Building intercultural health in Latin America. Advancing towards equity

Important efforts have been made in Latin America to advance equity in health and address the inequalities faced by indigenous peoples. There are several international and regional commitments including the 2030 Agenda for Sustainable Development and its objective of "leaving no one behind”. However, it has been important to strengthen the work with countries so that they recognize the need to adopt differentiated approaches that consider ethnic origin, not only from the perspective of the social determinants of health. Also, the value of culture, knowledge and traditions should be considered to advance the health situation of indigenous peoples. Inequalities due to ethnic origin have become even more visible with the arrival of the COVID-19 pandemic and its devastating consequences for many groups, including indigenous peoples. Through knowledge dialogues, or intercultural dialogues, it is possible to contribute to advances in achieving universal access to health and health coverage. PAHO is promoting efforts to implement this methodology in the field of health and generate intercultural minimums to advance towards equity. © 2022, UNIV CARLOSIII MADRID. All rights reserved.

Herders Mobility, Food Security and Covid-19 Pandemic Challenges during Lockdown in Nigeria

Climate change is one of the cores of the herders' movement in Nigeria. Some other variable is the classification of the Fulanis as indigenous peoples that have no specific abode of their own;they roam around looking for water and foliage for their animals. During the dry season, they move towards the southern part of Nigeria where they would find foliage and water for their animals because of their status under international law. A notion that in a bid to look for food for their animals, these herders sometimes feed their animals with grown corn, cassava, millet, sweet potato and even yam of the sedentary farmers. One of the geneses of food insecurity in many communities of the southern part of Nigeria. Food availability, affordability and accessibility in the country was compromised in 2020 due to these challenges by the urban dwellers which was compromised due to the activities of mobile herders. With general lockdown in Nigeria, many farmers were unable to go to farm while the Fulanis who were hardly affected by lockdown had their field-days in feeding their animals on crops planted by small scale farmers, the only source of food security in the country. The core of this paper is to interrogate Fulanis mobility as indigenous peoples based on relevant international law and its impact on small-scale farmers' sources of income and food availability for the teeming population of Nigeria. We contextualised this based on the COVID-19 pandemic that restricts the movement of people between March and December 2020. We conclude that the rights of the indigenous peoples at the domestic level need further interrogation to create an atmosphere of peaceful co-existence through aversion of herders-farmers clashes that envelope southern Nigeria.

Indigenous population in pandemic times: reflections about health in a decolonial perspective / População indígena em tempos de pandemia: reflexões sobre saúde a partir da perspectiva decolonial

Resumo A pandemia do novo coronavírus suscita discussões sobre saúde relacionadas à proteção da vida por meio de medidas preventivas e de contenção da covid-19, sob orientação da Organização Mundial da Saúde. No Brasil, o debate perpassa os marcadores de classe, raça, gênero e etnia, expondo as vulnerabilidades a que determinados povos são submetidos historicamente, para além da ação do vírus Sars-CoV-2. Este artigo apresenta uma pesquisa documental de cunho qualitativo, acerca dos sentidos produzidos sobre a saúde da população indígena diante da pandemia da covid-19, com enfoque nas notícias publicadas no site da Articulação dos Povos Indígenas do Brasil, entre março e setembro de 2020. As 65 notícias foram organizadas em três eixos: Ações do Governo e órgãos oficiais; Questão territorial; e Organização política e resistência indígena, e analisadas com base no referencial teórico dos estudos decoloniais. Os resultados apontaram para um aumento das violações de direito dos povos originários por parte da gestão atual do governo federal, através do acirramento das crises ambientais, da morosidade e ausência de políticas públicas emergenciais contra a covid-19, evidenciando, também, a resistência destes povos, por meio de uma luta ancestral que valoriza os saberes e práticas tradicionais no cuidado em saúde.

