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PubMed1982

Comparisons between inner-city and private school adolescents' perceptions of health problems.

A youth health survey was administered to 247 students in an inner-city ghetto high school and 404 students in a private boarding school. Significant differences between the two socioeconomic groups were found for responses about health information, health concerns and problems, and health status and service utilization. Sex-related issues were of greater concern to the private school youth and they desired more help with depression-sadness and birth control. Inner-city youth had more health worries and indicated a desire for more help with physical problems such as toothaches, headaches, and stomach aches, and social problems such as racial discrimination and parent relations. From a list of 22 health problems, the inner-city youth ranked dental problems, acne, and health worries highest while the private school youth ranked depression-sadness, tiredness, and acne highest. Regardless of social class, most adolescents perceived large gaps in their health education. One implication of our data is that the specific self-reported needs and concerns of adolescents should be considered in planning health services and education programs.

Adolescent↗
PubMed1998

Successful techniques for retention of study participants in an inner-city population.

The purpose of this work was to describe methods of retaining participants in studies of inner-city populations, including the timing and intensity of contacts; and to describe the characteristics of participants who did not complete all follow-up interviews and/or return all peak flow diaries in the National Cooperative Inner-City Asthma Study. A cohort study design was used involving hospital emergency rooms and community clinics in seven major urban areas. Participants included 1337 4- to 9-year-old asthmatic children and their caretakers. Nearly 89% of participants completed 3-, 6-, and 9-month follow-up interviews. The 15% of participants who completed a baseline interview on the weekends were significantly more likely to complete follow-up interviews on a weekend. The percent of follow-up interviews conducted in person increased over time from 5% to 8%. The percent of participants with complete follow-up increased as the number of contact names increased (86% with zero contacts, 91% with two contracts; p = 0.03, test for trend). Participants who required at least four phone calls to complete the 3- and 6-month assessment were significantly more likely to be black, have higher participant stress, and have a smoker in the household (p < 0.05). Multiple logistic regression suggests that higher social support and lower parental stress were both predictors of completed interviews. Within our study sample of inner-city minority participants with asthmatic children, only a small proportion of participants missed any follow-up interviews. Increased caretaker stress, decreased social support, and inability to provide several alternate contacts were all predictive of retention problems. Having a flexible staff, computer tracking, and face-to-face recruitment appear essential to achieving nearly complete follow-up within a population historically difficult to follow.

Asthma↗
PubMed1995

Age- and sex-based comparative distribution of selected metals in the scalp hair of an urban population from two cities in Pakistan.

Concentrations of Cu, Zn, Pb and Ni in the scalp hair of male and female donors, with an age range of 6-60 years, were determined by ICP atomic emission spectroscopy. The donors were drawn from the densely populated city of Lahore and the relatively less-populated capital city of Islamabad for comparative evaluation of the metal levels in relation to age, sex and location. Linear regression analyses and correlation between paired metals indicated a positive correlation between Cu and Zn for both sexes ( [Formula: see text] ) and between Pb and Ni ( [Formula: see text] ) for males and females of Lahore. Metal concentrations varied between the two cities and the two sexes. The highest mean concentration was found for Zn at 180.5 microg g(-1) for males and 202.4 microg g(-1) for females from Lahore, while for counterparts from Islamabad the values were 105.2 microg g(-1) and 206.6 microg g(-1). Copper showed an identical mean concentration (20.8 microg g(-1)) in the hair of both males and females from Lahore; however, relatively lower mean concentrations (7.7 and 10.8 microg g(-1)) were observed for donors from Islamabad. Mean Pb concentrations in hair of male donors from Lahore and Islamabad were 9.4 and 7.0 microg g(-1), respectively; in female groups the concentrations were 14.3 and 5.7 microg g(-1), respectively. Ni showed the lowest concentration range (4.3-4.5 microg g(-1)) of all the four metals for subjects from Lahore, and this was higher than the corresponding range (2.0-3.2 microg g(-1)) for subjects from Islamabad. The findings are discussed in relation to the available data from the literature.

Journal Article↗
PubMed1996

Percentage of elderly and the use of welfare services at city welfare offices in Japan.

