Updated review on contaminant communication experiences in the circumpolar Arctic.

Arctic populations are amongst the highest exposed populations to long-range transported contaminants globally, with the main exposure pathway being through the diet. Dietary advice is an important immediate means to address potential exposure and help minimize adverse health effects. The objective of this work is to enable easier access to dietary advice and communication guidance on contaminants with a focus on the Arctic. This manuscript is part of a special issue summarizing the Arctic Monitoring and Assessment Programme's Assessment 2021: Human Health in the Arctic. The information was derived with internet searches, and by contacting relevant experts directly. Results include risk communication efforts in European Arctic countries, effectiveness evaluation studies for several Arctic countries, experience of social media use, and the advantages and challenges of using social media in risk communication. We found that current risk communication activities in most Arctic countries emphasize the importance of a nutritious diet. Contaminant-related restrictions are mostly based on mercury; a limited amount of dietary advice is based on other contaminants. While more information on effectiveness evaluation was available, specific information, particularly from Arctic countries other than Canada, is still very limited.

Professionals ready to integrate care (PRI-Care): A mental health training collaborative.

INTRODUCTION: Increasing demand for integrated care necessitates interprofessional training of mental and behavioral professionals. This study examines the effect of an interprofessional training program for social work and counseling trainees (PRI-Care) in 3 areas: interprofessional valuing and socialization, team skills, and professional development, including the interrelationship between these 3 areas. METHOD: A cross-sectional survey-based pre-post design was utilized across 4 cohorts of students participating in the training program from 2018 through 2021. RESULTS: Among 111 students, interprofessional valuing and socialization, team skills, and professional development increased in pre- to post surveys. Older trainees had higher self-perceptions of interprofessional valuing and socialization. Further, higher levels of interprofessional valuing after training predicted higher self-perceived professional development. DISCUSSION: Students entering work in mental and behavioral health benefited from the specialized interprofessional training. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Testing of a mobile heating facility to sanitize N-95 respirators against an enveloped respiratory virus.

In the spring of 2020, the Alaska Native Tribal Health Consortium (ANTHC) designed and built a sanitizing treatment system to address shortages of filtering facepiece respirators (FFRs). The design criteria included sanitizing large numbers of FFRs, repeatedly achieving FFR fit test requirements, and deactivating enveloped respiratory viruses, such as SARS-CoV-2. The outcome was the Mobile Sanitizing Trailer (MST), a 20 by 8-foot modified trailer designed to process up to 1,000 FFRs during a standard heat cycle. This paper reports on the MST's ability to: (1) sustain a target temperature, (2) produce tolerable conditions for FFRs as measured by fit factor and (3) successfully deactivate an infectious model virus. We found that the MST reliably and uniformly produced 75 degrees Celsius in the treatment chamber for the prescribed periods. Quantitative analysis showed that the FFRs achieved acceptable post-treatment fit factor even after 18, 60-minute heat cycles. Finally, the treated FFR materials had at least a log 3.0 reduction in viral RNA and no viable virus after 30, 60 or 90 minutes of heat treatment. As a sanitizing treatment during supply shortages, we found the MST a viable option for deactivation of virus and extending the usable life of FFRs.

Pandemic-Related Disruptions in Nursing Education: Zooming Out for an Innovative Interprofessional Simulation.

When the COVID-19 global pandemic began, many higher education systems had to restructure their educational delivery system and transition to online learning. This posed a challenge for students in health professions education programs as it impacted their ability to participate in hands-on learning regarding patient care. As a result, the University of Cincinnati College of Nursing developed and implemented simulation-based learning experiences to allow graduate-level social worker, counselor, and psychiatric-mental health nurse practitioner students the opportunity to learn as an interdisciplinary team in a virtual format. The Opioid Use Disorder Simulation Case Study discussed in this article was developed as part of the Serving At-risk Youth Fellowship Experience Training program with the overarching aim to prepare culturally competent providers to deliver direct patient care and education around prevention and recovery services to individuals with substance use disorders.

Prevalence of serum antibodies to Coxiella burnetii in Alaska Native Persons from the Pribilof Islands.

