVENTIONS WITH CHILDREN AND ADOLESCENTS The population embraced 15 men and 5 women with a mean age of 34
EXPERIENCING MENTAL HEALTH DIFFICULTIES years old. Interviews were carried individually with the intension of
E. Rawana, K. Brownlee getting the most personal view from the interaction of its own group
with the base group (Navy) and its formal leader.
Lakehead University
Objective: To evaluate inter-group formation, structure and interaction;
This workshop is intended for front-line staff and their supervisors, the patterns of intersubjective relations and group as an emotional and
particularly those working in a northern environment. The presentation material support for a confined and isolated environment.
will focus on utilizing a strengths-based perspective in working with
children, adolescents and their families, including First Nations Methods: The individual interviews were recorded and analyzed with
families. Clinicians will be presented with a developmental model that the technique of discourse analysis. Each interviewee was taken as the
defines strengths and shows how strengths play an integral role in the spokesman of the group as a whole (Foulks, 1965). Their accounts were
developmental profile of children and adolescents. Clinicians will be analyzed in the light of group psychoanalysis theory, especially W. R.
provided with an instrument for assessing strengths in individuals and Bion, S.H. Foulks and E. J. Anthony.
their families. The instrument used for the assessment of strengths Results: It was identified three different reseachers’ groups: the
was particularly developed with a northern focus and thus reflects the camping group, the Comandante Ferraz Station group and the boat
unique spiritual and cultural influences on the psychological group (Ary Rongel). These three groups have different dynamics,
development of northern youth. Clinicians will also be provided with a structure and culture formation. Although they had superficially a
framework to incorporate the assessed strengths into their treatment formal group pattern (Nelson, 1973) the informal structure was soon
plans for children, adolescents and their families. This framework revealed. Through the discourses it was possible to identify intergroups
complements the more commonly used diagnostic approach and relations, more specifically, how the interaction between the
emphasizes a holistic and cultural model for working with clients. researchers and the base group (Navy) is organized. Many times work-
Contact: Edward Rawana (erawana@lakeheadu.ca) group activities were emotionally obstructed and diverted by basic
assumptions of dependence, flight and fight (BION, 1975). Because the
Brazilian Antartic Programme logistics is organized by the Navy and its
THREE CHILDREN ON ONE BIKE: AN ANTHROPOLOGICAL commanding officer, one of the common assumptions to all groups,
STUDY WITH ON WHAT CHILDREN ARE CAPABLE OF AND that is to do research, was not always carried out to its full extension.
WHAT CHILDREN WANT Therefore the Station Chief, depending on his personality, was
K. Thorsen, G. Bergenholtz evaluated as an autocratic or democratic leader.
Contact: Geny Cobra (geny.cobra@gmail.com)
Greenland Management of Health, Nuuk. Center of Health Education,
Nuuk
In Greenland today children may be classified as: relatively poor, RASCH ANALYSIS OF THE OSWESTRY DISABILITY INDEX
implicitly poor, need estimatedly poor and many other classifications. L. Lochhead, P. Macmillan
All these classifications children must bear without knowing it University of Northern British Columbia
themselves. Adults give classifications to children, but how do children
In northern resource based communities determination of readiness to Conclusions: Environmental and individual risk factors should be taken
return to work can be challenging due to the heavy nature of the work, into account when developing risk assessment and management
conditions in which the work is performed and the shortage of health strategies for preventing frostbite injuries in cold work.
professionals trained to assess work ability. Often health care Contact: Tiina Mäkinen (Tiina.Makinen@oulu.fi)
professionals rely on self report instruments to determine when and

how the worker will return to work. “The Oswestry Disability Index
(ODI) has become one of the principal condition-specific outcome NUTRITION, VITAMINS, SERUM LIPIDS, AND
measures used in the management of spinal disorders.” (Fairbank, CARDIOVASCULAR DISEASES RISK IN DRIVERS WORKED IN
2000). GAS INDUSTRY ON THE NORTH OF RUSSIA
The purpose of this study was to explore the construct validity of the N. Potolitsyna, N. Eseva, E. Bojko
ODI version 1 using Rasch Analysis. Data was collected on a sample of Department of Ecological and Social Physiology of Human, Institute of
300 northern dwelling individuals working primarily in the forest Physiology, Ural Division of the Russian Academy of Sciences, Syktyvkar,
industry. We are looking at the measurement properties of the ODI Russia
usingthe partial credit/rating scale Rasch models. The identification of
The composition of the actual meal and blood level of lipids and
poorly functioning items allow for their elimination or improvement of
vitamins was a studied in different groups drivers (man) working in gas
these items and therefore the improvement of the instrument.
industry depending on the gravity of the work (n=223). The 24-hours
When Andrich’s rating scale model is applied, all response levels interview analysis of the actual meal has revealed the differences in
appear to function. Level 2 however had a narrower range for which it ration of the nutrition in different groups of drivers. Ones having heavy
was the most probable choice. When Masters’ Partial Credit Model is physical activity and shift working type is often discovered a low caloric
applied, the level 2 response was seen to be particularly problematic value of the nutrition, mainly, to account of the reduction
for 3 items including the Pain Intensity item mentioned by White and carbohydrates in food and demonstrate the deficit of vitamins. In
Velozo(2002). We are not yet ready to concur that the pain intensity drivers group with middle heavies of work described the increased
item does not fit adequately (i.e. warrants removal or revision) caloric value of the nutrition leads to increase of serum lipids. The
In fact, we found that the 10 Version 1 Oswestry items showed analysis of serum indices has shown that examined workers had
adequate fit to the Rash model Health Professionals using this measure normal levels of total cholesterol and lipoproteins of high and low
should be aware that the ODI is a valid measure however for some density, apolipoprotein A1 and apolipoprotein B, however typically
items the rating scale steps do not perform as intended. they had high level of triglycerides. Biochemical analysis of vitamins in
Contact: Lois Lochhead (lois@cidms.com) blood has shown the low level of vitamins participate in antioxidant
system - α-tocopherol, retinol, riboflavine.
Contact: Bojko Evgeny (erbojko@physiol.komisc.ru)
OCCURRENCE AND RISK FACTORS OF FROSTBITES AT THE
POPULATION LEVEL WITH A SPECIAL EMPHASIS ON
WORKING LIFE PSYCHOPHYSIOLOGICAL ASPECTS OF ADAPTATION OF OIL
1 1,2 1,3 4 SHIFT WORKERS
T.M. Mäkinen , J. Jokelainen , S. Näyhä , T. Laatikainen , P.
Jousilahti4, J. Hassi1 G. Degteva
1 2
Institute of Health Sciences, University of Oulu, Unit of General The unfavorable production factors, flying stress, group isolation
Practice, Oulu University Hospital, Oulu, Finland, 3Finnish Institute of against the background of extreme geophysics and weather factors of
Occupational Health, Oulu, Finland, 4National Institute for Health and the North influences upon adaptive reactions.
Welfare, Helsinki, Finland The study of physiological reactions of organism of shift workers
Objectives: Frostbites are tissue injuries related to adverse cooling and reveals that 83% of workers has “after flying stress” formed by flying
unacceptable in the view of public health and occupational safety. The and the start of work at the oil field; 38% workers has tensions and
objective of the study was to examine the occurrence and risk factors exhaustion of regulation mechanism at the end of the shift.
of frostbites in the general population with a particular emphasis on From the 33-35th day of the shift 61% of workers was easily tired, had
frostbites occurring in working life. deterioration of concentration of attention, degradation with tension
Methods: Two national FINRISK studies and their cold sub studies of organism functional systems (cardiovascular, respiratory, red blood
(FINRISK 1997 n=2624, FINRISK 2002 n=6591) were analysed systems).
consisting of questionnaires administered to men and women aged 25- Psycho physiological features stand as regulators of biological
74 yrs. resources of organism under labour conditions, determine stress
Results: A total of 697 frostbites were reported in the two studies. tolerance, form range of adaptive possibilities. The analysis of different
Altogether 425 had occurred during the past year (330 mild and 95 regimes of labour and rest showed inefficiency of long shift (52 days) in
severe) and 272 during the lifetime according to the respondents. The the Extreme North, especially in winter. The dynamic of “vegetative
amount of annually occurring mild frostbite was 12.9% (330/2550) coefficient” showed the attitude towards active actions with optimal
being 14.2% (170/1201) in men and 11.9% (160/1341) in women. The mobilization of physical and psychological resources was characterized
annual incidence of severe frostbites was 1.1% 95/8788 being 1.6% for most of shift workers at the beginning of the shift. In the middle of
(66/4043) in men and 0.6% (29/4560) in women. The cumulative the shift the energetic potential of workers was significantly
lifetime incidence of severe frostbites was 10.6% (272/2568) and 14.1% decreased. Then tiredness, fussiness, agitation, impulsion were
(171/1210) in men and 7.4% (101/1358) in women. Frostbites occur more increased. Hasty steps became possible because of low self-control. At
often in men than women and decrease at age 65 or above. Most of the the end of the shift the self-appraisal of shift workers increased in
frostbites were reported in occupational groups, such as skilled expectation of the rest and the meeting with family.
agricultural and fishery workers, craft and related trades workers, plant Negative climate and production factors equally impact on all workers,
and machine operators, assemblers and technicians and associate but the characteristics of functional state are considerably different
professionals. Occupational related risk factors included employment because of diverse level of formal and dynamic features of
in a certain industry (e.g. outdoor work), high physical strain, and high individuality, personal, social psychological features, motive, needs,
reported weekly cold exposure at work. Individual factors that increase profession features. It requires different approach to professional
frostbite risk are: diabetes, white fingers in cold, cardiac insufficiency, selection and psychological maintenance of workers under the
angina pectoris, history of stroke, feelings of depression and heavy extreme conditions of the North.
alcohol use. Contact: Galina Degteva (lzubov@atnet.ru)
HUMAN HEALTH RISK ASSESSMENT AND BEYOND – THE and spina bifida in AO and spina bifida and gastroschisis in Norway was
COMMUNITY HEALTH highest in the young maternal age groups. The findings will be
presented in more detail orally at the conference and published (1,2).
G. Brown1, M. Lee2
1 2 We acknowledge the services of the Medical Birth Registry of Norway
Intrinsik Environmental Sciences Inc., Habitat Health Impact
and the Vyletsova Children Hospital in Arkhangelsk. The Norwegian
Cosulting
Barents Secretariat sponsored the study collaboration.
When plans for construction and operation of heavy industrial plants or Contact: Arild Vaktskjold (arild@nhv.se)
projects are announced by large corporations, local members of the
general public and of regional communities are legitimately concerned
about possible adverse effects on human health and well-being. It is CHART REVIEW ANALYSIS OF MATERNAL FACTORS AND
generally believed by the public that new industrial projects could MAJOR MALFORMATIONS ON BAFFIN ISLAND 2000-2005
adversely affect human health eg air quality, country foods and local C. Sy1, J. Cowan1, I. Sobol2, G. Osborne2, L. Arbour1
water sources are particular concerns. For regulatory approval of new 1
University of British Columbia, 2Nunavut Health and Social Services
projects, potential environmental impacts and human health risks
must be properly assessed, addressed and mitigated through the Birth defect rates have been previously (1989-1993) shown to be higher
Environmental Impact Assessment (EIA) process in Alberta and other in Canadian Inuit populations (Nunavut and Nunavik) than in Alberta. A
jurisdictions. recent (2000-2005) CCASS analysis (up until 1 month of age)
comparing Nunavut to the other Territories and the rest of Canada
What has been inadequately addressed, or is entirely missing from the
support a higher rate of birth defects in Nunavut (see Orlaw), largely
regulatory assessments required in Alberta is a process to address
because of a higher rate of heart defects. Furthermore, a chart review
broader issues of community health and well-being that are
of all births from Baffin Island in the same time period, (n=2015)
scientifically separate from exposures through proposed and operating
confirmed that even after folic acid fortification, the rate of
industrial facilities. Overall community health and well-being must
echocardiography confirmed heart defects (ICD-9 745) remain three
involve integration of health risk assessment findings and mitigation
times higher than in Alberta. This study uses case control methodology
plans with paradigms for assessing and mitigating bigger and broader
from the same chart review to determine if prenatally reported
community health issues, as well as involving open communication and
maternal risk factors were associated with major congenital
involvement with all public stakeholders - not only during the approval
malformations. Cases (n=77) were selected on the basis of having a
stage, but also ongoing during the operations of large industrial
confirmed major malformation without chromosome anomaly or
projects.
Contact: Gordon Brown (gbrown@intrinsikscience.com)
syndrome in ICD 9 categories 740-759. The next four births without
birth defects from the same community were selected as controls
(n=307). Using odds ratios (OR) and 95% confidence intervals (CI) for
significance, self reported alcohol consumption at the first prenatal
VENUE 3 visit in any quantity, smoking, marijuana, and pre-natal vitamin use
Newborn & Child Health #1 – Birth Defects were analyzed. Maternal age, and term vs preterm gestation were also
compared. Of these, alcohol consumption was significantly associated
(OR-2.2,CI:1.02-4.87), and infants with major malformations were 6
THE INCIDENCE OF SEVERE CONGENITAL DEFECTS IN times more likely to be born premature (OR-6.35,CI:3.15-12.80). No
NORWAY AND NORTHWEST RUSSIA other factors were significant. A sub-analysis of the same risk factors
A. Vaktskjold1, J.G. Petrova2 on infants with cardiac defects only revealed an association with
1 preterm birth (PDA and PFO excluded) (OR-11.59,CI:3.32-40.5). No
Nordic School of Public Health, Nordic Council of Ministers,
other maternal risk factors were significant, including alcohol intake
Sweden/Denmark, 2P.G. Vyletsova Clinical Children Hospital of
although marijuana use was close to significance. Although data were
Arkhangelskaja Oblast, Russia
limited, there was no evidence of protective effect with maternal
Congenital birth defects continue to be a pressing challenge in both vitamin use. Development of a comprehensive pregnancy and child
paediatric and general health work. These children eventually health surveillance system will provide on-going, more precise
comprise a major part of the overall indicators of children’s health, information on preventable causes of birth defects.
such as disability, mortality, morbidity and hospitalisation. Our aim Contact: Candice Sy (candices@interchange.ubc.ca)
was to assess and compare the incidence of isolated neural tube
defects (anencephaly and spina bifida) (NTD), anterior abdominal wall
defects (gastroschisis and omphalocele) and trisomy 13 in the foetal CONGENITAL ANOMALIES IN CANADA’S NORTHERN
and newborn populations (~12 weeks’ gestation) of the Arkhangelskaja TERRITORIES
Oblast (AO) in north-west Russia and Norway, and to study the C. Orlaw1, J. Rouleau2, B. Hanley3, A. Corriveau4, G. Osborne5, I. Sobol5,
maternal-age distribution of these defects. L. Arbour6
In Russia, systematic population-based computerised registration of all 1
University of Alaska Anchorage, 2Public Health Agency of Canada,
deliveries has been lacking, which has hampered the possibilities for 3
Yukon Health and Social Services, 4Northwest Territories Health and
epidemiological studies concerning birth defects there. However, by Social Services, 5Nunavut Health and Social Services, 6University of
year 2006, 34 regions (including four in the north) had put in place a British Columbia
programme for population-based registration of newborns and
Objectives: There is little information regarding congenital anomalies in
foetuses with defects, which facilitates for descriptive studies. Our
Canada’s circumpolar regions compared to southern Canada.
study is the first submitted for publication internationally based on
Discovering this information is a critical first step to help direct clinical
these data, and the first from Norway that also include abortuses with
the mentioned defects. and public health resources. The birth prevalence of specific significant
congenital anomalies also allows for the development of public health
35 per 10,000 newborns and abortuses had one of the defects in AO prevention strategies.
(whereof 24% had trisomy), and 34/10,000 in Norway (53%). Of those
Methods: Data for the first 30 days of life was gathered by the Canadian
with trisomy, 98% in AO were live born compared to 75% in Norway.
Institute of Health Information (CIHI) from discharge abstracts from
The incidence (~12 weeks’ gestation) of NTD was 21.1 (± 3.4)/10,000 in
AO and 10.8 (± 1.2) in Norway; and of abdominal wall defects 2000-2005. That information was compiled into congenital anomaly
categories for each province/territory as per the Canadian Congenital
5.4/10,000 (±1.7) in AO and 5.1 (±0.8) in Norway. Of the latter, 38% in
Anomalies Surveillance System. Totals and categories were compared
AO and 65% in Norway were live born. The incidence of anencephaly
per territory to those of the rest of Canada using odds ratios (OR) and
95% confidence intervals (CI). Socioeconomic indicators were gathered Department of Medical Genetics, Unviversity of British Columbia, The
from Statistics Canada. IUCH Birth Defect Working Group
Results: Total anomalies in Canada, Yukon, NWT and Nunavut per 1000 Introduction: As part of the International Polar Year, Arctic Human
births respectively are: 66, 57, 59, and 90. Only Nunavut had a Health Initiative, the Birth Defects Working Group of the International
significantly higher total rate than the rest of Canada. (OR 1.4; 95% CI Union of Circumpolar Health catalogued existing and developing birth
1.2-1.6). Rates of congenital anomalies in Yukon and Northwest outcome and birth defect surveillance within and around the
Territories were not significantly higher in any category when geographic jurisdiction of the International Union of Circumpolar
compared to the rest of Canada. However, congenital heart defects in Health (IUCH). It was found that systematic population-based
Nunavut were increased with an OR of 2.59 (95% CI 2.2-3.3). Socio- registration of birth outcomes including birth defects occurs to some
economic indicators such as infant mortality, low income and degree in all circumpolar countries, but the quality of collection and the
expenditures on food reflected the same trends as seen for congenital coverage in northernmost regions vary. For example, few circumpolar
anomalies. jurisdictions have registries that collect birth defects beyond the
Conclusions: Birth defects collected in the first 30 days of life are an perinatal period. Efforts are underway in some jurisdictions (Canada
underestimate of the true impact since many birth defects are not and Russia) to improve the quality and comprehensiveness of the
detected until later. Although congenital heart defects are information collected in the northern regions. It is hoped this baseline
multifactorial (genetic and environmental), the socioeconomic review of existing and developing surveillance systems will serve as a
indicators and congenital anomalies distributions are strikingly similar. guide for the development of additional surveillance systems and
The development of maternal child health surveillance systems will enhance the mandate of current systems with the eventual goal of
provide more specific information on potentially preventable causes of comprehensive and comparable coverage throughout the circumpolar
congenital heart defects. world. For now, however, although there is variability in the
Contact: Cynthia Orlaw (cindyorlaw@yahoo.ca) comprehensiveness of information collected in Northern jurisdictions
limiting sophisticated comparative analyses between regions, there is
substantial untapped potential for baseline analyses of specific risks
RATES OF HOSPITALIZATION FOR LUNG INFECTION OF and outcomes that could provide insight into geographic differences.
INUIT INFANTS FROM THE BAFFIN REGION AND Drs. Vaktskjold and Arbour will present a summary of the review
ASSOCIATION WITH HEART DEFECTS 2000-2005 carried out by the IUCH Birth Defect Working Group.
Contact: Laura Arbour (larbour@uvic.ca)
S. Peters1, J. Cowan1, G. Osborne2, I. Sobol2, L. Arbour1
1
University of British Columbia, 2Nunavut Health and Social Services
Previous and current research has suggested that Inuit infants in
Canada have a higher rate of heart defects than other Northern and
VENUE 4
Canadian populations. As well there is great concern over the rate of Education and Building Resource/Research Capacity #4
admissions for lung infection (lower respiratory tract infection) in the
first year of life. As part of a comprehensive chart review for all births THE SAFETY OF SMALL DRINKING WATER SYSTEMS IN
from January 1st, 2000 to December 31st 2005, all overnight CANADA: DISCUSSING THE NORTHERN PERSPECTIVE
hospitalizations for lung infection for infants born in the years 2000-
2004 inclusive were documented considering the question: Are H. Beanlands, F. Benoit, M. Fast, D. Ciliska, R. Copes, M. Greenwood
children with heart defects more likely to be admitted for lung National Collaborating Centres (NCCs) for Public Health
infection than children without? The International Union for Circumpolar Health has noted that “there
Methods: A chart review of all live births in the Baffin region of Nunavut has been a long-standing need for the exchange of medical knowledge,
was performed (n=1700). Maternal factors and birth defects were as well as the results of recent research and demonstrated solutions to
recorded, as well as all reasons for overnight hospitalizations. For all problems for the benefit of humankind.”
infants, overnight hospital admissions for lung infection, (single and One serious problem is the safety of small drinking water systems.
multiple) were recorded until the first birthday. Presence or absence of What support and what practical information do public health
a heart defect (confirmed with echocardiography, excluding PDA inspectors, public health nurses, and medical officers of health in
associated with prematurity) was noted (n=69). Annualized northern communities in Canada require to make the best use of the
incidence(AI) rates/1000 (admissions/population at risk) and odds knowledge and data arising from recent research initiatives into the
ratios (OR) with 95% confidence intervals (CI) were used in the analysis safety of small drinking water systems?
of rates and to determine increased risk for those with heart defects.
The National Collaborating Centres (NCCs) for Public Health are a
Results: Of 1688 infants, 408 were admitted at least once, with a total network of six centres across Canada providing a national focus for the
of 597 hospital admissions for lung infection (354/1000 AI rate). Twenty synthesis, translation and exchange of scientific evidence and other
nine children with heart defects were admitted 57 times, (826/1000 AI relevant knowledge to improve and sustain evidence-based informed
rate). Infants with heart defects were significantly more likely to be decisions by public health practitioners and policymakers.
hospitalized at least once (OR 2.36:CI 1.44-3.86), and to have repeat
The NCC for Environmental Health will present results of their study on
admissions (OR 2.6:CI 1.23-5.63).
retrospective surveillance for drinking-water related illnesses from
Conclusion: Rates of hospital admissions for lung infection remain high 1993-2008 in Canada as a basis for discussion around next steps for
in the Baffin Region of Nunavut. Infants with heart defects have a improving small drinking water systems.
particular high rate of admissions impacting further on the health care
Following the presentation, participants will be invited to share their
system. Although more study is needed to understand the reasons for
best views as to how issues surrounding the safety of small drinking
the increased rates, priority efforts in prevention of lung infections
water systems can be addressed and the group will explore
should be directed to those infants with heart defects.
Contact: Sarah Peters (scpeters@interchange.ubc.ca)
opportunities for future collaboration.
Specifically, the objective of the presentation is to
- identify research priorities and opportunities for future
THE STATE OF BIRTH DEFECTS AND BIRTH OUTCOME
collaboration regarding the safety of small drinking water
SURVEILLANCE IN THE CIRCUMPOLAR REGIONS OF THE systems in Canada’s North.
WORLD IN 2008 Contact: Philip Girvan (pgirvan@stfx.ca)
L. Arbour, V. Melnikov, B. Olsen, G. Osborne, A. Vaktskjold

BUILDING INDIGENOUS CAPACITY TO MEET HEALTH research. From developing a research topic, to gaining financial
NEEDS AND COMBAT HEALTH DISPARITIES: A MANITOBA support, to presenting results, CAAN’s goal is to disseminate
(CANADA) EXPERIENCE knowledge about the research process, while acknowledging real-life
barriers that make this process challenging. Although the same
M. Hall, B. Elias, P.J. Martens, J. Mignone intensive effort that has been applied in southern communities must
University of Manitoba also be applied to northern Canada, collapsing Inuit research into a
Introduction: In Canada, there is an urgent need for comparable and national effort limits the ability to develop innovative and targeted
relevant health indicators to address the health of the First Nations community-based research strategies.
(FN) population. In response, a collaborative interdisciplinary university CAAN and Pauktuutit recommend normalizing the research process
research and government partner team developed through the through storytelling. CAAN Community-Based Research Facilitators
Manitoba First Nations Centre for Aboriginal Health research resulted will present successes and challenges in the community-based
in funding from the Canadian Institutes of Health Research to support research process drawn from eight years of experience, while
targeted capacity building in identifying and reporting on comparable community leaders from Pauktuutit will discuss how these models
and unique indicators. This presentation reports on a collaborative have been implemented in northern communities, with the goal of
approach for effective knowledge transfer and exchange involving FN building enthusiasm for undertaking community-based research.
and tribal health personnel. The workshops promote opportunities to Contact: Renee Masching (reneem@caan.ca)
understand and explore health indicators, as well as map out crucial

indicators for a health-reporting framework.
YUKON FIRST NATION
Methods: In Manitoba, First Nations have access to a multitude of
informative data sources to investigate the health of their J. Jones
communities, including social determinant surveys and provincial Council of Yukon First Nations
health administration data (e.g., medical and hospital claims). To The Yukon First Nation Health and Social Development Commission
clearly distinguish Registered FN/non-Registered FN individuals in the (H&SDC) is comprised of 14 Yukon First Nation (YFN) Health and Social
administrative databases, permission to access and link the federal Directors. In the Yukon, where land claims are settled for the majority
government “Indian Registry” to the provincial population registry of YFNs, engaging collaboratively becomes both a barrier and a key to
system made it possible for FNs to investigate past, current and future success. When it became apparent that monies for the Aboriginal
health status and health service utilization by tribal areas Health Transition Fund (AHTF) would flow through a centralized body
(north/south). Combining these data sources and the indicators only and not to each Yukon First Nation, and that collaboration and
developed by the Manitoba Centre for Health Policy, we were able to support from Northern Region (Health Canada) and Yukon
design a health indicator training program which included a manual Government (YG) was required, YFNs examined means to work
(covering indicator development, data sources and data access collaboratively amongst themselves and with the new partners.
protocols), presentation materials, data to story training tools, and a
round-table discussion template to identify prevalent and emerging YFNs have already identified health and social initiatives to be funded
community health issues. FN health directors and program by AHTF, though a new means was required to ensure approval and
coordinators participated in the training collaboration from new program partners: Northern Region and YG. In
all, 11 initiatives, including gathering information on gaps and linkages
Results/Conclusion: The workshops enhanced the capacity of in existing health and social programs and services delivered to YFNs
participants to understand indicator development, data linkage from each individual First Nation were agreed upon and approved. By
possibilities, data interpretation, and ways to use indicators to inform defining commitment and collaboration, community engagement
policies and programs. techniques were used to identify areas of focus for the projects. The
Contact: Madelyn Hall (Madelyn_Hall@umanitoba.ca)
initiatives are large in scope to incorporate different outcome needs of
the partners, while keeping enough of a focus to ensure the final
INCREASING HIV/AIDS COMMUNITY-BASED RESEARCH outcomes will be sustainable and support better access and delivery of
health and social programs and services to all YFNs. The 10 additional
CAPACITY IN NORTHERN ABORIGINAL COMMUNITIES IN
initiatives include: developing an injury prevention strategy targeting
CANADA YFNs; identifying barriers that YFNs face in accessing formal
M. Mayoh, R. Masching, P. Lyta healthcare services and developing a formal health and social body in
Canadian Aboriginal AIDS Network which YFN can work collaboratively.
Issue: Unique social and environmental issues create greater It is through the collaboration of the YFN Health and Social Directors,
susceptibility to STIs and present obstacles for engagement of YG and Heath Canada that YFNs are engaging in unprecedented
northern communities in the community-based research process. research and development on a Territorial wide scale.
Contact: Jen Jones (jen.jones@cyfn.net)
The Challenges: STI data suggests an alarming over-representation of
infection in Inuit communities, compared to non-Aboriginal
communities. High rates of teenage pregnancies are also a concern. ANISHINABE HEALTH PLAN
Gaps in data in northern Canada limit our understanding of the current
J. Gordon, F. Tarrant
growth of the HIV/AIDS epidemic in northern communities. This
situation demands efforts to develop community-based research to Sioux Lookout First Nations Health Authority
further understand and combat the epidemic in the north through Sioux lookout First Nations Health Authority led a planning process
evidence-based policy and program implementation. that supported the First Nation communities in Northwestern Ontario
Next Steps: Early promulgators of HIV prevention and advocacy in to develop the Anishinabe Health Plan. The primary goal was to
Aboriginal communities in southern Canada faced many challenges, develop a Health Plan within a Primary Health Care Framework that
which has led to an epidemic. Nevertheless, early acknowledgement of would guide the reinvestment of federal dollars into community based
this growing epidemic among some led to an investment in community services in order to enhance and improve the current Primary Health
capacity to learn and engage in community-based HIV/AIDS research. Care delivery system.
Northern communities may circumvent a similar epidemic if they The objectives of this project was to:
invest in prevention through community ownership and partnerships. - To design a comprehensive integrated primary health care model
CAAN, in partnership with Pauktuutit, is committed to capacity and implementation plan for the communities of the Sioux
building in northern communities to increase community-based Lookout Zone.
- To design a district physicians plan within an integrated primary health services governance and close the gaps in health status and life
care framework which will include access and referral expectancy between the First Nations and other British Columbians.
mechanisms to specialized clinical services and ensure the This is a ten year health plan with four key elements: governance,
integration of physician services with nursing and other health relationships and accountability; health promotion, injury and disease
programs provided by and/or funded by FNIHB at the community prevention; health services; performance tracking. This is the first time
level. in Canada that the federal and a provincial government have
- To develop an outline of a nursing services plan within an collaborsted with the First Nations in a formal time-focussed plan to
integrated primary health care framework. close the gap in health inequities. This presentation will focus on the
- To design a mechanism for the governance and management of historical background leading up to the signing of the Tripartite First
the primary health care systems that is First Nation centered. Nations Health Plan and the elements of the plan discussing in
A multi-disciplinary, collaborative approach involving health particular the development of a new model for health governance. The
professionals, First Nations representatives, federal and provincial potential future benefits overall include: decisions made by First
government representatives participated in defining the new approach Nations in BC for First Nations in BC; a seamless continuum of care;
to primary health care in the Sioux Lookout Zone for the First Nation opportunity to pool, reallocate resources and leverage funds to
communities. increase access and obtain better care; more efficient and effective
programs and services; community based approach to ensure services
The Anishinabe Health Plan identifies service delivery in the areas of are reflective of regional differences and provided closer to home;
health promotion, disease and injury prevention, and the management ability to work more collaboratively across other sectors; and clearer
of chronic disease. accountabilities at all levels.
The development and the implementation of a Primary Health Care Contact: J. David Martin (john_david_martin@hc-sc.gc.ca)
framework that will ensure that all the Anishinawbe of the Sioux
Lookout area have equitable access to 24/7 services. The project
enabled the Anishinawbe to define a comprehensive range of Primary COLLABORATIVE RESEARCH IN NUNAVUT: A CASE
Health Care services that will be delivered to the whole population HISTORY
through an organized primary health care system. A well defined W.A. MacDonald
Primary Health Care framework ensures the coordination and
Health and Social Services, Government of Nunavut
integration of a wide range of health services where care is provided by
the right provider at the right time in the right place. Many women in Nunavut and rural Canada must leave their homes to
Contact: Janet Gordon (Janet.Gordon@slfnha.com) deliver their babies in a regional facility up to 4 weeks prior to their
delivery date. This imposes a significant financial and social cost on the
women, their families and the health care delivery system.
ONTARIO FIRST NATIONS PUBLIC HEALTH PROJECT: Several care providers in Nunavut thought that a research project into
TRIPARTITE APPROACH the utility of a promising laboratory test at term could improve the
L. Ogilvie1, L. Menominee-Batise1, L. Yuan2, T. Antone1, D. Dupont3 management of normal pregnancies in Nunavut. The care givers in
1
Chiefs of Ontario, 2First Nations and Inuit Health, Ontario Region, Nunavut lacked the research experience to plan an appropriate
3
Ministry of Health and Long Term Care research project. An alliance was established with experienced
researchers at University of Ottawa, University of British Columbia, the
Objective: To improve the delivery of public health services for Ontario newly created Arctic Health Research Network office in Iqaluit, and
First Nations communities. Qulliit Nunavut Status of Women’s Council.
Methods: In 2007, the Aboriginal Health Transition Fund provided Implementing the project required multijurisdictional ethics approval:
funding to the Chiefs of Ontario (COO) to develop an integrated University of British Columbia, The Ottawa Hospital; obtaining a
approach for public health services in First Nations communities. This research license in Nunavut through the Nunavut Research Institute
public health initiative is launched in concert with First Nations and and approval of the Department of Health and Social Services
Inuit Health -Ontario Region and the Ontario Ministry of Health and Research Review Committee. In addition to ethics and methodology
Long Term Care. There are two components to this project: the we have collaborated about financing the project, determining staffing
development of a Public Health Framework and the development and needs, approach to recruitment of patients, dissemination of
implementation of a strategy for the management of First Nations information regarding the project, and implementation of the study
public health information. Multiple stakeholders will be consulted in activities in Iqaluit
this process. A Project Management Team and two Working Groups
have been established since the launch. The development of this project highlights a collaborative research
project where a research question arises in the course of program
Results: The presentation will describe the Public Health Initiative as delivery in a remote region; and where university based researchers
well as the process used to engage First Nations partners and respond to the request for assistance in a fashion which enhances the
stakeholders in its development. local control and research capacity building. Further, this collaboration
Conclusion: The First Nations Public Health Initiative is an exciting has been enhanced significantly by the creation of a local research
tripartite initiative which will develop a framework for delivery of coordination program. (AHRN).
public health services for First Nations on reserve. This process can stand as a model for research in rural and remote
Contact: Linda Ogilvie (linda@coo.org)
jurisdictions which lack local research capacity.
Contact: W. Alexander Macdonald (wmacdonald2@gov.nu.ca)
THE TRIPARTITE FIRST NATIONS HEALTH PLAN- A

FUNDAMENTAL CHANGE IN GOVERNANCE OF HEALTH
SERVICES FOR THE FIRST NATIONS OF BRITISH COLUMBIA,
CANADA
J.D. Martin
Health Canada First Nations and Inuit Health Program
On June 11, 2007, the First Nations leadership Council, the Province of
British Columbia and the Government of Canada signed the BC
Tripartite First Nations Health plan to create fundamental change in
which at least 33% of residents self-identified as Inuit were selected,

VENUE 5 roughly corresponding with the geographic boundaries of the Inuit
Community Participatory Methods #1 (workshop) Nunaat land claims area.
This paper presents detailed results for mortality, cause-specific
mortality, life expectancy, probability of survival by cause (Chiang
COMMUNITY-BASED PARTICIPATORY RESEARCH – CBPR
1968), age-specific contributions to differences in life expectancy
101 FOR THE ARCTIC: OVERVIEW OF THE HISTORY, (Arriaga 1984), and cause-specific contributions to differences in life
DISTINCTIVE FEATURES, ADVANTAGES, AND PRACTICAL expectancy (Arriaga 1989). Life expectancy and mortality rates for the
TIPS CONCERNING THIS EMERGING APPROACH IN HEALTH Inuit-inhabited areas are compared to the Canadian population in
RESEARCH general. This analysis measures a) the contribution of specific age
M. Hammond, R. Collins, J. Gordon, J. Ogina, A. Kimiksana, T. groups to differences in life expectancy and b) the contribution of
Greenland, D. Dedam-Montour, L. Kuptana, A. Moses, N. Beauvais, C. specific causes of mortality to differences in life expectancy. Results
Carry show marked differences in age-specific and cause-specific
contributions to the differences in life expectancy for the population of
This workshop would start with an overview of the history of research,
the Inuit-inhabited areas and the Canadian population in general. For
from Copernicus many centuries ago, to the more recent development
instance, 29.4% of the 12.6 year difference in the life expectancy of
of the natural and social sciences, and the branches (Action Research,
males in the Inuit-inhabited area and the Canadian population is due to
Participatory Research, and Participatory Action Research) which
mortality differences of the 20-24 age stratum. If this is expanded to
caused Community-based Participatory Research (CBPR) to emerge in
include the 25-29 age stratum, the contribution to the total difference
the last decade. This would show where CBPR fits in to the big picture,
in life expectancy is 49.4%.
and why this approach is so promising for circumpolar health Contact: Paul Peters (paul.a.peters@statcan.gc.ca)
researchers to consider.
CBPR would then be examined in detail, starting with working
definitions (sample: “CBPR refers to work that recognizes the DIABETES AMONG ALASKA NATIVE PEOPLE – A 21 YEAR
interconnectedness of three goals: research, education and action”) OVERVIEW
and moving to a detailed checklist we have developed of issues that M. Ramesh, C. Schraer, A.M. Mayer, K. Koller, E. Asay
distinguish CBPR from conventional health research. The 10 headings
Alaska Native Tribal Health Consortium Diabetes Program
in the checklist include: Ethical & theoretical issues; Pre-funding phase;
Administration of funding; Planning research; Data gathering; Data Objectives: To examine trends in diabetes (prevalence and incidence)
analysis; Data interpretation; OCAP: Ownership, control, access, and and complications (amputations and renal replacement) and mortality
possession of data; Dissemination & reporting of results; and over two decades.
Community action & follow-up. Methods: We used data from the Alaska Native Diabetes Registry,
Each of these headings includes one or more specific items. For which has been in existence since 1985. We compared the first five
example, under the first heading, “Ethical & theoretical issues”, items (1986-1990) and last five years (2002-2006) for diabetes incidence,
include: Nature of knowledge; Purpose of research; Definition of amputations, renal replacement and mortality. Rates of complications
“community”; Vested interests of researcher versus community and mortality are reported per 1000 diabetic person-years of
empowerment; View of community knowledge; Community- observation. We compared the prevalence at the beginning and end of
oppressive versus community-supportive approaches; and Power the 21 year period. Prevalence and incidence were age-adjusted to the
relations. standard U.S. 2000 population. Since the age structure of the Alaska
Native diabetes population has changed over time, complications were
We would then present an original “Framework for CBPR”. It blends
age-adjusted to the mid-period (1995) Alaska Native diabetes
many of the progressive ideas from the older Participatory Research
population. Further statistical analyses for complications and mortality
tradition from the Third World in the 1970s, with more recent ideas of
data considering duration of diabetes are under way.
CBPR practitioners. In our opinion, this blend is most suited to work in
the Canadian Arctic, given the unique social, political and cultural Results: Prevalence increased from 17.3 to 47.6/1,000. The number of
imperatives there. As such, it may also have merit in other circumpolar people living with diabetes increased from 610 to 3386. Incidence
regions. increased from 16.5 to 32.7/1,o00. Comparing the five year periods
1986-1990 and 2002-2006, amputations decreased from 5.3 to
Finally, the workshop would end with some reflections on our own
2.6/1,000, renal replacement decreased from 3.3 to 1.2/1,000 and
practice of CBPR in two communities in the NWT: pitfalls, problems,
mortality decreased from 41.7 to 33.2/1,000. The average age of death
practical tips and potentials.
Contact: Merryl Hammond (merryl.hammond@videotron.ca)
increased from 69.4 to 71.0 years.
Conclusions: Increased funding to tribal programs enabled them to
increase diabetes screening and follow-up activities, which may have
partly responsible for the apparent increase in prevalence and
VENUE 6 incidence. Local control enabled the tribal programs to provide clinical
Chronic Diseases #3 services specifically targeted to reduce complications and mortality.
While the occurrence of diabetes itself is increasing among Alaska
Native people, our results suggest that even in remote, rural areas,
WHAT AGE GROUPS AND WHICH CAUSE OF DEATH
complications and mortality can be reduced.
CONTRIBUTE MOST TO THE LOWER LIFE EXPECTANCY OF Contact: Meera Ramesh (mramesh@anthc.org)
THE INUIT-INHABITED AREAS OF CANADA?
P. Peters
THE EFFECT OF TRADITIONAL FOODS ON INSULIN
Statistics Canada RESISTANCE AMONG INUIT IN GREENLAND AND NUNAVIK
Compared to what is known for the Canadian population as a whole,
C. Jeppesen1, A. Ferland2, E. Counil2, E. Dewailly2, P. Bjerregaard1
information on the contributions of specific causes to differences in 1
mortality and life expectancy for the Inuit is not readily available. In a Centre for Health Research in Greenland Directorate of Health and
previous paper, Wilkins et al. (2008) explored the feasibility of using a National Institute of Public Health, 2Unité de recherche en Santé
geographic-based approach to estimate health indicators among the Publique Centre de recherche du CHUL (CHUQ), Canada
population of the Inuit-inhabited areas. Census subdivisions (CSD) in
Background: Inuit populations all over the Arctic are undergoing a sharing of traditional knowledge (foods, medicines, healing) along with
dietary and lifestyle transition, which has led to increased prevalence contemporary self-care strategies.
of overweight and obesity. Obesity is associated with insulin This presentation will provide information on the creation of, and
resistance, which is a major risk factor for type 2 diabetes. Our content of Do-It-Yourself: Diabetes Prevention Activities – A Manual
objective was to examine the association between traditional foods for Everyone. Attendees will leave with new ideas and inspiration for
consumption and insulin resistance among Inuit from Greenland and approaching community-based diabetes education.
Nunavik. Contact: Jennifer Eskes (jeskes@wgh.yk.ca)
Methods: The inclusion criteria the cross-sectional study “Inuit Health

in Transition” conducted from 2003-2007 were: ~ 18 years, ~ 8 h
fasting, non-pregnant, and undeclared diabetes. In the analyses we INDIVIDUAL SATURATED FATTY ACIDS ARE ASSOCIATED
included men and women with a daily consumption of 3350-17 000 kJ WITH DIFFERENT COMPONENTS OF INSULIN RESISTANCE
and 2100-15 000 kJ, respectively. Greenland Inuit totalled 1733 (43% AND GLUCOSE METABOLISM: THE GOCADAN STUDY
men) and Nunavik Inuit 653 (45% men). The consumption of traditional S. Ebbesson, M.E. Tejero, J.C. Lõpez-Alvarenga, W.S. Harris, L.O.E.
food was reported as energy % of total energy intake (E%). The Ebbesson, R.B. Devereux, J.W. MacCluer, C.R. Wenger, S. Laston, R.R.
homeostatic model assessment index of insulin resistance (HOMA-IR) Fabsitz, W.J. Howard, B.V. Howard, A.G. Comuzzie
was used to assess the degree of insulin resistance. Linear regressions
Norton Sound Health Corporation, Alaska
were adjusted for sex; age; body mass index (BMI) or waist
circumference. Background: Recent increase in prevalence of diabetes and concurrent
increase in saturated fat consumption among Alaskan Eskimos
Results: The diet in Greenland had a higher E% from traditional food
requires research to characterize the role of saturated fat on glucose
(19 E%) than Nunavik (13 E%; p<0.001). Prevalence of insulin resistance
metabolism. Here we test the hypothesis that saturated fatty acids
was higher in Greenland than in Nunavik (32% vs. 28%; p=0.02).
(FAs) are associated with insulin resistance and glucose intolerance.
Among Inuit in Greenland the E% from traditional foods was
associated with HOMA-IR (r =-0.047; p=0.03) together with BMI (r Research design and Methods: Data from a sub-sample of the
=0.48; p<0.001). Only BMI (r =0.33; p<0.001) and age (r =0.12; p=0.005) participants in the GOCADAN study were analyzed for the association
was associated to HOMA-IR in Nunavik. No association was found of measures of glucose and insulin metabolism with FA components in
between traditional food E% and HOMA-IR (in any country) in analyses RBC measured by gas chromatography. The sample included 343
including waist circumference instead of BMI. women and 282 men ages 35-74. Statistical analyses were conducted
using SPSS v 9 to explore the associations of selected RBC FAs with
Conclusion: Results imply that traditional food as a single component
fasting glucose, fasting insulin, 2h glucose, 2h insulin and homeostasis
of lifestyle does not influence insulin resistance among Inuit. Future
model assessment (HOMA) index. The models included sex and
analyses will include physical activity, alcohol consumption, smoking,
glucose metabolism status (normal, glucose intolerant or diabetic) as
and socio-demographic variables.
Contact: Charlotte Jeppesen (chj@niph.dk)
fixed factors and age, body mass index (BMI), waist circumference, and
FA content in RBCs as covariates. Measures of insulin, glucose, and
HOMA index were used as dependent variables.
DO-IT-YOURSELF DIABETES PREVENTION ACTIVITIES: AN Results: The mean age (SD) was 48.5 (9.9) years, with a mean BMI of
INTERACTIVE MANUAL FOR COMMUNITY-BASED DIABETES 27.8 (5.8) and mean percent body fat of 39.4%. Positive associations
EDUCATION were found between myristic acid and fasting insulin (r = 0.47, p <
J. Eskes 0.001), 2h insulin (r = 0.53, p = 0.02), and HOMA index (r = 0.455, p <
0.001). Palmitic acid was associated with 2h glucose (r = 2.3x10-2, p
First Nations Health Program, Whitehorse General Hospital <0.001) and 2h insulin (r = 5.6x10-2, p = 0.002) and stearic acid was
Diabetes prevention training for Yukon First Nations front-line health associated with fasting glucose (r = 4.8x10-3, p = 0.006).
workers has frequently been identified as a health planning priority. Conclusions: These results support the hypothesis that specific
Such training is important in the Yukon due to remote geography, lack saturated fatty acids are variably associated with insulin resistance and
of diabetes professionals, and frequent turnover of health workers. glucose intolerance.
Moreover, enabling First Nations health workers to educate members Contact: Sven Ebbesson (ffsoe@uaf.edu)
of their own community about diabetes is a key way to increase
capacity at a local level.
In response to this identified need, a manual was created (Do-It- TYPE II DIABETES MELLITUS IN GREENLAND: THE IMPACT
Yourself: Diabetes Prevention Activities – A Manual for Everyone) to OF ELECTRONIC DATABASE IMPLEMENTATION ON THE
allow non- healthcare professionals to educate others about diabetes QUALITY OF DIABETES CARE
prevention. The manual contains 20 hands-on activities and is based on M. Pedersen, I. Fleischer
a familiar, health-fair format. The intent of this manual is to have
Center for Primary Health Care in Nuuk
learners create visual displays using everyday household items. Each
activity is intended to convey a key message about diabetes prevention Objectives: To estimate the age specific prevalence of diagnosed type 2
while being interactive, understandable, and fun. All activities are diabetes mellitus (T2DM) in Greenland in 2008, and to evaluate the
evidence-based and are divided into 3 sections: influence of electronic database access on the quality of the clinical
management of the disease.
- SHOW IT: contains clearly worded instructions on creating a
visual display. Study Design: Observational and cross sectional study, review of
- TELL IT: provides a readable script to guide the user through the medical records and databases.
activity and to relay key messages about diabetes prevention. Methods: Data on T2DM patients were collected from each rural
- KEY MESSAGE: recaps important information and rationale for district in Greenland.
the topic.
Results: The number of patients with T2DM, their age and gender were
The intention behind this manual was to ensure cultural-relevance in a collected from 15 out of 17 districts and from the outpatient clinic of
Yukon setting. For example, one activity highlights the recent and internal medicine in Nuuk. This sampling represents 90% of the
drastic lifestyle change among Yukon Aboriginal people and its impact population in Greenland. The prevalence among Greenlanders ~ 40
on health. Another activity based on the medicine wheel helps learners years old is 2.1%. The prevalence increased with age. The quality in the
put diabetes prevention in a holistic perspective by enabling the management of T2DM based on process indicators is significantly
higher in clinics with an electronic database than without.
102 SESSION 8: VENUE VIEWING ROOM
Conclusion: The prevalence of diagnosed type 2 diabetes mellitus in according to set standards) were used to assess implementation
Greenland is low. When compared with previous population based success.
surveys this suggests that the prevalence of undiagnosed diabetes is Results: HFN was implemented in 7 phases in 5 food stores and
high, especially in the age group between 40 and 60. Consequently, the included stocking healthier foods, shelf labels, posters, taste tests, and
focus should be on identifying undiagnosed type 2 diabetes in this distribution of flyers and giveaways. At the store level, HFN was
group. The quality in the management of type 2 diabetes mellitus implemented with moderate fidelity in terms of increased availability
seems to be improved by the use of an electronic database. of healthy foods, and with high fidelity in terms of signage. At the
Implementation of databases in all the clinics in Greenland is desirable. community/worksite level, the pedometer walking challenges were
Contact: Inuuti Fleischer (inf@peqqik.gl)
implemented with moderate to high fidelity. At the individual
consumer level, the program was implemented with high reach and
A DESCRIPTION OF PHYSICAL ACTIVITY AND BODY MASS dose, particularly in later phases of the program. Interactive sessions
increased from 2-3 sessions/phase/store in phase 1 to 8
INDEX IN THREE INUVIALUIT COMMUNITIES: RESULTS
sessions/phase/store in later phases. Total attendance at interactive
FROM HEALTHY FOODS NORTH sessions increased from about 100 people/phase to 500 people/phase.
S. Reaburn, S. Biggs, E. Erber, L. Beck, E. DeRoose, J. Gittelsohn, S. Conclusions: Process data provided insight that can help improve the
Sharma implementation of the next round of the HFN program, which may
Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON expand to additional communities. Improved intensity and duration of
Objective: To describe body mass index (BMI) and physical activity community-based interventions is essential to achieve high levels of
levels of Inuvialuit adults. reach and dose.
Setting: Three communities in the Arctic region of the Northwest Acknowledgements: The research was supported by the American
Territories that vary in degrees of isolation. Diabetes Association Clinical Research Award Grant # 1-08-CR-57.
Contact: Joel Gittelsohn (jgittels@jhsph.edu)
Methods: The short-form of the International Physical Activity
Questionnaire (IPAQ) was administered following a cross-sectional
random household study design. Heights and weights were recorded in CONSUMPTION OF HIGH FAT, HIGH SUGAR FOODS BY
75-84% of participants. The remainder was self-reported. Physical INUVIALUIT ADULTS: RESULTS FROM HEALTHY FOODS
activity levels were stratified by age, sex and community. BMI data NORTH
were stratified according to Health Canada standards.
S. Biggs, S. Reaburn, L. Beck, E. DeRoose, J. Gittelsohn, S. Sharma
Results: In total, 194 Inuvialuit adults (150 female and 44 male) aged
19-84 years (mean age of 43.2 years) participated with a response rate Simon Fraser University, Faculty of Health Sciences, Burnaby, British
of approximately 70-90%. Overall reported physical activity levels met Columbia, V5A 1S6
Health Canada recommendations. Women had statistically Objective: To characterize the consumption of high fat, high sugar
significantly (p=.01) lower levels of vigorous and moderate levels of foods by Inuvialuit adults by age, gender, and community.
activity per week than men. The mean BMI for the total population was Setting: Three communities with differing sizes and levels of isolation
30.55 kg/m2. Mean BMI was higher and physical activity levels were in the Northwest Territories, Canada.
lower in the less traditional, less isolated communities compared with
the more traditional, more remote communities. Methods: Cross sectional survey of Inuvialuit adults using a quantitative
food frequency questionnaire (QFFQ). Frequency of consumption was
Conclusions: These results highlight the need for a nutritional and assessed by eight categories ranging from “never or less than one time
physical activity program, such as Healthy Foods North, to reduce the in one month” to “two or more times a day.”
risk of chronic disease among the Inuvialuit.
Results: Two hundred and thirty-three Inuvialuit men and women
Acknowledgements: We’d like to thank Andrew Applejohn for his (aged 19-84 years) participated in the survey with a response rate of
incredible guidance and support on this project. We would also like to approximately 70-90%. High fat, high sugar foods were consumed 6.3
thank the Aurora Research Institute for their tremendous assistance. times per day for the total sample. Consumption was statistically
The research was supported by the American Diabetes Association higher in younger respondents (~ 50 years) and in the least remote
Clinical Research Award Grant # 1-08-CR-57. community. Coffee creamer (i.e. Coffeemate), butter/margarine/lard,
Contact: Sarah Reaburn (sangita_sharma@unc.edu)
sweetened drinks, and pop had high mean frequencies of daily
consumption.
IMPLEMENTATION OF A PROGRAM TO PREVENT CHRONIC Conclusions: The high consumption of high fat, high sugar foods
DISEASE RISK AMONG THE INUVIALUIT: PROCESS illustrates the need for a nutritional intervention, such as Healthy
EVALUATION FINDINGS FROM HEALTHY FOODS NORTH Foods North, to reduce risk of chronic disease among the Inuvialuit.
J. Gittelsohn, L. Beck, S. Biggs, S. Reaburn, S. Sharma Acknowledgements: We would like to thank Andrew Applejohn for his
tremendous guidance and support on our program. We would also like
Center for Human Nutrition, Bloomberg School of Public Health, Johns to thank the Aurora Research Institute for their help and commitment
Hopkins University, Baltimore, MD to our work. The research was supported by the American Diabetes
Objective: To describe the level of implementation of Healthy Foods Association Clinical Research Award Grant # 1-08-CR-57.
North (HFN) program components and to determine factors affecting Contact: Samantha Biggs (sangita_sharma@unc.edu)
implementation.
Setting: One remote and one semi-remote Inuvialuit community in
NWT, Canada. VENUE VIEWING ROOM
Methods: Process data were collected throughout implementation of Video #3
the program. Monthly store visits documented availability of promoted
foods and presence of signage, pedometer challenge activities were
logged, and interventionist activities in stores and media publications ANGUTIILLI QANUILIQPAT… HOW ARE WE AS MEN? A
and contacts were documented. Process evaluation constructs of reach SCREENING OF A LIVE-TO-TAPE 2-HOUR CALL-IN
(proportion of population exposed to intervention), dose (intensity of PROGRAM ABOUT INUIT MEN’S HEALTH
exposure) and fidelity (how well each component was implemented C. Carry
Inuit Tuttarvingat of the National Aboriginal Health Organization profit, volunteer and non-profit organizations. Results: Through
In 2007, Inuit Tuttarvingat of the National Aboriginal Health observations by staff and written evaluations completed by the
Organization interviewed Inuit men from various communities across campers and Big Buddies, camper participation and openness in
Canada to discuss their health and wellness. What we found was that sharing increased as the day’s activities progressed. Follow-up mailed
Inuit men are in need of help. They have lower than average evaluations completed by parents indicated the positive impact of
completion of education, they have limited access to male-specific Camp Coho continued in their home community. Conclusions: Camp
mental health information and services, and it appears that they are Coho demonstrates that one-day grief camps can be an effective grief
suffering from a degree of spiritual loss along with difficulties relating support resource when standard resources are not available. The Camp
to the changes in family dynamics and their traditional role in Inuit Coho model can be adapted and implemented by other special
society. populations
Contact: Karen Morgan (kmmorgan@anthc.org)
Through the live interactive broadcast, along with many partners, we
share encouraging examples that are helping men move forward.
The 2-hour program: THE ROLE OF MENTORING ABORIGINAL YOUTH
PARTICIPANTS OF THE COWACHIN (BRITISH COLUMBIA,
- discusses root causes within a historical context, looking at how
Inuit men’s roles have dramatically changed in just two CANADA) 2008 NORTH AMERICAN INDIGENOUS GAMES
generations. M. Kelly, R. Link, J. Reading
- highlights the need for men’s wellness and counselling programs, Centre for Aboriginal Health Research at University of Victoria
and looks at existing programs in Alaska and Inuit Nunaat.
- discusses related research, from sources such as the Objective: Mentorship is believed to positively benefit the health of
“Qanuippitali? Inuit Health Survey.” youth, although evidence of such benefits is limited. Indigenous
- explores opinions and ways forward shared by the panelists, Peoples of North America represent a population with unique
community focus groups and callers. demographic, geographic, social and cultural characteristics that may
- shares ideas on how men’s groups can be started. shape the nature of Indigenous youth mentorship. This paper explores
- points to Web-based resources for follow-up. the prevalence and roles of mentors identified by a sample of healthy
Indigenous youth athletes.
This 2.5 hour session will open with an introduction to the overall
Qanuqtuurniq - Finding the Balance TV series, an International Polar Methods: The Aboriginal Youth Lifestyle Survey (AYLS) was designed
Year outreach project on Inuit wellness. The series was broadcast on to survey Indigenous youth regarding their tobacco use and associated
the Aboriginal Peoples Television Network - North in May 2009 in the factors. Four questions regarding mentorship were added to the AYLS
Inuit language with English subtitles and simultaneously Web cast. A to investigate mentorship among Indigenous youth participants at the
main objective was to adapt and test a “communications for change” 2008 North American Indigenous Games (NAIG). Questions were
model for exchanging knowledge from different perspectives on designed to be relevant to Indigenous youth and to avoid limiting the
several wellness issues of concern to Inuit. Following the screening of responses of youth to a Western definition of mentorship.
the men’s health program, evaluation highlights will be shared along Results: Of the 298 participants for whom mentorship could be
with a question and answer period and an opportunity to give feedback assessed, 259 (86.9%) reported having at least one mentor. Nearly
into the model’s evaluation process. three-quarters (74.1%) of participants reported more than one mentor
Contact: Catherine Carry (ccarry@naho.ca) while almost a third (27.0%) of participants reported more than five
mentors. Almost half (43.6%) of all mentors identified were family
members of the respondent while one third (34.8%) were informal non-
family relationships and less than a quarter (20.8%) were formal non-
family relationships. More than three-quarters (78.8%) of participants
SESSION 9 reported that they provide mentorship to others.
Wednesday, July 15, 8:30-10:00 AM Discussion: This was a preliminary study of Indigenous youth
mentoring, an area of research which is largely unexplored. The
findings suggest that there are multiple mentors present in Indigenous
VENUE 1 communities with whom these healthy youth formed natural
mentoring relationships and it seems that youth themselves can
Mental Health & Wellness #6 – Children and Youth mentor others. Further research on the health benefits of Indigenous
youth mentoring is warranted and of interest to educators, policy
CAMP COHO: A CULTURALLY APPROPRIATE GRIEF CAMP makers, Indigenous community leaders and others that seek to close
FOR ALASKA NATIVE CHILDREN the gap in health status between Indigenous and non-Indigenous
people.
K. Morgan, C. DeCourtney, L.L. Harrigan
Contact: Miranda Kelly (mirandak@uvic.ca)
Background: Alaska Native children living in remote communities do
not have access to cancer support resources generally available in less
INFLUENCE OF ADVERSE ECOLOGICAL FACTORS ON
remote settings. There are few cancer support programs for children PSYCHOPHYSIOLOGICAL AND EMOTIONAL CONDITION OF
that incorporate cultural values. Camp Coho is a one-day camp that TEENAGERS LIVING IN THE EUROPEAN NORTH OF RUSSIA
helps Alaska Native children ages 6-12 years better understand and O. Ketkina, T. Loginova, E. Bojko
share their feelings about losing a loved one. Each child teams up with
Department of Ecological and Social Physiology of Human, Institute of
a Big Buddy. Camp Coho provides activities based on national
Physiology, Ural Division of the Russian Academy of Sciences, Syktyvkar,
standards to support children who have lost someone close to them.
Russia
The camp honors the child’s culture and incorporates cultural values.
Campers learn healthy ways to remember the person and better Owing to biological and psychological reasons teenagers are especially
understand their own feelings of loss. Methods: A Camp Coho planning prone to the influence of anthropogenic pollution of the environment,
committee was established. Staff identified 20 Alaska Native children, since the peculiarities of the juvenile age determine the increased risk
ages 6-12 years to attend Camp Coho. A quantitative and qualitative for the development of adaptive disorders under adverse ecological
evaluation was developed, with debriefing of staff and Big Buddies at effects. Teenagers (boys and girls) in two districts (“non-polluted” and
the day’s end to share observations. The project involved tribal, for- “polluted”) in European part of Russia were put to a psychological and
psycho-physiological test. The research allowed discovering sexual approach to programming is honoured during the canoe trip because
differences in the psycho-emotional and functional conditions of senior its spiritual framework fosters respect for the historical and sacred
schoolchildren in the investigated groups. Whereas the boys more significance of the land, the waterway and its people. Participants in
often have functional disorders (decrease of activity, disorder of the canoe trip are encouraged to build interdependence by developing
attention, headaches), the girls in addition to the functional disorders mutually reliant relationships with oneself, nature and others.
also have psycho-emotional disorders (a high level of anxiety, fear of As youth are given the opportunity to learn about their environment
not being able to learn the lesson material). Disorders of a number of and place, they develop a relationship to the people, the land and their
functional conditions were discovered in both groups, such as state of elders. The Mackenzie River youth trip builds on research completed
health, activity, attention problems and frequent headaches. These with Dene elders that acknowledges the importance of on the land
disorders are established in the “polluted” district at that. When programs for cultural resilience. The NWTRPA aims to make valuable
psycho-physiological indexes are compared, it is observed that contributions to the mental health and well being of NWT residents by
schoolchildren from the “polluted” district have a higher intensity of supporting the development and sustainability of an on the land canoe
nervous system, which is manifested in the increase of the dispersion trip engaging youth and elders in the NWT that values the community,
of the reaction time. It was discovered that the boys from the school in a cultural identity, and interdependence using a holistic approach.
the “polluted” district have a decrease of the nervous system liability Contact: Wendy Lahey (wendylahey@gmail.com)
(indexes of the critical frequency of shimmering). Thus, it seems to be
possible to connect the discovered peculiarities to the adverse
influence of ecological factors on the functional condition of the
schoolchildren. No significant influence of adverse ecological factors VENUE 2
on the psycho-emotional condition was discovered at that. Service Delivery & Infrastructure #1 – Health Service
Contact: Ketkina Olga (erbojko@physiol.komisc.ru)
Delivery
SEXISM/SEXUAL HARASSMENT IN SCHOOLS AND ITS HEALTH TECHNOLOGY ASSESSMENTS ON TELEHEALTH

