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A statewide survey of domestic violence screening behaviors among pediatricians and family physicians.

OBJECTIVE: To assess rates of previous domestic violence (DV) training, current screening practices, and barriers to screening among Connecticut pediatric primary care physicians. DESIGN: Self-administered mail survey. SETTING: State of Connecticut. PARTICIPANTS: Pediatricians and pediatric care-providing family practice physicians (N = 903). RESULTS: The response rate was 49% (n = 438). The demographic characteristics of the response sample were as follows: 70% male, 76% older than 40 years, 84% white, 87% in private practice, and 64% in suburban practice. Only 12% of the physicians reported routinely screening for DV at all well-child care visits, 61% reported screening only selective patients, and 30% said they did not screen for DV at all. Sixteen percent of the physicians reported having an office protocol for dealing with victims of DV. Respondents practicing in an urban setting were significantly more likely to screen routinely for DV than those practicing in a suburban setting (odds ratio, 1.77; 95% confidence interval, 1.12-2.79). Prior DV training was the strongest predictor of routine screening (odds ratio, 5.17; 95% confidence interval, 3.13-8.56). In fact, respondents with previous training made up 64% of those who routinely screened for DV. CONCLUSIONS: Only a minority of Connecticut pediatric care physicians routinely screen mothers for DV. Primary care physicians with education and training about DV are screening at higher rates than physicians with no education and training. Pediatric physicians need training, protocols, and best-practice models on how to identify and intervene with families experiencing DV.

Adult↗

Bicycle-riding circumstances and injuries in school-aged children. A case-control study.

OBJECTIVE: To identify bicycle-riding circumstances associated with bicycle-related injury among school-aged children. DESIGN: Case-control. SETTING: One metropolitan emergency department and 3 suburban emergency departments. SUBJECTS: Consecutive sample of children aged 7 through 18 years who experienced bicycle-related trauma and control children seen for non-bicycle-related trauma (matched for age within 1 year, sex, and area of residence [urban vs suburban]). METHODS: Parents and case children were interviewed by telephone about the bicycle ride resulting in their visit to the emergency department. Parents and control children were interviewed about their most recent bicycle ride. The survey instrument addressed the following potential risk factors: helmet use, bicycle speed, road conditions, riding location, bicycle condition, an adult presence, riding destination, bicycle style, and stunt riding. RESULTS: Interviews were completed with 47 (73%) of 64 eligible case children and 42 (69%) of 61 control children with the following age distribution: 27 (30%) of the interviews were completed with children aged 7 to 9 years, 40 (45%) of the interviews were completed with children aged 10 to 14 years, and 22 (25%) of the interviews were completed with children aged 15 to 18 years. Fourteen children (16%) were wearing helmets. There was a high degree of agreement between parent and child responses, higher for case children than for control children. In univariate analyses, injury was associated with riding with other children (vs riding alone or with adults), riding fast or slow (vs normal speed), riding a BMX-style (motocross) bicycle (vs another standard or multispeed style bicycle), playing on the bicycle (vs going to school or other purposeful or nonpurposeful trip), and riding only on the sidewalk (vs in the street). More case children than control children were farther than 3/4 mile (> 1.2 km) from home (38% vs 19%, P = .05). Multiple logistic regression identified' slow riding speed (odds ratio, 10.3;95% confidence interval, 1.6-66.8), distance from home farther than 3/4 mile (> 1.2 km) (odds ratio, 3.7;95% confidence interval, 1.1-12.5), and riding on the sidewalk (odds ratio, 6.1;95% confidence interval, 1.8-20.5) as independent risk factors for injury. CONCLUSIONS: This study identifies 3 counterintuitive but apparently strong behavioral risk factors for bicycle injuries treated in an emergency department in children aged 7 through 18 years in the Chicago (III) area. These findings will need to be confirmed in larger samples from a wider range of locales. In addition to stressing the importance of wearing a helmet when riding a bicycle, it may be desirable to include the findings of this study in anticipatory guidance discussions with school-aged children.

Adolescent↗

Fine-Scale Landscape Genomics Show Asymmetric Patterns of Gene Flow for the Invasive Mosquito Aedes albopictus.

