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1.
Br J Psychiatry ; 170(1): 69-76, Jan. 1997.
Artigo em Inglês | MedCarib | ID: med-2055

RESUMO

BACKGROUND: This study aimed to determine the prevalence of psychiatric disorder in young adults with homzygous sickle cell (SS) disease and in contols with normal haemoglobin, and to examine factors associated with psychiatric disorder. METHOD: The study design was cross-sectional. Subjects were aged 18-20 years: 63 with SS disease and 89 controls. The Psychiatric Assessment Schedule was used to determine psychiatric disorder at index of definition level 5. RESULTS: Psychiatric disorder was identified in 18 (29 percent) SS disease patient and in 22 (25 percent) control. In SS patients, psychiatric disorder was not related to illness severity but was associated with leaving school early, difficulties in social adjustment, impaired cognitive function and having previous psychiatric difficulties. Male SS patients with psychiatric disorder all had low body mass index (BMI < 17.60). In controls, psychiatric disorder was associated with female gender, unemployment and difficulties in social adjustment. CONCLUSION: The prevalence of psychiatric disorder was similar in patients and controls, although associated factors tended to be different. The association with low BMI in SS men merits further study.(AU)


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Anemia Falciforme/psicologia , Transtornos Mentais/etiologia , Anemia Falciforme/epidemiologia , Índice de Massa Corporal , Estudos de Coortes , Estudos Transversais , Cultura , Homozigoto , Jamaica/epidemiologia , Transtornos Mentais/epidemiologia , Prevalência , Psicologia Social
2.
The International journal of social psychiatry ; 43(4): 269-275, 1997. graf, tab
Artigo em Inglês | MedCarib | ID: med-17510

RESUMO

Using national statistics for the period 1978-1992, associations were examined between suicide rates and measures of social distress in Trinidad and Tobago. The latter included unemployment, serious crimes, emigration rates and admissions to the country's psychiatric hospital. There was a 319% increase in male suicide rates, from 4.96/100,000 in 1978 to 20.76/100,000 in 1992. Although there were fluctuations in the rate for females, it remained below 8/100,000. Over the 15-year period examined, there was a 51% increase in serious crime while male and female unemployment increased by 89% and 33% respectively. There was a 63% fall in the rate of permanent emigration while male and female admissions to the psychiatric hospital fell by 28% and 19% respectively. There were significant positive associations between male suicide and serious crimes as well as with male and female unemployment (p < 0.01). Male suicide rates were also negatively associated with the male admissions to the psychiatric hospital (p < 0.01). Female suicide rates were positively associated with serious crime and male unemployment (p < 0.01). Although it is not possible to determine whether the observed associations were causal, the results suggest that social distress may be an important contributor to the suicide rate in Trinidad and Tobago, particularly among men. The organisation of preventive strategies for suicidal behaviour must therefore include measures to counter the experience of social distress in this setting.


Assuntos
Humanos , Masculino , Feminino , Suicídio , Psicologia Social , Trinidad e Tobago
3.
Pediatrics ; 84(1): 157-64, July 1989.
Artigo em Inglês | MedCarib | ID: med-10008

RESUMO

Two studies were made of home visiting and psychosocial stimulation with deprived urban children in Jamaica. The aim was to determine the relative effectiveness of different frequencies of visiting on the children's developmental levels and the feasibility of integrating the model into government primary health care services. Health paraprofessionals supervised by a nurse from a local health centre conducted the intervention. In the first study 152 children aged 6 to 30 months were assigned to groups visited biweekly, monthly, or not at all by area of residence. The biweekly group showed small but significant increases in scores on the Griffiths Mental Development Scales (developmental quotient) and performance subscale compared with the monthly and control groups, whereas no benefit was shown in the Griffiths scores of the monthly group. In the second study 58 children aged 16 to 30 months from the same neighbourhoods were randomly assigned to weekly visited and control groups. The group visited weekly showed marked improvements in the performance and hearing and speech subscales as well as the developmental quotient scores. The results indicate that as the frequency of visiting increases from none through monthly and biweekly to weekly, the benefits increase as well. (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Masculino , Feminino , Desenvolvimento Infantil , Serviços de Assistência Domiciliar , Enfermagem em Saúde Comunitária , Jamaica , Assistentes de Enfermagem , Áreas de Pobreza , Testes Psicológicos , Psicologia Social , População Urbana
4.
In. Anon. Seminar/Workshop on Social and Community Development Issues: 1990's and Beyond, proceedings. Port of Spain, s.n., 1989. p.47-52.
Monografia em Inglês | MedCarib | ID: med-6852

RESUMO

Large scale migration is acknowledged to be a natural reaction to harsh conditions of one kind or another in the home country, as against the attraction of better prospects in the destination country. Unemployment, under-employment, the lure of better employment opportunities, deteriorating social services-health, education, housing, deteriorating social environment - crime, drug abuse, vagrancy - these are some of the main causes cited as being behind the mass exodus of citizens of Trinidad and Tobago within recent years. Suggested solutions:- i Incentives (financial and otherwise) for those in critical occupations to remain/return; ii Re-training; job enrichment strategies; iii Improved social services


Assuntos
Migração Humana , Meio Social , Psicologia Social/economia , Desemprego , Trinidad e Tobago
6.
Tese em Inglês | MedCarib | ID: med-8583