CONNECTIONS WITH SEXUALIZED VIOLENCE IN INTIMATE J. Polisena
RELATIONSHIPS IN ADULTHOOD
Canadian Agency for Drugs and Technologies in Health
V. Sunnari
Three health technology assessments (HTAs) on telestroke and
University of Oulu, Thule telehealth (synchronous and asynchronous) were previously conducted
In my presentation I will reflect the results of a study focused on to determine the available evidence. The study findings accompanied
schoolchildren’s experiences on physical sexual harassment (Sunnari by their impact on practice and policy will be briefly described. A recent
et al. 2009, in process to be published) at school. The data for the study HTA on home telehealth for chronic disease management published in
was collected from about 1700 boys and girls aged 11 - 12 years in the 2008 will also be presented. The literature was systematically reviewed
schools of North Finland and Northwest Russia. The research indicates and meta-analyses were performed to assess the clinical effectiveness
that physical sexual harassment is common in schools even in the of home telehealth compared with usual care for patients with chronic
northern peripheries of Europe. In addition to groping explicitly in the diseases. An economic review and a framework for economic
form of physical sexual harassment, especially Russia children wrote evaluations on home telehealth were also conducted. Findings from
about other types of violence. Furthermore, it was common for the the clinical review suggest that home telehealth is generally effective,
Russia children to say that they did not want to describe the details of but its impact on health service utilization is less certain. There is no
the experienced physical harassment The silence of the details gave a compelling evidence that home telehealth helps to reduce costs from
message that the experience had hurt their intimacy deeply. Girls the health care system and insurance provider perspectives. Ethical,
constituted the vast majority of the victims of physical sexual legal and psychosocial issues were also identified. Home telehealth
harassment and boys constituted the vast majority of perpetrators. may be clinically effective but its economic impact could not be
In my presentation I will compare the characteristics of the harassment established. Additional studies of higher methodological quality are
that the children described to have experienced at school with the required for better insights into the potential clinical and cost-
research results that have focused on characteristics of violence in effectiveness of home telehealth for chronic disease management and
intimate relationships, which topic area has been researched a lot other forms of telehealth. Policy and practice implications will be
during the last decades in varied countries. discussed.
Contact: Julie Polisena (juliep@cadth.ca)
Contact: Vappu Sunnari (vappu.sunnari@oulu.fi)
ON THE LAND CANOE TRIP FOR YOUTH AND ELDERS TELEHEALTH IN GREENLAND
SUPPORTING MENTAL HEALTH AND WELLNESS F. Christensen, L.C. Ragus, K. Kleinshmidt
W. Lahey Greenland Healthcare
NWT Recreation and Parks Association The achieving goal of the Greenlandic Telehealth project, witch was
founded at the 1st. of January 2008 and will succeed at the 31st of
The NWT Recreation and Parks Association (NWTRPA), a non profit
December 2010, is to provide a nationwide telehealth service.
organization that works with communities across the territory to
promote healthy living through active recreation, coordinates the The goal is to implement the Greenlandic Healthcare mission
Mackenzie River Youth Leadership canoe trip for youth and elders of “healthcare where you live’”.
the Dehcho and Sahtu regions of the NWT. The core curriculum of this The telehealthcare are to be established in all cities and village’s which
sixteen-day canoe trip incorporates four components of an Indigenous contains more than 50 inhabitants. Telemedicine are to assure better
model of mental health and healing: community, cultural identity, use of resources, faster and better diagnostic and more successful
holistic approach and interdependence. treatment, less waiting time and less transport of patients from village
The canoe trip is built on the foundation of community participation to city (nearest hospital).
through social events such as ceremonies, celebrations and feasts in In the entire project contains 70 installations of AFHCAN Carts – Alaska
each community along the route. With the help of elders, the canoe Federal Healthcare Access Network. The main reason for Greenland to
trip provides access to elements of Dene cultural identity such as have chosen the Alaskan model is the comparable of infrastructure.
language, stories, Indigenous knowledge, land and nature. A holistic
From a clinical perspective telemedicine are a long waited possibility to provides an integrated approach to assessment and treatment for
collect “hard” data from patient’s in the rural area. Those patients all children with special needs.
have one or more symptoms off diseases and would like to have fast The challenge the DHSS faces in the provision of adequate speech
clinical diagnoses from district hospitals. services to territorial residents is the inability to hire and retain the full
Telemedicine give Greenland Healthcare the possibility to collect these complement of speech language pathologists. There are currently 11
data in a far more cost-effective way than before. This gives Greenland speech language pathologist positions allocated across NWT, with a
a unique opportunity to do preventive care. current vacancy of four positions. Many Health Authorities are
In emergency situations in case of a medivac the collected data can experiencing prolonged periods of vacancy for speech language
save lives. pathologist personnel; as an example the Beaufort Delta Health
Contact: Finn Christensen (fich@peqqik.gl) Authority speech pathologist position was vacant for 3 years. NWT’s
struggle in hiring speech language pathologists is due to the
remoteness of NWT communities and the chronic shortage of speech
IMPLEMENTING ON E-HEALTH PROGRAM IN CANADA’S language pathologist across Canada.
MOST CHALLENGED REGION The business solution that was proposed for addressing the shortage of
T. McKinnon speech language pathologists and speech service provision to school
Department of Health and Social Services, Government of Nunavut age children is telespeech. Telespeech is enabling DHSS to utilize
speech language services from both NWT and southern providers to be
Nunavut was the 1st jurisdiction in Canada to implement Telehealth in provided to children directly in their communities and, more
all of our communities. However, we have faced many challenges in importantly, in their schools. The telespeech solution will also support
the last 10 years of our Ehealth program, namely buy-in from our the provision of services to pre-school children and adults.
clinical community, infostructure challenges, and community Contact: Ashley Geraghty (ashleygeraghty@gov.nt.ca)
readiness.
The goal of this presentation is to outline some of the challenges NU
has had in both the implementation of Telehealth in Canada’s most VIDEO RESUSCITATION SAVE LIVES IN REMOTE
challenged region. Our challenges range from geography, 25 COMMUNITIES
communities spread over 2 million square kilomters, providing services M. Jong
in 4 languages, an antiquated satellite/tecommunications network. Memorial University
This presentation would include video links to several Nunavut The biggest discrepancies in rural-urban death rates are seen among
communities, with testimonials from some of our providers. young people – rural Canadians less than 45 years of age have about a
We will discuss the evolution of our program into an E-health program 30 percent higher mortality rate than urban dwellers of the same age.
which will transform our health program from paper to electronic. Ultimately, the most isolated rural Canadians live three years less than
Contact: Tina McKinnon (tmckinnon@gov.nu.ca) their urban counterparts. This is a reality in remote communities where
there are no physicians. Our experience with video resuscitation has
permitted the ability to save lives in remote communities for patients
EXPANDING CLINICAL TELEHEALTH IN ALBERTA FIRST who would otherwise have died by the time aero medical services
NATIONS arrive.
A. Manyguns1, C. Sarin2 This paper describes how to set up video resuscitation and provide tips
1
Alberta First Nations Clinical Telehealth Change Management Project, on how to implement the program.
Treaty 8 First Nations of Alberta, 2First Nations and Inuit Health, Health Contact: Michael Jong (mjong@hvgb.net)
Canada Alberta Region

Telehealth can be defined as the use of information and
communication technology to deliver health services, expertise and VENUE 3
information over distance. Telehealth has the potential to lessen the
inequities in health status between First Nations living on reserve and
Education and Building Resource/Research Capacity #5
the general Canadian population. First Nations in the province of – Nursing Education
Alberta, Canada are involved in a collaborative effort to expand clinical
telehealth. Supported by Health Canada (FNIH) and Canada Health NURSING IN THE ARCTIC: GREENLANDIC NURSE’
Infoway, the Alberta First Nations Clinical Telehealth Change PERSPECTIVE
Management project is seeking to address the barriers to clinical
telehealth that exist in First Nations communities. This paper will H. Moeller
outline the key activities of this project, summarize the lessons learned University of Alberta, Lakehead University
to date, and identify the next steps that are necessary to realize the The objectives of this project are to highlight what, according to
potential of clinical telehealth. Greenlandic nurses, characterises nursing in Greenland and which
Contact: Christopher Sarin (chris_sarin@hc-sc.gc.ca)
qualifications, both personal and professional, Greenlandic nurses
deem important for nurses working in Greenland. The project also
TELESPEECH LANGUAGE PATHOLOGY attempts to paint a picture of whom the Greenlandic nurses are, and
what has made them choose and continue in the profession. The
A. Geraghty healthcare system in Greenland was developed and implemented by
Department of Health and Social Services, Government of the Northwest Danes. Today it is still governed largely by Danish norms and values
Territories although it services a population that is 87% Greenlandic. Historically,
In 2008/09 the Department of Health & Social Services (DHSS), the system has had difficulties recruiting and retaining nurses. In 1993
through funding provided by Canada Health Infoway Inc, began a $3.5 a nursing programs was established in Nuuk, Greenland. Today, 77
Million dollar project to provide comprehensive, equitable and nurses have graduated from the program and some Greenlanders have
sustainable speech language pathology (SLP) services across the also graduated from nursing schools in Denmark. Still, more than three
Northwest Territories (NWT). Services will be offered, by the end of the quarters of nurses employed in the Greenlandic healthcare system are
life of the project, in 28 communities across NWT (54 sites). The tele- recruited from outside of Greenland. Most are Danish speaking Danes
speech project will also support the Child Development Team that and the majority stay in Greenland only for shorter contracts. The
Greenlandic nurses, whether educated in Greenland or Denmark, are to deliver an integrated access and baccalaureate nursing education
pioneers: They add a unique set of professional and personal program to prepare Labrador Inuit nurses for what is now Nunatsiavut.
qualifications and knowledge to the Greenlandic healthcare system. The first phase was the development of an integrated access-first year
This project highlights and celebrates this uniqueness. The design is nursing program that allowed Labrador Inuit to prepare for and begin
qualitative and ethnographic. Data come from two sources; nursing education without leaving Labrador. The program was
manuscripts written by Greenlandic nurses, and, part of the data innovative and sensitive , focused on both the skills required to learn in
collected for a PhD research project focussing on the experiences of a university setting and Inuit ways of knowing and learning. Through
Greenlanders and Inuit who are nurses and nursing students. The case based scenarios, Inuit nurse mentors, the use of local literature
methods employed included soliciting Greenlandic nurses writing and the inclusion of Inuit culture at every opportunity , the curriculum
about being a nurse and nursing in Greenland and considering their was unique and responsive.
texts. It also included observation, participant observation, interviews,
questionnaires and document review. Results presented at the The first nurses graduate in Spring 2010, Nunatsiavut is now in a place
conference will have a narrative as well as an analytical component. to reflect on the program and what we have learned from it, to both
Contact: helle moeller (helle@ualberta.ca)
advise our future planning and also to share with others. The presenter
will show the nurses journey with a mixture of pride and honesty,
celebrating the accomplishments and identifying the obstacles and
“I HAVE TOLD MY COLLEAGUES: WHEN I WORK I AM what was put in place to solve the problems. Some unexpected
WHITE” ABOUT THE EXPERIENCES OF GREENLANDIC AND outcomes were the change to the indicators of success and the impact
INUIT NURSES AND NURSING STUDENTS of social determinants on the lives of the students.
Contact: Gail Turner (gail_turner@nunatsiavut.com)
H. Moeller
Department of Anthropology, University of Alberta
THE NURSE AS CARE ASSESSOR AND PRACTITIONER IN
The objective of this study is to examine the experiences of Inuit and
Greenlanders who are nursing students and nurses and who are being
GREENLAND
educated and practice in institutions dominated by western culture and A.B. Kjeldsen, E. Skifte
language. The design of the study is qualitative and it is ethnographic The Greenlandic home rule Ministry of Health
in nature. It was conducted by the author through 12 months of
The aim of this study is to assess the extent of nurse encounters with
fieldwork between August 2007 and June 2009 in five Greenlandic and
patients who have not been diagnosed by other practitioners in district
two Nunavut communities. Methods used included observation,
hospitals, health centers, nursing stations and physician offices in
participant observation, interviews, questionnaires and document
Greenland. It will identify circumstances in which nurses feel most
review. Results include that an Inuit language is the mother tongue of
competent and will assess whether they have sufficient access to
almost all participating nurses and nursing students. The majority of
clinical guidelines.
participants, including those who had withdrawn from the nursing
program, felt more at home with western culture and language than The study design takes the form of an internal audit (APO
people from the general populations. Many come from an ethnically methodology) and will be conducted by a nursing group who will also
mixed background and have been schooled almost exclusively in be responsible for registering patient encounters during a defined
Western languages in the latter part of elementary and throughout time-frame and providing an assessment of encounter proceedings. In
high school. Despite this, almost all participants noted differences in parallel, participating nurses will provide information regarding
the ways that Inuit and Western nurses care for Inuit patients. Most recruitment circumstances, amongst other details. In the first instance,
said that differences are rooted in language but that cultural the study will be conducted as a pilot to test whether the design will
differences also played a part. While almost all participants preferred satisfy the questions raised in the project description.
to read, write and be taught in one of the Western languages, most The pilot study results will describe the reasons for the patient
had a desire for medical and nursing literature in Greenlandic or encounters with the nurses. Furthermore, the study will show under
Inuktitut and said that they lacked medical, anatomical and health care which circumstances the nurse uses specific clinical procedures and
vocabulary in their mother tongue, disturbing their practice. Still, test results and how often she independently closes a case. The results
almost all participants felt that it would be impossible or even will uncover how often it is necessary to involve the doctor in
undesirable to deliver the nursing education in Inuktitut or diagnosing and/or treating as well as the extent of the doctor’s
Greenlandic. As many participants did, I connect this feeling with intervention (either via telephone or in person).
having been schooled most thoroughly in a Western language, and The nurse’s area of responsibility and own competency experience as a
with a continued dependency on, and therefore need to be able to spokesperson, care assessor and practitioner can only be described on
work with, Western health professionals who speak a Western
the backdrop of patient encounter experiences. The internal audit is
language. I understand the feeling to be systemically based, a result of expected to impact the identification of future qualifying nursing study
Western educational and health care policy.
programs as well as the scope of clinical guidelines.
Contact: helle moeller (helle@ualberta.ca)
Contact: Ann Birkaer Kjeldsen (abk@gh.gl)
NURSES FOR NUNATSIAVUT SHIFTING FROM CULTURAL COMPETENCE TO CULTURAL

G. Turner SAFETY
Inuit Organization R.L. Bourque-Bearskin, B.L. Cameron, M. King
The challenge of recruiting and retaining Community Health nursing University of Alberta
staff in remote aboriginal communities is one of the most concerning
Purpose: The changing landscape of nursing education in today’s
issues in health care delivery in Canada. The solutions are as complex
diverse society is creating many challenges for nurse educators to
as the issues and include validation of what was known for years at the
prepare culturally competent nursing graduates. In addition, the
community level, we need aboriginal nurses , trained in the regions.
concurrent growth of Canada’s Aboriginal population and advancing
In 2002, the former Labrador Inuit Health Commission, now health concerns is noted as a priority throughout the health care
Nunatsiavut Government, developed a plan in response to both the industry. Educational institutions across Canada are responding to the
critical shortage of nurses in Inuit communities and the barriers faced need and over the last decade, an emergence of nursing programs that
by Labrador Inuit who wished to pursue nursing careers. The goal was address the diverse needs of their Aboriginal student body. This study
was convened to explore the complexities associated with educating
nursing students in the area of cultural competence and cultural safety The Greenlandic society has undergone marked changes in living
when working with Aboriginal clients. conditions, a still ongoing process. A number of other diseases have
Methods: This exploratory research study was designed using a shown to change substantially in prevalence. It was therefore
qualitative approach guided by an Indigenous research methodology. somewhat surprising that the high prevalence of chronic otitis media
A convenience purposive sample of 14 nursing students was used. The remained unchanged from the 1980ies to the 1990ies.
students were divided into one Aboriginal group and one non- In January 2009 we carried out a field study among school children in
Aboriginal using the principles of an Aboriginal talking circle to Maniitsoq and Kangaamiut with the overall aim to determine the
compare the different perceptions of learning to care for Aboriginal prevalence of a number of infectious diseases. Approximately two third
individuals, as well as the students understanding of cultural of children in the two locations participated. To determine the
competence and cultural safety in relation to their nursing practice. prevalence of chronic otitis media and sequelae the children had
Results: All participants held a strong conviction what when learning otoscopy done. While a significant number of children in Maniitsoq
about cultural competence and cultural safety in relation to the town had chronic otitis media or sequelae, surprisingly, chronic otitis
Aboriginal clients they reported a lack of knowledge and media was almost non-existing among the studied children of the
understanding and the perpetuation of stereotyping in their nursing settlement of Kangaamiut.
education. The data was further analyzed and categorized through In this presentation the prevalence of chronic otitis media in 2008 in
content analysis into four themes; shared journey, valuing diversity, Maniitsoq and Kangaamiut will be compared with those found among
respectful relations and transformational learning. children in the 1980s and 1990s to describe the development in
Implications: This study will provide valuable information on to build a infectious middle ear disease in an Arctic country in change.
Contact: Anders Koch (ako@ssi.dk)
comprehensive learning experience and Aboriginal content into
nursing curricula. Furthermore, it exposes a greater understating of
students’ realities, knowledge, skills and attitude needed to promote AKLAVIK H.PYLORI PROJECT TREATMENT PHASE: SEEKING
nursing theory that is culturally congruent with the values and beliefs
AN EFFECTIVE THERAPY FOR A CANADIAN ARCTIC HAMLET
of a diverse cultures.
Contact: R. Lisa Bourque Bearskin (rbourque@ualberta.ca) A.L. Morse, K.J. Goodman, R. Munday, J.W. Morse, V. Van Zanten,
CANHelp Working Group
Helicobacter pylori infection has been associated with gastritis, peptic
PERSPECTIVES OF SOCIAL DETERMINANTS OF HEALTH: A ulcer disease and gastric cancer. Recent work by the Canadian North
COMPARATIVE ANALYSIS OF NURSING AND SOCIAL WORK Helicobacter pylori (CANHelp) Working Group has found that the
EDUCATION prevalence of H pylori infection is 58% in the Aklavik H pylori Project.
V. Faria, H. Fikowski The goal of the treatment phase of this project is to determine which
treatment regimens are optimal in the Arctic Aboriginal setting, taking
Aurora College, NT, Canada
into account antibiotic sensitivity profiles obtained in earlier phases of
This presentation will explore a comparative analysis of two this project.
disciplinary perspectives from nursing and social work that are tailored
Current recommended therapy for first-time H. pylori infection in
to incorporate the uniqueness of our Northern population while
Canada is multi-drug therapy with 7-10 days of a proton pump inhibitor
ensuring factors such as the social determinants of health are
plus clarithromycin and either amoxicillin or metronidazole (PPI-CA or
integrated into theory and practice teaching. A collaborative approach
PPI-CM). Canadian estimates of eradication rates for these standard
will be discussed evaluating how these programs address social
regimens from a recent meta-analysis are 84% and 82% respectively
determinants of health in practice. The lens used for each discipline will
(Rodgers & van Zanten 2007). A few anti-H. pylori treatment regimens
be outlined as well as current health inequities unique to our Northern
have shown somewhat higher success rates in trial reports; quadruple
populations. Qualitative findings compiled from focus group
therapy (proton pump inhibitor, bismuth, metronidazole and
discussions with faculty and students will be shared. Our findings
tetracycline) and sequential therapy (proton pump inhibitor and
critique the cross-disciplinary framework and ways in which
amoxicillin for days 1-5 followed by the same proton pump inhibitor in
interdisciplinary practice and education strengthens Northern
combination with tinidazole and clarithromycin).
community practice. Recommendations for future interdisciplinary
education will be made regarding the social determinants of health in Endoscopic evaluation in earlier phases of the Aklavik H pylori project
Northern settings. (n=192) allowed for collection of samples for culture and sensitivity
Contact: Heather Fikowski BA, MSW (hfikowski@auroracollege.nt.ca) analysis. Microbiological data showed that 33% of the Aklavik H pylori
was metronidazole resistant, 13% was clarithromycin resistant and 4%
was resistant to both. The treatment phase of the Aklavik H pylori
project has randomized 111 participants who had positive screening
VENUE 4 tests (urea breath test (UBT)) for H pylori infection to either standard
Infectious Diseases #6 or alternative therapy. Follow-up UBT in the winter of 2009 will provide
eradication rates and help determine what therapy is optimal in this
PREVALENCE OF CHRONIC OTITIS MEDIA IN GREENLAND Arctic hamlet.
OVER A 25-YEAR PERIOD
GASTRIC EPITHELIAL CELL APOPTOSIS IN PATIENTS WITH
A. Koch
CHRONIC HELICOBACTER PYLORI ASSOCIATION ANTRUM
Department of Epidemiology Research, Statens Serum Institut GASTRITIS AMONG NATIVE AND ALIEN INHABITANTS OF
Although the high prevalence of otitis media in Greenland has been EASTERN SIBERIA
known for decades, it was not until the early 1980s that exact
O.S. Amelchugova, V.V. Tsukanov, O.V. Shtygasheva, A.B. Salmina
frequency figures was obtained. This happened when a field study in
the town of Maniitsoq and an adjacent settlement Kangaamiut in west State Scientific Medical Research Institute for Northern Problems of
Greenland was carried out. It showed that 19% of children aged 3-8 Siberian Division of Russia Academy of Medical Sciences, Krasnoyarsk
years had chronic otitis media or sequelae of chronic otitis media. A State Medical University, Krasnoyarsk, Khakass State University,
study in the towns of Nuuk and Sisimiut a decade later showed Abakhan, Russia.
unchanged conditions.
Aim: To study epithelial cell apoptosis parameters, atrophy rate and demographic variables, Aboriginal ethnicity was significantly
Helicobacter pylori dissemination parameters in gastric antrum associated with greater life satisfaction, fewer financial worries, and
mucosa in various ethnic groups of the Eastern Siberia population. higher provider trust.
Methods: We examined 23 Evenks, 23 Khakases and 22 Europoids with Conclusion: Positive quality of life results highlight the resilience of the
histologically confirmed gastritis in the age from 18 till 50 years. All Aboriginal population despite worse socio-economic and clinical
subjects underwent upper digestive tract endoscopy and antrum status. Findings also indicate that, although clinical outcomes for
mucosa biopsy specimens were taken. Morphological research Aboriginal peoples need improvement, the positive experiences of
included microscopic examination after staining by hematoxylin and Aboriginal people already receiving HAART should encourage the
eosine with the description of results using a visual-analog scale (Dixon expansion of culturally appropriate antiretroviral therapy programs.
M.F. et al, 1996) and definition of H. pylori dissemination parameters Contact: Eirikka Brandson (ebrandson@cfenet.ubc.ca)
after Gimsa staining. Epithelial cell apoptosis in gastric antrum mucosa

was determined by TUNEL method (Mebstain Apoptosis kit direct,
Immunotech, France). Apoptotic index (AI) was determined by THE INCIDENCE RATES OF THE GASTRIC CANCER AND
counting the percentage of TUNEL-positive epithelial cells at x400 PREVALENCE OF HELICOBACTER PYLORI AT THE
magnification. POPULATION OF EASTERN SIBERIA
Results: In gastric antrum mucosa AI was 5.02% in Europoids (group 1); V.V. Tsukanov, N.N. Butorin, A.A. Maadi, O.S. Amelchugova
4.7% in Khakases (group 2); 2.67% in Evenks (group 3), p1-3<0.05; p2- State Scientific Medical Research Institute for Northern Problems of
3<0.05. Rate of atrophy in gastric antrum was 25.2% in group 1; 15.2% Siberian Division of Russia Academy of Medical Sciences, Krasnoyarsk;
in group 2; 14.9% in group 3 (p1-2=0.04, p1-3=0.03). H. pylori density Russia.
dissemination in gastric antrum mucosa in Europoids were higher, than
Aim: To compare interconnection of Helicobacter pylori (HP)
in Mongoloids: 206.4 in group 1; 125.1 in group 2; 126.6 in group 3 (p1-2
prevalence, atrophic gastritis and gastric cancer incidence rates in
<0.001; p1-3 <0.001).
various ethnic groups of the Eastern Siberia population.
Conclusions: High apoptotic index in Europoids was associated with
Methods: We carried out large scale epidemiological research of adult
high rate of antral atrophic gastritis and high H.pylori density
persons in Tyva, Khakassia and Evenkia.
dissemination in comparison to different ethnic groups of Mongoloids.
Contact: Olga Amelchugova (rsimpn@scn.ru)
Esophagofibregastroduodenoscopy and HP definition are executed in
3494 patients (1365 Mongoloids, 2129 Europoids). IgG cagA was
diagnosed by enzyme immunoassay method in blood serum in 533
A HAART FULL OF LIFE: VARIATIONS IN QUALITY OF LIFE Khakasses, 493 Evenks, 316 Tyvins and in 1352 Europoids.
AMONG ABORIGINAL AND NON-ABORIGINAL PEOPLES Morphological research was carried out to 128 Khakasses, 125 Evenks ,
EVER ON ANTIRETROVIRAL THERAPY 132 Tyvins and 374 Europoids. Data studying on gastric cancer
incidence rates using Medline system since 1996 till 2007 was done.
K.C. Duncan1, K. Clement2, D. Littlejohn5, C. Loppie6, E.K. Brandson1,
K.A. Fernandes1, A.K. Palmer1, V.D. Lima1, J.S.G. Montaner1,3, R.S. Results: Stomach cancer incidence rates was 22 per 100000 in Evenks,
Hogg1,4 25 in Khakasses, 50 in Tyvins, and 30 in Europoids. Prevalence of HP
1
had no differences at the studied populations and deviated about 90%.
British Columbia Centre for Excellence in HIV/AIDS, 2Canadian Prevalence of cagA HP was 44,0% in Evenks, 36,4% in Khakasses,
Aboriginal AIDS Network, Ottawa ON, 3Department of Medicine, 60,0% in Tyvins, 59,8 % in Europoids (p1-3 <0,001; p2-3 <0,001).
University of British Columbia, Vancouver BC, 4Faculty of Health Prevalence of antral atrophic gastritis was 14,9% in Evenkia
Sciences, Simon Fraser University, Burnaby BC, 5Vancouver Native Mongoloids, 15,2% in Khakasses, 25,8% in Tyva, 25,2% in Europoids
Health Society, Vancouver BC, 6School of Health and Human (p1-3 <0,03; p2-3 <0,04).
Performance, Dalhousie University, Halifax NS
Conclusion: The highest frequency of atrophic gastritis and gastric
Background: Aboriginal people remain over-represented in the cancer was recorded in Tyva Mongoloids and Europoids, among which
HIV/AIDS epidemic in Canada. Quality of life, an important factor in parameters of cagA HP detectability were maximal among the studied
overall health and well being, is significantly impacted by highly active populations.
antiretroviral therapy (HAART). Our objective was to compare the Contact: Vladislav Tsukanov (rsimpn@scn.ru)
quality of life of Aboriginal and non-Aboriginal participants in a cohort
of persons on HAART.
Methods: The Longitudinal Investigations into Supportive and Ancillary THE ASSOCIATION OF HELICOBACTER PYLORI CAG A
health services (LISA) cohort is a prospective study of HIV+ individuals STRAINS PREVALENCE WITH ULCER DISEASES IN SIBERIA
on HAART. Explanatory variables are collected through a MONGOLOIDS
comprehensive interviewer-administered survey and clinical variables V.V. Tsukanov, J.L. Tonkikh, O.S. Amelchugova, O.V. Shtygasheva,
are collected through a linkage with the Drug Treatment Program I.M. Ponomareva, E.P. Bronnikova
(DTP) at the BC Centre for Excellence in HIV/AIDS. Associations
State Medical Research Institute for Northern Problems, Siberian Division
between Aboriginal status and categorical variables were tested using
of Russia Academy of Medical Sciences, Krasnoyarsk, Russia
Fisher’s Exact Test and associations between Aboriginal status and
continuous variables were tested using the Wilcoxon Rank-Sum Test. A Aim: To study interconnection of Helicobacter pylori (HP) cagA strains
multivariable model was used to investigate the association between and ulcer disease in Mongoloids and Europoids in different regions of
Aboriginal ethnicity and quality of life while accounting for potential Eastern Siberia.
confounders. Methods: We carried out large scale epidemiological research in Tyva,
Results: Of 457 LISA participants, 150 (33%) reported Aboriginal Khakassia, Evenkia, Yakutia and Eastern Siberia middle latitudes. HP
ethnicity. Aboriginal ethnicity was associated with younger age, being was determined by serological, morphological (Gimza staining), urease
female, lower CD4 count, higher viral load, lower education, unstable methods and by polymerase chain reaction in 3494 patients (1365
housing, food insecurity, higher depression, current illicit drug use, and Mongoloids, 2129 Europoids). IgG cagA was diagnosed by enzyme
ever being incarcerated. In regards to the quality of life scale, immunoassay method in blood serum in 533 Khakasses, 493 Evenks,
Aboriginal participants reported greater life satisfaction, more health 316 Tyvins and in 1352 Europoids. Esophagofibrogastroduodenoscopy
worries and lower HIV mastery in unadjusted analysis. After adjusting was carried out in 5215 subjects (2701 Europoids and 2514
for clinical variables, being Aboriginal remained associated with Mongoloids).
greater life satisfaction. After adjusting for clinical and socio-
Results: Total prevalence of ulcer disease in Europoids was 8.4%, in improve health outcomes for children and youth. The experience of the
Mongoloids - 3.5%. HP prevalence was in Mongoloids 91.3%, in UBC Department of Pediatrics in this regard will be described and
Europoids - 89.6%. Prevalence of cagA HP was 44,0% in Evenks, 36,4% analyzed in a panel discussion format:
in Khakasses, 60,0% in Tyvins, 59,8% in Europoids (p1-3 <0,001; p2-3
<0,001). HP dissemination density in stomach antrum mucosa was OPTIMAL DRUG THERAPY FOR CHILDREN
higher in Europoids than in Mongoloids in 1.5-3 times in all regions.
S. MacLeod
Conclusion: HP cagA strains was associated with ulcer disease in
Mongoloids, but not in Europoids of Eastern Siberia. Ulcer disease was
associated with HP dissemination density in all populations. COMMUNITY-BASED INJURY SURVEILLANCE RESEARCH
Contact: Vladislav Tsukanov (rsimpn@scn.ru) A. George
FASD RESEARCH ACROSS THE PROVINCE

VENUE 5 S. Clarren, A. Salmon
Food Security #5 – Food Security and Indigenous
Wellness: Knowledge to Action PART A COMMUNITY READINESS TO ENGAGE IN FASD RESEARCH
M. Van Bibber
M. Van Bibber, N. Kassi, J. Christensen, S. Wadowska
In this workshop participants who are interested in indigenous wellness
FIRST NATION-UNIVERSITY PARTNERSHIP: LAXGALTS’AP
and the impacts of food security will have the opportunity to discuss VILLAGE GOVERNMENT’S PARTNERSHIP WITH
next steps – moving research and knowledge into action as we journey UNIVERSITY-BASED RESEARCHER
towards food security for all. A guided discussion format will be used. W. Martin, A. George
A PARTICIPATORY APPROACH TO ADDRESSING LONG QT

SYNDROME IN A LARGE NORTHERN BC COMMUNITY
SESSION 10 L. Arbour
Wednesday, July 15, 1:30-3:30 PM Contact: Stuart MacLeod (smacleod@cw.bc.ca
VENUE 1 VENUE 2
Focusing on Children and Families in Northern Canada: Indigenous Pedagogy on Mental Health Workshop
Moving Forward with University/Community Indigenous pedagogy in mental health: Healing teachings for mental
Partnerships health workers, valuable knowledge for clients.
CHILD HEALTH RESEARCH IN A NORTHERN CANADIAN

CONTEXT: ROLES AND RESPONSIBILITIES OF AN ACADEMIC VENUE 3
DEPARTMENT OF PEDIATRICS Newborn & Child Health #2 – Maternal Health &
B. Armstrong, A. George, S. MacLeod Surveillance
University of British Columbia, Department of Pediatrics and Child &
Family Research Institute A DETAILED COMPARISON OF PERINATAL MORTALITY
There is active and ongoing debate about the roles and responsibilities BETWEEN NORTHERN NORWAY AND MURMANSK
of academic health science centres. As the broad determinants of COUNTRY (RUSSIA)
health are increasingly recognized in medical curricula, attention has E. Anda, E. Nieboer, T. Wilsgaard, A.A. Kovalenko, J.Y. Odland
focused on the parallel social contract that should guide the
relationship between medical schools and the populations that they University of Tromsø
serve. These responsibilities are particularly prominent in child and Objectives: To explore perinatal mortality (PM) related to birth weight,
youth health. gestational age, optimal birth weight (OBW) and “small for gestation
The Department of Pediatrics at the University of British Columbia has age” (SGA) between two Arctic populations: Murmansk County
committed itself to a program of population health, clinical and basic [Murmanskaja Oblast (MO)] and Northern Norway (NN). The study is
research needed to inform decision making about child and youth focused on supplying useful information to the Russian Health Care
health in Canada’s north. Working through the Child & Family Officials.
Research Institute, the researchers who are listed at the end of this Study Design: A registry-based cohort study.
submission have addressed research questions in a number of spheres Methods: By the use of the existing Norwegian Medical Birth Registry
important to child and youth health in a northern setting. (NMBR), and the newly established Murmansk County Birth Registry
The themes to be explored in a workshop format include: (MCBR), we compared the PM-characteristics of two Arctic
- community-based injury surveillance research populations, with cohorts of N= 17303 (MO), 2006-2007, and N=16006
- environmental health (NN), 2004-2006.
- toxicology Results: The PM rate was 10.9/1000 in MO and 5.8/1000 in NN. The
- optimal access to pediatric therapies for vulnerable populations population risk based on the proportion in the residual birth weight
- FASD research across the province distribution was 3.2% (NN) and 3.9% (MO). MO had a higher per cent
- genetic/genomic factors in therapeutic choice of preterm deliveries (8.8%) compared to (6.9%). The adjusted odds
Presenters will examine the challenge of matching academic southern ratio (OR) or risk of mortality (NN as the reference group) was higher
research capacity with northern needs to inform policies that will for all gestational ages in MO, but the largest risk difference was at
term deliveries (OR=2.5). Proportionately more babies were born in the
vicinity (+/- 500 g) of the OBW (67.2% in MO and 47.6% in NN). The non-Indigenous) residents of Quebec 1991-2001, based on Statistics
SGA 10 percentile cut-off weight was comparable at all GAs up to 37 Canada’s linked birth and infant death data.
weeks. From 37-43 weeks, the difference in the cut-off weight Results: Births to northern mothers of all the three mother tongue
increased to it being about 500 g higher in NN. groups were at substantially elevated risks of infant death (adjusted
Conclusions: The PM was higher in MO at all birth weight strata and at odds ratios (aOR) ranged 1.7-2.9) especially postneonatal death (aOR
all gestational ages, but the difference was most significant for higher ranged 2.2-4.4) as compared to births to southern non-Indigenous
birth weights and term deliveries. Separate SGA standards are needed mother tongue women. Within northern Quebec, births to Inuit
for MO. The observed smallest OR difference for preterm deliveries is mother tongue women were most vulnerable to preterm birth
most likely due to an artefact related to GA estimation-methods and (aOR=1.4) and infant death (aOR=1.6) especially postneonatal death
MCBR inclusion-issues related to some very preterm mortalities. The (aOR=2.5); births to First Nations mother tongue women were much
potential use of the MCBR in environment-and- health studies is more likely to be macrosomic (aOR=2.3) but without elevated risks of
explored. perinatal and infant death as compared to births to non-Indigenous
Contact: Erik Eik Anda (erik.anda@ism.uit.no) mother tongue women.
Interpretation: There was a substantial need for improving infant health
REMOTE MIDWIFERY IN NUNAVIK: PERINATAL OUTCOMES for all northern residents. Within northern Quebec, there were
substantial differences in birth outcomes among Indigenous and non-
2000-2007
Indigenous sub-populations. These risk differences should be
V. Van Wagner considered in assessing unmet needs and designing programs for
Ryerson University, Midwifery Education Programme improving maternal and infant health in the northern regions.
Contact: Zhong-Cheng Luo (zhong-cheng.luo@recherche-ste-justine.qc.ca)
The Inuulitsivik midwifery service has provided maternity care on the
Hudson coast of Nunavik since 1986, attracting international attention
as a model for returning birth to remote communities and local Inuit THE DEVELOPMENT OF A COMPREHENSIVE MATERNAL
midwifery education. The birth centres in Puvirnituq, Inukjuak and CHILD HEALTH SURVEILLANCE SYSTEM FOR NUNAVUT
Salluit represent a community based, Inuit-led initiative that has been
recognized as an effective, sustainable perinatal health care model for G. Osborne1, S. Lauson2, M. Allan3, G.K. Healey4, C. Orlaw1, S.
the remote north, and as part of community healing and the McIntosh2, L. Arbour2
1
reestablishing of meaningful Indigenous roles and practices for the Health and Social Services, Nunavut, 2University of British Columbia,
3
Inuit. This presentation reports on a FNIHB funded project that Qikiqtani General Hospital, 4Arctic Health Research Network, Nunavut
analyzed the outcomes data from over 1200 births from 2000-2007, Nunavut is the most northerly jurisdiction in Canada, inhabiting 31,000
and highlights several important ICCH themes, including partnerships people, of which 85% are Inuit. There are great challenges to delivering
and Northern capacity development, knowledge transfer and active and preventative health care throughout this land mass of 1.8
exchange, and community involvement. Data will be presented in million km2. Although most infants are born healthy, Nunavut leads
context with previous evaluations and explore policy implications for the country for adverse early child health outcomes such as infant
maternity care in northern Canada and internationally. Our study mortality, rates of birth defects, low birth weight and prematurity.
involves a retrospective review of perinatal outcome data collected at Public health and community efforts are needed to understand and
the time of each birth. Data on women, who gave birth in other centres improve outcomes. To inform these issues and others, as a combined
after pregnancy risk screening or medical evacuation, were identified Canadian Institutes for Health Research circumpolar health team
and collected through an audit of the archived health records as well as grant/Nunavut public health strategy effort, the development of a
through correlation with other sources such as audit of midwifery comprehensive maternal-child health surveillance system (from 16
pregnancy lists and birth books. A Microsoft Access™ database was weeks gestation to 4 years of age) is underway. With the support of the
developed and used to calculate statistics. Indicators were chosen Arctic Health Research Network, a diverse group of professional and
based on a review of other Canadian and international databases to lay stakeholders were brought together initially to determine local
identify key comparators and to reflect the priorities of the Inuulitsivik interest. To follow, a series of small working groups commenced to
midwives and northern and remote maternity care. Analysis shows decide on the collection of potential prenatal, perinatal, and early child
outcomes, such as low rates of intervention, morbidity and mortality, health variables. Over 50 local participants have now had some role in
consistent with previous evaluations, thus supporting return of birth to the development of the system which is planned to be launched by the
rural, remote and aboriginal and Inuit communities. summer of 2009. This paper will discuss in more detail the overall
Contact: Vicki Van Wagner (vvanwagn@gwemail.ryerson.ca)
goals, utilization of public health structures as data sources, planned
variables, data base development, privacy protection, planned
BIRTH OUTCOMES AMONG FIRST NATIONS, INUIT, AND research review process, and developing research questions. It is hoped
this will be a straight forward, user-friendly system that can be utilized
NON-INDIGENOUS WOMEN IN NORTHERN QUEBEC
in improving the understanding of aboriginal maternal child health.
Z.-C. Luo1, M. Heaman2, J. Smylie3, P.J. Martens2, N.G.L. McHugh4, E. Contact: Laura Arbour (larbour@uvic.ca)
Labranche5, F. Simonet6, S. Wassimi6, K. Minich3, W.D. Fraser6, R.
Wilkins7
1
University of Montreal, CHU Sainte-Justine, 2University of Manitoba,
THE ANAANA PROJECT: MATERNAL HEALTH SURVEY IN
3
University of Toronto, 4First Nations of Quebec and Labrador Health and THE QIKIQTANI REGION OF NUNAVUT
Social Services Commission, 5Nunavik Regional Board of Health and M. Potyrala, J. Brewster
Social Services, Canada, 6University of Montreal, 7Statistics Canada Government of Nunavut
Background: In near-Arctic countries like Canada, northern regions Objectives: To assess the health status of pregnant Inuit women in the
represent a unique geographic entity characterized by remoteness, Qikiqtani (Baffin Island) region of Nunavut.
long frigid winters, and a relative shortage of tertiary care facilities.
There is a lack of comparative data on birth outcomes among Study Design: Cross-sectional survey. Study participants were recruited
Indigenous and non-Indigenous sub-populations within northern by convenience sampling between December 2005 and January 2007.
regions and compared to southern regions. Methods: Inuit women who were pregnant 36 weeks or more, and living
Methods: We assessed birth outcomes in a cohort study of all births by in one of the 12 communities in the Qikiqtani region were invited to
maternal mother tongue to northern (2,616 First Nations, 2,388 Inuit participate. A questionnaire collected data on demographics, country
and 5,006 non-Indigenous) and southern (2,563 First Nations, 810,643 food access and consumption frequency (1 year recall), food security,
Contact: Kathryn McIsaac (kathryn.mcisaac@utoronto.ca)