BACKGROUND: Q fever is a febrile illness caused by infection with the bacterium Coxiella burnetii. It is most often transmitted by inhalation of the bacteria after it is shed by infected livestock. Recent studies have found very high C. burnetii infection rates among marine mammals, but it is not known if shedding by marine mammals creates a risk of Q fever among humans. To better understand infection of humans with exposure to marine mammals, the prevalence of antibodies against C. burnetii in serum samples taken from Alaskan Native persons residing on the Pribilof Islands was evaluated. The Pribilof Islands support large populations of northern fur seals infected with C. burnetii that may increase the risk of exposure for island residents. METHODS: Serum testing for IgG antibodies against C. burnetii (phase I and phase II) was performed, and demographic data were analysed utilizing banked serum specimens drawn from island residents from 1980 to 2000. RESULTS: The overall seroprevalence rate was 11.6% (95% CI = 9.3%-14.4%; 72/621). This is higher than the previously reported 3.1% (95% CI = 2.1%-4.3%) seroprevalence for the U.S. CONCLUSIONS: These results suggest that Alaskan Native persons may be at higher risk for exposure to C. burnetii than the general US. population, possibly due to proximity to large populations of infected marine mammals.

Community Mental Health Provider Responses to a Competency-Based Training in Suicide Risk Assessment and Prevention.

The present study evaluates of a competency-based suicide prevention training. A sample of community mental healthcare providers took part in a suicide risk assessment and prevention training, completing pre-post measures of knowledge, competency/skill and attitudes, as well as baseline interprofessional education (IPE) socialization. Training yielded moderate-to-large improvements in suicide-related knowledge, perceived risk assessment/prevention skills, attitudes toward helping patients, and professional capacity to work with suicidal patients. Small pre-post differences were observed recognizing the need for additional training. IPE socialization moderated impacts on professional capacity. This study offers support for the promising impacts of competency-based and IPE-specific training.

Environmental observation, social media, and One Health action: A description of the Local Environmental Observer (LEO) Network.

As a result of the close relationships between Arctic residents and the environment, climate change has a disproportionate impact on Arctic communities. Despite the need for One Health responses to climate change, environmental monitoring is difficult to conduct in Arctic regions. The Local Environmental Observer (LEO) Network is a global social media network that recruits citizen scientists to collect environmental observations on social media. We examined the processes of the LEO Network, numbers of members and observations, and three case studies that depict One Health action enabled by the system. From February 2012 to July 2017, the LEO Network gained 1870 members in 35 countries. In this time period, 670 environmental observations were posted. Examples that resulted in One Health action include those involving food sources, wild fire smoke, and thawing permafrost. The LEO network is an example of a One Health resource that stimulates action to protect the health of communities around the world.

The Psychometrics of the Mini-K.

Many published studies have employed the Mini-K to measure a single fast-slow life history dimension. However, the internal structure of the Mini-K has not been determined and it is not clear that a single higher order K-factor fits the data. It is also not clear that the Mini-K is measurement invariant across groups such as the sexes. To establish the construct validity of K as well as the broader usefulness of applying life history theory to humans, it is crucial that these psychometric issues are addressed as a part of measure validation efforts. Here we report on three studies that used latent variable modeling and data drawn from two college student samples ( ns = 361 and 300) to elucidate the psychometrics of the Mini-K. We found that (a) the Mini-K had a six dimensional first-order structure, (b) the K-factor provided a parsimonious explanation of the associations among the lower order factors at no significant cost to fit, (c) the Mini-K measured the same K-factor across the sexes, (d) K-factor means did not have the same meaning across the sexes and thus the first-order factors should be used in studies of mean sex differences, and finally, (e) the K-factor was only associated with environment and aspects of mating competition in females. Implications and future directions for life history research are discussed.

Adaptation in Arctic circumpolar communities: food and water security in a changing climate.

The AMAP Human Health Assessment Group has developed different adaptation strategies through a long-term collaboration with all Arctic countries. Different adaptation strategies are discussed, with examples mainly from native population groups in Alaska.

Interpersonal Contact and Attitudes Toward Adolescents Who Abuse Substances.

Only 7.6% of adolescents in need of substance abuse treatment actually receive it. Many adolescents are hesitant to seek treatment due to public stigma (i.e., negative attitudes and beliefs of the general public toward individuals who abuse substances). However, decades of research indicate that interpersonal contact with stigmatized groups helps reduce stigma. This study used structural equations and data from 638 undergraduate students to test the relationships between students' total interpersonal contact with individuals who abuse substances and their attitudes toward those individuals. We found that total contact did not have significant effects on stigma and was associated with better helping attitudes toward adolescents who abuse alcohol but not marijuana. In addition, African Americans and females endorsed greater stigmatization of adolescents who abuse alcohol but better helping attitudes toward those who had received treatment. Increasing contact with individuals who abuse substances, irrespective of type and valence, may not be widely useful as a way of improving attitudes toward such people.