Japan's population is aging rapidly. As in other developed countries, the establishment of a system of care for the elderly, especially for those suffering from dementia, has become an urgent issue. As the role of welfare offices, which is to directly serve the people, has become increasingly important, the need to assess their use in terms of demographic factors has risen. With respect to demographic factors, this study analyses the use of the welfare services by the demented elderly at city welfare offices in Japan from 1987 to 1989. In December 1991, questionnaires were mailed to 670 city welfare offices nationwide, excluding those located in designated large cities and special wards in Tokyo. Four-hundred and thirty-seven (65.2%) of the offices responded. Offices located in areas with a relatively high percentage of elderly reported giving fewer counselling sessions and reported fewer people registered for or utilizing domiciliary welfare services than offices in areas with a relatively low percentage of elderly. The differences between the two areas in the total amount of counselling, counselling cases at the welfare office, and respite-care for 1989 and day-care service registration were significant. The Pearson's correlation coefficients for the percentage of elderly and these activities all showed negative values, except for home-help utilization in 1987 and 1989. Welfare offices in which the number of activities increased significantly over the 3 years examined in this study were more common in the areas where a committee for communication between medical and welfare sectors (hereinafter "liaison-committee") existed. Discriminant analysis suggests a correlation between the existence of a liaison-committee and the following variables: the percentage of the elderly living alone, the number of home-helpers per elderly, the capacity of day-care service per elderly and the number of surgeries per elderly. From the results, it is apparent that the welfare offices in areas with a high elderly percentage tended to have less activity. Today, municipalities with a high percentage of elderly in its population are particularly required to draw up plans for their health and welfare. The establishment of a network like a liaison-committee will enable the municipalities to achieve their goals.

Aged↗
PubMedDate not supplied

Prevalence of rhinitis and related-symptoms in schoolchildren from different cities in Brazil.

By using the standard written questionnaire (WQ), designed for the International Study of Asthma and Allergies in Childhood (ISAAC) we determined the prevalence of rhinitis and its related-symptoms, in Brazilian children and adolescents, living in different cities of the country. The WQ was answered by the parents of 11,403 children aged 6-7 years from five Brazilian cities: Porto Alegre (South, N = 2,846), São Paulo (Southeast, N = 3,005) Uberlândia (Southeast, N = 2,991), Itabira (Southeast, N = 1,151) and Recife (Northeast, N = 1,410). The WQ was also applied to 20,587 adolescents (13-14 years old) living in: Porto Alegre (South, N = 3,195), Curitiba (South, N = 3,004), São Paulo (Southeast, N = 3,008), Uberlândia (Southeast, N = 2,998), Itabira (Southeast, N = 2,134), Salvador (Northeast, N = 3,162) and Recife (Northeast, N = 3,086). The mean response rates were 75% and 95%, for the 6-7 year-old children and for the adolescents, respectively. The data was transcribed to a database (Epi-Info) and analyzed regarding the answers to questions of rhinitis module. The mean prevalence of rhinitis (affirmative response to question 2) was 26.6% and 34.2% in the groups of 6-7 and 13-14 year-old, respectively. Applying the criteria that evaluate the association between nasal and ocular symptoms (affirmative response to question 3) the mean prevalence of allergic rhinitis were 12.8% for the 6-7 year-old children and 18.0% for the adolescents. In conclusion, the prevalence of rhinitis and its related symptoms among children and adolescents living in different Brazilian cities was as high as the prevalence observed in other areas of the world.

Adolescent↗
PubMed2002

Prevalence of canine dirofilariosis in the City of Buenos Aires and its outskirts (Argentina).

During the past 10 years, the prevalence of canine dirofilariosis in the City of Buenos Aires and its outskirts, particularly in the northern and southern areas, has increased significantly. In the present work, studies were carried out in dogs living in the city and in its northern, western and southern outskirts from 1997 to 2001. For this purpose, 782 blood samples were collected and analyzed to determine circulating antigen, processed with the Witness Merial antigen test. The samples resulted in negative tests for subjects who lived in the city; however, 17.7 and 23.5% of the tests were positive from the northern and southern outskirts, respectively. When analyzed by sex, positive results were distributed as follows: 62.5% males and 37.5% females (P<0.05). No significant statistical difference was found on comparing purebred and cross-breds (P<0.05). It is interesting to point out the geographical distribution of the disease, which confirms that ecological factors such as water currents, abundant vegetation and the existence of mosquitoes all year round, are important for the biological cycle of Dirofilaria immitis.