nutrition knowledge in pregnancy, breastfeeding practices, adoption,
vitamin use, smoking, prior and present drug and alcohol use. Blood
and hair samples were also collected to measure selected nutrients and DEVELOPMENT OF A PERINATAL SURVEILLANCE SYSTEM
environmental contaminants. In total, 101 women completed the
FOR THE NORTHWEST TERRITORIES, CANADA
confidential interviews, 100 women provided blood samples and 86
gave hair samples. K. Machalek, S. Chatwood, L. Paulette, G. Becker
Results: Of the 101 women who participated, 22% were first time Institute for Circumpolar Health Research, Dalla Lana School of Public
mothers, 90% had completed at least a Grade 9 education, and 89% Health, University of Toronto
smoked during their pregnancy. Most had depleted iron stores Background: Government, clinicians and researchers have expressed a
(Ferritin) and were deficient in Vitamin D. Marine mammals, need for a comprehensive, territory-wide perinatal surveillance system
particularly seal and mattaaq, were reported as the most regularly in the Northwest Territories (NWT), Canada that would collect data on
consumed country food. Of the data comparable to a 1996 maternal all women conceiving and/or giving birth as well as their
survey in the same region, no change in the rate of smoking is noted, a fetuses/newborns.
general decline in the consumption of country food is observed and Objectives: The objectives of the research conducted were to
there is an overall decrease in maternal blood levels of long-range undertake an assessment of the needs for a perinatal surveillance
environmental contaminants (including lead, total mercury and PCBs). system in the NWT and to design a perinatal database that would
Conclusions: This research was timely. Maternal and infant health is reflect these needs.
identified as a priority concern in two recent strategies from the Methods: Stakeholder consultations to identify the needs for a
Department of Health and Social Services; the Public Health Strategy perinatal surveillance system in the NWT were undertaken. Objectives
and Nutrition in Nunavut: A framework for action. To date, there is and the design of the database were elucidated. Perinatal database
limited availability of Inuit-specific maternal health data in Nunavut. development was based on a number of background sources, including
The study was a further step in addressing the health-related needs of variables suggested by the World Health Organization, the Canadian
pregnant Inuit women. Perinatal Surveillance System, the Canadian Perinatal Programs
Contact: Mary Potyrala (mary.potyrala@utoronto.ca)
Coalition, the Canadian Congenital Anomalies Surveillance Network,
and the Fort Smith Health and Social Services Authority Midwifery
BREASTFEEDING INITIATION, DURATION, AND Program Evaluation Framework, amongst others.
DETERMINANTS AMONG CANADIAN INUIT IN NUNAVUT Results: Stakeholder consultations identified the need for a flexible
K.E. McIsaac1, T.K. Young1, N. Faraj2, G.M. Egeland2, Qanuippitali perinatal database that would meet a variety of objectives. Objectives
Steering Committee (Nunavut)3 included: program evaluation and quality assurance, surveillance and
1
research. Approximately 400 variables related to maternal and infant
Dalla Lana School of Public Health, University of Toronto, 2Centre for health were identified for data collection. Special considerations for
Indigenous People’s Nutrition and Environment, McGill University, 3L. northern and indigenous populations included documenting variables
Gunn, Nunavut Association of Municipalities; L. Williamson, Nunavut such as transfers for birth, type and number of caregivers, ethnicity,
Tunngavik Incorporated; I. Sobol and G. Osborne, Government of and risk factors such as smoking and alcohol consumption during
Nunavut Department of Health and Social Services; K. Young, University pregnancy. Results indicated that data collection must be dynamic in
of Toronto order to fulfill the objectives and cater to a variety of stakeholders.
Background: Canadian Inuit are less likely than other Canadians to Conclusions: The proposed NWT perinatal database has the capacity to
begin breastfeeding (66% compared to 80%), although there is notable meet data collection needs for surveillance, program evaluation and
geographical variation. The determinants of infant feeding practices research related to maternal and infant health. The collection of data
among Canadian Inuit have only been examined in a few communities specific to northern and indigenous communities ensures its relevance
using small samples, limiting the ability to extend these results to other to a variety of stakeholders interested in the health of women and
communities. Of particular interest is the impact of differing degrees of children from a circumpolar region.
traditional culture retention on infant feeding practices, which have yet Contact: Karolina Machalek (karolina.machalek@utoronto.ca)
to be evaluated.
Objectives: To evaluate the prevalence of initiation, the duration, and
the determinants of breastfeeding among Canadian Inuit who reside in
Nunavut, using a population based health survey. VENUE 4
Methods: We examined infant feeding practices in communities Infectious Diseases #5
participating in the Child Inuit Health Survey (IHS) of Nunavut. This
cross-sectional survey randomly sampled 388 children ages 3 to 5 years INTERNATIONAL CIRCUMPOLAR SURVEILLANCE OF
from 16 selected Inuit communities in the Nunavut territory (Canada). INVASIVE NON-TYPEABLE HAEMOPHILUS
Trained bilingual interviewers administered questionnaires to parents
T. Zulz1, M. Bruce1, M. Garner2, D. Parks1, A.J. Parkinson1
or guardians between August 2007 and September 2008. Infant 1
feeding practices as well as information on various potential Centers for Disease Control/Arctic Investigations Program, 2Public
determinants related to sociodemographic, behavioural, and Health Agency of Canada
environmental factors were collected, with a particular focus on those Background: The International Circumpolar Surveillance system
relating to traditional culture (e.g. language spoken). Initiation and conducts population-based surveillance of invasive bacterial diseases
duration of breastfeeding in all communities and in each of the 3 caused by Haemophilus influenzae (Hi) in Northern Canada (NCan) and
regions was estimated. Multivariate logistic regression was used to in the U.S. Arctic (Alaska [AK]).
examine factors associated with initiation and duration of Methods: Invasive Hi was defined as an isolate from a normally sterile
breastfeeding. site drawn from a surveillance region resident. Isolates were forwarded
Results: Results are embargoed until dissemination of results to to reference laboratories in AK and NCan for confirmation and
communities is completed in May of 2009. Full details of results will be serotyping. Serotyping was performed by slide agglutination or
provided at the ICCH. polymerase chain reaction (PCR) [Quebec (QC) only]. Clinical and
Conclusions: Identifying determinants of breastfeeding in Inuit demographic information were collected on standardized surveillance
communities can facilitate the creation of targeted public health forms. Data reported are for the years 2000 through 2007.
strategies to increase the initiation and duration of the behaviour.
Results: A total of 198 Hi cases were reported (AK=110, NCan=88). 191 RESPIRATORY SYNCYTIAL VIRUS: POTENTIAL TRENDS IN
isolates were serotyped; of those, 64 (34%) were non-typeable either INFECTION OF CHILDREN IN NUNAVUT, CANADA
by PCR [QC=8 of 13 (62%)] or slide agglutination [AK=44 of 105 (42%),
L.A. Butler1, G. Osborne2
rest of NCan=12 of 73 (16%)]. Isolates serotyped by PCR were more
likely to be determined non-typeable than those serotyped by slide Government of Nunavut; University of Toronto
agglutination (p=0.03). Age adjusted rates of invasive disease caused 1
Dalla Lana School of Public Health, Department of Public Health
by non-typeable Hi (NT-Hi) were 1.2/100,000 (AK) and 3.5/100,000 Sciences, University of Toronto, 2Dept. of Health & Social Services,
(NCan). Case ages ranged from 0 to 90 years. Age distribution differed Government of Nunavut, Iqaluit Nunavut, Canada
between countries; 64% of AK cases were > 40 years compared with
Background: Respiratory Syncytial Virus (RSV) is the primary causative
30% in NCan (p=0.03). For all ages, pneumonia was the most common
agent of lower respiratory tract infections (LRTI) in young children.
clinical presentation [AK (41%), NCan (45%)]. Ten fatal cases were
Bronchiolitis is a common LRTI that affects children and approximately
reported in AK, two in children less than 1 year old and eight among
50-80% of these infections are due to RSV. These factors are
adults ranging 22-90 years old. One fatality was reported in NCan (71
particularly important in Nunavut as children living in northern
year old). There were no significant differences in case fatality ratios
communities have an increased risk for bronchiolitis in comparison to
between AK and NCan when stratified by age.
children living in southern communities.
Conclusion: The variability in proportions of NT-Hi from areas using
Objective: To investigate possible trends in RSV infections in Nunavut
different typing methods should be further evaluated. Cases are more
children under the age of 24 months, paying attention to potential
likely to occur in older persons in AK and young children in NCan; age
differences in demographics, seasonality, hospitalization and use of
distribution differences warrant further study.
palivizumab (Synagis) prophylaxis.
Contact: Tammy Zulz (tsc3@cdc.gov)
Methodology: Descriptive analyses will be conducted on demographic,
seasonality and hospitalization data extracted from the Government of
COMPARISON OF INVASIVE PNEUMOCOCCAL DISEASE Nunavut’s Medical Travel Database and Community Health Reporting
RATES IN ALASKA AND NORTHERN CANADA FOLLOWING System Database, as well as the Canadian Institute for Health
PCV7 INTRODUCTION Information’s Discharge Abstract Database and the Qikiqtani General
Hospital’s emergency room records. The utilization of palivizumab will
M.G. Bruce1, T. Zulz1, M. Garner2, D. Bruden1, M. Lovgren3, L. Jette4, K.
be analyzed using data extracted from Nunavut’s Synagis Program
Rudolph1, D. Hurlburt1, J.D. Wenger1, T. Hennessy1, A.J. Parkinson1
1
records.
Arctic Investigations Program, National Center for Preparedness,
Conclusion: The results of these analyses will be used to provide insight
Detection and Control of Infectious Diseases, Centers for Disease Control
into the past and present burden of RSV and bronchiolitis in children
and Prevention, Anchorage, Alaska, 2Centre for Immunization and
less than 24 months of age in Nunavut and across its three regions:
Respiratory Infectious Diseases, Public Health Agency of Canada,
3 Baffin, Kitikmeot, and Kivalliq. These results will also be used to
National Centre for Streptococcus, Edmonton, Alberta, Canada, 4Quebec
evaluate the effectiveness of palivizumab and make informed
Public Health Laboratory, St.-Anne-De-Bellevue, Quebec, Canada
decisions about the future use of this treatment in the prevention of
Background: The International Circumpolar Surveillance Project is a serious LRTIs caused by RSV, such as bronchiolitis, in this population.
population-based surveillance network for invasive bacterial disease Contact: Leigh Ann Butler (Lbutler@GOV.NU.CA)
among 7 Arctic countries. The 7-valent pneumococcal conjugate
vaccine (PCV7) has been used for routine infant immunization in Alaska
since 2001, and in northern Canada (NCan) since 2003; however, the A TWO-YEAR SURVEILLANCE OF RESPIRATORY VIRUS IN
start date varied by region in the latter. SICK AND HEALTHY CHILDREN IN GREENLAND
Methods: Invasive pneumococcal disease (IPD) data from the North A. Koch, L.P. Nielsen, M. Andersson, M. Melbye
American Arctic (1999-2007, Alaska and NCan, total population Department of Epidemiology Research, Statens Serum Institut
783,500) were analyzed to determine predominant clinical findings,
disease rates, serotype distribution and antimicrobial susceptibility. Introduction: Although respiratory tract infections are highly prevalent
in children in Greenland, there is very little knowledge about the
Results: 1,386 cases of laboratory-confirmed IPD were reported. involved respiratory virus. We carried out a two-year continuous
Bacteremic pneumonia was diagnosed in 63% of IPD cases. Annualized surveillance of such virus in a cohort of children aged 0-4 years of age.
incidence rates of IPD in Alaska and NCan were 18 and 27
cases/100,000 persons, respectively (rates among indigenous persons: Methods: Nasopharyngeal aspirates were taken both from children
47 in Alaska and 35 cases/100,000 persons in NCan). Rates in children with symptoms and without symptoms. Aspirates were frozen at -80
<2 years of age were 109 and 156 cases/100,000 persons in Alaska and degrees C until tested by PCR for 12 virus (Influenza A & B, RSV A + B,
NCan, respectively (rates in indigenous children: 251 in Alaska; 170 in human Metapneumovirus (hMPV), Parainfluenzavirus 1, 2, & 3,
NCan). IPD rates in children <2 due to PCV7 serotypes declined by Adenovirus, Coronavirus 229E, OC43, & NL63, and Rhinovirus).
>80% after routine vaccination (Alaska: 130 to 11 cases/100,000 Results: Among 432 children 2612 aspirates were taken. All aspirates
persons, p<.001; NCan: 129 to 37 cases/100,000 persons, p<.001). Rates from episodes of lower respiratory tract infections (LRI, n=209) and
of disease with non-PCV7 serotypes in children <2 increased in Alaska 1633 aspirates drawn at random from children with upper (URI) or no
(25 to 76 cases/100,000 persons, p<.001), and in NCan (41 to 74 respiratory tract infections were tested for virus. Nine of the 12 tested
cases/100,000 persons, p=.17). Rates of IPD with penicillin-non virus were found, while Influenza B, Parainfluenza 2, and Corona 229E
susceptible isolates decreased from 63 to 27 cases/100,000 children in virus were not. Virus was found in 857 aspirates (46.5% of all); in 54% of
Alaska (p=0.001), and from 10 to 8 cases/100,000 persons (p=1.00) in aspirates from URI episodes and in 50% from LRI episodes. Rhinovirus
NCan. was the most frequent virus (found in 27% of tested aspirates),
Conclusions: The high IPD rates among Arctic Indigenous people have followed by Adenovirus (19%), RSV (5%), Coronavirus NL 63 (1.7%) and
declined in Alaska and NCan following PCV7 introduction. An increase hMPV (1.1%). hMPV appeared significantly more often in children with
in non-vaccine type disease of the magnitude seen in Alaska was not LRI than with URI; RSV and rhinovirus equally often in children with
observed in NCan. Continued surveillance is needed to determine the URI and LRI, but significantly more often in aspirates from children
impact of PCV7 and future higher valency conjugate vaccines when without infections. Adenovirus occurred more frequently in children
they come into use. with URI than with LRI, but not significantly. There were clear calendar
Contact: Michael Bruce (zwa8@cdc.gov) variations in the incidences of influenza, RSV, parainfluenza and
Corona NL63 virus, while there was no variation in the incidence of the
frequently occurring adeno- and rhinovirus.
Conclusions: Most virus tested in a standard western respiratory panel Methods: Inuit children under 6 years of age living in several
are found in Greenland. Some of these appear endemic, while others communities in Nunavut, Canada were randomized to receive an active
show epidemic patterns. or placebo heat recovery ventilators. Placebo ventilators increased air
Contact: Anders Koch (ako@ssi.dk) circulation, but did not draw additional fresh air from the outside. We
monitored respiratory symptoms, health center encounters, and
indoor air quality for six months.
INVASIVE PNEUMOCOCCAL DISEASE IN ALASKAN
Results: Heat recovery ventilators were placed in 68 homes, and 51
CHILDREN: THE ROLE OF WATER SUPPLY AND THE SEVEN
houses could be analyzed. Subjects had a mean age of 26.8 months.
VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV7) The active ventilators brought indoor carbon dioxide concentrations to
J.D. Wenger1, T. Zulz1, D. Bruden1, M.G. Bruce1, L. Bulkow1, D. Parks1, within recommended concentrations, and also reduced relative
K. Rudolph1, D. Hurlburt1, R. Singleton1, T. Ritter2, J. Klejka3, T. humidity. Use of an active heat recovery ventilator was associated with
Hennessy1 a significant reduction in the risk of reported wheeze. Rates of reported
1
Arctic Investigations Program, National Center for Preparedness, rhinitis were significantly lower in the heat recovery ventilator group
Detection and Control of Infectious Diseases, Centers for Disease Control than the placebo group. There were no significant reductions in the
and Prevention, Anchorage, Alaska, 2Division of Environmental Health number of health center encounters. There were no hospitalizations in
and Engineering, Alaska Native Tribal Health Consortium, Anchorage, either group. Occupants in both groups reported concerns about the
Alaska, 3Yukon-Kuskokwim Health Corporation, Bethel, Alaska devices appearing to make the homes feel cooler.
Background: Recent studies in Alaska show an association between a Conclusions: Use of heat recovery ventilators was associated with in
lack of in-home piped water and higher incidence of pneumonia, RSV improvement in air quality and reductions in reported respiratory
infection, and skin infections, but not gastrointestinal illness. It is likely symptoms in Inuit children.
Contact: Tom Kovesi (Kovesi@cheo.on.ca)
that scarce water supplies lead to decreased handwashing and other
personal hygiene practices, enhancing person-to-person transmission
of pathogens. One third of rural Alaska Native villages lack in home
piped water and sewage service. We evaluated the role of water supply VENUE 5
in childhood invasive pneumococcal disease (IPD) after use of seven-
valent pneumococcal conjugate vaccine (PCV7). Food Security #5 – Food Security and Indigenous
Methods: Cases of IPD (defined as the isolation of S. pneumoniae from Wellness: Knowledge to Action PART B
normally sterile sites in a resident of Alaska) were identified through
population-based laboratory surveillance from 1996-2007. The M. Van Bibber, N. Kassi, J. Christensen, S. Wadowska
association of IPD with immunization coverage, socioeconomic status
and in-home water service was assessed. This workshop is a continuation of the discussions and action strategies
identified in the morning workshop. Those planning to attend are
Results: IPD rates in Alaskan children < 5 years of age declined from 87 invited to bring copies of any examples of strategies and/or resources
cases/100,000 during 1996-2000 to 37/100,000 during 2001-2004 and from their jurisdictions that will help to move action forward.
then rose to 61/100,000 during 2005-2007. Introduction of PCV7 in
2001 resulted in elimination of IPD caused by serotypes contained in
the vaccine, but was followed by increasing rates of IPD caused by non-
vaccine serotypes. IPD rates were 3 to 10-times greater in the region
VENUE 6
with the smallest percentage of houses with in-home piped water than Service Delivery & Infrastructure #2 – Health Service
in other regions in the state. Within that region, the rate of IPD in Delivery
children <5 in villages where <10% of houses had in-home piped water
was 390/100,000, compared with 150/100,000 in villages where > 80%
SPEECH LANGUAGE PATHOLOGY TELESPEECH SERVICE
of house had in-home piped water (p= 0.008). This association
remained after controlling for household crowding, village size, and DELIVERY MODEL FOR REMOTE COMMUNITIES
income. D. Anderson
Conclusions: Introduction of PCV7 led to elimination of vaccine-type Anderson Speech Consultants
disease in high risk areas, but IPD recurred in these areas with disease This paper is designed to provide solutions with an emphasis on an
caused by other serotypes, especially in areas with low levels of in- innovative service delivery model which includes building community
home piped water. Provision of in-home piped water is a critical partnerships both in Canada and internationally. The extreme shortage
component to control of pneumococcal disease in Alaska Natives. of Speech Language Pathologists (SLP) in Canada has resulted in the
Contact: Jay Wenger (jdw2@cdc.gov)
remote areas of Northern Canada being without SLP services for years.
Anderson Speech Consultants (ASC) has been a pioneer in developing
A RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF HEAT and implementing innovative solutions to this problem with a focus on
building partnerships within communities. Our goal has been to
RECOVERY VENTILATORS FOR THE PREVENTION OF
provide consistent speech services within the Northwest Territories,
LOWER RESPIRATORY TRACT ILLNESS IN INUIT CHILDREN Nunavut, and Northern Ontario. All services utilize an adaptation
T. Kovesi model for the aboriginal/northern culture as well as a training model
Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, for local assistants. ASC, in conjunction with northern hospitals, health
ON Canada centres, daycares, and schools, has provided assessments and therapy
to hundreds of children/adults through the use of TeleSpeech,
Objectives: Inuit infants have high rates of reported hospitalization for
community visits, and capacity building.
respiratory infection, including bronchiolitis and pneumonia. We have
previously shown that this is associated with overcrowding and Practical methods on the “how to” of developing and implementing a
reduced ventilation. service delivery model that incorporates a culturally sensitive approach
will be addressed. A strong emphasis on building relationships within a
Study Design: We performed a randomized, double-blind, placebo-
community is emphasized to ensure the success of the service delivery
controlled trial to determine whether home heat recovery ventilators
model along with methods of training local people to be assistants.
would improve ventilation and reduce the risk of respiratory illnesses in
Realistic expectations of various levels of remote assistants will also be
young Inuit children.
explored. Family responses to the TeleSpeech model including VIRTUAL COMMUNITIES AS LOCATIONS
attendance, equipment issues and client progress will be addressed.
N. Poole
In conclusion, our model of SLP service delivery in Northern Canada
British Columbia Centre of Excellence for Women’s Health
has demonstrated exceptional success in achieving an innovative
solution for remote communities. Distance has not been an obstacle in In a context of fast-paced, globalization of information, and persistent
providing consistent, high quality services as evidenced by the positive inattention to inequities in women’s health, a Canadian network of
feedback and strong support of participating families and local researchers and research collaborators have found that virtual
partnerships. The potential for providing exceptional SLP services to communities can provide those interested in improving the health of
remote communities is unlimited through the implementation of this marginalized women, with opportunities to collectively examine
innovative service delivery model. various forms of knowledge, as well as power relations that impede
Contact: Deborah Anderson (danderson112@cogeco.ca) social change.
This session will describe the work of a virtual community comprised of
indigenous and non-indigenous women, working in the north and
THE MANITOBA FIRST NATIONS PATIENT WAIT TIME south of Canada, who are interested in the prevention of fetal alcohol
GUARANTEE PILOT PROJECT spectrum disorder. The community, comprised of researchers, service
M. Horton providers, educators and health system planners, is a Network Action
The Canadian government’s health care plan calls for a guarantee that Team (NAT) of the CanNorthwest FASD Research Network. Over the
ensures that all Canadians receive medical treatment within wait times past three years this community/NAT has collectively shared,
that are clinically acceptable. Fundamental to a wait time guarantee is generated and synthesized various forms of knowledge, and discussed
defined time frames for care and a set of alternative care options, routes for action on this knowledge (translated it into practice, policy
should that time frame be exceeded (recourse). In January 2007, a and further research), in virtual and face-to-face contexts.
unique Patient Wait Time Guarantee (PWTG) pilot project for the The presentation will contribute to our understanding of the potential
prevention, treatment and care of diabetic foot ulcers among for web-based technological supports to bridge geography, sectors,
Manitoba First Nations (MFNs) was announced. The project involved a and other diversities to involve those interested in accelerating the
partnership between an innovative home care nursing organization, application of research, to health care practice and health & social
Saint Elizabeth Health Care (SEHC), and a First Nations leadership policy. The session will describe the community’s model, process and
advocacy organization, the Assembly of Manitoba Chiefs (AMC). the technological support it has used, in order to support and learn
Within a PWTG framework, the project partners sought to establish a from others, who are or might find such virtual collaboration helpful in
clinical care pathway, benchmarks for care and recourse options for their work.
Contact: Nancy Poole (wavelength@telus.net)
patients who do not receive treatment within this time frame. The
guidelines for diabetes foot care were updated and standardized with a
diabetes foot risk assessment and management tool developed by TRACKING PUBLIC HEALTH FROM ORBIT: CSA EO SUPPORT
Manitoba foot care providers. This tool consists of a comprehensive TO EMERGENCIES, DISASTERS, DISEASES, ENVIRONMENT
screening assessment, risk category descriptions, and interventions
and standardized referral plans based on risk. This tool included clinical G. Aubé
benchmarks and time frames for care. Canadian Space Agency
The difficulty in testing the clinical benchmarks is that the real Over the last decade, the Canadian Space Agency (CSA) has been
challenge facing people living with diabetes in MFN communities was involved in the support of scientific initiatives, demonstration projects
more a matter of access than wait times. Funding for community and operational activities related to the Arctic ecosystems. Through
based foot care services is inconsistent and insufficient resulting in the Government Related Initiatives Program (GRIP) and the Earth
considerable disparity in foot care services available across MFNs. As a Observation Application Development Program (EOADP), the CSA and
result persons living with diabetes rarely have their feet assessed. This its public and private sector partners have fostered the development of
lack of assessment, early intervention, and care means that all too Earth Observation (EO) information and services related to emergency
often MFNs are presenting for care of their diabetic foot ulcer at a and environmental management, food security, health and diseases,
stage when amputation may be the only option. etc. The CSA understands the tremendous role and value that space-
Basic primary foot care services are critical to addressing this issue. based EO systems and information have regarding health and security
However, the project partners also understood that there were in the North and its environmental and socio-economic impacts and
challenges far more fundamental then access to health care impacting benefits. The proposed presentation provides a brief description of the
this issue for MFNs. Action on the broader determinants of health importance of the “Health” thematic area for the CSA EO programs
(housing, water, food) impacting MFNs will be necessary to truly and a brief review of the Canadian EO activities affecting circumpolar
address the higher rates of diabetes and the shockingly regions. It discusses the critical role the CSA applications development
disproportionate rates of amputations. The issues of care and access to programs can play in ensuring the integration of EO in the
care also cannot be viewed only through a western or biomedical management and stewardship of this sensitive area and a greater
model. This project was committed from the outset to consider all awareness and appreciation by Canadians of the benefits that they
effective options, including traditional healing, and to build a solution receive from the use of EO information, services and products.
Contact: Guy Aubé (Guy.Aube@asc-csa.gc.ca)
that would work and that recognized and emphasized Manitoba First
Nation cultural values and perspectives.
This project demonstrates that the most effective model to change MEDICAL IMAGING IN NORTHERN CANADA: A STUDY BY
wait times, and understand the reasons underlying those waits, is not THE CANADIAN RADIOLOGICAL FOUNDATION
to rely on health care professionals alone, but instead, to adopt
W. Mason
different ways of involving the people most affected. The project also
documented important lessons learned for improving health care and Canadian Radiological Foundation
wait times for First Nations and for all Canadians. The approach, The Canadian Radiological Foundation (CRF) is a charitable
finding, and recommendations from this important project will be organization of radiologists promoting the art and science of radiology
shared in this presentation. through research and education within Canada and internationally.
Contact: Mabel Horton (mhorton@manitobachiefs.com) Through the Canadian Radiological Foundation, and its sister
organization, the Canadian Association of Radiologists, radiology
physicians assume a proactive role in assisting governments and around the world, the WHO Commission on Social Determinants of
medical institutions in finding solutions to the growing challenges in Health (CSDOH) tabled its final report in October 2008. The report
distributing healthcare resources within Canada. challenges nations to address the gap in health inequalities in a
Through late 2008 and early 2009, the Canadian Radiological generation. But what does this mean for Indigenous peoples around
Foundation undertook a research study entitled Medical Imaging in the world?
Northern Canada to report on the status of radiological care in the The fact that Indigenous health was included in the work of the CSDOH
Yukon, Northwest Territories and Nunavut. The Canadian Radiological is due to the dedicated efforts of two Commissioners on the CSDOH,
Foundation undertook the study recognizing that the north is an often one Canadian and one Australian, who were instrumental in ensuring
under-serviced region of Canada with very unique challenges in the that Indigenous health would be addressed. Indigenous organizations
provision of quality radiological care to its population. The study results from around the world came together at an International Indigenous
are compiled into a comprehensive report bringing together for the Social Determinants of Health Symposium in Adelaide Australia in
first time ever detailed information on the service delivery and April 2007 to prepare a presentation on Indigenous health that was
infrastructure for imaging in the north. Topics covered in the report subsequently presented to the CSDOH Commissioners in June 2007. It
include: the types of modalities and imaging services provided; the was one of the most coordinated activities in Indigenous health at a
distribution of imaging services and resources, including which ones global level. In Canada, the process to coordinate First Nations, Inuit
are imported or sought elsewhere; the payment of services; the and Métis voices was undertaken by the National Collaborating Centre
application of teleradiology in the north; and a look at the for Aboriginal Health (NCCAH).
professionals providing the care. The Canadian Radiological This presentation will describe the process that was undertaken to
Foundation worked directly with health ministries, hospital bring together First Nations, Inuit and Métis organizations in order to
administrators and other regional stakeholders of the northern ensure that their voices were heard at the international level. It will also
territories to complete this study, and gratefully acknowledges their outline the learnings and issues from this process as well as the
participation. The report will be a valuable resource to policy makers findings that are captured in the final report of the CSDOH.
and administrators as they work to address the north’s distinctive
challenges. Key results of the Medical Imaging in Northern Canada Participants will be invited to discuss the relevance of these findings as
study will be shared during the presentation of the Canadian they apply to the public health needs of circumpolar populations and
Radiological Foundation. what actions they would recommend to ensure that the Canadian
Contact: Gregory Butler, MD (info@car.ca)
public health systems integrates and respects these needs.
Contact: Margo Greenwood (greenwom@unbc.ca)
ABORIGINAL NURSES ASSOCIATION OF CANADA –

LOW PHYSICAL ACTIVITY AT WORK IS ASSOCIATED WITH
CHANGING THE PICTURE OF ABORIGINAL HEALTH
SEX, OCCUPATION, AND COMMUNITY SIZE AMONG INUIT
J. Lys OF GREENLAND
Nurse Practitioner, Fort Smith, NT
I.K. Dahl-Petersen, P. Bjerregaard, M.E. Jørgensen
The current picture of Aboriginal health in Canada and many countries
Centre for Health Research in Greenland, National Institute of Public
in the world is often bleak. Aboriginal people are often at the extreme
Health and University of Southern Denmark
ends of the spectrum and for the most part, are not as healthy as non-
Aboriginal Canadians. Aboriginal people, once grounded in holistic Background: Greenland has undergone a rapid transition in life style
cultural practices, were previously much healthier than they are today. resulting in more sedentary jobs and potentially lower total daily
energy expenditure. Low energy expenditure is a well known risk factor
By recognizing the importance of cultural and addressing issues that
for several chronic diseases. Promotion of physical activity requires an
affect the health and well being of Aboriginal people, the Aboriginal
identification of factors associated with physical activity.
Nurses Association of Canada (ANAC) aspires to change the picture of
Aboriginal health in Canada to one of health and wellness. ANAC Methods: The International Physical Activity Questionnaire - long
promotes Aboriginal health and well being by bringing the voice of version (IPAQ) - was used to record physical activity in a
Aboriginal people from the frontline of the healthcare system to the representative, cross-sectional population survey of Inuit ~18 years in
national level and advocating for improvements to the healthcare Greenland (N=2247) (2005-2007). Energy expenditure in leisure time
system. and at work was estimated in MET-minutes per week, divided into
quartiles and entered in the analyses as quartile 1 vs. the rest and
This session will highlight the efforts made by ANAC at the national
quartile 4 vs. the rest. By logistic regression we analysed the
and local levels to improve health and healing for Aboriginal people in
association between physical activity at work and leisure time and
Canada. Issues such as cultural competence in health care and nursing
socio-demographic factors: sex, age, occupational status, marital
education, recruitment and retention of Aboriginal professionals,
status and community size.
Aboriginal health research, patient advocacy and holistic health
practices will be discussed. Results: No association was found between energy expenditure at work
Contact: Julie Lys (julie.lys@gmail.com) and leisure time stratified by sex. The results showed association
between a low energy expenditure at work and being a woman
(OR=1.5 (CI 1.1-1.9)), living in the largest community (Nuuk) compared
to smaller villages (OR=1.6 (CI 1.0-2.4)) and having a work requiring a
VENUE 7 mid-level or higher education compared to an unskilled work (OR=2.2
Social Determinants of Health #2 (CI 1.5-3.1)). Being a man (OR=2.3 (CI 1.8-3.0) and having an unskilled
work (OR=4.6 (CI 2.9-7.5)) or being a hunter/fisher (OR=4.8 (CI 2.7-8.5)
was associated with a high energy expenditure at work. Living in
SOCIAL DETERMINANTS OF INDIGENOUS HEALTH: THE smaller villages compared to Nuuk (OR=1.9 (CI 1.3-2.7)), being a
JOURNEY OF CANADA’S FIRST NATIONS, INUIT, AND MÉTIS hunter/fisher compared to having a work requiring a mid-level or
VOICES AT THE INTERNATIONAL LEVEL higher education (OR=1.8 (CI 1.1-3.0)), and being 25-59years vs. 18-
M. Greenwood, B. Downey 24years were associated with a low energy expenditure in leisure time.
University of Northern British Columbia Conclusion: Living in a large community compared to a small village,
being a woman and having a job requiring a mid-level or higher
There has been growing interest in social determinants of Indigenous
education is associated with low energy expenditure at work not
health at the international level. After two years of consultations
necessarily compensated by high energy expenditure in leisure time.
Contact: Inger Katrine Dahl-Petersen (idp@niph.dk)

women in a northern community and twenty women in the city of
Edmonton in 2006. The paper discusses the factors affecting rural to
REDUCING HEALTH DISPARITIES AND PROMOTING urban migration and the urban experience. The difference between
social capital in remote communities of the north and that emerging in
EQUITABLE ACCESS TO HEALTH CARE FOR ABORIGINAL
urban centres is also discussed. As the population of Aboriginal people
PEOPLES in Canada becomes increasingly urbanized, understanding these social
R. Martial1, B. Cameron2, M. King3, R.L. Bourque-Bearskin2, A.S. factors that affect rural to urban migration and “well-being” in urban
Savalas4 environments is important.
1
NEAHR-ACADRE University of Alberta, 2Faculty of Nursing, University of Contact: Brenda Parlee (bparlee@ualberta.ca)
Alberta, 3Faculty of Medicine and Dentistry, University of Alberta,

Canadian Institute of Health Research-Indigenous Aboriginal People ROLE OF EDUCATION IN INFLUENCING COMMUNITY WELL-
Health. (CIHR-IAPH), 4RN PhD, Chile
BEING
Background: Addressing access to health care issues began with a
R. Salokangas, B. Parlee
community consultation held by the Alberta ACADRE Network (AAN)
at the University of Alberta. This community request gave birth to University of Alberta
three strategies that created a relational structure. The first being an Health is variously defined across cultures. Indigenous communities
Access to health care services research initiative to address issues of have been shown to conceptualize “health” more broadly and
access to health care for Aboriginal peoples. Second, was the holistically than western models with links to family, community and
formation of an interdisciplinary, intersectorial, and intercultural the environment. Through various tools of social change and
collaborative research team with representatives from Aboriginal acculturation, these “traditional” beliefs about health held by Canada’s
communities, Aboriginal organizations, and health care agencies. Aboriginal peoples, have been transformed. The role of education in
Thirdly, three exploratory projects were undertaken to investigate the defining and delivering on the determinants of health has not been
experiences of access to health care services in the urban setting. well explored. This paper traces the link between the formal education
Participants involved Aboriginal people from the urban, rural, and inner system and “a good life” of the Inuvialuit of Tuktoyaktuk from the early
city residents. The findings from these studies supported further 1900s to the present day. The paper is based on secondary literature
research to action plans and tied our projects together in a strongly review and field work in Tuktoyaktuk during 2008. Salokangas
effective way. In follow up to the exploratory inquiry, a research conducted 25 multigenerational interviews with youth, parents and
proposal outlining five interrelated components was funded by the grandparents and key informants in the education system over a
Canadian Institutes for Health Research. period of three months. The discussion reveals the influence of the
Methods: A qualitative Indigenous research approach was used to formal education in defining and delivering a “good life”.
address critical elements in promoting equitable access to health care Contact: Raila Salokangas (Raila.Salokangas@gmail.com)
services and are listed as follows: 1) Consultation component

Gathering with the community. 2) Knowledge exchange/translation
component titled creating respectful spaces for intercultural dialogue.
3) A CHR intervention project aimed at taking action towards
developing effective treatment partnerships. 4) An evaluation SESSION 11
component to develop culturally appropriate access indicators. 5) An Thursday, July 16, 8:30 – 10:00 AM
International wing to initiate a two-way knowledge exchange between
Indigenous peoples in Chili and Canada
Results: Currently, the research team is actively immersed in initiating VENUE 1
the Community Health Representative (CHR) Intervention project in
Mental Health & Wellness #7 – Attitudes and
both an urban and rural hospital setting which has been lead by the
vision of our Elder Rose Martial, who will be discussing further some of Experiences in Mental Health
the initial findings on the work to-date including the challenges, and
successes of this project. NATIONAL STRATEGY TO PREVENT ABUSE IN INUIT
Conclusions: This multilayer relational approach includes research COMMUNITIES AND NATIONAL INUIT RESIDENTIAL
training, collaboration with community stakeholders and expanded SCHOOLS HEALING STRATEGY
community research projects. These five-core areas of research targets D. Tagornak
the urban, rural, inner city hospital settings as well as health
professionals with a related goal to understand the roots of health Pauktuutit Inuit Women of Canada
disparities and build reciprocal research capacity with Indigenous Pauktuutit Inuit Women of Canada is the national organization that
Peoples, health care professionals, and scholars with a view to represents all Inuit women across Canada. Established in 1984, the
promote effective and comprehensive improvements in the health of non-profit organization has achieved widespread recognition for its
Indigenous Peoples both locally and globally. dedication to and advocacy for Inuit women. Our mandate is to foster a
Contact: Rose Martial (rbourque@ualberta.ca) greater awareness of the needs of Inuit women, and to advocate for
their equitable participation in community, regional and national
concerns in relation to social, cultural and economic development.
SOCIAL CAPITAL AND THE WELL-BEING OF ABORIGINAL
Pauktuutit has developed two strategies in the area of abuse
SINGLE MOTHERS
prevention and addressing the impacts of residential schools.
B. Parlee, V. Napoleon
1. National Strategy to Prevent Abuse in Inuit Communities
Native Studies, University of Alberta
Pauktuutit is actively implementing its National Strategy to Prevent
Social capital plays an important role in the well-being of Aboriginal Abuse in Inuit Communities. This strategy has six main priorities that
peoles, particularly those living in urban centres. For single Aboriginal the current project will address: 1- Make abuse in Inuit communities a
mothers moving from the north to southern centres, the knowledge, priority issue; 2- Raise awareness and reduce tolerance of abuse; 3-
support and resources found through urban social networks are critical Invest in training and capacity development; 4- Sustain front-line
to their ability to cope with the challenges of inadequate housing, workers and community services; 5- Deliver services that heal Inuit;
employment and education. The researchers interviewed twenty and 6- Expand on programs that build on Inuit strengths and prevent
abuse. The overall goal of the strategy is a steady reduction in The central focus of this study is the examination of how rural reserve
incidents of violence and abuse in Inuit communities and the eventual living effects individual First Nations’ women’s lives and ability to cope
predominance of caring and respectful relationships. with depression within a highly politicized context. These issues of
2. Journey Forward – the National Inuit Residential Schools Healing social structure where biology, history and politics intersect, play a
Strategy particular role in how experiences of depression is conceptualized,
practiced, and expressed and therefore can effect how First Nations’
Pauktuutit has also developed a National Inuit Residential School women construct their individual and social identity. Women who
Healing Strategy. This strategy has main priorities that the project will reside on reserve land, live, love and experience life within the
address: 1. Strengthen Inuit language and culture; 2. Form partnerships boundaries of their rural, and First Nations’ identities. This study will
and strengthen relationships; 3. Increase the number of Inuit who can challenge the political ideals that have created these social and cultural
help others; 4. Develop the knowledge of service providers in Inuit borderlands and will attempt to offer insights into First Nation’s
Communities; 5. Educate and raise awareness about Inuit in Residential women’s two-world and multifaceted construction of self by exploring
Schools; 6. Share information and effective healing practices; 7. the First Nation’s women’s stories of wellness and depression, and how
Identify and fill gaps in healing services and programs. these experiences affect their understanding and construction of
Implementation activities of both strategies will be presented. identity when living within the context of rurality. Narrative Inquiry will
Contact: Deborah Tagornak (dtagornak@pauktuutit.ca) be used to portray the experiences of 5 women over a ten-month
period through individual interviews and focus groups called peace
gathering. This process is a suitable and meaningful method that
PSYCHOSOCIAL RISK FACTORS AMONG SÁMI WOMEN OF utilizes traditional possibilities that are common and familiar to First
REINDEER HERDING FAMILIES Nation’s people.
A. Edin-Liljegren, L. Daerga, M. Eriksson, L. Jacobsson, P. Sj’lander Contact: Brenda Green (bgreen@firstnationsuniversity.ca)
Southern Lapland Research Department

Objective: The aim of the present study was to identify psychosocial EFFECTS OF CLIENT AND THERAPIST ETHNICITY AND
risk factors among reindeer herding Sámi women. ETHNIC MATCHING
Materials: The data originate from a comprehensive health and S. Møllersen
working environment study, performed 2003-2006, in collaboration
The Sámi National Centre for Mental Health (SANKS), Norway
with individuals from seven Sámi communities in Sweden
(women=66). The women of reindeer-herding households were We explored the effects of ethnicity on mental health treatment in the
compared with two control populations of Swedish women who population of North Norway that largely consists of indigenous Sámi
participated in the MONICA-project in 2004, one living in rural (n=132) and non-Sámi Norwegians. As the two groups are comparable in their
and one in urban (n=132) areas of northern Sweden. The control socioeconomics, ethnic effects can be separated from their most
populations were matched by age to the study population. common confounders. The effect of client and therapist ethnicity and
client-therapist ethnic match on treatment was examined among
Methods: Questionnaires on psychological factors as demand-control
psychiatric outpatients in this setting.
at work, well being, social support and sense of coherence were used
together with interviews of 13 women from reindeer-herding Methods: Client (n = 335) and therapist (n = 33) demographics and
households. The interviews were performed in focus groups and via ethnicity were recorded prior to intake. Self-reported psychosocial
telephone calls and included questions about what they regarded as distress was recorded at intake, termination and 20-month follow-up.
important in life e.g. about meaningfulness, participation, appreciation Therapists reported their clinical assessment, treatment delivery at
and support. intake and discharge. The association between the ethnic variables and
treatment delivery, clinical status and improvement were examined
Results: The reindeer-herding Sámi women experienced a significant
with regression analyses and analyses of variance. We used linear
lower sense of coherence than both the rural (p<0.002) and the urban
growth curves to explore ethnic variation in change in psychosocial
Swedish women (p<0.011). The meaningfulness (p<0.000 for both
functioning over time.
groups) and manageability (p<0.007 and p<0.026 for urban and rural
women, respectively) were significantly lower among the Sámi Results: The results indicated that therapist ethnicity was associated
women, but not the comprehensibility that was similar in all with the amount and type of service provided, but improvement was
populations. The reindeer-herding women had larger social networks not. Both the delivery of treatment and improvement did not differ
(p<0.000) and reported more close relations (p<0.000) than the control significantly by client ethnicity. Ethnic matching was associated with
groups. There were no differences in work-demand, decision latitude, greater symptomatic improvement in treatments of moderate
intellectual discretion, job strain ratio or social support at work duration.
between the three populations. Also the well being in the social, the Limitations: This study was conducted in the small multiethnic
physical and the mental domain was reported to be very similar communities in Northern Norway. The sample size was moderate and
between the groups. The interviews were analysed by content analysis the measures used to describe clinical status were global. The use of a
and will be further discussed at the meeting. categorical ethnic classification and globally categorization of the
Conclusions: It seems that the reindeer-herding Sámi women types of interventions may have served to veil the complexity of the
experience a lower sense of coherence in life in comparison with other interaction between ethnicity and treatment
Swedish women. The Sámi Women’showed similar comprehensibility Challenge: Little is known about how therapist ethnicity shapes
but reported lower degree of meaningfulness and manageability. treatment, something that warrants further investigation.
These results might be explained by a life situation that is Contact: Snefrid Møllersen (snefrid.mollersen@helse-finnmark.no)
unpredictable and characterized by low status, low profitability, lack of
external understanding and appreciation.
Contact: Anette Edin-Liljegren (ael@vilhelmina.com) AWARENESS OF THEIR HEALTH & HEALTH ATTITUDES IN
MALES AND FEMALES AGED 25-64 YEARS DURING SOCIAL
AND ECONOMIC CRISIS IN RUSSIA (MONICA-
BORDERLANDS: A NARRATIVE INQUIRY INTO FIRST PSYCHOSOCIAL PROGRAM)
NATIONS’ WOMEN’S EXPERIENCES OF DEPRESSION
V. Gafarov, I. Gromova, A. Gafarova, D. Santrapinsky, Y. Kabanov
B. Green
Collaborative laboratory of Epidemiology Cardiovascular Diseases SB
First Nations University of Canada RAMS
Aim: To assess the attitude of the population in Russia towards its evaluation looked at whether or not the Program met the needs of the
health, its readiness to participate in preventive measures and to women they intended to serve, whether the models and strategies
implement guidelines for changing lifestyle. used by the program were aligned with best practice, and whether or
Methods: A random representative sample of males and females (2400) not the partnership and management structures were effective and
aged 24 to 64 years from 2 districts city Novosibirsk was examined appropriate.
within the framework two screening “MONICA-psychosocial” program. The WCHRP was created to assist women who have suffered the
We used questionnaire “Awareness and Attitude towards Health” impact of trauma as a result of colonization and ongoing violence with
Results: More than 60% of the males (p<0,0001) and 85% of the their journey to greater wellness. The vision which shaped this
females (p<0,0001) reported that they were not quite healthy or ill, initiative called for a program which would be especially for women,
only 7% of the individuals had their health examined, although almost would work on the underlying trauma which perpetuates self-
100% noted that they were most likely to fall ill with a serious disease destructive behaviours such as addictions, would offer longer-term
within 5-10 years. The males were more optimistic in their assessments options than the traditional twenty-eight day treatment cycle, would
than were the females. With age, the frequency of assessments, such have strong roots in the communities it serves, and would be sensitive
as “not quite healthy” and “ill” (p<0,05), concern about their health, to the cultural values, worldviews and experiences of the Aboriginal
and participation in prophylactic examinations increased. 45% of the peoples of the North. The implementation of this vision brought
respondents reported about the high level of stress in their working together two agencies with a long history of working for the well-being
place. The opportunity of the examinees to have a rest at home was of women and their families—the Yellowknife Women’s Centre and the
extremely little. Family stress was significant for both sexes. The YWCA of Yellowknife. This dynamic partnership was designed to
females showed a more negative attitude towards smoking than did maximize impact through building on existing institutional strengths.
the males The males more frequently considered that they did not The primary findings revolved around 10 thematic headings: 1) The
need to alter dietary habits and to do exercises than did the females. A Quality and Integrity of Services, 2) Assessing Participant Outcomes, 3)
total of 2.4% of the males and 2.5% of the females changed their Cultural Sensitivity, 4) A Holistic Approach, 5) Using an Empowerment
dietary habits for their health. Only 50% of the males and 31% of the Model, 6) Services for Children, 7) Community Ownership and
females slept well or very well, this parameter decreased with age. Involvement, 8) Partnership Approach, 9) Territorial or Yellowknife-
Conclusion: Despite a positive motivation in the context of prophylaxis, only Service Base, 10) Strengthening Program Management and
there are negative trends in both social and behavioral characteristics Operations.
Contact: Arlene Hache (arleneh10@hotmail.com)
of the population.
RESILIENCY AND INHALANT ABUSE TREATMENT VENUE 2

D. Dell Sexual Health #2
National Coordinator, YSAC
EVIDENCE-BASED STRATEGIES FOR SEXUAL HEALTH
In Canada, a major and innovative national response to inhalant abuse
EDUCATION: ARE THEY CULTURALLY SAFE FOR
among First Nations youth has been the establishment of residential
treatment centres through the federally funded National Native Youth ABORIGINAL COMMUNITIES?
Solvent Addiction program (NNYSA). This paper focuses on the role of A. Reeves
a holistic conception of resiliency in inhalant abuse treatment in the University of Toronto
NNYSA program. A blending of policy and practice issues and their
contribution to the health status of First Nations youth inhalant This presentation uses a northern First Nation as a case study for
examining the cultural appropriateness of evidence-based sexual
abusers guide the paper’s discussion of resiliency and its fundamental
health education curriculum in on-reserve schools. This First Nation
role in NNYSA’s traditional Native teachings program. A holistic
conception of resiliency is viewed as a key contributor to the program’s community, highly affected by such colonial forces as the Hudson Bay
and North West companies, the Anglican Church, Residential
achievements to date. The focus on resiliency has been identified in
assisting youth in uncovering their inner spirit and strengthening their Schooling, and more recently, major hydroelectric developments, has
seen change resulting in a generation of youth facing multiple sexual
spirit by drawing on available community resources. Data and case
health issues. Recent influxes of hydro workers have brought with
illustrations from two NNYSA treatment centres–White Buffalo Youth
Inhalant Treatment Centre (Prince Albert, Sask.) and Nimkee them money and alcohol, resulting in relationships with local
community members, as well as negative health outcomes related to
NupiGawagan Healing Centre (Muncey, Ont.)–are presented. The
violence and sexual assault. Because of religious undertones and other
paper also offers NNYSA policy solutions that have been guided by a
holistic concept of resiliency and account for the intersecting roles of factors, healthy sexuality has been absent in this environment for
several generations and local schools lack appropriate health
culture, spirituality, and community in creating and maintaining the
health of First Nations youth solvent abusers. The paper concludes programmes to address these concerns. Recent research on evidence-
based sexual health education strategies reveals several directions for
with suggestions for future research.
Contact: Debra Dell (ysac@shaw.ca)
curriculum improvement: teacher training for skills development with a
sexual health expert, and comprehensive content on reproduction as
well as social factors through a health promotion lens, among others.
MAKING THE PATH BY WALKING IT: A COMPREHENSIVE However, curriculum content based on research from Western test
EVALUATION OF THE WOMEN AND CHILDREN’S HEALING groups will be unsuccessful in addressing community concerns if it is
AND RECOVERY PROGRAM incongruent with community social values and beliefs. This may be of
concern to Aboriginal communities, as Western sexuality models differ
A. Hache significantly from Indigenous teachings around sexuality. This
Centre for Northern Families presentation reviews the literature on evidence-based practice and
Making the Path by Walking It: A Comprehensive Evaluation of the examines both where it might be applicable to Aboriginal
Women and Children’s Healing and Recovery Program (WCHRP) Pilot. communities, as well as where it should be applied with caution.
A review prepared by the Four Worlds Centre for Development Finally, suggestions for culturally safe curriculum, including instruction
Learning examines the outcomes of a 3-year pilot project focused on from Elders, sharing circles and Coming of Age Ceremonies, will be
addressing the therapeutic needs of Northern women. Specifically, the discussed as tools for restoring traditional ways. This information is
relevant and timely for all northern or rural communities who are 61%), CD4 > 200 (87% vs. 78%), and >95% adherence (61% vs. 61%)
challenged by issues related to sexual health and cultural continuity in between DOT participants and others.
their communities. Conclusion: Preliminary findings demonstrate the success of this
Contact: Allison Reeves (reeves.allison@Gmail.com)
program, as DOT participants showed similar clinical outcomes when
compared to their peers in the cohort. However, the self-adherent
PARTNERSHIP AND PROCESS IN COMMUNITY-BASED patient will only exist when the social inequalities and other “root”
causes are addressed.
RESEARCH IN THE NORTH Contact: Eirikka Brandson (ebrandson@cfenet.ubc.ca)
A. Daniels, R. Drybones, L. Lafferty, T. Moore, J. Naedzo
Tlicho Community Services Agency
YOU’RE BREAKING MY HAART: HIV AND VIOLENCE AMONG
The Tlicho Community Services Agency’s (TCSA) Healing Wind A COHORT OF WOMEN ON TREATMENT IN BRITISH
Strategy identifies a number of activities and interventions to address
COLUMBIA, CANADA
the prevention of STI/HIV/AIDS in the Tlicho region of the Northwest
Territories. As a part of this strategy, the TCSA and CIET facilitated E.K. Brandson1, A.K. Palmer1, C. Miller2, E. Ding2, K.A. Fernandes2,
research to develop a foundation for interventions targeting sexually J.S.G. Montaner1,3, R.S. Hogg1,2
1
transmitted infections. The project recruited and trained 16 British Columbia Centre for Excellence in HIV/AIDS, 2Faculty of Health
community-based researchers to understand the objectives of the Sciences, Simon Fraser University, 3Faculty of Medicine, University of
survey, the instruments for data collection, facilitation and interview British Columbia
techniques, the importance of consent and confidentiality; research
Background: HIV infection in Canada is most prevalent among
methodology and how to translate it in practice. The team of CBRs
marginalized groups and the past decade has shown women are
conducted a research survey on sexual health attitudes and behaviours
increasingly making up higher rates of infections. While associations
in the four Tlicho communities, covering 65% of the population above
between HIV and violence are well documented, the impact of current
9 years of age. CBRs also received hands on training in data entry, and
violence on treatment outcomes is not well understood. Our objective
analysis as they began to make sense of their findings. The research
is to examine the rates and predictors of violence among women on
process, outcomes, and the strategic plan that arose from the research
highly active antiretroviral therapy (HAART).
findings produced a clear framework for interventions that are
grounded in the community, but could also influence national and Methods: The Longitudinal Investigations into Supportive and Ancillary
territorial policy. The approach may be relevant in other settings. health services (LISA) cohort is a prospective study of HIV+ persons on
Contact: Nancy Gibson (nancy.gibson@ualberta.ca) HAART. Participants are ~18 years of age and recruited from the Drug
Treatment Program (DTP) at the BC Centre for Excellence in HIV/AIDS.
Explanatory variables are collected through a comprehensive
CONNECTING THE DOTS: SOCIAL DISPARITIES AMONG interviewer-administered interview. Clinical variables are obtained
PEOPLE LIVING WITH HIV ON HAART through linkages with the DTP. Two bivariate analyses compared
E.K. Brandson1, K.A. Fernandes1, S. Coulter4, A. Thio4, F. Sussman4, C. differences between women who ever experienced violence and those
Laviolette4, M. Tyndall1,3, V.D. Lima1, J.S.G. Montaner1,3, R.S. Hogg1,2 who have not, in addition to recent violence (<6 months) with ever
1 violence. A multivariable logistic regression model was used to
British Columbia Centre for Excellence in HIV/AIDS, 2Faculty of Health examine predictors of experiencing recent violence.
Sciences, Simon Fraser University, 3Faculty of Medicine, University of
British Columbia, 4Downtown Community Health Centre, Vancouver, BC, Results: Of 573 LISA participants, 151 (26%) are women with 125 (83%)
Canada reporting ever having experienced violence. Recent violence (<6
months) was reported by 31 (25%) women and 76 (61%) reported
Background: High rates of adherence are fundamental to the success of violence before the age of 16. Half of the women who have
HIV therapy. Social disparities, such as unstable housing, drug experienced violence reported more than 5 violent episodes. Mental
dependence, and poor mental health, create barriers to adherence. illnesses (p=0.007) and perceived stigma (p=0.001) are more common
Directly Observed Therapy (DOT) is used to optimize adherence in women who have ever experienced violence. Women with recent
among vulnerable groups. Our objective is to evaluate the social violence (<6 months) were more likely to be current illicit drug users
disparities and clinical outcomes among persons enrolled in a DOT (p=0.004) than those with ever violence. The multivariable model
program. showed stable housing to be protective of recent violence (AOR 0.22,
Methods: The Longitudinal Investigations into Supportive and Ancillary (0.08-0.59) (p=0.003).
health services (LISA) cohort is a prospective study of HIV+ persons on Conclusion: The women in this cohort are experiencing unprecedented
highly active antiretroviral therapy. Participants are ~18 years of age levels of violence. Stable housing could make a critical difference in a
and recruited from the Drug Treatment Program (DTP) at the BC woman’s ability to escape violence, remain safe, and improve
Centre for Excellence in HIV/AIDS. Explanatory variables are collected treatment outcomes.
through a comprehensive interviewer-administered interview. Clinical Contact: Eirikka Brandson (ebrandson@cfenet.ubc.ca)
variables are obtained through linkages with the DTP. Bivariable
analyses used Fisher’s Exact Test for categorical variables and
Wilcoxon Rank Sum Test for continuous explanatory variables. A REPORTING FROM GROUND ZERO: A SURVEY OF NUNAVUT
multivariable confounder model was used to investigate the HEALTH CARE PROFESSIONALS’ PERCEPTIONS ON
association between viral load suppression and being in the DOT SEXUALLY TRANSMITTED INFECTIONS
program.
A. Kumar
Results: There were 481 LISA participants, of whom 64 were enrolled in
Circumpolar health providers face many challenges. The high incidence
a DOT program as of 07/08. In spite of social disadvantages, no major
and prevalence rates of Sexually Transmitted Infections (STIs) in
differences were found on clinical variables. DOT participants were
Nunavut Territory are well documented. This is the first study to
more likely than others to have unstable housing (<0.001), be food
document health providers’ perceptions of Inuit health status in
insecure (0.030), receive provincial income assistance (<0.001), and be
relation to STIs in Nunavut Territory.
unemployed (<0.010). They were also more likely to be current illicit
drug users ((p<0.001), to have been recently (past 6 months) Research ethical approval was provided by means of UK ethics
incarcerated (p<0.001) and co-infected with HCV (p<0.001). Clinical committee & Nunavut Research Licence. A detailed 12 page
variables were similar including the rate of viral suppression (68% vs. questionnaire with 109 questions was distributed to each health centre
in the Baffin (Qikiqtani) Region, Nunavut. Anonymous responses from THE BLOOD LYMPHOCYTES METABOLISM IN STRANGE
8 of 11 health centres were received. POPULATION OF EVENKIAY, HEALTHY, AND WITH IMMUNE
All respondents reported concern regarding the continuing high rates REACTIVITY DISTURBANCES
of STIs, occasional cases of Hepatitis C and community risk to HIV V.T. Manchuk, S.V. Smirnova, A.A. Savchenko, A.G. Borisov, S. Valeriy
infection. It is also reported that while many community members hold
fears and misconceptions about STIs, there is good uptake in STI State Scientific Research Institute of Medical Problems of the North,
testing. However, poor uptake of HIV testing is reported with Siberian Division of RAMS, Krasnoyarsk, Russia
explanations including fear of stigma and discrimination with The optimal realization of immune response to great extent depends
documented leaks in confidentiality. from functional activity of lymphocytes, which determined their
The average age of Inuit treated for STIs is a concerns shared by all metabolic state. Especially oxidation-reduction enzymes possess of the
respondents. Respondents identified 12-25 year olds as a target high information for investigation of metabolic processes in cells.
audience for prevention efforts, with the need to start sexual education These enzymes carry out the key reactions of cellular metabolism and
in schools before Grade 7. Respondents also agreed that there is an coordinate different metabolic routs. The aim of our investigation was
obvious knowledge deficit within this group. Well known potentially the study of NAD(P)-depended dehydrogenases activity in blood
serious complications due to STIs, including pelvic inflammatory lymphocytes in strange population of Evenkiay, healthy and with
disease, were a cause for further concern. immune reactivity disturbances.
Factors reported as perpetuating local STI incidence rates included We examined 108 strange population of Evenkiay in age 22-45 years.
unprotected intercourse with multiple partners and sexual abuse. This Among them there were healthy, with secondary immune deficient
situation is reportedly exacerbated by the effects of the poor local state and with allergic diseases patients. The determination of NAD(P)-
social determinants of health including high rates of unemployment depended dehydrogenases activity in blood lymphocytes was made by
and housing shortages. bioluminescent method.
Condoms are widely available for free at health centres and also for The disturbance of adaptive process to new climate geographical
purchase at local stores. Respondents reported condom use as an conditions in strange population was displayed in development of
important but underutilised device in prevention. secondary immune deficient state and accompanied with decrease of
mitochondrial metabolic processes in blood lymphocytes. The
Respondents reported that sexual education initiatives from groups developing compensated activation of anaerobe reactions in cells of
such as Pauktuutit Inuit Women’s Association are useful but immune system in patients of this group support the intracellular ATP
infrequent, without full coverage. Community Health Representatives concentration on level of healthy people. The same time, in strange
reportedly remain underutilised. Respondents acknowledge there is a population with allergic diseases on the contrary we revealed the
lack of published epidemiological data on STI rates in Nunavut. activation of mitochondrial metabolic processes. The stimulation of
In summary, respondents believe the development a community led energetic reactions in lymphocytes was realized because of substrate
commitment towards prevention efforts by encouraging respect and output from the intermediate routes for synthesis processes.
self-esteem and tackling local stigma remains crucial to achieving a Contact: V.T. Manchuk (manchyk41@rambler.ru)
reduction in the burden of infections and improving Inuit health status.
Education remains key to prevention.
Contact: Alexander Kumar (themonke@hotmail.com) THE DISTURBANCE OF IMMUNE SYSTEM FUNCTION IN
PATIENTS WITH ACUTE LEUKEMIA IN SIBERIA
V.T. Manchuk, O.V. Smirnova
VENUE 3 State Scientific Research Institute of Medical Problems of the North,
Siberian Di-vision of RAMS, Krasnoyarsk, Russia
Human Biology #2
The aim was to study the peculiarities of cellular and humoral
compartments of immunity in patients with acute no lymphoblast
IMMUNE HOMEOSTASIS IN CHILDREN OF THE FAR NORTH
(ANLL) and acute lymphoblast (ALL) leukemia in Siberia.
AT DIFFERENT VARIANTS OF VEGETATIVE MAINTENANCE
We examined 100 patients with ANLL and 73 patients with ALL.
OF ACTIVITY
Popula-tion and subpopulation contents of blood lymphocytes were
N.S. Polovodova, T. Malzeva estimated with the help of method of indirect immune fluorescence.
State Scientific Research Institute on Medical Problems of the Far North Immunoglobulin concentrations were calculated by immune enzyme
of RAMS method.
The main function of vegetative nervous system in homeostasis The state of cellular immunity in patients with ANLL in attack was
sustention is known to be vegetative maintenance of activity (VMA). charac-terized by decrease of T- and CD4+- cells, in remission by
But nowadays, data provided by surveys of immune homeostasis on decrease lymphocytes, T-, CD4+-, cytotoxic lymphocytes, NK-cells, B-
the background of immune dysfunctions in children are highly and HLA-DR+-lymphocytes con-tent. In recurrence we observed the
debatable. Thus, aim of our research was to study the characteristics of leukocytes, lymphocytes T-, CD4+-, cytotoxic lymphocytes, NK-cells,
immune homeostasis at different variants of VMA in children, residing HLA-DR+-lymphocytes decrease. We revealed in attack no changes in
in the Far North. 133 practically healthy schoolchildren (mean age humoral immune compartment, in remission the IgG concentration
13,7±0,19 years), living in the Far North (Yamalo-Nenets Autonomous was decreased, in recurrence the IgA, IgM, IgG concentrations were
Okrug, Russia) since their birth took part in the survey. By the results of lowering.
orthostatic probe we distinguished seven variants of VMA. Normal The state of cellular immunity in patients with ALL in attack was
reaction to orthostatic probe was stated only in 16,0% of examined character-ized by increase of lymphocytes content and decrease of T-
schoolchildren – no complaints, heart rate increase by 20-40% from a cells; in remission we revealed the blood lymphocytes, T-, NK-, B- and
baseline. HLA-DR+-lymphocytes content decrease. In recurrence only there was
Contact: Nataly Polovodova (tokarev-s@inbox.ru)
the T-lymphocytes content reducing. In at-tack we observed no
changes in humoral immune compartment, in remission there was the
decrease of IgA, IgG concentrations, in recurrence there was the
decrease of IgA, IgM concentrations.
In Siberia the patients with ANLL in attack and remission had T-cellular
immune deficiency, in recurrence the combined immune deficiency
with defeat of T- and B- immune compartments. The peculiarity of atomic emission spectrometer “Optima-3100RL” of the “Perkin-Elmer”
ANLL was the lowering NK-cells content; probably it was responsible firm.
for recurrence development. In all stages of ALL there was T-cellular We established the increasing Cr, Sb, Ba levels among 100%, Sr among
immune deficiency. The decrease of T-lymphocytes content and the 54%, Mg among 60%, Al and Ni among 64% miners which we were
reducing of immune regular index value influenced on ALL attack examined. It caused by diamond extraction industry pollution. The
appearance. The peculiarity of ALL recurrence was the increase of NK- excess of Ba level among 82%, Sb 69%, Sr 50%, Cr 49%, Al 48% and Ag
cells content. 24% among rural habitant’s hair was revealed. The comparative
Contact: V.T. Manchuk (manchyk41@rambler.ru)
analysis showed that level of Cr in miners hair was 16 times higher, Al
twice higher, Sb 4,6 higher than in rural habitant’s hair. The level of Ca
IMMUNE STATE CHARACTERISTICS IN NATIVE (SCANTY) in rural habitant’s hair was 2.6 times higher than in miner’s hair. The
accumulation of chemical elements in hair depends on environmental
POPULATION OF THE RUSSIAN FAR NORTH (YAMALO-
factors. The Northern nature can’t process pollution itself by natural
NENETS AUTONOMOUS OKRUG) way. In Permafrost conditions purification mechanism is retarded and
N.A. Pashina, N.S. Polovodova, A.A. Buganov don’t work efficiently.
State Scientific Research Institute on Medical Problems of the Far North Our data demonstrate that different microelemental status causes
of RAMS different structure of sickness rate. For example, the miners suffer of
Adaptation of a man’s organism and immune system, in particular, to the pathology of nerve system more often than rural habitants. In
extreme conditions of the Far North is influenced by worsening of structure of miners’ sickness rate the pathology of nerve system is in 3
ecologic situation. Nowadays ecology of circumpolar regions is under position, meanwhile the same of the rural habitants is in 8 position.
the great stress of anthropogenous factors, those lead, at the end, to Despite equal frequency of gastric diseases both of miners and rural
dysadaptive changes even in native (aboriginal) population. Aim of our habitants, but rural habitants suffer of cholelithiasis 10 times often
survey was to study immune state characteristics of native (scanty) than miners, because they drink Lena river water with high level Ca.
population in the Russia Far North. 447 persons of employable age Thus ecological factors together with other factors influence on
took part in the survey (297 natives and 150 non-natives). A number of microelemental status of population that consequently influences on
standard laboratory unified tests was used for immunologic structure of the sickness rate.
examination. It was stated that in native residents of circumpolar Contact: Galina Mironova (mirogalin@mail.ru)
region absolute number of lymphocytes is higher by 37,0% (p<0,05),
monocytes by 27,3% (p<0,05), absolute and relative eosinophil number
by 35,0% (p<0,05) and 17,7% (p<0,05) respectively when compared to POPULATION AND SUB-POPULATION CONTENT OF BLOOD
those of non-natives. Relative number of segmented neutrophils was LYMPHOCYTE AND CYTOKIN PROPHILE UNDER DIFFERENT
found to be lower by 6,7% (p<0,001) when compared to that of non- CLINICAL PATHOGENIC FORMS OF ALLERY
natives. Analysis of lymphocyte-cellular part of immunity showed that RHINOSINUSOPATHY
in natives absolute number of lymphocytes with immunophenotype
I.A. Ignatova, S.V. Smirnova, V.T. Manchuk
CD3+ in 2,08 times (p<0,05), CD4+ in 1,70 times (p<0,05) and CD8+ in
1,73 times (p<0,05) lower when compared to those of non-native State Medical Research Institute for Northern Problems of Siberian
residents. Analysis of humoral part of immunity showed that in Division of Russia Academy of Medical Sciences, Krasnoyarsk
aboriginal population relative number of lymphocytes with The actuality of nose allergy is remarkably high. This fact is explained
immunophenotype CD20+ is higher by 15,9% (p<0,05) and serum IgM by prompt growth of prevalence and modification of allergy
by 56,3% (p<0,001) than in non-natives. The examination of system of rhinosinusopathy (AR) course. Differential diagnosis of AR various
nonspecific resistance showed that index of phagocyte neutrophil forms is impeded by complicated variability of terms and also by the
activity in natives is lower by 12,5% (p<0,05) when compared to that of absence of unified, pathogenically reasonable and clinically useful
non-natives. The results obtained demonstrate that immune state of classification. Taking into account the main pathogenic mechanism,
native inhabitants is characterized by imbalance of peripheral blood AR forms are divided into 2 groups: true AR and pseudo AR.
cell content, lower values of main lymphocyte subpopulations and Aim: To study IL-2, IL-4, IL-6 and IFN-α concentration in blood serum
indices of system of nonspecific resistance. At the same time content and nasal wash-out. To study population and sub population content of
of CD20+ -cells and IgM is increased. blood lymphocytes according to AR clinical pathogenic form.
Contact: N.A. Pashina (hypertonia@yandex.ru)
Materials and Methods: We examined AR patients (n=305) in ages 17 to
60 years. We marked IL-2, IL-4, IL-6 and IFN-α (μg/ml) concentration in
MICRO ELEMENTAL STATUS AND STRUCTURE OF blood serum and nasal wash-out by IEA method; investigated
SICKNESS RATE population and sub population content of lymphocytes by immune
fluorescent method with mono cloned antibodies.
G. Mironova
Results: We marked the predominance of cytokines, produced mainly
by T-helpers of the 2nd type: IL-4 (blood serum 70.9 and nasal wash-
problems SB RAMS
out 213.2, as well as IL-6: (correspondingly 21.8 and 58.4 in true AR. In
The health of the population is determined by a number of ecological pseudo AR we marked higher concentration of cytokines, produced by
determinants in addition to medical care. The purpose of study is T-helpers of the 1st type IL-2 (blood serum 36.8; nasal wash-out 19.1,
determination of the microelemental status and structure of sickness as well as IFN-α correspondingly 354.3.
rate among the adult population of Sakha republic living in the region
The study for population and sub population blood lymphocyte
of mining pollution (Udachny) with its well-developed diamond
content in accordance with AR pathogenic form showed established
extraction industry in comparison with rural habitants living in the
increase of CD4+-cells 41.8 and -CD72+-cells 19.3, the lowering of
region without mining pollution (Tit-Ary).
CD8+-lymphocytes 23.3 and CD16+-cells 13.2 in true AR. In pseudo AR
In order to reveal the structure of the sickness rate we carried out we marked the lowering of CD4+-lymphocytes, the increase of CD8+,
thorough biomedical exams of 497 miners in Udachny and 297 rural CD16+-CD72+-cells.
habitants in Tit-Ary. State of health was determined by means of Contact: Irina Ignatova (ignatovai@mail.ru)
functional, X-ray, hematological, biochemical and cytological
methods. As an indicator of unfavorable ecological factors influence
the levels of 15 chemical elements were determined in hair by means of
THE BIOACTIVITY OF COMPLEX POP MIXTURES IN HUMAN security and sustainability of the database, and maintaining the
SERUM AND THE POTENTIAL RELATION TO HEALTH confidentiality of sensitive information.
EFFECTS The database was structured in view of three main Objectives: (1) Build
E.C. Bonefeld-Jørgensen, T. Krüger, M. Long, P. Hjelmborg, M. Ghisari in-house data bank to maintain the data in a supervised and secure
place. (2) Document complete questionnaire contents, maintains and
Centre of Arctic Environmental Medicine, Cellular and Molecular tracks comprehensive information of respondents. Retain information
Toxicology, School of Public Health, University of Aarhus, Denmark on regions, sub-regions and communities participating in the study. (3)
Background: Persistent organic pollutants (POPs) including PCBs, Provide simple and powerful interface to promptly disseminate data
pesticides and dioxins can interfere with endogenous hormone for analyses. The database is developed in Microsoft Access platform
functions and are suspected to have the potential to introduce interfaced with Microsoft Excel and STATA (statistical analysis
developmental and reproductive disorders. The toxicological software). It has 16 relational datasets which are programmed to retain
assessment of the POPs is complicated since individuals are exposed to thousands of data points generated from the study.
a complex mixture of contaminants. Keeping in view the magnitude of the data and the issues of security
Aim: To compare the integrated xenobiotic activities of the actual and confidentiality, the 2007 and 2008 data are stored without
serum POP mixture on the function of sex hormone receptors and the identifiers. Only sub-sets of data for analyses are available for
Aryl hydrocarbon receptor (AhR) among study groups from different researchers and no community is identified in the data used for
districts in Greenland and European study groups (males from Sweden, analyses for added assurance of anonymity. Further, the database is
Poland and Ukraine). To evaluate associations of xenobiotic POP only accessible to the administrator of the database and data entry
bioactivities to chemical determined serum POP proxy markers and to staff using two tier security levels. The database is compacted and
sperm DNA damage as a health biomarker. repaired fortnightly and backed up twice every day to guard against
Methods: Serum samples were extracted to obtain the serum POP data loss. META data reporting requirements of Canadian Federal
fraction being free of endogenous hormones for the xenohormone Program for IPY includes a description of the various types of
activity analyses. The effects of serum POPs on the estrogen receptor information collected during the health survey.
Contact: Nelofar Sheikh (nelofar.sheikh@mcgill.ca)
(ER), the androgen receptor (AR) and the AhR function and the AhR-
TCDD equivalent (AhR-TEQ) were determined using chemical
activated luciferase gene expression (CALUX) assays applying the HEALTH SURVEILLANCE FOR FIRST NATIONS: DATA
MVLN, CHO-K1 and Hepa1.12cR cell lines, respectively. Human sperm
SOURCES AND LIMITATIONS
DNA damage was assessed by TUNEL assay.
L. Clearsky, T. White, L. Svenson, S. Samanani
Results: In overall, the effect of the actual serum POP mixtures on
hormone receptors (ER, AR) and AhR transactivity differed among Inuit First Nations EpiCentre of Alberta
from different Greenlandic districts, and data of Inuit and Europeans Background: One of the major limitations in reporting health statistics
differed significantly. Compared to Europeans Inuit had significantly for First Nations communities is determining place of residence.
higher level of sum POPs, lower level of ER transactivity, AhR-TEQ, Accurate reporting of community level data is further complicated by
and sperm DNA damage but a higher AR transactivity. The actual the lack of ability to identify client residence in sources of numerator
serum POP mixture of Inuit elicited antiestrogenicity, whereas data, such as health care utilization, vital statistics and Non-Insured
estrogenecity was observed for some samples from Europe. No Health Benefits.
consistent association between the xenobiotic POP bioactivities and Methods: Data sources used for health statistics for Alberta First
the level of chemically determined POP proxy markers was observed
Nations communities from Indian and Northern Affairs Canada (INAC),
across the study groups suggesting that the selected POP proxy Alberta Health and Wellness (AHW), Statistics Canada and Community
markers alone cannot predict integrated xenobiotic POP serum Planning Management System (CPMS) were reviewed. Definitions and
activities.
limitations of the various data sources are summarized. Data from
Conclusions: The actual serum POP mixtures elicited hormone Non-Insured Health Benefits were provided from one community to
disruption. The variances of serum xenobiotic activities reflects demonstrate the limitations of reporting.
differences in the actual serum POP mixture profile and can contribute
Results: In Alberta, the available annual sources of population data for
to the assessment of POP exposures and related health risks. Single calculating health surveillance measures (e.g. prevalence, mortality
chemical POP proxy markers alone cannot predict the integrated
rates) for First Nations are INAC or AHW. Provincial level reports using
serum xenobiotic activity and may not reflect the risk of health INAC data are expected to underestimate prevalence, as total band
outcome. Diet / nutrient factors, life style and genetically factors registrants is not limited to Alberta residents. Community level
should be considered as determinants for the sensitivity to POPs and
reporting using INAC data for persons living on their own reserves is
sperm DNA damage. also likely to be inaccurate, as the residence information is only
Contact: Eva Cecilie Bonefeld-Jørgensen (ebj@mil.au.dk)
recorded at life events. AHW data likely provides a reasonable estimate
of total First Nations persons living in Alberta, but also has limitations
for reporting health status at the community level. However, this data
VENUE 4 may no longer be available since provincial health care premiums in
Alberta have been discontinued. Other potential sources of population
Database & Surveillance #2 data for First Nations communities include Statistics Canada census
data and the CPMS, which provides data on the number of persons
IPY HEALTH SURVEY DATABASE MANAGEMENT SYSTEM who present at local community health centres. Depending on the data
AND META DATA 2007-2008 source and definition used to define community members, diabetes
N. Sheikh1, D.M. Sparks2, G.M. Egeland1 medication use for the example ranged from 5.4% to 9.5%.
1
Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill Conclusion: The example of diabetes medication use using these
University, 2DJH Training Solutions various data sources demonstrates the challenges in providing
meaningful data to First Nations and highlights the need for more
The Inuit Health Survey Database is designed to capture baseline data accurate enumeration in this population. Any reports on First Nations
generated in the comprehensive survey carried out in 36 Arctic health statistics using the currently available data sources should
communities in 2007 and 2008. The most crucial steps in the include several caveats related to the limitations of these data sources,
development of the database were addressing issues related to the particularly for reporting at the community level.
Contact: Salim Samanani (salims@fnepicentre.org)

