Volume X No. 3 • March 15, 2005 YKHC prepares for Gathering next month
Participants at last year's Tribal Gathering work on setting priorities for the communities in their election district. (photo by Michael Faubion)
Set for April 5–7 in Bethel, this will be the 12th Tribal Unity and Traditional Medicine Gathering
The coming together of people from throughout the region reorganizing the ambulatory clinics at the hospital, building subre- to discuss health care priorities and celebrate Native heal- gional clinics in Aniak, St. Maryʼs, Emmonak and Toksook Bay to ing traditions has itself become a tradition for YKHCʼs bring health care closer to home for most people, creating an inhal- customers, directors, leaders and employees.
ant abuse treatment facility, improving water and sewer systems, This is Gathering XII, and promises to be just as instrumental as and a great many other improvements addressing our healthcare Gatherings past in presenting an opportunity for YKHCʼs leader- ship to listen and learn what is most important to the people who The theme this year acknowledges the power and promise of live in our vast region.
YKHCʼs new mission statement: "Working Together to Achieve Over the years, YKHC has responded to the peoplesʼ concerns by Excellent Health." INSIDE: CHR Intro, p. 4 • PT Terms, p. 6 • Health Fair, p. 8-9 • Operators, p. 14
YKHC Board of Directors
Kotlik, Alaska 99620 Bethel, Alaska 99559 Aaron S. Kameroff
Henry Hunter, Sr.
Alakanuk, Alaska 99554 Bethel, Alaska 99559 Ray Alstrom
Bethel, Alaska 99559 Marshall, Alaska 99585 Joseph C. Bavilla
James C. Landlord
Napaskiak, Alaska 99559 Mt. Village, AK 99632 Chuck Chaliak
Nunapitchuk, Alaska Aniak, Alaska 99557 Robert Enoch
Kathy W. Chase
Aniak, Alaska 99557 Tuntutuliak, Alaska 99680 Hooper Bay, Alaska 99604 Holy Cross, Alaska 99602 H: 907-558-4096 - W: 558-4711 Moses J. Tulim
Honorary Board Member
James R. Charlie, Sr.
Chevak, Alaska 99563 Paul John
Akiachak, Alaska 99551 Toksook Bay, Alaska 99637 Toksook Bay, Alaska 99637 Moses Peter
Sam W. Alexie
Tuluksak, Alaska 99679 Toksook Bay, Alaska 99637 Eek, Alaska 99578 Numbers to Call
Subregional Clinic Appointments
Public Relations Dept. 543-6030 Aniak . 675-4556 Media Services . 543-6038 Emmonak . 949-3500 Ofﬁce of Environmental Health & Engineering . 543-6420 St. Maryʼs . 438-3500 Technology Help Desk . 543-6070 Public Health Nurses .543-2110 Human Resources . 543-6060 Pharmacy . 543-6382 Job Line . 543-6443 Travel Management Center . 543-6360 Learning Center . 543-6980 WIC Program . 543-6459 Administration . 543-6020 Health Services . 543-6024 Hospital . 543-6300 Village Operations . 543-6160 Emergency Room . 543-6395 Hospital Community Relations . 543-6350 Injury Prevention/EMS . 543-6080 Social Services . 543-6225 Community Health & Wellness . 543-6190 Clinic Appointments . 543-6442
Behavioral Health Services . 543-6100
Phillips Ayagnirvik . 543-6700 Dental Appointments . 543-6229
Village Services . 543-6740 Optometry Appointments . 543-6336
Home Care Services . 543-6170 Audiology Appointments . 543-6466
Volume X No. 3 • March 15, 2005 YKHC Board
& Committee Meetings
Finance Committee Medical Laboratory
Governing Body Finance Committee April Kameroff is the daughter of Joe Kameroff, Sr. and the late Sarah Ciletti of Aniak. April is quiet, outgoing, happy, and a very hard worker. She was raised April 5 –7
in Aniak until she relocated to Seward during her high school years.
Tribal Unity & Traditional She attended high school in Seward, but moved back to Aniak in her senior year, where she graduated from the Aniak High School. In May 10, 2004, April completed the Clinical Assistant Certiﬁcate program through the University of Alaska Anchor- April 7–8
age, (UAA) Medical Laboratory Technology Department. Currently she is pursuing Semi-Annual Full Board Meeting her Associates Degree through the University of Alaska Anchorage and continues to take distance delivery classes.
"When I was a young girl, I had a hero and his name was Richard Ciletti. Richard Finance Committee is my older brother and he was a Dragon Slayer for the Aniak Fire Department. I wit- nessed him save an elderly woman back then, and that inspired me to help my people get well. As I got older, I joined the Dragon Slayers and since then, I am pursuing a Governing Body Medical Laboratory Technician degree through UAA. Today, Richard is attending UAF in Fairbanks, and studying to be a paramedic. Heʼs the reason why I am where Finance Committee I am right now and thatʼs helping my people Clinical Lab Assistant
in a hospital setting. My brother showed • Demonstrates knowledge of me that I could be anything I wanted to be infection control and safety Executive Board "I enjoy helping people, and meeting new • Collects and prepares blood and body fluid specimens. Finance Committee faces that come through the Aniak Subre- gional Clinic Laboratory. Each day, I learn • Performs appropriate tests new things, techniques, different blood at the clinical assistant level, according to standard operat- Governing Body types and I am proud to say that I am doing something with my life. If you want to be ing procedures.
successful in life, you have to go follow • Follows established quality control protocols.
Finance Committee your heart and your dreams. At the end, you will have a career to count on.
• Starting salary The Messenger is a monthly publication pro- "As a Medical Laboratory Assistant, I duced by the Yukon-Kuskokwim Health Corporation as a start up and do quality control on all the Clinical Lab Assistant: report to Tribal Members. For questions, comments, sub- instruments that will be used, collect the mission of articles, or subscription information, write to specimens, draw blood, label the speci- Messenger Editor, Media Services, Yukon-Kuskokwim Health Corporation, P.O. Box 528, Bethel, Alaska 99559. E- men tubes, run tests in the lab, enter the lab mail: [email protected] Deadline is the last day results into the computer correctly, order lab supplies when needed and get lab speci- of the month preceding publication. Publication is on the mens ready for transport." 15th of every month. Anchorage Ofﬁce: 4700 Business Park Blvd. Suite E25, Anchorage, Alaska 99503. 907-677-2232. Please ask permission to reprint articles or pictures. Call The YKHC Learning Center: 907-543-6758
2005, Yukon-Kuskokwim Health Corporation.
