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1.
Sci Rep ; 14(1): 3381, 2024 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-38336916

RESUMO

The intestinal microbiome plays an important role in mammalian health, disease, and immune function. In light of this function, recent studies have aimed to characterize the microbiomes of various bat species, which are noteworthy for their roles as reservoir hosts for several viruses known to be highly pathogenic in other mammals. Despite ongoing bat microbiome research, its role in immune function and disease, especially the effects of changes in the microbiome on host health, remains nebulous. Here, we describe a novel methodology to investigate the intestinal microbiome of captive Jamaican fruit bats (Artibeus jamaicensis). We observed a high degree of individual variation in addition to sex- and cohort-linked differences. The intestinal microbiome was correlated with intestinal metabolite composition, possibly contributing to differences in immune status. This work provides a basis for future infection and field studies to examine in detail the role of the intestinal microbiome in antiviral immunity.


Assuntos
Quirópteros , Microbioma Gastrointestinal , Humanos , Animais , Feminino , Masculino , Jamaica , Caracteres Sexuais , Mamíferos , Metaboloma
2.
BMC Pediatr ; 24(1): 14, 2024 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-38178055

RESUMO

BACKGROUND: Jamaican soil is abundant in heavy metals including mercury (Hg). Due to availability and ease of access, fish is a traditional dietary component in Jamaica and a significant source of Hg exposure. Mercury is a xenobiotic and known neuro-toxicant that affects children's neurodevelopment. Human glutathione S-transferase (GST) genes, including GSTT1, GSTM1, and GSTP1, affect Hg conjugation and elimination mechanisms. METHODS: In this exposure assessment study we used data from 375 typically developing (TD) 2-8-year-old Jamaican children to explore the association between environmental Hg exposure, GST genes, and their interaction effects on blood Hg concentrations (BHgCs). We used multivariable general linear models (GLMs). RESULTS: We identified the child's age, consumption of saltwater fish, canned fish (sardine, mackerel), string beans, grain, and starches (pasta, macaroni, noodles) as the environmental factors significantly associated with BHgCs (all P < 0.05). A significant interaction between consumption of canned fish (sardine, mackerel) and GSTP1 in relation to BHgC using either a co-dominant or recessive genetic model (overall interaction P = 0.01 and P < 0.01, respectively) indicated that consumption of canned fish (sardine, mackerel) was significantly associated with higher mean BHgC only among children with the GSTP1 Ile105Val, Ile/Ile [Ratio of mean Hg (95% CI) = 1.59 (1.09, 2.32), P = 0.02] and Ile/Val [Ratio of mean Hg (95% CI) = 1.46 (1.12, 1.91), P = 0.01] genotypes. CONCLUSIONS: Since this is the first study from Jamaica to report these findings, replication in other populations is recommended.


Assuntos
Glutationa Transferase , Mercúrio , Criança , Pré-Escolar , Humanos , Estudos de Casos e Controles , Predisposição Genética para Doença , Genótipo , Glutationa Transferase/genética , Jamaica , Mercúrio/sangue , Polimorfismo Genético , Fatores de Risco
3.
BMJ Open ; 14(1): e078437, 2024 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-38262644

