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At least 325 records · Page 18Linked to original sources
PubMed1993

Comparative immunogenicity of four Haemophilus influenzae type b conjugate vaccines in Alaska Native infants.

We compared the immunogenicity of the four available Haemophilus influenzae type b (Hib) conjugate vaccines in Alaska Native infants. Three of the vaccines, Hib oligosaccharide-CRM197 (HbOC), polyribosylribitol phosphate-diphtheria toxoid (PRP-D) and polyribosylribitol phosphate-tetanus toxoid (PRP-T), were given at 2, 4 and 6 months of age, and the PRP Neisseria meningitidis outer membrane protein (PRP-OMP) conjugate vaccine was given at 2 and 4 months of age. Enrollment was largely sequential by vaccine availability beginning with HbOC and ending with PRP-T. A total of 225 infants completed the full vaccination series. Groups of infants receiving the different vaccines did not differ significantly by sex, ethnicity, degree Alaska Native or age at vaccination. The only vaccine that induced a response with the first 2-month dose was PRP-OMP; 91% of infants had > or = 0.15 micrograms/ml and 57% had > or = 1.0 microgram/ml of anti-PRP antibody by 4 months of age. After two doses it also remained the most immunogenic. After the full three vaccine series, trials that requires cough of 21 days is excessively restrictive.

Alaska↗
PubMed1996

Risk factors for nasopharyngeal carriage of resistant Streptococcus pneumoniae and detection of a multiply resistant clone among children living in the Yukon-Kuskokwim Delta region of Alaska.

BACKGROUND: Children < 2 years old living in the Yukon-Kuskokwim Delta (YKD) region of Alaska have one of the highest pneumococcal bacteremia rates of in the world. METHODS: To determine the prevalence of and risk factors for infection with intermediate or resistant Streptococcus pneumoniae in the YKD, we cultured nasopharyngeal secretions of healthy children < or = 5 years old, reviewed their hospital records and administered questionnaires to accompanying parents. RESULTS: Of 185 children evaluated we obtained 95 pneumococcal isolates; drug susceptibility patterns and serotyping results were available for 92. Of these, 33 (36%) were intermediate or resistant to at least one drug class tested; 27 isolates were intermediate (minimum inhibitory concentration 0.1 to 1.0 mg/l) and none were resistant to penicillin. Compared with other isolates, capsular serotype 6B isolates were more likely to be intermediate or resistant to at least one drug (relative risk, 5.3; P < 0.001) and to more than one drug (relative risk, 17.0; P < 0.001). The majority of 6B isolates had identical pneumococcal surface protein A patterns. Carriage of intermediate or resistant pneumococcus was associated with age < 2 years (relative risk, 3.0; P < 0.001) but not with antibiotic use or other evaluated risk factors. CONCLUSIONS: Young age but not antibiotic use was associated with carriage of intermediate or resistant S. pneumoniae in the YKD region of Alaska. Much of the intermediate or resistant pneumococcus in the YKD may have resulted from the proliferation of a single capsular serotype 6B clone.

Alaska↗
PubMed1997

The contribution of infectious diseases to infant mortality in Alaska.

BACKGROUND: Based on death certificates to determine cause of death, current research suggests that infectious diseases are less important causes of infant mortality than in the past. METHODS: To determine the contribution of infectious diseases to infant mortality and the sensitivity of death certificates for identifying infectious disease causes of death, we examined information from multiple sources for a population-based sample of infant deaths that occurred in Alaska during 1992 through 1994. RESULTS: We collected information for 181 of 272 reported infant deaths and identified 48 infants for whom an infection was a primary (n = 15), contributing (n = 12) or suspected (n = 21) cause of death (infectious disease-related infant mortality rate, 2.2/1000 live births). Of these 48 deaths 27 were associated with a maternal peripartum infection and 15 were associated with a postneonatal respiratory tract infection. A specific organism was identified for 15 of 29 infants who died during the neonatal period and for 5 of 19 infants who died during the postneonatal period (including 2 with coagulase-negative Staphylococcus and the rest with a variety of other organisms). Death certificates identified an infectious disease as a primary or contributing cause of death for 19 infants (sensitivity, 40%) and reported a specific organism for 4 infants. CONCLUSIONS: Infectious diseases caused or contributed to a high proportion of infant mortality in Alaska during 1992 through 1994. Death certificates had poor sensitivity for identifying infectious disease-related infant deaths.

Alaska↗
PubMed1997

Alaska's statewide trauma registry: a useful surveillance tool for injury prevention planning and evaluation.

