RESUMO
PURPOSE: Sickle cell disease (SCD) patients with asthma have an increased risk of death. Acute chest syndrome (ACS) is a major cause of mortality in patients with SCD, and ACS may be more common in SCD patients who smoke. The purpose of this study was to test the hypothesis that mortality in young adults with SCD would be greater than that of controls during a 10-year period and to determine whether asthma, reduced lung function, ACS episodes, and/or smoking predicted mortality during the follow-up period. METHODS: The outcomes during a 10-year period were ascertained of SCD patients and race-matched controls who had taken part in a pulmonary function study when they were between age 19 and 27 years. Smoking and asthma status and whether they had had ACS episodes were determined, and lung function was measured at the initial assessment. RESULTS: Seventy-five subjects with SCD were followed for 683 patient years. There were 11 deaths with a mortality rate of 1.6 deaths per 100 patient years, which was higher than that of the controls; one death in 47 controls was observed for 469 patient years with a mortality rate of 0.2 per 100 patient years (p = 0.03). There were no significant associations of body mass index, recurrent episodes of acute chest, steady state haemoglobin, or gender with mortality. Adjusting for baseline lung function in SCD patients, "current" asthma [hazard ratio (HR) 11.2; 95 % confidence interval (CI) 2.5-50.6; p = 0.002] and smoking [HR 2.7; (95 % CI 1.3-5.5); p = 0.006] were significantly associated with mortality during the 10-year period. CONCLUSIONS: Our results indicate that young adults with SCD should be discouraged from smoking and their asthma aggressively treated.
Assuntos
Síndrome Torácica Aguda/epidemiologia , Anemia Falciforme/epidemiologia , Anemia Falciforme/mortalidade , Asma/epidemiologia , Fumar/epidemiologia , Síndrome Torácica Aguda/fisiopatologia , Adulto , Anemia Falciforme/fisiopatologia , Asma/fisiopatologia , Estudos de Casos e Controles , Comorbidade , Feminino , Seguimentos , Humanos , Jamaica , Estudos Longitudinais , Pulmão/fisiopatologia , Masculino , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fumar/fisiopatologiaRESUMO
Background: The prevalence of cigarette smoking is high among adolescents in the Caribbean, including Jamaica. Age of initiation of cigarette smoking varies among adolescents. A number of factors has been reported to influence early age of initiation of cigarette smoking. The aim of this study was to determine if parental smoking status was associated with early age of onset of cigarette smoking among Jamaican adolescents. Methods: Data from the Jamaican National School Survey (NSS) conducted in 2013 were analysed. The nationally representative sample comprised of 3,365 students enrolled in 8th grade to 12th grade in 38 public and private secondary schools. Descriptive and inferential statistics were computed using SPSS. Results: The mean age of initiation of cigarette smoking among the subjects was 12.4years [SD: 2.69]. There was no significant association between parental cigarette smoking status and the age of initiation of cigarette smoking among the adolescents (female X2 = 0.753, P = 0.861; male X2 = 6.953, P = 0.073). Logistic regression analysis showed that parental smoking status was not a predictor of early age of initiation of cigarette smoking among the adolescents (father/ guardian AOR= 0.81, 95% CI= 0.56- 1.11; mother/guardian AOR= 0.96, 95% CI= 0.44 2.10; both parent AOR= 0.49, 95%CI= 0.22- 1.07). However, having a parent with secondary education was a risk factor for early initiation of smoking (AOR= 1.71, 95%CI= 1.13-2.57), while being in 8th grade was a protective factor against early age of initiation of cigarette smoking (AOR= 0.43, 95% CI= 0.23 - 0.80). Conclusion: Parental smoking cigarette smoking status was not a predictor of early age of cigarette smoking initiation among Jamaican adolescents.
