Suburban Group Research Articles

Are Low‐Income Groups More Dependent on Community Space? A Case Study of Nanjing

AbstractCommunity dependence reflects individuals' daily needs for community space and facilities and is closely related to the accurate allocation of social resources and human quality of life. This study examines the differences in community use and dependence among different income groups at the overall and community levels from the perspective of the microscale individual activity space. Compared with non‐low‐income groups, low‐income groups are generally more dependent on their communities during their daily lives. However, these differences are diverse among different communities; they are more moderate among different income groups in communities located in central city areas and significant among different income groups in suburban affordable housing communities. The regression models reveal that in addition to income, the characteristics of activities and built environment attributes also affect individuals' community dependence. Social policies should prioritize the quality and quantity of community resources for vulnerable suburban groups.

Implications of Transport Poverty and Social Exclusion in Lagos State Transportation System

The link between transportation and social inclusion is well-established. Poor access to transportation services makes goods and services inaccessible, further marginalizing those who do not own motor vehicles. Sociologists look at social exclusion from these dimensions - poverty, inequality, lack of decent and accessible public services, inadequate public transport, the welfare and benefits system, and lack of good housing. These inequalities existed in our transportation system before the introduction of new technologies and business models, and they are exacerbated by present-day social disadvantages. This study examined the transport poverty metrics and housing quality index in some selected parts of Lagos Nigeria. The sample for the study was taken from six (6) locations with four hundred and eighty (480) questionnaires i.e., eighty (80) for each location. There were one hundred and sixty-eight (168) female respondents and three hundred and twelve (312) male respondents with four stated objectives and data for the study was collected through questionnaires. The research hypothesis and questions were tested using the Mann Whitney-U Test Analysis and Analysis of Variance ANOVA to compare differences between the Suburban neighborhood group and the Central neighborhood group. The findings show that households in the Central neighborhood group tend to live closer to convenient transportation options and don't have to drive/travel far to obtain basic services like hospitals, grocery stores, and places of work, but they pay higher housing rentage even when the transport externalities are minimal while the Suburban neighborhood group spend an average of more than 34.7% of their income on transportation and tend to travel farther and lack access to good transportation alternatives. However, one of the recommendations is that waterways transportation around the Suburban group must be revamped with realistic fares to attract people and reduce stress on road transport.

Remoteness from urban centre does not affect gastric cancer outcomes with established care pathway to specialist centre.

Patients living in rural communities experience difficulty accessing specialized medical care. Rural patients with cancer present with more advanced disease, have reduced access to treatment and have poorer overall survival than urban patients. This study's aim was to evaluate outcomes of patients with gastric cancer living in rural and remote areas versus urban and suburban communities in the context of an established care corridor to a tertiary care centre. All patients treated for gastric cancer at the McGill University Health Centre during 2010-2018 were included. Travel, lodging and cancer care coordination were provided for patients from remote and rural areas and coordinated centrally by dedicated nurse navigators servicing these regions. Statistics Canada's remoteness index was used to categorize patients into a rural and remote group and an urban and suburban group. A total of 274 patients were included. Compared with patients from urban and suburban areas, patients from rural and remote areas were younger and their clinical tumour stage was higher at presentation. The number of curative resections and palliative surgeries and rate of nonresection were comparable (p = 0.96). Overall, disease-free and progression-free survival were comparable between the groups, and having locally advanced cancer correlated with poorer survival (p < 0.001). Although patients with gastric cancer from rural and remote areas had more advanced disease at presentation, their treatment patterns and survival were comparable to those of patients from urbanized areas in the context of a publicly funded care corridor to a multidisciplinary specialist cancer centre. Equitable access to health care is necessary to diminish any preexisting disparities among patients with gastric cancer.

The Study of Alternative Fire Commanders' Training Program during the COVID-19 Pandemic Situation in New Taipei City, Taiwan.

