Industrially produced trans fat and saturated fat content of food products in Jamaica

[ABSTRACT]. Objective. To estimate industrially produced trans and saturated fatty acid levels in foods within the Jamaican food system. Methods. A total of 308 commonly consumed foods were selected for analysis based on their potential to contain trans fatty acids. Samples were collected from supermarkets, convenience stores, and fast-food restaurants. Official methods of gas chromatography for the analysis of fats were used. The results were expressed as grams of fatty acid per 100 g of food sample and percentage of total fatty acids. Results. Total fat was found to exceed United Kingdom National Health Service (NHS) limits in 27.3% (n = 84/308) of food samples. About one-third (33.8%; n = 104/308) of commonly consumed foods in Jamaica contained varying levels of industrially produced trans fatty acids, while 7.8% exceeded the Pan American Health Organization limit of 2% of total fat. Industrially produced trans fatty acids were found in food cate- gories such as canned meats, baked goods, cooking oils, condiments, breakfast cereals, desserts, dairy, spreads, snacks, and confectionery. The subcategories coconut oils and burgers had the highest mean con- tent. Canned food, infant food, and pasta categories had no trans fat present. Saturated fats were found in almost all foods. Importantly, 32.5% (n = 100/308) of the foods had saturated fat concentrations higher than the NHS limit of 5 g per 100 g of food. Most of the food items with high levels of industrially produced trans fatty acids also contained high levels of saturated fats. Conclusions. Food products in Jamaica contain varying levels of fats that exceeded recommendations which support healthy consumption. Further exploration and reformulation efforts are needed to ensure that nutri- tional qualities are improved.

[RESUMEN]. Objetivo. Calcular los niveles de ácidos grasos trans y grasas saturadas producidos industrialmente en ali- mentos del sistema alimentario de Jamaica. Métodos. Se seleccionó un total de 308 alimentos de consumo común para su análisis en función de la posibilidad de que contuvieran ácidos grasos trans. Se recolectaron muestras de supermercados, tiendas de víveres y restaurantes de comida rápida. Para el análisis de las grasas, se utilizaron métodos oficiales de cromatografía de gases. Se expresaron los resultados en gramos por muestra de alimento y grasa total. Resultados. Se concluyó que la grasa total excedía los límites del Servicio Nacional de Salud del Reino Unido (NHS, por su sigla en inglés) en el 27,3% (n = 84/308) de las muestras de alimentos. Alrededor de un tercio (33,8%; n = 104/308) de los alimentos de consumo común en Jamaica contenían niveles variables de grasas trans producidas industrialmente, mientras que el 7,8% excedía el límite de 2% de grasa total de la Organi- zación Panamericana de la Salud. Se encontraron grasas trans producidas industrialmente en categorías de alimentos como carnes enlatadas, productos de repostería, aceites de cocina, condimentos, cereales para el desayuno, postres, lácteos, untables, bocadillos o snacks y dulces. Las subcategorías aceite de coco y hamburguesas mostraron el contenido medio más elevado. Las categorías alimentos enlatados, alimentos infantiles y pasta no presentaron grasas trans. Se encontraron grasas saturadas en casi todos los alimentos. Es importante destacar que el 32,5% (n = 100/308) de los alimentos mostraron concentraciones de grasas saturadas superiores al límite del NHS (5 g por cada 100 g de producto). La mayoría de los alimentos con niveles elevados de ácidos grasos trans producidos industrialmente también contenían altos niveles de gra- sas saturadas. Conclusiones. Los productos alimentarios en Jamaica contienen niveles variables de grasas que excedieron las recomendaciones relativas a un consumo saludable. Es necesario incrementar los esfuerzos de exploración y reformulación para garantizar una mejora de las cualidades nutricionales.

