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[American cutaneous leishmaniasis in the Federal District].

In the present study, we report 11 cases of mucocutaneous leishmaniasis (MCL) in patients living in the Federal District who had not left their area of residence for a period ranging from six months to two years before the onset of the disease. Six of the eleven patients live in the suburban town of Planaltina. All showed a positive Leishmanin intradermal reaction. Ten of them presented the parasite in their lesions. Leishmania (V) braziliensi was identified in the lesions of two patients by the monoclonal antibody method. Nine patients were treated with pentavalent antimoy and two with pentamidine. Relapse occurred in two cases after treatment with antimony. In view of the detection of vectors and infected patients in the Federal District, it is probable that Leishmania infection is occurring in Brasilia and its suburban areas.

Adolescent↗

Urbanization increases grassland carbon pools: effects of landscaping in Colorado's front range.

During the past few decades, urban and suburban developments have grown at unprecedented rates and extents with unknown consequences for ecosystem function. Carbon pools of soil and vegetation on landscaped properties were examined in the Front Range of Colorado, USA, in order to characterize vegetation and soils found in urban green spaces; analyze their aboveground biomass, vegetative C storage, and soil C storage; and compare these suburban ecosystem properties to their counterparts in native grassland and cultivated fields. Anthropogenic activities leave clear signatures on all three C compartments measured. Management level dominates the response of grass production, biomass, and N tissue concentration. This, in turn, influences the amount of C and N both stored in and harvested from sites. The site age dominates the amount of woody biomass as well as soil C and N. Soil texture only secondarily affects total soil carbon and total bulk density. Established urban green spaces harbor larger C pools, more than double in some cases, than native grasslands or agricultural fields on a per-area basis. Lawn grass produces more biomass and stores more C than local prairie or agricultural fields. Introduced woody vegetation comprises a substantial C pool in urban green spaces and represents a new ecosystem feature. After an initial decrease with site development, soil organic carbon (SOC) pools surpass those in grasslands within two decades. In addition to the marked increase of C pools through time, a shift in storage from belowground to aboveground occurs. Whereas grasslands store approximately 90% of C belowground, urban green spaces store a decreasing proportion of the total C belowground in soils through time, reaching approximately 70% 30-40 years after construction. Despite the substantial increase in C pools in this urban area, it is important to recognize that this shift is distinct from C sequestration since it does not account for a total C budget, including increased anthropogenic C emissions from these sites.

Carbon↗

Swine influenza vaccine program in the community: acceptability, reactions and responses.

The operation of the national swine influenza immunization program was observed in the community of Tecumseh, Michigan. The purpose was to determine acceptability of a parenteral vaccine intended for the general population. Participation of the residents was excellent. More than 64 per cent of eligibles were vaccinated; this figure resembled that of the rest of the local area, but not the national figures nor a suburban area of Michigan where a similar study was carried out. Sore arm after vaccination was reported most frequently in younger female participants; however, sore arm was accepted as part of the process of vaccination and not considered a reaction by most. Such perceived reactions were not as commonly reported as in the large suburban area. Antibody response to the vaccine was excellent, not only in terms of antibodies to the swine virus itself but also in terms of cross reactive antibodies to the emergent H1N1 (Russian) influenza strain. As a result of the program, many vaccine recipients in the 25 to 49 year age groups are protected against this new epidemic virus.

Adolescent↗

Building-related asthma in Denver office workers.

OBJECTIVES: Reported cases of building-related asthma and hypersensitivity pneumonitis among workers in a Denver office building prompted an epidemiologic investigation. METHODS: A cross-sectional, self-administered survey of employees in the office building of the reported cases was compared with that of employees in a comparison building. RESULTS: A significant excess of respiratory disease existed among 512 Denver workers (case building) compared with 281 office workers in a suburban agency (control building). Denver employees had a higher prevalence of respiratory symptoms, and the prevalence of physician-diagnosed asthma with onset or exacerbation since building occupancy was 4.9 times greater for Denver employees than for suburban employees. Asthma was not associated with any particular ventilation system in the building. Water incursion from a below-grade wall may have contributed to the problem, but the etiology is unknown. CONCLUSIONS: This investigation provided evidence of office building-related asthma. Individual cases may be sentinel events for other cases of work-related asthma or hypersensitivity pneumonitis and may indicate a need for public health investigation of remediable causes.