Assuntos
Comportamento do Adolescente , Pais/psicologia , Fumantes/psicologia , Fumar/epidemiologia , Fumar/psicologia , Estudantes/psicologia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Fatores de Risco , Instituições AcadêmicasRESUMO
Background: Religion sometimes shapes behaviours and experiences of its members including alcohol consumption. The aim of this study was to examine the possible influence of religious affiliation on alcohol consumption in Jamaica since they are predominantly Christians. Methods: Using a cross-sectional study design, we analysed data from National Household Survey 2,016 of 4,623 participants. Descriptive and inferential statistics were performed using SPSS. Results: Out of the 4,623 participants, majority 3,244 (70.2%) were above the age of 26 years and of Christian religion 3,737 (80.8%). Christian religious affiliation was significantly associated with past year and past month use of alcohol (AOR= 1.44, 95% CI=1.14-1.82 and AOR =1.34, 95% CI=1.03- 1.74 respectively). Being a male (AOR= 2.95, 95% CI=2.51- 3.47), and employed (AOR= 2.11, 95% CI= 1.49- 2.98) were significant risk factors for lifetime alcohol consumption. Age 12 17 years (AOR= 0.30, 95% CI=0.21- 0.43) and attaining primary education level (AOR=0.60, 95% CI=0.45-0.80) were protective factors against lifetime alcohol consumption. Conclusion: Being of Christian religion was significantly, positively associated with past year and past month alcohol consumption. Male gender and being employed were also risk factors for lifetime alcohol consumption.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Religião , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
Objective: Alcohol is one of the most commonly consumed substances in Jamaica, despite the many health problems associated with excessive alcohol use. The aim of this study was to identify potential risk factors for alcohol binge drinking among Jamaicans, and determine if there were significant gender differences in the associations between identified risk factors and frequent binge drinking. Methods: Data collected from the 2016 National Household Survey Jamaica were analysed. Descriptive and inferential statistics were computed using SPSS. Binary logistic regression analysis was used to determine factors associated with frequent binge drinking. Results: The total number of respondents was 4623. Females were 2,535 (54.8%) compared to males 2088 (45.2%). In bivariate analysis, there was a significant association between age and frequent binge drinking among males (X2 = 11.11, p =0.004), but not among females (X2 = 2.03, p = 0.36). Similarly, there was a significant association between employment and frequent binge drinking for males but not for females (X2= 12.85, p= 0.002; X2= 2.49, p= 0.29 respectively). In multivariate analysis, age 12- 17 years was significantly, inversely associated with frequent binge drinking in the crude logit model but not in the adjusted logit model (crude odds ratio [COR] 0.21, 95%CI= 0.6- 0.66; adjusted odds ratio [AOR] = 0.51, 95%CI= 0.12- 2.13 respectively). Employment was significantly, positively associated with frequent binge drinking in the adjusted logit model (employed: AOR= 3.63, 95% CI= 1.05- 12.59) among males. Among females, age showed no significant association with frequent binge drinking. Only having primary/ lower education was significantly, positively associated with frequent binge drinking among females (AOR= 5.17, 95%CI= 1.36- 19.65). Conclusion: Risk factors for frequent binge drinking differed by gender; being employed was a risk factor for males while having primary (or lower) education was a risk factor for females.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
Background: Underage alcohol use is a pervasive problem with serious health, social and safety consequences. This study was undertaken to assess alcohol use by primary school children in Trinidad and Tobago, and to identify associated risk factors. Methods: We analysed data collected from 40 primary schools in Trinidad and Tobago by the National Alcohol and Drug Abuse Prevention Programme (NADAPP). The sample comprised of children aged 8 -15 years old, in standards 3, 4 and 5. Result: Out of the 2052 children, 648 (31.6%) have consumed alcohol in their lifetime, and same proportion reported ever being drunk (31.6%). Male gender was significantly associated with lifetime alcohol use (AOR =1.60, 95% CI= 1.25 - 2.05). Children not living with their father (AOR= 2.45, 95% CI=1.86- 3.24) and those whose fathers have either primary or secondary education (AOR = 1.88, 95%CI=1.07 - 3.31; AOR= 1.58, 95%CI=1.12 - 2.23 respectively) were at higher risk for lifetime alcohol consumption. However, age group 8 11 years was significantly inversely associated with lifetime alcohol consumption (AOR= 0.67, 95% CI=0.48 - 0.94). Conclusion: Being a male student, not living with father, and father attaining either primary or secondary education level were significantly associated with increased likelihood for lifetime alcohol use. However, children between 8 11 years were less likely to consume alcohol.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Instituições Acadêmicas , Estudantes/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários , Trinidad e Tobago/epidemiologiaRESUMO