RESUMO

OBJECTIVES: To determine cannabis use patterns, the predictive sociodemographic correlates of driving under the influence of cannabis (DUIC) and the association between risk perception and cannabis dependence among vehicle drivers in Jamaica. DESIGN: Secondary data analysis. SETTING: Used the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: 1060 vehicle drivers extracted from the population sample of 4623. PRIMARY AND SECONDARY OUTCOME MEASURES: Analysis used Pearson's χ2 test and logistic regression. ORs and 95% CIs were recorded. A p<0.05 was considered statistically significant. RESULTS: More than 10% of Jamaican drivers admitted to DUIC in the past year. Approximately 43.3% of drivers who currently use cannabis reported DUIC only. Evidently, 86.8% of drivers who DUIC were heavy cannabis users. Approximately 30% of drivers with moderate to high-risk perception of smoking cannabis sometimes or often were dependent on cannabis. Notwithstanding, drivers with no to low-risk perception of smoking cannabis sometimes or often were significantly likelier to be dependent (p<0.001 and p<0.001, respectively). Logistic regression highlighted male drivers (OR 4.14, 95% CI 1.59 to 14.20, p=0.009) that were 34 years and under (OR 2.97, 95% CI 1.71 to 5.29, p<0.001) and were the head of the household (OR 2.22, 95% CI 1.10 to 4.75, p=0.031) and operated a machine as part of their job (OR 1.87, 95% CI 1.09 to 3.24, p=0.023) were more likely to DUIC, while those who were married (OR 0.42, 95% CI 0.22 to 0.74, p=0.004) and had achieved a tertiary-level education (OR 0.26, 95% CI 0.06 to 0.76, p=0.031) were less likely. CONCLUSIONS: Two in five Jamaican drivers, who currently smoke cannabis, drive under its influence, with over 85% engaging in heavy use. Public health implications necessitate policy-makers consider mobile roadside drug testing and amending drug-driving laws to meet international standards.


Assuntos
Cannabis , Dirigir sob a Influência , Abuso de Maconha , Fumar Maconha , Masculino , Humanos , Jamaica , Agonistas de Receptores de Canabinoides
4.
Int J STD AIDS ; 35(3): 188-196, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37966358

RESUMO

BACKGROUND: The Ministry of Health and Wellness of Jamaica has endorsed the use of pre-exposure prophylaxis (PrEP) as an HIV prevention strategy; however, PrEP was not included in the national HIV prevention program in 2021. METHODS: A cross-sectional online study involving physicians in Jamaica was conducted in 2021 to describe PrEP awareness, beliefs, attitudes, and practices. The study also assessed individual and social factors associated with discussing PrEP with patients and willingness to prescribe PrEP. FINDINGS: The mean age and standard deviation (SD) of the 69 physicians who completed the survey were 45.5 ± 13.6 years. Most of the participants (80%) reported that they were somewhat familiar with PrEP. PrEP attitude and perceived comfort in prescribing PrEP were moderate among participating physicians, with a mean and SD of 3.9 ± 0.8 and 3.6 ± 0.9 respectively. Six percent of physicians reported that they had prescribed PrEP and 17% had discussed PrEP with their patients in the past year. However, most (90%) reported that they were willing to prescribe PrEP after being informed about it. In the unadjusted model, identifying as Christian (compared to non-Christian) and reporting stronger homophobic beliefs were associated with reduced odds of discussing PrEP with patients. In the multivariable model, only homophobia remained statistically significant (OR, 0.24; 95% CI: 0.07-0.63). CONCLUSION: The findings suggest that physicians in Jamacia may be willing to prescribe PrEP; however, homophobia is a barrier to discussions, underscoring the need for the Ministry of Health and Wellness to recognize the role that homophobia plays in the national HIV program to further reduce HIV incidence in Jamaica.


Assuntos
Infecções por HIV , Médicos , Profilaxia Pré-Exposição , Humanos , Estudos Transversais , Jamaica , Infecções por HIV/prevenção & controle
6.
Arch Dis Child ; 109(2): 100-105, 2024 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-37918896

