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1.
Nutrients ; 13(7)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34371950

RESUMO

Long-chain omega-3 PUFAs, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are of increasing interest because of their favorable effect on cardiometabolic risk. This study explores the association between omega 6 and 3 fatty acids intake and cardiometabolic risk in four African-origin populations spanning the epidemiological transition. Data are obtained from a cohort of 2500 adults aged 25-45 enrolled in the Modeling the Epidemiologic Transition Study (METS), from the US, Ghana, Jamaica, and the Seychelles. Dietary intake was measured using two 24 h recalls from the Nutrient Data System for Research (NDSR). The prevalence of cardiometabolic risk was analyzed by comparing the lowest and highest quartile of omega-3 (EPA+ DHA) consumption and by comparing participants who consumed a ratio of arachidonic acid (AA)/EPA + DHA ≤4:1 and >4:1. Data were analyzed using multiple variable logistic regression adjusted for age, gender, activity, calorie intake, alcohol intake, and smoking status. The lowest quartile of EPA + DHA intake is associated with cardiometabolic risk 2.16 (1.45, 3.2), inflammation 1.59 (1.17, 2.16), and obesity 2.06 (1.50, 2.82). Additionally, consuming an AA/EPA + DHA ratio of >4:1 is also associated with cardiometabolic risk 1.80 (1.24, 2.60), inflammation 1.47 (1.06, 2.03), and obesity 1.72 (1.25, 2.39). Our findings corroborate previous research supporting a beneficial role for monounsaturated fatty acids in reducing cardiometabolic risk.


Assuntos
Grupo com Ancestrais do Continente Africano , Fatores de Risco Cardiometabólico , Gorduras na Dieta/administração & dosagem , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-6/administração & dosagem , Adulto , Fibras na Dieta/administração & dosagem , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácido Eicosapentaenoico/administração & dosagem , Ácido Eicosapentaenoico/análogos & derivados , Feminino , Gana/epidemiologia , Humanos , Inflamação/epidemiologia , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Prospectivos , Seicheles/epidemiologia , Estados Unidos/epidemiologia
2.
JCO Glob Oncol ; 7: 1206-1208, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34314227

RESUMO

PURPOSE: Understanding the distribution of human papilloma virus (HPV) subtypes in limited-resource settings is imperative for cancer prevention strategies in these regions. The objective of our study is to compare the prevalence of cervical HPV genotypes in women across the African diaspora. METHODS: This study was approved by the African Caribbean Consortium (AC3). Six member institutions (Benin, Ethiopia, The Bahamas, Tobago, Curacao, and Jamaica) provided independently collected HPV data. Prevalence comparisons across for each nation were performed followed by an assessment of anticipated 9-valent vaccine coverage. Chi-square or Fisher's exact tests were used with significance at P < .05. RESULTS: One thousand three hundred fifty high-risk (HR) and 584 low-risk (LR) HPV subtypes were identified in the entire cohort. The most common HR HPV subtype was HPV 16 (17.9%) of infections. The distribution of HR and LR subtypes varied by country. The proportion of HR-HPV subtypes covered by the current 9-valent vaccine was lower in African countries compared with the Caribbean countries (47.9% v 67.9%; P < .01). No significant difference was seen for LR subtypes (8.1% African continent v 5.2% Caribbean; P = .20). Marked variation in the proportion of infections covered by the 9-valent vaccine persisted in individual countries. CONCLUSION: Significant variations in HPV prevalence were identified among African and Afro-Caribbean women. A large number of women in these regions are potentially uncovered by current vaccination formulation, particularly low-risk HPV infections.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Bahamas , Benin , Curaçao , Etiópia , Feminino , Genótipo , Migração Humana , Humanos , Jamaica , Papillomaviridae/genética , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Trinidad e Tobago
3.
BMC Public Health ; 21(1): 1197, 2021 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162349

