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Sample records for urban pediatric population

  1. Usability testing of a computerized communication tool in a diverse urban pediatric population.

    Science.gov (United States)

    Tsimicalis, Argerie; Stone, Patricia W; Bakken, Suzanne; Yoon, Sunmoo; Sands, Stephen; Porter, Rechelle; Ruland, Cornelia

    2014-01-01

    Developed in Norway, Sisom is an interactive, rigorously tested, computerized, communication tool designed to help children with cancer express their perceived symptoms/problems. Children travel virtually from island to island rating their symptoms/problems. While Sisom has been found to significantly improve communication in patient consultations in Norway, usability testing is warranted with US children prior to further use in research studies. The objective of this study was to determine the usability of Sisom in a sample of English- and Spanish-speaking children in an urban US community. A mixed-methods usability study was conducted with a purposive sample of healthy children and children with cancer. Semistructured interviews were used to assess healthy children's symptom recognition. Children with cancer completed 8 usability tasks captured with Morae 3.3 software. Data were downloaded, transcribed, and analyzed descriptively. Four healthy children and 8 children with cancer participated. Of the 44 symptoms assessed, healthy children recognized 15 (34%) pictorial symptoms immediately or indicated 13 (30%) pictures were good representations of the symptom. Six children with cancer completed all tasks. All children navigated successfully from one island to the next, ranking their symptom/problem severity, clicking the magnifying glass for help, or asking the researcher for assistance. All children were satisfied with the aesthetics and expressed an interest in using Sisom to communicate their symptoms/problems. A few minor suggestions for improvement and adjustment may optimize the use of Sisom for US children. Sisom may help clinicians overcome challenges assessing children's complex symptoms/problems in a child-friendly manner.

  2. Population, migration and urbanization.

    Science.gov (United States)

    1982-06-01

    Despite recent estimates that natural increase is becoming a more important component of urban growth than rural urban transfer (excess of inmigrants over outmigrants), the share of migration in the total population growth has been consistently increasing in both developed and developing countries. From a demographic perspective, the migration process involves 3 elements: an area of origin which the mover leaves and where he or she is considered an outmigrant; the destination or place of inmigration; and the period over which migration is measured. The 2 basic types of migration are internal and international. Internal migration consists of rural to urban migration, urban to urban migration, rural to rural migration, and urban to rural migration. Among these 4 types of migration various patterns or processes are followed. Migration may be direct when the migrant moves directly from the village to the city and stays there permanently. It can be circular migration, meaning that the migrant moves to the city when it is not planting season and returns to the village when he is needed on the farm. In stage migration the migrant makes a series of moves, each to a city closer to the largest or fastest growing city. Temporary migration may be 1 time or cyclical. The most dominant pattern of internal migration is rural urban. The contribution of migration to urbanization is evident. For example, the rapid urbanization and increase in urban growth from 1960-70 in the Republic of Korea can be attributed to net migration. In Asia the largest component of the population movement consists of individuals and groups moving from 1 rural location to another. Recently, because urban centers could no longer absorb the growing number of migrants from other places, there has been increased interest in the urban to rural population redistribution. This reverse migration also has come about due to slower rates of employment growth in the urban centers and improved economic opportunities

  3. Effect of a text messaging intervention on influenza vaccination in an urban, low-income pediatric and adolescent population: a randomized controlled trial.

    Science.gov (United States)

    Stockwell, Melissa S; Kharbanda, Elyse Olshen; Martinez, Raquel Andres; Vargas, Celibell Y; Vawdrey, David K; Camargo, Stewin

    2012-04-25

    Influenza infection results in substantial costs, morbidity, and mortality. Vaccination against influenza is particularly important in children and adolescents who are a significant source of transmission to other high-risk populations, yet pediatric and adolescent vaccine coverage remains low. Traditional vaccine reminders have had a limited effect on low-income populations; however, text messaging is a novel, scalable approach to promote influenza vaccination. To evaluate targeted text message reminders for low-income, urban parents to promote receipt of influenza vaccination among children and adolescents. Randomized controlled trial of 9213 children and adolescents aged 6 months to 18 years receiving care at 4 community-based clinics in the United States during the 2010-2011 influenza season. Of the 9213 children and adolescents, 7574 had not received influenza vaccine prior to the intervention start date and were included in the primary analysis. Parents of children assigned to the intervention received up to 5 weekly immunization registry-linked text messages providing educational information and instructions regarding Saturday clinics. Both the intervention and usual care groups received the usual care, an automated telephone reminder, and access to informational flyers posted at the study sites. Receipt of an influenza vaccine dose recorded in the immunization registry via an electronic health record by March 31, 2011. Receipt was secondarily assessed at an earlier fall review date prior to typical widespread influenza activity. Study children and adolescents were primarily minority, 88% were publicly insured, and 58% were from Spanish-speaking families. As of March 31, 2011, a higher proportion of children and adolescents in the intervention group (43.6%; n = 1653) compared with the usual care group (39.9%; n = 1509) had received influenza vaccine (difference, 3.7% [95% CI, 1.5%-5.9%]; relative rate ratio [RRR], 1.09 [95% CI, 1.04-1.15]; P = .001). At the

  4. Psoriasis in the pediatric population

    International Nuclear Information System (INIS)

    Vindas Calderon, Wendy

    2013-01-01

    A scientific and updated bibliographic review is realized for handling and care of a pediatric patient with psoriasis disease. Health personnel related with this pathology must to know the different perspectives and angles of psoriasis, as well as clinical criteria, therapeutic and emotional in the treatment of patients. The incidence of psoriasis is recognized globally. Ethnic groups have developed with most frequently this disorder. The different clinical faces of psoriasis are studied. The morphological and topographical manifestations have presented a variety very similar to that of adults, and have made for the doctor difficult to make the diagnostic. Clinical studies that were realized in the last years, have reported etiological and pathogenic evidence, both genetic and immunological of this illness. Children with psoriasis usually have presented a mild illness, where psoriasis type plaque has been the predominant variant. Psoriasis in the population has required a special attention in triggers or aggravating factors of this disease such as infections, exposure to snuff, obesity, stress and interactions with other drugs. The discovery and use of new drugs have led to different etiological factors for the handling of psoriasis; so it is important to know the function, availability and adverse effects that can to cause new therapies. Treatments must to include the provision of a safe and effective therapy for the maintenance for free long periods of lesions, reducing the severity of the disease, and inhibiting structural damage of joints. The topical treatment has been the therapy of first choice in mild psoriasis and localized. An interrogatory is recommended to decide objectively a systemic treatment, because the infant population has been a sensitive group of possible adverse effects. Methotrexate has been the treatment of choice for psoriasis related to arthropathy both adults and children. Phototherapy, including UVB, PUVA light and excimer laser is

  5. Dexmedetomidine in the pediatric population

    DEFF Research Database (Denmark)

    Plambech, Morten; Afshari, A

    2015-01-01

    Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solution...... of sedation of children. In this paper, we assess 51 minor trials in the form of 44 randomized controlled trials and 7 prospective observational studies in an attempt to update the available evidence on dexmedetomidine use in pediatrics. Furthermore, we discuss its potential indications, benefits and adverse....... Based on the best current evidence dexmedetomidine is found suitable and safe for various indications. However, in order to discover its full potential, indications, dosing and safety profile for various ages and procedures, it should urgently be examined by conducting good quality pediatric trials...

  6. The family role in children׳s sleep disturbances: Results from a cross-sectional study in a Portuguese Urban pediatric population.

    Science.gov (United States)

    Martins, Andreia Luís; Chaves, Petra; Papoila, Ana Luísa; Loureiro, Helena Cristina

    2015-11-01

    Sleep Disorders (SlD) are frequently undervalued complaints in childhood. Several factors influence sleep, particularly socio-cultural environment and medical conditions such as breathing disorders. Poor sleep hygiene has physical, educational and social consequences. In Portugal, there are few published studies about children׳s sleep habits and rarely based on validated questionnaires. To study the prevalence of SlD and associated factors, in an outpatient pediatric population of a Primary Health Care Center (PHCC). Cross-sectional study of children admitted to a PHCC on a suburban area of Lisbon. Children Sleep Habits Questionnaire, validated for the Portuguese population (CSHQ-PT) for the screening of SlD (cut-off=44), was applied to parents, as well as a demographic inquiry. Body mass index z-score was evaluated. Children scoring 44 or above were sent to Pediatric Sleep Disorders consultation (PSDC). Parametric and non-parametric tests were used whenever appropriate. From 128 children, 57.8% were male; the median age was 6.0 years (P 25=5.0; P 75=8.0). The median of cohabitants per family was 4.0 (P 25=3.0; P 75=5.0); 21.1% lived in a single-parent family. From CSHQ-PT, 59.4% (76) scored above the cut-off. Data showed that children from a single-parent family have more SlD (p=0.048), particularly parasomnia (p=0.019). Children with sleep disordered breathing (SDB) suffer more daytime sleepiness (p=0.034). From 63 children sent to PSDC, 33 attended. Regarding these children, a difference was found between BMI z-scores of those with and without SDB (p=0.06). Family structure plays a non-negligible role in children's sleep habits. Daily performance of children with SDB may become compromised.

  7. Gastroesophageal scintiscanning in a pediatric population: dosimetry

    International Nuclear Information System (INIS)

    Castronovo, F.P. Jr.

    1986-01-01

    The dosimetry associated with orally administered [/sup 99m/Tc]sulfur colloid for the diagnosis of gastroesophageal reflux has not been adequately described for the pediatric populations. Standard MIRD methodology was performed for the following: newborn, 1, 5, 10, and 15 yr old, and adult standard man. The critical organ for all pediatric groups was the lower large intestine with absorbed dose of 0.927, 0.380, 0.194, 0.120 and 0.0721 rad/100 microCi, respectively. For the adult the critical organ was the upper large intestine with an absorbed dose of 0.0518 rad/100 microCi. These data should be considered when administering [99mTc]sulfur colloid orally in a pediatric population

  8. Thermodynamics of urban population flows.

    Science.gov (United States)

    Hernando, A; Plastino, A

    2012-12-01

    Orderliness, reflected via mathematical laws, is encountered in different frameworks involving social groups. Here we show that a thermodynamics can be constructed that macroscopically describes urban population flows. Microscopic dynamic equations and simulations with random walkers underlie the macroscopic approach. Our results might be regarded, via suitable analogies, as a step towards building an explicit social thermodynamics.

  9. Capital, population and urban patterns.

    Science.gov (United States)

    Zhang, W

    1994-04-01

    The author develops an approach to urban dynamics with endogenous capital and population growth, synthesizing the Alonso location model, the two-sector neoclassical growth model, and endogenous population theory. A dynamic model for an isolated island economy with endogenous capital, population, and residential structure is developed on the basis of Alonso's residential model and the two-sector neoclassical growth model. The model describes the interdependence between residential structure, economic growth, population growth, and economic structure over time and space. It has a unique long-run equilibrium, which may be either stable or unstable, depending upon the population dynamics. Applying the Hopf theorem, the author also shows that when the system is unstable, the economic geography exhibits permanent endogenous oscillations.

  10. Breastfeeding among Latino Families in an Urban Pediatric Office Setting

    Directory of Open Access Journals (Sweden)

    Elizabeth Sloand

    2016-01-01

    Full Text Available Objective. To determine the breastfeeding rate of Latino infants at an urban pediatric clinic in the first six months of life and to identify factors associated with breastfeeding. Methods. Investigators conducted a retrospective chart review of infants seen at the clinic in 2014 as part of a mixed methods study. Topics reviewed included demographics, infant health data, and feeding methods at 5 points in time. Bivariate correlations and cross-tabulations explored associations between variables. Results. Most of the mothers (75% fed their newborns with both breastfeeding and formula (las dos. At 6 months, a majority were formula-fed only (55.9%. Approximately 10% of mothers exclusively breastfed their newborns, and the trend of exclusive breastfeeding remained steady through the 6-month visit. Over time, the number of mothers who exclusively bottle-feed their infants steadily rises. There were no statistical differences among the feeding method groups with regard to birth order of child, number of adults or children in the household, vaccination rate, number of sick visits, or infants’ growth. Conclusions. More targeted attention to this population and other immigrant populations with culturally tailored interventions spanning the prenatal to early infancy periods could increase exclusive breastfeeding and ultimately improve child health.

  11. Branchial anomalies in the pediatric population.

    Science.gov (United States)

    Schroeder, James W; Mohyuddin, Nadia; Maddalozzo, John

    2007-08-01

    We sought to review the presentation, evaluation, and treatment of branchial anomalies in the pediatric population and to relate these findings to recurrences and complications. We conducted a retrospective study at a tertiary care pediatric hospital. Ninety-seven pediatric patients who were treated for branchial anomalies over a 10-year period were reviewed. Patients were studied if they underwent surgical treatment for the branchial anomaly and had 1 year of postoperative follow-up; 67 children met criteria, and 74 anomalies were studied. Patients with cysts presented at a later age than did those with branchial anomaly fistulas or sinus branchial anomalies. 32% of branchial anomalies were previously infected. Of these, 71% had more than one preoperative infection. 18% of the BA were first arch derivatives, 69% were second arch derivatives and 7% were third arch derivatives. There were 22 branchial cysts, 31 branchial sinuses and 16 branchial fistulas. The preoperative and postoperative diagnoses differed in 17 cases. None of the excised specimens that contained a cystic lining recurred; all five recurrences had multiple preoperative infections. Recurrence rates are increased when there are multiple preoperative infections and when there is no epithelial lining identified in the specimen.

  12. Novel gender-specific visceral adiposity index for Mexican pediatric population

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    María J. Garcés

    2014-10-01

    Conclusions: VAI formula construction seemed to be different in children compared to adults. In the present study we propose a new gender-specific visceral adipose index for pediatric Mexican population living in urban areas that could be further used to predict abnormal cardiometabolic outcomes.

  13. Tics in the Pediatric Population: Pragmatic Management.

    Science.gov (United States)

    Ganos, Christos; Martino, Davide; Pringsheim, Tamara

    2017-01-01

    Primary tic disorders, notably Tourette syndrome, are very common movement disorders in childhood. However, the management of such patients still poses great therapeutic challenges to medical professionals. Based on a synthesis of the available guidelines published in Europe, Canada, and the United States, coupled with more recent therapeutic developments, the authors provide a pragmatic guide to aid clinicians in deciding when and how to treat patients who have primary tic disorders. After a systematic assessment of tics and common neuropsychiatric comorbidities (primarily attention-deficit hyperactivity disorder [ADHD] and obsessive-compulsive disorder [OCD]), the first step in treatment is a comprehensive psychoeducation of patients and families that addresses the protean phenomenology of tics and associated behaviors, coping mechanisms, prognosis, and treatment options. When more active intervention beyond watchful monitoring is indicated, hierarchical evaluation of treatment targets (i.e., tics vs. comorbid behavioral symptoms) is crucial. Behavioral treatments for tics are restricted to older children and are not readily available to all centers, mainly due to the paucity of well-trained therapists. Pharmacological treatments, such as antipsychotics for tics, stimulants and atomoxetine for ADHD, and α2A-agonists for children with tics plus ADHD, represent widely available and effective treatment options, but safety monitoring must be provided. Combined polypharmacological and behavioral/pharmacological approaches, as well as neuromodulation strategies, remain under-investigated in this population of patients. The treatment of children with tics and Tourette syndrome is multifaceted. Multidisciplinary teams with expertise in neurology, psychiatry, psychology, and pediatrics may be helpful to address the complex needs of these children.

  14. DXA Performance in a Pediatric Population

    DEFF Research Database (Denmark)

    de Knegt, Victoria Elizabeth; Carlsen, Emma Louise Malchau; Bech Jensen, Jens-Erik

    2015-01-01

    , the effects of flannel sheets and breast milk were investigated using a pediatric phantom. Reconstruction of suboptimal scans resulted in more accurate body weight estimates. Moderate weight change and repositioning had no significant effect on the variation between scans. No significant body composition...

  15. Petrous apex lesions in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Rupa [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Son, Hwa Jung [University of Cincinnati College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH (United States); Koch, Bernadette L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-03-15

    A variety of abnormal imaging findings of the petrous apex are encountered in children. Many petrous apex lesions are identified incidentally while images of the brain or head and neck are being obtained for indications unrelated to the temporal bone. Differential considerations of petrous apex lesions in children include ''leave me alone'' lesions, infectious or inflammatory lesions, fibro-osseous lesions, neoplasms and neoplasm-like lesions, as well as a few rare miscellaneous conditions. Some lesions are similar to those encountered in adults, and some are unique to children. Langerhans cell histiocytosis (LCH) and primary and metastatic pediatric malignancies such as neuroblastoma, rhabomyosarcoma and Ewing sarcoma are more likely to be encountered in children. Lesions such as petrous apex cholesterol granuloma, cholesteatoma and chondrosarcoma are more common in adults and are rarely a diagnostic consideration in children. We present a comprehensive pictorial review of CT and MRI appearances of pediatric petrous apex lesions. (orig.)

  16. Overweight and obesity: overrepresentation in the pediatric reconstructive burn population.

    Science.gov (United States)

    Mayes, Theresa; Gottschlich, Michele M; Allgeier, Chris; Khoury, Jane; Kagan, Richard J

    2010-01-01

    Pediatric burn patients are predisposed to excessive weight gain in the reconstructive period, but the cause is unclear. An overweight (OW) or obese (OB) condition is associated with numerous health risks, decreased physical function, and increased morbidity. The purpose of this study was to compare the frequency of OW status in reconstructive, pediatric burn patients with the prevalence in the US population. The authors reviewed the records of 1533 pediatric patients, >1 year from acute burn, admitted for an elective reconstructive procedure. Body mass index between 85th and 95th percentile, according to the National Center for Health Statistics for 2000 growth charts, was classified as OW, and body mass index >95th percentile was classified as OB. Frequency of OW and OB and racial disparity was calculated as a percentage of total patients and compared with pediatric data from National Health and Nutrition Examination Survey for 1999 to 2006, a nationally representative sample. The rate of OW and OB was 16.3 and 24.1%, respectively, in the authors' pediatric burn population. White patients had OW and OB rates of 15.9 and 23.6%, respectively, compared with 18.2 and 30.2%, respectively, in black patients. All OW and OB rates were outside the 95% confidence interval of the nationally representative National Health and Nutrition Examination Survey population. The rates of OW and OB in pediatric reconstructive burn patients exceed the US population standard across age and race stratifications. The prevention and treatment of excessive weight gain should be a component of rehabilitation in pediatric burns.

  17. Population development in Ljubljana urban region

    Directory of Open Access Journals (Sweden)

    Dejan Rebernik

    2004-12-01

    Full Text Available The paper presents the main characteristic of population development and urbanisation processes in Ljubljana and Ljubljana urban region. Up to the end of the seventies fast population growth was a consequence of strong immigration from rural parts of Slovenia and the rest of Yugoslavia. In the eighties and nineties deconcentration of population within the region with intense suburbanisation and depopulation of inner city and older residential neighbourhoods were the main urbanisation processes. In the second half of the nineties the highest population growth was recorded in dispersed rural settlements in the periphery of the region. In some parts of the inner city reurbanisation and gentrification occurred.

  18. Shrinking population and the urban hierarchy

    OpenAIRE

    Kim, Ho Yeon

    2012-01-01

    This paper examines whether population shrinkage leads to changes in the urban hierarchy in terms of relative sizes of cities and their functions onomic geography. We work backwards in a racetrack economy with eight cities in a long-run equilibrium. Initial distribution of population is chosen to satisfy both the rank-size rule and central place hierarchy. We have a short-run equilibrium in which firms choose prices and consumers choose consumption taking the number of workers in each region ...

  19. Optimizing Perioperative Nutrition in Pediatric Populations.

    Science.gov (United States)

    Canada, Nicki L; Mullins, Lucille; Pearo, Brittany; Spoede, Elizabeth

    2016-02-01

    Nutrition status prior to surgery and nutrition rehabilitation after surgery can affect the morbidity and mortality of pediatric patients. A comprehensive approach to nutrition in pediatric surgical patients is important and includes preoperative assessment, perioperative nutrition considerations, and postoperative recovery. A thorough nutrition assessment to identify patients who are at nutrition risk prior to surgery is important so that the nutrition status can be optimized prior to the procedure to minimize suboptimal outcomes. Preoperative malnutrition is associated with increased complications and mean hospital days following surgery. Enteral and parenteral nutrition can be used in cases where food intake is inadequate to maintain and possibly improve nutrition status, especially in the 7-10 days prior to surgery. In the perioperative period, fasting should be limited to restricting solid foods and non-human milk 6 hours prior to the procedure and allowing clear liquids until 2 hours prior to the procedure. Postoperatively, early feeding has been shown to resolve postoperative ileus earlier, decrease infection rates, promote wound healing, and reduce length of hospital stay. If nutrition cannot be provided orally, then nutrition through either enteral or parenteral means should be initiated within 24-48 hours of surgery. Practitioners should identify those patients who are at the highest nutrition risk for postsurgical complications and provide guidance for optimal nutrition during the perioperative and postoperative period. © 2015 American Society for Parenteral and Enteral Nutrition.

  20. Pharmacologic studies in vulnerable populations: Using the pediatric experience.

    Science.gov (United States)

    Zimmerman, Kanecia; Gonzalez, Daniel; Swamy, Geeta K; Cohen-Wolkowiez, Michael

    2015-11-01

    Historically, few data exist to guide dosing in children and pregnant women. Multiple barriers to inclusion of these vulnerable populations in clinical trials have led to this paucity of data. However, federal legislation targeted at pediatric therapeutics, innovative clinical trial design, use of quantitative clinical pharmacology methods, pediatric thought leadership, and collaboration have successfully overcome many existing barriers. This success has resulted in improved knowledge on pharmacokinetics, safety, and efficacy of therapeutics in children. To date, research in pregnant women has not been characterized by similar success. Wide gaps in knowledge remain despite the common use of therapeutics in pregnancy. Given the similar barriers to drug research and development in pediatric and pregnant populations, the route toward success in children may serve as a model for the advancement of drug development and appropriate drug administration in pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China

    Directory of Open Access Journals (Sweden)

    Huikuan Chu

    2014-01-01

    Full Text Available Objective. To acquire more data about the epidemiologic characteristics of constipation in different kinds of populations in China. Methods. Using “constipation” and “China” as search terms; relevant papers were searched from January 1995 to April 2014. Data on prevalence, gender, diagnostic criteria, geographical area, educational class, age, race, and physician visit results were extracted and analyzed. Results. 36 trials were included. Prevalence rates of constipation in elderly population (18.1% and pediatric population (18.8% were significantly higher than that in general population (8.2%. Prevalence of constipation defined by non-Rome criteria was higher than that by Rome criteria in general population. Prevalence rates of constipation were different for different geographical area. People with less education were predisposed to constipation. In pediatric population, prevalence of constipation was the lowest in children aged 2–6 years. Prevalence of constipation in ethnic minorities was higher than that in Han people. People with constipation were predisposed to FD, haemorrhoid, and GERD. Only 22.2% patients seek medical advice in general population. Conclusions. In China, prevalence of constipation was lower compared with most of other countries. The factors including female gender, diagnostic criteria, geographical area, age, educational class, and race seemed to have major effects on prevalence of constipation.

  2. METHODOLOGICAL ISSUES OF CLINICAL TRIALS IN THE PEDIATRIC POPULATION

    Directory of Open Access Journals (Sweden)

    S.V. Topolyanskaya

    2010-01-01

    Full Text Available Conducting clinical trials on children population is a challenge both for organizers and pediatricians involved in trials. Difficulties in recruiting patients, a significant heterogenecity of the population, specific side reactions, difficulties in identifying the objective final points warrant the specific nature of designing clinical trials in pediatrics. The article illustrates key issues and methodology aspects: planning, design, control groups, patient recruitment. It stresses the need to carefully consider specific characteristics of a child’s system and multi-disciplinary approach involving a pediatrician at the early stages of planning, preliminary consultations with parent organizations, children and regulators.Key words: clinical trials, methodology, planning, design, patient recruitment, children. (Pediatric Pharmacology. – 2010; 7(5:6-10

  3. Analysis of a Pediatric Home Mechanical Ventilator Population.

    Science.gov (United States)

    Amirnovin, Rambod; Aghamohammadi, Sara; Riley, Carley; Woo, Marlyn S; Del Castillo, Sylvia

    2018-05-01

    The population of children requiring home mechanical ventilation has evolved over the years and has grown to include a variety of diagnoses and needs that have led to changes in the care of this unique population. The purpose of this study was to provide a descriptive analysis of pediatric patients requiring home mechanical ventilation after hospitalization and how the evolution of this technology has impacted their care. A retrospective, observational, longitudinal analysis of 164 children enrolled in a university-affiliated home mechanical ventilation program over 26 years was performed. Data included each child's primary diagnosis, date of tracheostomy placement, duration of mechanical ventilation during hospitalization that consisted of home mechanical ventilator initiation, total length of pediatric ICU stay, ventilator settings at time of discharge from pediatric ICU, and disposition (home, facility, or died). Univariate, bivariate, and regression analysis was used as appropriate. The most common diagnosis requiring the use of home mechanical ventilation was neuromuscular disease (53%), followed by chronic pulmonary disease (29%). The median length of stay in the pediatric ICU decreased significantly after the implementation of a ventilator ward (70 d [30-142] vs 36 d [18-67], P = .02). The distribution of subjects upon discharge was home (71%), skilled nursing facility (24%), and died (4%), with an increase in the proportion of subjects discharged on PEEP and those going to nursing facilities over time ( P = 0.02). The evolution of home mechanical ventilation has allowed earlier transition out of the pediatric ICU and with increasing disposition to skilled nursing facilities over time. There has also been a change in ventilator management, including increased use of PEEP upon discharge, possibly driven by changes in ventilators and in-patient practice patterns. Copyright © 2018 by Daedalus Enterprises.

  4. Laryngeal sarcoidosis: presentation and management in the pediatric population.

    Science.gov (United States)

    Strychowsky, Julie E; Vargas, Sara O; Cohen, Ezra; Vielman, Rene; Son, Mary Beth; Rahbar, Reza

    2015-09-01

    Sarcoidosis is a disease characterized by systemic non-necrotizing granulomas of unknown etiology. Laryngeal sarcoidosis is extremely uncommon, especially among pediatric patients. The clinical presentation and management of this entity in the pediatric population are poorly understood. A comprehensive search in PubMed was conducted to identify all cases in the published literature. We also present a case of isolated pediatric laryngeal sarcoidosis and outline the multidisciplinary approach to evaluation and management. A previously healthy 13-year-old female presented with a five-month history of mild dysphonia, dyspnea on exertion, and diffuse supraglottic edema. Biopsy showed non-necrotizing granulomas. Treatment with methotrexate led to marked improvement. The literature search identified seven previously published cases of pediatric laryngeal sarcoidosis, four in which disease was isolated to the larynx. All patients presented with a symptomatic and diffusely edematous supraglottis. Diagnoses were based on supraglottic biopsies showing non-necrotizing granulomas; all other possible etiopathologies were excluded. Three patients responded to corticosteroid therapy alone, one patient to tumor necrosis factor (TNF) inhibitor and methotrexate, and the remainder to a combination of corticosteroid therapy and surgical debulking. Laryngeal sarcoidosis in the pediatric population is challenging to diagnose and manage. When epithelioid granulomas are encountered histologically, other causes of granulomatous inflammation must be ruled out before a diagnosis of sarcoidosis can be made. Corticosteroid therapy alone may be ineffective. Medical therapy with methotrexate alone or in combination with TNF inhibitors versus surgical debulking alone or as part of multimodality treatment should be considered. A multidisciplinary approach with involvement of an otolaryngologist, pathologist, and rheumatologist is suggested. Copyright © 2015 Elsevier Ireland Ltd. All rights

  5. Use of an electronic medical record improves the quality of urban pediatric primary care.

    Science.gov (United States)

    Adams, William G; Mann, Adriana M; Bauchner, Howard

    2003-03-01

    To evaluate the quality of pediatric primary care, including preventive services, before and after the introduction of an electronic medical record (EMR) developed for use in an urban pediatric primary care center. A pre-postintervention analysis was used in the study. The intervention was a pediatric EMR. Routine health care maintenance visits for children eye-to-eye contact with patients was reduced, and 4 of 7 reported that use of the system increased the duration of visits (mean: 9.3 minutes longer). All users recommended continued use of the system. Use of the EMR in this study was associated with improved quality of care. This experience suggests that EMRs can be successfully used in busy urban pediatric primary care centers and, as recommended by the Institute of Medicine, must play a central role in the redesign of the US health care system.

  6. Obesity and outcomes following burns in the pediatric population.

    Science.gov (United States)

    Ross, Evan; Burris, Agnes; Murphy, Joseph T

    2014-03-01

    While obesity is associated with increased mortality and decreased functional outcomes in adult burn patients, the ramifications of larger than average body size in the pediatric burn population are less well understood. The present study examines whether obesity was associated with poor outcomes following pediatric burn injuries. Thermal injury data for patients ≤ 18 years of age admitted to a Level III burn center over ten years (n=536) was analyzed. Obesity was defined as ≥ 95 th percentile of weight for height according to the WHO growth charts (obese (n=154) and non-obese (n=382) children. All data was collected in accordance with IRB regulations. Obese and non-obese thermally-injured children did not differ in TBSA, percentage of full thickness burn, or overall mortality. However, these groups were significantly different with respect to age (obese=7.16 ± 0.46 years, non-obese=9.38 ± 0.32 years, pobese=4.89 ± 1.3 days, non-obese=2.67 ± 0.49 days, pobese (n=46) and non-obese (n=129) did not differ significantly with respect to age, TBSA, percentage of full thickness burn or other outcome measures. However, significant differences between these groups were noted for ICU LOS (obese=18.59 ± 5.18 days, non-obese=9.51 ± 1.82 days, pobese=11.65 ± 3.91 days, non-obese=3.92 ± 0.85 days, pobese pediatric patients required longer and more intensive medical support in the form of BICU care and respiratory intervention. Counter to findings in adult populations, differences in mortality were not observed. Collectively, these findings suggest obesity as a risk factor for increased morbidity in the pediatric burn population. © 2014 Elsevier Inc. All rights reserved.

  7. Endoscopic management of posttraumatic supraglottic stenosis in the pediatric population.

    LENUS (Irish Health Repository)

    Oosthuizen, Johannes Christiaan

    2012-02-01

    OBJECTIVES: Pediatric blunt laryngeal trauma is a rare and potentially life-threatening entity. External injuries can be misleading, and a high index of suspicion, as well as early intervention, is essential to achieve the best possible outcome. The authors of this report review the management of blunt laryngeal trauma in the pediatric population and describe the endoscopic management of posttraumatic supraglottic stenosis. METHODS: Methods used were case report from a tertiary referral institution and review of the literature. RESULTS: We describe the case of a 13-year-old girl whom developed supraglottic stenosis following blunt laryngeal trauma. Innovative endoscopic techniques were used in the successful management of this exceedingly rare entity. CONCLUSION: Early recognition and intervention are of paramount importance if successful endoscopic management of blunt laryngeal trauma is to be considered.

  8. Hypertension in a Brazilian urban slum population.

    Science.gov (United States)

    Unger, Alon; Felzemburgh, Ridalva D M; Snyder, Robert E; Ribeiro, Guilherme S; Mohr, Sharif; Costa, Vinícius B A; Melendez, Astrid X T O; Reis, Renato B; Santana, Francisco S; Riley, Lee W; Reis, Mitermayer G; Ko, Albert I

    2015-06-01

    Low- and middle-income countries account for the majority of hypertension disease burden. However, little is known about the distribution of this illness within subpopulations of these countries, particularly among those who live in urban informal settlements. A cross-sectional hypertension survey was conducted in 2003 among 5649 adult residents of a slum settlement in the city of Salvador, Brazil. Hypertension was defined as either an elevated arterial systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure. Sex-specific multivariable models of systolic blood pressure were constructed to identify factors associated with elevated blood pressure. The prevalence of hypertension in the population 18 years and older was 21% (1162/5649). Men had 1.2 times the risk of hypertension compared with women (95% confidence intervals (CI), 1.05, 1.36). Increasing age and lack of any schooling, particularly for women, were also significantly associated with elevated blood pressure (p slum community was lower than reported frequencies in the non-slum population of Brazil and Salvador, yet both disease awareness and treatment frequency were low. Further research on hypertension and other chronic non-communicable diseases in slum populations is urgently needed to guide prevention and treatment efforts in this growing population.

  9. Estimating changes in urban land and urban population using refined areal interpolation techniques

    Science.gov (United States)

    Zoraghein, Hamidreza; Leyk, Stefan

    2018-05-01

    The analysis of changes in urban land and population is important because the majority of future population growth will take place in urban areas. U.S. Census historically classifies urban land using population density and various land-use criteria. This study analyzes the reliability of census-defined urban lands for delineating the spatial distribution of urban population and estimating its changes over time. To overcome the problem of incompatible enumeration units between censuses, regular areal interpolation methods including Areal Weighting (AW) and Target Density Weighting (TDW), with and without spatial refinement, are implemented. The goal in this study is to estimate urban population in Massachusetts in 1990 and 2000 (source zones), within tract boundaries of the 2010 census (target zones), respectively, to create a consistent time series of comparable urban population estimates from 1990 to 2010. Spatial refinement is done using ancillary variables such as census-defined urban areas, the National Land Cover Database (NLCD) and the Global Human Settlement Layer (GHSL) as well as different combinations of them. The study results suggest that census-defined urban areas alone are not necessarily the most meaningful delineation of urban land. Instead, it appears that alternative combinations of the above-mentioned ancillary variables can better depict the spatial distribution of urban land, and thus make it possible to reduce the estimation error in transferring the urban population from source zones to target zones when running spatially-refined temporal areal interpolation.

  10. Accelerated subcutaneous immunotherapy in pediatric population – Systematic review

    Directory of Open Access Journals (Sweden)

    R.A. Gomes dos Reis Pimentel

    2018-05-01

    Full Text Available Background: Accelerated subcutaneous immunotherapy (SCIT schedules represent an alternative to conventional SCIT, providing immunotherapy benefits in a shorter period of time. The objectives of this systematic review were to assess clinical and immunological efficacy as well as safety of accelerated SCIT build-up schedules for the treatment of respiratory allergy in pediatric patients. Methods: Studies were located by searching PubMed, using “immunotherapy” and “desensitization” as keywords. The selection of studies, published from January 1st, 2006, to December 31th, 2015, was performed in two stages: screening of titles and abstracts, and assessment of the full papers identified as relevant, considering the inclusion criteria. Data were extracted in a standardized way and synthesized qualitatively to assess efficacy and safety of accelerated schedules in respiratory allergy. Results: Eleven trials were included: two evaluated rush SCIT and nine assessed cluster SCIT. This review demonstrated that rush and cluster schedules are clinically and immunological efficacious, with faster effect than conventional schedules. No relevant difference with respect to clinical outcomes was noticed between subgroups (pediatric, adult and mixed populations. Regarding safety, most local adverse reactions were mild and there were neither life-threatening systemic reactions nor fatal events. No relevant differences in the incidence and severity of either local or systemic reactions between the accelerated schedule group and control group were registered. Conclusions: Accelerated SCIT build-up schedules are effective in the treatment of respiratory allergy in pediatric patients, representing a safe alternative to the conventional schedules with the advantage of achieving clinical effectiveness sooner. Keywords: Allergy, Immunotherapy, Pediatrics

  11. Introduction: population migration and urbanization in developing countries.

    Science.gov (United States)

    Kojima, R

    1996-12-01

    This introductory article discusses the correlation between migration and rapid urbanization and growth in the largest cities of the developing world. The topics include the characteristics of urbanization, government policies toward population migration, the change in absolute size of the rural population, and the problems of maintaining megacities. Other articles in this special issue are devoted to urbanization patterns in China, South Africa, Iran, Korea and Taiwan as newly industrialized economies (NIEs), informal sectors in the Philippines and Thailand, and low-income settlements in Bogota, Colombia, and India. It is argued that increased urbanization is produced by natural population growth, the expansion of the urban administrative area, and the in-migration from rural areas. A comparison of urbanization rates of countries by per capita gross national product (GNP) reveals that countries with per capita GNP of under US$2000 have urbanization rates of 10-60%. Rates are under 30% in Africa, the Middle East, South Asia, China, and Indonesia. Rapid urbanization appears to follow the economic growth curve. The rate of urbanization in Latin America is high enough to be comparable to urbanization in Europe and the US. Taiwan and Korea have high rates of urbanization that surpass the rate of industrialization. Thailand and Malaysia have low rates of urbanization compared to the size of their per capita GNP. Urbanization rates under 20% occur in countries without economic development. Rates between 20% and 50% occur in countries with or without industrialization. East Asian urbanization is progressing along with industrialization. Africa and the Middle East have urbanization without industrialization. In 1990 there were 20 developing countries and 5 developed countries with populations over 5 million. In 10 of 87 developing countries rural population declined in absolute size. The author identifies and discusses four patterns of urban growth.

  12. Migration, urban population growth and regional disparity in China

    OpenAIRE

    Renard, Mary-Françoise; Xu, Zelai; Zhu, Nong

    2011-01-01

    The main objective of this paper is to study the determinants of city population growth in China during the 1990s', as well as the determinants of migrations towards cities, which constitutes the main source of urban population growth in this period. A second objective is to identify regional differences in the urban growth and migrations, that is, whether urban growth and migration patterns are different between coastal and inland provinces. Additionally, we are interested in the differences...

  13. Urban Ecology: Patterns of Population Growth and Ecological Effects

    Science.gov (United States)

    Wayne C. Zipperer; Steward T.A. Pickett

    2012-01-01

    Currently, over 50% of the world’s population lives in urban areas. By 2050, this estimate is expected to be 70%. This urban growth, however, is not uniformly distributed around the world. The majority of it will occur in developing nations and create megacities whose populations exceed at least 10 million people. Not all urban areas, however, are growing. Some are...

  14. Song convergence in multiple urban populations of silvereyes (Zosterops lateralis).

    Science.gov (United States)

    Potvin, Dominique A; Parris, Kirsten M

    2012-08-01

    Recent studies have revealed differences between urban and rural vocalizations of numerous bird species. These differences include frequency shifts, amplitude shifts, altered song speed, and selective meme use. If particular memes sung by urban populations are adapted to the urban soundscape, "urban-typical" calls, memes, or repertoires should be consistently used in multiple urban populations of the same species, regardless of geographic location. We tested whether songs or contact calls of silvereyes (Zosterops lateralis) might be subject to such convergent cultural evolution by comparing syllable repertoires of geographically dispersed urban and rural population pairs throughout southeastern Australia. Despite frequency and tempo differences between urban and rural calls, call repertoires were similar between habitat types. However, certain song syllables were used more frequently by birds from urban than rural populations. Partial redundancy analysis revealed that both geographic location and habitat characteristics were important predictors of syllable repertoire composition. These findings suggest convergent cultural evolution: urban populations modify both song and call syllables from their local repertoire in response to noise.

  15. Scintigraphy in gastrointestinal bleeding in the pediatric population

    International Nuclear Information System (INIS)

    Hall, T.R.; Miller, J.H.; Sty, J.R.

    1986-01-01

    Gastrointestinal (GI) tract bleeding in the pediatric population is not uncommon, especially in chronically ill patients. A total of 29 patients with GI tract bleeding were studied scintigraphically using Tc-99m-labeled red blood cells (RBCs) or sulfur colloid (SC). The patients ranged in age from 3 weeks to 20 years, with an equal sex distribution. Of 19 patients studied with Tc-99m-labeled RBCs using an in vitro labeling technique, evidence of GI tract bleeding was documented scintigraphically in 15. Tc-99m-labeled SC scans in the remaining ten patients demonstrated GI tract bleeding in six. The Tc-99m RBC method was slightly more sensitive than the Tc-99m SC method. Advantages of using labeled RBCs include increased sensitivity in detecting upper abdominal bleeding, ability to delay imaging for up to 18-24 hours, and the use of provocative testing

  16. Consolidating Data of Global Urban Populations: a Comparative Approach

    Science.gov (United States)

    Blankespoor, B.; Khan, A.; Selod, H.

    2017-12-01

    Global data on city populations are essential for the study of urbanization, city growth and the spatial distribution of human settlements. Such data are either gathered by combining official estimates of urban populations from across countries or extracted from gridded population models that combine these estimates with geospatial data. These data sources provide varying estimates of urban populations and each approach has its advantages and limitations. In particular, official figures suffer from a lack of consistency in defining urban units (across both space and time) and often provide data for jurisdictions rather than the functionally meaningful urban area. On the other hand, gridded population models require a user-imposed definition to identify urban areas and are constrained by the modelling techniques and input data employed. To address these drawbacks, we combine these approaches by consolidating information from three established sources: (i) the Citypopulation.de (Brinkhoff, 2016); (ii) the World Urban Prospects data (United Nations, 2014); and (iii) the Global Human Settlements population grid (GHS-POP) (EC - JRC, 2015). We create urban footprints with GHS-POP and spatially merge georeferenced city points from both UN WUP and Citypopulation.de with these urban footprints to identify city points that belong to a single agglomeration. We create a consolidated dataset by combining population data from the UN WUP and Citypopulation.de. The flexible framework outlined can incorporate information from alternative inputs to identify urban clusters e.g. by using night-time lights, built-up area or alternative gridded population models (e.g WorldPop or Landscan) and the parameters employed (e.g. density thresholds for urban footprints) may also be adjusted, e.g., as a function of city-specific characteristics. Our consolidated dataset provides a wider and more accurate coverage of city populations to support studies of urbanization. We apply the data to re

  17. Phenobarbital in intensive care unit pediatric population: predictive performances of population pharmacokinetic model.

    Science.gov (United States)

    Marsot, Amélie; Michel, Fabrice; Chasseloup, Estelle; Paut, Olivier; Guilhaumou, Romain; Blin, Olivier

    2017-10-01

    An external evaluation of phenobarbital population pharmacokinetic model described by Marsot et al. was performed in pediatric intensive care unit. Model evaluation is an important issue for dose adjustment. This external evaluation should allow confirming the proposed dosage adaptation and extending these recommendations to the entire intensive care pediatric population. External evaluation of phenobarbital published population pharmacokinetic model of Marsot et al. was realized in a new retrospective dataset of 35 patients hospitalized in a pediatric intensive care unit. The published population pharmacokinetic model was implemented in nonmem 7.3. Predictive performance was assessed by quantifying bias and inaccuracy of model prediction. Normalized prediction distribution errors (NPDE) and visual predictive check (VPC) were also evaluated. A total of 35 infants were studied with a mean age of 33.5 weeks (range: 12 days-16 years) and a mean weight of 12.6 kg (range: 2.7-70.0 kg). The model predicted the observed phenobarbital concentrations with a reasonable bias and inaccuracy. The median prediction error was 3.03% (95% CI: -8.52 to 58.12%), and the median absolute prediction error was 26.20% (95% CI: 13.07-75.59%). No trends in NPDE and VPC were observed. The model previously proposed by Marsot et al. in neonates hospitalized in intensive care unit was externally validated for IV infusion administration. The model-based dosing regimen was extended in all pediatric intensive care unit to optimize treatment. Due to inter- and intravariability in pharmacokinetic model, this dosing regimen should be combined with therapeutic drug monitoring. © 2017 Société Française de Pharmacologie et de Thérapeutique.

  18. Hydrophilic-coated catheter appreciation study in a pediatric population

    Science.gov (United States)

    Boucher, Andréanne; Cloutier, Jonathan; Lebel, Sylvie; Hamel, Micheline; Lamontagne, Pascale; Bolduc, Stéphane

    2010-01-01

    Objective: The objective of the paper was to compare the satisfaction of hydrophilic-coated catheters (HC) (SpeediCath, Coloplast Canada, Mississauga, ON) versus uncoated catheters in a pediatric neurogenic bladder population, in order to identify a target group for HC. The main hypothesis was that our patients, with regard to their limitations, might have difficulties using the HC. Material and methods: A comparative prospective study was initiated in one pediatric rehabilitation centre. Out of the 39 patients who tried the HC during a routine clinic visit, 31 patients/parents accepted to participate in a 1-week trial and to answer a satisfaction questionnaire. Their medical records were reviewed for age, neurological disease, intellectual deficit, impaired dexterity and method of catheterization (Mitrofanoff/urethra). Results: Thirty of the 31 patients answered the satisfaction questionnaire. The median age for the 30 patients was 13.5 years (range 6–20 years). Of these patients, 19 were females (63%), 26 performed self-catheterization (87%), and 6 had Mitrofanoff (20%). Ten children (33%) would be ready to proceed with HC and all 10 children would receive catheterization by the urethra. Of these, 9 were females (90%), 8 used compact-HC (80%) and all were self-sufficient. Patients using compact-HC would continue with this catheter. In the patient comments, males catheterizing per-urethra and patients using a continent stoma requiring long catheters had problems with the excess of lubricant. Conclusion: Most children preferred their usual uncoated catheter and would not change for HC. Female patients catheterizing per-urethra with a compact-HC seem to benefit most from this catheter. PMID:21749816

  19. Genetic diversity and population structure in contemporary house sparrow populations along an urbanization gradient.

    Science.gov (United States)

    Vangestel, C; Mergeay, J; Dawson, D A; Callens, T; Vandomme, V; Lens, L

    2012-09-01

    House sparrow (Passer domesticus) populations have suffered major declines in urban as well as rural areas, while remaining relatively stable in suburban ones. Yet, to date no exhaustive attempt has been made to examine how, and to what extent, spatial variation in population demography is reflected in genetic population structuring along contemporary urbanization gradients. Here we use putatively neutral microsatellite loci to study if and how genetic variation can be partitioned in a hierarchical way among different urbanization classes. Principal coordinate analyses did not support the hypothesis that urban/suburban and rural populations comprise two distinct genetic clusters. Comparison of FST values at different hierarchical scales revealed drift as an important force of population differentiation. Redundancy analyses revealed that genetic structure was strongly affected by both spatial variation and level of urbanization. The results shown here can be used as baseline information for future genetic monitoring programmes and provide additional insights into contemporary house sparrow dynamics along urbanization gradients.

  20. Attempted Suicide in a Pediatric Population, Alarming Reality

    Directory of Open Access Journals (Sweden)

    Myriam Jiménez Quenguan

    2014-01-01

    Full Text Available This article presents the research process that led to the clinical characterization of cases of attempted suicide in the pediatric population treated at the Hospital Infantil Los Angeles in Pasto, between June 2005 and June 2011. Materials and Methods: 242 records were studied, from a perspective of the general — including clinical and legal — aspects, thus allowing a conceptualization of the term suicide. The description of certain signs and symptoms characteristic of those who have attempted suicide was essential in contributing to identify some possible causes for further understanding this phenomenon, based on the study of 15 variables. Results: The results evidence a progressive increase in the cases of attempted suicide in the pedriatic population, particularly in females, and between 13 and 16 years of age. Conclusion: This situation has developed to a problem that is very difficult to treat; for this reason, it is essential to continue researching, as well as to establish interdisciplinary groups of professionals who can address the problem and create relevant and comprehensive treatments regarding this phenomenon.

  1. Pediatric Burns in the Bedouin Population in Southern Israel

    Directory of Open Access Journals (Sweden)

    Arnon D. Cohen

    2007-01-01

    Full Text Available Burn trauma is an important public health concern, with increased risk for burns in children. A cross-sectional study was performed to describe the epidemiological characteristics and risk factors for burns in hospitalized Bedouin children in Soroka University Medical Center during the years 2001–2002. In a population of 558 hospitalized burn-injured patients, 282 Bedouin children were identified. Two hundred and sixty five patients (94.0% had burns involving less than 20% of the body surface area. Cause of the burns was scald in 190 patients (67.4%, fire in 80 patients (28.4%, chemical in 8 patients (2.8%, and explosion in 2 patients (0.7%. Two female patients (0.7% aged 11 and 17 years died of their burns that were caused by fire. The mean length of hospitalization was 9.8 days. Pediatric burn injury has become a significant public health problem in the Bedouin population of the Negev. To reduce the burden of burn injury, it is necessary to increase current efforts in prevention of burns.

  2. Pediatric caregiver attitudes toward email communication: survey in an urban primary care setting.

    Science.gov (United States)

    Dudas, Robert Arthur; Crocetti, Michael

    2013-10-23

    Overall usage of email communication between patients and physicians continues to increase, due in part to expanding the adoption of electronic health records and patient portals. Unequal access and acceptance of these technologies has the potential to exacerbate disparities in care. Little is known about the attitudes of pediatric caregivers with regard to their acceptance of email as a means to communicate with their health care providers. We conducted a survey to assess pediatric caregiver access to and attitudes toward the use of electronic communication modalities to communicate with health care providers in an urban pediatric primary care clinic. Participants were pediatric caregivers recruited from an urban pediatric primary care clinic in Baltimore, Maryland, who completed a 35-item questionnaire in this cross-sectional study. Of the 229 caregivers who completed the survey (91.2% response rate), 171 (74.6%) reported that they use email to communicate with others. Of the email users, 145 respondents (86.3%) stated that they would like to email doctors, although only 18 (10.7%) actually do so. Among email users, African-American caregivers were much less likely to support the expanded use of email communication with health care providers (adjusted OR 0.34, 95% CI 0.14-0.82) as were those with annual incomes less than US $30,000 (adjusted OR 0.26, 95% CI 0.09-0.74). Caregivers of children have access to email and many would be interested in communicating with health care providers. However, African-Americans and those in lower socioeconomic groups were much less likely to have positive attitudes toward email.

  3. Urban-Rural Disparity in Geographical and Temporal Availability of Pediatric Clinics: A Nationwide Survey in Taiwan.

    Science.gov (United States)

    Leu, Hsin-I; Chang, Wei-Ting; Lin, Ming-Hwai; Chen, Tzeng-Ji; Hwang, Shinn-Jang; Chou, Li-Fang; Jeng, Mei-Jy

    2017-08-01

    The shortage and maldistribution of pediatricians affected after-hours pediatric services, especially in rural areas. Our study aimed to examine the urban-rural disparity in geographical and temporal availability of the pediatrician workforce in Taiwan by analyzing opening time schedules of all pediatric clinics throughout the country. The opening time schedules of nonhospital pediatric clinics were downloaded from the website of the National Health Insurance Administration in Taiwan for analysis. The geographical and temporal availability of pediatric clinics was calculated and stratified by urbanization level and opening time, which was divided into daytime and evening sessions over 1 week. Each of 368 towns in Taiwan was also regarded as a unit of measurement to estimate the local availability of at least one pediatric clinic open in after-hours sessions. Among 1483 nonhospital pediatric clinics in Taiwan, the overwhelming majority were situated in urban (65.8%) and suburban (30.6%) areas. On average, a pediatric clinic provided 16.3 (standard deviation=3.04) sessions of services per week. One-third (34.7%, n=50) of 144 suburban towns and over three-fourths (77.4%, n=120) of 155 rural towns had no pediatric clinic. Most pediatric clinics remained open on weekday evenings (91.1%) and during Saturday daytime (91.8%). The percentage of open clinics gradually decreased over the weekend: Saturday evening (58.1%), Sunday daytime (33.4%), and Sunday evening (19.4%). Rural pediatric clinics remained closed mostly on weekends. On Sunday evenings, pediatric clinics were open only in 5.2% of rural towns, with a decline of 77.1%, whereas they were open in 78.3% of urban towns, with a decline of 18.2%. Pediatric clinics in Taiwan were unevenly distributed between urban and rural areas. The disparity of pediatric services became more obvious at weekends. The consequences of undersupplied rural pediatric care deserve further investigation. Copyright © 2017. Published by

  4. Prophylactic ketoconazole shampoo for tinea capitis in a high-risk pediatric population.

    Science.gov (United States)

    Bookstaver, P Brandon; Watson, Holly J; Winters, Shauna D; Carlson, Adrian L; Schulz, Richard M

    2011-07-01

    Although topical agents for the treatment of tinea capitis decrease viable fungal elements and reduce shedding, their use as a prophylactic agent has not been investigated. This study evaluated the effectiveness of a prophylactic ketoconazole shampoo (Nizoral 2%) protocol to reduce the number of clinically evident tinea capitis infections in a high-risk African American, urban population. We conducted a retrospective analysis of a ketoconazole prophylaxis protocol that was implemented at an urban pediatric clinic for medically fragile children. Patients at high risk for tinea capitis received twice-weekly ketoconazole shampoo. The primary outcome of the study was a reduction in the number of documented tinea capitis infections between the 12-month preprotocol and 12-month postprotocol periods. A secondary outcome included the evaluation of predisposing risk factors for acquiring tinea infections. Ninety-seven patients, with a mean age of 8.06 years, were included. Most patients (78%) were African American. There were a total of 13 tinea capitis infections during the 12-month preprotocol period. During the 12-month postprotocol period, 41 infections were documented: 37 (90.2%) in the prophylaxis group and 4 (9.8%) in the nonprophylaxis group. The average numbers of per-patient infections in the postprotocol period were 0.79 and 0.08 in the prophylaxis and nonprophylaxis groups, respectively. Initiation of prophylaxis did not reduce tinea capitis infections (p=NS). Previous history of infection and a high level of care were significant predictors of infections (pshampoo) prophylaxis protocol.

  5. Experience with endoscopic holmium laser in the pediatric population

    Science.gov (United States)

    Merguerian, Paul A.; Reddy, Pramod P.; Barrieras, Diego; Bagli, Darius J.; McLorie, Gordon A.; Khoury, Antoine E.

    1999-06-01

    Introduction: Due to the unavailability of suitable endoscopic instruments, pediatric patients have not benefited fully from the technological advances in the endoscopic management of the upper urinary tract. This limitation may be overcome with the Holmuim:Yttrium-Aluminum-Garnet(Ho:YAG) laser delivered via small instruments. To date, there is no published report on the use of this modality in children. Purpose: We evaluated the indications, efficacy, and complications of endourological Ho:YAG laser surgery in the treatment of pediatric urolithiasis, posterior urethral valves, ureterocele and ureteropelvic junction obstruction. Methods: The patient population included 10 children with renal, ureteral and bladder calculi, 2 children with posterior urethral valves, 2 children with obstructing ureteroceles, 2 children with ureteropelvic junction obstruction and 1 child with a urethral stricture. Access to the lesions was either antegrade via a percutaneous nephrostomy tract or retrograde via the urethra. A solid state Ho:YAG laser with maximum output of 30 watts (New Star lasers, Auburn, CA) was utilized as the energy source. Results: A total of 10 patients underwent laser lithotripsy. The means age of the patients was 9 yrs (5-13 yrs). The average surface area of the calculi as 425.2 mm2 (92-1645 mm2). 8 of the patients required one procedure to render them stone free, one patient had a staghorn calculus filling every calyx of a solitary kidney requiring multiple treatments and one other patient with a staghorn calculus required 2 treatments. There were no complications related to the laser lithotripsy. Two newborn underwent successful ablation of po sterious urethral valves. Two infants underwent incision of obstructing ureteroceles with decompression of the ureterocele on postoperative ultrasound. Two children underwent endypyelotomy for ureteropelvic junction obstruction. One was successful an done required an open procedure to correct the obstruction. One child

  6. Population in urban development and the practical problems of urban planning policy in Africa

    Directory of Open Access Journals (Sweden)

    Joseph Uyanga

    2013-07-01

    Full Text Available The paper analyses the pattern of recent growth in African towns, examines the population component in this growth process and discusses the attendant urban planning problems. The contention in the study is that there are problems of definition. policy enunciation, and organisational co-ordination in the conceptualization. planning. orchestration and implementation of urban development and service systems. The magnitude of African urban developmental problems, and its multi-faceted nature demands that the latest in scientific knowledge and technological innovations should be integrated and incorporated into the urban planning and implementation processes.

  7. Factors and Mechanisms for Pharmacokinetic Differences between Pediatric Population and Adults

    Directory of Open Access Journals (Sweden)

    Jose T. Ramos

    2011-02-01

    Full Text Available Many physiologic differences between children and adults may result in age-related changes in pharmacokinetics and pharmacodynamics. Factors such as gastric pH and emptying time, intestinal transit time, immaturity of secretion and activity of bile and pancreatic fluid among other factors determine the oral bioavailability of pediatric and adult populations. Anatomical, physiological and biochemical characteristics in children also affect the bioavailability of other routes of administration. Key factors explaining differences in drug distribution between the pediatric population and adults are membrane permeability, plasma protein binding and total body water. As far as drug metabolism is concerned, important differences have been found in the pediatric population compared with adults both for phase I and phase II metabolic enzymes. Immaturity of glomerular filtration, renal tubular secretion and tubular reabsorption at birth and their maturation determine the different excretion of drugs in the pediatric population compared to adults.

  8. Patients’ Diets and Preferences in a Pediatric Population with Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Timothy J Green

    1998-01-01

    Full Text Available PURPOSE: To determine the dietary practices of the pediatric inflammatory bowel disease population at the Children's Hospital of the Hamilton Health Sciences Corporation and the reported effectiveness of those diets.

  9. Examining The Evolution Of The Khuzestan Urban Population Using The Urban Primacy Indexes

    Directory of Open Access Journals (Sweden)

    Mokhtar Karami

    2017-12-01

    Full Text Available Examining the status of a city in the surrounding metropolitan area network not only helpful for Specialists to understand the ups and downs of city life and surrounding it but also can set the groundwork for hierarchical relationships settlements and planners for discipline the urban network is studied. Research to study the evolution of the urban population in Khuzestan province was conducted during the statistical period 1957-2012. The method is a descriptive and analytical study. To collect the data in addition the study of literature the Facts Sheet the statistical yearbooks and census of population and housing censuses in all courses has been used. Then to enter data and analysis it the Excel and Minitab software was used. Models used in this study are Ginsberg index Urban Primacy Index Two City Index Four City Index Mehtas Four City Index Moomav and Alwosabi. The results show that is balance between the parameters of the Urban Primacy Indexes in Khuzestan province since 1957 to 1977. The process of balancing continue and is destroy until the beginning of the Imposed war and the depletion of the population of cities and in 1987 the Urban Primacy Index reached its highest level and due to the problems of the war in Ahvaz it earns the highest the Urban Primacy Index. Since 1987 the Urban Primacy Index reduced and their balancing process continues until 2012 that this balancing process due to natural population growth since after 1997.

  10. Secular trends in pediatric antiretroviral treatment programs in rural and urban Zambia: a retrospective cohort study.

    Science.gov (United States)

    Sutcliffe, Catherine G; Bolton-Moore, Carolyn; van Dijk, Janneke H; Cotham, Matt; Tambatamba, Bushimbwa; Moss, William J

    2010-07-30

    Since 2003 pediatric antiretroviral treatment (ART) programs have scaled-up in sub-Saharan Africa and should be evaluated to assess progress and identify areas for improvement. We evaluated secular trends in the characteristics and treatment outcomes of children in three pediatric ART clinics in urban and rural areas in Zambia. Routinely collected data were analyzed from three ART programs in rural (Macha and Mukinge) and urban (Lusaka) Zambia between program implementation and July 2008. Data were obtained from electronic medical record systems and medical record abstraction, and were categorized by year of program implementation. Characteristics of all HIV-infected and exposed children enrolled in the programs and all children initiating treatment were compared by year of implementation. Age decreased and immunologic characteristics improved in all groups over time in both urban and rural clinics, with greater improvement observed in the rural clinics. Among children both eligible and ineligible for ART at clinic enrollment, the majority started treatment within a year. A high proportion of children, particularly those ineligible for ART at clinic enrollment, were lost to follow-up prior to initiating ART. Among children initiating ART, clinical and immunologic outcomes after six months of treatment improved in both urban and rural clinics. In the urban clinics, mortality after six months of treatment declined with program duration, and in the rural clinics, the proportion of children defaulting by six months increased with program duration. Treatment programs are showing signs of progress in the care of HIV-infected children, particularly in the rural clinics where scale-up increased rapidly over the first three years of program implementation. However, continued efforts to optimize care are needed as many children continue to enroll in ART programs at a late stage of disease and thus are not receiving the full benefits of treatment.

  11. Genetic diversity and population structure in contemporary house sparrow populations along an urbanization gradient

    OpenAIRE

    Vangestel, C; Mergeay, Joachim; Dawson, D. A; Callens, T; Vandomme, V; Lens, L

    2012-01-01

    House sparrow (Passer domesticus) populations have suffered major declines in urban as well as rural areas, while remaining relatively stable in suburban ones. Yet, to date no exhaustive attempt has been made to examine how, and to what extent, spatial variation in population demography is reflected in genetic population structuring along contemporary urbanization gradients. Here we use putatively neutral microsatellite loci to study if and how genetic variation can be partitioned in a hierar...

  12. Exercise-Induced Oxidative Stress Responses in the Pediatric Population

    Directory of Open Access Journals (Sweden)

    Alexandra Avloniti

    2017-01-01

    Full Text Available Adults demonstrate an upregulation of their pro- and anti-oxidant mechanisms in response to acute exercise while systematic exercise training enhances their antioxidant capacity, thereby leading to a reduced generation of free radicals both at rest and in response to exercise stress. However, less information exists regarding oxidative stress responses and the underlying mechanisms in the pediatric population. Evidence suggests that exercise-induced redox perturbations may be valuable in order to monitor exercise-induced inflammatory responses and as such training overload in children and adolescents as well as monitor optimal growth and development. The purpose of this review was to provide an update on oxidative stress responses to acute and chronic exercise in youth. It has been documented that acute exercise induces age-specific transient alterations in both oxidant and antioxidant markers in children and adolescents. However, these responses seem to be affected by factors such as training phase, training load, fitness level, mode of exercise etc. In relation to chronic adaptation, the role of training on oxidative stress adaptation has not been adequately investigated. The two studies performed so far indicate that children and adolescents exhibit positive adaptations of their antioxidant system, as adults do. More studies are needed in order to shed light on oxidative stress and antioxidant responses, following acute exercise and training adaptations in youth. Available evidence suggests that small amounts of oxidative stress may be necessary for growth whereas the transition to adolescence from childhood may promote maturation of pro- and anti-oxidant mechanisms. Available evidence also suggests that obesity may negatively affect basal and exercise-related antioxidant responses in the peripubertal period during pre- and early-puberty.

  13. Value of myocardial perfusion SPECT in pediatric population

    International Nuclear Information System (INIS)

    Massardo, T.; Coll, C.; Prat, H.; Gonzalez, P.; Doggenweiller, P.; Castillo, M.E.; Solis, A.

    2002-01-01

    Isotopic myocardial perfusion studies are less frequently used in children than in adults and their indications are also different. Our goal was to analyze retrospectively the experience with stress perfusion myocardial SPECT in pediatric population. Method: Since 1998 to 2001, ten studies were performed to 5 girls and 3 boys. Their mean age was 7±3 years ranging from 1-11. Three of them presented abnormal coronary arteries pre and post surgical intervention with or without coil; three had Kawasaki disease with coronary aneurysms and the other two, congenital cardiopathies (Cantrell pentalogy and great vessel transposition,both with posterior left ventricular hypokinesia post surgery). Stress was obtained using dipyridamole infusion (0.56 mg/kg) in 6 cases and treadmill exercise using Bruce protocol in 4. All those tests were well tolerated. Sestamibi Tc99m was selected in 80% of the cases and Tl 201 in the rest. Only 2 small children required anesthesia during SPECT acquisition. Results: Stress EKG did not demonstrated ischemia in any case. Coronary angiography was performed only in 50% of the patients, it was concordant with SPECT features in all, two of those patients presented transient perfusion defects (one Kawasaki and one abnormal coronary artery with a fistulae).The repaired pentalogy presented ischemia and septal infarction; in that patient echocardiographic hipokinesia was concordant with fixed hypoperfusion. One case with abnormal coronary plus mitral regurgitation (without isotopic ischemia) was submitted to embolization posteriorly, obtaining motion improvement. Clinical outcome was concordant with the presence or absence of isotopic ischemia in the rest of the patients. Conclusion: SPECT myocardial perfusion was helpful in the therapeutic approach and in prediction of outcome in children

  14. Conceptualizing Astronomical Distances for Urban Populations

    Science.gov (United States)

    Popinchalk, Mark; Olson, Kristen; Ingber, Jenny; O'Brien, Mariel

    2017-01-01

    Students living in urban environments may have a washed-out night sky, but their enthusiasm for astronomy can still shine bright. As an educator, it can sometimes be a challenge to see the opportunities afforded by city living to the teaching of astronomy; however, several benefits can be identified. For example, the intrinsic understanding children have of the distances and scales involved in their everyday life is enhanced when they live in a regimented urban structure. This existing understanding of scale is critical to building a foundation for later conceptualizing of the universe.Leveraging the assets of New York City and the resources found in the American Museum of Natural History, The Science and Nature Program offers students (PreK through 8th grade) robust science learning experiences. To address concepts important for studying astronomy, we present a novel twist on the classic lesson “Earth as a Peppercorn,” by scaling the solar system to the size of New York City. Using local landmarks and their distance in relation to the Museum to represent the planets, students can use their prior knowledge of their surroundings to appreciate the impressive scale of our neighborhood in space in the context of their own neighborhoods. We correlate the activity with NGSS standards, present preliminary feedback on it’s success, and discuss the opportunities to apply a similar model lesson to other astronomical systems.

  15. Econometric studies of urban population density: a survey.

    Science.gov (United States)

    Mcdonald, J F

    1989-01-01

    This paper presents the 1st reasonably comprehensive survey of empirical research of urban population densities since the publication of the book by Edmonston in 1975. The survey summarizes contributions to empirical knowledge that have been made since 1975 and points toward possible areas for additional research. The paper also provides a brief interpretative intellectual history of the topic. It begins with a personal overview of research in the field. The next section discusses econometric issues that arise in the estimation of population density functions in which density is a function only of a distance to the central business district of the urban area. Section 4 summarizes the studies of a single urban area that went beyond the estimation of simple distance-density functions, and Section 5 discusses studies that sought to explain the variations across urban areas in population density patterns. McDonald refers to the standard theory of urban population density throughout the paper. This basic model is presented in the textbook by Mills and Hamilton and it is assumed that the reader is familiar with the model.