Adult↗

Lead isotope ratios in urban road runoff.

Lead isotopic analyses of road runoff and airborne particulate matter have been carried out to elucidate sources of lead pollution at urban and suburban sites. While lead is often observed in road runoff in suspended form, suspended particle size had no relation to the lead isotopic distribution, as a result of comparison between runoff samples with total suspended solids and those with minute particles passed through a 75 microm sieve. Lead isotope ratios in airborne particulate matter in urban areas fell within a wider range than those in road runoff. Since there was little difference of the ratios between a heavy traffic-flow site and residential sites, airborne lead derived from vehicle exhaust was found to make little contribution to the contamination of road runoff. On the other hand, the ratios in road runoff at a suburban site showed the same range as those at an urban site. Lead in road runoff was therefore suggested to be produced on site by traffic related substances, such as tire wear, other than vehicle exhaust.

Air Pollutants↗

Morbidity, Mortality, and incidence of cirrhosis in Denmark 1976-1978.

National and international statistics on the occurrence of cirrhosis are generally based on death rates. In Denmark as elsewhere the morbidity and incidence of cirrhosis is largely unknown. National patient register data from 1976 to 1978 and data from a suburban county hospital register during 1971-1977 form the basis for calculations of hospital-related prevalence of cirrhosis (discharge rates and consumption of bed-days). Furthermore, a measure of incidence was established and calculated for the suburban area. Mortality from cirrhosis was about 10 per 100,000 population during 1976-77. Eight-five per cent of the deaths occurred in hospitals. Data from the national patient register of somatic hospital wards underrated mortality from cirrhosis by 40%. Death certificate data classified about 1/3 of th deaths as due to alcoholic cirrhosis, whereas alcoholic cirrhosis constituted 2/3 of the deaths in the material derived from the national patient register. The discharge rate was about 60, and the expenditure of bed-days in somatic hospital departments was about 900 per 100,000 population during 1976-78. Forty per cent of the patients were women. Seventy per cent of the patients had alcoholic cirrhosis-80% of the male and 55% of the female patients. The annual incidence of cirrhosis during 1976-77 was about 27 per 100,000. Forty-three per cent of the patients were women. Two thirds of the newly diagnosed cases of cirrhosis were alcoholic-80% for men and 50% for women. These extended morbidity data on the occurrence of cirrhosis can easily be incorporated in future data based patient registers and should be applied in evaluation of costs and preventive strategies.

Denmark↗

Effects of a brief alcohol preventive intervention for youth attending school sports physical examinations.

This pilot study examined the feasibility and efficacy of a brief alcohol misuse preventive intervention for 178 7th-9th grade junior high school students attending sports physical examinations at three schools during the Summer of 1997. At 6-month posttest, fewer suburban intervention youth intended to use alcohol during the next 6 months (chi2 = 7.01, 1 df, p = .01), and fewer rural intervention youth used alcohol during the past 30 days (chi2 = 4.65, 1 df, p = .04), compared to control youth. When suburban and rural school samples were collapsed, intervention youth had significantly lower alcohol use on three of four measures than control subjects (p's < .05).

Adolescent↗

Particulate air pollution and chronic respiratory symptoms among traffic policemen in Bangkok.