standardized mortality rate ratios were highest in the younger age
groups and diminished with advancing age. Rate differences for Métis
LINKING THE CANADIAN INDIAN REGISTRY SYSTEM TO THE men were particularly elevated for external causes, circulatory,
respiratory and digestive system diseases, while for Métis women, they
MANITOBA PROVINCIAL HEALTH REGISTRY: LESSONS
were particularly elevated for circulatory system diseases, cancers,
LEARNED digestive and respiratory system diseases. Rate differences for
B. Elias, M. Hall, C. Kasper, A. Doraty, C. Burchill, P.J. Martens, E. Registered Indian men and women were generally even further
Kliewer, A. Demers, D. Turner elevated for most of the same causes.
University of Manitoba Conclusions: For most causes of death, Métis adults had higher
Introduction: There is no comprehensive Canadian health information mortality rates compared to other residents of Canada. However, their
system generally, or for Indigenous peoples specifically. As a rates were not as high as those for Registered Indians.
Contact: Michael Tjepkema (michael.tjepkema@statcan.gc.ca)
consequence, comparable and relevant information on the health of
the indigenous population is lacking. In the province of Manitoba, First
Nations (FN) have been operating with a health information deficit.
DOCUMENTATION CENTRE ON CHILDREN AND YOUTH IN
Until only very recently, the Manitoba Health Registry (MHR)
undercounted FN individuals by about 35%. This paper describes a new
GREENLAND
research initiative to link federal and provincial health information L. Lynge
systems to improve identification for the purpose of informing health MIPI - Documentation Centre on Children and Youth
policies, such as health system integration.
MIPI - Documentation Centre on Children and Youth in Greenland
Methods: A request was made to Indian and Northern Affairs Canada collects and systematizes existing knowledge. MIPI also creates and
for access to information from the federal Indian Registry System (IRS) conveys knowledge on children and youth. The Documentation Centre
to identify Registered FN individuals residing in Manitoba was officially established in 2004, and has two academic employees.
(approximately 143,000). Historically, membership lists were MIPI publishes statistics concerning Children and Youth in Greenland
established to track indigenous people who received treaty payments. every second year. The purpose of Statistik om B¯rn og Unge i Gr¯nland
The IRS database was a by-product of that history and is now a means (Statistics concerning Children and Youth in Greenland) is to create an
to track membership of people as defined in the Indian Act and Bill C- overview of the conditions under which children and Youth live in
31. The resulting file, which is a living file, was linked with the MHR Greenland, and thereby improve the basis for debate. Statistics
through a rigorous process of deterministic and probabilistic linkage concerning other indigenous children and youth is sparse, and MIPI is
based on name, gender, birthdate and geographic indicators. therefore distinctive because it concerns only with knowledge about
Results/Conclusion: Linkage of the IRS data with the MHR has resulted children and youth in Greenland where only 10% is non-inuit - divided
in identification of approximately 95% of records, reducing the by place of birth.
undercount of Registered Manitoba FN individuals from 35% to 5%. MIPI creates new knowledge and information that is needed and
The project resulted in a much greater ability to identify Registered evident in preparation for policies concerning children and youth in
FNs in the Manitoba health administrative databases and will provide Greenland. From 2003 to 2008, MIPI has published 10 titles. Almost
accurate information about FN health service utilization and health every publication has created a massive debate on living condition
status, such as chronic and infectious conditions (e.g., diabetes, among children and youth. The publications contribute to the political
sexually-transmitted diseases) and mental health (e.g., depression, debate. The documented knowledge on children and youth not only
suicidality). This research initiative has paved the way in Manitoba for creates debates among the politicians, but citizens are also active
accurate and timely information for FN communities to inform health debaters. One of the reasons is that MIPI seems to bring up important
integration and other policies. subjects in Greenland by publishing documented knowledge
Contact: Brenda Elias (elias@ms.umanitoba.ca)
concerning children and youth. MIPI finds it important to maintain
focus on the child and youth-perspective, because children and youth
cannot speak for themselves.
MORTALITY OF MÉTIS CANADIAN AND REGISTERED INDIAN
ADULTS: AN 11 YEAR FOLLOW-UP STUDY Currently MIPI has 5 on-going projects about different areas of living
conditions of children and youth in Greenland. Among them is a
M. Tjepkema, R. Wilkins, S. Senécal, E. Guimond project that deals with how to convey and convert research-based
Statistics Canada knowledge concerning children and youth into action in order to
Objectives: To date there has been little information on the mortality of strengthen the national effort to improve the life for children and
the Métis people of Canada. The objective of this study was to describe youth.
Contact: Lona Lynge (loly@gh.gl)
and contrast mortality patterns for Métis and Registered Indian adults
to those of the population of Canada as a whole, for both all-cause and
cause-specific mortality.
Methods: The 1991-2001 Canadian census mortality follow-up study VENUE 5
tracked mortality over more than a decade among a 15% sample of Newborn & Child Health #3 – Child Health Determinants
adult (aged 25 and older) residents of Canada, including 11,800 Métis,
56,700 Registered Indians and 2,666,700 others, all of whom
completed the 1991 census long-form questionnaire Age-specific and MORTALITY AFTER ADMISSION IN THE PEDIATRIC
age-standardized mortality rates were calculated, as were period life EMERGENCY DEPARTMENT OF REPUBLIC SAKHA
tables. Métis were defined by ethnic origin (ancestry), since questions (YAKUTIA)
on Aboriginal identity were not part of the 1991 census. Registered D. Chichakhov
Indians were identified by a direct question concerning status under
the Indian Act of Canada. Design: Prospective, longitudinal study, conducted in 1998-2007.
Results: Métis and Registered Indians had higher mortality rates and Setting: Pediatric Emergency Department at the Pediatric Center in
lower life expectancy compared to the entire cohort: remaining life National Center Medicine of Yakutia and Child Hospital Infection
expectancy at age 25 was 3.1 and 5.3 years shorter for Métis men and Diseases in Yakutsk City, Republic Sakha (Yakutia), Circumpolar
women, respectively, and 4.2 and 7.1 years shorter for Registered Region Russia.
Indian men and women, respectively. For both groups, age-
Patients: The children of 1 month to 14 years of age who required acute Complex economic situation in Russia, extreme astroheliophysical
care in the Pediatric Emergency Department (PICU). conditions, intensive industrial exploration in circumpolar regions
Results: Data included demographic variables, clinical profile, combine into specific complex of factors, which influence adversely
diagnoses, therapy, and in-hospital mortality after admission upon children’s health. The results of our continuous survey in Yamal
(outcome). In a cohort of 12 707 children, there were 206 deaths (1.6%). region (Russia) confirm this statement. The most serious risk factors
Mortality was highest in the postneonates group (24.4%), which revealed in children, are high prevalence of iodine deficiency, alcohol
accounted for 74% of all deaths. Among the postneonates, intake and low physical activity. The last one was found in every third
breathlessness, fever and fits ranked were the common presenting child at the age of 11-12 years. More than 70% of schoolchildren at the
problems. Multivariate analyses to determinate risk factors were done age of 13-14 years suffer hypodynamia. In the 5-6th forms 8,3% of
separately for postneonates, and those aged 1-3, 3-14 yrs. Among the schoolchildren smoke, their number dramatically increases to the 9th
postneonatal group, respiratory failure requiring ventilation and form (smoking was stated for nearly 50%). Serious concern is risen by
hemodynamic failure were significant risk factors for mortality. In girls’ smoking and alcohol addiction, as they become mothers in the
those aged <1 yr, respiratory failure and polyorgane dysfunction were future. More than 60% of adolescents undergo passive smoking. Every
major risk factors. fourth child in Yamal region is characterized by dyslipidemia – the main
predictor of atherosclerosis. Every fifth teenager suffers low blood
Conclusions: The incidence of mortality is high in ours settings and magnesium level, the factor preceding cardiometaboloc deviations.
further research is needed to identify causes of preventable deaths. According to our data nearly fifth part of children lives in maternal
Children presenting with signs of hypoperfusion and respiratory failure families. 57,5% of fathers and 22,7% of mothers are employed in a shift
had poor outcomes. This raises the concern that children may be labour, this factor leads to deficiency of parental care. The most part of
presenting late, with advanced, severe illness to our Pediatrics children, residing in circumpolar region is characterized by psychic and
Emergency Departments. emotional tension. The increased levels of aggression (65,8%), hostility
Contact: Dulustan Chichakhov (gulustaan@rambler.ru)
(73,7%) and anxiety (48,3%) are stated in population. The prevalence of
the foregoing factors increases with every passing year. Taking into
EARLY CHILD DEVELOPMENT AS A DETERMINANT OF account the present situation, in order to reduce the prevalence of risk-
HEALTH: EXPLORING THE CONTRIBUTION OF HOME factors in children, population approach should be elaborated. It
should be based on cooperation of children, parents and
VISITING
teachers/tutors. To our opinion, Regional Centre on Children Health
C. Betker, M. Greenwood, H. Beanlands, A. MacLeod should be organized on the basis of State Scientific Research Institute
National Collaborating Centre for Determinants of Health on Medical Problems of the Far North (Nadym city, Russia).
Contact: S.A. Tokarev (hypertonia@yandex.ru)
Early child home visiting is a public health strategy that is widely used
around the world. Here in Canada, home visiting is practiced, in varying
forms, in every province and territory. Yet, there is a well-recognized PROPOSING INDICATORS REGARDING CHILD HEALTH ON
shortage of communication and collaboration between and among THE FOCUS AREAS IN THE GREENLANDIC PUBLIC HEALTH
those involved in the practice of home-visiting, in various capacities,
PROGRAM
across Canada. There is also considerable debate about essential
components of an early child home visiting program, human resources. B. Niclasen
community supports needed and evaluation methods required. Based Aim: To propose indicators on the focus areas in the present
on that recognition, the National Collaborating Centre for Greenlandic public health programme regarding child health and
Determinants of Health, in partnership with the National Collaborating health determinants
Centre for Aboriginal Health, hosted a pan-Canadian forum in October Background: In spite of the high political priority given to children’s and
2008, “Early Child Development Forum: Exploring the Contribution of youth issues, no one has yet proposed a coherent strategy on the
Public Health Home Visiting.” The purpose of the forum was to improvement, protection, and monitoring of children’s health and well-
facilitate knowledge synthesis, translation and exchange around being in Greenland. Proposing indicators for children’s health and well-
effective strategies for home visiting and the contribution to early child being based on the focus areas in the Greenlandic public health
development as a determinant of health. programme, Inuuneritta, on the structural level with the highest
The forum brought together more than 120 participants from every responsibility for impact on the single child is an important supplement
Canadian province and territory. It profiled selected Early Child Home to the monitoring of children’s health at the national level. Inuuneritta
Visiting Programs and explored the relationship between home visiting focuses on health promotion and prevention, especially regarding
and health equity; provided an opportunity to identify and prioritize alcohol use, violence and abuse, diet, physical activity, smoking, and
policy and practice issues; and, explored the utility of stories as a tool sexual health. It also includes programs on suicide prevention, early
for knowledge synthesis, translation and exchange. The forum, which interventions to secure health and development, and dental health. To
included presentations from practitioners working in northern secure a context also indicators on demographic and social factors as
communities, was formally evaluated and was found to be a well as resources were proposed.
tremendous success, and a well valued exercise. Methods: Criteria for selecting the indicators were set up. Indicators
The objectives of this presentation are to: were searched and included in 4 domains (demographic and socio-
- describe the Early Child Development home visiting forum economic conditions; health status and well-being; determinants of
- share lessons learned and next steps health, risk, and protective factors; and health systems and health
- discuss the strengths and complexities of early child home policy) together with available data sources. In total 24 indicators on
visiting as a public health strategy Inuneritta’s focus areas, 6 on socio-demographic conditions, and 9 on
Contact: Claire Betker (cbetker@stfx.ca) resources proposed. Data on the indicators on capital, municipalities
with a larger town, a smaller town, and remote municipalities were
compared as well as data on the capital city, cities, and villages.
THE MAIN PROBLEMS OF CHILDREN’S HEALTH IN THE Results: Data revealed large differences between municipality types
RUSSIAN FAR NORTH and between the capital city, cities, and villages between many of the
S.A. Tokarev, A.A. Buganov selected indicators. In general, children in remote communities and in
State Scientific Research Institute on Medical Problems of the Far North settlements had the most unfavourable socio-demographic and health
of RAMS conditions. At the same time, larger communities’ access to health
care services is more favourable.
Contact: Birgit Niclasen (niclasen@greennet.gl)

and gender was evaluated. Socioeconomic and dietary factors
associated with an at-risk BMI %ile in preschoolers was evaluated
UNDERSTANDING OF ABORIGINAL CHILDREN IN ALBERTA - including traditional food use, sweetened beverage consumption, and
other indicators of unhealthy and healthy dietary habits. Results are
AN ANALYSIS OF CANADIAN ABORIGINAL CHILDREN’S
embargoed pending disclosure of findings to
SURVEY
participating communities scheduled for completion in the May of
X. Cui, J. Lamba, C. Werk, K. Schreiner, S. Tough, N. Reynolds 2009. Full details of findings will be presented at the Congress.
Child and Youth Data Lab, Alberta Center of Child, Family and Contact: Tracey Galloway (tracey.galloway@utoronto.ca)
Community Research
More and more Aboriginal families are leaving reserves and living in
PROGRESS TOWARDS OPTIMAL PEDIATRIC DRUG
cities which leads to changing conditions and challenges. There is a
lack of understanding of the situation of Aboriginal children especially
THERAPY: A NORTHERN CHILD/YOUTH HEALTH
younger children (0 to 5 years) who are living in such a changing IMPERATIVE
environment. Given that early childhood is a critical time period for S. MacLeod, N. McCullough, R. Peterson
brain development, understanding the early years is particularly Child & Family Research Institute, University of British Columbia
important for policy development. Programs and services designed to
improve children’s environments have a potential to impact the The millennium development goals set a standard to reduce child
intellectual, emotional, and social development of these children later mortality by 2/3 before 2015. Drug manufacturers, regulators,
in life. Policy makers and service providers are in great need of current pediatricians, pharmacologists, and pharmacists have, until recently,
and pertinent information to enhance the quality and relevancy of failed to meet the need for properly validated therapies available in
these services for Aboriginal children living off reserves. formulations suitable from infancy to adolescence. Nowhere is the lack
of evidence to inform optimal therapy more evident than in remote
The Aboriginal Children’s Survey conducted by Statistics Canada in communities where, in many cases, the majority of the population is
2006 surveyed Aboriginal children under 6 years of age who were living aged 18 years or less. There are, worldwide, an estimated 5 million
off reserve in Canada. This is an extensive survey that was designed to deaths annually among children 5 years or younger that could be
provide a picture of the early development of Aboriginal children and prevented by effective, affordable, accessible drug therapy.
the social and living environment in which they are learning and
growing. For the current study, data collected on Aboriginal children in In 2007 steps were taken to rectify this situation following passage of
Alberta and their parents were analyzed to generate a detailed resolution 60.20 “Better medicines for children” by the World Health
descriptive profile of this population. Key characteristics including Assembly. The WHO subsequently published an essential medicines
health status, developmental milestones, mental health, childcare list for children with considerable input by experts from circumpolar
situations, living arrangements, social support networks, housing and countries.
other social economic circumstances were described and contrasted by Importantly, a group of pharmacologists, pharmacists and
geographic locations such as urban and rural areas, different Children pediatricians have created the International Alliance for Better
and Family Service regions in Alberta, and by Aboriginal self- Medicines for Children. The Alliance comprises scientific and clinical
identification (First Nations and Métis children). organizations, regional leadership groups, and national societies as
Policy makers from the provincial ministries, local Children and Family well as individuals committed to research and knowledge transfer
Service Authorities, and representatives from Aboriginal communities relevant to pediatric therapeutic advances.
were involved in defining research questions that related specifically to Priority Alliance objectives 2009-2010 are to:
provincial policy priorities. An iterative process involving these partners - pursue international regulatory harmonization
at different stages of the research and dissemination processes is also - identify knowledge gaps and support WHO listing of essential
discussed. medicines for children
Contact: Xinjie Cui (xcui@research4children.com)
- clarify regional needs through formal needs assessments
- improve understanding of drug toxicity
CORRELATES OF EMERGING OBESITY AMONG PRESCHOOL - develop and test appropriate pediatric formulations
- catalyze improved access to effective pediatric therapies in
AGED CHILDREN: NUNAVUT CHILD INUIT HEALTH SURVEY
vulnerable populations
T. Galloway, A. Pacey, L. Johnson-Down, T.K. Young, G.M. Egeland, - develop guidelines for optimal and safe use of medications for
Qanuippitali Steering Committee (Nunavut)2 children and youth
Dalla Lana School of Public Health, University of Toronto, 2L. Gunn, While much work to date has focused on tropical disease and
Nunavut Association of Municipalities; L. Williamson, Nunavut developing countries the initiative is equally relevant to the needs of
Tunngavik Incorporated; I. Sobol and G. Osborne, Government of northern children and youth.
Nunavut Department of Health and Social Services; K. Young, University Contact: Stuart MacLeod (smmacleod@shaw.ca)
of Toronto
Among North American Aboriginal populations, obesity and metabolic
disease pose significant risk to health and well-being. Little
anthropometric data exists, however, especially for preschool aged
children in the Arctic. Identification of risk factors for obesity early in
life can help identify the need and means for preventing obesity in
adulthood and the many obesity related chronic diseases that are now
emerging in the Circumpolar North. The collection of uniform statistics
in the Arctic is costly and logistically problematic. Through the
International Polar Year Inuit Health Survey, accurate and timely data
on the health of Inuit Canadians has been collected. The field activities
of 2007 and 2008 included a child nutritional health survey of 3-5 year
olds residing in 16 Nunavut communities. Data were collected by a
team that included a nurse, bilingual interviewers, study coordinator
and lab technician/graduate student. The prevalence of preschool
children with an at risk body mass index (BMI kg/m2) > 95%ile by age
126 POSTER SESSIONS: A B C
publications were required to find a way to communicate the

POSTER SESSIONS traditional knowledge as well as research results and coping strategies
coming from Western counselling models. This presentation illustrates
Tuesday & Wednesday, July 14-15, 12:15-3:30 PM
that in order to be effective, the knowledge transfer strategy used
needs to ensure a sense of cultural safety. The poster explains that
presenting original wording and statements from Inuit who are
ABC traditional knowledge holders in the text can provide this sense of
cultural safety and encourage learning.
DEVELOPMENT AND IMPLEMENTATION OF AN Considering the intrinsic relationship that exists between coping and
ABORIGINAL FRAMEWORK AND MEASURES OF knowledge, the mental wellness materials are based on the
COMMUNITY HEALTH IN NORTHERN SASKATCHEWAN, understanding that learning is a key process in developing coping
CANADA strategies. As learners need to understand why something is useful or
necessary to learn, it is equally important that the individual learner
S. Abonyi1, B. Jeffery2, C. Hamilton3, T. Lidguerre4, E. Throassie5, F. recognizes how her/his life experiences and prior learning successfully
Michayluk6, V. Robillard6 contribute to new learning and the building of new knowledge.
1
University of Saskatchewan, 2University of Regina, 3SPHERU, 4Fond Du Contact: Lily Amagoalik (lamagoalik@naho.ca)
Lac Denesuline First Nation, 5Black Lake Denesuline First Nation,
6
Athabasca Health Authority
BEHIND THE SCENES: MANAGEMENT OF LARGE EXTENDED
There is a growing interest in developing relevant community level
FAMILY TREES FOR GENETIC ANALYSIS
health indicators for the purpose of measuring health status and
evaluating progress in reducing health disparities in Aboriginal F. Balbi, R. Plaetke
communities in Canada. This interest is reflected from the national Center for Alaska Native Health Research, University of Alaska Fairbanks
level in recent publications commissioned by the Canadian Institutes
Background: At the Center for Alaska Native Health Research
for Health Information (CIHI) and in statements made by the National
(CANHR), investigators collect information about extended family
Aboriginal Health Organization, and from the local level in work being
trees (pedigrees) for a genetic study of obesity and diabetes. Whenever
carried out in individual Aboriginal communities. This presentation will
they come back from the field, they need to update the pedigree
report on an ongoing program of community-based and participatory
information and perform merges of new and old pedigrees. So far, the
research on the development of a community health framework and
pedigree merge procedures have been performed “by hand” using a
indicators in northern Saskatchewan. Throughout, northern
pedigree drawing program. But this approach can be tedious and error
Saskatchewan Aboriginal health organizations and communities have
prone.
been active participants and leaders in setting the research agenda,
conducting the research, and interpreting and implementing the Purpose: To help investigators with this type of problem we developed
results. This research contributes to their goal of locating control over the program PedMerge.
the definition and tracking of changes in community health in Methods: PedMerge natively runs on Windows and has a user friendly
Aboriginal health organizations and communities; recognizing that interface. The program merges smaller pedigrees into larger ones.
ownership of health information is a component of self-government. Several error checks are performed to ensure a correct output. The
Following one CIHI author’s reflections on the process of developing a merge is based on “key persons”, i.e., individuals that occur in more
health community index for Aboriginal communities, the first phase of than one pedigree. For example, one woman can be in one pedigree as
research in northern Saskatchewan has considered two of his four a daughter, while in another pedigree as a mother having multiple
questions, “what is a healthy community?”, and “how would we children and a husband.
measure that?”. Our presentation will highlight process, activities, and Results: By using PedMerge a routine update of the pedigree structure
outcomes of the first phase of research that produced a conceptual can easily be performed after collecting information about newly
framework that reflects northern Saskatchewan views of healthy recruited family members in the field. The merging algorithm is fast. It
community and includes approximately 165 potential indicators takes a fraction of a second to merge large numbers of pedigrees to a
appropriate to the framework. The two remaining questions, “how single pedigree consisting of over 1000 individuals. The user can decide
healthy is our community”, and “why would we measure that” are the produced output format: A standard format for several genetic
being considered in the second phase of research. We will highlight our analyses or a master file for the genetic database Pedsys. In addition
progress in the first year of considering these questions, and outline Pedmerge generates a log file to help the user track the merging
our planned activities and outcomes. process.
Contact: Sylvia Abonyi (sylvia.abonyi@usask.ca)
Contact: Federico Balbi (ffrp@uaf.edu)
CULTURAL SAFETY AND KNOWLEDGE SHARING: WORK ON ARCTIC HEALTH WEB SITE: AN INFORMATION PORTAL TO
MENTAL WELLNESS AT THE INUIT TUTTARVINGAT OF ISSUES AFFECTING THE HEALTH AND WELL-BEING OF OUR
NAHO PLANET’S NORTHERN-MOST INHABITANTS
L. Amagoalik L. Bartlett, P. Maez, K. Murray
Inuit Tuttarvingat of NAHO National Institutes of Health, National Library of Medicine
This poster presentation explains important concepts and techniques The Arctic Health Web site (www.arctichealth.org) is a collaborative
used in the centre’s work on mental wellness. The poster summarizes effort between the University of Alaska, Anchorage (UAA), Health
concepts of cultural safety and knowledge translation and explains Sciences Information Services (HSIS), at the Consortium Library and
how the Inuit Tuttarvingat of the National Aboriginal Health the National Institutes of Health, National Library of Medicine,
Organization (NAHO) applies these concepts in the materials it Outreach and Special Populations Branch. The goal of the Web site is
produces for Inuit on the topics of mental illness, suicide prevention to bring together, in one location, information on diverse aspects of
and resilience. the arctic environment and the health of northern peoples. It gives
In the effort to pass on knowledge about coping strategies, our centre access to evaluated health information from hundreds of local, state,
published several booklets, a poster and factsheet. There were national, and international agencies, as well as from professional
particular challenges in preparing these products. Namely, the societies, universities and Native Alaskan and indigenous communities.
underlying research addressed Inuit traditional practices, yet the The portal contains several resources for both researchers and
POSTER SESSIONS: A B C 127
consumers. The topic areas covered are: publications and research, CHALLENGES TO TUBERCULIN SCREENING AND FOLLOW-
environmental health, telehealth and telemedicine, traditional healing, UP IN AN URBAN ABORIGINAL SAMPLE IN MONTREAL,
health topics and links to government organizations and programs. A CANADA
climate change and circumpolar health section is being developed and
seeks to provide access to unique and special collections not currently P. Brassard, K.K. Anderson, K. Schwartzman, M.E. Macdonald, D.
available on the Internet. Menzies
Arctic Health has made several unique and special collections available McGill University
on the Internet. The traditional healing page offers interviews and Background: Tuberculosis (TB) incidence rates in Canadian Aboriginal
video panel discussions about traditional healing and practices in the peoples are substantially higher than the general population. Health
Native Alaskan community. These provide a great resource for problems faced by Aboriginal people are compounded when migrating
understanding the practices and utilize the storytelling tradition to to urban areas.
pass on stories and understandings from generations of Native Objective: We sought to describe the prevalence and predictors of
Alaskans. Arctic Health has created robust databases containing tuberculin skin test (TST) reactors in a high-risk sample of urban
bibliographic information, research projects and grey literature. The Aboriginal people, and to evaluate adherence to medical evaluation
Frostbite collection is a series of photographs and notes from the and latent tuberculosis infection (LTBI) treatment among those with
leading frost bite expert Dr. William J Mills, Jr. The collection illustrates TST reactivity.
the danger of frost bite, treatments, and progression of the injury.
Arctic Health also hosts several educational cancer videos for Design: We obtained a convenience sample of high-risk Aboriginal
consumers created by the Alaska Native Tribal Health Consortium. peoples in Montreal and administered a one-stage TST. Financial
Arctic Health strives to locate, preserve and provide access to special compensation ($10 CAD) was provided for participation in the TST
collections for future generations. screening and an interview, and again for returning for TST reading
Contact: Laura Bartlett (bartlettl@mail.nih.gov)
within 48 to 72 hours.
Results: Of the 164 participants tested, 86% returned for TST reading.
Positive TST reactions (~10mm) were observed in 17.7% (25/141, 95%CI
FRUIT AND VEGETABLE CONSUMPTION AMONG 11.4-24.0) of participants, and were associated with older age (OR per
INUVIALUIT OF THE NORTHWEST TERRITORIES: RESULTS 10 year increase 1.8, 95%CI 1.2-2.7) and Inuit Aboriginal group (OR 2.8,
FROM HEALTHY FOODS NORTH 95%CI 1.1-7.3). We attempted to refer all individuals with TST reactivity
L. Beck, E. De Roose, S. Biggs, S. Reaburn, E. Erber, J. Gittelsohn, S. for medical evaluation, a step for which participants were not
Sharma compensated. Only four participants presented for evaluation, of
whom one initiated and none completed LTBI treatment.
The Canadian Public Health Association, Inuvik, NT
Conclusion: Tuberculin screening in this population can be an effective
Objective: To determine mean daily intake frequencies of fruits and strategy for identifying TST reactive individuals; however, screening
vegetables among Inuvialuit by age, sex and community. efforts will have minimal impact without additional efforts in this high-
Setting: Three Inuvialuit communities in the Northwest Territories, risk group. A costing exercise indicates that the provision of financial
Canada, which vary in terms of size and isolation. compensation for medical evaluation and treatment may be one cost-
Methods: Cross-sectional random household Quantitative Food effective strategy for improving adherence and subsequently
Frequency Questionnaires (QFFQs) were conducted with Inuvialuit preventing cases of active TB in addition to addressing other barriers to
adults. Thirteen fruit items and 16 vegetable items were selected for health care faced by urban Aboriginal people.
Contact: Paul Brassard (paul.brassard@mcgill.ca)
analysis from the QFFQ and ranged from fresh, canned and frozen
varieties.
Results: A total of 233 Inuvialuit adults (183 women and 50 men) aged KNOWLEDGE AND PERCEPTIONS OF TUBERCULOSIS
19-88 years participated with a mean age of 43 years. The response AMONG A SAMPLE OF URBAN ABORIGINAL PEOPLE
rate was approximately 70-90%. The overall mean frequency of daily
P. Brassard, K.K. Anderson, D. Menzies, K. Schwartzman, M.E.
fruit and vegetable consumption was approximately 3 times a day: fruit
Macdonald
1.3 times a day and vegetables 1.8 times a day. The three communities
differed significantly in mean frequency of daily consumption of fruit, McGill University
ranging from 0.9 to 1.5 times per day. Frequency of daily vegetable Achieving a high level of tuberculosis (TB) awareness is crucial for the
consumption, ranging from 1.5 to 2.1 times per day, were not success of prevention and treatment efforts in high-risk groups, and
significantly different by community. thus represents a key challenge for public health initiatives. Research
Conclusions: Low mean frequency of daily consumption of fruits and exploring knowledge and perceptions of TB in Aboriginal populations
vegetables among the Inuvialuit highlights the need for a nutritional has been lacking to date. We sought to explore the knowledge and
intervention program, such as Healthy Foods North, to promote fruit perception of TB in a sample of high-risk Aboriginal peoples in
and vegetable intakes to reduce risk of chronic disease. The Montreal who were undergoing a tuberculin skin test (TST) as part of a
community-based Healthy Foods North program will include larger study. We conducted standardized, face-to-face interviews using
components to address the unique issues/challenges to fruit and a structured interview guide. The interview explored participants’
vegetable consumption in isolated northern communities. knowledge and perception of TB using a combination of both
structured and open-ended questions. We also asked a series of open-
Acknowledgements: We thank Andrew Applejohn for his amazing
ended questions that probed for participants’ experiences with urban
guidance and support of the program, as well as the participating
health services, whether TB is discussed in Aboriginal communities and
communities. We also thank the Aurora Research Institute for their
participants’ intentions should their TST result be positive. A total of
incredible assistance. The research was supported by the American
164 eligible Aboriginal persons volunteered to participate in our study.
Diabetes Association Clinical Research Award Grant # 1-08-CR-57.
Contact: Lindsay Beck (sangita_sharma@unc.edu)
Close to one-third (54/164) reported knowing little about TB, and
participant responses indicated that there were many prevalent
misconceptions about the symptoms, transmission, cause and risk
factors for the disease. The majority of respondents felt that TB was
not openly discussed in their homes and communities, and
approximately half (90/164) of respondents reported that they were
not concerned about contracting TB. We conclude that there is a lack
128 POSTER SESSIONS: A B C
of knowledge and several misconceptions about TB among our sample emergent care practice that is required when working in isolated
of urban Aboriginal peoples. northern regions. Advanced health assessment and primary health
Contact: Paul Brassard (paul.brassard@mcgill.ca) care theory (diagnosing and treating common illnesses, suturing, x-ray
imaging and interpreting) are learned. Evidence-based education using
northern health research, as well as instruction and mentoring by
CENTRE FOR SÁMI HEALTH RESEARCH experienced nurse-instructors, is used to introduce the nurse to
A.R. Broderstad northern health care. The course is considered a vital part of the GNWT
Centre for Sámi Health Research strategy for northern health care provision, and is especially relevant at
a time when many provinces are considering formalized certification
The Centre for Sámi Health Research was established at the University
for nurses providing primary care. This educational model would be of
of Tromsø, Karasjok, Norway in 2001, marking the culmination of 50
interest to other northern primary health care providers, managers,
years of health activism and capacity development among Sámi health
and administrators.
care professionals. Since then, the centre has made major strides in Contact: Jennifer M Buck (jen_m_buck@hotmail.com)
surveying and developing culturally appropriate health care services for
Sámi people.
FOOD SECURITY IN NUNAVUT: A KNOWLEDGE SHARING
ELECTRONIC BULLYING IN TWO PROVINCIAL NORTH TOOL FOR POLICY-MAKERS
ELEMENTARY SCHOOLS M. Bzdell, G.K. Healey
K. Brownlee, E. Rawana, J. Rawana, M. Probizanski, J. Martin, J. Qaujigiartiit Arctic Health Research Network Nunavut
Franks, J. Whitley Background: Food security exists “when all people, at all times, have
Lakehead University access to sufficient, safe and nutritious food to meet their dietary
With the current increase in use of communication technologies such needs and food preferences for an active and healthy life” (FAO 1999).
as cell phones, internet, chat rooms and e-mail concern has arisen Food security has been raised as a priority issue to Qaujigiartiit Arctic
about the incidence of electronic bullying. Reports have indicated that Health Research Network Nunavut (AHRN) by AHRN board members
in Canada over 90% of youths between 12-18 years old use the internet and by Nunavut community members. Policy-makers are essential to
and nearly half of these youths have their own cell phones and that determining focus and effecting change on this important topic.
many of these youths are using these mediums to bully their peers. Purpose: to develop a tool to assist policy-makers to better understand
This type of bullying has received much media attention but the extent important aspects of Food Security in Nunavut such as current
of the problem in northern communities is unclear. As part of a wider statistics about food security; the nature of the issue; and current
project on bullying and safety in the schools this study explored the perspectives of stakeholders.
experiences of students with electronic bullying. This study Methods: Academic literature was reviewed and a grey literature
administered a Safe School Survey to 102 school children in grades search was conducted in fields pertaining to food security in Nunavut.
four to eight who were enrolled in two schools from the public school Interviews were held with policy-makers who work on the issue of food
system in a north western Ontario city. Students were invited to self- security in Nunavut. The knowledge sharing tool was developed by
report on their participation in electronic bullying. The students were AHRN.
asked about their experiences of being victims of electronic bulling,
their participation in electronically bullying others and whether they Findings: Relevant topics for the policy-makers’ food security tool in
were aware of others who were being bullied. Analysis of the results Nunavut include the multi-jurisdictional approach needed to examine
included an examination of gender and ethic differences in electronic this topic in the local context; the need for an Inuit-specific definition of
bullying. The results showed that electronic bulling was present in both food security; relevant socio-economic factors affecting food security
schools, although less prevalent than other forms of bullying such as in Nunavut; the impact of the high cost of store-bought food; the
physical, verbal and social bullying. The results indicated that females inclusion of information about successful interventions in the territory;
experienced more electronic bullying than males, that Aboriginal the importance of harvesting country food and its impact on food
students experienced similar levels of electronic bullying to non- security; the repercussions of increasing fuel prices on harvesting
Aboriginal students and that students were more reluctant to admit to country food; climate change and its relation to food security; and
perpetrating electronic bullying compared to being victims of information about the Food Mail program.
electronic bullying. The implications of the results for school Conclusion: Literature review and interviews with food security policy-
programming are discussed. makers has led to the identification of relevant topics and statistics
Contact: Keith Brownlee (kbrownle@lakeheadu.ca) about food security in this context. These perspectives were used to
develop a knowledge sharing tool to assist policy-makers who work in
Food Security in Nunavut.
AURORA COLLEGE’S INTRODUCTION TO ADVANCED Contact: Mandie Bzdell (mbzdell@hotmail.com)
PRACTICE PROGRAM: PRODUCING ADVANCED-PRACTICE
NURSES WITH NORTHERN-SPECIFIC SKILLS
A RAPID, HIGHLY DISCRIMINATORY GENOTYPING METHOD
J.M. Buck
FOR MYCOBACTERIUM TUBERCULOSIS ISOLATES IN
Aurora College, Tlicho Community Health Services MANITOBA, CANADA
Providing quality health care in northern communities requires S. Christianson, J. Wolfe, P. Orr, M.K. Sharma
overcoming many barriers, one of which is the dearth of qualified
human resources. Aurora College, in conjunction with the Government Public Health Agency of Canada
of the Northwest Territories, has addressed this problem by Objective: In order for any genotyping method to be highly effective in
developing a program called the Introduction to Advanced Practice the clinical microbiology laboratory, the method should be technically
(IAP) that provides registered nurses the skills and knowledge to straightforward, rapid, highly discriminatory, and generate easily
provide basic primary health care to specifically northern populations. interpretable results for inter-laboratory comparisons. Though the
Nurses attend the IAP from across Canada’s north and from many IS6110 RFLP typing method (RFLP) has proven to be a highly
southern provinces, often as a pre-requisite to working in remote discriminatory method for typing Mycobacterium tuberculosis
locations. This program is delivered in Yellowknife, NWT, and in a short complex (MTBC) organisms, it fails to achieve any of the other qualities
time frame (6 weeks) moves the nurse from hospital-, community-, or mentioned above. MIRU-VNTR typing has proven itself on all of the
public health nursing practice to the (novice) independent primary and above criterion but lacks the discriminatory power of the IS6110-RFLP
POSTER SESSIONS: D E F 129
typing method. Recent improvements to the MIRU-VNTR method, New mass media ideas for Sexual Health promotion are being
namely the addition of 12 new MIRU-VNTR loci and spoligotyping, explored. Examples include: texting, innovative condom distribution,
increased the discriminatory power of MIRU to more closely resemble wireless communication, and audio podcasts. Language & literacy is
that of the RFLP method. Our aim was to determine if typing the being taken into consideration and strategies to connect with high risk
additional 12 loci, with the addition of spoligotyping would provide populations & how they receive information are being examined.
further discrimination within the Manitoba MTBC genotyping Website Development has begun in the Northwest Territories with a
database. website launch planned for Spring 2009.
Contact: Karen Colbourne (karen_colbourne@gov.nt.ca)
Methods: A total of 315 MTBC isolates that were previously typed using
the 12 locus method were further tested using the additional 12 loci. A
selection of these samples was also genotyped using RFLP and/or
spoligotyping. The methodologies were then compared based upon DEF
discriminatory power and clustering rate.
Results: Cluster analysis using MIRU-VNTR data shows that by adding FOOD SOURCES AND DIETARY INTAKE OF VITAMIN D AND
the additional 12 loci to the traditional method, clustering rate is
decreased from 76% to 62%. With the addition of spoligotyping to the
CALCIUM AMONG INUVIALUIT IN THE NWT: RESULTS FROM
24 locus MIRU-VNTR, the Hunter Gaston discriminatory index (HGDI) HEALTHY FOODS NORTH
is equal to that of RFLP, 0.8628. That said, the clustering patterns E. De Roose, X. Cao, A. Donnison, J. Gittelsohn, S. Sharma
generated by the two techniques are not identical. Government of the Northwest Territories, Department of Health and
Conclusions: The addition of 12 new MIRU-VNTR loci to the traditional Social Services, Yellowknife, NT
MIRU-VNTR typing scheme vastly improves the discriminatory power. Objective: To describe food sources contributing vitamin D and calcium
The addition of spoligotyping to the 24 locus method increases the to the diet of the Inuvialuit.
discriminatory power to equal that of RFLP. Using 24 locus MIRU-
VNTR combined with spoligotyping will allow for rapid, highly Setting: Two communities in the northern Northwest Territories that
discriminatory typing of Manitoba isolates. vary in degrees of isolation.
Contact: Joyce Wolfe (joyce_wolfe@phac-aspc.gc.ca) Methods: A cross-sectional random household dietary study was
conducted with Inuvialuit adults using 24-hour dietary recalls. All
reported food items were coded, entered and analyzed using Nutribase
PAN-TERRITORIAL PARTNERSHIP: SOCIAL MARKETING Clinical Manager 5.18.
TOOLS IN SEXUAL HEALTH PROMOTION
Results: 101 Inuvialuit adults (48 men and 53 women) aged 19-88 years
K. Colbourne, L. Gushue completed the dietary recalls with a response rate of approximately 70-
Public Health Agency of Canada, Government of the Northwest 90%. The food sources for calcium in both communities included low
Territories fat, chocolate and evaporated milk, as well as oatmeal, white bread,
cheese and orange drinks and juices. Food sources that were major
Background: Sexually transmitted infections (STIs) are a growing
contributors to vitamin D in both communities included milk and
health concern — globally, nationally, & especially within the
butter and margarine. Traditional food sources provided minimally to
Northwest Territories. The most commonly reported STIs in Canada
intakes of these nutrients. Dietary intakes of vitamin D and calcium
are Chlamydia, Gonorrhea, and infectious Syphilis (Canadian
were also found to be low in the population.
Guidelines on Sexually Transmitted Infections, 2006). STIs can cause
serious life-long problems such as infertility, tubal pregnancies, Conclusions: These findings indicate the need for increased
premature births, damage to unborn children, and possibly death. STIs consumption of foods rich in vitamin D and calcium among the
spread quickly and can create hardships for individuals, families, and Inuvialuit. Healthy Foods North, a nutritional intervention program in
communities. Importantly, social factors such as violence, substance the surveyed communities, will promote a combination of traditional
abuse, and coercion contribute greatly to the issue of STIs. and store-bought foods that are rich in vitamin D and calcium for this
population.
The incidence of STIs in the Northwest Territories is up to 12 times
higher than the national average and the NWT has the highest rate of Acknowledgements: We give our heartfelt thanks for the incredible
Gonorrhea in the country and the second highest rate of Chlamydia. support and guidance of Andrew Applejohn and the Aurora Research
Rates of these infections have escalated exponentially in some regions. Institute. We would also like to thank the participating communities.
Youth aged 15 to 24 years are disproportionately affected by STIs The research was supported by the American Diabetes Association
compared to other age cohorts. Epidemiological indicators point to the Clinical Research Award Grant # 1-08-CR-57.
Contact: Elsie De Roose (sangita_sharma@unc.edu)
likelihood that HIV could become a significant issue in the North if
serious steps are not taken to address this important health issue.
Yukon, Nunavut & Northwest Territories share many commonalities,
RESILIENCY AND INHALANT ABUSE TREATMENT
similar demographics & comparable issues with STI rates.
Communication & collaboration between Territories is an effective D. Dell
method of pooling resources to achieve positive outcomes including YSAC
decreased STI rates. In Canada, a major and innovative national response to inhalant abuse
Methods: A partnership was developed between the three territories among First Nations youth has been the establishment of residential
through Pan Territorial Funding (Territorial Health Access Fund - treatment centres through the federally funded National Native Youth
THAF). Deputy Ministers from each territory supported a Pan Solvent Addiction program (NNYSA). This paper focuses on the role of
Territorial Sexual Health Website portal, linking health information a holistic conception of resiliency in inhalant abuse treatment in the
from all three territories. This collaborative project is a broad campaign NNYSA program. A blending of policy and practice issues and their
with common elements. It also includes specific niche marketing and is contribution to the health status of First Nations youth inhalant
flexible with room to create different messages for different abusers guide the paper’s discussion of resiliency and its fundamental
populations within Northwest Territories, Nunavut & Yukon. The role in NNYSA’s traditional Native teachings program. A holistic
diversity between territories & within territories will be represented conception of resiliency is viewed as a key contributor to the program’s
through these websites. achievements to date. The focus on resiliency has been identified in
Anticipated Results & Goals: Much collaboration between the territories assisting youth in uncovering their inner spirit and strengthening their
has occurred to date via teleconferences, meetings & idea sharing. spirit by drawing on available community resources. Data and case
130 POSTER SESSIONS: D E F
illustrations from two NNYSA treatment centres—White Buffalo Youth exchange which may enhance public health capacity and facilitate
Inhalant Treatment Centre (Prince Albert, Sask.) and Nimkee strategic resource allocation in these regions.
NupiGawagan Healing Centre (Muncey, Ont.)—are presented. The The role of the National Collaborating Centre for Infectious Diseases
paper also offers NNYSA policy solutions that have been guided by a (NCCID) is to enhance knowledge exchange to strengthen public
holistic concept of resiliency and account for the intersecting roles of health responses to infectious diseases. Consultations with
culture, spirituality, and community in creating and maintaining the practitioners, decision-makers and researchers working in northern
health of First Nations youth solvent abusers. The paper concludes reasons has initiated a dialogue to explore integrated public health
with suggestions for future research. programming which is responsive to strengths and vulnerabilities in
Contact: Debra Dell (ysac@shaw.ca)
populations rather than focusing only on individual pathogens or single
interventions.
PLACE OF RESIDENCE AND NEONATAL OUTCOME IN THE Results: Drawing from NCCID’s consultation in June 2008 and Forum in
NORTHWEST TERRITORIES March 2009, this presentation will describe infectious disease
epidemiology and transmission dynamics in northern and remote
B. Denning
communities and strategies to enhance and integrate existing public
Queen’s University; Public Health Agency of Canada health programs and services.
Purpose: To examine the relationship between place of residence and Steps needed for implementing new prevention and control strategies,
neonatal outcome within the Northwest Territories focusing more on populations as opposed to individual pathogens will
Background and Rationale: In the Northwest Territories, available be presented. Avenues to enhance existing strategies through
prenatal care and birthing options vary widely by community. Women innovation and collaboration will also be discussed.
in Yellowknife, Inuvik and Fort Smith have access to continuity of Conclusion: Efficient and effective use of limited resources in small and
caregiver, as they can have the same caregiver that provided their geographically-dispersed communities may be facilitated by
prenatal care present at the birth. As well, there are more social identifying commonalities in the public health responses to a variety of
programs available throughout their pregnancy, and they are not infectious diseases, and integrating prevention messaging with
subject to the psychological, social and financial stressors that are surveillance tools. Collaboration between regions and with existing
inherent in leaving their families and communities for an extended networks or organizations may further strengthen public health
period of time. This study hypothesizes that living in a community with programming.
more prenatal care options, including the option to give birth in their Contact: Elsabé du Plessis (eduplessis@icid.com)
home community, will lead to better neonatal outcomes.
Exposure: Transfer for Childbirth
PROVIDING LIBRARY SERVICES TO CONTRIBUTE TO
Women will be evaluated as being in either a “non-transfer” group, CAPACITY BUILDING AND KNOWLEDGE TRANSLATION IN
consisting of women who have the option to give birth in their own
THE CANADIAN NORTH
community, or as in a “transfer” group, consisting of women who
reside in communities where transfer is mandatory. A. Ducas, J. Linton, K. Young, L. Friesen
Outcome: Composite Neonatal Outcome Variable Neil John Maclean Health Sciences Library, University of Manitoba
A composite neonatal outcome variable will be used to compare the Program Objective: Bringing academic health sciences library services
two groups. A negative neonatal outcome will be recorded if the to community-based partners in Canada’s northern territories of
newborn exhibits one or more of the following: a five-minute Apgar Nunavut, NWT, and the Yukon.
score of less than seven; a birth weight of less than 2500 grams; a birth Setting: The Neil John Maclean Health Sciences Library (NJMHSL),
weight of greater than 4500 grams; stillbirth. located in Winnipeg, Manitoba, Canada has been building an
Results: Currently pending data collection; results should be available Aboriginal Health Collection and Information Services component,
by May 2009. including outreach services to health care providers in the Kivalliq
Region of Nunavut since 1999. This model has been so successful that
Relevance: This study is designed to provide a more accurate picture of
the NJMHSL was invited to join the Canadian Institutes of Health
the effects of choice in care and availability of care on neonatal health
Research (CIHR) Team in Circumpolar Health by team leader, Kue
outcome indicators. The findings of this study will hopefully provide
Young. Several team research projects are being undertaken between
evidence to inform future decision-making regarding childbirth policies
2006 and 2011.
in rural and remote regions.
Contact: Bryany Denning (1bbd@queensu.ca) Participants: CIHR Team members and community partners include
Canadian academics, international partners, and community-based
researchers.
INTEGRATIVE APPROACHES TO INFECTIOUS DISEASE
Program: Key elements of the CIHR Teams’ projects rely on developing
PREVENTION AND CONTROL IN CANADA’S NORTH community partnerships. The NJM Library provides services to
E. Du Plessis, S. Shaw, L. Thompson, C. Sevenhuysen, M. Fast enhance the skills of community-based researchers, giving more
National Collaborating Centre for Infectious Diseases equitable access to the professional literature similar to that enjoyed
by most Canadian academic researchers. Librarians provide
Introduction: Public health program and policy planning are often very
consultation, research and information services to enhance knowledge
specialized, focusing on one pathogen or population. The conceptual
translation, scholarly communication, open access initiatives and
integration of public health services happens naturally, if not by design,
evidence-based practice.
in communities or regions with relatively small populations (and a
limited number of health service providers) and innovative, integrated Conclusion: The NJM Library provides outreach services to community
approaches may better reduce infectious disease threats. Practitioners partners including literature searches, document delivery, and training
in northern and remote communities experience numerous in using open access databases like PubMed. Providing library services
geographic, administrative, and social conditions which influence their at no-cost to the end user enhances partnership building, creating
response to public health threats. Although some features are unique more equitable relationships between academic researchers and
to specific communities, many are common to several regions due to community partners. Partnerships between academics and
natural or historical linkages. Sharing program and practice tools community-based researchers are found in most Canadian universities.
among regions and agencies promotes knowledge translation and Academic libraries have a role to play in supporting the information
needs of all researchers involved in such exciting partnerships.
Contact: Janice Linton (janice_linton@umanitoba.ca)