Mosquito-borne viruses like dengue, Zika, and chikungunya pose increasing health risks in the United States due to the expanding range of Aedes albopictus, a highly invasive mosquito species that now has a global distribution. Aedes albopictus thrive in artificial containers associated with anthropogenic land use, allowing populations to reach high numbers in urban and suburban environments. While the global spread of Ae. albopictus has been well characterized, the effects of heterogeneous urban landscapes on dispersal and gene flow at fine spatial scales remain unclear. This study analyzed the genetic connectivity of Aedes albopictus populations collected in Wake County, North Carolina in 2018. We used single nucleotide polymorphisms (SNP) data from double-digest restriction-enzyme associated DNA sequencing (ddRADseq) and examined genetic connectivity through principal component analysis (PCA) and genetic network analysis. We then evaluated migration and source-sink dynamics using a Bayesian approach for SNP data (BA3-SNP). We found little evidence of genetic clustering or isolated populations of Ae. albopictus in Wake County, suggesting high gene flow between sites. Migration analysis demonstrated asymmetric gene flow from rural to urban regions within Wake County, with greater gene flow occurring between and within urban regions. These findings suggest that the pattern of gene flow of Ae. albopictus populations within local metropolitan areas may involve urban city centers serving as genetic sinks and surrounding suburban and rural regions serving as sources. This study highlights how heterogeneous landscapes shape mosquito population connectivity and migration at fine spatial scales, which is critical for informing vector control and public health intervention strategies.

Aedes albopictus↗

Blood lead in Uruguayan children and possible sources of exposure.

Blood samples and questionnaire background data were collected from 96 children (age 2-14 years) living in urban, suburban, or rural areas with varying traffic intensity and industrial lead pollution in Uruguay. Spot samples of tap water were collected from the homes of 44 children, and samples of top soil were taken from seven areas. Samples of air-borne dust were collected in central and suburban Montevideo. Blood lead concentrations (B-Pb) in children ranged between 47 and 191 (mean 96) micrograms/L and exceeded in 36% of the children 100 micrograms/L, the intervention level adopted by the United States Centers for Disease Control. Lead in tap water ranged from 0.2 to 230 (mean 15) micrograms/L and exceeded in 39% of the samples the maximum level recommended by WHO, 10 micrograms/L. Lead pipes were used in parts of the water supply systems. Lead in air varied between different locations from 0.15 to 1.7 micrograms/m3, highest in the very center of Montevideo. The median soil lead ranged from 6 to 2100 micrograms/g and was highest in industrially polluted areas. At multiple regression analysis, B-Pb was significantly associated only with age (P = 0.032) and traffic intensity at school (P = 0.045). No significant impact on B-Pb of lead in water or soil could be established.

Adolescent↗

Children's judgments of event upsettingness and personal experiencing of stressful events.

Five-hundred and three urban and suburban 4th- to 6th-grade schoolchildren judged event upsettingness and reported the occurrence of 22 life events. Judgments of event upsettingness ranged considerably, some corresponding to, others differing from, adult judgments. Children reported experiencing an average of seven events during their lifetimes. Girls judged events to be more upsetting than boys, and fourth and fifth graders judged events to be more upsetting than sixth graders. Urban children reported having experienced more stressful events than suburban children, and sixth graders experienced more events than fourth graders.

Age Factors↗

A longitudinal study of the impact of a school heart health curriculum.

This paper presents the findings of a study testing the impact of the Chicago Heart Health Curriculum on the behavior and attitudes towards cardiovascular disease prevention of 325 sixth graders residing in rural, suburban and residential suburban, northeast Ohio regions. Using a pre-test/post-test control group experimental design, data were gathered with a Student Health Questionnaire testing self-reported attitudes and behaviors regarding heart disease factors, at three points in time: 1) Pre-test: before implementation of the Heart Health Curriculum; 2) Post-test: immediately following implementation; and 3) FOLLOW-UP: one year later. Using an analysis of variance procedure, treatment effects were evidenced for only one of the outcome variables, Heart Health Knowledge (F = 26.80, df = 2/638, p less than .00005). Results revealed that while the Chicago Heart Health Curriculum contributed to an increase in cardiovascular knowledge among the sixth graders tested, it did not affect attitudinal/behavioral preference change among the students.

Analysis of Variance↗

Psychiatric sequelae of low birth weight at 6 years of age.

The study examined the association between low birth weight (LBW) (< or = 2,500 g) and attention deficit hyperactivity disorder (ADHD) in two socioeconomically disparate populations. LBW and normal birth weight (NBW) children from the 1983 to 1985 newborn lists of an urban and a suburban hospital in Southeast Michigan were randomly selected. A total of 823 children, 473 LBW and 350 NBW, participated. Data were gathered in 1990 to 1992, when the children were 6 to 7 years of age. The National Institute of Mental Health Diagnostic Interview Schedule for children-Parent version (DISC-P) was used to elicit information on DSM-III-R diagnoses of simple phobia, overanxious, separation anxiety, oppositional defiant, and ADHD. Teachers' ratings of behavior problems were obtained. LBW was associated with ADHD but not with childhood anxiety disorders or oppositional defiant disorder. The association was stronger in the urban than in the suburban population. Data from teachers' ratings revealed an association between LBW and attention problems. The prognostic significance of the observed psychopathology at 6 years of age requires follow-up assessment as the children mature.

