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1.
West Indian med. j ; 65(Supp. 3): [19], 2016.
Article in English | MedCarib | ID: med-18084

ABSTRACT

OBJECTIVE: To determine the prevalence of depression among students at The University of the West Indies, St Augustine campus over the period 2014–2015. SUBJECTS AND METHOD: A cross-sectional study utilizing convenience sampling was executed between January and May 2015. A self-administered questionnaire based on the Centre for Epidemiological Studies Depression Scale-Revised (CESD-R) was formulated by the addition of demographic and other variables and was distributed to a total of 1020 undergraduate students at The University of the West Indies, St Augustine. The acquired data were analysed using Statistical Package for Social Sciences (SPSS) for Windows 8. RESULTS: With a response rate of 95.2%, the study revealed the overall prevalence of depression to be 39.8%, with 39.3% of non-medical students and 40.2% of medical students being depressed (95%CI). The factors statistically associated with depression were religion (p = 0.013), smoking (p < 0.001), alcohol consumption (p < 0.001), illicit drug use (p = 0.008) and being previously treated for depression (p < 0.001). More than two-thirds (69.5%) of respondents thought that they could recognize the symptoms of personal depression; however, 53.5% of them misdiagnosed themselves as not being depressed (95%CI). A quarter (24.9%) of respondents believed there is a stigma attached to seeking help for depression while 37.8% of them were unaware of the available counseling resources (95%CI). CONCLUSION: The overall prevalence of depression at The University of the West Indies, St Augustine campus during the 2014–2015 period was found to be 39.8%. The factors associated with depression were alcohol consumption, illicit drug use, smoking, religion and a previous diagnosis of depression.


Subject(s)
Humans , Depression , Students , Trinidad and Tobago , Developing Countries
2.
Journal of health informatics in developing countries ; 7(1): 34-49, 2013. tab, graf, ilus
Article in English | MedCarib | ID: med-17781

ABSTRACT

This paper aims to evaluate the usability of the Trinidad and Tobago Virtual Health Library (TTVHL) website based upon opinions of employees, students and ‘walk-ins’ in health care environments. Questionnaires were administered either in person or via e-mail to 122 persons who agreed to comment on the TTVHL website. All 122 responses were usable, resulting in a response rate of 100%. Data were generated using coded or classified responses and the findings were derived from data analysis. Respondents represented three categories of participants, viz.: health care personnel; library/information personnel; and persons operating outside of the biomedical or library/information fields. Their overall opinion of the website was favourable. Limitations of time, research personnel, and Internet access curtailed the administration of the survey at some locations where eligible respondents were present. The method employed can readily be applied to other VHL websites. Research on virtual health libraries within Latin America and the Caribbean is still in the early stages.


Subject(s)
Humans , Male , Female , Libraries, Digital , User-Computer Interface , Information Storage and Retrieval , Information Management , Medical Informatics , Trinidad and Tobago , Developing Countries , Public Information , Information Dissemination , Information Products and Services , Information Technology
3.
The new microbiologica ; 34(2): 219-224, Apr. 30, 2011. tab
Article in English | MedCarib | ID: med-17577

ABSTRACT

Coxiella burnetii is a zoonotic, rickettsial pathogen which causes mild and severe diseases often referred to as Q-fever in humans, particularly those occupationally exposed. This study determined the seropositivity for Coxiella burnetii IgM immunoglobulins using the enzyme immunoassay (EIA) in livestock and abattoir workers in Trinidad and related to selected personal characteristics to seroprevalence. Overall, of the 455 humans whose serum samples were tested, 20 (4.4%) were seropositive for C. burnetii IgM immunoglobulin, comprising 13 (4.6%) out of 283 livestock workers, 4 (4.7%) out of 85 abattoir workers and 3 (3.4%) out of 87 office workers (P>0.05; ö2).The age, sex and race of workers were not significantly associated with the occurrence of acute Q-fever (P>0.05; ö2). This is considered the first documentation of Q-fever in the human population in Trinidad. It is difficult to assess the impact of the disease in the country since the disease is not routinely tested for in the local hospitals or diagnostic laboratories.