CADTH’S HEALTH TECHNOLOGY INQUIRY SERVICE
L. Dunfield
A FOLLOW-UP STUDY OF BLOOD LEVELS OF PERSISTENT Canadian Agency for Drugs and Technologies in Health
TOXIC SUBSTANCES (PTS) AMONG INDIGENOUS PEOPLE
The Health Technology Inquiry Service (HTIS) was officially launched
OF THE COASTAL CHUKOTKA, RUSSIA, 2001-2007
by the Canadian Agency for Drugs and Technologies in Health
1 1 2 2 1
A. Dudarev , V. Chupakhin , J.O. Odland , L.O. Reiersen , V. Chashchin (CADTH) in February 2005 to meet the needs of Canadian health care
1
Northwest Public Health Research Center, Russian Federation, 2AMAP decision makers. While comprehensive HTA reports are used to
Secretariate, Norway support many important deliberations, the urgency of some decisions
requires a more immediate response. The goal of HTIS is to provide
Data obtained during the Russian Arctic PTS study in 2001-2002
evidence-based information in a quick and efficient manner.
revealed the highest (for the Russian North) levels of PCBs and some
other POPs in the blood of indigenous populations of the coastal HTIS reports can be completed in 24 hours to 90 days. The types of
Chukotka (AMAP 2004, 2009). It is well known that many POPs and reports include a list of references (completed in 24 hours to five
some metals easily cross the placental barrier and are excreted into the business days), a summary of abstracts (10 business days), a summary
breast milk. A follow-up study was undertaken during 2007. The report with critical appraisal (30 business days), and a peer-reviewed
possible influence of breast feeding duration on maternal POPs blood systematic review (90 days).
serum levels has been assessed as well as the potential impact of the HTIS responds to inquiries about drugs, medical devices, diagnostic
children`s POPs blood serum levels on the frequency of infectious tests, and medical and surgical procedures from Canadian health care
diseases. decision makers in the federal government, provincial health
Materials and Methods: Individual data on PTS levels of blood samples ministries, hospitals, regional health authorities, and Local Health
from 17 mothers and cord blood from their 17 babies born in two Integration Networks. Each response is tailored to the specific needs of
settlements (Lorino and Lavrentiya) of Chukotka coastal area in the the requestor.
period August 2001 - February 2002 were compared with PTS levels in Feedback is gathered from the requestors to determine how reports
blood sampled from the same women and their 5-year old children in were used in decision making. Users of the service indicate that HTIS
2007. Chemical analysis of all samples was performed in the “Typhoon” has met their decision making needs when information is required in
laboratory (Obninsk, Russia), having international accreditation short timeframes. HTIS reports have been used to make decisions
according to standard procedures. Data on maternal and child health about purchasing medical equipment, to determine coverage of
were collected from the mother’s medical files, newborn’s delivery specific pharmaceuticals, and to make policy changes.
records and questionnaires of the mothers.
Since the service began, HTIS has responded to over 1000 inquiries.
Results and conclusions: Maternal blood serum levels of POPs have The service has grown substantially, and almost 300 of those requests
generally decreased significantly in 2007 compared with corresponding were completed from April 1, 2008 to December 31, 2008.
levels in 2001-2002. Reduction of total PCBs was 43.8% (average from Contact: Lesley Dunfield (LesleyD@cadth.ca)
3.52 to 1.98 mcg/L serum), of merged PCB congeners 29.8-48.2%,
oxychlordane 73.5%, trans-nonachlor 72.3%, mirex 43.1%, total HCH
33.1%, HCB 18.9%, total DDT 72.0%. However, the ratio 44DDE/44DDT EVALUATION OF HELICOBACTER PYLORI INFECTION IN
did not change, but remained about 12. Maternal blood levels of lead PATIENTS WITH PATHOLOGY OF THE GASTROINTESTINAL
decreased 21% while the average mercury level was the same. Children TRACT
blood serum levels of POPs generally have increased significantly in A.V. Efremova, A.V. Struchkova, A.S. Golderova, G.E. Mironova
2007 in comparison with corresponding cord blood serum levels in
2001-2002, except oxychlordane and 44DDT which dropped by about Establishment of RAMS, Yakutsk Research Center of complex medical
30% each. Increment of total PCBs was 132.1% (average from 1.43 to problems SB RAMS
3.33 mcg/L serum), of merged PCB congeners 88.2-161.6%, trans- According to P.M. Ivanova (2003) in the country every second revealed
nonachlor 14.3%, mirex 27.8%, total HCH 89.7%, HCB 72.4%, total DDT a tumor in men (45.1%) and third in women (32.4%) is localized in the
13.1%, the ratio 44DDE/44DDT 84% (from 10.6 to 19.5). Children blood digestive system, which confirms the high frequency of malignant
levels of lead did not change, remaining 38 mcg/L whole blood, while tumors of Gastroenterology located in the North and Aboriginal
the average mercury level decreased by 31.4%. During 5 years the patients with non-ethnic long-term stay at high latitudes.
levels of POPs in maternal blood serum generally have decreased so Chronic gastritis in many cases is accompanied by atrophy iron
that the levels of some organochlorines in 2007 became similar to that machine, which belongs to the background illness or “precancerous
observed in cord blood in 2001. Vice versa - the levels of POPs in conditions”, prior to the development of stomach cancer. We know
children blood serum are generally much higher than cord blood serum that gastric cancer often occurs against a background of atrophic
levels and in 2007 the levels of some organochlorines became similar to gastritis and the risk of significantly higher in patients with severe
the maternal levels of 2001. Of 17 women (Chukchi ethnicity) with atrophy of gastric mucosa than in those with unmodified mucous
average age 30,7 years in 2007 (range 22-39 years) 13 women already membranes. The important role given to Helicobacter pylori, chronic
had children born before 2001 (7 of them had more than one child). gastritis with calling the outcome of atrophic and is a carcinogen 1 st
Eight women gave additional births during 2002-2007 (2 of them more group.
than once), all except one breastfed during the 2001-2007 period
The purpose of the study to identify the degree of Helicobacter pylori
(average duration 24.4 months, range 1-72 months). All 17 children
infection with various forms of pathology of gastrointestinal tract.
born in 2001-2002 had infectious diseases (mostly acute respiratory)
during 2001-2007, in average 4.8 events per year (range 0.9-9.6 We conducted a study to identify the antibody H. pylori in 70 patients
incidents). No associations of breast feeding duration with maternal (55 women, 15 men) aged 30-50 years with various forms of pathology
POPs blood serum levels have been found. No correlation between of the gastrointestinal tract.
children’s POPs blood serum levels with infection frequency has been In the study of Non-invasive method used for determining the
derived. Further amplification of the study cohort will add more presence of antibodies to H. pylori in the serum of patients by ELISA.
statistical power. Among the surveyed patients, 50 people found the picture of chronic
Contact: Alexey Dudarev (dudarev@sznc.ru)
superficial gastritis, in 15 patients - atroficated form of gastritis, peptic
ulcer disease was found in 5 cases. Hp (+) - positive results were
observed in all (100%) patients, and in cases of superficial gastritis
results were 18% medium and 82% - a high degree of infection. In
132 POSTER SESSIONS: D E F
atrophic gastritis with 75% of Np (+) the result of a high degree of Conclusions: These data highlight specific nutrients and foods to be
infection. In patients with peptic ulcer disease in 80% of Np (+) was targeted by a nutritional intervention program (Healthy Foods North)
characterized by a high degree of infection. Thus, gelikobakterial to reduce risk of chronic disease among the Inuvialuit.
infection among surveyed patients with various forms of pathology of Acknowledgements: The research was supported by the American
the gastrointestinal tract was high and is a major risk factor for Diabetes Association Clinical Research Award Grant # 1-08-CR-57.
onkopatology that requires a serious approach to the prevention and Contact: Eva Erber (sangita_sharma@unc.edu)
treatment of these diseases.
Contact: Agrafena Efremova (oslik007.82@mail.ru)
CARDIOVASCULAR REACTIONS IN HYPERTENSIVE

PERSONS IN THE FAR NORTH
EVALUATING THE TOXIC EFFECTS OF METHYLMERCURY
ON NEUROTROPHIN CONFORMATION T.K. Erdakova, L.V. Salamatina
J. Eibl State Scientific Research Institute on Medical Problems of the Far North
of RAMS
Northern Ontario School of Medicne
Cardiovascular reactions play a great role in development of adaptive
Methylmercury is a common industrially-derived environmental mechanisms in hypertensive persons in the Far North. In order to study
neurotoxicant that is detrimental to the development and physiology these reactions, we examined 109 hypertensives (arterial hypertension,
of the nervous system. One possible mechanism for methylmercury’s stage I-II; mean age – 41,5±8,3 years; duration of arterial hypertension
toxicity stems from its ability to interfere with the signaling of the – 7,1±5,2 years; period of residing in the Far North – 23,2±6,2 years).
neurotrophins nerve growth factor (NGF) and brain-derived These people were divided into 2 groups – the first group comprised 39
neurotrophic factor (BDNF). It has been proposed that persons who lived in circumpolar region less than 10 years. The second
methylmercury’s effects may be due to either; (1) alterations in group included 68 persons, who resided in high latitudes more than 10
neurotrophin levels, or (2) abnormalities in cell signaling due to altered years. Control group comprised 38 practically healthy persons. All
neurotrophin-receptor interactions. It has previously been persons underwent exercise test; hemodynamic parameters were
demonstrated that metal ions such as Zn2+, Cu2+ and Hg2+ directly assessed by “Vivid-7” (USA). In group of healthy people cardiac index
alter the conformation of NGF and BDNF, decreasing their ability to (CI) was 2,5-3,5 l/min/m2; 26,3% of persons had hyperkinetic
bind the neurotrophin receptors and potentiate intracellular signals. It hemodynamic type, 52,6% – eukinetic type, 21,1% – hypokinetic type.
has also been demonstrated that metalorganics such as In hypertensives these types were revealed in 48,5%, 29,0% and 22,5%
methylmercury inhibit neurtorophin signaling receptor as measured by respectively. During exercise test statistically significant increase of CI
a decrease in Trk phosphorylation. In this study, we examine the effect and decrease of total peripheral vascular resistance (TPVR) were
of methylmercury to determine if it interferes with neurotrophin registered. In healthy persons, who had hyper- and eukinetic
signaling in a manner similar to Hg2+, or if it occurs via an alternate hemodynamics, CI became 29-35% higher and TPVR – 39% lower when
mechanism. Our findings indicate that although MeHg inhibits compared to baseline. At hyperkinetic hemodynamic type both indices
neurotrophin signaling, its toxic effects are not mediated via an changed for 35%. In hypertensive patients, independently on their
induced conformational change, as seen with other metal ions, hemodynamic type, TPVR fell insufficiently towards raised CI. This gap
including Hg2+. reached maximum in the second group of hypertensive patients – we
Contact: Joseph Eibl (joe.eibl@normed.ca)
registered 49% CI rise (p<0,05) and 18% TPVR fall (p<0,01) in
comparison to the patients of the first group. It is apparent from the
ASSESSMENT OF DIETARY INTAKE IN AN INUVIALUIT present study that along with prolongation of period of a man’s
residing in the Far North, discrepancy between CI and TPVR at exercise
POPULATION: RESULTS FROM HEALTHY FOODS NORTH
tests rise.
E. Erber, E. De Roose, S. Reaburn, S. Biggs, L. Beck, J. Gittelsohn, S. Contact: T.K. Erdakova (hypertonia@yandex.ru)
Sharma
University of North Carolina at Chapel Hill, Nutrition Research Institute,
ENDOTHELIAL DYSFUNCTION AND MYOCARDIAL
Kannapolis, NC
REMODELING IN HYPERTENSIVE PATIENTS IN THE FAR
Objective: To describe current dietary intake of adult Inuvialuit using 24
NORTH
hour recalls.
T.K. Erdakova, L.V. Salamatina
Setting: One remote Inuvialuit community in the Northwest Territories,
Canada. State Scientific Research Institute on Medical Problems of the Far North
of RAMS
Methods: Adult Inuvialuit were enrolled in a cross-sectional, random
household dietary study and completed up to three 24h recalls each. Assessment of contribution of endothelial dysfunction (ED) to
Mean daily energy and nutrient intake, most commonly reported processes of myocardial remodeling is of prime importance, as it
foods, and foods contributing to energy and nutrients were analyzed enlarges our understanding of pathogenic mechanisms of arterial
using NutriBase clinical nutrition manager and SAS statistical software. hypertension development in unfavorable climatic conditions. 113
hypertensive patients (arterial hypertension, stage I-II) were examined.
Results: Fourteen men and 49 women (n=63) aged 19-74 years
Mean age – 43,0±8,2 years, duration of arterial hypertension – 7,1±5,5
completed the 24-hour dietary recalls with a response rate of
years, period of residing in the Far North – 23,8±9,8 years. The patients
approximately 70-90%. Mean daily intake of energy was higher than
were divided into 2 groups in dependence on the results of
recommended in men (2,777 kcal) and women (2,457 kcal). The dietary
endothelium-dependent vasodilatation test (Celermajer D.S.). The first
recommendations were not met for many nutrients for men and
group comprised 55 hypertensives with normal endothelial function
women. For example, intake of iron did not meet the recommendation
(NEF), the second one included 58 hypertensive persons who showed
for 69% of women, dietary fibre (92%), vitamin A (91%), vitamin C
ED. All the patients underwent echocardiography (“Vivid-7”, USA). The
(66%), vitamin D (80%), vitamin E (98%), folate (84%), and calcium
changes in spherical form of left ventricle in both groups were
(96%) did not meet the dietary recommendations for both sexes.
represented by statistically significant increase in interventricular
Although consumption of traditional foods was low, these nutrient-
septum thickness and left ventricular posterior wall thickness (p<0,05).
dense foods did contribute significantly to intake of energy, fat, and
These parameters grew along with prolongation of period of a man’s
calcium. Sweetened juices and drinks were the main contributor to
residing in the Far North. Left ventricular mass index (LVMI) in patients
total energy, carbohydrates, and sugar.
of the second group who lived in high latitudes more than ten years
was statistically higher than LVMI in patients of the first group, who
resided in circumpolar region less than ten years. In order to prove the module (E) were significantly lower; distensibility coefficient (DC) and
previously described facts we analyzed the frequency of different types cross-sectional compliance (CC) were higher than in the main group. b
of myocardial remodeling in these groups. Left ventricle hypertrophy coefficient increased along with age, thus in persons younger 29 years
was revealed in 88,8% of hypertensives with ED, who lived in high it was 6,01±3,09, at the age of 30-39 years – 7,29±3,01, 40-49 years –
latitudes more than ten years, among them 66,6% had concentric type 8,26±4, 50 years and more – 10,19±3,71 (p<0,05). For DC, CC and E
22,2% - eccentric type of hypertrophy. In hypertensive patients with statistically significant variations in different age groups were not
NEF, who resided in the Far North less than ten years, we registered defined. Resiliency indices of carotid vascular wall were analyzed in
concentric remodeling in 57,7%, concentric hypertrophy - in 24,0% and dependence on period of a patient’s residing in the Far North. In
eccentric hypertrophy - in 19,2%. The data presented in this study hypertensives, who lived in high latitudes more than 10 years,
indicate that endothelial dysfunction contributes greatly to processes significant increase in E and b indices was stated, when compared to
of myocardial remodeling in hypertensive patients in the Far North. those of people, residing in the Far North less than 10 years. (E–
Contact: T.K. Erdakova (hypertonia@yandex.ru) 629,61±295,32 and 439,21±238,21 kPa respectively, p<0,05; b –
8,53±3,76 and 6,34±3,23 respectively, p<0,05). DC and CC, on the
contrary, decreased in hypertensives, who lived in high latitudes more
INTERCONNECTION OF CARDIAC STRUCTURAL- than 10 years, when compared to the same indices in people, who
FUNCTIONAL CHANGES IN HYPERTENSIVE PATIENTS IN stayed in the Far North less than 10 years. DC – 21,23±8,02 and
THE FAR NORTH 28,18±12,32x10-6Pa-1 respectively, p<0,05. CC – 8,73±3,21 and
T.K. Erdakova, L.V. Salamatina 12,10±4,91x10-7m2/Pa, respectively, p<0,05. Conclusion: Resiliency
indices of vascular wall in hypertensives worsen along with
State Scientific Research Institute on Medical Problems of the Far North
prolongation of period of a man’s residing in unfavorable conditions of
of RAMS
the Far North.
Aim of the research was to study the ways of interconnection of Contact: T.K. Erdakova (hypertonia@yandex.ru)
cardiac structural-functional changes in hypertensives residing in the
Far North. 113 hypertensive patients (arterial hypertension, stage I-II)
were examined. Mean age – 43,0±8,2 years, duration of arterial FACTORS THAT INFLUENCE THE BIOCHEMICAL
hypertension – 7,1±5,5 years, period of residing in the Far North – CHARACTERISTICS AND HORMONES OF HYPOPHYSEAL-
23,8±9,8 years. All the patients were divided into 2 groups in THYROID-ADRENAL SYSTEM OF MEN
dependence on their period of living in high latitudes – the 1-st group R. Fedina
(n=42) – less than 10 years and the 2-nd group (n=71) – more than 10
years. By ultrasound examination (“Vivid-7”, USA) the following indices State Educational Institution of Higher Professional Education,
were defined: interventricular septum thickness (IVST), left ventricular Novosibirsk State Medical University
posterior wall thickness (LVPWT) and diastolic function (duration of The purpose of the investigation: to determine the most significant
isovolumic relaxation phase and structural index of active relaxation, factors that influence the biochemical and hormone characteristics of
known as a ratio of time of acceleration of early left ventricle filling to hypophyseal-thyroid-adrenal system of men (HTAS).
period of isovolumic relaxation). It is known, that increased thickness The biochemical and hormone characteristics of HTAS in the
of myocardial walls contributes to prolongation of isovolumic population sample from 1058 almost healthy donor men at the age of
relaxation phase. Thus, in hypertensives referred to the 1-st group, 18-60 in the Novosibirsk megapolis were studied comprehensively. The
correlation coefficient between duration of isovolumic relaxation hormone status was determined using a radioimmunoassay technique;
phase and IVST at diastole was equal 0,3 (p<0,01), between duration of protein, carbohydrate and lipid metabolisms, by biochemical methods.
isovolumic relaxation phase and LVPWT at diastole – 0,28 (p<0,01). In The parametric Student t-criterion and nonparametric Wilkinson-
the 2-nd group this dependence appeared to be weak and was revealed Mann-Whitney testing were applied. A multifactor variance analysis
only for IVST (r=0,2; p<0,05). A ratio of time of acceleration of early left revealed 15 factors that influence the biochemical characteristics and
ventricle filling to period of isovolumic relaxation in both groups hormones of HTAS. The comparison of biochemical characteristics
changed in stereotype way; the strongest changes were revealed in (crude protein, common lipids, total cholesterol, triglycerides, glucose,
people, suffering isolated interventricular septum hypertrophy with unesterified fatty acid, and lipid peroxidation) and hormones
concentric left ventricular hypertrophy and eccentric hypertrophy with (adrenocorticotropin, somatotrophic hormone, adrenocortical
left ventricular dilatation. Weight of relaxation which took part in left hormone, triiodothyronine, thyroxine, and thyrotropic hormone)
ventricle filling at diastole, dropped along with progression of left makes it possible to find the significant differences among the donors
ventricle hypertrophy, independently on period of living in the Far (p > 0.003) who live in “clean” and “dirty” districts. Insufficient stability
North. Thus, processes of structural-functional remodeling in to the urbanization factors starts to manifest at the age of 18-19.
hypertensive patients in the Far North are closely interconnected.
Contact: T.K. Erdakova (hypertonia@yandex.ru)
The social-economic conditions in combination with ecological factors
require the extreme tension of adaptive biological and
psychoemotional mechanisms. The combination and summation of
RESILIENCY OF VASCULAR WALL IN HYPERTENSIVE different stress vectors under present conditions of life activity make
PATIENTS IN THE FAR NORTH regulatory components of men adaptation vulnerable. This leads to the
fast waste of reserves and dysaptation, first of all, of functionally
T.K. Erdakova, L.V. Salamatina
deficient components in the organism, as well as the rapid progress of
State Scientific Research Institute on Medical Problems of the Far North diseases, and the lower lifetime of Russia men. The main factors that
of RAMS influence the biochemical characteristics and hormones of HTAS are as
Aim of the research was to study structural-functional changes of follows: age, ecological conditions, and duration of living under such
vascular wall in hypertensive patients residing in the Far North. 69 conditions, year season, tobacco smoking, and alcohol drinking.
hypertensives, referred to main group, were examined (mean age Therefore, the obtained data can be used to examine men, to make
43,08±8,26 years, duration of arterial hypertension – 8,17±5,54 years, prognosis as well as to reveal persons with risk factors, as well as a
period of residing in the Far North – 21,83±9,88 years.). Control group regional norm for men in Novosibirsk.
included 19 practically healthy persons. Parameters of carotid elasticity Contact: Roza Fedina (froza@ngs.ru)
were defined by O’Rourke’s recommendations during duplex
ultrasound scanning (“Vivid-7”, USA). 24-hour profile of blood pressure
was registered by “AND” system (Japan). In control group resiliency
indices of carotid vascular wall – rigidity coefficient (b), Young’s
134 POSTER SESSIONS: G H I
AH - 41,2 %, p<0,05) . In too time at hostility of distinctions between

GHI groups it is not determined.
Conclusion: Received results testify to interrelation AH in a population
SLEEP DISTURBANCE AND RISK CARDIOVASCULAR with psychosocial factors and once again emphasize importance of
DISEASES THE PERIOD OF 10 YEARS IN MEN 25-64 YEARS their correction
OF AGE IN RUSSIA
V. Gafarov, E. Gromova, I. Gagulin, A. Gafarova, D. Santrapinsky, Y.
Kabanov AVERAGE LEVELS OF ARTERIAL PRESSURE AND
Collaborative Laboratory of Epidemiology CVD SB RAMS PSYCHOSOCIAL FACTORS IN MALES AGED 25-64 YEARS IN
RUSSIA (WHO MONICA-PSYCHOSOCIAL PROGRAM)
Purpose of the study: To study influence of sleep disturbance on risk of
occurrence of cardiovascular diseases (CVD) at men of 25-64 years. V. Gafarov, E. Gromova, Y. Kabanov, D. Panov, I. Gagulin, A. Gafarova
Methods: Within the framework of program WHO “ MONICA- Collaborative Laboratory of Epidemiology CVD SB RAMS
psychosocial” was representative sample of men of 25-64 years is Purpose: To study connection of average levels of arterial pressure
surveyed 1994 (657 persons) . Sleep disturbance were measured at (ALAP) with psychosocial factors at men in the age of 25-64 years in
baseline with the use of the MONICA - psychosocial Interview Sleep Russia.
Disturbance scale. The incidence new arterial hypertension (AH),
Methods: A random representative sample of males (a total of 2149
myocardial infarction (MI) and stroke were ascertained under
individuals) aged 25 to 64 years from one districts of the city
systematic surveillance the 10-year follow-up (1994-2004). Cox -
Novosibirsk was examined within the framework of the screening of
proportional regression model was used for an estimation of relative
the WHO “MONICA-psychosocial program” (“MOPSY”)
risk (RR).
(1984,1988,1994). The following psychosocial methods were used: the
Results: Sleep disturbance was in 9,1 % men with new incidence AH, in test “MOPSY” (depression (D), a vital exhaustion (VE), hostility (H),
18,4 % men with new incidence MI and, 29,4 % men with new sleep disturbance); test Berkman-Syme (social support - index of close
incidence stroke. The risk of occurrence CVD in men with sleep contacts (ICC) and index of social connections (SNI)); Spilbergers test
disturbance within 5 years was the following: for AH - in 5,4 times for estimation personal anxiety (PA)
more, for MI - in 2,4 times more (p < 0,05) and for stroke - in 3,9 times
Results: ALAP in a man’s population with age grow and achieve a
more (p < 0,01) in comparison with men non sleep disturbance. During
maximum in the most senior age group (25-34 years old; systolic
10 years periods the risk of occurrence CVD in men with sleep
arterial pressure (SAP) - 125 m.Hg; diastolic arterial pressure (DAP) - 82
disturbance has decreased and has made: for AH - in 2,3 times, for MI -
m.Hg; 55-64 years - the SAP - 149 m.Hg; DAP- 89 m.Hg). The tendency
in 2,6 time, for stroke - in 2,7 times is higher in comparison with men
is marked: 1. more high levels the SAP and DAP at sleep disturbance,
who marked quality of sleep as satisfactory or good.
than at good sleep (138 m.Hg and 86 m.Hg; 131 m.Hg and 84 m.Hg
Conclusion: The received results testify that sleep disturbance, first of accordingly); 2.in lower levels the SAP and DAP at high values of
all, the problem social and doing the powerful contribution to risk of indexes of social support - an ICC (low ICC - SAP - 134 m.Hg; DAP - 86
occurrence of cardiovascular diseases at men. m.Hg., high ICC - SAP - 131 m.Hg; DAP - 84 m.Hg) and an SNI (low SNI
Contact: Valery Gafarov (gafarov@ngs.ru) - SAP - 135 m.Hg; DAP - 86 m.Hg; high SNI - SAP - 132 m.Hg; DAP - 85
m.Hg) . Authentic connection ALAP is precisely defined and: 1.
personal anxiety (PA) (high PA - SAP - 134 m.Hg; DAP - 86 m.Hg; lower
ARTERIAL HYPERTENSION AND PSYCHOSOCIAL FACTORS
PA - SAP - 123 m.Hg; DAP - 81 m.Hg); 2. VE (high VE - SAP - 135 m.Hg;
IN MALES AGED 25-64 YEARS IN RUSSIA (WHO MONICA- DAP - 88 m.Hg; is not present VE - SAP - 128 m.Hg; DAP - 83 m.Hg);
PSYCHOSOCIAL PROGRAM) 3.D (big D - SAP - 135 m.Hg; DAP - 86 m.Hg; is not present D - the SAP
V. Gafarov, E. Gromova, Y. Kabanov, A. Gafarova, D. Panov - 132 m.Hg; DAP - 85 m.Hg). In too time at H a little bit other picture - is
Collaborative Laboratory of Epidemiology CVD SB RAMS observed at high levels H the SAP a little bit below, and DAP is higher,
than at its absence (high H - SAP - 131 m.Hg; DAP - 86 m.Hg; is not
Purpose: To study connection of arterial hypertension (AH) with present H - SAP - 132 m.Hg; DAP - 84 m.Hg).
psychosocial factors (PF) at men in the age of 25-64 years in Russia.
Conclusion: The received results testify to close connection of ALAP
Methods: A random representative sample of males (a total of 2149 pressure in a population with psychosocial factors. In this connection,
individuals) aged 25 to 64 years from one districts of the city one of the main ways of correction arterial pressure in a population, is
Novosibirsk was examined within the framework of the screening of correction of psychosocial factors.
the WHO “MONICA-psychosocial” program (“MOPSY”) Contact: Valery Gafarov (gafarov@ngs.ru)
(1984,1988,1994). The following psychosocial methods were used: the
test “MOPSY” (depression (D), a vital exhaustion (VE), hostility (H),
sleep disturbance); test Berkman-Syme (social support - index of close EPIDEMIOLOGY OF INVASIVE BACTERIAL DISEASES IN
contacts (ICC) and index of social connections (SNI)); Spilberger’s test NORTHERN CANADA, 1999 TO 2007
for estimation personal anxiety (PA) For AH accepted the arterial M. Helferty, S. Desai, M. Garner, T. Leung, Canadian International
pressure > 140/90 m.Hg. Circumpolar Surveillance Working Group*
Results: Determined, that persons with AH have tendencies: 1.in higher Public Health Agency of Canada
parameters of “average”, “bad” sleep, than “very good” and “good”
(40,8 %, 8,7 % and 32,4 %, 4,4 %, p<0,001, accordingly) 2.in lower Background: Since 1999, the northern regions of Canada (Northwest
values of indexes of social support - (a low ICC with AH - 65,1 %, Territories, Yukon, Nunavut, Northern Quebec, Northern Labrador)
without AH - 55,4 %, p<0,01) and SNI (low SNI with AH - 45,1 %, have participated in the International Circumpolar Surveillance (ICS)
without AH - 39,6 %, p<0,05) 3. in increase of a parameter of PA (with network, a population-based invasive bacterial surveillance network of
AH - 52,3 %, without AH - 46,2 %, p<0,05). Authentic connection AH is circumpolar regions, which includes: USA (Alaska), Denmark
precisely determined with:1. education, achieving a maximum of (Greenland), Iceland, Finland, Norway and Sweden. The organisms
distinctions at an initial education (initial : with AH - 25,1%, without AH under surveillance are Streptococcus pneumoniae (Sp) Group A
- 15,0%, p<0,05) 2.an professional level (heads with AH - 1,9 %, Streptococcus (GAS), Group B Streptococcus (GBS), Haemophilus
working trades - 10,7 % p<0,001) 3. with VE (a high level of VE: with AH influenzae (Hi), and Neisseria meningitidis (Nm).
- 16,6 %, without - 10,3 % p<0,05) 4.with D (with AH - 55,3%, without
POSTER SESSIONS: G H I 135
Purpose: To describe the epidemiology of diseases reported through Russia (1,94 ± 0,17 and 1, 44 ± 0,13 is revealed, expediently, at p
ICS from 1999 to 2007. <0,035). The obtained data of the preliminary analysis of inflammatory
Methods: Cases are reported to health regions by the laboratory or markers at patients IHD testifies to distinction depending on an ethnic
physician. A communicable disease officer completes a surveillance accessory which demand the further studying.
Contact: Aitalina Golderova (hoto68@mail.ru)
report form. Isolates are sent to a reference laboratory for serotyping
and antimicrobial resistance testing. The completed form, which
includes both laboratory and epidemiologic information, is sent to the A MEASURE OF RURAL PARTURIENT WOMEN’S
Public Health Agency of Canada.
EXPERIENCES OF PREGNANCY
Results: A total of 519 cases were reported: 323 cases of Sp, 88 cases of
S. Grzybowski
Hi, 77 cases of GAS, 20 cases of GBS and 11 cases of Nm. Over 60% of
all cases reported to ICS were Sp. In children < 2 years of age were Rural Maternity Care New Emerging Team (RM-NET), Centre for Rural
56.7% of Sp cases were serotypes included in the pneumococcal Health Research, UBC Family Practice
conjugate vaccine (PCV-7). The majority (95%) of Hi cases were among Background: Rural maternity services have eroded in British Columbia
Aboriginal people. Fifty percent of Hi cases were type a; 68.2% of Hi over the past decade. The centralization of health care has led to the
cases were among children < 2 years. Incidence rates of invasive GAS closure of 17 maternity centres in rural communities across the
for the surveillance period ranged from 1.5/100,000 to 13.5/100,000. province since 2000. As a result, rural women are obligated to travel to
Sporadic cases of invasive GBS and Nm were also reported. tertiary care centres to receive obstetric care.
Conclusions: Active surveillance that includes both laboratory and Objectives: 1) To validate a stress survey against existing stress
epidemiologic information remains important for early recognition of measures and 2) To measure stress in rural parturient women from
invasive bacterial diseases patterns. This information is used in the communities with and without local access to maternity services.
formulation of prevention and control strategies, including Methods: The survey has been validated against the Depression
immunization recommendations, and for monitoring and evaluating Anxiety Stress Scales (DASS). The second phase of this research is
current and recently implemented immunization programs. underway and to date, we have distributed over 500 surveys to rural
* The Canadian International Circumpolar Surveillance Working Group women.
includes the following members: Yukon (R. Robertson), Northwest Findings and Significance: The R value is 0.34, and this indicates a
Territories (C. Case, N. Fraley), Nunavut (C. Ogbuneke), Quebec (R.Carlin, reasonable concordance with the existing stress measures. Survey data
J.-F. Proulx), Newfoundland and Labrador (M. ar-Rushdi), Laboratoire de collection is still underway. Analysis will be completed prior to the
santé publique de Québec (R.A. Laurence), National Centre for conference. We will organize our findings according to Maslow’s
Streptococcus (M. Lovgren, G. Tyrrell), National Microbiology Laboratory Hierarchy of Needs, as outlined in the “Theory of Human Motivation”.
(R. Tsang), Public Health Agency of Canada (M. Helferty, S. Desai), and These themes include access to obstetrical care; the need for security,
the Arctic Investigations Program, U.S. Centers for Disease Control (M. stability and predictability during pregnancy; social support during
Bruce, T. Zulz) pregnancy; actualization of vision of ideal pregnancy; and self
Contact: Michael Helferty (melissa_helferty@phac-aspc.gc.ca)
actualization.
Contact: Stefan Grzybowski (sgrzybowski@interchange.ubc.ca)
INFLAMMATORY MARKERS FOR PATIENTS WITH ISCHEMIC

HEART DISEASE (IHD) AFFECTED BY CONDITIONS IN PLANNING THE OPTIMAL LEVEL OF LOCAL MATERNITY
YAKUTIA SERVICE FOR SMALL RURAL COMMUNITIES: A SYSTEMS
A.S. Golderova, C.D. Efremova, E.A. Alexeeva, A.N. Romanova STUDY IN BRITISH COLUMBIA
Establishment of RAMS, Yakutsk Research Center of complex medical S. Grzybowski, J. Kornelsen, N. Schuurman
problems SB RAMS. Rural Maternity Care New Emerging Team (RM-NET), Centre for Rural
Research of some authors are established that for Yakuts smaller Health Research, UBC Family Practice
frequency and the area of atherosclerotic defeats, and also “the slowed Background: Over the past 10 years, 17 rural maternity services have
down” rate of development of an atherosclerosis in comparison with closed in British Columbia. Similar closures have occurred across rural
unradical inhabitants. In our day, we’d received some facts about a Canada. A review of the policy literature demonstrates no systemic
considerable role of an inflammation in mechanisms of development of planning strategy defining appropriate and optimal maternity services
an atherosclerosis. It is known that citokins regulate intercellular for rural communities.
interactions, support a system and local inflammation in an
atherosclerotic plaque. A research objective – the comparative Goals and Objectives: To develop and apply a population isolation
characteristic of the maintenance of inflammatory markers at patients model to define the appropriate level of maternity service for rural
IHDin dependence about a national identity. 72 men (Yakutsk - 35, communities in British Columbia, Canada.
Russia - 37) with verified diagnosis IHD at the age from 45 till 67 years Methods: Iterative, mathematical model development supported by
which were in cardiological branch of Clinical centre RB - 1 - NCM have extensive multi-method research in 23 rural and isolated communities
been surveyed. In way of blood sick by a method immunofermated in British Columbia, Canada, which were selected for representative
analysis have been defined level of C-reactive protein (CRP), variance in population demographics and isolation.
proinflammatory cytokines - TNFα, IL-6, IL-1b, γ-IFN, antibodies A, M Findings/Significance: Main outcome measure was the Rural Birth Index
and G (sets of firm of Joint-Stock Company “the Vector-Best” (RBI) score for 42 communities in rural British Columbia. In rural
(Novosibirsk, Russia). Statistical processing has been spent with the communities with one-hour catchment populations of under 25,000,
using of package SPSS-11.5. At patients IHD depending on a the RBI score matched the existing level of service in 32 of 42 (76%)
nationality authentic distinctions are revealed under maintenance CRP. communities. Inappropriate service for the rural population was
At 78,8 % of Yakutsk of patients IHD level CRP exceeding “base” value postulated and supported by qualitative data available on 6 of the
of 5 mg ml whereas at Russia such values meet in 91,2 % is marked. At remaining 10 communities. The RBI is a potentially pragmatic tool to
comparison of both groups concentration CRP authentically above at help policy makers define the appropriate level of maternity service for
Russia, than in Yakutsk (9,7 ± 0,61 and 7,76 ± 0,56, expediently, p a given rural population. This model may be applicable to other health
<0,035). Level proinflammatory citokin IL-6 at Russia tends to increase service planning problems.
in comparison with Yakutsk (8,6 ± 1,7 and 5,3 ± 0,74 pg ml). Yakutsk Contact: Stefan Grzybowski (sgrzybowski@interchange.ubc.ca)
habitants have a high value of an antibody of M in comparison with
HYPERTENSION IN CHUKOTKA INDIGENOUS POPULATION RANGIFERINE BRUCELLOSIS ON SOUTHAMPTON ISLAND,

DURING THE LAST 20 YEARS NUNVUT
L. Gyrgolkau N.J. Harms, M. Campbell, B. Elkin, F.A. Leighton, K. Nielsen, W-L. Yu,
Institute of Internal Medicine SB RAMS A. Neimanis
Purpose: During the expeditions of 1983, 1991 and 2002 we three times University of Saskatchewan, Western College of Veterinary Medicine
studied the indigenous population of the Chukotka region. Brucella suis biovar, the causative agent of rangiferine brucellosis, is
Methods: In villages of Novoe Chaplino, Lorino, Sireniki, Yanrakynnot present in barren-ground caribou (Rangifer tarandus groenlandicus) and
live coastal aborigines, in a village Kanchalan with tundra aborigines. reindeer (Rangifer tarandus tarandus) herds across North America.
Using the method of random numbers we select 508 coastal aborigines However, until 2000, there was no evidence of the disease in barren-
and 159 tundra aborigines. The age of all subjects was from 25 to 64 ground caribou on Southampton Island, Nunavut. B.suis can cause
years old. Design of the study was cross-sectional. Blood pressure was abortion and has an affinity for the reproductive tract in caribou and
measured twice; results were adjusted to age and body mass index. reindeer; it is also a zoonotic disease which poses a potential human
health risk to people who are exposed to infected tissues during
Results: In the whole age group there were no gender differences in butchering or consumption of infected caribou. Over the previous eight
systolic, diastolic and pulse BP. By the age of 55 systolic, diastolic and years, routine serological testing of caribou on Southampton Island for
pulse BP increased, comparing with younger ages. antibodies to Brucella spp. has shown increasing numbers of
Comparing of the results of I (1983), II (1991) and III (2002) screenings seropositive caribou. In response to concern over potential effects of B.
shows the decrease in in average levels in systolic and diastolic BP in all suis infection on the reproductive success and health of caribou on
age groups. The number of hypertensive aborigines (BP 140/90) during Southampton Island, we evaluated reproductive tract lesions
this period decreased in men from 38% to 34%, in women from 42% to associated with B. suis infection in male and female caribou and
21%. Such dynamic is possibly connected with corresponding diagnosis examined the relationships between these pathologic changes, the
and treatment of hypertension. Thus, in 1983 only rare individuals had enhanced AMOS-PCR results from the reproductive tract tissue, and
taken anti-hypertensive medications, in 1991 - 4%, in 2002 - 10%. the serological evidence of Brucella spp. exposure. We found gross
Conclusion: Consequently, during the last years significantly increased reproductive tract lesions consistent with B. suis infection in 38.8%
awareness of indigenous Chukotka population about the hypertension, (29/75) of male and 4.2% (3/72) of female caribou. The reproductive
and also a number of aborigines receiving effective anti-hypertensive organs of a subset of male and female caribou were examined
treatment. histologically and tested for evidence of B. suis using AMOS-PCR. In
Contact: Larisa Gyrgolkau (ekaterina.t@iimed.ru) the males, 100% of animals with gross lesions had histologic lesions
and were positive for B. suis with AMOS-PCR. Though no gross or
histologic lesions were noted in the uterus or placenta of examined
FIERY AVENS GIRLS EMPOWERMENT GROUP pregnant females, 43.8% were positive for B. suis on AMOS-PCR.
M. Hall Histologic lesions were noted in 15% of non-pregnant females, and
60% were positive for B. suis on AMOS-PCR. These results indicate
Centre for Northern Families
that B. suis is present in the reproductive tracts of caribou on
“Empowerment is a broad thing, and invokes in me a lot of images. I Southampton Island, and may be a factor affecting the reproductive
think of a woman who taught me to make moccasins, Condoleeza Rice success of individual animals, the declining reproductive success of the
addressing the press. I think of my mother fighting for the under- herd, while also posing a zoonotic risk to humans who contact infected
privileged over many, long, hard years. I think of every mother who has animals.
had to balance the needs of her family on limited resources. I think of Contact: N. Jane Harms (naomi.harms@usask.ca)
girls skate-boarding and snowmobiling, my girlfriend beating up a guy
for making a rude, sexist comment... maybe that’s not the best
example?” CLIMATE CHANGE, WATER QUALITY, AND HUMAN HEALTH
In spite of all of these images we can draw upon of empowered IN NUNATSIAVUT, CANADA
females, how many of us are dogged by thoughts and feelings telling S. Harper1, V.L. Edge1,2, C. Wallace3, S.A. McEwen1
us that we aren’t good enough? That we aren’t strong enough? We are 1
Department of Population Medicine, University of Guelph, Guelph ON,
too fat, too thin, no one likes us. If we could change something about 2
Office of Public Health Practice, Public Health Agency of Canada,
ourselves we *would* be like those powerful women we see? Guelph ON, 3International Network on Water, Environment and Health,
Contemplate the powerful females around you (INCLUDING United Nations University, Hamilton ON
YOURSELF!). Take a picture, draw a painting, depict your vision of an Background: Generally it is suggested that climate change will cause
empowered female. changes in precipitation, runoff, and hydrological extremes which will
Fiery Avens is an empowerment group for girls initiated by young alter the environmental conditions that we live in. These ecological
women. Girls between 13-16 years of age meet on a weekly basis to changes might increase the risk and incidence of infectious disease. For
participate in activities that use traditional and contemporary creative example, heavy rainfall events, flooding events, and increased
arts to address social determinants of health. The group is peer led and temperature increase the risk of waterborne illnesses substantially.
provides a safe, supportive environment free of judgment where we Objectives: The main purpose of our study was to investigate
can network, gain confidence, build self-esteem and learn new skills. associations among weather patterns and drinking water quality and
Firey Avens has partnered with two national groups, Taking It Global a infectious gastrointestinal illness (IGI) outcomes in Nunatsiavut,
web based youth initiative that connects youth around the world and Canada. The main objectives of the study were to (1) compare water
the National Girls Power Camp, a Canadian girls group that has a quality variables with recorded weather events; (2) compare weekly
project specifically designed to involve northern girls in empowerment water quality and weather events with local health clinic records of IGI;
and community organizing activities. (3) provide the summary results in the form of educational material on
This poster presentation highlights the work of Fiery Avens. climate change, water quality, and health for local residents.
Contact: Mira Hall (mirahall@gmail.com) Methods: Meteorological stations provided weather and turbidity data
(objectives 1-2). Trained personnel conducted water quality testing
using Colilert® tests. Health data related to IGI was obtained from
retrospective (2005-2007) and prospective (2008) clinic records
(objective 2). Community members were encouraged to collaborate in
all phases of planning, implementation, assessment, and evaluation of stakeholder groups in Nunavut: researchers; policy- and decision-
this study. An interactive workshop for local high school students will makers; community members; and front-line health workers. This
show how data are collected and analysed, and encourage students’ approach has included: electronic communication via website and
participation in competitions to develop educational media for electronic mailing list, in English and Inuktitut; face-to-face meetings
communicating study results to the larger community (objective 3). including community visits and community consultations; a quarterly
Outcomes: Our study engages Inuit in a study that will use generated newsletter in English and Inuktitut; development of teaching resources
knowledge to create sustainable interventions, while developing the and delivering of community workshops on community-identified
community’s capacity to adapt and manage changes in water quality topics in northern health research; review of the literature on
due to a changing climate. Results from our study might inform policy knowledge sharing in the North and in Canada.
making decisions and help improve Inuit public health infrastructure. Findings: Evaluation of these initiatives in on-going. At this time we
Contact: Sherilee Harper (harpers@uoguelph.ca) have found: national and territorial organizations; researchers; and
non-governmental organizations make the greatest use of the
Qaujigiartiit web site and publications section; the electronic mailing
PREVALENCE, RISK FACTORS AND CONSEQUENCES OF list has been very helpful in sharing information and soliciting feedback
VITAMIN D DEFICIENCY AMONG INUIT CHILDREN from community members, front-line health workers, and other
J. Hayek, H. Weiler, Qanuippitali Steering Committee (Nunavut), G.M. stakeholders in Nunavut communities; face-to-face meetings and
Egeland workshops in Nunavut have been well-attended by community
McGill University members across the territory and have been the arenas where
knowledge sharing has been most effective between community
Rickets and hypovitaminosis D remain a public health concern in North members, health professionals, and policy-makers. They have been
America, and particularly among Aboriginal children living in the positive and exciting learning and sharing forums to date.
North. Age, winter season, higher body mass index, ethnicity, elevated
parathyroid hormone (PTH) concentrations, and low socio-economic Conclusion: A multi-pronged, creative and dynamic approach to
status have been associated with lower 25 (OH) D concentrations. knowledge sharing is necessary to ensure effective communication and
opportunities for knowledge sharing with different audiences in
The current research objectives were to: 1) assess vitamin D and PTH Nunavut. Knowledge Sharing is an essential part of northern health
levels of preschool Inuit children. 2) determine the incidence of vitamin research and Qaujigiartiit/Arctic Health Research Network-Nunavut is
D deficiency and insufficiency in preschool Inuit children. 3) identify playing a key role in the process.
which gender seems most at risk of vitamin D deficiency. 4) identify Contact: Gwen Healey (ahrn.nunavut@gmail.com)
risk factors for deficiency (time of year and socio-economic status);
and 5) evaluate the consequences of deficiency (slower growth and
lower bone mineral density (BMD) T-scores. EXPLORING PROCESSES IN HEALTH RESEARCH ETHICS IN
A total of 383 Inuit preschool Inuit children (3-5 years of age) CANADA’S NORTH
participated in the IPY Child Inuit Health Survey of Nunavut. A G.K. Healey1, J. Butler Walker2, S. Chatwood3
traveling child survey team conducted the research and included a 1
Qaujigartiit/Arctic Health Research Network- NU, 2Arctic Health
nurse, trained bilingual interviewers, a survey coordinator and lab Research Network – YU, 3Arctic Health Research Network – NT
technician/graduate student. Bone mineral density was assessed by
heel ultrasound. Dietary intake was assessed through the There exists a need throughout the North to increase capacity to
administration of a 24 hr dietary recall and a food frequency address issues of health research ethics, and in each territory, the
questionnaire, anthropometrics (height, weight) were assessed. Nurses needs are diverse.
collected venous blood samples from the children which were The goals of this project were to:
centrifuged on site and stored in -20o freezers until transported on ice - Develop a tri-territorial strategy for ethical review of health
to McGill University. Serum 25(OH) D and PTH were measured by research involving Indigenous peoples
Chemiluminesent technology (Diasorin, Liaison). - Conduct a survey of existing ethical guidelines and literature that
Results are embargoed until presentation to communities is completed are relevant to northern populations.
in May of 2009. Full details of results will be provided at the ICCH. The - Evaluate community capacity to provide input on ethical review
data indicated a high degree of deficient or sub-optimal levels of serum of health research projects by
25(OH) D among pre-school children and highlight the need for - To develop a draft of a Health Research Ethics Checklist for
interventions to improve vitamin D status among Inuit children. community proposal reviewers.
Contact: Jessy Hayek (jessyhayek@yahoo.com)
A review of literature and community ethical guidelines for health
research was conducted in 2007-08. Common themes in community
SHARING HEALTH RESEARCH KNOWLEDGE AMONG ethics across the territories revealed in the review were related to:
licensing; principles of respect – for communities and for researchers;
NORTHERN COMMUNITIES: A MULTI-PRONGED APPROACH
meaningful community engagement; the use of appropriate research
G.K. Healey methods; use of data and ownership, control, access and
Qaujigiartiit Arctic Health Research Network Nunavut protection/possession (OCAP) of data; sharing knowledge obtained
Introduction: Commonly, the concept of knowledge translation has from research.
been developed to refer to the creation and implementation of a In January, 2009, a meeting of stakeholders from Yukon, NWT,
strategy to translate health research results into applicable findings for Nunavut, Nunavik and Labrador met in Iqaluit, NU to discuss
those requiring the information. In the context of Qaujigiartiit/Arctic opportunities to collaborate on health research ethics review for
Health Research Network - Nunavut and the work that is conducted by northern communities. The result of this meeting was a commitment
this Iqaluit-based organization, Knowledge Sharing is defined as “the to work across jurisdictions to meet the health research ethics needs of
synthesis, translation and communication of health knowledge communities and northern regions by working to build capacity for
between various knowledge holders, such as policy-and decision- ethical review; to collaborate to share tools and resources; to provide
makers; researchers; community members; and health care providers. education opportunities when possible; and to form a working group to
Knowledge is dynamic and does not flow in a line from top to bottom, explore the possibility of developing a Northern Health Research Ethics
but fluidly between people and groups.” Council.
Contact: Gwen Healey (ahrn.nunavut@gmail.com)
Approach: A multi-level approach has been implemented at
Qaujigiartiit to facilitate knowledge sharing among 4 identified
USE OF THE FETAL FIBRONECTIN TEST FOR DETECTING 1. Posters and Flyers: “Safe in a Swim Vest” - door to door or mail-
PRE-TERM LABOUR IN NUNAVUT 2004-2007 drop
2. Tags: “Always be Careful” and “NWT Swim Vest Loaner Program”
G.K. Healey1, W.A. MacDonald2
3. School-based Promotion of Water Safety
1 2
Qaujigiartiit Arctic Health Research Network Nunavut, Qikiqtani 4. CKLB Native Communication Services – Radio Documentary on
Regional Hospital Injury Prevention, features “Safe in a Swim Vest” Pilot Project
Pre-term birth is the most important cause of peri-natal morbidity and (note: listening audience is + 10,000 First Nations, Inuvialuit and
mortality in industrialized countries. Fetal Fibronectin is a glycoprotein Métis residents of the NWT)
involved in the adhesion of cells present in extracellular matrix of the 5. Water Safe BBQ hosted by Health Centre in each community
decidua basalis, adjacent to the intervillous space. The presence of (wrap up event for return loaner vests at end of summer)
Contact: A.C. (Lona) Hegeman (lona_hegeman@gov.nt.ca)
fetal fibronectin in vaginal secretion has been shown to be predictive of
both pre-term and term delivery. In 2006, the FullTermÆ The Fetal
Fibronectin Test kits were distributed to all 26 community health
ACUTE MASTOIDITIS IN GREENLAND BETWEEN 1994-2007
centres and hospitals in Nunavut.
P. Homøe1, R.G. Jensen1, S. Brofeldt2
Methods: This study was a retrospective review of test forms and charts 1
for patients who were administered the fetal fibronectin test in Department of Otolaryngology, Head & Neck Surgery, Rigshospitalet,
2
Nunavut between 2004 and 2007. Test use records from the Qikiqtani University Hospital of Copenhagen, Department of
General Hospital Laboratory were the singular source of data regarding Otorhinolaryngology, Dronning Ingrids Hospital, Nuuk, Greenland
test use in the territory. A review of charts for outcome (birth) data was Objectives: The indigenous populations in the Arctic are prone to
conducted at the Qikiqtani General Hospital and the Cambridge Bay middle ear infections starting with early and frequent epidodes of
Regional Health Centre. Birth outcome data for cases outside of the 2 acute otitis media during childhood. A high proportion develops
institutions were collected via fax directly from the administering chronic otitis media. Acute mastoiditis is a serious complication of
health centre. acute otitis media in childhood with postauricular swelling, erythema,
Results: One hundred and sixty-six test records were obtained for the and tenderness, protrusion of the auricle, high fever and general
period between July 2004 and December 2007. Twenty-five test results malaise. The disease may protrude intracranially. The incidence rates
were excluded from the analysis for not meeting review criteria. A for acute mastoiditis in the western world range from 1.2 to 3.8
negative fetal fibronectin test result was 98.3% likely to be a true cases/100.000/year. There exists no epidemiological data on acute
negative test result among this sample. A positive fetal fibronectin test mastoiditis in the Arctic.
result was 23.8% likely to be a true positive test result among this Patients and Methods: We have retrospectively searched for the WHO
sample. The sensitivity of the fetal fibronectin test in this sample was ICD-10 coding entity DH70.0 for acute mastoiditis using the National
71.4%. The specificity of the fetal fibronectin test in this sample was Greenland Inpatient Register between 1994-2007 inclusive. We found
88.1%. 15 patients with this diagnose. However, four were misclassified,
Comment: The high negative predictive value of the test (98.3%) is leaving 11 patients for evaluation. The medical records were available
encouraging for health care providers treating pregnant women in in 10 patients. The diagnostic criteria for inclusion were written clinical
Nunavut, however continuing surveillance o The importance of signs of acute mastoiditis.
ensuring that all health centres have current, up-to-date, step-by-step Results: The incidence-rate was 1.4 for the whole population and 7.4 for
procedures for using the test and reporting the results to the children between 0 and 10 years of age. Median age was 14 months (5-
laboratory was emphasized by health care providers. 105 months) and 8 (72%) were females. Seven of ten were exclusively
Contact: Gwen Healey (ahrn.nunavut@gmail.com) treated with antibiotics and three had additional ear surgery. Culturing
for bacteriology was performed in five of ten. One 8 months old female
developed a contemporary facial nerve paralysis and was treated with
“SAFE IN A SWIM VEST” – COMMUNITY HEALTH
intravenous antibiotics and one 8 years old female was evacuated to
REPRESENTATIVES AS WATER SAFETY CHAMPIONS Copenhagen for acute surgery due to signs of meningitis. Acute CT-
A.C. Hegeman, G. Edwards, B. Tetso scan showed a cerebellar absces and a thrombosis in the sigmoid sinus.
H&SS, Government of the NWT At surgery was found an extensive cholesteatoma that was eradicated.
Six weeks later the patient returned home with maximal conductive
Summary: NWT “Safe in a Swim Vest” is a swim vest loander program hearing loss as the only complication. All patients recovered from the
for children aged 0-6 years. Community Health Representatives(CHRs) disease.
are champions and promoters/managers this loaner program.
Conclusion: The acute mastoiditis incidence in Greenland is seemingly
Need: December 2004: NWT Injury Report 1990-1999 identifies relatively low although acute otitis media occur frequent among small
drowning as the third leading cause of injury mortality (17%) of NWT children. The disease is serious and must be immediately treated with
children aged 0-14 (Source: NWT Vital Statistics) intravenous antibiotics and if no improvement also acute surgery.
Response: Contact: Preben Homøe (phom@rh.regionh.dk)
- March 2005: Key stakeholders responses during Injury Prevention

Community Consultation Tour (a partnership initiative with NWT
NUTRIENT INTAKE AMONG INUIT IN THE CANADIAN
Native Women’s Association) confirm need for prevention of all
drowning deaths.
ARCTIC: RESULTS FROM HEALTHY FOODS NORTH
- January 12, 2007: 7 CHR receive certification as First Aid and CPR B. Hopping, E. Mead, E. Erber, C. Roache, R. Reid, J. Gittelsohn, S.
Instructors - incorporate water safety in teaching Sharma
- January 19, 2007: CHRs accredited in First Aid and CPR: 21. University of North Carolina at Chapel Hill, Nutrition Research Institute,
- January 12, 2007: Safe in a Swim Vest images and messaging Kannapolis, NC
developed by 12 NWT CHRs Regional posters developed in all
Objective: To determine nutrient intakes of Inuit adults to guide a
NWT Aboriginal languages
community-based nutrition intervention program (Healthy Foods
- Spring, 2007: regional launch of Swim Vest Loaner Program
North) in Nunavut, Canada.
(aged 0-6)
- Summer, 2008: 2,000 swim vests distributed (loaner programs) in Setting: Data were collected in a remote community in Nunavut.
29 NWT communities Methods: Twenty-four hour dietary recalls were conducted among Inuit
Promotion of “Safe in a Swim Vest” includes adults utilizing a cross-sectional study design. Up to three 24-hour
dietary recalls were conducted for each participant on non-consecutive Aim of the research was to study cognitive functions in hypertensive
days, capturing both weekday and weekend consumption (n=209 patients in dependence on the obesity stage. We examined 97
days). These data were entered into and analyzed by Nutribase Clinical hypertensives (47 women and 50 men; AH, stage I-II; mean age – 50,8
Nutrition Manager and SAS Statistical Software. years, mean duration of arterial hypertension – 9,9 years, period of
Results: With a response rate of approximately 70-90%, 7 men and 69 residing in the Far North – 26,7 years). Obesity was identified on the
women between the ages of 19 and 89 years participated in the recall basis of body mass index calculation (WHO, 1997), CDs were stated by
data collection. Mean energy intake was 1,970 kcal for women and MMSE questionnaire. By the results of our study, obesity was revealed
2,215 kcal for men. For both men and women, the mean percentage of in 63,9% of examined sample: the I-st stage – 33 persons (53,2%), the
calories from fat was 30%. However, men had a lower mean II-nd stage – 22 persons (35,5%), the III-rd stage – 7 persons (11,3%).
percentage of calories (16%) from protein and a higher percentage CDs were absent only in 14,3% and 18,2% of patients having the III-rd
from carbohydrates (54%) compared to women (24% and 46% and II-nd stages of obesity respectively. Number of people without CDs
respectively). Intakes of calcium, folate, fiber, and vitamins D and E was significantly greater in a group of people having the first stage
were well below the recommendations. obesity– 33,4% (p<0,05). Prevalence of slight dementia increased along
with obesity progression: the I-st stage – 3,0% of patients, the II-nd
Conclusions: The inadequacy of intake of several essential nutrients in stage – 27,3%, the III-rd stage – 28,6% (p<0,05). Moderate dementia
this Inuit community indicates a need for a nutritional intervention, was registered only in hypertensives, suffering obesity of the III-rd
such as Healthy Foods North, that highlights nutrient-dense foods to stage (14,2%). From the foregoing it seems reasonable to conclude
improve the quality of the diet. that along with obesity progression the number of hypertensive
Acknowledgments: The research was supported by the American patients without cognitive deficiency decreases, while cognitive
Diabetes Association Clinical Research Award Grant # 1-08-CR-57. deviations become more pronounced.
Contact: Beth Hopping (sangita_sharma@unc.edu) Contact: G.I. Ievleva (hypertonia@yandex.ru)
QAMANITUAP NIQISIALIRIJIQUTINGIIT FINDING GENES FOR TYPE 2 DIABETES IN YAKUT