In this cross-sectional study, the authors examined the relationship between traffic-based air pollution and chronic, nonspecific respiratory symptoms among traffic policemen in Bangkok, Thailand. A total of 1,603 policemen who lived and worked in areas that had 3 different levels of airborne particulates were evaluated. The authors used a modified standardized questionnaire to identify nonspecific respiratory disease (NSRD) in participants. The prevalence of NSRD in heavily polluted, moderately polluted, and suburban areas was 13.0%, 10.9%, and 9.4%, respectively. Among nonsmokers, the age-adjusted prevalence of NSRD in the heavily polluted areas was significantly higher than in the suburban control area. Also among nonsmokers, the odds ratio for NSRD for each 10-microg/m3 increase in ambient particulate matter was 1.11. The authors concluded that the increased prevalence of respiratory symptoms among traffic policemen in Bangkok was associated with urban traffic air pollution.

Adult↗

Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi'an of Northwest China.

AIM: Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed population-based data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi'an, a northwestern city of China, and to explore the potential risk factors of GERD. METHODS: Symptoms suggestive of GERD, functional dyspepsia (FD), irritable bowel syndrome (IBS), upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified random samples of 2789 residents aged 18-70 years in Xi'an by using a standardized questionnaire. METHODS: With a response rate of 91.8%, the prevalence of SGER was 16.98% (95% CI, 14.2-18.92) in Xi'an adults, and no gender-related difference was observed (P<0.05). SGER was more common among subjects aged 30-70 years than in those aged 18-29 years (P<0.01). The prevalence of SGER in rural, urban and suburban subjects was 21.07%, 17.44% and 12.12%, respectively, and there was a significant difference between rural, urban and suburban regions (P<0.05). Compared with subjects without SGER, the prevalence of symptoms suggestive of FD and IBS, pneumonia, asthma, bronchitis, laryngitis, pharyngitis, chronic cough, wheeze, globus sensation, oral ulcer and snore was significantly increased in subjects with SGER (P<0.01). Heavy smoking (OR=5.76; CI, 3.70-6.67), heavy alcohol use (OR=2.85; CI, 1.67-4.49), peptic ulcer (OR=5.76; CI, 3.99-8.32), cerebral palsy (OR=3.97; CI, 1.97-8.00), abdominal operation (OR=2.69; CI, 1.75-4.13), obesity (OR=2.16; CI, 1.47-3.16), excessive food intake (OR=1.43; CI, 1.17-1.15), sweet food (OR=1.23; CI, 0.89-1.54), and consumption of coffee (OR=1.23; CI, 0.17-2.00) were independently associated with SGER. The episodes of GERD were commonly precipitated by dietary factors (66.05%), followed by body posture (26.54%), ill temper (23.72%), fatigue (22.32%) and stress (10.93%). CONCLUSION: GERD is common in Xi'an's adult population with a mild or moderate degree. The etiology and pathogenesis of GERD are probably associated with FD, IBS, and some respiratory, laryngopharyngeal and odontostological diseases or symptoms. Some lifestyles, diseases and dietary factors are the risk factors of GERD.

Adolescent↗

Psychological distress among students from five universities in Sri Lanka.

OBJECTIVE: To determine the proportion of university students that are psychologically distressed when compared to an age and sex matched population sample and to describe the factors that may contribute to their distress. DESIGN: A cross-sectional comparison study. METHODS: The general health questionnaire (GHQ 30), previously validated in Sinhala, was administered as a screening test to random samples of undergraduates in 5 universities. Age and sex matched controls from the respective communities were also administered the screening test. The undergraduates also filled in a pre-tested questionnaire with personal details. Chi-square tests were used to determine statistical significance between groups. RESULTS: Among the undergraduates, 104 (39.8%) had scores for psychological distress whereas only 67 (25.7%) from the community sample had scores for similar distress. This difference was significant (p = 0.0007). A significantly greater proportion (p = 0.009) of those entering from rural schools were psychologically distressed than those from suburban and urban schools, and a greater proportion living in rented rooms and hostels were (p = 0.001) distressed than those travelling from their homes. CONCLUSIONS: The psychological distress among undergraduates was significantly greater than among the general population. More students who enter from rural schools seem to be distressed than those who enter from suburban and urban schools.