Attention Deficit Disorder with Hyperactivity↗

No secular increase in the prevalence of vertebral fractures due to postmenopausal osteoporosis.

We examined whether the prevalence of vertebral fractures in otherwise healthy, 70-year-old Danish women had increased during an interval of 10 years. The population-based epidemiological study included two age-matched groups of postmenopausal women. Group 1 consisted of 70-year-old women (n = 386) living in a defined area of suburban Copenhagen recruited in 1979 for an epidemiological study. Of the 285 women who were entered, 173 were judged healthy, without secondary causes of osteoporosis. Group 2 was recruited by sending questionnaires to all women aged 68-72 years living in the same area in 1989. Of the 512 women who attended a medical screening, 387 were found to be without secondary causes of osteoporosis and had a spinal radiograph. Radiographs of the thoracolumbar spine were assessed for vertebral fracture by five radiological methods. There was no significant difference between the two groups in the prevalence of vertebral fractures and the 95% confidence intervals overlapped completely in all methods. The prevalence rates varied by method from about 35% to more than 80% but the distribution of fracture types was similar in the two groups. We conclude that the prevalence of vertebral fractures due to postmenopausal osteoporosis has not increased since 1979 in otherwise healthy women residing in suburban Copenhagen, and that comparison of prevalences between studies requires that they use the same method of radiological assessment.

Aged↗

Antibodies to spotted fever group rickettsiae in dogs in Croatia.

The prevalence of IgG antibodies to spotted fever group rickettsiae was studied by the indirect immunofluorescent antibody assay in a sample of 194 canine sera from different parts of Croatia. Dogs (n = 141) from urban and suburban-semirural environs from the middle part of the eastern coast of Adriatic sea, and dogs (n = 53) from Zagreb, the capital of Croatia located in the northern continental part of Croatia, were tested. The total of 88 (62.4%) dogs from southern coastal Croatia had antibodies to Rickettsia conorii, with a significantly higher prevalence (69.9%) in suburban-semirural areas. The prevalence rate of antibodies to Rickettsia conorii in canine sera from urban environment in the north of Croatia was 20.7%. The results show that the members of spotted fever group rickettsiae are present in both coastal and continental Croatia.

Animals↗

Depressive symptoms amongst adolescent primary care attenders. Levels and associations.

BACKGROUND: Background High rates of depressive disorder have been documented amongst adolescents attending general practitioners (GPs) in urban areas. However, little is known about the associations of adolescent depression in primary care. METHOD: We completed a cross-sectional questionnaire survey of adolescents, their parents and general practitioners, following adolescent attendance at the surgery. RESULTS: We found high levels of depressive symptoms to be present in adolescent attenders of a broad range of social backgrounds. Depressive symptoms were associated with the following demographic and contextual factors: older age, female gender and parental psychiatric symptoms. They were also associated with the presence of physical symptoms causing psychosocial impairment, with health risks (use of cannabis and exposure to drugs) and with use of services (both primary care and mental health services). Levels of depressive symptoms were similar in urban and suburban groups. However, associations of depressive symptoms with smoking, exposure to drugs, cannabis use and primary care attendance were demonstrated in the suburban group and not the urban group. CONCLUSION: Adolescent GP attenders have high levels of depressive symptomatology. GP recognition and intervention should have the potential to impact on adolescent depression and on associated risks.

Adolescent↗

Food chain aspects of chlordane poisoning in birds and bats.

