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Results for “Suburban Health”

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At least 19 recordsLinked to original sources
PubMed1995

The incidence and prevalence of anorexia nervosa in three suburban health districts in south west London, U.K.

OBJECTIVE: To determine incidence and prevalence of anorexia nervosa in a defined geographical area of south west London, UK, total population 519,900. METHOD: Hospital and community health workers in the defined area were contacted initially by letter asking them to identify all cases (new or existing) of anorexia nervosa known to them in the period July 1991-June 1992, using DSM-III-R criteria. A semistructured interview was conducted with the respondents to confirm the diagnosis. The large database record of the senior authors' specialist anorexia nervosa service, including inpatient and outpatient service records, was concurrently screened for cases living in the defined area. RESULTS: The prevalence of anorexia nervosa was found by this method to be 20.2 cases per 100,000 population (0.02% total population). Prevalence in females aged 15-29 years was 115.4 cases per 100,000 (0.1% of young females). Similarly, the annual incidence of anorexia nervosa was found to be 2.7 cases per 100,000 total population. In females aged 15-29 years the incidence was 19.2 cases per 100,000. DISCUSSION: Such prevalence and incidence figures are probably significant underestimates since the disorder can often defy detection or correct diagnosis and, with our own methodology, some identified cases may not have been reported to the study. However, these results can be used as a start for resource planning and service development.

Adolescent↗
PubMed1993

Dental health in suburban Jordanian preschool children.

There is no previous report from Jordan on dental health in preschool children. In the present study, carried out from November 1988 to January 1989, 255 Jordanian children aged 6 months to 6 years and living in a suburb of Amman were examined for dental caries and related factors. The disease was clinically visible in the second year of life. In the age group 3-6 years 72% had acquired caries, most of them severe. Boys and girls were affected similarly. The prevalence of caries was independent of social background factors. The reason for the high prevalence was probably early and uncontrolled intake of sweets combined with absence of dental cleaning. The authors pose that dental caries is becoming a major health problem among suburban Jordanian children and propose that this preventable disease should be tackled a the child health centers through teaching programmes directed to parents, commencing when the child is under one year of age.

Child↗
PubMed1988

Meeting the health care needs of suburban youth: review of a clinical service.

The demographic and medical data from the first 1,000 patients registered at a suburban adolescent health service were reviewed and the findings compared with the results of an initial survey performed in the same community and other health services located in urban communities. Most of the patients were white (92%), girls (82%), and 16 to 18 years of age (63%) and had parents who graduated from high school (59%) or college (28%). They reported higher rates of participation in health-risk behaviors, including smoking (50%), drinking (60%), drug use (67%), and sexual intercourse (83%), than their peers. Seventy-two percent of the patients sought medical attention for sexuality-related or gynecologic concerns, including contraception (39%), pregnancy determination (20%), and evaluation of possible sexually transmitted disease (9%), and 28% sought attention for general medical or emotional needs, including checkups or immunizations (11%), nutritional or weight problems (4%), and emotional issues or substance abuse (4%). Management of sexuality-related issues differed from that reported in urban settings, whereas laboratory screening tests indicated that problems were similar to those in other settings. Many problems described in an initial survey of youth in the community were not seen at the adolescent health service. We conclude that a suburban-based health service may meet certain health care needs of the higher risk youth of the community but that ultimate care for adolescents remains with the private physicians in this setting.

Adolescent↗
PubMed1995

Comparison of cocaine and opiate exposures between young urban and suburban children.