Adult↗

Community activation and health promotion: identification of key organizations.

PURPOSE: The purpose of this study is to identify the kinds of community organizations community leaders consider important for community health promotion efforts. DESIGN: Key informants were identified by reputational sampling of organizations relevant to community health promotion. Key informants were asked to list organizations they considered important for community health promotion. Differences in identified organizations were compared across informants from seven urban, five suburban, seven rural, and three Native American communities, with significance evaluated by chi-square tests. SETTING: This survey was conducted in 22 Western U.S. communities comprising the intervention and control communities of the Community Health Promotion Grants Program of the Henry J. Kaiser Family Foundation. SUBJECTS: Key informants (N = 184) from community organizations, identified using a reputational sampling technique beginning with the health department, were interviewed by telephone. MEASURES: Key informants listed organizations considered important for community health promotion in five areas: adolescent pregnancy, substance abuse, tobacco use, cancer, and cardiovascular disease. RESULTS: Informants frequently identified the health department (mentioned by 78% of informants overall), schools (72%), governmental agencies (55%), hospitals (47%), health clinics (42%), churches (33%), and newspapers (32%) as important. Organizations more prominent in urban and suburban areas than in rural and Native American areas included television stations, health-related private nonprofit organizations, substance abuse treatment centers, and colleges. Private physicians were frequently identified in rural areas (44% of informants).(ABSTRACT TRUNCATED AT 250 WORDS)

Health Education↗

Job satisfaction of nursing assistants in long-term care.

A study of job satisfaction of nursing assistants (NAs) was conducted in two nursing homes (one in a relatively poor urban neighborhood, the other in an affluent suburban neighborhood). When it comes to job content, NAs were more satisfied than dissatisfied. However, they are less satisfied with working conditions. The NAs of the suburban facility were less satisfied than those of the urban facility. Managers need to focus more on the work environment than on job content to develop a more satisfied work force.

Adult↗

[The results of questionnaire of basic concepts about asthma management and prevention for respiratory professionals in Beijing's hospitals at different levels].

OBJECTIVE: To evaluate the information of basic concepts about asthma management and prevention collected from respiralogy professionals in Beijing's hospitals at different levels and provide the basis of drawing up a work plan for Asthma Management and Prevention Committee. METHODS: Fifty-five hospitals including municipal hospitals, urban district hospitals and county hospitals of suburban district were involved and four hundred and thirty-six respiralogy professionals consisting of resident physician and physician-in-charge were asked using questionnaire method. RESULTS: The respiralogy professionals at different level hospitals have some confused ideas in the definition of asthma, the importance of inhalation and anti-inflammatory therapy and the value of peak flow meter. The results of quetionnaire of respiralogy professionals in municipal hospitals were superior to that in urban district hospitals and county hospitals of suburban district. CONCLUSION: The physician education of asthma management and prevention is an important task. Special attention should be paid on the hospitals at basic level.

Asthma↗

Helicopter in transit care of the critically ill--the Whangarei experience.

AIMS: To describe our experience in transit care of the critically ill in Northland and to highlight the multidisciplinary co-operation which renders this an efficient model of transit care in suburban and rural areas. METHODS: Since its inception in 1988, Northland's wholly community owned rescue helicopter has played an integral part in transit Intensive Care in Northland. This aids in transportation of medical and nursing intensive care staff to outlying primary hospitals for patient stabilisation, subsequent transfer of the patient to the intensive care unit (ICU) in Whangarei and, occasionally, for transfer to specialised critical care services in Auckland. RESULTS: As of August 1999, over 3,900 helicopter missions have been accomplished. A doctor, vetting each request for Medevac, minimises over-triage, thus ensuring adequate levels of transit care and effective utilisation of expensive resources. More than 90% of non-obstetric adult patients were ventilated and the number of Medevac missions increased over the years. The Accident Compensation Corporation (ACC) funds 40% of all flights, another 40% of flights are funded by Northland Health and the Order of St John funds the remainder. CONCLUSIONS: With a widespread geography, efficient transit care of the critically ill is imperative to quality hospital care and ensures equity of access to the rural populace. The Whangarei system of transit intensive care is an ideal template for suburban and rural areas.

