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1.
In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1046261

RESUMO

Objective: To compare biomedical research productivity among selected CARICOM countries. Design and Methodology: Biomedical publications of the selected CARICOM countries (Bahamas, Barbados, Dominica, Guyana, Grenada, Haiti, Jamaica, Suriname, and Trinidad & Tobago) were retrieved using 'PubMed' and 'ScImago Journal & country Rank' (SJR) databases. The publications for each country were then normalized by factors such as total population, gross domestic product (GDP) and Internet usage rate. Results: Total number of papers published by all 9 countries was 7,281 and 8,378 in PubMed (1990- 2015) and SJR databases (1996-2017) respectively. Jamaica produced highest number of biomedical publications [PubMed: 3,928 (54%) and SJR: 2,850 (34%)]. However, when adjusted, Grenada had the highest research publications per million populations, per billion GDP and per 1,000 Internet users in both databases. For trend analysis, PubMed showed that Jamaica produced highest number of additional publications each year ­ on an average 4.8 followed by Trinidad & Tobago (4.4). According to SJR, Jamaica had also highest number of citations (42,311) and H-index (76) followed by Trinidad & Tobago (29,152 and 71). Barbados had the highest number of citations per document (24.9) followed by Haiti (18.4). Conclusion: There was a marked imbalance noted among the CARICOM countries in terms of biomedical research and publications. A CARICOM-wide research may be embarked to explore disparities in biomedical research productivity and thus formulate informed health policies to alleviate diseases and eradicate poverty.


Assuntos
Pesquisa Biomédica , Suriname , Bahamas , Trinidad e Tobago , Barbados , Região do Caribe/etnologia , Dominica , Guiana , Haiti , Jamaica
2.
In. The University of the West Indies, Faculty of Medical Sciences. Faculty of Medical Sciences, Research Day. St. Augustine, Caribbean Medical Journal, March 21, 2019. .
Não convencional em Inglês | MedCarib | ID: biblio-1046374

RESUMO

Objective: Life expectancy at birth is a robust indicator of the mortality profile in any spatial unit. The paper draws on age-associated life expectancy estimates from six Caribbean nations between 1950 and 2015 to assess variable gain in longevity of life at various stages of human lifespan and make claims about the variable impact of nation-specific sociomedical interventions as well as likely lessons to be learned. Design and Methodology: Using Mixed Methodology, secondary data are drawn from the United Nations Population Databases that reflect mortality profiles at national and regional levels. The data relate to six Caribbean nations ­ Cuba, Barbados, Jamaica, Trinidad and Tobago, Guyana and Haiti and permit the detection of changes in age-associated life expectancy over 20-year intervals including four time points ­ 1955, 1975, 1995 and 2015. Descriptive statistics are used to discern variable national trends that could be understood drawing on qualitative evidence obtained from documentary research and elite interviews. Results: Three distinct mortality profiles emerge with the most favourable being in Cuba and Barbados, the least favourable in Guyana and Haiti, and Jamaica and Trinidad and Tobago being located between the two extremes. The timing and magnitude of gains in infant, child, adult and geriatric health states can be discerned from the results. Conclusion: The paper is heuristic and constitutes a basis comparing the effectiveness of primary, secondary and tertiary health care in promoting human resilience to mortality. As such, the paper provides important ameliorative lessons that have implications for critically informing the administration of health policies.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Epidemiologia , Trinidad e Tobago , Barbados , Mortalidade , Região do Caribe/epidemiologia , Cuba , Guiana , Haiti , Jamaica
3.
Kingston; Jamaica. Ministry of Health; Oct. 2017. 23 p. tab, graf, ilus.(Vitals: A quarterly report of the Ministry of Health).
Monografia em Inglês | MedCarib | ID: biblio-909675