A message from Community Health & Wellness
Diabetes and You
Meet your CHR
Diabetes is on the increase in the YK Delta and somebody is responsible! Waqaa. My name is Patrick Pavila from the Native village You might ask who is responsible and the answer you receive depends of Tuntutuliak. I work for YKHCʼs on whom you ask. There is a proﬁle of the responsible person. They may be Health Education Department as a male or female, young or old, rich or poor, educated or uneducated, working village-based Community Health or unemployed and have many other varied characteristics. Look around and Representative (CHR). I am writing look in the mirror. Who are they? to introduce myself and tell you a They are all of us. We are responsible for our own healthcare and prevent- little about the work that I do.
ing diabetes. We should be proactive not reactive in our care. Proactive I have been assigned to your village means that the ﬁrst responsibility lies in each of us. If we have health ques- to deliver health related presentations tions or problems, it is up to us to start our care. If we are sick, we should go at the school and community levels. to the doctor/healer so we can ﬁnd out what is wrong with us and how to treat As a CHR, I present material, data, the problem. Reactive means to wait for someone else to do something ﬁrst. and other pertinent information on We should act ﬁrst not only in our treatment, but also in being informed on health promotion in general and as it health issues and not wait on the health care provider. Health care providers relates to your village speciﬁcally.
are responsible for helping you in treatment and care.
Upon request I will travel to your Diabetes is a disease that is preventable and treatable in most cases. The village to deliver presentations on health community knows many of the reasons that a person develops diabetes certain topics: alcohol/drug abuse, but cannot predict exactly who will. We know that heredity/genetics, obesity, tobacco cessation, human sexuality lack of exercise, diet patterns/nutrition, and many other factors are involved (e.g. puberty, teen pregnancy preven- in developing diabetes. We canʼt change our heredity, but most other factors tion, STDs, etc.) and other health- related to diabetes are controlled by you.
related topics. After receiving a presentation request and It is the job of the health care providers to get good and useful information the name of a contact person from a village in my service out to the community. It is up to you to use that information in your care. Do area, a schedule is made to visit the village. Next, a date you smoke, chew or drink, eat a poor diet, exercise too little or not at all? Do is agreed upon on when I can go to the requesting school you help your loved ones to keep poor habits? If so, who is responsible for and/or village and we go from there.
developing diabetes? You are responsible. The Health Education Department (HE) can assist YKHC has extensive preventive care resources available to the community, a village if it wants to organize a health fair. This is a including a Diabetes Prevention and Control section in Village Operations. long-term commitment so requests should be made sev- The health care community stands ready to assist you in taking care of your eral months before the planned health fair. This can be a health and preventing future problems. Take advantage of the services and school or village-sponsored event, or both the school and information available. You are responsible!
village can work together with HE to plan the health fair.
The department also assists villages with establishing a Call Diabetes Prevention & Control
Community Wellness Team. Community wellness teams 543-6133 or 1-877-543-6133
primarily prioritize, plan, and present health promo- tion and disease prevention activities in their respective communities. If a village wants to start a wellness team, the Health Education Dept. will be more than happy to If you want more information or just want to chat, please call me at (907) 256-2290 or email to [email protected] You can also relay a message by dial- ing 1-800-478-4471 ext. 6493. I will be waiting to hear form you in the near future. Patrick Pavila, CHR, Tuntutuliak If you would like more information about
our services or the Community Health
Representative for your community, please
I need to find out who this is at the Health Fair. See more about the Health Fair on
call toll-free 1-800-478-4471
Volume X No. 3 • March 15, 2005 Career Pathways releases new ‘Proﬁles of Success'
The Yukon-Kuskokwim Health Corporation Health Career Pathways Program is proud to announce that sets of eight new "Proﬁles of Success" posters are being distributed to schools and clinics within the YKHC service area. The posters proﬁle Alaska Native health professionals and para-professionals employed by YKHC. The new set of posters includes proﬁles on Health Aides, Registered Nurse Debo- rah Samson, Physician Assistant Hazel Julius, Subregional Clinic Operations Manager Gail Alstrom, Licensed Practical Nurse Clara George, Dental Assistant Abigail Samuelson, Dispens- ing Optician Grace David, and Eye Care Technician Willie Lake.
Each poster also includes education and training requirements for the profession, starting salary and a short description of duties, along with personal education and work experiences for each individual. YKHCʼs Health Career Pathways Program is funded in part by a grant from the Administra- tion for Native Americans, a department of the U. S. Department of Health and Human Ser- vices. The Health Career Pathways Program is part of the Learning Center at YKHC and pro- vides health career information to public school students and to adults, and provides assistance to tribal members entering health professional training. YKHC is working with the school districts in the Yukon-Kuskokwim Delta region, the Uni- versity of Alaska statewide system, and other organizations to provide awareness activities, exploration of health careers, preparation activities, and training options for student and adult learners. "Growing our own" health professionals will help to improve the local economy by ensuring that salaries remain in the region, and health professionals who are tribal members have a better understanding of how to serve tribal members.
The Proﬁles of Success column has run in "The Messenger," YKHCʼs newsletter, for the last Hazel Julius, a certified physician assistant
year, and new proﬁles are still being developed and published monthly.
is one of eight employees featured in the
"Profiles of Success" poster series.
For more information about job openings at YKHC, health services and scholarships, please log on
to our website at www.ykhc.org, or contact the Health Career Pathways ofﬁce at 543-6758.
