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Prevalence of diabetes in a suburban population of Bangladesh.

To determine the prevalence of diabetes and hypertension, 6847 subjects of age 15 years or older, were investigated in a suburban population in Bangladesh. Fasting and post-prandial (capillary) blood glucose (2-hPG) was estimated. According to WHO criteria the crude prevalence of impaired glucose tolerance (IGT) was 7.5% and non-insulin-dependent diabetes mellitus (NIDDM) was 4.1%. The age standardized (30-64 years) prevalence of IGT was 7.7% with 95% confidence interval (CI) 6.96-8.44 and NIDDM was 4.5%, CI 3.94-5.12. Compared with the younger subjects the older subjects (< 40 vs. > or = 40 years) showed significant association with IGT (chi2, 65.9; P < 0.001) and NIDDM (chi2, 92.0; P < 0.001). Higher BMI (< or = 22.0 vs. > 22.1) was also significantly associated with IGT (chi2, 16.6; P < 0.001) and NIDDM (chi2, 83.9; P < 0.001). The higher BMI had stronger association with NIDDM than with IGT. Lower height showed significant association only with NIDDM. The logistic regression analyses also showed that increased age, higher BMI and short stature were independent risks for NIDDM. The study showed an increased prevalence of IGT and NIDDM among the suburban population of Bangladesh and the excess risk was observed with increased age, higher BMI and short stature.

Adolescent↗

Room-specific characteristics of suburban homes as predictors of indoor allergen concentrations.

BACKGROUND: Room characteristics predicting indoor allergen exposure in suburban homes have not been clearly identified. OBJECTIVE: To examine relationships between room characteristics and concentrations of indoor allergens in homes of suburban asthmatic patients. METHODS: The homes of 339 asthmatic children ages 6 to 17 years were studied. Home inspections were conducted by a trained technician, and dust samples were analyzed for indoor allergen content. A high allergen concentration was defined as 8 microg (U)/g or more of fine dust. RESULTS: Infrequent sheet washing and wall-to-wall carpet were risk factors for high bedroom dust mite concentrations. Infrequent sheet washing was also a risk factor for high Fel d 1 concentrations. Food remains in the bedroom was a risk factor for high bedroom Bla g 1 levels, and exposed food, leaks, and dirty pots were all risk factors for high kitchen Bla g 1 levels. The combination of lack of mattress or pillow encasements, infrequent sheet washing, and carpeting was associated with a 24-fold increase in odds of a high dust mite concentration (odds ratio [OR], 24.1; 95% confidence interval [CI], 3.2-181.4). Among non-cat owners, the combination of stuffed toys on the bed, lack of mattress or pillow encasements, and infrequent sheet washing was associated with a 49-fold increase in odds of a high Fel d 1 level (OR, 49.4; 95% CI, 2.8-887.3). The combination of leaks, exposed food, and dirty pots was associated with a high kitchen Bla g 1 concentration (OR, 10.6; 95% CI, 2.8-40.5). CONCLUSIONS: Specific room characteristics predict high indoor allergen exposure among children with asthma, and a combination of these characteristics may further increase the risk of high allergen exposure.

Adolescent↗

Tests on the centrifugal flotation technique and its use in estimating the prevalence of Toxocara in soil samples from urban and suburban areas of Malaysia.

The influence of soil texture (silt, sand and laterite) and flotation solutions (saturated NaCl, sucrose, NaNO3, and ZnSO4) upon the recovery of Toxocara ova from seeded soil samples with the centrifugal flotation technique was investigated. Soil samples of different texture were artificially seeded with Toxocara spp. ova and subjected to a centrifugal flotation technique which used various flotation solutions. The results showed significant (P < 0.001) interactions between the soil types and the flotation solutions. The highest percentage of ova recovery was obtained with silty soil (34.9-100.8%) with saturated NaCl as the flotation solution (45.3-100.8%). A combination of washing of soil samples with 0.1% Tween 80, and flotation using saturated NaCl and a 30 min coverslip recovery period was used to study the prevalence of contamination of soil samples. Forty-six soil samples were collected from up to 24 public parks/playgrounds in urban areas of Petaling Jaya and suburban areas of Serdang. The prevalence of Toxocara species in the urban and suburban areas was 54.5% and 45.8% respectively.

