Inductive
radio-frequency heating of magnetic nanoparticles embedded in tissue
(red material in container) preserved at very low temperatures restored
the tissue without damage (credit: Navid Manuchehrabadi et al./Science
Translational Medicine)
A research team led by the University of Minnesota has discovered a way to rewarm large-scale animal heart valves and blood vessels preserved at very low (cryogenic)
temperatures without damaging the tissue. The discovery could one day
lead to saving millions of human lives by creating cryogenic tissue and
organ banks of organs and tissues for transplantation.
The research was published March 1 in an open-access paper in Science Translational Medicine.
Long-term preservation methods like vitrification cool biological
samples to an ice-free glassy state, using very low temperatures between
-160 and -196 degrees Celsius, but tissues larger than 1 milliliter
(0.03 fluid ounce) often suffer major damage during the rewarming
process, making them unusable for tissues.
In the new research, the researchers were able to restore 50
milliliters (1.7 fluid ounces) of tissue with warming at more than
130°C/minute without damage.
Radiofrequency inductive heating of iron nanoparticles
To achieve that, they developed a revolutionary new method using
silica-coated iron-oxide nanoparticles dispersed throughout a
cryoprotectant solution around the tissue. The nanoparticles act as tiny
heaters around the tissue when they are activated using noninvasive
radiofrequency inductive energy, rapidly and uniformly warming the
tissue.
This
transmission electron microscopy (TEM) image shows the iron oxide
nanoparticles (coated in mesoporous silica) that are used in the tissue
warming process. (credit: Haynes research group/University of Minnesota)
The results showed that none of the tissues displayed signs of harm —
unlike control samples using vitrification and rewarmed slowly over ice
or using convection warming. The researchers were also able to
successfully wash away the iron oxide nanoparticles from the sample
following the warming.
“This is the first time that anyone has been able to scale up to a
larger biological system and demonstrate successful, fast, and uniform
warming of hundreds of degrees Celsius per minute of preserved tissue
without damaging the tissue,” said University of Minnesota mechanical
engineering and biomedical engineering professor John Bischof, the senior author of the study.
Organs next
Bischof said there is a strong possibility they could scale up to
even larger systems, like organs. The researchers plan to start with
rodent organs (such as rat and rabbit) and then scale up to pig organs
and then, hopefully, human organs. The technology might also be applied
beyond cryogenics, including delivering lethal pulses of heat to cancer
cells.
The researchers’ goal is to eliminate transplant waiting lists.
Currently, hearts and lungs donated for transplantation must be
discarded because these tissues cannot be kept on ice for longer than a
matter of hours, according to the researchers.*
It will be interesting to see if the technology can one day be extended to cryonics.
The research was funded by the National Science Foundation (NSF),
National Institutes of Health (NIH), U.S. Army Medical Research and
Materiel Command, Minnesota Futures Grant from the University of
Minnesota, and the University of Minnesota Carl and Janet Kuhrmeyer
Chair in Mechanical Engineering. Researchers at Carnegie Mellon
University, Clemson University and Tissue Testing Technologies LLC were
also involved in the study.
* “A major limitation of transplantation is the ischemic injury
that tissue and organs sustain during the time between recovery from the
donor and implantation in the recipient. The maximum tolerable organ
preservation for transplantation by hypothermic storage is typically 4
hours for heart and lungs; 8 to 12 hours for liver, intestine, and
pancreas; and up to 36 hours for kidney transplants. In many cases, such
limits actually prevent viable tissue or organs from reaching
recipients. For instance, more than 60% of donor hearts and lungs are
not used or transplanted partly because their maximum hypothermic
preservation times have been exceeded. Further, if only half of these
discarded organs were transplanted, then it has been estimated that wait
lists for these organs could be extinguished within 2 to 3 years.” —
Navid Manuchehrabadi et al./Science Translational Medicine
Abstract of Improved tissue cryopreservation using inductive heating of magnetic nanoparticles
Vitrification, a kinetic process of liquid solidification into glass,
poses many potential benefits for tissue cryopreservation including
indefinite storage, banking, and facilitation of tissue matching for
transplantation. To date, however, successful rewarming of tissues
vitrified in VS55, a cryoprotectant solution, can only be achieved by
convective warming of small volumes on the order of 1 ml. Successful
rewarming requires both uniform and fast rates to reduce thermal
mechanical stress and cracks, and to prevent rewarming phase
crystallization. We present a scalable nanowarming technology for 1- to
80-ml samples using radiofrequency-excited mesoporous silica–coated iron
oxide nanoparticles in VS55. Advanced imaging including sweep imaging
with Fourier transform and microcomputed tomography was used to verify
loading and unloading of VS55 and nanoparticles and successful
vitrification of porcine arteries. Nanowarming was then used to
demonstrate uniform and rapid rewarming at >130°C/min in both
physical (1 to 80 ml) and biological systems including human dermal
fibroblast cells, porcine arteries and porcine aortic heart valve
leaflet tissues (1 to 50 ml). Nanowarming yielded viability that matched
control and/or exceeded gold standard convective warming in 1- to 50-ml
systems, and improved viability compared to slow-warmed (crystallized)
samples. Last, biomechanical testing displayed no significant
biomechanical property changes in blood vessel length or elastic modulus
after nanowarming compared to untreated fresh control porcine arteries.
In aggregate, these results demonstrate new physical and biological
evidence that nanowarming can improve the outcome of vitrified cryogenic
storage of tissues in larger sample volumes.
