Blood-borne sexually transmitted infections among substance abuse patients in Jamaica

OBJECTIVE: The objective of this study was to determine the prevalence of blood-borne sexually transmitted infections (STI) including the human immunodeficiency virus (HIV), human T-cell lymphotropic virus type-1 (HTLV-1), hepetitis B virus (HBV) and syphillis in residents of a detoxification/rehabilitation unit in Jamaica. METHODS: The records of 301 patients presenting, over a 5-year period, for treatment of substance abuse were reviewed for demographic and laboratory data. The laboratory results were compared with those of 131 blood donors who were used as representative of the general population. The substances used were alcohol, cannabis and cocaine. None of the subjects was an intravenous (IV) drug user. Female substance abusers were at higher risk than males for STI. The prevalence of STI in substance abusers did not differ significantly from that in blood donors (12 percent v 10 percent). The prevalence of syphilis in substance abusers was significantly higher than in blood donors (6 percent v 3 percent; p < 0.05). The prevalence of syphilis was dramatically increased in female substance abusers and female blood donors (30 percent; p < 0.001 and 13 percent; p < 0.05, respectively) compared with males. An increased frequency of HTLV-1 was observed in female compared to male substance abusers. Unemployment was identified as a risk factor for sexually transmitted disease in substance abusers. CONCLUSION: These results support the policy of screening patients in detoxification units for STI and indicate a need for gender specific approaches in the control of substance abuse and STI in Jamaica.(Au)

Clinical Utility of CERAD neuropsychological battery in elderly Jamaicans

Information on the clinical utility of neuropsychological tests in non-North-American samples is limited. We examined the diagnostic efficacy of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery in Jamaican men and women age 65 and older. A total of 72 elders were diagnosed as normal and 12 were demented based on history, physical, and neurological examination, participants were tested with the CERAD battery. Normal controls scored significantly better than dementia patients on all tests in the CERAD battery. A discriminant function found that a combination of Word List Learning Sum Recall and Boston Naming Test correctly classified a total of 81 percent of the cases (83 percent of the dements and 81 percent of the normal controls). This study is the first to demonstrate thr clinical utility of the CERAD neuropsychological battery in the differential diagnosis of memory disorders of the aged in a non-North-American sample.(Au)

Jamaican and American adult perspectives on child psychopathology: further exploration of the threshold model

Although several factors determine whether children receive psychological intervention, cultural determinants may be particularly influential. Cultural factors may influence adults' levels of concern over child psychopathology. This possibility was explored by comparing adult attitudes in two socioculturally different societies. Jamaican and American parents, teachers, and clinicians (total N=382) judged vignettes of two children, one with over controlled (e.g., fearfulness) and one with undercontrolled (e.g., fighting) problems. Regression analyses revealed that although years of education affected some adult ratings, culture had the most profound effect. (AU)

Teacher and parent ratings of behavior problems in Jamaican children and adolescents: convergence and divergence of views

In child assesment, mental health workers often collect behavioral information from parents and teachers. The literature, however, generally indicates low correlations between parent and teacher child problem ratings. One possible explanation is that parents and teachers, in home and school settings, respectively, have disparate opportunities to observe some child problems. Teachers and parents may have equally good opportunities to observe Undercontrolled problems (eg., fighting, lying, disobedience), but teachers may have fewer opportunities to observe overcontrolled problems (e.g., depression, withdrawal, shyness). We explored this possibility, examining parent and teacher reports of overcontrolled and undercontrolled problems in Jamaican children. As expected, when parents and teachers rated overcontrolled problems we generally found nonsignificant correlations and generally significant correlations when they rated Undercontrolled problems. We inferred that because undercontrolled problems are directed outwardly they may be more objectively and similarly observed. Conversely, and thus less concordant judgments (AU)

Principal components analyses of behavior problems in Jamaican clinic-referred children: teacher reports for ages 6-17

Factor analyses of child behavior problems have often yielded two broad-band syndromes, Overcontrolled (e.g., worrying, fearfulness, withdrawl) and Undercontrolled (e.g., restlessness, fighting, disobedience). We explored whether these two broad-band syndromes might be identified for youngsters in Jamaica. We obtained teacher reports for 320 clinic-referred Jamaican youngsters on a 24-item problem checklist designed by Jamaican clinicians for the assessment of child behavior problems and subjected these to principal components analyses. Regardless of whether the sample was split according to age or sex, the analyses revealed factors similar to the Over- and Undercontrolled syndromes most often found in other cultures. The analyses also revealed school absence factors in each age and sex group; school avoidance was correlated with crying in children (aged 6-11) but with conduct problems in adolescents (aged 12-17). The findings suggest important similarities and possible differences between the factor structures of child behavior problems in Jamaica and the United States. (AU)