Rural Alaska Research Articles

The “Real Alaskan”

Using a cultural studies approach, we connect recent theories on rural masculinities and nostalgia to show how a particular variety of rural Alaskan masculinity becomes dominant and struggles to maintain its dominance even in late capitalist urban spaces. This Alaskan masculinity, we argue, is embedded in landscape and frontier nostalgia, through discourse, images, and practices surrounding the “real Alaskan.” Our examples come from both reflective nostalgia found in classic and contemporary literature about Alaska and restorative nostalgia found in the modern tourist industry. The real Alaskan, a cultural symbol deeply coded as masculine, rural, and white, repudiates—or at least marginalizes—that which is feminine, urban, and Native. We argue that it is not only part of the nation's imagination but also one in which many Alaskans are invested.

Trends in Perinatal and Infant Health Disparities Between Rural American Indians and Alaska Natives and Rural Whites

We examined disparities in perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time. We compared perinatal and infant health measures for 217 064 rural AIAN births and 5 032 533 rural non-Hispanic White births. Among American Indians and Alaska Natives, unadjusted rates of inadequate prenatal care (1985-1987, 36.3%; 1995-1997, 26.3%) and postneonatal death (1985-1987, 7.1 per 1000; 1995-1997, 4.8 per 1000) improved significantly. However, disparities between American Indians and Alaska Natives and Whites in adjusted odds ratios (AORs) of postneonatal death (1985-1987, AOR = 1.55; 95% confidence interval [CI] = 1.41, 1.71; 1995-1997, AOR = 1.46; 95% CI = 1.31, 1.64) and adjusted risk ratios (ARRs) of inadequate prenatal care (1985-1987, ARR = 1.67; 95% CI = 1.65, 1.69; 1995-1997, ARR = 1.84; 95% CI = 1.81, 1.87) persisted. Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close persistent health gaps for this group.

Transport of fecal bacteria by boots and vehicle tires in a rural Alaskan community

People living without piped water and sewer can be at increased risk for diseases transmitted via the fecal–oral route. One rural Alaskan community that relies on hauling water into homes and sewage from homes was studied to determine the pathways of fecal contamination of drinking water and the human environment so that barriers can be established to protect health. Samples were tested for the fecal indicator, Escherichia coli, and the less specific indicator group, total coliforms. Shoes transported fecal contamination from outside to floor material inside buildings. Contamination in puddles on the road, in conjunction with contamination found on all-terrain vehicle (ATV) tires, supports vehicle traffic as a mechanism for transporting contamination from the dumpsite or other source areas to the rest of the community. The abundance of fecal bacteria transported around the community on shoes and ATV tires suggests that centralized measures for waste disposal as well as shoe removal in buildings could improve sanitation and health in the community.

"Naltrexone was shown to be an efficacious treatment for [alcohol dependence] among geographically isolated and rural Alaskans,

"Naltrexone was shown to be an efficacious treatment for [alcohol dependence] among geographically isolated and rural Alaskans,

Changing community readiness to prevent the abuse of inhalants and other harmful legal products in Alaska.

This paper presents results from an application of the Community Readiness Model (CRM) as part of a multi-stage community mobilization strategy to engage community leaders, retailers, parents, and school personnel in preventing youth use of inhalants and other harmful legal products in rural Alaska. The CRM is designed to assess readiness to address a single social problem, based on a limited set of key informant interviews. In this study, researchers conducted 32 baseline and 34 post-intervention community readiness assessment interviews in four rural Alaskan communities. These interviews with key informants from the communities were coded and analyzed using CRM methods to yield readiness scores for each community. The aggregate results were analyzed using hierarchical linear modeling (HLM), and the individual community scores were analyzed in the context of the overall study. Significant positive changes in community readiness were found across six readiness dimensions as well as for the overall readiness score. Variation in the degree of changes in readiness across the four communities is attributed to differences in the intervention's implementation. The implications of these results include the potential for CRM assessments to serve as an integral component of a community mobilization strategy and also to offer meaningful feedback to communities participating in prevention research.