Subject(s)
Animals , Humans , Coxiella burnetii , Agricultural Workers' Diseases/immunology , Agricultural Workers' Diseases/veterinary , Immunoglobulins , Trinidad and Tobago , Developing Countries/diagnosis
4.
Journal of clinical anesthesia ; 22(3): 169-173, May 2010.
Article in English | MedCarib | ID: med-17695

ABSTRACT

STUDY OBJECTIVE: To evaluate the perioperative outcome of carotid endarterectomy (CEA) with regional anesthesia. DESIGN: Retrospective chart review of consecutive patients who underwent CEA with regional anesthesia in a 23-year period. SETTING: Operating rooms of a general hospital in a developing country. MEASUREMENTS: Demographic data, perioperative clinical data, postoperative morbidity and unplanned admissions were recorded. MAIN RESULTS: A total of 183 CEA procedures were performed. In 172 cases, CEA was done exclusively with deep cervical plexus block and local infiltration, while in 11 (6%) cases, there was a need for conversion to general anesthesia intraoperatively. Clamping of the internal carotid artery (ICA) for a three-minute period was the method used to monitor any development of neurological impairment. Perioperative complications included intraoperative seizures in one patient, intraoperative transient hemiparesis in three patients, postoperative transient hemiparesis in two patients, and intraoperative hemiplegia in one patient. One hundred fifty-three patients (83.6%) were discharged home within 24 hours, and 29 (15.8%) were discharged home in 48 hours. The hemiplegic patient had a hospital stay of 12 days. There was no perioperative mortality. CONCLUSIONS: Regional anesthesia is a safe method for CEA in a limited-resources setting, as it facilitates intraoperative clinical assessment of the effects of ICA clamping.


Subject(s)
Humans , Endarterectomy, Carotid , Developing Countries , Anesthesia, Conduction , Caribbean Region
5.
Cancer epidemiology ; 34(1): 20-23, Feb. 2010. tab, graf
Article in English | MedCarib | ID: med-17635

ABSTRACT

BACKGROUND: Breast cancer is the most frequently diagnosed cancer among women worldwide. This study examines the breast cancer mortality patterns and trends in the Caribbean island state, Trinidad and Tobago for the 35-year period, 1970-2004. METHODS: A retrospective analysis of the trends in breast cancer mortality from 1970 to 2004 was conducted. Crude mortality per 100,000 women, age-standardized mortality using World Standard population and age-stratified mortality were calculated and comparison was made between age groups above and below 50 years. RESULTS: A general pattern of increase was observed in both crude and age-standardized mortality. The overall average crude mortality was 15.6 per 100,000 women (95% confidence interval (CI) 13.9-17.1) and the average age-standardized mortality was 18.0 per 100,000 women (95% CI 16.7-19.2). There was a pattern of increase in mortality with increasing age. The mortality rate was considerably higher for the age groups above 50 years than those less than 50 years of age both showing an upward trend over the 35-year period. CONCLUSIONS: Breast cancer mortality continued to increase over the 35-year period in Trinidad and Tobago. This study did not identify the exact reasons for this increasing trend. However, it is known that Trinidad and Tobago is becoming much more industrialized. It may be speculated that decrease in fertility rates, increase in the incidence of obesity and hormone utilization could have influenced this trend.


Subject(s)
Adult , Middle Aged , Aged , Humans , Female , Breast Neoplasms , Mortality , Trinidad and Tobago , Developing Countries , Caribbean Region
6.
Fundamental & clinical pharmacology ; 23(5): 609-615, Oct, 2009. tabgraf
Article in English | MedCarib | ID: med-17867

