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PubMedDate not supplied

Seroepidemiology of selected zoonotic infections in Basra region of Iraq.

A community-based seroepidemiological study was made of 4 common zoonotic infections (brucellosis, hydatidosis, toxoplasmosis and visceral leishmaniasis) in 3 areas (rural, urban and suburban semirural) in Basra governorate, southern Iraq. The prevalence of brucellosis was higher in the suburban semirural area (29.3%) than the rural and urban areas. The prevalence of hydatidosis (19.0%-35.5%) and toxoplasmosis (41.1%-52.1%) were relatively high in all 3 areas. With respect to visceral leishmaniasis, low rates of infection were reported (0.2%-1.9%). The study shows in general that the suburban semirural area is at highest risk of zoonotic infections compared with other areas. The results could form a rational basis for the planning of an integrated comprehensive approach for control of zoonotic infections in the areas surveyed.

Adolescent↗
PubMed1987

Adolescents' compliance with the use of oral contraceptives.

To elucidate the factors that might influence compliance with oral contraceptive use among sexually active adolescents, we undertook a study of 209 unmarried adolescents initiating use of oral contraceptives in three different settings: an inner-city adolescent clinic, a birth control clinic in a midsized industrial city, and a suburban private practice. At the three-month follow-up visit, factors associated with compliance included older age, suburban residence, white race, health care in the suburban private practice, payment status, prior use of contraception, mother's unawareness of oral contraceptives, married parents, older boyfriend, lack of worry about being pregnant, and satisfaction with pill use. Compliance at long-term follow-up (13.5 +/- 3.7 months) was additionally associated with educational goals, father's education level, and absence of side effects. Ten pregnancies occurred during the study period among noncompliant site I patients. Inner-city clinic patients were at high risk of noncompliance and unplanned pregnancy.

Adolescent↗
PubMed1994

Prevalence of excess lead absorption and associated risk factors in children enrolled in a midwestern health maintenance organization.

OBJECTIVE: To assess the prevalence of lead intoxication in children in a defined low-risk population at the new levels recommended by the Centers for Disease Control and Prevention. DESIGN: During an 11-month period, whole blood lead tests were performed on 4678 children at routine well-child visits at 9 months and 2 years of age. For the last 8 months of the study, parents were asked to complete a prescreening risk factor questionnaire at these visits. The questionnaire and blood lead results were then matched. Data were collected from October 1, 1991 through August 31, 1992. SETTING: The study subjects were all enrolled in Group Health, Inc, a large health maintenance organization. Its 17 staff model clinics serve urban and suburban populations in the Minneapolis-St. Paul area. More than 95% of the population had coverage based on employment, not Medicaid. RESULTS: Results indicated that 2.5% (n = 119) of the children had BPb levels > or = 10 micrograms/dL. Urban clinics had rates of elevated BPb levels three to eight times those of suburban clinics (P < .00001), but the number of elevated BPb levels at the suburban clinics was greater than expected. BPb levels were significantly higher in summer and fall (P < .00001). The prescreening questionnaire addressed five areas potentially associated with risk according to the literature: housing, siblings with lead poisoning, parental hobbies or work involving lead, proximity to highways, and use of cultural medicines. Positive correlations were found between elevated BPb levels and residences built before 1950 (P < .00001). For children living in housing built before 1950, positive correlations were found between elevated blood lead levels and peeling paint (P < .01) or remodeling (P < .0001). CONCLUSIONS: Children who are at low socioeconomic risk but who live in housing built before 1950 are at increased risk for lead poisoning. The risk is greater if the house has peeling paint and especially if there is recent or ongoing renovation. Recommendations based on these results and the Centers for Disease Control and Prevention guidelines are made for screening programs in similar populations, and for the need to increase community awareness concerning this issue.

Child, Preschool↗
PubMedDate not supplied

Seasonal exposure to NO2 and respiratory symptoms in preschool children.