In Taiwan, firefighters are responsible for transporting confirmed coronavirus cases to hospitals or epidemic prevention hotels. During the epidemic, in order to reduce the chance of cross-infection between the general public and the fire brigade, traditional collective mobilization training was limited. As a solution, this study combines a fire command course (C1) and a VR simulation for training fire station captains (VRST) and then applies the pre- and post-test evaluation approaches and the after-class questionnaire to summarize the learning effectiveness. The results show that, from a total of 244 captains that were trained, the after-training scores are significantly better when compared with the scores before training (p < 0.05, Cohen’s d > 0.8). Additionally, the post-test scores collected during the epidemic (n = 158) have no significant difference compared to the ones taken before the outbreak (2019, n = 86) in terms of sizing up, decision making, and safety management. The training results are still improving. The after-class questionnaire showed that most trainees believed that VRST helped to improve their confidence as incident commanders (ICs) (mean = 4.63, top box = 66.98%), with the novice and suburban groups exhibiting more significant improvements in command ability after the training. After the pandemic, VRST can continue as a regular training method for ICs. Because of the intervention of VRST, the differences in the command experience between different IC groups can be compensated for.

Evaluation of the Relationship between Fractional Exhaled Nitric Oxide (FeNO) with Indoor PM10, PM2.5 and NO2 in Suburban and Urban Schools.

Numerous epidemiological studies have evaluated the association of fractional exhaled nitric oxide (FeNO) and indoor air pollutants, but limited information available of the risks between schools located in suburban and urban areas. We therefore investigated the association of FeNO levels with indoor particulate matter (PM10 and PM2.5), and nitrogen dioxide (NO2) exposure in suburban and urban school areas. A comparative cross-sectional study was undertaken among secondary school students in eight schools located in the suburban and urban areas in the district of Hulu Langat, Selangor, Malaysia. A total of 470 school children (aged 14 years old) were randomly selected, their FeNO levels were measured, and allergic skin prick tests were conducted. The PM2.5, PM10, NO2, and carbon dioxide (CO2), temperature, and relative humidity were measured inside the classrooms. We found that the median of FeNO in the school children from urban areas (22.0 ppb, IQR = 32.0) were slightly higher as compared to the suburban group (19.5 ppb, IQR = 24.0). After adjustment of potential confounders, the two-level hierarchical multiple logistic regression models showed that the concentrations of PM2.5 were significantly associated with elevated of FeNO (>20 ppb) in school children from suburban (OR = 1.42, 95% CI = 1.17–1.72) and urban (OR = 1.30, 95% CI = 1.10–1.91) areas. Despite the concentrations of NO2 being below the local and international recommendation guidelines, NO2 was found to be significantly associated with the elevated FeNO levels among school children from suburban areas (OR = 1.11, 95% CI = 1.06–1.17). The findings of this study support the evidence of indoor pollutants in the school micro-environment associated with FeNO levels among school children from suburban and urban areas.

Interactive Training of the Emergency Medical Services Improved Prehospital Stroke Recognition and Transport Time.

Background and PurposeAcute stroke treatment outcomes are predicated on reperfusion timeliness which can be improved by better prehospital stroke identification. We aimed to assess the effect of interactive emergency medical services (EMS) training on stroke recognition and prehospital care performance in a very high-risk cardiovascular risk population in Lithuania.MethodsWe conducted a single-center interrupted time-series study between March 1, 2019 and March 15, 2020. Two-hour small-group interactive stroke training sessions were organized for 166 paramedics serving our stroke network. We evaluated positive predictive value (PPV) and sensitivity for stroke including transient ischemic attack identification, onset-to-door time, and hospital-based outcomes during 6-months prior and 3.5 months after the training. The study outcomes were compared between EMS providers in urban and suburban areas.ResultsIn total, 677 suspected stroke cases and 239 stroke chameleons (median age 75 years, 54.8% women) were transported by EMS. After the training, we observed improved PPV for stroke recognition (79.8% vs. 71.8%, p = 0.017) and a trend of decreased in-hospital mortality (7.8% vs. 12.3, p = 0.070). Multivariable logistic regression models adjusted for age, gender, EMS location, and stroke subtype showed an association between EMS stroke training and improved odds of stroke identification (adjusted odds ratio [aOR] 1.6 [1.1–2.3]) and onset-to-door ≤ 90 min (aOR 1.6 [1.1–2.5]). The improvement of PPV was observed in urban EMS (84.9% vs. 71.2%, p = 0.003), but not in the suburban group (75.0% vs. 72.6%, p = 0.621).ConclusionsThe interactive EMS training was associated with a robust improvement of stroke recognition, onset to hospital transport time, and a trend of decreased in-hospital mortality. Adapted training strategies may be needed for EMS providers in suburban areas. Future studies should evaluate the long-term effects of the EMS training and identify optimal retraining intervals.

