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A 2010 study identified higher than average incidence of respiratory disease in Shiprock, NM, the largest city in the Navajo Nation. That study suggested that the potential cause was the combustion of solid fuels in in-home heating stoves and that respiratory disease could be greatly reduced by changing indoor heating behaviors and improving heating stove quality. Since the Navajo people are deeply embedded in culture and traditions that strongly influence their daily lives, a new framework was needed to identify feasible heating alternatives that could reduce the negative environmental and health impacts related to solid fuel use while respecting the culture of the Navajo people. The resulting Navajo framework included perception, cultural, and technical assessments to evaluate seven heating alternatives perceived viable by Navajo stakeholders. Cultural experts at the Diné Policy Institute identified potential cultural limitations and motivating factors for each alternative. A limited technical assessment of the health benefits of these options was conducted and integrated into the process. A parallel convergent mixed-methods approach was employed to integrate qualitative and quantitative results. The results and framework developed and presented here may be useful for decision makers in communities heavily reliant on solid fuels for heat, especially Native Nations, where culture plays an important role in the success of any intervention.

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More than 6million Americans require daily injections of insulin. Insulin therapy, using the vial and syringe method, can be complicated and time consuming. Insulin pens were introduced in the United States in 1987 and have simplified insulin administration for many patients. Continuous Subcutaneous Insulin Infusion (insulin pumps or CSII) is being utilized to achieve and maintain tight glycemic control for personswith Diabetes Mellitus (DM). CSII therapy has existed since the 1960s. These insulin delivery devices provide improvements in flexibility, convenience, and freedom for patients-with diabetes. These devices may also help promote dosing accuracy and often improve compliance. CSII uses only rapid acting insulin, which has more reliable and predictable absorption. Gone are the days of sliding scales and feeding times to match the insulin delivery systems. This article focuses on insulin pen therapy and other alternative methods of delivering insulin including insulin pump therapy.

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