Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Alaska Native”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed2006

Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002.

STUDY DESIGN: Review and analysis of data from two U.S. national surveys in 2002. OBJECTIVES: To examine the prevalence of back pain and physician visits for back pain in the United States. SUMMARY OF BACKGROUND DATA: National data on the prevalence of back pain become available only intermittently. METHODS: We summarized published data from the 2002 National Health Interview Survey (NHIS) on the prevalence of back pain and compared it with earlier surveys. We also analyzed the 2002 National Ambulatory Medical Care Survey (NAMCS) to determine physician visit rates for back pain. RESULTS: In the 2002 NHIS, there were 31,044 adult respondents. Low back pain lasting at least a whole day in the past 3 months was reported by 26.4% of respondents, and neck pain was reported by 13.8%. Among racial groups, American Indians and Alaska Natives had the highest prevalence of low back pain, and Asian Americans had the lowest. Prevalence generally declined with greater levels of education and increasing income. Prevalence estimates were consistent with those from previous surveys, although methodologic differences limited comparisons. NAMCS data suggested that the proportion of all physician visits attributable to low back pain (2.3% in 2002) has changed little since the early 1990s. CONCLUSIONS: About one fourth of U.S. adults report low back pain in the past 3 months; the proportion of physician visits attributed to back pain has changed little in the past decade.

Adult↗
PubMed2006

An exploratory study of total mercury levels in archaeological caribou hair from northwest Alaska.

Over the past ten years, total mercury (THg) levels have been surveyed in Alaskan wildlife and fish as part of the Arctic Monitoring and Assessment (AMAP). Beyond these studies there is little historical data on THg levels in important subsistence species for people in Alaska. A survey of THg in caribou hair from archaeological deposits would provide data to develop temporal trends for this region of the Arctic. Caribou hair from a Western Thule settlement beneath the Alaska native village of Deering (ca. AD 1150) show variability in hair THg values, with a mean level (86 ng/g) which is in the range that is observed in modern Rangifer sp. (caribou and reindeer). Hair from House 1 had a THg mean level of 99.6 ng/g and hair from House 2 had a THg mean of 64.2 ng/g. This is the earliest reported record of mercury in caribou associated with human subsistence activities in the western North American Arctic, and is a first step toward compilation of a needed database through which to measure and evaluate exposure to mercury by people who rely heavily on caribou as a food source. We hypothesize that similarity in mercury values in archaeological samples of caribou and in contemporary samples would give an additional perspective on human exposure to mercury through caribou harvest and consumption today. Since this hypothesis will be more useful if evaluated at a regional rather than global scale, further studies will be needed at different archaeological sites across Alaska to determine the generality of this observation in relation to geographic scale.

Alaska↗
PubMed2005

Reactions after 3 or more doses of pneumococcal polysaccharide vaccine in adults in Alaska.

BACKGROUND: Following vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV), pneumococcal antibody levels decline to prevaccination levels within 6-10 years. The Advisory Committee on Immunization Practices does not recommend routine revaccination because data on the safety and effectiveness of additional doses are insufficient. METHODS: To determine whether medically attended adverse events occur more frequently after the third dose of PPV than after the first or second dose, we performed a retrospective review of medical records from a computer database for health care facilities that serve more than one-half of the Alaska Native population. All persons who had received > or = 3 PPV doses (n = 179) were included in the review, as were a randomly selected comparison group of 181 persons who had received 1 or 2 doses. RESULTS: Only 1 (0.55%) of 179 persons who had received > or = 3 PPV doses and 4 (2.76%) of 181 persons in the comparison group had a medically attended adverse event, and no severe adverse events were recorded. CONCLUSION: We found no difference in the risk of medically attended adverse events following > or = 3 doses of PPV, compared with 1 or 2 doses.

Adult↗
PubMed1997

Correlates of drinking during the third trimester of pregnancy in Alaska.

