O besity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications and reduces lifespan. 1 Epidemiologic studies define obesity using the body mass index (BMI; weight/height 2), which can stratify obesity-related health risks at the population level. Obesity is operationally defined as a BMI exceeding 30 kg/m 2 and is subclassified into class 1 (30-34.9), class 2 (35-39.9) and class 3 (≥ 40). At the population level, health complications from excess body fat increase as BMI increases. 2 At the individual level, complications occur because of excess adiposity, location and distribution of adiposity and many other factors, including environmental, genetic, biologic and socioeconomic factors (Box 1). 11 Over the past 3 decades, the prevalence of obesity has steadily increased throughout the world, 12 and in Canada, it has increased threefold since 1985. 13 Importantly, severe obesity has increased more than fourfold and, in 2016, affected an estimated 1.9 million Canadian adults. 13 Obesity has become a major public health issue that increases health care costs 14,15 and negatively affects physical and psychological health. 16 People with obesity experience pervasive weight bias and stigma, which contributes (independent of weight or BMI) to increased morbidity and mortality. 17 Obesity is caused by the complex interplay of multiple genetic, metabolic, behavioural and environmental factors, with the latter thought to be the proximate cause of the substantial

ObjectiveCommunity engagement practices in Indigenous health research are promoted as a means of decolonising research, but there is no comprehensive synthesis of approaches in the literature. Our aim was to assemble and qualitatively synthesise a comprehensive list of actionable recommendations to enhance community engagement practices with Indigenous peoples in Canada, the USA, Australia and New Zealand.DesignIntegrative review of the literature in medical (Medline, Cumulative Index to Nursing and Allied Health Literature and Embase) and Google and WHO databases (search cut-off date 21 July 2020).Article selectionStudies that contained details regarding Indigenous community engagement frameworks, principles or practices in the field of health were included, with exclusion of non-English publications. Two reviewers independently screened the articles in duplicate and reviewed full-text articles.AnalysisRecommendations for community engagement approaches were extracted and thematically synthesised through content analysis.ResultsA total of 63 studies were included in the review, with 1345 individual recommendations extracted. These were synthesised into a list of 37 recommendations for community engagement approaches in Indigenous health research, categorised by stage of research. In addition, activities applicable to all phases of research were identified: partnership and trust building and active reflection.ConclusionsWe provide a comprehensive list of recommendations for Indigenous community engagement approaches in health research. A limitation of this review is that it may not address all aspects applicable to specific Indigenous community settings and contexts. We encourage anyone who does research with Indigenous communities to reflect on their practices, encouraging changes in research processes that are strengths based.

This article uses grounded theory methods to research the history of a therapeutic community and highlights the possibilities of ‘being able to learn’ as an aim for history of medicine research. For this case study, processes of research and learning allow consideration of the ‘dilemma of paternalism’ and the interaction between history, policy and practice. How can students enter into discourses about learning? How could this discourse help to make university systems of administration and assessment provide a more appropriate environment for staff and students to ‘be able to learn’?

Background:The aim of the study was to build understanding about the lived urban Indigenous experiences of early-onset dementia (EOD) to inform health services planning. Methods:A phenomenological qualitative pilot study completed with a total of five participants recruited and interviewed for 30 -60 min. Interviews were transcribed using NVivo12 software and thematically coded with a multi-step process.Results: Four overarching themes were identified: urban Indigenous understandings of living with EOD, Indigenous family experiences of adjusting to EOD, western approaches to healing and thriving with EOD, and Indigenous ways of healing and thriving with EOD. Conclusions:The findings of this project provide better understandings of urban Indigenous experiences of EOD and also dementia more broadly. Through a better understanding of the Indigenous experiences of dementia, urban healthcare providers can be more aware of the needs of urban Indigenous people living with dementia, and specifically EOD, and may face and plan to co-design health services accordingly.

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