ABSTRACT

This study aimed to evaluate the prescribing practices and utilization of antimicrobials in a tertiary care teaching hospital of a Caribbean developing country. A prospective observational cohort study was undertaken for a period of 12 weeks in the general wards and the intensive care unit (ICU) of the hospital. Demographic data, diagnoses on admission, antimicrobials prescribed, dosage and duration, route of administration, leukocyte count and microbiological culture and sensitivity reports were recorded. Hospital length of stay and final outcome were recorded. The usage was determined in terms of prescribed daily dose and the total costs of antimicrobials were calculated. Of 889 patients admitted, 335 (37.7 percent) received 22 different antimicrobial drugs. Overall, 67 percent of the prescriptions adhered to the hospital protocol. Median length of stay in the hospital was 7 days. Skin and soft tissue infections were the most common diagnoses for which antimicrobials were prescribed. Amoxicillin-clavulanate was the most common (32 percent) antimicrobial used. Eighty-nine percent of the antimicrobials were given through the intravenous route. Sixty percent of the patients received two antimicrobials, 26 percent received three, and 14 percent of patients were prescribed four or more antimicrobials during their stay at the hospital. There was significantly higher inappropriate choice of antimicrobials in ICU when compared with general wards (Mantel-Haenszel Odds Ratio 3.3; 95 percent Confidence Intervals 1.4, 7.7). Prescribing patterns did not strictly adhere to the hospital antimicrobial protocol. There is a need for monitoring and control of antimicrobial prescription.


Subject(s)
Humans , Drug Utilization , Trinidad and Tobago , Developing Countries
7.
International journal of surgery ; 7(6): 534-538, Sep. 2009. tab, graf
Article in English | MedCarib | ID: med-17696

ABSTRACT

OBJECTIVE: To evaluate the risk-adjusted perioperative outcome of colorectal cancer surgery, applying the Colorectal Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (CR-POSSUM). METHODS: A retrospective chart review of patients who underwent colorectal cancer surgery from 2004 to 2007 was done. Data including demographics and physiological data for CR-POSSUM were recorded. Predicted mortality was calculated; validation of CR-POSSUM was done using Hosmer-Lemeshow goodness-of-fit and Receiver Operating Characteristic (ROC) Curve analyses. RESULTS: 232 patients were studied. The overall mean CR-POSSUM score was 18.3+/-3.8 (SD). Predicted mortality was 7.7%, observed mortality was 6.9% and the standardized mortality ratio was 0.9. 34.4% of patients presented with Duke's Stage C or D and had a higher risk of mortality (Odds Ratio (OR) 3.1, 95% Confidence Intervals (CI) 1.1, 9.1). Emergency surgery was associated with a higher risk of mortality (OR 4.7, 95% CI 1.5, 14.1). CR-POSSUM calibrated well (Hosmer-Lemeshow Chi-square value 4.3; df: 8; p=0.82) and fairly discriminated outcome as shown by the area under the ROC Curve 0.69, (Standard Error: 0.07). CONCLUSIONS: Perioperative outcome of colorectal surgery in Trinidad and Tobago is comparable to the developed countries as evaluated by the CR-POSSUM. Patients presenting for emergency surgery and those with advanced stages of cancer had higher perioperative mortality.


Subject(s)
Humans , Male , Female , Colorectal Surgery , Colorectal Neoplasms , Developing Countries , Trinidad and Tobago
8.
The British journal of psychiatry ; 193(3): 197-202, Sep. 2008. tab
Article in English | MedCarib | ID: med-17799

ABSTRACT

BACKGROUND: It remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis. AIMS: To investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ). METHOD: Evaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239). RESULTS: Primary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ. CONCLUSIONS: Higher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.


Subject(s)
Humans , Diagnostic Techniques, Neurological , Cognitive Behavioral Therapy , Psychotic Disorders , Developing Countries
9.
Rev. panam. salud pública ; 22(6): 425-431, Dec. 2007. ilus
Article in English | MedCarib | ID: med-17359

ABSTRACT

Underserved regions in the developing world are challenging areas to provide emergency medical care. As populations in these often remote or isolated districts may have minimal access to regular health care, contacts with medical providers are frequently episodic and driven by an acute condition. Health promoters—practitioners who provide basic medical care and promote public health in numerous countries across Central and South America, Asia and Africa—help to fill this void. Typically, health promoters are certified through a formal training program in their country and come from the same population as the clients they serve, which helps them form a link between their community and the dominant health care system in the region (1-2). Access to health and social services in regions served by health promoters is usually minimal, resulting in high morbidity and mortality associated with preventable diseases. Health promoters strive to improve the overall health of these communities by supplementing and improving the curative, preventive, and promotional aspects of the existing health system.


