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PubMed1999

Crisis management to controlled recovery: the emergency planning response to the bombing of Manchester City Centre.

Fuelled by terrorist attacks on urban areas, emergency planning responses to manmade disasters is a growing area of critical debate within the field of urban management. The response of a major British city--Manchester--to the 1996 bombing of its commercial core, is examined in this paper. It focuses on the transformation of the emergency planning response from dealing with the immediate crisis during the first week, to a stage of controlled recovery that still continues. The response to the devastation caused by the bomb was co-ordinated by the city council, which developed a range of short- and long-term initiatives, but the re-opening of the city centre could not have happened so quickly had the council not worked in collaboration with other key organisations and agencies. Working partnerships were crucial to the immediate response and subsequent recovery, with such capacity for organisational learning built upon existing co-operative arrangements within the city, which had developed over the previous decade.

Crisis Intervention↗
PubMed2000

The demographic and socio-economic characteristics of post-1965 immigrants to New York City: a comparative analysis by national origin.

This article analyzes and compares the demographic and socioeconomic characteristics of persons born abroad who immigrated to New York City after 1965 and still lived in the City in 1990. Using data from the 1990 Census, the authors classify persons into the 24 largest national origin groups and compare their demographic and socioeconomic characteristics (sex, age, educational attainment, labor force participation, unemployment, occupation, income, and poverty). The authors pose and answer three empirical questions. The first question is: What are some of the main differences by national origin in the composition of persons immigrating to New York City after 1965? The second question is: What are some of the main differences in the location of post-1965 immigrants in New York's socioeconomic structure? The third question is: What are some of the differences in the economic rewards received by persons who immigrated to New York City since 1965? The authors find that immigrants with less than a high school education have higher labor force participation rates than the US-born population in the same educational category and also have slightly higher earnings. Immigrants with a high school degree have labor force participation rates close to (or slightly higher than) the average for the US-born population but their incomes are slightly lower than the average income for the US-born population. Immigrants with a college degree have participation rates similar or slightly lower than those of the US-born population while their earnings are significantly lower than those of US-born college graduates.

Americas↗
PubMed2000

Human immunodeficiency virus infection in rural areas and small cities of the southeast: contributions of migration and behavior.

The design of education and prevention strategies to stem the spread of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in rural areas depends on having accurate patterns of risk behavior and transmission in local areas. Interviews were conducted with people in rural areas and small cities in Delaware, Florida, Georgia and South Carolina who were at least 18 years old and infected with HIV in order to describe demographic characteristics, migration patterns and risk behaviors. Interviews were conducted with 608 people. Most respondents were male (66 percent), black (63 percent of men, 85 percent of women) and had been infected through sexual contact (67 percent of men, 66 percent of women). Most (65 percent) had lived away from a rural area or small city for at least one month; of those, 71 percent had moved from an urban area. Twenty-seven percent of respondents indicated they had been infected locally. People with a history of injection drug use were less likely to have been infected locally than those who had no history of injection drug use (6 percent vs. 26 percent among men, 3 percent vs. 40 percent among women, P < 0.001). Further understanding of the role of socioeconomic factors in HIV transmission in rural areas and small cities is needed. Programs designed to prevent HIV acquisition among people living in rural areas and small cities in the Southeast should focus on sexual behavior.

Adolescent↗
PubMed1991

The reorganization of the city of Toronto dental services: a community development model.

The dental program of the Department of Public Health, City of Toronto, is over 75 years old. Recently, the department engaged in extensive community-based planning, which culminated in the closing of forty-eight school-based clinics and the opening of eight community clinics. A geriatric dental program also was established. This paper will describe the data utilized, the analysis of which enabled the department to focus its efforts on those at high risk for dental disease. These groups included immigrants and institutionalized seniors. This analysis also enabled the department to locate its clinics in those areas of the city with greatest need. The community development model, quite unique to major reorganizations, is also described. It was this wide support that resulted in the unanimous approval by the city council of the reorganization and gave impetus to personnel changes resulting in the ability of staff to communicate in the major languages of a city where over 50 percent speak a language other than English or French.

Aged↗
PubMed1991

[T-serotype distribution of group A hemolytic streptococci in a rapidly expanding residential area in Sanda City, Hyogo Prefecture, with reference to an outbreak of serotype T-28 in autumn, 1988].