YKHC's Chief Operating Ofﬁcer resigns
On Thursday, February 17, Craig Peltola also appointed Jeff Murchison, YKHCʼs Performance Ambrosiani, YKHCʼs Chief Operat- Improvement Director and a member of the Senior Leadership, to ing Ofﬁcer and Vice President of Finance, lead the Napartet Goal Team. "YKHC looks forward to working tendered his resignation to YKHC. with Mr. Short, Mr. Murchision and Mr. Deakin in keeping the com- Ambrosiani had been with YKHC since pany focused on our present ﬁnancial and operational goals," said "As Finance Vice President, Ambro- "I also want to reassure our employees and clients that YKHC, sianiʼs responsibility was to the ﬁnancial through the control of its Administration and Board of Directors, is health of the company, which amounts to stable and doing ﬁne organizationally," Peltola added.
some $120 million annually," said Gene Peltola said the position of Vice President of Finance is already Peltola, YKHCʼs President and CEO.
being advertised nationally and that he expects to review applica- As COO, Ambrosiani oversaw the tions within the next couple of months.
operations of the company, including "I enjoyed working with Mr. Ambrosiani during his tenure here at administrative oversight of Aeromed International, YKHCʼs mede- YKHC and we will certainly miss him. On behalf of the company, vac service, which is based in Anchorage.
Iʼd like to wish him all the best in his future endeavors," Peltola Another of Ambrosianiʼs duties was to facilitate the new Napartet Goal Team (NGT) which was formed in late 2004 and tasked to oversee accomplishment of the companyʼs 2005 goals.
During this period of transition, Sam Deakin, YKHCʼs acting Controller, was appointed acting Chief Financial Ofﬁcer by Peltola. "And the job of administrative oversight of our medevac company has been assigned to Hugh Short, YKHCʼs Vice President of Support Services," he said.
Physical Therapy and Orthopedic Clinic
Basic Anatomy Terms
by Anne Kosacheff This month we will cover basic anatomy terms. Keep this column Ligaments, tendons and muscles (yualuq)
handy, as it will be referred to frequently over the next several These three tissues all perform the same function (support of the bony skeleton), but do so in different ways. Bones (timemta enri) and vertebrae (uyaqinrat)
Ligaments connect bone to bone. Generally they support joints
Bones make up the skeleton (timemta enri), and provide the sup-
directly, by connecting close to the moving part of the joint. Liga- porting structure for our body. Everyone has the same basic bony ments are relatively stiff, and provide more stability than tendons structure. There are common skeletal variants we see in the medical and muscles. Once stretched or torn, ligaments do not generally ﬁeld, but for the most part, we are all put together the same way. repair themselves. Scar tissue may form, but the ligament will never There are more than 200 bones in the body. Each one is held in place regain its initial strength and function. Common problems associ- by ligaments, tendons and muscles. Common problems associated ated with ligaments include sprain and tears.
with the bones of the body are fractures, bruises and osteopenia/ Tendons connect muscles to bone. Tendons provide stability,
but can stretch more than ligaments. They allow for mobility in Vertebrae (uyaqinrat) are specialized bones of the spine. They are the joint, but are not contractile: they do not get longer and shorter
only found in the back and neck. There are 33 vertebrae in the spine, actively, like muscles do. After most injuries, tendons can repair each specialized for a speciﬁc function. We will cover each speciﬁc themselves. Common problems associated with tendons include area of the back in future columns. strains, tears and ruptures.
Cartilage (qiaryimtaaq or tatangquk), menisci and
Nerves (temem elpeksuutai)
Nerves (temem elpeksuutai) are the communication pathways
between your skin, muscles and internal organs and your brain. As a qiaryimtaaq or tatangquk) is found on all joint sur- faces. It cushions the bony surfaces and allows the bones to move general rule, each nerve has two-way trafﬁc traveling up and down. against one another without being worn down. In the knee, the The nerves themselves travel next to your bones; can go under, over cartilage is called a or through a muscle; and run past every joint in your body. Prob- meniscus. There are two menisci in each knee. The menisci are thicker cartilage than that found in other joints. The lems with any of these structures can affect your nerves. Common menisci provide some stability in the knee, unlike the cartilage in problems associated with the nervous system include entrapment, other joints of the body, which only provide cushioning, and some impingement, overstretching and tearing.
protection from wear and tear.
Next month will begin our exploration of the musculoskeletal The cartilage found between each pair of vertebrae in the spine system. We will cover basic neck anatomy, and touch on common is called a disc (
problems found in the neck.
uivat). The disc not only cushions and protects the vertebral body, but also supports the space between the vertebrae where the nerves exit the spinal cord to innervate your muscles Physical Therapy Report to Tribal Gathering XII
and skin. Common problems associated with any cartilage tissue are generally due to degeneration (wearing away of the tissue),
The Physical Therapy Department expanded in 2004 to include four or a tear in the cartilage itself. We will discuss speciﬁc problems full time Physical Therapists and one part-time Massage Therapist. associated with each area of the body in future columns.
Our outreach programs expanded to include coordinated care with the Family Infant Toddler Program, Home Care, the McCann Inhal- ant Treatment Center, PATC and the sub-regional clinics in Aniak, Emmonak and St. Maryʼs.
Plans are underway to provide services in the Tooksok Bay subre- gional clinic beginning in the spring of 2005. More than 200 patients Employment Opportunities received PT services in subregional clinics in 2004. As part of the corporate Patient Centered Excellence Napartut goal, the Physical Therapy department has set a goal to visit 100 percent of the home-bound elders to provide a home safety assessment in the Messenger Back Issues 2005 ﬁscal year.
Volume X No. 3 • March 15, 2005 Don't Break the Cold Chain!
by Chris Desnoyers, YKHC Vaccine Distribution Technician What is the cold chain? It is the stable tempera- Pharmacy Care Quiz
ture kept during the long voyage of a vaccine 5=Always – 4=Most of the time – 3=Sometimes – 2=Rarely – 1=Never When receiving your prescriptions, how often do you…
It begins with vaccine production at the manufacturer. It ends at the village Take your medications exactly as instructed by your doctor clinic or hospital when the Community Health Aide or Nurse gives the shot and pharmacist? 5 4 3 2 1 to the baby, child, or adult.
