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"This paper reviews the literature on the nature and extent of interrelations among cities in advanced industrial societies. It summarizes contemporary population distribution and redistribution trends in these societies and their causes. Finally, it attempts to identify some of the most important issues for the development of a comparative theory of urbanization."
The structure and mathematical model of PARATI, a detailed computer programme developed for the assessment of the radiological consequences of an accidental contamination of urban areas, is described with respect to the scenarios used for the estimation of exposure fields in a village or town, the models for the initial and secondary contamination with the radionuclide 137Cs, the concepts for calculating the resulting radiation exposures and the changes with time of the contamination and radiation fields. Kerma rates at various locations in tropical urban areas are given, and the contribution of different contaminated surfaces to these rates after dry or wet deposition are discussed.
The study assessed views of teachers, pupils and their guardians on left-hand preference. Seventy-five percent of the responders indicated that the left hand should not be preferred for habitual activities and 87.6% of them indicated that left-handers should be forced to change the hand. Gender had significant effect on the view on left hand preference (df = 1, OR (odds ratio) = 0.465, p = 0.027). Giving a handshake when greeting a person, drawing and writing were the three top target activities against left-hand preference. An assumption that the left hand is less skilled and less powerful than the right one was the most common reason for negative view on left-hand use. Most of volunteers reported that parents and close relatives were the primary group of people who usually discourage left-hand use. Eighty point one percent of the responders indicated that people should stop preferring the left hand as soon as somebody noticed their left-handedness. The results indicated that cultural and environmental pressures might significantly affect visibility of left-handedness in urban Malawian populations.
To assess risk factors for malaria in pregnancy in Kisumu, western Kenya, we studied healthy women with an uncomplicated pregnancy of > or = 32 weeks attending the antenatal clinic in the Provincial Hospital. Between June 1996 and March 1999, malaria and human immunodeficiency virus (HIV) infection were examined in 5093 pregnant women: 20.1% of the women were parasitaemic and 24.9% were HIV-seropositive. 2502 women delivered in the hospital and a smear was obtained: the prevalence of placental malaria, maternal peripheral parasitaemia, and HIV infection was respectively 19.0%, 15.2% and 24.5%. HIV infection (risk ratio [RR] 1.58, 95% confidence interval [95% CI] 1.32-1.89), young age (< 21 years: RR 1.51, 95% CI 1.19-1.91), being a primigravidae (RR 1.41, 95% CI 1.05-1.88), a peri-urban residence (RR 1.50, 95% CI 1.21-1.88), and Luo ethnicity (RR 1.74, 95% CI 1.35-2.24) were risk factors for malaria at delivery. Use of sulfadoxine-pyrimethamine (SP), reported by 2.1% of the women, was a protective factor (RR 0.44, 95% CI 0.18-1.06). Results were similar in the third trimester. In this urban/peri-urban setting, preventing HIV infection, delaying the first pregnancy until after adolescence, and applying an effective antimalarial strategy such as intermittent therapy with SP will reduce the prevalence of malaria in pregnancy.
How do you keep patients down on the farm after they've seen high-tech? In other words, how do rural hospitals encourage patients who have been referred to urban tertiary facilities to return home for their other healthcare needs? One rural hospital instituted the Care Connection, a program that not only helped the hospital retain clients but assisted referred patients with the often-overwhelming logistics of using a large tertiary center.
AIMS: To study the association of serum lipids with diabetic retinopathy (DR) in Type 2 diabetic subjects. METHODS: Type 2 diabetic subjects (n = 1736) were randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), which was carried out on a representative population of Chennai in South India. DR was diagnosed by retinal colour photography and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. Classification of lipid abnormalities was done according to the National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) Guidelines. RESULTS: The mean serum cholesterol (P = 0.024), serum triglycerides (P = 0.017) and non-high-density lipoprotein (HDL)-cholesterol (P = 0.025) concentrations were higher in subjects with DR compared with those without DR. Multiple logistic regression analysis revealed that after adjusting for age, gender, duration of diabetes, total cholesterol Standardised regression estimate (SRE) = 1.178, 95% confidence interval (CI) 1.042, 1.331, P = 0.014), non-HDL-cholesterol (SRE = 1.169, 95% CI 1.040, 1.313, P = 0.012) and serum triglycerides (SRE = 1.292, 95% CI 1.136, 1.467, P = 0.001) were associated with DR and non-HDL-cholesterol (SRE = 1.264, 95% CI 1.000, 1.592, P = 0.045) and low-density lipoprotein (LDL)-cholesterol (SRE = 1.453, 95% CI 1.107, 1.896, P = 0.005) with diabetic macular oedema (DME). After adjusting for HbA(1c) and body mass index, only triglycerides maintained a significant association with DR (SRE = 1.137, 95% CI 1.000, 1.291, P = 0.007) and LDL-cholesterol with macular oedema (SRE = 1.358, 95% CI 1.034, 1.774, P = 0.026). CONCLUSIONS: There is a significant association of serum triglycerides with DR and LDL-cholesterol with DME.