[RESUMO]. Objetivo. Estimar o teor de ácidos graxos trans de produção industrial e ácidos graxos saturados em produ- tos alimentícios consumidos no sistema alimentar jamaicano. Métodos. Trezentos e oito gêneros alimentícios amplamente consumidos foram selecionados para análise, com base em seu potencial para conter ácidos graxos trans. As amostras foram coletadas em supermer- cados, lojas de conveniência e restaurantes de fast-food. Foram utilizados métodos oficiais para análise de ácidos graxos, à base de cromatografia gasosa. Os resultados foram expressos em gramas por gordura total e por amostra de alimento. Resultados. Verificou-se que o teor de gordura total excedeu os limites do Serviço Nacional de Saúde do Reino Unido (NHS) em 27,3% (n = 84/308) das amostras de alimentos. Cerca de um terço (33,8%; n = 104/308) dos alimentos comumente consumidos na Jamaica continham níveis variados de ácidos graxos trans de produção industrial, enquanto 7,8% excediam o limite de 2% de gordura total recomendado pela Organização Pan-Americana da Saúde. Ácidos graxos trans de produção industrial foram encontrados em diferentes categorias de alimentos, como carnes enlatadas, pães e doces, óleos de cozinha, condimentos, cereais matinais, sobremesas, laticínios, pastas, salgadinhos e confeitos. As subcategorias “óleos de coco” e “hambúrgueres” apresentaram o maior teor médio. As categorias “alimentos enlatados”, “alimentos infantis” e “massas” não continham gordura trans. Ácidos graxos saturados foram encontrados em quase todos os alimentos. Cabe notar que 32,5% (n = 100/308) dos alimentos tinham teor de gordura saturada superior ao limite preconizado pelo NHS (5 g por 100 g de alimento). A maioria dos alimentos com alto teor de ácidos graxos trans de produção industrial também continha alto teor de gorduras saturadas. Conclusões. Os produtos alimentícios na Jamaica contêm níveis variados de gorduras, excedendo as recomendações que apoiam o consumo saudável. Mais esforços de exploração e reformulação são necessários para garantir que a qualidade nutricional dos alimentos seja melhorada.

Characterizing Communicative Participation in Multilingual Jamaican Preschoolers.

PURPOSE: This study characterized communicative participation and related aspects of functional communication for Jamaican Creole (JC)-English-speaking preschoolers with and without functionally defined speech sound disorders (fSSDs). This study included parent reports and direct assessment measures from an existing corpus of baseline data collected prior to the COVID-19 pandemic. METHOD: The communicative participation of typically developing (TD; n = 226) bilingual JC-English-speaking preschoolers and those with fSSDs (n = 39) was documented using the Focus on the Outcomes of Communication Under Six (FOCUS). Functional speech intelligibility was recorded using the Intelligibility in Context Scale (ICS) in English and JC (ICS-JC). Objective measures of speech production were collected through direct child assessment in both languages and then transcribed and calculated for percent of consonants (PCC), vowels (PVC), and phonemes correct (PPC). Within-group relationships were explored using association testing, and differences between groups were explored through multivariate analyses. RESULTS: FOCUS scores and ICS and ICS-JC scores were found to be minimally to moderately related for Jamaican preschoolers in the TD group (r = .28-.34, p < .002) and strongly related in the fSSD group (r = .56-.60, p < .002). No relations were observed between the FOCUS scores and PCC/PVC/PPC in either language. There was a statistically significant difference between all FOCUS scores for Jamaican preschoolers in the TD and fSSD groups (p ≤ .002). CONCLUSIONS: These findings provide additional evidence for using the FOCUS beyond documenting change in communicative participation to support clinical decision-making in planning and developing speech-language interventions. This study also documents an important characterization of JC-English-speaking children with and without fSSDs, offering data on children's abilities that can be used in future comparisons of communicative participation and speech functioning observed during the COVID-19 pandemic and beyond.

Neighborhoods and adolescent polysubstance use in Jamaica.