In the fall of 1988, an outbreak of streptococcal infections was observed at 2 pediatric clinics in Sanda City, Hyogo prefecture. The 2 clinics were independent of each other; one (clinic A) was located in the down town area, in the older part of the city, where there is little population turn over, while the other (clinic B) was in a newly developed-fast growing residential district. The strains and the distribution of T-serotypes isolated at each location are as follows: clinic A; 58 strains (34.5% serotype T-4, 31.0% serotype T-12, 10.3% serotype T-1, and 23.3% serotype T-28), clinic B; 43 strains (48.8% serotype T-28, 23.3% serotype T-12, 11.6% serotype T-4 and 7.0% serotype T-1). According to the data from Kobe City infectious disease surveillance center, there were a total of 102 group A hemolytic streptococci strains isolated in 1988, the T-serotypes distribution of which was as follows: 47.0% serotype T-4, 15.7% serotype the T-12, 10.8% serotype T-1 and 9.8% serotype T-28. Serotype T-4 was dominant here, as it was in location A of Sanda City. The epidemic proportion of serotype T-28 found at location B is considered to be due to the fact that location B has very little social interaction with location A and other areas. No difference was observed among the different serotypes on the drug susceptibility test: all strains showed a sensitivity to ampicillin and penicillin G, but were resistant to tetracycline and chloramphenicol.

Adolescent↗
PubMed1991

[Epidemic of echovirus type 7 in Kitakyushu City in 1986--a survey of isolation of viruses from the sewage and seroepidemiology of children].

In 1986, under the Infectious Disease Surveillance system in Fukuoka Prefecture, no isolation of echovirus type 7 from aseptic meningitis patients were reported. It was unclear that epidemics of this virus occurred in Fukuoka Prefecture, including Kitakyushu City. We tried to isolate enteric viruses from the sewage (activated sludges) in Kitakyushu City in 1986. Outbreaks of isolations of echovirus type 7 started in September and continued until in December. This result suggested that echovirus type 7 caused epidemic during this period in Kitakyushu City. Sera were collected from children in 1989, and were examined neutralizing antibody titer against echovirus type 7. Antibody titers were positive in the sera of about half of children above 1 year of age in 1986. From results of virus isolations from the sewage and serological study, it was confirmed that echovirus type 7, reported no isolation in Fukuoka Prefectural surveillance system, caused epidemics in Kitakyushu City in 1986.

Child↗
PubMed2003

Role of the Bacillus methanolicus citrate synthase II gene, citY, in regulating the secretion of glutamate in L-lysine-secreting mutants.

The thermotolerant, restrictive methylotroph Bacillus methanolicus MGA3 (ATCC 53907) can secrete 55 g of glutamate per liter (maximum yield, 0.36 g/g) at 50 degrees C with methanol as a carbon source and a source of ammonia in fed-batch bioreactors. A homoserine dehydrogenase mutant, 13A52-8A66, secreting up to 35 g of L-lysine per liter in fed-batch fermentations had minimal 2-oxoglutarate dehydrogenase activity [7.3 nmol min(-1) (mg of protein)(-1)], threefold-increased pyruvate carboxylase activity [535 nmol min(-1) (mg of protein)(-1)], and elevated citrate synthase (CS) activity [292 nmol min(-1) (mg of protein)(-1)] and simultaneously secreted glutamate (20 to 30 g per liter) and L-lysine. The flow of carbon from oxaloacetate is split between transamination to aspartate and formation of citrate. To investigate the regulation of this branch point, the B. methanolicus gene citY encoding a CSII protein with activity at 50 degrees C was cloned from 13A52-8A66 into a CS-deficient Escherichia coli K2-1-4 strain. A citY-deficient B. methanolicus mutant, NCS-L-7, was also isolated from the parent strain of 13A52-8A66 by N-methyl-N'-nitro-N-nitrosoguanidine mutagenesis, followed by selection with monofluoroacetate disks on glutamate plates. Characterization of these strains confirmed that citY in strain 13A52-8A66 was not altered and that B. methanolicus possessed several forms of CS. Analysis of citY cloned from NCS-L-7 showed that the reduced CS activity resulted from a frameshift mutation. The level of glutamate secreted by NCS-L-7 was reduced sevenfold and the ratio of L-lysine to glutamate secreted was increased 4.5-fold compared to the wild type in fed-batch cultures with glutamate feeding. This indicates that glutamate secretion in L-lysine-overproducing mutants can be altered in favor of increased L-lysine secretion by regulating in vivo CS activity.

