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PubMedDate not supplied

Self-inflicted gunshot wounds among Alaska Natives.

Deaths by violence (accidents, homicide, suicide) have increased significantly among Alaska Natives who have a suicide rate three times that of the general U.S. population. Self-inflicted gunshot wounds comprised 75 percent of the suicides among Alaska Natives from 1976 through 1980. A review of psychiatric consultations concerning 34 Alaska Natives who had survived a self-inflicted gunshot wound indicated some common characteristics. Of the group, 28 were male, and 20 had been using alcohol at the time of the shooting. Interpersonal conflicts were cited by most persons as partial motivation for the shooting, and most shootings were impulsive rather than premeditated. Few patients had a psychiatric history or appeared impaired at the time of the consultation. Cultural and intrapsychic factors that might contribute to this high rate of self-destructive behavior were examined. These include a proscription against verbal expression of negative affect and an increase of non-Native influences with subsequent social disorganization and cultural conflict.

Accidents↗
PubMedDate not supplied

Benzene in Alaska.

Alaska Department of Environmental Conservation took indoor and ambient air samples during the winter of 1992-93 in Fairbanks. The samples showed a significant increase in the level of benzene in the air between December and February. The highest levels occurred in indoor air and exceeded workplace standards in garages. These findings were corroborated by NIOSH and OSHA personal monitoring studies done at the same time in Fairbanks and by blood samples taken by Centers for Disease Control and Prevention from workers exposed to gasoline in December and February. The blood samples showed a 300 percent increase in the amount of benzene in worker's blood after MTBE was taken out of gasoline. The most likely cause of this air pollution is gasoline evaporation and exhaust emissions. The benzene content of Alaska gasoline is 5 percent which is the highest in the nation. In view of these findings the Environmental Protection Agency is funding a new study of indoor air organic compounds including benzene in Anchorage, Alaska.

Air Pollution↗
PubMedDate not supplied

Health effects of methyl tertiary butyl ether (MTBE) in gasoline in Alaska.

OBJECTIVES: This ecologic study assessed whether there was a change in health status in Alaska in the winter of 1992-93 after the introduction of MTBE in gasoline. Methyl tertiary butyl ether(MTBE) is used as a fuel oxygenate in the United States and in Europe. In the winter of 1992-93 MTBE was added to gasoline in the cities of Fairbanks and Anchorage, Alaska. The program was discontinued in Fairbanks in December, 1992, but continued in Anchorage until February 28, 1993. METHODS: Outpatient visits for state employees and dependents (n = approximately 28,000) living in Alaska were compared over three winters by analyzing health insurance claims. RESULTS: Odds ratios were calculated. The odds ratios indicated that the winter of 92-93 was not statistically different from previous winters in numbers of claims for upper respiratory illness, bronchitis, headache, or asthma in either Anchorage or Fairbanks. CONCLUSION: There was no increase in claims for respiratory illness in either city after introduction of MTBE.

Air Pollutants↗
PubMed1996

Cervical cancer screening on the Yukon-Kuskokwim Delta, Southwest Alaska. A population-based study.

BACKGROUND: Alaska Native women suffer excess morbidity and mortality due to cervical cancer. This population-based study analyzed data from a regional Pap smear registry to describe the 2-year prevalence of cervical cancer screening for the women who live in remotely located villages in the Yukon-Kuskokwim Delta region. METHODS: All women older than 18 years of age who lived in one of the villages of the Yukon-Kuskokwim Delta were included (n = 6916). A 2-year Pap prevalence rate for each village was estimated by counting the number of women who had at least one Pap smear between September 1, 1992, and August 31, 1994, using the computer-based Pap registry located at the regional medical center in Bethel, Alaska. Population estimates for each village were obtained from a database maintained by the local office of the State of Alaska's Public Health Nurses. RESULTS: The overall 2-year Pap prevalence rate for the population was 62%. By age group, 2-year prevalence rates were as follows: women 18 to 44 years, 64%; women 45 to 64 years, 58%; and women 65 years and older, 52%. CONCLUSION: This study demonstrated that there is a significant need to improve access to and use of cervical cancer screening in this region to achieve national and state objectives. Village-based clinic staff are underutilized for cancer prevention service delivery; with additional training and supervision, staff members may serve as a means to improve this preventive health care service.