RESUMO

OBJECTIVE: To document the prevalence, clinical features, haematology and outcome of acute splenic sequestration (ASS) in homozygous sickle cell disease (HbSS). STUDY DESIGN: A cohort study from birth. SETTING: The Medical Research Council Laboratories at the University of the West Indies, Kingston, Jamaica. PATIENTS: 311 cases of HbSS detected during the screening of 100 000 deliveries at the main government maternity hospital between 1973 and 1981. INTERVENTIONS: Long-term follow-up and free patient care focusing on ASS. MAIN OUTCOME MEASURE: Acute splenic sequestration. RESULTS: There were 183 episodes of ASS in 105 patients representing 35% of the cohort. The median age for first event was 1.07 years. During ASS, median values for haemoglobin fell by 32 g/dL, reticulocytes increased by 8% and total nucleated cells increased by 10.5%. ASS recurred in 47 (45%) patients. Conservative therapy in 133 episodes of 85 patients was associated with five deaths and splenectomy in 20 patients with 50 episodes had no deaths. Symptoms were generally non-specific but acute chest syndrome occurred in 17, and blood cultures revealed coagulase negative staphylococci in 5. The ASS case fatality rate was 3.6% and may be higher if autopsy evidence of ASS is included. There was no seasonal pattern but higher levels of fetal haemoglobin predicted patients less prone to ASS and its later occurrence. CONCLUSIONS: ASS remains an important cause of morbidity and mortality in HbSS in developing societies. ASS appears to be a non-specific response to many possible risk factors including coagulase negative staphylococci.


Assuntos
Anemia Falciforme , Coorte de Nascimento , Gravidez , Humanos , Feminino , Lactente , Estudos de Coortes , Jamaica/epidemiologia , Coagulase , Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia , Hemoglobinas
7.
Drug Test Anal ; 16(2): 174-186, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37309060

RESUMO

Reports suggest that cannabis potency has dramatically increased over the last decade in the USA and Europe. Cannabinoids are the terpeno-phenolic compounds found in the cannabis plant and are responsible for its pharmacological activity. The two most prominent cannabinoids are delta-9-tetrahydrocannabinol (Δ9 THC) and cannabidiol (CBD). Cannabis potency is measured not only by the Δ9 THC levels but also by the ratio of Δ9 THC to other non-psychoactive cannabinoids, namely, CBD. Cannabis use was decriminalized in Jamaica in 2015, which opened the gates for the creation of a regulated medical cannabis industry in the country. To date, there is no information available on the potency of cannabis in Jamaica. In this study, the cannabinoid content of Jamaican-grown cannabis was examined over the period 2014-2020. Two hundred ninety-nine herbal cannabis samples were received from 12 parishes across the island, and the levels of the major cannabinoids were determined using gas chromatography-mass spectrometry. There was a significant increase (p < 0.05) in the median total THC levels of cannabis samples tested between 2014 (1.1%) and 2020 (10.2%). The highest median THC was detected in the central parish of Manchester (21.1%). During the period, THC/CBD ratios increased from 2.1 (2014) to 194.1 (2020), and there was a corresponding increase in the percent freshness of samples (CBN/THC ratios <0.013). The data show that a significant increase in the potency of locally grown cannabis has occurred in Jamaica during the last decade.


Assuntos
Canabidiol , Canabinoides , Cannabis , Alucinógenos , Cannabis/química , Dronabinol/análise , Jamaica , Canabinoides/análise , Canabidiol/análise , Agonistas de Receptores de Canabinoides
8.
PLoS One ; 18(12): e0290975, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38096252

RESUMO

BACKGROUND: People with comorbid mental illness (MI) and chronic physical illness (CPI) face a range of health and quality of life challenges. The appropriate screening and management of comorbid MI and CPI are crucial to improving outcomes for this population. Despite this, there is a dearth of research exploring the health system response to the screening and management of patients with these comorbidities in public primary care settings, in several jurisdictions including Jamaica. This study explored and described the attitudes, perspectives, experiences, and practices of policymakers, primary care physicians, psychiatrists, and mental health nurses regarding screening and management of comorbid MI and CPI. METHOD: Twenty-nine participants representing policymakers, primary care physicians, psychiatrists, and mental health nurses took part in semi-structured interviews. Data was collected over the period April to November 2020 and subject to thematic analysis. RESULTS: Three overarching themes emerged from the data related to: 1) Policies and Protocols; 2) Clinical Practice; and 3) Personnel. The interplay of these themes illustrated fragmentation and gaps between national policies and guidelines and clinical practice. The findings also identified factors related to personnel, including barriers that limit clinicians' abilities to adequately screen and manage this patient population. CONCLUSION: There is a need for the continued development and revision of policies and protocols that support integrated care for patients with comorbid MI and CPI in primary care settings in Jamaica. Additionally, programs and strategies to improve clinicans knowledge, skills and access to resources are necessary to help them offer improved quality of care around screening and management for this patient population.


