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The possible dream: the Navajo Nation Health Foundation.

The dream of high-quality health care for the Navajo began in Ganado, AZ, some 70 years ago. Now it has gone a step further through the work of the only hospital and clinic system in the United States that is owned and operated by American Indians.

Arizona

Current knowledge in pharmacogenomics and precision medicine: perspectives of the PGRN global PGx committee on improving drug therapies in underrepresented ethnic populations.

A precision medicine strategy is likely to be more impactful, when pharmacogenomics (PGx) guided selection of drugs and dosage wherever applicable is implemented across the globe. In regions where resources are disproportionately distributed, PGx implementation in routine clinical care can play a critical role in ensuring the optimal use of limited healthcare infrastructure. At present, PGx data from the majority of the distinct ethnic populations across Asia, Africa, and South America is limited. While international consortia, working groups, and scientific bodies have made significant contributions toward evaluating the evidence for PGx implementation, the majority of existing guidelines and recommendations are derived primarily from studies conducted in a limited number of ethnic groups. Precision Medicine Initiatives in countries like Korea, Taiwan, and Malaysia and PGx organizations like the African Institute of Biomedical Science and Technology (AiBST), Consortium for Genomics & Therapeutics in Africa (CGTA), implementation of pharmacogenetic testing for the effective care and treatment in Africa, Greater Middle East (GME) whole exome sequencing program, Ibero-American Network of Pharmacogenetics and Pharmacogenomics (RIBEF), Latin American Society of Pharmacogenomics and Personalized Medicine (SOLFAGEM), Latin American Network for Validation and Implementation of Pharmacogenomic Clinical Guidelines (RELIVAF), IndiGen initiative, Southeast Asian Pharmacogenomics Research Network (SEAPharm), are working toward consolidating the PGx presence in these regions.

Precision Medicine

Problems of child health in a Peruvian shanty town.

The basic child-health problems in the shanty towns of Lima are protein-calorie malnutrition and infectious disease. The background of social, economic and cultural conditionsa are related to these main health problems. The basic problems are poverty, lack of sewage disposal and running water, and the maldistribution of public expenditure between city and countryside on one hand and curative and preventive medicine on the other. Despite official statistics, which show a steadily decreasing infant mortality rate in Peru, and all other Latin American countries, it seems that the Infant Mortality Rate is almost twice the official states rate. Health education, particularly in nutritional matters, is not adapted to indigenous foods and customs, but attempts to promote westernized conceptrs. Medical care in Peru is by large directed to the needs of the middle class, and the middle class by and large dictates the type of medical care available.

Child

A heroin "epidemic" in Asia.

Heroin "epidemics" have been reported in North America but not in Asia. Following passage of an anti-opium law in Laos, heroin use suddenly began in one area during 1972. Initially heroin use prevailed among indigenous Asian addicts, mostly older addicts who gradually switched from opium to heroin. In addition, there evolved a new group of indigenous addicts: young, single, unemployed males in urban areas whose first narcotic drug was heroin. After the appearance of heroin in Laos, increasing numbers of younger Americans and Europeans were soon attracted to heroin use in Laos.

Adolescent

The nonwhite as child: G. Stanley Hall on the education of nonwhite peoples.

Although he was a significant educational reformer during the progressive era, a founder of various journals in psychology and pedagogy, a profile writer, and the individual who brought Freud and Jung to the United States, G. Stanley Hall's ideas on the education of nonwhites were, for his period, quite conventional. Unlike those of some of his contemporaries, Hall's racial ideas were not overtly vicious. He argued that nonwhites were the children of the human race and that their education, like that of children of particular ages, should be based on an understanding of their indigenous culture and inherent capabilities. This argument, although reformist in tone, supported a policy of nonwhite subservience.

Black or African American

Distribution of HLA antigens in a Mexican--American population and a comparison with two similar populations from different geographical locales.

The frequencies of 32 HLA antigens of the A and B series were determined in a previously unstudied population of Mexican-Americans in South Texas. The phenotype and gene frequencies for this group are presented and are contrasted with those determined in studies of Mexican/Mexican--American populations from two different locales. The statistically significant differences observed emphasize the need for indigenous controls when evaluating racially heterogeneous populations for disease-associated HLA antigens.

California

A workshop considering genetic research and data collection with American Indian and Alaska Native people outside of Tribal jurisdiction.

INTRODUCTION: In the United States (US), Tribes are sovereign nations and have the right to oversee research conducted with Tribal citizens. However, it is unclear who should approve research protocols when data from American Indian and Alaska Native (AIAN) people are collected off Tribal lands. As genetic research continues to advance and transform the delivery of healthcare, equitable inclusion of AIAN people is necessary, but oversight of research needs clarity. METHODS: We held a 3-day workshop with US thought leaders on genetic and other health research with AIAN people in urban areas to explore views and values on this issue and to discuss potential policy and practice solutions. RESULTS: Thirty-six individuals attended. Solidarity surfaced as a foundational motivation for Tribal Nations to review research conducted with AIAN people, whether on Tribal lands or not. Understanding data from Indigenous perspectives was identified as a way to ensure appropriate AIAN community protections are in place. Three discrete areas to improve policy were suggested-Tribal, Academic Institution, and National-to protect AIAN people participating in research both on and off Tribal lands. DISCUSSION: Researchers, whether Indigenous or not, must recognize Tribal sovereignty and operate in solidarity with the applicable and most appropriate ethical principles and regulations.