Contemporary Native American issues in the United States are issues arising in the late 20th century and early 21st century which affect Native Americans in the United States.
A little over one third of the 2,786,652 Native Americans in the United States live in three states: California at 413,382, Arizona at 294,137 and Oklahoma at 279,559.[1]
70% of Native Americans lived in urban areas in 2012, up from 45% in
1970 and 8% in 1940. Urban areas with significant Native American
populations included Minneapolis, Denver, Phoenix, Tucson, Chicago,
Oklahoma City, Houston, New York City, and Rapid City.[2]
In the early 21st century, Native American communities have
exhibited continual growth and revival, playing a larger role in the
American economy and in the lives of Native Americans. Communities have
consistently formed governments that administer services such as firefighting, natural resource management, social programs, health care, housing and law enforcement. Numerous tribes have founded tribal colleges.
Most Native American communities have established court
systems to adjudicate matters related to local ordinances. Most also
look to various forms of moral and social authority, such as forms of restorative justice,
vested in the traditional culture of the tribal nation. Native American
professionals have founded associations in journalism, law, medicine
and other fields to encourage students in these fields, provide
professional training and networking opportunities, and entree into
mainstream institutions.
To address the housing needs of Native Americans, Congress passed the Native American Housing and Self Determination Act
(NAHASDA) in 1996. This legislation replaced public housing built by
the BIA and other 1937 Housing Act programs directed towards Indian
Housing Authorities, with a block-grant program. It provides funds to be
administered by the Tribes to develop their own housing.
Universities have conducted relatively little public opinion research
on attitudes toward Native Americans. In 2007 the non-partisan Public Agenda
organization conducted a focus group study. Most non-Native Americans
admitted they rarely encountered Native Americans in their daily lives.
While sympathetic toward Native Americans and expressing regret over the
past, most people had only a vague understanding of the problems facing
Native Americans today. For their part, Native Americans told
researchers that they believed they continued to face prejudice and
mistreatment in the broader society.[3]
Journalists have covered issues of discrimination.
LeCompte also endured taunting on
the battlefield. "They ridiculed him and called him a 'drunken Indian.'
They said, 'Hey, dude, you look just like a haji—you'd better run.' They
call the Arabs 'haji.' I mean, it's one thing to worry for your life,
but then to have to worry about friendly fire because you don't know who
in the hell will shoot you?
— Tammie LeCompte, May 25, 2007, "Soldier highlights problems in U.S. Army"[4]
Affirmative action issues
Federal contractors and subcontractors such as businesses and educational institutions are legally required to adopt equal opportunity employment and affirmative action
measures intended to prevent discrimination against employees or
applicants for employment on the basis of "color, religion, sex, or
national origin".[5][6]
For this purpose, an American Indian or Alaska Native is defined as "A
person having origins in any of the original peoples of North and South
America (including Central America), and who maintains a tribal
affiliation or community attachment." However, self-reporting is
permitted, "Educational Institutions and Other Recipients Should Allow
Students and Staff To Self-Identify Their Race and Ethnicity Unless
Self-Identification Is Not Practicable or Feasible."[7]
Self-reporting opens the door to "box checking" by people, who,
despite not having a substantial relationship to Native American
culture, either innocently or fraudulently "check the box" for Native
American.[8] On August 15, 2011 the American Bar Association
passed a resolution recommending that law schools require supporting
information such as evidence of tribal enrollment or connection with
Native American culture.[9]
Racial achievement gap regarding language
To
evade a shift to English, some Native American tribes have initiated
language immersion schools for children, where a native Indian language
is the medium of instruction. For example, the Cherokee Nation instigated a 10-year language preservation plan that involved growing new fluent speakers of the Cherokee language
from childhood on up through school immersion programs as well as a
collaborative community effort to continue to use the language at home.[10] This plan was part of an ambitious goal that in 50 years, 80% or more of the Cherokee people will be fluent in the language.[11] The Cherokee Preservation Foundation
has invested $3 million into opening schools, training teachers, and
developing curricula for language education, as well as initiating
community gatherings where the language can be actively used.[11] Formed in 2006, the Kituwah Preservation & Education Program (KPEP) on the Qualla Boundary focuses on language immersion programs for children from birth to fifth grade,
developing cultural resources for the general public and community
language programs to foster the Cherokee language among adults.[12]
There is also a Cherokee language immersion school in Tahlequah, Oklahoma that educates students from pre-school through eighth grade.[13]
Because Oklahoma's official language is English, Cherokee immersion
students are hindered when taking state-mandated tests because they have
little competence in English.[14]
The Department of Education of Oklahoma said that in 2012 state tests:
11% of the school’s sixth-graders showed proficiency in math, and 25%
showed proficiency in reading; 31% of the seventh-graders showed
proficiency in math, and 87% showed proficiency in reading; 50% of the
eighth-graders showed proficiency in math, and 78% showed proficiency in
reading.[14]
The Oklahoma Department of Education listed the charter school as a
Targeted Intervention school, meaning the school was identified as a
low-performing school but has not so that it was a Priority School.[14] Ultimately, the school made a C, or a 2.33 grade point average on the state’s A-F report card system.[14]
The report card shows the school getting an F in mathematics
achievement and mathematics growth, a C in social studies achievement, a
D in reading achievement, and an A in reading growth and student
attendance.[14]
“The C we made is tremendous,” said school principal Holly Davis,
“[t]here is no English instruction in our school’s younger grades, and
we gave them this test in English.”[14] She said she had anticipated the low grade because it was the school’s first year as a state-funded charter school, and many students had difficulty with English.[14]
Eighth graders who graduate from the Tahlequah immersion school are
fluent speakers of the language, and they usually go on to attend Sequoyah High School where classes are taught in both English and Cherokee.
