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PubMed1988

Recent clinical and epidemiological trends in parasuicide in Edinburgh and Oxford: a tale of two cities.

This is a report of clinical and epidemiological trends in parasuicide in Edinburgh and Oxford over the period of 1976 to 1984. Rates of parasuicide declined in both cities, but more markedly among women than men. Male rates tended to be higher in Edinburgh and female rates higher in Oxford. Age-specific rates were similar for the two cities in 1983-84, with peak rates for females among 15-19 year olds and those for males among 20-24 year olds in Edinburgh and 25-34 year olds in Oxford. Parasuicide incidence was higher in lower social class groups and among the unemployed in both cities. During the study period there was a massive decline in barbiturate overdoses, a more modest decline in minor tranquillizer overdoses but, in Oxford, a marked increase in self-poisoning with paracetamol. By the end of the study period the proportion of patients receiving a diagnosis of drug addiction had doubled in Edinburgh, although it had remained fairly constant in Oxford. There were differences in patterns of aftercare offered to patients in the two cities; these almost certainly reflect differing clinical policies.

Adolescent↗
PubMed2005

Quantification of local and global benefits from air pollution control in Mexico City.

Complex sociopolitical, economic, and geographical realities cause the 20 million residents of Mexico City to suffer from some of the worst air pollution conditions in the world. Greenhouse gas emissions from the city are also substantial, and opportunities for joint local-global air pollution control are being sought. Although a plethora of measures to improve local air quality and reduce greenhouse gas emissions have been proposed for Mexico City, resources are not available for implementation of all proposed controls and thus prioritization must occur. Yet policy makers often do not conduct comprehensive quantitative analyses to inform these decisions. We reanalyze a subset of currently proposed control measures, and derive cost and health benefit estimates that are directly comparable. This study illustrates that improved quantitative analysis can change implementation prioritization for air pollution and greenhouse gas control measures in Mexico City.

Air Pollution↗
PubMed1998

A comparison of mortality rates in three prospective studies from Copenhagen with mortality rates in the central part of the city, and the entire country. Copenhagen Center for Prospective Population Studies.

Valid generalizations of results from population-based epidemiological surveys requires knowledge about how representative the sample is. The Copenhagen Center for Prospective Population Studies have assessed mortality on the basis of pooled data from three research programmes in the region of Copenhagen. In two of the studies, subjects were randomly selected, using the Danish Central Population Registry, within certain age groups and area-restricted sectors of the Greater Copenhagen. In the third study, men employed in 14 companies participated. Participation rates were between 78% and 87% in the three programmes. Standardized mortality rates (SMR) were calculated in relation to mortality rates in the municipality of Copenhagen and in the whole country in three age groups and the two genders. SMR values in the whole sample including non-participants were similar to rates for Copenhagen in the Copenhagen City Heart Study, whereas mortality rates in the Glostrup Population Studies were similar to rates for the whole country. The mortality rates among participants were lower than in the whole sample, and differences existed in relation to region and selection criteria of the cohorts. The Copenhagen Male Study, where only employed men were included, showed the lowest mortality rates, and higher rates were found in the study from the central part of the City (the Copenhagen City Heart Study) compared to the study from the suburbs (the Glostrup Population Studies). The difference between mortality rates in the cohorts and in Copenhagen City decreased with increasing age. The SMR converged towards 1.00 with increasing observation time. In conclusion, high participation rates were found in all three studies, resulting in SMR values for participants only slightly lower than in the source population in the two randomly selected samples, but 30% lower values in the sample of employed men. As mortality rates in the total samples including non-participants were markedly higher than among the participants, generalizations of results for participants to the whole population should be made with caution, especially during the first years of observation.

Adult↗
PubMed2002

Some issues of environmental concern in Kampala, the capital city of Uganda.

