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PubMed1997

Duty-related stressors and PTSD symptoms in suburban police officers.

This study examined the effects of duty-related stress on police officers. Using a sample of 100 suburban police officers, an anonymous questionnaire requested demographic information and included a measure of duty-related stressors, SCL-90-R, the Posttraumatic Stress Disorder scale of the Impact of Events Scale-Revised, and a locus of control scale. Also assessed was whether Critical Incident Stress Debriefing was experienced. The results showed significant correlations between scores on duty-related stress, somatization, and symptoms of PTSD. 13% of the sample met the DSM-IV (1994) diagnostic criteria for PTSD. Results of the regression analysis showed the best predictors for the diagnosis of PTSD were associated with the factor of Exposure to Death and Life Threat, which corresponds to the DSM-IV AI criteria. Finally, 63% of the respondents stated that a critical incident debriefing would be beneficial following an extremely stressful event related to duty.

Adult↗
PubMed1994

Assertive community treatment for the seriously mentally ill in suburban Sydney: a programme description and evaluation.

Assertive and intensive community treatment for the seriously mentally ill is becoming a widely accepted approach internationally. This type of service is, however, still relatively new in Australia and New Zealand, and it has rarely been fully integrated into a comprehensive catchment area community and hospital mental health service. This paper has two aims. Firstly, it describes an innovative assertive community mental health service in suburban Sydney. This service was initially provided to 64 clients with a serious mental illness, who had previously experienced repeated hospitalisations and were unable to benefit from existing high quality services. Secondly, it presents the results of the ongoing evaluation of this service. Following the implementation of the service, the number of psychiatric bed days occupied by these clients decreased by 62%; the number of clients admitted decreased, client functioning improved and symptom severity decreased, all to a significant degree.

Activities of Daily Living↗
PubMedDate not supplied

Influenza vaccination in pregnancy: current practices in a suburban community.

PURPOSE: The Centers for Disease Control (CDC) identify women in their second and third trimesters as a high-risk population warranting influenza vaccination. This study attempted to characterize understanding of these guidelines and obstacles to their implementation in a suburban community. METHODS: Family physicians and obstetricians with admitting privileges to a community-based hospital were surveyed regarding estimated vaccine availability and administration in their practices and regarding knowledge of indications and contraindications to influenza vaccination in pregnancy. RESULTS: Of the 20 obstetricians and 66 family physicians completing the survey, 68.4% of obstetricians and 90.5% of family physicians carried the vaccine in their offices (P =.027). Both obstetricians and family physicians incorrectly perceived multiple factors as contraindications to influenza vaccination in pregnancy. Obstetricians and family physicians reported similar proportions of their pregnant patients received the vaccine (35 versus 40%). CONCLUSIONS: In this study, more family physicians had the influenza vaccine available than obstetricians, but there was no difference in estimated rates of vaccination during pregnancy or in the understanding of its indications and contraindications. Finally, no physicians in our community reported providing influenza vaccination in pregnancy at recommended frequencies. Further research is needed to clarify methods of improving vaccination rates in both family practice and obstetric settings.

Clinical Competence↗
PubMed1993

Cryptosporidium infections in a suburban community in Maracaibo, Venezuela.

A point prevalence survey for Cryptosporidium was conducted in 212 subjects two months to 70 years of age in a suburban area with a low socioeconomic status in Maracaibo City, Venezuela. Single stool specimens were collected and modified Ziehl-Neelsen carbol-fuchsin staining of 10% formalin-preserved stool was used to identify Cryptosporidium oocysts. Direct wet mounts, iron-hematoxylin-stained smears and formalin-ether concentrates were examined to determine the presence of other intestinal parasites. Cryptosporidium infections were identified in 21 subjects (9.9%), with a high percentage of asymptomatic carriers (15 of 21, 71.4%). Six children (28.5%) had gastrointestinal symptoms and four of them were infants. Cryptosporidium was the single detectable potential pathogenic parasite in only five (23.8%) of 21 patients. The infection rate with one or more parasites was high (82%) and multiple infections, including pathogenic helminths and protozoa, were observed in the majority of patients who passed oocysts. Our findings suggest that although Cryptosporidium is an important pathogen, the proportion of asymptomatic carriers may be high in areas of low socioeconomic status in developing countries.