NUTARAQSALINGNUT: A COMMUNITY BASED PROGRAM POPULATION
FOR PRENATAL NUTRITION IN BAKER LAKE, NUNAVUT, P.M. Ignatyev1, F.A. Platonov1, L.G. Goldfarb2, V.L. Osayueskiy1, L.L.
CANADA Alekseeva1, I.V. Osokina3
1
B. Hughson, L. Kreuger Health Institute, Yakutsk; Russia, 2NINDS/NIH, Bethesda, USA,
3
Community Health Advocate Institute for Medical Studies of the North, Krasnoyarsk, Russia
In this presentation we describe the history, goal, methods, results and Introduction: Yakutia (Sacha) Republic is located in Eastern Siberia.
challenges of the Baker Lake Prenatal Nutrition Project. Created out of Two thirds of its vast territory lay north of the Polar Circle. During the
a desire to support women and their families in achieving healthy last decades there is the significant increase in incidents of type 2
pregnancies and newborn babies, this community based project was diabetes (T2D) among Yakuts. Probably the reason is the change in
established in 1995 with funding from the Public Health Agency of traditional nutrition and lifestyle.
Canada and community in-kind donations. It provides nutrition Several T2D-susceptibility genes have been identified through
education, prenatal classes, breastfeeding promotion, contact candidate gene and positional cloning approaches. For example,
between mothers and elders, food hampers to those in need, and common variants in PPARG and KCNJ11 each predispose to T2D in
weekly cooking classes. There are 75 participants (including fathers-to- diverse populations. Thanks to the discovery of molecular mechanism
be) and 800 client contacts every year in this Inuit community of 1700 of rare congenital forms of diabetes, the progress happened in
people. Provision of on-site day-care allows more participants to understanding of T2D. They connected with membrane ion-transport
attend. During cooking classes guest speakers, such as elders, dental protein, which is widely represented in cellular membranes in organism
therapists and others are invited to give educational talks. The tissues, including beta-cells of pancreas. This protein coded by ABCC8
program has resulted in publication of a cookbook called “Qamanituaq and KCNJ11 genes. It controls the process of insulin secretion, forming
Cooks”, which has been distributed across Nunavut. Women who join the channel for potassium ion transfer.
the program as prenatals often continue participating after delivery.
Aim: To search for the genes of predisposition to type 2 diabetes in
The program is guided by a volunteer board consisting of community
Yakut population.
members. Shared operating space with another program presents a
current challenge. Evaluations reveal the empowerment that Methods: The gene-typing for variants of ABCC8 gene (exons 12, 16,
participants experience through renewed connection with traditional 31) and KCNJ11 gene (E23K, 1339V exons) was performed in Yakut
healthy food choices and food preparation, within a supportive social population (213 patients with T2D and 231 control subjects). Gene
setting, and the link between food/nutrition and the physical, social, research was carried out in NINDS/NIH, Bethesda, MD, USA.
emotional, and mental dimensions of health. Results: There were significant differences (OR=1.312; p=0.047)
Contact: Betty Hughson (natsialuk@hotmail.com) between diabetes group (0.23) and control (0.29) in frequency of allele
A (exon 31) of ABCC8 gene. This gene predisposes to type 2 diabetes in
Yakut population. G allele of ABCC8 gene showed higher frequency in
DEVIATIONS OF COGNITIVE FUNCTIONS IN OBESE the whole population and didn;t show true differences between the
HYPERTENSIVE PATIENTS compared groups.
G.I. Ievleva, E.F. Teslya, D.M. Biktimirova, A.V. Kiklevich Conclusion: ABCC8 gene (A allele, exon 31) plays predisposition role in
State Scientific Research Institute on Medical Problems of the Far North T2D development in Yakuts and determines the peculiarities the
of RAMS disease in this native Siberian population.
Contact: Irina Osokina (osokina@rol.ru)
Pathologic changes in cognitive functions represent one of the early
vascular complications of arterial hypertension (AH). These deviations
adversely affect the course of AH. There is no doubt that risk of cardiac THE ARCTIC SOCIAL INDICATORS PROJECT
events increases greatly if AH is combined with obesity. Taking into
account the vast prevalence of this combination together with poor S. Irlbacher-Fox, J.N. Larsen, Steffanson Arctic Institute, et al.
data about cognitive deviations (CD) in hypertensive patients who live Arctic Social Indicators Working Group
in the Far North, the study of cognitive deficiency is of prime The Arctic Social Indicators (ASI) project is a project following up on
importance, both from medical and social-economical points of view. the activities of the Arctic Human Development Report (AHDR), and is
140 POSTER SESSIONS: J K L
initiated by the Stefansson Arctic Institute, Akureyri, Iceland, which concentration levels in this Norwegian population are low compared to
also hosts the secretariat. ASI has been endorsed by the Arctic Council, values reported for other populations in the Arctic, especially
and has also received the endorsement of the IPY. indigenous populations in Greenland and Arctic Canada.
Contact: Marthe Torunn Solhaug Jenssen (maj@niva.no)
The goal is to device Arctic social indicators which will help facilitate
the tracking and monitoring of human development in the Arctic over
time. While the AHDR is a major achievement, it is apparent that the TRADITIONAL FOOD USE AND DIETARY ADEQUACY
development of some means of monitoring trends in human
AMONG NUNAVUT PRESCHOOL CHILDREN
development in the Arctic would be extremely helpful from the
perspective of those involved in the policy process. Those wishing to L. Johnson-Down1, G.M. Egeland1, Qanuippitali Steering Committee
track developments relating to the status of Arctic cultures, the (Nunavut)2
1
evolution of indigenous rights, or the growth of the region’s economy, Centre for Indigenous Peoples’ Nutrition and Environment (CINE) and
for example, can take the picture presented in the AHDR as a point of School of Dietetics and Human Nutrition, McGill University, 2L. Gunn,
departure and compare developments at various temporal intervals in Nunavut Association of Municipalities; L. Williamson, Nunavut
order to get a handle on changes over time in human development or Tunngavik Incorporated; I. Sobol and G. Osborne, Government of
social welfare in the Arctic. What the AHDR does not do, however, is to Nunavut Department of Health and Social Services; K. Young, University
provide time series data regarding the various elements of human of Toronto
development in the Arctic, and nor does it present a suite of Dietary change and nutrition transition are ongoing concern in
quantifiable indicators suitable for use on the part of those seeking to Indigenous Peoples of the Canadian North. Nutrient inadequacy have
monitor or track changes in human development in the Arctic. also been observed among Indigenous children in US and Canadian
The goal of the ASI project is to move toward filling this gap. It is the communities and traditional food use correlates with greater nutrient
first step in a long-term effort to monitor and track human intake.
development in the Arctic. The development of indicators falls within A cross-sectional survey of 388 Inuit children, aged 3-5 yrs, from 16
six domains: Nunavut communities between August 2007 and September 2008 was
(1) Fate control and or the ability to guide one’s own destiny; conducted with funding from the Canadian Federal Program for
(2) Cultural integrity or belonging to a viable local culture; International Polar Year. Bilingual and trained interviewers conducted
(3) Contact with nature or interacting closely with the natural 24-hour recalls and food frequency questionnaires with the child’s
world; caregiver in order to quantify diet from both market and traditional
(4) Material Well-being; foods. Anthropometric measures such as height and weight were
(5) Education; measured by a nurse.
(6) Health/Population. Assessment of dietary adequacy was done using the Estimated
Contact: Stephanie Irlbacher-Fox (stephaniefox@theedge.ca)
Average Requirement (EAR) cut point method as outlined in the
Institute of Medicine’s Dietary Reference Intakes (DRIs). The method
requires a statistical adjustment of the nutrient data in order to
JKL compare it to the EAR. Some nutrients such as calcium, vitamin D and
fiber do not have an EAR and intakes of these nutrients were compared
to Adequate Intakes (AI) as defined in the DRIs. The extent of
MERCURY EXPOSURE AND LINKS TO HUMAN HEALTH IN A traditional food use was evaluated using a food frequency
COMMUNITY IN TROMSØ, ARCTIC NORWAY questionnaire. Dietary quality assessment included the extent to which
M.T.S. Jenssen1,2, I. Njålstad2, T. Larssen1, S. Rognerud1 dietary habits followed the Canadian Food Guide recommendations
1
Norwegian Institute for Water Research, 2Institute for Community and the degree of consumption of high sugar and high fat food and
Medicine, University of Tromsø sugar beverage consumption.
Persistent pollutants in the Arctic have received much attention. It is Results are embargoed until presentation to communities is completed
well known that these contaminants accumulate in food webs and in May of 2009. Full details of results will be provided at the ICCH. The
potentially can cause severe physiological damages to top level results will help lead to appropriate interventions and health
predators, including humans. People in Arctic regions tend to be more promotion strategies for Inuit children in the Canadian Arctic.
Contact: Louise Johnson-Down (louise.johnson-down@mcgill.ca)
exposed to these pollutants due to a potential high intake of wild fish
and animals. In many studies, focus has been on persistent organic
pollutants (POPs), rather than mercury, although food consumption DEVELOPMENT OF A FOOD FREQUENCY QUESTIONNAIRE
limits for fish often are driven by Hg. The present study assesses TO MEASURE DIETARY INTAKE IN AN ALASKAN NATIVE
mercury exposure and seriousness of Hg in a population in northern
POPULATION
Norway.
J.S. Johnson1, E. Asay1, X. Cao2, E. Mead2, S. Sharma3
Through a large epidemiological public health survey, around 9 000
people in the town of Tromsø have delivered hair samples in addition Alaska Native Tribal Health Consortium
1
to blood samples and supporting health information, including Office of Wellness and Prevention, Alaska Native Tribal Health
questionnaires related to potential contaminant exposure and other Consortium, C-DCHS, Anchorage, AK, 2University of North Carolina at
health related issues. Hair samples are analysed for MeHg and/or Chapel Hill, Nutrition Research Institute, Kannapolis, NC, 3Affiliation
TotHg in order to evaluate the levels and seriousness of Hg in the during research: Cancer Etiology Program, Cancer Research Center of
general Tromsø population in relation to diet. Additionally the unique Hawaii, University of Hawaii, current affiliation: University of North
connection to the health survey eventually will enable assessment of Carolina at Chapel Hill, Nutrition Research Institute, Kannapolis, NC
links between mercury exposure and possible health impacts, as
Objective: To describe the development of a food frequency
variables such as e.g. diet, sex, ischemic risk profiles and vitamin D
questionnaire (FFQ) that will be used to evaluate the Food Distribution
become available.
Program for Indian Reservations (FDPIR) in the Western region of
Although Tromsø is a coastal town with high access to high quality Alaska.
fresh fish and sea food, the dietary pattern show a surprisingly low
Setting: Geographically isolated villages in the Western region.
intake of fish. Hence, the general population has a low Hg exposure
through diet, although certain people with high intake of fish and other Subjects: Alaska Native people.
food from nature show higher Hg concentrations. Still, Hg
POSTER SESSIONS: J K L 141
Methods: 24 hour recall data from a previous project in the Western Results: The cost comparison showed that a mobile retinal screening
region of Alaska was used to construct an FFQ. Foods reported more program in rural/remote communities proves to have various financial
than six times were included. Other foods of interest were added, benefits.
including FDPIR foods. Conclusions: These findings, in conjunction with other factors such as
Results: The FFQ containing 150 food items was developed and the increasing prevalence of diabetes and evidence that patients prefer
included eight food categories: Breads and crackers (14 item); Cereals community based service, support the need for further expansion of
(3 items); Dairy foods (including eggs, 11 items); Meat, poultry and fish this type of mobile retinal screening program. These experiences also
(including mixed dishes, 69 items); Fruits (including locally gathered raise many prospective uses for a mobile retinal screening program
berries, 13 items); Vegetables (including wild greens, 22 items); Snack which could have many positive implications for rural and remote
and desserts (9 items); and Beverages (9 items). Consumption regions.
frequencies ranged from never to two or more times per day for food Contact: Eileen Koop (koope@cc.umanitoba.ca)
items and from never to six or more times per day for beverage items
during the last 12 months. Usual amount consumed was assessed using
culturally appropriate food models. DIABETIC RETINAL SCREENING IN RURAL/REMOTE FIRST
NATION COMMUNITIES IN MANITOBA: SUCCESSES AND
Conclusions: The FFQ will be used to assess total dietary intake of the
Alaska Native Yup’ik people before and after the FDPIR program and
CHALLENGES
to evaluate the program’s impact on diet. E. Koop, M. Routledge
Acknowledgements: This research was supported by the United States University of Manitoba Northern Medical Unit
Department of Agriculture Cooperative State Research, Education and Objectives: 1) Examine the successes and challenges from a program
Extension Service, Award no. 2007-55215-17923 initiated in 2005 by the University of Manitoba’s Northern Medical Unit
Contact: Jennifer Johnson (jsjohnson@anthc.org)
in providing diabetic retinal screening services and 2) Use these
findings to generate recommendations for improving the effectiveness
of retinal screening services for Aboriginal populations in rural/remote
THE FIRST HUMAN CASE OF Q FEVER IN THE ARCTIC - AN
communities.
UNDERDIAGNOSED OR EMERGING INFECTION?
Study Design: Qualitative and quantitative program review.
A. Koch, C.B. Svendsen, J.J. Christensen, M. Kemp, L. Vindfeld, C.B.
Christiansen, S. Villumsen Methods: 1) Quantitative data focusing on client assessments taken
from the NMU retinal screening program’s trip reports and the Secure
Department of Epidemiology Research, Statens Serum Institut
Diagnostic Imaging (SDI) database and 2) Qualitative information
The zoonosis Q fever is caused by the bacterium Coxiella burnetii. Q describing some of the successes and challenges experienced over the
fever is believed to be world-wide distributed, but has never been course of the program’s development.
observed in Arctic areas. We describe the first Arctic case of Q fever, a
Results: Both the quantitative and qualitative reviews indicate that the
case of Q fever endocarditis in a native person from a small settlement
program has been an effective one, specifically in regards to improving
in East Greenland. In 2001 the patient had two cardiac valves replaced
access to an integral service, and they also identify opportunities for
with biological valves due to rheumatic fever in childhood. In the fall of
further program development.
2007 he developed signs of endocarditis and in 2008 the affected
valves were replaced by mechanical valves; routine PCR and bacterial Conclusions: Continuation and expansion of the current Manitoba
culture from the removed valves showed massive C. burnetii infection. retinal screening model is needed in order to meet current Canadian
A serum sample from 2008 was strongly positive for C. burnetii Diabetes Association clinical guidelines for diabetic retinal screening.
antibodies, while a stored serum sample from 2004 was antibody This type of program also provides opportunities for new models of
negative. The fact that the patient had not been outside of East health promotion and disease prevention services to populations living
Greenland since 2001 indicates that he was infected locally. Likely in rural and remote communities.
Contact: Eileen Koop (koope@cc.umanitoba.ca)
animal sources include sledge dogs and seals. Q fever may be
underdiagnosed, but may also represent an emerging infection in the
Arctic. THE INDICATORS OF LIPID METABOLISM FROM THE
Contact: Anders Koch (ako@ssi.dk)
RESIDENTS OF YAKUTIA
Z.N. Krivoshapkina, G.E. Mironova
A COST ANALYSIS OF THE UNIVERSITY OF MANITOBA
NORTHERN MEDICAL UNIT’S DIABETIC RETINAL problems SB RAMS
SCREENING PROGRAM FOR RURAL AND REMOTE
Given the role of lipid metabolism in the body to adapt to the adverse
COMMUNITIES factors, the objective of this work was to assess indicators of lipid
E. Koop, M. Routledge metabolism in the ethnic groups of Yakutia.
University of Manitoba J. A. Hildes Northern Medical Unit Materials and Methods: Total surveyed 1719 residents of Yakutia,
Objective: Conduct a cost analysis of a Diabetic Retinal Screening including indigenous people, it was 1340, visitors - 379. The control
Program for First Nations Communities in rural and remote Manitoba, group consisted of 50 healthy individuals.
Canada. Results and discussion: At 35% of those surveyed, the concentration of
Study Design: A quantitative analysis which uses statistics from total cholesterol in the blood serum was higher than the norm. The
published literature to estimate costs and compares these with level of total cholesterol in both groups, although not higher than the
experiential data. generally accepted norms, but is within the limits considered to be
currently moderately elevated. Triglycerides in the blood of the
Methods: Statistics of prevalence rates of diabetes, diabetic
population of Yakutia comers 1,5 times higher (1,60 ± 0,06 mmol / l)
retinopathy, and associated costs for transporting clients from
than the indigenous population (1,06 ± 0,03 mmol / l), and ranged on
rural/remote First Nations communities in order to provide retinal
the upper boundary of the rules. Reducing HS HDL combined uptrend
screening were analyzed. These costs were compared to those
CS LPNP levels, in which ethnic groups were at the upper limit of
identified from the past three and a half years of providing a mobile
normal. The content of CS LPONP in blood in comparison groups was
retinal screening service which is based out of the nearest urban
below the generally accepted standards, and most expressed reduction
centre.
found in the indigenous inhabitants of Yakutia.
142 POSTER SESSIONS: M N O
The level of APO A-I in the blood varied within the normal values and elucidate a conceptual snapshot of the factors behind the scarcity of
are not dependent on age and ethnicity. Contents apoprotein has been data, with some emphasis on jurisdiction/exclusion issues. Following
the ethnic dependence, if the indigenous population, this figure ranged this, some recommendations including potential approaches to
lipid metabolism in normal quantities, the arrivals level of APO in achieving a wide-ranging set of Métis health/well-being data are
excess of normal values, and was 1.5 times higher than in Yakuts. discussed. A comprehensive collaborative strategy which may
Thus, the residents of Yakutia observed shifts indicators lipid incorporate many of the outlined approaches is explored.
Contact: Mohan Kumar (mkumar@naho.ca)
metabolism. The representatives comers population dyslipidemia is
characterized by an increase in blood triglycerides and APO B, which
indicates a reduction in reserve capacity in the adaptation of the liver,
and at the same time, one can not exclude the contribution of the type MNO
of food in dyslipidemia from visitors who have traditionally preferred
the carbohydrate diet. Indigenous residents of Yakutia has been a
steady increase in the number of diseases that are in violation of lipid A REVIEW OF INUIT ONCOLOGY PATIENTS TREATED AT
metabolism, possibly due to the decline in adaptive capacity. THE OTTAWA HOSPITAL CANCER CENTRE
Contact: Zoya Krivoshapkina (atec@mail.ru)
J.P. McGhie
The Ottawa Hospital Cancer Centre
TRACKING RISK: A REVIEW OF INFECTIOUS DISEASES Background: Nunavut, Canada’s largest territory (1.9 million km2), is
WITHIN CIRCUMPOLAR POPULATIONS roughly 3 times the size of Texas, but is sparsely populated with only
A. Kumar 27,000 residents. Its demographics are unique, with a median age of
22, 85% are Inuit, and 85% speak Inuktitut. No oncology services are
University of Oulu, Finland available within the territory. Residents must travel to cancer centers in
Background: Health indicators for circumpolar populations are poor Ottawa, Winnipeg, or Edmonton. The Ottawa Hospital Cancer Centre
with a high burden of infectious diseases, similar to African countries. (TOHCC) is responsible for all oncology consultations for the Baffin
This review discusses the rates of infectious diseases within the Arctic. region of Nunavut (distance 2,100-2,700km), where half of Nunavut’s
Methodology: Literature searches identified relevant and useful population reside (population 14,000).
research sources on all infectious diseases among Arctic aboriginal and Methods: Consecutive Nunavut patients seen in consultation at TOHCC
indigenous populations including but not limited to Inuit, Eskimo, from January 2002 to August 2007 were identified. Chart review was
Inupiaq, Sámi and Chukchi living in circumpolar countries including undertaken; extracting demographic information, ethnicity, diagnosis,
Russia, Canada, Greenland, Alaska, and Fenno-Scandanavia. stage, treatment, outcome, complications of care, and use of
Findings: There exist many challenges for local public health in the translation services.
control of the disproportionately high rates of infectious diseases for Results: 113 cancer patients of Inuit descent were identified. The
example sexually transmitted infections and respiratory tract average age at diagnosis was 57 years, (50%M, 50%F). Fifty-four
infections including Tuberculosis. Such infections are not indigenous to percent were actively smoking at the time of diagnosis. Previous
the Arctic. Arctic health providers and community members share tuberculosis (TB) infection was reported by 40%, while only 1 case of
concerns about the continuing burden of infectious diseases. There is TB reactivation while on therapy was identified. An Inuktitut/English
an identified lack of knowledge in regard to risk and routes of interpreter was required by 73%. Oncologic services at TOHCC
transmission shared among Arctic populations. Perceptions of included surgery (39%), radiation (64%), and chemotherapy (58%).
infection risk and transmission are influenced by government, media, Lung cancer was the most common (n=55), with the following
religious and sources. Risk factors including overcrowding, alcoholism, histological distribution: squamous (n=25), small cell (n=7),
sexual promiscuity and relative poverty, elevate rates of infections. adenocarcinoma (n=3), and unspecified non-small cell (n=20). A rare
Migration, travel and new natural resource extraction activities in the case of Kaposi’s sarcoma was identified in an HIV negative patient. No
Arctic pose new routes of transmission for infectious diseases imported cases of prostate cancer were identified.
from Southern populations. Conclusions: Cancer in the Inuit population differs radically from the
Conclusion: Circumpolar populations remain at high risk to foreign rest of the Canadian population. Causes for the variation may include
infections and suffer a considerable burden of disease. Education is key high incidence of smoking, young population, high parity and
to prevention. A proactive, creative, culture-specific, local community breastfeeding rates.
level approach is needed with international collaboration sharing Contact: John Paul McGhie (jpmcghie@gmail.com)
successful methods to curb the rates of preventable infections to
improve local health status.
Contact: Alexander Kumar (themonke@hotmail.com) THE PSYCHOSOCIAL DETERMINANTS OF DIET-RELATED
BEHAVIORS AMONG THE INUVIALUIT: RESULTS FROM
HEALTHY FOODS NORTH
MÉTIS HEALTH/WELL-BEING DATA COLLECTION:
E., Mead, E. De Roose, S. Biggs, S. Reaburn, J. Gittelsohn, S. Sharma
CONCEPTUAL SNAPSHOT OF FACTORS BEHIND DATA
PAUCITY AND ACTION STEPS University of North Carolina at Chapel Hill, Nutrition Research Institute,
Kannapolis, NC
M. Kumar
Objective: To describe the dietary behaviors and their psychosocial
Métis Centre of National Aboriginal Health Organization determinants of the Inuvialuit in the Northwest Territories, Canada, for
Numerous reports, environmental scans and discussion papers allude the development of a culturally appropriate chronic disease prevention
to the dearth of Métis health/well-being data. The shortcomings of the program.
current sources of data range from poor data quality, Setting: Two remote and one semi-remote community in the Arctic
insufficient/inadequate data to a complete lack of data. These region of the NWT.
deficiencies have serious consequences including an inadequate
understanding of the true state of Métis health, the disparities and Methods: Cross sectional random household surveys were conducted
determinants, and insufficient funding for programs, all of which with Inuvialuit adults. Descriptive statistics were generated for
collectively perpetuate health/wellbeing disparities. In this paper we sociodemographic, psychosocial (i.e., food knowledge, self-efficacy,
present some of the limitations of current sources of Métis data, and intentions), and behavioral (i.e., healthy food getting, unhealthy
including surveys and peer-reviewed publications. Further, we food getting, and healthiness of food preparation) dependent and
POSTER SESSIONS: M N O 143
independent variables. Their associations were analyzed using SHARING YOUTH PERSPECTIVES ON MENTAL HEALTH AND
multivariate linear regression in Stata. WELLNESS: PHOTOVOICE PROJECT
Results: Among the 230 Inuvialuit respondents (181 females and 49 J. Mike, M. Bzdell, G.K. Healey
males; mean age of 43 years), unhealthy foods (e.g., potato chips, pop,
Qaujigiartiit Arctic Health Research Network Nunavut
high sugar cereal) were acquired 2 times more frequently than healthy
foods (e.g., baked potato chips, diet pop, high fibre cereal). Food Introduction: This project is part of a pilot to to test and evaluate
preparation methods that added fat were more often utilized than knowledge sharing projects within the Qaujigiartiit specifically
methods that reduced fat content and neutral methods that neither targeting 2 groups: policy- and decision-makers in Nunavut on the
added nor subtracted fat. Higher levels of food knowledge (0.2, issue of food security, and community members in Nunavut on the
p<0.001), self-efficacy (0.1, p<0.001), and intentions (0.1, p<0.01) were issue of youth mental health and wellness. The latter, described here is
statistically associated with utilization of healthier cooking methods. a youth-led photovoice project to facilitate the sharing of key youth
Only increased intention was associated with greater frequency of mental health and wellness issues with community members. This
acquiring healthy foods (1.2, p<0.01), and only increased self-efficacy (- topic has been identified at the community and territorial level as an
1.1, p<0.01) was associated with decreased frequency of acquiring important topic to address. Particularly, it has been highlighted as
unhealthy foods. priority area for raising awareness by the Qaujigiartiit Arctic Health
Research Network Nunavut Board of Directors.
Conclusions: These results highlight the need for nutritional
intervention programs, such as Healthy Foods North, to target food Methods: This youth-led knowledge-sharing initiative directed at
knowledge, self-efficacy, and intentions to positively impact food communities included a review of commonly identified health and
preparation and acquisition among the Inuvialuit. By understanding wellness issues for youth in Nunavut; youth meetings about the topic;
and incorporating these factors, Healthy Foods North will be able to training for the youth participants in photography and the use of
address the specific risk needs of this population to reduce the risk of related equipment; the production of photographs; the analysis of the
chronic disease. photographs and discussion of key messages they felt the photos
represented.
Acknowledgements: The research was supported by the American
Diabetes Association Clinical Research Award Grant # 1-08-CR-57. Findings: The youth focused primarily on messages with a positive
focus, such as “have fun”, “stay positive”, and “take breaks”. The
photographs shown here are a selection of the many and varied artistic
ENVIRONMENTAL DETERMINANTS OF PERIPHERAL
and creative concepts the youth shared on this topic.
CIRCULATION IN NORTHERN AND SOUTHERN SIBERIAN
POPULATIONS - A COMPARISON Conclusion: This project was a youth-implemented project to raise
awareness about youth mental health issues in Nunavut. The focus on
V.N. Melnikov, Novitskaya, S.Yu., T.G. Komlyagina, A.O. Ondar positive messages highlights the need for youth programs and youth-
Institute of Physiology, SB RAMS, Novosibirsk, Russian Federation centred materials to focus on their strengths and abilities when
The prevalence of a number of risk factors for hypertension is addressing youth mental health and wellness in our communities. The
increasing among northern populations. It is thus thought of interest to photographs have been developed into posters and shared with
compare blood circulation parameters between northern and southern Nunavut communities through local health centres, schools and youth
populations and to relate them to environmental factors. We measured centres, as well as on the Qaujigiartiit web site to help promote the
forearm muscle blood flow at rest and at maximum reactive hyperemia messages identified by the youth group. The youth found the
by venous occlusion plethysmography in 209 hypertensive inhabitants experience to be both fun and challenging. The excitement generated
of Novosibirsk, the southern Siberian city (63 women and 146 men; among the group for the project and the discussions that ensued
mean±SD mean arterial pressure, 115+/-9 mm Hg; mean age, 41+/-9 around the photographs was meaningful and it is hoped that this
yr.) and 204 age matched Russia permanent residents of Mirny located project will be repeated in the future.
Contact: Jesse Mike (ahrn.nunavut@gmail.com)
in western Yakutia (41 women and 163 men, 114+/-10 mm Hg). We
consider the latter location a northern setting. All subjects were
industrial workers and examined in 1999-2004 while being patients of PREVALENCE OF CLINICAL RISK FACTORS FOR
academic clinic in Novosibirsk where they were treated for OSTEOPOROSIS IN WOMEN 50 TO 69 YEARS; THE BONE
hypertension. The examination was conducted before treatment.
HEALTH NUNAVIK (BOHN) PROGRAM
The resting forearm blood flows were 1.89+/-0.93 vs. 2.16+/-1.07
S. Morin1, A. Robitaille2, J. Poliquin3, S. Déry4, B. Young1,2
ml/100 ml tissue per minute for women (p<0.1) and 2.62+/-1.14 vs.
1
2.99+/-1.33 for men (p<0.01), Siberian group vs. northern group. Department of Medicine, McGill University, 2Nunavik Centre, Montreal
Similarly, the peak flows during reactive hyperemia were higher in General Hospital, Montreal, Canada, 3Ungava Tulattavik Health Centre,
northern subjects (p<0.1 for women and p<0.003 for men). The values Kuujjuaq, Canada, 4Nunavik Regional Board of Health and Social
of resting forearm vascular resistance (RVR*10(11)) were 6.04+/-5.43 Services, Kuujjuaq, Canada
vs. 4.52+/-2.21 N*m(-5)*sec for women (p<0.053) and 3.75+/-1.84 vs. Osteoporosis is a skeletal disease that compromises bone strength and
3.22+/-1.34 for men (p<0.005).Venous outflows as well as venous increases the risk for low-trauma fractures. Clinical risk factors known
capacities were higher in the northerners compared to southerners for to increase the risk for fractures include a history of low-trauma
both sexes (p<0.05 for all cases). No differences were found between fractures, family history of hip fractures, certain medications,
sex-matched subpopulations in diastolic, mean and systolic arterial advancing age, smoking and low body mass index. Studies have
pressure and heart rate. documented higher incidences of fractures in Canadian Aboriginal
The results show the higher arterial and venous blood flows and the women from Manitoba compared to white women. In the 2004 health
less peripheral vascular resistance in patients from the northern town survey of women of Nunavik, osteoporosis and low bone mineral
compared to Novosibirsk. We suggest the difference can be partly density (BMD) were documented in 77% of menopausal women
attributed to the adaptation of residents of Mirny to special screened by a heel ultrasound device, though data on clinical risk
geomagnetic field that is observed in the northern setting. factors were not reported. Although measurement of BMD is used in
Contact: Vladimir Melnikov (mvn@physiol.ru) practice to improve assessment of fracture risk, access to such
technology is lacking in Nunavik. Because the presence of clinical risk
factors has been shown to accurately predict the risk for fractures in
Caucasian women, we sought to determine the proportion of Inuit
women who would be identified at high risk on the basis of clinical risk
factors.
The primary objective of this study was to describe the prevalence of Cholestasis Familiaris Groenlandica (CFG): A total of 46 cases of CFG
clinical risk factors for low-trauma fractures in Inuit women aged 50 to (Progressive Familiar Intrahepatic Cholestasis type 1 (PFIC1)) have
69 years via the administration of a questionnaire. A trained nurse been diagnosed in Greenlandic Inuit children since 1943. Only three are
administered a 12-item questionnaire (~5 minutes) to 166 Inuit still alive. The carrier frequency varies geographically from 1-27 %.
participants from the region of Ungava in Nunavik, who were taking Propionic Acidemia (PA): A metabolic disease caused by deficiency of
part in a breast cancer screening program. Demographic information, the enzyme propionyl CoA-carboxylase. Since 1976 ten Greenlandic
height and weight and prescription medications were also recorded. Inuit children have been diagnosed. All children have died within the
Descriptive statistics will be used to describe the group characteristics. first days after birth. Several other children among the affected
Subgroup analyses will be conducted with stratification of the cohort childrens closest relatives have died from sudden unexpected death. It
by age groups (50 to 59 years and > 60 years). is suspected, that PA could be the course. The carrier frequency varies
The results of this project will guide the development of the Bone geographically from 2-7%.
Health Nunavik program which will consist of a comprehensive Prevention: Due to the high carrier frequency in Greenland of both CFG
osteoporosis management program for the people of Nunavik. and PA, The Greenland Home Rule decided to offer a screening for
Contact: Suzanne Morin (suzanne.morin@mcgill.ca)
carrier status for the two diseases to all pregnant women from the 1st
of January 2006. If the woman is a carrier, the husband is screened, and
CLIMATE CHANGE IMPACTS ON DIETARY NUTRIENT if they are both carriers of the same disease, they are offered prenatal
diagnosis.
STATUS OF INUIT IN NUNAVUT, CANADA
Results: Tests: 2.587 pregnant women, 264 men, 13 children and 15
T. Nancarrow1, H.M. Chan1, A. Ing1, H.V. Kuhnlein2
1
foetuses. Normal tests: 2653. Pregnant carriers of GFG/PA: 108/80.
Community Health Program, University of Northern British Columbia, Men carriers of CFG/PA: 11/4. Children carriers of CFG/PA: 5/1.
2
Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill Foetuses carriers of CFG/PA: 7/2. Homozygous foetus of CFG/PA: 1/0
University and the pregnancy was terminated. Carriers of both CFG and PA: 6
Introduction: Traditional food (TF) is locally derived plant, animal, and pregnant and 1 child.
fish foods, harvested from the environment, which give vital Contact: Inge-Merete Nielsen (imn@sund.ku.dk)
sustenance to Inuit. TF contributes significantly to daily required

amounts of nutrients, despite consumption of market foods. Rapid
Arctic climate change is affecting reproduction, foraging and migration
THE HEALTH OF SÁMI
patterns of key TF species. Changes in access and availability of TF A. Niittyvuopio1, R. Magga1, E. Näkkäläjärvi1, A. Rautio2
have the potential to affect nutrient intake in Inuit. 1
Dearvasit Eallin - Terveempi Elämä hanke (Healthier life project),
Objective: To characterizes the nutritional implications of climate SámiSoster, Inari, 2Centre for Arctic Medicine, Thule Institute, University
change related to the TF system of Inuit in Nunavut, Canada. of Oulu, Finland
Methods: Focus groups and a food frequency questionnaire (FFQ) The aim of Dearvasit Eallin - Healthier Life project was to increase the
consisting of 111 food items from 12 TF species were carried out in two participation of working-age and elderly Sámi population in promoting
Nunavut communities to record climate change observations and TF their own heath and well-being. It was funded by Ministery of Social
intake (g/day). Intake of 22 nutrients was compared to respective Affairs and Health during the years 2006-2007. At the moment in the
Dietary Reference Intakes. Sámi population, as well as globally, the heart and cardiovascular
diseases and diabetes are increasing. Obesity, alcohol consumption
Results: Focus group participants observed that climate change was
and smoking have also increased among Sámi people. The risk factors
affecting the TF harvest in both positive and negative ways. Key
for the diseases are high levels of serum cholesterol and glucose and
nutrients that could be affected were found to be protein, iron, zinc, ω-
rather high blood pressure.
3 fatty acids, selenium and vitamins D and A. Median daily intake of TF
was 386 g/day for the whole population. TF provided 100% of the The focus area of the project was the importance of change in the life-
Estimated Average Requirements (EAR) or Adequate Intake (AI) for style in preventing diseases. The aim was to inform the professionals in
protein, omega 3 fatty acids, vitamins A and B6, riboflavin, the counties of S·mi area about the traditional features of Sámi culture
phosphorus, iron, copper, zinc and selenium. Caribou was the most and perspectives of the life. During the project it was important to
commonly consumed country food (by weight and frequency). organize the new structures of health care services suitable for Sámi
and thus increase their own efforts of health promotion. The sphere
Conclusions: Community members confirmed that climate change is
includes tradition, values and habits, which are hard to change. E.g.
affecting their traditional food system, which is extremely important to
cooking recipes, which have been transferred from one generation to
their dietary nutrient status. Some changes occurring in the
another are rather resistant to new dietary recommendations.
communities appeared to increase access to TF. If this translates to an
increase in the TF harvest, nutrient intake may increase. Climate The main results of the projects are: 1) it is import to give the health
changes that have the potential to reduce access to TF may have promotion by using Sámi language and based on the cultural
serious consequences on dietary nutrient status of Inuit if no background; 2) the traditional food can be changed to lighter; 3) the
countermeasures are taken. health promotion is multidisciplinary work, which needs a good
Contact: Tanya Nancarrow (tanyanancarrow@yahoo.ca) infrastructure; 3) the usefulness of new technology; and 4)
development of co-operation with Norwegian professionals in Sámi
area.
FROM RESEARCH TO PREVENTION IN GREENLAND Contact: Arja Rautio (arja.rautio@oulu.fi)
I.M. Nielsen1, P. Kern2, H. Eiberg1

1
Dept. of Cellular and Molecular Medicine, University of Copenhagen, INNOVATIONS IN KNOWLEDGE TRANSLATION: CHILD INUIT
2
Queen Ingrids Hospital, Nuuk, Greenland HEALTH SURVEY RESULTS DVD
Three years prenatal screening of pregnant women for two lethal Qanuippitali Steering Committee (Nunavut), A. Pacey, H. Weiler, G.M.
autosomal recessive inherited diseases: Cholestasis Familiaris Egeland
Groenlandica and Propionic Acidemia: The diseases are frequent,
serious and the mortality rate is high. The genetic causes have been Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill
found, prenatal diagnosis possible and screening carried out since University
2006. Background: All too often research results are inaccessible to
communities and research participants. In efforts to improve
POSTER SESSIONS: M N O 145
knowledge translation and dissemination, a DVD describing the key PROGRESSION OF RESEARCH IN CANADA’S ARCTIC:
findings of the International Polar Year Child Inuit Health Survey of INTRODUCTION OF INUIT RESEARCH ADVISORS
Nunavut was developed.
S. O’Hara
Methods: Key findings were reviewed with steering committee
Inuvialuit Regional Corporation
members and other key stakeholders, a draft DVD was developed in
English and translated into Inuktitut, Nettilik, and Innuianaqtun, Recently headway has been made to conduct research in Canada’s
representing the 3 primary Inuit dialects found in the communities that Inuit regions, and since, it has increased at an unprecedented rate. This
participated in the child health survey conducted in Nunavut. increase is based on concerns expressed by Inuit populations, different
levels of government, regional and national Inuit organizations, and is
Results: A total of 384 pre-school children, aged 3-5 years, participated
now part of the advancement of research programs such as the
in the survey in 16 Nunavut communities. Key findings relating to
International Polar Year. Some national concerns of Inuit include
household crowding, passive smoking, food security, traditional food
climate change, contaminants, resource development and arctic
use, dietary adequacy and dietary quality, healthy weight, visual
sovereignty. Community level concerns include food security, water
acuity, methylmercury exposures, and other health indicators are
quality, infrastructure, industrial development, coastal erosion, and
presented. Recommendations were provided for promoting health of
local contaminated sites. A priority for Inuit is to build capacity in our
children in the Arctic. Specific information of results is embargoed until
regions to keep pace with this increased research and development in
dissemination of information on findings to communities is completed
the arctic. In 2005, progress was made in Canada, when Inuit Research
in May of 2009.
Advisors (IRAs) were introduced in the four Inuit regions by national
Conclusions: Presentation of research results in a multilingual DVD research funding organizations ArcticNet, Nasivvik and the Northern
format enhances uptake of research results by communities and other Contaminants Program.
stakeholders and improves the capacity of research to empower
This poster explains how IRAs work on community issues of
communities, inform policy, and ultimately make meaningful
importance to Inuit. It will also explain how IRA’s assist researchers
differences that will improve the health of children living in Arctic
meet regional guidelines and consultation requirements when working
communities.
Contact: Grace Egeland (grace.egeland@mcgill.ca)
in Inuit regions. Lastly, it will introduce the network of contacts IRAs
draw from to be productive in their roles. It will introduce aspects of
research IRAs wish to improve including, building capacity, research
NEGOTIATING PATHWAYS TO ADULTHOOD: SOCIAL ethics and licensing, meaningful community participation, advocating
CHANGE, MENTAL HEALTH AND INDIGENOUS CULTURE language and culture, seeking out education and training
opportunities, ensuring the inclusion of traditional knowledge in
K. Nystad
research, ensuring research results, and helping communities and
Sámi University College/University of Oslo researchers understand the research process. IRAs are a resource for
Contemporary dynamics of rapid social change have dramatically researchers and students by acquiring; community support, planning
affected the political, social, cultural, and economic systems of of logistics, and recruiting local assistance. Finally, this poster will
circumpolar Indigenous peoples (Allen 2007). The study seeks to examine the network of contacts IRAs have at the regional and
contribute to knowledge about how young people in one Sámi national level, including committees and working groups which IRAs
community adjusts to the rapid changes. The study will add new are members of on behalf of our regions. This involvement ensures
knowledge about how the youth manage the transition from childhood that Inuit stay at the forefront in decision making and are active
to adulthood in a society totally different from that in which their partners in guiding future research.
Contact: Shannon O’Hara (sohara@irc.inuvialuit.com)
parents and grandparents lived.
By focusing on local narratives about the everyday lives of young
indigenous people and how they negotiate pathways to adulthood, the A REPORT OF THE JAPAN WORKSHOP ON ANTARCTIC
study aims to explore ways youth are mobilizing themselves and how MEDICAL RESEARCH AND MEDICINE – WE NEED A BROAD
communities and families can support the safe passage of their young
NETWORK OF ANTARCTIC MEDICAL RESEARCH
members. How do the youth identify themselves with their cultural
background and what is the significance of this identification in a G. Ohno1, K. Watanabe2
1
society touched by rapid changes? The answer to this question may Tokatsu Hospital, 2National institute of Polar Research
contribute to our understand of how to give indigenous youth the Background: Antarctic medical issues are very widespread and some of
mental support necessary to allow them to successfully reach them are related with Arctic ones. In Japan, Antarctic medical
adultuhood. Sámi youth, like other indigenous youth in the North, researches are treated by Antarctic doctors employed each expedition.
must be able to find a life strategy in balance between two cultures in a In spite of so many medical problems, Antarctic medical research
world where social and environmental changes are rapid. In their group is very small without permanent specific departments. To
planning of careers the yout must be aware of the traditional and the conquer this obstacle, we set up the workshop of Antarctic medical
modern, their own culture and the majority culture. The choices they research and medicine.
may have to make may require deeper reflection than for other youth.
Coping and belonging are central elements, as is the need to feel Methods: Primary members of the workshop were medical doctors
acceptance and this can affect their choices. How do the youth cope with Antarctic experience. The task of this workshop is to discuss
with these challenges? Some will succeed and others will experience previous medical studies and to make research plan with the next
failure and have problems in coping and belonging. expedition doctors. Extensive specialists are invited to lecture in
various concerns of Antarctic medicine. We also manage the joint
The project will be carried out on three levels: in the local community, research between participants and Antarctic medical group. Since
with families and with individual (youth). The elders are also involved in 2006 we invited Asian nations’ members to this workshop.
the project.
Results: We started the workshop on 2004 with 23 participants from 16
This PhD research project is the Norwegian part of an international institutes, universities and hospitals. The workshop on 2008 was held
circumpolar project: “Negotiating pathways to Adulthood: Social on gathering 63 participant from 38 departments of four Asian nations
Change and Indigenous Culture in five Cirumpolar Communities” putting into Antarctic winter over operations. The resident doctors at
Contact: Kristine Nystad (kristine.nystad@gmail.com)
Antarctic Station joined the discussion through a real-time
telecommunication system. The issues discussed were psychological
studies in closed extreme society, the mortality and morbidity in
Antarctic wintering team, medical equipments, the telemedicine
system, the relationship between Antarctic medicine and space data on high-layer grinding wheels to cut diamond coating is applied
medicine, nutrition and metabolism in cold environment, survey of by the plasma at 1500 C, while agglomerate solid alloy is made up of
Regionella species in Antarctic stations and so on. particles of metal carbides. Stimulated chemiluminescence cells in the
Several joint researches has realized and some are running now. presence of luminol - informative indicator of the functional state of
phagocytes of blood and tissues, their ability to generate reactive
Conclusions: The Antarctic medical workshop successes to gather oxygen species, that is to carry out its protective function. Adding dust
many researchers from various institutes, universities and also from generated when cutting diamonds (2mg/ml) in termostatiruemable
Asian nations. The joint researches develop the Antarctic medical cuvettes suspension of leucocytes (106 in 1 ml) caused their activation.
study. We will pursuit still more co-operations with many fields Increased chemiluminescence recorded with a wavelength of 555 nm in
including Arctic area. a sharp peak.
Contact: Giichiro Ohno (oonog@mb.infoweb.ne.jp)
The dust generated during cutting of diamonds, has caused a rapid
response type of hemilyuminested one peak intensity of 3799 units and
THE STATUS OF LIPID PEROXIDATION OF SPORTSMEN IN the addition of dust generated during obdirke diamond, causing
CONDITIONS PREVAILING IN YAKUTIA hemilyuminested response to the three peaks from 3810 to 3818 units
E.D. Okhlopkova, A.I. Yakovleva, L.D. Olesova, E.I. Semenova, G.E. in the range of 545 -560 nm. The nature of chemiluminescence
Mironova response of leukocytes stimulated pylyami, resulting in the cut and
obdirke diamonds indicate that they have a high zeta - potential.
Establishment of RAMS, Yakutsk Research Center of complex medical Elektrostatical binding due to the composition of the investigated
problems SB RAMS dusts containing in iron, strontium, lead, copper, zinc, which causes the
Sportsmen in the North are often marked chronic physical stress, uneven distribution of electron density on the surface of the Dust and
which is a pathological condition. Physical stress caused by intense cause a rapid activation of phagocytes. Dust, enabling a quick XL-
physical exertion and extreme climates. response type of chemiluminescence different high biological
The aim of this study is to evaluate the intensity of lipid peroxidation aggressiveness and form a type of pneumoconiosis exogenous
for sportsmen. alveolita (Velichkovsky, 1980, 1995, 2001; Kudryashova, 1993;
Snegovaya, 1990). That’s why we can assume that citotoxic properties
We examined 16 highly skilled sportsmen whos aged 15-16. The first of dust formed in result of cutting diamonds, is not only carbon but
group of athletes involved in wrestling (n = 10), second - athletes also metals allocated grinding discs. The analysis of our results show
engaged in archery (n = 6). Control group consisted of 20 healthy that the dust generated when we cut the diamonds and it have a high
young men engaged in physical exercise at least twice a week. The cytotoxicity, as well as their fast typical chemiluminescence response.
intensity of sex was determined by concentration, malonable Contact: Luba Olesova (atec@mail.ru)
dialdehyde (MDA) in eritratsitation of blood. Indicators of antioxidant
(HPA) is defined as low total content of antioxidants (NMAO).
According to information received from the athletes noted an increase HORMONAL STATUS AND PREVALENCE OF ENDOCRINE
in the floor. In the first group, the level of MDA increased to 2.3 times DISEASES IN WORKERS OF GOLD COMPANY “POLE”
in the second group - at 3.8 times, compared with control. I.V. Osokina1, T. Starosotskaya1, M. Shapran2
Concentration NMAO statistically significantly reduced by more than 2 1
State Research Institute for Medical Studies of the North, Krasnoyarsk,
times in both groups. At the same time, a free-style wrestlers NMAO
Russia, 2Institute of Polyclinic Medicine
level was below 2.3 times, and the athletes involved in shooting at 2.8
times. Objectives: Today Gold Company “Pole” accounts for almost 85% of
gold output in Krasnoyarsk territory and is the largest gold producer in
The level of CS and TG in athletes vary depending on the sport. The
Russia. Gold Company “Pole” operates in the climatic conditions of the
content of CS and TS in the first group of athletes was higher by 20%
Far North practically unbearable for people’s permanent living.
and 7%, compared with control. In the second group of athletes the
Therefore the work is done by shift method and labour resources are
level of HS was lower by 1%, the level of TG - 12%, compared with
attracted from regions with good climatic conditions.
control.
Aim: To study the hormonal status and prevalence of endocrine
Thus, the observed changes in indicators of lipid metabolism (MDA,
diseases in shift workers of Gold Company “Pole” in the north of
TG, CS) in athletes, depending on the sport. In the first group of
Krasnoyarsk territory.
athletes tended to increase lipid metabolism. In the second group
observed a reduced (TS and HS), while raising the level of MDA. Methods: In the North-Eniseysk region of the Krasnoyarsk territory
Intense exercise increases the rate of lipid peroxidation and reduce (Eruda settlement, 62°N) we examined 400 workers (age median 36
unfermentative AOC athletes. The state of LPO depends on the type of years, 348 men). The assessment included clinical examination,
sport. measurement of weight and height; thyroid and hepatic ultrasound
Contact: Elena Okhlopkova (atec@mail.ru) scan; an oral glucose tolerance test, plasma lipids, glucose, hormones:
TSH, free thyroxine (fT4), insulin, testosterone (for men older 40
years).
THE CYTOTOXICITY OF INDUSTRIAL AEROSOLS FORMED IN Results: The average level of TSH was 1.53 mU/l, fT4 - 17.0 pmol/l,
DIAMOND testosterone - 4.4 ng/ml (normal 3.0-12.0). Hypothyroidism was
L.D. Olesova, G.E. Mironova revealed in 5 patients (1 - after thyroid surgery and 4 - autoimmune
Establishment of RAMS, Yakutsk Research Center of complex medical thyroiditis), hyperthyroidism - in 3 cases (2 - Graves’ disease, 1 - toxic
problems SB RAMS nodule). Endemic goiter was found in 16.6%. 97 workers (24.3%) were
overweight. Metabolic syndrome was diagnosed in 44 workers (11.0
Lyuminal dependant of hemilyuminestions dust particles generated in %). Four patients had diabetes type 2 (2 cases was diagnosed at first
the processing of diamonds, which was detected at time) and six had impaired glucose tolerance. Liver steatosis was found
spektrolyuminometry firm Perkins Elmer in termostatiruemable in 32 workers. Testosterone was reduced (1. 7 - 2.7 ng/ml, average 2.4 +
cuvette. Atomic-emission analysis showed the presence in the dust 0.6) in 26 from 119 men older 40 years (21,8%).
generated during the processing of diamonds 18 chemical elements,
which took the largest share of metals: iron, chromium, nickel, Conclusion: We found out high prevalence of thyroid diseases,
manganese, copper and zinc. As the diamond dust should be hypogonadism, obesity, and metabolic syndrome among workers of
composed of carbon, the presence of metals due to their allocation of Gold Company “Pole”.
Contact: Irina Osokina (osokina@rol.ru)
grinding wheels in the processing of diamonds. According to literature
POSTER SESSIONS: P Q R S 147
Results: Compared with Prevnar™, vaccination with Synflorix™ could

