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PubMed2004

Discrepancies in body image perception among fourth-grade public school children from urban, suburban, and rural Maryland.

OBJECTIVE: The objective of this study was to determine whether there is an association between body image perception and weight status as measured by the body mass index among a group of fourth graders in Maryland. DESIGN: Cross-sectional data on height, weight, and body image were collected in the classroom. At risk for being overweight and being overweight designations were assigned to participants with body mass index (BMI) percentile values for age and sex of >/=85 to <95 and BMI >/=95, respectively. Students selected a figure (range 1 to 7) to represent their current and ideal images. SUBJECTS: The subjects of this study were 524 fourth-grade public school students (54% girls; 61% white; mean age, 9.2 years) from three geographically distinct regions in Maryland (38.6% urban, 30.7% suburban, 30.7% rural). Statistical analyses chi(2) tests were used to compare weight status with sex, race, geographic location, and body image discrepancy categories. One-way analysis of variance was used to compare BMI and body image scores with sex and race/ethnicity to geographic location. RESULTS: Thirteen percent of students were overweight, and 15% were at risk of overweight. There was no association between weight status and race, body image perception, or geographic location. African Americans chose larger figures than whites and other races to represent their current and ideal images and were most satisfied with their body size. CONCLUSIONS: Perceptions of body image are formed early in life. Dietitians can provide guidance on appropriate weight and body size to children, parents, and school professionals. Dietitians can also use their influence to secure funding for nutrition education programs.

Black or African American↗
PubMed2006

Gas-particle concentration and characterization of sources of PAHs in the atmosphere of a suburban area in Athens, Greece.

Atmospheric polycyclic aromatic hydrocarbons (PAH) were determined in two places in a suburban area of Athens greater area (AGA) during June and November 2003. Fourteen PAHs were quantified in the collected samples. The total concentration in the gas phase ranged between 6.89 and 124ngm(-3), while in the particulate phase between 0.44 and 13.2ngm(-3). Maximum concentrations of the total PAHs (gas and particulate phase) were observed during the cold period with an average of 40.7ngm(-3). PAHs were correlated with NO, NO(2) and O(3), wind speed, wind direction and temperature. Positive correlation was observed between PAHs and NO, NO(2), while negative correlation was detected between PAHs and O(3). The most abundant members were phenanthrene, anthracene, fluorene, fluoranthene and pyrene. Potential sources of PAHs in aerosols were investigated using molecular diagnostic ratios, which reflect sources such as diesel and gasoline engines, although other sources such as coal combustion and liquefied petroleum gas also contributed.

Air Pollutants↗
PubMed2006

Prevalence of Brucella antibodies in rural and suburban communities in three provinces of Turkey: need for improved diagnosis and prevention.

OBJECTIVE: To determine the seroprevalence of Brucella-specific antibodies in rural and suburban communities in different provinces of Anatolia. METHOD: Cross-sectional seroepidemiological study on serum samples collected in communities in two relatively developed provinces in west Anatolia with an official low prevalence of brucellosis and in one province in southeast Anatolia with a high prevalence. RESULT: The seroprevalence of brucellosis in the two provinces in the west Anatolia appears to be high and ranged from 2.9 to 8.5% in Rose Bengal test and from 0 to 5.6% in Wright serum agglutination test at a titer equal or higher than 1:100. The seroprevalence in communities in the province in southeast Anatolia was lower and this might well be attributed to vaccination of livestock in the year preceding the survey. CONCLUSION: Adherence to traditional farming practices and lifestyle, and a preference for fresh dairy contribute to the high seroprevalence of brucellosis. Vaccination of livestock is of utmost importance and the consumption of fresh milk and dairy products prepared from unpasteurised milk should be halted. Better access to laboratory testing is needed for the confirmation and management of brucellosis.

Antibodies, Bacterial↗
PubMed2006

Whom can I rely on? Mothers' approaches to support for feeding: an interview study in suburban Dar es Salaam, Tanzania.