Age Factors↗
PubMed2002

Epidemiological data of patients hospitalized with burns and other traumas in some cities in the southeast of Brazil from 1991 to 1997.

This retrospective analysis of burn patients and victims of other forms of trauma from Ribeirão Preto and nearby cities admitted to hospitals in the city of Ribeirão Preto, São Paulo, Brazil, was carried out to determine the frequency of injuries of all types in order to identify the extent of the problem of burns relative to other forms of trauma. Data concerning 921 patients with burns and 60,344 patients with other traumatic injuries hospitalized during the period from 1991 to 1997 are described. Burns corresponded to 1.5% of the total number of traumatic injuries. When data are reported as absolute numbers or as incidence rate of hospitalized burn patients, burns were two times more frequent among men in most age groups. The case fatality ratio due to burns was 8.4% (77 deaths among 921 patients), with a rate of 6.4% for men and 12.2% for women. The case fatality ratio was higher among women than men regardless of the city of residence. The case fatality ratio was 3.2 and 4.4 times greater for men and women burn victims from other towns than for burn victims from Ribeirão Preto, indicating the need for additional equipment and training of medical and paramedical personnel in the initial measures to be taken with burn patients.

Adolescent↗
PubMed2000

Child and elderly victims in forensic autopsy during a recent 5 year period in the southern half of Osaka city and surrounding areas.

To outline the recent features of child and elderly victims from the medico-legal perspective with special reference to abuse and neglect, a retrospective investigation of forensic autopsy cases over a 5 year period (1994-1998) in the southern half of Osaka city and surrounding areas (a population of 1.57 million) was undertaken. Among 646 autopsy cases, there were 53 child cases (under the age of 15 years, about 80% below 6) and 121 elderly cases (65 years old and above). Nearly half of the child deaths and more than half of the elderly deaths were described as accidental. Fire and traffic victims were much more frequent in the elderly. Child victims included those of neonaticide/infanticide (n=6), physical abuse (n=10), unintentional fatal infliction (n=2), neglect (n=2), mutual suicide (n=2), suicide (n=1) and murder (n=3). Child abuse and neglect were domestic maltreatment by the parents. In this series, there was a comparable number of fatalities due to maltreatment in the elderly (n=13) and in children, and non-domestic violence was more frequent in the elderly than domestic violence. Elderly females tended to be battered by their sons or grandsons in domestic violence cases, whereas males were predominantly attacked by younger males in non-domestic violence. The other elderly victims included those of self-neglect (n=2), murder (n=7) and suicide (n=9). Non-domestic homicide of the elderly occurred mainly in the center of the city, whereas domestic maltreatment of children and the elderly was sporadic, although somewhat more frequent in the peripheral zone of the city and the surrounding areas. The above profile of child and elderly abuse suggests a substantial influence of social and familial backgrounds.

Accidents↗
PubMed2006

Geographic variations in probability of pregnancy in four cities of France.

BACKGROUND: Several studies have described geographic variations in human fecundability, but this phenomenon has almost exclusively been studied at an international level rather than within a given country. Our aim was to describe geographic variations in fecundability, the monthly probability of pregnancy, between four cities of France. METHODS: We conducted a cross-sectional study in four French maternity units from Toulouse, Rennes, Lyons and Paris, among partners of pregnant women. Women were asked about the time to pregnancy (TTP) of their current pregnancy. TTP was analysed with a discrete Cox model allowing to estimate fecundability ratios (FR). RESULTS: Time to pregnancy was defined for 894 couples. There was no strong evidence of heterogeneity in fecundability between the four compared cities (p=0.05 without adjustment and p=0.25 after adjustment for behavioural and medical factors). The highest fecundability was observed in Rennes and the lowest in Toulouse (fecundability ratio (FR)=1.28, 95% CI: 1.01-1.63). Differences in fecundability were smaller between the other cities. CONCLUSION: We highlighted a possibly slightly higher fecundability in Rennes compared to Toulouse. Possible explanations for this finding are discussed. We note that the finding is consistent with previous observations indicating a higher sperm concentration among semen donors in Rennes than in Toulouse.

