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Obligate anaerobic beer spoilage bacteria have been a menace to the brewing industry for several decades. Technological advances in the brewing process aimed at suppressing aerobic spoilers gave rise to problems with obligate anaerobes. In previous studies, the metabolic spectrum of Pectinatus and Megasphaera species has been described, but their metabolism in the beer environment remains largely unknown. We used high-performance anion exchange chromatography with pulsed amperometric detection (HPAEC-PAD) and headspace solid-phase microextraction–gas chromatography–mass spectrometry (HS-SPME-GCMS) to further characterize beer spoiled by 30 different strains from six beer-spoiling species of Pectinatus and Megasphaera (P. cerevisiiphilus, P. frisingensis, P. haikarae, M. cerevisiae, M. paucivorans, and M. sueciensis). We detected differences in carbohydrate utilization and the volatile organic compounds (volatilome) produced during beer spoilage by all six species. We were able to show that glycerol, one of the basic components of beer, is the common carbon source used by all strains. It appears that this carbon source allows for anaerobic beer spoilage by Pectinatus and Megasphaera despite the spoilage-preventing intrinsic barriers of beer (iso-α-acids, ethanol, low pH, scarce nutrients); thus, extrinsic countermeasures are key for prevention. [ABSTRACT FROM AUTHOR]

Although Native populations suffer a disproportionate cancer burden, studies of risk reduction for cancer incidence among Native peoples have not been strongly supported by federal or private funding sources, and few published data are available to assess the success of cancer control efforts among Native community members. Furthermore, cancer etiologic investigations and cancer control studies in Native populations have not commonly included Native researchers in principal roles. This lack of involvement is related primarily to the low numbers of Native researchers who have adequate training and experience to address Native cancer problems. Although numerous social and biological scientists who have Native status are engaged in productive research careers, the encouragement that has been offered Native students to formulate career goals devoted to cancer etiology or cancer control in Native peoples has had limited success.To address cancer-related challenges adequately and to implement successful cancer control programs in Native communities, more well-trained, culturally competent researchers are required. The Native Researchers’ Cancer Control Training Program (NRCCTP) was designed to address this need. The present essay provides a description of our training program and a summary of the NRCCTP from 1995 to the present.

INTRODUCTIONFew published data have addressed the descriptive epidemiology of cancer among various American Indian tribes nationwide, and risk factor information on a site-specific or tribal-specific basis is almost nonexistent in published reports. Nonetheless, with appropriately guided searches, a tenacious researcher of health care information can be directed to specific data sources on cancer among American Indians/Alaska Natives in various parts of the country. In this chapter, we will discuss some of these data sources, their access, and their limitations.METHODOLOGYA study of the descriptive epidemiology of cancer or any other disease generally starts with the calculation of incidence rates, which are based on the number of newly diagnosed cases in a defined population during a specified period of time, or mortality rates, which are based on the number of deaths during a specified period. Crude rates, obtained simply by dividing the number of cases (numerator) that occur during a specified period of time by the total population at risk (denominator), are seldom informative, because they do not take into account any variation in the distributions of ages in the different populations that one wants to compare. Indian groups in the United States tend to have young populations; crude rates for most tribes typically are very low, because the denominators are weighted with relatively large numbers of young persons who have not yet reached the ages at which cancers occur most frequently.

In this article, the authors describe a unique summer program to train American Indian/Alaska Native (AI/AN) health professionals in a variety of health research-related skills, including epidemiology, data management, statistical analysis, program evaluation, cost-benefit analysis, community-based participatory research, grant writing, and program/policy development. The Summer Research Training Institute for American Indian/Alaska Native Health Professionals is modeled on the authors' successful Native Researchers' Cancer Control Training Program, established in 1995. Their goal is to provide training in the conduct of scientific research to health professionals in order to increase research capacities and the number of qualified AI/AN principal investigators in Indian country. Here, the authors provide a brief description of their training program and an evaluation of its process and outcomes. (Contains 7 tables and 13 notes.)

Introduction: Criteria for maintenance of certification (MOC) emphasize the importance of competencies such as communication, professionalism, systems-based care, and practice performance in addition to medical knowledge. Success of this new competency paradigm is dependent on physicians' willingness to engage in activities that focus on less traditional competencies. We undertook this analysis to determine whether physicians' preferences for CME are barriers to participation in innovative programs. Methods: A geographically stratified, random sample of 755 licensed, practicing physicians in the state of Oregon were surveyed regarding their preferences for type of CME offering and instructional method and plans to recertify. Results: Three hundred seventy-six of 755 surveys were returned for plus or minus 5% margin of error at 95% confidence level; 91% of respondents were board certified. Traditional types of CME offerings and instructional methods were preferred by the majority of physicians. Academic physicians were less likely than clinical physicians to prefer nontraditional types of CME offerings and instructional methods. Multiple regression analyses did not reveal any significant differences based on demography, practice location, or physician practice type. Discussion: Physicians who participate in CME select educational opportunities that appeal to them. There is little attraction to competency-based educational activities despite their requirement for MOC. The apparent disparity between the instructional methods a learner prefers and those that are the most effective in changing physician behavior may represent a barrier to participating in more innovative CME offerings and instructional methods. These findings are important for medical educators and CME program planners developing programs that integrate studied and effective educational methods into CME programs that are attractive to physicians. (Contains 2 figures and 3 tables.)