The Relationship Between In-Home Water Service and the Risk of Respiratory Tract, Skin, and Gastrointestinal Tract Infections Among Rural Alaska Natives

We investigated the relationship between the presence of in-home piped water and wastewater services and hospitalization rates for respiratory tract, skin, and gastrointestinal tract infections in rural Alaska. We determined in-home water service and hospitalizations for selected infectious diseases among Alaska Natives by region during 2000 to 2004. Within 1 region, infant respiratory hospitalizations and skin infections for all ages were compared by village-level water services. Regions with a lower proportion of home water service had significantly higher hospitalization rates for pneumonia and influenza (rate ratio [RR] = 2.5), skin or soft tissue infection (RR = 1.9), and respiratory syncytial virus (RR = 3.4 among those younger than 5 years) than did higher-service regions. Within 1 region, infants from villages with less than 10% of homes served had higher hospitalization rates for pneumonia (RR = 1.3) and respiratory syncytial virus (RR = 1.2) than did infants from villages with more than 80% served. Outpatient Staphylococcus aureus infections (RR = 5.1, all ages) and skin infection hospitalizations (RR = 2.7, all ages) were higher in low-service than in high-service villages. Higher respiratory and skin infection rates were associated with a lack of in-home water service. This disparity should be addressed through sanitation infrastructure improvements.

Preverbal Photoscreening for Amblyogenic Factors and Outcomes in Amblyopia Treatment

Previous studies have suggested that infant photoscreening yields better results than visual acuity screening in preschool-aged children. With conventional vision screening, the patient must be able to provide monocular visual acuity cooperation, whereas objective screening for amblyogenic factors can be done at much younger ages. From February 1996 through February 2006, Alaska Blind Child Discovery photoscreened 21,367 rural and urban Alaskan children through grade 2, with an 82% positive predictive value (ie, true number of those referred); 6.9% were referred for a complete eye examination and treatment. All "referred" interpreted images for children younger than 48 months who were then followed up and treated for more than 2 years were reviewed to determine whether treatment was successful. Of 411 "positive" screening photos from children younger than 4 years, 94 patients had more than 2 years follow-up. The 36 children photoscreened before age 2 years had a mean treated visual acuity of 0.17 logarithm of the minimum angle of resolution (logMAR), which was significantly better than that of 58 children screened between ages 25 and 48 months (mean, 0.26 logMAR). Despite similar levels of amblyogenic risk factors, the proportion of children failing to reach a visual acuity of 20/40 was significantly less among those screened before age 2 years (5%) than in those screened from ages older than 2.0 years and younger than 4.0 years (17%). Very early photoscreening yields better visual outcomes in amblyopia treatment compared with later photoscreening in preschool-aged children.

The Services-Oriented Architecture: Ecosystem Services as a Framework for Diagnosing Change in Social Ecological Systems

Computational thinking (CT) is a way to solve problems and understand complex systems that draws on concepts fundamental to computer science and is well suited to the challenges that face researchers of complex, linked social-ecological systems. This paper explores CT’s usefulness to sustainability science through the application of the services-oriented architecture (SOA). The SOA is a popular organizational framework in information technology that enables businesses to describe the services they offer, including how, where, to whom, and under what terms these services are available to consumers. It provides a straightforward, scalable, and portable way to describe and organize complex business systems, with an emphasis on system controls and component interactions rather than on the system components themselves. Here, we present the SOA as a path to a more mature ecosystem services concept, in support of integrated assessment frameworks such as the Millennium Ecosystem Assessment (MA). With the SOA we capture important interrelationships among ecosystems, ecosystem service consumers, and ecosystem service governance authorities, particularly the effects of their interactions on the viability of ecosystem services. By standardizing the description and relationships involving ecosystem services, the SOA supports a diagnostic approach for evaluating stability and change in ecosystem service use across both space and time, when influenced by drivers of social, political, and/or ecological change, whether directional or stochastic, planned or otherwise. We present here a prototype of the SOA and illustrate its utility with an example from rural Alaskan communities.