  16. Relationships between pediatric asthma and socioeconomic/urban variables in Baltimore, Maryland

    Science.gov (United States)

    Kimes, Daniel; Ullah, Asad; Levine, Elissa; Nelson, Ross; Timmins, Sidey; Weiss, Sheila; Bollinger, Mary E.; Blaisdell, Carol

    2004-01-01

    Spatial relationships between clinical data for pediatric asthmatics (hospital and emergency department utilization rates), and socioeconomic and urban characteristics in Baltimore City were analyzed with the aim of identifying factors that contribute to increased asthma rates. Socioeconomic variables and urban characteristics derived from satellite data explained 95% of the spatial variation in hospital rates. The proportion of families headed by a single female was the most important variable accounting for 89% of the spatial variation. Evidence suggests that the high rates of hospital admissions and emergency department (ED) visits may partially be due to the difficulty of single parents with limited resources managing their child's asthma condition properly. This knowledge can be used for education towards mitigating ED and hospital events in Baltimore City.

  17. Computer simulation of population dynamics inside the urban environment

    Science.gov (United States)

    Andreev, A. S.; Inovenkov, I. N.; Echkina, E. Yu.; Nefedov, V. V.; Ponomarenko, L. S.; Tikhomirov, V. V.

    2017-12-01

    In this paper using a mathematical model of the so-called “space-dynamic” approach we investigate the problem of development and temporal dynamics of different urban population groups. For simplicity we consider an interaction of only two population groups inside a single urban area with axial symmetry. This problem can be described qualitatively by a system of two non-stationary nonlinear differential equations of the diffusion type with boundary conditions of the third type. The results of numerical simulations show that with a suitable choice of the diffusion coefficients and interaction functions between different population groups we can receive different scenarios of population dynamics: from complete displacement of one population group by another (originally more “aggressive”) to the “peaceful” situation of co-existence of them together.

  18. Urban population and economic growth: South Asia perspective

    Directory of Open Access Journals (Sweden)

    Sandip Sarker

    2016-07-01

    Full Text Available Previously economic growth was generally discussed in terms of foreign direct investment (FDI, educational growth, savings, investments, inflation as well as trade openness of a nation. Very recently it has been identified that population is one of the major determinants of economic growth of a nation. In the recent years, the study of urbanization has gained a matter of concern in developing countries as it has been recognized as part of a larger process of economic development which is affecting developing countries. South Asian countries are one of the emerging economics and growing at a faster rate over the past few years. At the same time, population of South Asia is growing at a significant rate. Therefore the study has attempted to identify the causal relationship between urban population and economic growth in South Asia using a panel data analysis. The study makes use of the Augmented Dickey-Fuller (ADF and Phillips-Perron (PP, Pesaran as well as Fisher methods for panel unit root test. The panel Pedroni cointegration test suggests that there is long run relationship between the variables. The further panel Vector Error Correction Model (VECM suggests that there is long run causality running from urban population growth to economic growth in South Asia. The study concludes that the growth of urban population can have significant impact on economic growth in South Asia in the long run.

  19. Population health and urban form : a review of the literature

    International Nuclear Information System (INIS)

    2004-11-01

    A review examining the links between public health and living spaces was presented. The aim of the review was to explore whether different urban forms created communities that encouraged healthy living and resulted in a healthier population as well as to suggest avenues and approaches for further research of the subject in British Columbia. The historical links between public health and community planning were examined. A conceptual model of the linkages of urban form and population health was developed and used to identify ways in which urban form and population health are linked. Areas of concern include vehicle emissions, water quality and heat build-up as well as noise pollution. Issues concerning health inequalities related to income and access to health services were examined, as well as the role that urban form plays as a barrier to physical activity. Findings indicated that there is a strong correlation between urban form and health. Lower density urban forms that require a vehicle generated more miles travelled by car with more traffic crashes and higher risks to pedestrians and cyclists. A growing body of evidence has indicated that community contacts are scarcer in low density areas. In addition, low density dwellers seemed to have higher stress levels. Car dependent lifestyles had negative impacts on children's play, growth and development. Urban forms which promoted a range of housing options in terms of affordability, tenure and type allowed people to remain within their neighbourhoods. Disadvantaged groups fared better in denser areas where there were more public facilities. 62 refs. 1 tab., 2 figs

  20. Intensity and sulci landmark combined brain atlas construction for Chinese pediatric population.

    Science.gov (United States)

    Luo, Yishan; Shi, Lin; Weng, Jian; He, Hongjian; Chu, Winnie C W; Chen, Feiyan; Wang, Defeng

    2014-08-01

    Constructing an atlas from a population of brain images is of vital importance to medical image analysis. Especially in neuroscience study, creating a brain atlas is useful for intra- and inter-population comparison. Research on brain atlas construction has attracted great attention in recent years, but the research on pediatric population is still limited, mainly due to the limited availability and the relatively low quality of pediatric magnetic resonance brain images. This article is targeted at creating a high quality representative brain atlas for Chinese pediatric population. To achieve this goal, we have designed a set of preprocessing procedures to improve the image quality and developed an intensity and sulci landmark combined groupwise registration method to align the population of images for atlas construction. As demonstrated in experiments, the newly constructed atlas can better represent the size and shape of brains of Chinese pediatric population, and show better performance in Chinese pediatric brain image analysis compared with other standard atlases. Copyright © 2014 Wiley Periodicals, Inc.

  1. Patients’ Diets and Preferences in a Pediatric Population with Inflammatory Bowel Disease

    OpenAIRE

    Green, Timothy J; Issenman, Robert M; Jacobson, Kevan

    1998-01-01

    PURPOSE: To determine the dietary practices of the pediatric inflammatory bowel disease population at the Children's Hospital of the Hamilton Health Sciences Corporation and the reported effectiveness of those diets.PATIENTS AND METHODS: A questionnaire mailed to 153 pediatric patients was returned by 125 patients (76 Crohn's disease [CD] and 49 ulcerative colitis [UC] patients) - an 82% response rate.RESULTS: The median age of respondents was 13 years, and 62% were male. Ninety per cent and ...

  2. Psoriasis in the pediatric population; Psoriasis en la poblacion pediatrica

    Energy Technology Data Exchange (ETDEWEB)

    Vindas Calderon, Wendy

    2013-07-01

    A scientific and updated bibliographic review is realized for handling and care of a pediatric patient with psoriasis disease. Health personnel related with this pathology must to know the different perspectives and angles of psoriasis, as well as clinical criteria, therapeutic and emotional in the treatment of patients. The incidence of psoriasis is recognized globally. Ethnic groups have developed with most frequently this disorder. The different clinical faces of psoriasis are studied. The morphological and topographical manifestations have presented a variety very similar to that of adults, and have made for the doctor difficult to make the diagnostic. Clinical studies that were realized in the last years, have reported etiological and pathogenic evidence, both genetic and immunological of this illness. Children with psoriasis usually have presented a mild illness, where psoriasis type plaque has been the predominant variant. Psoriasis in the population has required a special attention in triggers or aggravating factors of this disease such as infections, exposure to snuff, obesity, stress and interactions with other drugs. The discovery and use of new drugs have led to different etiological factors for the handling of psoriasis; so it is important to know the function, availability and adverse effects that can to cause new therapies. Treatments must to include the provision of a safe and effective therapy for the maintenance for free long periods of lesions, reducing the severity of the disease, and inhibiting structural damage of joints. The topical treatment has been the therapy of first choice in mild psoriasis and localized. An interrogatory is recommended to decide objectively a systemic treatment, because the infant population has been a sensitive group of possible adverse effects. Methotrexate has been the treatment of choice for psoriasis related to arthropathy both adults and children. Phototherapy, including UVB, PUVA light and excimer laser is

  3. Population growth, urban expansion, and private forestry in western Oregon.

    Science.gov (United States)

    Jeffrey D. Kline; David L. Azuma; Ralph J. Alig

    2004-01-01

    Private forestlands in the United States face increasing pressures from growing populations, resulting in greater numbers of people living in closer proximity to forests. What often is called the "wildland/urban interface" is characterized by expansion of residential and other developed land uses onto forested landscapes in a manner that threatens forestlands...

  4. Population pressure and health risks in urban market environment: a ...

    African Journals Online (AJOL)

    Population pressure and health risks in urban market environment: a study of Bodija market, Ibadan, Nigeria. ... International Journal of Development and Management Review ... This study was directed at permanent sellers in Bodija Market, (men and women) and people who frequent the market to make purchases.

  5. Living with infertility : Experiences among urban slum populations in Bangladesh

    NARCIS (Netherlands)

    Papreen, N; Sabin, K; Begum, L; Ahsan, SK; Baqui, AH

    This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and GO men

  6. Low Elevation Coastal Zone (LECZ) Urban-Rural Population Estimates, Global Rural-Urban Mapping Project (GRUMP), Alpha Version

    Data.gov (United States)

    National Aeronautics and Space Administration — The Low Elevation Coastal Zone (LECZ) Urban-Rural Estimates consists of country-level estimates of urban, rural and total population and land area country-wide and...

  7. Designing Urban Experiences for a Suburban Population

    DEFF Research Database (Denmark)

    Jantzen, Christian; Vetner, Mikael

    In the planning of Almere special attention was paid to establishing attractive  surroundings for modern middle class living. Accordingly the city was developed as a  network of suburbs with ample space for gardens, parks etc., and with an infrastructure aimed  at keeping different forms......, as a consequence of the governmental policy for  future regional development, agreed upon in the 1990es, Almere remains a kernel for future  growth. The population of the city is expected to extend further in the next decades. In 2030 it  should thus have 350.000 inhabitants, becoming by then the fifth largest......  dwellers, and also new segments of citizens with other preferences and more pronounced  expectations (esp. upper middle class, which at the time being are largely absent). To face  these challenges, the city council in 1995 decided to develop a new city centre, which should  enhance Almere’s regional...

  8. Metabolic syndrome in the pediatric population: a short overview

    Directory of Open Access Journals (Sweden)

    Natasa Marcun Varda

    2009-06-01

    Full Text Available The metabolic syndrome (MS in adults is defined as a concurrence of obesity, disturbed glucose and insulin metabolism, hypertension and dyslipidemia, and is associated with increased morbidity and mortality from cardiovascular diseases and type 2 diabetes. Studies now indicate that many of its components are also present in children and adolescents. Moreover, the clustering of these risk factors has been documented in some children, who are at increased cardiovascular risk in adulthood. The MS is highly prevalent among overweight children and adolescents. Identifying these children is important for early prevention and treatment of different components of the syndrome. The first-line treatment comprises lifestyle modification consisting of diet and exercise. The most effective tool for prevention of the MS is to stop the development of childhood obesity. The first attempt of consensus-based pediatric diagnostic criteria was published in 2007 by the International Diabetes Federation. Nevertheless, national prevalence data, based on uniform pediatric definition, protocols for prevention, early recognition and effective treatment of pediatric MS are still needed. The aim of this article is to provide a short overview of the diagnosis and treatment options of childhood MS, as well as to present the relationships between MS and its individual components.

  9. Pediatrics

    Science.gov (United States)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  10. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone

    2015-01-01

    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  11. The Rate of Sepsis in a National Pediatric Population, 2006 to 2012.

    Science.gov (United States)

    Schuller, Kristin A; Hsu, Benson S; Thompson, Allyson B

    2017-10-01

    The rate of pediatric severe sepsis is reported to be on the rise in the United States, increasing by approximately 6000 cases annually. The goal of this study was to determine the rate of pediatric sepsis per 100 000 inpatient discharges over time. The 2006, 2009, and 2012 Agency for Healthcare Research and Quality Healthcare Cost Utilization Project Kid's Inpatient Databases were used to analyze the rate of sepsis in children over time. The rate of pediatric sepsis has increased over time from 92.8 per 100 000 in 2006 to 158.7 per 100 000 in 2012. Children less than a year old with Medicaid coverage and 3 or more procedures during hospitalization have significantly higher rates than their counterparts. This study helps clarify the population demographics that are at greater risk for sepsis infections. Understanding the at-risk population aids policymakers and care providers in targeting these populations and make drastic changes to sepsis policies.

  12. Population Pharmacokinetic Modeling of a Desmopressin Oral Lyophilisate in Growing Piglets as a Model for the Pediatric Population

    Directory of Open Access Journals (Sweden)

    Elke Gasthuys

    2018-01-01

    Full Text Available Desmopressin is used to treat primary nocturnal enuresis in children. Over the years, various formulations of desmopressin were commercialized of which the sublingual melt tablet is preferred in the pediatric population, despite the lack of full PK studies in this population. A full PK study was performed in growing conventional piglets to evaluate if this juvenile animal model can provide supplementary information to complement the information gap in the pediatric population. A desmopressin sublingual melt tablet (120 μg was administered to 32 male piglets aged 8 days, 4 weeks, 7 weeks, and 6 months (each group n = 8. Population PK (pop-PK analysis was performed to derive the PK parameters, the between- and within-subject variabilities and the effects of covariates. Desmopressin demonstrated two-compartmental PK, with a dual, sequential absorption process, and linear elimination. Body weight was the only significant covariate on clearance and on apparent volume of distribution of the central compartment. In human pediatric trials, no double peak in the absorption phase was observed in the plasma concentration-time curves, possibly due to the sparse sampling strategy applied in those pediatric studies. Therefore, it is recommended to perform additional studies, based on the sampling protocol applied in the current study.

  13. Low Elevation Coastal Zone (LECZ) Urban-Rural Population and Land Area Estimates, Version 2

    Data.gov (United States)

    National Aeronautics and Space Administration — The Low Elevation Coastal Zone (LECZ) Urban-Rural Population and Land Area Estimates, Version 2 data set consists of country-level estimates of urban population,...

  14. Metabolic evaluation of urolithiasis and obesity in a midwestern pediatric population.

    Science.gov (United States)

    Roddy, John T; Ghousheh, Anas I; Christensen, Melissa A; Durkee, Charles T

    2014-03-01

    The incidence of urolithiasis has been proved to be increasing in the adult population, and evidence to date suggests that the same holds true for the pediatric population. While adult urolithiasis is clearly linked to obesity, studies of pediatric patients have been less conclusive. We hypothesized that a population of otherwise healthy children with stones would have an increased body mass index compared to a control population, and that obese pediatric stone formers would have results on metabolic assessment that are distinct from nonobese stone formers. We retrospectively reviewed the charts of all patients 10 to 17 years old with upper tract urolithiasis without comorbidities treated between 2006 and 2011. Mean body mass index of our population was compared to state data, and 24-hour urine collection results were compared between obese and nonobese patients with stones. The obesity rate in 117 patients with urolithiasis did not differ significantly from the obesity rate derived from the 2007 National Survey of Children's Health (observed/expected ratio 1.11, 95% CI 0.54-1.95). Using t-test and chi-square comparisons, overall 24-hour urine collection data did not show statistically significant differences. Our results do not confirm obesity as a risk factor for pediatric urolithiasis in otherwise healthy patients. We also found no substantial metabolic differences between healthy nonobese stone formers and obese patients. While the pediatric literature is mixed, our study supports the majority of published series that have failed to establish a link between pediatric urolithiasis and obesity. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Social Profile Of The Aged In An Urban Population

    Directory of Open Access Journals (Sweden)

    J A Khan

    1997-08-01

    Full Text Available Research Problem: What is the socio-demographic profile of urban aged population in Aligarh city.Objectives: i To describe the socio-demographic profile of the aged population in an urban area, ii To describe the attitude of these people.Design:Cross-sectional study.Setting : Urban areas of Aligarh city.Participants : 3951 persons aged 60 years and aboveStudy Variables: Socio-demographic characteristics, attitudes.Statistical Analysis : By proportions.Result: 15% of the total estimated elderly population covering all 10 sectors of Aligarh city was studied. The majority ofthe elderly (72.4% belonged to 60-70 years age group. Most of them (77.2% were illiterate, 61.6% belonged to lower socio-economic classes (IV & V, 78.1 % lived in joint families. 39.6% of the aged felt that they were not being given due respect by family members. Nearly half of them had an indifferent or unhappy attitude towards life.Conclusion: The socio-demographic characteristics of the aged are important and must be kept in mind for developing programs to assist them in living as respectful senior citizens.

  16. Procedural modeling of urban layout: population, land use, and road network

    NARCIS (Netherlands)

    Lyu, X.; Han, Q.; de Vries, B.

    2017-01-01

    This paper introduces an urban simulation system generating urban layouts with population, road network and land use layers. The desired urban spatial structure is obtained by generating a population map based on population density models. The road network is generated at two spatial levels

  17. High prevalence of complementary and alternative medicine use in the Dutch pediatric oncology population: a multicenter survey

    NARCIS (Netherlands)

    Singendonk, Maartje; Kaspers, Gert-Jan; Naafs-Wilstra, Marianne; Schouten-van Meeteren, Antoinette; Loeffen, Jan; Vlieger, Arine

    2013-01-01

    Although complementary and alternative medicine (CAM) is widely used in the pediatric population, research on the use of these therapies in the pediatric oncology population is of mixed quality. In this multicenter survey, we investigated the prevalence of CAM use, possible determinants of use, and

  18. Clinical and imaging features of intracranial arterial aneurysms in the pediatric population

    International Nuclear Information System (INIS)

    Abruzzo, Todd A.; Aeron, Gunjan; Jones, Blaise V.

    2013-01-01

    Intracranial arterial aneurysms (IAAs) are rare in children. Nevertheless, IAAs account for at least 10 % - 15 % of hemorrhagic strokes during the first two decades of life. Traditional vascular risk factors, which are common in the adult population, are generally absent in the pediatric population, engendering distinct modes of IAA pathogenesis. Classification of pediatric IAAs according to the pathogenetic mechanism shows eight distinct categories: idiopathic, traumatic, those due to excessive hemodynamic stress, vasculopathic, infectious, noninfectious inflammatory, oncotic, and familial. Pathogenetic mechanism is the best predictor of the clinical course of the disease, response to treatment, and long-term prognosis. The pathogenetic subtypes of pediatric IAA show characteristic and variably overlapping features. In most cases, IAAs manifesting during the first two decades of life are idiopathic. IAAs that are idiopathic, traumatic (second most common type), or due to excessive hemodynamic stresses (third most common type) account for more than 80 % of IAAs in the pediatric age group. Most of the remaining pediatric IAAs are the result of congenital cerebral aneurysmal arteriopathies or infection. Multiple IAAs are unusual in young children except in those with acquired (secondary to immune deficiency states) or congenital cerebral aneurysmal arteriopathies or infectious IAAs. (orig.)

  19. 75 FR 54351 - Cell and Gene Therapy Clinical Trials in Pediatric Populations; Public Workshop

    Science.gov (United States)

    2010-09-07

    ...] Cell and Gene Therapy Clinical Trials in Pediatric Populations; Public Workshop AGENCY: Food and Drug... Biologics Evaluation and Research (CBER) is announcing a public workshop entitled ``Cell and Gene Therapy... Institutional Review Boards (IRBs), gene and cellular therapy clinical researchers, and other stakeholders...

  20. Symptom Prevalence of ADHD and ODD in a Pediatric Population in Argentina

    Science.gov (United States)

    Michanie, Claudio; Kunst, Gabriel; Margulies, Daniel S.; Yakhkind, Aleksandra

    2007-01-01

    Objective: To assess the prevalence of DSM III-R symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in an outpatient pediatric population; to compare oppositional behavior and grade retention rates; and to establish local means and standard deviations (SD) for the ADHD rating scale. Method: 300…

  1. The impact of urbanization and population density on childhood Plasmodium falciparum parasite prevalence rates in Africa.

    Science.gov (United States)

    Kabaria, Caroline W; Gilbert, Marius; Noor, Abdisalan M; Snow, Robert W; Linard, Catherine

    2017-01-26

    Although malaria has been traditionally regarded as less of a problem in urban areas compared to neighbouring rural areas, the risk of malaria infection continues to exist in densely populated, urban areas of Africa. Despite the recognition that urbanization influences the epidemiology of malaria, there is little consensus on urbanization relevant for malaria parasite mapping. Previous studies examining the relationship between urbanization and malaria transmission have used products defining urbanization at global/continental scales developed in the early 2000s, that overestimate actual urban extents while the population estimates are over 15 years old and estimated at administrative unit level. This study sought to discriminate an urbanization definition that is most relevant for malaria parasite mapping using individual level malaria infection data obtained from nationally representative household-based surveys. Boosted regression tree (BRT) modelling was used to determine the effect of urbanization on malaria transmission and if this effect varied with urbanization definition. In addition, the most recent high resolution population distribution data was used to determine whether population density had significant effect on malaria parasite prevalence and if so, could population density replace urban classifications in modelling malaria transmission patterns. The risk of malaria infection was shown to decline from rural areas through peri-urban settlements to urban central areas. Population density was found to be an important predictor of malaria risk. The final boosted regression trees (BRT) model with urbanization and population density gave the best model fit (Tukey test p value <0.05) compared to the models with urbanization only. Given the challenges in uniformly classifying urban areas across different countries, population density provides a reliable metric to adjust for the patterns of malaria risk in densely populated urban areas. Future malaria risk

  2. Cardiovascular risk assessment between urban and rural population in Malaysia.

    Science.gov (United States)

    Noor Hassim, I; Norazman, M R; Diana, M; Khairul Hazdi, Y; Rosnah, I

    2016-12-01

    Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.

  3. Procedural modeling of urban layout: population, land use, and road network

    OpenAIRE

    Lyu, X.; Han, Q.; de Vries, B.

    2017-01-01

    This paper introduces an urban simulation system generating urban layouts with population, road network and land use layers. The desired urban spatial structure is obtained by generating a population map based on population density models. The road network is generated at two spatial levels corresponding to the road hierarchy. The land use allocation is based on the What If? allocation model. The expected results are urban layouts suitable for academic scenario analysis.

  4. HEALTH OF URBAN POPULATION IN MOSCOW AND BEIJING AGGLOMERETIONS

    Directory of Open Access Journals (Sweden)

    Svetlana M. Malkhazova

    2014-01-01

    Full Text Available The paper presents the results obtained under the joint Russian-Chinese RFBR project № 12-05-91175-ГФЕН_а aimed at assessment of the state of the environment and health of the population in urban areas in Russia and China. The paper presents the authors’ approach to a comprehensive evaluation of the impact of the environment on the populationhealth of urban agglomerations and a method of regional medico-geographical analysis. A series of analytical and synthetic maps was compiled and used for a comparative geographical analysis of medical and environmental situation in Moscow and Beijing – major metropolitan areas with different natural and socio-economic conditions. The paper discusses the influence of the environment on the state of public health and identifies the leading risk factors, both general and specific to each region.

  5. Prevalence of metabolic syndrome among an urban population in Kenya.

    Science.gov (United States)

    Kaduka, Lydia U; Kombe, Yeri; Kenya, Eucharia; Kuria, Elizabeth; Bore, John K; Bukania, Zipporah N; Mwangi, Moses

    2012-04-01

    Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya. This was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure. The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

  6. Radiation-sensitive genetically susceptible pediatric sub-populations

    Energy Technology Data Exchange (ETDEWEB)

    Kleinerman, Ruth A. [National Cancer Institute, NIH, DHHS, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Rockville, MD (United States)

    2009-02-15

    Major advances in pediatric cancer treatment have resulted in substantial improvements in survival. However, concern has emerged about the late effects of cancer therapy, especially radiation-related second cancers. Studies of childhood cancer patients with inherited cancer syndromes can provide insights into the interaction between radiation and genetic susceptibility to multiple cancers. Children with retinoblastoma (Rb), neurofibromatosis type 1 (NF1), Li-Fraumeni syndrome (LFS), and nevoid basal cell carcinoma syndrome (NBCCS) are at substantial risk of developing radiation-related second and third cancers. A radiation dose-response for bone and soft-tissue sarcomas has been observed in hereditary Rb patients, with many of these cancers occurring in the radiation field. Studies of NF1 patients irradiated for optic pathway gliomas have reported increased risks of developing another cancer associated with radiotherapy. High relative risks for second and third cancers were observed for a cohort of 200 LFS family members, especially children, possibly related to radiotherapy. Children with NBCCS are very sensitive to radiation and develop multiple basal cell cancers in irradiated areas. Clinicians following these patients should be aware of their increased genetic susceptibility to multiple primary malignancies enhanced by sensitivity to ionizing radiation. (orig.)

  7. Consensus and controversy regarding osteoporosis in the pediatric population.

    Science.gov (United States)

    Bachrach, Laura Keyes

    2007-09-01

    To review current consensus and controversy surrounding the diagnosis and treatment of osteoporosis in childhood and adolescence. The medical literature was reviewed with emphasis on the importance of early skeletal health, risk factors for bone fragility, and the diagnosis and management of children at risk for osteoporosis. Childhood and adolescence are critical periods for optimizing bone growth and mineral accrual. Bone strength is determined by bone size, geometry, quality, and mass-variables that are influenced by genetic factors, activity, nutrition, and hormones. For children with genetic skeletal disorders or chronic disease, bone growth and mineral accrual may be compromised, increasing the lifetime risk of osteoporosis. The goal for the clinician is to identify children at greatest risk for future fragility fracture. Bone densitometry and turnover markers are challenging to interpret in children. Prevention and treatment of bone fragility in children are less well established than in adults. Optimizing nutrition and activity may not restore bone health, but the drug armamentarium is limited. Sex steroid replacement has not proven effective in restoring bone mass in patients with anorexia nervosa or exercise-associated amenorrhea. Bisphosphonates can increase bone mass and may reduce bone pain and fractures, most convincingly in patients with osteogenesis imperfecta. Further studies are needed to establish the safety, efficacy, and optimal drug, duration, and dosage in pediatric patients. Bone health during the first 2 decades contributes to the lifetime risk of osteoporosis. Further research is needed to develop evidence-based recommendations for the diagnosis and treatment of osteoporosis in childhood.

  8. The development of a population of 4D pediatric XCAT phantoms for imaging research and optimization

    Energy Technology Data Exchange (ETDEWEB)

    Segars, W. P., E-mail: paul.segars@duke.edu; Norris, Hannah; Sturgeon, Gregory M.; Zhang, Yakun; Bond, Jason; Samei, E. [Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Minhas, Anum; Frush, D. [Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Tward, Daniel J.; Ratnanather, J. T.; Miller, M. I. [Center for Imaging Science, Johns Hopkins University, Baltimore, Maryland 21218 (United States)

    2015-08-15

    Purpose: We previously developed a set of highly detailed 4D reference pediatric extended cardiac-torso (XCAT) phantoms at ages of newborn, 1, 5, 10, and 15 yr with organ and tissue masses matched to ICRP Publication 89 values. In this work, we extended this reference set to a series of 64 pediatric phantoms of varying age and height and body mass percentiles representative of the public at large. The models will provide a library of pediatric phantoms for optimizing pediatric imaging protocols. Methods: High resolution positron emission tomography-computed tomography data obtained from the Duke University database were reviewed by a practicing experienced radiologist for anatomic regularity. The CT portion of the data was then segmented with manual and semiautomatic methods to form a target model defined using nonuniform rational B-spline surfaces. A multichannel large deformation diffeomorphic metric mapping algorithm was used to calculate the transform from the best age matching pediatric XCAT reference phantom to the patient target. The transform was used to complete the target, filling in the nonsegmented structures and defining models for the cardiac and respiratory motions. The complete phantoms, consisting of thousands of structures, were then manually inspected for anatomical accuracy. The mass for each major tissue was calculated and compared to linearly interpolated ICRP values for different ages. Results: Sixty four new pediatric phantoms were created in this manner. Each model contains the same level of detail as the original XCAT reference phantoms and also includes parameterized models for the cardiac and respiratory motions. For the phantoms that were 10 yr old and younger, we included both sets of reproductive organs. This gave them the capability to simulate both male and female anatomy. With this, the population can be expanded to 92. Wide anatomical variation was clearly seen amongst the phantom models, both in organ shape and size, even for

  9. Association of an Asthma Improvement Collaborative With Health Care Utilization in Medicaid-Insured Pediatric Patients in an Urban Community.

    Science.gov (United States)

    Kercsmar, Carolyn M; Beck, Andrew F; Sauers-Ford, Hadley; Simmons, Jeffrey; Wiener, Brandy; Crosby, Lisa; Wade-Murphy, Susan; Schoettker, Pamela J; Chundi, Pavan K; Samaan, Zeina; Mansour, Mona

    2017-11-01

    Asthma is the most common chronic condition of childhood. Hospitalizations and emergency department (ED) visits for asthma are more frequently experienced by minority children and adolescents and those with low socioeconomic status. To reduce asthma-related hospitalizations and ED visits for Medicaid-insured pediatric patients residing in Hamilton County, Ohio. From January 1, 2010, through December 31, 2015, a multidisciplinary team used quality-improvement methods and the chronic care model to conduct interventions in inpatient, outpatient, and community settings in a large, urban academic pediatric hospital in Hamilton County, Ohio. Children and adolescents aged 2 to 17 years who resided in Hamilton County, had a diagnosis of asthma, and were Medicaid insured were studied. Interventions were implemented in 3 phases: hospital-based inpatient care redesign, outpatient-based care enhancements, and community-based supports. Plan-do-study-act cycles allowed for small-scale implementation of change concepts and rapid evaluation of how such tests affected processes and outcomes of interest. The study measured asthma-related hospitalizations and ED visits per 10 000 Medicaid-insured pediatric patients. Data were measured monthly on a rolling 12-month mean basis. Data from multiple previous years were used to establish a baseline. Data were tracked with annotated control charts and with interrupted time-series analysis. Of the estimated 36 000 children and adolescents with asthma in Hamilton County (approximately 13 000 of whom are Medicaid insured and 6000 of whom are cared for in Cincinnati Children's Hospital primary care practices), asthma-related hospitalizations decreased from 8.1 (95% CI, 7.7-8.5) to 4.7 (95% CI, 4.3-5.1) per 10 000 Medicaid patients per month by June 30, 2014, a 41.8% (95% CI, 41.7%-42.0%) relative reduction. Emergency department visits decreased from 21.5 (95% CI, 20.6-22.3) to 12.4 (95% CI, 11.5-13.2) per 10 000 Medicaid patients per

  10. Spatial vulnerability of Australian urban populations to extreme heat events

    Science.gov (United States)

    Loughnan, Margaret; Tapper, Nigel; Phan, Thu; Lynch, Kellie; McInnes, Judith

    2013-04-01

    Extreme heat events pose a risk to the health of all individuals, especially the elderly and the chronically ill, and are associated with an increased demand for healthcare services. In order to address this problem, policy makers' need information about temperatures above which mortality and morbidity of the exposed population is likely to increase, where the vulnerable groups in the community are located, and how the risks from extreme heat events are likely to change in the future. This study identified threshold temperatures for all Australian capital cities, developed a spatial index of population vulnerability, and used climate model output to predict changes in the number of days exceeding temperature thresholds in the future, as well as changes in risk related to changes in urban density and an ageing population. The study has shown that daily maximum and minimum temperatures from the Bureau of Meteorology forecasts can be used to calculate temperature thresholds for heat alert days. The key risk factors related to adverse health outcomes were found to be areas with intense urban heat islands, areas with higher proportions of older people, and areas with ethnic communities. Maps of spatial vulnerability have been developed to provide information to assist emergency managers, healthcare professionals, and ancillary services develop heatwave preparedness plans at a local scale that target vulnerable groups and address heat-related health risks. The numbers of days exceeding current heat thresholds are predicted to increase over the next 20 to 40 years in all Australian capital cities.

  11. Ocular manifestations of Type 1 diabetes mellitus in pediatric population

    Directory of Open Access Journals (Sweden)

    Handan Akil

    2016-01-01

    Full Text Available Context: To evaluate the necessity of ocular screening in Type 1 diabetes mellitus (DM. Aims: This study aims to investigate the diabetes-related ocular changes according to the glycosylated hemoglobin (HbA1c level and duration of diabetes in children and compare the results with nondiabetic healthy children. Settings and Design: Observational cross-sectional study designed by ophthalmology and pediatric endocrinology clinics. Subjects and Methods: Forty-two children with Type 1 DM, 42 healthy gender- and age-matched children as controls were enrolled. All patients underwent ophthalmic and physical examination, with a review of medical history and current medication. HbA1c level, best corrected visual acuity, intraocular pressure (IOP, central corneal thickness (CCT, tear break-up time (BUT, Schirmer test, dilated fundus examination findings, central retinal thickness (CRT, and total macular volume (TMV measurements were noted. Statistical Analysis: Descriptive statistics, Student's t-test, Mann–Whitney U-test, Chi-square test for comparison of the group parameters and correlation analyses (Spearman analysis were performed with SPSS statistical software 17.0 (SPSS Inc., Chicago, IL, USA. Results: Type 1 DM group exhibited significantly reduced Schirmer test, increased IOP and decreased retinal thickness relative to the age-matched control group (P < 0.05 but no statistically significant difference was found for the BUT (P = 0.182 and for the CCT (P = 0.495. The correlations between the age, duration, HbA1c and IOP, BUT, Schirmer test, TMV, CRT measurements did not reach statistical significance. Conclusions: More frequent screening may be needed for complications, including neuropathy-related dry eye syndrome, IOP changes, and diabetic retinopathy in children with Type 1 DM.

  12. Epidemiology of Pediatric Traumatic Spinal Cord Injury in a Population-Based Cohort, 1998-2012.

    Science.gov (United States)

    Saunders, Lee L; Selassie, Anbesaw; Cao, Yue; Zebracki, Kathy; Vogel, Lawrence C

    2015-01-01

    Traumatic spinal cord injury (SCI) that occurs in children and adolescents who are still developing represents a different challenge than SCI in adults. However, information on the epidemiology and incidence of SCI in a population-based cohort is lacking. To describe the epidemiology of pediatric SCI in a population-based cohort in the United States and to assess trend in incidence over a 15-year period (1998-2012). Children and adolescents (0-21 years) with SCI were identified through the South Carolina SCI Surveillance Registry using hospital discharge records from 1998 to 2012. Overall age-adjusted incidence rates were calculated for each year, and incidence rates were stratified by age, gender, and race. The overall age-adjusted incidence rate was 26.9 per million population, and there was a trend (P = .0583) toward decreasing incidence of pediatric SCI. When stratified by race, there was a significant decrease in incidence among Whites(P = .0052) but not among non-Whites. Younger participants were more likely to be female, to be injured through sports, and to be more likely to have concomitant traumatic brain injury. Since 1998, the proportion of older pediatric patients (16-22 years) with SCI has increased, as has the proportion of non-White patients. Although there was an overall trend toward decreasing incidence in this population-based cohort, when stratified by race, this trend only occurred in the White population.

  13. The Use of Chest Computed Tomographic Angiography in Blunt Trauma Pediatric Population.

    Science.gov (United States)

    Hasadia, Rabea; DuBose, Joseph; Peleg, Kobi; Stephenson, Jacob; Givon, Adi; Kessel, Boris

    2018-02-05

    Blunt chest trauma in children is common. Although rare, associated major thoracic vascular injuries (TVIs) are lethal potential sequelae of these mechanisms. The preferred study for definitive diagnosis of TVI in stable patients is computed tomographic angiography imaging of the chest. This imaging modality is, however, associated with high doses of ionizing radiation that represent significant carcinogenic risk for pediatric patients. The aim of the present investigation was to define the incidence of TVI among blunt pediatric trauma patients in an effort to better elucidate the usefulness of computed tomographic angiography use in this population. A retrospective cohort study was conducted including all blunt pediatric (age blunt trauma victims, 119,821patients were younger than 14 years. Twelve (0.0001%, 12/119821) of these children were diagnosed with TVI. The most common mechanism in this group was pedestrian hit by a car. Mortality was 41.7% (5/12). Thoracic vascular injury is exceptionally rare among pediatric blunt trauma victims but does contribute to the high morbidity and mortality seen with blunt chest trauma. Computed tomographic angiography, with its associated radiation exposure risk, should not be used as a standard tool after trauma in injured children. Clinical protocols are needed in this population to minimize radiation risk while allowing prompt identification of life-threatening injuries.

  14. Effect of Hemoconcentration on Dural Sinus Computed Tomography Density in a Pediatric Population.

    Science.gov (United States)

    Yurttutan, Nursel; Kizildag, Betul; Sarica, Mehmet Akif; Baykara, Murat

    2016-10-01

    Unenhanced brain computed tomography (CT) is inexpensive, easily available, and the first-choice imaging modality for patients presenting with various neurologic symptoms. Venous thrombosis is not rare in childhood, but diagnosis can be difficult. In some cases, only denser vessels can be used to highlight an issue. The aim of this study was to retrospectively evaluate the relationship between X-ray attenuation and hemoconcentration in a pediatric population. This study enrolled 99 pediatric patients who had been referred radiology department for unenhanced brain CT. Images were retrospectively evaluated for measurement of dural sinus densities from four distinct dural sinus locations. Correlation between mean Hounsfield unit (HU) values and hemoglobin/hematocrit (Hb/Htc) levels, as well as age and gender were further analyzed. There was a strong correlation between mean HU and Hb levels (r = 0.411; standard deviation: 0.001) and also between mean HU and Htc levels (r = 0.393; p pediatric group. In conclusion, before deciding between a diagnosis of thrombosis and a determination of normal findings during an evaluation of unenhanced CT in a pediatric population, radiologists should consider complete blood count results as well as H:H ratios. Georg Thieme Verlag KG Stuttgart · New York.

  15. The auto-amputated adnexa: a review of findings in a pediatric population.

    Science.gov (United States)

    Focseneanu, Mariel A; Omurtag, Kenan; Ratts, Valerie S; Merritt, Diane F

    2013-12-01

    To quantify our experience and that of the literature with diagnosis and management of the auto-amputated adnexa in a pediatric population. Case series and literature review. Tertiary care medical center. Case series of pediatric patients (auto-amputation collected from our medical center and the literature. None. Auto-amputated adnexa. In addition to the 3 cases discussed from our institution, 91 cases of auto-amputated adnexa were identified in the literature dating back to 1943, for a total of 94 cases. Forty-nine percent (46/94) of the cases involved girls in a pediatric population (auto-amputated adnexa. 34 out of 46 cases were analyzed in detail. The right adnexa were involved in 56% of the cases. The most common presenting complaint verbalized by the older girls was pain; however, 8 cases were identified in asymptomatic girls undergoing unrelated diagnostic testing. The auto-amputated adnexa is a rare finding in the pediatric population, but it must be considered as a possible explanation for the incidental finding of absence of the fallopian tube or ovary in the subgroup of patients who undergo surgery for any reason. Patients with an antecedent history of pelvic pain either chronic or intermittent in nature may be diagnosed with torsion or less frequently auto-amputation of the adnexa. A fetal "pelvic mass" or "ovarian cyst" may predispose the adnexa to torsion and subsequent auto-amputation either in-utero or post-delivery. Many of these antenatally diagnosed cysts and even subsequent auto-amputations are completely asymptomatic, however, and do not compromise fertility assuming the contralateral adnexa are normal. Thus expectant management is appropriate for small (less than 4 cm), asymptomatic simple cysts and even suspected auto-amputated adnexa in an asymptomatic patient. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. Prevalence of primary glaucoma in an urban South Indian population

    Directory of Open Access Journals (Sweden)

    Jacob Aby

    1998-01-01

    Full Text Available Glaucoma is fast emerging as a major cause of blindness in India. In order to estimate the prevalence of primary open angle glaucoma (POAG and primary angle closure glaucoma (PACG in an urban South Indian population, we examined 972 individuals aged 30-60 years, chosen using a cluster sampling technique from 12 census blocks of Vellore town. They underwent a complete ocular examination, including applanation tonometry and gonioscopy, at the Medical College Hospital. Characteristic field defects on automated perimetry was a diagnostic requisite for POAG. Prevalence (95% CI of POAG, PACG, and ocular hypertension were 4.1 (0.08-8.1, 43.2 (30.14-56.3, and 30.8 (19.8-41.9 per 1,000, respectively. All the PACG cases detected were of the chronic type. Hitherto unavailable community-based information on primary glaucoma in our study population indicates that PACG is about five times as common as POAG.

  17. Prevalence and consequences of insomnia in pediatric population.

    OpenAIRE

    Magda Kaczor; Michał Skalski

    2016-01-01

    Insomnia presents an increasing and significant health issue in paediatric population. As the problem had grown over past decade, it became recognised by the specialists dealing with children and adolescents. In a recent study American Academy of Child and Adolescent Psychiatry members were asked about their experience with patients complaining about sleep disturbances. Doctors reported that sleep was a problem for 1/3 of their patients out of which 1/4 required pharmacotherapy [1]. Multiple ...

  18. Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes.

    Science.gov (United States)

    Edlynn, Emily S; Derrington, Sabrina; Morgan, Helene; Murray, Jennifer; Ornelas, Beatriz; Cucchiaro, Giovanni

    2013-04-01

    We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation. We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service. The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.

  19. Microgeographic differentiation in thermal performance curves between rural and urban populations of an aquatic insect.

    Science.gov (United States)

    Tüzün, Nedim; Op de Beeck, Lin; Brans, Kristien I; Janssens, Lizanne; Stoks, Robby

    2017-12-01

    The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization ("urban heat islands"), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life-history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations.

  20. Radiation dose to the pediatric population of Slovak Republic from diagnostic nuclear medicine procedures

    International Nuclear Information System (INIS)

    Ftacnikova, S.; Fueriova, A.

    1996-01-01

    The increased number of in vitro diagnostic nuclear medicine examinations has created the need for more precise determination of radiation dose to the population, specially to the children. A questionnaire survey has been performed on all nuclear medicine facilities in Slovak Republic through 1982 to 1994 with a special attention to pediatric patients in 1994. The information obtained was about the age distribution, number of different types of examinations, radiopharmaceuticals used and the value of mean administered radioactivity per exam. These data were used to evaluate the mean effective dose per exam and per capita, the collective effective dose for special type of examinations, for different radiopharmaceuticals and for radionuclides used in diagnostic procedures. In calculations we used the best available biokinetic models of the distribution of radiopharmaceuticals in organs as a function of age. The results show that the Slovak Republic appeared favorable in comparison to other countries in the judicious use of diagnostic nuclear medicine procedures performed on pediatric population. (author)

  1. Female fertility preservation in the pediatric and adolescent cancer patient population.

    Science.gov (United States)

    Algarroba, Gabriela N; Sanfilippo, Joseph S; Valli-Pulaski, Hanna

    2018-04-01

    The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population. Additionally, the fertility preservation methods for pre- and postpubertal females differ, with only experimental methods available for prepubertal females. We will review the risk of chemotherapy and radiation on female fertility, the approach to fertility preservation in the pediatric and adolescent female population, methods of fertility preservation for both pre- and postpubertal females, barriers to fertility preservation, cost, and psychological and ethical considerations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Extracorporeal Cardiopulmonary Resuscitation in the Pediatric Cardiac Population: In Search of a Standard of Care.

    Science.gov (United States)

    Lasa, Javier J; Jain, Parag; Raymond, Tia T; Minard, Charles G; Topjian, Alexis; Nadkarni, Vinay; Gaies, Michael; Bembea, Melania; Checchia, Paul A; Shekerdemian, Lara S; Thiagarajan, Ravi

    2018-02-01

    Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation. Pediatric hospitals providing extracorporeal mechanical support services to patients with congenital and/or acquired heart disease. Critical care/cardiology specialist physicians, cardiothoracic surgeons, advanced practice nurse practitioners, respiratory therapists, and extracorporeal membrane oxygenation specialists. None. Survey web links were distributed over a 2-month period with critical care and/or cardiology physicians comprising the majority of respondents (75%). Nearly all respondents practice at academic/teaching institutions (97%), 89% were from U.S./Canadian institutions and 56% reported less than 10 years of clinical experience. During extracorporeal cardiopulmonary resuscitation, a majority of respondents reported adherence to guideline recommendations for epinephrine bolus dosing (64%). Conversely, 19% reported using only one to three epinephrine bolus doses regardless of extracorporeal cardiopulmonary resuscitation duration. Inotropic support is held after extracorporeal membrane oxygenation cannulation "most of the time" by 58% of respondents and 94% report using afterload reducing/antihypertensive agents "some" to "most of the time" after achieving full extracorporeal membrane oxygenation support. Interruptions in chest compressions are common

  3. The Breathmobile Program: structure, implementation, and evolution of a large-scale, urban, pediatric asthma disease management program.

    Science.gov (United States)

    Jones, Craig A; Clement, Loran T; Hanley-Lopez, Jean; Morphew, Tricia; Kwong, Kenny Yat Choi; Lifson, Francene; Opas, Lawrence; Guterman, Jeffrey J

    2005-08-01

    Despite more than a decade of education and research-oriented intervention programs, inner city children with asthma continue to engage in episodic "rescue" patterns of healthcare and experience a disproportionate level of morbidity. The aim of this study was to establish and evaluate a sustainable community-wide pediatric asthma disease management program designed to shift inner city children in Los Angeles from acute episodic care to regular preventive care in accordance with national standards. In 1995 the Southern California Chapter of the Asthma and Allergy Foundation of America (AAFA), the Los Angeles County Department of Health Services (LAC DHS), and the Los Angeles Unified School District (LAUSD) established an agreement to initiate and sustain the Breathmobile Program. This program includes automated case identification, mobile school-based clinics, and highly structured clinical encounters supported by an advanced information technology solution. Interdisciplinary teams of asthma care specialists provide regular and ongoing care to children at school and county clinic sites over a wide geographic area of urban Los Angeles. Each team operates in a specially equipped mobile clinic (Breathmobile), efficiently moving a structured healthcare process to school and county clinic sites with large numbers of children. Demographic, clinical, and participation data is tracked carefully in an electronic medical record system. Program operations, clinical oversight, and patient tracking are centralized at a care coordination center. Clinical operations and methods have been replicated in fixed specialty clinic sites at the Los Angeles County + University of Southern California Medical Center. Clinical and process measures are regularly evaluated to assure quality, plan iterative improvement, and support evidence-based care. Four Breathmobiles deliver ongoing care at more than 90 school sites. The program has engaged over five thousand patients and their families in a

  4. A comparison of rural and urban rheumatoid arthritis populations.

    Science.gov (United States)

    Basu, N; Steven, M

    2009-02-01

    There is evidence to suggest that remote populations have poorer clinical outcomes in certain disease processes such as asthma and cancer. This study looks to identify any disparities in the management of patients with rheumatoid arthritis in the context of rurality. A retrospective observational study was performed on all 1314 patients with a diagnosis of rheumatoid arthritis who have been under the care of the principal rheumatologist at Raigmore Hospital, Inverness, between the years 1994 and 2004 inclusive. Rurality was defined according to the Scottish Household Survey. Populations were assessed in terms of age; sex; duration of diagnosis; number of years of Disease Modifying AntiRheumatic Drugs (DMARD) therapy, prednisolone use and the number of musculoskeletal practical interventions undertaken (eg joint aspiration or replacement). Two thirds of patients were considered rural dwellers. No significant difference was established between the populations with regards to management. DMARD therapy had been prescribed in 77% of rural patients vs 70% of their city counterparts for a mean 5.4 and 4.0 years respectively. The proportion of patients exposed to prednisolone therapy and who underwent musculoskeletal procedures were equivalent. Rural dwellers, with rheumatoid arthritis in the Highlands of Scotland, do not appear to be disadvantaged in regards to their disease management in comparison to the urban population.

  5. Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson

    International Nuclear Information System (INIS)

    Noel, Cory V.; Krishnamurthy, Ramkumar; Krishnamurthy, Rajesh; Moffett, Brady

    2017-01-01

    feasible pharmacologic stress agent for use in cardiac MR in older pediatric patients with congenital heart disease and acquired heart disease. The ease of use as a bolus and the advantage of a prolonged hyperemia make its use appealing in pediatrics. In a limited number of cases, regadenoson stress perfusion showed excellent agreement with cardiac catheterization. Regadenoson might be a viable pharmacologic stress agent in this population. (orig.)

  6. Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson

    Energy Technology Data Exchange (ETDEWEB)

    Noel, Cory V. [Baylor College of Medicine, Department of Pediatric Cardiology, Houston, TX (United States); Texas Children' s Hospital, Department of Pediatric Cardiology, Houston, TX (United States); Krishnamurthy, Ramkumar; Krishnamurthy, Rajesh [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Moffett, Brady [Texas Children' s Hospital, Department of Pharmacology, Houston, TX (United States)

    2017-03-15

    feasible pharmacologic stress agent for use in cardiac MR in older pediatric patients with congenital heart disease and acquired heart disease. The ease of use as a bolus and the advantage of a prolonged hyperemia make its use appealing in pediatrics. In a limited number of cases, regadenoson stress perfusion showed excellent agreement with cardiac catheterization. Regadenoson might be a viable pharmacologic stress agent in this population. (orig.)

  7. Race and asthma control in the pediatric population of Hawaii.

    Science.gov (United States)

    Wu, Brian H; Cabana, Michael D; Hilton, Joan F; Ly, Ngoc P

    2011-05-01

    The racially unique population of Hawaii has one of the highest prevalences of childhood asthma in America. We estimate the prevalence of impaired asthma control among asthmatic children in Hawaii and determine which factors are associated with impaired control. We analyzed data from 477 asthmatic children living in Hawaii participating in the 2006-2008 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-Back Surveys. Impaired asthma control was modeled after 2007 National Asthma Education and Prevention Program guidelines. Univariate and multivariate analyses were used to identify factors associated with impaired asthma control. Children (53.8%) with asthma were either part or full Native Hawaiian/Pacific Islander. While 35.6% of asthmatic children met criteria for impaired asthma control, being part or full Native Hawaiian/Pacific Islander was not associated with impaired control. Only 31.1% of children with impaired control reported the use of inhaled corticosteroids despite >80% having had a routine checkup for asthma in the past year and receipt of asthma education from a healthcare provider. A large proportion of asthmatic children in Hawaii have impaired asthma control that does not appear to be associated with race but may be associated with inadequate pharmacologic therapy. While a significant percentage reported receiving routine asthma care and asthma education, a minority reported using inhaled corticosteroids. Reasons for this discrepancy between asthma assessment and treatment are unclear. However, additional education on part of the physician, community, and healthcare system are likely to improve management and reduce morbidity in this population. Copyright © 2010 Wiley-Liss, Inc.

  8. Evaluation of pulmonary embolism in a pediatric population with high clinical suspicion

    International Nuclear Information System (INIS)

    Victoria, Teresa; Mong, Andrew; Altes, Talissa; Hernandez, Andrea; Gonzalez, Leonardo; Kramer, Sandra S.; Jawad, Abbas F.; Raffini, Leslie

    2009-01-01

    Pulmonary embolism (PE) is an underdiagnosed entity in the pediatric population in part because of the low level of suspicion and awareness in the clinical world. To examine its relative prevalence, associated risk factors and imaging features in our pediatric population. A total of 92 patients age 21 years and younger with a high clinical suspicion of PE and who had available radiographic studies were identified from January 2003 to September 2006. Patients with a positive CT scan or a high probability ventilation/perfusion scan formed the case group; patients with a high clinical suspicion of PE and no radiographic evidence of PE or deep venous thrombosis (DVT), randomly matched in age and sex, became the matched control group. We reviewed the charts of both groups and analyzed the imaging studies. In our hospital, the prevalence of PE in patients with a strong suspicion of PE was 14%. The overall prevalence of thromboembolic disease (PE and/or DVT) was 25%. Recent surgery or orthopedic procedure, blood dyscrasias and contraceptive use were more common in patients with PE. No child died of PE in our study. The youngest child with PE in our study was 13 years. Girls were twice as likely to develop PE as boys. PE is a relatively common diagnosis in our tertiary care pediatric population when the clinical suspicion is high. We suggest increased awareness and index of suspicion in order to initiate prompt diagnostic imaging and treatment. (orig.)

  9. [Migrations in Latin American countries. Characteristics of the pediatric population].

    Science.gov (United States)

    Vásquez-De Kartzow, Rodrigo; Castillo-Durán, Carlos; Lera M, Lydia

    2015-01-01

    Migration is a growing phenomenon among Latin American countries (LAC) as well as others; however, scarce information is available studying its impact on paediatric groups and its association with socioeconomic variables. To study the association among socioeconomic variables and the immigration rate of paediatric population in LAC. Official rates of migration of LAC were obtained from: International Organization for Migration, Pan American Health Organization, and United Nations Development Programme. Demographic and socioeconomic information was also obtained for: gross domestic product (GDP), human development index (HDI), Gini coefficient of inequality (GC), alphabetization rate for adults (AA), net migration rate (NMR), and immigration of childrenChile and Argentina. No association among NMR and GDP, HDI, GC, AA was found. A correlation of IM15 was found with: GC (r=0.668, P=.01), with GDP (r=-0.720; P=.01), AA (r=-0.755; P=.01) and with HDI (r=-0.799; P=.01). Rate of IM15 was lower in LA countries with advanced/medium development (GDP>median) vs those with low development (Fisher, P<.0001). There is a direct inverse association between GDP per capita, HDI, AA and GC and the proportion of each country IN15. We did not observe an association between NMR and HDI, AA, and GC. The health impact of these migrations should be analysed. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  10. Increasing STEM Competence in Urban, High Poverty Elementary School Populations

    Directory of Open Access Journals (Sweden)

    Sueanne McKinney

    2017-10-01

    Full Text Available Enhancing STEM competence (e.g., interests, knowledge, skills, and dispositions among urban, high poverty, elementary school populations in the United States (U.S. is and remains a growing national concern, especially since Science, Technology, Engineering and Mathematics (STEM competence is and will continue to be a necessary requisite for gainful employment in the future, according to workforce development experts. In an attempt to address this gap, many urban elementary schools have begun to offer STEM-related programs to increase STEM learning at an early age. STEM competence (interest, knowledge, skills, and dispositions, however, remains low. This paper results in a matrix used to analyze children's fictional literary selections and a model that argues that elementary teachers, as the first point of contact with young students, can affect STEM competence. By adopting a more culturally responsive pedagogy that attends to the 21st Century Learning Skills and the Next Generation Science Standards, teachers can choose literature that serves to excite and reinforce STEM learning.

  11. [Urbanization mechanisms in bird species: population systems transformations or adaptations at the individual level?].

    Science.gov (United States)

    Fridman, V S; Eremkin, G S; Zakharova-Kubareva, N Iu

    2008-01-01

    The present research deals with urbanization of wild bird and mammal species. Forms and mechanisms of population steadiness in the urban landscape have been examined. The urbanization process turned out to be a directed change of the population system forming de novo in the urbolandscape leading to a sustainable organization peculiar for the particular environment. The population organization of different types in urbolandscape is found to provide its stability under conditions of directed and fast changes accompanied with instability and heterogenous structure of habitats. It is shown that the same type of population organization meets the corresponding demands among different species settling in the urban environment. Its features are "openness" and "flowage" of the groups, far order of settlement levels and other units of population system, constant movements of the individuals between the groups as a respond to the signals of urboenvironment significant changes. The "urban" variant of the population system organization turns out to be opposite to that of the same species in the non-urban habitats. After formation of the urban types by the species and successful developing of the town, the urban population becomes separated from the maternal local population and begins to exist independently in the urban landscape. The variety of adaptation aberrations in ecology, behavior, and mode of life of urban birds is the population system stability function in the urban landscape and is not a results of individual selection. It is shown that the urbanization process of the species goes firstly on the population level being the system structure transformation developed by the species towards the most stable state in the town (city) territory. Only after the appearance of stable urban population, the urban individuals show the rapid growth of different changes in ecology, behavior, mode of life that was traditionally described by naturalists as species adaptation to the

  12. Population structure of fishes from an urban stream

    Directory of Open Access Journals (Sweden)

    Naiara Zanatta

    2017-05-01

    Full Text Available The aim of this study was to identify the population structure of the ichthyofauna in an urban stream within an environmental protection area in southern Brazil. Quarterly samplings were conducted between October 2009 and August 2010. Poecilia reticulata was the most abundant species, followed by Hypostomus ancistroides and Rhamdia quelen. It was found a higher proportion of adults instead of juveniles from P. reticulata and R. quelen populations, while the opposite was recorded for H. ancistroides. Sex ratio of 1:1 was found for H. ancistroides, but differed significantly for P. reticulata and R. quelen. Females of P. reticulata and R. quelen reached higher length than males in the smaller and higher length-classes, while H. ancistroides females were only longer in initial length-classes. It was recorded higher occurrence of mature and maturing individuals. Mature individuals of H. ancistroides were sampled in October, and P. reticulata and R. quelen throughout the sampling period. Despite adverse environmental conditions, the occurrence of juveniles indicates reproductive activity for these species. Population structure studies in degraded systems are urgent, since life-history features of species may suffer changes due to anthropic impacts. Providing such information contributes to decision making and management of degraded systems.

  13. [Urban and rural population of the state of Sao Paulo: results of the census of 1980].

    Science.gov (United States)

    Saad, P M

    1981-01-01

    The accelerated urban growth of Sao Paulo between 1940-70 has continued during the period 1970-80, according to the 1980 censes. During 1970-80 the urban population increased 55.47%, while the rural population decreased 18.67%, bringing the percentage of the urban population to 88.6% of the total population of the state. This phenomenon has been common to all the 11 administrative regions of the state. The highest percentage of the urban population in 1980 was in the region of Greater Sao Paulo, followed by Litoral and Vale do Paraiba. The largest increases in urban population were in the regions of Sorocaba, Campinas, and Vale do Paraiba, while the highest decreases in rural population were in the regions of Sao Jose do Rio Preto, Aracatuba, Presidente Prudente, and Marilia. The document presents detailed data for each of the 11 administrative regions of the state, and for each municipality within a region.

  14. Symbol Digit Modalities Test: Normative data for Spanish-speaking pediatric population.

    Science.gov (United States)

    Arango-Lasprilla, J C; Rivera, D; Trapp, S; Jiménez-Pérez, C; Hernández Carrillo, C L; Pohlenz Amador, S; Vergara-Moragues, E; Rodríguez-Agudelo, Y; Rodriguez-Irizarry, W; García de la Cadena, C; Galvao-Carmona, A; Galarza-Del-Angel, J; Llerena Espezúa, X; Torales Cabrera, N; Flor-Caravia, P; Aguayo Arelis, A; Saracostti Schwartzman, M; Barranco Casimiro, R; Albaladejo-Blázquez, N

    2017-01-01

    To generate normative data for the Symbol Digit Modalities Test (SDMT) in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the SDMT as part of a larger neuropsychological battery. SDMT scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models showed main effects for age in all countries, such that score increased linearly as a function of age. In addition, age2 had a significant effect in all countries, except in Honduras and Puerto Rico. Models indicated that children whose parent(s) had a MLPE >12 years of education obtained higher score compared to children whose parent(s) had a MLPE ≤12 years for Chile, Guatemala, Mexico, and Spain. Sex affected SDMT score for Paraguay and Spain. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate interpretation of the SDMT with pediatric populations.

  15. Suicide risk in relation to level of urbanicity - a population-based linkage study

    DEFF Research Database (Denmark)

    Qin, Ping

    2005-01-01

    BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

  16. [Cities and oil. Historical and prospective aspects of the urban population of Venezuela].

    Science.gov (United States)

    Papail, J; Picquet, M

    1989-01-01

    The authors present a historical overview of urbanization in Venezuela. The impact of the oil economy on population change and spatial distribution is emphasized. A typology of cities based on socioeconomic function and on a demographic classification of urban centers is devised. Future trends in urbanization are also considered. (SUMMARY IN ENG)

  17. Restricting youth suicide: behavioral health patients in an urban pediatric emergency department.

    Science.gov (United States)

    Rogers, Steven C; DiVietro, Susan; Borrup, Kevin; Brinkley, Ashika; Kaminer, Yifrah; Lapidus, Garry

    2014-09-01

    Suicide is the third leading cause of death among individuals age 10 years to 19 years in the United States. Adolescents with suicidal behaviors are often cared for in emergency departments (EDs)/trauma centers and are at an increased risk for subsequent suicide. Many institutions do not have standard procedures to prevent future self-harm. Lethal means restriction (LMR) counseling is an evidence-based suicide prevention strategy that informs families to restrict access to potentially fatal items and has demonstrated efficacy in preventing suicide. The objectives of this study were to examine suicidal behavior among behavioral health patients in a pediatric ED and to assess the use of LMR by hospital staff. A sample of 298 pediatric patients was randomly selected from the population of behavioral health patients treated at the ED from January 1 through December 31, 2012 (n = 2,294). Descriptive data include demographics (age, sex, race/ethnicity, etc,), chief complaint, current and past psychiatric history, primary diagnosis, disposition, alcohol/drug abuse, and documentation of any LMR counseling provided in the ED. Of the 298 patients, 52% were female, 47% were white, and 76% were in the custody of their parents. Behavior/out of control was the most common chief complaint (43%). The most common diagnoses were mood disorder (25%) and depression (20%). Thirty-four percent of the patients had suicidal ideation, 22% had a suicide plan, 32% had documented suicidal behavior, and 25% of the patients reported having access to lethal means. However, only 4% of the total patient population received any LMR counseling, and only 15% of those with access to lethal means had received LMR counseling. Providing a safe environment for adolescents at risk for suicidal behaviors should be a priority for all families/caretakers and should be encouraged by health care providers. The ED is a key point of entry into services for suicidal youth and presents an opportunity to implement

  18. Diabetes mellitus and impaired glucose tolerance in urban adult population

    Directory of Open Access Journals (Sweden)

    Walter Rodrigues Júnior

    2014-01-01

    Full Text Available Objective: Estimating the prevalence of diabetes mellitus (DM and impaired glucose tolerance (IGT in the urban population aged between 30 and 69 years in the municipality of Campo Grande, state of Mato Grosso do Sul, Brazil. Methods: Population-based cross-sectional study conducted between October/2009 and February/2011. The investigation included the determination of fasting glucose and participants with blood glucose ≥ 200 mg/dL were considered diabetic. Nondiabetic patients, which showed blood glucose ≥ 100 mg/dL and < 200 mg/dL, underwent an oral glucose tolerance test (OGTT to investigate whether they had DM or IGT. Results: 1.429 individuals participated in this investigation. The general prevalence, adjusted for sex and age, were: 12.3% for DM (95%CI: 10.5 to 13.9% and 7.1% for IGT (95%CI: 5.7 to 8.4%. There was a higher prevalence of DM with increasing age in people with low educational level, family history of diabetes, overweight, obesity and central obesity. Among diabetic patients (n = 195, 25% were unaware they had the disease and were diagnosed through investigation. Among patients who already knew they had DM (n = 146, 37% were unaware of the potential chronic complications. Conclusion: This study confirms the increased prevalence of DM in Brazil and emphasizes the need for early diagnosis, as well as the importance of strict adherence to medical treatment in order to prevent its much feared complications.

  19. POPULATION MOBILITY CHARACTERISTIC: NOTES FROM THE URBAN-URBAN INTERACTION IN SEMARANG METROPOLITAN REGION

    Directory of Open Access Journals (Sweden)

    MARDHOTILLAH Santi

    2016-12-01

    Full Text Available The rapid growth of cities is characterized by the "pressure" in the form of increasingly dense urban areas, slums, traffic congestion, unemployment in the cities, and the number of illegal housing in the suburbs. This issue demonstrates the need for a balance between urban and rural areas. The balance is obtained through the interaction, and the interaction there is a process of "transfer" in the form of the human population, natural resources, and other supporting components. This view of the phenomenon makes many researchers conducting various studies in the context of the interaction between rural and urban. Furthermore, the study of the interaction of cities such as Salatiga and Semarang are in fact joined in the same region, KSN Kedungsepur. Semarang and surrounding developments as Semarang Metropolitan Region (SMR are the main attraction for the people who are around Semarang that caused an increase in the spatial interactions between Semarang and surrounding areas. From some areas belonging to KSN Kedungsepur, there are only two areas with the status of the city of Semarang city as a centre of KSN and Salatiga. This becomes interesting, unique conditions for studying the phenomenon under study is the interaction of the cities. The method used in this research was a quantitative method with descriptive analysis. Data was collected through a questionnaire survey technique primary by taking a random sample of migrants from Salatiga City and studied at the city of Semarang. The results of the study there were four mobility characteristics formed between Salatiga and Semarang, namely, commuting-boarding, boarding-commuting, boarding and boarding-permanent.

  20. Intimate Partner Violence among General and Urban Poor Populations in Kathmandu, Nepal

    Science.gov (United States)

    Oshiro, Azusa; Poudyal, Amod K.; Poudel, Krishna C.; Jimba, Masamine; Hokama, Tomiko

    2011-01-01

    Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants…

  1. The effects of ageing and urbanisation on China's future rural and urban populations

    NARCIS (Netherlands)

    Chen, Quanrun; Dietzenbacher, Erik; Los, Bart

    2017-01-01

    This paper estimates China's future population and labour force by developing a novel forecasting model for population. It combines information about age-specific parameters on fertility and mortality for both rural and urban areas using information about rural-urban migration and the transformation

  2. Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

    Science.gov (United States)

    Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

    2018-06-01

    Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

  3. Hemodynamic variables predict outcome of emergency thoracotomy in the pediatric trauma population.

    Science.gov (United States)

    Wyrick, Deidre L; Dassinger, Melvin S; Bozeman, Andrew P; Porter, Austin; Maxson, R Todd

    2014-09-01

    Limited data exist regarding indications for resuscitative emergency thoracotomy (ETR) in the pediatric population. We attempt to define the presenting hemodynamic parameters that predict survival for pediatric patients undergoing ETR. We reviewed all pediatric patients (age <18years), entered into the National Trauma Data Bank from 2007 to 2010, who underwent ETR within one hour of ED arrival. Mechanism of injury and hemodynamics were analyzed using Chi squared and Wilcoxon tests. 316 children (70 blunt, 240 penetrating) underwent ETR, 31% (98/316) survived to discharge. Less than 5% of patients survived when presenting SBP was ≤50mmHg or heart rate was ≤70bpm. For blunt injuries there were no survivors with a pulse ≤80bpm or SBP ≤60mmHg. When survivors were compared to nonsurvivors, blood pressure, pulse, and injury type were statistically significant when treated as independent variables and in a logistic regression model. When ETR was performed for SBP ≤50mmHg or for heart rate ≤70bpm less than 5% of patients survived. There were no survivors of blunt trauma when SBP was ≤60mmHg or pulse was ≤80bpm. This review suggests that ETR may have limited benefit in these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Quantifying Normal Craniofacial Form and Baseline Craniofacial Asymmetry in the Pediatric Population.