Introduction: National health care concerns have led to the emergence of maintenance of certification (MOC) as a means to ensure the competence of practicing physicians. Little is known about physician perceptions of the barriers and/or benefits of MOC or proportions of physicians who participate in MOC programs. The purposes of this study were to assess physicians' plans for participating in MOC and to identify influences on decisions to participate. Methods: A geographically stratified, random sample of 755 licensed practicing physicians in the state of Oregon were surveyed regarding certification status, awareness of MOC requirements, influences on decision to participate in MOC, and resources available and/or desired to assist with MOC. Results: Three hundred seventy-six of 755 surveys were returned for plus or minus 5% margin of error at 95% confidence level. Of the respondents 91% were board certified; 95% with time-limited certificates planned to recertify. Factors rated extremely important in decisions to recertify were to demonstrate expertise in my specialty (50%), to demonstrate my medical knowledge is up to date (52%), and to demonstrate my competency to provide patient care in my specialty (51%). Practice groups provided physicians with few resources for MOC; 29% report that their practices provided no resources for the MOC process. Discussion: These results are important for hospitals, medical institutions, medical educators, and CME program planners. Although the large majority of physicians with time-limited certificates plan to participate in maintenance of certification, lack of some resources (time, money, and administrative support) and reluctance to utilize others (systems-based care) are identified as barriers to the success of MOC. (Contains 3 tables and 1 figure.)

Examined New Mexico vital statistics data for suicides and homicides among Hispanics, Native Americans, and non-Hispanic Whites from 1958 to 1987. Found high age-adjusted rates for suicides and homicides among Hispanic and Native American males and homicide rate increase for males in all groups over time. Low suicide rates among Native American women contrasted with high homicide rates. (Author/PVV)

Examines ethnic differences in infectious disease-related mortality in New Mexico's American Indian, Hispanic White, and other White populations from 1958-87. Findings indicate that for most infectious causes, American Indians had the highest mortality rates, followed by Hispanics. Discusses the influence of cultural beliefs and medical practices. (JS)

American Indians and Alaska Natives (AI/ANs) continue to be severely underrepresented in biomedical research, particularly in principal investigator roles. Efforts to decrease health disparities have shifted to building research capacity and training highly skilled AI/AN health researchers who can conduct quality research within their tribal communities. Funded by the National Institutes of Health and the Indian Health Service, the Northwest Native American Research Centers for Health (NW NARCH) program has offered financial support and mentorship to 149 AI/AN biomedical and public health graduate students for the past 15 years. In 2018, trainees were surveyed to track their progress and career development. Survey results confirmed that the financial support and mentorship available via the NW NARCH program were instrumental to their professional advancement. Support to AI/AN biomedical graduate students should continue not only to diversify the public health workforce, but also to address risk factors and health conditions that disproportionately affect AI/AN people. [ABSTRACT FROM AUTHOR]

Objectives. Little information exists regarding the causes of visual impairment and the most common eye problems in American Indians/Alaska Natives. Methods. We randomly sampled American Indians/Alaska Natives older than 40 years from 3 tribes within the Northwest region. Results. We found a higher prevalence of visual impairment and normal-tension glaucoma, as well as a lower prevalence of ocular hypertension, in American Indians/Alaska Natives compared with previous results in other racial/ethnic groups. Conclusions. American Indians/Alaska Natives have a need for vision correction. Future interventions in American Indians/Alaska Natives should include providing spectacles for refractive error, detecting glaucoma, and preventing visual impairment from age-related maculopathy and cataracts. doi:10.2106/AJPH.2004.054221)

Objectives. We compared the historical method of calculating cancer incidence rates with 2 new methods to determine which approach optimally estimates the burden of cancer among the Northwest American Indian/Alaska Native (AIAN) population. Methods. The first method replicates the traditional way of calculating race-specific rates, and the 2 new methods use probabilistic record linkages to ascertain cancer cases. We indirectly adjusted all rates to the standard 2000 US population. Results. Whereas the historical cancer incidence rates for all races are more than double those for the AIAN population, this apparent gap is considerably narrower when the all race rates are compared with AIAN specific rates calculated with probabilistic linkage methods. Similarly, there is no meaningful difference in incidence rates for selected site- and gender specific cancers between the AIAN population and all races combined, and, in fact, some of these rates may be higher among the AIAN population. Conclusions. Our results suggest that the burden of cancer among the AIAN population is considerably higher than was previously understood. We recommend that a standardized approach based on probabilistic linkage methods be adopted and that adequate financial and technical support be made available for conducting routine linkage studies throughout Indian communities. doi:10.2105/AJPH.2004.053769)