Information, communication, and educational technologies in rural Alaska

AbstractInterviews with bush Alaskan educators offer a close‐up perspective of the challenges surrounding the adoption of information, communication, and educational technologies in rural areas.

Distribution and Transport of Fecal Bacteria at Spring Thaw in a Rural Alaskan Community

People living without piped water and sewer can be at increased risk for diseases transmitted by the fecal-oral route. One Alaskan community that relies on hauled water and sewage was studied to determine the pathways of fecal contamination of drinking water and the human environment so that barriers can be established to protect human health. Samples were tested for the fecal indicators Escherichia coli and Enterococcus. Several samples were tested for the pathogens Giardia lamblia and Cryptosporidium parvum and source tracking methods were employed. Surface water flow transported bacteria within the community during spring thaw and human fecal contamination was detected in town, but flow from the dump did not appear to contribute to contamination in town. Within the home, fecal bacteria were found on water dippers, kitchen counters and floors, and in hand-washing basins. Giardia was found at the dump, but not in water from the river adjacent to the community. Exposure to fecal contamination could be red...

Westernizing Diets Influence Fat Intake, Red Blood Cell Fatty Acid Composition, and Health in Remote Alaskan Native Communities in the Center for Alaska Native Health Study

Objective To investigate the impact of a Westernizing diet on fat intake, red blood cell fatty acid composition, and health risks among Yup’ik Eskimos living in rural Alaskan Native communities. Design Diet data and blood specimens were collected from 530 Yup’ik Eskimos aged 14 to 94 years old. Height, weight, and waist circumference were measured. Statistical analyses Comparisons of select fatty acid intake between participants in quintiles of traditional food intake (percent energy) were made using analyses of variance and post hoc Bonferroni tests. General linear models were used to determine the association between traditional food intake and health outcomes. Results Fatty acid composition of the diet differed according to the level of traditional food intake. Traditional food intake was positively associated with higher total fat, eicosapentaenoic acid, and docosahexaenoic acid intake. No association was observed between traditional food intake and saturated fatty acid intake; indeed, participants consuming more traditional foods derived a substantially smaller proportion of their dietary fatty acids from saturated fatty acids ( P<0.001). Analyses of red blood cell fatty acid composition supported these findings. After multivariable adjustment, traditional food intake was significantly positively associated with high-density lipoprotein cholesterol concentration and significantly negatively associated with triglyceride concentration ( P<0.001). Conclusions Diets emphasizing traditional Alaskan Native foods were associated with a fatty acid profile promoting greater cardiovascular health than diets emphasizing Western foods. Further research needs to evaluate the effects of a Westernizing diet on the overall diet of Alaskan Natives.

Lack of Piped Water and Sewage Services is Associated with Pediatric Lower Respiratory Tract Infection in Alaska

To determine the association between the high incidence of lower respiratory tract infection (LRI) documented among young Alaskan children and the absence of modern water service (in-home piped water/septic system or water delivered by closed haul truck) found commonly in rural Alaskan communities. A community-level analysis was performed of all 108 Alaskan communities with at least 15 children <2 years of age enrolled in Medicaid during 1998-2003. Community LRI incidence rates were determined from a Medicaid database with standard LRI billing codes. Potentially confounding community-level demographic variables were obtained, as was availability of water service. During linear regression analysis, the percentage of households with modern water service in a community predicted community-level outpatient (beta = -0.53; P < .001) and inpatient (beta = -0.15; P = .088) LRI incidence rates when controlling for the degree of household crowding, unemployment, adult education, tobacco cigarette use, wood stove use, and poverty. Modest improvements in water service delivery were not shown to be associated with changes in LRI burden. Lack of modern water service in Alaska is associated with high pediatric LRI incidence. These communities should receive modern water service, but this intervention alone may not dramatically reduce LRI burden.