RESUMO

BACKGROUND: Non-communicable disease (NCD) multimorbidity is associated with impaired functioning, lower quality of life and higher mortality. Susceptibility to accumulation of multiple NCDs is rooted in social, economic and cultural contexts, with important differences in the burden, patterns, and determinants of multimorbidity across settings. Despite high prevalence of individual NCDs within the Caribbean region, exploration of the social epidemiology of multimorbidity remains sparse. This study aimed to examine the social determinants of NCD multimorbidity in Jamaica, to better inform prevention and intervention strategies. METHODS: Latent class analysis (LCA) was used to examine social determinants of identified multimorbidity patterns in a sample of 2551 respondents aged 15-74 years, from the nationally representative Jamaica Health and Lifestyle Survey 2007/2008. Multimorbidity measurement was based on self-reported presence/absence of 11 chronic conditions. Selection of social determinants of health (SDH) was informed by the World Health Organization's Commission on SDH framework. Multinomial logistic regression models were used to estimate the association between individual-level SDH and class membership. RESULTS: Approximately one-quarter of the sample (24.05%) were multimorbid. LCA revealed four distinct profiles: a Relatively Healthy class (52.70%), with a single or no morbidity; and three additional classes, characterized by varying degrees and patterns of multimorbidity, labelled Metabolic (30.88%), Vascular-Inflammatory (12.21%), and Respiratory (4.20%). Upon controlling for all SDH (Model 3), advancing age and recent healthcare visits remained significant predictors of all three multimorbidity patterns (p < 0.001). Private insurance coverage (relative risk ratio, RRR = 0.63; p < 0.01) and higher educational attainment (RRR = 0.73; p < 0.05) were associated with lower relative risk of belonging to the Metabolic class while being female was a significant independent predictor of Vascular-Inflammatory class membership (RRR = 2.54; p < 0.001). Material circumstances, namely housing conditions and features of the physical and neighbourhood environment, were not significant predictors of any multimorbidity class. CONCLUSION: This study provides a nuanced understanding of the social patterning of multimorbidity in Jamaica, identifying biological, health system, and structural determinants as key factors associated with specific multimorbidity profiles. Future research using longitudinal designs would aid understanding of disease trajectories and clarify the role of SDH in mitigating risk of accumulation of diseases.


Assuntos
Multimorbidade , Qualidade de Vida , Região do Caribe , Estudos Transversais , Feminino , Humanos , Jamaica/epidemiologia , Análise de Classes Latentes , Classe Social , Determinantes Sociais da Saúde
4.
Zootaxa ; 4988(1): 1-218, 2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34186778

RESUMO

As part of a long-term ecological study of the cryptic comunity of Jamaican coral reefs carried out by Jeremy B.C. Jackson and associates during the 1970s and early 1980s, collections were made of reef bryozoans found at 14 sites around the island. Space occupied by bryozoans on undercoral surfaces is dominated by relatively few species. However, during scanning electrone microscopy study and monograph preparation a diverse assortment of relatively rare species was discovered. Of the 132 species found, 56%, 74 species (70 cheilostomes and 4 cyclostomes) are new, as are one family (Inversiscaphidae) and 5 genera (Planospinella, Caribaria, Spirocoleopora, Gemellitheca, and Palliocella).


Assuntos
Briozoários/classificação , Recifes de Corais , Animais , Jamaica
5.
Nurse Educ Pract ; 53: 103088, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34044339

RESUMO

BACKGROUND: Graduate education is essential for the improvement of professions by facilitating advancements in career paths, personal growth and enhancing a country's economy. Graduate students frequently view graduate education as moderate to very stressful and this can have a negative impact on their lives. Stress can result in impaired coping, poor academic performance and reduction in cognitive functioning, resulting in the antithesis of academic success. OBJECTIVE: A qualitative study was done to gain insight into the perception and sources of academic- related stress among graduate nursing students at an urban school of nursing in Jamaica. DESIGN: A purposive sample of Master of Science in Nursing students in their penultimate semester for the academic year 2017/ 2018 were invited to participate in the study. METHODS: Nine students participated and each was assigned a selected pseudonym. Data were collected using one- to-one semi-structured interviews and interviews were transcribed verbatim. Thematic content analysis was used to determine emerging themes and coding was done manually. RESULTS: The themes that emerged were: (1) Workload (2) Research (3) Prioritization (4) Lack of support (5) Lack of feedback (6) Balancing school life (7) Very stressful (8) Expectations of lecturers. Participants perceived that graduate education was very stressful to overwhelming. Academic-related stress was multi-factorial and predominantly due to the rigid curriculum structure. Contributing factors included increased workload; time constraints; the research course itself; lack of support and timely response from research supervisors and delayed responses from the Ethics Committee. CONCLUSION: It is very important for educators and curriculum developers to implement innovative strategies that are essential in providing an environment that will facilitate learning and to mitigate stress faced by graduate students.


Assuntos
Estudantes de Enfermagem , Currículo , Humanos , Jamaica , Pesquisa Qualitativa , Universidades
6.
Vasc Health Risk Manag ; 17: 187-194, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33976549

RESUMO

Background: Ideal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean. Methods: Nationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries. Results: The prevalence of 0-1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3-4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01-1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17-1.82) and male sex (AOR: 1.35, 95% CI: 1.11-1.64) were positively associated with meeting 3-4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3-4 ideal CVHB metrics. Conclusion: The proportion of meeting 3-4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.