Cross-Sectional Studies↗
PubMed1997

Report on the meeting held at City University, London on 16 December 1996: recent progress in DNA repair, mutation and recombination.

This one-day DNA repair meeting was held at City University, London for the fourth consecutive year (P. Strike, Recent advances in DNA repair, mutation and recombination-a report of the meeting of the British Photobiology Society, London, 20 December 1993, Mutation Res. 315 (1994) 75-84; P. Strike, Recent advances in DNA repair and recombination: a report of the DNA Repair Network held at City University, London on 19 December 1994, Mutation Res. 337 (1995) 61-71 ; N.J. Jones, P. Strike, Recent research in DNA repair, mutation and recombination: a report of the DNA Repair Network meeting held at City University, London on 18 December 1995, Mutation Res. 364 (1996) 13-23). The programme consisted of 18 pre-offered talks, there being no specially invited speakers. The meeting was well attended with over 150 participants representing 23 universities, research institutes and hospitals the length and breadth of the United Kingdom. Overseas attendees represented laboratories from Japan, The Netherlands and Spain. The topics of the talks were varied and included mismatch repair, the repair of oxidative damage, transcription-coupled repair and various mutagen-hypersensitive human syndromes. Although wide-ranging, one recurring themes in many of the talks was that of homologous proteins and the correspondence of repair mechanisms in bacterial, fungal and mammalian systems.

Adenosine Triphosphatases↗
PubMed1996

An accident and emergency nurse in the besieged city of Sarajevo.

As war raged in Bosnia a team of doctors and nurses travelled into the besieged city of Sarajevo to treat some of the people injured by the war. More than half of the city's doctors had been killed or had escaped the city. This is the experience of one of the members of the team, an Accident and Emergency nurse.

Emergency Nursing↗
PubMed2002

Constructing access to legal abortion services in Mexico City.

For the last three decades, government and health institutions have recognised that unsafe abortion is an important social and public health problem in Mexico. Although the Penal Code in every state defines at least one situation in which abortion is legal, access to legal abortion services is restricted for women throughout Mexico. In August 2000, the Mexico City Legislative Assembly reformed the Penal Code to include a wider range of grounds on which abortion is legal and added regulations to ensure access to legal abortion services in cases of rape and forced artificial insemination. The Mexican Supreme Court upheld the constitutionality of the reforms in January 2002. This paper describes a collaborative project between Ipas Mexico and the Mexico City Department of Health to provide legal abortions in cases of rape and to ensure that comprehensive health services for survivors of sexual violence are available and accessible. It describes a model of care being introduced into 15 public general and maternal-child health hospitals in Mexico City through a programme of multi-disciplinary consciousness-raising workshops and training courses on sexual violence and legal abortion. Few health care providers have had prior training in service provision for survivors of sexual violence or abortion service delivery. Workshop participants showed a high level of willingness to participate in legal abortion services for survivors of sexual violence when and if they are receive solid institutional support.

Abortion, Legal↗
PubMed1998

Factors associated with Mexico City dentists' willingness to treat AIDS/HIV-positive patients.

OBJECTIVE: The purpose of this study was to investigate the characteristics and infection control practices of dentists in Mexico City in relation to their willingness to treat AIDS/HIV-positive patients. STUDY DESIGN: The population study encompassed Mexico City dentists who were selected according to a geographic criterion. A questionnaire was delivered personally to each participant, and multiple logistic regression was used for data analysis. RESULTS: A total of 598 dentists participated in the study. The response rate was 99.3% (598/602). Seventy-four percent (444) of the dentists said they would be willing to treat AIDS/HIV-positive patients. Among the variables associated with the prediction of willingness to treat these patients were glove-wearing patterns (odds ratio, 2.39; confidence interval, 1.4-4.2), types of available sterilization equipment (odds ratio = 2.42; confidence interval, 1.4-4.1), fear of losing non-AIDS/HIV-positive patients (odds ratio = 4.28; confidence interval, 2.3-8.4), and risk perception of HIV transmission (odds ratio = 2.66; confidence interval, 1.5-4.9). An interaction was found between perception of risk of HIV transmission and increase in costs (odds ratio = 3.35; confidence interval, 1.3-8.9). CONCLUSIONS: Approximately 26% of the Mexico City dentists included in the study were not willing to treat AIDS/HIV-positive patients. Educational programs aimed at misperceptions appear to be warranted.