American Indian activists in the United States and Canada have criticized the use of Native American mascots
in sports as perpetuating stereotypes. European Americans have had a
history of "playing Indian" that dates back to at least the
18th century.[15]
While supporters of the mascots say they embody the heroism of Native
American warriors, AIM particularly has criticized the use of mascots as
offensive and demeaning.
While many universities and professional sports teams (for example, the Cleveland Indians, who had a Chief Wahoo)
no longer use such images without consultation and approval by the
respective nation, some lower-level schools continue to do so. On the
other hand, in the Bay Area of California, Tomales Bay High and Sequoia
High have retired their Indian mascots.
(Trudie Lamb Richmond doesn't) know
what to say when kids argue, 'I don't care what you say, we are
honoring you. We are keeping our Indian.' ... What if it were 'our
black' or 'our Hispanic'?
— Amy D'orio quoting Trudie Lamb Richmond, March 1996, "Indian Chief Is Mascot No More"[16]
Could you imagine people mocking
African Americans in black face at a game?" he said. "Yet go to a game
where there is a team with an Indian name and you will see fans with war
paint on their faces. Is this not the equivalent to black face?
— "Native American Mascots Big Issue in College Sports", Teaching Tolerance, May 9, 2001[20]
Environmental justice
Environmental
justice academic case studies examine the erasure of indigenous culture
and ways of life, resource exploitation, destruction of sacred land,
environmental and indigenous health, and climate justice.[21]
From the arrival of white settlers, explorers and colonizers, Native
Americans have suffered from genocide, introduced diseases, warfare, and
the legacy of environmental racism persists in modern day.[21] The environmental justice movement has largely left out the Native American experience, but findings[by whom?] have shown that Native land is being, and has been, used for landfills, dump sites, and locations to test nuclear weapons.[citation needed] However, while these uses cause harm to the peoples health, they are not always unwanted.[citation needed]
The Mescalero Apache welcomed the proposal to have a monitored
retrievable nuclear waste storage facility built on their land because
over one-third of the tribal citizens were unemployed, and they lacked
enough housing and any sort of school system.[22]
Jamie Vickery and Lori M. Hunter have stated that the natives are being
coerced into accepting the nuclear waste storage facility by their own
economic hardships, which in turn has been caused by the US government
direct exploitation and marginalization.[23]
Historical depictions in art
Secotan Indians' dance in North Carolina, watercolor by John White, 1585
During the 16th century, the artist John White
made watercolors and engravings of the people native to the
southeastern states. John White’s images were, for the most part,
faithful likenesses of the people he observed.
The artist Theodore de Bry used White’s original watercolors to make a book of engravings entitled, A briefe and true report of the new found land of Virginia.
In his book, de Bry often altered the poses and features of White’s
figures to make them appear more European. During the period when White
and de Bry were working, when Europeans were first coming into contact
with Native Americans, Europeans were greatly interested in Native
American cultures. Their curiosity created demand for a book like de
Bry’s.
During the construction of the Capitol building in the early 19th century, the U.S. government commissioned a series of four relief panels to crown the doorway of the Rotunda.
The reliefs encapsulate a vision of European—Native American relations
that had assumed mythic historical proportions by the 19th century. The
four panels depict: The Preservation of Captain Smith by Pocahontas (1825) by Antonio Capellano, The Landing of the Pilgrims (1825) and The Conflict of Daniel Boone and the Indians (1826–27) by Enrico Causici and William Penn’s Treaty with the Indians (1827) by Nicholas Gevelot.
The reliefs by European sculptors present versions of the
Europeans and the Native Americans, in which the Europeans appear
refined and the natives appear ferocious. The Whig representative of Virginia, Henry A. Wise,
wrote about how Native Americans might think of the reliefs: "We give
you corn, you cheat us of our lands: we save your life, you take ours."
While many 19th-century images of Native Americans conveyed similarly
negative messages, artists such as Charles Bird King sought to express a more balanced image of Native Americans.
During this time, some fiction writers were informed about and sympathetic to Native American culture. Marah Ellis Ryan conveyed the culture with sympathy.
In the 20th century, early portrayals of Native Americans in movies and television roles were first performed by European Americans dressed in mock traditional attire. Examples included The Last of the Mohicans (1920), Hawkeye and the Last of the Mohicans (1957), and F Troop (1965–67). In later decades, Native American actors such as Jay Silverheels in The Lone Ranger
television series (1949–57) came to prominence. Roles of Native
Americans were limited and not reflective of Native American culture. By
the 1970s some Native American film roles began to show more
complexity, such as those in Little Big Man (1970), Billy Jack (1971), and The Outlaw Josey Wales (1976), which depicted Native Americans in minor supporting roles.
For years, Native people on U.S. television were relegated to secondary, subordinate roles. During the years of the series Bonanza (1959–1973), no major or secondary Native characters appeared on a consistent basis. The series The Lone Ranger (1949–1957), Cheyenne (1957–1963), and Law of the Plainsman (1959–1963) had Native characters who were essentially aides to the central white characters. This continued in such series as How the West Was Won. These programs resembled the "sympathetic" yet contradictory film Dances With Wolves
of 1990, in which, according to Ella Shohat and Robert Stam, the
narrative choice was to relate the Lakota story as told through a
Euro-American voice, for wider impact among a general audience.[24]
Like the 1992 remake of The Last of the Mohicans and Geronimo: An American Legend (1993), Dances with Wolves employed a number of Native American actors, and made an effort to portray Indigenous languages.