Assuntos
Comportamento do Adolescente , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Comportamento de Redução do Risco , Adolescente , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Dieta Saudável , República Dominicana/epidemiologia , Exercício Físico , Feminino , Inquéritos Epidemiológicos , Fatores de Risco de Doenças Cardíacas , Humanos , Jamaica/epidemiologia , Masculino , não Fumantes , Medição de Risco , Suriname/epidemiologia , Trinidad e Tobago/epidemiologia
7.
Lang Speech Hear Serv Sch ; 52(3): 807-826, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-33939554

RESUMO

Purpose The aim of this study was to investigate the appropriateness of standardized assessments of expressive grammar and vocabulary in a sample of preschool-age dual language learners (DLLs) who use Jamaican Creole (JC) and English. Adult models from the same linguistic community as these children were used to inform culturally and linguistically appropriate interpretation of children's responses to a standardized assessment. Method JC-English-speaking preschoolers (n = 176) and adults (n = 33) completed the Word Structure and Expressive Vocabulary subtests of the Clinical Evaluation of Language Fundamentals Preschool-Second Edition. Adults' responses were used to develop an adapted scoring procedure that considered the influence of JC linguistic features on responses. DLLs' responses scored using the standard English and adapted JC procedures were compared. Results JC-English DLLs and adults used similar linguistic structures in response to subtest questions. DLLs' scores differed significantly from the standardized sample on both subtests. Preschoolers received higher raw and corresponding standard scores with adapted scoring compared to standard scoring. Adapted scoring that made use of adult models yielded high classification accuracy at a rate of 93.8% for Word Structure and 92.1% for Expressive Vocabulary. Conclusions Adapting standardized assessment scoring procedures using adult models may offer an ecologically valid approach to working with DLL preschoolers that can support a more accurate assessment of language functioning. These findings suggest that the use of standardized assessments for bilingual JC-English speakers requires a culturally responsive approach. Supplemental Material https://doi.org/10.23641/asha.14403026.


Assuntos
Idioma , Multilinguismo , Criança , Linguagem Infantil , Pré-Escolar , Humanos , Jamaica , Testes de Linguagem , Vocabulário
8.
Behav Processes ; 188: 104413, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33957236

RESUMO

Sexually selected traits, including threat signals, have been shown to scale steeply positively with body size because their exaggeration maximizes honest signalling. However, the functional allometry hypothesis makes the opposite prediction for some weapons: because the biomechanics of force applied in their use may favor relatively smaller size, sexually selected weapons may exhibit negative allometry. Tests of these ideas in insects have largely focused on holometabolous species, whose adult body size is entirely dependent on nutrients acquired during the larval stage. In contrast, hemimetabolous insects may exhibit different patterns of allometry development because they forage throughout development, between successive moults. Here, we tested complementary and competing predictions made by the positive and functional allometry hypotheses, regarding intrasexually selected trait allometry in a hemimetabolous insect, the Jamaican field cricket (Gryllus assimilis). As expected, head width (a dominance and/or combat trait) was more positively allometric than non-sexually selected traits. In contrast, and consistent with the functional allometry hypothesis, mouthparts (weapons) were either isometric or negatively allometric. We also tested whether trait allometry responded to rearing diet by raising males on either a high protein diet or a high carbohydrate diet; we predicted stronger positive allometry under the high protein diet. However, diet did not influence allometry in the predicted manner. Overall, our results support the functional allometry hypothesis regarding sexually selected trait allometry and raise intriguing possibilities for integrating these ideas with recent paradigms for classifying intrasexually selected traits.


Assuntos
Gryllidae , Caracteres Sexuais , Animais , Tamanho Corporal , Jamaica , Masculino , Fenótipo
9.
Cancer Causes Control ; 32(8): 849-857, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33961148

RESUMO

PURPOSE: To identify staff and participants perspectives of best practices that facilitate achieving enrollment and retention targets in biomedical cohort studies in Caribbean populations. METHODS: Eight focus group discussions (FGDs) were held with research stakeholders including research (i) nurses/study supervisors, (ii) field staff/data collectors, and (iii) rural and urban participants of the Third Jamaica Health and Lifestyle Survey (a national NCD risk factor survey with biospecimen collection) to capture qualitative data on experiences with recruitment, training, retention challenges and potential solutions or strategies for strengthening future efforts. RESULTS: Our findings indicate that trained, experienced study staff with good interpersonal communication skills enhanced the proficiency of field operations and attracted study participants. Targeted community and stakeholder engagement alongside strong support from the coordinating center increased the reach and efficiency of the data collectors. Timely participant feedback, gender-appropriate approaches, and socioeconomic balance enhanced equitable enrollment and retention of participants of cohort studies particularly the hard to reach groups. CONCLUSION: Well-functioning research teams using traditional and social media promotion, applying gender-appropriate and personalized approaches together with strategies for reaching the less accessible socioeconomic groups, are effective for recruiting and retaining members of a Caribbean cohort. These strategies may also enhance the recruitment of other Black populations in the Diaspora including the US and Caribbean into biomedical studies including cancer research.