Adolescent↗
PubMed1996

Nutrition and cancer among American Indians and Alaska Natives.

BACKGROUND: More than a third of all cancers in the United States are thought to be attributable to various nutritional factors, and major changes in nutrition have been experienced by American Indians and Alaska Natives in the past century. METHODS: The published literature was reviewed to summarize the relationship between diet and cancer, to summarize what is known about the past and current diet of American Indians and Alaska Natives, and to consider whether nutrition might play a role in their current or future risk of cancer. RESULTS: Epidemiologic studies show a consistent pattern of lower risk for cancers of the colon and lung among those who eat larger amounts of fruits and vegetables and higher risk for cancers of the colon and prostate for those who eat larger amounts of fat. Limited data indicate that the diets of American Indians and Alaska natives are similar to the current average American diet, that is, high in fat and low in fruits and vegetables. CONCLUSIONS: Diet is an important factor for several major cancers. Although the cancer rates among many Native American groups are currently lower than among non-native Americans, they seem to be increasing. Cancer rates among Native Alaskans are already much higher than for non-native Americans. Nutrition-related cancers are likely to increase in the future among Native Americans as a result of past changes in diet. However, Native Americans may have a stronger cultural basis than do non-native Americans to adopt traditional principles of the value of good foods and physical activity to achieve future nutritional improvements to reduce cancer risk.

Alaska↗
PubMed1997

Geographic distribution, supply, and need for generalist physicians in Alaska.

This study provides the first comprehensive description of Alaska's geographic distribution of generalist physicians relative to population. All 443 generalist care physicians (family, general, general internal medicine, and pediatric) or their office managers were questioned about their specialties, ZIP codes, employers, populations served, and hours spent per week offering direct patient care. The results indicated a 30% overall shortage of generalist physicians for the state, representing roughly 141 full-time-equivalent generalists relative to national practice patterns and trends of health maintenance organizations. Of 17 primary health care areas, including the Anchorage area, 15 showed a need for additional generalist physicians. Most areas had a 20 to 40% shortage. Concerns about transportation and financial barriers to access to care, especially in remote regions, were raised. Other needs emphasized included knowledge of contributions of midlevel health care professionals, Alaska Native versus non-Native care, efforts to train and retain physicians in Alaska, and the need for longitudinal tracking of practice patterns.

Alaska↗
PubMed1998

Deaths associated with occupational diving--Alaska, 1990-1997.

During 1989-1997, the Occupational Safety and Health Administration (OSHA) recorded 116 occupational diving fatalities in the United States (OSHA, unpublished data, 1998). During 1990-1997, nine persons in Alaska died in work-related diving incidents (four were investigated by OSHA); only one had training beyond a recreational diving certificate, and three lacked any certification. In response to concerns about adequate training of occupational divers in Alaska and recent public inquiry, CDC's National Institute for Occupational Safety and Health (NIOSH) reviewed the nine occupational diving fatalities in Alaska. This report describes three of these incidents, summarizes the results of the review, and provides recommendations to improve the safety of commercial diving.

Accidents, Occupational↗
PubMed1999

Breast and cervical cancer screening practices among American Indian and Alaska Native women in the United States, 1992-1997.

BACKGROUND: Recent studies suggest that American Indian and Alaska Native women have important barriers to cancer screening and underuse cancer screening tests. METHODS: We examined the breast and cervical cancer screening practices of 4,961 American Indian and Alaska Native women in 47 states from 1992 through 1997 by using data from the Behavioral Risk Factor Surveillance System. RESULTS: About 65.1% [95% confidence interval (CI) 60.2 to 69.9%] of women in this sample aged 50 years or older had received a mammogram in the past 2 years. About 82.6% (95% CI 80.1 to 85.2%) of women aged 18 years or older who had not undergone a hysterectomy had received a Papanicolaou test in the past 3 years. Older women and those with less education were less likely to be screened. Women who had seen a physician in the past year were much more likely to have been screened. CONCLUSIONS: These results underscore the need for continued efforts to ensure that American Indian and Alaska Native women who are elderly or medically underserved have access to cancer screening services.

