Background: When conducting research with American Indian tribes, informed consent beyond conventional institutional review board (IRB) review is needed because of the potential for adverse consequences at a community or governmental level that are unrecognized by academic researchers.Objectives: In this article, we review sovereignty, research ethics, and data-sharing considerations when doing community-based participatory health–related or natural-resource–related research with American Indian nations and present a model material and data-sharing agreement that meets tribal and university requirements.Discussion: Only tribal nations themselves can identify potential adverse outcomes, and they can do this only if they understand the assumptions and methods of the proposed research. Tribes must be truly equal partners in study design, data collection, interpretation, and publication. Advances in protection of intellectual property rights (IPR) are also applicable to IRB reviews, as are principles of sovereignty and indigenous rights, all of which affect data ownership and control.Conclusions: Academic researchers engaged in tribal projects should become familiar with all three areas: sovereignty, ethics and informed consent, and IPR. We recommend developing an agreement with tribal partners that reflects both health-related IRB and natural-resource–related IPR considerations.

We examined the chemical composition of extracellular polymeric substances (EPS) extracted from two natural microbial pellicle biofilms growing on acid mine drainage (AMD) solutions. The EPS obtained from a mid-developmental-stage biofilm (DS1) and a mature biofilm (DS2) were qualitatively and quantitatively compared. More than twice as much EPS was derived from DS2 as from DS1 (approximately 340 and 150 mg of EPS per g [dry weight] for DS2 and DS1, respectively). Composition analyses indicated the presence of carbohydrates, metals, proteins, and minor quantities of DNA and lipids, although the relative concentrations of these components were different for the two EPS samples. EPS from DS2 contained higher concentrations of metals and carbohydrates than EPS from DS1. Fe was the most abundant metal in both samples, accounting for about 73% of the total metal content, followed by Al, Mg, and Zn. The relative concentration profile for these metals resembled that for the AMD solution in which the biofilms grew, except for Si, Mn, and Co. Glycosyl composition analysis indicated that both EPS samples were composed primarily of galactose, glucose, heptose, rhamnose, and mannose, while the relative amounts of individual sugars were substantially different in DS1 and DS2. Additionally, carbohydrate linkage analysis revealed multiply linked heptose, galactose, glucose, mannose, and rhamnose, with some of the glucose in a 4-linked form. These results indicate that the biochemical composition of the EPS from these acidic biofilms is dependent on maturity and is controlled by the microbial communities, as well as the local geochemical environment.

This paper discusses a study of four communities in Oregon that were divided into two control groups and surveyed according to water contamination problems and how their perceptions of risk affected their use of tap water versus bottled water. Results indicated that risk perception about drinking water appears to be affected by three factors: the consumer's level of awareness of a problem; the presence or absence of drinking water contamination problems; and, the chronicity of the problem. Findings suggest that water contamination problems contribute to increased levels of risk perception with those drinking tap water. Also, long‐term problems that are not easily solved by the water utility may heighten consumers' perception of risk. Higher levels of risk perception may be the driving force behind higher rates of bottled water use in some communities.

Purpose Breast and cervical cancer-mortality disparities are prominent among American Indian women. These disparities, in part, may result from patients perceived experiences of discrimination in health care. This report evaluates the impact of perceived discrimination on screening for breast and cervical cancer in a sample of 200 American Indian women with type 2 diabetes. Methods Data were collected from patient report and medical records. Prevalence of breast and cervical cancer screening were assessed. Unadjusted and adjusted logistic regression analyses were used to assess associations between perceived discrimination, cancer screening status, and patients' health care-seeking behaviors. Findings Substantial proportions of AI women in our sample were behind the recommended schedules of screening for breast and cervical cancer. Adjusted estimates revealed that perceived discrimination was significantly associated with not being current for clinical breast examination and Pap test, and was close to statistical significance with not being current for mammography. The number of suboptimal health care-seeking behaviors increased with higher mean levels of perceived discrimination. Conclusions Among AI women, perceived discrimination in health care may negatively influence use of breast and cancer screening services, and health care-seeking behaviors. More research is needed among AIs to examine features of health care systems related to the phenomenon patients perceived experience of discrimination.

This research examines the acceptability of solar disinfection of drinking water (SODIS) in a village in Kathmandu Valley, Nepal, using constructs from the Health Belief Model as a framework to identify local understandings of water, sanitation and health issues. There has been no published research on the acceptability of SODIS in household testing in Nepal. Understanding the context of water and water purity in Nepalese villages is essential to identify culturally appropriate interventions to improve the quality of drinking water and health. Forty households from the village census list were randomly selected and the senior woman in each household was asked to participate. Baseline data on water sources and behaviors were collected in March 2002, followed by training in SODIS. Follow-up data were collected in June and July 2002. Only 9% of households routinely adopted SODIS. Participants mentioned the benefit of treating water to reduce stomach ailments, but this did not outweigh the perceived barriers of heavy domestic and agricultural workloads, other cultural barriers, uncertainty about the necessity of treating the water, and lack of knowledge that untreated drinking water causes diarrhea. Strategies for developing safe water systems must include public health education about waterborne diseases, source water protection, and a motivational component to achieve implementation and sustained use. In addition, other options for disinfecting water should be provided, given the women's work constraints and low level of formal education.