Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.785
Filtrar
1.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47275

RESUMO

Since onset of the Novel Coronavirus (COVID-19) the Pan American Health Organization/World Health Organization (PAHO/WHO) Office for Barbados and Eastern Caribbean Countries (ECC) has actively assisted countries to prepare and respond to the virus.


Assuntos
Barbados/epidemiologia , Kit de Reagentes para Diagnóstico/normas , Betacoronavirus , Capacitação em Serviço/métodos
2.
Recurso na Internet em Inglês, Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47140

RESUMO

La Organización Panamericana de la Salud (OPS) está implementando un plan integral para apoyar los esfuerzos de preparación de Barbados para el brote asociado con la enfermedad por el coronavirus 2019 (COVID-19). Este plan incluye establecer y fortalecer la capacidad de laboratorio para la detección temprana del virus a través de las redes de salud pública y laboratorios de referencia en las Américas


Assuntos
Infecções por Coronavirus/diagnóstico , Barbados/epidemiologia , Betacoronavirus , Capacitação Profissional , Infecções por Coronavirus/prevenção & controle
4.
PLoS Negl Trop Dis ; 13(10): e0007772, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31658267

RESUMO

BACKGROUND: Small island developing states (SIDS) in the Caribbean region are challenged with managing the health outcomes of a changing climate. Health and climate sectors have partnered to co-develop climate services to improve the management of emerging arboviral diseases such as dengue fever, for example, through the development of climate-driven early warning systems. The objective of this study was to identify health and climate stakeholder perceptions and needs in the Caribbean, with respect to the development of climate services for arboviruses. METHODS: Stakeholders included public decision makers and practitioners from the climate and health sectors at the regional (Caribbean) level and from the countries of Dominica and Barbados. From April to June 2017, we conducted interviews (n = 41), surveys (n = 32), and national workshops with stakeholders. Survey responses were tabulated, and audio recordings were transcribed and analyzed using qualitative coding to identify responses by research topic, country/region, and sector. RESULTS: Health practitioners indicated that their jurisdiction is currently experiencing an increased risk of arboviral diseases associated with climate variability, and most anticipated that this risk will increase in the future. National health sectors reported financial limitations and a lack of technical expertise in geographic information systems (GIS), statistics, and modeling, which constrained their ability to implement climate services for arboviruses. National climate sectors were constrained by a lack of personnel. Stakeholders highlighted the need to strengthen partnerships with the private sector, academia, and civil society. They identified a gap in local research on climate-arbovirus linkages, which constrained the ability of the health sector to make informed decisions. Strategies to strengthen the climate-health partnership included a top-down approach by engaging senior leadership, multi-lateral collaboration agreements, national committees on climate and health, and shared spaces of dialogue. Mechanisms for mainstreaming climate services for health operations to control arboviruses included climatic-health bulletins and an online GIS platform that would allow for regional data sharing and the generation of spatiotemporal epidemic forecasts. Stakeholders identified a 3-month forecast of arboviral illness as the optimal time frame for an epidemic forecast. CONCLUSIONS: These findings support the creation of interdisciplinary and intersectoral 'communities of practice' and the co-design of climate services for the Caribbean public health sector. By fostering the effective use of climate information within health policy, research and practice, nations will have greater capacity to adapt to a changing climate.


Assuntos
Aedes , Controle de Doenças Transmissíveis , Doenças Transmissíveis , Saúde Pública , Adolescente , Adulto , Aedes/virologia , Idoso , Animais , Infecções por Arbovirus/prevenção & controle , Barbados , Mudança Climática , Doenças Transmissíveis/epidemiologia , Assistência à Saúde , Dengue/prevenção & controle , Dengue/transmissão , Vetores de Doenças , Dominica , Feminino , Política de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Setor Público , Participação dos Interessados , Inquéritos e Questionários , Adulto Jovem
5.
J Econ Entomol ; 112(6): 3002-3006, 2019 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-31289814