Background: The prevalence of alcohol use is quite high in the Caribbean region, and specifically, in Barbados. Alcohol use has been documented to negatively affect the way students behave within and outside school. This study set out to examine the role alcohol plays in students' behavioural problems at school. Methods: An analysis of crosssectional data collected during the National Secondary Schools Survey was done. Mean (and standard deviation), frequencies and percentages were computed, and differences in proportions among the groups were assessed using Pearson's Chi Square. Multivariate analysis using binary logistic regression was done to determine the association between explanatory variables and outcome variables. Results: In bivariate analysis, behavioural problems at school were significantly associated with age (p= 0.001), grade (p= 0.000), sense of belonging at school (p= 0.000), relationship with teachers (p= 0.000), and past month alcohol use (p= 0.007). In multivariate analysis, students' having frequent behavioural problems at school was significantly associated with neither past year nor past month alcohol use (AOR= 1.13, 95% CI= 0.91- 1.40, AOR= 1.02, 95% CI= 0.83- 1.24 respectively). Significant inverse associations were found between students' behavioural problems and age (11- 14 years: AOR= 0.53, 95% CI= 0.33- 0.84; AOR= 0.51, 95% CI= 0.32- 0.82 for models 1 and 2 respectively), and relationship with teachers (very good: AOR= 0.10, 95% CI= 0.07- 0.16; AOR= 0.13, 95% CI= 0.09- 0.20 for models 1 and 2 respectively). Conclusion: Neither past year nor past month alcohol consumption by students was associated with frequent behavioural problems at school. Students who were younger than 17 years, and who had a relationship with their teachers that was not very bad were significantly less likely to engage in frequent behavioural problems.
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Comportamento Problema/psicologia , Instituições Acadêmicas , Estudantes/psicologia , Adolescente , Adulto , Barbados/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Adulto JovemRESUMO
Background: In Barbados and the wider Caribbean region, alcohol is widely consumed by adolescents and young people, including those in secondary schools. The high prevalence of alcohol use, and its potential adverse effects are a source of concern to policy makers and the general population, which calls for better understanding of the drivers of this problem. This study thus aimed at investigating whether parental alcohol drinking habit is a predictor of alcohol use among secondary school students in the country. Methods: The predictor variables and response variables in the study were categorical, and so descriptive, univariate analysis consisted of computation of frequencies and percentages. Bivariate analysis using Pearson's Chi Square was done to test for significant differences in the response variables among groups. Logistic regression modeling was used in multivariate analysis to determine the predictor variables that were significantly associated with the response variables. Results: Significant associations were seen between students' age, (P= 0.00), grade (P=0.00), fathers' drinking habit (P=0.00), mothers' drinking habit (P=0.00), and both past year and past month alcohol use, in bivariate analysis. Logit model shows that students whose fathers drink only on weekends, sometimes during the week, or every day, respectively, had significantly increased risk of alcohol use in the past month (AOR= 2.62, 95%CI= 1.81- 3.77; AOR= 1.85, 95%CI= 1.19- 2.85; AOR= 2.18, 95%CI= 1.49- 3.18). Students whose mothers drink only on special occasion had significantly higher risk of alcohol use in the past year and past month (AOR= 1.99, 95%CI= 1.06- 3.74; AOR= 2.30, 95%CI= 1.36- 3.89 respectively). Conclusion: Having fathers who drink only on weekend, sometimes during the week and every day were significantly positively associated with alcohol use in the past month. Having mothers who drink only on special occasion was a risk factor for past year and past month alcohol use. However, having mothers who drin
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Pais/psicologia , Estudantes/psicologia , Adolescente , Barbados/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Instituições AcadêmicasRESUMO
Alcohol consumption has significant health, social and economic implications. Alcohol is the most prevalent psychoactive substance used by Jamaican adolescents. The aim of this study was to determine whether alcohol is associated with sexual risk behaviour among Jamaican adolescents. Methods: The data from National Secondary School Survey (NSS) conducted in 2013 was analysed. Descriptive statistics consisting of frequencies, percentages and Pearson's Chi square was done. Multivariate analysis was done using binary logistic regression. Result: The mean age of alcohol initiation among the participants was 12.3years [SD: 2.74]. There were significant associations between gender (X2= 14.56; p= 0.000), relationship with father/guardian (X2: 10.71; P= 0.03), relationship with mother (X2= 15.16; P= 0.004) and conversation with parents/ guardians about dangers of drug abuse (X2= 8.16; P=0.004). Adolescents who were males (AOR= 0.62, 95% CI= 0.43 - 0.88), in the 8th grade (AOR= 0.51, 95% CI= 0.26 - 0.98) or in the 10th grade (AOR: 0.52, 95% CI: 0.32 - 0.85) were less likely to engage in sexual risk behaviour. Lifetime alcohol consumption, past year alcohol consumption and past month alcohol consumption were not significantly associated with sexual risk behaviour (AOR= 0.35, 95% CI= 0.04 - 3.46; AOR= 1.75, 95% CI= 0.59 - 5.09, AOR= 0.78 95% CI= 0.56 - 1.11 respectively). Conclusion: Lifetime, past one year and past one month alcohol consumption among the students were not risk factors for sexual risk behavior (non-condom use) among Jamaican adolescents.
