Background: The incidence of diabetes is increasing faster in Native American adolescents than other age groups. Insulin resistance is known to precede diabetes and lifestyle changes can improve future risk of diabetes in individuals with insulin resistance, so identifying those at risk may be important to prevention of disease. The purpose of the study is to: 1) Determine prevalence of diabetes, and impaired glucose tolerance; 2) Identify which factors best predict insulin resistance, including life stresses; and 3) Determine if cultural affiliation reduces insulin resistance.

Update: We have screened 47 youth, ages 5-18 years (27 boys and 20 girls). Below are some preliminary findings:

• Average body mass index percentile for age and sex is 75%. In this group, 43% are "at risk" and 17% are considered "overweight." (The Centers for Disease Control suggest that all youth above the 85% for their age are at risk for being overweight and above 95% are overweight.)
• 4% have elevated blood pressure. (Blood pressure above 90% for their age is considered elevated.)
• 11% had acanthosis nigricans. (AN is sometimes used as a marker of insulin resistance.)
• 6% had elevated triglycerides >150 mg/dl. (High triglycerides accompanies insulin resistance.)
• 8% have small quantities of albumin in the urine. (Albumin in urine is used to identify risk of vascular disease or future kidney disease in individuals with diabetes, but has also been observed in individuals with insulin resistance. We are repeating those to be sure they were not caused by a recent infection, but thismay be another way to identify individuals at risk.)
• 12% have a HOMA-IR score >4. (HOMA-IR is a mathematical representation of insulin resistance based on fasting glucose and insulin.)
• Importantly, no one screened has been found to have diabetes suggesting that current screening methods are effective in identifying children and youth with diabetes.

Background: Screening for asthma in children has been reported to be feasible and cost-effective in selected populations, but has not been studied among AI/AN children. The overall purpose of this pilot study is to test the feasibility and utility of conducting an asthma screening program. The specific aims for this study are to: 1) Determine the proportion of children not previously diagnosed with asthma who meet diagnostic criteria for asthma; 2) Determine the proportion of children previously diagnosed with asthma whose treatment plan is not appropriate for their level of severity; and 3) Assess children who have risk factors for asthma, but who do not meet the diagnostic criteria for asthma.

Update: In September, focus groups were conducted in Pine Ridge to obtain feedback from community members and tribal leaders on how best to conduct the screening in their community. Suggestions included meeting with parents about the study during parents night and parent-teacher conferences, raising awareness about asthma screenings in the community, and determining how to be equitable in the selection of who will be screened (considering the size of the reservation). The actual screenings will begin in January 2006. At the Spirit Lake Tribe, focus groups have been conducted and the results are being compiled. In addition, the PI and RAs presented at an Asthma Conference in October to showcase the project.

The purpose of this scholarship is to help support American Indian and Alaska Native (AI/AN) students pursue an education in the health field. This scholarship is intended for students seeking a degree in a health-related area or for individuals currently working in tribal health and pursuing general education.

The scholarship may be applied to tuition, books, and living expenses. Funds will be provided directly to the students. Recipients are responsible for any applicable tax.

Scholarship amount: $1,500

Who is eligible:

• Any American Indian or Alaska Native student who is enrolled in an undergraduate or graduate program, preferably in a health-related field.
• Students must be enrolled in a minimum of two courses (typically 6 credits).
• Priority will be given to members of tribes in North Dakota, South Dakota, Nebraska, or Iowa.
• Priority will be given to students enrolled in a health-related field. Students not enrolled in health-related field, but working towards a degree that will serve them in their health careers should explain this link in their statement.

Number of available scholarships: Approximately 20 scholarships are available in 2007. Depending on availability, those who are awarded scholarships in Winter or Spring may be eligible for another round of funding later in the academic year, pending grades.

Scholarship Application Process and Requirements:

• Applications must be received by March 1, 2008
• Application Form
• Copy of tribal ID or proof of enrollment
• Copy of transcript(s) (unofficial transcripts accepted)
• Resume or Curriculum Vitae
• Statement of Need: Explain how this scholarship will help you to pursue your goals in the health-related field. If the degree that you are seeking is not directly health-related but will serve you in your health career (this may be most applicable at the undergraduate level), please explain how your education will support your work. Provide details of your past experiences and future goals to show your commitment in completing your degree and in working to improve the health of AI/ANs (250 word maximum).

Award notification will be made before April 2008.

Applications should be mailed to:
Aberdeen Area Tribal Chairmen’s Health Board
Attn: DeAnne Swan, NARCH Assistant
1770 Rand Road
Rapid City , South Dakota 57702

June 11-29, 2008 Portland, Oregon. Registration due May 15, 2008. The curriculum is designed to meet the needs of professionals who work in diverse areas of AI/AN health.

For additional information contact: Luella Azule, Northwest Portland Area Indian Health Board, 527 SW Hall Street, Suite 300, Portland, Oregon, 97201;(503) 228-4185; e-mail summerinstitute@npaih.org or visit www.ohsu.edu/summer-institute

Background: The purpose of this study is to determine if the assessments used in the clinical setting accurately measure depression, anxiety, Post Traumatic Stress Disorder (PTSD), and suicidal ideation among American Indians in North and South Dakota. These assessments are commonly used in clinical settings among American Indians as well as for the general population, but have never been examined to determine whether they are effective in the American Indian population. The project will use RPMS data to compare diagnosed depressed, diagnosed anxious and post-traumatic stress disorder, and controls with no mental health diagnosis (both men and women).

Update: The project began as of September 15, 2006. Work is underway to obtain the necessary tribal, IHS, and IRB approvals.