Adolescent↗
PubMedDate not supplied

Men's knowledge of and attitude with respect to family planning in a suburban Nigerian community.

BACKGROUND: Men's Knowledge of and attitudes to family planning (FP) in suburban and rural Nigeria is still poor despite a global move to increase the involvement of men in reproductive health matters. A cross-sectional survey was conducted to determine men's knowledge of and attitude to family planning at Ganmo, a sub-urban community on the outskirts of Ilorin, Nigeria. METHOD: The study employed an interviewer administered semi-structured questionnaire to elicit information from 360 men in the households. Only males above the age of 15 years resident in the community were selected for interview A proportionate sampling procedure was employed in selecting the required numberof men from each of the 32 compounds that make up the community. RESULTS: Nearly all men (96.5%) were aware of family planning and a majority of them were aware of some common methods of family planning e.g. Oral Contraceptive Pills (OCPs) (72.5%), Injectables (69.2%), Condoms (86.6%) and Traditional methods (70.6%). Knowledge of other alternative female methods was low e.g. Norplant (17.5%), IUCD (26.3%), Diaphragm (39.8%), Vaginal cream (30.2%), Vaginal tablet (37.8%) and Vaginal sponge (16.8%), and Tubal Ligation (51.3%). Knowledge of male controlled FP methods like Withdrawal (49.6%), Rhythm or periodic abstinence (54.6%) and Vasectomy (28.6%) was also poor. The Respondents had low knowledge of common side effects of FP methods e.g. nausea (9.8%), vomiting (13.1%), abnormal menstruation (34.4%), pain (23.2%) and unwanted weight gain (17.0%); some 25.3%% of respondents had no knowledge of any side effects. The attitude of respondents to family planning was also relatively poor as only a moderate proportion of men supported the FP concept (52.7%) and the Nigerian Population Policy (54.8%) of "four children to a woman". Some 54.8% of respondents were in support of men discussing about FP with their spouses. The major reasons for non-approval of FP by men were the fear of side-effects (70.4%) and perception of FP as being against religion (52.1%). The predictors of poor FP attitude were not having formal education, practice of polygyny and to a lesser extent being a Muslim. CONCLUSION: The study concluded that, men at Ganmo have limited knowledge of, and poor attitude to FP An intensive drive at a community based adult reproductive health education was advocated among other recommendations.

Adolescent↗
PubMedDate not supplied

Usefulness of a patient library in a suburban general practice.

OBJECTIVES: To provide health information by means of a patient library in an Australian general practice, and to examine the effects of such information on patient knowledge, anxiety and behaviour. DESIGN: Questionnaire survey of patients who borrowed library items and of doctors within the practice. SETTING: A five-doctor suburban practice serving approximately 7000 patients. RESULTS: 210 items were purchased and made available for loan over the two years of the study; 164 questionnaires were obtained after 229 borrowings in the first 15 months. Patients who borrowed items were mostly women (88%) and a high proportion of borrowers (47%) felt that the doctors' surgery was their main source of health information. 98% felt that borrowing an item had been "useful" or "very useful", 88% felt that it had increased their knowledge, 48% felt it had decreased their anxiety, and 79% felt it had changed their behaviour. The doctors were generally positive about the library. CONCLUSIONS: The practice library was a very useful addition to the surgery services and provided a valuable clinical tool for the doctors.

Anxiety↗
PubMed1999

Randomized controlled trial of general practitioner versus usual medical care in a suburban accident and emergency department using an informal triage system.

