A medevac involves the transport of a critically ill patient, usually by plane or helicopter, to access necessary and at times life-saving care, most often only accessible in urban centres. Medevacs are commonly used in resource-limited and geographically isolated areas in Canada.The objective of this study was to explore the determinants of medevac decision-making from the perspective of frontline care providers and decision-makers in Nunavut. For this purpose, we conducted a secondary analysis of 90 in-depth interviews.Findings indicate that medevacs can be the result of a number of intersecting factors, including the referring and receiving provider’s experience, insufficient staffing in health centres, lack of access to diagnostic or treatment-related, and challenges related to recruitment and retention. An expanded scope of practice for frontline care providers, and a related lack of training and/or confidence in skills, only add to these challenges.Medevacs play an important role related to managing shifting community nursing workloads, which expands and contracts in response to local needs. Attention to structural issues, putting in place virtual peer support systems, resolving vacancies left by the lag between attrition and recruitment, increasing access to training, and local diagnostic and treatment equipment, might decrease reliance of medevacs.
Increasing attention on the Arctic has led to an increase in research in this area. Health research in Arctic Indigenous communities is also increasing as part of this movement. A growing segment of the research community is focused on explaining and understanding Indigenous knowledge and ways of knowing. Researchers have become increasingly aware that Indigenous knowledge must be perceived, collected and shared in ways that are unique to, and shaped by, the communities and individuals from which this knowledge is gathered. This paper adds to this body of literature to provide Inuit perspectives on health-related research epistemologies and methodologies, with the intent that it may inform health researchers with an interest in Arctic health. The Inuit concepts of inuuqatigiittiarniq (“being respectful of all people”), unikkaaqatigiinniq (story-telling), pittiarniq (“being kind and good”), and iqqaumaqatigiinniq (“all things coming into one”) and piliriqatigiinniq (“working together for the common good”) are woven into a responsive community health research model grounded in Inuit ways of knowing which is shared and discussed.
The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal's rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not. In 2019, a total of 317 papers were published in the journal, with a median time to first decision of 22 days and a median time from submission to publication of 55 days. The editors would like to express their sincere gratitude to the following reviewers for their generous contribution in 2019:Abbas, Azhar
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