Animals↗

Accuracy of a priority medical dispatch system in dispatching cardiac emergencies in a suburban community.

INTRODUCTION: Over-triage of patients by emergency medical services (EMS) dispatch is thought to be an acceptable alternative to under-triage, which may delay how quickly life-saving care reaches a patient. Previous studies have looked at advanced life support (ALS) misutilization in urban- and county-based EMS systems and have attempted to analyze how dispatch methods either contribute to or alleviate this problem. OBJECTIVE: The purpose of this study is to assess the relationship between dispatches of a cardiac nature in a Medical Priority Dispatch (MPD) system, and the actual clinical diagnosis as determined by an emergency department physician. METHODS: Calls for emergency medical assistance in a suburban community outside of a major metropolitan area were surveyed over a three-month period. Medical Priority Dispatch protocols determined that 104 of these calls were cardiac-related. Of these emergency calls, 56 (53.8%) patients were transported to the local community hospital and treated by the emergency physician. A retrospective review of the medical records was conducted to determine whether the patient had a cardiac-related discharge diagnosis from the emergency department. RESULTS: Sixteen (28.6%) of the patients in this cohort were diagnosed with a cardiac-related condition upon discharge from the emergency department. Forty (71.4%) were diagnosed with a non-cardiac-related condition. The positive, predictive value of the dispatch protocol for the detection of an actual cardiac emergency in this EMS system was 28.6%. CONCLUSION: In this suburban community, the MPD system may over-triage emergency medical responses to cardiac emergencies. This can result in the only ALS (paramedic) unit in the community being unavailable in certain situations. Future studies should be conducted to determine what level (in any) of over-triage is appropriate in EMS systems using a MPD system.

Cardiac Output, Low↗

Compound class specific 14C analysis of polycyclic aromatic hydrocarbons associated with PM10 and PM1.1 aerosols from residential areas of suburban Tokyo.

Compound class specific radiocarbon analysis (CCSRA) was performed for polycyclic aromatic hydrocarbons (PAHs) associated with airborne particulate matter (APM) with diameter <10 microm (PM10) and <1.1 microm (PM1.1) collected from a residential area of suburban Tokyo, Japan, and seasonal and particle-size radiocarbon variations were investigated. Source diagnostic isomer pair ratios indicated mixed contributions from petroleum combustion and from biomass and coal combustion to the PAHs in APM. The delta14C- PAHs in APM, ranging from -787 to -514 per thousand, indicated dominance of fossil fuel combustion. The delta14C of 5-6 rings (HMW) PAHs were higher than the 3-4 rings (LMW) species in both PM10 and PM1.1 samples. The delta14C of HMW-PAHs indicated greater biomass-burning contributions in summer than in winter and no apparent particle-size variation. Conversely, the delta14C of LMW species showed a greater contribution from fossil sources in summer and in larger particles (PM10). This finding could be tentatively attributed to the recondensation of fossil-PAHs vaporized from petroleum sources. A 14C isotopic mass balance approach estimated that biomass burning contributes 17-45% of the PAH burden in suburban Tokyo, and that the increase in the biomass-PAH accounts for approximately 27% and 22% of winter-time elevation of LMW- and HMW-PAHs, respectively. These are far exceeding what is expected from the emission statistics for CO2 and combusted materials in Japan and emphasizing the importance of biomass-burning as a source of PAHs; which, in turn, demonstrates the utility and the significance of field-based source assessment by using CCSRA for an effective regulation of atmospheric pollution by PAHs.

