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 145 records · Page 8Linked to original sources
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↗
PubMed2005

Communicating respectfully with American Indian and Alaska natives: lessons from the California Health Interview Survey.

Background. California is home to the largest number of American Indians in the United States, including large numbers of residents who are from tribes outside of the state, in addition to Alaska Natives. In 2000 to 2001, the California Health Interview Survey randomly surveyed, by telephone, approximately 54,122 households throughout the state, focusing on public health and access to health care. Methods. American Indian and Alaska Native cultural competency training materials were developed for the data collection interviewers. Unique cultural and linguistic issues identified were (1) reservation dialect English, (2) the long pause, (3) slow speaking, (4) "walking on words," and (5) a brief review of the importance of collecting tribal heritage information. Conclusions. Since the successful implementation of the competency training, several researchers, practitioners, state agencies, and others have requested and implemented the training materials in their work. In this article, we review the training materials. We hope that these few tips will help others have successful experiences communicating respectfully with American Indian and Alaska Natives.

Alaska↗
PubMed1990

Botulism among Alaska Natives. The role of changing food preparation and consumption practices.

Alaska Natives have one of the highest rates of food-borne botulism worldwide. All outbreaks have been associated with the consumption of native foods, but in recent years outbreaks have occurred in previously unaffected areas and have involved new food items. Five botulism outbreaks occurred between 1975 and 1985 in an area of southwestern Alaska without previous confirmed outbreaks and among one ethnic group, the Yupik Eskimo. Of the 5 outbreaks, 3 were associated with fermented beaver tail, a nontraditional native food recently introduced into the region. Preparation techniques vary widely within villages and among ethnic groups. Traditional fermentation techniques have changed over the past 50 years; current preparation methods used by some families and ethnic groups may be more favorable for Clostridium botulinum growth. Prevention efforts should be targeted at high-risk subgroups of Alaska Natives who appear to have modified traditional practices and increased their risk of food-borne botulism.

Adult↗
PubMed1995

Dietary change and obesity associated with glucose intolerance in Alaska Natives.

OBJECTIVE: To investigate frequency of food intake, body weight, and glucose intolerance in Alaska Natives. DESIGN: Height, weight, and random blood glucose levels were measured and a frequency-of-food-intake questionnaire was obtained. This questionnaire classified persons as consumers of indigenous foods or nonindigenous foods within three food groups. Those with a random blood glucose measurement > or = 6.72 mmol/L received an oral glucose tolerance test. SETTING: Community screening in 15 villages in Alaska. SUBJECTS: Nutrition screenings were done for 1,124 Alaska Native residents aged 20 years or older. An oral glucose tolerance test was done for 202 subjects. OUTCOMES MEASURED: Subjects were classified as consumers of indigenous or nonindigenous foods within three food groups. A diagnosis of non-insulin-dependent diabetes mellitus (NIDDM) was made on the basis of World Health Organization criteria. A determination of overweight was made on the basis of National Center for Health Statistics criteria. STATISTICAL ANALYSIS: A chi 2 test with Yates correction, t test, and linear regression, with two-sided P values. RESULTS: Athabascan Indians had twice the rate of NIDDM as Yup'ik Eskimos with significantly higher frequency of nonindigenous food intake, plus lower frequency of indigenous carbohydrate and fat intake. Subjects < or = 30 years old consumed significantly more nonindigenous protein and fat and low-nutrient-density carbohydrates than those > or = 60 years old. Persons who had glucose intolerance reported significantly greater consumption of nonindigenous protein and less seal oil. Incidence of overweight was significantly higher than was found 25 years ago. Participants with glucose intolerance were significantly more overweight than others. CONCLUSION: A pattern of increased frequency of nonindigenous protein, low-nutrient-density carbohydrate, and fat intake with less indigenous carbohydrate and fat consumption was found in subjects < or = 30 years old and in association with the higher rate of NIDDM found in the Athabascan Indians. Persons with glucose intolerance were significantly more overweight than others. APPLICATIONS: Although the nutritional value of indigenous foods for reducing disease risk should be promoted, nutrition education, especially among young adults, should also include building skills to select and prepare nonindigenous foods to attain a healthful diet. Although snacking is a concern, dietary fat was the most significant factor in obesity and NIDDM.

Adult↗
PubMed2000

Tooth loss and need for extractions in American Indian and Alaska Native dental patients.