河流着生藻类多样性对城镇化的响应-以深圳市为例

PDF HTML阅读 XML下载 导出引用 引用提醒 河流着生藻类多样性对城镇化的响应——以深圳市为例 DOI: 10.5846/stxb202105271393 作者: 作者单位: 作者简介: 通讯作者: 中图分类号: 基金项目: 深圳市主要河流水生态监测与评价项目（NO.2019-07-233） Response of stream benthic algal diversity to urbanization: A case study in Shenzhen Author: Affiliation: Fund Project: 摘要 | 图/表 | 访问统计 | 参考文献 | 相似文献 | 引证文献 | 资源附件 | 文章评论 摘要:着生藻类是河流生态状况的重要指示生物，然而关于城镇化对着生藻类多样性影响的研究还较缺乏。基于深圳市9条主要河流74个样点2020年雨、旱季的调查数据，对比了城区、郊区河流样点的着生藻类α、β多样性。两次调查共鉴定出着生藻类301个分类单元，其中硅藻门种类最多。谷皮菱形藻（Nitzschia palea）、隐头舟形藻（Navicula cryptocephala）、平庸菱形藻（Nitzschia inconspicua）等污染指示种在城区组相对丰度更高，而清洁指示种微小曲丝藻（Achnanthidium minutissimum）在郊区组相对丰度更高。城镇化对着生藻类物种丰富度、香农维纳多样性指数、Pielou均匀度指数等α多样性指数均无显著影响，但对着生藻类群落结构有显著影响。城区组样点的着生藻类β多样性（用主坐标分析质心指示）低于郊区组，城区组与郊区组藻类β多样性差异在旱季更为显著。两组样点的藻类β多样性差异主要来源于物种周转组分。与城区组着生藻类群落显著相关的环境因子包括总氮、高锰酸钾指数、电导率、pH、浊度和水深，而与郊区组着生藻类群落显著相关的是总氮、溶解性无机磷和电导率。研究发现，城市人类活动导致的总氮、溶解性无机磷、高锰酸钾指数、电导率等指标的显著增高导致着生藻类β多样性的降低。为了保护河流生物多样性，建议有效控制城区生产生活污水排放，减少人类活动对河流的干扰。 Abstract:Benthic algae are important indicators for ecological conditions of streams and rivers, but studies on effects of urbanization on benthic algal diversity is still sparse. In this study, we surveyed 74 sites from nine rivers located in Shenzhen City in the wet and dry season of 2020, and compared differences of α- and β- diversity of lotic benthic algal assemblages between urban and suburban groups. A total of 301 algal taxa were identified in the two seasons, among which the most taxa belonging to diatoms. The relative abundance of pollution indicator species such as Nitzschia palea, Navicula cryptocephala and Nitzschia inconspicua was higher in the urban groups, while the suburban groups with higher relative abundance of Achnanthidium minutissimum, which is an indicator species of clean water. We found that urbanization had no significant effects on algal α-diversity indices including richness, Shannon-Wiener's diversity index, and Pielou's index; while, algal community compositions in urban sites were significantly different from that of suburban sites. β-diversity of benthic algae, represented by centroids of the principal coordinate analysis, was lower for the urban sites than that of the suburban sites, with more significant difference in the dry season. The difference of benthic algal assemblages between the two groups mainly came from species turnover components. Total nitrogen, CODMn, conductivity, pH, turbidity and water depth were identified by the Mantel test as the environmental factors that were significantly correlated with algal community compositions in the urban group; while, TN, Dissolved inorganic Phosphorus (PO4-P) and conductivity were significantly correlated with the community compositions of benthic algae in the suburban group. We found that levels of TN, PO4-P, CODMn and conductivity were significantly increased in the urban group, which decreased β-diversity of benthic algae communities in Shenzhen rivers. To protect biodiversity of Shenzhen rivers, we therefore suggest to effectively control domestic and industrial sewage in urban areas to reduce human disturbance to rivers. 参考文献 相似文献 引证文献