Aerosols↗

Accessibility of cigarettes to minors in suburban Cook County, Illinois.

This study assessed the problem of under age sale of cigarettes, educated vendors about the law restricting the sale of tobacco to minors, and determined the effectiveness of a vendor education intervention. Twenty-one teen volunteers, 14 to 17 years in age, attempted to purchase cigarettes in suburban Cook County from over-the-counter merchants and vending machines. Of the 347 vendors that were checked, the minors were successful in 37.2% of their attempts to purchase cigarettes. After information was sent to each vendor about the State of Illinois law, follow up visits were made to all the vendors who were willing to sell cigarettes to the minors during the first visits. Approximately 50% of the vendors were again willing to sell cigarettes to minors. This study's findings suggest that minors can easily purchase cigarettes in suburban Cook County. The education intervention component of the study had a limited but promising effect on compliance rates of the vendors.

Adolescent↗

Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non-lead-exposed suburban populations in the United States.

Measurements of lead (Pb) in bone reflect cumulative Pb exposure, whereas blood Pb levels are indices of absorption during the previous 21-30 days. This study was undertaken to estimate bone Pb concentrations by L-line x-ray fluorescence (LXRF) in a United States suburban population which was exposed to unusually high levels of Pb in emissions from an adjacent factory during 1963-1981, compared with concentrations similarly estimated in a matched suburban community without unusual Pb exposure. The mean bone Pb value in 269 residents of the highly exposed suburb (15 ppm) was 3-fold greater than that of the reference suburb (5 ppm). LXRF estimates of bone Pb identified those individuals at risk for adverse effects of Pb, whereas blood Pb levels were uninformative. Average LXRF-estimated bone Pb concentrations in residents of the unusually exposed suburb approximated estimated values in workers at Pb-processing factories.

Adolescent↗

Health risk behaviors among adolescents attending rural, suburban, and urban schools: a comparative study.

This study describes differences in health risk behaviors among 2,017 adolescents attending rural, suburban, and urban school districts in upstate New York. Differences in risk behaviors regarding use of tobacco, alcohol, and illegal substances; sexual activity; and carrying weapons were analyzed. A consistent pattern emerged from the analysis of the data, with rural students at most risk. The findings reinforce the need to focus on the relationship between residence and health risk behaviors, so that intervention programs specific to the needs of rural, suburban, and urban adolescents can be developed.

Adolescent↗

Seroprevalence of herpes simplex virus-2 in suburban primary care offices in the United States.

OBJECTIVE: The objective of this study was to estimate herpes simplex virus-2 (HSV-2) seroprevalence from a weighted sample of adults attending relatively affluent, suburban primary care physician (PCP) offices. GOAL: Many PCPs in relatively affluent areas do not believe national estimates of HSV-2 seroprevalence are representative of their patient populations. This study aimed to measure HSV-2 seroprevalence in these patient populations. STUDY DESIGN: We conducted a cross-sectional study with approximately 5400 individuals aged 18 to 59 years. Individuals were recruited at 36 PCP offices in 6 U.S. cities and tested for HSV-2 using Focus enzyme-linked immunosorbent assay. A computer-assisted questionnaire was used to assess risk behaviors associated with genital herpes. RESULTS: Among 5452 individuals who provided an analyzable blood sample, the overall weighted HSV-2 seroprevalence was 25.5% (95% confidence interval, 20.2-30.8%). Only 11.9% of HSV-2-seropositive patients reported a history of genital herpes. CONCLUSIONS: Results illustrate the need for greater suburban PCP and patient awareness of the high HSV-2 seroprevalence in this setting.

Adolescent↗

Prevalence of smokers and nicotine-addicted patients in a suburban emergency department.