Assuntos
Transtornos Mentais , Qualidade de Vida , Humanos , Jamaica/epidemiologia , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Saúde Mental , Comorbidade , Pesquisa Qualitativa
9.
BMJ Open ; 13(11): e076111, 2023 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-37963690

RESUMO

OBJECTIVES: This study aimed to examine concurrent polysubstance use of alcohol, tobacco and marijuana and determine correlations with access to marijuana, friend and familial drug use habits, risk perception and the age of initiation associated with the singular use of these substances. DESIGN: A secondary data analysis. SETTING: Used the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: Involved the entire dataset comprising 4623 randomly selected respondents between 12 and 65 years old. OUTCOME MEASURES: Primary outcome: concurrent polysubstance use recorded as using two or more of alcohol, tobacco and marijuana. Predictor variables include risk perception and age of initiation of singular alcohol, tobacco and marijuana use, ease of marijuana access and family and friend alcohol and illegal drug use. RESULTS: Approximately 58%-66% of respondents commenced singular alcohol, tobacco or marijuana use under 17. Participants commencing marijuana use at 11 years and under and between 12 and 17 were 3.346 and 4.560 times more likely to report past month concurrent polysubstance use (p=0.030 and p<0.001). Respondents who did not believe that smoking tobacco sometimes (p=0.049), and smoking marijuana sometimes and often was harmful, had increased odds of concurrent polysubstance use (p=0.047 and p<0.001, respectively). Respondents who indicated access to marijuana as easy were significantly more likely to report past month concurrent polysubstance use compared with those who reported access as difficult (p=0.002). Participants who indicated that friends or family members get drunk and take illegal drugs were associated with 1.722 and 1.864 increased odds of reporting past month concurrent polysubstance use (p=0.004 and p=0.017, respectively). CONCLUSIONS: Decreased perceived risk, childhood and adolescent age of initiation and easy access to marijuana were significantly associated with polysubstance use among Jamaicans. The influence of friends and family members' drug and alcohol use behaviours on individuals developing polysubstance use habits further endorses the need for interventions.


Assuntos
Cannabis , Fumar Maconha , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Humanos , Criança , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Jamaica/epidemiologia , Fumar Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Etanol
10.
Medicine (Baltimore) ; 102(40): e35308, 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37800785

RESUMO

This study aimed to estimate dietary sodium and potassium consumption among Jamaicans and evaluate associations with sociodemographic and clinical characteristics. A cross-sectional study was conducted using data from the Jamaica Health and Lifestyle Survey 2016-2017. Participants were noninstitutionalized Jamaicans aged ≥15 years. Trained staff collected sociodemographic and health data via interviewer-administered questionnaires and spot urine samples. The Pan American Health Organization formula was used to estimate 24-hour urine sodium and potassium excretion. High sodium level was defined as ≥2000 mg/day, and low potassium levels as <3510 mg/day (World Health Organization criteria). Associations between these outcomes and sociodemographic and clinical characteristics were explored using multivariable ANOVA models using log-transformed 24-hour urine sodium and potassium as outcome variables. Analyses included 1009 participants (368 males, 641 females; mean age 48.5 years). The mean sodium excretion was 3582 mg/day (males 3943 mg/day, females 3245 mg/day, P < .001). The mean potassium excretion was 2052 mg/day (males, 2210 mg/day; females, 1904 mg/day; P = .001). The prevalence of high sodium consumption was 66.6% (males 72.8%, females 60.7%, P < .001) and that of low potassium intake was 88.8% (85.1% males, 92.3% females, P < .001). Sodium consumption was inversely associated with older age, higher education, and low glomerular filtration rate but was directly associated with being male, current smoking, and obesity. Overall, males had higher sodium consumption than women, with the effect being larger among hypertensive men. Women with hypertension had lower sodium consumption than nonhypertensive women; however, hypertensive men had higher sodium consumption than nonhypertensive men. Potassium consumption was higher among men, persons with obesity, and those with high total cholesterol but was lower among men with "more than high school" education compared to men with "less than high school" education. We conclude that most Jamaican adults have diets high in sodium and low in potassium. In this study, sodium consumption was directly associated with male sex, obesity, and current smoking but was inversely associated with older age and higher education. High potassium consumption was associated with obesity and high cholesterol levels. These associations should be further explored in longitudinal studies and population-based strategies should be developed to address these cardiovascular risk factors.


