Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 214
Filtrar
2.
Am J Phys Anthropol ; 169(3): 482-497, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31125126

RESUMO

OBJECTIVES: From a genetic perspective, relatively little is known about how mass emigrations of African, European, and Asian peoples beginning in the 16th century affected Indigenous Caribbean populations. Therefore, we explored the impact of serial colonization on the genetic variation of the first Caribbean islanders. MATERIALS AND METHODS: Sixty-four members of St. Vincent's Garifuna Community and 36 members of Trinidad's Santa Rosa First People's Community (FPC) of Arima were characterized for mitochondrial DNA and Y-chromosome diversity via direct sequencing and targeted SNP and STR genotyping. A subset of 32 Garifuna and 18 FPC participants were genotyped using the GenoChip 2.0 microarray. The resulting data were used to examine genetic diversity, admixture, and sex biased gene flow in the study communities. RESULTS: The Garifuna were most genetically comparable to African descendant populations, whereas the FPC were more similar to admixed American groups. Both communities also exhibited moderate frequencies of Indigenous American matrilines and patrilines. Autosomal SNP analysis indicated modest Indigenous American ancestry in these populations, while both showed varying degrees of African, European, South Asian, and East Asian ancestry, with patterns of sex-biased gene flow differing between the island communities. DISCUSSION: These patterns of genetic variation are consistent with historical records of migration, forced, or voluntary, and suggest that different migration events shaped the genetic make-up of each island community. This genomic study is the highest resolution analysis yet conducted with these communities, and provides a fuller understanding of the complex bio-histories of Indigenous Caribbean peoples in the Lesser Antilles.


Assuntos
Grupos de Populações Continentais/genética , Grupos de Populações Continentais/história , Adulto , Cromossomos Humanos Y/genética , DNA/genética , DNA Mitocondrial/genética , Feminino , Genética Populacional , História do Século XV , História do Século XVI , História do Século XVIII , História do Século XIX , História Antiga , Migração Humana/história , Humanos , Masculino , São Vicente e Granadinas , Trinidad e Tobago
3.
J Laparoendosc Adv Surg Tech A ; 29(1): 94-97, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30133332

RESUMO

PURPOSE: There remains a critical need for the provision for pediatric humanitarian aid worldwide. Historically, the emphasis of global pediatric health needs has been focused on infectious diseases. Today, we are witnessing a shift in this paradigm, with growing attention being paid toward the surgical needs of children. The use and deployment of minimally invasive surgery (MIS) in these austere environments with its concomitant reduction in length of hospitalization, pain, and morbidity is logical. The goal of this study was to report our deployment strategy and review our experience with pediatric MIS during humanitarian missions to determine if it is safe, feasible, and efficacious. METHODS: As part of the World Pediatric Project (WPP), data were collected retrospectively from the general pediatric surgery (GPS) team missions from January 2007 to January 2017. All cases were performed at a single medical center in the Eastern Caribbean Island Nation of St. Vincent and the Grenadines (SVG). Data included patient demographics, diagnosis, procedure, conversion to open procedure, complications, and postoperative course. The teams utilized a dedicated WPP operating theater, prepositioned and deployed GPS supplies, and MIS resources. All anesthesia, surgical, and nursing personal were board certified and trained professionals functioning as part of the WPP team. RESULTS: One hundred thirty-four children underwent general and thoracic pediatric surgical procedures during the study period. Mean age 9.2 years (2-19 years). Thirty-seven children underwent MIS procedures (27%). There were no conversions to open procedures. There were only two postoperative complications, cellulitis following laparoscopic appendicostomies, which required intravenous antibiotics and were discharged on a course of oral antibiotics. The postoperative course for all children was uneventful and no child required readmission. There were no technical failures in the MIS systems or instrumentation. CONCLUSIONS: Our retrospective review supports the use of MIS techniques as part of GPS humanitarian missions. We have found it to be a safe, feasible, and effective modality that may reduce length of stay, pain, and morbidity compared with open procedures in these remote environments. Although our MIS systems and instrumentations functioned effectively, concerns regarding the storage and sustainability for future missions are significant. Onsite health care partners, redundant systems, and remote technical support access could potentially alleviate these concerns.