Adolescent↗
PubMed1996

Induction of hydrotropism in clinorotated seedling roots of Alaska pea, Pisum sativum L.

Roots of the agravitropic pea (Pisum sativum L.) mutant ageotropum show positive hydrotopism, whereas roots of Alaska peas are hydrotropically almost non-responsive. When the gravitropic response was nullified by rotation on clinostats, however, roots of Alaska peas showed unequivocal positive hydrotropism in response to a water potential gradient. These results suggest that roots of Alaska peas possess normal ability to respond hydrotropicallly and their weak hydrotropic response results from a counteracting effect of gravitropism.

Gravitation↗
PubMed1999

RESEARCH: Effects of Recent Volcanic Eruptions on Aquatic Habitat in the Drift River, Alaska, USA: Implications at Other Cook Inlet Region Volcanoes.

/ Numerous drainages supporting productive salmon habitat are surrounded by active volcanoes on the west side of Cook Inlet in south-central Alaska. Eruptions have caused massive quantities of flowing water and sediment to enter the river channels emanating from glaciers and snowfields on these volcanoes. Extensive damage to riparian and aquatic habitat has commonly resulted, and benthic macroinvertebrate and salmonid communities can be affected. Because of the economic importance of Alaska's fisheries, detrimental effects on salmonid habitat can have significant economic implications. The Drift River drains glaciers on the northern and eastern flanks of Redoubt Volcano. During and following eruptions in 1989-1990, severe physical disturbances to the habitat features of the river adversely affected the fishery. Frequent eruptions at other Cook Inlet region volcanoes exemplify the potential effects of volcanic activity on Alaska's important commercial, sport, and subsistence fisheries. Few studies have documented the recovery of aquatic habitat following volcanic eruptions. The eruptions of Redoubt Volcano in 1989-1990 offered an opportunity to examine the recovery of the macroinvertebrate community. Macroinvertebrate community composition and structure in the Drift River were similar in both undisturbed and recently disturbed sites. Additionally, macroinvertebrate samples from sites in nearby undisturbed streams were highly similar to those from some Drift River sites. This similarity and the agreement between the Drift River macroinvertebrate community composition and that predicted by a qualitative model of typical macroinvertebrate communities in glacier-fed rivers indicate that the Drift River macroinvertebrate community is recovering five years after the disturbances associated with the most recent eruptions of Redoubt Volcano. KEY WORDS: Aquatic habitat; Volcanoes; Lahars; Lahar-runout flows; Macroinvertebrates; Community structure; Community composition; Taxonomic similarity

Journal Article↗
PubMed2003

Comparison of mercury and methylmercury in northern pike and Arctic grayling from western Alaska rivers.

In western Alaska, mercury (Hg) could be a potential health risk to people whose diet is primarily fish-based. In 2000, total Hg (THg) and methylmercury (MeHg) were examined in northern pike (Esox lucius) and Arctic grayling (Thymallus arcticus) from two watersheds in western Alaska, the Yukon and Kuskokwim rivers. Whitefish (Coregonus sp.) were also examined from the Kuskokwim River. Pike from the Yukon and Kuskokwim rivers had mean concentrations of THg in muscle of 1.506 and 0.628 mg/kg wet wt, respectively. The mean concentrations of THg in grayling muscle from these rivers were 0.264 and 0.078 mg/kg, respectfully. Whitefish had a mean THg concentration in muscle of 0.032 mg/kg. MeHg, in pike and grayling constituted nearly 100% of the THg concentrations; the proportion was less in whitefish. A significant positive correlation between Hg levels and fish length was also found. Generally, there were no changes in Hg concentrations in pike or grayling over the last several years. Only pike from theYukon River had THg concentrations that exceeded the USFDA action level for human consumption of edible fish (1 mg/kg). Human hazard index for pike was > or = 1 for both adults and children, indicating a potential for toxic concern, especially among children. Further studies are needed to determine the environmental and human health impacts associated with these Hg concentrations in western Alaska, especially in the context of potentially increased consumption of resident fishes when anadromous salmon catches are reduced.

Animals↗
PubMed1970

Changes in Nucleic Acids in Phytochrome-dependent Elongation of the Alaska Pea Epicotyl.