The state of Alaska is unique because it is one of a small number of states with a surveillance system that collects trauma information from every hospital in the state. The Alaska Trauma Registry (ATR) collects up to 144 data elements for every injured patient. Information from the ATR is useful as an injury surveillance tool for federal, state, and local governments and other agencies and organizations when planning and evaluating injury prevention programs. Combining trauma registry data with Bureau of Vital Statistics cause of death data provides complete, statewide, population-based data on all injuries serious enough to result in death or hospitalization.

Adolescent↗
PubMed2003

Ethnicity and psychiatric comorbidity among alcohol-dependent persons who receive inpatient treatment: African Americans, Alaska natives, Caucasians, and Hispanics.

This study examined ethnic and gender differences of psychiatric comorbidity among alcohol dependent men and women from four ethnic groups: Alaska Native, Caucasians, African Americans, and Hispanics. The data were obtained through individual standardized interview; DSM-III-R diagnoses were obtained via a computer algorithm. The subjects included 1177 Caucasians, 361 African Americans, 93 Hispanics and 486 Alaska Natives. Significant ethnic differences were found in relation to age of onset of alcohol and multiple substance dependence and psychiatric comorbidity. Ethnic differences were also noted with regard to the health care utilization.

Adult↗
PubMed1995

Genetic variation in domestic reindeer and wild caribou in Alaska.

Reindeer (Rangifer tarandus tarandus) were introduced into Alaska 100 years ago and have been maintained as semidomestic livestock. They have had contact with wild caribou (R.t.granti) herds, including deliberate crossbreeding and mixing in the wild. Reindeer have considerable potential as a domestic animal for meat or velvet antler production, and wild caribou are important to subsistence and sport hunters. Our objective was to quantify the genetic relationships of reindeer and caribou in Alaska. We identified allelic variation among five herds of wild caribou and three herds of reindeer with DNA sequencing and restriction enzymes for three loci: a DQA locus of the major histocompatibility complex (Rata-DQA1), kappa-casein and the D-loop of mitochondrial DNA. These loci are of interest because of their potential influence on domestic animal performance and the fitness of wild populations. There is considerable genetic variation in reindeer and caribou for all three loci, including five, three and six alleles for DQA, kappa-casein and D-loop respectively. Most alleles occur in both reindeer and caribou, which may be the result of recent common ancestry or genetic introgression in either direction. However, allele frequencies differ considerably between reindeer and caribou, which suggests that gene flow has been limited.

Alaska↗
PubMed1995

Evolution of a public health nursing program, Yukon Kuskokwim Delta, Alaska, 1893-1993.

The role of public health in a reformed health care system is currently a matter of great debate at the national and state levels. Many public health nursing leaders have expressed concern about changes in public health policy and funding sources that have led to the near demise of the generalist public health nurse. Generalist public health nurses may be an endangered species; however, the role is still in existence in rural Alaska. Will they be one more example of how "what we learn from history is that we don't learn from history?" Taking the discrete area of the Yukon Kuskokwim Delta of Alaska and studying the forces of geography, politics, economics, social factors and health issues, this article provides an historic account of the development of a unique health care delivery system and the role of the public health nursing structure within it, from earliest known records to present day. The long-standing efforts to document these data were spurred by the National Centennial of Public Health Nursing activities, celebrated in 1993.

Alaska↗
PubMed1988

The underrecording of suicides in state and national records, Alaska, 1983-1984.

Information on Alaskan suicides has come primarily from studies based upon records obtained from the Alaska Bureau of Vital Statistics and the National Center for Health Statistics (NCHS). To evaluate the accuracy of these statistics, state and national (NCHS) vital statistics records were searched for suicide deaths in Alaska in 1983-1984. Of 195 deaths meeting our case definition of suicide, only 141 (72%) appeared in state records and 112 (57%) appeared in NCHS records. Native suicides were more likely to be underrecorded than non-Native suicides, even after differences in recording district personnel were adjusted for. Errors resulted primarily from delayed determinations of the cause of death and failure to update the records.

Alaska↗
PubMed2006

Immunologic response to Haemophilus influenzae type b (Hib) conjugate vaccine and risk factors for carriage among Hib carriers and noncarriers in Southwestern Alaska.

