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1.
Mona; s.n; 2001. ii,46 p. tab, gra.
Tese em Inglês | MedCarib | ID: med-17158

RESUMO

In Jamaica, health promotion and education programmes have focused on empowering and facilitating individuals and communities to engage in healthy lifestyle practices to reduce the incidence of non-communicable chronic diseases such as diabetes and hypetension. The elderly receive health education through senior citizens clubs, churches, health services and the mass media. A cross-sectional survey was carried out in Linstead, Saint Catherine among a quota sample of elderly adults (60 years and over) in order to ascertain their knowledge, attitude, beliefs, and practices of healthy lifestyles. Factors examined were their knowledge, self-reported eating habitis, practices, health seeking, and exercise behaviours. Most respondents were knowledgeable about the factors that contribute to a healthy lifestyle including the benefits to be derived from exercise. Ninety-one percent (91) of respondents knew that high fat and salt intake could eventually lead to stroke. Eighty-six percent (86) agreed that exercise reduces stress, and 88 percent knew that smoking was bad for health. Most of the elderly were physically able to engage in some form of exercise or strenuous work that burned calories. The study also revealed some health knowledge deficits, which has implications for health program planning (AU)


Assuntos
Humanos , Idoso , Promoção da Saúde , Comportamentos Relacionados com a Saúde , Fatores Etários , Atitude Frente a Saúde , Jamaica , Educação em Saúde , Região do Caribe
2.
Mona; s.n; Oct. 2000. i,60 p. maps, tab, gra.
Tese em Inglês | MedCarib | ID: med-17210

RESUMO

Students at the Mona Campus of the University of the West Indies are in the most vulnerable age group (20-39 years) for contracting STIs including HIV/AIDS. This study sought to determine the HIV related knowledge, attitudes and practices among students living on halls of residence. Questionnaires were self-administered by approximately 10 percent (146) of the students on the halls of residence over a two week period and informal discussions were held with two small groups of students to gain greater insights into their understanding of the HIV/AIDS situation. The results showed deficiencies in the knowledge, attitudes and behaviours of students. Approximatley 25 percent of students felt that HIV could be transmitted through blood donation and 29.5 percent said there was no link between STIs and contracting HIV. The students' attitude towards homosexuality was negative. The majority of students did not know the window period for HIV infection. Approximately 5 percent of students have had an STI and 15 percent of students who reported being sexually active were not using the condom. There was a significant association between the gender of students and condom use. The study concluded that the students are at risk of contracting and spreading HIV and other STIs. There is need for intense education on HIV/AIDS for students living on the halls and the placing of condom machines on the halls will give students easier access to condoms (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , HIV , Síndrome de Imunodeficiência Adquirida/sangue , Síndrome de Imunodeficiência Adquirida/transmissão , Conhecimento , Preservativos , Estudantes , Comportamentos Relacionados com a Saúde , Educação , Jamaica , Região do Caribe
3.
West Indian med. j ; 49(Supp 2): 28, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-974

RESUMO

OBJECTIVE: To design and implement a national health promotion programme in the Bahamas. DESIGN AND METHODS: A ten-week programme was designed for Bahamas to incorporate healthy lifestyle behaviour practices. A nurse-physician health team evaluated participants for 10 designated parameters of good health, initially, and then at the end of the ten-week period of health promotion and education. Private and government businesses were invited to enrol their employees as a group and compete for the Healthy Company Awards. RESULTS: From 12 Bahamian Island communities, 6,217 residents participated in the programme, 35 companies registered for the Healthy Company Awards competition. The 10 designated health indices were analyzed in a subset of 23 private companies on the Island of New Providence. In the Healthy Company Awards competition 1,636 persons were enrolled of whom 599 (67.4 percent females, 32.6 percent males) completed the 10-week programme. The mean overall score improved from 5.9 to 7.5 (SE +or- 0>1, p>0001). In the mass media campaign, 3 newspaper articles were published, 7 radio programmes were aired, one TV programme was produced and aired, and weekly health features were spotted at news times on the television and radio. Billboards were strategically placed at the roadside. Government health agencies and health allied Non-Government Organisations (NGOs) coordinated and conducted weekly lectures, four community fora, one health fair, health walks, and a no smoking programme. The national programme was self-funded: $75,331 US was generated from corporate sponsorship and company registration fees, thus balancing the projected budget. CONCLUSION: Bahamians are willing to undertake healthier lifestyles if so informed and educated. The programme's success formalized a health promotion Unit within the Ministry of Health.(Au)


