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1.
Bone ; 43(1): 156-161, Jul. 2008. tabgraf
Artigo em Inglês | MedCarib | ID: med-17700

RESUMO

Population dynamics predict a drastic growth in the number of older minority women, and resultant increases in the number of fractures. Low bone mineral density (BMD) is an important risk factor for fracture. Many studies have identified the lifestyle and health-related factors that correlate with BMD in Whites. Few studies have focused on non-Whites. The objective of the current analyses is to examine the lifestyle, anthropometric and health-related factors that are correlated with BMD in a population based cohort of Caribbean women of West African ancestry. We enrolled 340 postmenopausal women residing on the Caribbean Island of Tobago. Participants completed a questionnaire and had anthropometric measures taken. Hip BMD was measured by DXA. We estimated volumetric BMD by calculating bone mineral apparent density (BMAD). BMD was >10% and >25% higher across all age groups in Tobagonian women compared to US non-Hispanic Black and White women, respectively. In multiple linear regression models, 35-36% of the variability in femoral neck and total hip BMD respectively was predicted. Each 16-kg (one standard deviation (SD)) increase in weight was associated with 5% higher BMD; and weight explained over 10% of the variability of BMD. Each 8-year (1 SD) increase in age was associated with 5% lower BMD. Current use of both thiazide diuretics and oral hypoglycemic medication were associated with 4-5% higher BMD. For femoral neck BMAD, 26% of the variability was explained by a multiple linear regression model. Current statin use was associated with 5% higher BMAD and a history of breast feeding or coronary heart disease was associated with 1-1.5% of higher BMAD. In conclusion, African Caribbean women have the highest BMD on a population level reported to date for women. This may reflect low European admixture. Correlates of BMD among Caribbean women of West African ancestry were similar to those reported for U.S. Black and White women.


Assuntos
Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Humanos , Feminino , Research Support, Non-U.S. Gov't , Densidade Óssea , Inquéritos Epidemiológicos , Estilo de Vida , Pós-Menopausa , Inquéritos e Questionários , Trinidad e Tobago/epidemiologia , Saúde da Mulher , Grupo com Ancestrais do Continente Africano , Osteoporose Pós-Menopausa
2.
West Indian med. j ; 50(Suppl 5): 21, Nov. 2001.
Artigo em Inglês | MedCarib | ID: med-193

RESUMO

OBJECTIVE: Investigation of the impact of womens' sexual lifestyles on the development of cervical dysplasia. METHODS: Cases were recruited from women referred to the Colcoscopy Clinic, University Hospital of the West Indies, who had abnormal pap smears. Age-matched controls were recruited from the Gynaecology clinic. Women who consented to particpated were guaranteed anonymity and confidentiality and then interviewed on their sexual lifestyles. RESULTS: To date, 223 participants have been recruited: control (n=57), CIN I (n=69), CIN II (n=44), CIN III (n=32), Carcinoma (Ca) (n=9), and 12 cases whose colposcopy results are not yet available. One hundred and sixty-four of the 166 cases were diagnosed with the human papilloma virus (HPV). Twenty percent of the participants were unemployed, 21 percent were skilled/non-manual workers, while 21 percent were semi-skilled non-manual workers. Seven percent of the women occupied professional/managerial positions. There was no significant difference in age at first intercourse, number of lifetime sexual partners, number of biological fathers of their children, use of barrier contraceptives and pap smear history, between controls (n=57) and cases (n=166). When CIN I was grouped with the controls (n=126), there was a significant difference in the number of these women's lifetime sexual partners (4.1ñ2.4), compared to the women with CIN II-Ca (5.2ñ4.2), p=0.029. There was no significant difference in age between the two groups mean/SD (36.6ñ10.1 vs 36.8ñ10.5 yrs). CONCLUSIONS: The findings indicate that factors other than sexual behaviour play a role in the aetiology of cervical dysplasia in this population. (AU)


Assuntos
Feminino , Humanos , Displasia do Colo do Útero/etiologia , Estilo de Vida , Jamaica , Comportamento Sexual , Papel (figurativo)
3.
Artigo em Inglês | MedCarib | ID: med-115