RESUMO

This publication presents a special feature on surgeries performed in public hospitals for the reference period, January to March 2017. Readers will find the 22% percent reduction in live births (compared to similar period in 2016) an interesting observation, particularly when viewed against the background of the Zika outbreak and the encouragement to families to delay pregnancies.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Zika virus , Jamaica , Relatório de Pesquisa
4.
Kingston; Jamaica. Ministry of Health. Emergency Disaster Management and Special Services Branch; [2017]. 12 p. tab.
Não convencional em Inglês | MedCarib | ID: biblio-906600

RESUMO

A clinical management protocol for the Zika Virus was prepared for medical professionals by the Emergency, Disaster Management and Special Services Branch of the Ministry of Health, Jamaica. This protocol outlines clinical features, symptoms, and management procedures for medical and health personnel and the way they should respond to suspected cases of ZIka among pregnant women.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Protocolos Clínicos , Microcefalia , Zika virus , Jamaica/epidemiologia
5.
Kingston; Jamaica. Ministry of Health. Emergency Disaster Management and Special Services Branch; [2017]. 11 p. tab.
Não convencional em Inglês | MedCarib | ID: biblio-906601

RESUMO

This document discusses how the Guillain­Barre syndrome should be handled medical professionals in Jamaica. In addition to an overview of the disease, the clinical presentation, case definition, a sample laboratory diagnosis, treatment and complications are mentioned.


Assuntos
Humanos , Feminino , Gravidez , Administração de Caso , Síndrome de Guillain-Barré , Zika virus , Jamaica/epidemiologia
6.
Kingston; Jamaica. Ministry of Health; [2017]. 122 p. ilus, tab.
Não convencional em Inglês | MedCarib | ID: biblio-906757

RESUMO

The Ministry of Health Highlights of Key Initiatives 2016-2017, includes a look at the national response to the Zika Virus in Jamaica and other issues facing Jamaica's Public Health system.


Assuntos
Humanos , Masculino , Feminino , Zika virus , Jamaica/epidemiologia , Saúde Pública
7.
West Indian med. j ; 65(Supp. 3): [17], 2016.
Artigo em Inglês | MedCarib | ID: med-18081

RESUMO

OBJECTIVES: Premarin and ketoconazole are affordable secondary hormonal options available for castrate-resistant prostate cancer (CRPC) in Jamaica. The aim of this study was to compare the relative efficacy of both drugs to decrease prostate-specific antigen (PSA) in CRPC in a population of patients of predominantly African escent. SUBJECTS AND METHODS: This study retrospectively identified patients with CRPC that presented to the University Hospital of the West Indies (January 1, 2009-December 31, 2013) and patients from a private urology clinic (November 2, 2005-June 3, 2015). The primary endpoint was to identify the proportion of patients with a decline of ¡Ý 50% in PSA level after treatment. The relative efficacy was assessed by the time to progression (TTP), an increase in PSA of 25% above nadir with PSA progression defined by Prostate Cancer Clinical Trials Working Group2 criteria. RESULTS: Thirty-five patients diagnosed with CRPC were identified; 32 initially treated with premarin and three with ketoconazole. Nine of the patients initially on premarin were crossed over to the ketoconazole treatment roup, bringing to twelve the patients treated with ketoconazole. Decline in PSA of ¡Ý 50% was observed in 43.8% (14 of32) and 25% (3 of 12) of patients on premarin and ketoconazole, respectively. The median (95% CI) TTP for patients treated with premarin was 24.00 (19.28, 28.724)months and ketoconazole was 13.54 (1.66, 25.41) months with no statistically significant difference between the groups (p = 0.107; log rank test). CONCLUSION: The study did not identify differences in the relative efficacy between premarin and ketoconazole in treating patients with CRPC.