We determined if care provided by general practitioners (GPs) to non-emergency patients, in a suburban accident and emergency (A&E) department using an informal triage system, differs significantly from care provided by usual A&E staff. One thousand eight hundred and seventy-eight patients participated. By comparison with usual A&E staff, GPs prescribed significantly more often (percentage relative difference [% RD] = 12 [95% confidence interval = 1-23]) and referred more patients to hospital (% RD = 21 [95% CI = 9-33]). This is the first study to report that sessional GPs working in an A&E department utilize similar or more resources than usual A&E staff. It emphasizes the need for the continued audit of initiatives that have been introduced into new settings.

Emergency Service, Hospital↗
PubMed2000

[Suburban amebiasis: the diagnostic aspects via computed tomography and echography and the percutaneous treatment of amebic liver abscesses].

INTRODUCTION: Liver is the most common site of extraintestinal amebiasis and hepatic abscesses are the most frequent symptom, occurring in 3-9% of patients with amebic infection. Several studies have shown that drug treatment is more efficacious when combined with percutaneous drainage of the abscess, yielding quicker recovery and a positive body response. We report our US and CT findings in 16 patients with amebic abscesses, 12 of whom lived in a temperate peripheral area north-east of Naples. All patients had a clinical-diagnostic condition that we called "suburban amebiasis". Finally we report our personal experience with the US-guided therapeutic drainage of amebic abscesses with repeated cavity washings, which is important for positive parasitology. MATERIAL AND METHODS: We retrospectively reviewed the findings of 16 patients (11 men and 5 women; age range 36-78 years; mean 52) with amebic abscesses of liver examined with US and CT. US with a 3.5 MHz transducer was the technique of choice in all patients. 94% of liver abscesses and some extraintestinal complications were easily shown with this technique. CT angiography was then performed to detail and clarify US findings. Abscesses over 4 cm in diameter were submitted to US-guided percutaneous treatment which permitted abscess drainage, the collection of material for parasitology and repeated cavity washings. RESULTS: US showed multiple liver abscesses in 12 patients, which were multiseptate and formed by multiple hypo-/hyperechoic microabscesses in 4 of them. Four non-European patients had a single abscess, which is typical of tropical endemic forms. CT showed the amebic abscesses as hypodense roundish masses with clear-cut outline most often localized in the right lobe in the 12 multiple cases. After percutaneous drainage 13/16 patients (81%) reported less pain in the right hypochondrium and had a lower temperature; their hospitalization was also shorter. DISCUSSION AND CONCLUSIONS: Combined US and CT assessment facilitated the diagnosis of amebiasis and its differentiation from pyogenic abscess and hepatoma. The combination of US-guided drainage and drug treatment provides better results than either treatment alone and quicker improvement of patient conditions, with fewer extraintestinal complications. Percutaneous drainage should be used in abscesses bigger than 4-5 cm, those with questionable clinical-laboratory findings and finally those failing to respond to drug treatment alone. Positive parasitology of abscess content is related to repeated cavity washings after percutaneous drainage, likely because peripheral layers are much richer in amebae.

Adult↗
PubMedDate not supplied

Mapping child maltreatment: looking at neighborhoods in a suburban county.

This study used administrative data, census data, and geographic information system (GIS) technology to map and analyze the rates and distribution of child physical abuse, sexual abuse, and neglect at the neighborhood level in a suburban jurisdiction. The results provide an example of how administrative data, census data, and GIS technology can give child protective services and community-based agencies a visual tool to help identify and target neighborhoods in which children may be at high risk for maltreatment.

Adult↗
PubMed2001

[Functional characteristics of pharmacy services related to home care in a certain suburban area].

In order to clarify functional characteristics of pharmacy services related to home care in a suburban area, a questionnaire survey regarding home-care services was conducted for all 75 pharmacies belonged to T-City Pharmaceutical Association. The following services were investigated; A) prescription (medication guidance for patients and their families, provision of drug information to patients, management of the patient's drug history, dispensing, advice to physicians, inquiries, management of prescriptions for home infusion services); B) supply (sales of items such as over-the-counter [OTC] drugs [commercially available drugs that do not require a physician's prescription], display and catalogue sales of nursing items); C) consultation (consultation on home care, holding events such as health education programs); D) management (guidance for drug management by home visit); and E) information exchange (information exchange with other medical professionals and social workers). The results of the present study were as follows. (1) The following services were considered important and therefore regularly performed; A) prescription: medication guidance for patients and their families, provision drug information to patients, management of the patient's drug history, dispensing, advice to physicians, inquiries; and B) supply: sales of items such as OTC drugs. (2) The following services were considered important, but not sufficiently regularly performed; B) supply: display and catalogue sales of nursing items; C) consultation: consultation on home care, holding events such as health education programs; D) management: guidance for drug management by home visits; and E) information exchange. (3) On factor analysis, among home care-related pharmacy services, display and catalogue sales of nursing items as well as consultation on home care were present in the same factor group as contained sales of items such as OTC drugs, which showed a high accomplishment rate. Guidance for drug management by home visits and information exchange with other social workers were present in the same factor group as contained information exchange with other medical professionals, which showed a relatively low accomplishment rate. In summary, home care-related pharmacy services were found to be associated with information exchange and supply/consultation functions. This suggests that to improve home care-related services in pharmacies, information exchange among health, medical practices, and social welfare-associated professionals, not previously promoted, should be stimulated and supported.

Adult↗
PubMed2002

Comparative study of age, sex, illness profile, between suburban, rural and central urban population in general practice.

UNLABELLED: To investigate the differences between rural suburban and central urban patterns in General Practise, in terms of Patient age, sex and illness profiles, in Winter. Using a laptop computer, all relevant patient parameters were entered during the surgery consultation as each patient attended. The totals for each parameter were subsequently computed and using the Microsoft Excel program comparative pie charts for urban and rural categories were compiled, in percentage terms. SETTING: Cork. In the rural area 60% of those attending were male, while in the urban area only 43% were male. There were 2.75 times more people over 65 years old attending the urban surgery. However there were 80% more under 14 year olds and 43% more in the 15 to 64 year age group attending the rural surgery.

Adolescent↗
PubMed1992

A one year community-based study on the incidence of diarrhoea and rotavirus infection in urban and suburban Malaysian children.

A 1 year longitudinal study of 156 Malaysian children from urban and suburban areas in the Klang Valley revealed that the incidence rate of diarrhoea was 23.6 per 100 person-year with abnormal faeces reported on 0.26% of the total days of observation. Diarrhoea cases were detected in children from all socioeconomic classes. Rotavirus was isolated from 12% of the diarrheic children and asymptomatic rotavirus infection occurred in 3.2% of the children. All rotaviruses isolated were group A rotaviruses with long electrophoretypic pattern.

Child, Preschool↗
PubMed2004

Ixodes ricinus as a vector of Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti in urban and suburban forests.

In the suburban and urban forests in the cities of Gdansk, Sopot and Gdynia (northern Poland), Ixodes ricinus ticks should be considered as the vector of pathogenic microorganisms that may cause significant diseases in wild and domestic animals and humans. These microorganisms include etiologic agents of Lyme disease, human anaplasmosis (HA) and babesiosis: Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti, respectively. DNA extracts from 701 ticks collected in 15 localities were examined by PCR for the simultaneous detection of these 3 pathogens. Overall, 14 % were infected with A. phagocytophilum followed by 12.4 % with B. burgdorferi s.l. and 2.3 % with B. microti. In total, the percentage of infected females (32.9 %) was 2.4 times higher than in males (13.7 %) and 3.2 times higher than in nymphs (10.3 %). Among adult ticks (n = 303), 8.3 % were dually infected with A. phagocytophilum and B. burgdorferi s.l., 2.0 % with the agent of human anaplasmosis and B. microti and 0.3 % with borreliae and B. microti.