Alaska Native

Food preparation in colonial America. A Bicentennial study.

Both regional and national influences have pervaded America's culinary arts from colonial times until the present. In the South, for instance, indigenous foods, such as sweet potatoes--as well as an abundance of fruits and fowl--were commonly served. In the North, maple sirup was a New England product, as was codfish. Throughout the colonies, corn was easily grown and became a staple. Immigrants from the Old World brought their recipes to meld or adapt to conditions they met here. Recounted also is the unfolding of an American cuisine, especially in the southern colonies as it evolved from European food preparation practices. Cooking was done in great fireplaces, with equipment designed to fit. Meat was generally boiled or stewed in pots hung in the fireplace, although it might be slow-roasted on a hand-turned spit. Hot breads, the hallmark of southern cooking, date from colonial days. In the Noth, the Dutch farmer's wife developed real skill in using flour from home-grown wheat and rye, creating pancakes, waffles, doughnuts, crullers, and so on. After the first hard winter, food in New England became more plentiful. Boston brown bread was made from corn, wheat, or rye and probably sweetened with maple sirup. Imports of coffee, tea, and spices from the Orient and fruit from the tropics were later added to the cuisine. Colonial Americans understood well the art of food preparation and appreciated the taste of well prepared, well seasoned dishes.

Beverages

The Aymara of Western Bolivia. II. Maxillofacial and dental arch variation.

Maxillofacial and dental arch dimensions of the Bolivian Aymara population are age and sex dependent. Interpopulational comparisons reveal these dimensions to differ from those seen in Aleuts, Australian aborigines, and Swedes, but to be similar to those of the indigenous Taiwanese. Finally, these dimensions are not the same in Aymara of unmixed ancestry, and Mestizos residing in the same villages.

Adolescent

Mitochondrial DNA diversity in Ecuadorian populations: Recurrence of variant 16136 within haplogroup B2.

The identification of lineage-defining variants, frequently found in the coding region of mitochondrial DNA (mtDNA), is essential for refining haplogroup classification. Most mtDNA studies in South American populations have focused on the control region (CR), which has provided important insights into population structure and maternal lineage origins, although information needed for more robust phylogenetic resolution has been neglected. This study investigates the maternal genetic structure of Ecuadorian populations by combining CR and whole mitogenome analyses. Sequences from the mtDNA CR were obtained from 461 individuals (253 Mestizos and 208 Native Americans), while complete mitogenomes were sequenced for 127 individuals to improve phylogenetic resolution by identifying lineage-defining variants present in coding region. Most mtDNA haplogroups in the two population groups analyzed were of Native American origin (A2, B2, B4, C1, D1, D4), with significant differences in the distribution of specific lineages between them. Among Mestizos, African haplogroups (all within the L branches) and Eurasian haplogroups (H, K, R, U) were detected at low frequencies, whereas no African lineages were observed among Native Americans. The results obtained highlighted a heterogeneity within Ecuadorian populations that must be considered when developing mtDNA haplotype databases for forensic purposes. Whole mitogenome sequences enabled the identification of variants that refined haplogroup classifications, provided a more accurate reconstruction of the maternal genetic diversity, and improve the discrimination between Native American and Asian maternal lineages within haplogroup B4b.

Humans

Non-specific ileojejunitis in Arequipa, Peru.

Non-specific ileojejunitis, characterised by mild to moderate structural changes in the intestinal mucosa and often associated with asymptomatic malabsorption, is known to occur in the tropics and in countries with hot climates. This acquired condition is probably related to environmental factors, and some consider it to be a subclinical form of tropical sprue. Changes in the intestinal mucosa typical of non-specific ileojejunitis were found in 10 indigenous Indians as well as 5 people of Latin stock living in the Southern Peruvian sierra, where tropical sprue has not as yet been demonstrated and which has a temperate climate.

Adolescent

Hallucinogenic plant use and related indigenous belief systems in the Ecuadorian Amazon.

This review article focuses on the on-going use of plant hallucinogens, especially various Banisteriopsis species, among contemporary aboriginal populations of Ecuador. It surveys the evidence of prehistoric ayahuasca use by interpretations of Ecuadorian archaeological remains, and surveys in detail the use and belief systems connected to major plant hallucinogenic use among the Jibaro Indians and other tribal groups. A secondary theme includes coastal and Inter-Adnean aboriginal drug use. The article stresses the interrelatedness of aboriginal belief systems, folk medicine and world view linked to plant hallucinogenic ingestion.

Ecuador