Trust,institutions, and indigenous self‐governance: An exploratory study

Trust is important to the institutions that make societies successful. Globally, Indigenous peoples are actively building institutions for self‐governance, but there remains little empirical work on trust in this context. To address this gap, we use a mixed methods approach to explore three levels of trust among individual members from three related, but politically distinct First Nations (Indigenous peoples) in British Columbia, Canada. British Columbia offers a unique and dynamic context to explore trust and its relationship with the diverse institutional choices among First Nations. Survey results show that trust is low among respondents and individual variables predictive of trust in mainstream contexts, like education and employment, are not determinative. However, interpersonal trust and political trust were highest in the First Nation most active in institution building, and who linked this with a cultural revitalization narrative. Interviews suggested a bidirectional relationship between individual and collective drivers of trust in this context.     

Stewardship and health systems strengthening: An overview

The World Health Organization (WHO) introduced the concept of stewardship to clarify the practical components of governance in the health sector. For the WHO, stewardship concentrated on how government actors take responsibility for the health system and the wellbeing of the population, fulfill health system functions, assure equity, and coordinate interaction with government and society. This article overviews the contents of this special issue, which offers examples of how health stewards in a variety of countries have addressed issues of health security, primary care expansion, family planning, and quality of care. The contributors' articles draw lessons for policy, programs, and management useful for practitioners and scholars. Our overview identifies several themes emerging from the articles: the foundational role of legal frameworks for effective stewardship, the importance of institutional arrangements as enablers, the influence of regional and global entities on national stewardship, the connection between credible decision‐making structures and stewardship, and pathways to sustainable financing and domestic resource mobilization. The discussion concludes with highlighting several gaps in knowledge and practice related to health stewardship.     

Cone‐beam Computed Tomography for Analyzing Variations in Inferior Alveolar Canal Location in Adults in Relation to Age and Sex*

Abstract: Previous studies have indicated that the relative position of the inferior alveolar canal and its mental and mandibular foramina in adults vary with age and show sexual dimorphism. Conceivably, these purported differences could be of forensic value for determining identity of human remains. This study was designed to determine the influence of age and sex on the relative position of inferior alveolar canal and its foramina in cone‐beam computed tomography (CBCT) studies of adults. Existing CBCT studies of the maxillofacial region from dentate adult patients selected at random and ranging in age from 18 to 80 years (110 women and 55 men) were acquired, and the location of the inferior alveolar canal was assessed at three points: the mandibular foramen in axial view, the inferior alveolar canal in coronal view, and the mental foramen in coronal view. Measurements were also expressed for the mental foramen as the percentile position from the nearest superior bony crest to the inferior border; corresponding position of the mandibular foramen from the anterior to the posterior border of the mandibular ramus; and for the inferior alveolar canal at the level of first permanent molar from the nearest buccal bony surface to the lingual surface and from the superior alveolar crest to the inferior border. Regression analyses were performed on the variables with regard to the effects of age and sex. Most analyses resulted in no statistical significance (p < 0.05). A few of the sex‐specific traits demonstrated near‐statistically significant effects; however, these characterizations generally resulted in a 1% or less change per age decade. Overall, the results demonstrated that the relative location of the inferior alveolar canal and associated foramina in adults remain fairly constant without regard to age and sex.