Alaska medicine
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Children often ingest foreign bodies wihtout major consequences. Most foreign bodies will pass through the gastrointestinal tract without any detrimental results although in the case of multiple magnet ingestion, perforation and pressure necrosis, among a host of other possible effects, can occur. We describe a case of multiple bowel perforations as a result of fistulization from magnetic attraction across portions of the intestinal wall that demonstrate the importance in acquiring surgical attention.
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Aim of the study was to define the interconnection between the period of living in extreme conditions of the Far North and non-infectious risk-factors (RF) development. The research of prevalence of main RF (salt-sensitivity deviation (SSD), low physical activity (LPhA), dyslipidemia, hyperglycemia, smoking, low Mg blood level, excessive body mass (EBM), elevated blood pressure (EBP)) was done. 1,492 schoolchildren aged 11-14 years living in the Far North (Nadym-city, Yamalo-Nenets Autonomous Okrug) were examined. The comparative analysis of the RF mentioned above was carried out in two groups: in children living in high latitudes since their birth (66.7%) and in children living in the Far North less than 10 years (33.3%). ⋯ The number of children having RF increased in accordance with increase of age and period of living in the Far North. The prevalent pathology predictors were low physical activity, dyslipidemia, salt sensitivity deviation, low Mg blood level, smoking. The frequency of a single RF in the population increased with age 2-4 times. The obtained data evidence the negative influence of extreme factors of the Far North on children's health and demand early RF prevention. The great attention in medical care must be given to children who were born and grow in Circumpolar region conditions.
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The aim of the study was to determine the nature and size of the hygienical impact of social crisis on the public health of the population of a Circumpolar region. The study was carried out in the Sakha (Yakutia) Republic (area 3.1 million km2; population nearly 1 million). The analysis of health indicators was done using demographic and hygienical methods, and 15-year (1989-2005) statistical data from the Federal State Statistic Service division in the Sakha Republic. ⋯ Such low mortality due to degenerative diseases was predetermined by the small percent of the elderly in the age structure (8.4%), which was 2.5-fold lower compared to Russia and developed countries. The public health status of the residents of Circumpolar areas was extremely sensitive to socioeconomic changes. The social crisis had a multifactorial effect on lifestyle, quality of life-supporting infrastructure, and particularly, on the medical care system, with highly negative hygienical implications.
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Review
The electronic medical record: decision support and the effective use of clinical guidelines.
Embedding clinical guidelines into an electronic medical record is a form of clinical decision support that has the potential to improve the quality and consistency of care provided at the clinical encounter. The manuscript describes the consensus method of developing clinical guidelines and its components that have an impact on its output. These include questions asked, participants, the presentation of information, method of structuring group interaction, and method of synthesizing judgments. ⋯ The manner in which the presentation of guidelines is structured and implemented is also important in determining adherence. Monitoring guidelines by building a feedback loop is critical for ongoing guideline improvement. The literature on the long-term impact of electronic guidelines on clinician behavior is lacking.