    Science.gov (United States)

    Cho, Min-Jeong; Hallac, Rami R; Ramesh, Jananie; Seaward, James R; Hermann, Nuno V; Darvann, Tron A; Lipira, Angelo; Kane, Alex A

    2018-03-01

    Restoring craniofacial symmetry is an important objective in the treatment of many craniofacial conditions. Normal form has been measured using anthropometry, cephalometry, and photography, yet all of these modalities have drawbacks. In this study, the authors define normal pediatric craniofacial form and craniofacial asymmetry using stereophotogrammetric images, which capture a densely sampled set of points on the form. After institutional review board approval, normal, healthy children (n = 533) with no known craniofacial abnormalities were recruited at well-child visits to undergo full head stereophotogrammetric imaging. The children's ages ranged from 0 to 18 years. A symmetric three-dimensional template was registered and scaled to each individual scan using 25 manually placed landmarks. The template was deformed to each subject's three-dimensional scan using a thin-plate spline algorithm and closest point matching. Age-based normal facial models were derived. Mean facial asymmetry and statistical characteristics of the population were calculated. The mean head asymmetry across all pediatric subjects was 1.5 ± 0.5 mm (range, 0.46 to 4.78 mm), and the mean facial asymmetry was 1.2 ± 0.6 mm (range, 0.4 to 5.4 mm). There were no significant differences in the mean head or facial asymmetry with age, sex, or race. Understanding the "normal" form and baseline distribution of asymmetry is an important anthropomorphic foundation. The authors present a method to quantify normal craniofacial form and baseline asymmetry in a large pediatric sample. The authors found that the normal pediatric craniofacial form is asymmetric, and does not change in magnitude with age, sex, or race.

  5. Surgical Intervention for Primary Spontaneous Pneumothorax in Pediatric Population: When and Why?

    Science.gov (United States)

    Yeung, Fanny; Chung, Patrick H Y; Hung, Esther L Y; Yuen, Chi Sum; Tam, Paul K H; Wong, Kenneth K Y

    2017-08-01

    Spontaneous pneumothorax in pediatric patients is relatively uncommon. The management strategy varies in different centers due to dearth of evidence-based pediatric guidelines. In this study, we reviewed our experience of thoracoscopic management of primary spontaneous pneumothorax (PSP) in children and identified risk factors associated with postoperative air leakage and recurrence. We performed a retrospective analysis of pediatric patients who had PSP and underwent surgical management in our institution between April 2008 and March 2015. Demographic data, radiological findings, interventions, and surgical outcomes were analyzed. A total of 92 patients with 110 thoracoscopic surgery for PSP were identified. The indications for surgery were failed nonoperative management with persistent air leakage in 32.7%, recurrent ipsilateral pneumothorax in 36.4%, first contralateral pneumothorax in 14.5%, bilateral pneumothorax in 10%, and significant hemopneumothorax in 5.5%. Bulla was identified in 101 thoracoscopy (91.8%) with stapled bullectomy performed. 14.5% patients had persistent postoperative air leakage and treated with reinsertion of thoracostomy tube and chemical pleurodesis. 17.3% patients had postoperative recurrence occurred at mean time of 11 months. Operation within 7 days of symptoms onset was associated with less postoperative air leakage (P = .04). Bilateral pneumothorax and those with abnormal radiographic features had significantly more postoperative air leakage (P = .002, P < .01 respectively) and recurrence (P < .01, P = .007). Early thoracoscopic mechanical pleurodesis and stapled bullectomy after thoracostomy tube insertion could be offered as a primary option for management of large PSP in pediatric population, since most of these patients had bulla identified as the culprit of the disease.

  6. Defining Population Health Vulnerability Following an Extreme Weather Event in an Urban Pacific Island Environment: Honiara, Solomon Islands

    Science.gov (United States)

    Natuzzi, Eileen S.; Joshua, Cynthia; Shortus, Matthew; Reubin, Reginald; Dalipanda, Tenneth; Ferran, Karen; Aumua, Audrey; Brodine, Stephanie

    2016-01-01

    Extreme weather events are common and increasing in intensity in the southwestern Pacific region. Health impacts from cyclones and tropical storms cause acute injuries and infectious disease outbreaks. Defining population vulnerability to extreme weather events by examining a recent flood in Honiara, Solomon Islands, can help stakeholders and policymakers adapt development to reduce future threats. The acute and subacute health impacts following the April 2014 floods were defined using data obtained from hospitals and clinics, the Ministry of Health and in-country World Health Organization office in Honiara. Geographical information system (GIS) was used to assess morbidity and mortality, and vulnerability of the health system infrastructure and households in Honiara. The April flash floods were responsible for 21 acute deaths, 33 injuries, and a diarrhea outbreak that affected 8,584 people with 10 pediatric deaths. A GIS vulnerability assessment of the location of the health system infrastructure and households relative to rivers and the coastline identified 75% of the health infrastructure and over 29% of Honiara's population as vulnerable to future hydrological events. Honiara, Solomon Islands, is a rapidly growing, highly vulnerable urban Pacific Island environment. Evaluation of the mortality and morbidity from the April 2014 floods as well as the infectious disease outbreaks that followed allows public health specialists and policy makers to understand the health system and populations vulnerability to future shocks. Understanding the negative impacts natural disaster have on people living in urban Pacific environments will help the government as well as development partners in crafting resilient adaptation development. PMID:27091867

  7. Urban habitat fragmentation and genetic population structure of bobcats in coastal southern California

    Science.gov (United States)

    Ruell, E.W.; Riley, S.P.D.; Douglas, M.R.; Antolin, M.F.; Pollinger, J.R.; Tracey, J.A.; Lyren, L.M.; Boydston, E.E.; Fisher, R.N.; Crooks, K.R.

    2012-01-01

    Although habitat fragmentation is recognized as a primary threat to biodiversity, the effects of urban development on genetic population structure vary among species and landscapes and are not yet well understood. Here we use non-invasive genetic sampling to compare the effects of fragmentation by major roads and urban development on levels of dispersal, genetic diversity, and relatedness between paired bobcat populations in replicate landscapes in coastal southern California. We hypothesized that bobcat populations in sites surrounded by urbanization would experience reduced functional connectivity relative to less isolated nearby populations. Our results show that bobcat genetic population structure is affected by roads and development but not always as predicted by the degree that these landscape features surround fragments. Instead, we suggest that urban development may affect functional connectivity between bobcat populations more by limiting the number and genetic diversity of source populations of migrants than by creating impermeable barriers to dispersal.

  8. Quantitative thoracic CT techniques in adults: can they be applied in the pediatric population?

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Soon Ho [Seoul National University Medical Research Center, Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul (Korea, Republic of); Goo, Jin Mo [Seoul National University Medical Research Center, Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Cancer Research Institute, Jongno-gu, Seoul (Korea, Republic of); Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

    2013-03-15

    With the rapid evolution of the multidetector row CT technique, quantitative CT has started to be used in clinical studies for revealing a heterogeneous entity of airflow limitation in chronic obstructive pulmonary disease that is caused by a combination of lung parenchymal destruction and remodeling of the small airways in adults. There is growing evidence of a good correlation between quantitative CT findings and pathological findings, pulmonary function test results and other clinical parameters. This article provides an overview of current quantitative thoracic CT techniques used in adults, and how to translate these CT techniques to the pediatric population. (orig.)

  9. Genital Involvement In Pre-Pubertal Pediatric Population: A Rare Aspect of Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Qurratul Ann Warsi

    2016-09-01

    Full Text Available Crohn’s disease is an inflammatory bowel disease (IBD, characterized by chronic intestinal inflammation that causes the loss of immune tolerance leading to bizarre inflammatory signals and disruption of mucosal barriers. Environmental triggers and interaction of genetic determinants also play an indispensible role. In this case report, we present a pre-pubertal girl with intermittent and refractory genital swelling. We emphasize that Crohn’s disease must be considered in the differential diagnosis of recurrent, non-tender, erythematous and edematous lesions of the genital area. We conclude with future directions for diagnosing and managing vulvar Crohn’s disease in pediatric population.

  10. Population-based assessment of heartburn in urban Black Americans.

    Science.gov (United States)

    Friedenberg, F K; Makipour, K; Palit, A; Shah, S; Vanar, V; Richter, J E

    2013-08-01

    Prevalence data for heartburn in the urban Black American community is lacking. In order to estimate prevalence for this community, we analyzed data from an ongoing cohort study in progress at our hospital. Comprehensive interviews allowed for exploration of factors associated with heartburn. Complex, stratified sampling design was the method used. Survey invitations are hand-delivered to random blocks in a single zip code tabulation area. One member per eligible household is invited to complete a computer-based survey. Heartburn was defined as ≥ 3 days/week of symptoms as defined by the Montreal Definition and Classification of gastroesophageal reflux disease. Scaling and weighting factors were utilized to estimate population level prevalence. Multivariate logistic regression was used to identify independent predictor variables for heartburn. Enrolled 379 participants corresponding to a weighted sample size of 22,409 (20,888-23,930) citizens. Demographic characteristics of the sample closely matched those of the entire targeted population. Overall, the weighted prevalence of heartburn ≥ 3 times per week was 17.6% (16.4-18.8%). Variables independently associated with heartburn were body mass index, daily caloric and fat intake, diabetes mellitus (odds ratio = 2.95; 2.59-3.36), cigarette smoking, and alcohol consumption (odds ratio = 2.55; 2.25-2.89). Factors inversely associated included illicit drug use and increased physical activity. Waist : hip ratio showed no relationship. The prevalence of heartburn ≥ 3 times per week is high in the Black American community. Adverse lifestyle behaviors showed particularly important associations. Our study needs to be replicated in other communities with similar demographics. © 2012 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  11. Campylobacter jejuni colonization and population structure in urban populations of ducks and starlings in New Zealand.

    Science.gov (United States)

    Mohan, Vathsala; Stevenson, Mark; Marshall, Jonathan; Fearnhead, Paul; Holland, Barbara R; Hotter, Grant; French, Nigel P

    2013-08-01

    A repeated cross-sectional study was conducted to determine the prevalence of Campylobacter spp. and the population structure of C. jejuni in European starlings and ducks cohabiting multiple public access sites in an urban area of New Zealand. The country's geographical isolation and relatively recent history of introduction of wild bird species, including the European starling and mallard duck, create an ideal setting to explore the impact of geographical separation on the population biology of C. jejuni, as well as potential public health implications. A total of 716 starling and 720 duck fecal samples were collected and screened for C. jejuni over a 12 month period. This study combined molecular genotyping, population genetics and epidemiological modeling and revealed: (i) higher Campylobacter spp. isolation in starlings (46%) compared with ducks (30%), but similar isolation of C. jejuni in ducks (23%) and starlings (21%), (ii) significant associations between the isolation of Campylobacter spp. and host species, sampling location and time of year using logistic regression, (iii) evidence of population differentiation, as indicated by FST , and host-genotype association with clonal complexes CC ST-177 and CC ST-682 associated with starlings, and clonal complexes CC ST-1034, CC ST-692, and CC ST-1332 associated with ducks, and (iv) greater genetic diversity and genotype richness in ducks compared with starlings. These findings provide evidence that host-associated genotypes, such as the starling-associated ST-177 and ST-682, represent lineages that were introduced with the host species in the 19th century. The isolation of sequence types associated with human disease in New Zealand indicate that wild ducks and starlings need to be considered as a potential public health risk, particularly in urban areas. © 2013 The Authors. Microbiology Open published by John Wiley & Sons Ltd.

  12. Stroop Color-Word Interference Test: Normative data for Spanish-speaking pediatric population.

    Science.gov (United States)

    Rivera, D; Morlett-Paredes, A; Peñalver Guia, A I; Irías Escher, M J; Soto-Añari, M; Aguayo Arelis, A; Rute-Pérez, S; Rodríguez-Lorenzana, A; Rodríguez-Agudelo, Y; Albaladejo-Blázquez, N; García de la Cadena, C; Ibáñez-Alfonso, J A; Rodriguez-Irizarry, W; García-Guerrero, C E; Delgado-Mejía, I D; Padilla-López, A; Vergara-Moragues, E; Barrios Nevado, M D; Saracostti Schwartzman, M; Arango-Lasprilla, J C

    2017-01-01

    To generate normative data for the Stroop Word-Color Interference test in Spanish-speaking pediatric populations. The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the Stroop Word-Color Interference test as part of a larger neuropsychological battery. The Stroop Word, Stroop Color, Stroop Word-Color, and Stroop Interference scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The final multiple linear regression models showed main effects for age on all scores, except on Stroop Interference for Guatemala, such that scores increased linearly as a function of age. Age2 affected Stroop Word scores for all countries, Stroop Color scores for Ecuador, Mexico, Peru, and Spain; Stroop Word-Color scores for Ecuador, Mexico, and Paraguay; and Stroop Interference scores for Cuba, Guatemala, and Spain. MLPE affected Stroop Word scores for Chile, Mexico, and Puerto Rico; Stroop Color scores for Mexico, Puerto Rico, and Spain; Stroop Word-Color scores for Ecuador, Guatemala, Mexico, Puerto Rico and Spain; and Stroop-Interference scores for Ecuador, Mexico, and Spain. Sex affected Stroop Word scores for Spain, Stroop Color scores for Mexico, and Stroop Interference for Honduras. This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the Stroop Word-Color Interference test in pediatric populations.

  13. Clinical profile and neuroimaging in pediatric optic neuritis in Indian population: A case series

    Directory of Open Access Journals (Sweden)

    Rutika Khadse

    2017-01-01

    Full Text Available Purpose of the study: The purpose of this study was to report clinical features, neuroimaging, and visual outcome in pediatric optic neuritis (ON in Indian population. Materials and Methods: This is a retrospective study of children up to the age of 16 years, diagnosed with ON, that presented at pediatric and neuroophthalmology clinic of a tertiary eye care center, in South India, within the period of 2010–2015. Results: We identified 62 eyes of 40 children diagnosed as ON within the study period. The mean age was 11.15 ± 3.24 years (1–15 years with mean follow-up of 13 months. In this series, there was female preponderance (67%. Mean logarithm of the minimum angle of resolution visual acuity at presentation was 1.14 ± 0.93, which after treatment recovered to 0.10 ± 0.26 at final visit (P < 0.001. Involvement was bilateral in 22 children (55% and recurrent in 3 eyes of 3 children. Preceding febrile illness was reported in seven cases (18%. Four (10% cases were diagnosed as multiple sclerosis (MS, one with neuromyelitis optica , and one with acute disseminated encephalomyelitis. One case was associated with tuberculous meningitis, 1 with septicemia, and 1 with bilateral maxillary sinusitis. Neuroimaging studies of optic nerve in 14 children demonstrated isolated optic nerve enhancement. Magnetic resonance imaging brain revealed white matter T2 hyperintense lesions separate from optic nerve in ten cases, of which four cases were diagnosed as MS. Conclusions: Bilateral presentation was common, association with MS was low. Papillitis was more frequent than retrobulbar neuritis and prognosis was good in pediatric ON in Indian population.

  14. Urban air pollution and respiratory emergency visits at pediatric unit, Reggio Emilia, Italy.

    Science.gov (United States)

    Bedeschi, Emanuela; Campari, Cinzia; Candela, Silvia; Collini, Giorgia; Caranci, Nicola; Frasca, Gabriella; Galassi, Claudia; Francesca, Gabriella; Vigotti, Maria Angela

    2007-02-01

    Short-term effects of air pollution on daily mortality and hospital admissions for respiratory causes are well documented. Few studies, however, explore the association between exposure to air pollution and daily emergency room visits for respiratory disorders, particularly in Italy and particularly among children as a susceptible population. A time-series analysis was conducted to explore the short-term association between air pollutants (PM10, total suspended particulates [TSP], NO2, SO2, CO, O3) and pediatric emergency room (ER) visits in a small city of northern Italy, Reggio Emilia, during the period 03/01/2001-03/31/2002. There were 1051 ER visits included in the study. Data were analyzed using generalized additive models (GAM), adjusting for various confounding variables, including temperature, humidity, and pollens (Graminaceae). The analyses were also stratified according to the nationality of children (Italians and foreigners). In single-pollutant models, the strongest associations were observed at lag 3 for a 10-microg/m3 increase of TSP (2.7% increase in ER, 95% CI 0.7-4.6) and PM10 (3.0% increase, 95% CI 0.4-5.7), and at lag 4 for a 10-microg/m3 increase of NO2 (11.0% increase in ER, 95% CI 3.6-18.8). At lag 3, the percentage increase in ER visits is similar for the 2 groups of children (Italians and foreigners) for TSP and PM10. The results of the study support the findings that air pollution is a relevant determinant of deterioration of respiratory health among children.

  15. More than 500 million Chinese urban residents (14% of the global urban population) are imperiled by fine particulate hazard.

    Science.gov (United States)

    He, Chunyang; Han, Lijian; Zhang, Robin Q

    2016-11-01

    China's urbanization and the subsequent public vulnerability to degenerated environment is important to global public health. Among the environmental problems, fine particulate (PM 2.5 ) pollution has become a serious hazard in rapidly urbanizing China. However, quantitative information remains inadequate. We thus collected PM 2.5 concentrations and population census records, to illustrate the spatial patterns and changes in the PM 2.5 hazard levels in China, and to quantify public vulnerability to the hazard during 2000-2010, following the air quality standards of World Health Organization. We found that 28% (2.72 million km 2 ) of China's territory, including 78% of cities (154 cities) with a population of >1 million, was exposed to PM 2.5 hazard in 2010; a 15% increase (1.47 million km 2 ) from 2000 to 2010. The hazards potentially impacted the health of 72% of the total population (942 million) in 2010, including 70% of the young (206 million) and 76% of the old (71 million). This was a significant increase from the 42% of total the population (279 million) exposed in 2000. Of the total urban residents, 76% (501 million) were affected in 2010. Along with PM 2.5 concentration increase, massive number of rural to urban migration also contributed greatly to China's urban public health vulnerability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. 1 POPULATION PRESSURE AND HEALTH RISKS IN URBAN ...

    African Journals Online (AJOL)

    on urban market environment (and in this case, Bodija Market, Ibadan). Particular ... markets in most LDCs have become huge waste production centers. ... market. With about 90 percent of food purchases of urban residents being sourced from .... up a child's excrement in between attending to customers are created. Often ...

  17. Benefits and risks of preoperative bowel cleansing in the pediatric population

    Directory of Open Access Journals (Sweden)

    Silvia Cordero Castro

    2013-10-01

    Full Text Available This article has as aim to announce the results of a clinical question referred about the intestinal cleanliness method most adapted for the pediatric population before a colorectal surgery, in order to diminish the electrolytic alterations for the utilization of the same ones and hereby to provide a better intestinal preparation with the minor risks. Is true the method of intestinal cleanliness it is a medical indication, the infirmary professionals must think about his work and wonder it brings over of his own practice and to work in a surest way (Young, 2003. There was realized a search, review and analysis of the scientific literature for that there were use different databases, as for example seeker academic GOOGLE, administrators of articles PUBMED, MEDLINE, EMBASE, SCIELO and Cochrane in Spanish and English language. Found 31 investigations that refer to the interest topic in indirect form. The conclusion were that the fosfosoda oral is effective and better tolerated in the intestinal cleanlinesses with the exception of the magnesium citrate who overcomes in flavor, for this could be an option for the use in pediatric populations. Nevertheless to use cautiously it's recommended to take renal function test and electrolytic pre, trans and post administration, added to the use of intravenous solutions mixed or electrolytic balanced intravenous as reinstatement to the losses. Nevertheless, there is no forceful evidence to determine which method of intestinal cleanliness is better and less risky for the children.

  18. Bartonelosis (Carrion's Disease) in the pediatric population of Peru: an overview and update.

    Science.gov (United States)

    Huarcaya, Erick; Maguiña, Ciro; Torres, Rita; Rupay, Joan; Fuentes, Luis

    2004-10-01

    Bartonellosis, or Carrion's Disease, is an endemic and reemerging disease in Peru and Ecuador. Carrion's Disease constitutes a health problem in Peru because its epidemiology has been changing, and it is affecting new areas between the highland and the jungle. During the latest outbreaks, and previously in endemic areas, the pediatric population has been the most commonly affected. In the pediatric population, the acute phase symptoms are fever, anorexia, malaise, nausea and/or vomiting. The main signs are pallor, hepatomegaly, lymphadenopathies, cardiac murmur, and jaundice. Arthralgias and weight loss have also commonly been described. The morbidity and mortality of the acute phase is variable, and it is due mainly to superimposed infections or associated respiratory, cardiovascular, neurological or gastrointestinal complications. The eruptive phase, also known as Peruvian Wart, is characterized by eruptive nodes (which commonly bleed) and arthralgias. The mortality of the eruptive phase is currently extremely low. The diagnosis is still based on blood culture and direct observation of the bacilli in a blood smear. In the chronic phase, the diagnosis is based on biopsy or serologic assays. There are nationally standardized treatments for the acute phase, which consist of ciprofloxacin, and alternatively chloramphenicol plus penicillin G. However, most of the treatments are based on evidence from reported cases. During the eruptive phase the recommended treatment is rifampin, and alternatively, azithromycin or erythromycin.

  19. Bartonelosis (Carrion's Disease in the pediatric population of Peru: an overview and update

    Directory of Open Access Journals (Sweden)

    Erick Huarcaya

    Full Text Available Bartonellosis, or Carrion's Disease, is an endemic and reemerging disease in Peru and Ecuador. Carrion's Disease constitutes a health problem in Peru because its epidemiology has been changing, and it is affecting new areas between the highland and the jungle. During the latest outbreaks, and previously in endemic areas, the pediatric population has been the most commonly affected. In the pediatric population, the acute phase symptoms are fever, anorexia, malaise, nausea and/or vomiting. The main signs are pallor, hepatomegaly, lymphadenopathies, cardiac murmur, and jaundice. Arthralgias and weight loss have also commonly been described. The morbidity and mortality of the acute phase is variable, and it is due mainly to superimposed infections or associated respiratory, cardiovascular, neurological or gastrointestinal complications. The eruptive phase, also known as Peruvian Wart, is characterized by eruptive nodes (which commonly bleed and arthralgias. The mortality of the eruptive phase is currently extremely low. The diagnosis is still based on blood culture and direct observation of the bacilli in a blood smear. In the chronic phase, the diagnosis is based on biopsy or serologic assays. There are nationally standardized treatments for the acute phase, which consist of ciprofloxacin, and alternatively chloramphenicol plus penicillin G. However, most of the treatments are based on evidence from reported cases. During the eruptive phase the recommended treatment is rifampin, and alternatively, azithromycin or erythromycin.

  20. Factors associated with the utilization of dental health services by the pediatric population: an integrative review.

    Science.gov (United States)

    Curi, Davi Silva Carvalho; Figueiredo, Andreia Cristina Leal; Jamelli, Silvia Regina

    2018-05-01

    This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

  1. Perceptions about computers and the internet in a pediatric clinic population.

    Science.gov (United States)

    Carroll, Aaron E; Zimmerman, Frederick J; Rivara, Frederick P; Ebel, Beth E; Christakis, Dimitri A

    2005-01-01

    A digital divide with respect to computer and Internet access has been noted in numerous studies and reports. Equally important to ownership is comfort with computers and Internet technology, and concerns about privacy of personal data. To measure how households in a pediatric clinic vary in their attitudes toward computers, concerns about Internet confidentiality, and comfort using the Internet and whether these views are associated with household income or education. A phone survey was administered to a population-based sample of parents with children aged 0 to 11 years. All children received medical care from a community-based clinic network serving patients in King County, Wash. Eighty-eight percent of respondents used a computer once a week or more, and 83% of respondents reported favorable feelings toward computers. Although 97% of respondents were willing to share personal information over the Internet, many respondents considered data security important. While household income and parental education were associated with comfort and familiarity with computers, the effect is small. Respondents who already owned a computer and had Internet access did not differ in their perceptions according to socioeconomic or educational attainment. Most families like using computers and feel comfortable using the Internet regardless of socioeconomic status. Fears about the digital divide's impact on the attitudes of parents toward computers or their comfort using the Internet should not be seen as a barrier to developing Internet-based health interventions for a pediatric clinic population.

  2. Anaphylaxis in pediatric population: A 1-year survey on the Medical Emergency Service in Liguria, Italy.

    Science.gov (United States)

    Ruffoni, Silvano; Barberi, Salvatore; Bernardo, Luca; Ferrara, Francesca; Furgani, Andrea; Tosca, Maria Angela; Schiavetti, Irene; Ciprandi, Giorgio

    2015-12-01

    Anaphylaxis is a severe, life-threatening, generalized, or systemic hypersensitivity reaction. The diagnosis is mainly based on a clinical ground. This study aimed to evaluate the records of both phone calls and medical visits for anaphylaxis managed by the Liguria Medical Emergency Service (MES) in a pediatric population, occurred during 2013. The phone call is managed at each center and classified according to a level of care intensity and a presumed level of criticality, according to established criteria. Criticality is then re-evaluated (detected criticality) at the end of the medical visit following the same score adding the black code for patients who died. Most of the phone calls (86) to the MES were recorded in summer (40.7%), followed by spring (26.7%), autumn (16.3%), and winter (16.3%). Forty-eight patients (55.8%) were male. Anaphylaxis was confirmed in about half of patients. In addition, almost all subjects (97.7%) were referred to the Emergency Room. In conclusion, the present study shows that anaphylaxis represents a serious and relevant medical problem in the pediatric population and should be ever carefully managed. © The Author(s) 2015.

  3. Modification of Heat-Related Mortality in an Elderly Urban Population by Vegetation (Urban Green) and Proximity to Water (Urban Blue): Evidence from Lisbon, Portugal.

    Science.gov (United States)

    Burkart, Katrin; Meier, Fred; Schneider, Alexandra; Breitner, Susanne; Canário, Paulo; Alcoforado, Maria João; Scherer, Dieter; Endlicher, Wilfried

    2016-07-01

    Urban populations are highly vulnerable to the adverse effects of heat, with heat-related mortality showing intra-urban variations that are likely due to differences in urban characteristics and socioeconomic status. We investigated the influence of urban green and urban blue, that is, urban vegetation and water bodies, on heat-related excess mortality in the elderly > 65 years old in Lisbon, Portugal, between 1998 and 2008. We used remotely sensed data and geographic information to determine the amount of urban vegetation and the distance to bodies of water (the Atlantic Ocean and the Tagus Estuary). Poisson generalized additive models were fitted, allowing for the interaction between equivalent temperature [universal thermal climate index (UTCI)] and quartiles of urban greenness [classified using the Normalized Difference Vegetation Index (NDVI)] and proximity to water (≤ 4 km vs. > 4 km), while adjusting for potential confounders. The association between mortality and a 1°C increase in UTCI above the 99th percentile (24.8°C) was stronger for areas in the lowest NDVI quartile (14.7% higher; 95% CI: 1.9, 17.5%) than for areas in the highest quartile (3.0%; 95% CI: 2.0, 4.0%). In areas > 4 km from water, a 1°C increase in UTCI above the 99th percentile was associated with a 7.1% increase in mortality (95% CI: 6.2, 8.1%), whereas in areas ≤ 4 km from water, the estimated increase in mortality was only 2.1% (95% CI: 1.2, 3.0%). Urban green and blue appeared to have a mitigating effect on heat-related mortality in the elderly population in Lisbon. Increasing the amount of vegetation may be a good strategy to counteract the adverse effects of heat in urban areas. Our findings also suggest potential benefits of urban blue that may be present several kilometers from a body of water. Burkart K, Meier F, Schneider A, Breitner S, Canário P, Alcoforado MJ, Scherer D, Endlicher W. 2016. Modification of heat-related mortality in an elderly urban population by

  4. Is Demography Destiny? Urban Population Change and Economic Vitality of Future Cities

    Directory of Open Access Journals (Sweden)

    Jacques Poot

    Full Text Available ABSTRACT: The growth of cities has attracted considerable scholarly attention during the last decade as it is becoming clear that powerful agglomeration forces are reinforcing the role of cities as the engines of economic growth. Close to 4 billion people live in cities, about 55 per cent of the world's population. While population growth rates are declining and the world's population is likely to level off from the middle of the 21st century, probably ending up around 10 billion, further urbanization is expected to continue. Another 3 billion people will become urban citizens this century. At the same time no corner of the world will be sheltered from sweeping demographic changes due to population ageing and increasing migration. Such changes will be amplified in cities. In this paper we combine UN population projections and migration data with our own assumptions to derive projections of age composition and birthplace composition of urban populations by continent. We also briefly address the consequences of these demographic trends for future urban economic vitality. Particular attention is paid to the impacts of demographic changes on urban creativity and innovation. We conclude that, with the right policies in place, such demographic changes enhance rather than impede the future prosperity of the urban world. KEYWORDS: World population projections, urbanization, ageing, migration, ethnic diversity

  5. Trends in mortality and biological stress in a medieval polish urban population.

    Science.gov (United States)

    Betsinger, Tracy K; DeWitte, Sharon

    2017-12-01

    Urbanization in pre-modern populations may have had a variety of consequences related to population crowding. However, research on the effects of urbanization have provided inconsistent results regarding the biological impact of this transition on human populations. The purpose of this study is to test the hypothesis that urbanization caused an increase in overall biological stress in a medieval (10th-13th centuries AD) Polish population. A human skeletal sample (n=164) was examined for the presence of porotic hyperostosis, cribra orbitalia, linear enamel hypoplasia, periosteal reaction, and specific infectious diseases. Prevalence rates were compared among three temporal samples: initial urbanization, early urbanization, and later urbanization. Results indicate no significant trends for any of the pathological conditions. Cox proportional hazards analyses, however, revealed a significant increase in the risk of death over time, which supports the hypothesis. These results reflect the necessity of using multiple analyses to address bioarchaeological questions. The lack of significant results from skeletal indicators may be due to an earlier urbanization trend in the population. This study illustrates that the association of urbanization with elevated biological stress is complicated and dependent on various factors, including culture and time period. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Variation in Use of Pediatric Cardiology Subspecialty Care: A Total Population Study in California, 1983 to 2011.

    Science.gov (United States)

    Chamberlain, Lisa J; Fernandes, Susan M; Saynina, Olga; Grady, Stafford; Sanders, Lee; Staves, Kelly; Wise, Paul H

    2015-07-07

    American Academy of Pediatrics guidelines emphasize regionalized systems of care for pediatric chronic illness. There remains a paucity of information on the status of regionalized systems of care for pediatric congenital heart disease (CHD). This study evaluated variations in use of pediatric cardiology specialty care centers (PCSCC) for pediatric patients with CHD in California between 1983 and 2011. We performed a retrospective, total population analysis of pediatric CHD patients using the California Office of Statewide Health Planning and Development unmasked database. PCSCCs were identified by California's Title V program. There were 164,310 discharges meeting inclusion criterion. Discharges from PCSCCs grew from 58% to 88% between 1983 and 2011. Regionalized care was highest for surgical (96%) versus nonsurgical (71%) admissions. Admissions with a public payer increased from 42% (1983) to 61% (2011). Total bed days nearly doubled, and median length of stay increased from 2 to 3 days (nonspecialty care) and from 4 to 5 days (specialty care). There was a decrease in the pediatric CHD in-hospital death rate from 5.1 to 2.3 per 100,000 between 1983 and 2011, and a shift toward a larger percent of deaths occurring in the newborn period. California's inpatient regionalized specialty care of pediatric CHD has increased substantially since 1983, especially for surgical CHD discharges. The death rate has decreased, the number of bed days has increased, and a large proportion of these discharges now have public payers. Health care reform efforts must consider these shifts while protecting advances in regionalization of pediatric CHD care. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Suicide risk in relation to level of urbanicity - a population-based linkage study

    DEFF Research Database (Denmark)

    Qin, Ping

    2005-01-01

    from various Danish longitudinal registers. Data were analysed with conditional logistic regression. RESULTS: This study confirms that people living in more urbanized areas are at a higher risk of suicide than their counterparts in less urbanized areas. However, this excess risk is largely eliminated...... when adjusted for personal marital, income, and ethnic differences; it is even reversed when further adjusted for psychiatric status. Moreover, the impact of urbanicity on suicide risk differs significantly by sex and across age. Urban living reduces suicide risk significantly among men, especially......BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

  8. Mycobacterium tuberculosis Complex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico

    Directory of Open Access Journals (Sweden)

    Mercedes Macías Parra

    2011-01-01

    Full Text Available The aim of this study was to determine the frequency of drug resistance and the clonality of genotype patterns in M. tuberculosis clinical isolates from pediatric patients in Mexico (n=90 patients from 19 states; time period—January 2002 to December 2003. Pulmonary disease was the most frequent clinical manifestation (71%. Children with systemic tuberculosis (TB were significantly younger compared to patients with localized TB infections (mean 7.7±6.2 years versus 15±3.4 years P=0.001. Resistance to any anti-TB drug was detected in 24/90 (26.7% of the isolates; 21/90 (23.3% and 10/90 (11.1% were resistant to Isoniazid and Rifampicin, respectively, and 10/90 (11.1% strains were multidrug-resistant (MDR. Spoligotyping produced a total of 55 different patterns; 12/55 corresponded to clustered isolates (n=47, clustering rate of 52.2%, and 43/55 to unclustered isolates (19 patterns were designated as orphan by the SITVIT2 database. Database comparison led to designation of 36 shared types (SITs; 32 SITs (n=65 isolates matched a preexisting shared type in SITVIT2, whereas 4 SITs (n=6 isolates were newly created. Lineage classification based on principal genetic groups (PGG revealed that 10% of the strains belonged to PGG1 (Bovis and Manu lineages. Among PGG2/3 group, the most predominant clade was the Latin-American and Mediterranean (LAM in 27.8% of isolates, followed by Haarlem and T lineages. The number of single drug-resistant (DR and multidrug-resistant (MDR-TB isolates in this study was similar to previously reported in studies from adult population with risk factors. No association between the spoligotype, age, region, or resistance pattern was observed. However, contrary to a study on M. tuberculosis spoligotyping in Acapulco city that characterized a single cluster of SIT19 corresponding to the EAI2-Manila lineage in 70 (26% of patients, not a single SIT19 isolate was found in our pediatric patient population. Neither did we find any

  9. Seasonal associations with urban light pollution for nocturnally migrating bird populations.

    Science.gov (United States)

    La Sorte, Frank A; Fink, Daniel; Buler, Jeffrey J; Farnsworth, Andrew; Cabrera-Cruz, Sergio A

    2017-11-01

    The spatial extent and intensity of artificial light at night (ALAN) has increased worldwide through the growth of urban environments. There is evidence that nocturnally migrating birds are attracted to ALAN, and there is evidence that nocturnally migrating bird populations are more likely to occur in urban areas during migration, especially in the autumn. Here, we test if urban sources of ALAN are responsible, at least in part, for these observed urban associations. We use weekly estimates of diurnal occurrence and relative abundance for 40 nocturnally migrating bird species that breed in forested environments in North America to assess how associations with distance to urban areas and ALAN are defined across the annual cycle. Migratory bird populations presented stronger than expected associations with shorter distances to urban areas during migration, and stronger than expected association with higher levels of ALAN outside and especially within urban areas during migration. These patterns were more pronounced during autumn migration, especially within urban areas. Outside of the two migration periods, migratory bird populations presented stronger than expected associations with longer distances to urban areas, especially during the nonbreeding season, and weaker than expected associations with the highest levels of ALAN outside and especially within urban areas. These findings suggest that ALAN is associated with higher levels of diurnal abundance along the boundaries and within the interior of urban areas during migration, especially in the autumn when juveniles are undertaking their first migration journey. These findings support the conclusion that urban sources of ALAN can broadly effect migratory behavior, emphasizing the need to better understand the implications of ALAN for migratory bird populations. © 2017 John Wiley & Sons Ltd.

  10. Predicting Intra-Urban Population Densities in Africa using SAR and Optical Remote Sensing Data

    Science.gov (United States)

    Linard, C.; Steele, J.; Forget, Y.; Lopez, J.; Shimoni, M.

    2017-12-01

    The population of Africa is predicted to double over the next 40 years, driving profound social, environmental and epidemiological changes within rapidly growing cities. Estimations of within-city variations in population density must be improved in order to take urban heterogeneities into account and better help urban research and decision making, especially for vulnerability and health assessments. Satellite remote sensing offers an effective solution for mapping settlements and monitoring urbanization at different spatial and temporal scales. In Africa, the urban landscape is covered by slums and small houses, where the heterogeneity is high and where the man-made materials are natural. Innovative methods that combine optical and SAR data are therefore necessary for improving settlement mapping and population density predictions. An automatic method was developed to estimate built-up densities using recent and archived optical and SAR data and a multi-temporal database of built-up densities was produced for 48 African cities. Geo-statistical methods were then used to study the relationships between census-derived population densities and satellite-derived built-up attributes. Best predictors were combined in a Random Forest framework in order to predict intra-urban variations in population density in any large African city. Models show significant improvement of our spatial understanding of urbanization and urban population distribution in Africa in comparison to the state of the art.

  11. Interdisciplinary Approach to Fall Prevention in a High-Risk Inpatient Pediatric Population: Quality Improvement Project.

    Science.gov (United States)

    Stubbs, Kendra E; Sikes, Lindsay

    2017-01-01

    Within a tertiary care pediatric medical center, the largest number of inpatient falls (8.84 falls per 1,000 patient days) occurred within a 14-bed rehabilitation/transitional care unit between February and September 2009. An interdisciplinary fall prevention program, called "Red Light, Green Light," was developed to better educate all staff and family members to ensure safety of transfers and ambulation of children with neurological impairments. The purpose of this study was to develop and implement an interdisciplinary pediatric fall prevention program to reduce total falls and falls with family members present in this population. Preintervention 2009 data and longitudinal data from 2010-2014 were obtained from retrospective review of event/incident reports. This quality improvement project was based on inpatient pediatric admissions to a rehabilitation care unit accommodating children with neurological impairments. Data extraction included: total falls, falls with caregiver (alone versus staff versus family), type of falls, and falls by diagnosis. Descriptive statistics were obtained on outcome measures; chi-square statistics were calculated on preintervention and postintervention comparisons. Total falls decreased steadily from 8.84 falls per 1,000 patient days in 2009 to 1.79 falls per 1,000 patient days in 2014 (χ12=3.901, P=.048). Falls with family members present decreased 50% postintervention. (χ12=6.26, P=.012). Limitations included unit size nearly doubled postintervention, event reporting changed to both uncontrolled and controlled therapy falls (safely lowering patient to bed, chair, or floor), and enhanced reporting increased numbers of postintervention falls. The Red Light, Green Light program has resulted in reductions in overall fall rates, falls with family members present, increased staff collaboration, heightened staff and family safety awareness, and a safer environment for patients at high risk for neurological or musculoskeletal impairments

  12. Population genetics, community of parasites, and resistance to rodenticides in an urban brown rat (Rattus norvegicus) population.

    Science.gov (United States)

    Desvars-Larrive, Amélie; Pascal, Michel; Gasqui, Patrick; Cosson, Jean-François; Benoît, Etienne; Lattard, Virginie; Crespin, Laurent; Lorvelec, Olivier; Pisanu, Benoît; Teynié, Alexandre; Vayssier-Taussat, Muriel; Bonnet, Sarah; Marianneau, Philippe; Lacôte, Sandra; Bourhy, Pascale; Berny, Philippe; Pavio, Nicole; Le Poder, Sophie; Gilot-Fromont, Emmanuelle; Jourdain, Elsa; Hammed, Abdessalem; Fourel, Isabelle; Chikh, Farid; Vourc'h, Gwenaël

    2017-01-01

    Brown rats are one of the most widespread urban species worldwide. Despite the nuisances they induce and their potential role as a zoonotic reservoir, knowledge on urban rat populations remains scarce. The main purpose of this study was to characterize an urban brown rat population from Chanteraines park (Hauts-de-Seine, France), with regards to haematology, population genetics, immunogenic diversity, resistance to anticoagulant rodenticides, and community of parasites. Haematological parameters were measured. Population genetics was investigated using 13 unlinked microsatellite loci. Immunogenic diversity was assessed for Mhc-Drb. Frequency of the Y139F mutation (conferring resistance to rodenticides) and two linked microsatellites were studied, concurrently with the presence of anticoagulant residues in the liver. Combination of microscopy and molecular methods were used to investigate the occurrence of 25 parasites. Statistical approaches were used to explore multiple parasite relationships and model parasite occurrence. Eighty-six rats were caught. The first haematological data for a wild urban R. norvegicus population was reported. Genetic results suggested high genetic diversity and connectivity between Chanteraines rats and surrounding population(s). We found a high prevalence (55.8%) of the mutation Y139F and presence of rodenticide residues in 47.7% of the sampled individuals. The parasite species richness was high (16). Seven potential zoonotic pathogens were identified, together with a surprisingly high diversity of Leptospira species (4). Chanteraines rat population is not closed, allowing gene flow and making eradication programs challenging, particularly because rodenticide resistance is highly prevalent. Parasitological results showed that co-infection is more a rule than an exception. Furthermore, the presence of several potential zoonotic pathogens, of which four Leptospira species, in this urban rat population raised its role in the maintenance

  13. Dynamics of urban population growth in Nigeria: The role of repeated migration.

    Science.gov (United States)

    Adepoju, A

    1976-02-01

    The paper examines the direct contribution of migration to the growth of the urban population both in terms of its mobility and stability components with special reference to Western Nigeria. The basis of the paper is a survey of urban migration conducted by the author in 1971-1972; the findings are supplemented where necessary by the 1952-1953 and 1963 census figures. Migration is a major factor in the growth of the urban population. The direct contribution by migrants to such growth can be traced to the following groups: the initial streams of migrants, the follow-up migrants and the potentially mobile migrants attracted from the migrants' communities of origin to the towns. Repeated migration by some migrants, particularly the young, the educated and the white collar-workers, are also major factors in the urban population growth. Such repeated migrations are predominantly urban to urban or turnover moves. The high mobility rate among a group of migrants tends to conceal the relative stability among the migrant population as a whole. Repeated migrants usually stay between 3 and 5 years at each destination, before moving on. A substantial proportion of migrants, mainly farmers, the less educated and the old, are relatively stable in the survey towns (Ife and Oshogho). The urban residence ration indices also indicate an increase in the rate of immigration, mainly of young persons, to the towns. The youthful age structure, the age selectivity in migration and the marital status of the young migrants tend to exacerbate the masculinity in the form of unbalanced sex ratio prevailing in most urban centers. The urban population is unlikely to be stable. The tendency for old migrants of rural origin to return to their villages at the end of their migration career and for contemporary migrants to consist predominantly of youths, will for the next generation or 2 lead to a young and unstable urban population.

  14. Survival in pediatric medulloblastoma: a population-based observational study to improve prognostication.

    Science.gov (United States)

    Weil, Alexander G; Wang, Anthony C; Westwick, Harrison J; Ibrahim, George M; Ariani, Rojine T; Crevier, Louis; Perreault, Sebastien; Davidson, Tom; Tseng, Chi-Hong; Fallah, Aria

    2017-03-01

    Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4-11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30-0.46, p < 0.001) and Surgery (HR 0.42; 95% CI 0.30-0.58, p < 0.001) independently predict survival. The probability of mortality from a neurological cause is <5% in patients who are alive 8 years following diagnosis. The SEER cohort analysis demonstrates significant improvements in pediatric medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given

  15. Feasibility of the music therapy assessment tool for awareness in disorders of consciousness (MATADOC) for use with pediatric populations

    Science.gov (United States)

    Magee, Wendy L.; Ghetti, Claire M.; Moyer, Alvin

    2015-01-01

    Measuring responsiveness to gain accurate diagnosis in populations with disorders of consciousness (DOC) is of central concern because these patients have such complex clinical presentations. Due to the uncertainty of accuracy for both behavioral and neurophysiological measures in DOC, combined assessment approaches are recommended. A number of standardized behavioral measures can be used with adults with DOC with minor to moderate reservations relating to the measures’ psychometric properties and clinical applicability. However, no measures have been standardized for use with pediatric DOC populations. When adapting adult measures for children, confounding factors include developmental considerations for language-based items included in all DOC measures. Given the lack of pediatric DOC measures, there is a pressing need for measures that are sensitive to the complex clinical presentations typical of DOC and that can accommodate the developmental levels of pediatric populations. The music therapy assessment tool for awareness in disorders of consciousness (MATADOC) is a music-based measure that has been standardized for adults with DOC. Given its emphasis on non-language based sensory stimuli, it is well-suited to pediatric populations spanning developmental stages. In a pre-pilot exploratory study, we examined the clinical utility of this measure and explored trends for test-retest and inter-rater agreement as well as its performance against external reference standards. In several cases, MATADOC items in the visual and auditory domains produced outcomes suggestive of higher level functioning when compared to outcomes provided by other DOC measures. Preliminary findings suggest that the MATADOC provides a useful protocol and measure for behavioral assessment and clinical treatment planning with pediatric DOC. Further research with a larger sample is warranted to test a version of the MATADOC that is refined to meet developmental needs of pediatric DOC

  16. Feasibility of the music therapy assessment tool for awareness in disorders of consciousness (MATADOC) for use with pediatric populations.

    Science.gov (United States)

    Magee, Wendy L; Ghetti, Claire M; Moyer, Alvin

    2015-01-01

    Measuring responsiveness to gain accurate diagnosis in populations with disorders of consciousness (DOC) is of central concern because these patients have such complex clinical presentations. Due to the uncertainty of accuracy for both behavioral and neurophysiological measures in DOC, combined assessment approaches are recommended. A number of standardized behavioral measures can be used with adults with DOC with minor to moderate reservations relating to the measures' psychometric properties and clinical applicability. However, no measures have been standardized for use with pediatric DOC populations. When adapting adult measures for children, confounding factors include developmental considerations for language-based items included in all DOC measures. Given the lack of pediatric DOC measures, there is a pressing need for measures that are sensitive to the complex clinical presentations typical of DOC and that can accommodate the developmental levels of pediatric populations. The music therapy assessment tool for awareness in disorders of consciousness (MATADOC) is a music-based measure that has been standardized for adults with DOC. Given its emphasis on non-language based sensory stimuli, it is well-suited to pediatric populations spanning developmental stages. In a pre-pilot exploratory study, we examined the clinical utility of this measure and explored trends for test-retest and inter-rater agreement as well as its performance against external reference standards. In several cases, MATADOC items in the visual and auditory domains produced outcomes suggestive of higher level functioning when compared to outcomes provided by other DOC measures. Preliminary findings suggest that the MATADOC provides a useful protocol and measure for behavioral assessment and clinical treatment planning with pediatric DOC. Further research with a larger sample is warranted to test a version of the MATADOC that is refined to meet developmental needs of pediatric DOC populations.

  17. Feasibility of the Music Therapy Assessment Tool for Awareness in Disorders Of Consciousness (MATADOC for use with Pediatric Populations

    Directory of Open Access Journals (Sweden)

    Wendy L Magee

    2015-05-01

    Full Text Available Measuring responsiveness to gain accurate diagnosis in populations with disorders of consciousness (DOC is of central concern because these patients have such complex clinical presentations. Due to the uncertainty of accuracy for both behavioral and neurophysiological measures in DOC, combined assessment approaches are recommended. A number of standardized behavioral measures can be used with adults with DOC with minor to moderate reservations relating to the measures’ psychometric properties and clinical applicability. However, no measures have been standardized for use with pediatric DOC populations. When adapting adult measures for children, confounding factors include developmental considerations for language-based items included in all DOC measures. Given the lack of pediatric DOC measures, there is a pressing need for measures that are sensitive to the complex clinical presentations typical of DOC and that can accommodate the developmental levels of pediatric populations. The Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC is a music-based measure that has been standardized for adults with DOC. Given its emphasis on non-language based sensory stimuli, it is well-suited to pediatric populations spanning developmental stages. In a pre-pilot exploratory study, we examined the clinical utility of this measure and explored trends for test-retest and inter-rater agreement as well as its performance against external reference standards. In several cases, MATADOC items in the visual and auditory domains produced outcomes suggestive of higher level functioning when compared to outcomes provided by other DOC measures. Preliminary findings suggest that the MATADOC provides a useful protocol and measure for behavioral assessment and clinical treatment planning with pediatric DOC. Further research with a larger sample is warranted to test a version of the MATADOC that is refined to meet developmental needs of

  18. Internet and mobile technology use among urban African American parents: survey study of a clinical population.

    Science.gov (United States)

    Mitchell, Stephanie J; Godoy, Leandra; Shabazz, Kanya; Horn, Ivor B

    2014-01-13

    There is considerable potential for mobile technologies to empower pediatric patients and families by improving their communication with health professionals. National surveys suggest minority parents frequently communicate via mobile technology, but it is uncertain how amenable they are to receiving health care information in this format. Although the low cost and far reach characteristics of mobile health (mHealth) technology makes it advantageous for communication with minority parents, data on acceptance are needed. The objective of the study was to determine utilization of mobile and Internet technology by African American parents in an urban, underserved population, and to assess their interest in receiving health information via text messaging or other technologies (eg, social media and the Internet). A survey was administered to parents of children aged 1-12 years covered by public insurance receiving care at 3 pediatric primary care centers in Washington, DC. The African American sample (N=302) was composed of primarily single (75.8%, 229/302) mothers. Almost half had more than a high school education (47.7%, 144/302) and incomes above US $25,000 per year (43.0%, 130/302). Most (97.0%, 293/302) reported owning a cell phone, of which 91.1% (275/302) used it to text and 78.5% (237/302) used it to access the Internet. Most had service plans with unlimited text and data, but 26.5% (80/302) experienced service interruptions in the previous year. Home Internet access was more prevalent among those with higher income (86.2%, 112/130), but it was still relatively pervasive among lower income families (66.9%, 83/124). In adjusted logistic regression models, African American mothers with income greater than US $25,000 annually were 4 times as likely to own a tablet computer than their lower income counterparts. Of the participants, 80.8% (244/302) used social networking, primarily Facebook, and 74.2% (224/302) were interested in joining a social networking group

  19. Patients' diets and preferences in a pediatric population with inflammatory bowel disease.

    Science.gov (United States)

    Green, T J; Issenman, R M; Jacobson, K

    1998-01-01

    To determine the dietary practices of the pediatric inflammatory bowel disease population at the Children's Hospital of the Hamilton Health Sciences Corporation and the reported effectiveness of those diets. A questionnaire mailed to 153 pediatric patients was returned by 125 patients (76 Crohn's disease [CD] and 49 ulcerative colitis [UC] patients)--an 82% response rate. The median age of respondents was 13 years, and 62% were male. Ninety per cent and 71% of CD and UC patients, respectively, had changed their diets since diagnosis. Caloric supplements (eg, BOOST [Mead Johnson Nutritionals]), sole source nutrition, low fibre and lactose-free diets were used by more than 15% of CD patients, whereas lactose-free, nonspicy, low acid, additive-free, caloric supplement and low fibre diets were used by more than 15% of UC patients. A diet supplement was more commonly used in CD patients (P juice. A benefit was reported for 103 of 141 reported diets, with the most commonly alleviated symptoms being abdominal pain, diarrhea and flatulence. Many children with inflammatory bowel disease have altered their diets to manage their disease and have attributed symptomatic relief to these diets.

  20. Wheezing recognition algorithm using recordings of respiratory sounds at the mouth in a pediatric population.

    Science.gov (United States)

    Bokov, Plamen; Mahut, Bruno; Flaud, Patrice; Delclaux, Christophe

    2016-03-01

    Respiratory diseases in children are a common reason for physician visits. A diagnostic difficulty arises when parents hear wheezing that is no longer present during the medical consultation. Thus, an outpatient objective tool for recognition of wheezing is of clinical value. We developed a wheezing recognition algorithm from recorded respiratory sounds with a Smartphone placed near the mouth. A total of 186 recordings were obtained in a pediatric emergency department, mostly in toddlers (mean age 20 months). After exclusion of recordings with artefacts and those with a single clinical operator auscultation, 95 recordings with the agreement of two operators on auscultation diagnosis (27 with wheezing and 68 without) were subjected to a two phase algorithm (signal analysis and pattern classifier using machine learning algorithms) to classify records. The best performance (71.4% sensitivity and 88.9% specificity) was observed with a Support Vector Machine-based algorithm. We further tested the algorithm over a set of 39 recordings having a single operator and found a fair agreement (kappa=0.28, CI95% [0.12, 0.45]) between the algorithm and the operator. The main advantage of such an algorithm is its use in contact-free sound recording, thus valuable in the pediatric population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Studies of the reproducibility, acquisition and analysis of gastric emptying studies in pediatric population

    International Nuclear Information System (INIS)

    Yoo, J.H.K.; Rosen, P.R.

    1984-01-01

    The analysis, reproducibility and acquisition of gastric emptying data in a pediatric population was evaluated by obtaining data simultaneously with anterior and posterior gamma camera detectors, repetitive studies in patients and by the use of power exponential analysis, in addition to conventional monoexponential methodology. 13 patients with a variety of gastroesophageal pathologies were studied with simultaneous anterior and posterior gamma camera data acquisition. Excluding 4 subjects with substantial emesis, there was no statistical difference in data obtained anteriorly and posteriorly. The anterior scan in general revealed more rapid initial emptying compared to the posterior scan, resulting in a smaller shape factor (S) when power exponential function analysis was employed. T1/2 using either simple monoexponential or power exponential calculations showed no difference for data obtained anteriorly or posteriorly. T3/4 showed larger values in posteriorly obtained data as compared to anteriorly obtained data. 7 patients had repetitive studies performed at intervals from 1-9 days. Data so obtained showed no statistical difference in T1/2, T3/4 or S derived, either by single exponential or power exponential. The authors conclude therefore that gastric emptying data in a pediatric age group appears to be reproducible in repetitive studies. There appears to be no difference in data acquired anteriorly or posteriorly. The utilization of a power exponential analysis of gastric emptying data may augment the description of data by providing a quantitative expression of a multiexponential function

  2. Human population, urban settlement patterns and their impact on Plasmodium falciparum malaria endemicity

    Directory of Open Access Journals (Sweden)

    Kabaria Caroline W

    2008-10-01

    Full Text Available Abstract Background The efficient allocation of financial resources for malaria control and the optimal distribution of appropriate interventions require accurate information on the geographic distribution of malaria risk and of the human populations it affects. Low population densities in rural areas and high population densities in urban areas can influence malaria transmission substantially. Here, the Malaria Atlas Project (MAP global database of Plasmodium falciparum parasite rate (PfPR surveys, medical intelligence and contemporary population surfaces are utilized to explore these relationships and other issues involved in combining malaria risk maps with those of human population distribution in order to define populations at risk more accurately. Methods First, an existing population surface was examined to determine if it was sufficiently detailed to be used reliably as a mask to identify areas of very low and very high population density as malaria free regions. Second, the potential of international travel and health guidelines (ITHGs for identifying malaria free cities was examined. Third, the differences in PfPR values between surveys conducted in author-defined rural and urban areas were examined. Fourth, the ability of various global urban extent maps to reliably discriminate these author-based classifications of urban and rural in the PfPR database was investigated. Finally, the urban map that most accurately replicated the author-based classifications was analysed to examine the effects of urban classifications on PfPR values across the entire MAP database. Results Masks of zero population density excluded many non-zero PfPR surveys, indicating that the population surface was not detailed enough to define areas of zero transmission resulting from low population densities. In contrast, the ITHGs enabled the identification and mapping of 53 malaria free urban areas within endemic countries. Comparison of PfPR survey results showed

  3. The less healthy urban population: income-related health inequality in China.

    Science.gov (United States)

    Yang, Wei; Kanavos, Panos

    2012-09-18

    Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

  4. The less healthy urban population: income-related health inequality in China

    Science.gov (United States)

    2012-01-01

    Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200

  5. The less healthy urban population: income-related health inequality in China

    Directory of Open Access Journals (Sweden)

    Yang Wei

    2012-09-01

    Full Text Available Abstract Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

  6. Fasting glucose and cardiovascular risk factors in an urban population.

    Science.gov (United States)

    Gupta, R; Sarna, M; Thanvi, Jyoti; Sharma, Vibha; Gupta, V P

    2007-10-01

    To test the hypothesis that blood glucose levels in the range of normoglycemia are associated with increased cardiovascular risk we performed an epidemiological study in an urban population. Randomly selected adults > or = 20 years were studied using stratified sampling. Target sample was 1800 (men 960, women 840) of which 1123 subjects participated. Blood samples were available in 1091 subjects (60.6%, men 532, women 559). Measurement of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Cardiovascular risk factors were determined using US Adult Treatment Panel-3 guidelines. Pearson's correlation coefficients (r) of fasting glucose with various risk factors were determined. Fasting glucose levels were classified into various groups as 126 mg/dl or known diabetes. Prevalence of cardiovascular risk factors was determined in each group. There was a significant positive correlation of fasting glucose in men and women with body mass index (r = 0.20, 0.12), waist-hip ratio (0.17, 0.09), systolic blood pressure (0.07, 0.22), total cholesterol (0.21, 0.15) and triglycerides (0.21, 0.25). Prevalence (%) of cardiovascular risk factors in men and women was smoking/tobacco use in 37.6 and 11.6, hypertension in 37.0 and 37.6, overweight and obesity in 37.8 and 50.3, truncal obesity in 57.3 and 68.0, high cholesterol > or = 200 mg/dl in 37.4 and 45.8, high triglycerides > or = 150 mg/dl in 32.3 and 28.6 and metabolic syndrome in 22.9 and 31.6 percent. In various groups of fasting glucose there was an increasing trend in prevalence of overweight/obesity, hypertension, hypercholesterolaemia, hypertriglyceridaemia, and metabolic syndrome (Mantel-Haenzel X2 for trend, p fasting glucose continuous relationship of fasting glucose levels with many cardiovascular risk factors and level < 75 mg/dl is associated with the lowest prevalence.

  7. Population Invasion” versus Urban Exclusion in the Tibetan Areas of Western China

    OpenAIRE

    Fischer, Andrew Martín

    2008-01-01

    textabstractThis article examines the confluence of local population transitions (demographic transition and urbanization) with non-local in-migration in the Tibetan areas of western China. The objective is to assess the validity of Tibetan perceptions of "population invasion" by Han Chinese and Chinese Muslims. The article argues that migration to Tibet from other regions in China has been concentrated in urban areas and has been counterbalanced by more rapid rates of natural increase in the...

  8. Urbanization is Associated with Increased Trends in Cardiovascular Mortality Among Indigenous Populations: the PAI Study

    Directory of Open Access Journals (Sweden)

    Anderson da Costa Armstrong

    2018-02-01

    Full Text Available Abstract Background: The cardiovascular risk burden among diverse indigenous populations is not totally known and may be influenced by lifestyle changes related to the urbanization process. Objectives: To investigate the cardiovascular (CV mortality profile of indigenous populations during a rapid urbanization process largely influenced by governmental infrastructure interventions in Northeast Brazil. Methods: We assessed the mortality of indigenous populations (≥ 30 y/o from 2007 to 2011 in Northeast Brazil (Bahia and Pernambuco states. Cardiovascular mortality was considered if the cause of death was in the ICD-10 CV disease group or if registered as sudden death. The indigenous populations were then divided into two groups according to the degree of urbanization based on anthropological criteria:9,10 Group 1 - less urbanized tribes (Funi-ô, Pankararu, Kiriri, and Pankararé; and Group 2 - more urbanized tribes (Tuxá, Truká, and Tumbalalá. Mortality rates of highly urbanized cities (Petrolina and Juazeiro in the proximity of indigenous areas were also evaluated. The analysis explored trends in the percentage of CV mortality for each studied population. Statistical significance was established for p value < 0.05. Results: There were 1,333 indigenous deaths in tribes of Bahia and Pernambuco (2007-2011: 281 in Group 1 (1.8% of the 2012 group population and 73 in Group 2 (3.7% of the 2012 group population, CV mortality of 24% and 37%, respectively (p = 0.02. In 2007-2009, there were 133 deaths in Group 1 and 44 in Group 2, CV mortality of 23% and 34%, respectively. In 2009-2010, there were 148 deaths in Group 1 and 29 in Group 2, CV mortality of 25% and 41%, respectively. Conclusions: Urbanization appears to influence increases in CV mortality of indigenous peoples living in traditional tribes. Lifestyle and environmental changes due to urbanization added to suboptimal health care may increase CV risk in this population.

  9. Free anterolateral thigh perforator flap for sacroiliac defect: First case report in pediatric population

    Directory of Open Access Journals (Sweden)

    Alejandro E. Ramirez

    2016-08-01

    Full Text Available Soft tissue defects of the sacroiliac area, usually can be covered by local flaps. However, for more complex defects, free flap transfers became necessary. We report a case of reconstruction with a free anterolateral thigh (ALT perforator flap for coverage of a sacroiliac bone exposure in a child. A six-years-old boy, suffered a car accident, resulting in pelvic and sacral fractures, as well as degloving injuries of the left thigh, buttocks, and trunk. The patient evolved with an unstable scar over the sacroiliac region with bone exposure. ALT free flap was performed. Left superior gluteal vessels were used as the recipient vessels. A stable coverage was achieved without complications. This is the first case reported of a free ALT perforator flap for sacroiliac coverage in the pediatric population. In cases of complex reconstruction in children, free perforator flap is a safe choice and should be considered in the algorithm of treatment.

  10. Magnetic resonance imaging features of hip disorders in an Egyptian pediatric population

    Directory of Open Access Journals (Sweden)

    Y. Ragab

    2015-09-01

    Full Text Available Hip disorders in a pediatric population are a diagnostic challenge. The aim of the study is to assess the role of magnetic resonance imaging (MRI in the evaluation of non-traumatic hip disorders in a series of Egyptian patients and to review the literature on the most common hip conditions. Seventy two consecutive patients [40 males (55.6% and 32 females (44.4] with acute onset of hip complaints unrelated to trauma or falls were recruited. All patients underwent an initial full clinical assessment and blood tests as well as contrast enhanced MRI of both hips. The most common diagnosis in this group of Egyptian patients was transient synovitis in 29 (40.3% cases, followed by seronegative enthesopathy and arthropathy syndrome in 8 (11.1%, septic arthritis in 10 (13.9%, tuberculous arthritis in 4 (5.6%, sickle-cell disease in 7 (9.7%, complicated with septic arthritis in 3 (4.2%, transient bone marrow edema (BME in 3 (4.2%, osteomyelitis in 2 (2.8%, osteosarcoma in 2 (2.8%, sciatic nerve injury in 1 (1.4%, leukemia with BME in 1 (1.4%, coxa vara of both hips and L5/S1 facet joint ankylosis in 1 (1.4%, and a benign bone cyst in 1 (1.4%. MRI studies showed hip effusion in a total of 51 patients (70.8%, joint space narrowing in 9 (12.5%, and BME in 15(20.8%. MRI is a sensitive tool for assessing hip disorders in a pediatric population and can play an important role in both diagnosis and management of different hip disorders, irrespective of the underlying pathology.

  11. Prevalence of Discoid Meniscus During Arthroscopy for Isolated Lateral Meniscal Pathology in the Pediatric Population.

    Science.gov (United States)

    Ellis, Henry B; Wise, Kelsey; LaMont, Lauren; Copley, Lawson; Wilson, Philip

    2017-06-01

    Meniscus tears in the young patient are becoming more prevalent. Knowledge of presenting characteristics and morphology can affect treatment decisions. The purpose of this study was to review and evaluate all the isolated lateral meniscus pathology that required arthroscopic treatment in a pediatric sports medicine practice and compare presenting characteristics between those with a discoid meniscus and those with normal meniscal morphology. We performed a retrospective review of all isolated lateral meniscus arthroscopic procedures from 2003 to 2012 in a high-volume pediatric sports practice. Presentation, radiographs, and intraoperative findings were reviewed. The prevalence and clinical findings of a discoid meniscus in this population and among all age groups were compared with those with a meniscus tear occurring in a normal meniscus. Two hundred and sixty-one arthroscopies were performed for symptomatic isolated lateral menisci pathology. Of these, 75% were discoid in nature; the remainder was tears occurring in normal menisci. Ninety-six of 99 patients (97%) with lateral meniscus pathology under the age of 13 had a discoid meniscus and 66% presented with no injury. There was a transition within the population at 14 years of age, with a rise in the incidence of normal meniscal body tears. Even after this transition point, meniscal pathology incidence remained notable; 59% of isolated lateral meniscus pathology in patients between the ages of 14 and 16 years old were a discoid meniscus. Magnetic resonance imaging criteria for discoid meniscus (3 consecutive sagittal cuts or coronal mid-compartment measure) were unreliable after the age of 13 years old. The ratio of complete to incomplete discoids in all age groups was 4 to 3. In conclusion, discoid menisci have a high prevalence in isolated lateral meniscus pathology requiring knee arthroscopy. Clinical presentation, imaging, characteristics, and treatment may be different among different age groups. In the

  12. Constructing an Urban Population Model for Medical Insurance Scheme Using Microsimulation Techniques

    Directory of Open Access Journals (Sweden)

    Linping Xiong

    2012-01-01

    Full Text Available China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China’s medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme.

  13. Population growth and rural-urban migration, with special reference to Ghana.

    Science.gov (United States)

    De Graft-johnson, K T

    1974-01-01

    While the population of Ghana is expected to double in 25 years at the current rate of increase (approximately 2.5% per annum), the population of urban centers is increasing even faster. The 1970 census shows the urban population growing by 4.8% per annum. This is mainly the result of rural to urban migration and, to a smaller extent, the increase in the number of urban centers from 39 in 1948 to 98 in 1960 to 135 in 1970. In the 1970 census only 57.1% of the population were enumerated in their locality of birth and only 20.9% in a locality other than their place of birth but in the same region. 4.1% were born outside Ghana, mostly in another West African country. 1 striking difference between urban and rural areas is the differing sex ratio of the working population. In rural areas there are 91.0 males aged 15-64 years for every 100 females while in urban areas there are 107.1. Most migration in Africa is for employment and those most likely to migrate are working-age males. Because secondary schools are scarce in rural areas, urban dwellers generally have a higher education level. There are no significant differences between overall labor force participation rates for females. The nationwide participation rate was 38.9% for both males and females (males 43.8%, females 34.1%); in urban areas the total was 40.0% (males 46.3%, females 33.7%) and in rural areas 38.5% (males 42.7%, females 34.3%). Ghanaian women have traditionally occupied a prominent place in the labor force. The theory that urban migration is due to urban-rural income disparities is not confirmed by figures. Considering the high amount of unemployment in urban areas, a rural dweller can average as much as a city dweller. In fact, poorly educated migrants are the ones most affected by urban unemployment. A recent study by Kodwo Ewusi considered the impact of many variables on migration; he found depressed social conditions at the place of origin are more compelling motivations than economic factors

  14. Civilizing the city: populism and revanchist urbanism in Rotterdam

    NARCIS (Netherlands)

    Uitermark, J.; Duyvendak, J.W.