In the same period, the TNT Network presented a television movie
on Geronimo, as well as two others on Native American historical
figures, and a six-part documentary series on Native history, all within
a 14-month period.
In 2004 producer Guy Perrotta presented the film Mystic Voices: The Story of the Pequot War
(2004), a television documentary on the first major war between
colonists and Native peoples in the Americas. Perrotta and Charles
Clemmons intended to increase public understanding of the significance
of this early event. They believed it had significance not only for
northeastern Native Peoples and descendants of English and Dutch
colonists, but for all Americans today.
Wanting to make the film historically accurate and unbiased, the
producers invited a broadly based Advisory Board, and used scholars,
Native Americans, and descendants of the colonists to help tell the
story. They elicited personal and often passionate viewpoints from
contemporary Americans. The production portrayed the conflict as a
struggle between different value systems, which included not only the
Pequot, but a number of other Native American tribes, most of which
allied with the English. It presents facts and seeks to help viewers
better understand the several peoples who fought the War.
In 2009 We Shall Remain (2009), a television documentary by Ric Burns and part of the American Experience
series, presented a five-episode series "from a Native American
perspective". It represented "an unprecedented collaboration between
Native and non-Native filmmakers and involves Native advisors and
scholars at all levels of the project."[25] The five episodes explore the impact of King Philip's War on the northeastern tribes, the "Native American confederacy" of Tecumseh's War, the US-forced relocation of Southeastern tribes known as the Trail of Tears, the pursuit and capture of Geronimo and the Apache Wars, and concludes with the Wounded Knee incident, participation by the American Indian Movement, and the increasing resurgence of modern Native cultures since.
Terminology differences
Common usage in the United States
Native
Americans are more commonly known as Indians or American Indians, and
have been known as Aboriginal Americans, Amerindians, Amerinds, Colored,[26][27] First Americans, Native Indians, Indigenous, Original Americans, Red Indians, Redskins or Red Men.
The term Native American was introduced in the United States by academics[who?] in preference to the older term Indian to distinguish the indigenous peoples of the Americas from the people of India, and to avoid negative stereotypes associated with the term Indian. Some academics[who?] believe that the term Indian should be considered outdated or offensive. Many indigenous Americans, however, prefer the term American Indian.[28]
Others point out that anyone born in the United States is, technically,
native to America. In this sense, "native" was substituted for
"indigenous". Today, people from India (and their descendants) who are
citizens of the United States are called Indian Americans or Asian Indians.
Criticism of the neologismNative American comes from diverse sources. Russell Means, an American Indian activist, opposes the term Native American
because he believes it was imposed by the government without the
consent of American Indians. He has also argued that the use of the word
Indian derives not from a confusion with India but from a Spanish expression En Dio, meaning "in God".[29]
Furthermore, some American Indians[who?] question the term Native American
because, they argue, it serves to ease the conscience of "white
America" with regard to past injustices done to American Indians by
effectively eliminating "Indians" from the present.[30] Still others (both Indians and non-Indians)[who?] argue that Native American
is problematic because "native of" literally means "born in," so any
person born in the Americas could be considered "native". The compound
"Native American" is generally capitalized to differentiate the reference to the indigenous peoples.
A 1995 U.S. Census Bureau survey found that more Native Americans in the United States preferred American Indian to Native American.[28] Most American Indians are comfortable with Indian, American Indian, and Native American, and the terms are often used interchangeably.[31] The traditional term is reflected in the name chosen for the National Museum of the American Indian, which opened in 2004 on the Mall in Washington, D.C..
Recently, the U.S. Census Bureau has introduced the
"Asian-Indian" category to avoid ambiguity for descendants of people
from India.
Gambling has become a leading industry. Casinos
operated by many Native American governments in the United States are
creating a stream of gambling revenue that some communities are
beginning to use as leverage to build diversified economies. Native
American communities have waged and prevailed in legal battles to assure
recognition of rights to self-determination and to use of natural
resources. Some of those rights, known as treaty rights, are enumerated
in early treaties signed with the young United States government. These
casinos have brought an influx of money to the tribes; according to
tribal accounting firm Joseph Eve, CPAs, the average net profit of Indian casinos is 38.85%.[32][clarification needed]
Tribal sovereignty has become a cornerstone of American jurisprudence, and at least on the surface, in national legislative policies. Although many Native American tribes have casinos, the impact of Native American gaming is widely debated. Some tribes, such as the Winnemem Wintu of Redding, California,
feel that casinos and their proceeds destroy culture from the inside
out. These tribes refuse to participate in the gambling industry.
Crime on reservations
Prosecution of serious crime, historically endemic on reservations,[33][34] was required by the 1885 Major Crimes Act,[35] 18 U.S.C. §§1153, 3242, and court decisions to be investigated by the federal government, usually the Federal Bureau of Investigation, and prosecuted by United States Attorneys of the United States federal judicial district in which the reservation lies.[36][37] An investigation by The Denver Post in 2007 found that crimes in Indian Country have been a low priority both with the FBI and most federal prosecutors.[38] As of November 2012 federal resources were being reduced while high rates of crime continued to rise in Indian Country.[39]
Often serious crimes have been either poorly investigated or prosecution has been declined.[38] Tribal courts were limited to sentences of one year or less,[38] until on July 29, 2010 the Tribal Law and Order Act
was enacted which in some measure reforms the system permitting tribal
courts to impose sentences of up to three years provided proceedings are
recorded and additional rights are extended to defendants.[36][37]
The Justice Department on January 11, 2010 initiated the Indian Country
Law Enforcement Initiative which recognizes problems with law
enforcement on reservations and assigns top priority to solving existing
problems.