OBJECTIVE: This article reports results of the 1991 Indian Health Service Patient Oral Health Survey in the areas of tooth loss and need for tooth extraction. METHODS: The survey examined a sample of American Indian and Alaska Native dental patients. Tooth loss and need for tooth extraction are explored for a total of 12,349 individuals aged 18 years and older. RESULTS: Complete tooth loss in patients aged 35 years and older was 11 percent; in patients aged 65 years and older, it was 42 percent. The mean number of remaining teeth in dentate patients aged 35 years and older was 20.7; the mean number of remaining teeth decreased in each older age group. Partial and complete tooth loss were more severe in diabetic patients. In 35- to 44-year-old patients, only 20 percent had not lost at least one permanent tooth. The prevalence of tooth loss differs by geographic region. The percentage of dental patients with 20 or more teeth increased between 1984 and 1991. CONCLUSION: Tooth loss remains a substantial problem in American Indian and Alaska Native adult dental patients. This article presents results of an Indian Health Service (IHS) oral health survey conducted in 1991 of the American Indian and Alaska Native (Native American) population with respect to tooth loss. Limited comparisons of tooth loss observed in the 1991 patient survey are made to the 1984 patient survey.

Adolescent↗
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↗
PubMed2006

Adverse birth outcomes associated with open dumpsites in Alaska Native Villages.

This retrospective cohort study evaluated adverse birth outcomes in infants whose birth records indicated maternal residence in villages containing dumpsites potentially hazardous to health and environment. Birth records from 1997 to 2001 identified 10,073 eligible infants born to mothers in 197 Alaska Native villages. Outcomes included low or very low birth weight, preterm birth, and intrauterine growth retardation. Infants from mothers in villages with intermediate (odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.06, 2.84) and high (OR = 2.06, 95% CI: 1.28, 3.32) hazard dumpsites had a higher proportion of low birth weight infants than did infants from mothers in the referent category. More infants born to mothers from intermediate (OR = 4.38, 95% CI: 2.20, 8.77) and high (OR = 3.98, 95% CI: 1.93, 8.21) hazard villages suffered from intrauterine growth retardation. On average, infants weighed 36 g less (95% CI: -71.2, -0.8) and 55.4 g less (95% CI: -95.3, -15.6) when born to highly exposed mothers than did infants in the intermediate and low exposure groups, respectively, an effect even larger in births to Alaska Native mothers only. No differences in incidence were detected across exposure levels for other outcomes. This is the first study to evaluate adverse pregnancy outcomes associated with open dumpsites in Alaska Native villages.

Adult↗
PubMed2006

The National Eye Health Education Program: increasing awareness of diabetic eye disease among American Indians and Alaska Natives.

With the highest prevalence of diabetes in the United States, American Indians and Alaska Natives are at greatest risk for diabetic eye disease (DED), a leading cause of blindness. The National Eye institute (NEI) conducted formative research to understand DED-related knowledge, identify approaches to managing this disease, and design a communication plan to increase awareness and reduce DED among these populations. The NEI conducted qualitative research at five locations in indian country with representatives from national organizations, tribal members, and healthcare providers. While diabetes ranked high on their list of primary community health issues in need of attention, study participants had only a basic level of diabetes-related knowledge, acknowledged the need for DED education, and underscored the importance of the use of interpersonal and culturally appropriate communication strategies. This is the first exploratory qualitative research study to examine the status of diabetic eye disease among American indians and Alaska Natives whose primary purpose was to inform the design of a national DED communication campaign.

Adult↗
PubMed1997

Human papillomavirus type 16 DNA in esophageal carcinomas from Alaska Natives.

The possible etiological role of human papillomavirus (HPV) in esophageal carcinogenesis was evaluated in Alaska Natives in whom the incidence of esophageal cancer is 1.3 and 3.8 times higher than in US Caucasian men and women, respectively. Fixed paraffin-embedded esophageal tissues from 32 cases of squamous-cell carcinoma (SCC) and 3 cases of adenocarcinoma (AC) diagnosed between 1957 and 1988 were analyzed by polymerase chain reaction (PCR) and in situ hybridization for HPV DNA sequences. Detection of the human beta-globin gene by PCR was used as a control for sufficiency of DNA and its potential for amplification in the tissue samples. Twenty-five of the tumor tissues were considered adequate for PCR analyses; HPV DNA was detected in 10 of 22 SCCs and was not found in 3 ACs. Seven of the 10 HPV-positive tissues contained sequences from the E6 gene of HPV type 16. Koilocytosis, an epithelial change consistent with HPV infection, was found in 80% of the esophageal squamous-cell tumors with HPV DNA and in 75% of those without HPV DNA. The detection of amplifiable cellular DNA was related to recentness of diagnosis; however, the detection of HPV DNA within amplifiable specimens was not related to recentness of diagnosis. A 413-bp sequence from the L1 open reading frame of HPV 16 from esophageal tissue of 2 patients was identical to sequences previously identified in cervical cells from other Alaska Natives. Our results provide molecular evidence of HPV infection, especially type 16, in archival esophageal cancer tissues from 45% of those patients whose specimens contain adequate DNA for PCR analysis.