RESUMO

OBJECTIVES: To evaluate the quality of diabetic care in three clinics (one of them private and the other two public) in Jamaica, which is a middle-income country with a high prevalence (13 percent) of diabetes. METHODS: During a six-week census in 1995 at the three clinics we collected data retrospectively on a total of 437 diabetic patients. One of the clinics was a specialist public-hospital clinic ("SPMC"), one was a private group general practice ("PRMC"), and one was a public polyclinic ("PUBMC"). The patients median age ranged from 56 years at SPMC, 9.2 years at PRMC, and 6.3 years at PUBMC. RESULTS: Fewer than 10 percent of the patients wer controlled with diet alone. Insulin was the most commonly prescribed agent at SPMC (46 percent), compared to 7 percent each at the two other clinics. Sulfonylurea drugs alone or in combination with metformin were the most common agents at PUBMC and PRMC. Overall, 40 percent of the patients had satisfactory blood glucose control of (<8 mmol/L fasting or <10 mmol/L postprandial). There was no significant difference among the clinics in the proportion of patients with satisfactory blood glucose control (P= 0.26). A blood glucose measurement had been recorded in the preceding year in 84 percent of the patients at SPMC, 79 percent at PRMC, and 67 percent at PUBMC. Glycosylated hemoglobin was infrequently measured: 16 percent at SPMC, 10 percent at PRMC, and 0 percent at PUBMC. Overall, 96 percent of patients have had surveillance for hypertension, and 81 percent had had surveillance for proteinuria. Surveillance for foot and retinal complications was generally infrequent and had been noted in patients' clinical records most commonly at SPMC (14 percent for foot complications, and 13 percent for retinal complications). The staff at the three clinics seldom advised the diabetic patients on diet, exercise, and other nonpharmacological measures, according to the clinics' records. CONCLUSIONS: The management of diabetes in Jamaica fell short of international guidelines. Our results also indicate the need to better sensitize health care professionals to these standards in order to reduce the burden of diabetes. (AU)


Assuntos
Adulto , Idoso , Estudo Comparativo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus/terapia , Glicemia/análise , Pressão Arterial , Diabetes Mellitus/complicações , Diabetes Mellitus/fisiopatologia , Pé Diabético , Hospitais Públicos , Jamaica , Estilo de Vida , Educação de Pacientes como Assunto , Prática Privada
4.
Curacao; The Foundation for Promotion of International Cooperation & Research in Health Care; 2001. 144 p. ilus.
Monografia em Inglês | MedCarib | ID: med-16388

RESUMO

'The Saba Health Study' is the first large scale health interview survey of the island. This book presents the main results of the study. It discusses the population's health status, use of health services, and satisfaction with health care. Known health risks, such as smoking, alcohol consumption, and overweight are evaluated and compared with situations on the sister island of Curacao and in western countries. Attention is focused on the identification of risk groups in need of specific policy interventions and health promotion programs (AU)


Assuntos
Adulto , Humanos , Estudo Comparativo , Pesquisas sobre Serviços de Saúde , Nível de Saúde , Pesquisa sobre Serviços de Saúde , Qualidade, Acesso e Avaliação da Assistência à Saúde , Antilhas Holandesas , Estilo de Vida , Região do Caribe , Promoção da Saúde , Ética
7.
West Indian Med. J ; 49(4): 307-11, Dec. 2000. tab
Artigo em Inglês | MedCarib | ID: med-456

RESUMO

The aim of this study is to evaluate the impact of a six-month structured education programme on blood pressure (BP) control in patients with uncontrolled hypertension. All patients attending the Specialist Hypertension Clinic, University Hospital of the West Indies (UHWI), between January 4 and March 29, 1999, with blood pressure >140/90 mmHg (n=80), were randomly divided into Group 1, cases (n=42) and Group 2, controls (n=38). A 40-item pretested questionnaire, administered at the baseline and final visits of both groups, elicited demographic, lifestyles and knowledge data. Group 1 attending monthly structured interventions for six months. Except for diastolic blood pressure among male controls, disatolic blood pressure and systolic blood pressure were significantly reduced at the end of the intervention period (p < 0.01). Knowledge improved among the male patients (p < 0.01). Among the female patients, acitivity scores were significantly increased (p < 0.01), weight ( p < 0.05) and BMI (p < 0.05) were significantly reduced. There were no differences in these variables among the controls. This intervention had a benefit in blood pressure control.(Au)


