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1.
Artigo em Inglês | MEDLINE | ID: mdl-35010728

RESUMO

Arsenic (As) is a metalloid that has been classified as a xenobiotic with toxic effects on human beings, especially on children. Since the soil in Jamaica contains As, dietary intake is considered the main source of As exposure in Jamaicans. In addition, glutathione S-transferase (GST) genes, including GSTT1, GSTP1, and GSTM1, play an important role in the metabolism of xenobiotics including As in humans. Using data from 375 typically developing children (2-8 years) in Jamaica, we investigated the environmental and sociodemographic factors, as well as their possible interactions with the children's genotype for GST genes in relation to having a detectable level of blood As concentration (i.e., >1.3 µg/L). Using multivariable logistic regression, we have identified environmental factors significantly associated with blood As concentrations that include a child's age, parental education levels, and the consumption of saltwater fish, cabbage, broad beans, and avocado (all p < 0.01). Based on the multivariable analysis including gene x environment interactions, we found that among children with the Ile/Ile genotype for GSTP1 Ile105Val, children who consumed avocado had higher odds of having a detectable blood As concentration compared to children who did not eat avocado.


Assuntos
Arsênio , Estudos de Casos e Controles , Criança , Predisposição Genética para Doença , Genótipo , Glutationa S-Transferase pi/genética , Glutationa Transferase/genética , Humanos , Jamaica , Polimorfismo Genético , Fatores de Risco
2.
Washington, D.C.; OPS; 2021-11-22.
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55198

RESUMO

En Jamaica, las enfermedades no transmisibles (ENT) son la causa principal de la morbilidad y la mortalidad. Además de la carga que imponen sobre la salud, también representan una carga significativa para la economía nacional, ya que su tratamiento genera gastos elevados y las personas que los sufren son más propensas al abandono del ejercicio de la profesión, al absentismo o a trabajar con capacidad reducida. Además, los elevados costos de tratamiento imponen una carga económica directa al sistema de salud, la sociedad y el Estado, que puede llevar a una reducción de la inversión en ámbitos como la educación y el capital físico que, a la larga, aumentan el producto interno bruto (PIB). Con el propósito de ayudar a fortalecer la capacidad de los Estados Miembros para generar y utilizar evidencia económica sobre las ENT, la Organización Panamericana de la Salud (OPS) se asoció con el Ministerio de Salud de Jamaica, la Organización Mundial de la Salud (OMS), el Programa de las Naciones Unidas para el Desarrollo (PNUD) y RTI International para elaborar un caso a favor de la inversión en la prevención y el control de las ENT en Jamaica. Este proyecto aporta evidencia y orientación para apoyar la formulación, el financiamiento y la implementación de estrategias nacionales multisectoriales de prevención y control de las ENT. En concreto, calcula el rendimiento de la inversión en la implementación de intervenciones de política para el control del tabaco y el consumo nocivo de alcohol, así como intervenciones clínicas para disminuir las ENT, específicamente, las enfermedades cardiovasculares y la diabetes. También evalúa la viabilidad política de poner en marcha estas medidas.


Assuntos
Doenças não Transmissíveis , Morbidade , Mortalidade , Saúde Mental , Economia , Absenteísmo , Engajamento no Trabalho , Jamaica
3.
Global Health ; 17(1): 124, 2021 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-34688295

RESUMO

BACKGROUND: Understanding the differences in timing and composition of physical distancing policies is important to evaluate the early global response to COVID-19. A physical distancing intensity monitoring framework comprising 16 domains was recently published to compare physical distancing approaches across 12 U.S. States. We applied this framework to a diverse set of low and middle-income countries (LMICs) (Botswana, India, Jamaica, Mozambique, Namibia, and Ukraine) to test the appropriateness of this framework in the global context and to compare the policy responses in these LMICs with a sample of U.S. States during the first 100-days of the pandemic. RESULTS: The LMICs in our sample adopted wide ranging physical distancing policies. The highest peak daily physical distancing intensity during this period was: Botswana (4.60); India (4.40); Ukraine (4.40); Namibia (4.20); Mozambique (3.87), and Jamaica (3.80). The number of days each country stayed at peak policy intensity ranged from 12-days (Jamaica) to more than 67-days (Mozambique). We found some key similarities and differences, including substantial differences in whether and how countries expressly required certain groups to stay at home. Despite the much higher number of cases in the US, the physical distancing responses in our LMIC sample were generally more intense than in the U.S. States, but results vary depending on the U.S. State. The peak policy intensity for the U.S. 12-state average was 3.84, which would place it lower than every LMIC in this sample except Jamaica. The LMIC sample countries also reached peak physical distancing intensity earlier in outbreak progression compared to the U.S. states sample. The easing of physical distancing policies in the LMIC sample did not discernably correlate with change in COVID-19 incidence. CONCLUSIONS: This physical distancing intensity framework was appropriate for the LMIC context with only minor adaptations. This framework may be useful for ongoing monitoring of physical distancing policy approaches and for use in effectiveness analyses. This analysis helps to highlight the differing paths taken by the countries in this sample and may provide lessons to other countries regarding options for structuring physical distancing policies in response to COVID-19 and future outbreaks.