The Department of Justice recognizes the
unique legal relationship that the United States has with federally
recognized tribes. As one aspect of this relationship, in much of Indian
Country, the Justice Department alone has the authority to seek a
conviction that carries an appropriate potential sentence when a serious
crime has been committed. Our role as the primary prosecutor of serious
crimes makes our responsibility to citizens in Indian Country unique
and mandatory. Accordingly, public safety in tribal communities is a top
priority for the Department of Justice.
Emphasis was placed on improving prosecution of crimes involving domestic violence and sexual assault.[40]
Passed in 1953, Public Law 280 (PL 280) gave jurisdiction
over criminal offenses involving Indians in Indian Country to certain
States and allowed other States to assume jurisdiction. Subsequent
legislation allowed States to retrocede jurisdiction, which has occurred
in some areas. Some PL 280 reservations have experienced jurisdictional
confusion, tribal discontent, and litigation, compounded by the lack of
data on crime rates and law enforcement response.[41]
As of 2012, a high incidence of rape continued to impact Native
American women and Alaskan native women. According to the Justice
Department 1 in 3 women have suffered rape or attempted rape, more than
twice the national rate.[42] 80% of Native American sexual assault victims report that their attacker was "non-Indian".[43] As of 2013 inclusion of offenses by non-native men against native women in the Violence Against Women Act
continued to present difficulties over the question of whether
defendants who are not tribal members would be treated fairly by tribal courts or afforded constitutional guarantees.[44]
On June 6, 2012 the Justice Department announced a pilot plan to
establish joint federal-tribal response teams on 6 Montana reservations
to combat rape and sexual assault.[45]
Public health
As of 2004, according to the United States Commission on Civil Rights: "Native Americans die of diabetes, alcoholism,tuberculosis, suicide,
and other health conditions at shocking rates. Beyond disturbingly high
mortality rates, Native Americans also suffer a significantly lower
health status and disproportionate rates of disease compared with all
other Americans."[46]
In addition to increasing numbers of American Indians entering
the fields of community health and medicine, agencies working with
Native American communities have sought partnerships, representatives of
policy and program boards, and other ways to learn and respect their
traditions and to integrate the benefits of Western medicine within
their own cultural practices.
Alcoholism
The community suffers a vulnerability to and a disproportionately high rate of alcoholism.[47] Alcohol abuse is widespread in Native American communities. Native
Americans use and abuse alcohol and other drugs at younger ages, and at
higher rates, than that of all other ethnic groups.[48]
Consequently, their age-adjusted alcohol-related mortality rate is 5.3
times greater than the general population. The Department of Health and
Human Services, Substance Abuse and Mental Health Services
Administration’s National Household Survey on Drug Abuse reported the
following for 1997: 19.8 percent of Native Americans ages 12 and older
reported using illegal drugs that year, compared with 11.9 percent for
the total U.S. population. Native Americans had the highest prevalence
rates of marijuana and cocaine use, in addition to the need for drug
abuse treatment.[49]
Tribal governments have long prohibited the sale of alcohol on
reservations, but generally, it is readily for sale in nearby border
towns, and off-reservation businesses and states gain income from the
business. As an example, in 2010, beer sales at off-reservation outlets
in Whiteclay, Nebraska generated $413,932 that year in federal and sales taxes. Their customers are overwhelmingly Lakota from the Pine Ridge Indian Reservation in South Dakota.[50]
Acknowledging that prohibition
has not worked, in a major change in strategy since the late 20th
century, as of 2007, 63 percent of the federally recognized tribes in
the lower 48 states had legalized alcohol sales on their reservations.[51]
Among these, all the other tribes in South Dakota have legalized sales,
as have many in Nebraska. The tribes decided to retain the revenues
that previously would go to the states through retail sales taxes on
this commodity. Legalizing the sales enables the tribes to keep more
money within their reservation economies and support new businesses and
services, as well as to directly regulate, police and control alcohol
sales. The retained revenues enable them to provide health care and
build facilities to better treat individuals and families suffering from
alcohol abuse.[51] In some cases, legalization of alcohol sales also supported the development of resorts and casinos, to generate revenues for other economic enterprises.
Consequences of alcoholism
Native Americans and Whites have the highest rates of Driving Under the Influence
(DUI). A 2007 study conducted by the National Survey on Drug Use and
Health (NSDUH) reports that 13.3% of Native Americans report past-year
DUI.[52]
Of 1660 people from seven Native American tribes, the lifetime
prevalence of alcohol dependence ranged from 21%-56% for men and 17%-30%
for women among all tribes. Physical and sexual abuse significantly
increased the chances of alcohol dependence for men. Sexual abuse and
boarding school attendance increased the odds of alcohol dependence
among women.[53] Native Americans, especially women, are at high risk for alcohol-related trauma, such as rape and assault.[54]
Unintentional injuries due to alcoholism
Unintentional
injuries account for the third leading cause of death for Native
Americans and the leading cause of death for Native Americans under 44
years old. Unintentional injuries include motor vehicle crashes,
pedestrian-related motor vehicle crashes, drowning, and fire-related
injuries. From 1985 to 1996, 1,484 Native American children died in
motor vehicle crashes, which is twice the rate for white children.[55]
National estimates of alcohol-related motor vehicle deaths show
that Native Americans have a 250% higher death rate compared to the US
population.[56]
Cancer
Studies have indicated that there is are fewer cases of cancer
in Native Americans than other ethnic groups. However, cancer is
prevalent in Native Alaskan women and Native American women as the
leading and second leading cause of death, respectively. Death rates are
70% of that for whites, indicating that the ratio of death by cancer to
new cancer cases is the highest for Native Americans compared to other
ethnic groups.[57]
Women have been diagnosed with later-stage breast and cervical cancer.
