Health and Wellness Projects in New Mexico Native Communities: An Activity Resource Kit

The Indian Health Service initiated the mental health program to assist American Indian tribes in dealing with problems of mental health on Indian reservations. Mental health programs on Indian Reservations are intended to be community-based. In addition, the community model is intended as a means of ensuring that mental health program practitioners treat individuals from an holistic standpoint; that is, to involve families and other community resources in treating individuals with various disorders. This evaluation provides information from four Areas: 1) Phoenix; 2) Portland; and 3) Navajo. The evaluation attempted to gauge the attitudes and perceptions of individuals in terms of suitability of treatment, personnel and Tribal involvement, community involvement, and planning features of the mental health programs. The evaluation used two separate questionnaires to survey two groups: 1) patients and 2) health advisory board members. The sample size for the patients was 69, far short of the desired 200. The evaluation team reported numerous problems associated with the patient survey. Chief among these problems was the reluctance on the part of the mental health units to participate fully in the study. Participation by advisory board members was minimal, with only 11 individuals responding. The study team decided to interview only those individuals who had direct contact or involvement with mental health programs. The study found that the mental health program was achieving some of the goals that were initially developed. However, the study felt that the mental health program, as a whole, lacks the community orientation that is to be the basis for operations and service delivery. Although referrals come from a number of different sources, problem-solving was on a one-to-one basis, rather than utilizing a combination of resources such as community resources, families, or other Tribal entities. Three patient groups-children, adolescents, and men--were not well-represented in the survey and this requires attention. The most striking feature of the board survey was their desire to have more training that will enable them to become more informed about their duties and about the nature of the mental health programs. The survey indicated that board members could not adequately express either the particular nature of mental health programs, or the philosophy of community upon which the mental health program is generally based. The evaluation team advised that Tribal leaders are highly concerned about the loss of tribal autonomy and control. The effectiveness of any program, be it mental health or otherwise, is ultimately measured by its abilities to draw upon the history and culture of the Indian community which it serves and to devise appropriate strategies for meeting identified needs

US metric study mission to the United Kingdom and the Federal Republic of Germany: Report of the NASA representative (Full Report)

For abstract, see preceding accession

Engaging students with learning technologies

Curtin University initiated its eScholar program in 2009 making funds available for academic staff to implement innovative teaching using Curtin’s extensive suite of learning technologies. The program is based on the philosophy of engaging students with learning technologies that support their growing understanding through authentic and assessable activities.This publication presents the research findings of each of the eScholar projects conducted in 2010 and 2011. Each chapter has undergone a process of double-blind review resulting in high quality descriptions of learning using current and emerging technologies. The publication is divided into 6 sections based on these technologies.University teaching and learning is faced with many challenges. A major one is recognising appropriate learning technologies and their use that support ways in which adults learn. Rapid advances in technologies can easily seduce those with limited understanding of adult learning. This publication offers clear directions founded on teacher and learner experiences grounded in real classroom activity

Arctic passages: maternal transport, Iñupiat mothers and Northwest Alaska communities in transition