Women with cervical human papillomavirus (HPV) infection may have a greater risk of developing cervical dysplasia than those without HPV infection. Cervical dysplasia is an abnormal change in the shape or size of cervical cells, and may be a precursor of cancer. Interviews were conducted with 201 Hispanic and non-Hispanic white women with cervical dysplasia in order to gather information on their lifestyles and any past infections with sexually transmitted diseases (STDs). This information was compared with information gathered from 337 women without dysplasia. Infection with all HPV types increased the risk of dysplasia. HPV 16/18 infections increased the risk of dysplasia in Hispanic women 171-fold, while causing an 18-fold increase in risk for non-Hispanic whites. Herpes simplex virus-2 infection increased the risk in non-Hispanics, but was not a risk factor for Hispanics. A history of having had any STD or smoking at the time of treatment for dysplasia increased the risk in both Hispanic and non-Hispanic women., Objective.--To assess risk factors for high-grade cervical dysplasia among southwestern Hispanic and non-hispanic white women. Design.--Clinic-based case-control study. Sefting.--University-affiliated gynecology clinics. Subjects.--Cases were Hispanic and non-Hispanic white women with biopsyproven high-grade cervical dysplasia (n=201). Controls were Hispanic and non-Hispanic white women from the same clinics with normal cervical epithelium (n=337). Methods.--Study design included interviews focused on histories of sexually transmifted diseases, sexual behavior, reproductive histories, hygienic practices, contraceptive use, cigarette smoking, and diet. Laboratory studies included bacterial and protozoal cultures of the cervix; hybridization tests to identify human papillomavirus (HPV) genome with commercial (ViraPap and ViraType) and polymerase chain reaction-based assays; and serum antibody tests for herpes simplex virus, Chlamydia trachomatis, syphilis, hepatitis B, and hepatitis C. Results.--For both ethnic groups combined, after adjustment for ethnicity, age, and sexual behavior, the strongest risks for cervical dysplasia were associated with cervical HPV infection as identified by ViraPap (odds ratio [OR], 12.8; 95% confidence interval [CI], 8.2 to 20.0) or with polymerase chain reaction (OR, 20.8; 95% CI, 10.8 to 40.2). Other factors associated with dysplasia included cigarette smoking at the time of diagnosis (OR, 1.8; 95% CI, 1.2 to 2.8); low income (OR, 2.2; 95% CI, 1.2 to 4.0); low educational level (OR, 6.2; 95% CI, 3.4 to 11.1); history of any sexually transmifted disease (OR, 1.9; 95% CI, 1.3 to 2.7); and seroprevalence of antibodies to hepatitis B (OR, 1.8; 95% CI, 0.9 to 3.5). For Hispanic women, HPV 16/18 identified by ViraType was strongly associated with cervical dysplasia (OR, 171.0; 95% CI, 22.8 to 1280.5). Antibodies to herpes simplex virus type 2 were not associated with dysplasia in Hispanic women but were significantly associated with dysplasia among non-Hispanic whites. Risks associated with cigarette smoking also varied by ethnic group. Conclusions.--The strongest risk factor associated with high-grade cervical dysplasia among clinic attendees was HPV infection. Although most of the risk factors we examined showed similar associations for dysplasia for both ethnic groups, our data suggest that several different risk factors may be relevant to the development of cervical dysplasia in Hispanics compared with non-Hispanic whites who attend the same clinics. (JAMA. 1994;271:1181-1188)

To learn more concerning ethnic differences in the frequency of human papillomavirus (HPV) infections of the genital tract, which are common sexually transmitted diseases, 1,603 women in New Mexico (535 Hispanics, 746 Native Americans, 322 non-Hispanic whites) were assessed. Most of the women were economically disadvantaged. Pap tests (which are used to screen for cervical cancer) and tests to determine the presence of several types of HPV were performed on all subjects. Results showed that 13.7 percent of non-Hispanic white women, 9.7 percent of Hispanic women, and 6.6 percent of Native American women had cervical HPV infection. Women in all ethnic groups between 14 and 19 years were more likely to have HPV infections than those who were older. Although more than half (55.9 percent) the women with cervical HPV infection had normal Pap test results, those with abnormal Pap results (such as cervical dysplasia, often a precursor of cancer) were more likely to have HPV infection. A discussion is presented of the character of several HPV subtypes. The results show that HPV infection is common among this population of gynecologic patients in New Mexico. (Consumer Summary produced by Reliance Medical Information, Inc.)