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1.
Washington, D.C.; PAHO; 2020-01-27.
em Inglês | PAHO-IRIS | ID: phr-51834

RESUMO

Mental health is critical to personal well-being, interpersonal relationships, and successful contributions to society. Mental health conditions consequently impose a high burden not only on individuals, families and society, but also on economies. In Jamaica, mental health conditions are highly prevalent and major contributors to morbidity, disability, and premature mortality. Encouragingly, with timely and effective treatment, individuals suffering from mental health conditions can lead productive and satisfying lives. This publication, the first of its kind, provides evidence and guidance to support the development, financing, and implementation of mental health interventions in Jamaica. Specifically, it estimates the return on investment (ROI) from scaling up treatment for anxiety, depression, and psychosis. The results from this analysis show that Jamaica can significantly reduce the health and economic burden of mental health conditions by investing in cost-effective recommended interventions designed to improve mental health.


Assuntos
Saúde Mental , Doença Crônica , Indicadores de Desenvolvimento Sustentável , Doenças Cardiovasculares , Diabetes Mellitus , Economia da Saúde , Transtornos Relacionados ao Uso de Álcool , Jamaica
2.
Washington, D.C.; PAHO; 2020-01. (PAHO/NMH/19-019).
em Inglês | PAHO-IRIS | ID: phr-51828

RESUMO

[Extract]. Noncommunicable Diseases (NCDs) and Mental Health (MH) conditions are major drivers of morbidity and mortality in Jamaica. Beyond the toll on health, they also impose a significant burden on the national economy since treatment for NCDs leads to high expenditures and individuals with NCDs or MH conditions are more likely to exit the labor force, miss days of work, and/or work at a reduced capacity. In addition, MH conditions generate high social costs as MH is critical to personal well-being, interpersonal relationships, and successful contributions to society. These two investment cases were developed to help strengthen Jamaica’s capacity to generate and use economic evidence on NCDs and MH in order to support the development, financing, and implementation of national multisectoral prevention and control strategies. They estimate the return on investment (ROI), over the next 15-year period, from implementing priority policy interventions for tobacco and alcohol control, clinical interventions to reduce cardiovascular diseases and diabetes, and scaling up treatment for depression, anxiety, and psychosis. Though NCDs and MH conditions pose a significant health and economic burden, the results from these two investment cases show that Jamaica can significantly reduce this burden by investing in recommended interventions designed to improve NCDs and MH.


Assuntos
Doença Crônica , Indicadores de Desenvolvimento Sustentável , Doenças Cardiovasculares , Diabetes Mellitus , Economia da Saúde , Jamaica , Transtornos Relacionados ao Uso de Álcool , Tabagismo
3.
Zootaxa ; 4604(1): zootaxa.4604.1.4, 2019 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-31717203

RESUMO

Elpidium ostracods are known by their very particular niche (water accumulated in tank-bromeliads), their relatively low dispersal ability and their dependency on amphibians for dispersal and colonization of new bromeliads. All these characteristics make the genus an interesting group for evolutionary, ecological and even taxonomic studies. However, the diversity of the group remains poorly studied. Here, we describe three new species of Elpidium, Elpidium littlei n. sp., Elpidium heberti n. sp. and Elpidium wolfi n. sp., and re-describe Elpidium laesslei, all from Jamaica. These species are characterized by a copulatory process with separated ejaculatory duct and distal glans, a feature so far unique within the genus. Each species can, in turn, be diagnosed by soft part and carapace morphology, most notably comparing hemipenis, valve ornamentation and degree of sexual dimorphism. The observed morphological diversity of Elpidium is discussed in relation to previous genetic estimates that suggested an even higher diversity in Jamaica. We point to intraspecific variation and lack of complete morphological descriptions as possible explanations. We also reaffirm the need of multidisciplinary studies in order to do more objective and secure taxonomic classifications in future studies.


