Organ-specific model of simulated ischemia/reperfusion and hyperglycemia based on engineered heart tissue.

Here we aimed to establish an in vitro engineered heart tissue (EHT) co-morbidity mimicking model of ischemia-reperfusion injury and diabetes. EHTs were generated from primary neonatal rat cardiomyocytes. Hyperglycemic conditions or hyperosmolar controls were applied for one day to model acute hyperglycemia and for seven days to model chronic hyperglycemia. 120 min' simulated ischemia (SI) was followed by 120 min' reperfusion (R) and 1-day follow-up reperfusion (FR). Normoxic controls (N) were not subjected to SI/R. Half of the EHTs was paced, the other half was left unpaced. To assess cell injury, lactate-dehydrogenase (LDH) concentration was measured. Beating force and activity (frequency) were monitored as cardiomyocyte functional parameters. LDH-release indicated relevant cell injury after SI/N in each experimental condition, with much higher effects in the chronically hyperglycemic/hyperosmolar groups. SI stopped beating of EHTs in each condition, which returned during reperfusion, with weaker recovery in chronic conditions than in acute conditions. Acutely treated EHTs showed small LDH-release and âˆ¼80% recovery of force during reperfusion and follow-up, while chronically treated EHTs showed a marked LDH-release, only ∼30% recovery with reperfusion and complete loss of beating activity during 24 h follow-up reperfusion. We conclude that EHTs respond differently to SI/R injury in acute and chronic hyperglycemia/hyperosmolarity, and that our EHT model is a novel in vitro combination of diabetes and ischemia-reperfusion.

Seismicity on tidally active solid-surface worlds.

Tidal interactions between planets or stars and the bodies that orbit them dissipate energy in their interiors. The dissipated energy heats the interior and a fraction of that energy will be released as seismic energy. Here we formalize a model to describe the tidally-driven seismic activity on planetary bodies based on tidal dissipation. To constrain the parameters of our model we use the seismic activity of the Moon, driven by tidal dissipation from the Earth-Moon interactions. We then apply this model to predict the amount of seismic energy release and largest seismic events on other moons in our Solar System and exoplanetary bodies. We find that many moons in the Solar System should be more seismically active than the Earth's Moon and many exoplanets should exhibit more seismic activity than the Earth. Finally, we examine how temporal-spatial variations in tidal dissipation manifest as variations in the locations and timing of seismic events on these bodies.

Colorectal anastomotic leakage at the University Hospital of the West Indies an analysis of risk factors / Fuga anastomótica colorrectal en el Hospital Universitario de West Indies un análisis de los factores de riesgo

BACKGROUND: Anastomotic leakage remains a concern in general surgical practice. The significance lies in the resultant abdominal sepsis, related morbidity and mortality, risk of anastomotic loss, permanent stoma creation and the effect on local recurrence and overall patient survival in colorectal cancer cases. OBJECTIVES: This study serves to determine the leak rates and the mortality thereof related to colonic and rectal anastomoses at the University Hospital of the West Indies (UHWI) in Kingston, Jamaica. Independent factors contributing to anastomotic leaks in these patients will also be assessed and correlations determined. METHODS: A review of the medical records of one hundred and thirty-three cases of colonic and rectal anastomoses identified retrospectively over a three-year period provided relevant information for analysis. RESULTS: Anastomotic leaks were identified in twelve patients, providing a leak rate of 9.0%. No 30-day mortality related to anastomotic leakage was noted. Based on a multivariate analysis, male gender was identified as the sole independent factor related to anastomotic leakage. CONCLUSION: Colorectal anastomotic leak rates at UHWI fell at the upper limit of leak rates typically quoted in the literature. No modifiable risk factor appeared to contribute to this leak rate. Early identification and intervention is critical in limiting mortality associated with colorectal anastomotic leakage.

