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[From an urge for life to a wish to die. A sociocultural analysis].

In euthanasia and assisted suicide the wish to die has become greater than the wish to continue life. The reasons of this turn to death are subject of analysis. Examples, two from the Netherlands and one from the Eskimos demonstrate that the beginning of this process is an experience of irreversible loss. Cultural norms determine the meaning of this experience. Likewise, prevailing norms determine the possible unacceptability of the resulting deviancy. Coping with unacceptable deviancy is a restaurative strategy which fits in the prevailing cultural model. Eskimo assisted suicide is aimed at sectional interest: the request for life-ending help is posed on behalf of group survival. In the Netherlands euthanasia and assisted suicide are part of an individualistic culture with an earthly system of meaning. The emphasis is on good health, youth and representative appearance. The individual request for help is posed on behalf of the individual himself, to prevent social isolation, and to die in a clean way in self-selected company.

Adult↗

Vaccination coverage levels among Alaska Native children aged 19-35 months--National Immunization Survey, United States, 2000-2001.

In 2000, a total of 118,846 persons indicated that their race/ethnicity was Alaska Native (AN), either alone or in combination with one or more other racial/ethnic groups. AN groups comprise 19% of the population of Alaska and 0.4% of the total U.S. population. The AN grouping includes Eskimos, Aleuts, and Alaska Indians (members of the Alaska Athabaskan, Tlingit, Haida, or other AN tribes). Eskimo represented the largest AN tribal grouping, followed by Tlingit/Haida, Alaska Athabascan, and Aleut. Vaccination coverage levels among AN children have not been reported previously. This report presents data from the National Immunization Survey (NIS) for 2000-2001, which indicate that vaccination coverage levels among AN children aged 19-35 months exceeded the national health objective for 2010 (objective no. 14-22) for the majority of vaccines. This achievement indicates the effectiveness of using multiple strategies to increase vaccination coverage. Similar efforts might increase vaccination coverage in other rural regions with American Indian (AI)/AN populations.

Alaska↗

[Dog bites in the sledge-dog districts of Greenland].

Serious attacks on humans by dogs occur every year in Greenland. As prophylactic measures, cutting of dogs canine teeth and chaining of sledge dogs have been compulsory for many years. The significance of cutting of canine teeth and municipal regulations concerning keeping the sledge dogs in Greenland was evaluated in a retrospective study of the death certificates and the nosocomial reports. A total of twenty-two dog bite-related fatalities from 1967 through 1989 and 23 hospitalized patients following dog attacks from 1986 through 1988 in a population of 15,000 inhabitants and 29,000 dogs was studied. In only two of the killed and four of the hospitalized persons, reports of intact canine teeth as demonstrated by the typical lesions were available. However, the severe cut-out wounds in 14 survivors and twenty fatalities with great loss of tissue indicated intact canine teeth of the dogs. Unchained dogs were most frequently involved, but at least four fatalities and one severely injured person were caused by chained dogs. 87% (39/45) of the victims were under ten years of age, so future intervention should primarily involve this group despite a declining mortality rate since the mid-seventies. Small children should be escorted by adults out-of-doors and first aid education of laymen ought to have a higher priority because half of the killed children were still alive, on arrival in hospital. Infants and toddlers should be carried in an amaat, a special rucksack well known in the Eskimo culture and still used in Eskimo Canada, or alternatively rucksacks mounted on a tubular frame of aluminium.

Adult↗

[Genetic history of Aleuts of the Komandor islands from results of analyzing variability of class II HLA genes].

Variability of the HLA class II genes (alleles of the DRB1, DQA1, and DQB1 loci) was investigated in a sample of Aleuts of the Commanders (n = 31), whose ancestors inhabited the Commander Islands for many thousand years. Among 19 haplotypes revealed in Aleuts of the Commanders, at most eight were inherited from the native inhabitants of the Commander Islands. Five of these haplotypes (DRB1*0401-DQA1*0301-DQB1*0301, DRB1*1401-DQA1*0101-DQB1*0503, DRB1*0802-DQA1*0401-DQB1*0402, DRB1*1101-DQA1*0501-DQB1*0301, and DRB1*1201-DQA1*0501-DQB1*0301) were typical of Beringian Mongoloids, i.e., Coastal Chukchi and Koryaks, as well as Siberian and Alaskan Eskimos. Genetic contribution of the immigrants to the genetic pool of proper Aleuts constituted about 52%. Phylogenetic analysis based on Transberingian distribution of the DRB1 allele frequencies favored the hypothesis on the common origin of Paleo-Aleuts, Paleo-Eskimos, and the Indians from the northwestern North America, whose direct ancestors survived in Beringian/southwestern Alaskan coastal refugia during the late Ice Age.