OBJECTIVES: To examine characteristics related to drinking during pregnancy among a population-based sample of women. METHOD: We analyzed data related to third-trimester drinking collected from the Alaska Pregnancy Risk Assessment Monitoring System (PRAMS). PRAMS used a population-based, stratified sampling design to survey 9733 of the approximately 44,000 live births to Alaska-resident women during 1991-1994. We defined regular drinking as one or more drinks per week on average during the third trimester. Analyses included bivariate and multivariate associations with any and regular drinking. RESULTS: Of women mailed a survey, 6973 responded and answered the questions related to alcohol consumption. Nine percent reported any drinking during the third trimester and 2.5% were regular third-trimester drinkers. The strongest risk factors for both any and regular third-trimester drinking were older age and marijuana or cocaine use. Other risk factors for any third-trimester drinking included prenatal cigarette smoking, greater education, non-Alaska Native race, the experience of significant life stressors, and residence in a community that did not restrict the sale of alcohol. Other risk factors for regular third-trimester drinking included prenatal cigarette smoking and the experience of domestic violence. Prenatal counseling regarding the effects of alcohol consumption during pregnancy and adequacy of prenatal care were not significantly associated with either outcome variable. CONCLUSIONS: Efforts to decrease prenatal alcohol consumption should be directed at older women and should address social determinants of health, such as education, domestic violence, drug use, and the availability of alcohol. In the absence of these efforts, prenatal alcohol education by health care providers may have little impact on pregnancy-related drinking.

Adolescent↗
PubMed2006

The "Spirit of Eagles" legacy.

American Indians and Alaska Natives (AI/ANs) suffer from inordinate morbidity and mortality from various cancers. The Spirit of Eagles is a national Special Populations Network that has developed the community infrastructure to support culturally appropriate, long-range, comprehensive cancer control activities. Subcontracts were developed that involved major cancer centers, nonprofit organizations, policy boards, professional societies, and educators. Community-based cancer control grants were distributed through the Spirit of Eagles program. Community-based participatory research involved 38 communities in a broad range of cancer control activities. The key to long-range improvement in cancer morbidity and mortality in AI/AN communities lies in building infrastructure to support strong partnerships enabling community-based participatory research. Cancer 2006. (c) 2006 American Cancer Society.

Alaska↗
PubMed1998

C. Earl Albrecht and the struggle against tuberculosis in Alaska.

This paper outlines the contributions of C. Earl Albrecht in tuberculosis control in Alaska during his term as Territorial Commissioner of Health from 1945 to 1956. Tuberculosis, called the "Scourge of Alaska," had spread by the end of World War II to every corner of Alaska, with especially devastating effects on the Alaska Natives. When Dr. Albrecht became commissioner, the epidemic was at its peak. With an obvious zest for battle, he organized a campaign on many fronts, with initial emphasis on case-finding, establishing a tuberculosis register, and making available hospital beds both for orthopedic and pulmonary tuberculosis. Later, BCG vaccination, ambulatory chemotherapy, and chemoprophylaxis were added to the battle plan. The results were strikingly successful. He became an eloquent spokesman and advocate for health in both Juneau and Washington, and was successful in obtaining greatly increased territorial and federal appropriations, not to mention surplus military buildings, ships, and supplies. He was also notably effective in bringing together into a functional team such diverse agencies as the U.S. Public Health Service, the Bureau of Indian Affairs, the Territorial Department of Health, and various voluntary health organizations.

Alaska↗
PubMed2000

Elimination of new chronic hepatitis B virus infections: results of the Alaska immunization program.

An immunization assessment and a serologic survey were conducted to evaluate the effectiveness of a hepatitis B immunization program in eliminating hepatitis B virus (HBV) transmission among Alaska Natives in a region in which HBV infection is endemic. Hepatitis B vaccine coverage was 93% among 567 children </=10 years old residing in the study villages, and catch-up vaccine coverage among 582 susceptible persons 11-30 years old was 62%. None of 271 tested children </=10 years old were chronically infected with HBV, and just 4 (1.5%) had evidence of resolved infection. In contrast, 16% of 332 persons 11-30 years old (those born before implementation of routine infant hepatitis B vaccination) were chronically infected. A hepatitis B immunization program that includes prevention of perinatal HBV infection, routine infant vaccination, and catch-up vaccination of older children and adults can eliminate new chronic HBV infections in a population with a high rate of chronic infection.

Adolescent↗
PubMed2005

Polychlorinated biphenyls in serum of the Siberian Yupik people from St. Lawrence Island, Alaska.

