Use of the Quality of Life Inventory for measuring quality of life changes in an inpatient psychiatric population.

This study measured self-reported quality of life at two time points for 50 diagnostically heterogeneous patients in a state-funded psychiatric hospital and evaluated the Quality of Life Inventory for assessing changes over inpatient treatment. Participants completed the Quality of Life Inventory after admission and before discharge. Improvement occurred in overall scores during participants' hospital stays. Analysis of domains showed improvements in satisfaction with health and self-esteem. The inventory appears a useful tool for evaluating outcomes of psychiatric inpatient treatment from a patient perspective.

Cultural identification and smoking among American Indian adults in an urban setting.

OBJECTIVES: Among American Indians (AIs), an important relationship has been theorized between cultural identification and substance abuse, including smoking. We investigated the relationship between cultural identification and smoking among AI adults. DESIGN: Using the Orthogonal Cultural Identification Scale (OCIS), we examined the relationship between AI and White cultural identification and cigarette use in a sample of AI recruited at an urban Indian center (n=217). RESULTS: We found that high AIs identification predicted smoker status and high White identification predicted non-smoker status when controlling for age and reservation residence. Orthogonal cultural identification status (categorized as high White/high AI, high White/low AI, low White/high AI, or low White/low AI) did not predict smoker status when controlling for age and reservation residence. OCIS item analysis revealed that positive responses to the individual OCIS items 'My family lives by the American Indian way of life,' 'I live by the American Indian way of life,' and 'I am a success in the American Indian way of life' predicted smoker status when controlling for age and reservation residence. CONCLUSIONS: Our data suggest that, among some groups of urban AIs, recreational smoking is associated with AI cultural identification.

Tobacco and other substance use among Alaska Native youth in western Alaska.

OBJECTIVE: To examine tobacco, alcohol, and other drug use rates among Alaska Native youth from western Alaska. METHODS: The sample consisted of 665 youth ages 6-18. RESULTS: Of children 6-10 years of age, 12% reported current use, and the prevalence rates increased with age. Females were significantly more likely than males to report tobacco use. The rates of alcohol and other drug use were very low. After adjusting for age and gender, significant correlates of tobacco use were maternal tobacco use during and after pregnancy. CONCLUSIONS: Expanded efforts are needed to address tobacco use among Alaska Native youth.

Iqmik--a form of smokeless tobacco used by pregnant Alaska natives: nicotine exposure in their neonates.

OBJECTIVE: To determine the concentration of nicotine and cotinine in maternal blood and neonatal cord blood among pregnant Alaska Native women and to assess the neonates for neurobehavioral effects. METHODS: In a nonrandomized, clinical observational pilot trial, 60 pregnant Alaska Native women were enrolled for assessment of Iqmik (a mixture of leaf tobacco and ash) and other tobacco use during pregnancy and at delivery. Neonatal cord blood, nicotine and cotinine concentrations were obtained, and neonatal neurobehavioral effects were assessed using the Lipsitz scale. RESULTS: At delivery, there were 22 subjects who reported using only Iqmik, and 10 who used other tobacco products. Subjects who reported using only Iqmik prior to delivery had higher concentrations of cotinine (167+/-116 vs. 81+/-100) in maternal blood (rank sum test, p=0.036) and higher concentrations of nicotine (8.4+/-7.3 vs. 4.4+/-5.1, p=0.048) and cotinine (153+/-115 vs. 70+/-95, p=0.048) in cord blood compared to subjects who reported using other tobacco products. Neurobehavioral signs as assessed by the Lipsitz score were increased in neonates born to mothers using only Iqmik (3.7+/-1.8, p=0.011), or to mothers using other tobacco products (3.4+/-1.4, p=0.034) compared to neonates born to women who reported no tobacco use (1.8+/-1.4). CONCLUSIONS: Mothers who use Iqmik and their neonates have higher cotinine concentrations compared to mothers who use cigarettes and/or other forms of tobacco. Neurobehavioral signs occur in neonates born to women who use Iqmik but also in neonates born to mothers who use other forms of tobacco during pregnancy.

Focus groups of Y-K Delta Alaska Natives: attitudes toward tobacco use and tobacco dependence interventions.

BACKGROUND: Tobacco dependence interventions developed for Alaska Natives are virtually nonexistent. Alaska Natives residing on the Yukon-Kuskokwim (Y--K) Delta in southwestern Alaska use a unique form of smokeless tobacco (ST) known as Iqmik. This study employed focus group methodology to explore attitudes toward tobacco use and tobacco dependence interventions among Alaska Natives residing on the Y-K Delta. METHODS: Twelve focus groups of former and current tobacco users were conducted in four villages in the Y-K Delta. Participants were 35 adults (83% female) and 22 adolescents (27% female). Participants completed a brief demographic and tobacco use history form. Statements from the focus groups were transcribed for content coding and analysis of the major themes. RESULTS: Use of Iqmik in the villages is thought to be ubiquitous. Y-K Delta Alaska Natives are introduced to Iqmik at a very young age. Iqmik is mostly used and prepared by young Alaska Natives and adult women. There are few perceived adverse health effects of Iqmik or other tobacco use. Although there is interest in stopping, there is a perceived lack of availability of tobacco dependence interventions. The major barriers to preventing the initiation of and stopping tobacco use are the social acceptance and widespread use and availability of tobacco. CONCLUSION: The attitudes toward tobacco and identified barriers to stopping will be useful in developing tobacco dependence interventions for Alaska Natives.