Continued Haemophilus influenzae type b (Hib) carriage in rural Alaska contributes to the ongoing risk of invasive disease. Community-wide Hib carriage surveys were conducted in three villages in southwestern Alaska. Sixteen carriers and 32 age- and village-matched controls were enrolled and were vaccinated with Hib oligosaccharide-CRM(197) conjugate vaccine. Serum immunoglobulin G (IgG) concentration, antibody avidity, and serum bactericidal activity (SBA) were measured prior to Hib vaccination and 2 and 12 months after vaccination. We identified no demographic or behavioral factors associated with Hib colonization. Prior to vaccination, Hib carriers had a higher IgG geometric mean concentration than controls did (8.2 versus 1.6 microg/ml; P < 0.001) and a higher SBA geometric mean titer (7,132 versus 1,235; P = 0.006). Both groups responded to vaccination with increased IgG and SBA. These data illustrate the role of Hib colonization as an immunizing event and show that Hib carriers in communities with ongoing transmission have no evidence of reduced immune responsiveness that may have put them at risk for colonization.

Adolescent↗
PubMed1980

Psychiatric participation in the Hootch case: effects on Alaska native education.

The Hootch case was a class action suit that established the right of Alaska Native students to attend secondary school in their home communities. The authors review the history of Native education, give the background of the suit, and present behavioral science data on school adjustment of Alaska Natives and American Indian students. These data, included in an amicus curiae brief, were incorporated into the court decision. The authors consider this case a positive example of psychiatric involvement in social policy matters.

Adolescent↗
PubMed1992

Prevalence of seasonal affective disorder in Alaska.

OBJECTIVE: The goals of this study are to provide estimates of the prevalence of seasonal affective disorder in Alaska, to examine sociodemographic correlates, and to evaluate the relation between seasonal affective disorder and general depression. METHOD: A random sample of 283 residents of Fairbanks who had lived in Alaska for 3 years or more were interviewed with the Seasonal Pattern Assessment Questionnaire and the Center for Epidemiologic Studies Depression Scale (CES-D Scale). RESULTS: Twenty-six (9.2%) of the subjects met diagnostic criteria for seasonal affective disorder, one of the highest figures yet reported. These cyclic winter affective disorders occurred more often in women than men (ratio = 3:2) and were less prevalent among residents who were older than 40 years of age. Assessment of depression with the CES-D Scale supported the diagnostic classification of respondents and the differentiation of seasonal affective disorder from other depression. CONCLUSIONS: This study supports the conclusions that seasonal affective disorder is prevalent in northern populations and that sex and age may represent the major risk factors that differentiate it from the general experience of depression in northern communities.

Adult↗
PubMed1987

Psychiatric assessment and treatment of American Indians and Alaska Natives.

It is widely recognized that the cultural uniqueness of American Indians and Alaska Natives must be reflected in the methods of diagnosing and treating their mental health problems, but empirical validation of specific diagnostic instruments and treatment has been slow in coming. The authors' literature review indicates that many standardized self-rating scales and interview schedules can accurately assess mental illness among Indians, provided they are modified to reflect cultural heritage and experiences. Group therapy is increasingly chosen as a psychiatric treatment for American Indians, as are family-network therapy and several traditional Indian therapies. The authors also review the demographics and psychiatric epidemiology of American Indians and Alaska Natives.

Alaska↗
PubMed2001

Child maltreatment in American Indian and Alaska Native communities: integrating culture, history, and public health for intervention and prevention.

This article addresses child maltreatment intervention and prevention among American Indians and Alaska Natives. The authors argue that history and culture must be included as context and variables for developing and implementing prevention programs in Indian Country. They propose that the public health violence prevention model would benefit from incorporating tenets of the history and culture(s) of diverse groups, in this instance American Indians and Alaska Natives. The authors offer an approach that focuses on population- and individual-level risk and protective factors for child maltreatment intervention and prevention in American Indian/Alaska Native communities. They include suggestions and examples for doing the work in Indian Country.

Alaska↗
PubMed1996

Personality styles and dynamics of Alaska Native and nonnative incarcerated men.

The Rorschach and Million Clinical Multiaxial Inventory-II (MCMI-II) were used to examine personality styles and dynamics of 73 incarcerated Alaska Native and nonnative men. There were clear differences between native and nonnative inmates on both the MCMI-II and the Rorschach. Also, when the participants were separated into bicultural, assimilated, and traditional groups, the bicultural group had the most difficulties in coping and in interpersonal relationships. The results of this study suggest that the profile for offenders is not the same for Alaska natives and nonnatives. Culture and cultural styles may contribute to create a significantly different type of "criminal personality" seen in forensic settings.

