We acknowledge the traditional custodians of Country across theworld, and their continuing relationship to culture, community, land,waters and sky. We honour children born and yet to be, and pay ourrespects to Elders, past, present and future.
The authors declare that they have no conflict of interest with respect to their authorship or the publication of this article.C. Ethical Approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. D. Informed Consent: Informed consent was obtained from all individual participants included in each study described.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission causing coronavirus disease 2019 (COVID-19) may occur through multiple routes. We collected aerosol samples around six patients admitted into mixed acuity wards in April of 2020 to identify the risk of airborne SARS-CoV-2. Measurements were made to characterize the size distribution of aerosol particles, and size-fractionated, aerosol samples were collected to assess the presence of infectious virus in particles sizes of >4.1 μm, 1-4 μm, and <1 μm in the patient environment. Samples were analyzed by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR), cell culture, western blot, and transmission electron microscopy (TEM). SARS-CoV-2 RNA was detected in all six rooms in all particle size fractions (>4.1 μm, 1-4 μm, and <1 μm). Increases in viral RNA during cell culture of the virus from recovered aerosol samples demonstrated the presence of infectious, replicating virions in three <1 μm aerosol samples (P<0.05). Viral replication of aerosol was also observed in the 1-4 μm stage but did not reach statistical significance (0.05<P<0.10). Western blot and TEM analysis of these samples also showed evidence of viral proteins and intact virions. The infectious nature of aerosol collected in this study further suggests that airborne transmission of COVID-19 is possible, and that aerosol prevention measures are necessary to effectively stem the spread of SARS-CoV-2.
American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health.
I n the early months of the coronavirus disease (COVID-19) pandemic, meat processing facilities became among the largest epicenters of COVID-19 outbreaks in the United States (1). Declared a critical infrastructure industry in April 2020 (2), meat processing facilities are particularly vulnerable to COV-ID-19 because of the high density of workers required for operations, prolonged close contact of personnel on the production line, indoor work environments with compact cafeteria and locker room areas, and a workforce with diverse cultural and linguistic backgrounds that make educational efforts more challenging (3). A Centers for Disease Control and Prevention (CDC) report found that, as of May 31, 2020, >16,000 workers in meat and poultry processing facilities in the United States had been diagnosed with COVID-19 and 86 had died (4); as of October 2020, those case counts and deaths had more than tripled (5). Meat processing facilities in Nebraska employ ≈26,000 workers (6). The fi rst COVID-19 illness among meat processing facility workers in Nebraska was identifi ed March 9, 2020. As of July 2020, cases had been reported among workers in 23 Nebraska meat processing facilities. The University of Nebraska Medical Center (UNMC) and Nebraska Department of Health and Human Services partnered to mitigate COVID-19 risks in Nebraska among workers in this industry. Nebraska Department of Health and Human Services expanded case investigations and contact tracing teams and coordinated 2 mass testing events with participating meat processing facilities. UNMC created evidence-based guidelines for facilities (7) and assembled a team of infectious disease and infection prevention and control (IPC) experts to provide onsite and virtual technical assistance to facilities to evaluate gaps in IPC practices and provide facility-specifi c IPC recommendations. Local and state health departments conducted case investigations to collect information on demographics, employer, occupation, industry, illness descriptions, medical history, and outcomes among Nebraska meat processing workers. Moreover, although industry-specifi c guidelines for mitigating COVID-19 transmission in meat processing facilities have been issued by CDC and other public health
Background Aerosol transmission of COVID-19 is the subject of ongoing policy debate. Characterizing aerosol produced by people with COVID-19 is critical to understanding the role of aerosols in transmission. Objective We investigated the presence of virus in size-fractioned aerosols from six COVID-19 patients admitted into mixed acuity wards in April of 2020. Methods Size-fractionated aerosol samples and aerosol size distributions were collected from COVID-19 positive patients. Aerosol samples were analyzed for viral RNA, positive samples were cultured in Vero E6 cells. Serial RT-PCR of cells indicated samples where viral replication was likely occurring. Viral presence was also investigated by western blot and transmission electron microscopy (TEM). Results SARS-CoV-2 RNA was detected by rRT-PCR in all samples. Three samples confidently indicated the presence of viral replication, all of which were from collected sub-micron aerosol. Western blot indicated the presence of viral proteins in all but one of these samples, and intact virions were observed by TEM in one sample. Significance Observations of viral replication in the culture of submicron aerosol samples provides additional evidence that airborne transmission of COVID-19 is possible. These results support the use of efficient respiratory protection in both healthcare and by the public to limit transmission.
The conceptual framework of nursing in the Native American culture, with its seven dimensions, shares dimensions with mainstream nursing, yet it differs in many important ways. This model can be used by Native American nurses to provide a structure for engaging in the profession of nursing. Further, it can be used by nurses of other cultures to understand nursing in the Native American culture and to provide health care to Native American people.
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