Red light, which produces the physiologically active form of phytochrome (Pfr), inhibited epicotyl elongation in intact dark-grown Alaska pea seedlings. This red light response was detectable 3 hours after the light treatment and became pronounced after 5 hours. The growth inhibition was completely reversed by far red light applied immediately after the red or by pretreatment of the seedlings with the plant hormone gibberellin A(3).Comparison of the total (32)P-labeled nucleic acids from control and red light-treated Alaska pea epicotyls on methylated albumin-kieselguhr columns revealed a marked alteration of the pattern of nucleic acid synthesis in this plant material with little or no effect on total isotope incorporation into nucleic acids. A single 5-minute red light perturbation caused a 2-fold stimulation of (32)P incorporation into the tRNA fraction while, simultaneously, (32)P incorporation into tenaciously bound RNA was reduced to 50% of control levels. Red light treatment had no effect on (32)P incorporation into the DNA-RNA, rRNA, or mRNA fractions. Far red light reversed the effect of red light on tRNA synthesis but did not restore tenaciously bound RNA levels to the control value. Gibberellin A(3) treatment did not cause reversal of any of the red light effects on RNA synthesis.These light-induced changes in nucleic acids were measurable before any changes in the physiological response (epicotyl elongation) could be detected. These results are consistent with a phytochrome-mediated differential gene activation mechanism in the Alaska pea epicotyl elongation system.

Journal Article↗
PubMed2006

Using GIS in a first national mapping of functional disability among older American Indians and Alaska Natives from the 2000 census.

BACKGROUND: Geographical information systems (GIS) have been used mainly in understanding infectious diseases and environmental threats in health research. Here, GIS was used to examine patterns of functional disability as one impact of chronic disease in American Indians and Alaska Natives. The study purpose was to create the first national mapping of functional disability for AIANs using the 2000 U.S. Census. RESULTS: American Indians and Alaska Natives over age 65 reported disability at a rate of 57.6% versus 41.9% for all people over 65 (P < or = 0.0001). Regional differences in levels and type of disability were evident. CONCLUSION: Maps help visualize those who might otherwise be 'lost' from the data. The significance of this study is that gerontologic programs and policies are data-driven, yet there is a lack of reliable national level data from US health systems on functional disability among American Indians and Alaska Natives. One study limitation was that Census questions regarding disability differed from traditional measures of activities of daily living and instrumental activities of daily living. An immediate policy recommendation would be to incorporate standard activities of daily living and instrumental activities of daily living language into future Census for a comprehensive, linked database for the future.

Aged↗
PubMed2004

"Tied together like a woven hat:" Protective pathways to Alaska native sobriety.

BACKGROUND: The People Awakening Project (1RO1 AA 11446-03) had two purposes, completed in Phase I and Phase II of the project. The purpose of Phase I was to complete a qualitative study; the research objective was discovery oriented with the specific aim of identification of protective and recovery factors in Alaska Native sobriety. Results were used to develop a heuristic model of protective and recovery factors, and measures based on these factors. The research objective of Phase II was to pilot these measures and provide initial validity data. METHODS: Phase I utilized a life history methodology. People Awakening interviewed a convenience sample of 101 Alaska Natives who had either recovered from alcoholism (n = 58) or never had a drinking problem (n = 43). This later group included both lifetime abstainers (LAs) and non-problem drinkers (NPs). Life histories were transcribed and analyzed using grounded theory and consensual data analytic procedures within a participatory action research framework. Analyses were utilized to generate heuristic models of protection and recovery from alcohol abuse among Alaska Natives. RESULTS: Analyses generated a heuristic model of protective factors from alcohol abuse. The resulting multilevel and multi-factorial model describes interactive and reciprocal influences of (a) individual, family, and community characteristics; (b) trauma and the individual and contextual response to trauma, (c) experimental substance use and the person's social environment; and (d) reflective processes associated with a turning point, or a life decision regarding sobriety. The importance of cultural factors mediating all these protective processes is emphasized. For NPs, the resilience process drew from personal stores of self-confidence, self-efficacy, and self-mastery that derived from ability to successfully maneuver within stressful or potentially traumatizing environments. In contrast, for many LAs, efficacy was instead described in more socially embedded terms better understood as communal mastery. One style of mastery is more associated with individualistic orientations, the other with more collectivistic. Future research is needed regarding the generalizeability of this group difference. CONCLUSIONS: Results suggest that preventative interventions should focus on intervening simultaneously at the community, family, and individual levels to build resilience and protective factors at each level. Of particular importance is the building of reflexivity along with other cognitive processes that allow the individual to think through problems and to reach a life decision to not abuse alcohol.