Introducing the Geosciences to Alaska Natives via the Rural Alaska Honors Institute (RAHI)

The Rural Alaska Honors Institute (RAHI) is an intensive, six-week residential high school-to-college bridging program aimed at preparing talented rural Alaska youth for the social and academic challenges of college. Since its inception in 1983, RAHI has demonstrated that it is an effective means of encouraging Alaska Native students to attend college and finish a post-secondary degree. Since 2003, a four credit, college-level, field-intensive, introductory geoscience course has been part of the RAHI curriculum. While it is difficult to evaluate what effect this specific course is having on the long term goal of recruiting more minority geoscientists, short term indicators suggest that the course is very effective in increasing the visibility of geology as a desirable career option amongst college-bound Alaska Native youth.

Hair analysis in sled dogs (Canis lupus familiaris) illustrates a linkage of mercury exposure along the Yukon River with human subsistence food systems

The dog has been an important biomedical research model and hair samples from sled dogs could be used as a biomarker of exposure to metals. Hair samples were used as a non-invasive indicator of mercury exposure in sled dogs fed commercial food and traditional village diets. Sled dog populations living in rural New York and Alaska were sampled in 2005 and 2006. Total mercury (THg) content was determined on the entire hair sample in sled dogs from reference sites in North Creek, New York and Salcha Alaska. Both sites fed a commercial feed for high performance dogs and had mean THg levels of 36.6 ng/g for New York sled dogs while Alaskan sled dogs, occasionally supplemented with fish oil showed THg mean of 58.2 ng/g. These THg levels are below levels that are suggested to cause adverse effects and should be considered baseline levels. Yukon River sled dogs had higher THg, ranging from 139 to 15,800 ng/g and showed decreasing mean levels from the delta area to upriver. There were significant differences between THg in the dogs from Russian Mission (10,908.3+/-3028 ng/g), the farthest west village, and Ft. Yukon (1822.4+/-1747 ng/g), the farthest east village. All village dogs along the Yukon had higher THg levels than the THg mean level (657+/-273 ng/g) of hair from ancient dogs of the Seward Peninsula.

Survey Development for Measuring the Near-term Effectiveness of a Program to Recruit Minority Geoscientists

Theoretically and anecdotally, bridging programs that facilitate the transition from high school to college should increase the recruitment and retention of students into universities. Ideally, this type of program is deemed ‘effective’ if the program results in an increased number of the target population actually receiving a college degree. Thus, unless short-term indicators of success can be identified and measured, the program cannot be evaluated until five or more years have passed.The Rural Alaska Honors Institute (RAHI) at the University of Alaska Fairbanks is a bridging program aimed at preparing rural Alaska high school juniors and seniors for college. A geoscience course was recently added to the program in an effort to recruit Alaska Native students into geoscience careers. Using the concept of a geoscience career ‘pipeline,’ we developed a survey to evaluate the effectiveness of the program in recruiting potential geoscience majors. By using rigorous survey construction and testing methodology, we developed a survey that we are confident provides a short-term measure of the course's effectiveness in promoting the acquisition of the attitudes and knowledge associated with retention in a geoscience career pipeline. Keys to developing an effective survey were: identification of the model being tested; cognitive testing of survey questions; and identification of a control group. Results of the survey suggest that the RAHI geoscience course is an effective means of recruiting potential geoscientists.

Helicobacter pylori infection among non-Native educators in Alaska

Objectives. To determine seroprevalence of H. pylori infection in non-Native educators residing in urban or rural settings in Alaska, and to determine potential risk factors associated with infection in this population.Study Design. A cross-sectional survey of non-Native educators residing in urban or rural settings in Alaska.Methods. Participants completed a questionnaire detailing aspects of residential life; H. pylori antibody status was determined by a commercial assay.Results. Of the 203 non-Native participants, 49 (24%) had antibody to H. pylori. Univariate analysis demonstrated that the mean age of seropositive participants was higher than of seronegatives (48 vs. 42 years, respectively, p = .001). In addition, participants who had experienced childhood crowding were more likely to test seropositive for H. pylori (p = .058). On multivariate analysis, only age > or = 40 was associated with infection. No difference in median hemoglobin or ferritin levels were noted among seropositive and seronegative participants. There was no increased risk of seropositivity among participants who had lived in an Alaska Native village or in a developing country for > or = 6 months.Conclusions. Overall, 24% of non-Native educators residing in rural Alaska tested positive by serology for H. pylori. Age > or = 40 years was associated with infection. Median hemoglobin or ferritin levels did not differ significantly among seropositive and seronegative participants.