Assuntos
Evolução Biológica , Crustáceos , Animais , Ecologia , Jamaica , Caracteres Sexuais
4.
Rev Panam Salud Publica ; 43, November 2019
Artigo em Inglês | PAHO-IRIS | ID: phr-51722

RESUMO

[ABSTRACT]. Objective. To identify social and behavioral patterns and mental health concerns associated with intimate partner homicide-suicide (IPHS) in Jamaica through an analysis of media and police reports. Methods. This was an archival data review of police records and print, radio, and television reports of IPHS incidents from January 2007 – June 2017 in Jamaica. The 27 cases found were qualitatively analyzed using pre-identified codes and open coding to generate themes and patterns. Results. A prevalence rate of 0.1 per 100 000 was determined. In all cases, males were the homicide-offender. Sociodemographic patterns associated with IPHS incidents—age, personality traits, choice of weapon, and time of occurrence—were consistent with previous findings. Common triggers were offender obsession, sexual jealousy, and fear of separation. Despite reports of mental health concerns in both male and female partners, neither the couples nor community members sought help prior to the homicide-suicide. Conclusion. These findings demand a change in cultural attitudes toward domestic disputes and mental health concerns, and a redefining of the community’s responsibility in IPHS. The warning signs associated with IPHS should be part of existing violence and suicide prevention programs.


[RESUMEN]. Objetivo. Identificar los patrones sociales y de comportamiento y los problemas de salud mental asociados con el homicidio de la pareja íntima seguido de suicidio (HPIS) en Jamaica mediante el análisis de los informes de medios de comunicación y policiales. Métodos. Revisión de datos de los archivos policiales y de los informes publicados en la prensa escrita, la radio o la televisión sobre HPIS en Jamaica entre enero de 2007 y junio de 2017. Los 27 casos identificados se analizaron cualitativamente mediante códigos preidentificados y códigos abiertos adicionales a fin de generar temas y patrones. Resultados. Se determinó una tasa de prevalencia de 0,1 por 100 000 habitantes. En todos los casos, los autores del homicidio fueron hombres. Los patrones sociodemográficos asociados con los incidentes –edad, rasgos de personalidad, arma empleada y momento del suceso– coincidieron con los encontrados en incidentes anteriores. Fueron desencadenantes frecuentes la conducta obsesiva del agresor respecto de su pareja, los celos sexuales y el miedo a la separación. A pesar de la presencia de informes sobre problemas de salud mental tanto en los hombres como en las mujeres, ni las propias parejas ni los miembros de la comunidad buscaron ayuda antes del homicidio seguido de suicidio. Conclusión. Estos hallazgos exigen cambiar las actitudes culturales hacia las disputas domésticas y los problemas de salud mental, y redefinir la responsabilidad de la comunidad ante estos incidentes. Las señales de advertencia asociadas con el HPIS deben ser parte de los programas de prevención de la violencia y el suicidio.


[RESUMO]. Objetivo. Identificar os padrões sociais e comportamentais e as questões de saúde mental associados aos homicídios por parceiro íntimo seguidos por suicídio (HPIS) na Jamaica, a partir de análise da mídia e de inquéritos policiais. Métodos. Revisão de inquéritos policiais e de relatos publicados na imprensa escrita, no rádio ou na televisão sobre HPIS na Jamaica de janeiro de 2007 a junho de 2017. Os 27 casos identificados foram analisados qualitativamente utilizando códigos pré-identificados e codificação aberta para gerar temas e padrões. Resultados. Foi detectada uma taxa de prevalência de 0,1 por 100 000 habitantes. Em todos os casos, os autores do homicídio eram homens. Os padrões sociodemográficos associados aos incidentes de HPIS – idade, traços de personalidade, arma utilizada e momento do evento – coincidiram com os encontrados em estudos anteriores. Obsessão por parte do agressor, ciúme sexual e medo da separação foram gatilhos frequentes. Apesar dos relatos de problemas de saúde mental em ambos os parceiros, tanto do sexo feminino quanto do masculino, nem o casal nem os membros da comunidade procuraram ajuda antes do homicídio seguido do suicídio. Conclusão. Estes resultados indicam a necessidade de mudanças culturais na atitude frente a disputas domésticas e problemas de saúde mental e de uma redefinição da responsabilidade da comunidade quanto a HPIS. Os sinais de alerta associados a HPIS devem ser contemplados em programas de prevenção da violência e do suicídio.