Acquired Immunodeficiency Syndrome↗
PubMed2006

The Inner-City Asthma Intervention asthma counselor program: a collaborative model between physician and social worker to help empower families.

BACKGROUND: The Inner-City Asthma Intervention (ICAI) asthma counselor program was modeled after interventions proven to be effective by the National Cooperative Inner-City Asthma Study (NCICAS) with inner-city children with asthma. The objective of the ICAI program was to translate and implement the NCICAS intervention into the real-world setting. OBJECTIVE: To describe the unique pairing of a master's degree-level social worker asthma counselor (AC) and physician program manager (PM) as they collaborate to implement a successful chronic disease intervention program. METHODS: A case-study design was used to describe the asthma counselor program collaboration at our site. This information was supplemented by additional qualitative data from the final report submitted by the Alliance of Community Health Plans to the Centers for Disease Control and Prevention and from questionnaire data and enrollment and retention data compiled by Wood et al. RESULTS: A master's degree level trained social worker functioned as an AC and successfully collaborated with a physician PM to help combat one of the most common chronic diseases of childhood. This is evident when evaluating administration, recruitment, education and system issues, and community outreach. CONCLUSIONS: The AC/PM partnership is a blueprint of how a successful collaboration may be duplicated by future social worker-physician teams. An effective program needs to address administrative issues, patient recruitment, ongoing team education, patient retention, and community outreach. Practical examples of each element are described.

Asthma↗
PubMed2006

Implementation of an asthma intervention in the inner city.

BACKGROUND: Despite availability of asthma self-management interventions for children, few have been implemented in community-based settings. OBJECTIVE: To describe implementation of the Inner-City Asthma Intervention and factors associated with higher rates of program completion by enrollees. METHODS: Descriptive analyses of data from multiple data sources. Two-tailed Pearson correlation coefficients and analyses of variance were used to calculate associations of descriptive variables with the retention rate (percentage of enrolled children who completed the core intervention and had more than 1 follow-up visit) and with the percentage who had allergy testing done. RESULTS: A total of 4,174 children were enrolled at 22 sites; 2,153 (52%) completed the core intervention and had more than 1 follow-up visit. A total of 2,014 enrolled children (48%) were tested for allergies. Retention was related to type and location of site, ease of obtaining written plans, language and ethnicity of asthma counselor, and on-site allergy testing. Higher rates of allergy testing were associated with the same factors, as well as flexibility in scheduling and selective enrollment of participants. CONCLUSIONS: Inner-city children with asthma can be enrolled in the Inner-City Asthma Intervention outside a controlled research setting. However, completion of all intervention components is difficult to achieve. We identify having an asthma counselor who is representative of the community, access to asthma action plans, and on-site allergy testing as factors that facilitate the implementation of this intervention in community-based settings.

Asthma↗
PubMed2006

The Inner-City Asthma Intervention tool kit: best practices and lessons learned.

BACKGROUND: Asthma is a major public health problem of increasing concern in the United States. Low-income populations, minorities, and children living in inner cities experience disproportionately higher morbidity and mortality due to asthma. In 1991, the National Institute of Allergy and Infectious Disease at the National Institutes of Health funded the National Cooperative Inner-City Asthma Study (NCICAS), the foundation for the Centers for Disease Control and Prevention (CDC)-funded Inner-City Asthma Intervention (ICAI) on which the tool kit discussed in this article is based. OBJECTIVE: To summarize the purpose and content of a tool kit for health care organizations that wish to enhance their asthma management efforts and to improve the quality of life of children with asthma and their families. METHODS: The ICAI was tailored to the individual child and family through a combination of group and individual activities (core) and follow-up. Information contained in the tool kit is based on project reports, tracking and data collection reports, program oversight activity, and general subject matter knowledge. RESULTS: Although the NCICAS proved successful, moving from a research design to the real world of implementation was difficult. The tool kit draws on the experience of implementation and provides strategies, options, and considerations for health care organizations to use in tailoring project activities. CONCLUSION: The ICAI demonstrated that committed health care organizations, with trained and experienced individuals, could help empower children and families to manage childhood asthma. The tool kit was designed to share the best practices and lessons learned from the ICAI implementation of the NCICAS protocol at the community level.