Assuntos
Laparoscopia , Missões Médicas , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Laparoscopia/efeitos adversos , Masculino , Salas Cirúrgicas , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , São Vicente e Granadinas , Toracoscopia/efeitos adversos , Adulto Jovem
4.
Psychiatr Q ; 89(4): 801-815, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29704089

RESUMO

Harmful alcohol use encompasses a spectrum of habits, including heavy episodic drinking (HED) which increases the risk of acute alcohol-related harms. The prevalence of HED in Saint Vincent and the Grenadines (SVG) is 5.7% among the overall population aged 15 years and older and 10.2% among drinkers. Responsible Beverage Service interventions train alcohol servers to limit levels of intoxication attained by customers and decrease acute alcohol-related harms. The objectives of this study were to determine bar tenders' and rum shopkeepers' knowledge of and attitudes toward problem drinking and willingness to participate in server training. Researchers used convenience and purposive sampling to recruit 30 participants from Barraouile, Kingstown, and Calliaqua to participate in semi-structured interviews designed to explore study objectives. Results and conclusions were derived from grounded theory analysis. Heavy episodic drinking is common but not stigmatized. Heavy drinking is considered a "problem" if the customer attains a level of disinhibition causing drunken and disruptive or injurious behavior. Bartenders and rum shopkeepers reported intervening with visibly intoxicated patrons and encouraging cessation of continued alcohol consumption. Participants cited economic incentives, prevention of alcohol-related harms, and personal morals as motivators to prevent drunkenness. Respondents acknowledged that encouraging responsible drinking was a legitimate part of their role and were favorable to server training. However, there were mixed opinions about the intervention's perceived efficacy given absent community-wide standards on preventing intoxication and limitations of existing alcohol policy. Given respondents' motivation and lack of standardized alcohol server training in SVG, mandated server training can be an effective strategy when promoted as one piece of a multi-component alcohol policy.


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Intoxicação Alcoólica/etnologia , Alcoolismo/etnologia , Comércio , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adulto , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/prevenção & controle , Alcoolismo/prevenção & controle , Humanos , Masculino , São Vicente e Granadinas/etnologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-29627969

RESUMO

PURPOSE: Different students may adopt different learning approaches: namely, deep and surface. This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students' academic scores. METHODS: The study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs's Revised Two-Factor Study Process Questionnaire in paper form was distributed to subjects from January to November 2017. For statistical analyses, the Student t-test, 1-way analysis of variance followed by the post-hoc t-test, and the Pearson correlation test were used. The Cronbach alpha was used to test the internal consistency of the questionnaire. RESULTS: Of the 169 subjects, 132 (response rate, 78.1%) completely filled out the questionnaires. The Cronbach alpha value for the items on the questionnaire was 0.8. The score for the deep learning approach was 29.4± 4.6, whereas the score for the surface approach was 24.3± 4.2, which was a significant difference (P< 0.05). A positive correlation was found between the deep learning approach and students' academic performance (r= 0.197, P< 0.05, df= 130). CONCLUSION: Medical students in the basic science years at Trinity School of Medicine adopted the deep learning approach more than the surface approach. Likewise, students who were more inclined towards the deep learning approach scored significantly higher on academic tests.


Assuntos
Desempenho Acadêmico , Aprendizagem , Estudantes de Medicina , Estudos Transversais , Currículo , Educação de Graduação em Medicina , Humanos , São Vicente e Granadinas , Inquéritos e Questionários
7.
Rev Panam Salud Publica ; 41: e41, 2017 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-28614466

RESUMO

Objective: To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Methods: Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. Results: High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. Conclusions: These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.


Assuntos
Infecções por Papillomavirus/epidemiologia , Adulto , Idoso , Colo do Útero/virologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Prevalência , Medição de Risco , São Cristóvão e Névis/epidemiologia , São Vicente e Granadinas/epidemiologia , Esfregaço Vaginal
8.
Psychiatr Q ; 88(3): 423-434, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-27438471