Background: The purpose of this study was to identify latent classes of polysubstance use among adolescents in Jamaica and the role of neighborhood factors in the association with polysubstance use class membership. Methods: This secondary analysis utilized a national cross-sectional household drug use survey conducted across 357 households in Jamaica (April 2016-July 2016) among a total of 4,625 individuals. A total of 750 adolescents (11-17 years) were included in this analysis. Latent class analysis (LCA) was conducted to identify polysubstance use patterns as well as latent neighborhood constructs. Neighborhood factors included social disorganization, concentrated disadvantage, community resources, community violence, and police station concentration. Multinomial regression analysis was implemented to evaluate the association between polysubstance use class membership and latent classes of neighborhood factors. Result: The prevalence of lifetime polysubstance use was 27.56%. Four classes of polysubstance use were identified by comparing a series of five class models. The Bootstrap Likelihood Ratio Test (BLRT) indicated a good fit for the four-class model (<0.001). The prevalence of alcohol latent classes was: (1) heavy alcohol users and experimental smokers (Class I) (15.20%), (2) most hazardous polysubstance users (Class II) (5.33%), (3) heavy smokers and moderate alcohol users (Class III) (7.07%), and (4) experimental alcohol users (Class IV) (72.44%). Three classes of neighborhoods were identified by comparing a series of four-class models. The prevalence of the neighborhood classes was: (1) low social disorganization and disadvantage (Class I) (58.93%), (2) high social disorganization and moderate disadvantage (Class II) (10.93%), and (3) high social disorganization related to perceived drug use and disadvantage (Class III) (30.13%). The BLRT indicated a good fit for the three-class model (p =  < 0.004). Multinomial regression analysis indicated that adolescents living in neighborhoods with high disorder and moderate disadvantage (Class II) were 2.43 times (odds ratio (OR)) = 2.43, confidence interval (CI)) = 1.30-4.56) more likely to be heavy alcohol users and experimental smokers (Class I) compared to experimental alcohol users, adjusting for sex, age, ethnicity, religion, and income. Class II of neighborhood classes presented with the highest levels of community violence (100%), perceived disorder crime (64.6%), police station concentration (6.7%), and community resources (low resources is 87.6%), while the concentrated disadvantage was moderate (14.8%). Conclusions: Alcohol polysubstance use latent classes were identified among youth in this context. Neighborhoods with high disorder and moderate disadvantage (Class II) were associated with a higher likelihood of polysubstance use. The role of neighborhood conditions in shaping adolescent polysubstance use should be considered in policy, prevention, and treatment interventions.

Acceptability and use of waist-worn physical activity monitors in Jamaican adolescents: lessons from the field.

OBJECTIVE: We report our experience with a validated waist-worn activity monitor in Jamaican adolescents attending urban high schools. Seventy-nine adolescents from the Global Diet and Activity Research (GDAR) study, recruited from 5 urban Jamaican high schools (two coeducational (n = 37), two all-female schools (n = 32) and one all-boys school (n = 10)) were asked to wear Actigraph wGT3X-BT accelerometers for 7 days (24-h), removing the device only when bathing or swimming. They also logged wake up and bed times in an activity diary. Accelerometry was considered valid if at least 4 days with ≥ 10-h monitor wear were recorded. Validity was compared by adolescent demographic and school characteristics. We also reviewed the students' written feedback on objective physical activity measurement. RESULTS: Participants, 80.5% female, had a mean age of 15.5 ± 0.8 years with 60% attending schools in low-income communities. Accelerometer return rates were > 98% with 84% providing valid data. Validity did not vary by age group, sex and school setting. While participants were excited about participating in the accelerometer sub-study, commonly reported challenges included monitor discomfort during sleep and maintaining the study diary. Objective measurement of physical activity using 24-h waist-worn accelerometers is feasible and acceptable in Jamaican adolescents.

Characterizing Speech Sound Productions in Bilingual Speakers of Jamaican Creole and English: Application of Durational Acoustic Methods.

PURPOSE: This study examined the speech acoustic characteristics of Jamaican Creole (JC) and English in bilingual preschoolers and adults using acoustic duration measures. The aims were to determine if, for JC and English, (a) child and adult acoustic duration characteristics differ, (b) differences occur in preschoolers' duration patterns based on the language spoken, and (c) relationships exist between the preschoolers' personal contextual factors (i.e., age, sex, and percentage of language [%language] exposure and use) and acoustic duration. METHOD: Data for this cross-sectional study were collected in Kingston, Jamaica, and New York City, New York, United States, during 2013-2019. Participants included typically developing simultaneous bilingual preschoolers (n = 120, ages 3;4-5;11 [years;months]) and adults (n = 15, ages 19;0-54;4) from the same linguistic community. Audio recordings of single-word productions of JC and English were collected through elicited picture-based tasks and used for acoustic analysis. Durational features (voice onset time [VOT], vowel duration, whole-word duration, and the proportion of vowel to whole-word duration) were measured using Praat, a speech analysis software program. RESULTS: JC-English-speaking children demonstrated developing speech motor control through differences in durational patterns compared with adults, including VOT for voiced plosives. Children's VOT, vowel duration, and whole-word duration were produced similarly across JC and English. The contextual factor %language use was predictive of vowel and whole-word duration in English. CONCLUSIONS: The findings from this study contribute to a foundation of understanding typical bilingual speech characteristics and motor development as well as schema in JC-English speakers. In particular, minimal acoustic duration differences were observed across the post-Creole continuum, a feature that may be attributed to the JC-English bilingual environment. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21760469.

The Irie Classroom Toolbox: Mixed method assessment to inform future implementation and scale-up of an early childhood, teacher-training, violence-prevention programme.