How are your berries? Perspectives of Alaska's environmental managers on trends in wild berry abundance.

BACKGROUND: Wild berries are a valued traditional food in Alaska. Phytochemicals in wild berries may contribute to the prevention of vascular disease, cancer and cognitive decline, making berry consumption important to community health in rural areas. Little was known regarding which species of berries were important to Alaskan communities, the number of species typically picked in communities and whether recent environmental change has affected berry abundance or quality. OBJECTIVE: To identify species of wild berries that were consumed by people in different ecological regions of Alaska and to determine if perceived berry abundance was changing for some species or in some regions. DESIGN: We asked tribal environmental managers throughout Alaska for their views on which among 12 types of wild berries were important to their communities and whether berry harvests over the past decade were different than in previous years. We received responses from 96 individuals in 73 communities. RESULTS: Berries that were considered very important to communities differed among ecological regions of Alaska. Low-bush blueberry (Vaccinium uliginosum and V. caespitosum), cloudberry (Rubus chamaemorus) and salmonberry (Rubus spectabilis) were most frequently identified as very important berries for communities in the boreal, polar and maritime ecoregions, respectively. For 7 of the 12 berries on the survey, a majority of respondents indicated that in the past decade abundance had either declined or become more variable. CONCLUSIONS: Our study is an example of how environmental managers and participants in local observer networks can report on the status of wild resources in rural Alaska. Their observations suggest that there have been changes in the productivity of some wild berries in the past decade, resulting in greater uncertainty among communities regarding the security of berry harvests. Monitoring and experimental studies are needed to determine how environmental change may affect berry abundance.

One Health - a strategy for resilience in a changing arctic.

The circumpolar north is uniquely vulnerable to the health impacts of climate change. While international Arctic collaboration on health has enhanced partnerships and advanced the health of inhabitants, significant challenges lie ahead. One Health is an approach that considers the connections between the environment, plant, animal and human health. Understanding this is increasingly critical in assessing the impact of global climate change on the health of Arctic inhabitants. The effects of climate change are complex and difficult to predict with certainty. Health risks include changes in the distribution of infectious disease, expansion of zoonotic diseases and vectors, changing migration patterns, impacts on food security and changes in water availability and quality, among others. A regional network of diverse stakeholder and transdisciplinary specialists from circumpolar nations and Indigenous groups can advance the understanding of complex climate-driven health risks and provide community-based strategies for early identification, prevention and adaption of health risks in human, animals and environment. We propose a regional One Health approach for assessing interactions at the Arctic human-animal-environment interface to enhance the understanding of, and response to, the complexities of climate change on the health of the Arctic inhabitants.

Climate change and infectious diseases in the Arctic: establishment of a circumpolar working group.

The Arctic, even more so than other parts of the world, has warmed substantially over the past few decades. Temperature and humidity influence the rate of development, survival and reproduction of pathogens and thus the incidence and prevalence of many infectious diseases. Higher temperatures may also allow infected host species to survive winters in larger numbers, increase the population size and expand their habitat range. The impact of these changes on human disease in the Arctic has not been fully evaluated. There is concern that climate change may shift the geographic and temporal distribution of a range of infectious diseases. Many infectious diseases are climate sensitive, where their emergence in a region is dependent on climate-related ecological changes. Most are zoonotic diseases, and can be spread between humans and animals by arthropod vectors, water, soil, wild or domestic animals. Potentially climate-sensitive zoonotic pathogens of circumpolar concern include Brucella spp., Toxoplasma gondii, Trichinella spp., Clostridium botulinum, Francisella tularensis, Borrelia burgdorferi, Bacillus anthracis, Echinococcus spp., Leptospira spp., Giardia spp., Cryptosporida spp., Coxiella burnetti, rabies virus, West Nile virus, Hantaviruses, and tick-borne encephalitis viruses.

Washeteria closures, infectious disease and community health in rural Alaska: a review of clinical data in Kivalina, Alaska.

