"With Every Step, We Grow Stronger": The Cardiometabolic Benefits of an Indigenous-Led and Community-Based Healthy Lifestyle Intervention.

Community-based and Indigenous-led health and wellness approaches have been widely advocated for Indigenous peoples. However, remarkably few Indigenous designed and led interventions exist within the field. The purpose of this study was to evaluate an Indigenous-led and community-based health and wellness intervention in a remote and rural Indigenous community. This protocol was designed by and for Indigenous peoples based on the aspirations of the community (established through sharing circles). A total of 15 participants completed a 13-week walking and healthy lifestyle counselling program (incorporating motivational interviewing) to enhance cardiometabolic health. Measures of moderate-to-vigorous physical activity (MVPA; 7-day accelerometry and self-report), predicted maximal aerobic power (VO2max; 6-min walk test), resting heart rate and blood pressure, and other health-related physical fitness measures (musculoskeletal fitness and body composition) were taken before and after the intervention. The intervention led to significant (p < 0.05) improvements in VO2max (7.1 ± 6.3 % change), with the greatest improvements observed among individuals with lower baseline VO2max (p < 0.05, r = -0.76). Resting heart rate, resting systolic blood pressure, and resting diastolic blood pressure decreased significantly (p < 0.05) after the intervention. Self-reported and accelerometry-measured frequency of MVPA increased significantly (p < 0.05), and the total MVPA minutes (~275 min/week) were above international recommendations. Change in VO2max was significantly correlated with change in self-reported (r = 0.42) and accelerometry-measured (r = 0.24) MVPA minutes. No significant changes were observed in weight, body mass index, waist circumference, body fat (via bioelectrical impedance), grip strength, and flexibility. These findings demonstrate that a culturally relevant and safe, community-based, Indigenous-led, health and wellness intervention can lead to significant and clinically relevant improvements in cardiometabolic health and physical activity behaviour, with the greatest changes being observed in the least active/fit individuals.

Using students' journals about death experiences as a pedagological tool.

The purpose of this article is to evaluate a pedagological tool for student's study of death and bereavement. Previous research suggests that students may be more willing to discuss issues associated with death through written correspondence rather than through oral communication. However, despite these efforts there are still students who experience great difficulty in expressing themselves fully in class by no fault of the teacher but merely due to the student's own disposition. Based on the data, it appears as if journal writing may offer a way around this difficulty. Data were collected from two sites: a private college in New England and a Midwestern state university. Common themes that students stated effected their experiences with death included reactions of significant others to the death in question, the funeral services provided, and the familial events postfuneral. The limitations and benefits of using journaling as a pedagological tool for a bereavement course are discussed. Using projects such as this one may help students to accurately display their learning to the professor while still bringing in their own perceptions of death.

Sheway's services for substance using pregnant and parenting women: evaluating the outcomes for infants.

Sheway is a single-access comprehensive street-front service to pregnant and parenting women with a history of alcohol and/or drug abuse that is located in one of Canada's poorest neighbourhoods, the Downtown Eastside of Vancouver. This investigation assesses the concurrent health and social problems clients report upon entry into the program, service utilization, and the impact of services on neonate and infant well-being. Data were collected through the review of files from the 9 1/2 years of the agency's service. Findings suggest that the clients' concurrent health and social problems have increased over the years of operation while indicators of infant health have either improved or maintained steady rates.