RESUMO

The Icahn School of Medicine at Mount Sinai and the Saint Vincent/Grenadines Ministry of Health, Wellness and the Environment have been collaborating since 2012 in addressing the plight of alcoholism in Saint Vincent and the Grenadines (SVG). SVG is a middle-income country with few resources available for those who suffer from alcohol use disorders, and these efforts have centered on establishing and monitoring alcohol self-help groups based on the "Alcoholics Anonymous model" (AA model) in several communities in Saint Vincent and the Grenadines. In the summer of 2014, the efforts evolved to include an in-depth investigation of the experience of members of self-help group members via the qualitative research method known as Photovoice. Photovoice is a community based participatory research method in which a set of research questions are explored qualitatively through photographs, interviews, and focus groups. In June 2014, a Photovoice project was established with the longest running self-help group on the island of Saint Vincent in the fishing community of Barrouallie. This project consisted of three rounds of photo-taking, individual interviews, and focus groups, and analysis of the data revealed a number of broad themes relevant to perceptions about the impact of problematic drinking and about drinkers themselves; about the applicability of the AA model in SVG; and about factors that may perpetuate or mitigate problem drinking. It was evident that current and recovering alcoholics believed that there were different types of drinkers who because of their gender, public drinking or tendency for violence could be labeled as "irresponsible." These findings suggest areas for future interventions and research in SVG.


Assuntos
Alcoólicos Anônimos , Alcoolismo/etnologia , Alcoolismo/reabilitação , Pesquisa Participativa Baseada na Comunidade , Adulto , Humanos , Fotografação , Pesquisa Qualitativa , São Vicente e Granadinas
9.
Artigo em Espanhol | CUMED | ID: cum-73637

RESUMO

Las peculiaridades del estudio de personas con discapacidad realizado en San Vicente y las Granadinas merecen una visibilidad diferenciada por las innovaciones intangibles que se desarrollaron sobre la metodología cubana previamente diseñada, extrapolándose con resultados satisfactorios a un idioma y contexto diferente. Este estudio se desarrolló gracias a la triangulación entre Cuba, San Vicente y las Granadinas y la República Bolivariana de Venezuela. Describir las características biopsicosociales de las personas con discapacidad en San Vicente y las Granadinas, así como las peculiaridades metodológicas del estudio. Se realizó la revisión documental, análisis y comparación de la investigación-acción-participativa desarrollada por Cuba y aplicada en San Vicente, adecuando los instrumentos cubanos al idioma y características de ese país según las peculiaridades de esta Isla. La búsqueda activa en la comunidad y la estrategia definida permitió identificar las personas afectadas, con la participación activa de enfermeras y activistas de salud vicentinas. Se encontraron dos mil 332 personas con discapacidad en el país, para una prevalencia de 2,32(percent). La discapacidad físico-motora ocupó el primer lugar seguida de la intelectual y la mental. No se encontraron personas con insuficiencia renal. Predominó la discapacidad en el sexo masculino y en el grupo de edades de 60 años y más. Las principales restricciones fueron identificadas y se entregaron 50 prótesis auditivas donadas por la República Bolivariana de Venezuela. Los resultados obtenidos se debieron a la metodología empleada y la triangulación dada entre países del ALBA, lo cual permitió caracterizar la discapacidad en esa isla…(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoas com Deficiência/psicologia , São Vicente e Granadinas , Venezuela , Serviços de Saúde Comunitária
10.
MEDICC Rev ; 18(3): 22-4, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27510933

RESUMO

Persons with disabilities constitute one of the most vulnerable groups in every society; their identification, assessment and care present a major challenge. In 2001-2003, Cuba conducted the first comprehensive national study of persons with disabilities in the Americas. In 2007-2010, the study was replicated in Bolivia, Ecuador, Nicaragua, Saint Vincent and the Grenadines, and Venezuela, at their governments' request. Study results have enabled implementation of strategies with substancial impact on human health in these countries. In response to it, more than a million medical consultations were provided by professionals whose specialties are lacking in the participating countries, including 139,772 clinical genetic consultations. Once each country's needs were identified, Cuba provided technical assistance with equipment supplied by Venezuela. The study led to development of public policies and programs for disability prevention and care of disabled persons in Bolivia, Ecuador, Nicaragua and Venezuela, and the opening of the National Medical Genetics Center and orthotic and prosthetic laboratories in Venezuela, and rehabilitation centers in Bolivia. KEYWORDS Disability, epidemiology, health services research, needs assessment, human resources, workforce, Bolivia, Cuba, Ecuador, Nicaragua, Saint Vincent and the Grenadines, Venezuela.