Introduction: Violence against children (VAC) is a violation of child rights, has high prevalence in low- and middle-income countries, is associated with long-term negative effects on child functioning, and with high economic and social costs. Ending VAC at home and at school is thus a global public health priority. Methods: In Jamaica, we evaluated an early childhood, teacher-training, violence-prevention programme, (the Irie Classroom Toolbox), in a cluster-randomised trial in 76 preschools. The programme led to large reductions to teachers' use of VAC, although the majority of teachers continued to use VAC at times. In this paper, we describe a mixed-method evaluation of the Irie Classroom Toolbox in the 38 Jamaican preschools that were assigned to the wait-list control group of the trial. In a quantitative evaluation, 108 preschool teachers in 38 preschools were evaluated at pre-test and 91 teachers from 37 preschools were evaluated at post-test. One preschool teacher from each of these 37 preschools were randomly selected to participate in an in-depth interview as part of the qualitative evaluation. Results: Preschool teachers were observed to use 83% fewer instances of VAC across one school day after participating in the programme, although 68% were observed to use VAC at least once across two days. The qualitative evaluation confirmed these findings with all teachers reporting reduced use of violence, but 70% reporting continued use of VAC at times. Teachers reported that the behaviour change techniques used to deliver the intervention increased their motivation, knowledge and skills which in turn led to improved child behaviour, improved relationships and improved professional well-being. Direct pathways to reduced use of VAC by teachers were through improved child behaviour and teacher well-being. The main reasons for continued use of VAC were due to barriers teachers faced using positive discipline techniques, teachers' negative affect, and child behaviours that teachers perceived to be severe. Discussion: We describe how we used the results from the mixed-method evaluation to inform revisions to the programme to further reduce teachers' use of VAC and to inform the processes of training, supervision and ongoing monitoring as the programme is scaled-up through government services.

Distinguishing Four Calliphoridae Species (Diptera) from Jamaica Using the Cephalopharyngeal Skeleton: Application to Forensic Investigations.

Flies of the family Calliphoridae, commonly called blow flies, are important in the decomposition process. Knowledge on their succession pattern on corpses, species identification and the duration of their life cycle stages can be useful in forensic investigations especially when estimating the post-mortem interval. We performed linear-based morphometrics on the cephalopharyngeal skeleton of four blow fly species found in Jamaica to distinguish species and determine larval development stage. We collected eggs from pigs' heads used as bait in the field and conducted rearing exercises in the laboratory. We used the internal skeletonized structure, the cephalopharyngeal skeleton, to develop a practical and efficient method for species identification. For the first instar, we found species can be differentiated using all the measurements analysed in the study. We found that the mouth hook length may be useful in distinguishing larvae in the second instar. For the larvae in the third instar, the whole length of the skeleton, from mouth hook to length of the dorsal cornue, may be useful for separating species. We provide information on the cephalopharyngeal skeleton of Lucilia lucigerens (James), a blow fly species endemic to Jamaica, for the first time. Our work provides relevant information that could be utilized for species identification and life stage determination if fly evidence is to be incorporated in forensic investigations in Jamaica.

Annual Report 2021. Jamaica, Bermuda, and Cayman Islands: Responding to COVID-19 and Preparing for the Future

This Pan American Health Organization/World Health Organization Annual Report outlines contributions and achievements in Jamaica, Bermuda, and the Cayman Islands in the year 2021. The report also reinforces PAHO/WHO's core mission, through focus on the country level, recognizing that progress toward sustainable development hinges on improved health at the local and national levels. In 2021, PAHO/WHO supported Jamaica, Bermuda and the Cayman Islands on their path toward disaster risk reduction as well as the ongoing implementation of Phase II of the Smart Health Care Facilities in the Caribbean Project. This project, which aims to enhance the resilience of health facilities to ensure continuity of service delivery before, during and after hazards, such as hurricanes, has led to the upgrade of nine facilities so far. Working toward the upcoming restructuring of the Jamaican Ministry of Health and Wellness (MOHW) and Regional Health Authorities (RHAs) and health care reform in Jamaica, the country signed a technical cooperation agreement with PAHO to provide a national voluntary contribution, with projects developed to strengthen public financial management and results-based management, as well as a strategic plan for health information systems and a concept note for policy on health research. PAHO supported Jamaica’s efforts as the pandemic impact underscored the need to include mental health in emergency and disaster management, as well as activities that contributed to achieving milestones in tobacco control and road safety. Furthermore, PAHO assisted with initiatives to tackle the high prevalence of Noncommunicable Diseases (NCDs) in the population and promote better nutrition, such as the National Infant and Young Child Feeding Policy and Strategic Plan and front-of-package labelling.

