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Hereditary polymorphic light eruption of American Indians: occurrence in non-Indians with polymorphic light eruption.

BACKGROUND: Hereditary polymorphic light eruption (HPLE) occurs unique ly in the American Indian and Inuit and exhibits autosomal dominant transmission. Because the cutaneous expression of HPLE resembles that of polymorphic light eruption (PLE) and because many non-Indians in the United States have American Indian heritage, some instances of PLE may actually be HPLE. OBJECTIVE: Our purpose was to determine whether non-Indian patients with PLE have characteristics suggestive of HPLE. METHODS: We surveyed in Nebraska 25 European-Caucasian and 36 African-American patients with PLE for American Indian heritage and photosensitive relatives. Nonphotosensitive subjects (52 Caucasians and 40 African Americans) were surveyed for American Indian heritage. RESULTS: American Indian heritage occurred in 11 Caucasian patients (44%); of those, seven (64%) had photosensitive relatives. Likewise, 29 African Americans (81%) had American Indian heritage; 19 (66%) of those had photosensitive relatives. American Indian heritage occurred in 10 Caucasian control subjects (19%) and in 34 African-American control subjects (85%). CONCLUSION: If American Indian heritage and a family history of photosensitivity are definitive for HPLE, seven (28%) of our Caucasian patients and 19 (53%) of our African-American patients have HPLE rather than PLE. We urge physicians who suspect PLE in non-Indians to ask about American Indian heritage and photosensitive relatives and to screen their present patients with PLE for such characteristics.

Adolescent↗

An HLA class-II allele frequent in Eskimos and Amerindians is found in the Tyrolean Ice Man.

DNA was extracted from specimens derived from the calcaneus of the Tyrolean Ice Man under sterile conditions in a laboratory, where no DNA extractions and PCR experiments had been performed before. Agarose gel electrophoresis and ethidium bromide staining did not reveal any evidence of genomic DNA in the preparation obtained, indicating a high degree of DNA degradation. Nevertheless, we performed PCR amplifications with this sample using primer pairs specific for HLA class II alleles. HLA-DRB and DQB1 alleles were amplified in a nested PCR approach. In one of the reactions, we observed a distinct amplification product, which we directly sequenced. By comparing the obtained nucleotide sequence with a database of HLA alleles we assigned the HLA-DRB1*1402 type to the amplified sample. None of the investigators involved possesses this allele, indicating that no contamination with modern DNA had occurred. The HLA-DRB1*1402 allele is extremely rare in Europe, but is common in Inuits and South American Indians and has previously only once been identified in the laboratory.

Alleles↗

Early passive acquisition in Inuktitut.

Passive structures are typically assumed to be one of the later acquired constructions in child language. English-speaking children have been shown to produce and comprehend their first simple passive structures productively by about age four and to master more complex structures by about age nine. Recent crosslinguistic data have shown that this pattern may not hold across languages of varying structures. This paper presents data from four Inuit children aged 2;0 to 3;6 that shows relatively early acquisition of both simple and complex forms of the passive. Within this age range children are productively producing truncated, full, action and experiential passives. Some possible reasons for this precociousness are explored including adult input and language structure.

Adult↗

Space-time clustering of nasopharyngeal carcinoma in Greenland Eskimos.

Evidence of epidemicity of nasopharyngeal carcinoma (NPC) was sought in Greenland Inuits, who have a high incidence of this cancer, by examining the births of NPC cases for evidence of clustering in time and space. Births of cases were concentrated in autumn and winter. Fifty-four cases were analysed, and a two-fold excess of clustering within one year was observed, both within single districts and between adjacent districts. This excess was not significant at the 5% level; about 90 cases would have been required to confirm the observed effect at this level of significance. It is suggested that a search for space-time clustering of NPC cases in larger high-risk populations might prove more fruitful.

Age Factors↗

Blondes, lost and found: representations of genes, identity, and history.