ANTECEDENTES: La fuga anastomótica sigue siendo una preocupación en la práctica quirúrgica general. La importancia radica en la sepsis abdominal resultante, la morbilidad y mortalidad asociadas, el riesgo de pérdida anastomótica, la creación de estomas permanentes, y el efecto sobre la recidiva local así como en la supervivencia de los pacientes en general, en los casos de cáncer colorrectal. OBJETIVOS: Este estudio sirve para determinar las tasas de fuga y la mortalidad asociadas con ellas, en relación con las anastomosis colónicas y rectales en el Hospital Universitario de West Indies (HUWI) en Kingston, Jamaica. Asimismo, se evaluaran los factores independientes que contribuyen a las fugas anastomóticas en estos pacientes, y se determinaran las correlaciones. MÉTODOS: Una revisión de los registros médicos de ciento treinta y tres casos de anastomosis colónicas y rectales identificados retrospectivamente durante un período de más de tres años, proporcionaron la información relevante para el análisis. RESULTADOS: Se identificaron fugas anastomóticas en doce pacientes para una tasa de fuga de 9.0% . No se observó ninguna mortalidad de 30 días relacionada con fugas anastomóticas. Basado en un análisis multivariante, se identificó el género masculino como el único factor independiente relacionado con la fuga anastomótica. CONCLUSIÓN: Las tasas de fuga anastomótica colorrectal en UHWI cayeron al límite superior de las tasas de fuga típicamente citadas en la literatura. Ningún factor de riesgo no modificable pareció contribuir a esta tasa de fuga. La intervención e identificación temprana es esencial a la hora de limitar la mortalidad asociada con la pérdida anastomótica colorrectal.

Colorectal anastomotic leakage at the university hospital of the west indies: an analysis of risk factors.

BACKGROUND: Anastomotic leakage remains a concern in general surgical practice. The significance lies in the resultant abdominal sepsis, related morbidity and mortality, risk of anastomotic loss, permanent stoma creation and the effect on local recurrence and overall patient survival in colorectal cancer cases. OBJECTIVES: This study serves to determine the leak rates and the mortality thereof related to colonic and rectal anastomoses at the University Hospital of the West Indies (UHWI) in Kingston, Jamaica. Independent factors contributing to anastomotic leaks in these patients will also be assessed and correlations determined. METHODS: A review of the medical records of one hundred and thirty-three cases of colonic and rectal anastomoses identified retrospectively over a three-year period provided relevant information for analysis. RESULTS: Anastomotic leaks were identified in twelve patients, providing a leak rate of 9.0%. No 30-day mortality related to anastomotic leakage was noted. Based on a multivariate analysis, male gender was identified as the sole independent factor related to anastomotic leakage. CONCLUSION: Colorectal anastomotic leak rates at UHWI fell at the upper limit of leak rates typically quoted in the literature. No modifiable risk factor appeared to contribute to this leak rate. Early identification and intervention is critical in limiting mortality associated with colorectal anastomotic leakage.

Clinicopathologic features of breast disease in Jamaica: findings of the Jamaican Breast Disease Study, 2000-2002.

OBJECTIVE: To describe the clinicopathologic profile of breast disease in Jamaica. METHODS: The Jamaican Breast Disease Study is an ongoing prospective, multidisciplinary investigation of breast disease at the University Hospital of the West Indies (UHWI). The initial phase was a prevalence survey comprising all consenting patients referred to the Surgical Outpatient Department (SOPD) UHWI, for breast disease. Demographic, clinical, radiologic and pathologic information were recorded for each patient and the data for the first three years (2000-2002) were analyzed. RESULTS: A total of 1189 patients was enrolled for the study period (28.8% of all new SOPD patients). The age range was 10 to 93 years (mean/SD = 36.5 +/- 16.4 years) with a female : male ratio of 14:1. Most patients (67.8%) presented with a palpable lump and the clinical diagnosis was benign in the majority (70.4%) of patients. Fibroadenoma was the most common benign histologic result (39.4% of all biopsies) followed by non-proliferative (fibrocystic) disease (19.3% of all biopsies). Proliferative disease without atypia, complex fibroadenoma and atypical ductal hyperplasia accounted for 6.9%, 2.6% and 0.4% of biopsies respectively. Overall, 23.4% of biopsies showed malignant histology (10.8% patients); invasive ductal carcinoma accounted for the majority of these cases (69.5%). CONCLUSIONS: The majority of patients with breast disease in Jamaica are young women with clinically benign disease. There was a low prevalence of clinically significant premalignant disease. This is the first study to prospectively describe the clinicopathologic features of breast disease in Jamaica and supports the need for advocating breast cancer screening to facilitate detection of significant premalignant disease and early stages of breast cancer.

Surgical and intensive care needs of head-injured patients transferred to the University Hospital of the West Indies.

