Skip header and navigation

Refine By

18 records – page 1 of 2.

Alaska's obstetrical delivery systems: a descriptive epidemiologic study.

https://arctichealth.org/en/permalink/ahliterature4519
Source
Alaska Med. 2000 Jul-Sep;42(3):78-84
Publication Type
Article
Author
D W Smith
N J Murphy
Author Affiliation
University of Washington School of Medicine, Anchorage, Alaska 99508, USA. dsmith@afpr.fammed.washington.edu
Source
Alaska Med. 2000 Jul-Sep;42(3):78-84
Language
English
Publication Type
Article
Keywords
Alaska
Anesthesia, Obstetrical
Cesarean Section
Comparative Study
Delivery, Obstetric - methods
Emergencies
Female
Hospitals, Rural
Humans
Obstetrics - manpower
Operating Rooms
Pregnancy
Research Support, Non-U.S. Gov't
Risk factors
Rural Population
Ultrasonography, Prenatal
Abstract
Delivery of obstetrical care in rural Alaska can be very challenging, due to remoteness, lack of medical resources and transportation difficulties. This descriptive study looks at what the current delivery systems for obstetrical care in Alaska are. Alaska's obstetrical delivery systems can be divided into three basic systems. 1) Full comprehensive obstetrical care limited only by lack of neonatal ICU capability. 2) Cesarean delivery capable, but with limited resources. 3) Low risk vaginal deliveries with no cesarean delivery capability except by transports approaching 6 hours. This study raises questions about which system is most effective for which communities. Further studies need to be undertaken to better understand how to provide effective obstetrical care in rural and bush Alaska at an acceptable risk, and at reasonable cost.
PubMed ID
11042940 View in PubMed
Less detail

Antenatal diagnosis of a fetal sacral mass containing a pelvis and limb bones.

https://arctichealth.org/en/permalink/ahliterature4071
Source
J Am Board Fam Pract. 1995 Nov-Dec;8(6):491-3
Publication Type
Article
Author
N J Murphy
C M Murphy
F. Lukey
P J Hanaway
J H Tan
Author Affiliation
Department of Obstetrics and Gynecology, Alaska Native Medical Center, Anchorage 99501, USA.
Source
J Am Board Fam Pract. 1995 Nov-Dec;8(6):491-3
Language
English
Publication Type
Article
Keywords
Adult
Female
Fetal Diseases - ultrasonography
Humans
Pregnancy
Sacrococcygeal Region
Teratoma - ultrasonography
Ultrasonography, Prenatal
PubMed ID
8585411 View in PubMed
Less detail

An upstream approach to health care: the education of nurses for policy change.

https://arctichealth.org/en/permalink/ahliterature220943
Source
J Nurs Educ. 1993 Jun;32(6):285-7
Publication Type
Article
Date
Jun-1993
Author
N J Murphy
Author Affiliation
Dalhousie University, School of Nursing, Halifax, Nova Scotia.
Source
J Nurs Educ. 1993 Jun;32(6):285-7
Date
Jun-1993
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - organization & administration
Education, Nursing - trends
Health Policy
Humans
Leadership
Mental health
Nursing
Organizational Objectives
Primary Health Care
Social Problems
Abstract
Working within the social context of well-being, therefore, enables nurses to respond holistically to clients. Central to the accomplishment of this vision, however, is a reformation of policies, starting with the educational foundation of nursing students. Equipped with a liberal education, an internalization of the values that uphold human dignity and sense of self, and professional knowledge, nurses can become leaders in the process of policy change. With associate health professionals, nurses can assist in forming interventive policies that lay the foundation for community-based programs aimed at the preventive nature of an upstream approach.
PubMed ID
8394897 View in PubMed
Less detail

Community mental health nurses' perceptions of their practice as a factor in the reform of community-based mental health services in Nova Scotia.

https://arctichealth.org/en/permalink/ahliterature205776
Source
J Psychiatr Ment Health Nurs. 1998 Feb;5(1):59-60
Publication Type
Article
Date
Feb-1998
Author
N J Murphy
Author Affiliation
Dalhousie University/School of Nursing, Halifax, Nova Scotia.
Source
J Psychiatr Ment Health Nurs. 1998 Feb;5(1):59-60
Date
Feb-1998
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Community Health Nursing
Community Mental Health Services
Health Care Reform
Humans
Nova Scotia
Nursing Staff - psychology
Psychiatric Nursing
Questionnaires
PubMed ID
9573983 View in PubMed
Less detail

Diabetes mellitus in Alaskan Yup'ik Eskimos and Athabascan Indians after 25 yr.