Kampala, the capital city of Uganda is the administrative, political, commercial, industrial, educational and cultural centre of Uganda. The city has an area of 190 km2 and is located 8 km north of Lake Victoria (the second largest fresh water lake in the world) and approximately 42 km north of the equator. The population varies from about 1.2 million during the day to perhaps 0.9 million at night. The anthropogenic activity of this population far exceeds the infrastructure capacity of the city, leading to the deterioration of the urban environment. This article highlights the major sources of environmental degradation and pollution in the city, which include solid waste, abattoir waste, sewage, sanitation, drainage, industrial pollution, traffic pollution, atmospheric pollution, urban agriculture, rapid urbanisation and water hyacinth.

Air Pollution↗
PubMed2006

Risk factors for goiter in primary school girls in Qom city of Iran.

OBJECTIVE: Goiter is endemic in Iran. The iodine deficiency disorders program was begun a few years ago in Iran, and the coverage of iodized salt is sufficient now. But, in a periodic yearly medical examination of primary school girls in Qom, the prevalence of goiter was above 30% in 2002. This survey was designed to study the risk factors of goiter in those students. DESIGN: The study was a randomized (multistage, proportional simple random sampling) case-control study. SUBJECTS AND INTERVENTIONS: We selected and performed thyroid examinations in 1050 girl students in primary schools in Qom city of Iran in 2002. We found 284 cases: girls in primary schools had goiter in accordance with the clinical exam of World Health Organization classification. Among students who did not present with goiter in the clinical exam, we randomly selected 288 students as the control group. We used a questionnaire to evaluate them for the risk factors of goiter. RESULTS: The mean+/-s.d. ages of cases and controls were 8.7+/-1.3 and 8.9+/-1.3 years, respectively. There is no significant difference between the two groups regarding history of soya, kale, turnip, fish, daily iodized salt usage, education and job of mothers, monthly family income, nationality, immigration and residential situation. By using multinomial logistic regression, we found that storage of iodized salt in open containers, odds ratio (OR): 2.201 (1.412-3.428); P-value <0.0001, medium socioeconomic situation (SES) of family, OR: 2.099 (1.029-4.282), P-value=0.041, district 2 of Qom city, OR: 2.880 (1.376-6.027), P-value=0.005, and district 3 of Qom city, OR: 2.051(1.032-4.078), P-value=0.041, were the major risk factors for goiter in this population. CONCLUSIONS: In this study, the main risk factors for goiter were storage of iodized salt in open containers, medium SES and also living in specific districts of Qom city. As the coverage of iodinized salt is over 95% in Iran, we advise the education of the family about storage of iodized salt in closed containers. We also recommend the study of the other risk factors of goiter in the different geographical areas of Iran, because of differences in the SES and nutritional habits. SPONSORSHIP: This study was supported by issuing permission letters for our activities: (not funding support) Qom Health Network and Medical Services, Qom Medical University, Qom Primary School Education Office, Fathemieh Medical University.

Case-Control Studies↗
PubMed2001

Effects of socioeconomic status on the obesity knowledge of adolescents from six Latin American cities.

OBJECTIVE: To examine the effects of socioeconomic status (SES) on the obesity knowledge of adolescents in six Latin American cities. DESIGN: Data were collected using an anonymous, self-administered questionnaire consisting of demographic questions and a 25-item multiple-choice obesity knowledge test. Test items were clustered under five topics: the fat and calorie content of foods and beverages; weight loss methods; energy expenditure; food preparation methods; and the relationship between obesity and health. SUBJECTS: A total of 1272 ninth grade students from higher and lower SES families were recruited at schools in Buenos Aires, Argentina (n=195); Guatemala City, Guatemala (n=212); Havana, Cuba (n=213); Lima, Peru (n=218); Panama City, Panama (n=195); and Santiago, Chile (n=239). RESULTS: Mean test scores reflected a low level of obesity knowledge among adolescents from higher and lower SES groups in all six cities. Nevertheless, a trend for higher scores emerged in favor of adolescents from wealthier families. This income effect persisted after controlling for gender and weight status. The weakest knowledge areas among youth from the higher SES groups were food preparation methods and the relationship between obesity and health while those for adolescents from the lower SES groups were the fat and calorie content of foods and beverages and the relationship between obesity and health. Classroom instruction about obesity was generally more available to students from the higher SES groups. The majority of adolescents from both SES groups were interested in learning more about weight loss methods, energy expenditure, and the fat and calorie content of foods and beverages. The topic of least interest was the relationship between obesity and health. CONCLUSION: These preliminary findings suggest a need for more obesity education programs for adolescents, especially for those living in poverty.