Assuntos
COVID-19 , Botsuana , Humanos , Índia , Jamaica , Moçambique , Namíbia , Distanciamento Físico , Políticas , SARS-CoV-2 , Ucrânia , Estados Unidos
4.
BMC Palliat Care ; 20(1): 155, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34641826

RESUMO

BACKGROUND: Provision of palliative care to individuals with late-stage serious illnesses is critical to reduce suffering. Palliative care is slowly gaining momentum in Jamaica but requires a highly skilled workforce, including nurses. Out-migration of nurses to wealthier countries negatively impacts the delivery of health care services and may impede palliative care capacity-building. This critical review aimed to explore the evidence pertaining to the nurse migration effect on the integration of palliative care services in Jamaica and to formulate hypotheses about potential mitigating strategies. METHODS: A comprehensive search in the PubMed, CINAHL, and ProQuest PAIS databases aimed to identify articles pertinent to nurse migration in the Caribbean context. Grant and Booth's methodologic framework for critical reviews was used to evaluate the literature. This methodology uses a narrative, chronologic synthesis and was guided by the World Health Organization (WHO) Public Health Model and the Model of Sustainability in Global Nursing. RESULTS: Data from 14 articles were extracted and mapped. Poorer patient outcomes were in part attributed to the out-migration of the most skilled nurses. 'Push-factors' such as aggressive recruitment by wealthier countries, lack of continuing educational opportunities, disparate wages, and a lack of professional autonomy and respect were clear contributors. Gender inequalities negatively impacted females and children left behind. Poor working conditions were not necessarily a primary reason for nurse migration. Four main themes were identified across articles: (a) globalization creating opportunities for migration, (b) recruitment of skilled professionals from CARICOM by high income countries, (c) imbalance and inequities resulting from migration, and (d) mitigation strategies. Thirteen articles suggested education, partnerships, policy, and incentives as mitigation strategies. Those strategies directly align with the WHO Public Health Model drivers to palliative care integration. CONCLUSION: Emerged evidence supports that nurse migration is an ongoing phenomenon that strains health systems in Caribbean Community and Common Market (CARICOM) countries, with Jamaica being deeply impacted. This critical review demonstrates the importance of strategically addressing nurse migration as part of palliative care integration efforts in Jamaica. Future studies should include targeted migration mitigation interventions and should be guided by the three working hypotheses derived from this review.


Assuntos
Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Cuidados Paliativos , Emigração e Imigração , Feminino , Humanos , Jamaica , Motivação
5.
Kingston 7; PAHO; 2021-10-14. (PAHO/JAM/21-0001).
Não convencional em Inglês | PAHO-IRIS | ID: phr2-54996

RESUMO

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the country for the period, implementing the Country Cooperation Strategy, responding to the needs and priorities of the country, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.


Assuntos
Cooperação Técnica , Prioridades em Saúde , Sistemas de Saúde , Programas Nacionais de Saúde , Política de Saúde , Acesso Universal aos Serviços de Saúde , Cobertura Universal de Saúde , Doenças Transmissíveis , Doenças não Transmissíveis , Fatores de Risco , Saúde Mental , Serviços de Saúde , Administração Financeira , Administração em Saúde , Região do Caribe , Jamaica
6.
PLoS One ; 16(8): e0255781, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34383797