A REVIEW OF NEOPLASMS IN A POPULATION OF JAMAICAN FRUIT BATS (ARTIBEUS JAMAICENSIS) UNDER HUMAN CARE.

Although reports of tumors in chiropteran species are rare, postmortem examinations conducted on aging captive populations suggest that neoplasia may be more prevalent and clinically more significant contributors to morbidity and mortality than previously appreciated in these animals. A retrospective study was conducted to describe cases of neoplasia identified in Jamaican fruit bats (Artibeus jamaicensis) under human care at the Vancouver Aquarium between 01 January 2013 and 31 March 2021. Approximately 13.2% (N = 47/355) of the bat population died within this time span, and gross and histologic postmortem examinations were performed on 28 of 47 individuals. There were eight malignant and three benign neoplasms detected in 10 cases (eight females, two males), including: malignant histiocytoma, esophageal adenocarcinoma, two squamous cell carcinomas, spindle cell sarcoma, periosteal chondrosarcoma, uncharacterized uterine neoplasia with unrelated multicentric pulmonary carcinoma, and cholangiocarcinoma. Benign variants included three suspected uterine leiomyomas. A wide variety of tumor types and tissue predilections were identified, suggesting a complex and perhaps multifactorial pathogenesis in neoplastic transformation in microchiropterans. To the authors' knowledge, these tumor types have not been previously described in Artibeus sp., and some of these neoplasms have not previously been reported in chiropterans.

Interactions between Environmental Factors and Glutathione S-Transferase (GST) Genes with Respect to Detectable Blood Aluminum Concentrations in Jamaican Children.

Aluminum (Al) is a metallic toxicant at high concentrations following natural or unnatural exposures. Dietary intake is considered as the main source of aluminum exposure in children. We used data from 366 typically developing (TD) children (ages 2-8 years) who participated as controls in an age- and sex-matched case-control study in Jamaica. We investigated additive and interactive associations among environmental factors and children's genotypes for glutathione S-transferase (GST) genes (GSTT1, GSTM1, GSTP1), in relation to having a detectable blood aluminum concentration (BAlC) of >5.0 µg/L, using multivariable logistic regression models. Findings from interactive models revealed that the odds of having a detectable BAlC was significantly higher among children who ate string beans (p ≤ 0.01), whereas about 40% lower odds of having a detectable BAlC was observed in children with higher parental education level, (p = 0.02). A significant interaction between consumption of saltwater fish and GSTP1 in relation to having a detectable BAlC using either co-dominant or dominant genetic models (overall interaction p = 0.02 for both models) indicated that consumption of saltwater fish was associated with higher odds of having a detectable BAlC only among children with the GSTP1 Ile105Val Ile/Ile genotype using either co-dominant or dominant models [OR (95% CI) = 2.73 (1.07, 6.96), p = 0.04; and OR (95% CI) = 2.74 (1.08, 6.99), p = 0.03]. Since this is the first study from Jamaica that reports such findings, replication in other populations is warranted.

Culture and Self-Care: Practices in Jamaican Adults with Diabetes Mellitus Residing in South Florida.

Jamaican adults with diabetes mellitus (DM) living in South Florida often believe taking conventional medications can cause harm. In an effort to limit adverse effects of these medicines, they frequently engage in folk care. However, this practice could actually increase risks of DM-associated complications, such as chronic kidney disease. Little is known about what folk care Jamaican adults are integrating into everyday health care. This focused ethnography explored and described how Jamaican adults with DM who live in South Florida use folk care for managing their DM. Knowing what folk care is part of everyday health practices among ethnical and racially diverse populations, such as Jamaican adults in this study, can help inform nephrology nursing practice and support future research.

Vitamin D Deficiency at Diagnosis Increases All-Cause and Prostate Cancer-specific Mortality in Jamaican Men.

