Exploring Indigenous Traditional Healing support policies and programs in Canada, Australia, and New Zealand to inform the support for Indigenous Traditional Healing policies in Saskatchewan: a scoping review

The lower health status of Indigenous people in Canada, Australia, and New Zealand are well documented and largely attributed to colonization and colonial policies. Colonization also led to the suppression of Indigenous Traditional Healing practices, which have been revitalized over the years by Indigenous societies with evidence of a profound effect on their health and wellbeing. Despite various policy recommendations concerning the rights and recognition of Indigenous Traditional Healing practices including TRC Call to Action 22, there is evidence of a literature gap regarding the extent to which Traditional Healing practices are supported in the mainstream healthcare system. This study explored ways Indigenous Traditional Healing practices are supported by the healthcare system in Canada, Australia, and New Zealand through policies and programs. This study is a part of a larger project to determine what aspects of Indigenous Traditional Healing policies and programs identified from the healthcare systems can be adopted to inform the support for Indigenous Traditional Healing policies in Saskatchewan. A scoping review guided by the PRISMA extension for Scoping Reviews was conducted. Databases for sources of information included CINAHL, Medline, Embase, Web of Science, Public Health, Global Health, iPortal, and grey literature search. Twenty-two articles (Canada=14 and Australia and New Zealand =8) met the inclusion criteria for data extraction for this scoping review. After the analysis of data extracted from each source of evidence, ten (10) Healthcare systems and services were identified with programs and policies supporting Indigenous Traditional Healing practices, which included midwifery, mental health, and palliative care. Within these services, programs identified utilized Indigenous Traditional Healing practices as the main or choice treatment, to support Western biomedical treatment options and or adopted Indigenous Traditional knowledge. The impact of the support and recognition of Indigenous Traditional Healing within the mainstream healthcare system includes increased access and attendance, improved healthcare experience and health outcomes, empowered individuals, and their communities, brought healthcare back to communities and improved the health and wellbeing of Indigenous people and their communities. Therefore, we call upon those who can effect change within the healthcare system to recognize the value of Indigenous healing practices and use them in the treatment of Indigenous patients

Smart ophthalmics: the future in tele-ophthalmology has arrived

Smart Ophthalmics^© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage

The use of telemedicine to support Brazilian primary care physicians in managing eye conditions : the TeleOftalmo Project

Purpose: To determine whether teleophthalmology can help physicians in assessing and managing eye conditions and to ascertain which clinical conditions can be addressed by teleophthalmology in primary care setting. Methods: We evaluated the resolution capacity of TeleOftalmo, strategy implemented in the public health system of southern Brazil. Resolution capacity was defined as the ability to fully address patients’ eye complaints in primary care with remote assistance from ophthalmologists. Data from tele-eye reports were collected over 14 months. Resolution capacity was compared across different age groups and different ocular conditions. Results: Overall, 8,142 patients had a tele-eye report issued in the study period. Resolution capacity was achieved in 5,748 (70.6%) patients. When stratified into age groups, the lowest capacity was 43.1% among subjects aged �65 years, while the highest was 89.7% among subjects aged 13–17 years (p<0.001). Refractive error (70.3%) and presbyopia (56.3%) were the most prevalent conditions followed by cataract (12.4%) and suspected glaucoma (7.6%). Resolution capacity was higher in cases of refractive error, presbyopia, spasm of accommodation and lid disorders than in patients diagnosed with other condition (p<0.001). Conclusions: With telemedicine support, primary care physicians solved over two-thirds of patients’ eye or vision complaints. Refractive errors had high case resolution rates, thus having a great impact on reducing the number of referrals to specialty care. Teleophthalmology adoption in primary-care settings as part of the workup of patients with eye or vision complaints promotes a more effective use of specialty centers and will hopefully reduce waiting times for specialty referral