OBJECTIVE: To determine the prevalence of cocaine and opiate metabolites in the urine of young urban and suburban children. DESIGN: Survey. SETTING: Urban and suburban emergency departments and private pediatric practices. PATIENTS: A convenience sample of 1469 children between 1 and 60 months of age who required a urinalysis for investigation of the chief complaint. INTERVENTION: None. MAIN OUTCOME MEASURES: Urine was screened for benzoylecogonine and opiates using an enzyme-multiplied immunoassay technique and a fluorescence-polarization immunoassay, both with a sensitivity of 50 ng/mL. RESULTS: Benzoylecogonine was identified in the urine of 45 children (3.1%) (95% CI, 2.2% to 3.9%) and opiates in the urine of 38 children (2.6%) (95% CI, 1.8% to 3.4%). No difference was observed between urban and suburban health care facilities in the percentage of patients whose urine tested positive for benzoylecgonine (29 of 1011 vs 16 of 458, P = .6) or opiates (28 of 1011 vs 10 of 458, P = .6). CONCLUSION: Exposure to illicit drugs, as reflected by urinary metabolites, is similar for urban and suburban children.

Child, Preschool↗
PubMed2005

Breaking away from the medical model: perceptions of health and health care in suburban Sydney youth.

OBJECTIVES: To identify perceptions of health, health concerns, and health service needs among young people in a suburb of Sydney, New South Wales. DESIGN: Qualitative study using focus groups. SETTING: Berowra, a geographically isolated suburb on the outskirts of Sydney, between December 2002 and April 2003. PARTICIPANTS: 40 Berowra residents aged 14-24 years, recruited from two local government high schools (two groups), a local youth drop-in centre (one group), and the community, through advertising at the youth centre, local schools and church groups (one group). RESULTS: Focus group findings were classified into four broad themes. 1: Personal safety is a primary health concern. Berowra needs more recreational facilities to prevent drug and alcohol use related to boredom. 2: Health is more about quality of life than disease and illness. 3: Most health information comes from sources other than health providers. Health education must enable young people to make wise choices for the future. 4: Access to health services is of concern. More education is required on how Medicare works. Young people need to trust their service provider and will only see a doctor if they perceive themselves to be severely ill. Young people value meeting general practitioners in the school and community setting and not just in the doctor's consulting room. CONCLUSIONS: Young people desire a whole lifestyle approach to health rather than the traditional model based on diagnosis and disease. Health information needs to be accessible anonymously, and healthy lifestyles need to be promoted throughout the whole community, using youth workers and sporting leaders as role models.

Adolescent↗
PubMed1999

Improving quality in general practice: qualitative case study of barriers faced by health authorities.

OBJECTIVES: To identify and assess the barriers that health authorities face as they manage quality improvements in general practice in the context of the NHS reforms. DESIGN: Qualitative case study. SETTING: Three UK health authorities: a rural health authority in the south west, a deprived inner city health authority in the north east, and an affluent suburban health authority in the south east. PARTICIPANTS: Senior and junior managers. MAIN OUTCOME MEASURES: Structure of strategic and organisational management, and barriers to the leadership and management of quality improvement in general practice. RESULTS: Seven barriers were identified: absence of an explicit strategic plan for general practice, competing priorities for attention of the health authority, sensitivity of health professionals, lack of information due to poor quality of clinical data, lack of authority to implement change, unclear roles and responsibilities of managers within the organisations, and isolation from other authorities or organisations facing similar challenges. CONCLUSIONS: The health authorities faced significant barriers that would impede their ability to fulfil their responsibilities in the new NHS and that would reduce their capacity to contribute to quality improvements in general practice.

Family Practice↗
PubMed2004

Rising statin use and effect on ischemic stroke outcome.

BACKGROUND: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) have neuroprotective effects in experimental stroke models and are commonly prescribed in clinical practice. The aim of this study was to determine if patients taking statins before hospital admission for stroke had an improved clinical outcome. METHODS: This was an observational study of 436 patients admitted to the National Institutes of Health Suburban Hospital Stroke Program between July 2000 and December 2002. Self-reported risk factors for stroke were obtained on admission. Stroke severity was determined by the admission National Institutes of Health Stroke Scale score. Good outcome was defined as a Rankin score < 2 at discharge. Statistical analyses used univariate and multivariate logistic regression models. RESULTS: There were 436 patients with a final diagnosis of ischemic stroke; statin data were available for 433 of them. A total of 95/433 (22%) of patients were taking a statin when they were admitted, rising from 16% in 2000 to 26% in 2002. Fifty-one percent of patients taking statins had a good outcome compared to 38% of patients not taking statins (p = 0.03). After adjustment for confounding factors, statin pretreatment was associated with a 2.9 odds (95% CI: 1.2-6.7) of a good outcome at the time of hospital discharge. CONCLUSIONS: The proportion of patients taking statins when they are admitted with stroke is rising rapidly. Statin pretreatment was significantly associated with an improved functional outcome at discharge. This finding could support the early initiation of statin therapy after stroke.