OBJECTIVE: to explore and describe mothers' perceptions of baby feeding and approaches to support for baby feeding. DESIGN: individual qualitative semi-structured interviews conducted with mothers. Method used for analysis was qualitative content analysis. SETTING: suburban Dar es Salaam, Tanzania. PARTICIPANTS: 8 mothers with babies under 6 months of age. FINDINGS: the study revealed four categories of mothers' perceptions of baby feeding: (1) baby feeding, housework and paid work have to adjust to each other; (2) breast feeding has many benefits; (3) water or breast milk can be given to quench baby's thirst; and (4) crying provides guidance for baby feeding. Four different themes describing approaches to support emerged from the data: (1) adhering to diverse sources; (2) relying wholeheartedly on a mother figure; (3) working as a parental team; and (4) making arrangements for absence from the child. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: knowledge of the different approaches to support for baby feeding described in this study can help define counselling and promotional strategies in order to reach mothers with more effective messages and support for optimal baby-feeding practices.

Adolescent↗
PubMed2002

Chlamydia pneumoniae seropositivity and early carotid atherosclerosis in a suburban Japanese population.

To evaluate the association between Chlamydia pneumoniae (C. pneumoniae) infection and carotid atherosclerosis (CA), we investigated CA assessed by carotid B-mode ultrasound and known or suspected atherosclerotic risk factors including C. pneumoniae IgG and IgA antibodies in 2410 residents (mean age 54.5+/-13.6 years, 697 men) of a suburban Japanese town. CA was found in 30.1% of men and in 14.0% of women, IgG in 59.4% and in 51.4%, and IgA in 36.9% and in 32.4%, respectively. In univariate analysis, most conventional atherosclerotic risk factors and IgA antibody were significantly associated with CA in both sexes, but not IgG. In multivariate logistic regression analysis, independent risk factors for CA were confirmed with age and triglycerides (TG) in men and age, systolic blood pressure, pack-years of smoking, and low-density lipoprotein cholesterol (LDL-C) in women, but not IgG and IgA in either sex. These results do not support C. pneumoniae infection as an important risk factor for CA in this Japanese population.

Adult↗
PubMed1983

Assessment of health needs and willingness to utilize health care resources of adolescents in a suburban population.

We investigated whether adolescents living in a middle-class suburb believed that their health needs were being met, and the extent to which they were willing to utilize local health care resources for a range of problems. Self-administered, anonymous questionnaires were completed by 649 students in grades 9 through 12. The mean age of respondents was 15.4 years; 52% were female, and 95% white. They had ready access to medical care: 90% used a specific private physician. From a list of 15 health problems, 60% indicated that they had seen a health provider for at least one of them, most often for stomach pains (22%), headaches (18%), and coughing (16%). From an identical list, 48% indicated that there was at least one problem for which they had never seen a health provider but would like to, most often for a weight problem (14%), birth control (10%), and emotional upset (9%). Although 20% regularly used illegal drugs, 24% were sexually active, and 38% thought they had a weight problem, only 1%, 4%, and 10%, respectively, had sought care for these matters. A majority of students would not choose to go to a private physician for care related to sexuality, substance abuse, or emotional upset, and would not be willing to seek care for these problems with their parents' knowledge. Ready access to private primary care did not assure attention to important health needs among these suburban adolescents.

Adolescent↗
PubMed2004

Polycyclic aromatic hydrocarbons in the ambient air of suburban and industrial regions of central Taiwan.

The concentrations of gas-phase and particle-bound polycyclic aromatic hydrocarbons (PAHs) were measured simultaneously at an industrial area (Taichung Industrial Park) and a suburban area (Tunghai University Campus) in Taichung, Taiwan. Twenty-four hours samplings for two consecutive days were performed between August and December 2002 at both sampling sites. Ambient air particle-bound PAHs were collected on quartz filters and gas-phase PAHs were collected on glass cartridges using a PUF Sampler, respectively. Both types of samples were extracted with a DCM/n-hexane mixture (50/50, v/v) for 24 h, then the extracts were subjected to gas chromatography-mass spectrometric (GC-MS) analysis. Total PAHs concentrations at the Taichung Industrial Park (TIP) sampling site and the Tunghai University Campus (THUC) sampling site were found to be 1232.3+/-963.6 and 609.8+/-356.3 ng/m(3), respectively. Stationary combustion processes were mainly responsible for PAHs sources at the TIP sampling site, while traffic vehicle exhaust was the largest contributor for PAHs sources at the THUC sampling site.