Assuntos
Grupo com Ancestrais do Continente Africano , Pesquisa Biomédica/métodos , População Rural , Adulto , Idoso , Idoso de 80 Anos ou mais , Região do Caribe , Estudos de Coortes , Feminino , Grupos Focais , Humanos , Jamaica , Masculino , Pessoa de Meia-Idade , Percepção , Índias Ocidentais , Adulto Jovem
10.
PLoS One ; 16(4): e0249619, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33819299

RESUMO

OBJECTIVE: To examine whether proximity and density of public open spaces, public parks, street connectivity, and serious and violent crimes were associated with Body Mass Index (BMI) and Waist Circumference (WC) within and across levels of urbanicity, sex and socioeconomic status (SES) in Jamaica, a small island developing state (SIDS). METHODS: Secondary analysis was conducted using data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II). All respondents were geocoded to area of residence in Enumeration Districts (EDs). Intraclass correlation coefficients (ICCs) were derived and multilevel mixed effects regression models applied to 2529 participants nested within 101 EDs from all 14 parishes in Jamaica. RESULTS: There was significant clustering across neighborhoods for mean BMI (ICC = 4.16%) and mean WC (ICC = 4.42%). In fully adjusted models statistically significant associations included: increased mean BMI among men, with increased intersection density/ km2 (ß = 0.02; 95% CI = 1.96 x10-3, 0.04, p = 0.032); increased mean WC among urban residents with increased crimes/km2/yr (ß = 0.09; 95% CI = 0.03, 0.16, p<0.01) and among persons in the middle class, with further distance away from public parks (ß = 0.30; 95% CI = 0.08, 0.53, p<0.01). CONCLUSIONS: Neighborhood physical and crime environments were associated with obesity-related outcomes in Jamaica. Policymakers in SIDS such as Jamaica should also note the important differences by urbanicity, sex and SES in prevention efforts designed to stem the growing obesity epidemic.


Assuntos
Índice de Massa Corporal , Crime/estatística & dados numéricos , Estilo de Vida , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Classe Social , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Jamaica , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
11.
PLoS One ; 16(4): e0245703, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33819265

RESUMO

The queen conch fishery in Jamaica is sustained by Pedro Bank, which is the main harvesting site located approximately 80 km south-west from Kingston. Due to its relative size, Pedro Bank has been subdivided into zones for management purposes by the Fisheries Division and the Veterinary Services Division. Understanding whether these sub-divisions reflect different sub-populations is critical for managing exploitation levels because fisheries management must demonstrate that harvesting does not endanger the future viability of the population as queen conch are on Appendix II of the Convention in Trade in Endangered Species of Wild Fauna and Flora (CITES). This determination is essential for the continued export to international markets such as the European Union. Two hundred and eight samples were collected across the entire Pedro Bank and were genetically characterized using nine polymorphic microsatellite loci. Population structure analysis for Lobatus gigas from Pedro Bank yielded low but significant values (FST = 0.009: p = 0.006) and suggested a high magnitude of gene flow indicative of a fit and viable population throughout the bank. Analysis of molecular variance (AMOVA) indicated a 100% variation within individual samples with little variation (0.9%) between populations. In contrast pairwise genetic comparisons identified significant differences between populations located to the south eastern and eastern region of the bank to those in the central and western locations. Bayesian clustering analysis also indicated the likelihood of two population sub-divisions (K = 2) on Pedro Bank. The results provided evidence of a weak but significant population structure which has crucial implications for the fishing industry as it suggests the use of ecosystem based management (EBM) in setting quotas to promote sustainable harvesting of L. gigas within each monitoring zone on Pedro Bank.


Assuntos
Gastrópodes/genética , Animais , Espécies em Perigo de Extinção , Pesqueiros , Fluxo Gênico , Variação Genética , Jamaica , Repetições de Microssatélites , Polimorfismo Genético
12.
Genes (Basel) ; 12(4)2021 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-33924228

RESUMO

Amazon parrots (Amazona spp.) colonized the islands of the Greater Antilles from the Central American mainland, but there has not been a consensus as to how and when this happened. Today, most of the five remaining island species are listed as endangered, threatened, or vulnerable as a consequence of human activity. We sequenced and annotated full mitochondrial genomes of all the extant Amazon parrot species from the Greater Antillean (A. leucocephala (Cuba), A. agilis, A. collaria (both from Jamaica), A. ventralis (Hispaniola), and A. vittata (Puerto Rico)), A. albifrons from mainland Central America, and A. rhodocorytha from the Atlantic Forest in Brazil. The assembled and annotated mitogenome maps provide information on sequence organization, variation, population diversity, and evolutionary history for the Caribbean species including the critically endangered A. vittata. Despite the larger number of available samples from the Puerto Rican Parrot Recovery Program, the sequence diversity of the A. vittata population in Puerto Rico was the lowest among all parrot species analyzed. Our data support the stepping-stone dispersal and speciation hypothesis that has started approximately 3.47 MYA when the ancestral population arrived from mainland Central America and led to diversification across the Greater Antilles, ultimately reaching the island of Puerto Rico 0.67 MYA. The results are presented and discussed in light of the geological history of the Caribbean and in the context of recent parrot evolution, island biogeography, and conservation. This analysis contributes to understating evolutionary history and empowers subsequent assessments of sequence variation and helps design future conservation efforts in the Caribbean.