Adolescent↗
PubMed2002

Prevalence of breast-feeding and its correlates in Ho Chi Minh City, Vietnam.

BACKGROUND: The health benefits of breast-feeding are widely acknowledged and breast-feeding is crucial for the survival of the infants in developing countries. The present study aims to elucidate the prevalence of breast-feeding and the possible risk factors affecting the breast-feeding of infants at the age of 3 months in Ho Chi Minh City, Vietnam after the World Health Organization and the United Nations Children's Fund launched "the Baby-Friendly Hospital" Initiative in 1989. METHODS: A cross-sectional study was conducted in the urban areas of Ho Chi Minh City, Vietnam in February, 2000. Two hundred and sixty mother-infant pairs were conveniently recruited in three child health centers in Ho Chi Minh City. Mothers of infants aged 6-12 months were interviewed and completed a well-structured questionnaire regarding the feeding types of the infant, the maternal knowledge, attitudes and behaviors related to breast-feeding. RESULTS: The results indicated that although about 86.4% newborns in the maternity wards and 88.5% infants at 3 months were at least partially fed with breast milk, the prevalence of breast-feeding were 57.4 and 53.1%, respectively. About 47.5% newborns were fed with breast milk in the first feeding. The multivariate logistic regression analysis shows that the risk factors for the introduction of breast milk substitutes at 3 months of age were maternal antenatal plan of mixed or artificial feeding (odds ratio (OR) = 6.59, 95% confidence interval (CI): 3.18-13.64, P < 0.001) and the supplement of breast milk substitutes in the maternity ward (OR = 4.30, 95% CI: 2.10-8.77, P < 0.001). Higher maternal education levels were beneficial to the continuation of breast-feeding. About 18.5% mothers had attended antenatal breast-feeding education. Most of the mothers (94.1%) and families (95.4%) indicated supportive attitudes to breast-feeding. CONCLUSION: The prevalence of breast-feeding was relatively low in Ho Chi Minh City, Vietnam. The antenatal education in breast-feeding needs to be improved and the implementation of the "Baby-Friendly Hospital" policy needs to be strengthened.

Breast Feeding↗
PubMed2005

[Involuntary Hospitalisations in 2000 According to German "PsychKG" in the City of Hannover].

OBJECTIVE: To examine for one year which psychiatric services are involved in involuntary hospitalisations according to PsychKG (German law concerning psychiatric practice) in the City of Hannover. METHOD: All available data within the health administration of the former city and former county of Hannover of compulsory admissions in the year 2000 were evaluated. RESULTS: In 2000, 524 patients were involuntary admitted to psychiatric hospitals according to the data of the health administration of the city of Hannover. The two major diagnoses were schizophrenia or substance addiction of involuntarily admitted patients, most hospitalisation were documented for Fridays, the most frequent time was between 9 and 1 hour p. m. The services in Hannover which dealt most with involuntary admissions were the either physicians of "KV" (Kassenarztliche Vereinigung, the German physicians organisation who is in charge of the treatment of all patients for non-private health insurances) or the physicians of the psychiatric departments of the Hannover Medical School. CONCLUSIONS: The major provider of psychiatric assistence for compulsory admissions within the City of Hannover are the physicians of the KV and the psychiatric departments of the Hannover Medical School.

Catchment Area, Health↗
PubMed2003

Determination of aliphatic and polycyclic aromatic hydrocarbons in atmospheric particulate samples of A Coruña City (Spain).

The hydrocarbon composition of atmospheric particulate matter from A Coruña city (Northwest Spain) has been studied. TSP (total suspended particulate) and PM10 (particulate matter with aerodynamic diameter < 10 microm) samples were taken over 7 and 4 months at two stations located in residential and industrial sectors of A Coruña city, respectively. The levels of hydrocarbons found in atmospheric particulate samples of A Coruña city are higher than the ones found in other cities over the world. Ratios between the analysed compounds and their sources were established. Both anthropogenic and biogenic origins were found.