Research carried out during recent decades has revealed our genome not only to be a unique mine of information about health, disease and the human condition, but also about the origin and dispersal history of the species. In this context, the genome is simply an additional source of information about human history, epistemologically no different from other historical sources. However, media and public interpretation of genetic studies of human history are complicated by the wider connotations of genes as the determinants of hereditary features and identity. We discuss two examples of media and public fascination with the interrelated themes of history, identity and heredity, pointing out some implications of historical research using genetic data in the context of our own ongoing study of Inuit groups in Greenland and Victoria Island, Canada.

Arctic Regions↗

Chronic disease coverage in Canadian aboriginal newspapers.

PURPOSE: To determine the volume and focus of articles on four chronic diseases in newspapers targeting First Nations, Métis, and Inuit in Canada. METHODS: From a sampling frame of 31 Aboriginal newspapers published in English from 1996-2000, 14 newspapers were randomly selected allowing for national and regional representation. Newspaper archives were searched at the National Library of Canada and articles selected if the disease terms cancer, cardiovascular disease, diabetes, or HIV/AIDS appeared in the headline, or in the first or last paragraph of the article. Articles were coded for inclusion of mobilizing information (local, distant, unrestricted, not specified, none) and content focus (scientific, human interest, commercial, other). Cancer articles were categorized by tumor site specificity. Data were analyzed by frequency, cross tabulations, and chi-square analysis. RESULTS: Of 400 chronic disease articles, there were significantly more articles on HIV/AIDS (167 or 41.8%) and diabetes (135 or 33.8%) and few articles on cancer (56 or 14%) and cardiovascular disease (30 articles or 7.5%) (p<0.001). Slightly more than one third (36.5%) of the articles contained mobilizing information to enable readers to take further health action. Mobilizing information was virtually absent from cardiovascular (7/30 or 23%) and diabetes (29/135 or 21.5%) articles. Site specific cancer coverage differed significantly from chance (p<0.001) with 41% of the articles on breast cancer and no articles on lung or colorectal cancers. INTERPRETATION: Given the burden of tobacco-related cardiovascular disease and cancer in Canadian Aboriginal people, the lack of coverage and limited mobilizing information in ethnic newspapers are a missed opportunity for health promotion.

Bibliometrics↗

Suicide--a challenge in modern Greenland.

The incidence of youth suicides has increased dramatically among the Inuit in Greenland since the modernization started in the 1950s. Suicides currently peak at age 15-24 Men: 400-500, Women: 100-150 per 100,000 person-years. The methods are drastic: shooting or hanging. An early peak was seen in the capital, a later peak in the rest of West Greenland, and high and increasing rates in remote East Greenland. Suicidal thoughts occur more often in young people who grew up in homes with a poor emotional environment, alcohol problems and violence. There is a definite correlation with several aspects of the modernization process but it is hard to pinpoint causal relationships. It is rather the "modernization package" that should be regarded as risk factors for suicides.

Adolescent↗

Epidemiologic studies of PCB congener profiles in North American fish consuming populations.

Long range atmospheric and stream transport and oceanic currents drive the ecologic process of PCB deposition in the abiotic environment. In contrast short range transport via bioaccumulation-biomagnification up the food chain determines PCB congener profiles and concentrations and their adverse effects in biological organisms. Two research approaches to congeners, with potential to associate specific adverse human health effects with PCB concentrations in indigenous small populations, are summarized in this study. The field epidemiological approach includes giving questionnaires to target population groups in conjunction with sampling for PCBs (and selected persistent organic pollutants and metals), in foods purchased or hunted and collected by Inuit peoples. Direct determination of contaminant levels in food sources and among individuals in selected comparative subpopulations is also presented.

Animals↗

A method for estimating the intensity of overdominant selection from the distribution of allele frequencies.

