Perceptions about mental illness among pre-clinical medical students in Trinidad and Tobago

Perceptions about mental illness among medical practitioners are likely to determine their capacity to recognise, treat appropriately and refer patients who have mental health problems. It is therefore important that training of medical students in psychiatry is undertaken with knowledge of their attitudes to mental health disorders. We determined the perceptions of 108 pre-clinical medical students (69 males, 39 females; mean age 22 years) toward mental illness in Trinidad and Tobago by analysing their responses to a questionnaire based on a case vignette of a young man with a paranoid psychotic illness. 88 percent felt that medical treatment in hospital was the best means of treating the illness and 86 percent suggested that discharge should be conditional on regular visits to a doctor. 89 percent however opposed the patient's marrying into their families and 85 percent to his teaching their children. This was associated significantly with having a personal relationship with someone having a mental illnes (p < 0.03). Surprisingly, 25 percent believed that mental illness could be caused by supernatural forces, particularly females who were almost twice as likely as males to express this belief.(AU)

Distribution of HLA and haplotypes of Colombian and Jamaican black populations

To investigate the genetic background of the black populations of Colombia and Jamaica, we determined HLA types of 78 Colombian and 98 Jamaican blacks from 2 different socioeconomic groups (Jamaican #1 and Jamaican #2) and estimated the frequencies of HLA genes and haplotypes. A phylogenetic tree based on the HLA gene frequencies revealed that Jamaican #1 and Jamaican #2 were distinct from each other, Jamaican #1 being closely related to Colombian blacks and the Jamaican #2 being closely related to Senegalese and Zairean populations. Three-locus haplotypes of Colombian and Jamaican #1 blacks were an admixture between Africans and Caucasians or South American Indians while Jamaican #2 blacks were relatively homogeneous and appeared to conserve African lineages. The major five-locus HLA haplotypes were not shared among Colombian, Jamaican #1 and Jamaican #2 blacks. These results indicated that the black populations of Colombia and Jamaica were originated from African blacks and admixed variably with Caucasians and South Americans Indians to make genetic subpopulations in Colombia and Jamaica. (AU)

The meaning of sexual partnerships: re-examining the Jamaican family system

This paper seeks to re-examine some of the fairly accepted notions about Caribbean family and mating relationships. The situation in Jamaica is similar to that found in most other Caribbean countries. Data from a recently concluded study in this country is therefore utilized in this review. Specifically, this paper looks at the phenomena of multiple partnerships, union stability and longevity, and the alleged evolution of relationships from a visiting to marital status. Data from detailed union histories of men and women, aged 15 to 50 years in Jamaica are presented. It is argued that the dominant pattern appears to be one in which serial, as distinct from simultaneous partnering is the norm, and that the average length of relationships is short. It is further suggested that marriage rates may in fact be falling, that marriage is not normally a terminal state for unions, and that they may be entered into only when they are not perceived to represent a threat to the economic networks useful and necessary for the organisation and rationalisation of resources. (Au)

Union instability and fertility in three Caribbean societies

This paper examines the relationship between sexual union instability and fertility in 3 English-speaking Caribbean societies - Guyana, Jamica, and Trinidad/Tobago - using data collected in the World Fertility Program. There is usually a positive association between marital stability and fertility, the main reason being that marital instability causes periods of time in which a woman is not sexually active. High levels of divorce and marital separation are likely factors making for lower levels of aggregate fertility. To examine this relationship, this study used an index of cumulative fertility, the duration ratio, that controls for the biological effects of age, and age at 1st union was used as the dependent variable in a multiple regression analysis. The study demonstrated that despite many similarities between the three societies, there are also clear differences in terms of how membership in different types of sexual unions interacts with fertility. 1 main conclusion was that there is a positive association between the number of sexual unions and fertility, (in keeping with previous research on these societies). However, the factors were not uniform across the 3 societies. In Guyana marriage had the greatest effect on fertility while in Jamaica the 2 most unstable unions - visiting and common-law - had the greatest effect. In Trinidad/Tobago marriage and common-law had the greatest effect. (AU)

Women in search of stability

This paper is based on a study of 97 recuits-50 sterilized and 47 non-sterilized--to a family planning programme in Kingston, Jamaica and tries to account for the reluctance of Jamaican women to accept contraceptive sterilization. The study demonstrates the association between mating patterns in the island and the acceptance of sterilization. This irreversible method was more likely to be chosen by women in more stable sexual unions.(AU)

Young adult reproductive health survey, Jamaica 1987: final report

Survey attempts to explore the attitudes of young adults towards to sex education and sexual activity, the history of their sexual experience and the use of contraceptives and to arrest fertility trends among Jamaican youths. Project aimed to: to obtain the necessary data on sexual behaviour and contraceptive use of young adults and to provide information for the development of new programme strategy of existing national family planning programmes and strategies, provide information to develop new educational material in the national programme and to make available data for regional comparisons (AU)