    2008-01-01

    This paper discusses the relevance of American literature on ‘revanchist urbanism’ for understanding the policies of the populist government that ruled Rotterdam between 2002 and 2006. It is suggested that revanchist urbanism in the European context in general and in the case of Rotterdam in

  15. Personality Traits and Behavioral Syndromes in Differently Urbanized Populations of House Sparrows (Passer domesticus)

    Science.gov (United States)

    Bókony, Veronika; Kulcsár, Anna; Tóth, Zoltán; Liker, András

    2012-01-01

    Urbanization creates novel environments for wild animals where selection pressures may differ drastically from those in natural habitats. Adaptation to urban life involves changes in various traits, including behavior. Behavioral traits often vary consistently among individuals, and these so-called personality traits can be correlated with each other, forming behavioral syndromes. Despite their adaptive significance and potential to act as constraints, little is known about the role of animal personality and behavioral syndromes in animals' adaptation to urban habitats. In this study we tested whether differently urbanized habitats select for different personalities and behavioral syndromes by altering the population mean, inter-individual variability, and correlations of personality traits. We captured house sparrows (Passer domesticus) from four different populations along the gradient of urbanization and assessed their behavior in standardized test situations. We found individual consistency in neophobia, risk taking, and activity, constituting three personality axes. On the one hand, urbanization did not consistently affect the mean and variance of these traits, although there were significant differences between some of the populations in food neophobia and risk taking (both in means and variances). On the other hand, both urban and rural birds exhibited a behavioral syndrome including object neophobia, risk taking and activity, whereas food neophobia was part of the syndrome only in rural birds. These results indicate that there are population differences in certain aspects of personality in house sparrows, some of which may be related to habitat urbanization. Our findings suggest that urbanization and/or other population-level habitat differences may not only influence the expression of personality traits but also alter their inter-individual variability and the relationships among them, changing the structure of behavioral syndromes. PMID:22574204

  16. Changing pattern and outcome of pediatric chest injuries in urban Syria.

    Science.gov (United States)

    Darwish, Bassam; Mahfouz, Mohammad Z; Al-Nosairat, Saeed; Izzat, Mohammad Bashar

    2018-01-01

    Background Pediatric chest injuries were infrequent in our practice, but the outbreak of the Syrian crisis resulted in an increase in number and a change in the pattern of thoracic trauma incidents. We compared our experience of pediatric chest injuries before and during the crisis. Methods We reviewed the records of 256 children aged 12.8 ± 5 years who were admitted to our hospital with the diagnosis of chest trauma over a 12-year period. Collected data included mechanism of injury, associated injuries, method of management, length of hospital stay, complications, and mortality. Results The incidence of pediatric chest injuries increased significantly following the outbreak of the crisis, and penetrating injuries prevailed, mainly due to shrapnel, bullets, and stab wounds. Forty percent of patients with blunt injuries and 20% of those with penetrating injuries were managed conservatively, whereas urgent thoracotomies were indicated in 10%, mostly in patients with penetrating injuries. Associated injuries were more frequent in patients with blunt injuries and resulted in a longer hospital stay and an increased mortality rate. The overall mortality rate was 7.8% and it was higher in children younger than 7 years of age and in patients who had been subjected to blunt injuries. Conclusions There has been a recent substantial upsurge in the incidence of pediatric thoracic trauma, with a predominance of penetrating injuries. Most patients could be managed nonoperatively, but a small subset required an open thoracotomy. The presence of associated injuries constitutes the main determinant of prognosis in this group of patients.

  17. Myocardial infarction in Québec rural and urban populations between 1995 and 1997.

    Science.gov (United States)

    Loslier, Julie; Vanasse, Alain; Niyonsenga, Théophile; Courteau, Josiane; Orzanco, Gabriela; Hemiari, Abbas

    2007-01-01

    There is abundant evidence of health inequities between urban and rural populations. The purpose of this paper is to describe the socioeconomic characteristics of Québec urban and rural populations and the relation between rurality and incidence of myocardial infarction (MI), care management and outcomes. Socioeconomic data by census subdivisions were available from the 1996 Canadian census, representing 7,137,245 individuals. Data on patients with MI were taken from the provincial administrative health database (MED-ECHO), which is managed by the Ministry of Health and contains clinical and demographic information collected when patients are released from acute care hospitals in Québec. We included a total of 37,678 cases compiled over the 3 years of follow-up in the analyses. Residents of rural areas with low urban influence have higher MI incidence rates than all of the other populations in the study. In comparison with urban populations, their observed rural counterparts are at a disadvantage with regard to education, employment and income. Although angioplasty and coronary artery bypass graft surgery rates were higher in more urban areas, the survival rate was lower than in rural areas. This study revealed geographic heterogeneity of MI incidence, revascularization rates and survival rates among urban and rural populations.

  18. Analysis of Urban Growth in Edwardsville Illinois Using Remote Sensing and Population Change

    Science.gov (United States)

    Onuoha, Hilda U.

    Rapid urbanization is one of the many critical, global issues. This very significant social and economic phenomenon has brought about much debate in the past twenty years and has become a very important policy issue. Understanding its dynamics and patterns is important to develop appropriate policies and make more informed planning decisions. Many dimensions to the urban land growth have been identified in related literature including drivers, relationship with other factors like population, impacts, and methods of measurement. In this study, urban growth in the Edwardsville area (composed of Edwardsville and Glen Carbon, Illinois) is analyzed spatio-temporally using remote sensing and population change from 1990 to 2015. The objectives of this study are (a) identifying the major land use changes in the Edwardsville area from 1990 to 2015, (b) analyzing the rate of urban growth and its relationship to population change in the area from 1990 to 2015, (c) identifying the general pattern and direction of urban growth in the study area. Using multi-temporal satellite images to classify and derive changes in land cover classes during the study period, results showed that the land cover classes with major changes are the urban/built-up land and agricultural/grassland, with a steady increase in the former and steady decrease in the later. Results also show the highest rate of increase in urban land was between 2000 and 2010. In comparison to population, the both show increase over the study years but urban land shows a higher rate of increase indicating dispersion. To analyze urban growth pattern in the area, the study area was divided into three zones: NE, SE, and W. The SE zone showed the highest amount of the growth and from the results, the infill type of growth was inferred.

  19. External Port Tissue Expansion in the Pediatric Population: Confirming Its Safety and Efficacy.

    Science.gov (United States)

    Azadgoli, Beina; Fahradyan, Artur; Wolfswinkel, Erik M; Tsuha, Michaela; Magee, William; Hammoudeh, Jeffrey A; Urata, Mark M; Howell, Lori K

    2018-06-01

    External filling ports in tissue expander-based reconstruction have the advantages of being associated with less pain and emotional distress. However, among practicing surgeons using tissue expansion, a theoretical concern remains regarding higher risk of infection. The authors' goal was to evaluate external port safety in the pediatric population by looking at the complications and overall success rate of reconstruction. A retrospective review of all patients undergoing tissue expansion using external ports at Children's Hospital Los Angeles between January of 2008 and June of 2016 was conducted. Patient demographic and perioperative data were collected and analyzed. Two hundred forty-one expanders were placed in 100 pediatric patients, resulting in 123 procedures for congenital and acquired conditions, with an average age at the time of surgery of 7.1 years (range, 1 month to 19.9 years) and average follow-up length of 2.5 years (range, 2.8 months to 8.8 years). The overall complication rate was 29.9 percent, and the infection rate was 17 percent. The majority of these cases were treated conservatively without additional need for surgery. Of 123 cases, 25 required premature expander removal because of complications. Despite early intervention, 21 of these cases underwent successful completion of their reconstruction according to the preoperative plan, resulting in an overall 96.7 percent success rate of tissue expander reconstruction. In children, who are often less tolerant of the pain and distress associated with internal port expansion, the authors encourage the use of external ports. This study found a high success rate in terms of successful reconstruction, with the majority of complications being treated conservatively. Therapeutic, IV.

  20. Clinical Utility of Noninvasive Method to Measure Specific Gravity in the Pediatric Population.

    Science.gov (United States)

    Hall, Jeanine E; Huynh, Pauline P; Mody, Ameer P; Wang, Vincent J

    2018-04-01

    Clinicians rely on any combination of signs and symptoms, clinical scores, or invasive procedures to assess the hydration status in children. Noninvasive tests to evaluate for dehydration in the pediatric population are appealing. The objective of our study is to assess the utility of measuring specific gravity of tears compared to specific gravity of urine and the clinical assessment of dehydration. We conducted a prospective cohort convenience sample study, in a pediatric emergency department at a tertiary care children's hospital. We approached parents/guardians of children aged 6 months to 4 years undergoing transurethral catheterization for evaluation of urinary tract infection for enrollment. We collected tears and urine for measurement of tear specific gravity (TSG) and urine specific gravity (USG), respectively. Treating physicians completed dehydration assessment forms to assess for hydration status. Among the 60 participants included, the mean TSG was 1.0183 (SD = 0.007); the mean USG was 1.0186 (SD = 0.0083). TSG and USG were positively correlated with each other (Pearson Correlation = 0.423, p = 0.001). Clinical dehydration scores ranged from 0 to 3, with 87% assigned a score of 0, by physician assessment. Mean number of episodes of vomiting and diarrhea in a 24-hour period were 2.2 (SD = 3.9) and 1.5 (SD = 3.2), respectively. Sixty-two percent of parents reported decreased oral intake. TSG measurements yielded similar results compared with USG. Further studies are needed to determine if TSG can be used as a noninvasive method of dehydration assessment in children. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience

    Directory of Open Access Journals (Sweden)

    Daniela Hespanha Marinho

    2015-08-01

    Full Text Available OBJECTIVE: Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution.METHODS: A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test.RESULTS: This study included 118 patients (46.8% who received bone marrow and 134 (53.2% who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value < 0.001. Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value = 0.653. Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value = 0.007. Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value = 0.117. Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value = 0.4666.CONCLUSION: Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.

  2. Evaluating the sinus and Nasal Quality of Life Survey in the pediatric cystic fibrosis patient population.

    Science.gov (United States)

    Xie, Deborah X; Wu, Jeffanie; Kelly, Katherine; Brown, Rebekah F; Shannon, Chevis; Virgin, Frank W

    2017-11-01

    The Sinus and Nasal Quality of Life Survey (SN-5) is a validated quality of life (QOL) questionnaire for chronic rhinosinusitis in patients age 2-12. Its utility in the cystic fibrosis (CF) has been studied, but not yet validated. The purpose of this study is to determine the effectiveness of the SN-5 for evaluation of sinonasal symptoms in the pediatric CF population. This retrospective study analyzed SN-5 surveys completed between 2012 and 2015 by pediatric CF patients and caregivers. Baseline and follow-up overall QOL scores and specific symptom scores were obtained from surveys completed in the three-year span. Non-parametric statistics were conducted to identify differences in survey data. A total of 165 patients completed baseline and follow-up surveys. The overall QOL of the patient cohort did not change over the duration of the study (p = 0.660). Thirty-seven patients indicated higher overall QOL, with all five symptom scores showing significant improvement. Analysis by age group showed that QOL was significantly correlated with all five symptoms for children ages 0-4. In patients 5-12 years, overall QOL was only correlated with sinus infection (r = -0.3090, p = 0.01). QOL was significantly correlated with sinus infection (r = -0.2903, p = 0.04) and allergy symptoms (r = -0.5644, p 12 years of age. There remains a need for a validated CRS QOL tool for children with CF. Though the SN-5 has previously been described as a potential instrument, our data suggest that it may be more valuable in children ages 0-4. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Urban versus rural populations' views of health care in Scotland.

    Science.gov (United States)

    Farmer, Jane; Hinds, Kerstin; Richards, Helen; Godden, David

    2005-10-01

    To compare satisfaction with, and expectations of, health care of people in rural and urban areas of Scotland. Questions were included in the 2002 Scottish Social Attitudes Survey (SSAS). The Scottish House-hold Survey urban-rural classification was used to categorize locations. A random sample of 2707 people was contacted to participate in a face-to-face interview and a self-completion questionnaire survey. SPSS (v.10) was used to analyse the data. Relationships between location category and responses were explored using logistic regression analysis. In all, 1665 (61.5%) interviews were conducted and 1507 (56.0%) respondents returned self-completion questionnaires. Satisfaction with local doctors and hospital services was higher in rural locations. While around 40% of those living in remote areas thought A&E services too distant, this did not rank as a top priority for health service improvement. This could be due to expectations that general practitioners would assist in out-of-hours emergencies. Most Scots thought services should be good in rural areas even if this was costly, and that older people should not be discouraged from moving to rural areas because of their likely health care needs. In all, 79% of respondents thought that care should be as good in rural as urban areas. Responses to many questions were independently significantly affected by rural/urban location. Most Scots want rural health care to continue to be good, but the new UK National Health Service (NHS) general practitioner contract and service redesign will impact on provision. Current high satisfaction, likely to be due to access and expectations about local help, could be affected. This study provides baseline data on attitudes and expectations before potential service redesign, which should be monitored at intervals in future.

  4. Dynamic assessments of population exposure to urban greenspace using multi-source big data.

    Science.gov (United States)

    Song, Yimeng; Huang, Bo; Cai, Jixuan; Chen, Bin

    2018-09-01

    A growing body of evidence has proven that urban greenspace is beneficial to improve people's physical and mental health. However, knowledge of population exposure to urban greenspace across different spatiotemporal scales remains unclear. Moreover, the majority of existing environmental assessments are unable to quantify how residents enjoy their ambient greenspace during their daily life. To deal with this challenge, we proposed a dynamic method to assess urban greenspace exposure with the integration of mobile-phone locating-request (MPL) data and high-spatial-resolution remote sensing images. This method was further applied to 30 major cities in China by assessing cities' dynamic greenspace exposure levels based on residents' surrounding areas with different buffer scales (0.5km, 1km, and 1.5km). Results showed that regarding residents' 0.5-km surrounding environment, Wenzhou and Hangzhou were found to be with the greenest exposure experience, whereas Zhengzhou and Tangshan were the least ones. The obvious diurnal and daily variations of population exposure to their surrounding greenspace were also identified to be highly correlated with the distribution pattern of urban greenspace and the dynamics of human mobility. Compared with two common measurements of urban greenspace (green coverage rate and green area per capita), the developed method integrated the dynamics of population distribution and geographic locations of urban greenspace into the exposure assessment, thereby presenting a more reasonable way to assess population exposure to urban greenspace. Additionally, this dynamic framework could hold potential utilities in supporting urban planning studies and environmental health studies and advancing our understanding of the magnitude of population exposure to greenspace at different spatiotemporal scales. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Age-associated impact on presentation and outcome for penetrating thoracic trauma in the adult and pediatric patient populations.

    Science.gov (United States)

    Mollberg, Nathan M; Tabachnick, Deborah; Lin, Fang-Ju; Merlotti, Gary J; Varghese, Thomas K; Arensman, Robert M; Massad, Malek G

    2014-02-01

    Studies reporting on penetrating thoracic trauma in the pediatric population have been limited by small numbers and implied differences with the adult population. Our objectives were to report on a large cohort of pediatric patients presenting with penetrating thoracic trauma and to determine age-related impacts on management and outcome through comparison with an adult cohort. A Level I trauma center registry was queried between 2006 and 2012. All patients presenting with penetrating thoracic trauma were identified. Patient demographics, injury mechanism, injury severity, admission physiology, and outcome were recorded. Patients were compared, and outcomes were analyzed based on age at presentation, with patients 17 years or younger defining our pediatric cohort. A total of 1,423 patients with penetrating thoracic trauma were admitted during the study period. Two hundred twenty patients (15.5%) were pediatric, with 205 being adolescents (13-17 years) and 15 being children (≤ 12 years). In terms of management for the pediatric population, tube thoracostomy alone was needed in 32.7% (72 of 220), whereas operative thoracic exploration was performed in 20.0% (44 of 220). Overall mortality was 13.6% (30 of 220). There was no significant difference between the pediatric and adult population with regard to injury mechanism or severity, need for therapeutic intervention, operative approach, use of emergency department thoracotomy, or outcome. Stepwise logistic regression failed to identify age as a predictor for the need for either therapeutic intervention or mortality between the two age groups as a whole. However, subgroup analysis revealed that being 12 years or younger (odds ratio, 3.84; 95% confidence interval, 1.29-11.4) was an independent predictor of mortality. Management of traumatic penetrating thoracic injuries in terms of the need for therapeutic intervention and operative approach was similar between the adult and pediatric populations. Mortality from

  6. Evolution of disease phenotype in adult and pediatric onset Crohn’s disease in a population-based cohort

    Science.gov (United States)

    Lovasz, Barbara Dorottya; Lakatos, Laszlo; Horvath, Agnes; Szita, Istvan; Pandur, Tunde; Mandel, Michael; Vegh, Zsuzsanna; Golovics, Petra Anna; Mester, Gabor; Balogh, Mihaly; Molnar, Csaba; Komaromi, Erzsebet; Kiss, Lajos Sandor; Lakatos, Peter Laszlo

    2013-01-01

    AIM: To investigate the evolution of disease phenotype in adult and pediatric onset Crohn’s disease (CD) populations, diagnosed between 1977 and 2008. METHODS: Data of 506 incident CD patients were analyzed (age at diagnosis: 28.5 years, interquartile range: 22-38 years). Both in- and outpatient records were collected prospectively with a complete clinical follow-up and comprehensively reviewed in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008 in adult and pediatric onset CD populations. Disease phenotype according to the Montreal classification and long-term disease course was analysed according to the age at onset in time-dependent univariate and multivariate analysis. RESULTS: Among this population-based cohort, seventy-four (12.8%) pediatric-onset CD patients were identified (diagnosed ≤ 17 years of age). There was no significant difference in the distribution of disease behavior between pediatric (B1: 62%, B2: 15%, B3: 23%) and adult-onset CD patients (B1: 56%, B2: 21%, B3: 23%) at diagnosis, or during follow-up. Overall, the probability of developing complicated disease behaviour was 49.7% and 61.3% in the pediatric and 55.1% and 62.4% in the adult onset patients after 5- and 10-years of follow-up. Similarly, time to change in disease behaviour from non stricturing, non penetrating (B1) to complicated, stricturing or penetrating (B2/B3) disease was not significantly different between pediatric and adult onset CD in a Kaplan-Meier analysis. Calendar year of diagnosis (P = 0.04), ileal location (P < 0.001), perianal disease (P < 0.001), smoking (P = 0.038) and need for steroids (P < 0.001) were associated with presence of, or progression to, complicated disease behavior at diagnosis and during follow-up. A change in disease location was observed in 8.9% of patients and it was associated with smoking status (P = 0.01), but not with age at diagnosis. CONCLUSION: Long

  7. Atypical Chronic Ankle Instability in a Pediatric Population Secondary to Distal Fibula Avulsion Fracture Nonunion.

    Science.gov (United States)

    El Ashry, Saad R; El Gamal, Tarek A; Platt, Simon R

    Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population. We present 2 cases of chronic ankle instability, 1 in a 12-year-old and 1 in a 9-year-old patient. Unlike the typical adult etiology, the cause of instability was a dysfunctional lateral ligamentous complex as a consequence of bony avulsion of the tip of the fibula. Both patients had sustained a twisting injury to the ankle. The fractures failed to unite. The nonunion resulted in dysfunction of the anterior talofibular ligament with consequent chronic ankle instability. At the initial clinical assessment, magnetic resonance imaging was requested for both patients. In patient 1 (12 years old), the fracture was fixed with 2 headless screws and was immobilized in a plaster cast for 6 weeks. In patient 2 (9 years old), because of the small size of the avulsed fragment, fixation was not possible. A modified Gould-Broström procedure was undertaken, facilitating repair of the avulsed fragment using anchor sutures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Hallux valgus interphalangeus deformity: A case series in the pediatric population.

    Science.gov (United States)

    Grawe, Brian; Parikh, Shital; Crawford, Alvin; Tamai, Junichi

    2012-03-01

    The objective of this report is to describe three cases (four feet) of hallux valgus interphalangeus deformity in the pediatric population. A retrospective review was completed to identify three patients (four feet) with a deformity consistent with hallux valgus interphalangeus. Patients were followed at regular intervals for a minimum of 6 months. Treatment modalities and clinical results were reviewed for all patients for this relatively rare entity in the skeletally immature population. All patients in this report had a deformity that was not consistent with a traumatic etiology. Case number 1 had a significantly symptomatic deformity that failed conservative treatment, and eventually necessitated full surgical correction of the deformity. Symptom free unrestricted activity was obtained post-operatively, however final follow-up radiographs have demonstrated early changes consistent with arthritis. Case numbers 2 & 3 were relatively asymptomatic throughout their course of treatment, and responded well to non-operative intervention. Based on these findings excision of the exostosis and soft-tissue realignment appears to be a reliable option for symptom relief for patients who present with a painful symptomatic hallux valgus interphalangeus deformity. However, the risk of degenerative changes following spur removal must be entertained prior to the procedure. On the contrary a pain free deformity that does not impact functionality of toe, or impair shoe ware may be treated successfully with conservative measures. Copyright © 2011 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  9. Population Invasion” versus Urban Exclusion in the Tibetan Areas of Western China

    NARCIS (Netherlands)

    A.M. Fischer (Andrew Martín)

    2008-01-01

    textabstractThis article examines the confluence of local population transitions (demographic transition and urbanization) with non-local in-migration in the Tibetan areas of western China. The objective is to assess the validity of Tibetan perceptions of "population invasion" by Han Chinese and

  10. Urban and rural population growth in a spatial panel of municipalities

    NARCIS (Netherlands)

    Costa da Silva, Diego Firmino; Elhorst, J. Paul; Silveira Neto, Raul da Mota

    2017-01-01

    Urban and rural population growth in a spatial panel of municipalities. Regional Studies. Using Bayesian posterior model probabilities and data pertaining to 3659 Brazilian minimum comparable areas (MCAs) over the period 1970-2010, two theoretical settings of population growth dynamics resulting in

  11. Urban Optimum Population Size and Development Pattern Based on Ecological Footprint Model: Case of Zhoushan, China

    Directory of Open Access Journals (Sweden)

    Yuan LU

    2016-09-01

    Full Text Available The agglomeration of population in the city can reflect the prosperity in the economy, society and culture. However, it has also brought a series of problems like environmental pollution, traffic congestion, housing shortage and jobs crisis. The results can be shown as the failure of urban comprehensive function, the decline of city benefits, and the contradiction between socioeconomic circumstance and ecosystem. Therefore, a reasonable population capacity, which is influenced by ecological resources, urban environment, geographical elements, social and economic factors, etc., is objectively needed. How to deal with the relationship between the utilization of natural capital and development of the city is extremely essential. This paper takes Zhoushan Island as an example, which is the fourth largest island off the coast of China. Firstly, the interactively influencing factors of urban optimal population are illustrated. And method is chosen to study the optimal population size. Secondly, based on the model of ecological footprint (EP, the paper calculates and analyzes the ecological footprint and ecological capacity of the Zhoushan Island, in order to explore the optimal population size of the city. Thirdly, analysis and evaluation of the resources and urban environment carrying capacity is made. Finally, the solution of the existing population problems and the suggestion for the future development pattern of the city are proposed in the urban eco-planning of Zhoushan Island. The main strategies can be summarized in two aspects: one is to reduce the ecological footprint, the other is to increase the ecological supply. The conclusion is that the current population of Zhoushan Island is far beyond the optimum population size calculated by the ecological footprint model. Therefore, sustainable development should be the guidance for urban planning in Zhoushan Island, and a low-carbon development pattern for the city is advocated.

  12. [Obesity, body morphology, and blood pressure in urban and rural population groups of Yucatan].

    Science.gov (United States)

    Arroyo, Pedro; Fernández, Victoria; Loría, Alvar; Pardío, Jeannette; Laviada, Hugo; Vargas-Ancona, Lizardo; Ward, Ryk

    2007-01-01

    To characterize body morphology and blood pressure of adults of the Mexican state of Yucatan. Rural-urban differences in weight, height, waist, and hip circumferences, and blood pressure were analyzed in 313 urban and 271 rural subjects. No rural-urban differences in prevalence of obesity and overweight were found. Hypertension was marginally higher in urban subjects. Rural abnormal waist circumference was higher in young men and young women. Comparison with two national surveys and a survey in the aboriginal population (rural mixtecos) showed similar prevalence of obesity as ENSA-2000 and higher than mixtecos and ENEC-1993. Abnormal waist circumference was intermediate between ENSANUT-2006 and mixtecos and hypertension was intermediate between ENEC and mixtecos. The Maya and mestizo population of Yucatan showed a high prevalence of obesity and abnormal waist circumference not accompanied by a comparable higher hypertension frequency. This finding requires further confirmation.

  13. Scaling Law between Urban Electrical Consumption and Population in China

    Science.gov (United States)

    Zhu, Xiaowu; Xiong, Aimin; Li, Liangsheng; Liu, Maoxin; Chen, X. S.

    The relation between the household electrical consumption Y and population N for Chinese cities in 2006 has been investigated with the power law scaling form Y = A_0 N^{β}. It is found that the Chinese cities should be divided into three categories characterized by different scaling exponent β. The first category, which includes the biggest and coastal cities of China, has the scaling exponent β> 1. The second category, which includes mostly the cities in central China, has the scaling exponent β ≈ 1. The third category, which consists of the cities in northwestern China, has the scaling exponent β 1, there is also a fixed point population N f . If the initial population N(0) > N f , the population increases very fast with time and diverges within a finite time. If the initial population N(0) < N f , the population decreases with time and collapse finally. The pattern of population evolution in a city is determined by its scaling exponent and initial population.

  14. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis.

    Science.gov (United States)

    Sedky, Karim; Bennett, David S; Carvalho, Karen S

    2014-08-01

    A relationship between attention deficit hyperactivity disorder (ADHD) and sleep disordered breathing (SDB) in children and adolescents has been suggested by some authors. Yet, this topic remains highly controversial in the literature. A meta-analysis was conducted in order to examine the extent of relationship between SDB and ADHD symptoms in pediatric populations and whether there are differences in ADHD symptoms pre- versus post-adenotonsillectomy in pediatric populations. PubMed/Medline, PsychInfo and Cochrane databases were searched using the key words "attention deficit hyperactivity disorder" or "ADHD" and "obstructive sleep apnea" or "OSA" or "sleep disordered breathing" (SDB) or "SDB". English language publications through September 2012 were surveyed. Meta-analysis was conducted to assess the relationship between SDB and ADHD symptoms in the first part of the study, and the extent of change in ADHD symptoms before and after adenotonsillectomy in the second part. Eighteen studies satisfied the inclusion criteria for the first part of the study. This represented 1113 children in the clinical group (874 diagnosed with SDB who were examined for ADHD symptoms; 239 diagnosed with ADHD who were examined for SDB) and 1405 in the control-group. Findings indicate that there is a medium relationship between ADHD symptoms and SDB (Hedges' g = 0.57, 95% confidence interval: 0.36-0.78; p = 0.000001). A high apnea hypopnea index (AHI) cutoff was associated with lower effect sizes, while child age, gender and body mass index did not moderate the relationship between SDB and ADHD. Study quality was associated with larger effect sizes. In the second part of the study, twelve studies were identified assessing pre- versus post-surgery ADHD symptoms. Hedges' g was 0.43 (95% confidence interval = 0.30-0.55; p ADHD symptoms at 2-13 months post-surgery. The findings of this meta-analysis suggest that ADHD symptoms are related to SDB and improve after adenotonsillectomy

  15. A preliminary examination of child well-being of physically abused and neglected children compared to a normative pediatric population.

    Science.gov (United States)

    Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy

    2015-02-01

    Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment. © The Author(s) 2014.

  16. Population pharmacokinetics of intravenous Erwinia asparaginase in pediatric acute lymphoblastic leukemia patients.

    Science.gov (United States)

    Sassen, Sebastiaan D T; Mathôt, Ron A A; Pieters, Rob; Kloos, Robin Q H; de Haas, Valérie; Kaspers, Gertjan J L; van den Bos, Cor; Tissing, Wim J E; Te Loo, Maroeska; Bierings, Marc B; Kollen, Wouter J W; Zwaan, Christian M; van der Sluis, Inge M

    2017-03-01

    Erwinia asparaginase is an important component in the treatment of pediatric acute lymphoblastic leukemia. A large variability in serum concentrations has been observed after intravenous Erwinia asparaginase. Currently, Dutch Childhood Oncology Group protocols dose alterations are based on trough concentrations to ensure adequate asparaginase activity (≥100 IU/L). The aim of this study was to describe the population pharmacokinetics of intravenous Erwinia asparaginase to quantify and gather insight into inter-individual and inter-occasion variability. The starting dose was evaluated on the basis of the derived population pharmacokinetic parameters. In a multicenter prospective observational study, a total of 714 blood samples were collected from 51 children (age 1-17 years) with acute lymphoblastic leukemia. The starting dose was 20,000 IU/m 2 three times a week and adjusted according to trough levels from week three onwards. A population pharmacokinetic model was developed using NONMEM ® A 2-compartment linear model with allometric scaling best described the data. Inter-individual and inter-occasion variability of clearance were 33% and 13%, respectively. Clearance in the first month of treatment was 14% higher ( P <0.01). Monte Carlo simulations with our pharmacokinetic model demonstrated that patients with a low weight might require higher doses to achieve similar concentrations compared to patients with high weight. The current starting dose of 20,000 IU/m 2 might result in inadequate concentrations, especially for smaller, lower weight patients, hence dose adjustments based on individual clearance are recommended. The protocols were approved by the institutional review boards. (Registered at NTR 3379 Dutch Trial Register; www.trialregister.nl). Copyright© Ferrata Storti Foundation.

  17. Age-Specific Bacteriological Profile of Pediatric Septicemia; A Population- Based Study

    Directory of Open Access Journals (Sweden)

    Seyyed Shahin Eftekhari

    2017-06-01

    Full Text Available Background Septicemia is a life-threatening condition particularly among pediatric population. Early initiating a proper empiric antimicrobial treatment prior to definite isolation of the pathogen through blood culture has pivotal role in reducing further mortality and morbidity. The aim of this study was to evaluate the epidemiological properties of a distinct Iranian population by patients’ age and gender throughout the year. Materials and Methods As a retrospective study between March 2013 and March 2017, all consecutive patients referred to the Hazrat Masumeh hospital of Qom-Iran with suspicious of septicemia were reviewed. Patients with prior history of antibiotic consumption as well as patients over 6 years of age were excluded; incomplete hospital records were also excluded from further evaluations. Prespecified data-extraction forms were used to collect data including characteristics of patients and the results of antibiogram. Results Total of 378 patients were enrolled in this study and 200 of them were boys (52.91%. Escherichia coli (11.6% and Klebsiella (9.5% were the most common isolated pathogens (Gram-negative after coagulase-negatives. Escherichia coli, Citrobacter (Gram-negative, and Staph. Aureus (Gram-positive were the most common pathogens among age group of 0-1 year. Winter had the greatest outbreak of bacteremia (29.1% and the autumn had the least incidence (21.4%. The least and the most antimicrobial resistance were associated with Imipenem (1.8% and Ampicillin (78.78%, respectively. Conclusion Escherichia coliand Klebsiella were the most common isolated bacteria in patients suspected to bacteremia in our region. Imipenem and Ampicillin had the least and the most antimicrobial resistance in our population, respectively.

  18. How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training?

    Science.gov (United States)

    Lichtenstein, Cara; Hoffman, Benjamin D; Moon, Rachel Y

    2017-07-01

    In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations (P = .02) and public speaking (P pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. Spontaneous breathing test in the prediction of extubation failure in the pediatric population.

    Science.gov (United States)

    Nascimento, Milena Siciliano; Rebello, Celso Moura; Vale, Luciana Assis Pires Andrade; Santos, Érica; Prado, Cristiane do

    2017-01-01

    To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test. A total of 95 children were enrolled in the study, 71 in the Test Group and 24 in the Control Group. A direct comparison was made between the two groups regarding sex, age, mechanical ventilation time, indication to start mechanical ventilation and respiratory parameters before extubation in the Control Group, and before the spontaneous breathing test in the Test Group. There was no difference between the parameters evaluated. According to the analysis of probability of extubation failure between the two groups, the likelihood of extubation failure in the Control Group was 1,412 higher than in the Test Group, nevertheless, this range did not reach significance (p=0.706). This model was considered well-adjusted according to the Hosmer-Lemeshow test (p=0.758). The spontaneous breathing test was not able to predict the extubation failure in pediatric population. Avaliar se o teste de respiração espontânea pode ser utilizado para predizer falha da extubação na população pediátrica. Estudo prospectivo, observacional, no qual foram avaliados todos os pacientes internados no Centro de Terapia Intensiva Pediátrica, no período de maio de 2011 a agosto de 2013, que utilizaram ventilação mecânica por mais de 24 horas e que foram extubados. Os pacientes foram classificados em dois grupos: Grupo Teste, que incluiu os pacientes extubados depois do teste de respiração espontânea; e Grupo Controle, pacientes foram sem teste de respiração espont

  20. The development of a population of 4D pediatric XCAT phantoms for CT imaging research and optimization

    Science.gov (United States)

    Norris, Hannah; Zhang, Yakun; Frush, Jack; Sturgeon, Gregory M.; Minhas, Anum; Tward, Daniel J.; Ratnanather, J. Tilak; Miller, M. I.; Frush, Donald; Samei, Ehsan; Segars, W. Paul

    2014-03-01

    With the increased use of CT examinations, the associated radiation dose has become a large concern, especially for pediatrics. Much research has focused on reducing radiation dose through new scanning and reconstruction methods. Computational phantoms provide an effective and efficient means for evaluating image quality, patient-specific dose, and organ-specific dose in CT. We previously developed a set of highly-detailed 4D reference pediatric XCAT phantoms at ages of newborn, 1, 5, 10, and 15 years with organ and tissues masses matched to ICRP Publication 89 values. We now extend this reference set to a series of 64 pediatric phantoms of a variety of ages and height and weight percentiles, representative of the public at large. High resolution PET-CT data was reviewed by a practicing experienced radiologist for anatomic regularity and was then segmented with manual and semi-automatic methods to form a target model. A Multi-Channel Large Deformation Diffeomorphic Metric Mapping (MC-LDDMM) algorithm was used to calculate the transform from the best age matching pediatric reference phantom to the patient target. The transform was used to complete the target, filling in the non-segmented structures and defining models for the cardiac and respiratory motions. The complete phantoms, consisting of thousands of structures, were then manually inspected for anatomical accuracy. 3D CT data was simulated from the phantoms to demonstrate their ability to generate realistic, patient quality imaging data. The population of pediatric phantoms developed in this work provides a vital tool to investigate dose reduction techniques in 3D and 4D pediatric CT.

  1. Tackling the Urban Informal Economy: Some Lessons from a Study of Europe’s Urban Population

    Directory of Open Access Journals (Sweden)

    Colin C. WILLIAMS

    2017-06-01

    Full Text Available The aim of this paper is to evaluate themost effective way of tackling the urban informaleconomy. It has been recently argued that theconventional rational economic actor approach(which increases the costs of participating in theurban informal economy so that they outweighthe benefi ts should be replaced or complementedby a social actor approach which focusesupon improving tax morale. To evaluate the effectivenessof these supposedly alternative approachesto tackling the participation of urbanpopulations in the informal economy, we reportthe results of face-to-face interviews conductedin 2013 with 17,886 urban dwellers across the 28Member States of the EU. Multilevel logistic regressionanalysis reveals that both approachesare effective in signifi cantly reducing the urbanpopulation’s participation in the informal economy.When tax morale is high, however, the rationaleconomic actor approach of increasing thecosts has little impact on reducing the probabilityof engagement in the informal economy. The paperconcludes by calling for greater emphasis onimproving the tax morale of the urban populationso as to tackle the informal economy in the urbanareas of Europe and beyond.

  2. Fine-Scale Population Estimation by 3D Reconstruction of Urban Residential Buildings

    Science.gov (United States)

    Wang, Shixin; Tian, Ye; Zhou, Yi; Liu, Wenliang; Lin, Chenxi

    2016-01-01

    Fine-scale population estimation is essential in emergency response and epidemiological applications as well as urban planning and management. However, representing populations in heterogeneous urban regions with a finer resolution is a challenge. This study aims to obtain fine-scale population distribution based on 3D reconstruction of urban residential buildings with morphological operations using optical high-resolution (HR) images from the Chinese No. 3 Resources Satellite (ZY-3). Specifically, the research area was first divided into three categories when dasymetric mapping was taken into consideration. The results demonstrate that the morphological building index (MBI) yielded better results than built-up presence index (PanTex) in building detection, and the morphological shadow index (MSI) outperformed color invariant indices (CIIT) in shadow extraction and height retrieval. Building extraction and height retrieval were then combined to reconstruct 3D models and to estimate population. Final results show that this approach is effective in fine-scale population estimation, with a mean relative error of 16.46% and an overall Relative Total Absolute Error (RATE) of 0.158. This study gives significant insights into fine-scale population estimation in complicated urban landscapes, when detailed 3D information of buildings is unavailable. PMID:27775670

  3. Fine-Scale Population Estimation by 3D Reconstruction of Urban Residential Buildings

    Directory of Open Access Journals (Sweden)

    Shixin Wang

    2016-10-01

    Full Text Available Fine-scale population estimation is essential in emergency response and epidemiological applications as well as urban planning and management. However, representing populations in heterogeneous urban regions with a finer resolution is a challenge. This study aims to obtain fine-scale population distribution based on 3D reconstruction of urban residential buildings with morphological operations using optical high-resolution (HR images from the Chinese No. 3 Resources Satellite (ZY-3. Specifically, the research area was first divided into three categories when dasymetric mapping was taken into consideration. The results demonstrate that the morphological building index (MBI yielded better results than built-up presence index (PanTex in building detection, and the morphological shadow index (MSI outperformed color invariant indices (CIIT in shadow extraction and height retrieval. Building extraction and height retrieval were then combined to reconstruct 3D models and to estimate population. Final results show that this approach is effective in fine-scale population estimation, with a mean relative error of 16.46% and an overall Relative Total Absolute Error (RATE of 0.158. This study gives significant insights into fine-scale population estimation in complicated urban landscapes, when detailed 3D information of buildings is unavailable.

  4. An investigation of the role of China's urban population on coal consumption

    International Nuclear Information System (INIS)

    Michieka, Nyakundi M.; Fletcher, Jerald J.

    2012-01-01

    This paper investigates the causal relationship between urban population, real GDP, electricity production and coal consumption in China for the period 1971–2009. Using a vector autoregression framework and a modified version of the Granger (1969) causality test proposed by Toda and Yamamoto (J. Econ. 66 (1995) 225), the results suggest that there is causality running from GDP to coal consumption. The variance decomposition analysis report that urban population and coal affect electricity production variability over the forecast period. We also find that increasing urban population may negatively affect China's GDP over time. Policy measures aimed at influencing GDP could ultimately affect coal consumption. - Highlights: ► We find Granger Causality running from GDP to coal consumption. ► China can mitigate the adverse environmental effects of coal by altering GDP path. ► We find Granger Causality running from urbanization to electricity production. ► China needs to find other sources of energy to cater for growing electricity demand. ► Increasing urban population may slow economic growth due to overcrowding in cities.

  5. Household computer and Internet access: The digital divide in a pediatric clinic population

    Science.gov (United States)

    Carroll, Aaron E.; Rivara, Frederick P.; Ebel, Beth; Zimmerman, Frederick J.; Christakis, Dimitri A.

    2005-01-01

    Past studies have noted a digital divide, or inequality in computer and Internet access related to socioeconomic class. This study sought to measure how many households in a pediatric primary care outpatient clinic had household access to computers and the Internet, and whether this access differed by socio-economic status or other demographic information. We conducted a phone survey of a population-based sample of parents with children ages 0 to 11 years old. Analyses assessed predictors of having home access to a computer, the Internet, and high-speed Internet service. Overall, 88.9% of all households owned a personal computer, and 81.4% of all households had Internet access. Among households with Internet access, 48.3% had high speed Internet at home. There were statistically significant associations between parental income or education and home computer ownership and Internet access. However, the impact of this difference was lessened by the fact that over 60% of families with annual household income of $10,000–$25,000, and nearly 70% of families with only a high-school education had Internet access at home. While income and education remain significant predictors of household computer and internet access, many patients and families at all economic levels have access, and might benefit from health promotion interventions using these modalities. PMID:16779012

  6. Skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population: MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Kothary, Shefali [Mount Sinai Beth Israel, Department of Radiology, New York, NY (United States); Radiology Department, NYU Langone Medical Center: Hospital for Joint Disease, New York, NY (United States); Rosenberg, Zehava Sadka; Poncinelli, Leonardo L. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Radiology Department, NYU Langone Medical Center: Hospital for Joint Disease, New York, NY (United States); Kwong, Steven [School of Medicine, NYU Langone Medical Center, New York, NY (United States); Radiology Department, NYU Langone Medical Center: Hospital for Joint Disease, New York, NY (United States)

    2014-09-15

    To assess the MRI appearance of normal skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population. To the best of our knowledge, this has not yet been studied in detail in the literature. An IRB-approved, HIPAA-compliant retrospective review of 105 consecutive shoulder MRI studies in children, ages 2 months to 18 years was performed. The morphology, MR signal, and development of the following were assessed: (1) scapular-coracoid bipolar growth plate, (2) glenoid and glenoid-coracoid interface secondary ossification centers, (3) glenoid advancing osseous surface. The glenoid and glenoid-coracoid interface were identified in infancy as a contiguous, cartilaginous mass. A subcoracoid secondary ossification center in the superior glenoid was identified and fused in all by age 12 and 16, respectively. In ten studies, additional secondary ossification centers were identified in the inferior two-thirds of the glenoid. The initial concavity of the glenoid osseous surface gradually transformed to convexity, matching the convex glenoid articular surface. The glenoid growth plate fused by 16 years of age. Our study, based on MRI, demonstrated a similar pattern of development of the glenoid and glenoid coracoid interface to previously reported anatomic and radiographic studies, except for an earlier development and fusion of the secondary ossification centers of the inferior glenoid. The pattern of skeletal development of the glenoid and glenoid-coracoid interface follows a chronological order, which can serve as a guideline when interpreting MRI studies in children. (orig.)

  7. Factors affecting bone mineral mass loss after lower-limb fractures in a pediatric population.

    Science.gov (United States)

    Ceroni, Dimitri; Martin, Xavier; Kherad, Omar; Salvo, Davide; Dubois-Ferrière, Victor

    2015-06-01

    The purpose of this study was to assess the effects of the durations of cast immobilization and non-weight-bearing periods, and decreases in vigorous physical activity (VPA) on bone mineral parameters in a pediatric population treated for a lower-limb fracture. Fifty children and teenagers who had undergone a cast-mediated immobilization for a leg or ankle fracture were prospectively recruited. The durations of cast immobilization and non-weight-bearing periods were recorded for each participant. Dual-energy x-ray absorptiometry scans were performed at the time of fracture treatment (baseline) and at cast removal. Physical activity during cast immobilization was assessed using accelerometers. A strong negative correlation was found between the total duration of cast immobilization and decreases in both calcaneal bone mineral density (BMD) (r=-0.497) and total lower-limb bone mineral content (BMC) (r=-0.405). A strong negative correlation was also noted between the durations of the non-weight-bearing periods and alterations in calcaneal BMD (r=-0.420). No apparent correlations were found between lower BMD and BMC and decreased VPA. Bone mineral loss was correlated to the total duration of cast immobilization for all measurement sites on the affected leg, whereas it was only correlated to the durations of non-weight-bearing periods for calcaneal BMD and total lower-limb BMC. However, no correlations were noted between bone mineral loss and decreased VPA.

  8. Impact of obesity on the risk of venous thromboembolism in an inpatient pediatric population.

    Science.gov (United States)

    Stokes, Sean; Breheny, Patrick; Radulescu, Aurelia; Radulescu, Vlad Calin

    2014-08-01

    The incidence of venous thromboembolism in children has increased significantly over the past 20 years. Over the same period of time, there was an increase in the prevalence of obesity in the pediatric population. Obesity is a known risk factor for VTE in adults, but little information is available in children. This study evaluates the relation between obesity and VTE using a retrospective, case-control design, comparing the body mass index (BMI) of patients admitted with a diagnosis of VTE versus patients admitted with other diagnoses, at a single institution, between 2007 and 2011. We studied 48 inpatients diagnosed with deep venous thrombosis or pulmonary embolism and a control group of 274 age and gender matched patients admitted with other diagnoses. We found obese patients (BMI > 95th percentile) to have significantly higher risk of VTE (odds ratio 2.1, with 95% CI 1.1-4.2) than patients of normal weight (BMI obesity and VTE in a group of hospitalized children, showing a risk for VTE in obese children similar to the one described in much larger adult cohorts.

  9. Outcomes of complex robot-assisted extravesical ureteral reimplantation in the pediatric population.

    Science.gov (United States)

    Arlen, Angela M; Broderick, Kristin M; Travers, Curtis; Smith, Edwin A; Elmore, James M; Kirsch, Andrew J

    2016-06-01

    the true radiographic success rate is unknown. A larger patient cohort with longer follow-up is necessary to determine predictors of radiographic and clinical failure. Older children with a previous history of anti-reflux surgery were more likely to undergo RALUR. These children had success and complication rates comparable to younger patients following complex open extravesical reimplantation, which underscores the expanding role of robot-assisted lower urinary tract reconstructive surgery in the pediatric population. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  10. Evaluation of extent of UTI related renal parenchymal damage in pediatric patient population

    International Nuclear Information System (INIS)

    Sharma, A.R.; Charan, S.; Silva, I.

    2004-01-01

    Introduction: Urinary tract infection (UTI) is important cause of morbidity in childhood. UTI may lead to involvement of renal parenchyma ranging from recoverable acute inflammation, renal scarring of Reflux nephropathy, hypertension and ultimately end stage renal disease. Hence, extent of renal parenchymal involvement bears prognostic significance in pediatric population. Laboratory and clinical parameters have inherent limitations in detecting and localizing renal parenchymal involvement in the settings of UTI. Objectives: The present study has been designed with the aim to determine the frequency and degree of renal parenchymal involvement in pediatric patients having urinary tract infection. MATERIALS AND METHODS: From May to December 2003, 33 consecutive children (65 Kidneys, 32-paired, I-solitary) aged one month to 12 years (mean age 3 years, 20M, 13F) with positive past history and culture documented urinary tract infection were enrolled in the study. They were subjected to Renal cortical scan using Tc-99m DMSA (20-100 MBq) on Dual detectors gamma camera (e.cam) fitted with LEHR collimator in anterior, posterior and posterior oblique projections. DMSA renal scans were interpreted as per Clarke's interpretation criteria. Renal ultrasound (RUS) and cystourethrogram (MCUG) were available in all the cases. Results: As per Clarke's classification, there were 19 children with no evidence of renal cortical involvement (Type-1). Renal parenchymal involvement found to be unilateral (Type-4 to Type-6) and bilateral (Type-7 and 8) in 8 and 6 children respectively. DMSA scan was abnormal in 20 of 65 kidneys (31%). MCUG was positive for presence of VUR in 34 kidneys (Group A) and negative for VUR in remaining 31 units (Group B). In Gp A, 18 of 34 kidneys (53%) showed renal parenchymal involvement on DMSA Scan. In Gp A, presence or absence of renal parenchymal damage on DMSA scan did not show any statistically significant difference in age, sex and grade of VUR. Whereas

  11. Factors associated with post-ERCP pancreatitis and the effect of pancreatic duct stenting in a pediatric population.

    Science.gov (United States)

    Troendle, David M; Abraham, Omana; Huang, Rong; Barth, Bradley A

    2015-01-01

    Risk factors for the development of post-ERCP pancreatitis (PEP) have not been identified in the pediatric population. It remains unclear what constitutes appropriate prophylaxis in this patient population. To assess the prevalence and severity of PEP in the pediatric population and identify factors associated with developing PEP and to evaluate the effect of prophylactic pancreatic duct stenting in high-risk patients. Retrospective analysis of an ERCP database at a single large pediatric center. Academic center. A total of 432 ERCPs performed on 313 patients younger than 19 years of age from January 2004 to October 2013. ERCP for any indication. Rates and severity of PEP, preprocedural and procedural risk factors for the development of PEP, and the effect of pancreatic stents on preventing PEP in high-risk patients. PEP occurred after 47 procedures (prevalence, 10.9%). Thirty-four cases were mild, 9 were moderate, and 4 were severe. There was no mortality. On multiple logistic analysis, pancreatic duct injection (Ppancreatic sphincterotomy (Passociated with PEP. A history of chronic pancreatitis was negatively associated with PEP (Ppancreatic stent was associated with significantly increased rates of PEP in patients with pancreatic duct injection compared with those who had no attempt at stent placement (Ppancreatitis had prophylactic pancreatic stents in place. Retrospective investigation. In the pediatric population, pancreatic duct injection and pancreatic sphincterotomy are associated with significantly increased rates of PEP, whereas a history of chronic pancreatitis is negatively associated. Prophylactic pancreatic stenting is associated with higher rates of PEP in high-risk patients and does not eliminate severe PEP. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  12. Socio Economic Status and Traumatic Brain Injury amongst Pediatric Populations: A Spatial Analysis in Greater Vancouver

    Directory of Open Access Journals (Sweden)

    Ofer Amram

    2015-12-01

    Full Text Available Introduction: Within Canada, injuries are the leading cause of death amongst children fourteen years of age and younger, and also one of the leading causes of morbidity. Low Socio Economic Status (SES seems to be a strong indicator of a higher prevalence of injuries. This study aims to identify hotspots for pediatric Traumatic Brain Injury (TBI and examines the relationship between SES and pediatric TBI rates in greater Vancouver, British Columbia (BC, Canada. Methods: Pediatric TBI data from the BC Trauma Registry (BCTR was used to identify all pediatric TBI patients admitted to BC hospitals between the years 2000 and 2013. Spatial analysis was used to identify hotspots for pediatric TBI. Multivariate analysis was used to distinguish census variables that were correlated with rates of injury. Results: Six hundred and fifty three severe pediatric TBI injuries occurred within the BC Lower Mainland between 2000 and 2013. High rates of injury were concentrated in the East, while low rate clusters were most common in the West of the region (more affluent neighborhoods. A low level of education was the main predictor of a high rate of injury (OR = 1.13, 95% CI = 1.03–1.23, p-Value 0.009. Conclusion: While there was a clear relationship between different SES indicators and pediatric TBI rates in greater Vancouver, income-based SES indicators did not serve as good predictors within this region.

  13. Perception of the Local Population toward Urban Forests in Municipality of Aerodrom

    Directory of Open Access Journals (Sweden)

    Aneta Blazevska

    2012-12-01

    Full Text Available Background and Purpose: With the development of both society and economy, environmental issues have become a more popular topic. In recent decades both the role and perception of urban forests have changed regarding recreational and environmental aspects on both a local and global level. This coupled with urbanization places great importance on how people see and value the forests in an urban and peri-urban setting. Visitors are not a homogeneous category and hence have different needs and perceptions of urban and peri-urban green spaces. The study aims to understand the visitors` perception from municipality Aerodrom towards urban forests and their recreational use, benefits, preferences and perception regarding management activities of urban forests. Material and Methods: The method used for the research is qualitative with semi-structured questionnaire which was conducted face to face. Gathered data were analyzed by Excel and after that were presented in tables and graphs for better review of the results. The study area was municipality of Aerodrom which has the biggest space under urban forests per capita in Skopje. Results and Conclusion: Results have shown that all respondents have permanent residence in the municipality of Aerodrom, located in different settlements and with the length of stay mainly between 5 to 40 years. There is a dominance of female population and respondent’s age over 40 in the research. Results also showed that the average number of visit in urban forests by respondents during the week is three times. Regarding the meaning and association of term urban forests, results showed that majority of respondents have a clear and concise perception, and mainly this term for them is association on park and greenery, a nice decorated environment and place for walk. When it comes to the way how current situation with urban forest can be improved almost all of the respondents highlighted it can be through the following things

  14. The role of population density on the impact of urbaniza-tion on GHG emissions in China

    Science.gov (United States)

    Liu, Yonghong; Gao, Chaochao; Lu, Yingying

    2017-04-01

    Urbanization directly drives rural to urban population migration and indirectly causes west to east migration in China, two phenomena that may significantly impact China's greenhouse gas emissions given its huge population and vast difference between the western rural and eastern urban areas. These two phenomena were analyzed by using emissions as a per capita term, and extending the impact from the traditional urbanization rate effect to include population density effect. The results show that population density has actually been the dominant demographic player in changing per capita emissions for the past two decades in China, and its elasticity changed from positive in economically less-developed provinces to negative for the developed provinces. This study provides a new perspective in the study of the relationship between urbanization and greenhouse gas emissions, and the results indicate that population density change should be taken into account to accurately assess the impact of urbanization.

  15. Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

    Science.gov (United States)

    Malewski, David F; Ream, Aimrie; Gaither, Caroline A

    2015-01-01

    Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Epidural hematoma in the pediatric population – case study = Krwiak nadtwardówkowy w populacji pediatrycznej - opis przypadku

    Directory of Open Access Journals (Sweden)

    Kamila Woźniak

    2015-08-01

        Streszczenie Urazy głowy są głównymi przyczynami zgonu i nabytych zaburzeń neurologicznych. Odmienny niż u dorosłych przebieg urazu głowy w populacji dziecięcej powoduje, że w tej grupie zdarza się najwięcej nieoczekiwanych powikłań. Z uwagi na brak specyficznych objawów klinicznych krwiak nadtwardówkowy w populacji pediatrycznej stanowi duże wyzwanie zarówno diagnostyczne jak i lecznicze. Autorzy przedstawiają opis przypadku i postępowania u 6- letniego dziecka po urazie głowy,  z rozpoznanym w badaniu obrazowym krwiakiem nadtwardówkowym.   Słowa kluczowe: uraz czaszkowo-mózgowy, krwiak nadtwardówkowy, populacja pediatryczna.   Abstract Head injuries are the main causes of death and acquired neurological disorders. Differently than adults mileage head injury in the pediatric population means that in this group it happens most unexpected complications. Given the lack of specific clinical symptoms epidural hematoma in the pediatric population is a major challenge for both diagnostic and therapeutic. The authors present a case and proceedings in a child 6 years old after a head injury diagnosed in the study imaging epidural hematoma.   Key words: cephalo-cerebral trauma, epidural hematoma, pediatric population.

  17. Delays in accessing electroconvulsive therapy: a comparison between two urban and two rural populations in Australia.

    Science.gov (United States)

    Johnston, Natalie E

    2015-10-01

    A comparison of the timing, rates and characteristics of electroconvulsive therapy use between urban and rural populations. The medical records of patients who received an acute course of electroconvulsive therapy at two rural and two urban psychiatric hospitals in New South Wales (NSW), Australia, in 2010 were reviewed retrospectively. Main outcome measures were the time from symptom onset, diagnosis and admission to commencing electroconvulsive therapy. Rates of use of electroconvulsive therapy were also compared between rural and urban hospitals using NSW statewide data. There was a significant delay in the time it took for rural patients to receive electroconvulsive therapy compared with urban patients when measured both from the time of symptom onset and from when they received a diagnosis. There were corresponding delays in the time taken for rural patients to be admitted to hospital compared with urban patients. There was no difference in the time it took to commence electroconvulsive therapy once a patient was admitted to hospital. NSW statewide urban-rural comparisons showed rates of electroconvulsive therapy treatment were significantly higher in urban hospitals. Patients in rural areas receive electroconvulsive therapy later in their acute illness due to delays in being admitted to hospital. The rate of use of electroconvulsive therapy also differs geographically. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  18. Fertility preservation in the male pediatric population: factors influencing the decision of parents and children.

    Science.gov (United States)

    Wyns, C; Collienne, C; Shenfield, F; Robert, A; Laurent, P; Roegiers, L; Brichard, B

    2015-09-01

    How can the decision process for fertility preservation (FP) in adolescents and prepubertal boys be improved based on patient and parent feelings about FP counseling? The content of information given to patients and parents and hope for future parenthood appeared to positively impact on the decision to preserve fertility in the pediatric population and, therefore, deserves special attention to improve FP care. A vast body of literature on adult cancer patients shows that reproductive capacity is a major quality-of-life issue. Patients also have a strong desire to be informed of available FP options with a view to future parenthood of their own genetic child, considering that parents were able to make an informed and voluntary decision for their prepubertal sons despite the heavy emotional burden at the time of diagnosis, there is so far very limited information on patient expectations regarding FP. A lack of awareness often equates to suboptimal care by oncologists and FP specialists, and poor access to FP, therefore improving knowledge and identifying the expectations of pediatric patients and their parents are crucial for optimizing multidisciplinary collaborative care pathways (MCCPs), including counseling and access to FP methods, in the youngest population. A questionnaire survey was posted to an eligible population between May 2005 and May 2013. A total of 348 prepubertal boys and adolescents aged 0-18 years, diagnosed with cancer in a university hospital setting, were eligible. Three different questionnaires for two age groups of children (parents were established based on information from focus groups. Questions were subsequently reviewed by the institutional ethics board before being sent. Of the 348 eligible patients, 44 died and 14 were lost to follow-up. Thus, 290 patients (77 aged 12-18 years and 213 aged questionnaire. In total, 120 questionnaires were recovered, 45.5% (n = 35/77) from adolescents and 39.9% (n = 85/213) from children. FP acceptance

  19. Time spent in sedentary activities in a pediatric population in Pretoria Central, South Africa.

    Science.gov (United States)

    Goon, Daniel T; Nsibambi, Constance A; Chebet, Milton

    2016-12-01

    Scant information exist on screen time behavior of South Africa children and whether they do not meet the recommendation of American Association of Pediatrics (AAP) concerning screen time activity for children is only speculative. Therefore, the purpose of this study was to examine the time spent in sedentary activities, especially screen time of South African children with regard to gender. This cross-sectional study involved a random sample of 1136 school children (548 boys; 588 girls) aged 9-13 years attending public schools in Central Pretoria, South Africa. Questionnaire was used to collect data on the participants' sedentary behaviors. The prevalence estimates for sedentary time activity was based on the guidelines (i.e., <2 or ≥2 hours per day) of AAP. The mean age of the children was 11.1±1.4 years. Sedentary activity data were collected from 548 boys (48.2%) and 588 (51.8%) girls. The majority of children spent more than two hours per day (exceeding the AAP recommendation for sedentary activity) watching TV (3.0%), worked or played on the computer (25.4%), read (1.0%), played music (27.9%), played board games (14.7%), washing clothes (8.0%), floor sweeping (10.5%), art work (18.2%), and spent time on other unspecified activities (28.6%). Boys spent more time (2 hours, 3-4 hours) watching TV (38.3%; P=0.001), playing computer (31.8 %; P=0.024) and board games (17.4%; P=0.012) than girls. The corresponding figures for girls were 35.7%, 19.2% and 12.5% for TV, computer and board games, respectively. However, the proportion of those who spent more time playing music was higher among girls (32.7%) than boys (22.4%) (P=0.002). Overall, the time spent exceeding AAP recommendation (≥ 2 hours) was not statistically (P=0.427) different between boys and girls. The time spent in sedentary activities, particularly in screen time activity among urban primary school children in Pretoria Central is excessively higher than the recommendation (i.e., ≥2 hours per day

  20. Seasonal Differences in Determinants of Time Location Patterns in an Urban Population: A Large Population-Based Study in Korea.

    Science.gov (United States)

    Lee, Sewon; Lee, Kiyoung

    2017-06-22

    Time location patterns are a significant factor for exposure assessment models of air pollutants. Factors associated with time location patterns in urban populations are typically due to high air pollution levels in urban areas. The objective of this study was to determine the seasonal differences in time location patterns in two urban cities. A Time Use Survey of Korean Statistics (KOSTAT) was conducted in the summer, fall, and winter of 2014. Time location data from Seoul and Busan were collected, together with demographic information obtained by diaries and questionnaires. Determinants of the time spent at each location were analyzed by multiple linear regression and the stepwise method. Seoul and Busan participants had similar time location profiles over the three seasons. The time spent at own home, other locations, workplace/school and during walk were similar over the three seasons in both the Seoul and Busan participants. The most significant time location pattern factors were employment status, age, gender, monthly income, and spouse. Season affected the time spent at the workplace/school and other locations in the Seoul participants, but not in the Busan participants. The seasons affected each time location pattern of the urban population slightly differently, but overall there were few differences.

  1. Seasonal Differences in Determinants of Time Location Patterns in an Urban Population: A Large Population-Based Study in Korea

    Directory of Open Access Journals (Sweden)

    Sewon Lee

    2017-06-01

    Full Text Available Time location patterns are a significant factor for exposure assessment models of air pollutants. Factors associated with time location patterns in urban populations are typically due to high air pollution levels in urban areas. The objective of this study was to determine the seasonal differences in time location patterns in two urban cities. A Time Use Survey of Korean Statistics (KOSTAT was conducted in the summer, fall, and winter of 2014. Time location data from Seoul and Busan were collected, together with demographic information obtained by diaries and questionnaires. Determinants of the time spent at each location were analyzed by multiple linear regression and the stepwise method. Seoul and Busan participants had similar time location profiles over the three seasons. The time spent at own home, other locations, workplace/school and during walk were similar over the three seasons in both the Seoul and Busan participants. The most significant time location pattern factors were employment status, age, gender, monthly income, and spouse. Season affected the time spent at the workplace/school and other locations in the Seoul participants, but not in the Busan participants. The seasons affected each time location pattern of the urban population slightly differently, but overall there were few differences.

  2. Strategies to reduce exclusion among populations living in urban slum settlements in Bangladesh.

    Science.gov (United States)

    Rashid, Sabina Faiz

    2009-08-01

    The health and rights of populations living in informal or slum settlements are key development issues of the twenty-first century. As of 2007, the majority of the world's population lives in urban areas. More than one billion of these people, or one in three city-dwellers, live in inadequate housing with no or a few basic resources. In Bangladesh, urban slum settlements tend to be located in low-lying, flood-prone, poorly-drained areas, having limited formal garbage disposal and minimal access to safe water and sanitation. These areas are severely crowded, with 4-5 people living in houses of just over 100 sq feet. These conditions of high density of population and poor sanitation exacerbate the spread of diseases. People living in these areas experience social, economic and political exclusion, which bars them from society's basic resources. This paper overviews policies and actions that impact the level of exclusion of people living in urban slum settlements in Bangladesh, with a focus on improving the health and rights of the urban poor. Despite some strategies adopted to ensure better access to water and health, overall, the country does not have a comprehensive policy for urban slum residents, and the situation remains bleak.

  3. Strategies to Reduce Exclusion among Populations Living in Urban Slum Settlements in Bangladesh

    Science.gov (United States)

    2009-01-01

    The health and rights of populations living in informal or slum settlements are key development issues of the twenty-first century. As of 2007, the majority of the world's population lives in urban areas. More than one billion of these people, or one in three city-dwellers, live in inadequate housing with no or a few basic resources. In Bangladesh, urban slum settlements tend to be located in low-lying, flood-prone, poorly-drained areas, having limited formal garbage disposal and minimal access to safe water and sanitation. These areas are severely crowded, with 4–5 people living in houses of just over 100 sq feet. These conditions of high density of population and poor sanitation exacerbate the spread of diseases. People living in these areas experience social, economic and political exclusion, which bars them from society's basic resources. This paper overviews policies and actions that impact the level of exclusion of people living in urban slum settlements in Bangladesh, with a focus on improving the health and rights of the urban poor. Despite some strategies adopted to ensure better access to water and health, overall, the country does not have a comprehensive policy for urban slum residents, and the situation remains bleak. PMID:19761090

  4. Differential associations of urbanicity and income with physical activity in adults in urbanizing China: findings from the population-based China Health and Nutrition Survey 1991-2009.

    Science.gov (United States)

    Attard, Samantha M; Howard, Annie-Green; Herring, Amy H; Zhang, Bing; Du, Shufa; Aiello, Allison E; Popkin, Barry M; Gordon-Larsen, Penny

    2015-12-12

    High urbanicity and income are risk factors for cardiovascular-related chronic diseases in low- and middle-income countries, perhaps due to low physical activity (PA) in urban, high income areas. Few studies have examined differences in PA over time according to income and urbanicity in a country experiencing rapid urbanization. We used data from the China Health and Nutrition Survey, a population-based cohort of Chinese adults (n = 20,083; ages 18-75y) seen a maximum of 7 times from 1991-2009. We used sex-stratified, zero-inflated negative binomial regression models to examine occupational, domestic, leisure, travel, and total PA in Chinese adults according to year, urbanicity, income, and the interactions among urbanicity, income, and year, controlling for age and region of China. We showed larger mean temporal PA declines for individuals living in relatively low urbanicity areas (1991: 500 MET-hours/week; 2009: 300 MET-hours/week) compared to high urbanicity areas (1991: 200 MET-hours/week; 2009: 125 MET-hours/week). In low urbanicity areas, the association between income and total PA went from negative in 1991 (p Leisure PA was the only domain of PA that increased over time, but >95% of individuals in low urbanicity areas reported zero leisure PA at each time point. Our findings show changing associations for income and urbanicity with PA over 18 years of urbanization. Total PA was lower for individuals living in more versus less urban areas at all time points. However, these differences narrowed over time, which may relate to increases in individual-level income in less urban areas of China with urbanization. Low-income individuals in higher urbanicity areas are a particularly critical group to target to increase PA in China.

  5. An emerging etiological factor for hand injuries in the pediatric population: public exercise equipment.

    Science.gov (United States)

    Akşam, Berrak; Akşam, Ersin; Ceran, Candemir; Demirseren, Mustafa Erol

    2016-01-01

    The purpose of this study was to describe the role of public exercise equipment in pediatric hand traumas as a preventable etiological factor. Pediatric patients with hand injuries referred from the emergency department were evaluated retrospectively. Age and gender of the patients, timing, etiology, mechanism of hand trauma, localization of the injury, diagnoses of the patients, and hospitalization rates were reviewed. Amongst the 310 pediatric patients evaluated, 31 patients (10%) experienced injury related to public exercise equipment. Within this group of patients, most were between 5 to 9 years of age, and all injuries were blunt and crush type. Lacerations and fractures were the main diagnoses. Complex injuries that required inpatient care were reported in 19.3% of the patients. Public exercise equipment-related injuries are increasingly prevalent in pediatric hand traumas. Preventive actions such as shielding the moving parts should be taken to reduce these rates.

  6. Population pharmacokinetics of intravenous Erwinia asparaginase in pediatric acute lymphoblastic leukemia patients

    NARCIS (Netherlands)

    Sassen, Sebastiaan D. T.; Mathôt, Ron A. A.; Pieters, Rob; Kloos, Robin Q. H.; de Haas, Valérie; Kaspers, Gertjan J. L.; van den Bos, Cor; Tissing, Wim J. E.; te Loo, Maroeska; Bierings, Marc B.; Kollen, Wouter J. W.; Zwaan, Christian M.; van der Sluis, Inge M.