RESUMO

OBJECTIVE: The study aims to assess changes in HIV treatment outcomes for Jamaica after the implementation of the WHO Treat All strategy in January 2017, as well as identify variables associated with clinical stage at diagnosis and viral load status, in order to understand implications for enhancing the HIV clinical cascade and boosting progress towards the UNAIDS 90-90-90 targets. METHOD: This is a population-based study using the National Treatment Service Information System. The sample consists of persons 15 years and older, placed on treatment before and after Treat All was implemented, across all 4 regional health authorities in Jamaica. Patients were assessed for two binary outcomes: 1. stage at HIV diagnosis (early/baseline CD4 cell count ≧350 cells/mm3, or late/ baseline CD4 <350 cells/mm3), 2. viral load status achieved after ART initiation (suppressed/<1000 copies/ml or non-suppressed/ ≥1000 copies/ml). Categorical variables: age/years, gender and health regions, were investigated using multivariable logistic regression. Adjusted odds ratios and 95% confidence intervals are reported. RESULTS: After Treat All, there was an increase in median baseline CD4 results as the proportion of late diagnoses decreased from 60% to 39%. There was a small increase in viral suppression from 76% to 80%, a decrease in baseline viral load testing from 61% to 46% and an increase in the uptake of first viral load testing after starting treatment from 13% to 19%. Males and persons 40+ years had higher odds of late diagnosis before and after Treat All. CONCLUSION: Jamaica's HIV program outcomes have improved after Treat All was implemented. ART initiation time significantly decreased. Early diagnosis, viral load testing uptake and viral suppression increased. However, there is a need to implement targeted testing for men and persons over 40 years to decrease the frequency of late diagnosis.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV/patogenicidade , Vigilância da População , Adolescente , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/genética , Infecções por HIV/virologia , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Carga Viral/efeitos dos fármacos , Adulto Jovem
7.
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
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
8.
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
9.
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
10.
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
11.
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
12.
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
13.
J Palliat Med ; 24(9): 1413-1417, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33970707

RESUMO

Background: Near-death awareness (NDA) refers to visions and dreams commonly experienced by terminally ill individuals within months to hours before death. Methods: A case report of a 68-year-old Jamaican male diagnosed with advanced cholangiocarcinoma, who experienced visions of his deceased mother during hospitalization. Results: This article discusses how to differentiate NDA from delirium, core components for determining decisional capacity, and how clinicians can use a cultural guide to optimize patient-centered care. Conclusion: Improved recognition of NDA may promote cultural humility/competency and help to differentiate NDA from an underlying medical/psychiatric condition. It may assist the clinician in understanding the significance of NDA and the comfort and meaning these experiences may hold for both the individual and their family.


Assuntos
Neoplasias , Doente Terminal , Idoso , Hospitalização , Humanos , Jamaica , Masculino , Assistência Centrada no Paciente
14.
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
15.
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
16.
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
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
17.
Disabil Health J ; 14(4): 101107, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33867318

RESUMO

BACKGROUND: Health related quality of Life (HRQOL) is an important consideration when managing chronic diseases, like sickle cell disease (SCD). Assessment of neuropathic pain (NP) and its association with HRQOL in SCD are rarely reported. OBJECTIVES: To examine the prevalence of NP and its association with HRQOL in adult Jamaicans with SCD. METHODS: Adult SCD patients were recruited consecutively and data were collected on socio-demographics, NP using Douleur Neuropathique 4 (DN4), and HRQOL using the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me). Means, medians, t-tests, ANOVA tests, Wilcoxon Rank-sum tests, Kruskal-Wallis tests, Pearson's correlation and multivariate linear regression analyses were performed using STATA 14.2. RESULTS: There were 236 respondents, with 56.8% female, mean age 33.2 years (SD: 11.6; range: 18-67 years), and 75% had homozygous SS genotype. NP was likely present in 26.7% of the population. The standardized ASCQ-Me (mean ± SD; ordered from lowest to best HRQOL domain scores) were: emotional impact 53.3 ± 10.1; sleep impact 56.1 ± 9.7; social function 57.7 ± 10.6; pain impact 58.6 ± 7.8; and stiffness impact 61.0 ± 7.3. On multivariate analyses, NP significantly reduced emotional and social functioning and worsened sleep and stiffness. Higher acute pain scores significantly worsened all HRQOL domains, while higher disease severity worsened all except stiffness. Obesity was associated with worse sleep and greater stiffness. Females with leg ulcers reported lower social functioning and unemployed females had greater pain impact. CONCLUSIONS: NP is increasingly prevalent in SCD and worsens HRQOL. Gender specific studies are needed to understand the significantly poorer HRQOL in women.


Assuntos
Anemia Falciforme , Pessoas com Deficiência , Neuralgia , Adulto , Anemia Falciforme/complicações , Feminino , Humanos , Jamaica , Masculino , Neuralgia/etiologia , Qualidade de Vida
18.
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
19.
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
20.
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
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