Assuntos
Humanos , Neoplasias da Próstata , Jamaica , Região do Caribe
8.
West Indian med. j ; 65(Supp. 3): [18[, 2016.
Artigo em Inglês | MedCarib | ID: med-18082

RESUMO

OBJECTIVE: To analyse the HIV care cascade at the site level at the University Hospital of the West Indies,Kingston, Jamaica. SUBJECTS AND METHODS: This was a retrospective analysis of the national HIV treatment database for all entries between the years 2010 and 2013 identifying the key stepsin the HIV care cascade with an increased focus on parameters influencing viral load suppression. Proportions by classic cascade denominator and new denominators were calculated. Equality of proportions, with corresponding p-values and confidence intervals, was used to assess cascade step differences. RESULTS: Total enrolment in the clinic increased over the period (from 1206 to 1472 patients), as did number of patients receiving antiretroviral therapy [ART] (from 879to 1199). Using the classic denominator approach, significant increases were seen for patients on ART (8.4%,95% CI 0.053, 0.127) and significant declines were seen in viral load samples collected (-5.1%, 95% CI -0.099,-0.001) and viral load results returned (-12.1%, 95% CI-0.164, -0.056). No significant changes were identified in patients engaged in care (p = 0.885) or viral load suppression(p = 0.124). New denominator analysis showed significant changes in patients on ART engaged in care,-9.4% (95% CI -0.116, -0.072), as well as viral load suppression for patients on ART, 7.9% (95% CI 0.009,0.148). CONCLUSIONS: Site-level data can increase the detail included in the HIV care cascade and avoid limitations of the classic cascade. Site-level analysis can provide greater insight into the factors affecting patient outcomes and furnish the required data


Assuntos
Humanos , HIV , Jamaica , Região do Caribe
9.
West Indian med. j ; 65(Supp. 3): [24], 2016.
Artigo em Inglês | MedCarib | ID: med-18096

RESUMO

OBJECTIVE: To determine the association between pelvic floor disorders and selected sociodemographic and health related variables among outpatient gynaecology and urology clinic attendees 50 years and over. SUBJECTS AND METHODS: A total of 272 women 50 years and older were recruited from outpatient clinics at one tertiary hospital in Kingston. They were enrolled consecutively and data pertaining to sexual and genitourinary health, sociodemography, and health and social status were collected through use of an interviewer-administered questionnaire. Bivariate analyses were conducted to identify variables significantly associated with two pelvic floor disorders: symptomatic pelvic organ prolapse (POP) and urinary incontinence (UI). Based on these, a multivariate logistic regression model was developed to identify variables independently associated with having at least one pelvic floor disorder and to determine the strength of associations. RESULTS: Data relating to POP and UI were analysed for 268 and 263 women, respectively. More than half (51.7%) of the women had at least one pelvic floor disorder, withUI being more commonly reported (37.6%) than POP(25%). Controlling for education, hypertension, muscle/joint pain and menstrual status, each additional vaginal delivery was associated with a 15% (2.6%, 29.3%; p =0.017) increase in odds of having at least one pelvic floor disorder. CONCLUSION: Pelvic floor disorders are fairly common among outpatient clinic attendees and a higher number of vaginal deliveries significantly increase the likelihood of their occurrence. Due to their significant influence on health and well-being, risk factor identification is criticalfor informing prevention and mitigation strategies in women’s health.


Assuntos
Diafragma da Pelve/anormalidades , Mulheres , Saúde da Mulher , Jamaica
10.
West Indian med. j ; 65(Supp. 3): [25], 2016.
Artigo em Inglês | MedCarib | ID: med-18098