Understand the written information you with your medica- We all know that vaccines protect us from getting many diseases. But did you know that they are very fragile? The shots are temperature sensi- Learn the name of any prescription medications you take? tive and have to stay between 35° and 46° Fahrenheit (or 2° to 8° Celsius). That temperature is cold but not too cold. Many vaccines donʼt work as Know why the prescription medications you take have been well if they are frozen. prescribed for you? 5 4 3 2 1 There are also medicines that are temperature sensitive. These need to Have your prescriptions filled at the same pharmacy? stay in the Cold Chain, too.
At the manufacturer, the vaccines are put into a box with a mixture Check to see if a refill of your prescription is the same as of cold packs and ice packs. They are sent to Anchorage, to the Vaccine your last one? 5 4 3 2 1 Depot. There the vaccines wait for our order. The hospital or village clinic Read the written information about your medication when or subregional clinic count their vaccines each you receive the prescription medication? 5 4 3 2 1 month and send in an order. The Vaccine Distri- Some people Ask what to do if you experience side effects when taking bution Center sends the order each month to the your prescriptions? 5 4 3 2 1 State. After the state sends the order to YKHC, think that Ask your pharmacist any questions you may have about your the vaccines are sent to the village clinics, sub- health aides prescription medications? 5 4 3 2 1 regional clinics and also to the hospital.
Ask your pharmacist if it is safe to take a non-prescription Manufacturer—to—Anchorage (State and health medicine, herbal remedy, or nutritional supplement with Depot)—to—Bethel (Vaccine Distribution)— your prescription medicines? 5 4 3 2 1 practitioners to—Village Clinics/Subregional Clinics/Hos- Ask your pharmacist or doctor about any precautions you pital Pharmacy and Clinics—to—Babyʼs leg or should be aware of when taking prescriptions? 5 4 3 2 1 somebodyʼs arm.
patients. Some people think that health aides and health practitioners only see patients. That is simply That is simply 5=Very aware.22.214.171.124=Not at all aware not true. They are also very busy trying to keep vaccines within the cold chain. When the ship- How aware of you of each of the following…
ment comes in by plane, either the agent picks Pharmacists need to know your complete medication history up the vaccines to take to the clinic or the clinic staff must go and get when filling a prescription for you? 5 4 3 2 1 the vaccines. Once the box arrives, the health aide takes out the vaccines Pharmacists check your prescription for potentially harmful and puts them into a refrigerator. This special refrigerator (not for food or interactions? 5 4 3 2 1 drink) is checked two times a day to make sure the temperature is between Pharmacists check for possible allergies you may have to 35° and 46° Fahrenheit (2° and 8° Celsius).
medication before filling your prescription? 5 4 3 2 1 Besides taking care of patients, the health aides take care of medicines Pharmacists check your prescription to see if it will affect and vaccines. This is an important job. They make sure the vaccines you any of your known medical conditions? 5 4 3 2 1 get are the best available. The next time you get a shot, think about all the Pharmacists are available to answer your questions and people and all the time it took to get you the safe effective vaccine. advise you on taking your medication? 5 4 3 2 1 Next month check out the information about the links in the cold Congratulations! You have completed the Quiz. Now
chain—airports, agents, and aides, oh my! total your score and turn to page 10 to understand what
your score means.
a fair day Drawing for door prizes!
Nearly 300 people came to the Bethel Health Fair Feb. 19 to take part in the activities and visit information displays. WIC Nutrition Educator Ardene Constantine
stands by the Women, Infants & Children
Program display, ready with samples of
Alma Kanrilak and Debi Olick of YKHC's Health Education Dept.
have plenty to say about how much sugar is in soda pop.
Photos by Chris Ho Julia Brown, also with Health Education, was there to help people identify
traditional Native foods and learn about its nutritional value.
Volume X No. 3 • March 15, 2005 Children gather round REbecca Lupie, a volunteer with the VFW Ladies Auxiliary who was helping out at the Injury Preven-
The day began with a session that offered comprehensive blood tests, thyroid blood test screenings, and prostate blood test screenings. These began with registration, followed by blood pressure and height and weight measurements, and concluded with a one-on-one consultation with a health provider. Juice and snacks were provided to these participants to replen- ish basic energy after they prepared for the tests with a 12-hour fast.
For those who preferred morning activity to early morning tests, there was a 3K Fun Run/ Walk with prizes for the top ﬁnishers. In the afternoon, 25 booths provided infor- mation, materials, visual aids and hands-on displays covering various health topics.
Vision screenings and blood sugar readings were offered as well.
Traditional dancers from the local immer- sion school entertained fairgoers while chil- dren enjoyed games and other fun activities.
Door prizes—from gift certiﬁcates to safety gear and much more—were given away throughout the afternoon. Two lucky winners received round trip airline tickets.
It was a fun and informative event for the Lea Anne Abernathy, a nurse preactioner
Circle of Care Program Case Manager Carl
at the Yukon-Kuskokwim Delta Regional
Evans had information about the HIV Quick Test.
Hospital, explains things to a health fair
Raven's Quest Summer Institute seeks UA students
by Janice Troyer, University of Alaska Are you having trouble deciding what you would like to major in at college? Do you have an interest in the "helping" profes- sions? Do you like the idea of getting paid to go to school and earn- ing college credits at the same time? Then Ravenʼs Quest Summer Institute might be just the place for you! For the past two summers, University of Alaska students from across the state have come together to learn more about career opportunities in behavioral health, cultural diversity, and the behav- ioral health degree programs offered within the University of Alaska system. Students also work on building academic skills to help them succeed in future college courses.
Participants in the 8-week Ravenʼs Quest Summer Institute take part in a variety of activities including class discussions, guest speakers, special workshops and 75 hours of job shadowing. Stu- dents shadow staff at Southcentral Foundation, Cook Inlet Tribal Council, Southcentral Counseling, Alaska Childrenʼs Services, and Homeward Bound. Students also meet and talk to many profes- Pamela Notti, Crystal Swetzof, Carlyn Green, Bruce Ervin, Peer Mentor
sionals about their jobs and experiences in the ﬁeld. Many of these Jess Ruck, and Alice Kiunya during a weekend hike at Raven's Quest
speakers either live and/or work in rural Alaska.
