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At least 19 recordsLinked to original sources

Proceedings of the Alaska-Russia Native Peoples Health and Social Issues Conference. May 1992, Alaska.

An Alaska-Russia Native People's Health and Social Issues Conference, sponsored by the Alaska Department of Health and Social Services, the Alaska Native Foundation, the University of Anchorage Institute for Circumpolar Health Studies, the International Scientific Center "ARTIKA" (Magadan, Russia), the Associations of Native People of Chukotka and Kolyma, and the Magadan Native Association, was held in Wasilla, Alaska in May, 1992. The conference brought together Native people, primarily health and social services workers, to discuss differences and similarities in issues and approaches, and to lay the foundation for future collaboration. The primary participants came mostly from rural villages and small regional cities, and represented Native Health Corporations, Native Associations, and villages. Additional participants came from the University of Alaska, the Alaska Department of Health and Social Services, the Indian Health Service, the Magadan Health Department, the Inuit Circumpolar Conference, and the International Union for Circumpolar Health. A Total of 39 people participated, including: eight Russian Natives (Chukchi, Even, and Siberian Yup'ik); three non-Native Russians; 18 Alaska Natives (Aleut, Athabaskan, Inupiat, Siberian Yup'ik, Yup'ik); nine non-Native Alaskans; one Canadian. The issues discussed in individual and panel presentations, and in small groups, included history, demography, settlement patterns, the cash and subsistence economies, mental and physical health (epidemiology, etiology, treatment and prevention), education, governance, culture and language. As the conference participants came to know each other better, the discussions became increasingly open, and, particularly around shared feelings of cultural oppression and loss, emotional.(ABSTRACT TRUNCATED AT 250 WORDS)

Alaska↗

Limited efficacy of a Haemophilus influenzae type b conjugate vaccine in Alaska Native infants. The Alaska H. influenzae Vaccine Study Group.

BACKGROUND: The prevention of invasive Haemophilus influenzae type b disease requires a vaccine that is effective when administered during the first six months of life. The infants of Alaska Natives are at particularly high risk of invasive H. influenzae type b disease. METHODS: To evaluate the protective efficacy of a H. influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine (polyribosylribitol phosphate-diphtheria toxoid [PRP-D]), we enrolled 2102 Alaska Native infants in a randomized, double-blind, placebo-controlled trial in which either the vaccine or a saline placebo was administered at approximately two, four, and six months of age. RESULTS: After 3969 subject-years of follow-up and 32 episodes of H. influenzae type b disease, the overall incidence of invasive disease was not reduced significantly in the vaccinated subjects (6.0 cases per 1000 patient-years), as compared with the placebo controls (9.6) or with other Alaska Native infants (6.0). After one, two, or three doses there was no significant protective efficacy with the vaccine; after three doses the efficacy was only 35 percent (95 percent confidence interval, -57 to 73). The lack of efficacy was not related to the age at onset of disease, age at immunization, type of disease, degree of Alaska Native heritage, time after immunization, or year of the study. Levels of H. influenzae type b anticapsular antibody in recipients of the vaccine became significantly higher than levels in those who received placebo only after the second and third doses. Even after the third dose, only 48 percent of the vaccinated infants had antibody levels of more than 0.1 microgram per milliliter (geometric mean titer, 0.18). Antibody responses did not vary with the level of maternally acquired antibody, degree of Alaska Native ancestry, or age at time of the first or second immunizations, but they increased with increasing age at time of the third dose (P less than 0.001). CONCLUSIONS: We found no evidence that the PRP-D vaccine provides significant protection, at least for Alaska Native infants, against invasive diseases caused by H. influenzae type b. The ineffectiveness of the vaccine paralleled its limited immunogenicity.

Age Factors↗

Sociocultural stress and the American native in Alaska: an analysis of changing patterns of psychiatric illness and alcohol abuse among Alaska natives.