Air Pollution↗
PubMed2006

Anaemia and vitamin A status among adolescent schoolboys in Dhaka City, Bangladesh.

OBJECTIVES: To investigate the prevalence of anaemia and subclinical vitamin A deficiency among adolescent schoolboys in Dhaka City, Bangladesh, and to identify factors related to anaemia and vitamin A status. DESIGN: A cross-sectional study. SETTING: Government high schools in Dhaka City, Bangladesh. SUBJECTS AND METHODS: A total of 381 boys, aged 11-16 years, from 10 schools in Dhaka City participated in the study. Socio-economic, anthropometric and dietary data were collected. Haemoglobin and serum retinol (vitamin A) concentrations were determined. RESULTS: Seven per cent of the boys were anaemic and 22% had serum vitamin A levels below the adequate level of 1.05 micromol l(-1), with only 1.5% having subclinical vitamin A deficiency (<0.70 micromol l(-1)). Food frequency data revealed poor dietary habits. Multiple regression analysis showed that age, body mass index (BMI), parents' occupation, serum vitamin A level and frequency of intakes of meat and fruit were significantly independently related to haemoglobin level. The overall F-ratio (13.1) was highly significant (P<0.000) and the adjusted R(2) was 0.192. For serum vitamin A, BMI, father's education, per capita expenditure on food, haemoglobin concentration and frequency of intake of vitamin A-rich fruit were found to be significantly independently related. The overall F-ratio (14.5) was highly significant (P<0.000) and the adjusted R(2) was 0.186. CONCLUSION: The data show that adolescent schoolboys in Dhaka City have anaemia and inadequate vitamin A status, although the extent of the problems is lower than in other population groups in the country. Sociodemographic and dietary factors appear to have important relationships with anaemia and vitamin A status of these boys.

Adolescent↗
PubMedDate not supplied

Short-term effects of air pollution on mortality in nine French cities: a quantitative summary.

Between 1990 and 1995, 9 French cities provided data on daily air pollution, total mortality, cardiovascular mortality, and respiratory mortality. Personnel in individual cities performed Poisson regressions, controlling for trends in seasons, calendar effects, influenza epidemics, temperature, and humidity, to assess the short-term effects of air pollution. The authors describe results obtained from the quantitative pooling of these local analyses. When no heterogeneity could be detected, a fixed-effect model was used; otherwise, a random-effect model was used. Significant and positive associations were found between total daily deaths in these cities and the 4 air pollution indicators studied: (1) Black Smoke, (2) sulfur dioxide, (3) nitrogen dioxide, and (4) ozone. A 50-microg/m3 increase in Black Smoke (24 hr), sulfur dioxide (24 hr), nitrogen dioxide (24 hr), or ozone (8 hr) was associated with increases in total mortality of 2.9% (95% confidence interval [CI]) = 1.3, 4.4), 3.6% (95% CI = 2.1, 5.2), 3.8% (95% CI = 2.0, 5.5), and 2.7% (95% CI = 1.3, 4.1), respectively. Similar results were obtained for cardiovascular mortality. Except for sulfur dioxide, positive--but not significant--associations were found with respiratory mortality. The internal consistency among the cities studied, as well as consistency with previously published results, favors a causal interpretation of these associations.

Adolescent↗
PubMedDate not supplied

Umbilical cord blood lead levels in the Québec City area.