RESUMO

OBJECTIVES: To measure the prevalence of postpartum depression among women attending postnatal clinics in Kingston, Jamaica, and to determine the risk factors associated with the occurrence of postpartum depression in this population. SUBJECTS AND METHODS: This study was cross-sectional, and surveyed 132 women. The survey was conducted among postnatal women who attended the postnatal clinic at the Victoria Jubilee Hospital (VJH), the University Hospital of West Indies and several government health centres in Kingston during the months of July–September 2015. The survey instrument was a field tested interviewer-assisted questionnaire to which the Edinburgh Postnatal Depression Scale was incorporated to indicate the presence of depressive symptoms among the respondents. RESULTS: The prevalence of postpartum depression among the women in this study is estimated to be 47.7%. Mothers who had a life event with a significant negative impact were 2.7 times more likely to have postpartum depressive symptoms than those who did not (OR = 2.7; 95% CI 1.02,7.17; p = 0.046), and mothers who were unemployed were 60% more likely to develop postpartum depressive symptoms than those who were employed (OR = 1.60; 95% CI1.17, 2.18; p = 0.003).CONCLUSION: The prevalence of postpartum depressive symptoms in the Jamaican population of postpartum women in this study is higher than previous estimates andhigher than the World Health Organization estimates(2015). Studies should be undertaken with larger sample sizes to unearth further risk factors that may predispose women to postpartum depressive symptoms in Jamaica.


Assuntos
Criança , Humanos , Feminino , Depressão Pós-Parto , Cuidado Pós-Natal , Jamaica
11.
West Indian med. j ; 65(Supp. 3): [44], 2016.
Artigo em Inglês | MedCarib | ID: med-18127

RESUMO

OBJECTIVES: To evaluate whether education attainment oroccupation class was associated with the prevalence of tobacco smoking among Jamaican adults. SUBJECTS AND METHODS: This study was a secondary analysis of data collected from the Jamaica Health and Lifestyle Survey 2007–2008 (JHLS-II) and included participants who were 25–74 years old. Data on current tobacco smoking, highest educational attainment and usual occupation were collected using an interviewer-administered questionnaire. Poisson regression models were used to estimate sex-specific, age-adjusted prevalence and prevalence ratios (PR). RESULTS: Analyses included 2299 participants (696 men,1603 women) with mean age of 42.9 years. Prevalence of current smoking among men and women was 25.8% and 7.8%, respectively (p < 0.001). Age-adjusted prevalence of current smoking in men was highest in the primary education group (36.5%) and lowest in the post-secondary education group (10.2%), p (trend) = 0.003. Among women, prevalence was highest among those with junior secondary education (10.2%) and lowest among those with primary education (4.7%), p (trend) = 0.014. Using post secondary education as the reference category, age adjusted PR showed statistically significant two- to three fold higher prevalence of current smoking for all the lower education groups among men. Prevalence ratios for women were lower and not statistically significant. Disparity patterns for occupation were similar, with statistically significant higher age-adjusted prevalence among men in the lower occupational categories, but not among women. CONCLUSION: There are large socio-economic disparities in tobacco smoking among men, but less so among women in Jamaica. Interventions to reduce smoking should consider these socio-economic disparities.


Assuntos
Humanos , Masculino , Feminino , Fumar/tendências , Tabaco , Jamaica
12.
West Indian med. j ; 65(1): 243-249, 20160000. tab, maps, graf
Artigo em Inglês | MedCarib | ID: biblio-906595

RESUMO

BACKGROUND: Jamaica, along with the Americas, experienced major epidemics of arboviral diseases transmitted by the Aedes aegypti mosquito in recent years. These include dengue fever in 2012, Chikungunya fever in 2014 and Zika virus infection (ZIKV) in 2016. We present the emergence of the ZIKV epidemic in Jamaica and outline the national response. METHODS: The Ministry of Health's preparedness included: heightened surveillance, clinical management guidance, vector control and management, laboratory capacity strengthening, training and staffing, risk communication and public education, social mobilization, inter-sectoral collaboration, resource mobilization and international cooperation. RESULTS: The first case of ZIKV was confirmed on January 29, 2016 with date of onset of January 17, 2016. From January 3 to July 30, 2016 (Epidemiological Week (EW) 1-30), 4648 cases of ZIKV were recorded (4576 suspected, 72 laboratory-confirmed). Leading symptoms were similar among suspected and confirmed cases: rash (71% and 88%), fever (65% and 53%) and joint pains (47% and 38%). There were 17 suspected cases of Guillain Barre syndrome; 383 were reported in pregnant women, with no reports of microcephaly to date. Zika and dengue viruses were circulating predominantly in 2016. At EW30, 1744 cases of dengue were recorded (1661 suspected and 83 confirmed). Dengue serotypes 3 and 4 were circulating with 121 reports of dengue haemorrhagic fever...(AU) CONCLUSION:The possibility exists for endemicity of ZIKV similar to dengue and chikungunya in Jamaica. A ZIKV vaccine, similar to the dengue and chikungunya vaccines, is needed to be fast-tracked into clinical trials to mitigate the effects of this disease.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Infecções por Arbovirus/transmissão , Controle/métodos , Surtos de Doenças , Zika virus , Jamaica/epidemiologia
13.
Kingston; Jamaica. Ministry of Health. Emergency Disaster Management and Special Services Branch; [2016]. 8 p. ilus.
Não convencional em Inglês | MedCarib | ID: biblio-906602