Assuntos
Amazona/classificação , DNA Mitocondrial/genética , Mitocôndrias/genética , Análise de Sequência de DNA/métodos , Amazona/genética , Animais , Brasil , Cuba , Evolução Molecular , Sequenciamento de Nucleotídeos em Larga Escala , Jamaica , Anotação de Sequência Molecular , Filogenia , Porto Rico
13.
Artigo em Inglês | PAHO-IRIS | ID: phr-53410

RESUMO

[ABSTRACT]. Objective. To describe the needs of academic staff conducting non-communicable disease (NCD) research at the University of the West Indies, Mona Campus in Jamaica. Methods. Utilizing a cross-sectional design an online survey was created using the research electronic data capture application (REDCap); it was disseminated via email to 708 academic staff members in the Faculties of Medical Sciences and Science & Technology between September and November 2018. Participants were asked to indicate their level of access to expertise, training and equipment for conducting research. Descriptive analysis was conducted using STATA version 14. Results. Most respondents were women (74.2%), predominantly scientists (33.1%) or specialist physicians (22.6%). Less than 2/3 of respondents reported publishing research findings in peer reviewed journals, with a quarter not disseminating their research findings in any medium. Resources for field research/data collection, epidemiological methods and principles, and data management/data analysis were generally available. However, there was limited access to training, expertise and equipment in emerging techniques for NCD research such as metabolomics, bioinformatics/analysis of large-scale data sets and health economics. Additional challenges included limited access to financing for research, inadequate workspace and poor administrative support for conducting research. Conclusions. There is a need for more local research seed funding, stronger administrative support for researchers, and opportunities for training in cutting edge NCD research techniques. Jamaican researchers could benefit from being part of a regional research centre of excellence with critical research skills and equipment that builds research networks and strengthens the NCD research response.


[RESUMEN]. Objetivo. Describir las necesidades del personal académico que investiga las enfermedades no transmisibles (ENT) en el Campus de Mona de la Universidad de las Indias Occidentales, en Jamaica. Métodos. Mediante un diseño transversal, se elaboró una encuesta en línea con RedCap, una aplicación para la captura de datos electrónicos para la investigación, y se divulgó por correo electrónico a los 708 miembros del personal académico de las Facultades de Ciencias Médicas y Ciencia y Tecnología entre septiembre y noviembre del 2018. Se pidió a los participantes que indicaran su nivel de acceso a conocimientos, capacitación y equipo para llevar a cabo investigaciones. El análisis descriptivo se realizó con STATA, versión 14. Resultados. La mayoría de los entrevistados fueron mujeres (74,2%), predominantemente científicas (33,1%) o médicas especialistas (22,6%). Menos de dos terceras partes de los entrevistados informó que publicaban los resultados de sus investigaciones en revistas arbitradas y una cuarta parte declaró que no divulgaba los resultados de sus investigaciones en ningún medio. Por lo general, tenían a su disposición recursos para la investigación de campo o la recopilación de datos, métodos y principios epidemiológicos, así como para la gestión y el análisis de datos. Sin embargo, tenían poco acceso a conocimientos, capacitación y equipo en las técnicas emergentes para la investigación sobre ENT como la metabolómica, la bioinformática o el análisis de conjuntos de datos a gran escala y economía de la salud. Otros retos incluyeron poco acceso al financiamiento para la investigación, espacios de trabajo inadecuados y un apoyo administrativo deficiente para investigar. Conclusiones. Se necesita más capital inicial destinado a la investigación local, un mayor respaldo administrativo a los investigadores y oportunidades de capacitación en las técnicas más recientes de investigación de ENT. Los investigadores jamaiquinos podrían sacar provecho de formar parte de un centro regional de excelencia para la investigación con el equipo y las capacidades de investigación fundamentales para contribuir a la formación de redes de investigación y fortalecer la respuesta investigadora a las ENT.