RESUMO

This study examines the social and cultural correlates of essential hypertension, or high blood pressure, in St. Lucia, in the West Indies. The research is organized around the investigation of the following 3 topics: (1) the social and cultural risk factors that contribute to the development of hypertension; (2) the social and cultural factors that serve a beneficial or protective function with respect to the development of hypertension; and (3) the cultural factors affecting patient adherance to the treatment of essential hypertension. Fieldwork was conducted in a St. Lucian town for 11 monts during 1976 and 1977. A mix of qualitative and quantitative methods were used. During the first half of the fieldwork participant observation and key-informant interviewing were used as the primary data-gathering techniques to establish the major social, cultural, and psychological variables relevant to the research. During the second half of the fieldwork quantitative data were gathered using survey methods. Data gathered on a probability sample of a hundred 40- to 49 year olds were used to test etiologic hypotheses. Data were also gathered on a sample of 40 hypertensives under treatment at a local clinic to test hypotheses about patient adherance. Multivariate statistical methods were used to evaluate the hypotheses. The following major conclusions wer reached: (1) St. Lucia has undergone a process of "de-localization", or increasing dependence on non-local sources of energy and information, over the past two decades which has increased socioeconomic differentiation on the island. (2) Those individuals who aspire to a life style characterized by the acquisition of material items, but who lack the economic resources for the maintenance of that life style, have a risk of hypertension. (3) Those individuals who are embedded in a larger social network providing effective and instrumental social support have a lower risk of hypertension. (4) There is a non-addictive relationship between risk factors, social supports, and arterial pressure; that is, the deleterious effects of risk factors are contingent upon the level of social supports available to the individual (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Hipertensão/etiologia , Fatores Socioeconômicos , Características Culturais , Psicologia Social , Relações Médico-Paciente , Medicina Tradicional , Etnicidade
7.
Br J Psychiatry ; 113(499): 643-58, June 1976.
Artigo em Inglês | MedCarib | ID: med-9931

RESUMO

An alcoholism treatment programme has been in operation at the St. Ann's Hospital, Port of Spain, Trinidad since March, 1956, combining emetine aversion treatment in groups with milieu therapy and group psychotherapy. In January, 1961, the treatment programme was moved to a separate unit with 20 beds, and the group therapy was handed over to an occupational therapist. An Alcoholism Rehabilitation Officer was appointed who was himself an alcoholic, and A.A. meetings were held on the ward. Patients were followed up at weekly out-patient clinics. The closest collaboration has been maintained throughout with Alcoholics Anonymous, the first group of which begun in March, 1956. A significant role has been played in Community Education by the Alcoholism Sub-committee of the Mental Health Association. This collaboration produced a remarkable growth in the number of A.A. groups, which by 1966 numbered 31 in a population of 950,000. The growth of A.A. groups, especially in small rural villages, created a change in the social environment which gave the recovered alcoholic a sense of personal worth. Calypso singers treated at the unit wrote calypsoes about their experience and played a part in promoting community acceptance of the disease concept of alcoholism. A follow-up study was carried out in 1963 and 1964 on 370 patients, 57 of whom had been treated in 1956 and 313 in 1961. The differences in the characteristics of these two groups indicated an improvement in the community attitude to alcoholism and a greater willingness to seek treatment. The overall outcome was defined in terms of a seven-point scale of abstinence and social functioning with total abstinence of two years or better at one end, and death at the other. The overall success rates were calculated as percentages of the whole, counting those lost to follow-up as failures. Group I (seven-year follow-up of 57 patients) showed 52.6 per cent. success with 36.8 per cent. totally abstinent for more than two years, 3.5 per cent.(2 patients) having returned to social drinking, and 10.5 per cent. dead, half of them by suicide. These results compared favourably with the follow-up studies by Davies, Shepard and Myers and by Wing at the Maudsley Hospital over four years. A further comparison was made with the follow-up study of untreated alcoholics by Kendall and Staton over a period of similar to that of Group I of the Trinidad study. Group II (two-year follow-up of 313 patients) showed 42.49 percent. success with a total abstinence of 35.14 per cent. These rates are only apparently lower than those of Group I because of the large group (40.8 per cent.) lost to follow-up. The group lost to trace, was, however not significantly different from the sample as a whole, and there were reasons to believe that in fact Group II had done rather better than Group I. The ratio of success to known failures improved from 2:1 to 2.5:1. An attempt was made to break down the number treated in terms of type of treatment. As this was not a planned study no claims were made for the significance of the figures, but the group who elected to have emetine and who went to A.A. on discharge emerged with strikingly better results. The importance to therapy of obtaning cultural acceptance of the disease concept of alcoholism is stressed. Reasons are sought for the large proportion of East Indians among those coming for treatment. Negroes and East Indians in Trinidad form subcultures of comparable size, yet highest rates of alcoholism seem to come from the Indians with stable family units and male role models, while the matrifocal Negro group seems less vulnerable. This finding is at variance with the expectations of psychoanalytic theory, and sociocultural deprivation seems the likely explanation. (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Alcoolismo/terapia , Programas Médicos Regionais , Serviços de Saúde Comunitária , Emetina/uso terapêutico , Seguimentos , Terapia Ocupacional , Psicologia Social , Psicoterapia de Grupo , Fatores Socioeconômicos , Trinidad e Tobago , Índias Ocidentais
8.
Obstet Gynecol ; 34(5): 685-9, Nov. 1969.
Artigo em Inglês | MedCarib | ID: med-12609

RESUMO

One of every five pregnancies in Trinidad and Tobago occurs in a grand multipara, a woman who has previously had at least six gestations terminating beyond week 28. Several factors contributing to this high incidence of excessive parity are observed to include a lengthy reproductive career, illegitimacy, lack of religious beliefs, ethnic differences, and many ephemeral psychosocial influences (AU)


Assuntos
Humanos , Gravidez , Criança , Adolescente , Adulto , Feminino , Paridade , Fatores Etários , Etnicidade , Fertilidade , Ilegitimidade , Psicologia Social , Religião , Fatores Socioeconômicos , Trinidad e Tobago , Índias Ocidentais
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