Assuntos
Feminino , Humanos , Masculino , Programas Nacionais de Saúde , Promoção da Saúde , Estilo de Vida , Comportamentos Relacionados com a Saúde , Bahamas
4.
West Indian med. j ; 49(Supp 2): 26, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-979

RESUMO

OBJECTIVE: To study the physical activity habits of adolescent school attenders in Barbados. DESIGN AND METHODS: Four hundred and sixty-two students, randomly selected by school class, attending four schools at different points of the "academic rank ladder", were invited to complete a knowledge, attitudes and practices questionnaire, to be measured, and to have blood drawn. RESULTS: Fifteen percent of these 10-18-year-old students, (males 8 percent, females 20 percent, p<0.001) did not participate in any form of physical activity on a regular basis. The males participated in cycling (54 percent), cricket (52 percent), jogging (50 percent) and football (45 percent), while the females participated in dancing (47 percent) and brisk walking (36 percent). Generally the males were more active than the females. Competing with the physical activity as leisure time activities were more sedentary activities like television viewing, computer and video games, while these adolescents had also experimented with alcohol (60 percent) and cigarettes (9.5 percent). CONCLUSIONS: The role for the health promotion team is clear: to promote increased physical activity in adolescents, to discourage other inappropriate behaviour patterns, and to monitor the influence of adolescent physical activity habits on adult physical activity and ultimately adult disease.(Au)


Assuntos
Criança , Feminino , Humanos , Masculino , Adolescente , Aptidão Física , Exercício Físico , Comportamento do Adolescente , Barbados , Estilo de Vida , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Estudos Transversais , Estudantes , Conhecimentos, Atitudes e Prática em Saúde
5.
Mona; s.n; Oct. 1999. i,62 p. tab, gra.
Tese em Inglês | MedCarib | ID: med-17175

RESUMO

The aim of this study was to examine the extent to which peer pressure influences the behaviour of adolescents and the implications of such behaviours for health. The study, a cross-sectional one, was conducted at the Clan Carthy and Donald Quarry Comprehensive High Schools with 133 adolescents, and employed a muti-stage sampling process - a combination of random and stratified techniques. Subjects for the sample were selected from one class/stream each from grades 7-11, making a total of 5 classes in the study sample. A focus group study, involving 2 groups each of 6 students, was conducted to supplement the quantitative findings. Results showed that male adolescents were more involved in gangs/posses, than females. In relation to drug/substance abuse it was shown that the prevalence for males was much higher than that of females except for the use of inhalants, the majority was encouraged by friends to use ganja and alochol, males were more likely than females to be influenced or encouraged by their friends to use drugs, and males were 3 times more likely than females to meet with friends to drink alcohol. In relation to sexual behaviour, it was shown that approximately 76 percent of adolescents met with friends to discuss sexual matters 70 percent of the times, and that male adolescents were 11 times more likely than females to be encouraged by friends to have sexual intercourse, 14 times more likely to be encouraged to fondle a girl and 10 times more likely to be encouraged to have more than one lover. In relation to violence it was found that a knife was the most prevalent weapon carried or encouraged to be carried by adolescents; pencils/pens/divider were the most prevalent weapons encouraged to be used in fights at school and males were 3 times more likely than females to fight at school. It was concluded that males were more at risk than females to be influenced by their peers, and it was recommended that Family Life Education programmes in schools be intensified and specifically targeting the male adolescent (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Comportamento do Adolescente , Comportamentos Relacionados com a Saúde , Jamaica , Região do Caribe
7.
West Indian med. j ; 48(1): 9-15, Mar. 1999.
Artigo em Inglês | MedCarib | ID: med-1242