BACKGROUND: 25 hydroxyvitamin D [25(OH)D] and serum calcium have been associated with incident prostate cancer (PCa). However, there is limited data on whether these metabolites predict survival in men of African descent, a population disproportionately affected by PCa. We studied the relationship of 25(OH)D at PCa diagnosis with all-cause and cancer-specific mortality among Jamaican men and examined whether serum calcium modified any associations. METHODS: Serum 25(OH)D from 152 Jamaican men with incident PCa within the Prostate Cancer Risk Evaluation (PROSCARE) study were re-evaluated approximately 11 years after enrollment. 25(OH)D analyses were stratified using the using Holick criteria. PCa-specific and all-cause mortality were examined in Kaplan-Meier survival curves and Cox regression models adjusted for age, body mass index (BMI), smoking and Gleason score. Restricted cubic splines evaluated nonlinear associations. Serum calcium was assessed as an effect modifier of the association between 25(OH)D and mortality. RESULTS: Of cases with available 25(OH)D, 64 men with PCa survived, 38 deaths were PCa specific and 36 died of other causes. At baseline, 9.9% of cases were vitamin D deficient and 61.2% were vitamin D sufficient. Compared to 25(OH)D sufficient men, those with 25(OH)D <20.0 ng/mL concentrations were associated with higher PCa-specific mortality (adjusted HR, 4.95; 95% CI, 1.68, 14.63, P = .004) and all-cause mortality (adjusted HR, 2.40; 95%CI, 1.33, 4. 32, P = .003). Serum calcium was not associated with survival and did not modify any associations with 25(OH)D. CONCLUSIONS: 25(OH)D deficiency at PCa diagnosis predicted decreased survival for overall and PCa-specific cancer in Caribbean men of African ancestry.

Microplastic transfer from the American horseshoe crab to shorebirds through consumption of horseshoe crab eggs in Jamaica Bay, NY.

Microplastic transfer between horseshoe crabs (Limulus polyphemus) and migratory shorebirds through consumption of crab eggs was examined in Jamaica Bay, New York. Fertilized and unfertilized crab eggs, shorebird fecal pellets, beach sand, and bay water were processed with a hydrogen peroxide solution to remove organic material, then stained with a Nile Red to identify microplastics using fluorescence microscopy. Microplastics were present in all samples and ranged from approximately26-1300 µm. Unfertilized and fertilized eggs contained significantly higher numbers of microplastic particles per gram than shorebird fecal pellets, beach sand, and bay water. The presence of microplastics in unfertilized egg samples indicates that microplastics undergo maternal transfer during oogenesis. We estimated that 1 g of horseshoe crab eggs could contain approximately 426 to 840 microplastic particles, suggesting that shorebirds feeding on this resource could be ingesting a substantial burden of microplastics during their migratory stopover, much of which appears to be retained by shorebirds, rather than being eliminated in their fecal pellets.

Newborn screening for abnormal haemoglobins in Jamaica: Practical issues in an island programme.

OBJECTIVE: To report the diagnostic challenges of newborn screening for abnormal haemoglobins. SETTING: Cord blood samples from 13 hospitals in southwest Jamaica taken in 2008-2019. METHODS: Blood spots, collected from the umbilical cord, were analysed by high pressure liquid chromatography (HPLC) to reveal phenotypes for HbSS and HbCC, but genotype confirmation may require parental studies or gene sequencing. Such cases that were successfully traced were analysed in this follow-up study. RESULTS: HPLC screening of 121,306 samples detected HbAS in 11,846 (9.8%), HbAC in 4508 (3.7%) and other electrophoretic abnormalities in 1090 babies. Among 101 previously unconfirmed cases, 34/90 (38%) with HPLC evidence of a HbSS phenotype had other genotypes, and 7/11 (64%) with a HbCC phenotype had other genotypes. Syndromes from the interaction of ß thalassaemia occurred in 112 babies (85 with HbS, 27 with HbC) and of genes for hereditary persistence of fetal haemoglobin (HPFH) in 18 (12 with HbS, 6 with HbC). Variants other than HbS and HbC occurred in 270 babies, 16 in combination with either HbS or HbC, and 254 as traits. Most variants are benign even when inherited with HbS, although HbO Arab, HbD Punjab, or Hb Lepore Washington, which occurred in 6 cases, may cause sickle cell disease. CONCLUSIONS: Genes for ß thalassaemia and HPFH are common in western Jamaica and when associated with HbS may present diagnostic challenges in newborns, as HbF and HbA2 have not reached diagnostic levels. Family and DNA studies may be necessary for genotype confirmation.

Concordance of the Deuterium Dose to Mother Method and 24-Hour Recall to Measure Exclusive Breastfeeding at 6 Weeks Postnatally in Rural/Urban Setting in Jamaica.