Adenocarcinoma↗
PubMedDate not supplied

Risk factors for osteoporosis in Alaska Native women: a cross-sectional survey.

OBJECTIVES: To estimate the prevalence of risk factors for osteoporosis in Alaska Native (AN) women and to assess the feasibility of portable bone density measurement in rural Alaska. METHODS: We conducted a cross-sectional survey of a convenience sample of 452 patients from 17 clinics in Alaska. We interviewed subjects regarding risk factors for osteoporosis and measured calcaneal bone density by ultrasound. RESULTS: Of the 452 women, 316 (70%) were Alaska Natives. Risk factors for osteoporosis were common among study participants. Total dietary calcium intake was low (mean = 306 mg/day). Current smokers [Odds Ratio (OR) = 3.9, 95% Confidence Interval (95% C.I.) 1.8, 8.4], former smokers (OR = 2.8, 95% C.I. 1.3, 6.2) and chronic users of oral steroids (OR = 4.7, 95% C.I. 1.8, 12.0) were at increased risk for low bone density. CONCLUSIONS: Reduction of cigarette smoking, increase in dietary calcium, and reduction of oral steroid use would likely decrease the prevalence of osteoporosis in AN women. A comprehensive prevention program including bone density screening is warranted in rural Alaska.

Absorptiometry, Photon↗
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↗
PubMed1998

Preliminary experience with an orthopedic teleradiology service at the Alaska Native Medical Center.

The orthopedic service at the Alaska Native Medical Center (ANMC) in Anchorage provides comprehensive orthopedic care to 103,000 Native or "First Nation" peoples in the state of Alaska. From its base at ANMC, a 140-bed general hospital, the service provides outpatient services, inpatient services including surgery, and telephone consultation services to 10 regional medical centers, 15 subregional clinics, and 20 village health centers distributed over a wide geographical area. These outlying centers are staffed by 108 full- and part-time primary care physicians, 74 primary care advanced practice nurses or physicians assistants, and 456 Community Health Aides. In providing telephone consultation service, the current version of "radio clinic," a frequent challenge arises in interpretation of verbal descriptions of x-ray findings. Our primary care clinicians, while highly trained, cannot be expected to interpret x-rays at the same level as a specialist. Discrepancies occur in communicating radiographic detail. This can result in either delayed or unnecessary transfer of patients, inappropriate travel to regional medical centers or home villages, or simply suboptimal medical care. Fortunately, computer technology has evolved to a point at which quality x-ray images can be transmitted relatively inexpensively. This paper will describe our preliminary experience with such a system.

Academic Medical Centers↗
PubMed2003

Diabetes among Alaska Natives: a review.

This review summarizes the published information on diabetes mellitus and gestational diabetes among Alaska Natives. The most recently published age-adjusted prevalence was 28.3/1000 in 1998. There is evidence of a steadily increasing prevalence, documented both by cross sectional screening studies and patient registry methods. The overall incidence rates in 1986-1998 of lower extremity amputation (6.1/1000) and renal replacement therapy (2.1/1000) appear to be lower than those in other Native American populations in the United States. Incidence of stroke and MI in 1986-1998 varied widely by ethnic group and gender with Eskimo women having the highest rate of stroke (19.6/1000), and Aleut men the highest rate of MI (14/1000). The overall mortality among diabetic Alaska Native people in 1986-1993 (43.2/1000) was somewhat lower than that in other US diabetic populations, with heart disease being the most common cause of death. A high rate of gestational diabetes (6.7%) was reported in one region in 1987-88, but this appeared to decline following nutritional education intervention. In screening studies, the prevalence of abnormal glucose tolerance has been found to be positively associated with body mass index and negatively associated with daily seal oil or salmon consumption and higher levels of physical activity. Observations on the prevalence and relationships among other factors in the insulin resistance syndrome are summarized. Suggestions for prevention of diabetes and further studies are presented.