Abstract The pandemic of the new coronavirus enables discussions about health related to protecting life by adopting covid-19 prevention and contention measures, based on the World's Health Organization guidance. In Brazil, the debate involves issues of class, race, gender, and ethnicity, exposing vulnerabilities to which certain peoples are historically submitted beyond the action of the Sars-CoV-2 virus. This article presents qualitative documental research about the meanings produced regarding the health of indigenous peoples in face of the covid-19 pandemic focusing on news reports published in the site of the Articulação dos Povos Indígenas do Brasil between March and September of 2020. The 65 publications were organized in three categories: Actions from official departments and government; Territorial issue; and Political organization and indigenous resistance, and analyzed based in theories of decolonial studies. The results point to an increase of violations of the indigenous peoples' rights by the current executive office of the federal government, by aggravating environmental crisis, the morosity and absence of emergency public policies against covid-19, also evidencing the resistance of these peoples by an ancient struggle that values knowledge and traditional healthcare practices.

Militarization in the Special Indigenous Health District of Maranhao: from the "announced disaster" to the epicenter of the pandemic

This case study used a historiographical methodology to investigate the trajectory and performance of the Special Indigenous Health District of Maranhao, having as a parameter what the National Policy for Health Care for Indigenous Peoples, still officially in force in 2021, recommended. It has the general context of health policies in successive federal governments as background. The period analyzed and discussed ranges from 2010 to 2021, covering: the crisis in the management of the National Health Care Policy for Indigenous Peoples, implemented by the National Health Foundation;the subsequent creation of the Special Secretariat for Indigenous Health and the transfer, to its scope, of the role of manager of this policy, in 2010;the challenges faced by the Special Secretariat for Indigenous Health in its first years of management, in the context of the political crises that led to the impeachment of President Dilma Rousseff and the administration of Michel Temer;the administration of Jair Messias Bolsonaro, with the consequent systematic attack on principles and guidelines inscribed in the 1988 Brazilian Constitution and the dismantling and/or sabotage of the National Health Care Policy for Indigenous Peoples;the advent of the covid-19 pandemic in this context and its specific impacts on the indigenous population, in Brazil and Maranhao, until 2021.

The Ecological Disaster of the COVID-19 Pandemic: the Care for our Common Home from the Perspective of the UN and Indigenous Peoples

This paper aims to reflect on indigenous peoples' knowledge of nature and the way it may contribute to sustainability in the context of the ecological disaster of the COVID-19 pandemic. This study is justified given the current situation in which humanity finds itself, as the UN's assessment regarding the need to take care of nature, our "common home”, and the ancestral knowledge of indigenous peoples stands out. It is realized that the values preserved by the native peoples of the Americas, by contributing to the sustainability of the planet, could also help to improve the living conditions of present and future generations. © 2023 Universidad Nacional Autonoma de Mexico. All rights reserved.

Indian Act Philanthropy: Why are Community Foundations Missing from Native Communities in Manitoba, Canada?: Revue Canadienne de Recherche sur les OSBL et l'Économie Sociale (ANSERJ)

Un modèle philanthropique axé sur le développement communautaire serait-il en train de renforcer les politiques coloniales plutôt que d'offrir des bénéfices économiques équitables? Cette étude analyse les transcriptions de vingt webinaires publics sur la philanthropie et la Loi sur les Indiens et évalue les 54 fondations communautaires établis au Manitoba, Canada. Ces 54 fondations servent seulement les villes et municipalités des colons-il n'y en a pas une seule dans les communautés autochtones. Comme elles ne desservent que leurs régions géographiques spécifiques, les fondations communautaires au Manitoba concentrent la richesse dans les villes et municipalités dominées par les colons, accaparant des ressources qui pourraient aider les communautés autochtones. Ce modèle philanthropique, en excluant les communautés les plus pauvres du Manitoba, renforce la marginalisation, la pauvreté et les risques de santé dans les communautés autochtones.Alternate :Could a philanthropic model aimed at community development enforce colonial policy rather than providing equitable economic opportunity? This research analyzes the transcripts of 20 public webinars on philanthropy and the Indian Act and maps the 54 community foundations in Manitoba, Canada. All 54 community foundations in Manitoba service only settler-dominated cities and municipalities, with none on Native communities. As community foundations serve only their specific geographical areas, the community foundations in Manitoba effectively concentrate wealth in settler-dominated cities and municipalities, taking away needed resources from Native communities. In excluding the poorest communities in Manitoba, this philanthropic model further entrenches marginalization, poverty, and health risks for Native people on Native communities.