Evaluation of Nutrient Composition in Breast Milk of Breast Feeding Mothers in Urban and Sub-Urban Subjects in Rivers State

The human breast milk is considered to be the perfect food for infants, specifically adapted to their needs. Changes in lifestyle and environment may impact on breast milk composition. This study was aimed at comparing the nutrients composition in breast milk in postpartum women in urban and sub-urban areas in Rivers State. The cross-sectional study was conducted among 59 postpartum subjects between 0 and 10days of child delivery in each group. Sampling was done through a simple random sampling method. Human breast milk was collected by means of a manual breast pump for the analysis of carbohydrate, protein and lipid using ClegAnthrone Method, Kjedahl Method and Soxhelt Extraction Method respectively. The results revealed that carbohydrate level was 6.1±0.5% in urban group and 5.0±0.1% in sub-urban group which was statistically significant (t-value=2.2; p-value=0.04). Protein level was 3.5±0.6% in urban group and 3.9±0.3% in sub-urban group which was statistically non-significant (t-value=0.6; p-value=0.57). Lipid level was 6.1±0.5% and 5.0±0.1% in urban and sub-urban groups respectively which was statistically non- significant (t-value=1.2; p-value=0.27). This study has revealed that differences in settlements (urban and sub-urban) have no impact on breast milk composition except in carbohydrate.

Abstract P863: Did Covid 19 Highlight Disparities in Stroke Care: A Real-World Study of Telehealth Utilization Between Urban and Suburban Populations in a Health Care System

A viable alternative to in person assessments, telemedicine offered providers cost effective and safe alternative to patient care delivery during COVID19. Resource limitations, state and organizational safety precautions accelerated our system adoption of video visits for stroke post hospitalization assessments. Utilizing mixed methods we aimed to investigate an association between patients characteristics (age, gender, race, Modified Rankin Score-mRS, residence) and their choice for post-acute care during a five-month period. The subset selecting in-person visits was further interviewed regarding perceptions of barriers to telehealth. We analyzed data from 85 patients’ records (45 in the urban telehealth and 40 in the suburban clinic visit groups) according to ICD10 codes. While total volume of televisits increased during COVID 19, stroke accounted for &lt;1% of them. There was no significant difference in the mean age between the two groups-68.5 years in the clinic and 64.4 in the tele. The clinic subset had 42% of patients age greater than 75 years. Significant difference was detected in disabilities (t=3.5, p&lt;.001) with one-point higher mean mRS (1.7 vs .7) and stronger positive correlation of age to disabilities in the suburban group (r2=.26 vs r2=.16). Patients selecting in-person care outlined as barriers to telehealth a lack of technology, poor connectivity, no caregiver availability for tele exam, inability to communicate or other major co-morbidities, family’s perception of complexity of patient’s condition, fragmentation of care during the period. Patients selecting video assessment were more connected with a health care system and from the urban center. Strengths of the study are the application of mix methods and investigation of suburban patients’ perceptions of barriers to telehealth. Limitations consist of small sample size and 90% Caucasian population. Current technology advancements, software applications, and the goal of Healthy People 2030 of removing disparities in heart and stroke disease will require a new multipronged approach to improving stroke telehealth at population level. Further studies at national level including social determinates of health need to examine barriers to telemedicine in post-acute stroke care.

Family Engagement in Schools: Parent, Educator, and Community Perspectives

How engaged families are in their children’s lives, whether at home or in school, predicts their success in school and in life. The purpose of this study was to explore parent, educator, and community member perspectives of family engagement, preschool through grade 12, to inform state-level policy from an ecological framework. Ten semi-structured focus groups were conducted throughout one midwestern state, including five urban groups, four rural groups, and one suburban group. All focus groups were held in high-poverty areas serving high-need communities. All school communities received Title I funds and the average free and reduced lunch rate across participating districts was 75%. Several themes emerged through focus groups, including the importance of relationships, inclusive opportunities, communication, parent education, and family activities. Potential outcomes are included for policy and program development, as well as implications to further expand on issues relative to special education, fatherhood, and English language learners.

