Alaska medicine最新文献

This paper reviews the associations between physical performance and energy expenditure in cold environments. The basic question in cold is how to maintain adequate thermal insulation without marked cold or heat strain and with minimal impairment on physical performance. 24-hour energy expenditure is increased by 105-156 kJ when ambient temperature decreases by 1 degrees C either due to increased clothing, lowered body temperatures or environmental conditions like snow, ice or darkness. Clothing and other protective garments decrease performance due to the weight, bulkiness and friction, and by covering body areas which are important for sensory functions. Each additional kg in clothing weight increases energy costs approximately by 3% and each additional layer by 4%. Increased energy costs are associated with a decrease in physical performance: the decrease is task specific, and roughly comparable to the changes in the energy costs. The decrement in performance can be minimized by decreasing clothing weight and bulkiness as well as the friction between the clothing layers as well as the number of clothing layers. Minimal friction is important in sites where large range of movements is expected like in trouser legs and sleeves of jackets.

Life expectancy in Arctic populations has greatly improved over the last 50 years. Much of this improvement can be attributed health research that has resulted in a reduction in morbidity and mortality from infectious diseases, such as tuberculosis, and the vaccine-preventable diseases of childhood. However, despite these improvements in health indicators of Arctic residents, life expectancy and infant mortality remain higher in indigenous Arctic residents in the US Arctic, northern Canada, and Greenland when compared to Arctic residents of Nordic countries. The International Polar Year (IPY) represents a unique opportunity to focus world attention on Arctic human health and to further stimulate Circumpolar cooperation on emerging Arctic human health concerns. The Arctic Human Health Initiative (AHHI) is an Arctic Council IPY initiative that aims to build and expand on existing Arctic Council and International Union for Circumpolar Health (IUCH) human health research activities. The human health legacy of the IPY will be increased visibility of the human health concerns of Arctic communities, revitalization of cooperative Arctic human health research focused on those concerns, the development of health policies based on research findings, and the subsequent implementation of appropriate interventions, prevention and control measures at the community level.

Planning for International Polar Year (IPY) 2007-2008 is well underway. IPY 2007-2008 will be an intense, internationally coordinated campaign of polar observations, research and analysis that will further our understanding of physical and social processes in Polar Regions, examine their globally-connected role in the climate system, and establish research infrastructure for the future. It will galvanize new and innovative observations and research while building on and enhancing existing relevant initiatives. It will seek to excite the public and help develop the next generation of polar scientists. It will run for two years, from 1 March 2007 until 1 March 2009, to allow two field seasons of research and activities in each Polar Region. This IPY, unlike previous international science years in 1882-83, 1932-33, and 1957-58, includes a strong human dimension and thus health-related activities are being planned. The Arctic Human Health Initiative (AHHI), in particular, includes many potentially important elements.

Objective: To examine how Inuit in Nunavut experience and make meaning of TB, its history, protocols and regimes, and how this and the effects of historical and continuing colonization in Nunavut influence current levels of TB in Nunavut.

Design and methods: The study was qualitative, conducted through seven months of fieldwork in two Nunavut communities utilising ethnographic methods including 42 taped interviews, casual conversations, participant observation and document review.

Results: Inuit participants include explanations other than biomedical when making meaning of TB, and health and disease generally. Also, Inuit participants express a preference for methods of health education different from those presently employed. Lastly, and perhaps more importantly, this study suggests that the history of colonization and continuing colonization play a significant role in how some Inuit experience TB, other disease, and health, and in the high incidence of TB in Nunavut.

Conclusion: In order to decrease incidence of TB and increase levels of health in Nunavut decolonizing measures are necessary.

Population migration played the main role in the development of the North-East regions of Russia, and the processes of natural moving and reproduction of new generations were their after-effects. It is possible to mark out the main periods of population formation. The period of establishing from the beginning of development (the second half of the XVI century) to the 20th of the last century. The period of accomulation and intensive use of human resources (till the beginning of the 80th of the last century) when the population increased more than twice and reached 28 mln people, 3 mln of them living in the circumpolar regions. To the end of the 20th century the period of inert growth and stabilization of population numbers with the following stage of its decreasing. The main fundamental specific feature of Siberian population is its genetic diversity. This, on the one hand, points out the biological stability of the new generations of Siberian population and, on the other hand, predetermines the formation of peculiar features of pathology and the prevalence of the diseases among various categories and ethnic groups of the population. The intensive use of natural resources in Siberia (including people), inadequate social and economic development of Siberian territories are reflected in high levels of health loss in the population as the result of mortality, disability and morbidity caused by accidents and traumas, diseases of blood circulation system, respiratory and gastrointestinal diseases, malignant neoplasms, alcoholism, sexually transmitted diseases (which in some ethnic regions 1,5-5,5 times are above the average index for Russia) . Most of these diseases belong to the category of socially important pathology and reveal the problems of providing living conditions and medical care in these regions. We may suggest that despite of negative trends in health loss in Siberian population it is possible to preserve biological (genetic) stability of the new generations if the state and the society eliminate negative social-economic and ecological consequences of the development of the North-East regions in Russia.