Assuntos
Serviços de Saúde para Pessoas com Deficiência , Bolívia , Pessoas com Deficiência/reabilitação , Pessoas com Deficiência/estatística & dados numéricos , Equador , Serviços de Saúde para Pessoas com Deficiência/organização & administração , Serviços de Saúde para Pessoas com Deficiência/normas , Humanos , Determinação de Necessidades de Cuidados de Saúde , Nicarágua , Melhoria de Qualidade , São Vicente e Granadinas , Venezuela
11.
Emerg Med J ; 33(1): 47-51, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25841166

RESUMO

OBJECTIVE: We explored attitudes of non-urgent accident and emergency department (AED) patients in the middle-income healthcare setting Saint Vincent and the Grenadines (SVG) in the Caribbean to understand how and why they decide to seek emergency care and resist using primary care facilities. METHODS: In 2013, we conducted 12 semistructured interviews with a purposive sample of non-urgent AED users from a variety of social backgrounds. Verbatim transcripts were analysed with a grounded theory approach. RESULTS: In this study, we found, first, that participants automatically chose to visit the AED and described this as a locally shared custom. Second, the healthcare system in SVG reinforced this habitual use of the AED, for example, by health professionals routinely referring non-urgent cases to the AED. Third, there was also some deliberate use; patients took convenience and the systemic encouragement into account to determine that the AED was the most appropriate choice for healthcare. CONCLUSIONS: We conclude that the attitudes and habits of the Vincentian non-urgent patient are major determinants of their AED use and are intricately linked to local, socially shared practices of AED use. Findings show that health services research should reconsider rational choice behaviour models and further explore customs of health-seeking.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Comportamento de Escolha , Feminino , Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa , São Vicente e Granadinas , Adulto Jovem
12.
West Indian med. j ; 65(Supp. 3): [25], 2016.
Artigo em Inglês | MedCarib | ID: med-18097

RESUMO

OBJECTIVES: To examine the trend in maternal mortality in St Vincent and the Grenadines during the 2004–2013 period and to examine the use of the perinatal audit systemas a feedback and surveillance tool to effect an improvement in the quality of care for women, leading to a reduction in maternal mortality. SUBJECTS AND METHODS: This is a retrospective study that collected and analysed maternal mortality data from the annual perinatal audit during the 10-year period 2004–2013. Data were also matched with those of other data sources. The data were examined to identify the number of maternal deaths during the period under review and the cause of these deaths. RESULTS: During the 10-year period under review, there was an average 1.3 maternal deaths per year. The majority of these deaths were classified as direct deaths (92.3%) caused principally by pre-eclampsia/eclampsia, while only 7.7% were due to indirect causes. Maternal mortality ratio decreased significantly from 74 in 1990 to 45 deaths/100000 live births in 2014. CONCLUSION: Avoidable maternal deaths must be prevented. The perinatal audit system surveillance should be strengthened. Mortality rates are essential in identifying problems within the healthcare system. Maternal mortality reviews should continue to be held as they provide valuable feedback, data and evidence for the health sector.


Assuntos
Feminino , Mortalidade Materna , São Vicente e Granadinas
13.
PLoS One ; 10(10): e0139192, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26447794

RESUMO

Historical discourses about the Caribbean often chronicle West African and European influence to the general neglect of indigenous people's contributions to the contemporary region. Consequently, demographic histories of Caribbean people prior to and after European contact are not well understood. Although archeological evidence suggests that the Lesser Antilles were populated in a series of northward and eastern migratory waves, many questions remain regarding the relationship of the Caribbean migrants to other indigenous people of South and Central America and changes to the demography of indigenous communities post-European contact. To explore these issues, we analyzed mitochondrial DNA and Y-chromosome diversity in 12 unrelated individuals from the First Peoples Community in Arima, Trinidad, and 43 unrelated Garifuna individuals residing in St. Vincent. In this community-sanctioned research, we detected maternal indigenous ancestry in 42% of the participants, with the remainder having haplotypes indicative of African and South Asian maternal ancestry. Analysis of Y-chromosome variation revealed paternal indigenous American ancestry indicated by the presence of haplogroup Q-M3 in 28% of the male participants from both communities, with the remainder possessing either African or European haplogroups. This finding is the first report of indigenous American paternal ancestry among indigenous populations in this region of the Caribbean. Overall, this study illustrates the role of the region's first peoples in shaping the genetic diversity seen in contemporary Caribbean populations.