https://arctichealth.org/en/permalink/ahliterature3228
Source
Diabetes Care. 1992 Oct;15(10):1390-2
Publication Type
Article
Date
Oct-1992
Author
N J Murphy
C D Schraer
L R Bulkow
E J Boyko
A P Lanier
Author Affiliation
Alaska Area Native Health Service, Anchorage.
Source
Diabetes Care. 1992 Oct;15(10):1390-2
Date
Oct-1992
Language
English
Publication Type
Article
Keywords
Alaska - epidemiology
Blood Glucose - analysis
Diabetes Mellitus - diagnosis - epidemiology - prevention & control
Female
Humans
Indians, North American
Inuits
Male
Mass Screening - methods
Middle Aged
Obesity
Prevalence
Research Support, U.S. Gov't, P.H.S.
Abstract
OBJECTIVE--To estimate the prevalence of diabetes mellitus and overweight in two populations of Alaska Natives and to compare the results with previous data. RESEARCH DESIGN AND METHODS--Participants' heights, weights, and random plasma glucose levels were determined. Those with a glucose of greater than or equal to 6.72 mM received a follow-up glucose-tolerance test, interpreted by WHO criteria. Overweight was defined by National Center for Health Statistics criteria and also by criteria used in previous studies. The subjects were Eskimo and Athabascan residents greater than or equal to 40 yr of age in 15 villages in southwestern Alaska. RESULTS--Diabetes prevalence was 4.7% for Eskimos and 10.0% for Indians. Among Eskimo men and women, the prevalence of overweight was 34 and 56%, respectively, among Indian men and women, it was 29 and 55%, respectively. Comparisons with past data indicate that the prevalence of diabetes has increased from 1.7% in 1962 for Eskimos and 1.8% in 1969 for Indians. CONCLUSIONS--The prevalence of diabetes appears to have increased among Eskimos and Indians in Alaska. Overweight appears to be a significant problem in both groups.
PubMed ID
1425106 View in PubMed
Less detail

Diabetes prevalence, incidence, and complications among Alaska Natives, 1987.

https://arctichealth.org/en/permalink/ahliterature3223
Source
Diabetes Care. 1993 Jan;16(1):257-9
Publication Type
Article
Date
Jan-1993
Author
C D Schraer
L R Bulkow
N J Murphy
A P Lanier
Author Affiliation
Diabetes Program, Alaska Area Native Health Service, Anchorage 99501.
Source
Diabetes Care. 1993 Jan;16(1):257-9
Date
Jan-1993
Language
English
Publication Type
Article
Keywords
Alaska - epidemiology
Amputation
Cerebrovascular Disorders - epidemiology
Comparative Study
Diabetes Complications
Diabetes Mellitus - epidemiology
Diabetic Nephropathies - epidemiology
Humans
Incidence
Indians, North American
Inuits
Kidney Failure, Chronic - epidemiology
Myocardial Infarction - epidemiology
Prevalence
United States - epidemiology
Abstract
OBJECTIVE--To provide descriptive epidemiological data on diabetes mellitus among Alaska Natives, including incidence, updated prevalence, and incidence rates of ESRD, LEA, MI, and stroke in the diabetic population. RESEARCH DESIGN AND METHODS--In IHS and tribal contract hospitals and clinics throughout Alaska, Alaskan Indians, Eskimos, and Aleuts living in Alaska with documented diabetes mellitus were studied from 1986 to 1987. RESULTS--The number of diabetic patients increased from 610 to 708, and the prevalence changed from 15.7 to 17.4/1000 (not a statistically significant increase). Incidence rates per 10,000 diabetic person-yr for complications were 38 for ESRD, 69 for LEA, 92 for MI, and 92 for stroke. CONCLUSIONS--The prevalence of diabetes mellitus increased during the period of observation, but not to a statistically significant degree. Incidence rates for diabetes are lower than for the U.S. general population, but complications rates are as high as those in other diabetic populations.
PubMed ID
8422787 View in PubMed
Less detail

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

https://arctichealth.org/en/permalink/ahliterature3204
Source
J Am Diet Assoc. 1995 Jun;95(6):676-82
Publication Type
Article
Date
Jun-1995
Author
N J Murphy
C D Schraer
M C Thiele
E J Boyko
L R Bulkow
B J Doty
A P Lanier
Author Affiliation
Department of Obstetrics and Gynecology, Alaska Native Medical Center, Anchorage 99501, USA.
Source
J Am Diet Assoc. 1995 Jun;95(6):676-82
Date
Jun-1995
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Alaska - epidemiology
Body mass index
Diabetes Mellitus, Type 2 - complications - ethnology
Diet
Eating
Female
Glucose Tolerance Test
Humans
Indians, North American
Inuits
Male
Middle Aged
Obesity - complications - ethnology
Prevalence
Sex Factors
Abstract
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 = 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
PubMed ID
7759744 View in PubMed
Less detail

Human papillomavirus (HPV) types among Alaska native women attending a colposcopy clinic in Anchorage, Alaska, 2009-2011.