INTRODUCTION: The 2030 health agenda for the United Nations Sustainable Development Goals promote exclusive breastfeeding (EBF) for the first 6 months of life as a central step towards ensuring the survival of infants. As Jamaica attempts to achieve this goal, monitoring the rates of EBF is desirable. Currently, EBF rate is measured by questionnaires which are subject to recall and social desirability biases. We determined the rate of EBF using the Deuterium-oxide dose-to-mother (DTM) method and 24-h recall. The concordance of both methods and urban-rural differences of EBF were evaluated. Additionally, the growth of infants who were exclusively breastfed was compared to the infants who were mixed-fed. METHODS: Sixty-one healthy mother-child pairs were followed from birth. EBF was measured at 6 weeks. Growth was determined using standard anthropometric measurements. Differences in means were assessed by independent t-test or ANOVA. The agreement between the DTM and 24-h recall method was assessed with the kappa statistic. Differences in anthropometry and location were determined using a repeated measure model approach. RESULTS: Thirty (49%) women exclusively breastfed their infants with mean breast milk intake of 1024.3 ± 256.9 g/day. There was moderate agreement between the methods (Agreement 69%, kappa 0.37, p = 0.002). Rural women (65%) were more likely to practice exclusive breastfeeding. There was no significant difference between the growth of the exclusively breastfed infant and mixed-fed infants. CONCLUSION: EBF rate was successfully measured using the DTM method. Women from urban settings are less likely to practice EBF. Further research may be needed to gain an in-depth understanding of the factors affecting breastfeeding practices in urban Jamaica.

Adolescent Experience With Dating Violence in Relation to Virginity Status: Findings From a Jamaican Sample.

The association between adolescents' involvement in sexual intercourse and their experiences with adolescent dating violence (ADV) is an understudied topic. This study examined this relationship for 178 Jamaican adolescents in Grades 9-11. The expectation that adolescents who reported having had sexual intercourse would report greater victimization and greater perpetration than adolescents who had not had intercourse was consistent only for sexual abuse. Analyses also showed that sexually experienced males perpetrated and experienced more psychological abuse compared to males who were not so experienced. These results suggest different experiences based on adolescents' sex and so support others' calls for ADV research to do more examinations by sex. Also, it endorses the importance of doing research on both victims and perpetrators of intimate abuse. Implications of these findings for sexual and relationship education of adolescents are discussed.

Assessing the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica

[ABSTRACT]. Objective. To identify and assess the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica. Methods. Because of resource constraints, this cross-sectional assessment is based on a three-stage non-probability sample of 374 survey respondents in Jamaica aged ≥18 years. Firstly, three administrative areas (parishes) were randomly selected. Secondly, the main commercial areas within the selected parishes were identified, from which a non-probability sample of establishments was drawn. A broad selection of establishments covering public, private, and nongovernmental organizations was chosen. This array of establishments was selected to capture a sample of respondents that was as representative as possible. Patrons and employees in the selected establishments were asked to complete a questionnaire. Results. Respondents’ self-assessment of their general consumption revealed that 48.4% were unhealthy eaters. Among these, the top reasons for generally unhealthy dietary choices were greater accessibility of unhealthy foods (63.5%) and limited time to prepare healthy meals (61.3%). Additionally, 52.5% indicated “unhealthy foods cost less,” and 47.0% identified affordability as the main factor in the food choice equation. Findings revealed that the determinants of eating unhealthily tended to vary across income, age, and gender. Female, younger, and lower-income respondents have a higher likelihood of being impacted by the factors. Conclusions. The largest proportions of the sample identified limited time to prepare healthy meals and the ease of access to unhealthy foods as the foremost determinants of unhealthy eating habits. These barriers to healthy eating are more likely to impact survey participants in the 18–34 age group.