Linking Past to Present to Create an Image of the Child

Principles of the Reggio Emilia approach are a catalyst for thinking about practices in early childhood education. Teachers in the child care system of Reggio Emilia encourage us to think about our image of childhood and the ways we interact with children, plan curriculum, and design environments. This article examines experiences in a rural Alaskan Head Start program and the initial steps to identify an image of the children in their program. How do we connect principles of the Reggio Emilia approach within our own cultural context? How do we start rethinking our image of children in our own classrooms? These questions are addressed in the remote Cup'ik village of Chevak, Alaska. The author derives general guidelines from the Chevak experience that will be useful for other programs seeking to discern the meaning of childhood for their particular cultural context.

Bridging the Technology Gap: Building a Development Model for Rural Alaska

Using results from a three-year (2003–2006) National Science Foundation ”Partnership for Innovation“ project undertaken in Native Alaska, this paper addresses if and how Information Technologies (IT) can be incorporated into indigenous, geographically isolated environments in order to bring positive social and economic benefit to those who are often seen as the “victims,” rather than the beneficiaries, of economic globalization. Specifically, we argue that the merchandizing of Native crafts and their effective marketing via ecommerce may be used not to supplant indigenous social and economic structures but rather, to enhance and strengthen them. We conclude the paper with the acknowledgment that such change may be slow in coming, and that development in Native Alaska must be viewed as a long-term undertaking.

Community Associated Methicillin Resistant Staphylococcus Aureus Causing Fournier’s Gangrene and Genital Infections

We identified an emerging infectious disease of the genitoperineum caused by community associated, methicillin resistant Staphylococcus aureus. We report our experience with severe genital infections caused by community associated, methicillin resistant S. aureus occurring in 3 individuals who lacked any of the risk factors associated with traditional methicillin resistant S. aureus infection. Two cases were limited to scrotal abscesses that required only incision and drainage plus antimicrobial therapy. To our knowledge the third case represents the first and only reported case to date of Fournier's gangrene caused by community associated, methicillin resistant S. aureus. The prevalence of community associated, methicillin resistant S. aureus complicated skin and skin structure infections is increasing throughout the United States and other countries. Community associated, methicillin resistant S. aureus contains unique virulence factors but retains sensitivity to various nonbeta-lactam antibiotics. Historical risk factors associated with methicillin resistant S. aureus appear not to apply to infections associated with community associated, methicillin resistant S. aureus. Infections due to the latter cause have been identified in healthy individuals of all ages, races and ethnicities. Surgical and antimicrobial approaches to management are presented. Community associated, methicillin resistant S. aureus infections of the genitoperineum are likely to increase in incidence, necessitating heightened awareness on the part of the urologist.

Linking Past to Present to Create an Image of the Child

Abstract Principles of the Reggio Emilia approach are a catalyst for thinking about practices in early childhood education. Teachers in the child care system of Reggio Emilia encourage us to think about our image of childhood and the ways we interact with children, plan curriculum, and design environments. This article examines experiences in a rural Alaskan Head Start program and the initial steps to identify an image of the children in their program. How do we connect principles of the Reggio Emilia approach within our own cultural context? How do we start rethinking our image of children in our own classrooms? These questions are addressed in the remote Cup'ik village of Chevak, Alaska. The author derives general guidelines from the Chevak experience that will be useful for other programs seeking to discern the meaning of childhood for their particular cultural context.