Air Pollutants↗
PubMed2000

The study of fine and coarse particles, and metallic elements for the daytime and night-time in a suburban area of central Taiwan, Taichung.

Daily average concentrations of fine and coarse particulates, and TSP samples have been measured simultaneously at daytime and night-time periods by using Universal and PS-1 sampler in a suburban area of central Taiwan from June to August 1998. The samples were analyzed by atomic absorption spectrometry to determine the fine and coarse particulate concentrations of metallic elements (Ca, Fe, Mn, Pb, Cu, Zn and Cr). The concentration of PM2.5 and TSP showed a decreased trend for the daytime period. The fine particle concentrations were about two times as that of coarse particulate concentrations. The averaged fine particulate concentrations at daytime are higher than at night-time. Ca and Fe were mostly in the coarse particulate mode. The correlation coefficients were 0.63 and 0.69 for elements Ca and Fe in the coarse particle mode for day and night periods. Pb showed a similar distribution ratio with Mn for the fine to coarse particle ratios at both day and night period. Pb and Mn are highly correlated for the day (R = 0.78) and night period (R = 0.61) at particle size <2.5 microm. Cu and Zn were mainly in fine particles at both day and night period. Fe and Ca consist of the major parts of all the elements. Elemental Mn is the lowest among the rest of the heavy metals.

Air Pollutants↗
PubMed1988

Out-of-hospital cardiac arrest: a six-year experience in a suburban-rural system.

All out-of-hospital cardiac arrest advanced life support (ALS) trip sheets were collected from January 1980 through December 1985 for this suburban-rural system. Information was extracted according to a uniform reporting format. In our study, 18% of patients with early CPR (less than four minutes) and early ALS (less than ten minutes) survived to hospital discharge, compared with 7% with early CPR and late ALS, 6% with late CPR and early ALS, and 3% with both occurring late. Although 75% of the survivors had ventricular tachyarrhythmias as initial rhythms, bradyasystolic arrests were not uniformly lethal, even with long CPR and ALS times. This study supports the need for early CPR in the prehospital care of potential sudden-death victims. We recommend, with qualification, this reporting format to emergency medical services systems to describe their cardiac arrest experience.

Adult↗
PubMed1995

Chest pain associated with cocaine: an assessment of prevalence in suburban and urban emergency departments.

STUDY OBJECTIVE: Chest pain and myocardial infarction following the use of cocaine have been well documented. We assessed the prevalence of cocaine use in patients who presented to the emergency department with chest pain of possibly ischemic origin. DESIGN: During times of research assistant availability, consecutive adults with the chief complaint of chest pain unexplained by trauma or radiographic abnormality were questioned about cocaine use in the preceding week. Urine was tested for the presence of cocaine or cocaine metabolites with a highly accurate bedside urine test kit (specificity, 100%; sensitivity 98%). Anonymous unlinked data-collection methods were used. Therefore we could not determine whether the patients who used cocaine had sustained myocardial infarctions. SETTING: One suburban and three urban EDs. RESULTS: We enrolled 359 patients with a mean age of 51 years, 8% of whom sustained myocardial infarctions. Sixty patients (17%) had cocaine or cocaine metabolites in urine. The likelihood of testing positive for cocaine varied by age group: 18 to 30 years, 29%; 31 to 40 years, 48%; 41 to 50 years, 18%; 51 to 60 years, 3%; 61 years or older, 0% (P < .0001). Of the 60 patients who tested positive for cocaine, only 43 (72%) admitted recent use. CONCLUSION: Many ED patients with chest pain have recently used cocaine. Because the recent use of cocaine is not uncommon in patients with chest pain up to 60 years old, such patients should be questioned about cocaine use. When treatment or disposition may be altered, consideration should be given to objective assessment of cocaine use because patient self-report does not appear reliable.