OBJECTIVES: To determine serum levels of polychlorinated biphenyls (PCBs) in Siberian Yupik adults from St. Lawrence Island, Alaska, and to determine the relative contribution of atmospheric transport of PCBs and local contamination to body burdens. STUDY DESIGN: Siberian Yupiks of various ages were recruited from three populations: residents of the village of Gambell, residents of the village of Savoonga who did not have family hunting camps near the Northeast Cape (NEC), a Formerly Used Defense Site (FUDS) known to be contaminated with PCBs, and residents of Savoonga whose families had a hunting camp at the NEC. METHODS: Levels of PCBs were measured in serum samples from 130 people, ages 19-76. These Alaska Natives follow a traditional diet high in marine mammals and fish, which bioconcentrate organochlorine compounds that migrate to the Arctic via global air transport and ocean currents. RESULTS: The lipid-adjusted serum PCB levels of those members of families with hunting camps at the NEC had a mean lipid-adjusted PCB concentration of 1,143 ppb, whereas other residents of Savoonga had values of 847 ppb and residents of Gambell had values of 785 ppb. CONCLUSIONS: Our observations suggest that atmospheric transport of PCBs contributes to levels in the Yupik people, but that the abandoned military site at the NEC may also contribute to the human body burden in those individuals who have either spent substantial time or consumed food from there.

Adult↗
PubMed2004

From respect to rights to entitlement, blocked aspirations and suicidal behavior.

Dr. Bill Richards was a noted psychiatrist who worked with Alaska Native people for many years. This paper was taken from notes he used for a slide presentation at a conference. In it, he discussed the possible relationship between rapid social change and the increasing rates of suicide among northern people. He summarized the limitations in the existing suicide data, including its essentially descriptive nature, the short time periods of study, small numbers of observations and lack of complete health service use information which could help anticipate a suicidal event. Richards noted the importance of suicide as an indicator condition that could be used to link social survey and health information data bases. He closed his paper with a discussion of the transition from an era of "rights" to one of "entitlements," and described his observations of growing overt anger and hostile dependency upon government programs. Last, Richards related his concerns over the collection of health service use and epidemiological data associated with a suicidal event.

Alaska↗
PubMed2003

Employment retention of health care providers in frontier areas of Alaska.

OBJECTIVES: The objectives of this study were to: describe the length of employment of health care providers in rural Alaska; assess whether there are differences in length of employment among community health aides, medical doctors, and nurses; and determine whether provider length of employment is significantly increased following implementation of telemedicine. STUDY DESIGN: We conducted a prospective cohort study of length of employment among health professionals in rural Alaska, and identified the cohort based on current employment status of community health aides, medical doctors, and nurses. METHODS: Employment data were collected from four Alaska Native regional health corporations. Kaplan-Meier product-limit survival analysis was used to assess employment length. The Mantel-Haenszel log-rank test was used to test the difference between retention (survival) curves among doctors, nurses, and community health aides for all four regional health corporations combined. Data included provider hire date, termination date, and position title. Fifty seven percent of the data points were right-hand censored. RESULTS: The community health aides (median (Mdn) = 1186 days) were retained significantly longer than either the doctors (Mdn = 596 days), or the nurses (Mdn = 408 days), who were not significantly different from each other (log-rank chi2 (2, N = 996) = 68.30, p = 0.0001). CONCLUSIONS: Our findings document that community health aides in the region retain their jobs significantly longer than doctors and nurses. Findings highlight the problem of providing an adequate health work force in rural areas.

Alaska↗
PubMed2002

The relationship of childhood abuse history and substance use in an Alaska sample.

This study confirms a strong link between childhood abuse history and substance misuse based upon data obtained from an ethnically diverse (largely Alaska Native) sample of 192 pregnant women in substance misuse treatment in the mid-1990s. Nearly three-quarters of the women reported childhood victimization. Compared to women with no abuse history, abused women were significantly younger at the age of onset of substance misuse, used substances more frequently, had experienced more blackouts, had more family members with substance-misuse concerns, were more likely to have been raped, revealed more psychological problems, and had less formal education. Risk patterns differed slightly for women with physical versus sexual abuse histories, with the experience of physical violence having a stronger relationship with adulthood problem behaviors than the experience of sexual molestation. Overall, findings suggest an interactive cycle of violence and substance misuse that begins very early in childhood, especially for women who were physically abused, and continues in adulthood, though no cause-end-effect conclusions can be drawn. Treatment and prevention implications of these findings are discussed.

Adolescent↗
PubMed1996

Tribal-based cancer control activities. Services and perceptions.

BACKGROUND: Cancer is becoming a significant health problem for American Indians and Alaska Natives. Despite the precipitous increase in cancer rates in these populations, limited data are available regarding the extent of cancer control services available in these communities. METHODS: A cross-sectional survey of tribal health directors of all federally recognized tribes was undertaken to discover the breadth of cancer control activities offered and directors' perceptions of and priorities ascribed to cancer. RESULTS: Little more than half (53%) of respondents perceived cancer rates to be increasing. Cancer was found to rank fifth among seven health conditions when directors were asked to rank their tribe's commitment to confronting each. Lower relative levels of awareness of cancer patterns coupled with competing health problems relegated cancer control activities to low-priority issues. CONCLUSIONS: Findings from this study underscore the need to elevate the issue of cancer in Indian Country and to educate investigators to become more sensitive and responsive to other tribal health issues.