One hundred seventy-two preschool children, aged three to six years, who attended municipal day-care centers in central and suburban areas of Helsinki, were followed up for seven weeks during the winter season and for eight weeks during the spring season in 1991. For each child, the weekly average NO2 exposure was estimated using passive samplers attached to the outer garments of the children during their everyday activities. Respiratory symptoms were recorded in daily diaries by the parents. The median of personally measured seasonal NO2 exposures was 21 micrograms/m3 (range 11-45.8 micrograms/m3). The seasonal median NO2 exposure was significantly larger (p < 0.001) in the central area (27.4 micrograms/m3) than in the suburban area (18.2 micrograms/m3), reflecting a difference in exposure caused by automobile traffic. There also were significantly (p < 0.001) more days with stuffed nose (26% vs. 20%) and cough (18% vs. 15%) in the central area than in the suburban area. At the individual level, there was a nonsignificant positive correlation between personal NO2 exposure and cough during the spring season. Thus the areal difference in these symptoms was partly, but not completely, due to the difference in exposure to NO2.

Air Pollutants↗
PubMed1996

Making a place in the metropolis: locational attainment in cities and suburbs.

What accounts for the differences in the kinds of communities within the metropolis in which members of different racial and ethnic groups live? Do socioeconomic advancement and acculturation provide greater integration with whites or access to more desirable locations for minority-group members? Are these effects the same for Asians or Hispanics as for blacks? Does suburbanization offer a step toward greater equality in the housing market, or do minorities find greater discrimination in the suburban housing market? Data from 1980 for five large metropolitan regions are used to estimate "locational-attainment models," which evaluate the effects of group members' individual attributes on two measures of the character of their living environment: the socioeconomic standing (median household income) and racial composition (proportion non-Hispanic white) of the census tract where they reside. Separate models predict these outcomes for whites, blacks, Hispanics, and Asians. Net of the effects of individuals' background characteristics, whites live in census tracts with the highest average proportion of white residents and the highest median household income. They are followed by Asians and Hispanics, and-at substantially lower levels-blacks. Large overall differences exist between city and suburban locations; yet the gap between whites and others is consistently lower in the suburbs than in the cities of these five metropolitan regions.

Humans↗
PubMedDate not supplied

Personal NO2 exposures of preschool children in Helsinki.

Weekly personal NO2 exposures of 246 children aged 3-6 years were measured with Palmes tubes during 13 weeks in winter and spring in 1991. Measurements were made in eight day-care centers in the downtown and suburban areas of Helsinki, Finland. At the same time, inside and outside NO2 concentration of the day-care centers and the ambient air fixed site measurements were conducted. Palmes tubes were found to be applicable for NO2 exposure measurements of preschool children, but rather high sample losses could be expected. The geometric mean of personal NO2 exposure levels of 13-week period was 26.5 micrograms/m3 in the downtown and 17.5 micrograms/m3 in the suburban area. Gas stove and smoking at home increased significantly personal exposure to NO2. The weekly population NO2 exposure correlated rather poorly with the fixed site ambient air NO2 levels (R2 = 0.37), but much better with the NO2 levels inside and outside the day-care centers (R2 = 0.88 and 0.86). In the suburban and downtown groups the between children variations in the NO2 exposures were only 14% and 28% of the total variations, which were dominated by the within child variation. Stationary measurements at the ambient air fixed sites and inside and outside the day-care centers explained the variation in personal exposures of the children well during the spring, but not during the winter. A regression model, where data from outside day-care center measurements, fixed ambient air monitors, residential area and home characteristics (i.e., gas stove, smoking inside at home, type of dwelling) were included, explained 32% of the personal NO2 exposure variation in winter and 67% in spring. In the absence of personal exposure measurements, both stationary measurements and questionnaire information are useful in estimating variations in personal exposures.

Air Pollution, Indoor↗
PubMed1994

A gradient relationship between low birth weight and IQ at age 6 years.