RESUMO

A population based probability sample of 958 persons (454 males and 504 females) aged 15 to 49 years was surveyed in Jamaica in late 1993 for lifestyle and behaviour risk factors. Demographic characteristics of the sample were comparable to the general population. 60 percent of persons visited a private doctor the last time that they were ill. Based on self-reporting, 18 percent of the women and 8 percent of the men had never their blood pressure taken. 40 percent of the women had never had a Papanicolaou smear, 29 percent had never had a breast examination and 33 percent said that they were overweight compared with 18 percent of men. Smoking cigarettes and marijuana was more common among men (36 percent) than women (11 percent) as were drinking alcohol (79 percent of men, 41 percent of women) and heavy alcohol use (30 percent of men, 9 percent of women). Injuries requiring medical attention in the previous five years were reported by 40 percent of the men and 15 percent of the women. 34 percent of the men and 12 percent of the women regularly carried a weapon and 18 percent of the sample had participated in or witnessed at least one violent act in the previous month. Most of the people interviewed used a contraceptive method; 10 percent were not sexually active. Significantly more men than women had two or more sexual partners in the previous year (54 percent vs 17 percent, p<0.001) or reported ever having a sexually transmitted disease (29 percent vs 9 percent, p<0.001). Younger persons were more sexually active and more likely to use condoms during the most recent sexual intercourse. Higher socio-economic status and educational level generally had a more positive effect on health behaviour. This survey provides vital information relevant to planning health promotion campaigns and assessing their success.(AU)


Assuntos
Adolescente , Adulto , Estudo Comparativo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atitude Frente a Saúde , Comportamentos Relacionados com a Saúde , Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias da Mama/epidemiologia , Comportamento Contraceptivo , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Jamaica/epidemiologia , Estilo de Vida , Fumar Maconha/epidemiologia , Obesidade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância da População , Fatores de Risco , Fatores Sexuais , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/epidemiologia , Tabagismo/epidemiologia , Esfregaço Vaginal/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia
8.
West Indian med. j ; 48(Suppl. 1): 21, Mar. 7, 1999.
Artigo em Inglês | MedCarib | ID: med-1254

RESUMO

Traditionally, communication has been said to be a formal part of our effort in promoting health and nutrition in the region. But in what way is this reflected in our work? How do we see the role of communication? From observations, current effort is based on: *the perception that mass media channels are powerful means of influencing our audiences to accept our promotional messages, *knowledge based strategies. In recent years revoluntionary developments in communication technology, theory and practice facilitated partnership between those responsible for national health care programmes, and communication specialists with an orientation toward use of communication resources for social development. The secret of using health or nutrition communication effectively lies in find the appropriate medium, content and target audience to help to solve a specific health problem. The secret also lies in knowing how to place a health communication programme within the larger context of our national health and nutrition communication programme and services. All this must be done with limited resources and under circumstances that make healthier lifestyles the highest priority for the region in general and our country in particular. Merely providing information has been shown to be inadequate to change people's behaviour. The chronicle of failed behaviour change efforts demonstrates that new techniques are needed to supplement existing ones. Some of these techniques come from the commmerical marketing sector, which has devised a host of strategies to change human behaviour. These strategies can, for example, successfully motivate a particulr audience to buy one brand of processed food over another. Given that in health promotion our aim is also to change behaviour, some commerical communications techniques are believed to be appropriate contributions for bringing about the needed behaviour change that ensures a population's health and well-being. One approach to health and nutrition education is called social marketing. Social marketing is simply the application of generic private sector marketing to a specific class of problems. In this presentation, we show how social marketing techniques can be used effectively in the design and implementation of health promotion programmes aimed at behaviour change.(AU)


Assuntos
Humanos , Marketing de Serviços de Saúde , Educação Alimentar e Nutricional , Comportamentos Relacionados com a Saúde , Comunicação , Serviços de Informação
9.
West Indian med. j ; 48(Suppl. 1): 21, Mar. 7, 1999.
Artigo em Inglês | MedCarib | ID: med-1255