Alaska↗
PubMed1995

Alveolar hydatid disease. Review of the surgical experience in 42 cases of active disease among Alaskan Eskimos.

OBJECTIVE: The authors reviewed the pathophysiology and clinical management of endemic alveolar hydatid disease in Alaskan Eskimos, incorporating recent developments in diagnosis and treatment. SUMMARY BACKGROUND DATA: Alveolar hydatid disease is a highly lethal zoonotic infection caused by the larval stage of Echinococcus multilocularis. This cestode is restricted geographically to northern climates, where foxes and small rodents represent the natural hosts. Domestic dogs also may serve as definitive hosts, and thus, transmit the parasite to humans. Human infection is characterized by the development of a cancer-like hepatic mass, which may extend to adjacent structures or metastasize to distant sites. If the infection goes untreated, mortality reaches 80%. METHODS: The medical records of all patients with alveolar hydatid disease diagnosed or treated at the Alaska Native Medical Center between 1951 and 1993 were reviewed. Forty-two cases of active disease are presented. RESULTS: Nine patients underwent resection of hepatic lesions with intent to cure, and each had a favorable result. Average post-diagnosis survival of those patients was 22 years; six still are living and free of disease. Partial resections or drainage procedures were performed in ten patients. Chemotherapy was used to augment the surgical treatment of eight patients, and four received chemotherapy alone, resulting in improved outcomes compared with historic controls. Late complications included hepatic abscess, biliary obstruction, and portal venous hypertension. CONCLUSIONS: Whereas alveolar hydatid disease rarely is encountered in other areas of North America, the biologic potential for spread of the disease may be increasing because of illegal importation of infected foxes to the Eastern seaboard. Therefore, the surgical community should maintain an awareness of the diagnosis and management of this potentially devastating parasitic infection.

Adult↗
PubMed2006

Health services usage by Alaskan injection drug users.

OBJECTIVES: The purpose of this study was to explore health services usage among injection drug users in Anchorage, Alaska. DESIGN: 645 participants were recruited as part of a federally funded study of needle exchanges. They completed a health services usage questionnaire that elicited information on use of a health care provider (physician or nurse) and emergency room services. Chi-square and t-tests were used for the bivariate analyses, and multiple logistic regression was used to develop the final predictive models. RESULTS: The majority of respondents (n = 646) were male (77 percent). Race/ethnicity included 58 percent White, 22 percent Alaska Native, and 20 percent African American. The multivariate model predicting accessing a health care provider (HCP) included ever having had chlamydia (OR 2.7, CI 1.6, 4.5), current income from welfare or public assistance (OR 2.6, CI 1.7, 3.9), current income from disability (OR 5.0, CI 2.2, 11.4), current income from SSI (OR .30, CI .12, .77) and the number of days in the last 30 used opiates other than heroin (OR 1.04, CI 1.002, 1.078). The multivariate model predicting use of an emergency room (ER) was similar to that predicting use of an HCP, with the additional finding of a negative association between being African American and ER use. CONCLUSION: The role of public assistance benefits enabling access to health care for IDUs has policy implications. Large public programs, such as the Indian Health Service, paid for much of the health care received by the IDUs recruited as part of this study.

Adult↗
PubMed1996

Immunological parameters associated with susceptibility or resistance to alveolar hydatid disease in Yupiks/Inupiats.

Alveolar hydatid disease (AHD) is a serious and often fatal disease with a relatively high prevalence among the Alaska native Yupik/Inupiat population. In a few patients, however, a spontaneous cure of the disease has been shown by demonstrating the presence of dead metacestode lesions. The present study shows a comparative analysis of the humoral (antibody activity to two different antigens: Em2-antigen and recombinant II/3-10-antigen) immune response and a respective immunogenetic background (HLA-DR typing) in (i) "susceptible" patients who had a still active intrahepatic metacestode and (ii) "resistant" patients who were shown to be spontaneously cured by presenting dead and calcified lesions. Control groups included relatives who were genetically closely related and less related cohabitants of the same villages. Antibody levels in the Em2- and the II/3-10-ELISA were high for patients who had still active lesions and low (Em2-ELISA) or negative (II/3-10-ELISA) for cured patients with dead lesions. Comparative HLA-DR analyses between infected and non-infected Yupiks/Inupiats revealed a slight tendency for susceptibility markers respective to the HLA-DRB1*0901 and HLA-DRB1*1601,02 genes.