"In this study, it is argued that the rural to urban migration rate is both influenced by and influences the workforce participation rate and the level of service employment in the cities." The geographical focus is on India.
OBJECTIVE: To determine the rate and estimate the cost of hospitalization in a defined urban homeless population. DESIGN: Retrospective chart review. SETTING: Kalihi-Palama Health Clinic Health Care for the Homeless Project, Hawaii State Hospital and seven acute care hospitals in Honolulu, Hawaii. PATIENTS: A total of 1751 homeless clients contacted between 1 December 1988 and 30 November 1990. MEASUREMENTS AND MAIN RESULTS: A total of 1751 individuals were studied for an aggregate of 871.3 person-years. Five hundred sixty-four hospitalizations were identified: ninety-two to the state psychiatric hospital and 472 to acute care hospitals. The age- and sex-adjusted hospitalization rate for acute care hospitals was 542/1000 person-years (compared with the state rate of 96/1000 person-years). Homeless persons were admitted to acute care hospitals for 4766 days compared with a predicted 640 days. The age- and sex-adjusted rate of admission to the state psychiatric hospital was 105/1000 person-years (compared with the state rate of 0.8/1000 person-years). Homeless persons were admitted to the state psychiatric hospital for 3837 days compared with a predicted 139 days. CONCLUSIONS: Homeless individuals in this study were hospitalized in acute care and psychiatric hospitals far more frequently than were members of the general population.
Remotely sensed mapping information of multi-period of time and methods of landscape pattern analysis were used to study the structure and spatial distribution characteristics of two types of land use, built-up areas and new developing areas, during the fast urbanization process in Longhua area, Shenzhen City. The results indicated that from 1988 to 1996, the patch number and average size in the two types of land use increased significantly, but the fragmentation degree decreased. The increase of constructed land use could be divided into two patterns, continued expanding of big residential patches and continuous appearing of new isolated small patches, and most of the new developing area was constructed from 1990 to 1994. Under the impacts of topography and traffic, the built-up areas showed macroscopic spatial distribution with decreasing lacunarity values. Distribution difference of constructed patches was very obvious in small and moderate scales. The new developing patches, affected by the conditions as the built-up areas, were also characteristic of macroscopic heterogeneity, but the expression scale of heterogeneity was larger than the built-up areas. The fast expanding of the constructed land use produced some very negative ecological problems, which should urgently be resolved by adjusting the land use polices.
Many community based outreach programs in low income countries utilize illiterate women to provide health services. However, illiteracy may present special problems in immunization or other programs requiring extensive record-keeping and follow-up. In a trial involving twenty-nine volunteers from urban slum communities in Dhaka, Bangladesh, a community-based referral and record-keeping system for use by semi-literate and illiterate volunteers in immunization outreach activities was evaluated over a thirteen month period. The women were uniformly, regardless of literacy, able to use the system to effectively refer and follow-up clients. Although volunteer performance as measured by numbers of referrals was below initial targets, completion rates were high; 87% of children and 96% of women referred completed the full series of immunizations. By facilitating active community participation, the system provides a feasible approach to reducing the high drop-out rates currently associated with immunization programs.