OBJECTIVE: To define the prevalence of smokers and nicotine-addicted patients in a suburban, community ED. METHODS: This was a prospective survey of consecutive ED patients seen in a suburban ED with an annual patient census of 48,000. Medically stable patients aged 18 years or older were eligible for inclusion. Patients were excluded if they had predominantly psychiatric complaints or were critically ill. Patients were queried about their smoking habits by a closed-question survey, which included the previously validated Fagerstrom Test for Nicotine Dependence. The study was conducted during a six-week period, only at times when there were dedicated research associates available to ensure consecutive patient entry. Continuous variables were analyzed by Student's t-tests. Clinical variables were analyzed by chi-square tests. All tests were two-tailed with alpha at 0.05. RESULTS: 1,515 patients comprised the study group. The mean age (+/-SD) was 45.6 (+/-18.9) years; 52% were female, 25% were nonwhite, and 47% were college graduates. There were 317 (21%) smokers. Patients having private physicians were less likely to smoke (18% vs 29%, p = 0.001). Of all smokers, 46% were moderately to severely nicotine-dependent, 69% wanted to quit, and 30% expressed an interest in joining a smoking cessation program. CONCLUSION: A substantial percentage of ED patients smoke, many of them are nicotine-addicted, and the majority would like to quit. Randomized, controlled trials are needed to determine whether interventions by physicians in the ED can have an impact on the smoking habits of these patients.

Adult↗

Medically attended injuries among young children: observations in a suburban area. 1964.

A control study of the effect of public health education on the rate of accidental injuries among children under 7 years of age in a newly developing suburban area provided an opportunity to gain an insight into the nature and extent of the accident problem itself during a one year baseline period preceding the educational phase of the study. An accident was arbitrarily defined as any actual or presumed trauma following an incident for which direct medical or dental attention was obtained. Data were gathered through regular visits of data collectors to physicians, dentists, and hospitals in the area. An annual accident rate of 124 per 1000 children under 7 years of age was found. Two or more accident occurred to 10% of the children. The highest injury rate by age (179 per 1000 children) was found among 2 year old children, with the rate amount 2 year old boys 75% higher than any other age-sex group. The possible relationships of suburban living to the type and location of accidents by age and sex and to the variation in accidents by day of week are also presented.

Accident Prevention↗

Genetics and congenital malformations: interpretations, attitudes and practices in suburban communities and the shamans of ecuador.

OBJECTIVES: The purpose of the present article was to evaluate how shamans and the suburban communities of Quito interpret the terminology used in genetics. METHODS: One hundred people living in 5 suburban districts of Quito were surveyed as well as 19 shamans of the Salasaca community. RESULTS: The results show that members of both groups are little informed about genetics. As knowledge about genetics is correlated to educational level, which is very poor in both groups, knowledge and understanding of genetics are either very basic or nonexistent. As for the medical practices in treating genetic alterations, the surveys show that while in very severe cases scientific medicine is sought, in most cases explanations and a cure are given by shamanic medicine. CONCLUSION: There is limited knowledge of genetics and its terminology in the study population. Shamanic and marginal health practices seem to remain prevalent in these communities due to their low costs, the personal attention the individuals receive, and the holistic point of view employed. It is important that the community councils, the medical doctors and the shamans work together to set up community programs on medical education, particularly on genetics.

Adolescent↗

Patterns and correlates of substance use among affluent, suburban high school students.

Despite ongoing concern about substance use during adolescence, very little is known about alcohol and drug use among teens living in affluent social settings. In this longitudinal study, cluster analysis was used to characterize patterns of substance use and change in other dimensions of psychosocial adjustment within a cohort of 292 high school students (54% girls) living in an affluent, suburban community. When compared with a cluster of students reporting minimal use, clusters reporting escalating, declining, and persistently high use consistently demonstrated relatively poorer psychosocial adjustment. Moreover, other dimensions of psychosocial adjustment remained relatively stable despite changes in substance use, and there were relations involving substance use and other aspects of psychosocial adjustment that may be specific to this social setting. The findings highlight the need for preventive intervention grounded in a clear understanding of developmental process occurring within populations of affluent, suburban teens.