    2017-01-01

    Erwinia asparaginase is an important component in the treatment of pediatric acute lymphoblastic leukemia. A large variability in serum concentrations has been observed after intravenous Erwinia asparaginase. Currently, Dutch Childhood Oncology Group protocols dose alterations are based on trough

  7. Population pharmacokinetics of intravenous Erwinia asparaginase in pediatric acute lymphoblastic leukemia patients

    NARCIS (Netherlands)

    Sassen, Sebastiaan D. T.; Mathot, Ron A. A.; Pieters, Rob; Kloos, Robin Q. H.; de Haas, Valerie; Kaspers, Gertjan J. L.; van den Bos, Cor; Tissing, Wim J. E.; te Loo, D. Maroeska W. M.; Bierings, Marc B.; Kollen, Wouter J. W.; Zwaan, Christian M.; van der Sluis, Inge M.

    Erwinia asparaginase is an important component in the treatment of pediatric acute lymphoblastic leukemia. A large variability in serum concentrations has been observed after intravenous Erwinia asparaginase. Currently, Dutch Childhood Oncology Group protocols dose alterations are based on trough

  8. The population conundrums and some implications for urban development in Serbia

    Directory of Open Access Journals (Sweden)

    Petrić Jasna

    2012-01-01

    Full Text Available Population development may reveal either a potential or constraint on functional labour markets and spatial development of the territory in concern. The first results of the 2011 Census in Serbia depict a rather bleak demographic situation, which is only the continuation of population trends from the late 20th and beginning of the 21st century, substantially fuelled by dynamic political and socioeconomic processes featuring Serbia in the past few decades. The focus is on demographic changes in relation to three correlated aspects: 1 intensive ageing process; 2 depopulation and negative natural growth; and 3 migratory movements - population exodus. This paper addresses in particular the spatial consequences and institutional aspects of recent demographic changes and their reflection on urban areas in Serbia. In the past, population movements from rural to urban areas used to colour much of the migratory balance map of the country, however this situation changed due to exhaustion of the ‘traditional’ demographic reservoirs. Still, urban primacy of the capital city Belgrade has been even intensified with the recent demographic movements, or more precisely, a tissue of the two largest cities in relative proximity - Belgrade and Novi Sad is hypertrophied in a demographic sense. Other urban settlements in Serbia, especially the smaller towns, which are numerous but demographically shrinking, have not been empowered enough to substantiate better links with smaller and larger settlements within urban-rural interface, and their role has been challenged in that respect. Demographic changes, which affect urban growth or decline, are largely to do with border effects, economic and social gaps, educational opportunities, and search of certain ‘urban lifestyles’. The latter is particularly stressed regarding the process of ‘second demographic transition’ which encompassed Serbia and is manifested by changes in the family domain, viz. partnership

  9. Mathematical modeling of an urban pigeon population subject to local management strategies.

    Science.gov (United States)

    Haidar, I; Alvarez, I; Prévot, A C

    2017-06-01

    This paper addresses the issue of managing urban pigeon population using some possible actions that make it reach a density target with respect to socio-ecological constraints. A mathematical model describing the dynamic of this population is introduced. This model incorporates the effect of some regulatory actions on the dynamic of this population. We use mathematical viability theory, which provides a framework to study compatibility between dynamics and state constraints. The viability study shows when and how it is possible to regulate the pigeon population with respect to the constraints. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Urban soil biomonitoring by beetle and earthworm populations

    Energy Technology Data Exchange (ETDEWEB)

    Janossy, L.; Bitto, A. [ELTE Univ., Budapest (Hungary)

    1995-12-31

    Two macro invertebrate groups were chosen for biomonitoring environmental changes. The beetle population was pitfall trapped (five month in 1994) at five downtown sites (parks) of Budapest and in a hilly original woodland as a control site 33km NW of Budapest. Earthworms were collected by using formol solution. Five heavy metals were measured (Pb, Co, Hg, Zn, Cu) in the upper soil layer at the same sampling sites. Pb, Hg, Zn and Cu was over the tolerable limit in a park near the railway, extreme high Pb (530 mg/kg dry soil) and Zn content was measured in one park. Roads are also salted in wintertime. The number of beetle species in the downtown parks varied 10 to 22 (226--462 specimen). Near to the edge of the city up to 45 beetle species were found in a park with 1,027 specimen. In the woodland area 52 beetle species with 1,061 specimen were found. Less dominance and higher specific diversity showed the direction from downtown to woodland. Only 2 or 3 cosmopolitan earthworm species existed in downtown parks with 30--35 specimen/m{sup 2}, in the control woodland area 7 mostly endemic earthworm species were found with 74 specimens/m{sup 2}. But earthworm biomass was higher in three well fertilized parks (43--157 g/m{sup 2}), than in the original woodland (25-g/m{sup 2}). The beetle populations seem to be good tools for biomonitoring. Earthworms are susceptible to environmental changes but they also strongly depend on the leaf litter and the organic matter of the soil. The change in the animal populations is the result of summarized environmental impacts in such a big city like Budapest.

  11. Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever Among Rural and Urban Populations of Northern Vietnam

    NARCIS (Netherlands)

    Trung, N.V.; Hoi, L.T.; Thuong, N.T.H.; Toan, T.K.; Huong, T.T.K.; Hoa, T.M.; Fox, A.; Kinh, N.V.; Doorn, H.R. van; Wertheim, H.F.L.; Bryant, J.E.; Nadjm, B.

    2017-01-01

    AbstractRickettsial infections are recognized as important causes of fever throughout southeast Asia. Herein, we determined the seroprevalence to rickettsioses within rural and urban populations of northern Vietnam. Prevalence of individuals with evidence of prior rickettsial infections (IgG

  12. Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

    Science.gov (United States)

    Markham, Christine M.; Peskin, Melissa Fleschler; Addy, Robert C.; Baumler, Elizabeth R.; Tortolero, Susan R.

    2009-01-01

    Background: This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents. Methods: A total of 1279 seventh-grade students (57.3% female, 43.6%…

  13. Natural areas and urban populations: communication and environmental education challenges and actions in outdoor recreation

    Science.gov (United States)

    Deborah J. Chavez

    2005-01-01

    Challenges, opportunities, and actions exist in areas where large urban populations interface with natural areas, such as outdoor recreation sites in southern California. Challenges in the interface include intense recreation use, public safety issues, and complex information strategies. Research results on communications and environmental education offer opportunities...

  14. Influence of human population movements on urban climate of Beijing during the Chinese New Year holiday

    Science.gov (United States)

    Zhang, Jingyong; Wu, Lingyun

    2017-03-01

    The population movements for the Chinese New Year (CNY) celebrations, known as the world’s largest yearly migration of human beings, have grown rapidly in the past several decades. The massive population outflows from urban areas largely reduce anthropogenic heat release and modify some other processes, and may thus have noticeable impacts on urban climate of large cities in China. Here, we use Beijing as an example to present observational evidence for such impacts over the period of 1990-2014. Our results show a significant cooling trend of up to 0.55 °C per decade, particularly at the nighttime during the CNY holiday relative to the background period. The average nighttime cooling effect during 2005-2014 reaches 0.94 °C relative to the 1990s, significant at the 99% confidence level. The further analysis supports that the cooling during the CNY holiday is attributable primarily to the population outflow of Beijing. These findings illustrate the importance of population movements in influencing urban climate despite certain limitations. As the world is becoming more mobile and increasingly urban, more efforts are called for to understand the role of human mobility at various spatial and temporal scales.

  15. The importance of resident environmental awareness in conservation of urban wildlife populations

    Science.gov (United States)

    The proximity of humans and wildlife to each other along the wildland-urban interface results in constant potential conflict between human activity and wildlife populations. Since 2002, California biologists have observed a drastic increase in carnivore mortalities that are asso...

  16. Microsporum spp. onychomycosis: disease presentation, risk factors and treatment responses in an urban population

    Directory of Open Access Journals (Sweden)

    Erick Martínez

    2014-03-01

    Conclusion: This is the largest reported series of Microsporum onychomycosis and demonstrates such a disease in an urban population. In 27.78% of the cases risk factors for infection were associated to comorbid states. We also report the first 2 cases of successfully treated M. canis onychomycosis with photodynamic therapy and a rare case of M. canis associated dermatophytoma.

  17. Prevalence of psychiatric and physical morbidity in an urban geriatric population

    OpenAIRE

    Seby, K.; Chaudhury, Suprakash; Chakraborty, Rudraprosad

    2011-01-01

    Background: With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. Aims: To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Settings and Design: Cross-sectional, epidemiological study. Materials...

  18. Population, behavioural and physiological responses of an urban population of black swans to an intense annual noise event.

    Science.gov (United States)

    Payne, Catherine J; Jessop, Tim S; Guay, Patrick-Jean; Johnstone, Michele; Feore, Megan; Mulder, Raoul A

    2012-01-01

    Wild animals in urban environments are exposed to a broad range of human activities that have the potential to disturb their life history and behaviour. Wildlife responses to disturbance can range from emigration to modified behaviour, or elevated stress, but these responses are rarely evaluated in concert. We simultaneously examined population, behavioural and hormonal responses of an urban population of black swans Cygnus atratus before, during and after an annual disturbance event involving large crowds and intense noise, the Australian Formula One Grand Prix. Black swan population numbers were lowest one week before the event and rose gradually over the course of the study, peaking after the event, suggesting that the disturbance does not trigger mass emigration. We also found no difference in the proportion of time spent on key behaviours such as locomotion, foraging, resting or self-maintenance over the course of the study. However, basal and capture stress-induced corticosterone levels showed significant variation, consistent with a modest physiological response. Basal plasma corticosterone levels were highest before the event and decreased over the course of the study. Capture-induced stress levels peaked during the Grand Prix and then also declined over the remainder of the study. Our results suggest that even intensely noisy and apparently disruptive events may have relatively low measurable short-term impact on population numbers, behaviour or physiology in urban populations with apparently high tolerance to anthropogenic disturbance. Nevertheless, the potential long-term impact of such disturbance on reproductive success, individual fitness and population health will need to be carefully evaluated.

  19. Population, behavioural and physiological responses of an urban population of black swans to an intense annual noise event.

    Directory of Open Access Journals (Sweden)

    Catherine J Payne

    Full Text Available Wild animals in urban environments are exposed to a broad range of human activities that have the potential to disturb their life history and behaviour. Wildlife responses to disturbance can range from emigration to modified behaviour, or elevated stress, but these responses are rarely evaluated in concert. We simultaneously examined population, behavioural and hormonal responses of an urban population of black swans Cygnus atratus before, during and after an annual disturbance event involving large crowds and intense noise, the Australian Formula One Grand Prix. Black swan population numbers were lowest one week before the event and rose gradually over the course of the study, peaking after the event, suggesting that the disturbance does not trigger mass emigration. We also found no difference in the proportion of time spent on key behaviours such as locomotion, foraging, resting or self-maintenance over the course of the study. However, basal and capture stress-induced corticosterone levels showed significant variation, consistent with a modest physiological response. Basal plasma corticosterone levels were highest before the event and decreased over the course of the study. Capture-induced stress levels peaked during the Grand Prix and then also declined over the remainder of the study. Our results suggest that even intensely noisy and apparently disruptive events may have relatively low measurable short-term impact on population numbers, behaviour or physiology in urban populations with apparently high tolerance to anthropogenic disturbance. Nevertheless, the potential long-term impact of such disturbance on reproductive success, individual fitness and population health will need to be carefully evaluated.

  20. Identifying musical difficulties as they relate to congenital amusia in the pediatric population.

    Science.gov (United States)

    Wilcox, Lyndy J; He, Kaidi; Derkay, Craig S

    2015-12-01

    Approximately 4% of the population fails to develop basic music skills and can be identified as "amusic". Congenital amusia (CA), or "tone deafness", is thought to be a hereditary disordera predominantly affecting the perception and production of music. The gold standard for diagnosis is the Montreal Battery for Evaluation of Amusia (MBEA). This study aims to pinpoint factors in the history that may help identify amusic children and to determine if amusic pediatric patients can be identified using a widely available, shorter test validated in adults. Subjects ages 7-17 years were recruited to take an online test, validated against the MBEA, for CA. The sections tested recognition of "off-beat" (OB), "mistuned" (MT), and "out-of-key" (OOK) conditions. Parents filled out a questionnaire regarding the subject's past medical, educational, musical exposure, and family history. Of 114 subjects recruited, complete data was available on 105 with a mean age of 12.5 years. According to adult criteria, 63/105 (60%) of subjects scored in the "amusic" range. Children >10 years of age scored significantly higher on the off-beat section (p=0.001) and total scores (p=0.025). Subjects who were born prematurely scored significantly lower (p=0.045). Children whose father had difficulties with music scored significantly lower on the off-beat section (p=0.003) and total scores (p=0.008). CA is a disorder that has implications for quality of life. Earlier identification may help elucidate the pathogenesis of the condition and, in the future, the institution of prompt treatment. Further studies are needed to identify the most appropriate and convenient tests, as well as the optimal timing of testing, for reliably diagnosing CA in children. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Evaluation of Postoperative Hydronephrosis Following Ureteroscopy in Pediatric Population: Incidence and Predictors.

    Science.gov (United States)

    Gökce, Mehmet Ilker; Telli, Onur; Özkıdık, Mete; Akıncı, Aykut; Hajıyev, Perviz; Soygür, Tarkan; Burgu, Berk

    2016-07-01

    To identify the incidence and associated factors of the postoperative hydronephrosis in pediatric patients who underwent ureterorenoscopy (URS) for renal or ureteral stones. We evaluated the results of 116 patients who underwent semirigid or flexible URS retrospectively. Primary end points of the study were to determine the incidence of postoperative hydronephrosis and factors associated with the development of postoperative hydronephrosis. Logistic regression analysis was used to define factors associated with the presence of hydronephrosis. Mean age of the population was 9.5 years and mean stone size was 9.4 mm. Hydronephrosis was detected in 32 (27.6%) patients. Stone-free status was achieved in 101 (87%) patients. Univariate analysis revealed history of ipsilateral URS, duration of operation, presence of impacted stone, development of ureteral injury during operation, and presentation with a renal colic episode as the parameter associated with increased risk of hydronephrosis. History of ipsilateral URS (odds ratio: 1.664, P = .027), presence of impacted stones (odds ratio: 1.788, P = .014), and development of ureteral injury during operation (odds ratio: 1.106, P = .039) were found to be the independent markers of developing postoperative hydronephrosis in a multivariate analysis. Ipsilateral hydronephrosis following URS develops in a significant portion of patients. In patients with history of ipsilateral procedure and those with an impacted stone and had ureteral injury, the risk of postoperative hydronephrosis is higher; therefore, physicians should keep these parameters in mind in the decision-making process of selective imaging postoperatively. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Five-year experience with burns from glass fireplace doors in the pediatric population.

    Science.gov (United States)

    Baryza, Mary Jo; Hinson, Michelle; Conway, Jennifer; Ryan, Colleen M

    2013-01-01

    Burns from contact with glass doors of gas fireplaces have been previously reported. The purpose of this study is to examine the incidence and severity of this injury in our population. Patients were identified for inclusion in the retrospective chart review study using the National Trauma Registry of the American College of Surgeons (NTRACS) and our local outpatient database. Criteria for inclusion were burn injuries sustained from contact with fireplace glass doors treated at our pediatric burn center from 2007 through 2011. Fifty children met these criteria, including two children whose burns were caused by electric fireplace glass doors. BSA burned was 1.5 ± 1.5% (mean ± SD), range 0.5 to 10%. Age was 27.2 ± 27.3 months, range 8 months to 13 years. Forty-five children (90%) had hand burns; of these, 18 children had bilateral hand involvement. Facial burns were found in three children (6%), and eight children (16%) had other areas burned. One patient developed cellulitis. Two patients required surgery. Six children (12%) required hospitalization; mean length of stay was 5.8 ± 5 days, range 1 to 5 days. Although the number of inpatient admissions was relatively few, 329 outpatient visits and 309 rehabilitation visits were required for treatment of these children. Nineteen patients (38%) required splints and six patients (12%) required scar treatment with pressure garments. Burns from contact with fireplace glass doors are a recurring problem. Toddlers are most at risk. Directed preventive strategies including parent education, safety warnings, and design modifications such as temperature sensors and barrier screens could be potentially helpful in reducing the incidence of this injury.

  3. Innate Susceptibility to Norovirus Infections Influenced by FUT2 Genotype in a United States Pediatric Population

    Science.gov (United States)

    Currier, Rebecca L.; Payne, Daniel C.; Staat, Mary A.; Selvarangan, Rangaraj; Shirley, S. Hannah; Halasa, Natasha; Boom, Julie A.; Englund, Janet A.; Szilagyi, Peter G.; Harrison, Christopher J.; Klein, Eileen J.; Weinberg, Geoffrey A.; Wikswo, Mary E.; Parashar, Umesh; Vinjé, Jan; Morrow, Ardythe L.

    2015-01-01

    Background. Norovirus is a leading cause of acute gastroenteritis (AGE). Noroviruses bind to gut histo-blood group antigens (HBGAs), but only 70%–80% of individuals have a functional copy of the FUT2 (“secretor”) gene required for gut HBGA expression; these individuals are known as “secretors.” Susceptibility to some noroviruses depends on FUT2 secretor status, but the population impact of this association is not established. Methods. From December 2011 to November 2012, active AGE surveillance was performed at 6 geographically diverse pediatric sites in the United States. Case patients aged <5 years were recruited from emergency departments and inpatient units; age-matched healthy controls were recruited at well-child visits. Salivary DNA was collected to determine secretor status and genetic ancestry. Stool was tested for norovirus by real-time reverse transcription polymerase chain reaction. Norovirus genotype was then determined by sequencing. Results. Norovirus was detected in 302 of 1465 (21%) AGE cases and 52 of 826 (6%) healthy controls. Norovirus AGE cases were 2.8-fold more likely than norovirus-negative controls to be secretors (P < .001) in a logistic regression model adjusted for ancestry, age, site, and health insurance. Secretors comprised all 155 cases and 21 asymptomatic infections with the most prevalent norovirus, GII.4. Control children of Meso-American ancestry were more likely than children of European or African ancestry to be secretors (96% vs 74%; P < .001). Conclusions. FUT2 status is associated with norovirus infection and varies by ancestry. GII.4 norovirus exclusively infected secretors. These findings are important to norovirus vaccine trials and design of agents that may block norovirus-HBGA binding. PMID:25744498

  4. Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population.

    Science.gov (United States)

    Merino-Ingelmo, Raquel; Santos-de Soto, José; Coserria-Sánchez, Félix; Descalzo-Señoran, Alfonso; Valverde-Pérez, Israel

    2014-05-01

    Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population. The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up. Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients. Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. [Trends in smoking in an urban population over recent decades].

    Science.gov (United States)

    Villalbí, Joan R; Bartoll, Xavier; Rodríguez-Sanz, Maica; Borrell, Carme

    2016-05-06

    The objective of this study is to describe the distribution of smoking in the population and to assess changes and trends over recent decades. Cross sectional study in a sample of the non-institutionalized resident population (n=3,509) in Barcelona (Catalonia, Spain) using data from persons over 14 years of age from the health survey of 2011, and assessing trends for 1983-2011 using previous surveys. Dependent variables are having ever been a smoker, having quit, being a current smoker, and smoking daily. Independent variables include sex, age, and time. Prevalence and proportions are estimated, stratifying or adjusting for age. The prevalence of daily smokers is 18.8% in 2011: 22.2% for men and 15.9% for women. The age groups with higher smoking prevalence are 25-34 years for men and 15-24 for women. From 1983 to 2011 the reduction among men has been intense, and for women the prevalence has been decreasing since the survey of 2000. Among smokers, the proportion of both genders who do not smoke daily has increased. The smoking epidemic over the last years shows promising trends. The data do not lend support to the hardening hypothesis for current smokers. Smokers are a shrinking minority, although to improve public health it would be desirable to speed the process of change. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  6. Population genetics of the olive-winged bulbul (Pycnonotus plumosus) in a tropical urban-fragmented landscape.

    Science.gov (United States)

    Tang, Grace S Y; Sadanandan, Keren R; Rheindt, Frank E

    2016-01-01

    With increasing urbanization, urban-fragmented landscapes are becoming more and more prevalent worldwide. Such fragmentation may lead to small, isolated populations that face great threats from genetic factors that affect even avian species with high dispersal propensities. Yet few studies have investigated the population genetics of species living within urban-fragmented landscapes in the Old World tropics, in spite of the high levels of deforestation and fragmentation within this region. We investigated the evolutionary history and population genetics of the olive-winged bulbul (Pycnonotus plumosus) in Singapore, a highly urbanized island which retains landscape.

  7. SINONASAL AND ORBITAL MALIGNANT NEOPLASMS IN PEDIATRIC POPULATION: A STUDY FROM A TERTIARY CARE CENTRE IN INDIA

    Directory of Open Access Journals (Sweden)

    Koyela Mondal

    2015-01-01

    Full Text Available NTRODUCTION : Paranasal and extra - ocular orbital malignant tumors are comparatively rare in pediatric patients and difficult to diagnose early. Malignant lesions in this region tend to be locally aggressive, often presenting at an advanced stage. Non osseous, extra ocular orbital tumors represent a different histologic spectrum in children than in adults. AIMS: To study the spectrum of malignant lesions of paranasal sinuses and orbital area in patients under 18 years of age. MATERIALS AND METHODS: A retrospective and prospective study was done from July 2004 to June 2014. Malignant paranasal and orbital neoplasms were recorded including clinico - radiological and cytological data. Review of histopathological slides along with immunohistochemistry (IHC of selected cases were done. RESULTS: Total 69 cases were recorded over the ten year period as per our inclusion criteria. Out of these, 46 (67% patients presented with malignant paranasal neoplasm and 23 (33% with orbital mass. Most cases were found in the age group of 7 - 12 years, where females were preponderant. Rhabdomyosarcoma (RMS was the commonest tumor arising in paranasal as well as in orbital area (33%. IHC aided the confirmation of our diagnoses. CONCLUSION: Paranasal malignancy in the pediatric population often presents with non - specific symptoms, and high index of suspicion along with better diagnostic tools like computed tomography (CT scan is necessary for a timely diagnosis . IHC should be done in all malignant neoplasms of pediatric population to arrive at a proper diagnosis, to facilitate proper management to these patients

  8. The impact of AIDS on an urban population of high-risk female minority adolescents: implications for intervention.

    Science.gov (United States)

    Overby, K J; Kegeles, S M

    1994-05-01

    This study's purpose was to describe acquired immunodeficiency syndrome (AIDS)-related concerns, risk behaviors, and psychosocial/situational determinants of condom use among an urban minority population of sexually active, adolescent girls. In addition we sought to define the accuracy of personal AIDS risk-assessment, the relative importance of AIDS in relation to other concerns, and the broader context of sexual experience and attitudes in this population. A cross-sectional interview study was conducted involving sexually active female adolescents attending a pediatric clinic in an inner-city university-affiliated community hospital. Sixty-nine subjects (ages 13-19 yr, 90% African-American) were enrolled. While the goals of this study were primarily descriptive, subject characteristics felt to impact on condom use were identified prior to data collection and were examined against several measures of usage including: use at the time of last sexual intercourse, overall frequency of condom use, and reported behavior change to include initiation of or increased condom usage. Forty-one percent of participants reported knowing someone with AIDS. Global concern regarding this disease was high, although worry about poverty-related issues was often greater. Despite concern and high measures of AIDS risk (median number of sex partners, 3; past sexually transmitted disease, 55%; past pregnancy 77%), most participants perceived themselves to be at low personal risk owing to current monogamy, lack of intravenous drug use, and implicit trust in their partner's safety. Discussion with their partner about actual risk and awareness of the importance of past behaviors was generally lacking. Although 98% were aware that condoms may prevent AIDS, 64% used condoms half of the time or less when they had sex and use appeared to be primarily for contraception. Several intrinsic cognitive/psychological and extrinsic social/situational factors were found to correlate with measures of

  9. Late Causes of Death After Pediatric Cardiac Surgery: A 60-Year Population-Based Study.

    Science.gov (United States)

    Raissadati, Alireza; Nieminen, Heta; Haukka, Jari; Sairanen, Heikki; Jokinen, Eero

    2016-08-02

    Comprehensive information regarding causes of late post-operative death following pediatric congenital cardiac surgery is lacking. The study sought to analyze late causes of death after congenital cardiac surgery by era and defect severity. We obtained data from a nationwide pediatric cardiac surgery database and Finnish population registry regarding patients who underwent cardiac surgery at Causes of death were determined using International Classification of Diseases diagnostic codes. Deaths among the study population were compared to a matched control population. Overall, 10,964 patients underwent 14,079 operations, with 98% follow-up. Early mortality (death rates correlated with defect severity. Heart failure was the most common mode of CHD-related death, but decreased after surgeries performed between 1990 and 2009. Sudden death after surgery for atrial septal defect, ventricular septal defect, tetralogy of Fallot, and transposition of the great arteries decreased to zero following operations from 1990 to 2009. Deaths from neoplasms, respiratory, neurological, and infectious disease were significantly more common among study patients than controls. Pneumonia caused the majority of non-CHD-related deaths among the study population. CHD-related deaths have decreased markedly but remain a challenge after surgery for severe cardiac defects. Premature deaths are generally more common among patients than the control population, warranting long-term follow-up after congenital cardiac surgery. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  11. Air Pollutants, Climate, and the Prevalence of Pediatric Asthma in Urban Areas of China

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    Juanjuan Zhang

    2016-01-01

    Full Text Available Background. Prevalence of childhood asthma varies significantly among regions, while its reasons are not clear yet with only a few studies reporting relevant causes for this variation. Objective. To investigate the potential role of city-average levels of air pollutants and climatic factors in order to distinguish differences in asthma prevalence in China and explain their reasons. Methods. Data pertaining to 10,777 asthmatic patients were obtained from the third nationwide survey of childhood asthma in China’s urban areas. Annual mean concentrations of air pollutants and other climatic factors were obtained for the same period from several government departments. Data analysis was implemented with descriptive statistics, Pearson correlation coefficient, and multiple regression analysis. Results. Pearson correlation analysis showed that the situation of childhood asthma was strongly linked with SO2, relative humidity, and hours of sunshine (p<0.05. Multiple regression analysis indicated that, among the predictor variables in the final step, SO2 was found to be the most powerful predictor variable amongst all (β=-19.572, p < 0.05. Furthermore, results had shown that hours of sunshine (β = -0.014, p < 0.05 was a significant component summary predictor variable. Conclusion. The findings of this study do not suggest that air pollutants or climate, at least in terms of children, plays a major role in explaining regional differences in asthma prevalence in China.

  12. Canine Gouging: A Taboo Resurfacing in Migrant Urban Population.

    Science.gov (United States)

    Noman, Anila Virani; Wong, Ferranti; Pawar, Ravikiran Ramakrishna

    2015-01-01

    Cosmopolitan cities have become a pool of migrants from different parts of the world, who carry their cultural beliefs and superstitions with them around the globe. Canine gouging is a kind of infant oral mutilation (IOM) which is widely practiced among rural population of Africa where the primary tooth bud of the deciduous canine is enucleated. The belief is that the life threatening illnesses in children like vomiting, diarrhoea, and fevers are caused by worms which infest on tooth buds. This case report is of a 15-year-old Somalian born boy, who presented at the dental institute with intermittent pain in his lower right permanent canine which was associated with a discharging intra oral buccal sinus. The tooth was endodontically treated and then restored with composite. General dental practitioners need to be vigilant when encountered with tooth presenting unusual morphology, unilateral missing tooth, and shift in the midline due to early loss of deciduous/permanent canines. Identification of any such dental mutilation practice will need further counselling of the individual and family members. It is the duty of every dental professional to educate and safeguard the oral and dental health of general public.

  13. The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

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    Signe Timm

    2015-12-01

    Full Text Available The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8% than subjects growing up in inner cities (11% (hazard ratio 0.72 95% CI 0.57–0.91, and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02. An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.

  14. Prevalence and correlates of fear of falling among elderly population in urban area of Karnataka, India.

    Science.gov (United States)

    Mane, Abhay B; Sanjana, T; Patil, Prabhakar R; Sriniwas, T

    2014-07-01

    Falls are a major public health problem in the elderly population. Fear of falling (FOF) among elderly persons can compromise quality of life by limiting mobility, diminished sense of well-being and reduced social interactions. India is undergoing a demographic transitional phase with urban elderly population of 6.72% in 2001. The major challenge would be on the prevention of falls among them. Hence there is a need to highlight the problems related to fall faced by the elderly in India. To study the prevalence of FOF and its correlates among the elderly population in urban area. 250 elderly subjects above 60 years were randomly selected from urban area and interviewed for FOF using Short Fall Efficacy Scale-I (FES-I), history of falls and risk factors. The prevalence of FOF among the elderly was 33.2%. The significant correlates of FOF were educational status, family type, associated health problems, history of fall in past 6 months, worried of fall again among fallers, fearfulness of fall again among fallers, restriction of daily activities and depression among them. The insignificant correlates were gender and socio-economic status. FOF is a health problem among the elderly living in urban India needs urgent attention. It represents a significant threat to socialization, independence and morbidity or mortality. Knowledge of correlates of FOF may be useful in developing multidimensional strategies to reduce it among elderly.

  15. Comparison of patterns of substance abuse disorders in urban and rural population

    Directory of Open Access Journals (Sweden)

    Morad Rasouli-Azad

    2011-03-01

    Full Text Available Background: Studies of the prevalence of substance abuse in rural and urban population in different countries revealed variable results regarding to the study method, study population, age group and measuring tools. The purpose of this research is to compare the patterns of substance abuse disorders in urban and rural population in Mashhad.Materials and Method: Two groups consecutively admitted patients who referred to substance treatment clinics of Mashhad, were selected (110 urban and 100 rural patients. Samples were evaluated with structured demographic questionnaire and Structured Clinical Interview (SCID for DSM-IV. Data were analyzed by χ2 and independent t-test.Results: This study showed statistically significant differences between two groups in marital status, education level, monthly income and job. Also the samples were differed in substance type, history of injection and quit, abuse of nicotine, cannabis and alcohol in long life. Conclusion: Rural and urban societies have differences in patterns of substance abuse that can be originated from social-context differences

  16. Cardiovascular risk factors in a Mexican middle-class urban population. The Lindavista Study. Baseline data.

    Science.gov (United States)

    Meaney, Alejandra; Ceballos-Reyes, Guillermo; Gutiérrez-Salmean, Gabriela; Samaniego-Méndez, Virginia; Vela-Huerta, Agustín; Alcocer, Luis; Zárate-Chavarría, Elisa; Mendoza-Castelán, Emma; Olivares-Corichi, Ivonne; García-Sánchez, Rubén; Martínez-Marroquín, Yolanda; Ramírez-Sánchez, Israel; Meaney, Eduardo

    2013-01-01

    The aim of this communication is to describe the cardiovascular risk factors affecting a Mexican urban middle-class population. A convenience sample of 2602 middle class urban subjects composed the cohort of the Lindavista Study, a prospective study aimed to determine if conventional cardiovascular risks factors have the same prognosis impact as in other populations. For the baseline data, several measurements were done: obesity indexes, smoking, blood pressure, fasting serum glucose, total cholesterol, HDL-c, LDL-c and triglycerides. This paper presents the basal values of this population, which represents a sample of the Mexican growing urban middle-class. The mean age in the sample was 50 years; 59% were females. Around 50% of the entire group were overweighed, while around 24% were obese. 32% smoked; 32% were hypertensive with a 20% rate of controlled pressure. 6% had diabetes, and 14% had impaired fasting glucose; 66% had total cholesterol ≥ 200 mg/dL; 62% showed HDL-c levels150 mg/dL, and 34% levels of LDL-c ≥ 160 mg/dL. Half of the population studied had the metabolic syndrome. These data show a population with a high-risk profile, secondary to the agglomeration of several cardiovascular risk factors. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  17. Interpolating a consumption variable for scaling and generalizing potential population pressure on urbanizing natural areas

    Science.gov (United States)

    Varanka, Dalia; Jiang, Bin; Yao, Xiaobai

    2010-01-01

    Measures of population pressure, referring in general to the stress upon the environment by human consumption of resources, are imperative for environmental sustainability studies and management. Development based on resource consumption is the predominant factor of population pressure. This paper presents a spatial model of population pressure by linking consumption associated with regional urbanism and ecosystem services. Maps representing relative geographic degree and extent of natural resource consumption and degree and extent of impacts on surrounding areas are new, and this research represents the theoretical research toward this goal. With development, such maps offer a visualization tool for planners of various services, amenities for people, and conservation planning for ecologist. Urbanization is commonly generalized by census numbers or impervious surface area. The potential geographical extent of urbanism encompasses the environmental resources of the surrounding region that sustain cities. This extent is interpolated using kriging of a variable based on population wealth data from the U.S. Census Bureau. When overlayed with land-use/land-cover data, the results indicate that the greatest estimates of population pressure fall within mixed forest areas. Mixed forest areas result from the spread of cedar woods in previously disturbed areas where further disturbance is then suppressed. Low density areas, such as suburbanization and abandoned farmland are characteristic of mixed forest areas.

  18. Urban and rural populations and labour-force structures: current patterns and their implications.

    Science.gov (United States)

    Marcoux, A

    1990-01-01

    The discussion of the changing structure in urban and rural areas due to changing migration patterns reflects the effect on crop designation and production, the connection to development and fertility issues, and the labor force structure. Different patterns of migration by sex occur between Ethiopia where female rural-to-urban migration is the dominant trend and Indonesia where males moving to urban areas occurs. When countries are identified as primarily male urban and female rural, the migration pattern is male rural-to-urban and is concentrated in African countries, whereas the reverse with female urban and male rural occurs in Latin America and developed countries. The tendency of the age structure in developed and developing countries is for the concentration of the 20 -49 year olds in urban areas and the under 20 and over 49 in rural areas. It is determined that those under 20 have 3 times greater importance in developing rather than developed countries. While in Tunisia and the Near East the over-age-49 rural population has increased, in Cameroon, Myanmar, and Bangladesh, the rural under-age-30 population has increased suggesting different migration patterns; however, there is insufficient computerized data for analysis of regional world trends. The migration pattern of child bearing age women affects the aging rural population in either of two ways. 1) Women stay and bear children and help with farm production while male migrate, thus increasing the youth and over 50 populations. 2) Whole families move with only the aging remaining. The determinants of migration are complex. When there is inequality in land distribution, the most mobile population are those without land or with very small holdings. If agricultural workers are dependent on a landlord, then migration is decreased. Technology and mechanization which have predominated in the last decades can both displace labor in rural areas when situated next to farms and increase labor when multiple

  19. Population genetic structure of urban malaria vector Anopheles stephensi in India.

    Science.gov (United States)

    Sharma, Richa; Sharma, Arvind; Kumar, Ashwani; Dube, Madhulika; Gakhar, S K

    2016-04-01

    Malaria is a major public health problem in India because climatic condition and geography of India provide an ideal environment for development of malaria vector. Anopheles stephensi is a major urban malaria vector in India and its control has been hampered by insecticide resistance. In present study population genetic structure of A. stephensi is analyzed at macro geographic level using 13 microsatellite markers. Significantly high genetic differentiation was found in all studied populations with differentiation values (FST) ranging from 0.0398 to 0.1808. The geographic distance was found to be playing a major role in genetic differentiation between different populations. Overall three genetic pools were observed and population of central India was found to be coexisting in two genetic pools. High effective population size (Ne) was found in all the studied populations. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Pilot study of participant-collected nasal swabs for acute respiratory infections in a low-income, urban population

    Directory of Open Access Journals (Sweden)

    Vargas CY

    2016-01-01

    Full Text Available Celibell Y Vargas,1 Liqun Wang,1 Yaritza Castellanos de Belliard,1 Maria Morban,1 Hilbania Diaz,1 Elaine L Larson,2,3 Philip LaRussa,1 Lisa Saiman,1,4 Melissa S Stockwell1,5,6 1Department of Pediatrics, 2School of Nursing, 3Department of Epidemiology, Mailman School of Public Health, Columbia University, 4Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, 5Department of Population and Family Health, Mailman School of Public Health, Columbia University, 6NewYork-Presbyterian Hospital, New York, NY, USA Objective: To assess the feasibility and validity of unsupervised participant-collected nasal swabs to detect respiratory pathogens in a low-income, urban minority population. Methods: This project was conducted as part of an ongoing community-based surveillance study in New York City to identify viral etiologies of acute respiratory infection. In January 2014, following sample collection by trained research assistants, participants with acute respiratory infection from 30 households subsequently collected and returned a self-collected/parent-collected nasal swab via mail. Self/parental swabs corresponding with positive reverse transcription polymerase chain reaction primary research samples were analyzed. Results: Nearly all (96.8%, n=30/31 households agreed to participate; 100% reported returning the sample and 29 were received (median time: 8 days. Most (18; 62.1% of the primary research samples were positive. For eight influenza-positive research samples, seven (87.5% self-swabs were also positive. For ten other respiratory pathogen-positive research samples, eight (80.0% self-swabs were positive. Sensitivity of self-swabs for any respiratory pathogen was 83.3% and 87.5% for influenza, and specificity for both was 100%. There was no relationship between level of education and concordance of results between positive research samples and their matching participant swab. Conclusion: In this pilot study, self

  1. A dynamic urban air pollution population exposure assessment study using model and population density data derived by mobile phone traffic

    Science.gov (United States)

    Gariazzo, Claudio; Pelliccioni, Armando; Bolignano, Andrea

    2016-04-01

    A dynamic city-wide air pollution exposure assessment study has been carried out for the urban population of Rome, Italy, by using time resolved population distribution maps, derived by mobile phone traffic data, and modelled air pollutants (NO2, O3 and PM2.5) concentrations obtained by an integrated air dispersion modelling system. More than a million of persons were tracked during two months (March and April 2015) for their position within the city and its surroundings areas, with a time resolution of 15 min and mapped over an irregular grid system with a minimum resolution of 0.26 × 0.34 Km2. In addition, demographics information (as gender and age ranges) were available in a separated dataset not connected with the total population one. Such BigData were matched in time and space with air pollution model results and then used to produce hourly and daily resolved cumulative population exposures during the studied period. A significant mobility of population was identified with higher population densities in downtown areas during daytime increasing of up to 1000 people/Km2 with respect to nigh-time one, likely produced by commuters, tourists and working age population. Strong variability (up to ±50% for NO2) of population exposures were detected as an effect of both mobility and time/spatial changing in pollutants concentrations. A comparison with the correspondent stationary approach based on National Census data, allows detecting the inability of latter in estimating the actual variability of population exposure. Significant underestimations of the amount of population exposed to daily PM2.5 WHO guideline was identified for the Census approach. Very small differences (up to a few μg/m3) on exposure were detected for gender and age ranges population classes.

  2. Association of Ugrp2 gene polymorphisms with adenoid hypertrophy in the pediatric population.

    Science.gov (United States)

    Atilla, Mahmut Huntürk; Özdaş, Sibel; Özdaş, Talih; Baştimur, Sibel; Muz, Sami Engin; Öz, Işılay; Kurt, Kenan; İzbirak, Afife; Babademez, Mehmet Ali; Vatandaş, Nilgün

    2017-08-01

    Adenoid hypertrophy is a condition that presents itself as the chronic enlargement of adenoid tissues; it is frequently observed in the pediatric population. The Ugrp2 gene, a member of the secretoglobin superfamily, encodes a low-molecular weight protein that functions in the differentiation of upper airway epithelial cells. However, little is known about the association of Ugrp2 genetic variations with adenoid hypertrophy. The aim of this study is to investigate the association of single nucleotide polymorphisms in the Ugrp2 gene with adenoid hypertrophy and its related phenotypes. A total of 219 children, comprising 114 patients suffering from adenoid hypertrophy and 105 healthy patients without adenoid hypertrophy, were enrolled in this study. Genotypes of the Ugrp2 gene were determined by DNA sequencing. We identified four single nucleotide polymorphisms (IVS1-189G>A, IVS1-89T>G, c.201delC, and IVS2-15G>A) in the Ugrp2 gene. Our genotype analysis showed that the Ugrp2 (IVS1-89T>G) TG and (c.201delC) CdelC genotypes and their minor alleles were associated with a considerable increase in the risk of adenoid hypertrophy compared with the controls (p=0.012, p=0.009, p=0.013, and p=0.037, respectively). Furthermore, Ugrp2 (GTdelCG, GTdelCA) haplotypes were significantly associated with adenoid hypertrophy (four single nucleotide polymorphisms ordered from 5' to 3'; p=0.0001). Polymorfism-Polymorfism interaction analysis indicated a strong interaction between combined genotypes of the Ugrp2 gene contributing to adenoid hypertrophy, as well as an increased chance of its diagnosis (p<0.0001). In addition, diplotypes carrying the mutant Ugrp2 (c.201delC) allele were strongly associated with an increased risk of adenoid hypertrophy with asthma and adenoid hypertrophy with allergies (p=0.003 and p=0.0007, respectively). Some single nucleotide polymorphisms and their combinations in the Ugrp2 gene are associated with an increased risk of developing adenoid hypertrophy

  3. Comparison of the Effect of Cycloplegia on Astigmatism Measurements in a Pediatric Amblyopic Population: A Prospective Study.

    Science.gov (United States)

    Goyal, Sunali; Phillips, Paul H; Rettiganti, Mallikarjuna; Gossett, Jeffrey M; Lowery, R Scott

    2018-06-18

    To study the effect of cycloplegia on astigmatism measurements in pediatric patients with amblyopia. This was a prospective comparative clinical study. Participants 4 to 17 years old were recruited from the patient population at the Arkansas Children's Hospital eye clinic after informed consent was obtained. Autorefractor measurements were used to obtain values of refractive error in amblyopic and non-amblyopic patients before and after cycloplegia. The groups were subdivided into myopia and hyperopia and with and without underlying amblyopia. The refractive error was expressed as sphere, cylinder, axis of astigmatism, and spherical equivalent. The treatment effect was summarized as the mean difference (95% confidence interval) for each outcome. No statistically significant difference was found on the axis and power of astigmatism before and after cycloplegia in the patients with amblyopia (P = .28 and .99, respectively). Non-cycloplegic autorefraction measurements may be considered safe for refining astigmatism power and axis in pediatric patients with amblyopia. [J Pediatr Ophthalmol Strabismus. 201X; XX(X):XXXX.]. Copyright 2018, SLACK Incorporated.

  4. Some Important Observations on the Populations of Hooded Vultures Necrosyrtes monachus in Urban Ghana

    Directory of Open Access Journals (Sweden)

    Francis Gbogbo

    2016-01-01

    Full Text Available Despite major declines in the population of vultures around the world, noticeable increases were reported in the populations of Hooded Vultures Necrosyrtes monachus over the past decade in Accra—an important vulture habitat in Ghana. In recent times, however, there is a growing concern that the vulture numbers are decreasing even though scientific data to support this is nonexisting. As a vital zoogeographical and conservation tool, it is important to keep an up-to-date knowledge about urban bird populations amidst rapid urbanization and associated changes. Using a combination of field data, literature review, and stakeholder consultations, it was indicative that severe decline might have indeed occurred in the populations of Hooded Vultures in Accra. Evidence suggests the killing of vultures for consumption, traditional medicine, and black magic in an undercover trade with possible transboundary connections as important underlying factor. Additional factors suspected to underlie the declines include changes in management of urban facilities and destruction of roosting and nesting trees. The implications of interspecific competition with Pied Crows Corvus albus on Hooded Vultures however remain unclear. There is an urgent need for conservation campaign and education to save the Hooded Vulture in Ghana.

  5. Urban population genetics of slum-dwelling rats (Rattus norvegicus) in Salvador, Brazil

    Science.gov (United States)

    Kajdacsi, Brittney; Costa, Federico; Hyseni, Chaz; Porter, Fleur; Brown, Julia; Rodrigues, Gorete; Farias, Helena; Reis, Mitermeyer G.; Childs, James E.; Ko, Albert I.; Caccone, Adalgisa

    2013-01-01

    Throughout the developing world, urban centers with sprawling slum settlements are rapidly expanding and invading previously forested ecosystems. Slum communities are characterized by untended refuse, open sewers, and overgrown vegetation, which promote rodent infestation. Norway rats (Rattus norvegicus), are reservoirs for epidemic transmission of many zoonotic pathogens of public health importance. Understanding the population ecology of R. norvegicus is essential to formulate effective rodent control strategies, as this knowledge aids estimation of the temporal stability and spatial connectivity of populations. We screened for genetic variation, characterized the population genetic structure, and evaluated the extent and patterns of gene flow in the urban landscape using 17 microsatellite loci in 146 rats from 9 sites in the city of Salvador, Brazil. These sites were divided between three neighborhoods within the city spaced an average of 2.7 km apart. Surprisingly, we detected very little relatedness among animals trapped at the same site and found high levels of genetic diversity, as well as structuring across small geographic distances. Most FST comparisons among sites were statistically significant, including sites Salvador, linked to the heterogeneous urban landscape. Future rodent control measures need to take into account the spatial and temporal linkage of rat populations in Salvador, as revealed by genetic data, to develop informed eradication strategies. PMID:24118116

  6. [Urban and population development of the city of Puebla and its metropolitan area].

    Science.gov (United States)

    Barbosa Prieto, A

    1991-12-01

    Metropolitanization has been considered an important problem of regional development in developing countries. Attitudes toward the metropolis have been ambivalent in Latin America. On the 1 hand the metropolis is viewed as an obstacle to development that absorbs resources from the zone of influence and incurs high social costs of urbanization, but on the hand it is also viewed as a form of achieving levels of economic efficiency comparable to those of developed countries. Metropolitan areas should not be viewed as isolated, but rather as important points of demographic and manpower attraction, poles of economic growth and technological and cultural innovation. "Urban areas" and "metropolitan zones" are distinct ways of defining and delimiting urban phenomena. Although there is no consensus as to the exact definitions of these 2 urban units, it is generally accepted that the urban area is the city itself as well as the contiguous built up area reaching in all directions to the onset of nonurban land uses such as forests territorial extension that includes the politico-administrative units with urban characteristics such as work places and residences for nonagricultural workers, and that maintain constant and intense socioeconomic interrelations with the central city. The process of urban planning in the metropolitan zone of Puebla, Mexico, began in institutional form in 1980 with master plans for the population centers of Puebla, Amozoc, San Andres and San Pedro Cholula, and Zacatelco in the state of Tlaxcala. In 1987., an attempt was made by the governments of the states of Puebla and Tlaxcala to develop a plan for the metropolitan zone as a single unit. Population growth was greater within the city of Puebla than in the metropolitan zone from 1960-80, but after 1980 growth in the outlying areas exceeded that in the center city. The population density of the city of Puebla declined from 160/hectare in 1950 to 76/hectare in 1990, the result of progressive dispersion

  7. Land development, land use, and urban sprawl in Puerto Rico integrating remote sensing and population census data.

    Science.gov (United States)

    Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez

    2007-01-01

    The island of Puerto Rico has both a high population density and a long history of ineffective land use planning. This study integrates geospatial technology and population census data to understand how people use and develop the lands. We define three new regions for Puerto Rico: Urban (16%), Densely Populated Rural (36%), and Sparsely Populated Rural (48%). Eleven...

  8. Population-Based Pediatric Reference Intervals in General Clinical Chemistry: A Swedish Survey.

    Science.gov (United States)

    Ridefelt, Peter

    2015-01-01

    Very few high quality studies on pediatric reference intervals for general clinical chemistry and hematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The Swedish survey included 701 healthy children. Reference intervals for general clinical chemistry and hematology were defined.

  9. Pediatric acute respiratory distress syndrome: Host factors in Down syndrome and the general population

    NARCIS (Netherlands)

    Bruijn, M.

    2013-01-01

    We find that Down syndrome is an important risk factor for developing acute respiratory distress syndrome (ARDS) in children, but the reason why remains to be elucidated. In addition, we find several differences between adult and pediatric ARDS. The association between C-reactive protein (CRP)

  10. Survivability of Existing Peripheral Intravenous Access Following Blood Sampling in a Pediatric Population.

    Science.gov (United States)

    O'Neil, Sheree W; Friesen, Mary Ann; Stanger, Debra; Trickey, Amber Williams

    2018-03-07

    Although pediatric patients report venipuncture as their most feared experience during hospitalization, blood sampling from peripheral intravenous accesses (PIVs) is not standard of care. Blood sampling from PIVs has long been considered by healthcare personnel to harm the access. In an effort to minimize painful procedures, pediatric nursing staff conducted a prospective, observational study to determine if blood sampling using existing PIVs resulted in the loss of the access. The ability to obtain the sample from the PIV was measured along with patient and PIV characteristics. Specimen collection using 100 existing PIVs was attempted on pediatric inpatients. Each PIV was observed for functionality, infiltration, occlusion, and dislodgement following collection and again in 4h. Frequencies of PIV loss and successful blood sampling were calculated. Patient age, PIV gauge, access site, and PIV age were evaluated for associations with successful sampling using chi-square tests, Fisher's exact tests, and logistic regression. PIV survivability was reported at 99%. The ability to obtain a complete specimen was reported at 76% and found to be significantly related to PIV age and site. Size of PIV and patient's age were not significantly related to successful sampling. Encouraging rates of PIV survivability and collectability suggest blood sampling from PIVs to be a valuable technique to minimize painful and distressful procedures. Nursing practice was changed in this pediatric department. Patients and families are saved the pain and distress of venipuncture. Nurses reported saving time and personal distress by avoiding the venipuncture procedure. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Population-Adjusted Street Connectivity, Urbanicity and Risk of Obesity in the U.S

    Science.gov (United States)

    Wang, Fahui; Wen, Ming; Xu, Yanqing

    2013-01-01

    Street connectivity, defined as the number of (3-way or more) intersections per area unit, is an important index of built environments as a proxy for walkability in a neighborhood. This paper examines its geographic variations across the rural-urban continuum (urbanicity), major racial-ethnic groups and various poverty levels. The population-adjusted street connectivity index is proposed as a better measure than the regular index for a large area such as county due to likely concentration of population in limited space within the large area. Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS), this paper uses multilevel modeling to analyze its association with physical activity and obesity while controlling for various individual and county-level variables. Analysis of data subsets indicates that the influences of individual and county-level variables on obesity risk vary across areas of different urbanization levels. The positive influence of street connectivity on obesity control is limited to the more but not the mostly urbanized areas. This demonstrates the value of obesogenic environment research in different geographic settings, helps us reconcile and synthesize some seemingly contradictory results reported in different studies, and also promotes that effective policies need to be highly sensitive to the diversity of demographic groups and geographically adaptable. PMID:23667278

  12. Frequency of Usher syndrome in two pediatric populations: Implications for genetic screening of deaf and hard of hearing children.

    Science.gov (United States)

    Kimberling, William J; Hildebrand, Michael S; Shearer, A Eliot; Jensen, Maren L; Halder, Jennifer A; Trzupek, Karmen; Cohn, Edward S; Weleber, Richard G; Stone, Edwin M; Smith, Richard J H

    2010-08-01

    Usher syndrome is a major cause of genetic deafness and blindness. The hearing loss is usually congenital and the retinitis pigmentosa is progressive and first noticed in early childhood to the middle teenage years. Its frequency may be underestimated. Newly developed molecular technologies can detect the underlying gene mutation of this disorder early in life providing estimation of its prevalence in at risk pediatric populations and laying a foundation for its incorporation as an adjunct to newborn hearing screening programs. A total of 133 children from two deaf and hard of hearing pediatric populations were genotyped first for GJB2/6 and, if negative, then for Usher syndrome. Children were scored as positive if the test revealed > or =1 pathogenic mutations in any Usher gene. Fifteen children carried pathogenic mutations in one of the Usher genes; the number of deaf and hard of hearing children carrying Usher syndrome mutations was 15/133 (11.3%). The population prevalence was estimated to be 1/6000. Usher syndrome is more prevalent than has been reported before the genome project era. Early diagnosis of Usher syndrome has important positive implications for childhood safety, educational planning, genetic counseling, and treatment. The results demonstrate that DNA testing for Usher syndrome is feasible and may be a useful addition to newborn hearing screening programs.

  13. Factors Associated with Physical Inactivity among Adult Urban Population of Puducherry, India: A Population Based Cross-sectional Study.

    Science.gov (United States)

    Newtonraj, Ariarathinam; Murugan, Natesan; Singh, Zile; Chauhan, Ramesh Chand; Velavan, Anandan; Mani, Manikandan

    2017-05-01

    Physical inactivity is the fourth leading cause of death worldwide. Increase in physical activity decreases the incidence of cardiovascular diseases, Type 2 diabetes, stroke, and improves psychological wellbeing. To study the level of physical inactivity among the adult population in an urban area of Puducherry in India and its associated risk factors. This cross-sectional study was conducted among 569 adult participants from an urban area of Pondicherry. The level of physical inactivity was measured by using WHO standard Global Physical Activity Questionnaire (GPAQ). Overall prevalence of physical inactivity in our study was 49.7% (CI: 45.6-53.8). Among the physically active people, contribution of physical activity by work was 77.4%, leisure time activities were 11.6% and transport time was 11%. Both men and women were equally inactive {Physically inactive among women was 50% (CI:44.1-55.9)} and {Physically inactive among men was 49.5% (CI:43.8-55.2)}. Prevalence of physical inactivity was increasing with increasing age. Non tobacco users were two times more active than tobacco users {Adjusted Odds Ratio: 2.183 (1.175- 4.057)}. Employed were more active as compared to retired {Adjusted Odds Ratio: 0.412 (0.171-0.991)}, students {Adjusted Odds Ratio: 0.456 (0.196-1.060)}, house wives {Adjusted Odds Ratio: 0.757 (0.509-1.127)} and unemployed {Adjusted Odds Ratio: 0.538 (0.271-1.068)}. Non alcoholics were only 0.34 times as active as alcoholics. Level of physical activity was found to be insufficient among adult urban population of Puducherry. Working adult population found to be active, that too due to their work pattern. There is a need to promote leisure time and travelling time physical activity.

  14. An optimum city size? The scaling relationship for urban population and fine particulate (PM_2_._5) concentration

    International Nuclear Information System (INIS)

    Han, Lijian; Zhou, Weiqi; Pickett, Steward T.A.; Li, Weifeng; Li, Li

    2016-01-01

    We utilize the distribution of PM_2_._5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality. We found: 1) The relationship varies greatly among continents and countries. Large cities in North America, Europe, and Latin America have better air quality than those in other continents, while those in China and India have the worst air quality. 2) The relationships between urban population size and PM_2_._5 concentration in large cities of different continents or countries were different. PM_2_._5 concentration in large cities in North America, Europe, and Latin America showed little fluctuation or a small increasing trend, but those in Africa and India represent a “U” type relationship and in China represent an inverse “U” type relationship. 3) The potential contribution of population to PM_2_._5 concentration was higher in the large cities in China and India, but lower in other large cities. - Highlights: • Urban population and PM_2_._5 concentration varies greatly among regions. • Urban population size increase does not always enhances PM_2_._5 concentration. • Population's potential contribution to PM_2_._5 concentration higher in China. - We utilize the distribution of PM_2_._5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality.

  15. Knowledge and perceptions of diabetes in urban and semi urban population of peshawar, pakistan

    International Nuclear Information System (INIS)

    Zuhaid, M.; Diju, I.U.

    2012-01-01

    Background: Diabetes mellitus is a major health issue in Pakistan. The aim of this study was to evaluate the knowledge and perceptions of diabetes in a sample population of Peshawar. Methods: This crosssectional, descriptive study was carried out in seven different localities of Peshawar. A sample of 305 residents were interviewed aged from 15-60 years and above, using a questionnaire specifically designed and translated into Urdu language for convenience of selected subjects. Results: Knowledge of diabetes was suboptimal. The mean percentages of correct responses to questions regarding three classical symptoms and given complications were 47.1% and 30.8%. Excessive sugar intake, obesity, family history, lack of physical activities and stress were acknowledged by 46.2%, 42.3%, 39.3%, 33.4%, and 31.8% of the subjects respectively. Presence of family history and level of education were recognised to be associated with more knowledge. Conclusion: There is lack of awareness of major risk factors and some complications of diabetes mellitus. Level of education is a significant predictor regarding. (author)

  16. Seroprevalence of hepatitis C and associated risk factors among an urban population in Haiti

    OpenAIRE

    Hepburn, Matthew J; Lawitz, Eric J

    2004-01-01

    Abstract Background The seroprevalence of hepatitis C varies substantially between countries and geographic regions. A better understanding of the seroprevalence of this disease, and the risk factors associated with seropositive status, supply data for the development of screening programs and provide insight into the transmission of the disease. The purpose of this investigation was to determine the seroprevalence of hepatitis C and associated risk factors in an urban population in Haiti. Me...

  17. Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

    Directory of Open Access Journals (Sweden)

    Saurabh Goel

    2009-06-01

    Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur.Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas.Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined.Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

  18. Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

    Directory of Open Access Journals (Sweden)

    Saurabh Goel

    2009-06-01

    Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur. Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas. Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined. Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

  19. Determining the drivers of population structure in a highly urbanized landscape to inform conservation planning.

    Science.gov (United States)

    Thomassen, Henri A; Harrigan, Ryan J; Semple Delaney, Kathleen; Riley, Seth P D; Serieys, Laurel E K; Pease, Katherine; Wayne, Robert K; Smith, Thomas B

    2018-02-01

    Understanding the environmental contributors to population structure is of paramount importance for conservation in urbanized environments. We used spatially explicit models to determine genetic population structure under current and future environmental conditions across a highly fragmented, human-dominated environment in Southern California to assess the effects of natural ecological variation and urbanization. We focused on 7 common species with diverse habitat requirements, home-range sizes, and dispersal abilities. We quantified the relative roles of potential barriers, including natural environmental characteristics and an anthropogenic barrier created by a major highway, in shaping genetic variation. The ability to predict genetic variation in our models differed among species: 11-81% of intraspecific genetic variation was explained by environmental variables. Although an anthropogenically induced barrier (a major highway) severely restricted gene flow and movement at broad scales for some species, genetic variation seemed to be primarily driven by natural environmental heterogeneity at a local level. Our results show how assessing environmentally associated variation for multiple species under current and future climate conditions can help identify priority regions for maximizing population persistence under environmental change in urbanized regions. © 2017 Society for Conservation Biology.

  20. [Prevalence of type 2 diabetes and obesity in two Chilean aboriginal populations living in urban zones].

    Science.gov (United States)

    Carrasco, Elena P; Pérez, Francisco B; Angel, Bárbara B; Albala, Cecilia B; Santos, J Luis M; Larenas, Gladys Y; Montalvo, Domingo V

    2004-10-01

    The prevalence of cardiovascular risk factors is increasing in aboriginal populations in Chile. To study the prevalence of obesity, type 2 diabetes and serum lipids in two aboriginal populations, Mapuche and Aymara, that were transferred from a rural to a urban environment. Two groups of subjects over 20 years were analyzed, Mapuche and Aymara. The Mapuche group was formed by 42 men and 105 women, living in four urban communities of Santiago, and an Aymara group formed by 42 men and 118 women, living in Arica, in Northern Chile. Anthropometric measurements, blood pressure, lipid profile, oral glucose tolerance test, fasting insulin and serum leptin were determined. The prevalence of type 2 diabetes was 6.9% in Aymara and 8.2% in Mapuche subjects. The frequency of glucose intolerance was similar in both groups, but greater among men. A total blood cholesterol over 200 mg/dl was observed in 43.1% of Aymara and 27.9% of Mapuche subjects (p Mapuche individuals, respectively (p= NS). The prevalence of type 2 diabetes and dyslipidemia in turban aboriginal populations is higher than that of their rural counterparts. A possible explanation for these results are changes in lifestyles that come along with urbanization, characterized by a high consumption of saturated fat and refined sugars and a low level of physical activity.

  1. The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

    Directory of Open Access Journals (Sweden)

    Sandel Megan T

    2009-05-01

    Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

  2. MITIGATION SCENARIOS FOR RESIDENTIAL FIRES IN DENSELY POPULATED URBAN SETTLEMENTS IN SUKAHAJI VILLAGE, BANDUNG CITY

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    Saut Aritua Hasiholan Sagala

    2016-10-01

    Full Text Available Residential fires are a form of disaster that often occurs in urban areas especially in densely populated settlements. This study looks at possible mitigation scenarios for this kind of disaster. A case study was conducted in Babakan Ciparay Sub-District in Bandung City, among the densely populated settlements, and was focused especially on Sukahaji Village, a sub-unit of Babakan Ciparay, which is the most densely populated village in Bandung City with up to 234.14 people/ha. There have been six structural fires recorded from 2007 until 2010 occurring in Sukahaji. This study applied stratified random sampling as the preferred sampling technique and data collection method from a total population of 3,227 buildings. The data was then examined using risk analysis. The results have led to two intervention measures suggested as mitigation scenarios for residential fires that can be applied within the Sukahaji Village. The study concludes that mitigation measures through strengthening community capacity can be the principal option in reducing risk to fires in densely populated urban settlements.

  3. Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population.

    Science.gov (United States)

    Fox, Stephanie J; Park, Miguel A

    2014-01-01

    Penicillin skin testing has been validated in the evaluation of adult patients with penicillin allergy. However, the commercially available benzylpenicilloyl polylysine (Pre-Pen) is not indicated in the pediatric population. Moreover, the safety and validity of penicillin skin testing in the pediatric population has not been well studied. We describe the safety and validity of penicillin skin testing in the evaluation of children with a history of penicillin allergy. Children (penicillin allergy were evaluated with penicillin skin tests and were reviewed for basic demographics, penicillin skin test results, adverse drug reaction to penicillin after penicillin skin test, and adverse reaction to penicillin skin test. By using the χ(2) test, we compared the differences in the proportion of children and adults with a positive penicillin skin test. P value (penicillin skin testing; 703 of 778 patients had a negative penicillin skin test (90.4%), 66 had a positive test (8.5%), and 9 had an equivocal test (1.1%). Children were more likely to have a positive penicillin skin test (P penicillin skin test (52%) were challenged with penicillin, and 14 of 369 patients (3.8%) had an adverse drug reaction. No adverse reactions to penicillin skin testing were observed. Penicillin skin testing was safe and effective in the evaluation of children with a history of penicillin allergy. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. Pleural effusion following blunt splenic injury in the pediatric trauma population.

    Science.gov (United States)

    Kulaylat, Afif N; Engbrecht, Brett W; Pinzon-Guzman, Carolina; Albaugh, Vance L; Rzucidlo, Susan E; Schubart, Jane R; Cilley, Robert E

    2014-09-01

    Pleural effusion is a potential complication following blunt splenic injury. The incidence, risk factors, and clinical management are not well described in children. Ten-year retrospective review (January 2000-December 2010) of an institutional pediatric trauma registry identified 318 children with blunt splenic injury. Of 274 evaluable nonoperatively managed pediatric blunt splenic injures, 12 patients (4.4%) developed left-sided pleural effusions. Seven (58%) of 12 patients required left-sided tube thoracostomy for worsening pleural effusion and respiratory insufficiency. Median time from injury to diagnosis of pleural effusion was 1.5days. Median time from diagnosis to tube thoracostomy was 2days. Median length of stay was 4days for those without and 7.5days for those with pleural effusions (psplenic injury (IV-V) (OR 16.5, p=0.001) was associated with higher odds of developing a pleural effusion compared to low-grade splenic injury (I-III). Pleural effusion following pediatric blunt splenic injury has an incidence of 4.4% and is associated with high-grade splenic injuries and longer lengths of stay. While some symptomatic patients may be successfully managed medically, many require tube thoracostomy for progressive respiratory symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Femoral nerve blockade using various concentrations of local anesthetic for knee arthroscopy in the pediatric population

    Directory of Open Access Journals (Sweden)

    Veneziano G

    2016-11-01

    mg/kg (interquartile ranges [IQR]: 0 mg, 0.03 mg/kg compared to 0.02 mg/kg (IQR: 0, 0.08 mg/kg in the ropivacaine 0.2% group and 0.01 mg/kg (IQR: 0, 0.08 mg/kg in the bupivacaine 0.25% group (p=0.009. Median PACU time was shortest in the ropivacaine 0.5% group (47 min; IQR: 36, 68 min compared to the ropivacaine 0.2% (58 min; IQR: 41, 77 and bupivacaine 0.25% (54 min; IQR: 35, 75 min groups (p=0.040. Among groups, there were no significant differences in first postoperative pain scores or incidence of nausea and vomiting. No patient in any group experienced a serious adverse event.Conclusion: The results suggest that ropivacaine 0.5% for FNB offers superior postoperative analgesia in the form of decreased postoperative opioid consumption and earlier PACU/hospital discharge, when compared to ropivacaine 0.2% and bupivacaine 0.25% in the pediatric population.Level of evidence: III, Retrospective Comparative Study. Keywords: anesthesia, regional, nerve block, pain, postoperative, local anesthetic, child, adolescent

  6. Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

    Science.gov (United States)

    Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira

    2017-07-01

    AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

  7. Normative data and discriminative properties of short form 36 (SF-36 in Turkish urban population

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    Akvardar Yildiz

    2006-10-01

    Full Text Available Abstract Background SF-36 has been both translated into different languages and adapted to different cultures to obtain comparable data on health status internationally. However there have been only a limited number of studies focused on the discriminative ability of SF-36 regarding social and disease status in developing countries. The aim of this study was to obtain population norms of the short form 36 (SF-36 health survey and the association of SF-36 domains with demographic and socioeconomic variables in an urban population in Turkey. Methods A cross-sectional study. Face to face interviews were carried out with a sample of households. The sample was systematically selected from two urban Health Districts in Izmir, Turkey. The study group consisted of 1,279 people selected from a study population of 46,290 people aged 18 and over. Results Internal consistencies of the scales were high, with the exception of mental health and vitality. Physical health scales were associated with both age and gender. On the other hand, mental health scales were less strongly associated with age and gender. Women reported poorer health compared to men in general. Social risk factors (employment status, lower education and economic strain were associated with worse health profiles. The SF-36 was found to be capable of discriminating disease status. Conclusion Our findings, cautiously generalisable to urban population, suggest that the SF-36 can be a valuable tool for studies on health outcomes in Turkish population. SF-36 may also be a promising measure for research on health inequalities in Turkey and other developing countries.