Thesis (Ph.D.) University of Alaska Fairbanks, 2013While the primary goal of the northwest Alaska Native village maternal transport program is safe deliveries for mothers from remote villages, little has been done to examine the impact of transport on the mothers and communities involved. I explore how present values (Western and Iñupiat cultural values) can influence the desire of indigenous women of differing eras and Northwest Alaska villages to participate in biomedical birth practices, largely as made available by a tribal health-sponsored patient transport system. The work that follows portrays the varying influences on these women and their communities as they determine the level of importance for mothers to get to the hospital to deliver. I have enlisted viewpoints of Alaska Native families and women of different generations from various lñupiat villages to help paint a picture of the situation. With this research, I ask, how do generations of mothers, transport situations, and villages compare in terms of experiences during the processes of these Iñupiat women becoming mothers? What gender, ethnicity, and power interplays exist in this dynamic helix of social and political elements (embodiment) during their periods of liminality? What are influences (biomedical and community) that contribute to a woman's transition to motherhood in this community? Moreover, how do women, families, and community members perceive the maternal transport policy today? I examine how the transport policy figures into stages of liminality, as these mothers and communities produce future generations. With theoretical frameworks provided by medical anthropology and maternal identity work, I track the differences concerning the maternal transport operation for lñupiat mothers of the area. I compare the influences of cultural value systems present in each of the communities by birth era and location. Using content analysis to determine common themes, I found connections among presence of Iñupiat values, community acceptance of maternal transport, and expressed desire for community autonomy in maternal health care.Preface -- Chapter 1. Maternal health care for Iñupiat mothers of the Northwest -- 1.1. Introduction -- 1.2. The Alaska Native Village Maternal Health Transport (ANVMT) policy -- 1.3. Arctic passages research questions -- 1.4. Risk assessment and postneonatal mortality statistics -- 1.4.1. Data used for risk assessment -- 1.4.2. 'They must simply be asked' -- 1.5. Liminality, communitas, and maternal identity work -- 1.5.1. Liminality -- 1.5.2. Related studies use of liminality as analysis tool -- 1.5.3. Communitas -- 1.5.4. Communitas and Turner's contribution to liminality -- 1.5.5. Maternal identity work -- 1.6. Iñupiat communities of Northwest Alaska -- 1.6.1. Population -- 1.6.2. Geography, climate, and transportation -- 1.6.3. NW Alaska socio-political maternal health care governing bodies -- 1.7. Overview of the thesis -- Chapter 2. Design, methods and analytical techniques -- 2.1. Selection of topic and study area -- 2.1.1. ANVMT policy analysis in exploratory phase -- 2.1.2. ANVMT policy analysis and early stage hypothesis development -- 2.2. Version one of study scope and parameters -- 2.2.1. Development of new study scope -- 2.2.2. Development of new study design -- 2.3. Arctic Passages study scope and parameters -- 2.4. Sampling and data collection techniques -- 2.4.1. Arctic Passages framework approach -- 2.4.2. Arctic Passages grounded theory -- 2.5. Methodological and analytical techniques -- 2.5.1. Familiarization -- 2.5.2. Identifying thematic framework -- 2.5.3. Indexing -- 2.5.4. Charting -- 2.5.5. Mapping and interpretation -- 2.6. Summary -- Chapter 3. Biomedicine, maternal health policy, and birth models -- 3.1. Introduction: US maternal health care policy and biomedicine -- 3.2. Use of Alaska Native maternal and infant health data to inform policy -- 3.3. Anthropology of birth: medical anthropology and cultural competency -- 3.3.1. Physician-patient cultural divide and cultural competency -- 3.3.2. Cultural competency efforts in Alaska Native health care -- 3.3.3. History and cross-cultural treatment of birth -- 3.3.4. Jordan's midwife construct -- 3.4. Emergence of birth models -- 3.5. Midwifery and biomedical birth models -- 3.5.1. The midwifery birth model -- 3.5.2. The biomedical birth model -- 3.5.3. Authoritative knowledge in birth constructs -- 3.5. Summary -- Chapter 4. Maternal identity, embodiment and Iñupiat cultural values -- 4.1. Introduction -- 4.2. Nursing theories and maternal identity -- 4.2.1. Maternal identity and ethnic identity -- 4.2.2. Maternal identity and group membership -- 4.2.3. Public health policy, nationalism, and tribalism and maternal identity -- 4.3. Embodiment and birthing practice -- 4.3.1. Embodiment and the body politic -- 4.3.2. Embodiment among maternal Third and Fourth World identities -- 4.4. Iñupiat Ilitqusiat: backdrop to everyday changing realities -- 4.4.1. Maternal and medical cultural influences -- 4.4.2. Iñupiat Ilitqusiat definition for Arctic Passages -- 4.4.3. Iñupiat Ilitqusiat expressions in Arctic Passages -- 4.5. Summary -- Chapter 5. Iñupiat Birthways in Northwest Alaska and ANVMT policy -- 5.1. Sampling results and scope -- 5.2. Secondary birth and transport figures -- 5.2.1. Arctic Passages statistical data sources -- 5.2.2. Maternal and infant health statistical records on Maniilaq region births -- 5.2.3. Maniilaq region flight services impact on ANVMT policy -- 5.2.4. Maniilaq region facility usage trends, historical and current data -- 5.3. Delivery and infant mortality figures -- 5.3.1. Maniilaq service area 'type of delivery' statistics -- 5.3.2. Maniilaq Service Area infant mortality statistics -- Chapter 6. Iñupiat mothers navigating the ANVMT system: today and yesterday -- 6.1. Arctic Passage mothers and the ANVMT policy -- 6.1.1. Themes -- 6.1.2. Buckland mothers' views of the ANVMT policy -- 6.1.3. Kotzebue mothers' views of the ANVMT policy -- 6.1.4. Point Hope mothers' views of the ANVMT policy -- 6.2. Arctic Passages community and family members and the ANVMT policy -- 6.2.1. Buckland -- 6.2.2. Kotzebue -- 6.2.3. Point Hope -- 6.3. Maternal transport: a new tradition in the Arctic Passages communities? -- 6.4. Maternal identity work, liminality, communitas and the ANVMT system -- 6.4.1. Self-identification and embodiment as Iñupiat mothers -- 6.4.2. Iñupiat mothers, liminality, and communitas -- 6.5. Different generations of Arctic Passages Iñupiat mothers as participants -- 6.6. Influences and the ANVMT system -- 6.6.1. Biomedical influences -- 6.6.2. Family and community influences -- Chapter 7. Conclusion -- 7.1. Conclusions -- 7.2. Arctic Passages limitations and questions for further research -- 7.2.1. Limitations -- 7.2.2. Questions for further research -- 7.3. Maniilaq ANVMT policy: availability versus accessibility -- 7.3.1. Trust and communication between worldviews in Maniilaq maternal care -- 7.3.2. Alignment of like-minded communities and health care philosophies -- References