Adolescent↗
PubMed1998

Night of the sirens: analysis of carbon monoxide-detector experience in suburban Chicago.

STUDY OBJECTIVE: To determine the pattern and environmental causes of carbon monoxide (CO)-detector alarms. METHODS: Data including time, location, detector manufacturer, CO measurements in the home, reported illness, cause, and actions taken were collected between July 15, 1994, and January 26, 1995, on all calls to 17 suburban Chicago fire departments for CO-detector alarms. We used univariate time-series analysis involving joint estimation of model parameters and outlier effects to analyze data and compared data on ambient CO levels from the Illinois Environmental Protection Agency to the number of calls per day. RESULTS: During the study period, 777 calls for sounding CO detectors were made to the fire departments in question. The median number of calls per day was three. Our univariate time series identified 3 days with a significant excess of calls (December 12, 29 calls; December 21, 69; December 22, 128; P < .001). The average ambient CO readings on these days were 0.99, 3.25, and 3.89 ppm, respectively, compared with an overall mean of 8.8 ppm. In-home CO levels among all 828 measurements taken from the 777 domestic calls ranged from 0 to 425 ppm, 0 in 249 (30%), 1 to 10 in 340 (41%), 11 to 50 in 149 (18%), 51 to 100 in 22 (9%), and more than 100 in 11 (1.3%). No measurement was taken in six cases. Cause of alarm was listed as furnace in 25 cases, auto exhaust in 24, stove/oven in 22, poor location of detector in 14, water heater in 11, outside sources in 7, and multiple sources in 7. Other sources accounted for fewer than 1% each. The participating fire departments considered 242 cases (31%) to be false alarms. Cause was not determined in 400 calls (51%). In 37 calls (4.8%), people reported illness. CONCLUSION: Above-average ambient CO levels coincided with a significant increase in the number of calls and may have contributed to the triggering of CO alarms.

Air Pollution, Indoor↗
PubMed1998

Race and survival after out-of-hospital cardiac arrest in a suburban community.

STUDY OBJECTIVE: To determine whether race, when controlled for income, is an independent predictor of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). METHODS: Prospective OHCA data were collected over 4 years (1991-1994) from a convenience sample of OHCA patients transported to nine hospitals in three suburban counties. Race was determined from hospital and vital statistics records. The average household income was identified from ZIP codes and used as a marker of socioeconomic status. Demographic data and known predictors of survival were compared between blacks and whites. A logistic regression analysis was used to assess the association between race, income, and survival. RESULTS: Of the 1,690 patients, 223 (13%) were blacks and 1,467 (87%) were whites. Average household income was less for blacks than for whites ($40,225 versus $46,193; P < .001), but both populations were affluent by national standards (national percentile ranks were 73% and 88%, respectively). The populations were no different in percentage of witnessed arrests (57% versus 61%; P = .465). Blacks were younger (mean +/- SD, 62 +/- 16 versus 68 +/- 15 years; P < .001); less frequently received bystander CPR (11% versus 20%; P = .002); less often had ventricular tachycardia or ventricular fibrillation (37% versus 50%; P < .001); and had a shorter advanced life support call-response interval (median, 4 versus 6 minutes; P < .001). The odds ratio for survival (white/black) was .931 (95% confidence interval, .446 to 1.945). CONCLUSION: Race was not found to predict adverse OHCA outcomes in this affluent population.

Black or African American↗
PubMed1996

Evaluation of American College of Surgeons trauma triage criteria in a suburban and rural setting.