Native Indian and Alaska Native people are disproportionately prone to
colon and lung cancer. In some communities, this is consistent with a
high prevalence of risk factors such as smoking.
One research about the Pacific Northwest Native Americans found
that there were many misidentified rates of cancer between 1996-1997.
This misclassification was due to a low Native American blood quantum,
resulting in an over-reported amount of Native Americans diagnosed with
cancer. Because the research took data from the Oregon State Cancer
Registry, the Washington State Cancer Registry, and the Cancer Data
Registry of Idaho to research tribes in the respected states, their
findings show that cancer rates among tribes in the US are
heterogeneous.[58]
However, data collected from cancer cases are limited.
Regardless, experts have suggested that Native Americans experience
cancer differently than other ethnic groups. This can be due to genetic
risk factors, late detection of cancer, poor compliance with recommended
treatment, the presence of concomitant disease, and lack of timely
access to diagnostic and/or treatment methods. According to researchers,
addressing underlying risk factors and low screening rates by
implementing aggressive screening programs can prevent cancer from
forming in Native Indian and Alaska Native communities.[59]
Diabetes
Native Americans have some of the highest rates of diabetes
in the world, specifically Type 2 diabetes. Although mostly diagnosed
in adults, children are increasingly being diagnosed with Type 2
diabetes as well. Type 2 diabetes may be manageable through healthy
eating, exercising, oral medication, or insulin injections.[57]
A study published in Environmental Health Perspectives found that
the prevalence of diabetes found in Native Americans of the Mohawk
Nation was 20.2% due to traces of pesticides in food sources, where
elevated serum PCBs, DDE, and HBC were associated. Mirex did not have a
connection.[60]
Major cardiovascular disease
Heart disease
accounts for the number one cause of death among Native Americans,
causing them to have twice the rate of cardiovascular disease than the
US population. High rates of diabetes, high blood pressure, and risk
factors (unhealthy eating and sedentary lifestyle) contribute to the
increased risk of cardiovascular disease.[61]
Mental health
Native Americans are at high risk for mental disorders.
The most prevalent concerns due to mental health include substance
abuse, suicide, depression, anxiety, and violence. High rates of
homelessness, incarceration, alcohol and drug abuse, and stress and
trauma in Native American communities might attribute to the risk.
According to The Surgeon General's report, the U.S. mental health system
is not equipped to meet the needs of Native Americans. Moreover, the
budget constraints of the Indian Health Service allows only basic
psychiatric emergency care.[62]
Suicide
Suicide is a major public health problem for American Indians in the United States.
Prevalence of suicide among Native Americans
The Suicide rate for American Indians and Alaskan Natives is approximately 190% of the rate for the general population.[46]
Among American Indians/Alaska Natives aged 10 to 34 years suicide is
the second leading cause of death with suicide ranked as the eighth
leading cause of death for American Indians/Alaska Natives of all ages[63]
Youth who have experienced life stressors are disproportionately
affected by risky behaviors and at greater risk for suicide ideation.
Suicide rates among American Indians and Alaska Natives youth are higher
than those for other populations. The rate of suicide for American
Indian/Alaskan Natives is 70% higher than for that of the general
population and youth between age 10 and 24 are the most at risk.[64]
College students are also among those most at risk for suicide;
select data from the National College Health Association National
College Health Assessment (ACHA-NCHA) found that approximately 15% of
American Indian students reported seriously contemplating suicide over
the past 12 months, compared with 9.1% of non-American Indian students;
5.7% of American Indian students reported attempting suicide, compared
with 1.2% of non-American Indian students[65]
Suicide prevention
Prevention
aims at halting or stopping the development of individual or social
problem which is already evident. Prevention is different from
intervention and treatment in that it is aimed at general population
groups or individuals with various levels of risk.[66] Prevention's goal is to reduce risk factors and enhance protective factors. Suicide prevention is a collective effort of organizations, communities, and mental health practitioners to reduce the incidence of suicide. Social workers have an important role to play in suicide prevention.
Social workers are the largest occupational group of mental health
professionals in the USA, thus they play a significant role in the
national approach to preventing suicide.[67]
The social work approach to suicide prevention among Native Americans
identifies and addresses the individual’s immediate clinical needs,
community/environmental influences, and societal risk factors.