Aged↗
PubMed1995

Psychosocial variables associated with teenage pregnancy.

This study investigated whether psychosocial factors differentiate sexually active teenagers who become pregnant from those who do not. Data were collected from 64 unmarried adolescents who attended a suburban health clinic for a pregnancy test or for contraceptive care. Thirty-nine percent of the sample had been or were now pregnant, and 61% had never been pregnant. Each teenager completed a questionnaire and three self-report measures (Life Events Checklist, Self-Worth, Health Locus of Control) prior to her medical visit. Information about family, medical, and psychosocial history was obtained from chart review. When girls who had positive pregnancy tests, and sexually active girls who had never been pregnant were compared, no significant differences emerged on socioeconomic status, race, religion, age or psychological variables. However, when adolescents with a previous or current history of pregnancy (N = 25) were compared with girls who had never been pregnant (N = 39), using the Mann Whitney test, two significant differences were found: adolescents with a history of pregnancy had first intercourse at the mean age of 15 rather than 16 (p < .02) and scored higher than never-pregnant teenagers on the "Powerful Other" Health Locus of Control subscale, a measure of strong belief in external control by others (p < .01). No significant differences were detected between the groups for self-worth or life events perceived as stressful during the past year. These data indicate that in a middle-class suburban population of sexually active teenagers, earlier age at first intercourse and the influence of powerful others are important variables associated with pregnancy.

Adolescent↗
PubMed2003

Project teams produce successful turnaround for Illinois hospital.

When Jay Kreuzer was hired as president and CEO of West Suburban Health Care, it didn't take him long to realize the organization was headed in the wrong direction. The not-for-profit system, which includes a 258-bed medical center, was projected to end fiscal year 2001 with a loss of $19 million. Kreuzer put together a team that implemented an organization-wide performance improvement effort. In just two years the turnaround has been completed, as West Suburban ended fiscal year 2003 with a small surplus.

Cooperative Behavior↗
PubMedDate not supplied

Adverse events during interfacility transfers by ground advanced life support services.

OBJECTIVE: To identify risk factors for adverse events that occur during interfacility transfers by advanced life support (ALS). DESIGN: A four-year, retrospective, case series. SETTING: Three ALS units in a rural/suburban emergency medical services (EMS) system. PARTICIPANTS: 351 transports to or from twelve acute care facilities; two patients records could not be located. INTERVENTIONS: Patients were classified by illness/injury, transporting staff, and ongoing therapy; these were correlated with frequency of ALS intervention and patient deterioration. RESULTS: During the study period, the number of transfers as a percentage of total calls (1.1%-5.2%) rose consistently. There were 11 illness/injury categories; the largest was cardiac (44%, 154 patients). Hospital staff accompanied the patient in 15% (52). Advanced life support (ALS) therapy was required in 4.9% (17): one monitored cardiac arrest was defibrillated successfully, 13 patients required unanticipated medication therapy, and three were noted to have clinical deterioration en route. The upper 95% confidence limit for cardiac arrest is 12.9/1,000 transfers or 20.8/1,000 hours. Patient deterioration and the need for ALS intervention were associated with the presence of medication infusions (p < .05), but not with hospital staff (p > .40). CONCLUSIONS: Interfacility transfers of a heterogeneous group of patients in this series involve a low risk of cardiac arrest. Patients with medication infusions are at higher risk of deterioration and more frequently require ALS intervention en route. The presence of hospital staff had no measurable effect. These findings have implications for the development of ALS transfer protocols.

Ambulances↗