A cross-sectional, descriptive study utilizing data collected in the 'Trauma Registry' of the Department of Surgery, Radiology, Anaesthesia and Intensive Care at the University Hospital of the West Indies (UHWI) was undertaken to document injury severity, surgical requirements and intensive care needs of head-injured patients transferred to the UHWI over a three-year period Of 144 patients studied, the majority (71%) were young males. Overall, injury tended to be mild Twenty-three patients (16.0%) had severe head injury and 27 patients (18.8%) were admitted to the intensive care unit. Concussion with (33%) or without (36%) skull fracture was the commonest neurological admission diagnosis. Associated non-neurological injuries in 33% were primarily fractures. Fifty-six patients (39%) required surgical intervention. Craniotomies and open reduction and internal fixation of fractures were the commonest procedures. The majority of patients (79.2%) were discharged home; 56 (39%) made a good Glasgow outcome score recovery. Seventeen patients (11.8%) died in hospital. As most of the transferred patients with head injuries in this study had only mild injury, most commonly concussions, and their prognosis was good, we recommend that appropriate educational and training programmes and transfer policies be implemented to minimize inappropriate transfers.

Surgical and intensive care needs of head-injured patients transferred to the University Hospital of the West Indies / Necesidades quirúrgicas y de cuidados intensivos de los pacientes con lesiones cefálicas transferidos al hospital universitario de west indies

A cross-sectional, descriptive study utilizing data collected in the 'Trauma Registry' of the Department of Surgery, Radiology, Anaesthesia and Intensive Care at the University Hospital of the West Indies (UHWI) was undertaken to document injury severity, surgical requirements and intensive care needs of head-injured patients transferred to the UHWI over a three-year period Of 144 patients studied, the majority (71%) were young males. Overall, injury tended to be mild Twenty-three patients (16.0%) had severe head injury and 27 patients (18.8%) were admitted to the intensive care unit. Concussion with (33%) or without (36%) skull fracture was the commonest neurological admission diagnosis. Associated non-neurological injuries in 33% were primarily fractures. Fifty-six patients (39%) required surgical intervention. Craniotomies and open reduction and internal fixation of fractures were the commonest procedures. The majority of patients (79.2%) were discharged home; 56 (39%) made a good Glasgow outcome score recovery. Seventeen patients (11.8%) died in hospital. As most of the transferred patients with head injuries in this study had only mild injury, most commonly concussions, and their prognosis was good, we recommend that appropriate educational and training programmes and transfer policies be implemented to minimize inappropriate transfers

Se llevó a cabo un estudio transversal descriptivo utilizando datos tomados del "Registro de traumas" del Departamento de Cirugía, Radiología, Anestesia y Cuidados Intensivos en el Hospital Universitario de West Indies (HUWI), a fin de documentar la severidad de la lesión, los requerimientos quirúrgicos y las necesidades de cuidado intensivo de pacientes con lesiones cefálicas transferidos al HUWI durante un período de más de tres años. De 144 pacientes estudiados, la mayor parte (71%) eran varones jóvenes. En general, las lesiones tendían a ser leves. Veintitrés pacientes (16.0%) tuvieron lesiones cefálicas severas, y 27 pacientes (18.8%) fueron ingresados a la unidad de cuidados intensivos. Concusión con fractura del cráneo (33%) o sin fractura del cráneo (36%) fue el diagnóstico neurológico más común para el ingreso. Las lesiones no neurológicas asociadas en 33% fueron principalmente fracturas. Cincuenta y seis pacientes (39%) necesitaron intervención quirúrgica. Las craniotomías así como la reducción abierta y la fijación interna de fracturas, fueron los procedimientos más comunes. La mayoría de los pacientes (79.2%) fueron dados de alta; 56 (39%) tuvo una buena recuperación según la puntuación de la escala de Glasgow para la evolución clínica. Diecisiete pacientes (11.8%) murieron en el hospital. Como que la mayor parte de los pacientes transferidos con lesiones de cabeza en este estudio tuvieron solo lesiones leves ­ por lo general concusiones ­ y puesto que su prognosis era buena, recomendamos que se implementen programas adecuados de educación y entrenamiento, así como políticas de transferencia apropiadas, a fin de minimizar las transferencias inadecuadas

The prevalence of seat belt use in Kingston, Jamaica: a follow-up observational study five years after the introduction of legislation / Prevalencia del uso del cinturón de seguridad en Kingston, Jamaica: un estudio observacional de seguimiento, cinco años después de introducida la legislación