Adult↗
PubMedDate not supplied

Repeated infections with Neisseria gonorrhoeae in a population of Alaska natives.

Medical and laboratory records of 171 Alaska Natives were studied retrospectively, and the incidence of repeated infections with Neisseria gonorrhoeae was determined. Thirty-four per cent of the subjects had more than one gonorrheal infection within 18 months. The largest proportion of reinfections occurred within a relatively short period of time following the most recent previous infection: 29.3% within the first six weeks and, greater than 50% within 15 weeks. Men aged greater than or equal to 30 years were 2.4 times more likely than women in the same age group to acquire reinfections. The rate of reinfection for teenage women was nearly twice that for older women. Goodness-of-fit tests indicated the existence of a group of chronic repeaters responsible for a large number of reinfections.

Adult↗
PubMed1995

Research on excess deaths among American Indians and Alaska Natives: a critical review.

American Indians and Alaska Natives die younger and at higher rates proportionately than members of the general United States population. Causes of death among Native peoples in the U.S. have been the subject of numerous studies by health care professionals and social scientists. Many of these deaths are considered excess deaths, that is, deaths that occur statistically beyond the rate of incidence of the larger population. This paper examines 46 studies of excess deaths published within five years (1987 to 1993) and based on data gathered within ten years (1982 to 1992) and critiques the studies for methodology and context. Existing studies of excess death among Native peoples are limited by a lack of definitional clarity, ethnic misclassifications, lack of multidisciplinary and Native representation on research terms, superficial analysis of statistical findings, overrepresentation of data for some tribes and underrepresentation for others, bias for quantitative research methods and unbalanced prioritization.

Bias↗
PubMed1994

Weight perceptions and weight control practices in American Indian and Alaska Native adolescents. A national survey.

OBJECTIVE: To assess weight perceptions and weight control practices among American Indian-Alaska Native adolescents. DESIGN: Survey. SETTING: Nonurban schools from eight Indian Health Service areas. PARTICIPANTS: A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths. MAIN OUTCOME MEASURES: A revised version of the Adolescent Health Survey, a comprehensive, anonymous self-report questionnaire with eating- and body image-related questions. RESULTS: Forty-one percent of the adolescent girls reported feeling overweight, 50% were dissatisfied with their weight, and 44% worried about being overweight. Almost half (48%) had been on a weight-loss diet in the past year, with 27% reporting that they had self-induced vomiting at some time to try to lose weight. Eleven percent reported using diet pills. Girls who reported feeling overweight were more likely to engage in unhealthy weight control practices than were those who felt they were of normal weight or underweight. A larger proportion of boys were satisfied with their weight (68%), with 22% worrying about being overweight. However, compared with rural Minnesota youth, both American Indian girls and boys had greater dissatisfaction with body weight. CONCLUSIONS: Our study shows that American Indian youth, particularly girls, are dissatisfied with their weight and are worried about being overweight, and that unhealthy weight control practices are common. More attention needs to be placed on developing culturally appropriate weight management programs for Indian youths.

Adolescent↗
PubMed2006

Statin use in American Indians and Alaska Natives with coronary artery disease.

PURPOSE: The use and adherence to statin therapy in American Indians and Alaska Natives with coronary artery disease (CAD) were studied. METHODS: A retrospective database analysis of the Phoenix Area of the Indian Health Service was conducted. For the cohort of patients with CAD, prescription data were obtained for all statins during calendar year 2003. Use was determined by the presence of at least one statin prescription, whereas adherence was assessed using the medication possession ratio (MPR), persistence, and median gap. RESULTS: The study cohort was composed of 2095 adults (55.6% men) with at least one medical encounter for CAD during calendar year 2002. The mean +/- S.D. age of the cohort was 62.7 +/- 12.7 years. At least one prescription for any statin drug during 2003 was found for 865 (41.3%) patients. Those who received a statin were more likely to be male, be younger than 80 years, and have a greater number of medical visits. The mean MPR was 0.78 +/- 0.25, and nonadherence was found in approximately 40% of patients receiving statins. In the age category of 65-79 years, men were more adherent than women, and patients in this category were overall more adherent than younger patients. CONCLUSION: The use of statins in a cohort of American Indians and Alaska Natives at high risk for cardiovascular events was approximately 40% with a 60% adherence rate. Age, sex, and number of medical visits were associated with statin use, and age and sex were associated with adherence.

Adult↗
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↗