In suburban and rural counties, patient transport to specialized facilities such as trauma centers may result in prolonged transport times with the resultant loss of ambulance coverage in the primary service area. We evaluated the American College of Surgeons trauma triage criteria as modified by New York State to determine the ability of these criteria to predict the need for trauma center care in victims of blunt traumatic injury. Blunt trauma patients were retrospectively identified through review of patient care reports for the presence either of mechanism or of physiological criteria for transport to a trauma center. Controls were randomly selected from patients with blunt trauma not meeting any of the criteria. Main outcome parameters were the emergency department (ED) disposition, length of hospital stay, need for intensive care unit (ICU) care, and major nonorthopedic operative interventions. There were 857 patients enrolled. The presence either of mechanism or of physiological criteria increased the likelihood of hospital admission (control, 11%; mechanism, 35%; and physiological, 33%). Relative to patients without any criteria, the presence of mechanism criteria alone did not identify patients who required a prolonged length of stay (67% vs 71%), intensive care unit services (13% vs 19%) or major nonorthopedic operative interventions (0.2% vs 1.6%). The presence of physiological criteria increased the likelihood of requiring all of these services. These comparisons held true for victims of motor vehicle accidents, pedestrians struck by motor vehicles, and people who fell from heights above ground level. Patients with physiologic criteria may benefit from transport directly to a trauma center. Because of the low need for operative intervention and ICU services, patients with no criteria or mechanism criteria at long distances from a trauma center may be initially evaluated at the closest hospital and transferred to a trauma center if hospitalization or ICU care is necessary. Further study to determine the predictive value of certain individual mechanism criteria is warranted.

Adolescent↗
PubMed1999

Integrative research review of risk behaviors among adolescents in rural, suburban, and urban areas.

PURPOSE: The purpose of this integrative review was to describe the state of the science regarding adolescent risk behaviors, with particular emphasis on comparisons among rural, urban, and suburban populations. METHOD: The review was done at two levels, moving from the major national survey studies which included data collected in the late 1980s up to 1993, to more focused topical areas including studies with data collection and publication between 1990 and 1996 within each identified category of adolescent health issues. A total of 137 published works across several disciplines were reviewed. Suggestions for clinical practice were drawn from the significant research findings. In addition, risk behaviors were compared to national baseline data and objectives. RESULTS: The level of research in this topic area was primarily descriptive. Currently, only a small portion of the national objectives for decreasing adolescent risk behaviors have been met. Successful intervention programs, although few in number, usually included not only topical education but also adolescent interaction with peers and support systems to raise awareness and change behaviors. CONCLUSIONS: The risk behaviors for the adolescent population as a whole have been well described. Education alone is not sufficient to change behaviors. Objective outcomes must be identified and health care providers need to use research findings in their practice with adolescents. It is time to intervene with developmentally and culturally appropriate strategies. There was a large gap in the literature regarding risk behaviors and protective factors for rural adolescents. The few studies that included subjects from rural settings indicated that the view that rural adolescents are engaged in fewer or less severe risk behaviors is misleading.

Adolescent↗
PubMed1996

Incidence and prevalence of physician-diagnosed asthma in a suburban population of young adults.

BACKGROUND: Asthma is a common chronic disease of both children and adults, but there have been few reports of the incidence of asthma in well defined adult populations. OBJECTIVE: To determine the incidence and prevalence of asthma in a population of young adults living in suburban Detroit. METHODS: As part of a study of the development of allergic disease in children, the parents of 841 study children, from a defined, well characterized population, were questioned about their personal histories of allergic disease, including asthma, during the mother's pregnancy. The children have been followed from birth until 4 years of age. When the child became 4, the parents were again questioned about allergic disease. Those reporting asthma when the child was 4 but not prior to the child's birth, were recontacted to confirm that they had been diagnosed by a physician as having asthma in the 4-year interval. Because of prior reports concerning racial differences in the prevalence of asthma and the small number of non-white mothers in the study population, calculations of asthma prevalence and incidence were limited to the 760 mothers, who described themselves and their baby's father as white. RESULTS: The parents studied were young adults mean age 28.7 [(standard deviation (SD) 4.5 years] and 31.0 (SD 5.0) years, of mothers and fathers, respectively. These parents were relatively well educated with 30.7% of mothers and 43.5% of fathers having college degrees. The initial prevalence of a previous physician diagnosis of asthma was 7.5% [95% confidence interval (95% CI) = 5.7-9.6] in the mothers and 6.9% (95% CI = 5.2-9.0) in the fathers, yielding a total prevalence of 7.2% (95% CI = 5.9-8.7) in these 1484 adults. Five hundred thirty-three mothers and 498 fathers (total = 1031), who did not report asthma during the mothers' pregnancies, were available for questioning when the children were 4 years old. The average yearly incidence of asthma was 5.2 (95% CI = 2.6-9.2) per 1000 in the mothers and 1.5 (95% CI = 0.3-4.4) per 1000 in the fathers (P = .058), with an overall incidence of 3.4 (95% CI = 1.8-5.7) per 1000. The average yearly incidence was 5.3/1000 in those < 30 years old and 1.5/1000 in those > or = 30 years of age (P = .056). CONCLUSIONS: We conclude that the incidence of asthma in this population of relatively young, well educated, white adults is approximately 3.4 per 1000 per year and that newly diagnosed asthma was more common in women and in those < 30 years of age.

