Thursday, January 30, 2014

Yurts and Rudabaga

After work, one of the dentists in Bethel hosted a party in her very cool yurt-like structure, located next to the White House Bed and Breakfast. It's a very cool structure with a living room and kitchen on the ground floor and a bedroom in the loft.

The YKHC dentists and our study team enjoyed a gourmet potluck consisting of salmon (cooked two ways), two colorful salads, homemade baked bread and butter, and an amazing coconut rice (the last of which I somehow managed not to get a photo of…you can see part of the red bowl in which it was served). What a beautiful spread of amazing food. YUM!

I met and socialized with Baga (short for Rutabaga), a vivacious and affectionate female Husky from the YK Delta. She French kissed me three seconds after I walked into the house. You can't tell from the photo but Baga has a long juicy tongue.

The YKHC dentists have built a strong sense of community, which I really enjoy being part of each time I visit Bethel. They warmly welcome all visitors into their homes and lives. The gatherings remind me of what college was like – frequent social events that happen spontaneously without an ounce of  planning stress. I've had lots of really interesting conversations with authentic, genuine people. They call it the Bethel Family and I certainly feel like an honorary member. See if you can spot Baga. There she is!

We had another great enrollment day - 7 children - bringing our total enrollment to 18 participants. I’m getting used to my operatory in the YKHC dental clinic, which is spacious and set up nicely for participant examinations and data collection.

Wednesday, January 29, 2014

Stabilicers and Gasoline

I’ve been exposed to something new this trip: Stabilicers. What a product!

The unseasonably warm weather in the YK Delta has been nice. Once consequence is melting ice on the roads and walkways (and very few paved sidewalks). The melted ice freezes overnight, leading to many square miles of natural ice skating pathways in the morning. Stabilicers have metal screws implanted into the soles. I borrowed a pair from the UAF CANHR stash and strap them over my boots or shoes. I’ll be purchasing my own pair before I leave Bethel from the YKHC gift store for $35. I never leave my Bethel home without them.

I learned today that gas is super expensive in the YK, which is counterintuitive given the amount of oil that is extracted from Alaska territory. This may explain why cab rides in Bethel cost as much as they do.

Today we enrolled 6 participants, bringing our total enrollment to 11 children. We are one participant ahead of our daily recruitment goals. The YKHC dental clinic is a beautiful facility located across the street from the YK Hospital and the movie theatre/shopping mall currently under construction. There are a number of specialty health clinics in our building including optometry and behavioral health.

Alaska Native Sugar Sweetened Beverage (SSB) Study

We are thrilled to kick off our research funded by the University of Washington Royalty Research Fund (RRF). Tooth decay is a major public health problem in Alaska Native communities. Our work will examine the association between sugar sweetened beverage (SSB) intake and dental caries (tooth decay) in Alaska Native children. One really cool thing about this project is the use of carbon and nitrogen isotopes found in hair to measure SSB intake. We have a fantastic team consisting of Co-Investigators from the UW and the University of Alaska Fairbanks (UAF) Center for Alaska Native Health Research (CANHR). CANHR investigators have been in the Yukon Kuskokwim (YK) Delta for over a decade conducting NIH-funded studies in various YK communities.

Our initial grant application was submitted to the RRF in September 2012. We were not funded the first time. In March 2013, we resubmitted the grant and were notified in June 2013 that we had received a $40,000 grant.

Our project is taking place at the Yukon Kuskokwim Health Corporation (YKHC) dental clinic in Bethel. The YKHC dental staff has been amazing. We spent the early part of the day figuring out ways to identify potential participants, organize study forms, manage flow of study participants, document incentives, etc. The YKHC dental staff has been very accommodating and helpful. We worked out of two dental operatories (#13 and #14). In one of the operatories, my UAF collaborators consented parents and collected survey, height, and weight data as well as hair samples from the children. In the second operatory, I collected dental caries data.

After the YKHC dental clinic closed for the day, we were able to continue collecting data at the CANHR clinical research facilities at the Kuskokwim Campus (KuC), which is located next to the Bethel library.

We transported some of our examination materials to KuC around 6:00 PM. After we arrived and got settled into KuC, I realized I had left the mouth mirrors in the YKHC clinic. So I called a cab and went over to YKHC to pick up the mirrors. Speaking of cabs…

The cab system in Bethel is really interesting. Unless you own a car, cabs are one of the only ways to get around town. Word on the street (unconfirmed) is that there are more cabs per capita in Bethel than there are in Manhattan. I will try to find published data to support this claim. Based on personal experiences, I can attest that there are TONS of cabs in Bethel – TONS. You call the taxi dispatcher and a cab is usually at your door within minutes. The cab payment system in Bethel is flat rate - $7 one way from the airport to anywhere in Bethel and $5 one way to travel anywhere within Bethel. These rates are per person, which means that you end up sharing cabs with others, including strangers. If you want to stop someplace (e.g., the AC grocery store), you get charged an extra $2 per stop and $1 for every minute of waiting beyond three minutes. My cab ride from KuC to YKHC cost $10. I avoided the $2 stop fee, which the nice Macedonian cab driver waived. He and his family (wife, child, mother, and father) have all lived in Bethel for 3 years. His brother used to live in Bethel but moved back to Macedonia.

This morning, the temperature in Bethel was in the 30s, which is much warmer than usual. There are sheets of slippery ice covering most of the town. There are also reports that parts of the Yukon and Kuskokwim Rivers have started to thaw (usually this happens in April), which has led to major transportation problems for families that rely on a frozen river to get from one place to another using snow machines (=snow mobiles).

Our goal is to enroll 50 children. We saw 5 children today. Since we have a total of 10 enrollment days available, which includes working on the Saturday before the Super Bowl, we are currently on target. As clinic flow improves and word gets out into the community that we are in town, I am hoping to meet our enrollment goals ahead of time.