RESUMO

This document outlines the clinical management protocol Jamaican medical professionals should employ for suspected cases of pregnant women infected with the Zika virus. Clinical features, case definitions, testing procedures, symptoms and pregnancy management are included in this article.


Assuntos
Humanos , Feminino , Gravidez , Protocolos Clínicos , Zika virus , Jamaica/epidemiologia
14.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17922

RESUMO

OBJECTIVE: In the Caribbean, studies of intimate partner violence and aggression (IPVA) have rarely incorporated the experiences of men. In this study we compare the sexes in examining types, frequency and prevalence of IPVA. DESIGN AND METHODS: Data were from a population-based study of 15–30 year olds in Barbados, Jamaica and Trinidad and Tobago. The Revised Conflict Tactics Scales (CTS2) were used to measure incidence levels of IPVA in the 12-months preceding the survey. IPVA was defined as the combination of three subscales: physical violence, sexual coercion and psychological aggression. Physical injury was measured. RESULTS: Of 3,401 participants, more than half had experienced IPVA (53.0%), comprising physical violence (22.1%), sexual coercion (14.5%) and psychological aggression (43.5%). There were no significant differences by sex in IPVA or any contributing subscale. More women experienced injury (odds ratio 1.52; 95% confidence interval 1.07 - 2.15) and women experienced significantly greater frequency of physical violence. Physical violence and psychological aggression were lowest in Trinidad, and sexual coercion was highest in Jamaica with no other statistically significant country-level differences. CONCLUSION: Most of our results do not support the idea that women are the main victims of IPVA. Studies should examine a variety of potential risk factors beyond the sex of victims and perpetrators, as suggested by country differences, with further attention to IPVA frequency. Services should respond to the range of risks. Longitudinal studies and age group comparisons should identify whether these results signify shifts in gender relations within couples.


Assuntos
Mulheres , Violência Doméstica , Agressão , Prevalência , Barbados , Jamaica , Trinidad e Tobago
15.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17925

RESUMO

OBJECTIVE: The purpose of this study was to identify the prevalence of disordered eating behaviours and attitudes in Jamaican high school students and to determine the impact of media exposure. DESIGN AND METHODS: A cross-sectional survey of 524 Jamaican adolescents aged 11-19 years, identified using stratified random sampling, was conducted. Data was collected on sociodemographic factors, eating behaviours and attitudes (Eating Attitudes Test: EAT-26) self-esteem and media influence and anthropometric measurements were taken. Descriptive and inferential statistical analyses were performed at the 5% significance level. RESULTS: Most participants were normal weight (n=385, 76.7%) and males had lower mean body mass index (BMI) than females (females 20.7 ñ 4.2, males 19.4 ñ 3.2; p<0.01) with more females being overweight or obese (females n=46, 16.2%; males 21, 9.6%; p<0.05). Females had higher mean EAT-26 scores than males (females 15.0 ñ9.3, males 12.4 ñ 9.4; p<0.01). The mean media impact score (MIS) was higher in females (females 22.6, CI 21.7, 23.4; males 21.0, CI 20.1, 21.9; p=0.02) and in late adolescence (early adolescence 21.0, CI 20.1, 21.9, late adolescence 22.6, CI 21.7, 23.5; p=0.01). The MIS correlated positively with the EAT 26 score (p<0.001), the negative affect score (p<0.05) and BMI (p<0.05) and negatively with the self-esteem score (p<0.05). CONCLUSION: One in 5 Jamaican adolescents were deemed at risk of developing an eating disorder with an increasing prevalence of more severe disordered eating behaviours such as self-induced vomiting. There is a positive relationship between media influence and disordered eating behaviours and negative affect and a negative relationship with self-esteem.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento do Adolescente , Adolescente , Meios de Comunicação de Massa , Jamaica
16.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17943