Adolescent↗
PubMed1999

Immunization practices and beliefs of physicians in suburban Cook County, Illinois.

This study was conducted to ascertain the vaccination beliefs and practices of physicians who provide care for low income children. Sixty-two (56.9%) of a sample of 109 physicians in suburban Cook County, Illinois responded to a mail survey. A majority of physicians reported a willingness to immunize during well child care, follow-up, and chronic illness visits; yet, a substantial lack of willingness to immunize given certain acute mild illnesses was reported. Twenty-six percent of providers did not routinely identify children who were behind in immunizations and only 16% had completed a chart audit in the past three years. Seventy-four percent were willing to provide all shots needed at a single visit. Misconceptions regarding true contraindications was found among the group. Missed well child visits were identified as the greatest barrier to complete immunization. Improvements in vaccination rates are expected if physicians utilize all types of medical encounters to monitor the immunization status of patients and provide vaccines using only true medical contraindications.

Adult↗
PubMed1992

Social competence promotion with inner-city and suburban young adolescents: effects on social adjustment and alcohol use.

This study assessed the impact of school-based social competence training on skills, social adjustment, and self-reported substance use of 282 sixth and seventh graders. Training emphasized broad-based competence promotion in conjunction with domain-specific application to substance abuse prevention. The 20-session program comprised six units: stress management, self-esteem, problem solving, substances and health information, assertiveness, and social networks. Findings indicated positive training effects on Ss' skills in handling interpersonal problems and coping with anxiety. Teacher ratings revealed improvements in Ss' constructive conflict resolution with peers, impulse control, and popularity. Self-report ratings indicated gains in problem-solving efficacy. Results suggest some preventive impact on self-reported substance use intentions and excessive alcohol use. In general, the program was found to be beneficial for both inner-city and suburban students.

Adolescent↗
PubMed2003

The effect of sociodemographic factors on dental anxiety in children seen in a suburban Nigerian hospital.

OBJECTIVE: This paper attempts to determine the sociodemographic factors that relate to dental anxiety in suburban African children. METHODS: A short form of the Dental subscale of the Child Fear Survey schedule (DFSS_SF) was administered to 81 patients (first time attendees at the clinic) between the ages of eight and 13 years. The psychometric scale was used after determining its reliability and validity to ensure that it was culturally appropriate. Age, gender, sociodemographic status were also recorded. The dental anxiety score distribution, its threshold level as well as the relationship between the sociodemographic variables and patients' anxiety were determined. RESULTS: There was no statistically significant association between age (P = 0.856), gender (P = 0.124), socio-economic status of the children (P= 0.12) and level of dental anxiety. However, a statistically significant relationship did exist between the type of school the child attended and the anxiety level (P = 0.009). Also, 18 (14.8%) of the children were found to have high anxiety levels. CONCLUSIONS: Further studies involving larger non-clinic samples are needed to examine the issues raised by the findings of this study.

Adolescent↗