A method is proposed for estimating the intensity of overdominant selection scaled by the effective population size, S = 2Ns, from allele frequencies. The method is based on the assumption that, with strong overdominant selection, allele frequencies are nearly at their deterministic equilibrium values and that, to a first approximation, deviations depend only on S. Simulations verify that reasonably accurate estimates of S can be obtained for realistic sample sizes. The method is applied to data from several loci in the major histocompatibility complex (Mhc) in numerous human populations. For alleles distinguished by both serological typing and the sequence of the peptide-binding region, our estimates of S are comparable to those obtained by analysis of DNA sequences in showing that selection is strongest on HLA-B and weaker on HLA-A, HLA-DRB1, and HLA-DQA1. The intensity of selection on HLA-B varied considerably among populations. Two populations, Native American and Inuit, showed an excess rather than a deficiency in homozygosity. Comparable estimates of S were obtained for alleles at Mhc class II loci distinguished by serological reactions (serotyping) and by differences in the amino acid sequences of the peptide-binding region (molecular typing). A comparison of two types of data for DQA1 and DRB1 showed that serotyping led to generally lower estimates of S.

Algorithms↗

Serotyping for MLC gene products: I. Presumptive evidence that ABCIL may detect MLC factors.

Serum from a grand multiparous Inuit (Eskimo) woman, who is HL-A identical but stimulatory in MLC with cells of her husband, contains strong ABCIL reactivity. This serum is operationally monospecific against a cell membrane determinant on lymphocytes, but not platelets, of some unrelated persons. Cells of those who are ABCIL positive with this serum always give a lower MLC stimulation index compared with their MLC responsiveness to cells that are ABCIL negative. This serum also contains good MLC inhibitory activity but only in those one way MLC reactions in which it reacts, by ABCIL, with the stimulating cells. It is postulated that the ABCIL activity is directed against a common MLC factor on lymphocytes.

Antigen-Antibody Reactions↗

Seroprevalence and risk factors for Helicobacter pylori infection in Greenlanders.

BACKGROUND: In contrast to most populations worldwide, the incidence of gastric cancer increases among Inuit in Greenland. Contributing factors to this increase are unknown, but Helicobacter pylori may be involved. However, little is known regarding the epidemiology of H. pylori in Arctic communities. With the aim of determining age-specific prevalence, risk factors, and association with clinical conditions of H. pylori infection, we carried out a population-based study of H. pylori in Sisimiut, the second biggest town of Greenland. MATERIALS AND METHODS: A population-based sample of 685 persons had serum drawn that was analyzed for H. pylori IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Risk factors analyses were carried out using multivariate logistic regression models. RESULTS: The seroprevalence was lowest among children aged 0-4 years (6%), but increased rapidly thereafter. In persons aged 15-87 years the seroprevalence had stabilized around 58%. Total number of children in household, number of older, but not younger, siblings and narrow age gap to closest older sibling were associated with H. pylori seropositivity. In contrast, number of adults in household and socioeconomic status did not influence serostatus. CONCLUSIONS: The age-specific prevalence pattern in Greenland is intermediate between that of developing and developed countries. The risk factor pattern indicates crowding and older siblings in particular to be key elements in risk of infection.

Adolescent↗

Helicobacter pylori in the Canadian arctic: seroprevalence and detection in community water samples.