OBJECTIVE: To test for a suspected adverse effect of low birth weight (< or = 2500 g) on IQ at age 6 years in two socioeconomically disparate populations. DESIGN: Nonconcurrent prospective study. SETTING: An urban, predominantly disadvantaged population and a suburban middle-class population in southeastern Michigan. PARTICIPANTS: Low-birth-weight (N = 473) and normal-birth-weight (N = 350) subjects, randomly selected from the 1983 through the 1985 newborn lists of two major hospitals, one serving an urban and the other a suburban population. MAIN OUTCOME MEASURES: The Wechsler Intelligence Scale for Children-Revised to measure IQ. RESULTS: The mean full-scale IQ of low-birth-weight children was 4.9 points lower than that of normal-birth-weight children, controlling for population site, maternal IQ, maternal education, and race (95% confidence interval [CI], 3.0 to 6.8). There was no evidence of low-birth-weight interaction with population site, and the same IQ difference was detected in both populations. In the urban population, low birth weight was associated with an increased risk for IQ below 85 (odds ratio, 2.2; 95% CI, 1.3 to 3.7). In the suburban population, low birth weight was associated with an increased risk for IQ below 100 (odds ratio, 2.0; 95% CI, 1.2 to 3.4). A gradient relationship with full-scale IQ was observed, with the largest deficit in those born weighing 1500 g or less, an intermediate deficit in those born weighing 1501 through 2000 g, and the least pronounced deficit in those born weighing 2001 through 2500 g. CONCLUSIONS: The overall effect of low birth weight represents an increase of approximately 10% of low-birth-weight children with an IQ of more than 1 SD below the population's mean. Children born weighing 2000 g or less bore the major burden of the IQ deficits.

Child↗
PubMed1988

Epidemiology of Wuchereria bancrofti in Leogane, Haiti.

A survey for Wuchereria bancrofti in Leogane, Haiti, revealed that 140 of 421 individuals (33%) had a patent infection, of which 40% lived in the suburban outskirts of the city. The median microfilaria density was 19.1 per 20 mm3 of blood for suburban dwellers compared with only 8.8 for those living in the city. The vector, Culex quinquefasciatus (Say), breeds mostly in and around numerous rum distilleries, located exclusively around the periphery of the city, and this undoubtedly accounts for the higher prevalence and intensity of infection among suburban dwellers.

Adolescent↗
PubMed1990

Dogs, distemper and osteitis deformans: a further epidemiological study.

There is extensive evidence linking paramyxoviruses, notably measles and respiratory syncytial virus, with Paget's disease of bone. The epidemiology of Paget's disease does not fit with that of known human paramyxovirus infections and it is possible that the disease is a zoonosis with domestic animals acting as host. Canine distemper, a paramyxovirus of the morbillovirus family (closely related to measles) is therefore a potential candidate. We have surveyed previous pet ownership in 150 Paget's patients each of whom was matched with two general practice controls; one from an inner city practice and the other from a suburban practice both in Greater Manchester. Recall of previous dog ownership was higher in Paget's patients with differences being more marked against inner city than suburban controls. 88% of the patients had lived in the same household as a dog at some stage compared with 79% of the inner city controls (P less than 0.05) and 83% of the suburban controls (n.s.). The differences were greater in the years 1930-60 during which the proportion of patients owning dogs was largest. For Paget's patients and controls alike, recalled exposure to dogs with canine distemper appeared to cluster in certain periods between 1930 and 1960. Unexpectedly, significantly more (7 out of 22, P less than 0.01) of the patients with a known first degree relative suffering from Paget's disease had no previous history of dog ownership when compared with the other patients (10 out of 128).

Adult↗
PubMed1994

Exposure of bus and taxi drivers to urban air pollutants as measured by DNA and protein adducts.

Urinary 1-hydroxypyrene, lymphocyte DNA adducts, serum protein-bound PAH and hemoglobin-bound alkene adducts were analysed from 4 groups of non-smoking men: urban and suburban bus drivers, taxi drivers and suburban controls. The only differences between the groups were in DNA adducts between suburban bus drivers and controls, and in DNA adduct and plasma protein PAH-adducts between taxi drivers and controls.

Air Pollutants↗
PubMed1994

ED security: a national telephone survey.

To determine current practices regarding security measures in the emergency department (ED), a random sample of 250 hospitals with EDs was surveyed by telephone. Security issues addressed included personnel (in-house security, contract guards, or police), hours of staffing in the ED, how security is armed, whether ED doors are locked at off-hours, and whether alarm buttons, direct phone lines, a paging code, closed circuit surveillance, metal detectors, and seclusion rooms are used. This information was stratified according to hospital size, ED census, rural/suburban/urban setting, teaching/nonteaching status, and region. Generally, on-site security presence increases with increasing hospital size and ED census, suburban and urban locations, and teaching status. Small, rural hospitals are more likely to lock the ED doors at off-hours, whereas the use of security codes does not clearly follow demographic trends. Larger hospitals in suburban and urban settings and having a teaching status are more likely to have secure/detention rooms and closed circuit surveillance. The use of alarm buttons and/or direct telephone lines varies widely, but is generally more common in larger, teaching hospitals, located in urban and suburban settings.