Parent-Level Barriers and Facilitators to HPV Vaccine Implementation in Santo Domingo, Dominican Republic.

Cervical cancer is the second leading cause of cancer death for women in the Dominican Republic. Vaccination against human papillomavirus (HPV) could reduce mortality from cervical cancer globally by as much as 90%. The purpose of our study was to explore multi-level barriers and facilitators to implementation of a national HPV vaccine program in the Dominican Republic; this article focuses on parent-level barriers and facilitators. In this qualitative study, we conducted six focus groups (N = 64) with parents of school-age children in the Santo Domingo area of the Dominican Republic, representing diverse socioeconomic groups and geographic settings. Thematic content analysis, using inductive and deductive approaches, was done following transcription and translation of audio-recordings from focus group discussions. Among this group of parents in the Santo Domingo area, facilitators to vaccine uptake were favorable attitudes towards vaccines in general and concern about cervical cancer as a health issue. Barriers found were low to moderate knowledge of HPV and cervical cancer, especially in the rural and suburban groups, and cost and lack of public awareness of the vaccine. This study identified key barriers and facilitators to HPV vaccine implementation in the Dominican Republic. Health messaging, incorporating specialist providers as opinion leaders, will need to be tailored to broad audiences with varying levels of information and awareness, anticipating misinformation and concerns, and will need to emphasize HPV vaccine as a method to prevent cancer.

Hospitalization Rates Difference of Adult Emergency Patients between Urban and Suburban in Tianjin

Aim: Compare the hospitalization rate of adult emergency patients within 6 h of arrival between urban and suburban hospitals in Tianjin.Method: We analyzed a cross-sectional survey data for adult emergency patients. Fifty hospitals were divided into two groups: urban and suburban group according to geographical location. Each group was classified into two (secondary and tertiary hospital) subgroups. The emergency hospitalization rate within 6 h of arrival, gender and age of patients, Emergency Severity Index (ESI), as well as the mode of arrival and primary diagnosis, were collected and compared using Student’s t-test, χ2 test, or Fisher’s exact test as appropriate between both groups and subgroups.Results: 1) 6569 patients visited emergency departments and 494 (7.52%) were hospitalized within 6 h of arrival. 178 of 3680 (4.84%) and 316 of 2889 (10.94%) patients were hospitalized in the urban and suburban group, there was a significant difference between two groups (P <0.05). 2) Concerning tertiary subgroup, 157 of 2984 (5.26%) urban and 253 of 1833 (13.80%) suburban patients were hospitalized; in secondary subgroup, 21 of 696 (3.02%) urban and 63 of 1056 (5.97%) suburban patients were hospitalized, there were a significant difference between both two subgroups (P<0.05). 3) There was a significant difference in age, yet no significant difference in other aspects. 4) Injury patients in suburban hospitals were more than urban hospitals while pregnancy/childbirth patients were converse (P<0.05).Conclusions: Adult emergency patients' hospitalization rate was 7.52% in Tianjin and suburban tertiary hospitals possess the relatively higher hospitalization rate.

Education and Training Improve Quality of Life and Decrease Depression Score in Elderly Population

The elderly population in Bali have increased in recent years, influenced by the improvement of health and nutrition. On one hand, still very few programs exist to help the elderly live independently. On the other hand, there is a decreasing trend in the quality of life and an increasing trend in depression score. Aim: To understand the effect of education and training on quality of life and score of depression in the elderly population. Method: Elderly individuals were divided into three groups with 22 members, 32 members, and 38 members respectively. One group was in the University is an urban group, one group was in Kuta Utara (suburban) and one rural group was in Munggu village. All groups received education from Dhyana Pura University lecturers with different topics twice a week for 5 months, with physical exercise each Saturday. Before and after the process, depression scores (Back Depression Index) and quality of life using the World Health Organization Quality of Life (WHOQOL) were measured. Result: The result of this process is as follows: for the urban group BDI before the process was 17.14 ±14.87, and after the process was 7.14 ±4.29. The rural (village) group were 11.59 and 8.19, and the suburban group was 13,44 before process and 7.87 after the process. The quality of life scores was 20.41±2.32 and 22.50±1.50, for the physical domain, 16.45±3.10 to 19.82±2.38 for the psychological domain, 8.32±1.39 to 10.82±1.68 for social domain, and 24.14±2.75 to28.09±3.06, for environmental domain. Conclusion: Education and training can improve the quality of life and depression for elderly people. More participants are needed to achieve a general conclusion.