  8. Urban dogs in rural areas: Human-mediated movement defines dog populations in southern Chile.

    Science.gov (United States)

    Villatoro, Federico J; Sepúlveda, Maximiliano A; Stowhas, Paulina; Silva-Rodríguez, Eduardo A

    2016-12-01

    Management strategies for dog populations and their diseases include reproductive control, euthanasia and vaccination, among others. However, the effectiveness of these strategies can be severely affected by human-mediated dog movement. If immigration is important, then the location of origin of dogs imported by humans will be fundamental to define the spatial scales over which population management and research should apply. In this context, the main objective of our study was to determine the spatial extent of dog demographic processes in rural areas and the proportion of dogs that could be labeled as immigrants at multiple spatial scales. To address our objective we conducted surveys in households located in a rural landscape in southern Chile. Interviews allowed us to obtain information on the demographic characteristics of dogs in these rural settings, human influence on dog mortality and births, the localities of origin of dogs living in rural areas, and the spatial extent of human-mediated dog movement. We found that most rural dogs (64.1%) were either urban dogs that had been brought to rural areas (40.0%), or adopted dogs that had been previously abandoned in rural roads (24.1%). Some dogs were brought from areas located as far as ∼700km away from the study area. Human-mediated movement of dogs, especially from urban areas, seems to play a fundamental role in the population dynamics of dogs in rural areas. Consequently, local scale efforts to manage dog populations or their diseases are unlikely to succeed if implemented in isolation, simply because dogs can be brought from surrounding urban areas or even distant locations. We suggest that efforts to manage or study dog populations and related diseases should be implemented using a multi-scale approach. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. A clinico-epidemiological study of pediatric leprosy in the urban leprosy center of a tertiary care institute

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    Sukumaran Pradeep Nair

    2017-01-01

    Conclusions: This study showed a prevalence of 6.65% of pediatric leprosy cases. BT was the most common type of leprosy, and the prevalence of lepromatous leprosy, lepra reactions, and deformity was low.

  10. Key Challenges in the Search for Innovative Drug Treatments for Special Populations. Converging Needs in Neonatology, Pediatrics, and Medical Genetics.

    Science.gov (United States)

    MacLeod, Stuart

    2017-08-04

    The explosion of knowledge concerning the interplay of genetic and environmental factors determining pathophysiology and guiding therapeutic choice has altered the landscape in pediatric clinical pharmacology and pharmacy. The need for innovative research methods and design expertise for small clinical trials to be undertaken in sparse populations has been accentuated. At the same time, shortfalls in critical human resources represent a key challenge, especially in low- and middle-income countries where the need for new research and education directions is greatest. Unless a specific action plan is urgently developed, there will be a continuing gap in availability of the essential expertise needed to address treatment challenges in special patient populations such as neonates, patients suffering from rare or neglected diseases, and children of all ages.

  11. Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations.

    Science.gov (United States)

    Amoah, Padmore Adusei; Edusei, Joseph; Amuzu, David

    2018-05-13

    Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare.

  12. Plasma carotenoids are associated with socioeconomic status in an urban Indigenous population: an observational study

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    Maple-Brown Louise

    2011-02-01

    Full Text Available Abstract Background Indigenous Australians experience poorer health than other Australians. Poor diet may contribute to this, and be related to their generally lower socioeconomic status (SES. Even within Indigenous populations, SES may be important. Our aim was to identify factors associated with plasma carotenoids as a marker of fruit and vegetable intake among urban dwelling Indigenous Australians, with a particular focus on SES. Methods Cross sectional study in urban dwelling Indigenous Australians participating in the DRUID (Darwin Region Urban Indigenous Diabetes Study. An SES score, based on education, employment, household size, home ownership and income was computed and plasma carotenoids measured by high performance liquid chromatography in 897 men and women aged 15 - 81 years (mean 36, standard deviation 15. Linear regression analysis was used to determine the relationship between SES and plasma carotenoids, adjusting for demographic, health and lifestyle variables, including frequency of intakes of food groups (fruit, vegetables, takeaway foods, snacks and fruit/vegetable juice. Results SES was positively associated with plasma concentrations of lutein/zeaxanthin (p trend Conclusions Even within urban Indigenous Australians, higher SES was associated with higher concentrations of plasma carotenoids. Low plasma carotenoids have been linked with poor health outcomes; increasing accessibility of fruit and vegetables, as well as reducing smoking rates could increase concentrations and otherwise improve health, but our results suggest there may be additional factors contributing to lower carotenoid concentrations in Indigenous Australians.

  13. Social Stigma, Social Capital Reconstruction and Rural Migrants in Urban China: A Population Health Perspective.

    Science.gov (United States)

    Chen, Xinguang; Stanton, Bonita; Kaljee, Linda M; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua; Zhang, Liying; Li, Xiaoming

    2011-01-01

    In this study, we examine migrant stigma and its effect on social capital reconstruction among rural migrants who possess legal rural residence but live and work in urban China. After a review of the concepts of stigma and social capital, we report data collected through in-depth interviews with 40 rural migrant workers and 38 urban residents recruited from Beijing, China. Findings from this study indicate that social stigma against rural migrants is common in urban China and is reinforced through media, social institutions and their representatives, and day-to-day interactions. As an important part of discrimination, stigma against migrant workers creates inequality, undermines trust, and reduces opportunities for interpersonal interactions between migrants and urban residents. Through these social processes, social stigma interferes with the reconstruction of social capital (including bonding, bridging and linking social capital) for individual rural migrants as well as for their communities. The interaction between stigma and social capital reconstruction may present as a mechanism by which migration leads to negative health consequences. Results from this study underscore the need for taking measures against migrant stigma and alternatively work toward social capital reconstruction for health promotion and disease prevention among this population.

  14. SOME ASPECTS OF FEATURES CONCEPT AND NATURE OF ENVIRONMENTAL SAFETY LIFE URBAN POPULATION

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    Kirova M.

    2017-05-01

    Full Text Available Proved the concept and nature of the environmental safety of life of the urban population. A structural levels in the list of objects to enter the security levels of urban or rural communities of local communities, which changes the nature of the institutional environment environmental security. In assessing the quality of life of urban society used many parameters of socio-economic and environmental. General rules on the prevention of environmental degradation and risks to human health set forth in the applicable law "On Environmental Protection", on the basis of which developed a number of legal documents. As for the capital of Ukraine - Kyiv, it is a great cultural, historical and commercial and industrial center. So we can safely say that Kyiv is characterized by all the environmental problems that are inherent in all large cities. This, above all, traffic pollution, changes in the air quality, noise pollution, emissions of chemicals into the atmosphere, pollution, toxic waste, the problem of waste. But a special place in this region occupies a radioactive problem due to the Chernobyl nuclear power plant. Also, nearby, in the Kyiv region Kiev reservoir are with not the best environmental conditions. The most important components of ecosystems: the air of the city, urban and suburban water sources, soil city. International experts conducted a study in 215 cities around the world. Kyiv international ranking is 29 in place pollution. Thus, the problem of environmental security for the population of the city. Kyiv, as many large cities in Ukraine is quite relevant. In this regard, the article studies that the environmental safety of life of the urban population in the context of national security - a state of effective security systems (environment interconnected structural levels of the individual, the local community, society, state and international (global community of aggregate factors that endanger or threaten the very existence of which

  15. Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever Among Rural and Urban Populations of Northern Vietnam.

    Science.gov (United States)

    Trung, Nguyen Vu; Hoi, Le Thi; Thuong, Nguyen Thi Hong; Toan, Tran Khanh; Huong, Tran Thi Kieu; Hoa, Tran Mai; Fox, Annette; Kinh, Nguyen van; van Doorn, H Rogier; Wertheim, Heiman F L; Bryant, Juliet E; Nadjm, Behzad

    2017-05-01

    AbstractRickettsial infections are recognized as important causes of fever throughout southeast Asia. Herein, we determined the seroprevalence to rickettsioses within rural and urban populations of northern Vietnam. Prevalence of individuals with evidence of prior rickettsial infections (IgG positive) was surprisingly low, with 9.14% (83/908) testing positive to the three major rickettsial serogroups thought to circulate in the region. Prevalence of typhus group rickettsiae (TG)-specific antibodies (6.5%, 58/908) was significantly greater than scrub typhus group orientiae (STG)- or spotted fever group rickettsiae (SFG)-specific antibodies ( P < 0.05). The majority of TG seropositives were observed among urban rather than rural residents ( P < 0.05). In contrast, overall antibody prevalence to STG and SFG were both very low (1.1%, 10/908 for STG; 1.7%, 15/908 for SFG), with no significant differences between rural and urban residents. These results provide data on baseline population characteristics that may help inform development of Rickettsia serological testing criteria in future clinical studies.

  16. Screening mammography uptake within Australia and Scotland in rural and urban populations.

    Science.gov (United States)

    Leung, Janni; Macleod, Catriona; McLaughlin, Deirdre; Woods, Laura M; Henderson, Robert; Watson, Angus; Kyle, Richard G; Hubbard, Gill; Mullen, Russell; Atherton, Iain

    2015-01-01

    To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography.

  17. Urban "accidental" wetlands mediate water quality and heat exposure for homeless populations in a desert city

    Science.gov (United States)

    Palta, M.

    2015-12-01

    In urban settings where humans interact in complex ways with ecosystems, there may be hidden or unanticipated benefits (services) or harm (disservices) conferred by the built environment. We examined interactions of a highly vulnerable population, the homeless, with urban waterways and wetlands in the desert city of Phoenix, Arizona, U.S.A. Climate change models project increases in heat, droughts, and extreme floods for the southwestern U.S. These projected changes pose a number of problems for sustainability and quality of future water supply, and the ability of human populations to mitigate heat stress and avoid fatalities. Urban wetlands that are created "accidentally" (by water pooling in abandoned areas of the landscape) have many structural (e.g., soils and hydrology) and functional (e.g., high denitrification) elements that mimic natural, unaltered aquatic systems. Accidental wetland systems in the dry bed of the Salt River, fed by storm and waste water from urban Phoenix, are located within economically depressed sections of the city, and show the potential for pollutant and heat mitigation. We used a mixed-method socio-ecological approach to examine wetland ecosystem functions and the ways in which homeless populations utilize Salt River wetlands for ecosystem services. Interviews and trash surveys indicated that homeless people are accessing and utilizing the wetlands as a source of running water, for sanitary and heat mitigation services, and for recreation and habitation. Environmental monitoring demonstrated that the wetlands can provide a reliable source of running water, nutrient and pathogen removal, heat mitigation, and privacy, but they may also pose a health risk to individuals coming in contact with the water through drinking or bathing. Whether wetlands provided a net benefit vs. harm varied according to site, season, and particular service, and several tradeoffs were identified. For example, heat is highest during the summer storm season

  18. Measuring urban agglomeration using a city-scale dasymetric population map: A study in the Pearl River Delta, China

    OpenAIRE

    Wei, Chunzhu; Taubenböck, Hannes; Blaschke, Thomas

    2017-01-01

    The rates of urbanization and increase in urban sprawl that have occurred in China over the past thirty years have been unprecedented. This article presents a new city-scale dasymetric modelling approach that incorporates historical census data for 28 cities in the Pearl River Delta area of southern China. It combines Landsat imagery (from 2000, 2005, 2010, and 2015) with a ‘limiting variable’ estimation al-gorithm to generate a gridded estimate of population density. These gridded population...

  19. Does higher body mass index contribute to worse asthma control in an urban population?

    Science.gov (United States)

    Clerisme-Beaty, Emmanuelle M; Karam, Sabine; Rand, Cynthia; Patino, Cecilia M; Bilderback, Andrew; Riekert, Kristin A; Okelo, Sande O.; Diette, Gregory B.

    2009-01-01

    Background Epidemiologic findings support a positive association between asthma and obesity. Objective Determine whether obesity or increasing level of body mass index (BMI) are associated with worse asthma control in an ethnically diverse urban population. Methods Cross sectional assessment of asthma control was done in asthmatics recruited from primary care offices using four different validated asthma control questionnaires: the Asthma Control and Communication Instrument (ACCI), the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ) and the Asthma Therapy Assessment Questionnaire (ATAQ). Multiple linear regression analysis was performed to evaluate the association between obesity and increasing BMI level and asthma control. Results Of 292 subjects mean age of 47 years, the majority were women (82%) and African American (67%). There was a high prevalence of obesity with 63%, with only 15% being normal weight. The mean score from all four questionnaires showed an average sub-optimal asthma control (mean score/maximum possible score): ACCI (8.3/19), ACT (15.4/ 25), ACQ (2.1/ 6), and ATAQ (1.3/ 4). Regression analysis showed no association between obesity or increasing BMI level and asthma control using all four questionnaires. This finding persisted even after adjusting for FEV1, smoking status, race, gender, selected co-morbid illnesses, and long-term asthma controller use. Conclusion Using four validated asthma control questionnaires, we failed to find an association between obesity and asthma control in an urban population with asthma. Weight loss may not be an appropriate strategy to improve asthma control in this population. Capsule Summary Using four different validated asthma control measures, there was no association between obesity or increasing body mass index and asthma control in a largely obese urban outpatient minority population. PMID:19615731

  20. Comparison of the New Adult Ventilator-Associated Event Criteria to the Centers for Disease Control and Prevention Pediatric Ventilator-Associated Pneumonia Definition (PNU2) in a Population of Pediatric Traumatic Brain Injury Patients.

    Science.gov (United States)

    Cirulis, Meghan M; Hamele, Mitchell T; Stockmann, Chris R; Bennett, Tellen D; Bratton, Susan L

    2016-02-01

    The new Centers for Disease Control and Prevention paradigm for ventilator-associated events is intended to simplify surveillance of infectious and noninfectious complications of mechanical ventilation in adults. We assessed the ventilator-associated events algorithm in pediatric patients. A retrospective observational cohort study. This single-center study took place in a PICU at an urban academic medical facility. Pediatric (ages 0-18 yr old) trauma patients with moderate-to-severe traumatic brain injury ventilated for greater than or equal to 2 days. We assessed for pediatric ventilator-associated pneumonia (as defined by current Centers for Disease Control and Prevention PNU2 guidelines), adult ventilator-associated events, and an experimental ventilator-associated events definition modified for pediatric patients. We compared ventilator-associated events to ventilator-associated pneumonia to calculate the test characteristics. Thirty-nine of 119 patients (33%) developed ventilator-associated pneumonia. Sensitivity of the adult ventilator-associated condition definition was 23% (95% CI, 11-39%), which increased to 56% (95% CI, 40-72%) using the modified pediatric ventilator-associated pneumonia criterion. Specificity reached 100% for both original and modified pediatric probable ventilator-associated pneumonia using ventilator-associated events criteria. Children who developed ventilator-associated pneumonia or ventilator-associated condition had similar baseline characteristics: age, mechanism of injury, injury severity scores, and use of an intracranial pressure monitor. Diagnosis of ventilator-associated pneumonia and ventilator-associated condition portended similarly unfavorable outcomes: longer median duration of ventilation, ICU and hospital length of stay, and more discharges to rehabilitation, home health, or nursing care compared with patients with no pulmonary complication. Both current and modified ventilator-associated events criteria have poor

  1. Characteristics of Prolonged Concussion Recovery in a Pediatric Subspecialty Referral Population

    Science.gov (United States)

    Corwin, Daniel J.; Zonfrillo, Mark R.; Master, Christina L.; Arbogast, Kristy B.; Grady, Matthew F.; Robinson, Roni L.; Goodman, Arlene M.; Wiebe, Douglas J.

    2014-01-01

    Objective To identify pre-existing characteristics associated with prolonged recovery from concussion in a sample of patients referred to a pediatric sports medicine clinic. Study design This was a retrospective, exploratory cohort study of 247 patients age 5-18 years old with concussion referred to a tertiary pediatric hospital-affiliated sports medicine clinic from July 1, 2010, through December 31, 2011. A random sample of all eligible patient visits (3740) was chosen for further review and abstraction. Statistical comparisons between subsets of patients were conducted using exact chi-square tests, logistic regression, quantile regression, and Kaplan Meier survival curves. Results The median time until returning to school part-time was 12 days (interquartile range (IQR) 6-21); until returning to school full-time without accommodations was 35 days (IQR 11-105); until becoming symptom-free was 64 days (IQR 18-119); and until being fully cleared to return to sports was 75 days (IQR 30-153). 73% of all patients were symptomatic for >4 weeks, 73% were prescribed some form of school accommodation, and 61% reported a decline in grades. Characteristics associated with a prolonged recovery included a history of depression or anxiety; an initial complaint of dizziness; abnormal convergence or symptom provocation following oculomotor examination on physical examination; and history of prior concussion. Conclusion Pediatric and adolescent patients with concussion may experience cognitive and emotional morbidity that can last for several months following injury. Clinicians should consider specific pre-existing characteristics and presenting symptoms that may be associated with a more complicated recovery for concussion patients. PMID:25262302

  2. [Population in the northern border area. Urban dynamism and binational interrelation].

    Science.gov (United States)

    Ham Chande, R

    1988-01-01

    The 3300 km border between Mexico and the US constitutes the geopolitical separation between an underdeveloped country on the 1 hand and 1 of the most technologically and economically powerful countries in the world on the other. The border region is characterized by the contrasts on either side of the border and by the strong interrelation between both sides. Vast streams of persons, merchandise, money, services, communications, and cultural influences flow from 1 side to the other. The border region as a seat of population has a recent history. The border was defined in near current form only in the mid-19th century, when the expansionist tendencies of the US encountered a vast area of very sparse population. In 1900, the principal localities of the border zone had only about 39,000 inhabitants, of whom fewer than 5000 lived west of Ciudad Juarez. Between 1910-20, the population of the border region increased from 53,000 to 96,000 as a result of migrants fleeing the ravages of the revolution. The population of the border region was estimated at 3.826 million in 1988, resulting from rates of growth above Mexico's national average. Settlement in the area has depended on events and conditions in Mexico and on such US occurrences as Prohibition, the Great Depression, the 2nd World War, the Bracero program, and the Program of Border Industrialization. 82% of the border population lives in urban zones, partly because of lack of water. 80% of the urban population is concentrated in 6 cities, Juarez, Tijuana, Mexicali, Nuevo Laredo, Reynosa, and Matamoros. Much of the population of the 6 cities is composed of persons born elsewhere. The border area also has a large floating population of undocumented migrants in transit to or from the US. The high rates of urbanization and of binational interaction are reflected in demographic dynamics. In 1979, 71% of women in union in the border area vs 54% in the rest of Mexico had used contraception, and the infant mortality rate was

  3. Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

    Science.gov (United States)

    Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

    2015-07-01

    Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

  4. Prevalence of ischemic heart disease among urban population of Siliguri, West Bengal

    Directory of Open Access Journals (Sweden)

    Mandal Sukanta

    2009-01-01

    Full Text Available Objectives: To determine the prevalence of ischemic heart disease and the associated risk factors among the urban population of Siliguri. Materials and Methods: A cross-sectional survey of a random sample of the population aged ≥40 years old in the Municipal Corporation area of Siliguri. Study variables were age, sex, occupation, addiction, food habit, physical activity, body mass index, blood pressure, and electrocardiogram change. Results: Out of 250 individuals who took part in this study, 29 (11.6% had ischemic heart disease (IHD and 118 (47.2% had hypertension. Males had a higher (13.5% prevalence of IHD than females (9.4%. About 5% of the patients had asymptomatic IHD. IHD among the study population is significantly associated with hypertension and smoking.

  5. Population pharmacokinetics of methylphenidate hydrochloride extended-release multiple-layer beads in pediatric subjects with attention deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Teuscher NS

    2015-05-01

    Full Text Available Nathan S Teuscher,1 Akwete Adjei,2 Robert L Findling,3,4 Laurence L Greenhill,5 Robert J Kupper,2 Sharon Wigal6 1PK/PD Associates, Trophy Club, TX, 2Rhodes Pharmaceuticals L.P., Coventry, RI, 3Department of Psychiatric Services and Research, Kennedy Krieger Institute, Baltimore, MD, 4Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 5Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, 6AVIDA Inc., Newport Beach, CA, USA Abstract: A new multilayer-bead formulation of extended-release methylphenidate hydrochloride (MPH-MLR has been evaluated in pharmacokinetic studies in healthy adults and in Phase III efficacy/safety studies in children and adolescents with attention deficit hyperactivity disorder (ADHD. Using available data in healthy adults, a two-input, one-compartment, first-order elimination population pharmacokinetic model was developed using nonlinear mixed-effect modeling. The model was then extended to pediatric subjects, and was found to adequately describe plasma concentration–time data for this population. A pharmacokinetic/pharmacodynamic model was also developed using change from baseline in the ADHD Rating Scale (ADHD-RS-IV total scores from a pediatric Phase III trial and simulated plasma concentration–time data. During simulations for each MPH-MLR dose level (10–80 mg, increased body weight resulted in decreased maximum concentration. Additionally, as maximum concentration increased, ADHD-RS-IV total score improved (decreased. Knowledge of the relationship between dose, body weight, and clinical response following the administration of MPH-MLR in children and adolescents may be useful for clinicians selecting initial dosing of MPH-MLR. Additional study is needed to confirm these results. Keywords: population pharmacokinetics, Aptensio XR™, MPH-MLR, methylphenidate

  6. Population Density, Climate Variables and Poverty Synergistically Structure Spatial Risk in Urban Malaria in India.

    Science.gov (United States)

    Santos-Vega, Mauricio; Bouma, Menno J; Kohli, Vijay; Pascual, Mercedes

    2016-12-01

    The world is rapidly becoming urban with the global population living in cities projected to double by 2050. This increase in urbanization poses new challenges for the spread and control of communicable diseases such as malaria. In particular, urban environments create highly heterogeneous socio-economic and environmental conditions that can affect the transmission of vector-borne diseases dependent on human water storage and waste water management. Interestingly India, as opposed to Africa, harbors a mosquito vector, Anopheles stephensi, which thrives in the man-made environments of cities and acts as the vector for both Plasmodium vivax and Plasmodium falciparum, making the malaria problem a truly urban phenomenon. Here we address the role and determinants of within-city spatial heterogeneity in the incidence patterns of vivax malaria, and then draw comparisons with results for falciparum malaria. Statistical analyses and a phenomenological transmission model are applied to an extensive spatio-temporal dataset on cases of Plasmodium vivax in the city of Ahmedabad (Gujarat, India) that spans 12 years monthly at the level of wards. A spatial pattern in malaria incidence is described that is largely stationary in time for this parasite. Malaria risk is then shown to be associated with socioeconomic indicators and environmental parameters, temperature and humidity. In a more dynamical perspective, an Inhomogeneous Markov Chain Model is used to predict vivax malaria risk. Models that account for climate factors, socioeconomic level and population size show the highest predictive skill. A comparison to the transmission dynamics of falciparum malaria reinforces the conclusion that the spatio-temporal patterns of risk are strongly driven by extrinsic factors. Climate forcing and socio-economic heterogeneity act synergistically at local scales on the population dynamics of urban malaria in this city. The stationarity of malaria risk patterns provides a basis for more

  7. Population Density, Climate Variables and Poverty Synergistically Structure Spatial Risk in Urban Malaria in India.

    Directory of Open Access Journals (Sweden)

    Mauricio Santos-Vega

    2016-12-01

    Full Text Available The world is rapidly becoming urban with the global population living in cities projected to double by 2050. This increase in urbanization poses new challenges for the spread and control of communicable diseases such as malaria. In particular, urban environments create highly heterogeneous socio-economic and environmental conditions that can affect the transmission of vector-borne diseases dependent on human water storage and waste water management. Interestingly India, as opposed to Africa, harbors a mosquito vector, Anopheles stephensi, which thrives in the man-made environments of cities and acts as the vector for both Plasmodium vivax and Plasmodium falciparum, making the malaria problem a truly urban phenomenon. Here we address the role and determinants of within-city spatial heterogeneity in the incidence patterns of vivax malaria, and then draw comparisons with results for falciparum malaria.Statistical analyses and a phenomenological transmission model are applied to an extensive spatio-temporal dataset on cases of Plasmodium vivax in the city of Ahmedabad (Gujarat, India that spans 12 years monthly at the level of wards. A spatial pattern in malaria incidence is described that is largely stationary in time for this parasite. Malaria risk is then shown to be associated with socioeconomic indicators and environmental parameters, temperature and humidity. In a more dynamical perspective, an Inhomogeneous Markov Chain Model is used to predict vivax malaria risk. Models that account for climate factors, socioeconomic level and population size show the highest predictive skill. A comparison to the transmission dynamics of falciparum malaria reinforces the conclusion that the spatio-temporal patterns of risk are strongly driven by extrinsic factors.Climate forcing and socio-economic heterogeneity act synergistically at local scales on the population dynamics of urban malaria in this city. The stationarity of malaria risk patterns provides a

  8. Predicting symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network in a pediatric population.

    Science.gov (United States)

    Skoch, Jesse; Tahir, Rizwan; Abruzzo, Todd; Taylor, John M; Zuccarello, Mario; Vadivelu, Sudhakar

    2017-12-01

    Artificial neural networks (ANN) are increasingly applied to complex medical problem solving algorithms because their outcome prediction performance is superior to existing multiple regression models. ANN can successfully identify symptomatic cerebral vasospasm (SCV) in adults presenting after aneurysmal subarachnoid hemorrhage (aSAH). Although SCV is unusual in children with aSAH, the clinical consequences are severe. Consequently, reliable tools to predict patients at greatest risk for SCV may have significant value. We applied ANN modeling to a consecutive cohort of pediatric aSAH cases to assess its ability to predict SCV. A retrospective chart review was conducted to identify patients met study inclusion criteria. The median age for aSAH patients was 15 years. Ten underwent surgical clipping and 6 underwent endovascular coiling for definitive treatment. One patient experienced SCV and 15 did not. The ANN applied here was able to accurately predict all 16 outcomes. The mean strength of prediction for those who did not exhibit SCV was - 0.86. The strength for the one patient who did exhibit SCV was 0.93. Adult-derived aneurysmal SAH value nodes can be applied to a simple AAN model to accurately predict SCV in children presenting with aSAH. Further work is needed to determine if ANN models can prospectively predict SCV in the pediatric aSAH population in toto; adapted to include mycotic, traumatic, and flow-related origins as well.

  9. A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population.

    Science.gov (United States)

    Silva, Leni Verônica de Oliveira; Arruda, José Alcides Almeida; Martelli, Stephanie Joana; Kato, Camila de Nazaré Alves de Oliveira; Nunes, Laiz Fernanda Mendes; Vasconcelos, Ana Carolina Uchoa; Tarquinio, Sandra Beatriz Chaves; Gomes, Ana Paula Neutzling; Gomez, Ricardo Santiago; Mesquita, Ricardo Alves; Silveira, Marcia Maria Fonseca da; Sobral, Ana Paula Veras

    2018-03-15

    The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

  10. Prevalence and causes of low vision and blindness in an urban population: The Chennai Glaucoma Study.

    Science.gov (United States)

    Vijaya, Lingam; George, Ronnie; Asokan, Rashima; Velumuri, Lokapavani; Ramesh, Sathyamangalam Ve

    2014-04-01

    To evaluate the prevalence and causes of low vision and blindness in an urban south Indian population. Population-based cross-sectional study. Exactly 3850 subjects aged 40 years and above from Chennai city were examined at a dedicated facility in the base hospital. All subjects had a complete ophthalmic examination that included best-corrected visual acuity. Low vision and blindness were defined using World Health Organization (WHO) criteria. The influence of age, gender, literacy, and occupation was assessed using multiple logistic regression. Chi-square test, t-test, and multivariate analysis were used. Of the 4800 enumerated subjects, 3850 subjects (1710 males, 2140 females) were examined (response rate, 80.2%). The prevalence of blindness was 0.85% (95% CI 0.6-1.1%) and was positively associated with age and illiteracy. Cataract was the leading cause (57.6%) and glaucoma was the second cause (16.7%) for blindness. The prevalence of low vision was 2.9% (95% CI 2.4-3.4%) and visual impairment (blindness + low vision) was 3.8% (95% CI 3.2-4.4%). The primary causes for low vision were refractive errors (68%) and cataract (22%). In this urban population based study, cataract was the leading cause for blindness and refractive error was the main reason for low vision.

  11. Studies on manifestations of canine distemper virus infection in an urban dog population.

    Science.gov (United States)

    Blixenkrone-Møller, M; Svansson, V; Have, P; Orvell, C; Appel, M; Pedersen, I R; Dietz, H H; Henriksen, P

    1993-10-01

    An upsurge of canine distemper was recognized at the beginning of 1991 in the urban dog population of the Copenhagen area. The outbreak had the characteristics of a virulent morbillivirus introduction in a partly immune population, where the disease primarily was manifested in young individuals. Testing of single serum samples for the presence of canine distemper virus (CDV) IgM antibodies using an IgM ELISA confirmed current and recent CDV infections in an urban dog population, where the use of attenuated CDV vaccines was widespread. In 49 out of 66 sera from clinical cases suspected of canine distemper we detected CDV IgM antibodies, as compared to the detection of viral antigen by indirect immunofluorescence in 27 of 65 specimens of conjunctival cells. The antigenic make-up of isolates from acute and subacute clinical cases was investigated with a panel of 51 monoclonal antibodies directed against CDV and the related phocine distemper virus. The isolates exhibited an homogeneous reaction pattern and shared overall antigenic characteristics of the CDV prototype. The majority of cases were diagnosed among unvaccinated dogs and individuals with unknown or obscure vaccination record. However, severe clinical cases were also diagnosed in vaccinated individuals.

  12. [Use of psychoactive substances and contraceptive methods by the Brazilian urban population, 2005].

    Science.gov (United States)

    Bastos, Francisco I; Cunha, Cynthia B; Bertoni, Neilane

    2008-06-01

    To analyze the relationship between utilization patterns for condoms and other contraceptive methods and the consumption of alcohol and drugs. Exploratory study based on data from a probabilistic sample of 5,040 interviewees aged 16 to 65 years living in large urban regions of Brazil in 2005. The data were collected by means of questionnaires. The chi-square automatic interaction classification tree technique was used to study the use of condoms among interviewees of both sexes and other contraceptive methods among women, at the time of the last vaginal sexual intercourse. Among young and middle-aged adults of both sexes and young men in stable relationships, condom use was less frequent among those who said they used psychoactive substances (alcohol and/or illegal drugs). The possible modulating effect of psychoactive substances on contraceptive practices among mature women seems to be more straightforward, compared to the more subtle effects observed among younger women, for whom the different social classes they belonged to seemed to play a more important role. Despite the limitations resulting from an exploratory study, the fact that this was a representative sample of the urban population of Brazil and not from vulnerable populations, reinforces the need to implement integrated public policies directed towards the general population, with regard to preventing drug consumption, alcohol abuse, sexually transmitted infections, HIV/AIDS and unwanted pregnancy and promoting sexual and reproductive health.

  13. Morphometric characteristics of sycamore maple (Acer pseudoplatanus L. fruits in Novi Sad urban populations

    Directory of Open Access Journals (Sweden)

    Kostić Saša

    2017-01-01

    Full Text Available This paper shows the results of the analysis of the fruit morphometric characteristics of 29 trees of sycamore maple (Acer pseudoplatanus L. and red - leaf sycamore maple (Acer pseudoplatanus ‘Аtropurpureum’ Späth. in Novi Sad area. Based on the test trees, it can be concluded that the analyzed secondary population of sycamore maple has a high level of intra - populations variability, based on different degrees of variability of measured parameters and statistically significant differences of all analyzed parameters within the analysed genotypes. The results indicate that there are certain differences between fruit of sycamore maple and its red - leaf variety. Given that there is no statistically significant difference between sites and different urban spaces, it can be concluded that stress factors caused by a high degree of urbanity do not affect the morphometric characteristics of fruits in the analyzed test trees. Testing the symmetry of fruits indicates a high level of genetic variability within the analyzed population.

  14. Prevalence and causes of low vision and blindness in an urban population: The Chennai Glaucoma Study

    Directory of Open Access Journals (Sweden)

    Lingam Vijaya

    2014-01-01

    Full Text Available Aim: To evaluate the prevalence and causes of low vision and blindness in an urban south Indian population. Settings and Design: Population-based cross-sectional study. Exactly 3850 subjects aged 40 years and above from Chennai city were examined at a dedicated facility in the base hospital. Materials and Methods: All subjects had a complete ophthalmic examination that included best-corrected visual acuity. Low vision and blindness were defined using World Health Organization (WHO criteria. The influence of age, gender, literacy, and occupation was assessed using multiple logistic regression. Statistical Analysis: Chi-square test, t-test, and multivariate analysis were used. Results: Of the 4800 enumerated subjects, 3850 subjects (1710 males, 2140 females were examined (response rate, 80.2%. The prevalence of blindness was 0.85% (95% CI 0.6-1.1% and was positively associated with age and illiteracy. Cataract was the leading cause (57.6% and glaucoma was the second cause (16.7% for blindness. The prevalence of low vision was 2.9% (95% CI 2.4-3.4% and visual impairment (blindness + low vision was 3.8% (95% CI 3.2-4.4%. The primary causes for low vision were refractive errors (68% and cataract (22%. Conclusions: In this urban population based study, cataract was the leading cause for blindness and refractive error was the main reason for low vision.

  15. Prevalence and causes of low vision and blindness in an urban population: The Chennai Glaucoma Study

    Science.gov (United States)

    Vijaya, Lingam; George, Ronnie; Asokan, Rashima; Velumuri, Lokapavani; Ramesh, Sathyamangalam Ve

    2014-01-01

    Aim: To evaluate the prevalence and causes of low vision and blindness in an urban south Indian population. Settings and Design: Population-based cross-sectional study. Exactly 3850 subjects aged 40 years and above from Chennai city were examined at a dedicated facility in the base hospital. Materials and Methods: All subjects had a complete ophthalmic examination that included best-corrected visual acuity. Low vision and blindness were defined using World Health Organization (WHO) criteria. The influence of age, gender, literacy, and occupation was assessed using multiple logistic regression. Statistical Analysis: Chi-square test, t-test, and multivariate analysis were used. Results: Of the 4800 enumerated subjects, 3850 subjects (1710 males, 2140 females) were examined (response rate, 80.2%). The prevalence of blindness was 0.85% (95% CI 0.6–1.1%) and was positively associated with age and illiteracy. Cataract was the leading cause (57.6%) and glaucoma was the second cause (16.7%) for blindness. The prevalence of low vision was 2.9% (95% CI 2.4–3.4%) and visual impairment (blindness + low vision) was 3.8% (95% CI 3.2–4.4%). The primary causes for low vision were refractive errors (68%) and cataract (22%). Conclusions: In this urban population based study, cataract was the leading cause for blindness and refractive error was the main reason for low vision. PMID:23619490

  16. Toolbox for Urban Mobility Simulation: High Resolution Population Dynamics for Global Cities

    Science.gov (United States)

    Bhaduri, B. L.; Lu, W.; Liu, C.; Thakur, G.; Karthik, R.

    2015-12-01

    In this rapidly urbanizing world, unprecedented rate of population growth is not only mirrored by increasing demand for energy, food, water, and other natural resources, but has detrimental impacts on environmental and human security. Transportation simulations are frequently used for mobility assessment in urban planning, traffic operation, and emergency management. Previous research, involving purely analytical techniques to simulations capturing behavior, has investigated questions and scenarios regarding the relationships among energy, emissions, air quality, and transportation. Primary limitations of past attempts have been availability of input data, useful "energy and behavior focused" models, validation data, and adequate computational capability that allows adequate understanding of the interdependencies of our transportation system. With increasing availability and quality of traditional and crowdsourced data, we have utilized the OpenStreetMap roads network, and has integrated high resolution population data with traffic simulation to create a Toolbox for Urban Mobility Simulations (TUMS) at global scale. TUMS consists of three major components: data processing, traffic simulation models, and Internet-based visualizations. It integrates OpenStreetMap, LandScanTM population, and other open data (Census Transportation Planning Products, National household Travel Survey, etc.) to generate both normal traffic operation and emergency evacuation scenarios. TUMS integrates TRANSIMS and MITSIM as traffic simulation engines, which are open-source and widely-accepted for scalable traffic simulations. Consistent data and simulation platform allows quick adaption to various geographic areas that has been demonstrated for multiple cities across the world. We are combining the strengths of geospatial data sciences, high performance simulations, transportation planning, and emissions, vehicle and energy technology development to design and develop a simulation

  17. Association of Neck Circumference and Obesity with Blood Pressure among Adolescents in Urban and Rural Population in North Tamil Nadu.

    Science.gov (United States)

    Rajagopalan, Archana; Balaji, Nisha

    2017-01-01

    Since a few studies exist on the association of neck circumference (NC) and obesity with blood pressure (BP) among adolescents in India, we found it highly relevant to measure the NC and body mass index (BMI) using them as indicators of upper body subcutaneous fat and obesity and relate them to BP in a rural and urban adolescent population in North Tamil Nadu. This is a community-based cross-sectional study of descriptive design where 500 students from urban and rural areas were selected, and their BMI, NC, and BP were measured using standardized instruments. Among urban and rural population high and normal NC positively correlated with BMI, systolic BP (SBP) and diastolic BP (DBP), indicating that the data clearly reflects increase in BMI, SBP, and DBP values with increase in NC or vice versa. The correlation was statistically significant ( P < 0.001) significantly higher BMI ( P < 0.01), SBP ( P < 0.05), and NC ( P < 0.001) was observed in urban population than rural. DBP was not significantly different in rural and urban population. 95 th percentile values are significantly higher than rest in both urban and rural population. Only the 95 th percentile values correlate and reflect similar changes in BMI, SBP, and DBP. Our studies indicate a strong association of elevation in BP with high NC and increase in BMI. Overweight and obesity were positively correlated with increase in SBP and DBP.

  18. Transportation noise and exposed population of an urban area in the Republic of Korea.

    Science.gov (United States)

    Ko, Joon Hee; Chang, Seo Il; Kim, Minho; Holt, James B; Seong, Jeong C

    2011-02-01

    Using noise prediction models, we explored the transportation noise levels of Youngdeungpo-gu, an urbanized area of Seoul Metropolitan City in the Republic of Korea. In addition, we estimated the population exposed to transportation noise levels and determined how many people are vulnerable to noise levels that would cause serious annoyance and sleep disturbance. Compared with the World Health Organization [WHO] recommended levels, the daytime and nighttime transportation noise levels were still high enough to have the two psychosocial effects on people when considering the recommended levels of the World Health Organization (WHO; 55 decibels [dB[A

  19. Prayer Attendance and General Health in the Iranian Adult Urban Population.

    Science.gov (United States)

    Sotodehasl, Nemat; Ghorbani, Raheb; Mahdavi-Nejad, Gholamhosein; Haji-Aghajani, Saeed; Mehdizadeh, Jamileh

    2016-02-01

    This study was conducted to determine the relationship between prayer attendance and general health among adult urban population in Iran. A total of 470 males older than 17 years, chosen by multistage sampling, were investigated. The results showed that people who did not perform prayers compared to those who said prayers on time and performed Nafilahs (supererogatory prayers) were 2.87 (OR 2.87, 95 % CI 1.23-6.70, p = 0.015) times at risk of general health problems. In conclusion, the findings show that increasing the degree of people's belief in prayer can lead to improve general health.

  20. Acute traumatic rupture of the patellar tendon in pediatric population: Case series and review of the literature.

    Science.gov (United States)

    Ali Yousef, Mohamed Abdelhamid; Rosenfeld, Scott

    2017-11-01

    Intact knee extensor mechanism is required for the normal function of the lower extremity. Patellar tendon rupture is a relatively rare injury with peak age incidence around 40 years and usually occurs midsubstance. The occurrence of pure patellar tendon rupture without bony avulsion is an extremely rare injury in the pediatric population with few cases reported in the literature with limited information regarding frequency, complications, and outcomes in children. However, due to increased participation in sports and high-energy recreational activities during childhood, the frequency of such injuries has progressively increased. To evaluate the frequency of pediatric patellar tendon rupture injuries and describe the radiological findings, treatment modalities, and outcome of such injuries. Demographic and clinical data on a series of patients who sustained patellar tendon rupture were reviewed. These data included age at time of injury, sex, laterality, mechanism of injury, associated injuries, complications, presence or absence of Osgood-Schlatter disease, diagnostic imaging such as plain radiographs and magnetic resonance images (MRI), surgical technique, method of fixation, period of postoperative immobilization, total duration of physiotherapy, time to return to sports activities and follow-up duration. Insall-Salvati ratio was calculated on the preoperative lateral x-ray. The functional outcome was evaluated with regard to final knee active range of motion (AROM), manual quadriceps muscle testing, and presence or the absence of terminal extension lag. Clinical outcome rating using knee society score (KSS) was performed and functional outcome was further classified according to the calculated score. Five male patients with patellar tendon rupture (7%) were identified among 71 pediatric patients who sustained acute traumatic injury of the knee extensor mechanism. The mean age at the time of injury was 13.6 years (range: 12-15 years). The injury occurred in

  1. Clinical manifestations and management of prune-belly syndrome in a large contemporary pediatric population.

    Science.gov (United States)

    Seidel, Natan E; Arlen, Angela M; Smith, Edwin A; Kirsch, Andrew J

    2015-01-01

    To review the clinical manifestations and operative management of a large contemporary pediatric cohort of patients with prune-belly syndrome (PBS). PBS patients aged <21 years followed up in our pediatric urology clinic were identified by the International Classification of Diseases, Ninth Revision code (756.71). Demographics, concomitant diagnoses, surgical history, imaging studies, and renal or bladder function were evaluated. Data were available for 46 pediatric patients (44 boys and 2 girls). Mean age was 7.6 ± 4.7 years (range, 0.9-20 years). Average length of clinical follow-up was 6.8 ± 5 years. Forty-five children (97.8%) had hydroureteronephrosis, and 36 of them (78.3%) had vesicoureteral reflux. Five patients (10.9%) had significant pulmonary insufficiency, and 2 patients (4.3%) were oxygen dependent. Eighteen children (39.1%) had other congenital malformations, including cardiac in 4 patients (8.7%) and musculoskeletal anomalies in 10 patients (21.7%). Orchidopexy was the most common surgery, with all boys aged ≥3 years having undergone the procedure. Twenty-two patients (47.8%) had a history of ureteral surgery, 22 (47.8%) had bladder surgery, 11 (23.9%) had renal surgery, and 6 (13%) had urethral procedures. Nineteen patients (41.3%) underwent abdominoplasty. Eighteen children (39.1%) had documented chronic kidney disease, and 8 children (17.4%) underwent renal transplantation. Average age at transplantation was 5.1 ± 2.9 years. The mean nadir creatinine level for patients with end-stage renal disease was 1.4 mg/dL compared with 0.4 mg/dL for those not requiring transplantation (P <.001). Children with PBS have significant comorbidities and require frequent operative intervention, with disease heterogeneity necessitating an individualized management approach. Early end-stage renal disease is prevalent, with approximately 15% of children requiring kidney transplantation. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Descriptive study of interprofessional collaboration between physicians and osteopaths for the pediatric population in Quebec, Canada

    Directory of Open Access Journals (Sweden)

    Chantal Morin

    2017-11-01

    Full Text Available Abstract Background Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients. Methods A self-administered questionnaire was sent to osteopaths, family physicians, and pediatricians involved with pediatric patients in the province of Quebec. The postal questionnaire captured general knowledge about osteopathy and its practice parameters and role, sources of information, communication aspects including having a professional relationship and referrals, and influence of the upcoming government regulation. Quantitative data from the questionnaires were analyzed using descriptive statistics. Logistic regression model for factors associated with osteopathic referrals and multiple linear regression analyses for the number of correct answers about general osteopathic practice parameters were performed. Results A total of 274 physicians (155 family physicians (response rate 13% and 119 pediatricians (17% and 297 osteopaths (42% completed the survey. According to physicians, osteopathy was most appropriate for musculoskeletal pain (241; 91% and plagiocephaly (235; 88%. Osteopathic referral was positively associated with having a professional relationship (odds ratio [OR] 4.10 (95% confidence interval [CI] 2.12; 7.95, p < 0.001, personal consultation (OR 2.58 (95% CI 1.35; 4.93, p = 0.004, community-based practice (OR 1.89 (95% CI 1.03; 3.47, p = 0.040, and belief in the active role of osteopathy for pediatric conditions (OR 1.22 (95% CI 1.01; 1.47, p = 0.042. The majority of physicians (72% and

  3. [Ageing and chronic diseases in Senegal. A comparison between rural (Ferlo) and urban (Dakar) populations].

    Science.gov (United States)

    Duboz, P; Touré, M; Hane, F; Macia, E; Coumé, M; Bâ, A; Boëtsch, G; Guèye, L; Chapuis-Lucciani, N

    2015-02-01

    The objectives of this study were: to compare the prevalence of hypertension, overweight and obesity in rural (Ferlo) and urban (Dakar) Senegalese populations aged 50 and over. The survey was conducted on individuals aged 50 and older living in the rural area (N=478) and in the urban area (N=220). We have collected data about age, gender, marital status, education level, and knowledge, treatment of hypertension, height, weight and blood pressure. We have observed that overweight and obesity were more prevalent in the urban area (Dakar) than in the rural one (Ferlo). The risk of overweight or obesity decreased when age increased, and women had weight problems more often than men. The prevalence of arterial hypertension was lower in rural area (55.86%) than in Dakar (66.36%), but increased at an older age. However, the logistic regression showed that these increased proportion of hypertension in Dakar is linked to the more important proportion of overweight and obese people in this area. Moreover, rates of knowledge, treatment and control of hypertension are particularly low in the rural area of Senegal. In conclusion, age-associated diseases should be better managed in Senegal, particularly in rural areas.

  4. A novel method for sensing metastatic cells in the CSF of pediatric population with medulloblastoma by frequency domain FLIM system

    Science.gov (United States)

    Yahav, Gilad; Fixler, Dror; Gershanov, Sivan; Goldenberg-Cohen, Nitza

    2016-03-01

    Brain tumors are the second leading cause of cancer-related deaths in children, after leukemia. Patients with cancer in the central nervous system have a very low recovery rate. Today known imaging and cytology techniques are not always sensitive enough for an early detection of both tumor and its metastatic spread, moreover the detection is generally limited, reviewer dependent and takes a relatively long time. Medulloblastoma (MB) is the most common malignant brain tumor in children. The aim of our talk is to present the frequency domain fluorescence lifetime imaging microscopy system as a possible method for an early detection of MB and its metastatic spread in the cerebrospinal fluids within the pediatric population.

  5. Conservation genetics of extremely isolated urban populations of the northern dusky salamander (Desmognathus fuscus in New York City

    Directory of Open Access Journals (Sweden)

    Jason Munshi-South

    2013-04-01

    Full Text Available Urbanization is a major cause of amphibian decline. Stream-dwelling plethodontid salamanders are particularly susceptible to urbanization due to declining water quality and hydrological changes, but few studies have examined these taxa in cities. The northern dusky salamander (Desmognathus fuscus was once common in the New York City metropolitan area, but has substantially declined throughout the region in recent decades. We used five tetranucleotide microsatellite loci to examine population differentiation, genetic variation, and bottlenecks among five remnant urban populations of dusky salamanders in NYC. These genetic measures provide information on isolation, prevalence of inbreeding, long-term prospects for population persistence, and potential for evolutionary responses to future environmental change. All populations were genetically differentiated from each other, and the most isolated populations in Manhattan have maintained very little genetic variation (i.e. <20% heterozygosity. A majority of the populations also exhibited evidence of genetic bottlenecks. These findings contrast with published estimates of high genetic variation within and lack of structure between populations of other desmognathine salamanders sampled over similar or larger spatial scales. Declines in genetic variation likely resulted from population extirpations and the degradation of stream and terrestrial paths for dispersal in NYC. Loss of genetic variability in populations isolated by human development may be an underappreciated cause and/or consequence of the decline of this species in urbanized areas of the northeast USA.

  6. The influence of coyotes on an urban Canada goose population in the Chicago metropolitan area

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Justin L.; /Ohio State U.

    2007-01-01

    Canada geese (Branta canadensis) have become common in many urban areas, often creating nuisance problems for human residents. The presence of urban geese has raised concerns about the spread of disease, increased erosion, excessive noise, eutrophication of waterways, and general nuisance problems. Goose populations have grown due to an increase in urbanization resulting in an abundance of high quality food (urban grass) and suitable nesting sites, as well as a decrease in some predators. I monitored nest predation in the Chicago suburbs during the 2004 and 2005 nesting seasons using 3 nest monitoring techniques to identify predators: video cameras, plasticine eggs, and sign from nest using a classification tree analysis. Of 58 nests monitored in 2004 and 286 in 2005, only raccoons (Procyon lotor) and coyotes (Canis latrans) were identified as nest predators. Raccoons were responsible for 22-25% of depredated nests, but were rarely capable of depredating nests that were actively defended by a goose. Coyotes were responsible for 75-78% of all Canada goose nest depredation and were documented killing one adult goose and feeding on several others. The coyote is a top-level predator that had increased in many metropolitan areas in recent years. To determine if coyotes were actively hunting geese or eggs during the nesting season, I analyzed coyote habitat selection between nesting and pre-nesting or post-nesting seasons. Coyote home ranges (95% Minimum Convex Polygon) were calculated for 19 coyotes to examine third order habitat selection related to goose nest abundance. A 100 m buffer (buffer habitat) was created and centered on each waterway edge and contained 90% of all nests. Coyotes showed selection for habitats during all seasons. Buffer habitat was the top ranked habitat in both pre-nesting and nesting seasons, but dropped to third ranked in post-nesting season. Habitat selection across seasons was compared using a repeated measures MANOVA. Habitat selection

  7. Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study.

    Science.gov (United States)

    Falster, Kathleen; Banks, Emily; Lujic, Sanja; Falster, Michael; Lynch, John; Zwi, Karen; Eades, Sandra; Leyland, Alastair H; Jorm, Louisa

    2016-10-21

    Australian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children. This statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children. Using linked hospital data from 1 July 2000 to 31 December 2013, we identified pediatric avoidable, ambulatory care sensitive and non-avoidable hospitalization rates for Aboriginal and non-Aboriginal children. Absolute and relative inequalities between Aboriginal and non-Aboriginal children were measured as rate differences and rate ratios, respectively. Individual-level covariates included age, sex, low birth weight and/or prematurity, and private health insurance/patient status. Area-level covariates included remoteness of residence and area socioeconomic disadvantage. There were 365 386 potentially avoidable hospitalizations observed over the study period, most commonly for respiratory and infectious conditions; Aboriginal children were admitted more frequently for all conditions. Avoidable hospitalization rates were 90.1/1000 person-years (95 % CI, 88.9-91.4) in Aboriginal children and 44.9/1000 person-years (44.8-45.1) in non-Aboriginal children (age and sex adjusted rate ratio = 1.7 (1.7-1.7)). Rate differences and rate ratios declined with age from 94/1000 person-years and 1.9, respectively, for children aged primary care, have potential to narrow this gap.

  8. Full dose reduction potential of statistical iterative reconstruction for head CT protocols in a predominantly pediatric population

    Science.gov (United States)

    Mirro, Amy E.; Brady, Samuel L.; Kaufman, Robert. A.

    2016-01-01

    Purpose To implement the maximum level of statistical iterative reconstruction that can be used to establish dose-reduced head CT protocols in a primarily pediatric population. Methods Select head examinations (brain, orbits, sinus, maxilla and temporal bones) were investigated. Dose-reduced head protocols using an adaptive statistical iterative reconstruction (ASiR) were compared for image quality with the original filtered back projection (FBP) reconstructed protocols in phantom using the following metrics: image noise frequency (change in perceived appearance of noise texture), image noise magnitude, contrast-to-noise ratio (CNR), and spatial resolution. Dose reduction estimates were based on computed tomography dose index (CTDIvol) values. Patient CTDIvol and image noise magnitude were assessed in 737 pre and post dose reduced examinations. Results Image noise texture was acceptable up to 60% ASiR for Soft reconstruction kernel (at both 100 and 120 kVp), and up to 40% ASiR for Standard reconstruction kernel. Implementation of 40% and 60% ASiR led to an average reduction in CTDIvol of 43% for brain, 41% for orbits, 30% maxilla, 43% for sinus, and 42% for temporal bone protocols for patients between 1 month and 26 years, while maintaining an average noise magnitude difference of 0.1% (range: −3% to 5%), improving CNR of low contrast soft tissue targets, and improving spatial resolution of high contrast bony anatomy, as compared to FBP. Conclusion The methodology in this study demonstrates a methodology for maximizing patient dose reduction and maintaining image quality using statistical iterative reconstruction for a primarily pediatric population undergoing head CT examination. PMID:27056425

  9. Permanent Central Diabetes Insipidus as a Complication of S. pneumoniae Meningitis in the Pediatric Population.

    Science.gov (United States)

    Statz, Hannah; Hsu, Benson S

    2016-05-01

    Diabetes insipidus is a rare but recognized complication of meningitis. The occurrence of diabetes insidipus has been previously attributed to Streptococcus pneumoniae (S. pneumoniae) in a handful of patients and only once within the pediatric subpopulation. We present the clinical course of a previously healthy 2-year, 8-month-old male child ultimately diagnosed with central diabetes insipidus (CDI) secondary to S. pneumoniae meningitis. Permanent CDI following S. pneumoniae meningitis is unique to our case and has not been previously described. Following the case presentation, we describe the etiology, pathophysiology, diagnosis, and treatment of CDI. The mechanism proposed for this clinical outcome is cerebral herniation for a sufficient duration and subsequent ischemia leading to the development of permanent CDI. Providers should be aware of CDI resulting from S. pneumoniae meningitis as prompt diagnosis and management may decrease the risk of permanent hypothalamo-pituitary axis damage. Copyright© South Dakota State Medical Association.

  10. Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population.

    Science.gov (United States)

    Gray, Rachel; Gougoutas, Alexander; Nguyen, Vinh; Taylor, Jesse; Bastidas, Nicholas

    2017-06-01

    Virtual Surgical Planning (VSP) and computer-aided design/computer-aided manufacturing (CAD/CAM) have recently helped improve efficiency and accuracy in many different craniofacial surgeries. Research has mainly focused on the use in the adult population with the exception of the use for mandibular distractions and cranial vault remodeling in the pediatric population. This study aims to elucidate the role of VSP and CAD/CAM in complex pediatric craniofacial cases by exploring its use in the correction of midface hypoplasia, orbital dystopia, mandibular reconstruction, and posterior cranial vault expansion. A retrospective analysis of thirteen patients who underwent 3d, CAD/CAM- assisted preoperative surgical planning between 2012 and 2016 was performed. All CAD/CAM assisted surgical planning was done in conjunction with a third party vendor (either 3D Systems or Materialise). Cutting and positioning guides as well as models were produced based on the virtual plan. Surgeries included free fibula mandible reconstruction (n = 4), lefort I osteotomy and distraction (n = 2), lefort II osteotomy with monobloc distraction (n = 1), expansion of the posterior vault for correction of chiari malformation (n = 3), and secondary orbital and midface reconstruction for facial trauma (n = 3). The patient's age, diagnosis, previous surgeries, length of operating time, complications, and post-surgery satisfaction were determined. In all cases we found presurgical planning was helpful to improve accuracy and significantly decrease intra-operative time. In cases where distraction was used, the planned and actual vectors were found to be accurate with excellent clinical outcomes. There were no complications except for one patient who experienced a wound infection post-operatively which did not alter the ultimate reconstruction. All patients experienced high satisfaction with their outcomes and excellent subjective aesthetic results were achieved. Preoperative planning using

  11. Outpatient outcomes and satisfaction in pediatric population: data from the postoperative phone call.

    Science.gov (United States)

    Brenn, B Randall; Choudhry, Dinesh K; Sacks, Karen

    2016-02-01

    Quality and patient/parent satisfaction are goals for pediatric perioperative services. As part of the implementation of our operating room electronic medical record (EMR), a postoperative phone call questionnaire was developed to assess patients discharged after outpatient surgery. The goal of this initiative was to determine the rate of common postoperative complications and understand reasons for patient/parent dissatisfaction. Institutional Review Board approval was obtained for chart review. The postoperative phone call survey was attempted by our postanesthesia care unit nursing staff on all pediatric outpatients. The call was attempted for 3 days. From 2009 to 2013, more than 37 000 phone records existed in our EMR, Epic Optime (Epic Systems, Verona, WI). These data were extracted to a business intelligence (BI) program, QlikView (Qliktech, Radnor, PA, USA). A BI dashboard was constructed to obtain phone call results for any given time frame from monthly to spanning several years. Complications were logged as 4-point severity rating scales (none, mild, moderate, severe) with descriptions for each level. The BI dashboard calculated the overall and rates by severity for the following: (i) nausea, (ii) vomiting, (iii) pain, (iv) bleeding, (v) hoarseness, and (vi) difficulty eating. Of 42 688 outpatient cases, 37 620 postoperative phone calls were completed for an overall response rate of 88%. Pain, at 11.1%, was the highest reported postoperative complication. The rate of dissatisfaction was reported to be 0.31%. Most patients reporting dissatisfaction (62%) did not report any complications. Contingency coefficient showed that there was little relationship between satisfaction and presence of complications. A postoperative phone survey is cost-effective and appreciated by patients. We found that satisfaction with our perioperative services was not related to the rates of reported complications. Although reducing complications is of utmost importance

  12. The Ross Procedure in Patients among the Pediatric Population, Post Ten Years of Experience

    Directory of Open Access Journals (Sweden)

    Andrey A. Ivanov

    2013-09-01

    Full Text Available The aim of the study was to analyze the results of the surgical treatment in pediatric patients who had undergone the Ross procedure.Material and Methods: The study involved 114 patients between 12 days to 18 years in age. The early and late (up to 5 years results of the treatment were studied. The examination included echocardiography, catheterization of the cardiac chambers and angiocardiography. The case distribution of patients based on diagnosis was as follows: isolated aortic valve stenosis (IAVS in 38 (33.3% patients, aortic valve insufficiency (AVI in 33 (28.9%, and combined heart defects in 56 patients (49.1%.Results: The death rate was 6.14% during the early postoperative period and 1.14% in the late postoperative period; the actuarial survival in the long-term was 98.86%. The complication rate was 51.5%. The most frequent complication was pericarditis (25.6%, whereas cardiac and respiratory failure occurred in 7.6% of the cases and cardiac arrhythmias in 6.1% of the cases. The average time spent in the intensive care unit was 3.48 ± 2.90 days; the hospitalization period on average was 24.70±10.87 days. After surgery, there was a tendency of the echocardiographic parameters to move toward normalization. The frequency of reoperation in the late period was 23.7%, the main reason for which being the conduit dysfunction in the position of the pulmonary artery (PA.Conclusion: The clinical efficacy of the Ross procedure in the treatment of aortic valve malformations in the pediatric group was confirmed. However, in some cases, the need to perform repeated operations due to the increase in the ring size and an increase in the neo-aortic insufficiency during the somatic growth process.

  13. Ecotypic differentiation between urban and rural populations of the grasshopper Chorthippus brunneus relative to climate and habitat fragmentation.

    Science.gov (United States)

    San Martin Y Gomez, Gilles; Van Dyck, Hans

    2012-05-01

    Urbanization alters environmental conditions in multiple ways and offers an ecological or evolutionary challenge for organisms to cope with. Urban areas typically have a warmer climate and strongly fragmented herbaceous vegetation; the urban landscape matrix is often assumed to be hostile for many organisms. Here, we addressed the issue of evolutionary differentiation between urban and rural populations of an ectotherm insect, the grasshopper Chorthippus brunneus. We compared mobility-related morphology and climate-related life history traits measured on the first generation offspring of grasshoppers from urban and rural populations reared in a common garden laboratory experiment. We predicted (1) the urban phenotype to be more mobile (i.e., lower mass allocation to the abdomen, longer relative femur and wing lengths) than the rural phenotype; (2) the urban phenotype to be more warm adapted (e.g., higher female body mass); and (3) further evidence of local adaptation in the form of significant interaction effects between landscape of origin and breeding temperature. Both males and females of urban origin had significantly longer relative femur and wing lengths and lower mass allocation to the abdomen (i.e., higher investment in thorax and flight muscles) relative to individuals of rural origin. The results were overall significant but small (2-4%). Body mass and larval growth rate were much higher (+10%) in females of urban origin. For the life history traits, we did not find evidence for significant interaction effects between the landscape of origin and the two breeding temperatures. Our results point to ecotypic differentiation with urbanization for mobility-related morphology and climate-related life history traits. We argue that the warmer urban environment has an indirect effect through longer growth season rather than direct effects on the development.

  14. Clinical and imaging features of intracranial arterial aneurysms in the pediatric population; Klinische und radiologische Merkmale des intrakraniellen arteriellen Aneurysmas bei Kindern und Jugendlichen

    Energy Technology Data Exchange (ETDEWEB)

    Abruzzo, Todd A. [Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States). Dept. of Radiology; Aeron, Gunjan; Jones, Blaise V.

    2013-07-15

    Intracranial arterial aneurysms (IAAs) are rare in children. Nevertheless, IAAs account for at least 10 % - 15 % of hemorrhagic strokes during the first two decades of life. Traditional vascular risk factors, which are common in the adult population, are generally absent in the pediatric population, engendering distinct modes of IAA pathogenesis. Classification of pediatric IAAs according to the pathogenetic mechanism shows eight distinct categories: idiopathic, traumatic, those due to excessive hemodynamic stress, vasculopathic, infectious, noninfectious inflammatory, oncotic, and familial. Pathogenetic mechanism is the best predictor of the clinical course of the disease, response to treatment, and long-term prognosis. The pathogenetic subtypes of pediatric IAA show characteristic and variably overlapping features. In most cases, IAAs manifesting during the first two decades of life are idiopathic. IAAs that are idiopathic, traumatic (second most common type), or due to excessive hemodynamic stresses (third most common type) account for more than 80 % of IAAs in the pediatric age group. Most of the remaining pediatric IAAs are the result of congenital cerebral aneurysmal arteriopathies or infection. Multiple IAAs are unusual in young children except in those with acquired (secondary to immune deficiency states) or congenital cerebral aneurysmal arteriopathies or infectious IAAs. (orig.)

  15. Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.

    Science.gov (United States)

    Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong

    2017-07-18

    In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted

  16. Outcomes of cataract surgery in a rural and urban south Indian population

    Directory of Open Access Journals (Sweden)

    Vijaya Lingam

    2010-01-01

    Full Text Available Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated retinal examination. Statistical Analysis: Chi square test, t test and multivariate analysis were used. Results: Five hundred and twenty-eight (216 males, 312 females, 781 eyes rural subjects (13.5%, 95% confidence interval (CI 12.4% to 14.6% and 406 (197 males, 209 females, 604 eyes urban subjects (10.5%, 95% CI 9.6-11.5% had undergone cataract surgery. Outcome of cataract surgery was defined based on visual acuity. Using best-corrected visual acuity for classification, the single most important cause for visual impairment was cystoid macular edema in the aphakic group and posterior capsule opacification in the pseudophakic group. Aphakia (visual acuity of < 20/60 to ≤ 20/400 - odds ratio (OR 1.8; 95% CI 1.3 to 2.6%, visual acuity of < 20/400 - OR 6.2; 95% 4.0 to 9.8%, rural residence (visual acuity of < 20/60 to ≤ 20/400 - OR 3.2; 95% CI 2.2 to 4.5% and visual acuity of < 20/400 - OR OR 3.5; 95% CI 2.3 to 5.5% were associated with visual impairment. The urban cataract-operated population had significantly more pseudophakics ( P < 0.001, men ( P = 0.02 and literates ( P < 0.001. In the rural group the prevalence of cataract surgery (13.5% vs. 10.5%, P < 0.001 and number of people that had undergone cataract surgery within three years prior to examination ( P < 0.001 were significantly greater. In 30% of rural and 16% of urban subjects uncorrected refraction was the cause of visual impairment. Conclusions: Surgery

  17. Blindness and visual impairment in an urban West African population: the Tema Eye Survey.

    Science.gov (United States)

    Budenz, Donald L; Bandi, Jagadeesh R; Barton, Keith; Nolan, Winifred; Herndon, Leon; Whiteside-de Vos, Julia; Hay-Smith, Graham; Kim, Hanna; Tielsch, James

    2012-09-01

    To determine the prevalence, causes, and risk factors of blindness and visual impairment among persons aged 40 years or older residing in an urban West African location. Population-based, cross-sectional study. A total of 5603 participants residing in Tema, Ghana. Proportionate random cluster sampling was used to select participants aged 40 years or older living in the city of Tema. Presenting distance visual acuity (VA) was measured at 4 and 1 m using a reduced logarithm of the minimum angle of resolution tumbling E chart and then with trial frame based on autorefraction. A screening examination was performed in the field on all participants. Complete clinical examination by an ophthalmologist was performed on participants with best-corrected visual acuity (BCVA) Tema, Ghana, West Africa. Refractive error is a major cause of blindness and visual impairment in this population, followed by cataract, glaucoma, and corneal disease. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  18. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

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    Bordonaba-Bosque Daniel

    2011-06-01

    Full Text Available Abstract Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain. Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®. Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.

  19. The light pollution as a surrogate for urban population of the US cities

    Science.gov (United States)

    Operti, Felipe G.; Oliveira, Erneson A.; Carmona, Humberto A.; Machado, Javam C.; Andrade, José S.

    2018-02-01

    We show that the definition of the city boundaries can have a dramatic influence on the scaling behavior of the night-time light (NTL) as a function of population (POP) in the US. Precisely, our results show that the arbitrary geopolitical definition based on the Metropolitan/Consolidated Metropolitan Statistical Areas (MSA/CMSA) leads to a sublinear power-law growth of NTL with POP. On the other hand, when cities are defined according to a more natural agglomeration criteria, namely, the City Clustering Algorithm (CCA), an isometric relation emerges between NTL and population. This discrepancy is compatible with results from previous works showing that the scaling behaviors of various urban indicators with population can be substantially different for distinct definitions of city boundaries. Moreover, considering the CCA definition as more adequate than the MSA/CMSA one because the former does not violate the expected extensivity between land population and area of their generated clusters, we conclude that, without loss of generality, the CCA measures of light pollution and population could be interchangeably utilized in future studies.