OBJECTIVE: Many North American arctic communities are characterized by risk markers associated with Helicobacter pylori (H. pylori) infection, including overcrowded housing and inadequate water supply and sanitation systems. Our aim was to determine the seroprevalence of H. pylori infection in two traditional Inuit communities in the central Canadian arctic and to test for the presence of H. pylori, by polymerase chain reaction (PCR), in local water supplies. METHODS: Samples of venous whole blood from adults and capillary blood from children were collected and analyzed by enzyme immunoassay and Helisal Rapid Test, respectively, for IgG antibody to H. pylori. Antibodies to CagA were detected by enzyme immunoassay, and ABO and Lewis antigens were also determined. Demographic and clinical information were collected by questionnaire. Water samples from each community were tested for H. pylori by PCR. RESULTS: One hundred-thirty (50.8%) of 256 subjects from the two communities were positive for H. pylori IgG antibodies. Seropositive subjects were more likely to be male, compared with seronegative individuals (p = 0.01). Antibody status did not differ with respect to age, community, alcohol or cigarette use, number of persons per household, gastrointestinal complaints or previous investigations, medications, or presence of blood group O, Lewis a-b+. CagA antibodies were detected in 78 (61.9%) of 126 H. pylori-seropositive subjects tested; however, 41 (35.3%) of 116 H. pylori-seronegative subjects were also CagA positive. Water samples taken from the water delivery truck in Chesterfield Inlet and two lakes near Repulse Bay were positive for H. pylori. CONCLUSION: The seroprevalence of H. pylori in the study group was higher than rates in southern Canadian populations, but lower than the seroprevalence previously documented in a Canadian subarctic Indian (First Nations) community. The detection of H. pylori in local water supplies may indicate a natural reservoir for the organism or possible contamination from human sewage.

ABO Blood-Group System↗

Developing management information from an administrative database of dental services: identifying factors that influence costs.

OBJECTIVE: We describe service patterns and compare changes in program expenditures with the Consumer Price Index over eight years in a dental program with a controlled-fee schedule offered to Canadian First Nations and Inuit people. METHODS: We obtained the computerized records of dental services for the period from 1994 to 2001. Each record identified the date and type of service, region and type of provider, age of the client and encrypted identifying information on clients, bands, and providers. We classified the individual services into related types (diagnostic, preventive, etc.). We aggregated the records by client and developed indices for the numbers of clients, mean numbers of services per client, cost per service, and prices. FINDINGS: Over the 8 years, 16.0 million procedures, totaling 811.8 million dollars, were provided to 538,034 different individuals, approximately 76% of the eligible population. Restorative procedures accounted for 36% of all expenditures followed by diagnostic (12.7%), preventive (12.2%), and orthodontic (8.9%) services. For much of the period, increases in program expenditures were exceeded by increases in the Consumer Price Index. This was consistent with fewer services per client, a less expensive mix of services, and relatively flat prices. However, in 2000 and 2001 higher prices and more clients resulted in increasing expenditures. CONCLUSIONS: Program expenditures were influenced by different factors over the study period. In the final two years, increasing expenditures were driven by price increases and increasing numbers of clients, but not by increasing numbers of services per client, nor a 'richer' mix of services.

Canada↗

Review of research on aboriginal populations in Canada: relevance to their health needs.

OBJECTIVE: To determine if research has adequately examined the health needs of the aboriginal population of Canada. DESIGN: Review. STUDY SELECTION: Medline search of journal articles published during 1992-2001. The search terms used were "Canada" and various synonyms and categories for Canadian aboriginal people. Each paper was categorised according to the aboriginal group, age-sex group, comparison group, geographic location, and type of research topic (health determinant, health status, or health care). RESULTS: Of 352 citations found, 254 were selected after elimination of those without abstracts, not containing data on Canada, or not focusing on health issues. The proportion of papers does not reflect the demographic composition of aboriginal people in Canada, with severe under-representation of Métis, urban aboriginal people, and First Nations people not living on reserves and over-representation of the Inuit. Children and women received less attention proportional to their share of the population. A few prolific research groups have generated a disproportionate amount of publications from a few communities and regions. 174 papers dealt with health determinants (for example, genetics, diet, and contaminants), 173 with health status, and 75 with health care. Injuries, which account for a third of all deaths, were studied in only 8 papers. None of the health care papers examined rehabilitation. CONCLUSION: Researchers have not adequately examined several important health needs of the aboriginal population.

Canada↗

Current status of nutritional deficiencies in Canadian aboriginal people.