Bed Occupancy↗
PubMed1997

The seroprevalence of the rubeola antibody in a prenatal screening program.

OBJECTIVE: To evaluate the seroprevalence of the rubeola (measles) antibody in several obstetric populations. METHODS: In this cross-sectional study, women presenting for prenatal care underwent measurement of antibodies to the rubeola virus. The study population presented for care at either an urban medical center (group I) or a suburban medical center (group II). These groups were divided further into those receiving care in a resident-supervised clinic (A) and those in a private-practice setting (B). RESULTS: A total of 768 women were tested. Seventy-five (9.8%) women had rubeola antibody titers less than or equal to 0.13 and were classified as seronegative. The lowest percentage of seronegative women (3.2%) was found at the urban resident-supervised clinic site. The highest percentage of seronegative women (20.5%) was found in the suburban resident-supervised clinic site. Women classified as seronegative were younger, with a mean age of 25.0 years. No significant difference was observed based on gravidity, parity, or care received in an urban versus suburban private-practice setting. CONCLUSION: We suggest that an appreciable number of women presenting for prenatal care may lack antibodies to the rubeola virus. In the interest of personal and public health, populations believed to be at risk may benefit from ongoing surveillance of immune status and appropriate vaccination. Additional study is necessary to define best those groups that would benefit from surveillance and vaccination.

Adult↗
PubMed2002

A neural-network-based classification scheme for sorting sources and ages of fecal contamination in water.

Artificial neural networks (ANNs) were successfully applied to data observations from a small watershed consisting of commonly measured indicator bacteria, weather conditions, and turbidity to distinguish between human sewage and animal-impacted runoff, fresh runoff from aged, and agricultural land-use-associated fresh runoff from that of suburban land-use-associated-fresh runoff. The ANNs were applied in a cascading, or hierarchical scheme. ANN performance was measured in two ways: (1) training and (2) testing. An ANN was able to sort sewage from runoff with < 1% error. Turbidity was found to be relatively unimportant for sorting sewage from runoff, while gross measurements of gram-negative and gram-positive bacteria were required. Predictions clustered tightly around the known values. ANN classification of aged suburban runoff from fresh, and agricultural runoff from suburban was accomplished with > 90% accuracy.

Agriculture↗
PubMed2000

Trouble sleeping and anxiety/depression in childhood.

The purpose of this report was to estimate the association between children's trouble sleeping and anxiety/depression at ages 6 and 11, cross-sectionally and prospectively. Data come from a study of the psychiatric sequelae of low birth weight (LBW: <2500 g). LBW and normal birth weight children were randomly selected from the 1983-1985 newborn lists of an urban and a suburban hospital. Eight hundred and twenty-three children participated at age 6 and, of those, 717 (87.1%) participated at age 11. Achenbach's Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) were used to obtain ratings of psychiatric problems. The CBCL asked if the child had trouble sleeping during the past 6 months. Children with trouble sleeping had significantly increased odds of anxiety/depression based on mothers' reports (OR=6.9, 95% CI 4.1-11. 4) but not teachers' reports (OR=1.1, 95% CI 0.4-2.7). There was a greater association between sleep and depression at age 11 than at age 6, and among suburban than among urban children. These findings remained when adjusted for birthweight, sex, and mother's history of major depressive disorder. Profile analysis indicated a stronger association of trouble sleeping with anxiety/depression than other psychiatric problems. The association of trouble sleeping at age 6 with incidence of depression at age 11 was not statistically significant (suburban children RR=2.22, 95% CI 0.53-9.23; urban children RR=0.92, 95% CI 0.20-4.18).

Anxiety↗
PubMed1995

Alcohol-related injuries among adolescents in the emergency department.