The Web Weaved by Culture: Telehealth in Native America

Telehealth, with its focus of addressing healthcare at a distance and being cost efficient, has been suggested to be a good fit in Native American communities. However, very little study has been done bridging the two; even less has been done attempting to analyze the unique ways telehealth can be utilized. In what way is telehealth shaped or adapted by cultural factors? This work not only exhibits the ways Native peoples’ distinctive historical and political relationships to the U.S. Federal Government influence their health care, but also the unique cultural worldviews that seem to encompass their health practices. In this way, culture and health are examined in a variety of scopes to reveal that conceptions of healthcare can ultimately be altered

Clinical social work and community practice with children and youth through Carrier Sekani Family Services

In this report I weave the practical skills and knowledge I gained from my practicum with Carrier Sekani Family Services (CSFS) with theory related to child and youth mental health. I present human ecology as my grounding conceptual framework in my approach to wellness. I explore theoretical foundations for clinical social work, therapeutic modalities, rurality and cultural diversity through a literature review and build on these to support my practice experience. I include sections on youth mental health, Indigenous issues, ally-ship, trauma informed practice, attachment theory, connectedness, tele-mental health and rural social work practice. Services offered through Carrier Sekani’s counselling program that I have practiced include outreach, assessment, treatment planning, safety planning, referral and discharge. I connect practical experiences of working within Carrier culture as a mental health clinician to the literature and explore how I make sense of the shared and created knowledge

Optometry Outreach in Indigenous Communities in British Columbia, Saskatchewan, and Manitoba

Introduction: Inuit, Métis, and First Nations, the three main Indigenous groups within Canada, face disproportionate barriers to access for primary eye and vision care. Optometrists visit rural and remote Indigenous communities to provide outreach care to areas without a local optometrist; however, the approach is fragmented and not well represented. The purpose of this project is to assess the current state of outreach optometry within Indigenous communities by surveying optometrists who provide outreach care. Methods: In collaboration with the provincial optometry regulatory bodies, eligible participants were identified as optometrists who travel outside of their primary clinics to provide care within non-urban Indigenous communities. A questionnaire was developed through iterative stakeholder review for phase I of the study. The online questionnaire captured the delivery of care across one year (2022). The process of planning logistics, distances travelled, patient care provided and associated expenses were queried. A Semi-structured interview guide was developed for phase II of the study. One-on-one interviews expanded on questionnaire themes, providing insight into individual experiences. Data was collated through descriptive statistics and thematic coding for case and cross-case analysis. Results: The overall response rate was 50% (18/36) for the questionnaire and 30.5% (11/36) for the interview. Total questionnaire responses represent 96 outreach visits, 312.5 optometry clinic days, and 8,386 patient encounters across 64 communities in the three provinces. Optometrists coordinate with health center employees and school contacts to plan outreach visits, travelling primarily north to some of the most remote areas within each province. Overall Euclidean distances between participants primary clinic locations and communities visited ranged from 65 to 1405 kilometers (kms) (median: 438 kms). Costs per clinic day were highly variable ($174.44 -$3,800, mean: $765 per clinic day). Challenges reported were related to logistics, economic burden, and organizational challenges. Complementary enablers were identified, and recommendations are provided. Conclusions: This study is the first to provide visibility to the current state of outreach optometry care to Indigenous communities in British Columbia, Saskatchewan, and Manitoba. The process of planning outreach visits was variable for individual optometrists and between provinces. High variability in reported costs associated with outreach visits requires additional investigation. Multi-stakeholder collaboration to support optometry outreach programming would encourage outreach participation and improve services towards reducing eye and vision health inequity experienced by non-urban Indigenous populations. Acknowledgements: Project supported by Anonymous Philanthropic Foundation, Canadian Institute for Health Research Canadian Graduate Scholarship, and Canadian Optometric Education Trust Fund. No conflicts to declare