Social events are an important part of the Ravenʼs Quest Summer continue on my quest to obtain a degree in Social Work. The class, Institute. Besides the classroom and job shadowing experiences, classmates, bonding, friendships, internships and the whole experi- Ravenʼs Quest participants enjoy getting together for potlucks, gift ence was a goldmine of knowledge and experience." exchanges, movies, neon bowling, hiking and special events like If you are currently enrolled as a University of Alaska student UAA ice cream socials and an Eklutna Powwow. Many friendships with an undeclared major then you may be eligible to apply for are made during the course of the eight weeks. Ravenʼs Quest Summer Institute. Preference is given to students Alice Kiunya, originally from Kongiganak, attended the 2004 from rural Alaska. Selected students receive a $480/week stipend to Ravenʼs Quest Summer Institute. Alice comments that Ravenʼs help cover the costs of room and board. Additional travel funds are Quest helped her understand the classes she is currently taking and available for students who need assistance traveling into Anchor- gave her a very good overview of the behavioral health ﬁeld. She age. All students have the opportunity to earn up to six college cred- especially enjoyed the job shadowing experiences. Alice is currently its during the summer.
in Sitka ﬁnishing up a Human Services degree.
If you would like more information about this great opportunity Pamela Notti, who has spent many summers in Bethel, also or to ﬁnd out whether you are eligible to apply, call Program Man- attended the 2004 Ravenʼs Quest Summer Institute. Pam comments, ager Janice Troyer at (907) 786-6592 or email her at [email protected]
"Ravenʼs Quest was the most rewarding experience Iʼve had at alaska.edu . You might also try visiting the Ravenʼs Quest Summer UAA. The speakers that came in from the Social Work, Psychol- Institute website (www.ichs.uaa.alaska.edu/acrh/ravensquest) which ogy and Human Services programs, as well as the countless others has answers to frequently asked questions, applications and photos who spoke about the helping professions, gave me the motivation to from the 2003 and 2004 Summer Institutes.
Pharmacy Quiz, from page 7
help to take your medicine as prescribed and make you healthier in Here's what your score means
the long run.
Above 78—Chances are youʼre a health-conscious consumer. Keep
40 and below—This is an opportunity to remind you that todayʼs
up the good work and youʼre likely to avoid unnecessary complica- pharmacist does a lot more than just "count pills." Pharmacists are tions from your medicines.
specially trained in understanding todayʼs complex drugs and edu- 62-78—Though you may not always chat with the pharmacist,
cating patients about their medicines. Take advantage of the trusted youʼre comfortable asking questions when you donʼt understand resource of your pharmacist.
about your medicine. Take some extra time to tell the pharmacist ASK, LISTEN AND LEARN
all the over the counter products youʼre taking, you can be sure that youʼre doing all you can to safely take your medication.
For questions, please call YKHC Pharmacy
41-61—In todayʼs hectic world, it sometimes seem like thereʼs no
"time-out" for illness that requires medical treatment and prescrip- tion drug therapy. Get to know your pharmacist. Doing so could Volume X No. 3 • March 15, 2005 A message from our Grant Writers.
Community Plans, Community
Plans, Community Plans!
Does your village have a comprehensive commu-
by John Dickens nity plan yet? if it doesnʼt, YKHC can help.
It isnʼt enough to want-or need-a project in your community. Now, funding agencies want to know how you know you want it or need it. "And let none say it can not happen here…" And, they want to know that your community has thought through all the details including how your project will be supported for years into the Whether it is a new clinic funded by the Denali Commission, or a new The ancient Greek dramatist Sophocles words at the fall of Troy ring true even today. The recent earthquake and tsunami in south Asia is a grim reminder of how delicate and airport, school or water system, your community needs a community fragile our time on this planet can be.
plan. And it isnʼt just here on the YK Delta. Communities statewide must The U.S. Geological Survey says "one out of every ten earth- meet this new requirement.
quakes in the world occur in Alaska." There have been dozens The YKHC Grant Development Department is working with AVCP, of tsunamis recorded in Alaska since 1788. A massive array of Inc. and the AVCP Regional Housing Authority to assist Tribal Councils geologic, anthropologic and archeological evidence points to and Municipal Governments in the preparation of community compre- frequent, catastrophic events in Alaska that changed everything hensive plans. We can provide a variety of services, including technical assistance in the planning process as well as identifying funding sources Are you and your village ready? Where will you go when the to carry out community comprehensive planning.
big wave comes? When the great ﬂoods of yesteryear return? Grant Writer Jerry Pﬂugh will be making a presentation on the com- How are you going to feed your family? Keep warm? Stay munity planning process during the 2005 Tribal Gathering starting April alive? Care for the wounded? Rescue the stranded? Keep it 5 in Bethel.
together till help arrives? If you or your community has questions, or would like assistance, Have you thought about it? You had better start! please feel free to call Norman Ayagalria or Angie Whitman at the Grant Geologists point to possibly two huge 9.0 or bigger earth- Development Department. You can call toll free at 1-800-478-3321, quakes that are long overdue. The Shumagin gap and the extension 6041 (543-6041) for Norman, or 6612 (543-6612) or contact Yakutat gap. These geologic time bombs have got all the earth Norman by e-mail: [email protected] or Angie: angie_ In many ways we are probably one of the least prepared regions in the whole state. Other areas, even ones poorer and more remote than ours have Borough governments preparing and planning for these upcoming events. What are we doing? From what I can tell, not very much.
If Anchorage was hit by a 1964 style 9.2 earthquake, do you really think that they could help us quickly enough? If the "Big One" occurred tomorrow do you think your town is really ready to stand on its own for a few days? If you knew that a tsunami was coming where would you go? The time to start thinking about these issues is right now! I am calling on all the people of this great Delta of ours to start thinking about this. Start preparing now. Consult the New clinic in Mekoryuk. Funding for community projects require community
Elders, meet with your family, your tribe, your town. There are planning. Contact YKHC's Grantwriting Dept. for information: 907-543-6041.
tremendous resources available for those who will look. Do it The 2005 Dietary Guidelines
Fruits and Vegetables: Chronic Disease Fighters
Bring Down High Blood Pressure with Potassium-Rich
Chronic diseases, like heart disease, cancer, stroke and type 2 dia- Fruits and Vegetables
betes account for 7 out of every 10 deaths in the U.S.