PQRS prevent an additional 170,951 ambulatory visits for AOM, 144,454
antibiotic prescriptions for AOM, and 9,830 hospitalizations for
myringotomy per year. With Prevnar™, the total direct costs per year
RISK FACTORS FOR IRON DEFICIENCY ANEMIA AMONG
associated with AOM are $119.8 million of which $16.9 million could be
INUIT CHILDREN, AGES 3–5, LIVING IN NUNAVUT off-set by implementation of routine vaccination with Synflorix™.
A. Pacey1, Qanuippitali Steering Committee (Nunavut)2, G.M. Egeland1 Conclusion: Based on the base-case analysis, inclusion of Synflorix™ in
1
McGill University, School of Dietetics and Human Nutrition, routine immunization programs across Canada would be cost-saving to
2
Representatives from Nunavut Association of Municipalities and the healthcare system compared with Prevnar™. Synflorix™ offers
Nunavut Tunngavik Incorporated; I. Sobol and G. Osborne, Government substantial benefits in terms of reduced ambulatory visits, antibiotic
of Nunavut Department of Health and Social Services; K. Young, prescriptions and hospitalizations for AOM, a highly prevalent
University of Toronto childhood condition.
High rates of childhood iron deficiency anemia (IDA) have been Synflorix™, is a trademark of the GlaxoSmithKline group of
previously reported in some Inuit communities. This suggests that IDA companies. Prevnar™ is a registered trademark of Wyeth.
may be a public health concern for Inuit children living in Nunavut but Contact: Jennifer Pereira (jennifer.a.pereira@gsk.com)
information surrounding this health issue is lacking at the population

level. In addition, underlying food insecurity and household crowding
may predispose young children living in Nunavut to low iron in the diet BACTERIAL VS. VIRAL PATHOGENS: A SYSTEMATIC REVIEW
and infection with Helicobacter pylori (H. pylori), both of which are risk OF THE ETIOLOGY OF ACUTE OTITIS MEDIA
factors for iron deficiency. As such the overall objectives were to report J. Pereira
the prevalence of and investigate key risk factors for iron deficiency
GlaxoSmithKline
anemia among preschool-aged Inuit children living in Nunavut. We
conducted a cross-sectional survey with 388 Inuit children, aged 3-5, Background: Acute otitis media (AOM) is a common childhood
from 16 Nunavut communities between August 2007 and September condition with viral and bacterial etiology. Routine immunization
2008. Trained interviewers conducted interviews with the child’s programs currently include pneumococcal conjugate vaccine
caregiver and completed questionnaires about the child’s diet, Prevnar™, which is associated with AOM reduction caused by
household conditions and food security. A nurse measured height and Streptococcus pneumoniae only. The study objective was to conduct a
weight and collected a venous blood sample. Hemoglobin (Hb) was systematic literature review to identify current pathogen causation of
measured in whole blood. Serum was frozen and later analyzed for AOM.
serum ferritin, C-reactive protein (CRP) and antibodies to H. pylori. Methods: OVID (Medline, Current Content and International
Weighted prevalence estimates of anemia (Hb < 110 g/L or 115 g/L) and Pharmaceutical Abstract databases), EMBASE, Google and Google
iron deficiency anemia (SF < 12 ug/L, CRP < 8 g/L coupled with anemia) Scholar engines were searched with the following combination of
were calculated. Odds ratios and 95% confidence intervals were used keywords: “acute otitis media”, “bacteria” and “virus”. Eligible articles
to examine the relationship between iron deficiency anemia and were in English, published between 1995 and 2008, and described
various risk factors including exposure to H. pylori, food security status, studies of pediatric AOM patients with cultures for bacterial and viral
iron intake and household crowding. Results will be presented pending isolates.
delivery of summary results to Nunavut hamlets and health Results: Of the 398 articles screened, 24 separate studies met eligibility
departments. criteria, including only one study in a circumpolar region (Greenland).
Contact: Angela Pacey (angela.pacey@mail.mcgill.ca)
Based on a fixed-effects meta-analysis across all studies, pathogens
isolated were more frequently bacterial (74%) than viral (19%). U.S
A COST-CONSEQUENCE ANALYSIS OF THE NEW 10-VALENT studies reported a similar isolation rate for bacterial pathogens (73% vs
PNEUMOCOCCAL NON-TYPEABLE HAEMOPHILUS 74%) and a slightly higher rate for viral pathogens (23% vs 17%)
compared with non-North American studies. Twenty-three studies
INFLUENZAE PROTEIN-D CONJUGATE VACCINE
included data on the specific bacterial pathogens cultured. Based on a
SYNFLORIX™ AND PREVNAR™, ON THE REDUCTION OF fixed-effects meta-analysis of patients in these studies, S. pneumoniae
ACUTE OTITIS MEDIA IN CHILDREN and Haemophilus influenzae were isolated with similar frequency (35%
J. Pereira vs. 36%) and Moraxella catarrhalis at 6%. Slightly lower rates of H.
GlaxoSmithKline influenzae (31%) and higher rates of M. catarrhalis (10%) were
observed in U.S. patients, compared with non-North American
Background: Acute otitis media (AOM) is a prevalent pediatric patients.
condition, affecting approximately 80% of children by three years of
age. Prevnar™, a 7-valent pneumococcal conjugate vaccine, has been Conclusion: Bacterial pathogens are frequently associated with AOM in
included in routine immunization programs and is associated with a pediatric populations worldwide and were isolated 3-times more often
reduction of AOM events caused by Streptococcus pneumoniae. The than viral pathogens. S. pneumoniae and H. influenzae are the
objective of this study was to compare the costs and effects of bacterial pathogens most commonly isolated in AOM cases, with
Prevnar™ with Synflorix™ which has been newly approved in Canada nearly equal frequency. A vaccine that addresses both leading causes
and employs an active protein D-carrier associated with reduction of of AOM could greatly reduce the clinical and economic burden
nontypeable Haemophilus Influenzae (NTHi) AOM. associated with this common condition.
Methods: A vaccine steady-state, population-based model with a one- Prevnar™ is a registered trademark of Wyeth.
Contact: Jennifer Pereira (jennifer.a.pereira@gsk.com)
year time horizon was developed, and calibrated with Canadian
epidemiologic and demographic data, to investigate the costs and
effects associated with AOM episodes and other diseases across the INVASIVE PNEUMOCOCCAL DISEASE CAUSED BY
Canadian population. A 4-dose schedule for Synflorix™ vaccination SEROTYPES 1, 5 AND 7F IN CIRCUMPOLAR REGIONS
was compared with a 4-dose schedule for Prevnar™ vaccination. The
base-case included herd-protection for invasive pneumococcal disease J. Pereira
and serotype 6A cross protection. A healthcare system perspective was GlaxoSmithKline
taken with the assumption of 100% vaccination coverage. Background: Routine pneumococcal immunization programs provide
Prevnar™, which protects against invasive pneumococcal disease (IPD)
148 POSTER SESSIONS: P Q R S
caused by seven serotypes. The recent introduction of Synflorix™ adaptive reactions, which are aimed to provide successful adaptation
warrants a review of IPD events attributed to the three additional to life conditions can be found. Persons with insufficient variants
serotypes against which this 10-valent vaccine provides protection. prevail (68,3%). In examined schoolchildren with different VMA
This study summarizes the distribution of IPD cases due to serotypes 1, variants, changes in indices of immune state were defined
5 and 7F in circumpolar regions. predominantly in humoral part of immunity.
Contact: N.S. Polovodova (pinicola@mail.ru)
Methods: OVID and EMBASE were searched with the following key
words: invasive AND pneumococcal AND (serotype 1 OR serotype 5 OR
serotype 7F) AND (Canada OR United States OR Greenland OR Iceland NUTRIENT INTAKES AND VITAMIN D STATUS IN INUIT
OR Russia OR Norway OR Sweden OR Finland). Eligible articles
WOMEN 40 YEARS OF AGE AND OLDER
described studies in circumpolar regions, and published in English from
1999-2008. A. Pronovost1, G.M. Egeland1, S. Morin2, H. Weiler1, Qanuippitali
Steering Committee (Nunavut)3
Results: Of 1,024 articles identified, five met the eligibility criteria. In a 1
Greenland study describing 51 IPD cases (1996-2002, prior to Prevnar™ Centre for Indigenous Peoples’ Nutrition and Environment (CINE) &
use), serotype 1 was the second most common cause (n = 6), while 7F School of Dietetics and Human Nutrition, McGill University, 2Faculty of
caused 2 cases. A Northern Quebec study described an 11-case Medicine, McGill University, 3L. Williamson, Nunavut Tunngavik
serotype 1 outbreak in 2000-2002, but only 3 cases from 2002-2004, Incorporated; K. Young, University of Toronto; L. Gunn, Nunavut
after mass immunization with a 23-valent vaccine that protects against Association of Municipalities; G. Osborne, GN Department of Health and
serotype 1. Three studies examined the incidence of non-vaccine Social Services
serotypes pre- and post-2001 (when Prevnar™ use became Objectives: To determine nutrient intakes and vitamin D status in Inuit
widespread). While one Alaskan study found 80% and 67% reductions women ≥40 y.
in serotype 1 and 7F incidences, respectively, across all ages in 2002, a Study Design: Participants were a sub-sample (n=416, ages 40-90 y) of
study in Alaskan children found that serotype 7F cases tripled, from 3 those randomly selected to participate in the 2007/2008 IPY Inuit
cases (1995-2000) to 9 cases (2001-2006). Finally, a study of 11,244 IPD Health Survey from two regions in Nunavut.
cases in six circumpolar regions from 1999-2005 identified serotypes 1
and 7F among the five most prevalent serotypes throughout this Methods: Nutrient values were derived from single 24-hour recalls
period. using CANDAT. The concentration of 25-hydroxyvitamin D (25(OH)D)
was measured on fasting serum samples using a LIAISON® automated
Conclusion: The majority of evidence indicates that IPD incidence due analyzer. Nutrient intakes were compared between three sub-groups
to non-Prevnar™ serotypes — and 1 and 7F in particular — has been (40-49 y, 50-60 y, >60 y) using nonparametric K-sample tests on
significant in recent years. Routine vaccination with Synflorix™ could equality of medians. The proportion of women in each vitamin D status
provide the benefits of Prevnar™ while addressing this protection gap. group (severely deficient (25(OH)D≤25 nmol/L), mildly deficient (25.1-
Synflorix™ is a trademark of the GlaxoSmithKline group of companies. 50 nmol/L), suboptimal (50.1-75 nmol/L), optimal (75.1-125 nmol/L),
Prevnar™ is a registered trademark of Wyeth. supra optimal (>125 nmol/L)) was compared between sub-groups using
Contact: Jennifer Pereira (jennifer.a.pereira@gsk.com) a Pearson chi-square test.
Results: Complete nutrient data and 25(OH)D measurements were
IMMUNE HOMEOSTASIS IN CHILDREN OF THE FAR NORTH obtained for 333 and 374 women, respectively. Trends towards
AT DIFFERENT VARIANTS OF VEGETATIVE MAINTENANCE increasing intakes of protein, manganese, phosphorus, zinc,
polyunsaturated fatty acids, vitamin D, calcium and magnesium per
OF ACTIVITY
1000 kilocalories with age was observed. Median intakes were below
N.S. Polovodova,T.V. Maltseva the EAR for vitamin A in all groups and vitamin C in those >60 y, and
State Scientific Research Institute on Medical Problems of the Far North below the AI for vitamins D and K, and calcium. The proportion of
of RAMS women with serum 25(OH)D <75 nmol/L significantly decreased with
age (40-49 y, 72.2%; 50-60 y, 45.9%; >60 y, 20.0%).
The main function of vegetative nervous system in homeostasis
sustention is known to be vegetative maintenance of activity (VMA). Conclusions: Women >50 y tend to have higher vitamin D levels and
But nowadays, data provided by surveys of immune homeostasis on more nutrient-dense diets. The adequacy of vitamins A, D, K, and
the background of immune dysfunctions in children are highly calcium in all age groups, and vitamin C in those >60 y, warrants
debatable. Thus, aim of our research was to study the characteristics of further investigation over multiple days.
immune homeostasis at different variants of VMA in children, residing Contact: Amy Pronovost (amy.pronovost@mail.mcgill.ca)
in the Far North. 133 practically healthy schoolchildren (mean age

13,7±0,19 years), living in the Far North (Yamalo-Nenets Autonomous
ENVIRONMENTAL HEALTH – FROM EXPOSURE TO
Okrug, Russia) since their birth took part in the survey. By the results of
orthostatic test we distinguished seven variants of VMA. BIOMARKERS
Sympatheticoastenic variant was revealed in 10,5% of cases, A. Rautio1, P. Myllynen2, K. Vähäkangas2,3
hyperdiastolic – in 22,5%, asympatheticotonic variant – in 36,0%, 1
Centre for Arctic Medicine, Thule Institute, University of Oulu,
astenosympathetic – in 4,5%, paradoxical – in 9,8%, 2
Department of Biosciences (Pharmacology and Toxicology),
hypersympatheticotonic – in 0,7% of cases. Normal reaction to University of Oulu, 3Department of Pharmacology and Toxicology,
orthostatic test was stated only in 16,0% of examined schoolchildren – University of Kuopio, Finland
no complaints, heart rate increase by 20-40% from a baseline,+++
Biological, biochemical and molecular markers are needed in order to
systolic and diastolic blood pressure growth within acceptable range
find a pattern of measurable parameters for environmental health. Our
were registered. Indices of this group of children were used as controls
project concentrates on a selection of potentially useful molecular
during immune state assessment. At insufficient VMA variant, serum
biomarkers, by using human placental perfusion, cell culture models as
IgA and IgM levels, relative monocyte number, relative eosinophil
well as animal models. Our studies pursue toxicokinetics of
number, relative number of lymphocytes with immunophenotype
environmental chemicals in placental and human and animal hepatic
CD3+ and CD8+ were higher when compared to normal VMA variant.
models and their effects on the development of fetus in vitro.
At hybrid variant – relative eosinophil number and serum IgA and IgE
levels were lower, but serum IgM and neutrophil number were higher We are among the first to systemically study human fetal exposure to
when compared to normal VMA variant. Thus, we can conclude, that in chemical carcinogens and environmental chemicals by human
children who live in high latitudes, at least seven variants of phenotypic placental perfusion. In addition to providing actual data on
transplacental transfer processes our studies give more insight of the
usability of placental perfusion as a method for fetal exposure. The clients are First Nations youth. Every six weeks a new cohort of
function of placental transporter proteins that may cause variation in adolescents is admitted to the program. The data for this study
fetal exposure between individuals are not yet well understood. comprised of individual strengths assessed at admission, file reviews of
Already we have shown that ABCG2/BCRP, one of the major efflux treatment summaries and discharge reports. The data was collected
transports in human placenta affect the transport of PhIP, a from multiple cohorts upon program completion. Data was gathered at
heterocyclic amine and food carcinogen. The studies on the role of three months follow-up by telephone interview. The results showed
ABCG2 in fetal protection will continue with environmental chemicals. that increased individual strengths were associated with increased goal
The studies of bank and field voles living at the old sawmill area accomplishment and enhanced program participation. A relationship
contaminated by chlorinated dibenzo-p-dioxins and –furans (PCDD/Fs) was also found between increased strengths and positive attitudes
have a significant difference in their body burden of PCDD/Fs. towards the self as well as positive interpersonal relationships at the
Concentrations are much higher in bank voles, and the next steps of conclusion of treatment. These results offer support for the use of a
the research are the dose-response effects of TCDD on the xenobiotic strength-based approach in the treatment of substance abusing
metabolizing enzymes. adolescents who are experiencing mental health problems.
Contact: Edward Rawana (erawana@lakeheadu.ca)
This work is closely connected to the AMAP Human Health –program
and EU projects (ReProTect, NewGenerics and ArcRisk).
Contact: Arja Rautio (arja.rautio@oulu.fi)
A JOURNEY TO THE TEACHINGS: A COMMUNITY
APPROACH TO INJURY PREVENTION (2009)
DO PSYCHOLOGICAL STRENGTHS ACT AS PROTECTIVE L. Richardson
FACTORS AGAINST EARLY ADOLESCENT BULLYING IN Health Canada, First Nations & Inuit Health Branch
SCHOOLS?
Purpose: A Journey to the Teachings (JTT) is a culturally sensitive injury
E. Rawana, C. Anderson, K. Brownlee, J. Whitley prevention manual that has been created for use by service providers
Lakehead University and practitioners in First Nations and Inuit communities. The manual,
which includes ready-to-use presentation materials (slides, hand-outs),
This research explored whether personal qualities of students could be
has been developed to incorporate both First Nations and Inuit
identified that may act as protective factors against being bullied or
perspectives.
victimized by other students. It is possible for instance, that some
personal strengths possessed by the victim may help him or her JTT is organized according to the “four life cycle and stages of
surmount the risk factors associated with being bullied. Thus, the role learning” approach:
of psychological strengths in protecting students against different - Awareness: Looking at the Problem
forms of bullying was explored in a survey of grade 7 & 8 students from - Understanding: Identifying Risk and Protective Factors
a provincial northern city. The students were randomly selected to - Knowledge: Identifying Injury Patterns and Prevention
participate and responded to a series of questionnaires on strengths Strategies
(SAI and BERS-II) and bullying. Gender analysis was included in the - Wisdom: Using Prevention Strategies to Act
Results: The results showed that specific strengths, namely, school
Methods: This resource was developed using internationally recognized
functioning in boys and strengths in personality functioning for both
theories and principles of injury prevention that are based on public
genders appeared to serve as protective factors against different forms
health and epidemiological approaches. JTT is based on the resource,
of perceived bullying and victimization. Good school functioning was
A Journey: Strengthening Aboriginal Communities through injury
associated with lower frequencies of bullying experienced by boys. This
prevention, 2001 by the Alberta Centre for Injury Control and Research.
association was not found to hold for girls. Contrary to expectation,
It was developed through a consultative process with Aboriginal
both boys and girls indicated that strengths related to an increased
communities and educators and incorporates traditional and local
involvement with spirituality and cultural identification was associated
knowledge.
with greater victimization. A tentative explanation for these findings is
offered, but additional research on this topic is also indicated. The Results: JTT is a new resource with release in early 2009. Health
significant implications for anti-bullying programming in the school Canada will conduct ongoing program evaluations and report on
system are also discussed. progress.
Contact: Edward Rawana (erawana@lakeheadu.ca) Conclusions: Health Canada will be supporting training sessions for
community practitioners and service providers to enable them to
conduct local JTT workshops.
THE ASSOCIATION BETWEEN PSYCHOLOGICAL Contact: Lynda Richardson (lynda_richardson@hc-sc.gc.ca)
STRENGTHS AND THERAPEUTIC OUTCOME AMONG
ADOLESCENTS RECEIVING RESIDENTIAL TREATMENT FOR
SUBSTANCE ABUSE AT PROGRAM COMPLETION AND USING A DVD TO ADMINISTER INFORMED CONSENT: IPY
THREE MONTH FOLLOW-UP CHILD INUIT HEALTH SURVEY
E. Rawana, K. Brownlee, J. Brazeau, J. Rawana, N. Black, J. Franks R. Rosol1,2, G.M. Egeland1, Qanuippitali Steering Committee
(Nunavut)3
Lakehead University 1
Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill
There is an evolving body of literature that suggests that strength
University, 2Simon Fraser University, Faculty of Health Sciences,
based interventions are an important predictor of treatment outcome,
Government of Nunavut DHSS, Nunavut Tunngavik Inc., Nunavut
however, further information on the role of strengths in treatment for
Association of Municipalities, McGill University, University of Toronto
adolescent with co-morbid conditions of mental health and substance
abuse problems is very much needed. This study examined the The ethical requirements for the administration of informed consent
relationship between individual strengths and treatment outcomes for forms for potential participants in research has resulted in lengthy
adolescents in a residential substance abuse treatment program. The consent forms that represent a barrier to effective communication
program is offered by the Sister Margaret Centre as part of St. Joseph’s especially in cross-cultural and diverse linguistic settings. In order to
Care Group, Thunder Bay, Ontario and has a strong northern focus. facilitate recruitment into the International Polar Year Child Inuit
This centre provides a five week residential treatment program for Health Survey of Nunavut, a DVD was developed.
adolescents between the ages of 13 to 18 years of age with serious A multilingual informed consent DVD was developed and followed
substance abuse and mental health issues. About forty percent of the word-for-word the content of the written informed consent document
that was approved by the McGill Ethics Review Committee. Revisions Qanuippitali Steering Committee (Nunatsiavut), Qanuippitali Steering
were made in consultations with steering committee members and Committee (Nunavut)
then translated into 3 Inuit dialects (Inuktitut, Innuinaqtun and Netsilik) McGill University / C.I.N.E.
found in the 16 Nunavut communities that participated in the child
health survey. The traveling child health survey team included nurses, The IPY Inuit Health Survey was developed to better understand the
bilingual interviewers, nutritionist, and a lab technician/graduate factors contributing to Inuit health and spirit of thriving in the face of
student and involved local community research assistants. Inuit changes. Because of the vast distances involved, the CCGS Amundsen
children aged 3-5 years were identified by the community health was used to visit the 33 coastal communities in the Inuvialuit
centre and parents or guardians were invited to have their child Settlement Region, Nunatsiavut, and Nunavut Territory in 2007 and
participate. In larger communities, children were randomly selected 2008. Members of the ship survey team included interviewers, nurses,
using random digit numbers while in smaller communities all laboratory technicians, and specialists. A greeter welcomed
appropriately aged children were eligible for participation. After participants onboard and Coast Guard personnel ensured safe
viewing the DVD informed consent information and agreeing to transportation to and from the ship. Once participants were on board,
participate, guardians signed informed consent forms. nurses took fasting blood samples, administered a glucose tolerance
test, measured blood pressure and pulse, and took body composition
A total of 384 children participated in the health survey. The DVD was a measurements. Participants over 40 years of age underwent specialty
helpful tool in explaining the child health survey and what the tests.
participation involved for children and their parents.
Participants also met with bilingual interviewers to answer questions
Research practice standards are evolving and media approaches to about diet, general health and well-being, tobacco use, mental health,
enhancing communication with potential participants in health alcohol and drug use, physical activity and social support. Lab
research will likely become more widespread. DVD communication can technicians prepared all blood samples on board the Amundsen.
improve participants’ understanding of research while simultaneously Participants received some of their results (height, weight, waist
fulfilling the lengthy requirements of ethical review boards. circumference, blood pressure and hemoglobin readings) while on
Contact: Grace Egeland (grace.egeland@mcgill.ca)
board the ship. The fieldwork took place over 2 years. A total of 2,100
participants, ranging in age from 18 to 90 years from 33 coastal and 3
FOOD SECURITY IN NUNAVUT: PRELIMINARY RESULTS non-coastal communities in Inuvialuit Settlement Region, Nunavut,
and Nunatsiavut participated.
FROM THE IPY ADULT INUIT HEALTH SURVEY
The Inuit Health Survey will provide Inuit specific information that will
R. Rosol1,2, G.M. Egeland1, C. Huet1, L.H. Malcoe2, Qanuippitali
aid Inuit in making informed choices about their health. It also provides
Steering Committee (Nunavut)3
1
an analytically rich database for researchers exploring determinants of
Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill health, and for those developing health policies and interventions.
University, 2Simon Fraser University, Faculty of Health Sciences, Nearly all participants agreed to a 7-year follow-up forming the
3
Government of Nunavut DHSS, Nunavut Tunngavik Inc., Nunavut International Inuit Cohort Study in collaboration with plans for a
Association of Municipalities, McGill University, University of Toronto Nunavik, Quebec and Greenlandic follow-up evaluation. The successful
Food security is a social determinant of health and a public health work onboard the Amundsen is a testimony to capable individuals
priority for the Inuit. Traditionally sustained by nutrient-dense country working together for a common goal.
foods such as caribou, fish, and seal, the current trend among Inuit is Contact: Helga Saudny-Unterberger (helga.saudny-unterberger@mcgill.ca)
an increased consumption of market foods. While Inuit continue to

undergo changes in their lifestyle and cultural practices, diets that
emphasize a diverse array of traditional/country foods and nutritious
THE PARTICIPATORY APPROACH TO THE IPY INUIT HEALTH
market foods will be essential to sustaining good health. SURVEY 2007/2008
Limited data exist on food insecurity, and on the availability of and H. Saudny-Unterberger, C. Lennie, M. Wood, N. Obed, I. Sobol, K.
access to country foods among Indigenous Peoples in Canada. The IPY Young, G.M. Egeland, Qanuippitali Steering Committee (Inuvialuit),
Inuit Health Survey: “Qanuippitali? How about us, how are we?” was Qanuippitali Steering Committee (Nunatsiavut), Qanuippitali Steering
conducted across the Canadian Arctic and collected vital information Committee (Nunavut)
on health and household characteristics. Homes were randomly McGill University / C.I.N.E.
selected and one adult per home answered a household questionnaire Inuit have expressed a desire to have health information that is Inuit
which contained items on home characteristics, food security, and specific and of practical relevance so that informed decisions can be
family’s access to country food. The questionnaire was administered made in the face of the rapid changes that are affecting all dimensions
by trained bilingual land-team members. The prevalence and severity of life in Arctic communities. In response to these concerns, a
of food insecurity were calculated using a modified version of the multifaceted participatory health research project for those 18 years of
USDA Food Security Survey Module Questionnaire. age and above was developed and undertaken in the Inuvialuit
The Inuit-specific data carries important implications for Inuit in terms Settlement Region, Nunatsiavut, and Nunavut over a 2 year period.
of developing effective responses to mitigate the negative health The survey was designed to be compatible with a similar survey in
effects of food insecurity, and to help guide future policy and program Nunavik of Northern Québec in 2004 and with an ongoing health
interventions. Information collected on the availability, food sharing survey in Greenland.
practices, accessibility and harvesting methods of country food will All work was developed in full partnership with steering committees,
provide additional level of food security relevant to northern advisory committees and working groups representing the 3
communities. Preliminary results will be presented at a student jurisdictions and University researchers. Plans took into account the
session on the 20 communities surveyed in the Baffin and Kivalliq different traditional foods, languages and cultural identity of the 3
regions of Nunavut. Caveats of the USDA approach will be discussed as regions yet sought consistency in methods and approaches for a
it relates to assessing food security among Indigenous Peoples. unified Inuit Health Survey. Memoranda of Agreement, containing
Contact: Renata Rosol (renata.rosol@gmail.com)
precise language regarding roles and responsibilities of steering
committee members, committees and researchers, short and long-
A DAY IN THE LIFE OF THE IPY INUIT HEALTH SURVEY SHIP term storage of the data and information dissemination, were
developed with each steering committee. In addition, each community
TEAM: PARTICIPANTS VISITING THE CCGS AMUNDSEN
decided whether they wanted to be included in the survey by signing a
H. Saudny-Unterberger, H. Angootealuk, E. Elias, S. Chatwood, A. community-university research agreement. Community corporations
Nicholson, K. Young, Qanuippitali Steering Committee (Inuvialuit),
and steering committee members were indispensable in identifying methodology. We reviewed medical records for all children identified
bilingual individuals for land and ship teams. Face-to-face meetings with HSCR with birth years 1996-2007. HSCR was confirmed when a
and telephone conference calls with steering committees and hamlets child’s medical chart documented positive diagnostic testing by rectal
ensured a successful completion of the survey. biopsy. Reported HSCR was ruled out when the chart indicated that
The health survey will provide the most comprehensive look at diagnostic tests were negative or when an alternate diagnosis was
community and personal health of Inuit, and will assist health confirmed.
professionals and policy makers at the regional, provincial, territorial Results: HSCR prevalence fell from 9.8 per 10,000 live births before
and national level in formulating priorities and strategies for health case verification to 3.0 per 10,000 live births after case verification
policies. Alaska Native infants had confirmed HSCR rates three times that of
Contact: Helga Saudny-Unterberger (helga.saudny-unterberger@mcgill.ca) non-Native infants PVP was highest for Alaska’s largest neonatology
practice (ANA) and lowest for reports received through Medicaid
(DMA).
DECLINE IN THE PREVALENCE OF NEURAL TUBE BIRTH
Conclusions: A case-verification study demonstrated that Alaska does
DEFECTS, ALASKA, 1996-2004
not have an increased risk of HSCR overall but that the Alaska Native
K.J. Schoellhorn population has a three-fold increase in risk compared to the non-
State of Alaska Division of Public Health Native population. These findings have important implications for
Introduction: All women who are capable of becoming pregnant should development of etiologic hypotheses yet were not apparent during
consume 400mg of folic acid per day in order to reduce the number of evaluation of pre-verification reports.
Contact: K. Janine Schoellhorn (karen.schoellhorn@alaska.gov)
neural tube birth defects (NTDs). In 1996, the USFDA published a
requirement that all commercial grain products be fortified with folic
acid, effective January 1998. THE EPIDEMIOLOGY OF TUBERCULOSIS IN THE
Methods: We analyzed Alaska Birth Defects Registry (ABDR) data for CIRCUMPOLAR REGION OF CANADA, 1997 TO 2006
children born in 1996-2004 to examine post-fortification trends in NTD D. Scholten1, V. Gallant1, C. Case2, J.F. Proulx3, E. Randell4, P. Rivest5,
birth prevalence. C. Stannard6, M. Yetman7
Results: At the beginning of the study period, ABDR data indicated 1
Public Health Agency of Canada, 2Department of Health and Social
three-year average (1996-1998) NTD prevalences of 22.2 per 10,000 for Services, Yellowknife, 3Direction de santé publique du Nunavik, Quebec,
Alaska Native infants and 5.7 per 10,000 for non-Natives. Statewide 4
Department of Health and Social Services, Government of Nunavut,
NTD birth prevalence declined 50% between 1996 and 2004, from 7.9 5
Direction de la Protection de la Santé Publique, Ministère de la Santé et
to 3.9 cases per 10,000 live births (p<.05). The five year average NTD des Services Sociaux, Montreal, Quebec, 6Yukon Communicable Disease
birth prevalence declined 66% for the Alaska Native population and Control, Whitehorse, Yukon, 7Department of Health and Community
33% for non-Natives. Services, St. John’s, Newfoundland and Labrador
Discussion: Folic acid fortification of packaged grain products likely Background: The circumpolar region of Canada includes Yukon,
resulted in a 50% decline in NTD prevalence in Alaska during 1996- Northwest Territories, Nunavut, Nunavik (the northern region of
2004, meeting the CDC estimate of a 50% reduction in NTDs if all Quebec) and the northern region of Labrador in Newfoundland-
women of reproductive age consume the recommended dosage of Labrador. In 2006, Canada helped to establish the TB Working Group
folic acid. We found high pre-fortification NTD rates for Alaska Native, of the International Circumpolar Surveillance (ICS-TB) network. The
compared to non-Native, infants. The almost four fold excess risk of an purpose of this poster is to advance the work of the ICS-TB working
NTD-affected birth for Alaska Natives was virtually eliminated by 2004. group by presenting an historical review of the epidemiology of TB in
Single-year data show that most of the decline in NTD prevalence the circumpolar region of Canada.
among Alaska Natives occurred between 1998 and 1999,
corresponding temporally with the FDA fortification mandate. These Methods: Cases of new or relapsed active TB reported from 1997 to
data provide support for improving nutritional education and support 2006 were categorized as “circumpolar” or “non-circumpolar” based on
among Alaska Native women and implementing nutritional place of residence at the time of diagnosis. Descriptive analysis
intervention in the pre-conception settting. compared the groups on demographic and clinical characteristics.
Contact: K. Janine Schoellhorn (karen.schoellhorn@alaska.gov) Preliminary results include cases from Yukon, Northwest Territories
and Nunavut only.
Results: From 1997 to 2006, 17,324 cases of TB were reported; 430 (3%)
INCREASED RISK OF HIRSCHPRUNG’S DISEASE AMONG in the circumpolar region and 16,894 (97%) in the rest of Canada. The
ALASKA NATIVES IDENTIFIED FOLLOWING VERIFICATION average annual incidence rate in the circumpolar region (42.7 per
OF REPORTED CASES, 1996-2006 100,000) was almost eight times higher than the rest of Canada (5.4
K.J. Schoellhorn, S.A. Collins per 100,000). Circumpolar cases tended to be younger (30 vs. 43
median years) and most (96%) were of Aboriginal origin (Inuit 75.2%,
State of Alaska Division of Public Health
Métis 0.2% and Status Indian 23.4%). Circumpolar cases were more
Background: Hirschsprung’s disease (HSCR) is a potentially fatal likely to be identified through contact tracing (38.6% vs. 5.8%) and to
neonatal intestinal obstruction syndrome. During birth years 1996- be diagnosed with primary TB (17.2% vs. 6.1%). However, the rate of
2002, reported HSCR birth prevalence in Alaska was 13.3 per 10,000 drug resistance remains markedly lower in circumpolar cases (0.9 % vs.
live births, approximately six times higher than national estimates, 11.7%).
with no significant disparities by race, maternal age, Alaska Native
Conclusion: The epidemiology of TB in the circumpolar region of
status or maternal residence. Case verification sample surveys,
Canada shows higher rates of disease and a profile suggestive of
initiated at major hospitals in 2002 and 2004, reported high positive
ongoing transmission in the community, while low rates of drug
predictive value (PVP) for reports of HSCR to the Alaska Birth Defects
resistance remain encouraging. Ongoing, targeted surveillance of TB in
Registry (ABDR), lending support to the validity of elevated HSCR
the circumpolar region of Canada will provide important information to
prevalence estimates. As preparatory work for a study of genetic and
reduce disease rates and maintain low levels of drug resistance.
environmental HSCR risk factors, we a complete case verification study Contact: Derek Scholten (derek_scholten@phac-aspc.gc.ca)
of reported HSCR.
Methods: The ABDR is a statewide population-based birth defects
registry utilizing passive surveillance and multiple source reporting
WHAT’S IN YOUR FREEZER? TRADITIONAL FOOD USE IN normalization, and the number of monocytosis fell to 8,26 +/- 0,91%,
TWO FIRST NATIONS COMMUNITIES IN YUKON, CANADA however, the absolute monocytosis was still at 2 athletes. Saving
monocyitosis after the competition, we think, is a sign of tiredness and
R. Schuster, L.H.M. Chan, C. Dickson
dysadaptation of body. In this case, they need a development and
University of Northern British Columbia application of rehab measures.
Traditional foods are at the center of culture and health for Aboriginal Thus, changes in hematological parameters in athletes before
Peoples across Canada. With increased environmental, social and competition: increasing the concentration of hemoglobin, a color
economic pressures, the diet of many First Nations communities has indicator of conserning monocytosis possibly linked to the violation of
shifted from one largely comprised of traditional foods to one water-salt metabolism and dysadaptation of body also it will a clinical-
including increasing quantities of market foods. An improperly diagnostic indicator of physical fatigue athletes.
balanced diet of market foods can result in nutritional deficits and Contact: Evgenia Semenova (atec@mail.ru)
raises health concerns for chronic diseases. This project intends to
create a record of traditional food consumption in two Yukon First
Nations communities, the Vuntut Gwitchin of Old Crow, located above COLLABORATION AND CONSULTATION IN INFECTIOUS
the Arctic Circle, and the Teslin Tlingit, located southeast of DISEASE SURVEILLANCE AND PREVENTION IN CANADA’S
Whitehorse along the Alaska Highway. NORTH
Frequency of traditional food consumption per season from summer S. Shaw, E. du Plessis, L. Thompson, C. Sevenhuysen, M. Fast
2007-winter 2008 along with average portion size was documented in National Collaborating Centre for Infectious Diseases
interviews with 29 and 33 community members in Old Crow and Teslin,
respectively. This information was compared with data collected in the Introduction: Designing and implementing infectious disease
early 1990s to illustrate changes in food use over the past fifteen years. prevention programs is complicated by an evolving body of research,
The comparison, though limited by only two time points and and an expanding range of intervention options. In northern Canadian,
differences in methodologies, may provide a snapshot of general where rates of reportable infectious diseases have historically been
trends of changes in traditional food use. among the highest nationally, program and policy planning also faces
other unique and significant challenges. Access to health services,
The frequency of consumption of traditional foods was not shown to infrastructure limitations, geographic and environmental
decrease in Old Crow over the past fifteen years. Although the considerations, resource allocation, and social structures influence
frequency of consumption of mammals decreased, frequency of both clinical and public health strategies to reduce the impact of
consumption of fish, berries and other plants was reported to increase. infectious diseases.
In Teslin, frequency of traditional food use decreased overall, with
plants other than berries being the only group to show an increase in The mandate of the National Collaborating Centre for Infectious
frequency of use. The changes in traditional food use can be attributed Diseases (NCCID) is to help bridge the gap between evidence and
to changes in environment, food availability, and perhaps cultural action. In fulfilling this role, NCCID has consulted with northern
sensitivities. We are working with the communities to develop specific Canadian practitioners to identify public health priorities.
adaptation plans to minimize impact on their quality of diet. Results: Drawing from NCCID’s consultation in June 2008 and Forum in
Contact: Roseanne Schuster (schuster@unbc.ca) March 2009, this presentation will focus on identified gaps and
priorities for strengthening public health’s response to infectious
diseases in the Canadian north. This presentation will briefly outline
DYNAMICS OF HEMATOLOGICAL INDICATORS AS CLINICO- NCCID’s process for involving multiple parties in knowledge exchange.
DIAGNOSTIC TEST SPORTSMEN’S ADAPTATION OF The remainder of the session will outline critical gaps constraining the
YAKUTIA TO PHYSICAL EXERCISES strategic planning of prevention programs, as well as significant issues
E.I. Semenova, E.D. Okhlopkova, A.I. Yakovleva affecting the prevention and control of infectious diseases in the
Canadian north.
problems SB RAMS Conclusion: The identification and discussion of gaps, issues, and
opportunities for infectious disease prevention in northern Canada will
The most important element in learning to adapt to the restructuring
accelerate the development and implementation of effective
of the organism athletes intense physical strain in the extreme climatic
programming strategies.
conditions of Yakutia is the evaluation of morphological blood. The Contact: Souradet Shaw (sshaw@icid.com)
aim of our research was to study the physiological state champions
qualified shifts hematological indices of blood in different periods of
the training process. We examined 10 qualified and the most efficient PHYSICAL DEVELOPMENT AS A FACTOR OF CHILDREN’S
free-style wrestlers in age from 17 to 20 years who participated in the HEALTH IN THE FAR NORTH (RUSSIA)
championship of Russia among juniors. The concentration of
N.N. Shim
hemoglobin, the number of erythrocytes, leukocytes and differential
leukocyte formula was studied in the dynamics of 7 days before and State Scientific Research Institute on Medical Problems of the Far North
after the competition. of RAMS
Obtained showed that the athletes before and after the competition Physical development is one of the most important criteria which
the number of red blood cells fluctuated within the limits of the rules: reflects not only health status in a man but social welfare in population.
up to competition - 4,39 +/- 0,07, after - 4,42 +/- 0,09 million ml of Aim of a study was to define a level of physical development in
blood. The concentration of hemoglobin to the competition in line with schoolchildren living in the Far North (Tarko-Sale village and Nadym
the average of 153,29 +/- 2,74 g / l. The concentration of hemoglobin city) in comparison with other regions (town of Shatura, Central
above 160 g / l found in the three athletes. As a result, the average Russia). When comparing physical development of Nadym boys and
value of color index was higher standards. After the competition Tarko-Sale boys, significant increase in the following indices was
tended to normalize the concentration of hemoglobin - 135,4 +/- 3,49 g stated: height – by 5,7% (149,3±7,8 vs. 141,0±6,2, p<0,001), body mass
/ l and a color indicator - 0913. The total number of leukocytes before – by 16,6% (43,4±9,6 vs. 36,2±5,4, p<0,001), lung vital capacity (LVC) –
and after the competition changed slightly 5,74 +/- 0,37 Thousands and by 16,4% (2400±500 vs. 2006±290, p<0,001). Significant decrease in
thousands of 7,19 +/- 0,47 respectively. Differential counting of dynamometry of a right hand – by 2,8% and a left hand – by 6,9%
leukocytes revealed the presence of monocytosis (11,04 +/- 1,65%). (p<0,001) was also present. In Nadym and Tarko-Sale girls, the same
The monocytosis detected in 80% of the athletes, the absolute - 40% tendencies were revealed. There was stated significant increase in
of the athletes. After the tournament there was a gradual height – by 2,9% (149,4±6,2 vs. 145,1±6,3, p<0,001), body mass – by
13,5% (39,9±5,9 vs. 34,5±5,1, p< 0,001), LVC – by 13,9% (2300±400 vs. indigenous Sámi municipalities located in the inland area of Finnmark
1980±320, p<0,001). Decrease in dynamometry of a right hand reached County. The municipalities are all included in The Saami Language Act
15% and a left hand – 18,9% (p<0,001). Comparative analysis of Nadym of Norway. The Team serves adolescents and young adults aged 15 to
children and Shatura children showed that Nadym boys had 30 years. The Team’s main issues are prevention and treatment of
significantly higher height – by 3,8% (149,3±7,8 vs. 143,9±7,5, p<0,001), suicidal behaviour problems and substance abuse.
body mass – by 18,4% (43,4±9,6 vs. 33,7±7,1, p<0,001), LVC – by 27,0% Methods: The Team emphasizes a cultural sensitivity approach. First, a)
(2400±500 vs. 1811±310, p<0,001). Indices of dynamometry of a right the Team staffs are cross professional including psychologists, social
hand in Nadym boys were also higher by 23,5% and a left hand – by workers and a medical doctor, and b) the staffs have either indigenous
41,2% (p<0,001). We found out that only 42,9% of Nadym heredity or native Sámi language competence themselves, or formal
schoolchildren had harmonious physical development. So, physical education in Sámi culture competence. Secondly, a) the
development of Nadym schoolchildren was characterized by higher clients/adolescents have easy access to the treatment facilities as they
indices but was quite disharmonious mainly due to excessive body are able to admit themselves for treatment (not only school nurses,
mass. The fact can be explained both by more calorific nutrition of social workers etc.), b) the adolescents are able to receive treatment in
Nadym children and by extreme climato-geographic conditions of their local communities, and c) there is an extensively use for short
living and, as a result, by different intensity of metabolic processes. message services (SMS) — both for arranging appointments and as
Contact: N.N. Shim (hypertonia@yandex.ru)
part of clinical intervention.
Results: One fifth of the clients have admitted themselves for
ASSESSMENT OF INTELLECTUAL DEVELOPMENT IN NATIVE treatment. Extensively uses of SMS have increased the Teams
CHILDREN OF YAMALO-NENETS AUTONOMOUS OKRUG accessibility for communicating with indigenous Sámi adolescents.
(RUSSIA) SMS have been especially useful in cases of intervention with
adolescents who report self-harming, suicidal thoughts and attempts.
T.Ya. Shipulina, T.V. Maltseva, S.A. Tokarev There has also been a declined the dropouts’ rates due to SMS.
State Scientific Research Institute on Medical Problems of the Far North Conclusion: When working in a clinical setting with indigenous
of RAMS adolescents with mental health problems it is important to emphasize
Children of indigenous population of the Far North often come across both a cultural sensitivity approach and easy access to the treatment
difficulties during school study because of their intellectual facilities.
insufficiency. This problem is considered to be quite important. Aim of Contact: Anne Silviken (anne.silviken@ism.uit.no)
research was to study prevalence of mental and psychic retardation in
younger schoolchildren of native residents taking into account gender
and place of their residing (tundra, village). 112 native children who PRIMARY BIRTHING ATTENDANTS AND BIRTH OUTCOMES
studied in the 1st-4th forms of boarding school in Nyda village (Nadym IN REMOTE INUIT COMMUNITIES - A NATURAL
region) took part in the study on condition of written parents’ “EXPERIMENT” IN NUNAVIK, CANADA
agreement. Among them 24 boys and 21 girls were tundra residents, F. Simonet1, R. Wilkins2, E. Labranche3, J. Smylie4, M. Heaman5, P.J.
29 boys and 38 girls – village residents. Analysis of medical, Martens6, W. Fraser1, K. Minich7, Y. Wu1, C. Carry8, Z.-C. Luo1
psychological and pedagogical charts, results of a children 1
psychiatrist’s examination allowed to reveal in tundra children 18 boys Department of Obstetrics and Gynecology, Sainte-Justine Hospital,
and 13 girls and in village residents – 11 boys and 12 girls – suffering University of Montreal, Montreal, 2Health Information and Research
intellectual insufficiency. In tundra children intellectual insufficiency Division, Statistics Canada, 3Nunavik Regional Board of Health and
(mental and psychic retardation) was revealed twice more often when Social Services, Canada, 4Department of Public Health Sciences,
compared to village children (68,9% vs. 34,3%, p=0,0003). In the same University of Toronto, Centre for Research on Inner City Health, 5Faculty
groups we defined statistically significant differences in prevalence of of Nursing, University of Manitoba, 6Manitoba Centre for Health Policy,
mental retardation (24,4 vs. 8,9%, p=0,0354) and psychic retardation Department of Community Health Sciences, University of Manitoba,
7
(44,4% vs. 25,4, p=0,0487). Gender differences in prevalence of Department of Community Health Sciences, University of Toronto,
8
intellectual insufficiency were not revealed – 75,0% (boys) and 61,9% Ajunnginiq (Inuit) Center, National Aboriginal Health Organization,
(girls), p=05327 in tundra children and 37,9% (boys) and 31,6% (girls), Ottawa, Canada
p=0,5874 in village children. Psychic retardation also did not differ in Objectives: There is a lack of data on the safety of midwife-led
village boys and girls (20,7% and 28,9%, p=0,6268). The same situation maternity care in remote or Indigenous communities. In a de facto
was stated for tundra children – 50,0% (boys) and 38,1% (girls), natural “experiment”, we assessed birth outcomes by primary birthing
p=0,6163. Gender differences were not also revealed for mental attendant in two sets of remote Inuit communities.
retardation – 17,2% and 2,6%, p=0,0776 – in village boys and girls; Methods: A geocoding-based retrospective birth cohort study in 14
25,0% and 23,8%, p=1,0 – in tundra boys and girls. Conclusion: Native Inuit communities of Nunavik, Canada, 1989-2000: primary birth
children, residing in tundra, suffer intellectual insufficiency twice more attendants were Inuit midwives in the Hudson Bay (1,529 Inuit births)
often in comparison to children who live in villages. This fact demands versus Western physicians in Ungava Bay communities (1,197 Inuit
thorough study of a problem. births). The primary outcome was perinatal death. Secondary
Contact: T. Ya. Shipulina (hypertonia@yandex.ru)
outcomes included stillbirth, neonatal death, postneonatal death,
preterm, small-for-gestational-age and low birth weight birth. Multi-
THE SÁMI PSYCHIATRIC YOUTH TEAM: A CULTURAL level logistic regression was used to obtain the adjusted odds ratios
(aOR) controlling for maternal age, marital status, parity, education,
SENSITIVE TREATMENT APPROACH OF SUICIDAL
infant sex and plurality, community size and community-level random
BEHAVIOUR PROBLEMS AND SUBSTANCE ABUSE IN effects.
INDIGENOUS SÁMI
Results: The aOR (95% confidence interval) for perinatal death
A. Silviken comparing the Hudson Bay versus Ungava Bay communities were 1.29
The Sámi Psychiatric Youth Team (PUT), The Sámi National Centre for (0.63, 2.64) for all Inuit births, and 1.13 (0.48, 2.47) for Inuit births at
Mental Health, Helse-Finnmark ~28 weeks of gestation. There were no statistically significant
differences in the crude or adjusted risks of any of the outcomes
Objective: To present The Sámi Psychiatric Youth Team (The Sámi
examined.
National Centre for Mental Health (SANKS)). The Team was opened in
1990 and the main office is located in Karasjok municipality, in Conclusions: Risks of perinatal death were not significantly different in
Northern Norway. The Team’s catchment’s area is the five largest the Hudson Bay communities with midwife-led maternity care as
154 POSTER SESSIONS: T U V W X Y Z
compared to the Ungava Bay communities with physician-led graduation among a student population of predominantly (>50%)
maternity care. Our findings are inconclusive, although the results Indigenous high school students. Only English language studies
excluding extremely preterm births are more reassuring concerning the available through the University of Toronto library system were
safety of midwife-led maternity care in remote Indigenous reviewed. No restrictions were made based on study design, dates or
communities. location of publication.
Contact: Fabienne Simonet (fabiennes@hotmail.fr)
Results: Over 1,700 abstracts were identified and a total of five articles
that met the inclusion criteria and were available through the
ACTUAL NUTRITION AND CARDIOVASCULAR RISK University of Toronto library system were reviewed. All reports were
from Canada (N=2) or the United States (N=3). Reports focused on
FACTORS IN SIBERIA (1985-2005)
either individually-targeted programs for high risk students (N=2) or
G.I. Simonova, O.M. Bragina, Yu.B. Parlyuk, Yu.P. Nikitin population-level interventions for an entire class, school or school
Institute of Internal Medicine SB RAMS division (N=3). The most common intervention was the integration of
Purpose: To study twenty years dynamics of actual nutrition of adult Indigenous knowledge and pedagogical styles into school curriculum
Siberian population and to estimate its correlation with cardiovascular (N=2). Other strategies included an alternative high school, an
risk factors (cohort analysis for the period 1985-2005). intensive academic summer program and a program aimed at
developing creative problem skills and work experience. Although all
Methods: Two representative samples of men and women 25-64 years projects reported positive outcomes there was insufficient
old were investigated. We used data of Novosibirsk center in WHO homogeneity in terms of populations, interventions, study design or
MONICA project and HAPIEE study. Screenings were carried out in study quality to calculate a single measure of effect.
1984-1985, 1988-1989, 1994-1995 and 2002-2005 years. Total number
of subjects was 11670. Endpoints were taken from total mortality No exclusions were made based on study design because of the small
register database. number of applicable studies. As such, the quality of the studies varied
significantly but was generally low. Three of the five studies lacked
Results: The structure of urban Siberian population nutrition is highly comparison groups. Papers generally lacked structure and detail that
unbalanced: the large part of total fat from meat and dairy products is would allow judgments of potential biases. No randomized control
39-46%, and the small part of polyunsaturated fatty acids from fish ~ trials, or well designed quasi-experimental designs, were located.
1%. We also registered high consumption of sugar (up to 70-75g daily)
and starch saturated products alongside with low consumption of The identification of only five studies, despite a rigourous search (1738
compound carbohydrates, vitamins and cellulose. In 1995 and 2005 seemingly relevant abstracts were studied, and other efforts were
daily consumption of fruits was 290 and 437g per day respectively. made to find relevant studies without abstracts) suggests that this is an
underdeveloped area of research.
The prevalence of obesity in men increased by 2005 to 21%, that is for
about 10% higher than in 1995. Average total cholesterol level Conclusion: Additional methodologically-sound research in this area is
increased from 5.3 to 6.0 mmol/l. The prevalence of obesity in women required to capture and evaluate strategies and programs that
was 45%. Average total cholesterol level increased from 5.7 to 6.4 maximize the ability of Aboriginal youth and communities to succeed
mmol/l. The frequency of metabolic syndrome was 18% in men and academically.
Contact: Megan Stepushyn (mstepushyn@gmail.com)
33% in women.
Conclusion: Changes in actual nutrition of the population is associated
with the dynamics of major cardiovascular risk factors.
Contact: Galina Simonova (g.simonova@iimed.ru) TUVWXYZ
SYSTEMATIC REVIEW OF EDUCATIONAL INTERVENTIONS SOME DEMOGRAPHIC PECULIARITIES OF LONGEVITY IN