[RESUMO]. Objetivo. Descrever as carências enfrentadas pelo grupo acadêmico que realiza pesquisa em doenças não transmissíveis (DNT) na Universidade das Índias Ocidentais, campus de Mona, Jamaica. Métodos. Uma pesquisa transversal online foi desenvolvida com o uso da plataforma de captura eletrônica de dados de pesquisa (RedCap) e distribuída por e-mail a 708 integrantes dos grupos acadêmicos nas Faculdades de Ciências Médicas e de Ciência e Tecnologia entre setembro e novembro de 2018. Foi pedido aos participantes que informassem o grau de acesso a conhecimento especializado, capacitação e equipamentos para a realização de pesquisa. Uma análise descritiva foi realizada com o uso do software STATA versão 14. Resultados. Participaram, na sua maioria, mulheres (74,2%), com o predomínio de pesquisadores científicos (33,1%) ou médicos especialistas (22,6%). Menos de 2/3 informaram publicar os resultados de suas pesquisas em periódicos científicos com avaliação por pares e 25% disseram que não divulgavam seus resultados em nenhum veículo. Afirmaram que, em geral, havia recursos para realizar pesquisa de campo/coleta de dados, métodos e procedimentos básicos epidemiológicos e gerenciamento/análise de dados. Porém, era limitado o acesso a capacitação, conhecimentos especializados e equipamentos para empregar métodos emergentes de pesquisa de DNT como metabolômica, bioinformática/processamento em larga escala de grandes conjuntos de dados e economia da saúde. Outras dificuldades citadas foram limitação de financiamento para pesquisa, inadequação dos locais de trabalho e apoio administrativo deficiente à realização de pesquisas. Conclusões. Faz-se necessário mais financiamento para projetos iniciantes locais, firme apoio administrativo aos pesquisadores e oportunidades para capacitação em métodos de ponta de pesquisa de DNT. A situação dos pesquisadores jamaicanos poderia melhorar se fizessem parte de um centro de excelência regional com recursos e equipamentos essenciais para a realização de pesquisa que lhes permitisse formar redes de pesquisadores e fortalecer a resposta da pesquisa de DNT.


Assuntos
Países em Desenvolvimento , Agenda de Pesquisa em Saúde , Doenças não Transmissíveis , Jamaica , Região do Caribe , Países em Desenvolvimento , Agenda de Pesquisa em Saúde , Doenças não Transmissíveis , Região do Caribe , Países em Desenvolvimento , Agenda de Pesquisa em Saúde , Doenças não Transmissíveis , Região do Caribe
14.
Washington, D.C.; PAHO; 2021-03-05. (PAHO/NMH/RF/21-0002).
em Inglês | PAHO-IRIS | ID: phr-53328

RESUMO

This fact-sheet presents the results of the first study to take place in the Caribbean to examine the best performing front-of-package labeling (FOPL). It was conducted by the Ministry of Health and Wellness of Jamaica, the University of Technology, Jamaica, and the Pan American Health Organization, and contributes to the evidence that has been accumulated in the Region of the Americas on the topic. Consumers showed the octagonal warning labels had the highest chances of correctly identifying when products were excessive in sugars, sodium, or saturated fats, of correctly identifying the least harmful option, and of choosing the least harmful or none of the products more often.


Assuntos
Doenças não Transmissíveis , Alimentos, Dieta e Nutrição , Ciências da Nutrição , Desnutrição , Fatores de Risco , Rotulagem de Alimentos , Gorduras , Açúcares , Sódio , Jamaica
15.
Health Qual Life Outcomes ; 19(1): 97, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33741000

RESUMO

BACKGROUND: The EQ-5D instrument is increasingly used in clinical and resource allocation decision making in developed and developing countries. EQ-5D valuation and population norms studies have been undertaken for Trinidad and Tobago, however no population norms or value sets have been generated for the other Caribbean countries. The aims of this study were to provide population norms for Barbados and Jamaica, and to develop a set of population norms that could be used by the other English-speaking Caribbean countries. METHODS: The EQ-5D-5L self-reported health questionnaire was included in surveys of representative samples of adults in Barbados and adults in Jamaica in 2013. EQ-5D health states, mean EQ VAS scores and mean EQ-5D-5L index values (using the Trinidad and Tobago value set) were calculated for demographic groups in both countries based on 2347 respondents from Barbados and 1423 from Jamaica. A set of 'Caribbean' norms were developed by combining the Barbados and Jamaica data with norms recently published for Trinidad and Tobago. RESULTS: Data were obtained for 2347 and 1423 respondents in Barbados and Jamaica respectively. The mean index and EQ VAS values were 0.943 and 81.9 for Barbados, and 0.948 and 87.8 for Jamaica. The health states most commonly observed in the two countries were similar. Generally the demographic patterns of self-reported health were consistent with those found in other studies. Some differences between the countries were observed in the patterns of rates of reporting problems on the EQ-5D dimensions among age-gender groups specifically for anxiety/depression and pain/discomfort CONCLUSION: This study has produced a set of EQ-5D population norms that can be used as base-line values in clinical and clinico-economic analyses for Barbados and Jamaica and for the English-Speaking Caribbean region.