Achievement↗

[Structural analysis of users' needs from a community pharmacy related to home care in a suburban area].

OBJECTIVES: To clarify the needs of home care service users needs from a community pharmacy and the functions related to home care in a suburban area. METHODS: A questionnaire on pharmacy services and functions was submitted to 472 home care service users in a suburban area. Gender, age, family status, presence of carers, health condition, home care services being used, prescription and pharmacy utilization status, presence of family pharmacy, and recognition of the need for drug management guidance by home visiting pharmacists were surveyed as well as the users' needs from a community pharmacy and its functions. Using these results, principal component analysis was performed. RESULTS: It was found that the users had a great need for the following services and functions: adequate medication instruction, listening attentively to users, and a good attitude from pharmacists and clerks. Meanwhile, the users' need for home care related services was relatively low, i.e. counseling about home care and welfare services, provision of a home visiting service, and provision of home care supplies. Also, principal component analysis indicated that users' needs consisted of five components, viz, medical services, material supply, convenience, readiness of service provision, and consideration of privacy. Regarding home care related services, counseling about home care and welfare services was related to the medical services; provision of home care supplies was related to the material supply; provision of a home visiting service was related to convenience. CONCLUSIONS: It was shown that users did not clearly recognize a service need for home care services as a new function of community pharmacies. Rather, users recognized the need for home care services connected to these already provided by community pharmacies. Therefore, information provision and education are necessary so that users can clearly understand the details and merits of the home care services which community pharmacies provide.

Aged↗

[General practitioner's recognition of service cooperation with community pharmacists related to home care in a suburban area].

OBJECTIVES: To clarify the factors affecting a general practitioner's demands and the recognition of service cooperation with community pharmacists related to home care in a suburban area. METHODS: A questionnaire on pharmacy services and functions was administered to 215 general practitioners in a suburban area. Gender, age, specialty, length of practice, status of home visiting, requests for community pharmacists, awareness of a home visiting service by community pharmacists, status of issues about home visiting orders to community pharmacists and the criteria for deciding to issue an order, recognition of the necessity of a home visiting service by pharmacists, expectation value to the community of the pharmacists' participation in the home care service and requests, recognition of cooperation with other home care related professions, ease of cooperation with community pharmacists, disincentives for cooperation with community pharmacists, factors necessary to promote cooperation between practitioners and community pharmacists, and factors necessary to promote the home care system were surveyed. Using the results, chi 2 test and principal component analysis were performed. RESULTS: It was found that the general practitioners' main demands were support and management of pharmaceutical therapy. Meanwhile, the practitioners' low cognition of pharmacists' home visiting seemed to be one disincentive to cooperation with pharmacists. Every practitioner who had issued visiting orders to pharmacists practiced home visiting and issued the visiting orders based on patients' condition at home. Practitioners who practiced home visiting were more active in promoting the home care system and had a better cognition and more extensive demands for pharmacists' home visiting compared to practitioners with no home visiting. Practitioners with good recognition of cooperation with community pharmacists had better cognition, realized the necessity of, and expected pharmacist's home visiting compared to practitioners with low awareness. However, practitioners' overall recognition of cooperation with pharmacists was relatively low. As disincentives, practitioners pointed out lack of acquaintance, the unclear function of pharmacists, and no opportunity for cooperation. So, enhancing practitioners' awareness of home care, clarifying the pharmacist's role, establishing a relationship of mutual trust through information feedback and/or exchange based on practice would be effective in promoting service cooperation with community pharmacists.

Adult↗

Bongs and blunts: notes from a suburban marijuana subculture.

Bongs and blunts constitute significant elements of marijuana consumption in the United States, especially among youth. The author draws upon ethnographic methods to provide rich descriptions of these practices amongst a network of suburban marijuana users. The author first provides a description of bong use in a suburban home prior to detailing the same youth network engaging in the process of rolling and smoking a blunt in a public environment. Ultimately, the author examines and contrasts these two features of American marijuana consumption.