BACKGROUND: Kivalina is a northwest Alaska barrier island village of 400 people vulnerable to storm surges exacerbated recently by delayed winter sea and shore ice formation. The village has no in-home piped water or sewage; the "washeteria" is the only structure providing public showers, laundry facilities and flush toilets. In October 2004, a storm damaged the washeteria septic system resulting in prolonged facility closures. We assessed rates of gastrointestinal, respiratory and skin infections potentially impacted by prolonged washeteria closures. METHODS: We obtained washeteria closure dates from 2003 to July 2009 and defined >7 day closure as prolonged. We received de-identified data on all Kivalina clinic visits from 2003 to 2009 and selected visits with ICD-9 diagnosis codes for respiratory, skin, or gastrointestinal infection; subsequent same patient/same illness-category visits within 14 days were excluded. We compared annual visit rates, for all ages combined, before (2003-2004) and after (2005-2009) the "2004" storm. RESULTS: The washeteria had prolonged closures for 34 days (4.7%) in the 2 years 2003-2004 and 864 days (51.7%) between January 2005 and July 2009. Closures ranged from 8 to 248 days. Respiratory infection rates declined significantly from 1.32 visits/person/year in the 2003-2004 period to 0.99 visits/person/year in the 2005-2009 period. There was a significant increase in skin infection rates after 2004, peaking at 0.28 visits/person/year in 2007 and then declining significantly to 0.15 visits/person/year in 2009. Gastrointestinal infection rates remained stable and low throughout (average: 0.05 visits/person/year). No temporal association was observed between respiratory, gastrointestinal or skin infection rates and prolonged washeteria closures. CONCLUSION: The Kivalina washeteria was closed frequently and for extended periods between 2005 and 2009. Initial closures possibly resulted in increased skin infection rates. No increase in respiratory or gastrointestinal infections was noted. Evaluation of community adaptations to closures and other factors (e.g. childhood pneumococcal vaccination) would expand understanding of these findings.

Occupational and environmental exposures among Alaska Native and American Indian people living in Alaska and the Southwest United States.

Most occupational and environmental research describes associations between specific occupational and environmental hazards and health outcomes, with little information available on population-level exposure, especially among unique subpopulations. The authors describe the prevalence of self-reported lifetime exposure to nine occupational and environmental hazards among 11,326 American Indian and Alaska Native (AI/AN) adults enrolled in the Education and Research Towards Health (EARTH) Study in the Southwest U.S. and Alaska. The top three hazards experienced by AI/AN people in Alaska were petroleum products, military chemicals, and asbestos. The top three hazards experienced by AI/AN living in the Southwest U.S. were pesticides, petroleum, and welding/silversmithing. The study described here found that male sex, lower educational attainment, AI/AN language use, and living in the Southwest U.S. (vs. Alaska) were all associated with an increased likelihood of hazard exposure. The authors' study provides baseline data to facilitate future exposure-response analyses. Future studies should measure dose and duration as well as environmental hazards that occur in community settings.

Young adults' perceptions of an adolescent's use of marijuana and alcohol.

Adolescent substance use is a serious problem often invoking negative reactions. The current study extends the literature in this area. A total of 425 college students read one of five vignettes, each of which described an adolescent who used marijuana, hard liquor, or drank an occasional beer (control) and who had received or not received treatment. Participants responded to questions assessing acceptance, willingness to help, and beliefs about the adolescent's academic functioning. Students provided higher acceptance of the adolescent who drank an occasional beer compared to the one who had received treatment for alcohol use and the one who was using marijuana, but did not receive treatment. Results differed based on question type, suggesting that interpretation of stigma is complex and that context plays a role in understanding perceptions. Future research, focusing on reasons for differences in judgments across contexts, will provide new information.

Climate change and water security with a focus on the Arctic.

Water is of fundamental importance for human life; access to water of good quality is of vital concern for mankind. Currently however, the situation is under severe pressure due to several stressors that have a clear impact on access to water. In the Arctic, climate change is having an impact on water availability by melting glaciers, decreasing seasonal rates of precipitation, increasing evapotranspiration, and drying lakes and rivers existing in permafrost grounds. Water quality is also being impacted as manmade pollutants stored in the environment are released, lowland areas are flooded with salty ocean water during storms, turbidity from permafrost-driven thaw and erosion is increased, and the growth or emergence of natural pollutants are increased. By 2030 it is estimated that the world will need to produce 50% more food and energy which means a continuous increase in demand for water. Decisionmakers will have to very clearly include life quality aspects of future generations in the work as impact of ongoing changes will be noticeable, in many cases, in the future. This article will focus on effects of climate-change on water security with an Arctic perspective giving some examples from different countries how arising problems are being addressed.

Climate change and health effects in Northwest Alaska.