Assuntos
Hipertensão , Sódio na Dieta , Adulto , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Sódio/urina , Jamaica/epidemiologia , Potássio/urina , Estudos Transversais , Hipertensão/epidemiologia , Obesidade , Estilo de Vida
11.
Nat Commun ; 14(1): 6882, 2023 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-37898615

RESUMO

Bats are natural reservoirs for several zoonotic viruses, potentially due to an enhanced capacity to control viral infection. However, the mechanisms of antiviral responses in bats are poorly defined. Here we established a Jamaican fruit bat (JFB, Artibeus jamaicensis) intestinal organoid model of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Upon infection with SARS-CoV-2, increased viral RNA and subgenomic RNA was detected, but no infectious virus was released, indicating that JFB organoids support only limited viral replication but not viral reproduction. SARS-CoV-2 replication was associated with significantly increased gene expression of type I interferons and inflammatory cytokines. Interestingly, SARS-CoV-2 also caused enhanced formation and growth of JFB organoids. Proteomics revealed an increase in inflammatory signaling, cell turnover, cell repair, and SARS-CoV-2 infection pathways. Collectively, our findings suggest that primary JFB intestinal epithelial cells mount successful antiviral interferon responses and that SARS-CoV-2 infection in JFB cells induces protective regenerative pathways.


Assuntos
COVID-19 , Quirópteros , Interferon Tipo I , Vírus , Animais , SARS-CoV-2 , Jamaica , Antivirais , Organoides
12.
Transcult Psychiatry ; 60(5): 835-843, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37904537

RESUMO

This article presents a case study of an innovative culturally based therapeutic approach using collective poiesis to improve the functioning of a youth sports team in Jamaica. In recent decades, Jamaica has endured high levels of violence and corruption, and has been ranked among the top four countries in the world in terms of murder rate per capita. We conjecture that a high prevalence of personality disorder linked to the legacy of slavery and colonialism often impedes Jamaicans from achieving success in diverse fields, including sports. Psychological interventions in the preparation of football teams are a novelty, and have been used mainly to enhance global team performance or individual player skill. The use of psychological interventions to address personality disorder psychopathology on the soccer pitch has not been reported. Psychohistoriographic cultural therapy (PCT) integrates psychological perspectives with a dialectic method of historical analysis and uses collective poiesis as a vehicle to translate insights through an embodied cognitive restructuring process. Two workshops were carried out with a high school football team using PCT techniques. The process of dialectic reasoning engaged their collective ideas and insights to establish a psychic centrality that was expressed in poetic form to illustrate the pathologies of the group in an emotionally safe and psychologically acceptable narrative. This poetic narrative of the group's psychic centrality counters the personality disorder psychopathology caused by the lingering intergenerational wounds of slavery, colonial oppression and collective trauma.