Subject(s)
Humans , Emergency Medical Services/trends , Central America , Emergency Treatment/trends , South America , Delivery of Health Care , Nurse Midwives/education , Primary Health Care/methods , Developing Countries
10.
Oxford; Blackwell Publishing Limited; 2007. v,415 p. ilus, tab.
Monography in English | MedCarib | ID: med-17136

ABSTRACT

Introduction to veterinary and comparative forensic medicine is ground-breaking book in an emerging new spciality. It reflects the increasing demand for expert opinion by veterinarians and others in courts of law and elsewhere on such matters as: wildlife conservation, welfare of, and alleged cruelty to, animals, insurance, certification and malpractice, the indentification of live and dead species or their derivatives. It also discusses and analyses current concern over possible links between domestic violence and abuse of animals. Throughout the book the emphasis is on the need for a systematic and thorough approach to forensic work. A particular feature is practical advice, with protocols on dealing with common problems, together with case studies, various appendices and an extensive bibliography. A vital reference for members of the veterinary profession, lawyers, enforcement bodies and welfare and conservation organisations. The comparative aspects provide an important source of information for those working in human forensic medicine and the biological sciences (AU)


Subject(s)
Animals , Forensic Medicine/education , Veterinary Medicine , Veterinary Medicine/methods , Developing Countries , Pathology, Veterinary/legislation & jurisprudence , Expert Testimony
11.
Rev. panam. salud p£blica ; 20(2/3): 161-172, Aug-Sept. 2006. tab, gra
Article in English | MedCarib | ID: med-17129

ABSTRACT

Since 1969 the International Atomic Energy Agency and the World Health Organisation (along with the Pan American Health Organization, working with countries in Latin America and the Caribbean) have operated postal dosimetry audits based on thermoluminescent dosimetry (TLD) for radiotherapy centres. The purpose of these audits is to provide and independent dosimetry check of radiation beams used to treat cancer patients. The success of radiotherapy treatment depends on accurate dosimetry. Over the period of 1969 through 2003 the calibration of approximately 5200 photon beams in over 1300 radiotherapy centres in 115 countries worldwide was checked. Of these audits, 36 percent were performed in Latin America and the Caribbean, with results improving grealtly over the years. Unfortunately, in several instances large TLD deviations have confirmed clinical observations of inadequate dosimetry practices in hospitals in various parts of the world or even accidents in radiotherapy, such as the one that occurred in Costa Rica in 1996. Hospitals or centres that operate radiotherapy services without qualified medical physicists or without dosimetry equipment have poorer results than do hospitals or centres that are properly staffed and equipped. When centres have poor TLD results, a follow-up program can help them improve their dosimetry status. However, to achieve audit results that are comparable to those for centers in industrialized countries, additional strengthening of the radiotherapy infrastructure in Latin America and the Caribbean is needed (AU)


Subject(s)
Humans , Radiotherapy/classification , Radiotherapy/instrumentation , Quality Control , Medical Audit , International Cooperation , Developing Countries , Latin America , Caribbean Region
12.
Rev. panam. salud p£blica ; 20(2/3): 104-112, Aug-Sept. 2006. tab
Article in English | MedCarib | ID: med-17130

ABSTRACT

In recent decades, medical imaging has experienced a technological revolution. After conducting several surveys to assess the quality and safety of diagnostic imaging services in Latin America and the Caribbean, the Pan American Health Organisation (PAHO) developed a basic accreditation program that can be implemented by the ministry of health of any developing country. Patterned after the American College of Radiology's accreditation program, the PAHO program relies on a national accreditation committee to establish and maintain accreditation standards. The process involves a peer review evaluation of: (1) imaging and processing equipment, (2) physician and technologist staff qualifications, (3)quality control and quality assurance programs, and (4) image quality and, where applicable, radiation dose. Public and private conventional radiography/fluoroscopy, mammography, and ultrasound services may request accreditation. The radiography/fluoroscopy accreditation program has three modules from which to choose: chest radiography, general radiography, and fluoroscopy. The national accreditation committee verifies compliance with the standards. On behalf of the ministry of health, the accreditation committee also issues a three-year accreditation certificate. As needed, the accreditation committee consults with foreign technical and clinical experts (AU)


Subject(s)
Humans , Radiology/standards , Accreditation/legislation & jurisprudence , Developing Countries , Latin America , Caribbean Region
13.
Pediatric anesthesia ; 16(4): 388-393, March 2006.
Article in English | MedCarib | ID: med-17428