We have observed recurring chlordane poisonings of large numbers of common grackles (Quiscalus quiscula), European starlings (Sturnus vulgaris), and American robins (Turdus migratorius) at suburban roosts in New Jersey during the month of July. This paper describes aspects of the food chain uptake of chlordane that account for the periodicity of these poisonings. Chlordane concentrations ranged from < 0.02 to 20.3 microg/g wet weight in 11 soil samples collected from residential lawns and a golf course near one roost. Of the 10 species of insects and soil invertebrates collected from the area, two scarab beetles, the oriental beetle (Anomala orientalis) and Japanese beetle (Popilla japonica), had the highest concentrations of chlordane-related compounds (15.1 and 5.9 microg/g wet weight, respectively). Concentrations in the other eight species ranged from < 0.04 to 1.3 microg/g. Oriental and Japanese beetles collected from a rural location had concentrations of 0.03 and < 0.02 microg/g, respectively. Emergence of adult beetles peaked in mid- to late July, when bird mortality also peaked. Fecal pellets collected near the roost (n = 24) contained the remains of 1-5 beetles each (mean = 2), and scarab beetles accounted for 40% of the total number of insect parts in the stomach contents of common grackles (n = 8). Unlike soil samples, in which cis- and trans-chlordane predominated, beetles contained large amounts of the more toxic metabolites heptachlor epoxide and oxychlordane. Total chlordane-related compounds ranged from < 0.05 to 18.4 microg/g in Japanese beetles collected from 16 sites in New Jersey and 2 sites in Ohio. The highest concentrations were found in beetles from suburban areas and golf courses. We also analyzed brain tissue from insectivorous bats (15 big brown bats, Eptesicus fuscus, and 5 little brown bats, Myotis lucifugus) that were submitted to the New Jersey Rabies Laboratory in late June/July 1998 and 1999 but found to be rabies-negative. We suggest that high concentrations in three of the bats caused debility or abnormal behavior that may have precipitated submission for rabies testing.

Animals↗

The Selection and Design of Multiple-Species Habitat Preserves.

Multiple-species habitat conservation plans (MSHCPs) are designed to eliminate project-by-project review and minimize species-by-species conflicts; but these one-time, short-term processes invariably compress the divergent expectations of interest groups into an exercise driven by economic, amenity, and aesthetic values rather than scientific values. Participants may define an MSHCP as an exchange of habitat preserves for federal permits to take populations of endangered animals and plants, but the outcome is typically driven by overarching arguments over land development and suburban sprawl. Existing land uses also constrain the size, shape, and linkages among wildlife habitats, leading to a divergence of MSHCPs from the scientific preserve selection and design literature. Problems created by constraints to preserve configuration (e.g., land costs, fragmentation, pre-existing amounts of edge, lack of connectivity) must be resolved by long-term, post facto management. To date, estimates of preserve persistence have not been used in MSHCPs. Rather than focus on map-based exercises of preserve elements, it may be more productive to set goals for the persistence of species (states) and ecosystems (processes) within the preserves-accepting that preserve configurations and arrays will be defined by the landscape and politics of suburban areas and that long-term management will provide the primary means of maintaining biodiversity along the wildland/urban interface.

Journal Article↗

Characterization of an urban-rural CO2/temperature gradient and associated changes in initial plant productivity during secondary succession.

To examine the impact of climate change on vegetative productivity, we exposed fallow agricultural soil to an in situ temperature and CO2 gradient between urban, suburban and rural areas in 2002. Along the gradient, average daytime CO2 concentration increased by 21% and maximum (daytime) and minimum (nighttime) daily temperatures increased by 1.6 and 3.3 degrees C, respectively in an urban relative to a rural location. Consistent location differences in soil temperature were also ascertained. No other consistent differences in meteorological variables (e.g. wind speed, humidity, PAR, tropospheric ozone) as a function of urbanization were documented. The urban-induced environmental changes that were observed were consistent with most short-term (approximately 50 year) global change scenarios regarding CO2 concentration and air temperature. Productivity, determined as final above-ground biomass, and maximum plant height were positively affected by daytime and soil temperatures as well as enhanced [CO2], increasing 60 and 115% for the suburban and urban sites, respectively, relative to the rural site. While long-term data are needed, these initial results suggest that urban environments may act as a reasonable surrogate for investigating future climatic change in vegetative communities.

Atmosphere↗

Increasing HIV testing among latinos by bundling HIV testing with other tests.

Latinos in the United States are disproportionately impacted by HIV/AIDS. They accounted for 20.4% of the AIDS cases reported in 2003, despite the fact that they represent 13.3% of the civilian non-institutional population of the United States. Thus it is important to identify ways to increase HIV testing among Latinos engaging in high risk behaviors. One approach that has been proposed for increasing HIV testing is the "bundling" of HIV prevention interventions with other relevant services. This study examined whether offering HIV testing with screening for other conditions would increase HIV testing among Latino men who frequent gay bars. A cross-sectional survey of 394 Latino men was conducted at both urban and suburban gay bars. Overall, no statistical differences were found in the number of individuals who took the HIV test or who tested HIV-positive when the HIV test was offered with screening for other conditions (alcohol problems, drug dependence, depression, syphilis, gonorrhea and chlamydia) compared to when it was offered by itself. However, multivariate analysis found that three groups of Latino men were more likely to test for HIV when it was bundled with other tests: those who reported having sex primarily with women, those with other risk factors that could also be tested through a bundled test approach, and those who were clients of the suburban gay bar that was farthest from a large geographical gay community. Further studies of bundled HIV testing should be conducted with other key subpopulations that may be more willing to take an HIV test when it is offered with other relevant tests than when offered by itself.