Alleles↗

Rheumatic diseases in Alaskan Indians of the southeast coast: high prevalence of rheumatoid arthritis and systemic lupus erythematosus.

A review of rheumatic diseases in the southeast coastal Indians of Alaska revealed high frequencies of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Both prevalence and incidence rates of RA were significantly higher and the peak age of incidence was younger in the southeast Alaskan Indian population than in Alaskan Eskimo groups and the United States population in general. The prevalence of SLE in the Alaskan Indian population was about twice that reported for most white populations. The frequency of seronegative spondyloarthropathic disorders was similar in the Alaskan Indian and Eskimo populations. Comparable studies of the prevalence of spondyloarthropathy in general have not been carried out in white populations. The prevalence rate of ankylosing spondylitis, one of the major types of spondyloarthropathy, did not differ significantly in the SE Indians from rates in predominantly white US populations.

Adolescent↗

Nasopharyngeal carcinoma: epidemiology and dietary factors.

Nasopharyngeal carcinoma (NPC) is a disease with a remarkable racial and geographical distribution. It is very rare (incidence of less than 1 per 100,000 person-years) in most parts of the world, and in only a handful of populations does this low-risk profile deviate; these groups include people in southern China, Eskimos and other natives of the Arctic region, natives of south-east Asia, and the mainly Arab populations of North Africa and Kuwait. Convincing evidence implicates dietary factors as the primary cause of NPC among Chinese. A series of case-control studies conducted in various Chinese populations with distinct risks of NPC, ranging from the very high-risk Cantonese populations to the relatively low-risk northern Chinese, have suggested that ingestion of salted fish and other kinds of preserved foods constitutes the most important cause of NPC among these people. Preliminary data on Malays in south-east Asia, Eskimos in Alaska and Arabs of North Africa also suggests that ingestion of preserved foods by these population groups may be responsible for their raised incidence of NPC.

Animals↗

Passive immunization for infection with Haemophilus influenzae type b.

Haemophilus influenzae type b is the leading cause of meningitis in children younger than 5 years of age in the United States. The incidence of infection with H influenzae type b in certain populations, such as Apache and Navajo Indians and Alaskan Eskimos, is 10 to 20 times higher than in the general US population. Another important feature of H influenzae type b infections in these populations is that more than 80% of the cases occur during the first year of life, with 35% to 45% occurring during the first 6 months. One of the currently licensed vaccines that contains the capsular polysaccharide of the H influenzae type b organism is not reliably immunogenic in infants younger than 18 months of age. A number of new H influenzae type b vaccines prepared by covalently coupling the H influenzae type b capsular polysaccharide with a protein carrier antigen are undergoing clinical evaluation. One of these conjugate vaccines was shown to be efficacious in preventing disease caused by H influenzae type b in Finnish infants when they were immunized at 3, 4, and 6 months of age. Unfortunately, in a recently concluded trial, the same vaccine was not found to be efficacious in preventing such disease in infants younger than 1 year of age among the Alaskan Eskimo population. We have evaluated an alternative approach for protecting high-risk infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗

Diet and nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a disease with a remarkable racial and geographical distribution. It is very rare (incidence of less than 1 per 100,000 person-years) in most parts of the world and only a handful of populations are known to deviate from this low-risk profile, which include people of southern China, Eskimos and other natives of the Arctic region, natives of southeast Asia, and the mainly Arab populations of north Africa and Kuwait. There is now convincing evidence implicating dietary factors as the primary cause of NPC among Chinese. A series of case-control studies conducted in various Chinese populations with distinct risks of NPC, ranging from the very high-risk Cantonese to the relatively low-risk Northern Chinese, have suggested that ingestion of salted fish and other kinds of preserved foods by the Chinese constitutes the most important cause of NPC development among these people. Preliminary data on Malays in southeast Asia, Eskimos in Alaska, and Arabs of north Africa also suggest that ingestion of preserved foods by these population groups may be responsible for their raised incidence of NPC. Regardless of race and geography, the commonest form of nasopharyngeal cancers are those that arise from the epithelial cells lining the nasopharynx. These carcinomas (commonly referred to as NPCs) constitute 75-95% of nasopharyngeal cancers in low-risk populations and virtually all nasopharyngeal cancers in high-risk populations (Ho, 1971; Sugano et al, 1978; Levine and Connelly, 1985).