ABSTRACT

BACKGROUND:  The aim of this study was to evaluate the performance of a pediatric ambulatory anesthesia program in a tertiary care teaching hospital in a developing country. METHODS:  Data on all pediatric patients (<16 years of age) scheduled to have elective day-care surgery during a 1 year period from January 1999 to December 1999 were collected retrospectively. An audit form was used to determine the specialty of the procedures, anesthesia techniques, postoperative analgesia, perioperative complications, unplanned admissions and outcomes with respect to morbidity and mortality. RESULTS:  A total of 763 pediatric ambulatory surgical procedures were performed during the year of 1999. The procedures included general surgery, ENT, orthopedic and plastic surgery. The most common procedure was inguinal hernia repair followed by umbilical hernia repair, adenotonsillectomy and circumcision and 96% of the patients had general anesthesia. There were only three unplanned admissions (0.4%); one for a surgical reason and two for anesthetic reasons. There was no serious morbidity or mortality in any patient. CONCLUSIONS:  Performance of pediatric day-care anesthesia has been good in our day-care unit and we have a successful ambulatory surgery program, despite the limitations of a developing country.


Subject(s)
Infant , Humans , Admitting Department, Hospital/organization & administration , Hospitals, Teaching , Anesthesia/methods , Anesthesia/statistics & numerical data , Trinidad and Tobago , Developing Countries
14.
Rev. panam. salud p£blica ; 18(2): 84-92, August 2005. tab
Article in English | MedCarib | ID: med-17278

ABSTRACT

OBJECTIVES: This study is based on the 2000 Demographic and Health Survey (DHS) conducted in Haiti. Using the DHS information on women ages 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2) for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16 percent, compared to 85.83 percent in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 percent prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centers in rural areas consituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti (AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Care/statistics & numerical data , Prenatal Care/trends , Rural Health Services , Urban Health Services/statistics & numerical data , Haiti , Caribbean Region , Developing Countries
15.
Rev. panam. salud p£blica ; 18(2): 84-91, Aug. 2005. tab
Article in English | MedCarib | ID: med-17314

ABSTRACT

OBJECTIVES: This study is based on the 2000 Demograpic Health Survey (DHS) conducted in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2)for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did not make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16 percent, compared to 85.83 percent in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centres in rural areas constituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti(AU)


Subject(s)
Humans , Pregnancy , Prenatal Care/statistics & numerical data , Rural Health Services/trends , Haiti , Urban Health Services/statistics & numerical data , Caribbean Region , Urban Health Services , Developing Countries
16.
Rev. panam. salud p£blica ; 18(2): 114-121, Aug. 2005. tab
Article in English | MedCarib | ID: med-17315

ABSTRACT

OBJECTIVE: To determine the prevalence of experiences with physical violence and psychological violence that health staff had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. DESIGN AND METHODS: A total of 832 health staff answered the standardized questionnaire that was used in this cross-sectional study. Sampling was done at public facilities, including specialist, tertiary, and secondary hospitals in the Kingston Metropolitan Area; general hospitals in the rural parishes; and primary care centres in urban and rural areas. Sampling was also done in private hospitals and private medical centres. RESULTS: Psychological violence was more prevalant than was physical violence. Verbal abuse has been experienced in the prceeding year by 38.6 percent of the questionnaire respondents, bullying was reported by 12.4 percent, and physical violence was reported by 7.7 percent. In multivariate analyses there was a lower risk of physical violence for health staff who were 55 years or older, worked during the night, or worked mostly with mentally disbled patients, geriatric patients, or HIV/AIDS patients. Staff members working mostly with psychiatric patients faced a higher risk of physical assaults that did other health staff. Of the various health occupations, nurses were the ones mostly likely to be verbally abused. In terms of age ranges, bullying was more commonly experienced by health staff 40-54 years old. CONCLUSION: Violence in the health sector workplace in Jamaica is an occupational hazard that is of public health concern. Evaluation of the environment that creates risks for violence is necessary to guide the formulation of meaningful interventions for the country(AU)


Subject(s)
Humans , Workplace , Health Personnel , Violence/trends , Jamaica , Wounds and Injuries , Stress, Physiological , Caribbean Region , Occupational Health , Developing Countries
17.
International journal of clinical practice ; 59(8): 953-957, March 2005.
Article in English | MedCarib | ID: med-17560