Adult↗

Seroprevalence of Chlamydia pneumoniae antibodies in a young adult population sample living in Verona. European Community Respiratory Health Survey (ECRHS) Verona.

UNLABELLED: The aim of the study was to evaluate the prevalence of antibodies to Chlamydia pneumoniae in a random population sample of 369 young adults (aged 20-44 years), living in Verona, Italy. IgG and IgM titers were measured by micro-immunofluorescence. IgG antibodies, greater or equal to 16, were found in 104/177 (58.8%) men and 76/192 (39.6%) women (p < 0.001). No relationship was found between IgG seropositivity, age, social class, education and family size. Factors positively associated with IgG seropositivity included smoking (p < 0.001), occupational status (employed vs unemployed: p = 0.02; students vs unemployed: p < 0.01) and living area (suburban [65.0%] vs urban area [45.3%]: p = 0.03). The geometric mean of IgG titers was higher in students (GM: 26.05) than in both employed (GM: 11.02) and unemployed persons (GM: 4.80) (p < 0.01 and p < 0.001, respectively). IgG titres > or = 512 and/or IgM titers > or = 16 (suggestive of a recent C. pneumoniae infection) were found in 39 subjects (10.6%). Recent infection was more frequent in spring (14.9%), with no significant variation in the other seasons (mean prevalence 6.7%) (p < 0.01). Recent infection was also associated with cigarette smoking. On the other hand, no significant association was found between respiratory symptoms and serologic evidence of recent infection. IN CONCLUSION: 1) the prevalence of antibodies to C. pneumoniae in young adults from Verona is similar to that found in European countries, and therefore, in Europe, it seems not related to latitude or climate; 2) male sex, tobacco smoking, employment status and living in a suburban area are independent risk factors of infection; 3) the infection is subclinical in most cases.

Adult↗

Factors affecting plasma benzo[a]pyrene levels in environmental studies.

Benzo[a]pyrene (BaP) is a useful indicator of exposure to polycyclic aromatic hydrocarbons (PAHs), airborne carcinogenic compounds. Radioimmunoassay was used to test for plasma BaP differences in 61 subjects divided into three groups based on geographic-demographic locale: urban-industrial, urban-residential, and outer suburban. The results showed that the urban-industrial area participants had a significantly higher mean plasma BaP level than did the outer suburban subjects. The urban-residential subjects did not have a significantly different mean plasma benzo[a]pyrene level from either of the other two groups. Obesity, as measured by Quetelet's index, was found to have a significant correlation with BaP levels. These results indicate that radioimmunoassay of plasma for BaP may be used successfully to judge environmental exposure to PAHs, provided physiological considerations such as obesity are taken into account.

Adult↗

Population decentralization within metropolitan areas: 1970-1980.

Using a data set that maintains geographic and fiscal continuity over time and across a sample of major U.S. metropolitan areas, the authors identify factors of economic and population decentralization that affected central city areas between 1970 and 1980. The problems of annexation are resolved by estimating population changes for central cities and suburban areas with constant 1980 boundaries, and by calculating fiscal variables from overlapping jurisdictions by city area as opposed to municipal city government only. "The empirical investigation supports the view that demographic and housing stock variables seem to have had a greater impact on decentralization than central city-suburban fiscal differences."

Americas↗

Tissue and organ procurement in the emergency department setting.

A retrospective chart review of all emergency department (ED) deaths in patients younger than 65 years in seven area hospitals was performed for the calendar year of 1990. The number and percentage of families approached and consenting to tissue donation among the various EDs was compared and reasons for not approaching families were evaluated for their validity. Procurement rates between the years 1990 and 1991 were compared for two area hospitals, which made a specified (nonmedical) service responsible for tissue requests in 1991. There were 368 deaths, 255 of which were potential donors by acceptable criteria. Only 109 (43%) families were approached regarding tissue donation. The overall procurement rate was 12%. Suburban EDs had a higher approach and procurement rate than did urban EDs (49% vs 36%; P < .05 and 19% vs 5%; P < .01, respectively). Procurement rates for two hospitals that designated a specific procurement service in 1991 more than doubled (5% vs 11%; P = NS). Tissue procurement rates in EDs with procurement systems in place are low despite consent rates of those approached of 36%. The major contributing factor is the failure to request tissue from the families of eligible candidates even when there are no exclusion criteria met. Suburban EDs had a higher success rate than urban EDs.

Data Collection↗