https://arctichealth.org/en/permalink/ahliterature306615
Source
Infect Agent Cancer. 2020; 15:13
Publication Type
Journal Article
Date
2020
Author
N J Murphy
L R Bulkow
M Steinau
E F Dunne
E Meites
L E Markowitz
E R Unger
T W Hennessy
Author Affiliation
1Southcentral Foundation, Anchorage, AK USA.
Source
Infect Agent Cancer. 2020; 15:13
Date
2020
Language
English
Publication Type
Journal Article
Abstract
The first HPV vaccines licensed targeted two HPV types responsible for most cervical cancers. A 9-valent vaccine (9vHPV), targeting 5 additional types, was introduced in 2016 and is currently the only HPV vaccine available in the United States. Previous studies demonstrated high rates of HPV infection in Alaska Native (AN) women. We sought to measure prevalence of high risk HPV types in AN women undergoing colposcopy and to determine those preventable by vaccination.
For this cross-sectional study, we recruited women who were undergoing colposcopy for clinical indications at Alaska Native Medical Center to obtain cervical brush biopsy samples. Specimens were shipped to Atlanta, Georgia for DNA extraction, HPV detection, and typing using L1 PCR with type-specific hybridization to detect 37 HPV types.
Four hundred eighty eight specimens from 489 women were tested. At least one HPV type was found in 458 (94%) specimens. Of 458 participants who were HPV positive, 332 (72%) had two or more types. At least one type targeted by 9vHPV was detected in 95% of participants with CIN 3 (21/22), 82% with CIN 2 (37/45), and 65% with CIN 1 (119/184). (p 
PubMed ID
32158497 View in PubMed
Less detail

Hypertension in Alaska Natives: association with overweight, glucose intolerance, diet and mechanized activity.

https://arctichealth.org/en/permalink/ahliterature3185
Source
Ethn Health. 1997 Nov;2(4):267-75
Publication Type
Article
Date
Nov-1997
Author
N J Murphy
C D Schraer
M C Theile
E J Boyko
L R Bulkow
B J Doty
A P Lanier
Author Affiliation
Alaska Native Medical Center, Anchorage 99508, USA.
Source
Ethn Health. 1997 Nov;2(4):267-75
Date
Nov-1997
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alaska
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - complications - ethnology
Female
Food Habits
Humans
Hypertension - ethnology - etiology
Incidence
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Life Style
Male
Middle Aged
Obesity - complications - ethnology
Research Support, Non-U.S. Gov't
Risk factors
Sex Factors
Abstract
OBJECTIVE: Determine the prevalence of hypertension in Alaska Natives and evaluate risk factors. DESIGN: Population-based univariate and multivariate analysis of blood pressure in 1124 Alaska Natives over 20 years of age. RESULTS: The sample had mean: age 45 years, body mass index 27, systolic pressure 123 mmHg and diastolic pressure 73 mmHg. The age-adjusted rate of hypertension > or = 160/95 mmHg was 9.1% and 6.8% among Athabascan Indians and Yup'ik Eskimos, respectively. After controlling for age and sex there was significantly more hypertension among Athabascan Indians (OR = 1.53, CI = 1.07-2.2, p = 0.019) compared to Yup'ik Eskimos. Race was significantly associated with blood pressure > or = 140/90 when controlled for age and overweight (p = 0.01, OR = 0.78, CI = 0.69-0.95). The presence of hypertension was significantly associated with the following: intake of non-indigenous food (p = 0.01); mechanized activities (p = 0.01); and glucose intolerance in both women (p = 0.043) and men (p = 0.001). Multiple regression analysis revealed age (OR = 1.06, CI = 1.05-1.08) and overweight in both men (OR = 3.02, CI = 1.85-4.93) and women (OR = 2.76, CI = 1.81-4.19) to be significantly associated with BP > or = 140/90. CONCLUSION: Hypertension is no longer rare in Alaska Natives and is associated with overweight, non-indigenous diet, mechanized activities, and glucose intolerance.
PubMed ID
9526689 View in PubMed
Less detail

Lower prevalence of impaired glucose tolerance and diabetes associated with daily seal oil or salmon consumption among Alaska Natives.

https://arctichealth.org/en/permalink/ahliterature3207
Source
Diabetes Care. 1994 Dec;17(12):1498-501
Publication Type
Article
Date
Dec-1994
Author
A I Adler
E J Boyko
C D Schraer
N J Murphy
Author Affiliation
Department of Epidemiology, University of Washington, Seattle.
Source
Diabetes Care. 1994 Dec;17(12):1498-501
Date
Dec-1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alaska
Animals
Body mass index
Diabetes Mellitus, Type 2 - epidemiology
Diet
Dietary Fats, Unsaturated - administration & dosage
Female
Glucose Intolerance - epidemiology
Humans
Indians, North American
Inuits
Male
Middle Aged
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Salmon
Seals, Earless
Abstract
OBJECTIVE--To examine the association of seal oil and salmon consumption with impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) among Alaska Natives. RESEARCH DESIGN AND METHODS--Screening was performed on 666 Yup'ik Eskimos and Athabaskan Indians > or = 40 years old in 15 villages. Self-administered questionnaires were used to obtain partial food frequency data. A case was defined as IGT or NIDDM, either newly discovered or known. Newly discovered cases (11 patients with NIDDM and 17 with IGT) were determined by random blood glucose testing followed by a 2-h 75-g oral glucose tolerance test (OGTT) for those with values > or = 6.72 mmol/l or for subjects with unconfirmed histories of glucose intolerance. Known cases included 26 patients with NIDDM and 1 with IGT. Control subjects had random blood glucoses
PubMed ID
7882827 View in PubMed
Less detail

18 records – page 1 of 2.