Assuntos
Violência por Parceiro Íntimo , Saúde Mental , Jamaica , Violência por Parceiro Íntimo , Saúde Mental , Violência por Parceiro Íntimo , Saúde Mental
5.
PLoS One ; 14(7): e0219250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291297

RESUMO

The study examines the potential influence of sub-regional variations in climate, and specifically heavy rain events, in determining relative vulnerabilities of locations in twelve Caribbean countries. An aggregate vulnerability index, referred to as the Caribbean Vulnerability Score (CVS), is created using historical demographic and socioeconomic data and climate data representing extreme rain events. Four scenarios are explored. Firstly, comparative vulnerabilities are determined when heavy rainfall is incorporated in CVS versus when it is excluded. The impact of climate change is also investigated using future climate data derived from statistical downscaling but holding demographic and socioeconomic sub-indices constant. The analysis is repeated with projections of future demographic structure from the Shared Socioeconomic Pathway data (SSP3), future climate projections and constant socioeconomic. Finally, the sensitivity of the results is examined with respect to applying different weights i.e. versus using equal weights for the climate and non-climatic components of CVS as is done for the first three scenarios. Results suggest that the inclusion of historical susceptibility to rainfall extremes influences relative vulnerabilities within the Caribbean when compared to the rankings of vulnerability derived using only socioeconomic and demographic inputs. In some cases significant increases in relative rankings are noted. Projected changes in the intensity of rain events across the Caribbean region in the 2030s and 2050s, do not significantly alter the top and lowest ranked vulnerable locations when demographic and socioeconomic indices are held constant. Changes may however occur in the order of the top ranked locations dependent on scenario and time slice. In general, future shifts in relative vulnerabilities were found to be dependent on (i) changes in both future climate and demographic scenarios, (ii) the time horizons being considered, and (iii) the weighting assigned to climate in the future.


Assuntos
Mudança Climática , Demografia , Fatores Socioeconômicos , Belize/epidemiologia , Região do Caribe/epidemiologia , Cuba/epidemiologia , República Dominicana/epidemiologia , Guiana/epidemiologia , Humanos , Umidade , Jamaica/epidemiologia , Chuva
6.
PLoS One ; 14(7): e0215262, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31339887

RESUMO

Oral and fecal microbial biomarkers have previously been associated with cardiometabolic (CM) risk, however, no comprehensive attempt has been made to explore this association in minority populations or across different geographic regions. We characterized gut- and oral-associated microbiota and CM risk in 655 participants of African-origin, aged 25-45, from Ghana, South Africa, Jamaica, and the United States (US). CM risk was classified using the CM risk cut-points for elevated waist circumference, elevated blood pressure and elevated fasted blood glucose, low high-density lipoprotein (HDL), and elevated triglycerides. Gut-associated bacterial alpha diversity negatively correlated with elevated blood pressure and elevated fasted blood glucose. Similarly, gut bacterial beta diversity was also significantly differentiated by waist circumference, blood pressure, triglyceridemia and HDL-cholesterolemia. Notably, differences in inter- and intra-personal gut microbial diversity were geographic-region specific. Participants meeting the cut-points for 3 out of the 5 CM risk factors were significantly more enriched with Lachnospiraceae, and were significantly depleted of Clostridiaceae, Peptostreptococcaceae, and Prevotella. The predicted relative proportions of the genes involved in the pathways for lipopolysaccharides (LPS) and butyrate synthesis were also significantly differentiated by the CM risk phenotype, whereby genes involved in the butyrate synthesis via lysine, glutarate and 4-aminobutyrate/succinate pathways and LPS synthesis pathway were enriched in participants with greater CM risk. Furthermore, inter-individual oral microbiota diversity was also significantly associated with the CM risk factors, and oral-associated Streptococcus, Prevotella, and Veillonella were enriched in participants with 3 out of the 5 CM risk factors. We demonstrate that in a diverse cohort of African-origin adults, CM risk is significantly associated with reduced microbial diversity, and the enrichment of specific bacterial taxa and predicted functional traits in both gut and oral environments. As well as providing new insights into the associations between the gut and oral microbiota and CM risk, this study also highlights the potential for novel therapeutic discoveries which target the oral and gut microbiota in CM risk.