Acculturation↗
PubMed2005

Cancer education for Community Health Aides/Practitioners (CHA/Ps) in Alaska assessing comfort with cancer.

BACKGROUND: Village-based Community Health Aides and Community Health Practitioners (CHA/Ps) are the primary providers of health care in rural Alaska. METHODS: We discuss the development and results of a CHA/P cancer self-assessment survey, which assessed comfort with cancer knowledge and providing cancer information. RESULTS: A total of 402 responses were received from a mailed questionnaire to 477 CHA/Ps. Respondents were predominantly Alaska Native women. Using a 5-point Likert scale from don't know to very comfortable, approximately 50% of CHA/Ps reported feeling "OK" when providing information about cancer risk factors, cancer screening, surviving cancer, and providing care and support. CHA/Ps reported feeling less comfortable with discussing cancer diagnosis, treatment, pain, and loss and grief.

Adult↗
PubMed2002

Community involvement in the ethical review of genetic research: lessons from American Indian and Alaska Native populations.

The National Bioethics Advisory Commission has proposed that regulatory oversight for research with human subjects be extended beyond the protection of individual research participants to include the protection of social groups. To accomplish this, the commission recommends that investigators and ethics review boards a) work directly with community representatives to develop study methods that minimize potential group harms, b) discuss group implications as part of the informed consent process, and c) consider group harms in reporting research results. We examine the utility of these recommendations in the context of research with American Indian and Alaska Native communities. Because much attention has been given to the question of how best to consult with members of these communities in the design and conduct of research, we believe it behooves investigators to consider the lessons to be learned from research involving American Indians and Alaska Natives. After describing several difficulties surrounding the application of the commission's approach to these research contexts, we propose a research agenda to develop best practices for working with local communities in the ethical assessment of epidemiologic and environmental health research.

Alaska↗
PubMed1995

Contaminants and sea ducks in Alaska and the circumpolar region.

We review nesting sea duck population declines in Alaska during recent decades and explore the possibility that contaminants may be implicated. Aerial surveys of the surf scoter (Melanitta perspicillata), white-winged scoter (M. fusca), black scoter (M. nigra), oldsqaw (Clangula hyemalis), spectacled eider (Somateria fischeri), and Steller's eider (Polysticta stellei) show long-term breeding population declines, especially the latter three species. The spectacled eider was recently classified threatened under the Endangered Species Act. In addition, three other diving ducks, which commonly winter in coastal areas, have declined from unknown causes. Large die-offs of all three species of scoters during molt, a period of high energy demand, were documented in August 1990, 1991, and 1992 at coastal reefs in southeastern Alaska. There was no evidence of infectious diseases in those scoters. The die-offs may or may not be associated with the long-term declines. Many scoters had elevated renal concentrations of cadmium (high of 375 micrograms/g dry weight [dw]). Effects of cadmium in sea ducks are not well understood. Selenium concentrations in livers of nesting white-winged scoters were high; however, the eggs they laid contained less selenium than expected based on relationships for freshwater bird species. Histological evaluation found a high prevalence of hepatocellular vacuolation (49%), a degenerative change frequently associated with sublethal toxic insult. Cadmium and selenium mean liver concentrations were generally higher in those birds with more severe vacuolation; however, relationships were not statistically significant. We do not know if sea duck population declines are related to metals or other contaminants.

Alaska↗
PubMed2003

Health risk-factors for gay American Indian and Alaska Native adolescent males.

Having multiple identities as a homosexual American Indian or Alaska Native adolescent male increases the likelihood for poorer health and diminished well-being. This study assessed the differences in self-perceived health status between gay adolescent males and their heterosexual counterparts. A national nonrepresentative sample of 5,602 Indian and Native adolescent males was surveyed about issues of sexual behavior, physical and sexual abuse, mental health status, substance use, attitudes about school, participation in violence, and access to health care. Results indicate that there were no real differences between gay and heterosexual male respondents for substance use or attitudes about school. Statistically significant differences were found, however, in areas of mental health, as well as physical and sexual abuse. Gay adolescents were twice as likely to have thought of or attempted suicide. Gay adolescents were twice as likely to have been physically abused and nearly six times more likely to have been sexually abused. Gay American Indian or Alaska Native adolescent males constitute a very vulnerable population and are clearly in need of targeted health and social services. Unfortunately, the benefits seen by adults of the "two-spirited" gay and lesbian American Indian movement have not been accessible to Indian and Native adolescents.

Adaptation, Psychological↗