Jamaican mothers' influences of adolescent girls' sexual beliefs and behaviors.

PURPOSE: The purpose of this study was to identify the ways in which urban Jamaican mothers influence their adolescent daughters' sexual beliefs and behaviors in order to incorporate them into the design of a family-based human immunodeficiency virus (HIV) risk reduction intervention program. DESIGN: Focus groups were conducted with 46 14- to 18-year-old adolescent girls and 30 mothers or female guardians of adolescent girls recruited from community-based organizations in and around Kingston and St. Andrew, Jamaica. Separate focus groups were held with mothers and daughters; each included 6 to 10 participants. Focus group sessions were scripted, led by teams that included trained Jamaican and American facilitators and note-takers, and audio-taped to ensure data accuracy. Data were analyzed using qualitative content analysis. FINDINGS: Four major maternal influences were identified: mother-daughter relationship quality, mother-daughter sexual communication, monitoring or supervision, and maternal sexual role modeling. Mothers' and daughters' reports were consistent; both groups identified positive and negative influences within each category. CONCLUSIONS: Some maternal influences were positive and health promoting; others were negative and promoted unsafe sexual activity and risk for HIV and other sexually transmitted infections. These influences were incorporated into the design of a culture-specific family-based HIV risk reduction intervention tailored to the needs of urban Jamaican adolescent girls and their mothers. CLINICAL RELEVANCE: In order to be effective, family-based HIV risk reduction interventions should be theory based and tailored to the target audience. The four maternal influences identified in this formative study were incorporated into the subsequent intervention design.

The Jamaica asthma and allergies national prevalence survey: rationale and methods.

BACKGROUND: Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges. METHODS/DESIGN: An island wide, cross-sectional, community-based survey of asthma, asthma symptoms and allergies was done among adults and children using the European Community Respiratory Health Survey Questionnaire for adults and the International Study of Asthma and Allergies in Children. Stratified multi-stage cluster sampling was used to select 2, 163 adults aged 18 years and older and 2, 017 children aged 2-17 years for the survey. The Kish selection table was used to select one adult and one child per household. Data analysis accounted for sampling design and prevalence estimates were weighted to produce national estimates. DISCUSSION: The Jamaica Asthma and Allergies National Prevalence Survey is the first population- based survey in the Caribbean to determine the prevalence of asthma and allergies both in adults and children using standardized methods. With response rates exceeding 80% in both groups, this approach facilitated cost-effective gathering of high quality asthma prevalence data that will facilitate international and regional comparison and monitoring of asthma prevalence trends. Another unique feature of this study was the partnership with the Ministry of Health in Jamaica, which ensured the collection of data relevant for decision-making to facilitate the uptake of research evidence. The findings of this study will provide important data on the burden of asthma and allergies in Jamaica and contribute to evidence-informed planning of comprehensive asthma management and education programs.

Application of a partnership model for transformative and sustainable international development.

There are differences of intent and impact between short-term and long-term engagement of U.S. academic institutions with communities of need in developing nations. Global health programs that produce long-term transformative change rather than transient relief are more likely to be sustainable and in ethical harmony with expressed needs of a region or community. This article explores characteristics of successful ethical partnerships in global health and the challenges that threaten them, introducing a consensus community engagement model as a framework for building relationships, evolving an understanding of needs, and collaboratively developing solutions and responses to priority health needs in underserved regions of the world. The community engagement model is applied to a case study of an initiative by a U.S. school of nursing to establish long-term relationships with the nursing community in the Caribbean region with the goal of promoting transformative change through collaborative development of programs and services addressing health care needs of the region's growing elderly population and the increasing prevalence of noncommunicable chronic diseases. Progress of this ongoing long-term relationship is analyzed in the context of the organizational, philosophical, ethical, and resource commitments embodied in this approach to initiation of transformative and sustainable improvements in public health.

Antibacterial effects of Carica papaya on common wound organisms [abstract]

