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Objectives. The purpose of this study was to estimate cancer incidence for American Indians in Minnesota. Methods. Indian Health Service enrollment data were linked to the Minnesota tumor registry to identify cancers among American Indians in Minnesota. Incidence rates for the 5 most common cancers in this population, estimated after the linkage, were compared with rates estimated before the linkage and with rates for the total population of Minnesota. Results. The linkage identified 302 cancer cases not previously identified as occurring among American Indians in Minnesota. Postlinkage estimates suggested that incidence rates for prostate and colorectal cancer are similar to those for the total population of Minnesota, but that rates of lung and cervical cancer are significantly higher. Breast cancer rates are slightly lower than those for the total population of Minnesota but more than twice as high as previous estimates for American Indians. Conclusions. The postlinkage estimates suggest different priorities for cancer education, prevention, and control than might be assumed from either prelinkage estimates or previously published data, and underscore the importance offing accurate and specific data for setting these priorities. (Am J Public Health. 1999;89:1673-1677) [ABSTRACT FROM AUTHOR]

Simple Summary: We report here some of the major findings on the behavior of black bear mothers and cubs in their dens in the wild, based on observations in the state of Minnesota, USA. Wild female bears were outfitted with radio collars and their dens located as they prepared for hibernation in the fall. Cameras were installed in the dens and events in the den recorded until they and their cubs finally abandoned their dens in the spring. Although most reports of black bear cub behavior have been post den emergence, we provide intimate details of their birth, maternal behavior, and the development of the cubs from birth to emergence. Yearling cubs from the previous year sometimes remained with their mother for a second year. We discovered many aspects of mother, cub, and yearling behavior previously unknown and some of which contradict claims in the literature. Den cams are an important means of observing secretive behavior in settings previously impossible to observe unobtrusively. Denning behavior has long remained the least observed aspect of bear behavior. During 2010–2013, we used webcams, microphones, the internet, and 14,602 h of archived video to document the denning behaviors of two adult wild black bears (Ursus americanus) as they gave birth and cared for four litters through six winters in northeastern Minnesota. Observations included types of dens, labor, pre-parturient genital swelling, birthing positions, post-partum vocalizations, mothers removing amniotic tissues and warming newborn cubs in sub-freezing temperatures, frequency of nursing, cubs establishing nipple order, yearlings suckling, the ingestion of snow and icicles, the ingestion of foot pads, urination and defecation in latrine areas, toilet-licking, eye opening, reciprocal tongue-licking, play, rapid eye movement (REM) sleep and possible dreaming, and reactions to wildlife intruders. The use of this new method for observing natural bear dens allowed the identification of many behaviors undescribed for any species of wild bear in dens. We also discuss the need for future studies and how the depth and duration of black bear hibernation varies with body condition and geographic region. [ABSTRACT FROM AUTHOR]

Although the benefits of mammography are well established, many remain skeptical of the value of mammography for American Indian women. This skepticism stems in part from a belief that breast cancer is too rare an event among American Indians to warrant widespread screening. The validity of this assumption for Northern Plains Indians is challenged by a discussion of the limitations of available data on breast cancer in American Indian populations (including lack of generalizability, underestimation, and an overreliance on relative rather than absolute measures of cancer incidence) and by findings from the Minnesota Breast and Cervical Cancer Control Program, a federally funded program providing free breast and cervical cancer screening to American Indian and other women in Minnesota. In light of this information, the authors recommend that the low priority of mammography for American Indian women be reconsidered. [ABSTRACT FROM AUTHOR]

Background: Kidney transplant candidates face complex decisions about transplant options such as living donation or acceptance of lower quality kidneys. We sought to characterize knowledge and decision support needs regarding kidney transplant outcomes and options. Methods: We conducted 10 interviews and four focus groups of 28 adult kidney transplant candidates from two centers in Minnesota. Transcripts were analyzed thematically using a grounded theory approach. Results: We identified four themes: First, candidates have a limited understanding of treatment options and demonstrate confusion or a lack of awareness about waiting list outcomes and prognosis. Second, candidates desired frank discussions about likely outcomes and individualized prognosis. Third, emotional barriers impact how patients make informed decisions. Finally, participants relied on the support of family and friends to help process information, and many favored the medical community engaging their family and friends in their medical decisions. These findings were incorporated into a conceptual model to support kidney transplant candidates in medical decision making. Conclusions: Transplant candidates had limited understanding about treatment options and outcomes on the kidney transplant waiting list. Individualized risk information and cognitive approaches that recognize how patients process information and balance competing risks may improve informed decision making. [ABSTRACT FROM AUTHOR]