Animals↗

[Fish oil: clinical application possibilities].

Current interest in fish-oil stems in part from epidemiologic evidence gathered in eskimos. Due to a high proportion of fish in their diet eskimos have a low incidence in cardiovascular mortality. The active principle in fish-diet are n-3-fatty acids. These modulate prostaglandin and leukotriene metabolism. Numerous studies have been undertaken to demonstrate clinical usefulness. Current interests focus on lipid lowering, inhibition of hemostasis and antihypertensive actions. Furthermore antiinflammatory and immunologic effects as well as uses in oncology are discussed.

Blood Pressure↗

Marine lipids and coronary angioplasty. Benefit or risk.

More than 10 years ago Dyerberg and Bang first reported a lower incidence of coronary disease in the Greenland Eskimos. This finding was attributed to their diet, which was rich in fat from whale, fish, and seals. Further analysis revealed that the Eskimos had lower levels of plasma cholesterol and triglyceride and high plasma concentrations of certain polyunsaturated fatty acids. The fatty acids, eicosapentaenoic acid and docosahexaenoic acid, are part of the omega-3 fatty acid family. The effects of these fatty acids on serum cholesterol and platelet function have been the basis of extensive investigation. Most recently, studies have been conducted on the effect of omega-3 fatty acids on patients undergoing coronary angioplasty to determine if omega-3 fatty acid's effect on platelet function might decrease the high restenosis after coronary angioplasty. However, the results of these trials remain controversial. This article presents an overview of marine lipid research and its role in the treatment of coronary disease.

Angioplasty, Balloon, Coronary↗

[Transport of the fatty acids composing the phosphatidylcholines and sphingomyelins of the low- and very high-density lipoproteins in the blood plasma in myocardial hypertrophy].

A comparative analysis of the fatty acid composition of phosphatidylcholines (PC) and sphingomyelins (SP) of lipoproteins (LP) of low and very low density was performed in the blood plasma of Eskimos (indigenous population of the Chukot Peninsula) in myocardial hypertrophy and in the control group as well as in the control group of Muscovites. Some characteristic features of the fatty acid composition of low density LP PC and SP were revealed in Eskimos in myocardial hypertrophy. The role of changes in the transport of fatty acids of low density LP PC and SP of the blood plasma in the myocyte membrane liquidity as well as in the synthesis of biologically active prostacyclin revealed in myocardial hypertrophy was discussed.

Adult↗

The malignant lymphoepithelial lesion of the salivary glands.

Malignant lymphoepithelial lesion (MLEL) is a rare neoplasm of the salivary gland which has an exceptionally high incidence in the Eskimo. Eighty-four cases have been previously reported. Seven additional cases in six Eskimos and one Filipino patient are reported in this paper. The etiology, treatment and prognosis of these lesions is then discussed.

Adult↗

Human botulism in Canada (1919-1973).

Since 1919, in Canada, 62 authenticated outbreaks of human botulism have affected 181 persons, with 83 deaths, a fatality rate of 46%. Among these, 41 outbreaks were bacteriologically determined (31 in one laboratory) as six type A, four type B, one both A and B, and 30 type E. About two thirds of the total outbreaks, cases and deaths involved Eskimos and Pacific coast Indians consuming raw marine mammal products and salmon eggs, respectively. Other parts of Canada recorded seven occurrences due to miscellaneous vehicles, three being type B. Since January 1961 there have been 38 outbreaks, involving 94 cases with 33 deaths. These include 18 outbreaks among Eskimos, affecting 51 persons (of whom 24 died) in Labrador, southern Baffin Island, northern Quebec, and the Mackenzie area. Also, putrid salmon eggs caused 15 outbreaks among Pacific coast Indians, totalling 35 cases, of whom only six died, the low fatality rate reflecting the introduction of type E botulinus antitoxin during 1961.

Animals↗

The initial peopling of the Americas: an overview from the perspective of physical anthropology.