Alaska↗
PubMed2006

Prevalence and persistence of antibodies to herpes viruses, Chlamydia pneumoniae and Helicobacter pylori in Alaskan Eskimos: the GOCADAN Study.

The prevalence and persistence of antibodies against cytomegalovirus (CMV), herpes simplex virus types 1 (HSV1) and 2 (HSV2), Helicobacter pylori and Chlamydia pneumoniae were determined in Alaskan Eskimos. The study included 610 individuals (mean age 43 +/- 15 years; 45% males) participating in the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study. Archived serum samples and those collected during the GOCADAN study were analysed for antibodies against the above pathogens by ELISA. The current prevalence of antibody seropositivity was 94% to CMV, 90% to HSV1, 38% to HSV2, 80% to H. pylori, and 42% to C. pneumoniae. The persistence of antibodies (in both archived and current samples) against CMV, HSV1 and H. pylori was high (83%, 84% and 67%, respectively) compared with those against HSV2 (26%) and C. pneumoniae (29%). Moreover, the seroconversion rates to these organisms were low. Most individuals acquired CMV, HSV1 and H. pylori antibodies by the age of 24 years (94%, 90% and 72%, respectively), and >50% carried HSV2 and C. pneumoniae antibodies by the age of 45 years. There were gender differences in antibody seropositivity rates. Over 70% of individuals had antibodies to at least three of the five pathogens tested. The study demonstrated the high prevalence and lifelong persistence of multiple antibodies, suggesting chronic infections among Alaskan Eskimos.

Adolescent↗
PubMed2003

The tribal environment: solid waste in Indian country.

The issue of solid waste management in Indian country is multidimensional in scope because it affects more than just regulatory concerns. There are more than 550 federally recognized Alaska Native and American Indian Tribes in the United States. Tribes are sovereign nations that have a special relationship to the federal government and a unique legal status. The environmental problems faced by tribes are many, and it is only fair that tribes, as sovereigns, specify the levels of protection on their lands. The one-size-fits-all regulatory approach to environmental problems and solid waste management in particular does not work and often leads to conflict between tribes and the federal and state governments. Inherent tensions also exist between tribes and various levels of government concerning jurisdiction of lands and managing solid waste. These intergovernmental relationships are often complex and present unique challenges to all. More research needs to be done on targeting resources to meet the capacity-building needs of tribes, as well as the overall environmental management needs of Indian country under the federal trust obligation. Successful intergovernmental relationships can be fostered through partnership arrangements between tribes and federal, state, and local governments. In the area of solid waste such partnerships have worked. It requires that all levels of government deal with tribes with careful consideration of their cultural, historic, and socioeconomic aspects, which are often intertwined.

Alaska↗
PubMed2005

Nurse case manager effectiveness and case load in a large clinical practice: implications for workforce development.

AIMS: Description of nurse case management experiences across different settings and patient populations is needed to define critical elements of the intervention and to help develop a workforce capable of responding to the growing diabetic population. METHODS: In a clinic providing services to American Indian and Alaska Native people, a retrospective cohort design was used to assess outcomes of patients who did and did not receive case management services and to quantify the case load of a team of four nurse case managers. RESULTS: Patients with nurse case managers were more likely to have an eye examination [OR 2.9, 95% CI (2.1, 3.8)], diet and exercise instruction by a registered dietitian [OR 2.8, 95% CI (1.9, 4.1)], self monitor blood glucose [OR 2.1, 95% CI (1.5, 3.1)], dental examination [OR 1.7, 95% CI (1.3, 2.3)], foot examination [OR 1.6, 95% CI (1.2, 2.1)], and nephropathy screening [OR 1.6, 95% CI (1.2, 2.1)]. After adjustment for type of treatment, initial HbA(1c), and diet instruction by a registered dietitian, the change in HbA(1c) remained significantly greater among those patients with a case manager than in those without (-0.52 units with vs. -0.17 units without, P < 0.006). The case load used to achieve this outcome averaged one nurse case manager per 365 patients. CONCLUSIONS: In this setting, a case management team comprised of four nurses with varying degrees of clinical experience was effective in improving adherence with diabetes services and had a favourable effect on short-term glucose control trends.

Adult↗