Bringing Indigenous and Earth Sciences, Knowledges, and Practices Together to Understand and Respond to COVID-19

COVID-19 is having specific and devastating impacts, yet it is spurring resilient responses among Indigenous populations due to unique histories, cultures, geographies, and capacities. The Working Group on Indigenous and Earth Sciences Knowledges and Practices in Response to COVID-19 came together to foreground Indigenous perspectives in defining research questions for potential intercultural collaboration between Indigenous and Earth sciences to drive urgent, culturally relevant, and appropriate responses to COVID-19. The Working Group included intercultural, intergenerational, and interdisciplinary representatives from the Rising Voices Center for Indigenous and Earth Sciences, a nation-wide network of scientists, educators, students, and community leaders and organizers. To identify priority research areas and emerging questions, the Working Group hosted a webinar discussion and fielded a questionnaire with the Rising Voices community as well as utilized their own perspectives and expertise. The results highlighted four dynamics that many Indigenous Peoples are presently facing with the COVID-19 pandemic, including food security and safety; pre-existing conditions; turning to resilience and wisdom; and emerging questions at the nexus of Indigenous wisdom and knowledge and Earth sciences. Valuing Indigenous observations, knowledges, wisdom, and practices equally with Earth Sciences, this work contributes to decolonizing Earth Sciences, disaster management, and public health. It works to mitigate the particular threats and impacts that Indigenous communities and populations face from COVID-19 and the increasing spread of infectious diseases. Doing so addresses injustices in Earth Sciences and disaster management and the disproportionately adverse impacts of COVID-19 on Indigenous communities

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Addressing the challenges of climate-driven community-led resettlement and site expansion: knowledge sharing, storytelling, healing, and collaborative coalition building.

Presently coastal areas globally are becoming unviable, with people no longer able to maintain livelihoods and settlements due to, for example, increasing floods, storm surges, coastal erosion, and sea level rise, yet there exist significant policy obstacles and practical and regulatory challenges to community-led and community-wide responses. For many receiving support only at the individual level for relocation or other adaptive responses, individual and community harm is perpetuated through the loss of culture and identity incurred through forced assimilation policies. Often, challenges dealt to frontline communities are founded on centuries of injustices. Can these challenges of both norms and policies be addressed? Can we develop socially, culturally, environmentally, and economically just sustainable adaptation processes that supports community responses, maintenance and evolution of traditions, and rejuvenates regenerative life-supporting ecosystems? This article brings together Indigenous community leaders, knowledge-holders, and allied collaborators from Louisiana, Hawai'i, Alaska, Borikén/Puerto Rico, and the Marshall Islands, to share their stories and lived experiences of the relocation and other adaptive challenges in their homelands and territories, the obstacles posed by the state or regional governments in community adaptation efforts, ideas for transforming the research paradigm from expecting communities to answer scientific questions to having scientists address community priorities, and the healing processes that communities are employing. The contributors are connected through the Rising Voices Center for Indigenous and Earth Sciences, which brings together Indigenous, tribal, and community leaders, atmospheric, social, biological, and ecological scientists, students, educators, and other experts, and facilitates intercultural, relational-based approaches for understanding and adapting to extreme weather and climate events, climate variability, and climate change