Possible programs to improve native health disparities
Indian Health Service
The Indian Health Service
(IHS) was established within the Public Health Service in 1955 in order
to meet federal treaty obligations to provide health services to
members of federally recognized American Indian and Alaska Native
tribes. The IHS consists of three branches of service: the federally
operated direct care system, independent tribally operated health care
services, and urban Indian health care services.[68]
Affordable Care Act
In addition to the Indian Health Services, researchers have data suggesting that the Affordable Care Act
supplements Native American healthcare. With the two services, tribes
have greater flexibility in health care availability. Tribes have direct
access to IHS funds, which can be administered via contracts and other
arrangements made with providers. However, it alters trust
relationships.[69]
The Affordable Care Act provides an opportunity for uninsured adults to
gain Medicaid coverage. Although half of the uninsured adults are
white, increases in coverage expand to all races to substantially reduce
racial gaps in health insurance coverage.[70]
With new outreach and enrollment efforts, streamlined enrollment
systems, penalties for not having health insurance coverage, the
availability of newly created health insurance exchanges, and the
expectation under the ACA that everyone will have insurance coverage,
enrollment in Medicaid will increase in low-income communities.[71]
The Indian Health Care Improvement Act, which is part of the
Patient Protection and Affordable Care Act, does not guarantee a health
care arrangement of the kind Americans have generally come to
expect—namely, comprehensive inpatient and outpatient services available
on the basis of need— a critical point when considering the IHS, which
is often mistaken for a Native American health insurance program.
According to the governor of the Pueblo of Tesuque Mark Mitchell, IHS
does not cover everything that insurance does.[72] It is not an entitlement program, unlike Medicare or Medicaid.
The IHS is a series of direct health care services provided at IHS
facilities. A key distinction between IHS health services and insurance
concerns the policy framework and logic of budgeting that underpins
them.
This produces a fundamentally different dynamic than that which
drives programs such as Medicare or Medicaid, or especially private
managed care plans. The IHS does what it can with the resources it is
provided by Congress but is not obligated to provide the services
required to meet the broader health needs of Native Americans in the
pursuit of measurable outcomes.[73]
The Oregon Experiment
In 2008, Oregon initiated Medicaid to 10,000 of a randomized 90,000
low-income, uninsured adults to participate in what is now known as the Oregon Medicaid health experiment.
Within 4 study groups of one study, researchers observed that
utilization of primary care services will increase, as more individuals
will begin and continue to use medical care. The study was limited to
the Portland metropolitan area.[74] Researchers concluded that investment in primary care could help attend and mitigate the health care needs of individuals.[75]
Trauma
Trauma among American Indians can be seen through historical and intergenerational trauma and can be directly related to the abuse of alcohol and substances among American Indian populations.
Historical trauma
Historical trauma is described as collective emotional and psychological damage throughout a person’s lifetime and across multiple generations.[76] American Indians experience historical trauma through the effects of colonization such as wars and battles with the U.S. military, assimilation,
forced removal, and genocide amongst others. Even though many American
Indians did not experience first hand these traumatic events, they
continue to be affected by them. Events such as the Wounded Knee Massacre
are examples of historical trauma that span across generations. On
December 29, 1890, over 200 Lakota were killed. More than half were
women and children who were unarmed. Soldiers even shot women in the
back who were fleeing. Unanswered pain from the Wounded Knee Massacre
is still felt and has been related to present day substance abuse and
violence.[77]
The loss of lands are also instrumental to the effect of
historical trauma on American Indians. Four-fifths of American Indian
land was lost due to the Dawes Allotment Act
of 1887. The U.S. government gave American Indian men sections of land
and opened the “surplus” to white settlers and government interests.
The understanding of American Indian’s relationship to land is much more
than a physical place, it is the bases for their entire worldview and
well-being. The psychological effects of the Dawes Allotment Act can be
better appreciated when looking at American Indians relationship to the
land, which is similar for all Indian tribes. The land is the origin of
the People, who came out of the earth, and is the interdependent and
spiritual link to all things.[78]
Impacts of intergenerational trauma
American Indian youth are confronted with the burden of intergenerational trauma;
trauma experienced by family members that is passed from one generation
to the next. Often youth begin to take on these traumas and can abuse
alcohol and drugs to the point of death in some cases. This can
contribute to American Indian adolescents exceeding the national average
for alcohol and drug related deaths; being 1.4 and 13.3 times higher.[79] A study looking at two generations of American Indians and their relationship to psychological trauma
found that participants who experienced traumatic events early in their
lives were usually related to substance abuse of the offender. These
experiences have shown to be associated with the beginning of their own
substance abuse.[80] The abuse of alcohol and drugs are unhealthy coping mechanisms
that many American Indians learn to use at a young age. A person’s
substance abuse can be described as a defense mechanism against the
user’s emotions and trauma.[81] For many American Indians, alcoholism
is a symptom of trauma passed from generation to generation and
influenced by oppressive behaviors and policies by the dominant
Euro-American society.[82]
Boarding School
Many American Indians were assimilated into the Euro-American culture through boarding schools that were designed to civilize them. “Kill the Indian and save the man” was the motto and belief.[83] After hundreds of years of discrimination, American Indians have
developed a heavy sense of shame about their trauma. Shame can be
described as the belief that one is bad, horrible, impaired, tainted,
dishonorable, worthless, and more.[81]
Participants in a study who are survivors of American Indian mission
schools reported that Native Americans were thought to be "dirty" people
who needed to be treated with dichloro-diphenyl-trichloro-ethane
(DDT), a pesticide used for insect control, before entering class each
day. Accounts of DDT powder was applied to their hair occurred in the
1946 and 1957. Participants indicated a need for assistance to address
their suffered abuse.[84]
DDT was used during WWII as a pesticide for insect control, eliminating typhus in parts of Europe and controlling malaria and dengue fever.[85]
After DDT was made available to the public for commercial use, birds,
fish, insects, and humans were dying because of the chemicals. Many
states tried regulating the chemical[86][87] and eventually the Environmental Protection Agency placed a ban on DDT.[88]
Solutions
Many
researchers, psychologists, counselors, and social workers are calling
for culturally competent practitioners as well as using culturally
appropriate practices when working with American Indian clients. This
is largely due to the difference of worldviews between American Indians
and Euro-Americans. American Indians do not view mind, body, and soul
as separate from each other or themselves as the Western worldview does.