Air Ambulances↗

Energy and nutrients intake of elderly people living in the Warsaw region, Poland.

The dietary intake of energy, macronutrients, minerals and vitamins was studied in a group of elderly living in urban, suburban, and rural areas of Warsaw region, Poland. The study was conducted in spring 1999 and 298 persons, born between 1919-1924, randomly selected with criteria of age and place of living, were included. Dietary data were based on the 3-day food records. The energy and nutrients intake was calculated on the basis of tables of nutritive value of food products and compared to the Polish RDA's. Daily food rations of the subjects (except for men living in Warsaw) had an incorrect structure as well as insufficient energy content. The highest (i.e. almost 60% or higher) prevalence of intake lower than 2/3 of Polish RDA's was observed for calcium, magnesium, copper, vitamin B2 and vitamin C as well as for iron and vitamin B1 among women. The average intake of fat, cholesterol, and phosphorus was above recommended level. The differences related to area of living were less pronounced for men than for women. Women from suburban area were the most vulnerable group in respect to nutritional inadequacy.

Aged↗

Field testing of immunocontraception on white-tailed deer (Odocoileus virginianus) on Fire Island National Seashore, New York, USA.

Application of contraception for the control of suburban populations of white-tailed deer (Odocoileus virginianus) has been much debated, but few data are available on field applications and even fewer on population effects. Between 1993 and 1997, 74-164 individually known female deer living on Fire Island, New York, USA, were treated remotely with an initial shot of 65 microg porcine zona pellucida (PZP) in Freund's complete adjuvant followed by booster injections of 65 microg PZP in Freund's incomplete adjuvant. Starting in 1996, progressively increasing numbers of deer were treated with vaccinating/marking darts. Estimates of population density and composition, using distance sampling methods, began in 1995 in selected portions of the study area. Between 1993 and 1997, fawning rates among individually known, treated adult females decreased by 78.9% from pretreatment rates. Population density in the most heavily treated area increased by 11% per year from 1995 to March 1998 and then decreased at 23% per year to October 2000. In 1999-2000 surveys, fawns comprised 13-14% of the total population in the most heavily treated area, versus 16-33% in nearby untreated areas. These results show that PZP can be delivered effectively to sufficient deer to affect population density and composition in some environments, but that technical and logistical improvements are needed before contraception can be used widely to manage suburban deer populations.

Animals↗

Population deconcentration in metropolitan Manila in the twentieth century.

"The present analysis is intended to delineate the extent of population deconcentration through an examination of changes in core-periphery growth and density patterns within the Metropolitan Manila complex. Specifically, [the authors] examine changes in absolute and relative population growth and density levels in the central city of Manila, the inner suburban ring, and the outer suburban ring from 1903 to 1975. [The authors] also present a preliminary assessment of the demographic processes underlying the post-World War II trends." Data are from the 1975 Philippine census.

Asia↗

Patterns of medical drug use - a community focus.

The pattern and extent of medical use of drugs was examined by survey in a rural Ontario community (Smithville) and a suburban (Burlington) family practice. Changes in established patterns of drug use that occur after the introduction of a nurse practitioner were also examined in the suburban practice. In both surveys 60% of respondents were using at least one medication and 30% were taking at least one medication prescribed or suggested by a doctor. There were consistently high rates of use of nonprescribed drugs at all ages, especially among females. Vitamins and tonics were the most commonly used drugs, and were taken by 25 to 28% of the respondents, 40% of whom used them on the advice of a physician. From 8.8 to 10.5% of respondents used sedatives or tranquillizers, and reduction in the prescribed use of these drugs was found among patients managed by the nurse practitioners. Self-medication is apparently unrelated to the frequency of medical consultation.

Child↗