Impact of the talent development environment on the wellbeing and burnout of Caribbean youth track and field athletes.

This study examined the perceived talent development environment (TDE) of youth track and field athletes within the Caribbean region and explores the relationship with their subjective wellbeing and burnout levels. A sample of 400 Caribbean youth track and field athletes (male = 198, and female = 202; age 13-20 years) participated in this cross-sectional study. Athletes responded to a survey which included the Talent Development Environment Questionnaire (TDEQ-5), the World Health Organization Wellbeing Index (WHO-5) and the Athlete Burnout Questionnaire (ABQ). Structural equation modelling showed that a positive and supportive TDE was associated with better athlete wellbeing and lower athlete burnout. Moreover, gender and hours of training moderated relationships of athletes' perceptions of their development environment with wellbeing and burnout levels respectively. Furthermore, there was a positive association between the support network and athlete wellbeing, while holistic quality preparation was negatively associated with athlete burnout. Development environments perceived as supportive and geared towards a holistic athlete-centred approach were associated with better athlete wellbeing and lower burnout.

Food toxins and the Caribbean Parkinson plus types.

In the 90's, clinico pathological studies have considerably improved the diagnosis of specific and rare neurodegenerative diseases. After a training in Parkinsons' disease in Paris, the author moved to French West Indies (Guadeloupe) and observed a high incidence of atypical parkinsonism with dementia, unresponsive to levodopa. Similar features were observed in Martinique. An environmental origin has been suspected with the exposure to toxins of annonaceae leaves and seeds. The candidate toxins are acetogenins acting as mitochondrial poison. This was demonstrated in neuronal cell cultures, and in animals. However, the agency for food security did not conclude that Annonaceae should not be used for herbal (medicinal) tea, even if the population is now aware about the possible risk of parkinsonism after exposure to annonaceae acetogenins.

Anemia in the Turks and Caicos Islands: exploring the dietary link.

OBJECTIVE: To conduct the first national dietary survey and examine inter-island differences in and relationships between iron consumption and reports of anemia. DESIGN AND METHODS: A total of 144 households, randomly selected from electoral lists for Grand Turk (n=48), Providenciales (n=46), and Middle Caicos (n=50), participated in the survey. Food consumption (via food frequency questionnaire), self-reported health history, and sociodemographic data were collected from female household-heads during home interviews. Data on frequency of consumption and tabulated iron score for each "normal" food portion size were used to calculate each household's iron-intake-score. Chi-squared analyses were used to compare inter-island intake score categories. RESULTS: Households were assigned to low (<100), medium (100-160), or high (>160) iron-intake-score categories. The proportion of households with low scores was lower on Grand Turk (<5%) and Providenciales (0%) compared to Middle Caicos (20%), the least developed island. CONCLUSION: Suboptimal iron intakes, especially on Middle Caicos, support the prevailing view that anemia in vulnerable groups could be of dietary origin. Findings highlight the need for additional research to determine how various factors (eg, diet, supplement use, physiology, and environment) impact iron status. In the short term, we must identify and treat cases and provide culturally appropriate nutrition education to increase dietary iron intake and promote safe use of multivitamin/mineral supplements. National dependence on imported foods makes this the most viable public health intervention option until the etiology of anemia is fully determined.

Is atypical parkinsonism in the Caribbean caused by the consumption of Annonacae?

An abnormally frequent atypical levodopa-unresponsive, akinetic-rigid syndrome with some similarity to PSP was identified in the Caribbean island Guadeloupe, and was associated with the consumption of plants of the Annonacea family, especially Annona muricata (corossol, soursop) suggesting a possible toxic etiology. Annonaceae contain two groups of potential toxins, alkaloids and acetogenins. Both alkaloids and annonacin, the most abundant acetogenin, were toxic in vitro to dopaminergic and other neurons. However we have focused our work on annonacin for two reasons: (1) annonacin was toxic in nanomolar concentrations, whereas micromolar concentrations of the alkaloids were needed, (2) acetogenins are potent mitochondrial poisons, like other parkinsonism-inducing compounds. We have also shown that high concentrations of annonacin are present in the fruit or aqueous extracts of the leaves of A. muricata, can cross the blood brain barrier since it was detected in brain parenchyma of rats treated chronically with the molecule, and induced neurodegeneration of basal ganglia in these animals, similar to that observed in atypical parkinsonism. These studies reinforce the concept that consumption of Annonaceae may contribute to the pathogenesis of atypical parkinsonism in Guadeloupe.