After Broadband: A Study of Organizational Use of Broadband in Southwest Alaska

The purpose of this research was to gain a preliminary understanding of how organizations including large and small businesses, Native corporations and organizations, and local and regional governments are using broadband that is now available in much of southwest Alaska. To learn about community access to broadband, interviews were also conducted with library and school staff in communities where broadband had been installed under the OWL (Online with Libraries) program. Further, the study identifies research from other sources that could help to predict what socio-economic impacts the availability and adoption of broadband may have in rural Alaska. Financial institutions use online connections for teller services and credit and debit card processing, and stated that more people in rural communities now have debit cards that they can use for online purchases and bill paying. Large retailers use online services for payroll, for pointof-sale (POS) transactions, and online ordering. Seafood processors rely heavily on connectivity with their head offices (generally in the lower 48) for administrative services including payroll, accounting, shipping and receiving, purchasing, and ERP (enterprise resource planning), and access data base software to track fish tickets. Seafood processors also provide Internet access for their employees, most of whom are seasonal and from other states or countries. Tourism businesses use broadband for online reservation systems and for guests, who increasingly demand connectivity even for remote vacations. Village corporations and tribal councils use online services to help their residents obtain hunting and fishing licenses and fishing permits, to learn about funding opportunities, and to file reports on grants. Local Governments connect online for interoffice communications and for payroll and other administrative functions. Other online applications and services include providing remote desktop access from other agency sites, use of online tools for land management and mapping, training including webinars for workforce development, and providing access to social services for clients. An economic development organization sends newsletters to communities electronically and packets of documents to its board members rather than relying on fax or courier. Websites are important for tourism-related businesses to advertise and promote their businesses and for nonprofits and local governments to provide information about their services. 5 Broadband now plays many roles in rural education. Most students are required to use the Internet for class assignments. High school students can connect to classes in advanced subjects in other communities, and may complete online courses for college credit. Libraries remain important locations for community access, with residents going online to connect with friends on Facebook, as well as to download content for e-books, file income tax, and apply for jobs and government benefits. School and library Wi-Fi provides access inside and near the buildings for residents with smartphones. Despite enthusiasm for broadband and the adoption of many broadband-based applications and services, most organizations interviewed identified problems with broadband, particularly with the pricing, stating that the terrestrial broadband network is too costly for them to take full advantage of online services and applications. While the scope of this study was too limited to estimate long-term benefits, it found that broadband is highly valued and increasingly important to businesses and nonprofit organizations and local governments in southwest Alaska. Broadband helps businesses to be more efficient in their operations and to extend their reach to new customers and suppliers. It also helps to improve the effectiveness of public sector services such as those provided by borough and city governments and extends access to education and training. Broadband is also likely to be an important component of strategies to develop ecotourism and other ecosystem services.Support for this research came from Connect Alaska with funding from the National Telecommunications and Information Administration (NTIA) for the work of the State of Alaska Broadband Task Force, with additional support from GCI.Executive Summary / Introduction / Research Methodology / Technologies and Technical Support / Broadband Applications / Education and Community Access / Health Care / Benefits of Broadband in Southwest Alaska / Problems and Limitations / Potential Long-Term Social and Economic Impacts / Conclusions and Recommendations / Referemce