RESUMO

Lessons learnt from the field of HIV/STD prevention have significant implications for the efficacy of behaviour change interventions to facilitate health promotion in general. It is clear that interventions must address both the determinants of behaviour that may put people at risk and the actions that people may take to prevent ill health. Information, education and communication (IEC) stratetgies must therefore increase awareness, improve knowledge, influence attitudes, teach skills and facilitate social support structures. The coordination of goals and objectives, IEC strategies, messages and materials, and communication channels must be given priority. Behaviour change communication models including the Communication Pyramid and the Stages of Changes model have been very influential in the development of health promotion programmes in the Caribbean and elsewhere. Psychosocial and cultural factors play an important mediating role in the "operationalisation" of these models and constructs. A situational analysis of the communication processes used in a variety of interventions ranging from mass media campaigns to face to face counselling reveals that the impact of these interventions is significantly limited by existing paradigms and the social structures in which they operate. Relevant psycho-cultural issues are discussed, specific barriers to communication are identified and recommendations are made to improve behaviour modification strategies by matching behavioural interventions to the appropriate stage of change.(AU)


Assuntos
Humanos , Comunicação , Comportamentos Relacionados com a Saúde , Promoção da Saúde
10.
West Indian med. j ; 47(Suppl. 4): 49-52, Dec. 1998.
Artigo em Inglês | MedCarib | ID: med-1285

RESUMO

In recent years, increased attention has been given to the development of health promotion programmes in a number of countries worldwide. Although health promotion itself is not new, a number of issues have been emerged as the underlying concepts are articulated and put into practice. These relate to its relevance and ownership and to practical issues such as measurement of outcomes. This article provides a brief discussion on some of these issues and makes reference to Caribbean framework for implementing health promotion (AU)


Assuntos
Humanos , Promoção da Saúde , Região do Caribe , Educação em Saúde , Atenção Primária à Saúde , Países em Desenvolvimento , Saúde Ambiental , Comportamentos Relacionados com a Saúde , Planejamento em Saúde , Política de Saúde , Nível de Saúde , Avaliação de Resultados em Cuidados de Saúde , Desenvolvimento de Programas
11.
Kingston; s.n; Oct. 1997. 52 p. tab, gra.
Tese em Inglês | MedCarib | ID: med-496

RESUMO

The many health risks faced by adolescents place them high on the list of priorities for family health services. The inculcation of values and sound decision making skills among adolescents are factors which facilitate their resilence. The alleged negative influence of Jamaica's popular dance hall music has been an issue of much public debate. Even as the lyrical content of some dance hall music get more sexually explicit, a sizeable proportion of our population seem to enjoy them. Recognizing the powre of music, this study was undertaken to explore the relationship between music and adolescents' emotions, self-concept and gender perception. The preference for, use and effects of dance hall and other music was analysed among fifty sexually active (cases) and fifty, reportedly, non-sexually active (control) female adolescents in three parishes. It was statistically significant (p<0.05) that sexual activity was associated with the kinds of feelings evoked by music. There was no conclusive evidence however, that exposure to dance hall or other types of music is associated with early sexual involvement, or that they contribute to negative feelings about self, men and women. Soul music was the most valued by both cases and controls and significantly elicited feelings of love, intimancy and loneliness among those who were sexually active. Dance hall music was the preference among adolescents for fun and excitement while reggae music was seen as an instrument for building consciousness and for reflection. Gospel music was more for spirtuality. The words of songs were the major reasons for liking selected songs and this was significantly so for soul music among sexually active and non-sexually active adolescents. Although more detailed research is required, it can be concluded that music is vital to the lives of adolescents and offers scope for use in educational programmes.(Au)


Assuntos
Feminino , Humanos , Adolescente , Música/psicologia , Comportamentos Relacionados com a Saúde , Comportamento do Adolescente/psicologia , Jamaica , Comportamento Sexual
12.
Kingston; s.n; Oct. 1997. 57 p. tab, gra.
Tese em Inglês | MedCarib | ID: med-497