ABSTRACT

To evaluate and compare the outcome of open-heart surgery in elderly patients with a concurrent group of younger patients in a developing country, data of all adult patients who underwent open-heart surgery during the period of 3 years from January 1999 to December 2001 were collected prospectively. Demographic data such as age and gender, other data such as preoperative diagnoses, comorbid illnesses, type of surgery, time of cardio-pulmonary bypass, length of stay and hospital outcome were recorded. The characteristics of patients above the age of 65 years were compared with a concurrent cohort of patients aged less than 65 years. One hundred and forty-five adult patients underwent open-heart surgeries in 3 years, and the overall mortality rate was 4.8 per cent. The much common surgeries were coronary artery bypass grafting, valve repair/replacement surgery and surgery for adult congenital heart diseases. Forty-five (31 per cent) patients were above the age of 65 years. The mortality rate was 2.2 per cent for patients who were aged 65 years and above, in comparison with that of the concurrent cohort of younger patients (6 per cent). This was probably because of more number of surgeries for congenital heart diseases in the latter group. However, even with other surgeries such as coronary artery bypass grafting, the elderly group of patients did equally well as the younger group. Elderly patients tolerate cardiac surgery well, and age should not be an exclusive criterion to decide against open-heart surgery.


Subject(s)
Humans , Thoracic Surgery/statistics & numerical data , Thoracic Surgery/standards , Thoracic Surgery/trends , Developing Countries/statistics & numerical data , Aged/statistics & numerical data
18.
St. Augustine; Faculty of Social Sciences, The University of the West Indies; 2004. 29 p.
Monography in English | MedCarib | ID: med-16764

ABSTRACT

Using document analysis and discourse analysis approaches, this study addresses the impact of domestic violence on children in Trinidad and Tobago. With the growing incidence of domestic violence in the country, much attention has been given to the primary parties involved in the abuse - the abused woman and the perpetrator while very little attention has been given to the children witnessing it. The experience of the authors as clinicians, brought us into contact with children who suffer tremendously in these situations and heightened our awareness of the absence of scholarly inquiry on this phenomenon. This inquiry is intended to highlight the telling impact that domestic violence has on children. In addition, we highlight the perceptions of therapists who work with children and families about the adequacy of the services available to this population in Trinidad and Tobago (AU)


Subject(s)
Adult , Child , Humans , Domestic Violence/ethnology , Domestic Violence/psychology , Domestic Violence/trends , Trinidad and Tobago , Parenting , Developing Countries , Psychology, Child , Social Support , Caribbean Region
19.
St. Augustine; The University of the West Indies, Faculty of Medical Sciences; 2004.
Monography in English | MedCarib | ID: med-17013
20.
Dengue bulletin ; 28: 7-19, 2004. graf, mapas
Article in English | MedCarib | ID: med-17444

ABSTRACT

A retrospective analysis of the 1996 DEN-1 epidemic in Trinidad was undertaken to better understand the clinical and demographic expression of dengue infection in the island during one of the larger epidemics in the past 10 years and following the reintroduction of DEN-1 into the island in 1991 after a gap of 14 years. A total of 393 laboratory-confirmed cases were identified. Of these, notes for 157 patients were available for analysis. The epidemic was island-wide, though most cases occurred in the most densely populated county of St. George. There was a slight predominance of females (51.6 per cent) among the cases, and while all age groups were affected, older children and adults comprised the majority. South Asians among the population predominated. Overall, 27 clinical symptoms were reported. The most common were: fever (98.7 per cent), generalized pain (96.2 per cent) and anorexia (63.1 per cent). Rash, arthralgia, retro-orbital pain and haemorrhage (all mentioned in the WHO clinical description for dengue fever) were reported in <50 per cent of cases. Gastrointestinal symptoms were also very common and occurred in over two-thirds of cases at presentation. Bleeding manifestations were reported in 30 per cent of patients and commonly involved the gastrointestinal tract. Features of DHF were noted in only six (4 per cent)


Subject(s)
Humans , Dengue Virus/physiology , Dengue Virus/pathogenicity , Trinidad and Tobago/epidemiology , Developing Countries
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