  20. Attitudes towards suicide in urban and rural China: a population based, cross-sectional study.

    Science.gov (United States)

    Zou, Yaming; Leung, Ricky; Lin, Shao; Yang, Mingan; Lu, Tao; Li, Xianyun; Gu, Jing; Hao, Chun; Dong, Guanghui; Hao, Yuantao

    2016-05-26

    Suicide intervention programs have been guided by findings that attitude towards suicide and suicidal behavior may be causally linked. These findings also make it imperative to identify the factors that influence attitudes towards suicide. However, there has been little research on attitudes towards suicide among the general population, especially in low-income and middle-income countries. This population-based, cross-sectional study investigated the associated factors of attitudes towards suicide among a representative sample of urban and rural adult residents in China. A multi-stage, stratified random sampling approach was implemented to select participants. Data were collected by a survey using the Scale of Public Attitudes about Suicide (SPAS). The survey also collected some socio-demographic factors and suicidal history of participants. Statistical tests were conducted to identify associated factors that account for variations in attitudes towards suicide. The residents in China generally hold a neutral attitude towards suicide. Attitudes towards suicide among Chinese residents were associated with age, duration of formal education, marital status, job and suicidal ideation. Different attitudinal subscales seemed not to share the same risk factors. However, gender, ethnicity, religious belief, housing style and economic status might not influence residents' attitudes towards suicide. Attitudes towards suicide among Chinese urban and rural residents generally had no statistical difference with one notable exception: opinions on whether or not suicides and suicide attempts are different phenomena. Age, duration of formal education, marital status, job and suicidal ideation seem to have an impact on attitudes towards suicide among residents. Urban and rural residents have similar attitudes towards suicide with the only statistically significance difference being their opinions on whether or not suicides and suicide attempts are different phenomena.

  1. Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

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    Retel-Rude Nathalie

    2003-08-01

    Full Text Available Abstract Background Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36 was adapted into Arabic. Methods SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model was performed to test the effect of habitat (rural on urban areas on all domains of the SF-36. Results The rate of missing data is very low (0.23% of items. Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70, factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. Conclusion The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL.

  2. Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

    Science.gov (United States)

    Sabbah, Ibtissam; Drouby, Nabil; Sabbah, Sanaa; Retel-Rude, Nathalie; Mercier, Mariette

    2003-01-01

    Background Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic. Methods SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model) was performed to test the effect of habitat (rural on urban areas) on all domains of the SF-36. Results The rate of missing data is very low (0.23% of items). Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70), factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. Conclusion The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL. PMID:12952543

  3. Overweight and Obesity above 18 years of Age in An Urban Population

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    Amit Kumar Kamboj

    2017-06-01

    Full Text Available Background: Today however, as standard of living continues to rise, weight gain and obesity are posing a growing threat to health in both developed and developing countries and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concern including under nutrition and infectious diseases. Overweight and obesity is a major risk factor for high morbidity and mortality. Obesity is an independent risk factor for chronic heart disease related morbidity and mortality. Aims and Objectives: To find out the prevalence of overweight & obesity and to suggest measures for prevention of overweight and obesity in adult population. Material and Method: To cover a sample size of 1152 in Urban Health Centre area population ≥18 years every fifth family was selected by systematic random sampling from the total of 1698 families registered at Urban Health Centre. They were interviewed personally and information was collected about sociodemographic characteristics, personal factors, and measurements of weight, height, waist and hip circumference of the individuals were taken to calculate Body Mass Index (BMI and Waist Hip Ratio (WHR. Results: Prevalence of overweight (BMI -25-29.99 and obesity (BMI ≥30 being 28.0% and 8.0% respectively. Prevalence of abdominal obesity was 25.8%. About two-third (66.9% of abdominal obesity rightly corresponded with the high BMI (25+. Conclusion: The prevalence of overweight and obesity is increasing in urban area of Meerut, more in females than males and it is being affected by various socio-demographic correlates.

  4. Overweight and Obesity above 18 years of Age in An Urban Population

    Directory of Open Access Journals (Sweden)

    Amit Kumar Kamboj

    2017-06-01

    Full Text Available Background: Today however, as standard of living continues to rise, weight gain and obesity are posing a growing threat to health in both developed and developing countries and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concern including under nutrition and infectious diseases. Overweight and obesity is a major risk factor for high morbidity and mortality. Obesity is an independent risk factor for chronic heart disease related morbidity and mortality. Aims and Objectives: To find out the prevalence of overweight & obesity and to suggest measures for prevention of overweight and obesity in adult population. Material and Method: To cover a sample size of 1152 in Urban Health Centre area population ≥18 years every fifth family was selected by systematic random sampling from the total of 1698 families registered at Urban Health Centre. They were interviewed personally and information was collected about sociodemographic characteristics, personal factors, and measurements of weight, height, waist and hip circumference of the individuals were taken to calculate Body Mass Index (BMI and Waist Hip Ratio (WHR. Results: Prevalence of overweight (BMI -25-29.99 and obesity (BMI ≥30 being 28.0% and 8.0% respectively. Prevalence of abdominal obesity was 25.8%. About two-third (66.9% of abdominal obesity rightly corresponded with the high BMI (25+. Conclusion: The prevalence of overweight and obesity is increasing in urban area of Meerut, more in females than males and it is being affected by various socio-demographic correlates.

  5. Health inequalities among rural and urban population of Eastern Poland in the context of sustainable development.

    Science.gov (United States)

    Pantyley, Viktoriya

    2017-09-21

    The primary goals of the study were a critical analysis of the concepts associated with health from the perspective of sustainable development, and empirical analysis of health and health- related issues among the rural and urban residents of Eastern Poland in the context of the sustainable development of the region. The study was based on the following research methods: a systemic approach, selection and analysis of the literature and statistical data, developing a special questionnaire concerning socio-economic and health inequalities among the population in the studied area, field research with an interview questionnaire conducted on randomly-selected respondents (N=1,103) in randomly selected areas of the Lubelskie, Podkarpackie, Podlaskie and eastern part of Mazowieckie Provinces (with the division between provincial capital cities - county capital cities - other cities - rural areas). The results of statistical surveys in the studied area with the use of chi-square test and contingence quotients indicated a correlation between the state of health and the following independent variables: age, life quality, social position and financial situation (C-Pearson's coefficient over 0,300); a statistically significant yet weak correlation was recorded for gender, household size, place of residence and amount of free time. The conducted analysis proved the existence of a huge gap between state of health of the population in urban and rural areas. In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.

  6. Georeferenced Population Datasets of Mexico (GEO-MEX): Urban Place GIS Coverage of Mexico

    Data.gov (United States)

    National Aeronautics and Space Administration — The Urban Place GIS Coverage of Mexico is a vector based point Geographic Information System (GIS) coverage of 696 urban places in Mexico. Each Urban Place is...

  7. Poverty, race, and CKD in a racially and socioeconomically diverse urban population.

    Science.gov (United States)

    Crews, Deidra C; Charles, Raquel F; Evans, Michele K; Zonderman, Alan B; Powe, Neil R

    2010-06-01

    Low socioeconomic status (SES) and African American race are both independently associated with end-stage renal disease and progressive chronic kidney disease (CKD). However, despite their frequent co-occurrence, the effect of low SES independent of race has not been well studied in CKD. Cross-sectional study. 2,375 community-dwelling adults aged 30-64 years residing within 12 neighborhoods selected for both socioeconomic and racial diversity in Baltimore City, MD. Low SES (self-reported household income or =125% of guideline); white and African American race. CKD defined as estimated glomerular filtration rate poverty and CKD, stratified by race. Of 2,375 participants, 955 were white (347 low SES and 608 higher SES) and 1,420 were African American (713 low SES and 707 higher SES). 146 (6.2%) participants had CKD. Overall, race was not associated with CKD (OR, 1.05; 95% CI, 0.57-1.96); however, African Americans had a much greater odds of advanced CKD (estimated glomerular filtration rate urban populations. Low SES has a profound relationship with CKD in African Americans, but not whites, in an urban population of adults, and its role in the racial disparities seen in CKD is worthy of further investigation. Copyright 2010 National Kidney Foundation, Inc. All rights reserved.

  8. Epidemiology of uveitis in a Western urban multiethnic population. The challenge of globalization.

    Science.gov (United States)

    Llorenç, Victor; Mesquida, Marina; Sainz de la Maza, Maite; Keller, Johannes; Molins, Blanca; Espinosa, Gerard; Hernandez, María V; Gonzalez-Martín, Julian; Adán, Alfredo

    2015-09-01

    To report the anatomical pattern and etiological spectrum of uveitis in an urban multi-ethnic population from Barcelona, Spain. General and specific epidemiological data for the most prevalent aetiologies are also calculated. A cross-sectional study of consecutive uveitis cases was performed between 1 January 2009 and 31 December 2012. Exogenous endophthalmitis, surgery-related, post-traumatic and toxic uveitis along with masquerade syndromes were excluded. Anatomical (Standard Uveitis Nomenclature criteria) and aetiological patterns (by tailored tests), age, sex, geographical origin and laterality were analysed. Mean incidence and prevalence were calculated for a mid-period reference population. From 1022 patients included, 52% were anterior uveitis (AU), 23% posterior, 15% panuveitis and 9% intermediate uveitis. Aetiologically, 26% were unclassifiable, 29% infectious, 25% associated with systemic immune diseases, and 20% corresponded to ocular-specific syndromes. Among classified causes, herpesvirus (12%), toxoplasma (7%), Behçet's disease (BD) (5%), HLA-B27-isolated AU (5%), ankylosing spondylitis (5%), tuberculosis-related uveitis (TRU) (5%), birdshot chorioretinopathy (3%) and sarcoidosis (3%) were the most frequent. Non-Spanish origin was recorded in 22%, with 47% of Vogt-Koyanagi-Harada and 36% of toxoplasma cases coming from South America, 10% of BD and 11% of TRU from Africa and 24% of TRU cases from Asia. A mean annual incidence of 51.91 cases/100,000 inhabitants was found for the referral population. In our referral area, 74% of the uveitis cases can be correctly classified. A large myriad of uveitis aetiologies with a strong geographical origin burden are found in Western urban multi-ethnic populations. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  9. The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations

    OpenAIRE

    Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus FC; Simkhada, Padam; Smith, William CS; Ayres, Jon G

    2014-01-01

    Background Half of the world’s population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. Methods A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor...

  10. Pediatric AIDS

    International Nuclear Information System (INIS)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.; Fikrig, S.

    1988-01-01

    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon. (orig.)

  11. Yield of Echocardiogram and Predictors of Positive Yield in Pediatric Patients: A Study in an Urban, Community-Based Outpatient Pediatric Cardiology Clinic.

    Science.gov (United States)

    Billa, Ramya Deepthi; Szpunar, Susan; Zeinali, Lida; Anne, Premchand

    2018-01-01

    The yield of outpatient echocardiograms varies based on the indication for the echocardiogram and the age of the patient. The purpose of this study was to determine the cumulative yield of outpatient echocardiograms by age group and reason for the test. A secondary aim was to determine the predictors of a positive echocardiogram in an outpatient cardiology clinic at a large community teaching hospital. We retrospectively reviewed the charts of 891 patients who had a first-time echocardiogram between 2011 and 2015. Positive yield was defined as echocardiographic findings that explained the reason for the echocardiogram. The overall positive yield was 8.2%. Children between birth and 3 months of age had the highest yield (34.2%), and children between 12 and 18 years of age had the lowest yield (1%). Patients with murmurs (18.1%) had the highest yield compared with patients with other signs or symptoms. By age group and reason, the highest yields were as follows: 0 to 3 months of age, murmur (39.2%); 4 to 11 months of age, >1 symptom (50%); and 1 to 5 years of age, shortness of breath (66.7%). Based on our study, the overall yield of echocardiograms in the outpatient pediatric setting is low. Age and symptoms should be considered before ordering an echocardiogram.

  12. The Influence of Age and Gender on Skin-Associated Microbial Communities in Urban and Rural Human Populations.

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    Shi Ying

    Full Text Available Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urban or rural environment, with a significantly greater relative abundance of Trabulsiella in urban populations. Adults maintained greater overall microbial diversity than adolescents or the elderly, while the intragroup variation among the elderly and rural populations was significantly greater. Skin-associated bacterial community structure and composition could predict whether a sample came from an urban or a rural resident ~5x greater than random.

  13. Asthma exacerbation and proximity of residence to major roads: a population-based matched case-control study among the pediatric Medicaid population in Detroit, Michigan

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    Wahl Robert

    2011-04-01

    Full Text Available Abstract Background The relationship between asthma and traffic-related pollutants has received considerable attention. The use of individual-level exposure measures, such as residence location or proximity to emission sources, may avoid ecological biases. Method This study focused on the pediatric Medicaid population in Detroit, MI, a high-risk population for asthma-related events. A population-based matched case-control analysis was used to investigate associations between acute asthma outcomes and proximity of residence to major roads, including freeways. Asthma cases were identified as all children who made at least one asthma claim, including inpatient and emergency department visits, during the three-year study period, 2004-06. Individually matched controls were randomly selected from the rest of the Medicaid population on the basis of non-respiratory related illness. We used conditional logistic regression with distance as both categorical and continuous variables, and examined non-linear relationships with distance using polynomial splines. The conditional logistic regression models were then extended by considering multiple asthma states (based on the frequency of acute asthma outcomes using polychotomous conditional logistic regression. Results Asthma events were associated with proximity to primary roads with an odds ratio of 0.97 (95% CI: 0.94, 0.99 for a 1 km increase in distance using conditional logistic regression, implying that asthma events are less likely as the distance between the residence and a primary road increases. Similar relationships and effect sizes were found using polychotomous conditional logistic regression. Another plausible exposure metric, a reduced form response surface model that represents atmospheric dispersion of pollutants from roads, was not associated under that exposure model. Conclusions There is moderately strong evidence of elevated risk of asthma close to major roads based on the results obtained

  14. Asthma exacerbation and proximity of residence to major roads: a population-based matched case-control study among the pediatric Medicaid population in Detroit, Michigan

    Science.gov (United States)

    2011-01-01

    Background The relationship between asthma and traffic-related pollutants has received considerable attention. The use of individual-level exposure measures, such as residence location or proximity to emission sources, may avoid ecological biases. Method This study focused on the pediatric Medicaid population in Detroit, MI, a high-risk population for asthma-related events. A population-based matched case-control analysis was used to investigate associations between acute asthma outcomes and proximity of residence to major roads, including freeways. Asthma cases were identified as all children who made at least one asthma claim, including inpatient and emergency department visits, during the three-year study period, 2004-06. Individually matched controls were randomly selected from the rest of the Medicaid population on the basis of non-respiratory related illness. We used conditional logistic regression with distance as both categorical and continuous variables, and examined non-linear relationships with distance using polynomial splines. The conditional logistic regression models were then extended by considering multiple asthma states (based on the frequency of acute asthma outcomes) using polychotomous conditional logistic regression. Results Asthma events were associated with proximity to primary roads with an odds ratio of 0.97 (95% CI: 0.94, 0.99) for a 1 km increase in distance using conditional logistic regression, implying that asthma events are less likely as the distance between the residence and a primary road increases. Similar relationships and effect sizes were found using polychotomous conditional logistic regression. Another plausible exposure metric, a reduced form response surface model that represents atmospheric dispersion of pollutants from roads, was not associated under that exposure model. Conclusions There is moderately strong evidence of elevated risk of asthma close to major roads based on the results obtained in this population

  15. City Magistrate of Tsaritsyn as the Estates Court for Urban Population 1784-1866

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    Elena V. Bulyulina

    2017-10-01

    Full Text Available At the end of the 18th century in Russia caste system of the judiciary was legalized. For urban and suburban trade and craft population of the Russian Empire estates courts were magistrates. Despite the fact that the activities of magistrates are studied by native historians and legal scholars, regional aspects of the topic are not adequately reflected. This article examines the activities of the Tsaritsyn city magistrate court as an estates court for a merchant and petty-bourgeois population of the city of Tsaritsyn in 1784-1866. In 1775 Ekaterina II carried out a major reform of local government and the court, significantly expanding the functions of local government institutions, and, in fact, restoring estates of municipal government. From that moment in cities the magistrates managed the city, including city magistrates who represented the court of first instance in criminal and civil cases for the urban population – merchants, craftsmen, townspeople. Appeal to the city magistrate was of the Saratov provincial magistrate. Different aspects of his functional features and relations with another official instances are presented. The limits of the jurisdiction of the Tsaritsyn city magistrate was limited to the territory of Tsaritsyn. The objects of the jurisdiction could be only the regular citizens, i.e. assigned to the city, and not the entire population. Implementation of the rule of law, particularly the application of penalties in the material presented in the aspect of not only the all-Russian legal requirements, but also regarding regional social and legal assessments. Tsaritsyn city magistrate heard cases of theft, vandalism, rape, false receipts, and bills of exchange, unauthorized occupation of urban land, abandoned children, the accountability for deviations from the canons of Orthodoxy, committing a schismatic rites, violation of rules of transportation and logging, concealment of recruits, about the insult of the authorities

  16. Frailty syndrome in an independent urban population in Brazil (FIBRA study: a cross-sectional populational study

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    Larissa Barradas Calado

    Full Text Available ABSTRACT: CONTEXT AND OBJECTIVE: Frailty is a multifactorial syndrome. The aim of this study was to determine the prevalence and characteristics of frailty syndrome in an elderly urban population. DESIGN AND SETTING: Cross-sectional study carried out at the homes of a randomized sample representing the independent elderly individuals of Ribeirão Preto, Brazil. METHODS: Sociodemographic characteristics, clinical data and criteria of the frailty phenotype were obtained at the subjects' homes; 385 individuals were evaluated. Frailty was defined based on detection of weight loss, exhaustion, weakness, slowness and low physical activity level. Individuals with three or more of these characteristics were classified as frail and those with one or two as pre-frail. Specific cutoff points for weakness, slowness and low physical activity level were calculated. RESULTS: The participants' mean age was 73.9 ± 6.5 years, and 64.7% were women. 12.5% had lost weight over the last year; 20.5% showed exhaustion, 17.1% slowness, 24.4% low physical activity level and 20.5% weakness. 9.1% were considered frail and 49.6% pre-frail. Frail subjects were older, attended more medical visits, had a higher chance of hospitalization within the last 12 months and had more cerebrovascular events, diabetes, neoplasms, osteoporosis and urinary and fecal incontinence. CONCLUSION: In this independent elderly population, there were numerous frail and pre-frail individuals. Frailty syndrome was associated with high morbidity. Cutoff points for weakness, slowness and low physical activity level should be adjusted for the population under study. It is essential to identify frail and pre-frail older individuals for appropriate interventions.

  17. Patterns of reflux in gastroesophageal reflux disease in pediatric population of New South Wales.

    Science.gov (United States)

    Narayanan, Sarath Kumar; Cohen, Ralph Clinton; Karpelowsky, Jonathan Saul

    2017-02-01

    This study is to determine the association of ambulatory pH monitoring (24hr pH) with symptoms of gastroesophageal reflux and its other investigations. The clinical and epidemiological profiles of subjects referred for reflux disorders are also studied. Symptoms or group of symptoms, profiles and prior investigations of 1259 consecutive pediatric subjects (with 1332 24hr pH studies performed) referred for evaluation of reflux disorders between 1988 and 2012 were retrospectively studied. Chi-square or fisher exact test was used for hypothesis testing, student t-test for the comparison of means and the Wilcoxon rank-sum test for comparing medians of continuous variables. Gastroesophageal reflux disease (GERD), defined as reflux causing major symptoms and complications, was diagnosed in 57.5% subjects of the total sample. Forty-three percent were girls and 56.7% were boys. The most common age group was between 4 months and 2 years (51.2%). Vomiting (64.4%) and irritability (74%) were the most common symptoms with the neurological conditions (23.2%) being the most frequent underlying condition. The parameters used in 24hr pH were significantly higher in those diagnosed with GERD (P reflux disorders. 24hr pH is reliable and should be considered routine in reflux disorders, as it identifies patients with pathologic reflux and avoids a needless surgery. © 2016 International Society for Diseases of the Esophagus.

  18. Vulvovaginitis in a pediatric population: relationship among etiologic agents, age and Tanner staging of breast development.

    Science.gov (United States)

    Giugno, Silvina; Risso, Paula; Ocampo, Dolores; Rahman, Gisel; Rubinstein, Dra Anahí V

    2014-02-01

    Vulvovaginitis accounts for 25% of all pediatric gynecology consultations. To assess the etiology of vulvovaginitis based on age and Tanner staging of breast development. Descriptive, cross-sectional study conducted between January 1st and December 31st, 2011. Patients with vulvovaginitis were assessed based on two outcome measures: age group (GI: 0 to 8.9 years old, GII: 9 to 15.9 years old, and GIII: 16 to 18 years old), and the Tanner staging of breast development (I, II-III, IV-V). Results. Two hundred and twenty-nine patients were included, 78 girls in the GI group, 134 in the GII group, and 17 in the GIII group; 81 girls were classified as TI, 36 as TII-III, and 112 as TIV-V based on Tanner staging. Shigella and Oxyuris were the most commonly found etiologic agents in younger girls. Candida albicans, other Candida species, Gardnerella and Ureaplasma urealyticum were the germs most commonly observed in older patients. Oxyuris was predominant in prepubertal girls, while Candida albicans, in postpubertal girls. Hormonal influence was more relevant than the patient's age in terms of vulvovaginitis etiology.

  19. Surgical retroperitoneoscopic and transperitoneoscopic access in varicocelectomy: duplex scan results in pediatric population.

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    Mancini, Stefano; Bulotta, Anna Lavinia; Molinaro, Francesco; Ferrara, Francesco; Tommasino, Giulio; Messina, Mario

    2014-12-01

    This is a retrospective study to compare duplex scan results of laparoscopic Palomo's technique through retroperitoneal and transperitoneal approach for varicocelectomy in children. We statistically analyzed recurrence, testicular volume growth and complications. Surgical intervention was performed utilizing transperitoneoscopic (group A) or retroperitoneoscopic access (group B). Duplex scan control was performed after 12 months (T1), after 2 years (T2) and the last one at 18 years old in most patients. Statistical analysis was performed using the t-test for parametric data. Differences in proportions were evaluated using χ2 or Fisher's exact test. We treated 120 children (age range 10-17 years) who presented an asymptomatic IV grade of reflux, Coolsaet 1, associated with a left testicular hypotrophy in 36.6% of the cases (44 patients). No post-operative complications were verified. Duplex scan exam showed an increase of left testicular growth in both groups, with complete hypotrophy disappear in patients in both groups after 24 months. Hydrocele, diagnosed clinically and confirmed with duplex scan, was the most frequent post-operative complication (22/120 cases; 18.3%). This study showed the importance of duplex scan at all steps of this vascular pathology in children, and that there is no significantly difference in results between the two surgical techniques except for hydrocele in transperitoneoscopic access. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  20. Urban park characteristics, genetic variation, and historical demography of white-footed mouse (Peromyscus leucopus populations in New York City

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    Jason Munshi-South

    2014-03-01

    Full Text Available Severe fragmentation is a typical fate of native remnant habitats in cities, and urban wildlife with limited dispersal ability are predicted to lose genetic variation in isolated urban patches. However, little information exists on the characteristics of urban green spaces required to conserve genetic variation. In this study, we examine whether isolation in New York City (NYC parks results in genetic bottlenecks in white-footed mice (Peromyscus leucopus, and test the hypotheses that park size and time since isolation are associated with genetic variability using nonlinear regression and information-theoretic model selection. White-footed mice have previously been documented to exhibit male-biased dispersal, which may create disparities in genetic variation between males and females in urban parks. We use genotypes of 18 neutral microsatellite data and four different statistical tests to assess this prediction. Given that sex-biased dispersal may create disparities between population genetic patterns inferred from bi- vs. uni-parentally inherited markers, we also sequenced a 324 bp segment of the mitochondrial D-loop for independent inferences of historical demography in urban P. leucopus. We report that isolation in urban parks does not necessarily result in genetic bottlenecks; only three out of 14 populations in NYC parks exhibited a signature of a recent bottleneck at 18 neutral microsatellite loci. Mouse populations in larger urban parks, or parks that have been isolated for shorter periods of time, also do not generally contain greater genetic variation than populations in smaller parks. These results suggest that even small networks of green spaces may be sufficient to maintain the evolutionary potential of native species with certain characteristics. We also found that isolation in urban parks results in weak to nonexistent sex-biased dispersal in a species known to exhibit male-biased dispersal in less fragmented environments. In

  1. The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views.

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    Barke, Antonia; Nyarko, Seth; Klecha, Dorothee

    2011-11-01

    Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.

  2. Seroprevalence of hepatitis C and associated risk factors among an urban population in Haiti

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    Hepburn Matthew J

    2004-12-01

    Full Text Available Abstract Background The seroprevalence of hepatitis C varies substantially between countries and geographic regions. A better understanding of the seroprevalence of this disease, and the risk factors associated with seropositive status, supply data for the development of screening programs and provide insight into the transmission of the disease. The purpose of this investigation was to determine the seroprevalence of hepatitis C and associated risk factors in an urban population in Haiti. Methods A prospective survey for hepatitis C antibodies was conducted among an urban outpatient population in Cap-Haïtien, Haiti, with a sample size of 500 subjects. An anonymous 12 question survey, with inquiries related to demographic characteristics and risk factors for HCV acquisition, was concomitantly administered with testing. These demographic and behavioral risk factors were correlated with HCV antibody status using univariate and multivariate tests. Results The prevalence of positive HCV antibody was 22/500 (4.4%. Subjects that were anti-HCV positive had an average of 7 ± 8.6 lifetime sexual partners, compared to average of 2.5 ± 3.5 lifetime sexual partners among HCV-negative subjects (p = 0.02. In a multiple logistic regression model, intravenous drug use (OR 3.7, 1.52–9.03 95% CI and number of sexual partners (OR 1.1, 1.04–1.20 95% CI were independently associated with a positive HCV antibody result. Conclusions A substantial number of subjects with HCV antibodies were detected in this population in Haiti. Further investigation into the correlation between the number of sexual partners and testing positive for hepatitis C antibodies is indicated.

  3. Prevalence of glaucoma in an urban West African population: the Tema Eye Survey.

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    Budenz, Donald L; Barton, Keith; Whiteside-de Vos, Julia; Schiffman, Joyce; Bandi, Jagadeesh; Nolan, Winifred; Herndon, Leon; Kim, Hanna; Hay-Smith, Graham; Tielsch, James M

    2013-05-01

    Multiple studies have found an increased prevalence, younger age at onset, and more severe course of glaucoma in people of African descent, but these findings are based on studies conducted outside Africa. To determine the prevalence of glaucoma in an urban West African population of adults. A population-based, cross-sectional study of adults 40 years and older conducted from September 1, 2006, through December 31, 2008, from 5 communities in Tema, Ghana. Participants from randomly selected clusters underwent a screening examination that consisted of visual acuity, frequency doubling perimetry, applanation tonometry, and optic disc photography. Participants who failed any of these tests were referred for complete examination, including gonioscopy, standard automated perimetry, and stereoscopic optic disc photography. A total of 6806 eligible participants were identified, and 5603 (82.3%) were enrolled in the study. The field examination referred 1869 participants (33.3%) to the clinic examination, and 1538 (82.2%) came for complete examination. A total of 362 participants were identified as having glaucoma of any type and category. Primary open-angle glaucoma was the underlying diagnosis in 342 participants (94.5%). The prevalence of primary open-angle glaucoma was 6.8% overall, increasing from 3.7% among those 40 to 49 years old to 14.6% among those 80 years and older, and was higher in men than in women in all age groups, with an overall male-female prevalence ratio of 1.5. Of the participants with glaucoma, 9 (2.5%) were blind using World Health Organization criteria, and only 12 (3.3%) were aware that they had glaucoma. The prevalence of glaucoma is higher in this urban West African population than in previous studies of people of East or South African and of non-African descent. Strategies to identify affected persons and effectively manage the burden of glaucoma are needed in West Africa.

  4. Prevalence of Metabolic Syndrome in an Adult Urban Population of the West of Iran

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    F. Sharifi

    2009-01-01

    Full Text Available Objectives. We determine the prevalence of the metabolic syndrome in an urban population of Zanjan, a province located to the west of Tehran. Methods. Randomly selected adults >20 years were studied using stratified sampling. Target study sample was 2941 (1396 males and 1545 females. Metabolic syndrome was diagnosed using Adult Treatment Panel-III (ATP-III guidelines when any three of the following were present: central obesity, raised triglycerides ≥150 mg/dl, low high-density lipoprotein (HDL cholesterol, blood pressure ≥130/≥85 mm Hg, and diabetes or fasting plasma glucose (FPG ≥100 mg/dl. Results. Metabolic syndrome was present in 697 (23.7% subjects (CI 95%:22%–25%, P = .001, prevalence was 23.1% in men and 24.4% in women (P : .4. The prevalence increased from 7.5% in the population younger than 30 y to 45.6% in ages more than 50 years. Low HDL was the most common metabolic abnormality in both sexes. Most of those with metabolic syndrome had three components of the syndrome (75.6%, 170 subjects (24.4% had four and none had five components simultaneously. The prevalence of obesity (BMI≥30 kg/m2, hypercholesterolemia (≥200 mg/dl and high LDL cholesterol (≥130 mg/dl was greater in the metabolic syndrome group than normal subjects (P = .00. Conclusions. There is a high prevalence of metabolic syndrome in this urban population of the northern west of Iran. Focus of cardiovascular prevention should be undertaken in this area.

  5. Dyslipidemia and its risk factors among urban middle-aged Iranians: A population-based study.

    Science.gov (United States)

    Ebrahimi, Hossein; Emamian, Mohammad Hassan; Hashemi, Hassan; Fotouhi, Akbar

    2016-01-01

    Dyslipidemia is a known risk factor for cardiovascular disease and is a leading cause of mortality in developed and developing countries. This study was aimed to determine the prevalence of dyslipidemia and its risk factors in an urban group of Iranian adult population. In this study, based on the criteria set by the National Cholesterol Education Program, the prevalence of dyslipidemia was evaluated in a population of 4737 people aged 45-69 years who participated in the second phase of an ophthalmology cohort study in Shahroud. Dyslipidemia prevalence was determined by age, sex, and risk factors of the disease; the findings were tested by using simple and multiple logistic regression. The prevalence of dyslipidemia was 66.5% (CI 95%: 64.4-68.6) in males, 61.3% (CI 95%: 59.5-63.2) in females, and 63.4% (CI 95%: 62.0-64.9%) in both sexes. The prevalence of hypertriglyceridemia, hypercholesterolemia, low HDL-C, and high LDL-C, respectively, was 28.8%, 13.4%, 42.3%, and 13.4%, respectively. In multivariate logistic regression model, increase of age (for females), abdominal obesity, overweight and obesity, hypertension, and diabetes were associated with an increased odd of dyslipidemia. The prevalence of dyslipidemia in middle-aged urban population in Iran is high, and with increasing age there is an increased risk of dyslipidemia. Hence, considering the growing trend of aging in Iran, there is need for taking special measures to deal with dyslipidemia as a health priority. Furthermore, the need for planning in order to reduce the risk of dyslipidemia and prevent its complications is greater than ever. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. Application of convolutional artificial neural networks to echocardiograms for differentiating congenital heart diseases in a pediatric population

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    Perrin, Douglas P.; Bueno, Alejandra; Rodriguez, Andrea; Marx, Gerald R.; del Nido, Pedro J.

    2017-03-01

    In this paper we describe a pilot study, where machine learning methods are used to differentiate between congenital heart diseases. Our approach was to apply convolutional neural networks (CNNs) to echocardiographic images from five different pediatric populations: normal, coarctation of the aorta (CoA), hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and single ventricle (SV). We used a single network topology that was trained in a pairwise fashion in order to evaluate the potential to differentiate between patient populations. In total we used 59,151 echo frames drawn from 1,666 clinical sequences. Approximately 80% of the data was used for training, and the remainder for validation. Data was split at sequence boundaries to avoid having related images in the training and validation sets. While training was done with echo images/frames, evaluation was performed for both single frame discrimination as well as sequence discrimination (by majority voting). In total 10 networks were generated and evaluated. Unlike other domains where this network topology has been used, in ultrasound there is low visual variation between classes. This work shows the potential for CNNs to be applied to this low-variation domain of medical imaging for disease discrimination.

  7. Dengue seroprevalence and force of primary infection in a representative population of urban dwelling Indonesian children

    Science.gov (United States)

    Nealon, Joshua; Satari, Hindra Irawan; Karyanti, Mulya Rahma; Sekartini, Rini; Soedjatmiko, Soedjatmiko; Gunardi, Hartono; Medise, Bernie Endyarni; Sasmono, R. Tedjo; Simmerman, James Mark; Bouckenooghe, Alain; Hadinegoro, Sri Rezeki

    2017-01-01

    Background Indonesia reports the second highest dengue disease burden in the world; these data are from passive surveillance reports and are likely to be significant underestimates. Age-stratified seroprevalence data are relatively unbiased indicators of past exposure and allow understanding of transmission dynamics. Methodology/Principal Findings To better understand dengue infection history and associated risk factors in Indonesia, a representative population-based cross-sectional dengue seroprevalence study was conducted in 1–18-year-old urban children. From October to November 2014, 3,210 children were enrolled from 30 geographically dispersed clusters. Serum samples were tested for anti-dengue IgG antibodies by indirect ELISA. A questionnaire investigated associations between dengue serologic status and household socio-demographic and behavioural factors. Overall, 3,194 samples were tested, giving an adjusted national seroprevalence in this urban population of 69.4% [95% CI: 64.4–74.3] (33.8% [95% CI: 26.4–41.2] in the 1–4-year-olds, 65.4% [95% CI: 69.1–71.7] in the 5–9-year-olds, 83.1% [95% CI: 77.1–89.0] in the 10–14-year-olds, and 89.0% [95% CI: 83.9–94.1] in the 15–18-year–olds). The median age of seroconversion estimated through a linear model was 4.8 years. Using a catalytic model and considering a constant force of infection we estimated 13.1% of children experience a primary infection per year. Through a hierarchical logistic multivariate model, the subject’s age group (1–4 vs 5–9 OR = 4.25; 1–4 vs. 10–14 OR = 12.60; and 1–4 vs 15–18 OR = 21.87; p<0.0001) and the number of cases diagnosed in the household since the subject was born (p = 0.0004) remained associated with dengue serological status. Conclusions/Significance This is the first dengue seroprevalence study in Indonesia that is targeting a representative sample of the urban paediatric population. This study revealed that more than 80% of children aged 10

  8. Incidence and etiology of unplanned cast changes for fractures in the pediatric population.

    Science.gov (United States)

    DiPaola, Matthew J; Abzug, Joshua M; Pizzutillo, Peter D; Herman, Martin J

    2014-09-01

    The majority of pediatric fractures are treated in casts due to the child's ability to heal rapidly and remodel. Unplanned cast changes are a time and economic burden with potentially adverse effects on fracture management. The purpose of this study is to document the incidence, etiology, and complications related to unplanned cast changes. A prospective study was conducted over a 6-month period to determine the incidence of unplanned cast changes. All casts applied were nonwaterproof. Data collected include the reason for cast placement, type of cast placed, duration of wear before the unplanned change, reason for the unplanned change, experience level of the original cast applicator, and cast-related complications. A total of 1135 casts were placed with 58% placed by a resident, 38% by a cast technician, 2% by a physician's assistant, and 2% by an attending physician. Sixty casts (5.3%) required an unplanned change including 19 short-arm casts, 18 short-leg casts, 17 long-arm casts, 4 thumb spica casts, and 2 long-leg casts. The average duration from cast application until the unplanned change was 13 days. Twenty-eight (47%) were changed for wetness, 20 (33%) for wear/breakage, 2 (3%) for skin irritation, and 10 (17%) for other reasons including objects in the cast and patient self-removal. Two patients had superficial skin infections requiring oral antibiotics. No fracture reductions were lost secondary to an unplanned cast change. The need for an unplanned cast change did not correlate with the level of experience of the applicator. Most unplanned cast changes were the result of patient nonadherence to instructions and not related to cast application technique. Improved patient and family education regarding cast care may reduce the frequency of unplanned cast changes, thus reducing an economic and time burden on the health care system. Level II--prognostic study.

  9. Endoscopic Third Ventriculostomy for the Treatment of Hydrocephalus in a Pediatric Population with Myelomeningocele.

    Science.gov (United States)

    Rei, Joana; Pereira, Josué; Reis, Carina; Salvador, Sérgio; Vaz, Rui

    2017-09-01

    Hydrocephalus develops in up to 90% of patients born with myelomeningocele. Although endoscopic third ventriculostomy (ETV) is currently considered the preferred treatment for obstructive hydrocephalus, its results have been inconsistent in patients with myelomeningocele. This study focuses on clinical and radiologic outcomes of ETV in children with hydrocephalus related to myelomeningocele. Medical records of 18 pediatric patients with myelomeningocele treated with ETV from 1998 to 2015 at the Centro Hospitalar São João (Porto, Portugal) were reviewed retrospectively. Patients' caregivers were contacted to evaluate their clinical manifestations before and after surgery regarding signs and symptoms of hydrocephalus and Chiari malformation. Control neuroradiologic imaging of 9 patients was obtained and analyzed. Success of ETV was defined by clinical resolution and radiologic confirmation. ETV was successful in 8 of 18 cases (44.4%). Groups of patients were compared according to age at the time of surgery, with a 40% (2/5) success rate in newborns and a 50% success rate (3/6) in children older than 1 year. Eight patients underwent ETV as a first option, with a 37.5% success rate. Ten patients underwent the procedure after previous ventriculoperitoneal shunt (VPS), 5 for malfunction and 5 for VPS infection with 60% and 40% success rates, respectively. Early postoperative complications occurred in 2 patients. ETV can be performed in patients with myelomeningocele and hydrocephalus with success rates of almost 50%. Prior VPS or VPS malfunction or infection do not contraindicate ETV. If possible, the procedure should be delayed until the patient is at least 1 month old. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Vancomycin AUC/MIC and Corresponding Troughs in a Pediatric Population.

    Science.gov (United States)

    Kishk, Omayma A; Lardieri, Allison B; Heil, Emily L; Morgan, Jill A

    2017-01-01

    Adult guidelines suggest an area under the curve/minimum inhibitory concentration (AUC/MIC) > 400 corresponds to a vancomycin trough serum concentration of 15 to 20 mg/L for methicillin-resistant Staphylococcus aureus infections, but obtaining these troughs in children are difficult. The primary objective of this study was to assess the likelihood that 15 mg/kg of vancomycin every 6 hours in a child achieves an AUC/MIC > 400. This retrospective chart review included pediatric patients >2 months to AUCs were calculated four times using three pharmacokinetic methods. A total of 36 patients with 99 vancomycin trough serum concentrations were assessed. Baseline characteristics were similar between groups. For troughs in group 1 (n = 55), the probability of achieving an AUC/MIC > 400 ranged from 16.4% to 90.9% with a median trough concentration of 11.4 mg/L, while in group 2 (n = 44) the probability of achieving AUC/MIC > 400 ranged from 15.9% to 54.5% with mean trough concentration of 9.2 mg/L. The AUC/MICs were not similar between the different pharmacokinetic methods used; however, a trapezoidal equation (Method A) yielded the highest correlation coefficient (r 2 = 0.59). When dosing every 6 hours, an AUC/MIC of 400 correlated to a trough serum concentration of 11 mg/L. The probability of achieving an AUC/MIC > 400 using only a trough serum concentration and an MIC with patients receiving 15 mg/kg every 6 hours is variable based on the method used to calculate the AUC. An AUC/MIC of 400 in children correlated to a trough concentration of 11 mg/L using a trapezoidal Method to calculate AUC.

  11. Efficiency of aortic valve commissurotomy for congenital aortic valve stenosis in pediatric population

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    А. А. Лукьянов

    2015-10-01

    Full Text Available Background. This study was designed to evaluate short-term and long-term outcomes after open aortic valve commissurotomy in the pediatric patients at our center over a period of 10 years. Methods. A retrospective study of 94 patients who underwent open surgical commissurotomy because of aortic valve stenosis between 2003 and 2013 is presented. Follow-up time was in the range of 1 to 7 years. Results. The open aortic valve commissurotomy combined with debridement of leaflet free edge 36.1 %, LVOT myectomy 11.7%, leaflet suture plastic 7.4%, modified Konno procedure 6.3%, Brom's aortoplasty 4.2% was performed for all patients. Average cardiopulmonary bypass time was 59.2 30.7 min. Median aortic cross-clamping time was 31.52 15.1 min. Hospital complications were observed in 38.2% of cases. ICU time was in the range of 1 to 31 (mean 3.2 5.1 day. Artificial lung ventilation time varied from 2 to 76 (mean 15.3 18.3 hours. Inotropic support was needed in 26.5% of cases. Mean hospital stay time was 17.1 7.3 days. At follow-up between 2 and 7 years, reoperations were required for 3 patients who underwent a Ross procedure. Conclusions. The results evidence that open surgical commissurotomy is an effective way of treatment for aortic valve stenosis, considering the accuracy of plasty and additional techniques of leaflet correction. The best children age group for this type of operation is from first to five years of life.

  12. Prevalence of vitamin D deficiency and its associated factors among the urban elderly population in Hyderabad metropolitan city, South India.

    Science.gov (United States)

    Suryanarayana, Palla; Arlappa, Nimmathota; Sai Santhosh, Vadakattu; Balakrishna, Nagalla; Lakshmi Rajkumar, Pondey; Prasad, Undrajavarapu; Raju, Banavath Bhoja; Shivakeseva, Kommula; Divya Shoshanni, Kondru; Seshacharyulu, Madabushi; Geddam, Jagjeevan Babu; Prasanthi, Prabhakaran Sobhana; Ananthan, Rajendran

    2018-03-01

    Deficiency of vitamin D has been associated with various health conditions. However, vitamin D deficiency (VDD) and factors associated with VDD are not well studied, especially among the urban elderly population of India. To assess the prevalence of VDD and its associated factors among the urban free-living elderly population in Hyderabad. A community-based cross-sectional study was conducted among 298 urban elderly (≥60 years) by adapting a random sampling procedure. Demographic particulars were collected. Blood pressure and anthropometric measurements were recorded using standard equipment. Fasting glucose, lipid profile and 25-hydroxy vitamin D [25(OH) D] were estimated in plasma samples. The mean ± SE plasma vitamin D and the prevalence of VDD among the urban elderly population were 19.3 ± 0.54 (ng/ml) and 56.3%, respectively. The prevalence of VDD was significantly associated with education, high body mass index (BMI), hypertension (HT) and metabolic syndrome (MS). Multiple logistic regression analysis revealed HT as a significant predictor of vitamin D deficiency and the risk of VDD was double among the elderly with hypertension. The prevalence of VDD was high among the urban elderly population in the south Indian city of Hyderabad. High BMI, MS, HT and education are significant associated factors of VDD.

  13. Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

    Science.gov (United States)

    Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

    2017-12-01

      Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

  14. Pattern and frequency of substance abuse in urban population of Lucknow

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    S C Tiwari

    2008-01-01

    Full Text Available Background: The urban Lucknow community was studied during a project "A study to evolve material for prevention of drug/alcohol/tobacco (substance abuse through social marketing" funded by Council of Science & Technology, Lucknow. The paper presents pattern and frequency of substance abuse in urban population of Lucknow based upon it. Method: Two mohallas of a ward from Lucknow Municipal Corporation were selected randomly. A total of 842 heads of the households (out of 5420 members were studied using Semi Structured Socio demographic data-sheet and Proforma from WHO-ICMR a collaborative study on narcotics and psychotropic drugs. Data was analyzed using percentage, mean and S.D. Results: Out of 5420 subjects 34.31% (30.22% males & 4.09% females were found to be substance abusers. Majority of subjects used tobacco (68.17% smoking, 65.17% eating. Conclusion : Majority of subjects were regular users constituted 73.65% tobacco smokers and 74.38% eaters/chewers, 62.38% alcoholics were experimenters and amongst those who were psychotropic drug abusers, 64.28% were dependant.

  15. Phytoestrogens levels determination in the cord blood from Malaysia rural and urban populations

    International Nuclear Information System (INIS)

    Mustafa, A.M.; Malintan, N.T.; Seelan, S.; Zhan, Z.; Mohamed, Z.; Hassan, J.; Pendek, R.; Hussain, R.; Ito, N.

    2007-01-01

    This study is a result of an analysis of free and conjugated phytoestrogens daidzein, genistein, daidzin, genistin and coumesterol in human cord blood plasma using LCMS. Cord blood was collected from urban and rural populations of Malaysia (n = 300) to establish a simple preliminary database on the levels of the analyzed compounds in the collected samples. The study also aimed to look at the levels of phytoestrogens in babies during birth as this may have a profound effect on the developmental process. The sample clean up was carried out by solid-phase extraction using C18 column and passed through DEAE sephadex gel before analysis by LCMS. The mean concentrations of total phytoestrogens were daidzein (1.4 ± 2.9 ng/ml), genistein (3.7 ± 2.8 ng/ml), daidzin (3.5 ± 3.1 ng/ml), genistin (19.5 ± 4.2 ng/ml) and coumesterol (3.3 ± 3.3 ng/ml). Distribution of phytoestrogen was found to be higher in samples collected from rural areas compared to that of urban areas

  16. Status of Vitamin B12 and Folate among the Urban Adult Population in South India.

    Science.gov (United States)

    Sivaprasad, M; Shalini, T; Balakrishna, N; Sudarshan, M; Lopamudra, P; Suryanarayana, P; Arlappa, N; Ravikumar, B P; Radhika, M S; Reddy, G Bhanuprakash

    2016-01-01

    Deficiency of vitamin B12 (B12) and folate (FA) leads to a wide spectrum of disorders that affect all age groups. However, reports on B12 and FA status in healthy adults in India are limited. Hence, we determined the plasma levels and dietary intake of B12 and FA in the adult population. We conducted a community-based cross-sectional study in an urban setup among 630 apparently healthy adults distributed into 3 age groups: 21-40, 41-60 and >60 years. Plasma concentrations of B12 and FA were analyzed by radio immunoassay and dietary intake by 24-hour recall method. The overall prevalence of FA deficiency was 12%, but there was no significant difference in plasma FA concentrations among the groups. While the overall prevalence of B12 deficiency was 35%, it was significantly higher in the 21-40 (44%) and 41-60 age groups (40%) when compared with the >60 group (30%). B12 deficiency was higher in vegetarians (54%) compared to those consuming mixed diet (31%), and the reverse was the case with FA. However, the dietary intakes of FA and B12 were not significantly different among the groups. These results indicate a higher prevalence of B12 deficiency in apparently healthy adults in an urban setup. © 2015 S. Karger AG, Basel.

  17. Communication of urgent public health messages to urban populations: lessons from the Massachusetts water main break.

    Science.gov (United States)

    Wang, C Jason; Little, Alison A; Holliman, Jaime Bruce; Ng, Chun Y; Barrero-Castillero, Alejandra; Fu, Chong Min; Zuckerman, Barry; Bauchner, Howard

    2011-10-01

    To study when and how an urgent public health message about a boil-water order reached an urban population after the Massachusetts water main break. In-person surveys were conducted in waiting areas of clinics and emergency departments at a large urban safety net hospital within 1 week of the event. Of 533 respondents, 97% were aware of the order; 34% of those who lived in affected cities or towns were potentially exposed to contaminated water. Among those who were aware, 98% took action. Respondents first received the message through word of mouth (33%), television (25%), cellular telephone calls (20%), landline calls (10%), and other modes of communication (12%). In multivariate analyses, foreign-born respondents and those who lived outside the city of Boston had a higher risk of exposure to contaminated water. New modes (eg, cellular telephones) were used more commonly by females and younger individuals (ages 18 to 34). Individuals who did not speak English at home were more likely to receive the message through their personal networks. Given the increasing prevalence of cellular telephone use, public officials should encourage residents to register landline and cellular telephone for emergency alerts and must develop creative ways to reach immigrants and non-English-speaking groups quickly via personal networks.

  18. The Prevalence and Distribution of Vitreoretinal Interface Abnormalities among Urban Community Population in China

    Directory of Open Access Journals (Sweden)

    Lei Liu

    2015-01-01

    Full Text Available The aim of this research was to identify the prevalence and distribution of vitreoretinal interface abnormalities (VIAs among urban community population in Shenyang, China. According to the WHO criteria, a cross-sectional study was carried out among 304 Type 2 diabetes (T2D patients and 304 people without diabetes as control over 45 years old. The presence of VIAs was determined by standardized grading of macular optical coherence tomography (Optovue OCT; Optovue, Inc., Fremont, CA scans and two-field fundus photographs in at least one eye. For both men and women, high prevalence of VIAs (70.79% was observed among over 65-years-old T2D patients. Prevalence of VIAs was observed to be high among T2D patients in all age groups compared to normal subjects. Prevalence of VIAs increased with age in all subjects. Prevalence of components of VIAs was epiretinal membrane (ERM 11.43%, posterior vitreous detachment (PVD 17.76%, vitreomacular traction syndrome (VMT 5.67%, macular cysts/macular edema (MC/ME 4.61%, full-thickness macular hole (FTMH 0.82%, and partial thickness macular hole (PTMH 0.74% in any eye, respectively. ERM and MC/ME were more prevalent in T2D in both males and females. The results highlight the need for early detection using OCT and approaches for the prevention of VIAs of diabetes in urban community.

  19. Life after Stroke in an Urban Minority Population: A Photovoice Project

    Directory of Open Access Journals (Sweden)

    Revathi Balakrishnan

    2017-03-01

    Full Text Available Stroke is a leading cause of disability in the United States and disproportionately affects minority populations. We sought to explore the quality of life in urban, minority stroke survivors through their own photos and narratives. Using the Photovoice method, seventeen stroke survivors were instructed to take pictures reflecting their experience living with and recovering from stroke. Key photographs were discussed in detail; participants brainstormed ways to improve their lives and presented their work in clinical and community sites. Group discussions were recorded, transcribed, and coded transcripts were reviewed with written narratives to identify themes. Participants conveyed recovery from stroke in three stages: learning to navigate the initial physical and emotional impact of the stroke; coping with newfound physical and emotional barriers; and long-term adaptation to physical impairment and/or chronic disease. Participants navigated this stage-based model to varying degrees of success and identified barriers and facilitators to this process. Barriers included limited access for disabled and limited healthy food choices unique to the urban setting; facilitators included presence of social support and community engagement. Using Photovoice, diverse stroke survivors were able to identify common challenges in adapting to life after stroke and important factors for recovery of quality of life.

  20. Intestinal helminths of feral cat populations from urban and suburban districts of Qatar.

    Science.gov (United States)

    Abu-Madi, Marawan A; Behnke, Jerzy M; Prabhaker, K S; Al-Ibrahim, Roda; Lewis, John W

    2010-03-25

    A survey of the helminths of 658 adult cats from feral urban and suburban populations in Qatar was conducted across all months in 2006 and 2007. Six species of helminths were identified, comprising two cestodes (Taenia taeniaeformis [73.6%] and Diplopylidium acanthotetra [47.1%]) and four nematodes (Ancylostoma tubaeforme [14.7%], Physaloptera praeputialis [5.2%], Toxocara cati [0.8%] and Toxascaris leonina [0.2%]), and 83% of cats were infected with at least one of these. The average number of species harboured was 1.4 and the average worm burden was 55.8 worms/cat. The vast majority of worms (97.6%) were cestodes, nematodes being relatively rare. Prevalence and abundance of infections were analyzed, taking into consideration four factors: year (2006 and 2007), site (urban and suburban), season (winter and summer) and sex of the host. Analyses revealed marked year effects, female host bias in some species and interactions involving combination of factors, but especially sex and season of the year. The results indicate that whilst the majority of adult feral cats in Qatar carry helminth infections, infections are variable between years and subject to annual changes that may reflect climatic and other environmental changes in the rapidly developing city of Doha and its suburban surroundings. Only two species have the potential to infect humans and both were rare among the sampled cats (A. tubaeforme and T. cati).

  1. Life after Stroke in an Urban Minority Population: A Photovoice Project.

    Science.gov (United States)

    Balakrishnan, Revathi; Kaplan, Benjamin; Negron, Rennie; Fei, Kezhen; Goldfinger, Judith Z; Horowitz, Carol R

    2017-03-11

    Stroke is a leading cause of disability in the United States and disproportionately affects minority populations. We sought to explore the quality of life in urban, minority stroke survivors through their own photos and narratives. Using the Photovoice method, seventeen stroke survivors were instructed to take pictures reflecting their experience living with and recovering from stroke. Key photographs were discussed in detail; participants brainstormed ways to improve their lives and presented their work in clinical and community sites. Group discussions were recorded, transcribed, and coded transcripts were reviewed with written narratives to identify themes. Participants conveyed recovery from stroke in three stages: learning to navigate the initial physical and emotional impact of the stroke; coping with newfound physical and emotional barriers; and long-term adaptation to physical impairment and/or chronic disease. Participants navigated this stage-based model to varying degrees of success and identified barriers and facilitators to this process. Barriers included limited access for disabled and limited healthy food choices unique to the urban setting; facilitators included presence of social support and community engagement. Using Photovoice, diverse stroke survivors were able to identify common challenges in adapting to life after stroke and important factors for recovery of quality of life.

  2. Pediatric neurocritical care.

    Science.gov (United States)

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  3. Blindness and Visual Impairment in an Urban West African Population: The Tema Eye Survey

    Science.gov (United States)

    Budenz, Donald L.; Bandi, Jagadeesh R.; Barton, Keith; Nolan, Winifred; Herndon, Leon; Whiteside-de Vos, Julia; Hay-Smith, Graham; Kim, Hanna; Tielsch, James

    2012-01-01

    Objective To determine the prevalence, etiologies, and risk factors of blindness and visual impairment among persons age 40 years and older residing in an urban West African location. Design Population-based cross-sectional study. Participants Five thousand six hundred and three participants residing in Tema, Ghana. Methods Proportionate random cluster sampling was used to select participants age 40 and over living in the city of Tema. Presenting distance visual acuity was measured at 4 and 1 meters using a reduced Logarithm of the Minimum Angle of Resolution (logMAR) tumbling E chart and then with trial frame based on autorefraction. A screening examination was performed in the field on all participants. Complete clinical examination by an ophthalmologist was performed on participants with best corrected visual acuity blindness (visual acuity in the better eye of blindness was 1.2%. After refraction and spectacle correction, the prevalence of visual impairment and blindness decreased to 6.7% and 0.75% respectively, suggesting that refractive error is the major correctable etiology of visual impairment and blindness in this population. Of 65 subjects having visual acuity blindness and visual impairment. Conclusions There is a high prevalence of blindness and visual impairment among those aged ≥40 years in Tema, Ghana, West Africa. Refractive error is a major cause of blindness and visual impairment in this population, followed by cataract, glaucoma, and corneal disease. PMID:22677425

  4. Urban and global populism: An analysis of Jakarta as Resilient City

    Science.gov (United States)

    Sustikarini, A.; Kabinawa, L. N. R. W.

    2018-03-01

    One of the important elements of friendly city is its cordiality towards diversity. Cities will naturally attract people from different nationalities to live, study and work. The rapid development of cities has long been regarded as major drive of urbanization from other areas which contributed to the high level of ethnic and race diversities. However diversity is currently seen under threat due to the rise of global populism that is mainly fuelled by anxiety over economic condition. The growth of nationalist movement, anti-immigrant parties and xenophobia is gaining foothold across the planet. Against this backdrop, this paper aims at investigating the nexus between diversity and inequality in Jakarta. The current local election provides example of these two competing concepts. Jakarta as emerging global city with diverse communities had been marred by public protest and narration of identity issues. On the other hands, populism has deep root in severe economic inequality among the residents. A robust development in Jakarta has been marked by concentration of wealth in the hands of few. This paper presents case study on the root causes of growing populism and its relations with inequality in Jakarta.

  5. Medical Cannabis in Serbia: The Survey of Knowledge and Attitudes in an Urban Adult Population.

    Science.gov (United States)

    Gazibara, Tatjana; Prpic, Milica; Maric, Gorica; Pekmezovic, Tatjana; Kisic-Tepavcevic, Darija

    2017-01-01

    There are some indices in which legalization of medical cannabis in the Republic of Serbia might be considered. The purpose of this research was to assess knowledge and attitudes towards medical cannabis in an urban adult population. This cross-sectional study was conducted in December 2015 and January 2016. A convenience sample of study participants comprised users of the Community Health Center. A total of 360 adults were invited to participate. Data were collected through an anonymous questionnaire. Most participants (77.1%) answered correctly that cancer was indicative of medical cannabis treatment, while the remaining conditions were less frequently recognized. A total of 42% answered correctly that adverse effects of cannabis were hallucinations and dizziness. Persons who previously used cannabis were more knowledgeable on conditions for medical cannabis treatment (ρ = 0.155; p = 0.006). Study respondents expressed positive attitude towards legalization of medical cannabis (median 5 out of 5) and negative towards legalization of recreational cannabis (median 2 out of 5). In conclusion, the adult population in Belgrade had some knowledge of medical cannabis. The overall attitude of our population regarding legalization of medical cannabis was positive, while the attitude towards legalization of cannabis for recreational purposes was negative.

  6. Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population.

    Science.gov (United States)

    Albin, Stephanie; Agarwal, Shradha

    2014-01-01

    Penicillin allergy remains the most common drug allergy, with a reported prevalence of 10% in the United States. Epidemiology of penicillin allergy in outpatient populations is relatively scarce. This study sought to determine the prevalence and characteristics of reported penicillin allergy in an urban outpatient population and to identify trends in clinical evaluation and management from a tertiary center serving a large inner-city population. A retrospective review of electronic medical records was performed of adult patients seen in the Internal Medicine Associates Clinic of Mount Sinai Hospital between January 31, 2012, and July 31, 2012. Medical records were selected based on the documentation of penicillin in patient's allergy section. Of the 11,761 patients seen in the clinic, 1348 patients (11.5%) reported a history of penicillin allergy. The most common allergic reactions were rash (37%), unknown/undocumented (20.2%), hives (18.9%), swelling/angioedema (11.8%), and anaphylaxis (6.8%). There was an increased prevalence of penicillin allergy in female patients compared with male patients (odds ratio [OR] = 1.82; 95% CI = 1.60, 2.08; p penicillin allergy compared with Caucasians (OR = 0.51; 95% CI = 0.32, 0.83; p = 0.007). However, only 78 (6%) of the patients reporting penicillin allergy had a referral to an allergy specialist. Overall, improved referral to an allergist will help to identify patients who have penicillin allergy requiring avoidance.

  7. Modeling Effects of Climate Change on Air Quality and Population Exposure in Urban Planning Scenarios

    Directory of Open Access Journals (Sweden)

    Lars Gidhagen

    2012-01-01

    Full Text Available We employ a nested system of global and regional climate models, linked to regional and urban air quality chemical transport models utilizing detailed inventories of present and future emissions, to study the relative impact of climate change and changing air pollutant emissions on air quality and population exposure in Stockholm, Sweden. We show that climate change only marginally affects air quality over the 20-year period studied. An exposure assessment reveals that the population of Stockholm can expect considerably lower NO2 exposure in the future, mainly due to reduced local NOx emissions. Ozone exposure will decrease only slightly, due to a combination of increased concentrations in the city centre and decreasing concentrations in the suburban areas. The increase in ozone concentration is a consequence of decreased local NOx emissions, which reduces the titration of the long-range transported ozone. Finally, we evaluate the consequences of a planned road transit project on future air quality in Stockholm. The construction of a very large bypass road (including one of the largest motorway road tunnels in Europe will only marginally influence total population exposure, this since the improved air quality in the city centre will be complemented by deteriorated air quality in suburban, residential areas.

  8. Prevalence of risk factors for coronary artery disease in an urban Indian population

    Science.gov (United States)

    Sekhri, T; Kanwar, R S; Wilfred, R; Chugh, P; Chhillar, M; Aggarwal, R; Sharma, Y K; Sethi, J; Sundriyal, J; Bhadra, K; Singh, S; Rautela, N; Chand, Tek; Singh, M; Singh, S K

    2014-01-01

    Objective The objective of this study was to assess the prevalence of risk factors for coronary artery disease (CAD) in government employees across India. Methods The study population consisted of government employees in different parts of India ({n=10 642 men and n=1966 women; age 20–60 years}) and comprised various ethnic groups living in different environmental conditions. Recruitment was carried out in 20 cities across 14 states, and in one union territory. All selected individuals were subjected to a detailed questionnaire, medical examinations and anthropometric measurements. Blood samples were collected for blood glucose and serum lipid profile estimation, and resting ECG was recorded. Results were analysed using appropriate statistical tools. Results The study revealed that 4.6% of the study population had a family history of premature CAD. The overall prevalence of diabetes was 16% (5.6% diagnosed during the study and the remaining 10.4% already on medication). Hypertension was present in 21% of subjects. The prevalence of dyslipidemia was significantly high, with 45.6% of study subjects having a high total cholesterol/high density lipoprotein ratio. Overall, 78.6% subjects had two or more risk factors for CAD. Conclusions The present study demonstrates a high prevalence of CAD risk factors in the Indian urban population. Therefore, there is an immediate need to initiate measures to raise awareness of these risk factors so that individuals at high risk for future CAD can be managed. PMID:25488095

  9. [Population dynamics, urban structure, and production of living space in the metropolitan zone of Mexico City].

    Science.gov (United States)

    Schteingart, M

    1989-01-01

    "In this article, an attempt is made to account for certain trends in the growth and distribution of the population, and in the structuring of living space in the metropolitan zone of Mexico City.... Among the important conclusions of this essay are those having to do with the huge growth of some political-administrative units and the relation of this phenomenon to the practices followed by private realtors, often articulated with the policies and programs set by the State's housing agencies, as well as those that associate urban growth and expansion with the development of habitational spaces within the so-called 'formal' and 'informal' housing sectors." Data are from Mexican censuses and other official sources. (SUMMARY IN ENG) excerpt

  10. Prevalence, awareness, treatment and control of dyslipidemia in older persons in urban and rural population in the Astana region, Kazakhstan.

    Science.gov (United States)

    Supiyev, Adil; Nurgozhin, Talgat; Zhumadilov, Zhaxybay; Peasey, Anne; Hubacek, Jaroslav A; Bobak, Martin

    2017-08-11

    Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan. We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured. The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction. This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.

  11. [Sociodemographic and environmental factors associated with sports physical activity in the urban population of Peru].

    Science.gov (United States)

    Seclén-Palacín, Juan A; Jacoby, Enrique R

    2003-10-01

    To determine the frequency of sports physical activity in the urban population of Peru and to identify the sociodemographic, economic, and environmental factors associated with that activity. This study utilized information collected by the country's National Household Survey (Encuesta Nacional de Hogares) in the second quarter of 1997. That Survey is overseen by Peru's National Institute of Statistics and Informatics (Instituto Nacional de Estadística e Informática). The Survey was based on a probabilistic, multistage sample that was stratified for all the urban areas of the country, which was divided into eight geographic regions: metropolitan Lima, northern coast, central coast, southern coast, northern mountains, central mountains, southern mountains, and jungle. In total, 14 913 homes were visited and 45 319 people at least 15 years of age were interviewed. The frequency of engaging in sports physical activity was classified as daily, every other day, weekly, or occasional. "Regular sports activity" (RSA) was defined as engaging in sports either every day or every other day. The preferences for and obstacles to sports practice were also examined. A descriptive analysis of the levels of RSA was carried out for gender, using the chi-square test. The factors associated with RSA were analyzed through conditional multiple logistic regression and analysis of residuals, multicollinearity, and interactions. The level of significance was set at P jungle (15.3%), central mountains (12.8%), and central coast (12.1%). RSA was least common in two regions: southern mountains (9.7%) and metropolitan Lima (10.6%). The income bracket was not associated with RSA. However, other variables associated indirectly with the socioeconomic level - such as having more formal education, being employed, and having access to the Internet or cable television - and consumption of sports information were significantly and directly associated with RSA. The most frequent barriers to

  12. A case-control study of Drug-Induced Sleep Endoscopy (DISE) in pediatric population: A proposal for indications.

    Science.gov (United States)

    Collu, Maria Antonietta; Esteller, Eduard; Lipari, Fiorella; Haspert, Raul; Mulas, Demetrio; Diaz, Miguel Angel; Dwivedi, Raghav C

    2018-05-01

    To evaluate whether and when Drug-Induced Sleep Endoscopy (DISE) changes diagnosis and treatment plan in pediatric Obstructive Sleep Apnoea Syndrome (OSAS) with the aim to identify specific subgroups of patients for whom DISE should be especially considered. A case-control study of DISE in 150 children with OSAS. Pre-operative OSA were assessed through detailed history, Chervin questionnaire, physical examination and overnight polysomnography. The group of study was divided into three subgroups according to clinical and polysomnographyc criteria: conventional OSAS, disproportional OSAS and persistent OSAS. Endoscopic evaluation of the upper airway during DISE was scored using Chan classification. Surgical treatment was tailored individually upon the basis of sleep endoscopy findings: performance of any surgery other than tonsillectomy and adenoidectomy (T&A) was considered as a change of the treatment plan. Cases and controls were compared considering presence and absence of DISE-directed extra surgery, respectively. 150 patients with mean age (SD) 56.09 (23.94) months and mean apnoea-hypopnea index (AHI) of 5.79 (6.52) underwent DISE. The conventional subgroup represented the 58.67% of the sample (n = 88), while the disproportional one counted for the 26.67% (n = 40), and the persistent one for 14.66% (n = 22) of the population. Sleep endoscopy changed the surgical plan in 4.5% of conventional OSAS, 17.5% of disproportional OSAS and 72.7% of persistent OSAS (p < 0.005). Overall, a change of the treatment plan operated by DISE was associated with a non-conventional OSAS status (OR = 6; 95% CI = 1.6-26.4). DISE is a safe procedure in children suffering from OSAS, and, despite being unnecessary in conventional cases of OSA, DISE should be considered not only in syndromic children, as previously demonstrated, but also in the general non-syndromic pediatric population, in the case of non-conventional OSA patients, and in children with persistent

  13. Validation of the EQ-5D in a general population sample in urban China.

    Science.gov (United States)

    Wang, Hong-Mei; Patrick, Donald L; Edwards, Todd C; Skalicky, Anne M; Zeng, Hai-Yan; Gu, Wen-Wen

    2012-02-01

    To evaluate the reliability and validity of the EQ-5D in a general population sample in urban China. Thousand and eight hundred respondents in 18 communities of Hangzhou, China were recruited by multi-stage stratified random sampling. Respondents self-administered a questionnaire including the EQ-5D, the SF-36, and demographic questions. Test-retest reliability at 2-week intervals was evaluated using Kappa coefficient, the intraclass correlation coefficient. The standard error of measurement (SEM) was used to indicate the absolute measurement error. Construct validity was established using convergent, discriminant, and known groups analyses. Complete data for all EQ-5D dimensions were available for 1,747 respondents (97%). Kappa values were from 0.35 to 1.0. The ICCs of test-retest reliability were 0.53 for the EQ-5D index score and 0.87 for the EQ VAS score. The SEM values were 0.13 (9.22% range) and 4.20 (4.20% range) for the EQ-5D index and EQ VAS scores, respectively. The Pearson's correlation coefficients between the EQ-5D and the SF-36 were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. The Chinese EQ-5D distinguished well between known groups: respondents who reported poor general health and chronic diseases had worse HRQoL than those without. Older people, females, people widowed or divorced, and those with a lower socioeconomic status reported poorer HRQoL. Respondents reporting no problems on any EQ-5D dimension had better scores on the SF-36 summary scores than those reporting problems. The Chinese version of the EQ-5D demonstrated acceptable construct validity and fair to moderate levels of test-retest reliability in an urban general population in China.