The purposes of this study were to determine the umbilical cord blood lead levels in a nonindustrialized city and the effect of place of residence on the blood lead levels of newborns. During spring 1990, we conducted a survey of umbilical cord blood lead levels from 823 live newborns in two hospitals from the Québec City area. The geometric mean of cord blood lead levels was 0.094 mumol/l (95% confidence interval [95% CI] = 0.088-0.099). Less than 1% (95% CI = 0.2-1.7) of the babies had cord blood lead levels at 0.48 mumol/l or greater. We estimate that each year in the Québec City area between 150 and 200 newborns are at risk for developing psychoneurological problems during their first years of life. Frequency distribution of cord blood lead level did not differ significantly among urban, suburban, and rural areas; however, a higher proportion of cord blood lead levels greater than 0.25 mumol/l was observed in the urban area (9.4%), compared with suburban (2.6%) and rural (3.1%) areas. The proximity of potential environmental lead sources (highway, industry, city center) located within 1/2 mile (.8 km) of the mother's residence was associated with a high cord blood lead level. Cord blood lead levels were also elevated for newborns whose mothers lived in newer (< or = 5 y) and older buildings (> or = 50 y). We concluded that the environmental characteristics of the mother's residence are a better indicator of environmental lead exposure than the place of residence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Lead in inner-city soil and its possible contribution to children's blood lead.

This study was designed to assess distribution and sources of lead in inner-city soils in Washington, D.C. Duplicate soil samples were collected randomly from 239 unpaved front yards of homes in Washington, D.C. Soil samples were collected 1 m from the houses. Lead concentration in soil was determined by flame atomic absorption spectrophotometry. Presence of lead detected in soil was correlated and traced to the anticipated source of origin. A significantly high concentration of lead was present in inner-city soils. Areas of the city in which the highest lead concentrations were found (Wards 1, 4, 5, 6, 7, 8) were determined to contain a large number of residents who had attained lower education levels than most residents in the remaining wards. It was concluded that lead concentration in inner-city soil plays a significant role in the incidence of lead poisoning in children in the District of Columbia and that paint is the main source of soil lead. Demographic characteristics of the residents appeared to enhance the distribution of lead poisoning.

Adolescent↗
PubMed1991

Self-reported depression in younger and older pregnant inner-city adolescents.

Younger (14- to 17-year-old) inner-city adolescent mothers have been reported by Colletta (1983) as being more depressed than older (18- to 19-year-old) inner-city adolescent mothers. To determine whether this finding applies to pregnant adolescents, the revised Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979; Beck & Steer, 1987) was administered to 175 (65.1%) Black, 64 (23.8%) Hispanic, and 30 (11.1%) White inner-city adolescents during their 28th week of pregnancy. The sample was divided into 129 (48.0%) younger (13- to 15-year-old) adolescents and 140 (52.0%) older (16- to 18-year-old) adolescents. The mean profiles of the 21 BDI symptoms were comparable for both age groups, and it was concluded that younger and older pregnant inner-city adolescents describe similar levels of self-reported depression.

Adolescent↗
PubMed1995

Post-traumatic stress and coping in an inner-city child. Traumatogenic witnessing of interparental violence and murder.

Violence today appears to be ubiquitous: it even enters the clinical session, deeply internalized within child victims who were exposed to often unspeakable horror. Violence and its pernicious, horrific effects are observed in the streets, schools, parks, playgrounds, and homes of some inner-city communities. This article introduces the use of Anna Freud's Diagnostic Profile system with an inner-city child who, at the age of four, witnessed his mother fatally stab his father with a kitchen knife and at age eleven was assessed and treated by the author. Clinicians may wonder whether any kind of therapy could ever undo the serious fixations, regressions, developmental arrests, and integrate trauma-shattered ego functions observed in children exposed to visual horror and affective terror. Application of the Profile may offer some direction with these children: a panoramic view of their painful mood, their hypervigilance and distrust, fears, separation and annihilation anxieties, nightmares (with murder imagery), developmental anomalies and arrests is presented with clarity and force. The therapist uses countertransference responses to monitor the affect tolerance in the child and to determine the appropriate dosages of awareness the child can integrate from one moment to the next. The therapist also serves as the child's external stimulus barrier and explores feelings about media-driven portrayals of violence, stereotypes, and inner-city children and youths. The unsurpassed utility of the Profile as a diagnostic system that documents vital economic, dynamic, structural, genetic and adaptive-coping information about the child is discussed in detail as is the Profile's added benefit of possibly guarding against misdiagnosis and charting a course for psychotherapy in difficult city-violence trauma cases.

Adaptation, Psychological↗
PubMed1999

Polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and coplanar polychlorinated biphenyls in breast milk from two cities in Ukraine.

Substantial environmental pollution has been alleged in Ukraine, but little information is available to allow an assessment of the possible impact on humans. To help remedy this lack of information, it was of interest to investigate whether certain polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), or coplanar polychlorinated biphenyls (PCBs) were elevated in people from Ukraine. Samples of breast milk were obtained from 200 women from the cities of Kyiv and Dniprodzerzhinsk; Kyiv is the capital and Dniprodzerzhinsk is a highly industrialized city. The samples were combined into four pools by city and age, and analyzed for 7 PCDDs, 10 PCDFs, and 2 coplanar PCBs (126 and 169). The total of the measured PCDDs, expressed as toxic equivalent, ranged from 5.1 to 7.6 pg/g lipid; for PCDFs from 3.6 to 5.2, and for PCBs from 11 to 18 pg/g lipid. Results from the two cities were similar; older women had slightly higher concentrations than did younger women. Levels of these compounds seen in Ukraine were similar to or lower than those seen in other recent studies from European and Asian countries.

Adult↗
PubMedDate not supplied

Injection drug users in the Midwest: an epidemiologic comparison of drug use patterns in four Ohio cities.

Variations in the drug use patterns of injection drug users (IDUs) can have important implications for public health efforts aimed at reducing drug abuse and the transmission of the human immunodeficiency virus. This article describes and compares the characteristics of IDUs living in four Ohio cities and compares African-American and White IDUs at a statewide level. Data from 2,001 IDUs who were recruited for the National AIDS Demonstration Research project between 1989 and 1991 in Columbus, Cleveland, Cincinnati, and Dayton were compared on a number of variables by city and by ethnicity using descriptive statistics and ANCOVA analysis. Significant differences among IDUs in the four cities exist for the use of alcohol, marijuana, cocaine, crack, heroin, speedball, other opioids, shooting gallery use, "safer" needle practices, treatment history, and self-help participation. Differences by ethnicity emerged on all variables except marijuana use, overall injection frequency, and incarceration experience. The results suggest that dramatic differences exist between African-American and White IDUs, and among IDUs in cities relatively close together, regardless of ethnicity. These findings should be considered when developing policy and programs for prevention and treatment activities targeting IDUs.

Adult↗
PubMed2001

Nutritional status of middle-aged Vietnamese in Ho Chi Minh City.

OBJECTIVE: To investigate the nutritional status of middle-aged Vietnamese in Ho Chi Minh City. METHODS: A cross-sectional survey in 300 Vietnamese aged 40 to 59 years (113 men, 187 women) was conducted in an urban, suburban and rural area of Ho Chi Minh City based on interviews that included a 24-hour dietary recall, food frequency questionnaire, and a short socioeconomic questionnaire. Anthropometry and blood pressure were measured, and blood was collected for serum protein and lipid analysis. RESULTS: A high prevalence of underweight (BMI < 18.5) was observed in the rural and suburban populations (35% and 23%, respectively), and overweight (BMI > or = 25) was observed in the urban population (18%). A high percentage of serum total cholesterol (TC) below 150 mg/dL was observed in the rural and suburban areas (43% and 37%, respectively). By contrast, the prevalence of TC above 220 mg/dL was twofold higher in the urban and suburban residents (13% and 12%, respectively) than in rural residents (6%). More than 80% of urban residents were of medium or high-income status, whereas 61% of suburban residents were of medium-income status and 66% of rural residents were of low-income status. CONCLUSIONS: The nutritional status of middle-aged Vietnamese in Ho Chi Minh City was characterized by undernutrition in 35% of the low-income population and by overnutrition in 18% the high-income population. Undenutrition was still a public health problem in the rural area whereas overnutrition started to become a noteworthy problem in the urban area. The suburban area suffered from both under- and overnutrition problems. Low lipid intake was the most important problem related to undernutrition in middle-aged residents of Ho Chi Minh City.

Adult↗