Adolescent↗

Spatial analysis of Aedes albopictus (Diptera: Culicidae) oviposition in suburban neighborhoods of a Piedmont community in North Carolina.

Temporal and spatial distribution of egg-laying by Aedes albopictus (Skuse) (Diptera: Culicidae) was investigated in suburban neighborhoods in Raleigh, NC, by using oviposition traps (ovitraps) at fixed sampling stations during the 2002 and 2003 mosquito seasons. Variations in the phenology of oviposition between the two mosquito seasons resulted from differences in the patterns and amounts of rainfall early in the season. Aerial images of each study neighborhood were digitized, and the proportions of specific types of land cover within buffer zones encompassing ovitraps were estimated. Retrospective analyses showed that in some neighborhoods, oviposition intensity was significantly associated with specific types of land cover. However, in general, it seemed that gravid Ae. albopictus searched throughout the landscape for water-filled containers in which to lay eggs. Peridomestic surveys were carried out concurrently with ovitrap collections to estimate production of Ae. albopictus pupae in discarded water-filled containers and the abundance of females in vegetation that made up the resting habitat. Results of linear regression analyses indicated that the mean standing crop of pupae (total and per container) per residence was not a significant predictor of mean egg densities in ovitraps. However, the mean standing crop of adult females was a significant but weak predictor variable, because the magnitude and sign of regression coefficients varied between neighborhoods. Linear spatial regression analyses revealed that oviposition intensity was not spatially dependent on pupal standing crop or the numbers of pupae-positive containers distributed peridomestically. However, a weak spatial dependence on the standing crop of adult females was found in some neighborhoods. Based on spherical variogram models, kriging was carried out to predict the spatial patterns of oviposition in suburban neighborhoods. Focal areas of high and low oviposition intensity were evident in most neighborhoods; however, the spatial patterns of oviposition changed between mosquito seasons. Kriging predictions were evaluated, using cross-validation, by systematically removing each data point from our data set and predicting the removed point by using the remaining points. The root mean square (standardized) error values of best fitting variogram models approximated 1, and plots of standardized PRESS residuals showed no distinct pattern for most neighborhoods, indicating that predictions of the spatial distribution of oviposition intensity were valid. Spherical variogram models are a satisfactory method for describing the spatial distribution of Ae. albopictus oviposition, and kriging can be a useful technique for predicting oviposition intensity at locations that have not been sampled.

Aedes↗

Nutritional factors, parasite infection and allergy in rural and suburban Vietnamese school children.

Urban areas often have more allergy than rural areas. Dietary patterns and parasite infection have been suggested as possible related factors. This study evaluated the prevalence of allergy in school children in one rural and suburban area of Vietnam where parasite infection is common. A total of 195 children aged 9 to 13 years old completed a self-administered allergy questionnaire and provided blood and stool samples for analysis. Nutritional status, dietary intake and parasite infection were determined in all participants. Allergy was more common in girls (10.7% vs. 7.6%), suburban children (11.8% vs. 6.9%), children with weight-for-age (16.7% vs. 6.0%) and height-for-age (14.8% vs. 4.9%) in the 10th to 75th percentile compared to <3rd percentile, and in children without trichuriasis compared to light trichuriasis (12.5% vs. 9.3%), although none of these comparisons were statistically significant. Logistic regression adjusted for sex, age and area of residence revealed no association between allergy and nutritional status, food intake or parasite infection. Intake of riboflavin, however, was negatively associated with allergy (OR=0.00, 95% CI:0.00-0.65, p=0.038). In conclusion, we were unable to detect any association between allergy and nutritional status, diet, or parasite infection. However, in a population with high undernutrition and parasite infection, the prevalence of allergy was low and the extremely low intake of riboflavin was associated with a higher risk of allergy.

Adolescent↗