Nome, AK, United States
Nome, AK, United States

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2017 marks the first annual Trust Builder Awards designed to highlight individuals who have succeeded in building trust among their healthcare peers. The award recognizes those in health information management, clinical documentation improvement and revenue integrity fields who build trust among multiple groups and help improve the health of their organizations. "Our physicians would quit if Mark ever left," stated Trust Builder Award Winner Mark Schroeder's coworker Megan Mackiernan. "He brings an aura of calm when all others seem frantic in dealing with our EHR." Megan's nomination of Mark as a Clinical Documentation Improvement (CDI) Trust Builder included details on his work as the EHR Manager for Norton Sound Health Corporation and his ability to guide team members across a range of departments through any IT questions or EHR issues needing resolution. In the Health Information Management (HIM) category, Seth Katz was nominated by his co-worker Karen Reynolds. Seth's nomination sprang from his ability to lead the HIM Department at Truman Medical Center to include CDI functions and physician engagement activities. In addition to his ability to engage across HIM, CDI, and the provider groups, Seth was also instrumental in driving a successful coding outsource project that maintained positions for staffed coding team members with the outsourced partner. Both Trust Builder Award winners will have a $2,500 donation made in their name to the charity of their choice. Awards banquets are in the works to properly recognize the winners for their contributions. A full write up of the winners' nominations can be found at www.trusthcs.com/2017awards. About TrustHCS TrustHCS is a healthcare advisory and staffing services company for ambulatory, acute and post-acute care organizations. We build bridges between coding, coding compliance and CDI to deliver quantifiable advancements in cost reduction, revenue cycle acceleration and revenue integrity improvement. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/leaders-in-health-information-management-and-clinical-documentation-improvement-recognized-as-trust-builders-300463033.html


Howard B.V.,MedStar Research Institute | Comuzzie A.,Southwest Foundation for Biomedical Research | Devereux R.B.,Cornell University | Ebbesson S.O.E.,Norton Sound Health Corporation | And 9 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2010

Background and aims: Although Eskimos were thought to be protected from cardiovascular disease (CVD), state health data show a large proportion of deaths from CVD, despite traditional lifestyles and high omega-3 fatty acid intake. This article explores CVD prevalence and its relation to risk factors in Alaska Eskimos. Methods and results: A population-based cohort of 499 Alaska Eskimos > age 45 from the Norton Sound region was examined in 2000-2004 for CVD and associated risk factors as part of the Genetics of Coronary Artery Disease in Alaska Natives study. CVD and atherosclerosis were evaluated and adjudicated using standardized methods. Average age was 58 years; diabetes prevalence was low and high-density lipoprotein cholesterol (HDL-C) concentrations were high, but a large proportion smoked and had high pathogen burden. CVD was higher in men (12.6%) than in women (5.3%) (prevalence ratio 2.4, CI 1.3-4.4). Rates of stroke (6.1% in men, 1.8% in women) were similar to those for coronary heart disease (CHD) (6.1% men, 2.5% women). MI prevalence was low in both genders (1.9% and 0.7%). CVD was higher in men and in those >60 years. Hypertension, diabetes, high LDL-C, high apoB, and low HDL-C were all strong correlates (<.002) and albuminuria and CRP were also correlated with CVD (p<. .05) after adjustment for age and gender. Carotid atherosclerosis was correlated with CVD (p=.0079) independent of other risk factors. Conclusion: These data show high CHD and stroke prevalence in Alaska Eskimos, despite low average LDL-C and high HDL-C. Hypertension and high LDL-C were independent correlates; identifying these risk factors early and treating to target is recommended. © 2009.


Howard B.V.,MedStar Research Institute | Metzger J.S.,University of Alaska Anchorage | Jolly S.E.,Cleveland Clinic | Wang H.,MedStar Research Institute | And 9 more authors.
American Journal of Public Health | Year: 2014

Objectives. We determined all-cause, cardiovascular disease (CVD), and cancer mortality in western Alaska Native people and examined agreement between death certificate information and adjudicated cause of deaths. Methods. Data from 4 cohort studies were consolidated. Death certificates and medical records were reviewed and adjudicated according to standard criteria. We compared adjudicated CVD and cancer deaths with death certificates by calculating sensitivity, specificity, predictive values, and j statistics. Results. Men (n = 2116) and women (n = 2453), aged 18 to 95 years, were followed an average of 6.7 years. The major cause of death in men was trauma (25%), followed by CVD (19%) and cancer (13%). The major cause of death in women was CVD (24%), followed by cancer (19%) and trauma (8%). Stroke rates in both genders were higher than those of US Whites. Only 56% of deaths classified as CVD by death certificate were classified as CVD by standard criteria; discordance was higher among men (55%) than women (32%; js = 0.4 and 0.7). Conclusions. We found lower rates for coronary heart disease death but high rates of stroke mortality. Death certificates overestimated CVD mortality; concordance between the 2 methods is better for cancer mortality. The results point to the importance of cohort studies in this population in providing data to assist in health care planning.


Annuzzi G.,University of Naples Federico II | Rivellese A.A.,University of Naples Federico II | Wang H.,MedStar Research Institute | Wang H.,Georgetown Howard Universities Center for Clinical and Translational Science | And 9 more authors.
American Journal of Clinical Nutrition | Year: 2012

Background: Few studies have compared lipoprotein composition with dietary intake. Objective: The lipoprotein subfraction profile was evaluated in relation to diet in Alaska Eskimos at high cardiovascular risk but with a low frequency of hyperlipidemia and high intake of n-3 (omega- 3) fatty acids. Design: A population-based sample (n = 1214) from the Norton Sound Region of Alaska underwent a physical examination and blood sampling. Analyses were from 977 individuals who did not have diabetes or use lipid-lowering medications and had complete dietary information (food-frequency questionnaire) and a lipoprotein subfraction profile (nuclear magnetic resonance spectroscopy). Results: After adjustment for age, BMI, total energy intake, and percentage of energy from fat, the intake of n-3 fatty acids was significantly associated with fewer large VLDLs (P = 0.022 in women, P = 0.064 in men), a smaller VLDL size (P = 0.018 and P = 0.036), more large HDLs (P = 0.179 and P = 0.021), and a larger HDL size (P = 0.004 and P = 0.001). After adjustment for carbohydrate and sugar intakes, large VLDLs (P = 0.042 and 0.018) and VLDL size (P = 0.011 and 0.025) remained negatively associated with n-3 fatty acid intake in women and men, and large HDLs (P = 0.067 and 0.005) and HDL size (P = 0.001 in both) remained positively associated with n-3 fatty acid intake in women and men. In addition, large LDLs (P = 0.040 and P = 0.025) were positively associated in both sexes, and LDL size (P = 0.006) showed a positive association in women. There were no significant relations with total LDL particles in either model. Conclusions: Dietary n-3 fatty acids, independent of the reciprocal changes in carbohydrate and sugar intakes, are associated with an overall favorable lipoprotein profile in terms of cardiovascular risk. Because there are no relations with total LDL particles, the benefit may be related to cardiovascular processes other than atherosclerosis. © 2012 American Society for Nutrition.


Voruganti V.S.,Southwest Foundation for Biomedical Research | Cole S.A.,Southwest Foundation for Biomedical Research | Ebbesson S.O.E.,Norton Sound Health Corporation | Goring H.H.H.,Southwest Foundation for Biomedical Research | And 10 more authors.
American Journal of Clinical Nutrition | Year: 2010

Background: Alterations in plasma fatty acid distribution are linked to metabolic abnormalities related to type 2 diabetes and cardiovascular disease. Objective: The aim of this study was to investigate genetic factors influencing plasma fatty acid distribution in Alaskan Eskimos from the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study. Design: Fatty acids in plasma were measured by gas chromatography in 761 related individuals (>35 y of age). Results: Quantitative genetic analyses showed that fatty acid distribution is significantly heritable (P < 0.001), with heritabilities ranging from 0.33 to 0.55. A genome-wide scan for plasma fatty acids identified a 20-cM region on chromosome 8 (p12-p21) with a quantitative trait locus for monounsaturated fatty acids (logarithm of odds score = 3.8). The same region had a quantitative trait locus for polyunsaturated fatty acids (logarithm of odds score = 2.6). We genotyped single nucleotide polymorphisms (SNPs) in candidate genes in 8p12-p21 and found a significant association between fatty acids and SNPs in apolipoprotein J (APOJ), lipoprotein lipase (LPL), macrophage scavenger receptor 1 (MSR1), and tumor necrosis factor receptor superfamily member 10b (TNFRSF10B). A Bayesian quantitative trait nucleotide analysis based on a measured genotype model showed that SNPs in LPL, TNFRSF10B, and APOJ had strong statistical evidence of a functional effect (posterior probability ≥75%) on plasma fatty acid distribution. Conclusions: The results indicate that there is strong genetic influence on plasma fatty acid distribution and that genetic variation in APOJ, LPL, and TNFRSF10B may play a role. The GOCADAN study was registered at www.clinicaltrials.gov as NCT00006192. © 2010 American Society for Nutrition.