Asthma↗
PubMed2006

Household mouse allergen exposure and asthma morbidity in inner-city preschool children.

BACKGROUND: Inner-city children experience disproportionate asthma morbidity, and suspected reasons include indoor environmental exposures. OBJECTIVE: To determine if mouse allergen exposure is a risk factor for asthma morbidity. METHODS: Preschool children with asthma were recruited from inner-city Baltimore, MD. Skin testing was performed and blood was collected at the baseline visit for quantification of mouse allergen specific IgE. A questionnaire evaluated symptoms, medication, and health care use at baseline, 3 months, and 6 months. A trained technician collected dust samples from the child's home for analysis of Mus m 1 at baseline, 3 months, and 6 months. Outcomes were compared between mouse-sensitized, highly exposed children and all other children. RESULTS: A total of 127 children had complete data for mouse sensitization status and bedroom settled dust mouse allergen levels at baseline. The mean age of the children was 4.4 years, 92% were African American, and 26% were sensitized to mouse. Mouse-sensitized children exposed to higher levels of Mus m 1 (>0.5 microg/g) had 50% more days of symptoms (incidence rate ratio [IRR], 1.5; 95% confidence interval [CI], 1.1-2.1) and 80% more days of beta-agonist use than other children (IRR, 1.8; 95% CI, 1.3-2.5). Children in the sensitized and highly exposed group were also more likely to have an unscheduled physician visit (odds ratio [OR], 3.1; 95% CI, 1.6-6.3), emergency department visit (OR, 2.1; 95% CI, 1.1-4.1), and hospitalization (OR, 36.6; 95% CI, 4.1-327.3) than other children. These associations between mouse allergen exposure and asthma symptoms and morbidity remained statistically significant after adjusting for potential confounders, including atopy and cockroach sensitization and exposure. CONCLUSIONS: In mouse-sensitized inner-city children, exposure to mouse allergen may be an important cause of asthma morbidity.

Allergens↗
PubMed2005

Home environmental intervention in inner-city asthma: a randomized controlled clinical trial.

BACKGROUND: Airborne pollutants and indoor allergens increase asthma morbidity in inner-city children; therefore, reducing exposure, if feasible, should improve asthma morbidity. OBJECTIVE: To conduct a randomized controlled trial of methods to reduce environmental pollutant and allergen exposure in the homes of asthmatic children living in the inner city. METHODS: After the completion of questionnaires, spirometry and allergen skin tests, home inspection, and measurement of home air pollutant and allergen levels, 100 asthmatic children aged 6 to 12 years were randomized to the treatment group (home-based education, cockroach and rodent extermination, mattress and pillow encasings, and high-efficiency particulate air cleaner) or to the control group (treated at the end of the 1-year trial). Outcomes were evaluated by home evaluations at 6 and 12 months, clinic evaluation at 12 months, and multiple telephone interviews. RESULTS: In the treatment group, 84% received cockroach extermination and 75% used the air cleaner. Levels of particulate matter 10 microm or smaller declined by up to 39% in the treatment group but increased in the control group (P < .001). Cockroach allergen levels decreased by 51% in the treatment group. Daytime symptoms increased in the control group and decreased in the treatment group (P = .04). Other measures of morbidity, such as spirometry findings, nighttime symptoms, and emergency department use, were not significantly changed. CONCLUSIONS: A tailored, multifaceted environmental treatment reduced airborne particulate matter and indoor allergen levels in inner-city homes, which, in turn, had a modest effect on morbidity.

Air Pollution, Indoor↗