UNLABELLED: This article provides examples of adverse health effects, including weather-related injury, food insecurity, mental health issues, and water infrastructure damage, and the responses to these effects that are currently being applied in two Northwest Alaska communities. BACKGROUND: In Northwest Alaska, warming is resulting in a broad range of unusual weather and environmental conditions, including delayed freeze-up, earlier breakup, storm surge, coastal erosion, and thawing permafrost. These are just some of the climate impacts that are driving concerns about weather-related injury, the spread of disease, mental health issues, infrastructure damage, and food and water security. Local leaders are challenged to identify appropriate adaptation strategies to address climate impacts and related health effects. IMPLEMENTATION PROCESS: The tribal health system is combining local observations, traditional knowledge, and western science to perform community-specific climate change health impact assessments. Local leaders are applying this information to develop adaptation responses. OBJECTIVE: The Alaska Native Tribal Health Consortium will describe relationships between climate impacts and health effects and provide examples of community-scaled adaptation actions currently being applied in Northwest Alaska. FINDINGS: Climate change is increasing vulnerability to injury, disease, mental stress, food insecurity, and water insecurity. Northwest communities are applying adaptation approaches that are both specific and appropriate. CONCLUSION: The health impact assessment process is effective in raising awareness, encouraging discussion, engaging partners, and implementing adaptation planning. With community-specific information, local leaders are applying health protective adaptation measures.

Climate change health assessment: a novel approach for Alaska Native communities.

OBJECTIVES: Develop a process for assessing climate change impacts on public health that identifies climate-health vulnerabilities and mechanisms and encourages adaptation. STUDY DESIGN: Multi-stakeholder, participatory, qualitative research. METHODS: A Climate Change Health Assessment (CCHA) was developed that involved 4 steps: (1) scoping to describe local conditions and engage stakeholders; (2) surveying to collect descriptive and quantitative data; (3) analysis to evaluate the data; and (4) planning to communicate findings and explore appropriate actions with community members. The health effects related to extreme weather, thinning ice, erosion, flooding, thawing permafrost and changing conditions of water and food resources were considered. RESULTS: The CCHA process was developed and performed in north-west Arctic villages. Refinement of the process took place in Point Hope, a coastal Inupiat village that practices whaling and a variety of other traditional subsistence harvest practices. Local observers identified climate change impacts that resulted in damaged health infrastructure, compromised food and water security and increased risk of injury. Priority health issues included thawing traditional ice cellars, diminished quality of the community water source and increased safety issues related to sea ice change. The CCHA increased awareness about health vulnerability and encouraged informed planning and decision-making. CONCLUSION: A community-scale assessment process guided by observation-based data can identify climate health impacts, raise awareness and encourage adaptive actions, thereby improving the response capacity of communities vulnerable to climate change.

Onset and duration of action of nasal sprays in seasonal allergic rhinitis patients: olopatadine hydrochloride versus mometasone furoate monohydrate.

Rapid relief of symptoms should be one of the primary goals of treatment for allergic rhinitis (AR). The onset and duration of action of olopatadine hydrochloride nasal spray, 665 mcg (OLO; Patanese), for seasonal AR (SAR) was evaluated in this study. This study was performed to determine the onset and duration of action of OLO compared with placebo spray, with mometasone furoate monohydrate, 50 mcg (MM; Nasonex), as a reference standard. This was a single center, single-dose, randomized, double-blinded parallel-group environmental exposure chamber study. Patients were primed at two 2-hour priming visits. Eligible patients were randomized to OLO, placebo spray, or MM, 2 sprays/nostril. Allergy symptoms (sneezing, runny, itchy, and stuffy nose) were rated by patients at 16 time points during 12 hours after dosing and patient satisfaction was assessed at 4 and 12 hours postdose. Safety was assessed by a review of adverse events, cardiovascular and nasal examination parameters. Four hundred twenty-five adult patients were randomized. OLO was superior to placebo spray in reducing total nasal symptoms (TNSS) within 30 minutes after dosing and maintained superiority for at least 12 hours (p < 0.05). The onset of MM was not observed until 150 minutes postdose and was smaller in magnitude compared with OLO. OLO was superior to both placebo spray (p < 0.0001) and MM (p < 0.05) in patient satisfaction. Treatment was well-tolerated with no safety concerns. OLO is superior to placebo spray and MM in reducing allergy symptoms; OLO has a rapid onset of action and a duration of effect of at least 12 hours.