  14. Urban-rural differences in a population-based breast cancer screening program in Croatia

    Science.gov (United States)

    Stamenić, Valerija; Strnad, Marija

    2011-01-01

    Aim To investigate urban-rural differences in the distribution of risk factors for breast cancer. Methods We analyzed the data from the first round of the “Mamma” population based-screening program conducted in Croatia between 2007 and 2009 and self-reported questionnaire results for 924 patients with histologically verified breast cancer. Reproductive and anthropometric characteristics, family history of breast cancer, history of breast disease, and prior breast screening history were compared between participants from the city of Zagreb (n = 270) and participants from 13 counties with more than 50% of rural inhabitants (n = 654). Results The screen-detected breast cancer rate was 4.5 per 1000 mammographies in rural counties and 4.6 in the city of Zagreb, while the participation rate was 61% in rural counties and 59% in Zagreb. Women from Zagreb had significantly more characteristics associated with an increased risk of breast cancer (P < 0.001 in all cases): no pregnancies (15% vs 7%), late age of first pregnancy (≥30 years) (10% vs 4%), and the most recent mammogram conducted 2-3 years ago (32% vs 14%). Women from rural counties were more often obese (41% vs 28%) and had early age of first live birth (<20 years) (20% vs 7%, P < 0.001 for both). Conclusion Identification of rural-urban differences in mammography use and their causes at the population level can be useful in designing and implementing interventions targeted at the reduction of inequalities and modifiable risk factors. PMID:21328724

  15. The polaroid suppression test in a pediatric population with ophthalmologic disorders

    NARCIS (Netherlands)

    Pott, JWR; Kingma, C; Verhoeff, K; Grootendorst, RJ; de Faber, JTHN

    Purpose: The Polaroid suppression test (PST) is a new method for early detection of amblyogenic factors by screening for suppression. The apparatus can elicit suppression with the use of Polaroid filters. The aim of the present study was to examine a population of children with known ophthalmologic

  16. Epidemiology and population structure of Staphylococcus aureus in various population groups from a rural and semi urban area in Gabon, Central Africa

    NARCIS (Netherlands)

    Ateba Ngoa, Ulysse; Schaumburg, Frieder; Adegnika, Ayola Akim; Kösters, Katrin; Möller, Tina; Fernandes, Jose Francisco; Alabi, Abraham; Issifou, Saadou; Becker, Karsten; Grobusch, Martin Peter; Kremsner, Peter Gottfried; Lell, Bertrand

    2012-01-01

    Little data is available on the epidemiology of Staphylococcus aureus in Africa. In the present study we aim at characterizing the population structure of S. aureus in healthy subjects from a rural and a semi-urban area in Lambarene, Gabon as well as in hospital staff and inpatients. In total, 500

  17. Multistate matrix population model to assess the contributions and impacts on population abundance of domestic cats in urban areas including owned cats, unowned cats, and cats in shelters

    Science.gov (United States)

    Coe, Jason B.

    2018-01-01

    Concerns over cat homelessness, over-taxed animal shelters, public health risks, and environmental impacts has raised attention on urban-cat populations. To truly understand cat population dynamics, the collective population of owned cats, unowned cats, and cats in the shelter system must be considered simultaneously because each subpopulation contributes differently to the overall population of cats in a community (e.g., differences in neuter rates, differences in impacts on wildlife) and cats move among categories through human interventions (e.g., adoption, abandonment). To assess this complex socio-ecological system, we developed a multistate matrix model of cats in urban areas that include owned cats, unowned cats (free-roaming and feral), and cats that move through the shelter system. Our model requires three inputs—location, number of human dwellings, and urban area—to provide testable predictions of cat abundance for any city in North America. Model-predicted population size of unowned cats in seven Canadian cities were not significantly different than published estimates (p = 0.23). Model-predicted proportions of sterile feral cats did not match observed sterile cat proportions for six USA cities (p = 0.001). Using a case study from Guelph, Ontario, Canada, we compared model-predicted to empirical estimates of cat abundance in each subpopulation and used perturbation analysis to calculate relative sensitivity of vital rates to cat abundance to demonstrate how management or mismanagement in one portion of the population could have repercussions across all portions of the network. Our study provides a general framework to consider cat population abundance in urban areas and, with refinement that includes city-specific parameter estimates and modeling, could provide a better understanding of population dynamics of cats in our communities. PMID:29489854

  18. Multistate matrix population model to assess the contributions and impacts on population abundance of domestic cats in urban areas including owned cats, unowned cats, and cats in shelters.

    Science.gov (United States)

    Flockhart, D T Tyler; Coe, Jason B

    2018-01-01

    Concerns over cat homelessness, over-taxed animal shelters, public health risks, and environmental impacts has raised attention on urban-cat populations. To truly understand cat population dynamics, the collective population of owned cats, unowned cats, and cats in the shelter system must be considered simultaneously because each subpopulation contributes differently to the overall population of cats in a community (e.g., differences in neuter rates, differences in impacts on wildlife) and cats move among categories through human interventions (e.g., adoption, abandonment). To assess this complex socio-ecological system, we developed a multistate matrix model of cats in urban areas that include owned cats, unowned cats (free-roaming and feral), and cats that move through the shelter system. Our model requires three inputs-location, number of human dwellings, and urban area-to provide testable predictions of cat abundance for any city in North America. Model-predicted population size of unowned cats in seven Canadian cities were not significantly different than published estimates (p = 0.23). Model-predicted proportions of sterile feral cats did not match observed sterile cat proportions for six USA cities (p = 0.001). Using a case study from Guelph, Ontario, Canada, we compared model-predicted to empirical estimates of cat abundance in each subpopulation and used perturbation analysis to calculate relative sensitivity of vital rates to cat abundance to demonstrate how management or mismanagement in one portion of the population could have repercussions across all portions of the network. Our study provides a general framework to consider cat population abundance in urban areas and, with refinement that includes city-specific parameter estimates and modeling, could provide a better understanding of population dynamics of cats in our communities.

  19. Geo-ethical dimension of community's safety: rural and urban population vulnerability analysis methodology

    Science.gov (United States)

    Kostyuchenko, Yuriy; Movchan, Dmytro; Kopachevsky, Ivan; Yuschenko, Maxim

    2016-04-01

    calculate a distribution of losses connected with decision making in land-use is demonstrated. Rural community's vulnerability determines by water availability, quality of soils, effectiveness of land use (including climate change adaptation), intensity of pollutions, crop productivity variations during the period of crop rotation, annual national distribution of crops output, and distance to city centres. It should noted here that "distance to city centres" is not comprehensive indicator of market accessibility in general case: quality and availability of transport infrastructure should be described more detailed on the next stages of analysis. Urban population vulnerability determines by distribution of urban fractures and quality urban environment: density, quality and availability of infrastructure, balance between industrial, residential and recreational zones, effectiveness of urban land use and landscape management, and social policy, particularly, employment. Population density is closely connected with social density, with communications and decision making. Social learning, as the function of social communications, is the way to increase sustainability. Also it possible to say that social sustainability is a function of intensity and efficiency of communications between interlinked and interacted networks in the heterogeneous environment. Therefore the results of study demonstrated that risk management study should includes issues of risk and threats perception, which should be described in framework of appropriate tools and approaches connected with ethical dimension of vulnerability. For instance, problems of accessibility and availability of safety resources in view of social fairness and socio-economic dynamics should be included into future studies in field of risk analysis.

  20. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  1. Characteristics of cardiovascular risk factors in an urban and rural population of the Peruvian jungle - July, 2014

    Directory of Open Access Journals (Sweden)

    Yordan Martínez-Espichán

    2017-02-01

    Full Text Available Objective: To determine the characteristics of the place of residence and the cardiovascular risk factors in a Peruvian jungle population in July 2014. Materials and methods: A descriptive cross-sectional study conducted in individuals between 30 and 74 years old without a diagnosis of or treatment for a cardiovascular disease in an urban and rural population of the district of Yantaló. The sample was obtained using the Power Analysis and Sample Size Software (PASS program, and consisted of 268 people (152 urban and 116 rural residents. The studied factors were hypertension (HBP, diabetes mellitus (DM, body mass index (BMI, waist-hip ratio (WHR and smoking. Results: The urban population had higher rates of hypertension (18.4%, while the other risk factors showed no significant differences between the two populations. Conclusions: The only risk factor that showed a significant association with the place of residence was hypertension. In contrast, the other risk factors of the study showed no differences between the two populations, which demonstrates that the district of Yantaló is involved in a process of epidemiological transition due to urbanization.

  2. An epidemiological study of diabetes mellitus amongst high risk age group population in urban and Rural areas of kanpur

    Directory of Open Access Journals (Sweden)

    Nadeem Ahmad

    2003-12-01

    Full Text Available Research Question : - What is the magnitude of Diabetes mellitus in the urban and rural areas of Kanpur.Objectives:To study the prevalence of diabetes mellitus amongst high risk age group population in urban and rural areas of Kanpur.To compare the magnitude of problem of diabetes mellitus between urban and rural areas of Kanpur.To study the possible associates and socio-demographic variables related to diabetes mellitus.Study Design : Cross sectional study.Setting : The study was performed on three thousand population each in urban and rural areas of Kanpur.Participants : High risk age group population i.e. 45 years and above.Study variables : Age, Sex. impaired glucose tolerance. Body mass index, Education, Working status. Social class, family history of diabetes.Statistical analysis : Chi-square lest, percentagesResults From a total of 676 persons of high risk age group i.e. 45 years and above, the overall prevalence of diabetes mellitus in the study areas was observed lobe 7. l%with 9.94% in urban and 3.61% in rural areas, the maximum percetage of diabetes cases (41.66% was in the age group of 56-60 years. Higher prevalence of diabetes was observed in the obese (56.25% and sedentary (87.5% persons. The family history' of diabetes mellitus was present in (35.41% of diabetes mellitus cases.

  3. Rapid assessment of visual impairment in urban population of Delhi, India.

    Science.gov (United States)

    Gupta, Noopur; Vashist, Praveen; Malhotra, Sumit; Senjam, Suraj Singh; Misra, Vasundhara; Bhardwaj, Amit

    2015-01-01

    To determine the prevalence, causes and associated demographic factors related to visual impairment amongst the urban population of New Delhi, India. A population-based, cross-sectional study was conducted in East Delhi district using cluster random sampling methodology. This Rapid Assessment of Visual Impairment (RAVI) survey involved examination of all individuals aged 40 years and above in 24 randomly selected clusters of the district. Visual acuity (VA) assessment and comprehensive ocular examination were done during the door-to-door survey. A questionnaire was used to collect personal and demographic information of the study population. Blindness and Visual Impairment was defined as presenting VA visual impairment. Of 2421 subjects enumerated, 2331 (96.3%) were available for ophthalmic examination. Among those examined, 49.3% were males. The prevalence of visual impairment (VI) in the study population, was 11.4% (95% C.I. 10.1, 12.7) and that of blindness was 1.2% (95% C.I. 0.8, 1.6). Uncorrected refractive error was the leading cause of VI accounting for 53.4% of all VI followed by cataract (33.8%). With multivariable logistic regression, the odds of having VI increased with age (OR = 24.6[95% C.I.: 14.9, 40.7]; p visual impairment is considerable in this region despite availability of adequate eye care facilities. Awareness generation and simple interventions like cataract surgery and provision of spectacles will help to eliminate the major causes of blindness and visual impairment in this region.

  4. Prevalence of psychiatric and physical morbidity in an urban geriatric population.

    Science.gov (United States)

    Seby, K; Chaudhury, Suprakash; Chakraborty, Rudraprosad

    2011-04-01

    With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Cross-sectional, epidemiological study. All the consenting elderly persons in a municipal ward division (n=202) were enrolled after surveying a total adult population of 7239 people. A door to door survey was undertaken where the participants were interviewed and physically examined. General Health Questionnaire-12, Mini Mental State Examination, CAGE Questionnaire and Geriatric Depression Scale were used in the interview apart from consulting the available documents. Other family members were also interviewed to verify the information. Chi-square test with Yates correction. Psychiatric illnesses were detected in 26.7% while physical illnesses were present in 69.8% of the population surveyed. Predominant psychiatric diagnoses were depressive disorders, dementia, generalized anxiety disorder, alcohol dependence and bipolar disorder. The most common physical illness was visual impairment, followed by cardiovascular disease, rheumatic illnesses, pulmonary illnesses, hearing impairment, genitourinary diseases and neurological disorders. Presence of dementia was associated with increased age, single/widowed/separated status, nuclear family, economic dependence, low education, cardiovascular disorders, rheumatic disorders and neurological disorders. Depression was associated with female sex, single/widowed/separated status, staying in nuclear families, economic dependence on others and co-morbid physical illnesses, specifically cardiovascular disorders and visual impairment. This study presented a higher rate of dementia and old age depression. The interesting

  5. Urban landscape genetics: canopy cover predicts gene flow between white-footed mouse (Peromyscus leucopus) populations in New York City.

    Science.gov (United States)

    Munshi-South, Jason

    2012-03-01

    In this study, I examine the influence of urban canopy cover on gene flow between 15 white-footed mouse (Peromyscus leucopus) populations in New York City parklands. Parks in the urban core are often highly fragmented, leading to rapid genetic differentiation of relatively nonvagile species. However, a diverse array of 'green' spaces may provide dispersal corridors through 'grey' urban infrastructure. I identify urban landscape features that promote genetic connectivity in an urban environment and compare the success of two different landscape connectivity approaches at explaining gene flow. Gene flow was associated with 'effective distances' between populations that were calculated based on per cent tree canopy cover using two different approaches: (i) isolation by effective distance (IED) that calculates the single best pathway to minimize passage through high-resistance (i.e. low canopy cover) areas, and (ii) isolation by resistance (IBR), an implementation of circuit theory that identifies all low-resistance paths through the landscape. IBR, but not IED, models were significantly associated with three measures of gene flow (Nm from F(ST) , BayesAss+ and Migrate-n) after factoring out the influence of isolation by distance using partial Mantel tests. Predicted corridors for gene flow between city parks were largely narrow, linear parklands or vegetated spaces that are not managed for wildlife, such as cemeteries and roadway medians. These results have implications for understanding the impacts of urbanization trends on native wildlife, as well as for urban reforestation efforts that aim to improve urban ecosystem processes. © 2012 Blackwell Publishing Ltd.

  6. The population in China’s earthquake-prone areas has increased by over 32 million along with rapid urbanization

    Science.gov (United States)

    He, Chunyang; Huang, Qingxu; Dou, Yinyin; Tu, Wei; Liu, Jifu

    2016-07-01

    Accurate assessments of the population exposed to seismic hazard are crucial in seismic risk mapping. Recent rapid urbanization in China has resulted in substantial changes in the size and structure of the population exposed to seismic hazard. Using the latest population census data and seismic maps, this work investigated spatiotemporal changes in the exposure of the population in the most seismically hazardous areas (MSHAs) in China from 1990 to 2010. In the context of rapid urbanization and massive rural-to-urban migration, nearly one-tenth of the Chinese population in 2010 lived in MSHAs. From 1990 to 2010, the MSHA population increased by 32.53 million at a significantly higher rate of change (33.6%) than the national average rate (17.7%). The elderly population in MSHAs increased by 81.4%, which is much higher than the group’s national growth rate of 58.9%. Greater attention should be paid to the demographic changes in earthquake-prone areas in China.

  7. Anatomical variants of the internal spermatic vein discovered during the percutaneous embolization of left varicoceles in a pediatric population

    International Nuclear Information System (INIS)

    Garel, L.; Dubois, J.; Rypens, F.; Ouimet, A.; Yazbeck, S.

    2004-01-01

    To report on the high incidence of anatomical variants of the origin and course of the internal spermatic vein (ISV) discovered at the time of percutaneous embolization of left varicoceles in a pediatric population. We reviewed retrospectively the 65 cases of left varicocele treated by percutaneous embolization (grade II and III) in our institution between 1990 and 2000. The course of the left renal vein (LRV), the origin of the ISV, and the number of ISVs and their pathway were recorded in all cases, according to the B ren classification. In 37/65 (57%), the ISV was single and arose from a normal LRV (type I).The following variants were encountered: type V - circumaortic LRV 9/65 (14%); type IVb - intrarenal origin of ISV 8/65 (12%); type II - multiple ISV 5/65 (8%); and pelvic collaterals 6/65 (9%). Venous anatomical variants are frequently encountered (43%) at the time of left varicocele embolization in children. Such variants often impose some adjustments to the technique of embolization and, at times, hamper the procedure. (author)

  8. Cross-cultural validation of the Pediatric Evaluation of Disability Inventory (PEDI) norms in a randomized Norwegian population.

    Science.gov (United States)

    Berg, M; Aamodt, G; Stanghelle, J; Krumlinde-Sundholm, L; Hussain, A

    2008-09-01

    The Pediatric Evaluation of Disability Inventory (PEDI) is one of the most commonly used assessments for children with a disability. Normative data from the US are used to determine whether a deficit or delay exists with regard to functional skill development. The purpose of this study was to analyse the cross-cultural validity of the PEDI American normative data for a general Norwegian population. A random selection of 174 typically developed Norwegian children between 1.0 and 5.9 years participated. The results for capability and caregiver assistance in the domains of self-care, mobility, and social function ranged from a mean of 38.0-46.8 against an expected 50. The Norwegian sample scored significantly lower than the US reference values for functional skills and caregiver assistance, and the results had less fit, especially for self-care. For mobility and social function, the magnitudes of the differences were smaller than self-care. Specific items deviated, suggesting necessary adjustments for the applicability of the norm-referenced scores of the PEDI in the Norwegian culture. The result of this research confirms other findings of cultural influence of the age norms in PEDI. Even though interpretations of the normative score results must be made with some caution, the option of using the scaled scores of PEDI is useful and recommended to describe and measure abilities and to evaluate change. This finding highlights the importance of cultural validation of norm-referenced tests.

  9. Blood Lead Levels and Risk Factors for Lead Exposure in a Pediatric Population in Ho Chi Minh City, Vietnam

    Directory of Open Access Journals (Sweden)

    Deborah Havens

    2018-01-01

    Full Text Available Although lead recycling activities are a known risk factor for elevated blood levels in South East Asia, little is known regarding the prevalence of and risk factors for elevated blood lead levels (BLL among the general pediatric population in Vietnam. This study is a cross-sectional evaluation of 311 children from Children’s Hospital #2 in Ho Chi Minh City, Vietnam. Capillary blood lead testing was performed using the LeadCare II. Mean BLLs were 4.97 μg/dL (Standard Deviation (SD 5.50, with 7% of the participants having levels greater than 10 μg/dL. Living in Bing Duong province (OR 2.7, 95% CI 1.4–5.6.1 or the Dong Nai province (OR 2.3, 95% CI 1.0–5.1 and having an age greater than 12 months (OR 6.0, 95% CI 3.1–11.8 were associated with higher BLLs. The prevalence of elevated BLLs in Vietnam is consistent with other SE Asian countries. Mean BLLs in Ho Chi Minh City are markedly less than those seen in a separate study of children living near lead recycling activities. Additional evaluation is necessary to better detail potential risk factors if screening is to be implemented within Vietnam.

  10. Managing Asthma in Low-Income, Underrepresented Minority, and Other Disadvantaged Pediatric Populations: Closing the Gap.

    Science.gov (United States)

    Louisias, Margee; Phipatanakul, Wanda

    2017-09-15

    In this article, we review current understanding of the epidemiology and etiology of disparities in asthma. We also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors. However, multifaceted, innovative interventions that are sustainable and scalable are key to improving outcomes.

  11. Population ecology of free-roaming cats and interference competition by coyotes in urban parks.

    Science.gov (United States)

    Gehrt, Stanley D; Wilson, Evan C; Brown, Justin L; Anchor, Chris

    2013-01-01

    Free-roaming cats are a common element of urban landscapes worldwide, often causing controversy regarding their impacts on ecological systems and public health. We monitored cats within natural habitat fragments in the Chicago metropolitan area to characterize population demographics, disease prevalence, movement patterns and habitat selection, in addition to assessing the possible influence of coyotes on cats. The population was dominated by adults of both sexes, and 24% of adults were in reproductive condition. Annual survival rate was relatively high (S=0.70, SE=0.10), with vehicles and predation the primary causes of death. Size of annual home range varied by sex, but not reproductive status or body weight. We observed partitioning of the landscape by cats and coyotes, with little interspecific overlap between core areas of activity. Coyotes selected for natural habitats whereas cats selected for developed areas such as residences. Free-roaming cats were in better condition than we predicted, but their use of natural habitat fragments, and presumably their ecological impact, appeared to be limited by coyotes through intraguild competition.

  12. Air quality public policies and their implications for densely populated urban areas in Brazil

    Directory of Open Access Journals (Sweden)

    José Carlos de Moura Xavier

    2017-04-01

    Full Text Available Due to the current growth of the Brazilian population income and energy consumption and an increase in the population density in urban areas, air quality in the crowded Brazilian cities is being questioned. In searching for a solution we analyzed both the Brazilian and Regional (São Paulo state public policies of air quality that have been issued since 1981 by confronting them to the air quality official indexes. Following the growth of the national vehicle fleet, 48.8 million in 2012 from 9.3 million in 1980, the total carbon dioxide emissions tripled. At regional level, PM2.5 measurements have been carried out systematically since 1999 in the Metropolitan Region of São Paulo city, the largest Brazilian city, with 19.7 million inhabitants, and more than 7 million vehicles powered mainly by fossil fuels. Although the numbers are still above the state standard to be reached (10µg.m-3, there was a decrease on the annual average in 2008-2015 compared with 2001-2007. This was partially due to the limits established for new vehicles by federal programs. The analysis indicated that the reduction of air pollutants emission will be more easily achieved based on strategies that combine policies supported by current laws, government and private sector agreements and the community engagement.

  13. Population ecology of free-roaming cats and interference competition by coyotes in urban parks.

    Directory of Open Access Journals (Sweden)

    Stanley D Gehrt

    Full Text Available Free-roaming cats are a common element of urban landscapes worldwide, often causing controversy regarding their impacts on ecological systems and public health. We monitored cats within natural habitat fragments in the Chicago metropolitan area to characterize population demographics, disease prevalence, movement patterns and habitat selection, in addition to assessing the possible influence of coyotes on cats. The population was dominated by adults of both sexes, and 24% of adults were in reproductive condition. Annual survival rate was relatively high (S=0.70, SE=0.10, with vehicles and predation the primary causes of death. Size of annual home range varied by sex, but not reproductive status or body weight. We observed partitioning of the landscape by cats and coyotes, with little interspecific overlap between core areas of activity. Coyotes selected for natural habitats whereas cats selected for developed areas such as residences. Free-roaming cats were in better condition than we predicted, but their use of natural habitat fragments, and presumably their ecological impact, appeared to be limited by coyotes through intraguild competition.

  14. Chlamydia trachomatis detection in cervical PreservCyt specimens from an Irish urban female population.

    LENUS (Irish Health Repository)

    Keegan, H

    2012-02-01

    OBJECTIVE: The aim of this study was to determine the prevalence of cervical Chlamydia trachomatis infection by polymerase chain reaction (PCR) in urban women undergoing routine cervical cytological screening and to investigate the relationship with age, cytology, smoking status and concurrent human papillomavirus (HPV) infection. METHODS: A total of 996 women (age range 16-69 years) attending general practitioners for routine liquid-based cervical smear screening in the Dublin area were recruited in the study of prevalence of C. trachomatis. Informed consent was obtained and liquid-based cytology (LBC) specimens were sent for cytological screening. DNA was extracted from residual LBC and tested for C. trachomatis by PCR using the highly sensitive C. trachomatis plasmid (CTP) primers and for HPV infection using the MY09\\/11 primers directed to the HPV L1 gene in a multiplex format. RESULTS: The overall prevalence of C. trachomatis was 5.4%. Prevalence was highest in the <25 years age group (10%). Coinfection with HPV and C. trachomatis occurred in 1% of the screening population. A higher rate of smoking was observed in women positive for C. trachomatis, HPV infections or those with abnormal cervical cytology. Chlamydia trachomatis infection was not associated with abnormal cytology. CONCLUSIONS: Women (5.4%) presenting for routine cervical screening are infected with C. trachomatis. Opportunistic screening for C. trachomatis from PreservCyt sample taken at the time of cervical cytological screening may be a possible strategy to screen for C. trachomatis in the Irish female population.

  15. FLT3 mutation incidence and timing of origin in a population case series of pediatric leukemia

    Directory of Open Access Journals (Sweden)

    Chang Jeffrey

    2010-09-01

    Full Text Available Abstract Background Mutations in FLT3 result in activated tyrosine kinase activity, cell growth stimulation, and a poor prognosis among various subtypes of leukemia. The causes and timing of the mutations are not currently known. We evaluated the prevalence and timing of origin of FLT3 mutations in a population series of childhood leukemia patients from Northern California. Methods We screened and sequenced FLT3 mutations (point mutations and internal tandem duplications, ITDs among 517 childhood leukemia patients, and assessed whether these mutations occurred before or after birth using sensitive "backtracking" methods. Results We determined a mutation prevalence of 9 of 73 acute myeloid leukemias (AMLs, 12% and 9 of 441 acute lymphocytic leukemias (ALLs, 2%. Among AMLs, FLT3 mutations were more common in older patients, and among ALLs, FLT3 mutations were more common in patients with high hyperdiploidy (3.7% than those without this cytogenetic feature (1.4%. Five FLT3 ITDs, one deletion mutation, and 3 point mutations were assessed for their presence in neonatal Guthrie spots using sensitive real-time PCR techniques, and no patients were found to harbor FLT3 mutations at birth. Conclusions FLT3 mutations were not common in our population-based patient series in California, and patients who harbor FLT3 mutations most likely acquire them after they are born.

  16. The impact of share wave elastography in differentiation of hepatic hemangioma from malignant liver tumors in pediatric population

    International Nuclear Information System (INIS)

    Özmen, Evrim; Adaletli, İbrahim; Kayadibi, Yasemin; Emre, Şenol; Kılıç, Fahrettin; Dervişoğlu, Sergülen; Kuruğoğlu, Sebuh; Şenyüz, Osman Faruk

    2014-01-01

    Highlights: • We evaluated the impact of share wave elastography technique in differentiation hepatic hemangiomas from malignant liver tumors in pediatric population. • Share wave technique can increase the diagnostic capability of conventional ultrasonography in the differential diagnosis of liver tumors in children. • Share wave elastography is a potential adjunctive diagnostic technique for pediatric liver tumors. - Abstract: Objective: In children it is crucial to differentiate malignant liver tumors from the most common benign tumor, hepatic hemangiomas since the treatment strategies are quite different. We aimed to evaluate the efficiency of shear wave elastography (SWE) technique in differentiation of malignant hepatic tumors and hepatic hemangiomas. Methods: Twenty patients with hepatic tumor were included in our study. Two radiologists performed SWE for 13 patients with malignant hepatic tumors including hepatoblastoma (n = 7), hepatocellular carcinoma (n = 3), metastasis (n = 2), embryonal sarcoma (n = 1) and 7 patients with hepatic hemangioma. All of our patients were between the age of 1 and 192 months (mean age: 56.88 months). Receiver operating characteristic analysis was achieved to evaluate the diagnostic accuracy of SWE and to determine the optimal cut-off value in differentiation hepatic hemangioma from malignant hepatic tumors. Results: The mean SWE values (in kPa) for the first observer were 46.94 (13.8–145) and 22.38 (6.6–49.6) and those for the second observer were 57.91 (11–237) and 23.87 (6.4–57.5), respectively for malignant hepatic tumors and hepatic hemangiomas. The SWE values of malignant hepatic tumors were significantly higher than those of hepatic hemangioma (p = 0.02). The inter-observer agreement was almost perfect (0.81). The area under the receiver operating characteristic curve of SWE for differentiating the hepatic hemangioma from malignant hepatic tumors was 0.77 with a sensitivity of 72.7% and a specificity of 66

  17. Normal uptake of F-18 FDG in the testis as assessed by PET/CT in a pediatric study population

    International Nuclear Information System (INIS)

    Goethals, I.; Vriendt, C.D.; Hoste, P.; Smeets, P.; Ham, H.

    2009-01-01

    The objective of this study was to investigate the correlation between the F-18 fluorodeoxyglucose (FDG) uptake in the normal testis as assessed by positron emission tomography (PET)-CT and patient age in a pediatric study population. The study population consisted of 22 subjects aged between 9 and 17 years. For these subjects 42 PET-CT scans were available for analysis. The testis was identified on the CT images. Mean standard uptake values and testicular volume were calculated based on manually drawn regions-of-interest over the organ. The correlation between mean standardized uptake value (SUV) and age as well as between testicular volume and age was calculated using Pearson's correlation coefficient. A strong and statistically significant positive correlation between F-18 FDG uptake in the testis and age was documented. The correlation coefficient was 0.406 in the analysis based on 42 PET-CT studies (p=0.005). The correlation between tracer uptake and age was reassessed based on 22 PET-CT studies including the last recorded PET-CT scan per patient. The correlation coefficient was 0.409 (p=0.05). In addition, based on 22 PET-CT scans, a strong and statistically significant positive correlation between testicular volume and age was documented (r=0.67, p<0.001). Whereas it was previously shown that in adult men there was a weak but statistically significant negative correlation between F-18 FDG uptake in the normal testis and age, we found a strong and statistically significant positive correlation in children and teenage boys. (author)

  18. Prevalence, Characteristics, and Complications of Supernumerary Teeth in Nonsyndromic Pediatric Population of South India: A Clinical and Radiographic Study.

    Science.gov (United States)

    Syriac, Gibi; Joseph, Elizabeth; Rupesh, S; Philip, John; Cherian, Sunu Alice; Mathew, Josey

    2017-11-01

    Supernumerary teeth are the presence of more number of teeth over the normal dental formula and may occur in permanent as well as early mixed dentition. This study determined the prevalence, characteristics, and complications caused by supernumerary teeth in nonsyndromic South Indian pediatric population. Characteristics of supernumerary teeth determined by clinical and radiographic examination were recorded. The age, sex, number of supernumerary teeth, eruption status, morphology, position, orientation, and complications (if any) associated with supernumerary teeth were recorded for each patient who had supernumerary teeth. The data collected were statistically analyzed. Supernumerary teeth were detected in 45 subjects (1.1%), of which 34 (75.6%) were male and 11 (24.4%) were female. There was no association between the number of supernumerary teeth and the gender of the patient. The total number of supernumerary teeth among the affected 45 patients was 54. The average number of supernumerary teeth per person was 1.2. The number of supernumerary teeth was one in 35 cases, two in 8 cases, and 3 in 1 case. Of the 45 patients, 8 patients with supernumerary teeth were in deciduous dentition stage, 29 patients were in mixed dentition stage, and 8 patients were in permanent dentition stage. Most supernumerary teeth presented in the anterior maxilla. Morphologically, conical-shaped supernumerary teeth were the most common finding. 68.5% of supernumerary teeth presented with straight orientation and inverted orientation was seen in 24.1%. Complications seen in patients with supernumerary teeth were delayed or noneruption of adjacent tooth malposition or rotation of adjacent teeth, diastema formation, and formation of dentigerous cyst. Supernumerary teeth have an incidence of 1.1% in South Indian population and can cause many complications that can harm the developing occlusion. Knowledge about supernumerary teeth may help the dentist in early diagnosis and early

  19. Impact of Health Care Exposure on Genotypic Antiseptic Tolerance in Staphylococcus aureus Infections in a Pediatric Population.

    Science.gov (United States)

    McNeil, J Chase; Hultén, Kristina G; Mason, Edward O; Kaplan, Sheldon L

    2017-07-01

    Staphylococcus aureus possessing either the smr gene or the qacA/B genes is associated with decreased susceptibility to chlorhexidine gluconate (CHG) and other antiseptics. Previous studies of antiseptic-tolerant staphylococci have focused largely on high-risk populations, and the exact role of health care exposure in the acquisition of these organisms is unclear. We sought to describe the risk factors and features of infection caused by antiseptic-tolerant S. aureus in a general pediatric population. Isolates were selected from an ongoing S. aureus surveillance study. Every third sequential isolate in the year 2014 was selected for inclusion. All isolates underwent PCR for the genes qacA/B and smr Medical records were reviewed. Five hundred six isolates were included in the study, with 377 (74.3%) being community acquired. One hundred (19.8%) isolates were smr positive and 79 (15.6%) qacA/B positive. In univariable analyses, the presence of either gene was associated with underlying medical conditions, nosocomial acquisition, recent hospitalization, central venous lines, and CHG exposure. In multivariable analyses, only differences between patients with chronic medical conditions (odds ratio [OR] = 1.72; 95% confidence interval [CI], 1.22 to 2.64) and nosocomial acquisition (OR = 2.48; 95% CI, 1.16 to 8.17) remained statistically significant. Among patients without risk factors, 27.9% had infection with an antiseptic-tolerant isolate. smr - or qacA/B -positive S. aureus isolates are common in children and are independently associated with nosocomial acquisition and underlying medical conditions. These findings imply a role for the health care environment in acquisition of these organisms. However, genotypic antiseptic tolerance was seen in >25% of healthy children with an S. aureus infection, indicating that these organism are prevalent in the community as well. Copyright © 2017 American Society for Microbiology.

  20. Changes in home range sizes and population densities of carnivore species along the natural to urban habitat gradient

    Czech Academy of Sciences Publication Activity Database

    Šálek, Martin; Drahníková, L.; Tkadlec, Emil

    2015-01-01

    Roč. 45, č. 1 (2015), s. 1-14 ISSN 0305-1838 Institutional support: RVO:68081766 Keywords : Carnivores * home range size * natural–urban gradient * population density * review Subject RIV: EG - Zoology Impact factor: 4.116, year: 2015

  1. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    Directory of Open Access Journals (Sweden)

    Gilman Robert H

    2010-10-01

    Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as

  2. Epidemiological study of ocular trauma in an urban slum population in Delhi, India

    Science.gov (United States)

    Vats, S; Chandra, M; Gupta, S K; Vashist, P; Gogoi, M

    2008-01-01

    Purpose: To study the epidemiology and clinical profile of victims of ocular trauma in an urban slum population. Materials and Methods: This cross-sectional study, conducted on 500 families each in three randomly selected urban slums in Delhi, collected demographic data for all members of these families, and clinical data for all those who suffered ocular trauma at any time, that required medical attention. Data was managed on SPSS 11.0. Results: Of 6704 participants interviewed, 163 episodes of ocular trauma were reported by 158 participants (prevalence = 2.4%, confidence interval = 2.0 to 2.7) Mean age at trauma was 24.2 years. The association between the age of participants and the history of ocular trauma was significant (P < 0.001), when adjusted for sex, education and occupation. Males were significantly more affected. Blunt trauma was the commonest mode of injury (41.7%). Blindness resulted in 11.4% of injured eyes ( P = 0.028). Of 6704 participants, 1567 (23.4%) were illiterate, and no association was seen between education status and trauma, when adjusted for sex and age at injury. A significant association was noted between ocular trauma and workplace (Chi-square = 43.80, P < 0.001), and between blindness and place (Chi-square = 9.98, P = 0.041) and source (Chi-square = 10.88, P = 0.028) of ocular trauma. No association was found between visual outcome and the time interval between trauma and first consultation (Chi-square = 0.50, P = 0.78), between receiving treatment and the best corrected visual acuity (Chi-square = 0.81, P = 0.81), and between the person consulted and blinding ocular trauma (Chi-square = 1.88, P = 0.170). Conclusion: A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority. PMID:18579991

  3. Epidemiological study of ocular trauma in an urban slum population in Delhi, India

    Directory of Open Access Journals (Sweden)

    Vats S

    2008-01-01

    Full Text Available Purpose: To study the epidemiology and clinical profile of victims of ocular trauma in an urban slum population. Materials and Methods: This cross-sectional study, conducted on 500 families each in three randomly selected urban slums in Delhi, collected demographic data for all members of these families, and clinical data for all those who suffered ocular trauma at any time, that required medical attention. Data was managed on SPSS 11.0. Results: Of 6704 participants interviewed, 163 episodes of ocular trauma were reported by 158 participants (prevalence = 2.4%, confidence interval = 2.0 to 2.7 Mean age at trauma was 24.2 years. The association between the age of participants and the history of ocular trauma was significant ( P < 0.001, when adjusted for sex, education and occupation. Males were significantly more affected. Blunt trauma was the commonest mode of injury (41.7%. Blindness resulted in 11.4% of injured eyes ( P = 0.028. Of 6704 participants, 1567 (23.4% were illiterate, and no association was seen between education status and trauma, when adjusted for sex and age at injury. A significant association was noted between ocular trauma and workplace (Chi-square = 43.80, P < 0.001, and between blindness and place (Chi-square = 9.98, P = 0.041 and source (Chi-square = 10.88, P = 0.028 of ocular trauma. No association was found between visual outcome and the time interval between trauma and first consultation (Chi-square = 0.50, P = 0.78, between receiving treatment and the best corrected visual acuity (Chi-square = 0.81, P = 0.81, and between the person consulted and blinding ocular trauma (Chi-square = 1.88, P = 0.170. Conclusion: A significant burden of ocular trauma in the community requires that its prevention and early management be a public health priority.

  4. High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.

    Science.gov (United States)

    Riedel, David J; Mwangi, Evelyn Ivy W; Fantry, Lori E; Alexander, Carla; Hossain, Mian B; Pauza, C David; Redfield, Robert R; Gilliam, Bruce L

    2013-04-24

    To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population. Retrospective cohort study. All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models. There were 470 cases of cancer among 447 patients. Patients were predominantly African-American (85%) and male (79%). Non-AIDS-defining cancers (NADCs, 69%) were more common than AIDS-defining cancers (ADCs, 31%). Cumulative cancer incidence increased significantly over the study period. The majority (55.9%) was taking antiretroviral therapy (ART) at cancer diagnosis or started afterward (26.9%); 17.2% never received ART. Stage 3 or 4 cancer was diagnosed in 67%. There were 226 deaths during 1096 person years of follow-up, yielding an overall mortality rate of 206 per 1000 person years. The cumulative mortality rate at 30 days, 1 year, and 2 years was 6.5, 32.2, and 41.4%, respectively. Mortality was similar between patients on ART whether they started before or after the cancer diagnosis but was higher in patients who never received ART. In patients with a known cause of death, 68% were related to progression of the underlying cancer. In a large cohort of urban, predominantly African-American patients with HIV and cancer, many patients presented with late-stage cancer. There was substantial 30-day and 2-year mortality, although ART had a significant mortality benefit. Deaths were most often caused by progression of cancer and not from another HIV-related or AIDS-related event.

  5. Coronary heart disease events in Aboriginal Australians: incidence in an urban population.

    Science.gov (United States)

    Bradshaw, Pamela J; Alfonso, Helman S; Finn, Judith C; Owen, Julie; Thompson, Peter L

    2009-05-18

    To determine the incidence of coronary heart disease (CHD) events in an urban Aboriginal population. Cohort study of 906 Aboriginal people without CHD from 998 who had undergone risk-factor assessment in the Perth Aboriginal Atherosclerosis Risk Study (PAARS) in 1998-1999. PAARS cohort data were electronically linked to a range of databases that included Western Australian hospital morbidity data and death registry data. We analysed data from January 1980 to December 2006 to identify previous admissions for CHD from 1980 to baseline (1998-1999) and new events from baseline to 2006. First CHD event (hospital admission or death). There were 891 linked records for the 906 participants without previous CHD. The event rate was 12.6/1000 person-years (95% CI, 10.2-15.6/1000 person-years). Annual CHD event rates ranged from 8 to 18/1000 person-years. After adjustment for age (sex was not associated with the risk factors assessed), factors associated with risk of a CHD event in the PAARS cohort were a history of diabetes, overweight or obesity (indicated by body mass index), smoking, and hypertension, but not waist circumference. People with these risk factors were 1.9-2.7 times more likely to experience a CHD event. Compared with previously published information from a remote Aboriginal community in the Northern Territory, the incidence of CHD events among urban-dwelling Aboriginal people was not significantly different (P > 0.05 overall and for subgroups defined by age and sex). City-dwelling Aboriginal Australians have an incidence of CHD events comparable to that of Aboriginal people living in remote northern Australia.

  6. Population cardiovascular health and urban environments: the Heart Healthy Hoods exploratory study in Madrid, Spain

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    Usama Bilal

    2016-08-01

    Full Text Available Abstract Background Our aim is to conduct an exploratory study to provide an in-depth characterization of a neighborhood’s social and physical environment in relation to cardiovascular health. A mixed-methods approach was used to better understand the food, alcohol, tobacco and physical activity domains of the urban environment. Methods We conducted this study in an area of 16,000 residents in Madrid (Spain. We obtained cardiovascular health and risk factors data from all residents aged 45 and above using Electronic Health Records from the Madrid Primary Health Care System. We used several quantitative audit tools to assess: the type and location of food outlets and healthy food availability; tobacco and alcohol points of sale; walkability of all streets and use of parks and public spaces. We also conducted 11 qualitative interviews with key informants to help understanding the relationships between urban environment and cardiovascular behaviors. We integrated quantitative and qualitative data following a mixed-methods merging approach. Results Electronic Health Records of the entire population of the area showed similar prevalence of risk factors compared to the rest of Madrid/Spain (prevalence of diabetes: 12 %, hypertension: 34 %, dyslipidemia: 32 %, smoking: 10 %, obesity: 20 %. The food environment was very dense, with many small stores (n = 44 and a large food market with 112 stalls. Residents highlighted the importance of these small stores for buying healthy foods. Alcohol and tobacco environments were also very dense (n = 91 and 64, respectively, dominated by bars and restaurants (n = 53 that also acted as food services. Neighbors emphasized the importance of drinking as a socialization mechanism. Public open spaces were mostly used by seniors that remarked the importance of accessibility to these spaces and the availability of destinations to walk to. Conclusion This experience allowed testing and refining

  7. Application of the asthma phenotype algorithm from the Severe Asthma Research Program to an urban population.

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    Paru Patrawalla

    Full Text Available Identification and characterization of asthma phenotypes are challenging due to disease complexity and heterogeneity. The Severe Asthma Research Program (SARP used unsupervised cluster analysis to define 5 phenotypically distinct asthma clusters that they replicated using 3 variables in a simplified algorithm. We evaluated whether this simplified SARP algorithm could be used in a separate and diverse urban asthma population to recreate these 5 phenotypic clusters.The SARP simplified algorithm was applied to adults with asthma recruited to the New York University/Bellevue Asthma Registry (NYUBAR to classify patients into five groups. The clinical phenotypes were summarized and compared.Asthma subjects in NYUBAR (n = 471 were predominantly women (70% and Hispanic (57%, which were demographically different from the SARP population. The clinical phenotypes of the five groups generated by the simplified SARP algorithm were distinct across groups and distributed similarly to those described for the SARP population. Groups 1 and 2 (6 and 63%, respectively had predominantly childhood onset atopic asthma. Groups 4 and 5 (20% were older, with the longest duration of asthma, increased symptoms and exacerbations. Group 4 subjects were the most atopic and had the highest peripheral eosinophils. Group 3 (10% had the least atopy, but included older obese women with adult-onset asthma, and increased exacerbations.Application of the simplified SARP algorithm to the NYUBAR yielded groups that were phenotypically distinct and useful to characterize disease heterogeneity. Differences across NYUBAR groups support phenotypic variation and support the use of the simplified SARP algorithm for classification of asthma phenotypes in future prospective studies to investigate treatment and outcome differences between these distinct groups.Clinicaltrials.gov NCT00212537.

  8. Raising awareness of chronic kidney disease in a Brazilian urban population

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    M. Mazza Nascimento

    2009-08-01

    Full Text Available The incidence and prevalence of chronic kidney disease have been increasing in recent years in developing countries. The aim of this study was to report the results of a general chronic kidney disease awareness program applied to an urban population in a large Brazilian city. From January 2002 to January 2005 a total of 8883 individuals in the city of Curitiba (PR, Brazil were screened for hypertension, body mass index, hematuria, and proteinuria. A family history and previous medical diagnosis of hypertension and diabetes mellitus (DM were also recorded. Of the 8883 individuals assessed, 56% were women, subject median age was 47 years (range: 17-93 years and more than 90% were Caucasian. Thirty percent had signs of hematuria, 6% had proteinuria, and 3% had hematuria and proteinuria. The median of mean arterial pressure values was 93 mmHg (range: 71-135 mmHg and 16% of the population screened had a history of hypertension. A significant positive family history of both hypertension or DM was present in 42% (P < 0.0001; chi-square = 83.18 and 7% (P < 0.0001; chi-square = 161.31 of the hypertensive group, respectively. Finally, the prevalence of hypertension and DM was significantly higher in older individuals with proteinuria. In the present study, a higher prevalence of hematuria and proteinuria was found in older individuals with hypertension and diabetes compared to the general population. These data confirm the need for public awareness of renal disease in high-risk individuals.

  9. Underdiagnosis and Lower Rates of Office Visits for Overweight/Obese Pediatric Patients in Rural Compared with Urban Areas.

    Science.gov (United States)

    SanGiovanni, Christine; McElligott, James; Morella, Kristen; Basco, William

    2017-07-01

    This study compared the number of children enrolled in Medicaid in rural and urban areas of South Carolina with an overweight/obesity diagnosis and the mean rates of office visits with overweight/obesity diagnosed. Medicaid claims data from 2012 for children in three South Carolina counties, categorized as urban, rural high resource, and rural low resource, were used to identify those who had been diagnosed as being overweight/obese during any encounter. Logistic and Poisson regressions were performed to predict whether overweight/obese children in each county would receive an overweight/obesity visit diagnosis and to calculate the mean rate of total office visits with an overweight/obesity diagnosis in each county. A total of 1233 children enrolled in Medicaid were diagnosed as being overweight/obese at any encounter in the designated counties. Well visits with overweight/obesity diagnosed varied significantly, with 42.6%, 28%, and 11% in urban, rural high-resource counties, and rural low-resource counties, respectively ( P overweight/obese at a well visit. All of the children had a low number of total office visits with overweight/obesity diagnosed. When comparing the counties, urban children (1.22 visits per year) had more visits than rural low-resource children (0.75 visits per year, P Overweight/obesity is underdiagnosed in rural children enrolled in Medicaid in South Carolina, which affects the number of children who receive help to manage their weight. Interventions to overcome barriers of diagnosis and management are necessary to address childhood obesity properly.

  10. Prevalence and Predictors of Overweight and Obesity Among a Multiethnic Population of Pediatric Acute Lymphoblastic Leukemia Survivors: A Cross-Sectional Assessment.

    Science.gov (United States)

    Brown, Austin L; Lupo, Philip J; Danysh, Heather E; Okcu, Mehmet F; Scheurer, Michael E; Kamdar, Kala Y

    2016-08-01

    As previous studies of obesity in survivors of pediatric acute lymphoblastic leukemia (ALL) have primarily been conducted among non-Hispanic white survivors or children treated on older protocols, our objective was to describe the prevalence and correlates of overweight status among an ethnically diverse population of pediatric ALL survivors, largely treated with more contemporary therapies. We evaluated the overweight/obesity status of pediatric ALL survivors (n=406) followed in the Texas Children's Cancer Center between 2004 and 2014. Survivors were classified as underweight, normal weight, overweight, or obese on the basis of their body mass index at their most current follow-up visit. Our results showed that Hispanic ethnicity (39% of the subjects) was associated with being overweight (adjusted odds ratio=1.88; 95% confidence interval, 1.13-3.14) or obese (adjusted odds ratio=2.84; 95% confidence interval, 1.59-5.06) at follow-up, even after adjusting for cranial radiotherapy (CRT) exposure. Body mass index z-score at diagnosis was also associated with overweight/obesity at follow-up. In addition, there was a statistically significant interaction between younger age at diagnosis and CRT, indicating that younger age at diagnosis was associated with obesity among patients who received CRT. These findings may help identify pediatric ALL patients that are at increased risk of being overweight or obese after treatment.

  11. Disparities in pediatric leukemia early survival in Argentina: a population-based study

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    Gilda Garibotti

    2014-10-01

    Full Text Available OBJECTIVE: To identify disparities-using recursive partitioning (RP-in early survival for children with leukemias treated in Argentina, and to depict the main characteristics of the most vulnerable groups. METHODS: This secondary data analysis evaluated 12-month survival (12-ms in 3 987 children diagnosed between 2000 and 2008 with lymphoid leukemia (LL and myeloid leukemia (ML and registered in Argentina's population-based oncopediatric registry. Prognostic groups based on age at diagnosis, gender, socioeconomic index of the province of residence, and migration to a different province to receive health care were identified using the RP method. RESULTS: Overall 12-ms for LL and ML cases was 83.7% and 59.9% respectively. RP detected major gaps in 12-ms. Among 1-10-year-old LL patients from poorer provinces, 12-ms for those who did and did not migrate was 87.0% and 78.2% respectively. Survival of ML patients < 2 years old from provinces with a low/medium socioeconomic index was 38.9% compared to 62.1% for those in the same age group from richer provinces. For 2-14-year-old ML patients living in poor provinces, patient migration was associated with a 30% increase in 12-ms. CONCLUSIONS: Major disparities in leukemia survival among Argentine children were found. Patient migration and socioeconomic index of residence province were associated with survival. The RP method was instrumental in identifying and characterizing vulnerable groups.

  12. Dietary intake, physical activities and nutritional status of adolescent girls in an urban population of Bangladesh

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    Ali Abbas Mohammad Kurshed

    2010-07-01

    Full Text Available In Bangladesh, under-nutrition is a common health problem, but for socio-cultural background, it is most predominant among the female population starting from their early life to motherhood. For the adolescent girls, there has been no such study though they will be the future mothers. Therefore, this study is designed to address the lifestyle and nutrition of the Bangladeshi female adolescents. The study was conducted purposively in Dhaka selecting randomly 15 of 95 City corporation wards of Dhaka City. All adolescent girls aged 10–18 years were considered eligible participants of an urban population of Bangladesh. The study included socio-demographic information, clinical examination, dietary intake, physical activities and body mass index (BMI = weight in kg / height in m. sq.. Overall, 352 adolescent girls volunteered. Socio-economically, 51% of them had monthly family income ³ 20,000 BDT and 11.4% had <10,000 BDT. Of the participants, 14.8% had BMI <18.5, 80.7% had 18.5 – 24.9, and 4.6% had ³ 25. BMI was found not to have significant association with physical activities. No clinical signs of vitamin A deficiency were observed. On clinical examination 75% of the participants were found healthy, 15.9% had anemia and 5.7% had diarrhea. Compared with the national dietary intake, the cereal intake was lower but protein containing foods like pulse and nuts, meat, egg, fish, milk and milk products were found very much close to the national intake. On the average, 95 % of calorie, 93.5 % of protein and 96.5 % of fat requirement were met. For micronutrient requirement, very low intake was observed with calcium (62 % and iron (63 %. In conclusion, the participants consumed rice daily with frequent consumption of vegetables. Although the study subjects were mostly from higher class of urban dwellers their dietary intake was found not healthy as evidenced by daily rice intake and very low intake of fruits, calcium and iron indicating lack of

  13. Cardiovascular health among healthy population of Northeast region of India: a cross-sectional study comparing urban-tribal difference.

    Science.gov (United States)

    Saha, Soma; Gupta, Kinnari; Kumar, Soumitra

    2013-12-01

    Cardiovascular disease is the leading cause of adult mortality in India but data on the prevalence of cardiovascular risk factors are scarce, especially from North-east region of India. This study aims to assess the prevalence and the urban/tribal gradient of cardiovascular disease risk factors among healthy population of Tripura. A cross-sectional study was carried out among 238 healthy individuals (140 urban and 98 tribal) in one urban and five tribal areas of Tripura. Data was collected on sociodemographic profile, medical history, anthropometry, dietary patterns and addiction. Fasting blood samples were collected for biochemical analysis. Prevalence of cardiovascular disease risk factors and short-term cardiovascular disease risk score was calculated. The association of independent variables with 10-year cardiovascular disease risk score were examined by using multiple regression model. Prevalence of obesity, hypertension, diabetes, dyslipidaemia, metabolic syndrome and short-term cardiovascular disease risk score were higher in urban group. Urban people had higher salt, calories and fat intake. No difference was found in the addiction patterns of tobacco and alcohol but frequency and quantity being higher in tribal area. Dyslipidaemia and alcohol consumption showed significant positive association with 10-year cardiovascular disease risk score in both groups. While the non-sedentary lifestyle and dietary habits (low salt, low fat, carbohydrate predominant) of tribal population need to be promoted as a whole across the nation, they need to be protected from the adverse effects of rampant prevalence of tobacco and alcohol addiction among them. Urban population need to be extricated from adverse effects of sedentary lifestyle, modern food habits (high salt, high fat) and tobacco-alcohol addiction.

  14. Composition of physiologically important fatty acids in great tits differs between urban and rural populations on a seasonal basis

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    Martin N Andersson

    2015-08-01

    Full Text Available Fatty acids (FA have crucial functions in animals, affecting e.g. inflammatory responses, thermoregulation, and cell membrane fluidity. Diet and ambient temperature affect animals’ FA composition, which, in turn, may influence these physiological processes. Great tits (Parus major −common in both urban and rural habitats− are mainly granivorous during winter and insectivorous during summer. These diets show pronounced differences in FA composition. Such variation has context-dependent effects on physiology, because the thermal environment, food availability, and levels of pro-inflammatory environmental stressors differ between urban and rural areas. Thus, we investigated how great tit plasma FA composition varied between urban and rural habitats and across seasons. Eight FAs differed between urban and rural birds. Among these, arachidonic acid (omega (ω-6 polyunsaturated FA with thermoregulatory and pro-inflammatory properties was more abundant in urban than rural birds in winter, whereas ω-3 FAs with anti-inflammatory properties were more abundant in rural birds. The difference in pro- and anti-inflammatory FAs suggest that the negative health effects that urban birds suffer from being exposed to higher levels of pollutants might be enhanced by an elevated inflammatory response. Eight FAs differed between winter and summer birds. This variation reflected the diet change: FAs common in seeds, e.g. oleic- and linoleic acid, were present in higher amounts in winter birds, whereas ω-3 polyunsaturated FAs that are common in caterpillars were more abundant in summer birds. Overall, a larger seasonal variation was seen among the urban birds. This study is the first to reveal a difference in FA composition between urban and rural populations for all animals studied to date. Future experiments should unravel the physiological implications of this variation, and ultimately, link its effects to fitness of animals with different physiological and

  15. The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population

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    Indra Tri Mahayana

    2017-11-01

    Full Text Available Uncorrected refractive error (URE is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities (urban, exurban, suburban and rural. This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen’s chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses (urban=79, exurban=73, suburban=160 and rural=98 school children. Urban school children revealed the worst visual acuity (P<0.001 and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities (P=0.003. The risk of URE development in urban, suburban, exurban, and rural were 2.218 (95%CI: 0.914-5.385, 3.019 (95%CI: 1.266-7.197, 0.502 (95%CI: 0.195-1.293, and 0.130 (95%CI:0.017-0.972, respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.

  16. Geospatial Analysis of Pediatric EMS Run Density and Endotracheal Intubation

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    Matthew Hansen

    2016-09-01

    Full Text Available Introduction: The association between geographic factors, including transport distance, and pediatric emergency medical services (EMS run clustering on out-of-hospital pediatric endotracheal intubation is unclear. The objective of this study was to determine if endotracheal intubation procedures are more likely to occur at greater distances from the hospital and near clusters of pediatric calls. Methods: This was a retrospective observational study including all EMS runs for patients less than 18 years of age from 2008 to 2014 in a geographically large and diverse Oregon county that includes densely populated urban areas near Portland and remote rural areas. We geocoded scene addresses using the automated address locator created in the cloud-based mapping platform ArcGIS, supplemented with manual address geocoding for remaining cases. We then use the Getis-Ord Gi spatial statistic feature in ArcGIS to map statistically significant spatial clusters (hot spots of pediatric EMS runs throughout the county. We then superimposed all intubation procedures performed during the study period on maps of pediatric EMS-run hot spots, pediatric population density, fire stations, and hospitals. We also performed multivariable logistic regression to determine if distance traveled to the hospital was associated with intubation after controlling for several confounding variables. Results: We identified a total of 7,797 pediatric EMS runs during the study period and 38 endotracheal intubations. In univariate analysis we found that patients who were intubated were similar to those who were not in gender and whether or not they were transported to a children’s hospital. Intubated patients tended to be transported shorter distances and were older than non-intubated patients. Increased distance from the hospital was associated with reduced odds of intubation after controlling for age, sex, scene location, and trauma system entry status in a multivariate logistic

  17. Pediatric First Aid Practices in Ghana: A Population-Based Survey.

    Science.gov (United States)

    Gyedu, Adam; Mock, Charles; Nakua, Emmanuel; Otupiri, Easmon; Donkor, Peter; Ebel, Beth E

    2015-08-01

    Children in low- and middle-income countries (LMIC) often receive care outside the formal medical sector. Improving pre-hospital first aid has proven to be highly cost-effective in lowering trauma mortality. Few studies in LMIC have examined home first aid practices for injured children. We conducted a representative population-based survey of 200 caregivers of children under 18 years of age, representing 6520 households. Caregivers were interviewed about their first aid practices and care-seeking behaviors when a child sustained an injury at home. Injuries of interest included burns, lacerations, fractures and choking. Reported practices were characterized as recommended, low-risk, and potentially harmful. For common injuries, 75-96% of caregivers reported employing a recommended practice (e.g., running cool water over a burn injury). However, for these same injuries, 13-61% of caregivers also identified potentially harmful management strategies (e.g., applying sand to a laceration). Choking had the highest proportion (96%) of recommended first aid practice: (e.g., hitting the child's back) and the lowest percent (13%) of potentially harmful practices (e.g., attempting manual removal). Fractures had the lowest percent (75%) of recommended practices (e.g., immediately bringing the child to a health facility). Burns had the highest percent (61%) of potentially harmful practices (e.g., applying kerosene). While most caregivers were aware of helpful first aid practices to administer for a child injury, many parents also described potentially harmful practices or delays in seeking medical attention. As parents are the de facto first responders to childhood injury, there are opportunities to strengthen pre-hospital care for children in LMICs.

  18. Characterization of Vancomycin Reactions and Linezolid Utilization in the Pediatric Population.

    Science.gov (United States)

    Lin, Samantha K; Mulieri, Kevin M; Ishmael, Faoud T

    Red man syndrome (RMS) occurs because of non-IgE-mediated histamine release. Unlike vancomycin allergy, which necessitates the use of an alternative drug (often linezolid), RMS does not typically preclude further vancomycin use. Care should be taken to differentiate these reaction types from one another to prevent unnecessary vancomycin avoidance. To characterize vancomycin reaction types in our population, and to determine whether having a reaction consistent with RMS is associated with otherwise unexplained vancomycin avoidance and linezolid use. We retrospectively reviewed charts for children with documented vancomycin reactions. We classified the in-hospital reactions via an objective analysis and estimated the prevalence of different reaction types. We then identified children who received linezolid over 3 years, and investigated reasons for linezolid use instead of vancomycin. Of the 78 in-hospital reactions we characterized, 72 (92%) were objectively consistent with RMS, 5 we could not objectively classify (2 most likely RMS, 3 more suspicious for possible IgE-mediated allergy), and 1 was a non-RMS/non-IgE reaction. Of 60 children who received linezolid, 19 had previous reactions consistent with RMS, which should not preclude further vancomycin. Nevertheless, only 7 of 19 (37%) had a clear explanation for receiving linezolid instead of vancomycin compared with 32 of 39 (82%) children without previous vancomycin reactions (P linezolid utilization. We propose that this may be related to how reactions appear in the electronic medical record. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. The polaroid suppression test in a pediatric population with ophthalmologic disorders.

    Science.gov (United States)

    Pott, Jan Willem R; Kingma, C; Verhoeff, K; Grootendorst, R J; de Faber, J T H N

    2003-04-01

    The Polaroid suppression test (PST) is a new method for early detection of amblyogenic factors by screening for suppression. The apparatus can elicit suppression with the use of Polaroid filters. The aim of the present study was to examine a population of children with known ophthalmologic disorders using the PST to determine the rate of false-negative results of the PST. Six hundred four children, varying in age between 3 and 15 years (mean, 7.9) were examined using the PST. Ophthalmologic disorders ranged from strabismus and amblyopia to refractive disorders. Mean testing time for the PST was 43 seconds. The PST could not be administered to 34 children (5.6%); 443 children (73.3%) had abnormal results; and 127 children (22.2%) showed no suppression. The suppression in constant strabismus was detected in almost all cases. The sensitivity for accommodative forms of strabismus was lower, but amblyopia was never missed in these cases. In children with normal eye alignment, only 2.7% with an interocular acuity difference of more than 0.1 logMAR had no suppression. Of all 119 children with clinical defined amblyopia, only 1 (0.8%) did not have suppression. Overall sensitivity of the PST for strabismus and/or abnormal interocular acuity difference was 96.2% and specificity was 41.1%. The PST has great potential as a visual screening tool in young children. Only few children with amblyogenic factors were missed. Thus, the test can differentiate those children at risk for amblyopia from normally sighted children. Because specificity is lower, all children showing suppression with the PST in a screening situation should have further examination by the health care worker before being referred to the ophthalmologist.

  20. Prevalence of glucose intolerance and associated risk factors in rural and urban populations of different ethnic groups in Kenya

    DEFF Research Database (Denmark)

    Christensen, D.; Friis, H.; Mwaniki, D.

    2009-01-01

    Objective: To assess the prevalence of glucose intolerance in rural and urban Kenyan populations and in different ethnic groups. Further, to identify associations between lifestyle risk factors and glucose intolerance. Research design and methods: A cross-sectional study included an opportunity...... intolerance among the rural ethnic groups. High BMI, WC, AFA, abdominal visceral and subcutaneous fat thickness, low fitness and physical activity, frequent alcohol consumption, and urban residence were associated with glucose intolerance. Conclusions: The prevalence of diabetes and IGT among different Kenyan...

  1. Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population

    OpenAIRE

    Mittal A; Ahluwalia S; Singh J

    2007-01-01

    Objective: To study the effect of various maternal factors on the prevalence of underweight and stunting among 1-5-year-old children in urban slum population. Design: Cross-sectional study. Materials and Methods: The study was carried out in three urban slums of Tripuri Town, Patiala. All 1-5-year children living in these slums were included, whose mother′s demographic profile, weight and height were recorded. Results: Out of 482 children who participated in the study, 185 (38.38�...

  2. [Spatial distribution characteristics of urban potential population in Shenyang City based on QuickBird image and GIS].

    Science.gov (United States)

    Li, Jun-Ying; Hu, Yuan-Man; Chen, Wei; Liu, Miao; Hu, Jian-Bo; Zhong, Qiao-Lin; Lu, Ning

    2012-06-01

    Population is the most active factor affecting city development. To understand the distribution characteristics of urban population is of significance for making city policy decisions and for optimizing the layout of various urban infrastructures. In this paper, the information of the residential buildings in Shenyang urban area was extracted from the QuickBird remote sensing images, and the spatial distribution characteristics of the population within the Third-Ring Road of the City were analyzed, according to the social and economic statistics data. In 2010, the population density in different types of residential buildings within the Third-Ring Road of the City decreased in the order of high-storey block, mixed block, mixed garden, old multi-storey building, high-storey garden, multi-storey block, multi-storey garden, villa block, shanty, and villa garden. The vacancy rate of the buildings within the Third-Ring Road was more than 30%, meaning that the real estate market was seriously overstocked. Among the five Districts of Shenyang City, Shenhe District had the highest potential population density, while Tiexi District and Dadong District had a lower one. The gravity center of the City and its five Districts was also analyzed, which could provide basic information for locating commercial facilities and planning city infrastructure.

  3. Hepatocellular Carcinoma in the Pediatric Population: A Population Based Clinical Outcomes Study Involving 257 Patients from the Surveillance, Epidemiology, and End Result (SEER Database (1973–2011

    Directory of Open Access Journals (Sweden)

    Christine S. M. Lau

    2015-01-01

    Full Text Available Introduction. Hepatocellular carcinoma (HCC is a rare pediatric cancer accounting for 0.5% of all pediatric malignancies. This study examines a large cohort of HCC patients in an effort to define the factors impacting clinical outcomes in pediatric HCC patients compared to adults. Methods. Demographic and clinical data on 63,771 HCC patients (257 pediatric patients ≤ 19 and 63,514 adult patients age ≥ 20 were abstracted from the SEER database (1973–2011. Results. HCC was more common among males (59.5% pediatric and 75.1% adults and Caucasians (50.4% and 50.5%, p 4 cm in size (79.6% versus 62.0%, p=0.02. Pediatric HCC patients undergoing surgery (13.107 versus 8.324 years, p4 cm in Caucasian males. Children with HCC achieve significantly longer mean overall survival compared to adults with HCC, primarily attributable to the more favorable fibrolamellar histologic variant, and more aggressive surgical intervention, which significantly improves survival.

  4. Modeling the effects of land cover and use on landscape capability for urban ungulate populations: Chapter 11

    Science.gov (United States)

    Underwood, Harold; Kilheffer, Chellby R.; Francis, Robert A.; Millington, James D. A.; Chadwick, Michael A.

    2016-01-01

    Expanding ungulate populations are causing concerns for wildlife professionals and residents in many urban areas worldwide. Nowhere is the phenomenon more apparent than in the eastern US, where urban white-tailed deer (Odocoileus virginianus) populations are increasing. Most habitat suitability models for deer have been developed in rural areas and across large (>1000 km2) spatial extents. Only recently have we begun to understand the factors that contribute to space use by deer over much smaller spatial extents. In this study, we explore the concepts, terminology, methodology and state-of-the-science in wildlife abundance m