OBJECTIVE: Earlier studies in Europeans have identified small dense LDL to be associated with coronary artery disease and diabetes. In this study we assessed the association of small dense LDL with diabetes and CAD in Asian Indians. METHODS: Study subjects were selected from the Chennai Urban Rural Epidemiology Study (CURES), a population based study on representative sample of Chennai city in southern India. Group 1:non-diabetic subjects (n = 30); Group 2: diabetic subjects without CAD (n = 30); Group 3:diabetic subjects with CAD (n = 30). LDL subfractions were estimated using LipoPrint LDL system. LDL subfractions 3 and above, defined as small dense LDL was summed up to determine the overall small LDL. 75th percentile of the overall small dense LDL in non-diabetic subjects was used as a cut-off for defining elevated levels of small dense LDL. RESULTS: The mean age of the study subjects was not significantly different among groups. Overall small dense LDL was significantly higher in diabetic subjects with CAD (16.7 +/- 11.1 mg/dl, p < 0.05) and without CAD (11.1 +/- 8.0 mg/dl, p < 0.05) compared to non-diabetic subjects without CAD (7.2 +/- 6.8 mg/dl). Small dense LDL showed a positive correlation with fasting plasma glucose (r = 0.252, p = 0.023), HbA1c (r = 0.281, p = 0.012), total cholesterol (r = 0.443, p < 0.001), triglycerides(r = 0.685, p < 0.001), LDL(r = 0.342, p = 0.002), total cholesterol/HDL ratio (r = 0.660, p = < 0.001) and triglycerides/HDL ratio(r = 0.728, p < 0.001) and a negative correlation with HDL cholesterol (r = -0.341, p = 0.002) and QUICKI values (r = -0.260, p = 0.019). ROC curves constructed to predict elevated small dense LDL ((9.0 mg/dl) revealed that triglycerides/HDL ratio and total cholesterol/HDL ratio had higher AUC values compared to other parameters. A triglycerides/HDL ratio of 3.0 had the optimum sensitivity (80.0%) and specificity (78.0%) for detecting elevated small dense LDL. CONCLUSION: This data suggests that in Asian Indians, small dense LDL is associated with both diabetes and CAD and that a triglycerides/HDL ratio (3.0 could serve a surrogate marker of small dense LDL.
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Personal exposures and microenvironment concentrations of 30 target VOCs were measured for 401 participants living in five European cities as a part of the EXPOLIS (Air Pollution Exposure Distributions within Adult Urban Populations in Europe) study. Measurements in Basel used an active charcoal (Carbotech) adsorbent as opposed to the Tenax TA used in the other study centres. In addition, within each centre, personal and microenvironment VOC sampling required different sampling pumps and, because of different sampling durations, different sampling flow rates. Thus, careful testing of the sampling and analysis procedures was required to ensure accuracy and comparability of collected data. Monitor comparison tests using Tenax TA showed a mean VOC concentration ratio of 0.95 between the personal and microenvironment monitors. The LODs for the target VOCs using Tenax TA ranged from 0.7 to 5.2 microg m(-3). The LODs for the 14 target compounds quantifiable using Carbotech ranged from 0.9 to 3.2 microg m(-3). Tenax TA field blanks showed no remarkable contamination with the target VOCs, except benzaldehyde, a known artefact with this adsorbent. Thus, the diffusion barrier system used prevented contamination of Tenax TA samples by passive diffusion during non-sampling periods. Duplicate and parallel evaluations of the Tenax TA and Carbotech showed an average difference of < 17% in VOC concentrations within the sampling methods, but a systematic difference between the methods (Tenax TA: Carbotech concentration ratio = 1.18-2.36). These field evaluations and quality assurance tests showed that interpretation and comparison of the results in any VOC monitoring exercise should be done on a compound by compound basis. It is also apparent that carefully planned and realised QA and QC (QA/QC) procedures are needed in multi-centre studies, where a common sampling method and laboratory analysis technique are not used, to strengthen and simplify the interpretation of observed VOC levels between participating centres.
Ground-level ozone (O3) time series are characterized by the sum of several distinct temporal scales: long-term, seasonal, synoptic, diurnal (daily), and intraday variation. In this study, the authors use a Kolmorogov-Zurbenko filter to separate the 1981-2001 O3 time-series from many sites in and around Georgia into these various components. The authors compare the temporal components to examine differences between small and large metropolitan areas and between urban and rural areas. They then focus on the synoptic component to define a predominant transport region or airshed for each site.
This article characterizes the etiological conditions for schistosomiasis mansoni in the urban portion of the Greater Metropolitan Area of Belo Horizonte, Minas Gerais. Knowledge about this endemic disease is discussed with a clinical focus on subjects who lived in endemic areas from 1946 to 1994, taking into account the specific indicators for the endemic disease according to the measures adopted in its control.