Amino Acid Sequence↗
PubMed1998

Capsular serotype and antibiotic resistance of Streptococcus pneumoniae isolates in two Chilean cities.

We compared the incidence of nasopharyngeal colonization by Streptococcus pneumoniae, the serotypes causing mucosal and invasive diseases, and the antibiotic resistance of these strains in patients admitted to three large hospitals and children attending day care centers in two Chilean cities (Santiago and Temuco). The populations in both cities were similar in ethnic background, socioeconomic status, family size, and access to medical care. Significant differences in nasopharyngeal colonization rates, in serotypes causing infections, and in antibiotic resistance were found between the two cities. In children 0 to 2 years of age, 42% were colonized with S. pneumoniae in Santiago compared to 14% in Temuco. A total of 41 serotypes were identified in both Chilean cities studied. Six serotypes were found only in Santiago; 14 serotypes were found only in Temuco. Antibiotic-resistant serotypes 6A, 6B, 14, 19F, and 23F were detected only in Santiago. We show that important differences in the incidence of nasopharyngeal carriage, infection, and S. pneumoniae serotypes can exist in similar populations in different areas of the same country. Our findings are relevant for prevention strategies, antibiotic usage, and vaccine design.

Adolescent↗
PubMed1980

Comparison of modified New York City medium with Martin-Lewis Medium for recovery of Neisseria gonorrhoeae from clinical specimens.

A modified formulation of New York City medium was comparatively evaluated with Martin-Lewis medium for the recovery of Neisseria gonorrhoeae from clinical specimens. A total of 240 strains of gonococci were recovered from 1,250 specimens collected from walk-in patients attending a sexually transmitted disease clinic. N. gonorrhoeae was cultivated on both of these media from 182 clinical specimens with an additional 58 gonococcal strains isolated on either of the media. Of these discrepant gonococcal isolates, 27 strains were recovered on only modified New York City medium, whereas the remaining 31 strains were recovered on only Martin-Lewis agar. The differences in these isolation rates were not statistically significant. The overall results showed that modified New York City and Martin-Lewis media were comparable in their ability to grow gonococci from clinical material. Since modified New York City medium is capable of supporting the growth of N. gonorrhoeae, Mycoplasma pneumoniae, and urogenital mycoplasmas and inhibiting the growth of commensal microorganisms, it is possible that it may have considerable application as a multifunctional plating medium within the clinical laboratory.

Cervix Uteri↗
PubMed1981

Primary isolation of Neisseria gonorrhoeae on hemoglobin-free New York City medium.

New York City medium and New York City medium without hemoglobin were comparatively evaluated for their ability to support the growth of Neisseria gonorrhoeae isolated from 1,010 clinical specimens. Although hemoglobin in the form of lysed horse erythrocytes stimulated gonococcal growth, the absence of this component from New York City medium did not have a detrimental effect on the recovery of gonococci isolated from clinical specimens. Both media were comparable in their ability to cultivate gonococci from clinical material, with a total of 187 gonococcal isolates being recovered on each of the media. The results of this study showed that the preparation of New York City medium can be facilitated and that its cost can perhaps be reduced by the elimination of the hemoglobin component from the formulation without adverse effect on the recovery of N. gonorrhoeae isolated from clinical specimens.

Culture Media↗
PubMed1997

Short-term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: results from time series data from the APHEA project. Air Pollution and Health: a European Approach.