Current Status of Telemedicine Network in India and Future Perspective

India is a vast country with more than 1.15 billion population occupying an areaof 3 million sq km. It consists of 29 states and 6 Union Territories governed by a federalsystem. There is no national health insurance policy for the country. Government supportedhealthcare delivery follows a three tier system and is the primary responsibility of eachstate. It has been observed that there is a great deal of disparity in quality and access tohealthcare between urban and rural regions. This can be bridged through telemedicinetechnology if the tool is integrated into existing healthcare delivery system. Bothgovernment and private sector have been actively participating in tele-health programmes.India is starting to make strides in the fields of telemedicine and e-Health. The telemedicinemarket has witnessed spectacular growth during the last two years mainly because of timelyconvergence in the areas of Information technology, Communication &amp; Healthcare alongwith launching of central e-health schemes including telemedicine by the Ministry ofHealth &amp; Family Welfare

Telehealth in primary health care settings within Australia and internationally

Access to appropriate health care services is often limited for people living in rural or remote areas, or for those with restricted mobility. One approach to minimising the inequality in access for those located at a distance from health care services is through telehealth service delivery. This review examined the evidence on telehealth models in Australia and elsewhere, with a specific focus on synchronous, real-time video consultations, where patients and health care providers were present simultaneously

What do patients with diabetes and providers think of an innovative Australian model of remote diabetic retinopathy screening? A qualitative study

Background: Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Australia. The aim of this study was to explore the acceptability of this unique DR screening model to patients, health professionals and other key stakeholders. Methods: This descriptive qualitative study used semi-structured interviews with patients opportunistically recruited whilst attending DR screening, and purposefully selected health care professionals either working within or impacted by the programme. Interviews were audiotaped, transcribed and analysed using NVIVO. An iterative process of thematic analysis was used following the principles of grounded theory. Results: Interviews were conducted with fourteen patients with diabetes living in three remote communities and nine health professionals or key stakeholders. Nine key themes emerged during interviews with health professionals, key stakeholders and patients: i) improved patient access to DR screening; ii) efficiency, financial implications and sustainability; iii) quality and safety; iv) multi-disciplinary diabetes care; v) training and education; vi) operational elements of service delivery; vii) communication, information sharing and linkages; viii) coordination and integration of the service and ix) suggested improvements to service delivery. Conclusions: The Remote Outreach DR Screening Service is highly acceptable to patients and health professionals. Challenges have primarily been encountered in communication and coordination of the service and further development in these areas could improve the programme's impact and sustainability in remote communities. The service is applicable to other remote communities nationally and potentially internationally

Access to Indigenous and allopathic medicines: A systematic review of barriers and facilitators

Background: Globally, Indigenous peoples are the victims of social inequalities in health. Their state of health is much lower than the health of the general population. Colonialism, living conditions and access to care are the main determinants of observed health conditions. The scientific objective of this systematic literature review is to study the facilitators and barriers to access healthcare for both, traditional and allopathic medicines. Methods: An inclusive search of electronic databases (e.g ProQuest, Ovid, Medline, CINAHL PLUS, Cochrane Library, ApaPsyNet, PsyINFO and Sociological Abstracts databases) of the past 20 years was performed. We retained studies discussing (1) traditional medicine (TM) or allopathic medicine (AM) or both and occurring (2) within Indigenous population worldwide. We made no distinction between research carried out in rural as opposed to urban areas. Results: A total of 45 studies published between 1996 and 2016 met our inclusion criteria and this speaks to the high interest and contemporary pertinence of accessing both systems of healthcare for Indigenous populations worldwide. Our thematic analysis enabled us to group barriers and facilitators into five categories, namely related to personal, relational, cultural, structural and policy components. As far as barriers and facilitators are concerned, the category that encompasses the most themes is the structural category. Conclusions: Mutual respect, trust and understanding of each other’s modalities is essential to offer the best healthcare options from both AM and TM to Indigenous peoples and hence pave the way to reducing health inequities. Wellness and strength-based approaches must also be favoured