American Indians believe all is connected and related to each other.[81]
American Indian psychologists have been asked to use mental health
practices that cultivate American Indian values rather than using
conventional ways of counseling.[89]
The Wellbriety Movement creates a space for American Indians to learn
how to reconnect with their culture by using culturally specific
principles to become and remain sober.[79]
Some examples are burning sage, cedar, and sweetgrass as a means to
cleanse physical and spiritual spaces, verbally saying prayers and
singing in one’s own tribal language, and participating in tribal drum
groups and ceremonies as part of meetings and gatherings.
Japanese researchers have developed an amoeba-like
shape-changing molecular robot — assembled from biomolecules such as
DNA, proteins, and lipids — that could act as a programmable and
controllable robot for treating live culturing cells or monitoring
environmental pollution, for example.
This the first time a molecular robotic system can recognize signals
and control its shape-changing function, and their molecular robots
could in the near future function in a way similar to living organisms,
according to the researchers.
Developed by a research group at Tohoku University
and Japan Advanced Institute of Science and Technology, the molecular
robot integrates molecular machines within an artificial cell membrane
and is about one micrometer in diameter — similar in size to human
cells. It can start and stop its shape-changing function in response to a
specific DNA signal.
Schematic
diagram of the molecular robot. (A) In response to a start-stop DNA
signal, molecular actuators (microtubules) inside the robot change the
shape of the artificial cell membrane (liposome), controlled by a
“molecular clutch” that transmits the force from the actuator (kinesin
proteins, shown in green, assemble DNA to the cell membrane when
activated). (B) Microscopy images of molecular robots. When the input
DNA signal is “stop,” the clutch is turned “OFF,” deactivating the
shape-changing behavior. The shape-changing is activated when the the
clutch is turned “ON.” Scale bar: 20 μm. The white arrow indicates the
molecular actuator part that transforms the shape of the membrane.
(credit: Yusuke Sato)
The movement force is generated by molecular actuators (microtubules)
controlled by a molecular clutch (composed of DNA and kinesin — a
“walker” that carries molecules along microtubules in the body). The
shape of the robot’s body (artificial cell membrane, or liposome — a
vesicle made from a lipid bilayer) is changed (from static to active) by
the actuator, triggered by specific DNA signals activated by UV
irradiation.
Kinesin motor protein “walking” along microtubule filament (credit: Jzp706/CC)
The realization of a molecular robot whose components are designed at
a molecular level and that can function in a small and complicated
environment, such as the human body, is expected to significantly expand
the possibilities of robotics engineering, according to the
researchers.*
“With more than 20 chemicals at varying concentrations, it took us a
year and a half to establish good conditions for working our molecular
robots,” says Associate Professor Shin-ichiro Nomura
at Tohoku University’s Graduate School of Engineering, who led the
study. “It was exciting to see the robot shape-changing motion through
the microscope. It meant our designed DNA clutch worked perfectly,
despite the complex conditions inside the robot.”
Programmable by DNA computing devices
The research results were published in an open-access paper in Science Robotics on March 1, 2017.
The authors say that “combining other molecular devices would lead to
the realization of a molecular robot with advanced functions. For
example, artificial nanopores, such as an artificial channel composed of
DNA, could be used to sense signal molecules in the surrounding
environments through the channel.
“In addition, the behavior of a molecular robot could be programmed
by DNA computing devices, such as judging the condition of environments.
These implementations could allow for the development of molecular
robots capable of chemotaxis [movement in a direction corresponding to a
gradient of increasing or decreasing concentration of a particular
substance], [similar to] white blood cells, and beyond.”
The research was supported by the JSPS KAKENHI, AMED-CREST and Tohoku University-DIARE.
* In the current design, “there are still limitations in the
functions of the robot. For example, the switching of robot behavior is
not reversible. The shape change is not directional and as yet not
possible for complex tasks, for example, locomotion. However, to the
best of our knowledge, this is the first implementation of a molecular
robot that can control its shape-changing behavior in response to
specific signal molecules.” — Yusuke Sato et al./Science Robotics
Abstract of Micrometer-sized molecular robot changes its shape in response to signal molecules
Rapid progress in nanoscale bioengineering has allowed for the design
of biomolecular devices that act as sensors, actuators, and even logic
circuits. Realization of micrometer-sized robots assembled from these
components is one of the ultimate goals of bioinspired robotics. We
constructed an amoeba-like molecular robot that can express continuous
shape change in response to specific signal molecules. The robot is
composed of a body, an actuator, and an actuator-controlling device
(clutch). The body is a vesicle made from a lipid bilayer, and the
actuator consists of proteins, kinesin, and microtubules. We made the
clutch using designed DNA molecules. It transmits the force generated by
the motor to the membrane, in response to a signal molecule composed of
another sequence-designed DNA with chemical modifications. When the
clutch was engaged, the robot exhibited continuous shape change. After
the robot was illuminated with light to trigger the release of the
signal molecule, the clutch was disengaged, and consequently, the
shape-changing behavior was successfully terminated. In addition, the
reverse process—that is, initiation of shape change by input of a
signal—was also demonstrated. These results show that the components of
the robot were consistently integrated into a functional system. We
expect that this study can provide a platform to build increasingly
complex and functional molecular systems with controllable motility.