RESUMO

Biological invasions are a global threat to agricultural crops worldwide. In the Neotropical region, the spotted-wing Drosophila [Drosophila suzukii (Matsumura)] has rapidly expanded its geographical range spreading throughout South America in recent years. Besides climatic factors, the remarkable success of its establishment and subsequent distribution in this region is closely dependent on the diversity and availability of host plants. We evaluated the host potential (e.g., as food and oviposition sources) of fruits of jabuticaba [Plinia cauliflora (Mart.) Kausel (Myrtales: Myrtaceae)], Barbados cherry (Malpighia emarginata DC) (Malpighiales: Malpighiaceae), bonnet pepper (Capsicum chinense Jacq.) (Solanales : Solanaceae), and coffee (Coffea arabica L.) (Gentianales : Rubiaceae) and their effects on the biological and physiological traits of D. suzukii. For the fruit types where fly emergence occurred, we assessed the biological and physiological performance of the flies and compared these parameters with those recorded for flies reared on strawberries (Fragaria × ananassa Duchesne) (Rosales : Rosaceae) and an artificial diet. Our results revealed that oviposition into fruits and completion of the life cycle occurred on Barbados cherries only. Furthermore, field surveys revealed a higher emergence rate of D. suzukii on undamaged ripe Barbados cherries than damaged ones. Moreover, flies developing on Barbados cherries and an artificial diet presented earlier emergence, shorter developmental time, lower number of adults per female, and a female-biased sex ratio compared to flies developing on strawberries. Overall, our findings demonstrated suitability of Barbados cherry as a host for D. suzukii, which renders management of D. suzukii in Neotropical region an even more challenging task.


Assuntos
Fragaria , Malpighiaceae , Animais , Barbados , Drosophila , Feminino , América do Sul
6.
PLoS One ; 14(5): e0216458, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31086373

RESUMO

Contemporary West Indian biodiversity has been shaped by two millennia of non-native species introductions. Understanding the dynamics of this process and its legacy across extended temporal and spatial scales requires accurate knowledge of introduction timing and the species involved. Richard Ligon's 17th century account and celebrated map of early colonial Barbados records the translocation of several Old World species to the island in the post-contact era, including pigs (Sus scrofa) believed to have been released by passing sailors the century prior. Here we challenge this long-accepted historical narrative, presenting evidence that Ligon's "pigs" were in fact peccaries, a New World continental mammal often confused with wild boars. We document the first recorded instance of non-native peccary (Tayassuidae) on Barbados based on a securely identified mandibular specimen from a historic archaeological context. Results of specimen 87Sr/86Sr and AMS radiocarbon assays, along with newly reported data from Sr isotope environmental analyses, indicate a local origin dating to AD 1645-1670/1780-1800. These data support the presence of living peccary on Barbados some time during the first 175 years of English settlement, which, based on review of historical and archaeological data, most likely arises from 16th century peccary introduction from the Guianas/Trinidad by the Spanish or Portuguese. We argue dimorphic representations of "pigs" on Ligon's map reflect the co-occurrence of peccary and European domestic swine on historic Barbados. Our findings overturn conventional history and provide greater taxonomic and chronological resolution for Caribbean bioinvasion studies, helping to refine our understanding of potential ecological impacts. In addition, the new bioavailable 87Sr/86Sr data for Barbados reported here advance current efforts toward mapping the Caribbean Sr isoscape.


Assuntos
Artiodáctilos , Radioisótopos de Carbono/análise , Fósseis/história , Datação Radiométrica , Isótopos de Estrôncio/análise , Animais , Barbados , História do Século XVI , Espécies Introduzidas
7.
PLoS One ; 14(4): e0215392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30995272