Medicina: methods, models, strategies

The School of Nursing & Midwifery at Flinders University provides dedicated support for the English language needs of over 500 international students. As part of a strategic plan to deal with communication difficulties among these students, a series of language-learning initiatives are being implemented. One of these is a game called Medicina, which has already undergone the full cycle of development, testing, and release. This game familiarizes students with confusable and common medication names. It also aims to improve phonological awareness through a focus on word form. This chapter discusses the creation of Medicina from inception through to dissemination, detailing the stages, challenges, and lessons learned in the process, in the hope of informing other educators of the level of commitment involved in a digital game-based project

Reauthorization of the Indian Health Care Improvement Act

Purpose The purposes of this publication are to: 1) recognize and publicize outstanding examples of the application of managed care principles to direct care services in Indian health programs; 2) stimulate other innovative Indian Health Service (IHS) and tribal management efforts; and 3) demonstrate to others that IHS and tribal health programs have a commitment to managed care. Methods Experiences with managed care in Indian health programs are documented in this monograph. Specific program examples are provided from the following areas of the IHS: 1) Alaska Area; 2) Albuquerque Area; 3) Aberdeen Area; 4) Billings Area; 5) California Area; 6) Headquarters West; 7) Nashville Area; 8) Navajo Area; 9) Oklahoma City Area; and 10)Portland Area. Results The tools of managed care include utilization review, case management, provider contracting, and information technology. Applications of managed care principles reviewed in this monograph include: 1) pharmaceutical costs; 2) tribal program management; 3) mental health services; 4) telemedicine; 5) cancer screening services; 6) electronic clinical record; and 7) teleradiology. Conclusion Managed care flexibility provides a dynamic process for developing a cost-effective, high quality health care delivery system tailored to meet the very specific and unique needs of the American Indian and Alaska Native populations. The challenge to those involved in the delivery of health care to American Indians and Alaska Natives is to develop strategies to ensure the delivery of cost-effective, high quality health care

Improving Patient Care Delivery in a Small Alaska Native Health Care Organization

Chronic diseases impose heavy burdens on the United States health care system, particularly among some ethnic/racial groups such as American Indian and Alaska Natives who experience higher incidence of these diseases than non-Native population. In an effort to improve the health status of its patients, the Ukudigaunal Wellness Center (UWC) partnered with the Improving Patient Care (IPC) Collaborative to implement changes designed to improve chronic disease care for Native Alaskans through intensive monitoring of screening for chronic disease and selected chronic disease outcomes. For this program evaluation, the units of analysis were the changes in health service delivery and the resulting patient clinical outcomes. The data source was the Registration and Patient Management System (RPMS), repository for the data collected over the 14 months of the collaborative. The findings showed that the process measures that met IPC goals were due to improvements in service delivery by UWC. Goals for other services, such as diagnostic screenings, were not met because these clinical components had to be coordinated with facilities outside UWC. Outcome measures for BP and HgbA1c control were not met as these depended on the patients\u27 abilities to self-manage the required procedures. The implications for social change included: (a) Positive outcome in managing chronic diseases is possible by combining chronic care models with Deming\u27s model for improvement; (b) Increased patient awareness of chronic conditions and their long term consequences tended to support more responsible and successful patient self-management; (c) Use of external medical resources should be considered when patient privacy and confidentiality are concerns