An observational cross-sectional study conducted in Kingston in 2004 showed that seat belts were used by 81.2% of private motor vehicle drivers and 74.0% offront seat passengers. This was significantly improved compared to 21.1% and 13.6% respectively in 1996 before the introduction of legislation in 1999 (p < 0.001). Females were significantly more likely than males to wear seat belts, both when driving (92.5% vs 77.3%; p < 0. 001) and as front seat passengers (79.9% vs 66.3%; p < 0.001). Of the 2289 motor vehicles examined, all except one were equipped with seat belts. Rear passenger utilization of seat belts was not examined. Drivers of new vehicles were more likely than other drivers to use seat belts (p < 0.001). Male drivers, drivers of older vehicles and all passengers may require specific targeting in an educational and enforcement campaign if the maximum benefits of seat belt use are to be realized

Un estudio transversal observacional llevado a cabo en Kingston en el año 2004 mostró que los cinturones de seguridad eran usados por el 81.2% de los conductores de vehículos motorizados privados, y el 74.0% de los pasajeros del asiento delantero. Esto representa una mejoría significativa en comparación con el 21.1% y el 13.6% respectivamente en 1996 antes de que se introdujera la legislación en 1999 (p < 0.001). Las tendencia de las mujeres a usar cinturones de seguridad fue significativamente mayor que la de los hombres, tanto al conducir (92.5% vs 77.3%; p < 0.001) como al viajar como pasajeras en el asiento delantero (79.9% vs 66.3%; p < 0.001). De los 2289 vehículos motorizados examinados, todos – excepto uno – estaban equipados con cinturones de seguridad. No se examinó la utilización de los cinturones de seguridad por parte de los pasajeros en los asientos traseros. Los conductores de vehículos nuevos mostraron una tendencia mayor que los otros conductores a usar cinturones de seguridad (p < 0.001). Los conductores varones, los conductores de vehículos más viejos, y todos los pasajeros puede que requieran ser objeto específico de una campaña destinada a educarlos o a hacer cumplir la ley si se desea maximizar los beneficios del uso del cinturón de seguridad.

The prevalence of seat belt use in Kingston, Jamaica: a follow-up observational study five years after the introduction of legislation.

An observational cross-sectional study conducted in Kingston in 2004 showed that seat belts were used by 81.2% of private motor vehicle drivers and 74.0% offront seat passengers. This was significantly improved compared to 21.1% and 13.6% respectively in 1996 before the introduction of legislation in 1999 (p < 0.001). Females were significantly more likely than males to wear seat belts, both when driving (92.5% vs 77.3%; p < 0. 001) and as front seat passengers (79.9% vs 66.3%; p < 0.001). Of the 2289 motor vehicles examined, all except one were equipped with seat belts. Rear passenger utilization of seat belts was not examined. Drivers of new vehicles were more likely than other drivers to use seat belts (p < 0.001). Male drivers, drivers of older vehicles and all passengers may require specific targeting in an educational and enforcement campaign if the maximum benefits of seat belt use are to be realized

Transfer of head-injured patients in Jamaica: is there a problem?

Head-injured patients are often transferred to the University Hospital of the West Indies (UHWI) for tertiary care. There is no standardized, agreed protocol governing their transfer. During the three-year period January 1998 to December 2000, 144 head injured patients were transferred to the UHWI from other institutions. They were 70% male, had a mean age of 34 years and spent a mean of 13 days in hospital. Eighteen per cent were admitted to the Intensive Care Unit, where they spent a mean of nine days. On arrival, mean pulse rate was 92 +/- 22 beats/minute, mean systolic blood pressure was 130 +/- 27 mmHg and mean diastolic was 76 +/- 19mmHg. Twenty-eight per cent of patients had a pulse rate above 100/min on arrival and 13.8% had systolic blood pressure below 60 mmHg. The Glasgow Coma Scale score was unrecorded at the referring institution in 70% of cases and by the receiving officers at the UHWI in 23% of cases. Intubation was done on only half of those who were eligible. Junior staff members initiated and carried out transfers whenever this was documented. The types of vehicles and monitoring equipment used could not be determined in most instances. Fifty-eight per cent of patients had minor head injuries, 12%, severe injury and 33%, associated injuries requiring a variety of surgical procedures by multiple specialties. Most patients (80.6%) were discharged home but 11.8% died in hospital. Transfer of head-injured patients, many with multiple injuries is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardized protocol for the transfer of such patients in Jamaica.

Transfer of head-injured patients in Jamaica: is there a problem? / Transferencia de pacientes con heridas de cabeza en Jamaica: ¿hay problema?