Assuntos
Doenças Cardiovasculares/microbiologia , Microbioma Gastrointestinal , Doenças Metabólicas/microbiologia , Boca/microbiologia , Adulto , Doenças Cardiovasculares/epidemiologia , Feminino , Gana/epidemiologia , Humanos , Jamaica/epidemiologia , Masculino , Doenças Metabólicas/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , África do Sul/epidemiologia , Estados Unidos/epidemiologia , Circunferência da Cintura
7.
Acta Trop ; 199: 105112, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31351894

RESUMO

This report describes the presence of Aedes albopictus (Skuse) in Jamaica. The adults were found while conducting an ongoing survey of mosquitoes on the island. Specimens were collected using a combination of modified Center for Disease Control (CDC) miniature light traps and BG sentinel traps. A total of six adult female Ae. albopictus mosquitoes were collected at two different locations in October of 2018. This finding increases the number of Aedes mosquito species on the island bringing with it public health implications.


Assuntos
Aedes , Animais , Feminino , Jamaica , Controle de Mosquitos , Saúde Pública
8.
BMC Public Health ; 19(1): 894, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286918

RESUMO

BACKGROUND: Small island Caribbean countries such as Jamaica are now facing an epidemic of obesity and decreased physical activity (PA) levels. Public parks have been shown to be important resources for PA that also provide psychological and social benefits associated with increased PA. There are no studies that document PA in parks in the Caribbean. METHODS: This study utilized a mixed method approach by using the System for Observing Play and Recreation in Communities (SOPARC) to obtain baseline data on park usage patterns in Emancipation Park, a large urban public park in Jamaica. In addition, in-depth interviews were conducted to gain additional insights on the park's use for PA. RESULTS: The park was used mostly by females, in the evenings and by persons 18-64 years old. Females had significantly lower mean energy expenditure (EE) than males (0.078 versus 0.080 kcal/kg/min, p < 0.05). In-depth interviews revealed that safety, a central location within a business district, aesthetic appeal, a walking track and individual health benefits were key reasons for persons engaging in PA at the park. CONCLUSIONS: This is the first study to describe the usage of a public park for PA in Jamaica. The study elicited aspects of park use for PA in a major urban park in Jamaica from different vantage points by using direct systematic observation augmented with a qualitative approach. It revealed important differential park use for PA by sex, age group and EE levels, and provided insights into factors that motivate and hinder park usage for PA. This can be used by policymakers in Jamaica to inform PA interventions to reduce obesity, provide baseline data for comparisons with other parks in developing countries and to advocate for well-designed public parks.


Assuntos
Exercício/psicologia , Parques Recreativos/estatística & dados numéricos , Recreação/psicologia , Adolescente , Adulto , Metabolismo Energético , Planejamento Ambiental , Feminino , Geografia , Humanos , Jamaica , Masculino , Pessoa de Meia-Idade , Motivação , Projetos de Pesquisa , Fatores Sexuais , Adulto Jovem
9.
Pan Afr Med J ; 32: 84, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223375

RESUMO

Introduction: Sickle cell disease can result in visually threatening eye disease (proliferative sickle cell retinopathy). This can be prevented with timely eye screening. It is important for patients to understand their role. Our research is to determine the knowledge, beliefs and practices (KBP) regarding eye disease of Sickle Cell patients and the impact of genotype, demographic and socio-economic status. Methods: Cross-sectional study at the Sickle Cell Unit, Jamaica during May 2016. Consecutive non-pregnant adults (>18 years of age) attendees, who were not acutely unwell, were invited to participate. A 26-item single interviewer administered questionnaire was used to obtain socio-demographic data, highest level of education completed, employment status, sickle cell genotype, if known, frequency of clinic attendance and patients' knowledge, beliefs and practices. Ten of these were yes/no questions, whereas eight required that they choose correct answers from four choices. Results: One hundred subjects were recruited, 72% had homozygous SS disease. Their ages ranged from 18-63 years (mean 34.1 years, SD11.3). Fifty six percent were female. Most (75%) had achieved at least secondary education. The majority (62%) were unemployed. The mean belief score was 3.6/6(60%) and the mean knowledge and practice scores were 3.3/7(47%) and 2.2/5(44%) respectively. Milder genotypes had higher knowledge scores vs the more severe genotypes (4.0 vs 3.2, P=0.013). Only 28% had regular eye examinations; less than 50% had seen an ophthalmologist in the past year. Practice scores were higher in employed than in unemployed patients (2.6 vs 1.9, (P=0.04)). Employed patients were more likely than the unemployed to see their eye doctor for regular eye "examinations" (42.1% vs 19.4%, χ2=6.0, P=0.02). The practice and knowledge scores correlated (r2=0.363, P<0.001) and belief score (r2=0.304, P =0.002), except where 98% believed they should see an ophthalmologist annually, but only 42% did, and 21% had never. Conclusion: Knowledge scores were fair, however, the practice was not always in keeping with knowledge.