Assuntos
Futebol , Adolescente , Humanos , Jamaica/epidemiologia , Instituições Acadêmicas
13.
Am J Trop Med Hyg ; 109(6): 1344-1350, 2023 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-37871588

RESUMO

Mother to child transmission (MTCT) of human T-cell lymphotropic virus (HTLV)-1 is associated with increased risk of adult T-cell leukemia and can be unrecognized without routine antenatal screening. We assessed the seroprevalence of HTLV-1/2 among pregnant women attending The University Hospital of the West Indies Antenatal Clinic, 2019, and validated a cost-effective strategy to screen antenatal clinic attendees for HTLV-1/2. Residual antenatal samples from 370 women were tested for HTLV-1/2 by chemiluminescence microparticle immunoassay (CMIA). Six samples were confirmed HTLV-1 positive by Western blot (none for HTLV-2) for a prevalence of 1.62%. Four mother-child pairs were able to be recruited for HTLV testing of children, with two children testing HTLV-1/2 positive. Medical records of HTLV-1-infected women revealed that all women breastfed, indicating an unrecognized risk for HTLV MTCT. To assess whether pooling of samples as a cost-reduction strategy could be introduced, we pooled all antenatal samples received between November and December 2021 into 12 pools of eight samples/pool. Two pools were CMIA positive, and de-pooling of samples identified two CMIA-positive samples (one per pool), both confirmed as HTLV-1 by Western blot. These results indicate that HTLV-1 remains prevalent in pregnant Jamaican women and that sample pooling can be a cost-effective strategy to limit MTCT in Jamaica.


Assuntos
Infecções por HTLV-I , Vírus Linfotrópico T Tipo 1 Humano , Adulto , Feminino , Humanos , Gravidez , Infecções por HTLV-I/diagnóstico , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/prevenção & controle , Estudos Soroepidemiológicos , Jamaica/epidemiologia , Transmissão Vertical de Doenças Infecciosas , Diagnóstico Pré-Natal , Linfócitos T
15.
PLoS Pathog ; 19(10): e1011728, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37856551

RESUMO

Insectivorous Old World horseshoe bats (Rhinolophus spp.) are the likely source of the ancestral SARS-CoV-2 prior to its spillover into humans and causing the COVID-19 pandemic. Natural coronavirus infections of bats appear to be principally confined to the intestines, suggesting fecal-oral transmission; however, little is known about the biology of SARS-related coronaviruses in bats. Previous experimental challenges of Egyptian fruit bats (Rousettus aegyptiacus) resulted in limited infection restricted to the respiratory tract, whereas insectivorous North American big brown bats (Eptesicus fuscus) showed no evidence of infection. In the present study, we challenged Jamaican fruit bats (Artibeus jamaicensis) with SARS-CoV-2 to determine their susceptibility. Infection was confined to the intestine for only a few days with prominent viral nucleocapsid antigen in epithelial cells, and mononuclear cells of the lamina propria and Peyer's patches, but with no evidence of infection of other tissues; none of the bats showed visible signs of disease or seroconverted. Expression levels of ACE2 were low in the lungs, which may account for the lack of pulmonary infection. Bats were then intranasally inoculated with a replication-defective adenovirus encoding human ACE2 and 5 days later challenged with SARS-CoV-2. Viral antigen was prominent in lungs for up to 14 days, with loss of pulmonary cellularity during this time; however, the bats did not exhibit weight loss or visible signs of disease. From day 7, bats had low to moderate IgG antibody titers to spike protein by ELISA, and one bat on day 10 had low-titer neutralizing antibodies. CD4+ helper T cells became activated upon ex vivo recall stimulation with SARS-CoV-2 nucleocapsid peptide library and exhibited elevated mRNA expression of the regulatory T cell cytokines interleukin-10 and transforming growth factor-ß, which may have limited inflammatory pathology. Collectively, these data show that Jamaican fruit bats are poorly susceptible to SARS-CoV-2 but that expression of human ACE2 in their lungs leads to robust infection and an adaptive immune response with low-titer antibodies and a regulatory T cell-like response that may explain the lack of prominent inflammation in the lungs. This model will allow for insight of how SARS-CoV-2 infects bats and how bat innate and adaptive immune responses engage the virus without overt clinical disease.