This paper presents selected morbidity and mortality statistics to outline developing trends and the current status of psychiatric illness and alcohol abuse among the Aleut, Athabascan, Yupik, Inupiat, Tlingit, Haida and Tsimpshian people of Alaska. Analysis of the records of the Indian Health Service, the Community Mental Health Centers and the Alaska Psychiatric Institute, the providers of care for Alaska Natives, shows that the number of individuals treated as inpatients and outpatients for psychiatric illness and alcohol abuse has been rising steadily. Accidental injury and suicidal behavior are common. The treated prevalence rates for these diagnoses exceed recorded rates for other American Native and non-Native groups. For each category of violent death, suicide, homicide, accidents and alcohol, rates for Alaska Natives are higher than rates for Alaska non-Natives, American Indians and the U.S. (all races) and are rising. The data suggest a public health problem in which the primary elements are behavioral disturbance and violent death.

Adolescent↗

Grant award to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska. Center for Substance Abuse Treatment (CSAT), Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), HHS. Availability of grant funds for the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska.

This notice is to inform the public that CSAT and CMHS are making available approximately $5,000,000 for an award in FY 1999 to the Division of Mental Health and Developmental Disabilities, Department of Health and Social Services, State of Alaska to support development, implementation, and evaluation of a comprehensive, seamless system of care for persons with co-occurring substance abuse (including alcohol and other drugs) and mental health disorders in Anchorage, Alaska, and its environs. CSAT and CMHS will make this award if the application is recommended for approval by the Initial Review Group and the CSAT and CMHS National Advisory Councils. This is not a formal request for applications; assistance will be provided only to the Alaska Division of Mental Health and Developmental Disabilities. Eligibility for this program is limited to the State of Alaska, as specified in Congressional report language, in recognition of primacy of its responsibility for, and interest in, providing for the needs of its citizens, and because the success of the program will depend upon the authority and ability to broadly coordinate the variety of resources essential for full program success. The State has committed itself to moving certain mental health services from their extant institutional bases to community bases, and, simultaneously, changing from parallel systems of service delivery--for substance abuse and mental health problems--to an approach designed to deliver services seamlessly to persons with comorbidity. Alaska needs a high level of systemic competence in delivering these services due, in great part, to its climate (resulting in deaths of homeless comorbid persons), and to the requirements of its proposed systems changes. The proposed project presents a unique opportunity for SAMHSA and its Centers to learn, first hand, how the transition from parallel systems to a seamless system of care can be accomplished in a small city in a rural/frontier State, and at what costs. The project promises to yield learnings on the factors and circumstances that facilitate and/or retard systemic change in complex treatment systems. This "Anchorage Comorbidity Services" project is also part of SAMHSA's commitment to improving services, and relates directly to the resolution unanimously adopted by its National Advisory Council earlier this year. Funding from CSAT and CMHS will support some services to persons with co-occurring disorders; continuing planning, review, management, and infrastructure development for the effort; and a tripartite evaluation of the project, including process, outcome, and impact evaluations. This is a unique opportunity to evaluate significant change in a State system of care for persons with co-occurring disorders.

Alaska↗

Substance use, mental health, and health in Alaska: emphasis on Alaska Native peoples.

It has always been a problem in Alaska to obtain a compilation of accurate and current data with regard to mental health, health, and substance abuse. This paper was designed to pull together different sources of data to present a comprehensive perspective on the substance use, mental health, and health problems facing Alaskans today. The article summarizes the most current substance abuse, mental health, and health data available for the State of Alaska from public, academic, and institutional sources. It emphasizes data relevant to Alaska Native groups, calling for improved efforts in the future to collect data according to ethnicity and gender. The data presented identify a number of significant substance use and mental health problems that are prevalent in Alaska, providing geographic and ethnic data wherever available.

Adolescent↗

Alcohol control and injury death in Alaska native communities: wet, damp and dry under Alaska's local option law.