A central problem of human evolution is whether the transition from Homo erectus to Homo sapiens was anagenetic or cladogenetic. The existence of H. erectus at Zhoukoudian between 460,000 and 230,000 years B.P. is consistent with early cladogenesis or a later transition. Evidence from mitochondrial DNA suggests present day humans could have evolved from a population existing between 180,000 and 360,000 years ago. Genetic distance studies based on nuclear genes suggest divergence between Negroids and Mongoloid-Caucasoids 115,000 years ago and between Caucasoids and Mongoloids 41,000 years ago. Recent fossil evidence is consistent with these estimates. Other evidence is accumulating that Asia is the heartland for the emergence of Homo sapiens. The earliest clearly defined North American culture (Clovis) was established at most by 14,000 years B.P. and on some views had spread to Tierra del Fuego by 11,000 B.P. Other evidence from geographically diverse areas suggests an earlier arrival. The initial human occupation of the Americas probably occurred somewhere between 12,000 and 40,000 years ago. However, much of the work on dating skeletal material has yielded inconsistent or unreliable information. Paleoecology indicates that at the maximum lowering of sea-level, 18,000 years ago, the Beringia land bridge was 1000 Km wide and was an inhospitable region of wind-blown dunes and discontinuous vegetation. However, there may have been patches of greater productivity. One theory suggests humans were widely distributed in Beringia as early as 35,000 B.P. and had penetrated Alaska and Yukon by 25,000 B.P. Again, however, the archaeological evidence for early occupation is conflicting and uncertain. Evidence based on analysis of gene frequencies and on dental data suggests North American origins by 19,000 and 15,000 respectively. Further, both the genetic and dental evidence favour an Asian origin, but whether the result of a single or multiple migrations is still an open question. The view here is that the erectus-sapiens transition took place somewhere in South Asia between 125,000 to 200,000 years ago, with the appearance of anatomically modern man by 30-40,000 B.P. Sometime between 30,000-15,000 B.P. the first people crossed Beringia to North America, spreading to occupy all of the Americas rapidly. The ancestors of the Na-Dene Indians and the Aleut-Eskimos were later and perhaps separate arrivals from Asia between 14,000-8,500 B.P. The Eskimo ancestors arose finally by a fissioning of the Aleutian Island-Southwest Alaskan maritime population about 4,000 years ago.

Anthropology, Physical↗

Native healing in Alaska. Report from Serpentine Hot Springs.

Traditional Alaskan Native healing practices, specifically sweat bathing and hot springs bathing, have medical connotations in that they involve sociocultural factors important to practicing medicine among Alaskan Native people. At Serpentine Hot Springs in northwest Alaska, relief for arthritis, back pain, hip pain, headaches, skin rashes and other disorders was sought. The "treatment setting" was an informal bathhouse and bunkhouse and Eskimo tribal doctors and patients were assigned tasks related to healing. Continuity with traditional cultural patterns was achieved in several ways: meals tended to be traditional Eskimo fare, the predominant language spoken was Inupiaq and styles of interaction were Inupiat in character. All patients showed improvement. The experience reported herein is instructive for those seeking innovative approaches treating Native American groups.

Adult↗

Cancers of the gallbladder and biliary tract in Alaskan natives: 1970--79.

The records of Alaskan Native patients with gallbladder and extrahepatic bile duct cancers diagnosed during 1970--79 were reviewed. Of 34 cases identified, the primary cancer was in the gallbladder in 29, resulting in age-adjusted incidence rates for gallbladder cancer of 4.4 for males and 17.6 for females. On the basis of calculations applying cancer incidence rates for U.S. whites to the Alaska Native population, a greater than expected number of both Eskimo and Indian patients were diagnosed. A 5-year review of cholecystectomies indicated that nonmalignant gallbladder disease was also elevated in both Indians and Eskimos.

Adenocarcinoma↗

Cancer in Alaskan Natives: 1974-78.

Preliminary results of a cancer incidence survey among Alaskan Natives, 1974-78, indicated that patterns continue to differ from those of U.S. whites. Significantly high risks were found for cancers of the nasopharynx and liver in men, and cancers of the nasopharynx, gallbladder, cervix, and kidney in women. In men, significantly low risks were found for cancers of the prostate and bladder, leukemia, and lymphoma, and in women for cancers of the breast and uterus (excluding cervix), and lymphoma. Results are also given separately for Eskimo-Aleuts and Indians. Compared with Indians, Eskimo-Aleuts had higher risks for nasopharyngeal and liver cancers and lower risks for prostate and breast cancers.

Adult↗

Genetic relationships among the Native American populations.

Red cell antigen data were used to investigate the genetic relationship among the Native American populations and their affinities with Siberian and Eastern Asian populations. Correspondence analysis showed a clear subdivision of all the Native American populations into three clear-cut clusters corresponding to the three linguistic families (identified by Greenberg)--Amerind, Na-Dene and Eskimo-Aleut. This result, as well as the close genetic resemblance between the Eskimos and the Asian populations, support the conclusion that the Americas were populated during at least three distinct and subsequent migration waves of people coming from Asia.

Alleles↗