Assuntos
Nível de Saúde , Qualidade de Vida , Autorrelato , Adulto , Barbados , Feminino , Humanos , Jamaica , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários
16.
Cancer Causes Control ; 32(5): 547-554, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33660168

RESUMO

Jamaican women do not participate in routine Pap test screening as recommended, despite the availability of free Pap test services at community clinics. This low uptake has been associated with cultural and structural barriers such as limited knowledge and awareness, fear of pain associated with Pap tests, fear of diagnosis, modesty or self-consciousness, medical mistrust, and discontent with healthcare services. This study suggests that a multicomponent, community-based intervention that includes education and self-testing for the virus that causes cervical cancer (i.e., Human Papillomavirus, HPV) might increase screening rates. Community outreach workers were hired and recruited 163 women from two low socioeconomic status communities in Kingston, aged 30 to 65 years, and who had not had a Pap test in at least 3 years, to use an HPV self-test kit. Almost all the women (95.6%) used and returned the kit and reported in structured interviews that it was easy to use and preferable to visiting a doctor. Paired samples t-tests revealed that participants perceived higher threat of cervical cancer, greater susceptibility to cancer, greater sense of self-efficacy, and more positive screening social norms at post-test than at pretest. Among returners, 22% had an oncogenic HPV type detected in their sample. Findings demonstrate high acceptability of the HPV self-test among Jamaican women and, therefore, the potential of HPV self-test tools to increase screening uptake. Community-based approaches to disseminate this tool, such as outreach workers and educational small group sessions, appear to be culturally appropriate and effective in this context.


Assuntos
Programas de Rastreamento/métodos , Infecções por Papillomavirus/diagnóstico , Confiança , Adulto , Idoso , Feminino , Humanos , Jamaica , Pessoa de Meia-Idade , Teste de Papanicolaou , Papillomaviridae/isolamento & purificação , Autoeficácia , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal
17.
Clin Gerontol ; 44(3): 316-330, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33685368

RESUMO

Objectives: To explore relationships between sexual activity and depressive symptoms in urology and gynecology out-patients aged 50 years and older.Methods: Depressive symptoms were assessed using Zung Self-Rating Depression Scale. Sexual activity was measured by interviewer-administered questionnaires assessing relationships, intimacy and sexual function (N = 557). Aging and sexual activity were discussed in focus groups (N = 52).Results: More men (51%) than women (41%) reported engagement in sexual intercourse and approximately 40% of men reported sexual activities in the past 4 weeks. The mean number of sex-related complaints per woman was 1.5 (Standard Deviation, 1.2). Approximately four of every ten men reported difficulty with erectile function. Men placed high value on sexual intercourse while women also embraced other activities. After controlling for demographic and health variables, men who reported sexual activity in the past 4 weeks had depressive symptom scores approximately five points lower than those who reported no sexual activity. Each additional sexual complaint was associated with a two-point increase in depressive symptoms scores in women.Conclusions: Higher depressive symptom scores are associated with reduced sexual activity in men and increased sexual complaints in women. Sexual activities remain important for older adults, despite declining sexual function and men place higher value on sexual intercourse than women.Clinical implications: Mental health assessments and sexual activity history should be included in routine healthcare consultations in persons 50 and over.


Assuntos
Depressão , Comportamento Sexual , Idoso , Envelhecimento , Feminino , Humanos , Jamaica , Masculino , Parceiros Sexuais
18.
BJOG ; 128(10): 1703-1710, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33683802

RESUMO

OBJECTIVE: To document pregnancy outcome in homozygous sickle cell (SS) disease and in age-matched controls with a normal haemoglobin genotype followed from birth for up to 45 years. METHODS: A total of 100 000 consecutive non-operative deliveries screened for sickle cell disease at the main Government maternity hospital in Kingston, Jamaica between 1973 and 1981 detected 311 (149 female) babies with SS disease who were matched by age and gender with 250 (129 female) controls with an AA haemoglobin phenotype. These individuals have been followed from birth with prospective assessment of menarche and detailed documentation of all pregnancies. RESULTS: There were 177 pregnancies in 71 SS patients and 226 pregnancies in 74 AA controls. Mothers with SS disease had more spontaneous abortions (adjusted relative risk [aRR] 3.2, 95% CI 1.6-6.1), fewer live births (aRR 0.7, 95% CI 0.6-0.9) and their offspring were more likely to have a gestational age <37 weeks (aRR 2.1, 95% CI 1.1-3.7) and low birthweight <2.5 kg (aRR 3.0, 95% CI 1.6-5.3). They were more prone to acute chest syndrome (aRR 13.7, 95% CI 4.1-45.5), urinary tract infection (aRR 12.8, 95% CI 1.3-125.9), pre-eclampsia/eclampsia (aRR 3.1, 95% CI 1.1-8.8), retained placenta (aRR 10.1, 95% CI 1.1-90.3), sepsis (Fisher's Exact test 0.04) and pregnancy-related deaths (Fisher's Exact test 0.02). Four of five deaths were attributable to acute chest syndrome. There was no genotypic difference in pregnancy-induced hypertension or postpartum haemorrhage. CONCLUSION: Pregnancy in SS disease carries risks for both mother and child. The variable characteristics of pregnancy-related deaths complicate their prevention. TWEETABLE ABSTRACT: Pregnancy in SS disease compared with controls showed increased abortions and stillbirths, fewer live births and maternal deaths in 7% patients.