Psychological Divergence Between Urban and Suburban Chinese in Relation to Green Commuting

We used the extended theory of planned behavior to explore the moderating effect of residential area on choice of travel mode and identified the source of divergence. Both urban and suburban groups held favorable expectations about the positive externality of green commuting. However, urban residents were more accustomed to green commuting than were suburban residents, and had greater willingness to maintain it, which led to a higher frequency of, and greater inclination to perform, green commuting among the former group. Moreover, reduced frequency of private car use by urban residents can be better transformed into green commuting. Structural equation modeling revealed that environmental concern had a similar impact on both urban and suburban residents, but that subjective norms had a greater influence on suburban than on urban residents. Our findings can be used by government officials to promote green commuting through environmental education and targeted policy making.

The association between area-level socio-economic status and childhood overweight and the role of urbanicity

BackgroundThe relation between area-level socio-economic status (SES) and childhood overweight has primarily been investigated in urban areas. However, study areas have rarely been defined regarding their urbanicity. The aim of this study was to comparatively examine the relation between area-level SES and childhood overweight according to different types of areas within a German city. MethodsWe used the cross-sectional data of 2858 children (mean age 6 years, sd = 0.4, 49% female) who were taking the school entry examination. Individual data (weight status, parental SES) was subsequently linked to area-level SES. Multilevel logistic regression (MLRA) models were conducted to analyse associations between individual- and area-level SES and overweight in children from suburban, urban, and highly urban areas. ResultsUnadjusted analyses showed associations between parental and area-level SES and children's overweight in more urbanised areas but not in suburban areas. In multivariate MLRA models, only parental education remained statistically significant. None of the included SES predictors were associated with overweight in the suburban group. ConclusionsWhereas individual- and area-level SES are associated with childhood overweight in more urbanised areas, aspects of the physical environment might be more relevant in suburban areas. Levels of urbanicity should be considered when planning community-based obesity-prevention programmes.

Knowledge and practice of colorectal screening in a suburban group of Iraqi American women.

Colorectal cancer (CRC) was the second most common cancer among women in 2008, accounting for 571,000 cases, and 9.4% of all cancer cases afflicting women worldwide. According to the World Health Organization (WHO) and the Iraqi National Cancer Registry (INCR), Iraq has seen a steady rise in CRC rates among its general population over the past several decades. Despite Iraq's increasing national incidence of CRC and the growth of the US' Iraqi immigrant population over the last 10 years, little remains known about the prevalence of CRC among the latter population, their knowledge of CRC and associated risk factors, or their behavioral intent and practices regarding CRC screening. The aims of this study were to (1) examine the knowledge of and adherence to National Cancer Institute screening recommendations for CRC among a population of Iraqi women living in the Washington D.C. Metropolitan Area and (2) test the efficacy of a one-time educational intervention conducted using linguistically and culturally appropriate materials to raise awareness of, and promote future adherence to, CRC screening methods. This descriptive study used a pre/post design with a 12-month follow-up. Following extensive dissemination of information regarding the study in the Iraqi American community in the study location, 50 women were initially recruited, of whom 32 participated in the study. The study's findings revealed that the participants generally had low baseline levels of CRC screening adherence and preventive knowledge that significantly improved after the intervention as demonstrated by pre- and post-assessments of knowledge and behavior. These findings could be used to raise awareness (1) among clinicians regarding the need for early detection and screening of and referral for CRC treatment among Iraqi American women and (2) among Iraqi American women about risk factors for this disease and the importance of early detection and screening. The study also highlights the need for a larger study of knowledge, attitudes, and perceptions among both this population and the clinicians who serve them.