RESUMO

Diabetes Mellitus is one of the leading causes of chronic ill health, disability and death in the Caribbean. It is the cause of many serious complications and it is important that each diabetic obtain adequate knowledge about the condition and its complictions in a manner which will allow them to minimize or even prevent the complications. Furthermore, this knowledge has the potential to induce the adoption of healthy lifestyles, thereby improving the quality of life of the individual. This cross-sectional study, which was conducted from February 10 to March 30, 1997, collected data on the knowledge and practice of diabetic patients with complications and enabled and assessment of the possible relationship between their knowledge and practice of healthy lifestyles. The data collection instrument was a questionnaire which was used as an interview schedule and self-administered to a sample of 100. Respondents were members of the Diabetic and Medical Clinic of the University Hospital of the West Indies (UHWI), or inpatients of the medical or surgical wards. They were included in the sample on the basis of a case definition for patients with complications of diabetes. The data revealed that the most common complications among diabetics in the sample was eye diseases, 59 percent, followed by hypertension, 49 percent, and neuropathies, 41 percent. Knowledge of complications was high among respondents with a mean score of 45.9 (Standard Deviation 12.93), the median 48.5 and the range between 13-67. Practice scores showed that 78 percent of respondents have satisfactory/good scores. The mean was 22.3 (Standard Deviation 7.09), median 24.0 and the range 5-38. When knowledge and practice scores were assessed, it was found that among the 48 persons with good knowledge, 42 had good/satisfactory practice and among the 42 persons with satisfactory knowledge, 30 had good/satisfactory practice. Four persons were identified as having unsatisfactory knowledge and unsatisfactory practice. x2 between good/satisfactory knowledge and good/satisfactory practice showed no significant relationship (p > 0.05).(Au)


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Humanos , Masculino , Conhecimentos, Atitudes e Prática em Saúde , Diabetes Mellitus/complicações , Estudos Transversais , Jamaica , Estilo de Vida , Comportamentos Relacionados com a Saúde
13.
Kingston; s.n; Oct. 1997. 49 p. tab.
Tese em Inglês | MedCarib | ID: med-499

RESUMO

The psychosocial effects of breast cancer are many and should be managed in a way to encompass the psychological and social well-being of all these women and their families. The rationale of the study was to identify methods of assisting women with the disease to improve their coping skills. This cross-sectional study was conducted in Kingston and St. Andrew where one hundred and seven patients were interviewed at clinics. The principal objective and scope of the investigation was to assess the emotional reaction to the diagnosis, to compare the advice given by doctor and that of family. To assess the effects of treatment, if any, on behavioural changes, relationships with partners and families, self esteem and employment. The results demonstrated that acceptance of diagnosis was the dominant emotional reaction. The family agreed to follow treatment recommended by doctor. Almost all women expected a cure as partner and family support them in their fight to achieve it. Several had adopted a healthier lifestyle. The illness did not affect self-esteem and ability to work.(Au)


Assuntos
Adulto , Pessoa de Meia-Idade , Feminino , Humanos , Idoso , Neoplasias da Mama/psicologia , Estudos Transversais , Comportamentos Relacionados com a Saúde , Estilo de Vida , Jamaica
14.
West Indian med. j ; 46(Suppl.2): 41, Apr. 1997.
Artigo em Inglês | MedCarib | ID: med-2451

RESUMO

Company-sponsored annual examination of 150 workers, from two separate industries, revealed that unhealthy life-styles, in terms of drinking and smoking behaviours, were fairly common. Sixty percent drank alcohol at least every weekend, and 19 smoked at least ten cigarettes daily. Ten percent were obese. Previously undiagnosed diabetes and hypertension were present in 10 and 12 percent of subjects respectively. The workers had very limited contact with health care physicians, for reasons believed in part to be financial. In the circumstances, the physicians had to modify textbook approaches and utilize new approaches to 'opportunistic screening' for chronic disease. None of the problems encountered could be adequately managed on a single annual visit. Family physicians, employers and employees are encouraged to negotiate additional strategies for monitoring and maintaining the health of male workers. (AU)


Assuntos
Humanos , Masculino , Estilo de Vida , Comportamentos Relacionados com a Saúde , Homens , Barbados
15.
West Indian med. j ; 45(3): 78-81, Sept. 1996.
Artigo em Inglês | MedCarib | ID: med-3503