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão/terapia , Educação de Pacientes como Assunto/métodos , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida , Idoso de 80 Anos ou mais , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Fatores Sexuais , Fatores de Tempo
9.
West Indian med. j ; 49(suppl.4): 23, Nov. 9, 2000.
Artigo em Inglês | MedCarib | ID: med-376

RESUMO

This presentation aims to look at promoting active aging from a life course perspective. The study is based on literature review and incorporates views from the World Health Organisation Aging and Health Policy, other experts in the field and from the authors. Stastitics indicate that the year 2025 over 10 percent of the population of most Caribbean countries will be over 70 years old. The current life expectancy at birth in Jamaica and most Caribbean countries is over 72 years for both males and females. This increase in life expectancy has occurred largely due to increased access to, and qualify of, medical care, the increased use of antibiotics, better environmental health, and education. These have all significantly contributed to a decrease in the spread of communicable diseases. The present and future health care professional must understand that active aging is the only way to improve the quality of longevity. This presentation looks at strategies to promote active aging from a life course perspective. This is based on a proactive approach which incorporates educational programmes which focus on all aspects of life and encourage the individual to realize that healthy lifestyles from an early age have lifetime benefits. The teachings of geriatic medicine in medical schools, as well as social and corporate policy and community involvement, are also important aspects of the active aging approach. CONCLUSION: Healthy children have a much greater probability of becoming healthy adults, and healthy older people. It is imperative that this life course perspective of aging be encouraged so that life can be added to the years, even as years are being added to life.(Au)


Assuntos
Humanos , Envelhecimento , Região do Caribe , Estilo de Vida
10.
West Indian med. j ; 50(3): 13, July, 2001.
Artigo em Inglês | MedCarib | ID: med-261

RESUMO

After a hard day at work, there is nothing else like relaxing at home in one's favourite easy chair with favourite beverage and Miles Davis blowing his tunes. Many people are able to enjoy this with the traditional home stereo system. Now, however, the technology has grown to allow you to listen multi-channel music, which completely envelopes one with sound. The audio technology keeps growing at a phenomenal pace. Video is equally intriguing. With options ranging from direct view television to advanced projection systems and combined with an anvanced audio system you can have a home theater which will make you not want to go out to the movies ever again! In this presentation, I will show you how. This is truly technology to own which will reward you for all your hard work. (AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Adolescente , Saúde , Estilo de Vida , Dieta , Exercício Físico , Pensamento
11.
West Indian med. j ; 50(3): 11, July, 2001.
Artigo em Inglês | MedCarib | ID: med-266

RESUMO

Many of us expect to live longer, but find it hard to make the first step to find our retirement. One reason many people put off buliding their wealth temple is that they often lack direction or guidance. Simply put, we need a plan to act on. The four financial pillars which support our wealth temple are short-term savings, wealth accumulation, asset protection and income protection. No matter where we are in our life cycle and what our financial goals are at that juncture, we can best achieve them once we determine our personal and family goals and make plans to attain those goals with help from a financial adviser, and the appropriate investment tool or strategy that the financial adviser believes is best suited for us and our family. The younger we are, the more we should focus on buliding an investment strategy to save and accumulate assets for the future. A budget is needed in every life cycle, but more so in early adulthood. During the career development life cycle, or in our twenties and thirties, earnings are low and need to be channelled to make costly expenditures for a first home and to start a new family. At age 40 to 50 years, we enter the mid-life cycle. In this period, our earnings rise significantly, however, we must provide for children's college needs and life after work. Simultaneously, with larger salaries comes hugh spending on a second home or perhaps a vacation home, a boat, and the desire to start and build a business. While asset growth is still a key objective, we must shift gears to focus on asset preservation. In the golden years of the sixties to seventies, we stand at the door of retirement. Our financial cycle now advances to preservation and liquidation. A retiree's dream is to have a life similar to that enjoyed while working, with a vacation or two, and adequately tending to the necessary medical costs when they arise. Today, as biotechnology reforms healthcare, we will live longer and spend more than 20 years in retirement. If we plan to live longer, we will have an active lifestyle, so we need to establish a regular investment programme for the long-term. So, how can an investment programme support a vibrant lifestyle? Investing is a question of risk versus return. Since 1926, equities have been the best performing asset class. There appears no reason why investments in stocks should not continue to outperform real estate, fixed income, annuities, money markets or any other investment strategy. (AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Estilo de Vida , Investimentos em Saúde/organização & administração , Planejamento Estratégico , Administração Financeira/organização & administração , Financiamento de Capital , Financiamento Pessoal/organização & administração
12.
West Indian med. j ; 49(2): 118-22, Jun. 2000. tab
Artigo em Inglês | MedCarib | ID: med-812