Assuntos
COVID-19 , Quirópteros , Animais , Humanos , SARS-CoV-2 , Enzima de Conversão de Angiotensina 2 , Pandemias , Jamaica , Linfócitos T Reguladores
16.
Global Health ; 19(1): 69, 2023 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-37700357

RESUMO

BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical context to investigate underlying drivers of commercial determinants of health and attempts to counter them. We asked: how can a historical perspective of the drivers of high level SSB consumption in Jamaica contribute to an enhanced understanding of the context of public health policies aimed at reducing their intake? METHODS: An ethnographic approach with remote data collection included online semi-structured interviews and workshops with 22 local experts and practitioners of health, agriculture and nutrition in Jamaica and attending relevant regional public webinars on SSBs and NCD action in the Caribbean. Our analysis was situated within a review of historical studies of Caribbean food economies with focus on the twentieth century. Jamaican and UK-based researchers collected and ethnographically analysed the data, and discussed findings with the wider transdisciplinary team. RESULTS: We emphasise three key areas in which historical events have shaped contextual factors of SSB consumption. Trade privileged sugar as a cash crop over food production during Jamaica's long colonial history, and trade deregulation since the 1980s through structural adjustment opened markets to transnational companies. These changes increased Jamaican receptiveness to the mass advertisement and marketing of these companies, whilst long-standing power imbalances hampered taxation and regulation in contemporary public health actions. Civil society efforts were important for promoting structural changes to curb overconsumption of SSBs and decentring such entrenched power relations. CONCLUSION: The contemporary challenge of SSBs in Jamaica is a poignant case study of commercial determinants of health and the important context of global market-driven economies and the involvement of private sector interests in public health policies and governance. Historically contextualising these determinants is paramount to making sense of the sugar ecology in Jamaica today and can help elucidate entrenched power dynamics and their key actors.


Assuntos
Bebidas Adoçadas com Açúcar , Humanos , Região do Caribe , Jamaica , Pesquisa Qualitativa , Açúcares
17.
Psychol Sport Exerc ; 67: 102434, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37665887

RESUMO

Guided by the Sport-Confidence Model, this study examined the associations among a positive body image, sport-confidence, and sport performance evaluations. Using a cross-sectional design, a purposive sample of 314 Jamaican athletes (male = 70.7%; Mage = 22.85; SD = 4.89) completed measures of body and functionality appreciation, sport-confidence, and subjective sport performance. Results from path analysis provided evidence for good model-data fit. Body (B = 9.03, p < .001) and functionality (B = 4.93, p = .036) appreciation exerted direct effects on sport-confidence. Sport-confidence exerted a direct effect on sport performance evaluations (B = 0.09, p < .001). Body (B = 0.79, CI95% [0.44, 1.17]) and functionality (B = 0.43, CI95% [0.05, 0.92]) appreciation exerted indirect effects on sport performance evaluations through sport-confidence. Results indicate that supporting the development of a positive body image in athletes may contribute to feelings of sport-confidence and positive performance outcomes.


Assuntos
Imagem Corporal , Esportes , Masculino , Humanos , Adulto Jovem , Adulto , Estudos Transversais , Jamaica , Atletas
18.
J Speech Lang Hear Res ; 66(12): 4716-4738, 2023 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-37549376