OBJECTIVE: This article tests whether different forms of community-level alcohol control significantly affect injury deaths in a population with extremely high injury mortality. METHOD: The 1981 Alaska local option law provides a natural experiment for studying how implementation of community level controls may be associated with changes in injury deaths, most of which are alcohol-related, among Alaska Natives living in small communities. The study compares population and community-specific death rates under different levels of alcohol control for the 97 communities that passed restrictions between 1980 and 1993 with the death rates in the same communities during periods when no restrictions were in place. RESULTS: Injury death rates were generally lower during periods when alcohol sales, importation or possession were restricted than when no restrictions were in place (wet). More restrictive controls (dry) significantly reduced homicides; less restrictive control options (damp) reduced suicides. Accident and homicide death rates fell, on average, by 74 and 66 per 100,000, respectively, for the 89 communities that banned sale and importation or possession. A control group of 61 small communities that did not change control status under the law showed no significant changes over time in accident or homicide death rates. CONCLUSIONS: The changes in accidental and homicide death rates are statistically significant, although these reduced rates remain 2.5 to 7 times national death rates. The isolated nature of Alaskan villages may explain why alcohol control has more effect in Alaska than has been found in studies of Native Americans living in other states.

Accidents↗

Botulism among Alaska natives in the Bristol Bay area of southwest Alaska: a survey of knowledge, attitudes, and practices related to fermented foods known to cause botulism.

OBJECTIVES: Botulism cases due to traditional Alaska Native fermented foods occur periodically in Southwest Alaska. In this population, we conducted a survey on knowledge, attitudes, and practices related to botulism and fermented foods. METHODS: We interviewed 140 adults randomly chosen from nine villages. Data collected included fermented food consumption frequency; knowledge about the cause and symptoms of botulism; and fermented food preparation methods. RESULTS: Most respondents (81%) had eaten Alaska Native fermented foods at least once. Over 70% identified botulism as a foodborne illness, and over 87% believed eating certain Native fermented foods could cause botulism. One-third of fermented food preparers used plastic containers for fermentation. To prevent botulism, 45% vwould consider boiling fermented foods, and 65% would not eat foods fermented in plastic or glass containers. CONCLUSIONS: Despite high awareness of botulism in this population, one-third of fermented food preparers use plastic containers, a practice which may increase the risk of botulism. Misconceptions and acceptable prevention messages about botulism, such as using traditional nonplastic fermentation methods, were identified and included in an educational video.

Adolescent↗

Dietary intake among Alaska native women resident of Anchorage, Alaska.

OBJECTIVE: We summarized data from a study of Alaska Native women living in predominantly urban communities to assess the quality of their dietary intakes and compare to current US dietary recommendations. STUDY DESIGN: Descriptive cross sectional study of seventy-four Alaska Native women living in and around Anchorage, Alaska. Each completed up to four 24-h diet recalls during one year. Participants were enrolled in 1996 and 1997. Blood samples were analyzed for hematocrit, vitamin A, vitamin C, vitamin E and folate. RESULTS: Results were compared with current US dietary guide lines for food groups and nutrients. Mean intake of these women fell below recommendations for all food groups except the Meat and Beans Group. Mean intakes of sweets, sodium and energy from fat and saturated fat exceeded recommendations. Red blood cell folate levels were low in 32% of the women. Only one-quarter of the women reported eating Native foods. CONCLUSIONS: The survey shows room for improvement in diet to include reduced intakes of saturated fat, and increased intakes of folate, calcium, and dietary fiber by increasing consumption of fruits and vegetables, whole grain breads and cereals, non-fat milk products, and Native foods.

Adolescent↗

Oral health of young Alaska Native children and their caregivers in Southwestern Alaska.

OBJECTIVE: We sought to determine the prevalence of caries and associated risk factors in young Native children and their caregivers in two communities in rural Alaska. METHODS: A random sample of Alaska Native children between 12-36 months and a subset of their caregivers from two Southwestern Alaska communities were examined for dental decay. Caregivers completed a 43-item questionnaire about oral hygiene, dietary and other practices. RESULTS: Of the 65 children examined, 59% had evidence of decay. Among the 41 primary caregivers examined, 98% had experienced dental decay with an average of 11.4 decayed, missing, and filled teeth. On linear regression analyses, factors significantly associated with more decay in the children included a child taking a juice-containing bottle to bed, eating candy 1 or more times per day, and higher caregiver oral S. mutans counts. CONCLUSIONS: Our results suggest that preventive efforts for children at high risk for dental decay should begin early in life, should emphasize decreasing candy and bedtime juice bottle use, and should consider the caregivers' oral health status in addition to the child's.

Adult↗

Highly specific photoscreening at the Alaska State Fair. Valid Alaska Blind Child Discovery photography and interpretation.

During the Alaska State Fair, from 1999 through 2001, experienced MTI photoscreeners from the District 49-A Lions Club screened 1844 children as a part of the Alaska Blind Child Discovery. Physician interpretation produced the following recommendations: normal 93.8%, "normal +" 3.4%, "positive" 2.7% and inconclusive 0.2%. Extrapolating from 53 confirmatory follow-up exams estimates the specificity of this screening (true negatives/all normal follow-up exams) from 97% to 100%, with a positive predictive value (true positive/all positive screenings) greater than 90%. High specificity increases the cost-effectiveness of screening. We derived "ABCD-Specificity" equals true negatives/(exam negatives plus inconclusives). In 2002, an additional 655 children were screened yielding 22 "positive" (3.4%), 28 N+ (4.3%), 605 "normal" (92.4%) and no "inconclusive." This brings the total ABCD State Fair Effort to 2499 screened with 2.8% "positive," 3.6% N+, 93.4% "normal" and only 0.12% "inconclusive."

Alaska↗

Partial purification and properties of carbamoyl phosphate synthetase of Alaska pea (Pisum sativum L. cultivar Alaska).

1. Carbamoyl phosphate synthetase was purified up to 45-fold from Alaska pea seedling (Pisum sativum L. cultivar Alaska). 2. The enzyme was most active with and had the lowest K(m) for l-glutamine as compared with NH(4) (+). 3. The purest preparations utilized very poorly or not at all l-asparagine and urea as nitrogen donors. 4. At saturating concentrations of components of the reaction, the K(m) for l-glutamine was 1.2x10(-4)m, and the K(m) for ATP was approx. 3.9x10(-4)m. 5. Although the enzyme was very labile, stability was improved by glutamine, asparagine, ammonium sulphate, dithiothreitol and especially l-ornithine. 6. Free ATP was markedly inhibitory, and MgATP(2-) and Mg(2+) appeared to be the actual substrates utilized. 7. Fe(2+) and Mn(2+) were also utilized, but not as readily as Mg(2+) except at low concentrations. K(+) increased activity significantly. 8. Of the four nucleotides tested (ITP, ATP, GTP and UTP) only ATP served as an effective phosphate donor.

Adenosine Triphosphate↗

Severe respiratory syncytial virus disease in Alaska native children. RSV Alaska Study Group.

Hospitalization rates for respiratory syncytial virus (RSV) infection range from 1 to 20/1000 infants. To determine the rate and severity of RSV infections requiring hospitalization for infants in the Yukon-Kuskokwim (YK) Delta of Alaska, a 3-year prospective surveillance study was conducted. The annual rate of RSV hospitalization for YK Delta infants <1 year of age was 53-249/1000. RSV infection was the most frequent cause of infant hospitalization. RSV disease severity did not differ among non-high-risk infants in the YK Delta and at Johns Hopkins Hospital (JHH). On average, 1/125 infants born in the YK Delta required mechanical ventilation for RSV infection. During the peak season, approximately $1034/child <3 years of age was spent on RSV hospitalization in the YK Delta. In YK Delta infants </=6 months old, RSV microneutralizing antibody titers <1200 were associated with severe disease (odds ratio=6.2, P=.03). In the YK Delta and at JHH, newborns may be at greater risk for severe RSV illness than previously thought.

Age Factors↗