RESUMO

BACKGROUND: Although most countries face increasing population levels of obesity and diabetes their effect on coronary heart disease (CHD) mortality has not been often studied in small island developing states (SIDs) where obesity rates are among the highest in the world. We estimated the relative contributions of treatments and cardiovascular risk factors to the decline in CHD mortality from 1990 to 2012 in the Caribbean island, Barbados. METHODS: We used the IMPACT CHD mortality model to estimate the effect of increased coverage of effective medical/surgical treatments and changes in major CHD risk factors on mortality trends in 2012 compared with 1990. We calculated deaths prevented or postponed (DPPs) for each model risk factor and treatment group. We obtained data from WHO Mortality database, population denominators from the Barbados Statistical Service stratified by 10-year age group (ages 25-34 up to 85 plus), population-based risk factor surveys, Global Burden of Disease and Barbados' national myocardial infarction registry. Monte Carlo probabilistic sensitivity analysis was performed. RESULTS: In 1990 the age-standardized CHD mortality rate was 109.5 per 100,000 falling to 55.3 in 2012. Implementation of effective treatment accounted for 56% DPPs (95% (Uncertainty Interval (UI) 46%, 68%), mostly due to the introduction of treatments immediately after acute myocardial infarction (AMI) (14%) and unstable angina (14%). Overall, risk factors contributed 19% DPPs (95% UI 6% to 34%) mostly attributed to decline in cholesterol (18% DPPs, 95% UI 12%, 26%). Adverse trends in diabetes: 14% additional deaths(ADs) 95% UI 8% to 21% ADs) and BMI (2% ADs 95%UI 0 to 5% ADs) limited potential for risk factor gains. CONCLUSIONS: Given the significant negative impact of obesity/diabetes on mortality in this analysis, research that explores factors affecting implementation of evidenced-based preventive strategies is needed. The fact that most of the decline in CHD mortality in Barbados was due to treatment provides an example for SIDs about the advantages of universal access to care and treatment.


Assuntos
Doença das Coronárias/mortalidade , Complicações do Diabetes/mortalidade , Modelos Cardiovasculares , Obesidade/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Barbados/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
8.
Sci Total Environ ; 671: 76-82, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-30927730

RESUMO

Several micropollutants, including caffeine, artificial sweeteners, pharmaceuticals, steroid hormones and a current-use pesticide were analyzed in water samples collected from five groundwater pumping stations in Barbados. The presence of caffeine and three artificial sweeteners (i.e. acesulfame, sucralose, saccharin) in groundwater samples indicated that groundwater was being contaminated by infiltration of wastewater into the karst aquifer. An estrogen (i.e. estrone), three pharmaceuticals (i.e. carbamazepine, trimethoprim, ibuprofen) and a transformation product of the fungicide, chlorothalonil (i.e. 4-hydroxychlorothalonil) were also detected at ng/L concentrations in groundwater collected from two or more pumping sites. The concentrations of carbamazepine and trimethoprim were correlated with the concentrations of caffeine (R2 values of 0.70 to 0.80), indicating pharmaceutical contamination of groundwater by infiltration from domestic wastewater. The concentrations of caffeine were generally higher in groundwater samples collected in June during the wet season relative to the concentrations in samples collected in February during the dry season, indicating that infiltration of contaminants is higher during periods of heavy rainfall. Rapid rates of degradation and relatively slow rates of infiltration may explain why several target analytes were not detected in groundwater. Elevated concentrations of 4-hydroxychlorothalonil > 0.1 µg/L in samples collected at two of the monitoring sites warrant further studies on the sources and the distribution of this compound and other pesticides used in agriculture and for turf-treatment (e.g. golf courses). Overall, more data are needed in order to implement mitigation strategies that are effective in reducing chemical contamination in groundwater in Barbados.


Assuntos
Água Potável/análise , Monitoramento Ambiental , Água Subterrânea/análise , Águas Residuárias/análise , Poluentes Químicos da Água/análise , Barbados
9.
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
10.
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
11.
Int J Behav Nutr Phys Act ; 16(1): 13, 2019 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-30700311

RESUMO

BACKGROUND: The World Health Organization has advocated for sugar-sweetened beverage (SSB) taxes as part of a broader non-communicable disease prevention strategy, and these taxes have been recently introduced in a wide range of settings. However, much is still unknown about how SSB taxes operate in various contexts and as a result of different tax designs. In 2015, the Government of Barbados implemented a 10% ad valorem (value-based) tax on SSBs. It has been hypothesized that this tax structure may inadvertently encourage consumers to switch to cheaper sugary drinks. We aimed to assess whether and to what extent there has been a change in sales of SSBs following implementation of the SSB tax. METHODS: We used electronic point of sale data from a major grocery store chain and applied an interrupted time series (ITS) design to assess grocery store SSB and non-SSB sales from January 2013 to October 2016. We controlled for the underlying time trend, seasonality, inflation, tourism and holidays. We conducted sensitivity analyses using a cross-country control (Trinidad and Tobago) and a within-country control (vinegar). We included a post-hoc stratification by price tertile to assess the extent to which consumers may switch to cheaper sugary drinks. RESULTS: We found that average weekly sales of SSBs decreased by 4.3% (95%CI 3.6 to 4.9%) compared to expected sales without a tax, primarily driven by a decrease in carbonated SSBs sales of 3.6% (95%CI 2.9 to 4.4%). Sales of non-SSBs increased by 5.2% (95%CI 4.5 to 5.9%), with bottled water sales increasing by an average of 7.5% (95%CI 6.5 to 8.3%). The sensitivity analyses were consistent with the uncontrolled results. After stratifying by price, we found evidence of substitution to cheaper SSBs. CONCLUSIONS: This study suggests that the Barbados SSB tax was associated with decreased sales of SSBs in a major grocery store chain after controlling for underlying trends. This finding was robust to sensitivity analyses. We found evidence to suggest that consumers may have changed their behaviour in response to the tax by purchasing cheaper sugary drinks, in addition to substituting to untaxed products. This has important implications for the design of future SSB taxes.


Assuntos
Bebidas/economia , Comércio , Comportamento do Consumidor , Açúcares da Dieta/economia , Preferências Alimentares , Edulcorantes/economia , Impostos , Adulto , Barbados , Dieta/economia , Açúcares da Dieta/administração & dosagem , Humanos , Açúcares , Edulcorantes/administração & dosagem
12.
BMJ Open ; 9(1): e025977, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30696685

RESUMO

OBJECTIVES: In Barbados, high case fatality rates have been reported after myocardial infarction (MI) with higher rates in women than men. To explore this inequality, we examined documented pharmacological interventions for ST-segment elevated myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable and chronic angina in women and men. DESIGN: Prospective cohort registry data for STEMI and NSTEMI and retrospective chart review for unstable and chronic angina. SETTING: Tertiary care (acute coronary syndromes) and primary care (chronic angina) centres in Barbados. PARTICIPANTS: For the years 2009-2016, a total of 1018 patients with STEMI or NSTEMI were identified via the prospective study. For unstable and chronic angina, 136 and 272 notes were reviewed respectively for the years 2010-2014. OUTCOME MEASURES: The proportions of patients prescribed recommended medication during the first 24 hours after an acute event, at discharge and for chronic care were calculated. Prescribed proportions were analysed by gender after adjustment for age. RESULTS: Between 2009 and 2016, for the acute management of patients with NSTEMI and STEMI, only two (aspirin and clopidogrel) of six drugs had documented prescription rates of 80% or more. Patients with STEMI (n=552) had higher prescription rates than NSTEMI (n=466), with gender differences being more pronounced in the former. Among patients with STEMI, after adjustment for age, diabetes, hypertension and smoking, men were more likely to receive fibrinolytics acutely, OR 2.28 (95% CI 1.24 to 4.21). Compared with men, a higher proportion of women were discharged on all recommended treatments; this was only statistically significant for beta-blockers: age-adjusted OR 1.87 (95% CI 1.16 to 3.00). There were no statistically significant differences in documented prescription of drugs for chronic angina. CONCLUSION: Following acute MI in Barbados, the proportion of patients with documented recommended treatment is relatively low. Although women were less likely to receive appropriate acute care than men, by discharge gender differences were reversed.


Assuntos
Síndrome Coronariana Aguda/terapia , Angina Instável/terapia , Disparidades nos Níveis de Saúde , Infarto do Miocárdio/terapia , Prevenção Secundária/métodos , Fatores Sexuais , Síndrome Coronariana Aguda/epidemiologia , Fatores Etários , Idoso , Angina Instável/epidemiologia , Barbados/epidemiologia , Estudos de Coortes , Feminino , Mortalidade Hospitalar , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Sistema de Registros
14.
Geneva; World Health Organization; 2019. (WHO/MCA/19.04).
em Inglês | WHO IRIS | ID: who-326383
15.
J Infect Dev Ctries ; 13(1): 1-10, 2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-32032017

RESUMO

INTRODUCTION: Microbes such as Salmonella, Campylobacter and S. aureus have been implicated in Foodborne disease outbreaks (FBDOs) worldwide, yet information on their occurrence in Barbados is scanty. The purpose of this study was to determine the aetiological agents, food vehicles, locations and peak seasons of FBDOs in Barbados; assess the quality of epidemiological investigations; and identify deficiencies in food production practices and laboratory detection. METHODOLOGY: A search of FBDOs occurring in Barbados between 1998-2009 was conducted among published and unpublished literature sources and reports. The search terms included the keywords "foodborne disease," "outbreaks" and "Barbados". RESULTS: During the period 1998 to 2009, there were 24 foodborne outbreaks, 215 cases of illness, one hospitalisation and no deaths. Overall, 37.5% of outbreaks were associated with hotels/resorts. Salmonella Enteritidis phage type 8 was most commonly implicated with eggs and poultry being the primary vehicles. Three outbreak reports were available for assessment and revealed that there were deficiencies in the outbreak investigations. These reports also recorded high levels of food contamination with indicator organisms, suggesting that improvements in food hygiene and production practices were required. CONCLUSIONS: The number of FBDOs is low in comparison to developed countries. However, the data was likely affected by under-reporting and inadequacies in the outbreak investigations and laboratory detection. Improvements in these areas would lead to not only better detection and characterisation of FBDOs in Barbados but improved food safety control measures.


Assuntos
Campylobacter/isolamento & purificação , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/etiologia , Salmonella/isolamento & purificação , Staphylococcus aureus/isolamento & purificação , Barbados/epidemiologia , Campylobacter/classificação , Contaminação de Alimentos , Humanos , Salmonella/classificação , Estações do Ano , Staphylococcus aureus/classificação
16.
Artigo em Inglês | MEDLINE | ID: mdl-31892174

RESUMO

Despite widespread awareness of the rise of non-communicable diseases (NCDs) and the growing threat of climate change, little research has explored future health outcomes that will occur at the intersection of these challenges. Ten Barbadian health professionals were interviewed to assess their knowledge of health risks of climate change as it relates to NCDs in Barbados as a case study of a small island state at risk. There is widespread concern among health professionals about the current and future prevalence of non-communicable diseases among Barbadians. There is less concern about the future burden of NCDs in the context of a changing climate, largely because of a lack of knowledge among the majority of the health experts interviewed. Those knowledgeable about potential connections noted the difficulty that climate change would pose to the prevention and management of NCDs, given the impacts of climate stressors to food security, the built environment, and physiological and psychosocial health impacts. Lack of awareness among health professionals of the risk climate change poses to NCD prevalence and impact is reflective of the country's health priorities that fail to recognize the risk of climate change. We recommend efforts to disseminate information about climate change to stakeholders in the health sector to increase awareness.


Assuntos
Atitude do Pessoal de Saúde , Mudança Climática , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Prioridades em Saúde/estatística & dados numéricos , Doenças não Transmissíveis/epidemiologia , Adulto , Barbados/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
17.
J Food Prot ; 81(12): 2064-2073, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30485764

RESUMO

In Barbados, tourism is a significant pillar of the economy; however, there has been no research to document the food safety concerns of tourists. Therefore, the purpose of this study was to survey visitors' perceptions of food safety to understand their concerns, influences, and experiences with foodborne illness. A descriptive cross-sectional quantitative survey was conducted among 398 tourists, using stratified random sampling. Visitors were surveyed at two departure ports, the Grantley Adams International Airport (GAIA) ( n = 240) and the Bridgetown Cruise Terminal (BCT) ( n = 158). Descriptive statistics included frequency distributions. Cross tabulations were performed to determine associations among key variables, and logistic regression analyses were used to report predictor variables at a significance level of P ≤ 0.05. In both surveys (GAIA and BCT), most respondents had a positive perception of food safety (75.8 and 99.4%) and a low frequency of foodborne illness (6.0 and 0.6%), respectively. Most visitors perceived the likelihood of acquiring food poisoning as a result of eating food from local retailers as "not common," and more visitors were "not concerned" about food hazards than concerned. Significant associations ( P ≤ 0.05) were found among sociodemographic parameters such as age, gender, ethnicity, and education and three variables of risk perception. The findings in this study can be used to guide risk communication and food safety and risk management within the hospitality industry, and they add to the body of knowledge surrounding consumer risk perceptions.


Assuntos
Inocuidade dos Alimentos , Conhecimentos, Atitudes e Prática em Saúde , Barbados , Estudos Transversais , Comportamentos Relacionados com a Saúde , Humanos , Índias Ocidentais
18.
Psychiatry Res ; 269: 301-308, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30172187

RESUMO

Both childhood malnutrition and maltreatment are associated with mental health problems that can persist into adulthood. Previously we reported that in Barbados, those with a history of infant malnutrition were more likely to report having experienced childhood maltreatment. Few studies, however, address the long-term outcomes of those who have been exposed to both. We assessed the unique and combined associations of a history of early malnutrition and childhood maltreatment with personality pathology in mid-adulthood in participants of the 47-year longitudinal Barbados Nutrition Study. We used the Structured Clinical Interview for DSM-IV-TR Axis II Personality Disorders Personality Questionnaire (SCID-II-PQ) and NEO Personality Inventory-Revised derived Five-Factor Model (NEO PI-R FFM) personality disorder (PD) scores to assess personality pathology, the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to assess childhood maltreatment, and clinical documentation of malnutrition in infancy. We tested the associations of malnutrition and maltreatment with PD scores using linear regression models, unadjusted and adjusted for other childhood adversities. We found increased scores for paranoid, schizoid, avoidant, and dependent PDs among those who had been malnourished and increased scores for paranoid, schizoid, schizotypal, and avoidant PDs among those with higher childhood maltreatment scores. Overall, those exposed to both adversities had even greater PD scores.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/psicologia , Desnutrição/psicologia , Transtornos da Personalidade/etiologia , Adulto , Barbados , Criança , Feminino , Humanos , Masculino , Transtornos da Personalidade/psicologia , Inquéritos e Questionários
19.
BMC Public Health ; 18(1): 998, 2018 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-30092782

RESUMO

BACKGROUND: High sodium diets with inadequate potassium and high sodium-to-potassium ratios are a known determinant of hypertension and cardiovascular disease (CVD). The Caribbean island of Barbados has a high prevalence of hypertension and mortality from CVD. Our objectives were to estimate sodium and potassium excretion, to compare estimated levels with recommended intakes and to identify the main food sources of sodium in Barbadian adults. METHODS: A sub-sample (n = 364; 25-64 years) was randomly selected from the representative population-based Health of the Nation cross-sectional study (n = 1234), in 2012-13. A single 24-h urine sample was collected from each participant, following a strictly applied protocol designed to reject incomplete samples, for the measurement of sodium and potassium excretion (in mg), which were used as proxy estimates of dietary intake. In addition, sensitivity analyses based on estimated completeness of urine collection from urine creatinine values were undertaken. Multiple linear regression was used to examine differences in sodium and potassium excretion, and the sodium-to-potassium ratio, by age, sex and educational level. Two 24-h recalls were used to identify the main dietary sources of sodium. All analyses were weighted for the survey design. RESULTS: Mean sodium excretion was 2656 (2488-2824) mg/day, with 67% (62-73%) exceeding the World Health Organization (WHO) recommended limit of 2000 mg/d. Mean potassium excretion was 1469 (1395-1542) mg/d; < 0.5% met recommended minimum intake levels. Mean sodium-to-potassium ratio was 2.0 (1.9-2.1); not one participant had a ratio that met WHO recommendations. Higher potassium intake and lower sodium-to-potassium ratio were independently associated with age and tertiary education. Sensitivity analyses based on urine creatinine values did not notably alter these findings. CONCLUSIONS: In this first nationally representative study with objective assessment of sodium and potassium excretion in a Caribbean population in over 20 years, levels of sodium intake were high, and potassium intake was low. Younger age and lower educational level were associated with the highest sodium-to-potassium ratios. These findings provide baseline values for planning future policy interventions for non-communicable disease prevention.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Dieta/estatística & dados numéricos , Potássio/urina , Sódio/urina , Adulto , Barbados/epidemiologia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/urina , Estudos Transversais , Dieta/efeitos adversos , Inquéritos sobre Dietas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Potássio/análise , Prevalência , Sódio na Dieta/análise
20.
PLoS Med ; 15(7): e1002613, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30016319