RESUMO

The purpose of this study was to describe the knowledge of hypertension, its management, anthropometric measurements, blood pressure (BP), medication use, and current lifestyles of patients with persistent hypertension. Patients (n=80) attending the Specialist Hypertension Clinic at the University Hospital of the West Indies (UHWI) who had a baseline systolic BP> 140 mmHg and/or a diastolic BP> 90 mmHg were invited to participate in the study. Blood pressure, height, weight, waist and hip circumferences were measured. Body mass index (BMI) and waist/hip ratio (WHR) were calculated. A pretested questionannaire with 40 items eliciting demographic data, level of activity, dietary habits, knowledge of hypertension, medication compliance, use of alternative medicines, and substance use was administered to each participant. Mean BMI for men was 27.65 (95 percent CI 25.7 - 29.6); mean BMI for women was 30.89 (95 percent CI 26.1 - 35.7). In men, there was an association between BMI and WHR, r = 0.62, p<0.05, an association between BMI and diastolic BP and a negative association between BMI and activity level (r= -0.42, p<0.05). Although the majority of both men and women were classified as obese, only 12 percent of men and 7 percent of women recognized diet and overweight as contributing to high blood pressure. Reported diets tended to be high in fat, salt and meats and low in vegetables and fruits; the majority of the participants were sedentary. Medication compliance was good, with a mean of only four days of medications missed per month. These findings suggest that to lower blood pressure in this population, the use of nonpharmacologic theraphy involving lifestyle changes such as improved diet, weight loss and increased physical activity will be important.(AU)


Assuntos
Pessoa de Meia-Idade , Feminino , Humanos , Masculino , Hipertensão/fisiopatologia , Estilo de Vida , Antropometria , Anti-Hipertensivos/uso terapêutico , Índice de Massa Corporal , Dieta , Exercício Físico , Hipertensão/terapia , Distribuição por Sexo , Perda de Peso
14.
West Indian med. j ; 49(Supp 2): 28, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-974

RESUMO

OBJECTIVE: To design and implement a national health promotion programme in the Bahamas. DESIGN AND METHODS: A ten-week programme was designed for Bahamas to incorporate healthy lifestyle behaviour practices. A nurse-physician health team evaluated participants for 10 designated parameters of good health, initially, and then at the end of the ten-week period of health promotion and education. Private and government businesses were invited to enrol their employees as a group and compete for the Healthy Company Awards. RESULTS: From 12 Bahamian Island communities, 6,217 residents participated in the programme, 35 companies registered for the Healthy Company Awards competition. The 10 designated health indices were analyzed in a subset of 23 private companies on the Island of New Providence. In the Healthy Company Awards competition 1,636 persons were enrolled of whom 599 (67.4 percent females, 32.6 percent males) completed the 10-week programme. The mean overall score improved from 5.9 to 7.5 (SE +or- 0>1, p>0001). In the mass media campaign, 3 newspaper articles were published, 7 radio programmes were aired, one TV programme was produced and aired, and weekly health features were spotted at news times on the television and radio. Billboards were strategically placed at the roadside. Government health agencies and health allied Non-Government Organisations (NGOs) coordinated and conducted weekly lectures, four community fora, one health fair, health walks, and a no smoking programme. The national programme was self-funded: $75,331 US was generated from corporate sponsorship and company registration fees, thus balancing the projected budget. CONCLUSION: Bahamians are willing to undertake healthier lifestyles if so informed and educated. The programme's success formalized a health promotion Unit within the Ministry of Health.(Au)