Assuntos
Anemia Falciforme/complicações , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/métodos , Doenças Retinianas/etiologia , Adolescente , Adulto , Anemia Falciforme/genética , Estudos Transversais , Emprego/estatística & dados numéricos , Feminino , Genótipo , Humanos , Jamaica , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/diagnóstico , Doenças Retinianas/genética , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
10.
J Nurs Educ ; 58(5): 294-297, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31039264

RESUMO

BACKGROUND: Nursing programs are instrumental in developing the knowledge, skills, and attitudes necessary for nursing practice. Opportunities are lacking for role formation for successful transition into practice. METHOD: An intraprofessional global clinical immersion program was utilized as the setting for students to develop their role identity. Students from each level of nursing traveled to Jamaica to participate in a clinical immersion experience. Students participated in structured collaboration among students in different programs and acted as the instrument other students utilized to develop their role. Students had the opportunity to work with each other every day, and they provided authentic feedback for each other on their role-formation process. RESULTS: Program evaluation revealed that the immersion helped students gain confidence in their roles as they transition into practice. CONCLUSION: Results of this evaluation support the sustainability of the structured global immersion experiences for professional role formation. [J Nurs Educ. 2019;58(5):294-297.].


Assuntos
Intercâmbio Educacional Internacional , Papel do Profissional de Enfermagem/psicologia , Estudantes de Enfermagem/psicologia , Humanos , Jamaica , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem
11.
Int J STD AIDS ; 30(6): 536-541, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31074362

RESUMO

A cross-sectional survey of 295 persons attending a major sexually transmitted infection clinic in Jamaica's capital city showed that the Ministry of Health's syndromic algorithm has moderate sensitivity and negative predictive value for diagnosing cervicitis. In the absence of diagnostic tests for sexually transmitted infections, a syndromic algorithm continues to be useful for diagnosing sexually transmitted infections.


Assuntos
Doenças Sexualmente Transmissíveis/microbiologia , Cervicite Uterina/diagnóstico , Cervicite Uterina/microbiologia , Adulto , Algoritmos , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis , Estudos Transversais , Feminino , Gonorreia/diagnóstico , Gonorreia/microbiologia , Humanos , Jamaica/epidemiologia , Masculino , Neisseria gonorrhoeae , Sensibilidade e Especificidade , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Síndrome , Cervicite Uterina/epidemiologia
14.
New Dir Child Adolesc Dev ; 2019(164): 27-47, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30891926

RESUMO

Remote acculturation (RA) is a modern form of non-migrant acculturation toward distant cultures prompted by indirect/intermittent globalization-related cultural exposure. RA theory holds that not only are global cultures now pouring into local neighborhoods, but many youth are also internalizing these remote cultures. How well do they fare? Prior studies in Jamaica and elsewhere have reported that U.S./Western-oriented adolescents exhibit poorer health habits. However, no studies have yet investigated adolescents' behavioral or academic adjustment in the context of RA, whether in Jamaica or elsewhere. Therefore, 245 adolescents and their mothers from high schools in Kingston, Jamaica (Madolescent_age   = 13.3; Mmother_age  = 40.2) completed questionnaires assessing their RA in terms of behaviors and values, as well as the adolescents' behavioral resilience and grades. SEM analyses revealed that RA was, indeed, linked to adolescent behavioral and academic adjustment in Jamaica. Overall, Jamaican orientation was associated with better adaptation whereas European American orientation was associated with worse.