Journal Article↗
PubMed2000

Unemployment, drug use, and HIV risk among American Indian and Alaska Native drug users.

American Indians and Alaska Natives have had low employment in recent history. Drug users also have low employment due to cycles of drug use and relapse,and the impact of the type of drug abused on levels of functioning. Drug use is associated with increased HIV risk through injection drug use, frequency of injection, and needle sharing. Data from three sites of the NIDA Cooperative Agreement for Community Based-Outreach/Intervention Research were analyzed to determine the relationship among race/ethnicity, age, and level of educational attainment on employment and unemployment at intake interview and six-month follow-up. HIV risk for those employed and unemployed was then assessed. American Indian and Alaska Native drug users were younger, less educated, and less likely to have a paid job at both intake and follow-up than non-Native drug users. Those participants who were unemployed at baseline interview who were American Indian/Alaska Native were less likely to transition to employment at six-month follow-up than other race/ethnicity groups in the cohort. However, all participants showed low levels of employment at follow-up. Individuals who were employed at baseline and those who transitioned to employment had lower levels of injection drug use and needle sharing than those who were unemployed at both baseline and follow-up. American Indian and Alaska Native drug users may be at risk for acquisition of HIV due to drug risk behaviors that appear to be associated with unemployment.

Adult↗
PubMed2004

Intimate partner violence in American Indian and/or Alaska Native communities: a social ecological framework of determinants and interventions.

This essay synthesizes the research on intimate partner violence (IPV) in American Indian and/or Alaska Native communities using a social ecological framework. The review of literature demonstrates that American Indian and/or Alaska Native women are at an elevated risk for IPV compared to non-American Indian women and thus this essay describes multi-level interventions that are culturally appropriate for American Indian and/or Alaska Native communities. The interventions address a variety of determinants including gender, age, socioeconomic status, alcohol, European colonization, and infrastructure.

Adolescent↗
PubMed1999

Allozyme and morphological variation in two subspecies of Dryas octopetala (Rosaceae)in Alaska.

The Alaskan endemic shrub Dryas octopetala ssp. alaskensis and its circumpolar conspecific ssp. octopetala are adapted to closely adjacent habitats in alpine areas of Alaska. These alpine areas form geographically disjunct "islands" among which there are limited opportunities for gene flow. Allozyme electrophoresis and a common garden experiment were used to examine genetic variation between subspecies and among disjunct populations of each subspecies. Overall, allozyme variation in D. octopetala is low with little differentiation among populations or between subspecies. Morphological differences, however, are greater between subspecies than among populations within subspecies. Divergence for a few morphological and life-history characters has apparently occurred in response to strong selection, but without divergence at allozyme loci. The ancestors of both subspecies of D. octopetala in Alaska were isolated during the Pleistocene in the glacial refugia of Alaska and Yukon, which may explain low overall variation. Dryas. o. alaskensis is thought to be a Pleistocene derivative of ssp. octopetala, which may account for the low allozyme divergence between subspecies. Recent restriction to alpine areas may explain the low differentiation among disjunct populations.

Journal Article↗
PubMedDate not supplied

Quit rates at one year follow-up of Alaska Native Medical Center Tobacco Cessation Program.

The prevalence of tobacco use in the Alaska Native population is unusually high, as high as 50% in both adult men and women. In June of 1992, the Alaska Native Medical Center and the Alaska Area Native Health Service began a tobacco cessation program using behavioral modification classes and transdermal nicotine patches. Patients were subsequently followed at three month intervals for a year to assess smoking status. To date, 193 people have completed the program with at least three months having elapsed since completion of classes. The quit rates at three, six, nine, and twelve months were 31%, 30%, 24%, 21% respectively. The long-term quit rates for this tobacco cessation program are comparable to the rates of other studies which have included both behavioral modification and transdermal nicotine.

Administration, Cutaneous↗