TO INCREASE HIGH SCHOOL GRADUATION AMONG THE INDIGENOUS MINORITIES OF RUSSIA NORTH-EAST
INDIGENOUS HIGH SCHOOL STUDENTS REGIONS
A. Stepushyn O.V. Tatarinova, Yu.P. Nikitin
University of Toronto - Community Health and Epidemiology Institute of Internal Medicine SB RAMS
Background: Aboriginal populations in Canada are younger than then Purpose: We analyzed contemporary levels and dynamic tendencies of
non-Aboriginal population and Aboriginal children and youth are longevity in the Indigenous Minorities (IM) of Siberia and the Far East.
making up a larger proportion of the school population. Education is an Methods: Using the results of all-Russia censuses of enumeration 1989
important determinant of health and Aboriginal populations have and 2002 we studied the dynamic of absolute number of long-livers
lower educational attainment than the non-Aboriginal population. and census longevity indexes (correlation between subjects older than
Larger school-age population, the lower levels of educational 90 to the number of subjects older than 60 (LI-2)) in 21 Indigenous
attainment among Aboriginal youth and the importance of education Minorities of Asian North in 1989, and in 2002 — similar data
for future well-being has made it critical to identify strategies and concerning 37 ethnicities.
programs that are effective in increasing high school completion Results: The total number of Asian north aborigines in 1989 was
among Aboriginal youth. 181517, in 2002, 243982 (+34%). During the same period the absolute
Objectives: To evaluate educational interventions effective at number of long-livers decreased for 12%.
increasing high school completion among Aboriginal high school In 1989 the number of representatives of some IM (all ages) was from
students in Canada and Indigenous students internationally. 170 (Orokes) to 34190 (Nenets); in 2002 from 8 (Kereks) to 41302
Methods: A systematic overview was conducted in February 2009. (Nenets). The number of long-livers in indigenous ethnicities was from
Articles, reports and program evaluations were identified through a 1 to 40 in 1989 and from 1 to 37 in 2002.
systematic search of five electronic databases (MEDLINE, PsycInfo, In 1989 there were no long-livers older than 90 in 6 IM from 21 (29%).
ERIC, CBCA Education, and the Bibliography of Native North In 2002 this index increased to 35%. Centenary long-livers in 1989 was
Americans). Reference lists of articles and reviews as well as websites in 7 ethnicities, in 2002, in just 4.
of international organizations (governmental, non-profit and research)
were reviewed for relevant studies and reports. According to LI-2 estimations, some ethnicities had high indexes in
1989: Ulichs, Nenets, Evens and Evenkis; in 2002, Nenets and Ulichs.
Studies that were included examined a program, intervention, or
educational strategy that focused on improving retention and
POSTER SESSIONS: T U V W X Y Z 155
In 1989 men long-livers were represented in 15 from 21 IM (71%), in have been more expressed in the age of 40 years, and between the first
2002, in 17 (73 %). IL-2 indexes prevailed in women in all ethnicities. stage and the subsequent investigation phases. Thus, distinctions in
Conclusion: Despite the increase in total number of aboriginals in the area of elevated lesions in a descending branch of the left coronary
Russia north-east regions in 1989-2002, the absolute number of long- artery between the second and third stages of researches in persons of
livers older than 90 decreased. During the same period LI-2 in most non-indigenous nationality were less significant, than between the first
ethnicities also decreased. Long-livers were registered mostly in and the second, that testifies to some stabilization of atherosclerotic
women. process in the given population. For the native population rates of
Contact: Yuri Nikitin (nikitin@iimed.ru) growth of the area of elevated atherosclerotic lesions remain stably
high at all investigation phases. So, if in men of indigenous population
in the age of 50-59 years the area of elevated lesions in a descending
THE CAREGIVER’S JOURNEY branch of the left coronary artery made at 1st stage 15,4±0,9 %, on 2nd
A. Timmins and 3rd stages has increased accordingly up to 20,8±1,2 % and
27,8±0,6 % of the area of vessel. For the last period frequency of
Artico Biota Studio
stenoses of coronary arteries with prevalence of multiple stenosing
The “Caregiver’s Journey” is an exhibition of original paintings that sites has essentially increased. Preservation of rates of growth and
explores the emotional and physical journey of care giving and prevalence of heavy kinds of atherosclerotic lesions in coronary
recovery. I was the primary care giver during my daughter’s cancer arteries of aboriginals of Yakutia for last decades are the influence of
recovery. Later I realized that my personal resources were depleted, I the urbanization, accompanied by changes of the life way, a traditional
needed to find my healing process, which led me back to self feed and ecology of northern territories.
expression and healing through art.
Conclusion: Results of three stages of researches of an atherosclerosis
There are many shared aspects of care giving from a northern testify to its proceeding burdening in persons of indigenous nationality
community: and some stabilization for the last 20 years of an atherosclerosis
- traveling from a small community to a large city with a small child heaviness parameters in the non-indigenous population of Yakutia.
or sick person is stressful & lonely However, despite of progressive heavining of atherosclerosis, for
- seeing other families looking after their loved one, northerner indigenous population the law consisting to a lesser degree of an
caregivers need family support but often find that family bonds atherosclerosis in vessels that is caused by genetic features of a
are being stretched structure of a vascular wall, namely, smaller thickness of arteries
- learning how to communicate with nurses and doctors, so that intimas, in comparison with non-indigenous ones, is still kept.
Contact: Mikhail Tomskiy (ogus@list.ru)
one doesn’t feel diminished
- I found that it helps to reach out and share common experiences
in the hospital environment
INFLUENCE OF MIGRATION AND DURATION OF RESIDING
- lifting the spirits of a loved one in distress by taking their
thoughts away from their pain or worry
IN CONDITIONS OF THE NORTH ON ATHEROSCLEROTIC
- to overcome boredom during long periods of waiting it helps to PROCESS CURRENT
play a game or draw, even dreaming about good times in the past M. Tomskiy, V.A. Argunov
or in the future SB RAMS
- there are difficulties when a caregiver’s livelihood, routines and
their own personal lives are interrupted for an extended period of During intensive industrial development of northern territories, there
time came migrants to Yakutia, mainly, from the European part of Russia
- this show will attempt to show through imagery that caregivers and Siberia that sharply differed on the climatic conditions. In this
can access art and experience art in the midst of care giving to connection, revealing distinctions in rates of development of an
relieve their anxiety atherosclerosis in migrants from different regions of the country
Contact: Ann Timmins (ann.timmins@theedge.ca)
represents doubtless interest.
Aorta and coronary arteries in 770 men of non - indigenous nationality
in the age of 20-59 years which have arrived to Yakutia from the
FEATURES OF THE CORONARY ARTERIES European part of Russia and from Siberia are investigated by visually-
ATHEROSCLEROSIS AND ITS EVOLUTION IN INHABITANTS planometric method. Frequency and the fibrous plagues area, the
OF YAKUTIA FOR 40-YEAR PERIOD complicated lesions, calcinosis, and also frequency of CA stenoses
M. Tomskiy, V.A. Argunov were defined.
SB RAMS It is revealed, that, despite lacking essential distinctions in frequency
and the area of various kinds of atherosclerotic lesions in vessels in
Purpose: to estimate dynamics of atherosclerotic process in coronary
migrants from various regions of Russia, frequency of stenoses of
arteries in the men living in Yakutia for the 40-year period by
coronary arteries was almost in 2 times more in migrants from the
comparison of results of three stages of pathologic-anatomical
European part of Russia. So, stenoses of a descending branch of the
epidemiological researches.
left coronary artery in migrants from the European part of Russia were
Methods: For three stages of pathologic-anatomical epidemiological registered twice more often (20,0 %), than in natives of Siberia (10,3
researches coronary arteries in 1030 [1st stage-1962-65 (423), 2nd %).
stage - 1985-88 (443), 3rd stage-2001-03 (167)] practically healthy men
The comparative analysis of influence of northern experience on the
of indigenous and non-indigenous nationality in the age of 20-59 years,
area of atherosclerotic lesions in CA has shown, that in the men who
died by a violent death and not had any chronic diseases were
have lived in the North more than 10 years, the area of an
investigated by visually- planometric method. After total painting by
atherosclerosis was essentially larger, than in persons with smaller
sudan in vessels the stenosis degree, the area of elevated lesions which
northern experience. Significant distinctions are revealed in frequency
was combined from the sum of the fibrous plagues areas, complicated
of CA stenoses in persons with various northern experiences. So, in
lesions and calcinosis were defined.
right CA stenoses are met more than in 2 times often (18,2 %) in
Results and Discussion: It is established, that for the 40-year period northerners - old residents, than in persons with the 5 and 5-10 yrs
evolution of an atherosclerosis has undergone the essential changes experience (8,6 %). Similarly, DLCA stenoses are more often registered
that is worsening of atherosclerotic process current in coronary in northerners - old residents (in 36,5 % of cases), than in persons with
arteries, both in native, and non-native population due to increase in northern experience of 5-10 years (23,4 %) and till 5 years (20,7 %).
the area of elevated lesions. It is necessary to note, that distinctions
Thus, acceleration of development rates of coronary arteries congelation of tissues, difficulties of diagnostics and absence of
atherosclerosis with greater frequency of stenoses in migrants from objective methods of supervision over a condition of blood circulation
the European part of Russia, in comparison with migrants from Siberia, and efficiency of treatment, this problem remains to be vital and the
testifies to the best adaptation of Siberians to extreme conditions of most important.
the Far North. Frequency and the CA atherosclerosis area in migrants is Thermography is a valuable method of definition of efficiency of this or
directly proportional to duration of residing in conditions of the Far that method of treatment. The attractive side of this method of
North. inspection of patients is its absolute harmlessness, an opportunity of
multiple, repeated, dynamic researches and relative simplicity in
interpretation of the received results.
THE BASIC DIRECTIONS OF WORK OF THE YAKUT SCIENCE In particular, detailed studying of temperature changes in tissues of the
CENTRE OF COMPLEX MEDICAL PROBLEMS SB RAMS cooled segment, enables to diagnose presence of congelations of
tissues. Definition of superficial temperature cannot show temperature
M. Tomskiy, T.E. Burtseva
in depth.
SB RAMS
We offer to define interstitial temperature for diagnostics. For this
The staff of Yakut Research center of CMP SB RAMS is 69 employees. purpose, we apply the original thermometer with the gauge on a tip of
The given centre consolidates scientific potential of Republic and injection needle. The method is approved in more than 2000 patients.
coordinates the organization and carrying out of basic researches in In 96 patients admitted in pre-reactive period on depth of 3-4 mm the
the field of medicine in Republic. From the moment of creation of the temperature in tissues was from 2 to 23 below zero, thus the superficial
centre in 2001 employees have defended 5 theses for a doctor’s temperature was from 3 to 5-6 degrees above zero. In 34 patients at
degree, 22 master’s theses, 19 monographies on actual problems of admittance superficial temperature was from 14 to 16 degrees above
person health in the North, 263 articles in the Russian press and 22 zero, but in depth of 4 mm the temperature was from 3 to 6 degrees
articles in a foreign press have been published, 1 patent for the below zero.
invention was obtained. There are 3 departments: a department of
Thus, the true picture of depth of freezing of tissues can be defined
molecular genetics, a department of adaptation mechanisms, a
only by measurement of temperature on depth of 4-6 mm. By leaving a
department of chronic non-infectional diseases epidemiology. The
needle with the thermocouple on depth, it is possible to determine
basic directions of our centre are: studying of atherosclerosis,
efficiency of infusion therapy.
oncologic pathology, a hereditary pathology, cold traumas in
inhabitants of Republic, and studying of children’s health state.
In the Centre the population of Republic DNA bank is created, the
profound researches of prevalence of a hereditary pathology are HEALTH STATE OF SMALL IN NUMBERS PEOPLE CHILDREN
carried out, the register of a hereditary and congenital pathology is OF THE NORTH OF YAKUTIA
conducted, genes candidates of multifactorial diseases for populations M. Tomskiy, T.E. Burtseva, G.G. Dranaeva
are investigated.
SB RAMS
It is scientifically proved, that for the 40-year period evolution of an
atherosclerosis has undergone the essential changes that is worsening Burtseva T.E., Dranaeva G.G. 25154 representatives of small in
of atherosclerotic process current in coronary arteries, both in native, numbers people of the North (snpN), including 10373 Evens, 12729
and non-native population due to increase in the area of elevated Evenks, 961 Dolgans, 483 Chukchi, 608 Yukagirs live in Republic Sakha
lesions. (Yakutia) on the end of 2008. Number of the children’s population of
radical small in numbers people from 0 till 17 years inclusive for
Studying of physical development, the hormonal status of children of January, 1st 2008 has made 9414 children. On rank structure of
native small in numbers people of the North of Yakutia has revealed morbidity of children of aboriginals respiratory illnesses are in the lead,
essential regional and ethnic features, thus growth and weight of which relative density has made 54,5 % (2006-53,4 %), on the second
children of small in numbers people of the North are in the bottom place - digestive illnesses, relative density has made 9,9 % (2006-11, 5
corridor of nomograms (p<0,05), arterial pressure is higher, than in %), on the third place - illnesses of skin and hypodermic fat- 6,7 %
children of the alien population, parameters of the hormonal status (2006-6,6 %). The profound inspection of children has revealed the
essentially do not differ. following tendency: each 2nd child has disease of eyes and adnexal
Medical expeditions to places of compact residing of native small in apparatus and caries, each 4th child: gastrointestinal tract pathology,
numbers people of the North of Yakutia, to the regions of Republic for endocrine system, a pathology of ear, throat and nose, illness of
the profound studying of a health state of the indigenous and alien nervous system and noise in heart.
population are annually carried out. Studying of the hormonal status has revealed, that in girls Sakha and
YRC CMP SB RAMS closely communicates with large centres of small in numbers people of the North from 10-14 years follicle-
science: Scientific research institute of therapy SB RAMS (Novosibirsk), stimulating hormone (FCH) and luteinizing hormone (LH) contents
Tomsk centre of science of medical genetics SB RAMS, Institute of authentically differ (FSH: girls Sakha 11,13 mIU/ml; girls- snpN 7,39
biochemistry and genetics of the Ufa centre of science of the Russian mIU/ml; LH: girls Sakha 14,47 mIU/ml; girls- snpN 6,95 mIU/ml), and in
Academy of Science, and also with the foreign centres, including girls Sakha both FSH, and LH are higher, than in girls snpN.
scientific research institute of brain (Niigata, Japan), the Estonian Comparison of the received results of the hormonal status to
Biocentre (Tartu, Estonia), clinic Maunt-Sinaj (New York, USA). development of secondary sexual attributes has confirmed that girls
Contact: Mikhail Tomskiy (ogus@list.ru) Sakha advance in sexual development girls snpN. In boys Sakha FSH
and progesterone are higher, than in boys snpN in this age group (FSH:
boys Sakha 8,01 mIU/ml; boys- snpN 5,53 mIU/ml; progesterone: boys
WAY OF DEFINITION OF DEEP TISSUES TEMPERATURE Sakha 1,28 ng/ml; boys- snpN 0,60 ng/ml). Comparison of the received
AFTER COLD IMPACT IN PRE-REACTIVE PERIOD results of the hormonal status to development of secondary sexual
M. Tomskiy, J.R. Alexeev, R.Z. Alexeev attributes has confirmed that teenagers Sakha advance in sexual
SB RAMS development teenagers snpN.
The problem of conservative treatment of frostbites in pre-reactive With the purpose of studying of a hereditary pathology load 315
period and furthermore with a congelation of tissues until now children on two loci are surveyed: intron 2 (a marker of the classical
contains a significant amount of debatable questions and still is topical. form dhj; ltyyjq dysfunction of adrenal cortex (CDAC) and exon 7 (a
A relative rarity of patients in pre-reactive period, especially with a marker of nonclassical form CDAC). Results of research have appeared
to be unexpected. Mutation V281L causing occurrence of the 4-spiral computer tomograph Somaton Sensation-4 (Siemens,
nonclassical form of congenital adrenal hyperplasia: in Chikchi - 2:39 Germany); calcium index (CI) was calculated on Agatston.
(5,1:100), in Yukagirs - 2:40 (5:100), in Evens - 2:48 (4,2:100), in Sakha - Results: According to SCAG in indigenous people, stenoses up to 50 %
1:49 (2:100), in Evenks - 2:106 (1,9:100). Thus, the mutation frequency were found unlike alien which had stenoses of 50-75 % and occlusions
of a marker of CDAC nonclassical form revealed by us is comparable to (p=0,002). According to CI mean value in aboriginals has made
the data received earlier (in Yupik Eskimos 1,7:100 (Pang S., Wallace 238,8±83,3 units, in alien-545,6 ±98,6 un. (p=0,000). Q - myocardial
M.A .and al, 1998)). infarction is revealed in 54,9 % with identical frequency both in natives
Thus, studying of a health state of children of small in numbers people and in alien, more often in natives CAD began with AMI (78,6 %)
of the North of Yakutia is one of priority directions of YSC CMP SB whereas in alien with AMI began in 54,7 % (p=0,000). In natives more
RAMS. often overventricular infringements of rhythm came to light unlike
Contact: Mikhail Tomskiy (ogus@list.ru) alien in which more often ventricular infringements of rhythm, and of a
high gradation took place. The fraction of emission less than 45 % met
more often in alien (22,3 %), than in natives (10,6 %) (p=0,002).
THE POPULATION HISTORY OF SAKHA (YAKUTS) IN
Conclusions: The analysis of clinical-functional parameters has shown,
CONNECTION WITH PREVALENCE OF SOME HEREDITARY
that in aboriginals of Yakutia an atherosclerosis of coronary arteries is
DISEASES expressed more weakly, than in alien, thus the Q - myocardial
M. Tomskiy, S.A. Fedorova, E.K. Khusnutdinova, R. Villems infarction is revealed in 54,9 % with identical frequency both in natives
SB RAMS and in alien. In natives CAD painless forms were revealed more often,
on heaviness of a clinical picture in natives lighter current of disease
We have characterized, at high phylogenetic resolution, mtDNA
was noted.
variation (n=694) and Y chromosome haplotypes diversity (n=318) in Contact: Mikhail Tomskiy (ogus@list.ru)
populations of the Republic Sakha (Yakutia) in the northeastern part of
Russian Federation (Sakha or Yakuts, Evenks, Evens, Yukaghirs,
Dolgans) and analyzed our results in a broader context of the Eurasian IMPLEMENTING A NUTRITION INTERVENTION PROGRAM
mtDNA and Y-chromosomal variability. The genetic portraits of AMONG THE INUIT IN NUNAVUT: STORE-CENTERED
studied ethnic groups were obtained and scenarios of ethnogenesis of ACTIVITIES OF HEALTHY FOODS NORTH
different nations suggested by historians and archaeologists were
compared with genetic reconstructions M. Ugyuk, R. Rosol, A.J. Brunetti, E. Mead, C. Roache, R. Reid, J.
Gittelsohn, S. Sharma
Sakha (Yakuts) differ from other Siberian populations by the striking
prevalence of hg N3. The median-joining network of N3 lineages have The Hamlet of Taloyoak, Taloyoak, NU
very strongly pronounced star-like phylogeny in Yakuts, that specifies Objective: To describe how Healthy Foods North (HFN) implemented
on founder effect characteristic for the whole gene pool of this nation. store-centered activities to increase the availability and accessibility of
The coalescence time of N3-haplotypes in Yakut population is healthy store-bought foods, and to influence dietary choices among
1540±580. Thus, one can propose that the specific peculiarities of the Inuit.
Yakut gene pool have been formed at least during 20 centuries in Setting: Two remote communities in Nunavut, Canada.
isolated conditions. The mitochondrial gene pool of Yakuts differs
from other populations of Yakutia by high level of diversity of western Design: Fourteen month, seven-phase, multi-institutional, community-
Eurasian lineages that consists 10% and by significantly high frequency based nutritional intervention program aimed at Inuit men and
of cluster D5a2 (18%). The low level of lineages diversity in Yakuts in women, 19 years of age and older. This poster outlines activities
comparison with other populations indicates to the small size of related to the store component of Healthy Foods North.
ancestral population with subsequent significant expansion. We Results: Store-based activities, which included interactive sessions
considered our results in connection with some epidemiologic and such as food tasting, end-of-aisle displays, shelf labels, and posters,
molecular genetic researches of hereditary diseases characterized by a were an effective strategy to influence and inform community
high prevalence among Yakuts such as spinocerebellar ataxia type 1 members at the point-of-purchase. One-on-one encounters between
(1:2590) (Platonov, 2003), myotonic dystrophy (1:4690) shoppers and locally trained community interventionists were
(Sukhomyasova, 2005), 3-M syndrome (1:8775) (Maksimova et al., reinforced through giveaways, recipe cards and handouts throughout
2007). the program. Partnering with local store managers was essential to the
Contact: Mikhail Tomskiy (ogus@list.ru) implementation of the HFN at the community level, and to ensure the
availability of healthier food alternatives.
FEATURES OF CLINICAL -FUNCTIONAL CHANGES IN Conclusions: This novel multi-institutional nutritional intervention,
Healthy Foods North, benefits communities through these
ABORIGINALS OF YAKUTIA WITH THE VERIFIED CORONARY
partnerships as well as through locally trained interventionists who
ATHEROSCLEROSIS conduct the project activities.
M. Tomskiy, N.V. Maharova, R.V. Jakovlev Acknowledgements: The research was supported by the American
SB RAMS Diabetes Association Clinical Research Award Grant # 1-08-CR-57.
Contact: Mary Ugyuk (sangita_sharma@unc.edu)
Purpose: To reveal clinical -functional features in aboriginals of Yakutia
with the verified coronary atherosclerosis.
Methods: Results of inspection of 238 native and 244 alien inhabitants ETHICAL ASPECTS IN THE ENVIRONMENTAL HEALTH
of Yakutia with verified coronary sclerosis have been included in the RESEARCH
analysis. The analysis of rhythm infringements was made by results of
K. Vähäkangas1, A. Rautio2, A.M. Pietilä3
Cholter monitoring. Echocardiographic research was held by the
standard technique. Electrocardiographic research was made in rest in Departments of 1Pharmacology and Toxicology and 3Nursing Science,
12 standard assignments with a speed of 25 mm/sec. Selective University of Kuopio; and 2Centre for Arctic Medicine, Thule Institute,
coronary angiography (SCAG) was held on angiographic installation University of Oulu, Finland
“Axiom. Artis BA” (Siemens, Germany) by Judkins standard technique, At the moment in the Northern societies there is a huge change on-
the quantity and a degree of coronary arteries (CA) lesions was going not only in climate, ecosystems, but also in socio-economic and
defined. A multispiral computer tomography (MSCT) was held on the cultural issues. Environmental research is always multidisciplinary and
thus we need to consider research ethics also from multidisciplinary
point of view. Our aim is to find good practices in a multidisciplinary adolescents and 286 families were examined. We revealed the
approach. This is challenging because different research unfavourable influence of social reasons, including ethno-political and
fields/disciplines have their own paradigms, methodologies, and social-economic changes, happened during last 50 years. The change
research traditions. By listening, understanding, and finally working of ethno-political conditions, the assimilation of western culture in
together we can understand more deeply the complexity of mentality of tuvinian led to losing them former valuable orientation
environmental health problems. To start our collaboration it is (the value of family attitude, religious and ethnic identity), with
important first to analyze the existing literature and review the views revaluation on another social values. The consequence of this was
of different disciplines. disbalance between external manifestation of tuvinian life and their
Basic concepts in good research ethics are always the same: pursue of internal world; they could not realized affiliate need, one of the main
truth, scientifically sound research methodologies and respect for requirements, which was very important for orient culture. The change
research participants and collaborators. Additional recognized ethical of social-economic formation for short period of time, the disturbances
aspects in environmental health research are global: unequality of in system of life; the use of not typical cultural and domestic elements
resources and in means to influence the environment and take actions became excessive stress factors for native population, who had low
accordingly. The research training should be planned taking on dynamic adaptation because of ethnic peculiarities of psychical
account also ethical aspects of research. Mandatory courses for processes. The suicidal behaviour of tuvinian was the result of psychical
understanding research ethics in various disciplines may be advisable. adaptation disturbances and was the sign of psychical nervous
Education and training of young scientists in issues of environmental breakdown because of highest requirements to adaptative
changes and environmental health is naturally the prerequisite for the mechanisms in disbalance of human-environment system. For
future research. The multidisciplinary research team has to discuss at a prevention the disadaptive behaviour they need in complex of
very early phase such ethical issues, not only concerning the patients, measures, directed on improvement in the value of family attitude,
but also the whole process from setting the aims of the studies through ethnic mentality and creation of viability in children and adolescents of
the working phases to the publishing of data. Tyva in modern social-economic conditions.
Contact: Valery Manchuk (manchyk41@rambler.ru)
This is also essential to justify the projects, especially when dealing
with other stakeholders in society.
Contact: Arja Rautio (arja.rautio@oulu.fi) CREATING MODELS FOR MOTHER’S WELLNESS THROUGH
PARTNERSHIP RESEARCH: A COMMUNITY PARTNER
THE CLINICAL-MORPHOLOGICAL PECULIARITIES OF EXPERIENCE
GASTRODUODENAL PATHOLOGY IN EVENKIAY CHILDREN M. Van Bibber
M. Valery, T. Polivanova Inter Tribal Health Authority
State Scientific Research Institute of Medical Problems of the North Purpose: The purpose of the Healthy Community Mothers and Children
Research Project was to develop respectful and culturally appropriate
The aim of our investigation was to study the clinical-morphological
models of supporting the health and well-being of mothers at risk and
peculi-arities in schoolchildren of native and strange population of
ultimately promote the birth of healthy babies. Inter Tribal Health
Evenkiay. 1204 children of strange and 299 children of native (evenks)
Authority is committed to developing its capacity for community
population in age 7-16 years were examined. Esophageal gastro
based research as a way of promoting family and individual well-being
duodenal scope and morphological research of stomach mucous
amongst its 29 member First Nations. The poster will profile one of
membrane were made in representative children groups of each
four innovative models developed through collaboration between
population with dyspepsia syndrome. We revealed that dyspepsia was
researchers and four community partners in Canada. The models are
very often in evenks. Dyspepsia had func-tional character in the
designed to assist post partum mothers with risky drinking behaviours,
biggest part of children of native and strange population. The erosion-
in their journey to wellness.
ulcer defects of stomach and duodenum mucous membrane were
diagnosed in evenks in two times seldom. The evenks children with Process/Approach: The research process incorporated both community
erosion-ulcer de-fects of gastro duodenal zone complicated on and university based expertise to modify a model of brief alcohol
abdominal pain rarely; besides, the pathology in evenks was intervention to better fit the unique aspects of the partner
determined after prolonged dyspepsia syndrome. The erosion-ulcer communities. Aboriginal community members in four communities
defects of gastro duodenal mucous membrane in children of strange developed community-specific interventions utilizing local knowledge
population were associated with high activity of antral gastritis. We and expertise. University-based researchers provided examples of
revealed the high infection of H.pylori in the children of both research tools and a structured approach which supported community-
population and especially who had erosion-ulcer defects of gastro based researchers in conducting the research. These models can be
duodenal zone. We observed the increase of H.pylori contaminating useful to front line workers and others who are working with women in
area in children of Evenkiay strange population with gastro duodenal preventing maternal alcohol consumption during future pregnancies.
pathology, possible as a result of immune reactivity decrease. Findings: A community model of brief alcohol intervention profiled in
Conclusion: there are the determined ethnic peculiarities of clinical- this poster has incorporated local/indigenous knowledge and
morphological appearances of gastro duodenal pathology in children preliminary results indicate the models are both acceptable and
of Evenkiay, with most unfavorable course in strange population. effective.
Contact: Valery Manchuk (manchyk41@rambler.ru) Results: The community participation increased awareness of FASD
and the importance of supporting prospective mothers. As a result of
the HCMC research, ITHA successfully developed a proposal for an
THE REASONS OF SUICIDAL BEHAVIOUR OF SIBERIA
FASD mentor program to provide supportive services to women in five
NATIVE POPULATION First Nation communities on Vancouver Island. The research process
M. Valery, N. Semenova and partnership has raised awareness of the value of research as an
State Scientific Research Institute of Medical Problems of the North important tool for improving health status in Aboriginal communities.
Contact: Marilyn Van Bibber (mvanbibber@shaw.ca)
The highest indicators of mortality from suicide in Siberia are
registered in Tyva. The frequency of completed suicide in this region
exceed All-Russia indicator in 1,6 times, and average world index more NORTHERN BREASTFEEDING VIDEO
then 4 times. The aim of the present investigation was the study of the S. Wadowska1, A. Godfreyson2
reasons of suicidal behaviour of tuvinian, native population. 1634
1
Yellowknife Health and Social Services Authority, 2Beaufort-Delta ETHICAL AND CULTURAL IMPLICATIONS OF SPECIMEN
Health and Social Services Authority, Canada BANKING AMONG ALASKA NATIVE PEOPLE: HISTORICAL
Objectives: The aim of this video is to promote breastfeeding to pre PROJECT.
and postnatal women by providing a current, northern focused A. Willetto Wolfe
breastfeeding video for distribution to and use by Canada Prenatal
Nutrition Programs (CPNP) and other appropriate health programs. Southcentral Foundation
The reason for initiating such a project is the belief it would be valuable Background: The use of human biological specimens in research studies
to CPNP projects and other organizations across the territory to have has occurred in Alaska since the 1950s. Approximately 532,500 serum
access to a video that discusses breastfeeding within a northern specimen aliquots from 91,500 individuals are currently housed at the
population. The videos currently available for promotion of Arctic Investigations Program of the Centers for Disease Control (AIP
breastfeeding are not culturally appropriate for women in the CDC) located in Anchorage, Alaska. Specimens from Alaska Native
Northwest Territories (NWT). This statement has been made by many people make up 79% of the bank, 17% of the samples are from non-
CPNP Workers and participants in the NWT. The videos currently Native people, and 4% are unknown. The historical project focuses on
available are southern-based, depicting non-Aboriginal women or when and how the AASB was created and how it has been used and
women of southern-based Aboriginal groups. Women from the North governed over time. This includes changes in consent for collection,
have a difficult time relating to the women in these videos and storage and use. This chronology is important as a historical context
therefore the promotion of breastfeeding through the use of southern- for discussions regarding policy and procedures for the AASB.
based videos is severely impaired and arguably culturally insensitive. Purpose: To describe initial findings about the inception, use,
The video is narrated by a young aboriginal woman who is pregnant for management and documentation for collection and storage of the
the first time and is looking to find out more information about Alaska Area Specimen Bank (AASB) over time. Some members of the
breastfeeding. She meets with various people throughout the video, Alaska Native community have expressed concern about the use and
such as an elder who speaks about breastfeeding as traditionally being storage of specimens.
the best way to feed a baby. The video is seen as her journey in
discovering breastfeeding through the experiences of other women. Methods: Medical researchers were interviewed about their knowledge
and use of the AASB. They were specifically queried about research
Methods: The video is currently being filmed using northern women as approval processes and consent. Archived periodicals were used to
actors. A local production company has been hired to film, edit and cross reference information shared by informants and contemporary
produce the video. documentation.
Results: We hope that this video will increase initiation and duration Results: The AASB was created around 1960, but no informants
rates of breastfeeding in Northern women. We will launch the video at involved at inception have been interviewed to date. In 1973,
our annual CPNP workshop and do informal surveys with participants management was transferred from the Arctic Health Research Center
of the CPNP programs to measure the effectiveness of the video. (a university-based site) to the Artic Investigation Program at the
Contact: Sophia Wadowska (sophia_wadowska@gov.nt.ca)
Centers for Disease Control and Prevention (CDC) in Anchorage,
Alaska. Research since 1973 has predominantly involved
IMPACTS OF CLIMATE CHANGE ON INUIT DIET IN THE immunizations or improved screening for a pressing public health
issues. Consent processes have become increasingly detailed with
WESTERN ARCTIC: LINKS BETWEEN CLIMATE CHANGE,
more regulations and reviews by Tribal Health Organizations, village
FOOD SECURITY AND NUTRITIONAL HEALTH councils, and institutional review boards. Management of the AASB is
S. Wesche, L.H.M. Chan now the joint responsibility of the CDC and a group of Alaska Native
University of Northern British Columbia leaders from across the state.
There is a nutrition transition occurring among Indigenous peoples Conclusions: Accounts of the early years of the serum bank are less
globally. Similar trends are being observed in Inuit in the Arctic. While defined than more recent years. Preliminary information gathered
market foods now make up more than half of Inuit dietary intake, the does not reveal evidence of inappropriate access or use of the AASB.
consumption of traditional foods remains key for dietary quality and Future work will focus on obtaining additional information about the
central to local identity and livelihoods. Traditional foods provide early years of AASB.
Contact: Abbie Willetto Wolfe (AWolfe@Southcentralfoundation.com)
important nutrients, vitamins and minerals, and help restrict the intake
of the saturated fats, sucrose and excess carbohydrates often found in
store-bought alternatives. The access to, availability of, and condition
of traditional food species in the western part of Canadian Arctic are
affected by changing climatic conditions, with implications for food
security and human health. This study examines critical impacts of
climate change on Inuit diet and nutritional health in four communities
in the western Canadian Arctic to identify both community-based and
regional trends. The vulnerability of each community to changing food
security is differentially influenced by a range of factors, including
current harvesting trends, levels of reliance on individual species,
opportunities for food substitution, and exposure to climate change
hazards. At a regional scale, declining harvests of caribou are of
common concern, as this species is a primary meat source for all
communities in both summer and winter. Nutritional implications of
lower traditional food use include likely reductions in iron, zinc,
protein, vitamin D and omega-3 fatty acids, among others.
Understanding linkages between climate change and traditional food
security provides a basis for strengthening adaptive capacity and
determining effective adaptation strategies to respond to future
change.
Contact: Sonia Wesche (wesche@unbc.ca)
160 Presenters’ Index: By Initials & Surname
Presenters’ Index
By Initials & Surname
A. Tumchewics, 91 B. Kristensen, 32 C. Roache, 27, 39, 56, 76,
A A. Tzemis, 31 B. Larke, 77 140, 160
A. Vaktskjold, 97, 98 B. Martin, 54, 82 C. Sarin, 106
A. Abel, 48 A. Willetto Wolfe, 161 B. McMahon, 78 C. Schraer, 101
A. Apicyn, 24 A. Woods, 53 B. Niclasen, 126 C. Sevenhuysen, 132, 154
A. Baker, 61 A.A. Buganov, 122, 126 B. Olsen, 98 C. Sikora, 61
A. Banerji, 36 A.A. Kovalenko, 111 B. Parlee, 118 C. Southcott, 34
A. Binzer, 25, 65, 87 A.A. Maadi, 109 B. Revich, 70, 71 C. Stannard, 153
A. Brockman, 48 A.A. Rivellese, 92 B. Roos, 60 C. Sy, 97
A. Bult-Ito, 67 A.A. Roussin, 52 B. Søborg, 55 C. Tait, 23
A. Corriveau, 27, 44, 76, 97 A.A. Savchenko, 122 B. Tallio, 46 C. Van Waes, 40
A. Cortinois, 52 A.B. Kjeldsen, 107 B. Tetso, 140 C. Wallace, 138
A. Daniels, 43, 120 A.B. Salmina, 109 B. Walberg, 22 C. Werk, 126
A. Demers, 124 A.B.M. Andersen, 55 B. Young, 31, 145 C. Wild, 48
A. Donnison, 131 A.B.S. Nielson, 59 B.D. Roebuck, 38 C. Zanis, 78
A. Doraty, 124 A.C. Hegeman, 140 B.J. McMahon, 78 C. Zhirong, 57
A. Ducas, 89, 132 A.D. Neverov, 79 B.K. Poulsen, 26 C.B. Christiansen, 143
A. Dudarev, 132 A.G. Borisov, 122 B.L. Cameron, 108 C.B. Svendsen, 143
A. Edin-Liljegren, 118 A.G. Comuzzie, 67, 91, 92, B.V. Howard, 67, 91, 92, 102 C.D. Efremova, 58, 137
A. Ferland, 102 102 C.G. Himsworth, 88
A. Gafarova, 33, 58, 119, 135, A.G. Romashchenko, 68 C.N. Da Silva, 37
136 A.I. Yakovleva, 148, 154 C C.P. Archibald, 36
A. George, 26, 110, 111 A.J. Brunetti, 160 C. Alton, 91 C.P. Pedersen, 72
A. Geraghty, 106 A.J. Parkinson, 78, 90, 113 C. Anderson, 151 C.R. Wenger, 91, 92, 102
A. Giles, 61 A.K. Palmer, 31, 109, 121 C. Betker, 34, 125 C.V.L. Larsen, 73
A. Godfreyson, 161 A.L. Morse, 108 C. Burchill, 124 C.Y. Jean, 91
A. Hache, 51, 81, 120 A.M. Mayer, 101 C. Carry, 40, 72, 101, 104, Canadian Red Cross, 62
A. Hoechmann, 49, 50 A.M. Pietilä, 160 156 CANHelp Working Group,
A. Ing, 146 A.N. Romanova, 35, 58, 137 C. Case, 69, 137, 153 27, 108
A. Johns, 23 A.O. Ondar, 145 C. Christensen, 78
A. Kimiksana, 101 A.R. Spein, 94
A. Koch, 25, 32, 35, 55, 65, A.S. Golderova, 58, 133, 137
C. Cook, 52 D
C. Dallas, 30
67, 77, 87, 108, 114, 143 A.S. Iakovleva, 93 C. DeByle, 87 D. Allman, 25
A. Kronstal, 63 A.S. Savalas, 117 C. Dickson, 46, 56, 154 D. Anderson, 115
A. Kumar, 121, 144 A.V. Efremova, 133 C. Fletcher, 26, 91 D. Badry, 75
A. Kushwaha, 57 A.V. Kiklevich, 141 C. Furgal, 38, 75 D. Ballard, 52
A. MacLeod, 34, 125 A.V. Struchkova, 133 C. Graham, 42 D. Boon, 76
A. Manning, 37, 57 A-Track Working Group, 36 C. Greenberg, 25 D. Boulos, 36
A. Manyguns, 106 C. Gregson, 61 D. Bruden, 78, 87, 113, 114
A. Moses, 101
A. Nahwegahbow, 38
B C. Hamilton, 127 D. Carlino, 62
C. Homan, 78 D. Chichakhov, 125
A. Neimanis, 138 B. Adlard, 57 C. Huet, 57, 152 D. Ciliska, 89, 98
A. Nicholson, 152 B. Armstrong, 110 C. Jardine, 48 D. Dedam-Montour, 101
A. Niittyvuopio, 146 B. Boyer, 24, 25 C. Jeppesen, 75, 76, 102 D. Dell, 119, 131
A. Pacey, 57, 127, 147, 149 B. Cameron, 117 C. Kasper, 124 D. Desaulniers, 29
A. Porter-Chapman, 51 B. Denning, 131 C. Kehler, 48 D. Dieter, 62
A. Pronovost, 150 B. Dieter, 62 C. Kirby, 52 D. Dupont, 100
A. Rautio, 146, 151, 160 B. Downey, 117 C. Knotsch, 41, 82 D. Gesink-Law, 25, 65, 87
A. Reeves, 42, 120 B. Elias, 44, 99, 124 C. Laviolette, 120 D. Gravel, 88
A. Ritchie, 41 B. Elkin, 138 C. Lennie, 86, 153 D. Gretch, 78
A. Robitaille, 31, 145 B. Erasmus, 46 C. Lopez, 54, 69, 92 D. Hurlburt, 78, 87, 113, 114
A. Salmon, 74, 110 B. Farrell, 49 C. Loppie, 109 D. Kinnon, 34
A. Severini, 44, 45 B. Green, 119 C. Lys, 64 D. Koeller, 24, 25
A. Silverman, 91 B. Grimwood, 37, 57 C. Miller, 121 D. Kurszewski, 37
A. Silviken, 72, 155 B. Grueger, 75 C. Moniz, 76 D. Leavitt, 24
A. Stepushyn, 156 B. Hanley, 44, 62, 97 C. Orlaw, 97, 112 D. Littlejohn, 109
A. Thio, 120 B. Hopping, 140 C. Osiowy, 77 D. Martin, 46, 100
A. Timmins, 157 B. Hughson, 141 C. Palacios, 88 D. Menzies, 129
A. Trofimov, 57 B. Jeffery, 127 C. Penney, 33 D. Nibgoarsi, 88
Presenters’ Index: By Initials & Surname 161
D. Panov, 136 E.J. Virginia, 38 G.M. Egeland, 26, 33, 38, J. De Luce, 63
D. Parks, 113, 114 E.K. Brandson, 22, 31, 109, 112, 124, 127, 139, 142, J. Edwards, 48
D. Perkins, 66 120, 121 147, 149, 150, 152, 153 J. Eibl, 133
D. Priestly, 90 E.K. Khusnutdinova, 159 J. Eskes, 102
D. Reid, 74 E.L. Franco, 45 J. Franks, 129, 151
D. Rousell, 61 E.P. Bronnikova, 58, 59, 110 H J. Friborg, 40
D. Santrapinsky, 33, 119, 135 E.R. Mirdaleeva, 28 H. Angootealuk, 152 J. Gittelsohn, 27, 39, 56, 76,
D. Scholten, 35, 153 E.V. Fast, 79 H. Beanlands, 34, 89, 98, 125 103, 128, 131, 134, 140,
D. Simeon, 41 E.V. Lukicheva, 58, 59 H. Durrani, 81 144, 160
D. Sullivan, 78 E.V. Moshkova, 93 H. Dyson, 89 J. Gordon, 35, 99, 101
D. Tagornak, 118 E.V. Shakhtshneider, 35, 68 H. Eiberg, 67, 146 J. Hassi, 96
D. Turner, 124 E.Y. Kupershtein, 58, 59 H. El-Gabalawy, 66 J. Hayek, 139
D. Tzemis, 22 H. Fikowski, 108 J. Huntington, 26, 27
D.M. Biktimirova, 141 J. Jaud, 49
D.M. Sparks, 124 F H. Harder, 73
J. Johnson, 65
H. Krarup, 77
D.P. Charette, 37, 57 F. Balbi, 128 H. Kuhnlein, 46 J. Jokelainen, 96
F. Benoit, 89, 98 H. Leslie, 69 J. Jones, 99
J. Klejka, 114
E F. Christensen, 106 H. Moeller, 107
J. Kornelsen, 83, 137
F. Michayluk, 127 H. Nakimayak, 26
E. Affleck, 51, 52, 55 F. Simonet, 111, 156 H. Rosen, 78 J. Lamba, 126
E. Anda, 111 F. Stenz, 87 H. Saudny-Unterberger, 26, J. Leston, 64
E. Asay, 101, 142 F. Sussman, 120 152, 153 J. Linton, 89, 132
E. Bojko, 96, 105 F. Tarrant, 35, 99 H. Vallance, 24, 25 J. Lys, 116
E. Counil, 102 F. Tester, 83 H. Wang, 91, 92 J. MacKinnon, 69
E. Coutle, 45 F.A. Leighton, 138 H. Weiler, 139, 147, 150 J. Martin, 129
E. De Roose, 76, 128, 131, F.A. Platonov, 141 H.H.H. Garing, 67 J. Mignone, 99
134, 144 H.V. Kuhnlein, 33, 146 J. Mike, 145
E. DeRoose, 103 J. Muller, 91
E. Dewailly, 75, 102 G J. Naedzo, 43, 120
E. Ding, 121 I J. Ogina, 27, 56, 101
G. Annuzzi, 92 J. Pereira, 149, 150
E. Du Plessis, 132 G. Aubé, 116 I. Fleischer, 102
E. Dunaway, 78 J. Poliquin, 145
G. Baikie, 22 I. Gagulin, 33, 58, 135, 136 J. Polisena, 105
E. Elias, 152 G. Becker, 85, 112 I. Grant, 76
E. Erasmus, 48 J. Rawana, 129, 151
G. Bergenholtz, 95 I. Gromova, 119 J. Reade, 65
E. Erber, 103, 128, 134, 140 G. Brown, 96 I. Kleist, 68
E. Freeland-Ballantyne, 37 J. Reading, 80, 94, 104
G. Cobra, 95 I. Nielsen, 67 J. Rempel, 78
E. Giles, 77 G. Degteva, 96 I. Njålstad, 142
E. Gromova, 33, 58, 135, 136 J. Robbins, 21, 86
G. Dow, 32 I. Partridge, 53 J. Rossiter, 79
E. Guimond, 125 G. Edwards, 140 I. Pike, 61
E. Jenkins, 88 J. Rouleau, 97
G. Egeland, 57 I. Sobol, 33, 44, 45, 88, 97, J. Shoveller, 65
E. Kliewer, 124 G. Gibson, 86 98, 112, 127, 142, 149, 153
E. Koop, 143 J. Smylie, 111, 156
G. Gordon, 26 I. Tensen, 26 J. Soon, 65
E. Labranche, 111, 156 G. Hua-Xio, 29 I.A. Ignatova, 123
E. Lund, 63 J. Spika, 88
G. Jayaraman, 45 I.A. Pinigina, 60 J. Van Oostdam, 37, 57
E. Mead, 27, 39, 56, 140, G. Johnson, 44, 45 I.M. Nielsen, 146
142, 160 J. Whitley, 129, 151
G. Mironova, 123 I.M. Ponomareva, 110 J. Williams, 78
E. Myers, 37 G. Mulvad, 25, 65, 87, 94 I.R. Petrova, 59
E. Näkkäläjärvi, 146 J. Wolfe, 130
G. Ohno, 147 I.V. Karandashova, 79 J. Wortman, 60
E. Nieboer, 111 G. Osborne, 33, 61, 97, 98, I.V. Kulikov, 68
E. Nowgesic, 86 J.A. Jamieson, 33
112, 114, 127, 142, 149, I.V. Osokina, 27, 141, 148 J.C. Catholique, 23
E. Olofsson, 53 150 International Circumpolar
E. Randell, 153 J.C. Lopez-Alvarenga, 92
G. Pootoogook, 37 Surveillance Working J.D. Ford, 56
E. Rawana, 95, 129, 151 G. Rees, 76 Group, 87, 136, 137
E. Rink, 25, 65, 87 J.D. Martin, 100
G. Riccardi, 92 J.D. Otvos, 92
E. Rubinstein, 82, 89 G. Stadig, 61
E. Skifte, 107 J J.D. Wenger, 113, 114
G. Thomas, 80 J.E. Smith, 86
E. Sock, 86 G. Thunem, 33
E. Stewart, 47 J. Boffa, 69 J.F. Proulx, 153
G. Turner, 107 J. Brazeau, 151 J.G. Petrova, 97
E. Throassie, 127 G. Vivian, 76
E.A. Alexeeva, 137 J. Brewster, 112 J.I. Forrest, 22
G. Vrakas, 31 J. Bull, 22 J.J. Christensen, 143
E.A. Lexeeva, 58 G. Wurtak, 44
E.B. Kudryashova, 28 J. Butler Walker, 42, 43, 62, J.L. Tonkikh, 110
G.E. Mironova, 133, 143, 148 139 J.M. Buck, 130
E.C. Bonefeld-Jørgensen, G.G. Dranaeva, 159
123 J. Caines, 47 J.N. Larsen, 141
G.I. Ievleva, 141 J. Cheechoo, 38, 45 J.O. Odland, 132
E.D. Okhlopkova, 148, 154 G.I. Simonova, 156
E.F. Druyts, 22 J. Chen, 29 J.P. McGhie, 144
G.K. Healey, 42, 83, 112, 130, J. Cheung, 27 J.R. Alexeev, 158
E.F. Teslya, 141 139, 145
E.G. Samsonova, 28 J. Christensen, 82, 91, 110, J.S. Jensen, 87
G.K. Heatha, 52 115, 143 J.S. Johnson, 142
E.I. Semenova, 148, 154
J. Cowan, 97, 98
J.S.G. Montaner, 22, 31, 109, L. Edge, 54, 138 M. Buell, 71, 86 M.H. Therkildsen, 40
120, 121 L. Eichelberger, 82 M. Bzdell, 130, 145 M.I. Tomskii, 35
J.W. MacCluer, 67, 91, 92, L. Fournier, 31 M. Campbell, 138 M.I. Voevoda, 35, 68
102 L. Friesen, 89, 132 M. Dyck, 85 M.J. Kral, 30
J.W. Morse, 108 L. Grøtvedt, 94 M. Eriksson, 118 M.J. Ogarkov, 68
J.Y. Odland, 111 L. Gulliver, 62 M. Fast, 89, 98, 132, 154 M.J. Roman, 92
L. Gushue, 130 M. Fournier, 47 M.K. Mau, 42
L. Gyrgolkau, 137 M. Garner, 87, 113, 136 M.K. Sharma, 130
K L. Harms, 48 M. Ghisari, 123 M.L. Kelly, 31
K. Boyd-Hummel, 78 L. Harrison, 91 M. Greenwood, 80, 89, 98, M.R. Mulvey, 88
K. Brownlee, 95, 129, 151 L. Jacobsson, 118 117, 125 M.S. Cheranova, 30
K. Clement, 109 L. Jette, 113 M. Grey, 43 M.T.S. Jenssen, 142
K. Colbourne, 130 L. Johnson-Down, 127, 142 M. Guyot, 38
L. Kreuger, 141 M. Hall, 99, 124, 138
K. Edwards, 43
L. Kuptana, 101 M. Hammond, 101 N
K. Friendship, 38
K. Gray, 52 L. Lafferty, 43, 120 M. Heaman, 111, 156 N. Beauvais, 101
K. Haack, 67 L. Larcombe, 54, 81 M. Helferty, 136, 137 N. Black, 151
K. Kandola, 39 L. Lochhead, 95 M. Horton, 115 N. Edgecombe, 43
K. Kleinshmidt, 106 L. Lynge, 125 M. Ip, 37, 57 N. Enuaraq, 30
K. Knapp, 76 L. Menominee-Batise, 100 M. Jong, 52, 106 N. Eseva, 96
K. Koller, 101 L. Murawski, 62 M. Kelly, 94, 104 N. Faraj, 112
K. Ladefoged, 35, 55, 64, 68 L. Nicholas-Figueroa, 40 M. Kemp, 143 N. Hanlon, 65
K. Machalek, 112 L. Ogilvie, 100 M. King, 108, 117 N. Kassi, 43, 45, 110, 115
K. McMullin, 69 L. Okalik, 26, 30, 46 M. Kratsmann, 27 N. Lachance, 34
K. Minich, 111, 156 L. Panaro, 88 M. Kratzmann, 56 N. Lauster, 83
K. Mitchell, 41 L. Parton, 79 M. Kumar, 34, 144 N. McCullough, 127
K. Morgan, 91, 104 L. Patti, 92 M. Lee, 96 N. Murphy, 44
K. Murray, 128 L. Paulette, 85, 112 M. Lindegger, 88 N. Nielsen, 35, 55
K. Nielsen, 138 L. Piper, 53 M. Lodahl, 67 N. Obed, 153
K. Nisbet, 30 L. Richardson, 151 M. Long, 123 N. Poole, 116
K. Nystad, 147 L. Schwarzburg, 84 M. Lovgren, 113, 137 N. Potolitsyna, 96
K. Rudolph, 87, 113, 114 L. Shah, 88 M. Masulli, 92 N. Reynolds, 126
K. Schreiner, 126 L. Specht, 40 M. Mayan, 69 N. Schuurman, 137
K. Schwartzman, 129 L. Svenson, 124 M. Mayoh, 99 N. Semenova, 160
K. Thorsen, 95 L. Thompson, 132, 154 M. Melbye, 35, 55, 114 N. Sheikh, 124
K. Vähäkangas, 151, 160 L. Tranebjærg, 67 M. Melhus, 63, 94 N. Sibileva, 29
K. Verdecchia, 29 L. Van Pelt, 38 M. Nsungu, 88 N. Trotter, 69
K. Watanabe, 147 L. Vindfeld, 143 M. Ofner, 88 N. Wedzin, 86
K. Winters, 75 L. Wexler, 24 M. Pedersen, 102 N.A. Pashina, 122, 123
K. Young, 33, 52, 71, 89, 112, L. Whitbeck, 64 M. Petit, 21 N.C. Agnew, 84
127, 132, 142, 149, 150, L. Yuan, 100 M. Porter, 86 N.C. Doubleday, 37, 57
152, 153 L. Zubov, 24, 29 M. Potyrala, 112 N.C. Larter, 39
K.A. Fernandes, 22, 109, L.A. Butler, 114 M. Probizanski, 129 N.D. Rendtorff, 67
120, 121 L.A. Gyrgolkau, 35 M. Ramesh, 101 N.G.L. McHugh, 111
K.C. Duncan, 109 L.A. Huisman, 66 M. Roger, 45 N.J. Harms, 138
K.E. McIsaac, 112 L.C. Ragus, 106 M. Routledge, 143 N.J. Weissman, 91, 92
K.G. Nozdrachev, 58 L.D. Olesova, 148 M. Rydbacken, 64 N.K. Larsen, 59
K.J. Goodman, 26, 27, 108 L.G. Goldfarb, 141 M. Shapran, 148 N.N. Butorin, 109
K.J. Schoellhorn, 153 L.H. Malcoe, 152 M. Shum, 83 N.N. Shim, 155
K.K. Anderson, 129 L.H.M. Chan, 38, 46, 56, 154, M. Snowball, 78 N.S. Polovodova, 122, 150
K.L. Hansen, 63 161 M. Tjepkema, 125 N.S. Yudin, 68
L.L. Alekseeva, 141 M. Tomskiy, 157, 158, 159 N.V. Golubeva, 67
L.L. Harrigan, 104 M. Tyndall, 120 N.V. Maharova, 159
L L.O. Reiersen, 132 M. Ugyuk, 160 N.V. Makcharova, 35
L.O.E. Ebbesson, 92, 102 M. Valery, 160
L. Abryutina, 24 L.P. Nielsen, 114 M. Van Bibber, 110, 115, 161
L. Amagoalik, 128 L.V. Cox, 74 M. Voevoda, 50 O
L. Angalik, 88 L.V. Salamatina, 134, 135 M. Wideman, 47, 48
L. Arbour, 24, 25, 66, 97, 98, L.V. Tarabukina, 59 M. Williams, 46 O. Anoee, 88
111, 112 M. Wood, 153 O. Grishin, 93
L. Bartlett, 128 M. Yetman, 153 O. Ketkina, 105
L. Beck, 103, 128, 134 M M. Young, 36 O. Vaccaro, 92
L. Bulkow, 78, 114 M.A. Buyack, 28 O.A. Mirolyubova, 93
L. Clearsky, 124 M. Allan, 112 O.L. Barbarash, 68
M. Andersson, 32, 35, 55, 114 M.A. Mackenzie, 86
L. Daerga, 118 M.A. Romanyuk, 92, 93 O.M. Bragina, 156
L. Day, 49 M. Ar-Rushdi, 89 O.S. Amelchugova, 109, 110
M. Aslam, 36 M.E. Kelm, 65
L. Dean, 39 M.E. Macdonald, 129 O.V. Shtygasheva, 109, 110
L. Duffy, 40 M. Beaumier, 56 O.V. Smirnova, 122
M. Bell, 79 M.E. Moffatt, 48
L. Duncan, 43 M.E. Tejero, 67, 92, 102 O.V. Tatarinova, 157
L. Dunfield, 133 M. Bruce, 78, 87, 113, 137 O.V. Yanchenko, 35
M.G. Bruce, 113, 114
Presenters’ Index: By Initials & Surname 163
P R. Magga, 146 S. Laston, 67, 91, 92, 102 T. Korolenko, 30

R. Martial, 117 S. Lauson, 112 T. Kosatsky, 70
P. Anderson, 61 R. Masching, 99 S. Law, 52 T. Kovesi, 114
P. Bjerregaard, 59, 72, 73, 75, R. McCormick, 21, 66 S. Livingston, 78 T. Krüger, 123
76, 102, 117 R. Montgomery-Andersen, S. MacLeod, 110, 127 T. Laatikainen, 96
P. Brassard, 44, 45, 129 25, 65, 87 S. McIntosh, 112 T. Larssen, 142
P. Hayward, 82 R. Morales, 24 S. Mitchell, 43 T. Leech, 37
P. Hazelton, 82 R. Munday, 26, 27, 108 S. Moller, 31 T. Leung, 136
P. Hjelmborg, 123 R. Obomsawin, 53, 86 S. Møllersen, 119 T. Lidguerre, 127
P. Homøe, 40, 67, 140 R. Pearce, 57 S. Montgomery-Andersen, T. Loginova, 105
P. Jousilahti, 96 R. Peterson, 127 25, 65, 87 T. Mala, 24, 25
P. Kern, 146 R. Plaetke, 128 S. Morin, 145, 150 T. Malzeva, 122
P. Lubov, 73 R. Platonova, 69 S. Näyhä, 96 T. Marsden, 83
P. Lyta, 99 R. Rawat, 81 S. Negus, 78 T. McKinnon, 106
P. Macmillan, 95 R. Reid, 27, 39, 56, 76, 140, S. Nickels, 41 T. Moore, 43, 120
P. Maez, 128 160 S. O’Hara, 147 T. Myers, 25
P. Marquis, 76 R. Rosol, 152, 160 S. Ogunnaike-Cooke, 36 T. Nancarrow, 37, 146
P. McNicoll, 83 R. Salokangas, 118 S. Peters, 98 T. Neily, 61
P. Moffitt, 85 R. Schroth, 48 S. Reaburn, 103, 128, 134, T. Polivanova, 160
P. Myllynen, 151 R. Schuster, 154 144 T. Rendal, 68
P. Nicherson, 54 R. Singleton, 78, 114 S. Rognerud, 142 T. Ritter, 114
P. Orr, 54, 69, 81, 82, 86, 130 R. Timmins, 29 S. Salavat, 28 T. Sato, 29
P. Peters, 101 R. Tsang, 87, 137 S. Samanani, 124 T. Skifte, 55, 68
P. Rivest, 153 R. Villems, 159 S. Senécal, 125 T. Starosotskaya, 148
P. Sj’lander, 32, 118 R. Wilkins, 111, 125, 156 S. Sharma, 27, 39, 56, 76, T. Vlasova, 57
P. Tchouaffi, 61 R.A. Blake, 48 103, 128, 131, 134, 140, T. White, 124
P. Tobin, 56 R.A. Dieter Jr., 62 142, 144, 160 T. Wilsgaard, 111
P. Vlahos, 49 R.B. Devereux, 67, 91, 92, S. Shaw, 132, 154 T. Wong, 44, 45
P. Zizman, 47 102 S. Skinner, 88 T. Wuerz, 32
P.C. Tremblay, 86 R.C.A. Thompson, 88 S. Skov-Jensen, 65 T. Zulz, 35, 87, 113, 114, 137
P.I. Sidorov, 29 R.E. Scott, 81 S. Smith, 54, 90 T.A. Mala, 42
P.J. Martens, 99, 111, 124, R.G. Jensen, 40, 140 S. Suleymanov, 28 T.A. Romanova, 35, 59
156 R.L. Bourque-Bearskin, 108, S. Totten, 45 T.E. Burtseva, 158, 159
P.K. Wiebe, 30 117 S. Tough, 126 T.G. Komlyagina, 145
P.M. Ignatyev, 141 R.R. Fabsitz, 67, 91, 92, 102 S. Valeriy, 122 T.K. Erdakova, 134, 135
P.M. Okin, 92 R.S. Hogg, 22, 31, 109, 120, S. van Zanten, 27 T.K. Young, 112, 127
Pauktuutit Inuit Women of 121 S. Verhille, 83 T.L. Stuart, 88
Canada, 57, 65, 74, 84, 85, R.V. Jakovlev, 159 S. Villumsen, 143 T.M. Mäkinen, 71, 96
118 R.Z. Alexeev, 158 S. Vyacheslav, 71 T.R. Orchard, 22
S. Wadowska, 110, 115, 161 T.V. Maltseva, 150, 155
S. Wesche, 46, 161 T.Ya. Shipulina, 155
Q S S.A. Cole, 67
S.A. Collins, 153
Qanuippitali Steering S. Abonyi, 69, 127
S.A. Dogadin, 58 U
Committee (Inuvialuit), S. Andersen, 67
S. Bauhaus, 86 S.A. Fedorova, 159 U. Poppel, 25, 65, 87
26, 38, 152, 153
S. Bernier, 75 S.A. McEwen, 138
Qanuippitali Steering
S. Biggs, 103, 128, 134, 144 S.A. Rolin, 90
Committee (Nunatsiavut),
26, 38, 152, 153 S. Brofeldt, 40, 140 S.A. Tokarev, 126, 155 V
S. Chatwood, 37, 42, 44, 52, S.G. Donaldson, 37, 57
Qanuippitali Steering V. Chashchin, 70, 132
57, 80, 112, 139, 152 S.G. Kriroschekov, 60
Committee (Nunavut), V. Chupakhin, 132
S. Christianson, 130 S.I. Braslavskaya, 79
26, 33, 38, 57, 112, 127, V. Dekabrina, 77
S. Clarren, 110 S.K. Clarren, 74
139, 142, 147, 149, 150, V. Douglas, 85
S. Collins, 24, 25 S.O.E. Ebbesson, 67, 91, 92
152, 153 V. Faria, 108
S. Coulter, 120 S.V. Smirnova, 122, 123
Steffanson Arctic Institute, V. Gafarov, 33, 58, 119, 135,
S. Cross, 76 136
R S. Déry, 145 141
V. Gallant, 153
S. Desai, 87, 136, 137 V. Goleski, 45
R. Bennett, 45
R. Collins, 101
S. Duke, 48 T V. Illisiak, 37
S. Ebbesson, 102 V. Kamper, 32
R. Copes, 89, 98
S. Gryzbowski, 83 T. Andersen, 67 V. Maud, 56
R. Dieter, 62
S. Grzybowski, 137 T. Antone, 100 V. Melnikov, 98
R. Drybones, 43, 120
S. Harper, 138 T. Axtell, 80 V. Napoleon, 118
R. Fedina, 28, 135
S. Hassler, 32 T. Bliss, 29 V. Peskov, 24
R. Goodwin, 90
S. Hatjó, 47 T. Galloway, 127 V. Stordahl, 21
R. Hegele, 24, 25
S. Irlbacher-Fox, 24, 141 T. Greenland, 101 V. Sunnari, 105
R. Jackson, 31
S. Keefe, 89 T. Haldorsen, 72 V. Van Wagner, 111
R. Johnson, 24
S. Kelley, 91 T. Heale, 47 V. Van Zanten, 108
R. Kristiansen, 94
S. Khoja, 81 T. Hennessy, 44, 78, 113, 114 V.A. Argunov, 157, 158
R. Link, 94, 104
S. Kvernmo, 72, 94 T. Holton, 53 V.A. Baum, 68
R. Long, 69
V.A. Dolgin, 79 W W-L. Yu, 138 Y.A. Li, 44

V.D. Lima, 109, 120 Y.L. Tonkikh, 58, 59
V.L. Edge, 138 W. Burke, 24, 25 Y.V. Vorobyova, 28
V.L. Osayueskiy, 141 W. Fraser, 156
X Yu.B. Parlyuk, 156
V.N. Melnikov, 145 W. Hogg, 83 X. Cao, 76, 131, 142 Yu.P. Nikitin, 156, 157
V.Ø. Thomsen, 55 W. Lahey, 105 X. Cui, 126
V.P. Chulanov, 79 W. Martin, 26, 111
V.S. Voruganti, 67 W. Mason, 116
Z
V.T. Manchuk, 27, 122, 123 W. White, 88 Y Z. Chen, 40
V.V. Antipina, 59 W. Zhang, 22, 31 Z. Todd, 43
V.V. Tsukanov, 58, 59, 109, Y. Kabanov, 33, 58, 119, 135,
W.A. MacDonald, 50, 83, Z.-C. Luo, 111, 156
110 136
100, 139 Z.N. Krivoshapkina, 143
Y. Mao, 44, 45
W.J. Howard, 91, 92, 102 Z-C. Luo, 111, 156
Y. Nikitin, 93
W.S. Harris, 92, 102
Y. Wu, 156
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ABSTRACT BOOK

14th International Congress on

July 11 – 16, 2009

Table of Contents ......................................................................................................................................................... 5

Community Participatory Research Methods #1 ...................................................................................................................... 25

VENUE VIEWING ROOM ......................................................................................................................................................... 40

HEADING A SÁMI HEALTH INSTITUTION: EXPERIENCE AND CHALLENGES .............................................................................................................................. 52

WORKER FATALITIES IN THE ALASKA TOURISM INDUSTRY: 1990-2008 .................................................................................................................................... 61

MOLECULAR EPIDEMIOLOGY OF VIRAL HEPATITIS B, C, AND D IN THE CHUKOT REGION .......................................................................................................78

VENUE 5 ................................................................................................................................................................................ 100

VENUE 6 ................................................................................................................................................................................ 100

VENUE VIEWING ROOM ........................................................................................................................................................ 102

VENUE 2 ................................................................................................................................................................................ 104

HEALTH TECHNOLOGY ASSESSMENTS ON TELEHEALTH ........................................................................................................................................................104

VENUE 3................................................................................................................................................................................ 105

VENUE 5 ............................................................................................................................................................................... 109

VENUE 2 ............................................................................................................................................................................... 109

VENUE 4 ................................................................................................................................................................................ 111

VENUE 5 ................................................................................................................................................................................ 113

VENUE 7 ................................................................................................................................................................................ 115

VENUE 2 ................................................................................................................................................................................ 118

VENUE 3 ................................................................................................................................................................................ 120

Human Biology #2................................................................................................................................................................. 120

VENUE 4 ............................................................................................................................................................................... 122

POSTER SESSIONS .................................................................................................................................................. 126

Presenters’ Index ...................................................................................................................................................... 160

natural world was something that humans were destined to conquer

ground the necessity of organization of a new direction in medicine –

PAN-ARCTIC TV SERIES ON INUIT WELLNESS: PRELIMINARY Fox Consulting

interactive program included live broadcasts from Iqaluit, Nunavut

CARNITINE PALYMITOYLTRANSFERASE IA POLYMORPHISM THE REALITIES ENCOUNTERED WHILE INTRODUCING THE

STRATEGIES FOR COMMUNICATING HEALTH RESEARCH

Objective: To present a model for using formative research and

Contact: Salavat Suleymanov (passarudege@mail.ru)

of the cardiovascular system and the vegetative nervous system

Contact: Tsezar Korolenko (lengyel@irs.ru)

outcomes than “top down” ones. The authors are partners in a

University of Ottawa IN-PATIENT CARE UTILIZATION AMONG SÁMI IN SWEDEN

Contact: Gunhild Thunem (gunhild.thunem@kun.nl.no)

USING KNOWLEDGE SYNTHESIS, TRANSLATION, AND

1 Contact: Anna Banerji (anna.banerji@utoronto.ca)

COMMUNITY-BASED APPROACH TO HEALTH RESEARCH IN

toxicants; however, the fish in the James Bay Region predominately

L.H.M. Chan, L. Van Pelt, G.M. Egeland, Qanuippitali Steering

Conclusions: These results fill the research gap on the impact of

Peoples Television Network - North in May 2009 in the Inuit language

TOWARDS DEVELOPING PRINCIPLES OF ETHICAL

the Yukon worked together on issues of importance in their

WORKING ON THE LAND, WORKING OFF THE LAND

Contact: Y. Anita Li (y._anita_li@phac-aspc.gc.ca)

VENUE 4 IMPROVING HPV PREVENTION AMONG ABORIGINAL

Contact: George Wurtak (gwurtak@icid.com)

Results: A cohort of 629 Women aged 15-69 was assembled between

making pertaining to HPV vaccination and cervical cancer prevention.

Contact: Joyce Caines (joyceinthearctic@yahoo.ca)

HEALTHY SMILE HAPPY CHILD: RESEARCH AND

Contact: Linda Day (linda.day@vch.ca)

Manitoba. The incidence rate for tuberculosis for Canadian-born

and enhancing factors affecting food procurement and food stocking

higher in comparison with Evens and Evenks. In all populations

eccentric LV hypertrophy. Coronary angiography and left-

Contact: Alana Kronstal (akronstal@gmail.com)

Contact: Les Whitbeck (lwhitbeck2@unlnotes.unl.edu)

determine which factors were associated with infection.