[RESUMEN]. Objetivo. Identificar y evaluar los determinantes de los hábitos alimentarios poco saludables en una muestra de encuestados en Jamaica. Métodos. Debido a las limitaciones de recursos, esta evaluación transversal se basa en una muestra no probabilística de tres etapas de 374 encuestados en Jamaica de edad igual o superior a los 18 años. Primero, se seleccionaron al azar tres parroquias (áreas administrativas). Luego, se identificaron las principales áreas comerciales dentro de las parroquias seleccionadas, y se extrajo una muestra no probabilística de establecimientos de esas áreas comerciales. Se escogió una amplia selección de establecimientos que abarcaban organizaciones públicas, privadas y no gubernamentales. Se seleccionó este rango de establecimientos para reunir una muestra de encuestados que fuera lo más representativa posible. Se pidió a los clientes y empleados de los establecimientos seleccionados que llenaran un cuestionario. Resultados. La autoevaluación de los encuestados sobre su consumo general reveló que 48,4 % tenían una alimentación poco saludable. Entre estos, las principales razones tras estas decisiones alimentarias generalmente poco saludables fueron un mayor acceso a alimentos poco saludables (63,5 %) y limitaciones en el tiempo para preparar comidas saludables (61,3 %). Además, 52,5 % indicó que “los alimentos poco saludables cuestan menos”, y 47,0 % identificó la asequibilidad como el factor principal en la ecuación relativa a la selección de alimentos. Los resultados revelaron que los determinantes de una alimentación poco saludable tendían a variar según los ingresos, la edad y el sexo. Entre los encuestados, las mujeres más jóvenes y con menores ingresos tenían una mayor probabilidad de verse afectadas por los factores. Conclusiones. La mayoría de los encuestados identificó las limitaciones con el tiempo necesario para preparar comidas saludables y la facilidad de acceso a alimentos poco saludables como los principales determinantes de hábitos alimentarios poco saludables. Es más probable que estas barreras para una alimentación saludable afecten a los encuestados del grupo etario de 18 a 34 años.

[RESUMO]. Objetivo. Identificar e analisar os determinantes de hábitos alimentares não saudáveis em uma amostra de participantes de pesquisa na Jamaica. Métodos. Por limitação de recursos, esta análise transversal foi realizada a partir de uma amostra não probabilística com 374 participantes maiores de 18 anos na Jamaica. A amostragem seguiu um processo de três estágios. Primeiro, três áreas administrativas (localidades) foram selecionadas de forma aleatória e, em seguida, foram identificadas as áreas comerciais centrais em cada localidade selecionada. Para garantir a representatividade da população, uma amostra não probabilística de estabelecimentos comerciais em setores variados (público e privado e organizações não governamentais) foi obtida, com a aplicação do questionário da pesquisa aos seus clientes e funcionários. Resultados. Os participantes avaliaram o próprio consumo alimentar em geral, o que demonstrou que 48,4% consumiam alimentos não saudáveis. Os principais fatores para escolhas alimentares pouco saudáveis foram maior acesso a alimentos não saudáveis (63,5%) e falta de tempo para o preparo de refeições saudáveis (61,3%), sendo que 52,5% indicaram que “os alimentos pouco saudáveis são mais baratos” e 47,0% citaram os preços acessíveis como o principal fator na escolha dos alimentos. Os determinantes da alimentação pouco saudável tenderam a variar de acordo com o gênero, idade e o nível de renda, afetando mais as mulheres, os jovens e pessoas de baixa renda. Conclusões. Uma grande parcela da amostra estudada apontou a falta de tempo para o preparo de refeições saudáveis e a facilidade de acesso a alimentos pouco saudáveis como determinantes de hábitos alimentares não saudáveis. Os obstáculos à alimentação saudável repercutem mais entre os participantes jovens de 18 a 34 anos de idade.

Impact of COVID-19 on Human Resources for Health and Policy Response: the Case of Belize, Grenada, and Jamaica

Health workers are crucial in the preparedness and response to COVID-19, but the pandemic has evidenced the shortage of human resources for health (HRH) in certain countries, reduced or lack of protective equipment, and timely protocols to address occupational, health and safety issues. Health workers have been infected by the virus with consequences in terms of morbidity and mortality. Consequently, available staff workload is expected to increase. While the COVID-19 pandemic has stressed health workforce shortages in countries, it has also led to identifying ways to rapidly hire and train the health workforce. The recognition and understanding of the mechanisms used by countries (such as recruitment processes, type of redeployment, incentives) will provide evidence on ways to address health worker shortages during such outbreaks and therefore implementation gaps will be reduced. This report informs and analyzes the impact of COVID-19 on health workers' occupational health and safety concerns, working conditions, as well as policy responses to address these issues and to increase HRH surge capacity in Belize, Grenada, and Jamaica. The report also describes elements related to HRH and COVID-19 vaccination in selected countries and shares the experiences from Belize, Grenada, and Jamaica (members of CARICOM), which represent different areas of the Caribbean. The report will also inform the HRH Action Task Force and its contribution to technical cooperation and HRH management support. The target audience includes policy-makers, academics, and researchers on addressing health worker issues during health emergencies.