Since the Nutrition Canada Survey (1973) there has been clear evidence that Aboriginal people have low intakes of many nutrients such as iron, vitamin D, calcium, folate, vitamin A, and fluoride. Recent surveys suggest that the situation has not changed. Children are most likely to be affected clinically. More than half of Aboriginal children in some subpopulations in Manitoba suffer a period of iron deficiency, which may affect development. Nutritional rickets is still a common problem in Manitoba. We have seen cases of megaloblastic anemia due to folate deficiency. The relationship of the well-described low folate intake in pregnancy and birth defects has received no attention for the Aboriginal population. In a recent survey of Inuit children, dental caries of the primary teeth were present in over 70% of children, with a mean DMF (decayed, missing, and filled) index of 1.8 teeth in children under 2 and 9.5 in children 6 to 8 years. Although clinical vitamin A deficiency is not seen, there is now good evidence that subclinical deficiency increases susceptibility to infections. Although not all Aboriginal populations suffer all of these deficiencies, the problems are sufficiently widespread to suggest this is an urgent problem. It will not be solved simply by education. There must be a political will and a coordinated effort to make a balanced diet available to all at an affordable cost.

Avitaminosis↗

Tuberculosis in aboriginal Canadians.

Endemic tuberculosis (TB) was almost certainly present in Canadian aboriginal people (aboriginal Canadians denotes status Indians, Inuit, nonstatus Indians and metis as reported by Statistics Canada) before the Old World traders arrived. However, the social changes that resulted from contact with these traders created the conditions that converted endemic TB into epidemic TB. The incidence of TB varied inversely with the time interval from this cultural collision, which began on the east coast in the 16th century and ended in the Northern Territories in the 20th century. This relatively recent epidemic explains why the disease is more frequent in aboriginal children than in Canadian-born nonaboriginal people. Treatment plans must account for the socioeconomic conditions and cultural characteristics of the aboriginal people, especially healing models and language. Prevention includes bacillus Calmette-Guerin vaccination and chemoprophylaxis, and must account for community conditions, such as rates of suicide, which have exceeded the rate of TB. The control of TB requires a centralized program with specifically directed funding. It must include a program that works in partnership with aboriginal communities.

Antitubercular Agents↗

Perinatal vitamin A (retinol) status of northern Canadian mothers and their infants.

Vitamin A (retinol) status was determined in two groups living in the northern part of Canada: native (Indian and Inuit) and non-native (Caucasian). The dietary intake of vitamin A and its plasma concentration were measured prenatally, at delivery and postnatally in mothers. Plasma concentrations were also measured at birth and postnatally in their infants. The mean vitamin A intake of native mothers was significantly lower than that of non-native mothers, 661 +/- 485 versus 1,377 +/- 1,418 retinol equivalents (p < 0.00005), with a higher risk of deficiency without supplementation, 35% versus 8%. Plasma retinol concentrations, although not in the deficient range, were significantly lower in native than non-native mothers prenatally and postnatally. Infant mean plasma retinol concentrations at birth averaged only 52% of those of their mothers and were significantly lower among native than non-native infants although no clinical evidence of vitamin A deficiency was noted. We speculate that vitamin A supplementation in native Northern Canadian mothers during pregnancy and in their neonates during infancy may have a role to play in the prevention of vitamin A deficiency. We also postulate that plasma retinol concentrations of 50-60% of maternal levels and between 0.7 and 2.5 mumol/l represent a 'normal' range for newborn infants.

Canada↗

The mental health of Aboriginal peoples: transformations of identity and community.

This paper reviews some recent research on the mental health of the First Nations, Inuit, and Métis of Canada. We summarize evidence for the social origins of mental health problems and illustrate the ongoing responses of individuals and communities to the legacy of colonization. Cultural discontinuity and oppression have been linked to high rates of depression, alcoholism, suicide, and violence in many communities, with the greatest impact on youth. Despite these challenges, many communities have done well, and research is needed to identify the factors that promote wellness. Cultural psychiatry can contribute to rethinking mental health services and health promotion for indigenous populations and communities.

Anthropology, Cultural↗