Assuntos
Comportamento do Adolescente/efeitos dos fármacos , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Assunção de Riscos , Comportamento Sexual/efeitos dos fármacos , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Fatores de Risco , Estudantes/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Background: Cigarette is one of the most widely used addictive substances and a leading cause of death. Prevalence of cigarette smoking has been reported to be high in the Caribbean, including Jamaica. The aim of this study was to determine whether students' relationship with teachers influences their cigarette smoking behaviour in Jamaica. Methods: This was a statistical analysis of data based on a nationally representative sample of 3,365 secondary school students drawn from 8th to 12th grade across 38 secondary schools in Jamaica in 2013. Descriptive and inferential statistics were performed using SPSS. Results: There were significant differences in the past year and past month cigarette smoking respectively among students who had very good, good, average, bad and very bad relationship with their teachers (X2 = 11.67, p = 0.02; X2 = 9.61, p = 0.04) respectively. Students with very good relationship with teachers, were significantly less likely to report smoking cigarette in the past month (AOR= 0.09, 95% CI= 0.01- 0.88). Students who were 2 - 10 years, had very good relationship with teacher and father, and whose parents knew friends very well, were 0.96, 0.69, 0.70 and 0.94 times as likely to report smoking cigarette in the past year. However, these associations were not significant after controlling for other factors. Conclusion: Students' relationship with their teachers has a strong influence on cigarette smoking. Students with very good relationship with teachers were significantly less likely to report smoking cigarette in the past month.
Assuntos
Comportamento do Adolescente/psicologia , Fumar Cigarros/epidemiologia , Relações Interpessoais , Professores Escolares , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica , Masculino , Prevalência , Fatores de Risco , Instituições Acadêmicas , Meio Social , Inquéritos e QuestionáriosRESUMO
Background: Alcohol consumption among young people is a major public health problem world-wide and in Jamaica. A number of factors have been reported to affect alcohol use among high school students. The aim of this study was to investigate the influence of perception of the harmfulness of alcohol on alcohol use among secondary school students in Jamaica. Methods: Data collected from a nationally representative sample of 3,365 students were analyzed. Descriptive and inferential statistics were performed using SPSS. Results: Students' perception of risk of drinking alcohol frequently and getting drunk respectively had positive and significant associations with past month alcohol use (AOR= 1.44, 95% CI= 1.09- 1.88 and AOR= 1.38, 95% CI= 1.02- 1.86, respectively) compared to students who felt that drinking alcohol frequently and getting drunk were very harmful. Males, 12 years or younger were significantly less likely to use alcohol in the past month (AOR= 0.77, 95% CI=0.60- 0.97; AOR= 0.68, 95% CI= 0.53-0.97 respectively). Students with good relationship with their mothers were less likely to use alcohol in the past year and past month (AOR= 0.55, 95% CI= 0.35-0.87; AOR= 0.50, 95% CI= 0.32- 0.78). Conclusion: Risk perception of the harmfulness of alcohol significantly affects alcohol use among secondary school students in Jamaica. Males, 12 years or younger, who had good relationship with mothers, were significantly less likely to use alcohol in past month
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Atitude Frente a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Medição de Risco , Inquéritos e QuestionáriosRESUMO
The aim of this study was to examine the potential relationship between Jamaican secondary students' alcohol drinking habits and their family structure. Methods: Data collected from a nationally representative survey of 3,365 students were analysed. Descriptive and inferential statistics were performed. Results: Out of the 3,365 students, 1,044 (31.0%) were from single-parent families. Single-parent families, married-parent families and common law-parent families were significantly associated with lifetime use of alcohol (AOR= 1.72, 95% CI= 1.06 - 2.79; AOR= 1.73, 95% CI= 1.07- 2.81, AOR= 1.94, 95%CI= 1.17- 3.21 respectively). However, family structure was not significantly associated with past year and past month alcohol use. Students whose parents "sometimes" knew their whereabouts were significantly less likely to use alcohol in their lifetime compared to students whose parents "Always" knew where the students were. Conclusion: Family structure is an independent predictor of alcohol use among high school students in Jamaica. Being from single-parent families, married-parent and common- law parent families were significantly associated with increased likelihood for lifetime alcohol use.