Head-injured patients are often transferred to the University Hospital of the West Indies (UHWI) for tertiary care. There is no standardized, agreed protocol governing their transfer. During the three-year period January 1998 to December 2000, 144 head injured patients were transferred to the UHWI from other institutions. They were 70male, had a mean age of 34 years and spent a mean of 13 days in hospital. Eighteen per cent were admitted to the Intensive Care Unit, where they spent a mean of nine days. On arrival, mean pulse rate was 92 +/- 22 beats/minute, mean systolic blood pressure was 130 +/- 27 mmHg and mean diastolic was 76 +/- 19mmHg. Twenty-eight per cent of patients had a pulse rate above 100/min on arrival and 13.8had systolic blood pressure below 60 mmHg. The Glasgow Coma Scale score was unrecorded at the referring institution in 70of cases and by the receiving officers at the UHWI in 23of cases. Intubation was done on only half of those who were eligible. Junior staff members initiated and carried out transfers whenever this was documented. The types of vehicles and monitoring equipment used could not be determined in most instances. Fifty-eight per cent of patients had minor head injuries, 12, severe injury and 33, associated injuries requiring a variety of surgical procedures by multiple specialties. Most patients (80.6) were discharged home but 11.8died in hospital. Transfer of head-injured patients, many with multiple injuries is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardized protocol for the transfer of such patients in Jamaica.

Los pacientes con heridas en la cabeza son a menudo transferidos al Hospital Universitario de West Indies (UHWI) para su cuidado terciario. No existe ningún protocolo acordado en relación con las normas que deben regir la transferencia. En el trienio de enero de 1998 a diciembre 2000, 144 pacientes con heridas de cabeza, fueron transferidos al HUWI desde otras instituciones. El 70% de ellos eran varones de 34 años de edad promedio, y el período de permanencia en el hospital fue 13 días como promedio. El 18% fue ingresado en la Unidad de Cuidados Intensivos, donde permaneció un promedio de 9 días. Al llegar al hospital, su pulso medio era de 92 ± 22 pulsaciones/minuto, la presión arterial sistólica media era de 130 ± 27 mmHg, y la media diastólica de 76 ± 19 mmHg. El 28% de los pacientes tenía un ritmo de pulsaciones por encima de 100/min al momento del ingreso, y un 13.8% tenía la presión arterial sistólica por debajo de 60 mmHg. No había constancia de la aplicación de la Escala de Coma de Glasgow en las instituciones que remitieron a los pacientes en el 70% de los casos, ni por parte de los funcionarios médicos que recibieron a los pacientes en el HUWI en el 23% de los casos. La entubación se realizó solamente en la mitad de los pacientes elegibles. El personal subalterno inició y llevó a cabo las transferencias en todos los casos docu-mentados. En la mayor parte de los casos no fue posible determinar los tipos de vehículos ni el equipo de monitoreo utilizados. El 58% por ciento de los pacientes presentaba heridas menores de la cabeza, el 12% tuvo heridas graves, y un 33% acudió con heridas asociadas que requerían diversos procedimientos quirúrgicos de múltiples especialidades. La mayoría de los pacientes (80.6%) regresó de alta a sus casas, pero el 11.8% murió en el hospital. La transferencia de pacien-tes con heridas en la cabeza – muchos de ellos con lesiones múltiples – no se está realizando de manera consistente con la práctica médica moderna...

Cancer of the colon and rectum in a Jamaican population: diagnostic implications of the changing frequency and subsite distribution.

The aim of this study was to examine the clinical and pathological characteristics of colorectal cancer in Jamaica, to determine whether there was a change in the anatomic distribution and clinical presentation and to discuss the options for diagnosis and management. A comprehensive retrospective review of patients newly diagnosed with colorectal carcinoma was conducted at The University Hospital of the West Indies by reviewing both patient records and pathological data. These data were compared with previous reports of patients with colorectal cancer seen in Jamaica. One hundred and forty-seven patients were studied There were 85 females and 62 males with a female to male ratio of 1.37:1. The median age was 65.5 years (range 19 to 94 years). The predominant symptoms were abdominal pain in 91 patients, change in bowel habit in 77 patients and rectal bleeding in 74 patients. Sixty patients presented with weight loss and 28 with a rectal mass. The most common tumours were right-sided colonic cancers in 42 patients (28.5%) followed by sigmoid colon in 30 (20.4%) rectum in 34 (23.1%) and left and transverse colon accounting for 16 and 10 cases respectively. Most of the tumours were well or moderately differentiated adenocarcinomas. Only eight patients presented with Dukes' A disease, 50 with Dukes'B, 53 with Dukes'C disease and 34 with advanced disease. The findings showed that sigmoid and rectal tumours accounted for 43.5% of cancers. The colon/rectum ratio in this series was 3.3:1 indicating a significant proximal shift of colorectal cancers in this population in keeping with recent reports. The results of the current study suggest that the sub-site location of colorectal cancers seen is similar to that reported in high incidence countries such as the United States of America and parts of Europe but differs from the African continent which has a high proportion of rectal tumours. This right-sided preponderance also differs from previous studies in Jamaica, which report a higher incidence of rectal lesions The detection of early colorectal carcinoma will require screening at a stage when the disease is asymptomatic in order to improve the chance for cure. The data presented here imply that screening programmes should allow evaluation of the entire colon rather than the distal 25 cm.

Cancer of the colon and rectum in a Jamaican population: diagnostic implications of the changing frequency and subsite distribution

The aim of this study was to examine the clinical and pathological characteristics of colorectal cancer in Jamaica, to determine whether there was a change in the anatomic distribution and clinical presentation and to discuss the options for diagnosis and management. A comprehensive retrospective review of patients newly diagnosed with colorectal carcinoma was conducted at The University Hospital of the West Indies by reviewing both patient records and pathological data. These data were compared with previous reports of patients with colorectal cancer seen in Jamaica. One hundred and forty-seven patients were studied There were 85 females and 62 males with a female to male ratio of 1.37:1. The median age was 65.5 years (range 19 to 94 years). The predominant symptoms were abdominal pain in 91 patients, change in bowel habit in 77 patients and rectal bleeding in 74 patients. Sixty patients presented with weight loss and 28 with a rectal mass. The most common tumours were right-sided colonic cancers in 42 patients (28.5) followed by sigmoid colon in 30 (20.4) rectum in 34 (23.1) and left and transverse colon accounting for 16 and 10 cases respectively. Most of the tumours were well or moderately differentiated adenocarcinomas. Only eight patients presented with Dukes' A disease, 50 with Dukes'B, 53 with Dukes'C disease and 34 with advanced disease. The findings showed that sigmoid and rectal tumours accounted for 43.5 of cancers. The colon/rectum ratio in this series was 3.3:1 indicating a significant proximal shift of colorectal cancers in this population in keeping with recent reports. The results of the current study suggest that the sub-site location of colorectal cancers seen is similar to that reported in high incidence countries such as the United States of America and parts of Europe but differs from the African continent which has a high proportion of rectal tumours. This right-sided preponderance also differs from previous studies in Jamaica, which report a higher incidence of rectal lesions The detection of early colorectal carcinoma will require screening at a stage when the disease is asymptomatic in order to improve the chance for cure. The data presented here imply that screening programmes should allow evaluation of the entire colon rather than the distal 25 cm

The challenge of designing a database for auditing surgical in-patients.

Surgical audit is imperative in modern practice, particularly in the developing world where resources are limited and efficient allocation important. The structure, process and outcome of surgical care can be determined for quality assurance or for research. Improved efficiency and reduction of morbidity and mortality are additional goals which may be accomplished. However, computerization, medical staff cooperation and the availability of dedicated staff are among the hurdles which may be encountered. We report the challenge of designing and establishing a database for auditing surgical inpatients in a developing country and the difficulties which were encountered.

The prevalence of seat belt use in Jamaica. An observational study.

An observational cross-sectional survey showed that 21.1% of private motor vehicle drivers and 13.5% of front seat passengers voluntarily wore seat belts in Kingston, Jamaica, where there is no law requiring this. Rear passenger utilisation was not examined. Compared to males, females were significantly more likely to wear seat belts when driving but not as front seat passengers. Of all motor vehicles examined, 10.1% were not equipped with seat belts. The oldest group of vehicles were mostly not fitted with seat belts. Drivers of older vehicles were significantly less likely to use seat belts even when the vehicles were equipped with belts. Implementation of legislation can reduce mortality, morbidity and costs from road traffic accidents which are relatively frequent in Jamaica. Male drivers, drivers of older vehicles and all passengers may require specific targeting in an educational and enforcement campaign should legislation, which is highly desirable, be implemented.