The thermoneutral ambient temperature for naked and resting humans is ca. 27 degrees C. Exposure to cold stimulates cold receptors of the skin which causes cold thermal sensations and stimulation of the sympathetic nervous system. Sympathetic stimulation causes vasoconstriction in skin, arms and legs. Diminished skin and extremity blood flow increases the thermal insulation of superficial tissues more than 300% corresponding to 0.9 clo (0.13 degrees C x m(-2) x W(-1)). With thermoregulatory vasoconstriction/ vasodilatation the body heat balance can be maintained within a range of ca. 4 degrees C, the middle of the range being at ca. 21 degrees C when light clothing is used. Below the thermoneutral zone metabolic heat production (shivering) is stimulated and above the zone starts heat loss by evaporation (sweating). Cold induced vasoconstriction increases blood pressure and viscosity and decreases plasma volume consequently increasing cardiac work. Cold induced hypertensive response can be counteracted by light exercise, while starting heavy work in cold markedly increases blood pressure. Under very cold conditions the sympathetic stimulation opens the anastomoses between arterioles and venules which increases skin temperatures markedly but temporarily, especially in finger tips. Adaptation to cold takes ca. 2 weeks, whereafter the physiological responses to cold are attenuated and cold exposure is subjectively considered less stressful.

The aim of the study was to research the incidence of alimentary risk factors (RF) of chronic noninfectious diseases under severe conditions of complex climatoecologic and biogeochemical factors of the Far North. The representative sample of 2,094 Nadym-city non-Natives (Yamalo-Nenets Autonomous Okrug) aged 20-59 was examined. In the first cross-sectional study, 1,093 persons (39.1% of men and 60.9% of women)--and in the last screening 1,001 persons (33.9% of men and 66.1% of women)--were examined. The RF presence was established on the basis of the following criteria: arterial hypertension (WHO, ISAH (1999)) was defined at blood pressure levels > or = 140-90 mmHg. Persons who finished antihypertensive treatment no later than two weeks before examination were also referred to this group. Excessive body mass for both men and women was defined at Quetlet index > or = 29.0 kg/m2, hypercholesterolemia at plasma cholesterol level > or = .5 mmol/l, hypertriglyceridemia at triglyceride level > or = 2.26 mmol/ l, hypoalphacholesterolemia at high density lipoproteins cholesterol level < or = 0.88 mmol/l, and hypercholesterolemia of low density lipoproteids at low density lipoproteids cholesterol level > or = 4.1 mmol/l. The results of research revealed high incidence of alimentary-dependent RF of chronic noninfectious diseases. In six-year dynamics, the increase of dislipoproteidemias for 18.1% (31.3% vs. 26.5%), high incidence of arterial hypertension (31.0% vs. 38.5%), and excessive body mass (33.3% vs. 30.6%) were assessed. High incidence of alimentary-dependent RF of chronic noninfectious diseases is the direct consequence of unsatisfactory, misbalanced nutrition. In programs aimed at prevention of alimentary-dependent diseases the priority should be given to non-pharmacological (or non-medicamentous) methods, and, first of all, to dietologic methods aimed at correcting the nutrition structure in the population.

Background: Photoscreening and remote autorefraction showed promise in the urban "Vision in PreSchoolers Study." We transported a comparative screening with confirmation program to a remote part of interior Alaska.

Methods: Eighty children from villages in the Koyukon region received onsite three-pronged vision screening followed by gold-standard confirmatory exams. Each had patched HOTV acuity, photoscreening and Suresight remote autorefraction.

Results: There was a high prevalence of amblyopia and vision disorders in these villages. Acuity testing was moderately valid but not useful for children under four years old. Suresight has specificity over 90 percent with sensitivity of 60 percent. Photoscreening had specificity over 95 percent and sensitivity of 70 percent and was better than Suresight for children under age four.

Conclusion: The Welch Allyn Suresight had similar high validity in the Koyukon as in Vision in Preschoolers (VIPS) and provides immediate, onsite results. Photoscreening, particularly with commercial digital flash cameras and specific interpretation, is a cost effective screening tool particularly for younger children.

The research performed by histological methods has established structural maturation of human sympathetic ganglia during ontogenesis and revealed functional stability of sympathetic division of autonomic system in young people.