"To Cultivate Our Children to Be of East and West": Contesting Ethnic Heritage Language in Suburban Chinese Schools

“THE GREAT CHALLENGE AND INSPIRATION [for Chinese parents in the United States] is to cultivate our children to be you zhong you xi [of East and West] rather than bu zhong bu xi [without East or West],” members of the Association of Chinese Schools wrote in the group’s 1985 annual publication. Decades earlier, during the 1960s, Chinese suburbanites around the country had begun to establish weekend heritage language schools in an effort to help young Chinese Americans—many of them American-born— retain a sense of their Chinese heritage while living in primarily European American areas. The schools offered a structured environment to learn about Chinese culture, be among co-ethnic peers, hone Chinese-language skills, and negotiate an identity that would encompass both the students’ Chinese and American backgrounds. Heritage language education has been one strategy employed by many immigrant groups for preserving their ethnic heritage in the United States. According to anthropologist Joe C. Fong, this type of education complements (rather than undermines) a student’s formal primary and secondary schooling. Although Chinese Americans from a variety of class, geographic, and linguistic backgrounds have established heritage language schools, this study focuses on middle-class groups living in affluent and predominantly white suburban areas with dispersed Chinese populations in the post-1960 era. The schools became sites where intra-ethnic differences surfaced in powerful ways for suburban Chinese groups. Rather than promoting a singular or universal understanding of Chinese ethnic heritage and language, the conflicts within these schools reveal the complexities of these suburban populations. This study explores these intra-ethnic dynamics at schools nationally, but with an emphasis on the suburbs around Washington, DC, and Wilmington, Delaware, to demonstrate how suburban middle-class Chinese Americans continued to maintain ethnic identities and community networks despite living in primarily European American suburbs. Both areas have relatively

Differences in palliative care needs among women with gynecologic cancers in an inner city, academic facility versus a suburban, community facility

Objectives: The aim of this study was to determine differences in palliative care needs inwomenwith gynecologic cancers from anurban, inner city, academic facility compared to a suburban, community facility and also, to identify interventions that could improve palliative care for gynecologic cancer patients in varying locations. Methods: 71 women with gynecologic cancer were prospectively identified, 54 from an urban, inner city academic cancer center, and 17 from a suburban community cancer center in the same metropolitan area. All subjects were asked to complete a standardized, validated questionnaire intended to determine their palliative care needs after diagnosis but prior to treatment. Palliative care trained, Master's level social workers introduced themselves and the questionnaire to patients, and offered to help with additional needs. Completed questionnaires were collected and appropriate data was extracted. The data was depersonalized and analyzed by the authors. Statistical differences were assessed with SigmaStat V.2.0. Results: All patients were treated by board-certified gyn oncologists. The types of cancers seen and treatments offered (all of which met NCCN guidelines) were similar. Inner city academic patients were less likely to complete the questionnaire than the suburban community patients (64% vs 100% of those offered, p b 0.001). Patients from the inner city academic group were younger (54 years old vs 61 years old, p b 0.05) and more likely to be African–American (77% vs 29%, p b 0.05) than those from the suburban community group. The ratio of Medicaid to private/Medicare insurance coverage was higher in inner city academic patients than suburban community patients (58% vs 22%, p b 0.05). The most common palliative care concerns identified by suburban community patientswere: 1) pain, 2) anxiety, 3) depression, 4) nausea/vomiting. In comparison, the most common concerns identified by inner city academic patients were: 1) paying for medications, 2) travel to the treatment facility, 3) pain, and 4) child care. Conclusion: There are major differences in the palliative care needs of patients from an inner city academic facility compared to a suburban community facility. Interventions proposed for the suburban community facility were early access to: 1) grief counseling, 2) patient support groups, and 3) Nurse–Navigator services. Interventions proposed for the inner city academic facility include early access to: 1) programs for assistance with medication costs (local philanthropies, facility-based pharmacy discounts), 2) travel services (cab vouchers, coordination of treatments with public transportation schedules), and 3) on-site child care facilities. Further, inner city academic patients should be encouraged to voice their palliative care concerns. More specific determinations of patient concerns are needed to help structure palliative care services in different types of facilities.

