Addressing the Impacts of Racism on American Indian and Alaska Native Child Health.

The legacy of racism toward Native Americans is far-reaching. We will review the topic using the conceptual model of racism as a form of violence as it is inherent in racism, as are prejudice and power. Using the basic frameworks of racism as internalized, interpersonal, institutional, and structural, we will discuss the many types of racism affecting Native Americans today.

Enhancing American Indians'/Alaska Natives' Knowledge, Confidence, and Community During the Medical School Application Process: Findings From the Northwest Native American Center of Excellence.

Purpose: To describe a Medical School Applicant Workshop (MSAW); present lessons learned about its impact on American Indian/Alaska Native (AIAN) participants' knowledge, confidence, and sense of community; and report on participants' medical school application progress 1 year after workshop completion.

Method: The Northwest Native American Center of Excellence at Oregon Health & Science University developed and implemented an annual 1-day AIAN MSAW in 2018. The main objectives of the workshop are for participants to gain insights into the medical school application process; learn strategies to competitively apply; receive feedback on their personal statement and mock interviews; and discuss the medical school application process with AIAN faculty, admissions deans, and peer-mentors.

Wy'east: An Innovative, Culturally Responsive Postbaccalaureate Pathway for American Indians and Alaska Natives.

Problem: American Indians and Alaska Natives (AIANs) face significant health disparities that are exacerbated by limited access to high-quality, culturally congruent health care providers. There are no premedical postbaccalaureate programs focused on AIAN students.

Approach: The Northwest Native American Center of Excellence designed the Wy'east Pathway in 2018 to increase the number of AIANs matriculating to U.

American Indian/Alaska Native Child Health and Poverty.

One in three American Indian/Alaska Native (AI/AN) children live in poverty. This rate is higher in some reservation communities. The alarming rates of physical, mental, and social health inequities (eg, poverty) experienced by AI/AN children are symptoms of genocide, a legacy of inhumane Federal Indian policy, and ongoing structural violence.

Land Rights and Health Outcomes in American Indian/Alaska Native Children.

American Indian and Alaska Native (AI/AN) land rights, sovereignty conflicts, and health outcomes have been significantly influenced by settler colonialism. This principle has driven the numerous relocations and forced assimilation of AI/AN children as well as the claiming of AI/AN lands across the United States. As tribes across the country begin to reclaim these lands and others continue to struggle for sovereignty, it is imperative to recognize that land rights are a determinant of health in AI/AN children.

American Indians and Alaska Natives in the COVID-19 Pandemic: The Grave Burden We Stand to Bear.

The United States is bearing witness as a crisis-within-a-crisis unfolds across Indian Country, where a persistently underfunded system with inadequate resources and outdated facilities set the stage for coronavirus disease 2019 (COVID-19) to overwhelm Tribes. Now is the time to reimagine our way forward as a country beyond the pandemic. To address these issues, we recommend that (1) the federal government appropriately fund the Indian Health Service and work more closely with tribal governments, and (2) programs that recruit, train, and retain American Indian and Alaska Native (AIAN) health professionals be expanded.

Measurement of American Indian and Alaska Native Racial Identity Among Medical School Applicants, Matriculants, and Graduates, 1996-2017.

Importance: Accurate racial/ethnic identity measurement is needed to understand the effectiveness of outreach, recruitment, and programs to support American Indian and Alaska Native (AIAN) people becoming physicians.

Objective: To examine how changes in race/ethnicity data collection by the American Medical College Application System are associated with trends in applicants, matriculants, and graduates self-reporting as AIAN.

Design, Setting, And Participants: In this cohort study, interrupted time series regression was conducted using data from the American Medical College Application system identifying medical school applicants and graduates between January 1, 1996, and December 31, 2017, who identified as AIAN.

A Systematic Review of Tracheostomy Modifications and Swallowing in Adults.

Dysphagia occurs in 11% to 93% of patients following tracheostomy. Despite its benefits, the tracheostomy often co-exists with dysphagia given its anatomical location, the shared pathway of the respiratory and alimentary systems, and the medical complexities necessitating the need for the artificial airway. When tracheostomy weaning commences, it is often debated whether the methods used facilitate swallowing recovery.

Are Pediatricians Complicit in Vitamin K Deficiency Bleeding?

The American Academy of Pediatrics recommends that all newborns receive a single dose of intramuscular vitamin K to prevent vitamin K deficiency bleeding. How should the clinician respond when parents decline vitamin K? Although vitamin K deficiency bleeding can have devastating sequelae, they are uncommon; therefore, parents are generally allowed to decline vitamin K after counseling is provided. When parents ask for a vitamin K preparation of unproven effectiveness, should the clinician honor that request? To address these questions, we present a case of a healthy newborn whose parents declined intramuscular vitamin K and requested an oral preparation.