OBJECTIVES: To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide. DESIGN: Analysis of time series data on daily number of deaths from all causes and concentrations of sulphur dioxide and particulate matter (measured as black smoke or particles smaller than 10 microns in diameter (PM10)) and potential confounders. SETTING: 12 European cities in the APHEA project (Air Pollution and Health: a European Approach). MAIN OUTCOME MEASURE: Relative risk of death. RESULTS: In western European cities it was found that an increase of 50 micrograms/m3 in sulphur dioxide or black smoke was associated with a 3% (95% confidence interval 2% to 4%) increase in daily mortality and the corresponding figure for PM10 was 2% (1% to 3%). In central eastern European cities the increase in mortality associated with a 50 micrograms/m3 change in sulphur dioxide was 0.8% (-0.1% to 2.4%) and in black smoke 0.6% (0.1% to 1.1%). Cumulative effects of prolonged (two to four days) exposure to air pollutants resulted in estimates comparable with the one day effects. The effects of both pollutants were stronger during the summer and were mutually independent. CONCLUSIONS: The internal consistency of the results in western European cities with wide differences in climate and environmental conditions suggest that these associations may be causal. The long term health impact of these effects is uncertain, but today's relatively low levels of sulphur dioxide and particles still have detectable short term effects on health and further reductions in air pollution are advisable.

Air Pollutants↗
PubMed2005

Projected health impact of the Los Angeles City living wage ordinance.

STUDY OBJECTIVE: To estimate the relative health effects of the income and health insurance provisions of the Los Angeles City living wage ordinance. SETTING AND PARTICIPANTS: About 10 000 employees of city contractors are subject to the Los Angeles City living wage ordinance, which establishes an annually adjusted minimum wage (7.99 US dollars per hour in July 2002) and requires employers to contribute 1.25 US dollars per hour worked towards employees' health insurance, or, if health insurance is not provided, to add this amount to wages. DESIGN: As part of a comprehensive health impact assessment (HIA), we used estimates of the effects of health insurance and income on mortality from the published literature to construct a model to estimate and compare potential reductions in mortality attributable to the increases in wage and changes in health insurance status among workers covered by the Los Angeles City living wage ordinance. RESULTS: The model predicts that the ordinance currently reduces mortality by 1.4 deaths per year per 10,000 workers at a cost of 27.5 million US dollars per death prevented. If the ordinance were modified so that all uninsured workers received health insurance, mortality would be reduced by eight deaths per year per 10,000 workers at a cost of 3.4 million US dollars per death prevented. CONCLUSIONS: The health insurance provisions of the ordinance have the potential to benefit the health of covered workers far more cost effectively than the wage provisions of the ordinance. This analytical model can be adapted and used in other health impact assessments of related policy actions that might affect either income or access to health insurance in the affected population.

Cost-Benefit Analysis↗
PubMed2002

Neighbourhood socioeconomic context and self reported health and smoking: a secondary analysis of data on seven cities.

OBJECTIVE: Many studies have shown that poor health status and harmful health behaviour occur more frequently in deprived neighbourhoods. Most studies show modest associations between area level socioeconomic factors, the neighbourhood context, and health outcomes. However, estimates for the contextual effects vary. It is unclear if this variation is attributable to differences in methodology. This study examines whether contextual neighbourhood differences in health outcomes really vary between cities or that differences in methodology may account for these differences. DESIGN: Secondary analysis of data from health interview surveys in seven large Dutch cities in the 1990s comprising 23 269 residents of 484 neighbourhoods, using multilevel logistic models. SETTING: General population aged 16 and over. MAIN OUTCOME MEASURES: Self reported health, smoking of cigarettes. MAIN RESULTS: The socioeconomic context of neighbourhoods is associated with health outcomes in all large Dutch cities. The strength of the association varies between cities, but variation is much smaller in the age group 25-64. Furthermore, neighbourhood differences vary in size between native and other residents. Contextual neighbourhood differences are about two times larger for self reported health than for the smoking of cigarettes, but for native Dutch people they are of similar size. CONCLUSIONS: A comparatively large improvement in health may be gained in deprived neighbourhoods, because of the poorer health status to which the context of these neighbourhoods also contributes. Health promoting interventions should be aimed at the residents and at the context of deprived neighbourhoods, taking differences between ethnic groups and age groups into account.

Adolescent↗
PubMed2003

Diagnosis and treatment of presumed STIs at Mexican pharmacies: survey results from a random sample of Mexico City pharmacy attendants.

