An assessment of potential injury surveillance data sources in Alaska using an emerging problem: all-terrain vehicle-associated injuries

Using injuries associated with three-wheeled all-terrain vehicles in Alaska as an example, the existing injury data bases were assessed for usefulness, cost, simplicity, acceptability, flexibility, sensitivity, specificity, representativeness, and timeliness. In this study strengths and weaknesses of existing data for all-terrain vehicles were identified and ways to improve data collection and linkages across data systems are suggested. Based on this evaluation, linked death certificates and medical examiner data provide an excellent mechanism for monitoring vehicle-related fatalities. Information sources for nonfatal and nonvehicle-related injuries require further development. Police records provide supplemental information, but they are limited to the events reported to police. Although other sources were explored, they added no advantage to the primary sources. Data processing, analysis, and dissemination--traditional responsibilities for public health and other governmental agencies--can transform these data sources into meaningful mechanisms to define injury trends and monitor injury-specific intervention strategies.

Misalliances in the Barrow Alcohol Study

The Center for Research on the Acts of Man conducted a survey of the use of alcohol among the Inupiat of Barrow, Alaska, in 1979. The study resulted in grievances among many individuals and institutions associated with the community. In a retrospective analysis of the factors contributing to these misalliances, the author raises important ethical and procedural questions to be considered carefully in future projects of this nature.

Cancer in Alaskan Indians, Eskimos, and Aleuts, 1969-83: implications for etiology and control

The authors collected and analyzed cancer incidence data for Alaska Natives (Indians, Eskimos, and Aleuts) for the 15-year period 1969-83 by ethnic and linguistic groups. Compared with U.S. whites, observed-to-expected ratios are high in more than one ethnic group for cancer of the nasopharynx, salivary gland, liver, gallbladder, and cervix. Low ratios were found for cancer of the breast, uterus, bladder, and melanoma. In Alaska, Eskimos have the highest risk for cancer of the esophagus and liver and the lowest risk for breast and prostate cancer. Risk for multiple myeloma in Indian men in Alaska exceeds not only those of other Native groups in Alaska but that in U.S. whites as well. Despite the short period studied, increases in cancer incidence over time can be documented for lung cancer in Eskimo men and women combined, and for cervical cancer, especially in Indian women.

A community systems approach to research strategies

Conflict management skills are needed when dealing with research projects, in multi-cultural settings. Alcohol projects are especially prone to conflict because of the variety of different models of causation and intervention. There are a number of theories of conflict and type of conflict management approaches. The role of people who are in "cultural broker" or interface roles between conflicting parties has been reviewed elsewhere (Spiegel, 1973). My own approach--one of a number of possible alternatives--is briefly outlined here. It involves a form of systems analysis, and a role that many researchers might not initially feel comfortable with. The role goes beyond that of the "objective scientific reporter," and even beyond that of "conflict manager" or "culture broker." I am not sure quite what to call it: there are active attempts to get community members to resolve conflicts and carry out projects, but also what I consider a research orientation to try to carefully observe and describe and measure what is done. It is, I suppose, a form of "participant-observation," but the participation involves developing an overall strategic approach to the community's perceived problems. There is careful attention to who gets defined as the "problem," and who will actually be carrying out the project. Local community factions may need assistance in developing a very clear vision of the targeted results for the project. One has to also be keenly aware of possible problems that can result from differences in world view, pressures from funding sources or other intermediary groups who may have their own agendas for the research, as well as the overall context or environmental constraints.(ABSTRACT TRUNCATED AT 250 WORDS)

The Epizootiology of Trichiniasis in Wildlife

Significant reservoirs of trichiniasis in wildlife have been demonstrated only in Iowa and Alaska. Limited findings in other states would indicate, however, that the problem exists in most of the United States. Based on present knowledge, scavenging is probably the primary mode of transmission with predation being of major importance only in the Arctic region where a significant reservoir of the disease is present in the rodent population. Both direct and indirect routes of transmission of the disease from wildlife to man are indicated with the direct route being demonstrated primarily through the ingestion by man of improperly cooked bear meat. The indirect route, wildlife to swine to man, has been demonstrated as a possibility in epidemiological studies in Iowa. An educational program must be developed to alert the hunter, trapper, and swine producer of the significance of wildlife trichiniasis. Studies on the distribution of the disease in the wildlife population of the U.S., the modes of transmission within and between wildlife populations, and means of breaking interrelationships of the wildlife and domestic cycles of the disease are essential to decreasing and eventually eradicating the disease in man and swine.