Assuntos
Sucesso Acadêmico , Aculturação , Adaptação Psicológica , Comportamento do Adolescente/etnologia , Internacionalidade , Ajustamento Social , Adolescente , Adulto , Criança , Feminino , Humanos , Jamaica/etnologia , Masculino , População Urbana
15.
J Health Care Poor Underserved ; 30(1): 392-403, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30827990

RESUMO

OBJECTIVES: To assess the quality of asthma care within the paediatric population who attended health centres in Kingston & St. Andrew (KSA) and compare this quality to Global Initiative for Asthma (GINA) guidelines. METHODS AND MATERIALS: Data were collected from 257 dockets of children aged 2-17 years old with asthma attending seven health centres in KSA. RESULTS: Children aged 6-10 years accounted for 36.6% of the sample and males accounted for the majority (54.1%). There was generally poor documentation of performance indicators for asthma including written asthma action plans (1%), peak expiratory flow measurements (0%), inhaler demonstration (2.1%), and asthma control assessment (8.4%). The best documentation was for controller (60.9%) and reliever medication (63.4%) prescriptions/review. CONCLUSION: The study indicates that the documentation of paediatric asthma management in health centres in Jamaica is not congruous with international clinical practice guidelines and change is required.


Assuntos
Asma/prevenção & controle , Serviços de Saúde da Criança/normas , Qualidade da Assistência à Saúde , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Internacionalidade , Jamaica , Masculino , Guias de Prática Clínica como Assunto
16.
Hum Antibodies ; 27(3): 155-160, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30909200

RESUMO

BACKGROUND: Pneumococcal infections are a leading global cause of morbidity and mortality, complicated by the increasing antimicrobial resistance of pneumococcal isolates. OBJECTIVE: To evaluate morbidity and mortality associated with both invasive pneumococcal disease (IPD) and non-IPD in Jamaica in both the paediatric and adult population. Pneumococcal isolates (n= 94) were collected over a 2-year period (2008-2009). METHODS: Risk factors for poor clinical outcomes: death, complicated disease and length of hospitalization (LOH) were evaluated and antimicrobial resistance patterns were determined by Kirby-Bauer disc diffusion. RESULTS: The case fatality rate was 6.8%. Independent mortality risk factors included complicated disease [OR 30.9 (3.4-276.6)] and diabetes mellitus [OR 8.3 (1.4-48.8)]. Independent risk factors for the development of complicated disease included sickle cell disease [OR 36.5 (4.2-320.3)] and sepsis [OR 3.5 (1.2-10.4)]. The LOH was increased most in patients with invasive disease (4.6-fold) and resistance to ceftriaxone (4.3-fold). Penicillin (16.0%) and erythromycin (14.9%) resistance was most prevalent, while ceftriaxone (4.3%) resistance was least prevalent. CONCLUSIONS: The high burden of IPD in at-risk groups in our population and the associated increase in morbidity and mortality underlie the need for improved preventive and therapeutic management strategies in these patients.


Assuntos
Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Farmacorresistência Bacteriana/efeitos dos fármacos , Feminino , Humanos , Lactente , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Morbidade , Infecções Pneumocócicas/tratamento farmacológico , Fatores de Risco , Streptococcus pneumoniae/efeitos dos fármacos , Adulto Jovem
17.
Pathog Glob Health ; 113(1): 27-31, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30714498

RESUMO

Although traditionally chikungunya virus is considered non-fatal, recent studies suggest that there may be in fact underreporting of deaths in some situations. A major chikungunya epidemic hit Jamaica in 2014 but no chikungunya-associated deaths were reported. We assessed the excess of all-cause deaths during this epidemic. Excess deaths were estimated by difference between observed and expected mortality based on the average age-specific mortality rate of 2012-2013, using the 99% confidence interval. There was an excess of 2,499 deaths during the epidemic (91.9/100,000 population), and a strong positive correlation between the monthly incidence of chikungunya and the excess of deaths (Rho = 0.939, p < 0.005). No significant concomitant epidemiological or climatic phenomenon occurred. Chikungunya is a major contributor to morbidity during epidemics and may be an unrecognized cause of death. Thus, it is urgent to review clinical protocols and improve the investigations of specific-cause deaths during chikungunya epidemics. Excess deaths could be a strategic tool for epidemiological surveillance.


Assuntos
Febre de Chikungunya/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Causas de Morte , Criança , Pré-Escolar , Epidemias , Feminino , Humanos , Lactente , Recém-Nascido , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade , Adulto Jovem
18.
Int Nurs Rev ; 66(2): 191-198, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30734275

RESUMO

AIM: This study sought to review documentation of client teaching and discharge planning performed on the medical wards of an urban Jamaican hospital. BACKGROUND: Amid a chronic disease epidemic in Jamaica, adequate discharge planning and client education among hospitalized clients are essential to ensure optimal health outcomes and reduced healthcare costs. METHOD: A total of 131 records from six medical wards were audited. The audit instrument was developed based on the Ministry of Health, Jamaica guidelines, and appraised the completeness of assessment, use of the nursing process, client teaching and discharge planning. Quota sampling facilitated the selection of medical records which met the inclusion criteria. The SPSS® version 22 for Windows® facilitated data analysis. RESULTS: Eighty-eight adult (67.2%) and 43 (32.8%) paediatric records were audited; 89.3% indicated the clients were diagnosed with at least one non-communicable disease. Fourteen percent of records reflected documented evidence of client teaching within the first 72 h of admission. On the day of discharge, only 18.3% reflected client teaching. Nurses seldom began discharge planning within the first 24 h of admission as only 6.9% records had documented evidence. These trends were common to adult and paediatric units. DISCUSSION AND CONCLUSION: The requisite client teaching and discharge planning appeared to be lacking in the records reviewed and may be contributory to deficiencies noted in self-care management. Research is needed to determine factors which could facilitate improved client teaching and discharge planning in the local context. Failure to address this gap in nursing care can significantly affect the country's ability to the reduce the economic burden associated with chronic diseases. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study highlighted an opportunity for advocacy among nurses and requires nursing leadership to collaboratively develop policies and guidelines to address discharge planning and client education among hospitalized clients. Given the significant health costs associated with non-communicable diseases this should be made a priority in the National Strategic and Action Plan for the Prevention and Control Non-communicable Diseases in Jamaica with clear articulations.


Assuntos
Registros de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/organização & administração , Alta do Paciente/estatística & dados numéricos , Educação de Pacientes como Assunto/estatística & dados numéricos , Padrões de Prática em Enfermagem/organização & administração , Adulto , Criança , Humanos , Jamaica , Auditoria de Enfermagem
19.
AIDS Behav ; 23(6): 1530-1540, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30600454

RESUMO

Syndemics approaches explore the convergence of psychosocial factors that elevate HIV vulnerabilities. Less research has explored syndemics among lesbian, gay, bisexual and transgender (LGBT) persons in contexts where criminalization has downstream impacts on LGBT discrimination, such as Jamaica. We implemented a cross-sectional survey with LGBT persons (n = 911) in Jamaica. We conducted structural equation modeling to examine direct and indirect effects of a latent syndemics construct (binge drinking, depressive symptoms, childhood/adult abuse) on HIV vulnerabilities (lifetime sex partners, perceived HIV risk, condom self-efficacy) and the mediating role of protective factors (social support, resilient coping). Direct paths from syndemics to lifetime sex partners, perceived HIV risk, and condom self-efficacy were significant. Resilient coping and social support partially mediated the association between syndemics and condom use self-efficacy. Resilient coping partially mediated the relationship between syndemics and lifetime sex partners. Interventions can target syndemic issues to reduce HIV vulnerabilities among Jamaican LGBT persons.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Fatores de Proteção , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Sindemia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Resiliência Psicológica , Apoio Social , Adulto Jovem
20.
J Immigr Minor Health ; 21(3): 570-577, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29951775

RESUMO

This study assessed dietary intakes, nutritional composition, and identified commonly eaten foods among Jamaicans in Florida. Dietary intake was assessed among 44 study participants to determine commonly eaten foods and nutrient composition. Weighed recipes were collected and analyzed to determine nutrient composition for traditional foods. Top foods that contributed to macronutrient and micronutrient intake were identified and adherence to dietary recommendations was evaluated. Mean daily energy intake was 2879 (SD 1179) kcal and 2242 (SD 1236) kcal for men and women respectively. Mean macronutrient intakes were above dietary recommendations for men and women. Top foods contributing to energy included rice and peas, sweetened juices, chicken, red peas soup, and hot chocolate drink. Results showed sodium intake was more than double the adequate intake estimate (1300-1500 mg). Findings highlight the need to include commonly eaten traditional foods in dietary questionnaires to accurately assess diet-related chronic disease risk. Findings have implications for risk factor intervention and prevention efforts among Jamaicans.


Assuntos
Dieta/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Ingestão de Energia/etnologia , Adulto , Índice de Massa Corporal , Comportamento do Consumidor , Feminino , Florida/epidemiologia , Humanos , Jamaica/etnologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Fatores Socioeconômicos
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