Assuntos
Cromossomos Humanos Y , DNA Mitocondrial/genética , Variação Genética , Grupo com Ancestrais do Continente Africano/genética , Grupo com Ancestrais do Continente Asiático/genética , Região do Caribe , Hibridização Genômica Comparativa , DNA Mitocondrial/análise , DNA Mitocondrial/classificação , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Genética Populacional , Haplótipos , Humanos , Masculino , Filogenia , Polimorfismo de Nucleotídeo Único , São Vicente e Granadinas , Trinidad e Tobago
14.
J Anim Ecol ; 84(6): 1678-89, 2015 11.
Artigo em Inglês | MEDLINE | ID: mdl-26344713

RESUMO

There has been ongoing flattening of Caribbean coral reefs with the loss of habitat having severe implications for these systems. Complexity and its structural components are important to fish species richness and community composition, but little is known about its role for other taxa or species-specific responses. This study reveals the importance of reef habitat complexity and structural components to different taxa of macrofauna, total species richness, and individual coral and fish species in the Caribbean. Species presence and richness of different taxa were visually quantified in one hundred 25-m(2) plots in three marine reserves in the Caribbean. Sampling was evenly distributed across five levels of visually estimated reef complexity, with five structural components also recorded: the number of corals, number of large corals, slope angle, maximum sponge and maximum octocoral height. Taking advantage of natural heterogeneity in structural complexity within a particular coral reef habitat (Orbicella reefs) and discrete environmental envelope, thus minimizing other sources of variability, the relative importance of reef complexity and structural components was quantified for different taxa and individual fish and coral species on Caribbean coral reefs using boosted regression trees (BRTs). Boosted regression tree models performed very well when explaining variability in total (82·3%), coral (80·6%) and fish species richness (77·3%), for which the greatest declines in richness occurred below intermediate reef complexity levels. Complexity accounted for very little of the variability in octocorals, sponges, arthropods, annelids or anemones. BRTs revealed species-specific variability and importance for reef complexity and structural components. Coral and fish species occupancy generally declined at low complexity levels, with the exception of two coral species (Pseudodiploria strigosa and Porites divaricata) and four fish species (Halichoeres bivittatus, H. maculipinna, Malacoctenus triangulatus and Stegastes partitus) more common at lower reef complexity levels. A significant interaction between country and reef complexity revealed a non-additive decline in species richness in areas of low complexity and the reserve in Puerto Rico. Flattening of Caribbean coral reefs will result in substantial species losses, with few winners. Individual structural components have considerable value to different species, and their loss may have profound impacts on population responses of coral and fish due to identity effects of key species, which underpin population richness and resilience and may affect essential ecosystem processes and services.


Assuntos
Antozoários/fisiologia , Biodiversidade , Recifes de Corais , Peixes/fisiologia , Animais , Antilhas Holandesas , Densidade Demográfica , Porto Rico , São Vicente e Granadinas
15.
Epilepsy Behav ; 51: 267-72, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26312988

RESUMO

Very little has been reported about the health resources available for patients with epilepsy in the five English-speaking southern Caribbean countries of Trinidad and Tobago, Barbados, Grenada, Saint Vincent and the Grenadines, and Saint Lucia. There is no comprehensive resource describing their health systems, access to specialty care, antiepileptic drug (AED) use, and availability of brain imaging and EEG. The purpose of this study was to profile epilepsy care in these countries as an initial step toward improving the standard of care and identifying gaps in care to guide future policy changes. In each southern Caribbean country, we conducted study visits and interviewed health-care providers, government health ministers, pharmacy directors, hospital medical directors, pharmacists, clinic staff, radiologists, and radiology and EEG technicians. Health-care providers completed extensive epilepsy care surveys. The five countries all have integrated government health systems with clinics and hospitals that provide free or heavily subsidized care and AEDs for patients with epilepsy. Only Trinidad and Tobago and Barbados, however, have neurology specialists. The three smaller countries lack government imaging and EEG facilities. Trinidad had up to one-year waits for public MRI/EEG. Government formularies in Grenada, Saint Vincent and the Grenadines, and Saint Lucia are limited to first-generation AEDs. One or more second-line agents are formulary in Trinidad and Barbados. Nonformulary drugs may be obtained for individual patients in Barbados. Grenada, Saint Lucia, and Saint Vincent and the Grenadines participate in an Organization of Eastern Caribbean States formulary purchasing system, which added levetiracetam following the survey. Newer generic AED formulations with the lowest risks for pregnancy malformation were not in use. In conclusion, patients with epilepsy in the southern Caribbean have excellent access to government clinics and hospitals, but AED choices are limited. Local medical providers reported that the major limitations in care were lack of specialty care, lack of imaging and EEG services, financial barriers to care, long wait times for care, and limited access to additional AEDs.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Epilepsia/epidemiologia , Epilepsia/terapia , Anticonvulsivantes/provisão & distribução , Barbados , Região do Caribe/epidemiologia , Países em Desenvolvimento , Uso de Medicamentos , Eletroencefalografia , Feminino , Formulários Farmacêuticos como Assunto , Pessoal de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Neurologia/estatística & dados numéricos , Gravidez , Santa Lúcia , São Vicente e Granadinas
16.
Food Nutr Bull ; 36(2 Suppl): S129-38, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26125198