The role of tumor associated macrophages in ovarian cancer

Objectives: The aim of this study was to determine differences in palliative care needs inwomenwith gynecologic cancers from anurban, inner city, academic facility compared to a suburban, community facility and also, to identify interventions that could improve palliative care for gynecologic cancer patients in varying locations. Methods: 71 women with gynecologic cancer were prospectively identified, 54 from an urban, inner city academic cancer center, and 17 from a suburban community cancer center in the same metropolitan area. All subjects were asked to complete a standardized, validated questionnaire intended to determine their palliative care needs after diagnosis but prior to treatment. Palliative care trained, Master's level social workers introduced themselves and the questionnaire to patients, and offered to help with additional needs. Completed questionnaires were collected and appropriate data was extracted. The data was depersonalized and analyzed by the authors. Statistical differences were assessed with SigmaStat V.2.0. Results: All patients were treated by board-certified gyn oncologists. The types of cancers seen and treatments offered (all of which met NCCN guidelines) were similar. Inner city academic patients were less likely to complete the questionnaire than the suburban community patients (64% vs 100% of those offered, p b 0.001). Patients from the inner city academic group were younger (54 years old vs 61 years old, p b 0.05) and more likely to be African–American (77% vs 29%, p b 0.05) than those from the suburban community group. The ratio of Medicaid to private/Medicare insurance coverage was higher in inner city academic patients than suburban community patients (58% vs 22%, p b 0.05). The most common palliative care concerns identified by suburban community patientswere: 1) pain, 2) anxiety, 3) depression, 4) nausea/vomiting. In comparison, the most common concerns identified by inner city academic patients were: 1) paying for medications, 2) travel to the treatment facility, 3) pain, and 4) child care. Conclusion: There are major differences in the palliative care needs of patients from an inner city academic facility compared to a suburban community facility. Interventions proposed for the suburban community facility were early access to: 1) grief counseling, 2) patient support groups, and 3) Nurse–Navigator services. Interventions proposed for the inner city academic facility include early access to: 1) programs for assistance with medication costs (local philanthropies, facility-based pharmacy discounts), 2) travel services (cab vouchers, coordination of treatments with public transportation schedules), and 3) on-site child care facilities. Further, inner city academic patients should be encouraged to voice their palliative care concerns. More specific determinations of patient concerns are needed to help structure palliative care services in different types of facilities.

Comparing sleep disorders in urban and suburban adolescents

Background Sleep disturbances commonly occur in adolescents. Socioeconomic levels, lifestyle, and urban or suburban environments influence the sleep patterns of adolescents. The modernization process in urban environments is marked by the development of information technology media, and the lack of parental monitoring potentially influencing adolescent sleep disturbances. Sleep disturbances may affect children's physical growth, as well as their emotional, cognitive, and social development.Objective To assess for sleep disorders in urban and suburban adolescents, and to determine the factors that influence the prevalence of sleep disturbances.Methods A cross-sectional study was conducted on 12 to 15-year-old junior high school students in urban (n=350) and suburban (n=350) environments in the city of Medan, North Sumatera. The study was undertaken from May to June 2010 using the Sleep Disorders Scale for Children (SDSC), a set of questionnaires. The SDSC was filled out by parents based on what they remembered about their children's sleep patterns in the prior 6 months.Results In the urban group, there were 133 (38.0%) subjects with sleep disturbances, 182 (52.0%) were borderline, and 35 (10.0%) were normal. In the suburban group, there were 132 (37.7%) subjects with sleep disturbances, 180 (51.4%) were borderline, and 38 (10.9%) were normal. The most influential factors for sleep disturbances in urban and suburban youth were environmental noise (P=0.001) and consuming beverages that contain caffeine (P=0.001). There were three types of sleep disorders that significantly found more in urban adolescents: disorders of initiating and maintaining sleep, disorders of excessive somnolence, and sleep hyperhidrosis.Conclusion The prevalence of sleep disturbances do not differ between urban and suburban adolescents. Howevet; there are significant differences in the types of sleep disorders experienced. The most influential factors on sleep disturbance in both areas are environmental noise and consuming beverages that contain caffeine.