Blood pressure in the Caribbean.

A review of original and published data yields the consistent finding that chronic hypertension is endemic and prevalent throughout the Caribbean area. The prominent involvement of genetics is suggested in several lines of evidence, including significant ethnic differences in blood pressure values, higher incidence in smaller isolated island populations, the discovery of polymorphic blood proteins that appear to be linked to hypertension susceptibility, and the slavery hypothesis of natural selection favoring a salt-conserving physiology in ancestral populations. Environmental factors--climatic, demographic, and cultural--exert strong influences on blood pressure levels and hypertension etiology in the Caribbean. Salt intake and other dietary behaviors, degree of community awareness of the disease, and differential treatment modalities are related to hypertension epidemiology in indigenous and migrant Caribbean populations. The traditional use of medicinal plants, historically successful in part because of the beneficial bioactivity of many antihypertensive phytochemical components, has been recently supplemented with the widespread introduction of synthetic biomedical drugs. Prospective research strategies are recommended that might further elucidate the complex gene-environment interactions contributing to blood pressure variation and hypertension patterns in the Caribbean region.

Integrated primary mental health care

Mental health is increasingly being recognised as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30 percent of the population. Increasingly, patients needing health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.(AU)

Integrated primary mental health care

Mental health is increasingly being recognized as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30of the population. Increasingly, patients needing mental health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.

Integrated primary mental health care.

Mental health is increasingly being recognized as contributing significantly to the burden of disease, particularly now that the indicators have shifted from measures of mortality to measures of morbidity. Psychiatric morbidity in the community, based on community surveys, is estimated at 20 to 30% of the population. Increasingly, patients needing mental health services prefer to be in a general health care setting than in specialized centres. Internationally and regionally, the general policy has been to move toward the development of comprehensive mental health programmes integrated within primary health care. This integration may be structural (use of shared facilities), administrative (shared administrative resources) or functional (complete integration of clinical services, with staff jointly responsible for patient welfare). This paper examines how this integration can be achieved, and the potential role of the Department of Community Health and Psychiatry, University of the West Indies in advancing this integrative process through research and training.

Micronutrient deficiencies in the English-speaking Caribbean and methods for their control - abstract

Multiple micronutrient deficiencies is not a public health problem in the Caribbean. The most widespread micronutrient deficiency is iron. In some countries as many as 75 per cent of pregnant women had low haemoglobin levels. In one country 80 per cent of children 6 months to 2 years of age had no iron reserves as measured by ferritin levels. There is also a high prevalence of dental caries in some countries. Flouride has been added to salt in Jamaica. This paper reviews some of the data on micronutrient deficiencies and concentrates on the approaches for the control of iron deficiency in the region. These approaches are supplementation, nutrition education, parasitic control and fortification. The problems and successes of each approach are discussed and how they are helping to control anaemia in the English-speaking Caribbean (AU)

Control of iron and other micronutrient deficiencies in the English-speaking Caribbean

Most micronutrient deficiencies affect relatively few people in the Caribbean; however, many Caribbean residents are affecfted by anemia that appears due primarily to a lack of dietary iron. While generally substantial, the prevalences of such anemia have differed a good deal from place to place and study to study, observed rates ranging from 27 percent to 75 percent in pregnant women, 19 percent to 55 percent in lactating women, and 15 percent to 80 percent in young children. Severe anemia, defined by a blood hemoglobin concentration below 8 g/dl, has been found in approximatelty 6 percent of the pregnant women and 11 percent of the preschool children in some Caribbean countries. The principal ways of controlling iron deficiency anemia are through food fortification, control of intestinal parasites, direct oral supplementation, and dietary modification. Progress has been made in iron fortification of wheat flour and wheat products (the principal foodstuffs consumed by the general public in most of the English-speaking Caribbean). Data on control of relevant parasites in the Caribbean (primarily hookworm and to a lesser extent whipworm) are limited. Health services throughout the English-speaking Caribbean have been providing direct iron supplementation for pregnant women, but high levels of anemia during pregnancy still exist because of coverage, monitoring, and compliance problems. All the Caribbean countries also have education programs, which mainly advise pregnant women about iron-rich foods and iron absorption inhibitors and enhancers (AU)