Ebbesson S.O.E.,Norton Sound Health Corporation | Devereux R.B.,New York Medical College | Cole S.,Southwest Foundation for Biomedical Research | Ebbesson L.O.E.,University of Bergen | And 14 more authors.
American Heart Journal | Year: 2010

Background: Consumption of ω-3 fatty acids (FAs) is associated with a reduction in deaths from coronary heart disease, arrhythmia, and sudden death. Although these FAs were originally thought to be antiatherosclerotic, recent evidence suggests that their benefits are related to reducing risk for ventricular arrhythmia and that this may be mediated by a slowed heart rate (HR). Methods: The study was conducted in Alaskan Eskimos participating in the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) Study, a population experiencing a dietary shift from unsaturated to saturated fats. We compared HR with red blood cell (RBC) FA content in 316 men and 391 women ages 35 to 74 years. Results: Multivariate linear regression analyses of individual FAs with HR as the dependent variable and specific FAs as covariates revealed negative associations between HR and docosahexaenoic acid (22:6n-3; P = .004) and eicosapentaenoic acid (20:5n-3; P = .009) and positive associations between HR and palmitoleic acid (16:1n-7; P = .021), eicosanoic acid (20:1n9; P = .007), and dihomo-γ-linolenic acid (DGLA; 20:3n-6; P = .021). Factor analysis revealed that the ω-3 FAs were negatively associated with HR (P = .003), whereas a cluster of other, non-ω-3 unsaturated FAs (16:1, 20:1, and 20:3) was positively associated. Conclusions: Marine ω-3 FAs are associated with lower HR, whereas palmitoleic and DGLA, previously identified as associated with saturated FA consumption and directly related to cardiovascular mortality, are associated with higher HR. These relations may at least partially explain the relations between ω-3 FAs, ventricular arrhythmia, and sudden death. © 2010 Mosby, Inc.


Jolly S.E.,Cleveland Clinic | Mete M.,MedStar Research Institute | Wang H.,MedStar Research Institute | Zhu J.,MedStar Research Institute | And 7 more authors.
Journal of Clinical Hypertension | Year: 2012

It is unknown what role uric acid (UA) may play in the increasing rates of cardiovascular disease (CVD) among Alaska Eskimos. UA is associated with both hypertension (HTN) and chronic kidney disease (CKD). The authors analyzed 1078 Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) participants. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine measures using the Modification of Diet in Renal Disease equation. CKD was defined by an eGFR of <60mL/min/1.73m 2. The authors adjusted for age, sex, education, diabetes, hypertension (or eGFR), obesity, lipids, and smoking status; 7% (n=75) had prevalent CKD. eGFR decreased with increasing tertiles of serum UA (P<.001). UA was independently associated with prevalent CKD (adjusted odds ratio [OR] and 95% confidence interval [CI] of 2.04 (1.62-2.56), respectively). Twenty-one percent (n=230) had prevalent HTN and UA was independently associated with prevalent HTN (adjusted OR, 1.2; 95% CI, 1.1-1.5). UA is independently associated with prevalent CKD and HTN in this population. © 2011 Wiley Periodicals, Inc.


PubMed | University of Washington, University of Alaska Anchorage, University of Alaska Fairbanks, Norton Sound Health Corporation and 3 more.
Type: Journal Article | Journal: Diabetes research and clinical practice | Year: 2015

Previously rare among Alaska Native (AN) people, type 2 diabetes (DM2) prevalence as indicated by registry data has increased by as much as 300% in some western Alaska regions. We sought to determine prevalence and incidence of DM2 and analyze associated cardiometabolic risk factors in western AN people.DM2 and prediabetes prevalence and incidence were determined by the Western Alaska Tribal Collaborative for Health using consolidated data from cohort studies conducted during 2000-2010. Crude and age-adjusted incidence for DM2 and prediabetes were calculated using 2010 American Diabetes Association criteria. Effects of covariates on DM2 and prediabetes were determined using univariate and multivariate Cox proportional hazards analyses, adjusted for age and sex.Excluding baseline diabetes (n=124, 4.5%), 53 cases of new DM2 were identified among 2630 participants. Age- and sex-adjusted DM2 incidence was 4.3/1000 (95% CI 2.9, 5.0) person-years over an average 5.9-year follow up. After excluding baseline prediabetes, 387 new cases of prediabetes were identified among 1841 participants; adjusted prediabetes incidence was 44.5/1000 (95% CI 39.5, 49.5) person years. Independent predictors for DM2 included age, impaired fasting glucose, and metabolic syndrome; family history of diabetes and obesity were additional independent predictors for prediabetes.DM2 incidence in western AN people is substantially lower than that for U.S. whites; however, incidence of prediabetes is more than 10-fold higher than western AN DM2 incidence and more closely aligned with U.S. rates. Interventions aimed at achieving healthy lifestyles are needed to minimize risk factors and maximize protective factors for DM2 in this population.

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