RESUMO

Do persons who utilize the services of the alternative therapist demonstrate a greater self-care response to illness? This cross-sectional study was done to compare the health perceptions and self-care response to minor illness among users of conventional medical care and alternative therapy. Data were collected with a pre-tested, self-administered questionnaire to 99 patients of medical practitioner and 74 of alternative therapists. Results indicated statistically significant differences in some health perceptions such as ways to improve general health and responsibility for personal health. For both groups there were similarities in socio-demographic characteristics and self-care responses to minor illness, such as headaches, constipation, diarrhoea, sinus congestion and colds or flu. Also, results reflected a common practice of self-management of minor illness and an overlap in attendance by patients to both groups of practitioners. Recommendations are made for the public to be guided in its practice of self-management of minor illness and that a regulatory body be set up to govern the practice of alternative therapy in Jamaica. (AU)


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atitude Frente a Saúde , Autocuidado , Terapias Complementares , Comportamentos Relacionados com a Saúde , Papel do Doente , Nível de Saúde , Jamaica
16.
West Indian med. j ; 45(Suppl. 2): 24-5, Apr. 1996.
Artigo em Inglês | MedCarib | ID: med-4629

RESUMO

This study was aimed at assessing the health behaviours of clients through their knowledge, perceptions and practices in relation to diet, exercise, weight control and medication and identifying the factors that impact on those behaviours, including the services offered to clients. The questionnaire survey was administered July-August, 1994 to 230 clients who attended chronic disease clinics at the eight health centres in the country of St. George West, Trinidad. Results revealed that the majority of clients were hypertensive, female pensioners of African descent who were obese with a family history of diabetes mellitus, hypertension or heart disease. The health professionals who were in a position to advise clients about lifestyle changes, did not provide them with sufficient knowledge and skills necessary for the adoption of healthy lifestyles. Clients thought it was important to practise the recommended behaviours and recognised a relationship between health behaviour and health status. However, clients failed to practise the desired behaviours due to other reasons such as insufficient financial resources, inadequate social support and lack of motivation. There was an absence of combined clinical and psychosocial management strategy, and clients' illnesses were being managed by drug therapy only, with little client responsibility for their well-being through the use of non-drug methods. The study identified a need for health professionals to be equipped with communication and counselling skills in relation to diet, exercise and weight control for health promotion/health education programmes for clients' families to reduce the risk to family members and also to create a supportive environment for the clients (AU)


Assuntos
Humanos , Comportamentos Relacionados com a Saúde , Atitude Frente a Saúde , Educação de Pacientes como Assunto , Hipertensão/psicologia , Diabetes Mellitus/psicologia , Cardiopatias/psicologia , Trinidad e Tobago
18.
West Indian med. j ; 44(2): 58-9, June 1995.
Artigo em Inglês | MedCarib | ID: med-6568

RESUMO

In the management and prevention of recurrence of peptic ulcer disease, patients' awareness of their disorder is essential. Fifty-one patients with peptic ulcer disease were studied regarding their awareness of their disorder and compliance with medications. There were 30 women and 21 men with a mean age of 45 years. Thirty-five per cent had secondary school education; 22 per cent had tertiary training and 10 per cent had no formal education. Sixty-three per cent of patients knew their ulcer location but 37 per cent were unaware of their diagnosis. Twenty-nine per cent received most of their information from their pharmacists. Twenty per cent of patients smoked cigarettes; 31 per cent drank alcohol, and 14 per cent took non-steroidal analgesics. Seventy-six per cent thought that poor eating habits were a contributory cause of their ulcer, 39 per cent thought that stress was a cause and 16 per cent implicated heredity. Seventy-six per cent of patients took their medications daily, and 24 per cent only when symptomatic. Jamaican patients' awareness of their ulcer disease is inadequate. There is a need for more physician education of their patients as well as public health promotion about peptic ulcer disease. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Úlcera Péptica/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Cooperação do Paciente , Educação de Pacientes como Assunto , Comportamentos Relacionados com a Saúde
19.
Nassau; Bahamas. Ministry of Health and Environment; Feb. 1994. 76 p. ilus, gra.
Monografia em Inglês | MedCarib | ID: med-3459
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