Assuntos
Feminino , Humanos , Masculino , Programas Nacionais de Saúde , Promoção da Saúde , Estilo de Vida , Comportamentos Relacionados com a Saúde , Bahamas
15.
West Indian med. j ; 49(Supp 2): 26, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-979

RESUMO

OBJECTIVE: To study the physical activity habits of adolescent school attenders in Barbados. DESIGN AND METHODS: Four hundred and sixty-two students, randomly selected by school class, attending four schools at different points of the "academic rank ladder", were invited to complete a knowledge, attitudes and practices questionnaire, to be measured, and to have blood drawn. RESULTS: Fifteen percent of these 10-18-year-old students, (males 8 percent, females 20 percent, p<0.001) did not participate in any form of physical activity on a regular basis. The males participated in cycling (54 percent), cricket (52 percent), jogging (50 percent) and football (45 percent), while the females participated in dancing (47 percent) and brisk walking (36 percent). Generally the males were more active than the females. Competing with the physical activity as leisure time activities were more sedentary activities like television viewing, computer and video games, while these adolescents had also experimented with alcohol (60 percent) and cigarettes (9.5 percent). CONCLUSIONS: The role for the health promotion team is clear: to promote increased physical activity in adolescents, to discourage other inappropriate behaviour patterns, and to monitor the influence of adolescent physical activity habits on adult physical activity and ultimately adult disease.(Au)


Assuntos
Criança , Feminino , Humanos , Masculino , Adolescente , Aptidão Física , Exercício Físico , Comportamento do Adolescente , Barbados , Estilo de Vida , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Estudos Transversais , Estudantes , Conhecimentos, Atitudes e Prática em Saúde
16.
Kingston; Lithographic Printers Ltd; Mar. 2000. 187 p. ilus.
Monografia em Inglês | MedCarib | ID: med-504
17.
20.
West Indian med. j ; 48(1): 9-15, Mar. 1999.
Artigo em Inglês | MedCarib | ID: med-1242

RESUMO

A population based probability sample of 958 persons (454 males and 504 females) aged 15 to 49 years was surveyed in Jamaica in late 1993 for lifestyle and behaviour risk factors. Demographic characteristics of the sample were comparable to the general population. 60 percent of persons visited a private doctor the last time that they were ill. Based on self-reporting, 18 percent of the women and 8 percent of the men had never their blood pressure taken. 40 percent of the women had never had a Papanicolaou smear, 29 percent had never had a breast examination and 33 percent said that they were overweight compared with 18 percent of men. Smoking cigarettes and marijuana was more common among men (36 percent) than women (11 percent) as were drinking alcohol (79 percent of men, 41 percent of women) and heavy alcohol use (30 percent of men, 9 percent of women). Injuries requiring medical attention in the previous five years were reported by 40 percent of the men and 15 percent of the women. 34 percent of the men and 12 percent of the women regularly carried a weapon and 18 percent of the sample had participated in or witnessed at least one violent act in the previous month. Most of the people interviewed used a contraceptive method; 10 percent were not sexually active. Significantly more men than women had two or more sexual partners in the previous year (54 percent vs 17 percent, p<0.001) or reported ever having a sexually transmitted disease (29 percent vs 9 percent, p<0.001). Younger persons were more sexually active and more likely to use condoms during the most recent sexual intercourse. Higher socio-economic status and educational level generally had a more positive effect on health behaviour. This survey provides vital information relevant to planning health promotion campaigns and assessing their success.(AU)


Assuntos
Adolescente , Adulto , Estudo Comparativo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atitude Frente a Saúde , Comportamentos Relacionados com a Saúde , Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias da Mama/epidemiologia , Comportamento Contraceptivo , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Jamaica/epidemiologia , Estilo de Vida , Fumar Maconha/epidemiologia , Obesidade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância da População , Fatores de Risco , Fatores Sexuais , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Tabagismo/epidemiologia , Esfregaço Vaginal/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia
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