Anaplasma phagocytophilum↗
PubMed1992

Successful implementation of a long-term care unit for patients with acquired immunodeficiency syndrome in an underserved suburban area with a high incidence of human immunodeficiency virus.

BACKGROUND: Long Island (NY) has the highest incidence of human immunodeficiency virus infection of any suburban area in the United States. Until 1988, however, no patient with the acquired immunodeficiency virus had been admitted to any one of the 61 Long Island nursing home facilities. METHODS: A 10-bed acquired immunodeficiency syndrome unit was established in a county-owned skilled nursing facility. Before implementation of the unit, all staff members underwent extensive training and education, and standard precautions against infection were emphasized. Meetings were held with current residents of the nursing home and their families to address their fears and concerns. The unit was staffed entirely on a volunteer basis. RESULTS: The unit was opened in October 1990, and 16 patients have been admitted since that time. The geriatric and human immunodeficiency virus-positive patients interact well, and no complaints have been received from the geriatric patients or their families. No known breaches in infection control policies have occurred. There have been no problems in staff recruitment. CONCLUSIONS: Long-term care for patients with human immunodeficiency virus in an existing nursing home facility is an achievable goal.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Self-perceived oral function in elderly residents in a suburban area of Stockholm, Sweden.

PURPOSE: The primary aim was to describe self-perceived oral health and function in a group of adults aged 75 to 84 years. The secondary aim was to study the agreement between self-reported oral function and clinical findings. MATERIAL AND METHODS: A 5% sample (150 subjects) was selected at random from the total population (2,910) of 75 to 84-year-old residents in suburban Stockholm, Sweden. The inclusion criterion was that the individual lived independently, without any community assistance. A questionnaire covering self-perceived chewing ability, mouth dryness and bleeding gums was sent by mail. The total response rate was 86%. Of these 129 respondents, a 25.0% subsample was randomly selected for clinical examination by a dental hygienist. No radiographs were used. RESULTS: The average age of the individuals was 78.7 years (SD 2.71). Most were satisfied with their oral status and function: > 75.0% reported good chewing ability, correlating with the number of remaining teeth and dentures. Mouth dryness was reported by 41.5% of respondents to the questionnaire; one case was diagnosed in the subsample which underwent clinical examination. Bleeding gums were reported by 11.8% of respondents; clinical examination disclosed bleeding on probing in all participants. Mouth dryness and bleeding gums were not associated with chewing ability. CONCLUSION: Most subjects reported satisfactory chewing ability. Deterioration in oral function correlated with fewer remaining teeth and removable dentures. In relation to the clinical findings, mouth dryness was 'over-reported' and bleeding gums were 'under-reported'.

Aged↗
PubMed1992

[Problems and eradication of Ambrosia artemisiifolia L. in Quebec in the urban and suburban environments].

Ambrosia artemisiifolia is a common weed in Canada and it is one of the most important source of aero-allergenic pollen in the north-eastern part of North America. It is a problem mostly along roads in urban or suburban areas. It is easily controlled by herbicides but their use is increasingly restricted because of environmental considerations. Therefore, new methods must be developed to control this weed. Three types of controls were evaluated against Ambrosia artemisiifolia along an expressway in the summer of 1990. The control methods were hand weeding, mowing at 2 cm, 5 cm, or 8 cm, and crushing by a roadroller. These treatments were done at different dates in the course of the summer. Hand weeding was the most effective in reducing pollen and seed production although it was also the most expensive. Mowing was very effective when it was done at a height of 2 cm from the soil. It is the only height at which seed production was significantly reduced. Mowing efficacy in reducing pollen production tended to decrease with the raising of the mowing blade. The efficiency of weed pulling or moving improved when they were performed later in the growing season. Crushing was not an effective method of control. Mowing or hand weeding cannot eradicate Ambrosia artemisiifolia but if they are consistently used, they could reduce its population level over several years by decreasing seed production. The treatments either eliminated pollen production or reduced it at least by 88%, thereby insuring a relative relief for people allergic to the pollen of this plant.

Agriculture↗