Food insecurity definitions and body mass index. Response

In his commentary, Dr Edward A. Frongillo criticizes our use of a well-described household food security scale in Trinidad. There will always be some uncertainty concerning the application of a given measure as there is no perfect instrument to evaluate food security or dietary patterns in any population. The household food security measure was used in the US national Current Population Survey (which provided the comparison data used in Dr Frongillo's commentary) but the application of the instrument to all groups in the multilingual, culturally diverse US population 'has not been examined sufficiently' (ref. 3, p. 8). Questionnaire evaluation must be considered when differences in literacy, language, dialect, or culture, as well as socioeconomic status, may influence responses and this consideration might suggest that an instrument should be tailored to local requirements. It is advisable, however, to be judicious in modifying such measures so as not to compromise the validity or comparability of an instrument. Departures from a previously tested template should only be undertaken to guarantee enhanced performance of a measure. Dr Frongillo's comments appear to underestimate both the weight of evidence required to justify an alteration to an established measure and the limitations of local 'validation' studies. Before concluding that a measure gives unsatisfactory results in a given local population, or a particular group within a population, it is essential to ensure that the findings cannot be ascribed to error or bias. There is a relatively high risk that local questionnaire evaluation studies, implemented within the short time scales suggested, will lead to erroneous conclusions if sample sizes are too small or if subjects are insufficiently representative.

Retrospective audit of blood donation at a Hospital-based blood centre: Implications for blood product supply and safety

An audit of blood donation at the University Hospital of the West Indies (UHWI) was performed between January 1995 and December 1998. During these four years, 21,733 persons attended the blood collection centre and 6,711 (30.8 percent) were rejected as donors. Females accounted for 3, 054 (45.6 percent) of rejected donors while 3,647 (54.4 percent) were males. Females were rejected primarily because of low haemoglobin levels, while rejection was most frequently attributed to symptoms of the common cold and recent drug use. One hunderd and two rejected donors (1.5 percent) admitted to recent treatment of a sexually transmitted disease, and 138 (2.0 percent) presented within 16 weeks of a prior donation. Of 15,022 units donated, altruistic voluntary donations accounted for 307 (2 percent) and 53 (0.3 percent) were autologous donations. Seven hundred and four units (4.6 percent) were discarded because of positivity on initial testing for a marker of transmissible infection. Overall prevalence for markers of infection was 2.5 eprcent for HTLV-1, 0.9 percent for Hepatitis B and 0.4 percent for HIV I/II. Donations at the University Hospital of the West Indies (UHWI) collection centre contributed 15.8 percent of the national blood supply for the period under study.(Au)

The organisation of helicopter emergency services for the rescue of aircraft crash victims in the tropical forest

The purpose of this report was to describe lessons learned from experience in the tropical forest of Guyana and one helicopter rescue mission in that hostile environment. With previous data reported in the literature several guidelines for organizing these operations can be proposed. These rescue operations involve hoisting the victim to helicopter, medical treatment itself, and penetration into a hostile environment. Effectiveness and safety mandate that the physicians involved receive regular training in the techniques of helicopter evacuation, first aid, and survival. It is necessary to adapt conventional first aid kits for the purpose and to develop light and adequate survival equipment as listed exhaustively by the author.(AU)

Why wash

An essential part of safety in the health care field is the practice of good hygiene on a daily basis. One of the most common practices taken for granted is the technique of good hand washing. THe need to strictly adhere to good hand washing techniques becomes even more apparent in our own laboratory setting where contaminated hands can easily pass potential pathogens, compiled by LCDC, that could readily be passed by an unsuspecting pair of hands that have contacted a contaminated surface (AU)

A study of occupational injuries, Bahamas

The rising incidence of occupational injuries continues to place a severe burden on the Bahamian economy. This study examined all data relating to injuries reported to the N.I.S., Bahamas (1992) for medical compensation. These secondary data were complemented with information on attitudes and perceptions towards safety in the work place obtained by use of a questionnaire administered to 69 members of the kitchen staff of two specially selected hotels in the Bahamas. The secondary data (524 injuries) revealed that the modal injuries were sprains and strains (27.9 percent). Government workers and the hotel industry accounted for 29.6 percent and 20.8 percent of the total injuries respectively. Overall, females were more likely to sustain fractures, dislocations, sprains, strains (p<0.014). Further, injuries that included sprains and strains were highly likely to affect the trunk than other parts of the body (p<0.02). The questionnaire data revealed that subjects who reported "unavailability of protective gears" and "experiencing discomfort from wearing protective gears" were more likely to report work-related injuries in the past year (p<0.02). These findings suggest the need for gender-specific interventions in relation to females and their increased susceptibility to particular injuries. Further, there is need for increased surveillance of work places to ensure the provision and use of protective gears. Also, manufacturers should give much consideration to the reports of discomfort experienced by some workers while wearing protective gear (AU)

Lab safety: Packaging of samples for air transport

Gives a guide on the packaging of medical samples for air transport. The handling, transfer and shipment of improperly packaged specimens pose a risk of infection to all persons engaged in, or in contact with, any part of the process (AU)

Safe use of drugs: some helpful hints

Pamphlet describing safety guidelines for the use of medication.