RESUMO

BACKGROUND: Zinc deficiency affects multiple vital functions in the life cycle, especially growth. Limited information is available on the magnitude of zinc deficiency in Latin America and the Caribbean. OBJECTIVE: To examine the latest available information on both the prevalence of zinc deficiency and the risk of zinc deficiency in Latin America and the Caribbean. METHODS: The prevalence of zinc deficiency was identified through a systematic review looking for the latest available data on serum zinc concentrations from surveys or studies with national representativeness conducted in Latin America and the Caribbean. The risk of zinc deficiency in Latin America and the Caribbean was estimated based on dietary zinc inadequacy (according to the 2011 National Food Balance Sheets) and stunting in children under 5 years of age. RESULTS: Only four countries had available national biochemical data. Mexican, Colombian, Ecuadorian, and Guatemalan children under 6 years of age and women 12 to 49 years of age had a high prevalence of zinc deficiency (19.1% to 56.3%). The countries with the highest risk of zinc deficiency (estimated prevalence of inadequate zinc intake > 25% plus prevalence of stunting > 20%) were Belize, Bolivia, El Salvador, Guatemala, Haiti, Honduras, Nicaragua, and Saint Vincent and the Grenadines. Zinc dietary inadequacy was directly correlated with stunting (r = 0.64, p < .001). CONCLUSIONS: Prevalence data from the four available Latin America and Caribbean national surveys indicate a high prevalence of zinc deficiency in children under 6 years of age and women 12 to 49 years of age. High rates of both estimated zinc dietary inadequacy and stunting were also reported in most Latin America and Caribbean countries.


Assuntos
Zinco/deficiência , Adolescente , Adulto , Belize/epidemiologia , Bolívia/epidemiologia , Região do Caribe/epidemiologia , Criança , Pré-Escolar , Colômbia/epidemiologia , Dieta , Equador/epidemiologia , El Salvador/epidemiologia , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Guatemala/epidemiologia , Haiti/epidemiologia , Inquéritos Epidemiológicos , Honduras/epidemiologia , Humanos , Lactente , América Latina/epidemiologia , México/epidemiologia , Pessoa de Meia-Idade , Nicarágua/epidemiologia , Estado Nutricional , São Vicente e Granadinas/epidemiologia , Adulto Jovem , Zinco/administração & dosagem
17.
BMC Health Serv Res ; 15: 148, 2015 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-25890181

RESUMO

BACKGROUND: Numerous Caribbean countries are considering implementing National Health Insurance (NHI) and pooling resources to finance their health sectors. Based on this increased interest in health insurance, we investigated the willingness to participate and to pay for NHI in St. Vincent and the Grenadines, an upper-middle-income Caribbean country. METHODS: Four hundred heads of household in St. Vincent and the Grenadines were interviewed in August 2012 and September 2012. The samples were selected through simple random sampling, including the stratification of rural, semiurban, and urban communities to ensure the representativeness of the sample. A contingent valuation method with a pretested interviewer-led questionnaire was used. Respondents were presented with a hypothetical NHI plan. Chi-squared analysis was performed to identify factors that are associated with the willingness to participate. Multiple logistic regression was used to explore the factors that influence respondents' willingness to pay. RESULTS: In total, 69.5% (n = 278) of the respondents indicated that they were willing to participate in the proposed NHI plan, of whom 72.3% were willing to pay for the first bid (EC$50). When the bid was reduced to EC$25, all of the remaining respondents who indicated they were willing to participate were willing to pay this lowered bid. Overall, the respondents were willing to pay EC$77.83 (US$28.83) per month for each person to enroll in the NHI plan. Age, income, and having some form of health insurance were significantly associated with a willingness to participate in the plan. CONCLUSIONS: A higher socioeconomic status was the principal determinant factor for the willingness to participate. This is similar to studies on developing economies. The government can use these findings to guide the successful implementation of the proposed NHI program. People with a lower socioeconomic status must be engaged from the start of and throughout the development process to enhance their understanding of and participation in the plan.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Financiamento Pessoal/economia , Seguro Saúde/economia , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Financiamento Pessoal/estatística & dados numéricos , Humanos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , São Vicente e Granadinas , Fatores Sexuais , Fatores Socioeconômicos , População Suburbana/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
18.
Ann Glob Health ; 80(2): 83-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24976544

