Caring for Alaska Native prostate cancer survivors in primary care: a survey of Alaska Tribal Health System providers.

BACKGROUND: Little is known about the constraints of optimizing health care for prostate cancer survivors in Alaska primary care. OBJECTIVE: To describe the experiences and attitudes of primary care providers within the Alaska Tribal Health System (ATHS) regarding the care of prostate cancer survivors. DESIGN: In late October 2011, we emailed a 22-item electronic survey to 268 ATHS primary care providers regarding the frequency of Prostate Specific Antigen (PSA) monitoring for a hypothetical prostate cancer survivor; who should be responsible for the patient's life-long prostate cancer surveillance; who should support the patient's emotional and medical needs as a survivor; and providers' level of comfort addressing recurrence monitoring, erectile dysfunction, urinary incontinence, androgen deprivation therapy, and emotional needs. We used simple logistic regression to examine the association between provider characteristics and their responses to the survivorship survey items. RESULTS: Of 221 individuals who were successfully contacted, a total of 114 responded (52% response rate). Most ATHS providers indicated they would order a PSA test every 12 months (69%) and believed that, ideally, the hypothetical patient's primary care provider should be responsible for his life-long prostate cancer surveillance (60%). Most providers reported feeling either "moderately" or "very" comfortable addressing topics such as prostate cancer recurrence (59%), erectile dysfunction (64%), urinary incontinence (63%), and emotional needs (61%) with prostate cancer survivors. These results varied somewhat by provider characteristics including female sex, years in practice, and the number of prostate cancer survivors seen in their practice. CONCLUSIONS: These data suggest that most primary care providers in Alaska are poised to assume the care of prostate cancer survivors locally. However, we also found that large minorities of providers do not feel confident in their ability to manage common issues in prostate cancer survivorship, implying that continued access to specialists with more expert knowledge would be beneficial.

November 2007: National American Indian & Alaska Native Heritage Month

http://digitalcommons.winthrop.edu/dacusdocsnews/1024/thumbnail.jpg

A Comprehensive health plan for American Indian and Alaska native people for fiscal years 1981-1984 : the Indian Health Care Improvement Act, Public Law 94-437 /

"December 1979."

American Indian and Alaska Native Agricultural Conference : summary report.

Mode of access: Internet.

American Indian and Alaska Native Agricultural Conference : February 7-8, 1979, Albuquerque, New Mexico /

Report prepared by Ovid Bay, J. C. Massey, and Lauren L. Fuller.

Identifying outstanding talent in American Indian and Alaska Native students /

"Contract no. 433JAH2IP148"--T.p. verso.

American Indian/Alaska native injury prevention campaign.

Mode of access: Internet.

Alaska native land claims. Hearings, Ninety-second Congress, first session, on S. 35 and S. 835 ... February 18 and March 16, 1971-

Mode of access: Internet.

Alaska native cancer update, 1986-98 : by sex, age, service unit and year /

"May 2001."

Building the future : a blueprint for change : "By our homes you will know us" : final report of the National Commission on American Indian, Alaska Native, and Native Hawaiian Housing.

Mode of access: Internet.

Harvest History of Belugas, Delphinapterus leucas, in Cook Inlet, Alaska

Belugas, Delphinapterus leucas, in Cook Inlet, Alaska, represent a unique and isolated marine mammal population that has been hunted for a variety of purposes since prehistoric times. Archeological studies have shown that both Alutiiq Eskimos and Dena'ina Atabaskan Indians have long utilized many marine resources in Cook Inlet, including belugas. Over the past century, commercial whaling and sport hunting also occurred periodically in Cook Inlet prior to the Marine Mammal Protection Act of 1972 (MMPA). During the 1990's, the hunting mortality by Alaska Natives apparently increased to 40-70 whales per year, which led to the decling of this stock and its subsequent designation in 2000 as depleted under the MMPA. Concerns about the decline of the Cook Inlet stock resulted in a voluntary suspension of the subsistenc hunt by Alaska Natives in 1999. The difficulty in obtaining accurate estimates for the harvest of these whales is due to the inability to identify all of the hunters and, in turn, the size of the harvest. Attempts to reconstruct harvest records based on hunters' recollections and interviews from only a few households have been subject to a wide degree of speculation. To adequately monitor the beluga harvest, the National Marine Fisheries Service established marking and reporting regulations in October 1999. These rules require that Alaska Natives who hunt belugas in Cook Inlet must collect the lowere left jaw from harvested whales and complete a report that includes date and time of the harvest, coloration of the whale, harvest location, and method of harvest. The MMPA was amended in 2000 to require a cooperative agreement between the National Marine Fisheries Service and Alaska Native organizations before hunting could be resumed.

Traditional Knowledge of the Ecology of Belugas, Delphinapterus leucas, in Cook Inlet, Alaska

The population of belugas, Delphinapterus leucas, in Cook Inlet, Alaska, is geographically isolated and appears to be declining. Conservation efforts require appropriate information about population levels and trends, feeding and behavior, reproduction, and natural and anthropogenic impacts. This study documents traditional ecological knowledge of the Alaska Native hunters of belugas in Cook Inlet to add information from this critical source. Traditional knowledge about belugas has been documented elsewhere by the author, and the same methods were used in Cook Inlet to systematically gather information concerning knowledge of the natural history of this beluga population and its habitat. The hunters’knowledge is largely consistent with what is known from previous research, and it extends the published descriptions of the ecology of beluga whales in Cook Inlet. Making this information available and involving the hunters to a greater extent in research and management are important contributions to the conservation of Cook Inlet beluga

Assessment of contaminant body burdens and histopathology of fish and shellfish species frequently used for subsistence food by Alaskan Native communities

Subsistence food items can be a health concern in rural Alaska because community members often rely on fish and wildlife resources not routinely monitored for persistent bioaccumulative contaminants and pathogens. Subsistence activities are a large part of the traditional culture, as well as a means of providing protein in the diets for Tribal members. In response to the growing concerns among Native communities, contaminant body burden and histopathological condition of chum and sockeye salmon (Oncorhynchus keta and Oncorhynchus nerka) and the shellfish cockles and softshell clams (Clinocardium nuttallii and Mya arenaria) were assessed. In the Spring of 2010, the fish and shellfish were collected from traditional subsistence harvest areas in the vicinity of Nanwalek, Port Graham, and Seldovia, AK, and were analyzed for trace metals and residues of organic contaminants routinely monitored by the NOAA National Status & Trends Program (NS&T). Additionally, the fish and shellfish were histologically characterized for the presence, prevalence and severity of tissue pathology, disease, and parasite infection. The fish and shellfish sampled showed low tissue contamination, and pathologic effects of the parasites and diseases were absent or minimal. Taken together, the results showed that the fish and shellfish were healthy and pose no safety concern for consumption. This study provides reliable chemistry and histopathology information for local resource managers and Alaska Native people regarding subsistence fish and shellfish use and management needs.

A Case Study of Polar Bear Co-Management in Alaska

Thesis (Master's)--University of Washington, 2016-06

Native Women, Intimate Partner Violence, and Drug Use and Consequences: Prevalence and Associations Among Tribal College and University Students

Thesis (Ph.D.)--University of Washington, 2016-08