Diets rich in potassium can lower blood pressure and help blunt Compared to people who consume a diet with only small amounts the effects of salt on blood pressure. Health authorities recommend of fruits and vegetables, people who eat a healthful diet with gener- increasing intake of fruits and vegetables rich in potassium to lower ous amounts of fruits and vegetables are likely to have reduced risk high blood pressure or keep blood pressure in normal range.
of chronic diseases, including stroke and perhaps other cardiovascu- Many American adults will develop hypertension (high blood lar diseases, type 2 diabetes, and cancer in certain sites (oral cavity pressure) during their lifetime.
and pharynx, larynx, lung, esophagus, stomach, and colon-rectum).
Lifestyle changes can prevent or delay the onset of high blood Fiber Fights Heart Disease
pressure. These changes include reducing salt intake, increasing Diets rich in foods containing ﬁber, such as fruits and vegetables potassium intake, losing excess body weight, increasing physical and whole grains, have been shown to have a number of beneﬁ- activity, and eating an overall healthful diet.
cial effects, including decreased risk of coronary heart disease and Great sources of potassium are sweet potatoes, white potatoes, improvement in laxation. There is also interest in the potential rela- white beans, winter squash, bananas, spinach, melons (cantaloupe, tionship between diets containing ﬁber-rich foods and lower risk of honeydew), and tomato sauce.
On average, the higher an individualʼs salt (sodium chloride) • Key recommendation: Choose fiber rich fruits, vegetables, and intake, the higher an individualʼs blood pressure. Nearly all Ameri- whole grains often.
cans consume substantially more salt than they need. Americans • The recommended dietary fiber intake is 14 grams per 1000 calo- may be consuming more sodium than they think because 75 percent ries consumed.
of sodium is added to processed foods by manufacturers whereas • The majority of servings from the fruit group should come from only 5 to 10 percent comes from salt added while cooking or at the whole fruit rather than juice. Increasing the proportion of fruit table, and 10 percent comes from natural salt content of foods.
eaten whole is desirable to increase fiber intake.
The potassium in fruits and vegetables is more readily available • Legumes (dry beans and peas) are especially rich in fiber and for absorption than that from meat, milk, and cereal products.
should be consumed several times per week.
The Dietary Guidelines for Americans is a report issued by law How does ﬁber work?
every five years from the secretaries of Health and Human Services 1. Fiber lowers blood triglyceride levels. High triglycerides can damage arteries and increase risk for heart disease.
and Agriculture that "shall contain nutritional and dietary informa- tion and guidelines for the general public." For more information 2. Fiber slows down the absorption of food in the gut resulting in better blood sugar control which may help prevent diminished about the food groups and nutrition values, or to pick up some new sugar control and type-2 diabetes.
ideas on physical activity, go to www.healthierus.gov/dietary guide- Murkowski proclaims March as Alaska Nutrition Month
Research shows that good cancer deaths can be attributed to what 2,000-calorie diet. nutrition lowers peopleʼs people eat. Current research shows that good "In many rural village stores in Alaska, nutrition lowers peopleʼs risk for obesity and fresh fruits and vegetables are often in short risk for obesity, many chronic many other chronic conditions, including supply, are of poor quality due to long ship- diseases, and some types of heart disease, stroke, diabetes, osteoporosis ping times, or are too expensive to purchase and some types of cancer. on a regular basis. Fortunately, there are The 2005 Dietary Guidelines for all Amer- other ways to get your ﬁve cups of fruits and icans, published in January 2005 by the U.S. vegetables. Frozen, canned and dried fruits from the Governor's Press Ofﬁce Department of Health and Human Services and vegetables are just as nutritious as fresh. (Juneau) – Governor Frank H. Murkowski (DHHS), encourages individuals to eat a diet Most canned and frozen fruits and veg- on March 2 proclaimed March 2005 as rich in fruits and vegetables, whole grains, etables have the same amount of nutrients Alaska Nutrition Month.
low fat dairy products and lean protein as fresh, serving per serving," said DHSS Cancer, heart disease, diabetes and stroke are foods. Fruits and vegetables are an important Public Health Director Richard Mandsager, among the leading causes of death in Alaska, component of the guidelines, which recom- and almost a third of all heart disease and mend consuming two cups of fruit and 2 1/2 cups of vegetables per day for a reference Volume X No. 3 • March 15, 2005 Nicotine Control to open Cessation Clinic in March
Nicotine Control and Research is proud to announce that they will soon be taking appointments and scheduling patients for Nicotine Cessation. This means a patient can call the clinic, schedule an appointment which ﬁts into their schedule, and be seen accordingly.
Thus, a patient who only needs Cessation and Nicotine Replacement Therapy or any other tobacco-related service, can be screened and triaged in the Nicotine Cessation Clinic WITH- OUT having to ﬁrst be seen in one of the other ambulatory clin- ics at the hospital.
Additionally, Nicotine Control and Research will handle walk- ins on a ﬁrst come, ﬁrst serve basis. They will not have to be pro- cessed through the ambulatory clinics if they are only requiring nicotine cessation treatment.
"To better serve our customers, who are our patients, this seemed a no-brainer," said Alexandria Modigh-Hicks, Director of the Program. As YKHC strives to achieve excellence in patient care, innovative ideas about how to make this happen are wel- Work begins on remodeling the Nicotine Control offices in a Nicotine Ces-
comed by corporate leadership.
"We are so excited to have this clinic. Our patients have assistance in the scheduling and registration aspect. always seemed frustrated at how they would have to go to Delta "We will make a formal announcement when the Nicotine Ces- Clinic ﬁrst to have their blood pressure and vitals taken, and then sation Clinic is ofﬁcially open," said Caroline Nevak, Outreach and referred to Nicotine. This added a lot of wait time for these patients" Media Specialist for Nicotine.
said Carrie Enoch, Senior Counselor/Coordinator.