RESUMO

OBJECTIVES: Determine the factors associated with violence related injuries (VRI) presenting the Cornwall Regional Hospital (CRH). DESIGN AND METHODS: Data were collected from the Jamaica Injury Surveillance System (JISS) on all patients presenting to the CRH during April and May 2014. This information was collected at hospital registration from all patients with VRIs after triage in the hospital emergency room. RESULTS: A total of 438 patients presented to the Cornwall Regional Hospital during April and May 2014. Complete data were located for 407 of these patients (93%). Of these 58% (237) were males and 42% (170) were female. The most common age group presented in the data was 18-29 years (37%) and blunt trauma was the most common method of injury (34%). The most common circumstance surrounding VRIs was a fight (77%) and 43% of persons were injured by an acquaintance. Gang and drug related VRIs accounted for less than 1% of injuries. CONCLUSIONS: The JISS represents an excellent source of data on VRIs in Montego Bay and Jamaica. It allows the creation of a profile of those injured during violence and the surrounding circumstances. Violence might be a common part of interaction between friends and family.


Assuntos
Violência/tendências , Ferimentos e Lesões , Jamaica
17.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17945

RESUMO

OBJECTIVE: To estimate the economic cost of road traffic fatalities in Jamaica. DESIGN AND METHODS: This study used the Gross Output Approach to estimate the economic cost of road traffic fatalities in Jamaica for 2012 and 2013. It entailed estimating the cost of loss of output, cost of medical treatment, cost of damage to vehicles and other property and administrative cost. RESULTS: The fatalities per accident for 2012 and 2013 were 2.24 and 1.56 respectively. The average age of fatal accident victim is 39. With an average retirement age of 64, the average productive years lost is 26 years. Using an annual average wage of $1,021,488 in 2012 and $1,060,852 in 2013, the discounted loss of output per fatal crash in 2012 and 2013 is $42,131,733.1 and $30,472,454 respectively. CONCLUSION: Estimates from 2012 and 2013 suggested that loss of output alone from road traffic crashes accounted for $42,131,733.1 and $30,472,454 respectively.


Assuntos
Economia da Saúde , Acidentes de Trânsito , Evolução Fatal , Jamaica
18.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17981

RESUMO

OBJECTIVE: To determine the knowledge and beliefs about seizures and actions during seizures of parents/ caregivers of children hospitalised for convulsive seizures. DESIGN AND METHODS: This was a cross-sectional study of parents and caregivers of children with acute convulsive seizures hospitalised at the Bustamante Hospital, Kingston, Jamaica between May 1 and October 31, 2013. Subjects were identified by admission records. Parents/caregivers were invited to participate. A questionnaire on the knowledge, beliefs and response of parents/ caregivers during the child’s current seizure episode was administered face to face. Data were analysed for frequencies; comparisons between groups using Chi Square analysis for categorical variables, and the Mann-Whitney U test for data not normally distributed. RESULTS: Fifty participants were enrolled; 39 (78%) mothers; mean age (SD) was 33.8 (10.1) years. All sought medical care first. Twenty-two (44%) had plausible beliefs about the cause of seizures. Twenty-seven (54%) knew of appropriate actions during a seizure, 10 (20%) knew of appropriate precautions and 11 (22%) responded appropriately during the seizure. Eleven (22%) reported receiving seizure education. Witnessing a previous seizure, education level and seizure education were positively associated with knowledge of seizures (p < 0.05). Socioeconomic status was higher in those with plausible beliefs about seizures and lower in those who took appropriate action during a seizure (p<0.05). CONCLUSION: Parents/caregivers of children with convulsive seizures have appropriate health-care seeking behaviour but inadequate knowledge. Seizure education should be prioritised to improve parental knowledge of and response to convulsive seizures.