RESUMO

BACKGROUND: Over the last 5 years (2013-2017), the Caribbean region has faced an unprecedented crisis of co-occurring epidemics of febrile illness due to arboviruses transmitted by the Aedes sp. mosquito (dengue, chikungunya, and Zika). Since 2013, the Caribbean island of Barbados has experienced 3 dengue outbreaks, 1 chikungunya outbreak, and 1 Zika fever outbreak. Prior studies have demonstrated that climate variability influences arbovirus transmission and vector population dynamics in the region, indicating the potential to develop public health interventions using climate information. The aim of this study is to quantify the nonlinear and delayed effects of climate indicators, such as drought and extreme rainfall, on dengue risk in Barbados from 1999 to 2016. METHODS AND FINDINGS: Distributed lag nonlinear models (DLNMs) coupled with a hierarchal mixed-model framework were used to understand the exposure-lag-response association between dengue relative risk and key climate indicators, including the standardised precipitation index (SPI) and minimum temperature (Tmin). The model parameters were estimated in a Bayesian framework to produce probabilistic predictions of exceeding an island-specific outbreak threshold. The ability of the model to successfully detect outbreaks was assessed and compared to a baseline model, representative of standard dengue surveillance practice. Drought conditions were found to positively influence dengue relative risk at long lead times of up to 5 months, while excess rainfall increased the risk at shorter lead times between 1 and 2 months. The SPI averaged over a 6-month period (SPI-6), designed to monitor drought and extreme rainfall, better explained variations in dengue risk than monthly precipitation data measured in millimetres. Tmin was found to be a better predictor than mean and maximum temperature. Furthermore, including bidimensional exposure-lag-response functions of these indicators-rather than linear effects for individual lags-more appropriately described the climate-disease associations than traditional modelling approaches. In prediction mode, the model was successfully able to distinguish outbreaks from nonoutbreaks for most years, with an overall proportion of correct predictions (hits and correct rejections) of 86% (81%:91%) compared with 64% (58%:71%) for the baseline model. The ability of the model to predict dengue outbreaks in recent years was complicated by the lack of data on the emergence of new arboviruses, including chikungunya and Zika. CONCLUSION: We present a modelling approach to infer the risk of dengue outbreaks given the cumulative effect of climate variations in the months leading up to an outbreak. By combining the dengue prediction model with climate indicators, which are routinely monitored and forecasted by the Regional Climate Centre (RCC) at the Caribbean Institute for Meteorology and Hydrology (CIMH), probabilistic dengue outlooks could be included in the Caribbean Health-Climatic Bulletin, issued on a quarterly basis to provide climate-smart decision-making guidance for Caribbean health practitioners. This flexible modelling approach could be extended to model the risk of dengue and other arboviruses in the Caribbean region.


Assuntos
Aedes/virologia , Clima , Vírus da Dengue/patogenicidade , Dengue/epidemiologia , Surtos de Doenças , Vetores de Doenças , Tempo (Meteorologia) , Animais , Barbados/epidemiologia , Teorema de Bayes , Dengue/diagnóstico , Dengue/transmissão , Dengue/virologia , Secas , Inundações , Temperatura Alta/efeitos adversos , Humanos , Dinâmica não Linear , Chuva , Medição de Risco , Fatores de Risco , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA