Nursing care for the Warao people: an experience report based on transcultural theory

OBJECTIVE

To report on the experience of nurses from the Street Clinic in caring for the Indigenous Venezuelan population of the Warao ethnic group in Maceió/AL based on Madeleine Leininger's Transcultural Theory.

METODOLOGY

A descriptive study, of the experience report type, based on the care of the Warao Indigenous population in the light of Madeleine Leininger's Transcultural Theory, carried out during the year 2022.

RESULTS

Light technologies were used to form bonds and understand the cultural universe of the Warao people. The concepts of preservation, accommodation and cultural restructuring of care from Leininger's transcultural theory helped to elucidate the practice. Comprehensive care was offered in accordance with the programs recommended by the Ministry of Health, with transcultural care, including respect for refusal of care. The language barrier and health beliefs represented challenges in the context of singular care.

FINAL CONSIDERATIONS

The experience of nurses from the Street Clinic in caring for the Indigenous population favored significant social interaction and expanded the possibilities for achieving comprehensive health care. The application of Transcultural Theory proved to be an effective and congruent device for health care.

Determinación social de la obesidad, la diabetes y la hipertensión arterial desde las narrativas de mujeres de una comunidad indígena en el sur de Morelos, México

OBJETIVO

comprender los procesos críticos (PC) de determinación social de la obesidad, la diabetes y la hipertensión (ODH) en una comunidad nahua de México.

METODOLOGÍA

estudio cualitativo de registros de un taller de fotovoz, donde las participantes fotografiaron su entorno y analizaron las causas y posibles soluciones a la ODH. Para analizar los PC de la ODH utilizamos como método la investigación narrativa y, como referente teórico, la epidemiología crítica.

RESULTADOS

la ODH se reproduce social e históricamente a través de PC destructivos vinculados con las relaciones de producción global y de género. Estas determinan modos de vida deteriorantes que limitan la atención a la salud, comprometen la salud mental, producen contaminación y diferenciación de uso de espacios, y reducen oportunidades para alimentarse nutritivamente y realizar actividad física. Todo ello se expresa como ODH y problemas de salud mental. Los PC protectores ante estas expresiones incluyen la atención estatal, las oportunidades de trabajo, y la promoción de dispositivos culturales y comunitarios.

CONCLUSIONES

nuestros resultados aportan a la discusión global sobre cómo las condiciones históricas de vida son parte de la determinación social de la ODH. Comprender los PC y sus expresiones locales puede orientarnos hacia la descolonización de la forma de pensar y hacer promoción de la salud.

Sociodemographic inequalities in cardiovascular risk factors among adolescents from indigenous areas in Chiapas, Mexico

This study was aimed to determine the prevalence of cardiovascular risk factors among different sociodemographic groups of adolescents from indigenous communities in Chiapas, Mexico. A cross-sectional prevalence study was performed in urban and rural communities in the Tzotzil-Tzeltal and Selva regions of Chiapas. A sample of 253 adolescents was studied, of whom 48% were girls and 52% were boys. A descriptive analysis of quantitative variables was performed using measures of central tendency and dispersion. The prevalence of cardiovascular risk factors stratified by sex, geographical area, years of schooling, and ethnicity of the mothers was estimated. The prevalence of cardiovascular risk factors was analyzed in relation to the sociodemographic characteristics of the study population. Low HDL-c (51%) was the predominant cardiovascular risk factor. Girls had a higher prevalence of abdominal obesity, hypertriglyceridemia, and borderline total cholesterol than boys. High diastolic blood pressure was more prevalent in boys. Adolescents from urban areas had a higher prevalence of overweight/obesity and insulin resistance than adolescents from rural areas. The prevalence of overweight/obesity and abdominal obesity was higher in adolescents whose mothers had ≥ 7 years of schooling compared with adolescents with less educated mothers. Differences by maternal ethnicity also influenced the prevalence of insulin resistance. Among the main findings, this study associated sociodemographic and geographical inequalities with cardiovascular risk factors. Promoting a healthy lifestyle for this young population is absolutely necessary to prevent cardiovascular diseases in adulthood.

Rates of tree cover loss in Key Biodiversity Areas on Indigenous Peoples' lands

Indigenous Peoples' lands (IPL) cover at least 38 million km2 (28.1%) of Earth's terrestrial surface. These lands can be important for biodiversity conservation. Around 20.7% of IPL intersect areas protected by government (PAs). Many sites of importance for biodiversity within IPL could make a substantial but hitherto unquantified contribution to global site-based conservation targets. Key Biodiversity Areas (KBAs) represent the largest global network of systematically identified sites of high importance for biodiversity. We assessed the effectiveness of IPL in slowing biodiversity loss inside and outside PAs by quantifying tree cover loss from 2000 to 2019 in KBAs at international and national levels and comparing it with losses at equivalent sites outside mapped IPL. Based on a matched sample of 1-km2 cells in KBAs inside and outside mapped IPL, tree cover loss in KBAs outside PAs was lower inside IPL than outside IPL. By contrast, tree cover loss in KBAs inside PAs was lower outside IPL than inside IPL (although the difference was far smaller). National rates of tree cover loss in KBAs varied greatly in relation to their IPL and PA status. In one half of the 44 countries we examined individually, there was no significant difference in the rate of tree cover loss in KBAs inside and outside mapped IPL. The reasons for this intercountry variation could illuminate the importance of IPL in meeting the Convention on Biological Diversity's ambition of conserving 30% of land by 2030. Critical to this will be coordinated action by governments to strengthen and enforce Indigenous Peoples' rights, secure their collective systems of tenure and governance, and recognize their aspirations for their lands and futures.

Indigenous guardians as an emerging approach to indigenous environmental governance

Over the past 3 decades, indigenous guardian programs (also known as indigenous rangers or watchmen) have emerged as an institution for indigenous governments to engage in collaborative environmental governance. Using a systematic review of peer-reviewed literature for research conducted in Australia, Canada, Aotearoa-New Zealand, and the United States, we sought to characterize the emergence of indigenous guardians in the literature and explore whether guardian approaches are representative of Indigenous approaches to environmental governance. Using a multistep relevance-screening method, we reviewed 83 articles published since 1995, that report on, critique, or comment on Indigenous guardians. Our findings indicated that most articles on the topic were published in the last decade (88%), focused on Australia (65%), and were in a social science discipline (53%). The lead author of the majority of articles was an academic, although only half of the articles included an indigenous scholar or member of an indigenous group or organization as a coauthor. Finally, 11 articles were on research of guardian programs that were locally led and only 5 exemplified indigenous governance, based on 2 well-known community-based monitoring typologies. Our findings indicate that more research is required to understand the implications of current guardian programs for indigenous self-determination, particularly when such programs are embedded in a broader western environmental governance structure.

The Family Resilience Inventory: A Culturally Grounded Measure of Current and Family-of-Origin Protective Processes in Native American Families

The purpose of this article is to introduce the Family Resilience Inventory (FRI) and present findings on initial efforts to validate this measure. The FRI is designed to assess family resilience in one's current family and in one's family of origin, enabling the assessment of family protective factors across these generations. The development of the FRI was the result of many years of ethnographic research with Southeastern Native American tribes; yet, we believe that this scale is applicable to families of various backgrounds. Items for the FRI were derived directly from thematic analysis of qualitative data with 436 participants, resulting in two 20-item scales. Due to missing data, eight cases were removed from the 127 participants across two tribes, resulting in an analytic sample size of 119. Conceptually, the FRI is comprised of two factors or scales measuring distinct dimensions of family resilience (i.e., resilience in one's current family and resilience in one's family of origin). The results of the confirmatory factor analysis supported the hypothesized two-factor structure (X2 (644) = 814.14, p = .03, X2 /df = 1.10, RMSEA = .03, CFI = .97, TLI = .96). Both the subscales and the total FRI scale (α = .92) demonstrated excellent reliability. The results also provided preliminary evidence of convergent and discriminant validity. This measure fills a gap in the absence of community-based, culturally grounded, and empirical measures of family resilience. The examination of family resilience, which may occur across generations, is an exciting new contribution of the FRI.

Considering the needs of indigenous and local populations in conservation programs

Local rural and indigenous communities have assumed increasing responsibility for conservation within and between areas buffering the impacts of agricultural or resource-extraction zones and protected areas. Empowering local communities as central partners in conservation and climate-change mitigation has allowed many people to gain access to land and citizenship rights but has provided limited improvements in access to social services and economic opportunities even as expectation about their role as environmental stewards grows. These expectations, however, are inconsistent with reality. We conducted multiple field studies in Brazil since the mid-1980s to illustrate the discrepancies between conservation programs and local conditions and expectations. We suggest that public policies and conservation programs should not delegate responsibility for managing protected areas to local and indigenous communities without considering local needs and expectations and locals' attitudes toward conservation. In other words, behavior that maintains or improves the environment should not be treated as traditional based on the expectations of outsiders. Framing local populations as traditional environmentalists creates contradictions and frustrations for local populations and for conservation professionals and policy makers.