Het gebruik van bestrijdingsmiddelen in de landbouw en de gezondheidszorg / The use of pesticides in agriculture and health care

With the rise of agricultural production and the protection of public health, the importance of pesticides keeps increasing. However, pesticides are not without danger for man, animal and environment, so its application should be with the necessary knowledge, precaution and care. The public policy is to intensify research and education on this matter. This working-paper from the "Working-group Pesticides" provides information on the necessity, benefit and danger of pesticides. That is why the use, structure, safety precautions, dangers, legislation, consequences, research and future perspectives are being discussed. Some advice on using pesticides safely is given as an appendix

Nutritional status and development of St. Lucian children at day care centres

This was a comparative study of children who attended day-care centres with those who stayed at home in St. Lucia. The children came from very similar social backgrounds and were compared using anthropometry and their performances at the Bettye Caldwell Preschool Inventory and the Peabody Picture Vocabulary tests. The quality of the service given in the day care centres was assessed. Finally the environment of the centres was compared with that of the homes of the community children. The sample consisted of 60 children, 30 in three rural government centres and 30 from the communities nearest the centres. There were 28 boys and 32 girls with an age range of 40 - 64 months and a mean age of 51.7ñ5.7 months. It was found that there was no significant difference between the combined centre and the combined community anthropometry values. No significant difference was found between the centre and community children in the Peabody Picture Vocabulary raw scores (centre mean - 16.5ñ4.6; community mean - 15.9ñ6.9). However significant differences was found in the Bettye Caldwell Preschool Inventory total scores between centre ( mean = 33.8ñ7.7) and community children ( mean = 27.7ñ8.1), p<0.01. School achievement and language development test scores were similar to those of four year old Dominican children, but lower than those of Jamaican children. The centres were found to offer an environment richer in play equipment than that of the homes, but not necessarily safer or with greater adult-child interactions. The centres were found to be deficient in safety measures such as fire safety, first aid, monitoring of health and nutritional status, furniture available, toilet facilities for the children and staff, and space available for the children to play. The staff had duties other than child care, and although reasonably qualified, with a reasonable staff-child ratio of 1:12.5, interaction with the children was limited. It was concluded that a higher school achievement was associated with attendance at the centre and may be attributed mainly to the presence of the higher level of play equipment offered at the centre. Attention should be paid to the improvement of safety measures, monitoring of health and nutritional status and availability of outdoor space. It is suggested that possibly training of the mothers to interact with their children may improve the school achievement scores of the community children (Summary)

Safety and immunogenicity of a new Haemophilus influenzae type b vaccine in infants under one year of age

64 healthy infants, 2-3 months old, were randomly assigned to one of three vaccination groups which either diphtheria-pertussis-tetanus (DPT) vaccine, Haemophilus influenzae type b capsular polysaccharide polyribosyl-ribitol phosphate (PRP) vaccine, or PRP+P (with pertussis adjuvant) vaccine in three doses at intervals of two months. Local and systemic reactions occurred most frequently after DPT vaccination and least frequently for PRP alone. Data for 60 infants from whom complete sera sets were available indicated that 70 percent of the infants who received three doses of PRP+P showed two fold or greater increases in titers of antibody to PRP with final values above the level assumed to give protection against invasive H. influenzae type b disease (>0.15 ug/ml). In contrast, less than 10 percent of infants who received PRP vaccine alone showed 2-fold or greater increases (Summary)

A study of community participation for the prevention of motor vehicle accidents in Kingston and St. Andrew

In Jamaica, 89,531 motor vehicle accidents were reported to the police during a 10 year period (1965-74). In these accidents, 3,527 persons lost their lives. Between 1973 and 1974, accidents and violence were the second cause of admission to government hospitals. Between 1974 and 1976, motor vehicle accidents represented the second and fourth major cause of deaths over the island. The cause of motor vehicle accidents were analysed from an ecological point of view, in terms of the roads, the vehicle and the road user. They all play their part in these accidents, but experts agree that human factors are the root of the problem. (AU)

Towards an occupational health program for Jamaica: a review and two surveys

The study reviews Occupational Health - what it is, its modern practice and how it has developed over time. The situation in Jamaica is examined critically and two occupational health surveys are carried out. (AU)