RESUMO

BACKGROUND: Although alcohol consumption is recognized as a global problem, little research to date explores treatment options for alcohol use disorders in developing nations. Given the scarce mental health resources available in Saint Vincent and the Grenadines, community self-help programming for alcohol use disorders could potentially provide an important complement to the existing mental health services. OBJECTIVE: The aim of this study was to gather baseline data on knowledge and attitudes toward alcohol consumption among community members, and subsequently, to pilot self-help rehabilitation programs for alcohol use disorders, while determining factors that affect the feasibility and sustainability of such programs. METHODS: Focus groups were conducted in 3 communities to discuss community perceptions of alcohol use and the feasibility of self-help programs. Focus group findings guided the development and implementation of the self-help groups. A postintervention focus group was held to determine the effectiveness and community-wide effect of the self-help programs. FINDINGS: Focus group participants agreed that alcohol consumption was a problem in Saint Vincent, leading to underage drinking and violence. Suggestions to encourage self-help meeting attendance included organizing group activities and providing visuals to illustrate alcohol's effects on health. Self-help group members were surveyed about their group experience. Of the 35 members surveyed, 77% said the group was very helpful, and 91% indicated that they would attend again. Postintervention focus group participants stated that individuals had reduced alcohol consumption after attending at least 1 self-help meeting. CONCLUSIONS: Elements that contributed to the sustainability of self-help groups included strong local leadership from district health nurses as well as willingness of participants to seek support. However, efforts need to be made to increase community awareness of alcohol use disorders and its associated dangers. Our results suggested self-help programs to address alcohol use disorders are a feasible intervention in Saint Vincent that warrants further development, dissemination, and exploration.


Assuntos
Transtornos Relacionados ao Uso de Álcool/terapia , Alcoólicos Anônimos , Serviços Comunitários de Saúde Mental/métodos , Países em Desenvolvimento , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Projetos Piloto , Desenvolvimento de Programas , São Vicente e Granadinas
20.
Psychiatr Q ; 84(3): 395-406, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23378041

RESUMO

Saint Vincent and the Grenadines (SVG) is an Eastern Caribbean country with limited inpatient and outpatient resources to meet the country's mental health needs. In preparation for integrating mental health care into the primary care setting, we assessed knowledge of and attitudes toward mental illness among primary care providers in SVG. From October 24-November 11, 2011, we visited a convenience sample of District Health Centers in SVG. We gave a multiple-choice-answer, self-administered questionnaire to primary care providers and then administered a structured interview. Survey responses were analyzed for frequencies and interview transcripts qualitatively analyzed for major themes. We completed 53 surveys and interviews representing all nine SVG Health Districts. Results demonstrated a provider population with basic, but inadequate, knowledge of mental illness diagnosis and treatment. Results also revealed a curious and interested group of providers who felt mental illness should be a health priority and were willing and eager to receive further mental health training. Providers suggested strengthening resources in existing district clinics, providing additional staff training sessions, establishing positions with a dual health and mental health role, instituting annual mental health screening examinations, and creating weekly mental health clinics. Integrating mental health care into primary care necessitates involvement of primary care staff during the planning stages, and this study initiates an intensive effort to do so in SVG. Results have led to the development of a "mental health check-up" tool, which we hope will improve access to mental health care in this community.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Atenção Primária à Saúde , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Transtornos Mentais/epidemiologia , Serviços de Saúde Mental , Pessoa de Meia-Idade , Estudos Retrospectivos , São Vicente e Granadinas/epidemiologia , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA