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At least 973 records · Page 54Linked to original sources
PubMed2004

Hepatitis A incidence and hepatitis a vaccination among American Indians and Alaska Natives, 1990-2001.

OBJECTIVES: We assessed the effect on trends in hepatitis A incidence of the 1996 recommendation for routine hepatitis A vaccination of American Indian/Alaska Native (AIAN) children. METHODS: We examined trends in hepatitis A incidence among AIAN peoples during 1990-2001 and vaccination coverage levels among children on the largest American Indian reservation. RESULTS: Hepatitis A rates among AIANs declined 20-fold during 1997-2001. Declines in hepatitis A incidence occurred among AIANs in reservation and metropolitan areas. Among 1956 children living on the Navajo Nation whose medical records were reviewed, 1508 (77.1%) had received at least one dose of hepatitis A vaccine, and 1020 (52.1%) had completed the vaccine series. CONCLUSIONS: Hepatitis A rates among AIAN peoples have declined dramatically coincident with implementation of routine hepatitis A vaccination of AIAN children.

Adolescent↗
PubMed1993

Cardiovascular disease among American Indians and Alaska Natives.

OBJECTIVE: To compare the regional differences in cardiovascular disease in AI/AN with the U.S. general population and determine the parity gap and preventable proportion of cardiovascular mortality. RESEARCH DESIGN AND METHODS: Age-adjusted cardiovascular disease mortality rates for 1981-1983 and hospital discharge rates for 1982-1984 reported by the IHS were compared with U.S. data for 1982 and 1983, respectively. RESULTS: Rates of ischemic heart disease and atherosclerosis were found to be generally low among AI/AN although those in the 25- to 44-yr age-group have higher death rates from cardiovascular disease than in the U.S. population. Although the mortality rate from cardiovascular disease in AI/AN is 19% lower than the rate for the general U.S. population, the parity gap in individual regions of the U.S. ranges from favorable to extremely unfavorable. There were also wide variations in the preventable gap theoretically possible by reduction of the three major risk factors. CONCLUSIONS: Changing nutrition and exercise patterns and the increasing prevalence of diabetes in many Indian tribes may have adverse effects in the future, possibly increasing the prevalence of heart disease. Regional differences in the prevalence of some major cardiovascular risk factors (smoking, hypertension, hypercholesterolemia, and diabetes) are the probable explanation for these differences in cardiovascular morbidity and mortality rates. Prevention and treatment of these risk factors will have the greatest impact in attempts to reduce cardiovascular disease among AI/AN. In addition, moderation in the use of alcohol, or abstinence, may prevent sudden deaths resulting from acute intoxication.

Adult↗
PubMed1983

Development of a competency-based training curriculum for substance abuse counselors in Alaska.

The development of a comprehensive competency-based substance abuse curriculum is reviewed and described. The curriculum, which is designed to help persons to further their understanding of alcohol and drug abuse, and/or to help strengthen counseling skills, can be adopted to meet a wide variety of delivery methods. The curriculum, which can be delivered at a university or within a treatment setting, offers a flexible and innovative way of providing substance abuse training to alcohol and drug workers and to those in health and health-related professions.

Alaska↗
PubMed2005

Evaluation of a volunteer sample in nasopharyngeal colonization surveys for Streptococcus pneumoniae in rural Alaska.

OBJECTIVE: To compare characteristics of persons in rural northern communities who participated in a study on antimicrobial use and drug-resistant Streptococcus pneumoniae (SP) to those who did not participate. STUDY DESIGN: The original study (1998--2000) was a community-based, controlled intervention trial designed to determine the penicillin susceptibility of nasopharyngeal SP isolates in relation to community-wide use of antibiotics. The study continued after 2000, in a subset of the original communities, to prospectively evaluate the impact of the heptavalent pneumococcal conjugate vaccine on the carriage of SP. The results presented here are an analysis of the first five years of data. METHODS: We conducted annual surveys (1998--2002) for nasopharyngeal colonization of SP using a volunteer sample of residents in rural communities. Medical chart reviews for health clinic visitation and antibiotic use were completed for all village residents. RESULTS: Participants were younger (22.8 vs. 28.4 years), had more health clinic utilization (3.3 vs. 2.4 visits) and received more antibiotics (1.0 vs. 0.6 courses) than non-participants. Differences between participants and non-participants were similar across all years of the study. CONCLUSIONS: Our study provides further empirical evidence that selection bias should be considered when designing studies. However, a volunteer sample provided internal consistency for comparison of our main study outcomes across time.

Adolescent↗
PubMed2005

Cardiovascular disease and risk factors in three Alaskan Eskimo populations: the Alaska-Siberia project.

OBJECTIVES: To determine the prevalence of CVD and to identify and characterize associated risk factors in three distinct Eskimo populations. STUDY DESIGN: Cross-sectional. METHODS: A slightly modified Strong Heart Study protocol was followed to examine 454 participants, aged 25-91, from four villages. RESULTS: Overall, 6% of the participants under 55 years of age and 26% of those > or = 55 years of age showed evidence of CHD by ECG, or in patient records. The prevalence of "definite coronary heart disease" (CHD) in women with glucose intolerance (GI) was 21.0%, compared to 2.4% in those with normal glucose tolerance (NGT). Men had comparable values of 26.7% and 6.3%. In addition, comparable values for "possible CHD" were 29.7% vs 6.0% for women and 21.4% vs 8.0% for men. GI was associated with relatively higher prevalences of CHD in women than in men (prevalence ratio = 8.5 vs 4.3). CHD was significantly related to age, glucose intolerance and insulin. Hypertension and obesity were significantly associated with CHD only in some ethnic groups. The prevalence of current smokers was 56%. CONCLUSIONS: Recent changes in lifestyle and diet of Alaskan Eskimos, leading to obesity, hypertension, insulin resistance and DM, contribute to an increased risk for cardiovascular disease.

Adult↗