Suicide in Jamaica

The paper describes the methodology and findings of a personal enquiry on suicide in Jamaica. Seventy-six possible cases of sudden death were indentified among 29,000 deaths during 1975/76. It has been confirmed that suicide is rare in Jamaica. The rate in the total population of 2,000,000 was 1.4 per 100,000 per annum in 1975/76. The results of a field survey reveal that the suicide verdict was given in 16 out of 58 probable cases. This finding gives partial support to the hypothesis that this low suicide rate was the result of social factors but which consistently lead to the under-recording of suicide. Thus the verdict of suicide will not be given among farmers but is more likely to be given among the married and those who die in prison. The epidemiology of suicide is described. The data support the view that in the stable environment of a traditional society, the clearly defined female role will act as a defence against suicide. The suicide rate of females is higher than expected among the elderly and the previously married but is lower than expected for city dwellers. It is noteworthy that suicide among males in small towns is 3 to 4 times greater that expected (AU)

Population regulation in an island community

The biodemographic of a small Bahamian island are explored historically through the analysis of religious documents, censuses, vital statistics records, and computerized anthropological survey data on 84 percent of the current residents. In contrast to the Caribbean area in general, population size of Bimini, Bahamas has stabilized since 1963. While completed fertility (women over 40) is relatively high, various biosocial factors are contributing to population regulation on Bimini including falling natality rates, increasing availability and usage of contraceptives, comparatively late onset of menstruation and delayed marriage, extensive emigration, pronounced childhood mortality, and other aspects of the island's rapidly changing demographic structure. The present evidence suggests that the current trend of population stabilization and regulation is likely to continue for some time in the future (AU)

Teenage pregnancy in Trinidad

The reproductive performance of 368 Negro and 87 East Indian mothers under 16 years of age was studied. Their marital status, desire for the pregnancy, and outcome of the pregnancy were recorded. There was a high incidence of unwanted pregnancies in both groups of patients. Hypertension, prolonged labour and postpartum haemorrhage occurred more commonly among Indians but the operative delivery rate was higher in Negroes (AU)

Fertility and number of partnerships in Barbados

Based on a random sample of 4,199 lower and lower-middle socio-economic status women in Barbados these researchers examined the relationship between fertility and the number of sexual partnerships, and the relationship between stability of sexual unions and fertility. Findings indicate that the larger the number of partnerships engaged in by a woman the higher is her fertility. This relationship holds in spite of several variables that were introduced as controls. Correlation analysis also established a positive relationship between the number of partnerships and the number of live births (Summary)

Patterns of sex-union formation in Barbados

This study, based on a sample of 4199 lower socioeconomic status women interviewed on the the island of Barbados in 1971, examines patterns of sex-union formation. Three types of sex unions are identified - visiting, commonlaw, and married. The overwhelming majority of all partnerships is intiated and terminated as a visiting union. A large number of partnerships progresses from one union type to only one other, with the most frequent being visiting to commonlaw and visiting to married. In general, when there is a change-of-union status within a partnership it is in the direction of a more stable type of union. The findings of this study support those of a 1956 study in Jamaica (AU)

Factors associated with dropping out of family planning clinics in Jamaica

This report concerns some 600 women who had either remained active cases in Jamaican family planning clinics or had dropped out. Women more likely to drop out were single (vs. married or common law union), either very young or very old, with few or large number of living children, who had never had a miscarriage, and whose last pregnancy was not a recent one. Religion, social class variables (on clients and partners), and type of contraceptive method failed to differentiate active cases from drop-outs. An additional sample of 300 drop-outs was interviewed on reasons for dropping out.(AU)

Post-partum mood change in Jamaican women: a description and discussion on its significance

Forty-three Jamaican women were followed up through pregnancy into the early puerperium. Highest depression scores were obtained in pregnancy, but 60.4 per cent were found to experience some emotional upset during the first 11 days post-partum, mostly on days 1-3. In form the blues do not differ from the condition reported in other cultures, but it was felt that they have a different meaning in this population, being a function of higher parity. Underlying social and economic factors are considered, and the concept 'post-partum blues syndrome' is discussed (AU)

Consensual unions and fertility

Census data were examined for Puerto Rico and Jamaica in an attempt to deal with the question of a relation between consensual unions and fertility in Latin America. The Puerto Rican women were found to be much more prolific than the Jamaican women. They began reproduction earlier and continued reproduction at higher rates. However, the fertility of single Jamaican women is higher than that of single Puerto Ricans; the fertility of married Jamaicans is only slightly lower, while the fertility of the consensually married is much lower. It appears that the common law union in Jamaica is less stable than in Puerto Rico. The high incidence of single and consensually mated women in Jamaica is largely responsible for the lower rates of birth. In contrast to the Jamaican women, Puerto Rican women in consensual unions show higher fertility than married women, the relationship decreasing with age. Consensual unions may be the result of accidental pregnancies more frequently than are marriages, but in time the more fertile unions may be legalized. However, the fertility differentials by marital status are particularly marked among the urban, working, and better educated women