OBJECTIVE: The objective was to investigate the antibacterial activity of the crude Carica papaya preparations as used by nurses, on gram negative and gram positive organisms; to determine which part and stage of maturity of the fruit yielded the best antibacterial activity, and determine the effects of storage conditions on the observed activity. METHODS: The pathogens commonly found in human wounds were obtained from the Microbiology Department, University of the West Indies, Biochemistry Section, The University of the West Indies and the Jamaican Bureau of Standards. Cultures were routinely maintained in nutrient agar slants at 4§c. Extracts were obtained by separately grinding fractions of the epicarp, endocarp and seeds of the immature, mature and ripe Carica papaya fruit and filtering them through guaze. Sensitivity tests were conducted by adding 0.06 ml. of agar wells (6 mm diameter) prepared from 20 ml agar seeded with 10 cells/ml suspension of one of the eight organisms per plate. The inoculated plates were allowed to equilibrate at 4§c for one hour then incubated at 37§c for 24 hours, after which zones of inhibition were measured in millimeters. Antibacterial activity was expressed in terms of the radius of the zone of inhibition calculated as the difference in radius of the observed zones and the edge of the agar wells. Daily sensitivity tests were carried out on extracts stored at 5§c, 25§c and 35§c for 7 days. RESULTS: The seed extracts from all three stages of the fruit showed an average order of inhibition in the following order: B cereus> E coli> S faecalis> S aureus> P vulgaris> and X flexneri. There was no significant difference in bacterial sensitivity between the immature, mature and ripe fruits tested. The epicarp and endocarp did not produce any inhibition zone in any of the three stages of the fruit tested. There was a gradual reduction in antibiotic activity with increasing storage item. Also, a fall-off of activity was found to be more drastic at higher temperatures. CONCLUSION: The findings show that crude extracts of Carica papaya seed have antibacterial activity that inhibits the growth of both gram positive (B cereus, S aureus and S faecalis) and gram negative (E coli, P vulgaris and S flexneri) organisms. Observed activity was dependent on stage of maturity but tended to decrease with duration and conditions of storage. No antibacterial activity was observed from the epicarp and the endocarp of the fruit. (AU)

Topical use of Papaya in chronic skin ulcer therapy in Jamaica

The objective of the study was to determine the prevalence of the use of the fruit (papaya) or Carica papaya as topical ulcer dressings by registered nurses in the Spanish Town Hospital (STH), Kingston Public Hospital (KPH) and the University Hospital of the West Indies (UHWI), Jamaica. A ten-item pre-tested self-administered questionnaire was distributed to 285 randomly selected registered nurses at the UHWI, KPH and STH. There was a 72 percent response rate. The prevalence of topical papaya use among the respondents was 75 percent. Comments from the users of papaya suggested that topical application of the unripe fruit promoted desloughing, granulation and healing and reduced odour in chronic skin ulcers. It was cost effective. Papaya was considered to be more effective than other topical applications in the treatment of chronic ulcers. There was some difficulty in preparation of the fruit and occasionally a standardised procedure but there were no reports of wound infection from its use. Papaya is widely used by nurses as a form of dressing for chronic ulcers and there is need for standardisation of its preparation and application.(Au)

Fostering collaboration between researchers and non-governmental organizations on women and AIDS in Jamaica

Reports findings of a study of researchers and community-based NGOs in Jamaica and a forum held to build stronger bonds between persons from the two groups. Presents the objectives of the project which were to: document and analyze research efforts on women and AIDS and the program experiences of NGOs with the aim of identifying progress in research and successful interventions that could be replicated in other settings; identify the lessons learned from existing collaborations between the research and action communities; conduct a forum in which researchers and NGOs could share their experiences and needs, as well as to identify ways to strengthen communication and collaboration. In addition disseminate to researchers, NGOs, policy makers, and donors at the national and international level, the findings from analyzing the progress in research and program experience, as well as the lessons learned from the collaborative process. Suggests the need for: training and educating women and men about HIV/AIDS; collaboration among NGOs, churches and public institutions; a central pool of research findings and materials; more research; and more funding for more programs(AU)

Educating nurses to change their attitudes about caring for patients with HIV/AIDS

Changing nurses' attitude about caring for HIV/AIDS patients is a challenge for nursing leaders, who have no choice but to promote an attractive and acceptable environment in which nurses can practice safely, compassionately and knowledgeably. Below, how nursing administrators and educators can develop strategies to meet nursing needs (AU)

The Jamaica asthma and allergies national prevalence survey: rationale and methods

BACKGROUND: Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges. METHODS/DESIGN: An island wide, cross-sectional, community-based survey of asthma, asthma symptoms and allergies was done among adults and children using the European Community Respiratory Health Survey Questionnaire for adults and the International Study of Asthma and Allergies in Children. Stratified multi-stage cluster sampling was used to select 2, 163 adults aged 18 years and older and 2, 017 children aged 2-17 years for the survey. The Kish selection table was used to select one adult and one child per household. Data analysis accounted for sampling design and prevalence estimates were weighted to produce national estimates.DISCUSSION: The Jamaica Asthma and Allergies National Prevalence Survey is the first population- based survey in the Caribbean to determine the prevalence of asthma and allergies both in adults and children using standardized methods. With response rates exceeding 80% in both groups, this approach facilitated cost-effective gathering of high quality asthma prevalence data that will facilitate international and regional comparison and monitoring of asthma prevalence trends. Another unique feature of this study was the partnership with the Ministry of Health in Jamaica, which ensured the collection of data relevant for decision-making to facilitate the uptake of research evidence. The findings of this study will provide important data on the burden of asthma and allergies in Jamaica and contribute to evidence-informed planning of comprehensive asthma management and education programs.