Assuntos
Pais , Cuidadores , Conhecimentos, Atitudes e Prática em Saúde , Convulsões , Criança , Jamaica
19.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17983

RESUMO

OBJECTIVES: To assess the effect of educational interventions on disease knowledge, illness perception (IP) and quality of life (QOL) of adolescents with sickle cell disease (SCD) in Kingston, Jamaica. METHODS: A randomized controlled intervention study was conducted among 150 adolescents (ages 13-19 years) attending for routine visits. Baseline disease knowledge, IP and QOL were assessed prior to randomization to 3 groups (Group A: routine care; B: educational booklet; C: booklet + formal counselling) and all measures were repeated 3 months later. Changes in outcomes were analysed using random effects analysis of variance models. RESULTS: There were 76 girls and 74 boys (Mean age 16.1ñ1.9 years; 77% had homozygous SS disease), of whom 63.3% were reviewed at three months. Baseline knowledge was higher: with age (p value: 0.007) and in girls (p value: 0.024). Teen QOL was lower in girls (p value: 0.038) and lower in severe disease (p value< 0.001). Post-intervention knowledge scores were significantly higher within all 3 groups (increase of 1.68 in group A, 2.03 in B and 2.88 in C), but there was nil effect of interventions. There were no changes in QOL or IPs either. Adolescents who had higher knowledge scores had better understanding that their illness was long lasting (Coef: 0.22; p value: 0.008), and they perceived better personal control (Coef: 0.30; p value<0.001), as well as the effect of treatment (Coef: 0.12; p value: 0.01), in managing their illness. CONCLUSIONS: Participation in the study was associated with improved knowledge scores, but interventions per say appeared to have no effects.


Assuntos
Educação , Conhecimentos, Atitudes e Prática em Saúde , Qualidade de Vida , Doença da Hemoglobina SC , Adolescente , Jamaica
20.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17984

RESUMO

OBJECTIVE: Several agencies have recommended integrating early child development interventions with health services. We developed and evaluated a parent training programme integrated into primary health visits. DESIGN AND METHODS: A cluster randomised trial conducted in Jamaica, Antigua and St Lucia with health centre as the unit of randomization. Fifteen centres were randomised to control (n=250 mother-child pairs) and 14 to intervention (n=251). Participants were recruited at the 6-8 week child health visit. Intervention was provided at routine health visits from age 3-18 months and comprised short films of child development messages followed by discussion and demonstration led by community health workers, and mothers’ practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child development, measured 2 weeks after the 18 month visit, with the Griffiths Mental Development Scales and the Communicative Development Inventory (CDI). RESULTS: 85% of enrolled children were tested (control = 210; intervention=216). Loss did not differ by group. Multilevel analyses showed significant intervention benefits for cognitive development, (3.09 points; 95% CI 1.31, 4.87), effect size 0.30 SD. There were no benefits to language or hand and eye subscales, or CDI vocabulary score. Of six secondary outcomes there was a significant benefit to parenting knowledge, treatment effect 1.59 (95% CI 1.01 to 2.17), effect size 0.40. CONCLUSION: An innovative parenting intervention, requiring no additional clinic staff or mothers’ time, can be integrated into health services, with benefits to cognitive development and parent knowledge.


Assuntos
Poder Familiar , Atenção Primária à Saúde , Desenvolvimento Infantil , Jamaica , Antígua e Barbuda , Santa Lúcia
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