OBJECTIVES: People in developing countries often seek medical advice for common ailments from pharmacies. As one example, pharmacists routinely diagnose and treat symptomatic sexually transmitted infections (STIs). We aimed to assess the quality of advice provided in Mexico City pharmacies by presenting hypothetical STI related syndromes and recording pharmacy attendants' suggested diagnoses and treatments. METHODS: We interviewed the first available attendant in each of a 5% random sample of Mexico City's pharmacies. We inquired about the training, age, and experience of the attendant and about the typical number of clients coming for treatment of suspected STIs. After considering three hypothetical case studies, attendants recommended diagnoses, treatments, and, sometimes, physician follow up. RESULTS: Most Mexico City "pharmacists" are actually clerks, with trained pharmacists rarely available on the premises. The average pharmacy attendant was 32 years old, with a median of 5 years' experience at that pharmacy, but very limited (if any) training. 62% reported seeing 10 or more clients with genital or vaginal infections per month. Depending on the case study, attendants provided appropriate diagnoses in 0-12% of cases, recommended appropriate treatments in 12-16% of cases, and suggested physician follow up for 26-67% of cases. CONCLUSIONS: In general, surveyed pharmacy personnel were unable to diagnose accurately or offer appropriate treatment advice when presented with classic, common STI symptoms. Given the volume of clients seeking advice from this source, training pharmacy attendants could significantly help to reduce the burden of disease associated with STIs in Mexico City.

Adolescent↗
PubMed1987

City employment change in the Republic of Korea, 1960-1970.

Changes in the employment characteristics of Korean cities during the 1960s, a period of polarized development and rapid industrialization, are examined. The expectation of modernization and world-system/dependency theorists that the national metropolis, Seoul, increased its dominance in many key sectors is supported. Other cities, however, also grew rapidly, specialized in different economic sectors, and changed their economic structures. Polarized development, therefore, need not imply atrophy of noncore cities. Both modernization and world-system/dependency theorists need to apply more complex conceptualizations of systems of cities in developing nations.

Asia↗
PubMed1982

City size distributions and spatial economic change.

"The concept of the city size distribution is criticized for its lack of consideration of the effects of interurban interdependencies on the growth of cities. Theoretical justifications for the rank-size relationship have the same shortcomings, and an empirical study reveals that there is little correlation between deviations from rank-size distributions and national economic and social characteristics. Thus arguments suggesting a close correspondence between city size distributions and the level of development of a country, irrespective of intranational variations in city location and socioeconomic characteristics, seem to have little foundation." (summary in FRE, ITA, JPN, )

Demography↗
PubMed2005

Calls to an inner-city hospital breastfeeding telephone support line.

Support for breastfeeding mothers after they leave the hospital is often inadequate in low-income, inner-city areas where few resources are available. In becoming a Baby-Friendly Hospital, inner-city Boston Medical Center established a breastfeeding telephone support line to overcome this discrepancy. Records of support line calls for the first 5 years of operation were reviewed to record the level of need and determine reasons for use. A total of 1959 calls for 2482 reasons were received between January 1999 and December 2003. The most common reason for calling was "need help obtaining a breast pump" or "need information about breast pumps" (44%; 1096/2482), followed by "breast issue" (7%; 181/2482) and "milk supply question" (7%; 167/2482). The results indicate that inner-city women seek breastfeeding support and demonstrate a substantial need for breast pumps. These findings suggest that the lack of breast pumps may be a barrier to continued breastfeeding for inner-city breastfeeding women.

Adult↗
PubMed1996

Effects of the Stanford Five-City Project Media Advocacy Program.

The authors investigated the effects of a media advocacy program to build support for cardiovascular disease (CVD)-related policy changes and to encourage adoption of heart-healthy behaviors in the Stanford Five-City Project, a long-term trial of community-wide CVD risk reduction. The authors content analyzed 4,824 health articles in two treatment city newspapers and two reference city newspapers between 1977 and 1990. One treatment city newspaper responded well to the program; the other did not. In the Salinas Californian, the number of CVD-related articles increased during the campaign; these articles became more prominent and conspicuous, the focus on prevention increased, and more of these articles were written by local staff. Maintenance of these effects after the campaign was mixed. Results suggest that frequent, regular, systematic contact with media professionals and provision of materials influence newspaper coverage of health-related topics, which has important implications for shaping public opinion and policy change.

California↗