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Indigenous research on Turtle Island has existed for millennia, where knowledge(s) to work with the land and its inhabitants are available for next generations. These knowledge systems exist today but are rarely viewed as valid biomedical ‘facts’ and so are silenced. When Indigenous knowledge is solicited within health research, the knowledge system is predominantly an ‘add-on’ or is assimilated into Western understandings. We discuss disrupting this colonial state for nurse researchers. Two concepts rooted in Indigenous teachings and knowledges, Etuaptmumk (Two-Eyed Seeing) and Ethical Space, shed light on ways to disrupt health researchers’ attraction to a singular worldview which continue to privilege Western perspectives. Knowledge rooted in diverse knowledge systems is required to challenge colonial relations in health research and practice. A synergy between Etuaptmumk and Ethical Space can support working with both Indigenous and biomedical knowledge systems in health research and enhance reconciliation.
T he shifting landscape of Canadian cardiovascular health over the last couple of decades presents 2 notable trends. First, the incidence of coronary artery disease and related mortality among the general population continue to decrease, 1 which is attributed to improvements in lifestyle factors, diagnostic procedures and treatments. [2][3][4][5] Second, before the 1980s, rates of coronary
ObjectivesTo investigate recipient characteristics and rates of index angiography among First Nations (FN) and non-FN populations in Manitoba, Canada.SettingPopulation-based, secondary analysis of provincial administrative health data.ParticipantsAll adults 18 years or older who received an index angiogram between 2000/2001 and 2008/2009.Primary and secondary outcome measures(1) Descriptive statistics for age, sex, income quintile by rural and urban residency and Charlson Comorbidity Index for FN and non-FN recipients. (2) Annual index angiogram rates for FN and non-FN populations and among those rates of ‘urgent’ angiograms based on acute myocardial infarction (AMI)-related hospitalisations during the previous 7 days. (3) Proportions of people who did not receive an angiogram in the 20 years preceding an ischaemic heart disease (IHD) diagnosis or a cardiovascular death; stratified by age (<65 or ≥65 years old).ResultsFN recipients were younger (56.3vs63.8 years; p<0.0001) and had higher Charlson Comorbidity scores (1.32vs0.78; p<0.001). During all years examined, index angiography rates were lower among FN people (2.67vs3.33 per 1000 population per year; p<0.001) with no notable temporal trends. Among the index angiogram recipients, a higher proportion was associated with an AMI-related hospitalisation in the FN group (28.8%vs25.0%; p<0.01) and in both groups rates significantly increased over time. FN people who died from cardiovascular disease or were older (65+years old) diagnosed with IHD were more likely to have received an angiogram in the preceding 20–30 years (17.8%vs12.5%; p<0.01 and 50.9%vs49.5%; p<0.03, respectively). FN people diagnosed with IHD who were under the age of 65 were less likely to have received an angiogram (47.8%vs53.1%; p<0.01)ConclusionsIndex angiogram use differences are suggested between FN and non-FN populations, which may contribute to reported IHD disparities. Investigating factors driving these rates will determine any association between ethnicity and angiography services.
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