For the time being, patients will continue to be seen in the origi- The new process will take a lot of the burden off the other ambu- nal manner, but by mid March the program anticipates that the latory clinics and reduce wait times for patients overall, since they clinic will be open and actively treating patients.
are having to screen patients who have no medical complaint other than nicotine cessation treatment.
For help in Quitting or more information
Many different departments in the corporation came together and about the Nicotine Cessation Clinic or
assisted in making the transformation. "I would like to especially thank Manny Konig, Peter Charles, for any other tobacco related comments,
Olrick Nick and Robert Larson of the Maintenance Department," please call 1-800-478-3321.
said Ms. Modigh-Hicks. "They answered the call for the reconstruc- tion of the ofﬁce into a clinic in one day!" Other departments include Nursing and the Emergency Room, who are providing blood pressure and monitoring equipment; the Well Child Program, directed by Anna Simon, with instruction by Lynette Collins, who is teaching the staff how to take vitals and record. Additionally, Registration and Scheduling, led by Karen Sidell, has been extremely helpful and collaborative in lending www.ykhc.org/
post in your
Village water plant operators meet for training in Bethel
"The boiler is the heart of the water plant," said Jeff Severn, Environmental Health Ofﬁcer and O&M Training Coordinator from YKHC Ofﬁce of Environmental Health and Engineering (OEHE).
"It is critical that the boiler is operational for the rest of the water plant to function," said Severn, as Water Plant Operators from the YK Delta met in Bethel for a Boiler Maintenance Training workshop last The three-day workshop, jointly sponsored by Alaska Native Tribal Health Consortium (ANTHC) and OEHE, covers a variety of topics from boiler systems and maintenance to troubleshooting.
"Itʼs great to be able to get together with water plant operators from different villages and troubleshoot different problems," said Sam Bur- kett, lead water plant operator in Grayling.
Samʼs father, Dave Burkett, was the Grayling water plant operator for more than 20 years before passing the torch to his son. "Being an operator is a good profession to get into," said the elder Burkett. "Itʼs interesting because there is always something different to be done." Village water plant operators must receive detailed boiler training to Jeff Severn, YKHC Operations and Maintenance Training Coordinator
ensure that the water plant is heated and functional, and provide safe looks on as Joseph Sallaffie from Tuluksak and James Aqwiak from
drinking water for their communities.
Emmonak troubleshoot a burner gun unit at the YKHC / ANTHC Boiler
Maintenance Training held in Bethel February 15–17.
"This is a skilled and dedicated group of men," said Severn. "Their jobs are crucial for the villages they serve, and their efforts often go unnoticed until there is a problem." A letter from the State Immunization Program
Operator of the Year Award
March 3, 2005Sometimes our lives seem to get too busy, and we put off doing something even In 2003, OEHE introduced the annual Water Plant Operator of the Year Award to recognize the though itʼs very important. Such is the case as we write to offer a very belated operatorʼs outstanding achievements. David Fitka thank you to several wonderful YKHC employees. of Marshall won the award in 2003 for his supe- rior work. The 2004 winner will be announced this The Alaska Immunization Program, Division of Public Health, has been work- ing with a consultant group to consider whether we should develop a new If anyone in any community throughout the Delta method for maintaining immunization information for Alaskaʼs children. To help feels that their operator should be nominated for this the consultants understand the needs of rural Alaska ﬁrsthand, we took a trip to award they can contact YKHC-OEHE at 1-800-478- Bethel, Aniak and Crooked Creek last November.
The trip was wonderful and educational…and none of it would have been possi- ble without the assistance of several YKHC employees. We want to thank them publicly for sharing their valuable time with us and providing great insight into "Cauyaput Piniutekaput Our Drum is Our Strength" the needs of their communities. So we offer a huge "thank you" to: Deborah Burnard, RN, YK Immunization Coordinator
Jackie Wassilie, Certiﬁed Health Practitioner, Aniak Subregional Clinic
Cama-i Dance Festival Kassi Keene, Certiﬁed Health Practitioner, Crooked Creek Clinic
April 8th, 9th and 10th These individuals are great ambassadors of the typical YK spirit of helpfulness. We thank them for their time and for their daily efforts to assure all children are Sponsored by the Bethel Council on the Arts protected against vaccine-preventable diseases.
Bethel High School To reserve a craft table call Elsie 543-3838 evenings
Immunization Program Manager To volunteer call: Joan 543-7231 days,
Deputy Immunization Program Manager Volume X No. 3 • March 15, 2005 Kusko and Yukon Family Medicine Clinics
We treat patients of all ages,
Family Medicine Goal: from infants to elders, in many
To provide the best care for our patients and to maximize continuity of care by areas such as:
improving availability of services of Healthcare Providers.
• Routine physical exams: Yukon Clinic Villages Served
• Pre-employment physicals Kusko Clinic Villages Served
• Women's routine health care • Well child exams EPSDT and • Prenatal care • Family planning • Cholesterol screening • Chronic medical conditions • Preventative services • Hypertension management • Lesion removal • Specialty Clinic referrals • Joint injections Clinic Hours: Monday–Friday — 9 a.m.–5 p.m.
• Medication refills For an Appointment call: 543-6442 or 1-800-478-3321
• Lab and Blood testing Delta Walk-in Clinic
The Delta Walk-in Clinic is available for acute/urgent needs that require The Pediatric Clinic is designed to provide care same-day attention. The staff consists primarily of Certiﬁed Physicians for chronic sick children. This clinic offers local Assistants and Nurse Practitioners who emphasize quick encounters with primary care and specialty consultative care for referrals to other clinics when necessary. children. At the parents request an appointment "Delta Walk-in Clinic Project"
with a pediatrician can be scheduled.
Project Priority: Improve patient satisfaction by decreasing wait times.
Clinic Hours: Monday–Friday — 9 a.m.–5 p.m.
For an Appointment call 543-6297
The Delta Clinic opened in March, 2001, to allow patients to "walk-in" for acute/urgent medical needs. The average number of patients seen is 70 per day, with an average of 3-4 medical providers per day.