Assuntos
Anemia Falciforme/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Adolescente , Adulto , Anemia Falciforme/mortalidade , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Jamaica/epidemiologia , Masculino , Morte Materna , Gravidez , Complicações Hematológicas na Gravidez/mortalidade , Resultado da Gravidez , Fatores Socioeconômicos , Natimorto , Adulto Jovem
19.
Surg Radiol Anat ; 43(5): 795-803, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33538876

RESUMO

PURPOSE: In the classical description of normal liver anatomy, the umbilical fissure is a long, narrow groove that receives the ligamentum teres hepatis. The pons hepatis is an anatomic variant, where the umbilical fissure is converted into a tunnel by an overlying bridge of liver parenchyma. We carried out a study to evaluate the existing variations of the umbilical fissure in a Caribbean population. METHODS: We observed all consecutive autopsies performed at a facility in Jamaica and selected cadavers with a pons hepatis for detailed study. A pons hepatis was considered present when the umbilical fissure was covered by hepatic parenchyma. We recognized two variants: an open-type (incomplete) pons hepatis in which the umbilical fissure was incompletely covered by parenchyma ≤ 2 cm in length and a closed type (complete) pons hepatis in which the umbilical fissure was covered by a parenchymal bridge > 2 cm and thus converted into a tunnel. We measured the length (distance from transverse fissure to anterior margin of the parenchymatous bridge), width (extension across the umbilical fissure in a coronal plane) and thickness (distance from the visceral surface to the hepatic surface measured at the mid-point of the parenchymal bridge in a sagittal plane) of each pons hepatis. A systematic literature review was also performed to retrieve data from relevant studies. The raw data from these retrieved studies was used to calculate the global point prevalence of pons hepatis and compared the prevalence in our population. RESULTS: Of 66 autopsies observed, a pons hepatis was present in 27 (40.9%) cadavers. There were 15 complete variants, with a mean length of 34.66 mm, mean width of 16.98 mm and mean thickness of 10.98 mm. There were 12 incomplete variants, with a mean length of 17.02 mm, width of 17.03 mm and thickness of 9.56 mm. The global point prevalence of the pons hepatis (190/5515) was calculated to be or 3.45% of the global population. CONCLUSIONS: We have proposed a classification of the pons hepatis that is reproducible and clinically relevant. This allowed us to identify a high prevalence of pons hepatis (41%) in this Afro-Caribbean population that is significantly greater than the global prevalence (3.45%; P < 0.0001).


Assuntos
Variação Anatômica , Fígado/anormalidades , Ligamentos Redondos/anormalidades , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência
20.
J Affect Disord ; 283: 172-178, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33556751

RESUMO

BACKGROUND: Youth non-suicidal self-injury (NSSI) and suicide are major public health concerns, but limited data are available on the prevalence and correlates of these problems in developing countries. The aim of this study is to describe experiences of three suicidal phenomena (NSSI, suicidal ideation [SI], and suicide attempt [SA]) among children and adolescents from two developing countries. We also examine how depression, anxiety, sleep problems, child maltreatment, and other socio-demographic variables associate with the risk of NSSI only, SI only, SA only, and co-occurring NSSI/SI/SA. METHODS: We conducted a population-based cross-sectional study of school-based Ugandan and Jamaican children and adolescents. Participants were 11,518 (52.4% female) Ugandan and 7,182 (60.8% female) Jamaican youths aged 9-17 years. RESULTS: The estimated lifetime prevalence of NSSI, SI, and SA was 25.5%, 25.6%, and 12.8% respectively among Ugandan boys and 23.2%, 32.5%, and 15.3% respectively among Ugandan girls. As for the Jamaican sample, the estimated lifetime prevalence of NSSI, SI, and SA was 21%, 27.7%, and 11.9% respectively among boys and 32.6%, 48.6%, and 24.7% respectively among girls. The odds of experiencing SI only, SA only, and co-occurring NSSI/SI/SA were significantly elevated among participants with mild, moderate, and severe depression in both countries. LIMITATIONS: The current study relied on retrospective data. CONCLUSIONS: This study found that suicidal phenomena are common among youths from Uganda and Jamaica, with rates substantially higher than among youths from high-income countries. The risk of suicidal phenomena was especially high among youths with severe depression.


Assuntos
Comportamento Autodestrutivo , Ideação Suicida , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Tentativa de Suicídio , Uganda/epidemiologia
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