Assessing the Impact of COVID-19 on Indigenous Peoples in Latin America: Towards Effective Post-Pandemic Policies

[...]a broad and inclusive approach to post-pandemic policy-making—one that considers Indigenous forms of knowledge whilst fostering appreciation for their cultures and lives—is needed to adequately assist Indigenous peoples in repairing the harm they have suffered as a result of COVID-19.3 COVID-19 and its deadly impact on Indigenous communities There are no less than eight hundred distinct Indigenous communities across Latin America, each with its own unique identity, culture, and [End Page 169] history. In Bolivia, for example, where Indigenous groups comprise a significant portion of the electorate (between 41 and 62 percent of the population), Latin America's first Indigenous political executive was elected in 2006.4 In most instances, however, Indigenous peoples make up only a small proportion of Latin American country populations (generally ranging from 0.5–15 percent), one factor ensuring limited political influence and the widespread marginalization of their interests.5 As a consequence, Indigenous peoples across the region entered the pandemic whilst already suffering from a range of serious economic and socio-cultural inequalities.6 Inadequate access to medical care, chronic poverty and economic marginalization, racism and prejudice, and inadequate access to education are common issues that exacerbated the impact of the pandemic.7 The World Health Organization confirmed the arrival of the pandemic in the region on February 26, 2020. [...]Indigenous mortality rates were 4.03 percent in Brazil and 19.9 percent in Mexico—significantly higher than 2.2 percent and 5.7 percent overall mortality rates in each country respectively.9 Unfortunately, the lack of regional data on, and deliberate under-reporting of, Indigenous mortality rates across much of Latin America has problematized many of the available datasets.10 In Brazil, for example, organizations such as The Articulation of Indigenous Peoples (APIB), have shown that the total number of recognized Indigenous deaths (902 persons as of April 7, 2022), undercounts the actual figure by at least 31 percent.11 Other sources, such as the Special Secretariat for Indigenous Health (SESAI), which is responsible for Indigenous medical care, also provides incomplete data on Brazilian Indigenous mortality by failing to count Indigenous urban dwellers or those who live outside of recognized government-controlled territories in their data sets.12 Such groups are among some of the most vulnerable Indigenous communities in the country, receiving little, if any, support from government agencies charged with supporting Indigenous communities.13 As a result, the scale and scope of COVID-19's impact on Indigenous Brazilians is, and for the foreseeable future will likely remain, unknowable.14 Despite a lack of adequate data across much of Latin America, a growing body of evidence indicates that Indigenous peoples were particularly vulnerable to COVID-19, and that they likely died or suffered long-term health issues in disproportionate numbers.15 In a study of Indigenous peoples in Chile, for instance, regions with larger Indigenous populations recorded a noticeable increase in overall mortality.16 Where direct data do not exist, emerging studies suggest that the medical impact of COVID-19 was likely compounded by a range of structural inequalities and environmental factors.17 Many Indigenous peoples lack access to adequate medical care. [...]disproportionate exposure to pesticides—used extensively in agricultural industries in which many Indigenous people find employment, as well as exposure to smoke inhalation—caused by out-of-control forest fires across Latin America—likely exacerbated the repertory symptoms caused by COVID-19.18 As a consequence, Indigenous peoples had to face COVID-19 not only with fewer resources, but with greater exposure to the types of pre-existing conditions known to aggravate the impact of the disease.19 Particularly high mortality rates among Indigenous elders, who act as stores of traditional knowledge, affected cultural continuity and community cohesion.20 To better understand this we spoke with a representative of the Indigenous Kaingang people, Duko Vãgfy, who explained that "[t]he worst losses [we suffered] were the elders, because they held so much knowledge about [our] people.

Education Remains Critical with Unemployment, Employment, and Participation Rates in 2020 Being the Worst in Many Years for Aboriginals and Non-Aboriginals

The higher the level of education completed the higher the wage rates, the lower the rate of unemployment, and the higher the employment rates. Unemployment rates were significantly higher and participation and employment rates were significantly lower for Aboriginals and non-Aboriginals in Canada in 2020. This may be attributed to the impact of the Coronavirus pandemic. The rate of unemployment increased more for nonAboriginals than for Aboriginals in 2020. However, participation and employment rates decreased more for Aboriginals than for non-Aboriginals. Employment, unemployment, and participation rates are and historically have been more favourable for non-Aboriginals than for Aboriginals. As educational levels increase, employment measures and wage rates improve. Employment measures are examined by gender, age, province, and education, and for Métis, Inuit, and First Nations.

Editors' Note

Returning to the world prior to March 2020, though, is perhaps more of a return to a status quo in which those occupying positions of privilege and power—particularly in the Global North—shift focus back to the conventional news cycle. Aside from early reporting on COVID-19, former President Donald Trump's first impeachment trial and reactions to the United States' assassination mission of Qasem Soleimani dominated headlines in early 2020. [...]we cannot return to holding that level of unconcern for similar violence in the United States towards historically marginalized communities like Black and Indigenous People of Color.

Lives More Recognizable Than Individual: Indigenous Communities in the Face of Pandemics

In light of these actions, the pandemic could be perceived as having bolstered the autonomy and jurisdiction of Indigenous governments relative to local municipalities, provinces, and the federal government. [...]these assertions should not be mistaken as a signal that the structures of Indigenous political subordination relative to state power have been, or stand to be, transformed in any significant way. With all eyes attuned to the need for "economic recovery," Indigenous people have predictably been invited to play a role in mainstream postpandemic economic recovery strategies. Any semblance of intergovernmental cooperation between Indigenous and Canadian governments, then, has once again been tethered to Indigenous participation in capitalist economies, which presumes an association between economic development and the transformation of Indigenous political subordination and excludes Indigenous people whose interests do not align with these ideals.

Bringing together podcasting, social work field education and learning about practice with Aboriginal peoples and communities

Social work content podcasting has increased exponentially in recent years, playing a new role in the emerging social work education debate surrounding online and remote delivery of social work content. Although podcasting itself is not now a new digital innovation, how and why social work educators and academics would embrace the use of podcasting is still debated and is often positioned as inferior to face-to-face classroom teaching. In the Australian context this is particularly important when non-Aboriginal students are engaging with Aboriginal understandings of place and ways of relating to Country, a challenging reflexive exercise without the added complexity that remote educational delivery can provide. The brief history of podcasting and its relationship to social work education provides a context for re-imagining the pedagogy of critical thinking, with a case example provided of a remote field placement with The Social Work Stories Podcast during the Covid-19 pandemic in 2020.

Tourism Recovery and Sustainability Post Pandemic: An Integrated Approach for Kenya's Tourism Hotspots

The COVID-19 pandemic has had a significant impact on the tourism industry, leading to global economic and societal disruptions, and a growing risk of a global recession. This project aimed to investigate the impact of the pandemic on conservation, communities, and businesses in Masai Mara, and identify critical factors for sustainable tourism recovery. Four objectives were explored: (1) awareness of critical factors for tourism recovery and sustainability during and after the pandemic period;(2) socio-economic vulnerabilities of indigenous communities to COVID-19;(3) lessons learned to enhance adaptation and resilience;and (4) the impact of COVID-19 on conservation management of the destination. We used mixed methods, including field observations, key informant interviews, and focus group discussions, to collect data from tourism industry businesses and policymakers in the Masai Mara conservation area. The findings indicated a negative large-scale effect on conservation, tourism business, and communities in the area. The study recommends integrated interventions by both county and national governments, targeting small, medium, and micro enterprises. The persistence of the economic damage to the tourism sector will depend on how both county and national governments handle policy interventions towards the funding of tourism SMMEs, the community livelihood programme, and conservation partnerships to incentivize tourism recovery.

Housing as a determinant of Inuit mental health: associations between improved housing measures and decline in psychological distress after rehousing in Nunavut and Nunavik.

INTERVENTION: In 2014-2015, more than 400 public housing units were constructed in Nunavut and Nunavik, two of the four Inuit regions in Canada. This provided the opportunity to assess the impact of improved housing conditions from a population health perspective in 12 Inuit communities where housing needs were the most severe. The aim of the research is to examine the associations between changes in housing conditions and changes in psychological distress pre-post rehousing. METHODS: A pre-post uncontrolled study was conducted in collaboration with Nunavut- and Nunavik-based organizations. Applicants at the top of public housing waitlists were recruited by local housing officers; participants completed questionnaires 1-6 months before rehousing, and 15-18 months after. Change in psychological distress was measured with the Kessler 6-item scale. Changes in three housing measures were examined: number of adults per household, number of children per household, and sense of home score. For each housing measure, a categorical variable stratified participants into three categories. The reference category included participants reporting significant change in the concerned housing measure; the two other categories included participants reporting little or no change. Associations were tested with linear multilevel regression models for change. RESULTS: A total of 102 Inuit adults completed the study. A reduction in the number of adults per household (living with 2 adults or less after rehousing) and an increase in sense of home were associated with significant decline in psychological distress pre-post rehousing (p < 0.001). CONCLUSION: Increased investments leading to such improvements in housing circumstances are promising ways to promote mental health in Inuit regions.

RéSUMé: INTERVENTION: En 2014-2015, plus de 400 logements sociaux ont été construits au Nunavut et au Nunavik, deux des quatre régions inuites du Canada, permettant ainsi d'évaluer l'impact de l'amélioration des conditions de logement sur la santé. Cette étude vise à examiner les associations entre les changements dans les conditions de logement et les changements dans la détresse psychologique avant et après le déménagement, dans 12 communautés inuites où les besoins en logement étaient les plus criants. MéTHODES: Une étude pré-post non contrôlée a été menée en collaboration avec des organisations du Nunavut et du Nunavik. Les participants figurant en tête des listes d'attente pour le logement social ont rempli les questionnaires de recherche 1-6 mois avant le déménagement et 15-18 mois après. Les changements de la détresse psychologique ont été mesurés à l'aide de l'échelle Kessler 6-item. Les changements des trois conditions de logement suivantes ont été examinés : le nombre d'adultes par ménage, le nombre d'enfants par ménage et le sentiment d'avoir un chez-soi. Pour chaque condition de logement, une variable catégorielle a été créée pour stratifier les participants ayant rapporté des changements (référence) et les participants n'ayant rapporté que peu ou pas de changement. Les associations ont été testées avec des modèles de régression linéaire multiniveaux. RéSULTATS: Un total de 102 adultes Inuit ont complété l'étude. Une réduction du nombre d'adultes par ménage (vivre avec 2 adultes ou moins après le déménagement) et une augmentation du sentiment d'avoir un chez-soi étaient associées à une baisse significative de la détresse psychologique (p < 0,001). CONCLUSION: Des investissements accrus menant à de telles améliorations des conditions de logement représentent une avenue prometteuse pour promouvoir la santé mentale dans les régions inuites.

"We are Tired but Do Not Give Up" the Dilemma and Challenges of Primary Nurses Facing the Omicron Variant: Qualitative Research.

Background: Everyone becomes aware due to the epidemic, especially primary department nurses. The significance of their experiences teaches nurses how to take care of themselves and be successful in their caregiving. Objective: The purpose of this study was to investigate the perceptions of nurses working in primary care settings in rural regions during the omicron variant pandemic. Methods: On the basis of the Nvivo 12 analytic approach, extensive semi-structured interviews were used to perform this qualitative study. 20 interviews later, data saturation had been reached. Data collecting was place from February to March 2022 for a month. The following participant characteristics were discovered through semi-structured interviews with 20 nurse participants. Ages of the participants, who were split between eight men and twelve women, varied from 28 to 43 years (average age 36.4 years). The majority (75% of them) had a vocational education, and their years of experience ranged from five to fifteen (average 11 years). Results: 4 topics and 7 sub-themes' results. The results' fundamental message is: The Nursing Clinical Practice Dilemma, school district, virus type uncertainty Indigenous peoples do not adhere to the concept of the afterlife. Must Be Excited and Alert; School Cluster; Virus Type Confusion; Non-Belief in Covid; and the Dilemma of Nursing in Clinical Practice are the Overarching Themes of This Study. Conclusion: Making innovations to increase motivation thereby reducing mental and physical fatigue are the implications of the results of this study. Further exploration of the readiness of nurses to treat patients in the main department is believed to be beneficial for the results of this study.

Inequalities and pandemic in Paraguayan indigenous communities

This article discusses the measures introduced by Paraguay to respond to the health crisis between March and December 2020 and problematizes its impact on indigenous communities. Starting from a historicization of the origins of inequalities, it demonstrates that the marginalization that Paraguayan indigenous communities are currently experiencing is the result of a historical and institutional continuity that is rooted in a logic of dispossession of indigenous people and their territory. We argue that the interaction between previous structural conditions and the political choices emanating from the struggle against Covid-19 has not allowed for an institutional change in these relationships. Indeed, in Paraguay, the unprecedented health crisis and governmental responses accelerated the pre-existing trajectories affecting indigenous communities, resulting in institutional continuity in the formulation of public policies. © 2022 Institut des Hautes Etudes de l'Amerique Latine (IHEAL). All rights reserved.

Time for New Epistemological Inquiries, the Global South, and Resilience in the Time of COVID-19

In this chapter, I discuss social organization, the resistance strategies that have been constructed, and the worldviews of ordinary peoples, all of which have contributed to the Global South's development of a strength, in the middle of the COVID-19 crisis, that has been unknown in the Global North. This development allows the Global South to build narratives and views of resistance, survival, and visions for the future. This resistance force exists despite the fact that the implications and consequences of COVID-19, and its impact on health systems and economies will be harsher there, and negative prospects will be worse than in the Global North. These conditions of resistance contribute to produce a stronger resilience than what can be found in the Global North, as well as an intellectual production that is more focused on alternative views for prospects for the future. The fast production of texts, the continuous organization of events, and the online debates focused on what a post-COVID-19 future should be like, are proof of that. The Global South has been producing ideas and thoughts on causalities whereas the Global North has been discussing immediate effects. Now, the planet's future depends on taking into account views from the Global South-which have, so far, been silenced by the Global North. These views-based on disruptive experiences and lessons from contexts different from those that are usually universalized-make proactive contributions. In the Global South, a view of the future is being constructed that surpasses the dystopia-continuity dichotomy mainly built in the Global North during the COVID-19 crisis. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Actualization and Adoption of Renewable Energy Usage in Remote Communities in Canada by 2050: A Review

Remote community initiatives for renewable energy are rapidly emerging across Canada but with varying numbers, success rates, and strategies. To meet low-carbon transition goals, the need to coordinate technology deployment and long-term policy to guide the adoption is critical. Renewable resources such as wind, solar, hydro, and biomass can provide energy at a subsidized cost, create sustainable infrastructure, and provide new economic viability in social value integration. The renewable energy transition is crucial to Canada in sustaining remote and indigenous communities by providing local, clean, and low-carbon-emission energy for heat, power, and possibly transportation. This paper identified 635 renewable resources projects deployed to improve and increase electricity supply. To an extent, balancing demand within the remote and indigenous communities of Canada and highlighting sustainable renewable energy development through ownership participation within the communities is achievable before 2050 and beyond through energy efficiency and the social value of energy. The article identifies clean energy targets as mandated by the different provinces in Canada to reach net-zero GHG emissions.

COVID-19 exposes weaknesses in public health in the Peruvian Amazon and highlights opportunities for a one health approach

The Amazon is home to important wildlife and a biodiversity hotspot of global importance. The ancestral knowledge kept by Indigenous communities about its fauna and flora contributes further to its irreplaceable value. The Peruvian Amazon was heavily struck by the COVID-19 epidemic with a cumulative incidence of 725, a mortality rate of 34 per 100,000 inhabitants, and a case fatality rate of 4.6% by the end of July 2020. In this work, we review scientific literature and media to trace the events that happened at the beginning of the COVID-19 epidemic in the Peruvian Amazon. Results are synthesized in three observations: (1) the evolution of the COVID-19 epidemic within the Peruvian Amazon and the response of the Peruvian health care system, (2) Confusing information about Ivermectin use for COVID-19 treatment and prevalent self-medication (3) The response of the traditional Indigenous health care system to the COVID-19 epidemic. These three observations are interdependent. There is an unexploited potential for integrative approaches linking traditional medical practices (TMP) and biomedical approaches and they may benefit from the interactions that occur between them. Synergies can also be explored between the human and animal health care sector, especially in terms of the use and stewardship of medicines. We conclude that there is a benefit of the One Health approach in the region, which can go through the common ambition to improve the integrated health of people, animals and ecosystems, facilitate the enhancement of equity and inclusion while improving access to health services and conserving biodiversity.

Indigenous and immigrant voices for healing and wellness in graduate education

The importance of healing and wellness is a local, global, and historical concern, especially for Indigenous Peoples on Turtle Island/North America and across the world. Since the COVID-19 pandemic commenced in March 2020, the issues of sustainability and wellbeing have been shared intensely in virtual graduate classrooms by Indigenous and non-Indigenous Peoples. The space in which Indigenous Peoples and Settlers on Turtle Island/North America express intents for their education is uncomfortable. Decolonizing efforts to address systemic discrimination in graduate education require truths to be told and heard before there can be reconciliation for past and current injustices against Indigenous Peoples. Systemic discrimination is an impediment to Indigenous and Settler graduate students and faculty healing, wellness, and academic success as they pursue teaching, learning, and self-sustainability. Reading the literature on Indigenous and Settler voices in graduate education and discussing the emerging insights and reflections, this chapter identifies the challenges and the possibilities for graduate student and faculty healing and wellness. This spontaneous and honest atmosphere allowed to access the self of each other despite the diverse sociocultural backgrounds and experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Effectiveness of COVID-19 mRNA Vaccines in Preventing COVID-19-Associated Outpatient Visits and Hospitalizations Among American Indian and Alaska Native Persons, January-November 2021: A Test-Negative Case-Control Analysis Using Surveillance Data.

Background: Despite the disproportionate morbidity and mortality experienced by American Indian and Alaska Native (AI/AN) persons during the coronavirus disease 2019 (COVID-19) pandemic, few studies have reported vaccine effectiveness (VE) estimates among these communities. Methods: We conducted a test-negative case-control analysis among AI/AN persons aged ≥12 years presenting for care from January 1, 2021, through November 30, 2021, to evaluate the effectiveness of mRNA COVID-19 vaccines against COVID-19-associated outpatient visits and hospitalizations. Cases and controls were patients with ≥1 symptom consistent with COVID-19-like illness; cases were defined as those test-positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and controls were defined as those test-negative for SARS-CoV-2. We used unconditional multivariable logistic regression to estimate VE, defined as 1 minus the adjusted odds ratio for vaccination among cases vs controls. Results: The analysis included 207 cases and 267 test-negative controls. Forty-four percent of cases and 78% of controls received 2 doses of either BNT162b2 or mRNA-1273 vaccine. VE point estimates for 2 doses of mRNA vaccine were higher for hospitalized participants (94.6%; 95% CI, 88.0-97.6) than outpatient participants (86.5%; 95% CI, 63.0-95.0), but confidence intervals overlapped. Conclusions: Among AI/AN persons, mRNA COVID-19 vaccines were highly effective in preventing COVID-associated outpatient visits and hospitalizations. Maintaining high vaccine coverage, including booster doses, will reduce the burden of disease in this population.