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Relações Familiares , Família Monoparental/psicologia , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Instituições AcadêmicasRESUMO
The aim of this study is to determine the levels of stress among students in the Jamaican clinical setting and describe the perceived contributing factors to this stress. This cross-sectional study of 106secondyear students enrolled at 2 schools of nursing in Jamaica used a 30-item self-administered questionnaire to gather data on levels of stress and contributing factors. Participants were asked to rate the levels of stress experienced (scale: 0-5, where 5 was highest). Data were analyzed using Statistical Package for the Social Sciences® Version 19 for Windows®. The response rate was 98% (106/108), and 97.2% were females. The average age of respondents was 23.16 ± 9.01years. The majority of participants were single (78.3%) and resident in Kingston and St. Andrew (61.3%). The level of stress experienced in the clinical setting was rated 3.48 ± 1.3/5; financial difficulties (3.17 ± 1.6/5) and interactions with unit staff (3.15 ± 1.4/5) were rated the greatest contributors to stress. Students experienced fear of harming the patient (50%), and only 24% expressed consistent confidence. Except for the interactions with preceptors (P < .05), there were no differences in levels of stress between schools. Students enrolled at 2 nursing schools experienced moderately high levels of stress in the clinical environment. Financial concerns and interaction with ward staff were significant sources of stress. Collaborative strategies to address stress in the clinical areas are imperative.
Assuntos
Preceptoria/métodos , Estresse Psicológico/psicologia , Estudantes de Enfermagem/psicologia , Estudos Transversais , Educação em Enfermagem , Feminino , Humanos , Jamaica , Masculino , Recursos Humanos de Enfermagem Hospitalar , Estresse Psicológico/economia , Inquéritos e Questionários , Adulto JovemRESUMO
Faculty members are viewed as nurturers within the academic setting and may be able to influence students' behaviors through the formation of positive interpersonal relationships. Faculty members' attributes that best facilitated positive interpersonal relationships according to Carl Rogers' Person-Centered Model was studied. Students (n = 192) enrolled in a 3-year undergraduate nursing program in urban Jamaica were randomly selected to participate in this descriptive cross-sectional study. A 38-item questionnaire on interpersonal relationships with nursing faculty and students' perceptions of their teachers was utilized to collect data. Factor analysis was used to create factors of realness, prizing, and empathetic understanding. Multiple linear regression analysis on the interaction of the 3 factors and interpersonal relationship scores was performed while controlling for nursing students' study year and age. One hundred sixty-five students (mean age: 23.18 ± 4.51years; 99% female) responded. The regression model explained over 46% of the variance. Realness (ß = 0.50, P < .001) was the only significant predictor of the interpersonal relationship scores assigned by the nursing students. Of the total number of respondents, 99 students (60%) reported satisfaction with the interpersonal relationships shared with faculty. Nursing students' perception of faculty members' realness appeared to be the most significant attribute in fostering positive interpersonal relationships.
Assuntos
Docentes de Enfermagem/psicologia , Estudantes de Enfermagem/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Jamaica , Modelos Lineares , Masculino , Distribuição Aleatória , Adulto JovemRESUMO
The aim of this study was to examine illness presentation and understand how psychiatric patients make meaning of the causes of their mental illnesses. Six Jamaican psychiatric patients were interviewed using the McGill Illness Narrative Interview Schedule. Of the 6, 3 representative case studies were chosen. The hermeneutic phenomenological approach and the common sense model were used in the formulation of patients' explanatory models. Results indicate that psychiatric patients actively conceptualized the causes and resultant treatment of their mental illnesses. Patients' satisfaction and compliance with treatment were dependent on the extent to which practitioners' conceptualization matched their own, as well as practitioners' acknowledgement of patients' concerns about causation, prognosis, and treatment.