In an effort to decrease waiting time, a group of nursing staff attended an The Specialty Clinic provides services to patients extensive Quality Improvement workshop through Alaska Native Medical Center by referral only. Some examples: Gynecology, and have brought back several ideas for improvement. We have developed Urology, Cardiology, Neurology, and Nursing Protocols for the Delta walk-in clinic. The Clinic is also opening one Dermatology. Please schedule an appointment hour earlier to capture the early morning rush. So far we have already seen a with your designated healthcare provider for decreased wait time by 25 percent. We are excited to achieve and maintain a continued decreased wait time.
Clinic Hours: Monday–Friday — 9 a.m.–5 p.m.
Clinic Hours : Monday–Friday — 8:30 a.m.–7 p.m.
For an Appointment call 543-6442
Protection Prevents STDs
Using condoms can protect your sexual health from sexually transmitted diseases and infections (STD/Is).
Protect yourself. Talk honestly to your sexual partner about the safety of sex to reduce the risk of getting infected with STD/Is. Be honest with yourself and your partner.
Do you know if you have a sexually transmitted disease or infection? Many people do not know that they are infected. Condoms can protect you from contracting or transmitting STD/Is.
Alcohol and drug abuse are often risk factors in transmission. Limiting, or eliminating altogether, alcohol intake can aid in making better decisions to protect yourself. If you wish to quit using or abusing alcohol or drugs, resources are available.
If you want to learn more about STD/Is, please call Public Health Nurses 907-543-2110 or 1-800-478-2456, or Circle of Care 907-543-6941 Volume X No. 3 • March 15, 2005 Employees honored at February Recognition Luncheon
On Friday, Feb. 25, ﬁve YKHC employees were honored for he can. His hobbies include hunting, ﬁshing, snowmachining, and their years of service, and job and personal accomplishments, with a luncheon and a special recognition at the Community Health Richard is outgoing and enjoys the outdoors. His future goals Services Buliding boardroom.
include studying accounting. He presently works as a behavioral The ﬁve joined VP of Hospital Services Jack Crow and Native health sitter. Kendra works at optometry. He and his family live in Hire Coordinator Wally Richardson, who presented them with awards and gifts.
The special guests in attendance were John Dickens, Senior EMT Anne is the Director of Physical Therapy Services at YKHC. The trainer; Richard Hoffman, Behavioral Health Float Technician; Anne department and a staff of ﬁve provide a range of physical therapy Kosacheff, Senior Physical Therapist; Skidoo Pavil, LAN/WAN interventions for inpatients and outpatients. They also travel to the Administrator; and Ed DeMoss, CHAP Field Supervisor.
subregional clinics, to other programs in Bethel, and even make John Dickens
home care visits.
John has worked as an EMS Instructor for YKHC for ﬁve years. Anneʼs contributions to our organization, the staff and the patients Since March, 2000, he has taught 1,474 students with a total of throughout her 10 years here have been remarkable. The Physical 2,074 classroom hours. Using his own funds, he became a Medevac Therapy Departmentʼs equipment, layout, schedules and stafﬁng Escort Instructor, Emergency Medical Dispatcher and was appointed are the result of her hard work. There have been no customer com- in 2004 by Gov. Frank Murkowski to the Alaska Council of EMS.
plaints since the start of the Department.
John also invested his own funds to become a certifying ofﬁcer Anne has achieved recognition for her nine years of volunteer and is now capable of certifying others as EMTs. John is also a cer- work with the Bethel Fire Department, including the Fireﬁghter Of tiﬁed Hazmat Technician and a licensed Aircraft Dispatcher. He has The Year award in 2001, and in 2002, the Alaska EMS Provider of written a regular column, EMS Corner, for the YKHC Messenger the Year award.
for the past four years.
Skidoo has been working for YKHCʼs Technology Dept. since In September, Ed DeMoss joined Village Operations as the Direc- 2000. He is an A+ certiﬁed network professional, and received tor of Field Supervision. Prior to this, he served as a Behavioral accomplished training in HEAT system administration, CCNA, and Health Clinician. Currently Edward manages the daily operations Microsoft ISA Servers.
of the village clinics, including eight Supervisor Instructors, two Skidooʼs accomplishments include work as a Help Desk support Clinical Instructors, two Health Aide Support Coordinators, and 190 staffer, customer service manager, Help Desk Support Supervisor. Health Aides. Additionally, Edward represents YKHC at the State- He is presently one of the LAN/WAN Administrators.
wide CHAP Directors meetings.
Skidoo was in charge of overseeing the installation of new com- puters at the new locations such as Bethel Community Services, Kendra, who is Richardʼs wife and works at optometry, said he KEYES, the Learning Resource Center, Inhalant Treatment Center, enjoys playing with his three boys and helping the 7-year-old with and the new Toksook Bay Subregional Clinic. He trained his Help his homework and school activities. He likes to help people any way Desk staff despite having numerous temporary and contracted Non -Proﬁt Org.
Yukon-Kuskokwim Health Corporation Bethel, Alaska 99559
Generation and Characterization of Conditional Heparin-Binding EGF-Like Growth Factor Knockout Mice Atsushi Oyagi1, Yasuhisa Oida1, Kenichi Kakefuda1, Masamitsu Shimazawa1, Norifumi Shioda2, Shigeki Moriguchi2, Kiyoyuki Kitaichi3, Daisuke Nanba4, Kazumasa Yamaguchi5, Yasuhide Furuta6, Kohji Fukunaga2, Shigeki Higashiyama4, Hideaki Hara1* 1 Department of Biofunctional Evaluation, Molecular Pharmacology, Gifu Pharmaceutical University, Gifu, Japan, 2 Department of Pharmacology, Graduate School of
Available online at www.sciencedirect.com Biochemistry & Physiology Pesticide Biochemistry and Physiology 91 (2008) 90–95 Warfarin resistance in Rattus losea in Guangdong Province, China Jianshe Wang a, Zhiyong Feng b, Dandan Yao b, Jingjing Sui b, Wenqin Zhong a, Ming Li a, Jiayin Dai a,* a Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Datun Road, Beijing 100101, PR China