RESUMO

PURPOSE: There is a shortage of available methods to accurately inform the developmental status of children whose cultural and linguistic backgrounds vary from the mainstream. The purpose of this review article was to describe different approaches used to support the accurate characterization of speech, language, and functional communication in children speaking Jamaican Creole and English, an understudied paradigm in the speech pathology research. METHOD: Approaches used across four previously published studies in the Jamaican Creole Language Project are described. Participants included 3- to 6-year-old Jamaican children (n = 98-262) and adults (n = 15-33). Studies I and II described validation efforts about children's functional communication using the Intelligibility in Context Scale (ICS; speech) and the Focus on the Outcomes of Communication Under Six (FOCUS; speech and language). Study III described efforts to accurately characterize difference and disorder in children's expressive grammar using adapted scoring, along with adult models to contextualize child responses. Last, Study IV applied acoustic duration (e.g., whole word) and an adapted scoring protocol to inform variation in speech sound productions in the Jamaican context where a post-Creole continuum exists. RESULTS: Studies I and II offered promising psychometric evidence about the utility of the ICS and the FOCUS. Study III revealed strong sensitivity and specificity in classifying difference and disorder using adult models. Last, in Study IV, linguistically informed acoustic analyses and an adapted protocol captured variation in speech productions better than a standard approach. CONCLUSIONS: Applying culturally responsive methods can enhance the accurate characterization of speech, language, and functional communication in Jamaican children. The innovative methods used offer a model approach that could be applied to other linguistic contexts where a mismatch exists between speech-language pathologists and their clientele. PRESENTATION VIDEO: https://doi.org/10.23641/asha.23929461.


Assuntos
Transtornos da Comunicação , Idioma , Criança , Humanos , Pré-Escolar , Jamaica , Fala , Fonética
19.
J Natl Med Assoc ; 115(5): 475-481, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37550160

RESUMO

OBJECTIVE: Children with sickle cell disease (SCD) are at risk for neurocognitive deficits that can affect school performance, and psychosocial functioning. The aim of this study was to assess the academic performance of school-aged children with SCD in Jamaica compared to their school peers. METHOD: A cross-sectional survey of academic performance was done in a group of children 11 to 13 years of age, using a standardized state administered examination, the Grade Six Achievement Test (GSAT), covering 5 subjects. Scores were obtained from the Ministry of Education (MOE) for eligible children with SCD, as well as mean scores with standard deviation for unaffected classmates by gender. Socio-demographic and clinical data were obtained from our sickle cell clinic database and an interview administered questionnaire. RESULTS: Sixty-four children satisfied eligibility criteria. Children with SCD had lower percentage scores and significantly lower mean z-scores for 4 of 5 subjects (p < 0.05). Males had significantly lower mean z-scores compared with females. Thirty-seven children (57.8%) were classified as underperformers. Haemoglobin level was a significant predictor of subject score rank. CONCLUSION: Children with SCD in Jamaica perform worse in standardized school examinations than their class peers with boys being particularly vulnerable.


Assuntos
Desempenho Acadêmico , Anemia Falciforme , Masculino , Feminino , Humanos , Criança , Jamaica/epidemiologia , Estudos Transversais , Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia , Escolaridade
20.
Perfil de carga de enfermedad por diabetes 2023OPS/NMH/NV/23-0024.
Monografia em Espanhol | PAHO-IRIS | ID: phr-57846

RESUMO

El propósito fundamental de esta serie de perfiles nacionales de la carga de enfermedad por diabetes y de enfermedad renal crónica debida a diabetes es apoyar a los países de la Región de las Américas en el seguimiento de las estrategias puestas en marcha para enfrentar la diabetes. Esta primera versión de los perfiles, que abarca el período comprendido entre el 2000 y el 2019, muestra la tendencia de la mortalidad, los años de vida perdidos por muerte prematura, los años vividos con discapacidad y los años de vida ajustados por discapacidad de ambas enfermedad. Se han elaborado con los últimos datos disponibles de las estimaciones mundiales de salud de la Organización Mundial de la Salud y tiene como objetivo convertirse en una herramienta útil para llevar a cabo el monitoreo de las estrategias conexas.


Assuntos
Diabetes Mellitus , Nefropatias , Perfis Sanitários , Jamaica
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