STUDY OBJECTIVE: To determine the frequency of positive alcohol readings in adolescent patients presenting for treatment of injury. DESIGN: Patients aged 10 through 21 years were prospectively enrolled in this descriptive study. Demographic data and information about the injury were collected at enrollment. Blood ethanol concentration was measured with a saliva alcohol assay with a lower detection limit of 10 mg/dL (2 mmol/L). SETTING: Enrollment was conducted at four emergency departments, an urban trauma center, an urban children's trauma center, a suburban hospital, and a rural hospital. Enrollment at each facility was conducted during two 24-hour periods for every day of the week (14 days total). Consecutive sampling was used during each enrollment period. RESULTS: We enrolled 295 patients (92% of eligible subjects). Sixty-three percent were male; 74% were white, 19% black, 3% Hispanic, 1% Asian, and 3% from other racial groups. The mean age was 15.6 +/- 3.2 years. Fifteen patients (5%) tested positive for ethanol (range, 10 to 120 mg/dL [2 to 24 mmol/L]). Only four of these patients underwent ethanol testing as part of their medical evaluations. Of the 125 subjects aged 17 through 21 years, 14 (11.2%) tested positive for ethanol. Hospital distribution was (number of patients with positive ethanol test results): urban trauma center, 8 of 52; urban children's trauma center, 0 of 91; suburban hospital, 4 of 111; rural hospital, 3 of 41. The highest percentage of positive ethanol test results was found at the urban trauma center, where 15% of total subjects and 22% of subjects aged 17 through 21 tested positive. Injuries related to assaults and motor vehicle crashes were particularly associated with alcohol use. CONCLUSION: Alcohol is associated with injuries in urban, suburban, and rural settings in the older pediatric population. Alcohol use is underrecognized and should be considered in patients presenting with injuries, especially victims of assaults or motor vehicle crashes.

Adolescent↗
PubMed2000

Expanded school mental health services: assessing needs related to school level and geography.

We surveyed 62 school administrators from three midatlantic (MD, VA, WV) and one northeastern (CT) state on factors relevant to developing school-based mental health programs. Administrators were from schools that varied on education level (elementary, middle, and high) and geographic location (urban, suburban, and rural), with equivalent numbers in each subgroup. Administrators provided ratings to questions grouped in five categories: (a) Stressful Conditions, (b) Internalizing Behavioral Problems, (c) Externalizing Behavioral Problems, (d) Substance Abuse, and (e) Barriers to Mental Health Care, and provided open-ended comments on needs of youth and mental health programs for them. They rated behavioral and substance abuse problems as progressively more serious as students advanced in school level. Urban youth were reported to encounter higher stress and present more severe internalizing problems than suburban or rural youth. Suburban and rural schools provided more health and mental health services than urban schools. Across geographic locales, physical health services far outnumbered mental health services. Findings related to barriers to mental health care, and the viability of schools as delivery sites for comprehensive mental health services, are discussed.

Adolescent↗
PubMed2003

Prevalence of antibodies to spotted fever group rickettsiae in the region of Split (southern Croatia).

The prevalence of IgG antibodies to spotted fever group rickettsiae (SFG) was investigated by the indirect immunofluorescence assay in a sample of 1207 healthy residents of the central part of southern Croatia (eastern coast of Adriatic Sea). Sera obtained from subjects living in three different places of residency (urban, suburban and rural environs of the region) were tested. Overall 528 (43.7%) persons had significant antibody titers (1:40 or higher), with a significantly higher prevalence in suburban and rural areas. The results show that inhabitants in the area are clearly being exposed to SFG rickettsiae. Risk factors significantly associated with seropositivity to SFG rickettsiae were: living in suburban and rural settlements (odds ratio [OR] = 1.81; 95% confidence interval [CI] = 1.35-2.4), contact with animals (OR: 1.52; 95% CI: 1.15-1.99), and increase of age (OR: 1.18; 95% CI: 1.09-1.26).

Adolescent↗
PubMed1990

Effects of decisional control and work orientation on persistence in preventive health behavior.

Examined persistence in the daily use of fluoride mouthrinse among adolescents as a function of an induced-choice manipulation concerning self-management strategies and freedom to participate in the program. Seventh-grade boys and girls from urban and suburban schools were randomly assigned to a series of either high- or low-choice decisional control manipulations; their daily, home use of fluoride was monitored over a 20-week period. In order to ameliorate the relatively lower persistence rates found previously among suburban (vs. urban) students, all students were given self-management and action instructions as per previous studies. Although suburban students still declined in persistence relative to urban students, female students who received high choice persisted at a higher rate than girls who received low choice. Boys, for the most part, were unaffected by the manipulation. In addition, students' self-reported work orientation was also positively associated with persistence.

Adolescent↗